Factors associated with accidental injuries in children with ADHD-combined type: more than a motor problem?

OBJECTIVE: We explored the relationship between accidental injuries, motor impairment, and co-occurring autism spectrum disorder (ASD) symptoms in children with ADHD-combined type (ADHD-CT).

METHOD: Participants were 32 male children diagnosed with ADHD-CT and 23 typically developing male children (7-12 years, full scale IQ [FSIQ] > 80). Parents completed a customized questionnaire on the occurrence of accidental injuries (e.g., bruises, cuts) their child experienced in the past 12 months. Motor proficiency was assessed using the Movement ABC-2 (MABC-2). Parents rated motor, ADHD-CT, ASD, and anxiety symptoms.

RESULTS: Children with ADHD-CT had significantly increased parent-reported accidental injuries compared with typically developing children. Among children with ADHD-CT, Spearman's rho rank correlations revealed no association between increased accidental injuries and MABC-2 score, but significant associations with increased hyperactivity/impulsivity, ASD, and anxiety symptoms.

CONCLUSION: Although these findings require validation, they suggest a need for further research investigating the contribution of co-occurring ASD and anxiety symptoms to accidental injuries in children with ADHD-CT.

Identifying the characteristics of child sexual abuse cases that exit the criminal justice system before the forensic interview

Most child sexual abuse cases do not result in conviction; rather, they result in attrition at an earlier point in the system. Although research has looked at case characteristics associated with attrition at later stages of the system (i.e. the laying of charges and prosecution stages), to date, no research has studied the case characteristics associated with attrition as soon as a report has been made to authorities. The aim of this study was to determine the case characteristics (child complainant, suspect and additional case characteristics) associated with attrition when a case first enters the criminal justice system before a forensic interview is conducted. All child sexual abuse incidents reported to police in one jurisdiction of Australia in 2011 were examined. Three case characteristics were found to predict attrition: previous disclosure, abuse frequency and the child complainant’s age. Specifically, cases were more likely to result in attrition when the child had not previously disclosed the abuse to an adult, the abuse was a single incident rather than repeated, and a curvilinear relationship was found for child age. Cases involving children aged 7–12 years were less likely to result in attrition than cases involving younger (0–6 years) and older (13–15 years) children. This information should assist professionals and researchers in developing interventions to reduce the attrition when necessary during this early stage of the criminal justice system.

Identifying the characteristics of child sexual abuse cases associated with the child or child's parents withdrawing the complaint

Most child sexual abuse cases do not result in a full trial or guilty plea; rather, case attrition occurs at earlier stages of the criminal justice system. One reason for the attrition of these cases is the withdrawal of complaints, by children or their caregivers. The aim of the current study was to determine the case characteristics associated with complaint withdrawal in child sexual abuse cases by the child or his or her parents once a report has been made to authorities. All child sexual abuse incidents reported to authorities in one jurisdiction of Australia in 2011 were analyzed (N=659). A multinomial logistic regression was used to predict the following case outcomes: (1) withdrawn by the child or his or her parents, (2) exited for other reasons (e.g., the alleged offender was not identified, the child refused to be interviewed), and (3) resulted in a charge. Five predictors significantly added to the prediction of case outcome: child age, suspect gender, suspect age, child-suspect relationship, and abuse frequency. These results should contribute to the design of interventions in order to reduce complaint withdrawals if these withdrawals are not in the child's best interests.

Early-life markers of atherosclerosis using aortic and carotid intima-media thickness: an assessment of methods to account for child size

Background.—Distinguishing pathological from physiological relationships between vessel size and aortic intima-media thickness (aIMT) is an important challenge, especially in growing children. We examined the relationship between childhood vessel diameter and aIMT and assessed common analytic approaches used to address this relationship.Methods.—We analyzed aIMT in two population-derived cohorts; 6-week-old infants and 19-year-olds. We simulated datasets in which we assumed a simple physiological relationship between vessel diameter and aIMT, and then superimposed possible pathological effects on aIMT; (a) intrauterine growth retardation, (b) macrosomia and (c) both intrauterine growth retardation and macrosomia. Using simulated datasets and cohorts, we evaluated analytic strategies including those in which the relationship between vessel diameter and aIMT was (a) ignored, (b) adjusted for by dividing aIMT by weight, or (c) adjusted for using varying regression techniques.Results.—aIMT was found to increase in proportion to vessel diameter in both cohorts (138 μm/mm at 6 weeks and 52 μm/mm at 19 years of age). Simply dividing aIMT by weight produced negative associations with weight across all datasets. By contrast, adjusting for vessel diameter as a covariate enabled accurate distinction of the direction of the association between aIMT and weight in all simulated datasets. These results were replicated in the cohort studies for both aIMT and carotid intima-media thickness.Conclusion.—There is a physiological relationship between vessel diameter and aIMT. Simply dividing aIMT by weight may lead to incorrect assumptions regarding the relationship between weight and aIMT. However, the physiological relationship is appropriately estimated by including vessel diameter as a covariate in regression.

Negative reactivity and parental warmth in early adolescence, and depressive symptoms in emerging adulthood

ObjectiveCross-sectional research suggests that relationships between temperamental negative reactivity and adolescent depressive symptoms may be moderated by parental warmth. The primary purpose of this study was to conduct the first prospective analysis of this relationship.MethodData from 1,147 families in an Australian population-based longitudinal study were used to examine: (1) temporal relationships between negative reactivity in early adolescence (13–14 years) and depressive symptoms in emerging adulthood (19–20 years); (2) the moderating role of parent-reported warmth in early adolescence (13–14 years); and (3) the moderating role of child gender. Hierarchical multiple regression was conducted to test the hypothesis that parental warmth would moderate the relationship between early adolescent negative reactivity and depressive symptoms in emerging adulthood.ResultsAfter accounting for previous depressive symptoms at age 13–14 years, negative reactivity was positively associated with later depressive symptoms. By contrast, parental warmth at 13–14 years was negatively associated with later depressive symptoms for females but not males. Parental warmth did not moderate the association between early adolescent negative reactivity and subsequent depressive symptoms.ConclusionsThis study was the first to use prospective data to assess the protective effects of early adolescent parental warmth on the association between negative reactive temperaments and early adult depressive symptoms. Findings suggest that parental warmth for negatively reactive children provides only concurrent protection against subsequent depressive risk. This study did not examine parent–child transactional models, which may, in future longitudinal research, improve understanding of how trajectories of parent–child goodness-of-fit contribute to depressive symptoms.

Relationship between executive functioning and symptoms of attention-deficit/hyperactivity disorder and autism spectrum disorder in 6-8 year old children

This study examined relationships between executive functioning (EF) and ADHD/ASD symptoms in 339 6-8 year-old children to characterise EF profiles associated with ADHD and ADHD + ASD. ADHD status was assessed using screening surveys and diagnostic interviews. ASD symptoms were measured using the Social Communication Questionnaire, and children completed assessments of EF. We found the EF profile of children with ADHD + ASD did not differ from ADHD-alone and that lower-order cognitive skills contributed significantly to EF. Dimensionally, ASD and inattention symptoms were differentially associated with EF, whereas hyperactivity symptoms were unrelated to EF. Differences between categorical and dimensional findings suggest it is important to use both diagnostic and symptom based approaches in clinical settings when assessing these children's functional abilities.

The first year: the support needs of parents caring for a child with an intellectual disability

AIM: To describe the support needs of parents caring for a child with an intellectual disability in the first year of life. BACKGROUND: Parents of children with intellectual disabilities face significant challenges during the first year of their child's life which is an important developmental period not previously addressed in the literature. The provision of support by health professionals, particularly nurses and midwives, during this crucial period can impact on parental well-being and on the health and developmental outcomes of their children. However, parents often feel unsupported. DESIGN: The study used a qualitative descriptive methodology. METHODS: Semi-structured interviews were conducted with parents of eleven children with an intellectual disability in Victoria, Australia, during 2014. Interviews were digitally recorded, transcribed verbatim and analysed using thematic data analysis. FINDINGS: Three key areas of support need were identified to assist parents to provide effective care for their child with an intellectual disability in the first year of life: (1) emotional support as parents adjusted to their role of caring for a child with an intellectual disability; (2) information support as they embarked on a quest for knowledge; and (3) support to facilitate their connection to peer networks. The findings highlighted inconsistent provision of support for parents. CONCLUSION: This study informs health professionals about how to provide holistic, timely support to parents of children with intellectual disabilities in the first year of life. There is an urgent need to review how nurses and midwives can provide relevant support that is responsive to parents' needs.

Validação da security scale para a população portuguesa: Análise fatorial confirmatória e estudo empírico davinculação na pré-adolescência

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção do grau de Mestre em Psicologia especialidade de Psicologia Clínica.

Validation and reliability of the Japanese version of the Food Allergy Quality of Life Questionnaire - Parent Form

Background: Food allergy (FA) is a heavy burden for patients and their families and can significantly reduce the quality of life (QoL) of both. To provide adequate support, qualitative and quantitative evaluation of the parents' QoL may be helpful. The objective of this study is to develop and validate a Japanese version of the Food Allergy QoL QuestionnaireeParent Form (FAQLQ-PF-J), an internationally validated disease-specific QoL measurement of the parental burden of having a child with FA. Methods: The FAQLQ-PF and the Food Allergy Independent Measure (FAIM), an instrument to test the construct validity of the FAQLQ-PF-J, were translated into Japanese. After language validation, the questionnaires were administered to parents of FA children aged 0e12 years and those of age-matched healthy (without FA) children. Internal consistency (by Cronbach's a) and test-retest reliability were evaluated. Construct validity and discriminant validity were also examined. Results: One hundred twenty-seven parents of children with FA and 48 parents of healthy children filled out the questionnaire. The FAQLQ-PF-J showed excellent internal consistency (Cronbach's a > 0.77) and test-retest reliability. Good construct validity was demonstrated by significant correlations between the FAQLQ-PF-J and FAIM-J scores. It discriminated parents of children with FA from those without. The scores were significantly higher (lower QoL) for parents of FA children with a history of anaphylaxis than those without, for those with >6 FA-related symptoms experienced than those with less FA-related symptoms. Conclusions: The FAQLQ-PF-J is a reliable and valid measure of the parental burden of FA in children.

The baby makes 3 plus project in the Great South Coast region: final report from the external evaluator, January 2016

This report presents the evaluation of the Baby Makes 3 Plus project in the Great South Coast region of Victoria. Baby Makes 3 Plus was one of 12 projects funded by the Department of Justice and Regulation in Victoria under initiative to support primary prevention and early intervention-focused partnership projects to address violence against women and children. The project provided the Baby Makes 3 relationship education program to new parents across the region, and conducted a variety of training to increase the skills of Great South Coast early years practitioners (the Plus component of the project). The three key objectives of the project were:• To increase the capacity of first time parents to build equal and respectful relationships in response to the lifestyle and relationship changes that follow the birth of a child.• To increase the capacity of health professionals and organisations to promote equal and respectful relationships during the transition to parenthood.• To building capacity to identify women at risk of experiencing family violence through a gender equity component of in-service training.

Child AD/HD severity and psychological functioning in relation to divorce, remarriage, multiple transitions and the quality of family relationships

Both Attention-Deficit/Hyperactivity Disorder (AD/HD) and divorce are very prevalent in western societies, and they may occur together. AD/HD is generally viewed as a neurobiological disorder, which has led to a commonly held belief that social-environmental factors play little role in the symptom profile of children diagnosed with the disorder. This study investigated the association between parental divorce, remarriage, multiple transitions, the quality of relationships with family members and the psychological well-being of children and adolescents with AD/HD. First, differences in children’s AD/HD symptom profiles in relation to parents’ divorce status (single/multiple divorce) and family composition (single parent/stepfamily) were examined. Second, the association between the quality of children’s relationships with each family member and parents’ marital status (divorced/non-divorced) and family composition was investigated. In addition, age, gender and AD/HD subtype differences were assessed. Third, the association between the quality of children’s interactions with family members and children’s AD/HD symptom profile was explored. No significant differences in children’s behavioural profiles were found in terms of parents’ divorce status. Living in stepfamilies was associated with greater AD/HD severity and social malfunctioning. Disruptive parent–child and sibling relationships were found to be related to children’s age, gender, AD/HD subtype and parents’ marital status. Further, poor interactions with family members correlated with children’s AD/HD severity and psychological well-being. In summary, divorce, remarriage and the quality of relationships with family members are important correlates of the symptom profile of children with AD/HD, and this emphasises the need for special treatment modules for these families.

The influence of mother-child interactions on preschoolers' eating and weight.

The investigation of maternal and child factors influencing the socialization of children’s eating and weight, including the validation of an observational coding system for assessing dyadic mother-child feeding interactions, revealed a range of shared maternal and child mealtime behaviors potentially associated with preschoolers’ willingness to accept parent’s healthful feeding guidance.

Tumor talk and child-well being: perceptions of 'good' and 'bad' news among parents of children with advanced cancer

CONTEXT: Little is known about how parents of children with advanced cancer classify news they receive about their child's medical condition.

OBJECTIVE: To develop concepts of "good news" and "bad news" in discussions of advanced childhood cancer from parent perspectives.

METHODS: Parents of children with advanced cancer cared for at three children's hospitals were asked to share details of conversations in the preceding 3 months that contained "good news" or "bad news" related to their child's medical condition. We used mixed methods to evaluate parent responses to both open-ended and fixed response items.

RESULTS: Of 104 enrolled parents, 86 (83%) completed the survey. Six (7%) parents reported discussing neither good nor bad news, 18 (21%) reported only bad news, 15 (17%) reported only good news, and 46 (54%) reported both good and bad news (1 missing response). Seventy-six parents (88%) answered free response items. Descriptions of both good and bad news discussions consisted predominantly of "tumor talk" or cancer control. Additional treatment options featured prominently, particularly in discussions of bad news (42%). Child well-being, an important good news theme, encompassed treatment tolerance, symptom reduction, and quality of life.

CONCLUSION: A majority of parents of children with advanced cancer report discussing both good and bad news in the preceding 3 months. While news related primarily to cancer control, parents also describe good news discussions related to their child's well-being. Understanding how parents of children with advanced cancer classify and describe the news they receive may enhance efforts to promote family-centered communication.

Recours aux services de soutien formel par les parents immigrants d’un enfant en situation de handicap

Les parents immigrants d’un enfant en situation de handicap présentent davantage de sources de vulnérabilité que d’autres parents. Cette situation peut diminuer le temps disponible et altérer leur implication dans le programme de réadaptation de leur enfant. L’objectif de cette thèse doctorale est de déterminer les attentes et les besoins en services de soutien formel de ces parents, afin de leur proposer une aide adaptée à leurs conditions de vie, et ceci, au fur et à mesure que l’enfant grandit. D’abord, une étude de la portée des écrits scientifiques est menée dans le but de mieux cerner les connaissances existantes en lien avec le recours aux services de soutien par les parents immigrants (chapitre 1). Les vingt publications sélectionnées indiquent que l’aide pour trouver de l’information s’avère la plus requise, que ce soit au sujet de la condition de l’enfant, du fonctionnement sociosanitaire et éducatif du pays d’accueil, ou encore des services de soutien. En outre, la transmission de ces informations peut se compliquer en cas de non-maîtrise de la langue du pays d’accueil ou lorsque des interculturelles apparaissent entre les parents immigrants et les différents intervenants rencontrés. Quant au non-recours aux aides formelles, il semble principalement dû à l’inadéquation entre l’aide concrète et les attentes des parents, au soutien informel reçu, à la méconnaissance des opportunités d’obtenir des services d’aide destinés aux parents, ou encore à un épuisement non ressenti. Compte tenu du nombre restreint d’écrits scientifiques recensés, des entrevues semi-dirigées sont conduites auprès de 28 parents immigrants d’un enfant en situation de handicap dans la province du Québec (Canada) dans le cadre d’une recherche de plus grande envergure portant sur la communication avec les intervenants en petite enfance (chapitre 2). Le but de cette deuxième étude est de mieux saisir l’utilisation des services de soutien formel par les parents immigrants et les facteurs influençant leurs choix. Il faut préciser que les propos recueillis restent très centrés sur les services destinés à l’enfant. Le soutien pour recevoir des informations et l’accompagnement à la décision apparaissent comme les aides formelles les plus utilisées par les participants, suivies du soutien à l’éducation, de l’écoute active et de l’aide financière. Cinq facteurs semblent guider le recours au soutien formel qui est destiné aux parents, soit : (1) leur perception de la condition de leur enfant, (2) l’accès à l’information, (3) leurs stratégies et leur capacité d’agir, (4) l’implication du réseau informel, et (5) leur perception de leur besoin de services de soutien. Suite à ces résultats, de nouvelles entrevues semi-dirigées sont menées auprès de huit parents immigrants d’enfants d’âges différents à Montréal et à Québec. Cette démarche permet d’approfondir le thème du recours au soutien formel destiné aux parents, et ce, au fur et à mesure que l’enfant grandit (chapitre 3). Le guide d’entretien conçu pour cette étude met l’emphase sur les attentes et les besoins des parents immigrants afin d’atteindre un équilibre dans toutes les sphères de leur vie. Suite à une analyse thématique exploratoire du discours des parents et par l’application d’un modèle de stress et de coping, sept principales sources de stress sont mises en évidence : (1) le parcours migratoire, (2) la condition de l’enfant, (3) l’organisation sociosanitaire du pays d’accueil, (4) l’insertion professionnelle, (5) la relation de couple, (6) le réseau social, et (7) l’état de santé du parent. Afin de faire face à ces circonstances difficiles, les parents immigrants recourent principalement à de l’aide financière, du soutien pour obtenir des informations, de l’accompagnement à la décision, de l’aide en éducation et pour le transport. La satisfaction exprimée varie, notamment en raison des divergences entre les attentes et les services obtenus (soutien en éducation, écoute active, services de garde), ainsi qu’en termes de quantité d’aide reçue (soutien financier, informations, accompagnement à la décision). Un modèle théorique original est proposé afin d’illustrer le contexte parental en termes d’attentes, de besoins et de recours au soutien. Si certains moments de la vie de l’enfant peuvent entraîner un stress supplémentaire pour les parents (annonce du diagnostic, arrivée à l’école, transition à l’âge adulte), le parcours migratoire semble davantage expliquer le recours aux aides formelles.