Family-centred practice : empowerment, self-efficacy, and challenges for practitioners in early childhood education and care

Family-centred practice has been included in the Victoria, Australia Early Years Learning and Development Framework as a key practice principle for professionals working across all early years programs in that state. While this model of partnership for engaging and collaborating with families has long been used in the early intervention sector, the efficacy of adopting this model more widely across the wider early childhood education and care sector has not been explored. This article presents a discussion on family-centred practice as a model for engaging with families in the care and education of their children. Through an analysis of the underlying philosophy and an examination of the core principles and characteristics, the article explores family-centred practice as it sits within a broader theory of partnership. This analysis identifies that while there are essential principles and characteristics that position the model within a partnership framework, it is the notion of empowerment, an underpinning philosophy guiding the model, that adds another dimension to the way practitioners in early childhood education and care settings collaborate with families. In examining the broader early childhood context, the capacity of many early childhood practitioners to effectively implement empowering behaviours is challenged.

'It's not enough for the work of art to be great' : children and young people as museum visitors

This paper examines trends in the understanding of children as visitors to art and natural history museums. It begins by examining research into the qualities of engagement by museum visitors generally. It then addresses the specific challenges posed by children as visitors, and the responses developed by museums to enhance their engagement. Three strategies are identified: social/family-centred interactivity, immersive experiences and engagement through interpretive dialogue. The three examples of programs of children’s engagement examined in this paper represent a major departure from such models towards a profoundly social form of interaction. The paper argues that these strategies are museums’ responses to shifts in pedagogical theory, and have been developed to increase the engagement of the child-visitor with exhibitions. Such strategies represent a genuine engagement between adults (both museum staff and parents) and children, and an opportunity for children to define the experience of cultural engagement. The consequence of this is a redefinition of the cultural role of museums in relation to children.

Building the capacity of family day care educators to promote children’s social and emotional wellbeing : an exploratory cluster randomised controlled trial

Background: Childhood mental health problems are highly prevalent, experienced by one in five children living in socioeconomically disadvantaged families. Although childcare settings, including family day care are ideal to promote children’s social and emotional wellbeing at a population level in a sustainable way, family day care educators receive limited training in promoting children’s mental health. This study is an exploratory wait-list control cluster randomised controlled trial to test the appropriateness, acceptability, cost, and effectiveness of “Thrive,” an intervention program to build the capacity of family day care educators to promote children’s social and emotional wellbeing. Thrive aims to increase educators’ knowledge, confidence and skills in promoting children’s social and emotional wellbeing.
Methods/Design: This study involves one family day care organisation based in a low socioeconomic area of Melbourne. All family day care educators (term used for registered carers who provide care for children for financial reimbursement in the carers own home) are eligible to participate in the study. The clusters for randomisation will be the fieldworkers (n = 5) who each supervise 10-15 educators. The intervention group (field workers and educators) will participate in a variety of intervention activities over 12 months, including workshops; activity exchanges with other educators; and focused discussion about children’s social and emotional wellbeing during field worker visits. The control group will continue with their normal work practice. The intervention will be delivered to the intervention group and then to the control group after a time delay of 15 months post intervention commencement. A baseline survey will be conducted with all consenting educators and field workers (n = ~70) assessing outcomes at the cluster and individual level. The survey will also be administered at one month, six months and 12 months post-intervention commencement. The survey consists of questions measuring perceived levels of knowledge, confidence and skills in promoting children’s social and emotional wellbeing. As much of this intervention will be delivered by field workers, field worker-family day care educator relationships are key to its success and thus supervisor support will also be measured. All educators will also have an in-home quality of care assessment at baseline, one month, six months and 12 months post-intervention commencement. Process evaluation will occur at one month, six months and 12 months post-intervention commencement. Information regarding intervention fidelity and economics will also be assessed in the survey.
Discussion: A capacity building intervention in child mental health promotion for family day care is an essential contribution to research, policy and practice. This initiative is the first internationally, and essential in building an evidence base of interventions in this extremely policy-timely setting.

The association between parental personality patterns and internalising and externalising behaviour problems in children and adolescents

Background:  This study investigated the relationship between parental personality patterns and internalising and externalising behaviour problems in a clinically referred sample of children (aged 4–8) and adolescents (aged 12–18).

Methods:  Data from families involved in two clinical trials in Victoria, Australia were analysed (n = 59). Families were administered the Millons Clinical Multiaxial Inventory—III (MCMI-III) which reports personality patterns consistent with Axis II disorder and an Achenbach measure of mental health as appropriate to child's age (Child Behavior Checklist (CBCL), Youth Self-Report (YSR), or Adult Self-Report (ASR)). Relationships between internalising and externalising behaviour problems, and parental personality patterns were examined via correlation and regression analyses.

Results:  The study found a positive correlation between parental borderline, paranoid, and avoidant personality patterns, and child and adolescent externalising behaviour problems. The relationships were generally stronger for adolescents than for children. However, no relationship was observed between parental personality patterns and internalising behaviour problems.

Conclusions:  These findings underline the importance of clinical assessment of the family ecology as a whole—including the interaction between parental personality patterns and child and adolescent behaviour and emotional problems. These findings contribute to the understanding of developmental risk factors for child and adolescent mental health and the transmission of psychopathology across generations.

Preventing mental health problems in children : the families in mind population-based cluster randomised controlled trial.

Background

Externalising and internalising problems affect one in seven school-aged children and are the single strongest predictor of mental health problems into early adolescence. As the burden of mental health problems persists globally, childhood prevention of mental health problems is paramount. Prevention can be offered to all children (universal) or to children at risk of developing mental health problems (targeted). The relative effectiveness and costs of a targeted only versus combined universal and targeted approach are unknown. This study aims to the effectiveness, costs and uptake of two approaches to early childhood prevention of mental health problems ie: a Combined universal-targeted approach, versus a Targeted only approach, in comparison to current primary care services (Usual care).
Design

Three armed, population-level cluster randomised trial (2010-2014) within the universal, well child Maternal Child Health system, attended by more than 80% of families in Victoria, Australia at infant age eight months. Participants: Families of eight month old children from nine participating local government areas. Randomised to one of three groups: Combined, Targeted or Usual care. Intervention: (a) the Combined universal and targeted program where all families are offered the universal Toddlers Without Tears group parenting program followed by the targeted Family Check-Up one-on-one program or (b) the Targeted Family Check-Up program. The Family Check-Up program is only offered to children at risk of behavioural problems. Analysis: Participants will be analysed according to the trial arm to which they were randomised, using logistic and linear regression models to compare primary and secondary outcomes. An economic evaluation (cost consequences analysis) will compare incremental costs to all incremental outcomes from a societal perspective.
Discussion

This trial will inform public health policy by making recommendations about the effectiveness and cost-effectiveness of these early prevention programs. If effective prevention programs can be implemented at the population level, the growing burden of mental health problems could be curbed.

Home and neighbourhood correlates of BMI among children living in socioeconomically disadvantaged neighbourhoods

A detailed understanding of the underlying drivers of obesity-risk behaviours is needed to inform prevention initiatives, particularly for individuals of low socioeconomic position who are at increased risk of unhealthy weight gain. However, few studies have concurrently considered factors in the home and local neighbourhood environments, and little research has examined determinants among children from low socioeconomic backgrounds. The present study examined home, social and neighbourhood correlates of BMI (kg/m2) in children living in disadvantaged neighbourhoods. Cross-sectional data were collected from 491 women with children aged 5–12 years living in forty urban and forty rural socioeconomically disadvantaged areas (suburbs) of Victoria, Australia in 2007 and 2008. Mothers completed questionnaires about the home environment (maternal efficacy, perceived importance/beliefs, rewards, rules and access to equipment), social norms and perceived neighbourhood environment in relation to physical activity, healthy eating and sedentary behaviour. Children's height and weight were measured at school or home. Linear regression analyses controlled for child sex and age. In multivariable analyses, children whose mothers had higher efficacy for them doing physical activity tended to have lower BMI z scores (B = − 0·04, 95 % CI − 0·06, − 0·02), and children who had a television (TV) in their bedroom (B = 0·24, 95 % CI 0·04, 0·44) and whose mothers made greater use of food as a reward for good behaviour (B = 0·05, 95 % CI 0·01, 0·09) tended to have higher BMI z scores. Increasing efficacy among mothers to promote physical activity, limiting use of food as a reward and not placing TV in children's bedrooms may be important targets for future obesity prevention initiatives in disadvantaged communities.

Parent initiated prednisolone for acute asthma in children of school age : randomised controlled crossover trial

Objective To evaluate the efficacy of a short course of parent initiated oral prednisolone for acute asthma in children of school age.

Design Double blind, randomised, placebo controlled, crossover trial in which episodes of asthma, rather than participants, were randomised to treatment.

Setting The Barwon region of Victoria, Australia.

Participants Children aged 5-12 years with a history of recurrent episodes of acute asthma.

Intervention A short course of parent initiated treatment with prednisolone (1 mg/kg a day) or placebo.

Main outcome measures The primary outcome measure was the mean daytime symptom score over seven days. Secondary outcome measures were mean night time symptom score over seven days, use of health resources, and school absenteeism.

Results 230 children were enrolled in the study. Over a three year period, 131 (57%) of the participants contributed a total of 308 episodes of asthma that required parent initiated treatment: 155 episodes were treated with parent initiated prednisolone and 153 with placebo. The mean daytime symptom score was 15% lower in episodes treated with prednisolone than in those treated with placebo (geometric mean ratio 0.85, 95% CI 0.74 to 0.98; P=0.023). Treatment with prednisolone was also associated with a 16% reduction in the night time symptom score (geometric mean ratio 0.84, 95% CI 0.70 to 1.00; P=0.050), a reduced risk of health resource use (odds ratio 0.54, 95% CI 0.34 to 0.86; P=0.010), and reduced school absenteeism (mean difference −0.4 days, 95% CI −0.8 to 0.0 days; P=0.045).

Conclusion A short course of oral prednisolone initiated by parents when their child experiences an episode of acute asthma may reduce asthma symptoms, health resource use, and school absenteeism. However, the modest benefits of this strategy must be balanced against potential side effects of repeated short courses of an oral corticosteroid.

Sibling incest within violent families : Children under 12 years seeking nurture.

This article will draw on theories of childhood and current sociological debates of shame to explore and understand the formation of sexual identity in children who experience a violent family. Children have limited resources available to them and in violent family situations may turn to their siblings for nurture. Contextualising this type of dependency within the usual processes of childhood sexual development, including exploration and experimentation, may increase the likelihood of sibling incest.

Animals as disregarded pawns in family violence : exclusionary practices of feminist based refuge policies

Commonly agreed upon is the relationship between family violenceand violence toward nonhuman animals. Workers in the field of family violence also acknowledge that women may delay leaving a violent home due to loyalty to their nonhuman counterparts, and because refuge policies often do not allow them to accompany humans into safe shelter. The recent work of Clifton Flynn has indicated the relationship between nonhuman animals and human animals to be one of responsive interaction, with theoretical analyses most often based upon Goffman’s theory of symbolic interaction. Despite literature indicating the level of harm inflicted upon nonhuman family members in violent homes, and requests from women and children that they accompany them to safe shelter, refuge policies often negate the possibility of this occurring. This article critiques the feminist ideals on which refuge policies are based, and in doing so, argues that justice is denied to nonhuman animals. Their existence in the violent home is maintained by lack of choices available to their human counterpart, and is enforced by feminist ideals, which are ironically based upon equity. Unless feminist principles are challenged, nonhuman family members will continue to be denied justice in violent families where escape is the only option to ensure safety.

The factor structure of the Chinese family assessment instrument adapted for parent report

This article reports on a confirmatory factor analytic study of an adapted version of an instrument designed to assess family functioning of Chinese families. The Chinese Family Assessment Instrument, originally designed for completion by adolescents, was adapted for completion by parents. A sample of 700 parent dyads of elementary school children (382 girls and 318 boys) completed the adapted questionnaire. Initial factor analyses showed that the existing five-factor structure used for adolescents’ responses was not a good fit for these data. Instead, a four-factor solution emerged where the factors were positive family functioning, negative family functioning, tolerance for family members, and parental understanding. This structure was the same for both mothers and fathers. Further studies of the Chinese Family Assessment Instrument parent adaptation are required to test the factor structure that emerged. Following such studies, validation studies will be required.

Childhood cruelty to animals in China: the relationship with psychological adjustment and family functioning

Background
The current study broadened the general scope of research conducted on childhood cruelty to animals by examining the association between psychological adjustment, family functioning and animal cruelty in an Eastern context, China.

Method
The mothers and fathers of 729 children attending primary school in Chengdu, China participated in this study. Each parent completed the Strengths and Difficulties Questionnaire, the Chinese Family Assessment Instrument, and the Children's Attitudes and Behaviours towards Animals questionnaire.

Results
Findings from an actor partner interdependence model demonstrated that parents' ratings of family functioning and of their child's externalizing coping style predicted only modest amounts of variance in animal cruelty. In particular, parents' ratings of their child's externalizing coping style most consistently predicted animal cruelty. Family functioning, fathers' ratings in particular, played a minor role, more so for boys compared with girls.

Conclusion
This study provided the first insight into childhood animal cruelty in China, and suggests that further research may enhance our understanding of these phenomena.

"These are our children" : polyamorous parenting

Some LGBT individuals are polyamorous—that is, they have relationships with multiple partners of the same and/or the other gender. This chapter discusses the findings from an Australian focus group of 13 polyfamily participants, and also presents an overview of previous research on polyparenting. Issues of being “out” to their children, relations with extended families and friendship networks, and navigating broader societal systems and structures are the greatest concerns for polyparents. The duality of lack of visibility and fear of disclosure is examined in the context of formal societal structures such as education, health, and the law; less formal networks such as family, friends, neighbors, and social groups; and the mass media and popular culture. Another theme we discuss is how polyfamilies can be supportive environments. Shared child rearing is creating new forms of kinship structures that are beneficial to both children and adults in polyfamilies, although attachment to transient members of the family is raised as a concern. The chapter concludes with a call for more research into all facets of polyfamilies as well as the need for legitimization and resource development in social, health, educational, media, and legal institutions.

Role of multidrug resistance associated proteins in drug development

The Multidrug Resistance Associated Proteins (MRPI, MRP2, MRP3, MRp4, MRp5, MRP6, MRP7, MRPS and MRP9) belong to the ATP-binding cassette superfamily (ABCC family) of transporters expressed differentially in the liver, kidney, intestine and blood-brain barrier. MRps transport a structurally diverse array of endo- and xenobiotics and their metabolites (in particular conjugates) and are subject to induction and inhibition by a variety of compounds. An increased efflux of natural product anticancer drugs and other anticancer agents by MRPs in cancer cells is associated with tumor resistance. These transporting proteins play a role in the absorption, distribution and elimination of various compounds in the body. There are increased reports on the clinical impact of genetic mutations of genes encoding MRP1-9. Therefore, MRPs have an important role in drug development, since a better understanding of their function and regulating mechanism can help minimize and avoid drug toxicity, unfavorable drug-drug interactions, and to overcome drug resistance.

Children's media use : perspectives from social research

The paper explains the impacts of digital media on previously observed developmental patterns of time choices for the current generation of young children, age 5-11. It shows that work and family routines still influence patterns of media use, rather than just broadcast media schedules and access to digital and mobile devices. Contrary to previous research on digital natives that predicted that interactive media would eventually displace traditional linear media, these findings from a nationally-representative study show that time-use of 'lean back media' and 'lean forward media' run in parallel for Australian children 5-11.

Bisexual parents and family diversity : findings from the work, love, play study

This article reports on findings from the Work, Love, Play study, an Australian/New Zealand study of same-sex attracted parents. There were 48 parents in this study who identified as bisexual. There was a diversity of contexts in which people in this sample were parenting: heterosexual relationships, same-sex relationships, coparenting with ex-partners or nonpartners, and sole parenting. A large number of these bisexual parents had experience of divorce or separation since having children, but most reported positive aspects to their parenting relationships with ex-partners. Very few people in this study reported that bisexual identity created difficulties for them as a parent.