: media-1vid110.1542/5789654354001PEDS-VA_2018-0023
BACKGROUND AND OBJECTIVES: Adverse childhood experiences (ACEs) include stressful and potentially traumatic events associated with higher risk of ...long-term behavioral problems and chronic illnesses. Whether parents' ACE counts (an index of standard ACEs) confer intergenerational risk to their children's behavioral health is unknown. In this study, we estimate the risk of child behavioral problems as a function of parent ACE counts.
We obtained retrospective information on 9 ACEs self-reported by parents and parent reports of their children's (1) behavioral problems (using the Behavior Problems Index BPI), (2) attention-deficit/hyperactivity disorder diagnosis, and (3) emotional disturbance diagnosis from the 2013 Panel Study of Income Dynamics (PSID) core interview and the linked PSID Childhood Retrospective Circumstances Study and 2014 PSID Child Development Supplement. Multivariate linear and logistic regression models were used to estimate child behavioral health outcomes by parent retrospective ACE count.
Children of parents with a history of 4 or more ACEs had on average a 2.3-point (95% confidence interval CI: 1.3-3.2) higher score on the BPI, 2.1 times (95% CI: 1.1-3.8) higher odds of hyperactivity, and 4.2 times (95% CI: 1.7-10.8) higher odds of an emotional disturbance diagnosis than children of parents with no ACEs. Maternal ACEs revealed a stronger association with child behavior problems than paternal ACEs. Relationships between parents' 9 component ACEs individually and children's BPI scores revealed consistently positive associations. Mediation by parent emotional distress and aggravation were observed.
Parents with greater exposure to ACEs are more likely to have children with behavioral health problems.
The current investigation reports the results of a randomized controlled trial of a brief, relational intervention for maltreated preschool-aged children and their mothers, called Reminiscing and ...Emotion Training (RET). RET facilitates elaborative and emotionally supportive parent-child communication, which is an essential component of the parent-child relationship and is especially relevant for the preschool age period. Participants were 248 children between the ages of 3- to 6-years-old and their mothers. Following a baseline assessment, 165 maltreating families were randomized into RET or a Community Standard (CS) condition in which families received case management and written parenting information; 83 families participated in the nonmaltreating comparison condition. Results indicated that the key mechanisms targeted by the RET interventions were enhanced, such that mothers who participated in RET were significantly better in elaboration and sensitive guidance during reminiscing at the posttest than were maltreating mothers who did not receive the intervention, with medium to large effect sizes; additionally, mothers in the RET group were more elaborative than mothers from the nonmaltreatment group. Children in the RET condition also contributed significantly more memories and had better emotional knowledge than did children in the CS condition, controlling for baseline values and language, and approximated the functioning of nonmaltreated children. These findings add to a growing literature underscoring the benefits of brief, focused, relational interventions for maltreated children and their caregivers.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ
The present study examined the prevalence and country-level correlates of 11 responses to children's behavior, including nonviolent discipline, psychological aggression, and physical violence, as ...well as endorsement of the use of physical punishment, in 24 countries using data from 30,470 families with 2-to 4-year-old children that participated in UNICEF's Multiple Indicator Cluster Survey. The prevalence of each response varied widely across countries, as did the amount of variance accounted for by country in relation to each response.Country-level indicators of life expectancy, educational attainment, and economic well-being were related to several responses to children's behavior. Country-level factors are widely related to parents' methods of teaching children good behavior and responding to misbehavior.
A widespread conviction in the need to rescue China's children took hold in the early twentieth century. Amid political upheaval and natural disasters, neglected or abandoned children became a ...humanitarian focal point for Sino-Western cooperation and intervention in family life. Chinese academics and officials sought new scientific measures, educational institutions, and social reforms to improve children's welfare. Successive regimes encouraged teachers to shape children into Qing subjects, Nationalist citizens, or Communist comrades.InRaising China's Revolutionaries, Margaret Mih Tillman offers a novel perspective on the political and scientific dimensions of experiments with early childhood education from the early Republican period through the first decade of the People's Republic. She traces transnational advocacy for child welfare and education, examining Christian missionaries, philanthropists, and the role of international relief during World War II. Tillman provides in-depth analysis of similarities and differences between Nationalist and Communist policy and cultural notions of childhood. While both Nationalist and Communist regimes drew on preschool institutions to mobilize the workforce and shape children's political subjectivity, the Communist regime rejected the Nationalists' commitment to the modern, bourgeois family. With new insights into the roles of experts, the cultural politics of fundraising, and child welfare as a form of international exchange,Raising China's Revolutionariesis an important work of institutional and transnational history that illuminates the evolution of modern concepts of childhood in China.
Children in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the ...care system on children’s mental health outcomes from the effects of the adverse circumstances that led to their admission to care.
This research investigated the association between care placement and the presence of child mental health problems after controlling for children’s pre-care experiences. It also identified factors associated with mental health problems among children in care.
The sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159).
The mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers.
The odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032).
These findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care.
Children investigated for maltreatment are particularly vulnerable to experiencing multiple adversities. Few studies have examined the extent to which experiences of adversity and different types of ...maltreatment co-occur in this most vulnerable population of children. Understanding the complex nature of childhood adversity may inform the enhanced tailoring of practices to better meet the needs of maltreated children. Using cross-sectional data from the National Survey of Child and Adolescent Well-Being II (N=5870), this study employed latent class analysis to identify subgroups of children who had experienced multiple forms of maltreatment and associated adversities among four developmental stages: birth to 23 months (infants), 2–5 (preschool age), 6–10 (school age), and 11–18 years-old (adolescents). Three latent classes were identified for infants, preschool-aged children, and adolescents, and four latent classes were identified for school-aged children. Among infants, the groups were characterized by experiences of (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) caregiver divorce. For preschool-aged children, the groups included (1) physical neglect/emotional abuse/caregiver treated violently, (2) physical neglect/household dysfunction, and (3) emotional abuse. Children in the school-age group clustered based on experiencing (1) physical neglect/emotional neglect and abuse/caregiver treated violently, (2) physical neglect/household dysfunction, (3) emotional abuse, and (4) emotional abuse/caregiver divorce. Finally, adolescents were grouped based on (1) physical neglect/emotional abuse/household dysfunction, (2) physical abuse/emotional abuse/household dysfunction, and (3) emotional abuse/caregiver divorce. The results indicate distinct classes of adversity experienced among children investigated for child maltreatment, with both stability across developmental periods and unique age-related vulnerabilities. Implications for practice and future research are discussed.
In a randomized controlled trial, we compared abandoned children reared in institutions to abandoned children placed in institutions but then moved to foster care. Young children living in ...institutions were randomly assigned to continued institutional care or to placement in foster care, and their cognitive development was tracked through 54 months of age. The cognitive outcome of children who remained in the institution was markedly below that of never-institutionalized children and children taken out of the institution and placed into foster care. The improved cognitive outcomes we observed at 42 and 54 months were most marked for the youngest children placed in foster care. These results point to the negative sequelae of early institutionalization, suggest a possible sensitive period in cognitive development, and underscore the advantages of family placements for young abandoned children.
Child maltreatment in the family context is a prevalent and pervasive phenomenon in many modern societies. The global perpetration of child abuse and neglect stands in stark contrast to its almost ...universal condemnation as exemplified in the United Nation’s Convention on the Rights of the Child. Much work has been devoted to the task of prevention, yet a grand synthesis of the literature is missing. Focusing on two core elements of prevention, that is, antecedents for maltreatment and the effectiveness of (preventative) interventions, we performed an umbrella review of meta‐analyses published between January 1, 2014, and December 17, 2018. Meta‐analyses were systematically collected, assessed, and integrated following a uniform approach to allow their comparison across domains. From this analysis of thousands of studies including almost 1.5 million participants, the following risk factors were derived: parental experience of maltreatment in his or her own childhood (d = .47), low socioeconomic status of the family (d = .34), dependent and aggressive parental personality (d = .45), intimate partner violence (d = .41), and higher baseline autonomic nervous system activity (d = .24). The effect size for autonomic stress reactivity was not significant (d = −.10). The umbrella review of interventions to prevent or reduce child maltreatment showed modest intervention effectiveness (d = .23 for interventions targeting child abuse potential or families with self‐reported maltreatment and d = .27 for officially reported child maltreatment cases). Despite numerous studies on child maltreatment, some large gaps in our knowledge of antecedents exist. Neurobiological antecedents should receive more research investment. Differential susceptibility theory may shed more light on questions aimed at breaking the intergenerational transmission of maltreatment and on the modest (preventive) intervention effects. In combination with family‐based interaction‐focused interventions, large‐scale socioeconomic experiments such as cash transfer trials and experiments with vouchers to move to a lower‐poverty area might be tested to prevent or reduce child maltreatment. Prevalence, antecedents, and preventive interventions of prenatal maltreatment deserve continuing scientific, clinical, and policy attention.
Read the Commentary on this article at doi: 10.1111/jcpp.13175
With his dirty, tattered clothes and hollowed-out face, the image of Oliver Twist is the enduring symbol of the young indigent spilling out of the orphanages and haunting the streets of ...late-nineteenth-century London. He is the victim of two evils: an aristocratic ruling class and, more directly, neglectful parents. Although poor children were often portrayed as real-life Oliver Twists-either orphaned or abandoned by unworthy parents-they, in fact, frequently maintained contact and were eventually reunited with their families.In Imagined Orphans, Lydia Murdoch focuses on this discrepancy between the representation and the reality of children's experiences within welfare institutions-a discrepancy that she argues stems from conflicts over middle- and working-class notions of citizenship. Reformers' efforts to depict poor children as either orphaned or endangered by abusive or "no-good" parents fed upon the poor's increasing exclusion from the Victorian social body. Reformers used the public's growing distrust and pitiless attitude toward poor adults to increase charity and state aid to the children.With a critical eye to social issues of the period, Murdoch urges readers to reconsider the stereotypically dire situation of families living in poverty. While reformers' motivations seem well-intentioned, she shows how their methods solidified the public's anti-poor sentiment and justified a minimalist welfare state that engendered a cycle of poverty. As they worked to fashion model citizens, reformers' efforts to protect and care for children took on an increasingly imperial cast that would continue into the twentieth century.
Policy reforms to children's services in the UK and elsewhere encourage a greater focus on outcomes defined in terms of child well-being. Yet for this to happen, we need not only a better ...understanding of what child well-being is and how services can improve it, but also the ability to measure child well-being in order to evaluate success. This book investigates the main approaches to conceptualising child well-being, applies them to the child population using household survey and agency audit data, then considers the implications for children's services. The author: provides a clear conceptual understanding of five perspectives on well-being: need, rights, poverty, quality of life and social exclusion demonstrates the value of each perspective charts levels of child well-being in an inner-London community, including violated rights and social exclusion sets out the features that children's services must have if they are to improve child well-being defined in these terms This book should be read by everyone involved in developing, implementing and evaluating children's services, including researchers, policy makers and practitioners.
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