This study describes recent trends and patterns in antipsychotic treatment of privately insured children aged 2 through 5 years.
A trend analysis is presented of antipsychotic medication use ...(1999-2001 versus 2007) stratified by patient characteristics. Data are analyzed from a large administrative database of privately insured individuals. Participants were privately insured children, aged 2 through 5 years, with 12 months of continuous service enrollment in 1999-2001 (N = 400,196) or 2007 (N = 755,793). The main outcomes are annualized rates of antipsychotic use and adjusted rate ratios (ARR) of year effect on rate of antipsychotic use adjusted for age, sex, and treated mental disorder.
The annualized rate of any antipsychotic use per 1,000 children increased from 0.78 (95% confidence interval CI 0.69-0.88) (1999-2001) to 1.59 (95% CI 1.50-1.68) (2007) (ARR 1.76, 95% CI 1.56-2.00). Significant increases in antipsychotic drug use were evident for boys (ARR 1.66, 95% CI 1.44-1.90) and girls (ARR 2.26, 95% CI 1.70-3.01) and for children diagnosed with several different psychiatric disorders. Among antipsychotic-treated children in the 2007 sample, pervasive developmental disorder or mental retardation (28.2%), attention deficit/hyperactivity disorder (ADHD) (23.7%), and disruptive behavior disorder (12.9%) were the most common clinical diagnoses. Fewer than one-half of antipsychotic-treated young children received a mental health assessment (40.8%), a psychotherapy visit (41.4%), or a visit with a psychiatrist (42.6%) during the year of antipsychotic use.
Despite increasing rates of antipsychotic use by very young children, provision of formal mental health services remains sparse. These service patterns highlight a critical need to improve the availability of specialized and well integrated mental health care for very young children with serious mental health problems.
Two experiments investigated response tendencies of preschoolers toward yes—no questions about actions. Two hundred 2- to 5-year-old children were asked questions concerning actions commonly ...associated with particular objects (e.g., drinking from a cup) and actions not commonly associated with particular objects (e.g., kicking a toothbrush). The impact of delay and comprehension of questions were also investigated. Results revealed a consistent developmental transition: Younger children tended to display a yes bias whereas older children did not display a bias unless they faced incomprehensible questions, in which case they displayed a nay-saying bias. Delay shifted children's responses in such a way that "no" answers were given more often. These findings hold important implications regarding the use of yes—no questions with children.
This study is the first to test whether receipt of a federal child care subsidy is associated with children of immigrants' school readiness skills. Using nationally representative data (n ≈ 2,900), ...this study estimates the associations between subsidy receipt at age 4 and kindergarten cognitive and social outcomes, for children of immigrant versus native-born parents. Among children of immigrants, subsidized center-based care (vs. subsidized and unsubsidized home-based care) was positively linked with reading. Among children of native-born parents, those in subsidized center care displayed poorer math skills than those in unsubsidized centers, and more externalizing problems than those in unsubsidized home-based care.
What does the novice practitioner or the experienced practitioner moving into child care work from another sector need to know to practice effectively? What skills do they need to call on?In this ...valuable addition to The Social Work Skills Series, Stella Coleman and Corinne May-Chahal bring together their considerable teaching and practice experience to provide a reliable and practical guide to child protection work. Topics covered include:
the legal and procedural context
the professional context
explanatory theoretical frameworks and models of practice
managing risk
evidence-based practice
social work interventions
parents, carers and families
continuing professional development.
This is an essential text for all students, teachers and professionals working with children and families.
Clinical diagnosis of autism spectrum disorder (ASD) relies on time-consuming subjective assessments. The primary purpose of this study was to investigate the utility of salivary microRNAs for ...differentiating children with ASD from peers with typical development (TD) and non-autism developmental delay (DD). The secondary purpose was to explore microRNA patterns among ASD phenotypes.
This multicenter, prospective, case-control study enrolled 443 children (2–6 years old). ASD diagnoses were based on DSM-5 criteria. Children with ASD or DD were assessed with the Autism Diagnostic Observation Schedule II and Vineland Adaptive Behavior Scales II. MicroRNAs were measured with high-throughput sequencing. Differential expression of microRNAs was compared among the ASD (n = 187), TD (n = 125), and DD (n = 69) groups in the training set (n = 381). Multivariate logistic regression defined a panel of microRNAs that differentiated children with ASD and those without ASD. The algorithm was tested in a prospectively collected naïve set of 62 samples (ASD, n = 37; TD, n = 8; DD, n = 17). Relations between microRNA levels and ASD phenotypes were explored.
Fourteen microRNAs displayed differential expression (false discovery rate < 0.05) among ASD, TD, and DD groups. A panel of 4 microRNAs (controlling for medical/demographic covariates) best differentiated children with ASD from children without ASD in training (area under the curve = 0.725) and validation (area under the curve = 0.694) sets. Eight microRNAs were associated (R > 0.25, false discovery rate < 0.05) with social affect, and 10 microRNAs were associated with restricted/repetitive behavior.
Salivary microRNAs are “altered” in children with ASD and associated with levels of ASD behaviors. Salivary microRNA collection is noninvasive, identifying ASD-status with moderate accuracy. A multi-“omic” approach using additional RNA families could improve accuracy, leading to clinical application.
A Salivary miRNA Diagnostic Test for Autism; https://clinicaltrials.gov/; NCT02832557.
Objectives
This study examines the financial and childcare support provided to mothers from paternal kin, as well as whether this support varies based on relationship characteristics of the mother ...and father, child support provided by the father, and father–child contact.
Background
Despite the documented importance of familial support for many mothers of young children, especially single mothers, minimal quantitative research has examined the factors that pattern transfers of support from fathers' family members.
Methods
Using data from the Fragile Families and Child Wellbeing Study (n = 4,296), we employ multivariate logistic regression analyses to examine mothers' receipt of financial and childcare support from paternal kin.
Results
Results indicate that mothers who report having no relationship with their child's father have a lower probability of receiving support from his family. Mothers with nonresidential fathers are more likely to receive support from the father's kin when the father provides informal or sporadic child support.
Conclusion
Fathers occupy a brokering role between mothers and their kin. When a relationship with the father is completely absent, support from his family decreases.
Implications
The findings offer insight into the social capital and economic stability of mothers, particularly those with nonresidential fathers.
Youth engagement in research, which involves meaningfully collaborating with youth as full partners in the research process, has contributed to improved research collaborations, enhanced youth ...participation, and increased motivation for researchers to address scientific questions relevant to youth. Engaging youth as partners in the research process is especially needed in the field of child maltreatment due to the high prevalence of maltreatment, its poor association with health outcomes, and the disempowerment that can occur following exposure to child maltreatment. Although evidence-based approaches for youth engagement in research have been established and applied in other areas such as mental health services, youth engagement in child maltreatment research has been limited. This is particularly disadvantageous to youth exposed to maltreatment as their voices remain absent from research priorities, which contributes to a discrepancy between the research topics that are relevant to youth and those that are pursued by the research community. Using a narrative review approach, we provide an overview of the potential for youth engagement within the field of child maltreatment research, identify barriers to youth engagement, provide trauma-informed strategies for engaging youth in the context of research, and review existing trauma-informed models for youth engagement. This discussion paper suggests that youth engagement in research can contribute to improvements in the design and delivery of mental health care services for youth exposed to traumatic experiences and should be prioritized in future research endeavors. Moreover, it is essential for youth who have historically experienced systemic violence to be engaged and have a voice in research that has the potential to impact policy and practice.
The main theme of this book concerns the continuing psychic centrality of parents for their children. Several chapters examine an author and his works, outlining that author's relationships with ...parents, good-and-bad, and making descriptive comments about these based both on information gleaned from the author's life and writings as well as from observations found in autobiographies, biographies and critical works. Since these studies in part concern stories of child abuse and deprivation, the book predominantly illustrates bad parenting that seems to have contributed to the child's psychopathology. Yet in most cases there has also been an evocation by the trauma and deprivation of adaptive and even creative reactions--this positive effect also of course largely attributable to concomitant good parenting--and yet there are some cases where little of this seems to have existed and yet the children still turn out to be able to make something of themselves. The conditions that make for psychic health in a traumatized childhood are mysterious and can't always be accounted for.
Abstract General population studies find that rates of child maltreatment are higher than those identified in the child welfare system. Some modes of administration may result in higher disclosure ...rates of child maltreatment by respondents. This study assesses differences in characteristics of parents who are recruited using telephone sampling techniques or via the internet and whether the survey was administered by telephone or the web. We have 1599 parent respondents recruited from listed samples and Craigslist advertisements. Surveys were administered via the telephone or online. Survey included measures of parenting behaviours, psychosocial characteristics and demographics for the parent, child and family. Data were analysed using logit multilevel models. We found no differences between mode of administration and our child maltreatment and parenting measures, including physical abuse, corporal punishment and supervisory neglect. Recruitment strategy was not related to leaving a child home alone and corporal punishment. However, we did find that parents recruited by Craigslist use physical abuse more frequently. That we found no difference in use of punitive and neglectful parenting practices by survey mode of administration and recruitment method provides some degree of confidence that survey methods other than random‐digit‐dialling telephone surveys may result in generalizable samples in this age of declining landline use.
Child maltreatment and its consequences are considered a major public health problem. So far, there is only one study from Germany reporting prevalence rates on different types of maltreatment.
A ...representative sample of the German general population was examined for experiences of child maltreatment using the Childhood Trauma Questionnaire (CTQ) between September and November 2016. A total of 2510 (53.3% female) participants between 14 and 94 years (M = 48.8 years) were enrolled. Besides the CTQ, a range of sociodemographic information was collected. The interrelatedness of different types of maltreatment was examined using configuration analysis and predictors for maltreatment were identified by performing binary logistic regression analyses.
Overall, 2.6% (f: 3.9%, m: 1.2%) of all participants reported severe emotional abuse, 3.3% (f: 3.4%, m: 3.3%) severe physical abuse, 2.3% (f: 3.7%, m: 0.7%) severe sexual abuse, 7.1% (f: 8.1%, m: 5.9%) severe emotional neglect and 9% (f: 9.2%, m: 8.9%) severe physical neglect. Women were more likely to report at least moderate sexual and emotional abuse than men. The largest difference between age groups was reported for physical neglect, with participants aged over 70 years reporting the highest rates. Participants who reported childhood maltreatment were more likely to be unemployed or have lower educational outcomes. The most common combination of maltreatment types were physical and emotional neglect, all five types of maltreatment combined and physical and emotional neglect and physical abuse combined.
Child maltreatment, especially physical neglect is common in the German population. Women seem to be at greater risk for sexual and emotional abuse than men. Knowledge about different types of maltreatment based on the Childhood Trauma Questionnaire (CTQ) can help to put findings of future studies into an epidemiological and societal context.
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