Unaccompanied migrant children and families seeking humanitarian protection face health and well-being risks throughout the migration journey. US immigration policies and enforcement practices that subject children and families to detention and separation compound these risks. Grounded in the Best Interest of the Child (BIOTC) framework, this policy statement recontextualizes reception and proposes recommendations to ensure the safety and well-being of children and families seeking humanitarian protection.
Socio-ecological contexts shape trauma and recovery after sexual abuse, but little is known about these contexts, particularly for racial and ethnic minority families. We aimed to describe contextual stressors for Black and Latino families after child sexual abuse. We interviewed 30 Black and Latino, English and Spanish-speaking caregivers of children who were sexually abused. Interviews were analyzed using thematic analysis. Caregivers (87% mothers) reported two sociocultural stressors: (1) beliefs about sexual abuse (patriarchy and stigma) and (2) beliefs about help-seeking (trust in family advice and mistrust of mental health care). Caregivers reported one main systems stressor: sexual abuse evaluation, investigation, and legal processes. They described how experiences with multidisciplinary systems can lead to child re-traumatization, caregiver blame and powerlessness, and family and community identity-based stress. Our findings highlight areas of intervention to strengthen and uplift communities, improve child protection systems, and promote child and family well-being after sexual abuse.
Abstract Background: Caring for a child with attention-deficit/hyperactivity disorder (ADHD) can impact caregivers' psychological well-being, family relationships, and social participation. However, little qualitative research has examined how Iranian mothers experience these challenges. The present study aimed to explore the psychological and social experiences of Iranian mothers caring for children with ADHD. Methods: A descriptive phenomenological design was employed. Thirteen biological mothers of children aged six to twelve years with a clinical ADHD diagnosis based on DSM-5 criteria were purposely recruited from four psychology and mental health clinics in Tehran, Iran. Data were collected through individual, semi-structured, in-depth interviews lasting approximately 60 minutes. The interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi’s seven-step phenomenological method. Results: The analysis generated 131 preliminary codes, which were refined into 72 substantive codes and 20 conceptual categories. These categories were organized within two overarching domains: psychological and social difficulties. Psychological difficulties included psychological exhaustion, hopelessness about the future, depressive experiences, reduced personal autonomy, marital and family difficulties, irritability, sleep problems, persistent anxiety and worry, family tension, and a reduced quality of life. Social difficulties included embarrassment, social withdrawal, perceived social insecurity, reduced social relationships, insufficient social support, and a perceived lack of social acceptance. Conclusion: Mothers described raising a child with ADHD as a multidimensional experience that affects psychological well-being, family and marital relationships, daily functioning, and social participation. These findings underscore the importance of family-centered, culturally responsive support that addresses caregiver well-being, relational challenges, social isolation, and access to supportive services.
Background/Objectives: Child social vulnerability is a multidimensional phenomenon influenced by poverty, material deprivation, inequality, and institutional protection. This study analysed child and adolescent social vulnerability in Europe between 2017 and 2023 and developed a Child Social Vulnerability Index (CSVI). Methods: A longitudinal ecological study was conducted using Eurostat country-year data from European countries. Indicators included severe child poverty, severe material deprivation, income inequality (Gini index), preventive healthcare expenditure, and social protection expenditure. Descriptive, longitudinal, principal component, and cluster analyses were performed. Results: The findings revealed substantial differences in child social vulnerability across European countries. Poverty, material deprivation, and inequality were strongly associated, supporting the multidimensional nature of vulnerability. Principal Component Analysis supported the internal structure of the child Social Vulnerability Index (CSVI), identifying two components that explained 76.35% of the variance. The CSVI showed a very high correlation with the first principal component (r = 0.97, p < 0.001) confirming its structural consistency. Longitudinal analyses revealed a significant decline in child social vulnerability between 2017 and 2023 with an additional reduction during the COVID-19/post-COVID period. Cluster analysis identified three distinct European vulnerability profiles based on the CSVI and institutional protection dimension. Conclusions: Child social vulnerability in Europe is shaped by the interaction of socioeconomic inequalities and institutional protection mechanisms. The CSVI provides a useful tool for monitoring vulnerability and informing policies to reduce inequalities and promote child and adolescent well-being.
Pérez-Jorge D, González-Afonso MC, Hernández-González IA et al.
Children with heart failure are at high risk of multiple hospitalizations, eventual need for heart transplant, and mortality. When at home, support and medical care are provided by parents. In this high-stakes situation, the quality of life of both the child and parents can be impacted. In recent years quality of life is increasingly relevant, as more medically complex children are now cared for at home and transplant waitlist times have lengthened. In this contemporary cohort, we conducted semi-structured interviews of dyads of children with HF and their parents, then used thematic analysis to identify quality of life themes. Among 13 dyads, 5 central themes emerged: (1) Both parents and children desire as much of a "normal" life as possible. (2) Parent responsibilities are extensive- they operate at maximum capacity in their medicalized parent role and face psychosocial challenges of their own. (3) Parents and children experience social isolation which is multifactorial and increases over time. (4) Coping methods are diverse- parents and children are resilient. (5) Specific supportive resources, in particular mental health resources, are lacking. We conclude that many opportunities exist to develop and improve program support for the pediatric HF population.
Research on how children develop emotion concepts is vital to successful, culturally sensitive social-emotional learning (SEL) programs that account for individual differences in the development of SEL skills. This study presents a thematic analysis of child emotion definitions and potential implications for SEL programs as an exploration of how children are taught about emotions and to center child voice in SEL research. It is the first, to the researchers' knowledge, to link child emotion representation with SEL programs by analyzing emotion-focused program content through the lens of a child's emotional representational system. A total of 1239 definitions produced by 49 children ages 8 to 11 (Mage = 9.24; SD = 0.75; 46.9% Female; 69% multilingual) were analyzed. Eight themes were identified in the definition corpus via thematic analysis and used as a framework to which 38 SEL programs were mapped. A majority of SEL programs addressed the following themes in the child-informed emotion framework: 'interpersonal dynamics' (addressed by 97% of programs), 'cognitive states' (95%), 'performing an activity' (87%), and 'observable signs' (71%) that referred to physical/sensory experience. When defining emotions, over 80% of children mentioned 'interpersonal dynamics' (e.g., rejection), 'experiencing a non-social situation' (e.g., a disappointing event), and 'observable signs' (e.g., sleeping). Findings offer preliminary insight into how a sample of children in middle childhood describe and make meaning of emotions, and prompt an exploratory discussion on emotion-focused content in SEL programs for middle childhood. Definitions collected constitute an emotion definition database available for future research on child emotion language.
Background/objectives Schools constitute the principal setting for the identification of children's psychosocial risk and the delivery of preventive support, and school-health surveillance therefore depends on informant reports. Selection of the reporting informant is constrained by feasibility, cost, and questionnaire length, which frequently preclude multi-informant assessments, and the question of whether adult and child reports index a common property has predominantly been examined in single-country designs. The present study estimated the criterion-related validity of child, teacher, and principal reports of school safety across multiple education systems, against outcomes spanning children's experience, institutional functioning, and externally assessed achievements; the estimand was thus informant-specific validity rather than cross-informant agreement. Methods TIMSS 2023 Grade 4 data from 12,955 schools in 63 education systems (395,961 children, 27,100 teacher records) were analyzed, with child, teacher, and principal reports modeled as separate informants. Students were randomly split within schools so that no student contributed both a predictor and an outcome; the split was replicated 50 times and averaged. Convergence was evaluated with a multitrait-multi-informant model, with ceiling effects and differential unreliability specified as rival explanations; informant contributions were estimated by an exact relative-importance (LMG) variance decomposition, with response surface analysis reported as a secondary characterization of directional discrepancy. Results Median school-level cross-informant correlations were below 0.10 and were not attributable to ceiling effects or to unreliability. With all three informants retained, the child report accounted for 95% (95% CI 92-97) of the informant-explained variance in school belonging and 75% (65-82) in peer victimization, but 44% (28-59) in mathematics, where the three contributions were approximately equal. These proportions were computed on a modest total: the three informant scores jointly explained between 1% and 13% of between-school variance. The pattern was robust to informant, item, covariate, and weighting specifications, and to correction for differential predictor unreliability. Conclusions Criterion-related informant validity in school safety measurement was domain-specific. For outcomes describing children's experience, adult reports contributed substantially lesser than child reports and cannot be regarded as interchangeable substitutes for children's reports of experienced safety. Because school-health surveillance, risk identification, preventive targeting, and resource allocation depend on these inputs, valid monitoring requires student self-reports rather than adult proxy reports alone.
Background Integrating the perspectives of people with lived experience is integral to developing new healthcare interventions. However, individuals from under-represented communities may face additional barriers to taking part in such patient and public involvement (PPI) activities. Within paediatric speech and language therapy (SLT), under-represented communities might include families from lower SES backgrounds and/or families where the majority language for that country is not spoken. Excluding families from under-represented communities poses the risk of new interventions not being acceptable to them, thus exacerbating pre-existing healthcare inequalities. Objective The aim of this study was to optimise the prospective acceptability of a new paediatric speech and language therapy intervention with parents from under-represented backgrounds, in the hope of optimising future accessibility to families from diverse communities. Methods An individualised PPI approach was taken, consisting of two semi structured interviews informed by the Theoretical Framework of Acceptability (TFA). Six parent partners from non-majority language and/or lower SES backgrounds were recruited through a local charity. In the first interview, parent partners were shown a video of the intervention and identified key areas for increasing acceptability. Refinements were made to the intervention by the project steering group in an online meeting. These refinements were the topic of the second interview, where the impact on prospective acceptability was explored. Results Following the first round of interviews, areas for improvement included consideration of access to/co-ordination with wider services, and the financial and practical implications for parents accessing the intervention. Most of the intervention refinements and solutions to potential barriers came directly from the parent partners themselves, rather than the steering group. In the second round of interviews, parent partners rated the intervention's prospective acceptability between 4/5 (acceptable) and 5/5 (very acceptable). Conclusion By working with parent partners from under-represented communities, the research team was able to enhance the prospective acceptability of a new paediatric speech and language therapy intervention. Many refinements related to the wider healthcare and support system, rather than to the content of the intervention itself. This reinforces the importance of exploring and addressing wider contextual barriers within the intervention development process. Patient or public contribution The methods for this project were co-designed with a project steering group consisting of 3 Speech and Language Therapists (one with specialist EDI expertise), a bi/multilingual education support worker, a specialist early years teacher, a parent of a child with developmental language disorder (DLD) and an adult with DLD. The steering group also assisted with identifying potential intervention refinements. The parent partners were responsible for identifying areas where acceptability could be increased and addressing the prospective acceptability of the intervention refinements.
Introduction Poverty is a well-established determinant of adolescent mental health, but associations between ethnicity and mental health are less clear. We quantified inequalities in mental health and well-being among adolescents in Bradford, UK. Methods We conducted a cross-sectional analysis of the Born in Bradford birth cohort, using surveys from 2023/2024 (ages 12-15). Participants completed validated measures of anxiety and depression (Revised Child Anxiety and Depression Scale 25), well-being (Short Warwick-Edinburgh Mental Well-being Scale), emotional and behavioural problems (Strengths and Difficulties Questionnaire), loneliness (UCLA Loneliness Scale 4), eating-related problems (Eating Disorders Examination Questionnaire-Short) and psychosis-like experiences (Psychosis-Like Symptoms Scale 8). We used linear regression to estimate associations with ethnicity and family income (measured by free school meals eligibility). Results We included 9496 participants (median age 13.9 years; 52.1% female; 40.9% Pakistani ethnicity; 34.4% white British ethnicity; 24.6% other ethnicities; and 62.0% living in the most deprived quintile of neighbourhoods in England). Compared with adolescents of white British ethnicity, those of Pakistani ethnicity had fewer anxiety and depression symptoms (Cohen's d=-0.31, 95% CI -0.37 to -0.24); higher well-being (d=0.15, 95% CI 0.10 to 0.20), fewer emotional and behavioural problems (d=-0.40; 95% CI -0.48 to -0.32); less loneliness (d=-0.22, 95% CI -0.26 to -0.17), fewer eating-related problems (d=-0.07; 95% CI -0.11 to -0.02) and no evidence of a difference in psychosis-like experiences (d=-0.07; 95% CI -0.17 to 0.02). Estimates for other minority ethnic groups were less precise but generally suggested better mental health than white British adolescents. Adolescents eligible for free school meals had poorer outcomes across all measures: anxiety and depression (d=0.13; 95% CI 0.07 to 0.18); well-being (d=-0.17; 95% CI -0.22 to -0.12); loneliness (d=0.09; 95% CI 0.04 to 0.14); emotional and behavioural problems (d=0.14; 95% CI 0.06 to 0.22); eating-related problems (d=0.06; 95% CI 0.01 to 0.11); and psychosis-like experiences (d=0.10; 95% CI 0.01 to 0.20). In exploratory sex-stratified analyses, girls reported poorer mental health and ethnic differences were wider among girls than boys. Conclusions Poverty was consistently associated with poorer adolescent mental health. Despite higher deprivation, Pakistani adolescents reported substantially better outcomes than white British adolescents, particularly for emotional and behavioural problems.
Introduction Intrafamilial child maltreatment poses a serious risk to children's and adolescents' physical, psychological, and sexual integrity. This study analyzed the prevalence of this phenomenon among students of the Enrique Proaño Educational Institution in Quito, Ecuador, during the 2024-2025 period. Methods A quantitative, descriptive design was used to assess the dimensions of physical, psychological, and sexual abuse, as well as neglect, considering the involvement of maternal and paternal figures. Results Physical abuse showed the highest prevalence among the maltreatment types assessed, followed by moderate levels of neglect. Psychological abuse occurred less frequently but remains a significant concern, and sexual abuse, although low in prevalence, was still present. The maternal figure was more frequently associated with neglect, whereas the paternal figure was more often linked to physical abuse. Discussion These patterns highlight the need for prevention and intervention strategies tailored to both the type of maltreatment and the parental figure involved.
