BACKGROUND: Children with developmental disabilities are at heightened risk for maltreatment. However, little is known regarding the prevalence of maltreatment among specific groups, such as autism spectrum disorder (ASD) and/or intellectual disability (ID). Information about maltreatment in these groups can aid in the development of supports and prevention strategies for vulnerable children and their families. METHODS: Using record linkage between the Department of Social Services (DSS) and the Autism and Developmental Disabilities Monitoring (ADDM) network, this study compares the prevalence and characteristics of maltreatment among children with ASD-only (n = 316), ASD and comorbid ID (ASD+ID; n = 291), ID-only (n = 1,280), and controls (n = 3,101). Behavioral correlates of maltreatment are examined. RESULTS: Controlling for demographic factors, this study found significantly higher odds of reported and substantiated maltreatment among children with ASD-only (odds ratio = 1.86 for reported, 1.51 for substantiated), ASD+ID (odds ratio = 2.35 for reported, 1.97 for substantiated), and ID-only (odds ratio = 2.45 for reported, 2.49 for substantiated) relative to a population control group, with large effects. In particular, children with ASD+ID and ID-only were between two and three times more likely to experience maltreatment. All groups were more likely to experience physical neglect, and children in the ASD+ID and ID-only groups were more likely to experience all forms of abuse. Children in the ASD-only group were more likely to experience physical abuse. Maltreated children in the ASD-only and ID-only groups experienced more cases of physical abuse and neglect, and were victimized by more perpetrators compared to other maltreated youth. Maltreatment was associated with higher likelihood of aggression, hyperactivity, and tantrums for children with ASD. CONCLUSIONS: Children with ASD and/or ID are at heightened risk for maltreatment. Empirically-supported assessment and intervention approaches for identifying and addressing traumatic stress related to maltreatment in ASD are urgently needed.
Christina G. McDonnell, Andrea D. Boan, Catherine C. Bradley et al.
Abstract The current study aimed to explore health behaviour, quality of life and well-being in older children in relation to social background, parental academic socialisation and academic expectation stress, and the role of emerging constructs of self-compassion and psychological capital as potential protective factors. A survey was administered to a sample of 373 children (150 males and 223 females) aged between 11 and 15 years. Children were assessed on academic expectations stress, home and social background, parenting experience, psychological capital, self-compassion, health behaviour, well-being and quality of life. Academic expectation stress was inversely predictive of well-being and quality of life and through its impact on self-compassion and psychological capital, to health behaviour. Findings from this study would suggest that positive psychology interventions to build self-compassion and psychological capital may be efficacious in reducing the negative impact of academic expectation stress in children.
Abstract Over a third of individuals diagnosed with a psychotic disorder are also a parent. The symptoms of psychosis and side effects of antipsychotic medication can impact on parents’ awareness of the needs of their children and, at times, the parent may be emotionally and practically unavailable to their child. This study assessed the expressed emotion of parents with psychosis and used qualitative methods to investigate their needs and experience in order to identify how best to support this parent group. Twelve parents with a diagnosed psychotic disorder and with a child aged between 3 and 11 years took part in semi-structured interviews. The majority of parents displayed high levels of warmth and low levels of negativity towards their child. Four themes were generated using reflexive thematic analysis: (1) the impact of psychosis on parenting, (2) the need to protect their child, (3) the need to feel normal, and (4) the impact of parenting stress on psychosis. These results showed how parents want to protect their children and feel normal despite experiencing psychosis. They also highlighted the cyclical relationship between parenting stress and psychotic symptoms, whereby psychotic symptoms can impact on a parent’s capacity to care for their child and parenting stress can exacerbate psychotic symptoms.
BACKGROUND: Children younger than 7 years can develop mental disorders that might manifest differently than in older children or adolescents. However, little is known about the prevalence of mental disorders at this early age. METHODS: We systematically searched the literature in the databases Web of Science, PsycINFO, PSYNDEX, MEDLINE, and Embase to identify epidemiological studies of community samples published between 2006 and 2020. A series of meta-analyses was conducted to estimate the pooled worldwide prevalence of mental disorders in general, specific mental disorders, and comorbidity in young children. RESULTS: A total of ten epidemiological studies reporting data on N = 18,282 children (12-83 months old) from eight countries met the inclusion criteria. The pooled prevalence of mental disorders in general was 20.1%, 95% CI [15.7, 25.4]. Most common disorders were oppositional defiant disorder (4.9%, 95% CI [2.5, 9.5]) and attention-deficit hyperactivity disorder (4.3%, 95% CI [2.5, 7.2]). The prevalence of any anxiety disorders was 8.5%, 95% CI [5.2, 13.5], and of any depressive disorders was 1.1%, 95% CI [0.8, 1.6]. Comorbidity was estimated at 6.4%, 95% CI [1.3, 54.0]. CONCLUSIONS: The literature search reveals that the epidemiology of mental disorders in children younger than 7 years is still a neglected area of research. The findings also indicate that there are a significant number of young children suffering from mental disorders who need appropriate age-adapted treatment.
Mira Vasileva, Ramona K. Graf, Tilman Reinelt et al.
ProtectionAU
Peer-reviewed article·Journal of Child and Family Studies·
Abstract Parental engagement in parenting programs is essential for good outcomes but can be challenging for many families. In low- and middle-income countries, where resources are limited and there are fewer support services, there is little research examining the factors that influence engagement. This mixed-methods study explored factors associated with parent engagement, as well as barriers and supports, in a pilot evaluation of a parenting program with 140 parents in North Macedonia, Republic of Moldova, and Romania. The relationship between various quantitative types of engagement (e.g., premature drop-out, participation) and a range of demographic, personal, and implementation factors were examined. Qualitative parent interviews explored barriers and supports to program engagement. Implementation variables (e.g., phone calls with parents, program fidelity and text messages sent to parents) were consistently positively associated with different types of engagement after controlling for other factors. Parents of boys, being a victim of intimate partner violence, more children in the household and better parental well-being were positively associated with premature drop-out whilst having a child enrolled in school was positively associated with participation. Barriers included logistical factors such as timing and lack of childcare facilities. Factors that increased engagement included facilitator skills/support, weekly text messages and phone calls and engagement strategies such as transport and childcare. The results emphasise the importance of implementation factors in increasing parent engagement in parenting programs and will help to inform the next phase of the project as well as other family-support initiatives in the three countries. The trial is registered on ClinicalTrials.gov (ID: NCT03552250).
Margiad Elen Williams, Heather M. Foran, Judy Hutchings et al.
Development
Peer-reviewed article·Journal of Child Psychology and Psychiatry·
BACKGROUND: The impact of chronic stressors like the COVID-19 pandemic is likely to be magnified in adolescents with pre-existing mental health risk, such as attention-deficit/hyperactivity disorder (ADHD). This study examined changes in and predictors of adolescent mental health from before to during the COVID-19 pandemic in the Southeastern and Midwestern United States. METHODS: Participants include 238 adolescents (132 males; ages 15-17; 118 with ADHD). Parents and adolescents provided ratings of mental health symptoms shortly before the COVID-19 pandemic and in spring and summer 2020. RESULTS: Adolescents on average experienced an increase in depression, anxiety, sluggish cognitive tempo, inattentive, and oppositional/defiant symptoms from pre-COVID-19 to spring 2020; however, with the exception of inattention, these symptoms decreased from spring to summer 2020. Adolescents with ADHD were more likely than adolescents without ADHD to experience an increase in inattentive, hyperactive/impulsive, and oppositional/defiant symptoms. Adolescents with poorer pre-COVID-19 emotion regulation abilities were at-risk for experiencing increases in all mental health symptoms relative to adolescents with better pre-COVID-19 emotion regulation abilities. Interactive risk based on ADHD status and pre-COVID-19 emotion regulation abilities was found for inattention and hyperactivity/impulsivity, such that adolescents with ADHD and poor pre-COVID-19 emotion regulation displayed the highest symptomatology across timepoints. Lower family income related to increases in inattention but higher family income related to increases in oppositional/defiant symptoms. CONCLUSIONS: The early observed increases in adolescent mental health symptoms during the COVID-19 pandemic do not on average appear to be sustained following the lift of stay-at-home orders, though studies evaluating mental health across longer periods of time are needed. Emotion dysregulation and ADHD increase risk for sustained negative mental health functioning and highlight the need for interventions for these populations during chronic stressors. Results and clinical implications should be considered within the context of our predominately White, middle class sample.
Peer-reviewed article·Journal of Child and Family Studies·
Abstract Raising a deaf child can have significant impacts on parents’ wellbeing, their relationship with the deaf child, and their ability to parent effectively. Using an online survey, this study explored two questions: First, to examine whether hearing parents treat and perceive their deaf and hearing children differently while controlling for parent characteristics (including resolution of diagnosis), specifically in terms of parenting styles and perceived vulnerability. Second, whether hearing parents’ ability to resolve their feelings about their child’s hearing loss diagnosis was related to their parenting morale, and whether they perceived their deaf child as vulnerable. A total of 84 parents with a deaf child aged 5–12 years completed the survey, with 32 of those also reported about a second child without hearing loss in the same age range. They were asked to answer questions from the Reaction to Diagnosis Interview, and to complete several questionnaires addressing parenting morale, child vulnerability, and parenting styles. Findings suggest that unresolved feelings of diagnosis were linked to lower parenting morale and greater perception of child vulnerability. Sibling comparisons indicated that parents also reported a higher perceived child vulnerability score for the deaf child compared to the hearing sibling. No sibling differences were found regarding parenting styles. These findings suggest that the experience of having a deaf child can have a negative impact on hearing parents’ morale and perception of child vulnerability, particularly when parents remain unresolved about the diagnosis, highlighting the need for targeted supports and further research.
Abstract This paper aims to explore young people’s perspectives of a real-life scenario of child language brokering in a healthcare setting (the doctor’s office), when the topic of discussion is sensitive and potentially conflictual. Child Language brokers are migrant young people who translate and interpret for family members, peers and the local community. Often the spaces in which children broker (e.g., healthcare, banks), referred to here as a ‘contact zone’, are dominated by adults in positions of authority and unequal power differentials. The language broker and those for whom they are brokering may be in a less powerful position because of their migration status and/or age status. Existing research has focused mainly from the view of adults and young people’s perspectives on the practice are underexplored. We draw the existing literature to explore how brokers understand the wider societal context and the strategies they employ to manage conflict. Findings are presented from 29 individual qualitative vignette-based interviews with language brokers (aged 13–16) in the United Kingdom which were qualitatively analysed. Findings show how these children play a vital role in protecting those for whom they broker, often navigating sophisticated social interactions and tactics (such as delay and selective modification). Equally, they carry a weight of responsibility trying to manage complicated, perhaps morally questionable, situations. By asking brokers to reflect on a real-life healthcare scenario, we are advancing understanding of migrant youth brokers and the families they support in their day to day lives.
Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.
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.
