Suchergebnisse

Tackling Child Neglect: Research, Policy and Evidence-Based Practice, edited by Ruth Gardner -- Foreword -- Introduction by Ruth Gardner -- Part 1 - The Effects of Child Neglect -- 1. The effects of Emotional Neglect During the First Two Years of Life by Jane Barlow -- 2. Child Neglect and the Development of Communication by Jan McAllister and Wendy Lee -- 3. Making a Difference to the Neglected Child's Lived Experience by Jan Horwath -- Research Note: Preventing dental neglect by Emily Keene, Specialist in Paediatric Dentistry -- Part 2 - Perspectives on child neglect

Purpose
– Foetal programming is one of the key mechanisms by which physical and social adversity is biologically embedded during pregnancy. While early interest in such programming focused on the long-term impact of the mother's nutritional state on the child's later physical health, more recent research has identified an increased risk of psychopathology in children of women who have experienced stress, anxiety and depression during pregnancy. The purpose of this paper is to examine the literature addressing the impact of stress in pregnancy and the implications for practice.


Design/methodology/approach
– An overview of the literature has been provided.


Findings
– Both anxiety and depression in pregnancy are common, with a prevalence in the region of 20 per cent. Exposure in pregnancy to anxiety, depression and stress from a range of sources (e.g. bereavement, relationship problems, external disasters and war), is associated with a range of physical (e.g. congenital malformations, reduced birthweight and gestational age), neurodevelopmental, cognitive, and emotional and behavioural (e.g. ADHD, conduct disorder) problems. The magnitude is significant, with the attributable risk of childhood behaviour problems due to prenatal stress being between 10 and 15 per cent, and the variance in cognitive development due to prenatal stress being around 17 per cent. A range of methods of intervening are effective in improving both maternal anxiety and depression, and in the longer term should improve outcomes for the infant and child.


Research limitations/implications
– This research highlights the importance of intervening to support the psychological wellbeing of pregnant women to improve outcomes for infants and children, and points to the need for further research into innovative ways of working, particularly with high-risk groups of pregnant women.


Originality/value
– The paper provides an update of earlier overviews.

Purpose
– The purpose of this paper is to outline brain structure and development, the relationship between environment and brain development and implications for practice.


Design/methodology/approach
– The paper is based on a selected review of the literature and clinical experience.


Findings
– While genetics determine the sequence of brain maturation, the nature of brain development and functioning is determined by the young child's caregiving environment, to which the developing brain constantly adapts. The absence of input during sensitive periods may lead to later reduced functioning. There is an undoubted immediate equivalence between every mind function – emotion, cognition, behaviour and brain activity, although the precise location of this in the brain is only very partially determinable, since brain connections and function are extremely complex.


Originality/value
– This paper provides an overview of key issues in neurodevelopment relating to the development of young children, and implications for policy and practice.

Purpose
– Drawing on the scientific literature, the purpose of this paper is to elucidate the harmful effects of toxic stress on the developing brain. It explains how severe, chronic adversity during development, in the absence of responsive caregiving, can impair brain architecture. It also outlines policy implications for preventing or mitigating the effects of toxic stress in early childhood.


Design/methodology/approach
– The National Scientific Council on the Developing Child, based at the Center on the Developing Child at Harvard University, is a multidisciplinary, multiuniversity panel of scholars that seeks to bring science to bear on public decision making. Council members selected excessive stress as a topic meriting translation for a general audience and conducted extensive peer review in drafting the paper's key scientific concepts.


Findings
– The paper discusses how healthy development can be derailed by excessive or prolonged activation of the biological stress response systems and how that increases lifetime risk for certain behavioural and physiological disorders. It finds that supportive relationships with caregivers can help buffer the negative consequences of toxic stress.


Social implications
– The paper calls for improvements to family support programmes, mental health services, and the quality and availability of early care and education.


Originality/value
– This paper describes an original taxonomy of positive, tolerable, and toxic stress and demonstrates the need to translate scientific knowledge about the developing brain into actionable strategies for the prevention and treatment of the effects of adverse childhood experiences.

AbstractThe case has been made for introducing a rights‐based, public health approach to child protection in England. A continuum of prevention is proposed, with multi‐agency responses calibrated more carefully to the level of risk identified by children, parents and practitioners. The aim was to allocate inter‐professional authority and resources in such a way as to ensure the safeguarding response is proportionate to the nature and level of concerns expressed and reliable in achieving good outcoSmes for children and parents alike. Recent research findings confirm the need for new models of service alignment and inter‐professional responsibility at the interface of 'primary' and 'specialist' health‐care services and 'children's social care', where significant safeguarding concerns are raised. This paper reports the findings of a scoping study, designed to establish the extent to which innovative practice methodologies have been implemented and evaluated in England to date. While the evidence to support the effectiveness of specific practice methodologies and contrasting logics of service design and implementation is shown to be very limited still, achieving reliability and legitimacy in the safeguarding relationships established at the service interface seems to depend on the integrity of the dialogue facilitated in each case.

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.

While existing studies have examined the effectiveness of school-based child sexual abuse (CSA) prevention programs in China, there is currently little qualitative evidence on how stakeholders view these programs and research on CSA in China more generally. To address this research gap, the aims of this study were to explore stakeholders' perspectives on: (a) school-based CSA prevention programs in China; (b) the components of these programs; (c) CSA research in China. Qualitative semi-structured interviews were conducted with 21 participants in Beijing and a county under Lanzhou City, China. Interview transcripts were systematically coded and emerging themes were developed from the codes. An inductive thematic analysis approach was utilized to analyze the interview data. Participants' perspectives on school-based CSA prevention programs included: (a) recognition of the importance of school-based CSA prevention programs; (b) fear about a possible negative impact on children participating in such programs; (c) assessment that school-based CSA prevention programs alone are not enough to prevent CSA. Components that participants thought needed to be part of Chinese school-based CSA prevention programs were: (a) content regarding online-facilitated CSA; (b) the use of a rights-based approach; and (c) greater parental and community involvement. Participants also identified factors that have both fostered the implementation of CSA research (e.g., the growing awareness of CSA in the central government) and prevented researchers from effectively conducting CSA research: (a) lack of national data; (b) inadequate government support; and (c) barriers to research collaboration among organizations. The findings indicate that while CSA prevention programs are on the whole regarded positively by key stakeholders in China, a number of important concerns were identified. Our study highlighted a number of ways in which future CSA prevention programs and research on CSA could be strengthened in the Chinese context.

Purpose– The purpose of this paper is to review the evidence base for effective public health interventions which aim to improve the diet of children aged zero to three years.Design/methodology/approach– General review.Findings– Key approaches and components of effective interventions include: repeated tasting, parental modelling, use of rewards, moderate restriction of "unhealthy" foods alongside an increase in portion sizes of fruits and vegetables, culturally appropriate messages, culturally acceptable health care provider, sufficient intensity of intervention, and an intervention which targets parental self-efficacy and modelling. Interventions which provide home visits (rather than require visits to a GP surgery or local community centre) financial incentives and/or mobile phone reminders may increase retention, particularly for some individuals. Recruiting mothers into programmes whilst they are pregnant may improve recruitment and retention rates.Originality/value– Allows for key public health interventions, approaches and components to be explored and identified. This will ensure that there is guidance to inform the development of new interventions for this age group and more importantly recommend that those components which are most successful be incorporated in policy and practice.

Purpose– The purpose of this paper is to describe the major factors affecting health during pregnancy, birth and the postnatal period and outline the evidence for interventions to improve outcomes in women and their children.Design/methodology/approach– Selective review of the literature. A number of electronic bibliographic databases were searched, including the Cochrane Database of Systematic Reviews, PubMed and PsycINFO, for relevant studies published since 1990. Papers were restricted to those published in English which presented data from studies conducted in high-income countries, with priority given to systematic reviews, randomised controlled trials and other quantitative studies which present a higher level of evidence.Findings– Many factors may affect maternal and infant health during and after pregnancy. Potentially modifiable factors with an evidence base to support intervention include improving diet, and the avoidance of smoking, alcohol and illicit drugs. Good clinical management of underlying illness is also important, along with attempts to engage women in improving health prior to conception and postnatally rather than once pregnancy is established.Research limitations/implications– The evidence base for interventions on some potentially modifiable risk factors is incomplete. There is good evidence of benefit from some health behaviours such as smoking cessation and uptake of breastfeeding and accumulating evidence of the benefit of some models of maternity care.Practical implications– Good maternal health during and after pregnancy plays a key role in giving the child a better start in life. Improved health behaviours are vital but often these are heavily dependent on social context and hence working to tackle social inequality and provide maternity care tailored to individual need is likely to be just as important as trying to directly alter behaviour.Originality/value– Pregnancy and the postnatal period present an opportunity to improve maternal health and have a positive effect on future child health. Greater investment is required in this antenatal period of life.

Purpose The purposes of this systematic review were to systematically summarize components in existing school-based child sexual abuse (CSA) prevention programs and identify predictors for program effectiveness. Method Building upon the most comprehensive systematic review on this topic, we conducted systematic searches in both English-language from September 2014 to October 2020 and Chinese-language from inception to October, 2020. Meta-regressions were performed to identify predictors for program effectiveness. Results Thirty-one studies were included with a total sample size of 9049 participants. Results from meta-analyses suggested that interventions are effective in increasing participants' CSA knowledge as assessed via questionnaires ( g = 0.72, 95% CI [0.52–0.93]) and vignette-based measures ( g = 0.55, 95% CI [0.35–0.74]). Results from meta-regression suggested that interventions with more than three sessions are more effective than interventions with fewer sessions. Interventions appear to be more effective with children who are 8 years and older than younger children. Discussion CSA is a global issue that has significant negative effects on victims' physical, psychological, and sexual well-being. Our findings also provide recommendations for future research, particularly in terms of optimizing the effectiveness of school-based CSA prevention programs, and the better reporting of intervention components as well as participant characteristics.