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Services For Children (services + for_children)
Kinds of Services For Children Selected AbstractsTreatment Acceptability of Healthcare Services for Children with Cerebral PalsyJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 5 2007Norm Dahl Background, Although treatment acceptability scales in intellectual and developmental disabilities research have been used in large- and small-scale applications, large-scale application has been limited to analogue (i.e. contrived) investigations. This study extended the application of treatment acceptability by assessing a large sample of care givers' perceptions of treatment for children with cerebral palsy (CP) in a real-world setting and tested if responses differed across child characteristics, type of medical service or respondent demographics. Method, One hundred and fifty four care givers' for children with CP rated the acceptability of treatments and related medical services by clinicians working in a multi-disciplinary children's specialty setting using Kazdin's (Journal of Applied Behavior Analysis, 13, 1980, 259) Treatment Evaluation Inventory. Results, There were significant (P < 0.05) differences between male and female respondents' ratings of treatment acceptability. There were no other significant differences for caregiver ratings in relation to child characteristics, type of appointment, severity of CP or other respondent demographic characteristics. Conclusion, Mothers and fathers of children with developmental disabilities may differ in their perceptions of the acceptability of medical treatment services for children with developmental disabilities. Future studies addressing treatment acceptability should expand the scope of demographic information assessed and include items specific to the roles respondents have in providing and coordinating therapeutic regimens for their children's medical needs. [source] Revisiting the Emergency Medicine Services for Children Research Agenda: Priorities for Multicenter Research in Pediatric Emergency CareACADEMIC EMERGENCY MEDICINE, Issue 4 2008Steven Zane Miller MD Abstract Objectives:, To describe the creation of an Emergency Medical Services for Children (EMSC) research agenda specific to multicenter research. Given the need for multicenter research in EMSC and the unique opportunity afforded by the creation of the Pediatric Emergency Care Applied Research Network (PECARN), the authors revisited existing EMSC research agendas to develop a PECARN-specific research agenda. They sought to prioritize PECARN research efforts, to guide investigators planning to conduct research in PECARN, and to describe the creation of a prioritized EMSC research agenda specific for multicenter research. Methods:, The authors used the Nominal Group Process and Hanlon Process of Prioritization (HPP), which are recognized research prioritization methods incorporating both quantitative and qualitative data collection in group settings. The formula used to generate the final priority list heavily weighted practicality of conduct in a multicenter research network. By using size, seriousness, and practicality measures of each health priority, PECARN was able to identify factors that could be scored individually and were weighted relative to each other. Results:, The prioritization processes resulted in a ranked list of 16 multicenter EMSC research topics. Top among these priorities were 1) respiratory illnesses/asthma, 2) prediction rules for high-stakes/low-likelihood diseases, 3) medication error reduction, 4) injury prevention, and 5) urgency and acuity scaling. Conclusions:, The PECARN prioritization process identified high-priority EMSC research topics specific to multicenter research. PECARN has the capacity to answer long-standing, important clinical controversies in EMSC, largely due to its ability to conduct randomized controlled trials and observational studies on a large scale. [source] Decision-making in community-based paediatric physiotherapy: a qualitative study of children, parents and practitionersHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2006Bridget Young BA PhD Abstract Approaches to practice based on partnership and shared decision-making with patients are now widely recommended in health and social care settings, but less attention has been given to these recommendations in children's services, and to the decision-making experiences of non-medical practitioners and their patients or clients. This study explored children's, parents' and practitioners' accounts of shared decision-making in the context of community-based physiotherapy services for children with cerebral palsy. Semi-structured interviews were conducted with 11 children with cerebral palsy living in an inner city area of northern England, and with 12 of their parents. Two focus groups were conducted with 10 physiotherapy practitioners. Data were analysed using the constant comparative method. When asked explicitly about decision-making, parents, children and practitioners reported little or no involvement, and each party saw the other as having responsibility for decisions. However, when talking in more concrete terms about their experiences, each party did report some involvement in decision-making. Practitioners' accounts focused on their responsibility for making decisions about resource allocation, and thereby, about the usefulness and intensity of interventions. Parents indicated that these practitioner-led decisions were sometimes in conflict with their aspirations for their child. Parents and children appeared to have most involvement in decisions about the acceptability and implementation of interventions. Children's involvement was more limited than parents'. While parents could legitimately curtail unacceptable interventions, children were mostly restricted to negotiating about how interventions were implemented. In these accounts the involvement of each party varied with the type of issue being decided and decision-making appeared more unilateral than shared. In advocating shared decision-making, greater understanding of its weaknesses as well as its strengths, and greater clarity about the domains that are suitable for a shared decision-making approach and the roles of different parties, would seem a helpful step. [source] A retrospective study of treatment provided in the primary and secondary care services for children attending a dental hospital following complicated crown fracture in the permanent dentitionINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2000A. Maguire Objectives. To investigate treatment provision in primary and secondary dental care following complicated crown fracture of permanent teeth. Design and methods. Retrospective observational survey of dental records of all patients attending a dental hospital trauma clinic during a 2-year period with complicated crown fracture. Results. Eighty children (70% male) aged 6,16 years (mean age 10·3 years) with 98 complicated crown fractures were identified. Of these children, 54% were seen for emergency treatment on the day of their injury, 75% within 48 h. Of the 98 injured teeth, 60% were seen initially in general dental practice but only 56% of these 59 cases were provided with emergency treatment in practice, the others being referred immediately to the trauma clinic for treatment. The main cause of fractures was transport, in particular, bicycles. Radiographs were available for 96 teeth; for the 43 open apex teeth, the definitive treatment was pulp capping (44% of cases) and pulpotomy (30%), with vitality maintained in five cases up to 4·8 years after trauma. The 53 closed apex cases were treated definitively with pulp capping (38%) and pulpectomy (36%) and six teeth had maintained their vitality up to 4·3 years after trauma. Sixty-seven per cent of the pulp caps and 47% of the 19 pulpotomies provided relied on a doubtful coronal seal. This was primarily due to the extensive use of a conventional glass ionomer cement as an emergency bandage. The use of an etched or bonded material at initial presentation extended the Median Survival Time for vitality in open apex teeth from 188 to 377 days and in closed apex teeth from 15 to 64 days. Conclusions. Emergency treatment of complicated crown fractures, particularly in primary care services is often inappropriate or inadequate with regard to emergency management of the exposed pulp and provision of a hermetic coronal seal. [source] Treatment Acceptability of Healthcare Services for Children with Cerebral PalsyJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 5 2007Norm Dahl Background, Although treatment acceptability scales in intellectual and developmental disabilities research have been used in large- and small-scale applications, large-scale application has been limited to analogue (i.e. contrived) investigations. This study extended the application of treatment acceptability by assessing a large sample of care givers' perceptions of treatment for children with cerebral palsy (CP) in a real-world setting and tested if responses differed across child characteristics, type of medical service or respondent demographics. Method, One hundred and fifty four care givers' for children with CP rated the acceptability of treatments and related medical services by clinicians working in a multi-disciplinary children's specialty setting using Kazdin's (Journal of Applied Behavior Analysis, 13, 1980, 259) Treatment Evaluation Inventory. Results, There were significant (P < 0.05) differences between male and female respondents' ratings of treatment acceptability. There were no other significant differences for caregiver ratings in relation to child characteristics, type of appointment, severity of CP or other respondent demographic characteristics. Conclusion, Mothers and fathers of children with developmental disabilities may differ in their perceptions of the acceptability of medical treatment services for children with developmental disabilities. Future studies addressing treatment acceptability should expand the scope of demographic information assessed and include items specific to the roles respondents have in providing and coordinating therapeutic regimens for their children's medical needs. [source] Rural telepsychology services for children and adolescentsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2010Eve-Lynn Nelson Abstract Because of the overwhelming maldistribution of mental health specialists in metropolitan areas and the many underserved families living in rural settings, rural areas are natural homes for the use of telemedicine or videoconferencing technology for clinical services. The authors describe telepsychology services for rural clients, placing best psychology practices within the context of broader telemental health services. The goal is to approximate evidence-based child psychotherapy from face-to-face practice using the videoconferencing technology. Telepsychology is illustrated with a case report of a rural Hispanic teen and her family presenting through the teen's primary care clinic. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,12, 2010. [source] Parental attitudes to health of children in child-care centres and options when children are illJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2000L M Slack-Smith Objective: To determine parental attitudes regarding the health of children attending child-care centres, to explore concerns when children who normally attend child care are ill, and to investigate options in these circumstances. Methodology: Focus groups conducted with parents whose children attended child-care centres. Ten focus groups were conducted. Results: Many parents encountered difficulty when children who normally attend child care were ill and there was a lack of options for care. Parents were concerned about the spread of infections among children but considered that there were also many health and other advantages for their children in attending child care. Child-care centres were perceived as providing a valuable support role for families. Conclusions: Many parents lack adequate options for care when their children are ill. Parents' concerns regarding health in child care are important in policy decisions regarding the health of children in child care, and the development of alternative care services for children. [source] Eclecticism in health services for developmental disordersJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2000M McDowell Abstract: The term ,eclectic', as applied to health care for children with developmental disorders, portrays an individualized, adaptive service response to local constraints and pressures. While this may appear appropriate for the local setting, the end result is a broad diversity of health care approaches. This paper discusses three separate processes that interact at a local level, increasing the likelihood of an eclectic local model of health care for this population of children. The first process draws from the direct clinical work. Variable training, knowledge and skills among health care providers, in combination with differing beliefs around the nature of the problems and their management leads to health care which directly reflects the attributes of the local clinicians. A separate, second process fuelling variability is the differing models of departmental responsibility across Australia , which Government departments fund which aspect of care for children with disabilities. The final process relates to funding streams for health care. State public health, federal Medicare and private insurance all support health services for children with disabilities, with the financial incentives (budgets compared to fee-for-service) driving a divergence of practice. This paper concludes that the external political, administrative and financial frameworks within which health care is constructed will continue to promote clinical eclecticism to a degree that would probably be considered unacceptable in other areas of child health care. The solution can only arise from within the clinical work itself, with greater clarity of understanding around the nature of the disorders, the outcomes for which health care takes responsibility, and an increasing focus on an evidence based set of approaches towards achieving these. [source] Comparative Policy Brief: Status of Intellectual Disabilities in the Republic of ZambiaJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 2 2008James Mung'omba Abstract, In the Republic of Zambia, an estimated 256,000 persons have some form of disability, and of these, 5.4% have intellectual disabilities. Even now, traditional beliefs about the etiology of intellectual disabilities persist and considerable stigma is attached to the presence of persons with intellectual disabilities who are often excluded from community life. Recently, antidiscrimination legislation has been enacted and there is a policy related to pupils with special educational needs. Although a range of Zambian and international nongovernmental organizations and church groups have developed services for children and their families, their impact is impeded by widespread poverty. Adults remain vulnerable, with no entitlement to social welfare benefits and very limited access either to government-led trust funds for persons with disabilities or to employment. The most striking issue is poverty (Zambia is one of the world's poorest nations) and an absence of even basic support for people with intellectual disabilities outside of families. Other key issues include a lack of useful data, no specific policy related to persons with intellectual disabilities, and limited progress in achieving education for all. [source] A Review of Outcome Measures in Early Childhood ProgramsJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 4 2006Hasheem Mannan Abstract, The authors undertook a review of measures available for assessing outcomes of early childhood services for children with disabilities and their families. With principles of family-centered practice mandating the inclusion of both family and child outcome measures in effective evaluation plans, the review examined measures with established psychometric properties for (a) documenting the effectiveness of partnerships with families, and (b) documenting the effectiveness of services and supports for families. Constructs and their associated measures related to partnerships include satisfaction with the overall program and empowerment. The constructs for outcomes of supports and services include social support, parenting, and family quality of life. The authors reviewed measures for each of the five constructs. They note that the selection of appropriate measures to assess the outcomes of family support and services depends on the specific configuration of support services provided by the program and that each program may have to be explicit about the outcomes it wants to impact and therefore measure. [source] Early Intervention in an International PerspectiveJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2006Michael J. Guralnick Abstract, The importance and potential value of a worldwide commitment to provide comprehensive early intervention services for children at risk for or with identified intellectual disabilities are considered in the context of this special issue on early intervention. Further refinement of policies and advances in effective practices will result through the application of relevant research findings, through the development and implementation of comprehensive professional training programs, and through model program development with corresponding efforts to bring programs to scale. Articles in this special issue are discussed as representing major early intervention themes in the international community. [source] Learning Disabilities in Taiwan: A Case of Cultural Constraints on the Education of Students with DisabilitiesLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 3 2007Shih-Jay Tzeng Learning disabilities (LD) has been recognized as a category of special education in Taiwanese law since 1984, and policies ensure educational services for children and youth who have LD. The official definition and identification criteria established in Taiwan's laws closely correspond with those of the United States, but practice differs, largely influenced by the people's cultural and linguistic background. I discuss these legal and cultural features as well as other matters (e.g., growth and change in professional literature on LD). Compared to economically developed countries such as the United States, the educators in Taiwan implement identification procedures, placement, and services at a lower cost. Contents of implementation are introduced in detail. The prevalence rate of LD has been very low (<1 percent). I examine culture- and/or society-specific reasons for low prevalence, such as Chinese orthography, regular teachers' compliance with referral procedures, the education-first belief of parents, and problems with identification procedures. [source] The Importance of Context in Fostering Responsive Community Systems: Supports for Families in Systems of CareAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2010James R. Cook The importance of helping families of children with severe emotional disturbances (SED) connect with informal or natural supports,that is, individuals who are part of their ongoing communities and daily lives,has been widely recognized. Utilization of informal supports has thus become a core element within systems of care (SOCs) designed to improve services for children with SED and their families. However, research demonstrates that implementation of wraparound, the key practice approach within SOCs, often does not include involvement of informal supports. Using a measure of social connectedness (SC), developed to augment the instruments used for the SOC national evaluation, this study assessed parents' and caregivers' views of their connections to and support from their community within a SOC. Overall, parents and caregivers reported low levels of support across multiple sources as well as a desire for more support. Greater levels of perceived support related positively to caregiver strain, types of and satisfaction with services received, and views of their communities as supportive and safe. Greater attention to families' contexts and the identification of effective ways to connect families to their communities are recommended. [source] The school-based health center as a resource for prevention and health promotionPSYCHOLOGY IN THE SCHOOLS, Issue 1 2008Michael B. Brown The importance of school-based health centers (SBHCs) in overall prevention and health promotion programming is growing as they become increasingly common in schools. SBHCs can improve access to comprehensive physical and mental health services for children and families, and make a significant contribution to universal prevention efforts in schools. Partnering with school-based health centers in the overall prevention and health promotion programming provides an opportunity for school psychologists to broaden their impact on the entire school population. This article describes the role and primary functions of SBHCs and how these centers can provide important prevention and health promotion services for children and adolescents. Research regarding SBHCs' primary prevention outcomes is also reviewed with the goal of providing school psychologists the necessary background to work collaboratively with SBHCs. © 2007 Wiley Periodicals, Inc. [source] School-based health centers: Strategies for meeting the physical and mental health needs of children and familiesPSYCHOLOGY IN THE SCHOOLS, Issue 3 2003Michael B. Brown School-based health centers are fast becoming a part of mainstream health care in the United States. The centers provide enhanced access to comprehensive physical and mental health services for children and families. Although originally established in urban areas, they can also have a significant impact on service delivery for children in rural and suburban areas. This manuscript describes the role and primary functions of school-based health centers, describes several important issues in developing and implementing the centers, and reviews the effectiveness of services provided through school-based health centers. School psychologists are in an excellent position to provide leadership for the establishment of school-based health centers. Participation in school-based health services delivery enables school psychologists to expand their role and broadens both their client population and the range of services. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 279,287, 2003. [source] Children's experiences with chat support and telephone supportTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 6 2009Ruben G. Fukkink Background:, In line with the wider trend of offering support via the Internet, many counseling and referral services for children have introduced online chat, often in addition to a traditional telephone service. Methods:, A comparative study was conducted between the telephone service and the confidential one-on-one online chat service of the Dutch Kindertelefoon. The design included a concise pretest and a posttest (n = 902). The study also comprised a follow-up test (n = 213), which included the Strengths and Difficulties Questionnaire. Results:, Children experienced a higher sense of well-being and a reduced severity of their problems after consulting the Kindertelefoon. The results were slightly more favorable for the chat service than for the telephone service. The follow-up survey showed that many of the children who contact the Kindertelefoon suffer from relatively severe emotional problems. Conclusions:, Both the telephone and the web-based support improved the children's well-being and decreased their perceived burden of problem. The results of this study underline the need for closer cooperation between child helplines and mental health and child welfare services. [source] Do Children in Rural Areas Still Have Different Access to Health Care?THE JOURNAL OF RURAL HEALTH, Issue 1 2009Results from a Statewide Survey of Oregon's Food Stamp Population ABSTRACT:,Purpose: To determine if rural residence is independently associated with different access to health care services for children eligible for public health insurance. Methods: We conducted a mail-return survey of 10,175 families randomly selected from Oregon's food stamp population (46% rural and 54% urban). With a response rate of 31%, we used a raking ratio estimation process to weight results back to the overall food stamp population. We examined associations between rural residence and access to health care (adjusting for child's age, child's race/ethnicity, household income, parental employment, and parental and child's insurance type). A second logistic regression model controlled for child's special health care needs. Findings: Compared with urban children (reference = 1.00), rural children were more likely to have unmet medical care needs (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.07-2.04), problems getting dental care (OR 1.36, 95% CI 1.03-1.79), and at least one emergency department visit in the past year (OR 1.42, 95% CI 1.10-1.81). After adjusting for special health care needs (more prevalent among rural children), there was no rural-urban difference in unmet medical needs, but physician visits were more likely among rural children. There were no statistically significant differences in unmet prescription needs, delayed urgent care, or having a usual source of care. Conclusions: These findings suggest that access disparities between rural and urban low-income children persist, even after adjusting for health insurance. Coupled with continued expansions in children's health insurance coverage, targeted policy interventions are needed to ensure the availability of health care services for children in rural areas, especially those with special needs. [source] Time use, parenting practice and conduct problems in four- to five-year-old Australian childrenAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 5 2010Mong-Lin Yu Background:, Conduct problems (CoP) represent one of the most common mental health issues manifesting in childhood, with the potential to influence the developmental trajectory of children negatively. Early identification of children at risk of developing CoP is a key strategy to their effective management. Evidence suggests that parenting practices are important contributors to CoP; however, these practices can also interact with the activities in which children engage and these have not yet been addressed in combination. Method:, A cross-sectional study of a nationally representative sample of 4936 four- to five-year-old children from Wave 1 of the Longitudinal Study of Australian Children was undertaken to examine the relationship between CoP, parenting practices and time use. Results:, All children were at a lower risk of CoP if they were exposed to less hostile and consistent parenting practices and if they did not have sleep problems as reported by their parents. However, boys were more vulnerable if they had fathers who had not undertaken tertiary education, and spent more time in risk-oriented physical activities. Conclusion:, Parenting practices are affirmed as a significant independent predictor of risk for developing CoP. The nature of activities in which children engaged, particularly boys, also has the potential to influence the manifestation of CoP. Occupational therapy services for children with CoP are best provided in the context of family-centred practice and should incorporate an examination of daily time use. [source] The role of the adult urologist in the care of children: findings of a UK surveyBJU INTERNATIONAL, Issue 1 2001D.F.M. Thomas Objective To document the current role of adult urologists in the care of children in the UK and to consider the future provision of urological services for children within the context of published national guidelines. Methods A detailed postal questionnaire was sent to all 416 consultant urologists listed as full members of the British Association of Urological Surgeons and resident in the UK. The range of information sought from each urologist included details of personal paediatric training, scope of personal practice, and information about facilities and provision of urological services for children in their base National Health Service hospital. Results The response rate was 69%; most consultant urologists (87%) in District General Hospitals (DGHs) undertake paediatric urology, mainly routine procedures of minor or intermediate complexity. Of urologists in teaching hospitals, 32% treat children but their involvement is largely collaborative. Consultants appointed within the last 10 years are less willing to undertake procedures such as ureteric reimplantation or pyeloplasty than those in post for ,10 years. Currently, 18% of DGH urologists hold dedicated children's outpatient clinics and 34% have dedicated paediatric day-case operating lists. Almost all urologists practise in National Health Service hospitals which meet existing national guidelines on the provision of inpatient surgical care for children. Conclusion Urologists practising in DGHs will retain an important role as providers of routine urological services for children. However, the tendency for recently appointed consultants to limit their practice to the more routine aspects of children's urology is likely to increase. Training and intercollegiate assessment should focus on the practical management of the conditions most commonly encountered in DGH practice. The implementation of national guidelines may require greater paediatric subspecialization at DGH level to ensure that urologists treating children have a paediatric workload of sufficient volume to maintain a high degree of surgical competence. [source] An increase in the prevalence of type 1 and 2 diabetes in children and adolescents: results from prescription data from a UK general practice databaseBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 2 2009Yingfen Hsia WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT , Increasing antidiabetic drugs use in youths has been reported in the USA, however there is a lack of epidemiological evidence in the UK. , There is an increase in the prevalence of both type 1 and 2 diabetes, but precise estimates are difficult to obtain and as such are uninformative for future health services planning. WHAT THIS STUDY ADDS , The prevalence of children receiving insulin and oral antidiabetic drugs has increased twofold and eightfold, respectively, between 1998 and 2005. , The data reflect the prevalence of both type 1 and type 2 diabetes rapidly increase in recent years. , The prevalence of antidiabetic drug use increases with increasing age, especially among those aged 12,18 years. , Consideration needs to be given to the funding and design of future services for children and particularly adolescents with diabetes to take account of these epidemiological findings. AIMS Despite evidence of an increase in the incidence of both type 1 and type 2 diabetes in youths, there are few data on the prevalence of either type in children and adolescents. The aim of this study was to investigate the prevalence of childhood diabetes over an 8-year period in the UK. METHODS This was a retrospective cohort study that covered 8 years (January 1998 to December 2005) of UK IMS Disease Analyzer (IMS DA) data. The cohort comprised all children and adolescents aged 0,18 years who received at least one antidiabetic drug prescription during the study period. The prevalence of antidiabetic drug prescribing was used as a proxy for diabetes itself. RESULTS Data were available on 505 754 children aged 0,18 years and a total of 37 225 antidiabetic prescriptions were issued. Insulin use increased significantly from 1.08 per 1000 children [95% confidence interval (CI) 0.96, 1.20] in 1998 to 1.98 (95% CI 1.80, 2.10) in 2005 (P < 0.001), more markedly in those aged 12 and 18 years. The use of oral antidiabetic drugs for diabetes treatment rose significantly from 0.006 per 1000 children in 1998 (95% CI 0.0043, 0.017) to 0.05 (95% CI 0.025, 0.080) (P < 0.001) in 2005. CONCLUSIONS This study indicates a significant increase in prevalence on both type 1 and type 2 diabetes treatment in children and adolescents in the UK. Thus, this supporting evidence from other sources that the prevalence of childhood diabetes is rising rapidly. Further epidemiological studies are required to investigate the aetiology and risk factors. [source] Schools: Central to Providing Comprehensive CAMH Services in the Future?CHILD AND ADOLESCENT MENTAL HEALTH, Issue 3 2008Gill Salmon It is now widely agreed that meeting the mental health needs of children and young people is a task only possible if all children's services work together. Recent epidemiological data indicate that schools are a key entry point to mental health services for children and young people, and have an important role in the assessment and management of children with neurodevelopmental disorders. This paper explores the rationale for collaborative working between health and educational professionals, examines some examples of good practice, explores factors contributing to their success or failure and considers future developments. [source] Evaluation of the processes of family-centred care for young children with intellectual disability in Western AustraliaCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2010A. Wilkins Abstract Introduction Government early intervention services for children with intellectual disability (ID) in Western Australia have adopted the model of family-centred care. The aim of this study was to evaluate how well it was being practised, to describe the pattern of service utilization and to identify factors influencing parental perceptions of family-centred care. Methods The study included children aged 0,6 years with ID, who were registered clients of Disability Services Commission, Western Australia. Parents completed a postal survey questionnaire about the frequency and type of services received and their perceptions of services using the Measure of Processes of Care (MPOC-56) questionnaire. Mean scores for the five MPOC domains were compared using anova against the independent variables of child age group, child diagnostic group, service type and frequency, place of residence, family and demographic variables. Significant variables in each domain were then entered into multivariate analyses. Results Of 292 eligible families, 165 (59%) returned a completed questionnaire. While over 50% of children had contact with occupational, speech and physical therapists at least once per month, less than 20% of children had at least annual contact with either psychology or dental services. Families rated their satisfaction highest for ,respectful and supportive care' and lowest for ,providing general information'. Individual item analyses indicated less satisfaction with ,co-ordinated and comprehensive care'. Higher means were associated with more frequent contact with occupational therapy. Conclusion Overall respondents reported early intervention services for young children with ID in Western Australia provided satisfactory family-centred care by means of the 56-item MPOC. The frequency of contact with allied health professionals was positively associated with parental ratings of family-centred care. The study indicates under-servicing in dental care and psychology services. [source] Parental satisfaction with follow-up services for children with major anatomical congenital anomaliesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2010M. Van Dijk Abstract Background Since 1999 a multidisciplinary follow-up programme for parents and children with major anatomical congenital anomalies is in place in our hospital, run by a dedicated team. The aim of the present study was to evaluate the services of this team from a parental perspective. Methods Parents completed a questionnaire including open and closed questions about satisfaction with the various professional disciplines involved in the follow-up, statements on usefulness of the follow-up services and suggestions for improvement. Results Four hundred and sixty-nine surveys were sent out, of which 71% were returned. Non-responding parents included significantly more parents of non-Dutch origin (P= 0.038) and parents who never responded to invitations for follow-up examinations (P < 0.001). Parental satisfaction differed for the various disciplines. Eighty per cent of the parents were (very) satisfied with the social worker, compared with 92% with nurses. More than half of the parents agreed that the follow-up services give peace of mind. Almost a quarter of parents, however, considered the follow-up services as redundant. The children of these parents had significantly shorter intensive care unit stay (P= 0.02), were older at the time of the questionnaire (P= 0.04), of higher socio-economic status (P= 0.001) and less likely to be of non-Dutch origin (P= 0.008). Sixty-one per cent of the parents had contacted the 24-h helpline. Ninety per cent of the parents were satisfied with the intensive care unit, almost 80% with the general ward. Conclusion Overall, parents were satisfied with the services of the follow-up team. Some parents, however, saw room for improvement related to better communication, recognizability of the team and better planning and organization. [source] ,Jumping through hoops': parents' experiences with seeking respite care for children with special needsCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2009J. L. Doig Abstract Background Respite care may act as a means to reduce stress and fatigue in people caring for a dependent who has a disability. Despite this, a variety of barriers may exist to obtaining such services. This study explored caregivers' experiences seeking respite care for their children with special needs within a province in Canada. Methods Caregivers were recruited from two agencies providing respite care for children with fetal alcohol spectrum disorders and other mental health and developmental difficulties. In total, 10 caregivers participated in in-depth individual interviews. A constructivist grounded theory approach was employed in the design and analysis of the data. Results Caregivers discussed their frustrations with the process of finding and obtaining respite care, a course of action described as ,jumping through hoops'. This construct was composed of subcategories emphasizing the complexity of ,navigating the system', the bidirectional process of ,meeting the requirements' and the challenges of ,getting help'. Conclusions The collective experiences of these caregivers point to the need for more flexibility and co-ordination of respite care services for children with special needs. [source] Listen to me, too!CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2007Lessons from involving children with complex healthcare needs in research about multi-agency services Abstract Background, Children with complex healthcare needs are often excluded, both from active involvement in research projects and from direct consultation in services. During a 3-year research study into multi-agency services for children with complex healthcare needs, the authors involved children in a number of innovative ways and endeavoured to discover what impact, if any, multi-agency working made to them. Methods, The researchers ,spent time' with 18 children with complex healthcare needs. They used a variety of methods to engage with the children in a meaningful way. More than half of the children had no verbal communication, so it was necessary in some cases to work with an advocate, usually the parent, to aid the process. Results, Children with complex healthcare needs can take part in research as long as the research is set up sensitively and flexibly. In terms of the impact of multi-agency working, the authors concluded significant advances had been achieved for this group: almost all the children were living at home and attending school. However, there were significant gaps in addressing children's human rights in relation to communication, independence and relationships. In addition, many of the children had very little effective direct consultation with the multi-agency services. Conclusions, There are significant advances in involving disabled children in research and in service delivery, but there is still some way to go in involving those with complex healthcare needs. The challenges are considerable, but the benefits far outweigh these, not least being the value that parents, carers and the children themselves place upon being listened to. [source] Waiting time for rehabilitation services for children with physical disabilitiesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2002D. Ehrmann Feldman Abstract Background Early rehabilitation may minimize disability and complications. However, children often wait a long time to gain admission to rehabilitation centres. Objectives To describe waiting times for paediatric physical and occupational therapy and to determine factors associated with these waiting times. Research Design The study was a prospective cohort design. Patients were followed from 1 January 1999 to 1 March 2000. Subjects All children with physical disabilities, aged 0,18 years, referred in 1999 from the Montreal Children's Hospital to paediatric rehabilitation centres. Measures Data on date of referral, date of first appointment at the rehabilitation centre, age, gender, diagnosis, region and language were obtained from the rehabilitation transfer database. Primary family caregivers of children who were transferred to a rehabilitation facility participated in a telephone interview regarding their perceptions of the transfer process. Results There were 172 children referred to rehabilitation facilities. The mean age of the children was 2.5 years. Average waiting time was 157.4 days (SD 57.1) for occupational therapy and 129.4 days (SD 51.6) for physical therapy. Decreased waiting time was associated with living in the city as opposed to the suburbs (hazard ratio = 1.77; 95% confidence interval = 0.92,3.41) and inversely associated with age (hazard ratio = 0.46; 95% confidence interval = 0.34,0.62). Among the 41 primary family caregivers who participated in the survey, higher empowerment scores were associated with shorter waits for rehabilitation. Conclusion Waiting time for rehabilitation services needs to be reduced. Empowered parents appear to manoeuvre within the system to reduce waiting times for their children. [source] Child psychiatric skills in primary healthcare , self-evaluation of Finnish health centre doctorsCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2002A. Heikkinen Abstract Objective To study Finnish general practitioners' (GP's) perceptions of their child psychiatric skills. Methods The study sample consisted of physicians (n = 755) working in health centres situated in the special response area of the Tampere University Hospital, Finland. They were requested to assess their competence in 16 areas on a four-step Likert scale. The response rate was 66.1% (n = 499). Results Physicians evaluated their child psychiatric skills as inadequate on many issues. The ability to identify depression was poorer the younger the child in question. Only a minority (14%) felt they were well able to identify a depressed infant. Many physicians considered themselves poorly skilled in assessing the relationship between infant and parents (39.8%), in assessing a child's need for psychiatric treatment (42.7%) and in identifying a child with attention-deficit disorder (40.7%). A majority (75.9%) rated their skills poor in co-operating with daycare personnel or school staff in matters concerning a child with conduct disturbance. Only 26.8% could assess the necessity of taking a child into custody. Women gave higher ratings of their skills in identifying depressed infants and in assessing the infant,parent relationship than men, whereas men assessed their skills as better in cases in which there were problems in co-operation with parents. Conclusions In order to provide good psychiatric services for children, attention should be paid to the GPs' child psychiatric skills. [source] Developing Responsive Preventative Practices: Key Messages from Children's and Families' Experiences of the Children's FundCHILDREN & SOCIETY, Issue 2 2008Katherine Pinnock As part of the prevention and social inclusion agenda, the Children's Fund, set up in 2000, has developed preventative services for children at risk of social exclusion. Drawing on a large qualitative dataset of interviews conducted in 2004/05 with children, young people and their parents/carers who accessed Children Fund services, this article analyses key practices and approaches valued by children and parents. These included: specialist support tailored to individual support needs, family-oriented approaches, trusting relationships with service providers, multi-agency approaches and sustainability of services. Finally, the article draws out key lessons for the future development of preventative services. [source] The Area and Community Components of Children's Well-beingCHILDREN & SOCIETY, Issue 5 2006Gordon Jack Until recently, mainstream services for children in the UK have largely relied upon individual and reactive approaches to safeguarding children's welfare. However, recent legislative and policy reforms require the development of a more preventive orientation, capable of promoting the well-being of all children. This will require that agencies responsible for the integrated delivery of children's services develop strategies that, for the first time, take full account of the area and community components of children's well-being. The challenges presented by these reforms, to existing organisational and professional cultures and ways of working, are examined in the light of recent research evidence. Copyright © 2006 The Author(s). [source] Early multiple intervention: a view from On TrackCHILDREN & SOCIETY, Issue 2 2005Jean Hine On Track started life in 2000 as part of the Crime Reduction Programme in the Home Office, but was shifted to the Children and Young People's Unit less than a year later. This paper describes tensions that emerged during the first phase of the evaluation of this innovative programme, designed to provide interventions for four to twelve year olds at risk of becoming involved in crime. Analysis of interventions and multiple intervention is presented, together with reflections on the need for a different kind of evaluation and a more positive approach to services for children and young people. [source] | ||||||||||||||||||||||||||||