Child & Youth Care Forum

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Factor structure for the Short-BESAA-S model (14 items). (Note: AVE = Average Variance Extracted)
Article
  • Lucia Beltrán-GarrayoLucia Beltrán-Garrayo
  • Esther Mercado-GarridoEsther Mercado-Garrido
  • Francisco Javier RománFrancisco Javier Román
  • [...]
  • Ana Rosa SepúlvedaAna Rosa Sepúlveda
Background “How do I perceive my own body?“ is a central question during adolescence, which addresses the subjective assessment of body image, called Body Esteem. Although concern about body esteem increases during adolescence, there is a lack of psychometrically validated measures to assess it specifically among Spanish adolescents. Objective This study aims to validate the Body-Esteem Scale for Adolescents and Adult populations (BESAA), a widely used measure of body esteem across cultures, among the Spanish adolescent population. Methods The cross-cultural adequacy and acceptability of the Argentinian-Spanish version by Forbes et al., (2012) were pilot tested and the questionnaire was completed by 1,258 students (Mage = 15.56). Next, several psychometric analyses were carried out: exploratory (AFE) and confirmatory (CFA) factorial structure, convergent and discriminant validity, nomological validity, internal consistency, and temporal reliability. Results The AFE and CFA supported a reduced Spanish version of the BESAA of 14 items (BESAA-S) and maintained the original three-factor structure (BE-Weight, BE-Appearance, and BE-Attribution subscales). The BESAA-S showed acceptable internal consistency and strong test-retest reliability. Discriminant validity between subscales was appropriate, and convergent validity was appropriate except for the BE-Attribution subscale. Nomological validity was supported through significant correlations with body appreciation, general self-esteem, sociocultural attitudes towards appearance, and disordered eating symptoms. Body esteem was negatively associated with weight status. Conclusions This study presents a culturally appropriate, shortened Spanish BESAA as a reliable instrument for body esteem assessment among Spanish speaking adolescents.
 
Flowchart of Participants Through the Study
Diagrammatic Representation of Themes
Article
  • C JewellC Jewell
  • A WittkowskiA Wittkowski
  • S CollingeS Collinge
  • Daniel PrattDaniel Pratt
Background Parent-only psychological interventions can be effective treatments for child anxiety. Involving parents in treatment may be beneficial for children, ensuring that interventions are delivered effectively in a supportive environment. Few studies have investigated the feasibility and acceptability of parent-only interventions for child anxiety. Objective In this study, we report on feasibility, acceptability and preliminary clinical outcomes of a brief cognitive behavioural group intervention for parents of children (4- to 10-years-olds) experiencing anxiety in the absence of a diagnosed anxiety disorder. Method Parent participants attended a three-session group intervention delivered online. We collected feasibility information (recruitment and retention rates); parents and children (when appropriate) completed acceptability and clinical outcome measures after each session. Participants were also interviewed about the acceptability of the intervention and study processes. Results Nineteen parents consented to take part (child mean age 6.47, SD 1.23). Participant retention rates (68.4%) and intervention satisfaction (total mean CSQ score 28.52) were high . Calculated effect sizes were moderate to large for parent-rated outcomes, small for child self-reported anxiety, and small to moderate for parent confidence/efficacy. Thematic analysis of interview data identified benefits, such as connecting with parents and learning strategies, as well as challenges associated with the intervention. Conclusions Attendance appeared to be associated with positive changes for parents and children. Overall, participants found this to be an acceptable and useful intervention. These findings demonstrated the potential benefit of a brief intervention for parents of anxious children. A larger trial is required to further investigate these preliminary findings.
 
Article
Background: Technology and its use within mental health services has advanced dramatically over recent years. Opportunities for mental health services to utilise technology to introduce novel, effective, and more efficient means of delivering assessment, and treatment are increasing. Objective: The current rapid-evidence paper reviews evidence regarding the introduction of novel technology to support young people’s mental health and psychological well-being. Methods: A rapid evidence review was conducted. PSYCHINFO and CINAHL were searched for research articles between 2016 and 2021 that were specific to young people, mental health, and technology developments within this domain... N = 27 studies which explored the introduction, feasibility, and value of technology for mental health purposes were included in a narrative synthesis. Quality or risk of bias analyses were not completed. Results: Overall, technological advancements in young people’s care were considered positive and engaging for young people. Factors including resources, efficiency of care, engagement, therapeutic effectiveness, ethical considerations, therapeutic alliance, and flexibility were considered within this review. Nevertheless, potential barriers include clinician concerns, socioeconomic factors and motivation. Conclusion: Effective and sustained use of technology within young people’s mental health services will depend on the technology’s usability, efficiency, and ability to engage young people. This paper expands on existing research by reviewing a broader range of technology proposed to support young people’s mental health and well-being. This will assist in the application of novel technological advancements by indicating effectiveness, preferences, potential barriers, and recommendations for the feasibility and efficacy of introducing technology into young people’s services.
 
Barriers to Treatment Questionnaire - Latina/o/x Caregivers Global Model (N = 598)
Barriers to Treatment Questionnaire - Latina/o/x Caregivers Three Factor Model (N = 598)
Article
Background Knowledge regarding barriers faced by Latina/o/x caregivers in accessing youth mental health services (MHS) have largely depended on resource intensive interview-based assessments. Objective We evaluated a questionnaire for Latina/o/x caregivers of youths that presents a briefer and more feasible alternative. Method We conducted a psychometric evaluation of the Barriers to Treatment Questionnaire - Latina/o/x Caregivers (BTQ-LC) with a sample of 598 Latina/o/x caregivers from across the United States. Descriptive statistics and confirmatory factor analyses were used to identify common barriers to services, confirm the factor structure of the scale, and establish construct validity. Results Descriptive statistics suggest that not knowing where and how to access services, and normalization of youth psychopathology were the most frequently reported barriers among caregivers of youth with clinically elevated problems on the CBCL. Confirmatory factor analysis suggests that the BTQ-LC was best represented by a three-factor structure: (1) structural, (2) perceptions regarding mental health problems, and (3) services. Our finding suggest that the BTQ-LC could also be used as a single factor as fit indices ranged from acceptable to poor. BTQ-LC scales were all negatively correlated with the utilization of common youth MHS (i.e., psychological counseling, medical doctors, school professionals). Conclusions The BTQ-LC represents an important step towards improving our understanding and assessment of barriers to services contributing to mental health disparities among Latina/o/x youths.
 
Interaction between time and trauma with thought problems outcome. Adolescents with high levels of trauma tended to report higher levels of thought problems that decreased to a level similar to adolescents with low trauma at 36 months. Adolescents with low trauma tended to report low thought problems, which remained stable over time
Interaction between time and trauma with aggression outcome. Adolescents with higher levels of trauma tended to be higher in aggression, and their aggression levels decreased to those similar to adolescents with low trauma over 36 months. In contrast, adolescents low in trauma reported lower aggression, which remained stable over the study period
Article
Background Youth in foster care may demonstrate high levels of aggression and thought problems. There is a growing trend to consider mental health symptoms of youth involved with the foster care system from a developmental trauma perspective.Objective The aim of this study was to test if trauma, race, age, and gender predicted variability in thought problems and aggression for youth in foster care.Method The sample (n = 303) included youth in out-of-home placements with a mean age of 14 years, a diverse racial demographic, and almost an equal percentage of males and females. Participants were assessed over three waves using a series of multilevel growth curve models.ResultsResults indicated significant decreases in thought problems and aggression and youth with higher levels of trauma reported higher initial levels and swifter decreases of both thought problems and aggression over time.Conclusions While trauma was associated with aggression and thought problems, results found that youth demonstrated significant decreases in aggression and thought problems over time. A better understanding of the long-term effects of trauma on thought problems and aggression of youth in foster care is needed. While our findings suggest foster care may be protective in fostering resilience, additional research on the nature of potential positive effects of foster care on aggression and thought problems is suggested.
 
Article
Background Growing evidence informs about the detrimental impact that COVID-19 has had on youths’ mental health and well-being. As of yet, no study has directly examined the experiences and perspectives of children and young adolescents from racial and ethnic minority groups in the U.S., despite being exposed to more adversity, which may affect coping with the many challenges posed by the pandemic.Objective This study aimed to give voice to a mostly Hispanic/Latinx group of youth regarding the impact of COVID-19 stay-at-home measures and to identify their emotional responses and coping strategies amid the pandemic in the U.S. when restrictions were at their hardest.MethodA total of 17 youths (70.6 % Hispanic; age range = 10–14 years; 52.9 % female) participated in four virtual semi-structured focus groups for each grade level (grades 5–8). Data was transcribed and analyzed using a gold standard thematic analysis approach.ResultsSeven themes were identified concerning the impact of COVID-19, centering around the impact of racism, loss of income, the role of community and family in coping with stress, information overload, home-schooling, loneliness and boredom, and lack of structured routines.Conclusions Our findings suggest that cultural factors (e.g., collectivism and familism) in Hispanic communities may offer important buffering during COVID-19. Future research studies evaluating the implementation of structured programs that provide a space to talk about emotions and thoughts related to the impact of the pandemic and training in strategies to cope with distress during mandatory home-schooling are needed.
 
a Association between social responsibility values and social distancning. b Association between self-interest values and social distancing. c Association between social responsibility values and disinfecting behavior. d Association between social trust and disinfecting behavior. e Association between self-interest values and disinfecting behavior. f Association between social trsut and horading behavior. g Association between self-interest values and hoarding behavior
Means, Standard Deviations, and Correlations among Study Variables.
Article
Background: Community attachments are thought to promote adolescents’ engagement in public health behaviors. To date, past research has exclusively examined the social benefits of community attachments among adolescents in the United States and less is known about these benefits among youth in low-income adolescent-dense countries such as Pakistan. Objective: The present study examined associations between Pakistani adolescents’ community attachments and COVID-19 public health behaviors, including social distancing, disinfecting, hoarding, news monitoring. Method: Adolescents living in Pakistan (N = 1,110; 13-18 years; M = 16.70) reported on their COVID-19 public health behavior (social distancing, disinfecting behaviors, hoarding behaviors, news monitoring) and community attachments (social responsibility values, social trust, self-interest values). Results: Greater social responsibility values were associated with greater social distancing (B = .09, p = .009) and disinfecting behavior (B = .39, p < .001). Greater social trust was significantly associated with greater disinfecting (B = .09, p < .001) and greater hoarding behaviors (B = .07, p = .001) and greater self-interest values were associated with lower social distancing (B = -.06, p = .010), greater disinfecting (B = .15, p < .001), and greater hoarding behaviors (B = .11, p = .001). Conclusion: Results from this study demonstrate that community attachments may play an important role in guiding adolescents’ public health behavior in Pakistan. These findings extend past research and contribute to an inclusive and culturally sensitive model of the benefits of adolescents’ community attachments for public health.
 
Article
Background Several studies conducted since the beginning of the COVID-19 pandemic have shown its harmful effects on young people’s mental health. In Québec and Canada, few studies have focussed on adolescents, and even fewer of these studies have examined this subject using a methodology that involved comparisons of data obtained before and during the pandemic, which is the purpose of this study. Objective The objective of this study is to determine the impact of the COVID-19 pandemic on the anxiety of secondary 1 and 2 students in Québec, using data obtained before and during the pandemic. Method Participants were 2990 French Canadian students in secondary 1 (grade 7) and secondary 2 (grade 8) in Québec. Two independent samples completed the questionnaires, one sample before the pandemic (fall 2019) and one sample during the pandemic (fall 2020). Their answers were subjected to descriptive analysis and multivariate analysis of variance. Results Results show that the pandemic has had variable impacts on the student’s mental health, with some of them reporting negative effects on their lives, others reporting no effect, and some reporting positive effect. However, the students surveyed during the pandemic generally reported more symptoms of generalized anxiety, and higher levels of test anxiety, fear of judgment and perfectionism than the ones surveyed before the pandemic. Conclusions The discussion puts forward possible explanations for the results obtained, which contribute to a better understanding of young adolescents’ experience during the COVID-19 pandemic. It also discusses the importance of developing interventions for adolescents affected by this pandemic.
 
Article
Background In the United States, 68% of children do not get the recommended nine hours of sleep, which can lead to many negative health outcomes (e.g., mental health). Mindfulness meditation mobile apps may be an option for improving children’s sleep and mental health outcomes; however, there is limited research on how children across different ages access these types of apps, the content they prefer, and the benefits they experience.Objective The purpose of this study was to describe parents’ reports of how and why their children use the Calm mindfulness meditation app and how using Calm may impact their sleep and mental well-being across age and gender.Method This study was a cross-sectional survey of Calm subscribers (N = 2437) with children who used Calm. Participants were asked how their child accessed content, why their child used Calm, and the benefits of Calm for their child’s sleep and mental well-being.ResultsApproximately half of the parents reported that they used Calm with their child. Older children (13–17 years) were more likely to use Calm independently, preferred content outside of Calm Kids, and were more likely to use Calm to manage emotions. Younger children (2–12 years) most commonly used Calm with their parents and on a parent’s device and preferred Calm Kids Sleep Stories.Conclusion To our knowledge, this is the first study to explore parents’ perceptions of children’s use of a commercial mindfulness meditation app across ages. Children use Calm differently based on their.
 
The linear regression and regression spline that predict growth curve for ego-identity. Note The left figure is the linear regression; the right figure is the regression spline (the right figure). An interior knot—called the stationary point where the coefficient suddenly changes—at Time 2 (2014) was applied. The regression line with the gray color represents the standard error.
A rate of change in the association between Korean language proficiency and ego-identity. Note N = 7053 (n = 2351 for each time). Estimates are based on Model 4 in Table 4. Korean language proficiency was measured with a five-point Likert-type scale, ranging from 1 = very poor, 2 = poor, 3 = fair, 4 = good, and 5 = excellent. This scale was categorized in this graph to observe the interaction point.
Article
Background Despite extensive research examining features of adolescents’ ego-identity development, little research has demonstrated patterns of ego-identity development and its relationship with various individual and environmental factors that are theoretically important for identity development.Objective The current study investigated developmental trajectories of ego-identity and the longitudinal relationship between multiple predictors (Korean language proficiency, sex/gender, logged household income, and child maltreatment) and ego-identity development.Methods Data from three time points (Time 1 = 9th grade; Time 2 = 11th grade; Time 3 = 12th grade) of the Korean Children and Youth Panel Survey (N = 7053) were used. The mean age of participants in each wave was 15, 17, and 18 years old.ResultsThe results showed that the level of ego-identity development varied across times—that the developmental pattern plateaued and decreased slightly after Time 2. A significant association between Korean language proficiency and ego-identity development was found, indicating that individuals who reported a higher level of Korean language proficiency displayed a greater level of ego-identity over the three observation periods. Sex/gender, logged household income, and child maltreatment were significantly associated with ego-identity development at the initial level.Conclusion The findings highlight the importance of identifying patterns of ego-identity development and understanding its association with multiple predictors.
 
First Encounter with the World of Asylum Seekers: Shock and Revelation
Article
Background Children of African asylum seekers are a growing population in the Western world. Many of them who live in extreme social exclusion experience social alienation and powerlessness. Based on the assumption that the unique relationships between mentors and mentees can increase well-being, more in depth data on the perspectives of the practical work strategies of the volunteers themselves would be useful to understand their actions and underlying principles of actions in mentoring children of asylum seekers.Objective To explore the experiences and strategies employed by nonprofessional volunteers who mentor children of asylum seekers.Method In-depth semi-structured interviews with 19 volunteers who mentor children (age range 6–12) of African asylum seekers in Israel were conducted. A thematic analysis based on grounded theory approach was employed.ResultsBased on the volunteers’ perceptions, the data suggest a four-level process of strategies aimed at resistance to othering and the development of a sense of personal agency through mentoring.Conclusions The perceptions of volunteers who work with the children of asylum seekers suggest they use strategies that seek to increase the children’s sense of belonging and agency and to provide them with the unconditional support they usually do not receive elsewhere. The findings suggest that volunteers may help create an agency-promoting environment to help asylum seeker children cope with their distress. Studies using controlled designs might examine the effects of volunteers by developing guidelines and action principles as a basis for fostering standardized training for volunteers who work with children in extreme social exclusion.
 
Article
Background Due to the risk of cross-contamination and the enforcement of strict infection control guidelines, patients with cystic fibrosis (CF) and their families have engaged in social and physical distancing for the past decade and a half. Family members, such as parents, are considered to be a critical component of patients’ lives.Objective We explored how the parents of young people living with CF in Canada take up, navigate, and negotiate cross-contamination restrictions in the context of their everyday lives with their children.Methods We drew upon social theories of loneliness and also employed a thematic analytic descriptive qualitative approach. Our descriptive qualitative approach included conducting semi-structured interviews with 13 parents of young people with CF.ResultsAlthough the parents of young people with CF carefully adhered to the cross-contamination rules, many were critical of the practice and spoke to the social costs of physical distancing. As well, parents often felt isolated from social activities, their partners or spouses, and from access to informational resources within the CF community.Conclusions Perceptions of social isolation and loneliness were common in the reported experiences of CF parents in this sample. These parents also conveyed concerns about cross-contamination restrictions and other biomedical regimes, finding it difficult to balance the rules with their lives. Development of social support programs and interventions that address the themes identified may be useful.
 
Article
Background Italy was one of the first European countries to be affected by Covid-19. Due to the severity of the pandemic, the Italian government imposed a nationwide lockdown which had a great impact on the population, especially adolescents. Distance-learning, moving restrictions and pandemic-related concerns, resulted in a particularly stressful situation. Objective This cross-sectional study aims to analyse substance consumption and its associated factors during the Covid-19 lockdown imposed by the Italian government. Methods ESPAD is a questionnaire that is administered yearly in Italian high schools. In 2020, it was administered online during dedicated hours of distance learning, collecting data from 6027 Italian students (52.4% were male) aged 15–19. Data collected from the 2020 questionnaire was matched with that collected in 2019, in order to make them comparable. Results The prevalence of consumption of each substance decreased during the restriction period, and the most used substance during the lockdown period was alcohol (43.1%). There were some changes in factors associated with psychoactive substance use, especially painkillers and non-prescription drugs. For instance, unlike what was observed in the 2019 model, in 2020 spending money without parental control was associated with painkillers and non-prescription drug use while risk perception was not. Conclusions The restrictions and the increased difficulties in obtaining psychoactive substances did not prevent their consumption, and students with particular risk factors continued to use them, possibly changing the substance type of substance. This information is useful in order to better understand adolescents’ substance use during the ongoing pandemic.
 
Results of Autoregressive Cross-Lagged Model
Article
Background In recent years, the penetration rate of smartphones among Korean teenagers has increased, making it critical to clarify the influence of these devices on adolescents’ lives. Objective This study investigated the effects of smartphone dependence on peer relationships and life satisfaction among Korean adolescents. Methods Using the middle school panel of the Korean Children and Youth Panel Survey (KCYPS), longitudinal data of 2,250 participants (53.4% boys) at Grade 1 (Mage = 14.01, SD = 0.03) in 2018, Grade 2 in 2019, and Grade 3 in 2020 were analyzed to examine the causal relationships between smartphone dependence, peer relationships, and life satisfaction. Results This study found that smartphone dependence had a longitudinal effect on negative peer relationships. Negative peer relationships had a longitudinal negative effect on early adolescents’ life satisfaction. Finally, negative peer relationships in early adolescents longitudinally mediated the relationship between smartphone dependence and life satisfaction. Conclusions This study showed that early adolescents’ dependence on smartphones negatively affects their social relationships and, in turn, negative relationships with peers hindered life satisfaction, suggesting that adolescents’ smartphone use should be guided and, when necessary, receive assistance to develop control of their smartphone use.
 
Article
Background The long-term effectiveness of Head Start remains a topic of debate. Previous research with families of children enrolling in Head Start at three years of age has shown patterns of familial risk moderate the short-term effects of Head Start suggesting some children benefit more than others. However, we know little about patterns of risk that moderate Head Start’s effectiveness for children who first enroll in Head Start at four-year-old and even less about risk factors that moderate the long-term effectiveness of Head Start. Objective In the current study, we sought to address these gaps by examining differential treatment effects of Head Start on elementary school outcomes for subgroups of children who first enrolled in Head Start at age four. Methods Latent class analysis (LCA) was used to identify subgroups of children from the four-year-old cohort of the Head Start Impact Study (N = 2,108) based on family risk variables in preschool (e.g., maternal depression). Weighted regression analyses were then conducted to assess if the effects of Head Start on end of pre-kindergarten, kindergarten, 1st, and 3rd grade academic and social-emotional outcomes varied by latent class membership. Results While a subsample of children attending Head Start experienced sustained benefits, others had worse outcomes in elementary school, and predominantly any initial benefits of Head Start were not sustained into elementary school. Conclusion Irrespective of patterns of familial risk, initial benefits gained via Head Start for children first enrolling in at four-years of age typically fade out during elementary school.
 
Proposed theoretical model linking teachers’ engagement in suicide prevention training to their efficacy expectations, outcome expectations, and outcome values
Results of the structural equation model with standardized path coefficients depicting associations between suicide prevention training, efficacy expectations, outcome expectations, and outcome values
Results of the structural equation model with standardized path coefficients depicting associations between teachers’ suicide exposure, suicide prevention training, efficacy expectations, outcome expectations, and outcome values
Article
Background Teachers are important gatekeepers in suicide prevention for children and youth, yet little is known about factors that contribute to suicide prevention training effectiveness and the influence of student suicidality on teachers’ role as gatekeepers. Objective This study examined teachers’ attitudes and self-efficacy in suicide prevention including an examination of suicide prevention training and exposure to student suicidality. Researchers examined incremental prediction of the relationship between teachers’ self-efficacy, outcome expectations, and outcome values following prevention training. Methods Participants included teachers in PreK-12th grade schools in the United States (N = 505). Researchers used non-parametric statistics to examine group level differences and a structural equation model (SEM) to test the proposed theoretical model. Results Teachers who experienced a student death by suicide reported significantly higher levels of gatekeeper reluctance than teachers who had not experienced a student death by suicide (p < 0.01). Similarly, teachers who encountered students with suicidal thoughts reported greater levels of gatekeeper reluctance (p < 0.01) and higher self-efficacy to engage in suicide prevention (p < 0.05) compared to teachers who had not had this exposure. Results of the SEM indicated an adequate goodness of fit and fit statistics [χ² (87) = 194.420, p = 0.000; CFI = 0.95; RMSEA = 0.05]. The model remained in-tact when exposure to student suicide was added. Conclusions Findings support the importance of supporting teachers continued engagement in youth suicide prevention and prevention training that targets specific outcomes in teachers’ attitudes and efficacy.
 
Hypothesised model of the influence of stigma, threat, and trust on support seeking: an adaption from the TTC
Simple slopes for the direct effect of the interaction term (trust online* threat) and seeking online support for the Self condition
Article
Background Stigma and trust influence how adolescents seek support for mental illness, though it is unclear how these influence their decisions to approach a range of potential sources of support. Moreover, even less is known about the ways in which these issues are related when a friend discloses symptoms of mental illness. Objective The study’s aims were to understand the role of stigma, trust, and threat appraisals in adolescents’ support seeking when exposed to their own, or to a friend’s, symptoms of mental illness. Method A vignette-based study comparing reports of support (friends, parents, teachers, professionals, and online) was completed with reference to either (i) experiencing symptoms of mental illness or (ii) having a friend disclose these types of symptoms. Two hundred and fifty adolescents (M = 12.75 years) answered questions pertaining to stigma (public and self), trust levels, threat appraisals, and support seeking. Results When dealing with their own symptoms, threat accounted for 4.8 and 2.5% of the variance when seeking support from parents and professionals, respectively. Self-stigma accounted for 2.4% of variance when seeking support from parents and 0.8% of variance when seeking support from professionals. Trust moderated the association between threat and the use of online support. When responding to a friend’s disclosure, higher levels of public-stigma were associated with lower support seeking from friends, parents, and professionals. Conclusions This study showed a distinction in how adolescents deal with their own or a friend’s symptoms of mental illness, and what resources they choose to ask for support from. Self-stigma, threat, and trust levels were particularly relevant when experiencing their own symptoms, while dealing with a friend’s disclosure was related to levels of public-stigma.
 
Article
This correction is to alert readers of an earlier version of Nunno, M. A., McCabe, L. A., Izzo, C. V., Smith, E. G., Sellers, D. E., & Holden, M. J. (2021). A 26-year study of restraint fatalities among children and adolescents in the United States: A failure of organizational structures and processes.
 
How a mentor should treat the young person (N = 11)
Article
Background In residential youth care, group care workers and teachers often serve as a mentor for individual adolescents. Although favorable mentoring relationships are associated with positive adolescent outcomes, few studies examined the role of mentoring in residential youth care. Objective The present study aims to assess adolescents’, care workers’ and teachers’ mentoring relationship needs in terms of their one-on-one conversations during residential care. Methods We conducted structured interviews with eleven adolescents, ten group care workers and two teachers and content analysis to assess the data Results All respondents are rather satisfied with their conversations, which are often concerned with how the adolescent is doing. Adolescents mostly consider their family and home-situation as difficult topics, while care workers mostly consider sexuality as a difficult topic to talk about. Although ‘improvement’ with the youth is often the aim, most adolescents report that they do not (know if they) show changes because of these conversations. Moreover, only one of the twelve professionals thinks that it is his core task to achieve behavior change with the adolescents. According to the professionals, conversations often aim at building a good relationship, coaching, determining treatment goals, and gaining insight into the adolescent. Adolescents prefer a mentor who is calm, has respect, listens, and is reluctant in giving advice. Most professionals do not use a specific method and doubt whether they want to have conversations according to a manual or support tool. Conclusions Despite being rather satisfied, adolescents and professionals indicate several points for improvement of one-on-one conversations.
 
Ollie was removed from his parent’s custody when he was 9 years old due to severe malnutrition and neglect. He often was found foraging the neighborhood for food and ate out of dumpsters. His parents’ parental rights were terminated two years later. Ollie was diagnosed as having post-traumatic stress syndrome and had a difficult time concentrating on tasks. There was some evidence that he had received a brain injury, although there was never a diagnosis. His placements in multiple foster homes failed because of his severe outbursts when he did not have access to food when hungry, but he never attacked or became violent towards others. He had been in his latest therapeutic foster home placement for eighteen months and was doing well. His outbursts were diminishing in frequency and intensity. His foster parents used time out as a behavior support, and he was learning to self-isolate when he was frustrated. He was beginning to relate to other children and was able to participate in neighborhood games. Ollie was placed in a new special education classroom in a mental health day treatment program to prepare him for a community school program. The classroom housed both children who resided in residential and foster homes and specialized in behavior management. His foster parents worried that the new classroom would set Ollie back and feared that his food anxiety would increase and be misunderstood. In class one day Ollie became agitated because he was hungry. He failed to respond to his teacher’s repeated, vocal commands to calm himself and sit down. He paced the classroom and when he did not follow the teacher’s orders, the teacher placed him in a chair and held him via a seated basket hold with his arms around his torso. When Ollie, who was 5′1″ and 130 pounds, continued to struggle, she placed him face-down on the floor with his crossed arms still under him. His teacher, who weighed 225 pounds and was 6″1’, lay on top of him while the aide held his legs. During the restraint Ollie said, “I can’t breathe” and “I give”. The assistant principal asked the teacher to end the restraint after 15 min according to school policy. The aide and the teacher sat Ollie, who was limp, in a chair and wiped drool from his mouth. The assistant principal reported that he thought he was playing possum. The procedure was witnessed by a teacher aide, a school assistant principal, and other students. While the state protective authorities determined that the teacher’s response was abusive and an administrative judge upheld the ruling saying that he thought the teacher was “reckless”, the school and the restraint trainers continued to support the teacher’s restraint methods
Plymouth was upset that the shirt she loved was missing from her closet. She walked angrily to her friend’s room to accuse her of taking the shirt but was escorted back to her room by a staff. She was agitated and went immediately to her closet to show the staff that it was gone. When she was at the closet, she retrieved a small object in her hand. Staff asked to see what it was, but she refused to comply. A supervisor, hearing the Plymouth disturbance, told the staff person to take care of business in there because it was time for dinner. The situation escalated and the staff person immediately initiated a single person restraint, but lost her balance and fell on Plymouth who landed face up on her back. The staff person remained laying on Plymouth’s torso to maintain control. Plymouth was upset that the shirt she loved was missing from her closet. She walked angrily to her friend’s room to accuse her of taking the shirt but was escorted back to her room by a staff. She was agitated and went immediately to her closet to show the staff that it was gone. When she was at the closet, she retrieved a small object in her hand. Staff asked to see what it was, but she refused to comply. A supervisor, hearing the Plymouth disturbance, told the staff person to take care of business in there because it was time for dinner. The situation escalated and the staff person immediately initiated a single person restraint, but lost her balance and fell on Plymouth who landed face up on her back. The staff person remained laying on Plymouth’s torso to maintain control. Plymouth died from mechanical asphyxiation while staff lay on her in a supine position on the floor. Her death was the fourth restraint-related fatality to occur within the umbrella organization over the past eight years. Just days prior to Plymouth’s death, the state’s regulatory agency placed the treatment center on probation because of persistent concerns cited, such as multiple restraints, the frequent use of PRNs (as the need arises) to control behavior, and the lack of treatment and crisis plans for individual children. In the previous two years, the administration and care staff were cited for abuse when they “encouraged” competitions where the girls wrestled with one another for food and snack prizes
Restraint Fatalities by Organization Type and Time Period
Article
Background Physical and mechanical restraints used in treatment, care, education, and corrections programs for children are high-risk interventions primarily due to their adverse physical, emotional, and fatal consequences. Objective This study explores the conditions and circumstances of restraint-related fatalities in the United States by asking (1) Who are the children that died due to physical restraint? and (2) How did they die? Method The study employs internet search systems to discover and compile information about restraint-related fatalities of children and youth up to 18 years of age from reputable journalism sources, advocacy groups, activists, and governmental and non-governmental agencies. The child cohort from a published study of restraint fatalities in the United States from 1993 to 2003 is combined with restraint fatalities from 2004 to 2018. This study’s scope has expanded to include restraint deaths in community schools, as well as undiscovered restraint deaths from 1993 to 2003 not in the 2006 study. Results Seventy-nine restraint-related fatalities occurred over the 26-year period from across a spectrum of children’s out-of-home child welfare, corrections, mental health and disability services. The research provides a data snapshot and examples of how fatalities unfold and their consequences for staff and agencies. Practice recommendations are offered to increase safety and transparency. Conclusions The study postulates that restraint fatalities result from a confluence of medical, psychological, and organizational causes; such as cultures prioritizing control, ignoring risk, using dangerous techniques, as well as agencies that lack structures, processes, procedures, and resources to promote learning and to ensure physical and psychological safety.
 
QRIS-rated quality levels predicting toddlers’ early learning skills (Mullen early learning raw score composite) over time from ages 12–36 months (n = 225; 3 repeated measures for 75 toddlers) accounting for all covariates. Note: **p < .01; ns–not significant
QRIS rated quality predicting toddlers’ social competence skills over time (n = 225; 3 repeated measures for 75 toddlers) controlling for all demographic covariates. Note: *p < .05
Caregiver education level predicting Mullen early learning skills composite over time (n = 225; over three repeated measures for 75 toddlers) controlling for demographic covariates. Note: **p < .01; *p < .05
Article
Background State-level child care quality rating and improvement systems (QRIS) have been implemented in a majority of states in the U.S.A. One goal is to improve developmental outcomes for young children, especially from families with fewer resources. Research is needed to determine if QRIS can produce quality improvements that will support the development of children from birth to three years. Objective Explore the association of toddlers’ growth trajectories over two years with their participation in varying quality-rated levels of child care.Methods In this two-year longitudinal study of 75 toddlers (M age = 15.5 months; SD = 2.36) children’s cognitive and social-emotional growth trajectories were estimated in three assessments, 12 months apart. All toddlers were low-income Child Care and Development Fund voucher recipients, cared for by child care providers within a Midwestern state’s voluntary QRIS. QRIS-rated child care quality, caregiver education level, and child–adult ratio were observed in parallel with individual cognitive and social-emotional child assessments. Growth analyses controlled for parent education, child race, ethnicity, disability status, and gender.ResultsToddlers who received care in settings rated highest by the QRIS and those with caregivers who had higher education levels progressed at significantly higher rates of development in early learning skills, compared with toddlers placed in QRIS-rated lower quality settings or with caregivers with less education.Conclusions State-level QRIS have the potential to inform parents’ and policymakers’ decisions about child care quality associated developmental outcomes for children under three years of age. Especially important is the role of QRIS in incentivizing the educational preparation of toddler caregivers.
 
Interaction effect of lockdown
Descriptive statistics for full sample and subgroups
Unstandardized effects of regression analyses predicting alliance
Article
Background A strong therapeutic alliance or working relationship is essential for effective face-to-face family-based psychotherapy. However, little is known about the use of VC on alliance in family-based therapy. The recent COVID-19 pandemic led to a national lockdown during which most family-based therapy transferred to VC. Objective The current study analyzed the development and strength of alliance prior and during lockdown for multi-stressed families participating in Multisystemic Therapy (MST). Method Alliance with the therapist was reported monthly by 846 caregivers (81% female). Using latent growth curve models (longitudinal approach), the development of alliance was estimated for families participating in MST prior to the lockdown, transferring to VC early in treatment or late in treatment. Using regression analyses (cross-sectional approach), lockdown (yes/no) was included as predictor of alliance. In these analyses, type of family (regular; intellectual disability; concerns regarding child abuse or neglect) and gender of caregiver were included as moderators. Results Both analytical approaches showed that alliance was not affected by VC, except for families with concerns of child abuse, who reported lower alliances during lockdown. However, these results where no longer significant when controlling for multiple testing. Conclusions Strong alliances can be developed and maintained during family-based VC sessions with multi-stressed families. However, for some subgroups, such as families with concerns of child abuse, VC might not be suitable or sufficient. Future research needs to investigate the potential and limitations of using VC with families.
 
Study enrollment timeline in relation to COVID-19 safety measures and reopening stages in Rhode Island. (¹Schools transition to Online learning following the Governor’s order for school closure, ²Stay-at-home order is issued which instructs individuals to only leave homes to perform essential activities. The order also directs non-essential businesses to close. ³New daily COVID-19 cases reach the highest numbers since the start of the pandemic, peaking at 36.9 per 100,000. ⁴Phase I initiates limited re-opening of non-essential businesses under the safety requirements of face coverings and social distancing. Gatherings of up to 5 individuals are now allowed. ⁵Phase II initiates the opening of even more non-essential businesses with expanded limited capacities. Gatherings of up to 15 individuals are now allowed. ⁶Phase III furthers the opening of non-essential businesses. Gatherings of up to 25 individuals indoors and up to 50 individuals outdoors are now allowed. This figure is based on the timeline described in Thompson et al. (2021) study).
Youth who reported negative COVID-19-related impact on their daily functioning evidenced higher levels of suicidal ideation at the time of admission (n = 103), *p < 0.05
Article
Background Given reports of the adverse effects of COVID-19 on adolescent mental health, it is critical to understand how it impacts psychiatrically hospitalized youth who may be particularly vulnerable to its effects. Objective This study aimed to advance our understanding of high-risk adolescents’ experiences of COVID-19, including COVID-19-related stress, changes in daily functioning, and coping as they relate to suicidal ideation (SI). Method Participants were 107 youth (ages 11–18; M = 15.06, SD = 1.79) admitted to an adolescent psychiatric inpatient unit during the time when the initial COVID-19 safety measures (i.e., school closure, stay-at-home- order) and reopening initiatives (Phase I, II, and III) were implemented in Rhode Island between March 13th and July 19th 2020. Adolescents completed measures of COVID-19-related stress, coping, functioning, and SI at the time of admission. Results Nearly half of the sample (43%) reported a negative impact of COVID-19 on daily functioning. Youth who endorsed COVID-19-related decline in functioning evidenced higher levels of SI compared to youth with no change or improvement in functioning due to COVID-19. Overall levels of stress were not associated with SI. Greater coping repertoire, but not the use of specific coping strategies was associated with higher levels of SI. Conclusions Findings demonstrate the importance of examining COVID-19-related changes in functioning and broadening repertoire of coping strategies among adolescents at high risk for SI.
 
Article
Background Teachers’ roles in the emotional socialization of preschoolers have been less studied. Less attention has been given to the contributions of both child- and teacher-level variables.Objective This study aimed at exploring the association between child- and teacher-level factors with growth in children’s emotion regulation (ER) and emotion knowledge (EK).Method We used hierarchical linear modeling and two-time-point (fall & spring) data consisting of 187 Taiwanese preschool children and 15 teachers. The child-level predictors included temperament characteristics and how the child’s negative emotion is responded to with six aspects of the Coping with Children’s Negative Emotions Scale (CCNES). The teacher-level variables consisted of teacher-reported reactions to negative emotions of children and duration of the teacher–child interaction as a group.ResultsER growth was predicted by three child-level predictors—teachers’ punitive reactions to an individual child were negatively associated with, whereas children’s negative affectivity and effortful control were positively associated with the change in ER. EK growth was predicted by both child- and teacher-level predictors—children’s surgency/extraversion and teachers’ minimization reactions to children as a group were negatively associated with, whereas both group-level child-teacher interactions and expressive encouragement were positively associated with EK growthConclusion This study supports that teacher’s individual-level punitive reactions to a child’s negative emotions negatively predicted ER growth, and that teacher’s group-level minimization reactions negatively predicted, whereas group-level expressive encouragement and child-teacher interactions positively predicted children’s EK growth, indicating children could put together repeated experiences of watching other children’s emotions being reacted to.
 
Theory of Planned Behavior
Relationships and Connections Between Conceptual Findings. (The bold lines between concepts represent a consistent and strong relationship while the dotted lines between concepts represent an inconsistent connection)
Article
Background Gatekeeper training (GKT) is a common strategy in suicide prevention that educates informal helpers (e.g., friends) about warning signs and risk factors for suicide as well as strategies to support distressed peers. Sources of Strength (Sources) is an effective intervention model that combines GKT with school-wide prevention activities and relies on trained gatekeepers—peer leaders—to diffuse intervention elements into their social networks to reduce peer distress and promote wellness.Objective The present study identified internal characteristics of peer leaders that make them successful gatekeepers for Sources and explored how Sources skills are successfully transmitted into peer leader networks.Method Using qualitative interview data from two cohorts of peer leaders, we investigated diffusion and intervention efforts during high school and in post-high school environments.ResultsResults support the use of the Theory of Planned Behavior (TPB) in understanding behavioral precursors that encourage effective gatekeeping (GK) behavior. Findings also suggest that Sources diffusion was robust in high school but declined post-high school. However, there were important inherent characteristics that appeared to spur greater uptake of Sources’ GKT, including optimism, empathy, kindness, and extraversion.ConclusionsTPB offers well-defined constructs that can be targeted to promote GK behavior in the context of Sources or similar suicide prevention programming. Specific internal traits may reinforce gatekeepers’ behavioral intentions, which then may support greater engagement in GK behavior. However, declines in GK behavior may occur over time, which suggests post-high school booster activities may be important to offset such declines.
 
Hypothesized structural equation model predicting bullying victimization and perpetration in SEN, LD and Typical Development students. TD = Students with Typical Development. SEN = Student with Special Education Needs
Results of the structural equation model predicting bullying victimization and perpetration in SEN, LD, and Typical Development students. Standardized coefficients of the model. TD = Students with Typical Development. SEN = Student with Special Education Needs
Article
Background Children with Special Education Needs and Learning Difficulties are at risk of being excluded, or bullied because of their impairments. Within the bullying literature, two variables have been shown to be key in terms of its predictions: student–teacher relationship and students’ social status among peers. Objective The aim of this research was to assess the association between the student–teacher relationship and students’ social status in the peer group and bullying dimensions in children with SEN, LD, and typical development. Method A total of 320 children—55 with LD, 46 with SEN, and 219 in the control group – participated in the study, with a mean age of 11.04 ( SD = 1.42), and 59.7% of whom were male. The model tested showed a good fit: χ ² (40) = 102.395, p < .001, CFI = .940, RMSEA = .070 [90% CI = .054, .088]. Results Main findings show that children with SEN and LD had more difficulties in social participation and might be at higher risk of being bullied, compared with their classmates. Conclusions This study offers evidence on bullying in children with SEN and LD and its association with both relationship with teacher and students’ social status. For teachers, results highlight peculiarities and possible problems of school inclusion of children with SEN and LD. For educational researchers, findings add knowledge on literature focused on bullying in children with difficulties.
 
Model for primary care-mental health specialty care interactions for patient care
Article
Background Behavioral health interventions that support low-income children and their families in under-resourced communities have a positive impact on child development; however, few interventions exist that highlight approaches providers use to contribute to this positive development. Objective To identify key strategies used by pediatric primary care physicians (PCP) and specialty mental health providers to improve access to and engagement in mental health services for low-income children and their families engaged in behavioral health services. Method Using the inductive constant comparative approach, researchers conducted 11 semistructured interviews with six PCPs, one staff member from a federally qualified health center (FQHC), and three mental health providers and one staff member from two local mental health clinics. Results Three main themes were identified that were used by PCPs and specialty mental health providers to improve access to and engagement in mental health services for low-income children and their families. Conclusions These themes highlight how PCPs and specialty mental health providers engage in critical strategies to support their efforts to improve access to and engagement in mental health services for low-income children and their families. The present study offers evidence that identifying effective strategies for providers to improve access to and engagement in mental health services for low-income children and their families is an important step toward the national priority of integrating mental and behavioral health services into pediatric primary care.
 
Article
Background A need-supportive group climate is a prerequisite for successful treatment in secure residential youth care. For girls, positive relationships with peers are an essential part of the group climate. Relational aggression threatens the residential group climate. Objectives This study explored whether a group counseling program can actively promote the quality of the interrelationships between girls in a residential group in the Netherlands; the aim is to elucidate how residential group climate affects treatment results. The girls in this single-gender residential group had been admitted because of (suspicions of) commercial sexual exploitation. Method The study combined participatory observations with a case-based time-series design. For 18 weeks, changes in the residential group climate and the interrelationships between the girls and achievement of treatment goals over time were measured. Results The residential group climate in this group was negative initially; much relational aggression between girls was found. Considering treatment, some girls were making significant progress, but others mainly deteriorated. Moderate improvement of residential group climate was visible after a group social worker was permanently present. Conclusions A group counseling program aimed at improving interrelationships cannot cure an overall negative residential group climate. This article offers implications for preventing and recognizing deterioration of residential group climate and improving girls' residential group climate.
 
Article
Background African-American and Latinx youth are disproportionately exposed to neighborhood violence and are overrepresented in the U.S. juvenile justice system. Perceived neighborhood violence is associated with negative health outcomes. Objective We examined associations between African-American and Latinx youths’ perceived neighborhood violence and health during reentry after juvenile incarceration. Methods Youth (n = 50) returning home after incarceration completed health questionnaires at one-month post-incarceration. A subset of participants (n = 25 youth) also participated in one-on-one, semi-structured longitudinal interviews. Results Twenty-eight (56%) participants reported neighborhood violence in quantitative surveys. Quantitative analyses revealed that perceived neighborhood violence was positively associated with reported asthma diagnosis, doctor recommendations for medical follow-up, perceived stress, and adverse childhood experiences (ACEs). Perceived neighborhood violence was negatively correlated with perceived family support. Stress ratings were associated with ACE total scores, moderate to severe depression symptoms, and family support. Moderate-to-severe depression symptoms were significantly correlated with lower ratings of family support. Qualitative interviews supplemented our quantitative findings and showed that responses to perceived neighborhood violence were linked to specific health-related behaviors, such as substance use or avoidance of gang activity. Conclusions Overall, our quantitative and qualitative results indicate that perceived neighborhood violence is associated with many negative psychosocial factors that could impact overall health and wellbeing of youth undergoing reentry. Treatment implications include the development and testing of family-centered interventions that help improve the transition back into the community for youth undergoing reentry and especially, their access to evidence-based treatment, including leveraging family telehealth substance use interventions .
 
Schematic illustration of the Group Concept Mapping (GCM) Process
Youth Concept Map Displaying Six Clusters of Ideas for Programming with Newcomer Youth. (Note. Each point is numbered and represents an individual statement. Numbered statements can be seen in Table 2. Clusters that are closer together on the map are similar in meaning, and larger clusters indicate broader concepts. This figure was produced with the groupwisdom™ software.)
Article
Background There is a well-documented need for more responsive promotion and prevention programming for young immigrants and refugees in the context of mental health and healthy development. Incorporating the voice of newcomers in the development of promotion and prevention efforts could assist in producing culturally-relevant materials and improve program outcomes. Objective Our goal was to utilize youth voice to identify considerations for developing programming to support newcomer youths’ healthy development. Methods We employed mixed methods and analyzed data using concept mapping. A total of 37 newcomers between the ages of 14 and 22 participated in focus groups to share their ideas for creating programming that would focus on relationships and well-being. Relevant responses were collated, cleaned, and generated into unique statements, and then sorted individually by 26 youth into thematically similar categories. We used multidimensional scaling and hierarchal cluster analysis to produce a concept map. Results Six concepts, in rank order of importance, emerged as follows: create a space for sharing; discuss relational issues; teach strategies for adjusting to a new country; teach wellness skills; have feel-good activities; and plan for diversity. Conclusions Participants’ lived experience and their own attendance in programming at newcomer organizations assisted them in brainstorming what types of activities, topics, and skills would be helpful for other newcomer youth, as well as considerations for facilitators implementing such programming. Promotion and prevention efforts intended for newcomer youth may benefit by incorporating ideas from the concept map.
 
Cognitive profiles
Article
Background Many studies have examined which kindergarteners’ skills best predict reading acquisition later at school. Most of these studies focused on emergent literacy skills such as letter knowledge, phonological awareness, and oral language abilities as the basis for reading acquisition. Additionally, several studies have also found cognitive skills such as memory, executive functions, and visual processing to be related to reading abilities. Although much research has been devoted to the connection between these two types of skills and reading, the relationship between the emergent literacy and cognitive skills has not been widely investigated. Objective The current study aimed to examine the contribution of different cognitive skills to emergent literacy and to explore the cognitive profile of children with low and high emergent literacy skills. Methods The study was conducted among 125 Hebrew-speaking kindergarten children. Cognitive measures including memory, speed of processing (SOP), executive functions, visual perception, and attention were collected, as well as literacy measures such as phonological awareness, orthographic knowledge, and vocabulary. Results The research findings indicated a very strong association between the cognitive measures and the literacy measures. Children with low emergent literacy skills exhibited lower cognitive abilities. In addition, a significant association was found between visual perception, rapid naming, inhibition, and emergent literacy. Conclusions These findings suggest that literacy knowledge associated with basic cognitive skills, which play an important role in its development.
 
Flow chart of study inclusion
Article
Background Parent–child interaction therapy (PCIT) is an evidence-based approach typically used for children aged 2–7 with externalizing disorders. Research suggests that PCIT is effective in treating a broad range of populations and problems. Several adaptations of PCIT have been developed for its use with children younger than the age of 2, though it is unclear how efficacious these adaptations are. Given the differences in terminology used in the developmental adaptations of PCIT, the current meta-analysis defines 12–24-month-olds as younger preschoolers and 25–59-month-olds as older preschoolers. Objectives The current meta-analysis aims to synthesize the literature on PCIT with children younger than the age of 5 and compare the effect of PCIT for younger preschoolers and older preschoolers. Methods Searches of PsycINFO and PubMed yielded 30 studies meeting inclusion criteria which were aggregated via meta-analysis. Results Statistical analyses suggest that PCIT overall has a large aggregate effect size when examining child externalizing symptoms, child internalizing symptoms, caregiver distress, and caregiver behaviors. PCIT interventions for older preschoolers were found to be comparably effective as PCIT adaptations for younger preschoolers in improving child externalizing symptoms, caregiver distress, and caregiver behaviors. Conclusions Overall, this meta-analysis provides preliminary findings that PCIT adaptations for younger preschoolers are effective in improving the well-being of children and caregivers. These adaptations may have benefits beyond the outcomes examined in this meta-analysis and future studies should continue to focus on the effects of these adaptations.
 
Model representing identified themes and associations of the impact of using videoconferencing in FFT
Means and standard deviations for alliance, split by teletherapy group (n = 76)
Article
Background Due to the recent COVID-19 pandemic, mental health care has largely transferred its services to online platforms, using videoconferencing (VC) or teletherapy. Within the field of family therapy, however, there is little evidence on the feasibility of using VC, especially when working with whole families at the edge of care. Objective This study investigated the feasibility of remote Functional Family Therapy (FFT), using a mixed-method approach. Method Study 1 consisted of semi-structured interviews with 23 FFT professionals (18 female) about their experience of providing remote FFT during the COVID-19 pandemic. Study 2 included monitoring data of 209 FFT clients (46% female, Mage = 14.00) who participated in FFT during the pandemic. We compared families who received mainly in-person, mainly remote or a mix of remote and in-person on client-reported alliance, drop-out, therapist-rated outcomes, and treatment intensity using MANCOVA’s and chi-square tests. Results In Study 1 two themes emerged around experienced challenges, namely ‘Feeling in control’ and ‘Engagement and alliance’. Two other themes emerged around adaptations, namely ‘Being more on top’ and ‘Connecting in different ways’. In Study 2, we found that the therapeutic alliance was not related to using VC. Also, families had less between-session contact during the Engagement and Motivation Phase when receiving mainly VC, but had more sessions and longer therapy when receiving a mix of in-person and remote therapy. Conclusions The current study suggests that providing systemic family teletherapy to families on the edge of care is feasible. Further development of systemic family teletherapy is warranted.
 
Article
Background Early childhood teachers play a key role in creating positive teacher-child relationships, which are shown to promote child outcomes. However, turnover rates of early childhood teachers are strikingly high, which may compromise the quality of teacher-child relationships. Lack of early childhood education program policies (i.e., wage, benefits, and teacher support) may contribute to such high turnover rates. Objective This study examined whether the availability of early childhood program policies is related to program-level lead and assistant teacher turnover rates. We hypothesized that turnover rates would be higher in programs that do not offer these policies. Methods Participants were 354 early childhood providers working in center-based programs. Data came from the Year 3 Child Care provider Survey, part of the Fragile Families and Child Wellbeing study. Independent t-tests were used to compare the program-level lead and assistant teacher turnover rates in programs that do versus do not provide wage, benefits, and teacher support policies. Results Results showed that teacher turnover rates were generally higher in programs where policies were not available. While lead teachers’ turnover rates were significantly higher in programs where only a few wage and benefit policies were not available, assistant teachers’ turnover rates were significantly higher in programs that did not offer many more wage and benefit policies and some teacher support policies. Conclusions Providing wage, benefit, and teacher support policies in the early childhood programs may help programs retain teachers. Further examination of the availability and usability of early childhood education program policies and how they may motivate teachers to stay or leave the program is needed.
 
Article
Background Trauma exposure is common in children and adolescents. Parents and other key adults, such as teachers, are necessary to facilitate help-seeking behavior, which involves recognizing trauma and adverse reactions and awareness of accessing treatments. Where screening measures in schools are used to detect post-traumatic stress disorder (PTSD), the attitudes of parents and teachers towards screening need to be considered. Objective To examine whether parents and teachers can accurately detect trauma events, symptoms and effective treatments. In addition, to assess how supportive parents and teachers are towards PTSD screening in schools. Method A total of 439 parents and 279 teachers completed online questionnaires assessing PTSD knowledge across three domains: traumatic events, PTSD symptoms and evidence-based treatments. Responses of acceptability of using PTSD screening tools in schools were elicited. Results Teachers and parents were accurate in recognizing trauma events and PTSD symptoms. However, understanding was inclusive, with events not considered traumatic and non-PTSD diagnostic criteria being endorsed. Trauma-Focussed Cognitive-Behavioral Therapy was recognized as an effective treatment for PTSD, but Eye-Movement Desensitization and Reprocessing was not. Treatments not recommended by health guidelines were frequently endorsed. The majority of participants were supportive of PTSD screening in schools, but a minority were not. Conclusions Parents and teachers are able to recognize trauma events and symptoms of PTSD, although this tends to be overly inclusive. Schools could be targeted to promote understanding trauma among parents and teachers. Agreement with screening is encouraging and further research is warranted to understand barriers and facilitators.
 
Conditional line plots showing the moderation of children’s DAT1 genotype on the relationship between children’s ADHD problems and children’s DAT1 methylation. a The moderation of children’s DAT1 genotype on the relationship between children’s ADHD Problems and children’s DAT1 methylation at M1 CpG site. b The moderation of children’s DAT1 genotype on the relationship between children’s ADHD Problems and children’s DAT1 methylation at M6 CpG site
Conditional line plots showing the moderation of children’s DAT1 genotype on the relationship between children’s ADHD and dysregulation problems and parental psychopathological risk. a The moderation of children’s DAT1 genotype on the relationship between children’s ADHD Problems and maternal Global Severity Index (GSI). b The moderation of children’s DAT1 genotype on the relationship between children’s Dysregulation Profile (DP) and paternal GSI
Article
Background International literature has underlined the complex interplay between genetic and environmental variables in shaping children’s emotional-behavioral functioning. Objective This study aimed to explore the dynamic relationship between children’s Dopamine Transporter (DAT1) genotype and methylation, and maternal and paternal affective environment, on children’s Attention Deficit Hyperactivity Disorder (ADHD) problems and dysregulation problems. Method In a community sample of 76 families with school-aged children, we assessed children’s DAT1 genotype and methylation, their own ADHD problems and dysregulation profile (CBCL 6–18 DP), and maternal and paternal psychopathological risk, parenting stress, and marital adjustment. Hierarchical regressions were carried out to verify the possible moderation of children’s genotype on the relationship between children’s methylation and psychopathological risk, parental environment and children’s methylation, and parental environment and children’s psychopathological risk. Results The levels of methylation at M1 CpG significantly predicted ADHD problems among children with 10/10 genotype, whereas high levels of methylation at M6 CpG predicted low ADHD problems for children with 9/x genotype. High levels of methylation at M3 CpG were associated with high scores of CBCL DP. DAT1 genotype moderated the relationship between maternal and paternal variables with children’s methylation and psychopathological risk. The scores of maternal and paternal Dyadic Adjustment Scale showed indirect effects on children’s methylation and psychopathological risk in relation to those exerted by risk factors. Conclusion Our study has supported the emerging evidence on the complex nature of children’s emotional-behavioral functioning and the associated risk and protective factors, with important implications for the planning of preventive programs.
 
The hypothesized model of psychological resilience mediating the effect of trait mindfulness on psychological stress
Participant flow through trial
Structural equation model of the relationship among trait mindfulness, psychological pesilience and psychological stress
Article
Background Adolescents’ psychological stress has become an important problem. Mindfulness-based interventions (MBIs) are proven to be effective in school settings in the Western world, and so expanding MBIs further is a particularly important consideration. Objective This study addresses the effectiveness of MBI in reducing psychological stress in Chinese school settings and the mediating role of resilience between trait mindfulness and psychological stress. Methods This study conducts a cluster randomized controlled trial. Ninety-two middle school students in the experimental group received 10 weeks of MBI, with 10 sessions of a mindfulness course, while 97 students in the control group followed their regular school program without intervention. Results Psychological stress, trait mindfulness, and psychological resilience were measured by the Psycho-Somatic-Tension-Relaxation Inventory (PSTRI), Five Facet Mindfulness Questionnaire (FFMQ), and Resilience Scale for Chinese Adolescents (RSCA). The results showed that (1) compared with the pretest scores of the experimental group, and the pre- and post-test scores of the control group, the post-test scores of trait mindfulness and psychological resilience in the experimental group were significantly increased, while psychological stress was significantly decreased. (2) Trait mindfulness was positively associated with psychological resilience. Trait mindfulness and psychological resilience were negatively associated with psychological stress. (3) The mediating effect of psychological resilience accounted for 43.58% of the overall effect of trait mindfulness on psychological stress. Conclusions These findings provide encouraging evidence for MBI’s effectiveness in reducing adolescents’ psychological stress and the possible mediating role of psychological resilience; thus, MBI is worthy of expanding to Chinese school settings.
 
Hypothesized autoregressive cross-lagged model. Note. Item residuals are expected but not included for clarity
Simplified final autoregressive cross-lagged model with significant unstandardized pathways. Note. Item residuals were estimated but not included for clarity
Article
Background While researchers have demonstrated the positive effects of School-Based Health Centers (SBHCs) on student health outcomes, less is known about the long-term impact of SBHC use on academic outcomes, such as attendance. Objective Our objective was to examine the direct and indirect effects of SBHC use on attendance among high school students over time. We posed three hypotheses: (1) SBHC use will predict less absenteeism, (2) SBHC use will positively predict physical activity and health status, and (3) The relationship between high school students’ SBHC use and absenteeism will be mediated by physical activity and health status over time. Method Using structural equation techniques, we estimated autoregressive cross-lagged models for a subsample of high schoolers (N = 413) from a 3-year statewide SBHC evaluation. Results SBHC use did not predict self-reported health status, physical activity, or attendance, but was predicted by physical activity and absenteeism. In addition, student health status, physical activity, and attendance were positively correlated with each other cross-sectionally and longitudinally. Conclusions Our findings build upon previous research on the important role student health plays in attendance and provide unique insights into the potential bi-directional relationship between student SBHC use and attendance, suggesting that SBHCs could be an opportunity to connect students to non-healthcare resources. Several implications also emerged for future longitudinal SBHC research, such as more frequent data collection intervals and examining the effects of different types of SBHC use with clinic or electronic health record data.
 
Article
Background Parenting strategies such as communicating clear expectations, providing calm directions, and teaching specific skills can strengthen young children’s social-emotional development. Parenting programs for children with disruptive behavior often emphasize gaining compliance via effective directives, and less on how to facilitate child skill acquisition or on effective parenting for differing situations and task demands.Objective We aimed to study how parenting strategies and associated child behavior vary by situational contexts. Specifically, we focused on the differential use of directives and guidance during different tasks.Method This observation study utilized a microsocial coding system, the Parent–Child Play Task Observation System (PCPTOS), to closely examine parent and child interactions in multiple analogue task situations. The study drew on pre-intervention data for 224 parent–child dyads who participated in a parenting-focused intervention trial for children ages 3–7 who presented elevated levels of disruptive behaviors.ResultsInterrater reliabilities were very good to excellent. Parents used directives more frequently during the clean-up task and guidance more frequently during the teaching task compared to the other tasks. Associations of parent use of directives and guidance with child behavior and affect differed by task. Observed parent directives were associated with child disruptive behavior during each task, whereas parent guidance was negatively associated with child disruptive behavior and positively associated with child positive affect during the teaching task.Conclusions Parenting strategies that are well matched to the situational context and proactively consider task demands are more likely to facilitate children’s social-emotional development.
 
Months in center-based care—distribution by disadvantage
Mean standardized scores, 2012, by 2010 vulnerability type
Improvement in standardized scores by 2010 vulnerability type: Coefficient on natural log of months in center-based care
Improvement in standardized scores by day length & 2010 vulnerability type: Coefficient on natural log of months in center-based care
Improvement in standardized scores by age at enrollment & 2010 vulnerability type: Coefficient on natural log of months in center-based care
Article
Background Research finds center-based child care typically benefits children of low socio-economic status (SES) but few studies have examined if it also reduces inequalities in developmental disadvantage. Objective I test if the length of time in center-based care between ages one and three years associates with child development scores at age three years, focusing on the impact for groups of children in the lower tercile of child development scores and in the lower SES tercile. Method Using data from 1,606 children collected in a nationally representative Chilean survey, I apply a value-added approach to measure gains in child development scores between age one and three years that are associated with length of time in center-based child care. Results Disadvantages at age one year were associated with lower child development scores at age three years. No benefits of additional time in center-based care were found for the non-disadvantaged group, but positive associations were found between more time in center-based care and child development outcomes for children with the SES disadvantage only. Center-based care was not associated with child development trajectories of children with lower child development scores at age one year, no matter their SES status. Conclusions There is evidence that Chilean center-based child care reduces SES inequality in child development scores between ages one and three years, but only if children already were not low-scorers at age one year.
 
Path analysis model loading all self-regulation indices on age-standardized school readiness scores, controlling for covariates of age, sex, maternal education (MatEd), home learning environment (HLE), and area-level socioeconomic status (SEIFA). Note. χ²(10) = 22.46, p = .013, CFI = .99, RMSEA = .07. Not depicted here, yet still modelled, are error terms for each predictor, correlations between these errors, and an error term for the outcome. Factor loadings are standardized regression weights. Significant paths are indicated by full lines, while non-significant paths are denoted by dashed lines. HTKS = Head-Toes-Knees-Shoulders task. PRSIST = Preschool Situational Self-Regulation Toolkit Assessment. CBRS = Child Behavior Rating Scale. CSBQ = Child Self-Regulation & Behavior Questionnaire. CSR = cognitive self-regulation. BSR = behavioral self-regulation. SESR = social-emotional self-regulation
Path analysis models loading individual self-regulation indices on age-standardized school readiness scores, controlling for covariates of age, sex, maternal education (MatEd), home learning environment (HLE), and area-level socioeconomic status (SEIFA). Note. (a) CSBQ-CSR on school readiness. χ²(10) = 22.84, p = .011, CFI = .81, RMSEA = .08. (b) PRSIST-CSR on school readiness. χ²(10) = 22.44, p = .013, CFI = .84, RMSEA = .07. (c) HTKS on school readiness. χ²(10) = 23.03, p = .011, CFI = .84, RMSEA = .08. Not depicted here, yet still modelled, are error terms for each predictor, correlations between these errors, and an error term for the outcome. Factor loadings are standardized regression weights. Significant paths are indicated by full lines, while non-significant paths are denoted by dashed lines. HTKS = Head-Toes-Knees-Shoulders task. PRSIST = Preschool Situational Self-Regulation Toolkit Assessment. CSBQ = Child Self-Regulation & Behavior Questionnaire. CSR = cognitive self-regulation. BSR = behavioral self-regulation. SESR = social-emotional self-regulation
Structural equation model loading a latent self-regulation variable on age-standardized school readiness scores, controlling for covariates of age, sex, maternal education (MatEd), home learning environment (HLE), and area-level socioeconomic status (SEIFA). Note. χ²(22) = 44.33, p = .003, CFI = .90, RMSEA = .07. Factor loadings are standardized regression weights. Significant paths are indicated by full lines, while non-significant paths are denoted by dashed lines. HTKS = Head-Toes-Knees-Shoulders task. PRSIST = Preschool Situational Self-Regulation Toolkit Assessment. CSBQ = Child Self-Regulation & Behavior Questionnaire. CSR = cognitive self-regulation. BSR = behavioral self-regulation. SESR = social-emotional self-regulation
Article
Background Over the past few decades early self-regulation has been identified as foundational to positive learning and wellbeing trajectories. As a consequence, a wide range of approaches have been developed to capture children’s developmental progress in self-regulation. Little is known, however, about whether and which of these are reliable indicators of future ability and risk for young children.Objective This study examined measures from prominent approaches to self-regulation assessment (i.e., task-based, observation, adult-report) to determine: their structure; how these predict future academic school readiness in 3–5-year-old children, individually and if combined; and whether thresholds could be ascertained to reliably discriminate those children at risk of poor academic outcomes.Methods Longitudinal analyses were conducted on start-of-year self-regulation data from 217 children in the final year of pre-school, using three prominent approaches to self-regulation assessment, and their end-of-year school readiness data. Data were subjected to path analysis, structural equation modelling and receiver operating characteristic curve analyses.ResultsStart-of-year cognitive self-regulation indices—but not behavioral or emotional self-regulation indices—from each approach reliably predicted school readiness 7 months later, just prior to commencing school. Only when combined into a composite score was a threshold with sufficient sensitivity and specificity for predicting school readiness risk established; yet this provided better prediction of true-negative than true-positive cases.Conclusions Taken together, these results suggest the importance of cognitive self-regulation in particular for school readiness, as measured here, although self-regulation is just one of the contributing factors to school readiness risk.
 
Latent Class Profiles of School Victimization and Problem Behaviors in Males
Latent Class Profiles of School Victimization and Problem Behaviors in Females
Article
Background Middle school victimization and problem behaviors often co-occur, but little is known about patterns of co-occurrence, or how long effects persist into adulthood.Objective Drawing on general strain theory, this study aimed to identify sex-specific profiles of victimization and problem behaviors during middle school, and their association with socioeconomic, violence, and criminal justice outcomes in young adulthood.Method Latent class analyses was conducted on data from the National Longitudinal Study of Youth–1997, including subsamples of seventh grade females (n = 529) and males (n = 494).ResultsTwo classes were identified for females: (1) low-risk and (2) high-risk; these classes were associated with outcomes in the hypothesized directions. For males, however, there were three groups: (1) low-risk, which reported low rates of victimization and problem behaviors; (2) victimized, with high victimization but low rates of problem behaviors; and (3) high-risk, with high rates of both victimization and problem behaviors. Interestingly, victimized males had socioeconomic and criminal justice outcomes similar to low-risk males, but rates of assault comparable to high-risk males. For example, victimized males were five times more likely to obtain a college degree than high-risk males (27.1% versus 4.6%) and three times less likely to live in poverty (9.5% versus 25.9%), but only slightly less likely to commit assault (41.7% versus 59.8%). However, there was alarming over-representation of Black youth in the high-risk groups.Conclusions Findings emphasize the urgency with which schools and community agencies need to address victimization and problem behaviors among adolescents, but simultaneously target structural racism.
 
Article
Background The process of transition to adult life of youth with a record of protection is crucial to overcome the difficulties to achieve an independent life.Objective This research aims to analyze the conditions under which protected youth are emancipated, as well as the factors that facilitate emancipation.MethodA qualitative study was performed with three samples: longitudinal follow-ups with youths when they exit the system and during 12 months (N = 24); life stories of youths who have exited the child welfare system at least 2 years ago and a maximum of 5 years ago (N = 22); interviews with professionals conducting their intervention in adolescent protection resources (N = 18).ResultsThe results indicate that protective action is not enabling youths’ learning in normalized contexts, which negatively affects the conditions under which emancipation occurs. The experience of the protective action conditions the tendency to benefit from the post-majority socio-educational accompaniment.Conclusions The importance of socio-educational intervention continuing during the first moments of emancipation, providing professional accompaniment to the entire collective, is highlighted.
 
Article
Background Although the link between substance use and criminal behavior is well-established, associations between the use of specific substances and specific criminal charges remains unclear. That is, there are mixed findings in the literature, and the majority of extant literature focuses only on associations between alcohol and marijuana use and a limited range of charges.Objective The current study examined 30-day frequency of use of various substances (i.e., traditional tobacco, alcohol, marijuana, e-cigarettes, and prescription drugs) prior to detainment, percentages of youth charged with various offenses, and whether certain offenses were associated with more frequent use of particular substances prior to detainment among detained youth. Additionally, differences in substance-charge associations among Black and White youth were evaluated.Method Detained youth (N = 235; 71.9% male; M age = 15.59 years) from two facilities self-reported on their substance use and the facilities provided charge data.ResultsMarijuana was the most frequent substance used and violent-related offenses were the most common charge received. Interestingly, several charges (i.e., sex-, weapon-, and violent-related offenses) were associated with less frequent use of tobacco and/or marijuana use, but youth who were detained for non-criminal reasons (i.e., children in need of care) reported more frequent use of various substances than youth detained for criminal charges. Findings were more similar than different for Black and White youth, with very few differences evident.Conclusions Children in need of care appear more at risk for certain substances than those detained for criminal offenses, with associations similar for detained Black and White youth.
 
Flow diagram of recruitment process
Article
Background Self-harm usually begins during adolescence and adolescents that self-harm most commonly confide in friends, yet to date, there is little research from the friend’s perspective.Objective This qualitative study explores adolescents’ experiences of what it is like to have a friend who self-harms by cutting and what this experience means for friendship, the wider peer group and psychological well-being.Methods Semi-structured interviews were conducted face-to-face with a community sample of eight females aged between 13 and 18 years, living in England. Interpretative Phenomenological Analysis was used to analyse the data.ResultsFour superordinate themes emerged: desperately searching for meaning, I will be there at all costs, too hot to handle and identification. Adolescents were concerned about escalations in their friends’ behaviours and felt a sense of duty to help, but the majority experienced a dilemma as to whether to disclose to others and all reported some form of distress.Conclusions The results highlight the important, yet complex nature of friendship in this context. Friends play a key role in supporting adolescents who self-harm but need greater support managing this role and the effects. Schools/colleges should educate young people about self-harm to increase their knowledge and skills in relation to supporting a friend with this issue. Furthermore, they should promote environments for talking about mental health openly to give young people increased opportunities for help-seeking.
 
An integrated stage-based active implementation framework (ISAIF)
Article
Background This study was the first attempt to investigate the status of implementation and sustainability of early childhood positive behavior support (PBS) via the lens of implementation science for community-based child care centers in a Midwest state of the United States.Objective Obtain state-level data and gain insights on PBS implementation and sustainability in target child care centers.Method Through a total population sampling method, we recruited administrators (N = 94, 12% of the full population) of target child care centers to participate in a survey.ResultsThe results suggested that the majority of the responding centers (59.57%) had not received PBS professional development (PD) indicating PBS PD opportunities had not been disseminated in the majority of community-based child care centers in the target state. Nearly half of the programs were not implementing PBS practices after they received PBS PD, which raised questions about continuous use of PBS and the return on investment of PBS PD efforts. The results of ANOVA found that the scope of PBS training significantly affected the level of PBS implementation; the type of training significantly affected the level of PBS sustainability. Simple linear regression revealed programs that had a higher level of PBS implementation also had a higher level of PBS sustainability.Conclusions Using implementation science theories and tools, we developed two preliminary measures to obtain meaningful information about early childhood PBS implementation and sustainability in community-based child care centers. Understanding the factors associated with implementation can provide insights for the improvement of PD programs when disseminating the use of evidence-based PBS practices.
 
Visualization of cluster analysis. Participants are represented by points on the scatterplot
Provider relationships with families and children by cluster group
Provider ratings in responsiveness to children’s negative emotions by cluster group
Article
Background There is a concern regarding the decreasing number of family childcare (FCC) providers, due to the population that primarily relies on it. Compared to studies of center- and school-based preschool practitioners, the FCC literature is lacking robust workforce studies, including examinations of whether and how FCC providers’ workplace appraisals of and feelings while at work are associated with indicators of interaction quality (relationships with families, relationships with children, and responsiveness to children's negative emotions) and the quality of their interactions with children and families.Objective The present study examines how groups of FCC providers, categorized based on differences in appraisals of and feelings experienced at work, differ in the quality of interactions with children and families. The study seeks to extend the FCC literature by also describing socio-ecological factors, such as provider and program characteristics, of these different groups of providers.Method Survey data was collected through a national study of FCC providers (N = 888). A person-centered analysis using hierarchical clustering was used to classify providers into groups based on their workplace appraisals and feelings experienced at work.ResultsA person-centered cluster analysis identified four groups. Indicators of interaction quality varied between groups. Group membership was associated with FCC providers' professional commitment, job satisfaction, and emotional exhaustion.Conclusions Findings from the current study support calls to increase investment in the support of the FCC workforce by addressing FCC providers’ needs through recognition of differences in workplace appraisals and provider feelings at work. In particular, reducing FCC providers’ emotional exhaustion may be an effective way to increase the quality of their interactions with children and families.
 
Article
Background Although the literature in medical anthropology and transcultural psychiatry has documented how cultural representations shape individual experiences and perceptions of psychosocial distress and its management, less attention has been given to what is actually meant when the concept of culture is used in professional practice, and how this may influence experience of care. Objective The objective of this article is to explore what understandings of culture circulate in youth mental health practitioners’ and families’ narratives, and to analyse how different operationalizations of the concept may affect experience of services. Methods This article draws upon the qualitative components of a larger mixed-methods research program on collaborative care in youth mental health. Semi-structured interviews were conducted in Montréal (Québec, Canada) with 39 parents, 48 youths and 29 practitioners about their experience of services, and with 26 practitioners about their experience of intercultural training. Data was analyzed using thematic and narrative approaches. Results Results show that families and practitioners use a multiplicity of understandings of the concept of culture in their discourses as a narrative strategy to mediate dialogue in clinical encounters, either by engaging in it, avoiding it, or refusing it. Conclusions The concept of culture and its use in the clinical realm can be seen a double-edged sword, both as a tool to reify stereotypes and inequalities, and as a means to mobilize representations towards cultural safety and transformative practices. Minority families’ experiences of services may be improved by providing intercultural training and a supportive work environment to clinicians.
 
Top-cited authors
Sanna J. Thompson
  • University of Texas at Austin
Janet Lantry
  • University of Texas at San Antonio
Michael Southam-Gerow
  • Virginia Commonwealth University
Candice A Alfano
  • University of Houston
Amanda Gamble
  • Woolcock Institute of Medical Research