Falling off the ladder: Using focal theory to understand and improve the educational experiences of young people in transition from public care

Coleman's focal theory, developed in relation to adolescents in the general population, appears to offer some explanation for the poor educational achievement and social exclusion of care leavers, but has been little tested empirically. This paper revisits data from two studies of care-experienced young people aged 18–25, drawing on qualitative interviews in the UK and four other European countries, to see if focal theory would have helped to predict their educational progression or otherwise. The lives of research participants were found to be characterised by disruptions and uncertainty, with multiple challenges confronting them in quick succession, making it hard for them to pace their transitions as, according to focal theory, other young people do. Findings suggest that the theory could be used to inform policy designed to improve educational outcomes and should be incorporated into training for those responsible for supporting care leavers through their transition to adulthood.     

Visible difference amongst children and adolescents: issues and interventions

Whether present at birth or acquired later in life, a visible difference (disfigurement) can have considerable psychological ramifications for children and adolescents. Whilst many young people adapt to the demands placed upon them and appear relatively unaffected, others report difficulties including adverse effects on body image, quality of life, self-esteem and difficulty with social encounters. This review examines the issues experienced by those affected, summarizes the factors identified as exacerbating or ameliorating any difficulties, then considers the particular pressures associated with developmental stages and the issues for family members. The current provision of care, the potential benefit of psychosocial interventions and the challenges faced by researchers in this area are explored.     

Psychological functioning in children and adolescents with Sturge-Weber syndrome

Previous studies of individuals with Sturge-Weber syndrome have focused on the medical aspects of this syndrome, but little has been known about the affective and behavioral correlates. We collected psychological and medical data from parents and teachers for 79 children and adolescents with Sturge-Weber syndrome and a group of their siblings. We also obtained the results of intellectual assessment for a subset of the Sturge-Weber syndrome group. The young people with Sturge-Weber syndrome exhibited more problems than the group of siblings across a number of behavioral domains: intellectual/academic, social skills, mood, and compliance. Those children most at risk for psychological problems were those with lower levels of intellectual functioning, those with seizure disorders, and those with more frequent seizures. Larger port-wine stains were also associated with an increase in mood and social problems but only for older children. Increased age was not associated with lower levels of intellectual or academic functioning, but mood and social problems were more common in older children.     

Similarities amid the difference: Caregiving burden and adaptation outcomes in dyads of parents and their children with and without cerebral palsy

This study had two main objectives: first, to examine the direct and indirect effects, via social support, of caregiving burden on the adaptation outcomes of children/adolescents with cerebral palsy and their parents; and second, to assess the invariance of such models in clinical vs. healthy subsamples. Participants were 210 dyads of children/adolescents and one of their parents (total N = 420), divided in 93 dyads of children/adolescents with cerebral palsy and 117 dyads of children/adolescents with no medical diagnosis. Data on caregiving burden, social support and adaptation outcomes were obtained through self-report questionnaires. Caregiving burden was linked to parents and their children's psychological maladjustment and quality of life both directly (except for children's quality of life) and indirectly through social support. Findings were invariant across clinical and healthy subsamples. Caregiving burden may influence adaptation outcomes of children/adolescents with CP and their parents both directly and via their social support perceptions. These patterns are similar to those observed in typically developing children/adolescents.     

Meta-analysis of quality of life in children and adolescents with ADHD: By both parent proxy-report and child self-report using PedsQL™

Attention deficit hyperactivity disorder (ADHD) is a prevalent developmental disorder that seriously and negatively impacts a child's health-related quality of life (HRQOL). However, no meta-analysis has been conducted to examine the magnitude of impact, domains affected and factors moderating the impact. This review included nine studies that compared HRQOL of children or adolescents with ADHD with those with typical development using both child self-reports and parent proxy-reports. Seven among nine studies were meta-analytically synthesized to examine the degree of impact of ADHD on children and adolescents, parent–child discrepancy, and the moderators. The results indicate that ADHD impact a child's or adolescent's HRQOL negatively with a moderate effect in physical and a severe effect in psychosocial (i.e., emotional, social, and school) domains. Parental ratings of overall HRQOL in children or adolescents with ADHD were not significantly different from child's ratings when compared with typically developing children and adolescents. Age was negatively associated with all domains of HRQOL in children and adolescents with ADHD both by parent- and child-ratings, and the strongest effect was found in parental ratings of child's emotional HRQOL, with a moderate correlation. This meta-analysis suggests that HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports, and that interventions may be planned accordingly. Future meta-analysis may explore how measures of HRQOL and other factors including child, parental, familiar and school characteristics influence the impact of ADHD and the parent–child agreement in children and adolescents.     

Competencies and problems of Irish children and adolescents

This study set out to investigate the behavioural and emotional problems and competencies of Irish children and adolescents using Achenbach's Child Behaviour Checklist (CBCL) and Youth Self Report (YSR). The Child Behaviour Checklist was completed by parents of 481 Irish school children aged 7–9 years and 13–15 years, and the Youth Self Report was completed by 240 adolescents. The schools were selected to represent a wide social and cultural spread. Irish young people of all ages scored significantly lower than their American counterparts on measures of competence, whether rated by themselves or their parents. The parents of the 7–9 year olds rated their children as having significantly lower total problem scores than their American counterparts, but for 13–15 year olds there were no differences in total problem scores between the Irish and American samples, whether rated by parents or the adolescents themselves. Total problem scores and externalizing scores increased with age on the CBCL and the YSR, a pattern in which Irish young people differed from those in most other cultures. Despite differences in sampling and methodology, the Irish results are similar in many respects to those seen in a number of other European studies. Accepted: 22 July 1998     

Cerebral palsy -the transition from youth to adulthood

Service provision for those with cerebral palsy (CP) becomes fragmented after adolescence. Young people with CP in two age groups, their carers and associates, were interviewed, and use of health and social services was investigated. Leisure activities were also compared with a matched control group of able-bodied young people. Use of health and social services decreased when the children with CP left school, thereby increasing the demands upon carers. Carers expressed anxieties about the provision of services, and frustration in obtaining information about help. Findings from the questionnaires showed the young people with CP in both age groups to be socially less active than the controls. Among the subjects, the older age group was socially less active than the younger age group. Communication is poor both between the agencies providing care and between the agencies and the young person or carer. There is a need to identify those with responsibility for coordinated-care planning for adolescents with CP.     

Living without psychiatrists in the Andes: Plight and resilience of the Quichua (Inca) People

There is an estimated 30 million indigenous peoples in South America. Most of them live in the Andes. Regional states and governments neglect their health care needs and exclude them from the conventional Western health services in general and mental health care in particular. This review first describes this population's current situation of social exclusion, poverty and poor health. The problem of mental health care inequities in the region is illustrated through the case of the Quichua people. Indeed, for the population of over 5 million Quichua people in Ecuador, there are no psychiatric services. There are no culturally sensitive services offered in the Quichua language. The doctor–Quichua patient communication is poor and interactions are loaded with prejudice. The review provides a rationale for the Quichuas' reluctance to seek medical doctors in Ecuador. Finally, traditional healers' contribution to the mental health care of indigenous peoples is stressed, as well as their preference for a form of medical pluralism, mainly combining both traditional Quichua medicine and Western medicine. Woeful inequalities and inaccessibility to psychological and biomedical psychiatric care still widely affect the children of the sun in the Pacific Rim.     

Effects of autistic traits on social and school adjustment in children and adolescents: The moderating roles of age and gender

This study examined the associations between children's and adolescents’ autistic-like social deficits and school and social adjustment as well as the moderating roles of age and gender in these associations. The sample consisted of 1321 students (48.7% boys) in Grade 1 to Grade 8 from northern Taiwan. Children's and adolescents’ autistic-like social deficits were assessed using the Social Responsiveness Scale (SRS), and their school and social adjustment (i.e., academic performance, negative attitudes toward schoolwork/teachers/classmates, behavioral problems at schools, negative peer relationships, and problems with peers) were assessed using the Social Adjustment Inventory for Children and Adolescents (SAICA). Both measures were completed by the mothers of the participants. Results from the linear mixed models demonstrated that autistic-like social deficits were associated with poor academic performance, negative attitudes toward schoolwork, teachers, and classmates, behavioral problems at schools, negative peer relationships, and problematic peer interactions. Moreover, gender and/or age moderated the associations between autistic-like social deficits and school and social adjustment problems. For example, autistic-like social deficits were more strongly related to negative school attitude, school social problems, and negative peer relationships in boys than in girls. Further, autistic-like social deficits were more strongly related to problems with peers in older girls than in older boys or younger children (regardless of gender). In conclusion, the present study suggests that autistic-like social deficits may place children and adolescents at increased risk for social and school maladjustment and that the extent of maladjustment may vary with the child's age and gender and the domains of adjustment under discussion.     

Repetitive behaviour and obsessive–compulsive features in Asperger syndrome: Parental and self-reports

Symptoms of repetitive, obsessive and compulsive behaviour were explored in a group of adolescents and young adults with Asperger syndrome and compared to a typically developing group. By means of self-evaluations and an interview regarding such symptoms with the adolescents and young adults and parental evaluations, the parents retrospectively assessed the behaviour of their children from preschool years to middle teens, and the young participants assessed their own behaviour from school years until present time. An anxiety scale was also used. The results revealed no significant differences between the groups on the interview and the anxiety scale. There were, however, significant differences on both the parental and the self-evaluations. Thus, the parents reported that their children had difficulties with repetitive, obsessive–compulsive behaviour, and social interaction from preschool years, and both the parents and the adolescents and young adults reported considerable difficulties in those areas during school years. When comparing the evaluations from the parents and the young participants it was shown that the parents in the Asperger group reported significantly more problems than their children while in the comparison group the parents reported less problems than their children.     

Aspects of sleep disorders in children and adolescents

Sleep disorders in children and adolescents is a topic that has been, and remains, neglected in both public health education and professional training. Although much knowledge has been accumulated in recent times, it has been poorly disseminated and, therefore, relatively little is put into practice. Only some general issues can be discussed in this article. The aspects chosen relate mainly to clinical practice, but they also have relevance for research. They concern various differences between sleep disorders in children and those in adults, the occurrence of such disorders in young people, their effects on psychological and physical development, the essential (but often ignored) distinction between sleep problems and their underlying causes (ie, sleep disorders), types of sleep disturbance encountered at different ages during development, and the differential diagnosis of certain parasomnias that are at particular risk of being confused with each other.     

Predictors of academic attainments of young people with Down's syndrome

Background Earlier studies of young people with Down's syndrome have investigated a relatively limited range of variables which may influence their academic attainment. The relative strength of such influences and how they may vary during the school career, has also been under‐researched. Aims The aim of the paper is to identify the contemporary and antecedent predictors of the level of academic attainment achieved by a representative sample of young people with Down's syndrome. Sample The paper reports data from three studies of 71 young people with Down's syndrome and their families. Mean IQ at the time of the first study (t1) was 40.4. Mean chronological age was 9 years at t1, 14 at t2, and 21 at t3, when all the young people had left school. Methods The outcome measure was the 58‐item Academic Attainments Index (AAI), comprising three sub‐scales covering reading, writing and numeracy. Predictors of the outcome were derived from questionnaires and interviews from tutors, mothers and fathers. A path analysis approach was used to investigate the pattern of predictors of the outcome over the three studies. Results Factors predicting greater progress in this measure between t2 and t3 were lower chronological age and attendance at mainstream school. Progress from t1 to t2 was also associated with attendance at mainstream school, as well as with higher t1 mental age, mother's practical coping style and higher child attentiveness. Background factors predicting higher t1 AAI scores were higher mental age, attendance at mainstream school and father's internal locus of control. The path analysis model predicted 48% of the variance in t3 outcome scores. Severity of intellectual impairment was by far the most significant predictor. Conclusion Limitations to the study include evidence of attrition bias towards more able children, and the need to obtain the t3 outcome measure from tutors for some young people and parents for others. Parents may have over‐estimated abilities. Results are broadly in agreement with other studies, and confirm the pattern reported earlier with this group. Mainstream school attendance had a modest beneficial effect on AAI scores throughout the school career of the children, independently of level of intellectual disability. Identification of predictors of attainment levels and of improvement over time may help parents, teachers and other professionals involved with families of children and young people with Down's syndrome optimise the attainment of such skills.     

Understanding the experiences and emotional needs of unaccompanied asylum-seeking adolescents in the UK

For adolescents who flee to the UK seeking asylum, the experience of leaving their home country puts them at risk of developing mental health problems. Although there is a research base exploring the mental health of asylum-seeking children and adolescents who arrive with their families, there is in contrast very little focusing on the mental health needs of children and adolescents who arrive in the UK alone. There has been ongoing debate about whether current theoretical models for understanding reactions to trauma and loss are helpful in supporting unaccompanied asylum-seeking children and adolescents with complex psychological and social issues as a result of fleeing their home countries. This article draws on young people's own understanding of their experiences of seeking asylum in the UK using a qualitative semi-structured interview. It attempts to develop a more contextually relevant understanding of their emotional reactions to adversity and to consider the sorts of support required. Interpretative Phenomenological Analysis was used to provide an in-depth understanding of six young asylum seekers' experiences, exploring themes of loss, negotiating a new life, psychological distress and the process of adjustment. Psychological interventions and future service provision for this group are discussed.     

Systems in Conflict: Labeling Youth Creativity as Mental Illness

ABSTRACT

Highly creative children and adolescents often behave in ways that may appear to be symptoms of mental illness. Multiple systems, including family, school, and mental health professionals, may unknowingly fail to recognize and nurture the creative side of these young people. This article presents a review of literature about the characteristics of creative people that may overlap some symptoms of mental illness. Case studies introduce a new therapeutic approach that embraces youth creativity, invites a positive meaning for symptoms, removes the stigma of a mental illness diagnosis, and improves the young persons' self-esteem and behavior.     

Education in ‘folk high school’ for younger aphasic people

Abstract

Studies of the behavioural changes in aphasic patients arc dominated by reports of minor psychiatric disordcrs and depression (see Wihrborg 1986). Thc complex social and psychological situation which presents the young person with aphasia is often mirrored in behavioural changes. It is our view that rehabilitation which takes into account many differcnt aspects of the aphasic person's over- all situation will be more likely to show improvement. Rchabilitation attempts in hospital take place during a limited period of time and often provide a protective and somewhat artificial social atmosphere for the patient. Because of the communication problems facing the aphasic person and the psychological reactions experienced, interactions within the family can change and interrupt normal married life. These changes might well be more drastic for young people, who prior to their aphasia, led an active social and professional life.     

Adaptive behaviour in children and adolescents with foetal alcohol spectrum disorders: a comparison with specific learning disability and typical development

Foetal alcohol spectrum disorders (FASD) is a leading cause of intellectual disability in the western world. Children and adolescents with FASD are often exposed to a double burden in life, as their neurological sequelae are accompanied by adverse living surroundings exposing them to further environmental risk. In the present study, the adaptive abilities of a group of children and adolescents with FASD were examined using the Vineland Adaptive Behaviour Scales (VABS) and compared to those of a group of IQ-matched children with specific learning disorder (SLD) as well as with typically developing controls (CON). The results showed significantly different adaptive abilities among the groups: Children with FASD performed worse than IQ-matched children with SLD, who in turn performed worse than typically developing children on all domains (communication, daily living skills and socialization) on the VABS. Compared to the other groups, social skills declined with age in the FASD group. These results support previous studies of adaptive behaviour deficits in children with FASD and provide further evidence of the specificity of these deficits. On a societal level, more efforts and resources should be focused on recognizing and diagnosing FASD and supporting communication skills, daily living skills and most of all social skills across diagnostic groups within FASD. Without adequate intervention, adolescents and young adults with FASD run a great risk of marginalization and social maladjustment, costly not only to society but also to the lives of the many young people with FASD.     

Using motivational interviewing with children and adolescents: a cognitive and neurodevelopmental perspective

Motivational interviewing (MI) is an effective method of promoting change in adults, but its efficacy with children and adolescents is in the early stages of evaluation. The brevity of the intervention, documented effectiveness in adult populations and emphasis on motivating behavioural change have encouraged some researchers to test MI in educational settings. However, the number and quality of studies of MI with children and adolescents are limited, and it remains unclear whether MI is developmentally appropriate for children. This conceptual paper reviews cognitive and neurodevelopmental evidence of children's and adolescents' cognitive and social–emotional readiness for mental tasks thought to drive behavioural change in MI. Owing to the social context of MI, we place this research in a developmental framework using the social information processing network model of Nelson, Leibenluft, McClure, and Pine (2005). Based on these findings, we recommend continued testing of MI with students in middle and high schools but caution against using MI with elementary school students.     

Social support, ethnicity and mental health in adolescents

Objective In this study, we explored whether social support varied with ethnic group in young people, and if it explained ethnic differences in prevalence of psychological distress. Methods A representative sample of 2790 East London adolescents (11–14 years) completed a classroom-based self-report questionnaire for this cross sectional survey. Social support was assessed using the Multidimensional Scale of Perceived Social Support (MSPSS). Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) and the Short Moods and Feelings Questionnaire (SMFQ). Results High levels of social support were reported by most participants, with some variation by ethnic group and gender. Participants reporting low family and overall social support had an increased likelihood of psychological distress compared with those who reported high support. Low support from friends, family and overall was also associated with depressive symptoms. These relationships did not alter with adjustment for ethnic group. Conclusions This study identified an independent association between different sources of social support and mental health in a young, ethnically diverse sample. Differences in social support did not explain ethnic differences in psychological distress.     

Les tuteurs de résilience des enfants et adolescents vivant dans des camps à Port-au-Prince et dans les villes avoisinantes

ObjectivesIn the context of sustainable reconstruction of Haiti following the earthquake of January 12, 2010, this research analyses the processes of resilience and creators of young and adolescent Haitians. In particular, it examines the role of family, school, care institutions, beliefs, association networks, the state and the international community in the development of these processes. These strata are considered as human resources that may assist in the living of difficult experiences, and reconstruction-shoring research mainly aims to identify guardians’ resilience among young and adolescent Haitians living in camps in Port-au-Prince and the other most affected cities after the nearby earthquake.MethodologyFrom a questionnaire developed jointly with the University Lumière Lyon 2 (CRPPC) Editec and the State University of Haiti (UEH) in the context of research, individual interviews were conducted with a sample of n = 1475 children and adolescents, 782 girls and 693 boys, 19% of whom were under the age of 6 years, 52% aged 6 to 15 years and 29% aged 15 to 20 years. This allowed the collection of their perception and representation of different elements, which serve as scaffolding to cope with the post-traumatic situation they experienced and to analyse and establish the correlation links between the tutors identified. Among the young people in the sample, 97% are mostly educated, and they remain in three cities that have been particularly affected by the earthquake: the capital Port-au-Prince, Leogane a commune of Port-au-Prince located in the department of the West, and Jacmel a commune of Haiti and head of the department of the South East. We enjoyed the perception and representation of children and adolescents on several potential guardians’ resilience: family, school, health care institutions, places of worship, social and community networks, government and international organizations.ResultsSome data concluded that tutors can actually be correlated and identified by sex and level of development topics. Analyses revealed that the majority of children had not lost their parents and said they feel safe with their families. Academic performance tended mostly to increase after the earthquake, young people perceived care as accessible and available, and the majority claim to be Protestant. They certify that they have many friends and have ties in the community and feel safe in the streets. The data show a positive dominance of religious practice and sense of trust in institutions of care on the part of girls while the boys claim to have more confidence in the State. The school performance is more important to those aged between 6–15 years, while the older ones practice less religion and rely less on the State and international organizations. These results suggest the importance of institutions such as the family, places of worship, educational institutions, health centres, community, etc.     

Support and Companionship in Virtual Communities: Establishing a COVID-19 Counseling Network for Soldiers and the Collective Healing Phenomenon

Counseling people, particularly those in the military engaged in group living, who are in quarantine during the COVID-19 pandemic is a challenge. Therefore, supporting the people in quarantine who are experiencing psychological and interpersonal problems has become a new challenge in military mental health. This study’s primary concern was how to overcome the problems caused by physical quarantine. The study subject was a virtual counseling network and its operating experience during the quarantine period in Taiwan amidst the global COVID-19 pandemic. For soldiers who mainly live in groups, this study discussed how the virtual counseling network combined with the existing military support group to determine what influence the network had on people in quarantine. This study found that this group exhibited four types of experiences: togetherness, empathy, confidence, and belonging and cohesion. Such experiences are beneficial for group healing through mutual support and companionship. Collective cohesion and psychological healing can be achieved through a virtual community. This is worthy of attention, particularly in the pandemic or post-pandemic era. Physical isolation has become a fact of life, and such isolation is not just isolation from disease but also between regional boundaries. Counseling and support systems in virtual space or the operation of virtual teams must be considered for the future.