Welfare Reform and Children's Health

This study investigates the effect of the Temporary Aid to Needy Families (TANF) program on children's health outcomes using data from the Survey of Income and Program Participation over the period 1994 to 2005. The TANF policies have been credited with increased employment for single mothers and a dramatic drop in welfare caseload. Our results show that these policies also had a significant effect on various measures of children's medical utilization among low‐income families. These health measures include a rating of the child's health status reported by the parents, the number of times that parents consulted a doctor, and the number of nights that the child stayed in a hospital. We compare the overall changes of health status and medical utilization for children with working and nonworking mothers. We find that the child's health status as reported by the parents is affected by the maternal employment status. Copyright © 2014 John Wiley & Sons, Ltd.     

Are children rational decision makers when they are asked to value their own health? A contingent valuation study conducted with children and their parents

Despite the importance of including children's preferences in the valuation of their own health benefits, no study has investigated the ability of children to understand willingness‐to‐pay (WTP) questions. Using a contingent valuation method, we elicit children's and parents' WTP to reduce children's risk of an asthma attack. Our results suggest that children are able to understand and value their own health risk reductions, and their ability to do so improves with age. Child age was found to be inversely related to parents' and children's WTP. The results also suggest that non‐paternalistic altruism is predictive of children's WTP. For parents, care for their own health was found to be inversely related with their WTP for children's risk reductions. Comparison of parents' and children's WTP suggests that parents are willing to sacrifice for their child's health risk reduction an amount that is approximately twice that of their children. The analysis of matched pairs of parents and children suggest that there are within‐household similarities as the child's WTP is positively related to parents' WTP.     

Maternal mental health and childrearing context in the development of children at 6, 18 and 36 months: a Taiwan birth cohort pilot study

Background This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. Methods Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36‐Item Short Form Health Survey (SF‐36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self‐report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. Results This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. Conclusions This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self‐report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow‐up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.     

The association between maternal serious psychological distress and child obesity at 3 years: a cross-sectional analysis of the UK Millennium Cohort Data

Background The prevalence of child obesity is increasing rapidly worldwide. Early childhood has been identified as a critical time period for the development of obesity. Maternal mental health and early life environment are crucial factors and have been linked to adverse child outcomes. The objective of the study was to examine the relationship between maternal serious psychological distress and obesity in early childhood. Methods A cross‐sectional analysis of data from the Millennium Cohort Study was conducted. Subjects consisted of all natural mothers (n= 10 465) who had complete and plausible data for Kessler‐6 scores, socio‐demographic and anthropometric variables, and their children for whom anthropometric measurements were completed at age 3. Maternal serious psychological distress was defined as a score of 13 or more on the Kessler‐6 scale. Obesity was defined as body mass index ≥95th centile of the 1990 reference chart for age and sex in children. The data were analysed using spss 16. Maternal socio‐demographic factors that are known to influence maternal mental health and child obesity were identified and adjusted using multivariate logistic regression. Results Of the 10 465 mother–child dyads, 3.5% of mothers had serious psychological distress and 5.5% of children were obese at 3 years of age. Logistic regression analysis showed that maternal serious psychological distress was associated with early childhood obesity (P= 0.01; OR 1.62, 95% CI 1.11, 2.37). After adjusting for potential confounding factors using multivariate logistic regression, maternal serious psychological distress remained significantly associated with early childhood obesity (P= 0.01; OR 1.59, 95% CI 1.08, 2.34). Conclusions The results show that maternal serious psychological distress is independently associated with early childhood obesity.     

Young children's views of the role of preschool educators

This article aims to explore young children's (from one to three years old) perspectives of the role and pedagogy of educators in play in an Icelandic preschool. The intention is to explore the meaning that children put into involving educators in their play and whether the children experience educators' actions as a resource for their play. The study is based on a phenomenological approach. Data consist of video recordings and field notes of 46 children, from one to three years old, as well as eight educators. Four main categories that illustrate children's perspectives on the role of the educators emerged: (a) assistance connected to play situations and play material, (b) confirmation of competence, (c) support connected to children's social interactions, and (d) participation in play and playful actions. The findings reveal that children's perspectives and experiences in their own life-worlds in play can be considered an important dimension that contributes to changes in the pedagogical practices that are emphasised in curriculum.     

Personal and environmental pathways to participation in young children with and without mild motor disabilities

Objective Participation in everyday activities has a positive influence upon health and well‐being and is considered as an outcome measure. According to recent models child participation is the product of the dynamic interaction between health states and both individual and environmental factors. Children with mild developmental disabilities often present decreased participation in everyday activities. The purpose of this study was to explore the extent to which individual and environmental factors explain the participation of young children, with and without mild motor disabilities. Methods The study population included 58 kindergarten children together with their parents (29 children with mild motor disabilities who were referred to occupational therapy and 29 children without motor disabilities). Both groups of children were matched for: age; gender; age of parents; and socio‐economic status (SES). We assessed participation using the Child Participation Questionnaire (intensity, diversity, independence, child enjoyment and parental satisfaction) and we assessed children's self‐efficacy and motor abilities for individual factors. Parental self‐efficacy and SES were collected by questionnaires. Results Participation diversity (number of activities) was predicted by child and mother self‐efficacy and by SES. Child independence and enjoyment as well as parental satisfaction were predicted by child motor ability but mainly by maternal self‐efficacy. Results suggest that the total explained variance is more than double when the environmental variables (parental self‐efficacy and SES) are inserted to the participation model. Conclusions Maternal self‐efficacy and SES serve as facilitators to increased participation and well‐being of children with mild motor disabilities.     

Low‐Income Mothers' Employment Experiences: Prospective Links with Young Children's Development

This study assessed mothers' employment experiences and links with children's long‐term cognitive achievement and socio‐emotional adjustment using a representative sample of low‐income mothers and children (N = 538) from the Three‐City Study. Maternal employment involvement, quality, and stability were assessed over a 2‐year period when children were aged 24 to 48 months. Cluster analysis of the employment characteristics yielded 4 distinct employment patterns differing by the quality and stability of employment. OLS regression analyses linking these employment patterns with children's functioning at age 9 revealed that high‐quality stable employment was associated with enhanced cognitive skills and behavioral functioning among children. Further analysis suggested the significance of mothers' consistent insurance benefits to the long‐term well‐being of their children.     

Social competence of elementary-school children: relationships to maternal authoritativeness, supportive maternal responses and children's coping strategies

Background Although the influences of parenting on children's development of social competence have been well established, research on the underlying mechanisms of this link is relatively limited. The present study examined children's coping strategies as a mediator of the effects of maternal authoritativeness and maternal inductive responses on their social competence. Method The mothers of 183 Hong Kong Chinese children aged 6 to 8 years (89 girls and 94 boys) reported on their adoption of authoritative parenting and their responses to their children's expressions of emotion, and rated their children's adoption of constructive coping strategies. The children's teachers reported on the children's prosocial behaviour, and rated their level of peer acceptance at school. Results A model of maternal authoritativeness and supportive maternal responses affecting children's social competence is presented. The study results show that the effects of authoritative parenting on children's adoption of constructive coping strategies were mediated by supportive maternal responses to children's expression of emotion, and that the effects of maternal authoritativeness and maternal responses on children's social competence were mediated by children's coping strategies. These results suggest that school personnel should organize training programmes on emotion‐coping strategies for both parents and children. Conclusion The findings imply that positive parenting facilitates children's acquisition of constructive emotion‐coping strategies. Programmes on emotion‐coping strategies should be introduced for both parents and school children.     

The SOS Children's Villages: Behaviour of Children reared in a Permanent Foster Care

The present study has investigated the behavioural development of 157 children aged 7‐15 reared in a long term placement. They had been in a SOS children's village for 4 and a half years. All school results and questionnaires from teachers scale were collected. Family backgrounds, parental alcoholism and number of previous placements have important long‐term effects on children's development. Some behavioural problems appear when 2 or 3 groups of siblings are reared together. The proportion of behaviour problems for such children reared in a mono‐parental foster care is equivalent to those of children reared in working‐class‐families whether adopted quite early or remaining in their natural families.     

Childhood sexuality and rights in the context of HIV/AIDS

The primary objective in this study was to explore what HIV and AIDS mean to seven‐ and eight‐year‐old children in South Africa and how sexual and gender dynamics are embedded within these meanings. Against representations that associate young children with innocence, the paper argues for a more capacious view of young children as sexual and gendered agents with the ability to exercise their rights. In contrast to research that addresses children as relatively passive desexualised beings, focusing on their dependence on adults, their innocence and their need for protection, this paper examines how HIV and AIDS are constructed and negotiated by young people. It views children not simply in terms of their need for sexual rights but as potentially active participants in the negotiation of their rights. Viewing children's rights as highly contested, the notion that young children have sexual rights opens up possibilities for children (including those from marginalised groups) to talk about their concerns and pleasures, fears and hopes, as well as issues relating to sexual rights and resistances. By working creatively with teachers, it may be possible to broaden young children's knowledge of HIV and AIDS and sexuality within a more supportive environment.     

The Effect of Medicaid Policies on the Diagnosis and Treatment of Children's Mental Health Problems in Primary Care

Primary care physicians play a substantial role in diagnosing and treating children's mental health disorders, but Medicaid managed care policies may limit these physicians' ability to serve low‐income children. Using data from the universe of Medicaid recipients in three states, I evaluate how Medicaid managed care policies impact primary care diagnosis and treatment of children's mental health disorders. Specific policies examined include the presence of a behavioral carve‐out, traditional health maintenance organization, or primary care case management program. To alleviate concerns of endogenous patient sorting, my preferred identification strategy uses variation in Medicaid policy penetration to instrument for individual plan choices. I show that while health maintenance organizations reduce diagnosis and non‐drug treatment of mental health disorders, primary care case management program policies shift in diagnosis and treatment from within primary care to specialist providers such as psychiatrists, where serious mental health conditions are more likely to be identified. Copyright © 2013 John Wiley & Sons, Ltd.     

A View of the Professional Nurse

The author's purpose in this study was to examine whether children's hospitals treat more resource-intense children within their communities than do general acute-care hospitals in the same communities, and then to examine which general acute-care hospitals in communities without children's hospitals fill the role of caring for very sick children. In large communities without children's hospitals, at least one general hospital is likely to treat resource-intense children. Healthcare managers in community hospitals need to be prepared to meet the healthcare needs of resource-intense children, which includes having the appropriate specialized staff and technology to care for the sickest children.     

National survey of the injury prevention activities of children's centres

Children's centres were established across England to provide a range of services including early education, social care and health to pre‐school children and their families. We surveyed children's centres to ascertain the activities they were undertaking to prevent unintentional injuries in the under fives. A postal questionnaire was sent to a sample of children's centre managers (n = 694). It included questions on current activities, knowledge and attitudes to injury prevention, health priorities and partnership working. Responses were received from 384 (56%) children's centres. Overall, 58% considered unintentional injury prevention to be one of the three main child health priorities for their centre. Over half the respondents (59%) did not know if there was an injury prevention group in their area, and 21% did not know if there was a home safety equipment scheme. Knowledge of how child injury deaths occur in the home was poor. Only 11% knew the major cause of injury deaths in children under five. Lack of both staff time and funding were seen as important barriers by children's centre staff to undertake injury prevention activities. Nearly all stated that training (97%) and assistance with planning injury prevention (94%) would be helpful to their centres. Children's centres need further support if they are to effectively tackle this important public health area.     

'I felt I have grown up as an adult': caregiving experience of children affected by HIV/AIDS in China

Background The growing global epidemic of HIV/AIDS has a significant impact on the lives of both people living with HIV/AIDS and their family members including children. Children of parents with HIV/AIDS may experience an increased responsibility of caregiving in family. However, limited data are available regarding the caregiving experience and its impact on psychosocial well‐being among these children. This study was designed to address these issues by using qualitative data collected from children affected by HIV/AIDS in China. Methods The qualitative data were collected in 2006 in rural central China, where many residents were infected with HIV/AIDS through unhygienic blood collection procedures. In‐depth individual interviews were conducted by trained interviewers with 47 children between 8 and 17 years of age who had lost one or both parents to AIDS. Results Findings of this study suggest that many children affected by AIDS had experienced increased responsibilities in housework and caregiving for family members. Such caregiving included caring for self and younger siblings, caring for parents with illness and caring for elderly grandparents. Positive impacts from children's participation in family caregiving included personal growth and emotional maturity. Negative consequences included physical fatigue, psychological fear and anxiety and suboptimal schooling (dropping out from school, repeated absence from school and unable to concentrate in class). Conclusion While the increased caregiving responsibilities among children reflected some cultural beliefs and had some positive effect on personal growth, the caregiving experience generally negatively effected the children's physical and mental health and schooling. The findings in the current study suggest that community‐based caregiving support is necessary in areas with high prevalence of HIV and limited resources, especially for the families lacking adult caregivers. In addition, social and psychological support should be made available for children participating in family caregiving.     

The SOS Children's Villages : School Achievement of Subjects reared in a permanent Foster Care

This paper reports the long term effects of maternal deprivation and of a foster family care for siblings. In a permanent placement (children's villages) a single housemother cares for siblings until adulthood and receives the help of a psycho‐educative team. Investigation on school achievement and on level of education was made on all the subjects reared in a voluntary association of children's villages. It proves to be better compared with children in traditional foster care and children brought up by their parents from very disadvantaged backgrounds. A large part of school failure is lessened for children admitted before 6.     

Expressive vocabulary in 18-month-old children in relation to demographic factors, mother and child characteristics, communication style and shared reading

Background Previous research has elucidated the associations between children's language development and reading habits, and maternal education, communication style, gender and birth order. Research including maternal age and child temperament is more scarce. We studied the associations of all these factors with children's expressive vocabulary and reading habits. We also analysed the relationships of reading with expressive vocabulary, and effect sizes associated with frequent reading. Methods Questionnaires were completed by mothers of 1091 children aged 17–19 months visiting the Swedish Child Health Services. Expressive vocabulary was assessed by the Swedish Communication Screening at 18 months, a screening version of McArthur‐Bates Communicative Development Inventories. Mother's perception of ability to communicate was measured by a scale constructed ad hoc from the International Child Development Programmes, a parent education curriculum. Bates' ‘difficultness’ scale was used to assess temperament. Results Good communication, low maternal age, female gender and frequent reading were significantly associated with expressive vocabulary. High maternal education, good communication, higher maternal age, female gender and being a first‐born child were significantly associated with frequent reading. Reading at least 6 times/week added more than 0.3 SD in vocabulary regardless of gender and communication. Conclusions The findings support the importance of reading and communication quality to early language development. Knowledge of the relationship between children's vocabulary and book reading in a context of joint attention is both theoretically and practically valuable to speech and language pathologists, pre‐school teachers, child health workers and other professionals.     

Children's views on attending a remedial class - because of concentration difficulties

Background An increasing number of segregating solutions (e.g. remedial classes) can be seen in Swedish schools. The aim of this article is to stress how children describe why they attend a remedial class and what it means to be a pupil in that setting. Methods The data collection consists of semi‐structured interviews with 10 pupils between 10 and 12 years old attending 10 different remedial classes because they had been attributed with having concentration difficulties or diagnosed with attention deficit/hyperactivity disorder. The content of the interviews was described and analysed in relation to the classroom context. The socio‐cultural perspective is used as a screen to describe and understand the children's comments about attending remedial class. Results and conclusions All interviews with the children indicate that they are carriers of their schools' compensatory perspective. This means that they are fully aware of the fact that they are regarded as difficult, with annoying and problematic behaviour, deviating from pupils' in general. The remedial class creates social difficulties for the children; they see themselves as deviant, they lose old friends and there are limited possibilities of establishing new friendship in remedial classes.