Motor skills of mild-malnourished compared with normal preschool Senegalese children

The relationship between motor skills and mild protein-energy malnutrition was studied in a rural Senegalese setting. Eighty-eight children in good health, aged between 3 and 5 years were examined on 3 occasions in the course of one year, and their physical performance and motor skills evaluated. Regular progress in their abilities was observed over the year. Nevertheless, 3#sh4 of them portrayed mild somatic deficiencies. After dividing the children into 4 nutritional groups according to their height-for-age and weight-for-height deficiencies, it was found that normal and thin children, scored higher in the various tests than did children who were underheight, or both underheight and underweight.

Insufficient muscular mass available for exercise seemed to be the principle factor limiting the performance of these mildly undernourished children. However, other hypotheses should be mentioned: reduction in the children's habitual physical activity, and the neuro-motor consequences resulting from former, severe malnutrition.

These observations show that even slight degree malnutrition can affect a child's ability to perform physical work and, thus, hinder his future development and learning.     

Food behaviors of young children: Cognitive and attitudinal factors

Young children's diets are determined to a large degree by their mothers' nutritional knowledge and food attitudes. The primary purpose of this investigation was to determine the effects of mothers' nutritional knowledge and food attitudes on their children's nutritional knowledge and food behavior.

The subjects were 159 children. They ranged in ages from 7 to 9 years old. Their mothers also participated in the study.

Bivariate relationships between pairs of variables were tested using the Pearson product-moment correlation. The major findings were:

(1) Children's nutritional knowledge was related to their mothers' nutritional knowledge and attitudes of sociability.

(2) Mothers' nutritional knowledge was related to their attitudes of sociability and frugality. Nutritional knowledge was negatively correlated with mother's attitudes toward health and social status.

(3) Children's food behavior was related to their nutritional knowledge and their mothers' nutritional knowledge.     

Evaluation of nutritional status and incidence of anaemia among primary school children in Lagos, Nigeria

A list of 53 primary schools was obtained from Ikorodu Local Government of Lagos State, Nigeria. Five primary schools were chosen from the list by numerical series which had a total of 4,515 pupils representing 13.6#pc of the total primary school population. Two hundred and fifty pupils were chosen randomly using Fisher#shYates random sample table. The following information enumerated from the study.

Chi-square value [P#lt.05] showed relationship between the PCV level and nutritional status of the children. Similar association also showed between the MCHC and nutritional status. Twenty four had their PCV less than 30 while 21 had the MCHC less than 33 which is an indicator of iron deficiency anaemia.

The stool examination showed a total of 180 [72#pc] pupils comprising of 89 [70.6#pc] males and 91 [73.4#pc] females had intestinal parasites. Ascaris and Trischuris and hookworm were commonly identified among the children. This also indicated a chi-square value [P#lt.05] association between the nutritional status and worm infestation.     

“Missing Milestones”

Missing milestones are known to be a normal variant of development. The purpose of our study is to find if missing milestones always lead to normal development?

METHODS

This is a prospective case study on seven patients referred for motor developmental problems from July 1997 to February 1998 and then followed over a 2-year period. On each attendance, the multi-disciplinary team assessed children

RESULTS

We present a case series of seven children with “missing motor milestones”. Six of the seven, had tactile defensiveness but absent parachute reflexes on presentation

At the end of the two year period, 3 infants had normal development (Group I). One was discharged after 7 months. The second one had speech problems most likely secondary to her bilateral serous otitis media, with no other developmental problems. The third child acquired age appropriate milestones before the care was transferred to another hospital. Of the four in Group II, three developed global developmental delay and the fourth was diagnosed to have multiple cavernous haemangiomata in the brain. The pre-school alert panel was alerted for two of them possibly needing future help in school

Five of the seven children in our study were still being followed up after two years

CONCLUSIONS

Missing milestones in a subject can be a benign variation of normal motor development. However, they may also be the first sign to appear in children with neuro-developmental disorders

Tactile defensiveness may be the most useful early sign to enable the early diagnosis of non-weight bearing children with 'missing milestones'     

Effect of Intervention on the Language Facility of Poor, Black Adolescent Mothers and their Preschool Children

This study investigates the effects of varying degrees of mother-child language stimulation activities on the test performance of poor Black children and their adolescent mothers.

The sample consisted of 60 mothers paired with their three or four year old children who attended full day preschool. The families were randomly assigned to one of three groups for a twelve week period.

The tests used in the study were the Peabody Picture Vocabulary Test; the Cultural Language Test — Mean Length of Utterance; the Cultural Language Test — Standard English; and the Conversation — Mean Length of Utterance Measure.

Three major findings result from the study:

1. The children of mothers provided with intensive training and practice (Group 1) scored significantly higher on all four tests than did the children whose mothers received minimal help (Group 2) or children whose mothers received no help at all (Group 3).
2. Group 2 children did not score any higher than did Group 3.
3. Group 1 mothers scored significantly higher on all measures.

     

Co-operating to protect children -shifting the thresholds

It is now 30 years since Kempe delivered his watershed address to the American Academy of Paediatricians graphically describing the battered child syndrome. In the 30 years that followed elaborate child protection procedures, supported by strong legal powers, have developed not only in the UK and the USA but also in may countries around the world. In the last 5 years or so, however, there has been another great watershed. Independently in both the USA and in the UK, evidence has accumulated which is questioning the efficacy of our elaborate child protection systems. For social workers in the UK the history is familiar; the child abuse inquiries leading on to the Cleveland Inquiry, on going scandals in residential care and concern about the outcomes for children in the public care system, and, finally, the recent message from the Department of Health in 1995 “Child Protection - Messages from Research”. Less familiar will be the concerns which emerged in the USA. There, following the introduction of mandatory reporting which in some states is mandatory even for civil citizens, there was a huge rise in the number of children reported (3 million reported in 1992 of which less than half were substantiated). This largely incapacitated the child protection agencies and led to large numbers of children being admitted into the public care. In 1990 the US Advisory Board on Child Abuse and Neglect concluded that there was an urgent need to develop new approaches.

The answer put forward in this country and the USA has been the rediscovery of targeted preventive approaches. Central to these approaches is what we call family support and what is called social support in the USA.

Child protection is an important and demanding activity

- research and our own limited local information does pose serious questions about the efficacy of the process;

- this points to the need for reviews by area child protection committees;

- research also tells us important things about the characteristics of families involved especially about their social and economic circumstances. These need to be addressed.

Addressing these needs requires several things

- a good individual assessment and population assessment to plan appropriate services;

- a sound interagency/multiprofessional approach;

- maximising all the resource options and taking a broader view of the task - as well as mainstream services as currently arranged, we need to embrace a community development approach and to view die families involved in terms of their inclusion or exclusion from society and address these shortfalls.

We are only at the threshold of the implementation of the Order and we need to approach it with a broad vision.     

Effect of Urbanisation on the Nutritional Status of Primary School Children in Lagos - Nigeria

Effect of urbanisation on Nutritional status of 250 primary school children was assessed among the children of working parents. Children involved were those who were dropped early in the morning 6 am by parents and picked up around the school premises later in the evening between 6.30-7.00pm in the University of Lagos Staff School.

Questionnaires were prepared for the parents to fill including the history of the children, time usually spent with the children from Monday through Friday, dietary information including information on whether they were breast-fed in childhood. These information emanated from the study 193 (77%) were breast-fed exclusively for two months while 57 (22.8%) were both breast-fed and bottle-fed. On feeding habits, children fed on cookies and soft drinks around the school premises with dinner at home around 8.00pm. Food served for dinner was mainly carbohydrates. No time for interaction with parents Monday through Friday. Average Anthropometric measurements obtained from these children (7-10 years) were 29kg, 132cm for weight and height. Incidence of nutritional anaemia was very high among these children 87 (34.8%) had severe anaemia, below 9gm%, 65 (26% moderate 7-10gm%) and 98 (39.2%) had their haemoglobin above 10gm%.

This study was carried out in Lagos University Staff School. This school is owned and run by the University Authority and admits both staff and non-staff. Lagos University Staff School is an expensive private school well subsidised by the University for the staff children.     

Integration: Quality in care and education for the young disabled child

The presentation aims to examine the criteria of quality for care and education programmes for young disabled children in integrated early childhood settings. The conceptual and practical issues which influence quality programmes will be discussed with particular reference to the Integration Programmes operated throughout South Australia in early childhood centres.

The Integration Programmes, developed to enable and support the integrated or normalised development of young children has as its specific 'target' group individual children who are 'too delayed or disabled' to be able to fully participate or participate without direct assistance in community based early childhood programmes. Some of these children are extremely disabled and others' handicapping conditions are exacerbated by severe lack of other available community resources, isolation and other factors.

Integration is more than 'being there'—it is a complex process based upon the recognition of human value and human rights. For greater insight into the Integration Programmes an appraisal of the following aspects will be provided.

• the principles of integration

• the goals of integration

• the dimensions of integration.

The dimensions of integration will be placed in relation to the indicators of quality in early childhood programmes. The juxtaposing of these parameters of quality will lead to the emergence of guidelines for practical goalsetting and evaluation hallmarks of excellence in integration.     

“caught in the middle” exploring children and young people's experience of domestic violence

This document seeks to explore children's experiences of domestic violence and the effects such violence may have on their lives, both in the short term and in the long term. It draws on the conclusions of various studies in this area which have been carried out in America and the United Kingdom. It aims to raise awareness of the complexity of this issue and to highlight the importance of support for both women and children who may be survivors of domestic violence. The document highlights a number of issues, namely

How children and young people may experience domestic violence;

Identification of links between domestic violence and child abuse;

The impact domestic violence may have on mothering;

The effects domestic violence may have on children and young people's lives;

The legitimacy of the cycle of violence theory;

Issues to be considered when assessing the possible impact of domestic violence on children and young people.     

The development of cognitive organization in young children: An exploratory study

Four questions guided the formulation of this study of the development of cognitive organization in young children. First, what organizational process-patterns do young children display when faced with an organizational task employing non-representational materials? Second, what developmental changes can be observed in the processes children employ as they engage in tasks? Third, what kinds of products are generated as a consequence of these process? Fourth, what are implications of the study of cognitive organization for developing educational programs for young children?

Eight preschool children were tested at 3 and again at 4-years-of age with the Designs Tasks, a non-representational set of items varying in the degree to which they could be fit together.

Children's performance on the tasks were video-taped and coded using the subject-process-product paradigm.

Findings suggest that irrespective of age and task type, children engage in tasks with high levels of affect and focus. However, the processes employed and the products generated indicated that both processes and products varied from Time 1(3-years-of age) to Time 2(4-years-of age). Findings are discussed in terms of the practicality of studying the development of cognitive organizational strategies of young children for both theories of child learning and the practice of teaching.     

Adoption in Nigeria — A review of the Lagos cases

Two hundred and thirty six adoptions were granted from inception to December 1990 in Lagos State of Nigeria. There were 119 males and 117 females aged 0-17 years, most #op41.6#pc#cp of them were aged 0-4 years. Most of the adopters were married #op80.5#pc#cp. Christians #op80.9#pc#cp, literates #op71.2#pc#cp and aged, 26-70 years.

Some women #op11.9#pc#cp who had had their children but wanted more were able to adopt to make up their desired number and 7.6#pc had more than one adoptee.

There is a dearth of information on adoption in Nigeria and nothing is known about the behavioural#shemotional development of these children, their academic acheivements and eventual integration into the society. It is therefore suggested that research on adoption and the development of the adoptees thereafter should be encouraged.     

NIGERIAN CHILDREN'S PERSPECTIVE OF URBAN LIFE QUALITY

The Convention on the Rights of the child put in place some set of standards to ensure that in all consenting countries every child is wanted, healthy, educated, safe and loved. Nigeria is one of the countries that has taken some steps to put into practice the accepted rights.

Two hundred children (100 boys and 100 girls) in primary schools in four urban centres were served with questionnaires requesting their views on issues bordering on their well being and quality of life, in such areas as:

1. quality of education
2. space for movement and play
3. food and clean water for drinking and washing
4. play equipment and materials and
5. loving care giver.

The children's responses showed that provision was not made for recreational space for play, the quality of education is poor, there was no provision for play equipment and material and in most cases the adult-child ration was low. Children also complained of polluted environment.

Suggestions were made for the provision of adequate play parks for recreational purposes for the children. Suggestion is also made for government to pay more attention to the well being and health of the children.     

South Australian Parents want Child Protection Programs to be offered in Schools and PreSchools

It is now widely realized that child sexual abuse is an all too common crime against children, resulting in long term damage to victims and heavy costs to the community. It is also realized that much abuse could have been prevented if children had been given basic information about acceptable and unacceptable touching, secrecy about touching and norms of adult-child behaviour.

Parents representing 250 families, caring for 565 children aged 3-12 were interviewed to find out what parents tell their children to protect them from sexual molestation.

Three quarters of all parents told their children nothing and most of those who thought that they had given information had only given hints. Furthermore, this “information” was passed on only after a traumatic event had already occurred.

Parents revealed an inadequate knowledge of the dangers to children and a desire for school and preschool programs to remedy the deficit.     

Research Note: Unmet Needs for Education of Primary School Children in Nigeria

According to the Convention on the rights of the Child, every child is entitled to receive compulsory basic education, and no child should suffer any discrimination irrespective of origin, birth, colour, sex, social beliefs, status or disability.

Bearing in mind these stated objectives of this Convention, three hundred children and three hundred teachers from twenty public schools in Lagos were the subjects of a survey carried out to Identify the unmet needs for education of Nigerian children.

About 90% of the teachers surveyed, admitted that the quality of education was poor and deteriorating on a daily basis. Reasons given were for the poor condition of services, poor teacher morale due to poor condition of service, lack of parental cooperation and general lack of interest among the children.

An observation of the children in the school showed that about 60% of the children had chronic malnutrition with ravages of diseases such as malaria, cough, catarrh, diarrhoea, and skin rashes. Many of the children complained of lack of adequate supply of water and electricity at home for several weeks. A large number (70%) were also found to be unkempt, without decent uniforms and textbooks.

Suggestions were made for proper teacher training, remuneration and more parental concern and involvement for the proper education of their children.     

The “syndrome of the post-premature child”: a study of its significance -- Part I

Prematurity has the greatest influence upon frequency and degree of mechanical disturbances uncovered by the Test of Imitation of Gestures. The authors look for the significance of this syndrome at various levels:

1. Possible organic damage to the central nervous system structures, through the tonic and motor disturbances checked out by the neurological examination.
2. In the disturbances of the early development of posturomotor abilities.
3. Deviant and delayed development of the cognitive factors (spatial and temporal structuring).
4. Emotional and relationship development.

The investigations were carried out on a sample group of prematurely born children and a control group group of children born at term.

After observing certain behavior disorders which occur among normal children -- mild disorders which become less obvious with age -- the authors show that frequent and gross disturbances which appear in the first months of life and persist beyond the age of 6 years distinguish the premature child. In this same group, however, delays in mental development noted early in life often disappear entirely by the age of 4 years, even among children who were born very prematurely.

The authors then isolated the most typical disturbances found among the premature children, with stress on factors of pathology, maturation, adjustment, and environment.

The authors study the relationship between the disturbances described above and the various aspects of the neurological examinations which enable them to objectify the dynamic factors of the body adjustment to the external world and to other people. The hypothesis that a fundamental relationship exists between disturbances of adjustment and the genesis of the “post-premature child syndrome”, develops from the comparison between the psychological and neurological data in their longitudinal evolution.

Commenting on the relevance of these findings for the care of premature children, the authors stress the value of motor training and remedial education for overcoming the disturbances of spatial structuration and body schema.     

The development of perception and activity

This brief review article by one of the foremost contemporary Soviet educational psychologists presents the work of the author and his associates on the relationships between the development of perception and the character of the purposeful acts of children.

While perception orientates and regulates the purposeful acts of children, its own development is concomitantly dependent upon the specific features of that activity.

During the course of development of the child, qualitatively new features of perception appear due to the influence of substantial changes in the child's activity.     

Early reading: A developmental psycholinguistic approach

Experimental studies of reading in children as young as two or three years of age have indicated several factors: children from various socioeconomic backgrounds with a wide IQ range can learn to read words relatively easily during their first years; early readers tend to read better later on than matched non-early readers; early reading has not been shown to lead to eye injury or to emotional disturbance; young children generally enjoy reading; early readers have not been shown to be confused by differing preschool-school teaching methods nor need they be bored in first grade. Current controversy about teaching reading is discussed as an outgrowth of historical theoretical viewpoints.

Data on early reading, information about early bilingualism, and findings among children without early exposure to spoken language contribute to the viewpoint presented here that learning to read, if prevented until age six, may be similar to learning a second language.

Some parallels between the course of early reading and language development are suggested. Broad outlines are drawn of a psycholinguistic account of reading development in preschool children.

Investigation of this area is significant for both theoretical understanding of the nature of the reading process and practical questions relating to reading achievement and reading disability.     

Group treatment work with parents/carers of young people who have sexually abused children and others

This article reflects on group work with parents/carers of young people who have sexually abused children and others. It highlights the paucity of relevant literature and outlines the context, format and goals of a support group for parents/carers.

Recurring themes observed over a four year period are examined in detail. Three key areas are discussed :-

1. Emotional reactions of the parents /carers to the disclosure of the sexual abuse.

2. Lack of resources to facilitate/ accommodate the special needs of this population of parents/carers.

3. The parents'/carers' need to be aware of, understand and, where possible, facilitate the treatment programme of the young person who sexually abused.

Results from the evaluation of the four groups support the conclusion that parents are an important part of the treatment programme of young people who sexually abuse, and should be viewed as 'gate-keepers' in sustaining and monitoring relapse prevention plans.     

Ethical and practical considerations in palliative child care and the support needs of parents and siblings

Death is one of the few certainties in life and yet it is the one event that most people avoid contemplating until forced to do so. When considering death and dying it is assumed by most to occur in old age and in hospital. The death of a child is a devastating loss which can cause the most distressing and long lasting grief (Davey, 1995). According to “Childhood cancer UK” the number of children developing cancer in the United Kingdom has remained constant over the past 30 years (about 1300 new cases each year), with only two-thirds of children with the disease being treated successfully. In Britain 32 per cent of cancer deaths occur at home (Bean, 1994) however only a small proportion of these will be children. Despite the deaths of children at home being a statistically small group it must not be ignored due to the great emotional impact it has on the individual, family, health workers and often local community.

The changing status of children in the UK means that health care professionals must uphold childrens' rights whilst working in partnership with parents. A balance must be found between the traditional protectionist and paternalistic attitude of care and the liberationist approach. This can only be achieved through communication and collaboration between families and members of the multi-disciplinary team allowing the promotion of constructive problem solving

The key aim of palliative care is to give the child as good a quality of life as possible in the time remaining with freedom from distressing symptoms including pain. Every health professional working with a dying child who has pain should give consideration to the complexity of pain, it's unique and diverse effects and engage the entire family and health care team in planning interventions and providing support to the child and to each family member (Graner, 1976).

Siblings, parents and health professionals may be profoundly affected by the experience of the death of the child, therefore, each multi-disciplinary team must develop formal coping strategies to deal with the possible psychological disturbance and to facilitate adjustment after the death of the child.

Martinson, writes of her greatest encouragement which came from the parent of a dying child;

“No matter if it culminates a full life or a life shortened much too soon, does death have to be terrorising? There are many to rejoice and aid in the event of birth, as with the patient that can be helped, but for those going through the frustration of 'not getting better' when science and the masses, sometimes even family and friends who can no longer face them, have deserted, could there be a greater challenge or more considerable need for help?”

(1976, p. 13)

This is a powerful message for health professionals caring for children in the end stages of a terminal illness. It is at this time that the family and dying child are in most need of the consistent, expert and humane relationships provided by the caring professions. The challenges are immense but great reward lies in the privilege of being intimately involved in this final rite of passage through life.