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.     

Quality children's television: the case of “Lift Off”

“Lift off” is a new, innovative children's television series produced by the Australian Children's Television Foundation. It has been well received by critics, parents, educators and most significantly, by its three-to-eight year old target audience.

The program easily satisfies the five criteria for quality programming formulated by the Children's Program Committee of the Australian Broadcasting Tribunal. The typical half-hour program is dense, requiring close viewer attention but it is claimed that the viewer is rewarded for her viewing investment with an enriching and pleasurable experience. The doubt is raised that the socially disadvantaged segment of the child audience, who use television for diversion rather than enrichment, may not be prepared to make such an investment of viewing attention.

One final concern is voiced. The Foundation's official spokespeople publicly claim that “Lift Off” will enrich the lives of a whole age cohort. It is argued that such claims overemphasise the supposed direct consequences and impact of media messages on individuals.     

Children are unbeatable!

The Children's Law Centre are members of The Children Are Unbeatable Alliance which is lobbying for effective legal reform to ensure that children and young people are given the same protection from assault as adults. In our view this means that legislative change will be necessary to protect children who are subjected to physical punishment. This needs to be done in conjunction with the promotion of positive, non-violent discipline and education programmes about positive discipline.

The Office of Law Reform in Northern Ireland is about to issue a consultation document on the use of physical punishment on children and we are seeking to extend the Northern Ireland membership of Children Are Unbeatable in an attempt to positively influence the debate which will be going on over the next 12 months about the physical punishment of children in Northern Ireland. We would encourage everyone working with or on behalf of children and young people to become involved in this debate and respond to the consultation document.     

First evaluation of The Down Lisburn Trust Befriending scheme for young people leaving care

The Down Lisburn Trust befriending scheme was initially set up in October 1998, this piece of research was conducted in April 2000 and is the first evaluation of the scheme.

The purpose of this research study was to evaluate the benefits of the befriending scheme for young people 'looked after' or leaving the care of Down Lisburn Trust. This was achieved by collecting the retrospective views of the young people and their befrienders in relation to how the befriending scheme has benefited them.

As the befriending scheme is a relatively new project, the subjects used in the study were from the first intake of participants on the scheme. This comprised of 5 young people and 6 befrienders. In order to obtain the relevant information, questionnaires were devised for the young people and the befrienders.

The findings of this research study indicated that the befriending scheme benefits those young people in care and leaving care, by providing them with someone to talk to and help them pursue their interests. Also it has ensured there was someone to support them through difficult familial relationships, life in care and/or life after care. The findings also highlighted the need for clearer procedures and follow up in relation to the ending of befriending relationships to ensure that this already vulnerable group of young people are not damaged further.

The findings of this study agree with the findings of other research studies dating from the early 1980's, regarding the plight of young people in care and leaving care.

The Adolescence Team was established in 1990/91 and provides an integrated, specialised service to young people aged between 14 and 21 years old living within the Down Lisburn Trust area. It also provides a supported continuum of care, which enables young people who have been or are in care to live independently and safely in the community. It aims to do so by providing the following services; individual counselling, family work, assessment, mediation/negotiation, preparation for leaving care, aftercare support, group work, and child protection investigations. The following is an overview of the first evaluation of the scheme.     

“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'     

Working with a child exposed to community and domestic violence in Northern Ireland: an illustrated case example

The focus of this paper is on the author's multi-modal therapeutic practice with a 7-year-old boy referred to the Family Trauma Centre, following paramilitary assaults on his father. The work also addresses the boy's experience of domestic violence.

The work is contextualised in terms of the “Peace Process” in Northern Ireland, including the establishment of the Family Trauma Centre as a response to the needs of victims of the Troubles. A rationale for working with children using a multi-modal approach is presented.     

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.     

Too early to school?

This paper examines the dangers and problems inherent in the prevalent practice of introducing academic work into Nigeria Nursery School Curriculum.

The paper presents research data from the fields of developmental psychology and education, which establish that nursery school children are not developmen-tally ready for academic work. Similarly data on the objectives of nursery education are used to establish that nursery school is not an ideal setting for the teaching of academic skills as stated in the National Policy on Education.

The paper concludes with a number of proposals on how to develop a virile Nursery Education practice in Nigeria which provides adequately for the socio-cultural peculiarities in the lives of Nigerian Pre-School children.     

The impact of exposure to domestic violence on children and young people: a review of the literature

The impact of exposure to domestic violence on children and young people: a review of the literature
Holt, S. , Buckley, H. & Whelan, S. ( 2008 ) Child Abuse & Neglect , 32 , 797 – 810 . Objective This article reviews the literature concerning the impact of exposure to domestic violence on the health and developmental well‐being of children and young people. Impact is explored across four separate yet interrelated domains (domestic violence exposure and child abuse, impact on parental capacity, impact on child and adolescent development and exposure to additional adversities), with potential outcomes and key messages concerning best practice responses to children's needs highlighted. Method A comprehensive search of identified databases was conducted within an 11‐year framework (1995–2006). This yielded a vast literature that was selectively organized and analysed according to the four domains identified above. Results This review finds that children and adolescents living with domestic violence are at increased risk of experiencing emotional, physical and sexual abuse, of developing emotional and behavioural problems and of increased exposure to the presence of other adversities in their lives. It also highlights a range of protective factors that can mitigate against this impact, in particular a strong relationship with and attachment to a caring adult, usually the mother. Conclusion Children and young people may be significantly affected by living with domestic violence, and impact can endure even after measures have been taken to secure their safety. It also concludes that there is rarely a direct causal pathway leading to a particular outcome and that children are active in constructing their own social world. Implications for interventions suggest that timely, appropriate and individually tailored responses need to build on the resilient blocks in the child's life. Practice implications This study illustrate the links between exposure to domestic violence, various forms of child abuse and other related adversities, concluding that such exposure may have a differential yet potentially deleterious impact for children and young people. From a resilient perspective this review also highlights range of protective factors that influence the extent of the impact of exposure and the subsequent outcomes for the child. This review advocates for a holistic and child‐centred approach to service delivery, derived from an informed assessment, designed to capture a picture of the individual child's experience and responsive to their individual needs.     

The efficacy of the parent-teacher “partnership” of the 1990s

The 1990s are times of rapid social and technological change. There are many unknowns that face both adults and children. We all have problems that need resolution. The time when adults “knew” the answers and children learned by “watching” echo faintly in the whirl of scientific change which is impacting on most aspects of our daily life. As early childhood teachers we have to learn to enquire, to listen, to think together with children, their families and society. The concept of negotiation is central to communication while the basic tenet of the process focusses not on the person but the issue. It is in these times of rapid change that we need to deepen our understanding of the family and further our professional insights by “tapping” the wealth of crucial kndowledge that parents have about their children. Hurst asserts that the partnership of parents in issues of their children's education:

“is probably the greatest single opportunity for educational advance open to teachers today”.

Hurst: 1987; 109     

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.     

“Early detection of learning difficulties”

All 788 children attending kindergarten in 2 boroughs of Athens were screened for concentration, hyperkinesis, behaviour disorder and language delay with the help of two questionnaires.

The ones with high scores (high risk for presenting learning difficulties (n = 40) were compared with the low (n = 43) and medium (n = 14) risk ones on psychological tests. The above children were reexamined one year later with reading, writing and arithmetic tests. 25% of the high risk groups failed to learn, to read and write while all the low risk group had achieved these abilities. The best predictors were the tests Frostig I and IV and TMS.     

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.

     

“Potentially” contaminating behavioural practices in the preparation, feeding and storage of “ogi” — an infant cereal in a rural Nigerian community

Thirty households with children aged 6-18 months from four villages in the Badagry Local Government Area of Lagos State, Nigeria were studied. Open-ended unstructured ethnographic interviews were used to collect information on “potentially” contaminating food handling behaviour with particular reference to the preparation, feeding and storage of “ogi” an infant cereal. Focus group studies were conducted for women aged 18-45 years in the four villages to obtain more information.

Improper handwashing, widespread acceptance and use of feeding bottles, long storage and safety of place of storage were some of the “potentially” contaminating behavioural patterns identified.

Intensive health education on the dangers of feeding bottles, improper hand-washing and long storage of cooked “ogi” to the health of infants and young children is strongly recommended.     

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.     

From Togetherness to Equal Partnership in Role Play

In the day care centre, already at the transition stage to role play children show different kinds of participation. They observe each other's play, share goal orientation and directly tutor each other. The play process is materially supported and often initiated by educators. However, children also need to acquire the power to act autonomously in role play.

The different kinds of participation in young children's play, as well as the appearance and development of basic features of joint role play were examined in three games of a two-year-old girl, Katju, in her day care group. The games are examples of ten play sessions she was involved in. These data were collected by means of reactive participant observation and analyzed by using interpretive methods.

It turned out that Katju proceeded from a feeling of togetherness in a shared space, through parallel and successive play actions to reciprocity and equal exchange of play actions. Moreover, the three educators contributed to this process in different ways.

The findings may be of interest in discussions about play in early education practices, in particular with regard to the development of autonomy, social abilities and partnership in sociocultural activities.     

The impact of mothers' perception of child care services and utilization

To examine the impact of mothers' perception of the roles of pre-primary institutions and what motivates them to choose a particular child care service, 138 working mothers and 20 proprietors of nursery schools and day care centers were interviewed. The facilities available to children in the centers studied was also assessed.

The results suggested that these mothers' expected these institutions to play custodial functions as well as to provide early childhood education. This knowledge could guide proprietors and other interested organizations in the provision of appropriate child care programmes to meet the needs of mothers and their children.

The demand for nursery/day care services in Nigeria has become very high due to the increasing number of women in the workforce.     

Physical punishment - thinking about the issues, looking at the evidence

Introduction

Physical punishment Of children is an issue on which many people hold strong but radically divergent views. Some see it as an important part of child discipline, others as a violation of children's basic human rights, yet others as something of little consequence. These views may be based on people's own experience as parents or children - for many they are at the level of an instinctive reaction. The readers of Child Care In Practice, social workers, medical and child care professionals, have the advantage of having thought about child discipline in the course of their professional training and lives. The Minister for Finance and Personnel, through the Office of Law Reform, is consulting about the law on physical punishment, and wants people to look beyond our own instinctive positions and really explore the issue.     

"We need to talk": a study of working relationships between field social workers and fostering link social workers in Northern Ireland

Foster care in the United Kingdom and Northern Ireland has been in crisis throughout the past decade. This is most clearly demonstrated in the shortage of placements for children. The difficulty in recruiting new carers has taken a new significance for most agencies that struggle with more referrals than placements. As it becomes more difficult to recruit new carers, it becomes essential to retain existing carers.

This research has focused on the working relationships between field workers and link workers and the role these relationships play in supporting carers. Previous research by the author (Sheldon, 2002) has indicated that carers wish to be treated with respect and as partners in a process of caring for children. It follows, therefore, that when social workers fail to work in this way carers become dissatisfied and this may lead to them ceasing to foster.

The study was carried out via a postal questionnaire to all 80 field and link social workers within South and East Belfast Health and Social Services Trust, and this was followed by a series of 13 face-to-face interviews, nine with field workers and four with link workers.

The results of the research have indicated a mixed picture of practice within the Trust. Foster carers are unanimously held in high regard by social workers and the task they fulfil is highly valued. There are many examples of successful working practices between field and link workers, but there are also examples of little or no communication. Many field workers have little idea of the problems facing fostering at the moment and this can be frustrating for their link work colleagues. New social workers have little or no preparation for working with carers and there is confusion as to the nature of the working relationship with them.