The Little Hulton Project: A Pilot Child Clinical Psychology Service for Pre-School Children and their Families

A community-based early intervention psychology service for pre-school children with emotional and behavioural problems is described. The intervention included parent training groups, a weekly open clinic, and multi-agency training, liaison and consultancy. The aims were to provide successful intervention to families, to maximise liaison with community staff and to provide a seamless service to and from the main hospital department. Evidence indicated improvements in parental coping and children's behavioural difficulties using standardised measures and gains were maintained at 6- and 12-month follow-up. This article outlines a framework for service delivery in a small community with high socio-economic deprivation.     

Psychological services utilization: relationship to severity of behaviour problems in intellectual disability services

Using the Developmental Disabilities Profile, a population service registry, the present study gives an analysis of the relationship between the rated frequency of contact with psychology specialists and a composite rating of 13 behaviour problems in intellectual disability services. An analysis of information on 45 810 adults with intellectual disability indicated that, when the population was divided into quintile groups based on behaviour severity, distinctively different distributions of rated contacts with psychologists were discernible. The people rated in the highest quintile for severity of maladaptive behaviour constituted especially high utilizers of psychology services. About 37% of participants had had no contact with psychologists during the past year, whereas 26% had such contact weekly or more frequently. The findings are introduced and discussed in the context of psychological practice in intellectual disability services and trends toward managed health and behavioural health care in the USA.     

Service use and access in young children with an intellectual disability or global developmental delay: Associations with challenging behaviour

Background Challenging behaviours are frequently shown by children with an intellectual disability. This study documents service use within this population and explores its relationship with challenging behaviours and child and parent characteristics.

Method Forty-nine mothers of young children with an intellectual disability or global developmental delay completed questionnaires focusing on child behaviour, parental mental health, and service use.

Results Maternal mental health was not associated with services accessed. Cost of services accessed differed by topography of challenging behaviour for destruction of the environment or aggression. No differences were noted for self-injurious behaviour.

Conclusion In this small study, topography of challenging behaviour impacts on the frequency and/or duration (and therefore cost) of community-based health care accessed. Behaviours that have external impact, such as aggression and destruction of the environment, are associated with a higher cost of services used, a pattern not noted for behaviours that had less external impact (e.g., self-injurious behaviour).     

Community Treatment of Child Sexual Abuse: A Survey of Practitioners in the National Child Traumatic Stress Network

Practitioners from numerous agencies who sought training in Trauma-Focused Cognitive-Behavioral Therapy in several regional sites under the auspices of the National Child Traumatic Stress Network completed a baseline survey to describe their backgrounds, settings, practices, attitudes, and perceived outcomes with sexually abused children and youth. The results documented a range of experiences and common treatment practices, and identified contributors to practitioners’ use of gradual exposure and perceived levels of positive treatment outcome. The results were not accounted for by geographic region or agency. The findings support recommendations to optimize research and training related to the dissemination of evidence-based treatments in the child abuse field. Portions of these data were presented at the Annual Meeting of the American Psychological Association, July, 2004, Honolulu, Hawaii.     

Collaboration Between the NHS and Social Services in the Provision of Child and Adolescent Mental Health Services: A Personal View

The quality of collaborative links between the NHS and Social Services in the field of child mental health is dependent on the culture of co-operation set at the highest level of government. There needs to be an understanding of the different theoretical models that underpin working practices. The importance of personality factors, power struggles and misperceptions is highlighted. Constructive suggestions are made on how to ensure that collaboration works effectively.     

Emotional and behavioural problems in a sample of Finnish three-year-olds

 Behavioural and emotional problems in Finnish three-year-olds was studied using the Child Behavior Checklist for ages 2–3 as a standardised rating scale at well-baby clinics in two cities in Finland. Altogether 374 questionnaires were analysed which is 71% of the target population. When compared with studies from other countries the mean scores and prevalences of preschool children's problem behaviours were rather similar. Boys were reported to be more destructive than girls. Parental education level, living in one-parent family and parental unemployment were associated with a higher level of problem behaviours. No significant differences were found in emotional or behavioural problems related to the child's day care. Co-sleeping with parents was associated with sleep problems. Accepted: 30 August 2000     

Psychology from the Bench1

In this article, the authors review the implications of the recent Northern Territory case of NJB v The Queen, and argue that it reveals the true depth of a paradox that has opened up with regard to the guidance afforded to a criminal trial jury. It is argued that there is an incongruity between the reluctance to adduce expert opinion evidence on the credibility of child witnesses and having judges inaccurately comment on the subject. This problem extends to judicial directions routinely employed in other areas of the criminal law where witnesses’ credibility is at issue. It is independent of whether or not these directions are framed as obligatory directions or as opinions that the jury is free to accept or reject. It requires a suspension of disbelief to accept long cherished legal maxims as to the efficacy of judicial directions in such circumstances.     

False-Negative Reporting and Mental Health Services Utilization: Parents' Reports About Child and Adolescent Services

Parents' ability to make reliable and valid reports about health service utilization is a key research design consideration for studies about the unmet needs of children and adolescents with emotional or behavioral problems. This research report addresses the validity of parents' reports, in particular, parents' rates of false-negative reporting about their children's mental health service use. Our findings show that only a few parents of known service users fail to report that their child or adolescent has received services for an emotional or behavioral problem. However, when parents are asked to report about their child's service use with specific providers or in specific service settings, the rate of false-negative reporting tends to increase, and in some circumstances this increase is dramatic. Logistic regression results indicate that false-negative reporting is more likely to occur among parents whose children are male, less frequent service users, or service users whose use is less recent. After controlling for these factors, we did not find a significant difference in the rate of false-negative reporting for parents of Anglo and Latino children. Implications for research designs and survey instruments are discussed.     

Child and Family Outcomes of the European Early Promotion Project

This chapter concerns the outcomes for the families involved in the European Early Promotion Project and presents data collected when the children were between six and eight weeks old and when they were 24 months old. A total of 824 families were recruited from the five countries involved. At baseline, differences were found between country samples in the extent and type of need (Finnish families having the lowest risk factor rates and Serbia the highest, for example), but recruitment was generally successful in including families from the whole range of need, excluding those with the most severe physical and psychiatric problems. Although not randomised, Intervention families (receiving the EEPP service) were reasonably matched with Comparison families (receiving usual services) on most variables initially, except in Greece, where Intervention families were somewhat more at risk. At 24 months, in spite of low intensity of service provision and methodological difficulties likely to reduce effects, there was evidence, particularly in Greece, of differences in outcome favouring the Intervention group, who also showed significantly higher levels of satisfaction with the intervention they had received. It was concluded that the service merits further exploration to assist in understanding promotional and preventative processes.     

Perceived Need and Use of Child Mental Health Services in Korea

This study examined the degree of perceived need and use of child mental health services in Korea, as well as the factors associated therewith. The sample consisted of 3,477 children aged 8–13 years. Overall, 10.4% of the parents demonstrated a perceived need for mental health services regarding their children’s emotional or behavioral problems, while 1.9% used mental health services. Although the perceived need for mental health services is high, only a small proportion of children receive them. Whether a child receives mental health care is influenced by the child’s psychopathology, especially when social and/or thought problems exist.     

A Characterisation of Tier 2 Services in Child and Adolescent Mental Health

UK government initiatives have proposed changes in the provision of child and adolescent mental health services (CAMHS) within the NHS. In response to this, tier 2 services have been created to provide early assessment and intervention and improved access. This study investigated whether these services met the aims compared to traditional generic tier 3 services, using data from a national mapping exercise. The results were consistent with the tier 2 services providing early assessment and intervention and enhanced accessibility of the services compared to tier 3. The implications of these results in relation to service development are discussed.     

Child behaviour problems mediate the association between coping and perceived stress in caregivers of children with autism

Coping and child behaviour problems (CBP) predict psychological distress in caregivers of children with autism. Whether CBP mediate the relationship between coping and caregivers’ psychological functioning has yet to be determined. This was the aim of the current study. A sample of 56 caregivers of children with autism completed an electronic survey assessing perceived stress, disengaged and problem focused coping, and CBP. Disengaged and problem focused coping predicted both CBP and perceived stress, albeit in different directions. CBP was also predictive of perceived stress. Data revealed an indirect effect of both disengaged and problem focused coping on perceived stress through CBP. In conclusion, caregivers who use more disengaged coping might be less effective at managing the problematic behaviours of the child with autism, thus resulting in poorer psychological functioning. Conversely, caregivers who use more problem focused strategies might, due to fewer CBP, be relatively protected against the psychological sequelae associated with the caregiving experience. Whether interventions that enhance problem focused coping have adaptive effects for caregivers’ psychological functioning, and whether these effects are mediated by fewer CBP might be the focus of subsequent research.     

Integrating Vocational Services on Case Management Teams: Outcomes from a Research Demonstration Project

Recent innovations to improve employment rates among persons with psychiatric disabilities include hybrid case management/employment services. Project WINS was a research/demonstration project which integrated specialized vocational services into case management teams. In this report, client outcomes of WINS involvement are evaluated, using a quasiexperimental, longitudinal design. On almost all the work-related variables, participants in the immediate and delayed treatment conditions displayed better outcomes than those in the control condition, as did individuals receiving moderate or substantial service versus no/minimal services. To address possible selection bias due to the quasiexperimental nature of the design, further analyses used baseline differences across conditions and participation levels as covariates. Results of multivariate analyses showed some anomalous findings regarding significant positive effects for the delayed, but not the immediate treatment condition versus the no-treatment control group. However, in similar analyses involving participation level as the independent variable, a moderate or substantial amount of service increased the odds of working by almost five times and also positively affected three other work-related variables. While limitations of this quasiexperimental design are noted, the results appear promising enough to support replications of WINS.     

The Relationship Between Maternal and Child Symptom Change in Community Mental Health

The mental health of mothers and children are closely linked. This study examined the relationship between child and maternal symptom change during a period in which children participated in community mental health treatment. Symptom change was measured using the Child Behavior Checklist for children and the Beck Depression Inventory for Mothers. Results indicate that mothers whose children improve in community mental health treatment are significantly more likely to report a reduction in maternal depressive symptoms than mothers whose children do not improve. Implications of these findings for mental health service settings are discussed.     

Measuring Community Preferences for Public Mental Health Services: Pilot Test of a Mail Survey Method

This study tested the feasibility of a simple mail survey approach to measuring community preferences for mental health services. A 38 item survey detected statistically significant differences in preferences for four central goals, finding that community members most value Focus on the Severely Mentally Ill, followed by Community Safety and Environment, Service Quality and Original Community Mental Health Goals. Some procedural problems were encountered that reduced the response rates, however, the study yielded information that suggests improved procedures for future surveys. Simple mail surveys appear to offer a potentially affordable, efficient way to assess community service priorities.     

Development of a specialized psychiatric service for people with learning disabilities and mental health problems: report of a project from Kwai Chung Hospital,Hong Kong

With the promotion of the concepts of normalization and integration, the mental health needs of people with learning disabilities are increasingly being recognized in Hong Kong. The present paper describes the development of a specialized psychiatric unit in Kwai Chung Hospital that was designed to provide mental health care for people with learning disabilities. A hospital‐based system with multidisciplinary input and strong community linkage was adopted to suit the local situation, and this was funded almost entirely by redistributing existing resources. Since the service came into operation, the responses received from patients, carers and other service providers in the community have been highly favourable. This project is important because it signifies a major step forward in the health care of people with learning disabilities in Hong Kong.     

温州市6-11岁托养儿童行为问题调查

目的了解温州市6-11岁托养儿童行为问题发生情况。方法根据分层整群抽样的原则,对温州地区3860名6—11岁同学采用自制问卷和Achenbach's儿童行为量表(CBCL)进行调查分析。结果872名为托养儿童,占调查总数22．59%(872/3860)。托养儿童6-11岁行为问题检出率18．57%(156/840)高于非托养普通儿童检出率13．38%(396/2960),两者对比差异有显著性(P＜0．05)。温州6-11岁儿童行为问题检出率14．53%(552/3800)高于中国常模12．97%,两者对比无统计学意义(P＞0．05)。托养儿童行为问题的影响因素与出生时患病、学前所处环境、性别、托养家庭结构、托养方式、托养人文化程度及教育方式等有关。结论6-11岁托养儿童行为问题检出率较高,心理健康状况应引起关注。     

Knowledge and prevalence of energy drinks consumption in Shanghai,China: a cross-sectional survey of adolescents

BackgroundIn recent years, energy drinks (EDs) have been widely used among young people around the world. The extensive use of EDs also affects the sleep and exercise of adolescents.AimsThis study aimed to investigate the consumption of EDs, the knowledge, attitude towards EDs and associated factors of EDs consumption among adolescents in Shanghai, China.MethodsA total of 4608 adolescents completed a self-administered questionnaire assessing EDs use history, knowledge and attitude towards EDs. Adolescent Self-rating Life Events Checklist (ASLEC) was used to assess their life events. All participants were divided into two groups based on whether they used them or not. t-test and χ² test were used to compare the differences between the two groups, and binary logistic regression analysis was used to investigate the related factors for EDs consumption.Results70.5% of the participants reported having ever used EDs. The main avenues to getting information on EDs were from advertisements. 67.56% of them believed that EDs had adverse effects on health. 22.09% of the participants and 31.55% of their parents took a negative attitude towards EDs. Compared with the non-consumption group, participants in the consumption group were likely to be male, with older age, identified EDs more correctly and did not believe EDs had adverse effects, with more positive attitude and higher ASLEC score. Logistic regression results showed that gender, age, attitude of parents and themselves, knowledge of EDs and ASLEC score significantly predicted EDs consumption.ConclusionEDs consumption was popular among adolescents in Shanghai, and the tailored intervention programmes need to be developed based on the characteristics of adolescents.     

Validity of the Child Behaviour Checklist in a Norwegian sample

The purpose of the study was to test the applicability of the Child Behaviour Checklist for assessing behaviour problems and competencies in Norwegian children and adolescents. Information was obtained by mailing checklists to parents of random sampled children and adolescents in a mixed rural/semirural area and the urban Oslo area. High-scoring children and random samples of normal-scoring children in two different age groups were clinically assessed in the second part of the study. The results support the predictive validity of the CBCL as judged by its ability to distinguish between children with psychiatric disorders and psychiatrically nondisordered children. Differences pertaining to sex, age, SES, and degree of urbanisation confirm findings of earlier studies across cultures. Accepted: 17 September 1998