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.     

City Hospital Child Development Centre: An Evaluation of Parental Satisfaction

This study is concerned with the satisfaction expressed by parents whose children attend the Child Development Centre at City Hospital in Birmingham. In addition, participants were also asked questions relating to the extent of their involvement in helping plan specific interventions. Whilst parents expressed satisfaction with service provision in general the results clearly showed that parents:

1. Would like to have more of a role in the initial assessment meeting.
2. Welcome the chance to help decide upon service quality.
3. Greatly appreciate more help with issues such as information regarding availability of benefits.


The implications of the results are discussed and suggestions for further research are made.     

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.

     

Prosocial Behaviors of Handicapped and Typical Peers In An Integrated Preschool

This Study explores initiations of prosocial actions by mainstreamed handicapped and normal preschoolers to discover:

1. which preschool activity setting was more conducive to prosocial interactions.
2. which specific prosocial bids were more likely to occur in which setting.
3. whether frequency of prosocial behaviors was related to directionality, since typical children are reported to choose interactions with typical rather than atypical peers preferentially.
4. what proportion of prosocial behaviors were child initiated rather than teacher directed.

Six types of prosocial bids were recorded for 10 typical and 5 special (4 autistic, 1 multiply handicapped) children (mean age 4-4 years) in 4 activity settings (80 total minutes per child). Setting had a significant effect. Most of the 210 prosocial bids occurred during free play, many during structured play and gym, and the fewest during teacher-directed structured circle time. Sharing, cooperating and helping were the most frequent prosocial behaviors. Sympathy and praise were rare; no nurturing was observed.

No directionality preferences were found. Typical children initiated twice as many prosocial bids (X=20) as atypical peers (X=10-2). Taking into account the expected probabilities for interactions given the significantly different prosocial activity levels for each group and the different numbers of children per group, no preferences or “prejudices” were found.

Contact alone with typical children does not build interpersonal skills of atypical children. Teachers and therapists must specifically model and facilitate prosocial skills.     

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.     

Mother-child interaction: Impact on children's intellectual competence

This study of 24 families seeks to investigate verbal interaction between mothers and children in poor homes, in order to analyse the effect that the number, type and content of linguistic interactions may have on language development in preschool children.

The areas of interest in this study are:

1. The number and type of conversations, when they begin, how long they last and the number of different subjects discussed; and
2. The mother's role when communicating with her child. Here we are interested in finding out things like: the mother's attitude towards dialogue, the way she contributes to, or the kinds of demands she makes on her child's knowledge during conversations, the way she responds to her child's questions, as well as others.
     

Methodological Reflections on Using the Early Childhood Environment Rating Scale as a Measure to Make Cross-National Evaluations of Quality

How useful is the Early Childhood Environment Rating Scale (ECERS) as a research instrument in making cross-national comparisons of the quality of nurseries?

The paper briefly outlines the ECERS and discusses the extent to which it can be used as a universal evaluative tool to measure quality. The author reflects on her use of the ECERS scale in cross-national contexts, to comment on its advantages and its limitations.

The author used the ECERS as part of a qualitative investigation into nursery provision and practice between 1991 and 1994 in cities in fourcountries, New York, (USA) Harnosand, (Sweden), Arezzo (Italy) and Barcelona (Spain). The nurseries in which the author carried out observations and interviews were chosen by contacts in the countries concerned for both their willingness to participate and for their representativeness. A minimum of four institutions which took children under three were visited for at least half a day in each city.

The author uses examples derived from this research to argue that while the scale may have some advantages in that, ratings can be undertaken in two hours, and the scale can provide comparison measures on a number of criteria which child care professionals have agreed are significant, it also has a number of disadvantages. Because the scale is empirically rather than theoretically based and is not explicit about the evaluative categories, which underlie it, its use can obscure rather than illuminate, what different countries see as the most significant aspects of their care and education provision.

The paper concludes that we need to develop measurement tools which explicitly state the values and theoretical perspectives behind their construction.     

“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.     

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.     

Enhancing Nigerian rural women's food production through appropriate child care assistance

Nigerian rural women play an important role in feeding the nation. They are largely responsible for 80 percent of all food items produced and sold in different parts of the country. Since most of these women are in their active childbearing age, there is no doubt that the provision of adequate child care facilities would not only enhance the productivity of these women but would also address the educational and health needs of preschool children in the rural communities.

The paper stresses the importance and the need for joint efforts between community cooperative societies and government/private agencies in the organization and successful implementation of childcare programmes for rural women in agriculture.     

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.     

Aetiologies of Autism: Psychodynamic, Pharmacological and Behavioural, Related to Kuwait

Autism is a severe form of childhood psychopathology which has enormous impact on the child, his/her family, and the wider community. It challenges the expertise of doctors, teachers and therapists.

In Kuwait, recognition of the disorder is still in its infancy. However, the government has established a new Centre for Autism, the first of its kind in the country, to provide up-to-date medical care and education for autistic children.

This article will assess Kuwait's progress in catering for autism, in the light of current international thinking. Discussion of the roles of the main governmental and non-governmental bodies concerned with provision for autistic children in Kuwait, with an account of the only two special schools which are currently known to cater specifically for this disorder, is given.

It was found that, in Kuwait, provision is limited and fragmented compared with that of the UK and the USA. Moreover, there is, as yet, relatively little information available to researchers, parents, or the general public. Accordingly, recommendations are made for both action and research, in order to raise the profile of this disorder in Kuwait and extend provision.     

Parental coping and family stress I: Resources for and functioning of families with a preschool child having a developmental disability

While some families function well in the face of the demands of raising a handicapped child, many experience considerable stress. To assist these families, it is important to identify the characteristics of some families which allow them to raise their children while maintaining the well being of individual family members and the family system.

The purpose of this study was to examine the T-Double ABCX Model of Family Adaptation in relation to the adaptive functioning of 16 families raising preschoolers with developmental disabilities. It was concluded that the model provided a useful framework for guiding future research into the adaptive process of families raising children having disabilities.     

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.     

Factors Influencing Success or Underachievement of the Able Child

The aim of this research is to look for reasons for success or underachievement in able children aged between 9 and 11. Those who have a considerable influence on a child during the primary years are teachers and parents and this research explores these relationships.

The participants were selected from three schools within the state sector which represented different aspects of the social spectrum. The children were divided into achievers and underachievers.

Quantitative and qualitative methods have been used for this study and this paper reports on the quantitative analysis. A number of issues are considered including the marital status of parents, handwriting, self-concept and gender. Cognitive style and the possible dissonance between pupil and teacher are also discussed.     

Psychological screening in the course of the health control of four-year-old children

The health control of four-year-old Swedish children will include an examination of possible psychologtcal abnormalities and defects. The methods which have been worked out for this purpose by a committee of the Social Council include two main components. A nurse will carry out an interview with the child's caretaker and then evaluate the child's behavior. In addition, a physician will make an attempt to evaluate the child's development. The “risk children” will then be selected for further psychological investigation.

An attempt has been made to test the efficiency of the screening methods mentioned. The evaluations by the child care centers have been compared to more comprehensive clinical-psychological investigations and the results show good agreement between the two teams.

The Investigation has been carried out at PBU, Stockholm (Chief physician Hans Curman, psychologist Lillian Gottfarb).     

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 treatment of psychological problems experienced by the children of police officers in Northern Ireland

This paper will discuss the recent establishment of the Police Rehabilitation and Retraining Trust's Child and Adolescent Therapy Service. This service was set up in response to an expressed need within the police family to provide evidenced-based psychological therapies for child and adolescent psychopathology caused either directly by service-related incidents or indirectly via parental psychopathology. Officers receiving treatment within the Trust's Adult Psychological Therapies Service frequently expressed distress and guilt regarding the impact their service and related symptoms had on their children. In addition, officers reported a reluctance to utilise existing statutory child and adolescent mental health services.

The impact of the constantly changing political landscape on this population will be examined as the general decrease of an overt terrorist threat allows an opportunity for police families to count the cost the 'troubles' have had on their mental health and to assess what support is required. But the uncertainty of what level of covert threat remains continues to impact directly on family life.

This paper will examine the clinical approaches adopted by this specialist service, in particular Cognitive Behavioural Therapy and Eye Movement Desensitisation and Reprocessing. It will examine how an ongoing and current threat of further trauma impacts on treatment provision and on the establishment of the therapeutic alliance. Primary and secondary stressors unique to this population will be explored, and their impact on treatment, along with how these trauma-related problems might manifest themselves in a variety of disorders.

While the Child and Adolescent Therapy Service exists specifically to provide treatment for police children, the service aims to establish links with statutory services in an attempt to ensure that police families will be able to utilise existing resources, gradually moving away from the feelings of community isolation expressed by some police families.