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).     

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.     

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.     

“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.     

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.     

Parental participation at child protection case conferences: An evaluation of practice in north and west belfast

Parental participation at child protection case conferences is still a relatively new and contentious phenomenon. In January 1994 a strategy for this process was implemented in North and West Belfast Health and Social Services Trust and this research was undertaken in order to monitor and evaluate this new way of working.

Structured interviews were carried out with twenty-two parents and a postal questionnaire was sent to six main professional groups (field social workers, non-field social workers, police, doctors, teachers, and community nurses). The questionnaire achieved a response rate of 68% (i.e. 108 returned out of 160).

The results indicate that a positive start has been made to the participation of parents at case conferences and that this was generally welcomed by parents and professionals. Parents do not appear to be “emotionally damaged” by participation and the results indicate that they have a clearer understanding of concerns and a greater commitment to plans as a result of attending. Parental participation also does not appear to affect the focus and purpose of case conferences and indeed, professionals mainly found the presence of parents helpful to conferences.

The research highlighted deficiencies in the preparation of parents, a general feeling of inhibition amongst professionals, and a divergence in the views of parents and professionals as to whether or not participation should be full or partial. A number of conclusions for policy and practice are reached in light of die findings.     

Who is the odd man out: men in early childhood settings?

Australia has, on the whole, been slow to react to many of the more innovative or welfare-oriented programs for young children and their families in the past two or three decades. We can speculate about this in terms of geographic isolation, natural caution or a population which is not appropriately tuned to the needs of parents with young children. Whatever the reason, Australia appears to be slow to respond to changes in attitude. One of the major potential areas for change in attitude is the employment of males in early childhood settings.

The history of the United States, which thirty years ago appeared to totally reject the notion of men working with young children, now records a substantial move towards encouraging males and females to assume androgynous roles in children's services.

It is interesting to note that this contemporary view has flourished in spite of the lack of empirical evidence to support previous notions relating to the role of male teachers and caregivers in terms of providing male models for fatherless children, offering more appropriate teaching strategies to young boys and providing examples of more tolerant caregivers for exhuberant boys.

While evidence suggests that prejudice still exists in U.S.A. about male teachers in early childhood settings, the androgynous philosophy appears to point the way in which early childhood services in Australia must go in order to provide a more balanced program for all young children.     

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.     

Brain damage and neuropsyochological impairment in female and male alcoholics and implications for their offspring

Matched pairs of 40 male and 40 female alcoholic inpatients living in Stockholm were examined and found to fulfill the alcoholism criteria of DSM-III-R. They comprised 40 matched pairs of men and women consecutively admitted to the Karolinska Alcohol Clinic and staying at least one week for treatment. The examination included a general medical examination, a psychiatric and social history, blood tests, ECG, computed tomography of the brain and neuropsychological testing. The subjects' and their families' possibilities of creating a good upbringing environment and their own and their children's childhood were studied.

The alcoholics and their offspring were followed from the registers of the child welfare committees, temperance boards, social service departments, the Social Insurance Office and the Medical Information System of the Medical Services Board of Stockholm County Council.

The children of the female alcoholics had, during their childhood, more often had contact with an educational welfare officer, a psychologist or a physician for various problems and also had a significantly higher rate of registration in the children's welfare committee registers than children of male alcoholics. The male alcoholics more often came from broken homes. 29% of the female and 32% of the male alcoholics had been fostered by their biological mother alone or by grandparents until 16 years of age. 51% of the women and 39% of the men had an alcohol-abusing mother and father during childhood. Signs of social maladjustment and having been under the care of a child welfare committee were recorded in 32% and 24% respectively of the male alcoholics and 20% and 12% of the females.

62% of the male alcoholics and 30% of the females showed cortical atrophy. Signs of neuropsychological impairment were present in 35% of the females but only 16% of the males.

It is concluded that female and male alcoholics resemble each other and that they both have a disturbed childhood and that female alcoholics more often have an alcohol and drug-abusing parent, nervous problems in the parents, attempted suicide by a parent and serious schisms in the family than male alcoholics.     

Recovery work with child victims of sexual abuse: A framework for intervention

With each high profile case of sexual assault perpetrated against a child there generally follows a media driven reaction narrowly focusing on stranger danger or paedophile activity The difficulty is that this can present the false impression that therein lies the greatest danger to our children.

The situation with which parentdcarers, and professionals, are faced with in dealing with cases of child sexual abuse is much more complex for a variety of reasons. These include the fact that such abuse is mostly perpetrated by a member of the family or a close friend of the family or child; there are many cases of crossgenerational and sibling abuse; there is often fragmentation of families following disclosure; the immense challenge to strongly held beliefs regarding familv, society and religious values; and thaf a child's coping strategies often involves blocking out the abuse, disassociation and extreme forms of self-harm.

Much good literature exists on the phenomenon of child sexual abuse. However, there is a lack of written material on models of therapeutic intervention, and to engage in this area of work in the absence of a well thought-out framework for intervention would be highly irresponsible and dangerous. The purpose of this paper is to discuss the issue of intervention and in setting out a framework for intervention, the premise is followed that the child is not abused in isolation, but within a family and community context. For this reason theoretical considerations relating to victim impact, family functioning, social learning and developmental stages will be viewed as underpinning practice.     

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.     

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.     

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.     

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.     

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.     

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.     

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.