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– The purpose of this paper is to outline brain structure and development, the relationship between environment and brain development and implications for practice.
Abstract
Purpose
The purpose of this paper is to outline brain structure and development, the relationship between environment and brain development and implications for practice.
Design/methodology/approach
The paper is based on a selected review of the literature and clinical experience.
Findings
While genetics determine the sequence of brain maturation, the nature of brain development and functioning is determined by the young child's caregiving environment, to which the developing brain constantly adapts. The absence of input during sensitive periods may lead to later reduced functioning. There is an undoubted immediate equivalence between every mind function – emotion, cognition, behaviour and brain activity, although the precise location of this in the brain is only very partially determinable, since brain connections and function are extremely complex.
Originality/value
This paper provides an overview of key issues in neurodevelopment relating to the development of young children, and implications for policy and practice.
Details
Keywords
Vivette Glover and Jane Barlow
Foetal programming is one of the key mechanisms by which physical and social adversity is biologically embedded during pregnancy. While early interest in such programming focused…
Abstract
Purpose
Foetal programming is one of the key mechanisms by which physical and social adversity is biologically embedded during pregnancy. While early interest in such programming focused on the long-term impact of the mother's nutritional state on the child's later physical health, more recent research has identified an increased risk of psychopathology in children of women who have experienced stress, anxiety and depression during pregnancy. The purpose of this paper is to examine the literature addressing the impact of stress in pregnancy and the implications for practice.
Design/methodology/approach
An overview of the literature has been provided.
Findings
Both anxiety and depression in pregnancy are common, with a prevalence in the region of 20 per cent. Exposure in pregnancy to anxiety, depression and stress from a range of sources (e.g. bereavement, relationship problems, external disasters and war), is associated with a range of physical (e.g. congenital malformations, reduced birthweight and gestational age), neurodevelopmental, cognitive, and emotional and behavioural (e.g. ADHD, conduct disorder) problems. The magnitude is significant, with the attributable risk of childhood behaviour problems due to prenatal stress being between 10 and 15 per cent, and the variance in cognitive development due to prenatal stress being around 17 per cent. A range of methods of intervening are effective in improving both maternal anxiety and depression, and in the longer term should improve outcomes for the infant and child.
Research limitations/implications
This research highlights the importance of intervening to support the psychological wellbeing of pregnant women to improve outcomes for infants and children, and points to the need for further research into innovative ways of working, particularly with high-risk groups of pregnant women.
Originality/value
The paper provides an update of earlier overviews.
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Keywords
Lorenz S. Neuwirth and Jordan Bell
Lead is a well-established environmental contaminant that over the last 50 years has become recognized as a neurotoxin with its greatest concern for the developing child (i.e…
Abstract
Purpose
Lead is a well-established environmental contaminant that over the last 50 years has become recognized as a neurotoxin with its greatest concern for the developing child (i.e. both in-utero and postnatally). What is problematic is that children exposed to lead often come from lower socioeconomic status (SES), are largely Black communities and are further at increased risk for developing adverse childhood experiences (ACEs). The literature on ACEs had focused much on trauma, single parenting, child abuse, lack of finances and stress, etc., but has not considered the intersectionality of these ACEs as risk factors within environmental neurotoxic exposures such as lead poisoning. This is important as most low SES communities are Black. In particular, within the New York City Housing Authority (NYCHA), Black families have been neglected of proper lead-abatement to their apartments for nearly 70 years.
Design/methodology/approach
This is a viewpoint/perspective paper that examines the lived experiences of Black folxs in NYCHA through a Black critical theory (BlackCrit) and antiblackness framework pertaining to ACEs, and lead poisoning within the NYCHA system of New York City. This perspective paper draws upon the last three years of news reports, five decades of publicly available data sets from NYCHA and the comptroller to raise an awareness of how Black children are treated by NYCHA generation after generation which can be argued as a mass atrocity against NYCHA residents. Furthermore, the systematic and institutionalized racism and environmental injustices by NYCHA and the state can also be considered as a crime against humanity. As such, BlackCrit could help to position awareness, advocacy and knowledge about Black folxs residing in NYCHA to achieve fair, safe and affordable public housing to experience Black joy across future generations.
Findings
Thus, rather than civic and state government response efforts focusing their full attention and resources to serving and supporting individuals affected by ACEs they should equally consider the environments in which Black people live and also allocate funds proportionally to address these areas often overlooked. Moreover, proportions of these funds should be redirected especially to lead-abatement and removal of known sources of lead exposures, evaluation of suspected sources of lead exposures (i.e. drinking water, baby food and formula, children’s juice and cereal products, superfund and other waste sites, electronic recycling plants, etc.) and accompanied by all affected children undergoing full and comprehensive neuropsychological testing and follow up studies paid for by the state. The goal should have two fundamental objectives: (1) accepting accountability for failing to address these preventable neuropsychological issues directly affecting Black children generation after generation and (2) offering the proper waived or reimbursable supports and resources to help Black children sustain the best quality of life (QOL) trajectory possible when diagnosed with lead poisoning.
Research limitations/implications
The manuscript is a viewpoint/perspective paper grounded in BlackCrit and an antiblackness framework. There are ample public news reports and public data available from NYCHA on these matters over the last three years. However, the scope of this paper was not to delve too deep into these numbers per se, but rather to address the concerns leading up to and arguably contributing to, at least in part, to these numbers of lead-exposed Black children in NYCHA. Lead poisoning has never been considered as an ACE and its relationship to mass atrocity research is novel which may pave a new avenue for research of this kind through the utility of BlackCrit and antiblackness framework to support and advocate for change so that Black children can be provided with a basic human right of safe housing and experience Black joy.
Practical implications
BlackCrit has not been used in the context of lead poisoning research. Mostly individuals and families of middle- and low-income have been studied in the context of poverty and lead poisoning. However, many people who live in poverty, in public housing, within New York are Black. Thus, Black children are generation after generation exposed to unaddressed lead-abatement and it appears that now more than ever BlackCrit should become the framework for how this work should be discussed in the literature to raise awareness to state governments regarding Black folx's persistent lead poisoning, NYCHA's neglect and mass atrocity research as a long overdue advocacy effort to bring the necessary voice, authentic narrative, and actual knowledge of the lived experiences of Black families in NYCHA with lead poisoning.
Social implications
The goal of this viewpoint/perspective paper should have two fundamental objectives (1) NYCHA and New York State accepting accountability for failing to address these preventable lead poisoning issues directly affecting Black children; and (2) offering the proper support and resources to help Black children sustain the best QOL trajectory possible when diagnosed with lead poisoning.
Originality/value
Lead poisoning research has never been approached through a mass atrocity and BlackCrit framework and perspective. This is the first report on bridging these fields within the context of NYCHA public housing neglect of lead-abatement and continued poisoning of current and future generations of Black children. This failure of NYCHA lead-abatement contributes annually to economic loss in New York State for many years to come which could be entirely avoided.
Details
Keywords
William C. Curran and Matt C. Danbrook
Child welfare services (CWSs) globally continue to absorb high rates of children living with or suspected of fetal alcohol spectrum disorder (FASD). Such high prevalence rates…
Abstract
Purpose
Child welfare services (CWSs) globally continue to absorb high rates of children living with or suspected of fetal alcohol spectrum disorder (FASD). Such high prevalence rates render CWS with major ethical and moral dilemmas of meeting complex needs. Currently, many jurisdictions are challenged by diagnostic capacity and cost implications of formal FASD diagnosis. This paper aims to recommend a screening protocol to address management gap between FASD initial presentation and formal diagnosis.
Design/methodology/approach
This is a follow-up paper from a grounded-theory study of a sample (N = 18) of child welfare social workers (CWSWs), allied health professionals and foster parents. A stepwise protocol was developed through systematical interpretation of the final data.
Findings
The application of a five-step screening protocol would greatly support CWSW in meeting the needs of children with suspected FASD. This CWSWs-led assessment model incorporates a clinical evaluation to exclude neurodevelopmental conditions caused by known genetic disorders, followed by behavioral and neurocognitive psychosocial assessments.
Research limitations/implications
This study had several limitations. Firstly, as a specific social work-based sample, it is not necessarily representative of the wider population of social workers globally due to different cultural responses to FASD in CWSs. The transferability of findings will have to be considered due to cultural variations concerning FASD.
Practical implications
By offering a management and nonlabeling approach, this five-step screening protocol offers a delineated pathway for CWSW and addresses the major professional frustrations while seeking to plan safe care for a child suspected of having FASD.
Social implications
The research offers a pragmatic low-cost to society to alleviate the mounting social and monetary implications of FASD. A large percentage of children impacted by prenatal alcohol exposure do not qualify under formal clinical diagnostic guidelines. Leaving these children without intervention is problematic. The recommendation of this study addresses this critical gap in services. The primary aim is to alleviate the burden on this cohort of vulnerable children by offering nonlabeling neurodevelopmental screening.
Originality/value
The direct implications of FASD and how it impacts CWS are well documented. However, few studies focus on the critical interface of FASD and the role of CWSW responsible for planning their safe care. This paper offers a novel pragmatic and functional multistep protocol to aid CWSW in this complex area of practice.
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Damian Tago, Henrik Andersson and Nicolas Treich
This study contributes to the understanding of the health effects of pesticides exposure and of how pesticides have been and should be regulated.
Abstract
Purpose
This study contributes to the understanding of the health effects of pesticides exposure and of how pesticides have been and should be regulated.
Design/methodology/approach
This study presents literature reviews for the period 2000–2013 on (i) the health effects of pesticides and on (ii) preference valuation of health risks related to pesticides, as well as a discussion of the role of benefit-cost analysis applied to pesticide regulatory measures.
Findings
This study indicates that the health literature has focused on individuals with direct exposure to pesticides, i.e. farmers, while the literature on preference valuation has focused on those with indirect exposure, i.e. consumers. The discussion highlights the need to clarify the rationale for regulating pesticides, the role of risk perceptions in benefit-cost analysis, and the importance of inter-disciplinary research in this area.
Originality/value
This study relates findings of different disciplines (health, economics, public policy) regarding pesticides, and identifies gaps for future research.
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Keywords
Alia Salam, Russell K. McIntire and Lucille B. Pilling
The purpose of this paper is to identify the severity of certain communication disorders (CD) in a sample of Syrian refugee children. There are a limited number of studies about…
Abstract
Purpose
The purpose of this paper is to identify the severity of certain communication disorders (CD) in a sample of Syrian refugee children. There are a limited number of studies about CD among refugee children.
Design/methodology/approach
Over a period of 22 months, 161 cases of CD – not caused by motor or structural disorders – were seen at a Mental Health Clinic in Beqaa, Lebanon. The authors calculated descriptive statistics (frequencies and percentages) and bivariate statistics to identify relationships between CD, demographics and school enrollment among cases.
Findings
Ages ranged between 3 and 16 years with a mean of 6.91. Male to female ratio was 1.6:1. The most prevalent category of CD was speech, followed by expressive language, then receptive language. Parents reported behavioral or emotional problems in 38 percent of the cases; emotional problems, mainly anxiety, were much more common than behavioral problems. Enrollment in school was associated with a lower number of impairments and less severe speech and language impairments.
Originality/value
The results highlight the importance of early detection and intervention among Syrian refugee children. Schools can alleviate some psychological issues that compound CD by enhancing resilient behaviors and providing social support. They can also implement measures for detection and intervention.
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Keywords
Vivette Glover and Carole Sutton
The purpose of this paper is to update the evidence for the long‐term effects of the fetal environment on the later antisocial behaviour of the child, and possible interventions.
Abstract
Purpose
The purpose of this paper is to update the evidence for the long‐term effects of the fetal environment on the later antisocial behaviour of the child, and possible interventions.
Design/methodology/approach
The authors present a literature review of recent research on the topic.
Findings
Recent research confirms and extends previous conclusions. The emotional state, alcohol use, smoking and drug consumption of the mother during pregnancy all increase the risk of the child developing antisocial behaviour. Prenatal anxiety may contribute 10‐15 per cent of the attributable load to behavioural outcomes. The Nurse Family Partnership programme remains the only intervention to start in pregnancy and show a long‐term reduction in the child's antisocial behaviour. However, several other interventions are likely to be helpful.
Originality/value
Stress, anxiety and depression during pregnancy are frequently undetected by health professionals and left untreated. Programmes to help with this, together with the reduction of smoking and alcohol consumption, should help reduce later criminal behaviour.
Georgina L. Barnes, Alexandra Eleanor Wretham, Rosemary Sedgwick, Georgina Boon, Katie Cheesman and Omer Moghraby
Clinicians working in UK child mental health services are faced with several challenges in providing accurate assessment and diagnosis of attention deficit hyperactivity disorder…
Abstract
Purpose
Clinicians working in UK child mental health services are faced with several challenges in providing accurate assessment and diagnosis of attention deficit hyperactivity disorder (ADHD). Within the South London & Maudsley (SLaM) NHS Trust, community Child & Adolescent Mental Health Services (CAMHS) are developing structured pathways for assessing and diagnosing ADHD in young people. To date, these pathways have not been formally evaluated. The main aims of this evaluation are to evaluate all ADHD referrals made to the service in an 18-month period, including the number of completed assessments and proportion of children diagnosed with ADHD; and investigate adherence to the National Institute for Clinical Excellence (NICE) guideline for diagnosing ADHD in children and young people.
Design/methodology/approach
Retrospective data analysis was performed using service databases and electronic patient records. Adherence to the clinical guideline was measured using the NICE data collection tool for diagnosing ADHD in children and young people. All completed ADHD assessments were compared to four key recommendation points in the guideline.
Findings
Within the time frame, 146 children aged 4-17 years were referred and accepted for an ADHD assessment. Of these, 92 families opted in and were seen for an initial appointment. In total, 36 ADHD assessments were completed, of which 19 children received a diagnosis of ADHD and 17 did not. Aside from structured recording of ADHD symptoms based on ICD-10 criteria (69%) and reporting of functional impairment (75%), adherence to all guidance points was above 90%. The study also found that although a greater proportion of children referred to the service were male and identified as White, these differences narrowed upon receipt of ADHD diagnosis.
Research limitations/implications
Relationship to the existing literature is discussed in relation to the assessment process, demographic characteristics and rates of co-occurrence.
Practical implications
The findings demonstrate that in child mental health services, gold standard practice for diagnosing ADHD should be the adoption of clear, protocol-driven pathways to support appropriate access and treatment for young people and their families.
Originality/value
This article is unique in that it is, to the best of the authors’ knowledge, the first to describe and report clinician-adherence to a structured pathway for diagnosing ADHD in young people within a community CAMHS service in South London.
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Jillian Roberts, Angela Donkin and Michael Marmot
– Poor mental health and well-being disproportionately affects vulnerable and disadvantaged children and young people. The paper aims to discuss this issue.
Abstract
Purpose
Poor mental health and well-being disproportionately affects vulnerable and disadvantaged children and young people. The paper aims to discuss this issue.
Design/methodology/approach
The focus of this paper is socioeconomic inequalities in perinatal, child and adolescent mental health.
Findings
Children and young people in the poorest British households are up to three times more likely to develop mental health problems than their more advantaged peers (Green et al., 2005). The pattern can also be observed in the opposite direction, with poor mental health known to contribute to socioeconomic and other health problems (McCulloch and Goldie, 2010, Parckar, 2008). At a larger scale, the higher the level of inequality within developed countries, the higher the rate of child and adolescent mental health problems (Pickett et al., 2006).
Social implications
Mechanisms posited as underlying such inequalities include family investment and stress processes. These factors have been taken into account when developing the economic case for investing in perinatal, child and adolescent mental health.
Originality/value
Illustrative examples of progressive universal strategies and policies to help reduce socioeconomic inequalities in mental health, include: action to address the inequality gap in the UK; early intervention to improve mental health; investing in sustainable and evidence-based mental health services; ensuring parity of esteem, and; using appropriately designed social media and online sources to support children’s mental health.
Details
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In Canada, food insecurity is characterized by the consumption of low quantity or low-quality foods, worrying about food supply and/or acquiring foods in socially unacceptable…
Abstract
In Canada, food insecurity is characterized by the consumption of low quantity or low-quality foods, worrying about food supply and/or acquiring foods in socially unacceptable ways, such as begging or scavenging. As of 2012, approximately 15.2% of Ontario, Canada, children are living in food insecure households, a prevalence which has remained steady since 2005. This is particularly concerning when considering that school-aged children are a population whose growth and developing is sensitive to nutritional stress, and the experience of childhood food insecurity is highly associated with the development of adverse physical, mental and learning outcomes. This study aims at establishing the relationship between food insecurity and Education Quality and Accountability Office (EQAO) standardized test scores in order to highlight the incompatibility of the EQAO's reliance on test outcomes in determining Ontarian school's accountability, specifically for those with a high prevalence of food insecurity.
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