The family practices of service providers for young handicapped children

A survey was distributed to service providers in Connecticut working with newborn to 6-year-old handicapped children to examine the degree to which service activities currently focus on the family. Most service-provision goals elicited by the survey were child-focused clinical goals, but family-focused goals were frequently cited However, 30% reported spending no time with families during a typical week. Published programs or curricula were rarely used. The providers felt they were successfully achieving goals set for families but that they encountered some problems, including a lack of time to work with families. Comparisons were made between those working with children from birth to 3 years of age and those working with children 3 to 6 years of age. Suggestions concerning the implementation of the family-focused agenda were made.     

Aging family caregivers: policies and practices

This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving, (3) support needs of families, (4) family support policies and practices, and (5) recommendations for a research and policy agenda. Research examining outcomes of life-long caregiving has shown that most families adapt well to having a family member with disabilities. However, some families are at risk for poorer physical and mental health outcomes. These include cultural minorities and families of adults with behavioral challenges. Caregiving does seem to have a negative impact on maternal employment and family income as mothers often give up or cut back on employment to care for a child with developmental disabilities, who is more likely to continue living in the family home throughout adulthood than other adult children. Federal and state initiatives are addressing issues of family support through both the developmental disabilities and aging service systems.     

Audit and family systems consultation: evaluation of practice at a child and family centre

This audit of practice at a child and family centre included a 16-month case note review covering 319 cases, a postal survey of 45 families and an interview survey of ten GPs who typically referred cases to the centre. The audit furnished information from three different perspectives on the referral process, the consultation process, and outcome for clients attending the centre. The referral rate was about one new case per day and peak referral times were the beginning of the autumn and winter school terms. Almost half the referrals came from GPs; the remainder were largely from Paediatrics, Education and Social Services. Most clients were seen within two months. Half of the families referred had serious psychosocial difficulties including multiple problem members, multi-problem children, multi-agency involvement, psycho-educational difficulties, child protection problems or child placement difficulties. The majority of cases received six hours of consultation. Families where child abuse had occurred or families containing a multi-problem adolescent received a more intensive service. Between a half and three-quarters of cases had positive outcomes as rated by staff and parents. The service was viewed by GPs to be highly satisfactory. On the negative side, many parents felt ill-prepared for the consultation process and most children did not enjoy the experience.     

Naming practices,typicality, and underextension in child language

Preschool children (3 to 5 years of age) in an initial study underextended superordinate labels. The labels (e.g., food) were not applied to category instances that were rated as atypical by adults (e.g., ketchup). In a second experiment, mothers seldom used a superordinate term in referring to pairs of the same atypical instances, but they did label pairs of typical instances with a superordinate. A third experiment demonstrated the effects of several word-referent modeling conditions on young children's comprehension of a superordinate term. The results were viewed as suggesting that the child undergeneralizes superordinate labels because adult naming practices are such that category instances having certain functional or perceptual attributes may be labeled with a superordinate, while other, dissimilar instances are almost always labeled with subordinate names instead of a superordinate.     

Rorschach predictors of therapeutic outcome in a child psychiatric inpatient service

This study tested the hypothesis that Rorschach indicators of psychological instability and perceptual sensitivity are predictive of therapeutic outcome in a child psychiatric inpatient service. Thirty-four children, matched for age, were divided into two groups, Improvers and Decliners, based on changes in behavioral problems over 60 days of hospitalization. The groups were not distinguishable by scores on intellectual tests, sex, or the initial quality or severity of psychological disturbance. Analyses of Rorschach protocols indicated that children who obtained higher ep, ep-EA, Blends, Zf, and Z sum and lower Lambda had improved in treatment. The results suggest that children who are less stabilized and manifest perceptual sensitivity do achieve the greatest gains.     

The application and utility of a family assessment procedure in a child psychiatry clinic

The application of a method of assessing families from a total family systems viewpoint is explored. It was found that the method (the McMaster Model) was well-suited to routine practice in a British child psychiatry setting with routine clinic referrals. It constituted a good procedure both for assessing and for preparing families for family therapy. In this paper the practical procedure is described. Some of the issues arising from the approach and from the assessment of thirty-four clinic families are discussed. It was also found that the method provided a very good framework for teaching.     

The family and the child with epilepsy

Reports documenting psychosocial epiphenomena of chronic illness in individuals with that illness have been common in recent years. Few studies, however, have been concerned with how illness might affect the family. Those that have appeared in the literature often lack critical controls (i.e., control groups) and often fail to investigate possible links between illness-specific variables (i.e. chronicity, inhibition of mobility) and psychosocial outcomes on the family. The present study of 45 families focused on how children with epilepsy affect their families' functioning relative to families with a child with diabetes and families with no chronically ill members. The results suggest several areas of child and family adjustment (i.e. child self-concept, family communication, family cohesion) in which the families of epileptic children have great difficulty. Implications of these results are discussed with regard to differential influences of various chronic illnesses on families and family-based preventive and remedial treatment programs.     

A family intervention in psychosis service integrating the systemic and family management approaches

A project to establish new family intervention services to support people with psychotic symptoms and their families is described. The new services are developed by training a whole team in each main population centre. The multidisciplinary training course and the family intervention service are described, and the way in which we integrate the 'family management' and 'family therapy' approaches is discussed.     

Parenting practices and their relevance to child behaviors in Canada and China

Liu, M. & Guo, F. (2010). Parenting practices and their relevance to child behaviors in Canada and China. Scandinavian Journal of Psychology, 51, 109–114. Recent studies have revealed that parents in different cultures endorse different child‐rearing practices. Studies in the West suggest that there is a cluster of behavioral characteristics in children that are linked with each type of parenting styles. Mixed results, however, were found in non‐Western countries. This study examined (1) parenting practices in Canadian and Chinese mothers, and (2) the relevance between parenting practices and child behaviors in Canada and China. Forty Canadian children (average age = 5.40) and 39 Chinese children (average age = 4.84) and their mothers participated in the study. Information on maternal authoritative and authoritarian behaviors and children’s behaviors, including coercive request, polite request, and assertiveness, was obtained from observations of mother‐child interactions in a laboratory situation. The results indicated that Chinese mothers were less authoritative and more authoritarian than Canadian mothers. Both cross‐cultural differences and similarities were found on the associations between maternal parenting practices and child behaviors.     

Training child abusers in the use of positive reinforcement practices

A parent training program involving reading assignments, practice assignments, role-playing and contingent reinforcement was implemented for two parents identified as child abusers. Measures selected from the Patterson Coding System served as the dependent variables. Several constructive changes in parent-child interactions were observed, some of which were maintained for as long as five months post-training.     

Parental meta-emotion structure predicts family and child outcomes

Abstract

Fifty-six families with a preschool child whose parents varied widely in parental marital satisfaction were studied at two time points: at time-I when the children were 5 years old and again at time-2 when the children were 8 years old. At time-1 each parent was separately interviewed about their “meta-emotion structure”, that is, their feelings about their own emotions, and their attitudes, and responses to their children's anger and sadness. Their behaviour during this interview was coded with a meta-emotion coding system. Two meta-emotion variables were studied for each parent, awareness of the parent's own sadness, and parental “coaching” of the child's anger. We termed the high end of these variables an “emotion coaching” (EC) meta-emotion structure. Meta-emotion structure was found to relate to time-1 marital and parent-child interaction. EC-type parents had marriages that were less hostile and they were less negative and more positive during parent-child interaction. Their children showed less evidence of physiological stress, greater ability to focus attention, and had less negative play with their best friends. At time-2 those children showed higher academic achievement in mathematics and reading had fewer behaviour problems, and were physically healthier than non-EC parents. The relations between child outcome and parental meta-emotion structure were not explained by social class variables, emotional expressiveness, or the greater happiness and stability of parents with an EC-type meta-emotion structure.     

Impact of substance abuse and child maltreatment training on service utilization in a rural setting

Substance abuse and child maltreatment have been recognized as co-morbid problems encountered in families presenting in the child protective services (CPS) system. Nonetheless, utilization rates of substance abuse treatment services have generally lagged well behind what the research would suggest are prevalence rates for substance abuse disorders in this population, suggesting problems in recognition and referral practices among CPS workers. In response to this, 25 training programs were funded by the National Center on Child Abuse and Neglect. This study reports data from one program. Trainees indicated a high level of satisfaction and demonstrated significant knowledge gains. More importantly, utilization of substance abuse services increased significantly across time in a multi-county region receiving training relative to a comparison region receiving none. The gain was limited, suggesting that while increased knowledge may translate into increased service utilization, additional barriers to accessing needed services must also be addressed.     

Toward an integration of child and family therapy

Current forms of treatment for the symptomatic child are reviewed and analyzed. There are four general approaches to treatment: individual child psychotherapy, conjoint parent-child psychotherapy and counseling, parent therapy and counseling, and conjoint family therapy. Each approach has certain strengths, but in-and-of itself is an incomplete treatment mode. An integration of child and family therapy is recommended, and recent attempts at this integration are described. These include approaches which work within the framework of conjoint family therapy and those which provide concurrent child and family therapy.     

Outcome studies of family therapy in child and adolescent depression

There is surprisingly little good-quality evidence for the effectiveness of family systemic interventions with child and adolescent depression given the prevalence of depression and the demonstrated association with a range of family factors. What studies there are suggest the possibility of family therapy being an effective intervention but more research is needed before firm conclusions may be drawn. Family interventions may be more effective in children than in adolescents and where other family members are depressed. It is possible that family interventions continue to bring about improvement in symptoms after cessation of treatment. What research there is evaluates older structural models of therapy: there is a real need for more evaluation of newer models of practice.