Sample records for children receiving services
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25 CFR 20.400 - Who should receive Services to Children, Elderly, and Families?
Code of Federal Regulations, 2010 CFR
2010-04-01
... 25 Indians 1 2010-04-01 2010-04-01 false Who should receive Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.400 Who should receive Services to Children, Elderly, and Families? Services to Children, Elderly, and Families...
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25 CFR 20.400 - Who should receive Services to Children, Elderly, and Families?
Code of Federal Regulations, 2011 CFR
2011-04-01
... 25 Indians 1 2011-04-01 2011-04-01 false Who should receive Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.400 Who should receive Services to Children, Elderly, and Families? Services to Children, Elderly, and Families...
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Family Characteristics and Children's Receipt of Autism Services in Low-Resourced Families.
Karp, Elizabeth A; Dudovitz, Rebecca; Nelson, Bergen B; Shih, Wendy; Gulsrud, Amanda; Orlich, Felice; Colombi, Costanza; Kuo, Alice A
2018-04-01
Parents of children with autism spectrum disorder (ASD) face competing demands when caring for their child and fulfilling family commitments. It remains unknown whether family obligations and parental stress might decrease the use of intervention services for young children with ASD. The current study is a secondary analysis of baseline date from a published randomized control trial with 147 low-resourced caregiver-child dyads. Demographic information, data on service use, maternal employment, parent's perception of their child's development, and parental stress were collected for primary caregivers of 2- to 5-year-old children with ASD from 5 sites. Multiple logistic regressions of accessing any intervention services or more than 1 services on familial characteristics were performed, controlling for demographic and contextual variables. Twenty-five percent of children were receiving no intervention service; 26% were receiving 1 service; and 49% were receiving 2 or more services. Perceived developmental delay and not having a sibling in the home were associated with higher odds of receiving intervention services. Children were more likely to receive more than 1 service if their parents had at least a college education and low levels of stress. Factors including perceived developmental level, parental stress, and caring for siblings may play a role in accessing services for children with ASD. Results reveal that competing family needs may be barriers to service use. Mothers of children with ASD with multiple children in the home, low levels of education, and high levels of stress may need additional supports or alternative service delivery models. Copyright © 2018 by the American Academy of Pediatrics.
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Increased Use of Dental Services by Children Covered by Medicaid: 2000–2010
Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie
2013-01-01
This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done. PMID:24753975
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Increased use of dental services by children covered by Medicaid: 2000-2010.
Ku, Leighton; Sharac, Jessica; Bruen, Brian; Thomas, Megan; Norris, Laurie
2013-01-01
This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done.
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Hurlburt, Michael S.; Leslie, Laurel K.; Zhang, Jinjin; Horwitz, Sarah McCue
2012-01-01
Objectives To examine emergency department (ED) use among children involved with child protective services (CPS) in the U.S. but who remain at home, and to determine if ED use is related to child, caregiver and family characteristics as well as receipt of CPS services. Method We analyzed data on 4,001 children in the National Survey of Child and Adolescent Well-being. Multivariate models compared rates of ED use for whether the family received CPS services or did not receive CPS services as well as child characteristics, caregiver characteristics and caregiver/family psychological variables. Results ED use among children who remained at home receiving CPS services was similar to that of children who did not receive CPS services (35.6% and 37.4%, respectively). In multivariate modeling, children with families who received CPS services, children six years or older, and children without a chronic health problem were less likely to use the ED. Children who remained at home in families identified with numerous stressors and, therefore, likely at high risk for future abuse and neglect were 1.73 times (95% CI, 1.14–2.63) more likely to have repeat ED use than children in low risk families. Conclusion Children who remain at home after a CPS evaluation are at high risk for ED use. Future research should focus on the health problems that precipitate an ED visit as well as the relationship between primary care and ED use. PMID:22265905
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Who Receives Speech/Language Services by 5 Years of Age in the United States?
Hammer, Carol Scheffner; Farkas, George; Hillemeier, Marianne M.; Maczuga, Steve; Cook, Michael; Morano, Stephanie
2016-01-01
Purpose We sought to identify factors predictive of or associated with receipt of speech/language services during early childhood. We did so by analyzing data from the Early Childhood Longitudinal Study–Birth Cohort (ECLS-B; Andreassen & Fletcher, 2005), a nationally representative data set maintained by the U.S. Department of Education. We addressed two research questions of particular importance to speech-language pathology practice and policy. First, do early vocabulary delays increase children's likelihood of receiving speech/language services? Second, are minority children systematically less likely to receive these services than otherwise similar White children? Method Multivariate logistic regression analyses were performed for a population-based sample of 9,600 children and families participating in the ECLS-B. Results Expressive vocabulary delays by 24 months of age were strongly associated with and predictive of children's receipt of speech/language services at 24, 48, and 60 months of age (adjusted odds ratio range = 4.32–16.60). Black children were less likely to receive speech/language services than otherwise similar White children at 24, 48, and 60 months of age (adjusted odds ratio range = 0.42–0.55). Lower socioeconomic status children and those whose parental primary language was other than English were also less likely to receive services. Being born with very low birth weight also significantly increased children's receipt of services at 24, 48, and 60 months of age. Conclusion Expressive vocabulary delays at 24 months of age increase children’s risk for later speech/language services. Increased use of culturally and linguistically sensitive practices may help racial/ethnic minority children access needed services. PMID:26579989
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34 CFR 300.226 - Early intervening services.
Code of Federal Regulations, 2010 CFR
2010-07-01
... CHILDREN WITH DISABILITIES Local Educational Agency Eligibility § 300.226 Early intervening services. (a... annually report to the SEA on— (1) The number of children served under this section who received early intervening services; and (2) The number of children served under this section who received early intervening...
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Congdon, David
2010-10-01
Children who are receiving services for abuse and neglect are likely to have reduced developmental levels and are less prepared for success in school as a result. The progress of 144 children receiving services from The Children's Home Society of Florida was tracked with half being randomly assigned to a control group and half to an experimental group receiving enhanced infant mental health oriented case management services from two social work professionals in each of two locations in Tallahassee and West Palm Beach Florida. Those receiving enhanced case management showed significantly higher results in the following areas: more visits with their parents (for those removed from the family home), more service referrals, more completed assessments for services, more services based on the assessments they received, and more success in completing goals of treatment for which they were referred. Their parents had more contact with professionals to whom they were referred and had more success in completing goals of the treatment for which they were referred. Children who received intensive case management also showed improvement in their developmental skills related to problem solving from inception to completion of services. Implications for further research are considered.
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Pastor, Patricia N; Reuben, Cynthia A
2015-06-01
This report describes trends in health conditions reported by parents as the limitations leading to special education services for their children. Data are reported for children ages 6-17 (N=182,998) surveyed in households in the 2001-2012 National Health Interview Survey. Between 2001 and 2012, the overall percentage of U.S. children ages 6-17 who were receiving special education services increased from 7.2% to 8.7%. Between 2001 and 2012, the leading causes of activity limitations among children receiving special education services included emotional or behavioral problems, which increased from 36% to 43%; speech problems, which increased from 16% to 22%; and learning disability, which decreased from 41% to 27%. There were no significant trends in any of the other conditions considered as possible sources of activity limitations. Emotional and behavioral problems have become the most frequently reported source of activity limitations among children receiving special education services.
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ERIC Educational Resources Information Center
US Government Accountability Office, 2016
2016-01-01
Research has shown that early intervention can greatly improve the development of a child with autism. Children with disabilities--including children with autism--can receive intervention services through the Individuals with Disabilities Education Act. Low income children may also receive intervention services through Medicaid or the State…
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Effects of Person- and Process-Focused Feedback on Prosocial Behavior in Middle Childhood
Dunsmore, Julie C.
2014-01-01
Effects of person- and process-focused feedback, parental lay theories, and prosocial self-concept on children’s prosocial behavior were investigated with 143 9- and 10-year-old children who participated in a single session. Parents reported entity (person-focused) and incremental (process-focused) beliefs related to prosocial behavior. Children completed measures of prosocial self-concept, then participated in a virtual online chat with child actors who asked for help with service projects. After completing the chat, children could assist with the service projects. In the first cohort, children were randomly assigned to receive person-focused, process-focused, or control feedback about sympathy. In the second cohort, with newly-recruited families, children received no feedback. When given process-focused feedback, children spent less time spent helping and worked on fewer service projects. When given no feedback, children spent less time helping when parents held incremental (process-focused) beliefs. Children with higher prosocial self-concept who received no feedback worked on more service projects. PMID:25684859
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ERIC Educational Resources Information Center
Ivanova, Masha Y.; Israel, Allen C.
2006-01-01
Family stability, defined as the consistency of family activities and routines, was examined in a sample of urban families (n = 70) with children (ages 7 to 16) receiving psychological services. Parent-reported family stability was associated with lower parent-reported children's internalizing behavior problems. Child-reported family stability…
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Gross-Panico, Michelle L; Freeman, Wilbur K
2012-01-01
Minority children and children from lower income families are more likely to experience the burden of oral disease. Since oral disease reduces quality of life, it is a priority to utilize preventive dental services. The research questions ask if affiliated practice increases utilization of preventive dental services by underserved children from birth to 18 years of age, and what the barriers to receiving preventive dental services are and their level of importance. A survey was administered to parents/guardians of patients from birth to 18 years of age who received preventive dental services from Catholic Healthcare West East Valley Children's Dental Clinic, an affiliated practice dental clinic in Chandler, Arizona. Thirty-four surveys were completed: 21 completed in English and 13 completed in Spanish. The data was analyzed to provide descriptive statistics and non-parametrically analyzed using the Friedman's, Kendall's W and Wilcoxon Signed Ranks Tests. The cost of preventive dental services is more important to this population than both convenience of appointment time and distance traveled. As the cost increases for preventive dental services, this population will utilize preventive dental services less frequently. The study indicated that the increase of self-reported utilization of preventive dental services by underserved children, ranging in age from birth to 18 years old, in Arizona affiliated practice dental clinics, was primarily impacted by perceived reduced costs of receiving care. Funding efforts, reimbursement mechanisms and legislative policies should support this dental care delivery model to provide care to underserved children, adults and seniors throughout the U.S.
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Use of Low-Value Pediatric Services Among the Commercially Insured
Schwartz, Aaron L.; Volerman, Anna; Conti, Rena M.; Huang, Elbert S.
2016-01-01
BACKGROUND: Claims-based measures of “low-value” pediatric services could facilitate the implementation of interventions to reduce the provision of potentially harmful services to children. However, few such measures have been developed. METHODS: We developed claims-based measures of 20 services that typically do not improve child health according to evidence-based guidelines (eg, cough and cold medicines). Using these measures and claims from 4.4 million commercially insured US children in the 2014 Truven MarketScan Commercial Claims and Encounters database, we calculated the proportion of children who received at least 1 low-value pediatric service during the year, as well as total and out-of-pocket spending on these services. We report estimates based on "narrow" measures designed to only capture instances of service use that were low-value. To assess the sensitivity of results to measure specification, we also reported estimates based on "broad measures" designed to capture most instances of service use that were low-value. RESULTS: According to the narrow measures, 9.6% of children in our sample received at least 1 of the 20 low-value services during the year, resulting in $27.0 million in spending, of which $9.2 million was paid out-of-pocket (33.9%). According to the broad measures, 14.0% of children in our sample received at least 1 of the 20 low-value services during the year. CONCLUSIONS: According to a novel set of claims-based measures, at least 1 in 10 children in our sample received low-value pediatric services during 2014. Estimates of low-value pediatric service use may vary substantially with measure specification. PMID:27940698
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Which Preschool Children with Specific Language Impairment Receive Language Intervention?
ERIC Educational Resources Information Center
Wittke, Kacie; Spaulding, Tammie J.
2018-01-01
Purpose: Potential biases in service provision for preschool children with specific language impairment (SLI) were explored. Method: In Study 1, children with SLI receiving treatment (SLI-T) and those with SLI not receiving treatment (SLI-NT) were compared on demographic characteristics and developmental abilities. Study 2 recruited children with…
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Participation in an occupational therapy referral program for children with retinoblastoma.
Sparrow, Jessica; Brennan, Rachel; Mao, Shenghua; Ness, Kirsten K; Rodriguez-Galindo, Carlos; Wilson, Matthew; Qaddoumi, Ibrahim
2016-05-31
Because retinoblastoma typically arises at a very young age, children are particularly vulnerable to vision impairment, associated developmental delays, and functional limitations. Limited information is available describing developmental delay and functional limitations in this population, necessitating supportive services including rehabilitation. The aims of this study were to describe the participation of children with newly diagnosed retinoblastoma in an occupational therapy program that identifies children in need of rehabilitation services. We also identify indications for referral to rehabilitation services among children with newly diagnosed retinoblastoma and enumerate the likelihood of these children receiving the recommended services. Twenty-two children participated in longitudinal occupational therapy assessments during the first year after diagnosis. We recommended 1 or more types of rehabilitation services for 16 of 22 (72.7%) participants. Twelve of 16 (75%) received services. The results of this pilot study indicate that implementing a prospective occupational therapy-screening program is feasible and results in identification and initiation of therapy services in some children with retinoblastoma. Developmental screenings and follow-up of children with retinoblastoma is strongly recommended.
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Meinck, Franziska; Cluver, Lucie; Loening-Voysey, Heidi; Bray, Rachel; Doubt, Jenny; Casale, Marisa; Sherr, Lorraine
2017-03-01
Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential self-report questionnaires were completed by adolescents aged 10-17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims.
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32 CFR 80.2 - Applicability and scope.
Code of Federal Regulations, 2010 CFR
2010-07-01
... FAMILIES, AND SPECIAL EDUCATION CHILDREN WITH DISABILITIES WITHIN THE SECTION 6 SCHOOL ARRANGEMENTS § 80.2... children, and children receiving or entitled to receive early intervention services or special educational...
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Behavioral Health Services Following Implementation of Screening in Massachusetts Medicaid Children
Penfold, Robert B.; Arsenault, Lisa N.; Zhang, Fang; Murphy, Michael; Wissow, Lawrence S.
2014-01-01
OBJECTIVES: To determine the relationship of child behavioral health (BH) screening results to receipt of BH services in Massachusetts Medicaid (MassHealth) children. METHODS: After a court decision, Massachusetts primary care providers were mandated to conduct BH screening at well-child visits and use a Current Procedural Terminology code along with a modifier indicating whether a BH need was identified. Using MassHealth claims data, a cohort of continuously enrolled (July 2007–June 2010) children was constructed. The salient visit (first use of the modifier, screening code, or claim in fiscal year 2009) was considered a reference point to examine BH history and postscreening BH services. Bivariate and multivariate logistic regression analyses were performed to determine predictors of postscreening BH services. RESULTS: Of 261 160 children in the cohort, 45% (118 464) were screened and 37% had modifiers. Fifty-seven percent of children screening positive received postscreening BH services compared with 22% of children screening negative. However, only 30% of newly identified children received BH services. The strongest predictors of postscreening BH services for children without a BH history were being in foster care (odds ratio, 10.38; 95% confidence interval, 9.22–11.68) and having a positive modifier (odds ratio, 3.79; 95% confidence interval, 3.53–4.06). CONCLUSIONS: Previous BH history, a positive modifier, and foster care predicted postscreening BH services. Only one-third of newly identified children received services. Thus although screening is associated with an increase in BH recognition, it may be insufficient to improve care. Additional strategies may be needed to enhance engagement in BH services. PMID:25225135
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Sullivan, Amanda L; Field, Samuel
2013-04-01
The purpose of this study was to examine the average treatment effect of preschool special education services on children's kindergarten academic skills. Using data from a nationally representative sample of United States children who participated in the Early Childhood Longitudinal Study-Birth Cohort, we examined the effectiveness of preschool special education services by comparing reading and math outcomes for children who received special education services at preschool-age to a propensity-score-weighted sample of children who did not receive these services. Results indicated that the receipt of these special education services had a statistically significant moderate negative effect on children's kindergarten skills in both reading (d=-0.21) and mathematics (d=-0.29). These findings have implications for the implementation and evaluation of services for young children experiencing developmental delays or disabilities. Copyright © 2012 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Halfon, Neal; Regalado, Michael; McLearn, Kathryn Taaffe; Kuo, Alice A.; Wright, Kynna
Although most American infants and young children receive adequate well-child care, they may not receive needed help if developmental problems arise. This report examines primary health care services that promote infant/child development and suggests ways to improve those services as part of routine primary child health care. The report details…
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ERIC Educational Resources Information Center
Dragoo, Kyrie Elizabeth
2013-01-01
The purpose of this study was to examine the characteristics and predictive factors for children receiving special education services, and if they received special education services, factors associated with them discontinuing those services before eighth grade. In addition, a second purpose was to determine whether there are differences in the…
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ERIC Educational Resources Information Center
Olsson, Lena M.; Elgmark Andersson, Elisabeth; Granlund, Mats; Huus, Karina
2015-01-01
Background: Children with a mild intellectual disability (ID) and their families often require social services; however, because of the characteristics of the formal service system, these families may be at risk of not receiving necessary services. The aim of this study was to obtain knowledge regarding the types and number of services that…
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Children of mothers diagnosed with serious mental illness: patterns and predictors of service use.
Mowbray, Carol T; Lewandowski, Lisa; Bybee, Deborah; Oyserman, Daphna
2004-09-01
Children who have a parent diagnosed with a mental illness are at risk of psychiatric and behavioral problems; yet, these children do not necessarily receive needed services. Research has investigated correlates of child mental health service use, but not for these high-risk children. This study is part of an NIMH-funded, longitudinal investigation and describes child problems, service use, and predictors of service use for 506 children of 252 mothers diagnosed with serious mental illness. Mothers are primarily poor, minority women from urban areas. A multilevel-model approach is used to examine service use for multiple siblings in a family. More than one third of children had received services (from school or mental health agencies) in their lifetimes. Service use was predicted by child demographic characteristics (being male, non-African American, and older), social context variables (more negative life events, less financial satisfaction, and more parenting dissatisfaction), and maternal psychiatric variables (positively by high levels of case management receipt and affective diagnoses, negatively by maternal substance abuse history). In a subsample of "target children," mothers' rating of child behavior problems additionally predicted service use. Implications of results for research and intervention are discussed.
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Wilson, Patrick B; Haegele, Justin A; Zhu, Xihe
2016-09-01
To examine physical activity participation, screen time habits, and the prevalence of overweight/obesity among children in the general population with mobility limitations and those enrolled in special education services. An observational, cross-sectional analysis of the 2011-2014 National Health and Nutrition Examination Survey, a representative sample of the US population. Mobility limitations, special education services utilization, proxy-reported physical activity and screen time, and overweight/obesity status were assessed in children aged 5-11 years. Boys with mobility limitations were less likely to meet physical activity guidelines (≥60 minutes daily) compared with those with no limitations (58.1% vs 74.4%, adjusted F = 4.61, P = .04). In a logistic regression model, boys with mobility limitations had significantly lower odds (0.42, 95% CI 0.20-0.86) of meeting physical activity guidelines. The prevalence of children meeting screen time recommendations (≤2 hours daily) among those receiving special education services (42.4%) was lower than children not receiving services (53.2%; adjusted F = 8.87, P < .01). In a logistic regression model, children receiving special education services showed a trend toward significantly lower odds (0.74, 95% CI 0.54-1.03, P = .07) of meeting screen time recommendations. No statistically significant differences for overweight/obesity were found. Clear differences were present in physical activity between boys with and without mobility limitations. Furthermore, children receiving special education services demonstrated a lower likelihood of meeting screen time recommendations. Children with disabilities may benefit from targeted interventions aimed at increasing physical activity while decreasing screen time. Copyright © 2016 Elsevier Inc. All rights reserved.
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Taichman, L Susan; Sohn, Woosung; Lim, Sungwoo; Eklund, Stephen; Ismail, Amid
2009-07-01
The authors investigate the relationship of preventive dental treatment to subsequent receipt of comprehensive treatment among Medicaid-enrolled children. The authors analyzed Medicaid dental claims data for 50,485 children residing in Wayne County, Mich. The study sample included children aged 5 through 12 years in 2002 who had been enrolled in Medicaid for at least one month and had had at least one dental visit each year from 2002 through 2005. The authors assessed dental care utilization and treatment patterns cross-sectionally for each year and longitudinally. Among the Medicaid-enrolled children in 2002, 42 percent had had one or more dental visits during the year. At least 20 percent of the children with a dental visit in 2002 were treated by providers who billed Medicaid exclusively for diagnostic and preventive (DP) services. Children treated by DP care providers were less likely to receive restorative and/or surgical services than were children who were treated by dentists who provided a comprehensive mix of dental services. The logistic model showed that children who visited a DP-care provider were about 2.5 times less likely to receive restorative or surgical treatments than were children who visited comprehensive-care providers. Older children and African-American children were less likely to receive restorative and surgical treatments from both types of providers. The study results show that the type of provider is a significant determinant of whether children received comprehensive restorative and surgical services. The results suggest that current policies that support preventive care-only programs may achieve increased access to preventive care for Medicaid-enrolled children in Wayne County, but they do not provide access to adequate comprehensive dental care.
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Documenting the Experiences of Special Education Advocates
ERIC Educational Resources Information Center
Burke, Meghan M.; Goldman, Samantha E.
2017-01-01
Many parents struggle to advocate for their children with disabilities to obtain services at school. Subsequently, parents may turn to special education advocates to help ensure that their children receive appropriate services. However, it is unclear how special education advocates support families and secure services for children with…
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Funakoshi, Akiko; Miyamoto, Yuki
2015-04-01
Hikikomori is a new psychosociological phenomenon among youth, of almost complete withdrawal from social interaction, and it has received considerable attention in community mental health in Japan. The aims of the present study were to identify the influential factors of family difficulties of parents who use support services for children with hikikomori, and compare them between fathers and mothers. Data were collected from 110 parents (55 couples) of children with hikikomori with regard to family difficulties, quality of life, and depression variables via self-report questionnaires. To assess the influential factors of Family Difficulties for parents with children with hikikomori, hierarchical multiple linear regression analysis was carried out for gender. While 94.5% of mothers received some kind of family support, only 61.9% of fathers received it. For both genders, the number of services that the fathers received was significantly correlated with marital cooperation, and the number of services that the mothers received was significantly correlated with support resource utilization. It is necessary for fathers to receive more support, and it is important for professionals to encourage parents to address their difficulties together. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.
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ERIC Educational Resources Information Center
McLennan, John D.; Huculak, Susan; Sheehan, Debbie
2008-01-01
Whether children with autistic spectrum disorders (ASD) and their families are receiving recommended assessments and services is poorly known. This pilot study examined service receipt as reported by parents of young children with ASD (n = 64) from four specialty centers in Canada. While almost all children had a speech and language assessment…
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ERIC Educational Resources Information Center
Mandak, Kelsey; Light, Janice
2018-01-01
Although family-centered services have long been discussed as essential in providing successful services to families of children with autism spectrum disorder (ASD), ideal implementation is often lacking. This study aimed to increase understanding of how families with children with ASD and limited speech receive services from speech-language…
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Therapy service use in children and adolescents with cerebral palsy: An Australian perspective.
Meehan, Elaine; Harvey, Adrienne; Reid, Susan M; Reddihough, Dinah S; Williams, Katrina; Crompton, Kylie E; Omar, Suhaila; Scheinberg, Adam
2016-03-01
The aim of this study was to describe the patterns of therapy service use for a sample of children and adolescents with cerebral palsy over a 1 year period and to identify factors associated with frequency of therapy and parental satisfaction with therapy frequency. Parents of 83 children completed a survey on their child's use of occupational therapy, physiotherapy and speech and language pathology services over the previous year. Participants were randomly selected from a sample stratified by age and Gross Motor Function Classification System (GMFCS) level. During the year prior to survey completion, 83% of children had received occupational therapy, 88% had received physiotherapy and 60% had received speech and language pathology services. Frequency of therapy was higher for younger children (P < 0.01), those classified at GMFCS levels IV-V (P < 0.05) and those attending schools specifically for children with disabilities. Current structures for therapy service delivery for children with cerebral palsy are systems-based, and age-based funding systems and the organisation of services around the education system are preventing the delivery of needs-based therapy. Paediatricians that care for children and young people with cerebral palsy need to pay particular attention to those that may miss out on therapy due to age or school type, and support these families in accessing appropriate therapy. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
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Yampolskaya, Svetlana; Sharrock, Patty J; Clark, Colleen; Hanson, Ardis
2017-10-01
This longitudinal study examined the parallel trajectories of mental health service use and mental health status among children placed in Florida out-of-home care. The results of growth curve modeling suggested that children with greater mental health problems initially received more mental health services. Initial child mental health status, however, had no effect on subsequent service provision when all outpatient mental health services were included. When specific types of mental health services, such as basic outpatient, targeted case management, and intensive mental health services were examined, results suggested that children with compromised functioning during the baseline period received more intensive mental health services over time. However, this increased provision of intensive mental health services did not improve mental health status, rather it was significantly associated with progressively worse mental health functioning. These findings underscore the need for regular comprehensive mental health assessments focusing on specific needs of the child.
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Benevides, Teal W; Carretta, Henry J; Lane, Shelly J
2016-04-01
We examined population-based trends in unmet need for therapy service in children with autism spectrum disorder (ASD) compared to other children with special health care needs (CSHCN), and identified factors associated with unmet need for therapy. A pooled cross-sectional comparison of the 2005-2006 and 2009-2010 waves of the National Survey for Children with Special Health Care Needs (NS-CSHCN) was used. Weighted bivariate analyses were used to compare children ages 3-17 years with ASD (n = 5113) to other CSHCN (n = 71,294) on unmet need for therapy services. Survey weighted multivariate models were used to examine child, family, and contextual characteristics associated with unmet need. A greater percentage of children with ASD across both surveys were reported to need therapy than other children with CSHCN. Among children with a reported need, children with ASD were 1.4 times more likely to report an unmet need for therapy compared to other CSHCN (OR 1.42, 95 % CI 1.18-1.71). Variables significantly associated with unmet need for therapy services included not receiving a well-child visit in the past year (OR 5.81, CI 3.83-8.81), surveyed in 2009 (OR 1.42, CI 1.18-1.71), child being female (OR 1.27, CI 1.05-1.53), uninsured (OR 1.72, CI 1.15-2.56), and having greater functional limitation (OR 2.44, CI 1.80-3.34). Children with ASD require supportive services such as occupational, physical, and speech therapy but are less likely to receive such services than other CSHCN. Receiving a well-child visit in the past year was strongly associated with receipt of needed therapy services.
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Child Welfare Involvement among Children in Homeless Families
ERIC Educational Resources Information Center
Park, Jung Min; Metraux, Stephen; Brodbar, Gabriel; Culhane, Dennis P.
2004-01-01
An analysis of 8,251 homeless children in New York City found that 18% of them received child welfare services over the five-year period following their first shelter admission, and an additional 6% had a history of having received such services before their first shelter admission. Recurrent use of public shelters, exposure to domestic violence,…
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ERIC Educational Resources Information Center
Bryson, Stephanie A.; Corrigan, Susan K.; McDonald, Thomas P.; Holmes, Cheryl
2008-01-01
Despite the presence of significant psychiatric comorbidity among children with autism spectrum disorders (ASDs), little research exists on those who receive community-based mental health services. This project examined one year (2004) of data from the database maintained by 26 community mental health centers (CMHCs) in the Midwestern US state of…
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ERIC Educational Resources Information Center
Citizens' Committee for Children of New York, NY.
The Living for the Young Family through Education (LYFE) program is a school-based daycare and support program for adolescent parents and their children in the New York City Public Schools. Infants receive daycare services in the LYFE nursery, usually located in the high school. Parents receive social services provided by a social worker and…
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Ivanova, Masha Y; Israel, Allen C
2006-12-01
Family stability, defined as the consistency of family activities and routines, was examined in a sample of urban families (n = 70) with children (ages 7 to 16) receiving psychological services. Parent-reported family stability was associated with lower parent-reported children's internalizing behavior problems. Child-reported family stability significantly attenuated the influence of parental depressive symptoms on parent-reported children's internalizing, externalizing, and total behavior problems, while controlling for the effect of children's age. Parental depressive symptoms were associated with problems in child adjustment only at the low level of family stability.
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Vander Stoep, Ann; McCarty, Carolyn A; Zhou, Chuan; Rockhill, Carol M; Schoenfelder, Erin N; Myers, Kathleen
2017-01-01
The Children's Attention-deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) tested the hypotheses that children and caregivers who received guideline-based treatment delivered through a hybrid telehealth service delivery model would experience greater improvements in outcomes than children and caregivers receiving treatment via a comparison delivery model. Here, we present caregiver outcomes. 88 primary care providers (PCPs) in seven geographically underserved communities referred 223 children (ages 5.5 - 12.9 years) to the randomized controlled trial. Over 22 weeks, children randomized to the CATTS service delivery model received six sessions of telepsychiatry and six sessions of caregiver behavior management training provided in person by community therapists who were trained and supervised remotely. Children randomized to the comparison Augmented Primary Care (APC) service model received management in primary care augmented by a single telepsychiatry consultation. Caregiver outcomes included changes in distress, as measured by the Patient Health Questionnaire (PHQ-9), Parenting Stress Index (PSI), Caregiver Strain Questionnaire (CSQ) and Family Empowerment Scale (FES). Caregivers completed five assessments. Multilevel mixed effects regression modeling tested for differences between the two service delivery models in caregiver outcomes from baseline to 25 weeks. Compared to caregivers of children in the APC model, caregivers of children in the CATTS service model showed statistically significantly greater improvements on the PHQ-9 (β = -1.41, 95 % CI = [-2.74, -0.08], p < .05), PSI (β = -4.59, 95 % CI = [-7.87, - 1.31], p < .001), CSQ (β = -5.41, 95 % CI = [- 8.58, -2.24], p < .001) and FES (β = 6.69, 95 % CI = [2.32, 11.06], p < .01). Improvement in child ADHD symptoms mediated improved caregiver scores on the PSI and CSQ. Improvement in child ODD behaviors mediated caregiver CSQ scores. The CATTS trial supports the effectiveness of a hybrid telehealth service delivery model for reducing distress in caregivers of children with ADHD and suggests a mechanism through which the service model affected caregiver distress.
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Overlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs
Goldman, Eliot; Offord, David; Costello, Elizabeth J.; Friedman, Robert; Huff, Barbara; Crowe, Maura; Amsel, Lawrence; Bennett, Kathryn; Bird, Hector; Conger, Rand; Fisher, Prudence; Hoagwood, Kimberly; Kessler, Ronald C.; Roberts, Robert
2011-01-01
OBJECTIVE: The US Surgeon General has called for new approaches to close the mental health services gap for the large proportion of US children with significant mental health needs who have not received evaluation or services within the previous 6 to 12 months. In response, investigators sought to develop brief, easily understood, scientifically derived “warning signs” to help parents, teachers, and the lay public to more easily recognize children with unmet mental health needs and bring these children to health care providers' attention for evaluation and possible services. METHOD: Analyses of epidemiologic data sets from >6000 children and parents were conducted to (1) determine the frequency of common but severely impairing symptom profiles, (2) examine symptom profile frequencies according to age and gender, (3) evaluate positive predictive values of symptom profiles relative to Diagnostic and Statistical Manual of Mental Disorders diagnoses, and (4) examine whether children with 1 or more symptom profiles receive mental health services. RESULTS: Symptom-profile frequencies ranged from 0.5% to 2.0%, and 8% of the children had 1 or more symptom profile. Profiles generated moderate-to-high positive predictive values (52.7%–75.4%) for impairing psychiatric diagnoses, but fewer than 25% of children with 1 or more profiles had received services in the previous 6 months. CONCLUSIONS: Scientifically robust symptom profiles that reflect severe but largely untreated mental health problems were identified. Used as “action signs,” these profiles might help increase public awareness about children's mental health needs, facilitate communication and referral for specific children in need of evaluation, and narrow the child mental health services gap. PMID:22025589
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Reflections on Meeting the Needs of Children with Disabilities in Ethiopia
ERIC Educational Resources Information Center
Kurtz, Kimberly M.; Shepherd, Terry L.
2011-01-01
In many countries, children with disabilities seldom receive the educational services they need. Economic instability has often forced a reduction in services for children with disabilities. Cultural values have also impacted support for children with disabilities. A special education residential facility in Ethiopia that serves orphaned children…
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34 CFR 200.62 - Responsibilities for providing services to private school children.
Code of Federal Regulations, 2010 CFR
2010-07-01
... Participation of Eligible Children in Private Schools § 200.62 Responsibilities for providing services to... a basis equitable to the participation of teachers and families of public school children receiving... school children. 200.62 Section 200.62 Education Regulations of the Offices of the Department of...
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Instructional Services for Limited English Proficient Children.
ERIC Educational Resources Information Center
O'Malley, J. Michael
1982-01-01
The 1978 Children's English and Services Study (United States) contains five findings for limited English proficient children aged 5-14, e.g., one-third are served by bilingual education/English (second language); Federal and state support for special types of instruction are received predominantly by limited English proficient children within the…
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A Propensity Score Matching Analysis of the Effects of Special Education Services.
Morgan, Paul L; Frisco, Michelle; Farkas, George; Hibel, Jacob
2010-02-01
We sought to quantify the effectiveness of special education services as naturally delivered in U.S. schools. Specifically, we examined whether children receiving special education services displayed (a) greater reading or mathematics skills, (b) more frequent learning-related behaviors, or (c) less frequent externalizing or internalizing problem behaviors than closely matched peers not receiving such services. To do so, we used propensity score matching techniques to analyze data from the Early Childhood Longitudinal-Study Kindergarten Cohort, 1998-1999, a large scale, nationally representative sample of U.S. schoolchildren. Collectively, results indicate that receipt of special education services has either a negative or statistically non-significant impact on children's learning or behavior. However, special education services do yield a small, positive effect on children's learning-related behaviors.
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Wang, C Jason; Elliott, Marc N; McGlynn, Elizabeth A; Brook, Robert H; Schuster, Mark A
2008-02-01
The purpose of our work was to determine whether children with very low birth weight (< 1500 g) who are at high risk for vision and hearing problems and enrolled in Medicaid receive recommended follow-up vision and hearing services and to examine predictors of services. We conducted a retrospective analysis of 2182 children born in South Carolina from 1996 to 1998 with birth weights of 401 to 1499 g, gestations of > or = 24 weeks, and survival of > or = 90 days of life. Receipt of services for Medicaid-enrolled children was assessed by using a linked data set that included files from vital records, death certificates, Medicaid, Chronic Rehabilitative Services, and the Early Intervention Program. We assessed the receipt of hearing rehabilitation by 6 months of age for children with nonconductive hearing loss and routine ophthalmologic examination between ages of 1 and 2 years for all children with very low birth weight. Multivariate logistic regression was restricted to ophthalmologic examinations because of sample size. Among children with very low birth weight with nonconductive hearing loss, 20% received hearing rehabilitation by 6 months of age. Twenty-three percent of children with very low birth weight received an ophthalmologic examination between the ages of 1 and 2 years. Limiting our analysis to children < 1000 g or extending the measurement period to 7 months (hearing) and age 3 years (vision) did not substantially increase the percentage of children receiving the services. The receipt of an ophthalmologic examination was associated positively with Medicaid enrollment by the time of hospital discharge and birth in a level-3 hospital and negatively associated with higher birth weight, an Apgar score of > or = 7, and black maternal race. Among children born at < 1000 g, all of whom were eligible for the Early Intervention Program, the receipt of an ophthalmologic examination was positively associated with program enrollment. There is a shortfall in the provision of critical services for children with very low birth weight. These findings reinforce the Institute of Medicine's concerns regarding inadequate outcome data and health care services for preterm infants and support the importance of enrollment in the Early Intervention Program for children with very low birth weight.
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O’Brien, Kelly A.; Carter, Carolyn G.; Eyberg, Sheila M.
2009-01-01
Objective This study examined maternal attitudes and practices that may prevent preschoolers from receiving needed mental health services. Methods Mothers of 110 children ages 3–6 completed a survey of maternal attitudes and practices and the Eyberg Child Behavior Inventory (ECBI). Results Mothers wanted pediatrician assistance with child behavior concerns. Mothers of children with elevated ECBI scores reported most often discussing disruptive behaviors with their pediatrician, and preferred clinician-provided services, whereas mothers of children with normal range ECBI scores most often discussed developmental issues with the pediatrician and preferred parenting help from handouts and books. Mothers reported receiving clinician-provided services almost never. Conclusions Mothers were open to psychosocial services for child behavior problems, particularly via primary care, and ratings of barriers were relatively low despite reporting infrequent service use. Mothers’ responses highlight the need for mental health providers in primary care to ensure accessibility of desired services. PMID:19064608
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ERIC Educational Resources Information Center
Dempsey, Ian
2014-01-01
The extent to which school students continue to receive special education services over time is largely unknown because longitudinal studies are rare in this area. The present study examined a large Australian longitudinal database to track the status of children who received special education support in 2006 and whether they continued to access…
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Iverson, G L; Iverson, A M; Barton, E A
1994-01-01
The Children's Orientation and Amnesia Test (COAT) is an objective, standardized means of assessing cognitive functioning in children and adolescents who are in the early stages of recovery from traumatic brain injury. The COAT is composed of 16 items that assess general orientation, temporal orientation, and memory. This study was designed to determine if children who are receiving special education services perform more poorly on the COAT than children who are in the regular classroom. It was found that children receiving special services performed significantly more poorly, and 13% of them were classified in the impaired range, as compared to 3% of the students in the regular classroom. The results provide important reference data for interpreting COAT scores of children with traumatic brain injuries who have either premorbid learning disabilities or other special service needs.
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Outpatient Rehabilitation for Medicaid-Insured Children Hospitalized With Traumatic Brain Injury
Symons, Rebecca G.; Wang, Jin; Ebel, Beth H.; Vavilala, Monica S.; Buchwald, Dedra; Temkin, Nancy; Jaffe, Kenneth M.; Rivara, Frederick P.
2016-01-01
OBJECTIVES: To describe the prevalence of postdischarge outpatient rehabilitation among Medicaid-insured children hospitalized with a traumatic brain injury (TBI) and to identify factors associated with receipt of services. METHODS: Retrospective cohort of children <21 years, hospitalized for a TBI between 2007 and 2012, from a national Medicaid claims database. Outcome measures were receipt of outpatient rehabilitation (physical, occupational, or speech therapies or physician visits to a rehabilitation provider) 1 and 3 years after discharge. Multivariable regression analyses determined the association of demographic variables, injury severity, and receipt of inpatient services with receipt of outpatient rehabilitation at 1 and 3 years. The mean number of services was compared between racial/ethnic groups. RESULTS: Among 9361 children, only 29% received any type of outpatient rehabilitation therapy during the first year after injury, although 62% sustained a moderate to severe TBI. The proportion of children receiving outpatient therapies declined to 12% in the second and third years. The most important predictor of receipt of outpatient rehabilitation was receipt of inpatient therapies or consultation with a rehabilitation physician during acute care. Compared with children of other racial/ethnic groups, Hispanic children had lower rates of receipt of outpatient speech therapy. CONCLUSIONS: Hospitalized children who received inpatient assessment of rehabilitation needs were more likely to continue outpatient rehabilitation care. Hispanic children with TBI were less likely than non-Hispanics to receive speech therapy. Interventions to increase inpatient rehabilitation during acute care might increase outpatient rehabilitation and improve outcomes for all children. PMID:27244850
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32 CFR 57.2 - Applicability and scope.
Code of Federal Regulations, 2011 CFR
2011-07-01
... PROVISION OF EARLY INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS § 57.2...”). (b) Applies to infants, toddlers, and children receiving or entitled to receive special services from...
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32 CFR 57.2 - Applicability and scope.
Code of Federal Regulations, 2010 CFR
2010-07-01
... PROVISION OF EARLY INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS § 57.2...”). (b) Applies to infants, toddlers, and children receiving or entitled to receive special services from...
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Côté, Sylvana M; Boivin, Michel; Nagin, Daniel S; Japel, Christa; Xu, Qian; Zoccolillo, Mark; Junger, Marianne; Tremblay, Richard E
2007-11-01
Physical violence is an important health problem, and low maternal education is a significant risk for the development of chronic physical aggression (PA). We hypothesized that nonmaternal care (NMC) services could prevent the development of childhood PA problems, depending on the age at which the services are initiated. Method Children who followed a trajectory of atypically frequent PA between 17 and 60 months of age among a population sample of 1691 Canadian families were identified. Maternal education and NMC were considered in predicting group membership while controlling for confounding family characteristics. Children of mothers with low education levels (ie, no high school diploma) were less likely to receive NMC. Those who did receive such care had significantly lower risk of a high PA trajectory. Results from logistic regressions indicated that NMC reduced the risk of high PA, especially when initiated before age 9 months (odds ratio, 0.20; 95% confidence interval, 0.05-0.90). Children of mothers who graduated from high school were less at risk of PA problems, and NMC had no additional protective effect. Nonmaternal care services to children of mothers with low levels of education could substantially reduce their risk of chronic PA, especially if provided soon after birth. Because children most likely to benefit from NMC services are less likely to receive them, special measures encouraging the use of NMC services among high-risk families are needed.
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ERIC Educational Resources Information Center
McIntyre, Laura Lee; Zemantic, Patricia K.
2017-01-01
Autism spectrum disorder (ASD) is the fastest growing group of neurodevelopmental disorders in childhood. Earlier detection means an increased need for early intervention and other educational services. This study examined what services a sample of young children with ASD received, what variables predicted service utilization, and how satisfied…
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76 FR 24887 - Submission for OMB Review; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-03
... healthy development and wellness of children ages birth to eight years. A total of 24 Project LAUNCH... development and on services that children and families receive. The electronic data reports also will collect... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for...
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76 FR 7865 - Proposed Information Collection Activity; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-02-11
... information about Head Start and Early Head Start services received by the children and families enrolled in... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed... Report. OMB No. 0980-0017. Description: The Office of Head Start within the Administration for Children...
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Addressing Parental Mental Health within Interventions for Children: A Review
ERIC Educational Resources Information Center
Acri, Mary C.; Hoagwood, Kimberly Eaton
2015-01-01
Purpose: Untreated parent mental health problems have deleterious effects upon the family, yet caregivers are unlikely to receive services for their emotional health. We conducted a review of treatments and services for children and adolescents that also offered services to parents. Methods: Child treatment and service studies were included in the…
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Everyday beliefs about sources of advice for the parents of difficult children.
Sonuga-Barke, E J; Thompson, M; Balding, J
1993-01-01
Parents were asked which sources of advice families with difficult children should seek. The results suggested a similar hierarchy of agencies for both boys and girls with emotional and behavioural problems. Teachers, doctors, child psychiatrists and health visitors all received strong positive ratings, books about children with problems received moderate positive ratings, religious leaders received the strongest negative ratings and grandparents and friends received neutral ratings. Implications for service provision are discussed.
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Congenital Heart Defects and Receipt of Special Education Services.
Riehle-Colarusso, Tiffany; Autry, Andrew; Razzaghi, Hilda; Boyle, Coleen A; Mahle, William T; Van Naarden Braun, Kim; Correa, Adolfo
2015-09-01
We investigated the prevalence of receipt of special education services among children with congenital heart defects (CHDs) compared with children without birth defects. Children born from 1982 to 2004 in metropolitan Atlanta with CHDs (n = 3744) were identified from a population-based birth defect surveillance program; children without birth defects (n = 860 715) were identified from birth certificates. Cohorts were linked to special education files for the 1992-2012 school years to identify special education services. Children with noncardiac defects or genetic syndromes were excluded; children with CHDs were classified by presence or absence of critical CHDs (ie, CHDs requiring intervention by age one year). We evaluated the prevalence of receipt of special education services and prevalence rate ratios using children without birth defects as a reference. Compared with children without birth defects, children with CHDs were 50% more likely to receive special education services overall (adjusted prevalence rate ratio [aPRR] = 1.5; 95% confidence interval [CI]: 1.4-1.7). Specifically, they had higher prevalence of several special education categories including: intellectual disability (aPRR = 3.8; 95% CI: 2.8-5.1), sensory impairment (aPRR = 3.0; 95% CI: 1.8-5.0), other health impairment (aPRR = 2.8; 95% CI: 2.2-3.5), significant developmental delay (aPRR = 1.9; 95% CI: 1.3-2.8), and specific learning disability (aPRR = 1.4; 95% CI: 1.1-1.7). For most special education services, the excess prevalence did not vary by presence of critical CHDs. Children with CHDs received special education services more often than children without birth defects. These findings highlight the need for special education services and the importance of developmental screening for all children with CHDs. Copyright © 2015 by the American Academy of Pediatrics.
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Rurality and African American Perspectives on Children's Mental Health Services
ERIC Educational Resources Information Center
Mukolo, Abraham; Heflinger, Craig Anne
2011-01-01
The combined effect of race and place of residence on caregivers' perceptions of children's mental health services is underresearched. Differences in caregiver strain, barriers-to-care endorsement, and provider satisfaction are examined among 175 rural and urban African American caregivers from one Southern state whose children received Medicaid…
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Afzelius, Maria; Östman, Margareta; Råstam, Maria; Priebe, Gisela
2018-01-01
A parental mental illness affects all family members and should warrant a need for support. To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration. Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions. Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care. Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.
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Cost Offset Associated With Early Start Denver Model for Children With Autism.
Cidav, Zuleyha; Munson, Jeff; Estes, Annette; Dawson, Geraldine; Rogers, Sally; Mandell, David
2017-09-01
To determine the effect of the Early Start Denver Model (ESDM) for treatment of young children with autism on health care service use and costs. We used data from a randomized trial that tested the efficacy of the ESDM, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents, for 2 years. Parents were interviewed about their children's service use every 6 months from the onset of the intervention to follow-up (age 6 years). The sample for this study consisted of 39 children with autism who participated in the original randomized trial at age 18 to 30 months, and were also assessed at age 6 years. Of this sample, 21 children were in the ESDM group, and 18 children were in the community care (COM) group. Reported services were categorized and costed by applying unit hourly costs. Annualized service use and costs during the intervention and post intervention for the two study arms were compared. During the intervention, children who received the ESDM had average annualized total health-related costs that were higher by about $14,000 than those of children who received community-based treatment. The higher cost of ESDM was partially offset during the intervention period because children in the ESDM group used less applied behavior analysis (ABA)/early intensive behavioral intervention (EIBI) and speech therapy services than children in the comparison group. In the postintervention period, compared with children who had earlier received treatment as usual in community settings, children in the ESDM group used less ABA/EIBI, occupational/physical therapy, and speech therapy services, resulting in significant cost savings in the amount of about $19,000 per year per child. Costs associated with ESDM treatment were fully offset within a few years after the intervention because of reductions in other service use and associated costs. Early Characteristics of Autism; http://clinicaltrials.gov/; NCT0009415. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Reinke, Wendy M.; Herman, Keith C.; Dong, Nianbo
2014-01-01
A significant number of children in schools have mental health problems (World Health Organization, 2004). If children receive any type of mental health services, the vast majority receive these supports at school (Rones & Hoagwood, 2000). Mental health needs in children often manifest as emotional dysregulation, social incompetence, and…
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Jolles, M P; Wells, R
2017-03-01
Many children in contact with child welfare agencies do not receive needed health services. These agencies have used participatory decision making (PDM) practices as a way to increase families' use of recommended services. However, we lack evidence of whether caregiver participation in PDM increases children's use of health services. This study uses a national sample of children involved with child welfare to compare their health service use between those children serve through a PDM practice and those who did not experience it. Cross-sectional analyses using the 2009-2010 National Survey of Child and Adolescent Well-Being. Propensity score analysis accounted for observed selection bias. PDM practice was measured as whether the caregiver was included in decision-making during service planning meetings. Health service use was measured as child's receipt of any primary or mental health care services in the past year. Primary health care need was measured using standardized measures and caseworker report. The sample was comprised of children ages 2-17 with primary or mental health needs in contact with a child welfare agency. In the unmatched sample of 1,358 children, 14% were served through a PDM service practice, and 12% had a primary health care and 37% a mental health need. Families served through PDM were also reported by caseworkers as more cooperative during the child welfare investigation, and with fewer reports of domestic violence and agency re-referrals (P < 0.05). Analyses using matched samples showed that for primary health care, 59% of PDM children received services compared with 40% for non-PDM children (P = 0.004). Group differences were not significant for mental health services. Lower-risk families were more likely to be served through PDM which was positively associated with child use of primary health services. Inclusion of caregivers in decision making may not be sufficient to overcome barriers to children's mental health service use. © 2016 John Wiley & Sons Ltd.
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Saha, Kuntal Kumar; Chowdhury, Ashfaqul Haq; Garnett, Sarah P.; Arifeen, Shams El; Menon, Purnima
2017-01-01
Background In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS) by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC) and management of sick children younger than five years. Methods Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 541 mothers/caregivers of sick children. Results Structural readiness to provide nutrition services was higher for ANC compared to management of sick children; 73% of ANC rooms had >5 of the 13 essential items while only 13% of the designated areas for management of sick children had >5 of the 13 essential items. One in five (19%) healthcare providers had received nutrition training through the NNS. Delivery of the nutrition services was poor: <30% of women received all four key antenatal nutrition services, 25% of sick children had their weight checked against a growth-chart and <1% had their height measured. Nevertheless, most mothers/caregivers rated their satisfaction of the service above average. Conclusions Strengthening the provision of equipment and increasing the coverage of training are imperative to improve nutrition services. Inherent barriers to implementing nutrition services in primary health care, especially high caseloads during the management of sick under-five children, should be considered to identify alternative and appropriate service delivery platforms before nationwide scale up. PMID:28542530
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ERIC Educational Resources Information Center
Brown, Kay; Bascetta, Cynthia A.
2009-01-01
Providing health care services for foster children, who frequently have significant health care needs, can be challenging. The Administration for Children and Families (ACF) oversees foster care, but state child welfare agencies are responsible for ensuring that these children receive health care services, which are often financed by Medicaid. In…
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Merritt, Jantraveus M.; Greenlee, Geoffrey; Bollen, Anne Marie; Scott, JoAnna M.; Chi, Donald L.
2016-01-01
Introduction We assess the relationship between race and orthodontic service utilization for Medicaid-enrolled children. Methods This cross-sectional study focused on 570,364 Washington Medicaid-enrolled children ages 6-19 years. The main predictor variable was self-reported race (White versus non-White). The outcome variable was orthodontic service utilization, defined as children who were pre-authorized for orthodontic treatment by Medicaid in 2012 and subsequently received orthodontic records and initiated treatment. Logistic regression models were used to test the hypothesis that non-Whites would be less likely to utilize orthodontic care than Whites. Results A total of 8,223 children were approved by Medicaid for orthodontic treatment and 7,313 received records and initiated treatment. Non-Whites were significantly more likely to utilize orthodontic care than Whites (Odds Ratio [OR]=1.18; 95% confidence interval [CI]=1.02, 1.36; p=.031). Hispanic non-White children were more likely to utilize orthodontic care than non-Hispanic White children (OR=1.42; 95% CI=1.18, 1.70; p<.001). Conclusion In 2012, non-White children in Washington Medicaid were significantly more likely to utilize orthodontic care than White children. The Washington Medicaid program demonstrates a potential model for addressing racial disparities in orthodontic service utilization. Future research should identify mechanisms underlying these findings and continue to monitor orthodontic service utilization for minority children in Medicaid. PMID:27021456
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Contextual Predictors of Mental Health Service Use Among Children Open to Child Welfare
Leslie, Laurel K.; Landsverk, John; Barth, Richard P.; Burns, Barbara J.; Gibbons, Robert D.; Slymen, Donald J.; Zhang, Jinjin
2006-01-01
Background Children involved with child welfare systems are at high risk for emotional and behavioral problems. Many children with identified mental health problems do not receive care, especially ethnic/minority children. Objective To examine how patterns of specialty mental health service use among children involved with child welfare vary as a function of the degree of coordination between local child welfare and mental health agencies. Design Specialty mental health service use for 1 year after contact with child welfare was examined in a nationally representative cohort of children aged 2 to 14 years. Predictors of service use were modeled at the child/family and agency/county levels. Child- and agency-level data were collected between October 15,1999, and April 30, 2001. Setting Ninety-seven US counties. Participants A total of 2823 child welfare cases (multiple informants) from the National Survey of Child and Adolescent Well-being and agency-level key informants from the participating counties. Main Outcome Measures Specialty mental health service use during the year after contact with the child welfare system. Results Only 28.3% of children received specialty mental health services during the year, although 42.4% had clinical-level Child Behavior Checklist scores. Out-of-home placement, age, and race/ethnicity were strong predictors of service use rates, even after controlling for Child Behavior Checklist scores. Increased coordination between local child welfare and mental health agencies was associated with stronger relationships between Child Behavior Checklist scores and service use and decreased differences in rates of service use between white and African American children. Conclusions Younger children and those remaining in their homes could benefit from increased specialty mental health services. They have disproportionately low rates of service use, despite high levels of need. Increases in interagency coordination may lead to more efficient allocation of service resources to children with the greatest need and to decreased racial/ethnic disparities. PMID:15583113
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Parents' Experiences with Services and Treatment for Their Children Diagnosed with Cerebral Palsy
ERIC Educational Resources Information Center
Knis-Matthews, Laurie; Falzarano, Mary; Baum, Deborah; Manganiello, Jennifer; Patel, Sargam; Winters, Laura
2011-01-01
While there is a considerable body of knowledge investigating the efficacy of constraint-induced movement therapy (CIMT), there is a need for information focusing on parents' experiences when their children receive these services. This qualitative research study initially explored the experiences of four parents with children who are diagnosed…
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ERIC Educational Resources Information Center
Underwood, Donna J.; Kopels, Sandra
2004-01-01
Recent changes in the Individuals with Disabilities Education Act (IDEA) provide that children with attention deficit/hyperactivity disorder (AD/HD) can receive services under the "other health impairments" category. This article reports on complaints filed by parents against school districts about educational services for children with…
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ERIC Educational Resources Information Center
Zand, Debra H.; Pierce, Katherine J.; Bultas, Margaret W.; McMillin, Stephen Edward; Gott, Rolanda Maxim; Wilmott, Jennifer
2015-01-01
Parents' involvement in early intervention (EI) services fosters positive developmental trajectories in young children. Although EI research on parenting skills has been abundant, fewer data are available on parents' knowledge of normative child development. Sixty-seven mothers of children participating in a Midwestern city's EI program completed…
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Usage of emergency medical services by children with special health care needs.
Suruda, A; Vernon, D D; Diller, E; Dean, J M
2000-01-01
To describe the usage of emergency medical services (EMS) by children with special health care needs (CSHCN). All EMS runs and related hospital records for children aged 0-17 years in Utah in 1991-92 were linked. The CSHCN status was determined from ICD-9 diagnoses using three available definitions. The amounts of EMS usage were compared between CSHCN and other children. A pediatric intensive care practitioner determined CSHCN status by chart review for 915 children transported by EMS to a pediatric tertiary care hospital, and his classification was compared with the CSHCN status assigned by the three ICD-9-based definitions. The three definitions assigned CSHCN status for 2% to 24% of children using EMS. When compared with other children, CSHCN were more likely to be admitted to the hospital, more likely to use EMS for transfer between health care facilities, and more likely to receive prehospital procedures such as intravenous therapy. In the group of children whose charts were reviewed individually, one ICD-9-based definition most closely agreed to determination of CSHCN status by a pediatric intensive care practitioner. Children with special health care needs who use EMS are more likely to receive advanced life support service, to receive prehospital procedures, and to be transferred from one health care facility to another. There is need for a specific and measurable definition of CSHCN that can be applied to existing health data.
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Dambi, Jermaine M; Jelsma, Jennifer
2014-12-05
Cerebral palsy requires appropriate on-going rehabilitation intervention which should effectively meet the needs of both children and parents/care-givers. The provision of effective support is a challenge, particularly in resource constrained settings. A quasi-experimental pragmatic research design was used to compare the impact of two models of rehabilitation service delivery currently offered in Harare, Zimbabwe, an outreach-based programme and the other institution-based. Questionnaires were distributed to 46 caregivers of children with cerebral palsy at baseline and after three months. Twenty children received rehabilitation services in a community setting and 26 received services as outpatients at a central hospital. The Gross Motor Function Measurement was used to assess functional change. The burden of care was measured using the Caregiver Strain Index, satisfaction with physiotherapy was assessed using the modified Medrisk satisfaction with physiotherapy services questionnaire and compliance was measured as the proportion met of the scheduled appointments. Children receiving outreach-based treatment were significantly older than children in the institution-based group. Regression analysis revealed that, once age and level of severity were controlled for, children in the outreach-based treatment group improved their motor function 6% more than children receiving institution-based services. There were no differences detected between the groups with regard to caregiver well-being and 51% of the caregivers reported signs consistent with clinical distress/depression. Most caregivers (83%) expressed that they were overwhelmed by the caregiving role and this increased with the chronicity of care. The financial burden of caregiver was predictive of caregiver strain. Caregivers in the outreach-based group reported greater satisfaction with services and were more compliant (p < .001) as compared to recipients of institution-based services. Long term caregiving leads to strain in caregivers and there is a need to design interventions to alleviate the burden. The study was a pragmatic, quasi-experimental study thus causality cannot be inferred. However findings from this study suggest that the provision of care within a community setting as part of a well-structured outreach programme may be preferable method of service delivery within a resource-constrained context. It was associated with a greater improvement in functioning, greater satisfaction with services and better compliance.
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Mental Health Services in School-Based Health Centers: Systematic Review
ERIC Educational Resources Information Center
Bains, Ranbir Mangat; Diallo, Ana F.
2016-01-01
Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…
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Bell, Janice F; Huebner, Colleen E; Reed, Sarah C
2012-04-01
This study examines associations between parents' report of their children's oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1-17 years, using data from the 2007 National Survey of Children's Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.
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Who gets help for pre-school communication problems? Data from a prospective community study.
Skeat, J; Wake, M; Ukoumunne, O C; Eadie, P; Bretherton, L; Reilly, S
2014-03-01
Pre-school communication problems are common, with implications for school readiness and educational achievement. Help is available from a variety of community healthcare providers. This study examined the extent to which help is received, and the predictors of service receipt. Prospective community study, in Melbourne, Victoria. At age 4 years, we assessed the speech, receptive and expressive language and fluency of 1607 children and gave feedback to their parents. At age 5 years, 983 families provided data on service use for communication problems between and 4 and 5 years. We compared service use between participants with and without impairment, and used logistic regression to estimate the strength of association between potential predictors (gender, socio-economic status, maternal education, English-speaking background status, family history of speech and language problems and parent concern) and service use (binary outcome). Data were available for both communication status and service use for 753 children. Only 44.9% of the 196 children with communication impairment received help from a professional. Furthermore, 7% of the 557 that did not meet criteria for communication impairment nevertheless received help from a professional. Parent concern was the strongest predictor of service use (adjusted odds ratio = 9.0; 95% CI: 5.6-14.8). Both over- and under-servicing for communication problems were evident. This study shows that accessing help for communication problems requires more than simply informing parents about the problem and having services available; there is a need for systematic support to get the right children to services. © 2013 John Wiley & Sons Ltd.
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Merritt, Jantraveus M; Greenlee, Geoffrey; Bollen, Anne Marie; Scott, JoAnna M; Chi, Donald L
2016-04-01
We assessed the relationship between race and orthodontic service use for Medicaid-enrolled children. This cross-sectional study focused on 570,364 Medicaid-enrolled children in Washington state, ages 6 to 19 years. The main predictor variable was self-reported race (white vs nonwhite). The outcome variable was orthodontic service use, defined as children who were preauthorized for orthodontic treatment by Medicaid in 2012 and subsequently received orthodontic records and initiated treatment. Logistic regression models were used to test the hypothesis that nonwhites are less likely to use orthodontic care than are whites. A total of 8223 children were approved by Medicaid for orthodontic treatment, and 7313 received records and began treatment. Nonwhites were significantly more likely to use orthodontic care than were whites (odds ratio [OR] = 1.18; 95% confidence interval [CI] = 1.02, 1.36; P = 0.031). Hispanic nonwhite children were more likely to use orthodontic care than were non-Hispanic white children (OR = 1.42; 95% CI = 1.18, 1.70; P <0.001). In 2012, nonwhite children in the Washington Medicaid program were significantly more likely to use orthodontic care than were white children. The Washington Medicaid program demonstrates a potential model for addressing racial disparities in orthodontic service use. Future research should identify mechanisms underlying these findings and continue to monitor orthodontic service use for minority children in Medicaid. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Craig, Rebecca T.
1988-01-01
Many mentally ill children, especially those who are seriously disturbed, are not receiving the mental health care they need. Although the federal government offers financing to the states for child and adolescent mental health programming, the primary responsibility for financing mental health services has been assumed by state governments. At…
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42 CFR 435.217 - Individuals receiving home and community-based services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 4 2013-10-01 2013-10-01 false Individuals receiving home and community-based... Families and Children and the Aged, Blind, and Disabled § 435.217 Individuals receiving home and community.... (b) In the absence of home and community-based services under a waiver granted under part 441— (1...
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What's Possible for First-Grade At-Risk Literacy Learners Receiving Early Intervention Services
ERIC Educational Resources Information Center
Bufalino, Janet; Wang, Chuang; Gomez-Bellenge, Francisco X.; Zalud, Garreth
2010-01-01
This paper summarizes a study that was conducted on data from children who received a one-on-one intervention called Reading Recovery[R] during the first half of their first-grade year in school. The purpose was to investigate the relationship between accelerated progress children made during and after receiving a Reading Recovery intervention,…
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Predictors of Change in Eligibility Status among Preschoolers in Special Education
ERIC Educational Resources Information Center
Daley, Tamara C.; Carlson, Elaine
2009-01-01
Relatively little is known about the incidence of declassification among young children who receive preschool special education services or about factors associated with declassification. The Pre-Elementary Education Longitudinal Study (PEELS) follows a nationally representative sample of children who were receiving preschool special education…
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34 CFR 303.148 - Transition to preschool programs.
Code of Federal Regulations, 2010 CFR
2010-07-01
... evaluations of children. • The development and implementation of an individualized education program (“IEP... EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... procedures to be used to ensure a smooth transition for children receiving early intervention services under...
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34 CFR 303.148 - Transition to preschool programs.
Code of Federal Regulations, 2011 CFR
2011-07-01
... evaluations of children. • The development and implementation of an individualized education program (“IEP... EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND... procedures to be used to ensure a smooth transition for children receiving early intervention services under...
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Mandell, David S.; Machefsky, Aliza; Rubin, David; Feudtner, Chris; Pita, Susmita; Rosenbaum, Sara
2010-01-01
BACKGROUND Recent changes to Medicaid policy may have unintended consequences in the education system. This study estimated the potential financial impact of the Deficit Reduction Act (DRA) on school districts by calculating Medicaid-reimbursed behavioral health care expenditures for school-aged children in general and children in special education in particular. METHODS Medicaid claims and special education records of youth ages 6 to 18 years in Philadelphia, PA, were merged for calendar year 2002. Behavioral health care volume, type, and expenditures were compared between Medicaid-enrolled children receiving and not receiving special education. RESULTS Significant overlap existed among the 126,533 children who were either Medicaid enrolled (114,257) or received special education (27,620). Medicaid-reimbursed behavioral health care was used by 21% of children receiving special education (37% of those Medicaid enrolled) and 15% of other Medicaid-enrolled children. Total expenditures were $197.8 million, 40% of which was spent on the 5728 children in special education and 60% of which was spent on 15,092 other children. CONCLUSIONS Medicaid-reimbursed behavioral health services disproportionately support special education students, with expenditures equivalent to 4% of Philadelphia’s $2 billion education budget. The results suggest that special education programs depend on Medicaid-reimbursed services, the financing of which the DRA may jeopardize. PMID:18808472
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Mandell, David S; Machefsky, Aliza; Rubin, David; Feudtner, Chris; Pati, Susmita; Pita, Susmita; Rosenbaum, Sara
2008-10-01
Recent changes to Medicaid policy may have unintended consequences in the education system. This study estimated the potential financial impact of the Deficit Reduction Act (DRA) on school districts by calculating Medicaid-reimbursed behavioral health care expenditures for school-aged children in general and children in special education in particular. Medicaid claims and special education records of youth ages 6 to 18 years in Philadelphia, PA, were merged for calendar year 2002. Behavioral health care volume, type, and expenditures were compared between Medicaid-enrolled children receiving and not receiving special education. Significant overlap existed among the 126,533 children who were either Medicaid enrolled (114,257) or received special education (27,620). Medicaid-reimbursed behavioral health care was used by 21% of children receiving special education (37% of those Medicaid enrolled) and 15% of other Medicaid-enrolled children. Total expenditures were $197.8 million, 40% of which was spent on the 5728 children in special education and 60% of which was spent on 15,092 other children. Medicaid-reimbursed behavioral health services disproportionately support special education students, with expenditures equivalent to 4% of Philadelphia's $2 billion education budget. The results suggest that special education programs depend on Medicaid-reimbursed services, the financing of which the DRA may jeopardize.
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34 CFR 303.124 - Prohibition against supplanting.
Code of Federal Regulations, 2010 CFR
2010-07-01
... amount of State and local funds actually expended for early intervention services for these children and.... Allowance may be made for— (1) Decreases in the number of children who are eligible to receive early... EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND...
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34 CFR 300.137 - Equitable services determined.
Code of Federal Regulations, 2014 CFR
2014-07-01
... CHILDREN WITH DISABILITIES State Eligibility Children with Disabilities Enrolled by Their Parents in... disability is enrolled in a religious or other private school by the child's parents and will receive special... related services. No parentally-placed private school child with a disability has an individual right to...
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34 CFR 300.137 - Equitable services determined.
Code of Federal Regulations, 2013 CFR
2013-07-01
... CHILDREN WITH DISABILITIES State Eligibility Children with Disabilities Enrolled by Their Parents in... disability is enrolled in a religious or other private school by the child's parents and will receive special... related services. No parentally-placed private school child with a disability has an individual right to...
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34 CFR 300.137 - Equitable services determined.
Code of Federal Regulations, 2012 CFR
2012-07-01
... CHILDREN WITH DISABILITIES State Eligibility Children with Disabilities Enrolled by Their Parents in... disability is enrolled in a religious or other private school by the child's parents and will receive special... related services. No parentally-placed private school child with a disability has an individual right to...
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Snowden, Lonnie R; Masland, Mary C; Libby, Anne M; Wallace, Neal; Fawley, Kya
2008-01-01
We examined rates and intensity of crisis services use by race/ethnicity for 351,174 children younger than 18 years who received specialty mental health care from California's 57 county public mental health systems between July 1998 and June 2001. We used fixed-effects regression for a controlled assessment of racial/ethnic disparities in children's use of hospital-based services for the most serious mental health crises (crisis stabilization services) and community-based services for other crises (crisis intervention services). African American children were more likely than were White children to use both kinds of crisis care and made more visits to hospital-based crisis stabilization services after initial use. Asian American/Pacific Islander and American Indian/Alaska Native children were more likely than were White children to use hospital-based crisis stabilization services but, along with Latino children, made fewer hospital-based crisis stabilization visits after an initial visit. African American children used both kinds of crisis services more than did White children, and Asian Americans/Pacific Islander and American Indians/Alaska Native children visited only when they experienced the most disruptive and troubling kind of crises, and made nonrecurring visits.
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Special Education Considerations in Student Discipline Procedures.
ERIC Educational Resources Information Center
Michigan State Dept. of Education, Lansing. Office of Special Education and Early Intervention Services.
This policy statement from the Michigan Department of Education interprets federal provisions and the laws of the state as they may pertain to children receiving special education services. It describes disciplinary procedures for students already receiving special education services, students not yet eligible for special education, students…
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Trends in characteristics of children served by the Children's Mental Health Initiative: 1994-2007.
Walrath, Christine; Garraza, Lucas Godoy; Stephens, Robert; Azur, Melissa; Miech, Richard; Leaf, Philip
2009-11-01
Data from 14 years of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program were used to understand the trends of the emotional and behavioral problems and demographic characteristics of children entering services. The data for this study were derived from information collected at intake into service in 90 sites who received their initial federal funding between 1993 and 2004. The findings from this study suggest children entering services later in a site's funding cycle had lower levels of behavioral problems and children served in sites funded later in the 14 year period had higher levels of behavioral problems. Females have consistently entered services with more severe problems and children referred from non-mental health sources, younger children, and those from non-white racial/ethnic backgrounds have entered system of care services with less severe problems. The policy and programming implications, as well as implications for local system of care program development and implementation are discussed.
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Emotional and Behavioral Problems Reported in Child Welfare over 3 Years
ERIC Educational Resources Information Center
McCrae, Julie S.
2009-01-01
Child welfare agencies are required to provide services that ensure that children receive adequate mental health care. This study provides a comprehensive view of the emotional and behavioral problems of children who are referred to child welfare services, using nationally representative data. Bivariate analyses compare rates by child…
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The Receipt of Special Education Services Following Elementary School Grade Retention
Silverstein, Michael; Guppy, Nicole; Young, Robin; Augustyn, Marilyn
2009-01-01
Objective To estimate the proportion of children who receive an Individualized Education Program (IEP) following grade retention in elementary school. Design/setting Descriptive analysis of a nationally representative, longitudinal cohort. Participants Children retained in K/1 and 3rd grade for presumed academic reasons, followed through fifth grade. Outcome measure Presence or absence of an IEP. Results 300 children retained for presumed academic reasons in K/1, and 80 in 3rd grade were included in the study. Of the K/1 retainees, 68% never received an IEP over the subsequent four to five years; of the 3rd grade retainees, 73% never received an IEP. K/1 retainees in the highest SES quintile and suburban K/1 retainees were less likely to receive an IEP than retained children in all other SES quintiles (aOR 0.17; 95% CI 0.05-0.62) and in rural communities (aOR 0.16; 95% CI 0.06-0.44), respectively. Among K/1 retainees with persistent low academic achievement in reading and math (as assessed by standardized testing), 37% and 28%, respectively, never received an IEP. Conclusions The majority of children retained in K/1 or 3rd grade for academic reasons, including a many of those who demonstrate sustained academic difficulties, never receive an IEP during elementary school. Further studies are important to elucidate whether retained elementary school children are being denied their rights to special education services. In the meantime, early grade retention may provide an opportunity for pediatricians to help families advocate for appropriate special education evaluations for children experiencing school difficulties. PMID:19487611
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Ma, Nylanda; Furber, Gareth; Roberts, Rachel; Winefield, Helen
2016-01-01
Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g., are they assessed for mental health problems? Do they receive appropriate psychological treatment?). The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e., treatment utilisation). Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined.
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Unmet Need for Specialty Mental Health Services Among Children Across Europe.
Kovess-Masfety, Viviane; Van Engelen, Julia; Stone, Lisanne; Otten, Roy; Carta, Mauro Giovanni; Bitfoi, Adina; Koc, Ceren; Goelitz, Dietmar; Lesinskiene, Sigita; Mihova, Zlatka; Fermanian, Christophe; Pez, Ondine; Husky, Mathilde
2017-08-01
The aim of this study was to examine the determinants of use of mental health services for children across Europe, with a specific focus on differences in the availability of mental health resources. Data were drawn from the School Children Mental Health in Europe Project. Parent- and teacher-reported child mental health status was based on the Strengths and Difficulties Questionnaire. Sociodemographic characteristics of parents and children, as well as academic performance and use of mental health services in the previous 12 months, were collected. Countries were categorized as having high versus low mental health resources. The sample comprised 4,894 schoolchildren in seven countries. Across Europe, only 25.6% of children with a mental disorder had received mental health services in the previous 12 months, including 31.5% in high-resources countries and 18.9% in low-resources countries (p=.001) (N=4,867). The presence of any mental disorder, maternal psychological distress, gender, living in a single-parent home, and low academic performance were determinants of service use. The effect of resources group on the likelihood of receiving services remained significant when the analyses controlled for all predictors (odds ratio=1.41, p<.01). Determinants differed between groups-maternal psychological distress was associated with service use in high-resources countries, and gender was associated with service use in low-resources countries. The findings point to a substantial portion of unmet need across Europe and to major differences in access to care in low- versus high-resources countries. Efforts are needed to address unmet need among children with mental disorders, especially in low-resources countries.
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Rassekh, Bahie Mary; Santosham, Mathuram
2014-01-01
Aceh, Indonesia, was the hardest-hit area in the December 26, 2004 Indian Ocean earthquake and tsunami, with more than 500,000 people displaced, 120,000 people dead, and total damages and losses estimated at $4.5 billion. The relief effort following the tsunami was also immense, with billions of dollars of aid pledged to this province alone. Since then, there have been several natural disasters, including Typhoon Haiyan, which have caused great loss of life and displacement and for which these results are applicable. This study aimed to determine and assess utilization patterns of health services for children under the age of five with diarrhea, cough and difficulty breathing, fever, or skin disease and to identify determinants of formal and non-formal healthcare usage. A household survey of 1439 households was administered to caretakers of children aged 1–5 years. A sample of clusters within Banda Aceh and Aceh Besar were selected and those caretakers within the cluster who fit the inclusion criteria were interviewed. In the two weeks prior to the survey, 78.3% of respondents utilized formal health services as the first line of care for their child's illness episode. Factors significantly associated with decreased formal healthcare usage for the sick children were if the children were living in a displaced household, if the children's mother or father were not living, and if the children's caretaker was not the mother. Although utilization of formal health services for children was quite high after the tsunami, there were certain children who received significantly less care, including those who were displaced, those who were being cared for by someone other than their mother, and those for whom one or both parents had died. Among the recommendations are suggestions to target these children to ensure that they receive the health care they need. PMID:25750772
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Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results
ERIC Educational Resources Information Center
Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.
2014-01-01
Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…
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Asfaw, Abay; Colopy, Maria
2017-01-01
Background We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. Methods We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. Results Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06–1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04–1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76–0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27–0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82–0.97] fewer ER visits per year. Conclusion PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. PMID:28169438
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ERIC Educational Resources Information Center
Black, Lindsey I.; Vahratian, Anjel; Hoffman, Howard J.
2015-01-01
Increasing the proportion of children with voice, swallowing, speech, or language disorders who receive intervention services is a Healthy People 2020 goal (1). Timely receipt of intervention services is shown to be effective for treatment of communication disorders (2-5). Using data from the 2012 National Health Interview Survey (NHIS), this…
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Locke, Jill; Kang-Yi, Christina D; Pellecchia, Melanie; Marcus, Steven; Hadley, Trevor; Mandell, David S
2017-01-01
We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders. Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD], conduct/oppositional defiant disorder, and "other") and by race/ethnicity (African-American, Hispanic, white, and other). Logistic and generalized linear regression analyses were used. Differences in service use by racial/ethnic group were identified within and across diagnostic groups, both for in-school service use and out-of-school service use. For all disorders, Hispanic children had significantly lower use of in-school services than white children. Among children with ADHD, African-American children were less likely to receive in-school services than white children; however, there were no differences in adjusted annual mean Medicaid expenditures for in-school services by race/ethnicity or psychiatric disorders. Statistically significant differences by race/ethnicity were found for out-of-school service use for children with ADHD and other psychiatric disorders. There were significant differences by race/ethnicity in out-of-school service use for each diagnostic group. Differences in the use of school-based behavioral health services by racial and ethnic groups suggest the need for culturally appropriate outreach and tailoring of services to improve service utilization. © 2016, American School Health Association.
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Housing problems experienced by recipients of child welfare services.
Courtney, Mark E; McMurtry, Steven L; Zinn, Andrew
2004-01-01
This study uses data on the experiences of families involved with child welfare services to examine the nature of housing problems and needs among these families and whether housing status affects case outcomes. First, the article describes the housing difficulties faced by two distinct child welfare service populations: families receiving voluntary in-home services and families with children in court-ordered out-of-home care. Second, the study demonstrates the relationship between housing problems and the likelihood of family reunification for children in out-of-home care. The findings have implications for the delivery of child welfare services and the provision of housing assistance to low-income families with children.
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Educational Placement After Pediatric Intracerebral Hemorrhage.
Hawks, Charlotte; Jordan, Lori C; Gindville, Melissa; Ichord, Rebecca N; Licht, Daniel J; Beslow, Lauren A
2016-08-01
This study describes educational placement of school-aged children after spontaneous intracerebral hemorrhage and examines whether educational placement is associated with severity of neurological deficits. Children with spontaneous intracerebral hemorrhage presenting from 2007 to 2013 were prospectively enrolled at three tertiary children's hospitals. The Pediatric Stroke Outcome Measure and parental interview gathered information about neurological outcome, school attendance, and educational placement. The cohort of 92 enrolled children included 42 school-aged children (6 to 17 years) with intracerebral hemorrhage. Four children died; one was excluded because of preexisting cognitive deficits. Thirty-seven children completed three-month follow-up, and 30 completed 12-month follow-up. At 12 months, 14 children (46.7%) received regular age-appropriate programming, 12 (40%) attended school with in-class services, three (10%) were in special education programs, and one child (3.3%) received home-based services because of intracerebral hemorrhage-related deficits. Of 30 children with three- and 12-month follow-up, 14 (46.7%) improved their education status, 13 (43.3%) remained at the same education level, and three (10%) began to receive in-class services. An increasing Pediatric Stroke Outcome Measure score predicted the need for educational modifications at three months (odds ratio, 3.3; 95% confidence interval, 1.4 to 7.9; P = 0.007) and at 12 months (odds ratio, 2.1; 95% confidence interval, 1.1 to 3.9; P = 0.025). Most children returned to school within a year after intracerebral hemorrhage, and many had a reduction in the intensity of educational support. However, a great need for educational services persisted at 12 months after intracerebral hemorrhage with fewer than half enrolled in regular age-appropriate classes. Worse deficits on the Pediatric Stroke Outcome Measure were associated with remedial educational placement. Copyright © 2016 Elsevier Inc. All rights reserved.
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Educational Placement after Pediatric Intracerebral Hemorrhage
Hawks, Charlotte; Jordan, Lori C.; Gindville, Melissa; Ichord, Rebecca N.; Licht, Daniel J.; Beslow, Lauren A.
2016-01-01
Objectives This study describes educational placement of school-aged children after spontaneous intracerebral hemorrhage (ICH) and examines whether educational placement is associated with severity of neurological deficits. Methods Children with spontaneous ICH presenting from 2007 to 2013 were prospectively enrolled at 3 tertiary children’s hospitals. The pediatric stroke outcome measure (PSOM) and a parental questionnaire gathered information about neurological outcome, school attendance, and educational placement. Results The cohort of 92 enrolled children included 42 school-aged children (6–17 years) with ICH. Four died; 1 was excluded due to preexisting cognitive deficits. Thirty-seven completed 3-month follow-up, and 30 completed 12-month follow-up. At 12 months, 14 (46.7%) received regular age-appropriate programming, 12 (40%) attended school with in-class services, 3 (10%) were in special education programs, and one child (3.3%) received home-based services due to ICH-related deficits. Of 30 children with 3-month and 12-month follow-up, 14 children (46.7%) improved their education status, 13 (43.3%) remained at the same education level, and 3 (10%) began to receive in-class services. Increasing PSOM score predicted the need for educational modifications at 3 months (OR 3.3, 95% CI 1.4–7.9, p=0.007) and at 12 months (OR 2.1, 95% CI 1.1–3.9, p=0.025). Conclusions Most children returned to school within a year after ICH and many had a reduction in the intensity of educational support. However, a great need for educational services persisted at 12 months after ICH with fewer than half enrolled in regular age-appropriate classes. Worse deficits on the PSOM were associated with remedial educational placement. PMID:27262667
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ERIC Educational Resources Information Center
Cho, Sun-Mi; Kim, Hyun-Chung; Cho, Hyun; Shin, Yun-Mi
2007-01-01
As children with emotional or behavioral problems often fail to receive the treatment available to them, this study examined (1) the degree of perceived need (PN) among Korean parents regarding mental health services for their children, (2) the factors associated with such perceptions, (3) the degree to which Korean parents actually engage mental…
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He, Ping; Guo, Chao; Luo, Yanan; Wen, Xu; Salas, J M Ian; Chen, Gong; Zheng, Xiaoying
2017-12-01
To investigate trends in rehabilitation services use in children and adolescents with intellectual disabilities, and to explore factors potentially contributing to the trends. A population-based study using a multistage, randomized cluster-sampling process to ascertain participants in 2006. A subsample was selected for follow-up surveys from 2007 to 2013. Thirty-one provinces of China. Children (N=5432) aged 0 to 17 years with intellectual disabilities were followed up for 7 years. Not applicable. The outcome variable was whether individuals received at least 1 of the following rehabilitation services in the past 12 months: occupational therapy, physical therapy, and speech or communication therapy. Overall, the utilization rates of rehabilitation services significantly increased from 14.4% in 2007 to 37.1% in 2013. The trends were also significant in children aged 0 to 10 and 11 to 17 years, in boys and girls, and in rural participants. From 2007 to 2013, rehabilitation services utilization increased at an annual rate of 22.39% (95% confidence interval, 18.11%-26.82%) in the total sample. The rise was only significant in rural rather than urban individuals, resulting in the urban-rural gap in rehabilitation services use being narrowed. However, minority populations and those without health insurance still received fewer rehabilitation services than their respective counterparts. There were upward trends in rehabilitation services use in participants over time, and the urban-rural gap was narrowed. However, there were still socioeconomic differences on rehabilitation services use among children and adolescents with intellectual disabilities. Copyright © 2017. Published by Elsevier Inc.
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ERIC Educational Resources Information Center
Ford, Karen L.; Cabell, Sonia Q.; Konold, Timothy R.; Invernizzi, Marcia; Gartland, Lauren B.
2013-01-01
This study explored heterogeneity in literacy development among 2,300 Hispanic children receiving English as a Second Language (ESL) services at the start of kindergarten. Two research questions guided this work: (1) Do Spanish-speaking English language learners receiving ESL services in the fall of kindergarten demonstrate homogeneous early…
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ERIC Educational Resources Information Center
Carlson, Elaine; Jenkins, Frank; Bitterman, Amy; Keller, Brad
2011-01-01
The Pre-Elementary Education Longitudinal Study (PEELS), which is funded by the U.S. Department of Education, is examining the characteristics of children receiving preschool special education, the services they receive, their transitions across educational levels, and their performance over time on assessments of academic and adaptive skills.…
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Receipt of special education services following elementary school grade retention.
Silverstein, Michael; Guppy, Nicole; Young, Robin; Augustyn, Marilyn
2009-06-01
To estimate the proportion of children who receive an Individualized Education Program (IEP) following grade retention in elementary school. Longitudinal cohort study. Children retained in kindergarten or first (K/1) grade and third grade, presumably for academic reasons, were followed up through fifth grade. Presence or absence of an IEP. A total of 300 children retained in K/1 and 80 retained in third grade were included in the study. Of the K/1 retainees, 68.9% never received an IEP during the subsequent 4 to 5 years; of the third-grade retainees, 72.3% never received an IEP. Kindergarten/first-grade retainees in the highest quintile for socioeconomic status and those with suburban residence were less likely to receive an IEP than retained children in all other socioeconomic status quintiles (adjusted odds ratio, 0.17; 95% confidence interval, 0.05-0.62) and in rural communities (0.16; 0.06-0.44). Among K/1 retainees with persistently low academic achievement in math and reading, as assessed by standardized testing, 38.2% and 29.7%, respectively, never received an IEP. Most children retained in K/1 or third grade for academic reasons, including many of those who demonstrated sustained academic difficulties, never received an IEP during elementary school. Further studies are important to elucidate whether retained elementary schoolchildren are being denied their rights to special education services. In the meantime, early-grade retention may provide an opportunity for pediatricians to help families advocate for appropriate special education evaluations for children experiencing school difficulties.
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A Service Delivery Model for Children with DCD Based on Principles of Best Practice.
Camden, Chantal; Léger, France; Morel, Julie; Missiuna, Cheryl
2015-01-01
In this perspective article, we propose the Apollo model as an example of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on function and participation. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. The Apollo model has 5 components: first contact, service delivery coordination, community-, group-, and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD.
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Immunization Services for Adolescents within Comprehensive School Health Programs.
ERIC Educational Resources Information Center
Vernon, Mary E.; Bryan, Gloria; Hunt, Pete; Allensworth, Diane; Bradley, Beverly
1997-01-01
Discusses school health services, adolescent immunization, current school immunization practices, and support for school-based immunization programs. Children and adolescents can receive preventive health services, including immunizations and monitoring of immunization levels. Expanding school health services could improve the immunization levels…
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76 FR 52957 - Proposed Information Collection Activity; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-24
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed... Children in Foster Homes and Children in Families Receiving Payment in Excess of the Poverty Income Level... respondents respondent response hours Annual Statistical Report on Children in 52 1 264.35 13,746.20 Foster...
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ERIC Educational Resources Information Center
Congress of the U.S., Washington, DC. House Committee on Energy and Commerce.
Hearings were held to: (1) receive "Healthy Children: Investing in the Future," an Office of Technology Assessment (OTA) study on cost-effective strategies for improving the health of mothers and children; and (2) consider reauthorization of the Federal Family Planning Program (FFPP), Title X of the Public Health Service Act. This…
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Wang, M; Petrini, M A; Guan, Q
2015-05-01
Family-centred service (FCS) has become essential to parents of children with cerebral palsy (CP) and professionals in Chinese paediatric rehabilitation services. FCS practice meets the unique needs of the child and family, through facilitation of optimal service provision delivered by professionals, and ensures service systems to be flexible, appropriate and actively responsive to the family needs. Parents used the Measure of Processes of Care 20 (MPOC-20) questionnaire to evaluate and verify the efficacy of use in China. The aims of the present study were twofold: to assess the validity and reliability of the Chinese MPOC-20, and investigate the range of parents' satisfaction with service provision in an FCS practice using the MPOC-20. The Chinese MPOC-20 was selected to assess parent satisfaction with service provision of professionals in FCS practice. Participants were parents of children under 8 years of age with CP, who had received rehabilitation services between May 2012 and May 2013, and were receiving rehabilitation services in May 2013 at a hospital outpatient department and a rehabilitation centre. The reliability and validity of the Chinese MPOC-20 were confirmed. Parents evaluated FCS practice with the MPOC-20 survey. Respectful and supportive care was rated with the highest score and providing general information the lowest. Parents according to the data were dissatisfied with the lack of information. Parents fairly evaluated service provision of professionals in FCS practice with the Chinese MPOC-20. Professionals received feedback reports of parents, summaries of the inadequacy of service delivery, and developed and implemented ameliorated measures in the FCS policy to strive to provide exemplary service. © 2014 John Wiley & Sons Ltd.
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Language Barriers Impact Access to Services for Children with Autism Spectrum Disorders.
St Amant, Helaine G; Schrager, Sheree M; Peña-Ricardo, Carolina; Williams, Marian E; Vanderbilt, Douglas L
2018-02-01
Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized education plan (IEP) compared to children of parents whose primary language was not English. Additionally, children of primary English speakers received significantly more hours of direct services from their state disability program. After controlling for demographic covariates, findings suggest that language barriers may negatively affect parents' abilities to access health care services for their child with ASD. Acculturation factors must therefore be considered when analyzing disparities in autism.
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ERIC Educational Resources Information Center
General Accounting Office, Washington, DC.
Child welfare directors in 19 states and juvenile justice officials in 30 counties estimated that in fiscal year 2001 parents placed over 12,700 children into the child welfare or juvenile justice systems so that these children could receive mental health services. Neither the child welfare nor the juvenile justice system was designed to serve…
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ERIC Educational Resources Information Center
Noyes-Grosser, Donna M.; Rosas, Scott R.; Goldman, Alyssa; Elbaum, Batya; Romanczyk, Ray; Callahan, Emily H.
2013-01-01
State early intervention programs (EIPs) have been encouraged to develop and implement comprehensive outcomes measurement systems. As the number of children with autism spectrum disorders (ASD) and their families receiving services in state EIPs increases, disability-specific outcomes data are needed to better understand issues of access, costs,…
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'I don't know how we coped before': a study of respite care for children in the home and hospice.
Eaton, Nicola
2008-12-01
To describe the experiences of families, whose children have life-limiting and life-threatening conditions and who have complex healthcare needs, of receiving respite care at home or in a hospice. Respite provision is an extremely important service in assisting families to cope with the extra stresses and problems of coping with children with complex healthcare needs. There are different issues when the venue is home or a hospice. Semi-structured interviews were carried out with families of children with complex healthcare needs, receiving respite care at home or in a hospice. A convenience sample of 11 families was interviewed using an interview schedule, exploring their experiences of the service and their views on the service. The areas of concern identified as significant to all the families were referral to respite service, service organisation, communication, relinquishing control to respite carers and satisfaction with service. Within the provision of respite care, there needs to be more overt referral systems and criteria, negotiation of appropriate roles, continuity of care, regular assessment of need and acknowledgement of the difficulty, which parents have in relinquishing control to respite carers. High-quality respite care for families involves more than just organising a respite session. Healthcare professionals organising and providing care could manage a service more effectively, if taking the above issues into consideration.
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ERIC Educational Resources Information Center
Migliore, Alberto; Zalewska, Agnieszka
2012-01-01
In 2002, about six children aged eight years per every 1000 people in the general population received a diagnosis of autism spectrum disorder (ASD). The corresponding figure in 2008 was about 11 children, a 78% increase in just six years. To better understand how the increasing population of people with autism may impact adult programs, the…
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Asfaw, Abay; Colopy, Maria
2017-03-01
We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06-1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04-1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76-0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27-0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82-0.97] fewer ER visits per year. PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. Am. J. Ind. Med. 60:276-284, 2017. © 2017 Wiley Periodicals, Inc. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Children's Mental Health: Problems and Services. Background Paper.
ERIC Educational Resources Information Center
Congress of the U.S., Washington, DC. Office of Technology Assessment.
This background paper on children's mental health indicates that less than one-third of the children who have mental health problems receive treatment. Types of mental health problems are discussed, including intellectual, developmental, behavior, emotional, psychophysiological, and adjustment disorders. Enviromental risk factors of poverty and…
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Dietary and Physical Activity Counseling Trends in U.S. Children, 2002-2011.
Odulana, Adebowale; Basco, William T; Bishu, Kinfe G; Egede, Leonard E
2017-07-01
In 2007 and 2010, Expert Committee and U.S. Preventive Services Task Force guidelines were released, respectively, urging U.S. practitioners to deliver preventive obesity counseling for children. This study determined the frequency and evaluated predictors of receiving counseling for diet and physical activity among a national sample of children from 2002 to 2011. Children aged 6-17 years were used from the 2002-2011 Medical Expenditure Panel Surveys and analyzed in 2016. Parental report of two questions assessed whether children received both dietary and exercise counseling from the provider. Children were grouped by weight category. Bivariate analyses compared the frequency of receiving counseling; logistic regression evaluated predictors of receiving counseling. The sample included 36,114 children; <50% of children received counseling. Across all time periods, children were more likely to receive counseling with increasing weight. Logistic regression models showed that obese children had greater odds of receiving counseling versus normal-weight children, even after adjusting for covariates. Additional significant positive correlates of receiving counseling were Hispanic ethnicity, living in an urban setting, and being in the highest income stratum. Being uninsured was associated with lower odds of counseling. Years 2007-2009 and 2010-2011 were associated with increased counseling versus the benchmark year category in the multivariable model. Counseling appears more likely with greater weight and increased after both guidelines in 2007 and 2010. Overall counseling rates for children remain low. Future work should focus on marginalized groups, such as racial and ethnic minorities and rural populations. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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School-Age Test Proficiency and Special Education after Congenital Heart Disease Surgery in Infancy
Mulkey, Sarah B.; Bai, Shasha; Luo, Chunqiao; Cleavenger, Jordyn E.; Gibson, Neal; Holland, Greg; Mosley, Bridget S.; Kaiser, Jeffrey R.; Bhutta, Adnan T.
2016-01-01
Objective To evaluate test proficiency and the receipt of special education services in school-age children who had surgery for congenital heart disease (CHD) <1 year of age. Study design Data from Arkansas-born children who had CHD surgery at Arkansas Children's Hospital at <1 year of age from 1996–2004 were linked to state birth certificates and the Arkansas Department of Education longitudinal database containing achievement test scores in literacy and mathematics for grades 3-4 and special education codes. The primary negative outcome was not achieving grade-level proficiency on achievement tests. Logistic regression accounting for repeated measures associated achieving proficiency with demographics, maternal education, and clinical factors. Results 362 of 458 (79%) children who received surgery for CHD matched to the ADE database; 285 had grade 3 and/or 4 achievement tests scores. Fewer students with CHD achieved proficiency in literacy and mathematics (P < .05) compared with grade-matched state students. Higher 5-minute Apgar score, shorter hospitalization, and higher maternal education predicted proficiency in literacy (P < .05). White race, no cardiopulmonary bypass, and shorter hospitalization predicted proficiency in mathematics (P < .05). Sex, gestational age, age at surgery, CHD diagnosis, and type and number of surgeries did not predict test proficiency. Compared with all public school students, more children with CHD received special education services (26.9% vs 11.6%, P < .001). Conclusion Children with CHD had poorer academic achievement and were more likely to receive special education services than all state students. Results from this study support the need for neurodevelopmental evaluations as standard in children with CHD. PMID:27453376
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Hariharan, S; Hosey, M T; Bernabe, E
2017-05-12
Aims To compare the profile of paediatric patients receiving dental treatment under general anaesthesia (GA) or conscious sedation (CS). A second aim was to explore whether there is an overlap between the two patient groups.Design This service evaluation study was based on sociodemographic and clinical data extracted from clinical records of patients attending dental appointments for GA or CS services at King's College Hospital. Sociodemographic and clinical differences between GA and CS groups were explored using logistic regression models.Results Data from 113 children (58 GA and 55 CS) were analysed. There were differences between groups in terms of age and numbers of quadrants and teeth treated, but not in terms of sex, ethnicity or deprivation scores. In the adjusted model, older children and those having more teeth treated were more likely to be in the GA than in the CS group. An overlap between the GA and CS groups was found, with 50% of children aged four to nine years having two to four teeth treated in both groups.Conclusion Age and number of teeth treated were the main characteristics associated with receiving care under GA or CS. Some overlap between children receiving dental treatment under GA or CS existed despite demographic and clinical differences between both groups.
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Palisano, Robert J; Begnoche, Denise M; Chiarello, Lisa A; Bartlett, Doreen J; McCoy, Sarah Westcott; Chang, Hui-Ju
2012-11-01
The aims of this study were to describe physical therapy (PT) and occupational therapy (OT) services for a cohort of 399 children with cerebral palsy (CP), 2-6 years old, residing in the United States and Canada. Parents completed a services questionnaire by telephone interview. Therapists classified children's Gross Motor Function Classification System (GMFCS) level. Mean minutes per month of PT and OT were greater for children receiving services in both an educational and clinic setting. Mean minutes per month of PT and OT were greater for children in levels IV-V than children in level I and greater for children in the United States than children in Canada. Parents reported that interventions focused a moderate to great extent on primary impairments, secondary impairments, activity, and structured play activities, a moderate extent on environmental modifications and equipment; and a moderate to small extent on self-care routines. The results support the importance of coordination of PT and OT services.
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Saleh, M; Almasri, N A
2014-09-01
Family-centred service (FCS) is widely accepted now as best practice in paediatric rehabilitation. The Measure of Processes of Care-20 items set (MPOC-20) is a valid and reliable self-report measure of parents' perceptions of the extent to which health services are family-centred. Arabic-translated and validated version of the MPOC-20 (AR-MPOC-20) is used to examine Jordanian families' perception of service providers' caregiving behaviours as they receive rehabilitation services for their children with cerebral palsy (CP). Parents of 114 children with CP who are receiving services at different settings in Jordan were interviewed using the AR-MPOC-20. Participating children aged 4.1 ± 4.4 years, 53.5% were males. Children varied across gross motor functional classification system (GMFCS). Parents were mostly mothers (76.3%), with at least high school education (71.9%). Factor analyses of the AR-MPOC-20 yielded a five-factor solution with items loaded differently from the original measure. All items correlated best and significantly with their own Arabic scale score (rs: 0.91-0.26, P < 0.01). Internal consistency values of AR-MPOC-20 scales were acceptable (Cronbach's α: 0.69-0.82). Scale 'Providing Written Information' has the lowest average score (1.9 ± 1.6), while scale 'Respectful & Coordinated Care' has the highest average score (5.2 ± 1.5). The AR-MPOC-20 is found to be a valid and reliable measure for use with Arabic-Jordanian families of children with CP. FCS is not yet well implemented in Jordan, with parents reporting more need for information about their children's health and available services. Service providers are encouraged to apply FCS in paediatric rehabilitation, and giving more attention to effective communication and information exchange with families. AR-MPOC-20 is recommended for use for program evaluation.
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ERIC Educational Resources Information Center
Irvin, Dwight W.; McBee, Matthew; Boyd, Brian A.; Hume, Kara; Odom, Samuel L.
2012-01-01
This study examines child and family characteristics thought to affect the dosage and type of common in-school and private services (i.e., speech language therapy (SLT), occupational therapy (OT) and applied behavior analysis (ABA)) received by children with ASD. Participants included 137 families and their preschool-aged children with ASD from…
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ERIC Educational Resources Information Center
Storie, Sloan; Coogle, Christan Grygas; Rahn, Naomi; Ottley, Jennifer Riggie
2017-01-01
This article reports the results of a post hoc analysis of child data from a single-case multiple-probe study of pre-service teachers' use of communication strategies before, while, and after receiving distance coaching. Data were analyzed for the number of functional communication utterances used by groups of preschool children with and without…
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ERIC Educational Resources Information Center
Barnett, R. A.; Hunter, M.
2012-01-01
This study examined the adjustment of siblings of children with mental health problems. The participants had brothers or sisters receiving treatment at a Child and Adolescent Mental Health Service within the Hunter New England Health Service, New South Wales, Australia. Seventy-five siblings completed questionnaires on their self-concept, quality…
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Wall-Wieler, Elizabeth; Roos, Leslie L; Brownell, Marni; Nickel, Nathan; Chateau, Dan; Singal, Deepa
2018-03-01
The objective of this study is to examine suicide attempts and completions among mothers who had a child taken into care by child protection services (CPS). These mothers were compared with their biological sisters who did not have a child taken into care and with mothers who received services from CPS but did not have a child taken into care. A retrospective cohort of mothers whose first child was born in Manitoba, Canada, between April 1, 1992, and March 31, 2015, is used. Rates among discordant biological sisters (1872 families) were compared using fixed-effects Poisson regression models, and mothers involved with CPS (children in care [ n = 1872] and received services [ n = 9590]) were compared using a Poisson regression model. Compared with their biological sisters and mothers who received services, the adjusted incidence rate ratio (aIRR) of death by suicide was greater among mothers whose child was taken into care by CPS (aIRR = 4.46 [95% confidence interval (CI), 1.39-14.33] and ARR = 3.45 [95% CI, 1.61-7.40], respectively). Incidence rates of suicide attempts were higher among mothers with a child taken into care compared with their sisters (aIRR = 2.15; 95% CI, 1.40-3.30) and mothers receiving services (aIRR = 2.82; 95% CI, 2.03-3.92). Mothers who had a child taken into care had significantly higher rates of suicide attempts and completions. When children are taken into care, physician and social workers should inquire about maternal suicidal behaviour and provide appropriate mental health.
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For Better or Worse? Change in Service Use by Children Investigated by Child Welfare Over a Decade.
Stein, Ruth E K; Hurlburt, Michael S; Heneghan, Amy M; Zhang, Jinjin; Kerker, Bonnie; Landsverk, John; Horwitz, Sarah McCue
2016-04-01
Children, particularly minority children, referred to child welfare because of suspected maltreatment are vulnerable and need many services. We sought to assess whether service use has improved over the past decade and whether racial-ethnic disparities in service use have decreased. We used 2 national data sets (the National Survey of Child and Adolescent Well-Being [NSCAW] I and II) collected a decade apart to assess changes over time in health, education, mental health (MH), and dental services and overall service use. In NSCAW II more children were young, had lower Child Behavior Checklist (CBCL) scores, and were Hispanic. We found significant increases in dental services, a decrease in special education services, and a decrease in MH services on the bivariate level (all P < .01). A large proportion of the change in MH services occurred in school settings, but the pattern continued when examining only those services delivered outside of school. The greatest decrease occurred for children with CBCL scores <64. However, in multivariate analyses, older children, white non-Hispanic children, and children placed out of the home were significantly more likely to receive MH services. Rates of MH services controlling for CBCL scores showed no improvement over the decade, nor was there a decrease in racial and ethnic disparities. These data showed no change in MH services over time for children referred for child welfare evaluation, but improvement in dental services was noted. Racial and ethnic disparities persist. Decrease in MH services occurred predominantly among children whose MH symptoms were below the clinical range. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Saxe, Leonard; And Others
Children with serious emotional disorders receive inadequate and inappropriate services, rather than the comprehensive and coordinated system of care needed. To develop the knowledge needed to provide adequate and appropriate services, an alliance is needed among advocates, practitioners, and researchers. The Mental Health Services Program for…
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Shu, B-C; Lung, F-W; Huang, C
2002-03-01
The aims of the present study were to describe the change in mental health over time in a group of family caregivers with a child with intellectual disability (ID) and to explore the effect of a home care service on the psychological well-being of the caregiver. The authors identified children with ID who received home care services in the southern part of Taiwan. A total of 46 primary family caregivers (age range = 21-65 years) were recruited for the present study. The study design was a quasi-experimental follow-up analysis. The children with ID and their families regularly received home-based care. The 12-item version of the Chinese Health Questionnaire (CHQ) was used to evaluate the subjects' mental health at three time points: (1) baseline, (2) 3 months and (3) 9 months. The validity and reliability of the CHQ have been tested in Taiwan. The Generalized Estimating Equation was used to conduct longitudinal data analyses. The authors found that the family caregivers showed a significant improvement in their mental health by month 9. The preliminary findings of this study accredit the effect of home care services and suggest that home care services are necessary for family caregivers.
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Myers, Kathleen; Stoep, Ann Vander; Zhou, Chuan; McCarty, Carolyn A.; Katon, Wayne
2015-01-01
Objective To test the effectiveness of a telehealth service delivery model for the treatment of children with attention-deficit/hyperactivity disorder (ADHD) that provided pharmacological treatment and caregiver behavior training. Method The Children’s ADHD Telemental Health Treatment Study (CATTS) was a randomized controlled trial with 223 children referred by 88 primary care providers (PCPs) in 7 communities. Children randomized to the experimental telehealth service model received 6 sessions over 22 weeks of combined pharmacotherapy, delivered by child psychiatrists through videoconferencing, and caregiver behavior training, provided in person by community therapists who were supervised remotely. Children randomized to the control service delivery model received treatment with their PCPs augmented with a telepsychiatry consultation. Outcomes were diagnostic criteria for ADHD and oppositional defiant disorder (ODD) and role performance on the Vanderbilt ADHD Rating Scale (VADRS) completed by caregivers (VADRS-Caregivers) and teachers (VADRS-Teachers) and impairment on the Columbia Impairment Scale-Parent Version (CIS-P). Measures were completed at 5 assessments over 25 weeks. Results Children in both service models improved. Children assigned to the telehealth service model improved significantly more than children in the augmented primary care arm for VADRS-Caregiver criteria for inattention (χ2[4]=19.47, p<.001), hyperactivity (χ2[4]=11.91, p=0.02), combined ADHD (χ2[4]=14.90, p=0.005), ODD (χ2[4]=10.05, p=0.04), and VADRS-Caregiver role performance (χ2 [4]=12.40, p=0.01) and CIS-P impairment (χ2[4]=20.52, p<.001). For the VADRS-Teacher diagnostic criteria, children in the telehealth service model had significantly more improvement in hyperactivity (χ2[4]=11.28, p=0.02) and combined ADHD (χ2[4]=9.72, p=0.045). Conclusion The CATTS trial demonstrated the effectiveness of a telehealth service model to treat ADHD in communities with limited access to specialty mental health services. Clinical trial registration information Children’s Attention Deficit Disorder With Hyperactivity (ADHD) Telemental Health Treatment Study; http://clinicaltrials.gov; NCT00830700. PMID:25791143
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Lewandowski, Cathleen A.; Hill, Twyla J.
2008-01-01
This study assesses the impact of having a child in foster care and receiving cash benefits through Temporary Assistance for Needy Families (TANF) on women's completion of a residential drug treatment program. The study's hypothesis was that drug treatment completion rates for women who had children in foster care and/or who were receiving TANF would differ from women who did not receive these services. The sample included 117 women age 19 to 54, in a Midwestern state. Findings suggest that women with a child or children in foster care were less likely to complete treatment. Women receiving cash benefits were also somewhat less likely to complete treatment than women not receiving these services. Women with children in foster care had similar levels of psychological, employment, and drug and alcohol concerns as other women, as measured by the Addiction Severity Index. Future research should focus on identifying strategies that enhance retention rates of these vulnerable women. Implications for improving treatment retention are discussed in light of the Adoption and Safe Families Act of 1997 and the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. PMID:19122866
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Homeless Children and Their Families' Perspectives of Agency Services.
Lorelle, Sonya; Grothaus, Tim
2015-10-01
While numerous programs aim to mediate the risks for children experiencing homelessness, there is a lack of research representing the children's and parents' perspectives in supportive housing programs. With this phenomenological qualitative study, the authors share the voices of 22 participants, including children and their families, regarding their experiences while receiving services from a homeless agency. Participating parents perceived that the program provided resources to the children that they could not provide themselves, opportunities for exposure to positive new experiences, and improved psychosocial outcomes for their children. Participants also discussed desired program changes and the responsiveness of agency staff regarding unmet needs of the children. Implications for policies and programs are discussed.
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Jouriles, Ernest N; McDonald, Renee; Rosenfield, David; Norwood, William D; Spiller, Laura; Stephens, Nanette; Corbitt-Shindler, Deborah; Ehrensaft, Miriam
2010-06-01
Project Support is an intervention designed to decrease coercive patterns of aggressive discipline and increase positive parenting. This research evaluates Project Support in a sample of families reported to Children's Protective Services (CPS) for allegations of physical abuse or neglect; 35 families with a child between 3- and 8-years-old participated. In all families, CPS allowed the children to remain in the family home while the family received services. Families were randomly assigned to receive either Project Support or services as usual, which were provided by CPS or CPS-contracted service providers. To evaluate intervention effects, a multimethod, multi-informant assessment strategy was used that included data from mothers' reports, direct observation of parents' behavior, and review of CPS records for re-referrals for child maltreatment. Families who received Project Support services showed greater decreases than families who received services as usual in the following areas: mothers' perceived inability to manage childrearing responsibilities, mothers' reports of harsh parenting, and observations of ineffective parenting practices. Only 5.9% of families in the Project Support condition had a subsequent referral to CPS for child maltreatment, compared with 27.7% of families in the comparison condition. The results suggest that Project Support may be a promising intervention for reducing child maltreatment among families in which it has occurred. (c) 2010 APA, all rights reserved.
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Supporting Young Children with Disabilities
ERIC Educational Resources Information Center
Hebbeler, Kathleen; Spiker, Donna
2016-01-01
What do we know about young children with delays and disabilities, and how can we help them succeed in prekindergarten through third grade? To begin with, Kathleen Hebbeler and Donna Spiker write, identifying children with delays and disabilities to receive specialized services under the Individuals with Disabilities Education Act poses several…
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42 CFR 435.1101 - Definitions related to presumptive eligibility for children.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under... children. 435.1101 Section 435.1101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...
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42 CFR 435.1101 - Definitions related to presumptive eligibility for children.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under... children. 435.1101 Section 435.1101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...
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42 CFR 435.1101 - Definitions related to presumptive eligibility for children.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under... children. 435.1101 Section 435.1101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...
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Family Life with Children with Disabilities: The Key Role of Rehabilitation.
ERIC Educational Resources Information Center
Rogers, Michelle L.; Hogan, Dennis P.
2003-01-01
Examines the effects of children's medical impairments and functional disabilities and the use of medical care and rehabilitation on three family consequences (job changes, severe financial problems, and sleep disruptions). Finds that the rehabilitation services that children receive account for a large part of the observed association of…
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Does Special Education Improve Preschoolers' Academic Skills? Research Brief
ERIC Educational Resources Information Center
Sullivan, Amanda L.; Field, Samuel
2013-01-01
This study investigated associations between enrollment in preschool special education and school readiness skills for children with mild to moderate delays. Findings indicated that on average, children who received preschool special education services had lower scores in reading and math in kindergarten than similar children who did not receive…
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School-Based Counseling of Abused Children
ERIC Educational Resources Information Center
Brassard, Marla R.; Rivelis, Erin; Diaz, Vielka
2009-01-01
Abused children experience high rates of behavior, emotional, and learning problems but infrequently receive treatment. Most services provided to abused children and their families are not based on any clear evidence that they work. A number of evidence-based treatments (EBTs), demonstrated to be safe and effective in treating a range of…
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Children's Art Carnival Creative Reading Program.
ERIC Educational Resources Information Center
Mercado, Aurea A.
The implementation of the Children's Art Carnival Creative Reading Program in New York City is evaluated in terms of the services it was designed to provide to 210 Title I eligible children in grades 2 to 5 who were at least one grade behind in reading. Children in the program attended the Art Carnival twice a week and received instruction from…
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ERIC Educational Resources Information Center
Poirier, Martine; Déry, Michèle; Toupin, Jean; Verlaan, Pierrette; Lemelin, Jean-Pascal; Jagiellowicz, Jadzia
2015-01-01
There is limited empirical research on the correlates of conduct problems (CP) and depression comorbidity during childhood. This study investigated 479 elementary school children (48.2% girls). It compared children with comorbidity to children with CP only, depression only, and control children on individual, academic, social, and family…
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Holl, Jane L; Oh, Elissa H; Yoo, Joan; Amsden, Laura B; Sohn, Min-Woong
2012-12-01
We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services. We identified American Academy of Pediatrics-recommended preventive care visits from medical records of children in the 1999-2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics. The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods. The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care.
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Danielson, Melissa L; Visser, Susanna N; Chronis-Tuscano, Andrea; DuPaul, George J
2018-01-01
To characterize lifetime and current rates of attention-deficit/hyperactivity disorder (ADHD) treatments among US children and adolescents with current ADHD and describe the association of these treatments with demographic and clinical factors. Data are from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, a follow-back survey of parents from the 2011-2012 National Survey of Children's Health. Weighted analyses focused on receipt of ADHD treatment among children aged 4-17 years with current ADHD (n = 2495) by 4 treatment types: medication, school supports, psychosocial interventions, and alternative treatments. Medication and school supports were the most common treatments received, with two-thirds of children and adolescents with ADHD currently receiving each treatment. Social skills training was the most common psychosocial treatment ever received (39%), followed by parent training (31%), peer intervention (30%), and cognitive behavioral therapy (20%). Among alternative treatments, 9% were currently taking dietary supplements, and 11% had ever received neurofeedback. Most children (67%) had received at least 2 of the following: current medication treatment, current school supports, or lifetime psychosocial treatment; 7% had received none of these 3 treatment types. A majority of school-aged children and adolescents with ADHD received medication treatment and school supports, whereas fewer received recommended psychosocial interventions. Efforts to increase access to psychosocial treatments may help close gaps in service use by groups currently less likely to receive treatment, which is important to ensure that the millions of school-aged US children diagnosed with ADHD receive quality treatment. Published by Elsevier Inc.
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Ziviani, Jenny; Darlington, Yvonne; Feeney, Rachel; Rodger, Sylvia; Watter, Pauline
2014-04-01
To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context. Qualitative interviews with families receiving early intervention for their children with physical disabilities (N=10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled. Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these. Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future. © 2013 Occupational Therapy Australia.
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Phillips, Charles D
2015-01-01
Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.
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Phillips, Charles D.
2015-01-01
Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges. PMID:26740744
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ERIC Educational Resources Information Center
Robert, Marie; Leblanc, Line; Boyer, Thierry
2015-01-01
Parents of children with developmental disabilities (autism or intellectual disabilities) are more susceptible to stress and have a greater burden of adversity than other parents. Their well-being and satisfaction greatly depend on the system's response of finding them formal support and the help they need. This study proposes an interpretive…
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ERIC Educational Resources Information Center
Comptroller General of the U.S., Washington, DC.
Many handicapped Indian children in Bureau of Indian Affairs (BIA) schools are not receiving the benefits of special education services due to problems caused by poor leadership and a lack of emphasis on the program. Because of the late and incomplete evaluation of students, too few special education teachers have been hired, and funds that should…
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Mordoch, Elaine
2010-01-01
Objectives: To understand how children living with parental mental illness (PMI) understand mental illness (MI) and what they want to tell other children. Method: The study design was a secondary analysis of a grounded theory study exploring Canadian children’s perceptions of living with PMI. Interviews from 22 children, ages 6 – 16, living with a parent with depression, bipolar disorder or schizophrenia receiving treatment for the MI, were re-read, coded and analyzed along with data categories, their properties, field notes and memos from the original data. Results: Children revealed that they had limited understanding of MI and received few factual explanations of what was happening. Limited information on MI caused undue hardship. Younger children worried about their parent dying, while older children also were concerned about developing MI. Children offered suggestions for other children in similar circumstances. Conclusions: This study raises awareness of children living with PMI and identifies them as a population requiring services. It incorporates children’s perceptions of what they know and need to know. Children require assistance to understand and to respond to PMI. Mental health and primary health care clinicians have opportunities to assist these children within collaborative care models developed in conjunction with school services. PMID:20119563
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Chlebowski, Colby; Brookman-Frazee, Lauren
2018-01-01
Children with autism spectrum disorder (ASD) exhibit high rates of challenging behaviors that impair functioning and represent the primary presenting problem in mental health (MH) services. Obtaining symptom reports from multiple informants is critical for treatment planning. This study evaluated caregiver-teacher concordance of ratings of the intensity of challenging behaviors in children with ASD receiving MH services, and identified child clinical factors associated with concordance. This sample included 141 children (M = 9.07 years), their caregivers, and teachers. Caregiver-teacher concordance of challenging behaviors was low and impacted by the degree and type of child psychiatric comorbidity. Findings support need for increased attention to the range of psychiatric problems children with ASD present to tailor treatment recommendations and service delivery. PMID:28343342
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45 CFR 303.7 - Provision of services in interstate IV-D cases.
Code of Federal Regulations, 2010 CFR
2010-10-01
... ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES STANDARDS FOR PROGRAM OPERATIONS § 303.7 Provision of services in interstate IV... central registry responsible for receiving, distributing and responding to inquiries on all incoming...
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Use of early remedial services in children with transposition of the great arteries.
Calderon, Johanna; Bonnet, Damien; Pinabiaux, Charlotte; Jambaqué, Isabelle; Angeard, Nathalie
2013-10-01
To characterize the prevalence of use of early remedial services and its associated demographic, medical, and cognitive factors in children aged 4-6 years with corrected transposition of the great arteries (TGA). This was a prospective study of neurocognitive outcomes after TGA. Children underwent formal neuropsychological testing including general intelligence and a comprehensive battery of executive functions (EF) including motor and interference control, short-term memory, and working memory as well as cognitive flexibility. Parental reports on the children's behavior and EF were also evaluated. Demographic factors and preoperative, intraoperative, and postoperative factors as well as cognitive factors were examined according to the current use of remediation. Forty-five patients (67% male) and their parents participated in this study. Twenty-four (53%) patients were receiving remedial services. Male sex, a postnatal diagnosis of TGA, and a longer postoperative intensive care unit stay were significantly associated with use of remediation. Children receiving remediation had lower EF scores, had more severe EF deficits as observed by formal testing, and were rated as having more behavioral daily life difficulties. However, in the group without remediation, 13 children (43%) also displayed EF deficits rated as moderate to severe. Demographic and medical factors could help identify children at higher risk for neurocognitive delays. Evaluation of executive functioning from an early age may influence referral for remediation. Copyright © 2013 Mosby, Inc. All rights reserved.
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Lanier, Paul; Kohl, Patricia L; Raghavan, Ramesh; Auslander, Wendy
2015-02-01
Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment. © The Author(s) 2014.
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ERIC Educational Resources Information Center
Bruder, Mary Beth; Dunst, Carl J.; Mogro-Wilson, Cristina
2009-01-01
The provision of services under Part C of the Individuals With Disabilities Education Act is built on a premise that children benefit from early intervention. This article presents findings from a study of children adopted from China. Given information obtained from a survey, the researchers grouped children as (a) those who received early…
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ERIC Educational Resources Information Center
Bilaver, Lucy A.; Cushing, Lisa S.; Cutler, Ann T.
2016-01-01
This study examined the prevalence and correlates of educational intervention utilization among U.S. preschool aged children with autism spectrum disorder (ASD) prior to recent policy changes. The analysis was based on a nationally representative longitudinal survey of children receiving special education services during the 2003-2004 school year.…
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ERIC Educational Resources Information Center
Kummerer, Sharon E.; Lopez-Reyna, Norma A.; Hughes, Marie Tejero
2007-01-01
Purpose: This qualitative study explored mothers' perceptions of their children's communication disabilities, emergent literacy development, and speech-language therapy programs. Method: Participants were 14 Mexican immigrant mothers and their children (age 17-47 months) who were receiving center-based services from an early childhood intervention…
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A Parent Training Program for Increasing the Visual Development of School-Aged Children.
ERIC Educational Resources Information Center
Dikowski, Timothy J.
This practicum provided training for 50 parents of children receiving clinic services for visual processing disorders and provided information on visual disorders to the children's teachers. The 8-month program involved 13 parent training sessions. These sessions focused on such topics as: current research findings on vision; identification of…
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Maternal Infancy Predictors of School Adaptation of Low-Income Children.
ERIC Educational Resources Information Center
Schaefer, Earl S.; Edgerton, Marianna
An analysis of longitudinal data on a sample of low-income mothers and children was conducted to identify maternal characteristics during pregnancy and infancy that predict child school adaptation during kindergarten. The sample consisted of low-income mothers recruited while receiving prenatal services from public health clinics. The children,…
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Outcomes for Children Served through IDEA's Early Childhood Programs: 2014-15
ERIC Educational Resources Information Center
Early Childhood Technical Assistance Center, 2016
2016-01-01
In 2014-2015, children with delays or disabilities who received services under the Individuals with Disabilities Act (IDEA) showed greater than expected developmental progress. Many children exited the program functioning within age expectations, and most made progress. States' Part C and Part B Preschool programs report data annually on three…
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Choi, Chris; Ferro, Mark A
2018-01-01
This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children's Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=-.26; p=.035). Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged.
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Mahoney, Gerald; Wheeden, C Abigail; Perales, Frida
2004-01-01
Developmental outcomes attained by children receiving preschool special education services in relationship to both the general instructional approach used by their teachers and their parents' style of interaction were examined. The sample included 70 children from 41 Early Childhood Special Education (ECSE) classrooms. The type of instructional model children received was determined by dividing the sample into three clusters based upon six global ratings of children's classroom environment: Choice; Cognitive Problem-Solving; Child-Initiated Learning; Developmental Match; Child-Centered Routines; and Rewards and Discipline Strategies. Based on this analysis, 27 children were classified as receiving developmental instruction; 15 didactic instruction; and 28 naturalistic instruction. Observations of parent-child interaction collected at the beginning and end of the year were classified along four dimensions using the Maternal Behavior Rating Scale: Responsiveness, Affect, Achievement Orientation and Directiveness. Results indicated that the kinds of experiences that children received varied significantly across the three instructional models. However, there were no significant differences in the impact of these instructional models on children's rate of development. Regression analyses indicated that children's rate of development at the end of intervention was significantly related to their parents' style of interaction but was unrelated to the type of instructional model they received.
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Gurwitch, Robin H; Messer, Erica Pearl; Masse, Joshua; Olafson, Erna; Boat, Barbara W; Putnam, Frank W
2016-03-01
Child maltreatment impacts approximately two million children each year, with physical abuse and neglect the most common form of maltreatment. These children are at risk for mental and physical health concerns and the ability to form positive social relationships is also adversely affected. Child Adult Relationship Enhancement (CARE) is a set of skills designed to improve interactions of any adult and child or adolescent. Based on parent training programs, including the strong evidence-based treatment, Parent-Child Interaction Therapy (PCIT), CARE was initially developed to fill an important gap in mental health services for children of any age who are considered at-risk for maltreatment or other problems. CARE subsequently has been extended for use by adults who interact with children and youth outside of existing mental health therapeutic services as well as to compliment other services the child or adolescent may be receiving. Developed through discussions with Parent-Child Interaction Therapy (PCIT) therapists and requests for a training similar to PCIT for the non-mental health professional, CARE is not therapy, but is comprised of a set of skills that can support other services provided to families. Since 2006, over 2000 caregivers, mental health, child welfare, educators, and other professionals have received CARE training with a focus on children who are exposed to trauma and maltreatment. This article presents implementation successes and challenges of a trauma-informed training designed to help adults connect and enhance their relationships with children considered at-risk. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Disparity of care for children with parent-reported autism spectrum disorders.
Harstad, Elizabeth; Huntington, Noelle; Bacic, Janine; Barbaresi, William
2013-01-01
Although children with autism spectrum disorders (ASDs) are eligible to receive special education services via an individualized education program (IEP), approximately 12% to 20% do not. Our objective was to determine which clinical and demographic characteristics are associated with IEP receipt among a nationally representative sample of children with ASD. Using data from the 2007 National Survey of Children's Health, we determined which clinical and demographic covariates are associated with IEP receipt for children ages 6 to 17 years with a current, parent-reported ASD diagnosis (n = 759). Logistic regression models were used to assess the association of covariates with IEP receipt. Application of weighting techniques made the findings representative of the noninstitutionalized population of US children 6 to 17 years old. In the weighted model, 90% of children with ASD receive an IEP. Maternal education level above high school (adjusted odds ratio [aOR] 4.08, P = .01) and presence of perceived need for coordination of care (aOR 3.62, P = .02) were associated with IEP receipt, while Hispanic children were less likely to receive an IEP compared with white children (aOR 0.12, P = .001). The following factors were not associated with IEP receipt: severity of ASD, speech, and behavior problems. For children with ASD in the United States, socioeconomic factors, not disability severity, are associated with IEP receipt. Future research should address methods to overcome this disparity in care. Health care providers may help to advocate for appropriate educational services for patients with ASD. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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Burns, Barbara J; Phillips, Susan D; Wagner, H Ryan; Barth, Richard P; Kolko, David J; Campbell, Yvonne; Landsverk, John
2004-08-01
This study assessed the relationship between the need for and use of mental health services among a nationally representative sample of children who were investigated by child welfare agencies after reported maltreatment. Data were collected at study entry into the National Survey of Child and Adolescent Well-Being and were weighted to provide population estimates. Nearly half (47.9%) of the youths aged 2 to 14 years (N = 3,803) with completed child welfare investigations had clinically significant emotional or behavioral problems. Youths with mental health need (defined by a clinical range score on the Child Behavior Checklist) were much more likely to receive mental health services than lower scoring youth; still, only one fourth of such youths received any specialty mental health care during the previous 12 months. Clinical need was related to receipt of mental health care across all age groups (odds ratio = 2.7-3.5). In addition, for young children (2-5 years), sexual abuse (versus neglect) increased access to mental health services. For latency-age youths, African-American race and living at home significantly reduced the likelihood of care. Adolescents living at home were also less likely to receive services, whereas having a parent with severe mental illness increased (odds ratio = 2.4) the likelihood of service use. Routine screening for mental health need and increasing access to mental health professionals for further evaluation and treatment should be a priority for children early in their contact with the child welfare system.
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Children with Epilepsy in School: Special Service Usage and Assessment Practices
ERIC Educational Resources Information Center
Wodrich, David L.; Kaplan, Allen M.; Deering, William M.
2006-01-01
Special services usage and related assessment procedures were investigated for 50 students with epilepsy. Fifty-six percent of students with epilepsy received special education services, with mental retardation designation and self-contained placement common, especially among individuals with epilepsy plus a coexisting neurological diagnosis.…
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A Propensity Score Matching Analysis of the Effects of Special Education Services
ERIC Educational Resources Information Center
Morgan, Paul L.; Frisco, Michelle L.; Farkas, George; Hibel, Jacob
2010-01-01
We sought to quantify the effectiveness of special education services as naturally delivered in U.S. schools. Specifically, we examined whether children receiving special education services displayed (a) greater reading or mathematics skills, (b) more frequent learning-related behaviors, or (c) less frequent externalizing or internalizing problem…
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Mulambia, Yabwile; Miller, Aaron J; MacDonald, Geraldine; Kennedy, Neil
2018-04-30
The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as 'Chikwanekwanes' - 'everything under one roof') to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country's first Chikwanekwane in the large, urban city of Blantyre. One hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services. All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.
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An exploratory analysis of behavioral health care use within families.
Lave, Judith R; Peele, Pamela B; Xu, Ying; Scholle, Sarah H; Pincus, Harold Alan
2002-06-01
The authors studied enrollees in employer-sponsored managed health plans to determine the extent of multiple behavioral health consumers within families, use of behavioral health services by employees who have another family member using such services, congruence of diagnoses between two family members using behavioral health services, and the effect on covered charge per behavioral health consumer when other family members use behavioral health services. Claims data from 911 plans sold or managed by a single managed behavioral health care company were examined. The plans provided coverage for 724,789 employees and covered about 1.7 million lives. Family members of employees were identified by the relationship codes on the claims. Service utilization rates were calculated for employees overall and for employees who had spouses or children who used behavioral health services. Mean and median covered charges were determined and were examined by number and type of consumers in the family. The use of behavioral health services was greater among employees whose children or spouses used behavioral health services. Utilization rates varied by the child's or spouse's diagnoses. More than 50 percent of male employees whose children received treatment for a depressive disorder also received such treatment. Congruence of diagnoses within families was noted. Covered charges per person generally increased with the number of family members who used behavioral health services. Greater knowledge about patterns of use of behavioral health services within families may help in improving access to care and developing more effective family interventions.
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Finno-Velasquez, Megan; Cardoso, Jodi Berger; Dettlaff, Alan J; Hurlburt, Michael S
2016-02-01
Latino families may be at risk of experiencing stressors resulting from the immigration process, such as those related to documentation status and acculturation, that may increase their need for mental health services. However, little research exists on the mental health needs and service use of Latino children. This study examined how parental nativity and legal status influence mental health needs and service utilization among children in Latino families investigated by child welfare. Data from the second National Survey of Child and Adolescent Well-Being, a nationally representative, prospective study of families investigated by child welfare agencies for maltreatment, were used to examine mental health need and service use in a subset of Latino children who remained in the home following a maltreatment investigation (N=390). Although children of immigrants did not differ from children of U.S.-born parents in levels of clinical need, they had lower rates of mental health service receipt. After the analyses accounted for other relevant variables, the odds of receiving services were significantly lower (odds ratio=.09) for children whose parents were undocumented compared with children whose parents were U.S. citizens. This study contributes to growing discourse on Latino family needs within the child welfare system. Analyses support earlier research regarding the effects of parent nativity on mental health service use and advance the literature by identifying parent legal status as a unique barrier to child service receipt.
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Code of Federal Regulations, 2013 CFR
2013-07-01
... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES State Application and... eligible for preschool services under section 619 of the Act and who previously received early intervention services under this part, may choose the continuation of early intervention services under this part for...
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Code of Federal Regulations, 2014 CFR
2014-07-01
... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES State Application and... eligible for preschool services under section 619 of the Act and who previously received early intervention services under this part, may choose the continuation of early intervention services under this part for...
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Code of Federal Regulations, 2012 CFR
2012-07-01
... EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH DISABILITIES State Application and... eligible for preschool services under section 619 of the Act and who previously received early intervention services under this part, may choose the continuation of early intervention services under this part for...
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ERIC Educational Resources Information Center
Carlson, Elaine; Daley, Tamara; Bitterman, Amy; Heinzen, Harriotte; Keller, Brad; Markowitz, Joy; Riley, Jarnee
2009-01-01
The Pre-Elementary Education Longitudinal Study (PEELS), funded by the U.S. Department of Education, is examining the characteristics of children receiving preschool special education, the services they receive, their transitions across educational levels, and their performance over time on assessments of academic and adaptive skills. PEELS…
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ERIC Educational Resources Information Center
Stellwagen, Kurt K.; Kerig, Patricia K.
2010-01-01
We examined the association of callous-unemotional (C/U) traits with length of psychiatric hospitalization among two samples each with 50 participants: a group of 7-11 year-olds (39 males and 11 females) receiving services on a children's unit, and a group of 12-17 year-olds (27 males and 23 females) receiving services on an adolescent unit. Our…
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DeMattei, Ronda R; Allen, Jessica; Goss, Breanna
2012-06-01
Children with special health care needs face many barriers to oral care and are at high risk for oral disease. School nurses are in a unique position to promote oral wellness in this vulnerable population. Collaboration between school nurses and dental hygiene faculty resulted in the formation of a partnership between a university-based dental hygiene program and two special education districts in rural southern Illinois. Senior dental hygiene students participated in a school-based service-learning project that provided dental examinations, preventive services, and education to children with special health care needs. Evidence-based behavioral interventions were used to teach children to comply with oral procedures. School nurses mentored dental hygiene students in behavior management of children. Dental exams were provided to 234 children from four special education schools with the majority receiving cleanings and fluoride.
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Diabetes services in the UK: third national survey confirms continuing deficiencies.
Jefferson, I G; Swift, P G F; Skinner, T C; Hood, G K
2003-01-01
To determine the current level of diabetes services and to compare the results with previous national surveys. A questionnaire was mailed to all paediatricians in the UK identified as providing care for children with diabetes aged under 16 years. Information was sought on staffing, personnel, clinic size, facilities, and patterns of care. Responses were compared with results of two previous national surveys. Replies were received from 244 consultant paediatricians caring for an estimated 17 192 children. A further 2234 children were identified as being cared for by other consultants who did not contribute to the survey. Of 244 consultants, 78% expressed a special interest in diabetes and 91% saw children in a designated diabetic clinic. In 93% of the clinics there was a specialist nurse (44% were not trained to care for children; 47% had nurse:patient ratio >1:100), 65% a paediatric dietitian, and in 25% some form of specialist psychology or counselling available. Glycated haemoglobin was measured routinely at clinics in 88%, retinopathy screening was performed in 87%, and microalbuminuria measured in 66%. Only 34% consultants used a computer database. There were significant differences between the services provided by paediatricians expressing a special interest in diabetes compared with "non-specialists", the latter describing less frequent clinic attendance of dietitians or psychologists, less usage of glycated haemoglobin measurements, and less screening for vascular complications. Non-specialist clinics met significantly fewer of the recommendations of good practice described by Diabetes UK. The survey shows improvements in services provided for children with diabetes, but serious deficiencies remain. There is a shortage of diabetes specialist nurses trained to care for children and paediatric dietitians, and a major shortfall in the provision of psychology/counselling services. The services described confirm the need for more consultant paediatricians to receive specialist training and to develop expertise and experience in childhood diabetes.
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Code of Federal Regulations, 2010 CFR
2010-07-01
... with disabilities (birth to age 2 inclusive) and their families, and special education and related services to children with disabilities (ages 3-21 inclusive) entitled to receive special educational... EDUCATION CHILDREN WITH DISABILITIES WITHIN THE SECTION 6 SCHOOL ARRANGEMENTS § 80.1 Purpose. This part: (a...
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Code of Federal Regulations, 2011 CFR
2011-07-01
... with disabilities (birth to age 2 inclusive) and their families, and special education and related services to children with disabilities (ages 3-21 inclusive) entitled to receive special educational... EDUCATION CHILDREN WITH DISABILITIES WITHIN THE SECTION 6 SCHOOL ARRANGEMENTS § 80.1 Purpose. This part: (a...
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Holl, Jane L.; Oh, Elissa H.; Yoo, Joan; Amsden, Laura B.
2012-01-01
Objectives. We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services. Methods. We identified American Academy of Pediatrics–recommended preventive care visits from medical records of children in the 1999–2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics. Results. The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods. Conclusion. The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care. PMID:23078495
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ERIC Educational Resources Information Center
American Journal of Play, 2009
2009-01-01
Vivian Gussin Paley is a teacher, writer, lecturer, and advocate for the importance of play for young children. Author of a dozen books about children learning through play, she has received numerous honors and awards including an Erickson Institute Award for Service to Children, a MacArthur Foundation Fellows award, and a John Dewey Society's…
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ERIC Educational Resources Information Center
Fessenden, Vanessa Marie
2013-01-01
Early intervention for children with autism spectrum disorders (ASD) has significant impact on children and families. Early intervention optimizes long-term diagnosis for children with ASD. Unfortunately, many children with ASD are not diagnosed until after age three and often receive services from a local school district rather than through early…
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Are We Helping All the Children That We Are Supposed to Be Helping?
ERIC Educational Resources Information Center
Morgan, Paul L.; Farkas, George
2016-01-01
We reply to three critiques regarding our reporting that White, English-speaking children are much more likely than otherwise similar racial, ethnic, and language minority children to receive special education services in the United States. We show how each critique is unsound. We present further evidence of the robustness of our findings.
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Epidemiological Findings of Pervasive Developmental Disorders in a Venezuelan Study
ERIC Educational Resources Information Center
Montiel-Nava, Cecilia; Pena, Joaquin A.
2008-01-01
The study aims to determine the prevalence of autism spectrum disorders (ASDs) for children receiving services in Maracaibo County, Venezuela. Children aged 3-9 with diagnosis of any ASD were recruited. We ascertained area, referral process, and definitions of ASD for each patient. A total of 430 children were identified, and 76.5 percent were…
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ERIC Educational Resources Information Center
Segool, Natasha K.; Mathiason, Jacob B.; Majewicz-Hefley, Amy; Carlson, John S.
2009-01-01
Currently, more than two thirds of school-aged children with mental health needs do not receive treatment. By exploring the numerous barriers that limit children's access to mental health care, the authors argue that school psychologists have a key role to play in supporting comprehensive mental health services for children. This article provides…
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ERIC Educational Resources Information Center
Shapiro, Jennifer R.; Bauer, Stephanie; Hamer, Robert M.; Kordy, Hans; Ward, Dianne; Bulik, Cynthia M.
2008-01-01
Objective: To examine acceptability, attrition, adherence, and preliminary efficacy of mobile phone short message service (SMS; text messaging) for monitoring healthful behaviors in children. Design: All randomized children received a brief psychoeducational intervention. They then either monitored target behaviors via SMS with feedback or via…
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ERIC Educational Resources Information Center
Grandpierre, Viviane; Fitzpatrick, Elizabeth M.; Na, Eunjung; Mendonca, Oreen
2018-01-01
Following the establishment of newborn hearing screening programs, age of identification and length of time before receiving interventions has been reduced for children, including those with milder degrees of hearing loss who were previously not identified until school age. This population of early-identified children requires new support programs…
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Broken Promises: How the Bush Administration is Failing America's Children [with] Executive Summary.
ERIC Educational Resources Information Center
Children's Defense Fund, Washington, DC.
Asserting that President Bush's proposal to shift responsibility for Head Start to the states would allow the federal government to abandon its promise to truly give children a head start, this report, with accompanying executive summary, outlines what is known about children receiving Head Start services and how the program addresses their needs.…
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Medical home services for children with behavioral health conditions.
Sheldrick, Radley C; Perrin, Ellen C
2010-01-01
Whether medical services received by children and youth with behavioral health conditions are consistent with a Medical Home has not been systematically studied. The objectives of this study were to examine the variation among four behavioral health conditions in regard to services related to the Medical Home. Cross-sectional analyses of the 2003 National Survey of Children's Health were conducted. Multiple logistic regression analyses tested the impact of behavioral health conditions on medical needs, on Medical Home components, and on likelihood of having a Medical Home overall. Autism, Depression/Anxiety, and Behavior/Conduct problems were associated with reduced likelihood of having a Medical Home, whereas Attention-Deficit Hyperactivity Disorder was associated with increased likelihood. All health conditions predicted increased access to a primary care physician (PCP) and a preventive visit in the past year. However, all were also associated with higher needs for specialty care and all behavioral health conditions except Attention-Deficit Hyperactivity Disorder were associated with difficulties accessing this care. A detailed examination of the receipt of services among children and youth with behavioral health conditions reveals two primary reasons why such care is less likely to be consistent with a Medical Home model: (1) parents are more likely to report needing specialty care; and (2) these needs are less likely to be met. These data suggest that the reason why services received by children and youth with behavioral health conditions are not consistent with the Medical Home has more to do with difficulty accessing specialty care than with problems accessing quality primary care.
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ERIC Educational Resources Information Center
Carlson, Elaine; Daley, Tamara; Shimshak, Amy; Riley, Jarnee; Keller, Brad; Jenkins, Frank; Markowitz, Joy; Rosenquist, Celia
2008-01-01
PEELS involves a nationally representative sample of children, 3 to 5 years of age when they entered the study, with diverse disabilities who are receiving preschool special education services in a variety of settings. Topics covered in the report include declassification (children leaving special education), reclassification (movement from one…
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Churchill Forum, Volume VIII, Numbers 1-4, November 1985-June 1986.
ERIC Educational Resources Information Center
Churchill Forum, 1986
1986-01-01
This collection of four newsletters focuses on abilities and problems of and services for learning disabled persons. Major articles have the following titles and authors: "From Service Receiver to Service Provider: The Learning Disabled Young Adult Moves into the Work World" (A. Roffman); "Our Children's Future in the Workplace" (F. Yauch);…
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A Consumer's Guide To Outcomes in Early Childhood Intervention.
ERIC Educational Resources Information Center
Accreditation Council on Services for People with Disabilities, Landover, MD.
This collection of 21 suggested outcome measures for early childhood intervention services is designed to assist families in evaluating the quality of early intervention services they receive. The measures apply to all types of service and support program models for children with various developmental delays and/or disabilities and their families.…
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34 CFR 300.513 - Hearing decisions.
Code of Federal Regulations, 2010 CFR
2010-07-01
... receive a FAPE only if the procedural inadequacies— (i) Impeded the child's right to a FAPE; (ii... REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES Procedural Safeguards Due Process Procedures for Parents and Children § 300.513 Hearing decisions...
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Quick Statistics about Voice, Speech, and Language
... or swallowing disorder received intervention services in the past year. 1 White children (ages 3-17) with a ... lasted for a week or longer during the past 12 months. 1 Sources ... among children aged 3–17 years: United States, 2012 . NCHS data brief, no 205. ...
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ERIC Educational Resources Information Center
Gould, Judith
2008-01-01
Australian Aboriginal children typically receive communication assessment services from Standard Australian English (SAE) speaking non-Aboriginal speech-language pathologists (SLPs). Educational assessments, including intelligence testing, are also primarily conducted by non-Aboriginal educational professionals. While the current paper will show…
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77 FR 63318 - Submission for OMB Review; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-16
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for OMB Review; Comment Request Title: National Youth in Transition Database and Youth Outcome Survey. OMB... Administration on Children and Families (ACF) data on the characteristics of youth receiving independent living...
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ERIC Educational Resources Information Center
Eskow, Karen Goldrich; Chasson, Gregory S.; Summers, Jean Ann
2015-01-01
State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families…
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Stanley, Nicky; Miller, Pam; Foster, Helen Richardson; Thomson, Gill
2011-08-01
Police notifications of incidents of domestic violence to child protection services constitute an acknowledgement of the harm that domestic violence inflicts on children. However, these notifications represent a substantial demand on child welfare services and the outcomes for children and victims of domestic violence have been questioned. This paper presents findings from the first UK study to examine these notifications in depth and examines the interface between the police and child protection services in responding to domestic violence incidents. The research reports on police interventions in 251 incidents of domestic violence involving children; the communication of information to child protection services and the subsequent filtering and service response. Social workers found that notifications conveyed little information on children's experiences of domestic violence. Forty per cent of families notified had had no previous contact with child protection services in that area, but those cases most likely to receive social work assessment or intervention were those where the case was already open. Notifications triggered a new social work intervention in only 5% of cases. The study also identified a range of innovative approaches for improving the co-ordination of police and child protective services in relation to children's exposure to domestic violence. Arrangements that maximized opportunities for police and social workers to share agency information appeared to offer the best option for achieving informed decisions about the appropriate level of service response to children and families experiencing domestic violence.
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Lerebo, Wondwossen; Callens, Steven; Jackson, Debra; Zarowsky, Christina; Temmerman, Marleen
2014-04-23
Prevention of mother to child HIV transmission (PMTCT) remains a challenge in low and middle-income countries. Determinants of utilization occur--and often interact--at both individual and community levels, but most studies do not address how determinants interact across levels. Multilevel models allow for the importance of both groups and individuals in understanding health outcomes and provide one way to link the traditionally distinct ecological- and individual-level studies. This study examined individual and community level determinants of mother and child receiving PMTCT services in Tigray region, Ethiopia. A multistage probability sampling method was used for this 2011 cross-sectional study of 220 HIV positive post-partum women attending child immunization services at 50 health facilities in 46 districts. In view of the nested nature of the data, we used multilevel modeling methods and assessed macro level random effects. Seventy nine percent of mothers and 55.7% of their children had received PMTCT services. Multivariate multilevel modeling found that mothers who delivered at a health facility were 18 times (AOR = 18.21; 95% CI 4.37,75.91) and children born at a health facility were 5 times (AOR = 4.77; 95% CI 1.21,18.83) more likely to receive PMTCT services, compared to mothers delivering at home. For every addition of one nurse per 1500 people, the likelihood of getting PMTCT services for a mother increases by 7.22 fold (AOR = 7.22; 95% CI 1.02,51.26), when other individual and community level factors were controlled simultaneously. In addition, district-level variation was low for mothers receiving PMTCT services (0.6% between districts) but higher for children (27.2% variation between districts). This study, using a multilevel modeling approach, was able to identify factors operating at both individual and community levels that affect mothers and children getting PMTCT services. This may allow differentiating and accentuating approaches for different settings in Ethiopia. Increasing health facility delivery and HCT coverage could increase mother-child pairs who are getting PMTCT. Reducing the distance to health facility and increasing the number of nurses and laboratory technicians are also important variables to be considered by the government.
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Predictors of and barriers to service use for children at risk of ADHD: longitudinal study.
Sayal, Kapil; Mills, Jonathan; White, Kate; Merrell, Christine; Tymms, Peter
2015-05-01
Many children with, or at risk of, ADHD do not receive healthcare services for their difficulties. This longitudinal study investigates barriers to and predictors of specialist health service use. This is a 5-year follow-up study of children who participated in a cluster randomised controlled trial, which investigated school-level interventions (provision of books with evidence-based information and/or feedback of names of children) for children at risk of ADHD. 162 children who had high levels of ADHD symptoms at age 5 (baseline) were followed up at age 10 years. Using baseline data and follow-up information collected from parents and teachers, children who had and had not used specialist health services over the follow-up period were compared and predictors (symptom severity, comorbid problems, parental perception of burden, parental mental health, and socio-demographic factors) of specialist service use investigated. The most common parent-reported barrier reflected lack of information about who could help. Amongst children using specialist health services who met criteria for ADHD at follow-up, 36% had been prescribed stimulant medication. Specialist health service use was associated with each one-point increase in teacher-rated symptoms at baseline [inattention symptoms (adjusted OR = 1.40; 95% CI 1.12-1.76) and hyperactivity/impulsivity symptoms (adjusted OR = 1.23; 95% CI 1.05-1.44)]. Parental mental health problems were also independently associated with service use (for each one-point increase in symptoms, adjusted OR = 1.41; 95% CI 1.04-1.91). Severity of teacher-rated ADHD symptoms in early school years is a determinant of subsequent service use. Clinicians and teachers should be aware that parental mental health problems are independently associated with service use for children at risk of ADHD.
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Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-21
... meetings and written submissions, is seeking input from State agencies responsible for early learning and... intervention service providers and other providers of services to young children), students, technical... receive all written submissions of comments on the four early learning topics on or before 5 p.m...
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A Networking of Community-Based Speech Therapy: Borabue District, Maha Sarakham.
Pumnum, Tawitree; Kum-ud, Weawta; Prathanee, Benjamas
2015-08-01
Most children with cleft lip and palate have articulation problems because of compensatory articulation disorders from velopharyngeal insufficiency. Theoretically, children should receive speech therapy from a speech and language pathologist (SLP) 1-2 sessions per week. For developing countries, particularly Thailand, most of them cannot reach standard speech services because of limitation of speech services and SLP Networking of a Community-Based Speech Model might be an appropriate way to solve this problem. To study the effectiveness of a networking of Khon Kaen University (KKU) Community-Based Speech Model, Non Thong Tambon Health Promotion Hospital, Borabue, Maha Sarakham, in decreasing the number of articulation errors for children with CLP. Six children with cleft lip and palate (CLP) who lived in Borabue and the surrounding district, Maha Sarakham, and had medical records in Srinagarind Hospital. They were assessed for pre- and post-articulation errors and provided speech therapy by SLP via teaching on service for speech assistant (SA). Then, children with CLP received speech correction (SC) by SA based on assignment and caregivers practiced home program for a year. Networking of Non Thong Tambon Health Promotion Hospital, Borabue, Maha Sarakham significantly reduce the number of post-articulation errors for 3 children with CLP. There were factors affecting the results in treatment of other children as follows: delayed speech and language development, hypernaslaity, and consistency of SC at local hospital and home. A networking of KKU Community-Based Speech Model, Non Thong Tambon Health Promotion Hospital, Borabue, and Maha Sarakham was a good way to enhance speech therapy in Thailand or other developing countries, where have limitation of speech services or lack of professionals.
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McManus, Beth M; Lindrooth, Richard; Richardson, Zachary; Rapport, Mary Jane
2016-01-01
To describe urban/rural differences in physical (PT) and occupational therapy (OT) service utilization and spending among a sample of young Medicaid-enrolled children with developmental conditions. We analyzed Colorado Children's Medicaid administrative claims from 2006 to 2008. The sample included children who were younger than 36 months of age, had a select developmental condition, and were continuously eligible for each study year up to their third birthday. The study outcomes were number of PT/OT claims, type of PT/OT service, and Medicaid PT/OT spending. Multivariable analyses examined urban/rural differences in PT/OT utilization and spending, adjusting for child, family, and health service characteristics. The sample included 20,959 children. In adjusted analyses, urban children had 2-fold higher odds (odds ratio 2.18, 95% confidence interval 1.89, 2.51) of receiving PT/OT compared to their rural peers. Median annual per-child Medicaid PT/OT spending was $99 higher ($98.79 [$3.23, $194.35]) for urban children versus rural children. When place of PT/OT service and PT/OT procedures was included, this spending difference was drastically reduced. Even accounting for child, family, and health service characteristics, Medicaid PT/OT spending is lower for rural children compared to their urban peers. The difference in spending is largely attributable to utilization of services that are less specialized than urban peers, thus suggesting disparities in access to appropriate PT/OT services. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Fabiano, Gregory A.; Vujnovic, Rebecca K.; Pelham, William E.; Waschbusch, Daniel A.; Massetti, Greta M.; Pariseau, Meaghan E.; Naylor, Justin; Yu, Jihnhee; Robins, Melissa; Carnefix, Tarah; Greiner, Andrew R.; Volker, Martin
2010-01-01
Children with attention deficit hyperactivity disorder (ADHD) make up a considerable proportion of students who receive special education services in schools. The present study aimed to enhance the outcomes of students with ADHD in special education settings by using a daily report card (DRC). Thirty-three children with ADHD in special education…
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ERIC Educational Resources Information Center
Vinen, Zoe; Clark, Megan; Paynter, Jessica; Dissanayake, Cheryl
2018-01-01
This study followed children with Autism Spectrum Disorder (ASD) from early intervention into their early schooling years, when they were aged between 6 and 9 years, on autism symptom severity and cognitive functioning. The children, matched at pre-intervention, were compared on type of community provided service: 31 were in receipt of…
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ERIC Educational Resources Information Center
Himes, John H.; And Others
The Lawrence (Massachusetts) Children's Health Project (LCHP) was a demonstration project consisting of an alternative approach to providing health care to children, many of whom were not receiving health services. The project was carried out by the Merrimack Education Center and focused on a school-based model for Early Periodic Screening,…
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Disparities in the use of preventive health care among children with disabilities in Taiwan.
Tsai, Wen-Chen; Kung, Pei-Tseng; Wang, Jong-Yi
2012-01-01
Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three nationwide databases from the Ministry of the Interior, Bureau of Health Promotion, and National Health Research Institutes were linked to gather related information between 2006 and 2008. A total of 8572 children with disabilities aged 1-7 years were included in this study. Multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 37.58% of children with disabilities received preventive health care in 2008. Children with severe and very severe disabilities were less likely to use preventive care than those with mild severity. Children with disabilities from the lowest income family were less likely to have preventive care than other income groups. Urbanization was strongly associated with the receipt of preventive health care. However, surprisingly, urban children with disabilities were less likely to receive preventive care than all others. Under universal health insurance coverage, the overall usage of preventive health care is still low among children with disabilities. The study also identified several disparities in their usage. Potential factors affecting the lack of use deserve additional research. Policymakers should target low socioeconomic brackets and foster education about the importance of preventive care. Mobile health services should be continually provided in those areas in need. Capitation reimbursement and other incentives should be considered in improving the utilization among children with disabilities. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Cho, Sun-Mi; Kim, Hyun-Chung; Cho, Hyun; Shin, Yun-Mi
2007-12-01
As children with emotional or behavioral problems often fail to receive the treatment available to them, this study examined (1) the degree of perceived need (PN) among Korean parents regarding mental health services for their children, (2) the factors associated with such perceptions, (3) the degree to which Korean parents actually engage mental health services for their children, and (4) the factors associated with such use. To determine the degrees of PN and actual use, 1,058 children aged between 9 and 12 years were asked to complete the Children's Depression Inventory, while their parents completed the Child Behavior Checklist. About 11.4% of the parents demonstrated PN, compared to 2.7% who actually engaged child mental health services. While most of the CBCL factors were associated with PN, the child's self-report significantly affected the perception as well. The attention problem score in the CBCL was the only factor that strongly corresponded to the actual use of services in Korea, a country where academic achievement is considered paramount, which suggests that cultural forces may play a powerful role in determining parents' decisions regarding child mental health care.
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45 CFR 400.104 - Continued coverage of recipients who receive increased earnings from employment.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Conditions of Eligibility for Refugee Medical Assistance § 400.104 Continued coverage of recipients who receive increased earnings from...
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Carroll, Clare
2010-08-01
Tailoring the delivery of disability services to the preferences and requirements of service users allows for more effective partnerships. The aim of this research was to explore parents' perceptions and the expectations of their child's speech-language pathology (SLP) within an intellectual disability service. Parents of school-aged children with intellectual disability who received a SLP service in Ireland participated in the research: 17 parents participated in focus groups and 103 parents answered questionnaires. The core themes from the focus groups, which subsequently informed the questionnaire design, were: experience of the SLP service, communication difficulties, expectations of the SLP service, and future developments. The key questionnaire results indicated that parents viewed their SLP as the "expert" and viewed school-based and clinic-based services differently. Parents were more likely to believe that their child would always need therapy if they received a school-based service. Whereas, parents were more likely to think that their child's speech was improving as they got older and were more likely to be aware of therapy activities if therapy was clinic-based. The findings have implications for the delivery of SLP services suggesting that clarification of parents' roles and expectations are required.
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Pajuelo, Mónica J; Anticona Huaynate, Cynthia; Correa, Malena; Mayta Malpartida, Holger; Ramal Asayag, Cesar; Seminario, Juan R; Gilman, Robert H; Murphy, Laura; Oberhelman, Richard A; Paz-Soldan, Valerie A
2018-03-01
Delays in receiving adequate care for children suffering from pneumonia can be life threatening and have been described associated with parents' limited education and their difficulties in recognizing the severity of the illness. The "three delays" was a model originally proposed to describe the most common determinants of maternal mortality, but has been adapted to describe delays in the health seeking process for caregivers of children under five. This study aims to explore the caregivers' perceived barriers for seeking and receiving health care services in children under five years old admitted to a referral hospital for community-acquired pneumonia in the Peruvian Amazon Region using the three-delays model framework. There were two parts to this mixed-method, cross-sectional, hospital-based study. First, medical charts of 61 children (1 to 60 months old) admitted for pneumonia were reviewed, and clinical characteristics were noted. Second, to examine health care-seeking decisions and actions, as well as associated delays in the process of obtaining health care services, we interviewed 10 of the children's caregivers. Half of the children in our study were 9 months old or less. Main reasons for seeking care at the hospital were cough (93%) and fever (92%). Difficulty breathing and fast breathing were also reported in more than 60% of cases. In the interviews, caregivers reported delays of 1 to 14 days to go to the closest health facility. Factors perceived as causes for delays in deciding to seek care were apparent lack of skills to recognize signs and symptoms and of confidence in the health system, and practicing self-medication. No delays in reaching a health facility were reported. Once the caregivers reached a health facility, they perceived lack of competence of medical staff and inadequate treatment provided by the primary care physicians. According to caregivers, the main delays to get health care services for pneumonia among young children were identified in the initial decision of caregivers to seek healthcare and in the health system to provide it. Specific interventions targeted to main barriers may be useful for reducing delays in providing appropriate health care for children with pneumonia.
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Developmental and Behavioral Needs and Service Use for Young Children in Child Welfare
Stahmer, Aubyn C.; Leslie, Laurel K.; Hurlburt, Michael; Barth, Richard P.; Webb, Mary Bruce; Landsverk, John; Zhang, Jinjin
2006-01-01
Objective To determine the level of developmental and behavioral need in young children entering child welfare (CW), estimate early intervention services use, and examine variation in need and service use based on age and level of involvement with CW by using a national probability sample in the United States. Methods As part of the National Survey of Child and Adolescent Well-Being, data were collected on 2813 children <6 years old for whom possible abuse or neglect was investigated by CW agencies. Analyses used descriptive statistics to determine developmental and behavioral needs across 5 domains (cognition, behavior, communication, social, and adaptive functioning) and service use. Logistic regression was used to examine the relationship between independent variables (age, gender, race-ethnicity, maltreatment history, level of CW involvement, and developmental or behavior problems) and service use. Results Results indicate that age and level of CW involvement predict service use when controlling for need. Both toddlers (41.8%) and preschoolers (68.1%) in CW have high developmental and behavioral needs; however, few children are receiving services for these issues (22.7% overall). Children that remain with their biological parents have similar needs to those in out-of-home care but are less likely to use services. Children <3 years of age are least likely to use services. Conclusions Children referred to CW have high developmental and behavioral need regardless of the level of CW involvement. Both age and level of involvement influence service use when controlling for need. Mechanisms need to be developed to address disparities in access to intervention. PMID:16199698
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Service system finance: implications for children with depression and manic depression.
Glied, S; Neufeld, A
2001-06-15
An estimated 6.2% of children in the United States satisfy the criteria for a depression diagnosis, but approximately half of this group do not receive necessary treatment. Thus it is important to consider potential barriers to use through service system finance. This article reviews three major types of changes affecting access: parity legislation, managed care, and public contracting. How these developments will affect children with depression and manic depression (DMD) is unclear. To better understand the potential effects on children with DMD, this review uses new data from the Medical Expenditure Panel Survey to describe the service use patterns of this population. These children have higher levels of expenditures, higher rates of inpatient use, and higher rates of Medicaid payment than do other children with mental health diagnoses; they also are overrepresented among the costliest cases of mental illness in children. Children with DMD pay a relatively low out-of-pocket share, suggesting that parity efforts focusing only on copayments and deductibles will have little effect on the absolute out-of-pocket burden for these children. Because children with DMD are overrepresented among high utilizers of health services, health care rationing arrangements or techniques, such as utilization review and capitation, may place this population at particular risk.
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Kindergarten Screening and Parent Engagement to Enhance Mental Health Service Utilization
ERIC Educational Resources Information Center
Girio, Erin L.
2010-01-01
The majority of youth in need of mental health services do not receive intervention as many are not identified as having a problem or their families experience practical or attitudinal barriers that interfere with service utilization. The school environment provides a unique point of access to reach all children, yet this setting has been…
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What Specialized Knowledge Is Needed to Provide Early Intervention Services in Children's Hospitals?
ERIC Educational Resources Information Center
Weitzner-Lin, Barbara; And Others
1994-01-01
A survey of 175 speech-language pathologists was conducted to determine the preparation they received to comply with Public Law 99-457's mandated services to infants and toddlers. Respondents reported that important content areas in provision of early intervention services included oral-motor/feeding issues, family assessment and intervention, and…
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A Case Study of Education Support and Services for Foster Children
ERIC Educational Resources Information Center
Chambers-Nash, Carmen Jeneice
2013-01-01
The research problem was a case study to understand the problem of a significant number of high school graduates leaving foster care without receiving the services necessary to survive as adults. The purpose of the study was to explore services and supports for youths that are necessary for post-graduation success. The research questions in this…
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ERIC Educational Resources Information Center
Sullivan, Amanda L.; Simonson, Gregory R.
2016-01-01
Refugees often experience significant psychological distress, but many do not receive necessary services. Among children and youth, most mental health services are provided by schools, so schools are an important service provider for young refugees. We conducted a systemic literature review to synthesize and evaluate the existing research on…
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Expanding mental health services through novel models of intervention delivery.
Kazdin, Alan E
2018-06-13
Currently, in the United States and worldwide, the vast majority of children and adolescents in need of mental health services receive no treatment. Although there are many barriers, a key barrier is the dominant model of delivering psychosocial interventions. That model includes one-to-one, in-person treatment, with a trained mental health professional, provided in clinical setting (e.g., clinic, private practice office, health-care facility). That model greatly limits the scale and reach of psychosocial interventions. The article discusses many novel models of delivering interventions that permit scaling treatment to encompass children and adolescents who are not likely to receive services. Special attention is accorded the use of social media, socially assistive robots, and social networks that not only convey the ability to scale interventions but also encompass interventions that depart from the usual forms of intervention that currently dominate psychosocial treatment research. © 2018 Association for Child and Adolescent Mental Health.
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Childhood Placement in Special Education and Adult Well-Being.
Chesmore, Ashley A; Ou, Suh-Ruu; Reynolds, Arthur J
2016-08-01
The present study investigates the relationship between childhood placement in special education and adult well-being among 1,377 low-income, minority children participating in the Chicago Longitudinal Study. Roughly 16% of the sample received special education services in grades 1-8. After accounting for sociodemographic factors and early academic achievement, children receiving special education services tended to have lower rates of high school completion and fewer years of education, as well as greater rates of incarceration, substance misuse, and depression. Eighth grade academic achievement significantly mediated the association between childhood placement in special education and adult well-being outcomes. The study contributes to the literature by providing support for a pathway from childhood special education placement to adult outcomes among an inner-city minority cohort.
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42 CFR 435.1101 - Definitions related to presumptive eligibility for children.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Child Care and Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and... children. 435.1101 Section 435.1101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...
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42 CFR 435.1101 - Definitions related to presumptive eligibility for children.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Child Care and Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and... children. 435.1101 Section 435.1101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...
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Tablet Technology to Monitor Physical Education IEP Goals and Benchmarks
ERIC Educational Resources Information Center
Lavay, Barry; Sakai, Joyce; Ortiz, Cris; Roth, Kristi
2015-01-01
The Individual with Disabilities Education Act (IDEA) mandates that all children who are eligible for special education services receive an individualized education program (IEP). Adapted physical education (APE) professionals who teach physical education to children with disabilities are challenged with how to best collect and monitor student…
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Measuring Worker Cognitions about Parents of Children with Mental and Emotional Disabilities.
ERIC Educational Resources Information Center
Johnson, Harriette C.; And Others
1994-01-01
Analysis of an instrument for assessing workers' beliefs about parents of children receiving mental health-related services identified five factors: parent blame, giving information, parent validation, use of psychotropic medications, and parent instruction. Differences in beliefs were revealed among workers who endorsed psychodynamic, family…
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75 FR 19403 - Proposed Data Collections Submitted for Public Comment and Recommendations
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-14
... future outcomes, such as cognitive development, and family dynamics. These data will also assist state..., children, and adults with disabilities. As part of these efforts the Center is actively involved in... children are receiving recommended screening and follow-up services, documenting the occurrence and...
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Interdisciplinary Journal Club: Advancing Knowledge Translation in a Rural State
ERIC Educational Resources Information Center
Dennis, Ruth E.; Potvin, Marie-Christine; MacLeod, Marie
2010-01-01
Professionals who provide health and related supports and services to children with disabilities in educational programs and community settings must practice in an evidence-based manner to ensure children and families receive the highest quality care. Vermont's Interdisciplinary Journal Club provides a successful approach to supporting…
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Tsai, Yuping
2018-01-01
To examine the association between state Medicaid vaccine administration fees and children's receipt of immunization services. The study used the 2008-2012 Medicaid Analytic eXtract data and included children aged 0-17 years and continuously enrolled in a Medicaid fee-for-service plan in each study year. Analyses were restricted to 8 states with a Medicaid managed-care penetration rate <75%. Linear regressions were used to estimate the probability of children making ≥1 vaccination visit and the numbers of vaccination visits in the year as a function of state Medicaid vaccine administration fees, age group, sex, race/ethnicity, state unemployment rate, state managed-care penetration rate, and state and year-fixed effects. A total of 1,678,288 children were included. In 2008-2012, the average proportion of children making ≥1 vaccination visit per year was 31% and the mean number of vaccination visits was 0.9. State Medicaid reimbursements for vaccine administration was positively associated with immunization service utilization; for every $1 increase in the payment amount, the probability of children making ≥1 vaccination visit increased by 0.72 percentage point (95% confidence interval, 0.23-1.21; P=0.01), representing a 2% increase from the mean and the number of vaccination visits increased by 0.03 (95% confidence interval, -0.00 to 0.06; P<0.1). The estimated effect was greater among younger children. Higher Medicaid reimbursements for vaccine administration were associated with increased proportion of children receiving immunization services.
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Baiden, Philip; Fallon, Barbara
2018-05-01
Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Intervention pilot for parents of children with autistic spectrum disorder.
Giarelli, Ellen; Souders, Margaret; Pinto-Martin, Jennifer; Bloch, Joan; Levy, Susan E
2005-01-01
Parents of children who receive the diagnosis of autistic spectrum disorder (ASD) experience a situational crisis related to receiving the diagnosis, which causes feelings of distress and urgency to access services for the affected child. This paper describes a randomized trial (n = 31) that was conducted at a regional diagnostic center of a large metropolitan children's hospital to (a) refine a nursing intervention designed for parents of children with ASD and (b) to identify methodological revisions for a larger study. A secondary purpose was to test the effects of a post-diagnosis nursing intervention on parents' reports of stress, impact of event (diagnosis), and use of services after a child is newly diagnosed with ASD. The intervention consisted of usual care plus 3 hours contact with a pediatric nurse practitioner (PNP) for counseling, instruction, and assistance with implementation of the recommended treatment plan. The control group received only the usual care post-diagnosis, which consisted of a 1-hour consultation session to receive the results of diagnostic tests and a written copy of the recommended treatment plan provided by a developmental pediatrician and/or PNP. Between group differences in measures of "impact of event" and "perceived stress" were not statistically significant. This was attributed to a small sample size. A larger study is feasible and recommended with an expanded nursing intervention and a significantly larger sample recruited from an additional recruitment site. Nurses working with this special population must recognize that parents have information and counseling needs that begin after they receive the diagnosis of ASD for their child and can address these needs with a standardized nursing intervention.
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Strategies for Supporting Inclusive Education for Students with Disabilities
ERIC Educational Resources Information Center
Mumford, Vincent E.; Chandler, Judy Potter
2009-01-01
The Individuals with Disabilities Education Improvement Act (IDEA) of 2004 supports equitable access to educational opportunities for all children who have disabilities. IDEA requires that students who receive services for special needs receive a free appropriate public education, and have access to the general education curriculum, which includes…
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45 CFR 96.74 - Annual reporting requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.74 Annual reporting requirements. (a) Annual report. In accordance with 42 U.S.C... Block Grant, showing separately the number of children and the number of adults who received such...
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Camargo, Maria Beatriz Junqueira; Barros, Aluísio J D; Frazão, Paulo; Matijasevich, Alicia; Santos, Iná S; Peres, Marco Aurélio; Peres, Karen Glazer
2012-02-01
To estimate the prevalence of dental visits among preschool children and determine the factors associated with using dental services. A cross-sectional study was conducted with 1,129 five-year-old children from the Pelotas Birth Cohort Study in Pelotas (Southern Brazil) 2004, from September 2009 to January 2010. Use of dental services at least once in the child's life and the reason for the child's first dental visit were recorded. The categories assigned for the first dental visit were: routine check-up, resolution of a problem, or never saw a dentist. The oral examinations and interviews were performed in the children's homes. Socioeconomic aspects and independent variables related to the mother and child were analyzed using multivariable logistic regression. The prevalence of dental visits (both categories combined) was 37.0%. The main predictors for a routine visit were higher economic status, mothers with more schooling, and mothers who had received guidance about prevention. Major predictors for a visit because of a problem were having felt pain in the previous six months, mothers with higher education level, and mothers who had received guidance about prevention. Approximately 45.0% of mothers received information about how to prevent cavities, usually from the dentist. Children of mothers who adhered to health programs were more likely to have had a routine dental visit. The rate of preschool visits to dental services was lower than the rate for medical appointments (childcare). In addition to income and education, maternal behavior plays an important role in routine visits. Pain reported in the last six months and a high number of teeth affected by tooth decay, independent of other factors, were associated with visits for a specific problem. It is important to integrate oral health instruction into maternal and child health programs.
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Mason, Craig A; Gaffney, Marcus; Green, Denise R; Grosse, Scott D
2008-06-01
To demonstrate the need for standardized data definitions and reporting for early hearing detection and intervention (EHDI) programs collecting information on newborn hearing screening and follow-up, and types of information best collected in a standardized manner. A hypothetical birth cohort was used to show the potential effects of nonstandardized definitions and data classifications on rates of hearing screening, audiologic follow-up, and hearing loss. The true screening rate in this cohort was 92.4%. The calculated rate was between 90.0% and 96.5%, depending on the measure used. Among children documented as screened and referred for follow-up, 61.0% received this testing. Only 49.0% were documented to have been tested. Despite a true prevalence of 3.7 per 1,000 births, only 1.5 per 1,000 children were documented with a hearing loss. Ensuring that children receive recommended follow-up is challenging. Without complete reporting by audiologists to EHDI programs, accurate calculation of performance measures is impossible. Lack of documentation can lead to the overstatement of "loss to follow-up." Also, standardization of measures is essential for programs to evaluate how many children receive recommended services and assess progress toward national goals. A new survey has been implemented to collect more detailed and standardized information about recommended services.
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Service use in children aged 6-8 years with attention deficit hyperactivity disorder.
Efron, Daryl; Moisuc, Olga; McKenzie, Vicki; Sciberras, Emma
2016-02-01
This study investigated prevalence, types and predictors of professional service use in families of children identified with attention deficit hyperactivity disorder (ADHD) in the community. children with ADHD were identified through 43 schools using parent and teacher screening questionnaires (Conners 3 ADHD Index) followed by case confirmation using the Diagnostic Interview Schedule for Children Version IV. Parents completed a survey about professional service use in the last 12 months. data on variables potentially associated with service use were collected from parents (interview and questionnaires), teachers (questionnaires) and children (direct assessment). Logistic regression was used to examine predictors of service use in univariate and multivariable analyses. The sample comprised 179 children aged 6-8 years with ADHD. Over one-third (37%) had not received professional services in the last 12 months. The strongest predictors of service use were older child age (adjusted OR=3.0, 95% CI 1.0 to 8.9, p=0.05), and the degree to which the child's behaviour impacted on the family (adjusted OR=2.0, 95% CI 1.3 to 3.3, p=0.007), after controlling for ADHD subtype and severity, externalising comorbidities, academic achievement and parent-reported impairment. A substantial proportion of children with ADHD are not accessing professional services. Our findings suggest that the child's age and the impact of the child's behaviour on the family are the strongest predictors of service use. Given the demonstrated benefits from various interventions in ADHD, there is a need to improve case identification and referral for services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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ERIC Educational Resources Information Center
Son, Esther
2011-01-01
Peer victimization is a serious social problem that can negatively affect a child's psychosocial development and school adjustment, and may have lasting effects for victims. Previous studies on peer victimization have suggested that children with disabilities (CWD) are likely to be more frequent targets of peer victimization. This longitudinal…
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ERIC Educational Resources Information Center
Barrow, Donna Marie
2017-01-01
Over the past two decades reported rates of autism have steadily risen. The current incidence is 1 in 68 children. While autism can be reliably diagnosed at 18 months in most children with the condition, specialized autism treatment rarely begins before a child's third or fourth birthday. As screening and diagnosis procedures improve so does the…
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Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders
Mandell, David S.; Novak, Maytali M.; Zubritsky, Cynthia D.
2010-01-01
Objective Early diagnosis of children with autism spectrum disorders (ASD) is critical but often delayed until school age. Few studies have identified factors that may delay diagnosis. This study attempted to identify these factors among a community sample of children with ASD. Methods Survey data were collected in Pennsylvania from 969 caregivers of children who had ASD and were younger than 21 years regarding their service experiences. Linear regression was used to identify clinical and demographic characteristics associated with age of diagnosis. Results The average age of diagnosis was 3.1 years for children with autistic disorder, 3.9 years for pervasive developmental disorder not otherwise specified, and 7.2 years for Asperger’s disorder. The average age of diagnosis increased 0.2 years for each year of age. Rural children received a diagnosis 0.4 years later than urban children. Near-poor children received a diagnosis 0.9 years later than those with incomes >100% above the poverty level. Children with severe language deficits received a diagnosis an average of 1.2 years earlier than other children. Hand flapping, toe walking, and sustained odd play were associated with a decrease in the age of diagnosis, whereas oversensitivity to pain and hearing impairment were associated with an increase. Children who had 4 or more primary care physicians before diagnosis received a diagnosis 0.5 years later than other children, whereas those whose pediatricians referred them to a specialist received a diagnosis 0.3 years sooner. Conclusion These findings suggest improvements over time in decreasing the age at which children with ASD, especially higher functioning children, receive a diagnosis. They also suggest a lack of resources in rural areas and for near-poor families and the importance of continuous pediatric care and specialty referrals. That only certain ASD-related behaviors, some of which are not required to satisfy diagnostic criteria, decreased the age of diagnosis suggests the importance of continued physician education. PMID:16322174
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Barnett, Erin R; Cleary, Sarah E; Butcher, Rebecca L; Jankowski, Mary K
2018-05-03
Caring for children in foster or adoptive care with behavioral health needs can severely stress parents, contributing to adverse outcomes for children and families. Trauma-informed services from the child welfare and mental health sectors may help prevent poor outcomes by helping children and parents identify and understand trauma and its impact on children's behavioral health and receive effective treatment. To help understand the role of trauma-informed services for the child welfare population, we examined whether trauma-informed child welfare and mental health services moderated the relationship between children's behavioral health needs and parent satisfaction and commitment. The researchers analyzed data from a cross-sectional statewide survey of foster and adoptive parents (n = 512 respondents, 42% of 1,206 contacted) from one state. Foster (but not adoptive) parent ratings of trauma-informed mental health services significantly moderated the relationship between children's behavioral health needs and foster and adoptive parent satisfaction and commitment. As ratings of trauma-informed mental health services increased, the association between child behavioral health needs and parent satisfaction and commitment became nonsignificant, suggesting a buffering effect. Trauma-informed child welfare services did not moderate the relationship for foster or adoptive parents. Leaders and policymakers are urged to promote trauma-informed mental health services for children involved with child welfare to potentially buffer foster parents against lower parenting satisfaction and commitment. More research is needed to replicate and expand on these findings and to examine the effectiveness of trauma-informed services on other relevant child and family outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Ruddick, Loraine; Davies, Louise; Bacarese-Hamilton, Monique; Oliver, Chris
2015-01-01
Children with severe intellectual disabilities are at increased risk of presenting with self-injurious, aggressive and destructive behaviour. Severity of these behaviours is an important predictor of psychological and behavioural service use by people with intellectual disabilities. However, studies suggest that the needs of children with intellectual disabilities and their families are not being met. The aims of the present study were to: (1) describe the self-injurious, aggressive and destructive behaviours and subsequent support needs of children with severe intellectual disabilities attending special schools in one major city within the UK, (2) compare teacher and primary carer ratings of behaviour and service need and (3) explore the extent to which the needs of children with intellectual disabilities are being met in terms of contact with relevant specialist services. Questionnaires were completed by teachers and primary family carers of children with a severe intellectual disability. Results indicated that at least 5.3% and 4.1% of children showed at least one behaviour at a clinically significant frequency and management difficulty respectively. Primary carers identified more children with significant behaviour difficulties and support needs than teachers. The odds for children presenting with high levels of the behaviours of interest for having a service need for behavioural intervention were at least 13 times those for children not showing the behaviours, yet only doubled for contact with a specialist relevant health-care professional. These results quantify the magnitude of the substantial gap between level of need and relevant support received. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Almasri, Nihad A; An, Mihee; Palisano, Robert J
2017-07-28
Understanding parent perceptions of family-centered care (FCC) is important to improve processes and outcomes of children's services. A systematic review and meta-analysis of research on the Measures of Processes of Care (MPOC-20) were performed to determine the extent parents of children with physical disabilities perceive they received FCC. A comprehensive literature search was conducted using four databases. A total of 129 studies were retrieved; 15 met the criteria for the synthesis. Meta-analysis involving 2,582 mothers and fathers of children with physical disabilities mainly cerebral palsy was conducted for the five scales of the MPOC-20. Aggregated mean ratings varied from 5.0 to 5.5 for Providing Specific Information about the Child; Coordinated and Comprehensive Care; and Respectful and Supportive Care (relational behaviors) and Enabling and Partnership (participatory behaviors) indicating that, on average, parents rated FCC as having been provided to "a fairly great extent." The aggregated mean rating was 4.1 for Providing General Information, indicating FCC was provided "to a moderate extent." Service providers are encouraged to focus on child and family needs for general information. Research is needed to better understand parent perspectives of service provider participatory behaviors which are important for engaging families in intervention processes.
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Otolaryngology Service Usage in Children With Cleft Palate.
Whittemore, Kenneth R; Dargie, Jenna M; Dornan, Briana K; Boudreau, Brian
2018-05-01
To determine the usage of otolaryngology services by children with cleft palate at a pediatric tertiary care facility. Retrospective case series. Specialty clinic at a pediatric tertiary care hospital. Children born between January 1, 1999, and December 31, 2002, with the diagnosis of cleft palate or cleft lip and palate. A total of 41 female and 48 male patients were included. Total number of otolaryngology clinic visits and total number of otolaryngologic surgeries (tympanostomy tube placements and other otologic or upper airway procedures). In the first 5 years of life, these children utilized an average of 8.2 otolaryngology clinic visits (SD = 5.0; range: 1-22) and underwent 3.3 tympanostomy tube surgeries (SD = 2.0; range: 0-10). Seventy-three had their first tube placed at the time of palate repair, and 4 at the time of lip repair. Fifty-one (57.3%) required other otologic or upper airway procedures, including tonsillectomy and/or adenoidectomy (27 children), removal of tympanostomy tubes (24 children), tympanomastoidectomy (3 children), and tympanoplasty (14 children). Of the children who underwent other procedures, they underwent a mean of 1.67 (SD = 0.84; range: 1-4) surgeries. Children with cleft palate are at increased risk for eustachian tube dysfunction, frequently utilize otolaryngology care, and typically receive multiple sets of tympanostomy tubes. This study found that children with cleft palate receive on average of approximately 3 sets of tympanostomy tubes, and the majority required another otologic or upper airway surgery.
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Watkins, Stephanie; Jonsson-Funk, Michele; Brookhart, M Alan; Rosenberg, Steven A; O'Shea, T Michael; Daniels, Julie
2014-05-01
Children born very low birth weight (VLBW) are at an increased risk of delayed development of motor skills. Physical and occupational therapy services may reduce this risk. Among VLBW children, we evaluated whether receipt of physical or occupational therapy services between 9 months and 2 years of age is associated with improved preschool age motor ability. Using data from the Early Childhood Longitudinal Study Birth Cohort we estimated the association between receipt of therapy and the following preschool motor milestones: skipping eight consecutive steps, hopping five times, standing on one leg for 10 seconds, walking backwards six steps on a line, and jumping distance. We used propensity score methods to adjust for differences in baseline characteristics between children who did and did not receive physical or occupational therapy, since children receiving therapy may be at higher risk of impairment. We applied propensity score weights and modeled the estimated effect of therapy on the distance that the child jumped using linear regression. We modeled all other end points using logistic regression. Treated VLBW children were 1.70 times as likely to skip eight steps (RR 1.70, 95 % CI 0.84, 3.44) compared to the untreated group and 30 % more likely to walk six steps backwards (RR 1.30, 95 % CI 0.63, 2.71), although these differences were not statistically significant. We found little effect of therapy on other endpoints. Providing therapy to VLBW children during early childhood may improve select preschool motor skills involving complex motor planning.
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Cross, J Helen; Wait, Suzanne; Arzimanoglou, Alexis; Beghi, Ettore; Bennett, Christine; Lagae, Lieven; Mifsud, Janet; Schmidt, Dieter; Harvey, Gordon
2013-01-01
Objective This paper explores the issues that arise from the discussion of administering rescue medication to children who experience prolonged convulsive seizures in mainstream schools in the UK. Situation analysis Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5 min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally. Recommendations A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan. Implications Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall. PMID:23899921
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Cross, J Helen; Wait, Suzanne; Arzimanoglou, Alexis; Beghi, Ettore; Bennett, Christine; Lagae, Lieven; Mifsud, Janet; Schmidt, Dieter; Harvey, Gordon
2013-10-01
This paper explores the issues that arise from the discussion of administering rescue medication to children who experience prolonged convulsive seizures in mainstream schools in the UK. Current guidelines recommend immediate treatment of children with such seizures (defined as seizures lasting more than 5 min) to prevent progression to status epilepticus and neurological morbidity. As children are unconscious during prolonged convulsive seizures, whether or not they receive their treatment in time depends on the presence of a teacher or other member of staff trained and able to administer rescue medication. However, it is thought that the situation varies between schools and depends mainly on the goodwill and resources available locally. A more systematic response is needed to ensure that children receive rescue medication regardless of where their seizure occurs. Possible ways forward include: greater use of training resources for schools available from epilepsy voluntary sector organisations; consistent, practical information to schools; transparent guidance outlining a clear care pathway from the hospital to the school; and implementation and adherence to each child's individual healthcare plan. Children requiring emergency treatment for prolonged convulsive seizures during school hours test the goals of integrated, person-centred care as well as joined-up working to which the National Health Service (NHS) aspires. As changes to the NHS come into play and local services become reconfigured, every effort should be made to take account of the particular needs of this vulnerable group of children within broader efforts to improve the quality of paediatric epilepsy services overall.
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Ensuring financial access to hearing AIDS for infants and young children.
Limb, Stephanie J; McManus, Margaret A; Fox, Harriette B; White, Karl R; Forsman, Irene
2010-08-01
Many young children with permanent hearing loss do not receive hearing aids and related professional services, in part because of public and private financing limitations. In 2006 the Children's Audiology Financing Workgroup was convened by the National Center for Hearing Assessment and Management to evaluate and make recommendations about public and private financing of hearing aids and related professional services for 0- to 3-year-old children. The workgroup recommended 4 possible strategies for ensuring that all infants and young children with hearing loss have access to appropriate hearing aids and professional services: (1) clarify that the definition of assistive technology, which is a required service under Part C of the Individuals With Disabilities Education Act (IDEA), includes not only analog hearing aids but also digital hearing aids with appropriate features as needed by young children with hearing loss; (2) clarify for both state Medicaid and Children's Health Insurance Programs that digital hearing aids are almost always the medically necessary type of hearing aid required for infants and young children and should be covered under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program; (3) encourage the passage of private health insurance legislative mandates to require coverage of appropriate digital hearing aids and related professional services for infants and young children; and (4) establish hearing-aid loaner programs in every state. The costs of providing hearing aids to all 0- to 3-year old children in the United States are estimated here.
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Transportation. The Neglected Related Service.
ERIC Educational Resources Information Center
Carter, Mary; And Others
This monograph presents a five-module staff training program used to improve the related service of transportation of children with disabilities in Union County, North Carolina. Each module takes from 4 to more than 8 hours of training and bus drivers and transportation safety assistants with current certificates in all five modules receive a…
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Code of Federal Regulations, 2012 CFR
2012-10-01
... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE... receive Federal reimbursement at the 50 percent level for expenditures related to the planning, design...
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Code of Federal Regulations, 2014 CFR
2014-10-01
... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE... receive Federal reimbursement at the 50 percent level for expenditures related to the planning, design...
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Code of Federal Regulations, 2013 CFR
2013-10-01
... Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE... receive Federal reimbursement at the 50 percent level for expenditures related to the planning, design...
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Parent Perceptions of School-Based Occupational Therapy Services
ERIC Educational Resources Information Center
Benson, Jeryl D.; Elkin, Kathleen; Wechsler, Julie; Byrd, Lindsey
2015-01-01
This study aims to explore the perceptions of parents of children receiving occupational therapy in educational settings, understand the importance of the parent/occupational therapist relationship and its impact on the outcomes of therapy. In addition, this study aims to reveal best practices when providing services within the school system in…
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Caregiver Strain and Youth Suicide Attempt: Are They Related?
ERIC Educational Resources Information Center
Barksdale, Crystal L.; Walrath, Christine M.; Compton, Jill S.; Goldston, David B.
2009-01-01
There are scant data documenting the relationship between caregiver strain and suicidal behavior among youth. This study includes data from the caregivers of 1,854 youth who received services through the Comprehensive Community Mental Health Services for Children and Their Families Program. Caregiver strain, family functioning, and youth…
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Categories of Disability under IDEA
ERIC Educational Resources Information Center
National Dissemination Center for Children with Disabilities, 2012
2012-01-01
Every year, under the federal law known as the Individuals with Disabilities Education Act (IDEA), millions of children with disabilities receive special services designed to meet their unique needs. Early intervention services are provided through the state to infants and toddlers with disabilities under three years of age and their families. For…
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Transportation and Children Who Have Disabilities. Alliance Action Information Sheets
ERIC Educational Resources Information Center
Technical Assistance ALLIANCE for Parent Centers, 2007
2007-01-01
The Individuals with Disabilities Education Act (IDEA) includes transportation within its definition of "related services." This means that students with Individualized Education Programs (IEPs) have the right to receive special transportation services if it is needed. Transportation and assistance may be provided to a child whose…
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Collaboration in Early Childhood Intervention Services in Gauteng: Caregiver Perspectives
ERIC Educational Resources Information Center
Kyarkanaye, Thilendree; Dada, Shakila; Samuels, Alecia E.
2017-01-01
A central tenant of early childhood intervention (ECI) is collaboration between professionals and the caregivers of children receiving these services. There are limited studies on caregiver perceptions of collaboration in ECI teams particularly in resource-limited countries. Sixty-four caregivers participated in this study by completing a…
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78 FR 76149 - Proposed Information Collection Activity; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2013-12-16
... services to vulnerable older adults, persons with disabilities, at-risk adolescents and young adults, and... on a standard post-expenditure reporting form. The current form includes a yearly total of adults and... individuals (including number of children and number of adults) who receive services paid for, in whole or in...
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75 FR 65352 - Proposed Information Collection Activity; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-22
... services to vulnerable older adults, persons with disabilities, at-risk adolescents and young adults, and... on a standard post-expenditure reporting form. The current form includes a yearly total of adults and... individuals (including number of children and number of adults) who receive services paid for, in whole or in...
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Mental health screening of preschool children: validity and reliability of ABLE.
Barbarin, Oscar A
2007-07-01
Children with behavioral, emotional or language problems struggle to do well at school often with limited success. ABLE (Attention, Behavior, Language, and Emotions), a new screening tool, was used to estimate the prevalence and the severity of concerns parents and teachers have about children's school adjustment and evaluate their need for services. Data obtained from the parents and teachers of children randomly selected from public Pre-K classrooms in 6 states (N = 415) and from a mental health screening of rural and urban children (N = 5,577) support the validity and reliability of ABLE. Parents identified severe problems in 18.4% of children and Pre-K teachers identified 10.5%. By kindergarten, the proportion of children identified by their teachers with serious problems more than doubled to 23%. Inattention/overactivity and behavior problems were identified most often. These children were 3.4 times more likely to be certified later for special education services by kindergarten than children not identified with problems by ABLE. However, fewer than 14% of children in public Pre-K identified with serious problems in Pre-K had received mental health services by the end of Kindergarten. ((c) 2007 APA, all rights reserved).
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Ascertaining educational outcomes after assessment in children with learning disorders.
Waber, Deborah P; Boiselle, Ellen C; Girard, Jonathan M; Amaral, Joseph L; Forbes, Peter W
2017-01-01
To survey educational outcomes after an interdisciplinary, neuropsychologically based team assessment for learning disorders. Parents of 137 children who underwent a comprehensive interdisciplinary neuropsychologically based assessment for learning problems completed an online survey one to four years later. Questions pertained broadly to school outcomes: positive or negative school responses, changes in special education services, and parental perceptions about the helpfulness of those services. These outcomes were examined in relation to demographic characteristics and parent satisfaction with the evaluation. We also obtained recent performance on state-based academic testing for descriptive purposes. Parents reported that schools generally responded positively (78%), and 70% reported that their children had access to more or different special education services after the evaluation. Parents nearly uniformly (98%) viewed these services as helpful. Positive changes in education services were related to income (lower income received more services, p < .05) and parent satisfaction with the evaluation (p < .05). The intensity of special education services was strongly related to performance on state-based testing (p < .0001-p < .01). School response is a relatively objective and meaningful metric of educational outcome after neuropsychologically based evaluation for children with learning problems.
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The impact of autism services on mothers' psychological wellbeing.
Hodgetts, S; McConnell, D; Zwaigenbaum, L; Nicholas, D
2017-01-01
Families with a child diagnosed with autism spectrum disorder (ASD) often utilize a variety of professional services. The provision of these services has many potential benefits for families; however, these services also place demands on parents, particularly mothers, to access, navigate and participate. Little is known about how involvement with these services and service systems influences the psychological wellbeing of mothers of children diagnosed with ASD. We examined the relationship between professional services and psychological wellbeing for mothers of children diagnosed with ASD. Mothers (n = 119) of children (mean child age 10.1 years; range 2-24 years) diagnosed with ASD anonymously completed a comprehensive survey. The survey included data related to maternal psychological wellbeing, professional services received and perceptions of these services, and child, mother and household characteristics. Regression analyses revealed that maternal psychological wellbeing was positively associated with the perceived continuity of services, and negatively associated with the number of professionals involved. Child and maternal age, and household income were also statistically significant predictors of maternal psychological wellbeing. The study findings draw attention to the potentially negative impact of systems-level challenges, especially fragmentation of services, on maternal psychological wellbeing, despite positive front-line services. In particular, our data suggest that psychological wellbeing among mothers of children with ASD may vary more as a function of service system variables than practitioner-level or child-level variables. © 2016 John Wiley & Sons Ltd.
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Missed opportunities: mental disorder in children of parents with depression
Potter, Robert; Mars, Becky; Eyre, Olga; Legge, Sophie; Ford, Tamsin; Sellers, Ruth; Craddock, Nicholas; Rice, Frances; Collishaw, Stephan; Thapar, Anita; Thapar, Ajay K
2012-01-01
Background Emerging evidence suggests that early intervention and prevention programmes for mental health problems in the offspring of parents with depression are important. Such programmes are difficult to implement if children with psychiatric disorder are not identified and are not accessing services, even if their parents are known to primary care. Aim To investigate service use in children of parents who have recurrent depression, and factors that influence such contact. Design and setting A total of 333 families were recruited, mainly through primary health care, in which at least one parent had received treatment for recurrent depression and had a child aged 9–17 years. Method Psychiatric assessments of parents and children were completed using research diagnostic interviews. The service-use interview recorded current (in the 3 months prior to interview) and lifetime contact with health, educational, and social services due to concerns about the child’s emotions or behaviour. Results Only 37% of children who met criteria for psychiatric disorder were in contact with any service at the time of interview. A third, who were suicidal or self-harming and had a psychiatric disorder at that time, were not in contact with any service. Lack of parental worry predicted lower service use, with higher rates in children with comorbidity and suicidality. Conclusion Most children with a psychiatric disorder in this high-risk sample were not in contact with services. Improving ease of access to services, increasing parental and professional awareness that mental health problems can cluster in families, and improving links between adult and child services may help early detection and intervention strategies for the offspring of parents with depression. PMID:22781997
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ERIC Educational Resources Information Center
Self, Trisha L.; Mitchell, Linda M.; Hess, Sean; Marble, Karissa J.; Swails, Jeffrey
2017-01-01
Upon entering the workplace, speech-language pathologists (SLPs) are required to work on interprofessional teams, yet many of these professionals have not received adequate preservice instruction on how to collaborate. Furthermore, collaborating to provide services for children with autism spectrum disorder (ASD) has been found to improve…
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Workforce strategies to improve children's oral health.
Goodwin, Kristine
2014-12-01
(1) Tooth decay is the most common chronic disease for children. (2) As millions receive dental coverage under the Affordable Care Act, the demand for dental services is expected to strain the current workforce's ability to meet their needs. (3) States have adopted various workforce approaches to improve access to dental care for underserved populations.
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An Overview of Transition Planning for Students Who Are Deafblind
ERIC Educational Resources Information Center
Zatta, Mary; McGinnity, Betsy
2016-01-01
Children who are deafblind are one of the lowest-incidence yet most diverse groups receiving services mandated by the Individuals With Disabilities Education Improvement Act. Despite this population's diversity, the development of communication skills is critical for all children who are deafblind, and is the foundation on which good transition…
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Early Childhood Intervention in China from the Families' Perspective
ERIC Educational Resources Information Center
Zheng, Yuzhu; Maude, Susan P.; Brotherson, Mary Jane; Merritts, Ashley
2016-01-01
Research highlights the importance of early childhood intervention (ECI) for children with disabilities, and there is an increasing interest in China with respect to research on ECI. However, little research exists exploring the experience of families of young children with disabilities receiving ECI services and supports in China. The purpose of…
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Too Many Pieces: A Study of Teacher Fragmentation in the Elementary School.
ERIC Educational Resources Information Center
Klugman, Edgar; And Others
Fragmentation of elementary school teachers' time and attention is an almost universal problem. Frequent coming and going of children to and from the classroom for legitimate purposes disrupts and distracts the teacher and other students. Children receiving special education services frequently leave the classroom for half-hour periods, thus…
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42 CFR 436.1101 - Definitions related to presumptive eligibility period for children.
Code of Federal Regulations, 2011 CFR
2011-10-01
... child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under section 17 of the...
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42 CFR 436.1101 - Definitions related to presumptive eligibility period for children.
Code of Federal Regulations, 2013 CFR
2013-10-01
... child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under section 17 of the...
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42 CFR 436.1101 - Definitions related to presumptive eligibility period for children.
Code of Federal Regulations, 2014 CFR
2014-10-01
... child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under section 17 of the...
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42 CFR 436.1101 - Definitions related to presumptive eligibility period for children.
Code of Federal Regulations, 2012 CFR
2012-10-01
... child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under section 17 of the...
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42 CFR 436.1101 - Definitions related to presumptive eligibility period for children.
Code of Federal Regulations, 2010 CFR
2010-10-01
... child care services for which financial assistance is provided under the Child Care and Development Block Grant Act of 1990; (4) Is authorized to determine eligibility of an infant or child to receive assistance under the special nutrition program for women, infants, and children (WIC) under section 17 of the...
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Alternative Pathways in Family Child Care Quality Rating and Improvement Systems
ERIC Educational Resources Information Center
Kelton, Robyn E.; Talan, Teri N.; Bloom, Paula J.
2013-01-01
As research continues to underscore the positive impact high-quality early childhood programs have on young children, numerous states have implemented quality rating and improvement systems (QRIS) to measure and improve the services young children receive across a wide range of early learning settings. These state systems range from two to five…
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Federal support for state and local response operations - PHE
Electronic Benefits Transfer program, which provides summertime nutrition assistance to children who receive 15, a USDA Food and Nutrition Service nutritionist presented USDA nutrition information and menu Nutrition Program for Women, Infants, and Children (WIC) funds to conduct lead testing for WIC participants
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ERIC Educational Resources Information Center
Hunter, William C.; Elswick, Susan E.; Perkins, J. Helen; Heroux, JoDell R.; Harte, Helene
2017-01-01
Parents and family members play an essential role in the literacy development of their children. Research indicates that children with disabilities enrolled in early childhood programs are likely to experience marginalization in terms of receiving educational services. This research emphasizes the importance of exposing students with disabilities…
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Key Workers and Schools: Meeting the Needs of Children and Young People with Disabilities
ERIC Educational Resources Information Center
Webb, Rosemary; Greco, Veronica; Sloper, Patricia; Beecham, Jennifer
2008-01-01
Across the world countries are advocating the education of children and young people with disabilities in mainstream schools. There is also increasing interest in developing effective coordination of the specialist services pupils with disabilities receive from different agencies. This is accompanied by growing recognition that such care…
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Working with Teachers to Promote Children's Participation through Pupil-Led Research
ERIC Educational Resources Information Center
Burton, Debbie; Smith, Margaret; Woods, Kevin
2010-01-01
Enabling children and young people to act as researchers is increasingly viewed as useful in supporting their increased "participation" within settings where they live, work or receive services. This paper reports upon a project conducted by two educational psychologists (EPs) with two primary school class groups, in which the children…
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Case-Smith, J
2000-01-01
This study examined how performance components and variables in intervention influenced fine motor and functional outcomes in preschool children. In a sample of 44 preschool-aged children with fine motor delays who received occupational therapy services, eight fine motor and functional performance assessments were administered at the beginning and end of the academic year. Data on the format and intervention activities of each occupational therapy session were recorded for 8 months. The children received a mean of 23 sessions, in both individual and group format. Most of the sessions (81%) used fine motor activities; 29% addressed peer interaction, and 16% addressed play skills. Visual motor outcomes were influenced by the number of intervention sessions and percent of sessions with play goals. Fine motor outcomes were most influenced by the therapists' emphasis on play and peer interaction goals; functional outcomes were influenced by number of sessions and percent of sessions that specifically addressed self-care goals. The influence of play on therapy outcomes suggests that a focus on play in intervention activities can enhance fine motor and visual motor performance.
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Mitchell, Jean M; Gaskin, Darrell J
2008-10-01
Although not widely recognized, tooth decay is the most common childhood chronic disease among children ages five to seventeen. Despite higher rates of dental caries and greater needs, low-income minority children enrolled in Medicaid are more likely to go untreated relative to their higher income counterparts. No research has examined this issue for children with special needs. We analyzed Medicaid enrollment and claims data for special-needs children enrolled in the District of Columbia Medicaid program to evaluate receipt of recommended preventive dental care. Use of preventive dental care is abysmally low and has declined over time. Enrollment in managed care rather than fee for service improves the likelihood that special-needs children receive recommended preventive dental services, whereas residing farther from the Metro is an impediment to receipt of dental care.
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Feasibility of shelter-based mental health screening for homeless children.
Lynch, Sean; Wood, Julia; Livingood, William; Smotherman, Carmen; Goldhagen, Jeffrey; Wood, David
2015-01-01
Homeless children are known to be at risk for mental health and behavioral disorders due to housing instability and family and environmental risk factors, such as domestic violence. However, homeless children seldom receive screening for mental health and behavioral disorders with validated instruments. Moreover, few examples exist of programs that integrate outreach, screening, referral to appropriate diagnostic and therapeutic services, and care coordination. We describe early results of the Medical Home for Homeless Children Project, whose nurse care coordinators work with homeless families to conduct standardized nursing assessments that include evidence-based screening for child mental health and behavioral disorders with referral and case management for mental and behavioral health services. Screening identified a group of children with mental health issues that warranted referral, and many of those referrals were successfully completed.
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Bray, Nathan; Yeo, Seow Tien; Noyes, Jane; Harris, Nigel; Edwards, Rhiannon Tudor
2016-01-01
Approximately 95 million children worldwide are disabled; 10 % use a wheelchair. In the UK, an estimated 770,000 children are disabled. National Health Service Wheelchair Services are the largest provider of wheelchairs in the UK; however, recent reports have highlighted issues with these services. This study explores the use of discrete choice experiment methods to inform wheelchair service provision for disabled children based on service user preferences. The aim was to explore how disabled children and their parents prioritise different attributes of wheelchair services. The secondary aims were to compare priorities between parents and disabled children and to explore marginal rate of substitution for incremental changes in attributes. Discrete choice experiments are a method of attribute-based stated preference valuation used by health economists to understand how individuals prioritise different attributes of healthcare services and treatments. We conducted the first pilot discrete choice experiment to explore how disabled children (aged 11 to 18) and their parents prioritise different attributes of hypothetical wheelchair services. Eleven disabled children (aged 11 to 18) and 30 parents of disabled children completed eight pairwise choice tasks based on five service attributes: wheelchair assessment, cost contribution, training, delivery time and frequency of review. Data were analysed using conditional logistic regression. For each pairwise choice, the participants were asked to choose which service scenario (A or B) they preferred. Comprehensiveness of wheelchair assessment and wheelchair delivery time significantly ( P < 0.05) affected service preferences of children ( β -coefficients = 1.43 [95 % bootstrapped CI = 1.42 to 2.08] and -0.92 [95 % bootstrapped CI = -1.41 to -0.84], respectively) and parents ( β -coefficients = 1.53 [95 % bootstrapped CI = 1.45 to 2.16] and -1.37 [95 % bootstrapped CI = -1.99 to -1.31], respectively). Parents were willing to contribute more financially to receive preferred services, although this was non-significant. Both samples placed the greatest importance on holistic wheelchair assessments encompassing more than health. The National Health Service should consider using discrete choice experiment methods to examine wheelchair service preferences of disabled children (aged 11 and over) and their parents on a wider scale; however, care must be taken to ensure that this method is used appropriately.
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Marks, David J; Mlodnicka, Agnieszka; Bernstein, Melissa; Chacko, Anil; Rose, Scott; Halperin, Jeffrey M
2009-07-01
To examine whether preschool children with Attention deficit/hyperactivity disorder (ADHD) utilize more speech and language therapy (ST), occupational therapy (OT), and physical therapy (PT) services and are more likely to be placed in special education (SPED) classrooms as compared to their peers. Corresponding financial consequences were also examined. The amount of ST, OT, and PT, as well as SPED placements, was examined in 3- and 4-year-old children with and without ADHD (n = 109 and n = 97, respectively) during the baseline portion of an ongoing, 5-year longitudinal study. Costs for individual services and aggregate cost were determined per child and compared across groups. Preschool children with ADHD were more likely to receive individual and multiple services. Higher rates of service utilization translated into increased costs for each individual service with the exception of PT. A comprehensive understanding of service utilization in the early years of development is important in addressing the increased service use in the preschool years and assist in guiding allocation of resources.
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Childhood Placement in Special Education and Adult Well-Being
Chesmore, Ashley A.; Ou, Suh-Ruu; Reynolds, Arthur J.
2015-01-01
The present study investigates the relationship between childhood placement in special education and adult well-being among 1,377 low-income, minority children participating in the Chicago Longitudinal Study. Roughly 16% of the sample received special education services in grades 1-8. After accounting for sociodemographic factors and early academic achievement, children receiving special education services tended to have lower rates of high school completion and fewer years of education, as well as greater rates of incarceration, substance misuse, and depression. Eighth grade academic achievement significantly mediated the association between childhood placement in special education and adult well-being outcomes. The study contributes to the literature by providing support for a pathway from childhood special education placement to adult outcomes among an inner-city minority cohort. PMID:27429477
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Predictors of Access to Sex Education for Children with Intellectual Disabilities in Public Schools
ERIC Educational Resources Information Center
Barnard-Brak, Lucy; Schmidt, Marcelo; Chesnut, Steven; Wei, Tianlan; Richman, David
2014-01-01
Data from the National Longitudinal Transition Study-2 (SRI International, 2002) were analyzed to identify variables that predicted whether individuals with intellectual disability (ID) received sex education in public schools across the United States. Results suggested that individuals receiving special education services without ID were only…
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The Modification of Intelligence through Early Experience.
ERIC Educational Resources Information Center
Ramey, Craig T.; Haskins, Ron
Infants judged to be at risk for subnormal intellectual growth were randomly assigned to an experimental (N=27) or a control (N=25) group. Infants in both groups received medical care and dietary supplements; their families received social work services on a request basis. Experimental children participated in an educational day care program…
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Women with Osteoporosis: The Role of the Family and Service Community.
ERIC Educational Resources Information Center
Roberto, Karen A.
1988-01-01
Studied women (N=115) with osteoporosis who reported their major problems to be pain and their inability to do housework. Results showed most viewed their family as being supportive, reporting they frequently received help from their children. Those with lower incomes and specific fractures reported receiving the most help. (Author/ABL)
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A Propensity Score Matching Analysis of the Effects of Special Education Services
Morgan, Paul L.; Frisco, Michelle; Farkas, George; Hibel, Jacob
2013-01-01
We sought to quantify the effectiveness of special education services as naturally delivered in U.S. schools. Specifically, we examined whether children receiving special education services displayed (a) greater reading or mathematics skills, (b) more frequent learning-related behaviors, or (c) less frequent externalizing or internalizing problem behaviors than closely matched peers not receiving such services. To do so, we used propensity score matching techniques to analyze data from the Early Childhood Longitudinal—Study Kindergarten Cohort, 1998–1999, a large scale, nationally representative sample of U.S. schoolchildren. Collectively, results indicate that receipt of special education services has either a negative or statistically non-significant impact on children’s learning or behavior. However, special education services do yield a small, positive effect on children’s learning-related behaviors. PMID:23606759
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Correlates of physician visits among older adults in China: the effects of family support.
Li, Yawen; Chi, Iris
2011-09-01
We examined how family support influenced the use of health services among older Chinese adults. Data came from a national representative survey including 20,255 respondents aged 60 and older. The dependent variable was the number of physician visits in the past 12 months. Family support variables include living arrangement, family size, financial support, instrumental support, and filial piety. Providing or receiving financial support increased the likelihood as well as number of physician visits. By contrast, living with children and regarding children as filial decreased physician visits. Financial sufficiency as indicated by the exchange of financial resources within families indicates the importance of money in predicting older adults' physician visits. Living with children may indicate a higher level of support, which substitutes some of physician services. Perceiving children as being filial may render psychological protective effects to older adults which results in less health service use.
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The Individuals With Disabilities Education Act (IDEA) for Children With Special Educational Needs.
Lipkin, Paul H; Okamoto, Jeffrey
2015-12-01
The pediatric health care provider has a critical role in supporting the health and well-being of children and adolescents in all settings, including early intervention (EI), preschool, and school environments. It is estimated that 15% of children in the United States have a disability. The Individuals with Disabilities Education Act entitles every affected child in the United States from infancy to young adulthood to a free appropriate public education through EI and special education services. These services bolster development and learning of children with various disabilities. This clinical report provides the pediatric health care provider with a summary of key components of the most recent version of this law. Guidance is also provided to ensure that every child in need receives the EI and special education services to which he or she is entitled. Copyright © 2015 by the American Academy of Pediatrics.
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Kayama, Misa
2010-04-01
Cultural beliefs about disability and related systems of special education affect the experience of children with disabilities and their parents. This article reviews research on the perceptions and experiences of parents who have preschool or elementary school-age children with disabilities in the United States and Japan. Parents' experiences affect their children's development--for example, through caregiving and advocacy for appropriate services. Existing research suggests that U.S. and Japanese parents report similar difficulties, including difficulties establishing relationships with professionals providing services for their children, but that they have different expectations regarding these relationships. Japanese parents are more likely to emphasize the importance of emotional connections, such as empathy, with professionals and to express feelings of stigma, whereas U.S. parents are more likely to assert that their children are entitled to receive appropriate educational resources. These experiences reflect structural differences in U.S. and Japanese special education services. Parents' perceptions also have the potential to recreate cultural beliefs and eventually modify service delivery systems to reflect those beliefs. Discussion of U.S. and Japanese concepts of disability suggests ways in which services in both countries may be strengthened. The Japanese case suggests ways of strengthening empathy and trust, and the U.S. case provides a positive model of inclusion.
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Pilot statewide study of pediatric emergency department alignment with national guidelines.
Costich, Julia F; Fallat, Mary E; Scaggs, C Morgan; Bartlett, Richard
2013-07-01
The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nursing Association have developed consensus guidelines for pediatric emergency department policies, procedures, supplies, and equipment. Kentucky received funding from the Health Resources and Services Administration through the Emergency Medical Services for Children program to pilot test the guidelines with the state's hospitals. In addition to providing baseline data regarding institutional alignment with the guidelines, the survey supported development of grant funding to procure missing items. Survey administration was undertaken by staff and members of the Kentucky Board of Emergency Medical Services Emergency Medical Services for Children work group and faculty and staff of the University of Kentucky College of Public Health and the University of Louisville School of Medicine. Responses were solicited primarily online with repeated reminders and offers of assistance. Seventy respondents completed the survey section on supplies and equipment either online or by fax. Results identified items unavailable at 20% or more of responding facilities, primarily the smallest sizes of equipment. The survey section addressing policy and procedure received only 16 responses. Kentucky facilities were reasonably well equipped by national standards, but rural facilities and small hospitals did not stock the smallest equipment sizes because of low reported volume of pediatric emergency department cases. Thus, a centralized procurement process that gives them access to an adequate range of pediatric supplies and equipment would support capacity building for the care of children across the entire state. Grant proposals were received from 28 facilities in the first 3 months of funding availability.
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Research utilization among children's mental health providers.
Barwick, Melanie A; Boydell, Katherine M; Stasiulis, Elaine; Ferguson, H Bruce; Blase, Karen; Fixsen, Dean
2008-04-09
Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use - access, assess, adapt, and apply - research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.
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McManus, Beth Marie; Robert, Stephanie; Albanese, Aggie; Sadek-Badawi, Mona; Palta, Mari
2013-07-11
The Individuals with Disabilities Education Act (Part C) authorizes states to establish systems to provide early intervention services (e.g., therapy) for children at risk, with the incentive of federal financial support. This study examines family and neighborhood characteristics associated with currently utilizing physical, occupational, or speech therapy among very low birthweight (VLBW) 2-year-old children who meet Wisconsin eligibility requirements for early intervention services (EI) due to developmental delay. This cross-sectional analysis used data from the Newborn Lung Project, a regional cohort study of VLBW infants hospitalized in Wisconsin's newborn intensive care units during 2003-2004. We included the 176 children who were age two at follow-up, and met Wisconsin state eligibility requirements for EI based on developmental delay. Exact logistic regression was used to describe child and neighborhood socio-demographic correlates of parent-reported receipt of therapy. Among VLBW children with developmental delay, currently utilizing therapy was higher among children with Medicaid (aOR = 5.3, 95% CI: 1.3, 28.3) and concomitant developmental disability (aOR = 5.2, 95% CI: 2.1, 13.3) and lower for those living in a socially more disadvantaged neighborhood (aOR=0.48, 95% CI: 0.21, 0.98, per tertile). Among a sample of VLBW 2-year olds with developmental delays who are EI-eligible in WI, 4 out of 5 were currently receiving therapy, per parent report. Participation in Medicaid positively influences therapy utilization. Children with developmental difficulties who live in socially disadvantaged neighborhoods are at highest risk for not receiving therapy.
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Prescription of Psychiatric Medications and Polypharmacy in the LAMS Cohort
Kowatch, Robert A.; Youngstrom, Eric A.; Horwitz, Sarah; Demeter, Christine; Fristad, Mary A.; Birmaher, Boris; Axelson, David; Ryan, Neal; Frazier, Thomas W.; Arnold, L. Eugene; Young, Andrea S.; Gill, MaryKay; Findling, Robert L.
2014-01-01
Objective This study evaluated demographic and clinical correlates and predictors of polypharmacy at baseline assessment in the Longitudinal Assessment of Manic Symptoms (LAMS) sample, a cohort of children age six to 12 years at their first outpatient mental health visit at university-affiliated clinics. Methods Use of medications in four classes (mood stabilizers, antidepressants, antipsychotics, and stimulants) was assessed, and the Service Assessment for Children and Adolescents classified lifetime and current use of various services. Analyses examined correlates of the number of medications prescribed and odds of polypharmacy, defined as use of two or more concurrent medications. Results In the total sample, 201 of 698 participants (29%) were prescribed two or more medications. These participants had lower Children's Global Assessment Scale scores, more comorbid disorders, and higher baseline parent-reported mood symptoms than those prescribed no or one medication. White youths were three times as likely as nonwhite youths to be receiving two or more psychotropics, even after adjustment for other demographic and clinical characteristics. Of 262 participants (38% of sample) not being treated with medications, 252 (96%) had a diagnosis of at least one psychiatric disorder (74% had two or more). Conclusions Findings suggest that patients with greater severity and comorbidity were more likely to receive two or more medications. However, 38% of these children with serious disorders were not receiving psychotropic medication at the time of this assessment. Results counter findings suggesting overtreatment with medications of children with psychiatric disorders in the community. PMID:23852186
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The Workforce Shortage of Child and Adolescent Psychiatrists: Is It Time for a Different Approach?
Findling, Robert L; Stepanova, Ekaterina
2018-05-01
Psychiatric disorders affect a large number of children around the world. Recent data have reported that approximately 10% to 13% of children have a serious emotional disturbance with significant functional impairment, suggesting that at least 1 in 10 children require mental health services. 1,2 Approximately half the adults with mental illness received their diagnosis before 15 years of age 3 and close to three fourths of mental health disorders start by the mid-20s. 4 Mental illnesses are associated with a large disease burden because these conditions lead to increases in morbidity, mortality, and financial costs. For example, in high-income countries such as the United States, 3 of the leading illnesses associated with pediatric disease burden are psychiatric (depression, bipolar disorder, and schizophrenia) and psychiatric illness in children and adolescents is a key risk factor for completed suicide. 5 In the United States, suicide is the second leading cause of death in people 15 to 24 years of age, 6 with rural areas having particularly high suicide rates. 7 What is even more disconcerting is the fact that most youngsters who might benefit from psychiatric or behavioral health treatment do not receive it. For example, only 45% of adolescents with mental illness received psychiatric services in 2013. This number is even smaller for children and adolescents with internalizing disorders and for minorities. 8 . Copyright © 2018 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
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Toppelberg, Claudio O; Hollinshead, Marisa O; Collins, Brian A; Nieto-Castañon, Alfonso
2013-06-01
The aim of the study is to examine the rates of mental health service utilization in young Latino children of immigrants in relation to maternal and teacher reports of child mental health need. Specific knowledge is lacking about gaps in service utilization among young Latino children, the fastest growing and possibly the most underserved segment of the US child population. The associations of mental health service utilization (Service Assessment for Children and Adolescents) and mental health need (clinical levels of internalizing, externalizing, or total problems reported by mothers [Child Behavior Checklist] and teachers [Teacher's Report Form]) were examined in a community sample of young Latino children of immigrants ( n = 228; mean age = 6) and compared across mothers' and teachers' responses. Mother-teacher agreement was also studied. Sixty-five children (28.5 %) had a mental health need; most (76.9 %) of these received no services. For all types of mental health need, service utilization was more likely when need was reported by mothers rather than teachers ( p = .03). Teachers' reports were not associated with service utilization. Mother-teacher agreement was low for externalizing ( r = .23; p ≤ 0.01) and total problems ( r = .21; p ≤ 0.05), and nonsignificant for internalizing problems. This study is the first in the United States to document, in such a young Latino group, high rates of unmet need comparable to those among older Latino youth; low or no mother-teacher agreement on which children had a mental health need; low utilization of school-based services; and a lack of association between service utilization and teacher-reported mental health need-both for externalizing and internalizing problems. These findings suggest that schools are not effectively leveraging mental health services for young Latino children. Potential factors responsible for the findings are discussed.
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Barriers to dental care for children in Virginia with autism spectrum disorders.
Brickhouse, Tegwyn H; Farrington, Frank H; Best, Al M; Ellsworth, Chad W
2009-01-01
The purposes of this study were to examine the reported use of dental services for families of children with autistic spectrum disorders and identify barriers that affect their access to dental care. Participants were caregivers of at least 1 child with an autism spectrum disorder. Caregivers completed a questionnaire that assessed access and barriers to dental services. Descriptive, bivariate, and multivariate regression analyses were conducted to examine dental care access issues in relation to individual factors. Each respondent's household income and child's history of difficult behavior in the dental office were significantly related to the ability to receive care when needed and whether the child had a regular dental provider. An inability to find a dentist with the skills or willingness to work with people with disabilities was the most frequent reason cited for not having a regular dental provider. Children with autism spectrum disorders who display difficult behavior are less likely to have a dentist for routine car, have longer intervals between dental appointments, and receive care when needed.
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Therapy service use among individuals with fragile X syndrome: findings from a US parent survey.
Martin, G E; Ausderau, K K; Raspa, M; Bishop, E; Mallya, U; Bailey, D B
2013-09-01
Fragile X syndrome (FXS) is known to be associated with a range of developmental challenges, yet the occurrence and intensity of therapy services along with associated factors have not been determined. In a US national survey, caregivers provided information regarding the therapy services received by their sons (n = 1013) and daughters (n = 283) with FXS (from birth to 63 years; mean = 15.6 years, SD = 10.6). Caregivers reported (1) type, (2) amount, (3) location, and (4) overall satisfaction with services. Associations with other child variables and family income were also examined. Key findings included that 72% of males and 47% of females were currently receiving at least one type of therapy service; the most common services for both males and females were speech-language therapy (ST) and occupational therapy (OT). Overall, males were more likely to receive therapy services as well as a greater number of services than females. Autism status was significantly associated with both males and females receiving ST and males receiving OT and behaviour management therapy. Therapies were provided in a variety of locations, and parents were generally satisfied with the amount and quality of therapy services. Age-related declines were evident in the use of services for both males and females, with very few individuals receiving any therapy services after 20 years of age. This study provides a baseline description of the current state of therapy services for children with FXS, laying a foundation for future research and recommendations for service provision and policy. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.
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Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew
2018-06-01
The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P < .02) correlated with the gap in home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.
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ERIC Educational Resources Information Center
Steffenberg, Mary L.
A Food Service Laboratory Project was initiated at a junior high school for the training, participation, and observation of educable mentally retarded (EMR) students. Thirty EMRs participated in the vocational training program, the academic portion of which was work-oriented and closely related to the work in the Food Service Laboratory. Students,…
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Sartori, Ana Lucia; Minamisava, Ruth; Afonso, Eliane Terezinha; Policena, Gabriela Moreira; Pessoni, Grécia Carolina; Bierrenbach, Ana Luiza; Andrade, Ana Lucia
2017-02-15
Vaccination coverage is the usual metrics to evaluate the immunization programs performance. For the 10-valent pneumococcal conjugate (PCV10) vaccine, measuring the delay of vaccination is also important, particularly as younger children are at increased risk of disease. Routinely collected administrative data was used to assess the timeliness of PCV10 vaccination, and the factors associated with delay to receive the first and second doses, and the completion of the PCV10 3+1 schedule. A population-based retrospective cohort study was conducted with children born in 2012 in Central Brazil. Children who received the PCV10 first dose in public health services were followed-up until 23months of age. Timeliness of receiving each PCV10 dose at any given age was defined as receiving the dose within 28days grace period from the recommended age by the National Immunization Program. Log-binomial regression models were used to examine risk factors for delays of the first dose and the completion PCV10 3+1 schedule. In total, 14,282 children were included in the cohort of study. Delayed vaccination occurred in 9.4%, 23.8%, 36.8% and 39.9% children for the first, second, third and the booster doses, respectively. A total of 1912 children (12.8% of the cohort) were not adequately vaccinated at the 6months of life; 1,071 (7%) received the second dose after 6months of age, 784 (5.4%) did not receive the second dose, and 57 (0.4%) received the first dose after six months of life. A considerable delay was found in PCV10 third and booster doses. Almost 2 thousand children had not received the recommended PCV10 doses at 6months of age. Timeliness of vaccination is an issue in Brazil although high vaccination coverages. Copyright © 2017 Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
McMullen, Mary Benson; Lash, Martha
2012-01-01
University early childhood programs attempt to balance a traditional tri-part mission: service to children and families; professional development of caregivers/teachers, clinicians, and researchers; and research on child development, learning, and/or education. Increasingly, infants receive care and education on university campuses, yet little is…
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Transdisciplinary Model and Early Intervention: Building Collaborative Relationships
ERIC Educational Resources Information Center
Boyer, Valerie E.; Thompson, Stacy D.
2014-01-01
The National Early Childhood Technical Assistance Center (NECTAC) reported 348,604 children received services in the United States under Part C of the Individuals With Disabilities Education Act (IDEA) in 2009, representing 2.7% of the population (NECTAC, 2012). Early Intervention (EI), or Part C, is designed to provide services to families of…
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7 CFR 225.6 - State agency responsibilities.
Code of Federal Regulations, 2013 CFR
2013-01-01
... AGRICULTURE CHILD NUTRITION PROGRAMS SUMMER FOOD SERVICE PROGRAM State Agency Provisions § 225.6 State agency... assistance under this Act or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.), whether received... proposes to provide a food service for the children of migrant workers; a failure to do so would deny the...
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7 CFR 225.6 - State agency responsibilities.
Code of Federal Regulations, 2012 CFR
2012-01-01
... AGRICULTURE CHILD NUTRITION PROGRAMS SUMMER FOOD SERVICE PROGRAM State Agency Provisions § 225.6 State agency... assistance under this Act or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.), whether received... proposes to provide a food service for the children of migrant workers; a failure to do so would deny the...
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7 CFR 225.6 - State agency responsibilities.
Code of Federal Regulations, 2014 CFR
2014-01-01
... AGRICULTURE CHILD NUTRITION PROGRAMS SUMMER FOOD SERVICE PROGRAM State Agency Provisions § 225.6 State agency... assistance under this Act or the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.), whether received... proposes to provide a food service for the children of migrant workers; a failure to do so would deny the...
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The Feasibility of Virtual Home Visits to Provide Early Intervention: A Pilot Study
ERIC Educational Resources Information Center
Kelso, Ginger L.; Fiechtl, Barbara J.; Olsen, Susan T.; Rule, Sarah
2009-01-01
Although videoconferencing has been used to deliver distance education, tutoring for children, and telemedicine observations, there is limited information on the efficacy of its use in delivering part C early intervention services. Four families receiving early intervention services in a rural program participated in a pilot study to test the…
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Yoga as a School-Based Mental Health Intervention
ERIC Educational Resources Information Center
Hubbard, Alexandra
2017-01-01
Research has estimated that the percentage of children and adolescents experiencing significant mental health difficulties is as high as 20% of all youth, and that only one-fourth of these students receive therapeutic services outside of school. Given this gap between the need and availability of mental health services, schools often become the…
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Provision of Early Intervention: A Case Study of One Canadian Province
ERIC Educational Resources Information Center
Kienapple, Kim; Lyon, Mary; McSorley, Adele
2007-01-01
In Nova Scotia as in much of Canada, early intervention service providers for young children with special needs are predominantly independent non-profit organizations which, although subject to government regulation, may or may nor receive government financial support. Basic information about who provides and uses services, the types of services…
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Family Quality of Life of South African Families Raising Children with Autism Spectrum Disorder
ERIC Educational Resources Information Center
Schlebusch, Liezl; Dada, Shakila; Samuels, Alecia E.
2017-01-01
This article describes the family quality of life among families who are raising a young child with autism spectrum disorder. Survey research was conducted with 180 families of children with autism spectrum disorder who were receiving disability-related services in the Gauteng province of South Africa. The principle measure used was the Beach…
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ERIC Educational Resources Information Center
Cholewicki, Judith Marie
2015-01-01
With the rapid increase in the rate of children diagnosed with Autism Spectrum Disorder (ASD), there has been a surge in treatment interventions and outcome measures. Treatment interventions consist of evidence-based practices and programs that lack scientific validation. Parents' selection of a treatment or multiple treatments is often based on…
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ERIC Educational Resources Information Center
Greenwood, Charles R.; Carta, Judith J.; Walker, Dale; Hughes, Kere; Weathers, Mary
2006-01-01
Early interventionists are accountable for the progress of children receiving their services. Technically adequate measures of the progress of individual children are needed. While the Early Communication Indicator (ECI) for infants and toddlers is one such measure, data to support its use are limited to a single research report. In this…
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Efficacy Beliefs and the Learning Experiences of Children with Cancer in the Hospital Setting.
ERIC Educational Resources Information Center
Crossland, Andrea
2002-01-01
A study examined how self-efficacy beliefs influenced motivation, affect, and adjustment in five students aged 9-13 with cancer, receiving educational services in a hospital setting. Education was an effective vehicle through which children with cancer could experience control and autonomy and also achieve many necessary developmental outcomes for…
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Does Your Organization Welcome Participants with Disabilities? A New Assessment Tool
ERIC Educational Resources Information Center
Galloway, Fred; Shea, Mary McAllister
2009-01-01
During the 2005-06 school year, more than 6.7 million children with disabilities received special education and related services in our public schools; this represents more than a 20 percent increase over the previous decade (U.S. Department of Education, 2009). These children, who are typically at risk for chronic physical, developmental,…
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Potential for Expatriate Involvement with Handicapped Children in the N.W.F.P. of Pakistan.
ERIC Educational Resources Information Center
Miles, M.
The North West Frontier Province of Pakistan plans to improve services and facilities for handicapped children and is encouraging expatriates to bring their skills to Pakistan. Staff of current institutions are either untrained or have received short courses of training within Pakistan. There are currently about five expatriates working in the…
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Examining the Validity of the Arizona English Language Learners Assessment Cut Scores
ERIC Educational Resources Information Center
Florez, Ida Rose
2012-01-01
The Arizona English Language Learners Assessment (AZELLA) is used by the Arizona Department of Education to determine which children should receive English support services. AZELLA results are used to determine if children are either proficient in English or have English language skills in one of four non-proficient categories (pre-emergent,…
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ERIC Educational Resources Information Center
National Center for Educational Statistics (DHEW/OE), Washington, DC.
This statistical report presents the results of a survey of educational services provided by State-operated institutions for delinquent and neglected children. Data was gathered from 257 institutions that received federal assistance under Title I of the Elementary and Secondary Education Act. At the time of the survey, participating institutions…
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2012-01-01
The number of children ages 6 to 21 in the United States receiving special education services under the autism disability category increased 91% between 2005 to 2010 while the number of children receiving special education services overall declined by 5%. The demand for special education services continues to rise in disability categories associated with pervasive developmental disorders. Neurodevelopment can be adversely impacted when gene expression is altered by dietary transcription factors, such as zinc insufficiency or deficiency, or by exposure to toxic substances found in our environment, such as mercury or organophosphate pesticides. Gene expression patterns differ geographically between populations and within populations. Gene variants of paraoxonase-1 are associated with autism in North America, but not in Italy, indicating regional specificity in gene-environment interactions. In the current review, we utilize a novel macroepigenetic approach to compare variations in diet and toxic substance exposure between these two geographical populations to determine the likely factors responsible for the autism epidemic in the United States. PMID:22490277
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School-Age Test Proficiency and Special Education After Congenital Heart Disease Surgery in Infancy.
Mulkey, Sarah B; Bai, Shasha; Luo, Chunqiao; Cleavenger, Jordyn E; Gibson, Neal; Holland, Greg; Mosley, Bridget S; Kaiser, Jeffrey R; Bhutta, Adnan T
2016-11-01
To evaluate test proficiency and the receipt of special education services in school-age children who had undergone surgery for congenital heart disease (CHD) at age <1 year. Data from Arkansas-born children who underwent surgery for CHD at Arkansas Children's Hospital at age <1 year between 1996 and 2004 were linked to state birth certificates and the Arkansas Department of Education longitudinal database containing achievement test scores in literacy and mathematics for grades 3-4 and special education codes. The primary negative outcome was not achieving grade-level proficiency on achievement tests. Logistic regression accounting for repeated measures was used to evaluate for associations between achieving proficiency and demographic data, maternal education, and clinical factors. A total of 362 of 458 (79%) children who underwent surgery for CHD were matched to the Arkansas Department of Education database, 285 of whom had grade 3 and/or 4 achievement tests scores. Fewer students with CHD achieved proficiency in literacy and mathematics (P < .05) compared with grade-matched state students. Higher 5-minute Apgar score, shorter duration of hospitalization, and higher maternal education predicted proficiency in literacy (P < .05). White race, no cardiopulmonary bypass, and shorter hospitalization predicted proficiency in mathematics (P < .05). Sex, gestational age, age at surgery, CHD diagnosis, and type and number of surgeries did not predict test proficiency. Compared with all public school students, more children with CHD received special education services (26.9% vs 11.6%; P < .001). Children with CHD had poorer academic achievement and were more likely to receive special education services than all state students. Results from this study support the need for neurodevelopmental evaluations as standard practice in children with CHD. Copyright © 2016 Elsevier Inc. All rights reserved.
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Vern-Gross, Tamara Z.; Lam, Catherine G.; Graff, Zachary; Singhal, Sara; Levine, Deena R.; Gibson, Deborah; Coan, April; Anghelescu, Doralina L.; Yuan, Ying; Baker, Justin N.
2015-01-01
Context Pediatric patients with solid tumors can have a significant symptom burden that impacts quality of life and end-of-life care needs. Objectives We evaluated outcomes and symptoms in children with solid tumors, and compared patterns of end-of-life care after implementation of a dedicated institutional pediatric palliative care service. Methods We performed a retrospective cohort study of children with solid tumors treated at St. Jude Children’s Research Hospital, before and after implementation of the institutional Quality of Life/Palliative Care (QoL/PC) Service in January 2007. Patients who died between July 2001- February 2005 (historical cohort; n=134) were compared to those who died between January 2007- January 2012 (QoL/PC cohort; n=57). Results Median time to first QoL/PC consultation was 17.2 months (range, 9–33 months). At consultation, 60% of children were not receiving or discontinued cancer-directed therapy. Within the QoL/PC cohort, 54 patients had documented symptoms; 94% required intervention for ≥ 3 symptoms; 76% received intervention for ≥ 5 symptoms. Eighty-three percent achieved their preferred place of death. Compared to the historical cohort, the QoL/PC cohort had more end-of-life discussions per patient (median, 12 vs. 3; P<0.001), earlier end-of-life discussions, with longer times before do-not-resuscitate orders (median, 195 vs. 2 days; P<0.001), and greater hospice enrollment (71% vs. 46%, P=0.002). Conclusion Although children with solid tumor malignancies may have significant symptom burden towards end of life, positive changes were documented in communication and in places of care and death following implementation of a pediatric palliative care service. PMID:25891664
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Ganz, Michael L; Tendulkar, Shalini A
2006-06-01
To estimate the prevalence and correlates of unmet needs for mental health care services for children with special health care needs and their families. We use the National Survey of Children With Special Health Care Needs to estimate the prevalence of unmet mental health care needs among children with special health care needs (1-17 years old) and their families. Using logistic-regression models, we also assess the independent impact of child and family factors on unmet needs. Substantial numbers of children with special health care needs and members of their families have unmet needs for mental health care services. Children with special health care needs who were poor, uninsured, and were without a usual source of care were statistically significantly more likely to report that their mental health care needs were unmet. More severely affected children and those with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet. Families of severely affected children or of children with emotional, developmental, or behavioral conditions were also statistically significantly more likely to report that their mental health care needs went unmet. Our results indicate that children with special health care needs and their families are at risk for not receiving needed mental health care services. Furthermore, we find that children in families of lower socioeconomic status are disproportionately reporting higher rates of unmet needs. These data suggest that broader policies to identify and connect families with needed services are warranted but that child- and family-centered approaches alone will not meet the needs of these children and their families. Other interventions such as anti-poverty and insurance expansion efforts may be needed as well.
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Wise, Marissa D; Little, Alison A; Holliman, Jaime Bruce; Wise, Paul H; Wang, C Jason
2010-01-01
To determine whether Early Intervention programs have the capacity to accommodate the expected increase in referrals following the American Academy of Pediatrics' 2007 recommendation for universal screening of 18- and 24-month-old children for Autism Spectrum Disorders (ASD). We conducted a telephone survey of all state and territory early. Intervention coordinators about the demand for ASD evaluations, services, and program capacity. We used multivariate models to examine state-level factors associated with the capacity to serve children with ASD. Fifty-two of the 57 coordinators (91%) responded to the survey. Most states reported an increase in demand for ASD-related evaluations (65%) and services (58%) since 2007. In addition, 46% reported that their current capacity poses a challenge to meeting the 45-day time limit for creating the Individualized Family Service Plan. Many states reported that they have shortages of ASD-related personnel, including behavioral therapists (89%), speech-language pathologists (82%), and occupational therapists (79%). Among states that reported the number of service hours (n = 34) 44% indicated that children with ASD receive 5 or fewer weekly service hours. Multivariate models showed that states with a higher percentage of African-American and Latino children were more likely to have provider shortages whereas states with higher population densities were more likely to offer a greater number of service hours. Many Early Intervention programs may not have the capability to address the expected increase in demand for ASD services. Early Intervention programs will likely need enhanced resources to provide all children with suspected ASD with appropriate evaluations and services.
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Toro, Maria L; Eke, Chika; Pearlman, Jonathan
2016-01-22
For people who have a mobility impairment, access to an appropriate wheelchair is an important step towards social inclusion and participation. The World Health Organization Guidelines for the Provision of Manual Wheelchairs in Less Resourced Settings emphasize the eight critical steps for appropriate wheelchair services, which include: referral, assessment, prescription, funding and ordering, product preparation,fitting and adjusting, user training, and follow-up and maintenance/repairs. The purpose of this study was to investigate how the provision of wheelchairs according to the World Health Organization's service provision process by United Cerebral Palsy Wheels for Humanity in Indonesia affects wheelchair recipients compared to wait-listed controls. This study used a convenience sample (N = 344) of Children, Children with proxies, Adults, and Adults with proxies who were on a waiting list to receive a wheelchair as well as those who received one. Interviews were conducted at baseline and a 6 month follow-up to collect the following data: Demographics and wheelchair use questions, the World Health Organization Quality of Life-BREF, Functional Mobility Assessment, Craig Handicap Assessment Recording Technique Short Form. The Wheelchair Assessment Checklist and Wheelchair Skills Test Questionnaire were administered at follow up only. 167 participants were on the waiting list and 142 received a wheelchair. Physical health domain in the World Health Organization Quality of Life-BREF improved significantly for women who received a wheelchair (p = 0.044) and environmental health improved significantly for women and men who received a wheelchair as compared to those on the waiting list (p < 0.017). Satisfaction with the mobility device improved significantly for Adults with proxies and Children with proxies as compared to the waiting list (p < 0.022). Only 11 % of Adults who received a wheelchair reported being able to perform a "wheelie". The condition of Roughrider wheelchairs was significantly better than the condition of kids wheelchairs for Children with proxies as measured by the Wheelchair Assessment Checklist (p = 0.019). Wheelchair provision according to World Health Organization's 8-Steps in a less-resourced setting has a range of positive outcomes including increased satisfaction with the mobility device and better quality of life. Wheelchair provision service could be improved by providing more hours of wheelchair skills training. There is a need for outcome measures that are validated across cultures and languages.
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Nienaber, A; Wieskus-Friedemann, E; Kliem, S; Hoppmann, J; Kemper, U; Löhr, M; Kronmüller, K-T; Wabnitz, P
2017-02-01
Objective: Evaluation of a project offering low-threshold anonymous counseling services jointly by mental health services and child and youth services to support children in families with mentally ill parents Methods: Evaluating performance data and completed questionnaires returned by parents included in the project. Results: Between 2011-2014, 150 families received up to 10 sessions of family-oriented counseling. The survey results indicate a high level of satisfaction with the services of the cooperation project. The vast majority of respondents said that they would recommend this service to others or would themselves take advantage of the services again. Conclusion: A collaboration of service providers from psychiatry and child and youth welfare department resulting in continuous availability of counseling with a common family medical perspective represents a forward-looking model for families with a mentally ill parent. © Georg Thieme Verlag KG Stuttgart · New York.
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42 CFR 438.50 - State Plan requirements.
Code of Federal Regulations, 2010 CFR
2010-10-01
... limit freedom of choice by requiring recipients to receive their benefits through managed care entities..., cooperative agreement or compact with the Indian Health Service. (3) Children under 19 years of age who are...
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Hosey, M T; Makin, A; Jones, R M; Gilchrist, F; Carruthers, M
2004-01-01
To report on both the use and dosage of propofol, as a new intravenous (IV) conscious sedative agent, for anxious children referred to a specialist paediatric dentistry service. Paediatric Dentistry Unit, Glasgow Dental Hospital and School. Thirty-four children, 25 females and 9 males, mean age 12 years 10 months, with a mean weight of 54.6 kg (range 30-110 kg). Report from 34 patients receiving intravenous sedation for the first time in respect of weight dose and amount of treatment completed. Thirty-two children successfully accepted operative dental care on their first visit, they received a mean total dose of 146.25 mg of propofol (range 10 mg to 356 mg); in relation to body weight, the mean was 2.5 mg/kg (range 0.2-5.4 mg/kg). The treatment that they received included fissure sealants, amalgam and adhesive restorations, root canal therapy and single and multiple extractions. Their sedation and recovery were uneventful. Sub-anaesthetic doses of propofol used for IV conscious sedation infusion facilitated operative dental treatment in anxious children.
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ERIC Educational Resources Information Center
Thistle, Jennifer J.; McNaughton, David
2015-01-01
Purpose: This study examined the effect of instruction in an active listening strategy on the communication skills of pre-service speech-language pathologists (SLPs). Method: Twenty-three pre-service SLPs in their 2nd year of graduate study received a brief strategy instruction in active listening skills. Participants were videotaped during a…
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Kurowski, Brad G; Wade, Shari L; Kirkwood, Michael W; Brown, Tanya M; Stancin, Terry; Taylor, H Gerry
2013-12-01
To characterize utilization of mental health services and determine the ability of a behavior problem and clinical functioning assessment to predict utilization of such services within the first 6 months after moderate and severe traumatic brain injury in a large cohort of adolescents. Multicenter cross-sectional study. Outpatient setting of 4 tertiary pediatric hospitals, 2 tertiary general medical centers, and 1 specialized children's hospital. Adolescents age 12-17 years (n = 132), 1-6 months after moderate-to-severe traumatic brain injury. Logistic regression was used to determine the association of mental health service utilization with clinical functioning as assessed by the Child and Adolescent Functional Assessment Scale and behavior problems assessed by the Child Behavioral Checklist. Mental health service utilization measured by the Service Assessment for Children and Adolescents. Behavioral or functional impairment occurred in 37%-56%. Of the total study population, 24.2% reported receiving outpatient mental health services, 8.3% reported receiving school services, and 28.8% reported receiving any type of mental health service. Use of any (school or outpatient) mental health service was associated with borderline to impaired total Child and Adolescent Functional Assessment Scale (odds ratio 3.50 [95% confidence interval, 1.46-8.40]; P < .01) and the Child Behavioral Checklist Total Competence (odds ratio 5.08 [95% confidence interval, 2.02-12.76]; P < .01). A large proportion of participants had unmet mental health needs. Both the Child and Adolescent Functional Assessment Scale and the Child Behavioral Checklist identified individuals who would likely benefit from mental health services in outpatient or school settings. Future research should focus on methods to ensure early identification by health care providers of adolescents with traumatic brain injury in need of mental health services. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
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Miller, Thomas R; Elliott, Timothy R; McMaughan, Darcy M; Patnaik, Ashweeta; Naiser, Emily; Dyer, James A; Fournier, Constance J; Hawes, Catherine; Phillips, Charles D
2013-10-01
Medicaid Personal Care Services (PCS) help families meet children's needs for assistance with functional tasks. However, PCS may have other effects on a child's well-being, but research has not yet established the existence of such effects. To investigate the relationship between the number of PCS hours a child receives with subsequent visits to physicians for evaluation and management (E&M) services. Assessment data for 2058 CSHCN receiving PCS were collected in 2008 and 2009. Assessment data were matched with Medicaid claims data for the period of 1 year after the assessment. Zero-inflated negative binomial and generalized linear multivariate regression models were used in the analyses. These models included patient demographics, health status, household resources, and use of other medical services. For every 10 additional PCS hours authorized for a child, the odds of having an E&M physician visit in the next year were reduced by 25%. However, the number of PCS hours did not have a significant effect on the number of visits by those children who did have a subsequent E&M visit. A variety of demographic and health status measures also affect physician use. Medicaid PCS for CSHCN may be associated with reduced physician usage because of benefits realized by continuity of care, the early identification of potential health threats, or family and patient education. PCS services may contribute to a child's well-being by providing continuous relationships with the care team that promote good chronic disease management, education, and support for the family. Copyright © 2013 Elsevier Inc. All rights reserved.
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Improved hydroxyurea effect with the use of text messaging in children with sickle cell anemia.
Estepp, Jeremie H; Winter, Bryan; Johnson, Margery; Smeltzer, Matthew P; Howard, Scott C; Hankins, Jane S
2014-11-01
In children with sickle cell anemia (SCA), hydroxyurea reduces morbidity, but adherence is frequently suboptimal. Because most families of children with SCA have access to cellular telephone services, we assessed the impact of text messaged reminders as a tool to improve adherence to hydroxyurea. All patients <19 years of age with HbSS or HbSβ(0) thalassemia who were treated with hydroxyurea at a maximal tolerated dosage (MTD) at St. Jude Children's Research Hospital Comprehensive Pediatric Sickle Cell Program and who received automated text message reminders (SIMON®) were retrospectively identified. Laboratory parameters, hospitalizations, and medication possession ratios (MPR) prior to and after initiation of SIMON® were compared to assess the impact of SIMON®. Of the 97.3% of families with access to a cell phone, 91% elected to receive text message reminders. Among 55 children receiving hydroxyurea at MTD, laboratory parameters reflected waning medication compliance during the 12 months prior to SIMON®. Following initiation of SIMON®, children had higher mean corpuscular volumes, hemoglobin levels and fetal hemoglobin percentages and lower absolute reticulocyte counts and bilirubin levels, suggesting improved medication adherence. Hospitalizations were uncommon before and after SIMON®, and medication possession ratios (MPRs) were high before and after SIMON®, neither was significantly changed. SIMON® was feasible and improved hematologic parameters in children with SCA receiving hydroxyurea at a MTD. Future work will include extension of this technology to children with other chronic medical conditions who require daily use of medication. © 2014 Wiley Periodicals, Inc.
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Lives of Quality in the Face of Challenge in Israel
ERIC Educational Resources Information Center
Neikrug, S.; Roth, D.; Judes, J.
2011-01-01
Purpose: The purpose of this study is to describe and analyse the quality of life of Israeli families raising a child with a disability while challenged with all the usual demands of family life. Methods: Respondents were main caregivers of 103 children with disability receiving services at Beit Issie Shapiro, a service agency in Israel. The…
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ERIC Educational Resources Information Center
Hernández Finch, Maria E.; Finch, W. Holmes; Mcintosh, Constance E.; Thomas, Cynthia; Maughan, Erin
2015-01-01
Students who are medically involved often require sustained related services, regular care coordination, and case management to ensure that they are receiving a free and appropriate public education. Exploring the collaboration efforts of school psychologists and school nurses for meeting the educational and related services needs of these…
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ERIC Educational Resources Information Center
Bitterman, Amy; Daley, Tamara C.; Misra, Sunil; Carlson, Elaine; Markowitz, Joy
2008-01-01
The Pre-Elementary Education Longitudinal Study (PEELS) examines the preschool and early elementary school experiences of a nationally representative sample of 3,104 children ages 3-5 with disabilities from 2004 through 2009. This paper describes the special education and related services received by a subsample of 186 preschoolers with autism…
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ERIC Educational Resources Information Center
Green, Jennifer Greif; Xuan, Ziming; Kwong, Lana; Holt, Melissa K.; Comer, Jonathan S.
2016-01-01
After mass crises, trauma-exposed children report increased psychological distress, yet most receive no mental health (MH) services and supports. This study identifies factors associated with teachers' reports of outreach to school-based MH providers (such as social workers, psychologists, and counselors) as well as provision of informal supports…
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Pre-Service Teacher Education for Mental Health and Inclusion in Schools
ERIC Educational Resources Information Center
Atkins, Melanie-Anne; Rodger, Susan
2016-01-01
Pre-service teacher education in mental health and mental health literacy is essential to creating the conditions necessary to support the mental health and wellness of children and youth in schools. Many teachers report never having received any education about mental health, but recognize the importance of this knowledge in meeting the needs of…
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Contrasting Mother-Infant Contact: Educational Consequences a Decade Later.
ERIC Educational Resources Information Center
Wallick, Mollie Marcus
Effects of maternal-neonatal extended contact or separation were examined in 76 children (8 to 10 years old), five of whom were receiving special education services, and 28 who had been retained in their grade. Of the five Ss requiring special services, three were classified as slow learners and two as speech impaired, two conditions linked by…
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Isong, Inyang; Dantas, Laila; Gerard, Macda; Kuhlthau, Karen
Significant disparities exist in children's receipt of preventive dental care (PDC) in the United States. Many of the children at greatest risk of dental disease do not receive timely PDC; when they do receive dental care, it is often more for relief of dental pain. Chelsea is a low-income, diverse Massachusetts community with high rates of untreated childhood caries. There are various dental resources available in Chelsea, yet many children do not access dental care at levels equivalent to their needs. Using Chelsea as a case-study, to explore factors contributing to forgone PDC (including the age 1 dental visit) in an in-depth way. We used a qualitative study design that included semi-structured interviews with parents of preschool children residing in Chelsea, and Chelsea-based providers including pediatricians, dentists, a dental hygienist and early childhood care providers. We examined: a) parents' dental attitudes and oral health cultural beliefs; b) parents' and providers' perspectives on facilitators and barriers to PDC, reasons for unmet needs, and proposed solutions to address the problem. We recorded, transcribed and independently coded all interviews. Using rigorous, iterative qualitative data analyses procedures, we identified emergent themes. Factors perceived to facilitate receipt of PDC included Head-Start oral health policies, strong pediatric primary care/dental linkages, community outreach and advertising, and parents' own oral health experiences. Most parents and providers perceived there to be an adequate number of accessible dental services and resources in Chelsea, including for Medicaid enrollees. However, several barriers impeded children from receiving timely PDC, the most frequently cited being insurance related problems for children and adults. Other barriers included limited dental services for children <2 years, perceived poor quality of some dental practices, lack of emphasis on prevention-based dental care, poor care-coordination, and insufficient culturally-appropriate care. Important family-level barriers included parental oral health literacy, cultural factors, limited English proficiency and competing priorities. Several solutions were proposed to address identified barriers. Even in a community with a considerable number of dental resources, various factors may preclude access to these services by preschool-aged children. Opportunities exist to address modifiable factors through strategic oral health policies, community outreach and improved care coordination between physicians, dentists and early childhood care providers.
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Is more better than less? An analysis of children's mental health services.
Foster, E M
2000-01-01
OBJECTIVE: To assess the dose-response relationship for outpatient therapy received by children and adolescents-that is, to determine the impact of added outpatient visits on key mental health outcomes (functioning and symptomatology). DATA SOURCES/STUDY SETTING: The results presented involve analyses of data from the Fort Bragg Demonstration and are based on a sample of 301 individuals using outpatient services. STUDY DESIGN: This article provides estimates of the impact of outpatient therapy based on comparisons of individuals receiving differing treatment doses. Those comparisons involve standard multiple regression analyses as well as instrumental variables estimation. The latter provides a means of adjusting comparisons for unobserved or unmeasured differences among individuals receiving differing doses, differences that would otherwise be confounded with the impact of treatment dose. DATA COLLECTION/EXTRACTION METHODS: Using structured diagnostic interviews and behavior checklists completed by the child and his or her caretaker, detailed data on psychopathology, symptomatology, and psychosocial functioning were collected on individuals included in these analyses. Information on the use of mental health services was taken from insurance claims and a management information system. Services data were used to describe the use of outpatient therapy within the year following entry into the study. PRINCIPAL FINDINGS/CONCLUSIONS: Instrumental variables estimation indicates that added outpatient therapy improves functioning among children and adolescents. The effect is statistically significant and of moderate practical magnitude. These results imply that conventional analyses of the dose-response relationship may understate the impact of additional treatment on functioning. This finding is robust to choice of functional form, length of time over which outcomes are measured, and model specification. Dose does not appear to influence symptomatology. PMID:11130814
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Johnson, M B; Cappelli, D P; Bradshaw, B S; Mabry, J C
2010-01-01
This study's purpose was to compare pediatric dental services provided for Medicaid and military dependent children to determine if differences in dental treatment choices exist based on site and payment method. Subjects included 120 Medicaid patients at the University of Texas Health Science Center at San Antonio and 120 military dependents at Lackland Air Force Base, Texas. Demographic data and treatment information were abstracted for children younger than 6 years old receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using Wilcoxon rank sum, Kruskal-Wallis, and Fisher's exact tests. The Medicaid recipients were younger (40.2 vs 49.8 months, P<.001) and more likely to be Hispanic (78% vs 30%, P<.001). The means of decayed teeth, fillings, and stainless steel crowns did not differ between sites. Medicaid children received more composite fillings (P<.001), fewer amalgam fillings (P<.001), fewer pulp therapies (P<.001), more extractions (P=.01), and fewer sealants (P<.001). Age and gender did not affect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs 8.6, P=.02). This study found no difference in the number of less conservative, albeit more costly, procedures performed with Medicaid children at a university compared to military dependents at a military base.
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Expanding the Role of the School Psychologist in the Delivery of School-Based Mental Health Services
ERIC Educational Resources Information Center
Eklund, Katie; Vaillancourt, Kelly; Pedley, Trisha
2013-01-01
Approximately 20% of children in the United States experience significant mental, emotional, or behavioral symptoms that would qualify them for a psychiatric diagnosis (Burns et al., 1995; Costello et al., 2003). Unfortunately, only 15%-30% of these children receive any type of help or support (Ringel & Sturm, 2001; United States Public Health…
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ERIC Educational Resources Information Center
Florez, Ida Rose
2010-01-01
The Arizona English Language Learners Assessment (AZELLA) is used by the Arizona Department of Education to determine which children should receive English support services. AZELLA results are used to determine if children are either proficient in English or have English language skills in one of four pre-proficient categories (pre-emergent,…
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Concept Paper on the Effects of the Physical Environment on Day Care.
ERIC Educational Resources Information Center
Prescott, Elizabeth; David, Thomas G.
This paper presents a discussion of the effect of the physical environment on children receiving day care services. Various dimensions of the physical environment which may affect the well-being of infants, preschool and school age children in group or family day care settings are examined. The focus is on the overall well-being and development of…
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ERIC Educational Resources Information Center
Morgan, Paul L.; Farkas, George
2016-01-01
We summarize our recent findings that White children in the United States are more likely than otherwise similar racial or ethnic minority children to receive special education services, including for emotional and behavioral disorders. We show how the findings are robust. We explain why our findings conflict with prior reports in education that…
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ERIC Educational Resources Information Center
Pierre-Okerson, Marie Judith
2014-01-01
The purpose of this research study was to explore how parents in a large school district in Florida perceive the referral process leading to their children placement in Special Education. Participants in the study were 12 parents of special needs students whose children were, at the time of the study, receiving Special Education related services…
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ERIC Educational Resources Information Center
Hider, Erin D.
Factors involved in assistive technology use by young children with disabilities were explored through case studies of five families who had received intensive training at Camp Gizmo, an assistive technology camp for young children. Families, service providers, and preservice students in special education and speech language pathology engaged in a…
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ERIC Educational Resources Information Center
D'Angelo, Angela Valdovinos; Rich, Lauren; Kwiatt, Jaclyn
2013-01-01
A commonly held belief is that children whose families are struggling with poverty--and the housing, health, safety, and other concerns that often go with it--cannot focus on learning unless their nonacademic needs are met. This belief is supported by research showing that the children of poor parents who receive income supplements and other…
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ERIC Educational Resources Information Center
Lilly, Julianna D.; Reed, Dianne
2004-01-01
This study examined issues of psychological contract violation between parents of children with autism spectrum disorder and school districts that serve them. As such, the sampling strategy was to focus on parents who were dissatisfied with the educational services their child was receiving from the school district so that the parents' "lived…
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ERIC Educational Resources Information Center
Drake, Pamela Marie; Greenspoon, Bayla; Unti, Lisa; Fawcett, Linda K.; Neville-Morgan, Sarah
2006-01-01
Family, friend and neighbor (FFN) child caregivers represent a significant proportion of caregivers for young children. Yet, these caregivers receive little support for their services. In 2003, the First 5 California Children and Families Commission (First 5 California) began a study to determine the work-related needs of FFN caregivers in…
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ERIC Educational Resources Information Center
Armstrong, Theresa Sacchi
2017-01-01
After a brain injury, children often return to school with complex learning needs. Most special educators receive little specific preparation relating to TBI and may lack the experience to assist children to reach their full potential. This study examined novice teachers' perceptions of the value of the academic and in-service professional…
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Charles, Joanna M; Bywater, Tracey J; Edwards, Rhiannon Tudor; Hutchings, Judy; Zou, Lu
2013-12-18
There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children's health and social care service use, but little is known about the programme's impact on parental service use. This paper explores whether an above clinical cut-off score on the Beck Depression Inventory II (BDI II) is associated with high or low parental health and social care service use in high-risk families receiving the IY Basic Programme. This is a secondary analysis of a subsample (N = 119) from the first U.K. community-based randomised controlled trial of the 12-week IY Basic Programme (N = 153). Parents with children at risk of developing conduct disorder were randomised to receive the programme or to a waiting-list control group. BDI II total and BDI II clinical depression cut-off scores were compared to frequencies and costs of parents' service use, at baseline, six, twelve and eighteen months post-baseline for the intervention group and at baseline and six months post-baseline for the control group. Intervention group parents who scored above the clinical cut-off on the BDI II at baseline used more health and social care services than those who scored below at baseline, six and eighteen months. Significant reductions in service use frequencies were found for the intervention group only. Parents with higher levels or depression used more health and social care service and parenting programmes have been shown to reduce parental depression and also health and social service use. However, further exploration of depressed parents' service use and the cost implications for publically funded health and social care services is needed.
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2013-01-01
Background The Individuals with Disabilities Education Act (Part C) authorizes states to establish systems to provide early intervention services (e.g., therapy) for children at risk, with the incentive of federal financial support. This study examines family and neighborhood characteristics associated with currently utilizing physical, occupational, or speech therapy among very low birthweight (VLBW) 2-year-old children who meet Wisconsin eligibility requirements for early intervention services (EI) due to developmental delay. Methods This cross-sectional analysis used data from the Newborn Lung Project, a regional cohort study of VLBW infants hospitalized in Wisconsin’s newborn intensive care units during 2003–2004. We included the 176 children who were age two at follow-up, and met Wisconsin state eligibility requirements for EI based on developmental delay. Exact logistic regression was used to describe child and neighborhood socio-demographic correlates of parent-reported receipt of therapy. Results Among VLBW children with developmental delay, currently utilizing therapy was higher among children with Medicaid (aOR = 5.3, 95% CI: 1.3, 28.3) and concomitant developmental disability (aOR = 5.2, 95% CI: 2.1, 13.3) and lower for those living in a socially more disadvantaged neighborhood (aOR=0.48, 95% CI: 0.21, 0.98, per tertile). Conclusions Among a sample of VLBW 2-year olds with developmental delays who are EI-eligible in WI, 4 out of 5 were currently receiving therapy, per parent report. Participation in Medicaid positively influences therapy utilization. Children with developmental difficulties who live in socially disadvantaged neighborhoods are at highest risk for not receiving therapy. PMID:23845161
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Fibert, Philippa; Relton, Clare; Heirs, Morag; Bowden, Deborah
2016-05-01
20 consecutively enrolled children age 5-16 with Attention Deficit Hyperactivity Disorder (ADHD) received treatment by a homeopath (8 consultations and individualized remedies) for one year. Ten subsequently enrolled children received similar time and attention for 4 months. The study explored optimum treatment protocols; the effectiveness, deliverability and acceptability of treatment; and the feasibility of outcome measurement and recruitment. Parents completed Conners' Parent Rating Scale, Revised Long Version ( L) every 4 months, from which DSMIV total scores were extracted; and Measure Your Own Medical Outcome Profile (MYMOP) every consultation. An interaction between time (baseline/4 months) and group (treatment/non-treatment) was found .756 F (1,28)=9.06, p=0.005. The intervention was associated with statistically significant improvements in treated children over the year: L (t (18)=4.529, p≤0.000); MYMOP (t (18)=6.938, p≤0.000). Mean DSMIV total t scores decreased at each time point: baseline: 85 (SD 5.1); 4 months 76.2 (SD 10.9); and 12 months 71.5 (SD 12.77). Recruitment of control participants was problematic. Recruitment to treatment was feasible via ADHD support groups, charities, police support agencies and social services, not schools or NHS services. Attending appointments was problematic for some participants, but home visits did not improve uptake. The best venue was a familiar clinic. Some participants took medicines inappropriately, but generally taking homeopathic remedies was acceptable and well implemented. L (80 items) was problematic for some parents. MYMOP was preferred by parents but not acceptable to stakeholders. In this small consecutive sample the intervention was associated with improvements in criminality, anger and children with a concomitant diagnosis of Autism Spectrum Disorder ASD. Treatment by a homeopath was associated with sustained, increasing improvements and the intervention was acceptable to participants. More methodically rigorous research is warranted. "We recommend that future research in this area uses comparative effectiveness randomised controlled trial designs. We also recommend that these trials measure outcomes of relevance to stakeholder needs - the people and services who care for those with ADHD - parents, teachers and social workers and the criminal justice system". Copyright © 2015 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.
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Mental health services at selected private schools.
Van Hoof, Thomas J; Sherwin, Tierney E; Baggish, Rosemary C; Tacy, Peter B; Meehan, Thomas P
2004-04-01
Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism for addressing their students' mental health needs. Understanding that need requires data to guide the services and programs a school may put in place. Having data helps inform those services, and comparative data from other schools provides feedback and perspective. This project surveyed type and frequency of mental health problems experienced by students who received a formal evaluation at 11 private schools in Connecticut during academic year 2001-2002.
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Köhler, M; Emmelin, M; Hjern, A; Rosvall, M
2015-05-01
This study investigated the impact of being in family foster care on selected health determinants and participation in Child Health Services (CHS). Two groups of 100 children, born between 1992 and 2008, were studied using data from Swedish Child Health Services for the preschool period up to the age of six. The first group had been in family foster care, and the controls, matched for age, sex and geographic location, had not. Descriptive statistics were used to describe differences in health determinants and participation in Child Health Services between the two groups. The foster care group had higher health risks, with lower rates of breastfeeding and higher levels of parental smoking. They were less likely to have received immunisations and attended key nurse or physician visits and speech and vision screening. Missing data for the phenylketonuria test were more common in children in family foster care. Children in family foster care were exposed to more health risks than the control children and had lower participation in the universal child health programme during the preschool period. These results call for secure access to high-quality preventive health care for this particularly vulnerable group of children. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
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34 CFR 303.721 - Annual report of children served-report requirement.
Code of Federal Regulations, 2012 CFR
2012-07-01
... the State, by race, gender, and ethnicity, who are receiving early intervention services (and include....731(e)(1)); (2) The number and percentage of infants and toddlers with disabilities, by race, gender...
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34 CFR 303.721 - Annual report of children served-report requirement.
Code of Federal Regulations, 2013 CFR
2013-07-01
... the State, by race, gender, and ethnicity, who are receiving early intervention services (and include....731(e)(1)); (2) The number and percentage of infants and toddlers with disabilities, by race, gender...
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34 CFR 303.721 - Annual report of children served-report requirement.
Code of Federal Regulations, 2014 CFR
2014-07-01
... the State, by race, gender, and ethnicity, who are receiving early intervention services (and include....731(e)(1)); (2) The number and percentage of infants and toddlers with disabilities, by race, gender...
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Some Evidence of Race Bias in the Diagnosis and Treatment of the Juvenile Offender.
ERIC Educational Resources Information Center
Lewis, Dorothy Otnow; And Others
1979-01-01
Clinical and epidemiological evidence is presented indicating that many more Black delinquent children and their families fail to receive needed psychiatric and medical services than do White delinquents. (Author)
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ERIC Educational Resources Information Center
Ehrle, Jennifer; Geen, Rob; Clark, Rebecca
This brief documents the numbers of children living in different types of kinship environments, characteristics of those environments, and services these children receive. Data come from the 1997 National Survey of America's Families, a nationally representative survey of households with people under age 65 that measures economic, health, and…
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Caregivers’ Quality of Life and Quality of Services for Children with Cancer: A Review from Iran
Sajjadi, Homeira; Vameghi, Meroe; Ghazinour, Mehdi; KhodaeiArdakani, Mohammadreza
2013-01-01
Objective: Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers’ quality of life and quality of services in the social work section. Method: 125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire. Findings: Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers’ quality of life regarding psychological status and environmental conditions. Conclusion: Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers’ satisfaction and quality of life. PMID:23618487
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Caregivers' quality of life and quality of services for children with cancer: a review from iran.
Sajjadi, Homeira; Vameghi, Meroe; Ghazinour, Mehdi; Khodaeiardekani, Mohammadreza
2013-03-04
Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers' quality of life and quality of services in the social work section. 125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire. Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers' quality of life regarding psychological status and environmental conditions. Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers' satisfaction and quality of life.
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McCoy, Marcia Burton; Geppert, Joni; Dech, Linda; Richardson, Michaela
2018-01-01
Background Peer counseling (PC) has been associated with increased breastfeeding initiation and duration, but few analyses have examined the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) model for peer counseling or the continuation of breastfeeding from birth through 12 months postpartum. Objectives Identify associations between Minnesota WIC Peer Breastfeeding Support Program services and breastfeeding initiation and continuation. Methods Retrospective analysis of observational data from the Minnesota WIC program's administrative database of women who gave birth in 2012 and accepted a PC program referral prenatally (n = 2219). Multivariate logistic regression and Cox regression models examined associations between peer services and breastfeeding initiation and continuation of any breastfeeding. Results Among women who accepted referral into a PC program, odds of initiation were significantly higher among those who received peer services (Odds Ratio (OR): 1.66; 95% CI 1.19-2.32), after adjusting for confounders. Women who received peer services had a significantly lower hazard of breastfeeding discontinuation from birth through 12 months postpartum than women who did not receive services. (Hazard Ratio (HR) month one: 0.45; 95% CI 0.33-0.61; months two through twelve: 0.33; 95% CI 0.18-0.60). The effect of peer counseling did not differ significantly by race and ethnicity, taking into account mother's country of origin. Conclusion for practice Receipt of peer services was positively associated with breastfeeding initiation and continued breastfeeding from birth through 12 months postpartum. Making peer services available to more women, especially in communities with low initiation and duration, could improve maternal and child health in Minnesota.
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Skiles, Martha Priedeman; Curtis, Siân L; Basinga, Paulin; Angeles, Gustavo; Thirumurthy, Harsha
2015-09-14
Performance-based financing (PBF) strategies are promoted as a supply-side, results-based financing mechanism to improve primary health care. This study estimated the effects of Rwanda's PBF program on less-incentivized child health services and examined the differential program impact by household poverty. Districts were allocated to intervention and comparison for PBF implementation in Rwanda. Using Demographic Health Survey data from 2005 to 2007-08, a community-level panel dataset of 5781 children less than 5 years of age from intervention and comparison districts was created. The impacts of PBF on reported childhood illness, facility care-seeking, and treatment received were estimated using a difference-in-differences model with community fixed effects. An interaction term between poverty and the program was estimated to identify the differential effect of PBF among children from poorer families. There was no measurable difference in estimated probability of reporting illness with diarrhea, fever or acute respiratory infections between the intervention and comparison groups. Seeking care at a facility for these illnesses increased over time, however no differential effect by PBF was seen. The estimated effect of PBF on receipt of treatment for poor children is 45 percentage points higher (p = 0.047) compared to the non-poor children seeking care for diarrhea or fever. PBF, a supply-side incentive program, improved the quality of treatment received by poor children conditional on patients seeking care, but it did not impact the propensity to seek care. These findings provide additional evidence that PBF incentivizes the critical role staff play in assuring quality services, but does little to influence consumer demand for these services. Efforts to improve child health need to address both supply and demand, with additional attention to barriers due to poverty if equity in service use is a concern.
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Vinen, Zoe; Clark, Megan; Paynter, Jessica; Dissanayake, Cheryl
2018-05-01
This study followed children with Autism Spectrum Disorder (ASD) from early intervention into their early schooling years, when they were aged between 6 and 9 years, on autism symptom severity and cognitive functioning. The children, matched at pre-intervention, were compared on type of community provided service: 31 were in receipt of community-based group Early Start Denver Model and 28 had received other community provisions for ASD. Irrespective of groups, cognitive functioning was found to have significantly improved by school age compared to pre-intervention. Autism symptom severity increased during the same developmental period, seemingly driven by an increase in restricted and repetitive behaviours over time. In contrast, both groups displayed improved social affect by school age.
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Paula, Cristiane S; Bordin, Isabel A S; Mari, Jair Jesus; Velasque, Luciane; Rohde, Luis A; Coutinho, Evandro S F
2014-01-01
Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU. Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721). Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1) children/adolescent characteristics [(1.1) Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL)-psychiatric disorders; (1.2) Ten Questions Screen-neurodevelopment problems; (1.3) two subtests of WISC-III-estimated IQ; (1.4) Academic Performance Test-school performance)], (2) factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression), (3) family (Brazilian Research-Companies-Association's Questionnaire-SES). Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions) regardless of the presence of any psychiatric disorders/neurodevelopmental problems. Only a small proportion of children/adolescents with psychiatric disorders had been seen by a mental health specialist in the previous 12 months. Structural/psychosocial/demographic factors were associated with uneven access to service for certain groups of children/adolescents. These results call attention to the urgent need to implement programs to help reduce this large unmet mental health need; inequalities must be considered by policy makers when planning strategies to address barriers for care.
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Cullington, H E; Bele, D; Brinton, J C; Cooper, S; Daft, M; Harding, J; Hatton, N; Humphries, J; Lutman, M E; Maddocks, J; Maggs, J; Millward, K; O'Donoghue, G; Patel, S; Rajput, K; Salmon, V; Sear, T; Speers, A; Wheeler, A; Wilson, K
2017-01-01
This fourteen-centre project used professional rating scales and parent questionnaires to assess longitudinal outcomes in a large non-selected population of children receiving simultaneous and sequential bilateral cochlear implants. This was an observational non-randomized service evaluation. Data were collected at four time points: before bilateral cochlear implants or before the sequential implant, one year, two years, and three years after. The measures reported are Categories of Auditory Performance II (CAPII), Speech Intelligibility Rating (SIR), Bilateral Listening Skills Profile (BLSP) and Parent Outcome Profile (POP). Thousand and one children aged from 8 months to almost 18 years were involved, although there were many missing data. In children receiving simultaneous implants after one, two, and three years respectively, median CAP scores were 4, 5, and 6; median SIR were 1, 2, and 3. Three years after receiving simultaneous bilateral cochlear implants, 61% of children were reported to understand conversation without lip-reading and 66% had intelligible speech if the listener concentrated hard. Auditory performance and speech intelligibility were significantly better in female children than males. Parents of children using sequential implants were generally positive about their child's well-being and behaviour since receiving the second device; those who were less positive about well-being changes also generally reported their children less willing to wear the second device. Data from 78% of paediatric cochlear implant centres in the United Kingdom provide a real-world picture of outcomes of children with bilateral implants in the UK. This large reference data set can be used to identify children in the lower quartile for targeted intervention.
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Sardell, A; Johnson, K
1998-01-01
The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, which was designed to ensure that Medicaid-eligible children receive comprehensive health services, is the only national attempt to provide a right to these services. The political factors that have shaped national EPSDT policy during the past decade are described, based on a conceptual framework developed by John W. Kingdon. The analysis focuses on the roles of two distinct sets of policy entrepreneurs: child health advocates and fiscally conservative governors. Their activities are described in relation to the larger political environment, or "political stream," from the period of the expansion of Medicaid eligibility for pregnant women and children in the late 1980s to the enactment of a new State Children's Health Insurance Program (SCHIP) in 1997. The relative saliency of eligibility and benefit issues in children's health policies had a major influence on the politics and outcomes.
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Zhai, Fuhua; Raver, C Cybele; Jones, Stephanie M
2015-09-01
A variety of universal school-based social and emotional learning (SEL) programs have been designed in the past decades to help children improve social-emotional and academic skills. Evidence on the effectiveness of SEL programs has been mixed in the literature. Using data from a longitudinal follow-up study of children (n = 414) originally enrolled in a clustered randomized controlled trial (RCT) when they were in Head Start, we examined whether universal SEL services in third grade were associated with the development of children from disadvantaged families. We took advantage of pairwise matching in the RCT design to compare children who had similar family background and preschool experiences but received different doses of SEL services in third grade. The results showed that the frequent (i.e., weekly to daily) exposure to SEL opportunities was associated with favorable social-emotional and academic development in third grade, including increased social skills, student-teacher relationship, and academic skills, as well as reduced impulsiveness.
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Koegl, Christopher J; Farrington, David P; Augimeri, Leena K; Day, David M
2008-07-01
This study tested the effectiveness of a multifaceted, cognitive-behavioral therapy (CBT) program for antisocial children--the SNAP Under 12 Outreach Project (ORP)--in relation to age, sex and indices of treatment intensity. Study participants were 80 clinic-referred children (59 boys and 21 girls) aged 6-11 years assigned to one of the following groups: control (CG; n = 14) who did not receive the ORP, matched (MG; n = 50) who received the ORP, and experimental (EG; n = 16) who received an enhanced version of the ORP. Results indicated significant pre-post changes for the EG and MG for Child Behavior Checklist (CBCL)-measured delinquency and aggression, but no improvement for the CG. Positive relationships between the number of individual ORP components (e.g. number of children's CBT sessions) received and CBCL change scores were also found. Statistical associations tended to be larger for girls and older children (i.e. 10-11 years old) who may have been more cognitively advanced. Also, the number of children's CBT sessions predicted later convictions, even after controlling for prior CBCL delinquency scores. Findings from this study support the effectiveness of the ORP, but also highlight the need to take into account client characteristics when offering clinical treatment.
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Halverson, Julie L; Russell, Jesse Rio; Kerwin, Colleen
2018-06-05
The mission and responsibility of child protective services (CPS) is to investigate maltreatment; intervene to protect children from harm; and promote safety, permanency, and well-being (DePanfilis & Salus, 2003; Goldman, Salus, Wolcott, & Kennedy, 2003). In 2015, approximately 7.2 million children in the United States were referred to CPS agencies, and 3.4 million children had an investigation or received an alternative response (US Department of Health & Human Services, 2017). Fluke, Shusterman, Hollinshead, and Yuan (2005) found that about one third of children with an allegation of maltreatment would have at least one re-report within a five-year period. Research indicates that the rates of child maltreatment or changes in indicators of child maltreatment have remained unchanged over time (Gilbert et al., 2012). Despite policies aimed at reducing or preventing maltreatment, the development of CPS systems across the United States, and a CPS workforce, the aggregate effects of the CPS system, services, and worker efforts are not well understood. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Weaver, Meaghann S; Rosenberg, Abby R; Tager, Julia; Wichman, Christopher S; Wiener, Lori
2018-04-01
Little is known about the composition, availability, integration, communication, perceived barriers, and work load of pediatric palliative care (PPC) providers serving children and adolescents with cancer. To summarize the structure and services of programs to better understand successes and gaps in implementing palliative care as a standard of care. Cross-sectional online survey about the palliative care domains determined by the Psychosocial Care of Children with Cancer and Their Families Workgroup. A total of 142 surveys were completed with representation from 18 countries and 39 states. Three-fourths of sites reported having a PPC program available for the pediatric cancer population at their center. Over one-fourth (28%) have been in existence less than five years. Fewer than half of sites (44%) offered 24/7 access to palliative care consultations. Neither hospital-based nor local community hospice services were available for pediatric patients at 24% of responding sites. A specific inpatient PPC unit was available at 8% of sites. Criteria for automatic palliative referrals ("trigger" diagnoses) were reported by 44% respondents. The presence of such "triggers" increased the likelihood of palliative principle introduction 3.41 times (p < 0.003). Six percent of respondents perceived pediatric oncology patients and their families "always" were introduced to palliative care concepts and 17% reported children and families "always" received communication about palliative principles. The most prevalent barriers to palliative care were at the provider level. Children and adolescents with cancer do not yet receive concurrent palliative care as a universal standard.
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Preventive dental health care experiences of preschool-age children with special health care needs
Huebner, Colleen E.; Chi, Donald L.; Masterson, Erin; Milgrom, Peter
2014-01-01
Purpose This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Methods Study methods included 90 parent interviews and dental examinations of their preschool-age children. Results Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37 percent experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Conclusions Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. PMID:25082666
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Preventive dental health care experiences of preschool-age children with special health care needs.
Huebner, Colleen E; Chi, Donald L; Masterson, Erin; Milgrom, Peter
2015-01-01
This study examined the preventive dental health care experiences of young children with special needs and determined the feasibility of conducting clinical dental examinations at a community-based early intervention services center. Study methods included 90 parent interviews and dental examinations of their preschool-age children. Thirteen percent of the children received optimal preventive care, defined as twice daily tooth brushing with fluoridated toothpaste and two preventive dental visits in the prior 12 months; 37% experienced care that fell short in both areas. Optimal care was more common among children of parents who reported tooth brushing was not a struggle and those with a personal dentist. Parents' opinion of the study experience was generally positive. Few children with special needs receive effective preventive care early, when primary prevention could be achieved. Barriers to optimal care could be readily addressed by the dental community in coordination with early intervention providers. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.
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Social and demographic factors that influence the diagnosis of autistic spectrum disorders.
Russell, Ginny; Steer, Colin; Golding, Jean
2011-12-01
Recent studies in epidemiology have highlighted the existence of children with autistic difficulties who remain undiagnosed. Other studies have identified 'access barriers' to clinics which include factors mediated by parents as well as health and education services. The purpose of this study was to examine whether social and demographic factors play a role in receiving a diagnosis of autistic spectrum disorder (ASD) independently of symptom severity. Retrospective secondary analysis of a longitudinal UK cohort study, namely, the Avon Longitudinal Study of Parents and Children (ALSPAC). With the severity of autistic traits held constant, boys were more likely to receive an ASD diagnosis than girls. Younger mothers and mothers of first-born children were significantly less likely to have children diagnosed with ASD. Maternal depression before and around the time of their children's autistic difficulties was associated with lack of diagnosis. The study provides evidence that social as well as biological factors can influence whether children are brought to the clinic.
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Pears, Katherine C; Kim, Hyoun K; Fisher, Philip A; Yoerger, Karen
2016-08-01
Two hundred and nine children receiving early childhood special education services for developmental disabilities or delays who also had behavioral, social, or attentional difficulties were included in a study of an intervention to increase school readiness, including early literacy skills. Results showed that the intervention had a significant positive effect on children's literacy skills from baseline to the end of summer before the start of kindergarten (d=.14). The intervention also had significant indirect effects on teacher ratings of children's literacy skills during the fall of their kindergarten year (β=.09). Additionally, when scores were compared to standard benchmarks, a greater percentage of the children who received the intervention moved from being at risk for reading difficulties to having low risk. Overall, this study demonstrates that a school readiness intervention delivered prior to the start of kindergarten may help increase children's early literacy skills. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
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Warren, Zachary; Vehorn, Alison; Dohrmann, Elizabeth; Newsom, Cassandra; Taylor, Julie Lounds
2014-01-01
There is limited evidence surrounding the ability of families of children with autism spectrum disorders to access and implement recommended interventions following diagnosis. The distress a family may encounter with regard to inability to access recommended services is also poorly understood. In this study, we present preliminary data regarding implementation of clinical recommendations following autism spectrum disorder diagnosis as well as associations of implementation with maternal functioning. In total, 75 mothers of young children diagnosed with autism spectrum disorder through a university-based preschool autism clinic returned surveys regarding access to recommended services as well as maternal mental health and distress. Results indicate that while families were able to implement numerous recommendations, specific categories of intervention were less likely to be received. Challenges implementing recommended services were not related to increased maternal distress. These results suggest that despite potential barriers toward accessing some specific recommended services following diagnosis of autism spectrum disorder, many families may be quite successful in implementing many other core recommended services and that failure to access such services may not necessarily negatively impact maternal mental health and distress. PMID:23045221
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Rupp, Kalman; Davies, Paul S; Newcomb, Chad; Iams, Howard; Becker, Carrie; Mulpuru, Shanti; Ressler, Stephen; Romig, Kathleen; Miller, Baylor
This article provides a nationally representative profile of noninstitutionalized children 0 to 17 years of age who were receiving support from the Supplemental Security Income (SSI) program because of a disability. To assess the role of the SSI program in providing assistance to low-income children with disabilities and their families, it is important to obtain detailed information on demographic characteristics, income and assets, health and disabilities, and health care utilization. Yet administrative records of the Social Security Administration do not contain many of the relevant data items, and the records provide only an incomplete picture of the family relationships affecting the lives of children with disabilities. The National Survey of SSI Children and Families fills this gap. This summary article is based on survey interviews conducted between July 2001 and June 2002 and provides some highlights characterizing children with disabilities who were receiving SSI and their families. Most children receiving SSI (hereafter referred to as "SSI children") lived in a family headed by a single mother, and less than one in three lived with both parents. A very high proportion, about half, were living in a household with at least one other individual reported to have had a disability. About 70 percent of children received some kind of special education. SSI support was the most important source of family income, with earnings a close second. On average, SSI payments accounted for nearly half of the income for the children's families, and earnings accounted for almost 40 percent. When all sources of family income were considered, slightly more than half (54 percent) of SSI children lived in families above the poverty threshold, a notable fact given that the federal SSI program guarantees only a subpoverty level of income. However, beyond these averages there was substantial variation, with some children living in families with income well below the poverty threshold and others having income well over 200 percent of the poverty threshold. About one-third of SSI children lived in families owning a home, two-thirds lived with parents or guardians with at least one car, and about 40 percent lived with parents or guardians with zero liquid assets. Less than 4 percent lived with adults who owned stocks, mutual funds, notes, certificates of deposit, or savings bonds. The Social Security Administration's administrative records contain only a limited amount of information about disability diagnoses. The National Survey of SSI Children and Families supplements those records with data from an array of questions on functional limitations, self-reported health, and the perceived severity of disabilities. The data suggest that a great degree of variation in severity exists within the childhood caseload, as reflected in reports of the presence or absence of six functional limitations, perceived overall health status, and perceived impact of disability on the child's ability to do things. Overall, 36 percent of the children were reported to have had disabilities that affected their abilities to do things "a great deal," and for 21 percent their difficulties had very little or no impact. Physical disabilities were most common among children aged 0 to 5, and mental disabilities dominated the picture for the other two age groups: 6 to 12 and 13 to 17. Virtually all SSI children are covered by some form of health insurance, with Medicaid being by far the most common source of health insurance coverage. Just as in the case of the severity of disabilities, substantial variation was reported in health care utilization among SSI children. Almost 30 percent of children had two or fewer doctor visits during the 12 months preceding the interview, and close to 50 percent had five or more doctor visits. About four-fifths of the children had no reported hospitalizations or surgeries during the previous year. More than 40 percent of the children visited an emergency room during the previous year, most of them more than once. Importantly, no out-of-pocket costs associated with medical care were reported for more than two-thirds of the children, and only about 3 percent had annual expenses exceeding $1,000 for physical and mental health care. This finding suggests that SSI payments are not used to cover medical expenses for the overwhelming majority of children. The use of supportive therapies varied widely among SSI children: more than half reported having used physical, occupational, or speech therapy; only 8 percent used respite care for the parents or other family members. An analysis of the perception of the survey respondents shows that more than one-third of children had unmet needs for mental health counseling services, and about three-quarters of families had unmet needs for respite care. In several service categories, the proportion perceived to have had unmet service needs was around 10 percent or less. In the dominant service category of physical, occupational, and speech therapy, only 11 percent perceived to have had unmet service needs.
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Children after adoption: Exploring their psychological needs.
DeJong, Margaret; Hodges, Jill; Malik, Osman
2016-10-01
Children adopted from care are known to be at increased risk for mental health difficulties although relatively little research has been carried out to explore this question. This study assessed the mental health and psychological development of children placed for adoption by one UK Local Authority. We compared the pattern and prevalence of difficulties to existing data including that on Looked-After Children (LAC) children. Totally, 106 families were initially approached and parent interviews and at least partial questionnaire data were gathered on 47 children, 72.3% of whom were known to have been maltreated prior to adoption. Of the 34 children with a complete data set including Development and Well-Being Assessment (DAWBA), 76.4% met full criteria for at least one neurodevelopmental or mental health diagnosis, a markedly higher rate than comparison data on LAC or community samples. Less than half of those identified with a mental health diagnosis had received any prior diagnosis, and only a minority had received appropriate services. Despite the children's difficulties, the great majority of parents reported high enjoyment of bringing up their child. © The Author(s) 2015.
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Isong, Inyang; Dantas, Laila; Gerard, Macda; Kuhlthau, Karen
2014-01-01
Background Significant disparities exist in children’s receipt of preventive dental care (PDC) in the United States. Many of the children at greatest risk of dental disease do not receive timely PDC; when they do receive dental care, it is often more for relief of dental pain. Chelsea is a low-income, diverse Massachusetts community with high rates of untreated childhood caries. There are various dental resources available in Chelsea, yet many children do not access dental care at levels equivalent to their needs. Objective Using Chelsea as a case-study, to explore factors contributing to forgone PDC (including the age 1 dental visit) in an in-depth way. Methods We used a qualitative study design that included semi-structured interviews with parents of preschool children residing in Chelsea, and Chelsea-based providers including pediatricians, dentists, a dental hygienist and early childhood care providers. We examined: a) parents’ dental attitudes and oral health cultural beliefs; b) parents’ and providers’ perspectives on facilitators and barriers to PDC, reasons for unmet needs, and proposed solutions to address the problem. We recorded, transcribed and independently coded all interviews. Using rigorous, iterative qualitative data analyses procedures, we identified emergent themes. Results Factors perceived to facilitate receipt of PDC included Head-Start oral health policies, strong pediatric primary care/dental linkages, community outreach and advertising, and parents’ own oral health experiences. Most parents and providers perceived there to be an adequate number of accessible dental services and resources in Chelsea, including for Medicaid enrollees. However, several barriers impeded children from receiving timely PDC, the most frequently cited being insurance related problems for children and adults. Other barriers included limited dental services for children <2 years, perceived poor quality of some dental practices, lack of emphasis on prevention-based dental care, poor care-coordination, and insufficient culturally-appropriate care. Important family-level barriers included parental oral health literacy, cultural factors, limited English proficiency and competing priorities. Several solutions were proposed to address identified barriers. Conclusion Even in a community with a considerable number of dental resources, various factors may preclude access to these services by preschool-aged children. Opportunities exist to address modifiable factors through strategic oral health policies, community outreach and improved care coordination between physicians, dentists and early childhood care providers. PMID:25614878
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A Guide for Minnesota Parents to the Individualized Education Program (IEP), 2014 Edition
ERIC Educational Resources Information Center
PACER Center, 2014
2014-01-01
Every child is unique and learns in different ways. Some children are identified as needing special education services to support his or her learning at school. Parents can play a major role in shaping the services a child receives. This guidebook has been written for parents, guardians, and surrogate parents of a child (ages 3 to 21 or…
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ERIC Educational Resources Information Center
Puig, Victoria I.
2012-01-01
This study was designed to gain insight into how early intervention (EI) services incorporate the cultural and linguistic resources of families and how EI professionals and families build partnerships with each other. Through observation and interview, the author looked deeply at the experiences of a small group of culturally and linguistically…
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Impact of a private health insurance mandate on public sector autism service use in Pennsylvania.
Stein, Bradley D; Sorbero, Mark J; Goswami, Upasna; Schuster, James; Leslie, Douglas L
2012-08-01
Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on use of Medicaid-funded ASD services. We used Medicaid claims data from July 1, 2006, through June 30, 2010, to identify children with ASD and to assess their use of behavioral health services and psychotropic medications. Service and medication use were examined in four consecutive 12-month periods: the 2 years preceding passage of the legislation, the year after passage but before implementation, and the year after implementation. We examined differences in use of services and medications, and used growth rates from nonwaiver children to estimate the impact of the legislation on Medicaid spending for waiver-eligible children with ASD. The number of children with ASD receiving Medicaid services increased 20% from 2006-2007 to 2009-2010. The growth rate among children affected by the legislation was comparable to that of other groups before passage of the legislation but decreased after the legislation's passage. We project that, without the legislation, growth in this population would have been 46% greater in 2009-2010 than observed, associated with spending of more than $8 million in 2009-2010. Passage of legislation increasing private insurance coverage of ASD services may decrease the number of families seeking eligibility to obtain Medicaid-funded services, with an associated substantial decrease in Medicaid expenditures. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Milovancevic, Milica Pejovic; Jovicic, Milica
2013-01-01
It has been estimated that 9 to 13% of children and adolescents have a mental disorder that causes significant functioning impairment and that only one fifth of those who need mental health services actually receive them. The majority of children and adolescents are enrolled in schools, where they spend a considerable amount of time, and this is…
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Simşek, Zeynep; Erol, Neşe; Oztop, Didem; Ozer Ozcan, Ozlem
2008-01-01
We examined the prevalence of emotional and behavioral problems, and associated factors in children and adolescents aged 6-18 years that were reared in orphanages. We aimed to compare these children and adolescents with a nationally representative age-matched sample that were raised by their own families and to identify mental health service needs in orphanages. This cross-sectional study included 674 children and adolescents aged 6-18 years that were selected from orphanages using stratified and probability cluster sampling. A socio-demographic information form, and the Child Behavior Checklist (CBCL), Teacher's Report Form (TRF), and Youth Self-Report Form (YSR) were used for data collection. According to the information provided by caregivers, teachers, and youths, the prevalence of problem behaviors ranged between 18.3% and 47% among those in institutional care versus between 9% and 11% among the national sample. Among those in institutional care, the prevalence of externalizing problems (21.4%-41.9%) was significantly higher than the prevalence of internalizing problems (6.2%-40.1%). At the syndrome level, the prevalence of social problems (5.7%-11.7%), thought disorders (7.2%-18.4%), and attention problems (7.7%-31.4%) among the youths in institutional care was higher than among the national sample (1.6%-5.8%). Age at first admission, receiving institutional care because of neglect and abuse, moves 2 or more times between institutions, recurrent physical illness, receiving poor quality care, lack of regular contact with parents or relatives, lack of regular contact with teachers and the institutional staff, poor problem-solving skills, fatalistic beliefs, tobacco and alcohol use, the feeling of stigmatization, and low-level competency were significantly associated with an increased risk of behavioral and emotional problems. In this representative study, only 2.4% of the children received any mental health care services. There is an urgent need to develop alternative care models and routine screening for mental health. The training of professionals and development of mental health services for children in institutional care should be a priority.
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Chandrasekaran, Saravanan; Patil, Sooraj; Suthar, Renu; Attri, Savita Verma; Sahu, Jitendra Kumar; Sankhyan, Naveen; Tageja, Mini; Singhi, Pratibha
2017-04-01
Long-term therapy with phenytoin and carbamazepine is known to cause hyperhomocysteinaemia. We evaluated the prevalence of hyperhomocysteinaemia in North Indian children receiving phenytoin or carbamazepine monotherapy for >6 months duration and the effect of folic acid supplementation on plasma homocysteine. In this cross-sectional observational study we enrolled consecutive children aged 2-12 years with epilepsy who had received phenytoin or carbamazepine monotherapy for >6 months. Plasma total homocysteine, folic acid, vitamin B12 and antiepileptic drug concentrations were measured. Healthy age- and sex-matched controls were recruited. Children with homocysteine >10.4 µmol/L received folic acid supplementation for 1 month and homocysteine and folic acid concentrations were measured after 1 month follow-up. A total of 112 children receiving antiepileptic monotherapy for >6 months were enrolled. Hyperhomocysteinaemia was present in 54 children (90%) receiving phenytoin, 45 children (90%) receiving carbamazepine therapy and 17 (34%) controls (p<0.05). Mean plasma homocysteine concentrations were significantly higher (18.9±10.2 vs 9.1±3 µmol/L) and serum folic acid concentrations (10.04±8.5 ng/ml vs 12.6±4.8 p<0.001) and vitamin B12 concentrations (365±155 pg/mL vs 474±332 pg/mL, p=0.02) were significantly lower in the study group compared with the control group. Duration of antiepileptic drug therapy correlated significantly with elevated homocysteine and reduced folic acid concentrations (p<0.05). Supplementation with folic acid for 1 month led to a reduction in plasma homocysteine concentrations in the study group (from 20.9±10.3 µmol/L to 14.2±8.2 µmol/L, p<0.05). Phenytoin or carbamazepine monotherapy for >6 months duration is associated with hyperhomocysteinaemia in 90% of North Indian children. Elevated homocysteine concentrations were normalised in these children with folic acid supplementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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ERIC Educational Resources Information Center
Kivett, Vira R.
Although the support network of elderly individuals has received increased attention recently, most research has focused on the parent child relationship without examining other levels of kin interrelations. To examine the help received by rural-transitional older adults from their consanguineous kin (adult children, grandchildren, siblings,…
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Code of Federal Regulations, 2012 CFR
2012-04-01
... 25 Indians 1 2012-04-01 2011-04-01 true How many hours can a student be taken out of the academic..., DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN... a student be taken out of the academic setting to receive behavioral health services? A student may...
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Code of Federal Regulations, 2011 CFR
2011-04-01
... 25 Indians 1 2011-04-01 2011-04-01 false How many hours can a student be taken out of the academic..., DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN... a student be taken out of the academic setting to receive behavioral health services? A student may...
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Code of Federal Regulations, 2013 CFR
2013-04-01
... 25 Indians 1 2013-04-01 2013-04-01 false How many hours can a student be taken out of the academic..., DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN... a student be taken out of the academic setting to receive behavioral health services? A student may...
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Code of Federal Regulations, 2014 CFR
2014-04-01
... 25 Indians 1 2014-04-01 2014-04-01 false How many hours can a student be taken out of the academic..., DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN... a student be taken out of the academic setting to receive behavioral health services? A student may...
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Barkaia, Ana; Stokes, Trevor F; Mikiashvili, Tamar
2017-07-01
This study examined the effects of intercontinental telehealth coaching on the mastery of therapists' skills and improvements in verbalizations by children with autism, testing whether telehealth can be a solution for underserved communities in developing countries such as Georgia-Sakartvelo in Eastern Europe. Three therapists delivering and three children with autism receiving early-intervention services from the nongovernmental organization Children of Georgia in Tbilisi participated. Experimenters provided coaching from Virginia, USA to therapists in Georgia-Sakartvelo. Observers in Georgia-Sakartvelo and in Virginia conducted the behavioral observations. We used inexpensive communications technology to provide the coaching and a multiple-baseline design across participants to evaluate the effects of the intervention. Therapists demonstrated improvements in two classes of behaviors: correct command sequences and positive consequences. The children demonstrated improvements with echoics and mands. The study demonstrated that telehealth can be a good model for delivering early-intervention services to children with autism in underserved and distant regions of the world. © 2017 Society for the Experimental Analysis of Behavior.
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A profile of Hawaiians in the Medicaid Fee-For-Service program.
Loke, M; Kang-Kaulupali, K T; Honbo, L
2001-09-01
In Hawai'i, the Medicaid Fee-For-Service (FFS) program enrolled approximately 39,000 individuals in fiscal year (FY) 1999. This program specifically provides healthcare services to enrollees classified as aged, blind, disabled, in-state foster children, and children who live out-of-state in subsidized adoptions. The total expenditure associated with this program was over $300 million in FY 1999. Nearly 4,600 enrollees in the Medicaid FFS program were self-identified as Native Hawaiians or part-Hawaiians. Although the proportion of Hawaiians in the Medicaid program was a fair representation of Hawaiians in the state, the distribution by recipient category within the program was in sharp contrast. Aged Hawaiians appeared to be under-represented in the program while disabled Hawaiians were overrepresented. Foster children and children under subsidized adoption accounted for 1% of the total Hawaiian population. Excluding the foster children and children under subsidized adoption, recipients of Hawaiian ancestry in the Medicaid FFS program (aged, blind, and disabled) obtained health care services amounting to approximately $34 million in FY 1999. Females in this population received more services, with total Medicaid payments amounting to $18.7 million. A higher proportion of Hawaiian recipients were on the neighbor islands. In this FFS Hawaiian population, the top three disease-states by dollar volume in FY 1999, were Alzheimer's disease, acute cerebrovascular disease, and profound mental retardation. A total of $3 million in services were provided to recipients with these primary disease-states. The five leading disease-states facing Hawaiians were generally comparable to those confronting the overall FFS population.
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School-related and social-emotional outcomes of providing mental health services in schools.
Ballard, Kristin L; Sander, Mark A; Klimes-Dougan, Bonnie
2014-02-01
This study evaluated student outcomes of an expanded school mental health (ESMH) model that placed community mental health clinicians on-site in schools to identify and treat children with mental health needs. The first aim of this study was to consider school-related outcomes (suspension rates and attendance rates) for those students who received ESMH treatment (n = 159) were compared to a matched high-risk sample that did not receive such services (n = 148). Results demonstrated differences between groups over time on measures of suspensions and attendance but not academic achievement. The second aim of this study was to evaluate change in social-emotional functioning (Strengths and Difficulties Questionnaire Scores) over time for the treatment group. Results indicated significant improvements on several parent and teacher ratings. Despite limitations of the ESMH framework examined in this study, the overall results suggest some promising advantages for students who received ESMH services.
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Vitamin D supplementation: we must not fail our children!
Drury, Rosalyn; Rehm, Andreas; Johal, Simran; Nadler, Robert
2015-05-01
There is increasing concern that vitamin D deficiency poses a major health problem for children. Deficiency can cause hypocalcemic seizures, growth disturbances, and rickets and may influence diabetes, cardiovascular dysfunction, autoimmune diseases, and attention deficit hyperactivity disorders. Reduced vitamin D levels in children presenting to pediatric orthopedic services are common.In the United Kingdom, recommendations on vitamin D supplementation are set by the Department of Health (DoH) and the National Institute of Health and Clinical Excellence. These state that all children aged 6 months to 5 years ought to receive 7 to 8.5 μg of vitamin D daily.We carried out a survey of 203 parents attending our pediatric and pediatric orthopedic and fracture clinics to evaluate parental awareness of the DoH recommendations on vitamin D supplementation for children and to assess the extent to which children were receiving vitamin D supplements.About 85.71% of parents were not aware of the recommendations. Only 14.29% stated that they were aware of the benefits of vitamin D for their children and just 17.73% of children were receiving vitamin D supplementation; 17 via formula milk and 18 via multivitamin formulations.Parents are generally not aware about vitamin D supplementation because of a lack of information with the high rates of reported suboptimal vitamin D levels amongst children not being addressed resulting in increased health risks to our children. Major improvements are needed in the implementation of supplementation at all points of contact between parents and health-care professionals.
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Kogan, Michael D; Strickland, Bonnie B; Blumberg, Stephen J; Singh, Gopal K; Perrin, James M; van Dyck, Peter C
2008-12-01
We sought to examine the health care experiences of children with autism spectrum disorder and the impact of autism spectrum disorder on the family and to assess whether having a medical home is associated with less family impact. We used the 2005-2006 National Survey of Children With Special Health Care Needs to compare 2088 children with special health care needs, aged 3 to 17 years, reported by their parents to have autism spectrum disorder, with children with special health care needs with "other emotional, developmental, or behavioral problems" (excluding autism spectrum disorder; n=9534) and 26751 other children with special health care needs. We used weighted logistic regression to examine unmet needs for specific health care and support services, delayed care, no usual care source or personal physician, difficulty receiving referrals, and financial, employment, or time problems because of child's care. Nationally, an estimated 535000 children have special health care needs and autism spectrum disorder, a prevalence of 86 per 10000 children aged 3 to 17 years. Among children with special health care needs, 5.6% have autism spectrum disorder. Compared with other children with special health care needs without emotional, developmental, or behavioral problems, children with special health care needs with autism spectrum disorder were more likely to have unmet needs for specific health care services, family support services, delayed or foregone care, difficulty receiving referrals, and care that is not family centered. Children with special health care needs with autism spectrum disorder were more likely to live in families that report financial problems, need additional income for the child's medical care, reduce or stop work because of the child's condition, spend >or=10 hours per week providing or coordinating care, and paid more than $1000 in the previous year for the child's care. The financial impacts of autism spectrum disorder were significantly more burdensome when children with special health care needs did not have a medical home. Children with special health care needs with autism spectrum disorder are significantly more likely to have problems regarding access to care and unmet needs, and their families have greater financial, employment, and time burdens compared with other children with special health care needs. Receipt of primary care in a medical home may reduce these burdens.
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Evaluation of oral health status and influential factors in children with autism.
Onol, S; Kırzıoğlu, Z
2018-04-01
The aim of the present study was to comparatively analyze oral health status and influential factors in children with autism living in the Western Mediterranean Region of Turkey. This cross-sectional study was conducted in two steps: 1 - questionnaire and 2 - interview. This study was conducted at the Department of Pediatric Dentistry, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey, within the period from March to July 2016. Although the questionnaire part involved 126 children with autism and 111 children without autism, 63 children who did not satisfy the inclusion criteria were excluded from the study in the interview part. The forms were sent to previously determined schools, and factors such as age, socioeconomic status, medical history, dental history, eating habits, bad habits, and treatment methods preferred by children's parents were analyzed. Later, interviews with the children were carried out by the same researcher and their oral health conditions were recorded. Children with autism often have nutritional problems, and early initiation of special education appears effective in preventing these conditions. Although children with autism apply for dental services, the rate for these children receiving dental services is considerably low and most of the services rendered are tooth extractions. It appears that the oral status of children with autism is affected negatively by many factors. Thus, the parents, the educators, and the dentists should be aware of this fact and encouraged to improve such children's oral hygiene and provide the dental care they need.
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Randomized pilot study to disseminate caries-control services in dentist offices
Grembowski, David; Spiekerman, Charles; del Aguila, Michael A; Anderson, Maxwell; Reynolds, Debra; Ellersick, Allison; Foster, James; Choate, Leslie
2006-01-01
Background To determine whether education and financial incentives increased dentists' delivery of fluoride varnish and sealants to at risk children covered by capitation dental insurance in Washington state (U.S.). Methods In 1999, 53 dental offices in Washington Dental Service's capitation dental plan were invited to participate in the study, and consenting offices were randomized to intervention (n = 9) and control (n = 10) groups. Offices recruited 689 capitation children aged 6–14 and at risk for caries, who were followed for 2 years. Intervention offices received provider education and fee-for-service reimbursement for delivering fluoride varnish and sealants. Insurance records were used to calculate office service rates for fluoride, sealants, and restorations. Parents completed mail surveys after follow-up to measure their children's dental utilization, dental satisfaction, dental fear and oral health status. Regression models estimated differences in service rates between intervention and control offices, and compared survey measures between groups. Results Nineteen offices (34%) consented to participate in the study. Fluoride and sealant rates were greater in the intervention offices than the control offices, but the differences were not statistically significant. Restoration rates were lower in the intervention offices than the control offices. Parents in the intervention group reported their children had less dental fear than control group parents. Conclusion Due to low dentist participation the study lacked power to detect an intervention effect on dentists' delivery of caries-control services. The intervention may have reduced children's dental fear. PMID:16670027
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Sakai, Christina; Lin, Hua; Flores, Glenn
2011-02-01
To comprehensively assess family services, health, and health care outcomes for US children in kinship care vs foster care. A 3-year prospective cohort study. National Survey of Child and Adolescent Well-Being. The sample consisted of 1308 US children entering out-of-home care following reported maltreatment. Kinship care vs foster care. Baseline caregivers' support services and the children's behavioral, mental health, and health service use outcomes 3 years after placement. Kinship caregivers were more likely than foster caregivers to have a low socioeconomic status but reported significantly fewer support services (caregiver subsidies, parent training, peer support, and respite care). Kinship care was associated with a lower risk ratio (RR) of continuing behavioral problems (RR = 0.59; 95% confidence interval [CI], 0.41-0.80), low social skills (RR = 0.61; 95% CI, 0.40-0.87), mental health therapy use (RR = 0.45; 95% CI, 0.27-0.73), and psychotropic medication use (RR = 0.46; 95% CI, 0.24-0.82) but higher risk of substance use (RR = 1.88; 95% CI, 0.92-3.20) and pregnancy (RR = 4.78; 95% CI, 1.07-17.11). Kinship caregivers received fewer support services than foster caregivers. Children in kinship care fared better with behavioral and social skills problems, mental health therapy use, and psychotropic medication use. Adolescents in kinship care may be at higher risk for substance use and pregnancy.
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Hendrix, Kristin S; Downs, Stephen M; Brophy, Ginger; Carney Doebbeling, Caroline; Swigonski, Nancy L
2013-01-01
Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost-effectiveness do not show cost-savings. Our objective is to apply state-specific claims data to an existing published model to quickly and inexpensively estimate the cost-savings of a policy consideration to better inform decisions - specifically, to assess whether Indiana Medicaid children's restorative service rates met the threshold to generate cost-savings. Threshold analysis was based on the 2006 model by Quiñonez et al. Simple calculations were used to "align" the Indiana Medicaid data with the published model. Quarterly likelihoods that a child would receive treatment for caries were annualized. The probability of a tooth developing a cavitated lesion was multiplied by the probability of using restorative services. Finally, this rate of restorative services given cavitation was multiplied by 1.5 to generate the threshold to attain cost-savings. Restorative services utilization rates, extrapolated from available Indiana Medicaid claims, were compared with these thresholds. For children 1-2 years old, restorative services utilization was 2.6 percent, which was below the 5.8 percent threshold for cost-savings. However, for children 3-5 years of age, restorative services utilization was 23.3 percent, exceeding the 14.5 percent threshold that suggests cost-savings. Combining a published model with state-specific data, we were able to quickly and inexpensively demonstrate that restorative service utilization rates for children 36 months and older in Indiana are high enough that fluoride varnish regularly applied by physicians to children starting at 9 months of age could save Medicaid funds over a 3-year horizon. © 2013 American Association of Public Health Dentistry.
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Disability and the education system.
Aron, Laudan; Loprest, Pamela
2012-01-01
Education is important for all children, but even more so for children with disabilities, whose social and economic opportunities may be limited. In this article, Laudan Aron and Pamela Loprest assess how well the nation's education system is serving students with disabilities. Aron and Loprest trace the evolution of the special education system in the United States from its origins in the civil rights movement of the mid-twentieth century. They note the dual character of federal legislation, which both guarantees eligible children with disabilities the right to a "free, appropriate public education in the least restrictive setting" and establishes a federal funding program to help meet this goal. They then review the types of services and accommodations these children receive from infancy through young adulthood. The special education system has given children with disabilities much greater access to public education, established an infrastructure for educating them, helped with the earlier identification of disabilities, and promoted greater inclusion of these children alongside their nondisabled peers. Despite these advances, many problems remain, including the over- and underidentification of certain subgroups of students, delays in identifying and serving students, and bureaucratic, regulatory, and financial barriers that complicate the program for everyone involved. More important, the authors show that special education students still lag behind their nondisabled peers in educational achievements, are often held to lower expectations, are less likely to take the full academic curriculum in high school, and are more likely to drop out of school. Only limited evidence is available on the effectiveness of specific special education services or on how to improve student achievement for this important subgroup of students. Improving the system will require better ways of understanding and measuring both ends of the special education continuum, namely, what services special education children need and receive, and what academic outcomes these students achieve. Without stronger evidence linking these two aspects of the system, Aron and Loprest argue, researchers will be unable to gauge the efficacy of the services now being delivered or to formulate effective reforms to the system as a whole.
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Parents' preferences for services for children with hearing loss: a conjoint analysis study.
Fitzpatrick, Elizabeth; Coyle, Douglas E; Durieux-Smith, Andrée; Graham, Ian D; Angus, Douglas E; Gaboury, Isabelle
2007-12-01
Early identification of permanent childhood hearing loss through universal newborn hearing screening is rapidly becoming a standard of care. However, it is well recognized that hearing screening must be embedded within a comprehensive system of rehabilitation and parent support services. This study was undertaken with parents of young children with permanent hearing loss to examine their preferences for characteristics associated with intervention services. A secondary goal was to explore whether preferences may differ according to patient subgroups. Conjoint analysis, a preference-based economic technique, was used to investigate parents' strength of preferences. A cross-sectional survey that consisted of hypothetical clinic scenarios was developed based on information from qualitative interviews with parents. The questionnaire was administered to parents receiving intervention services in the province of Ontario, Canada, shortly after the implementation of a universal hearing screening program. The sample was recruited from three different clinical programs. A total of 48 of 75 respondents completed the questionnaire, a response rate of 64%. The participants varied by screening status of the child (25 screened, 23 not screened), type of device (23 hearing aids, 25 cochlear implants), and region. All five characteristics of care that were selected for inclusion in the survey were found to be statistically significant attributes of services: coordinated services, access to parent support, access to information, frequency of services, and location of services. Parents showed a preference for clinic-based rather than home-based services. Preferences toward once a week therapy services rather than services two to three times weekly were also found. In particular, parents valued service models that consisted of well-coordinated care with access to support from other parents. Differences in respondents according to hearing screening status (screened or unscreened), type of hearing device (hearing aid or cochlear implant), or region (Ottawa or Toronto) did not seem to affect parents' preferences for attributes of care. Conjoint analysis is a useful technique for quantifying parents' preferences for care. The values expressed by parents provide insights into the aspects of a service model that should receive consideration in the development of programs for young children with hearing loss and their families.
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Goettems, Marília L; Ardenghi, Thiago M; Demarco, Flávio F; Romano, Ana R; Torriani, Dione D
2012-10-01
The purpose of the study was to investigate the influence of a child's clinical condition; maternal characteristics such as dental anxiety and dental visit pattern; socioeconomic conditions; and maternal perception of the child's oral health-related quality of life (OHRQoL) on a child's use of dental care services. A cross-sectional study of 608 mother-child dyads was conducted during the Children's Immunization Campaign in Pelotas, Brazil. Mothers answered a questionnaire regarding their use of dental services, dental anxiety (Dental Anxiety Scale), socioeconomic status, and perception of their children's OHRQoL (the Early Childhood Oral Health Impact Scale). Clinical examination of the children was performed to assess dental caries (dmf-t). Associations between the above-mentioned factors and child use of dental services were assessed using Poisson regression models (prevalence ratio [PR]; 95% CI; P ≤ 0.05). The majority of children (79.3%) had never had a dental appointment and of the children who had visited a dentist, 55 (43.65%) presented with untreated dental caries at the time of examination. More than half the mothers (60.2%) did not visit a dentist regularly. In the final model, low schooling level of mothers (PR, 0.64) and irregular visits to a dentist by the mother (PR, 0.48) were factors because of which a child did not have a dental appointment. Children who had experienced pain (PR, 1.56), those who had poor OHRQoL (PR, 1.49), and older children (PR, 2.14) visited a dentist with higher frequency. Use of dental care services by preschool children was low, and treatment was neglected even among children who had visited a dentist. Children of mothers with low schooling level who do not visit a dentist regularly were at greater risk of not receiving dental care. Maternal perception of their child's oral health motivated visits to the dentist. © 2012 John Wiley & Sons A/S.
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Thomas, Nicole; Blake, Sharon; Morris, Christopher; Moles, David R
2018-03-01
Accessing and receiving preventative dental treatment can be difficult for children with autism due to sensory processing disorders and/or challenging behaviours coupled with a reported reluctance by dentists to treat these children. To gather dental experiences of UK parents of children with autism or working diagnosis of autism and explore how they feel primary care dental services can be improved. A total of 17 parents of children with a diagnosis or working diagnosis of autism took part in semi-structured interviews. Data were analysed thematically. Key themes identified were flexibility of the dental team and environment, confidence of the parents to advocate for their children's needs, continuity of services and clear referral pathways to specialist services. Cross-cutting all themes was the value of clear communication. The experiences provide greater understanding of issues such as hyper-empathy, the dental chair, challenges of the waiting room, perceived medical authority, and the importance of continuation of care. In line with previous research about the importance of family-centred care, a strong relationship between parents and the whole dental team is essential for children with autism to access dental examinations and have satisfactory experience of care. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan
2013-10-01
To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.
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The dental care of U.S. children: access, use and referrals by nondentist providers, 2003.
Chu, May; Sweis, Luciana E; Guay, Albert H; Manski, Richard J
2007-10-01
Improvements in oral health care services have not reached evenly across every segment of American society. The authors examine the role of nondentist practitioners in referring child patients for dental care by analyzing data from the 2003 Medical Expenditure Panel Survey conducted by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. The authors provide national estimates of the percentage of the civilian noninstitutionalized population of the United States aged 2 through 17 years who had a dental visit, who had a dental checkup and who received advice from a nondentist health care provider to have a dental checkup. Overall, 38 percent of all poor, near-poor or low-income children and 60 percent of all middle- or high-income children aged 2 through 17 years reported having had a dental checkup during 2003. The authors observed no significant differences between poor, near-poor and low-income children and higher-income children in terms of having been advised by a nondentist health care provider to have a dental checkup. Although income may not predict the likelihood of patients' receiving advice from a nondentist health care provider to have a dental checkup, children from families with higher levels of income were more likely to seek dental care than were children from families with lower levels of income. Practice Implications. Efforts to increase access to dental care should aim to maximize the benefit of advice provided by nondentist health care practitioners to receive a dental checkup, so that children from families with limited income are as likely to receive a dental checkup as are children from families with higher levels of income.
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Spillover Effects of Adult Medicaid Expansions on Children's Use of Preventive Services.
Venkataramani, Maya; Pollack, Craig Evan; Roberts, Eric T
2017-12-01
Since the passage of the Affordable Care Act, Medicaid enrollment has increased by ∼17 million adults, including many low-income parents. One potentially important, but little studied, consequence of expanding health insurance for parents is its effect on children's receipt of preventive services. By using state Medicaid eligibility thresholds linked to the 2001-2013 Medical Expenditure Panel Surveys, we assessed the relationship between changes in adult Medicaid eligibility and children's likelihood of receiving annual well-child visits (WCVs). In instrumental variable analyses, we used these changes in Medicaid eligibility to estimate the relationship between parental enrollment in Medicaid and children's receipt of WCVs. Our analytic sample consisted of 50 622 parent-child dyads in families with incomes <200% of the federal poverty level, surveyed from 2001 to 2013. On average, a 10-point increase in a state's parental Medicaid eligibility (measured relative to the federal poverty level) was associated with a 0.27 percentage point higher probability that a child received an annual WCV (95% confidence interval: 0.058 to 0.48 percentage points, P = .012). Instrumental variable analyses revealed that parental enrollment in Medicaid was associated with a 29 percentage point higher probability that their child received an annual WCV (95% confidence interval: 11 to 47 percentage points, P = .002). In our study, we demonstrate that Medicaid expansions targeted at low-income adults are associated with increased receipt of recommended pediatric preventive care for their children. This finding reveals an important spillover effect of parental insurance coverage that should be considered in future policy decisions surrounding adult Medicaid eligibility. Copyright © 2017 by the American Academy of Pediatrics.
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Koulidiati, Jean-Louis; Nesbitt, Robin C; Ouedraogo, Nobila; Hien, Hervé; Robyn, Paul Jacob; Compaoré, Philippe; Souares, Aurélia; Brenner, Stephan
2018-01-01
Objective To estimate both crude and effective curative health services coverage provided by rural health facilities to under 5-year-old (U5YO) children in Burkina Faso. Methods We surveyed 1298 child health providers and 1681 clinical cases across 494 primary-level health facilities, as well as 12 497 U5YO children across 7347households in the facilities’ catchment areas. Facilities were scored based on a set of indicators along three quality-of-care dimensions: management of common childhood diseases, management of severe childhood diseases and general service readiness. Linking service quality to service utilisation, we estimated both crude and effective coverage of U5YO children by these selected curative services. Results Measured performance quality among facilities was generally low with only 12.7% of facilities surveyed reaching our definition of high and 57.1% our definition of intermediate quality of care. The crude coverage was 69.5% while the effective coverages indicated that 5.3% and 44.6% of children reporting an illness episode received services of only high or high and intermediate quality, respectively. Conclusion Our study showed that the quality of U5YO child health services provided by primary-level health facilities in Burkina Faso was low, resulting in relatively ineffective population coverage. Poor adherence to clinical treatment guidelines combined with the lack of equipment and qualified clinical staff that performed U5YO consultations seemed to be contributors to the gap between crude and effective coverage. PMID:29858415
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ERIC Educational Resources Information Center
Lundy, Heather F.
2011-01-01
Family quality of life (FQOL) refers to the degree to which families of individuals with disabilities are able to meet their basic needs, enjoy time together, and pursue leisure interests and activities (Park et al., 2003). Researchers have identified barriers that families of individuals with disabilities encounter as they pursue a life of…
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Thistle, Jennifer J; McNaughton, David
2015-01-01
This study examined the effect of instruction in an active listening strategy on the communication skills of pre-service speech-language pathologists (SLPs). Twenty-three pre-service SLPs in their 2nd year of graduate study received a brief strategy instruction in active listening skills. Participants were videotaped during a simulated parent meeting before and after the strategy instruction. Simulated parent meetings addressed issues that parents of children who use augmentative and alternative communication (AAC) may face. Social validity measures were gathered from the participants and from parents of children who use AAC. Pre- and postinstruction use of the active listening strategy was scored and compared using a Wilcoxon signed-ranks test, with statistically significant results. Postinstruction scores were significantly higher than preinstruction scores, providing evidence of the effectiveness of the instruction. Furthermore, participants and parents of children who use AAC described the postinstruction interactions more positively than the preinstruction interactions, suggesting that the pre-service SLPs benefited from the instruction. The current study provides evidence of the effectiveness of strategy instruction in active listening skills that may be incorporated into SLP preparation programs.
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The importance of family support in pediatrics and its impact on healthcare satisfaction.
Sigurdardottir, Anna Olafia; Garwick, Ann W; Svavarsdottir, Erla Kolbrun
2017-06-01
To evaluate predictors of healthcare satisfaction for parents whose children received hospital-based healthcare services at the Children's hospital at Landspitali University Hospital. In this cross-sectional study, data on perceived family support, family quality of life, expressive family functioning, coping strategies and healthcare satisfaction were collected from 159 mothers and 60 fathers (N = 177 families) of children and adolescents from 2011 to 2012. Logistic regression analysis revealed that, for mothers, 38.8% of the variance in satisfaction with healthcare services was predicted by perceived family support and their coping strategies, while for fathers, 59.9% of the variance of their satisfaction with healthcare service was predicted by perceived family support, family quality of life and whether the child had been hospitalised before. Perceived family support was the one factor that was found to predict both the mothers' and the fathers' satisfaction with healthcare services. Knowing which factors predict satisfaction with health care among parents of hospitalised children with different chronic illnesses and health issues can inform the delivery of effective family-focused interventions and evidence-based practice to families. © 2016 Nordic College of Caring Science.
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Parent perceptions of school-based support for students with traumatic brain injuries
GFROERER, SUSAN DAVIES; WADE, SHARI L.; WU, MICHELLE
2015-01-01
Primary objective To determine whether parents believe schools provided necessary support to their children who sustained traumatic brain injuries. Research design Interview, to determine parent perceptions. Methods and procedure Sixty-six primary caregivers of school-age children who experienced a TBI within the previous 2 years were interviewed regarding what types of special support were needed by and provided for their children during the 3 months immediately following school re-entry. They then rated how difficult it was to obtain support or services from the school and how satisfied they were with the support or services. Main outcomes and results The majority of participants did not perceive the need for school-based services, even when the injury was severe. Almost all students whose parents perceived a need for an adjusted schedule were granted that accommodation, but few students received school-based counselling or behavioural support. Conclusions Results indicated that participants perceived relatively few school-based supports, particularly given the actual academic, behavioural and social challenges experienced by children who have sustained a TBI. Schools and hospitals must take steps to ensure appropriate post-head injury support services. PMID:18608201
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Anzman-Frasca, Stephanie; Braun, Abbey C; Ehrenberg, Sarah; Epstein, Leonard H; Gampp, April; Leone, Lucia A; Singh, Anita; Tauriello, Sara
2018-08-01
Children's consumption of restaurant foods is associated with higher energy intake and lower nutritional quality compared to foods prepared at home. The aim of this pilot study was to test whether an in-restaurant intervention promoting healthy children's meals (i.e. two meals that met nutrition recommendations and were thus healthier than typical children's meal offerings across leading restaurants) affected children's meal selection and intake. Families with 4-to-8-year-old children were recruited from one location of Anderson's Frozen Custard, a regional quick-service restaurant chain. Families were randomly assigned to return to the restaurant during an intervention or control period and were blinded to group assignment. All families received free meals. During the intervention period families also received placemats featuring two healthy "Kids' Meals of the Day" upon restaurant entry. After families finished dining, researchers recorded children's orders and collected leftovers for quantifying dietary intake via weighed plate waste. Poisson regression and chi-square tests were used to compare children's orders between study groups, and t-tests were used to test for differences in dietary intake among children ordering a promoted healthy entrée (main dish) versus those who did not. Fifty-eight families participated. Children who were exposed to the study placemats prior to ordering ordered a significantly greater number of healthy food components compared to controls (p = 0.03). Overall, in the intervention group, 21% of children ordered a healthy entrée or side dish, versus 7% of controls. Children who ordered one of the promoted healthy entrées consumed less saturated fat across the total meal compared to those who did not (p = 0.04). Manipulating the prominence of healthy choices in restaurants may shift children's meal selections. Future research should build on these initial promising results, aiming to increase the potency of the intervention to achieve more widespread effects. Copyright © 2018 Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Grygas Coogle, Christan; Guerette, Amy R.; Hanline, Mary Frances
2013-01-01
The purpose of this study was to obtain an understanding of the unique experiences of families who have a young child at risk for or identified with an autism spectrum disorder and their experiences with early intervention. Thirty-nine parents of children with or at risk for an autism spectrum disorder receiving Part C services in a state in the…
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Chan, Grace J; Moulton, Lawrence H; Becker, Stan; Muñoz, Alvaro; Black, Robert E
2007-10-01
To determine the non-specific effects of diphtheria, tetanus and pertussis (DTP) vaccination and sex on mortality before 30 months of age among those who received Bacille Calmette Guerin (BCG) vaccine in a high mortality area. This analysis used a longitudinal study of child survival monitoring the use of primary care services, morbidity and mortality in Metro Cebu, The Philippines. Participants included 14 537 children under 30 months of age who received a BCG vaccination from July 1988 to January 1991. The main outcome measure was all-cause mortality. Mortality before 30 months of age was 57% lower among BCG-vaccinated children who received DTP vaccination than BCG-vaccinated children who did not receive DTP vaccination {hazard ratio (HR) for vaccinated vs unvaccinated 0.43 [95% confidence interval (CI) 0.21-0.88]}. Females had lower mortality rates [HR = 0.19 (0.04-0.86), P = 0.03] than males among DTP-unvaccinated children. The protective effect of DTP vaccination was more pronounced in males [HR 0.32 (0.14-0.73)] than in females [HR 0.86 (0.18-4.23)]. DTP vaccination increased (interaction term P = 0.08) the female-to-male mortality ratio to 0.76 (0.52-1.12). Among BCG-vaccinated children under 30 months of age, DTP vaccination is associated with improved survival. The increased female-male mortality ratio is associated with reduced mortality among males following DTP vaccination rather than increased mortality among female children.
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Moore, David R; Sieswerda, Stephanie L; Grainger, Maureen M; Bowling, Alexandra; Smith, Nicholette; Perdew, Audrey; Eichert, Susan; Alston, Sandra; Hilbert, Lisa W; Summers, Lynn; Lin, Li; Hunter, Lisa L
2018-05-01
Children referred to audiology services with otherwise unexplained academic, listening, attention, language, or other difficulties are often found to be audiometrically normal. Some of these children receive further evaluation for auditory processing disorder (APD), a controversial construct that assumes neural processing problems within the central auditory nervous system. This study focuses on the evaluation of APD and how it relates to diagnosis in one large pediatric audiology facility. To analyze electronic records of children receiving a central auditory processing evaluation (CAPE) at Cincinnati Children's Hospital, with a broad goal of understanding current practice in APD diagnosis and the test information which impacts that practice. A descriptive, cross-sectional analysis of APD test outcomes in relation to final audiologist diagnosis for 1,113 children aged 5-19 yr receiving a CAPE between 2009 and 2014. Children had a generally high level of performance on the tests used, resulting in marked ceiling effects on about half the tests. Audiologists developed the diagnostic category "Weakness" because of the large number of referred children who clearly had problems, but who did not fulfill the AAA/ASHA criteria for diagnosis of a "Disorder." A "right-ear advantage" was found in all tests for which each ear was tested, irrespective of whether the tests were delivered monaurally or dichotically. However, neither the side nor size of the ear advantage predicted the ultimate diagnosis well. Cooccurrence of CAPE with other learning problems was nearly universal, but neither the number nor the pattern of cooccurring problems was a predictor of APD diagnosis. The diagnostic patterns of individual audiologists were quite consistent. The number of annual assessments decreased dramatically during the study period. A simple diagnosis of APD based on current guidelines is neither realistic, given the current tests used, nor appropriate, as judged by the audiologists providing the service. Methods used to test for APD must recognize that any form of hearing assessment probes both sensory and cognitive processing. Testing must embrace modern methods, including digital test delivery, adaptive testing, referral to normative data, appropriate testing for young children, validated screening questionnaires, and relevant objective (physiological) methods, as appropriate. Audiologists need to collaborate with other specialists to understand more fully the behaviors displayed by children presenting with listening difficulties. To achieve progress, it is essential for clinicians and researchers to work together. As new understanding and methods become available, it will be necessary to sort out together what works and what doesn't work in the clinic, both from a theoretical and a practical perspective. American Academy of Audiology.
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Nogueira, Zeni Drubi; Boa-Sorte, Ney; Leite, Maria Efigênia de Queiroz; Kiya, Márcia Miyuki; Amorim, Tatiana; Fonseca, Silvana Fahel da
2015-01-01
To study breastfeeding history (BF) and the anthropometric status of children with Sickle Cell Disease (SCD). A cross-sectional study of 357 children with SS and SC hemoglobinopathies aged between 2 and 6 years old receiving regular follow-up at a Newborn Screening Reference Service (NSRS) between November 2007 and January 2009. The outcome was anthropometric status and the exposures were: BF pattern, type of hemoglobinopathy and child's age and sex. The average (SD) age was 3.7 (1.1) years, 52.9% were boys and 53.5% had SS hemoglobinopathy. The prevalence of exclusive breastfeeding (EBR) up to six months of age was 31.5%, the median EBR times (p25-p75) was 90.0 (24.0-180.0) days and the median weaning ages (p25-p75) was 360.0 (90.0-20.0) days respectively. Normal W/H children experienced EBR for an average duration almost four times longer than malnourished children (p=0.01), and were weaned later (p<0.05). Height deficit was found in 5.0% of children, while all the children with severe short stature had SS hemoglobinopathy and were over 4 years of age. EBR time and weaning age were greater than found in the literature, which is a possible effect of the multidisciplinary follow-up. Duration of EBR and later weaning were associated with improved anthropometric indicators. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
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Benefits of a school-based health center in a preschool.
Gance-Cleveland, Bonnie; Yousey, Yvonne
2005-11-01
Although school-based health centers (SBHCs) deliver health care to vulnerable children, their effectiveness has not been well documented. This study compared the benefits of an SBHC with a School Health Survey and selected HEDIS measures in preschool children with and without access to an SBHC. Preschoolers with access to an SBHC (N = 130) and preschoolers without access (N = 131) were compared on (a) HEDIS measures including well-child care, immunizations, dental care, and smoke exposure; (b) measures of access and use of physical and mental health services; (c) satisfaction with health care; (d) barriers and facilitators to care; and (e) health insurance. Significant differences were found in parents' perceptions of children's physical and emotional health, self-esteem, incidence of behavioral problems, difficulty in obtaining care, number of hospitalizations, and satisfaction with care received. Findings suggest that holistic services provided by an SBHC positively impact the health of vulnerable preschool children.
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Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic.
Maslow, Gary R; Banny, Adrienne; Pollock, McLean; Stefureac, Kristen; Rosa, Kendra; Walter, Barbara Keith; Hobbs Knutson, Katherine; Lucas, Joseph; Heilbron, Nicole
2017-10-01
An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns. Copyright © 2017 Elsevier Inc. All rights reserved.
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Linking Mother and Child Access to Dental Care
Grembowski, David; Spiekerman, Charles; Milgrom, Peter
2016-01-01
Objectives Among young children in low-income families covered by Medicaid, we estimate by racial/ethnic group whether children who have mothers with a regular source of dental care (RSDC) at baseline have greater dental utilization in the following year than children with mothers without a regular source. Patients and Methods From a population of 108,151 children enrolled in Medicaid aged 3 to 6 and their low-income mothers in Washington state, a disproportionate stratified random sample of 11,305 children aged 3 to 6 was selected from enrollment records in four racial/ethnic groups: 3,791 Black; 2,806 Hispanic 1,902 White; and 2,806 other racial/ethnic groups. In a prospective cohort design, we conducted a baseline survey of mothers and for respondents, collected their children’s Medicaid dental claims in the 1-year follow-up period. Mutivariable regression models estimated the associations between the mothers having a RSDC at baseline and their children’s prospective dental utilization. Results About 38% of mothers had a RSDC. Among children of Black and Hispanic mothers, having a mother with a RSDC at baseline was associated with greater odds of receiving any dental care in the following year (OR 1.69, 95% CI 1.10-2.62 for children of Black mothers; OR 1.84, CI 1.23-2.73 for children of Hispanic mothers). For children with dental utilization, children of Black or Hispanic mothers with a RSDC received 1.22 (CI 1.08-1.38) and 1.10 (CI 1.01-1.19) more preventive services, respectively. For children of White mothers, associations were in the same direction but not significant. Conclusions For young children of Black and Hispanic mothers, dental care utilization is higher when their mothers have a RSDC. For low-income young children with Medicaid, increasing the mothers’ access to dental care may increase the children’s utilization of dental and preventive services, which, in turn, may reduce racial/ethnic inequalities in oral health. PMID:18829778
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Jamison, J M; Fourie, E; Siper, P M; Trelles, M P; George-Jones, Julia; Buxbaum Grice, A; Krata, J; Holl, E; Shaoul, J; Hernandez, B; Mitchell, L; McKay, M M; Buxbaum, J D; Kolevzon, Alexander
2017-05-01
Autism spectrum disorder (ASD) affects individuals across all racial and ethnic groups, yet rates of diagnosis are disproportionately higher for Black and Hispanic children. Caregivers of children with ASD experience significant stressors, which have been associated with parental strain, inadequate utilization of mental health services and lower quality of life. The family peer advocate (FPA) model has been utilized across service delivery systems to provide family-to-family support, facilitate engagement, and increase access to care. This study used a randomized controlled design to examine the efficacy of FPAs in a racially and ethnically diverse sample. Results demonstrate significantly increased knowledge of ASD and reduced levels of stress for caregivers who received the FPA intervention as compared to treatment as usual.
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van Dijk, Janneke H.; Moss, William J.; Hamangaba, Francis; Munsanje, Bornface; Sutcliffe, Catherine G.
2014-01-01
Background Travel time and distance are barriers to care for HIV-infected children in rural sub-Saharan Africa. Decentralization of care is one strategy to scale-up access to antiretroviral therapy (ART), but few programs have been evaluated. We compared outcomes for children receiving care in mobile and hospital-affiliated HIV clinics in rural Zambia. Methods Outcomes were measured within an ongoing cohort study of HIV-infected children seeking care at Macha Hospital, Zambia from 2007 to 2012. Children in the outreach clinic group received care from the Macha HIV clinic and transferred to one of three outreach clinics. Children in the hospital-affiliated clinic group received care at Macha HIV clinic and reported Macha Hospital as the nearest healthcare facility. Results Seventy-seven children transferred to the outreach clinics and were included in the analysis. Travel time to the outreach clinics was significantly shorter and fewer caretakers used public transportation, resulting in lower transportation costs and fewer obstacles accessing the clinic. Some caretakers and health care providers reported inferior quality of service provision at the outreach clinics. Sixty-eight children received ART at the outreach clinics and were compared to 41 children in the hospital-affiliated clinic group. At ART initiation, median age, weight-for-age z-scores (WAZ) and CD4+ T-cell percentages were similar for children in the hospital-affiliated and outreach clinic groups. Children in both groups experienced similar increases in WAZ and CD4+ T-cell percentages. Conclusions HIV care and treatment can be effectively delivered to HIV-infected children at rural health centers through mobile ART teams, removing potential barriers to uptake and retention. Outreach teams should be supported to increase access to HIV care and treatment in rural areas. PMID:25122213
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Daudji, Anisa; Eby, Sarah; Foo, Tina; Ladak, Fahreen; Sinclair, Cameal; Landry, Michel D; Moody, Kim; Gibson, Barbara E
2011-01-01
The objectives of this study were to describe perceptions of disability among South Asian immigrant mothers of children with disabilities in a large multicultural urban centre in Ontario, Canada, and to explore how these perceptions influence rehabilitation services. The study was built on our previous work conducted with mothers in South Asia. A descriptive qualitative research design was employed. Semi-structured interviews were conducted with five mothers who had immigrated to Canada from South Asia in the last decade, and whose children were receiving outpatient rehabilitation services. Three primary themes were identified: (1) perceptions of disability reflected a mix of traditional and western beliefs; (2) mothers experienced physical, emotional and social suffering related to socio-cultural and material barriers and (3) mothers' primary goal for their children was the achievement of independent walking, which was linked to notions of achieving a ?normal? life and the desire for more rehabilitation interventions. South Asian immigrant mothers' perceptions of their children's disabilities had important similarities and differences to mothers living in South Asia. Healthcare professionals can assist families in managing and coping with their child's disabilities by exploring their unique values and beliefs and identifying achievable outcomes together.
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Gautun, Heidi; Bratt, Christopher
2017-06-01
The need to provide care for older people can put a strain on their adult children, potentially interfering with their work attendance. We tested the hypothesis that public care for older people (nursing homes or home care services) would moderate the association between having an older parent in need of care and reduced work attendance among the adult children. The analysis used data from a survey of Norwegian employees aged 45-65 ( N = 529). Institutional care for older people in need of care (i.e. nursing homes) was associated with improved work attendance among their children-their daughters in particular. Data also indicated a moderating effect: the link between the parents' reduced health and reduced work attendance among the children was weaker if the parent lived in a nursing home. However, the results were very different for home-based care: data indicated no positive effects on adult children's work attendance when parents received non-institutionalised care of this kind. Overall, the results suggest that extending public care service to older people can improve their children's ability to combine work with care for parents. However, this effect seems to require the high level of care commonly provided by nursing homes. Thus, the current trend towards de-institutionalising care in Europe (and Norway in particular) might hamper work attendance among care-giving adult children, women in particular. Home care services to older people probably need to be extended if they are intended as a real alternative to institutional care.
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76 FR 71933 - Submission for OMB Review; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-21
..., Office of Management and Budget (OMB), [email protected] or fax (202) 395-5806 and to... it displays a currently valid OMB control number. Food and Nutrition Service Title: National School... Collection: Direct certification enables children in households that receive Supplemental Nutrition...
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Sung, Lillian; Robinson, Paula; Treister, Nathaniel; Baggott, Tina; Gibson, Paul; Tissing, Wim; Wiernikowski, John; Brinklow, Jennifer; Dupuis, L Lee
2017-03-01
To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children (0-18 years) receiving treatment for cancer or undergoing haematopoietic stem cell transplantation (HSCT). The Mucositis Prevention Guideline Development Group was interdisciplinary and included internationally recognised experts in paediatric mucositis. For the evidence review, we included randomised controlled trials (RCTs) conducted in either children or adults evaluating the following interventions selected according to prespecified criteria: cryotherapy, low level light therapy (LLLT) and keratinocyte growth factor (KGF). We also examined RCTs of any intervention conducted in children. For all systematic reviews, we synthesised the occurrence of severe oral mucositis. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to describe quality of evidence and strength of recommendations. We suggest cryotherapy or LLLT may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. We also suggest KGF may be offered to children receiving HSCT conditioning with regimens associated with a high rate of severe mucositis. However, KGF use merits caution as there is a lack of efficacy and toxicity data in children, and a lack of long-term follow-up data in paediatric cancers. No other interventions were recommended for oral mucositis prevention in children. All three specific interventions evaluated in this clinical practice guideline were associated with a weak recommendation for use. There may be important organisational and cost barriers to the adoption of LLLT and KGF. Considerations for implementation and key research gaps are highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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[The community-oriented experience of early intervention services in Taipei City].
Chu, Feng-Ying
2007-10-01
The purpose of this paper is to emphasize the importance of early intervention. The purpose of early intervention in Taipei City is to help child development, promote parenting skills, and reduce educational and social costs. In order to meet these goals, parenting groups and Taipei City Council have made great efforts to make early intervention work in Taipei City. In April 1995, Taipei City Government started planning and setting up the service network. To date, Taipei City has set up one reporting and referral center?, ?six community resources centers, 22 medical assessment and intervention clinics, 12 child development centers, one early intervention training center, three non-profit foundations and more than 300 inclusion schools, such as kindergartens and day care centers. With parent participation, professional devotion and Taipei City Government's commitment, the number of assisted children has increased from 98 to 2,523 /year. By the end of 2006, Taipei had already funded 25,277 children. We estimate Taipei City early intervention services to have affected at least 75,000 persons, including development-delayed and disabled children, their parents?, ?grandparents and siblings. We found that early intervention services help the children to build up self esteem, grow their potential, learn how to socialize, and receive an education, while the most important aim is to help them to reduce their level of disability or to prevent them from getting worse. At the same time, their families get support and a diverse range of services. An integrated early intervention program should include children, families, and multidisciplinary professionals. The system should therefore be more "family-centered" and "community-oriented" to provide appropriate services to children and families through a positive and aggressive attitude.
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Post-marketing surveillance of CustomBone Service implanted in children under 7 years old.
Frassanito, Paolo; Tamburrini, Gianpiero; Massimi, Luca; Di Rocco, Concezio; Nataloni, Angelo; Fabbri, Greta; Caldarelli, Massimo
2015-01-01
The CustomBone Service is a bioceramic implant suitable for cranial repair in both adults and children, although there are no clinical data about its use in children under 7 years of age. This surveillance study investigates the outcome in this age group. Twenty-eight children under 7 years old (range, 2.5-6 years) received CustomBone Service from July 2006 to May 2013 in 16 international hospitals. Data of 23 children (12 males and 11 females), harboring 24 prosthesis, were available with a minimum follow-up of 1 year. Sites of the cranial defect were frontal or parietal (20.8 % each), parieto-temporal (16.7 %), fronto-parietal or occipital (12.5 % each), fronto-parieto-temporal or fronto-temporal (8.3 % each). Initial diseases were trauma (54.2 %), malformation (37.5 %), or tumor of the bone/skin (8.3 %). Rupture of the implant occurred in a single case during the implant (1/26 surgeries, 3.8 %) and the cranial repair was achieved by means of the back-up prosthesis. Five adverse events were registered during the follow-up period consisting of three cases of fracture and two of exposure/infection of the prosthesis. All cases required the removal of the device (20.8 %). The failure rate of CustomBone Service under 7 years of age was higher than reported in adults and children over 7 years old (20.8 vs. 3.8 %), However, CustomBone Service may be considered a valid option under 7 years old since other materials are burdened by more significant rates of complications in the long-term period. Due to specific properties of this material, indication to CustomBone Service in toddlers should be carefully evaluated by the surgeon on a case-by-case basis.
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Pickard, Katherine E; Wainer, Allison L; Bailey, Kathryn M; Ingersoll, Brooke R
2016-10-01
Research within the autism spectrum disorder field has called for the use of service delivery models that are able to more efficiently disseminate evidence-based practices into community settings. This study employed telehealth methods in order to deliver an Internet-based, parent training intervention for autism spectrum disorder, ImPACT Online. This study used mixed-methods analysis to create a more thorough understanding of parent experiences likely to influence the adoption and implementation of the program in community settings. Specific research questions included (1) What are parents' perceptions of the online program? (2) How does ImPACT Online compare to other services that parents are accessing for their children? And (3) Do parents' experience in, and perceptions of, the program differ based on whether they received a therapist-assisted version of the program? Results from 28 parents of a child with autism spectrum disorder indicate that parents saw improvements in their child's social communication skills and their own competence during the course of the program, regardless of whether they received therapist assistance. However, qualitative interviews indicate that parents who received therapist assistance were more likely endorse the acceptability and observability of the program. These findings support the potential for Internet-based service delivery to more efficiently disseminate evidence-based parent training interventions for autism spectrum disorder. © The Author(s) 2016.
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Adhvaryu, Achyuta
2012-01-01
Objectives To study the impact of a new franchise health clinic model (The HealthStore Foundation's CFWShops) on access to vaccinations and treatment for acute illnesses in a nationally representative sample of children in Kenya. Design The authors used multivariate linear and count regressions to examine associations between receipt of vaccinations or treatment and proximity to a franchise health clinic, adjusting for individual, household and clinic attributes as well as region fixed effects. Setting Demographic and Health Survey data from Kenya, 2008–2009. Participants 6079 Kenyan children younger than 5 years, of whom 2310 reported recent acute illness. Main outcome measures Outcomes for all children were number of polio doses received, number of DPT doses received, receipt of BCG vaccine, receipt of measles vaccine and number of total vaccinations received. Outcomes for acutely ill children were receipt of any medical treatment, treatment for fever, treatment for malaria and treatments specifically stocked by CFWShops. Results Children living within 30 km of a CFWShop received 0.129 (p=0.017) and 0.113 (p=0.025) more DPT and polio doses, respectively; and 0.285 more total vaccinations (p=0.023). Among acutely ill children, CFWShop proximity was associated with significant increases in the probabilities of receiving any medical treatment (0.142; p<0.001), treatment for fever (0.117; p=0.007) and treatments specifically stocked by CFWShops (0.064; p=0.015). Use of CFWShop services was not significantly different for lower-income vis-a-vis higher-income households. Conclusions The franchise health clinic model could substantially increase access to essential vaccinations and treatments in low-income countries. Moreover, the model's benefits may accrue to lesser- and higher-income households alike. PMID:22786948
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Berk, Justin; Adhvaryu, Achyuta
2012-01-01
To study the impact of a new franchise health clinic model (The HealthStore Foundation's CFWShops) on access to vaccinations and treatment for acute illnesses in a nationally representative sample of children in Kenya. The authors used multivariate linear and count regressions to examine associations between receipt of vaccinations or treatment and proximity to a franchise health clinic, adjusting for individual, household and clinic attributes as well as region fixed effects. Demographic and Health Survey data from Kenya, 2008-2009. 6079 Kenyan children younger than 5 years, of whom 2310 reported recent acute illness. Outcomes for all children were number of polio doses received, number of DPT doses received, receipt of BCG vaccine, receipt of measles vaccine and number of total vaccinations received. Outcomes for acutely ill children were receipt of any medical treatment, treatment for fever, treatment for malaria and treatments specifically stocked by CFWShops. Children living within 30 km of a CFWShop received 0.129 (p=0.017) and 0.113 (p=0.025) more DPT and polio doses, respectively; and 0.285 more total vaccinations (p=0.023). Among acutely ill children, CFWShop proximity was associated with significant increases in the probabilities of receiving any medical treatment (0.142; p<0.001), treatment for fever (0.117; p=0.007) and treatments specifically stocked by CFWShops (0.064; p=0.015). Use of CFWShop services was not significantly different for lower-income vis-a-vis higher-income households. The franchise health clinic model could substantially increase access to essential vaccinations and treatments in low-income countries. Moreover, the model's benefits may accrue to lesser- and higher-income households alike.
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Psarros, Colleen; Love, Sarah
2016-01-01
Newborn hearing screening has led to the early diagnosis of hearing loss in neonates and early device fitting is common, based primarily on electrophysiologic and radiologic information, with some supplementary behavioral measures. Such early fitting of hearing devices, in particular cochlear implants (CIs), has been beneficial to the majority of children implanted under the age of 12 months who meet the cochlear implant candidacy criteria. Comorbidities are common in children with hearing loss, although they may not be evident in neonates and may not emerge until later in infants. Evidence suggests that the child's outcomes are strongly influenced by a range of environmental factors including emotional and social support from the immediate and extended family. Consequently, such factors are important in service planning and service delivery for babies and children receiving CIs. The World Health Organization's International Classification of Functioning, Health and Disability (ICF) can provide a framework to facilitate the holistic management of pediatric cochlear implant recipients. The ICF also can be used to map the progress of recipients over time to highlight emerging issues that require intervention. This article will discuss our preliminary use of the ICF to establish clinical practice; develop advocacy skills among clients and their families; identify eligibility for services such as support in educational settings; enable access to modes of service delivery such as telepractice; provide a conceptual framework for policy and program development for pediatric cochlear implant recipients (i.e., in both disability and health services); and, most importantly, establish a clear pathway for the longitudinal management of the cochlear implant in a child's future. It is anticipated that this model will be applied to other populations receiving cochlear implants through our program. PMID:27489404
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Wilson, Kumanan; Duque, Daniel Rodriguez; Murphy, Malia Sq; Hawken, Steven; Pham-Huy, Anne; Kwong, Jeffrey; Deeks, Shelley L; Potter, Beth K; Crowcroft, Natasha S; Bulman, Dennis E; Chakraborty, Pranesh; Little, Julian
2018-02-08
T-cell receptor excision circle levels are a surrogate marker of T-cell production and immune system function. We sought to determine whether non-pathological levels of infant T-cell receptor excision circles were associated with adverse events following immunization. A self-controlled case series design was applied on a sample of 231,693 children who completed newborn screening for severe combined immunodeficiency in Ontario, Canada between August 2013 and December 2015. Exposures included routinely administered pediatric vaccines up to 15 months of age. Main outcomes were combined health services utilization for recognized adverse events following immunization. 1,406,981 vaccination events were included in the final dataset. 103,007 children received the Pneu-C-13 or Men-C-C vaccine and 97,998 received the MMR vaccine at 12 months of age. 67,725 children received the varicella immunization at 15 months. Our analysis identified no association between newborn T-cell receptor excision circle levels and subsequent health services utilization events following DTa-IPV-Hib, Pneu-C-13, and Men-C-C vaccinations at 2-month (RI 0.94[95%CI 0.87-1.02]), 4-month (RI 0.82[95%CI 0.75-0.9]), 6-month (RI 0.63[95%CI 0.57-0.7]) and 12-month (RI 0.49[95%CI 0.44-0.55]). We also found no trends in health services utilization following MMR (RI 1.43[95%1.34-1.52]) or varicella (RI 1.14[95%CI 1.05-1.23]) vaccination. Our findings provide further support for the safety of pediatric vaccinations.
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Gillison, Fiona; Beck, Fay; Lewitt, Joanna
2014-05-01
Increasing parental awareness of childhood obesity is an important part of tackling the issue. However, parents' negative reactions to being informed that their children are overweight or obese can hinder their engagement with relevant services. The present study aimed to develop a deeper understanding of why parents react negatively, to help commissioners and service providers design services that are more acceptable to them. Open, qualitative responses to a survey were collected using a postal questionnaire. Responses were analysed using content analysis. One local authority in south-west England. The sample frame included all parents receiving letters informing them that their child was overweight (91st-98th centile) or very overweight (98th-100th centile) through the UK National Child Measurement Programme in 2012. Forty-five of 313 eligible parents (14 %) responded to the survey, of whom forty-three rejected either to the judgement that their child was overweight and/or being provided with this feedback. Primary reasons for objection included: lack of trust in the measures used, lack of belief that being overweight is important for children's health (relative to a healthy lifestyle), and fear that discussing weight with children will trigger eating disorders. In addition, parents' responses suggested that they considered receiving this feedback to be a criticism of their parenting skills. Overall, three areas for improving communication with parents were suggested: tailoring letters; providing information about the importance of weight independently of lifestyle; and addressing parents' concerns about the risks of talking to children about their weight.
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Reiki Therapy for Symptom Management in Children Receiving Palliative Care: A Pilot Study.
Thrane, Susan E; Maurer, Scott H; Ren, Dianxu; Danford, Cynthia A; Cohen, Susan M
2017-05-01
Pain may be reported in one-half to three-fourths of children with cancer and other terminal conditions and anxiety in about one-third of them. Pharmacologic methods do not always give satisfactory symptom relief. Complementary therapies such as Reiki may help children manage symptoms. This pre-post mixed-methods single group pilot study examined feasibility, acceptability, and the outcomes of pain, anxiety, and relaxation using Reiki therapy with children receiving palliative care. A convenience sample of children ages 7 to 16 and their parents were recruited from a palliative care service. Two 24-minute Reiki sessions were completed at the children's home. Paired t tests or Wilcoxon signed-rank tests were calculated to compare change from pre to post for outcome variables. Significance was set at P < .10. Cohen d effect sizes were calculated. The final sample included 8 verbal and 8 nonverbal children, 16 mothers, and 1 nurse. All mean scores for outcome variables decreased from pre- to posttreatment for both sessions. Significant decreases for pain for treatment 1 in nonverbal children ( P = .063) and for respiratory rate for treatment 2 in verbal children ( P = .009). Cohen d effect sizes were medium to large for most outcome measures. Decreased mean scores for outcome measures indicate that Reiki therapy did decrease pain, anxiety, heart, and respiratory rates, but small sample size deterred statistical significance. This preliminary work suggests that complementary methods of treatment such as Reiki may be beneficial to support traditional methods to manage pain and anxiety in children receiving palliative care.
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Vitamin D Supplementation: We Must Not Fail Our Children!
Drury, Rosalyn; Rehm, Andreas; Johal, Simran; Nadler, Robert
2015-01-01
Abstract There is increasing concern that vitamin D deficiency poses a major health problem for children. Deficiency can cause hypocalcemic seizures, growth disturbances, and rickets and may influence diabetes, cardiovascular dysfunction, autoimmune diseases, and attention deficit hyperactivity disorders. Reduced vitamin D levels in children presenting to pediatric orthopedic services are common. In the United Kingdom, recommendations on vitamin D supplementation are set by the Department of Health (DoH) and the National Institute of Health and Clinical Excellence. These state that all children aged 6 months to 5 years ought to receive 7 to 8.5 μgof vitamin D daily. We carried out a survey of 203 parents attending our pediatric and pediatric orthopedic and fracture clinics to evaluate parental awareness of the DoH recommendations on vitamin D supplementation for children and to assess the extent to which children were receiving vitamin D supplements. About 85.71% of parents were not aware of the recommendations. Only 14.29% stated that they were aware of the benefits of vitamin D for their children and just 17.73% of children were receiving vitamin D supplementation; 17 via formula milk and 18 via multivitamin formulations. Parents are generally not aware about vitamin D supplementation because of a lack of information with the high rates of reported suboptimal vitamin D levels amongst children not being addressed resulting in increased health risks to our children. Major improvements are needed in the implementation of supplementation at all points of contact between parents and health-care professionals. PMID:25950689
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Emergency residential care settings: A model for service assessment and design.
Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira
2018-02-01
There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Morgan, Gwen; And Others
Noting that over 11 million children are involved in early care and education outside their homes, and that the quality of the services these children receive depends on the knowledge and skills of the people who care for and teach them, this report presents the results of the first national study of career development in early care and education.…
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Das, Aritra; Mahapatra, Sanchita; Sai Mala, Guntur; Chaudhuri, Indrajit; Mahapatra, Tanmay
2016-01-01
Background Insufficiencies in complementary feeding put infants and young children at increased risk of undernutrition. Till now, most Indian studies have looked at the individual level determinants of complementary feeding practices. We aimed to evaluate the association of frontline worker (FLW) provided nutritional counselling services, with change in community level indicators of complementary feeding practices among 9–11 month old children over time. Methods The study data was obtained from five rounds of ‘Lot Quality Assurance Sampling’ survey in eight districts of Bihar, an impoverished Indian state. The surveys were conducted as evaluation exercises for the ‘Integrated Family Health Initiative (IFHI)’–a multi-faceted program aimed at improving the maternal and child health outcomes in Bihar. The main outcome indicators were—current breastfeeding, age-appropriate minimum frequency of semi-solid food, age-appropriate minimum quantity of semi-solid food, initiation of complementary feeding at the right age, and dietary diversity. Repeated measures analysis was performed to determine the association of changes in the outcome indicators with coverage of FLW-provided counselling services. Results Visits by FLW, advices on age-appropriate frequency and handwashing were significant predictors of receiving age-appropriate frequency of feeding. The determinants of receiving age-appropriate quantity were—advices on age appropriate frequency and advices on handwashing. Receiving food support from AWC and FLW visits were significantly associated with initiating complementary feeding at the right age. Conclusions The present study identified the critical elements among the different types of FLW-provided services. The study findings, from an economically and socially underdeveloped region of India, would inform the relevant programs about the nutritional counselling services that need to be emphasized upon for reducing the burden of childhood malnutrition. PMID:27832211
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Dempster, Robert; Davis, Deborah Winders; Faye Jones, V; Keating, Adam; Wildman, Beth
2015-12-01
Significant numbers of children have diagnosable mental health problems, but only a small proportion of them receive appropriate services. Stigma has been associated with help-seeking for adult mental health problems and for Caucasian parents. The current study aims to understand factors, including stigma, associated with African American parents' help-seeking behavior related to perceived child behavior problems. Participants were a community sample of African American parents and/or legal guardians of children ages 3-8 years recruited from an urban primary care setting (N = 101). Variables included child behavior, stigma (self, friends/family, and public), object of stigma (parent or child), obstacles for engagement, intention to attend parenting classes, and demographics. Self-stigma was the strongest predictor of help-seeking among African American parents. The impact of self-stigma on parents' ratings of the likelihood of attending parenting classes increased when parents considered a situation in which their child's behavior was concerning to them. Findings support the need to consider parent stigma in the design of care models to ensure that children receive needed preventative and treatment services for behavioral/mental health problems in African American families.
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Maternal depression in the United States: nationally representative rates and risks.
Ertel, Karen A; Rich-Edwards, Janet W; Koenen, Karestan C
2011-11-01
To examine the public health burden of major depressive disorder (MDD) among mothers: its prevalence and sociodemographic patterns; associated functioning, comorbidities, and adversities; and racial/ethnic disparities. This was a cross-sectional analysis of 8916 mothers in the National Epidemiologic Survey of Alcohol and Related Conditions, a nationally representative survey of the civilian U.S. population in 2001?2002. Past-year MDD was assessed with a structured interview protocol. Ten percent of mothers experienced depression in the past year. White and Native American women, those with low education or income, and those not married had high rates of depression. Depression was not strongly patterned by number of or age of children. Depressed mothers experienced more adversities (poverty, separation or divorce, unemployment, financial difficulties) and had worse functioning. Half of depressed mothers received services for their depression. Black and Hispanic depressed mothers were more likely to experience multiple adversities and less likely to receive services than white depressed mothers. Maternal depression is a major public health problem in the United States, with an estimated 1 in 10 children experiencing a depressed mother in any given year. Professionals who work with mothers and children should be aware of its prevalence and its detrimental effects.
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Podlogar, Matthew C.; Novins, Douglas K.
2015-01-01
Research regarding the quality of behavioral health care for American Indian (AI) children and adolescents is extremely limited, and no study has considered the qualitative perspectives of the AI children receiving such services or that of their families. This pilot study investigated AI patient and family perspectives of what quality of care means to them. Data were drawn from interviews of parents (n = 15), and the youth (if they were age 11 or older; n = 11) of 16 children and adolescents who received treatment at three behavioral health programs serving AI communities. Interview transcripts were coded and analyzed for key themes that related to treatment structure, process, and outcomes. According to these participants, the principal indicator of treatment quality was “being able to trust the clinician.” The most valued treatment outcomes for improvement were the youth’s “self-efficacy and self-worth,” “functioning in school,” and “relationship with the family.” Future research is needed on how to best integrate these domains into specific and objective indicators for standardized quality of care assessments of AI child and adolescent behavioral health services. PMID:25961647
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Characteristics of coordinated ongoing comprehensive care within a medical home in Maine.
Tippy, Kathy; Meyer, Katie; Aronson, Richard; Wall, Toni
2005-06-01
Access to coordinated, ongoing comprehensive care in a medical home (CCMH) is a national health objective and a federal performance measure. The National Survey of Children With Special Health Care Needs (National Survey of CSHCN) provides state level data on this Maternal Child Health Bureau performance measure. In Maine, only 60% of CSHCN received CCMH in 2001. Here we described characteristics of receiving comprehensive care in a medical home for CSHCN, in Maine. Data from the National Survey of CSHCN were used for the analysis. We examined associations between receiving CCMH and demographic factors, severity of a condition or problem, and having adequate insurance coverage for services in univariate and multivariate logistic regression models. The distribution of children who received CCMH did not differ across gender, race, age, or poverty level. Children with adequate insurance were more likely to have received this care than those without adequate insurance and those with a more severe condition or problem were less likely to receive CCMH. We found that receiving CCMH was positively related to adequate insurance, independent of poverty. We also found that CSHCN with more severe conditions have more unmet needs than those with less severe conditions. CSHCN programs, which have a responsibility to assure that CSHCN receive CCMH, must work to maximize insurance coverage. Programs can also work to raise awareness among providers of the complexity of CCMH and the role it plays in maximizing the health of the child and family.
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Code of Federal Regulations, 2014 CFR
2014-01-01
... and Plant Health Inspection Service to conduct phytosanitary field inspections of seed crops to serve... processing received. Family. An inspector or agent and his or her spouse, their parents, children, and first... products. Products derived from nursery stock, other plants, plant parts, roots, bulbs, seeds, fruits, nuts...
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Code of Federal Regulations, 2011 CFR
2011-01-01
... and Plant Health Inspection Service to conduct phytosanitary field inspections of seed crops to serve... processing received. Family. An inspector or agent and his or her spouse, their parents, children, and first... products. Products derived from nursery stock, other plants, plant parts, roots, bulbs, seeds, fruits, nuts...
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Code of Federal Regulations, 2010 CFR
2010-01-01
... and Plant Health Inspection Service to conduct phytosanitary field inspections of seed crops to serve... processing received. Family. An inspector or agent and his or her spouse, their parents, children, and first... products. Products derived from nursery stock, other plants, plant parts, roots, bulbs, seeds, fruits, nuts...
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Code of Federal Regulations, 2013 CFR
2013-01-01
... and Plant Health Inspection Service to conduct phytosanitary field inspections of seed crops to serve... processing received. Family. An inspector or agent and his or her spouse, their parents, children, and first... products. Products derived from nursery stock, other plants, plant parts, roots, bulbs, seeds, fruits, nuts...
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Code of Federal Regulations, 2011 CFR
2011-10-01
..., termination of pregnancy, leave for persons of either sex to care for children or dependents, or any other... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...
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Code of Federal Regulations, 2012 CFR
2012-10-01
..., termination of pregnancy, leave for persons of either sex to care for children or dependents, or any other... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...
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Code of Federal Regulations, 2013 CFR
2013-10-01
..., termination of pregnancy, leave for persons of either sex to care for children or dependents, or any other... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...
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Code of Federal Regulations, 2014 CFR
2014-10-01
..., termination of pregnancy, leave for persons of either sex to care for children or dependents, or any other... Department of Health and Human Services GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...
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Code of Federal Regulations, 2010 CFR
2010-10-01
..., termination of pregnancy, leave for persons of either sex to care for children or dependents, or any other... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex...
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Code of Federal Regulations, 2010 CFR
2010-07-01
... EDUCATION CHILDREN WITH DISABILITIES WITHIN THE SECTION 6 SCHOOL ARRANGEMENTS § 80.4 Policy. It is DoD... educational instruction from the Section 6 School Arrangements shall be provided a free, appropriate education... (inclusive) and their families are entitled to receive early intervention services under this part, provided...
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Code of Federal Regulations, 2011 CFR
2011-07-01
... EDUCATION CHILDREN WITH DISABILITIES WITHIN THE SECTION 6 SCHOOL ARRANGEMENTS § 80.4 Policy. It is DoD... educational instruction from the Section 6 School Arrangements shall be provided a free, appropriate education... (inclusive) and their families are entitled to receive early intervention services under this part, provided...
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Kagee, Ashraf; Donenberg, Geri; Davids, Alicia; Vermaak, Redwaan; Simbayi, Leickness; Ward, Catherine; Naidoo, Pamela; Mthembu, Jacky
2014-01-01
High risk sexual behaviour, alcohol and drug use, and mental health problems combine to yield high levels of HIV-risk behaviour among adolescents with mental health problems. In South Africa, little research has been conducted on parental perspectives of HIV-risk among this population. We conducted a series of focus group discussions with 28 mothers of adolescents receiving services at two mental health clinics in South Africa to identify, from their perspectives, the key community problems facing their children. Participants indicated that HIV remained a serious threat to their adolescent children's well-being, in addition to substance abuse, early sexual debut, and teenage pregnancy. These social problems were mentioned as external to their household dynamics, and thus seemingly beyond the purview of the parent-adolescent relationship. These data have implications for the design of family-based interventions to ameliorate the factors associated with HIV-risk among youth receiving mental health services.
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Case finding and mental health services for children in the aftermath of the Oklahoma City bombing.
Pfefferbaum, Betty; Sconzo, Guy M; Flynn, Brian W; Kearns, Lauri J; Doughty, Debby E; Gurwitch, Robin H; Nixon, Sara Jo; Nawaz, Shajitha
2003-01-01
The 1995 Oklahoma City bombing killed 168 people, including 19 children, and injured hundreds more. Children were a major focus of concern in the mental health response. Most services for them were delivered in the Oklahoma City Public Schools where approximately 40,000 students were enrolled at the time of the explosion. Middle and high school students in the Oklahoma City Public Schools completed a clinical assessment 7 weeks after the explosion. The responses of 2720 students were analyzed to explore predictors of posttraumatic stress symptomatology, functioning, and treatment contact. Posttraumatic stress symptomatology was associated with initial reaction to the incident and to bomb-related television exposure. Functional difficulty was associated with initial reaction and posttraumatic stress symptomatology. Only 5% of the students surveyed had received counseling. There was no relationship between posttraumatic stress symptomatology and counseling contact for students with the highest levels of posttraumatic stress. Implications for school-based services are discussed.
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Adhisesha Reddy, Priya; Kishiki, Elizabeth A; Thapa, Hari Bahadur; Demers, Lisa; Geneau, Robert; Bassett, Ken
2018-06-01
Gender and blindness initiatives continue to make eye care personnel aware of the service utilization inequity strongly favouring men, yet interventions to reduce that inequity, particularly for girls, are under developed. This descriptive study gathered quantitative data on the degree of gender equity at five Child Eye Health Tertiary Facilities (CEHTFs) in Asia and Africa and conducted in-depth interviews with eye care personnel to assess their strategies and capacity to reduce gender inequity. Cataract surgery was utilized to assess the degree of inequity and success of interventions to reduce inequity in case finding, service utilization, and follow-up. CEHTF administrative data showed significant gender inequity in cataract surgical services favouring boys in all settings. CEHTFs actively seek children through community and school-based outreach, yet do not have initiatives to reduce gender inequity. Little gender inequity was found among children receiving surgical and follow-up care, although two out of three children were boys. CEHTF staff, despite being aware, offered no effective means to reduce gender inequity involving cataract surgical services. Interventions that successfully increased service utilization by girls came from individual cases, involving extraordinary effort by a single eye care programme person. Community-based case finders such as Anganwadi workers in India, Female Community Health Volunteers (FCHVs) in Nepal, and Key Informants (KIs) in Africa are necessary to identify children in need of cataract services, but insufficient to increase service utilization by girls. Secondary, often extra-ordinary community-based interventions by eye care personnel are needed in all settings.
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McKernan, Susan C.; Kuthy, Raymond A.; Momany, Elizabeth T.; McQuistan, Michelle R.; Hanley, Paul F.; Jones, Michael P.; Damiano, Peter C.
2014-01-01
Objectives To describe rates of Medicaid-funded services provided by orthodontists in Iowa to children and adolescents, identify factors associated with utilization, and describe geographic barriers to care. Methods We analyzed enrollment and claims data from the Iowa Medicaid program for a 3-year period, January 2008 through December 2010. Descriptive, bivariate, and multivariable logistic regression analyses were performed with utilization of orthodontic services as the main outcome variable. Service areas were identified by small area analysis in order to examine regional variability in utilization. Results The overall rate of orthodontic utilization was 3.1 percent. Medicaid enrollees living in small towns and rural areas were more likely to utilize orthodontic services than those living in urban areas. Children who had an oral evaluation by a primary care provider in the year prior to the study period were more likely to receive orthodontic services. Service areas with lower population density and greater mean travel distance to participating orthodontists had higher utilization rates than smaller, more densely populated areas. Conclusions Rural residency and increased travel distances do not appear to act as barriers to orthodontic care for this population. The wide variability of utilization rates seen across service areas may be related to workforce supply in the form of orthodontists who accept Medicaid-insured patients. Referrals to orthodontists from primary care dentists may improve access to specialty care for Medicaid enrollees. PMID:23289856
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Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan
2014-01-01
Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689
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Siebes, R C; Wijnroks, L; Ketelaar, M; van Schie, P E M; Gorter, J W; Vermeer, A
2007-03-01
The importance of family-centred care and services has been increasingly emphasized in paediatric rehabilitation. One aspect of family-centred care is parent involvement in their child's treatment. The aims of this study were (1) to describe how, and to what extent parents are involved in the paediatric rehabilitation treatment process in the Netherlands; (2) to determine the level of parents' satisfaction about the services they and their child have received; and (3) to describe what ideas parents have to enhance their involvement in the treatment process. A total of 679 parents of children aged 1-20 years who participated in our longitudinal study on family centred care in the Netherlands. The children had various diagnoses and were treated in nine out of 23 Dutch paediatric rehabilitation centres. A random sample of 75 parents was interviewed within 4 weeks after completion of the Measure of Processes of Care and the Client Satisfaction Questionnaire. A Quality of Care cycle with six stages was used to structure the evaluation. The data showed that parents are involved in all stages of their child's rehabilitation process in various ways. The average level of parent satisfaction about the services received was high. According to the interviewed parents, the communication between professionals and parents, parents' involvement in goal setting, and parents' involvement in treatment could be improved upon. Parents are to a large extent involved in all stages of the treatment process in Dutch paediatric rehabilitation settings. Although parents valued the services received, they suggested various ways to enhance parent participation.
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Needs of Internally Displaced Women and Children in Baghdad, Karbala, and Kirkuk, Iraq
Lafta, Riyadh; Aflouk, Nesreen A; Dhiaa, Saba; Lyles, Emily; Burnham, Gilbert
2016-01-01
Background: The continuing conflict in Iraq has now created an estimated four million internally displaced persons (IDPs). The bulk of recently displaced persons are in Central Iraq, often in insecure and difficult situations. Objective: To determine the health status and health needs of women and children, age 15 and under, among a sample of this IDP population in Kirkuk, Baghdad, and Karbala governorates. Methods: Data were collected from the senior female in 1216 families which contained 3665 children living in 45 makeshift settlements. Findings: The majority of IDPs were living in tents or religious centers. Repeated displacements were common. Kidnappings were reported by 5.2% of families, and 7.9% of families reported a death of a family member during or after displacement. Intentional violence accounted for 72.3% of deaths. Only a third of children in school at the time of displacement continued in school. On average, households had received assistance on 3.2 occasions since displacement, food being the most common form. Access to health services was difficult. Some form of transport was often required. Few women knew where to secure antenatal services and many did not know where childhood immunization services were available. During or after displacement 307 women had delivered or were currently pregnant. Complications of pregnancies were common, with a quarter reporting anemia, and 22.1% experiencing hemorrhage. Both communicable and non-communicable diseases (NCDs) were common in the women and children in the survey. Scabies, diarrhea and lice were common among children. Among women, hypertension accounted for 36.6% of NCDs and type 2 diabetes for 15.9%. Domestic violence directed against women was reported in 17.4% of families and against children in 26.6% Interpretation: Women and children in IDP settlements of Central Iraq experience many vulnerabilities involving their health, education and their environment, in addition to living in physical danger. While some external assistance was received, much more is needed to meet the needs of a displaced population which is unlikely to return home soon. PMID:28966867
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2010-01-01
Background Improving the way artemether-lumefantrine (AL) is provided to patients attending clinics is critical to maximize the benefit of this new medicine. In 2007, a new initiative was launched in one part of Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. Methods An evaluation of the intervention using pre- and post-intervention cross sectional health facility surveys was conducted in Bondo district. The surveys included: audit of government health facilities, health worker structured interviews and exit interviews with caretakers of sick children below five years of age. The outcome indicators were the proportions of febrile children who had AL prescribed, AL dispensed, and four different dispensing and counseling tasks performed. Results At baseline 33 government health facilities, 48 health workers and 386 febrile child consultations were evaluated. At follow-up the same health facilities were surveyed and 36 health workers and 390 febrile child consultations evaluated. The findings show: 1) no health facility or health worker was exposed to all components of the intervention; 2) the proportion of health workers who received the enhanced in-service training was 67%; 3) the proportion of febrile children with uncomplicated malaria treated with the first-line anti-malarial drug, artemether-lumefantrine (AL), at health facilities where AL was in stock increased from 76.9% (95%CI: 69.4, 83.1) to 87.6% (95% CI: 82.5, 91.5); 4) there were modest but non-significant improvements in dispensing and counseling practices; and 5) when the analyses were restricted to health workers who received the enhanced in-service training and/or had received new guidelines and job aids, no significant improvements in reported case-management tasks were observed compared to baseline. Conclusion In-service training and provision of job aids alone may not be adequate to improve the prescribing, dispensing and counseling tasks necessary to change malaria case-management practices and the inclusion of supervision and post-training follow-up should be considered in future clinical practice change initiatives. PMID:20849650
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Wasunna, Beatrice; Zurovac, Dejan; Bruce, Jane; Jones, Caroline; Webster, Jayne; Snow, Robert W
2010-09-18
Improving the way artemether-lumefantrine (AL) is provided to patients attending clinics is critical to maximize the benefit of this new medicine. In 2007, a new initiative was launched in one part of Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. An evaluation of the intervention using pre- and post-intervention cross sectional health facility surveys was conducted in Bondo district. The surveys included: audit of government health facilities, health worker structured interviews and exit interviews with caretakers of sick children below five years of age. The outcome indicators were the proportions of febrile children who had AL prescribed, AL dispensed, and four different dispensing and counseling tasks performed. At baseline 33 government health facilities, 48 health workers and 386 febrile child consultations were evaluated. At follow-up the same health facilities were surveyed and 36 health workers and 390 febrile child consultations evaluated. The findings show: 1) no health facility or health worker was exposed to all components of the intervention; 2) the proportion of health workers who received the enhanced in-service training was 67%; 3) the proportion of febrile children with uncomplicated malaria treated with the first-line anti-malarial drug, artemether-lumefantrine (AL), at health facilities where AL was in stock increased from 76.9% (95%CI: 69.4, 83.1) to 87.6% (95% CI: 82.5, 91.5); 4) there were modest but non-significant improvements in dispensing and counseling practices; and 5) when the analyses were restricted to health workers who received the enhanced in-service training and/or had received new guidelines and job aids, no significant improvements in reported case-management tasks were observed compared to baseline. In-service training and provision of job aids alone may not be adequate to improve the prescribing, dispensing and counseling tasks necessary to change malaria case-management practices and the inclusion of supervision and post-training follow-up should be considered in future clinical practice change initiatives.
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Choi, Chris; Ferro, Mark A.
2018-01-01
Objective This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Method Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children’s Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. Results The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=−.26; p=.035). Conclusions Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged. PMID:29375635
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Choi, Chris; Ferro, Mark A.
2018-01-01
Objective This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Method Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children’s Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. Results The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=−.26; p=.035). Conclusions Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged. PMID:29399020
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Medina-Solis, Carlo Eduardo; Maupomé, Gerardo; del Socorro, Herrera Miriam; Pérez-Núñez, Ricardo; Avila-Burgos, Leticia; Lamadrid-Figueroa, Hector
2008-01-01
To determine the factors associated with the dental health services utilization among children ages 6 to 12 in León, Nicaragua. A cross-sectional study was carried out in 1,400 schoolchildren. Using a questionnaire, we determined information related to utilization and independent variables in the previous year. Oral health needs were established by means of a dental examination. To identify the independent variables associated with dental health services utilization, two types of multivariate regression models were used, according to the measurement scale of the outcome variable: a) frequency of utilization as (0) none, (1) one, and (2) two or more, analyzed with the ordered logistic regression and b) the type of service utilized as (0) none, (1) preventive services, (2) curative services, and (3) both services, analyzed with the multinomial logistic regression. The proportion of children who received at least one dental service in the 12 months prior to the study was 27.7 percent. The variables associated with utilization in the two models were older age, female sex, more frequent toothbrushing, positive attitude of the mother toward the child's oral health, higher socioeconomic level, and higher oral health needs. Various predisposing, enabling, and oral health needs variables were associated with higher dental health services utilization. As in prior reports elsewhere, these results from Nicaragua confirmed that utilization inequalities exist between socioeconomic groups. The multinomial logistic regression model evidenced the association of different variables depending on the type of service used.
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Oxford, Monica L; Spieker, Susan J; Lohr, Mary Jane; Fleming, Charles B
2016-09-19
We conducted a community-based randomized control trial with intent-to-treat analysis on Promoting First Relationships® (PFR), a 10-week home visiting program. The study included 247 families with 10- to 24-month-old children who had a recent, open child protective services investigation of child maltreatment. Families were randomly assigned to receive either the 10-week home visiting PFR service or a telephone-based, three-call resource and referral (R&R) service. Across postintervention time points, parents in the PFR condition scored higher than families in the R&R condition in parent understanding of toddlers' social emotional needs (d = .35) and observed parental sensitivity (d = .20). Children in the PFR condition scored lower than children in the comparison condition on an observational measure of atypical affective communication (d = .19) and were less likely than children in the comparison group to be placed into foster care through 1-year postintervention (6% vs. 13%, p = .042). No significant differences were found on measures of parenting stress or child social-emotional competence, behavior problems, or secure base behavior. Overall, the results show support for the promise of PFR as an intervention for enhancing parent sensitivity and preventing child removals for families in the child welfare system. © The Author(s) 2016.
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Sanz, Jacqueline H; Berl, Madison M; Armour, Anna C; Wang, Jichuan; Cheng, Yao I; Donofrio, Mary T
2017-03-01
Executive function, a set of cognitive skills important to social and academic outcomes, is a specific area of cognitive weakness in children with congenital heart disease (CHD). We evaluated the prevalence and profile of executive dysfunction in a heterogeneous sample of school aged children with CHD, examined whether children with executive dysfunction are receiving school services and support, and identified risk factors for executive dysfunction at school age. Ninety-one school aged patients completed questionnaires, including the Behavior Rating Inventory of Executive Function (BRIEF) and a medical history questionnaire. An age- and gender- matched control sample was drawn from a normative database. Children with CHD had a higher rate of parent reported executive dysfunction (OR = 4.37, P < .0001), especially for working memory (OR = 8.22, P < .0001) and flexibility (OR = 8.05, P < .0001). Those with executive dysfunction were not more likely to be receiving school services (P > .05). Gender, premature birth (≤37 weeks), and CHD with aortic obstruction were predictive of executive dysfunction, especially for behavior regulation skills. School aged children with CHD have an increased prevalence of executive dysfunction, especially problems with working memory and flexibility, and are underserved by the school system. The increased risk for executive dysfunction in those with CHD and prematurity or CHD with aortic obstruction suggests an etiology of delayed brain development in the fetal and neonatal periods, while male gender may increase susceptibility to brain injury. This study highlights the need for regular neurodevelopmental follow up in children with CHD, and a need to better understand mechanisms that contribute to adverse neurodevelopmental outcomes. © 2016 Wiley Periodicals, Inc.
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The Advantaged: A Preschool Program for the Disadvantaged.
ERIC Educational Resources Information Center
Tuscumbia Public Schools, AL.
Objectives of this program are to provide health services, foster emotional development, plan for educational growth as a developmental and purposeful process, and encourage parent participation. Children receive medical and dental examinations and care. Social workers serve as liaisons between school, home, and community for recruitment and…
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45 CFR 261.10 - What work requirements must an individual meet?
Code of Federal Regulations, 2014 CFR
2014-10-01
... (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK What Are the Provisions Addressing Individual Responsibility? § 261.10 What work requirements must an individual meet? (a)(1) A parent or caretaker receiving assistance must...
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45 CFR 261.10 - What work requirements must an individual meet?
Code of Federal Regulations, 2012 CFR
2012-10-01
... ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK What Are the Provisions Addressing Individual Responsibility? § 261.10 What work requirements must an individual meet? (a)(1) A parent or caretaker receiving assistance...
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45 CFR 261.10 - What work requirements must an individual meet?
Code of Federal Regulations, 2010 CFR
2010-10-01
... ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK What Are the Provisions Addressing Individual Responsibility? § 261.10 What work requirements must an individual meet? (a)(1) A parent or caretaker receiving assistance...
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45 CFR 261.10 - What work requirements must an individual meet?
Code of Federal Regulations, 2011 CFR
2011-10-01
... ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK What Are the Provisions Addressing Individual Responsibility? § 261.10 What work requirements must an individual meet? (a)(1) A parent or caretaker receiving assistance...
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45 CFR 261.10 - What work requirements must an individual meet?
Code of Federal Regulations, 2013 CFR
2013-10-01
... (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENSURING THAT RECIPIENTS WORK What Are the Provisions Addressing Individual Responsibility? § 261.10 What work requirements must an individual meet? (a)(1) A parent or caretaker receiving assistance must...
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76 FR 81897 - TRICARE; Extended Care Health Option
Federal Register 2010, 2011, 2012, 2013, 2014
2011-12-29
... Autism Spectrum Disorders (ASD). DATES: Written comments received at the address indicated below by... and Plan on Services to Military Dependent Children with Autism.'' The plan included a proposal to use... Duty Family Members (ADFM) diagnosed with one of the Autism Spectrum Disorders (ASD). Central to the...
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76 FR 68617 - National Diabetes Month, 2011
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-04
... have made substantial progress in combating diabetes, the number of Americans burdened by this disease... and children alike. It is essential that all Americans take steps to assess and reduce their risk of... Americans joining a new health plan can receive recommended preventive services, like diabetes screenings...
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45 CFR 213.22 - Authority of presiding officer.
Code of Federal Regulations, 2011 CFR
2011-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND.... (7) Examine witnesses. (8) Receive, rule on, exclude or limit evidence or discovery. (9) Fix the time... the production of witnesses, papers, or other evidence. (c) If the presiding officer is a hearing...
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45 CFR 213.22 - Authority of presiding officer.
Code of Federal Regulations, 2010 CFR
2010-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND.... (7) Examine witnesses. (8) Receive, rule on, exclude or limit evidence or discovery. (9) Fix the time... the production of witnesses, papers, or other evidence. (c) If the presiding officer is a hearing...
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45 CFR 213.22 - Authority of presiding officer.
Code of Federal Regulations, 2013 CFR
2013-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND.... (7) Examine witnesses. (8) Receive, rule on, exclude or limit evidence or discovery. (9) Fix the time... the production of witnesses, papers, or other evidence. (c) If the presiding officer is a hearing...
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45 CFR 213.22 - Authority of presiding officer.
Code of Federal Regulations, 2014 CFR
2014-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND.... (7) Examine witnesses. (8) Receive, rule on, exclude or limit evidence or discovery. (9) Fix the time... the production of witnesses, papers, or other evidence. (c) If the presiding officer is a hearing...
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45 CFR 213.22 - Authority of presiding officer.
Code of Federal Regulations, 2012 CFR
2012-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND.... (7) Examine witnesses. (8) Receive, rule on, exclude or limit evidence or discovery. (9) Fix the time... the production of witnesses, papers, or other evidence. (c) If the presiding officer is a hearing...
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ERIC Educational Resources Information Center
Dickstein, Daniel
2009-01-01
Children with autism are likely to have unmet health care needs and live in families that have financial problems. Preschoolers with attention deficit hyperactivity disorder receive 2 to 4 times in health services than those without the disease. Cost effective treatments for childhood and adolescent depression are also discussed.
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Public health dental hygiene: an option for improved quality of care and quality of life.
Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura
2013-10-01
The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.
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Prehospital analgesia in New South Wales, Australia.
Bendall, Jason C; Simpson, Paul M; Middleton, Paul M
2011-12-01
With at least 20% of ambulance patients reporting pain of moderate to severe intensity, pain management has become a primary function of modern ambulance services. The objective of this study was to describe the use of intravenous morphine, inhaled methoxyflurane, and intranasal fentanyl when administered in the out-of-hospital setting by paramedics within a large Australian ambulance service. A retrospective analysis was conducted using data from ambulance patient health care records (PHCR) for all cases from 01 July 2007 through 30 June 2008 in which an analgesic agent was administered (alone or in combination). During the study period, there were 97,705 patients ≤ 100 years of age who received intravenous (IV) morphine, intranasal (IN) fentanyl, or inhaled methoxyflurane, either alone or in combination. Single-agent analgesia was administered in 87% of cases. Methoxyflurane was the most common agent, being administered in almost 60% of cases. Females were less likely to receive an opiate compared to males (RR = 0.83, 95% CI, 0.82-0.84, p <0.0001). Pediatric patients were less likely to receive opiate analgesia compared to adults (RR = 0.65, 95% CI, 0.63-0.67, p <0.0001). The odds of opiate analgesia (compared to pediatric patients 0-15 years) were 1.47; 2.10; 2.56 for 16-39 years, 40-59 years, and ≥ 60 years, respectively. Pediatric patients were more likely to receive fentanyl than morphine (RR = 1.69, 95% CI, 1.64-1.74, p < 0.0001). In this ambulance service, analgesia most often is provided through the use of a single agent. The majority of patients receive non-opioid analgesia with methoxyflurane, most likely because all levels of paramedics are authorized to administer that analgesic. Females and children are less likely to receive opiate-based analgesia than their male and adult counterparts, respectively. Paramedics appear to favor intranasal opiate delivery over intravenous delivery in children with acute pain.
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Stewart, Ray E; Sanger, Roger G
2014-11-01
The Pediatric Oral Health Access Program is a joint project of the California Dental Association and the California Society of Pediatric Dentistry. The results have been remarkable in terms of the number of underserved children who have received oral health services. What is less certain is the number of general dentists who, as a result of the training, have been able and willing to provide comprehensive care to more and younger children.
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Slack, Kristen S; Font, Sarah; Maguire-Jack, Kathryn; Berger, Lawrence M
2017-10-11
This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele.
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Wondafrash, Beyene; Hiko, Desta
2016-01-01
Infants and children living with HIV receive antiretroviral treatment often late, are exposed to opportunistic infection and quickly develop AIDS. Few hospitals are providing ART service after Dried Blood Spot (DBS)test.The objective of this study is to assess the status of infants and children linked to ART. Descriptive cross-sectional study was conducted in hospitals. Data of 138 infants and children exposed to HIV were collected from registration books and data bases from 2009 to 2011. Data were analyzed using SPSS version 16. Chi-squared test and p-value were computed. In-depth interviews were conducted with key informants. Ninety-eight (71%) infants and children exposed to HIV were diagnosed for HIV infection of which 68(69.4%) initiated ART. Twenty four (35.3%) initiated ART one month after HIV screening results. Thirty-three (50.0%) and 23(35.3%) infants and children dropped from and adhered to ART respectively. Eleven (16.2%) of them who initiated ART died within the study period. HIV infection status (p-value=0.003), dropping from ART (p-value=0.002) and death after ART initiation (p-value=0.010) showed significance with mothers' PMTCT service status. Seven in ten HIV-exposed infants and children were diagnosed with HIV, and almost all of them initiated ART. The overall turnaround time was 10 days. Based up on mothers' PMTCT service status, there was a significant difference among HIV-exposed infants and children in acquiring HIV infection from mothers during pregnancy (p-value=0.003) and dropping from ART (p-value=0.010). There were challenges in sample collection and transportation. Early HIV screening during pregnancy and PMTCT service should be strengthened.
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Home Health Nursing Care and Hospital Use for Medically Complex Children.
Gay, James C; Thurm, Cary W; Hall, Matthew; Fassino, Michael J; Fowler, Lisa; Palusci, John V; Berry, Jay G
2016-11-01
Home health nursing care (HH) may be a valuable approach to long-term optimization of health for children, particularly those with medical complexity who are prone to frequent and lengthy hospitalizations. We sought to assess the relationship between HH services and hospital use in children. Retrospective, matched cohort study of 2783 hospitalized children receiving postdischarge HH services by BAYADA Home Health Care across 19 states and 7361 matched controls not discharged to HH services from the Children's Hospital Association Case Mix database between January 2004 and September 2012. Subsequent hospitalizations, hospital days, readmissions, and costs of hospital care were assessed over the 12-month period after the initial hospitalization. Nonparametric Wilcoxon signed rank tests were used for comparisons between HH and non-HH users. Although HH cases had a higher percentage of complex chronic conditions (68.5% vs 65.4%), technology assistance (40.5% vs 35.7%), and neurologic impairment (40.7% vs 37.3%) than matched controls (P ≤ .003 for all), 30-day readmission rates were lower in HH patients (18.3% vs 21.5%, P = .001). At 12 months after the index admission, HH patients averaged fewer admissions (0.8 vs 1.0, P < .001), fewer days in the hospital (6.4 vs 6.6, P < .001), and lower hospital costs ($22 511 vs $24 194, P < .001) compared with matched controls. Children discharged to HH care experienced less hospital use than children with similar characteristics who did not use HH care. Further investigation is needed to understand how HH care affects the health and health services of children. Copyright © 2016 by the American Academy of Pediatrics.
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Das, Aritra; Chatterjee, Rahul; Karthick, Morchan; Mahapatra, Tanmay; Chaudhuri, Indrajit
2016-01-01
Background Exclusive breastfeeding (EBF) during the first six months of life is considered a high impact but low-cost measure for reducing the morbidity and mortality among children. The current study investigated the association of seasonality and frontline worker(FLW) provided counselling with practice of EBF in Bihar, India. Methods We used the ‘Lot Quality Assurance Sampling’ technique to conduct a multi-stage sampling survey in 8 districts of Bihar. Regarding EBF, mothers of 0–5 (completed) months old children were asked if they had given only breastmilk to their children during the previous day, while mothers of 6–8 (completed) months old children were inquired about the total duration of EBF. We tested for association between EBF during the previous day with season of interview and EBF for full 6 months with nursing season. We also assessed if receiving counselling on EBF and complementary feeding had any association with relevant EBF indicators. Results Among the under-6 month old children, 76% received EBF during the previous day, whereas 92% of 6–8 (completed) months old children reportedly received EBF for the recommended duration. Proportion of 0–5 (completed) month old children receiving only breastmilk (during last 24 hours) decreased significantly with increasing age and with change of season from colder to warmer months. Odds of receiving only breastmilk during the previous day was significantly higher during the winter months (Adjusted odds ratio(AOR) = 1.50; 95% CI = 1.37, 1.63) compared to summer. Also, the children nursed primarily during the winter season had higher odds of receiving EBF for 6 months (AOR = 1.90, 95% CI = 1.43, 2.52) than those with non-winter nursing. Receiving FLW-counselling was positively associated with breastfeeding exclusively, even after adjusting for seasonality and other covariates (AOR = 1.82; 95% CI = 1.67, 1.98). Conclusions Seasonality is a significant but non-modifiable risk factor for EBF. However, FLW-counselling was found to increase practice of EBF irrespective of season. Scale-up of FLW-counselling services, with emphasis on summer months and mothers of older infants, can potentially reduce the impact of seasonality on EBF. PMID:27513642
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Lee, Barbara; Fuller-Thomson, Esme; Fallon, Barbara; Black, Tara; Trocmé, Nico
2017-05-01
Using administrative child welfare data from the Ontario Child Abuse and Neglect Data System (OCANDS), this study compared the profiles of Asian-Canadian and White-Canadian children and families that experienced a case closure after an investigation instead of being transferred to ongoing child protection services (CPS). Child protection investigations involving Asian-Canadian and White-Canadian children and families that were transferred to ongoing CPS presented a different profile of case characteristics and caregiver and child clinical needs. Asian-Canadian children and families received ongoing CPS for over a month longer than White-Canadian children and families and were less likely (odds ratio [ OR] = 0.39) to be reinvestigated for any form of maltreatment-related concerns within 1 year after case closure. It appears that child protection investigations involving Asian-Canadian children and families are less likely to be closed prematurely than White-Canadian children and families, and the child protection system may be meeting the needs of Asian-Canadian communities. Alternatively, it is possible there is unaccounted biases that may be reflective of systemic problem of discriminative practices in the child protection system. Further research is needed to explore this phenomenon.
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Factors influencing vaccination compliance in peri-urban Gambian children.
Hanlon, P; Byass, P; Yamuah, M; Hayes, R; Bennett, S; M'Boge, B H
1988-02-01
The vaccination status of 251 children aged 12-18 months in two peri-urban Gambian communities was determined from their health cards. Two subgroups were identified: children who were fully vaccinated, and those who had received less than half their vaccinations. The social and environmental circumstances of these children were investigated to detect factors which were associated with poor vaccination compliance. Mothers of well vaccinated children were more inclined to bring them for non-curative services. Mothers of poorly vaccinated children had a poorer knowledge of the diseases against which their children should be vaccinated and they also had a more superstitious view of disease causation. Those children who showed poor compliance came from larger families. In the poorly vaccinated group both parents were less well educated and there was a trend towards poorer literacy.
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Ravn, Henrik; Batista, Celso Soares Pereira; Rodrigues, Amabelia
2016-01-01
Background Recent studies have revealed a low measles vaccination (MV) rate in the Republic of Guinea-Bissau (West Africa) that has not increased in accordance with the increasing coverage of other vaccinations. Measles is the deadliest of all childhood rash/fever illnesses and spreads easily, implying that if the vaccination coverage is declining there is a significant risk of new measles outbreaks [27]. Meanwhile, mobile health (mHealth; the use of mobile phones for health interventions) has generated much enthusiasm, and shown potential in improving health service delivery in other contexts. Objective The aim of this study is to evaluate the efficiency of mHealth as a tool for improving MV coverage while contributing to the mHealth evidence base. Methods This study will take place at three health centers in different regions of Guinea-Bissau. Participants, defined as mothers of the children receiving the MV, will be enrolled when they arrive with their children at the health center to receive the Bacillus Calmette-Guérin vaccination, usually within one month of the child’s birth. Enrolment will continue until a study population of 990 children has been reached. The participants will be randomly assigned to a control arm or one of two intervention arms. Each of the three groups will have 330 participants, distributed equally between health centers. Participants in the first intervention arm will receive a scheduled short message service (SMS) text message reminding them of the MV. Participants in the second intervention arm will receive a voice call in addition to the SMS message, while the control arm will receive no interventions. The MV is scheduled to be administered at 9 months of age. Although the vaccine would still be effective after 12 months, local policy in Guinea-Bissau prevents children aged >12 months from receiving the vaccination, and thus the study will follow-up with participants after the children reach 12 months of age. Children who have not yet received the MV will be offered vaccination by the project group. Results The study will analyze the efficiency of the intervention by determining its overall effect on MV coverage and timeliness when children reach 12 months of age. The main analysis will be stratified by intervention group, health center, level of education, ethnic group, and role of the person receiving the text messages (eg, mother, father, other family member). Secondary outcomes include the average number of health center visits (with intention to obtain the MV) required before successful administration. Conclusions Despite the rapid proliferation of mHealth projects, only a small number have been evaluated in terms of direct links to health outcomes. This gap in knowledge requires solid evidence on which policy-makers can base decisions. This study aims to produce significant knowledge about mHealth implementation within a Sub-Saharan context while creating data-supported evidence. Trial Registration Clinicaltrials.gov: NCT02662595; https://clinicaltrials.gov/ct2/show/NCT02662595 (Archived by WebCite at http://www.webcitation.org/6jH8YiSjY) PMID:27466046
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Psychological wellbeing, physical impairments and rural aging in a developing country setting.
Abas, Melanie A; Punpuing, Sureeporn; Jirapramupitak, Tawanchai; Tangchonlatip, Kanchana; Leese, Morven
2009-07-16
There has been very little research on wellbeing, physical impairments and disability in older people in developing countries. A community survey of 1147 older parents, one per household, aged sixty and over in rural Thailand. We used the Burvill scale of physical impairment, the Thai Psychological Wellbeing Scale and the brief WHO Disability Assessment Schedule. We rated received and perceived social support separately from children and from others and rated support to children. We used weighted analyses to take account of the sampling design. Impairments due to arthritis, pain, paralysis, vision, stomach problems or breathing were all associated with lower wellbeing. After adjusting for disability, only impairment due to paralysis was independently associated with lowered wellbeing. The effect of having two or more impairments compared to none was associated with lowered wellbeing after adjusting for demographic factors and social support (adjusted difference -2.37 on the well-being scale with SD = 7.9, p < 0.001) but after adjusting for disability the coefficient fell and was non-significant. The parsimonious model for wellbeing included age, wealth, social support, disability and impairment due to paralysis (the effect of paralysis was -2.97, p = 0.001). In this Thai setting, received support from children and from others and perceived good support from and to children were all independently associated with greater wellbeing whereas actual support to children was associated with lower wellbeing. Low received support from children interacted with paralysis in being especially associated with low wellbeing. In this Thai setting, as found in western settings, most of the association between physical impairments and lower wellbeing is explained by disability. Disability is potentially mediating the association between impairment and low wellbeing. Received support may buffer the impact of some impairments on wellbeing in this setting. Giving actual support to children is associated with less wellbeing unless the support being given to children is perceived as good, perhaps reflecting parental obligation to support adult children in need. Improving community disability services for older people and optimizing received social support will be vital in rural areas in developing countries.
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International Perspectives on Early Childhood Curricula
ERIC Educational Resources Information Center
Oberhuemer, Pamela
2005-01-01
The early years of childhood are receiving increased public policy attention in many countries around the world. Debates on providing quality services and ensuring a good foundation for lifelong learning are generating a new interest in curriculum issues. What understandings do we have of young children? How do they access and construct knowledge…
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45 CFR 1340.10 - Purpose of this subpart.
Code of Federal Regulations, 2010 CFR
2010-10-01
..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... meet in order to receive grants to develop, strengthen, and carry out State child abuse and neglect...
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45 CFR 302.35 - State parent locator service.
Code of Federal Regulations, 2011 CFR
2011-10-01
... parents, non-parent relatives, and children upon request of authorized individuals specified in paragraph... seek an order against a noncustodial parent for the support and maintenance of a child, or any agent of such court; (3) The resident parent, legal guardian, attorney, or agent of a child who is not receiving...
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45 CFR 302.35 - State parent locator service.
Code of Federal Regulations, 2012 CFR
2012-10-01
... parents, non-parent relatives, and children upon request of authorized individuals specified in paragraph... seek an order against a noncustodial parent for the support and maintenance of a child, or any agent of such court; (3) The resident parent, legal guardian, attorney, or agent of a child who is not receiving...
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Violence and Aggression in Children and Youth. ERIC/OSEP Digest E572.
ERIC Educational Resources Information Center
Fitzsimmons, Mary K.
This digest discusses the need for troubled students to receive habilitative services instead of haphazard punishment, then outlines sources of frustration for aggressive students and stages of frustration (anxiety, stress, defensiveness, physical aggression, and tension reduction), and appropriate responses. Teachers are advised to prevent…
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45 CFR 1340.10 - Purpose of this subpart.
Code of Federal Regulations, 2013 CFR
2013-10-01
..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... meet in order to receive grants to develop, strengthen, and carry out State child abuse and neglect...
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45 CFR 1340.10 - Purpose of this subpart.
Code of Federal Regulations, 2011 CFR
2011-10-01
..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... meet in order to receive grants to develop, strengthen, and carry out State child abuse and neglect...
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45 CFR 1340.10 - Purpose of this subpart.
Code of Federal Regulations, 2014 CFR
2014-10-01
..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT Grants to States... meet in order to receive grants to develop, strengthen, and carry out State child abuse and neglect...