A narrative review of interventions addressing the parental-fetal relationship

Background Expectant parents develop varying degrees of emotional affiliation with the unborn child. Interventions supporting this relationship may be beneficial given its link to maternal health behaviour during pregnancy, as well as the parental–infant bond after birth. Aim To identify and describe the effects of programmes and strategies that have addressed the parental–fetal relationship. Method English-language primary studies, published between 2005–2015, were identified and their methodological quality was assessed. Databases used included CINAHL, Cochrane Library, MEDLINE, PsycINFO and Web of Science. Key search terms included maternal/paternal–fetal attachment, prenatal bond, parental–fetal relationship and intervention. RCTs, non-RCTs, observational and non-comparative studies, before and after studies and case studies were included. Findings Twenty-seven papers were included. Studies evaluated the effects of various strategies, including ultrasound and screening procedures, fetal awareness interventions, social and psychological support techniques, educational programmes and relaxation strategies. Results are inconsistent due to the diversity of interventions and significant variation in methodological quality. Conclusion There is insufficient evidence to support definitive conclusions regarding the efficacy of any included intervention. A number of limitations, such as non-probability sampling, lack of blinding, and insufficient follow-up weaken the evidence. The inclusion of fathers in only three studies reflects the overall neglect of men in research regarding the prenatal relationship. Further in-depth study of the nature of the maternal/paternal–fetal relationship may be needed in order to allow for the identification of interventions that are consistently beneficial and worthwhile

Paved with Good Intentions: The Failure of Passive Disability Policy in Canada

It is common in the disability community to speak of unfulfilled aspirations for full citizenship and participation in the mainstream of Canadian society. In Canada, as in much of the developed world, many adults with disabilities remain outside the mainstream, especially in regard to economic opportunities. Unfortunately, many of the disability policies currently pursued by Canadian governments are unlikely to improve this situation, and may in fact make it worse. This paper offers a critical analysis of a common instrument of current disability policy, the passive cash benefit. I will focus, in particular, on the effects of passive transfers on prospects for adults with disabilities to reach their full income potential through employment. I will attempt to establish that passive income support strategies – for adults with disabilities and for low-income people in general – force their intended beneficiaries to sacrifice employment prospects for help with short-term income needs, a trade-off that reinforces poverty and dependency over the longer term

The School Attachment Monitor—A novel computational tool for assessment of attachment in middle childhood

© 2021 Rooksby et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.Background Attachment research has been limited by the lack of quick and easy measures. We report development and validation of the School Attachment Monitor (SAM), a novel measure for largescale assessment of attachment in children aged 5–9, in the general population. SAM offers automatic presentation, on computer, of story-stems based on the Manchester Child Attachment Story Task (MCAST), without the need for trained administrators. SAM is delivered by novel software which interacts with child participants, starting with warm-up activities to familiarise them with the task. Children’s story completion is video recorded and augmented by ‘smart dolls’ that the child can hold and manipulate, with movement sensors for data collection. The design of SAM was informed by children of users’ age range to establish their task understanding and incorporate their innovative ideas for improving SAM software. Methods 130 5–9 year old children were recruited from mainstream primary schools. In Phase 1, sixty-one children completed both SAM and MCAST. Inter-rater reliability and rating concordance was compared between SAM and MCAST. In Phase 2, a further 44 children completed SAM complete and, including those children completing SAM in Phase 1 (total n = 105), a machine learning algorithm was developed using a “majority vote” procedure where, for each child, 500 non-overlapping video frames contribute to the decision. Results Using manual rating, SAM-MCAST concordance was excellent (89% secure versus insecure; 97% organised versus disorganised; 86% four-way). Comparison of human ratings of SAM versus the machine learning algorithm showed over 80% concordance. Conclusions We have developed a new tool for measuring attachment at the population level, which has good reliability compared to a validated attachment measure and has the potential for automatic rating–opening the door to measurement of attachment in large populations.Peer reviewedFinal Published versio

The impact of enhancing a behavioral program for children with severe behavioral disorders by promoting parents\u27 coherent life story

The purpose of this study was to investigate the impact of enhancing an already existing day treatment program for youth with severe behavior disorders. The intervention consisted of a short-term parent therapy group which operationalized elements of attachment theory and narrative therapy and then compared this to the program\u27s regular treatment. This group focused on assisting parents (1) to review their past for a coherent story, (2) to identify and utilize a parenting strength, and (3) to voice their hopes and fears to their child with an emphasis on the child\u27s potential. The effectiveness of this pilot group was assessed by both quantitative and qualitative methodology. There were six clients in the enhanced treatment condition, and nine clients in the regular treatment condition;For the quantitative aspect of this study a repeated measures design (specifically a split-plot design) was utilized to evaluate the effectiveness of the parent therapy group. The instruments used in this study included the Child Behavior Checklist1 and the Parent Attitude Survey2. For the qualitative aspect of this study, written responses to several open-ended questions were analyzed by three raters. This process allowed the emergence of thematic and theoretical inferences regarding the clients\u27 experience of the parent therapy group;The results of the analysis of variance indicated no treatment effect and no treatment by time effect. There was a time effect which indicated that all of the parents reported an improvement in their perception of their child\u27s behavior from pretest to posttest which likely supported the behavioral component of the program. The qualitative aspect to this study suggested the importance of this group for assisting the parents to gain an experience of cooperation, connection, and competency. The theoretical construct that was derived from the parental responses suggested that the group fulfilled deficit needs and was based on Maslow\u27s3 theory of the hierarchy of needs. It did seem that the group experience fostered a change in self-definition and may be a useful tool to combat resistance which is frequently identified with this population;ftn1Achenbach, T. M. (1991). Child Behavior Checklist. Burlington, VT: University of Vermont. 2Hereford, C. F. (1963). Changing parental attitudes through group discussion. Austin, TX: Hogg Foundation for Mental Health. 3Maslow, A. H. (1970). Motivation and personality (2nd edition). New York, NY: Harper & Row

An Exploratory Study of an Arts-Based Measure and Research Model that Examines the Relationship Between Attachment Style, Trauma, and the Use of Adhesive Materials in Art Therapy

Though the use of art materials (pencil, paint, clay) have been widely researched in art therapy, little has been written about the role of adhesives (glue, tape, staples) in the art making process. This exploratory, sequential mixed methods study examined the relationship between attachment style, trauma, and the use of adhesive materials in art therapy and serves as a model for arts-based research which combines the scientific rigor of quantitative inquiry with a rich narrative descriptive of qualitative data. This research was the first step in developing the Arts-based Attachment Style Assessment (ABASA), a newly created art-based diagnostic tool to predict attachment style. A purposive sample (N=91) of college students from a small New England college participated in the research. While an initial MANOVA showed no main effect of adhesive choice for attachment style, F (6, 172) = 1.26, p = .278; Wilk\u27s Λ = 0.918, a qualitative analysis of artwork and written narrative suggest that gender and trauma in combination with adhesive choice, might have a relationship to attachment style. As exploratory research, a second MANOVA, examining attachment style including three independent variables (trauma, gender, adhesive choice), was performed. Again, there was no significant main effect for adhesive on attachment. There was, however, a significant three-way interaction effect of gender, trauma, and adhesives on the attachment depend scale F(2,76) =5.50, p = .006 with a small effect size (partial η2 = .126) and high power (1 - β) =.838. Future research should include replication with testing of gender and trauma as covariates with larger sample sizes along with establishing face and construct validity, factor analysis, and testing of internal consistency for the ABASA

The Use of Clinical Judgment in Differentiating Symptoms of Autism Spectrum Disorder from Those of Other Childhood Conditions: A Delphi Study

More and more, due to long waiting lists at diagnostic clinics and access barriers for certain segments of the population, schools are often the first environment in which children are evaluated for ASD (Sullivan, 2013). And while accurate identification of autism spectrum disorders (ASD) is essential for proper treatment and service provision, large percentages of school and community-based identifications of ASD are overturned when children are re-evaluated with strict clinical criteria (Wiggins et al., 2015). In part, challenges faced in accurately differentiating ASD from other conditions may be contributed to the diagnostic complexities of the condition itself. Clinical expertise is one of, if not the most important factors in accurate diagnostic decision-making during evaluations of ASD. However, there exists little insight into what comprises this expert judgment. Using the Delphi methodology, a panel of clinical and school psychology experts in ASD identification were surveyed until consensus was reached about their use of clinical judgment in differentiating ASD from other conditions. The results of these rounds of questioning were compiled into a decision-making guideline entitled Beyond Test Results: Developing Clinical Judgment to Differentiate Symptoms of Autism Spectrum Disorders from Those of Other Childhood Conditions. Implications of this guide include incorporation into school psychology training courses and guidance for school-based evaluation teams

Psychological Adjustment and Caregive Attributes in Children Referred to Contact House

Child abuse and neglect (CAN) encompasses a heterogenous group of adverse practices with devastating personal, social, educational, health, legal and welfare consequences. The term child abuse and neglect covers four types maltreatment: physical abuse, emotional abuse, sexual abuse, and neglect, with many children experiencing a combination of these types. Australian child protection notifications have more than doubled in the 5-year period to 2004. Of most concern is that, of all the Australian States and Territories, Queensland has the highest rate of substantiated cases with 14.1 per 1,000 children (AIHW, 2006). Childhood abuse and neglect can have profound short- and long-term effects. Children with a history of abuse and neglect have been shown to experience insecure attachment, developmental delays, diminished social skills, violent behaviour and learning problems. Previous studies have also found that abused and neglected children frequently experience a higher incidence of a diverse range of adverse mental health outcomes including helplessness and sadness, lowered self-esteem and post traumatic stress disorder. However, relatively few studies have examined the psychological adjustment of children in more immediate terms especially within an Australian context. Furthermore, adults experiencing CAN during childhood frequently exhibit diverse psychopathologies. The variability in adverse consequences suggests the existence of mediating and moderating factors influencing the level of distress experienced by children. While associations have been made between factors surrounding the type of abuse, the child’s age and gender and negative outcomes, little is known about the role of the child’s non-offending caregiver and the relationship between caregiver attributes and the level of distress experienced by the child. A primary aim of this study was to investigate caregiver attributes and the psychological adjustment of children referred to a non-government treatment centre. This specific aims were: (i) to describe the psychological adjustment of children who have experienced abuse and/or neglect (ii) to compare the psychological functioning of children presenting for treatment with a community sample of children (iii) to describe the level of psychosocial functioning of the caregivers in the clinical group across a range of psychosocial and parenting practice variables and (iv) to explore the relationship between demographic variables, factors relating to the abuse and neglect, and caregiver variables, which may predict, mediate, or moderate the child’s psychological adjustment. In addition the study aimed to establish a database for future research into treatment outcomes. Through the inclusion of a comparison community sample, this study provided evidence to complement existing research and develop a more complete picture of families living with and without CAN. The findings also offer preliminary evidence regarding the effectiveness of treatment and underscore the need for ongoing evaluation of service outcomes to optimise the quality of life for children and families affected by CAN

Equine Assisted Psychotherapy: Implications for Treating Trauma

Trauma related symptoms and Posttraumatic Stress Disorder (PTSD) have been increasingly recognized for the key roles they occupy in mental health and overall individual well-being within both adult and childhood populations. They often represent significant barriers to the provision of mental healthcare within military populations and individuals diagnosed with serious mental illness (SMI). This original contribution to practice explores the significance of Equine Assisted Psychotherapy as a novel adjunctive approach to treating trauma. symptoms in adults and children. An extensive literature review examines current research and discussion on common definitions and nomenclature. It begins with discussion on the broader areas of Human Animal Interventions and Animal Assisted Interventions and narrows to Equine Assisted Therapies as readers are led to focus on Equine Assisted Psychotherapy (EAP) for treating trauma. This is followed by a comprehensive review of the current empirically based research on EAP and its specific uses in the provision of trauma-focused mental healthcare. Commonly occurring themes, within the literature base, are identified and further explored. They centered on the current applications of EAP, methods employed in the provision of EAP for trauma, and issues with research design and methodology. General conclusions indicate EAP is likely an effective adjunctive approach to more traditional models of trauma focused psychotherapy. However, several significant barriers to the production of rigorous future research must be overcome to further define specific mechanisms of action while validating a standardized nomenclature and manualized EAP treatment protocol