NPM-2017: nationale prevalentiestudie mishandeling van kinderen en jeugdigen

Development Psychopathology in context: famil

Reliability and Validity of the KIPPPI: An Early Detection Tool for Psychosocial Problems in Toddlers

Background: The KIPPPI (Brief Instrument Psychological and Pedagogical Problem Inventory) is a Dutch questionnaire that measures psychosocial and pedagogical problems in 2-year olds and consists of a KIPPPI Total score, Wellbeing scale, Competence scale, and Autonomy scale. This study examined the reliability, validity, screening accuracy and clinical application of the KIPPPI. Methods: Parents of 5959 2-year-old children in the Rotterdam area, the Netherlands, were invited to participate in the study. Parents of 3164 children (53.1% of all invited parents) completed the questionnaire. The internal consistency was evaluated and in subsamples the test-retest reliability and concurrent validity with regard to the Child Behavioral Checklist (CBCL). Discriminative validity was evaluated by comparing scores of parents who worried about their child's upbringing and parent's that did not. Screening accuracy of the KIPPPI was evaluated against the CBCL by calculating the Receiver Operating Characteristic (ROC) curves. The clinical application was evaluated by the relation between KIPPPI scores and the clinical decision made by the child health professionals. Results: Psychometric properties of the KIPPPI Total score, Wellbeing scale, Competence scale and Autonomy scale were respectively: Cronbach's alphas: 0.88, 0.86, 0.83, 0.58. Test-rete

Evaluation of an early detection tool for social-emotional and behavioral problems in toddlers: The Brief Infant Toddler Social and Emotional Assessment - A cluster randomized trial

<p>Abstract</p> <p>Background</p> <p>The prevalence of social-emotional and behavioral problems is estimated to be 8 to 9% among preschool children. Effective early detection tools are needed to promote the provision of adequate care at an early stage. The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) was developed for this purpose. This study evaluates the effectiveness of the BITSEA to enhance social-emotional and behavioral health of preschool children.</p> <p>Methods and Design</p> <p>A cluster randomized controlled trial is set up in youth health care centers in the larger Rotterdam area in the Netherlands, to evaluate the BITSEA. The 31 youth health care centers are randomly allocated to either the control group or the intervention group. The intervention group uses the scores on the BITSEA and cut-off points to evaluate a child's social-emotional and behavioral health and to decide whether or not the child should be referred. The control group provides care as usual, which involves administering a questionnaire that structures the conversation between child health professionals and parents. At a one year follow-up measurement the social-emotional and behavioral health of all children included in the study population will be evaluated.</p> <p>Discussion</p> <p>It is hypothesized that better results will be found, in terms of social-emotional and behavioral health in the intervention group, compared to the control group, due to more adequate early detection, referral and more appropriate and timely care.</p> <p>Trial registration</p> <p>Current Controlled Trials <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2035">NTR2035</a></p

Detection of unsafety in families with parental and/or child developmental problems at the start of family support

Background Risk assessment is crucial in preventing child maltreatment as it can identify high-risk cases in need of child protection intervention. Despite this importance, there have been no validated risk assessment instruments available in the Netherlands for assessing the risk of child maltreatment. Therefore, the predictive validity of the California Family Risk Assessment (CFRA) was examined in Dutch families who received family support. In addition, the added value of a number of experimental items was examined. Finally, it was examined whether the predictive value of the instrument could be improved by modifying the scoring procedure. Methods Dutch families who experienced parenting and/or child developmental problems and were referred by the Centres for Youth and Family for family support between July 2009 and March 2011 were included. This led to a sample of 491 families. The predictive validity of the CFRA and the added value of the experimental items were examined by calculating AUC values. A CHAID analysis was performed to examine whether the scoring procedure could be improved. Results About half of the individual CFRA items were not related to future reports of child maltreatment. The predictive validity of the CFRA in predicting future reports of child maltreatment was found to be modest (AUC = .693). The addition of some of the experimental items and the modification of the scoring procedure by including only items that were significantly associated with future maltreatment reports resulted in a ‘high’ predictive validity (AUC = .795). Conclusions This new set of items might be a valuable instrument that also saves time because only variables that uniquely contribute to the prediction of future reports of child maltreatment are included. Furthermore, items that are perceived as difficult to assess by professionals, such as parental mental health problems or parents’ history of abuse/neglect, could be omitted without compromising predictive validity. However, it is important to examine the psychometric properties of this new set of items in a new dataset

Clustering of health and risk behaviour in immigrant and indigenous Dutch residents aged 19–40 years

Objectives\ud Studies on the co-occurrence, ‘clustering’ of health and other risk behaviours among immigrants from non-industrialised countries lack until now. The aim of this study was to compare this clustering in immigrant and indigenous adults.\ud \ud Methods\ud A representative sample (N = 2,982; response 71%) of the Dutch population aged 19–40, with 247 respondents from non-industrialized countries (Turkey, Morocco, Surinam, Netherlands Antilles), was asked about health behaviours (alcohol, smoking, drugs, unsafe sex, exercise, nutrition, sleep behaviour, traffic behaviour), and about rule-breaking behaviour and aggression. Data were collected using internet questionnaires, which excluded respondents unable to read Dutch.\ud \ud Results\ud Among indigenous adults, health and risk behaviours co-occur in three clusters (alcohol, health-enhancing behaviour, and rule-breaking behaviour), whereas among immigrant groups two clusters were found (alcohol and rule-breaking behaviour/smoking). Differences mostly concerned health-enhancing behaviours such as nutrition, which was not part of any cluster, and physical activity.\ud \ud Conclusions\ud This supports an integrated promotion of healthier lifestyles to immigrants who are able to read Dutch. Regarding potentially risky behaviours like alcohol use and rule-breaking behaviours, this could be similar to that for indigenous people\u

Predicting growth curves of early childhood externalizing problems: Differential susceptibility of children with difficult temperament

Using an accelerated longitudinal design, the development of externalizing problems from age 2 to 5 years was investigated in relation to maternal psychopathology, maternal parenting, gender, child temperament, and the presence of siblings. The sample consisted of 150 children selected at age 2-3 years for having high levels of externalizing problems. Parenting was measured using observational methods, and maternal reports were used for the other variables. Overall, mean levels of externalizing problems decreased over time, and higher initial levels (intercept) were related to a stronger decrease (negative slope) in externalizing problems. Results showed that higher levels of maternal psychopathology were related to less decrease in early childhood externalizing problems. Parental sensitive behavior predicted a stronger decrease in externalizing problems, but only for children with difficult temperaments. A stronger decrease of externalizing problems in children with older siblings also pertained only to children with difficult temperaments. Thus, temperamentally difficult children appear to be more susceptible to environmental influences on the development of externalizing behaviors. Our results indicate that the role of siblings in early childhood externalizing problems deserves more research attention, and that intervention efforts need to take into account temperamental differences in children's susceptibility to environmental influences. © 2009 Springer Science+Business Media, LLC

Early parenting intervention: Family risk and first-time parenting related to intervention effectiveness

The effects of cumulative risk and parity on the effectiveness of a home based parenting intervention were tested in a randomized controlled trial with 237 families with 1- to 3-year-old children screened for high levels of externalizing behavior. The intervention was aimed at enhancing positive parenting and decreasing externalizing behaviors. The results showed that cumulative risk was not associated with either change in child externalizing behaviors or change in positive parenting. When intervention effectiveness was compared for primiparas (i.e., first-time mothers) versus multiparas (i.e., mothers with more than one child), we found that intervention mothers of first-born children displayed an increase in their use of positive discipline strategies as compared to first-time mothers in the control group, whereas a similar effect for multiparas was absent. Among multiparas we found an intervention effect on sensitivity, with control group mothers showing an increase in sensitivity, whereas the intervention group showed a constant level of sensitivity over time. These results suggest that parity may be a moderator of intervention effectiveness. Implications for investigating moderators of intervention effectiveness are discussed. © 2007 Springer Science+Business Media, LLC

Effectiveness of a family-centered method for the early identification of social-emotional and behavioral problems in children: a quasi experimental study

Background: Social-emotional and behavioral problems are common in childhood. Early identification of these is important as it can lead to interventions which may improve the child's prognosis. In Dutch Preventive Child Healthcare (PCH), a new family-centered method has been implemented to identify these problems in early childhood. Its main features are consideration of the child's developmental context and empowerment of parents to enhance the developmental context. Methods/design: In a quasi-experimental study, embedded in routine PCH in the Netherlands, regions in which the family-centered method has been implemented (intervention condition) will be compared to "care as usual" regions (control condition). These regions are comparable in regard to socio-demographic characteristics. From more than 3,500 newborn babies, 18-month follow-up data on social-emotional and behavioral development will be obtained. PCH professionals will assess development during each routine well-child visit; participating parents will fill in standardized questionnaires. Primary outcomes in the study are the proportion of social-emotional and behavioral problems identified by PCH professionals in children aged 2-14 and 18 months in both conditions, and the proportion of agreement between the assessment of PCH professionals and parents. In addition, the added value of the family-centered approach will be assessed by comparing PCH findings with standardized questionnaires. The secondary outcomes are the degree to which the needs of parents are met and the degree to which they are willing to disclose concerns. Discussion: The family-centered method seems promising for early identification of social-emotional and behavioral problems. The results of this study will contribute to evidence-based public health. Trial registration: NTR2681

Randomized controlled trial and economic evaluation of nurse-led group support for young mothers during pregnancy and the first year postpartum versus usual care

Background Child maltreatment is a significant public health problem. Group Family Nurse Partnership (gFNP) is a new intervention for young, expectant mothers implemented successfully in pilot studies. This study was designed to determine the effectiveness and cost effectiveness of gFNP in reducing risk factors for maltreatment with a potentially vulnerable population. Methods A multi-site randomized controlled parallel-arm trial and prospective economic evaluation was conducted, with allocation via remote randomization (minimization by site, maternal age group) to gFNP or usual care. Participants were expectant mothers aged <20 with at least one live birth, or 20–24 with no live births and with low educational qualifications. Data from maternal interviews at baseline and when infants were two, six and 12 months, and video recording at 12 months, were collected by researchers blind to allocation. Cost information came from weekly logs completed by gFNP family nurses and other service delivery data reported by participants. Primary outcomes measured at 12 months were parenting attitudes (Adult- Adolescent Parenting Index, AAPI-2) and maternal sensitivity (CARE index). The economic evaluation was conducted from a UK NHS and personal social services perspective with cost-effectiveness expressed in terms of incremental cost per quality-adjusted life year (QALY) gained. Main analyses were intention to treat with additional complier average causal effects (CACE) analyses. Results Between August 2013 and September 2014, 492 names of potential participants were received of whom 319 were eligible and 166 agreed to take part, 99 randomly assigned to receive gFNP and 67 to usual care. There were no between-arms differences in AAPI-2 total (7·5/10 in both, SE 0.1), difference adjusted for baseline, site and maternal age-group 0·06 (95% CI -0·15 to 0·28, p=0·59) or CARE Index (intervention 4·0 (SE 0·3); control 4·7(SE 0·4); difference adjusted for site and maternal age-group -0·68; 95% CI -1·62 to 0·16, p=0·25) scores. The probability that gFNP is cost-effective based on the QALY measure did not exceed 3%. Conclusions The trial did not support gFNP as a means of reducing the risk of child maltreatment in this population but slow recruitment adversely affected group size and consequently delivery of the intervention