Reflection in Home Visiting: The What, Why, and a Beginning Step Toward How

The work of home visitors in early childhood fields may include addressing many challenges to achieving curricular outcomes, including issues such as maintaining boundaries and managing one’s own reactions to children, parents, and overall family situations. Increasingly, reflective supervision and consultation are recognized as a way for workers in home visiting early intervention and early care fields to address these personal and professional challenges and build competence (Watson, Gatti, Cox, Harrison, & Hennes, 2014). The features of home visiting that make reflective supervision/consultation essential are discussed. Next, results of a pilot project in which a sample of Part C early intervention providers respond to a vignette portraying a challenging parent-child interaction are briefly presented and discussed. Despite often stating the importance of relationships, participants did not identify concrete methods of supporting relationship or demonstrate recognition of parallel process. In addition, providers seldom endorsed the use of reflective skills, such as observing, listening, wondering, or reflecting (Weatherston, 2013) and no providers discussed a need for reflective supervision/consultation. We suggest that these findings illustrate some of the areas in which early intervention home visitors could benefit from participation in reflective supervision/consultation to move from identifying reflective skills as important to actually being able to use such skills in their work with families

Infant/Early Childhood Mental Health and Collaborative Partnerships: Beyond the NICU

The NICU experience impacts all family dynamics not just during the intensive care unit stay but in the months and years afterwards. For each family, the first experiences with their baby, whether in the home or the intensive care unit, can set the trajectory for the long-term parent–child relationship and the parent's perspective of their parent roles. These difficult experiences have the potential to be addressed through infant and early childhood mental health (I/ECMH) methods. In this article we review the need for a wide range of social and emotional supports that present in intensive care and continue as families and infants transition to home and community. The potential for addressing these ongoing issues by a variety of providers within many different settings using Infant and Early Childhood Mental Health (I/ECMH) approaches is discussed and examples of successful programs are provided. Finally, we make recommendations for infusing I/ECMH across programs that serve intensive care unit graduates and their families, from the hospital to the home, with primary care providers and other community support programs

The Forensic Restrictiveness Questionnaire : development, validation and revision

Introduction: Forensic psychiatric care is often practiced in closed institutions. These highly regulated, secure, and prescriptive environments arguably reduce patient autonomy, self-expression, and personhood. Taken together these settings are restrictive as patients’ active participation in clinical, organizational, community, and personal life-worlds are curtailed. The consequences of patients’ experiences of restrictiveness have not been explored empirically. This study aimed to develop a psychometrically-valid measure of experiences of restrictiveness. This paper presents the development, validation, and revision of the Forensic Restrictiveness Questionnaire (FRQ). Methods: In total, 235 patients recruited from low, medium, and high secure hospitals across England completed the FRQ. The dimensionality of the 56-item FRQ was tested using Principle Axis Factor Analysis and parallel analysis. Internal consistency was explored with Cronbach’s α. Ward climate (EssenCES) and quality of life (FQL-SV) questionnaires were completed by participants as indicators of convergent validity. Exploratory Factor Analysis (EFA) and Cronbach’s α guided the removal of items that did not scale adequately. Results: The analysis indicated good psychometric properties. EFA revealed a unidimensional structure, suggesting a single latent factor. Convergent validity was confirmed as the FRQ was significantly negatively correlated with quality of life (Spearman’s ρ = −0.72) and ward climate (Spearman’s ρ = −0.61). Internal consistency was strong (α = 0.93). Forty-one items were removed from the pilot FRQ. The data indicate that a final 15-item FRQ is a valid and internally reliable measure. Conclusion: The FRQ offers a novel and helpful method for clinicians and researchers to measure and explore forensic patients’ experiences of restrictiveness within secure hospitals

Exploring Early Care and Education Policy for Young Children of Incarcerated Parents

Children of incarcerated parents who participate in the early care and education system may face an increased risk for developmental and behavioral problems, however, these children are largely hidden when it comes to formal early care and education policy and program initiatives. This article will focus on the impacts of parental incarceration on young children, consider trends and opportunities in early care and education policy that can help address the needs of children of incarcerated parents, and provide suggestions for future policy strategies

Promoting Resilience with Children Impacted by Parental Incarceration

In prison, jails, and detention centers, the United States incarcerates more people than any other country, and most of these individuals are parents. As a result, early care and intervention professionals are likely to encounter infants and young children affected by parental incarceration. This article will review the scope of the problem, the effects on children, and discuss how providers can best help young children by being aware of their own bias, recognizing and supporting resilience, responding sensitively, knowing and sharing resources, and advocating as appropriate

Understanding Secondary Trauma and Stress in the Early Childhood Workforce

Early care and education workers are increasingly recognizing their role in helping children who have experienced trauma, including extended parental separations due to incarceration. These children may have emotional reactions and behaviors that are particularly challenging in group settings. Moreover, early care and education professionals themselves have often had challenging experiences in their own lives. As a result, there is a need for training and support to help the workforce recognize the secondary trauma and stress associated with caring for these young children. This article will explore how to establish systems and policies that support the early care and education workforce who are on the frontlines of helping children cope with trauma

A Statewide Tiered System for Screening and Diagnosis of Autism Spectrum Disorder

Although autism spectrum disorder (ASD) can be reliably detected in the second year of life, the average age of diagnosis is 4 to 5 years. Limitations in access to timely ASD diagnostic evaluations delay enrollment in interventions known to improve developmental outcomes. As such, developing and testing streamlined methods for ASD diagnosis is a public health and research priority. In this report, we describe the Early Autism Evaluation (EAE) Hub system, a statewide initiative for ASD screening and diagnosis in the primary care setting. Development of the EAE Hub system involved geographically targeted provision of developmental screening technical assistance to primary care, community outreach, and training primary care clinicians in ASD evaluation. At the EAE Hubs, a standard clinical pathway was implemented for evaluation of children, ages 18 to 48 months, at risk for ASD. From 2012 to 2018, 2076 children were evaluated (mean age: 30 months; median evaluation wait time: 62 days), and 33% of children received a diagnosis of ASD. Our findings suggest that developing a tiered system of developmental screening and early ASD evaluation is feasible in a geographic region facing health care access problems. Through targeted delivery of education, outreach, and intensive practice-based training, large numbers of young children at risk for ASD can be identified, referred, and evaluated in the local primary care setting. The EAE Hub model has potential for dissemination to other states facing similar neurodevelopmental health care system burdens. Implementation lessons learned and key system successes, challenges, and future directions are reviewed

Fluoride in the diet of 2-years-old children

Objectives This study aimed to calculate the fluoride concentrations of commonly consumed foods and beverages for 2-years-old children utilizing market basket information for the US Midwest region. Methods Total Diet Study food lists were cross-referenced with National Health and Nutrition Examination Survey—What We Eat in America data to determine the foods and beverages to be included. Fluoride concentrations were determined using a modification of the hexamethyldisiloxane microdiffusion technique. Fluoride concentrations were summarized for each of the food categories. Daily dietary fluoride intake was estimated using a simulation analysis. Results Food and beverage fluoride concentrations varied widely, ranging from nondetectable for some oils and dairy products to more than 3.0 μgF/g food for some processed meats, fish and fruits. The estimated mean (±SD) daily dietary fluoride intake, excluding dentifrice and supplements, was 412±114 μgF/d. The estimated average ingestion for a 2-years-old weighing 12.24 kg was 0.034±0.009 mg/kg/d. A diet based on foods and beverages in the fifth percentile of fluoride intake distribution for an average child would result in 247 μgF/d or 0.020 mg/kg/d, while a diet with foods and beverages in the 95th percentile would result in a total intake of 622 μgF/d or 0.051 mg/kg/d. Conclusions The fluoride concentrations of foods and beverages vary widely, and, if items in the 95th percentile of fluoride intake distribution are ingested, children could consume more fluoride than the recommended 0.05 mg/kg/d. Fluoride intake calculated in this study was higher than historically reported dietary levels

Approaches to suicide prevention: Ideas and models presented by Japanese and international early career psychiatrists

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146308/1/pcn12737.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146308/2/pcn12737_am.pd

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy