ABSTRACT
Children with histories of trauma exposure experience a wide-range of developmental, social, emotional, and behavioral symptoms. The effects of traumatic life experiences can impact children's ability to learn and function within the school environment. Trauma-informed (TI) schools seek to create environments in which children with experiences of trauma can build resilience and be successful and must begin as early as possible in the child's educational experience. The current paper summarizes preliminary evaluation results from a two-year initiative focused on implementing TI organizational change in two school district pre-kindergarten (pre-k) systems in a Southern state. Site 1 (urban) had 7 pre-k locations with 31 classrooms, while site 2 (micropolitan) had 5 locations with 12 classrooms (43 classrooms total). In surveys across two years, participating teachers (N = 91) reported gains in trauma-related knowledge and implementation of TI teaching strategies. Surveys of a subset of staff who were involved in district-level teams focused on implementation of broader TI organizational changes (e.g. adapting policies and procedures) revealed that most staff felt they developed an effective and sustainable process for facilitating organizational change. Theoretical implications and future directions are discussed.
ABSTRACT
There are profound effects of childhood psychiatric disorders on families and communities. Given that each year over half a million youth receive mental health services through inpatient psychiatric hospitals, focus on assessment and treatment strategies for this group is paramount The purpose of this paper is to present an overview of an innovative, evidenced-based model of inpatient child psychiatric care that challenges commonly used traditional practices of inpatient child psychiatry. The highlighted model utilizes an interdisciplinary approach to clarify psychiatric diagnoses; create a comprehensive biopsychosocial formulation of the child and family; establish a rational medication regimen; provide individually tailored recommendations; and address the "revolving door" of repeated psychiatric hospitalizations. Descriptive analyses are presented that provide demographic, developmental, and psychiatric characteristics of the children admitted to the unit. The potential benefits of using this innovative model with developmentally and psychiatrically complex children are discussed.
Subject(s)
Child Psychiatry , Hospitals, Psychiatric , Inpatients , Mental Disorders/therapy , Models, Theoretical , Child , Evidence-Based Medicine , Humans , Mental Disorders/psychologyABSTRACT
OBJECTIVES: Examine the association between mothers' low- and high-level depressive symptoms in early childhood and children's behavior problems in middle childhood. METHODS: We used data from 1844 families in a multi-site, longitudinal study beginning when children were 14 months and continuing to age 11 years. Children's internalizing and externalizing behavior problems at age 11 were assessed using the child behavior checklist for ages 6-18. Mothers' scores on the Center for Epidemiological Studies-Depression Scale when children were 14 months were used to classify them into three groups: 'no depressive symptoms', 'low-level depressive symptoms (below the clinical cut-off)' and 'clinically significant depressive symptoms (above the clinical cut-off).' RESULTS: Mothers were racially/ethnically diverse, including Caucasian (38.9 %), African-American (34.4 %), Hispanic (21.6 %), or other (5.1 %). More than one-third (39.2 %) were teenaged mothers, and 46.0 % did not complete high school. Of the 1844 families, 1172 had age 11 child outcome data. Logistic regression analyses controlling for family demographics revealed a significant association between early maternal depressive symptoms and later child behavioral outcomes. Both low level and clinically significant symptoms were associated with internalizing and externalizing behavior problems. For example, children whose mothers had low-level depressive symptoms were twice as likely to have clinically elevated internalizing problems compared with children whose mothers never had symptoms of depression. CONCLUSIONS: Children whose mothers experience low-level depressive symptoms early in their development have increased risk for later behavioral problems, suggesting a possible need for new screening and intervention strategies for mothers with lower than clinically elevated symptoms.
Subject(s)
Child Behavior Disorders/psychology , Child of Impaired Parents , Depression/diagnosis , Internal-External Control , Mother-Child Relations , Mothers/psychology , Parenting/psychology , Child , Child Behavior Disorders/diagnosis , Depression/epidemiology , Depression/etiology , Depression/psychology , Emotions/physiology , Female , Humans , Infant , Longitudinal Studies , Male , Psychiatric Status Rating Scales , Severity of Illness IndexABSTRACT
Our objective was to examine how mothers' warmth can protect children from the negative effects of maternal alcohol problems on children's externalizing behavior and, alternately, how harsh parenting can exacerbate the problem. We used data from 1,563 families eligible for Early Head Start and assessed when children were age 5 and again at age 11. We examined whether mothers' warmth or harsh parenting at age 5 moderated the effect of maternal alcohol problems on children's behavior problems at age 11. Results indicated that mothers' symptoms of alcohol problems when children were age 5 predicted greater externalizing behavior problems (aggression and rule breaking) when children were age 11. Aggression and rule-breaking behaviors, externalizing behaviors commonly associated with maternal alcohol problems, were lessened when mothers were warm and did not engage in harsh parenting techniques. Our findings highlight the importance of positive parenting techniques in high-risk families.
