Development of a supplement to the HOME Scale for children living in impoverished urban environments.

A Supplement to the HOME (Home Observation for Measurement of the Environment Scale) for impoverished Families (SHIF) was developed for use with young children living in impoverished urban environments. After interviews with clinicians and pilot studies with families, we developed 20 items and added them to the HOME. The supplement was field tested in a sample of 73 high-risk families to evaluate its psychometric properties and ease of use. During the home visit, the Nursing Child Assessment Feeding Scale and the Nursing Child Assessment Teaching Scale were also administered to examine construct validity. Results indicated that the SHIF provided new clinical data, was easy to administer, and, when added to the HOME, had good psychometric properties, e.g., high inter-rater reliability, internal consistency, item-total reliability, and intact construct validity. The SHIF offers a reliable and valid addition to the HOME for use with young children living in impoverished urban environments.

The psychological effects of parental human immunodeficiency virus infection on uninfected children.

OBJECTIVES: To assess the mental health of children of mothers infected with the human immunodeficiency virus. DESIGNS: Matched comparison of 26 children of mothers infected with the human immunodeficiency virus and 26 children with no experience of human immunodeficiency virus infection within their families. SETTINGS: Subject children were identified through hospital acquired immunodeficiency syndrome clinics and comparison children were identified through the primary care center of the same hospital. PARTICIPANTS: Subjects and controls were aged 6 to 16 years and matched by age, sex, race, and maternal marital and employment status. MAIN OUTCOME MEASURES: Parents completed the Child Behavior Checklist and the children completed the Revised Children's Manifest Anxiety Scale and the Children's Depression Inventory. RESULTS: Controlling for confounding variables, subjects were found by the Child Behavior Checklist to be significantly more withdrawn (P < .05) and to have more problems with attention (P < .005) than controls, although total Child Behavior Checklist scores were not significantly different. Compared with control children, the subject children reported more depression on the Children's Depression Inventory (P < .05) but were not more anxious. However, compared with children of asymptomatic mothers, the children of symptomatic mothers were reported to be significantly more anxious and/or depressed on the Child Behavior Checklist (P < .01) and the children reported more anxiety on the Revised Children's Manifest Anxiety Scale (P < .05). CONCLUSIONS: This study focusing specifically on uninfected children in families affected by the human immunodeficiency virus demonstrates some of the psychological ramifications of this disease. Larger studies are required to identify factors that contribute to the vulnerabilities and resilience of such children. Attention needs to focus on ameliorating these adverse effects on the children of the acquired immunodeficiency syndrome epidemic.