Early childhood mental health consultation: Care providers' experiences of the consultative relationship.

This article presents findings from a qualitative research study exploring child care teachers' experiences receiving early childhood mental health consultation (ECMHC). As an emerging intervention in early childhood education, ECMHC is already yielding promising results, namely in helping teachers better address challenging behaviors in their classroom and promote a more nurturing classroom environment. However, there remains a lack of personal testimony from teachers who receive this intervention. Considering that teachers are the primary focus of most ECMHC interventions, the purpose of this study was to examine child care teachers' personal experiences receiving consultation. Eight child care teachers were interviewed for this study. Results from this study illuminate key interpersonal processes in the development of the consultant-consultee relationship, indicate what teachers consider to be the most helpful components of consultation, and speak to the challenges that teachers experience in consultation. By examining the personal testimony of child care teachers who have received ECMHC services, consultants and researchers can consider ways to expand and improve future implementation of ECMHC.

Este artículo presenta resultados de un estudio de investigación cualitativa que explora experiencias de los maestros de guardería infantil que reciben la consulta de salud mental en la temprana niñez (ECMHC). Como una intervención que surge en el campo de la educación en la temprana niñez (ECE), la ECMHC está ya mostrando resultados prometedores, particularmente al ayudar a maestros a manejar mejor las conductas que son un desafío en la sala de clases y a promover un ambiente más acogedor dentro del aula. Sin embargo, se nota aún la falta de testimonios personales por parte de los maestros que reciben esta intervención. Considerando que los maestros son el enfoque principal de la mayoría de las intervenciones ECMHC, el propósito de este estudio fue examinar las experiencias de los maestros de guardería infantil que reciben esta consulta. Se entrevistaron ocho maestros de guardería infantil para este estudio. Los resultados de este estudio dan luz a procesos interpersonales claves en el desarrollo de la relación entre consulta y consultante, indican lo que los maestros consideran ser los componentes de la consulta que más ayudan, y hablan sobre los retos que los maestros experimentan en el proceso de consulta. Por medio de examinar el testimonio personal de maestros de guardería infantil que han recibido los servicios de ECMHC, los consultantes y los investigadores pueden considerar maneras de expandir y mejorar la futura implementación de ECMHC.

Cet article présente les résultats d'une étude de recherches qualitatives explorant les expériences des puéricultrices de crèches recevant une consultation de santé mentale précoce de l'enfance (abrégé en anglais ECMHC). En tant qu'intervention émergente dans l'éducation de la petite enfance, l'ECMHC offre déjà des résultats promettant, en particulier dans la manière dont elle aide les enseignants à mieux adresser des comportements difficiles dans leur classe et dont elle promeut un environnement éducatif plus chaleureux. Il reste cependant un manque de témoignages personnels d'enseignants ayant reçu cette intervention. Vu que les enseignants sont les premiers ciblés par la plupart des interventions ECMHC, le but de cette étude était d'examiner les expériences personnes des puéricultrices ou puériculteurs recevant l'intervention. Huit enseignants ont été interviewés pour cette étude. Les résultats de cette étude illuminent les processus interpersonnels clés dans le développement de la relation consultant-consulté, indiquent ce que les enseignants considèrent comme étant les composantes les plus importantes de la consultation, et montrent les défis dont les enseignants font l'expérience en consultation. En examinant le témoignage personnel de puéricultrices ou puériculteurs ayant reçu les services ECMHC, les consultants et les chercheurs peuvent considérer des manières d'étendre et d'améliorer la mise en place à venir de l'ECMHC.

Short-term intellectual outcome after arterial ischemic stroke and sinovenous thrombosis in childhood and infancy.

Arterial ischemic stroke is approximately four times more prevalent than sinovenous thrombosis and has been associated with a worse neurologic outcome than sinovenous thrombosis; however, no data are available comparing intellectual outcome after pediatric arterial ischemic stroke and sinovenous thrombosis. We report the short-term intellectual outcome (mean 5.8 months since stroke) in a sample of 72 children, 47 with arterial ischemic stroke, and 25 with sinovenous thrombosis. Intellectual outcome measures were the Full-Scale IQ of the age-appropriate Wechsler intelligence test for older children and the Mental Developmental Index of the Bayley Scales of Infant Development for younger children. Stroke type did not directly influence intellectual outcome. Intellectual outcome was in the normal range whether the children had suffered an arterial ischemic stroke or a sinovenous thrombosis.

Neurocognitive outcome after acute disseminated encephalomyelitis.

Cognitive dysfunction has been demonstrated in multiple sclerosis but has not been extensively studied after acute disseminated encephalomyelitis (ADEM). Because ADEM often presents with widespread demyelination, which may not completely resolve, these patients may be at risk for persistent cognitive dysfunction. The study objective was to explore the profile and severity of neurocognitive sequelae in pediatric ADEM. Children aged 6-15 years diagnosed with ADEM were invited to participate in a structured neurologic assessment, neuropsychological evaluation, and a follow-up magnetic resonance imaging. Nine of 15 children diagnosed with ADEM met the age criteria and six participated in the study. The mean age at presentation was 7.7 years; the mean duration of follow-up was 3.5 years. As a group, these children with prior ADEM performed within the average range on cognitive testing. However, a variety of mild cognitive deficits were demonstrated in each of the children, even in those whose magnetic resonance imaging studies had completely normalized. Four children demonstrated a cognitive profile of relatively poorer visuospatial/visuomotor function. The cognitive deficits observed in these children are similar but less severe than those previously reported in adults and children with multiple sclerosis, which may reflect the monophasic nature of ADEM, compared with the chronic, recurrent demyelination characteristic of multiple sclerosis.