Highlights in Child Mental Health Research: June 2019
Various, Australia, 2019
This monthly research summary provides a selection of recently released papers, systematic reviews, and meta-analyses related to infant and child mental health.
Each summary includes an introductory overview of the content for that month, followed by a list of selected articles. Each article is accompanied by a brief synopsis which presents the key messages and highlights. Links to abstracts, full-text articles and related resources, where available, are provided.
What's new this month in child mental health research?
Children with ADHD and physical activity
The June 2019 Research Highlights includes an interesting systematic review by Jeyanthi and colleagues that explored the effects of physical exercise on attention, motor skills and fitness in children with ADHD.
The studies included reported benefits of a variety of exercise programmes in improving attention, social behaviour, and physical fitness in children with ADHD, suggesting that physical exercise may hold promise as a possible add-on to traditional intervention approaches (e.g., pharmacological, psychological).
The research article by Canas and colleagues discusses the development, implementation, and evaluation of a youth advisory council model of engagement.
The findings and recommendations in this article may help to support youth engagement in youth-focused services/organisations. It also offers a rationale for youth engagement and its potential impact.
In their editorial article, Scorza and colleagues (2019) emphasise the importance of implementation science in reducing the global child mental health treatment gap (i.e. the gap between children requiring mental health care and those who receive such care). The authors also provide a series of recommendations on how this gap might be addressed.
Other topics covered in this month’s Research Highlights include:
- mothers’ exposure to adverse childhood experiences (ACEs) and children’s mental health
- tools for assessing immediate risk of self-harm and suicide in children and young people
- the role of implementation science in helping improve access to child and adolescent mental health services
Effect of physical exercises on attention, motor skill and physical fitness in children with attention deficit hyperactivity disorder: a systematic review
Authors: S, Jeyanthi; Arumugam, Narkeesh; Parasher, Raju K.
Journal: Attention Deficit Hyperactivity Disorders
- The authors of this article conducted a systematic review of research studies exploring effects of physical exercise on attention, motor skills and fitness in children with ADHD.
- Fifteen research studies met inclusion criteria for analysis.
- “The studies reviewed were of moderate-to-high quality and reported benefits of a variety of exercise programmes” in improving attention, social behaviour, and physical fitness in children with ADHD.
- As the researchers highlight, traditional management approaches to ADHD have been heavily focused on pharmacological interventions (and to a lesser extent non-pharmacological interventions). This research finding suggests that physical exercise may hold promise as an add-on to traditional approaches (e.g., pharmacological, psychological).
Read the Abstract here
Maternal Adverse Childhood Experiences (ACEs) and child development at 5 years (Canada)
Authors: Hetherington, Erin; McDonal, Sheila; Tough, Suzanne
Journal: Paediatrics and Child Health
This study used a longitudinal Canadian cohort of 1,992 mothers and children to investigate the impact of mothers’ exposure to adverse childhood experiences (ACEs) on children’s development at age 5 years, including on externalising behaviours (i.e. negative behaviours that are directed outwards to the environment or others, such as aggression) and internalising behaviours (i.e. negative behaviours that are directed inwards and that reflect a child’s emotional state, such as anxiety).
The study also investigated possible protective factors associated with resilience in high-risk children.
Key findings were:
- Maternal ACEs were not associated with internalising behaviours, but some maternal risk factors for children’s internalising behaviours were identified (e.g., persistent mental health symptoms, hostile parenting practices).
- Children whose mothers were working or studying had reduced odds of internalising problems.
- While maternal ACEs were not associated with internalising behaviours, they were associated with increased odds of externalising behaviours in children.
- Other maternal risk factors for children’s externalising behaviours included persistent mental health symptoms and hostile parenting practices.
- Importantly, a high level of social support was found to be a protective factor against internalising behaviours amongst those children deemed at high-risk (i.e. those children whose mothers had been exposed to a high number of ACEs).
While mothers’ exposure to ACEs may impact aspects of children’s development, the researchers suggest that focusing on maternal psychosocial health, rather than maternal ACEs, may offer a less-stigmatising approach to identifying high-risk children.
The researchers also emphasise the importance of strategies that support parents, including parental mental health, in promoting positive outcomes for children’s mental health.
Read the Abstract here
Assessment tools of immediate risk of self-harm and suicide in children and young people: A scoping review (United Kingdom)
Authors: Carter T; Walker GM; Aubeeluck A; Manning JC
Journal: Journal Of Child Health Care: For Professionals Working With Children In The Hospital And Community
- Children who present with a mental health crisis require careful assessment to ensure their safety, including an assessment of their immediate risk of self-harm and suicide.
- The authors of this review aimed to identify currently existing tools for assessing immediate risk of self-harm and suicide, and to investigate their validity and reliability.
- While the researchers identified 22 assessment tools, these were limited by a variety of factors (e.g. limited psychometric testing, lack of validity/reliability to non-mental health settings, lack of inclusion of self-harm risk).
- Importantly, the researchers highlight a critical gap in existing assessment tools in the form of a need for a “clinically appropriate, valid and reliable tool that assesses immediate risk of self-harm and suicide in paediatric settings” (p. 178).
Read the Abstract here
What makes for effective, sustainable youth engagement in knowledge mobilization? A perspective for health services (Canada)
Authors: Canas E; Lachance L; Phipps D; Birchwood CC
Journal: Health Expectations: An International Journal Of Public Participation In Health Care And Health Policy
- Youth advisory councils (YACs) are increasingly common in research and knowledge mobilisation initiatives. They are formed with the view that “sustained youth perspectives are a necessary knowledge input into service and system improvement” (p. 2).
- The article discusses the development, implementation, and evaluation of a youth advisory council model of engagement. This was implemented as part of a Canadian knowledge mobilisation network (called “Wisdom2Action”) that aims to improve the well-being and mental health of children and young people by increasing the use of engagement, evidence, and evaluation in the youth-serving sector.
- Youth advisors (YA’s) were engaged to co-design activities, lead their own projects and provide input to the Board.
- The findings and recommendations in this article may help to support youth engagement in youth-focused services/organisations. It also offers a rationale for youth engagement and its potential impact.
- The researchers identified challenges and facilitators associated with implementing an effective and sustainable youth advisory council model of engagement, including:
- “supportive mentorship”,
- “retention” and engagement of youth (including helping youth see their impact),
- “professional development” of youth (including a growing need for remuneration),
- “organisational sustainability” (including organisational resources and commitment), and
- “diversity and quality of youth-perspective and representation” (p.5).
Read the Full Text here
Editorial Perspective – Reaching beyond the clinic: leveraging implementation science to improve access to child and adolescent mental health services
Authors: Scorza, Pamela; Duarte, Cristiane; Lovero, Kathryn; Carlson, Catherine; Mootz, Jennifer; Johnson, Karen; Wainberg, Milton
Journal: The Journal of Child Psychology & Psychiatry
This editorial perspective article emphasises the importance of implementation science in reducing the global child mental health treatment gap (i.e. the gap between children requiring mental health care and those who receive such care).
Recommendations on how this gap might be addressed include:
- Implementation research should extend its focus beyond mental health interventions delivered in clinics by mental health professionals. The authors propose that this will be particularly important for reducing the gap between need and access in low-resource settings that often have few or none of these professionals.
- Implementation research should progress towards exploring how interventions might be effectively delivered by non-mental health professionals.
- Implementation research needs to extend to include “implementing, adopting and sustaining…interventions from prevention to treatment” (p. 707).
- Interventions should not only focus on children with mental health disorders, but should encompass the entire continuum with inclusion of prevention efforts for those children who are at a higher risk of developing mental health problems (e.g. children of parents with a mental illness, children exposed to family violence).
- A “cross-sector approach” is needed that extends the implementation of child and adolescent mental health services into contexts and sectors that are routinely accessed by children and families (p. 707). This includes a need to engage and involve non-mental health providers (e.g., perinatal health clinics, community-based centres, welfare systems, schools).
- The aforementioned “cross-sector approach” should include the engagement of policy-makers beyond the health sector (e.g., education, welfare).
The authors identify the need for implementation science to investigate important research questions related to this cross-sector approach, as this will help foster effectiveness, timeliness, and sustainability.
Read the Full Text here.