Resource Summary

The 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 the 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?

This month’s highlights include:

This Australian study explores the relationship between parenting behaviours and managing screen time in young children aged 0-4 years old. Data from 106 parents in an online survey showed a relationship between dysfunctional parenting styles (e.g., over-reactive or lax parenting) and screen-time related behavioural problems in children (e.g., emotional or behavioural difficulties). Results also suggest that parenting style and behaviour can help to mediate the relationship between parent distress and difficulties managing children’s screen time.

This paper reviews the evidence on psychosocial, pharmacological, and natural product interventions for children and adolescent who engage in self-harm. Data from 17 randomised controlled trials were analysed, involving 2280 children who had recently engaged in self-harm. Little evidence was found to demonstrate benefits in many interventions, although some promising results were demonstrated in children receiving Dialectic Behavioural Therapy for Adolescent. Further research and evaluation are recommended by the researchers.

This review study explores the evidence from 43 studies on perceived school safety among children and adolescents. The percentage of children who reported feeling unsafe at school ranged widely from 6.1% to 69.1% (mean 19.4%). Variation between studies was attributed to differences in study methods and definitions of perceived school safety. Students’ negative perceptions of school safety were associated with factors such as being victimised or bullied, and positively associated with measures such as having a security officer and fair school rule enforcement.

This paper outlines findings of a case file review examining characteristics of prenatal reports to an Australian child protection authority. Data from a random sample of prenatal child protection reports were analysed, relating to 131 unborn children. Most families with prenatal reports were experiencing three or more risk factors, including previous or current intimate partner violence (70%), parental alcohol or other drug use (63%), parental mental health difficulties (58%) and parental criminal activity (34%). More than 38% of parents with prenatal child protection reports had experienced abuse or neglect as children, and 90% of families with older siblings had already been the subject of a child protection report.

Coronavirus (COVID-19) and children: Resources, research, and reports

Recently released journal articles on COVID-19 include:

This UK study reviews the impact of COVID-19 and other quarantine or restrictive environments on children’s ability to thrive through play. Data from fifteen studies were analysed, exploring restrictions on children’s play in settings such as hospitals, juvenile and immigration detention, and refugee camps. Children’s access play was found to be impacted by crises and quarantine measures, although studies exploring children’s isolation due to infectious diseases were limited. Evidence also showed that play could support children during isolation.

This article discusses the development of a children’s storybook “Our smallest warriors, our strongest medicine: Overcoming COVID-19”, which draws on the strengths and resilience of indigenous peoples in the face of the pandemic.  This children’s book is a strengths-based and culturally-based public health education tool that supports mental health coping skills in indigenous children and families. It was developed by the Johns Hopkins Center for American Indian Health in collaboration with 14 indigenous and allied child development, mental health, health communications experts and public health professionals, as well as a Native American youth artist.

This review article explores the impact of COVID-19 and past pandemics on the mental health of children and adolescents around the world. Data from 18 articles were analysed, with results showing that pandemics can cause stress, worry and helplessness in young people, it can disrupt sleep and appetite and it can impair social interactions. Monitoring children’s mental health status will be an important mechanism for improving future mental health outcomes for children.

Parenting behaviours and screen time with young children

Parenting and child behaviour barriers to managing screen time with young children (Australia)

Authors: Halpin, S., Mitchell, A., Baker, S., Morawska, A.

Journal: Journal of Child and Family Studies

Highlights

  • Screen time in young children and factors influencing their screen use is under-explored in research.
  • This study investigated the relationship between parenting style, parents’ self-efficacy, parental distress, child behaviour and young children’s screen time.
  • An online survey was completed by 106 parents of young children aged 0-4 years old in Australia.
  • Key study findings included:
    • A relationship was found between dysfunctional parenting styles (e.g. over-reactive or lax parenting) and screen time related child behaviour problems (e.g. emotional or behavioural difficulties).
    • Dysfunctional parenting was also associated with reduced parental self-efficacy in managing children’s screen time behavioural difficulties.
    • Parents reported confidence in managing their child’s problem behaviours, however these behaviours were still occurring at a moderate intensity.
    • In contrast to previous research, no relationship was found between parent psychological adjustment and child screen time behavioural difficulties.
    • Results suggest the possibility that ‘the relationship between parent distress and difficulties with managing child screen time could be mediated by parenting style and behaviour’ (p. 835).
  • Some limitations were identified by the researchers, including the reliance of parent self-reporting and an over-representation of mothers in the sample. However, results identified a significant positive relationships between dysfunctional parenting behaviours and screen time related child behaviour problems.
  • Targeting parenting skills and confidence in managing children’s screen time behavioural difficulties, and promoting parental self-efficacy in managing children’s screen time, were identified as potential areas for future interventions.
  • These findings will be of interest to researchers and program developers targeting parenting behaviours to reduce screen-related child behavioural difficulties.

 

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Self-harm interventions for children and adolescents

Interventions for self-harm in children and adolescents

Authors: Witt, K., Hetrick, S., Rajaram, G., Hazell, P., Taylor Salisbury, T., Townsend, E., Hawton, K.

Journal: The Cochrane Database of Systematic Reviews

Highlights

  • This paper reviews the evidence on interventions available to children and adolescents who engage in self-harm.
  • Psychosocial interventions, pharmacological agents, and natural products (such as dietary supplementation) for children up to 18 years old were investigated in comparison to other types of care (e.g., treatment-as-usual, routine psychiatric care, enhanced usual care, active comparator, placebo, alternative pharmacological treatment or a combination of these).
  • Data was analysed from 17 randomised controlled trials involving 2280 children who had engaged in recent self-harm (i.e. within six months of trial entry). Children in the studies had a mean age of 7 years old and 87.6% were female.
  • Key study findings included:
    • A lower rate of repeated self-harm in children receiving Dialectic Behavioural Therapy for Adolescents (DBT-A; (30%) compared to treatment as usual, enhance usual care or alternative psychotherapy (43%).
    • No difference in the occurrence of repeated self-harm post-intervention in children and adolescents receiving individual Cognitive Behavioural Therapy (CBT)-based psychotherapy and treatment as usual.
    • Little evidence to demonstrate benefits from mentalisation-based therapy for adolescents, group-based psychotherapy, enhanced assessment approaches, compliance enhancement approaches, family interventions or remote contact interventions.
  • This review highlights that more research and evidence is needed to support interventions for children and adolescents who engage in self-harm, although some promising results were demonstrated in those receiving DBT-A.
  • These results may be of interest to service providers or clinicians working with children and adolescents who engage in self-harm, as well as researchers and policy-makers.

 

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Student perception of school safety

Feeling unsafe at school and associated mental health difficulties among children and adolescents: A systematic review

Authors: Mori, Y., Tiiri, E., Khanal, P., Khakurel, J., Mishina, K., Sourander, A.

Journal: Children

Highlights

  • This review explored the literature on perceived school safety among children and adolescents, specifically exploring prevalence, factors and associated mental health difficulties.
  • Data from 43 studies were analysed, using a narrative synthesis methodology. The majority of studies were from North America and published between 2016-2020.
  • Children and adolescents aged up to 18 years old and who were enrolled in school were included in the analysis.
  • All studies assessed students’ feelings of safety at school using self-report measures, for example, asking students to respond to the statement “I feel safe at school”.
  • Key study findings included:
    • The percentage of children who reported feeling unsafe at school ranged widely from 1% to 69.1% (mean 19.4%). Variation between studies was attributed to differences in study methods and definitions of perceived school safety.
    • Students’ negative perceptions of school safety were associated with factors such as being victimised or bullied.
    • Students’ negative perceptions of school safety were also associated with mental health difficulties such as depression or suicidal behaviour.
    • A lack of cross-cultural studies and studies undertaken in non-Western countries limited researchers’ abilities to identify culture-specific factors in school safety perceptions.
    • Students’ perception of school safety was positively associated with measures such as having a security officer and fair school rule enforcement.
  • These findings will be of interest to educators and policy-makers, as well as clinicians working with school-aged children who present with mental health difficulties, reports of victimisation or bullying at school, or ongoing school absenteeism.

 

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Risk factors and family characteristics in prenatal child protection reports

Risk factors identified in prenatal child protection reports (Australia).

Authors: Meiksans J., Arney, F., Flaherty, R., Octoman, O., Chongm A., Ward, F., Taylor, C.

Journal: Children and Youth Services Review

Highlights

  • This paper outlines findings of a case file review examining characteristics of prenatal reports to a statutory child protection Specifically, the review explored risk factors and family characteristics associated with a prenatal child protection report.
  • Data were extracted and coded from a random sample of prenatal child protection reports in a single Australian jurisdiction during 2014. These data related to 131 unborn children.
  • Key findings included:
    • Most families with prenatal child protection reports were experiencing three or more risk factors, including:
      • Current or previous intimate partner violence (70%),
      • Parental alcohol and other drug use (63%),
      • Parental mental health difficulties (58%),
      • Parental criminal activity (34%).
    • More than 38% of parents with prenatal child protection reports had experienced abuse or neglect themselves as children.
    • 90% of older siblings in families with a prenatal child protection report had also been the subject of a child protection report.
  • The review highlights that traditional assessment and referral methods in child protection may not be suitable for families with complex circumstances such as multiple co-occurring risk factors.
  • It also highlights the importance of multi-agency responses to concerns about child wellbeing during pregnancy and infancy, particularly if the parents themselves have experienced abuse, neglect, or removal as a child.
  • This review may be of interest to professionals working with vulnerable families and their children (including unborn children, such a maternity social workers). Giving families early support to address multiple co-occurring risk factors has the potential to benefit families and help reduce the intergenerational cycle of child abuse and neglect.

 

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