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Milićević M. Functional and environmental predictors of health-related quality of life of school-age children with cerebral palsy: A cross-sectional study of caregiver perspectives. Child Care Health Dev 2023; 49:62-72. [PMID: 35305043 DOI: 10.1111/cch.13007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 03/01/2022] [Accepted: 03/14/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Caregivers' reports often serve as a decision-making guide in the treatment and rehabilitation of children with cerebral palsy (CP). This study identified predictors of the caregiver-reported health-related quality of life (HRQoL) of school-age children with CP. METHODS A cross-sectional study was conducted using the convenience sample of 108 children with CP (60 males; aged 7-18 years; mean age 12 years 8 months [SD 3 years 5 months]). Caregivers reported their child's HRQoL using KIDSCREEN-27. Standard multiple regression analyses were conducted to test if the child characteristics (gender, age, Gross Motor Function Classification System-Expanded & Revised [GMFCS-E&R], Manual Ability Classification System [MACS], intellectual disability, health problems, communication, social skills, behavioural difficulties); family characteristics (income, type, home adaptation); physical, social and attitudinal barriers; environmental features; and family-centeredness of service delivery significantly predicted HRQoL. RESULTS Fine manual abilities, home adaptation and the magnitude of barriers predicted physical well-being. The child's challenging behaviour, the magnitude of barriers and the barriers related to different policies predicted psychological well-being. The home adaptation level and provision of general information about the child's disability and available types of services predicted HRQoL domain related to interactions and relationships with parents. Children with behavioural difficulties and more severe limitations in communication had less social support from friends and peers. The social skills and intellectual functioning combined with the parental ratings of the child's behaviour, other people's attitudes towards the child and the lack of support predicted HRQoL in the School Environment domain. The magnitude and frequency of barriers were the strongest predictors of general HRQoL. CONCLUSION From the caregivers' perspective, home adaptation, supportive laws and policies and family-centred rehabilitation care that meets the family needs may promote children's HRQoL. Specific interventions addressing modifiable environmental features and continuous support to children in improving their fine motor abilities, communication and social skills and families in managing behavioural difficulties may be relevant for HRQoL of school-age children with CP.
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Affiliation(s)
- Milena Milićević
- Institute of Criminological and Sociological Research, Belgrade, Serbia
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Kostyrka-Allchorne K, Ballard C, Byford S, Cortese S, Daley D, Downs J, French B, Glazebrook C, Goldsmith K, Hall CL, Hedstrom E, Kovshoff H, Kreppner J, Lean N, Sayal K, Shearer J, Simonoff E, Thompson M, Sonuga-Barke EJS. Online Parent Training for The Initial Management of ADHD referrals (OPTIMA): the protocol for a randomised controlled trial of a digital parenting intervention implemented to support parents and children on a treatment waitlist. Trials 2022; 23:1003. [PMID: 36510236 PMCID: PMC9744042 DOI: 10.1186/s13063-022-06952-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Children referred for attention-deficit/hyperactivity disorder (ADHD) often present with a broader pattern of conduct problems including oppositionality and defiance. This combination can be extremely stressful to parents, lower parents' self-esteem and negatively impact family life. The National Institute for Health and Care Excellence (NICE) recommends that families receive support as soon as possible after their referral. However, as clinical services are overstretched, and traditional in-person parenting intervention programmes are expensive, families often must wait times a long time prior to receiving this vital input. To address this, we have created a digital parenting programme called STEPS. It is delivered as a mobile phone app providing a set of tools and resources that can be easily accessed at parents' convenience. This study aims to evaluate the clinical and cost-effectiveness of STEPS in supporting parents of children with high levels of hyperactivity/impulsivity, inattention and conduct problems, who are waiting to be assessed by specialist children's clinical services. METHODS Online Parent Training for The Initial Management of ADHD referrals (OPTIMA) is a two-arm superiority parallel randomised controlled trial with an internal pilot study. We aim to recruit 352 parents and their children, who have been accepted onto a waitlist in Child and Adolescent Mental Health Services or similar child health services. Parents who consent will be randomised 1:1 to either the STEPS or wait-as-usual (WAU) group. The trial will be conducted remotely (online and telephone) with measures taken at baseline and 3, 6, 9 and 12 months post-randomisation. The primary objective is to evaluate whether STEPS reduces the severity of children's oppositional and defiant behaviour, as rated by parents, measured at 3 months post-randomisation compared to WAU. DISCUSSION Digital solutions, such as mobile phone apps, have potential for delivering psychological support for parents of children with clinical-level needs in a timely and inexpensive manner. This trial will provide data on the clinical and cost-effectiveness of the STEPS app, which could support the implementation of this scalable parenting intervention programme into standard clinical care and, ultimately, improve the outcomes for families of children referred to specialist child and adolescent health services. TRIAL REGISTRATION ISRCTN 16523503. Prospectively registered on 18 November 2021. https://www.isrctn.com/ISRCTN16523503.
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Affiliation(s)
- Katarzyna Kostyrka-Allchorne
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Claire Ballard
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Sarah Byford
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA
| | - David Daley
- NTU Psychology, School of Social Science, Nottingham Trent University, Nottingham, UK
| | - Johnny Downs
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Blandine French
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Cristine Glazebrook
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Kimberley Goldsmith
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Charlotte L Hall
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Ellen Hedstrom
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Hanna Kovshoff
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Jana Kreppner
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Nancy Lean
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Kapil Sayal
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - James Shearer
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Margaret Thompson
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
- Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark.
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Bourke-Taylor HM, Cordier R, Pallant JF. Criterion Validity of the Child's Challenging Behavior Scale, Version 2 (CCBS-2). Am J Occup Ther 2017; 72:7201205010p1-7201205010p9. [PMID: 29280721 DOI: 10.5014/ajot.2018.023366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The Child's Challenging Behavior Scale, Version 2 (CCBS-2), measures maternal rating of a child's challenging behaviors that compromise maternal mental health. The CCBS-2, the Child Behavior Checklist (CBCL), and the Strengths and Difficulties Questionnaire (SDQ) were compared in a sample of typically developing young Australian children. METHOD Criterion validity was investigated by correlating the CCBS-2 with "gold standard" measures (CBCL and SDQ subscales). Data were collected in a cross-sectional survey of mothers (N = 336) of children ages 3-9 yr. RESULTS Correlations with the CBCL externalizing subscales demonstrated moderate (ρ = .46) to strong (ρ = .66) correlations. Correlations with the SDQ externalizing behaviors subscales were moderate (ρ = .35) to strong (ρ = .60). CONCLUSION The criterion validity established in this study strengthens the psychometric properties that support ongoing development of the CCBS-2 as an efficient tool that may identify children in need of further evaluation.
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Affiliation(s)
- Helen M Bourke-Taylor
- Helen M. Bourke-Taylor, PhD, is Associate Professor, Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia;
| | - Reinie Cordier
- Reinie Cordier, PhD, is Associate Professor, School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Bentley, Perth, Western Australia
| | - Julie F Pallant
- Julie F. Pallant, PhD, is Adjunct Associate Professor, Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
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