Definitions and Operationalization of Mental Health Problems, Wellbeing and Participation Constructs in Children with NDD: Distinctions and Clarifications

New Brunswick's mental health action plan: A quantitative exploration of program efficacy in children and youth using the Canadian Community Health Survey

In 2011, the New Brunswick government released the New Brunswick Mental Health Action Plan 2011-2018 (Action Plan). Following the release of the Action Plan in 2011, two progress reports were released in 2013 and 2015, highlighting the implementation status of the Action Plan. While vague in their language, these reports indicated considerable progress in implementing the Action Plan, as various initiatives were undertaken to raise awareness and provide additional resources to facilitate early prevention and intervention in children and youth. However, whether these initiatives have yielded measurable improvements in population-level mental health outcomes in children and youth remains unclear. The current study explored the impact of the Action Plan by visualizing the trend in psychosocial outcomes and service utilization of vulnerable populations in New Brunswick before and after the implementation of the Action Plan using multiple datasets from the Canadian Community Health Survey. Survey-weighted ordinary least square regression analyses were performed to investigate measurable improvements in available mental health outcomes. The result revealed a declining trend in the mental wellness of vulnerable youth despite them consistently reporting higher frequencies of mental health service use. This study highlights the need for a concerted effort in providing effective mental health services to New Brunswick youth and, more broadly, Canadian youth, as well as ensuring rigorous routine outcome monitoring and evaluation plans are consistently implemented for future mental health strategies at the time of their initiation.

Analyzing Trends in Mental and Behavioral Health Support for Children: A Comprehensive Study Using National Survey of Children's Health Database

Objective This study aimed to explore mental and behavioral health support trends for children aged 3-17, analyzing treatment and counseling using United States data from the 2016-2020 National Survey of Children's Health (NSCH) database. Methods Employing a retrospective observational design, we systematically retrieved and analyzed NSCH Database data from 2016 to 2020. The focus was on understanding mental and behavioral health treatment percentages over time, specifically targeting demographic variations such as age groups, gender, race/ethnicity, and the federal poverty level percentage. Graphical representation utilized Excel, summarizing results based on aggregated data for distinct time intervals, highlighting the importance of mental and behavioral health support for children aged 3-17. Results The study identified significant temporal trends in mental and behavioral health treatment, revealing notable fluctuations across demographic and socio-economic variables. Of the 22,812 participants, 51.7% (CI: 50.2-53.1%, n=12,686) received treatment, exposing disparities. Gender differences were evident, with higher treatment rates in females (53.7%, CI: 51.6-55.9%, n=6,166) than males (50.1%, CI: 48.2-52.0%, n=6,520). Age-specific patterns indicated lower intervention rates in younger children (33.5%, CI: 28.6-38.8%, n=447, ages 3-5) compared to adolescents (58.1%, CI: 56.2-59.9%, n=8, 222 ages 12-17). Conclusion The conclusion highlights significant temporal fluctuations and pronounced demographic disparities. Findings underscore varying prevalence rates among age groups, genders, racial/ethnic backgrounds, and socio-economic status categories. This study provides valuable insights for policymakers, healthcare professionals, and researchers, informing targeted interventions to enhance mental and behavioral health support for United States children.

Construct validity of the simplified Chinese version of the instrument 'Picture My Participation'

BACKGROUND

Preliminary evidence of the content validity of the simplified Chinese version of 'Picture My Participation' (PMP-C; Simplified) items and reliability of the subscale attendance for the effectiveness of the use with children and youth in mainland China has been collected. However, evidence of construct validity for the instrument is not yet available.

AIM

To explore the construct validity of the attendance scale in PMP-C (Simplified).

METHODS

A cross-sectional study using convenience sampling was conducted using PMP-C (Simplified) with a picture-supported interview for 290 children and youths aged 5-21 with and without ID in urban and rural areas of mainland China. Exploratory factor analysis (EFA) was performed using the principal component analysis (PCA) to analyse the resulting data.

RESULTS

The EFA extracted five factors with eigenvalues greater than one and the cumulative contribution rate of factors accounted for 51.62% of the variance. All items had factor loadings above 0.50. The five subcomponents included: organised activities, social activities, taking care of others, family life activities and personal care and development activities.

CONCLUSION

The results of the factor analysis support the construct validity of the PMP-C (Simplified) attendance scale. It provides further psychometric evidence that PMP-C (Simplified) is a sound measure to assess participation for children and youths in mainland China.

School Health Services' Use of Information and Communication Technologies in Interorganizational Collaboration Regarding Students With Mental Illness: A Scoping Review

School health services (SHSs) and school nurses play a crucial role in identifying and supporting students with mental illness. The integration of information and communication technology (ICT) can facilitate interorganizational collaboration in this context. Due to the limited research in this area, a scoping review was conducted to explore SHSs' use of ICT in interorganization collaboration regarding students with mental illness. Six articles were reviewed, revealing three key themes: "types of ICT employed by SHSs in interorganizational collaboration," "constellation of SHSs in interorganizational collaboration," and "opportunities and challenges for SHSs using ICT in interorganizational collaboration." Notably, two of the six articles highlighted the absence of school nurses in interorganizational collaboration. Even though ICT plays a crucial role in interorganizational collaboration, no comprehensive solution was found. This scoping review confirms that there are challenges with operability and regulations that govern the exchange of private information between organizations.

How can we reach long-lasting inclusive participation for all? A vision for the future

In 2022, an international conference was held focusing on 'participation'. We shared current evidence, identified knowledge gaps and worked together to understand what new knowledge and community and practice changes were needed. This brief communication is a summary of the conference delegates' discussions. We present the key assumptions we make about participation and propose what is needed to create change for societies, communities, families and individuals. While we have some robust evidence to support participation approaches, more is needed, and it is everyone's responsibility to build an inclusive society where participation for all is the reality.

Relationship Between Change in Participation and Later Mental Health Problems in Children

BACKGROUND

Participation in everyday activities is beneficial for mental health. However, little is known about the extent to which changes in children's participation are associated with later mental health.

OBJECTIVES

To investigate the association between changes in the frequency and involvement in home, school, and community activities and subsequent mental health problems in children. Methodology: We recruited 242 school-aged children. Their parents completed the Participation and Environment Measure for Children and Youth twice, and after 2 years, they completed the Strengths and Difficulties Questionnaire.

RESULTS

After controlling for demographic factors, hierarchical regression analysis revealed that reductions in children's involvement in home and community activities were significantly associated with elevated levels of externalizing and internalizing problems. Furthermore, an increase in children's involvement in school activities showed significant relationships with better mental health outcomes.

CONCLUSION

These findings inform participation-based interventions for occupational therapists aimed at mitigating children's future mental health problems.

Practitioner Review: Effectiveness and mechanisms of change in participatory arts-based programmes for promoting youth mental health and well-being - a systematic review

BACKGROUND

Participatory arts-based (PAB) programmes refer to a diverse range of community programmes involving active engagement in the creation process that appear helpful to several aspects of children's and young people's (CYP) mental health and well-being. This mixed-methods systematic review synthesises evidence relating to the effectiveness and mechanisms of change in PAB programmes for youth.

METHOD

Studies were identified following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. Eleven electronic databases were searched for studies of PAB programmes conducted with CYP (aged 4-25 years), which reported mental health and well-being effectiveness outcomes and/or mechanisms of change. A mixed-methods appraisal tool assessed study quality. A narrative synthesis was conducted of effectiveness and challenges in capturing this. Findings relating to reported mechanisms of change were integrated via a metasummary.

RESULTS

Twenty-two studies were included. Evidence of effectiveness from quantitative studies was limited by methodological issues. The metasummary identified mechanisms of change resonant with those proposed in talking therapies. Additionally, PAB programmes appear beneficial to CYP by fostering a therapeutic space characterised by subverting restrictive social rules, communitas that is not perceived as coercive, and inviting play and embodied understanding.

CONCLUSIONS

There is good evidence that there are therapeutic processes in PAB programmes. There is a need for more transdisciplinary work to increase understanding of context-mechanism-outcome pathways, including the role played by different art stimuli and practices. Going forward, transdisciplinary teams are needed to quantify short- and long-term mental health and well-being outcomes and to investigate optimal programme durations in relation to population and need. Such teams would also be best placed to work on resolving inter-disciplinary methodological tensions.

Occupation as means and ends in paediatric occupational therapy - A systematic review

BACKGROUND

There is a lack of evidence-based knowledge in paediatric occupational therapy about the effectiveness of interventions using daily activities as a treatment modality in improving children's participation.

OBJECTIVE

This study aimed to evaluate the effectiveness of occupation-based and occupation-focused interventions in improving participation in everyday occupations for young children with a disability.

MATERIAL AND METHODS

A systematic review based on Joanna Briggs Institute methodology and critical appraisal tools was conducted. Six databases were searched for quantitative intervention studies aimed at improving participation in everyday occupations of young children with a disability through the use of everyday occupation.

RESULTS

The search yielded 3732 records, of which 13 studies met inclusion criteria. Ten studies met methodological quality criteria and were included in the synthesis, five randomised controlled trials and five quasi-experimental studies, involving a total of 424 children with a mean age of 6.5 years. The studies were classified into cognitive (n = 5), context-focussed (n = 2) and playgroup interventions (n = 3). Study quality ranged from low to moderate, only one study was rated high quality.

CONCLUSIONS AND SIGNIFICANCE

Occupation-based and occupation-focused interventions may have a positive effect on participation in everyday occupations for young children with a disability, but study design, risk of bias and insufficient reporting limit confidence in the body of evidence.

Patterns of mental health problems and well-being in children with disabilities in Sweden: A cross-sectional survey and cluster analysis

BACKGROUND

Children with disabilities have an increased risk of mental health problems. Patterns of mental health problems and well-being may vary.

AIMS

To identify patterns of mental health problems and well-being in children with disabilities in Sweden, and investigate the influence of parental background (migration, education), and child cognitive level.

METHOD

In this cross-sectional study, cluster analysis was used to analyse parents' ratings of conduct problems, emotional symptoms, and prosocial behaviour on the Strengths and Difficulties Questionnaire (SDQ) in children with disabilities (n = 136). The influence of parental background (migration, education) and child cognitive level on cluster membership was explored through multinomial logistic regression.

RESULTS

Five clusters of mental health patterns emerged. Three clusters had mean ratings near or past clinical cut-off for one each of the SDQ-subscales. One cluster had difficulties on all three subscales. Greater child cognitive difficulties increased the likelihood of low prosocial behaviour (OR 2.501, p < .001) and of difficulties on all three subscales (OR 2.155, p = .006). Parental background did not influence cluster membership.

CONCLUSION

Children with disabilities display varying mental health patterns. Awareness of the complexity of mental health patterns among children with disabilities is important. Screening and support for emotional symptoms and prosocial behaviour deficits should be considered for children with conduct problems.

Management practice and discharge outcome of patients with psychiatric disorder admitted to psychiatry wards of selected specialized settings in Ethiopia

BACKGROUND

Evidence on treatment practice, discharge outcomes, and associated factors in patients with psychiatric disorders are rarely discussed in Ethiopia. Results from the available studies are also seldom consistent and miss important factors, including treatment-related variables. Therefore, this study intended to describe management practice and discharge outcome among adult psychiatric patients admitted to psychiatry wards of selected specialized settings in Ethiopia. By pointing out associated factors, this study will also provide insight on targets to improve discharge outcomes.

PATIENTS AND METHODS

A cross-sectional study was conducted involving 278 adult psychiatry patients admitted to the psychiatry wards of Jimma Medical Center and St. Amanuel Mental Specialized Hospital in the study period from December 2021 to June 2022. The data was analyzed using STATA V.16. Descriptive statistics and logistic regression analysis were performed to present patient characteristics and identify factors associated with discharge outcome, respectively. In all the analysis, p value < 0.05 was used to declare statistical significance.

RESULTS

Schizophrenia (125, 44.96%) and bipolar disorders (98, 35.25%) were the top two psychiatric disorders diagnosed at admission. A greater share of patients with schizophrenia were treated with the combination of diazepam, haloperidol, and risperidone than with diazepam and risperidone, 14 (5.04%) each. Patients with bipolar disorder were being treated primarily with the combination of diazepam, risperidone, and sodium valproate, or risperidone and sodium valproate, 14 (5.04%) each. Overall, 232 (83.4%) patients were on psychiatric polypharmacy. In this study, 29 (10.43%) patients were discharged unimproved, and this risk was significantly higher in those patients with a khat chewing habit (AOR = 3.59, 95% CI = 1.21-10.65, P = 0.021) than non-chewers.

CONCLUSION

Psychiatric polypharmacy was found to be a common treatment approach in patients with psychiatric disorders. In the study, a little more than one-tenth of patients with psychiatric disorders were discharged without improvement. Hence, interventions targeting risk factors, especially khat use, should be undertaken to improve discharge outcomes in this population.

Mental health problems among transition-aged youth with physical disabilities: an initial evaluation

Aim

Decreased participation and complex transitions into adulthood among youth with disabilities may impede their well-being. To advance knowledge on the co-occurrence of mental health problems and physical disability, this brief report describes the frequency of mental health problems, measured by the Behavior Assessment System of Children (BASC-3), among transition-aged youth (14-25 years) with physical disabilities and examines the association between mental health problems and sex, age, and number of functional issues.

Methods

Thirty-three participants completed a demographic questionnaire and the BASC-3. Frequency of BASC-3 scales falling within 3 categories: "within norms", "at risk", and "clinically significant" were described. Crosstabs and Chi-square tests were used to examine the association between BASC-3 scales and sex, age (< and ≥ 20), and number of functional issues (< and ≥ 6).

Results

Overall, "somatization", "self-esteem", "depression" and "sense of inadequacy" were the most common subscales being at risk. Participants with a higher number of functional issues (≥6) were more likely to fall within "at risk" or "clinically significant" categories across 20 (out of 22) BASC-3 scales, and female participants tended to fall more within "at risk" or "clinically significant" categories for 8 of BASC-3 scales. Younger participants (<20) were ranked in the "at risk" or "clinically significant" categories for 7 scales.

Conclusions

Findings lend further support for the occurrence of mental health problems emerging in youth with physical disabilities and highlight initial trends especially across functional levels. Further investigation of such co-occurrences and the factors that affect their development is needed.

Implications of Early Diagnosis and Intervention in the Management of Neurodevelopmental Delay (NDD) in Children: A Systematic Review and Meta-Analysis

Neuro-developmental delay (NDD) is when a child's reflexes and nervous system are underdeveloped or immature at a given stage of child development. Neurodevelopmental delays account for delayed skill development surrounding speech, social, emotional, behavioral, motor, and cognitive delays. NDD might affect the child's psychological and physical well-being, resulting in chronic disease and disabilities throughout adulthood. This review sought to investigate the implication of early diagnosis and intervention of NDD in children. In this regard, this research opted for a systematic meta-analysis that used keywords and Boolean operators to search through main databases, including the Web of Science, JStor, PsychINFO, Science Direct, Cochrane, Scopus, and ASSIA. The result identified that telehealth interventions improved the management of NDD in children. Also, the Early Start Denver Model (ESDM) model was determined to improve the quality of life for NDD children. Another model was LEAP (Learning Experience and Alternative Program for Preschoolers and Their Parents) and Leap (Learning, engaging, and Playing), which improved behavioral, education, and social interventions in NDD children. The study identified that technology could revolutionize NDD interventions in children, possibly improving the quality of life. The parent-children relationship was shown to enhance the management of this condition; thus, it is recommended as one of the best ways to intervene in the management of NDD. Most importantly, the integration of machine learning algorithms and technology can create models; while this may not be significant in the treatment of childhood NDD but instead might be ideal in improving the quality of life for NDD children. Moreover, their social and communication skills along with academic achievements will improve. The study proposes further research in order to understand the different types of NDDs and their intervention strategies to help the researchers identify the most accurate models to improve the conditions and support the parents and guardians in the management.

"You got an instant conversation": Goal progress and perceptions following an e-mentoring social media intervention for young people who use augmentative and alternative communication

INTRODUCTION

Persons with communication disability are at increased risk of social isolation due to multiple societal barriers. Young people with communication disability are not using social media to the same extent as the general population, limiting their access to social networks. The aim of this research was to investigate an e-mentoring intervention to progress the goal attainment of online conversation for young people who use augmentative and alternative communication (AAC).

METHODS

Using a mixed-methods design, four participants between 13 and 18 years of age who used AAC participated in a 4-month cross-age peer e-mentoring intervention. Mentoring was provided by adults who were considered cross-age peers as they also used AAC. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) tools were used to measure progress in individually developed goals for online conversation. Interviews with participants, their parents, and their mentors were conducted to describe their experiences of the intervention.

RESULTS

Changes in participants' COPM ratings of performance and satisfaction with performance following intervention were statistically significant (p = 0.001, p = 0.032 respectively) and on average participant goals were attained at the expected level on the goal attainment scale (T = 63.97). However, goal attainment varied when considering specific goals. Variability in goal progress was described by participants alongside a range of barriers and facilitators. Mentees, their parents, and their mentors perceived that the intervention enabled goal progress and described improvements in social media use that extended beyond the targeted goals.

CONCLUSIONS

Outcomes from the COPM and GAS demonstrate the value of cross-age peer e-mentoring to support young people who use AAC to participate in online conversation. Benefits of the intervention were commonly perceived by mentees, their parents, and mentors to extend beyond the specific goal attainments.

Participation of children and young people with cerebral palsy in activities of daily living in rural Uganda

AIM

To compare the participation attendance and involvement of children and young people with and without cerebral palsy (CP) in a low-resource area of Uganda.

METHOD

Eighty-two children and young people with CP aged 6 to 22 years (49 males, 33 females) and 81 age- and sex-matched peers without CP (6 to 22 years; 48 males, 33 females) participated in this population-based, cross-sectional study. Data on attendance and involvement in 20 home and community activities were obtained using Picture My Participation, an instrument intended to measure participation in children with disabilities, particularly in low- and middle-income countries. Non-parametric statistical methods were used to assess between-group differences. Effect size estimates were calculated.

RESULTS

Pooled attendance across all activities was lower in children and young people with CP than in children and young people without CP (p < 0.001) and for each activity item (p = 0.004 to p < 0.001). The effect sizes for each activity were 0.2 to 0.7. Between-group differences were larger for community activities than for home activities. Pooled involvement across all activities was less in the group with CP (p < 0.001) and for each activity (p = 0.014 to p < 0.001). The effect sizes for each activity were 0.2 to 0.5. Children and young people in Gross Motor Function Classification System (GMFCS) levels I and II had higher attendance (p < 0.001) and involvement (p = 0.023) than those in GMFCS levels III to V.

INTERPRETATION

Participation of young people living with CP in Uganda was restricted, especially for community activities. There is a need to identify context-specific participation barriers and develop strategies to overcome them.

WHAT THIS PAPER ADDS

Children and young people with cerebral palsy (CP) attended all activities less than their peers without CP. Differences in attendance were larger for community-based activities than home activities. When attending activities, children and young people with CP were less involved than their peers. Children and young people with milder impairments attended less frequently than their peers without CP. Children and young people with milder impairments attended more frequently than their peers with severe impairments.

Digital self-report instruments for repeated measurement of mental health in the general adult population: a protocol for a systematic review

INTRODUCTION

Digital technologies present tremendous opportunities for enabling long-term measurement of mental health in the general population. Emerging studies have established preliminary efficacy of collecting self-report data digitally. However, a key challenge when developing a new self-report instrument is navigating the abundance of existing instruments to select relevant constructs for measurements. This review is a precursor to developing a novel future integrated digital instrument for repeated measurements. We interrogate the literature as the first step towards optimal measurement of the multifaceted mental health concept, in the context of digital repeated measurement. This review aims to identify (1) digital self-report instruments administered repeatedly to measure the mental health of the general adult population; (2) their structure and format; (3) their psychometric properties; (4) their usage in empirical studies; and (5) the constructs these instruments were designed to measure (as characterised in the original publication), and the constructs the instruments have been used to measure in the identified empirical studies.

METHODS AND ANALYSIS

Five major electronic databases will be searched. Studies administering mental health instruments (in English) repeatedly to community dwellers in the general adult population are eligible. A reviewer will preliminarily screen for eligible studies. Then, two reviewers will independently screen the full text of the eligible articles and extract data. Both reviewers will resolve any disagreement through discussion or with a third reviewer. After the data extraction, a reviewer will manually search for the structure, format, psychometric properties and the original constructs these instruments were developed to measure. This review will synthesise the results in a narrative approach. The reporting in this review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.

ETHICS AND DISSEMINATION

Ethical approval is not required as no data will be collected. Findings of the systematic review will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO REGISTRATION NUMBER

CRD42022306547.

Parental migration status moderates the link between parent-child relationship and children's well-being through psychological distress

The effects of parental migration on the well-being of left-behind children (LBC) are varied. Several studies demonstrated that parental migration reduces children's psychological health but other research showed contradictory results. This study sought to clarify this issue by examining the mediating role of psychological distress and the moderating role of parental migration status in the association between the parent-child relationship and children's psychological distress. A total of 743 LBC and 688 non-LBC self-reported their parent-child relationship, psychological distress, and well-being. Findings showed that psychological distress mediated the association between parent-child relationship and children's well-being. This denotes that greater parent-child relationship results into lowered levels of psychological distress, and in turn, increases children's emotional, psychological, and social well-being. Moreover, the link between parent-child relationship and psychological distress was found to be contingent to parental migration status. Specifically, the negative association between parent-child relationship and psychological distress was especially strong among LBC in contrast to non- LBC. This implies that children with higher quality relationships with their parents tend to exhibit decreased severity of psychological distress symptoms, especially in children whose parents are working overseas. These results underscore the dynamic role of parent-child relationship in the well-being of LBC, and suggest ways to develop intervention programs that include cultivating skills in managing psychological distress and improving the emotional, psychological, and social well-being of LBC.

A scoping review of interventions using occupation to improve mental health or mental wellbeing in adolescent populations

Introduction

Occupation-based interventions could help to address a growing mental health crisis among young people and adolescents. To develop new interventions and avoid research waste, a review of the academic literature is needed that systematically identifies and describes interventions designed to improve the mental health and wellbeing of 11–25 year-olds.

Aim

The scoping review aims to systematically review the academic, literature to identify and describe key characteristics of intervention studies using occupation to improve adolescents’ and young people’s mental health and wellbeing, exploring the range of interventions, reviewing reporting quality and illuminating gaps for further research.

Method

An iteratively developed scoping review protocol informs a systematic database search and review of the literature. Core characteristics are extracted and described, using the TIDIER guidelines and the CASP assessment tool.

Results

Five occupational therapy-based interventions, and 69 other occupation-based studies representing a wide breadth of approaches, outcomes and settings were identified.

Conclusions

Robust development, testing and reporting of occupation-based and occupation-focused intervention studies to promote and support mental health and wellbeing in adolescents and young people are needed. Interventions should be co-designed, developmentally appropriate and scaffold development. However, better agreement is needed about core outcomes measurement in this area.

Residential care staff are the key to quality of health care for adults with profound intellectual and multiple disabilities in Sweden

Background

People with profound intellectual and multiple disabilities (PIMD) have combined severe intellectual and physical disability and need extensive health care support. They cannot communicate by spoken language and need around the clock support. The health care for people with PIMD is typically provided by a number of different health care services in collaboration with residential care staff and their managers. The quality of health care for people with PIMD are important due to their limited ability to communicate their needs. The aim of this study was to explore residential care staff and manager’s experiences and views of health care services for adults with PIMD.

Methods

Thirteen semi-structured interviews with residential care staff (n = 7) and managers (n = 6) were conducted and analysed using qualitative content analysis.

Results

The informants expressed a variety of experiences, under the theme was Quality of health care is enhanced through residential care staff. The theme was comprised of four subthemes: (1) Individually tailored support promotes quality, (2) Accessibility requires adaptation and prioritization by healthcare providers, (3) Disability competence promotes quality and safety and (4) Complex collaboration conditions between the person with PIMD, residential care staff and disability health care.

Conclusions

The residential care staff create quality of care in their role as representatives for adults with PIMD. The care situation is complex and requires adequate competence in the disability, the individual’s needs and adaptations to ensure quality of health care. It is also important to build collaboration with other services that are involved in the care of people with PIMD.

Overcoming mental health stigma through student's awareness and project-based inclusive pedagogy in English teaching colleges: Moderating role of institutional support in China

Mental health stigma undermines collaborative work and creates communication breakdowns for students to face real-world challenges. Moreover, project-based English learning in East-Asian nations is a significant challenge for advancing students' effective learning, while students lack mental health self-awareness. Unawareness causes distractions and results in learning inefficiencies. Furthermore, without institutional support (IS) achieving effective learning could never be possible. Therefore, this study investigates the relationships between project-based learning (PBL) and mental health awareness (MHA) with effective English language teaching among university students in China. We also tested the moderation effect of IS in the relationships between PBL and MHA with effective English language learning (EEL). Using the purposive sampling technique, we collected valid responses from 713 students studying English as a foreign language in universities and colleges in Harbin, China. The findings interestingly supported the direct hypotheses between PBL and EEL, as well as MHA and EEL. Moreover, the moderating role of IS established a significant effect on both PBL and EEL, as well as MHA and EEL, respectively. Policymakers, practitioners, and academicians should understand that integrating PBL as an inclusive pedagogy method with proper IS may enhance effective learning; however, it will consume more time.

Is there a social gradient in how youth with mental disorder perform academically? Findings from a Swedish longitudinal register-based study

Background

It is well established that academic achievement and other school-related outcomes are associated with mental health status in children and youths. However, few studies have examined the influence of socioeconomic background on the relationship between poor childhood/adolescent mental health and school performance. From an equity perspective, it is important to explore how school-related outcomes are affected for young people with mental disorder and if these outcomes differ depending on gender and socioeconomic background. This study aimed to investigate social gradients in the prospective association between childhood/adolescent mental disorder and academic achievement.

Methods

This register based study used data from the Umeå SIMSAM Lab of linked Swedish registers on all children born between 1990 and 1994 and their parents (N = 642 558). The outcome was school grades achieved upon compulsory school graduation (age 15/16). Mental disorder was indicated by number of hospitalisations due to ICD classified mental disorders and prescription of psychoanaleptic drugs. Indicators of socioeconomic position were parental level of education and family income in four categories respectively. Parental history of mental disorder was controlled for. Linear regressions, including interaction analyses, were performed.

Results

Mental disorder in childhood/adolescence was related to lower grades, particularly in boys. The drop in academic achievement among youth with mental disorder was more pronounced among girls in mid SEP categories than among their less and more advantaged peers. A less clear interaction pattern was identified in boys.

Conclusions

Based on theory and existing research we expected a typical social gradient in the strength of the association between mental disorder and academic achievement. However, we identified a U-shaped social gradient among girls. Analyses of the links between mental health and academic outcomes need to take both gender and social position into account. More research is needed to investigate these patterns further.

The utility of goal attainment scaling in evaluating a structured water dance intervention for adults with profound intellectual and multiple disabilities

BACKGROUND

Adults with profound intellectual and multiple disabilities (PIMD) have problems to be actively involved in essential life activities that affect their health. The aim of this study was to explore the utility of goal attainment scaling (GAS) in evaluating an intervention for adults with PIMD, and to describe how the GAS goals were set according to the International Classification of Functioning, Disability and Health (ICF) domains of body function as well as activity and participation.

METHOD

As part of an aquatic intervention (Structured water dance), 28 adults with PIMD received GAS goals which were adapted to their individual needs and which the intervention could affect.

RESULT

Twenty of the goals were formulated within the ICF Activity/Participation domain and eight within the Body Functions domains. On average, participants improved by 1.25 levels on the five-level GAS scales.

CONCLUSION

GAS can be a useful tool for setting and evaluating individualized and meaningful goals, in body functions as well as in activity and participation, related to a healthpromoting activity for adults with PIMD.

Trajectories of participation, mental health, and mental health problems in adolescents with self-reported neurodevelopmental disorders

PURPOSE

Having a neurodevelopmental disorder (NDD) increases the risk of mental health problems and lower participation. We investigated the trajectories of mental health problems and participation in adolescents with NDD and compared these with trajectories for peers without NDD. In addition, the relationship between participation, mental health (well-being), and mental health problems were investigated.

MATERIALS AND METHODS

Data from a Swedish longitudinal survey study (LoRDIA) was used and adolescents with and without self-reported NDD were followed from 12/13 to 17 years, in three waves. Mental health problems were measured using the Strength and Difficulties Questionnaire, and well-being was measured with the Mental Health Continuum short form.

RESULTS

Adolescents with NDD experience more mental health problems than adolescents without NDD. Hyperactivity, a key feature of NDD, remains stable, while emotional problems and psychosomatic complaints, increase over time for girls, independent of NDD. Participation is stable over time but is more related to well-being than to NDD or mental health problems.

CONCLUSIONS

Gender is an important factor with girls exhibiting more problems. Mental health explains more of the variation in participation than mental health problems and NDD. Probably participation intervention can enhance mental health which may protect from mental health problems.Implications for rehabilitationMental health, i.e., emotional-, social-, and psychological well-being is more strongly related to participation and to reduced levels of mental health problems than having an NDD or not, thus assessing mental health separately from measuring NDD is important.Interventions focusing on participation may lead to higher mental health and having high mental health (flourishing) may facilitate participation.Girls with self-reported NDD seem to have a higher burden of mental health problems, especially if they also are languishing, i.e., having low mental health, therefore a strong focus on this group is needed both in research and clinical practice.Half of all adolescents are flourishing, independently of NDD or not, even if they are experiencing some symptoms of mental health problems, adolescents with NDD who are also languishing, have much higher ratings of mental health problems.

Psychotropic medication use and academic performance in adolescence: A cross-lagged path analysis

INTRODUCTION

The study investigated the directionality of associations between mental health problems and school grades across two timepoints (T1 and T2) during mid to late adolescence; in school year 9 (ages 15-16) and school year 12 (ages 17-18). The study also investigated variation in the associations as a function of gender and across socioeconomic groups.

METHODS

Longitudinal data from several Swedish administrative registers were utilised. Information on prescribed psychotropic drugs was used as a proxy for mental health problems, and teacher-assigned school grades were used to measure academic performance. The study sample comprised 85 186 individuals (50.7% girls) born in 1991 who were alive and resident in Sweden in 2010. Directions of associations were analysed by estimating a series of cross-lagged path models.

RESULTS

The model with the best fit to data showed that higher school grades at T1 were associated with relatively lower rates of mental health problems by T2, for both boys and girls, mainly in socioeconomic groups with the highest educated parents. This association was equal in size across all of the socioeconomic groups that were explored.

CONCLUSIONS

Performing well in school is equally important for boys' and girls' subsequent mental health, but only among adolescents in socioeconomic groups with the highest educated parents. The results underscore the importance of promoting opportunities for youth to do as well as they can in school.

The utility of the International Classification of Functioning construct as a statistical tool - operationalizing mental health as an indicator of adolescent participation

BACKGROUND

The ICF provides a common scientific language for the study of health and functioning. Adolescent mental health, operationalized as engagement in life situations, is one aspect of functioning. Engagement as mental health has a bi-directional relation with environmental factors.

AIM

To test the statistical utility of the International Classification of Functioning (ICF) classification in coding adolescent mental health and mental health problems.

METHODS

Using data measuring mental health in a representative Swedish sample of 12-13-year-olds linking responses to the classification codes. The internal structure of the classification system constructs was tested using factor analysis.

RESULTS

A factorial solution could be found for most chapters indicating that the ICF framework and coding system could be used; however, the variance explained was quite low. Linking worked better at code-level, rather than chapter level. Items measuring risk behavior or risk factors are loaded in separate constructs.

CONCLUSIONS

When coding items for statistical purposes, code-level rather than chapter level is to be preferred. Also, participation in risk behavior loads in separate factors indicating that these behaviors are separate from other types of participation.Implications for rehabilitationConsidering some challenges with varying level of detail in the ICF-CY's chapters, the framework can be used to identify the content of mental health questionnaires to be used in rehabilitation.To provide more detailed information in rehabilitation addressing mental health, a code-level solution is more appropriate than a chapter level solution.Despite the use of same ICF-CY codes, negative participation, i.e., risk behavior, measures a different dimension than positive participation, is especially relevant in rehabilitation addressing mental health.