Evaluation of a Home Visiting and Befriending Scheme for Young Mothers: Newpin

Befriending schemes to support families with young children are now widespread in the United Kingdom. One such scheme, Newpin, which aims to prevent child abuse is described. Evaluation compared those recruited to befriend as well as those befriended. Assessments at baseline and 6 months' follow-up comprised interviews with mothers, developmental assessments of the children and observation of mother–child interaction using video tapes. All assessments were conducted in the home and similar measures were applied to a control sample in an area where a Newpin scheme was planned. Newpin recruits, whether befrienders or befriended had high rates of adverse early experiences, but depression was more common amongst those referred for befriending. Approximately a third did not sustain involvement in the scheme, but those that did were more likely to have had training as volunteers and mental health problems of more than 2 years' duration.

Parent-infant vocalisations at 12 months predict psychopathology at 7 years

This study investigated the utility of adult and infant vocalisation in the prediction of child psychopathology. Families were sampled from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Vocalisation patterns were obtained from 180 videos (60 cases and 120 randomly selected sex-matched controls) of parent-infant interactions when infants were one year old. Cases were infants who had been subsequently diagnosed aged seven years, with at least one psychiatric diagnostic categorisation using the Development and Wellbeing Assessment. Psychopathologies included in the case group were disruptive behaviour disorders, oppositional-conduct disorders, Attention Deficit Hyperactivity Disorder, pervasive development disorder, and emotional disorders. Associations between infant and parent vocalisations and later psychiatric diagnoses were investigated. Low frequencies of maternal vocalisation predicted later development of infant psychopathology. A reduction of five vocalisations per minute predicted a 44% (95%CI: 11-94%; p-value=0.006) increase in the odds of an infant being a case. No association was observed between infant vocalisations and overall case status. In sum, altered vocalisation frequency in mother-infant interactions at one year is a potential risk marker for later diagnosis of a range of child psychopathologies.

Predictors of diagnosis of child psychiatric disorder in adult-infant social-communicative interaction at 12 months

To establish which social interactive behaviours predict later psychiatric diagnosis, we examined 180 videos of a parent-infant interaction when children were aged one year, from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Sixty of the videos involved infants who were later diagnosed with a psychiatric disorder at seven years, and 120 were a randomly selected sex-matched control group. Interactive behaviours for both the caregiver and the one year old infant were coded from the videos according to eight holistic categories of interpersonal engagement: Well-being, Contingent Responsiveness, Cooperativeness, Involvement, Activity, Playfulness, Fussiness, and Speech. Lower levels of adult activity and speech in interaction at one year significantly predicted overall diagnosis of child psychiatric disorder.

Can psychopathology at age 7 be predicted from clinical observation at one year? Evidence from the ALSPAC cohort

One of the challenges of developmental psychopathology is to determine whether identifiable pathways to developmental disorders exist in the first months or years of life. Early identification of such disorders poses a similar challenge for clinical services. Using data from a large contemporary birth cohort, we examined whether psychopathology at age seven can be predicted from clinician observation at one year. Two groups of clinical raters observed videos of caregiver-infant interaction. Neither group of raters could reliably identify any precursors of later development of psychopathology in the one-year-old infants in this setting.

Disruptive behaviour disorders: a systematic review of environmental antenatal and early years risk factors

Disruptive behaviour disorders (DBDs), including attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are chronic disorders with significant overlap in aetiology and presentation. An integrative examination of environmental risk factors is lacking. Six literature searches of web-based bibliographic databases were completed to identify literature on DBDs in general and five disorders in particular: CD, ODD, ADHD, deficits of attention, motor control and perception, and reactive attachment disorder. Searches were filtered to focus on studies including diagnostic assessment, focussing on environmental risk and protective factors in the first 4 years of life. The database searches generated 9806 papers of which 47 were reviewed after filters had been applied. The evidence suggests links between a number of early life risk factors and DBDs, including prenatal cigarette smoking and alcohol use, prenatal viral illness, maternal stress and anxiety, low birthweight, peri-partum and early neonatal complications, parental stress and parenting styles in infancy, early deprivation, adoption and separation. Despite the understanding that there is sharing of risk factors between the DBDs, there has been a disproportionate focus on the role of certain risk factors at the expense of others and the field is weakened by difficulties in controlling for all potential confounding variables.

Should we aspire to screen preschool children for conduct disorder?

Life-course persistent conduct disorder is a major public health problem with implications for individual health and for society at large. Recent evidence has shown that treatment can be cost-effective, and early symptom detection is improving. We weigh the evidence for and against the introduction of population screening for conduct disorder in early childhood using Wilson and Jungner's criteria.

At HOME in Scotland: validation of the home observation for measurement of the environment inventory

BACKGROUND

This study used the Home Observation for Measurement of the Environment (HOME) Inventory to measure aspects of the quality and quantity of psychological stimulation and cognitive support available in the home environment of a sample of Scottish children and to examine the effectiveness of this measure in a British context.

METHODS

Forty-seven families who had previously attended parent-training programmes at family centres were assessed. The Middle Childhood (MC) and Early Adolescent (EA) version of the HOME were used with children aged between 8 and 13 years old. Measures of family adversity were also taken.

RESULTS

There were no significant differences in the demographics of the MC-HOME and EA-HOME groups nor in their total HOME scores. Total HOME scores were compared with independent measures of family adversity. The results of the MC-HOME and the EA-HOME were similar to results reported for socially deprived American samples.

DISCUSSION

This Scottish sample had similar MC-HOME and EA-HOME scores as previously reported in American samples and the HOME scores related strongly to family adversity, supplying a proximal link between social conditions and the environment of children. These results suggest that the HOME Inventory is reliable and has concurrent validity with measures of social adversity in a British sample.

Mother-child interaction and the cognitive and behavioural development of four-year-old children with poor growth

A whole population inner-city survey identified 23 stunted, otherwise healthy, children with persistently poor growth from infancy to 4 years. Their cognitive development was significantly retarded relative to a matched comparison group. Unstructured home observations were used to create transcripts of verbal and nonverbal mother-child interactions. In both groups child behavioural adjustment was linked to maternal negativity, and cognitive performance was correlated with quality of stimulation. The developmental delay associated with chronic failure to thrive appeared more likely to arise from other influences, perhaps a previous biological insult, than to contemporaneous parenting practices.

Nutrition and mealtime behaviour in families of growth-retarded children

A sample of 4-year-olds from a London inner city area whose growth fell below the 10th population centile for height and weight were matched with children whose rate of growth was within normal limits. Neither food intake nor gross environmental variables distinguished the two groups. However, mealtime observations revealed considerably more disorganization and negative attitudes in case group families. Retrospective information obtained by interview indicates that these factors had been operative since early infancy. The findings suggest that in surveys of child nutrition the role of family dysfunction should be considered.

The impact of maternal depression in young children

An urban working class sample of depressed mothers with two-yr-old children was compared with a control group of non-depressed mothers using maternal interviews, home observation of mother/child interaction, and developmental assessment of the children. Measures were repeated after six months. Children of depressed mothers showed more emotional and behavioural disturbance and delay in expressive language development. Depressed mothers had more past and current adverse experiences, particularly in close relationships. In general depressed mothers were less responsive to their children and less able to sustain social interaction: their children were more often distressed, but there was a big variation in quality of mother/child interaction within the depressed group.

Growth retardation and developmental delay amongst inner-city children

A whole population survey of an inner-city health district (population 130,000) was undertaken in order to study the association between social deprivation and non-organic growth delay in preschool children. Potential cases were identified from health clinic records. Cases comprised white, full-term singletons, whose weight and height lay below the tenth centile at 4 years of age. Allowance was made for parental stature. A comparison group was closely matched for socio-economic conditions, and other salient variables. Case children were comparatively significantly delayed in all areas of their cognitive development. One-third were seriously retarded and likely to require special education.