This report considers how outcomes for children known to children's social care might be improved through policies, practices and interventions with evidence of improving vulnerable children's life-chances. It identifies over 50 interventions and activities with evidence of improving child and family outcomes within five categories of vulnerability: problematic child behaviour, family conflict, parental mental health, domestic abuse and parental substance misuse. Six key messages stand out from this review: 1. There are a range of interventions with good evidence that could be included in local family help offers; 2. Increasing the availability of evidence-based interventions can accelerate improvements in practice; 3. There are interventions that are currently not available in the UK that could add value to the current system; 4. Increasing the availability of evidence-based interventions is likely to require support for implementation; 5. There are limitations to the current evidence base, and areas where UK evidence remains insufficient for guiding practice; 6. Evidence-based interventions will never be enough to reverse the impact of poverty.
(Edited publisher abstract)
This report considers how outcomes for children known to children's social care might be improved through policies, practices and interventions with evidence of improving vulnerable children's life-chances. It identifies over 50 interventions and activities with evidence of improving child and family outcomes within five categories of vulnerability: problematic child behaviour, family conflict, parental mental health, domestic abuse and parental substance misuse. Six key messages stand out from this review: 1. There are a range of interventions with good evidence that could be included in local family help offers; 2. Increasing the availability of evidence-based interventions can accelerate improvements in practice; 3. There are interventions that are currently not available in the UK that could add value to the current system; 4. Increasing the availability of evidence-based interventions is likely to require support for implementation; 5. There are limitations to the current evidence base, and areas where UK evidence remains insufficient for guiding practice; 6. Evidence-based interventions will never be enough to reverse the impact of poverty.
(Edited publisher abstract)
Subject terms:
childrens social care, vulnerable children, intervention, children, behaviour problems, families, mental health problems, parenting, domestic violence, substance misuse, family support, good practice;
NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London
Publication year:
2022
Pagination:
117
Place of publication:
London
This thematic literature review about hoarding behaviour provides an overview of research findings and debates for researchers, practitioners, and other interested parties, and to inform a wider study on social care responses to self-neglect and hoarding behaviour among older people in England. Hoarding behaviour is complex and not always easy to understand. Over the years, several clinical terms have been used in relation to hoarding behaviour, such as clutter(ing), squalor, or Diogenes syndrome. These terms are used to describe the excessive accumulation of items and possessions in people's homes. Hoarding behaviour can lead to dangerous circumstances such as unhygienic living conditions, greater risk of falls, increased risk of injury in fires, homelessness, and even death, as well as harm to other people. This review explores theories about and definitions of hoarding behaviour and hoarding disorder, known causes for and risk factors associated with hoarding behaviour. It also presents research findings on age of onset, progression, severity and prevalence of hoarding behaviour among older people. It also provides information on what is known about treatment and interventions, including therapeutic approaches, community-based schemes, and medication. Another section explores critical perspectives on hoarding behaviour discourses. Finally, the review offers some conclusions and considerations for practice.
(Edited publisher abstract)
This thematic literature review about hoarding behaviour provides an overview of research findings and debates for researchers, practitioners, and other interested parties, and to inform a wider study on social care responses to self-neglect and hoarding behaviour among older people in England. Hoarding behaviour is complex and not always easy to understand. Over the years, several clinical terms have been used in relation to hoarding behaviour, such as clutter(ing), squalor, or Diogenes syndrome. These terms are used to describe the excessive accumulation of items and possessions in people's homes. Hoarding behaviour can lead to dangerous circumstances such as unhygienic living conditions, greater risk of falls, increased risk of injury in fires, homelessness, and even death, as well as harm to other people. This review explores theories about and definitions of hoarding behaviour and hoarding disorder, known causes for and risk factors associated with hoarding behaviour. It also presents research findings on age of onset, progression, severity and prevalence of hoarding behaviour among older people. It also provides information on what is known about treatment and interventions, including therapeutic approaches, community-based schemes, and medication. Another section explores critical perspectives on hoarding behaviour discourses. Finally, the review offers some conclusions and considerations for practice.
(Edited publisher abstract)
Background and Objectives: Assisted living (AL) residents with dementia commonly exhibit behavioural expressions (BEs), yet no study has examined how AL staff perceive and respond to BEs in terms of the "ABC" model of antecedents, behaviours, and consequences, or how perceptions relate to organizational characteristics. Understanding staff perceptions may inform interventions. Research Design and Methods: A convergent, mixed methods design was used in a study of health care supervisors from 250 AL communities in 7 states who reported 366 cases of resident BEs (one successful and one unsuccessful case). Qualitative analysis identified antecedents, BEs, staff responses, resident outcomes, and disposition (aging in place or discharge). Content analysis identified themes and compared case types. Descriptive statistics examined organizational characteristics associated with identifying antecedents. Results: One quarter of cases recognized antecedents; slightly more were identified in successful (28%) compared to unsuccessful cases (20%); staff in dementia-only and smaller communities identified antecedents more often. Combativeness and anxiety were the most frequently reported BEs. The majority of both types of cases reported staff responses. Medication management was enacted as a response in 40% of cases compared to psychiatric assessment in 33% of cases. Discussion and Implications: Staff training is indicated to increase AL staff recognition of antecedents; doing so might reduce the use of antipsychotic medications. Psychiatric assessment plays an important role in dementia care in AL and warrants further examination. Results could be helpful for applied behavioural researchers interested in developing ways to improve the identification of antecedents of BEs of persons with dementia.
(Edited publisher abstract)
Background and Objectives: Assisted living (AL) residents with dementia commonly exhibit behavioural expressions (BEs), yet no study has examined how AL staff perceive and respond to BEs in terms of the "ABC" model of antecedents, behaviours, and consequences, or how perceptions relate to organizational characteristics. Understanding staff perceptions may inform interventions. Research Design and Methods: A convergent, mixed methods design was used in a study of health care supervisors from 250 AL communities in 7 states who reported 366 cases of resident BEs (one successful and one unsuccessful case). Qualitative analysis identified antecedents, BEs, staff responses, resident outcomes, and disposition (aging in place or discharge). Content analysis identified themes and compared case types. Descriptive statistics examined organizational characteristics associated with identifying antecedents. Results: One quarter of cases recognized antecedents; slightly more were identified in successful (28%) compared to unsuccessful cases (20%); staff in dementia-only and smaller communities identified antecedents more often. Combativeness and anxiety were the most frequently reported BEs. The majority of both types of cases reported staff responses. Medication management was enacted as a response in 40% of cases compared to psychiatric assessment in 33% of cases. Discussion and Implications: Staff training is indicated to increase AL staff recognition of antecedents; doing so might reduce the use of antipsychotic medications. Psychiatric assessment plays an important role in dementia care in AL and warrants further examination. Results could be helpful for applied behavioural researchers interested in developing ways to improve the identification of antecedents of BEs of persons with dementia.
(Edited publisher abstract)
Background: A sizable number of previous research investigated the influences of untreated behavior problems in children's early age, as well as how different environmental factors affect child behavior problems (King etal., 2004; Vaillancourt etal., 2013). However, few studies focused on the influences of different types of neighborhood factors on early childhood internalizing
(Edited publisher abstract)
Background: A sizable number of previous research investigated the influences of untreated behavior problems in children's early age, as well as how different environmental factors affect child behavior problems (King etal., 2004; Vaillancourt etal., 2013). However, few studies focused on the influences of different types of neighborhood factors on early childhood internalizing and externalizing symptoms via adverse childhood experiences. Objective: This study aims to capture the specific pathways from neighborhood structural factors and process factors to early childhood internalizing and externalizing symptoms. Participants and setting: The restricted version of the Fragile Family Child Wellbeing Study (FFCWS) dataset at ages 3 and 5 were used, and 2722 children were included in the final model. Methods: The Structural Equation Model was used to estimate the pathways from neighborhood structural and process factors to early childhood internalizing (INT) and externalizing (EXT) symptoms. Neighborhood structural factors were measured at the census tract level. Neighborhood collective efficacy, child maltreatment experiences, and early childhood internalizing, and externalizing symptoms were reported by the focal child's mother. Results: Neighborhood process factors and structural factors showed both direct and indirect effects on early childhood EXT and INT differently. Emotional assault and neglect worked as mediators in this relationship. Conclusions: Findings emphasize the importance for researchers and practitioners to involve neighborhood context when assisting children with early childhood behavior problems. Implications for research and interventions are further discussed.
(Edited publisher abstract)
Previous research suggests that adopted children are at a greater risk of experiencing psychological and behavioural difficulties or accessing mental health services than non-adopted peers and that post-adoption variables are significant risk and protective factors producing this situation. This review seeks to summarise the post-adoption variables associated with adopted children’s mental health or behavioural difficulties to inform future research and shape interventions. A search for publications that assess associated risk and protective factors using Web of Science, Psychinfo, Medline and Sociological Abstracts identified 52 studies that met rigorous methodological criteria. Children’s and adolescents’ mental health and behavioural outcomes were associated with parent, parent–child and wider family factors and by contextual variables. The findings highlight the importance of focusing on the multitude of systemic factors surrounding a child following adoption. Clinical implications and direction for future research are discussed.
(Edited publisher abstract)
Previous research suggests that adopted children are at a greater risk of experiencing psychological and behavioural difficulties or accessing mental health services than non-adopted peers and that post-adoption variables are significant risk and protective factors producing this situation. This review seeks to summarise the post-adoption variables associated with adopted children’s mental health or behavioural difficulties to inform future research and shape interventions. A search for publications that assess associated risk and protective factors using Web of Science, Psychinfo, Medline and Sociological Abstracts identified 52 studies that met rigorous methodological criteria. Children’s and adolescents’ mental health and behavioural outcomes were associated with parent, parent–child and wider family factors and by contextual variables. The findings highlight the importance of focusing on the multitude of systemic factors surrounding a child following adoption. Clinical implications and direction for future research are discussed.
(Edited publisher abstract)
Subject terms:
behaviour problems, adopted children, mental health problems, systematic reviews, post adoption services, risk, adoption, mental health;
Gerontologist, early cite January 2022, p.gnac016.
Publisher:
Oxford University Press
Background and Objectives: When staff experience responsive behaviours from residents, this can lead to decreased quality of work-life and lower quality of care in long-term care homes. This study synthesised research on factors associated with resident responsive behaviours directed towards care staff and characteristics of interventions to reduce the behaviours. Research Design and Methods: conducted a mixed-methods systematic review with quantitative and qualitative research. Researcher searched 12 bibliographic databases and “grey” literature, using two keywords (long-term care, responsive behaviours) and their synonyms. Pairs of reviewers independently completed screening, data extraction, and risk of bias assessment. The researchers developed a coding scheme using the ecological model as an organising structure and prepared narrative summaries for each factor. Results: From 86 included studies (57 quantitative, 28 qualitative, 1 mixed methods), multiple factors emerged, such as staff training background (individual level); staff approaches to care (interpersonal level); leadership and staffing resources (institutional level); and racism and patriarchy (societal level). Quantitative and qualitative results each provided key insights, such as qualitative results pertaining to leadership responses to reports of behaviours, and quantitative findings on the impact of staff approaches to care on behaviours. Effects of interventions (n=14) to reduce the behaviours were inconclusive. Discussion and Implications: this study identified the need for enhanced understanding of the interrelationships among factors associated with resident responsive behaviours towards staff and processes leading to the behaviours. To address these gaps and to inform theory-based effective interventions for preventing or mitigating responsive behaviours, the authors suggest intervention studies with systematic process evaluations.
(Edited publisher abstract)
Background and Objectives: When staff experience responsive behaviours from residents, this can lead to decreased quality of work-life and lower quality of care in long-term care homes. This study synthesised research on factors associated with resident responsive behaviours directed towards care staff and characteristics of interventions to reduce the behaviours. Research Design and Methods: conducted a mixed-methods systematic review with quantitative and qualitative research. Researcher searched 12 bibliographic databases and “grey” literature, using two keywords (long-term care, responsive behaviours) and their synonyms. Pairs of reviewers independently completed screening, data extraction, and risk of bias assessment. The researchers developed a coding scheme using the ecological model as an organising structure and prepared narrative summaries for each factor. Results: From 86 included studies (57 quantitative, 28 qualitative, 1 mixed methods), multiple factors emerged, such as staff training background (individual level); staff approaches to care (interpersonal level); leadership and staffing resources (institutional level); and racism and patriarchy (societal level). Quantitative and qualitative results each provided key insights, such as qualitative results pertaining to leadership responses to reports of behaviours, and quantitative findings on the impact of staff approaches to care on behaviours. Effects of interventions (n=14) to reduce the behaviours were inconclusive. Discussion and Implications: this study identified the need for enhanced understanding of the interrelationships among factors associated with resident responsive behaviours towards staff and processes leading to the behaviours. To address these gaps and to inform theory-based effective interventions for preventing or mitigating responsive behaviours, the authors suggest intervention studies with systematic process evaluations.
(Edited publisher abstract)
Subject terms:
systematic reviews, older people, long term care, care homes, evidence, behaviour, quality of life, aggression, agitation, behaviour problems, ecological approach;
Journal of Family Violence, early cite January 2022,
Publisher:
Springer
Coercive control is characterised by negative behaviours which intimidate, threaten, and humiliate a person or restrict a person’s liberty. In addition to being a known risk factor for experiencing other forms of violence, research has linked coercive control to symptoms of psychological distress and suicidality. In the UK, coercive and controlling behaviours within intimate and familial relationships have been legislated as offending behaviours. However, there still exists a lack of international evidence on wider public knowledge and understanding of coercive control. The Northern Ireland Life and Times Survey (NILT) is an annual cross-sectional representative survey of social policy topics. Participants are adults aged 18 years or over. Concerning coercive control, respondents were presented with two relationship scenarios: obvious and less obvious coercive control. Following each scenario, respondents indicated their level of agreement to ten statements covering attitudes towards coercive control, victims of coercive control, talking about coercive control, and whether coercive control is a crime. Respondents indicated whether they had heard of the term ‘coercive control’. Predictors of coercive control awareness were assessed using multinomial logistic regression. Mixed analysis of variance assessed if agreement levels to the ten statements varied by type of coercive control and victim gender. Most respondents said that they had heard of the term coercive control and knew what it meant. Those who had not heard of coercive control at all were more likely to be on a lower income, less qualified and younger, when compared to those who said they knew what the term meant. Significant interactions between coercive control type and victim gender were evident for all ten statements. While most respondents are aware of the term coercive control, a significant number have not and are therefore unlikely to recognise the signs of this type of abuse.
(Edited publisher abstract)
Coercive control is characterised by negative behaviours which intimidate, threaten, and humiliate a person or restrict a person’s liberty. In addition to being a known risk factor for experiencing other forms of violence, research has linked coercive control to symptoms of psychological distress and suicidality. In the UK, coercive and controlling behaviours within intimate and familial relationships have been legislated as offending behaviours. However, there still exists a lack of international evidence on wider public knowledge and understanding of coercive control. The Northern Ireland Life and Times Survey (NILT) is an annual cross-sectional representative survey of social policy topics. Participants are adults aged 18 years or over. Concerning coercive control, respondents were presented with two relationship scenarios: obvious and less obvious coercive control. Following each scenario, respondents indicated their level of agreement to ten statements covering attitudes towards coercive control, victims of coercive control, talking about coercive control, and whether coercive control is a crime. Respondents indicated whether they had heard of the term ‘coercive control’. Predictors of coercive control awareness were assessed using multinomial logistic regression. Mixed analysis of variance assessed if agreement levels to the ten statements varied by type of coercive control and victim gender. Most respondents said that they had heard of the term coercive control and knew what it meant. Those who had not heard of coercive control at all were more likely to be on a lower income, less qualified and younger, when compared to those who said they knew what the term meant. Significant interactions between coercive control type and victim gender were evident for all ten statements. While most respondents are aware of the term coercive control, a significant number have not and are therefore unlikely to recognise the signs of this type of abuse.
(Edited publisher abstract)
Subject terms:
emotional abuse, behaviour problems, abuse, public opinion, user views, domestic violence;
Journal of Gerontological Nursing, 48(1), 2022, pp.35-41.
Publisher:
Healio
The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviours, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome.
(Edited publisher abstract)
The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviours, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome.
(Edited publisher abstract)
Subject terms:
residential care, family relations, carer views, staff views, digital technology, behaviour, participation, assistive technology, dementia, behaviour problems;
Child: Care, Health and Development, 48(1), 2022, pp.55-67.
Publisher:
Wiley
Background: The study aims to investigate the social, emotional, and behavioral challenges in children with a specific learning disability (SLD) and to identify the factors that accompany these problems by screening with the Strengths and Difficulties Questionnaire (SDQ). Methods: The descriptive study was conducted on 278 children with SLD. Strengths and difficulties in children were evaluated by the SDQ applied to their mothers. The percentage of cases above the cut-off limits of the SDQ was calculated. Chi-square test and multiple logistic regression analysis were used for analysis. Results: The mean (SD) total SDQ score was 15.8 (6.5). The percentage of scores of abnormal total difficulties in SLD was 47.8%. Multivariate analysis revealed that cases exposed to antenatal smoking had higher odds ratio of abnormal emotional symptoms and abnormal total difficulties; cases with poor familial income and the presence of a history of antenatal smoking exposure showed considerably higher odds ratio of conduct problems; cases with younger age at the diagnosis of SLD, dyscalculia, extreme duration of preschool screen time (≥4 h), and history of hospitalization had significantly higher odds ratio for hyperactivity–inattention problems; and cases having shorter breastfeeding duration had higher odds ratio of peer problems compared to counterparts. Conclusion: Children with SLD have a high score on the SDQ. Practitioners could especially give guidance and support to families with financial problems and those having a child with an early age at diagnosis, exposure to antenatal smoking, short breastfeeding period, early age of the first screen use, and long screen exposure duration during the preschool period.
(Edited publisher abstract)
Background: The study aims to investigate the social, emotional, and behavioral challenges in children with a specific learning disability (SLD) and to identify the factors that accompany these problems by screening with the Strengths and Difficulties Questionnaire (SDQ). Methods: The descriptive study was conducted on 278 children with SLD. Strengths and difficulties in children were evaluated by the SDQ applied to their mothers. The percentage of cases above the cut-off limits of the SDQ was calculated. Chi-square test and multiple logistic regression analysis were used for analysis. Results: The mean (SD) total SDQ score was 15.8 (6.5). The percentage of scores of abnormal total difficulties in SLD was 47.8%. Multivariate analysis revealed that cases exposed to antenatal smoking had higher odds ratio of abnormal emotional symptoms and abnormal total difficulties; cases with poor familial income and the presence of a history of antenatal smoking exposure showed considerably higher odds ratio of conduct problems; cases with younger age at the diagnosis of SLD, dyscalculia, extreme duration of preschool screen time (≥4 h), and history of hospitalization had significantly higher odds ratio for hyperactivity–inattention problems; and cases having shorter breastfeeding duration had higher odds ratio of peer problems compared to counterparts. Conclusion: Children with SLD have a high score on the SDQ. Practitioners could especially give guidance and support to families with financial problems and those having a child with an early age at diagnosis, exposure to antenatal smoking, short breastfeeding period, early age of the first screen use, and long screen exposure duration during the preschool period.
(Edited publisher abstract)
Background: Although the child welfare field has initiated efforts to use standardized screening for trauma and behavioral health needs, research has rarely examined whether these screenings have influenced permanency outcomes. Objective: Using data from three states' federal demonstration projects, we examined whether receipt of trauma and behavioral health screening and results of screening were associated with placement stability (i.e., fewer placements). Our inquiry focused on whether similar patterns of statistical associations would be observed in three distinct state settings. Participants and setting: Samples comprised children in out-of-home care in three states newly implementing trauma and behavioral health screening. The states included a South Central state, New England state, and a Central Midwestern state. Results: In all three states, findings showed children who received screening had a higher number of placements (i.e., placement instability). Likewise, all three states found that children whose screening results indicated greater need, such as higher number of trauma symptoms or lower behavioral health functioning, were more likely to experience a higher number of placements (i.e., placement instability). Conclusion: Despite differences in screening tools and state-specific approaches, findings suggest that early screenings may provide important information that could be used to identify children's needs, make appropriate service referrals, establish well-matched placements, and support resource parents and birth parents toward better permanency outcomes. Regardless of potential benefits of early screening, it may be underutilized in the field. Future research is needed to replicate these findings and continue to build an evidence base for trauma and behavioral health screening.
(Edited publisher abstract)
Background: Although the child welfare field has initiated efforts to use standardized screening for trauma and behavioral health needs, research has rarely examined whether these screenings have influenced permanency outcomes. Objective: Using data from three states' federal demonstration projects, we examined whether receipt of trauma and behavioral health screening and results of screening were associated with placement stability (i.e., fewer placements). Our inquiry focused on whether similar patterns of statistical associations would be observed in three distinct state settings. Participants and setting: Samples comprised children in out-of-home care in three states newly implementing trauma and behavioral health screening. The states included a South Central state, New England state, and a Central Midwestern state. Results: In all three states, findings showed children who received screening had a higher number of placements (i.e., placement instability). Likewise, all three states found that children whose screening results indicated greater need, such as higher number of trauma symptoms or lower behavioral health functioning, were more likely to experience a higher number of placements (i.e., placement instability). Conclusion: Despite differences in screening tools and state-specific approaches, findings suggest that early screenings may provide important information that could be used to identify children's needs, make appropriate service referrals, establish well-matched placements, and support resource parents and birth parents toward better permanency outcomes. Regardless of potential benefits of early screening, it may be underutilized in the field. Future research is needed to replicate these findings and continue to build an evidence base for trauma and behavioral health screening.
(Edited publisher abstract)