Research conducted over the past several decades has shown that overt inter- parental conflict to which children are exposed has a greater impact on child distress than covert conflict to which children are not exposed (see Cummings & Davies [2, 49]). This finding has led researchers to consider a second set of hypotheses that focus on the underlying psychological processes engendered in children who live in households marked by hostile inter-parental relations. Three primary theoretical perspectives have emerged that emphasise the importance of children’s own understanding, interpretation, and expectations pertaining to parental behaviour when explaining the effects of inter-parental conflict on children’s psychological development. Grych and Fincham (1990), in their cognitive-contextual framework, propose that the specific beliefs and attributions children assign to their parents’ relationship arguments account for effects on well-being . Davies and Cummings (1994) emphasise the importance of attachment processes and highlight the role of children’s emotional insecurity in the context of inter-parental conflict, beyond that of the more traditional focus on the mother–child relationship, as a factor in explaining negative effects on psychological outcomes . Harold and Conger (1997) offer an integrative theoretical model and propose that the specific attributions that children assign to conflict occurring between their parents affect the expectations they have for how parents (mothers and fathers) engage or behave towards them (mother–child, father–child conflict), which in turn affects their psychological outcomes .
For the purposes of this realist review, ‘early years’ will be defined as pre-conception to 5 years of age. The definition of wellbeing will be drawn from the SHANARRI indica- tors , devised by the Scottish Government to encom- pass eight domains of wellbeing: safe, healthy, achieving, nurtured, active, respected, responsible and included. In- clusive of the social, physical and emotional aspects of wellbeing, the SHANARRI indicators are evidence-based  and are therefore generalizable to other jurisdictions with similar aspirations for children. The definition of health used here includes physical health but also includes mental health and wellbeing and the social determinants of health . Accordingly, health inequalities are viewed as differences in health or health outcomes between differ- ent population groups or across the social gradient ; here they are defined (i) in relation to immediate negative health outcomes such as low birth weight and (ii) in terms of exposure to socio-economic risk factors—such as pov- erty or parental drug or alcohol misuse—that increase the possibility of or prolong poor health outcomes in the short, medium and long term [8, 36]. Evaluations of both universal services (available to all, regardless of need) and targeted programmes (based on need) will be included: large-scale or small-scale, including pre- and postnatal, in- terventions and programmes directed at infants and chil- dren and/or their parents/families/carers. All settings and contexts will be considered for inclusion, including but not limited to clinical, centre-based, home-based, early years educational settings and community settings. In contrast to traditional systematic reviews, this review will cross discipline and policy boundaries, drawing evidence from a broad range of international sources, and will in- clude empirical, theoretical and experiential data. Areas of interest will include but not be limited to maternal and pre-natal/infant/child health, social care, early years edu- cation, child protection, social inclusion and public health.
Results: On the basis of current evidence that takes into account whether outcomes are blinded, behavioural intervention cannot be supported as a front-line treatment for core ADHD symptoms. There is however, evidence from measures that are probably blinded that these interventions benefit parenting practices and improve conduct problems which commonly co-occur with ADHD, and are often the main reason for referral. Initial positive results have also been found in relation to parental knowledge, children’s emotional, social and academic functioning – although most studies have not used blinded outcomes. Generic as well as specialised ADHD parent training approaches - delivered either individually or in groups – have reported beneficial effects. High quality training, supervision of therapists and practice with the child, may improveoutcomes but further evidence is required. Evidence for who benefits the most from behavioural interventions is scant. There is no evidence to limit behavioural treatments to parents with parenting difficulties or children with conduct problems. There are positive effects of additive school based intervention for the inattentive subtype. Targeting parental depression may enhance the effects of behavioural interventions.
Beyond this issue about the existing evidence base, there are a number of questions that might be asked about the GLM. Are the primary human goods as universally pursued as the model suggests? How can practitioners manage the deep tensions that exist in contemporary societies around diverse views of what constitutes the good life and the conflicts that arise in the pursuit of very different versions of that life within communities? Do all of those offenders with whom social workers engage require the holistic reconstruction of the self that the thoroughgoing revision of a good lives plan seems to suggest? Might less intensive interventions suffice in many cases? That said, there is no reason why the GLM would not allow for varying degrees of reconstruction and revision and indeed its emphasis on tailored intervention might require this. Does the GLM perhaps underplay the extent to which criminogenic social contexts (and limited life opportunities) might make a ‘criminal’ good lives plan logical and functional from the offender’s point of view. Finally, might a sharper focus on the importance of interventions around the familial and social contexts of offending and desistance, and on work to develop legitimate opportunities (or licit social capital – see below) also be required?
3. Lindsay, G., Dockrell, J.E., Law, J., & Roulstone, S. (2011) Better communication research programme 2nd interim report. DFE-RR 172. London: DfE. (131pp). https://www.education.gov.uk/publications/eOrderingDownload/DFE-RR172.pdf This report presents interim findings of the project that had been underway between July 2010 – January 2011. Further work is reported from analyses of the national pupil data sets examining development and transitions of pupils with SLCN or ASD between categories of special educational needs, the prospective study, and parents’ preferred outcomes (an online survey). In addition, interim reports from new projects include: the initial phase of development of a Communication Supporting Classrooms Tool; a survey of speech and language therapists’ practice regarding interventions; a study of language and literacy attainment during the early years through Key Stage 2, examining whether teacher
The program was conducted by the Memphis/Shelby County Health Department. The nurses completed a mean of 7 home visits (range: 0 –18) during pregnancy (same mean number of prenatal visits for groups 1 and 2) and 26 home visits (range: 0 –71) during the first 2 years postpartum. They followed detailed visit-by-visit guidelines in their efforts to (1) improve the outcomes of pregnancy by promoting women’s healthy prenatal be- haviors; (2) improve the health and development of the child by promoting parents’ competent care of their children; and (3) enhance parents’ life-course develop- ment by encouraging parents to plan subsequent preg- nancies, complete their education, and find work. The nurses helped families make use of needed health and human services and attempted to involve other family members and friends (particularly the children’s fathers and grandmothers) in the pregnancy, birth, and early care of the child. Program protocols were grounded in epidemiology and theories of human ecology, human attachment, and self-efficacy. 7,14
This project was carried out by ROWA! (Read On – Write Away!), a literacy initiative funded by Derbyshire County Council, in 2008–09. The project worked with 15 families of Y6 children who were due to transfer to Y7 in September 2009. They all came from one primary school; 13 transferred to one secondary school, and the other two to a different secondary. The Y6 children were identified from the full cohort at their primary school, through consultation between their teachers and the county’s educational psychologist, as being liable to suffer educational disruption at transition. Self-rating data also showed they were markedly less confident than their peers. They were paired with Y8 pupils of the first secondary school, and met and worked with them on a variety of activities from January to October 2009. They were dubbed ‘researchers’ and given the task of collecting information on the secondary school by exploring and investigating it. They wrote and presented reports on what they had found. In the intervening summer the Y6 and Y8 pupils made two joint library visits, one about ICT, the other about poetry. The Y8 pupils were mainly from the secondary’s Gifted and Talented group. They had to submit a formal written application, with references, to become mentors, and were interviewed, selected and trained for the job.
The Nuffield Dyspraxia Programme (Williams & Stephens, 2004) is designed to meet the needs of children with severe speech disorders and specifically those with significant difficulty with motor programs/programming and motor planning stages of the speech processing model (referred to as developmental verbal dyspraxia in the UK and childhood apraxia of speech in the US). The programme focuses on building up articulatory skills, in small graded steps, through frequent systematic practice. It uses a motor skills learning approach and sees articulation as a complex hierarchical motor skill. Skills are established by means of frequent repetition elicited by cues and reinforced or modified with the support of specific feedback. The focus is on establishing a full set of motor programs supporting the development of a full range of psycholinguistic processing skills. Phonological contrasts are also taught and work on input (phonological discrimination) is taught as necessary.
IInnovative teaching methods to address emerging practice needs are critical components of effective occupational therapy education. Experiential learning strategies can enhance skill development and translation of knowledge into OT clinical practice. In addition, skills such as coaching may provide important links to health promotion practices. Thirty-two occupational therapy students took part in an experiential project to connect occupational engagement and health for a community of older adults. A pretest/posttest design was used to evaluate program outcomes in student perceived abilities, and narrative reflection papers provided postexperience qualitative information. The students improved in all 10 areas of abilities self-assessment with mean total scores from pretest (M = 42) improving significantly at posttest (M = 58). Themes from reflection papers indicated a positive response to experiential learning and a desire for more opportunities to prepare for clinical practice, including the use of interprofessional training. The students improved in their abilities to use coaching and health promotion strategies through the use of experiential learning methods. Outcomes suggest that experiential learning opportunities are an effective way to enhance student competencies in coaching, improve readiness for wellness
With regard to parental expressiveness of positive emotion, the above statement must be qualified. That is, studies examining parental expressions of positive emotions sample very different populations, as demonstrated by the significant heterogeneity statistic (compare, for example, Cassidy, et al., 1992 and Berenbaum & James, 1994). These methodological issues in and of themselves attest to the diversity in opinions as to what constitutes expressiveness of positive emotions. One such source of diversity may have to do with differential determinations between trait and state. As an example, researchers may be making faulty assumptions as to when a parent is “happy” versus when they are highly expressive of positive emotions. Similarly, a parent may be angry in a particular situation rather than consistently expressive of negative-dominant
later, Kornhaber (1996) himself acknowledged that these new social contracts may not be as prominent as he had previously argued. Troll (1985) argues that the significance and meaning that grandpar- ents attach to grandparenthood is contingent on the circumstances of the grandparent. Factors she forwards as influencing the significance of the role include grandparents’ personality, health and employment status, the timing of entry into the grandparental role in the life of the grandparent and family characteristics. She argues that these vari- ables interact to influence the importance of grandparenthood in the life of the grandparent. Neugarten and Weinstein (1964) qualitative study also concluded that the significance of grandparenthood differs among grandparents. Among their sample of 70 sets of middle-class American grandparents (46 maternal, 25 paternal), there were some who intimated that grandparenthood had had little effect on them and others who ascribed great importance to the role. Those in the latter group said it provided emotional self-fulfilment, a vindication of one’s life history and represented biological renewal and family continuity. Some believed grandparenthood provided them with the opportunity to rectify mistakes made as a parent and to be a better grandparent than parent. Others hoped to accomplish life achieve- ments vicariously through their grandchildren, to compensate for past lack of opportunities for themselves or their children. Peterson (1999), in an Australian study of 146 grandparents, cited biological renewal of the generations, sharing in the activities of grandchildren and watching their development as aspects of emotional fulfilment associated with grandparenthood.
relationships with providers and careers advisers who were well integrated, but they recognised the potential pitfalls of this. Whilst other schools and all colleges employed their own careers adviser. Gatsby argues that there is no clear evidence which points to one model being better than another. There are potential pitfalls with both approaches, but we observed that schools with an external adviser needed to attend more carefully to the integration of this adviser into the wider programme. Conversely, those that utilised an internal careers adviser needed to ensure that the advisers’ professionalism and impartiality were respected.
(A talk) brings a further dimension. I think it adds so much more. Because I used to teach employability skills and you can stand up in front a group and tell them things about careers or about employability skills and they don't really take notice. But you get someone from outside and they really take notice, it makes them really think about what skills they've got and how they can show them off, especially if the employer asks tough questions. I also think when you get a guest speaker in it makes young people think "hang on a minute she's (my usual teacher) been talking about this all year, maybe it's time I pay attention a bit to what she's said.” Someone has come in and backed her up. Careers advisor, Further Education College – Oxfordshire 12
Careers in the curriculum has been found to have a small but significant impact, espe- cially on young people’s personal effectiveness and career readiness. While the effect sizes are typically modest, the inputs that are being measured are often quite small as well. This means that cost effectiveness is generally good although further cost-benefit analyses would be valuable. We also believe that careers in the curriculum has the poten- tial to have a bigger impact on young people’s educational outcomes if the quality and consistency of interventions can be raised and more robust studies were commissioned to measure this.
At the heart of our ability to do this is our commitment to listening to and developing the evidence base. It is only by being clear about whatworks in careers and enterprise that we are able to ensure that what we do will make a difference to young people.
The Pediatric Health Information System (PHIS) database case-mix indices, particularly the associated expected charges and expected LOS, were used to account for potential differences in hospital charges and LOS that might result from variation in patient severity. Adjustment consisted of revising the preintervention results to coincide with what they would have been, had the case-mix been the same as the postintervention. The initial (January 2011–May 2012) average values of charges and LOS were adjusted downward (because postintervention case- mix was less severe) by the same percentage as the reductions in the corresponding average PHIS expected charges and LOS. 24 The
Parental conflict has been identified as a key mediating variable in producing negative outcomes in children, including those in intact families (Smith and Jenkins, 1991). Parental conflict may be a continuing feature of family life post-separation, as well as in intact families. Research comparing intact families experiencing high levels of conflict with lone parent families, found that children fared less well in intact families (Booth and Edwards, 1990; Slater and Haber, 1984, cited in Rodgers and Pryor, 1998), demonstrating that family functioning has a greater impact than family structure (McFarlane, Bellissimo and Norman, 1995) or divorce (Amato and Keith, 1991) in contributing to child outcomes. Indeed, research by Hanson (1999) found that 75 per cent of couples experiencing high levels of conflict chose not to separate. The consequences of impaired family functioning for children, regardless of family structure, should therefore not be ignored. However, research also indicates the importance of identifying persistent and unresolved conflict, rather than conflict per se, as having a negative impact on children, particularly when children witness domestic violence or where they feel ‘caught in the middle’ (Kelly, 1993 cited in Rodgers and Pryor, 1998).
Reviews of research have shown that effectiveness is associated with the level of involvement of a leader in all stages of programme delivery and in overseeing implementation. Organisational barriers are equally well recognised as problematic. Gendreau (1996) found that programme integrity can be under- mined by what he called the ‘MBA management syndrome’ – generalist managers who may be very capable of effective management but who have little or insufficient knowledge about intervention with young people who offend to know if staff are planning and implementing programmes with integrity. At the same time programmes can be viewed by managers as ‘bolt-on’ activities peripheral to mainstream service provi- sion and activity. Programmes must be located within mainstream strategic planning for children, young people and families as part of social inclusion provision. Lipsey’s review demonstrated that the important characteristics of effective programmes ‘were not fully embedded in the nature of the intervention … but were part of the administrative context for the intervention … Effective intervention, therefore, requires more than a ‘magic bullet’ program(me) concept – it also depends on a good match between program(me) concept, host organisation, and the clientele targeted (Lipsey & Wilson 1998: 331). A high level of organi- sational commitment is essential to ensure adequate resources, the availability of skilled staff, interventions directed by well structured plans and explicit procedures for monitoring and evaluation.
Understanding the definition and diagnosis of CP is an important concept for individuals with CP, their families, and health care professionals to grasp, as it is a diverse health condition. Several classification schemes for CP have been adopted in general practice to aid in this process. There are two general types of classification systems that individuals should be aware of: non-functional and functional. The next section provides a more complete understanding of these two types of classification systems, focusing primarily on the benefits and relationships among functional classification systems. The next section begins with a further description of cerebral palsy and elaborates upon the utility of the ICF with respect to a focus on function.