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Background Recent initiatives have emphasized the ongoing need to include children in healthcare research, which is relevant to the development of both paediatric and mental healthcare services. Our aim was to contribute children and their parents' perceptions and experiences of Child and Adolescent Mental Health Services ( CAMHS), with the objective of providing guidance for those wishing to improve inclusivity and empowerment. Method We performed a thematic analysis of interview data taken from 11 children (9 boys, 2 girls, aged 8-12) and their parents (12 mothers, 2 fathers), who had recently been referred to CAMHS for mental health and educational problems. Results Three core themes emerged from the data. Fear of the unknown refers to emotional apprehension due to uncertainty of what happens in CAMHS. However children also provided useful reassurances for future service users. Therapeutic engagement refers to the importance of being listened to and building up good relationships with professionals. Finally making services acceptable was discussed in terms of issues of accessibility, session tolerances and suggestions for the development of child-centred services. Conclusions Children were able to provide potentially useful opinions of CAMHS. In a time of limited resources it is imperative that the voices of children and their parents are acknowledged in order to improve accessibility and experiences within CAMHS. [ABSTRACT FROM AUTHOR]

There is increasing international concern over the rising number of children involved in labour, particularly in developing countries. Despite the multitude of related risk factors, and some evidence on their social needs, there has been limited research on these children's mental health. The aim of this study was to establish the association between labour-related variables and mental health problems among 780 children in labour (aged 9-18 years, mean 15.8) in the Gaza Strip. Measures included a demographic checklist, the Strengths and Difficulties Questionnaire, the Spence Children's Anxiety Scale and the Depression Self-rating Scale for Children. Children came from large families (73.2% had eight or more siblings), mainly worked to increase family income, worked an average 6.8 h per day (range 1-16), and only 37.1% had regular rest. Ratings of mental health problems were predicted by different factors, i.e. total difficulties scores by poor friendship relationships and lack of health insurance; anxiety scores by selling in the streets, working to help family, low family income and lack of health insurance; and depression scores by parents' dissatisfaction with the job and longer working hours. Mental health problems of children in labour are likely to be associated with socio economic determinants, as well as factors related to their under age employment. Policy, legislation and preventive programmes from statutory and voluntary agencies should adopt an integrated approach in meeting their mental health needs, by enhancing protective factors such as return to school. [ABSTRACT FROM AUTHOR]

Background Most children experience some degree of fear during their development. Specific fears are considered as an appropriate response provided that they are proportionate to the intensity of the perceived threat. Our aim is to present the prevalence of specific fears among children in the Great Britain, their socio-demographic correlates, in particular their association with ethnicity. Methods Data on the child's experience of specific fears were obtained from parents of a national representative sample of 5- to 16-year-olds using the Development and Well-Being Assessment. Biographic, socio-demographic and socioeconomic characteristics of the child and the family were included in the questionnaire. Results About one-third of children were assessed by their parents as having at least one of 12 specific fears. The most commonly reported fears were animals (11.6%), blood/injections (10.8%) and the dark (6.3%). Just less than 1% of all children were assessed according to International Classification of Diseases research diagnostic criteria as having a specific phobia. Biographic, socio-demographic and socioeconomic factors were independently associated with a greater likelihood of a child having particular fears. The most marked associations were fears of the dark, loud noises, imagined supernatural beings in younger children and fear of animals among girls and all non-white groups. Conclusions Although fears are only labelled as phobias when they impair functioning and interfere with life, they can cause personal distress to children and also can interfere with their daily activities. Children's fears differ in nature across different ethnic groups. Culturally mediated beliefs, values and traditions may play a role in their expression. [ABSTRACT FROM AUTHOR]

The aim of this study was to establish the medium-term (three-year) psychosocial outcome of children with behavioural problems and their parents, who had received an intervention from a family support service. Forty families were traced at the three-year follow-up and agreed to participate. Pre- and post-intervention and follow-up measures were the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Strengths and Difficulties Questionnaire (SDQ). The primary HoNOSCA outcome items (i.e. those initially targeted by the parenting intervention) of aggression/antisocial behaviour and family relationships were not found to have changed significantly from the baseline (but had not sustained the sort-term improvement following the intervention). Deterioration was found in other HoNOSCA items such as overactivity, self-harm, scholastic/language skills, emotional, and poor school attendance. When we compared pre-intervention with follow-up SDQ scores, there was no significant change on any scales, i.e. these had returned to the level reported at the time of the original referral to the family support service. Following the intervention from a family support service, children and families reported a significant improvement in most outcome measures, predominantly child behaviour and family relationships. However, these improvements were either not sustained or there were additional difficulties at three-year follow-up. These could be related to various external and developmental factors. This lack of sustainable treatment effects for children with behavioural problems is consistent with previous research findings on parenting programmes. [ABSTRACT FROM AUTHOR]

To study the services for pre-school children with behaviour problems in a Midlands city and the level of co-ordination and co-operation between providers. A socially and ethnically diverse Midlands city in the UK. Survey methods were employed with city health visitors in order to determine their role and identify service providers. Service providers from different agencies were interviewed and data collected related to service offered, materials used, theoretical basis of interventions, referrals to and from the service, inclusion and exclusion criteria and co-ordination and co-operation with other providers. Themes were identified related to the content and process of the services using qualitative data analysis methods. Frequencies of themes were estimated for different provider groups. Health visitors and nursery nurses working in the primary care services were the primary point of contact for children with pre-school behaviour problems. Nursery nurses were one of the major sources of referral for children with pre-school behaviour problems and a significant majority of these providers had not received any specific training for this role. The majority of the providers used evidence-based programmes but few adhered strictly to a particular programme and instead used a mixture of materials drawn from different programmes. Many health service providers in particular offered interventions to parents on a one-to-one basis only. Most providers used behaviour modification approaches. While many providers claimed to have knowledge of other local providers and have good links, there was little evidence of co-ordination within and between agencies. While there appears to be high levels of activity by providers from both statutory and voluntary sectors in providing services for pre-school children with behaviour problems, there is evidence to suggest that some of the main providers of services are not being adequately prepared and supported in the role. There is a lack of co-ordination within and between services, and indication that evidence-based programmes are being modified and used in an ad hoc manner. It is concluded that surveys of this nature may be an important preliminary step in establishing co-ordinated services for the primary and secondary prevention of pre-school behaviour problems. [ABSTRACT FROM AUTHOR]

The detection and diagnosis of autism may be delayed until middle childhood, 3-4 years after its onset. This is more likely in high-functioning autism and in cases of co-morbidity with mental retardation. Such delays have serious effects on children and their families as well as on the provision of clinical and educational resources. In addition to greater awareness among professionals and to the development of comprehensive services, early detection could be facilitated by screening for early signs and symptoms of autism. The instruments that have been developed to rate autistic behaviours, particularly in pre-school children, are reviewed in this paper. Although the majority of these observational or informant-based measures were not initially designed for screening purposes, previous research findings from their application could be useful in the future development of such a screening instrument. Relevant research findings are discussed and suggestions are made for further evaluation in appropriate populations. [ABSTRACT FROM AUTHOR]