Search

Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey ( N = 7,977). Use of social services was significantly higher by children with CD than emotional disorders (ED) in the absence of co-morbidity, while use of specialist child mental health and paediatric was significantly higher by children with hyperkinetic disorders (HD) than CD. Children who had comorbid physical disorders used more primary healthcare services compared to those without physical disorders. Utilization of specialist child mental heath and social services was significantly higher among children with unsocialized CD than socialized CD and oppositional defiant disorders. Services utilization and its correlates varied with the type of service. Overall, specialist services use was associated with co-morbidity with learning disabilities, physical and psychiatric disorders. Several correlates of services use in CD appeared non-specific, i.e. associated with use of different services indicating the possibility of indiscriminate use of different types of services. The findings led to the conclusion that there is the need for effective organization and co-ordination of services, and clear care pathways. Involvement of specialist child mental health services should be requested in the presence of mental health co-morbidity. [ABSTRACT FROM AUTHOR]

Panos Vostanis, Guv Bassi, Howard Meltzer, Tamsin Ford and Robert Goodman examine data from the England survey on the use of services by looked after children with behavioural problems (or conduct disorders -- CD). Of the total 1,039 looked after children who participated, 384 (37%) fulfilled criteria for CD, of whom 57 (or 17% of children with CD) had an additional hyperkinetic and 46 (or 12% of the CD group) an additional emotional disorder. Children had high rates of multiple and overlapping contacts with social care, health, education and youth justice services. Children with additional emotional and hyperkinetic disorders had particularly high rates of contact with primary care, specialist child and adolescent mental health services (CAMHS), child health and special educational services. In conclusion, looked after children and young people with behavioural problems are likely to require access to a range of services, but these should be clearly defined and co-ordinated, with local care pathways and referral criteria, in order to maximise the use of resources. Although CAMHS involvement should not automatically be requested for all behavioural problems, looked after children with underlying mental health or developmental disorders would particularly benefit from specialist CAMHS input. [ABSTRACT FROM AUTHOR]

Children with behavioural problems are often referred to child mental health services without rationalization of criteria or referral routes. The aims of the present study were to establish the psychosocial characteristics of children with behavioural problems referred to a tertiary Day Resource, and to compare these with children referred for similar problems to a specialist outpatient child mental health service and a family support community service. Demographic data, the Strengths and Difficulties Questionnaire and the Health of the Nations Outcome scales for Children and Adolescents were used. Families attending the Day Resource were found to have more involvement with other agencies, and children showed higher levels of clinical severity and complexity. Most of this difference was accounted for by attentional difficulties, as well as communication and physical health problems. These findings confirmed the hypothesis that families seen at tertiary service level presented with more complex psychosocial needs and frequent child comorbidity, thereby justifying the multimodal treatment package developed at that service level. It is concluded that there is a need for this level of parenting interventions, but only for complex cases that have not responded to community interventions. [ABSTRACT FROM AUTHOR]

Background: There has been little reported research into the effect of war on the behaviour and emotional well-being of pre-school children.Aims: To investigate the relationship between exposure to war trauma and behavioural and emotional problems among pre-school children.Method: A total of 309 children aged 3-6 years were selected from kindergartens in the Gaza Strip, and were assessed by parental reports in regard to their exposure to war trauma, using the Gaza Traumatic Checklist, and their behavioural and emotional problems, using the Behaviour Checklist (BCL) and the Strengths and Difficulties Questionnaire (SDQ).Results: Pre-school children were exposed to a wide range of traumatic events. The total number of traumatic events independently predicted total BCL and SDQ scores. Exposure to day raids and shelling of the children's houses by tanks were significantly associated with total behavioural and emotional problems scores.Conclusions: Direct and non-direct exposure to war trauma increases the risk of behavioural and emotional problems among pre-school children, which may present as non-specific psychopathology. [ABSTRACT FROM AUTHOR]

The aim of this study was to establish the perceptions of children and their parents following a Family Support intervention for child behavioural and related difficulties. One hundred parents and 22 children aged 5-12 years participated in structured interviews, following the intervention. A framework approach to thematic content analysis was used. Themes, categories and subcategories were established. Parents discussed the usefulness of the intervention and the service in relation to therapeutic work (behavioural techniques and advice), support, practical help, and liaison with other agencies. They also identified service gaps. A number of factors were identified as responsible for improvement, both directly arising from and independently of the intervention. Despite their young age, children had good understanding of the interventions and their role in them, and expressed their wish for active involvement. The intervention was underpinned by a solution-focused therapy model, combined with behavioural techniques. Families' perceptions indicate that they predominantly applied behavioural strategies, while some parents and children generated solutions in other areas of their lives. Family support has an important preventive role and should consist of an integral component of inter-agency services for children with a broad range of behavioural and emotional difficulties and their families, and have close links with child mental health services. [ABSTRACT FROM AUTHOR]

Background Children with conduct disorders and their families come into contact with a range of community and specialist agencies. Methods The aim of this study was to establish the lifetime service utilisation rates among children with conduct disorders from the Great Britain National Study (N = 10,438), and to examine the association between comorbid disorders, family and social factors, and service utilisation. The Development and Well-Being Assessment, a service checklist, and a battery of family and social functioning measures were used. Results The weighted prevalence of oppositional and conduct disorders was 5.4 %. Within this group (N =403), 241 (59.8%) had conduct disorder only 79 (19.6%) comorbid emotional, 72 (17.9%) comorbid hyperkinetic, and 11(2.7%) comorbid emotional and hyperkinetic disorders. These subgroups were compared on service utilisation with children with other psychiatric disorders (N=351). Children with conduct disorders had significantly higher lifetime rates of utilisation of social and educational services than children with other psychiatric disorders. Contact with primary health, specialist health, and educational services was significantly associated with comorbid physical and psychiatric disorders. In contrast, contact with social services was associated with family discord and social sector tenancy. Conclusions The findings are discussed in the context of organisation and coordination of health, other statutory, and non-statutory services, also taking into account previous research on interventions for children with conduct disorders and their families. [ABSTRACT FROM AUTHOR]

The Family Environment Scale (FES) was completed by parents of 30 children with conduct disorders (CD), 30 children with emotional disorders (ED), and 30 well-functioning controls. Parents were also interviewed and rated for Expressed Emotion (EE), and mothers completed the Child Behaviour Checklist (CBCL). Clinical families had significantly lower ratings of Cohesion, Expressiveness, Intellectual- Cultural and Active-Recreational Orientation. These differences were not specific to either diagnostic group. Maternal Criticism was associated with reported conflict in the CD group. The EE scales of Criticism and Warmth (absence of warmth) were correlated with child behaviour ratings in the CD group, in contrast with FES sub-scales. Maternal scores of Cohesion were significantly associated with social competence in the ED and the control group. Maternal ratings of Conflict predicted dropping-out of treatment (CD group), and ratings of Cohesion and Control had some value in predicting clinical Outcome. The implications for the future use of the Family Environment Scale and other self-rated measures of family functioning are discussed. [ABSTRACT FROM AUTHOR]