The effects of the Newborn Behavioral Observations (NBO) system in early intervention: A multisite randomized controlled trial.

The purpose of this pilot study was to evaluate the effect of an infant mental health intervention, the Newborn Behavioral Observations system (NBO), versus usual care (UC) on infant neurodevelopment and maternal depressive symptoms in early intervention (EI). This multisite randomized trial enrolled newborns into the NBO (n = 16) or UC group (n = 22) and followed them for 6 months. Outcome measures included the Battelle Developmental Inventory (BDI-2), Bayley Scales of Infants Development (BSID-III), and Center for Epidemiologic Studies Depression Scale (CES-D). The CES-D and BSID-III were collected at 3- and 6-months post EI entry and the BDI-2 was collected at EI entry and 6-months post-EI entry. We estimated group differences [95% CI], adjusting for program characteristics. At 6 months, the NBO group had greater gains in Communication (b = 1.0 [0.2, 1.8]), Self-Care (b = 2.0 [0.1, 3.9]), Perception and Concepts (b = 2.0 [0.4, 3.6]), and Attention and Memory (b = 3.0 [0.4, 6.0]) than the UC group. The NBO group also had greater decline in maternal postnatal depressive symptoms (b = -2.0 [-3.7, -0.3]) than the UC group. Infants receiving the NBO infant mental health intervention had greater gains in cognitive and adaptive functions at 6 months than infants receiving UC. Caregivers receiving NBO care had greater improvements in maternal depressive symptoms than caregivers receiving UC.

El propósito de este estudio piloto fue evaluar el efecto que una intervención de salud mental infantil, el sistema de Observación de Comportamiento del Recién Nacido (NBO), versus el cuidado usual (UC), tiene en el desarrollo neurológico del infante y los síntomas de depresión materna en la Temprana Intervención (EI). Este ensayo al azar de múltiples lugares inscribió a recién nacidos en el NBO (n = 16) o en el grupo UC (n = 22) y les dio seguimiento por 6 meses. Las medidas de los resultados incluyeron el Inventario Battelle del Desarrollo (BDI-2), las Escalas Bayley del Desarrollo de Infantes (BSID-III), y la Escala de Depresión del Centro para Estudios Epidemiológicos (CES-D). El CES-D y BSID-III fueron implementados a los 3 y 6 meses posteriores a la entrada en EI y el BDI-2 fue implementado al momento de entrar en EI y a los 6 meses posteriores a dicha entrada. Estimamos las diferencias de grupos [95% CI], con ajustes en cuanto a características del programa. A los 6 meses, el grupo NBO presentaba mayores logros en Comunicación (b = 1.0 [0.2, 1.8]), Autocuidado (b = 2.0 [0.1, 3.9]), Percepción y Conceptos (b = 2.0 [0.4, 3.6]) y Atención y Memoria (b = 3.0 [0.4, 6.0]) que el grupo de UC. El grupo NBO también tuvo una mayor baja en síntomas maternos depresivos postnatales (b = 2.0 [-3.7, -0.3]) que el grupo UC. Los infantes que recibían la intervención NBO tuvieron mayores logros en la función cognitiva y adaptiva a los 6 meses que los infantes del grupo UC. Aquellos cuidadores que recibían el cuidado NBO presentaron mejoras significativamente mayores en síntomas depresivos maternos que los cuidadores del grupo UC.

Le but de cette étude pilote était d'évaluer l'effet d'une intervention en santé mentale du nourrisson, le système d'Observation Comportementale du Nourrisson (en anglais, Newborn Behavioral Observation system, soit NBO utilisé ici dans ce texte), par rapport aux soins ordinaires (ici abbrégé SI) sur le neurodéveloppement du nourrisson et les symptômes dépressifs maternels dans l'Intervention Précoce (IP). Cet essai randomisé effectué sur plusieurs sites a concerné des nouveaux-nés dans le NBO (n = 16) ou le groupe SI (n = 22) et les a suivis pendant 6 mois. Les mesures de résultat ont inclus l'Inventaire du Développement de Battelle (BDI-2), les Echelles Bayley de Développement des Nourrissons (BSID-III) et les Echelles de Dépression du Centre d'Etudes Epidémiologiques (CES-D). Les CES-D et BSID-III ont été faites à 3 et à 6 mois après l'entrée en IP et la BDI-2 a été faite à l'entrée en IP et à 6 mois après l'entrée en IP. Nous avons estimé les différences de groupe [95% CI), en faisant des ajustements pour les caractéristiques du programme. A six mois, le groupe NBO avait fait de plus grands gains en Communication (b = 1,0 [0,2, 1,8]), Autosoin (b = 2,0 [0,1, 3,9]), Perception & Concepts (b = 2,0 [0,4, 3,6]), et Attention & Mémoire (b = 3,0 [0,4, 6,0]) que le groupe SI. Le groupe NBO a également vu le plus grand déclin dans les symptômes dépressifs postnatals maternels (b = -2,0 [-3,7, -0,3]) par rapport au groupe SI. Les nourrissons recevant l'intervention NBO ont fait preuve de plus grands gains dans la fonction cognitive et adaptive à 6 mois, par rapport aux nourrissons SI. Les personnes prenant soin des enfants et recevant le soin NBO ont témoigné d'améliorations plus importantes dans les symptômes dépressifs maternels que le groupe SI.

Impact of physical and psychosocial dysfunction on return to work in survivors of oral cavity cancer.

OBJECTIVE: To compare the levels of social support, physical function, and social-emotional function between oral cavity cancer survivors who did or did not resume work 6 months or longer after treatment completion. METHODS: This cross-sectional study examined survivors of oral cavity cancer who were treated at the outpatient radiation department of a medical center in Northern Taiwan. Questionnaires were used to collect data regarding perceived social support, physical function, social-emotional function, and return to work status after treatment. Logistic regression was conducted to determine factors related to returning to work. RESULTS: We examined 174 survivors of oral cavity cancer, 55.2% of whom returned to work after treatment. Relative to survivors who returned to work, those who did not return to work reported needing greater tangible social support, having fewer positive social interactions, having poorer physical function, and having poorer social-emotional function. Multivariable analysis indicated that younger age (OR = 0.864, P < .05), higher family income (OR = 10.835, P < .05), sufficient tangible social support (OR = 0.943, P < .05), positive social interaction (OR = 1.025, P < .05), and better physical function (OR = 1.062, P < .05) were significantly associated with the return to work. CONCLUSIONS: Survivors of oral cavity cancer who did not return to work had worse physical and social-emotional function and required more tangible social support and positive social interactions. Providing occupational rehabilitation and counseling for oral cavity cancer survivors may help them return to work.

Pervasive influence of maternal and paternal criminal offending on early childhood development: a population data linkage study.

BACKGROUND: Parental criminal offending is an established risk factor for offending among offspring, but little evidence is available indicating the impact of offending on early childhood functioning. We used data from a large Australian population cohort to determine associations between exposure to parental offending and a range of developmental outcomes at age 5 years. METHOD: Multi-generation data in 66 477 children and their parents from the New South Wales Child Development Study were combined using data linkage. Logistic and multinomial regressions tested associations between any and violent offending histories of parents (fathers, mothers, or both parents) obtained from official records, and multiple measures of early childhood developmental functioning (social, emotional-behavioural, cognitive, communication and physical domains) obtained from the teacher-reported 2009 Australian Early Development Census. RESULTS: Parental offending conferred significantly increased risk of vulnerability on all domains, particularly the cognitive domain. Greater risk magnitudes were observed for offending by both parents and by mothers than by fathers, and for violent than for any offending. For all parental offending exposures, vulnerability on multiple domains (where medium to large effects were observed) was more likely than on a single domain (small to medium effects). Relationships remained significant and of comparable magnitude following adjustment for sociodemographic covariates. CONCLUSIONS: The effect of parental offending on early childhood developmental outcomes is pervasive, with the strongest effects on functioning apparent when both parents engage in violent offending. Supporting affected families in early childhood might mitigate both early developmental vulnerability and the propensity for later delinquency among these offspring.

The 2015 Middle Childhood Survey (MCS) of mental health and well-being at age 11 years in an Australian population cohort.

PURPOSE: The Middle Childhood Survey (MCS) was designed as a computerised self-report assessment of children's mental health and well-being at approximately 11 years of age, conducted with a population cohort of 87 026 children being studied longitudinally within the New South Wales (NSW) Child Development Study. PARTICIPANTS: School Principals provided written consent for teachers to administer the MCS in class to year 6 students at 829 NSW schools (35.0% of eligible schools). Parent or child opt-outs from participation were received for 4.3% of children, and MCS data obtained from 27 808 children (mean age 11.5 years, SD 0.5; 49.5% female), representing 85.9% of students at participating schools. FINDINGS TO DATE: Demographic characteristics of participating schools and children are representative of the NSW population. Children completed items measuring Social Integration, Prosocial Behaviour, Peer Relationship Problems, Supportive Relationships (at Home, School and in the Community), Empathy, Emotional Symptoms, Conduct Problems, Aggression, Attention, Inhibitory Control, Hyperactivity-Inattention, Total Difficulties (internalising and externalising psychopathology), Perceptual Sensitivity, Psychotic-Like Experiences, Personality, Self-esteem, Daytime Sleepiness and Connection to Nature. Distributions of responses on each item and construct demarcate competencies and vulnerabilities within the population: most children report mental health and well-being, but the population distribution spanned the full range of possible scores on every construct. FUTURE PLANS: Multiagency, intergenerational linkage of the MCS data with health, education, child protection, justice and early childhood development records took place late in 2016. Linked data were used to elucidate patterns of risk and protection across early and middle child development, and these data will provide a foundation for future record linkages in the cohort that will track mental and physical health, social and educational/occupational outcomes into adolescence and early adulthood.