Review: Improving access to mental health interventions for children from birth to five years: A Scoping Review.

BACKGROUND: In spite of infants and children aged 0-5 years experiencing mental health difficulties being estimated to be in the range of 6%-18% globally, the mental health care needs for this age group are often overlooked in the design of specialist mental health services. Although there is increasing recognition of the importance of infant mental health services and treatments for younger children, access remains a barrier. Mental health services specifically designed for children 0-5 years are vital; however, little is known about how these services ensure access for infants at risk of mental health difficulties and their families. This scoping review seeks to address this knowledge gap. METHODS: A scoping review methodology framework was used to search for relevant articles published between January 2000 and July 2021, identified using five databases: MEDLINE, CINAHL, PsycINFO, SocIndex and Web of Science. The selection of studies was based on empirical research about access to infant mental health services and models of care. A total of 28 relevant articles met the eligibility criteria for inclusion in this review. RESULTS: Findings can be summarised under five broad themes: (1) accessibility for at-risk populations (2) the importance of early detection of infants in need of mental health services and interventions; (3) the promotion of culturally responsive services and interventions; (4) ensuring the sustainability of IMH services and programs and (5) the integration of innovative interventions to improve existing practice models. CONCLUSIONS: The findings from this scoping review highlight barriers to access and provision of infant mental health services. Future infant mental health service design, informed by research, is needed to improve access for infants and young children with mental health difficulties and their families.

Pathways to participation in gymnastics for children with disability.

PURPOSE: To understand the pathways of children with disability participating in gymnastics in Victoria, Australia. MATERIALS AND METHODS: A sequential explanatory mixed-method study design was used. Participants completed an online survey, with selected participants purposively invited to undertake semi-structured interviews via videoconference. Quantitative survey data was analysed using descriptive statistics with preliminary findings informing the invitation of interview participants and refinement of interview questions. Qualitative survey and interview data were analysed together using thematic analysis to create themes. Data was combined to create a conceptual model. RESULTS: Fifty-eight parents consented to participate in the study with eight interviews conducted. Key themes were: (1) Tailored, accessible, supportive environments and programs make a difference, (2) An explicitly inclusive club culture helps young people get and stay involved, (3) Coach knowledge about engaging children with disability is valued, (4) Enjoyment, recognition, and achievement facilitate ongoing participation, and (5) Gymnastics has physical and social benefits for children with disability. The findings inform a conceptual model that describes three key stages along a pathway to participation including; choosing gymnastics as a sport, selecting a club, and ongoing participation. CONCLUSION: To our knowledge, this is the first study to explore participation of children with disability in gymnastics in Australia. These findings provide guidance to those supporting children with disability to participate in gymnastics (e.g., policy makers, club owners, coaches, and allied health professionals) regarding creating more inclusive environments and experiences at each stage of participation.

This study furthers our understanding of the impact of childhood disability on participation in sport and recreation, with a focus on gymnastics.A combination of accessible environments, inclusive club cultures, recognition and enjoyment, and knowledgeable coaches facilitated participation in gymnastics.Parents perceive gymnastics to have physical and social benefits for their child.A conceptual model has been developed based on the findings to support gymnastics clubs and assist rehabilitation professionals to understand the challenges and enablers to participating in gymnastics.

Mapping the focus of research conducted with adults with cerebral palsy: an overview of systematic reviews.

PURPOSE: To map research conducted with adults with cerebral palsy (CP) to the International Classification of Functioning, Disability and Health (ICF) to understand the array of research available, identify key clinical messages and inform future research. MATERIALS AND METHODS: An overview of systematic reviews was conducted. Comprehensive searches (to December 2021) were conducted in PsycINFO, Web of Science, MEDLINE, CINAHL, Cochrane, JBI, and EMBASE. Eligible studies were systematic reviews that included primary studies of adults with CP. Included reviews were assessed for study quality and mapped to the ICF components and chapters. A narrative synthesis of commonly reported outcomes within the component/s and chapter/s was conducted. RESULTS: All 24 included reviews were published since 2010. Thirteen focused on body functions: movement related functions and cardiovascular and respiratory systems. Although nine reviews focused on gait and mobility, considerable overlap of included studies limited the volume of evidence and variability in review quality limited generalisability of findings. CONCLUSIONS: Research involving adults with CP is growing; however, this overview of reviews found a predominant focus on mobility and gait. Future research, informed by consumer priorities, is needed to address a broader range of key health and participation outcomes.Implications for rehabilitationFitness, mobility, and gait were the most common research topics found in these systematic reviews suggesting a narrow research focus in adults with CP.There are significant gaps in our knowledge to inform clinical messages for practice about broad long-term outcomes of CP and how best to support their activity performance and participation.There is very limited evidence with which to guide and support rehabilitation professionals working in this field.

Australian parent and sibling perspectives on the impact of paediatric acquired brain injury on family relationships during the first 6 weeks at home.

This study explores the impact of paediatric acquired brain injury (ABI) on family relationships. Twenty-three families (n = 18 mothers, n = 7 fathers, and n = 4 siblings) of children who sustained an ABI requiring treatment from inpatient acute and rehabilitation services reported on their perceptions regarding changes in family relationships since the injured child's return home. Thematic analysis of survey data was conducted. Family members (parents and siblings) described four themes: (1) negative changes in sibling interactions; (2) role changes arising from an increase in parental expectations of non-injured siblings; (3) family system challenges in balancing needs within the parent-child dyad and sibling subsystems; and (4) supporting emotional responses within the family system. Findings reveal a critical time for families as they resume full care of the injured child at home. Clinical implications for social workers and other rehabilitation clinicians are explored.

When co-design works (sort of): the case of the Australian elder abuse screening instrument.

Applying co-design methodologies is increasingly recommended for engaging diverse end-users and bridging evidence-practice gaps. Yet, one of the ongoing challenges for research using co-design is the lack of evidence as to whether co-design leads to better outcomes than not using co-design. In this article, we outline how, despite adhering to a time and resource intensive co-design process with strong moral and ethical foundations, its implementation by end-users led to mixed outcomes around improved elder abuse screening. We discuss the implications of these ambiguous results, arguing that "noise" in our data might be inevitable due to the inherent sensitivities associated with elder abuse screening and offer a polemical recommendation about why the Australian Elder Abuse Screening Instrument (AuSI) should nevertheless be rolled out.

The engagement of children in out-of-home care with nursing and allied health professionals: A scoping review.

BACKGROUND: Children living in out-of-home care (OOHC) have significant unmet health care needs and use more tertiary and specialist health care services compared with children from similar social and economic backgrounds. Allied health professionals and nurses have a central role in health care; however, very little is known about the engagement of children in OOHC with nursing and allied health professionals. This scoping review addresses this knowledge gap. METHODS: A scoping review methodology framework was used to search for relevant articles published between January 1970 and November 2019, identified using three databases: MEDLINE, CINAHL and ProQuest. Selection of studies was based on empirical research about the health of children in OOHC and their engagement with nursing or allied health services. A total of 37 relevant articles met the eligibility criteria for inclusion in this review. RESULTS: Findings could be summarized under five broad themes: (1) nursing and allied health professionals engaging with children in OOHC to support their health and development, (2) opportunities and challenges for nursing and allied health professionals to engage children in OOHC in healthcare, (3) identification and complexity of healthcare needs, (4) access to healthcare services and (5) coordination of healthcare. CONCLUSIONS: Children in OOHC have multiple healthcare needs that require monitoring and treatment by allied health professionals and the health and development of these children is best supported through comprehensive health screening on entry into OOHC, and community-based, multidisciplinary healthcare while children are living in OOHC. While nurses in hospitals and community settings were found to play a role in health assessment and care coordination targeted at children in OOHC, the literature was silent on the role of allied health professionals in this healthcare approach.

Family Forward: a social work clinical trial promoting family adaptation following paediatric acquired brain injury.

OBJECTIVE: To test the efficacy of a family intervention Family Forward in promoting early adaptation following a child's acquired brain injury (ABI). RESEARCH DESIGN: Prospective, sequential comparison group design. METHODS AND PROCEDURES: Families of children (n = 47) diagnosed with ABI received Family Forward (n = 25): two family counselling sessions plus optional multi-family group session per week or Usual Care (n = 22) during their child's inpatient rehabilitation admission. Family adaptation outcomes were measured using Family Assessment Device (FAD-GF) and Family Management Measure (FAMM). Relationships between family psychosocial risk, social work interventions, and family adaptation outcomes were explored. MAIN OUTCOMES AND RESULTS: The Family Forward group endured longer hospital admissions (FF M = 56.4 days SD 46.1; p = 0.029), rehabilitation admissions (FF M = 33.3 days SD 29.0; p = 0.019) and reported poorer functioning pre-intervention FAD-GF (FF M = 1.626 SD = 0.391; UC M = 1.491 SD 0.394) than the Usual Care group. No significant difference in family adaptation outcomes (FAD-GF) were detected; this suggests that the Family Forward intervention played a protective role in preventing deterioration in family functioning. The Family Forward group achieved superior outcomes in managing their child's care at home (FAMM Child Management Ability scale p = 0.029) and greater parental satisfaction in focusing on their child's care (FAMM Parent Mutuality scale p = 0.04) post-intervention. CONCLUSION: The Family Forward intervention moderated for poorer initial family functioning to achieve positive family adaptation outcomes.

Family appraisal of paediatric acquired brain injury: a social work clinical intervention trial.

OBJECTIVE: To compare the efficacy of a new intervention 'Family Forward' with 'Usual Care' social work practice in optimising family appraisal of a child's acquired brain injury to ensure better adaptation during the inpatient rehabilitation phase of care and early transition home. RESEARCH DESIGN: Single site, prospective, sequential comparison group design. METHODS AND PROCEDURES: Families were recruited on admission to an inpatient rehabilitation service based at a tertiary paediatric hospital. The 'Usual Care' group (n = 22; 29 parents) recruitment, intervention and data collection were completed first (Phase 1), followed by the 'Family Forward' group (n = 25; 43 parents) (Phase 2). Parents/caregivers completed measures: (Impact of Event Scale- Revised: IES-R; Parents Experience of Childhood Illness and Brief Illness Perception Questionnaire: Brief IPQ) at the time of their child's inpatient rehabilitation admission, inpatient rehabilitation discharge, and 6 weeks post-discharge. MAIN OUTCOMES AND RESULTS: There were more children with traumatic brain injuries in the Family Forward group (n = 13) than Usual Care (n = 6) and the Family Forward group had a longer hospital admission (days, M = 56.4, SD = 46.1 vs. M = 37.5, SD = 16.4, p = 0.019). No significant group differences were found for family appraisal outcomes at any of the three time-points. Both groups reported reductions in trauma and grief responses, emotional experiences and perceptions of their child's injury at post-intervention and follow-up. Both groups continued to have depleted emotional resources (PECI scale) at 6 weeks post-discharge. CONCLUSIONS: The study contributes important insights into family appraisal experience in the early stages following paediatric acquired brain injury. In this context, 'Family Forward' needs to incorporate interventions that support and promote ongoing family appraisal as issues related to their child's injury arise over time. Future research is needed to focus on whether the Family Forward approach does sustain family system adaptation (a key aim informing the design of the intervention) over the longer term.

Family Forward: Promoting Family Adaptation Following Pediatric Acquired Brain Injury.

This article describes a new and innovative social work intervention, Family Forward, designed to promote early adaptation of the family system after the onset of a child's acquired brain injury. Family Forward is integrated into inpatient rehabilitation services provided to the injured child and recognizes the important role of family in child rehabilitation outcomes and the parallel process of recovery for the child and family following an injury. Family Forward is informed by clinical practice, existing research in family adaptation after pediatric acquired brain injury, the resiliency model of family adjustment and adaptation, and family therapy theories and approaches.