Participation Outcomes Among Black Children with Disabilities: A Scoping Review.

AIM: Participation disparities among Black children with disabilities are widely documented in a variety of disciplines. Grounded in the Social Model of Disability and Disability Critical Race Theory, the purpose of this scoping review was to examine the extent to which occupational therapy has contributed to the study of participation outcomes among Black children with disabilities. METHODS: Empirical studies published from 2010 to 2021 that reported participation outcome data published in nine frequently cited journals were included in this scoping review. Twenty studies were found to meet the criteria. RESULTS: Participation outcomes were reported for six occupations: play, social participation, activities of daily living (ADLs), education, sleep, and health management). The majority of studies reviewed recruited small samples of Black children with disabilities and provided limited to no description of the specific participation differences by racial/ethnic demographics. CONCLUSION: Occupational therapy has made few contributions to the growing literature on participation disparities for Black children with disabilities. Implications for practice are discussed.

Resilience to COVID-19 challenges: Lessons for school psychologists serving school-attending black South African youth aged 10 to 19 years old.

Several studies have highlighted the mental health challenges of children and youth during the COVID-19 pandemic lockdown period, especially, in relation to an escalation of depression, anxiety, and stress. Whilst this may be the reality, it is unfortunate that most of the studies adopt a psychopathological point of departure often portraying doom and gloom. Adopting a social ecological resilience perspective the author focuses on the resilience of school-attending black South African youth during the COVID-19 lockdown period. The Child and Youth Resilience Measurement (CYRM-28) was completed by 4165 respondents in grades 4 to 12 (females = 2431, 58.4%; males = 1734, 41.6%) from the Gauteng, Mpumalanga and North-West provinces in South Africa. The findings indicate that school psychologists must consider gender, age and school levels when they design school-based resilience programmes for black South African children. Particular emphasis should be placed on contextual resilience highlighting spiritual, religious, cultural and educational factors. A major lesson for school psychologists is to ensure that school-based resiliency programmes adopt a whole school approach that includes children, their families and local communities for the successful promotion of resilience during adverse situations as postulated by the social ecological resilience model.

Delivering on the promise of early childhood education for black children: An equity strategy.

The early years are a critical period for setting children up for school and life. For Black children who are exposed to adversities before and after birth, early childhood education (ECE) has been shown as one potentially strategy to mitigate against systemic inequities. However, evidence continues to show the negative impact of structural racism and system inequities in the lives of Black children. While Black children continue to thrive even in the face of biased experiences and unfairness, it is imperative that simultaneous attention focus on how to best support the well-being Black children and address systemic racism. This paper discusses ECE and its evidence and calls for policies and strategies that dismantle racism inherent in ECE by ensuring equitable funding, equity-centered monitoring, and equity-centered assessment of family engagement. To support Black children's health, development, and well-being, we must attend to policies that address equitable access, supports, experiences, and outcomes.

Examining current physical activity interventions in Black school-age children and parents: A systematic review.

Obesity is prevalent in Black children and adults; increasing physical activity (PA) can aid in reducing childhood obesity in both age groups. The purpose of this systematic review is to examine current research on PA interventions in school-age Black children. Adhering to PRISMA guidelines, a systematic search was conducted in six databases for PA interventions in Black children. A total of 13 articles met inclusion criteria (n = 7 randomized controlled trial, n = 5 quasi-experimental, n = 1 cross-sectional). The majority of the articles were on a combination of diet and PA programs (n = 9). Four articles targeted PA and parental role modeling of PA as the outcome showing positive intervention effects. Nine additional studies included PA as an outcome variable along with at least one additional obesity-related predictor. PA interventions for Black school-age children typically use a parent-child dyadic approach (n = 13), are guided by theory (n = 11) and are high quality. However, continued investigation is warranted to draw definitive conclusions and determine how to best involve parents within the PA interventions. Theory-driven higher quality trials that clearly describe the structured PA component and outcomes among Black parent-child dyads are needed.

Suicide among Black Children: An Integrated Model of the Interpersonal-Psychological Theory of Suicide and Intersectionality Theory for Researchers and Clinicians.

Recently, research has reported that the rates of suicide among Black children between the ages of 5 to 12-years-old are increasing as they are now more likely to commit suicide than White children. Yet, there are very few, if any, frameworks being used by researchers to explain the risks of suicide among Black children. Suicide research has overwhelmingly been focused on White youth thus leaving a critical gap in suicide research. This conceptual paper provides an integrated framework using the Interpersonal-Psychological Theory of Suicide and Intersectionality theory, as a guide for researchers, clinicians, and practitioners to incorporate culturally appropriate techniques in their work as a way to prevent suicide among Black children. This framework highlights racial discrimination, mental health, socioeconomic status, and sexual/gender minority status to be the most preeminent, yet understudied factors leading to suicide risk among Black children in the United States.

The Retrospective Roles of Black Women in the Coddling of Black Boys.

This study reports the secondary analysis of a theme that emerged from a larger study on Black women's perceptions of Black men's depression. This emerging theme was concerning the role of Black women in rearing Black boys. Eight focus groups with Black women (N = 46) were used to further explore this theme. Our secondary analysis identified three subthemes, including the (a) presence (or absence) of fathers in parenting Black children, (b) Black women's role in coddling Black boys, and (c) Black women's role in "raising" Black girls. Study implications include the contextual lens that underscores parenting variations within Black families.

A network analysis of psychopathology in young Black children: Implications for predicting outcomes in adolescence.

OBJECTIVE: Network analysis may identify specific symptoms involved in the maintenance and development of psychopathology. This approach, however, has not been applied to the study of young Black children, a population facing unique challenges and developmental risks. It is also unclear whether network analysis identifies early symptoms in Black children that are linked to their longer-term difficulties and strengths in adolescence. METHODS: We conducted a network analysis of emotional and behavioral difficulties in 1238 Black (non-Hispanic) children from the age-3 assessment in the Future of Families and Child Wellbeing Study (47 % female). We also explored whether early childhood symptoms predict subsequent caregiver-reported internalizing and externalizing problems, and youth-reported social competencies and extracurricular and community involvement, at the age-15 assessment. RESULTS: We identified specific symptoms of externalizing and emotional reactivity as central in the network. Symptoms of emotional reactivity were also involved in comorbidity, bridging different communities of symptoms. Using elastic net models, we identified specific central and bridge symptoms, but also peripheral network symptoms, that contributed uniquely to the prediction of internalizing and externalizing problems in adolescence. Early childhood symptoms were less predictive of positive outcomes in adolescence. CONCLUSIONS: This study identified central and bridge symptoms in young Black children, an underrepresented population in network analysis research. Some of these central and bridge symptoms, but also peripheral network symptoms, may be useful targets in early interventions to prevent long-term difficulties. Conversely, network approaches to understanding early psychopathology may have less utility for predicting Black children's subsequent strengths in adolescence.

"I would be so proud of you guys and myself:" Exploring guided play learning interactions among Black caregivers and their children within a Black history home learning intervention during the COVID-19 pandemic.

Existing literature on Black caregiver's interactions with their children has overwhelmingly focused on parenting deficits and interventions designed to "fix" Black families. In utilizing the BlackCreate framework (2023), this study explores how Black caregivers intentionally crafted learning spaces for their children within the context of a six month intervention. Brilliant Joy in a Box was a six-month intervention developed in partnership with a Black woman entrepreneur that delivered caregiver-child Black history home learning boxes to families during the COVID-19 pandemic with the goal of addressing the impacts of persistent historical educational inequities for Black youth, the disproportionate impact of the pandemic Black families, and requests from community members seeking additional programming during the winter months. In the current study, we analyzed videos of 77 families interacting during a guided play activity. We found that the learning spaces created by Black families focused on four subject matters and their domains: literacy, scientific curiosity, math, and identity. We also found that Black caregivers organically utilized guided play to promote joyful interaction and learning. Findings underscore the importance of educators and school staff learning from families in order to reimagine learning and design community based interventions.

BMI Growth Profiles Among Black Children from Immigrant and US-Born Families.

A large body of research has documented racial/ethnic disparities in childhood obesity in the United States (US) but less work has sought to understand differences within racial groups. Longitudinal studies are needed to describe BMI trajectories across development, particularly for Black children from immigrant families who have been underrepresented in childhood obesity research. The current study utilizes BMI data collected longitudinally from ages 5 to 8 years and growth mixture modeling to (1) identify and visualize growth patterns among Black children from primarily Caribbean immigrant families, and (2) to compare these patterns to growth trajectories among Black children from US-born families. First, we identified four classes or trajectories of growth for Black children from immigrant families. The largest trajectory (70% of the sample) maintained non-overweight throughout the study period. A second trajectory developed overweight by age 8 (25%). Two small trajectory groups demonstrated high rates of moderate and severe obesity-i.e., specifically, a trajectory of accelerated weight gain ending in moderate/severe obesity (3%), and a trajectory of early severe obesity with BMI decreasing slightly with age (2%). We identified a very similar four class/trajectory model among Black children from US-born families, and compared the model to the one for children from immigrant families using multi-group growth mixture modeling. We found that the patterns of growth did not differ significantly between the populations, with two notable exceptions. Among Black children from immigrant families, ∼ 5% were classified into the two heavier BMI trajectories, compared to ∼ 11% of children from US-born families. Additionally, among children with an accelerated weight gain trajectory, children from immigrant families had lower BMIs on average at each time point than children from US-born families. These findings describe the multiple trajectories of weight gain among Black children from immigrant families and demonstrate that although these trajectories are largely similar to those of Black children from US-born families, the differences provide some evidence for lower obesity risk among Black children from immigrant families compared to Black children from US-born families. As this study is the first to describe BMI trajectories for Black children from immigrant families across early and middle childhood, future work is needed to replicate these results and to explore differences in heavier weight trajectories between children from immigrant and US-born families.

[Influence of tropical endemic limboconjunctivitis on the distribution of astigmatism in a black pediatric population: A hospital-based case-control study]. / Influence de la limbo-conjonctivite endémique des tropiques sur la distribution de l'astigmatisme dans une population d'enfants mélanodermes camerounais : étude hospitalière cas-témoins.

PURPOSE: To study the influence of tropical endemic limboconjunctivitis (TELC) on the distribution of astigmatism in a population of black children. PATIENTS AND METHODS: We matched two groups of 36 children between the ages of 3 and 15 by age and sex. Group 1 consisted of children with TELC, and group 2 was made up of controls. All underwent cycloplegic refraction. The studied variables were age, sex, type and stage of TELC, spherical equivalent, absolute cylinder value and clinical type of astigmatism. The odds ratio was used to quantify the link between TELC and astigmatism. We used the Chi2 test for the comparison of qualitative variables and the Student T test for the comparison of the means of quantitative variables. The threshold of significance of the differences was set at 0.05. RESULTS: Astigmatism was more common in children with TELC (61.97% vs. 37.5%), (OR=1.53; 95% CI 1.08-2.15; P=0.012). The history of TELC was associated with an increased risk of with-the-rule astigmatism (OR 1.91; 95%CI (1.23-2.97). CONCLUSION: Pediatric TELC is frequently associated with the with-the-rule astigmatism in our practice setting.

Racial Differences in Emergency Department Visit Characteristics and Management of Preadolescents at Risk of Suicide.

OBJECTIVE: Suicide rates and frequency of pediatric emergency department (ED) visits for suicidal thoughts and behaviors have increased among Black preadolescents in the United States in recent years. This study examined whether characteristics of ED visits and treatment management of preadolescents with suicidal thoughts and behaviors differed by race. METHODS: An electronic medical record query identified patients ages 8-12 (N=504) who visited a pediatric ED with a psychiatric-related chief complaint in 2019. The authors examined suicidal thoughts and behaviors that were reported with the Ask Suicide-Screening Questions tool, ED clinical impression, and ED disposition overall and by race. RESULTS: Compared with other racial groups, Black preadolescents were less likely to report suicidal thoughts, despite equivalent lifetime histories of suicide attempts, and were more likely to be brought to the ED by police and discharged (instead of being admitted to inpatient psychiatric care). CONCLUSIONS: Research to better understand racial disparities in suicide risk among preadolescents can inform prevention efforts.

An intergenerational examination of retrospective and current depression patterns among Black families.

BACKGROUND: There is limited information regarding the intergenerational transmission of mental health among three generations (i.e., grandparents, parents, and children) of Black families. Given that intergenerational and kinship ties are integral in Black families, this study explores the context that might contribute to the generational transmission of mental health among Black families. METHODS: The present study examined the retrospective family history of mental health among fathers and mothers, current reports of their depression, and their children's internalizing and depressive symptoms among a sample of 2530 Black families from the Future of Families and Child Wellbeing Study using waves 4 to 6. All analyses were conducted using STATA 15.1. RESULTS: Focal children's maternal and paternal grandparents' history of mental health was associated with higher odds of depression in their mothers and fathers; in addition, child-internalizing symptoms were associated with a report of depression in maternal grandparents in waves 4 and 5. Children of mothers who were depressed had higher internalizing scores in waves 4, 5, and 6. LIMITATIONS: This descriptive study did not account for how parenting might also be protective against childhood internalizing behaviors. A retrospective account may not fully encapsulate a complete understanding of mental health patterns. CONCLUSIONS: In treating the mental and behavioral health of Black families, it is essential to focus on multiple generations of family health, given that family history is the strongest predictor of the youth's onset of depression. The utility of these findings in understanding psychological distress and strengths among Black families is discussed.

Reasons for admission to service and overrepresentation of Black youth in the child welfare system in Ontario, Canada: Does race matter?

BACKGROUND: In studies exploring racial disparities in the Canadian child welfare systems, evidence is still lacking on the reasons for admission of children to service. OBJECTIVE: This study investigates the reasons for admission to service in Ontario child welfare based on racial identities. METHODS: We analyzed three-time points (2018, 2019, and 2020) of the Ontario Looking After Children (OnLAC) project. The sample included 4036 children (Mage = 14.30, SD = 2.21; 39.22 % girls). Univariate and multiple random-effects (REs) logistic regressions were performed to analyze the admission to service according to racial identities. RESULTS: The results showed that the most frequent reason for admission to service was caregiver capacity in 2018 (56.02 %), 2019 (57.76 %), and 2020 (55.49 %). The results revealed few differences between racial groups on the reasons for their admission to service. There were more differences between racial groups in 2019 and 2020. The three-year cohort analyses showed that Black youth were less likely to have admission to service due to harm by omission (AOR = 0.41, 95%CI 0.18-0.93, z = -2.14, p < .05) and emotional harm (AOR = 0.40, 95%CI 0.17-0.92, z = -2.12, p < .05) than other racial groups. Results from the multiple random-effects logistic regression showed that in 2019 (AOR = 1.83, 95%CI 1.28-2.62, z = 3.32, p < .01) and 2020 (AOR = 2.13, 95%CI 1.41-3.21, z = 3.58, p < .01), youth were particularly at risk of having been admitted to service for caregiver capacity. CONCLUSIONS: The present study reveals a comprehensive description of the reasons for admission in child welfare in Ontario according to racial identities. Implications for research, prevention, and intervention are discussed.

Analysis of the 2007-2018 National Health Interview Survey (NHIS): Examining Neurological Complications among Children with Sickle Cell Disease in the United States.

This study compared neurological complications among a national sample of United States children with or without sickle cell disease (SCD) and evaluated health status, healthcare and special education utilization patterns, barriers to care, and association of SCD status and demographics/socioeconomic status (SES) on comorbidities and healthcare utilization. Data was acquired from the National Health Interview Survey (NHIS) Sample Child Core questionnaire 2007-2018 dataset that included 133,542 children. An affirmation from the guardian of the child determined the presence of SCD. Regression analysis was used to compare the associations between SCD and demographics/SES on neurological conditions at p < 0.05. Furthermore, adjusted odds ratios (AORs) were estimated for having various neurological conditions. Of the 133,481 children included in the NHIS, the mean age was 8.5 years (SD: 0.02) and 215 had SCD. Of the children with SCD, the sample composition included male (n = 110), and Black (n = 82%). The SCD sample had higher odds of having neuro-developmental conditions (p < 0.1). Families of Black children (55% weighted) reported household incomes < 100% of federal poverty level. Black children were more likely to experience longer wait times to see the doctor (AOR, 0.3; CI 0.1-1.1). Compared to children without SCD, those with SCD had a greater chance of seeing a medical specialist within 12 months (AOR 2.3; CI 1.5-3.7). This representative sample of US children with SCD shows higher odds of developing neurological complications, increased healthcare and special education services utilization, with Black children experiencing a disproportionate burden. This creates the urgency to address the health burden for children with SCD by implementing interventions in healthcare and increasing education assistance programs to combat neurocognitive impairments, especially among Black children.

Suicide Among Black Children: An Integrated Model of the Interpersonal-Psychological Theory of Suicide and Intersectionality Theory for Researchers and Clinicians.

Recently, research has reported that the rates of suicide among Black children between the ages of 5 to 12-years-old are increasing as they are now more likely to commit suicide than White children. Yet, there are very few, if any, frameworks being used by researchers to explain the risks of suicide among Black children. Suicide research has overwhelmingly been focused on White youth thus leaving a critical gap in suicide research. This conceptual paper provides an integrated framework using the Interpersonal-Psychological Theory of Suicide and Intersectionality theory, as a guide for researchers, clinicians, and practitioners to incorporate culturally appropriate techniques in their work as a way to prevent suicide among Black children. This framework highlights racial discrimination, mental health, socioeconomic status, and sexual/gender minority status to be the most preeminent, yet understudied factors leading to suicide risk among Black children in the United States. Reprinted with permission of SAGE Publications; Opara et al. J Black Stud (51:611-631), copyright 2020.

Addressing the overrepresentation of Black children in Ontario's child welfare system: insights from child welfare workers and community service providers.

BACKGROUND: The overrepresentation Black children experience in the child welfare system is well documented in the United States, but such studies are now emerging in Canada. In Ontario, there are few studies that address this issue concerning Black families. OBJECTIVE: This study is to explore the insights of child welfare workers and community service providers on how to potentially address Black children's overrepresentation in Ontario's child welfare system. PARTICIPANTS AND SETTING: Twenty-one child welfare workers from two child welfare organizations in Ontario that serves many Black families and thirteen community service providers in Toronto participated in the study. METHODS: Six focus groups were conducted with thirty-four participants. Audio recording from each of the focus groups was manually transcribed verbatim. We utilized constant comparison analysis to analyse the transcribed data. RESULTS: Potential solutions to overrepresentation that emerged from the focus group discussions included viewing Black families as experts of their own lives; increasing workforce diversity; educating referral sources and Black families on child welfare practices; subjecting referral sources to detailed questioning; stopping harmful record keeping on families; providing cultural sensitivity training and education; partnering with community organizations; and providing mentorship opportunities. CONCLUSIONS: The findings from this study emphasize the need for changes related to child welfare assessment tools, workforce development, and shifts in system orientation to address systemic racism and Black children's overrepresentation in the child welfare system.

Understanding the overrepresentation of Black children in Ontario's child welfare system: Perspectives from child welfare workers and community service providers.

BACKGROUND: The overrepresentation of Black children in the child welfare system is a social problem that has received longstanding attention in the United States, but has recently received increasing attention in Canada. OBJECTIVE: This qualitative study explores the findings of two quantitative studies (Antwi-Boasiako et al., 2020, 2021) in order to interpret them through the perspectives of child welfare workers and community service providers. The aim is to gain a deeper understanding on the potential factors that contribute to the overrepresentation of Black children in Ontario's child welfare system. PARTICIPANTS AND SETTING: The study involved twenty-one child welfare workers from two child welfare organizations in Ontario serving lots of Black families and thirteen community service providers in Toronto. METHODS: Six focus groups were completed with thirty-four participants. Each of the focus groups was audio recorded and manually transcribed verbatim. Constant comparison analysis was used to analyze the transcribed data. RESULTS: Themes that emerged from the study include the following concerns: racism and bias from referral sources; racism and bias from child welfare workers; lack of cultural sensitivity; lack of workforce diversity/training; lack of culturally appropriate resources; assessment tools; duty to report; fear of liability; lack of collaboration; and poverty. CONCLUSIONS: The results from this study reinforce the need to shift practice that acknowledges Black families as valuable stakeholders and experts of their own lives and involves them in the development and implementation of policies and practices that affect them.

Impacts of race on family reunification: A longitudinal study comparing exits from Quebec's child welfare system.

BACKGROUND: In the United States, Black children spend more time in out-of-home placement than other children and are less likely to experience family reunification following involvement with child welfare services. Within Canada, very few studies have examined Black children's exits from the child welfare system and factors influencing their service trajectory. OBJECTIVE: This study, the first of its kind in Canada, uses longitudinal clinical administrative data to examine reunification outcomes for Black children following placement in out-of-home care. PARTICIPANTS AND SETTING: The study population includes 1395 children receiving ongoing child welfare services in Quebec between April 1, 2002 and March 31, 2011. METHODS: A longitudinal research design from anonymized clinical administrative data extracted from a single child welfare agency in Montreal. Survival analysis using a Kaplan Meier and Cox proportional hazard regression examined the trajectory and chances of family reunification from the point of each child's initial placement. RESULTS: Black children spend longer lengths of time in out-of-home placement and are less likely to experience family reunification when compared to other children. Poorer reunification outcomes for Black children were associated with placement instability, the age of the child and reasons for child welfare involvement. CONCLUSIONS: While we tend to prioritize prevention services for vulnerable communities, this study indicates that attention must be given to services all throughout Black children's service trajectory to ensure that these children are able to exit the child welfare system in a timely manner.

Schooling While Black: Analyzing the Racial School Discipline Crisis for Behavior Analyst.

The persisting issue of racial injustice within disciplinary action referred to as the school-to-prison pipeline has been frequently examined and studied across multiple disciplines spanning education, public policy, criminal justice, and others. The racial school discipline crisis is the disproportionate and differential use of exclusionary action against Black children in school. While disproportionate exclusion occurs throughout the educational continuum, early childhood expulsions and suspensions are a growing concern and are linked to further problems in kindergarten and beyond. With national attention from civil rights organizations drawing eyes to the injustices, educational systems are looking to solve the over-use of suspension and expulsion to address student behavior. Behavior analysts are often tasked with addressing and reducing the behavioral concerns of students; however, there is a gap in the behavior analytic literature on racism in schools. Bringing awareness to anti-Black racism in American schooling is an initial step for behavior analysts to take toward dismantling oppressive systems within education.

A Literature Review of Racial Disparities in Overall Survival of Black Children With Acute Lymphoblastic Leukemia Compared With White Children With Acute Lymphoblastic Leukemia.

Despite major advances in acute lymphoblastic leukemia [ALL] treatment, poorer overall survival (OS) persists for Black children with ALL compared with White children with ALL. The purpose of this literature review was to examine the racial disparities on OS in Black versus White children with ALL. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, PubMed, and Academic Search Complete databases were searched using the Medical Subject Heading (MeSH) terms: survival or mortality or outcome AND black or African-American or AA or minority AND racial disparities or race or racial/ethnic disparities AND cancer in children or pediatric cancer or children with leukemia or children with ALL for articles published in English between January 2009 and July 2019. Exclusion criteria were non-research articles, systematic reviews, conference abstracts, editorials, commentaries, correspondence, and case reports. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data were extracted, appraised, and synthesized. Sixteen articles met the inclusion criteria. Sample sizes across studies ranged from 184 to 31,866 participants. The factors most associated with disparities in OS included: age at diagnosis (e.g., <1 year and/or >10 years old), differences in clinical prognosticators (e.g., white blood cell count at diagnosis, T-cell vs. precursor B-cell immunophenotype, central nervous system disease status, cytogenetic profile) and lower socioeconomic status. Future prospective studies are needed to elucidate the role of these factors in OS of Black children with ALL.