The point of view of children in residential and foster care on their health: A comparative study / Le point de vue des enfants en foyer et famille d'accueil sur leur santé : étude comparative

Although it is a major issue, the health of children and adolescents in care is still mainly explored on the basis of information provided by adults in French studies. This study therefore aims to make up for the lack of studies integrating the young people's own point of view and to explore certain aspects of health, as reported by the children and adolescents themselves, by comparing the health of children in care with that of children in the general population. The sample consists of 477 children in care (versus 23,672 who are not). The data were collected through a cross-sectional survey conducted by UNICEF France between October 2020 and March 2022 among 25,300 children and adolescents aged 6 to 18 who responded to a paper or online self-administered questionnaire. The main results of this study confirm the existing findings concerning the much greater health care needs of children and adolescents placed outside their homes (foster families, children's homes) compared to their peers. In particular, they underline greater psychological suffering linked to their life histories, health risk practices, sexual violence, and suicidal risk. The discussion addresses the complexity of the issues associated with their health and underlines the importance of taking into account the child's own point of view.

Bien qu'elle constitue un enjeu majeur, la santé des enfants et adolescents pris en charge au titre de la protection de l'enfance reste majoritairement explorée à partir d'éléments renseignés par les adultes dans le cadre des études françaises. Cette étude vise ainsi à pallier le manque d'études intégrant le propre point de vue des jeunes et à explorer certains aspects liés à la santé, tels que les enfants et adolescents peuvent eux-mêmes en rendre compte, en comparant la santé d'enfants accueillis en foyer ou famille d'accueil à celle d'enfants de la population générale. L'échantillon est constitué de 477 enfants placés (versus 23 672 qui ne le sont pas). Les données ont été recueillies dans le cadre d'une enquête transversale réalisée par l'UNICEF France entre octobre 2020 et mars 2022 auprès de 25 300 enfants et adolescents de 6 à 18 ans ayant répondu à un questionnaire papier ou en ligne auto-administré. Les principaux résultats de cette étude confirment les constats existants concernant les besoins de soins de santé beaucoup plus importants des enfants et des adolescents placés hors de leur domicile (famille d'accueil, foyer) comparativement à leurs pairs. Ils soulignent notamment une plus grande souffrance psychologique liée à leurs histoires de vie, les pratiques constituant un risque pour la santé, les violences sexuelles et le risque suicidaire. La discussion aborde la complexité des enjeux associés à leur santé et souligne l'intérêt de prendre en compte le point de vue de l'enfant lui-même.

The Global School Adaptation score: a new neurodevelopmental assessment tool for very preterm children at five years of age.

OBJECTIVE: To determine the usefulness of a neurodevelopmental assessment tool consisting of a questionnaire administered to teachers to measure the Global School Adaptation (GSA) scores of very preterm children at the age of 5 years. STUDY DESIGN: A sample of 445 very preterm children (<35 weeks of gestation) was assessed at 5 years of age using GSA and IQ scores. According to the consistency between the scores, children were determined to be well classified, intermediately classified, or misclassified. The differences between groups were assessed through univariate and multivariate logistic regression. RESULTS: The GSA score was highly or intermediately consistent with the IQ score for 89.2% of the children, and 10.8% were considered misclassified. Children with a higher GSA than IQ score had more autonomy and self-confidence (P < .01), and those with a lower GSA than IQ score had more behavioral problems (P < .01). Analysis by logistic regression showed that sex and gestational age significantly affected the consistency between the 2 scores. Thus, girls were less likely to have a lower GSA than IQ score (aOR = 0.45; 95% CI: 0.24-0.84; P = .01), and a lower gestational age significantly increased the likelihood of having a higher GSA than IQ score (for children born between 24 and 28 weeks of gestation: aOR = 2.70; 95% CI: 1.23-5.92; P = .01). CONCLUSIONS: The GSA score is a simple, inexpensive, and reliable screening tool for assessing neurodevelopment in very preterm children at 5 years of age.

Predicting mental quality of life in breast cancer survivors using comparison participants.

The objective of this research is to propose a comprehensive model for the prediction of long-term mental health in breast cancer survivors diagnosed 5 to 15 years earlier, compared to female participants referring to the most stressful event that occurred within the last 20 years. Nearly 300 survivors and 132 comparison participants were consulted using a questionnaire, which evaluated personality variables, transactional variables, and current mental quality of life. Structural equation modeling was used. The transactional proposed model was able to account for long-term mental health variance in both groups but was more relevant to women with breast cancer.

Cognitive self-regulation and social functioning among French children: A longitudinal study from kindergarten to first grade.

This study adds to the body of research examining the links between two components of cognitive self-regulation (inhibitory control and verbal working memory) and social functioning (social integration, social problem solving, and prosocial skills) and focuses on children's sex as a moderator of the association between cognitive self-regulation and social functioning. The participants (N = 131) were French schoolchildren followed from kindergarten (Mage = 68.36 months, SD = 3.33 months) through Grade 1. Using hierarchical regression analyses, three major findings were revealed: (1) inhibitory control was a better predictor than verbal working memory of prosocial skills assessed by peers using the sociometric technique as well as by teachers using questionnaires, after controlling for sex, mother's education, and verbal and non-verbal IQ; (2) the prosocial skills assessed by teachers in kindergarten contributed more to explaining the prosocial skills and peer acceptance assessed in Grade 1 than cognitive self-regulation; and (3) sex did not moderate the relationship between cognitive self-regulation and social functioning. These results suggest that developing strong cognitive self-regulation, especially inhibitory control and prosocial skills, in young children schooled in France could be beneficial for their social development.

The Association of Urbanicity with Cognitive Development at Five Years of Age in Preterm Children.

OBJECTIVE: To determine the association of urbanicity, defined as living in an urban area, with cognitive development at five years of age in preterm children who were free of any disabilities or neurodevelopmental delays. DESIGN: Prospective population-based cohort. SETTING: French regional Loire Infant Follow-up Team (LIFT) network. PARTICIPANTS: Included in the study were 1738 surviving infants born between March 2003 and December 2008 before 35 weeks of gestational age. At two years of age, the children were free of any disabilities and neurodevelopmental delays and were living in the Pays de la Loire region from their birth to five years of age. MAIN OUTCOME MEASURES: The cognitive development at five years of age was evaluated with the Global School Adaptation score (GSA). The urbanicity of the residence for each child was classified into three groups: urban, quasi-rural, and rural area. RESULTS: Quantile regression approaches were used to identify a significant association between urbanicity and the GSA score at five years of age (adjusting for child and family characteristics). We found that the negative impact of urbanicity on the GSA score was more important for the lower quantile of the GSA scores. CONCLUSIONS: Urbanicity was significantly associated with cognitive neurodevelopment at five years of age in preterm children born before 35 weeks of gestation. Complementary results additionally suggest that this relation could be mediated at the residence level by a high socioeconomic deprivation level. If these results are confirmed, more personalized follow-ups could be developed for preterm children. Further studies are needed to finely identify the contextual characteristics of urbanicity that underlie this association.

Posttraumatic growth in long term breast cancer survivors: relation to coping, social support and cognitive processing.

Post-traumatic growth (PTG) has rarely been studied in long term breast cancer survivors using open interviews. In order to address the issue of how women integrate PTG in their overall cancer experience, 28 open interviews concerning changes after cancer were carried out with 5- to 15-year survivors. The analysis of results, performed using Alceste software, revealed one thematic class of PTG which was specific to women with high coping and social support and active cognitive processing. PTG theme appeared most often as a conclusion of interviews rather than in response to the question about changes after cancer.