In recent years, there has been a substantial increase in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children. Without appropriate management of symptoms and care, ADHD has been associated with a variety of negative child and adult outcomes. Environmental and familial factors that may contribute to three different pediatric referral types (academic, behavioural, and attentional) associated with ADHD were examined in the current study. In total, data from 477 families who were interviewed as a part of the intake process to a pediatric clinic were included in this study. Data for the current study was extracted from the intake questionnaires and included information on family history of mental health issues, socioeconomic status, and family relationships. The sample included children between the ages of three and 17 and mostly comprised males ( n = 340). A frequency analysis of the data demonstrated relatively high rates of mental health issues within families (61.4%); almost half of the mothers reported some post-secondary education (46.1%) and most reported having normal relationships with their children (mothers, 78%; fathers, 62.9%). Finally, three stepwise regression analyses were conducted to predict referral type. All three regressions yielded significant models. Fifteen percent of the variability of the academic referral type was predicted by being male, age at the time of referral, mother’s education level, and mother’s learning. The behavioural referral types were predicted by a family history of depression, being male, mother-child relationship, and age at the time of referral; these accounted for 23% of the variance. Attentional referral type was predicted only by mother-child relationship that captured 6% of the variance. Overall, this study describes a population of parents of children with academic, behavioural, and attention-related referrals to pediatrics. Results indicate that mothers have a profound influence on their child’s referral types, something that may transfer into later diagnosis and perhaps prognosis. Clinicians and researchers alike should focus their efforts toward developing integrative service assessment and treatment approaches that include important people in the child’s life. The implementation of Community Social Pediatrics (a streamlined, inclusive approach to care) should be considered in urban centres like this one, where referrals like this are prevalent.
Objective: Social Pediatrics focuses on targeting and mitigating the effects of the social determinants of health on a child's well-being and development. Negative health outcomes have been seen in children who have faced poverty, food insecurity, inadequate housing, and traumatic events. In particular, children who come from socioeconomically disadvantaged households are more likely to develop behavioural problems. The purpose of this study is to explore the experiences of caregivers for children with a behaviour-related disorder. This includes children affected by attention, academic, and social issues (e.g. attention-deficit hyperactivity disorder, autism spectrum disorder). This study will aim to understand the strengths, barriers, and social limitations to accessing and receiving care for children with behavioural disorders.Methods: A qualitative descriptive design was used to conduct three focus groups. Of the 64 caregivers contacted, a total of 13 participants agreed to be in the study. All focus groups were analyzed using inductive thematic analysis.Results: Preliminary findings suggest that caregivers value pediatricians who spend time, communicate, and make a human connection with their patients. Barriers included physician turnover, long wait times for referrals, and a lack of knowledge regarding services and programs available in their area. Three major themes emerged from this study including (1) timeliness to care, (2) advocacy, and (3) relationship building.Conclusion: Findings suggested that caregivers valued pediatricians who spend time to make a human connection with their patients. Barriers included physician turnover, long wait times for referrals, and a lack of knowledge of available services. Caregivers who were young mothers felt an added layer of judgement when accessing the necessary care for their children. This study is important as it contributes to our knowledge on the role Social Pediatrics can play in the care of children with behaviour-related disorders.
Introduction/Background Adverse childhood experiences (ACEs), including exposure to neglect, abuse and household dysfunction, have been linked to a higher risk of addiction and mental illness. As these children grow up and start families of their own, their children are at higher risk for ACEs. Evidence has shown that interventions targeting high-risk families with young children are most effective at disrupting these cyclic mechanisms, especially where maternal addiction is present. Objectives The purpose of this study is to examine the predominance of generational addiction in a cohort of families impacted by maternal addiction, and to identify the potential risks that are present for the current generation of children, in terms of ACEs. Design/Methods The Addiction Severity Index (ASI) was administered to women who experienced alcohol- or substance-use disorder during pregnancy. Participants were asked about their family’s history of addiction and if anyone in a given category (i.e. maternal grandmother, mother’s brother) has been affected by either alcohol- or substance-use disorder. Furthermore, existing conditions that are risk factors for ACEs in the current generation were identified (i.e. addiction, incarceration of a family member, domestic violence, mental illness). Results Many participants reported that at least one of their maternal (68.9%) or fraternal (42.2%) grandparent was impacted by addiction. The subsequent generation was similarly impacted with most participants reporting the presence of addiction in their father and/or his siblings (88.9%) and their mother and/or her siblings (86.7%) Participants report that they experienced an average of seven ACEs (M = 7.13, SD = 2.501) before their 18th birthday. Of this cohort, 53.35% have been incarcerated at least once, 91.1% have been hit by a sexual partner, and 44.4% have been diagnosed with at least one mental health issue. All participants have personally experienced addiction. Conclusion The participants of this study are clients of the Parent-Child Assistance Program (PCAP), a three-year intervention that supports families impacted by maternal addiction. Given the results of the current study, it is evident that growing up in a home where addiction is present increases the risk of ACEs and future addiction and mental health issues. The PCAP intervention is designed to disrupt this cycle and help families to create a healthier family environment.
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