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Communimetric screening tools help clinicians identify and communicate their patient's areas of need and the corresponding level of action. However, few tools exist to identify mental health (MH) and developmental needs in young children. We aimed to implement and evaluate a new communimetric MH and developmental screening tool for children under 6 (HEADS-ED Under 6) in a community MH agency in Ontario, Canada. Using a prospective cohort design, we explored how intake workers used the HEADS-ED Under 6 screening tool from November 2019 to March 2021. 94.5% of children (n = 535/566) were screened with the HEADS-ED at intake. Total HEADS-ED scores and domains were used to inform the intensity of recommended services. Three clinical domains (Eating & sleeping, Development, speech/language/motor, and Emotions & behaviors) also independently predicted a priority recommendation. The tool showed good concordance with the InterRAI Early Years for children under 4 years old. The HEADS-ED Under 6 was a brief, easy, and valid screening tool, and can be used to identify important MH and developmental domains early, rate level of action/impairment, communicate severity of needs, and help determine intensity of service required.

Les outils de dépistage communimétrique aident les cliniciens à identifier et à communicer les besoins et le niveau d'action correspondant de leur patient. Cependant il existe peu d'outil pour identifier les besoins en Santé Mentale (SM en français) et les besoins développentaux chez les jeunes enfants. Nous nous sommes donné pour but d'appliquer et d'évaluer un nouveal outil communimétrique de SM et développemental pour les enfants de moins de 6 ans (HEADS­ED de moins de 6 ans) dans une agence communautaire de SM dans l'Ontario au Canada. En utilisant une conception de cohorte prospective nous avons exploré la manière dont les préposés à l'accueil ont utilisé le HEADS­ED de moins de six ans de novembre 219 à mars 2021. 94,5% des enfants (n = 535­566) ont été dépister avec le HEADS­ED à l'accueil. Tous les scores et domaines HEADS­ED ont été utilisé pour éclairer l'intensité des services recommandés. Trois domaines cliniques (Manger et dormir, Développement/parole/langage/moteur, et les Emotions, comportements ont aussi prédit une recommandation de priorité indépendamment. L'outil a fait preuve d'une bonne concordance avec le InterRAI Early Years pour les enfants de moins de 4 ans. Le HEADS­ED de moins de 6 ans s'est avéré être un outil de dépistage valide, bref et facile, et peut être utiliser pour identifier des domaines de SM et des domaines du développement importants tôt, d'évaluer un niveau d'action/de dépréciation, de communiquer la sévérité de besoins, et aider à déterminer l'intensité des services requis. Kommunimetrische Screening­Instrumente helfen klinisch Tätigen dabei, die Bedürfnisse ihrer Patienten zu erkennen, zu kommunizieren und die entsprechenden Maßnahmen zu ergreifen. Es gibt jedoch nur wenige Instrumente welche die Bedürfnisse von Kleinkindern hinsichtlich ihrer psychischen Gesundheit und Entwicklung ermitteln. Unser Ziel war es, ein neues kommunimetrisches Screening­Instrument für die psychische Gesundheit und Entwicklung von Kindern unter 6 Jahren (HEADS­ED unter 6 Jahren) in einer kommunalen Einrichtung der psychischen Gesundheitsversorgung in Ontario, Kanada, einzuführen und zu evaluieren. In einer prospektiven Kohortenstudie untersuchten wir von November 2019 bis März 2021 wie die Mitarbeitenden der Einrichtung bei Aufnahmen das HEADS­ED­Screening­Tool für Kinder unter 6 Jahren einsetzten. 94,5 % der Kinder (n = 535/566) wurden bei Aufnahme mit dem HEADS­ED gescreent. Die HEADS­ED­Gesamtergebnisse und ­Domänen wurden verwendet, um die Intensität der empfohlenen Gesundheitsleistungen zu bestimmen. Ebenfalls sagten drei klinische Domänen (Essen und Schlafen, Entwicklung/Sprechen/Sprache/Motorik und Emotionen/Verhaltensweisen) unabhängig voneinander eine prioritäre Empfehlung voraus. Das Instrument zeigte eine gute Übereinstimmung mit dem InterRAI Early Years für Kinder unter 4 Jahren. Das HEADS­ED für Kinder unter 6 Jahren erwies sich als ein kurzes, einfaches und valides Screening­Instrument, das eingesetzt werden kann, um frühzeitig wichtige Bereiche psychischer Gesundheit und Entwicklung zu identifizieren, das Ausmaß von Interventionen/Beeinträchtigungen einzuschätzen, die Stärke dahingehender Bedürfnisse mitzuteilen und die notwendige Intensität von Gesundheitsleistungen zu bestimmen. コミュニメトリックスクリーニングツールは、臨床医が患者の必要な領域とそれに対応する行動レベルを特定し、伝えるのに役立つ。しかし、幼児のメンタルヘルス(MH)と発達のニーズを特定するツールはほとんど存在しない。本研究は、カナダ・オンタリオ州の地域MH機関において、6歳未満児を対象とした新しいコミュニメトリックMHおよび発達スクリーニングツール(HEADS­ED under 6)の導入および評価を目的とした。前向きコホートデザインを用いて、2019å¹´11月から2021å¹´3月に、インテイク担当者が6歳未満児スクリーニングツールHEADS­EDをどのように使用したかを調査した。94.5％の子ども(n = 535/566)がインテーク時にHEADS­EDでスクリーニングを受けた。HEADS­EDの総スコアと領域は、推奨されるサービスの程度を知るために使用された。また、3つの臨床領域(食欲と睡眠、発達・発語・言語・運動、感情/行動)が、個別の優先順位を予測した。このツールは、4歳未満児を対象とするInterRAI Early Yearsと良好な一致を示した。HEADS­ED Under 6は、簡潔で、簡単で、有効なスクリーニングツールであり、早期に重要な精神保健および発達領域を特定し、活動/障害のレベルを評価し、ニーズの重症度を伝え、必要なサービスの強度を決定するために使用することができる。.

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Purpose: This study investigated the potential influence of the 2019 Canada's Food Guide (CFG) on the eating environment and food provided in early learning and childcare centres across Canada.Methods: Directors of childcare centres were invited to complete an online survey about their awareness and adoption of the 2019 CFG and submit their menus for analysis.Results: Twenty-five directors completed the survey, and eighteen cycle menus were analyzed. Frequency and the types of foods offered in childcare centres were assessed. Ninety-two percent reported being aware of the changes in the food guide. Many challenges including the lack of support and resources, cost of food, and food reluctance could affect their ability to apply the changes, especially the incorporation of plant-based protein and the uncertainty around the amount of dairy products to provide. Menu analysis indicated frequency of offering items from the various food groups. Vegetables were mostly offered during lunchtime with an average offering rate of 4.83 ± 0.24 times per week.Conclusion: Representatives of early learning and childcare centres identified having difficulties in interpreting and applying the changes in the 2019 CFG. Dietitians have the knowledge and skills required to support childcare centres through training opportunities, workshops, toolkits, and advocacy.

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The home environment and parental influence are strong predictors of eating behaviours in young children and can influence healthy development. The objective of this study was to describe the feeding practices of a sample of families on Prince Edward Island. Eleven parent participants were recruited, one-on-one interviews were held, and a thematic analysis was conducted. Conversations with parents revealed that the family feeding environment is influenced by a multitude of factors that change daily and need to be navigated based on the age of the child. Parents saw family meals as time together and an opportunity to model healthy eating behaviours; however, they faced several challenges at mealtimes, including perceived picky eating. Parents recognized their children's hunger and satiety cues, although they respected satiety signals more often if children ate what they perceived as a lot of food. Many parents used food as a reward to encourage their children to eat more but recognized that it could lead to the development of undesirable habits. Despite the complex factors that influence feeding, dietitians can work with families to foster a responsive feeding environment by encouraging family meals, recognizing and respecting hunger and satiety cues, and understanding typical changes in eating behaviours as children age.

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Purpose: The values, beliefs and practices between the family home and child care environment can play a role in shaping a responsive food environment for young children, but few studies have explored the differences across these settings. The purpose of this study was to compare responsive feeding practices in child care and home environments through the framework of the 2019 Canada Food Guide healthy eating recommendations.Methods: Nova Scotia families and child care providers completed an online survey on responsive feeding. Independent-samples t-tests explored the differences between family and child care respondents on variables related to the 2019 Canada's Food Guide, including: food variety, mindfulness, eating with others, cooking more often, and enjoyment of food. A directed content analysis was used to code the open-ended qualitative questions.Results: Family respondents (n = 603) were more likely to report offering a variety of foods, repeated exposures to new foods, and asking children about fullness. Child care respondents (n = 253) were more likely to sit with children during meals and less likely to encourage children to finish their food.Conclusions: The results identify potential points of intervention, including the importance of increasing communication to ensure mutually supportive messages and environments for healthy eating.

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Purpose: To determine if intake (servings/day) of total dairy and/or dairy subtypes (milk, cheese, and yogurt) were associated with biomarkers related to dyslipidemia, insulin sensitivity and inflammation in a sample of cardio-metabolically healthy young children from the Guelph Family Health Study at the University of Guelph, Guelph, Ontario, Canada.Methods: Baseline data from 42 children (aged 2.0-6.2 years) from 33 families who provided a dietary assessment and a fasted blood sample were included in this cross-sectional analysis. Linear and logistic regressions using generalized estimating equations were used for analysis and models were adjusted for age, gender, and household income.Results: In total, 42 children (3.74 ± 1.23 years old; mean (± SD)) consumed median (25th percentile, 75th percentile) servings/day of 1.70 (1.16, 2.81) for total dairy, 0.74 (0.50, 1.70) for milk, 0.63 (0.00, 1.16) for cheese, and 0.00 (0.00, 0.38) for yogurt. Cheese intake was significantly inversely associated with LDL cholesterol (-0.16 (95% CI: -0.29, -0.03) mmol/L per serving; P = 0.02)). No other associations between dairy intake and biomarkers were significant.Conclusions: Cheese intake was inversely associated with LDL cholesterol in this preliminary study of cardio-metabolically healthy young children, thereby warranting further research on dairy intake and cardiometabolic risk factors.

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PURPOSE: The need to enhance mental health in primary care settings for infants and toddlers is increasingly becoming apparent. However, the lack of trained healthcare personnel and culturally appropriate measures makes it a challenge in low- and middle-income countries. A needs-based assessment of the extent of the problems in toddlers will help address the lacunae in providing mental health services. METHODS: A needs-based assessment was carried out of a community sample of 9,287 mothers with toddlers aged between 13 and 25 months in Kerala, India. This assessment was conducted by junior public health nurses using an indigenously developed checklist titled 'Screening checklist for Behavioural, Emotional and Rhythm-related disturbances in Toddlers' (S-BERT). RESULTS: According to the mothers surveyed, 30.4% of toddlers had concerning or distress causing behaviours. Three factors, namely behavioural, rhythm-related and emotional disturbances, were deemed significant when the item response theory was used to examine the factor structure of S-BERT. CONCLUSION: This study suggests that behaviours that cause distress to mothers of toddlers are common, if queried specifically. Given the constraints in health resources as the cultural factors in operation, use of indigenous tools and principles of collaborative stepped care may be the way forward.

Propósito: La necesidad de mejorar la salud mental en lugares de atención primaria para infantes y niños pequeñitos es cada vez más aparente. Sin embargo, la falta de un personal entrenado de cuidado de salud y medidas culturalmente apropiadas la convierte en un reto en países de bajos y medianos recursos económicos. Una evaluación, con base en las necesidades, de la extensión de los problemas en los niños pequeñitos ayudará a llenar el vacío de proveer servicios de salud mental. Métodos: Una evaluación con base en las necesidades se efectuó en un grupo muestra comunitario de 9,287 madres con niños pequeñitos de edad entre los 13 y 25 meses en Kerala, India. Esta evaluación la llevó a cabo por un grupo de nuevas enfermeras de salud pública usando una lista de verificación desarrollada localmente y conocida como "Lista para verificar la examinación de trastornos en el comportamiento, la emoción y relacionados con el ritmo en niños pequeñitos" (S-BERT). Resultados: De acuerdo con las madres de la encuesta, 30.4% de los niños pequeñitos presentaban preocupaciones o angustias que causaban el comportamiento. Tres factores, a saber, del comportamiento, relacionados con el ritmo y trastornos emocionales, fueron considerados significativos cuando se usó la Teoría de Respuesta a los Asuntos para examinar el factor estructura de S-BERT. Conclusión: Este estudio sugiere que los comportamientos que causan la angustia a las madres de niños pequeñitos son comunes, si se consultan específicamente. Dadas las limitaciones en cuanto a los recursos de salud como los factores culturales operativos, el uso de herramientas locales y principios de cuidados escalonadamente colaborativos pudiera ser el camino a seguir.

But: Le besoin d'améliorer la santé mentale dans des contextes de soin primaire pour les bébés et les jeunes enfants devient de plus en plus apparent. Cependant le manque de personnel de soin de santé formé et le manque de mesures culturellement appropriées en font un véritable défi dans les pays à revenu faible ou intermédiaire. Une évaluation de l'étendue des problèmes chez les jeunes enfants, basée sur le besoin, aidera à s'attaquer aux lacunes en offrant des services de santé mentale. Méthodes: Une évaluation basée sur les besoins a été faite chez un échantillon communautaire de 9287 mères avec des petits enfants âgés de 13 à 25 mois à Kerala en Inde. Cette évaluation a été faite par de jeunes infirmières et infirmiers de santé publique utilisant une checklist développée sur place intitulée "Checklist de dépistage de troubles comportementaux, émotionnels et du rythme chez les petits enfants" (S-BERT). Résultats: Selon les mères qui ont été sondées, 30,4 des petits enfants avaient des comportements inquiétants ou des comportements de détresse. Trois facteurs, soit les perturbations comportementales, liées au rythme et émotionnelles, ont été estimées être importants lors que la Théorie Item Response a été utilisée afin d'examiner la structure de facteur de la S-BERT. Conclusion: Cette étude suggère que les comportements qui causent de la détresse aux mères de petits enfants sont communs, s'ils se trouvent spécialement dans les questions. Compte tenu des contraintes des ressources de santé en tant que facteurs culturels de l'opération l'utilisation d'outils développés sur place et les principes de soins élaborés de manière collaborative peuvent s'avérer être la meilleure manière d'aller vers l'avant.

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Parent-Child Interaction Therapy with Toddlers (PCIT-T) is a new attachment-based parenting intervention designed to meet the needs of children aged 12-24 months presenting with challenging behaviors. This study examined outcomes of the first phase of PCIT-T, Child Directed Interaction-Toddler (CDI-T), 4-months post treatment. Participants were 56 toddlers (Child Mage = 19.13 months) referred to receive CDI-T over an 8-week period at an Australian community-based child behavior treatment clinic for treatment of difficult toddler behaviors. Participants completed questionnaires and observational measures at baseline (Time 1), post-treatment (Time 2), and 4-month follow-up (Time 3). At both Time 2 and Time 3, there were statistically significant increases in observed positive parenting skills and emotional availability and decreases in negative parenting behaviors and child noncompliance. There were also significant improvements in parent-reported child externalizing and internalizing behaviors, parental stress, and maternal depression. There was a pattern of a shift away from attachment insecurity and attachment disorganization. Results suggest that the CDI-T phase of PCIT-T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings, using larger samples and utilizing randomized controlled designs.

La terapia de interacción progenitor-niño con niños pequeñitos (PCIT-T) es una nueva intervención de crianza con base en la afectividad y diseñada para cubrir las necesidades de niños de edad de 12 a 24 meses que enfrentan retos de comportamiento. Este estudio examinó los resultados de la primera fase de PCIT-T, Interacción Dirigida del Niño - Niño Pequeñito (CDI-T), 4 meses después del tratamiento. Participaron 56 niños pequeñitos (Edad promedio del niño = 19.13 meses) que habían sido referidos para recibir el CDI-T en un período de 8 semanas en una clínica en Australia con base comunitaria de tratamiento de comportamiento del niño, dedicada al tratamiento de comportamientos difíciles de niños pequeñitos. Los participantes completaron cuestionarios y medidas de observación al momento básico (Primer momento), posteriormente al tratamiento (Segundo momento) y en el seguimiento a los 4 meses (Tercer momento). Tanto en el momento segundo como en el tercero, se dieron mejorías estadísticamente significativas en cuanto a las observadas habilidades positivas de crianza y la disponibilidad emocional y disminuciones en cuanto a las conductas de crianza negativas y la falta de obediencia del niño. También se dieron mejorías significativas en los comportamientos de externalización e internalización del niño según el reporte del progenitor, el estrés de los padres y la depresión materna. Se dio un patrón de alejarse de la inseguridad de la afectividad y la desorganización de la afectividad. Los resultados sugieren que la fase CDI-T del PCIT-T es una intervención prometedora para niños pequeñitos que presentan asuntos de comportamiento. Futuros estudios deben llevarse a cabo para evaluar la efectividad en otros escenarios, usando grupos muestras más grandes y utilizando diseños de control al azar.

La thérapie d'interaction parent-enfant avec un jeune enfant (en anglais Parent-child interaction therapy with Toddlers, soit PCIT-T) est une nouvelle intervention de parentage basée sur l'attachement, conçue afin de remplir les besoins d'enfants âgés de 12 à 24 mois qui présentent des comportements difficiles. Cette étude a examiné les résultats de la première phase de PCIT-T, l'Interaction Dirigée vers l'Enfant - Petit Enfant (Child Directed Interaction - Toddler, soit CDI-T), à 4 mois après le traitement. Les participants ont consisté en 56 jeunes enfants (âgeM de l'Enfant = 19,13 mois) envoyés consulter afin de recevoir une CDI-T sur une période de 8 semaines dans une clinique de traitement du comportement de l'enfant communautaire en Australie, spécialisé dans le traitement de comportements difficiles de jeunes enfants. Les participants ont rempli des questionnaires et des mesures d'observation au niveau de référence (Temps 1), après le traitement (Temps 2) et au suivi de 4 mois (Temps 3). A la fois au Temps 2 et 3 on a noté des augmentations statistiquement significatives dans les compétences positives observées de parentage et la disponibilité émotionnelle ainsi que des baisses dans les comportements négatifs de parentage et le refus d'obéir. On a aussi noté des améliorations importantes dans l'externalisation de l'enfant rapportée par le parent et les comportements d'internalisation, le stress parental et la dépression maternelle. On a observé une tendance se détachant de l'insécurité de l'attachement et de la désorganisation de l'attachement. Les résultats suggèrent que la phases CDI-T de la PCIT-T est une intervention prometteuse pour les jeunes enfants présentant des problèmes de comportement. Des études futures devraient être faites afin d'évaluer l'efficacité d'autres contextes, en utilisant des échantillons plus larges et en utilisant des plans d'étude contrôlées randomisées.

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Resumo A sobrevida do bebê humano é possibilitada pelo sistema de apego, na medida em que ele busca proximidade, emitindo comportamentos mediadores em direção a uma figura que lhe proporciona segurança. Reflexões provindas da existência de uma intersubjetividade inata e evidências de habilidades mais refinadas do que se conhecia à época da formulação da teoria de Bowlby levaram à hipótese de que o comportamento de apego pode ser observado antes do proposto por esse autor. Empreendeu-se um estudo de caso, em que se analisaram videogravações do primeiro semestre de vida de Marina. Selecionaram-se e analisaram-se microgeneticamente episódios de comportamento diferencial do bebê com seus cuidadores antes dos seis meses de idade; e mapearam-se os comportamentos mediadores com cada cuidador. O comportamento diferencial com uma figura discriminada foi visualizado já aos três meses de vida. Discutiram-se os processos dialógicos e culturais que repercutiram na seleção da mãe como figura de apego.

Abstract The survival of a human baby is enabled by the attachment behavioral system, as babies seek proximity, directing attachment mediator behaviors toward a figure who provides security. Reflections from the existence of a primary intersubjectivity and evidence of more refined abilities than what was known at the time in which Bowlby formulated this theory conducted us to the hypothesis that attachment is perceived before the period he proposed. We performed a case study in which we analyzed video-recordings from Marina's six months of life. Episodes of differential behavior towards a figure were selected and micro-genetically transcribed. Moreover, mediator behaviors with each of the baby's caregivers were mapped. Results suggested differential behavior towards a discriminated figure since her third month. The dialogical and cultural processes that reverberated in selecting the mother as the attachment figure were discussed.

Résumé La survie du jeune enfant est rendue possible par la relation d'attachement, quand il cherche de la proximité, en émettant des comportements médiateurs vers une figure qui lui fournit sécurité. Réflexions de l'existence d'une intersubjectivité innée et évidences d'habiletés raffinées qu'on connaissait à l'époque de la formulation de la théorie on conduit à l'hypothèse que le comportement d'attachement peut être observé avant la période proposé par Bowlby. On a réalisé une étude de cas où des enregistrements vidéo du premier semestre de Marina ont été analysés. Episodes de comportement différentiel du jeune enfant avec une figure discriminée avant six mois ont été sélectionnés et analysés micro génétiquement; les comportements médiateurs avec chaque soignant ont été enregistrés à intervalles. Le comportement différentiel avec une figure discriminée a été observé déjà à trois mois de vie. L'influence des processus dialogiques et culturels sur le choix de la mère comme figure d'attachement sont discutés.

Resumen La garantía de supervivencia del bebé humano es posibilitada por el sistema de apego, en la medida en que el bebé busca acercamiento, mediante comportamientos mediadores emitidos en dirección de una figura que le proporcione seguridad. Las reflexiones derivadas de la intersubjetividad innata y evidentes habilidades mucho más refinadas de lo que eran conocidas en la época de la formulación de la teoría de Bowlby llevaron a la hipótesis de que el comportamiento de apego puede observarse antes de lo propuesto por él. Se realizó un estudio de caso a partir del análisis de grabaciones en video del primer semestre de vida de Mariana. Para ello, se seleccionaron y se analizaron microgenéticamente episodios de comportamiento diferencial del bebé con cuidadores antes de los seis meses; y se enumeraron los comportamientos mediadores con cada cuidador. Los resultados sugieren que el comportamiento diferencial con una figura discriminada se observó ya a los tres meses de vida. Se discutieron los procesos dialógicos y culturales que repercutirán en la selección de la madre como la figura de apego.

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The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well-being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research on the reproductive health of incarcerated women, (b) characteristics and experiences of pregnant incarcerated women, (c) outcomes of infants and young children with incarcerated parents, (d) implications of research findings for policy and practice, and (e) the need for increased research, public education, and advocacy. We strongly recommend that correctional policies and practices be updated to address the common misconceptions and biases as well as the unique vulnerabilities and health needs of incarcerated women and their young children.

Estados Unidos ha visto un crecimiento sin precedentes en el número de mujeres encarceladas, la mayoría de las cuales son madres con niños menores. Mayores preocupaciones de salud pública conciernen a la salud reproductiva de mujeres en prisiones y cárceles y el bienestar de sus infantes y niños pequeños. En el presente artículo, usamos un marco de trabajo de justicia reproductiva para examinar la intersección del encarcelamiento y la salud materno-infantil. Revisamos 1) la investigación actual sobre la salud reproductiva de mujeres encarceladas, 2) las características y experiencias de mujeres embarazadas encarceladas, 3) lo que resulta de infantes y niños pequeños con progenitores encarcelados, 4) las implicaciones de los resultados de la investigación en cuanto a políticas y prácticas, y 5) la necesidad de aumentar la investigación, la educación pública y la defensoría. Recomendamos fuertemente que se actualicen las políticas y prácticas correccionales para incluir los conceptos erróneos y prejuicios acerca de mujeres encarceladas y sus niños pequeños, así como también sus distintivas vulnerabilidades y necesidades de salud.

Les Etats-Unis d'Amérique ont été les témoins d'une augmentation sans précédent dans le nombre de femmes incarcérées, la plupart étant des mères avec des enfants mineurs. De grands problèmes de santé publique sont liés à la santé reproductive des femmes en prison et au bien-être de leurs nourrissons et de leurs jeunes enfants. Dans cet article nous utilisons une structure de justice reproductive afin d'examiner l'intersection de l'incarcération et de la santé maternelle et de l'enfant. Nous passons en revue: 1) les recherches actuelles sur la santé reproductive des femmes incarcérées, 2) les caractéristiques et les expériences de femmes incarcérées enceintes, 3) les résultats de nourrissons et de jeunes enfants avec des parents incarcérés, 4) les implications des résulats de recherche pour les lois et la pratique, et 5) le besoin de plus de recherches, plus d'éducation publique, plus de promotion et défense. Nous recommandons fortement que les lois correctionnelles et les pratiques correctionnelles soient mises à jour afin de traiter et de faire face aux conceptions erronées et à la partialité communes, ainsi qu'aux vulnérabilités uniques et aux besoins de santé des femmes incarcérées et de leurs jeunes enfants.

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Toddlers with language delay are at risk for persistent developmental and behavioral difficulties; however, the association between socioemotional/behavior problems and language in young children is not well understood. This study explored socioemotional/behavior problems in a unique sample of toddlers with language delays using a measure developed explicitly for this age group. Toddlers identified by 18 months with receptive and expressive language delay (LD; n = 30) or typical development (TD; n = 61) were evaluated at 18 and 24 months of age using the Infant-Toddler Social and Emotional Assessment (ITSEA) and the Mullen Scales of Early Learning. Compared to toddlers who had TD, toddlers with LD had significantly more concerning scores at 18 and 24 months on all ITSEA domains. The rate of "clinical concern" on most domains was not high in either group, except that >60% of LD toddlers were in the clinical concern range on the Competence domain. Socioemotional/behavioral problems were dimensionally related to receptive and expressive language, with greater language delay associated with more concerning ITSEA scores. Socioemotional and behavioral problems are related to receptive and expressive language abilities in 18- and 24-month-olds, indicating the need for screening of both types of concerns in toddlers identified with potential language delays.

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Poverty and its associated factors put people at risk for depression. The aims of this study were to describe the prevalence of depressive symptoms (DS) of primary caregivers and socioemotional development (SED) delays of young children in poor rural areas of China, and to explore the association between them. Cross-sectional data of 2,664 children aged 3 to 35 months and their primary caregivers were used for analysis. Characteristics of the child, caregiver, and family were collected through face-to-face caregiver interviews. DS were assessed by the Zung Self-Rating Depression Scale (W.W. Zung, 1965, as cited in World Health Organization, ), and SED was evaluated by the Ages and Stage Questionnaires: Social-Emotional (J. Squires, D. Bricker, & L. Potter, 1997). The χ2 test, stratification analysis, and logistic regression analyses were used to explore the association. Among the caregivers, 40.3% (95% confidence interval [CI] [38.4, 42.1]), reported DS. Caregivers who were male, older and ethnic minorities as well as had a low level of education, a low family income, or more children were more likely to have DS. Of the children, 24.4% (95% CI [22.8, 26.0]) were recognized with SED delays. Older children displayed more delays than did younger children, but no significant differences between males and females were found. SED delays were significantly associated with mother outmigrating, male caregivers, older age, ethnic minorities, and low education or families with a single parent, low-income, and having more children. Caregivers having DS, odds ratio (OR) = 2.40, 95% CI [1.99, 2.88], was a significant predictor of increased odds of SED delays; other factors were single-parent family, OR = 1.99, 95% CI [1.37, 2.89], inadequate care, OR = 1.69, 95% CI [1.30, 2.21], physical punishment, OR = 1.61, 95% CI [1.33, 1.95], ethnic minorities, OR = 1.41, 95% CI [1.17, 1.71], and child age in months, OR = 1.03, 95% CI [1.02, 1.04], according to the logistic regression analysis. DS are prevalent among caregivers with young children in poor rural areas. Interventions to improve the mental health of caregivers and their parenting behaviors are needed to improve children's SED.

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The expansion of infant mental health (IMH) to at-risk preschoolers and their families has contributed to the integration of relational play therapy (RPT) into IMH treatment services for this population. Integrating RPT allows access to specialized play and expressive techniques specific to preschool and family development, which improves the clinical ability to meet the multiple and complex needs of at-risk parent-child dyads and their families. This article will examine the RPT literature and explore the similarities and differences between IMH and RPT. In addition, two case studies will highlight a five-phase, integrative clinical-treatment process and provide insight into how IMH clinicians are integrating RPT models and maintaining adherence to the IMH treatment approach.

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The reciprocal transactions that shape early parent-child relationships are influenced by contextual stress, such as family conflict. Although family conflict is a salient stressor to the family system, few studies have considered how parent-child transactions vary according to exposure to family conflict. The present study examined how family conflict alters early parent-child behavioral transactions. We utilized three waves of data from a multisite longitudinal study of low-income families (N = 2, 876), child age 14 months, 24 months, and 36 months, to identify behavioral transactions of positive and negative maternal (supportiveness, negative regard) and child (engagement, negativity) behaviors. Results indicated that family conflict at 14 months diminished the positive association between maternal supportiveness and child engagement, and amplified the inverse association between maternal negativity and child engagement. Family conflict at 14 months also was associated with increased stability of child negativity and subsequent increased maternal negative regard at 36 months, in part via increases in 24-month child negativity. In sum, family conflict occurring early in childhood predicted and moderated behavioral transactions between young children and their mothers.

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This article highlights the feasibility of a dyadic prolonged exposure (DPE) intervention (L. Rachamim, I. Mirochnik, L. Helpman, N. Nacasch, & E. Yadin, ) in a 3-year-old preschooler and in a 6-year-old kindergartener immediately following the traumatic death of their younger sibling. It presents a detailed case description of the DPE treatment addressing traumatic grief and includes transcribed treatment dialogue. At the time of treatment termination, both children and caregivers resumed normal functioning. The results suggest that DPE intervention may ameliorate posttraumatic grief symptoms in young children. Controlled studies of preventive interventions for this population are clearly warranted.

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Since a substantial portion of infants and toddlers reenter care after reunification, the question of whether family reunification is feasible needs to be answered very cautiously. How parenting is assessed is of major importance in answering this question, but the quality of these assessments is often poor. With an eye to improving current practice, we conducted an integrative review, in which we analyzed the challenges related to the assessment of parenting vis-à-vis reunification and linked relevant knowledge from research with significant know-how from practice. The challenges appear to be embedded in the struggle to define (especially good enough) parenting and the complex context of child protection. As an answer to the challenges, the integrative review resulted in a framework of four key components required for sufficient parenting-assessment practice: (a) the use and development of expertise; and (b) providing families aiming for reunification with an intervention that is intensive, (c) flexible, and (d) organized as teamwork. Providing families with such an intervention gives them the opportunity to make substantial changes in their parenting and helps professionals assess the capacity of parents to grow to an acceptable level of caretaking for their child. Further implications for research and practice are discussed.

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This article provides a description of the development, implementation, and preliminary evaluation of feasibility and acceptability of the Managing Youth Trauma Effectively (MYTE) program and highlights perceptions of changes in mothers' trauma-informed parenting practices. The program consists of a training and consultation program for staff of the U.S. State of Arkansas' Specialized Women's Programs (SWS), and an 8-week, group psychoeducational program designed to help mothers with substance-abuse problems learn how traumatic experiences may affect their children and how they may help support their children by creating a safe and nurturing environment. A posttraining evaluation with leadership and staff at SWS centers, feedback provided on consultation calls with MYTE facilitators, and a retrospective pre/post survey were used to examine feasibility, acceptability, and perceptions of changes in mothers' trauma-informed parenting practices. Preliminary results suggest that the MYTE program is feasible to implement and is acceptable to training participants, facilitators, and mothers participating in the program. Mothers reported significant growth in their perceptions of use of trauma-informed parenting practices. Future research is necessary to confirm these results and examine the effectiveness of the program using a randomized clinical trial.

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Using the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) data set (U.S. Department of Education Institute of Education Sciences, National Center for Education Statistics, 2001), this study examined child, family, and community factors in the early years (infant and toddler years) to predict the cognitive and language outcomes for preschool-age Black boys in relation to Black girls and White boys. Findings indicate that Black children face many challenges, with Black boys experiencing less sensitive parenting as compared to their peers. We live in a highly complex, racialized environment. While there are universal indicators that predict children's preschool outcomes such as strong social positioning and positive parenting, there are, in addition, some indicators that are more beneficial for Black boys' early development, including a stable, less urban home environment with parents engaging in "tough love."

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