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Mothers' experiences of caring for children with Prader-Willi Syndrome (PWS) is largely unknown. With no treatment for PWS, parents undertake (extra)ordinary care practices to keep children safe from overeating and self harm. Knowledge of these care practices could lead to effective interventions. Narrative inquiry was used to study everyday experience with Canadian mothers. Participants cared for a child 3 to 17 years old who had hyperphagia. Participants were interviewed 8 to 12 times each over the course of a year. Narrative accounts were co-composed through a collaborative process of analysis. Engaging with participants' everyday experiences amplified complex care needs for families and gaps in health and social care systems. Narrative threads focused on engaging in (extra)ordinary care practices, rigid care work to keep children healthy and safe, tension from others while enacting these care practices, and difficulty conforming to social expectations with childrearing and care work. Recommendations for practice and policy include (a) shifting from untenable care practices, (b) reconceptualizing care work, and (c) alternative care models. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a complex and multifactorial public health problem associated with important physical and psychological repercussions. Recent studies suggest that cumulative childhood trauma (CCT) may be related to higher IPV perpetration through dysfunctional communication patterns, but to our knowledge, no study has tested this proposition in a clinical population. This study aimed to explore the direct and indirect links between CCT and perpetrated IPV through dysfunctional communication patterns among 577 men seeking help from community centers specializing in IPV. Prior to receiving services, participants completed a battery of questionnaires including validated brief measures of CCT (sexual, physical, and psychological abuse; physical and psychological neglect; witnessing of physical and psychological parental violence; bullying), communication patterns (demand/demand, partner demands/man withdraws, man demands/partner withdraws), and IPV (psychological, physical, coercive control). Results from a path analysis reveal that having sustained a higher number of different forms of childhood trauma is directly related to men's higher risk of perpetrating psychological IPV. CCT is also indirectly related to higher perpetrated psychological and physical IPV and coercive control through a higher report of the demand/demand communication pattern and a higher report of the man demands/partner withdraws communication pattern. The tested model explains 23% of the variance in psychological IPV, 6% of the variance in physical IPV, and 12% of the variance in coercive control. Results highlight the importance of assessing, in therapy, both distal and proximal variables associated with IPV, including the accumulation of many forms of childhood interpersonal trauma, and to tailor trauma-informed interventions that promote constructive communication strategies. [ABSTRACT FROM AUTHOR]

This qualitative study adds to research on the experiences of professionals who support newcomer women who have experienced intimate partner violence (IPV). Findings from seven focus groups with 32 service providers from newcomer-serving and domestic violence agencies in Saskatchewan, Canada, include newcomer survivors' experiences of isolation, the impact of IPV on newcomer children, and challenges and opportunities for supporting newcomer women who have experienced IPV. Service providers described gaps in existing services and the need for additional services; they also described ways of working effectively with newcomer women survivors of IPV and their children. Professionals indicated the importance of a trauma-and-violence-informed, survivor-centered approach and highlighted the need for compassion, empathy, and patience when working with newcomer women who have experienced IPV. This article includes recommendations for service providers, including IPV shelters and services and newcomer-serving agencies, to improve service to newcomer survivors. [ABSTRACT FROM AUTHOR]

It has long been established that bullying has many negative impacts on the mental health of adolescents. Young people who are victimized by bullying may cope by drawing on available assets to protect themselves from harm. One such asset with ancient roots but with the potential for contemporary application is the concept of spiritual health—the idea that the connections in our lives (whether to ourselves, others, nature, or something transcendent) affect our well-being. In this study, we examined 12,593 Canadians aged 11–15 years to determine the effects of being victimized by bullying on their mental health, as measured by frequent subjective health complaints. We then explored whether strong spiritual health connections were effect modifiers that buffer such negative pathways, thereby acting as protective health assets. Data were obtained from the 2017/18 Canadian Health Behaviour in School-aged Children study. Generalized linear regression models were used to estimate associations and evaluate effect modification in different age and gender groups. Approximately 21% of participants reported being victimized by bullying. Strength of "connections to self" (i.e., a sense of meaning/purpose or joy and happiness in one's life) was found to act as an effect modifier, but in girls alone. Contrary to expectations of a buffering effect, the strongest associations between victimization and frequent health complaints were identified for girls with high connections to self. Relative risks for poor mental health among these highly self-connected girls were 1.63 [95% CI: 1.26–2.12] and 1.25 [1.06–1.47] for younger and older girls, respectively. We interpreted this unexpected finding in light of cognitive theories of trauma, which suggest that adverse events may lead to worse health outcomes among those who place particular value on their world being meaningful, controllable or benevolent. Implications for clinical intervention and health promotion are considered. [ABSTRACT FROM AUTHOR]

Objectives: To determine if Cognitive Orientation to Occupational Performance was effective in improving performance and transfer of motor learning in children with developmental coordination disorder (with/without attention deficit hyperactivity disorder); and whether outcomes were maintained three months post-intervention. Design: Randomized waitlist-control trial (ClinicalTrials.gov ID: NCT02597751) Setting: BC Children's Hospital, Vancouver, Canada Subjects: Thirty-seven children with developmental coordination disorder and 41 children with co-occurring attention deficit hyperactivity disorder (all 8–12 years), randomized to treatment or waitlist groups. Interventions: One-hour of intervention once weekly for 10 weeks. Main Measures: (1) Canadian Occupational Performance Measure to measure self-perceived performance of motor goals (10-point scale); (2) Performance Quality Rating Scale to measure therapist-observed movement quality (10-point scale); and (3) Bruininks-Oseretsky Test of Motor Proficiency – 2nd ed. to measure overall motor skill ability/transfer of motor learning (percentile). Results: Both groups showed significant improvement (p < 0.001) in motor performance (developmental coordination disorder: pre: 2.7 ± 2.2, post: 7.0 ± 1.0; developmental coordination disorder with attention deficit hyperactivity disorder: pre: 2.3 ± 1.7, post: 7.0 ± 1.5) and movement quality (developmental coordination disorder: pre: 3.0 ± 1.5, post: 6.3 ± 1.7; developmental coordination disorder with attention deficit hyperactivity disorder: pre: 3.0 ± 1.9, post: 5.7 ± 2.3). Three months after treatment, children maintained their gains, but only children with developmental coordination disorder showed transfer of learning to overall motor skills (pre:12 ± 15, post:12 ± 12, follow-up:14 ± 20, p < 0.001). Conclusion: Intervention was similarly effective for children with developmental coordination disorder with/without attention deficit hyperactivity disorder in achieving and maintaining functional motor goals, but only children with developmental coordination disorder showed transfer of learning to other motor skills. [ABSTRACT FROM AUTHOR]

Summary: Even though an extensive body of literature on children has swept the field of domestic violence in the last 30 years, little is known about how domestic violence shelter workers understand children's situations and how they intervene with them. This article seeks to address this gap in the literature, and presents the results of a study conducted with 48 advocates in the province of Québec (Canada). Findings: The data suggest that most of the participants adopt a child-centred perspective and consider the children in their own right during their stay. The accounts of the participants' practices also reveal that they perceive children as being vulnerable and at-risk. With a moderate emphasis on vulnerability and risk, the participants tend to support the children alongside their mothers, while associating potential risks with the behaviour of the perpetrator of domestic violence. However, with a strong focus on vulnerability and risk, participants tend to cast aside the perpetrators' behaviour and monitor the women-as-mothers during their stay while associating potential risk with their [in]actions under the circumstances. This can lead to mother-blaming, surveillance and more authoritarian interactions. Applications: The understanding of children living with domestic violence needs to remain rooted in a feminist analysis of violence against women in order to avoid some of the issues highlighted in the article. Furthermore, studies that seek to shed light on best social work practices when working with children in alliance with their mothers from a feminist perspective are crucially needed. [ABSTRACT FROM AUTHOR]

The negative effects of exposure to intimate partner violence (IPV) on children have been well documented, including externalizing difficulties such as aggression. Although aggressive behavior is a common concern for these children, sibling aggression in children exposed to IPV has rarely been studied. Our purpose was to investigate similarities and differences in multiple informant reports of aggression by siblings exposed to IPV, and to examine how exposure to IPV was linked to these differing perspectives. Forty-seven sibling dyads and their mothers were recruited from the community. Aggression was assessed by observers, by mothers, and by the siblings themselves, whereas IPV was assessed by both maternal and child report. Informants had very differing views on aggression. Regression results indicated that children's reports of their own exposure to IPV accounted for significant variance in observed aggression between siblings, as well as in the maternal reports of aggression by both siblings. Aggression did not vary by sibling age, sex, or age spacing. Results were discussed within a risk and resilience framework. [ABSTRACT FROM AUTHOR]

Pediatric hematopoietic stem cell transplant (HSCT) is an intensive treatment that can be life-threatening. All family members experience distress. We conducted a grounded theory study using a family systems-expressive arts framework to develop a theoretical understanding of the family experience of HSCT. Six families (15 family members) participated in two interviews, drew an image, and were guided through a "dialoguing with images" process. Participants did not always perceive HSCT as an experience they had lived as a family and were surprised to hear other family members' experiences. While one mother drew, she suddenly understood it was not only her ill child, but the entire family who had "fallen down the rabbit hole." The family experience of HSCT is described across (a) the pre-HSCT trajectory, (b) family fragmentation (hospitalization), and (c) family reintegration. We identified a critical need for targeted family intervention during the transition into HSCT, throughout and following hospitalization. [ABSTRACT FROM AUTHOR]

Corporal punishment is a widely used and widely endorsed form of parental discipline. Inter-partner violence places enormous stress upon women. The rate of corporal punishment is higher in homes where other types of domestic violence are also occurring. This study compares two groups: those who participated in an intervention for women exposed to intimate partner violence (The Moms' Empowerment Program [MEP]) and those in a comparison group. Using standardized measures, women in both groups were assessed at baseline and at the end of the program, 5 weeks later. The 113 mothers who participated in the MEP program had significantly improved their parenting, such that they had less use of physical punishment post-intervention. Findings suggest that a relatively brief community-based intervention program can reduce the use of parental physical punishment even in disadvantaged populations coping with stressful circumstances. [ABSTRACT FROM AUTHOR]

Introduction. Little is known about Canadian youth football injuries. The objectives of this study were (a) to contrast the injuries in Canadian and American football players aged 6 to 17 years and (b) compare the injuries sustained during organized football with those in nonorganized football. Methods. Using a retrospective cohort design based on data from the Canadian Hospitals Injury Reporting and Prevention Program and the National Electronic Injury Surveillance System a comparison of injuries was made. Results. Trends in injuries were comparable. Proportions and odds of injuries were similar, except for a few exceptions. In Canada, more girls were injured and fractures were more prevalent. Compared with nonorganized football, organized football players were older, involved more males, and suffered more traumatic brain injuries and injuries to their lower extremities. Conclusion. Canadian and American youth football injuries were similar. The type of football, be it organized or nonorganized, has an impact on injuries. [ABSTRACT FROM AUTHOR]

There are some children who encounter unexpected reading difficulties in the fourth grade. This phenomenon has been described as late emerging reading disabilities (LERD). Using Grade 4 as a starting point, this study examined the reading development of 964 children between kindergarten and Grade 7. The results showed that 72.0% of children had typical reading performance in Grade 4, whereas there was 0.7% with poor word reading, 12.6% with poor reading comprehension, 2.5% with poor word reading and comprehension, and 12.2% with borderline performance. We also showed that there were similar proportions of children who had early versus late emerging reading difficulties; however, most of the late emerging poor readers recovered by Grade 7. Furthermore, our study showed that poor comprehenders showed poorer performance than typical readers on word reading, pseudoword decoding, and spelling between Grade 1 and Grade 7 and poorer performance on a working memory task in kindergarten. Overall, this study showed that most children recover from late emerging reading problems and that working memory may be an early indicator for reading comprehension difficulties. [ABSTRACT FROM AUTHOR]

An emerging body of mental health research provides evidence that callous-unemotional (CU) traits explain significant and meaningful variance among children with disruptive behavior disorders. However, the classroom behavior of students with CU traits has not yet been adequately studied. This study examined this issue using teacher-recorded classroom rule violations (RVs). Participants were 648 children (346 boys; M age = 8.14) from 28 classrooms (kindergarten-sixth grade) distributed across three schools participating in a schoolwide behavioral intervention. Teachers completed rating scales approximately 4 to 6 weeks after the start of the school year, prior to initiating the schoolwide intervention. After completing ratings, teachers recorded daily frequency counts of RVs for each student in their classroom for the remainder of the school year. Growth curve modeling analyses indicated that (a) CU traits were associated with elevated rates of RVs at the start of the school year even after taking attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder/conduct disorder (ODD/CD) into account and (b) CU traits were associated with a significant decrease in rates of RVs across the school year. CU traits appear to explain significant and important variance in classroom RVs among elementary school age students. [ABSTRACT FROM AUTHOR]

Youth with autism spectrum disorder are a vulnerable, often poorly understood patient group, who may experience periodic and chronic health challenges, in addition to their primary developmental social and communication problems. Developmental and behavioural challenges can complicate management of acute health-care needs. To date, there is an absence of empirical research exploring the hospital experiences of children and youth with autism spectrum disorder, their families and their health-care providers. Therefore, the purpose of this study was to understand these experiences in order to inform hospital-based care. A total of 42 participants were interviewed (youth with autism spectrum disorder, their parents and health-care providers) at one of two Canadian paediatric hospitals, representing 20 distinct cases of patients with autism spectrum disorder. Results from the qualitative analyses indicated that patients with autism spectrum disorder faced several challenges in the context of health-care delivery in the hospital setting, as did their families and health-care provider team. Problems identified included communication and sensory challenges, and the degree of flexibility of health-care providers and the hospital organization. Supportive health-care providers were those who acknowledged parents as experts, inquired about the requirements of patients with autism spectrum disorder and implemented strategies that accommodated the unique clinical presentation of the individual patient. These recommendations have wide-reaching utility for hospital and health-care practices involving this patient group. [ABSTRACT FROM PUBLISHER]

Few youth with autism spectrum disorder (ASD) nationally report receiving services to help them transition from the pediatric health care system to the adult health care system. For example, only one-fifth (21.1%) of youth with ASD receive any transition planning services. To better understand why the transition from pediatric to adult health care is so difficult, we interviewed pediatric health care providers with extensive experience serving youth with ASD. We gathered information about the strategies and interventions they use to transition their patients with ASD to an adult provider. Five interventions or strategies are currently being used. These include providing families with written medical summaries to give to adult providers, compiling lists of available adult providers or community resources, coordinating care and communication between individual pediatric and adult providers, making transition-specific appointments, and using checklists to track transition progress. Other interventions or strategies were identified as needed but not currently in practice, and these focused on education and training. For example, informational workshops were suggested to train families and youth about transition. Training adult providers and medical students was also seen as important. Several respondents additionally identified the need for a transition center where all services could be coordinated in one place. With large numbers of youth with ASD becoming young adults, it seems that pediatric practices might want to consider some of the activities described here. Some of these activities, such as family educational seminars and written medical summaries, are likely relatively easy for a practice to implement. [ABSTRACT FROM PUBLISHER]

Anxiety disorders frequently co-occur in youth with autism spectrum disorders. In addition to developing efficacious treatments for anxiety in children with autism spectrum disorders, it is important to examine the transportability of these treatments to real-world settings. Study aims were to (a) train clinicians to deliver Facing Your Fears: Group Therapy for Managing Anxiety in Children with High-Functioning Autism Spectrum Disorders to fidelity and (b) examine feasibility of the program for novel settings. A secondary aim was to examine preliminary youth treatment outcome. Results indicated that clinicians obtained excellent fidelity following a workshop and ongoing consultation. Acceptability ratings indicated that Facing Your Fears Therapy was viewed favorably, and critiques were incorporated into program revisions. Meaningful reductions in anxiety were reported posttreatment for 53% of children. Results support the initial effectiveness and transportability of Facing Your Fears Therapy in new clinical settings. [ABSTRACT FROM PUBLISHER]

Children’s musculoskeletal (MSK) injury pain remains poorly managed. This survey of pediatric emergency physicians and orthopedic surgeons assessed analgesia administration practices and discharge advice for children with acute MSK pain; 683 responses were received. Ibuprofen was the most commonly reported analgesic used in the emergency department (52%) and at discharge (68%). Most (85%) reported using oral opioids in the previous 6 months. Codeine use was the most commonly reported opioid used in the emergency department (38%) and at home (51%). For equal levels of pain, younger children received less opioids than older children. Younger physicians and recent graduates chose acetaminophen and codeine more than older and more experienced colleagues, who preferred ibuprofen and non-codeine containing opioid compounds (P < .001 and .006, respectively). Orthopedic surgeons reported less ibuprofen use than pediatric emergency physicians (P < .001). Choice of analgesic agents is heterogeneous among physicians and is influenced by pain severity, child’s age, and physician characteristics. [ABSTRACT FROM PUBLISHER]

Parents of children diagnosed with autism spectrum disorder often report higher levels of depression, anxiety, and mental health–related issues. The combination of stressors and family adjustment difficulties can cause distress which may develop into a crisis. Understanding crisis in the family is important to mental health practice since it can serve as a guide in delivering service to at-risk families. This study investigated the subjective experience of crisis in 155 mothers of children diagnosed with autism spectrum disorder. Thematic analysis revealed that crisis is characterized by factors influencing four major areas: demands, internal capabilities, external resources, and subjective appraisal. Understanding what crisis means to families of individuals with autism spectrum disorder can help inform effective preventative and crisis services. [ABSTRACT FROM PUBLISHER]

Only 7% of Canadian children achieve activity recommendations, contributing to obesity and preventable disease. The Heart Healthy Kids (H2K) program was designed to test the relationship between peer mentoring, physical activity, and cardiovascular fitness. Participants from 10 schools (5 control, 5 intervention) were enrolled in the program. In control schools, H2K included a physical activity challenge and education sessions. Intervention schools included the addition of a peer-mentoring component. Physical activity was measured through daily pedometer recording. Cardiovascular fitness was evaluated using the PACER (Progressive Aerobic Cardiovascular Endurance Run) protocol to calculate maximal oxygen uptake (VO2 max). Participants included 808 children (average age 9.9 ± 1.0 years). Although control and intervention schools did not differ at baseline, participants with peer mentoring logged significantly more steps per school day, on average, than those in control schools (6,785 ± 3,011 vs. 5,630 ± 2,586; p < .001). Male participants logged significantly more steps per school day than female participants. A significant improvement in VO2 max was also noted in intervention schools, with an average increase of 1.72 ml/mg/min. H2K was associated with positive change in physical activity and cardiovascular fitness, suggesting that peer mentoring shows promise for application in health promotion interventions. [ABSTRACT FROM PUBLISHER]

There are growing concerns in many industrialized Western societies about declining opportunities for children to play, and fears that this will have adverse health consequences for them. Informed by anti-obesity efforts, public health institutions have recently begun to advance active forms of play as a way of improving children’s physical health; however, promoting play for physical health might reshape meanings of play for children. We conducted photography and interview sessions with 25 Canadian children aged 7 to 11 years to examine their representations of play. Our findings suggest that for children, (a) play is an end in itself, (b) play involves but is more than active play, (c) there is ambivalence about scheduled play, and (d) risk is considered a pleasurable component of play. These findings point to a dissonance between children’s play promoted for physical health and the meaning of play for children as emotionally contingent, intrinsically motivated, and purposeless. [ABSTRACT FROM PUBLISHER]