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Psychiatric disorders are common in youth with intellectual and developmental disabilities. This is a vulnerable group of children whose behavioural problems often have more complicated care needs than other children, which can place a great deal of stress on their families. However, the association of family mental health issues, level of intellectual ability, and diagnostic co-morbidity in children is relatively under-studied. In the present study, we investigated the relationship among child diagnoses, family mental health problems, risk for self-injury, and disruption in care among children with (N = 517) and without (N = 517) intellectual and developmental disabilities. A negative binomial regression showed that mental health problems in multiple family members, self-injurious behaviour, and self-reported abuse/trauma was related to greater likelihood of provisional diagnoses of co-occurring psychiatric disorders in both a clinically referred sample and a sample with IDD. Implications for care-planning are discussed.

School disruption (SD) places students at risk of early school departure and other negative psychological outcomes. Based on the data derived from a sample of Ontario children and youth, this study aims to identify risk factors associated with SD among 1,241 school-aged students. A logistic regression model revealed that substance use, family functioning, Attention Deficit/Hyperactivity Disorder and experiencing bullying, significantly predicted SD. Substance use and family functioning resulted in the largest contributions to SD when holding other variables constant. This study provides supporting evidence of risk factors predicting SD and suggests that mental health and school personnel should consider family functioning and substance use in particular, when creating interventions to decrease premature school termination.

Background: While empirical testing of many of the interRAI Child and Youth Mental Health (ChYMH) assessment scales have been found to be reliable and valid across both child and adult samples, other scales have yet to be psychometrically evaluated within child populations. Objective: The current study evaluates the psychometric properties of the Depressive Severity Index (DSI) embedded in the ChYMH instrument in a child sample. Method: ChYMH data from 6093 children (aged 4-18) across mental health agencies in Ontario, Canada, were obtained. Results: The scale showed good inter-item reliability with a Cronbach's alpha of 0.86 and high inter-item correlations. The scale also demonstrated good convergent validity when tested against DSM-IV mood disorders diagnosis, Child Behaviour Checklist Internalizing scores, and Behaviour Assessment System for Children, Third Edition-Depression scores. Furthermore, children's DSI scores significantly predicted their s-injury attempts and suicide intent using receiver operating characteristic (ROC) analysis, showing good criterion validity of the scale. Conclusions: Overall, the results were in support of the reliability, convergent validity, and criterion validity of the DSI in detecting depression symptoms in the children and youth population.

Background: This study examined predictors of service complexity in children with comorbid intellectual developmental disorder (IDD) and mental health concerns. We examined whether patient type, safety risk, exposure to trauma, and family dysfunction were related to service complexity. Method: The study had a cross-sectional design, wherein trained clinicians assessed 330 outpatient and inpatient children with IDD and mental health problems using an interRAI ChYMH-DD instrument. Results: Inpatients experienced a greater prevalence of abandonment by caregiver than outpatients. The patient type defined relationships between age, family dysfunction, safety risk, cumulative trauma, and service complexity. Specifically, in a multivariate model, older age, higher family dysfunction, higher safety risk, and higher cumulative trauma predicted higher service complexity in outpatients but not inpatients. Conclusions: In addition to older age, poly-victimisation, family dysfunction, and safety risk need to be considered when predicting service complexity in this population.

Previous research linking school disruption with mental health problems has largely relied on assessments of academic achievement to measure school disruption. Early disruptive classroom behaviour (e.g., conflict with school staff, negative attitudes toward school), however, may precipitate poor academic performance and may stem from emerging mental health concerns, particularly among young children. To address this gap in the literature, 912 clinically referred children and youth (ages 4-18 years old) were assessed using the interRAI Child and Youth Mental Health (ChYMH) assessment utilizing a cross-sectional study design. The ChYMH assessment evaluates school disruption independently of academic achievement, and includes a comprehensive assessment of the child's mental health functioning, needs, and preferences. A logistic regression analysis revealed that various provisional mental health diagnoses (i.e., attention-deficit/hyperactivity disorder, disruptive behaviour, mood disorders, and, to a lesser extent, anxiety) were associated with disruption in the classroom. Implications for school-based care planning are discussed.

Introduction Methods Results Conclusion Children with fetal alcohol spectrum disorder (FASD), a neurodevelopmental disorder associated with cognitive, emotional, and learning impairments have an increased likelihood of experiencing behavioral and socio-emotional difficulties and historical trauma.Using the interRAI Child and Youth Mental Health instrument, this study examined associations between FASD, polyvictimization, daily cognitive decision-making, family functioning, and externalizing problems in 18,701 children and youth from 4 to 18 years of age (M age  = 12.33, SD age  = 3.53).Children with FASD, compared to children without FASD, were at an increased risk of being polyvictimized, were more likely to endorse greater difficulties with daily cognitive decision-making and family dysfunction, and scored higher on proactive and reactive aggression.The findings highlight the increased risk of individual and familial difficulties in children diagnosed with FASD. The limitations and clinical implications are discussed to inform further research and assist in the development of trauma-informed clinical interventions. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined deliberate self-harm (DSH) among children in residential treatment in Canada. Most of the existing studies examined adolescent students or children from pediatric emergency departments. Objectives: The objectives of this study were to examine the prevalence of DSH among children in tertiary care residential treatment and the factors associated with DSH. Methods: Data on 284 children aged 5-17 years (M = 11.54 years, SD = 2.56) with mental health problems in tertiary care residential treatment were analyzed. Binary logistic regression was performed to examine the likelihood of engaging in DSH. Results: About 35 % of children engaged in DSH. Suicidal talk emerged as the strongest factor to be associated with DSH. Children who used alcohol or drugs were also more likely to engage in DSH than those who did not use alcohol or drugs. Furthermore, symptoms of conduct problems were associated with the likelihood of engaging in DSH. Conclusions: Identifying children at risk for engaging in DSH and suicidal behavior is of critical importance to mental health care providers. These factors could assist in identifying children who might require more specialized treatment related to self-harm during their stay in residential treatment.

Background: There is growing interest in identifying changes in ways of practice associated with the growth of professional expertise. Research on highly experienced or expert teachers and therapists (i.e. occupational, physical and behavioural therapists) can provide insights into how they approach practice, providing guidance for new practitioners. Purpose: The objective was to compare and contrast children's mental health therapists' and elementary/secondary schoolteachers' perceptions of changes in perspectives and approaches related to the development of expertise. Sample: Nine children's mental health therapists and five teachers/principals took part. Design and methods: Using a nested sampling design, therapists and teachers/principals were selected based on years of experience and peer reputation, and participated in two separate focus groups. Similarities and differences between the practice groups were examined qualitatively, using cross-group analysis. Results: Common reported changes in perspective included the development of open, broad, flexible and relational perspectives. Changes in approach included a focus on children's needs/desires, psychosocial issues/outcomes and realistic goals. Conclusions: The findings indicated how expert practitioners viewed their practice as changing over time, contributing to a better understanding of the nature and development of expertise in children's service practitioners. The findings suggest the importance of paying attention to children's needs/desires, cultivating awareness of their motivation and psychosocial issues, and setting realistic goals. Practitioners linked these changes in perspective and approach to more positive life and learning outcomes for children, which may have implications for guiding the practice of more novice teachers and therapists.