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Single Parentings Guide

Single Parentings Guide

Finally! You Can Put All Your Worries To Rest! You Can Now Instantly Learn Some Little-Known But Highly Effective Tips For Successful Single Parenting! Understand Your Role As A Single Motherfather, And Learn How To Give Your Child The Love Of Both Parents Single Handedly.

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Smart Parenting Guide

This ebook from Daniel Dwase gives you the very best tips and information about how to raise your children in such a way as to get smart, responsible, caring, and loving children. If you have problems disciplining your children, this is the book for you. You don't have to be concerned about your children running amok; Dwase gives you the insight that you need to make sure that your children turn out well in the end. This ebook lets you give your child the best gift that you ever could: a loving, nurturing, healthy and loving childhood. By building a quality relationship with them, you will be able to raise a child that continues that relationship into adulthood. Building a quality relationship is the best way to give your child a healthy future and a loving family. You will both empower your child to succeed and reduces behavioral problems Start building your child's future today!

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Author: Daniel Dwase
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I've really worked on the chapters in this ebook and can only say that if you put in the time you will never revert back to your old methods.

All the modules inside this ebook are very detailed and explanatory, there is nothing as comprehensive as this guide.

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Sexual relationships marriage and parenthood

Long-term relationships and parenting children (at some stage) are generally considered to be an integral part of being an adult. In adolescence, emotional and sexual interest and needs develop, and it is at this stage that most young people start to have sexual relationships. However, in spite of a policy of normalization, people with mental retardation are seldom encouraged to develop intimate sexual relationships. Parents tend not to want it to happen, (1.8> and service managers and care staff, though they may not necessarily actively discourage it, often provide little opportunity, or privacy, to enable it to happen. Many people in the general population find it difficult to accept that men and women with mental retardation have ordinary sexual feelings and desires, let alone that they should be allowed to act on them. The argument against allowing people with mental retardation to have sexual partners often involves judgements about whether someone is deemed fit to be a parent....

The purposes of reports

Social Services Child Care Departments and others involved in the welfare of children may request reports of the supervising psychiatrist for Child Protection Case Conferences on the contribution of a psychiatric disorder to the child care problem, and on the likely impact of the psychiatric disorder on the future parenting of the patient b. solicitors acting for all parties in child care proceedings (the child, the Social Services Department, and the patient) may ask for a psychiatric report on a mentally ill parent about the likely risk to the child of suffering significant physical, developmental or emotional harm from the patient in question.

Sensory Integration Dysfunction

You open the fridge only to realize that there is nothing to make for tea. Not a problem for most parents - it's then merely a case of grabbing your child or children, and nipping around the corner shop to buy a few essentials. Easy .I wish For those of you who have battled with your children as they insist that their socks are too lumpy, their clothes are itchy, they don't like the texture of so many foods and don't like bright lights or loud noises, I am sure that you can identify only too well with the difficulties of performing the seemingly simplest of tasks. Moreover, those of you with a tornado for a child will, I am sure, identify equally as well. Joe needs to chew and shred and pick and prod in order to gain the sensory stimulation that his body is craving.

Critical issues in development

When one takes a closer look at how children develop, one cannot help but be amazed at the complexities of the process. Children the world over start using words around their first birthday, and within a couple of years more they are talking in complex sentences using complicated ideas. The contrast between the language development of most children and the minority who suffer a severe mental handicap is devastating. Likewise, blind children start to smile at the same time as sighted children deaf children start to use a similar range of phonemes children in Japan, France, and the United Kingdom all start uttering the same range of sounds only to have them narrowed down to those they need in their native language with the later consequence that they may not even be able to discriminate some of the unused sounds, let alone incorporate them when learning a foreign language. The broad developmental trajectory seems very similar across cultural groups, but particular children do not always...

Chapter References

Quinton, D. and Rutter, M. (1984). Parents with children in care 1. Current circumstances and parenting skills. Journal of Child Psychology and Psychiatry, 25, 211-29. 70. Quinton, D. and Rutter, M. (1984). Parents with children in care 2. Intergenerational continuities. Journal of Child Psychology and Psychiatry, 25, 231-50. 71. Pawlby, S.J., Mills, A., and Quinton, D. (1997). Vulnerable adolescent girls opposite-sex relationships. Journal of Child Psychology, 38, 909-20. 73. Bifulco, A., Brown, G.W., and Harris, T.O. (1994). Childhood experience of care and abuse (CECA) a retrospective interview measure. Child Psychology and Psychiatry, 35, 1419-35.

Characteristics of the alcoholmisusing population

The factors involved in women's help-seeking have recently been the subject of increased research activity. Thom and Green have identified three main factors that may account for the underrepresentation of women in alcohol treatment.(61) Women tend to perceive their problems differently from men, less often identifying themselves as 'alcoholic'. This may in part be related to negative public stereotypes of female drinking and negative attitudes towards female problem drinkers amongst professionals, who, in the medical profession, are still predominantly male. Women have also been found to perceive the 'costs' of entering treatment differently from men. This is particularly in relation to the perceived social stigma as well as other costs, both financial, in relationships, and in terms of losing their children into the care system. Finally, women often find the services offered to be less appropriate in meeting their needs than do men. Often specialist alcohol services do not offer...

PECS Picture Exchange Communication System

For us as a family, PECS worked wonders and changed our lives. After an assessment with a speech and language therapist at the Child Development Centre, it was suggested that Ben may be able to use pictures as a means of communication. Our Portage worker (thank you Julie ) soon began the PECS training programme and to cut a long story short, Ben changed from being a head banging, frustrated little boy, to a far happier little chap who could easily pass me a sentence strip telling me that he wanted to go out to McDonald's and eat French fries, cheeseburger and a milkshake Whilst the initial stage was very difficult and consistency is of utmost importance, the system needing to be used in all places and by everyone, for us it was a precursor to speech and alleviated frustration for all.

What is meant by the harmreduction approach

In the early 1980s, a radical departure from the conventional abstinence-oriented approach took place when it was appreciated that 'the spread of HIV is a greater danger to individual and public health than drug misuse'. (23> A harm-reduction philosophy is centred on the belief that it is possible to exert a powerful impact upon morbidity and mortality without necessarily insisting upon abstinence. A hierarchy of aims begins with attempts to make contact with as many problem drug users as possible in order to provide access to clean needles and syringes, advice about safer sex and injecting, basic health care, and help with housing, child care, or legal issues. Then, for some people but not all, a move away from street drugs on to a prescribed oral substitute may be feasible, possibly followed by detoxification and rehabilitation.

Nonaccidental injury NAI

Since 1980, there has been increasing awareness of the extent of child abuse. As a result, organizations with responsibility for child care have established effective protocols for the appropriate response to reports of any form of child abuse. In the United Kingdom, each local authority has a Child Protection Register and the officer responsible for this can be contacted 24 hours of the day

Parenting an ADHD child

When I listen to Luke drone on for hours on end about his current 'specialist subject' or I watch Ben spin around in circles, flicking his fingers in front of his eyes, I smile to myself on good days and other days I am crushed with feelings of despair as I worry how they will ever manage in the big wide world. One thing I do not do however, is blame myself. Even if it is not evident to those without knowledge, or in other settings when the children are running effective 'emulators', those of us who know my children can see autism quite clearly and I cannot see any way in which poor parenting skills could make children behave in such bizarre ways. Joe however, is another kettle of fish focus on parenting skills and family life If a child is a member of a large family or has a single parent or is of an ethnic minority or maybe has disabled family members, then archaically such scenarios, despite much research to the contrary, are often seen as being causal in the behaviours of an ADD...

Interventions What works

The most obvious way in which ECD programs can address chronic undernutrition is through school-based feeding programs. Evidence discussed shows such programs can be effective in improving child development and school readiness. However, such programs can be costly and often difficult

Protein And Amino Acid Requirements

Another related question is whether dispensable, nonessential amino acids ever become indispensable. If a nonessential amino acid is used in the body faster than it is made, it becomes essential for that condition (6). Tyrosine and cysteine are made from phenylalanine and methionine, respectively, but if insufficient phenylalanine or methionine is consumed, tyrosine and cysteine also become deficient and essential. This question must be answered across the range of life from infancy to the elderly as well as in sickness and health. For example, enzymes for amino acid metabolism mature at different rates in the growing fetus and newborn infant. Histidine is essential in infants but not necessarily in healthy children or adults. Therefore, the classification of essential or nonessential depends upon species, maturation (i.e., infant, growing child, or adult), diet, nutritional status, and pathophysiologic condition. Also to be considered is whether a particular amino acid given in...

Determine Whether Foreign Body Should Be Removed

Usually performed under fluoroscopic guidance by a radiologist. The uninflated balloon end of the Foley catheter is inserted until it is located beyond the coin. The balloon is then inflated with contrast material and the coin is pulled upward into patient's mouth. This technique works best for round, smooth objects. It does not permit inspection of the esophagus and should be reserved for use in healthy children who have had uncomplicated coin ingestion. A concern about the balloon-tipped catheter technique is the lack of airway control. iii. Bougienage. The least commonly used procedure for coin removal. A lubricated esophageal dilator is passed into the esophagus, dislodging the coin and causing it to pass into the stomach. This technique should be reserved for use in healthy children who were seen ingesting a single foreign body.

What Needs To Be Done

Selection of the appropriate evolutionary model is a critical premise for forensic attribution. It must be kept in mind that phylogenetic reconstructive methods involving mathematical simulations grossly simplify the relationship between organisms. The unavoidable translation of the biological properties of a virus in nature to numerical units is not an absolute and exact process. Data used in these analyses do not contain the complete historical record of the virus and are far from ideal in representing all possible evolutionary pathways of the population, which can result in erroneous phylogenies.75 We must take into account the stochastic nature of transmission and the lack of knowledge about its consequences in viral population genetics, and the biases and gaps involuntarily inflicted during collection and processing of epidemiological data. For example, FMDV infects up to 70 species of cloven-hoofed mammals, but the extent of lesions and clinical disease are host-dependent sheep...

Watersoluble b vitamins what impact do they have on wound healing

Recommended intakes of the B vitamins will be identified as either recommended dietary allowance (RDA) or adequate intake (AI) as defined by the U.S. Department of Agriculture (USDA).1 The RDA represents the average daily intake of a nutrient which meets the requirements of approximately 98 of all healthy people and is listed related to age and gender. The estimated average requirement is calculated from scientific evidence. When there is not enough scientific evidence about a nutrient to determine a specific estimated average requirement for an RDA, an AI is estimated. While the AI is based on current scientific research, further research is needed to determine a more exact amount of the specific nutrient. The AI is also designed to meet the needs of all healthy children and adults.1

Childhood and Adolescent Obesity

Helping children and adolescents in weight maintenance or weight loss in the primary care setting is more complex and challenging than helping adults lose weight. Growth and development variables within the child and external variables outside the child's control, coupled with the lack of an evidence-based clinical practice guideline for the primary care setting, make helping such patients difficult and long-term weight loss success uncertain at best. As a result of these barriers, it is tempting for the physician to refer such patients to a specialty pediatric obesity treatment clinic. Unfortunately, such clinics typically are not located nearby or are not financially feasible, especially for patients with limited income. Another option is for the physician to offer obese patients and families sound-bite type recommendations like don't make the child clean his or her plate, simply reduce TV viewing time, or play outside until it gets dark. Such an approach may or may not be effective...

Establishing the estimation dataset of available data

Reliable data were extracted from national demographic and health surveys originating with Macro International1, the Pan Arab Project for Child Development (PAPChildK, the Gulf Child Health Surveys (GCHS) , Centers for Disease Control (CDC1 and other national surveys (often relying on an adaptation of the Macro Demographic and Health Survey questionnaire). These organizations carry out and or support demographic and health surveys in developing countries in collaboration with country partners, providing comparable mortality data for some other health indicators definitions may differ, e.g. presence of a skilled attendant at delivery. However, surveys did not always provide all the age-at-death rates, and frequently did not report stillbirth data. f The Pan-Arab Project for Child Development (PAPCHILD) endeavours to diagnose and improve the health and social status of the mother and child through the building of a solid information base that would help in determining the problems and...

Behaviour Modification

Many children work well with reward schemes such as earning tokens towards a bigger reward (Joe being one of them). One thing to remember however is that it is not only the child who needs to learn to change his or her behaviour. As parents, we too need 'behaviour modification'. We need to learn to lavish praise on our children for all the good things they do, and bite our tongues when the children maybe try, but do things in a different way to how we want. When they have been kind to their sibling or even not been nasty, then praise them. When they have not answered back or argued, then praise them and let them know that you have noticed. Any attention for an AD HD child is better than none, and sometimes negative attention is actually preferred because it is more predictable. It takes no small amount ofwill-power and determination to only comment on the good things .however that is what is needed. After a few days of feeling very strange as you praise your child for something,...

Evaluation Of Scientific Literature

Terrorist or biological warfare attacks often do not take place in isolation. Successful attacks usually follow successful research and field trials. Any technology has a parenthood and genealogy attached to it.61 Similar research may be conducted in different facilities by students or teachers of the perpetrators. There are exceptions, however, such as the New Zealand farmers who infected pet rabbits with rabbit calicivirus (which had been smuggled into the country

Treating Obese Pre Adolescents

Even if the parents are not obese, taking them through the adult program and then assisting them in learning how they can teach those principles to their child puts the responsibility for success on the parent, not the child. For example, parental influence on a 9-year-old regarding food choice is enhanced, not limited, by using the CAMES approach to food explained in Chapter 9. If a certain food is a family favorite, applying the C option (portion control) means the family can have their special food while controlling portion sizes. Another favorite tool when teaching children how to improve their dietary choices in order to reduce calories is the S or substituting option of the CAMES approach. Parents can make going to the grocery store an educational experience to learn about the various choices a person has when selecting specific food items.

And a few more visitors

Whilst on the subject of extra family members, do any of you have a problem with even smaller parasites .head lice or nits As children attend nursery or school it seems that not many families escape an invasion of these little critters and in a large family such as mine, they seem to be permanent residents. Over the years, one or other of the children have come home with nits on many occasions and I have tried every solution and every possible remedy in a bid to shift them for good .still they seem attracted to my colourful children. There seems to be some misconception about head lice and my children are living proof that these tales are wrong. Firstly the misconception that head lice are a sign of uncleanliness has been more or less quashed over recent years only to be replaced by the myth that they only go for clean hair .if anyone met my boys they would realize instantly that that just isn't true For those of you with autistic or AS kids who are sitting smugly and thinking that...

Immune Response to Influenza Viral Infection

The influenza A virus enters the body through the respiratory tract. Although an infected individual can sneeze in your face to transfer the virus, inoculation is typically a bit more surreptitious. The virus can exist in nasal droplets on the doorknob that you will use to open the door to your office, on the handset to the phone you use to tell your kids you are coming home early from work, on the handle of the shopping cart at your local grocery store, or on the hand that you will shake to say hello or goodbye. In fact, most people infect themselves hand-to-nose. Once the virus obtains entry to the body, it has to gain entry into specific cell populations for its own survival as it is an obligate intracellular parasite requiring the host cell's machinery for replication. The typical influenza A virus productively infects respiratory epithelial cells (Matrosovich et al., 2004). Once the virus binds to the surface of the first respiratory epithelial cell, the race is on pitting...

Antepartumpostpartum depression

Pregnancy and the postpartum period are times of heightened depressive risk for patients who may wish to avoid pharmacotherapy. Spinelli at Columbia University is using IPT to treat women with antepartum depression. Pregnancy is deemed a role transition that involves the depressed pregnant woman's self-evaluation as a parent, physiological changes of pregnancy, and altered relationships with the spouse or significant other and with other children. Complicated pregnancy has been added as a fifth potential interpersonal problem area. Session timing and duration are adjusted for bed rest, delivery, obstetrical complications, and child care, and postpartum mothers may bring children to sessions. As with depressed HIV-positive patients, therapists use telephone sessions and hospital visits as necessary (Spinelli, 1997). A controlled clinical trial is comparing 16 weeks of acute IPT and 6-month follow-up sessions to a didactic parent education group in depressed pregnant women.

Patient followup and prognosis

On completion of their chemotherapy, patients are advised to avoid pregnancy for one year and remain on HCG follow-up for life to confirm that their disease is in remission. About 2 of low-risk and 4 of high-risk patients will relapse. All low-to middle-risk patients are salvaged with further chemotherapy (EMA CO or alternative regimens) and the cure rate is almost 100 in this group. The high-risk group has 90 survival rate beyond 10 years. With the addition of platinum and other new agents salvage rates for patients relapsing following EMA CO therapy can be in excess of 70 . Neither metho-trexate nor EMA CO therapy reduce fertility or cause abnormalities. Thus women treated for GTD can expect to have healthy children.

Lifestyles and social networks

The experience of old age is determined by the life lived and as a result the lifestyles of older people demonstrate a wide range of heterogeneity. Most people over retirement age live relatively active engaged lives, but the nature of their lives continues to be affected by demographic variables such as age, gender, marital status, social class, income, parenthood or childlessness, migration history, education, personality, family, and community. The post-retirement population potentially includes two generations. Variation is more marked than homogeneity. Patterns of interaction with friends and neighbours in old age tend to reflect patterns established earlier in the life-course. Friendship is based on affinity and reciprocity. In the United Kingdom, middle-class people and women are more inclined to maintain relationships with friends. Working-class people tend not to distinguish between friends and neighbours. Most old people have friends living nearby, but with increasing age...

A tribute to Emma Jane

When Ben first attended the Child Development Centre as a tiny, immobile baby, parents were given the opportunity to sit and have coffee and leave their children to play with the toys whilst they chatted to other parents. Ben however made that difficult. He screamed incessantly and so I spent the majority of my time rocking him backwards and forwards in a bid to quieten him and give other parents and myself some peace. Other parents were sympathetic but Ben made far more noise than the other children .except for one little girl. She sat with flaming red cheeks and gave Ben a good run for his money Her mother and I got chatting amidst the howls and screams of Ben and Emma-Jane and we became good friends. Many times we both attended a Portage 'stay and play' session or a nursery session at the Child Development Centre and whilst Emma-Jane banged around and was physically so active, Ben crawled around trying to shield himself from her noise. In many other ways though, Emma-Jane and Ben...

Pathophysiology of OSAS

Sound of snoring originates in the collapsible part of the airway, where there is no rigid support, which implicates a primary role of the nasopharyngeal inlet, pharynx, and tongue. The key force that promotes the closure of the upper airway is the negative pressure applied during inspiration, which is determined by the inspiratory effort and the physiological dimensions of the upper airway. The primary force holding the airway is the activity of the dilator muscles that give tone and tension to the pharyngeal wall. Another cause of OSAS is nasal airway obstruction that contributes to nearly 40 of total airway resistance in healthy children. Causes of nasal airway obstruction are many, including enlarged adenoids as well as local inflammation.

Contexts and development

As in all aspects of child psychiatry, a developmental perspective is crucial when considering environmental risks. Key sources of environmental influence change with age, and the meaning and impact of events will vary with the child's stage of cognitive, emotional, and social development. In infancy and early childhood, the family is the central source of environmental influences, charged as it is in most societies with prime responsibility for the care, nurture, and socialization of the young. As children develop, so their social worlds expand childcare and school settings take on increased importance, as do relationships with friends and peers. Throughout, each of these proximal contexts is shaped by influences from the wider culture and society. Any comprehensive assessment of a child's environment needs to take each of these types and levels of influence into account.

Family relationships and parenting

Many other aspects of family life and relationships, and of parenting styles and behaviours, have been examined for their impact on children's development. Research on families emphasizes the complexity of family relationships each dyadic relationship is influenced by other relationships in the family, and normative transitions in family life the birth of a sibling, or mother starting work reverberate to affect all family members. (8) Relationships with parents and siblings change as children develop, and both these, and specific aspects of parenting, may impact on risks for disorder. 2. hostile or rejecting parent-child relationships, or those markedly lacking in warmth

Parent and family characteristics

Maternal age is associated with a risk for conduct problems, with very young mothers being markedly more likely to have children who show disruptive and delinquent behaviour problems. In part, these associations reflect the educational and social disadvantages that predict very early parenthood in part, the poor social conditions and lack of support faced by many young mothers and in part, less than optimal parenting styles. Delinquency is also associated with large family size, especially with having a large number of brothers. Once again, the more proximal risks involved here are likely to be complex parental supervision may be less effective in large families, and opportunities to 'learn' from delinquent siblings higher. In addition, antisocial parents tend to have larger families, so that risks may be genetically

Single parents and step families

Research on the effects of growing up in single-parent and step families illustrates the complexity of family-related influences. (H) Overall, children in single-parent and step families show higher mean levels of emotional and behavioural problems than those in non-divorced two-parent families they also have an increased probability of health problems and educational underachievement. But there are also marked differences within each family type, and associations between the quality of mother-child relationships and children's adjustment is similar across family settings. In addition, single-parent and reconstituted families often differ from stable two-parent families in a plethora of other ways in particular, they are much more likely to face economic pressures, poor social support, and higher levels of maternal depression. Once these variations, and the degree of negativity in family relationships are taken into account, family type per se shows few consistent links with...

Further clinical examination and testing32

Herjanic, B., Herjanic, M., Brown, F., and Wheatt, T. ( 975). Are children reliable reporters Journal of Abnormal Child Psychology, 3, 4 -8. 8. Angold, A., Costello, E.J., and Erkanli, A. ( 999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57-87. 9. Stanger, C. and Lewis, M. ( 993). Agreement among parents, teachers, and children on internalizing and externalizing behavior problems. Journal of Clinical Child Psychology, 22, 07- 5. 0. Reich, W., Herjanic, B., Welner, Z., and Gandhy, P.R. ( 982). Development of a structured psychiatric interview for children agreement on diagnosis comparing child and parent interviews. Journal of Abnormal Child Psychology, 10, 325-36. . Bruck, M., Ceci, S.J., and Hembrooke, H. ( 998). Reliability and credibility of young children's reports from research to policy and practice. American Psychologist, 53, 136-5 . 2. Steward, M.S. and Steward, D.S. ( 996). Interviewing young children about body touch and handling. Monographs of the Society...

Outreach and home visiting are important

Because families who would benefit most from parent management training also tend to those least likely to attend training sessions, home visiting has been an important component of several well-evaluated prevention schemes, (25,26) particularly the Rochester nurse home visitation programme for socially disadvantaged pregnant teenagers, the Perry preschool project, and the programme for health visitors developed by Davis and Spurr(27) which shows tangible mental health gains for children. However, this cannot be a sanction for all home visiting schemes. Two of those widely employed in the United Kingdom to promote child development have either not been subjected to rigorous evaluation (Bristol Child Development Programme) or else have been found wanting. (28> The use of non-professional befrienders for mothers and young children (Homestart and Newpin in the United Kingdom) is quite widespread but evaluation has yielded mixed results, generally positive but not definitive. Exceptions...

Psychoanalytic theories

The importance of early interpersonal experiences in psychological development was argued for by Melanie Klein (1946), and subsequent object-relations theorists. Klein's proposition that representations may be split into good and bad, and that if these are not in contact with each other there is a price to be paid, is a form of explanation that is highly compatible with a consideration of the consequences of threats to intentionality. However, and with hindsight perhaps surprisingly, Klein assumes that this is the basic universal human condition in early infancy which is 'cured' by good parenting. The evidence, which we reviewed briefly in Chapter 6, would suggest that infants possess substantial integrative capabilities from birth, and that disorder is more likely to arise from threats to the integrity of intentionality. Notwithstanding this difference, both analyses lead to the conclusion that parents, or other committed care-givers, are important to the developmental processes...

A time for everything

Most parents are quick to become aware that there is something different about their child and by the time their child has been assessed and a diagnosis has been given, they are often merely expecting the professional to tell them what they already knew and even feel a sense of relief that they have some answers. However to have it confirmed and to see it in writing is very different from knowing in your heart that there is something different about your child. Some parents have battled for years to gain a diagnosis in order for their child to access the support he or she needs, yet still feel a sense ofloss, griefand confusion when the diagnosis is finally given. If you are reading this and are at this stage, indeed if you are at the unfortunate stage of realizing that your child is on the autistic spectrum but have not yet been listened to by kind to yourself. One day that knot in the pit of your stomach will start to loosen and you will feel able to eat again, one...

Evolution of the concept

In many respects, theories of AD-HKD have changed little over the decades. These theories have continued to reflect the belief that the syndrome is a consequence of an interaction between subtle hereditary and acquired traumatic or toxic processes acting on the nervous system during fetal or early child development to cause minimal brain damage or dysfunction.(5)

Behavioural treatment

Behavioural parent training may be the most commonly prescribed non-pharmacological intervention for AD-HKD. Parent training is predicated on the observation that parents of children with AD-HKD use overly controlling and inefficient parenting strategies. (19 ) Parent-training programmes are based on social-learning theory principles these programmes use direct instruction, modelling, and role playing to teach parents to reinforce positive behaviour, decrease the use of punitive strategies, and manage oppositional behaviour effectively.( .92) Behavioural therapy involves trained therapists (e.g. camp counsellors), parents, or teachers reinforcing positive behaviour, academic accomplishment, and response-cost procedures for disruptiveness (i.e. withholding rewards when inappropriate behaviour occurs) to alter behaviour. ( 98) Cognitive-behaviour therapy attempts to enhance self-control by teaching children self-instructional strategies. These therapies may yield short-term improvement....

Maintaining your own identity

That this applies equally to them and whilst it is vitally important that you both spend time together and be a couple rather than just parents, it is still important to maintain your own identity. Whilst your children are a pivotal part of your life and caring for them and worrying about them probably occupies every waking hour, without taking a break in some way, however small, the stress will eventually take its toll and the whole family will suffer.

Treatment and prognosis

Because of the aetiological differences discussed earlier, especially parental involvement, treatment often needs to be very different in children compared to adults. Appropriate behavioural approaches usually entail alterations to parenting practices designed to be acceptable and feasible in each individual family. Other forms of treatment, including chronobiological measures (such as adjustment of sleep schedules for the delayed sleep-phase syndrome in adolescents) usually require considerable parental involvement. The same is true of the general sleep hygiene principles described in Ch.a.ptei 4,1.4.2. Explanation and (where appropriate) reassurance for the child and parents is an essential part of any treatment and may be effective in their own right without the need for more specific measures.

Children with mental retardation or neurodegenerative disorder

The sleep problems in this group are often behavioural in origin (largely attributed to parenting practices), arising from often understandable overpermissiveness, inconsistency, or parents' inability to set limits on their child's behaviour because of their own emotional state or excessive demands on their time.

The nature of the evidence on the impact of adoption and fostering on child mental health

The impact of loss will also vary with the child's temperament. A 'born worrier' will go through life wondering what there was about him or her that was not worth keeping, and no amount of positive parenting will make this angst go away a resilient child will shrug away the past and make the best of even not particularly good parenting by the substitute parents. The placement process that researchers seek to evaluate is extremely complex. When, as with adoption or permanent fostering, the aim is to improve the long-term well being of the future adult, it becomes impossible to unpick the very many events and variables that will have had an impact on the life of a young person between placement at 6 weeks and maturity at 25 or 26. Moreover, there is some evidence that adopted young people move towards emotional maturity at a slower pace than those who have not been adopted not suprisingly with at least two extra hurdles to surmount that of loss and separation, and that of making sense...

Preventive intervention

Therapeutic elements associated with good outcome include the promotion of communication within the family about the dead parent and the promotion of mourning. For young children this includes help in clarifying what has happened to the dead parent and in helping them to understand and cope with dysphoric affects both in themselves and in the surviving family members. It is doubtful if children under the age of 3 can understand the components of the concept of death, but by the age of 5 about 80 per cent of children can understand most of them. (3 > Supporting a widowed parent in his or her grief, and enabling the process of mourning to occur by providing practical help (child care, financial advice, etc.), is probably as important as counselling in helping the children. Given the indications that problems may develop much later, a useful intervention strategy should include follow-up appointments after any time-limited intervention

Differences from adult psychotherapy

A number of interesting paradoxes and dilemmas occur when treating children with psychotherapy. For example, who should give consent for treatment. Should it be the child, a parent, both parents, or all three Clearly, this depends on the age and understanding of the child, and each case should be approached in a way that puts the child's needs first. It is generally best to obtain consent from the child and both parents. Any other arrangement is likely to lead to problems at some stage. Psychotherapy and counselling are traditionally non-directive and patient-led, but children, unlike most adults, need to be given some direction otherwise they become easily lost and confused. They cannot be expected to find their own solutions without guidance and support. Most psychotherapeutic approaches for adults are based on coming to terms with and finding explanations for problems that are rooted in the past. However, children are still busy making their past, and their main focus of concern...

Training and supervision

The objectives of training in psychotherapy are primarily to do with increasing knowledge and understanding of the issues that arise during psychotherapeutic treatment, many of which have been referred to above 2 ) It is essential for this to be underpinned by a sound knowledge of child development, but less important for therapy to be founded in any particular psychodynamic theory. The key training method in psychotherapy is the conduct of therapy under supervision. Choosing a supervisor and the role of that supervisor are critically important issues for the trainee therapist, since the relationship between supervisor and trainee mirrors that of the therapist and client even if there is a clear understanding that the purpose of the supervision is not intended to be therapeutic. Most therapists find that supervision continues to be helpful even after they are 'trained'.

Prenatal and early childhood family interventions

Among the most influential work in this area has been the home visitation programme developed and evaluated by Olds et al.(7) to prevent antisocial behaviour in children. This project involved a randomized control trial that included longitudinal data collection over a 15-year period. A total of 400 pregnant women enrolled in the study. The three criteria for eligibility were under 19 years of age, unmarried, or of low socio-economic status. Those assigned to the intervention condition received an average of nine home visits during pregnancy and an average of 23 visits between birth and the child's second birthday. The home visits were conducted by nurses. The focus of the visits was upon prenatal and neonatal maternal health behaviours, child-care skills, and maternal life issues such as education and employment.

Family interventions in the preschool years

Within the parenting literature, there are many different types of parenting skills that have been found to be important in promoting healthy child development, but they can basically be summarized into two molar categories positive and negative parenting. Positive parenting refers to supportive warm involved parenting that includes praise, positive support, approval, and responsiveness to children and their needs. (9) Negative parenting refers to parenting deficits, including poor limit-setting, inconsistency, verbal and physical aggression, and harsh discipline. ( ,0) Family interventions at this age typically focus on building a strong and positive parent-child relationship, in addition to teaching specific behavioural management techniques to promote healthy child adjustment and prevent later problems. Although some programmes may target at-risk children, such as those in the Head Start programme or those with early behaviour problems, there is some...

Family interventions in the schoolaged years

Although the emphasis on increasing positive parenting and decreasing negative parenting typically is maintained through interventions at this age, additional components targeting academic achievement, learning and early literacy, and parent-school involvement are also important. Recent research suggests that achievement in school may serve as an important mediator between intervention effects and improvements in behaviour at school. ( 8 Similarly, parental involvement in school is an important component of interventions at this age. Involvement may include parental behaviour, such as attending school functions and volunteering, or cognitive stimulation, such as providing learning materials and helping children with homework. Research suggests that parents who are involved in their children's schooling are more satisfied with their children's school and have more positive attitudes about education, and that children whose parents are involved have higher attendance records, better...

Cultural issues in family interventions

In this chapter, we have outlined a number of intervention programmes for families. In each case, the interventions have been developmentally appropriate and ecologically valid. However, one of the greatest challenges to interventionists with a developmental psychopathology focus is to implement interventions that are sensitive to the diversity of families. Family interaction by necessity is embedded within a cultural context. As such, not all parenting strategies and family interventions will be effective with all cultural groups. For example, racial differences are evident in the literature linking parenting practices to child behaviour problems 2,30)

The psychiatrist as educator

Bolton, D., Luckie, M., and Steinberg, D. (1996). Obsessive-compulsive disorder treated in adolescence 14 long-term case histories. Clinical Child Psychology and Psychiatry, 1, 409-30. 28. Steinberg, D. (1993). Consultative work in child and adolescent psychiatry. In Helping children with psychiatric problems (ed. M.E. Garralda), pp. 115-25. BMJ Publishing, London.

The family and other carers

Disability or disturbance hinders normal developmental experience, reducing the opportunities to be taught. Effective parenting skills may have never been learned or else have been destroyed by a child's atypical response. These may need to be taught to carers who have often been demoralized or deskilled. They include how to engage socially with the person, to play with them, to give clear and understandable instructions, and how to divert rather than confront them. Disturbance may reflect boredom and be reduced merely by an increase in the amount and variety of activities. Any approach must take a broad view for carers have to work together comfortably enough to be consistent over time. A treatment programme may have to address the relationship between the carers as well as their needs. This may be sufficient in itself, improvement in the patient following an overall improvement in functioning in the family, school, or residential placement.

People with mental retardation who become parents themselves

Although sexuality and pregnancy is a fear of many parents of severely intellectually disabled adolescents, their fertility appears to be very low and there are very few pregnancies in people who are totally dependent. The majority of people identified as having mild retardation during the period of education disappear from services when they leave school and so it is not possible to estimate how many women with mild or borderline retardation become mothers. However, a certain number do come before the family courts or are already known to services for other reasons. However, problems arise with planning ahead and the constant protection from danger that young babies require. There are now techniques to help teach these skills. The secret of success in such teaching is a positive attitude of enhancing skills and not one of undermining the mother. With a partner who is both stable and more able, many quite limited young women cope. As the children grow older, the problems increase as...

Neglect and Noncompliance

Although this form of child abuse is perhaps the most common, it is also the most difficult to identify and manage. Although neglect may manifest as a more dramatic physical failure to thrive (psychosocial growth retardation), the ophthalmologist is more often confronted with parents and other caregivers who fail to attend scheduled appointments or adhere to prescribed treatment regimens such as occlusion therapy for amblyopia. Apparent noncompli-ance may result from confounding factors that significantly impair a parent's ability to comply poverty leading to an inability to afford care, access to care (transportation, insurance coverage), lack of child care for siblings, inability to leave work, misunderstanding of the instructions or the seriousness of the eye disease, and others. When concerned about possible abusive neglect and noncompliance, the ophthalmologist should first explore such factors, perhaps with the help of a social worker or other support personnel. Absent such...

Consent to treatment and mental incapacity

For a comprehensive legal review of mental incapacity and its relation to decision making, the report of the Law Commission on the subject is recommended. (19 Child care proceedings Expert opinions from clinicians working in child and family mental health services are increasingly sought in relation to child care proceedings. In England and Wales this area of practice is governed by the framework of the Children Act 1989. The central principle that governs the decisions of the court is the child's welfare, and in making decisions that affect a child's upbringing the court must consider any harm that the child has suffered or is at risk of suffering, and the ability of the child's parents (or other relevant people) to meet the child's needs. The essential criterion for making a care order or supervision order (which place the child under the care or supervision of a local authority) is that the child is suffering, or is likely to suffer, significant harm. Clinicians may be asked to...

Childhood periodontal diseases

Chediak Higashi Syndrome Oral

And leukotoxin-non-producing strains of the bacteria were also recovered from localized aggressive periodontitis patients 66 . Furthermore, recent studies using a PCR detection method revealed that the prevalence rate of the microorganism was relatively high even in periodontally healthy children it was greater than 50 in saliva, and 30 in subgingival plaque of Japanese children (2-15 years old) 67, 68 . Thus, A. actinomycetemcomitans appears to be an early colonizer in the human oral cavity. However, the accumulation of the bacteria to a critical amount in plaque may contribute as the predisposing factor for the onset and or progression of localized aggressive periodontitis especially in children with systemic risk factors such as functional impairments abnormalities of PMNL. In addition to the two periodontopathic bacteria described above, Capnocytophaga sputigena, C. ochracea, E. corrodens, Campylobacter rectus, P. intermedia, P. nigrescens, T. forsythensis and T. denticola have...

Severe malaria in children compared to adults

Why malarial disease displays such age-related differences in pathophys-iology is unclear. However, these differences are not exclusive to malaria. ARDS, which is more frequently observed as a complication of trauma in adults compared with children 12 , is believed to reflect an exaggerated pro-inflammatory response within the lung 9 . A possible lead for future studies on these age-related differences in malaria is suggested by a report of peritoneal macrophages collected from healthy adults producing much less interleukin (IL)-10 (an anti-inflammatory cytokine), but the same levels of pro-inflammatory cytokine, than those from healthy children, giving adults a much higher pro-inflammatory status 13, 14 .

Measures of effectiveness and outcome

Interpersonal psychotherapy for adolescent depression. Child Psychology and Psychiatry Review, 3, 169-75. Kazdin, A. (1990). Psychotherapy for child and adolescent. Annual Review of Psychology, 41, 21-51. Spence, S.H. (1994). Practitioner review cognitive therapy with children and adolescents from theory to practice. Journal of Child Psychology and Psychiatry, 35, 1191-228. 7. Fombonne, E. (1998). Interpersonal psychotherapy for adolescent depression. Child Psychology and Psychiatry Review, 3, 169-75. 13. Spence, S.H. (1994). Practitioner review cognitive therapy with children and adolescents from theory to practice. Journal of Child Psychology and Psychiatry, 35, 1191-228.

The Evolutionary Neurodevelopmental Perspective

Indeed, parental overvaluation through the stages of neuropsychological development may be seen as a core factor in the development of narcissistic patterns. Feelings of omnipotence begin shortly after birth but do not take hold in a meaningful fashion until the sensorimotor-autonomy stage. Every minor achievement of future narcissists is responded to with such favor as to give them a deluded sense of their own extraordinary self-worth. Extreme confidence in your child need not be a disservice if it is well earned. In the case of the future narcissist, however, a marked disparity exists between the child's actual competence and the impression he or she has of it.

Sleeprelated Breathing Disorders Clinical Features

Although SRBD in children have many important similarities to the adult versions of these diseases, there are also marked differences in presentation, diagnosis, and management (Table 1). While awake breathing is typically silent, and the most obvious of nocturnal SRBD is snoring. Snoring indicates turbulent airflow and is not normal in children (21,35-39). The American Academy of Pediatrics (AAP) has recommended all children should be screened for snoring as part of well child care (40). If a sleeping animal is vulnerable to be attacked by a predator, why would it make breathing noises when its guard is down Indeed animals in the wild do not seem to snore only domestic animals snore. Not all snoring is due to OSA. It may be due to other forms of obstruction such as nasal allergies or a cold (41,42). A study from Israel found that children with SDB had lower scores on neuro-cognitive testing compared to controls but the scores improve after treatment (23). This prospective study of 39...

ADHKD and anxiety disorder53 Diagnosis and differential diagnosis Assessment of children

Rather than the informant's global impression about the presence of AD-HKD symptoms, the interviewer should elicit descriptions of the child's specific behaviours in a range of situations, such as those during structured and unstructured tasks, group and individual work, and academic and recreational activities. This approach minimizes the informant bias that arises from expectations of the child's behaviour or the presence of a comorbid psychopathology, such as oppositional or aggressive child behaviour.'2 2Z> Semistructured interviews also broadly cover the symptoms of potentially comorbid disorders and elicit descriptions of parenting practices and other contextual factors that are important for planning treatment. Similarly, a direct interview with the child's classroom teacher is preferable to a second-hand parental report of the child's behaviour at school or to a questionnaire completed by the teacher.

Psychosocial mechanisms

Barlow Panic Modelk

An important aspect of a healthy parent-child relationship is its ability to foster in the child a sense of control over events. According to Chorpita and Barlow, (47> an individual who lacks sufficient early experiences of control may develop a general perception of personal inefficacy which may predispose him or her to chronic negative emotional states such as GAD. Two aspects of parenting appear to be important in providing a child with opportunities to experience control responsiveness to the child's efforts at engagement and encouragement of the child to explore and manipulate the environment. A parenting style characterized by excessive control of the child's environment (overprotection) coupled with a lack of warmth and responsiveness toward the child would deprive the child of such opportunities and thus, theoretically, could contribute to the development of anxiety.

Clinical characteristics

University hospital, indicated that the prevalence and clinical severity due to hMPV infections are slightly lower than those of RSV infections during the winter season 32 . Most of the hMPV-positive patients were children < 2 years old without any underlying illnesses. hMPV was found significantly less frequently than RSV in children < 2 months old. Of the 31 hMPV-posi-tive children < 2 years old, only 4 (31 ) were < 2 months old, whereas 43 (35 ) of the 122 hRSV-positive children < 2 years old were also < 2 months old. Others have found that the mean age of patients infected with hMPV was slightly lower than that compared to RSV 39 . Of the hMPV-posi-tive patients who were > 5 years old, most had other diseases (e.g., cystic fibrosis, leukemia, and non-Hodgkin lymphoma) or had recently received bone marrow or kidney transplantation, indicating an association with immunosuppression. Two severely immunocompromised patients died due to progressive respiratory failure with...

Psychiatry and law as an exercise in construct relations

The provision of reports and the giving of oral evidence to both civil and criminal courts by mental health scientists (of whatever specific discipline) involves delivering information derived from a science whose purposes are entirely different from those of the law.(3) Therefore there is both a need to translate the constructs of the one discipline into those of the other and a need to educate the recipient of the evidence. There is also a need to educate, in a different sense, the giver of the evidence so that he or she is able to effect the necessary translation. For some theorists of the jurisprudence of expert evidence such translation verges on the impossible. The law, it is argued by Gunther Teubner,(4) is 'autopoietic', or self-referential, pursuing a discourse which is determined to such an extent by its own purposes and processes that it is impossible for the reality of another science to be admitted within it. Even branches of the law that expressly, and often...

Intervention and psychological treatment

Psychological treatments in the field of neglect have concentrated on improving parenting skills and sensitivity through direct encouragement of positive interactions in feeding, play, and general care, combined with individual therapy for parents themselves, who have frequently experienced multiply deprived childhoods. Psychiatric treatment of parental mental health problems, such as depression or substance abuse, is critical. Mobilizing community-based supports and networks to overcome social isolation, and linking neglectful mothers with other parents who can provide role modelling and support, appear to be promising approaches. Psychiatric interventions for psychological maltreatment have not been subjected to empirical evaluation. A process that focuses on improving the sensitivity and responsiveness of parent-child relationships (through direct work and feedback), together with family-based work, and, where appropriate, individual work with parents who have been subjected to...

Developmental considerations Memory

According to Kolhberg's seminal description of children's moral development, children below 10 years of age operate with 'pre-conventional morality' and evaluate events according to whether the child will gain reward or avoid punishment. Only after this age do children develop 'conventional morality' and begin to be motivated by the approval of other people and society.(11 Therefore, only older child witnesses have a full understanding of their moral obligations in court. However, young children, who hold concrete world views such as 'Bad people must be punished' as moral imperatives, may be strongly motivated to tell the truth in court.

Eeg Frequencies And Intelligence

Associated with relatively a higher resting EEG frequency in the left hemisphere than in the right hemisphere, but only in a sample of academically talented children, not in the academically handicapped group. Fischer et al. also investigated the ratio of the average alpha frequency to the average overall frequency. While they found no relationship between the alpha ratio measure and performance on various cognitive tests for the academically talented group, there were significant correlations in the academically handicapped group. The findings indicated that for the academically handicapped group, a decrease in the average alpha frequency in relation to the average overall frequency was associated with better scores on a reasoning test and lower scores on the mathematics and reading tests.

Changing family patterns

Recent decades have seen massive changes in the pattern of many children's family lives. The most obvious markers are the dramatic increases in rates of ivorce, single parenthood, and step-family formation.(9) In the years immediately after the Second World War, just 6 per cent of British couples divorced within 20 years of marriage. By the mid-1960s that figure had increased fourfold recent estimates suggest that almost 40 per cent of all marriages begun in the 1990s will eventually end in divorce. On these projections, approaching a fifth of all 10-year-olds, and over a quarter of 16-year-olds, will experience the breakdown of their parents' marriage in childhood or adolescence. For most, this will be followed by a period in a single-parent household for a substantial minority, further family transitions will mean that they become part of a step family. In the early 1990s, almost one in five children in the United Kingdom lived with a separated single parent or in a step family. In...

John Bowlby and attachment theory

Winnicott's contemporary John Bowlby(1.5) was considered for many years as a psychoanalytical renegade, despite (or perhaps because of) the fact that his life's work was essentially an attempt to bring logical and scientific rigour to psychoanalytical thought. Attachment theory, which can be thought of as an empirically validated version of object relations theory, starts from Freud's(16) revised theory of anxiety, in which, rather than viewing it as the result of incomplete repression of incestual wishes, anxiety is conceptualized in interpersonal terms as a response to the threat of the loss of a loved one. Based on his observations of delinquent youths, many of whom had suffered the loss of a parent during early childhood, and the depressive reactions of small children to separation from their parents on entering hospital, Bowlby saw that protection from danger was a key component of the parent-child relationship, and that there were built-in psychological mechanisms to ensure the...

Primary Orbital Lesions

Dumbbell Dermoid

Infantile Hemangioma A benign vascular tumor (Figure 8.3), infantile hem-angioma usually appears during the first few months of life. The majority of these lesions enlarge in size within the first 2 years and in approximately 70 of the cases undergo spontaneous involution by the age of 7 years. The tumor is generally unilateral (although bilaterality has been reported),6 and it occurs most commonly in the superior nasal quadrant in otherwise healthy children.

Training and dissemination

Many versions of CBT are available in manual form, which should help in their dissemination into routine clinical work. It has to be said, however, that there are at present only limited training opportunities to learn the approach. Many training programmes in child psychiatry and child psychology can provide some exposure to CBTs, but there are few formal training opportunities. The application of cognitive-behavioural methods requires knowledge of social learning principles and a variety of different skills. These skills can be readily taught, but this does take time. This time is likely to be well spent because there is evidence that proper training in the psychological therapies enhances clinical efficacy. (5JJ

Early adolescent gender identity disorder

Achenbach, T. and Edelbrook, C. (1981). Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monographs of the Society for Research in Child Development, 46. 10. Maccoby, E. and Jacklin, C. (1980). Sex differences aggression. Child Development, 51, 964-80. 12. Jacklin, C., Maccoby, E., and Dick, A. (1973). Barrier behavior and toy preference. Child Development, 44, 196-200. 14. Jacklin, C. and Maccoby, E. (1978). Social behavior at thirty-three months in same-sex and mixed-sex dyads. Child Development, 49, 557-69. 16. Kuhn, D., Nash, S., and Brucbern, L. (1978). Sex role concept of two and three-year-olds. Child Development, 49, 445-51. 17. Fagot, B. (1977). Consequences of moderate cross-gender behavior in preschool children. Child Development, 49, 459-65. 18. Snow, M., Jacklin, C., and Maccoby, E. (1983). Sex-of-child differences in father-child interaction at one year of age. Child Development, 54, 227-32. 27. Hines,...

The Biological Perspective

Casual observers have often remarked that antisocials and psychopaths appear to have inborn temperaments that make them seem tough, aggressive, fearless, impulsive, hotheaded, and sensation seeking. Naturally, such traits tend to send the individual down certain life trajectories rather than others, namely, toward the development of delinquent and antisocial behaviors and away from the development of prosocial or altruistic attitudes. In an interesting chapter, one of the leaders of the field, David Lykken (1995) discusses his pet bull terrier, a breed that crosses the strength and temperament of a bulldog with the agility of a terrier, thus providing, according to Lykken, something of an animal model of psychopathy. Pups easily and playfully destroy household items with their powerful jaws, he states, and are almost indifferent to punishment. Consequently, raising a bull terrier requires patience and fortitude. Drawing on four parenting styles described by Baumrind (1971, 1980),...

Applied Behavioural Analysis ABA Lovaas Institute for Early Intervention

Are you left scratching your head and wondering where (or if) to start now This list of therapies and interventions merely skims the surface of the amount of approaches for parents to think about when searching for ways in which to best help their child. All I can say is to research fully, listen to other parents, and if possible watch the approach and the child. As a parent you need to find an approach that fits in with the needs of your autistic child, your family belief system and your family life as a whole and there is no reason why a package of approaches cannot be used in order to best suit your child. Much evidence suggests that early intervention in autism gives rise to a much better overall quality of life for the child (and therefore the family). If as a parent, you are still on the diagnosis treadmill, then you can still get onto the internet or into the library and find ways to help your child whilst you are waiting for an official diagnosis. Good luck

Developmental psychopathology

Developmental psychopathology emerged in the 1980s to bridge the rift between academic and clinical child psychology. (2, ,21) 'The developmental psychopathologist is concerned with the time course of a given disorder, its varying manifestations with development, its precursors and sequelae, and its relation to non-disordered

Structure of reports

The second section should describe in appropriate detail the patient's personal, social, medical, and psychiatric history, the mental state and behaviour at examination, the diagnosis and differential diagnosis, and comments upon aetiology, management, and prognosis. In almost all reports, the prognosis is the primary concern, so this should be given special attention. It is important to remember that one of the most reliable predictors of the recurrence of behaviours or episodes of illness in the future is the frequency of their occurrence in the past. Similarly, the vulnerability of the patient in the past (that is, any enduring predisposing factors and patterns of past precipitants) will tend to predict future vulnerability and the likelihood of further episodes of illness. Some mention of the past will therefore always be necessary, but in many instances this can be brief and reduced to a commentary of a few lines. But in other situations, particularly those involving civil court...


One of the most intriguing observations in the current child development literature is the contrast between the ever-increasing evidence of just how complicated children's cognitive development is and the phenomenon known as 'infantile amnesia'. Basically, people have very few memories before the age of 3 years. Clearly from all that has been described earlier about the differential reactions of babies to specific stimuli, to their recognizing their mother's voice or holding out their arms to their father rather than to a stranger, children increasingly have some form of central representations that they can work on. However, these early memories are not accessible in later life. It is really not until language is well established that people have what is ordinarily termed memory for past events. Clearly, infantile amnesia poses a major challenge to any theory of child development or personality that tries to link very early experiences with later adjustment. But early experience does...

Concluding comments

This chapter has shown that there are many small focused models of development that deal with discrete areas. Stage theories emphasize differences at different stages social learning theories emphasize continuities on processes of development. As long as practitioners are aware that when they say a child is 'at a particular stage', this is but a rough guide to describing the child, that may be acceptable. It is when such models are taken literally that oversimplification leads to poor practice. There is no single overarching theory of child development, and while this may be inconvenient for examiners, it truly reflects the rich diversity of human development. By paying more attention to the interactions between biological, social, and psychological factors, a better understanding of healthy normal development will emerge. Empirical studies will help identify risk and protective factors which in turn will lead to better mental health promotion and more effective interventions when...

Respiratory Causes

Spontaneous pneumothorax or pneumomediastinum. Causes chest pain with respiratory distress, decreased breath sounds on affected side (if pneumothorax is significant), and possibly palpable subcutaneous air. Children with asthma, cystic fibrosis, and Marfan syndrome are at high risk for these conditions, although in previously healthy children an unrecognized subpleural bleb may rupture with minimal precipitating factors. Adolescents who snort cocaine are at risk for similar barotrauma and may complain of severe, sudden chest pain with associated anxiety, hypertension, and tachycardia.

Jeanne V Linden

Sam Cohen loved his job as a paramedic. It offered the opportunity to truly help people in time of need and posed diverse challenges every day. It also posed a contrast to his stable personal life. He had dated his wife, Donna, when they were in high school, and they had married a few years later. Their sons, Brian, age 6, and Jeremy, age 4, were the joy of their life. Raising children in an urban setting was a challenge, but Sam always made it a point to take them to the park on his one weekend day off.


Whatever school a child is placed in and however much they appear to enjoy it, school is a stressful experience for all children and even more so for those that are different in any way. Most of you parents reading this will have experienced your own particular battle with the education system in order for your child to be understood and properly provided for. I have written a bit about advocacy in Chapter 5, included useful websites at the back of the book and there are many books written on educational issues, so all I am going to say about the subject is to arm yourself with information and to fight for your child's rights.


Hosts of the parasite, it is attracting a lot of attention of physicians of different specialities, of epidemiologists and of immunologists. Toxocara canis was revealed in 4.1 of dogs and caged wild animals in the European part of the Russian North (Avdyukhina and Lysenko 1994). Sero-epidemiological survey accomplished in Russia in 1984-1989 showed 6 of seroprevalence with Toxocara antigen (ELISA) in the healthy children of the Irkutsk

Genetic Counselor

Robin Bennett is a senior genetic counselor and clinic manager at the Medical Genetics Clinic of the University of Washington. Individuals and couples who seek genetic counseling include people whose family members have birth defects or genetic disorders and people who may be at risk for an inherited condition. Clients may be expecting a child or considering parenthood, or they may

Fight the good fight

Whilst as parents we have a responsibility (and a desire) to be our child's advocate and to do our very best to maximize his or her full potential, life often seems to be a constant fight for understanding and support. I know only too well how wearing this can be and as we battle, both with our child, their siblings and the professionals, it is all too easy to lose sight of ourselves, our goals for our children and the reason why we are fighting at all. I know exactly how tiring it is to do battle with your child over the slightest thing, to face shaving foam and squirted toothpaste each morning, to go and put on your favourite piece of jewellery only to find it has been destroyed and to be on the receiving end of physical and verbal abuse. Nevertheless our children need us to be their advocates and whilst children with AD HD are notoriously difficult to parent as they just do not seem to respond to the ways of discipline and encouragement that work for other children, they also have...

Awaiting a diagnosis

If you are a parent reading this and your child has already been diagnosed with Asperger Syndrome, you will already be used to his or her little idiosyncrasies and unusual ways. If your child has little idiosyncrasies and unusual ways and no diagnosis then don't doubt yourself for one moment - if you think your child has AS, then you are probably right. While it often seems to be an uphill task trying to convince professionals that you are not paranoid or have spent too much time on the internet, remember that having an official stamp of AS doesn't change your child one bit. If your child fits the criteria for AS, even if professionals have seen him or her on a day when certain criteria are not so evident, then don't wait for an official diagnosis before you start to work with your child in order to alleviate some of the difficult aspects of AS and help him or her make sense of the world. Whilst awaiting a diagnosis, whilst maybe fighting for a diagnosis, there is no reason why you...

Maternity testing

There are some situations in which mother child testing is requested. For example, public authorities responsible for aliens often allow family reunion only after proved kinship. Maternity can also be demonstrated by sequencing mitochondrial DNA (mtDNA), however this technique would not always yield the same level of certainty. For example, mtDNA sequences are identical not only to those of their own children but also to nephews and nieces in a maternal line. Furthermore, due to the high rate of illegitimate paternity in modern societies, the identification of skeletons or carcasses by mother child testing is more reliable than through the assessment of father child relationships.

Treasured memories

I am sure that all parents reading this will have their own examples of family outings, parties and holidays, many of which will, I am sure, have not gone to plan. How many of you have tried to take your child shopping and ended up rolling on the floor trying to protect him or her from an injury as he or she has a meltdown How many of you have gone to a relative's house and spent an agonizing ten minutes running around trying to stop your child from destroying the place (Why do people place delicate ornaments on child sized tables ). I know that these incidents are often soul destroying at the time and I myself have come home and sobbed on many occasion after such an excursion. However, I have found that the secret is to try, if at all possible, to look for a positive and preferably humorous side to the outing .one thing about the bad times is that they make us appreciate the good ones far more All these memories, though rather different from other families', are a valuable part of...

Large families

If you are one of these people who, like me, automatically answers when someone shouts Mum regardless of where you are or who is with you, if you have to count your children when you are out, or you go through a few names before you hit on the right one then undoubtedly you have mayhem in your house too As parents ofmore than one child, the difficulties we face and the fun we have will differ from those with only one or maybe even two children, and the presence of any shade of adolescence, autism, AD HD and AS can sometimes be entertaining When reading snippets in magazines (OK so it is only when I am sitting in a doctors', or hospital waiting room ) or on the internet about large families, most say that what they cherish about having a large family is that the younger children learn from the older ones and they all become self-sufficient far earlier in life. It seems that unless my parenting skills are seriously defunct then autism has stamped its hobnail boots over this theory too

Cognitive Functions

Times as much anandamide as those of unstressed mice. Such increase was not seen in the hippocampi of these mice (149). An interesting set of observations on children of marijuana-smoking mothers indicated that these children develop impaired executive functioning, which is thought to be a cognitive deficit of the PFC (150).


Besides their primary educational role, schools are important settings for mental health promotion in order to teach children important life skills aimed at reducing acute and chronic social stresses and enhancing social supports, all of which have a direct influence on mental health. Schools need to be committed to improving and sustaining the mental and physical health of children. Mental health promotion in schools should include teaching coping skills, citizenship skills, examination skills and techniques, stress management, achieving potential in relationships and working situations, recognizing and combating bullying, learning to say no to risky behaviours, and education about parenting and child rearing, in collaboration with the health education programme and the addiction programme. (38)

Parental divorce

A variety of different mechanisms may contribute to these effects. In addition to disrupted attachments, some adverse consequences may flow from modelling, with children imitating the discordant or aggressive interactions they observe within the family. Stress may impair children's capacities to regulate emotional responses, or to develop appropriate coping strategies. In a rather different way, parental discord may disrupt the quality of parenting, affecting the consistency and quality of discipline, increasing the likelihood of harsh disciplinary methods, or leading to arguments over discipline that directly involve the child. Finally, the affective quality of parent-child relationships may also be compromised by parental stress, and by 'spillover' effects from strains in other relationships.


AD-HKD is associated with serious social, academic, and psychological difficulties at each stage of development. The quality of the social relationships of children with AD-HKD with their siblings, peers, parents, and other adults is poor as a result of their verbal and physical aggressiveness, inattention to social cues, and bias toward attributing hostile motives to others. (31 As a result, children with AD-HKD are rejected by others and treated in a controlling and negative fashion by their peers, teachers, and parents.(3233> Their families experience considerable stress, feelings of incompetence, and marital discord because of these behavioural problems. These children's parents tend to use coercive parenting strategies. Children with AD-HKD are more likely than their unaffected peers to live in families whose lives are disrupted by poverty, marital separation, and parental psychopathology. (3 35 and 36

Family environment

Parenting practices Conduct disorder is strongly associated with harsh erratic discipline, hostility directed at the child, lack of warmth, and poor supervision. (24> Follow-up and intervention studies show that these factors have a causal role in initiating and maintaining the child's disorder, and are not just a reaction to the child's behaviour. However, there is also good evidence that children with conduct problems elicit harsh negative parenting both processes operate. In adolescence, supervision becomes a major factor, with parents of antisocial youths typically not knowing where they are for several hours in the day and at night. Discord between parents is also associated with persistent antisocial behaviour.(11' The association of conduct disorder with large family size, and with broken homes (divorce, single parenthood, adoption), seem chiefly to be mediated by parenting practices and the previous characteristics of the individuals, rather than by the impact of a large...

Sleeping sickness

I have tried every possible way to get Luke, and subsequently Joe and Ben, off to sleep and to keep them asleep once they managed it. Some ways have been successful for one and not another, some work for a short period oftime and some not at all. Here are some tips that may help your child (and thus you ) get a better night's sleep. For those of you who have read Luke's book, you may recognize some of these tips .obviously the strategies I have tried over the years are the ones he is familiar with Any annoying sounds in your own or your child's room can prevent sleep. People on the autistic spectrum tend to be far more sensitive to noise and smells. Tell your children what to do when they go to bed. It seems so simple but the actual routine of drawing the curtains or blind, turning the light off, getting into bed, lying down and pulling the quilt over you and going to sleep, is not something instinctive to people on the autistic spectrum. Encourage your children to talk for a while...

Survival skills

One of the best pieces of advice I can give to parents of children with any special needs, particularly a 'hidden' one such as autism or AD HD, is to release others to think what they like. If you have tried unsuccessfully to 'educate' family or friends about the differences of your children then at some time, however frustrating (believe me I know ) you must accept that some people are unwilling or unable to learn. The key to self-preservation is your own acceptance and that includes the acceptance of ignorance and intolerance in others. Some people we just cannot change. Some things we cannot change. The secret is to recognize these and move on. Do away with guilt. Guilt first rears its ugly head as we wonder if we have 'given' our children their problems. It then attaches itself to our shoulders as we beat ourselves up for handling a situation badly. If you truly feel that you have done wrong by your child, apologize and explain clearly how you felt. Even if you believe your child...

Parental influences

Parental practices are commonly the reason why a child's sleep problem develops or is maintained. Early child-rearing practices determine sleep-wake patterns which can be delayed or disrupted by overconscientious night-time feeding in infancy, failure to set limits on bedtime activities, or inconsistency. Sleep disorders of physical origin may be complicated in these ways and exacerbated. It follows that treatment of many sleep disorders relies heavily on correcting parenting practices.

Attempted suicide

Stressful life events often precede a suicide and or suicide attempt. (12> They are rarely a sufficient cause in suicide, and their importance seems to lie in their action as a precipitant of stress in young people who are at risk by virtue of their psychiatric condition. Family discord, lack of family warmth, and a disturbed parent-child relationship are commonly associated with types of child and adolescent psychopathology, but these factors do not play a more important role in suicide. (12>

Initial assessment

In the initial assessment of children with suspected GID the professional should attempt to engage both parents as well as the child. Frequently there is reluctance by one parent, usually the father, to attend. However, this is a family matter, and the clinician needs to gain impressions of the parent-child relationship, the parent-parent relationship, and the child's behaviour from both parents as well as the child.


We each have a mental image of 'a child'. Often this is a stereotypical child aged about 5 to 10 years old. But childhood covers the whole period from birth to adulthood, and of course every adult is also somebody's child. In this chapter the term 'child' will be used to refer to anyone who is not an adult, but who has matured sufficiently to develop a clear concept of themselves as individuals and of the nature of the real world around them. The ability to distinguish fact from fantasy is an important prerequisite for psychotherapy. This develops as a gradual process with an important stage at 2.5 years of age when children normally start to refer to themselves as 'I' for the first time. Another stage occurs around 7 to 8 years of age when children develop a clear understanding of time and of the real world. If the therapist ignores these developmental issues it is likely that treatment will be harmful rather than helpful.

Involving parents

The extent of parental involvement depends on the problem that is presented. There is a long history of parental involvement in the treatment of behavioural problems, where it may be crucial in ensuring that skills are transferred to the home. A typical programme is as follows. (38) Parents participate initially in educational sessions about the disorder and about its management. They then take part in group or family sessions about how to model and reinforce the skills that the young person is learning. The cognitions of the parents may then be examined. Parental beliefs about parenthood and attitudes towards the child may be crucial in determining the outcome of treatment. It seems, for example, that parents' models of their own parenting relationships predict the attachment that they will have to their children.(39) Negative attitudes towards the child, as shown by high levels of hostility and criticism, are highly predictive of outcome. (4Q> It may be possible to work with the...


Deciding who needs to know any information gathered is not easy when other people are involved and share responsibility, but the problem is more manageable if it is treated for what it is an important and interesting subject, legally and ethically, and directly relevant to child care, rather than as a peripheral and troublesome concern. The following points may be helpful.

Aicardi syndrome

This is a rare X-linked dominant condition which is associated with dysgenesis of the corpus callosum and severe mental retardation. So far, over 200 cases (all females) of this syndrome have been reported 68 However, there are other syndromes in which corpus callosal dysgenesis has been shown to be associated with mental retardation 15 Common physical features of Aicardi syndrome include microcephaly, scoliosis, muscular hypotonia, facial asymmetry, low set ears, and eye lesions such as chorioretinal lacunae. A high proportion of children develop epileptic seizures, particularly in the form of infantile spasms. Neuroimaging studies show evidence of cerebral dysgenesis in the form of neuronal migration disorder in the brains of the affected children along with corpus callosal dysgenesis. (69 The prognosis for this condition remains poor and death in infancy is common. Over a quarter of the children manifest behavioural problems in the form of aggression towards people and objects,...