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Influenced by news reports of young children brutalized by their parents, most of us see the role of child services as the prevention of severe physical abuse. But as Tina Lee shows inCatching a Case, most child welfare cases revolve around often ill-founded charges of neglect, and the parents swept into the system are generally struggling but loving, fighting to raise their children in the face of crushing poverty, violent crime, poor housing, lack of childcare, and failing schools. Lee explored the child welfare system in New York City, observing family courts, interviewing parents and following them through the system, asking caseworkers for descriptions of their work and their decision-making processes, and discussing cases with attorneys on all sides. What she discovered about the system is troubling. Lee reveals that, in the face of draconian budget cuts and a political climate that blames the poor for their own poverty, child welfare practices have become punitive, focused on removing children from their families and on parental compliance with rules. Rather than provide needed help for families, case workers often hold parents to standards almost impossible for working-class and poor parents to meet. For instance, parents can be accused of neglect for providing inadequate childcare or housing even when they cannot afford anything better. In many cases, child welfare exacerbates family problems and sometimes drives parents further into poverty while the family court system does little to protect their rights. Catching a Caseis a much-needed wake-up call to improve the child welfare system, and to offer more comprehensive social services that will allow all children to thrive.

Parents of a child with chronic kidney disease (CKD) must safely perform advanced care and treatment while at the same time allowing the child some freedom and maintaining everyday parenting and family tasks. Drawing on interviews with primary caregivers of children with CKD in Portugal, we examine the context of raising a child with CKD and how the parents practise their parenthood. The study takes inspiration from parenting studies and child studies and explores how good parenthood is constructed. Based on thematic analysis, three core themes emerged: protecting the child, involving the child in their treatment, and transferring responsibility. The transformation of life-limiting circumstances into a life that worked well for both parents and their child represents what we call ‘readiness parenting’. Assessing risks, supporting the child’s autonomy, and relating to social norms required constant vigilance and readjustments as well as negotiations about parental responsibility.

Introduction The transition to primary school is a significant milestone for children. Transition periods can offer new opportunities to build skills, relationships, and experiences that strengthen self-efficacy. In Singapore, parents play an important role in supporting transition as preschools and primary schools operate independently. Occupational therapists are involved in supporting children with special needs in transitions. Objective Focusing on the transition period of getting children ready for primary school, the objectives are (i) to learn about the strategies that parents used for the purpose of transition and understand the intentions behind what they do and (ii) to compare the transition practices and perceived school readiness between parents of children with and without special needs. Method A longitudinal study involving 48 parents was conducted over 12 months. Parents completed a survey at the start and end of the year to detect changes from baseline, and semi-structured interviews every two months to gather their subjective experiences and track their child’s readiness for transition. The surveys and interviews were conducted on a mobile instant messaging platform. Coding of responses was guided by school readiness domains identified in earlier studies and Occupational Therapy Practice Framework’s approaches to intervention. Results Most parents focused on establishing and maintaining new self-help and academic skills across the year while few were “modifying” or “preventing”. Increasing trends in child readiness were noted for both children with and without special needs. Conclusion In family-centred practice, it is important to recognise parents’ expertise and resources.

The aims of the present study were to describe variations in the early course of development in autism by utilizing an in-depth parent interview that incorporated techniques to improve accuracy of parent recall, and to examine the relation between variations in early developmental course in autism and behavioral outcome at 3-4 years of age. The Early Development Interview, which consisted of questions about child's behavior in several domains from birth through 2 years of age, was created and administered to parents of 72, 3-4-year-old children with autism spectrum disorder and 34, 3-4-year-old children with developmental delay, who were matched on mental and chronological age, and 39 1-4-year-old typically developing children, who were matched to the clinical groups on mental age. At 3-4 years of age, children were administered standardized measures (some clinician administered and some parent report); these included verbal and nonverbal IQ, autism symptom severity, and adaptive and aberrant behavior. Based on the Early Development Interview, children with autism spectrum disorder (ASD) were reported to have elevated symptoms in the social and regulatory domains by 3-6 months. By 12-15 months, parents of children with ASD reported significantly higher levels of social symptoms than parents of children with developmental delay. At 3-4 years of age, children with autism with early vs. late on set of symptoms, and with vs. without a history of loss of skills (regression) were not found to differ on standardized tests of verbal and nonverbal IQ and observational measures of autism symptom severity.

Background 'Emotion work' is a term used to describe the emotional responses that may arise in qualitative research exploring difficult experiences. Parents' experiences of neonatal care can raise sensitive issues during interviews, which may lead to emotional responses. Aim To reflect on an interpretive study involving narrative interviews with parents of preterm neonates, to inform researchers about the potential emotive issues that may arise in such work. Discussion Reflection on interviews with parents of preterm neonates revealed areas for discussion relating to emotion work, the role of the researcher, emotional connections and empathic interviewing. Consideration of these areas highlights the importance of reflexivity for researchers. Conclusion Qualitative researchers undertaking narrative interviews should be prepared for emotive issues that arise and recognise the need for emotional intelligence. Achieving a balance between being an empathic, emotionally aware interviewer and remaining objective can be challenging. Implications for practice Strategies that researchers can use to address this balance and to manage the emotion work involved in research of this nature are provided.

Not much is known about the early development in children that are later diagnosed with disorders of attention and activity (ADHD). Using prospective information collected from mothers in the Danish National Birth Cohort (DNBC), we investigated if developmental deviations in the first years of life are associated with later ADHD. In the DNBC 76,286 mothers were interviewed about their child’s development and behaviour at age 6 and 18 months. At the end of follow-up, when the children were 8–14 years of age, 2034 were registered in Danish health registers with a clinical diagnosis of ADHD. The Hazard Ratio of ADHD was estimated using Cox regression model. At 6 months of age deviations in development showed associations with the child later being diagnosed with ADHD such as duration of breastfeeding, motor functioning, and incessant crying. At 18 months, many observations clearly associated with ADHD as for example the child not being able to fetch things on request [HR 3.0 (95 % CI 2.4; 3.7)], or the child being significantly more active than average [HR 2.0 (95 % CI 1.8; 2.2)]. An association to ADHD was shown, especially at 18 months, if the mother found it difficult to handle the child [HR 2.9 (95 % CI 2.4–3.5)]. However, it goes for all observations that the positive predictive values were low. Many children with ADHD showed signs of developmental deviations during the first years of their life. In general, however, ADHD cannot be identified solely on basis of the questions in DNBC.

Little is known about the natural history of children with pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS). This study prospectively followed 33 children with PANDAS for up to 4.8 years (mean 3.3 ± 0.7 years) after enrollment in a 24-week randomized, double-blind, placebo-controlled trial of intravenous immunoglobulin (IVIG) (N = 35). Fourteen of eighteen children randomized to placebo received open label IVIG 6 weeks after the blinded infusion, so follow-up results reported below largely reflect outcomes in a population of children who received at least one dose of IVIG. Telephone interviews with the parents of participants found that at the time of phone follow-up, 29 (88%) were not experiencing clinically significant obsessive–compulsive symptoms. During the interim period (6–57 months after entering the clinical trial), 24 (72%) had experienced at least one exacerbation of PANDAS symptoms, with a median of one exacerbation per child (range 1–12; interquartile range 0–3). A variety of treatment modalities, including antibiotics, IVIG, psychiatric medications, cognitive behavioral therapy, and others, were used to treat these exacerbations, and were often used in combination. The outcomes of this cohort are better than those previously reported for childhood-onset OCD, which may support conceptualization of PANDAS as a subacute illness similar to Sydenham chorea. However, some children developed a chronic course of illness, highlighting the need for research that identifies specific symptoms or biomarkers that can be used to predict the longitudinal course of symptoms in PANDAS.

The author articulates some understandings about transactional analysis's theory of the Parent ego state and discusses its involvement in the transmission of intergenerational trauma and wounds. She includes an overview of the literature about the Parent ego state and offers some contemporary understandings of working with intergenerational trauma. A contemporary approach to the Parent interview is introduced as a means of working with historical trauma. A case study describing a relational unfolding of trauma in the Parent ego state is offered, and a clinical reparative sequence is suggested.

Background Interventions that promote infant mental health face challenges when applied for parents who struggle with psychosocial and psychological burdens. Video-based guidance using the Marte Meo method is used in specialized clinical settings with high-risk families to improve parent-child interaction, parental sensitivity and mentalizing. However, knowledge about the lifeworlds of these parents and their experiences of the therapeutic process during video guidance is limited. Aim This qualitative study explores how parents in an infant mental health outpatient clinic who had difficulties mentalizing and maintaining an emotional connection with their infants experienced the change process during Marte Meo video guidance. Methods We identified a strategic sample of parents with difficulties mentalizing and maintaining an emotional connection with their infants through the Parent Development Interview. Twelve parents received video guidance and were afterwards interviewed in-depth. The research interviews were qualitatively analysed via a team-based reflexive thematic analysis. Result We identified four themes: a) feeling inadequate or disconnected as a parent; b) discovering the infant as a relating and intentional person; c) becoming more agentic and interconnected; and d) still feeling challenged by personal mental health issues. Conclusion Parents described positive changes in their interactions, in mentalizing their infants, the relationship and themselves as parents, in their experiences of self-efficacy and on a representational level. They also described increased confidence and improved coping despite ongoing personal mental health challenges. The findings suggest that video guidance using the Marte Meo method can be a critical intervention for vulnerable parents but should be coordinated with parents’ primary treatments when complex parental mental health issues are involved.

To identify possible early signs of autism spectrum disorder (ASD) within the Danish National Birth Cohort, we studied prospectively collected interviews from 76,441 mothers about their children’s development and behaviour at 6 and 18 months. In Danish national registries, 720 children with ASD and 231 children with intellectual disability (ID) were identified. At 6 months, associations between early signs and ASD or ID were found only in few areas. At 18 months social, language, and motor skills were delayed, and suspicion of vision and hearing problems were increased for both groups. Signs distinguishing ASD from ID were unclear, and the positive predictive values regarding ASD were below 10 % for individual predictors and aggregated risk scores.