The role of early care and education in addressing early childhood trauma

Examining the impact of a paediatric trauma family support service on the quality of life of injured children: A longitudinal cohort study

PURPOSE

We describe and evaluate the introduction of a trauma family support service (TFSS) in an Australian tertiary paediatric hospital.

DESIGN AND METHODS

A longitudinal mixed-methods cohort study evaluated the effectiveness of the TFSS on quality of life. PedsQL4.0 and EuroQol 5D-Y scores were collected at 6 and 12 months at intervention and non-intervention sites and outcomes were compared using a two-sample t-test. Qualitative data from field notes collected during the administration of the quality-of-life measures were analysed using inductive content analysis. Data were integrated during the interpretation of results to expand and strengthen findings.

RESULTS

Data from 192 children were collected (intervention site: 104, control site: 88). Significant increases were seen in the PedsQL and EQ-5D-Y scores at the intervention site compared to the control site at both timepoints, indicating an increase in overall health related quality of life. Two main categories were generated from the qualitative analysis: "Psychosocial impact of trauma" and "Access to psychosocial services."

CONCLUSIONS

The introduction of a dedicated family support service after paediatric injury improved well-being up to 12 months post injury.

PRACTICE IMPLICATIONS

Healthcare providers should emphasise dedicated family support services for paediatric trauma patients, focusing on their psychosocial needs and ensuring access to suitable resources. Paediatric nurses are a major part of this service and should contribute to future research, co-designing and implementing these improved family support services to better serve families affected by paediatric trauma.

Factors Associated With Service Referrals and Uptake in Early Head Start: The Importance of Care Setting

Secondary analysis of the Early Head Start Family and Child Experiences Survey 2018 data set (Baby FACES 2018) explored links between family risk events and referral-making and referral uptake among families receiving Early Head Start (EHS) services. Referrals to both behavioral health and entitlement programs were considered. Results showed that referrals to behavioral health programs were much more likely to be given to families receiving care from home-based care than center-based care, and that referrals were slightly more likely to be given to families who did not have any family risk events. Several factors also moderated the relationship between family risk and referrals, including perceived closeness of the parent/caregiver-EHS staff relationship, family conflict, and caregiver depression. There were no observed effects for referrals to entitlement programs. Caregiver depression weakened the link between family risk and service uptake for entitlement programs.

Infant and early childhood teleconsultation and training: Program description and feasibility outcomes from a statewide implementation

To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.

Understanding the Impact of Trauma in Hispanic Nursing Students: Resilience and Learning Outcomes

Introduction: The purpose of the research was to examine the relationship between Hispanic nursing students' trauma experiences and the influence on resilience and learning outcomes. Methods: The study used quantitative, correlational methods to analyze the data. The survey tool included the Adverse Childhood Experience International Questionnaire, a resilience scale, and results from a standardized academic exam. Data Analysis was conducted using descriptive statistics and multivariate correlation analysis. Results: The results provide evidence of a negative relationship between trauma levels and resilience. As students' trauma scores increased their level of resilience decreased. No observed significant relationship between the Hispanic nursing student's lived trauma and learning outcomes was noted. Conclusion: This study will help in understanding the stressors that might affect students and help educators to create environments within the classroom that will allow students to overcome these stressors. Evidence identified that Hispanic nursing students experienced multiple traumatic childhood events. Through the study of traumatic experiences in nursing students, we garner insights into the prevalence of adverse experiences in this population. Additionally, given projections of a nursing shortage, evidence that lends insights to ensure Hispanic nursing student success will ultimately benefit nursing and patient care.

Early Childhood Professionals’ Perspectives on Dealing with Trauma of Children

Childhood trauma is a significant concern in Australia and internationally. Professionals working in the early childhood education sector (i.e., providing early childhood education and care to infants, toddlers, and children from birth to age eight) are positioned to provide valuable support for children affected by trauma. However, there is less research on early childhood professionals’ perspectives and experiences of supporting trauma-exposed children compared to other education professionals (e.g., primary and secondary school teachers). This study explored early childhood professionals’ perspectives and experiences in relation to supporting children exposed to trauma. Semi-structured interviews were conducted with 14 early childhood professionals in Victoria, Australia, and data were analysed using thematic analysis. The findings illustrate that while educators develop valuable skills and experience growth from supporting trauma-exposed children and their families, they also experience emotional distress and challenges. Educators noted that there are limited professional development opportunities to learn about childhood trauma, and limited access to qualified and knowledgeable staff who can help them when supporting these learners. Implications from this study emphasise the importance of designing and delivering trauma-based professional learning opportunities and policies for early childhood educators.

A Review on Early Intervention Systems

Purpose of Review

Early intervention programs have been shown to increase the overall socio-emotional and physical wellbeing of children in early childhood and educational settings. The goal of this narrative review is to explore recent literature that describes implementation of these systems and highlights innovative practices in the early childhood intervention sector.

Recent Findings

Twenty-three articles were included, and we identified three themes in this review. The literature addressed concepts of innovative techniques in relation to childhood disability interventions; policy practices that promote child, family, and practitioner wellbeing; and attention to the importance of trauma-informed care in education for children and families who face the impacts of social marginalization such as racism and colonization.

Summary

Notable shifts in the current early intervention paradigms are approaches to understanding disability informed by intersectional and critical theories, as well as systems level thinking that goes beyond focusing on individual intervention by influencing policy to advance innovative practice in the sector.

Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention

Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.

Exploring School Staff Perceptions Relating to Animals and Their Involvement in Interventions to Support Mental Health

Given the growing awareness of the health benefits of human–animal interactions, the use of animal-assisted interventions (AAIs) in educational settings has increased over the years. While many school districts are now considering or utilizing AAIs, the literature investigating AAI-related perceptions among school stakeholders is limited with previous studies focusing on evaluating specific programs. To address this gap, a qualitative exploratory study was conducted using semi-structured interviews with school staff in the San Antonio, TX community. A total of 11 interviews were completed with staff serving preschool and elementary school age children. Data collected from interviews were analyzed using thematic analysis. Findings demonstrated that participating staff had some knowledge of the potential benefits of human–animal interactions and perceived the involvement of animals in interventions to be beneficial to children’s emotions and social-emotional skills. While perceptions of AAIs were generally positive, concerns around children’s safety and well-being were expressed as potential barriers in the adoption of AAIs in schools. These findings are preliminary and provide a segue to future research that can help expand our understanding of how school staff perceive AAIs, their impact on children’s mental health, their compatibility with school values, and their advantage relative to other interventions.

Collaboration of Child Protective Services and Early Childhood Educators: Enhancing the Well-Being of Children in Need

This paper examines the role of interprofessional collaboration in the identification and reporting of a child in need. Such collaboration is especially important in the context of the global pandemic caused by the novel Coronavirus disease of 2019, known as COVID-19. The child protection system must have the capacity and resources to respond to increased demands during this time, and early childhood educators serve as an essential link for child protective services in identifying and reporting a child in need. As an effective system to accomplish these two aims requires a working collaboration among its participants, Bronstein's interdisciplinary collaboration model was used as a framework to interpret this practice. A small-scale qualitative study was conducted that included principals of nursery schools and child protection workers from one region in Estonia. Findings indicate that effective collaboration was believed to require communication and ongoing systematic relationship building. Collaboration in practice varied, as principals reported a high turnover rate for the child protection workers, which hindered the development of a working relationship and support for the process of noticing and thereby identifying a child in need. In contrast, child protection workers assessed collaboration more positively, recognizing the need to have a supportive system in place for nursery schools. Both groups of collaborators acknowledged the need to train teachers, particularly to conduct joint training exercises to foster a common understanding of the child in need and of the intervention process itself.