Best practices and children and mental health

BACKGROUND: Psychological and mental health difficulties are common in children and young people (CYP) living with skin conditions and can have a profound impact on wellbeing. There is limited guidance on how best to assess and support the mental health of this population who are at risk of poor health outcomes. OBJECTIVES: The primary objective was to provide consensus-based recommendations on the assessment and monitoring of and support for mental health difficulties in children and young people (CYP) with skin conditions (affecting the skin, hair and nails)...

The Massachusetts Multi-City Young Children's System of Care Project was a federally funded program to provide integrated early childhood mental health (ECMH) services in primary care for families of very young children (birth-six years old) with Serious Emotional Disturbances across three cities in Massachusetts, U.S.A. This study describes lessons learned from the implementation of this program and makes recommendations for best practices to improve the delivery and efficacy of ECMH services in primary care settings...

BACKGROUND: In 2011, the Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) published guidelines for the metabolic monitoring of antipsychotic-treated children and youth. Population-based studies examining adherence to these guidelines are needed to ensure the safe use of antipsychotics in children and youth. METHODS: We conducted a population-based study of all Ontario residents aged 0 to 24 who were newly dispensed an antipsychotic between April 1, 2018, and March 31, 2019...

OBJECTIVE: Many children in low-income and middle-income countries are disadvantaged in achieving early developmental potential in childhood as they lack the necessary support from their surroundings, including from parents and caregivers. Digital technologies, such as smartphone apps, coupled with iterative codesign to engage end-users in the technology-delivered content development stages, can help overcome gaps in early child development (ECD). We describe the iterative codesign and quality improvement process that informs the development of content for the Thrive by Five International Program , localised for nine countries in Asia and Africa...

PURPOSE OF REVIEW: Transgender and gender-diverse (TGD) youth experience a discordance between their binary sex assigned at birth and gender identity. All TGD youth benefit from compassionate care delivered by clinicians who are informed in matters of gender diversity. Some of TGD youth experience clinically significant distress, termed gender dysphoria (GD), and may benefit from additional psychological support and medical treatments. Discrimination and stigma fuel minority stress in TGD youth and thus many struggle with mental health and psychosocial functioning...

BACKGROUND: Practitioners report a lack of knowledge and confidence in treating autistic children, resulting in unmet healthcare needs. The Extension of Community Healthcare Outcomes (ECHO) Autism model addresses this through discussion of participant-generated cases, helping physicians provide best-practice care through co-created recommendations. Recommendations stemming from ECHO cases have yet to be characterized and may help guide the future care of autistic children. Our objective was to characterize and categorize case discussion recommendations from Project ECHO Ontario Autism to better identify gaps in clinician knowledge...

OBJECTIVE: Evidence-based practice (EBP) is the preferred approach to treatment in mental health settings because it involves the integration of the best available research, clinical expertise, and patient values to optimize patient outcomes. Training on empirically supported treatments (ESTs) in mental health settings is an important component of EBP, and supervision of therapists' implementation of ESTs is critical for therapists to develop and maintain a strong EBP skill set. This study aimed to evaluate training and supervision histories of therapists in outpatient and inpatient psychiatric care settings as an essential first step in improving patient outcomes...

Infants and children born with CHD are at significant risk for neurodevelopmental delays and abnormalities. Individualised developmental care is widely recognised as best practice to support early neurodevelopment for medically fragile infants born premature or requiring surgical intervention after birth. However, wide variability in clinical practice is consistently demonstrated in units caring for infants with CHD. The Cardiac Newborn Neuroprotective Network, a Special Interest Group of the Cardiac Neurodevelopmental Outcome Collaborative, formed a working group of experts to create an evidence-based developmental care pathway to guide clinical practice in hospital settings caring for infants with CHD...

BACKGROUND: Children and young people (CYP) with comorbid physical and/or mental health conditions often struggle to receive a timely diagnosis, access specialist mental health care, and more likely to report unmet healthcare needs. Integrated healthcare is an increasingly explored model to support timely access, quality of care and better outcomes for CYP with comorbid conditions. Yet, studies evaluating the effectiveness of integrated care for paediatric populations are scarce. AIM AND METHODS: This systematic review synthesises and evaluates the evidence for effectiveness and cost-effectiveness of integrated care for CYP in secondary and tertiary healthcare settings...

Pain disrupts neonatal vital signs and internal environment homeostasis and affects the recovery process, and recurrent pain stimulation is one of the important risk factors for neurodevelopmental disorders and some chronic diseases. In order to standardize pain management practice in neonatal wards in China and effectively prevent and reduce the adverse effects of pain on the physical and mental development of neonates, National Clinical Research Center for Child Health and Diseases (Children's Hospital of Chongqing Medical University) convened a multidisciplinary panel to formulate the evidence-based guideline for neonatal pain management in China (2023 edition) following the principles and methods for the guideline development issued by the World Health Organization...

Childhood and adolescence are key developmental periods in the life course for addressing mental health, and there is ample evidence to support significant, increased investment in mental health promotion for this group. However, there are gaps in evidence to inform how best to implement mental health promotion interventions at scale. In this review, we examined psychosocial interventions implemented with children (aged 5–10 years) and adolescents (aged 10–19 years), drawing on evidence from WHO guidelines...

Weight talk in the home-parents talking to their children about their weight, shape or size-has been associated with many negative health outcomes in children and adolescents, although the majority of research has been with adolescents. This study explored associations between weight talk in the home and a broad range of child biopsychosocial outcomes (e.g., weight status, diet quality, psychological well-being, peer problems), in addition to child sex and race/ethnicity. Parents of 5-7 year old children from six racial/ethnic groups (White, African American, Hmong, Latino, Native American, Somali) (n=150) completed an online survey and completed 24-hour dietary recalls on the child...

Emergency department (ED) crowding has been and continues to be a national concern. ED crowding is defined as a situation in which the identified need for emergency services outstrips available resources in the ED. Crowding is associated with higher morbidity and mortality, delayed pain control, delayed time to administration of antibiotics, increased medical errors, and less-than-optimal health care. ED crowding impedes a hospital's ability to achieve national quality and patient safety goals, diminishes the effectiveness of the health care safety net, and limits the capacity of hospitals to respond to a disaster and/or sudden surge in disease...

BACKGROUND: Chronic health conditions in children and adolescents can have profound impacts on education, well-being and health. They are described as non-communicable illnesses that are prolonged in duration, do not resolve spontaneously, and rarely cured completely. Due to variations in the definition of chronic health conditions and how they are measured prevalence estimates vary considerably and have been reported to be as high as 44% in children and adolescents. Of young people with a chronic health condition, an estimated 5% are affected by severe conditions characterised by limitations to daily activities impacting their ability to attend school...

In 2020, 21% of people who sought asylum in the UK were children. This population has complex interconnecting health and social needs. Assessment requires a holistic approach, with consideration of physical and mental health in addition to social and developmental well-being, within the whole family group. A trauma-informed life-cycle and intergenerational care approach is important. This article, aimed at all health professionals who may work with asylum-seeking families, outlines the best practice principles for undertaking health assessments in migrant children and young people...

Neurodevelopmental disorders - including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, communication disorders, intellectual disability, motor disorders, specific learning disorders, and tic disorders - manifest themselves early in development. Valid, reliable and broadly usable biomarkers supporting a timely diagnosis of these disorders would be highly relevant from a clinical and public health standpoint. We conducted the first systematic review of studies on candidate diagnostic biomarkers for these disorders in children and adolescents...

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects individuals from all life stages, genders, and races/ethnicities. Accurate assessment of ADHD across different populations is essential as undiagnosed ADHD is associated with numerous costly negative public health outcomes and is complicated by high comorbidity and developmental change in symptoms over time. Predictive analysis suggests that best-practice evidence-based assessment of ADHD should include both ADHD-specific and broadband rating scales from multiple informants with consideration of IQ, academic achievement, and executive function when there are concerns about learning...

BACKGROUND: Population-based research examining geographic variability in psychotropic medication dispensing to children and youth and the sociodemographic correlates of such variation is lacking. Variation in psychotropic use could reflect disparities in access to non-pharmacologic interventions and identify potentially concerning use patterns. METHODS: We conducted a population-based study of all Ontario residents aged 0 to 24 years who were dispensed a benzodiazepine, stimulant, antipsychotic or antidepressant between January 1, 2018, and December 31, 2018...

There is growing evidence of the efficacy of evidence-based interventions in improving the academic and social outcomes of children who exhibit challenging behaviors during program implementation periods. However, less is known about the extent to which practices learned as part of these interventions are sustained after these projects end, when funding is paused temporarily, and in less-than-ideal conditions. This study used qualitative methods to investigate whether teachers previously trained in the BEST in CLASS-Elementary intervention continued to use the program's evidence-based practices with students 1-2 years after completing the program and in the context of the COVID-19 pandemic...

All-terrain vehicle (ATV) incidents are one of the leading causes of injuries and fatalities among youth in the agricultural industry. It has been hypothesized that many youth-related ATV incidents occur because children ride ATVs that do not fit their capabilities and are not following basic safe riding practices. In addition, various ATV safety guidelines regarding youth (e.g., CPSC, ANSI/SVIA, ASI) are inconsistent and may not align with state or local laws. To the best of our knowledge, no comprehensive studies have compared the physical and mental requirements for riding ATVs and the youth's capabilities to ride ATVs safely...