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Extracts from the Journals relating to Children, Youth and Families - in the fields of health, substance abuse, education, psychology, science ...

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Recognize the effects of intimate partner violence to help children heal

Olivia can’t sit still long enough to get through a single lesson in her second-grade class. Jayson picks fights with other kids without the slightest provocation and has trouble expressing his emotions. Aaron zones out when the teacher asks him questions, and walks around the playground with his head down while other children play.

As professionals who work with children, our mind cycles through potential diagnoses: Does Olivia have attention deficit hyperactivity disorder? Does Jayson have autism? Does Aaron have a learning disorder? Perhaps. But all these behaviors have one thing in common: They may be a manifestation of the trauma inherent in exposure to intimate partner violence.

In the United States, 15.5 million children live in families where intimate partner violence occurred at least once in the past year. For children who live in a home with intimate partner violence (IPV), the one place that should be most safe and secure can feel like a war zone. While children are often physically harmed by the abusive partner’s actions, there are also countless other ways that person’s behavior hurts family functioning, all of which damage a child’s well-being.

As educators, child welfare and human services professionals, it’s absolutely critical to recognize the signs of possible IPV as soon as possible and to create paths toward healing. As noted above, those signs can often be mistaken for other issues. Misdirected treatment means that kids aren’t getting the correct responses to meet their needs.

It’s also important to know the different ways that kids can be exposed to IPV that are not so obvious. They do not have to see the abuse directly to be affected by it. The violence disrupts their essential daily routines, affects the survivor’s ability to parent and undermines children’s sense of what it means to be safe. It impairs a child’s ability to sleep. Kids are often caught up in the abuse when the violent partner uses them as a weapon to threaten and coerce the survivor.

What’s more, trauma can actually harm the development of children’s brains, resulting in overactive stress responses that may cause them to have difficulty in social, home and school settings. These impacts are even felt before children are born.

Signs of trauma, abuse exposure in children

Recognizing the signs of trauma and IPV exposure is not always simple. Symptoms manifest themselves differently in different children and across the various developmental stages. For example, babies may experience sleep and eating disturbances, an exaggerated startle response and an inability to be comforted. Toddlers may exhibit slow motor responses, extreme separation anxiety from their primary caretaker or they may not know how or when to play.

In elementary school-aged children, like Olivia, Jayson and Aaron, behaviors vary greatly from child to child. Kids like Olivia are often hypervigilant, experience difficulty concentrating and are fearful of staying still too long. They have learned to expect that the world is not a safe place and are constantly scanning for the next threat. They may act out and bully other children, like Jayson, and have trouble expressing their emotions in a family where they’ve been told that talking about feelings is forbidden or not safe. Children may also experience intrusive thoughts or flashbacks related to the trauma they suffered, like when Aaron “goes somewhere else” in his mind or feels numb.

In teens, trauma symptoms can very easily look like behaviors we are quick to punish: violence toward peers or in their own relationships, truancy, drug or alcohol abuse, and lack of involvement with social groups. Only in recognizing these symptoms as a function of trauma can we truly begin to help children heal.

How can we help children heal?

Break the silence. Children often believe that they are at fault and that they have caused the IPV in their home. Some are even told by the abusive partner that if they just behaved or were “better” that the abuse wouldn’t have happened. Children need to hear that it isn’t their fault – not only from their parents but also from anyone working with that child in a professional capacity.

Given the guilt kids carry, many will cope by becoming the overachieving model child who just wants to please adults. It’s important to recognize that even though children may not show the outward symptoms of behavioral issues, depression or anxiety, studies show that they are still just as affected by trauma exposure.

It is important to let children know that it’s OK to talk about the abuse. Use simple facts to the extent that you know them. Encourage parents to talk about the abuse too: (“Mom and dad had a fight. Mom got hurt.”) Let kids know that any and all the feelings they’re experiencing are OK. Give reassurance and give them a chance to ask questions.

Get help: you are not alone. Educators and child welfare professionals help families with so many challenges every day. We need to rely on the support of others to assist with the complex challenges children face. Consult with an IPV expert, link families to IPV-specific supportive resources (including trauma-informed therapy and supportive groups for children), provide families with the number for the National Domestic Violence Hotline.

Establish healthy routines and boundaries. Children’s boundaries and sense of what it means to have a safe, stable routine are disrupted when violence occurs in the home. When one parent is abusive, children don’t know if they’ll be sitting down to dinner at night or if it will be thrown on the floor. You can help create that stability in whatever setting you are seeing the child in, and provide support and education to parents to create important routines and boundaries as well.

Using nonviolent discipline to establish rules is also essential in helping traumatized kids heal. Children who are exposed to violence learn it is an acceptable way to gain power and get what they want. Set limits while explaining why helps develop healthier behavior regulation. (For example, “Someone might get hurt,” or “That’s not respectful.”)

Work on self-care: This is difficult work. In the spirit of making sure you get expert help for kids, also ensure that you take care of yourself. Ultimately, you will be able to better serve the children and families with whom you work if you feel supported and strong.

Recognizing and understanding the signs of trauma and giving children a space to begin to talk about the abuse are vital to increasing resilience. Educators and professionals play an important role in supporting children on the pathway to healing.

By Kaylin Padovano and Nazy Kaffashan

23 August 2017

Kaylin Padovano has spent nearly a decade in the field of intimate partner violence services as a training and capacity-building coordinator, community educator, researcher and licensed social worker in New York state.

Nazy Kaffashan is a licensed mental health counselor who has worked as a psychotherapist, senior clinician and group coordinator serving survivors, abusive partners and children impacted by trauma and intimate partner violence for more than 15 years. 



Young children's sense of self is similar to that of adults

Young children's sense of self is similar to that of older kids and adults, a team of psychology researchers has found. The results show that our ability to reason about our self-worth as individuals develops early in life, but also suggest that failure can instill discouragement sooner than previously thought.

"Young children's self-concepts are not qualitatively different from those of older children and adults," explains Andrei Cimpian, an associate professor in New York University's Department of Psychology and the study's senior author. "Young children can think of themselves as possessing abstract traits and abilities, and they can also reason about their self-worth, which has implications for self-esteem.

"However, this level of maturity in reasoning about the self also means that young children can become dispirited in the face of failure and are not the undaunted optimists that previous theories have described. In light of this new work, we need to think carefully about, and investigate, ways of supporting young children's motivation and engagement with important – but often difficult – activities such as school."

The study, which appears in the journal Child Development, also included Matthew Hammond, a faculty member at New Zealand's Victoria University of Wellington, as well as Giulia Mazza and Grace Corry, who were undergraduate researchers at the University of Illinois when this research was conducted.

It has long been thought that young children think of themselves in concrete, behavioral terms and, unlike adults or older children, are cognitively incapable of reasoning about their traits or their worth as individuals.

The researchers tested this belief, aiming to understand if young children can think about themselves in terms of general traits and abilities (e.g., "I'm smart") and judge their global worth as individuals – or if they are largely focused on concrete behaviors and outcomes (e.g., "I got a good grade").

To answer this question, the researchers conducted a series of studies of children ranging from four to seven years old. The participants were presented several hypothetical scenarios – commonly employed in psychology research for this age group – that varied in several respects. In them, the children were asked to imagine they could not complete a task (e.g., solving a puzzle) despite "trying really hard." In some cases, they were told the task was easy (e.g., drawing the sun) and in others that it was difficult (e.g., drawing a horse). In addition, some children were informed the task was done at the request of an adult (a parent or teacher) while others were told it was self-initiated.

They were then asked questions about their abilities (e.g., "Does not drawing the sun/horse right make you feel like you're good at drawing or not good at drawing?") and their global sense of self-worth (e.g., "Does not finishing the puzzle make you feel like a good boy/girl or not a good boy/girl?"). At the end of the sessions, children acted out positive scenarios and were debriefed.

The results showed that children as young as four can flexibly reason about their abilities and their global sense of self-worth based on the context of their behavior. For example, children lowered their estimation of their abilities, but not their global self-worth, when told they failed an easy, as opposed to hard, task. Conversely, they lowered their estimation of their global self-worth, but not their abilities, when informed they failed an adult-requested (vs. self-initiated) task – in other words, adult involvement could negatively affect self-esteem, independent of the task.

"This evidence reveals surprising continuity between young children's self-concepts and those of older children and adults," Cimpian observes. "However, more importantly, our findings show the impact others can have on young children's sense of self-worth at a very young age.

"It is therefore important for both parents and educators to understand that our children may become more discouraged than we previously realized and find ways to foster a productive learning environment."

24 August 2017



HIV in youth: Another area for cultural competence

Adolescents and young adults aged 13 to 24 years old are particularly vulnerable to HIV infection, representing 21% of newly infected individuals in most recent data. Roughly 40% of youths with HIV are aware of their diagnosis, and just 6% of those treated have reached virologic suppression.

Researchers from the Johns Hopkins School of Medicine addressed the unique concerns of HIV infections in youths in a study published in the October 2017 issue of AIDS Care. According to the authors, younger individuals with HIV have many competing needs that distract them from fully engaging in care, including unstable housing, under-employment, and co-morbid physical and mental health issues.

The researchers aimed to address these challenges by understanding where and how youths with HIV receive care. Although this population accounts for an increasingly disproportionate share of infections, clinicians provide care in a variety of settings that generally have larger patient volumes and more comprehensive services than pediatric clinics. Despite the array of services, youths have poorer outcomes than adults treated in these settings. Their outcomes also lag behind those treated at pediatric HIV clinics.

Most pediatric/adolescent clinics have limited capacities. The researchers noted that better interventions are needed, citing combination antiretroviral therapy, contingency management, nurse-derived interventions, and co-located substance abuse treatment as care gaps.

The researchers advocate for youth-friendly multidisciplinary teams and additional training for adult providers. While this study does not identify youth-friendly interventions specifically, other research indicates that this may involve:

• Educating staff to be culturally competent and avoid mentally assigning youths to stereotypes
• Provision of integrated services in locations where youths gather
• Acknowledging fear and anxiety without overemphasizing it
• Respecting the youth’s autonomy and confidentiality needs
• Being patient, positive, and nonjudgmental

Youths also like seeing the same health care providers at every encounter. In pharmacies, staff can establish trusting relationships with youths and promote retention in care.

21 August 2017



Eye patterns in children: The development of anxiety and emotion

We spend a lot of time looking at the eyes of others for social cues – it helps us understand a person's emotions, and make decisions about how to respond to them. We also know that adults avoid eye contact when anxious. But researchers have known far less about eye gazing patterns in children.

According to new research by Kalina Michalska, assistant professor of psychology at the University of California, Riverside, we now know that anxious children tend to avoid making eye contact, and this has consequences for how they experience fear. The shorter and less frequently they look at the eyes of others, the more likely they are to be afraid of them, even when there may be no reason to be. Her study, "Anxiety Symptoms and Children's Eye Gaze During Fear Learning," was published in the journal The Journal of Child Psychology and Psychiatry.

"Looking at someone's eyes helps us understand whether a person is feeling sad, angry, fearful, or surprised. As adults, we then make decisions about how to respond and what to do next. But, we know much less about eye patterns in children – so, understanding those patterns can help us learn more about the development of social learning," Michalska said.

Researchers addressed three main questions:

1. Do children spend more time looking at the eyes of a face that's paired with something threatening, but not expressing an emotion at that moment?

2. Would children who were more anxious avoid looking at the eye region, similar to what has previously been observed in adults?

3. Would avoiding eye contact affect how afraid children were of the face they saw?

To examine these questions, Michalska and the team of researchers showed 82 children, 9 to 13 years old, images of two women's faces on a computer screen. The computer was equipped with an eye tracking device that allowed them to measure where on the screen children were looking, and for how long. The participants were originally shown each of the two women a total of four times. Next, one of the images was paired with a loud scream and a fearful expression, and the other one was not. At the end, children saw both faces again without any sound or scream.

"The question we were interested in was whether children would spend more time looking at the eyes of a face that was paired with a scream than the face that was not paired with a scream, during that second phase," Michalska said.

"We examined participants' eye contact when the face was not expressing any emotions, to determine if children make more eye contact with someone who is associated with something bad or threatening, even when they are not expressing fear at that moment. We also looked at whether children's anxiety scores were related to how long children made eye contact."

The following three conclusions can be drawn from the study:

1. All children spent more time looking at the eyes of a face that was paired with the loud scream than the face that was not paired with the scream, suggesting they pay attention to potential threats even in the absence of outward cues.

2. Children who were more anxious avoided eye contact during all three phases of the experiment, for both kinds of faces. This had consequences for how afraid they were of the faces.

3. The more children avoided eye contact, the more afraid they were of the faces.

The conclusions suggest that children spend more time looking at the eyes of a face when previously paired with something frightening suggesting they pay more attention to potentially threatening information as a way to learn more about the situation and plan what to do next.

However, anxious children tend to avoid making eye contact, which leads to greater fear experience. Even though avoiding eye contact may reduce anxiety in the short term, the study finds that – over time – children may be missing out on important social information. This includes that a person may no longer be threatening or scary, and yet the child continues feeling fearful of that person.

University of California

17 August 2017



Harmful effects of spanking a toddler can trigger bad behavior – even 10 years later

A new study finds spanking and other physical discipline techniques continue to have adverse effects on children for far longer than originally thought.

Children spanked when they were as young as 15 months old displayed negative temperament and were less likely to show positive behaviors in the fifth grade and even into their teenage years, researchers at the University of Missouri say. The finding was vastly more pronounced in African-American children than those of European origin.

"How parents treat their children at a young age ... significantly impacts their behavior," says Gustavo Carlo, a study co-author who is a Milsapp professor of diversity at the university and director of its center for family policy and research. "It is very important that parents refrain from physical punishment as it can have long-lasting impacts. If we want to nurture positive behaviors, all parents should teach a child how to regulate their behaviors early,"

Past research has indicated physical punishment can have negative consequences on children's development, but previous studies only examined short-term impacts.

In the new study published in Developmental Psychology late last month, Carlo's team analyzed data from 1,840 mothers and children who were at or below the federal poverty level and identified as either of European or African descent. Information was collected when children were about 15 months old, 25 months old and in the fifth grade. Researchers used surveys of mothers and children, home visits and interviews with fifth-grade teachers to complete the study.

Long-term effects of severe discipline, such as increased aggressive and delinquent behaviors, were only found in African-American children, according to the study. Previous research, however, has shown short-term negative effects for children of all races and ethnicities. Carlo says that disparity might be tied to more frequent and more severe disciplining of the African-American children involved in the study.

Parenting expert Carole Lieberman, who authored "Lions and Tigers and Terrorists, Oh My! How to Protect Your Child in a Time of Terror" says physical discipline is bad for any child and wonders if the parents of European-descent children involved in the study were less forthcoming with how much physical discipline they used.

“With each spanking, children experience physical pain as well as emotional pain as a sign that their parents don’t love them,” she says. "Spanking conveys a message to them that they are not good. It causes them to become aggressive later on in their lives."

Carlo stressed the study does not suggest that the use of physical disciplining automatically means any child exposed to spanking or other physical discipline will end up maladjusted. However, this research, along with the majority of existing studies, highlight the use of such practices significantly increases the likelihood of problems later in life.

“If we think about child development as a jigsaw puzzle where many things are affecting our kids, this is one piece of the puzzle that increases the chances of negative child outcomes," he said. "As a parent, it is worth considering whether it is worth the risk, especially when there are many other alternatives available."

Alternative techniques to discipline children include time outs, distractions, removing them from the situation, moral conversations and loss of privileges, Carlo says. While physical punishment and yelling are both relatively bad for children, verbal discipline might not be so harmful if done in a controlled manner that relays a message that the child's behavior is unacceptable.

Psychologists have known for many years that physical punishment is detrimental to the development of children and this study provides further evidence for that relationship, says Brian Johnson, Professor of Counseling Psychology at the University of Northern Colorado and Co-author of "WARNING SIGNS: How to Protect Your Kids from Becoming Victims or Perpetrators of Violence and Aggression".

“Physical discipline, including spanking, is associated with increased aggressive behavior and lower self-esteem in children," he says. "Spanking models for children that using aggression is fine when one is upset, or has a conflict."

Parents often resort to spanking because they see quick changes in their children's behavior. Unfortunately, Johnsonsays, any positive behavior changes are seldom long-lasting, while the detrimental effects on behavioral and emotional health can be.

“Spanking suppresses behavior quickly, but does not change it," he says. "Spanking also increases a child's anger, resentment, and desire to get revenge."

By Waseem Abbasi

16 August 2017



Children are hard-wired to be kind, so why does civility dwindle?

Pediatric health care is by its very nature holistic. Not only do we have the opportunity to treat acute illnesses, we can guide and support child development. We often think of the physical or cognitive stages of development but we must also remember to nurture the emotional aspects of a child's growth. There is no curriculum to teach, there is no single instructor. Rather, these are lessons learned at the hands of society. In the world today, civility is one of the most important of these tutorials. But it seems as if it's slipping away.

The true meaning of civility is somewhat in the eye of the beholder but several scholars have attempted to define it. At its simplest, it is courtesy and politeness. Many have described it as the outward expression of the value of others, a straightforward recognition of humanity. Or, simply stated, putting the common good above our self-interest. Whatever definition we use, it seems that civility is amorphous subject matter that relies on the world as a classroom.

Interestingly, children are hard-wired to be kind when they are born. As early as toddlerhood, they will show empathy, for example lending a peer their blankie when they perceive an injury or sadness. By school age, when children are able to understand their own emotions, they begin to show compassion by both action and word. Then we hit middle school, the denizens of which are commonly known as the "mean girls," and the kindness once so evident seems much harder to find. As time goes on, the hard-wired kindness from birth may reappear, but not always. Where does it go? Why is it so hard to conjure up with age?

Many factors seem to contribute to the demise of civility over time. Children are incredible observers and mimics. If the prominent figures in their lives, which can change with time, act with disregard for others, kids will emulate that behavior. After all, children do learn what they live. It starts with the inner circle of nuclear family but over time includes peers, teachers, public servants and celebrities. As these role models erode their civil behavior, the humanity that is inborn begins to dissolve.

In addition, television, video games and social media are huge teachers in life lessons for all of us, children included. These venues can be very valuable but if not monitored closely, they can change the course of social development very quickly. In the worst-case scenario, this can lead to increases in violent behavior, societies in conflict and political division, all of which are not hard to demonstrate in the world today.

So can we change this shift away from civility and preserve the innate kindness that people are born with? There are many things we can instill in our behavior to nurture humanity in each other, and most of all, in our children.

First, we start at home. By thinking, speaking and acting with an open mind, we can set the frame of reference for children that can persist throughout their lives. We can teach the concept of always looking out – seeing others first and not expecting anything in return. This will breed awareness of things beyond the self and foster tolerance and acceptance, critical elements of civility. It will grow the innate seeds of empathy and kindness and eventually, teach respect for others both like and unlike ourselves.

We can model restraint and self-control. We can still allow human discourse and debate – in fact that is paramount to our ability to continuously improve the human condition. But we must listen and respond thoughtfully instead of just dominating the conversation. We must hear other opinions and adopt the best ones. The ones that do not elevate the human condition can be disposed of as long as it is done with respect.

We can apologize when we are wrong and we can change. We can share stories of events that helped shape us and taught us kindness throughout our life. Social media can promote acts of kindness and joy in 140 characters or less. We can write better stories and better blogs that lead to conversations about preservation of the ideal human situation. We can hold ourselves to the highest standard of compassion and civility. We can emulate societies that really do subscribe to the "it takes a village" concept when it comes to raising children to be responsible and caring human beings. The entire society takes on the child rearing and demonstrates in daily activity and interaction how to live a compassionate and caring life.

For us to do that in all societies, we must first demand civility in our public servants and politicians. We must take a stand against incivility and let others know it is not the way for a thriving society to exist. Our media must stop lauding those with celebrity status who have histories of behaviors that are antonyms of the desired, such as domestic violence and illegal behavior. Rather, let's hold up those who do charitable work and make the world a better place. Ignore the rogues and they will cease to be relevant.

Maybe civility is not such a vague concept at all. Recently it was described as standing up and taking responsibility for the feelings of others. Maybe we don't need to teach our children the lesson. Maybe they have the answer and the grownups of the world, especially those of high influence, should be the ones taking the notes.

By Elaine Cox

15 August 2017



Mental health programs in schools: Growing body of evidence supports effectiveness

School-based mental health programs can reach large numbers of children, with increasing evidence of effectiveness in improving mental health and related outcomes, according to a research review in the September/October issue of the Harvard Review of Psychiatry.

"This review provides evidence that large-scale, school-based programs can be implemented in a variety of diverse cultures and educational models as well as preliminary evidence that such programs have significant, measurable positive effects on students' emotional, behavioral, and academic outcomes," write J. Michael Murphy, EdD, of Massachusetts General Hospital and colleagues.

An estimated 13 percent of children and adolescents worldwide have significant mental health problems such as anxiety, disruptive behavior disorders, attention-deficit/hyperactivity disorder, and depression. Especially if left untreated, these disorders often persist into adulthood, with lasting effects on many aspects of life.

Over the years, many programs have been designed to deliver preventive mental health services in schools, where children and teens spend so much of their time. Substantial research now shows that school-based mental health interventions can be widely implemented and can lead to population-wide improvements in mental health, physical health, educational, and social outcomes.

Dr. Murphy and colleagues identified and analyzed school-based mental health programs that have been implemented on a large scale and have collected data on specific mental health outcomes. The authors estimate that the eight largest programs have reached at least 27 million children over the last decade.

The interventions vary in their focus, methods, and goals. The largest program, called "Positive Behavior Interventions and Supports" (PBIS), focuses on positive social culture and behavioral support for all students. The second-largest program, called "FRIENDS," aims to reduce anxiety and to teach skills for managing emotions and coping with stress – not only to children, but also to parents and teachers.

Most of the school-based mental health interventions were designed to focus on mental health promotion or primary prevention for all students in the school; some programs also target students at high risk of mental health problems. Most of the programs have been implemented across school districts, while some have been introduced on the state or national level.

Available research provides "moderate to strong" evidence that these interventions are effective in promoting good mental health and related outcomes. For example, studies of FRIENDS have reported reductions in anxiety, while PBIS has shown improved reading scores and fewer school suspensions. Other programs have shown benefits such as reducing bullying at school; one intervention has even been linked to lower rates of substance abuse in young adulthood.

The authors point out that school-based mental health interventions have been studied almost exclusively in high-income countries – despite the fact that about 80 percent of the global population of children live in low- and middle-income countries (LMICs). But there's evidence that this may be changing, since three of the eight largest programs have been implemented "to scale" in LMICs. One of these, called "Skills for Life," has been running on a national basis in Chile for more than a decade.

"Data sets of increasing quality and size are opening up new opportunities to assess the degree to which preventive interventions for child mental health, delivered at scale, can play a role in improving health and other life outcomes," Dr. Murphy and colleagues conclude. With ongoing data collection and new evaluation frameworks, they believe that school-based mental health programs have the potential to "improve population-wide health outcomes of the next generation."

10 August 2017



India: Progress, one girl at a time

In 2014, Rehana (name changed), a 15-year old from a school in West Bengal’s Sunderbans region, was rescued from a red light area in Delhi. The Class IX student had been ensnared by traffickers who then sold her off in Kolkata. After being brought back, the local administration and a non-governmental organisation (NGO) re-enrolled her in school. They feared she would drop out in months. Her script ran differently though. Rehana is today training to become a nurse.

Activist Rishi Kanta, whose NGO Shakti Vahini in Delhi aids in the rescue of trafficked girls and women, believes it is the West Bengal government’s girl child welfare scheme, Kanyashree Prakalpa, that has helped Rehana and others like her make a new life.

A lifeline

“Not only has the scheme prevented schoolgirls vulnerable to trafficking from dropping out, it has also offered a lifeline to girls like Rehana who did not have much institutional support after being rescued,” says Rishi Kanta. In June, Kanyashree Prakalpa was awarded the United Nation’s Public Service Award at The Hague.

Instituted in 2013, Kanyashree Prakalpa is a conditional cash-transfer scheme aimed at improving the status and well-being of the girlchild. Official statistics say there are around 41.2 lakh beneficiaries (as of July 25, 2017) of the scheme, implemented through 15,826 institutes and schools. “We want to ensure that every eligible person gets the benefits of the scheme,” says Shashi Panja, Minister of State for Women & Child Development and Social Welfare.

West Bengal was a ripe case for such a scheme. Although child marriage is prohibited by law, the State was among the top five when it came to early marriages. Further, in districts such as Murshidabad, Birbhum, Malda and Purulia, every second girlchild was found married off before 18. These are also districts where trafficking of girls is fairly common.

Now, National Family Health Survey statistics show that the number of women married before 18 has dropped from 53.3% in 2004-05 to 40.7% in 2015-16, though still above the national average of 26.8%.

Experts says the launch of the cash incentive scheme has convinced many families to send their daughters to school and also delay their marriage (the scheme offers a one-time grant of Tk 25,000, apart from annual scholarships, when the girl turns 18 and if she is studying in school or undergoing vocational training).

In April 2015, when Lakshmi Gorai from Raipur in Bankura district was pulled out of school to be forcibly married off, the district administration intervened and stopped her parents. When the family claimed they had no means to keep the 15-year-old in school, the authorities enrolled Gorai and other school-going girls from the neighbourhood in the Kanyashree scheme.

Ayesha Sultana, a first-year B.A. student at Women’s Christian College in Kolkata, was enrolled in the Kanyashree scheme by her school when she was in Class VIII. The yearly scholarships, she says, helped her continue studies, and subsequently encouraged 20 other girls from her lower-middle-class neighbourhood in Mominpur to join school.

Staying ahead

“The scheme has come as encouragement to pursue higher studies. The Tk 25,000 grant will help me complete my graduation,” Sultana says. Officials say the scheme has also helped girls stay ahead of boys in the board-level examinations. This year, girls accounted for 69% of the candidates in the West Bengal Madrasah Board Examination.

The tangible benefits aside, officials say the scheme has motivated young girls, especially in the rural and semi-urban areas, and encouraged them to stand up for themselves. In many places, Kanyashree Sanghas (associations) have been formed and according to reports, these are now the first line of defence against child marriages. The sanghas also help identify girls who have dropped out of school.

Recently, West Bengal Chief Minister Mamata Banerjee announced that the scheme would soon be extended to cover postgraduation studies as well.

By Shiv Sahay Singh and Indrani Dutta

5 August 2017



Parents turning to psychologists for advice about teen Netflix movie 'To The Bone'

Worried Adelaide parents and educators are turning to psychologists for advice about a “graphic” new Netflix movie about anorexia that is aimed at teenagers.
The film "To The Bone" tells the “confronting” story of a young woman with anorexia nervosa, and should have carried a “trigger warning” according to the national voice on eating disorders, The Butterfly Foundation.

There are fears the film – which stars a waif-thin Lily Collins alongside Hollywood star Keanu Reeves – glamorises the potentially dire eating disorder.

Butterfly Foundation chief executive Christine Morgan says: “My concern is, that while this film might cast a spotlight on the reality of eating disorders, it needs to come with clear warnings at the start. There are two groups who are particularly vulnerable – those who already have an eating disorder as well as those in ‘pre-stage’ who are really concerned about their own body image.”

Internationally, there have been calls to ban the film because experts are worried it might incite eating disorders.

The Butterfly Foundation has created a “fact sheet” that schools can use to provide as a guide for parents and staff that includes safe viewing tips. Local psychologists and eating disorder specialists also say they are being contacted for advice by parents as well as schools. Some teachers are concerned about conversations they’re hearing in the schoolyard.

The film’s release comes less than two months after the controversial series on suicide "13 Reasons Why", also created for Netflix.

Researchers from the San Diego State University found there was a spike in internet searches about suicide, including phrases such as “how to kill yourself”, in the wake of that show.

Adelaide clinical psychologist Kirrilie Smout says while the film has some positives as a “conversation starter”, it contains “unhelpful messages” and parents need to be wary.

“(It) underestimates the suffering involved in eating disorders, doesn’t accurately portray treatment and may make eating disorders seem attractive or interesting,” the director of Developing Minds Psychology and Education said. “I believe that for some kids and teens who either have, or who are at risk of developing an eating disorder, it could quite feasibly trigger jealousy, anxiety about current weight, desire for weight loss and disordered eating behaviour.”

Ms Smout, who has written a blog on the issue, says the movie isn’t suitable for young children. “It is entirely appropriate to say to a 13-year-old ‘no, you are not watching this’, and to provide the reasons why and suggest another film to watch instead.

“If you have an older child (16-plus) who wants to watch it and won’t be distracted by another suggestion, ask them if you can watch it together so you can talk about it afterwards ... then monitor and watch what’s going on later.”

If a young person has a negative body image:

1. NEVER ignore and dismiss concerns as, “this is just a phase”
2. DON’T forget the importance of role-modelling (be careful about your own language and how you refer to yourself)
3. DECOUPLE size and shape with value as a person (remind young people while it is important to be healthy, a body is there to help live life, it doesn’t define them)

By Rebecca Baker

4 August 2017  



Teen depression increases risk for violence

These findings emphasize the need for early detection and intervention.

Adolescent depression increases the risk of violence, suggests a study published in the August 2017 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

The study examined the longitudinal association between depression and subsequent violence from three representative samples in the Netherlands, United Kingdom and Finland. Researchers for these three cohorts used complementary measures of depression, including self-report and clinical diagnoses, and different measurements of violence including informant reports of violence and official convictions for violent crimes.

The research team, led by Professor Seena Fazel, from the Forensic Psychiatry Group at the University of Oxford, United Kingdom, found modest increases in risk of violence in depression. In absolute terms, for instance, in the Finnish sample, 7.1% of individuals with depression were convicted of one or more violent crimes, compared with 3.6% in the general population without depression.

In relative terms, across samples and measurements, the study shows a consistent pattern of increased relative risk of later violence. In the Dutch and UK samples, an increase in depressive symptoms was associated with a significant elevated risk of later violence. In the Finnish sample, the odds of violence in individuals with a diagnosis of depression were increased two-fold, compared to those without depression. These findings highlight the need for active and early treatment of depression in adolescents and young people. The mechanisms behind this link need further investigation, and may involve increased impulsivity, hostility and poor self-regulation.

"We know that high rates of depression have been reported among adolescents in juvenile detention and correctional facilities (e.g.,11% in boys and 29% in girls)," said Dr. Rongqin Yu, lead researcher at the Forensic Psychiatry Group at the University of Oxford, United Kingdom. "However, the longitudinal link between depression and violence was unclear. Our longitudinal design allowed us to take into account previous violence, enabling us to test whether adolescent depression is associated with changes in violence over time. We found a consistent pattern of increased risk of later violence across samples. Both depression and violence are prevalent in adolescents and young adults; our findings indicate the importance of early detection and treatment of depression."

Professor Fazel said: "This research is important for two main reasons. First, it adds to the evidence of the many potential harms of untreated depression in young people. Second, it suggests that closer liaison between criminal justice and mental health might prevent violence in high-risk individuals."

1 August 2017




Youth suicide prevention starts with building resilience young – PM's chief science adviser

Resilience programmes should be introduced into primary schools for children as young as 6 and 7, as part of plans to reduce New Zealand's high youth suicide rates.

There was "clear evidence" that behaviour programmes focused on primary school children contributed to reducing "later adolescent suicidality as well as other unwanted behaviours", the prime minister's chief science adviser has told ministers.

In a discussion document released on Wednesday, Sir Peter Gluckman delved into the risks associated with growing up in the 21st century and points to the need to better develop the resilience of children "to the inevitable stressors of growing up".

With young people hitting puberty earlier right across the Western world, analysis showed "compelling evidence" that children who enter puberty at a younger age, were at "far greater risk of behavioural, psychological and emotional disorder".

There was "unequivocal evidence" that children who entered puberty early were "more likely to indulge in alcohol and drug abuse" and often demonstrated more impulsive behaviours. Boys, in particular, showed greater impairment in the quality of their relationships.

Adolescence was a period of "relatively poorly developed self-control and heightened impulsive behaviour", Gluckman said.

"So, rather than resilience, which might be expected – and needed – we see severe and harmful (including self-harm) responses."

In fact, the rates of hospital admissions for self-harm were 50 to100 times higher than those for suicide. Many more than that again had suicidal thoughts, although that was difficult to quantify in statistics.

But a further possible factor in increasing rates of youth suicide was a "substantial change in the way we raise our children", Gluckman said.

"They now tend to be under tight control in the pre-pubertal period but less control post-puberty (as reflected in school subject choice, parental controls on time, place and behaviour, access to credit cards and the internet etc).

"In contrast, 50 years ago Western child-rearing practice followed a loose-tight pattern in which pre-pubertal children had more freedoms – especially to undertake risky play – but adolescence was much more constrained.

"This reversal may have resulted in a reduction in the capacity to self-assess risk in adolescence."

As well as changes in family structure and parenting practices, children were also growing up with different levels of parental engagement, and technology had changed the nature of their social networks and communication.

Meanwhile, media, celebrities and other social factors were combining to create "unrealistic expectations and pressures on young people".

"Compared to previous generations, youth face many more choices at an earlier age, but at the same time may have less clarity as to their path ahead," Gluckman said.

New Zealand's youth suicide mortality rate in 2010 was 15.6 per 100,000 adolescents aged 15-19 – the highest among reported OECD rates.

But National rates should be treated with caution, Gluckman advised. "There were reasons why many countries may under-report," he said.

From July 1, 2014 to June 30, this year, there were 238 suicides among New Zealanders aged 12-24. Rates were significantly higher for Maori youth aged 15-24, and had not lowered. But the Maori youth population was smaller, meaning the total number of Maori youth suicides was low and it was hard to pinpoint a trend.

Suicide prevention was hard, because causes were not understood well enough at the individual level.

"Completed suicide is a rare event, so it is difficult to study in the way we can study influenza or diabetes."

But primary prevention, with the right programmes placed early on in schools was "strongly suggested". But some formal programmes that had been implemented were likely not helping.

"Indeed, some programmes may actually increase the risk of suicidality."

Reducing access to alcohol, further education to enhance the skills of young people growing up in a digital world and whole-school cultural changes in positive messaging and cultivating media literacy, self-control and social skills were among the most effective early prevention methods.

Programmes that focused on young teens and young adults in their adolescence had seen some successes. But some of those programmes were "distressingly ineffective".

But a focus solely on youth mental health, "although important, is not sufficient", Gluckman said.

"Rather, we conclude that the high-priority need is to introduce and reinforce programmes focused on primary prevention starting early in life and developing secondary prevention strategies involving well-trained and engaged mentors, including peer mentors."

Earlier on Wednesday, Health Minister Jonathan Coleman announced the Government would extend funding for the Suicide Mortality Review Committee to continue its work, beyond its trial period.

"Our suicide rate is too high, particularly the rates for youth and specifically Maori and Pacific young people," said Coleman.

"Although wider interventions and support have been made available, there is always more we can do."

The review committee was established under the New Zealand Suicide Prevention Action Plan 2013-16 and operated on a trial basis under the Health Quality & Safety Commission. It will now receive $750,000 annually, reprioritised from Ministry of Health baseline funding.

In line with international trends, there had been a significant increase in demand for mental health and addiction services in recent years.

"To help meet this increase, the Government's funding for mental health and addiction services has lifted by $300 million. In addition to this, Budget 2017 committed an extra $224m, including $124m for new approaches.

"Cabinet is in the process of considering new mental health initiatives, and the details of these are expected to be released in the next few weeks."

By Stacey Kirk

26 July 2017


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