Carolyn Blackburn

Guidelines for identification and treatment of individuals with attention deficit/hyperactivity disorder and associated fetal alcohol spectrum disorders based upon expert consensus

BackgroundThe association of attention deficit/hyperactivity disorder (ADHD) and fetal alcohol spectrum disorders (FASD) results in a complex constellation of symptoms that complicates the successful diagnosis and treatment of the affected individual. Current literature lacks formal guidelines, randomized control trials, and evidence-based treatment plans for individuals with ADHD and associated FASD. Therefore, a meeting of professional experts was organized with the aim of producing a consensus on identification and treatment guidelines that will aid clinicians in caring for this unique patient population.MethodsExperts from multiple disciplines in the fields of ADHD and FASD convened in London, United Kingdom, for a meeting hosted by the United Kingdom ADHD Partnership (UKAP; www.UKADHD.com) in June 2015. The meeting provided the opportunity to address the complexities of ADHD and FASD from different perspectives and included presentations, discussions, and group work. The attendees worked towards producing a consensus for a unified approach to ADHD and associated FASD.ResultsThe authors successfully came to consensus and produced recommended guidelines with specific regards to identification and assessment, interventions and treatments, and multiagency liaisons and care management, highlighting that a lifespan approach to treatment needs to be adopted by all involved. Included in the guidelines are: 1) unique ‘red flags’, which when identified in the ADHD population can lead to an accurate associated FASD diagnosis, 2) a treatment decision tree, and 3) recommendations for multiagency care management.ConclusionsWhile clinically useful guidelines were achieved, more research is still needed to contribute to the knowledge base about the diagnosis, treatment, and management of those with ADHD and associated FASD.

Policy-to-practice context to the delays and difficulties in the acquisition of speech, language and communication in the early years

ABSTRACT The aim was to investigate the policy-to-practice context of delays and difficulties in the acquisition of speech, language and communication (SLC) in children from birth to five in one local authority within the context of Bronfenbrenner’s bio-ecological model. Methods included a survey of early years practitioners (64 responses), interviews with 11 early years practitioners and observations of 9 children in the context of their early years settings. Policy texts revealed a growing consensus on the importance of early learning and development, the centrality of language and early intervention. Practitioner survey and interview findings indicated confident practice in relation to early identification, assessment and support, despite minimal initial professional training in SLC and virtually none for children with English as an additional language. Greater use of specialist assessment tools and alternative communication systems was made in specialist than mainstream settings. Observation showed considerable variation in the organisation of staff, groups, activities and interactional patterns with more targeted, short and intensive adult-led activity in special settings that led to less child-initiated interactions and private ‘self-talk’, characteristic of large-group free play of mainstream settings. Challenges and opportunities of generalist and specialist provision are discussed.

Relationship-based early intervention services for children with complex needs: lessons from New Zealand

Purpose A case study is reported of a relationship-based early intervention (EI) service for children with complex needs in New Zealand. The purpose of this paper is to explore parent and professional views and perceptions about the key characteristics of a relationship-based EI service. Design/methodology/approach This qualitative study involved interviews and observations with 39 participants (10 children, 11 parents and 18 professionals). Findings Parents appreciated the knowledgeable, well-trained professionals who invested time in getting to know (and love) children and families and family practices, worked together in harmony and valued the contribution that parents made to their child’s progress and achievement. Professionals described the key characteristics of the service in terms of the range of therapies offered by the service, the focus on a strengths-based and family-focussed approach, play-based assessments, acceptance and value of family practices (including responsiveness to Maori and bi-culturalism), appropriate and respectful places to meet and greet families and work with children, and recruitment and retention of humble professionals who identified with the ethos of the model. Observable social processes and structures within the delivery of the model include respectful professional interactions and relationships with children and families, integrated professional working, effective and timely communication between professionals and families, pedagogy of listening, waiting and personalisation, engaged families and actively participating children. Originality/value This case study emphasises the significance of professional love and relational pedagogy to EI services and the value of this to improving parent-child relationships and children’s long-term outcomes.

Early Childhood Inclusion in the United Kingdom.

A policy-to-practice paper is presented of early childhood inclusion in England. The article aims to report the benefits of early intervention services and early childhood inclusion for children with special educational needs and disabilities (SEND), document the chronology of policy development, and discuss research evidence about policy-to-practice considerations for early childhood inclusion. Policy development for children with SEND in England has been informed by international human rights and European inclusion agendas and has been significantly revised and reformed recently with a new Children and Families Act (2014), which places families at the center of individual education, health, and care plans for children SEND. The article discusses the practicalities of delivering policy initiatives for children with SEND in a diverse and fragmented early childhood market and suggests possible future directions for policy and practice.

The role of a national fostering helpline in the recruitment and retention of foster carers: implications for policy and fostering practice

There is a shortfall of foster carers currently in England as the number of children in care is rising faster than the number of foster carers. Supporting foster carers in their role of providing safe nurturing environments for children in the looked after system is crucial in ensuring their recruitment and retention. This article reports on an evaluation of a national fostering helpline, Fosterline England, which provides independent, impartial advice to carers on a range of concerns. Findings suggest that the provision of a helpline service can influence foster carers’ motivation to enter or stay in fostering. However, it is only one factor that can make a difference. Improvements to working practices in fostering are needed, including more effective communication with and between professionals.

‘A different kind of normal’: parents’ experiences of early care and education for young children born prematurely

ABSTRACT The number of preterm births is increasing globally and in England, yet professional knowledge about the short- and long-term developmental consequences and the psycho-social effect on parents is limited amongst the early years workforce. Using a social-ecological systems theory approach, this paper reports on a mixed-methods study that aimed to explore parents’ experiences of early care and education for young children born prematurely. Findings suggest that having a baby born prematurely has the potential to have a detrimental effect on parent–child bonding and can lead to post-traumatic stress disorder for parents. Parents identified a need for professional training for early years practitioners and teachers to help them understand the concept of ‘corrected age’ and the extra support that children born prematurely (and their parents) might need in attending parent and toddler groups, early years settings and on transition to school, especially if there are also multiple births.

Young children’s musical activities in the home

ABSTRACT The association between human speech, language and communication (SLC) and participation in music is manifest in music education and psychology literature in a number of ways. Research studies into young children’s SLC are numerous and policy focus on this area of children’s learning and development and their later literacy has been intense. By contrast, there is a gap in research into young children’s musical worlds especially in the home, even though existing research shows the additional benefits of shared music activities over shared reading activities for children’s prosocial skills and music making for parent–child communication. This paper reports on a survey and interviews of parents carried out in England with a focus on the musical activities of children aged birth to five in the home. Contrary to previous studies, findings suggest that children participate in a range of spontaneous shared musical activities in the home daily. The factors that both promote and inhibit musical activities in the home for young children are highlighted. The study also shows that children are participating in a wide range of organised, structured musical activities outside the home. Research is needed to examine the quality of such activities and the appropriateness of formal musical activities for very young children to ensure that formality does not disturb spontaneity in young children’s musical worlds.