E. Brugman

Infant crying and abuse

Child abuse and neglect are important causes of child morbidity and death. We assessed potentially detrimental parental actions induced by infant crying in 3259 infants aged 1-6 months, in the Netherlands. In infants aged 6 months, 5.6% (95% CI 4.2-7.0) of parents reported having smothered, slapped, or shaken their baby at least once because of its crying. The risks of detrimental actions were highest for parents from non-industrialised countries, those with either no job or a job with short working hours, and those who judged their infants crying to be excessive. Clinicians should be aware of the risks of abuse in children known to cry a lot and should target interventions at parents to help them cope with this crying.

Family factors and life events as risk factors for behavioural and emotional problems in children

Abstract. The aim of this study was to identify groups of children at increased risk of behavioural or emotional problems on the basis of socio-demographic characteristics, family characteristics, and recent life events with a focus on unemployment and divorce or separation. We obtained data on the Child Behavior Checklist (CBCL) from a community-based national sample of 4480 parents of school-aged children and interviewed them about their demographic and family characteristics and about the childs recent life events. Results showed that family characteristics and recent life events were more strongly associated with childrens risks of behavioural and emotional problems as measured by the CBCL than other demographic characteristics. Risks were somewhat higher for children who had experienced parental unemployment and divorce or separation recently, as compared to those who had experienced these events in the more distant past. We conclude that children with recent experience of parental unemployment or parental divorce or separation are at a relatively high risk of behavioural and emotional problems as reported by parents. Although relatively high, the risks that were found do not justify restriction of screening for behavioural and emotional problems to these children.

Psychosocial problems among immigrant and non-immigrant children - Ethnicity plays a role in their occurrence and identification

BackgroundThis study aims to examine a) the prevalence of psychosocial problems and b) the association between parent-reported problems and the identification by doctors and nurses (child health professionals, CHP) working in preventive child health care, among immigrant and non-immigrant children.MethodsCHPs examined 4,098 children aged 5 through 15 years (response: 90.1%) and interviewed parents and children during their routine health assessments in 19 Child Healthcare Services across the Netherlands, serving nearly all school-aged children routinely. The Child Behavior Checklist (CBCL) was completed by the parents. We compared five ethnic groups: indigenous Dutch, economic immigrants, immigrants from (former) Dutch colonies, from other non-industrialised, and from other industrialised countries.ResultsThe prevalence of parent-reported problems on the CBCL is higher among children from former Dutch colonies and economic immigrant children than among indigenous children, especially regarding internalising problems (odds ratios (OR); 95% confidence interval: 1.84; 1.03 to 3.29, and 2.52; 1.46 to 4.34). CHPs identified more problems among economic immigrant children (OR: 1.62; 1.01 to 2.60). Regarding associations, rates of CHP-identified problems were higher among indigenous children with clinical compared with normal CBCL Total Problems scores (OR: 6.90; 5.27 to 9.03), but not among economic immigrant children (OR: 0.73; 0.16 to 3.21).ConclusionsPsychosocial problems occur more frequently among some immigrant groups. CHP identification of psychosocial problems is poorly associated with parent report regarding economic immigrant children. This needs to be improved in order to provide better care.

Area deprivation and child psychosocial problems: A national cross-sectional study among school-aged children

We examined the association of area deprivation with the occurrence of psychosocial problems among children aged 4–16 in a representative national sample of children based on standardised measures of parent-reported problems and diagnoses made by doctors and nurses working in child healthcare (child health professionals, CHPs). The study comprised 4480 children aged 4–16 years, eligible for a routine health assessment (response: 90.1 %), in 19 Child Healthcare Services across the Netherlands that routinely provided preventive child healthcare to nearly all school-aged children. Parents completed the Child Behaviour Checklist (CBCL). CHPs examined the child and interviewed parents and child during their routine health assessments. Main outcome measures concerned psychosocial problems as reported by parents (i. e. a clinical score on the CBCL) and as identified by CHPs. Prevalence rates of psychosocial problems were 8.6% for parent-reported problems and 10.1 % for CHP-identified problems. They were much higher in the most deprived third of the areas. Odds ratios (95 % confidence intervals) compared with the least deprived third were 1.93 (1.41–2.64) regarding parent-reported problems and 1.76 (1.30–2.38) regarding CHP-identified problems. Regarding parent reports, associations were slightly stronger for behavioural problems than for emotional problems. Less than a quarter of the area differences could be explained by individual and family characteristics. Child psychosocial problems occur more frequently in deprived areas. Both preventive and curative health services should be better equipped for this concentration of child and adolescent morbidity in deprived areas.

Infantile colic: maternal smoking as potential risk factor

The association of maternal smoking and type of feeding with colic was assessed in 3345 children aged 1–6 months (96% response). The prevalence of colic was twofold higher among infants of smoking mothers, but less among breastfed infants. Maternal smoking as a potential risk factor for infantile crying needs further study.

Continuous admission to primary school and mental health problems

BackgroundYounger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year.MethodsWe assessed mental health problems based on parent-reports (using the Child Behavior Checklist, CBCL) and on professional assessments, among two Dutch national samples of in total 12,221 children aged 5–15 years (response rate: 86.9%).ResultsAt ages 5–6, we found a higher occurrence of mental health problems in relatively young children, both for mean CBCL scores (p = 0.017) and for problems assessed by child health professionals (p < 0.0001). At ages 7–15, differences by relative age did not reach statistical significance.ConclusionContinuous admission to primary school does not prevent mental health problems among young children, but may do so at older ages. Its potential for the prevention of mental problems deserves further study.