Patti Bokony

The Family Map: Structured Family Interview to Identify Risks and Strengths in Head Start Families.

The Family Map is a semistructured interview developed to assess important aspects of the family and home environment associated with well-being in 3- to 5-year old children. The measure is designed so that it can be used during home visits with Head Start families. Accordingly, it was developed in collaboration with Head Start providers and families. The Family Map systematically identifies areas of concern and strength so that providers can design interventions to reduce risk factors (e.g., food insecurity, physical safety issues, family conflict, harsh parenting practices, parental depression) or enhance factors associated with healthy development (e.g., availability of learning materials in the home, good monitoring and supervision, or home safety). The areas assessed by the Family Map are targeted by Head Start performance standards. The Family Map has been successfully implemented in Head Start agencies and is also being adopted in non-Head Start early childcare settings.

Voucher-Based Incentives for Cigarette Smoking Reduction in a Women's Residential Treatment Program

Participants were women (N = 16) living with their children in a residential substance abuse treatment facility. In this within-subjects repeated measures study, a 1-week baseline was followed by a 4-week intervention and a 2-week follow-up (same as the baseline). The intervention consisted of exposure to an educational video and a smoking cessation workbook, brief individual support meetings, and an escalating schedule of voucher-based reinforcement of abstinence. Throughout the study, three daily breath samples (8 a.m., noon, and 4 p.m.) were collected Monday through Friday to determine carbon monoxide (CO) concentration. In addition, urine cotinine (COT) was assessed on Monday mornings to monitor weekend tobacco use. Participants received vouchers of escalating value for CO-negative breath and COT-negative urine samples. Positive samples reset the voucher value. Significantly more negative tests were submitted during the intervention than during baseline and follow-up. The intensive behavioral intervention evaluated in this study produced a substantial reduction in cigarette smoking, and 25% of participants remained abstinent 2 weeks after the intervention was suspended. Nevertheless, the percentage of CO-negative samples submitted during the follow-up returned to baseline levels. While retaining many real-world characteristics, residential treatment facilities provide important opportunities for smoking cessation treatment and research.

Low-Level Depressive Symptoms Reduce Maternal Support for Child Cognitive Development

OBJECTIVE The objective of this study was to examine the relationship between low-level depressive symptoms in mothers and their support for child cognitive development. METHODS Participants included 913 low-income mothers of preschool-age children who were screened for maternal depression and interviewed about support for learning in the childs home environment. RESULTS Of the 770 mothers in the analysis, 21.5% reported low-level depressive symptoms (below the cutoff on the screening tool indicating clinically elevated symptoms). Logistic regression analyses revealed that children of mothers with low-level depressive symptoms were significantly less likely to experience six of seven types of support for learning compared with children of mothers with no depressive symptoms. CONCLUSIONS Results suggest that children whose mothers experience even low-level depressive symptoms are less likely to receive important supports for cognitive development and school readiness, pointing to the need for screening and interventions to address maternal depression at all levels of severity.

Combat-related Parental Deployment: Identifying the Impact on Families with Preschool-age Children

This manuscript describes a qualitative study using focus group methods to gain insight into how combat-related parental deployments affect preschool-age children. Using the Resiliency Model of Role Performance for Service Members, Veterans, and their Families, the authors found that decreases in social connection and individual assets impacted the role performance of all family members. As parental role performance deteriorated, similarly did their childrens behaviors and emotions. Results indicate the need for improved military and community support, especially during deployment; counseling and increased communication within the military, public schools, and family systems; and decreased stigma in help seeking for service personnel and veterans.

Counselors Called for Service: Impact of Parental Deployment on Preschool Children:

Children and families often experience stress from the physical or emotional absence of a parent due to deployment. The health of the family system plays a vital role in the successful transition through deployment and redeployment phases. Even very young children show signs of behavioral problems, sleep disturbances, depressive symptoms, and anxiety from parental deployment. This article reviews the literature concerning the impact of parental deployment on preschool aged children and current interventions and discusses implications for counselors assisting military families.

Protecting Young Children: Identifying Family Substance Use and Risks in the Home.

This study examines the usefulness of a screening process implemented in the context of a Head Start home visit and compares families who screened positive for substance abuse with those who did not on an array of child and family indicators important for healthy child development. The sample included 1,105 low-income families with preschool-age children enrolled in Head Start programs. Families were interviewed using the Family Map, an interview tool used to screen on a wide range of areas important for healthy child development. Children identified as having a positive screen for family problems with alcohol and other drugs (9.1%) were more likely to be at risk on 10 of 11 additional areas assessed.

Building a residential treatment program for dually diagnosed women with their children

SummaryThe epidemic of drug and alcohol abuse in our nation impacts millions of women, mothers, and children. Addicted mothers with complex problems and numerous co-morbidities present unique treatment challenges. This intergenerational cycle of abuse and addiction is difficult to stop. Arkansas CARES (Center for Addictions Research Education and Services, referred to in this article as CARES) initially was created to treat addicted pregnant and postpartum women and their infants. CARES evolved into a residential treatment program for dually diagnosed mothers with their children. This paper is a synopsis of a presentation delivered at the North American Society for Psychosocial Obstetrics and Gynecology. It shares a glimpse inside the treatment program and lessons learned along the way in an effort to assist others who are interested in building treatment programs for addicted women with their children.

A Little Bit of the Blues: Low-Level Symptoms of Maternal Depression and Classroom Behavior Problems in Preschool Children

Research Findings: The purpose of this study was to examine the relationship between low-level depressive symptoms in mothers and teacher-reported child behavioral outcomes. Participants included 442 low-income mothers of preschool-age children who were screened for maternal depression by their childs preschool teacher. Teacher reports of child behavior problems were collected on a random sample of the children (n = 264). Of mothers screened for depression, 16.7% reported low-level depressive symptoms (below the cutoff on the screener indicating clinically elevated symptoms). Analyses revealed that children of mothers with low-level depressive symptoms had significantly greater problems with externalizing behavior compared to children of mothers with no depressive symptoms. Practice or Policy: Results suggest that children whose mothers experience even low-level depressive symptoms are at risk for problems with behavior, pointing to the need for screening and interventions to address maternal depression at all levels of severity. Early childhood education providers are in an excellent position to support families impacted by symptoms of maternal depression through screening and education, supportive daily interactions, and referrals for services if needed. Teachers can also provide direct support for high-risk childrens social and emotional skill development through the provision of sensitive, nurturing care.

Maternal Low- and High-Depressive Symptoms and Safety Concerns for Low-Income Preschool Children

Objectives. Our objective was to examine the relationship between low- and high-level depressive symptoms in mothers’ and children’s risks in the areas of home and car safety, monitoring, and exposure to violence. Methods. Participants included 978 mothers of preschool-age children who were interviewed about their home environment and screened for maternal depression. Results. Whereas only 5.7% scored at high depressive levels on the screen, another 21.3% scored at low depressive levels. Logistic regression analyses controlling for demographics revealed that children were significantly more likely to experience home safety risks in 6 of 7 areas when mothers reported either low or high levels of depressive symptoms. Conclusions. Results suggest that children whose mothers experience even low-level depressive symptoms are at increased risk for safety problems in the home environment, pointing to the need for screening and interventions to reduce the risk of injury.

Psychological Traumas of War: Training School Counselors as Home‐Front Responders

PURPOSE With nearly 3 million U.S. troops having deployed for Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND) since the conflicts began, an estimated 2 million children have been separated from a parent. This manuscript describes a collaborative project between a states Veterans Healthcare System, a branch of the American Counseling Association, and a medical university on the OEF/OIF/OND deployment experience. METHODS The project sought to educate school counselors about experiences of OEF/OIF/OND families and learn from their observations as home-front responders in public schools during a 2-day summer workshop. This manuscript describes the framework of the workshop, pre/post evaluation results, and implications for counselors, educators, and supervisors. FINDINGS School counselors identified childcare and parenting, emotions and behaviors, finances, and barriers to counseling services as challenges for military children and families. Following the workshop, school counselors reported a greater knowledge concerning understanding aspects of outreach for schools and communities in working with veterans and their families. They also reported a better understanding of the impact of war on military families and knowledge of local and state resources for this population. Specifically, attendees felt they could better identify issues and needs of OEF/OIF/OND families with young children, recommend parenting skills to assist these families, and recognize their psychiatric or medical issues. CONCLUSION In addressing the mental health disparities of military children experiencing combat-related parental separation, it is important to identify protective environments that could provide prevention interventions for this population. Collaboration between the Department of Defense, Department of Veterans Affairs (VA), and Department of Education could help support military families and a society facing continued conflicts abroad.