Pirjo Pölkki

Children's Participation in Child-protection Processes as Experienced by Foster Children and Social Workers

Children in foster care often have no means of influencing matters that concern them, and can easily become outsiders in their own lives. The United Nations Convention on the Rights of the Child enshrines the rights of capable children to express their views freely in matters affecting them and to be heard in any judicial or administrative proceedings concerning them. The aim of this study is to analyse foster childrens participation in child welfare processes in different time periods and contexts from the perspective of children and social workers. The data comprise semi-structured interviews of eight children and young people aged seven to 17 in family foster care, as well as interviews of four child welfare social workers. Ethical questions were taken carefully into account. The results suggest that participation in matters concerning them is very significant to children, although they do not always want be active participants (e.g. in meetings). The children hoped that social workers would take a genuine interest in them, listen to them and take their opinions and wishes into consideration. Children sought true and essential information about the reasons for placements and the plans for their future. They felt they were better heard and more able to influence their own affairs after being placed in a foster home than during earlier phases of services. The study identifies many obstacles in childrens participation at different systemic levels. Childrens loyalty to their parents may prevent them from expressing their opinions. According to social workers, the most serious obstacles in participatory work with children are related to a lack of human and time resources. Social workers need time, work practices, skills and practical wisdom through which childrens personal experiences, opinions and wishes can be better heard. They also seek support in handling the emotional aspects of child-protection work and suggest some other measures to develop their work.

Maternal and paternal sleep during pregnancy in the Child-sleep birth cohort

STUDY OBJECTIVES Maternal and paternal sleep insufficiency during pregnancy appears to be a risk factor for health and wellbeing in young families. Here, we evaluated the prevalence of sleep insufficiency and symptoms of insomnia during pregnancy (at 32nd pregnancy week) and their relationship to depression, anxiety and environmental stress. METHODS The study is based on a population based sample from Finland consisting of 1667 mothers and 1498 fathers from the Child-sleep birth cohort. We evaluated both the core symptoms of insomnia (sleep onset problems, nocturnal awakenings, too-early awakenings, and poor sleep quality) and the presence of insufficient sleep. Insufficient sleep was defined as a two-hour difference between self-assessed sleep need and reported sleep duration, or sleep duration shorter than six hours per night. RESULTS We found that symptoms of insomnia were more prevalent among women than among men (9.8% vs. 6.2%), whereas sleep debt was less prevalent among women than among men (4.5% vs. 9.6%). Overall, 11.8% of the women and 14.9% of the men reported either significant insomnia or short sleep. Symptoms of insomnia were related to symptoms of depression both among women and men (AOR 3.8, 95% CI 2.6-5.6 vs. AOR 1.9, 95% CI 1.1-3.2), while short sleep was related to depression among women (AOR 3.3, 95% CI 1.8-5.8), and to low education, poor health and a larger number of children among men. CONCLUSIONS The study showed that insomnia and sleep insufficiency are prevalent among women and men during pregnancy. The findings underline the impact of insomnia to both maternal and paternal health during pregnancy as well as to the implementation of effective interventions to prevent negative consequences of sleep disturbances.

Variants in calcium voltage-gated channel subunit Alpha1 C-gene (CACNA1C) are associated with sleep latency in infants

Genetic variants in CACNA1C (calcium voltage-gated channel subunit alpha1 C) are associated with bipolar disorder and schizophrenia where sleep disturbances are common. In an experimental model, Cacna1c has been found to modulate the electrophysiological architecture of sleep. There are strong genetic influences for consolidation of sleep in infancy, but only a few studies have thus far researched the genetic factors underlying the process. We hypothesized that genetic variants in CACNA1C affect the regulation of sleep in early development. Seven variants that were earlier associated (genome-wide significantly) with psychiatric disorders at CACNA1C were selected for analyses. The study sample consists of 1086 infants (520 girls and 566 boys) from the Finnish CHILD-SLEEP birth cohort (genotyped by Illumina Infinium PsychArray BeadChip). Sleep length, latency, and nightly awakenings were reported by the parents of the infants with a home-delivered questionnaire at 8 months of age. The genetic influence of CACNA1C variants on sleep in infants was examined by using PLINK software. Three of the examined CACNA1C variants, rs4765913, rs4765914, and rs2239063, were associated with sleep latency (permuted P<0.05). There was no significant association between studied variants and night awakenings or sleep duration. CACNA1C variants for psychiatric disorders were found to be associated with long sleep latency among 8-month-old infants. It remains to be clarified whether the findings refer to defective regulation of sleep, or to distractibility of sleep under external influences.

The significance of supportive and undermining elements in the maternal representations of an unborn baby

Abstract Objective: The maternal representations of an unborn baby begin to develop during pregnancy. However, the factors that moderate them are not well identified. The objective of this study was to jointly explore supportive and undermining factors in the maternal representations of an unborn baby and motherhood. Methods: Cross-sectional data comprising 1646 women studied during the third trimester of pregnancy. Maternal expectations were measured using a 12-item self-report questionnaire, Mother’s Representations about an Unborn Baby. Depression, anxiety, family atmosphere and adult attachment were measured using standardised questionnaires. Statistical analysis is based on multivariate linear regression analysis. Results: The most powerful predictors of a mother’s prenatal expectations were the mother’s educational status, age, closeness in adult relationships, higher levels of depressive symptoms and family atmosphere. In accordance with our hypothesis, depression was related to the mother’s more negative expectations on their relationship with the unborn baby and on regularity in the baby’s sleeping and eating patterns. A positive family atmosphere and the mother’s ability for closeness and dependence (i.e. confidence) in adult relationships were related to more positive expectations of the mother–unborn baby relationship. On the other hand, stress, anxiety and adverse life events were not related to the mother’s expectations of her unborn baby. Conclusions: The results may be helpful in identifying families who need early professional support and call for studies where the prenatal phase is explored as a proactive phase for the development of the child–parent relationship.

Critical factors of intensive family work connected with positive outcomes for child welfare clients

Mechanisms producing positive change in troubled families were analysed. The study aimed to answer the questions: What kind of case and client outcomes does intensive family work (IFW) produce for child welfare clients? From the perspective of family workers, what kind of critical factors for positive child, parent and family outcomes can be identified? The study used child welfare case files of 35 families with 93 children from one social office and interviews with 20 family workers and IFW managers in 5 municipalities in Finland. The shades of worries scale was used in evaluating the change in each familys situation. The case outcome measures for children included changes in the childs status in open care, short-term placement or foster care. During IFW, positive changes took place in 23 families out of 35 (66%). Twenty-seven children from 16 families did not continue as child welfare clients. Eleven children were placed into foster care during IFW and two years after it. The critical processes for outcomes included time, trust building and engagement, practical help, facilitating communication and guaranteeing the best interest of the child. IFW was considered effective for positive outcomes for the majority of families with complex needs.

The effects of maternal risk factors during pregnancy on the onset of sleep difficulties in infants at 3 months old

Sleep problems in young children are among the most common concerns reported to paediatricians. Sleep is thought to have important regulatory functions, and sleep difficulties in early childhood are linked to several psychosocial and physiological problems. Moreover, several prenatal factors have been found to influence infants’ sleep. Among them, most of the studies have been focused on maternal prenatal depression and/or anxiety as potential risk factors for sleep problems in childhood, whereas other relevant psychological factors during pregnancy have not received as much attention. Therefore, we aimed to examine the effect of several psychiatric maternal risk factors during pregnancy (i.e. symptoms of anxiety, depression, insomnia, alcohol use, seasonality, attention deficit and hyperactivity disorder and/or stressful life events) on the onset of some sleep problems related to sleep quality and sleep practices in 3‐month‐old infants. We examined 1,221 cases from a population‐based birth cohort, with subjective measures during pregnancy in mothers, and at 3 months after birth in the infants. The findings showed that all the maternal risk factors during pregnancy, except for symptoms of alcoholism and sleepiness, were related to sleep difficulties in infants. Interestingly, attention deficit and hyperactivity disorder symptomatology in mothers during pregnancy was the only variable that predicted more than two sleeping difficulties (i.e. long sleep‐onset latency, co‐sleeping with parents and irregular sleeping routines) at 3 months old. Our results highlight the relevance of maternal risk factors during pregnancy, and not only prenatal depression and/or anxiety, as variables to be considered when examining sleep difficulties in infants.