Stephen Edward McMillin

Accuracy of Knowledge of Child Development in Mothers of Children Receiving Early Intervention Services

Parents’ involvement in early intervention (EI) services fosters positive developmental trajectories in young children. Although EI research on parenting skills has been abundant, fewer data are available on parents’ knowledge of normative child development. Sixty-seven mothers of children participating in a Midwestern city’s EI program completed the Knowledge of Infant Development Inventory. Compared with mothers in normative referent samples, mothers of children enrolled in EI reported significantly less knowledge of normative child development and were significantly more likely to underestimate the timing of normative developmental milestones. The race/ethnicity of mothers of children in EI was significantly related to their milestone accuracy scores even after the mothers’ education level was controlled. Implications of the findings are discussed within the context of providing EI services that are family centered.

Reducing Barriers to Care in the Office-Based Health Care Setting for Children With Autism

The purpose of this survey-design research study was to evaluate the usefulness of a researcher-developed tool designed to improve office-based health care services and to assess the barriers and resources affecting office-based health care services for children with autism spectrum disorder. Fifty-four health care providers (HCPs) and 59 parents participated in the study. HCPs reported child behaviors, communication, and fears as barriers to providing care, whereas parents reported child behavior, sensory issues, and feelings of a disconnect with the HCP as barriers. HCPs identified the parent as a key resource. Parent-identified resources included provider adaptations to the patient, including slowing down the delivery of care and environmental adaptations to the office. In addition, both HCPs and parents indicated that the researcher-developed tool would be useful in reducing barriers during the HCE. Reducing barriers and improving health care interactions during delivery of care for children with autism spectrum disorder has the potential to improve health outcomes.

Rapid-Response Parenting Intervention in Diagnostic Centers as a Patient-Centered Innovation for Autism Spectrum Disorders

Parents of children newly diagnosed with autism spectrum disorders are a high-need population for whom skills-based parenting interventions likely help. Diagnostic centers are compelling locations to deliver parenting interventions because families are served in an accessible location and at a time they receive overwhelming treatment recommendations. Additionally, behavioral interventions in these settings may be especially effective in helping parents feel an early sense of mastery of disruptive child behaviors and enable families grappling with this diagnosis to be proactive and build resilience. Providing parenting interventions in diagnostic centers is a promising service delivery innovation and deserves expanded piloting and testing.

Brief, Rapid Response, Parenting Interventions Within Primary Care Settings.

Opportunities created by the Patient Protection and Affordable Care Act along with the increased prevalence of pediatric behavioral and mental health concerns provide new challenges for pediatric health care providers. To address these matters, providers need to change the manner by which they provide health care to families. A novel approach is providing brief, rapid response, evidence-based parenting interventions within the pediatric primary care setting. Family-focused parenting programs support the American Academy of Pediatrics recommendations of improving mental health via supports in pediatric primary care to maximize the social and psychological well-being of families. A considerable body of research indicates that parenting interventions reduce the severity and frequency of disruptive behavior disorders in children and provide support to parent by bolstering parental resilience and improving overall family functioning. Providing these services within the pediatric primary care setting addresses the need for fully integrated health services that are family-centered and easily accessible.

The Role of Maternal Knowledge of Child Development in Predicting Risk for Child Maltreatment

Child maltreatment is a serious pediatric concern that results in immediate physical and emotional injuries and also creates increased risk for other adverse outcomes across the life course, such as substance abuse, risky sexual behavior, obesity, mental illness, and criminal behavior. Child maltreatment is difficult to quantify as many cases are not reported, but nationally representative data suggest that at some point during childhood, 25.6% of children have experienced some degree of maltreatment. Pediatricians are mandated reporters of child abuse and neglect and will likely encounter patients at risk for maltreatment in their practice. Incomplete and often poor parental knowledge of child development is linked to unrealistic expectations of young children, leading to maltreatment. Increasingly child protection systems recognize parental knowledge of child development as a key protective factor against maltreatment. Parents with enough child development knowledge to understand the needs and limitations of their developing children are better prepared to provide a safe home environment. Poor parental knowledge of child development is especially problematic in specific subgroups. The overall risk of child maltreatment increases 3 to 4 times for children with developmental disabilities and is related to both child and parent factors. As a result, medically and/or developmentally complex children are at even greater risk of child maltreatment. Because 70% of reported child abuse deaths occur prior to age 3, understanding parents’ knowledge and perspective about the child development of very young children is important to prevent maltreatment early. This study seeks to contribute to the ability of pediatricians to offer anticipatory guidance to parents about developing appropriate expectations for and anticipating the needs of very young, developmentally disabled children. Methods

Knowledge of Child Development as a Predictor of Mother-Child Play Interactions

Promoting optimal parent-child interactions is a core skill for pediatricians who work with young children and their families. Beneficial parent-child interactions such as in parent-child play foster positive developmental trajectories. It has been well documented that play is critical for promoting a child’s social, emotional, physical, and cognitive growth, and pediatricians commonly have opportunities to observe parent-child play because play is often used as a way of calming children’s anxieties when visiting pediatric settings. Data suggest that knowledge of normative child development may inform the way in which mothers interact with their children. Mothers who receive education about child development in pediatric practice offices and become more knowledgeable about normative child development are more likely to report positive interactions with their children. Mothers who are knowledgeable about child development and confident in their parenting skills have higher-quality interactions with their children. Although the pediatric literature is full of recommendations for specific play activities based on the child’s stage of normative development and the need for parents to provide ample opportunities for child-led play, less information is available to guide parents of children with developmental delays and disabilities on how to promote child-led play. To date, no studies are available that investigate how different types of developmental knowledge may be associated with mother-child play interactions among children with developmental delays/ disabilities. The purpose of the current study was to begin to fill this gap and examine whether mothers with more knowledge of normative child developmental milestones are more likely to report engaging in child-led play than mothers with less knowledge of developmental milestones. Because knowledge is a multidimensional construct and learning is a dynamic process, increased understanding about how different types of developmental knowledge may be associated with child-led play can help pediatricians provide targeted, developmental anticipatory guidance.

Healthy Families and Gay Rights: A Multiple Streams Analysis of Civil Union Legislation in Illinois

Using Kingdons (1995) multiple streams framework, this article analyzes the processes of problem definition, policy proposal, and political decision-making in the passage of civil union legislation in Illinois in 2009–2011. Prominent problem definitions emphasized family vulnerability in the health care system, eclipsing the concerns of religious organizations that the existence of civil unions violated their religious liberty. Political factors which permitted both civil unions and same-sex adoption protection included disorganized and detached opponents; a state attorney general who served as a policy entrepreneur for family rights; and postelection, strategic bipartisan negotiation which opened a narrow window for policy change. Implications for family policy issues are discussed.

More Than Place-Based: Viewing Geography on a Continuum and the Implications for Social Work Practice

Communities play an important role within the field of social work as the context within which specific social work activities occur. To date, much of the social work literature divides communities into the mutually exclusive, dichotomous categories of geographic and functional communities. The authors propose a new method for defining community that views geography on a continuum and suggests that membership within a community is moderated by place. The concept of place-moderated communities is applied to specific examples, and the application to social work practice is discussed within the context of community membership, community engagement, community rights, and community development efforts.

Organizational Policy Advocacy for a Quality Improvement Innovation in a Maternal and Child Health Network: Lessons Learned in Early Implementation

ABSTRACT This article analyzes and reports lessons learned in early implementation of a large quality improvement innovation for a maternal and child health network working in a large Midwestern metropolitan area. It uses a case study method to focus on how internal advocacy and policy practice helped network partners accept and adapt to the initial rollout of a mandated quality improvement system that required careful data tracking for a universal screening and referral process for perinatal mood and anxiety disorders. Three key findings emerged. Network participants endorsed new outreach to the executives of network partners to confirm their support of and compliance with the new quality improvement system. Participants also strategized ways to maintain program autonomy and disperse concerns about heavy-handed implementation of the quality improvement program. Finally, they identified ways to adapt the quality improvement program in response to concerns raised.

A conceptual model for the pathways of effect for intermediary organizations: A case study from maternal and child health

•Evaluating intermediary organizations is challenging because their work has many distinct foci.•Process and impact evaluations may not capture the unique contributions of IOs.•We offer a conceptual model to guide such evaluation work that acknowledges these complexities.