Opportunity gaps in out-of-school learning: How structural and process features of programs relate to race and socioeconomic status

Abstract

Out-of-school learning programs can be a context for positive development and learning for children and youth. However, research points to potential racial and socioeconomic disparities, or opportunity gaps, in this context. In this study, we use survey and video data from 106 staff across 30 out-of-school programs to examine how three features, staff, activities, and adult–child interactions, differ based on the racial and socioeconomic makeup of programs. We find that staff at programs serving children from low-income families on average have less experience and education. Also, programs serving children from African American and low-income families tend to offer more academic-focused activities. Finally, we found no differences in adult–child interaction quality across programs in the sample. Our findings suggest that a racial and socioeconomic opportunity gap may exist in the out-of-school context. This has implications for educational equity and the positive development of children that participate in this context.     

Early detection of visual defects in infancy

To determine the part played by screening in detecting visual defects questionnaires were sent to 240 families with blind or partially sighted children identified from the Family Fund''s database. Questions were asked on social and family background, the visual disorder and its severity, any other disability, and how and when the disabilities were discovered and subsequently managed. Data from 189 families were analysed, constituting all those with children with major visual defects from the 219 families who replied. The visual defect was first discovered in 111 children by parents, friends, and neighbours, and in 36 by a doctor at the neonatal examination. In only three children who did not have a family history of visual impairment was the defect discovered during a formal screening examination at a child health clinic. Dissatisfaction about medical services was expressed by about a third of the parents, particularly a lack of provision of information and consideration of their worries and a failure to refer the child promptly to educational and treatment services.Visual defects in children under 5 are generally detected by family and friends, not by screening, but detection by the medical profession could be improved by increased awareness and observation and quick referral.     

Drivers of human development: How relationships and context shape learning and development1

ABSTRACT

This article synthesizes knowledge on the role of relationships and key macroand micro-contexts - poverty, racism, families, communities, schools, and peers - in supporting and/or undermining the healthy development of children and youth, using a relational developmental systems framework. Relationships with parents, siblings, peers, caregivers, and teachers are explored in the context of early care and childhood settings, schools, classrooms, and school-based interventions. Additional contextual factors include; chronic stress, institutionalized racism, stereotype threat, and racial identity. A companion article focuses on how the human brain develops, and the major constructs that define human development, the constructive nature of development, and the opportunities for resilience. Human development occurs through reciprocal coactions between the individual and their contexts and culture, with relationships as the key drivers. Relationships and contexts, along with how children appraise and interpret them, can be risks and assets for healthy learning and development, and their influence can be seen across generations and can produce intra- as well as intergenerational assets and risks. This knowledge about the individual’s responsiveness to context and experience has both positive and negative implications across early childhood, adolescence and into adulthood. Sensitive periods for brain growth and development are considered within the contextual factors that influence development including; parental responsiveness and attunement, intentional skill development, mindfulness, reciprocal interactions, adversity, trauma, and enriching opportunities. The accumulated knowledge on human development and the power of context and culture can inform child-serving systems that support positive adaptations, resilience, learning, health, and well-being.     

Carrier testing of children for two X-linked diseases: a retrospective evaluation of experience and satisfaction of subjects and their mothers

Carrier testing of children for inherited disease that will not affect the health of the children themselves but of their future children is generally regarded as problematic. In this retrospective study, we determined how young women had experienced genetic carrier testing when they were children. The families of 66 young females who had been tested for carriership during childhood between 1984 and 1988, were approached. Of them, 23 young females in families affected by Duchenne muscular dystrophy, and 23 young females in families affected by hemophilia A, and their mothers, participated in our study. We used a questionnaire including multiple-choice and open-ended questions. We recorded general attitudes to testing, satisfaction with testing, degree of trust in test results, making decisions regarding testing, privacy, and opinions about age at testing. Thirty-five out of 46 of the young women tested (76%) were satisfied with carrier testing in childhood. However, the young women in whom the test results had been uncertain were statistically more often unsatisfied with the testing than those who had been found or not found to be carriers (p = 0.002). In each group, the opinions of mothers were parallel to those of their daughters. Seventy-eight percent of daughters regarded carrier testing as a family matter in which parents can make a decision. About half of those tested recalled that they had been allowed to participate in decision-making in a satisfying way. Thirty-nine out of 46 (85%) of the young women tested, and 33/46 (72%) of the mothers, suggested that carrier testing should be performed in childhood or during teenage years.     

The balancing of virtues—Muslim perspectives on palliative and end of life care: Empirical research analysing the perspectives of service users and providers

In this paper, I will share findings from a qualitative study that offers a thematic analysis of 76 interviews with Muslim patients and families as well as doctors, nurses, allied health professionals, chaplains and community faith leaders across the United Kingdom. The data show that for many Muslims, Islam—its texts and lived practice—is of central importance when they are deliberating about death and dying . Central to these deliberations are virtues rooted within Islamic theology and ethics, the traditions of adab (virtue) and aqhlaq (proper conduct). Themes analysed include theological and moral understandings around the virtues of hope and acceptance. The study provides an analysis of these themes in relation to the experiences of Muslim patients and families arriving at meaning making around death and dying and how this interfaces with their interaction with biomedicine and healthcare. The study shows that the juxtaposition of different values and moral frameworks require careful negotiation when Muslim patients and families encounter the healthcare system. The study also describes how healthcare professionals and staff of other faiths and no faith encounter Muslim beliefs and practices, and the challenges they face in interpreting virtues and values rooted in faith, especially when these are perceived to be mutually opposed or inconsistent.     

Unhealthy Aid: Food Security Programming and Disaster Responses to Cyclone Pam in Vanuatu

ABSTRACT

In this paper, I examine the disconnect between government and NGO responses to Cyclone Pam, and previous healthy food initiatives in Port Vila, Vanuatu. Decades of nutrition education programs across Vanuatu have urged families to limit their consumption of tinned meat and imported food in favour of locally grown fruits and vegetables. These dietary guidelines call on families to watch their food consumption in order to raise healthy children and avoid serious non-communicable diseases such as hypertension and diabetes. In spite of these guidelines, the food aid offered after Cyclone Pam, on which many ni-Vanuatu depended, consisted primarily of imported white rice, tinned meat, and instant noodles – foods previously labelled unhealthy in nutrition education campaigns. Humanitarian agencies often envision disaster relief as a short-term intervention. However, the cyclone exacerbated inequality across Port Vila, magnifying socioeconomic disparities and associated food insecurity that existed before the cyclone, forcing many families to rely reluctantly on unhealthy food aid. Drawing on research conducted over several fieldwork trips from 2010 to 2016, I discuss food security and nutrition programs in Vanuatu and how ni-Vanuatu families interpreted disaster relief efforts in the context of existing nutrition programming. I argue that disaster preparedness has not accounted for the values promoted in nutrition education programs, the health needs of the community, or food preferences. I conclude with a call for the creation of culturally appropriate responses to natural disaster relief efforts so as to promote sustainable food security measures.     

Child–Companion Animal Attachment Bonds in Single and Two-Parent Families

ABSTRACT

This study addressed the issue of whether children who potentially have reduced access to parental resources have a stronger attachment bond with a dog, compared with children who have greater access. The study compared children in single-parent families with those in two-parent families on level of attachment to their family dog. Parents judged children's level of attachment to dogs by completing the Companion Animal Bonding Scale. The children's ages ranged between three and twelve years. Overall, children in single-parent families did show significantly higher levels of attachment to dogs than children in two-parent families. A comparison of attachment to dogs across family type showed that children in the early childhood stage in single-parent families had significantly higher levels of bonding with dogs than children in the early childhood stage in two-parent families. For the middle childhood stage there was no significant difference between family type and attachment to dogs. Comparisons within family type showed mixed results, and there were no significant gender differences in attachment levels across family type. Findings are discussed in light of attachment theory, family systems theory and implications for child development.     

Mental health problems of homeless children and families: longitudinal study

Objective: To establish the mental health needs of homeless children and families before and after rehousing. Design: Cross sectional, longitudinal study. Setting: City of Birmingham. Subjects: 58 rehoused families with 103 children aged 2-16 years and 21 comparison families of low socioeconomic status in stable housing, with 54 children. Main outcome measures: Children’s mental health problems and level of communication; mothers’ mental health problems and social support one year after rehousing. Results: Mental health problems remained significantly higher in rehoused mothers and their children than in the comparison group (mothers 26% v 5%, P=0.04; children 39% v 11%, P=0.0003). Homeless mothers continued to have significantly less social support at follow up. Mothers with a history of abuse and poor social integration were more likely to have children with persistent mental health problems. Conclusions: Homeless families have a high level of complex needs that cannot be met by conventional health services and arrangements. Local strategies for rapid rehousing into permanent accommodation, effective social support and health care for parents and children, and protection from violence and intimidation should be developed and implemented.

Key messages

• Homeless children and their mothers have a high level of mental health problems
• Homeless families experience many risk factors, such as domestic violence, abuse, and family and social disruption
• In two fifths of children and a quarter of mothers, mental health problems persisted after rehousing
• In contrast with a comparison group of families of low socioeconomic status, a substantial proportion of homeless families remained residentially and socially unstable

     

Bilingualism,Language Disorders and Intercultural Families in Contemporary Italy

This study aims to show how language disorders in children affect language transmission and the mixedness experience in intercultural families. To this end, it adopts a qualitative method of study based on the administration of ad hoc interviews to intercultural couples who consulted our Child Neuropsychiatry Service because of language disorders in their children. One of the main consequences, when the child of an intercultural couple presents a language disorder and a diagnostic process has to be initiated, may be interruption of the transmission of the second language, especially if it is the mother’s language. The decision to do this, which may be taken on the advice of teachers and health professionals, but also because the parents themselves often attribute their child’s language disorder to his bilingual condition, affects not only the relationship between the mother and her child, but also processes in the construction of parenthood and in the structuring of the child’s personality and the plurality of his affiliations. A clear understanding of how the dialectic between the categories of “alien” and “familiar” is managed in these contemporary families, which have to reckon with the condition of otherness, is crucial for psychiatrists and psychotherapists working in settings in which cultural difference is an issue to consider.     

Intergenerational persistence of health: Do immigrants get healthier as they remain in the U.S. for more generations?

It is well known that a substantial part of income and education is passed on from parents to children, generating substantial persistence in socioeconomic status across generations. In this paper, we examine whether another form of human capital, health, is also largely transmitted from generation to generation. Using data from the NLSY, we first present new evidence on intergenerational transmission of health outcomes in the U.S., including weight, height, the body mass index (BMI), asthma and depression for both natives and immigrants. We show that between 50% and 70% of the mothers’ health status persists in both native and immigrant children, and that, on average, immigrants experience higher persistence than natives in BMI. We also find that the longer immigrants remain in the U.S., the less intergenerational persistence there is and the more immigrants look like native children. Unfortunately, the more generations immigrant families remain in the U.S., the more children of immigrants resemble natives’ higher BMI.     

Effectiveness of out-of-home day care for disadvantaged families: randomised controlled trial

Objective To assess the effects of providing daycare facilities for young children on the health and welfare of disadvantaged families.Design Randomised controlled trial. Eligible children from the application list to a daycare facility were randomly allocated to receive a daycare place or not.Setting Early Years daycare centre in Borough of Hackney, London.Participants 120 mothers and 143 eligible children (aged between 6 months and 3.5 years).Intervention A place at the centre, which provided high quality day care. Control families used other child care that they secured for themselves.Main outcome measures Maternal paid employment, household income, child health and development.Results At 18 months'' follow up, 67% of intervention group mothers and 60% of control group mothers were in paid employment (adjusted risk ratio 1.23 (95% confidence interval 0.99 to 1.52)), but were no more likely to have a weekly household income of above £200 (risk ratio 0.88 (0.70 to 1.09)). Intervention group children had more otitis media with effusion (risk ratio 1.74 (1.02 to 2.96)) and used more health services (1.58 (1.05 to 2.38)), but both estimates were imprecise.Conclusion The provision of child day care may have increased maternal employment, but it did not seem to increase household income. The results suggest that providing day care may be insufficient as a strategy to reduce poverty. The study shows how random allocation can be used to ration and evaluate interventions where demand exceeds supply.     

Fathers matter: Intrahousehold responsibilities and children's wellbeing during the COVID-19 lockdown in Italy

The lockdown imposed during the spring of 2020 as a result of the COVID-19 pandemic upset families lives, in addition to the health consequences of the virus, forcing parents to completely reorganize their labor, domestic work and childcare time. At the same time, school closures forced children to rearrange their lives and learning processes: in Italy, schools and nurseries were closed for four months, and the incidence and quality of distance learning activities was heterogeneous across education levels and among schools. Using real-time survey data on families with under-16 children collected in April 2020, which include information on parents’ market and household work, and their perception of their children's wellbeing, we estimate how the lockdown has affected children's use of time, their emotional status and their home learning, and whether the reallocation of intrahousehold responsibilities during the lockdown played a role in this process. Changes in the parental division of household tasks and childcare, mostly induced by the labor market restrictions imposed during the lockdown, point to a greater involvement of fathers in childcare and homeschooling activities. This positive variation in fathers’ involvement is accompanied by an increase in children's emotional wellbeing and by a reduction in TV and passive screen time. On the other hand, the quality of children's home learning does not appear to depend on which parent is overseeing their work, but rather on the type of distance learning activities proposed by their teachers.     

EMF recommendations specific for children?

When discussing health risks for children due to electromagnetic fields it is crucial to translate scientific knowledge both into adequate protection and precautionary measures for the general public and, more particularly into specific recommendations for children. It is often aimed at influencing health-related attitudes and behaviour by means of information about health affecting behaviour, health risk factors, and health promoting possibilities. Children have to be treated differently from adults in addressing their ability and willingness to modify behaviour and their competence to comprehend cognitively the sense of behavioural recommendations. Research has shown that adults can be motivated to adjust their own behaviour in order to protect their children or to be role models for their children. Hence one way to modify children’s behaviour is to address the parents and care persons. Generally education in the family, the social environment and in peer groups, nursery school and at school plays an important role in forming and influencing individual behaviour. The age of the target group has also to be taken into consideration.An important question is how to deal with scientific uncertainties when expressing EMF recommendations for children. Accentuating scientific uncertainties may under certain circumstances raise risk awareness. This can be an intended effect. But the expression of scientific uncertainties can also lead to unintended consequences in parent’s behaviour or even senseless dealing with the respective EMF source.The paper points out relevant aspects of risk communication regarding EMF and children and suggests how recommendations for children might be designed.     

Professional and personal attitudes about access and confidentiality in the genetic testing of children: a pilot study

The ability to perform predictive genetic testing of children raises ethical concerns regarding whether and when to test and the disclosure of results. Semi-structured interviews with a convenience sample of pediatricians (12) and geneticists (13) were conducted to see how they would react to parental requests for predictive genetic testing of their children, and their attitudes about testing their own children. We also asked about disclosure attitudes and practices for their patients' relatives and within their own families. Respondents would provide predictive genetic testing for most conditions, yet were less likely to seek this information about their own children. Respondents believed it was very important for patients to share some types of genetic information with relatives, and were directive in their counseling about intrafamilial disclosure, especially within their own families. Although respondents would almost never breach patient confidentiality, many would breach confidentiality within their own families. Health care professionals distinguish between their professional and personal roles with regard to issues of access and confidentiality in predictive testing of children. They are willing to provide greater access and more confidentiality for their patients than within their own families.     

The Practitioner and School Age Child Problems

The extraordinary plasticity of the growing child offers the general practitioner an unusual opportunity to intervene either in a preventative or therapeutic manner. Such intervention, properly the task of any informed physician dealing with families, can alter unhealthy growth to healthier development. The whole child is just as important as his medical illnesses; the whole family usually needs help when there is an emotional disturbance in any child.Common problems that lend themselves readily to physician intervention are behavior disorders accompanying a neurological deficit, conduct disorders, enuresis and school phobias. Knowing how to elicit information, to evaluate clinical data and to utilize the findings of a skilled psychologist, and when to refer to a psychiatrist, plus a thorough knowledge of community resources are part and parcel of a physician''s equipment for dealing with children and families.     

Mental Ill Health,Recovery and the Family Assemblage

The recovery approach is now among the most influential paradigms shaping mental health policy and practice across the English-speaking world. While recovery is normally presented as a deeply personal process, critics have challenged the individualism underpinning this view. A growing literature on “family recovery” explores the ways in which people, especially parents with mental ill health, can find it impossible to separate their own recovery experiences from the processes of family life. While sympathetic to this literature, we argue that it remains limited by its anthropocentricity, and therefore struggles to account for the varied human and nonhuman entities and forces involved in the creation and maintenance of family life. The current analysis is based on an ethnographic study conducted in Australia, which focused on families in which the father experiences mental ill health. We employ the emerging concept of the “family assemblage” to explore how the material, social, discursive and affective components of family life enabled and impeded these fathers’ recovery trajectories. Viewing families as heterogeneous assemblages allows for novel insights into some of the most basic aspects of recovery, challenging existing conceptions of the roles and significance of emotion, identity and agency in the family recovery process.     

Costs of Inaction on Maternal Mortality: Qualitative Evidence of the Impacts of Maternal Deaths on Living Children in Tanzania

Background

Little is known about the interconnectedness of maternal deaths and impacts on children, beyond infants, or the mechanisms through which this interconnectedness is established. A study was conducted in rural Tanzania to provide qualitative insight regarding how maternal mortality affects index as well as other living children and to identify shared structural and social factors that foster high levels of maternal mortality and child vulnerabilities.

Methods and Findings

Adult family members of women who died due to maternal causes (N = 45) and key stakeholders (N = 35) participated in in-depth interviews. Twelve focus group discussions were also conducted (N = 83) among community leaders in three rural regions of Tanzania. Findings highlight the widespread impact of a woman’s death on her children’s health, education, and economic status, and, by inference, the roles that women play within their families in rural Tanzanian communities.

Conclusions

The full costs of failing to address preventable maternal mortality include intergenerational impacts on the nutritional status, health, and education of children, as well as the economic capacity of families. When setting priorities in a resource-poor, high maternal mortality country, such as Tanzania, the far-reaching effects that reducing maternal deaths can have on families and communities, as well as women’s own lives, should be considered.     

Trends in overweight from 1980 through 2001 among preschool-aged children enrolled in a health maintenance organization

Objective: To examine overweight trends over a 22‐year period among preschool‐aged children from primarily middle‐income families enrolled in a health maintenance organization. Research Methods and Procedures: From well‐child care visits to a Massachusetts health maintenance organization, we randomly selected one visit per child per calendar year, yielding a study sample of 120,680 children seen at 366,109 visits from 1980 through 2001. Using multivariate logistic regression models accounting for repeated observations of individual children across years, we estimated trends in prevalence of overweight (weight‐for‐length/height ≥ 95th percentile) and at‐risk‐for‐overweight (85th to 95th percentile). Results: Over the 22‐year study period, the observed prevalence of overweight increased from 6.3% to 10.0% and at‐risk‐for‐overweight increased from 11.1% to 14.4%. These increases were evident among all groups of children including infants < 6 months of age. Overall, the adjusted odds ratios were 1.21 per decade (95% confidence interval, 1.17 to 1.25) for overweight and 1.06 per decade (95% confidence interval, 1.03 to 1.08) for at‐risk‐for‐overweight. Discussion: Rates of overweight are increasing in very young children, even infants, from primarily middle‐class families.     

The response of amphibian larvae to environmental change is both consistent and variable

Many environments are undergoing rapid environmental change and there is a need to understand the mechanisms by which species can persist in altered environments. Model systems, such as amphibian metamorphosis, which can be generalized across many types of environmental change and across many species, are a powerful tool for understanding mechanisms that facilitate persistence in altered and disturbed environments. Amphibian larvae respond to environmental change by varying age at metamorphosis, or size at metamorphosis. Differential selection pressures on age or size at metamorphosis may result in a differential response among taxa to environmental change. Using a meta‐analysis, we investigated whether age at metamorphosis, size at metamorphosis, and larval growth rate vary within and among taxonomic families of amphibians in experiments that modified the environmental temperature, density of individuals, food, hydroperiod and the presence of predators. For all environmental factors except predators, the direction of the response was consistent across most of the studied taxa. However, there was considerable variation in effect size both within and among families. Results demonstrate that amphibian metamorphosis is a valuable model system for studying the effects of environmental change. Yet, we stress the need for caution in making generalizations about how individuals respond to environmental factors that have an indirect effect on physiology and require the perception of an environmental cue, such as the presence of predators. Synthesis As the current conditions of the environment are rapidly changing there is a need to understand how organisms respond to environmental change, and whether response of one species can be generalized to other species. Using a meta‐analyses, we tested whether the phenotypic response of amphibian larvae to five types of environmental change is consistent among and within taxonomic families. The phenotypic response to changes in environmental factors was consistent when the environmental factor has a direct effect on physiology, but varies among and within family if the environmental factor has an indirect effect on physiology or requires the perception of an environmental cue.