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Highlights in child mental health research: May 2022

Prepared by AIFS, Australia, May 2022

Related to Anxiety, Autism, Child and family, Child development, Child mental health, Depression, Pandemic, Parenting, Resilience, Responding to traumatic events, Stress, Temperament, behaviour, attention and conduct difficulties, Trauma

Resource Summary

The monthly research summary provides a selection of recently released papers, systematic reviews, and meta-analyses related to infant and child mental health.

Each summary includes an introductory overview of the content for the month, followed by a list of selected articles. Each article is accompanied by a brief synopsis which presents the key messages and highlights. Links to abstracts, full-text articles and related resources, where available, are provided.

What's new this month in child mental health research?

This month’s highlights include: 

This systematic review and meta-analyses examined the efficacy of psychological interventions targeting behavioural inhibition and anxiety in preschool-aged children, evaluated within randomised controlled trials. Meta-analyses revealed that psychological intervention did not reduce behavioural inhibition as assessed by structured laboratory observations but did reduce behavioural inhibition as reported by parents and teachers. Psychological intervention also appeared to reduce the risk of anxiety disorders and parent-report anxiety symptoms in preschool-aged children.

This study aimed to examine whether Australian children’s after-school activities vary based on socioeconomic status (SES); and the association between frequency of after-school activities and wellbeing among Australian children from low SES backgrounds. Children from low SES backgrounds generally had poorer wellbeing and participated in less frequent after-school activities than children from high SES backgrounds. Amongst children from disadvantaged backgrounds, participating in sport, spending time with friends and getting less screen time may be protective for wellbeing.

Research points to the significant impact of maternal distress on the parent-infant relationship and infant development. This randomized controlled trial examined the effectiveness of Newborn Behavioural Observations (NBO) in a population with antenatal distress and risk of postnatal depression. The authors found NBO exerted meaningful effects on relationship quality and distress; and very early, brief integrated infant-parent mental health intervention may enhance the infant’s interaction experience and maternal emotional adjustment in at-risk populations.

Contemporary multimedia narratives, such as television programmes and animations, can help develop coping strategies in children and mitigate anxiety when they experience global or collective trauma. This paper examines a selection of narratives produced for Australian children during COVID-19 and considers how they can support coping strategies in young children under the age of five. Narratives to support children’s coping strategies should provide age-appropriate knowledge and explanations to support their capacity to prepare for disaster and deal with changes to their normal activities.

The efficacy of interventions for behaviourally inhibited preschool-aged children

The efficacy of interventions for behaviourally inhibited preschool-aged children: A meta-analysis

Authors: Ooi, J., Dodd, H., Meiser-Stedman, R., Hudson, J., Bridges, J., and Pass, L.

Journal: Journal of Anxiety Disorders

Highlights

  • Behavioural inhibition in the preschool years has been identified as a major risk factor for developing anxiety.
  • This systematic review and meta-analyses examined the efficacy of psychological interventions targeting behavioural inhibition and anxiety in preschool-aged children, evaluated within randomised controlled trials.
  • Intervention may be efficacious in reducing anxiety in preschool-aged behaviourally inhibited children. It is less clear whether intervention leads to change in behavioural inhibition.

Key findings

  • Ten studies (N = 1475 children, aged 3 – 7 years) were included in the review. Due to the preliminary nature of the evidence, the review included all interventions targeting preschool behavioural inhibition, regardless of the type of intervention (i.e., parent education, social skills training).
  • The authors examined whether interventions for behaviourally inhibited preschool-aged children are efficacious in reducing (a) behavioural inhibition, and (b) anxiety symptoms and diagnosis.
  • Meta-analyses revealed that intervention did not reduce behavioural inhibition as assessed by structured laboratory observations but did reduce behavioural inhibition as reported by parents and teachers.
  • Additionally, intervention appeared to reduce the risk of anxiety disorders and parent-report anxiety symptoms in preschool-aged children.

Implications

  • Preliminary evidence from this meta-analysis indicated that intervention targeted at behaviourally inhibited preschool-aged children may be effective in reducing behavioural inhibition and anxiety, but this change was not consistently observed across all outcomes.
  • Further work is needed to gain a more comprehensive understanding on how to best support preschool-aged children identified as at-risk for anxiety.
  • Studies in this meta-analysis only reported outcomes between post-intervention and 1-year follow-up. The findings should be interpreted as short-term outcomes of intervention for inhibited young children.

 

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Children's wellbeing, socio-economic disadvantage and after-school activities

The relationships between school children’s wellbeing, socio-economic disadvantage and after-school activities: a cross-sectional study

Authors: Kennewell, E., Curtis, R., Maher, C., Luddy. S., and Virgara, R.

Journal: BMC Pediatrics

Highlights

  • Lower socioeconomic status (SES) is associated with poorer wellbeing among children.
  • This study aimed to 1) examine whether Australian children’s after-school activities vary on the basis of SES and 2) examine the association between frequency of after-school activities and wellbeing among Australian children from low SES backgrounds.
  • Children from low SES backgrounds generally had poorer wellbeing than children from high SES backgrounds. Compared with children from high SES backgrounds, children from low SES backgrounds participated in less frequent after-school activities.

Key findings

  • This study analysed cross-sectional data from 61,759 school students in years 4 to 9 who completed the 2018 South Australian Wellbeing and Engagement Collection.
  • Children from high SES backgrounds had higher levels of wellbeing, and after-school activities differed according to socioeconomic status.
  • High socioeconomic status children did more frequent sport, homework, and reading and low socioeconomic status children did more frequent screen-based activities (TV, videogames and social media). This could be because children from low SES backgrounds have less opportunity to participate in organised activities.
  • Among children from low socioeconomic status backgrounds, higher wellbeing was associated most consistently with more frequent sports participation, homework, reading and spending time with friends, and less frequent videogames, social media and after-school care.

Implications

  • Amongst children from disadvantaged backgrounds, participating in sport, spending time with friends and getting less screen time may be protective for wellbeing.
  • The authors suggest that programming targeted at increasing sports participation and reducing screen time amongst children from low socioeconomic status backgrounds may support their wellbeing.

 

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Supporting early infant relationships and reducing maternal distress with Newborn Behavioural Observations

Supporting early infant relationships and reducing maternal distress with the Newborn Behavioural Observations: A randomized controlled effectiveness trial

Authors: Nicolson, S., Carron, S., and Paul, C.

Journal: Infant Mental Health Journal

Highlights

  • Research points to the significant impact of maternal distress on the parent-infant relationship and infant development.
  • This randomized controlled trial examined the effectiveness of the Newborn Behavioural Observations (NBO) in a population with antenatal distress and risk of postnatal depression.
  • The NBO is a brief intervention supporting the infant, the parent, and their relationship, including joint clinician and parent(s) reflection on the meaning of the observed baby’s behaviours and caregiving implications.
  • The NBO reduced maternal distress symptoms and enhanced relationship quality but did not prevent depression diagnosis.

Key findings

  • Pregnant, first-time mothers with current anxiety or depression symptoms or past mental illness were recruited from two Australian hospitals. 74 mothers completed the trial. Participants received three NBO sessions in the first month of life plus treatment as usual, or treatment as usual only.
  • There were intervention effects on emotional availability, with higher sensitivity and non-intrusiveness in the intervention group (n = 40) than the comparison group (n = 34).
  • There was an intervention effect approaching significance for anxiety symptoms at 4 months (p = .06), and a significant effect over time (p = .014), but not for depression symptoms.
  • There were fewer depression diagnoses than expected across groups, with no observed intervention effect. No adverse intervention effects were seen.

Implications

  • The authors found the NBO exerted meaningful effects on relationship quality and distress; and very early, brief integrated infant-parent mental health intervention may enhance the infant’s interaction experience and maternal emotional adjustment in at-risk populations.
  • The NBO may provide acceptable and effective preventative care for vulnerable new families identified with maternal distress.

 

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Pandemic narratives to support coping strategies in Australian children under five

Coping with COVID: pandemic narratives for Australian children

Authors: Gildersleeve, J., Cantrell, K., Bryce, I., Daken, K., Durham, J., Mullens, A., et al.

Journal: Heliyon

Highlights

  • Contemporary multimedia narratives, such as television programmes and animations, can help develop coping strategies in children and mitigate anxiety when they experience global or collective trauma.
  • This paper examines a selection of narratives produced for Australian children during COVID-19 and considers how they can support coping strategies in young children under the age of five.
  • Narratives to support children’s coping strategies should provide age-appropriate knowledge and explanations to support their capacity to prepare for disaster and deal with changes to their normal activities.

Key findings

  • The authors used thematic analysis to examine multimedia resources (n = 8) developed for children in response to the pandemic. They found four core themes in the resources that form a narrative logic: information provision, promotion of a ‘new normal’, anxiety reduction, community and connection.
  • The narrative logic process is described as beginning with information provision to explain the problem or the ‘new normal’, for the purpose of anxiety reduction, which is possible through community and connection.
  • The most effective narratives are those that move through all parts of the ‘narrative logic’ (in an age-appropriate way) to support the development of children’s coping strategies for social isolation and stress management.
  • Narratives that include the assurance of a ‘happily ever after’ conclusion or platitudes such as ‘It will all be over soon,’ may be more harmful than helpful.
  • Narratives that only include information provision may be less effective because the failure to explain why a child must alter their daily activities can make following instruction seem hollow and prevents the child from preparing for exposure to danger.

Implications

  • Authors of pandemic narratives should understand the needs of children and include children in the development of resources.
  • These pandemic narratives can provide a potential model for public health narratives aimed at young children who find themselves in stressful situations around the world.
  • Resource and narrative development should consider diversity and inclusion, including access to technology, Auslan and language interpreters, and the representation of cultural diversity.

 

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