Nursing and Vulnerable Children: Our Role

Description

Text description: The increasing recognition of the importance of early childhood on adult health and educational outcomes has increased the complexity of nursing and midwifery roles. This perspective piece outlines some of the impacts of vulnerability on children and proposes an expansion of the nurse and midwifery role in addressing complex family needs.

Given the increasing diversity of nursing and midwifery roles, and the extensive body of international and Australian research outlining that children’s early experience are intrinsically related to adult health and educational outcomes. It is paramount that nurses and midwives engage with vulnerable children. Nursing and midwifery practice provides vital insights into the existing challenges and potential opportunities in the area with the ultimate aim of strengthening the capacity of the profession to respond to the needs of vulnerable children.

Early human development impacts on health, learning and behaviour throughout life [1]. Programs targeting parents of children at risk aim to decrease the impact of the negative characteristics in adulthood and address the children’s potential level of complex vulnerabilities that accumulate to produce poorer adult health outcomes [2-18]. Of note, the use of parenting programs has been effective in decreasing emotional and behavioral problems in children [19]. This includes children with behavioral conduct disorder, oppositional behaviour, attention-deficit hyperactivity disorder, and anxiety disorders [4,19]. In addition, there is evidence that investing economically in early childhood programming for children in disadvantaged circumstances has sustained benefits for the community and from a human resources perspective [4,20-25]. Early Child Development (ECD) projects research has proven that children who participate in well-conceived ECD programs tend to be more successful in later school, are more competent socially and emotionally, and show higher verbal and intellectual development during early childhood than children who are not enrolled in high quality programs [1,4,6,21,25]. Ensuring healthy child development, therefore, is an investment in a country’s future workforce and capacity to thrive economically and as a society [25]. Nurses and midwife’s increased capacity to provide public health and community based interventions will assist in addressing the complex needs of vulnerable children [10].

Nurses and midwives play an essential part in prevention and early intervention strategies circumventing the long-term effects of child abuse and neglect. The capacity to prevent abuse and neglect requires an autonomous, informed and proactive workforce that can recognise the signs of abuse and neglect and is prepared to intervene. Therefore future nursing and midwifery intervention programs and practice addressing the most vulnerable and disadvantaged members in society, with the goal of reducing risk factors and improving family functioning and wellbeing, will be instrumental in promoting improved health and education outcomes for vulnerable children.

References

1. Mustard J. Preface, in Bridging the 'Know-Do' Gap. Bammer G, Michaux A, Sanson A, Editors. The Australian National University: Canberra. 2010. ix-xiii.
2. Mackintosh J, White M, Howel D, Chadwick T, Moffatt S, Deverill M, et al. Randomised controlled trial of welfare rights advice accessed via primary health care: pilot study [ISRCTN61522618]. BMC Public Health. 2006; 6: 162.
3. Noble-Carr D. The experiences and effects of family homelessness for children: a literature review. In: The experiences and effects of family homelessness for children: a literature review, Institute of Child Protection Studies, Editor. Australian Catholic University (National), Canberra. 2007.
4. DoCS. What makes parenting programs effective? An overview of recent research. D.o.C. Services, Editor. Department of Community Services: NSW. 2009.
5. Keys D. Children and homelessness: Literature review. T.S.A.A.S. Territory, Editor. The Salvation Army Australia Southern Territory. Melbourne. 2009.
6. Dockery AM. Housing and children’s development and wellbeing: a scoping study. , A.H.a.U.R. Institute., Editor. Australian Housing and Urban Research Institute: Melbourne. 2010.
7. Gibson C, Johnstone T. Investing in our future: Children’s journey’s through homelessness and child protection. A sample of the literature, Policy and Practice. A.R.A.f.C.Y.M.A.A.C.f.C. Protection, Editor. Australian Research Alliance for Children & Youth. Mission Australia. Australian Centre for Child Protection. Adelaide. 2010.
8. Solar O, Irwin A. A Conceptual Framework for Action on the Social Determinants of Health. D.p.f.t.C.o.S.D.o. Health, Editor. WHO: Geneva. 2010.
9. Marcynyszyn L, Maher E, Corwin T. Getting with the (evidence-based) program: An evaluation of the Incredible Years Parenting Training Program in child welfare, Children and Youth Service Review, 2011; 33: 747-757.
10. Nelson F, Mann T. Opportunities in public policy to support infant and early childhood mental health: the role of psychologists and policymakers. Am Psychol. 2011; 66: 129-139.
11. Kilmer R, Cook JR, Crusto C, Strater KP, Haber MG. Understanding the Ecology and Development of Children and Families Experiencing Homelessness: Implications for Practice, Supportive Services, and Policy. Am J Orthopsychiatry. 2012; 82: 389-401.
12. McCartney G. What would be sufficient to reduce health inequalities in Scotland? MTF (12) Paper 3a. 2012.
13. McCoy-Roth M, Mackintosh B, Murphey D. When the Bough Breaks: The Effects of Homelessness on Young Children. 2012.
14. Zlotnick C, Tam T, Zerger S. Common needs but divergent interventions for U.S. homeless and foster care children: results from a systematic review. Health Soc Care Community. 2012; 20: 449-476.
15. Coren E, Rosa Hossain, Jordi Pardo Pardo, Mirella MS Veras, Kabita Chakraborty, Holly Harris, et al., Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street-connected children and young people (Review). Evidence-Based Child Health: a Cochrane Review Journal. 2013; 8: 1140-1272.
16. Embleton L, Mwangi A, Vreeman R, Ayuku D, Braitstein P. The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis. Addiction. 2013; 108: 1722-1733.
17. Roos LE, Mota N, Afifi TO, Katz LY, Distasio J, Sareen J, et al. Relationship between adverse childhood experiences and homelessness and the impact of axis I and II disorders. Am J Public Health. 2013; 103 Suppl 2: S275-281.
18. Kuehn BM. AAP: Toxic stress threatens kids' long-term health. JAMA. 2014; 312: 585-586.
19. Kaminski JW, Valle LA, Filene JH, Boyle CL. A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol. 2008; 36: 567-589.
20. Belfield C. The High/Scope Perry Preschool Program. Cost–Benefit Analysis Using Data from the Age-40 Followup. The Jornal of Human Resources. 2006; XLI: 162-190.
21. Mustard J. Experience-based brain development: Scientific underpinnings of the importance of early child development in a global world. Paediatr Child Health. 2006; 11: 571-572.
22. Noble KG, Norman MF, Farah MJ. Neurocognitive correlates of socioeconomic status in kindergarten children. Dev Sci. 2005; 8: 74-87.
23. Moffitt TE, Arseneault L, Belsky D, Dickson N, Hancox RJ, Harrington H, et al. A gradient of childhood self-control predicts health, wealth, and public safety. Proc Natl Acad Sci U S A. 2011; 108: 2693-2698.
24. Bartik T. Investing in Kids: Early Childhood Programs and Local Economic Development. Investing in Kids: Early Childhood Programs and Local Economic Development. Bartik T, editor. Kalamazoo: Upjohn Institute for Employment Research. 2011.
25. Reynolds AJ, Temple JA, White BA, Ou SR, Robertson DL. Age 26 cost-benefit analysis of the child-parent center early education program. Child Dev. 2011; 82: 379-404.