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Research has shown associations between parental and child mental health problems. However, there is a paucity of Swedish studies on this topic. Investigating this link in a Swedish context could inform preventive interventions aimed at reducing mental health problems in affected families. This longitudinal cohort study aimed to explore the association between parental mental health problems and children's subsequent mental disorders in Sweden. We used data on children, 3-5 years old, whose mothers (n = 6379) and fathers (n = 6218) had responded to the 12-item General Health Questionnaire for assessment of parental mental health problems using a cut-off of >= 12 points. The children were followed for approximately seven years with regard to subsequent mental disorders, collected from the Swedish National Patient Register. The associations between parental mental health problems and children's mental disorders were explored through Cox-regression models. In unadjusted Cox regression models, mothers (HR: 1.63, 95% CI: 1.37-1.94) and fathers (HR: 1.36, 95% CI: 1.12-1.65) with mental health problems were more likely to have children diagnosed with a subsequent mental disorder than mothers and fathers with no mental health problems. In adjusted models controlling for children's emotional and behavioral problems and parental sociodemographic factors, the associations remained significant for mothers' mental health problems (AHR: 1.33, 95% CI: 1.12-1.59), but not for fathers' (AHR: 1.14, 95% CI: 0.93-1.40). Children with emotional and behavioral problems, whose parents were single or living apart and whose parents had lower educational levels also had an elevated risk of being diagnosed with a mental disorder. Maternal mental health problems and child emotional and behavioral problems during the preschool years may serve as risk factors for subsequent child mental disorders. Assessment of these problems at child health services in Sweden could facilitate delivery of interventions to promote parental and child mental health.

BackgroundYoung children with subclinical neurodevelopmental disorders (NDDs) and concurrent emotional and behavioral problems (EBP) are at significant risk of negative short- and long-term outcomes. Although early parenting support interventions are recommended and requested, there is a lack of interventions specifically designed for this group and adapted to the Swedish context. Based on this gap, a parenting support intervention for parents with children aged 2-6 years with subclinical NDDs and EBP has been co-created with clinicians and parents. The project described in this study protocol aims to evaluate the effectiveness and cost-effectiveness of this new group-based parenting intervention.MethodsThe project uses a multiple-baseline single-case experimental design (SCED) with pre-post measures and a 3-month follow-up. The intervention is provided to families with children who are referred to child health psychologists at the child pediatric outpatient clinic in Uppsala Region, Sweden. Outcomes will include child EBP and parent self-efficacy, stress, well-being, and quality of life, as well as costs for the intervention, health care use, and QALYs.DiscussionThe project could lead to improved mental health in both children and parents through participation in the group-based parenting intervention. The study design, with longitudinal data from both children and/or their parents, will provide valuable insights into the trajectories of mental health and well-being within this group. In addition, the inclusion of young children as informants will provide important information about their experiences. Furthermore, the use of pre-, post- and follow-up questionnaires will allow reliable and clinically significant changes to be assessed and our findings to be compared with randomized trials in similar populations. The results of this project will be relevant to children with subclinical NDDs and their parents, as well as to health care organizations and the scientific community. The intervention is well adapted to the end users and the clinical context, as it has been co-created with clinicians and parents.Trial registrationISRCTN10835479 https://doi.org/10.1186/ISRCTN10835479, date of registration 2024-10-08.

Aim: Language difficulties in children can have enduring impacts on their academic and emotional well-being. Consequently, early identification and intervention are critical. This study aimed to investigate the impact of introducing Sprakfyran, a language screening tool, on the identification and referral rates for speech and language assessment compared to the previous method.

Methods: An observational study was conducted in Gotland, Sweden, using the medical records of 3537 children (53% boys) who were 3-4 years of age. The study period lasted between 5 January 2016 and 29 April 2022, encompassing data collection both before and after the introduction of Sprakfyran.

Results: Following the introduction of Sprakfyran, 15% failed the screening, compared to 20% with the previous speech test. However, referrals for assessment increased significantly with Sprakfyran, rising to 7% compared to 3% with the speech test.

Conclusion: The proportion of children who failed the Sprakfyran screening was consistent with findings from previous studies. Children who failed the screening were more likely to be referred for speech and language assessment after the introduction of Sprakfyran. This indicates that Sprakfyran is a clinically relevant tool that promotes children's language development through increased referral rates.

Despite extensive research assessing parenting support, there is a lack of knowledge about the perspectives of the youngest children. In this study, we explored changes in preschool children's emotional and relational experiences at home before and after their parents participated in a parenting intervention, the Triple P parenting programme. Nine children in total were interviewed, aged 3-6 years, whose parents participated in a group parenting intervention. The interviews were conducted during the first and final group sessions attended by the children's parents. Data were analysed qualitatively, using a longitudinal approach, resulting in a deductive mapping of the children's statements onto four themes, based on the parenting intervention's main objectives. Further, changes in content for each of the four themes were assessed. Before the programme, children described conflicts with siblings, parents' negative emotions, and punitive parenting behaviours. After the programme, sibling conflicts remained, but parents' negative emotions decreased and parent threats and violence ceased. Positive family interactions and quality time increased, along with experiences of tenderness and being comforted. Parents also implemented new strategies such as verbal management and more comforting or soothing behaviours. Clinical implications of the results include promoting positive sibling relationships, emphasising parental self-regulation, encouraging empathy and reconciliation, and highlighting the importance of spending quality time with children. These findings contribute to a better understanding of children's perspectives and provide implications for clinical practice and future research.

Purpose To explore the association between early emotional and behavioural problems and use of habilitation services among children in Sweden.Methods In this longitudinal cohort study, we used data on children, 3-5 years of age, whose mothers (n = 7343) and fathers (n = 6322) had responded to the Strengths and Difficulties Questionnaire (SDQ) for assessment of emotional and behavioural problems, and who were followed for approximately 6.5 years with regard to use of habilitation services. The relations between emotional and behavioural problems and use of habilitation services were explored through cox regression models.Results In unadjusted models, children with identified emotional and behavioural problems were more likely to utilise habilitation services compared to those with no identified problems. These associations were shown for both mothers' (HR: 5.02) and fathers' (HR: 4.25) SDQ ratings. In adjusted cox-regression models, the associations remained significant for both mothers' (AHR: 4.24) and fathers' (AHR: 4.03) ratings.Conclusions Early emotional and behavioural problems predict later habilitation service use among children in Sweden. Assessment of these problems in all children at child health services could facilitate early identification and timely interventions. Habilitation centres in Sweden could integrate mental health care into the standard treatment for children using these services.

Background Communication and language disorders are common conditions that emerge early and negatively impact quality of life across the life course. Early identification may be facilitated using a validated screening tool such as the Infant-Toddler Checklist (ITC). We introduced the ITC at the 18-month visit to child health services (CHS) in a Swedish county. Using the RE-AIM implementation framework, this study assessed the implementation of the ITC according to five key dimensions: reach, effectiveness, adoption, implementation and maintenance.

Methods This observational study used medical records at CHS as data source. Data were collected from children who visited a child health nurse at 17–22 months. The sample included 2633 children with a mean age of 17.8 months, 1717 in the pre-implementation group and 916 in the post implementation group. We calculated the ITC completion rate (reach) and use at each site (adoption). We compared rates of referral to speech and language therapy (effectiveness) before and after implementation of the ITC using OR and 95% CIs. We described actions to facilitate implementation and maintenance of ITC screening over time.

Results The overall screening rate was 93% (reach) which increased from 80% initially to 94% at the end of the 2-year period (maintenance). All centres used the ITC (adoption). The ITC screen positive rate was 14%. Of children who had reached at least 24 months (n=2367), referral rate was 0.4% pre-implementation versus 6.9% post implementation (OR=18.17, 95% CI 8.15, 40.51, p<0.001) (effectiveness). Implementation strategies included training sessions, collaboration, written and automatic procedures and modifications to the medical records system.

Conclusion The implementation of the ITC was associated with high reach, higher referral rate, complete adoption, and sustained maintenance over time.

Aim

There is limited research on the impact of preschool attendance on socio-emotional problems. This study aimed to investigate the association between not attending preschool and emotional and behavioural problems among children aged 3–5 years in Sweden.

Methods

We analysed cross-sectional data from 9395 children, rated by both parents or by one parent. The dependent variable, emotional and behavioural problems, was measured using the Strengths and Difficulties Questionnaire (SDQ). Preschool attendance served as the independent variable. Single and multiple logistic regression analyses were conducted.

Results

Only 1.2% of children did not attend preschool. Single logistic regression models, using SDQ subscales with scores at or above the cut-off point as outcomes, showed that not attending preschool was associated with peer relationship problems, rated by mothers, and with peer relationship problems and overall difficulties, rated by fathers. These associations remained significant when controlling for covariates. Children with parents born outside Sweden or with lower educational levels had higher odds of experiencing peer relationship problems and overall difficulties.

Conclusion

Children who do not attend preschool are at heightened risk of experiencing peer relationship problems. It is important to ensure that children who may benefit most from preschool education receive adequate support.

Aims:

The aim of this study was to explore the association between preschool-level socio-economic deprivation and emotional and behavioural problems among preschool children in Sweden using a multilevel approach.

Methods:

In this cross-sectional study, we used data on 2267 children whose parents and preschool teachers had responded to items measuring individual-level socio-economic deprivation and the Strengths and Difficulties Questionnaire (SDQ) for assessment of emotional and behavioural problems. Further, the Socioeconomic Structure Compensation Index (SSCI), collected from Uppsala municipality, was used to assess preschool-level socio-economic deprivation. Unadjusted and adjusted multilevel logistic regression models were used to explore the relations between preschool-level socio-economic deprivation and emotional and behavioural problems.

Results:

In unadjusted models, children who attended preschools classified as highly deprived had elevated odds for emotional symptoms (odds ratio (OR) 1.71) as rated by parents. However, this association did not remain significant after adjusting for individual-level socio-economic deprivation factors. In both unadjusted and adjusted models, children who attended preschools classified as moderately deprived had elevated odds for peer-relationship problems as rated by parents (OR 1.63; adjusted OR 1.48). There were no significant associations between preschool deprivation and emotional and behavioural problems as rated by preschool teachers.

Conclusions:

Swedish preschools may have a compensatory capacity in addressing children’s emotional and behavioural problems, whereas preschool-level deprivation remained significantly associated with peer-relationship problems after controlling for individual-level socio-economic deprivation factors. This implies that peer-relationship problems in deprived preschools need to be addressed in a broader community context.

A changing view of children, accelerated by the Convention of the Rights of the Child (UN in Convention on the rights of the child, UN Doc. A/RES/44/25, 1989, http://www2.ohchr.org/english/law/pdf/crc.pdf) has shifted the landscape of child and family research over the last few decades. Once viewed with low credibility and operating outside the interpretive framework of adult researchers, the rights-bearing child is increasingly recognized not only as having the capacity but also the right to participate in research. More recently, this movement has transitioned from the direct engagement of children as research participants—now considered commonplace, although less so for those who are structurally vulnerable—to the involvement of children in research design, review, conduct, and dissemination. Yet, both practical and ethical challenges remain. While children have the right to participation, they also have the right to protection. In this commentary, we set out to: (i) lay forth epistemic, child rights, and child sociology arguments for doing research about, with and by children and youth; (ii) recount our own journey of including children and youth in research to demonstrate the unique knowledge and insights gained through these approaches; and (iii) offer lessons learned on how to engage children and youth in research, including the involvement of structurally vulnerable groups.

Parenthood can be defined by the contradiction that it is one of the most satisfying yet stressful experiences in life. Many parents experience stress during parenthood, and some to the extent that they display symptoms of parental burnout. Nevertheless, research on parental burnout is scant and many studies have only examined the condition in Western settings. The aim of this study was to examine parental burnout among Somali mothers in Mogadishu, Somalia, and its association with certain psychological, psychosocial, and sociodemographic factors. In this cross-sectional study, questionnaire data were collected through the measurements Parental Burnout Assessment and Patient Health Questionnaire 9, as well as through social and demographic questions. A total of 882 Somali mothers in Mogadishu participated. The analysis methods used were univariate, bivariate, and multiple linear regression analysis. The results revealed that the mean parental burnout score was low in the sample. Additionally, a significant association was found between higher levels of parental burnout and higher levels of depression, perceived lack of social support, being unmarried, having a low monthly household income, and when the youngest child was of school-age.