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Nazmun Nahar, S., Fäldt, A., Dahlberg, A. & Durbeej, N. (2025). Preschool children of parents who screen positive for mental health problems have an increased risk of subsequent mental disorders: Findings from a longitudinal follow-up study in Sweden. PLOS ONE, 20(3), Article ID e0318971.
Open this publication in new window or tab >>Preschool children of parents who screen positive for mental health problems have an increased risk of subsequent mental disorders: Findings from a longitudinal follow-up study in Sweden
2025 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 20, no 3, article id e0318971Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2025
National Category
Psychiatry Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:uu:diva-553834 (URN)10.1371/journal.pone.0318971 (DOI)001443008600016 ()40072939 (PubMedID)2-s2.0-86000764262 (Scopus ID)
Funder
Swedish Research CouncilSwedish Research Council FormasVinnova, 259-2012-68Forte, Swedish Research Council for Health, Working Life and Welfare, 2021-01046
Available from: 2025-04-07 Created: 2025-04-07 Last updated: 2025-04-07Bibliographically approved
Dahlberg, A., Levin, A. & Fäldt, A. (2024). A higher proportion of children aged 4 years were referred to speech and language therapists after the introduction of a new language screening tool. Acta Paediatrica
Open this publication in new window or tab >>A higher proportion of children aged 4 years were referred to speech and language therapists after the introduction of a new language screening tool
2024 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
child health service, language assessment, language screening, screening
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-525419 (URN)10.1111/apa.17183 (DOI)001174315000001 ()38415885 (PubMedID)
Funder
Länsförsäkringar AB
Available from: 2024-03-22 Created: 2024-03-22 Last updated: 2024-03-22Bibliographically approved
Fäldt, A., Nejat, S., Durbeej, N. & Holmgren, A. (2024). Childhood Overweight and Obesity During and After the COVID-19 Pandemic [Letter to the editor]. JAMA pediatrics, 178(5), 498-500
Open this publication in new window or tab >>Childhood Overweight and Obesity During and After the COVID-19 Pandemic
2024 (English)In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 178, no 5, p. 498-500Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
American Medical Association (AMA), 2024
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-544281 (URN)10.1001/jamapediatrics.2024.0122 (DOI)001189497900003 ()38497991 (PubMedID)2-s2.0-85188014571 (Scopus ID)
Available from: 2024-12-03 Created: 2024-12-03 Last updated: 2025-02-20Bibliographically approved
Ashok, P., Fäldt, A., Dahlberg, A. & Durbeej, N. (2024). Early emotional and behavioural problems predict use of habilitation services among children: Findings from a longitudinal follow-up study. PLOS ONE, 19(5), Article ID e0303685.
Open this publication in new window or tab >>Early emotional and behavioural problems predict use of habilitation services among children: Findings from a longitudinal follow-up study
2024 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 5, article id e0303685Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2024
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-541034 (URN)10.1371/journal.pone.0303685 (DOI)001227144600158 ()38753629 (PubMedID)
Funder
Swedish Research CouncilSwedish Research Council FormasForte, Swedish Research Council for Health, Working Life and WelfareVinnova, 259-2012-68Forte, Swedish Research Council for Health, Working Life and Welfare, 2021-01046Swedish Research Council FormasForte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2024-12-03 Created: 2024-12-03 Last updated: 2024-12-03Bibliographically approved
Zahlander, J., Fäldt, A., Kirby, A. & Johansen, K. (2024). Exploring adults' recollections of growing up with childhood motor difficulties: a qualitative study using systematic text condensation. BMJ Open, 14(8), Article ID e084346.
Open this publication in new window or tab >>Exploring adults' recollections of growing up with childhood motor difficulties: a qualitative study using systematic text condensation
2024 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 14, no 8, article id e084346Article in journal (Refereed) Published
Abstract [en]

Objective: To explore the ramifications of childhood motor difficulties, providing insights into their impact and consequences over time.

Design: A qualitative study using semistructured individual interviews. Data were analysed using systematic text condensation.

Setting: Neonatal intensive care recipients born at Uppsala University Children's Hospital, Uppsala, Sweden, between 1986 and 1989, were enrolled in a longitudinal follow-up study and subsequently interviewed in 2019-2020.

Participants: 13 individuals in their early 30s, who met the criteria for developmental coordination disorder or performed below the 5th percentile on motor tests at 6.5 years of age, were interviewed. Those with co-occurring deficits in attention or social behavioural at age 6.5 were excluded.

Results: Two themes emerged: (1) lifelong challenges and (2) navigating the journey of motor difficulties: support, awareness and confidence. Five participants reported persistent motor difficulties. They adapted and integrated these challenges into their daily lives without feeling constrained. Parental support was crucial to their success, whereas support from schools was limited.

Conclusion: Adults who faced motor difficulties in childhood developed effective coping strategies, overcame challenges and now lead fulfilling lives. The findings stress the importance of parental support and understanding, addressing contextual factors and fostering positive attitudes and supportive environments to enhance well-being and participation.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
developmental neurology & neurodisability, neonatology, quality of life
National Category
Other Health Sciences
Identifiers
urn:nbn:se:uu:diva-539393 (URN)10.1136/bmjopen-2024-084346 (DOI)001312973500001 ()39122399 (PubMedID)
Funder
Gillbergska stiftelsenRegion UppsalaUppsala University
Available from: 2024-11-01 Created: 2024-11-01 Last updated: 2025-05-07Bibliographically approved
Dahlberg, A., Levin, A. & Fäldt, A. E. (2024). Implementation of the Infant-Toddler Checklist in Swedish child health services at 18 months: an observational study. BMJ Paediatrics Open, 8(1), Article ID e002406.
Open this publication in new window or tab >>Implementation of the Infant-Toddler Checklist in Swedish child health services at 18 months: an observational study
2024 (English)In: BMJ Paediatrics Open, E-ISSN 2399-9772, Vol. 8, no 1, article id e002406Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
Screening, Infant
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-526191 (URN)10.1136/bmjpo-2023-002406 (DOI)001191299300001 ()38531549 (PubMedID)
Funder
Länsförsäkringar AB
Available from: 2024-04-05 Created: 2024-04-05 Last updated: 2024-04-05Bibliographically approved
Fäldt, A. & Fängström, K. (2024). 'Of course you crash': Parenting a young child with neurodevelopmental difficulties. Research in Developmental Disabilities, 153, Article ID 104825.
Open this publication in new window or tab >>'Of course you crash': Parenting a young child with neurodevelopmental difficulties
2024 (English)In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 153, article id 104825Article in journal (Refereed) Published
Abstract [en]

Background

Parents of children with neurodevelopmental disorders often experience heightened levels of parenting stress and diminished well-being. However, less is known about the well-being of parents whose children exhibit symptoms of neurodevelopmental disorders without yet having a formal diagnosis.

Aim

This study aims to deepen our understanding of the need for support among families with young children with neurodevelopmental difficulties. Specifically, it explores parents’ perspectives concerning their children, life circumstances, and emotional experiences in parenting.

Methods and procedures

Qualitative semi-structured interviews were conducted with ten parents of children aged 2.5–5 years, referred to a child psychologist due to reported neurodevelopmental difficulties. The interviews were transcribed and analysed using qualitative content analysis.

Outcomes and results

Two themes, each containing four and three categories, respectively, emerged in the analysis: Parenting our child with neurodevelopmental difficulties is tough in so many ways and Prevent, manage and make up like a Pro.

Conclusion and implications

The parents express very similar challenges, difficulties and problems as parents of children with diagnosed neurodevelopmental disorders. The main difference lies in the lack of accessible support or help for these parents.

What this paper adds

This study provides insights into how parents of children with suspected neurodevelopmental difficulties perceive their child and their overall life circumstances. The narratives show the challenges these parents face due to their children's multifaceted difficulties, leading to a need for multi-disciplinary support from professionals. The narratives also illustrate the strong emotions that arise in parenting, which in itself indicates a need for support. The study also provides further support for the importance of parents connecting with others facing similar life circumstances. The families often feel isolated despite the need for increased informal support in terms of more adults being involved with the children.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Preschool aged children, Neurodevelopmental difficulties, Parents, Multi-disciplinary coordinated support
National Category
Psychiatry Pediatrics
Identifiers
urn:nbn:se:uu:diva-538209 (URN)10.1016/j.ridd.2024.104825 (DOI)001299877300001 ()39173406 (PubMedID)
Funder
Stiftelsen Sunnerdahls Handikappfond, F7/21Region Uppsala, LUL964145
Available from: 2024-09-11 Created: 2024-09-11 Last updated: 2024-09-11Bibliographically approved
Sarkadi, A., Thell, M., Fängström, K., Dahlberg, A., Fäldt, A., Pérez-Aronsson, A., . . . Eriksson, M. (2023). Are We Ready to Really Hear the Voices of Those Concerned?: Lessons Learned from Listening to and Involving Children in Child and Family Psychology Research. Clinical Child and Family Psychology Review
Open this publication in new window or tab >>Are We Ready to Really Hear the Voices of Those Concerned?: Lessons Learned from Listening to and Involving Children in Child and Family Psychology Research
Show others...
2023 (English)In: Clinical Child and Family Psychology Review, ISSN 1096-4037, E-ISSN 1573-2827Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Child rights, Research, Participation, Involvement, Vulnerability, Parenting, Co-creation
National Category
Ethics
Identifiers
urn:nbn:se:uu:diva-515156 (URN)10.1007/s10567-023-00453-4 (DOI)001067507800001 ()
Funder
Uppsala UniversityEU, Horizon 2020, 754849Public Health Agency of Sweden , 03303-2020-2.3.2Länsförsäkringar AB, T2/20
Available from: 2023-10-27 Created: 2023-10-27 Last updated: 2023-10-27Bibliographically approved
Fäldt, A., Durbeej, N. & Fabian, H. (2023). Family and child health centre characteristics associated with exposure to universal language and literacy promotion. Child Language Teaching and Therapy, 39(1), 5-15
Open this publication in new window or tab >>Family and child health centre characteristics associated with exposure to universal language and literacy promotion
2023 (English)In: Child Language Teaching and Therapy, ISSN 0265-6590, E-ISSN 1477-0865, Vol. 39, no 1, p. 5-15Article in journal (Refereed) Published
Abstract [en]

Aims: This study investigated which specific socio-demographic characteristics of the family and child health service centre are associated with parents receiving a video guide. The video guide, intended to be offered universally, aimed at promoting language and literacy development.

Methods: The video guide included language and literacy activities and was offered through child healthcare centres to all visiting families. Cross-sectional data were collected during three years through parental self-reported questionnaires when the children were three years old, and families of 2512 children were included.

Results: In 60% of the families, none of the parents reported receiving the video guide, and in 84%, none of the parents reported that they had watched the video guide. Most of the parents who watched the video guide reported having tried the presented activities. Socio-demographic characteristics associated with parents having received the video guide were: being married or cohabiting, having a university education, or if the mother was native-born. The child's age when the video guide was initially offered and the child's birth order were also factors associated with parents having received the video guide.

Conclusions: The results indicate that few parents overall received the video guide. Socio-economically advantaged parents seemed to have received the video guide to a higher extent.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
child health, child health services, language disorders, preventive health services, health prevention
National Category
Pediatrics Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:uu:diva-501749 (URN)10.1177/02656590221119923 (DOI)000840149500001 ()
Available from: 2023-05-22 Created: 2023-05-22 Last updated: 2025-02-20Bibliographically approved
Fäldt, A., Nystrand, C. & Fängström, K. (2023). Family-Based Intervention for Substance Using Parents: Experiences and Resource Use. Research on social work practice, 33(7), 810-821
Open this publication in new window or tab >>Family-Based Intervention for Substance Using Parents: Experiences and Resource Use
2023 (English)In: Research on social work practice, ISSN 1049-7315, E-ISSN 1552-7581, Vol. 33, no 7, p. 810-821Article in journal (Refereed) Published
Abstract [en]

Purpose: The study aimed to assess families? resource use and to explore parents? experiences of the Sofia model, a family-based intervention for parents with substance use disorder (SUD). Methods: Interviews were conducted with 14 parents. Data were analyzed with qualitative content analysis. The resource use assessment was estimated based on data for 40 families referred to the Sofia model and 30 reference families. Results: Parents described difficulties accessing family support and differences in received services in the Sofia model. The intervention lacked focus on the children. Families? communication regarding substance use did not increase. Resource use estimations indicated larger use of services by families in the Sofie model, but little co-parent and child-specific support. Conclusions: The intervention failed its aim to focus on the children, and enhance communication about SUD. Parents voiced a need for more long-term comprehensive support for their children and themselves.

Place, publisher, year, edition, pages
Sage Publications, 2023
National Category
Social Work
Identifiers
urn:nbn:se:uu:diva-492480 (URN)10.1177/10497315221138070 (DOI)000890222400001 ()
Available from: 2023-01-05 Created: 2023-01-05 Last updated: 2024-05-23Bibliographically approved
Projects
Reducing inequities in health and development through improving the compensatory capacity of universal child health and early education services [2023-01130_Forte]; Uppsala University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7257-8758

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