USING PARENTS AS THERAPISTS TO EVALUATE APPROPRIATE BEHAVIOR OF THEIR CHILDREN: APPLICATION TO A TERTIARY DIAGNOSTIC CLINIC

We conducted a preliminary analysis of maintaining variables for children with conduct disorders in an outpatient clinic. Eight children of normal intelligence between the ages of 4 and 9 years were evaluated during 90-min sessions. The children's parents conducted the assessments by varying task demands (easy and difficult) and parental attention (attention and no attention) within a multielement design. The assessment focused on appropriate child behavior and was conducted to formulate hypotheses regarding maintaining contingencies. Results demonstrated that the children's appropriate behavior varied across assessment conditions and, for 7 of the 8 children, occurred at a higher rate during one condition than during other conditions. In addition, treatment integrity data demonstrated that parents were able to implement the procedures as intended. The recommended treatments were rated as being both effective and acceptable to parents for up to 6 months following the evaluation. Our results extend previous studies of functional analytic procedures conducted by trained experimenters with severely handicapped children in more controlled settings.     

Availability of three-year-old kibbutz children to mothers and metapelets in two functional contexts

Responsiveness and availability of kibbutz children to mothers and to metapelets in two functional contexts were studied. Thirty-three 3-year-old children, participated in the study. Every child participated twice in two co-construction tasks: once with the mother and once with the metapelet. A factor analysis conducted over the present categories yielded six orthogonal factors: Three pertained to cooperative child involvement of the adult and three referred to oppositional involvement. Analyses of variance indicated that children involved the mother more often than the metapelet in their activities and were more responsive to her. Additional analyses conducted on each factor separately showed that this higher level of involvement of the mother was evident in the cooperative factors. The children's involvement of the adults and their responsiveness to the adults' bids differed significantly between tasks. © 1997 Michigan Association for Infant Mental Health     

REDUCING BEHAVIOR PROBLEMS THROUGH FUNCTIONAL COMMUNICATION TRAINING

It is generally agreed that serious misbehavior in children should be replaced with socially appropriate behaviors, but few guidelines exist with respect to choosing replacement behaviors. We address this issue in two experiments. In Experiment 1, we developed an assessment method for identifying situations in which behavior problems, including aggression, tantrums, and self-injury, were most likely to occur. Results demonstrated that both low level of adult attention and high level of task difficulty were discriminative for misbehavior. In Experiment 2, the assessment data were used to select replacements for misbehavior. Specifically, children were taught to solicit attention or assistance or both verbally from adults. This treatment, which involvedthe differential reinforcement of functional communication, produced replicable suppression of behavior problems across four developmentally disabled children. The results were consistent with an hypothesis stating that some child behavior problems may be viewed as a nonverbal means of communication. According to this hypothesis, behavior problems and verbal communicative acts, though differing in form, may be equivalent in function. Therefore, strengtheningthe latter should weakenthe former.     

Effects of parent enhancement therapy on the treatment outcome and generalization of a parent training program

The purpose of the present study was to examine the effectiveness of parent enhancement training in facilitating treatment and maintenance effects of a parent training program. Seventeen mothers and their clinic-referred noncompliant children were assigned to either a parent training alone group or a parent training plus parent enhancement therapy group. Fifteen mothers and their nonclinic children served as a quasi-control group. All clinic-referred mother-child dyads were treated individually by teaching the mother to reward compliance and other prosocial behavior and to use time-out for noncompliance. In addition, mothers in the parent training plus parent enhancement group also received treatment related to the following areas: parent's perception of their child's behavior, parent's personal adjustment, parent's marital adjustment, and parent's extrafamilial relationships. Assessment consisted of four home observations by independent observers prior to treatment, after treatment, and at a 2-month follow-up. The data indicated that the parent training plus parent enhancement therapy was more effective than parent training alone in changing child deviant behavior at posttreatment and in maintaining child compliance, child deviant behavior, parental rewards and parent contingent attention at follow-up. The control group did not change over the three assessment periods.     

Preschoolers’ autobiographical memory specificity relates to their emotional adjustment

Reduced autobiographical memory specificity (AMS) has robust associations with psychopathology. As such, understanding the development of AMS (or its inverse, overgeneral autobiographical memory) and how it may be unique from other aspects of memory performance is important. In particular, it is unclear whether child AMS is distinct from autobiographical memory performance in other contexts, such as during mother–child reminiscing, and whether reduced AMS during early childhood is associated with emotional adjustment as found later in development. In this study, associations between children’s AMS and memory performance during mother–child reminiscing were evaluated. Moreover, the contributions of each type of child memory performance to child internalizing and externalizing symptoms were examined. Participants included 95 mother–child dyads drawn from a diverse, low-income community. Children’s ages ranged from 3.5 years to 6 years. Dyads participated in a joint reminiscing task about 4 past events, children participated in assessments of AMS, and mothers rated children’s emotional adjustment. Path analysis results indicated that children’s AMS was not significantly related to children’s unique memory contributions during reminiscing. Child AMS was negatively associated with emotional symptoms, whereas child memory during reminiscing was not.     

Using brief assessments to evaluate aberrant behavior maintained by attention

We examined the use of brief functional assessments to identify idiosyncratic variables associated with aberrant behavior maintained by positive reinforcement in the form of attention. Two participants with severe developmental disabilities and their parents were involved in the assessment and treatment evaluation process. A modified attention condition was introduced, which involved both parents interacting with a third person. Results of the assessment demonstrated that aberrant behavior occurred only in the modified attention condition for both participants. Treatment consisted of the parents delivering attention on a fixed-time schedule during this specific social context. Results indicated that the treatment reduced problem behavior. Follow-up evaluations with 1 participant indicated maintenance of treatment effects for up to 6 months.     

ANALYSIS OF THE EFFECTS OF TASK PREFERENCES,TASK DEMANDS,AND ADULT ATTENTION ON CHILD BEHAVIOR IN OUTPATIENT AND CLASSROOM SETTINGS

Two studies were conducted with children who displayed behavior problems to evaluate the effects of task preference, task demands, and adult attention on child behavior. In Study 1, we conducted brief functional analyses in an outpatient clinic to identify variables that facilitated appropriate behavior. For 8 of 10 children, distinct patterns of performance occurred; 3 children displayed improved behavior with changes in task demands, 1 child displayed improved behavior with a preferred task, and 4 children displayed improved behavior with changes in adult attention. In most cases, the children's parents carried out the assessments with adequate procedural integrity. In Study 2, we applied similar assessment methods to a classroom setting over an extended period of time. We identified independent variables controlling appropriate, on-task, and academic behavior for 2 children on two tasks, with slightly different treatment procedures across tasks for both children. In addition, the results of brief functional analyses for both children corresponded to the extended classroom assessments.     

Acceptability of Behavioral Family Therapy among Caregivers in China

In the U.S., helping the noncompliant child and parent child interaction therapy represent behavioral family therapy programs that are empirically supported for treating the conduct problems of 2- to 7-year old children. This study examined how caregivers in China would view behavioral family therapy. Caregivers in Hangzhou, China reported the perceived age of deviance for behavioral family therapy targets (e.g., noncompliance) and rated the acceptability of behavioral treatment components (e.g., timeout). Chinese caregivers agreed with European-American culture on considering noncompliance, aggression, tantrums, and negative talk deviant during the pre-school period. Overall, Chinese caregivers considered all the following nine behavioral family therapy components acceptable: contingent praise, responsive play, ignoring deviant attention seeking, authoritative instruction-giving, warnings, chair timeouts, ignoring tantrums during timeout, room backups for chair timeouts, and immediate timeouts for aggression. However, specific parental reservations were found regarding backup procedures for chair timeouts, particularly room backups. Possible treatment accommodations of behavioral family therapy for Chinese families are discussed.     

Maternal satisfaction with clinic-referred children: Assessment by use of a single-subject methodology

Prior research has indicated that maternal perception of or satisfaction with their children may be predicted by factors other than the child's behavior. The present study was designed to examine this issue further by using a single-subject methodology, improving the assessment procedures utilized, and increasing the number of predictor variables. It was hypothesized that factors other than child behavior would contribute to maternal satisfaction with the child but that the particular factor would vary across mothers. Two clinic-referred children and their mothers served as subjects. Prior to, during, and after treatment, the mothers completed a daily series of questionnaires to assess satisfaction with her child, daily child behavior, maternal depression, the marital relationship, and physical health. The results indicated that maternal satisfaction and maternal report of child behavior changed with treatment. The hypothesis was confirmed as physical health for one mother and the marital relationship for the second mother combined with child behavior to predict maternal satisfaction. Correlational analyses suggested that the maternal satisfaction with the child is related more to the child's negative behavior than positive behavior. The implications of the findings and of the methodology which was employed are discussed.     

Parenting contributors to early emerging problem behaviour in children of mothers in methadone maintenance treatment

This study explored whether variations in parenting provided by mothers with substance‐abuse disorders are related to behaviour problems in their young children and whether specific parenting practices are associated with specific types of behaviour problems. Mother‐reported and observational assessments were used to examine contributions of parenting behaviour and home environment to internalizing and externalizing behaviour problems in 150 preschool children of mothers receiving methadone‐maintenance treatment for heroin addiction. In multivariate analyses, mother‐reported child externalizing behaviour was related to greater maternal harshness and to mother history of illicit drug use during pregnancy but not other features of substance use and treatment history. Observer‐coded child internalizing behaviour was related to less maternal sensitivity and less provision of learning activities in the home. Additionally, mother report of her own psychopathology symptoms was related to mother‐reported, but not observer‐coded, child internalizing and externalizing problems. Findings suggest that women in substance abuse treatment should receive parenting interventions and that interventions should focus on increasing maternal sensitivity, reducing harshness, and providing children with cognitively stimulating environments. Findings also suggest that the need for attention to ongoing mental health problems of women in substance abuse treatment—both for their own well‐being and the well‐being of their children.

Highlights

• This study explored whether variations in parenting provided by mothers with substance‐abuse disorders are related to behavior problems in their young children.
• Maternal harshness was related to child externalizing behavior, low sensitivity, and low provision of learning opportunities to child internalizing problems.
• Findings suggest that women in substance abuse treatment should be provided access to parenting interventions.

     

Attention Problems as a Mediator of the Relation between Executive Function and Social Problems in a Child and Adolescent Outpatient Sample

Social functioning is critical for the successful navigation of everyday life for children, adolescents, and adults. Recent theories have postulated a neuropsychological basis for social functioning with particularly strong links with the executive functioning (EF) system. The current study examined attention problems as a mediator between EF (e.g., working memory, planning, and response inhibition) and social functioning in a child and adolescent outpatient sample. Participants were 218 children ages 6–16 (M = 10.23; SD = 2.52; 68.8 % males) who were referred to an outpatient clinic for psychoeducational assessment. Bias-corrected bootstrapping mediation analyses were used to examine the hypothesized models. The effects of working memory and planning (but not response inhibition) on social problems were mediated by attention problems in both teacher- and mother-reported models. These findings also held up in cross-source models (e.g., mother-reported attention problems as a mediator in a model predicting teacher-reported social problems). These findings have implications for dimensional models of social functioning and conceptual models for specific clinical populations (e.g., attention-deficit/hyperactivity disorder).     

Children’s Maternal Support-Seeking: Relations to Maternal Emotion Socialization Responses and Children’s Emotion Management

The present study examined children’s support-seeking of mothers (SSM) as a moderator of the association between maternal emotion socialization responses and children’s emotion management. Participants included 119 mother–child dyads (63 boys, M age = 9.61 years, 73.1 % Caucasian). Maternal emotion socialization was assessed via observed mother–child interactions and child report. Analyses indicated several main effects such that child-reported maternal reward responses were associated with stronger child emotion management, whereas perceived maternal punishment and neglect were associated with poorer child emotion management. Regarding the significant interactions, observed maternal general unsupportive socialization responses were negatively associated with emotion management. Additionally, for children low in SSM, child-reported maternal overriding of children’s emotions was positively associated with better emotion management. Support-seeking of mothers may mitigate the risk of some unsupportive maternal socialization responses and may be an adaptive strategy in middle childhood in particular contexts.     

Children Exposed to Intra-Familial Violence

Abstract

This investigation examined factors associated with attrition and retention within a sample of children with a history of intra-familial violence referred for outpatient services. The sample included 118 children, aged 4-17 years; of these 64% completed treatment, 20% did not engage in treatment and 16% terminated prematurely. Caregivers reporting high child-related parental distress (F(2, 32) = 3.9, p = 0.03) and high psychological distress (F(2, 70) = 3.3, p = 0.04) were less likely to engage in treatment. Making a child abuse report during assessment or treatment was not found to be associated with treatment engagement or attrition, χ² ₍₂₎= 0.4, p = 0.82. The implications of these findings for clinical practice and treatment outcome research are discussed.     

Inner-City Children Living with an HIV-Seropositive Mother: Parent–Child Relationships, Perception of Social Support, and Psychological Disturbance

Despite ongoing concern about the well-being of HIV-seronegative children living in urban poverty with a seropositive mother, very little is known about this expanding population of children. In this cross-sectional study, the psychosocial adjustment of 60 ethnic minority children 11 to 16 years of age who were living with an HIV-seropositive mother was compared with that of 108 children attending public school in the same community. Results of three multivariate analyses of covariance indicated that, after allowance for differences associated with age, gender, ethnicity, and family structure, the HIV-affected group confirmed (a) greater disturbance in the parent–child relationship, (b) less social support, and (c) greater disturbance in psychological functioning. Secondary analysis of the multivariate findings indicated that the differences were characterized primarily by (a) perception of more indifference and hostility in the mother–child relationship, (b) perception of less social support available from parents, friends, and teachers, and (c) less self-esteem. The findings suggest that HIV infection and concurrent problems may compromise parent–child relationships and perception of social support in ways that leave older, seronegative children living with an infected mother at risk for psychological disturbance.     

Functional Analysis Identified Habit Reversal Components for the Treatment of Motor Tics

This study included brief functional analyses and treatment for motor tics exhibited by two children with Tourette Syndrome. Brief functional analyses were conducted in an outpatient treatment center and results were used to develop individualized habit reversal procedures. Treatment data were collected in clinic for one child and in clinic and school for the other child. Brief functional analysis results were mixed for each child, but provided useful information for informing unique habit reversal components for each child. Treatment results indicated reductions in motor tics for each child. Results are discussed in terms of utility of functional analysis for tics.     

The disappointing gift: dispositional and situational moderators of emotional expressions

Inferences about emotions in children are limited by studies that rely on only one research method. Convergence across methods provides a stronger basis for inference by identifying method variance. This multimethod study of 116 children (mean age = 8.21 years) examined emotional displays during social exchange. Each child received a desirable gift and later an undesirable gift after performing tasks, with or without mother present. Children’s reactions were observed and coded. Children displayed more positive affect with mother present than with mother absent. Independent ratings of children by adults revealed that children lower in the personality dimension of Agreeableness displayed more negative emotion than their peers following the receipt of an undesirable gift. A curvilinear interaction between Agreeableness and mother condition predicted negative affect displays. Emotional assessment is discussed in terms of links to social exchange and the development of expressive behavior.     

French translation and validation of the Karitane Parenting Confidence Scale

IntroductionPerceived parental self-efficacy (PSE) is thought to play a crucial role in parental well-being, the parent-infant relationship, and other aspects of infant development, particularly in the early postnatal period. The Karitane Parenting Confidence Scale (KPCS) is a 15-item self-report questionnaire designed for parents with infants aged 0–12 months.ObjectiveTo explore the factor structure of a French translation of the KPCS and assess its psychometric qualities.MethodUsing a French-language translation of the KPCS (KPCS-F), 257 parents of children aged 0–12 months were recruited via childcare structures (e.g. nurseries, community centers, mother and child protection centers). Confirmatory factor analyses (CFA) were conducted to examine 2- and 3-factor solutions for the KPCS-F scale. Internal reliability and convergent validity were evaluated.ResultsThe best model was a two-factor solution (PSE “infant care” and PSE “parental role”) restricted to 12 items. Sound internal consistency was indicated, with a Cronbach's alpha coefficient of 0.80 and a McDonald's omega coefficient of 0.80. Test-retest reliability was good. KPCS-F score was correlated with social support and psychological well-being scores.ConclusionThe KPCS-F showed substantial validity and reliability for this sample. The translated scale should therefore improve assessment and intervention processes for professionals working with parents of young children.     

Multiple Victimization of Children

Abstract

The authors identify three areas of empirical and clinical scholarship that need further attention in the area of multiple victimization of children. These include assessment of multiple victimization, assessment of additional sources of adversity in the child's environment, and the creation and use of developmentally appropriate, theoretically driven measures of child outcome. This is the last article in an edited book on multiple victimization of children that focuses on research and treatment issues from a developmental perspective.     

Child-Directed Interaction: Prediction of Change in Impaired Mother–Child Functioning

The first phase of parent–child interaction therapy (PCIT), called child-directed interaction, teaches parents to use positive and differential social attention to improve the parent–child relationship. This study examined predictors of change in mother and child functioning during the child-directed interaction for 100 mother–child dyads. The children were 3–6-years-old and diagnosed with oppositional defiant disorder. After establishing that significant improvements occurred in mother report of child disruptive behavior, parenting stress, and parenting practices, these three variables were combined to form a latent impaired mother–child functioning construct. Structural equation models were examined using maternal demographic and psychosocial variables as predictors of impaired mother–child functioning before and after the child-directed interaction. Mothers’ self-reported daily hassles and depressive symptomatology predicted 74% of variance in impaired mother–child functioning before treatment. Mothers’ report of social support predicted impaired mother–child functioning after the child-directed interaction, with 57% of the variance accounted for in this longitudinal model. These findings suggest the importance of improving maternal social support during the initial phase of PCIT.