Normal versus deviant children

The present study investigated differences between referred and nonreferred children and their families on the basis of home and clinic observations and parent questionnaires. Subjects were 28 families with children between 4 and 8 years of age who had been referred to a clinic for actingout behavior and 28 nonreferred controls matched on several variables. Home observation results indicated that referred children showed significantly more deviant behavior and less prosocial behavior than nonreferred children and that their parents emitted more negative and commanding behavior in contrast to the control group. Systematic observation in the clinic revealed significant differences only in parent negativeness and number of commands. Finally, all five factors of the parent attitude questionnaire yielded large and significant differences between groups. There was considerable overlap between groups on all behavior variables but less overlap on the parent attitude measure. Results from a stepwise discriminant analysis classified 90% of referred children and 90% of nonreferred children correctly on the basis of the parent attitude variable alone. Taken together, these results suggest that child behavior is not always the critical variable in referral and stress the importance of multiple assessment procedures for child-family problems when children are referred for treatment.This research was supported by National Institute of Mental Health Grant MH 19633. The authors would like to express their appreciation to Sheila Eyberg and Orin Bolstad, who assisted in the completion of various aspects of this work.     

Parent-Child Interactions Among Low-Income Mexican American Parents and Preschoolers: Do Clinic-Referred Families Differ From Nonreferred Families?

This study compared low-income Mexican American parents of young children referred for behavior problems to their nonreferred counterparts on an observational measure of parent-child interactions. Referred Mexican American parents demonstrated more negative behaviors than their nonreferred counterparts in both nondirective and highly directive situations. However, no differences were found at moderate levels of directiveness. The most and least directive situations in the Dyadic Parent-Child Interaction Coding System best differentiated referred from nonreferred Mexican American families, and families differed more in their negative behaviors than positive behaviors. Many of the parenting behaviors that have been found to differ between referred and nonreferred Caucasian families were also observed to differ between their Mexican American counterparts.     

THE ADAPTATION AND STANDARDIZATION OF THE TEACHER VERSION OF THE CHILD BEHAVIOR PROFILE: TURKISH BOYS AGED 7–12

This article reports on the adaptation and standardization of the teacher version of the Child Behavior Profile for boys aged 6–11 to Turkish boys aged 7–12. Data were obtained from 48 referred and 294 nonreferred boys. Comparison of referred and nonreferred samples showed significant differences on all behaviour problem scores, except the ‘Anxious’ scale. The median of the Cronbach internal consistency of the scale scores was 0.75.     

The role of fathers in child and adolescent psychopathology: make room for daddy.

This review summarizes research concerning the relation between paternal factors and child and adolescent psychopathology. When compared with mothers, fathers continue to be dramatically underrepresented in developmental research on psychopathology. However, findings from studies of children of clinically referred fathers and nonreferred samples of children and their fathers indicate that there is substantial association between paternal characteristics and child and adolescent psychopathology. Findings from studies of fathers of clinically referred children are stronger for fathers' effects on children's externalizing than internalizing problems. In most cases the degree of risk associated with paternal psychopathology is comparable to that associated with maternal psychopathology. Evidence indicates that the presence of paternal psychopathology is a sufficient but not necessary condition for child or adolescent psychopathology.     

Comparing Television Use and Reading in Children With ADHD and Non-Referred Children Across Two Age Groups

There has been abundant speculation, but very little research, concerning the role of television in the lives of children with attention deficit hyperactivity disorder (ADHD). This study compared the use of television and other media in samples of children with ADHD and nonreferred children. Children with ADHD were reported to watch more television, a difference partially accounted for by demographic and environmental characteristics. Children with ADHD were also reported to enjoy television more and have greater involvement in television-related activities, and to enjoy reading less and be less involved in reading-related activities. However, there were no diagnostic group differences in reports of weekly reading, and weekly reading was unrelated to television viewing in children with ADHD. Results suggest a complex relation between television viewing and ADHD not recognized in previous research and popular commentary, and suggest that research on children with ADHD's television use should consider environmental and developmental contexts.     

Family demographics of clinically referred children: What we know and what we need to know

Published empirical studies were reviewed to establish family demographics of clinically referred children and adolescents. Data on parental marital status were collected from studies of referred and nonreferred children and adolescents in six empirical journals. Data on family socioeconomic status (SES) and child race or ethnicity were also collected. Based on 86 studies that presented parental marital status, 56.4% of clinically referred children and adolescents live with both their biological mother and biological father. Family SES data were difficult to summarize because of the different methods of presenting this information. When considering race and ethnicity, 86% of the children and adolescents in the clinical samples were Caucasian American. Of the studies that were originally reviewed, 80.4% did not include parental marital status and 36. 7% did not include SES, race, or ethnicity of the participants. There were no significant differences between journals in the rates of inclusion of family demographic data. In addition to revealing family demographic information about children and adolescents who participate in clinical research, these data highlight the lack of consistency in the presentation of family demographic data in published research. Suggestions are provided to help researchers colled and present meaningful family demographic data in clinical and nonclinical research with children and adolescents.This study was completed with support from the Division of Sponsored Research at the University of South Florida and preparation of this article was supported in part by National Institute of Mental Health Grant R29 49601-02 to the first author. We express our gratitude to Georgetta Bosco and Tracy Burbine for their diligent data collection in the library.     

What Do Youth Referred for Anxiety Problems Worry About? Worry and Its Relation to Anxiety and Anxiety Disorders in Children and Adolescents

This study examined worry and the parameters of worry that may be associated with clinical anxiety in a sample of 119 children and adolescents referred to a childhood anxiety disorders specialty clinic. Using an interviewing procedure, results indicated that the types of worries reported by the children were similar to those reported in previous studies of nonreferred community children. Also similar to previous community studies were findings showing moderate but significant correlations between different indices of worry (i.e., number, intensity, and frequency of the worries) and children's scores on self-rating scales of anxiety. Results further indicated that worry contributed additional variance beyond that of anxiety in predicting fear. In addition, intensity differentiated clinic children's worries from nonreferred children's. Intensity, and number of worries differentiated subsamples of children within the clinic-referred sample (i.e., children with overanxious disorder or generalized anxiety disorder and children with simple phobia). The importance of examining children's worries to further understand anxiety and its disorders in youth is discussed.     

Teacher Ratings of Hyperactivity, Inattention, and Conduct Problems in Preschoolers

Age and sex norms of classroom behavior in preschoolers were established on a standard measure, the Revised Conners Teacher Rating Scale, and the utility of this measure for assessing problem behavior in preschoolers was examined. Teachers provided ratings for 455 nonreferred preschoolers. In addition, ratings were obtained for 12 clinically referred preschoolers diagnosed with attention deficit hyperactivity disorder. The Conduct Problems, Inattention, and Hyperactivity subscales, as well as the Hyperactivity Index, were found to have good internal reliability and were related to each other in predictable ways. Normative data are presented by age and sex. Age was inversely related to scores for the Conduct Problems subscale, the Hyperactivity subscale and the Index. Sex was a significant predictor of subscale scores, with boys receiving higher scores than girls. Subscale scores and nearly all item scores were highly significantly different between clinically referred and nonreferred preschoolers. The results provide a standard upon which to evaluate preschool-aged children in clinical and research settings.     

A preliminary study of the emotion understanding of youths referred for treatment of anxiety disorders

Examined the emotion understanding of children and adolescents referred for treatment of Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) anxiety disorders (separation anxiety disorder, generalized anxiety disorder, or social phobia). Referred youths (n = 17) and nonreferred youths (n = 21) and their parents participated by completing self-report and parent-report questionnaires and structured diagnostic interviews. We interviewed all youths by using an emotion understanding interview. Referred youths demonstrated poorer understanding of hiding emotions and changing emotions compared with nonreferred youth. The 2 groups were not significantly different regarding their understanding of emotion cues and multiple emotions, however. No statistically significant relation emerged between general intelligence and emotion understanding. Future research directions are discussed.     

The Emotional Development Scale: Assessing the Emotional Capacity of 4–12 Year Olds

The practice of assessing children’s emotional development based on a theoretical foundation of attachment theory, developmental psychology, and brain research is fast developing within the field of clinical psychology and family social work. The Emotional Development Scale (EDS) has been developed to assess the current emotional functioning level of 4–12 year olds within the theoretical framework of neuroaffective developmental psychology. Included in the pilot study were eight family treatment centers in Denmark, with 36 families participating. The psychometric investigation included analyses of interrater reliability, test-retest reliability, and internal consistency, while construct validity was analyzed by correlating EDS results between referred and nonreferred groups. The analysis between nonreferred and referred groups was based on the data from the empirical study and a preliminary ad hoc sample from Hogrefe Ltd. (n = 213). We concluded the EDS appears to be a reliable and partially valid tool that could aid in assessing the emotional development of 4–12 year olds. Further research on psychometric properties and clinical application of EDS is needed.     

Are American children's problems still getting worse? A 23-year comparison

Child Behavior Checklists were completed in home interviews by parents of 7–16-year-olds in 1976, 1989, and 1999. Competence scores decreased from 1976 to 1989, but increased in 1999. Problem scores increased from 1976 to 1989 and decreased in 1999 but remained higher than in 1976. Items, empirically based scales, and DSM-oriented scales showed similar patterns for demographically similar nonreferred samples assessed in 1976, 1989, and 1999 and for national samples that included referred children assessed in 1989 and 1999. For the 114 problem items that were common to the 1976, 1989, and 1999 assessments, the Q correlation was .98 between the mean scores on the 114 items in 1976 versus 1989 and was .94 between the mean scores on the 114 items in 1976 vs. 1999. This indicated very high stability in the rank ordering of item scores across intervals up to 23 years. For all children, the 1-year prevalence rate for mental health services use was 13.2% in 1989 versus 12.8% in 1999. For children with deviant Total Problems scores, the 1989 prevalence for service use was 30.5 versus 26.6% in 1999. Neither difference was statistically significant.     

A Brief Parent Rating Scale for Assessing Young Children's Adjustment

This report describes the development of the Parent Rating Scale (PRS), a 20-item scale for use by parents in rating the adjustment of young normal children. Based on the responses of 416 parents of urban and suburban 2nd and 3rd grade children, a principal components factor analysis with varimax rotation yielded a 4-factor solution accounting for 48.3% in total variance. Low to moderate relationshps were found between PRS scores and teacher, self, and sociometric ratings fo children. PRS total and factor and total scores discriminated clearly between referred and nonreferred children. Suburban children had higher PRS scores than urban children and girls had higher scores than boys.     

Hand test AGG and AOS variables: relation with teacher rating of aggressiveness

The purpose of this study was to determine the extent to which the Hand Test (Wagner, 1983) variables Aggression (AGG) and the Acting Out Score (AOS) were able to differentiate a group of children who were identified as aggressive and referred for psychological assessment by their teachers from a nonreferred, control group. Hand Test scores of 37 children who had consecutive referrals for psychological assessment because of aggressiveness were compared to the Hand Test scores of 37 children, matched on age and sex, from a nonreferred group. Through the use of an analysis of variance, AOS and AGG were found to significantly differentiate between the two groups. Spearman (rho) correlations between AGG and AOS scores with aggressive-referred status were rho = .45, p = .0001, and rho = .32, p = .006, respectively. Also, diagnostic efficiency statistics demonstrated moderate to high overall correct classification rates for AOS > or = 0 and AGG > or = 2 in identifying children in the aggressive-referred group. The results of this study provide support for the validity of the AGG and AOS scores in the assessment of aggressive behavior in children and demonstrate the utility of the Hand Test to identify aggressive tendencies in children.     

Learning disability as related to infrequent punishment and limited participation in delay of reinforcement tasks

By comparing for learning disabled and control children parental frequency ratings of physical punishment and of completing household tasks, this experiment tested the hypothesis that parental indulgence is associated with learning disorders. Referral children with learning problems (N=18), matched on grade and sex with those in two control groups, were rated significantly lower on both measures than were either the students referred for other reasons or the nonreferred students. The infrequent punishment suggests that some children have learning problems because of a failure to acquire adequate response inhibition tendencies, which are necessary to control inappropriate behaviors resulting from the ineffective classroom positive reinforcement system. Furthermore, the lower responsibility index suggests some of their academic problems result from limited experiences functioning under delayed reinforcement.     

The Relationship Between Sluggish Cognitive Tempo,Subtypes of Attention-Deficit/Hyperactivity Disorder,and Anxiety Disorders

The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7–13 years were assigned to four groups, i.e., referred children with comorbid AnxDs and ADHD (n = 25), ADHD (n = 39), AnxDs (n = 41), and nonreferred controls (n = 36). Furthermore we explored the association between SCT and several neurocognitive measures (reaction time, verbal memory, and spatial memory). Diagnoses were established using Kiddie-SADS P/L. SCT was assessed using a 17-item mother-reported questionnaire. SCT correlated significantly with inattentiveness, regardless of the subtype of ADHD. Furthermore, we found significant differences in the levels of SCT among the four groups, with the highest SCT scores observed in the comorbid group. SCT correlated with variability in spatial memory; in contrast, there was no correlation between SCT and reaction time.     

The Relation of Story Structure Properties to Recall of Television Stories in Young Children with Attention-Deficit Hyperactivity Disorder and Nonreferred Peers

In this study, the authors examined memory for televised stories to gain insight into similarities and differences in story comprehension between young children with attention-deficit hyperactivity disorder (ADHD) and their typical peers. In particular, the authors investigated the extent to which 4- to 6-year-old children's free recall of story events is predicted by several structural properties of story events (number of causal connections, whether an event is on or off the story's causal chain, story-grammar category, and position in the story's hierarchical structure), whether differences exist between children with ADHD and nonreferred comparison children in their sensitivity to structural features of stories, and whether age differences in sensitivity to structural features are similar for both groups. For both groups, recall of story events was predicted by all four structural properties, but the effects of the two causal properties was stronger for comparison children than for children with ADHD. Further examination revealed that this difference was observed only when a competing activity was available during television viewing. These findings indicate that both groups of preschool children are able to benefit from causal structure when recalling television stories, but that children with ADHD lose this benefit when attention is divided. Consistent with previous findings for nonreferred children (P. W. van den Broek, E. P. Lorch, & R. Thurlow, 1996), in both diagnostic groups the effects of causal properties increased across age, and older children were more likely to include causally important protagonists' goals in their recalls than younger children.     

Callous-unemotional traits and developmental pathways to severe conduct problems

One method for defining pathways through which children develop severe conduct problems is based on the presence or absence of callous-unemotional (CU) traits. This study investigated potential differences between nonreferred children (mean age = 12.36 years; SD = 1.73) with and without CU traits (n = 98). Children with conduct problems, irrespective of the presence of CU traits, tended to have significant problems in emotional and behavioral regulation. In contrast, CU traits, irespective of the presence of conduct problems, were associated with a lack of behavioral inhibition. Hostile attributional biases were associated with conduct problems but only in boys and in the absence of CU traits. These findings suggest that the processes underlying deficits in emotional and behavioral regulation in children with conduct problems may be different for children with CU traits.     

Analogue Measures of DSM-IV Mood and Anxiety Disorders Based on Behavior Checklists

Although symptom checklists are commonly used to assess childpsychopathology, confusion arises due to differences between empirically derived checklist syndromes and rationally derived DSM-IV diagnostic categories. This paper explores analogue measures of DSM-IV mood and anxiety disorders created using items from the Youth Self-Report and Child Behavior Checklist (T. M. Achenbach, 1991a, 1991b) that parallel DSM-IV symptoms. In a matched sample of clinically referred and nonreferred adolescents, analogue measures demonstrated expected patterns of age differences, sex differences, and comorbidity. Meeting criteria for an analogue diagnosis was also associated with referral for mental health services and poor social competence. Informant effects are highlighted and the potential benefits and limitations of using existing behavior checklists to assess DSM disorders are discussed. These findings suggest the utility of checklists in identifying analogues of anxiety and mood disorders in children and adolescents.     

Extending the spectrum idea: child personality,parenting and psychopathology

The spectrum hypothesis, postulating that differences between referred and non‐referred samples are confined to mean level differences, is elaborated by exploring whether the covariation between child problem behaviour and its predictors—child personality and parenting, rated by mothers—is similar in referred (N = 205) and non‐referred (N = 596) children and whether personality by parenting interactions can be generalized across samples. Results showed significant mean level differences for all the variables. Both personality and parenting explained problem behaviour, with some differences in strength of the effects across samples. Parenting by personality interactions mainly predicted externalizing behaviour, with benevolence and conscientiousness as the most prominent moderators. Results confirmed that moderators of problem behaviour operate similarly in the two samples, thus corroborating the spectrum hypothesis. Copyright © 2006 John Wiley & Sons, Ltd.