Beyond behavior modification: Benefits of social–emotional/self-regulation training for preschoolers with behavior problems

The current study evaluated the initial efficacy of three intervention programs aimed at improving school readiness in preschool children with externalizing behavior problems (EBP). Participants for this study included 45 preschool children (76% boys; M_age = 5.16 years; 84% Hispanic/Latino background) with at-risk or clinically elevated levels of EBP. During the summer between preschool and kindergarten, children were randomized to receive three newly developed intervention packages. The first and most cost effective intervention package was an 8-week School Readiness Parenting Program (SRPP). Families randomized into the second and third intervention packages received not only the weekly SRPP, but children also attended two different versions of an intensive kindergarten summer readiness class (M-F, 8 a.m.–5 p.m.) that was part of an 8-week summer treatment program for pre-kindergarteners (STP-PreK). One version included the standard behavioral modification system and academic curriculum (STP-PreK) while the other additionally contained social–emotional and self-regulation training (STP-PreK Enhanced). Baseline, post-intervention, and 6-month follow-up data were collected on children's school readiness outcomes including parent, teacher, and objective assessment measures. Analyses using linear mixed models indicated that children's behavioral functioning significantly improved across all groups in a similar magnitude. Children in the STP-PreK Enhanced group, however, experienced greater growth across time in academic achievement, emotion knowledge, emotion regulation, and executive functioning compared to children in the other groups. These findings suggest that while parent training is sufficient to address children's behavioral difficulties, an intensive summer program that goes beyond behavioral modification and academic preparation by targeting socio-emotional and self-regulation skills can have incremental benefits across multiple aspects of school readiness.     

Parenting Stress through the Lens of Different Clinical Groups: a Systematic Review & Meta-Analysis

Research has demonstrated an association between parenting stress and child behavior problems, and suggested levels of parenting stress are higher among parents of children at risk for behavior problems, such as those with autism and developmental delay (ASD/DD). The goal of the present study was to conduct a systematic review of parenting stress and child behavior problems among different clinical groups (i.e., ASD/DD, chronic illness, with or at-risk for behavioral and/or mood disorders). We also examined demographic and methodological variables as moderators and differences in overall levels of parenting stress between the clinical groups. This systematic review documents a link between parenting stress and child behavior problems with an emphasis on externalizing behavior. One-hundred thirty-three studies were included for quantitative analysis. Parenting stress was more strongly related to child externalizing (weighted ES r = 0.57, d = 1.39) than internalizing (weighted ES r = 0.37, d = 0.79) problems. Moderation analyses indicated that the association between parenting stress and behavior problems was stronger among studies which had mostly male and clinic-recruited samples. Overall, parenting stress levels were higher for parents of children with ASD/DD compared to parents of children from other clinical groups. Findings document the association between parenting stress and child behavior problems and highlight the importance of assessing parenting stress as part of routine care and throughout behavioral intervention programs, especially for groups of children at high risk for behavior problems, such as children with ASD/DD, in order to identify support for both the parent(s) and child.     

Improving School Readiness in Preschoolers with Behavior Problems: Results from a Summer Treatment Program

To examine a) the feasibility of delivering a summer treatment program for pre-kindergarteners (STP-PreK) with externalizing behavior problems (EBP) and b) the extent to which the STP-PreK was effective in improving children’s school readiness outcomes. Participants for this study included 30 preschool children (77 % boys; Mean age?=?5.33 years; 77 % Hispanic background) with at-risk or clinically elevated levels of EBP. The STP-PreK was held at an early education center and ran for 8-weeks (M-F, 8 a.m.–5 p.m.) during the summer between preschool and kindergarten. In addition to a behavioral modification system and comprehensive school readiness curriculum, a social-emotional curriculum was also embedded within the STP-PreK to target children’s self-regulation skills (SR). Children’s pre- and post-school readiness outcomes included a standardized school readiness assessment as well as parental report of EBP, adaptive functioning, and overall readiness for kindergarten. SR skills were measured via a standardized executive functioning task, two frustration tasks, and parental report of children’s emotion regulation, and executive functioning. The STP-PreK was well received by parents as evidenced by high attendance and satisfaction ratings. Additionally, all school readiness outcomes (both parent and observational tasks) significantly improved after the intervention (Cohen’s d effect sizes ranged from 0.47 to 2.22) with all effects, except parental report of emotion regulation, being maintained at a 6-month follow-up. These findings highlight the feasibility and utility of delivering an early intervention summer program that can successfully target multiple aspects of children’s school readiness, including behavioral, social-emotional/self-regulation, and academics.     

The Psychosocial Construction of Parenting: An Examination of Parenting Goals and Narratives in Relation to Well-Being

In two studies, we examined the implications psychosocial constructions of parenting hold for an understanding of well-being. In studies 1 (N = 504) and 2 (N = 98) participants provided a list of personal goals and narratives about the experience of becoming parents, respectively. In both studies, measures of well-being were also completed. Goals were categorized on the basis of whether they contained reference to parenting as well as agentic and communal motivation, whereas stories were coded for themes of exploration and resolution. In Study 1, the proportion of parenting goals related positively with well-being, although this effect was rendered non-significant after accounting for the communal motivation of parenting goals. In Study 2, themes of exploration and resolution in parents’ narratives positively predicted well-being. Collectively, these results provide intimation of parenting’s “meaningfulness” within the current socio-cultural context.     

The Role of ADHD and Negative Emotional Lability in Predicting Changes in Parenting Daily Hassles

The present study examined the extent to which children’s negative emotional lability (measured via ecological momentary assessment—EMA) and ADHD diagnostic status predicted changes in the frequency of daily parenting hassles and the stress resulting from daily hassles at one-week follow-up when controlling for baseline parenting hassles. Parents of 84 children 8–12 years-old (47 with ADHD, 37 without ADHD) completed a measure of parenting daily hassles at baseline and follow-up and participated in EMA assessment protocol ratings of their child’s mood (3-times daily) for one week. Analyses of covariance indicated that parents of children with ADHD reported significantly greater frequency of daily parenting hassles and intensity of parenting stress resulting from daily hassles than parents of children without ADHD at baseline and follow-up. Hierarchical regression analyses suggested that children’s negative emotional lability was a significant predictor of the intensity of parenting stress resulting from daily hassles, but not the frequency of daily parenting hassles. There was also an interaction of ADHD diagnostic status and greater EMA-derived negative emotional lability in the prediction of the frequency of daily parenting hassles due to children’s challenging behaviors. Specifically, greater negative emotional lability predicted more frequent daily parenting hassles due to children’s challenging behaviors among parents of children without ADHD but not among parents of children with ADHD. Overall, this study suggests that children’s negative emotional lability is a significant predictor of aspects of daily parenting hassles across parents of children with and without ADHD.     

The Association of Parent Mindfulness with Parenting and Youth Psychopathology Across Three Developmental Stages

The primary purpose of the current study was to test a model examining the process by which parent dispositional mindfulness relates to youth psychopathology through mindful parenting and parenting practices. The universality of the model across youth at three developmental stages was examined: young childhood (3–7 years; n?=?210), middle childhood (8–12 years; n?=?200), and adolescence (13–17 years; n?=?205). Overall, participants were 615 parents (55 % female) and one of their 3-to-17 year old children (45 % female). Parents reported on their dispositional mindfulness, mindful parenting, positive and negative parenting practices and their child’s or adolescent’s internalizing and externalizing problems. Consistent findings across all three developmental stages indicated that higher levels of parent dispositional mindfulness were indirectly related to lower levels of youth internalizing and externalizing problems through higher levels of mindful parenting and lower levels of negative parenting practices. Replication of these findings across families with children at different developmental stages lends support to the generalizability of the model.     

Family Cohesion and Adaptation in Pediatric Chronic Conditions: The Missing Link of the Family’s Condition Management

The quality of family functioning has been considered an important predictor of adaptation in children with chronic conditions and their parents. Previous research suggests that beyond general family functioning, the specific experience of the family’s condition management is paramount for understanding family members’ adaptation. This study’s first goal was to compare family functioning and parents’ and children’s adaptation outcomes across four chronic conditions: asthma, diabetes, epilepsy, and obesity. Secondly, we explored the mediating role of family life difficulties and parental mutuality, as two potential paths through which family cohesion is linked to family members’ adaptation. A total of 263 parents of children (3–19 years old) with asthma (n = 77), obesity (n = 79), epilepsy (n = 52) and diabetes (n = 55) completed self-report measures of family cohesion, family life difficulty, parental mutuality, anxiety and depressive symptoms, and their children’s health-related quality of life (HrQoL). The results showed that families of children with diabetes, obesity, and epilepsy were at higher risk of experiencing family difficulties and children’s deteriorated HrQoL when compared to families of children with asthma. With regard to the links among study variables, although family cohesion had both a direct and indirect relationship with parental depressive symptoms, its links with parental anxiety symptoms and children’s HrQoL were only indirect, through family life difficulty. These associations were consistent across the four clinical groups. These findings emphasize the relevance of family-centered interventions aimed at promoting family cohesion, parents’ mutuality, and effective coping with the demands of pediatric chronic conditions.     

In the Eye of the Beholder? Parent-Observer Discrepancies in Parenting and Child Disruptive Behavior Assessments

This study examined parent-observer discrepancies in assessments of negative child behavior and negative parenting behavior to shed more light on correlates with these discrepancies. Specifically, we hypothesized that informant discrepancy between observers and parents on child behavior would be larger when parents reported high levels of negative parenting (and vice versa) because high levels of these behaviors might be indicators of negative perceiver bias or patterns of family dysfunctioning. Using restricted correlated trait–models, we analyzed cross-sectional observation (coded with the Dyadic Parent-Child Interaction Coding System) and survey data (Eyberg Child Behavior Inventory and Parenting Practices Interview) of 386 Dutch parent-child dyads with children aged 4–8 years (M_age = 6.21, SD?=?1.33; 55.30% boys). Small associations between parent-reported and observed child and parenting behavior were found, indicating high discrepancy. In line with our hypothesis, this discrepancy was higher when parents self-reported more negative parenting or more negative child behavior. Parent-observer discrepancy on negative child behavior was also predicted by child gender. For boys parents reported higher levels of negative child behavior than were observed, but for girls parents reported lower levels of negative child behavior than were observed. These findings suggest that informant discrepancies between observers and parents might provide important information on underlying, problematic family functioning and may help to identify those families most in need of help.     

Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT

This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7–14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.     

Feasibility and Preliminary Efficacy of an Internet Support Group for Parents of a Child with Neurofibromatosis Type 1: a Pilot Study

This pilot study investigated the feasibility and preliminary efficacy of an Internet Support Group (ISG) for parents of children with NF1. Eligible parents were recruited by email and completed baseline questionnaires assessing social support, self-efficacy, depression, and anxiety. The ISG involved eight weekly 90-min chat sessions and a discussion forum open 24 h/day for 8 weeks. Follow-up measures were completed immediately post-intervention and 3 months later. Parents from 33 families (29 mothers, 4 fathers) completed baseline measures. Over half of parents (52 %) rated their child’s disease severity as mild, 33 % moderate, and 15 % severe. Among 21 parents who completed post-intervention measures, ratings of perceived emotional (p = .0008) and informational (p = .0003) support increased. There were no significant changes in self-efficacy, depression, or anxiety (ps > .05). The mean satisfaction rating was moderately high (7.6/10; range 4–10). Some parents commented that the chat sessions were at inconvenient times, which may have limited participation. Preliminary evidence in this small sample of parents suggests that ISGs may be a feasible and potentially efficacious method of providing support to parents of children with NF1. Having multiple weekly chat sessions held at various days and times may improve accessibility and participation. Clinicians are encouraged to help parents access online support resources.     

Effects of Parent Training on Callous-Unemotional Traits,Effortful Control,and Conduct Problems: Mediation by Parenting

Callous-unemotional (CU) traits and effortful control (EC) are personality and temperament traits implicated in early-onset antisocial trajectories. This secondary analysis of Hitkashrut’s randomized controlled trial first tested parent training’s effects on EC and CU traits while controlling for more general treatment effects on conduct problems (CP), and subsequently tested mediation by parenting. Prekindergarten teachers in three Israeli cities identified 209 3–5 year-old (163 boys; 46 girls) preschoolers with subclinical-clinical range conduct problems. All participants were Jewish ranging from ultra-orthodox to secular. They were assigned to 14-session co-parent training groups (n = 140 couples), or to minimal intervention control groups with referral to local services as necessary (n = 69 couples). We employed averaged indices of pre- and post-intervention questionnaires completed by both parents. The testing of all hypothesized models controlled for treatment effects on CP in order to strengthen the robustness of the analyses. We found significant concurrent treatment effects on CP and on either CU traits or EC. All effects were mediated by ineffective parenting (IP): a latent variable that was indicated by negative/inconsistent practices and perceived parenting inefficacy. This is the first demonstration of parenting mediated treatment effects on both EC and CU traits in a randomized controlled study conducted in everyday practice contexts. This finding supports a disruption model of change: the reduction of IP facilitates a caregiving environment that affects children’s behavior and developing personality. The changing of personality and temperament characteristics implicated in early-onset pathways suggests an innovative prevention strategy for disruptive behavior disorders.     

When a Non-resident Worker is a Non-resident Parent: Investigating the Family Impact of Fly-In,Fly-Out Work Practices in Australia

Non-resident work practices, which involve prolonged separations from family, long-distance commuting between home and remote work sites and long work hours across compressed rosters, are now commonplace in Australia. This study examined the impact of these work arrangements, often termed Fly-In/Fly-Out (FIFO), on children and families, and to identify family-related and employment-related factors that influence child and family outcomes. Anonymous online surveys containing measures of family and couple relationship quality, child behavioral and emotional adjustment, parenting and personal adjustment were completed by 232 partners of FIFO workers, 46 FIFO workers, and a comparison group of community parents (N = 294 mothers, N = 36 fathers). There were no differences between FIFO partners and community parents on family or couple relationship quality, parenting competence and child behavioral or emotional difficulties. FIFO partners reported higher levels of personal emotional problems and greater usage of harsh discipline practices than community mothers, while FIFO workers reported greater work to family conflict and alcohol use than community fathers. Regression analyses on the FIFO partners sample indicated that child and family functioning were best predicted by family factors, including harsh parenting and parental emotional adjustment. Implications of the findings for the design and provision of family-based support for FIFO families are discussed.     

Strengths and Subjective Wellbeing in Adolescence: Strength-Based Parenting and the Moderating Effect of Mindset

Recent research suggests that strength-based parenting—the tendency for parents to see and encourage children to use their strengths—relates to lower stress and higher life satisfaction in adolescents. The current study tests whether strength-based parenting, in conjunction with a teenager’s strengths use, influences the teenager’s subjective wellbeing, and whether a growth mindset moderates the relationship between strength-based parenting and strengths use. Three hundred and sixty three adolescents (M _age = 13.74, 51% female) completed questionnaire measures of strength-based parenting, strengths use, subjective wellbeing (life satisfaction, positive affect, and negative affect), Extraversion, Neuroticism, and two aspects of growth mindset. A hierarchical regression using latent variables found that strengths use and strength-based parenting were both significant independent predictors of subjective wellbeing, over and above the effects of extraversion and neuroticism. A mediation analysis found that strengths use partially mediated the relationship between strength-based parenting and subjective wellbeing. Finally, a novel measure of strengths mindset significantly moderated the relationship between strength-based parenting and strengths use. These results suggest that adolescents who see their parents as strength-based report greater strengths use (especially when they have a growth mindset about their strengths) and greater subjective wellbeing.     

Treatment Response among Preschoolers with EBP: The Role of Social Functioning

The purpose of the study was to identify profiles of social functioning for preschoolers with externalizing behavior problems (EBP) and examine how profiles are predictive of response to a behavioral treatment program. 139 preschoolers with EBP participated in an 8-week Summer Treatment Program for Pre-Kindergartners (STP-PreK). Latent profiles of social functioning were created from parent and teacher rated atypicality and social skills scales, along with child performance on an emotion knowledge and hostile attribution task. Baseline and treatment outcomes included behavioral, academic, and executive functioning measures. Latent profile analyses resulted in two profiles (e.g., average and low) marked by differences in social skills, emotion knowledge and rates of atypical behaviors. Children in the low social functioning group had higher teacher rated hyperactivity and attention problems at baseline (d?=?.44 & 1.07), as well as lower IQ (d?=?.39). Children in the low social functioning group also had poorer treatment response as they had lower executive functioning scores (β?=??.17, p?< .05) at the completion of treatment. IQ moderated the association between social functioning profiles and behavioral treatment outcomes, such that lower social functioning was only associated with higher rates of attention problems for children with average IQ. Findings highlight the differential impact of social functioning in predicting treatment outcomes.     

Mediators and Moderators of the Relation between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms

The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children’s ADHD.     

Examining the Efficacy of Online Administration of a Time-Limited School Readiness Intervention in the Face of COVID-19

Although the efficacy of online administration of behavioral parent training (BPT) programs is well-established, such programs address a single risk factor (behavioral functioning) for school readiness difficulties (comprised of academics, cognitive skills, and social, emotional, and behavioral functioning). The current study aims to examine the feasibility, acceptability, and efficacy of a telemedicine delivery of the School Readiness Parenting Program (SRPP), an integrative adaptation of PCIT designed to address the behavioral and academic domains of school readiness. The present study takes the first step towards validating an online administration of the SRPP as a treatment for early childhood disruptive behavior. Data were collected for 64 children ages 2–6 years (M^age = 4.63, SD = 0.86; 78.1% Hispanic/Latinx) and their families, who received either in-person administration of time-limited PCIT (PCIT-TL; n=30) or online administration of SRPP (n=34). A series of repeated measures ANOVAS were conducted to examine within and between group effects. Results revealed that both SRPP and PCIT-TL significantly reduced inattention (d’s = −0.54 to −0.88), aggression (d’s = −0.55 to −1.06), and behavioral symptomology (d’s = −0.55 to −0.85) and produced significant gains in parental skills (d’s = −1.47 to 2.99). Notably, online SRPP demonstrated greater improvement in positive parental verbalization, whereas PCIT-TL demonstrated greater reductions in parental stress. Overall, findings support the utility of online SRPP for addressing behavioral school readiness concerns.     

Parenting Style and Children’s Life Satisfaction and Depressive Symptoms: Preliminary Findings from Romania,France, and Russia

This study evaluated how culture relates to parenting and children’s life satisfaction and depressive symptoms, and whether there are cultural differences in how maternal parenting style relates to children’s adjustment among three cultural contexts: Romanian, Russian, and French. The sample included 325 children, aged 9–11 years, from Romania (n = 123), Russia (n = 112), and France (n = 90). Children completed questionnaires regarding their perceptions of maternal parenting style, and their life satisfaction and depressive symptoms. French children reported lower levels of authoritative parenting style and higher levels of authoritarian parenting style compared to their Romanian and Russian peers. Further, French children reported higher levels of depressive symptoms than both their Romanian and Russian peers, while Russian children had higher life satisfaction than their Romanian and French peers. The strengths of the associations between parenting style and both children’s life satisfaction and depressive symptoms, however, did not differ based on children’s cultural context. Our findings suggest the importance of cultural context in relation to parenting styles and children’s life satisfaction and depressive symptoms. Further, our study shows that the relations between parenting and children’s adjustment are similar across the cultural contexts included in this study.     

Maternal Psychosocial Maladjustment and Child Internalizing Symptoms: Investigating the Modulating Role of Maternal Sensitivity

In light of evidence suggesting that maternal adaptation may impact early child emotional development, this study investigated the interactive effects of maternal psychosocial maladjustment and maternal sensitivity on child internalizing symptoms, with the aim of investigating the potentially protective function of maternal sensitivity. Families (N?=?71 to 106 across measures, with gender spread almost evenly: number of boys?=?31 to 51 across measures) took part in four assessments between child ages 1 and 3 years. Mothers completed measures of parental stress, psychological distress, and marital satisfaction when their children were between 12 and 15 months. A composite score of maternal psychosocial maladjustment was derived from these measures. Maternal sensitivity was rated by trained observers at 12 months following a home visit. Child internalizing symptoms were assessed by both parents when the child was 2 and 3 years old. Hierarchical regressions revealed that increased maternal psychosocial maladjustment was related to more internalizing symptoms in children, however only among children of less sensitive mothers. In contrast, children of more sensitive mothers appeared to be protected. This was observed with maternal reports at 2 years, and both maternal and paternal reports at 3 years. These results suggest that young children may be differentially affected by their parents’ emotional adjustment, while highlighting the pivotal protective role of maternal sensitivity in this process.