Effects of parent and child characteristics on participation and outcome of an individualized booster parent intervention for children with externalizing behaviour

In this study, we examined whether a booster parent training, offered after a cognitive behavioural child intervention, is effective in reduction of aggressive behaviour and changes in parenting. A second aim was to identify parent and child characteristics that influence parental participation. Children (73% boys, 40% immigrants, mean age = 10.1 (.53)) were randomly assigned to the child (n = 97 children) or child and parent intervention (n = 94 children) condition. Results of both intention-to-treat and completers only analyses indicated no extra effects of the parent intervention for the total group. Parents who participated (47%) did not differ from non-participants in demographic characteristics. However, mother's perceived level of child's aggression at the end of the child intervention was of significant meaning for the decision to participate in the parent intervention. Participation seemed to interrupt the development of more aggressive behaviour and less appropriate parenting skills for those children in highest need and resulted in increased maternal involvement.     

Maternal and Paternal Perception of Child Vulnerability and Behaviour Problems in Very Preterm Born Children

Preterm born children have more behaviour problems than term born children. Perinatal risks, current child functioning, sociodemographic characteristics, parental psychological distress and parental perceptions of child vulnerability (PCV) have been shown to be risk factors for behaviour problems. However, the role of maternal and paternal PCV is unclear, as these have not been investigated as a risk factor for behaviour problems, with all other risk factors taken into account. Aim of this study is to investigate whether maternal and paternal PCV are independent risk factors for behaviour problems in very preterm (VP) and term born children. The present study is a single centre prospective cohort study. Preterm children (n = 104), born at <30 weeks' gestation and/or birth weight <1000 g, and term children (n = 95) were assessed at age 5. Results showed that risk factors for parent‐rated behaviour problems were low/middle parental education, VP birth, parental stress and, in VP children, maternal PCV. Risk factors for teacher‐rated behaviour problems were low/middle parental education, foreign parental country of birth, intrauterine growth restriction and objective child vulnerabilities. It can be concluded that maternal PCV is a risk factor for parent‐rated behaviour problems in VP children. When VP children are presented with behavioural problems, clinicians ought to be aware of the possibility that parents might still perceive their child as vulnerable. The neonatal history of the child, the way parents experienced that period, their perceptions of the child and possible consequences of these perceptions could be subjects for conversation during visits at follow‐up clinics. Copyright © 2015 John Wiley & Sons, Ltd.     

Mothers' subjective employment experiences and the behaviour of their nursery school children

Most research on the effects of maternal employment on children has followed the ‘maternal deprivation’ hypothesis, which focuses on differences in the behaviour of children of employed and non-employed mothers. Yet this framework may have impeded an examination of a more relevant question, namely the impact of mothers' employment-related experiences. Accordingly, this study assesses the influence of mothers' job satisfaction, job involvement and role conflict on the behaviour of their nursery school sons and daughters (n=46 and 45 respectively). The effects of maternal employment on their nursery school children were found to be mediated by (a) the nature and quality of the employment experience (i.e. positive or negative), (b) the type of child behaviour assessed, and (c) the sex of the child. Mothers' job satisfaction was positively associated with daughters' self-control and negatively with conduct problems; their role conflict was negatively related to sons' and daughters' self-control, and positively associated with sons' conduct problems and daughters' immaturity. These results support the hypothesis that the quality of the maternal employment experience influences nursery school children's behaviour.     

Teacher–child conflict and aggressive behaviour in first grade: the intervening role of children's self‐esteem

High levels of teacher–child conflict have repeatedly been found to amplify children's aggressive behaviour. Up to now, however, research on possible mechanisms explaining this link is largely lacking. The current study aimed to test whether children's self‐esteem is an intervening mechanism. Participants were 139 children (70 boys, M age = 6.18 years) and their teachers from 35 classes in 19 schools who were followed longitudinally throughout first grade. Teacher–child conflict was measured during the first trimester (October to December), children's self‐esteem (three child interviews) during the second trimester (January to March) and children's aggressive behaviour during the first and third trimester (April to June). Teacher–child conflict had a significant indirect effect on changes in children's aggressive behaviour across first grade through its effect on children's self‐esteem. Copyright © 2011 John Wiley & Sons, Ltd.     

Concordance Between Mothers' and Children's Reports of Somatic and Emotional Symptoms in Patients with Recurrent Abdominal Pain or Emotional Disorders

Mother–child concordance regarding children's somatic and emotional symptoms was assessed in children with recurrent abdominal pain (n = 88), emotional disorders (n = 51), and well children (n = 56). Children between 6 and 18 years of age and their mothers completed questionnaires assessing the children's somatic symptoms, functional disability, and depression. Mothers of children with recurrent abdominal pain reported more child somatic and depressive symptoms than did their children, and mothers of children with emotional disorders reported more child depressive symptoms than did their children. Higher levels of maternal distress were associated with greater mother-child discordance in the direction of mothers reporting more child symptoms than did their children. No significant child age or sex differences were found in concordance patterns.     

Predictors of early vocabulary growth in children born preterm and full term: A study of processing speed and medical complications

Delays in expressive vocabulary may be harbingers of long-term language difficulties. In toddlers born full term (FT), individual differences in language processing speed are associated with variation in expressive vocabulary growth. Children born preterm (PT) are at increased risk for persistent language deficits. Here, we evaluate predictors of early vocabulary growth in PT toddlers in relation to two sources of variability: language processing speed and medical complications of prematurity. Vocabulary growth from 16 to 30 months (adjusted for degree of prematurity) was modeled longitudinally using parent reports in English-speaking FT (n = 63; ≥37 weeks, ≥2495 g) and PT (n = 69; ≤32 weeks, <1800 g) children, matched on sex and socioeconomic status. Children were tested in the “looking-while-listening task” at 18 months to derive a measure of language processing speed. Each PT child was assessed for number of medical complications (13 maximum), based on medical chart reviews. PT and FT children displayed similar vocabulary trajectories; however, birth group disparities began to emerge by 30 months. PT children were slower in language processing speed than FT children. Critically, language processing speed predicted expressive vocabulary size at 30 months; interactions with birth group were not significant (all p > .20). In PT children, faster language processing speed predicted stronger outcomes regardless of number of medical complications; slower processing speed and more medical complications predicted poorer outcomes. Faster processing speed reflected favorable neuropsychological processes associated with faster expressive vocabulary growth that overrode the impact of medical complications on language outcomes in PT children.     

Behavior Problems in Toddlers With and Without Developmental Delays: Comparison of Treatment Outcomes

The purpose of this study is to examine the effectiveness of an in-home parent management program for toddlers with behavior problems and developmental delays by comparing outcomes for a group of toddlers with developmental delays (n = 27) and a group of toddlers without developmental delays (n = 27). The majority of children lived in single parent, low-income homes. Results suggest that the parent management program is equally effective for children with and without developmental delays. Parents from both groups reported clinically significant improvement in their children's behavior and parenting practices. Clinical implications regarding the importance of these findings for improving outcomes for toddlers with behavior problems and developmental delays living in poverty were discussed.     

Outcome of psychodynamic child psychotherapy in routine practice

The aim of the present naturalistic study was to explore the effectiveness of psychodynamic child psychotherapy in routine practice. The sample comprised 207 psychotherapies with children 4–12?years of age with a broad range of mental health problems. Data on two measures, children’s global assessment scale (CGAS) and strength and difficulties questionnaire (SDQ), were collected pre-post therapy. Within-group changes were analysed using repeated measures mixed-models ANOVA. Individual changes were examined by means of clinical significance. The analyses revealed improvement in general functioning, decrease in problem severity and problem impact on the child’s everyday life, as well as an increase in prosocial behaviour. For CGAS, an interaction effect was discovered suggesting a larger improvement for younger children (4–6?years) than for older children (10–12?years). After therapy, 38% (n 76) achieved clinically significant improvement. Time-limited psychotherapy proved favourable for children assigned to that particular treatment modality. The study generated similar results as previous well-controlled trials, revealing statistically significant results in a large sample and in spite the use of non-specific outcome measures. The study provides everyday evidence to the effectiveness of child psychodynamic treatment with parallel parental work for a broad range of child mental health problems.     

Attention Bias for Threatening Information in Children Following a Distressing Medical Procedure

Attention bias is common in adults with post‐traumatic stress disorder (PTSD) but is less studied in children. Children (n = 22) who experienced a potentially distressing procedure in an outpatient clinic (removal of K‐wires from orthopaedic fractures) and a group of medically unwell children (illness group; n = 27) were compared with healthy controls (n = 32). Children's baseline level of PTS symptoms were indexed prior to the medical procedure, and again at 1‐week follow‐up. Immediately after the K‐wire removal, children completed a dot probe task using two categories of target words (medical threatening and emotionally threatening). While K‐wire children showed an overall bias away from negative words relative to healthy controls, the illness group did not significantly differ from healthy controls. Attention bias in K‐wire and illness groups was unrelated to later PTS symptoms.     

Change in the Psychological Adjustment of Children with Cystic Fibrosis or Sickle Cell Disease and Their Mothers

Objectives: This study has three interrelated objectives: (1) to track the adjustment of children and adolescents with sickle cell disease (SCD) or cystic fibrosis (CF) and their mothers through a third assessment point 2 years after the initial assessment; (2) to determine whether the adaptational processes of the transactional stress and coping model associated with adjustment at the initial assessment continue to be associated with adjustment 2 years later; and (3) to determine whether the pattern of association of adaptational processes with adjustments differs by illness subgroup. Methods: The study samples included 59 children with CF and 50 children with SCD and their mothers. Measures were obtained on maternal adjustment and appraisals of daily and illness stress, coping methods, and family functioning. Child measures included child-reported and mother-reported child adjustment and child perceptions of self-worth and health locus of control and pain coping methods. Results: Consistency in adjustment classification was only 31–32% for child self-report, 66% for mother-reported child behavior problems, and 56–77% for mother self-reported adjustment for the CF and SCD groups, respectively. Support was provided for the association of adaptational processes with maternal adjustment and with the adjustment of children with SCD but not for children with CF. Conclusion: The stability of adjustment has implications for prevention and treatment intervention and subsequent research steps. Intervention efforts should be focused on the relatively small subgroups of children with chronic illnesses and their mothers with consistently poor adjustment.     

Parent–child interaction: Does parental language matter?

Although parental language and behaviour have been widely investigated, few studies have examined their unique and interactive contribution to the parent–child relationship. The current study explores how parental behaviour (sensitivity and non‐intrusiveness) and the use of parental language (exploring and control languages) correlate with parent–child dyadic mutuality. Specifically, we investigated the following questions: (1) ‘Is parental language associated with parent–child dyadic mutuality above and beyond parental behaviour?’ (2) ‘Does parental language moderate the links between parental behaviour and the parent–child dyadic mutuality?’ (3) ‘Do these differences vary between mothers and fathers?’ The sample included 65 children (M_age = 1.97 years, SD = 0.86) and their parents. We observed parental behaviour, parent–child dyadic mutuality, and the type of parental language used during videotaped in‐home observations. The results indicated that parental language and behaviours are distinct components of the parent–child interaction. Parents who used higher levels of exploring language showed higher levels of parent–child dyadic mutuality, even when accounting for parental behaviour. Use of controlling language, however, was not found to be related to the parent–child dyadic mutuality. Different moderation models were found for mothers and fathers. These results highlight the need to distinguish parental language and behaviour when assessing their contribution to the parent–child relationship.     

The quality of caregiving in child care: relations to teacher complexity of thinking and perceived supportiveness of the work environment

This study examined the relationship between the complexity of thinking about children by child care teachers and observed teachers' caregiving for infants and toddlers. It was hypothesized that the perceived supportiveness of the work environment would affect this relationship. Fifty‐six child care teachers completed a survey assessing complexity of thinking about children's behaviour as well as a measure of the perceived opportunities for professional development. Teachers' quality of caregiving was assessed using the Caregiver Interaction Scale. Planned contrasts revealed that when professional development opportunities were perceived unfavourably, teachers who were complex in thinking about children's behaviour provided significantly more sensitive care than did teachers who were less complex in their thinking. Findings indicate that the complexity of teachers' thinking about children may be very important in understanding teacher's sensitivity when the quality of the work environment is poor. High‐quality work environments may buffer teachers with less complexity of thinking from being less sensitive with children. Efforts to improve quality of care could focus on individual teachers to improve their complexity of thinking as well as on the work environment to make it more supportive of teachers' professional development. Copyright © 2008 John Wiley & Sons, Ltd.     

Mother–child affect and emotion socialization processes across the late preschool period: predictions of emerging behaviour problems

The current study examined concurrent and longitudinal relations between maternal negative affective behaviour and child negative emotional expression in preschool age children with (n=96) or without (n=126) an early developmental risk, as well as the predictions of later behaviour problems. Maternal negative affective behaviour, child externalizing emotional expression, and child internalizing emotional expression were observed during a number of lab tasks at child ages 4 and 5, and child externalizing and internalizing behaviour problems were assessed via maternal questionnaire at age 6. Path analyses using structural equation modeling were utilized to test the relations among the variables at ages 4, 5, and 6. A parent‐driven model of emotion socialization emerged, wherein stronger relations were found among maternal negative affect and child externalizing emotions and behaviours than among maternal negative affect and child internalizing emotions and behaviours. Early child risk did not appear to alter the overall emotion socialization process, although higher levels of maternal and child negativity were observed for the children with a developmental risk. Results underscore the complexity of emotion socialization processes throughout the preschool period. Copyright © 2011 John Wiley & Sons, Ltd.     

Neuropsychological complications of insulin dependent diabetes in children

Previous research suggests that children with insulin dependent diabetes (IDDM) show selective impairments on neuropsychological tests, with those developing IDDM before 5 years of age appearing to be the most affected. The effect of hypoglycaemia on the developing brain has been suggested as a possible risk factor as has the disruptive effect of chronic hyperglycaemia on myelinisation. A cohort of children (n = 124) with newly diagnosed IDDM, managed at The Royal Children's Hospital, Melbourne has been assembled and evaluated 3 months post diagnosis on standardised tests of general intelligence, attention, memory, new learning, executive functions, and educational achievement. The performance of the children with IDDM has been compared with that of a demographically representative control group (n = 129) of healthy children. At this baseline assessment, the findings strongly support the hypothesis that the neuropsychological and educational profiles of newly diagnosed children are not different from that of controls early in the course of the illness. Both groups will be reassessed 2 and 5 years after the initial evaluation when it is hypothesised that children with diabetes will perform more poorly. Parameters of the illness, such as age of onset, major metabolic crises, and history of glycaemic control will be related to the test performance of the children with IDDM to identify specific risk factors for neuropsychological and educational sequelae in that population.     

Parent-Child Interaction Therapy for Toddlers: A Pilot Study

Parent-Child Interaction Therapy (PCIT) is an evidence-based program used to treat behavioral disorders in early childhood (2–7 years; Eyberg, 1988 Eyberg , S. ( 1988 ). Parent-Child Interaction Therapy: Integration of traditional and behavioral concerns . Child Family Behavior Therapy , 10 ( 1 ), 33 – 46 .[Taylor & Francis Online] , [Google Scholar]). This article describes a modified version of PCIT for young toddlers (PCIT-T) adapted to meet the developmental needs of children aged 12–24 months. A pilot study was conducted to evaluate the effectiveness of PCIT-T with 29 parent-toddler dyads (children aged <2 years) presenting with significant behavior problems, assessed pretreatment and posttreatment. Outcomes for two groups of older children who participated in PCIT (Group 1: 2–3 years, n = 29; Group 2: 3–4 years, n = 29) were also assessed. Results showed PCIT-T to be associated with a range of positive child and parental outcomes including decreased intensity of disruptive child behaviors, increased parental utilization of PCIT parenting skills, decreased parental depressive symptoms, and high levels of consumer satisfaction with the program. This study provides early evidence that a modified version of PCIT can be successfully used to treat behavior disorders in children aged less than 2 years.     

Factors related to the comorbidity between oppositional defiant disorder and anxiety disorders in preschool children

Background and objectives: The aim of the study is to identify factors related to comorbid oppositional defiant disorder (ODD) and anxiety disorders (ADs). Design: A sample of 622 children was assessed longitudinally at 3 and 5 years of age. Methods: At baseline, there were 310 boys (49.8%), most participants were of Caucasian–white ethnicity (89.1%) and attended to public school (64.0%), and families’ socioeconomic status was 64.3% medium-high, 14.1% medium and 20.5% medium-low. Children diagnosed with ODD and/or AD were selected: n?=?103 at 3 years of age (44 ODD, 42 AD and 17 ODD?+?AD) and n?=?106 at 5 years of age (31 ODD, 60 AD and 15 ODD?+?AD). Results: High levels of the child’s negative affectivity and the mother’s aggressive behavior (versus AD), and high scores in the father’s psychopathology measurements (versus ODD) were related to the presence of comorbid ODD?+?AD at 3 years of age. High scores in approach-positive anticipation, fears (only in boys, in girls the reverse effect occurred) compared to ODD and AD independently and aggressive behavior (versus AD), and low scores for smiling and laughter (versus ODD only and AD only) were predictive of comorbidity at the 5 years of age. Conclusions: Temperament traits may be a common factor in explaining longitudinal ODD?+?AD comorbidity.     

Attachment and Affect between Mothers with Depression and their Children: Longitudinal Outcomes of Child Parent Psychotherapy

The present investigation examined the longitudinal effects of Child-Parent Psychotherapy (CPP) for toddlers and their mothers with depression on: a) maternal affective expression, b) child affective expression, and c) mother-child cohesion. Mothers with depression (M_age?=?31.7 years; 92.8% White, 3.5% Black, 2.1% Hispanic, 2.3% other) and their toddlers were randomized to receive CPP (DI; n?=?66) or to a control group (DC; n?=?64). Mothers without depression and their toddlers (NC; n?=?68) were recruited as an additional comparison group. Dyads were assessed at baseline (T1; 20 months old), post-intervention (T2; 36 months old), and follow-up (T3; 9 years old). Data from a mother-child conflict task was coded as a measure of observed outcome variables. Change in post-intervention attachment security assessed via the Strange Situation was evaluated as a mediator between intervention condition and maternal and child affective expression and dyadic cohesion at T3. Change to secure attachment post-intervention significantly mediated the association between intervention condition and T3 maternal warmth and child anger/problem behavior. Toddlers of mothers with depression who received CPP showed higher rates of change to secure attachment compared to those in both the DC and NC groups. Dyads who changed to secure attachment at T2 displayed higher levels of maternal warmth at T3 and lower levels of child anger and problem behavior at T3. Implications for the use of CPP as a preventive intervention and the importance of attachment as a mediator of long-term outcomes are discussed.

     

The Treatment of Childhood Disruptive Behavior Disorders in Ambulatory Mental Health Centers

Over the years, evidence-based treatments for children with disruptive behavior disorders (DBDs; e.g., conduct disorder, oppositional defiant disorder) have been developed, however, there is not much information about the treatment children receive in usual mental healthcare settings. This study examined the common treatment provided in US ambulatory mental health clinics to children aged 3 to 9 years who are diagnosed with DBDs. An online survey was filled by appropriate respondents from 145 ambulatory mental health centers across 33 states within the US. The most common treatment provided for childhood DBDs was a combination of child therapy (CT) and parent training (PT) (n?=?81, 56%), followed by family therapy (n?=?42, 29%), CT (n?=?17, 12%), and PT (n?=?5, 3%). Behavioral and cognitive principles were reported as the most common treatment orientations across all types of treatment (n?=?116/145, 80%). The mean number of sessions administered was 31.38?±?22.72, and PT as a standalone treatment required approximately a third of sessions (10.6?±?1.34). In treatments combining CT and PT, the utilization of specific parenting programs was associated with fewer administered sessions. Results suggest that the importance of parental involvement in treating DBDs is acknowledged in routine practice. However, more studies are needed to determine why certain types and orientations of treatments are favored over others.     

High self-perceived social competence in rejected children is related to frequent fighting

High levels of aggression have long been assumed to be related to low self-esteem. Empirical studies have, however, never demonstrated any relation between low self-esteem and aggressive behaviour. Recently Baumeister and colleagues (1996 Baumeister, RF, Smart, L and Boden, JM. 1996. Relation of threatened egotism to violence and aggression: The dark side of high self-esteem. Psychological Review, 103: 5–33. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) proposed that aggressive behaviour does not result from low, but from unrealistically high self-esteem. They expect aggressive behaviour to occur when an unrealistically positive evaluation of oneself is disputed or threatened by others. In the present study Baumeister's proposition was tested for the domain of social acceptance in 179 third- and fourth-grade children. Self-esteem in the social domain was operationalized as self-perceived social competence, while threats to high self-perceived social competence were operationalized as rejection by peers. Participants completed the Dutch version of the Self-Perception Profile for Children and sociometric ratings of (dis)likeability and aggressiveness. Three rival hypotheses were tested: (1) the traditional hypothesis that aggressive behaviour is associated with low self-perceived competence; (2) the simplified hypothesis that aggressive behaviour is associated with high self-perceived competence; and (3) Baumeister's original hypothesis that aggressive behaviour is related to high self-perceived competence only when the latter is combined with less-favourable judgments from others. No support was found for the traditional hypothesis. Baumeister's original hypothesis was supported and explained more variance in aggressive behaviour than the simplified hypothesis.