A typology of behavior problems in preschool children

The purpose of this study was to produce a typology of behavior problems in preschool children. Distinct subtypes were identified through the use of cluster analytic techniques on data from the Behavior Assessment System for Children (BASC)-Parent Rating Scales. Analyses were based on archival data collected on a sample of 268 children, aged 2 to 5 years, who were referred to determine their suitability for a day treatment program. Five distinct and reliable subtypes of preschool children's behavior problems emerged. Ratings of adaptive and social skills based on the BASC Adaptive Scales and measures from the Parenting Stress Index served as external variables to assess the distinctiveness of the derived subtypes. The findings provide evidence for the reliability and validity of the subtypes identified in this study that are consistent with the findings of previous subtyping investigations focusing on school-aged children.     

A comparison of response cost and differential reinforcement of other behavior to reduce disruptive behavior in a preschool classroom

This study investigated the effectiveness of response cost and differential reinforcement of other behavior (DRO) in reducing the disruptive behaviors of 25 children in a preschool classroom. Using an alternating treatments design, disruptive behavior was reduced when the participants earned tokens for the absence of disruptive behavior (DRO) or lost tokens for the occurrence of disruptive behavior (response cost). Initially, DRO was more successful in reducing the number of disruptive behaviors; however, over time, response cost proved to be more effective.     

Temperament profiles from infancy to middle childhood: development and associations with behavior problems

The authors applied I-States as Objects Analysis (ISOA), a recently proposed person-oriented analytic approach, to the study of temperament development in 921 Norwegian children from a population-based sample. A 5-profile classification based on cluster analysis of standardized mother reports of activity, sociability, emotionality, and shyness at ages 18 months, 30 months, 4-5 years, and 8-9 years was interpretable and highly replicable. The prevalence of temperament profiles changed markedly with age, and individual stability in temperament profiles was significant. Specific typical and atypical developmental sequences of profiles were identified. Selective patterns of concurrent group differences in externalizing and internalizing problems by temperament profiles were remarkably similar across ages. The findings to some degree support the notion that individual temperament-variable values take on meaning in relation to the whole individual configuration and indicate some lawfulness in temperament changes over time. Future person-oriented studies of temperament development should replicate the current results using multiple data sources, rigorous tests of gender differences, and latent group modeling. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

The relations between emotional understanding,intellectual functioning,and disruptive behavior problems in elementary-school-aged children

This study examined individual differences in children's emotional understanding and behavioral adjustment. Participants included 220 first- and secondgrade children (75% regular education, 25% special education) who were individually interviewed using the Kusche Affective Interview—Revised. Dependent measures of emotional understanding and experience included the ability to provide personal examples of 10 different emotions and the cues used for recognition of five emotions in oneself and other persons. Children were also administered the WISC-R Vocabulary, Block Design, and Coding subtests. One parent independently completed an Achenbach Child Behavior Checklist for each child. Results indicated that children who were rated as higher in behavior problems showed deficits in emotional understanding. Intellectual functioning was negatively associated with behavior problems and attenuated the effects of behavior problems on emotional understanding. Implications of the current findings for prevention and treatment programs for children with behavior problems are discussed.This research was supported by Grant PHS RO1 MH42131 from the Prevention Branch, National Institute of Mental Health. The authors thank Lisa Anderson and Dawn Kresevich for their invaluable help with data collection; Bob Beilke for his assistance in the development of the KAI-R coding system; and the dedicated coders of the KAI-R for their careful work.     

Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems.

Examined parent role distress and coping in relation to childhood attention deficit hyperactivity disorder (ADHD) in mothers and fathers of 66 children age 7 to 11 (42 boys, 24 girls; mean age = 10.2). Parents of children with ADHD combined and inattentive subtypes expressed more role dissatisfaction than parents of control children. Parents of ADHD combined and inattentive type children did not differ significantly in levels of distress. For mothers, child inattention and oppositional-conduct problems but not hyperactivity contributed uniquely to role distress (dissatisfaction related to parenting or parenting performance). For fathers, parenting role distress was associated uniquely with child oppositional or aggressive behaviors but not with ADHD symptom severity. Parent coping by more use of positive reframing (thinking about problems as challenges that might be overcome) was associated with higher role satisfaction for both mothers and fathers. Community supports were associated with higher distress for mothers only.     

Reducing disruptive behavior through consultation

A university laboratory school counselor was consulted by a fourth grade teacher in order to resolve disruptive classroom behaviors of one student who did not stay seated and frequently spoke without permission. A behavioral approach in the classroom enabled the counselor to help. The teacher was instructed to pay attention to the child only when he remained seated or raised his hand for recognition. The student's behavior improved substantially. This study illustrates how the counselor can be effective as a consultant.     

Parenting practices and child disruptive behavior problems in early elementary school. Conduct Problems Prevention Research Group

Examined the hypothesis that distinct parenting practices may be associated with type and profile of a child's disruptive behavior problems (e.g., oppositional, aggressive, hyperactive). Parents of 631 behaviorally disruptive children described the extent to which they experienced warm and involved interactions with their children and the extent to which their discipline strategies were inconsistent and punitive and involved spanking and physical aggression. As expected from a developmental perspective, parenting practices that included punitive interactions were associated with elevated rates of all child disruptive behavior problems. Low levels of warm involvement were particularly characteristic of parents of children who showed elevated levels of oppositional behaviors. Physically aggressive parenting was linked more specifically with child aggression. In general, parenting practices contributed more to the prediction of oppositional and aggressive behavior problems than to hyperactive behavior problems, and parenting influences were fairly consistent across ethnic groups and sex.     

Etiology of preschool behavior problems: Contributions of temperament attributes in early childhood

The present study was conducted to examine the contributions of early appearing temperament attributes to toddler and preschool‐age behavior problems. High levels of negative emotionality and low levels of effortful control were linked to both externalizing and internalizing difficulties. All fine‐grained dimensions of negative affect were concurrently associated with internalizing problems whereas relations between components of negative affect and externalizing were observed only for frustration, sadness, and low falling reactivity. Higher surgency was associated with increased risk for externalizing behaviors whereas low surgency increased the likelihood of internalizing problems. Trait‐by‐trait moderation occurred, such that negative emotionality was most closely related to behavior problems when orienting/regulatory capacity or effortful control was low or when infant surgency was high. Results of this study have implications for theory linking temperament and psychopathology, and clinical applications utilizing temperament assessment to prevent behavior problems.     

Preventing preschool externalizing behavior problems through video‐feedback intervention in infancy

In the present study (1) intervention effects on children's preschool behavior problems were evaluated in a high risk sample with an overrepresentation of insecure adult attachment representations in 77 first‐time mothers, and (2) predictors and correlates of child problem behavior were examined. Early short‐term video‐feedback intervention to promote positive parenting (VIPP) focusing on maternal sensitivity and implemented in the baby's first year of life significantly protected children from developing clinical Total Problems at preschool age. Also, compared with the control group, fewer VIPP children scored in the clinical range for Externalizing Problems. No intervention effects on Internalizing clinical problem behavior were found. The VIPP effects on Externalizing and Total clinical Problems were not mediated by VIPP effects on sensitivity and infant attachment or moderated by mother or child variables. Maternal satisfaction with perceived support appeared to be associated with less children's Internalizing, Externalizing, and Total Problems. More research is needed to find the mechanisms triggered by VIPP, but the outcomes could be considered as promising first steps in the prevention of disturbing, externalizing behavior problems in young children.     

School-based mental health programming for children with inattentive and disruptive behavior problems: first-year treatment outcome

This article examines the effectiveness of an evidence-based behavioral treatment package for children with inattentive and disruptive behavior problems when delivered in the context of a school-based mental health program. Child symptomatology and functioning are assessed in a treatment group (n = 30) and a waitlist control group (n = 12) across multiple time points (fall, winter, and spring). Treatment includes a daily report card procedure, year-long teacher consultation, and parenting sessions. According to the parent report, treated children show marked reductions in hyperactive and impulsive, oppositional or defiant and aggressive behavior, and marked improvement in peer relationships. Teachers observe treatment-related group differences in inattention, academic functioning, and the student-teacher relationship. Feasibility and acceptability data have implications for transporting evidence-based treatments to community settings and for integrating mental health services into the culture of the school community.     

The effects of the Triple P-Positive Parenting Program on preschool children with co-occurring disruptive behavior and attentional/hyperactive difficulties

Two variants of a behavioral family intervention (BFI) program known as Triple P were compared using 87 preschoolers with co-occurring disruptive behavior and attentional/hyperactive difficulties. Families were randomly allocated to enhanced BFI (EBFI), standard BFI (SBFI), or a waitlist (WL) control group. At postintervention both BFI programs were associated with significantly lower levels of parent-reported child behavior problems, lower levels of dysfunctional parenting, and greater parental competence than the WL condition. The EBFI condition was also associated with significantly less observed child negative behavior in comparison to the WL. The gains achieved at postintervention were maintained at 1-year follow-up. Contrary to predictions, the enhanced program was not shown to be superior to the standard program using any of the outcome measures at either postintervention or follow-up. Each of the programs produced significant reductions in children's co-occurring disruptive behavior and attentional/hyperactive difficulties with 80% of the children showing clinically reliable improvement in observed negative behavior from preintervention to follow-up.     

Temperament and play interaction behavior across infancy

Temporal stability and convergent validity of infant temperament ratings and play interaction behaviors were examined across early to late infancy. Stability was noted for the temperament dimensions activity, rhythmicity, intensity, mood, and persistence. Stability also was noted for the infant play interaction behaviors looking, smiling, and vocalizing. In addition, convergent validity was noted for attentive-affective behaviors and comparable temperament ratings; for example, gaze aversion and nondistractability, and distress brow behavior and negative mood. Generally easier temperament infants were noted to vocalize more and to cry less frequently during their play interactions.     

Instrumental and hostile aggression in childhood disruptive behavior disorders

An analogue task of instrumental and hostile aggression during a competitive game was evaluated in a sample of clinically-referred 8-to 12-year-old aggressive boys. Similar to a prior task in a normative sample (Having, Wallace, & La Forme, 1979), both types of aggression increased during provocation as compared to baseline, indicating the success of the provocation manipulation, with moderate correlations between the two aggressive responses. The aggressive group with attention-deficit hyperactivity disorder (ADHD) and the aggressive group without ADHD each had higher rates of instrumental aggression than controls. Only the aggressive/ADHD group had higher rates of hostile aggression than controls. Parent Child Behavior Checklist ratings indicated a modest but significant unique relationship between instrumental aggression and delinquency. The high rate of both types of aggression in the aggressive/ADHD group suggests that comorbid ADHD and aggression may result in qualitative differences in aggressive behavior. The high rate of hostile aggression in the aggressive-ADHD group supports theoretical assumptions regarding the relationship of hostile aggression to poor impulse control.This research was supported in part by grants to the first author from the Medical College of Pennsylvania, the Allegheny-Singer Research Institute, NIMH First Award (MH4682), and support from NICHD Mental Retardation Research Center Core Center Grant (DH26979); and NIMH grants (MH40364 and MH00590) awarded to the second author. The authors are grateful to Marianne Torchinsky and Abby Michaleski for assistance in data collection. Preliminary data were presented at the annual meetings of the Association for Advancement of Behavior Therapy, New York, November 1988, and the Society for Research in Child and Adolescent Psychopathology, Costa Mesa, CA, January 1990.     

Neuroanatomy of childhood disruptive behavior disorders

Our aims were to (1) examine possible neuroanatomical abnormalities associated with the Disruptive Behavior Disorders (DBDs) as a group and (2) assess neuroanatomical anomalies specific to each DBD (i.e., conduct disorder [CD] and oppositional defiant disorder). Cortical thickness analysis and voxel-based morphometry were analyzed in 47 8-year-old boys (22 DBDs with and without CD and/or ODD and 25 healthy controls) from Magnetic Resonance Imaging brain scans. DBD symptoms were assessed using the Dominic-R. In DBD subjects relative to controls, we found (1) a decreased overall mean cortical thickness; (2) thinning of the cingulate, prefrontal and insular cortices; and (3) decreased gray matter density (GMd) in the same brain regions. We also found that scores on the Dominic-R were negatively correlated with GMd in the prefrontal and precuneus/superior temporal regions. There was a subdiagnostic main effect for CD, related to thinning of the middle/medial frontal, and for ODD in the left rectal/orbitofrontal. Findings suggest that thinning and decreased GMd of the insula disorganizes prefrontal circuits, diminishing the inhibitory influence of the prefrontal cortex on anger, aggression, cruelty, and impulsivity, and increasing a person's likelihood of aggressive behavior. These findings have implications for pathophysiologic models of the DBDs, their diagnostic classification system, and for designing more effective intervention programs.     

Maternal insightfulness and preschoolers' emotion and behavior problems: Reciprocal influences in a therapeutic preschool program

Mothers' insightfulness, which involves understanding the motives underlying the child's behavior in a complete, open, and accepting way, was examined both at the beginning and at the end of a therapeutic preschool program for preschoolers using the Insightfulness Assessment (Oppenheim & Koren‐Karie, 2002). The goal of the study was to examine the links between improvement in mothers' insightfulness and reduction in children's behavior problems. Thirty‐two children referred to a therapeutic preschool program for a range of behavioral and emotional problems and their mothers participated in the study. Results showed that mothers who shifted from noninsightfulness before treatment to insightfulness after treatment had children whose behavior problems decreased whereas mothers who did not make such gains had children whose behavior problems increased. The social skills of all children improved during treatment. The possible mechanisms linking the gains of mothers and children are discussed within the framework of attachment theory.     

Personality heterogeneity in adolescents with disruptive behavior disorders

We first confirmed adolescents diagnosed with disruptive behavior disorders (oppositional defiant, conduct disorder; n = 158) had lower constraint and higher negative emotionality, and greater psychiatric comorbidity and psychosocial dysfunction, relative to adolescents without (n = 755), in a population-based sample enriched for externalizing psychopathology (mean age = 17.90 years; 52% female). We then explored whether different personality types, defined by patterns of personality identified via latent profile analysis, were differently associated with clinical features in adolescents with a disruptive behavior disorder diagnosis. Four distinct personality types (“disinhibited,” “high distress,” “low distress,” “positive”) were meaningfully different from one another. Results highlight personality heterogeneity as a means of identifying individuals at greatest risk for the most deleterious forms of externalizing psychopathology.     

Self-regulation in the modification of disruptive classroom behavior

This study compared self-regulation and external regulation procedures in the treatment of children's disruptive classroom behavior. After baseline data were collected, three of the four most disruptive children in each of 10 first- and second-grade classrooms received reinforcement for achieving low rates of disruptive behavior. The fourth child served as a control subject throughout the experiment. Two of the three experimental subjects were then taught to self-observe their own disruptive behavior. In the final reinforcement period, these subjects were given control over dispensing reinforcers to themselves, based on their self-collected behavioral data while subjects in the other experimental group continued with the externally managed reinforcement. In extinction, reinforcement was discontinued for all subjects, but one of the self-regulation subjects in each classroom continued overtly to self-observe. Results indicated that both reinforcement programs reduced disruptive behavior. The self-regulation procedures were slightly more effective in reducing disruptiveness than was the external regulation procedure, and this advantage persisted into extinction. These results suggest that self-regulation procedures provide a practical, inexpensive, and powerful alternative in dealing with disruptive behavior in children.     

Assessment of peer rejection and externalizing behavior problems in preschool boys: a short-term longitudinal study

We examined the longitudinal stability of measures of negative peer status and aggressive-disruptive behavior in preschool boys. Subjects were 53 white 4- to 5- year- old boys from low-income family backgrounds. Peer sociometric measures of rejection and behavioral deviance were assessed in the fall and spring of the preschool year. Complementary measures were also obtained from teachers at both assessment points. Half of the boys designated as rejected on the basis of peer nominations maintained this status at the end of the preschool year. Teachers and peers did not agree on their selections of socially rejected children, but had good agreement concerning the identification of children with externalizing-type behavior problems. Finally, teacher and peer classifications of aggressive-disruptive children were highly stable throughout the preschool year. These findings indicate that peer-rejected children can be identified at very young ages, and that preschoolers can be reliable informants about the social maladjustment of peers.We thank the Head Start children, parents and staff who participated, and Karen Lifgren for her help with data collection.     

Effects of using self-recording and self-observation in reducing disruptive behavior

In an attempt to reduce the levels of disruptive behavior, six participants in a school for students with behavior disorders were shown edited videotapes depicting themselves appropriately engaged in classroom activities. The participants were first exposed to a training condition in which both appropriate and inappropriate behaviors of a peer were either observed or observed and recorded. In the intervention condition, the participants either self-observed and self-recorded their behaviors from videotape or simply observed themselves on videotape. The results showed idiosyncratic effects across both conditions. Measures of treatment integrity and treatment acceptability were also conducted. The results of this study are compared with similar research investigating self-observation interventions.