An evaluation of parent preference for prompting procedures

Parent participation in intervention can enhance intervention efficacy and promote generalization of skills across settings. Thus, parents should be trained to implement behavioral interventions. The purpose of the current investigation was to evaluate parent preference for and acceptability of 3 commonly used prompting procedures. We trained parents of children with disabilities to use 3 empirically validated prompting strategies (i.e., least-to-most, most-to-least, and a progressive-prompt delay). Once the parent reached the mastery criteria with each prompting procedure, we evaluated his/her preference for each of the procedures using a concurrent-chains arrangement. We also measured treatment acceptability of all procedures throughout the study. All participants met the mastery criteria for each of the prompting procedures and showed a preference for least-to-most prompting. Results suggest parents' acceptability of procedures prior to training were different than posttraining/post-child practice. In addition, acceptability rating scores obtained at the end of the investigation corresponded to preference of intervention during the concurrent-chains arrangement. The results demonstrate the benefits of objective measures for studying preference for behavioral, skill-acquisition procedures.     

Therapeutic Assessment With Children: A Pilot Study of Treatment Acceptability and Outcome

Therapeutic Assessment (TA) with children is a hybrid of psychological assessment and short-term intervention. It uses the ongoing process and results of psychological assessment to enhance parents' understanding of their child and to facilitate change. Clinical reports and single case studies suggest that TA with children is an acceptable and effective brief intervention. However, no aggregate data have been published to support this claim. This pilot study investigated the acceptability and preoutcome–postoutcome of TA with 14 clinically referred children with emotional and behavior problems and their parents. Results indicated high treatment acceptability as well as significantly decreased child symptomatology and enhanced family functioning as reported by children and mothers. In addition, mothers demonstrated a significant increase in positive emotion and a significant decrease in negative emotion pertaining to their children's challenges and future. The findings, although limited due to the design and small sample size, support assertions from published single case studies that TA is possibly an efficacious child and family intervention for children with emotional and behavioral problems and should be studied in a larger, comparison design.     

Evaluating motion detection to score sleep disturbance for children: A translational approach to developing a measurement system

Information obtained via direct observation of children's sleep disturbance throughout the night in their home can guide the assessment and treatment process, but watching live or via recorded video might be impractical in terms of time expenditures. In Experiment 1, we assessed the accuracy and reliability of a motion‐detection camera with human motor movements. In Experiment 2, we tested the system's generality by using it to obtain in‐home measures of sleep disturbance for three children with autism spectrum disorder and compared the accuracy to a continuous measurement system. We also measured scoring efficiency and assessed parents' acceptability of the camera. Results provide preliminary support for motion detection in measuring sleep disturbance, but further evaluation of motion detection to improve accuracy is warranted.     

What leads to coordinated attention in parent–toddler interactions? Children's hearing status matters

Coordinated attention between children and their parents plays an important role in their social, language, and cognitive development. The current study used head‐mounted eye‐trackers to investigate the effects of children's prelingual hearing loss on how they achieve coordinated attention with their hearing parents during free‐flowing object play. We found that toddlers with hearing loss (age: 24–37 months) had similar overall gaze patterns (e.g., gaze length and proportion of face looking) as their normal‐hearing peers. In addition, children's hearing status did not affect how likely parents and children attended to the same object at the same time during play. However, when following parents' attention, children with hearing loss used both parents' gaze directions and hand actions as cues, whereas children with normal hearing mainly relied on parents' hand actions. The diversity of pathways leading to coordinated attention suggests the flexibility and robustness of developing systems in using multiple pathways to achieve the same functional end.     

A psychoanalytic approach to language delay: When autistic isn't necessarily autism

This paper describes family work with four children from different ethnic backgrounds presenting with autistic features in the context of delayed or deviant language development and, in one case, elective mutism. It begins by describing how psychoanalytic approaches to language development have tended to see the process as underpinned by symbol formation as a compensation for loss of the object. This is contrasted with an approach which, following Bion, emphasizes language development as an aspect of a broad process concerned with enabling emotional experience to become thought. I also emphasize the significance of the survival and development of the self in achieving separation. In the case studies, the paper highlights the degree of trauma in the parents' backgrounds, which had impeded them from containing their children's developmental anxieties. The parents' telling their stories was both valuable to them and enabled them to become more emotionally available to their children. In all cases the work promoted language development and autistic features disappeared or waned considerably after relatively brief intervention. The conclusions discuss the relevance of these findings to the autistic child population, and the value of child psychotherapy to differential diagnosis within the autistic spectrum.     

Treatment Acceptability

The present study assessed mothers' and fathers' acceptance of six interventions frequently used to alter children's problem behavior. This is the first study to assess fathers' perceptions of behavioral interventions for children. Positive reinforcement, response cost, medication, room timeout, chair timeout and spanking were rated by parents using the Treatment Evaluation Inventory (TEI). In addition, parents' perceptions of their children's behavior and own marital adjustment were measured using standardized checklists. Parents' acceptability ratings differed significantly across treatment conditions depending on parent gender, child behavior problems, and marital adjustment. Treatment preference order was equivalent for all groups.     

Pragmatic aspects of communication and language comprehension in groups of children differentiated by teacher ratings of inattention and hyperactivity

Children with attention‐deficit hyperactivity disorder (ADHD) experience pragmatic language deficits, but it is not known whether these difficulties are primarily associated with high levels of inattention, hyperactivity, or both. We investigated pragmatic aspects of communication and language comprehension in relation to poor attention and/or high hyperactivity in a nondiagnosed population of 7‐ to 11‐year olds. Classroom teachers rated their pupils' attention and hyperactivity/impulsivity on the ADD‐H Comprehensive Teacher Rating scale (ACTeRS). Three groups were formed: children with poor attention and low hyperactivity (poor attention group), children with good attention and high hyperactivity (high hyperactivity group), and children with both poor attention and high hyperactivity (poor attention/high hyperactivity group). Their performance was compared with that of same‐age controls in two studies: Study 1 (N = 94) investigated the comprehension of figurative language in and out of context and Study 2 (N = 100) investigated the pragmatic aspects of communication using the Children's Communication Checklist – Second Edition. Two groups, the poor attention and the poor attention/high hyperactivity groups, were impaired in both their comprehension of figurative language and their communication skills. The high hyperactivity group was impaired in their comprehension of figurative language but they did not exhibit communication impairments. The findings extend work with clinical populations of children with ADHD: even in a nondiagnosed sample of children, poor attention and elevated levels of hyperactivity are associated with pragmatic language weaknesses.     

Behavioral Telehealth Consultation with Families of Children with Autism Spectrum Disorder

In this study, desktop video teleconferencing was used to facilitate behavioral consultation at a distance with three parents of school‐age children with autism spectrum disorders. Parents were supported via desktop video teleconferencing as they conducted functional analyses and learned to implement an antecedent manipulation strategy, functional communication training, and a consequence‐based strategy. Parents then conducted a brief multi‐element treatment comparison to evaluate the preliminary effectiveness of each intervention strategy on their child's challenging behavior. The results of this study provide additional support to previous research suggesting that a telehealth model of behavioral consultation may be an effective way to assist parents of children with autism spectrum disorders address challenging behavior that disrupts family routines. Suggestions for future research are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

Increasing access to low‐intensity interventions for childhood anxiety: A pilot study of a guided self‐help program for Scandinavian parents

Cognitive Behavior Therapy (CBT) is an effective treatment for child anxiety. However, access to treatment is limited. It has been suggested that low‐intensity formats of parent‐delivered CBT may improve access to treatment. Our aim was to develop and pilot‐test the acceptability and effect of a low‐intensity therapist‐guided parent‐delivered group program for anxious children (age 7–12 years) adjusted to the Scandinavian culture. The program required 1.5 hours of therapist‐time per family. Mothers, fathers and children reported on revised child anxiety and depression scale (RCADS) at referral, pre‐ and post‐treatment. Mothers and fathers also gave a qualitative account of their experiences. Thirty‐one families were enrolled and only one family dropped out. Mean age of the children was 9 years. Intent‐to‐treat analyses revealed significant reductions in anxiety and depressive symptoms from pre‐ to post‐treatment for all informants. Large effect sizes were found for child anxiety symptoms as reported by mothers and fathers, and for child depressive symptoms as reported by mothers. Medium to large effect sizes was found for the self‐reported anxiety symptoms by the children, and for depressive symptoms reported by both children and fathers. More than 93% of the parents would recommend the program. Results suggest that our program may provide a new approach to improve access to treatment for anxious children in Scandinavia; however, further research must be conducted before firm conclusions can be drawn.     

Supporting early oral language skills for English language learners in inner city preschool provision

Background. A significant number of children now enter formal education in England with reduced levels of proficiency in oral language. Children who come from disadvantaged backgrounds and who are English language learners (ELL) are at risk of limited oral language skills in English which impacts on later educational achievement. Aims. This paper reports the development of a theoretically motivated oral language intervention, Talking Time, designed to meet the needs of preschool children with poor language skills in typical preschool provision. Sample. One hundred and forty‐two 4‐year‐old children attending three inner city preschools in a disadvantaged area of London, England. Method. This is a quasi‐experimental intervention study comparing children exposed to Talking Time with children exposed to a contrast intervention and children receiving the statutory early years curriculum. Measures were taken of both targeted and non‐targeted language and cognitive skills. Results. Data were analysed for the ELL. The intervention had a significant effect on vocabulary, oral comprehension, and sentence repetition but not narrative skills. As predicted, there were no effects on the skills which were not targeted. Conclusions. Regular evidence‐based oral language interactions can make significant improvements in children's oral language. There is a need to examine the efficacy of more intensive interventions to raise language skills to allow learners to access the curriculum.     

The Efficacy of Child Parent Relationship Therapy for Adoptive Families: A Replication Study

This randomized controlled replication study examined the effectiveness of child parent relationship therapy (CPRT) with 49 adoptive families. Statistically significant improvement and large treatment effects for child behavior problems, parent–child relationship stress, and parents' empathic interactions with their children indicated the effectiveness of CPRT over treatment as usual. Findings confirm Carnes‐Holt and Bratton's ( 2014 ) results and provide strong support for CPRT as a responsive intervention for adoptive families.     

Educational advocacy for children with autism

There exists a great divide between parents' demands for intensive behavioral interventions for their children with autism and the public education system's reluctance to support early intensive behavioral intervention programs. More and more, professionals with expertise in applied behavior analysis are being asked to advocate for effective, early behavioral intervention for autism in education litigation brought about by frustrated parents. The progress made in recent years in the behavioral treatment of children with autism and the schools' lack of adherence to the requirements of IDEA have made it possible for educational policy change through effective advocacy by behavioral interventionists. This paper discusses preparing for educational advocacy on behalf of young children with autism. We explore the personal and emotional reasons why parents choose to engage in the financially risky endeavor of educational litigation. We then outline an approach to developing expert testimony based upon evaluation of the target child and his/her educational history. Issues related to assessment, training, and ethical practice are addressed. Copyright © 2002 John Wiley & Sons, Ltd.     

The Nature and Predictive Value of Mothers' Beliefs Regarding Infants' and Toddlers' TV/Video Viewing: Applying the Integrative Model of Behavioral Prediction

Viewing television and video programming has become a normative behavior among U.S. infants and toddlers. Little is understood about the extent of parents' decision making regarding their young children's viewing, although numerous organizations are interested in reducing time spent viewing among infants and toddlers. Prior research has examined parents' belief in the educational value of TV/videos for young children and the predictive value of this belief for understanding infant and toddler viewing rates, although other possible salient beliefs remain largely unexplored. This study employs the integrative model of behavioral prediction to examine 30 maternal beliefs about infants' and toddlers' TV/video viewing, which were elicited from a prior sample of mothers. Results indicate that mothers tend to hold more positive than negative beliefs about the outcomes associated with young children's TV/video viewing and that the nature of the aggregate set of beliefs is predictive of their general attitudes and intentions to allow their children to view, as well as children's estimated viewing rates. Analyses also uncover multiple dimensions within the full set of beliefs, which explain more variance in mothers' attitudes and intentions and children's viewing than the uni-dimensional index. The theoretical and practical implications of the findings are discussed.     

Increasing Single‐Word Requests to Multiword Requests in Children with Autism and Related Disabilities

Initial language training with children with autism often focuses on the production of single‐word requests (i.e., mands). As a child progresses in treatment, it is desirable to increase the mean length of utterance (MLU) of requests. The present study examined treatment outcomes of behavioral intervention designed to increase the MLU of requests in a larger sample of children with language delays (n = 30). Intervention consisted of prompts and differential reinforcement for lengthier requests, and trials were conducted flexibly throughout the treatment session. A non‐concurrent multiple baseline across participants design was utilized to establish experimental control, and MLU intervention consisted of a baseline and treatment phase for each participant. Nonoverlap of all pairs (NAP) was employed to estimate an effect size. Overall treatment effects were medium to large (average NAP = 0.89; average d = 2.36), and the majority of the sample (70%) demonstrated strong treatment effects. Results suggest that targeted behavioral intervention to increase the length of requests can be effective for children with autism and associated language delays. Copyright © 2015 John Wiley & Sons, Ltd.     

Therapist Factors Matter: A Systematic Review of Parent Interventions Directed at Children’s Behavior Problems

The present review systematically explored research examining the relationship between therapist‐related factors and the outcomes of parent interventions directed at children’s behavior problems. A systematic search of the literature was conducted with online scientific databases, parenting programs, web sites, and bibliographic references of the selected articles, according to PRISMA guidelines. A total of 24 quantitative studies met the inclusion criteria. Although some methodological limitations were identified with respect to the measurement of therapist factors, the reviewed research strongly suggests that the therapist plays a critical role in parent interventions directed at behavior problems. In particular, many parent outcomes are found to be related to the parent–therapist alliance, the therapist’s fidelity to the intervention, specific therapist’s in‐session actions, and the therapist’s personal variables. The parent–therapist alliance and therapist fidelity to the intervention consistently relate to changes in parenting practices, and alliance additionally relates to fewer perceived barriers to participation in treatment, more treatment acceptability, and greater parenting satisfaction and self‐efficacy. In addition, specific in‐session therapist interpersonal actions relate to parents’ engagement and satisfaction, while both the therapist’s interpersonal actions and more active skills relate to parent change. Therapist’s personal variables have been scarcely or poorly studied to date, but the results found justify the need to develop further research in this area. In conclusion, more attention should be given to the role of the therapist when implementing parenting programs directed at behavior problems, and more and better research is needed that can overcome the methodological limitations identified.     

The development of comprehension and reading‐related skills in children learning English as an additional language and their monolingual,English‐speaking peers

Background. A significant number of pupils in UK schools learn English as an additional language (EAL). Relative differences between the educational attainment of this group and monolingual, English‐speaking pupils call for an exploration of the literacy needs of EAL learners. Aims. This study explores the developmental progression of reading and listening comprehension skills and a range of reading‐related skills in EAL learners, whose first language is of South Asian origin, and their monolingual peers. Sample. Participants were 39 children learning EAL and 39 monolingual, English‐speaking children who were all in school Year 3 at the start of the study. Method. Children completed standardized measures of comprehension, vocabulary, reading accuracy, and reading fluency in school Year 3 and again in Year 4. Results. The results suggest that, although children learning EAL often demonstrate fast and accurate reading accuracy skills, lower levels of vocabulary knowledge place significant constraints on EAL learners' comprehension of spoken and written texts. Conclusions. Reciprocal relationships between vocabulary and comprehension may lead to increasing gaps in reading comprehension between monolingual and EAL pupils over time. It is proposed that support for the development of vocabulary skills in children learning EAL is needed in early years' classrooms.     

Longitudinal patterns of behaviour problems in children with specific speech and language difficulties: Child and contextual factors

Background. The purpose of this study was to examine the stability of behavioural, emotional and social difficulties (BESD) in children with specific speech and language difficulties (SSLD), and the relationship between BESD and the language ability. Method. A sample of children with SSLD were assessed for BESD at ages 8, 10 and 12 years by both teachers and parents. Language abilities were assessed at 8 and 10 years. Results. High levels of BESD were found at all three ages but with different patterns of trajectories for parents' and teachers' ratings. Language ability predicted teacher‐ but not parent‐rated BESD. Conclusions. The study confirms the persistence of high levels of BESD over the period 8–12 years and the continuing comorbidity of BESD and language difficulties but also indicates a complex interaction of within‐child and contextual factors over time.     

A parent intervention with a growth mindset approach improves children's early gesture and vocabulary development

Socioeconomic disparities in children's early vocabulary skills can be traced back to disparities in gesture use at age one and are due, in part, to the quantity and quality of communication children are exposed to by parents. Further, parents' mindsets about intelligence contribute to their interactions with their children. We implemented a parent gesture intervention with a growth mindset component with 47 parents of 10‐month‐olds to determine whether this approach would increase parents' use of the pointing gesture, infants' use of pointing, and child vocabulary growth. The intervention had an effect on parent gesture such that by child age 12‐months, parents who received the intervention increased in their pointing more than parents in the control condition. Importantly, the intervention also had a significant effect on child gesture use with parents. There was no main effect of the intervention on child vocabulary. Further, the effect of the intervention on pointing was stronger for parents who endorsed fixed mindsets at baseline, and had an added benefit of increased vocabulary growth from 10–18 months for children of those parents who endorsed fixed mindsets. Incorporating growth mindset approaches into parenting interventions is encouraged.     

Brief mother–infant treatment: Psychoanalytically informed video feedback

Specific patterns of interactive regulation documented by microanalytic methods of infant research can be applied to clinical interventions with mothers and infants. A brief treatment model is described that includes face‐to‐face split‐screen videotaping (one camera on each partner) and therapeutic observation of the videotape with the parent. The intervention uses “video feedback” informed by a psychoanalytic approach, including positive reinforcement, modeling, and information giving, as well as interpretation, while watching the videotape. Specific interactions in the areas of attention, arousal, affect, and timing regulation are evaluated. The psychoanalytic intervention links the “story” of the presenting complaints, the “story” seen in the videotape, and the “story” of the parent's own upbringing. An attempt is made to identify specific representations of the baby that may interfere with the parents's ability to observe and process the nonverbal interaction. The mother's powerful experience of watching herself and her baby interact, and our joint attempts to translate the action‐sequences into words, facilitates the mother's ability to “see” and to “remember,” stimulating a rapid integration of the mother's procedural and declarative modes of information‐processing. One treatment case, involving six contacts, is presented to illustrate the approach. By applying the specificity of interactive regulation identified by microanalysis of videotape into the psychodynamic treatment of mother–infant pairs, basic research can be translated into clinical practice. ©2003 Michigan Association for Infant Mental Health.     

Phonological awareness and language intervention in preschoolers from low socio‐economic backgrounds: A longitudinal investigation

This study examines the literacy outcomes for children from socially disadvantaged backgrounds who had received specific whole‐class phonological awareness (PA) and language intervention in preschool. The participants were 57 children who had been involved in the original intervention study. Their PA skills, letter‐sound knowledge, real word and non‐word spelling and reading comprehension were assessed in Grade 2. The results indicated that children who had received intervention in preschool performed similarly to the children who had not received intervention. The gains made in PA and language skills post intervention had failed to augment further literacy development. A post hoc examination of individual student profiles, however, revealed that a subgroup of children who had received intervention had maintained their enhanced performance and that the intervention cohort had similar scores on tests of PA ability to their age‐matched peers in the population. It was concluded that whole‐class, teacher‐delivered, PA and language intervention, while effective in the short term, does not lead to a generalized improvement in literacy skills in Grade 2. Possible reasons for the failure of the program to produce medium term gains are discussed.