Broader Autism Phenotype in Parents of Children with Autism: A Systematic Review of Percentage Estimates

The broader autism phenotype (BAP) is a collection of sub-diagnostic autistic traits more common in families of individuals with autism spectrum disorder (ASD) than in the general population. BAP is a latent construct that can be defined using different domains, measured using multiple instruments, and reported using different techniques. Therefore, estimates of BAP may vary greatly across studies. Our objective was to systematically review studies that reported occurrence of BAP in parents of children with ASD in order to quantify and describe heterogeneity in estimates. We systematically searched PubMed and Scopus using PRISMA guidelines for studies quantifying percentage of parents of children with ASD who had BAP. We identified 41 studies that measured BAP in parents of children with ASD. These studies used eight different instruments, four different forms of data collection, and had a wide range of sample sizes (N?=?4 to N?=?3299). Percentage with BAP ranged from 2.6% to 80%. BAP was more prevalent in fathers than mothers. Parental BAP may be an important tool for parsing heterogeneity in ASD etiology and for developing parent-mediated ASD interventions. However, the variety in measurement instruments and variability in study samples limits our ability to synthesize estimates. To improve measurement of BAP and increase consistency across studies, universal methods should be accepted and adopted across studies. A more consistent approach to BAP measurement may enable efficient etiologic research that can be meta-analyzed and may allow for a larger evidence base that can be used to account for BAP when developing parent-mediated interventions.     

Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis

Clinical Child and Family Psychology Review - Parent stress and mental health problems negatively impact early child development. This study aimed to systematically review and meta-analyze the...     

Enhancing Initial Parental Engagement in Interventions for Parents of Young Children: A Systematic Review of Experimental Studies

Low rates of participation in parenting interventions may undermine their effectiveness. Although a wide range of strategies to engage parents in interventions are described in the literature, little is known about which engagement strategies are most effective in enhancing parental engagement. This systematic review explores effective engagement strategies to encourage initial parental engagement (recruitment, enrolment, and first attendance) in parenting interventions for parents of children aged 2–8 years old. This review was conducted based on the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions (Higgins and Green 2011) and the Preferred Reporting Items for Systematic Review and Meta-Analysis (Moher et al. 2009). Electronic systematic searches from January 1996 to August 2017 were conducted in PsycINFO, Scopus, ProQuest Social Sciences Journals, CINAHL, and PubMed databases. Eight studies met the inclusion criteria representing 1952 parents from four different countries. Of the engagement strategies tested in included studies (monetary incentive, setting, testimonial, advertisement, and engagement package), three strategies (advertisement, incentive, and engagement package) showed a significant effect on a stage of engagement, but none across stages. The low methodological quality of the selected studies limits their generalisability and thus provides limited evidence regarding effective engagement strategies to increase recruitment, enrolment, and first attendance rates in parenting interventions. There is a need for further, more methodologically rigorous, research evidence regarding how to engage parents more effectively in the early stages of parenting interventions.     

Perceptions of ADHD Among Diagnosed Children and Their Parents: A Systematic Review Using the Common-Sense Model of Illness Representations

Research on children and parents’ experiences of ADHD has grown in recent years, attracting attention to their subjective perception of ADHD as a disorder. Theoretical accounts of illness perception suggest that it is multi-dimensional, consisting of at least five core constructs (see the common-sense model of illness representations or CSM: Leventhal et al., in: Rachman (ed) Medical psychology, Pergamon, New York, vol 2, pp 7–30, 1980, in: Baum, Taylor, Singer (eds) Handbook of psychology and health: social psychological aspects of health, Earlbaum, Hillsdale, vol 4, pp 219–252, 1984). We suggest that the application of CSM in children/adolescents with ADHD and their parents may play an important role in understanding their coping behavior, treatment adherence, and emotional well-being. A systematic search identified 101 eligible studies that investigated the perception of ADHD among diagnosed children/adolescents and their parents. In general, these studies support the existence of the multiple facets of illness representations proposed by the CSM in both diagnosed youngsters and parents indicating substantial variability among both parents and youngsters on each of these facets. The comprehensive assessment of the representations of ADHD indicates imbalance attention to the different representations of ADHD in the literature; disproportional research attention has been paid to the perceived effectiveness of treatment (i.e., treatment control dimension) compared to other illness representations (e.g., timeline, consequence, and coherence), despite research showing their relevance to treatment adherence among other implications. The review identifies the limitation of existing relevant research, needed foci for future studies, specific testable hypotheses, and potential clinical implications of the multifaceted representations of ADHD among youngsters and carers alike.     

Psychological Distress in Refugee Children: A Systematic Review

Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style review was conducted searching nine major databases, bibliographies, and grey literature from 2003 to 2008. Included studies had to meet the reporting standards of STROBE and investigate mental health in non-clinical samples of asylum seeking and refugee children residing in OECD countries. A total of twenty-two studies were identified of 4,807 retrieved citations, covering 3,003 children from over 40 countries. Studies varied in definition and measurement of problems, which included levels of post-traumatic stress disorder from 19 to 54%, depression from 3 to 30%, and varying degrees of emotional and behavioral problems. Significant factors influencing levels of distress appear to include demographic variables, cumulative traumatic pre-migration experiences, and post-migration stressors. Importantly, the research base demands greater contextual and methodological refining such that future research would have greater generalizability and clinical implications.     

A Systematic Review of Courses,Training, and Interventions for Adoptive Parents

Adoption requires thorough preparations prior to the arrival of the child and support post-adoption among parents, to promote a positive parent–child relationship and healthy family functioning. The purpose of our study was, therefore, to systematically review the literature on pre- and post-adoption interventions for caregivers, and determine the possibility for conducting a meta-analysis. We searched 12 electronic databases and identified 7574 references that were considered for inclusion by two independent raters. Articles meeting the following criteria were retrieved in full-text; studies that examined the effects of (a) a pre- and/or post-adoption intervention, (b) against a comparator (including quasi-experimental studies), and (c) report on outcomes for parents. Finally, we included 10 studies that met our inclusion criteria and which were assessed in terms of reported intervention effects and study quality using Cochrane’s Risk of Bias tool. All studies were associated with a high risk of bias in at least one out of seven domains and unclear reporting on several domains. Eight studies examined intervention effects related to interpersonal functioning; three of which found positive effects. In addition, three studies investigated effects on parenting and stress, respectively; however, only one study demonstrated effects on parenting and none on parental stress. Overall, the study designs, interventions, and results were characterized by substantial heterogeneity, making a meta-analysis unfeasible. In conclusion, the results from the included studies in our review does not point in any particular direction. The most consistent finding across studies was the lack of studies on pre-adoption interventions, and poor design and unclear reporting. Consequently, future studies should evaluate pre-adoption interventions, and need to use more rigorous design, transparent and comprehensible reporting, as well as more homogenous interventions and methods, to move the field forward in support of adoptive parents.     

Post-concussive Signs and Symptoms in Preschool Children: A Systematic Review

Neuropsychology Review - Mild traumatic brain injury (mTBI) is common in children aged?<?5 years, however, less is known about their experience of post-concussive signs...     

A Systematic Review of Frequency Building and Precision Teaching with School-Aged Children

This paper presents a systematic review of the literature that assessed the effectiveness of frequency building and precision teaching with school-aged children. The authors evaluated studies in accordance with the What Works Clearinghouse standards and the council for exceptional children standards for evidence-based practices in special education. A total of 11 studies examining the effectiveness of frequency building and precision teaching for 170 participants were included in this review. Additionally, effect sizes were calculated for eligible studies. Small to large effects were found for all included variables. Overall, results indicated that the combination of frequency building and precision teaching is an effective method for increasing a variety of academic skills with school-aged children. Limitations, recommendations for future research, and implications for practitioners are discussed.

     

Transactional Paths Between Children and Parents in Pediatric Asthma: Associations Between Family Relationships and Adaptation

The particular challenges posed by pediatric asthma may have a negative impact on the adaptation of children and their parents. From a transactional approach it is important to examine how reciprocal links between children and parents contribute to explain their adaptation and under which conditions these associations occur. This cross-sectional study aimed at examining the direct and indirect links between children’s and parents’ perceptions of family relationships and adaptation, separately (within-subjects) and across participants (cross-lagged effects), and the role of asthma severity in moderating these associations. The sample comprised 257 children with asthma, aged between 8 and 18 years-old, and one of their parents. Both family members completed self-reported questionnaires on family relationships (cohesion and expressiveness) and adaptation indicators (quality of life and psychological functioning). Physicians assessed asthma severity. Structural Equation Modeling was used to test within-subjects and cross-lagged paths between children’s and parents’ family relationships and adaptation. The model explained 47 % of children’s and 30 % of parents’ adaptation: family relationships were positively associated with adaptation, directly for children and parents, and indirectly across family members. Asthma severity moderated the association between family relationships and health-related quality of life for children: stronger associations were observed in the presence of persistent asthma. These results highlight the need of including psychological interventions in pediatric healthcare focused on family relationships as potential targets for improving children’s and parents’ quality of life and psychological functioning, and identified the children with persistent asthma as a group that would most benefit from family-based interventions.     

Co-Sleeping among School-Aged Anxious and Non-Anxious Children: Associations with Sleep Variability and Timing

Little is known about the co-sleeping behaviors of school-aged children, particularly among anxious youth who commonly present for the treatment of sleep problems. The current study examined the occurrence of co-sleeping in both healthy and clinically anxious children and its associated sleep patterns. A total of 113 children (ages 6–12), 75 with primary generalized anxiety disorder and 38 healthy controls, participated along with their primary caregiver. Families completed structured diagnostic assessments, and parents reported on their child’s co-sleeping behaviors and anxiety severity. Children provided reports of anxiety severity and completed one week of wrist-based actigraphy to assess objective sleep patterns. A significantly greater proportion of anxious youth compared to healthy children co-slept, and greater anxiety severity was related to more frequent co-sleeping. Co-sleeping in anxious youth was associated with a delay in sleep timing and with greater sleep variability (i.e., more variable nightly sleep duration). All analyses controlled for child age, race/ethnicity, family income, and parental marital status. Co-sleeping is highly common in anxious school-aged children, with more than 1 in 3 found to co-sleep at least sometimes (2–4 times a week). Co-sleeping was even more common for youth with greater anxiety severity. Increased dependence on others to initiate and maintain sleep may contribute to poorer sleep in this population via shifted schedules and more variable sleep patterns.     

Early Traumatic Stress Responses in Parents Following a Serious Illness in Their Child: A Systematic Review

A systematic review of the literature investigating the early traumatic stress responses in parents of children diagnosed with a serious illness/injury. A literature review was conducted (September 2013) using Medline, PsycINFO, and CINAHL databases. Twenty-four studies related to parents of children hospitalized due to diagnosis of cancer, type 1 diabetes, meningococcal disease, trauma or serious injury, preterm birth and other serious illnesses requiring admission to intensive care were included. Parents were assessed for early traumatic stress symptoms within 3 months of their child’s diagnosis/hospitalization. Prevalence rates of acute stress disorder in parents ranged from 12 to 63 %. Prevalence of posttraumatic stress disorder ranged from 8 to 68 %. Variability was related to methodological factors including differences in study design, timing of assessments, measurement tools, and scoring protocols. Psychosocial factors rather than medical factors predicted parent distress. This review integrates and compares early traumatic reactions in parents with children suffering a range of serious illnesses. Findings suggest a high prevalence of acute and posttraumatic stress symptoms in parents. Methodological inconsistencies made comparison of early traumatic stress prevalence rates difficult. Risk factors associated with traumatic stress symptoms were identified.     

Executive Functions in Children and Adolescents with Turner Syndrome: A Systematic Review and Meta-Analysis

Turner syndrome (TS) is a genetic disorder, affecting 1/2500 to 1/3000 live female births, induced by partial or total deletion of one X chromosome. The neurocognitive profile of girls with TS is characterized by a normal Verbal IQ and weaknesses in visual-spatial, mathematics, and social cognitive domains. Executive functions (EFs) impairments have also been reported in these young patients. However, methodological differences across studies do not allow determination of which EFs are impaired and what is the magnitude of these impairments. The aim of this review was to clarify the EF profile of children and adolescents with TS. Sixteen samples, from thirteen studies, were included in the current meta-analysis. EFs measures used in these studies were classified into working memory, inhibitory control, cognitive flexibility, or higher-order EFs tasks in accordance with Diamond’s model, Annual Review of Psychology, 64, 135–168 (2013). Results confirmed that girls with TS had significant executive impairments with effect sizes varying from small (inhibitory control) to medium (cognitive flexibility) and large (working memory, higher-order EFs). Analyses by task revealed that cognitive inhibition may be more impaired than the other inhibitory control abilities. Heterogeneity across cognitive flexibility measures was also highlighted. Between-sample heterogeneity was observed for three tasks and the impact of participants’ characteristics on EFs was discussed. This meta-analysis confirms the necessity to assess, in patients living with TS, each EF by combining both visual and verbal tasks. Results also underline that, when studying girls with TS’ executive profile, it is important to explore the impact of moderator variables, such as IQ, parental socio-economic status, TS karyotype, psychiatric comorbidities, and hormonal treatment status.     

Sleep in Women: A Review

Sleep complaints are common in women, and women are more likely to suffer from insomnia than men. Multiple factors across a woman's lifespan, including hormonal changes, age‐related physiological changes, psychosocial factors, the presence of sleep disorders, and physical and mental health conditions, can contribute to complaints of poor sleep in women. This article reviews the literature on the characteristics of, and contributing factors to, subjectively and objectively measured sleep during the menstrual cycle, pregnancy, and post‐partum period, as well as the menopausal transition and postmenopause. Evidence from both subjective and objective measurements supports the presence of chronic sleep fragmentation associated with pregnancy, acute sleep deprivation during labour and the immediate post‐partum periods, as well as disrupted sleep during the first few months after childbirth. While there is evidence for menstrual cycle and menopause related sleep disturbance based on women's self report, findings from objectively measured sleep have been mixed. Observational and intervention studies on the relationship between sleep and women's psychological well‐being suggest that underlying causes of sleep disturbance across a woman's lifespan are often multi‐factorial. Comprehensive assessments and targeted interventions are needed in managing sleep problems in women. Cognitive behavioural interventions have been shown to reduce sleep complaints during the perinatal and menopausal periods, and improvements in sleep are likely to lead to improvements in women's overall well‐being.     

A Systematic Review and Meta-analysis of Narrative Language Abilities in Children with Attention-Deficit/Hyperactivity Disorder

Research on Child and Adolescent Psychopathology - While children with ADHD are reported to have language problems, it is less clear if their ability to use language to tell a story (i.e., form a...     

Prevalence of Sexual Abuse Among Children with Conduct Disorder: A Systematic Review

Many clinicians and researchers have speculated that child sexual abuse and conduct disorder co-occur frequently, yet no systematic reviews of literature have specifically addressed both these conditions. To estimate the prevalence of sexual abuse among children with conduct disorder, the pertinent literature was systematically reviewed. Ten databases were searched, supplemented with hand search of reference lists from retrieved papers. Blind assessments of study eligibility and quality were conducted by two independent researchers. Disagreements were resolved by consensus. Twenty-three studies meeting minimum quality criteria that were enough to insure objectivity and not to invalidate results and including 7,256 participants with either conduct disorder or child sexual abuse were examined. The prevalence of child sexual abuse among participants with conduct disorder was 27 %; however, such figure might be underestimated due to selection, sampling, and recall biases; poor assessment methods; and narrow definitions of abuse in included studies. Participants with conduct disorder, compared with healthy individuals, reported higher rates of child sexual abuse. However, compared with other psychiatric populations, they reported similar or lower rates. There was also some evidence suggesting that children with conduct disorder might be more likely to report child physical abuse. Female participants with conduct disorder, compared with males, were significantly more likely to report child sexual abuse. Youths with conduct disorder are at risk of being (or having been) sexually abused, although such risk seems to be neither more specific to nor stronger for these individuals, compared with people with other psychiatric disorders.     

Treating Parents and Children Together

SUMMARY

In this paper I look at two traditions of psychotherapy with children: family therapy {here considered in its common paradigm of systems theory and not in its diversity of approaches) and individual psychodynamically oriented child therapy. The author examines how, in these two modalities of treatment, the real world of the parent-child relationship, which remains mostly a world of women and children, tends to be left out in practice. Many family therapists “exclude” children from their sessions and concentrate on the marital relationship while child therapists “exclude” parents from the core of the therapeutic process. The issues for therapists and the consequences for adults and children in families in this com-partmentalization of services are examined within a feminist framework. The development which is advocated is for therapists to expose themselves fully to the world of the parent-child relationship as a fust step in reexamining their stereotypical views of motherhood and fatherhood which trap women in conflicted and potentially exploitative situations and do not consider that children actively construct their own relationships.