National Trends in Implementing Wraparound: Results of the State Wraparound Survey, 2013

The wraparound process aims to provide an effective practice-level approach to coordinating care for youths with complex behavioral health needs, and reformed system structures to support such integration of care. The current study provides an update to two prior surveys of state children’s mental health directors, completed in 1998 and 2007, on the extent of wraparound implementation in the United States and implementation supports that have been employed. Results from 2013 found that 100 % of states reported having some type of wraparound program that conformed to the definition and yielded an estimate of 75,000 children and families served via wraparound in that year. States reported a continued increase in use of wraparound standards; however, fewer states reported collection of fidelity data, and availability of internal resources for training and coaching. Over three-quarters of states reported availability of parent to parent peer support, and 46 % of states are supporting wraparound implementation by blending or braiding funding across child-serving systems. Results also revealed that 61 % of states had a centralized oversight entity for wraparound, an important finding given that such “statewideness” was also associated with more youth served, greater accountability, use of standards, and other implementation supports.     

Influence of Child Factors on Health-Care Professionals’ Recognition of Common Childhood Mental-Health Problems

Early recognition of childhood mental-health problems can help minimise long-term negative outcomes. Recognition of mental-health problems, needed for referral and diagnostic evaluation, is largely dependent on health-care professionals’ (HCPs) judgement of symptoms presented by the child. This study aimed to establish whether HCPs recognition of mental-health problems varies as a function of three child-related factors (type of problem, number of symptoms, and demographic characteristics). In an online survey, HCPs (n = 431) evaluated a series of vignettes describing children with symptoms of mental-health problems. Vignettes varied by problem type (Attention-Deficit/Hyperactivity Disorder (ADHD), Generalised Anxiety Disorder (GAD), Autism Spectrum Disorder (ASD), Conduct Disorder (CD) and Major Depressive Disorder), number of symptoms presented (few and many), and child demographic characteristics (ethnicity, gender, age and socio-economic status (SES)). Results show that recognition of mental-health problems varies by problem type, with ADHD best recognised and GAD worst. Furthermore, recognition varies by the number of symptoms presented. Unexpectedly, a child’s gender, ethnicity and family SES did not influence likelihood of problem recognition. These results are the first to reveal differences in HCPs’ recognition of various common childhood mental-health problems. HCPs in practice should be advised about poor recognition of GAD, and superior recognition of ADHD, if recognition of all childhood mental-health problems is to be equal.     

An Evaluation of a Brief Multiple-Stimulus Without Replacement Preference Assessment Conducted in an Electronic Pictorial Format

We compared the results of a brief electronic pictorial multiple-stimulus without replacement (EP-MSWO) preference assessment to a brief tangible MSWO preference assessment in five children with autism. Results of both assessments yielded a match between high preferred (HP) toys for four participants and low preferred toys for three participants. The overall correlation between assessments across participants was strong and statistically significant (ρ = .67, p < .01). A reinforcer assessment conducted with three participants confirmed HP toys identified in the EP-MSWO functioned as reinforcers.     

Assessing the Helpfulness of One Parenting Assistance Helpline

This study examined the services provided by one statewide warmline established to assist parents and caregivers of children from birth through adolescence. Warmlines offer telephone-based, non-crisis support for individuals experiencing diverse issues that include parenting questions and concerns. The University of Alabama Child Development Resources collaborated with the Alabama State Department of Child Abuse and Neglect Prevention to institute the Parenting Assistance Line to provide information and support to parents and caregivers of children, age birth through adolescence. Overall, the staff of the Parenting Assistance Line responded to 9487 calls during the 6 years of data reported here. Through a secondary data analysis of calls to the Parenting Assistance Line from June 2007 to July 2013, this study describes the concerns of callers in relation to the ages of the children about whom they are calling and also evaluates the perceptions of the helpfulness of the information and support provided by the warmline. We found that frequently calls involved parent support and parental stress for parents and caregivers of children from infancy through adolescence. The findings suggest that telephone assistance lines offer a viable choice for parents and caregivers seeking affordable and accessible resources when stressed by the responsibilities of caring for children and adolescents and/or seeking information related to parenting issues. The study identified the limitations of research involving secondary data collected for purposes other than research that program administrators and evaluators should consider when planning and implementing services of this nature.     

Screening for Significant Behavior Problems in Diverse Young Children Living in Poverty

The development and use of first line screening instruments is an essential first step in assessing behavior disorders in very young children. The Early Childhood Behavior Screen (ECBS) is a parent-report measure for behavior disorders and is normed on young children (1–5 years old) living in poverty. The current study presents psychometric support for the discriminative validity of the ECBS’s 10-item Challenging Behavior Scale (CBS) as a first-line screener for externalizing behavior problems for preschool aged-children in poverty. The study’s sample included 673 participants (M age years = 2.81; 63.2 % male; 65.8 % African American) that all met the federal definitional standard for living in poverty. A confirmatory factor analysis was run to provide support for the ECBS factor structure. Receiver operating characteristics (ROC) curve analyses were used to test the CBS’s ability to distinguish between 428 clinic-referred children and 245 non-clinic-referred children. Results showed an acceptable fit model for the ECBS, providing further evidence of its construct validity. Optimal cut-scores by child age derived from the ROC curve analyses were provided with corresponding levels of sensitivity, specificity, and positive and negative predictive values. Sensitivity rates for cut scores ranged from 0.76 to 0.83 and specificity rates ranged from 0.88 to 0.95. Acceptable test–retest reliability and good internal consistency also was observed. The CBS quickly identifies young children from low-income, urban, diverse populations that may be at-risk for developing significant behavior disorders and should be considered by health care professionals who work with very young children.     

Psychometric Evaluation of the Rage Outbursts and Anger Rating Scale in an Outpatient Psychiatric Sample

The primary objective of this study was to examine the psychometric properties of a measure of anger/rage attacks—the Rage Outburst and Anger Rating Scale (ROARS)—in a sample of youth (n = 81, ages 7–17 years, 72.8 % male) receiving treatment at an outpatient pediatric psychiatric clinic. A trained rater completed the ROARS and Clinical Global Impression-Rage (CGI-Rage). Children completed the Spence Children’s Anxiety Scale for Children and Center for Epidemiological Studies Depression Scale. Parents completed the Spence Children’s Anxiety Scale for Parents. Internal consistency (α = .89), inter-rater reliability (κ = .94) and 1-week test–retest reliability (r = .72) were calculated for the ROARS. The ROARS was correlated with CGI-Rage (r = .68, ρ < .001), although not with parent- and child-rated anxiety symptoms or with child-rated depressive symptoms. Implications regarding clinical utility of the ROARS and directions for future research are discussed.     

Criminally Involved Parents Who Misuse Substances and Children’s Odds of Being Arrested as a Young Adult: Do Drug Treatment Courts Mitigate the Risk?

This paper examined (1) the association between parents who are convicted of a substance-related offense and their children’s probability of being arrested as a young adult and (2) whether or not parental participation in an adult drug treatment court program mitigated this risk. The analysis relied on state administrative data from North Carolina courts (2005–2013) and from birth records (1988–2003). The dependent variable was the probability that a child was arrested as a young adult (16–21). Logistic regression was used to compare groups and models accounted for the clustering of multiple children with the same mother. Findings revealed that children whose parents were convicted on either a substance-related charge on a non-substance-related charge had twice the odds of being arrested as young adult, relative to children whose parents had not been observed having a conviction. While a quarter of children whose parents participated in a drug treatment court program were arrested as young adults, parental completion this program did not reduce this risk. In conclusion, children whose parents were convicted had an increased risk of being arrested as young adults, irrespective of whether or not the conviction was on a substance-related charge. However, drug treatment courts did not reduce this risk. Reducing intergenerational links in the probability of arrest remains a societal challenge.     

Economic Pressure,Individual and Family Processes,and Children’s Reticence in Romanian Families

Using Conger’s family stress model as a theoretical framework, a series of mediated associations among economic hardship, perceived economic pressure, parental depression, marital conflict, psychologically controlling parenting, and children’s reticent behaviors in Romanian families were studied. The sample consisted of 121 Romanian mothers and fathers of 4–5-year-old children. Children’s kindergarten teachers living in urban and rural locations evaluated child reticence. Findings generally support the family stress model. Structural equation modeling showed that after controlling for living in a rural location, economic pressure was indirectly linked with marital conflict through depression. Depression was indirectly related to psychological control through marital conflict, and marital conflict was indirectly linked to child reticence through psychological control. Directions for future research and recommendations for interventions and public policy are described.     

Parenting Dimensions and Internalizing Difficulties in Italian and U.S. Emerging Adults: The Intervening Role of Autonomy and Relatedness

The present study examined the associations between emerging adults’ perceived parental psychological control and autonomy support, and their autonomy, relatedness and internalizing difficulties in Italy and the U.S. The participants included 494 Italian and 414 U.S. college students, between 18 and 28 years of age (Mean = 21.58, SD = 2.18). Our findings showed that dependency-oriented psychological control had no significant direct associations with autonomy, relatedness or internalizing difficulties. Moreover, the association between parental autonomy support and internalizing problems was fully intervened by autonomy and relatedness, whereas the association between achievement-oriented psychological control and anxiety and depressive symptoms was partially intervened by autonomy and relatedness. Finally, although parental psychological control and autonomy support had similar effects on maladjustment across the two countries, relatedness appeared to play a more central role as an intervening variable for anxiety in the Italian group than in the U.S. group. Overall, our findings highlighted the importance of examining parents’ contributions to emerging adults’ internalizing problems via autonomy support and psychological control across cultures.