The Application of Behavior Change Theory to Family-Based Services: Improving Parent Empowerment in Children’s Mental Health

We describe the development of a parent empowerment program (PEP) using a community-based participatory research approach. In collaboration with a group of dedicated family advocates working with the Mental Health Association of New York City and state policy makers, academic researchers took an iterative approach to crafting and refining PEP to better prepare family advocates to help bridge the gaps in service access among children with emotional and behavioral problems. Despite the growth of family-led, family support programs nationally, research that demonstrates the positive benefits of such programs is scarce in the children’s mental health literature. The PEP model is based on research data about barriers families face in mental health service utilization (e.g., stigma, perceptions of providers, attitudes towards mental illness, service availability, etc.). PEP is premised on (a) the concept of empowerment as a process, (b) the need to engage parents in becoming active agents of change, and (c) the application of an integrated framework to empower parents, called the Parents as Agents of Change model. Our paper focuses on describing the application of a Unified Theory of Behavior Change as a theoretical framework to help activate parents as change agents in meeting their children’s mental health needs. Based on an integrated model of grassroots driven Principles of Parent Support and research-based Unified Theory of Behavior Change, PEP’s Parents as Agents of Change model provides a conceptual framework for testing the effectiveness of family support services in children’s mental health, a much-needed area for future research.     

Evaluating the effects of physical reactions on aggression via concurrent‐operant analyses

Under naturally occurring conditions, the individual who is the target of aggression is likely to physically react to evade the aggressor and avoid physical harm. Like other forms of attention that occur following problem behavior, physical reactions may maintain problem behavior. However, evaluating the effects of physical reactions is complicated by issues related to therapists' ability to consistently and safely control their reactions, which may prove difficult to achieve in functional analyses. We evaluated the utility of a concurrent‐operant analysis to test behavioral sensitivity to physical reactions. The results suggest that the concurrent‐operant analysis may be useful when therapists cannot consistently refrain from responding contingent on problem behavior in the control condition of a more typical functional analysis.     

Bidirectional Spillover in the Family across the Transition to Parenthood

Although family systems theory posits reciprocal causality between subsystems of the family, such as intimate partner violence exacerbating harsh parenting and vice versa, longitudinal studies with cross‐lagged models have been used infrequently to test these principles. As guided by the spillover model, this study examined bidirectional associations between couple dysfunction, parent–child aggression risk, and child functioning across the transition to parenthood to determine whether and how disruptions in one subsystem relate to problems in other family subsystems. Participants were 201 first‐time mothers and 151 fathers from a diverse community sample, evaluated during pregnancy, and reassessed two more times through their child's first 18 months of life. Individual and dyadic path model results indicate bidirectional spillover effects between parent–child aggression risk and child functioning for both mothers and fathers, and spillover from parent–child aggression risk to couple dysfunction for mothers but not fathers. However, limited spillover effects were identified between couple functioning and child adjustment, in contrast to previous work. Findings suggest that spillover can happen reciprocally and early in the family, supporting transactional models of behavior and highlighting the need for early family level intervention.     

Assessing the social validity of telehealth-based applied behavior analysis services for autism spectrum disorder

During the COVID-19 pandemic, applied behavior analysis services for many autistic individuals were transitioned to telehealth. The current study assessed caregiver-reported quality of life (QoL) and social validity for families of autistic children receiving only telehealth services (n = 96) or a combination of telehealth and in-person services (n = 173). Barriers to the telehealth experience were analyzed via an ANOVA, and the impact of funding source was analyzed using an independent samples t-test. Caregivers reported benefit across QoL and social validity items, with scores ranging from 3.31 to 4.44 (1 = least benefit, 5 = most benefit). While many caregivers reported no barriers regarding technology (44.61%), childcare (69.52%), and employment (64.68%), the presence of those barriers significantly impacted QoL and social validity scores. Funding source was not found to have a significant impact. Overall, caregivers found value in their child's telehealth services. Clinicians have an obligation to mitigate barriers to ensure the success of the intervention.     

Braille literacy as a human right: A challenge to the “inefficiency” argument against braille instruction

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) affirms a right to education for disabled persons and aims to ensure braille instruction for blind individuals. However, there is evidence that braille instruction is often circumvented or abandoned early in CRPD nations because it is perceived as an inefficient learning medium for blind students. This perception persists despite insufficient empirical evidence and a lack of understanding of the efficiency of reading versus listening for learning in sighted individuals. We therefore investigated the efficiency of learning written versus spoken words in blind and sighted samples. Participants (23 blind, 20 sighted) studied the written definitions of 70 rare English words in successive rounds, presented in conjunction with written or spoken wordforms. Blind participants learned with equal efficiency across modalities, whereas sighted participants learned spoken words more efficiently. The findings indicate the inefficiency argument against teaching braille is groundless, both because braille word learning is not less efficient than auditory word learning for blind individuals, and because reading is valued in the education of sighted individuals despite its apparent inefficiency in that population.     

Parent–Child Aggression Risk in Expectant Mothers and Fathers: A Multimethod Theoretical Approach

The current investigation evaluated whether cognitive processes characteristic of the Social Information Processing model predicted parent–child aggression (PCA) risk independent of personal vulnerabilities and resiliencies. This study utilized a multimethod approach, including analog tasks, with a diverse sample of 203 primiparous expectant mothers and 151 of their partners. Factors considered in this study included PCA approval attitudes, empathy, reactivity, negative child attributions, compliance expectations, and knowledge of non-physical discipline alternatives; additionally, vulnerabilities included psychopathology symptoms, domestic violence victimization, and substance use, whereas resiliencies included perceived social support, partner relationship satisfaction, and coping efficacy. For both mothers and fathers, findings supported the role of greater approval of PCA attitudes, lower empathy, more overreactivity, more negative attributions, and higher compliance expectations in relation to elevated risk of PCA. Moreover, personal vulnerabilities and resiliencies related to PCA risk for mothers; however, fathers and mothers differed on the nature of these relationships with respect to vulnerabilities as well as aspects of empathy and PCA approval attitudes. Findings provide evidence for commonalities in many of the factors investigated between mothers and fathers with some notable distinctions. Results are discussed in terms of how findings could inform prevention programs.     

Intimate partner violence among HIV positive pregnant women in South Africa

The aim of the study was to determine the prevalence of intimate partner violence (IPV) and associated factors among pregnant HIV-infected women in primary health care facilities in Nkangala and Gert Sibande districts, Mpumalanga, South Africa. Participants were 673 women who were, on average, 28.39 ± 5.73 years old. Data were collected through Audio Computer Assisted Self Interview (ACASI), and analysed using the IBM Statistical Package for Social Sciences (SPSS). Overall, 56.3% reported having experienced either psychological or physical IPV, and 19.6% reported physical IPV. In logistic multivariable regression analyses, higher levels of depressive symptoms and greater perceived stigma were associated with combined physical and psychological IPV. Psychological IPV and physical IPV were also individually associated with greater perceived stigma and higher levels of depressive symptoms. The design and implementation of evidence-informed interventions that can empower and protect HIV-infected pregnant women from IPV is essential to managing their health-related quality of life.     

Toward establishing a qualifying autoclitic repertoire in children with autism spectrum disorder

Autoclitics are secondary verbal operants that are controlled by a feature of the conditions that occasion or evoke a primary verbal operant such as a tact or mand. Qualifying autoclitics extend, negate, or assert a speaker's primary verbal response and modify the intensity or direction of the listener's behavior. Howard and Rice (1988) established autoclitics that indicated weak stimulus control (e.g., “like a [primary tact]”) with four neurotypical preschool children. However, generalization to newly acquired tacts was limited. In Experiment 1, we addressed similar behavior as in Howard and Rice but with autistic children while using simultaneous teaching procedures, and we observed generalization across sets and with newly acquired tacts. In Experiment 2, we evaluated the effects of multiple-exemplar training on generalization of autoclitics across sets of naturalistic stimuli. Across participants, gradual increases in the frequency of autoclitics occurred with untaught stimuli after teaching with one or more sets.     

Examining Gender-Specific Modeling in the Intergenerational Transmission of Parenting Style and Physical Child Abuse Risk

Journal of Child and Family Studies - Although research demonstrates intergenerational transmission of parenting attitudes and child abuse risk, greater clarity on the potential mechanisms in this...