Parent-Collected Behavioral Observations: An Empirical Comparison of Methods

Treatments for disruptive behaviors are often guided by parent reports on questionnaires, rather than by multiple methods of assessment. Professional observations and clinic analogs exist to complement questionnaires, but parents can also collect useful behavioral observations to inform and guide treatment. Two parent observation methods of child aggression and noncompliance were compared: the Parent Daily Report (PDR) and Behavior Record Cards (BRC). Parents tracked misbehavior for 2 weeks using the PDR or BRC. BRC data proved to be more accurate, though both systems yielded strong reliability and moderate validity. The BRC is recommended to clinicians on empirical and conceptual grounds.     

Integrated Behavior Therapy for Selective Mutism: A randomized controlled pilot study

Objective

To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech.

Method

A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains.

Results

Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up.

Conclusion

IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers.     

What Must You Know and Do to Get Good Outcomes With DBT?

Because little research has been conducted on which therapist-client interactions lead to intermediate and end-point improvements in Dialectical Behavior Therapy (DBT), we have a small evidence-base from which to specify what therapists must know and do in order to obtain good outcomes using DBT. As with other evidence-based practices, dissemination of DBT has defaulted to assumptions and methods from the “psychotherapy technology model,” which emphasizes transfer of the validated treatment package from the research clinic to routine settings with high fidelity (Morgenstern & McKay, 2007). However, serious limitations of the psychotherapy technology model require pursuit of alternative complementary models to guide dissemination. One complementary approach is to use well-designed practice-based training research. In this approach, therapists learn modular competencies linked to a highly structured yet flexible clinical decision-making framework. Modular training of therapist competencies emphasizes the continuity of the component therapist strategies across evidence-based protocols rather than emphasizing the packages or manuals as separate and distinct. Key hypotheses about the change processes responsible for client change and the associated treatment strategies used to influence these change processes should be specified and measured at the level of client, therapist, and service delivery setting. Adopting this approach may offer advantages that apply to the dissemination and implementation of DBT and other evidence-based practices (EBPs).     

Direct and Indirect Effects of Adolescent Self-Control of Emotions and Behavioral Expression on Adult Health Outcomes

In the ongoing Jyväskylä Longitudinal Study of Personality and Social Development, we examined the direct and indirect effects of self-control of emotions and behavioral expression, as rated by teachers at age 14, on various self-reported health outcomes at age 36 in 123 women and 129 men. The relation between independent and dependent variables was expected to be mediated by health-related behaviors at age 36 (exercise, tobacco use, heavy drinking). Path analysis showed that, in men, low self-control of emotions was linked to self-assessed poor health and physical symptoms indirectly via health-risk behaviors, but directly to disabilities. Behavioral expression at age 14, indexed by social activity, was directly linked to disabilities. In women, behavioral expression was unrelated to health outcomes, but low self-control of emotions was indirectly linked to self-assessed poor health, physical symptoms, and disabilities via health-risk behaviors.     

The Dimensionality of Contextual and Citizenship Performance in Military Recruits: Support for Nine Dimensions Using Self-, Peer,and Supervisor Ratings

Organizational Citizenship Behavior and Contextual Performance make up a domain that can be referred to as Contextual and Citizenship Performance (CCP). CCP is essential to assess and promote in military and civilian organizations because it defines the “good soldier” prototype. Unfortunately, extant research has led to confusion as to whether CCP consists of one, two, three, six, or nine dimensions. We shed new light on the composition of CCP by evaluating one-, two-, three-, six-, and nine-dimensional theoretical models using supervisor, self-, and peer ratings of military recruits undergoing basic training. We employed Relative Percentile Method ratings to improve distinctions among ratees when the level of CCP is high. Contrary to much recent literature, our results supported a nine-dimensional theoretical model in all three rating sources. Thus, conceptualizing, assessing and promoting the proverbial “good soldier” may require a more highly nuanced perspective of CCP than is generally acknowledged.     

Neurobehavioral Characteristics of Children with Duchenne Muscular Dystrophy

This study investigated cognitive, metacognitive, and psychosocial aspects of neurobehavioral functioning in 22 boys with Duchenne muscular dystrophy (DMD) and 18 unaffected siblings, all between the ages of 6 and 16 years. Probands and siblings completed the Wechsler Abbreviated Scale of Intelligence, as well as selected subtests from the Children's Memory Scale and from the Delis-Kaplan Executive Function System, while parents completed the Child Behavior Checklist and the Behavior Rating Inventory of Executive Function. Compared to siblings, probands demonstrated relative weaknesses on both verbal and nonverbal measures of delayed recall and response generation and were rated by parents as having more difficulties with social interaction, initiation, and adaptation. It is concluded that DMD is associated with mild but potentially significant difficulties in a range of neurobehavioral areas, likely related to deficient dystrophin levels in an integrated brain circuit that includes the cerebellum, hippocampus, and association neocortex.     

Subtypes of Psychopathology in Children Referred for Neuropsychological Assessment

The validity of a Personality Inventory for Children-Revised edition (PIC-R) typology was examined in a sample of 323 children aged 6–16 years. These children had been referred to a children's mental health centre for neuropsychological assessment. In study 1, K-means cluster analysis (k = 12) was applied to the PIC clinical scales in an attempt to replicate the 12 clusters identified by Gdowski, Lachar, and Kline (1985). Partial cluster replication was achieved. Examination of the obtained clusters revealed significant overlap, suggesting that fewer clusters would represent an optimal solution. In study 2, a two-stage cluster analysis yielded a seven-cluster solution consistent with several key forms of psychopathology previously reported in the literature using specific neuropsychological populations. Identified subtypes included profiles characterized as: normal, cognitive deficit, cognitive deficit with internalized psychopathology, cognitive deficit with social impairment, cognitive deficit with hyperactivity, cognitive deficit with both internalized and externalized psychopathology, and combined internalized and externalized psychopathology without a cognitive deficit component.     

Objective measures of executive functioning are highly discrepant with parent-report in fetal alcohol spectrum disorders

The purpose of the current study was to evaluate the relationship between parent-report and objective measures of executive function in children diagnosed with Fetal Alcohol Spectrum Disorder (FASD). The participants were a clinical sample of 551 children who completed 597 evaluations, including initial and re-evaluations. Participants were 6–16 years old, with a mean age of 10. Pearson correlations were used to determine the relationship between performance-based measures and parent-report measures of executive functioning. Relationships among the same types of measures, that is, performance based or parent report, were also evaluated. The data largely demonstrate low nonsignificant correlations between performance-based measures and parental report of executive function. Parent-report measures were internally consistent as were objective measures. It is possible that a third variable, for example, parental frustration, significantly influences parent reports. It is also likely that objective measures, which are administered in a controlled environment, do not fully capture children’s day-to-day functioning. That is, a child may have the executive function abilities (i.e., good performance on objective measures) but may be unable to deploy the appropriate skills in their daily lives, as evidenced by parental report. Children with FASD who have executive function abilities but not implementation skills likely require different interventions than children who lack abilities and skills.     

Age-Related Changes in Executive Function: A Normative Study with the Dutch Version of the Behavior Rating Inventory of Executive Function (BRIEF)

This study examined age-related change in executive function by using a Dutch translation of the Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al., 2000 Gioia, G. A., Isquith, P. K., Guy, S. C. and Kenworthy, L. 2000. Behavior Rating Inventory of Executive Function BRIEF): Professional manual, Lutz, FL: Psychological Assessment Resources.  [Google Scholar]) that was applied to a normative sample (age range 5–18 years). In addition, we examined the reliability and factorial structures of the Dutch BRIEF. Results with respect to age revealed a decrease in reported executive function problems with increasing age. On the Behavior Regulation Index (BRI), 5- to 8-year-olds showed significantly more executive function problems than 9- to 11-year-olds, as did the 12- to 14-year-olds compared to 15- to 18-year-olds (except on the Shift subscale). On the Metacognition Index, we found that 9- to 11-year-olds differed significantly from 5- to 8-year-olds on the Working Memory subscale. In addition, the current study showed that the internal consistency of the Dutch BRIEF is very high, and that this version of the BRIEF has a high test-retest stability. Item factor analysis confirmed the expected eight common factor model, and factor analysis of the eight test scores confirmed the two-factor model, as proposed by Gioia et al., in the Dutch data.     

Latent mean comparisons on the BRIEF in preterm children: Parent and teacher differences

Executive function is a heterogeneous construct applied to cognitive capacities that together enable individuals to effectively engage in activities toward a purposive goal. Children born at extremely low birth weight (ELBW) are at risk of executive dysfunction on performance-based measures. In natural contexts, executive function may be described using such parental and teacher questionnaires as the Behavior Rating Inventory of Executive Function (BRIEF). This study examined the factor structure of the BRIEF-parent form in 124 ELBW children and of the BRIEF-teacher form in 90 ELBW children. Although our data showed that the fit of a two-factor structure was adequate for the parent report, a three-factor model provided advantages over the two-factor model across all fit indices and best characterized the data. For teacher report, these data supported a three-factor but not a two-factor model. Using the three-factor model for both groups of informants, we compared parent and teacher reports (n = 90 pairs) between the three identified latent variables. Parents reported significantly more difficulty with Emotional Regulation (p < .05), and teachers reported significantly more difficulty with Behavioral Regulation (p < .05). No significant differences were found between parent and teacher reports for Metacognition.