Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2–6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.     

Parental assessment of the adjustment of children following abduction by the other parent

We present a multiple regression model that explores post-return adjustment of school-age children who experienced abduction by a parent. The model includes: a) child and family characteristics preceding abduction, b) characteristics of the abduction experience, and c) child and family characteristics following return. Overall, the model accounts for 21% of the variance in post-return adjustment of children (p.05). The most salient finding is that post-return adjustment of children was best explained by characteristics of the child and family before the abduction occurred. Domestic violence perpetrated by one or both parents was the most significant factor.     

The aggression-coercion cycle: Use of seclusion and restraint in a child psychiatric hospital

The widespread use of seclusion and restraint in child psychiatric hospitals to manage aggression and noncompliance is based on the assumption that coercive consequences reduce the frequency of undesirable behaviors exhibited by the patients. We report a study of the use of seclusion and restraint in a public child psychiatric hospital during a 3-year period. Twenty-eight percent of the patients had been secluded or restrained a total of 1670 times. About 25% of these patients had been secluded more than five times during their hospitalization, and 32% had been placed in restraints more than once. Behaviors that typically resulted in repeated seclusion included physical aggression toward staff, verbal aggression toward peers, non-compliant or oppositional behavior, and self-harm. Variables that predicted patients most at risk for repeated seclusion included age, gender, and psychiatric diagnosis. The predictor variables for those most at risk for repeated restraint included age, property destruction, and self-harm. The high rates of use of seclusion and restraint suggest that these methods for controlling the behavior of children and adolescents in this child psychiatric hospital may not have been therapeutic. We suggest that staff in such hospitals engage in a pattern of behavior characterized by an aggression-coercion cycle, in which increasingly aggressive and coercive behaviors are exhibited by both patients and staff.     

The effects of family composition,family health,parenting behavior and environmental stress on children's divorce adjustment

The traditional family composition model of children's divorce adjustment was compared to a family competence model. Subjects included 81 children whose parents remained married, were divorced, or were divorced and subsequently remarried. Divorced families had been separated for between 24 and 48 months. Custodial parents completed questionnaires regarding family functioning, occurrence of stressful life events, and child's psychosocial adjustment. Children completed questionnaires regarding parenting behaviors and self-esteem. A trained examiner conducted a structured diagnostic interview of the child. Multivariate analysis of covariance showed that family composition had a significant effect on the occurrence of stressful events and change in income but not children's adjustment. Hierarchical multiple regression correlations indicated the most powerful predictors of child adjustment were family competence variables which accounted for 21% of the variance in child adjustment scores. In contrast, family composition accounted for only 8% of variance in child adjustment scores. Further, hierarchical multiple regression correlations indicated that higher levels of family functioning were associated with families where parental hostility was low and parents displayed few rejecting behaviors while practicing consistent and appropriate discipline.     

Pediatric Psychology: Child Psychological Health in the Next Century

The future of pediatric psychology is reviewed and placed in brief historical context in relation to children's psychological health care. Contemporary trends affecting the delivery of psychological services, research, and clinical training are highlighted, with suggestions for future development. Pediatric psychology is a child-based, developmentally-focused multidisciplinary practice directed toward psychosocial and neuropsychological issues of health and illness in children and youth. Pediatric psychologists need to develop strong professional identities as health care psychologists combined with a collegial and collaborative arrangement with physicians to ensure the future growth and development of pediatric psychology in the next century as a major vehicle to promote children's health care.     

The Development of the Toddler Behavior Screening Inventory

The purpose of the present study was to develop the Toddler Behavior Screening Inventory (TBSI) for rapidly assessing maternal reports of toddler behavior problems. The TBSI is a 40-item measure intended for use by pediatricians, psychologists, and other child-care professionals. A group of mothers (n = 312) rated the initial 93-item TBSI in terms of behavior frequency and parental perception of the behavior as problematic. Following item elimination, 40 items were retained due to being both frequent and problematic at all toddler age levels. Data were obtained with a new sample of mothers (n = 581) and showed the TBSI to possess good reliability and validity.     

Child abuse and neglect by parents with disabilities: A tale of two families

Two families, in which the children had been placed in foster care due to abuse and neglect by parents who had disabilities, were studied. In the first case, the mother was instructed in skills that our assessment suggested were important for her child's survival. The mother readily acquired and applied these skills, a fact reflected both in changes in her behavior and in changes in the child's well-being. In the second case, the parent's incremental resumption of child custody was made contingent upon completion of relevant parenting tasks. Initially, improvements in the completion of such tasks were evident, but over time and with the onset of militating factors, no further progress was made and all parental rights were terminated. The implications of these cases for behavior analysis and the effort to reunite and preserve families are discussed.     

Parenting stress in parents of children with attention-deficit hyperactivity disorder and parents of children with learning disabilities

Parenting a child with ADHD can challenge parenting resources and coping. Increasingly, researchers are examining the relationship between the behavior of the child with ADHD and family functioning. While studies have shown inceased parenting stress in parents of children with ADHD, these studies have compared children with ADHD to non-disabled children. This study compares reports of parenting stress among mothers of children with ADHD, mothers of children with learning disabilities and mothers of non-referred children. Results showed that parenting stress was highest for mothers of children with ADHD. Increased parenting stress was associated with child characteristics and, in particular, with externalizing behavior problems.     

小学儿童对虚假话语间接意义的理解

探讨了小学儿童对隐含在虚假话语中间接意义的理解特点。结果发现：（１）一年级儿童不能理解虚假话语的非字面意义,三年级儿童才基本上能够理解。（２）小学低年级儿童不能理解虚假话语的间接意义的主要原因是他们不能根据话语与事实不符和说话者知道事实真相来判断说话者说虚假话语的有意性和推论隐含的意义。部分原因可能在于他们没有意识到说话者了解事实真相,因而不知道说话者是故意使用虚假话语的。     

Involving the family in the evaluation and treatment of the child patient: A psychodynamic approach

The purpose of this article is to provide psychotherapists with a tool for family evaluation using the basic principles of psychodynamic work; and to introduce a transitional format for therapists who have practiced family evaluations in their training institutions and now need to adapt this model to the private practitioner's office. A case example illustrates: (1) Use of the therapist's unconscious for diagnosis of the child and its family, (2) joining the family's intersubjective space, and (3) use of play and therapist's neutrality as ways that the psychodynamically oriented clinician involves the family in the evaluation and treatment of the child.