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The latent class structure of autism symptoms from the time of diagnosis to age 6 years was examined in a sample of 280 children with autism spectrum disorder. Factor mixture modeling was performed on 26 algorithm items from the Autism Diagnostic Interview-Revised at diagnosis (Time 1) and again at age 6 (Time 2). At Time 1, a "2-factor/3-class" model provided the best fit to the data. At Time 2, a "2-factor/2-class" model provided the best fit to the data. Longitudinal (repeated measures) analysis of variance showed that the "2-factor/3-class" model derived at the time of diagnosis allows for the identification of a subgroup of children (9% of sample) who exhibit notable reduction in symptom severity.

Objectives: To identify factors associated with repeat emergency department (ED) presentations for suicide-related behaviors (SRB)--hereafter referred to as repetition--among children/youth to aid secondary prevention initiatives. To compare rates of repetition in children/youth with substantiated maltreatment requiring removal from their parental home with their peers in the general population. Methods: A population-based (retrospective) cohort study was established for children/youth with a first ED SRB presentation at risk for repetition in the Province of Ontario, Canada between 1 January 2004 and 31 December 2008. Children/youth legally removed from their parental home because of substantiated maltreatment (n = 179) and their population-based peers (n = 6,305) were individually linked to administrative health care records over time to ascertain social, demographic, and clinical information and subsequent ED presentations for SRB during follow-up. These children/youth were described and their repetition-free probabilities over time compared. To identify factors associated with repetition we fit multivariable, recurrent event survival analysis models stratified by repetition and present unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Children/youth with substantiated maltreatment (as noted) were two times more likely to have repetition than their peers after adjustments for social, demographic, and clinical factors (conditional on prior ED SRB presentations). A number of these factors were independently associated with repetition. No one factor distinguished between having a first and second repetition nor was more strongly associated with repetition than another. Conclusions: The risk of repetition is higher in children with substantiated maltreatment (as noted) than their peers. No one factor stood out as predictive of repetition. Implications for secondary prevention initiatives include a non-selective approach, sensitive to family difficulties and the need to better contextualize repetition and harness data linkages. (Contains 2 figures and 2 tables.)

Research Findings: Individual and contextual variables were examined in relation to children's ability to cope with socioemotional and academic challenges in a sample of typically developing (n = 51) and anxious (n = 72) children of elementary and middle school age. Anxious children had greater social difficulties than controls and showed different directions of cortisol response to a public speaking task, but there were no group differences in academic performance. Across the sample, greater salivary cortisol reactivity to the speech task was associated with both increased social difficulties and higher academic achievement. For a subset of younger (M = 6.9 years) but not older (M = 12.3 years) children, social functioning was also highly sensitive to contextual variables (e.g., family income level). Practice or Policy: Findings suggest that social functioning in elementary school is as sensitive to contextual variables as it is to physiological ones. Interventions promoting stress recovery, social interaction, and social competence may be beneficial during the elementary school years. (Contains 5 tables, 3 figures and 3 footnotes.)

Objective: Children of teen mothers exhibit adverse outcomes through adolescence. It is unclear whether these adverse outcomes extend to adulthood and apply to all of her children, or only those born when she was a teen. We examine the associations between young adult functioning and being born to a teen mother aged less than or equal to 20 years at the time of birth (current teen), and being born to a teen mother later in her life (greater than 21 years, prior teen). Method: The 1983 Ontario Child Health Study (OCHS) and 2001 follow-up are used, including 2,355 participants 4 to 16 years old in 1983 with 2001 data. Using multilevel modeling we assessed the association between being born to a current versus prior teen mother, relative to a nonteen mother, and 2001 outcomes, controlling for individual and family level characteristics assessed in childhood. Results: Being born to a teen mother (versus a nonteen mother) is associated with poorer educational achievement, life satisfaction, and personal income. Accounting for time of sample children's birth in teen mothers' lives, individuals born to current and prior teen mothers showed a -0.8-year educational deficit, relative to individuals born to nonteen mothers in fully adjusted models. Individuals born to current teen mothers reported lower life satisfaction and personal income (-$7,262). There were no significant group differences at follow-up in mental or physical health between individuals born to nonteen mothers and those born to current or prior teen mothers. Conclusions: Although being born to a teen mother exerts a pervasive adverse effect on educational attainment, the adverse effects on life satisfaction and personal income appear to be selective for individuals born to a current teen mother. Further research is required to understand these differential effects. (Contains 8 tables.)

We examined whether associations between symptoms of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), depression, and anxiety assessed in a sample of 2,026 youth aged 6 to 16 years and socioeconomic functioning measured 18 years later varied as a function of whether parents or teachers had rated symptomatology. After accounting for confounding variables (e.g., family socioeconomic status in childhood), psychological symptoms explained 2.78% of the variability in adult socioeconomic status. Much of that variance was unique to teachers or parents (0.90% and 1.41%, respectively). Moreover, several informant-specific associations emerged: teacher-rated depression and parent-rated ADHD and ODD were significant predictors of later socioeconomic functioning. Overall, these findings provide further evidence that differences between informants are meaningful and support the utility of maintaining the unique perspective of each rater in analytic and measurement strategies. (Contains 3 tables.)

Background: Although structured interviews are assumed to be scientifically superior to checklists for measuring youth psychopathology, few studies have tested this hypothesis. Interviews place a much greater burden on respondents, making it critical to determine their added value when quantifying psychiatric symptoms. Methods: Confirmatory factor analysis was used to compare interviews and checklists in community (N = 251) and clinically referred (N = 406) samples of youth aged 5 to 17 years. We examined the associations between mother-reported externalizing symptoms assessed by interview versus checklist against (a) teacher-reported externalizing symptoms, and (b) child's gender, academic performance, single- versus two-parent family, and family income. Models in which associations were estimated freely were contrasted to models in which the interview and the checklist were constrained to have equal associations with the variables. Finding these models fit comparably would suggest no difference between interviews and checklists. Results: In the community sample, both the constrained and unconstrained models provided comparable fit to the data, suggesting no marked differences between interviews and checklists. In the clinical sample, associations with the interview were generally stronger. Reducing the number of items on the interview to match those on the 6-item checklist eliminated these differences, suggesting that the increased reliability of the interview scales, afforded by additional items, enhanced their quantification of psychopathology. Conclusions: Consistent with previous studies, interviews were not notably superior to checklists for the measurement of externalizing symptoms. When only a few items are used, small performance differences between checklists and interviews may be due to scale length.

The authors examined internalizing behavior problems at middle childhood, adolescence, and young adulthood and brain-based measures of stress vulnerability in 154 right-handed, nonimpaired young adults (M age = 23 years): 71 (30 males, 41 females) born at extremely low birth weight (ELBW; less than 1,000 g) and 83 (35 males, 48 females) controls born at normal birth weight (NBW). Internalizing behavior problems increased from adolescence to young adulthood among ELBW individuals. ELBW adults exhibited greater relative right frontal electroencephalogram activity at rest and more concurrent internalizing behavior problems than NBW controls. Being born at ELBW may have subtle influences on brain-behavior relations even in survivors without major impairments and evidence of these influences may not emerge until young adulthood. (Contains 5 tables and 2 figures.)

Background: This study examines the use of the Brief Child and Family Phone Interview (BCFPI) to screen for childhood psychiatric disorder based on Diagnostic Interview Schedule for Children Version IV (DISC-IV) classifications of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety (SAD), generalized anxiety (GAD) and major depression (MDD). Methods: Data for analysis come from a sample of 399 children and adolescents aged 5-17 years old referred to child mental health outpatient services in three Ontario cities. Mothers were administered the BCFPI on three occasions: baseline, 2 and 13 months; and the DISC-IV on two occasions: 1 and 12 months. Results: Based on kappa, test-retest reliability for disorders classified by the BCFPI exceeded 0.50 for all conditions except MDD (0.45). In receiver operating characteristic (ROC) analysis, area-under-the-curve (AUC) estimates for BCFPI scale score associations with DISC-IV classifications of disorder exceeded 0.80 for CD, ODD, ADHD and SAD; and were lower for GAD (0.76) and MDD (0.75). In stratified analyses, there were no statistically significant differences in AUC estimates for boys versus girls and 5 to 11 versus 12 to 17-year-olds. Conclusions: Classifications of childhood disorder derived from the BCFPI provided a reasonable approximation to disorders classified by the DISC-IV administered by lay interviewers.

Background: This study describes the development of the Brief Child and Family Phone Interview (BCFPI)--a computer-assisted telephone interview which adapts the revised Ontario Child Health Study's (OCHS-R) parent, teacher, and youth self-report scales for administration as intake screening and treatment outcome measures in children's mental health services. It focuses on the factor structure of the BCFPI's hypothesized parent-reported child mental health scales describing attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety disorder (SAD), generalized anxiety disorder (GAD), and major depression (MDD). Methods: Data for the analysis come from an OCHS-R measurement study that included two groups of children and adolescents selected from the same urban area: a general population sample (n = 1,712) and a clinic-referred sample (n = 1,512); and a third sample that was enlisted in a province-wide implementation study of clinic-referred 6- to 18-year-olds (n = 56,825). We used confirmatory factor analysis to assess the factor structure of the BCFPI scales in different populations and to test measurement equivalence across selected groups. Results: Despite the strong constraints imposed on the measurement models, estimates of model fit across the three samples were comparable in magnitude and approached the cut-offs suggested for the GFI and CFI (greater than 0.9) and RMSEA (less than 0.05). Measurement equivalence was demonstrated between the OCHS-R clinic and provincial implementation samples. Within the implementation sample, the factor structure of the BCFPI scales was equivalent for boys versus girls and for 6- to 12- versus 13- to 18-year-olds. A companion paper examines the test-retest reliability, sensitivity, specificity, and validity of these BCFPI scales when used for screening. Conclusion: This project supports the feasibility and acceptability of a computer-assisted telephone interview for assessing emotional-behavioral problems of children and adolescents referred to children's mental health services.

The goal of the present study is to demonstrate the ways in which multilevel models can be applied to family research. We emphasize the conceptual issues in family research that this data analytic technique helps us to address. The family represents a nested, hierarchical structure in which multiple children from the same family are not independent from one another. Multilevel models can be used to accommodate the complex structure of families. We draw on two data structures to illustrate the utility of the analytic technique. The first data structure involves children nested within families. With this data structure, it is possible to: 1) differentiate between family-wide and child-specific processes, 2) examine the way in which adverse family environments may exacerbate differences across siblings and 3) examine the way in which individual child characteristics may modify the impact of the family environment. In addition to children nested within families, data structure # 2 involves a cross-classification, as each parent reports on the emotional problems of multiple children. This hierarchical, cross-classified model allows us to examine predictors of children's emotional problems, predictors of informant agreement on children's emotional problems and the extent of children's similarity with their siblings on emotional problems.

This study applies multilevel logistic regression to Demographic and Health Survey data from 22 sub-Saharan African countries to examine whether the relationship between child mortality and family structure, with a specific emphasis on polygyny, varies cross-nationally and over time. Hypotheses were developed on the basis of competing theories on the relationship between child health and family structure. Although children of mothers in polygynous marriages are more likely to die than those of mothers in monogamous unions, the relationship is constant across time. Familial factors including education, socioeconomic status (SES), and urban residence accounted for most of the observed cross-national variation associated with polygyny. Consequently, improving maternal education and household SES would greatly benefit child health in sub-Saharan Africa.

This study uses multilevel models to examine longitudinal associations between contextual influences (neighborhood and family) assessed in 1983 in a cohort of 2,355 children, 4-16 years of age, and educational attainment in 2001. Variation in educational attainment in 2001 attributable to between-neighborhood and between-family differences was 8.17% and 36.88%, respectively. The final model explained 33.64% of the variance in educational attainment, with unique variances of 14.53% for neighborhood and family-level variables combined versus 10.94% for child-level variables. Among the neighborhood and family-level variables, indicators of status (5.29%) versus parental capacity/family process (4.03%) made comparable predictions to attainment while children from economically disadvantaged families did not benefit educationally from living in more affluent areas.

Data from a nationally representative sample of 13,470 children aged 4-11 years were used to study contextual influences on children's mental health and school performance, the moderating effects of family immigrant status and underlying family processes that might explain these relationships. Despite greater socioeconomic disadvantage, children living in recent immigrant families had lower levels of emotional-behavioral problems and higher levels of school performance. Living in a neighborhood characterized with higher concentration of immigrants was associated with lower levels of emotional-behavioral problems among children living in immigrant families; the reverse was true for children living in nonimmigrant families. These differences are partially explained by family process variables. The implications of these findings for future research and policy are discussed.

This study addressed four questions which parents of children with selective mutism (SM) frequently ask: (1) Is SM associated with anxiety or oppositional behavior? (2) Is SM associated with parenting and family dysfunction? (3) Will my child fail at school? and (4) Will my child make friends or be teased and bullied? In comparison to a sample of 52 community controls, 52 children with SM were more anxious, obsessive, and prone to somatic complaints. In contrast, children with SM were less oppositional and evidenced fewer attentional difficulties at school. We found no group differences in family structure, economic resources, family functioning, maternal mood difficulties, recreational activities, or social networks. While parents reported no differences in parenting strategies, children with SM were described as less cooperative in disciplinary situations. The academic (e.g., reading and math) and classroom cooperative skills of children with SM did not differ from controls. Parents and teachers reported that children with SM had significant deficits in social skills. Though teachers and parents rated children with SM as less socially assertive, neither teachers nor parents reported that children with SM were victimized more frequently by peers.

Examined the impact of family home ownership on the emotional and behavioral problems of children 4 to 16 years old. Found that home ownership was inversely associated with ratings of emotional-behavioral problems. The concentration of home ownership in neighborhoods was not associated with ratings of child behavior. (JPB)

Assesses the suitability of existing measures of emotional and behavioral disorders among children for use in general populations. Focuses on the definition of emotional and behavioral disorder, measurement approaches, and guidelines for choosing which disorders to study. Seven measurement instruments are evaluated using the folowing criteria: acceptability, applicability, procedural adequacy, reliability, and validity. (AS)

Purpose: Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, selfstigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact. Method: One hundred one children and adolescents who stutter, aged 10-18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering. Results: We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages. Conclusions: Children as young as 10 years old may experience stuttering selfstigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of selfstigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma. [ABSTRACT FROM AUTHOR]

Background: The standard approach for classifying child/youth psychiatric disorder as present or absent in epidemiological studies is lay‐administered structured, standardized diagnostic interviews (interviews) based on categorical taxonomies such as the DSM and ICD. Converting problem checklist scale scores (checklists) to binary classifications provides a simple, inexpensive alternative. Methods: Using assessments obtained from 737 parents, we determine if child/youth behavioral, attentional, and emotional disorder classifications based on checklists are equivalent psychometrically to interview classifications. We test this hypothesis by (1) comparing their test–retest reliabilities based on kappa (κ), (2) estimating their observed agreement at times 1 and 2, and (3) in structural equation models, comparing their strength of association with clinical status and reported use of prescription medication to treat disorder. A confidence interval approach is used to determine if parameter differences lie within the smallest effect size of interest set at ±0.125. Results: The test–retest reliabilities (κ) for interviews compared with checklists met criteria for statistical equivalence: behavioral,.67 and.70; attentional,.64 and.66; and emotional,.61 and.65. Observed agreement between the checklist and interviews on classifications of disorder at times 1 and 2 was, on average, κ =.61. On average, the β coefficients estimating associations with clinical status were.59 (interviews) and.63 (checklists); and with prescription medication use,.69 (interviews) and.71 (checklists). Behavioral and attentional disorders met criteria for statistical equivalence. Emotional disorder did not, although the coefficients were stronger numerically for the checklist. Conclusions: Classifications of child/youth psychiatric disorder from parent‐reported checklists and interviews are equivalent psychometrically. The practical advantages of checklists over interviews for classifying disorder (lower administration cost and respondent burden) are enhanced by their ability to measure disorder dimensionally. Checklists provide an option to interviews in epidemiological studies of common child/youth psychiatric disorders. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this study were to examine the self-efficacy of school-based speech-language pathologists (SLPs) in conducting multidimensional treatment with children who stutter (CWS) and to identify correlates of self-efficacy in treating speech-related, social, emotional, and cognitive domains of stuttering. Method: Three hundred twenty randomly selected schoolbased SLPs across the United States responded to an online survey that contained self-efficacy scales related to speech, social, emotional, and cognitive components of stuttering. These ratings were analyzed in relation to participants' beliefs about stuttering treatment and their comfort level in treating CWS, perceived success in therapy, and empathy levels, in addition to their academic and clinical training in fluency disorders as well as demographic information. Results: Overall, SLPs reported moderate levels of selfefficacy on each self-efficacy scale and on a measure of total self-efficacy. Significant positive associations were observed between SLPs' self-efficacy perceptions and their comfort level in treating CWS, self-reported success in treatment, beliefs about the importance of multidimensional treatment, and self-reported empathy. There were some discrepancies between what SLPs believed was important to address in stuttering therapy and how they measured success in therapy. Conclusions: Among school-based SLPs, self-efficacy for treating school-age CWS with a multidimensional approach appears stronger than previously reported; however, more progress in training and experience is needed for SLPs to feel highly self-efficacious in these areas. Continuing to improve clinician self-efficacy for stuttering treatment through improved academic training and increased clinical experiences should remain a high priority in order to enhance outcomes for CWS. [ABSTRACT FROM AUTHOR]

Background: A better understanding of factors contributing to the observed variability in estimates of test–retest reliability in published studies on standardized diagnostic interviews (SDI) is needed. The objectives of this systematic review and meta‐analysis were to estimate the pooled test–retest reliability for parent and youth assessments of seven common disorders, and to examine sources of between‐study heterogeneity in reliability. Methods: Following a systematic review of the literature, multilevel random effects meta‐analyses were used to analyse 202 reliability estimates (Cohen's kappa = ҡ) from 31 eligible studies and 5,369 assessments of 3,344 children and youth. Results: Pooled reliability was moderate at ҡ = .58 (CI 95% 0.53–0.63) and between‐study heterogeneity was substantial (Q = 2,063 (df = 201), p < .001 and I2 = 79%). In subgroup analysis, reliability varied across informants for specific types of psychiatric disorder (ҡ = .53–.69 for parent vs. ҡ = .39–.68 for youth) with estimates significantly higher for parents on attention deficit hyperactivity disorder, oppositional defiant disorder and the broad groupings of externalizing and any disorder. Reliability was also significantly higher in studies with indicators of poor or fair study methodology quality (sample size <50, retest interval <7 days). Conclusions: Our findings raise important questions about the meaningfulness of published evidence on the test–retest reliability of SDIs and the usefulness of these tools in both clinical and research contexts. Potential remedies include the introduction of standardized study and reporting requirements for reliability studies, and exploration of other approaches to assessing and classifying child and adolescent psychiatric disorder. [ABSTRACT FROM AUTHOR]

Disruptive behavior disorders are prevalent in youth, yet most children with disruptive behavior do not have access to timely, effective treatment. Distance-delivered service (e.g., via telephone, Internet) can overcome several barriers to care. This study tested the effectiveness of a 12-week parent training program, Strongest Families™ Parenting the Active Child, delivered via written material, skill-based videos, and telephone coaching sessions, as compared to usual care in reducing child externalizing behavior. Participants were 172 primary caregivers of a 6- to 12-year-old (29% girls; M age = 8.5 years) recruited from community children's mental health clinics. Participants were randomized to either Strongest Families™ or usual care and completed measures of child externalizing behavior, parenting practices, parent distress, and intervention services consumed at baseline and 5-, 10-, 16-, and 22-months post-baseline. Growth curve analysis showed significant reductions in externalizing behavior in both conditions over time. Improvements were significantly greater at 10 months in the Strongest Families™ condition (d = 0.43). At 22 months, however, the differences were not significant and small in magnitude (d = -0.05). The intervention decreased inconsistent discipline significantly more than usual care. Parents in both conditions showed significant reductions in distress. We also conducted a cost-effectiveness analysis to assess the value for money of the Strongest Families™ program versus usual care. Distance parent training is a promising way to increase access to, and reduce costs associated with, mental health care for families with a child with disruptive behavior. [ABSTRACT FROM AUTHOR]

Perinatal and later postnatal adversities have been shown to adversely affect socioeconomic trajectories, while enhanced early cognitive abilities improve them. However, little is known about the combined influence of these exposures on social mobility. In this study, we examined if childhood IQ moderated the association between four different types of postnatal adversity (childhood socioeconomic disadvantage, childhood sexual abuse, lifetime psychiatric disorder, and trait neuroticism) and annual earnings at 30–35 years of age in a sample of 88 extremely low birth weight survivors. Our results suggested that higher childhood IQ was associated with greater personal income at age 30–35. Extremely low birth weight survivors who did not face psychological adversities and who had higher childhood IQ reported higher income in adulthood. However, those who faced psychological adversity and had higher childhood IQ generally reported lower income in adulthood. Our findings suggest that cognitive reserve may not protect preterm survivors against the complex web of risk factors affecting their later socioeconomic attainment. [ABSTRACT FROM AUTHOR]

Children's mental health in Canada is characterized by high needs coupled with stark service shortfalls. In Ontario and in many provinces, addressing these shortfalls is hampered by the absence of a measurement system, something that researchers have long called for. This commentary aims to review the issues and suggest prospects for improving the measurement of children's mental health in Ontario and elsewhere. As background, we first describe the children's mental health needs; outline the rationale for a measurement system; describe previous attempts to introduce such systems, including in Ontario; and discuss the current Ontario situation. We then explore some of the issues that constrain policy and that need to be overcome, and suggest prospects for change -- for advancing the measurement of children's mental health in Ontario and Canada. [ABSTRACT FROM AUTHOR]

Exposure to early adversity is known to have deleterious effects on brain-behaviour relations across the lifespan and across a range of domains. Here, we tested a cumulative risk hypothesis of adult social functioning and health outcomes in the fourth decade of life, using the oldest known longitudinally followed cohort of survivors of extremely low birthweight ( ELBW; <1,000 g). We investigated the additional impact of peer victimization in youth on social outcomes at age 29-36 years in ELBW survivors and matched normal birthweight ( NBW; >2,500 g) participants. In the combined sample, peer victimization was associated with lower likelihood of having children and household income, poorer family functioning and self-esteem, more loneliness and chronic health conditions, less social support, and increased likelihood for contact with police. Moderation analyses indicated that among ELBW survivors, compared to their NBW counterparts, victimization was more strongly associated with being convicted of a crime and with having chronic health conditions. These findings highlight the negative long-term impact of peer victimization on all children and that some outcomes may be differentially affected by prenatal and early post-natal environments. [ABSTRACT FROM AUTHOR]

Background. Extremely low birth weight (ELBW; <1000 g) children may be at risk for experiencing peer victimization. We examined retrospectively reported peer victimization in ELBW and control children in the oldest known, prospectively followed, population-based birth cohort of ELBW survivors. Method. We compared levels of verbal and physical peer victimization in ELBW and control children. We also predicted peer victimization in the ELBW sample from child characteristics. Results. ELBW children, especially girls, were at an increased risk for verbal, but not physical victimization. In addition, ELBW children with a higher IQ reported higher levels of verbal victimization, although ELBW females who had a lower body mass index in childhood reported higher levels of physical victimization. Conclusion. Findings highlight the need for parents and clinicians to be aware that ELBW girls, especially those with a lower body mass index in childhood, may be at increased risk of peer victimization, as are ELBW children with a higher IQ. [ABSTRACT FROM AUTHOR]

The latent class structure of autism symptoms from the time of diagnosis to age 6 years was examined in a sample of 280 children with autism spectrum disorder. Factor mixture modeling was performed on 26 algorithm items from the Autism Diagnostic Interview - Revised at diagnosis (Time 1) and again at age 6 (Time 2). At Time 1, a '2-factor/3-class' model provided the best fit to the data. At Time 2, a '2-factor/2-class' model provided the best fit to the data. Longitudinal (repeated measures) analysis of variance showed that the '2-factor/3-class' model derived at the time of diagnosis allows for the identification of a subgroup of children (9 % of sample) who exhibit notable reduction in symptom severity. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this study was to test for the measurement invariance of the Attention and Thought Problems subscales of the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) in a population-based sample of adolescents with and without epilepsy. Data were obtained from the 14-year follow-up of the Mater University Study of Pregnancy in which 33 adolescents with epilepsy and 1068 healthy controls were included for analysis. Confirmatory factor analysis was used to test for measurement invariance between adolescents with and without epilepsy. Structural equation modeling was used to test for group differences in attention and thought problems as measured with the CBCL and YSR. Measurement invariance was demonstrated for the original CBCL Attention Problems and YSR Thought Problems. After the removal of ambiguous items (“confused” and “daydreams”), measurement invariance was established for the YSR Attention Problems. The original and reduced CBCL Thought Problems were noninvariant. Adolescents with epilepsy had significantly more symptoms of behavioral problems on the CBCL Attention Problems, β =0.51, p =0.002, compared with healthy controls. In contrast, no significant differences were found for the YSR Attention and Thought Problems, β =−0.11, p =0.417 and β =−0.20, p =0.116, respectively. In this population-based sample of adolescents with epilepsy, the CBCL Attention Problems and YSR Thought Problems appear to be valid measures of behavioral problems, whereas the YSR Attention Problems was valid only after the removal of ambiguous items. Replication of these findings in clinical samples of adolescents with epilepsy that overcome the limitations of the current study is warranted. [Copyright &y& Elsevier]

Objective: The aim of this study was to use meta-analytic techniques to compare self-concept between children and adolescents (abbreviated to youth) with a chronic illness versus healthy controls, and to examine methodological influences on effect sizes. Method: Databases were searched for asthma, cerebral palsy, diabetes, epilepsy, and juvenile arthritis. Inclusion criteria were: 1) original research studies in English; 2) youth <18 years; 3) the inclusion of self-reported self-concept; and 4) data available to estimate effect sizes. Study quality was assessed with a modified Quality Index. Effect sizes were calculated as Hedges' g using a random effects model. Results: A total of 60 studies were analyzed. On average, youth with a chronic illness had compromised self-concept, d = -0.17 [-0.27, -0.07]. However, type of control group exerted a moderating influence that resulted in discrepant findings. Studies based on normative data reported higher self-concept in youth with a chronic illness, d = 0.27 [0.06, 0.47], whereas studies that recruited healthy controls reported lower self-concept in youth with a chronic illness, d = -0.25 [-0.34, -0.15]. Conclusions: Self-concept is compromised in youth with a chronic illness; however, the effect size may be underestimated because of methodological weaknesses and systematic biases in existing studies. Future research should avoid the use of normative data and employ rigorous methods to ensure representative sampling and control of confounding variables to better appreciate the impact of chronic illness on youths' self-concept. [ABSTRACT FROM AUTHOR]

Objectives Examine the contribution of sleep problems and indicators of inadequate sleep to psychopathology among children after accounting for shared risk and comorbid psychopathology. Methods Secondary analyses of cross-sectional data on 4- to 11-year-old (N = 1,550) children without chronic illness or developmental delay or disability. Parents provided information about sleep problems, indicators of inadequate sleep, symptoms of psychopathology, and risk factors for psychopathology. Teachers provided information about indicators of inadequate sleep and symptoms of psychopathology. Results Adjusting for risk factors and comorbid psychopathology, sleeping more than other children was related to parent-rated aggression. Nightmares and trouble sleeping were related to parent-rated anxious/depressed mood. Sleep problems were not related to attention problems. Being overtired was related to parent- and teacher-rated psychopathology. Conclusions Relations among sleep problems, indicators of inadequate sleep, and psychopathology are complex; accounting for potential confounding variables and considering sleep variables separately may clarify these relations. [ABSTRACT FROM AUTHOR]

We examined receptive language and academic abilities in children with selective mutism (SM; n = 30; M age = 8.8 years), anxiety disorders (n = 46; M age = 9.3 years), and community controls (n = 27; M age = 7.8 years). Receptive language and academic abilities were assessed using standardized tests completed in the laboratory. We found a significant group by sex interaction for receptive vocabulary scores such that, within females, the SM and mixed anxiety groups had significantly lower receptive vocabulary scores than community controls. We also found that children with SM and children with anxiety disorders had significantly lower mathematics scores than community controls. Despite these differences in mathematics and receptive vocabulary performance, children with SM and children with anxiety disorders still performed at age-level norms, while more children in the community control group performed above age-level norms. Findings suggest that despite their speaking inhibition in the school setting, children with SM are still able to attain the receptive vocabulary and academic abilities that are expected at their age levels. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Data from a nationally representative sample of 13,470 children aged 4–11 years were used to study contextual influences on children’s mental health and school performance, the moderating effects of family immigrant status and underlying family processes that might explain these relationships. Despite greater socioeconomic disadvantage, children living in recent immigrant families had lower levels of emotional–behavioral problems and higher levels of school performance. Living in a neighborhood characterized with higher concentration of immigrants was associated with lower levels of emotional–behavioral problems among children living in immigrant families; the reverse was true for children living in nonimmigrant families. These differences are partially explained by family process variables. The implications of these findings for future research and policy are discussed. [ABSTRACT FROM AUTHOR]

This study uses multilevel models to examine longitudinal associations between contextual influences (neighborhood and family) assessed in 1983 in a cohort of 2,355 children, 4–16 years of age, and educational attainment in 2001. Variation in educational attainment in 2001 attributable to between-neighborhood and between-family differences was 8.17% and 36.88%, respectively. The final model explained 33.64% of the variance in educational attainment, with unique variances of 14.53% for neighborhood and family-level variables combined versus 10.94% for child-level variables. Among the neighborhood and family-level variables, indicators of status (5.29%) versus parental capacity/family process (4.03%) made comparable predictions to attainment while children from economically disadvantaged families did not benefit educationally from living in more affluent areas. [ABSTRACT FROM AUTHOR]

Background Members of families headed by single mothers are at increased risk of psychosocial disadvantage and mental health problems. We assessed the effect of a community-based program of social support and education groups for single mothers of young children on maternal well-being and parenting. Methods We recruited 116 single mothers of children 3 to 9 years old through community advertisements. Eligible mothers were randomly assigned either to participate in a 10-week program of group sessions (1.5 hours per week) offering social support and education, with a parallel children's activity group, or to receive a standard list of community resources and the option to participate in group sessions at the end of the follow-up period. Interviewers blinded to the randomization collected assessment data from all mothers at baseline and at 3 follow-up visits (immediately after the intervention and at 3 and 6 months after the intervention). Outcome measures were self-reported mood, self-esteem, social support and parenting. Results Between February 2000 and April 2003, the program was offered to 9 groups of single mothers. Most of the mothers in the trial reported high levels of financial and mental health problems. In the short term (after the intervention), mothers in the intervention group had improved scores for mood... [ABSTRACT FROM AUTHOR]

• Board Certified Specialists in Fluency Disorders reported their self-efficacy for providing treatment. • Self-efficacy for providing multidimensional therapy for children who stutter was high. • Self-efficacy was correlated with several cognitive, affective, and behavioral variables. • Specialists reported that seeking and maintaining specialty certification increased their self-efficacy. The purpose of this study was to document fluency specialists' self-efficacy beliefs for providing multidimensional treatment to children who stutter and to identify cognitive, affective, and behavioral correlates of self-efficacy. Sixty-six Board Certified Specialists in Fluency in the United States completed an online survey measuring self-efficacy in providing multidimensional stuttering therapy, perceived importance of multidimensional aspects of therapy, feelings of comfort in providing therapy, perceived treatment success, and employment and demographic questions. Open-ended questions were also asked for participants to describe why they chose to specialize and what benefits they received from it. Participants reported high levels of self-efficacy (averages above 9 on a scale from 0 to 10) in speech-related, cognitive, emotional, and social domains of stuttering therapy, as well as high levels of comfort and clinical success. Higher ratings of overall self-efficacy were significantly correlated with beliefs about the importance of multidimensional treatment, τ = 0.27, treatment comfort, τ = 0.25, and self-reported treatment success, τ =.49. Responses indicated that many participants believed that their self-efficacy grew because of specialty certification. Although not the same as treatment outcome data, self-efficacy among clinical service providers is an important variable to consider. Board Certified Specialists in Fluency in the United States report very high levels of self-efficacy for school-age stuttering treatment. The process of certification helps to increase self-efficacy and provides a means for advertising competence in stuttering treatment. This information could help in recruiting the next generation of fluency specialists. [ABSTRACT FROM AUTHOR]

In the 21st century, clinicians are expected to listen to, and understand their patients' views about, their conditions and the effects that these conditions have on their functioning, values, life goals, and welfare. The goals of this review are as follows: (i) to inform, update, and guide clinicians caring for children with epilepsy about developments in the content and new methods of research on patient-reported outcomes, quality of life, and functioning; and (ii) to discuss the value of using these concepts to explore the impact of diverse interventions that are implemented in daily practice. Drawing on the literature and our program of research over the past two decades, we focus on our current understanding of a variety of health concepts and recently acquired knowledge about their significance for the lives of patients and their families. We discuss the advantages of measuring patient-reported outcomes that tell us what is important to patients. We advise on what characteristics to look for when choosing a patient-reported measure, and the relevance of these considerations. In addition, we address gaps in research knowledge and the causes of confusion that have limited their use in our daily clinical practice. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is characterized by notable phenotypic heterogeneity, which is often viewed as an obstacle to the study of its etiology, diagnosis, treatment, and prognosis. On the basis of empirical evidence, instead of three binary categories, the upcoming edition of the DSM 5 will use two dimensions - social communication deficits (SCD) and fixated interests and repetitive behaviors (FIRB) - for the ASD diagnostic criteria. Building on this proposed DSM 5 model, it would be useful to consider whether empirical data on the SCD and FIRB dimensions can be used within the novel methodological framework of Factor Mixture Modeling (FMM) to stratify children with ASD into more homogeneous subgroups. Methods: The study sample consisted of 391 newly diagnosed children (mean age 38.3 months; 330 males) with ASD. To derive subgroups, data from the Autism Diagnostic Interview-Revised indexing SCD and FIRB were used in FMM; FMM allows the examination of continuous dimensions and latent classes (i.e., categories) using both factor analysis (FA) and latent class analysis (LCA) as part of a single analytic framework. Results: Competing LCA, FA, and FMM models were fit to the data. On the basis of a set of goodness-of-fit criteria, a 'two-factor/three-class' factor mixture model provided the overall best fit to the data. This model describes ASD using three subgroups/classes (Class 1: 34%, Class 2: 10%, Class 3: 56% of the sample) based on differential severity gradients on the SCD and FIRB symptom dimensions. In addition to having different symptom severity levels, children from these subgroups were diagnosed at different ages and were functioning at different adaptive, language, and cognitive levels. Conclusions: Study findings suggest that the two symptom dimensions of SCD and FIRB proposed for the DSM 5 can be used in FMM to stratify children with ASD empirically into three relatively homogeneous subgroups. [ABSTRACT FROM AUTHOR]