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Purpose: Examine the reliability of field-based fitness assessments in school-aged children with emotional or behavioral difficulties (EBD). Understanding the impact of fitness on physical activity participation for children with EBD is limited by our ability to reliably measure it. Methods: Fifteen children aged 7–12 years with EBD completed 7 assessments—standing broad jump, overhead throw, grip strength, isometric plank hold, isometric wall squat, unilateral heel raise, and modified 6-minute walk test—in a random order on 2 separate occasions. Intraclass correlation coefficients (ICCs) were computed to evaluate reliability. Results: ICCs ranged from.65 to.99 representing moderate to excellent reliability for all assessments. Shorter assessments requiring less attention and behavior regulation tended to demonstrate higher ICC values while assessments with greater attention or behavioral regulation demands tended to have lower ICC values. Conclusion: Results demonstrate varied reliability for fitness tests in children with EBD. Practitioners can use grip strength and standing broad jump assessments with confidence. Other assessments have good reliability but greater variability indicating they may be a challenge for some children with EBD. [ABSTRACT FROM AUTHOR]

Objective Methods Results Significance Behavioral problems in children with new onset epilepsies have been well established in the literature. More recently, the literature indicates the presence of unique behavioral patterns or phenotypes in youth with epilepsy that vary significantly in vulnerability and resilience to behavioral problems. This study contrasts the interpretation of behavioral risk as inferred from cross‐sectional versus latent group analytic perspectives, as well as the presence, consistency, stability, and progression of behavioral phenotypes in youth with new onset epilepsy and sibling controls over 3 years.Three hundred twelve participants (6–16 years old) were recruited within 6 weeks of their first recognized seizure along with 223 unaffected siblings. Each child's behavior was recorded by parents and teachers frequently over 36 months using the Child Behavior Checklist (CBCL), and each child completed self‐report measures of depression symptoms over 36 months. Measures were evaluated cross‐sectionally and longitudinally to identify clusters with prototypical behavioral trajectories.Cross‐sectional analyses exhibited a pattern of generalized and undifferentiated behavioral problems compared to sibling controls at baseline and prospectively. In contrast, latent trajectory modeling identified three distinct behavior phenotype clusters across all raters (parents, teachers, and youth) over baseline and longitudinal assessments. CBCL Cluster 1 (~30% of youth with epilepsy) exhibited behavior similar to/better than controls, Cluster 2 (~50%) exhibited moderate behavior issues, and Cluster 3 (~20%) exhibited the most pronounced/problematic behavior, falling into Achenbach's clinically relevant behavior range. Behavior within clusters remained stable and consistent. Teachers' and children's behavior assessments corresponded to these cluster groupings consistently over 36 months. Predictors of cluster membership include seizure syndrome type and social determinants of health.This study demonstrates the varying public health perspectives of behavioral risk in youth with epilepsy that result as a function of analytic approach as well as the presence of distinct latent behavioral trajectory phenotypes over time in youth with new onset epilepsy. [ABSTRACT FROM AUTHOR]

Background: This study aims to examine the association for paternal care and father-child screen use with early childhood development and children's temper tantrums. Method: Study file included questions about paternal characteristics, child care, father-child screen habits, and utilized the UNICEF Early Childhood Development Index (ECDI). Factors influencing ECDI-on-track status and children's responses when screen use was restricted were investigated with Chi-square test and multiple logistic regression. Results: The study included 464 fathers having children aged 3–4 years. The findings showed that 89.7% of the children were on track in three out of the four ECDI subgroups. When screen use was restricted, 55.6% of the children engaged in another activity, while 44.4% reacted by crying. Multiple logistic regression analysis revealed that the father's education level, the child's age and gender, the starting age for screen usage, the child's reaction to screen restriction, and having three or more books were associated with ECDI. Furthermore, the child's reaction to screen restriction was related to the child's and father's screen time, the presence of three or more books, the adequacy of care, and being on track in the literacy-numeracy ECDI subgroup. Conclusion: Screen usage habits significantly impact early childhood development and children's reactions to screen restrictions. These findings underscore the importance of educating fathers about the effects of their own and their child's media habits, the quality of fatherly caregiving, and the presence of books in fostering positive child development. [ABSTRACT FROM AUTHOR]

Objective: Limited evidence exists regarding the impact of the COVID‐19 pandemic on the onset and trajectory of eating disorders (EDs) among young in Spain. This study aims to analyze the characteristics and recent trends in hospital admissions for EDs within the pediatric population. Methods: A retrospective analysis was conducted on hospital admissions for EDs among patients aged 10–19 years between 2016 and 2022. The main outcomes examined included hospital rates (overall, stratified by ED type and age group), psychiatric comorbidities, and length of stay. Results: A total of 8275 hospitalizations due to EDs were identified, constituting 1 in 6 hospital admissions for mental illness and behavioral disorders. Predominant characteristics of this population included female sex (93%), aged 15–19 years (58.3%), admission primarily for anorexia nervosa (71.6%), and psychiatric comorbidity (35.6%). Hospital admissions for EDs in the pediatric population showed an increasing trend, with an annual average increase of 11.1% (95% CI: 2.6, 22.6). This rise was led by children aged 10–14 years, with a yearly increase in EDs hospitalization rates of 28.4% (95% CI: 13.5, 56.3) since 2019. Each discharge related to EDs was associated with a median stay of 24 days (IQR: 10, 40). Discussion: Efforts in community healthcare should prioritize early detection and intervention for symptoms indicative of EDs in the pediatric population, aiming to mitigate the severity of cases requiring hospitalization. These findings underscore the necessity for targeted health planning policies to address the growing burden of EDs among Spanish youth. [ABSTRACT FROM AUTHOR]

Single-case designs substantiate the effectiveness of interventions for people with disabilities and other populations through the repeated measurement of behavior over time. Consequently, employing accurate and reliable systems of measurement is critical to the validity of single-case designs. Much of the data in single-case research are collected through systematic direct observation. Direct observation often involves the use of time sampling, wherein an observer indicates whether a behavior occurred during a specific period. Although scholars have highlighted the potential for time sampling to distort the results of single-case design, targeted reviews indicate time sampling continues to be used in literature involving people with disabilities. The current study reviews literature from the field of special education, in which single-case designs are frequently used to evaluate the efficacy of practices. Using a large, representative sample of 1,425 randomly selected single-case design articles from 33 special education journals, we coded articles to determine the type and features of measurement systems employed by researchers. Findings indicate one-fifth of articles feature some form of time sampling. In addition, time sampling is more prevalent in journals pertaining to individuals with emotional/behavioral disorders. A discussion of implications for research quality follows an overview of results. [ABSTRACT FROM AUTHOR]

Middle childhood marks an important phase for moral and social-emotional development, yet little research has focused on a combined focus within this age range. A person-centered research approach could capture the complex co-development of the moral self and behavior problems. We thus sought to determine exploratively what emergent subgroups/profiles exist when examining combinations of moral self, emotional, conduct and peer problems in middle childhood. For the study, we recruited 369 children aged five to eleven (Mage = 8.19, SDage = 1.30) in Germany. Children completed a questionnaire to assess their moral self (i.e. ascribed importance of moral characteristics), and their parents/caregivers completed the Strengths and Difficulties Questionnaire. Using cluster analytic strategies, three profiles were identified. Profile 1 (high moral/high problems) comprised children exhibiting high moral self, emotional problems, peer problems, and average conduct problems (24.12%). Profile 2 (low moral/high problems) included children with low moral self and high emotional, peer, and conduct problems (14.91%). Profile 3 (moderate moral/low problems) encompassed children with average moral self and lower emotional, peer, and conduct problems (60.98%). We discuss the findings and note that future research should strive for a comprehensive understanding of children's social-emotional and moral development, considering the intricate interplay between moral self and behavior problems. [ABSTRACT FROM AUTHOR]

Background: Pediatric irritability is a pervasive psychiatric symptom, yet its etiology remains elusive. While trauma exposure may contribute to the development of irritability, empirical research is limited. This study examined the prevalence of irritability among trauma‐exposed children, identified factors that differentiate trauma‐exposed children with and without irritability, and employed a network analysis to uncover associations between irritability and trauma exposure in the family unit. Methods: Sample included 676 children (56.3% male, mean age = 9.67 ± 3.7 years) and their parents referred by the Connecticut Department of Children and Families to Fathers for Change – a psychotherapy intervention designed to reduce intimate partner violence (IPV) and child maltreatment. Child's trauma exposure, post‐traumatic stress disorder (PTSD) symptoms, and irritability were assessed pre‐intervention using self‐ and caregiver‐report. Parents self‐reported their childhood and adulthood trauma exposures, PTSD symptoms, irritability, psychopathology, and IPV. Results: Across caregiver‐ and child‐reports, 16%–17% of children exhibited irritability. Irritable children experienced greater trauma exposure, interpersonal violence, emotional abuse, and PTSD severity. They had caregivers, particularly mothers, with greater trauma histories, IPV, and psychopathology. Network analysis revealed 10 nodes directly correlated to child's irritability including child's PTSD severity, parental IPV (specifically psychological violence), and parental psychopathology. Conclusions: Results provide initial empirical evidence that pediatric irritability is linked to trauma exposure, suggesting trauma histories be considered in the diagnosis and treatment of irritability. Interventions addressing caregiver trauma, IPV, and psychopathology may ameliorate pediatric irritability. Future studies could benefit from adopting network approaches with longitudinal or time series data to elucidate causality and points of intervention. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the association between adolescents' adherence to attention‐deficit/hyperactivity disorder (ADHD) medication and their risk of committing minor offenses. Methods: Using two Dutch databases, Statistics Netherlands (CBS) and the Foundation for Pharmaceutical Statistics (SFK), we aimed to investigate the association between adherence to ADHD medication and registered minor offenses between 2005 and 2019 of 18,234 adolescents (12–18 years). We used Cox regression analyses to compare the rate of committing minor offenses of adolescents during periods of high ADHD medication adherence compared to periods of low adherence (i.e., periods with or without sufficient amounts of dispensed medication). We additionally tested associations with adherence to selective serotonin reuptake inhibitors (SSRIs) as control medication and analyzed potential reverse causation. Results: High ADHD medication adherence was associated with a reduced risk of committing a minor offense of between 33% and 38% compared to low adherence periods of ≥3 months (hazard ratio [HR] 0.67, confidence interval [CI] 0.64–0.71) or ≥6 months (HR 0.62, CI 0.59–0.65). The reduction in risk can likely be attributed to ADHD medication, given the absence of effects of SSRIs and no reverse causation. The reduction rate remained between 16% and 55% per sex, stimulant versus non‐stimulant medication, different offense categories and further sensitivity analyses. Conclusions: Among adolescents using ADHD medication, rates of criminality were lower during periods of high medication adherence, suggesting that adherence to ADHD medication may contribute to prevention of minor offenses in adolescents. [ABSTRACT FROM AUTHOR]

Background: When unaddressed, contamination in child maltreatment research, in which some proportion of children recruited for a nonmaltreated comparison group are exposed to maltreatment, downwardly biases the significance and magnitude of effect size estimates. This study extends previous contamination research by investigating how a dual‐measurement strategy of detecting and controlling contamination impacts causal effect size estimates of child behavior problems. Methods: This study included 634 children from the LONGSCAN study with 63 cases of confirmed child maltreatment after age 8 and 571 cases without confirmed child maltreatment. Confirmed child maltreatment and internalizing and externalizing behaviors were recorded every 2 years between ages 4 and 16. Contamination in the nonmaltreated comparison group was identified and controlled by either a prospective self‐report assessment at ages 12, 14, and 16 or by a one‐time retrospective self‐report assessment at age 18. Synthetic control methods were used to establish causal effects and quantify the impact of contamination when it was not controlled, when it was controlled for by prospective self‐reports, and when it was controlled for by retrospective self‐reports. Results: Rates of contamination ranged from 62% to 67%. Without controlling for contamination, causal effect size estimates for internalizing behaviors were not statistically significant. Causal effects only became statistically significant after controlling contamination identified from either prospective or retrospective reports and effect sizes increased by between 17% and 54%. Controlling contamination had a smaller impact on effect size increases for externalizing behaviors but did produce a statistically significant overall effect, relative to the model ignoring contamination, when prospective methods were used. Conclusions: The presence of contamination in a nonmaltreated comparison group can underestimate the magnitude and statistical significance of causal effect size estimates, especially when investigating internalizing behavior problems. Addressing contamination can facilitate the replication of results across studies. [ABSTRACT FROM AUTHOR]

Background: Observation of child behaviour provides valuable clinical information but often requires rigorous, tedious, repetitive and time expensive protocols. For this reason, tests requiring significant time for administration and rating are rarely used in clinical practice, however useful and effective they are. This article shows that Artificial Intelligence (AI), designed to capture and store the human ability to perform standardised tasks consistently, can alleviate this problem. Case study: We demonstrate how an AI‐powered version of the Manchester Child Attachment Story Task can identify, with over 80% concordance, children with insecure attachment aged between 5 and 9 years. Discussion: We discuss ethical issues to be considered if AI technology is to become a useful part of child mental health assessment and recommend practical next steps for the field. [ABSTRACT FROM AUTHOR]

Purpose/Objective: To investigate the occurrence of behavioral problems 7 years after severe pediatric traumatic brain injury (TBI), and their evolution from 3 months to 7 years postinjury. Method/Design: Thirty-four participants, 38% girls, M (SD) age at injury 7.6 (4.7) years, age at assessment 15 (4.6) years, underwent comprehensive assessments 7 years after severe TBI from March 2014 to March 2016 and were matched to a control group by age, gender, and parental education. A subgroup of 20 participants had available behavioral assessments at 3, 12, and 24 months postinjury. Internalizing, externalizing, and total behavioral problems were assessed with self- and parent reports of the Achenbach's Behavioral Checklist. Additional data included sociodemographic background, initial injury severity, and specific outcomes assessed concurrently 7 years postinjury. Results: Compared to controls: (a) a significant proportion of participants with severe TBI fell above the clinical cutoff for self- (42%) and parent-reported (36%) externalizing problems, but not for self- (33%) or parent-reported (45%) internalizing problems; (b) withdrawn/depressed, intrusive behavior, and somatic complaints were significantly higher in self-reports; and (c) rule-breaking behavior, attention, and social problems were significantly higher in parent reports. Parent-reported internalizing problems were associated with older age at injury, whereas externalizing problems correlated with greater injury severity and concurrent levels of greater overall disability, lower intellectual ability, and poorer family functioning. In multiple hierarchical regression analyses, overall disability and worse family functioning significantly predicted externalizing problems. Parent-reported internalizing and externalizing problems persisted over time. Conclusions/Implications: These results highlight the importance of long-term follow-up and individualized behavioral interventions for children who sustained severe TBI. Impact and Implications: Approximately half of the parents of children who sustained severe pediatric traumatic brain injury (TBI) report clinically significant internalizing and externalizing behavior problems 7-year postinjury, indicating long-term persistence of behavioral issues with significant consequences on participation and overall academic achievement. Concordance between parent- and self-reports assessing internalizing and externalizing behavioral problems is high, suggesting that patients who sustained severe childhood TBI and their parents might perceive and deal more frequently with symptoms related to more overtly noticeable behaviors, such as externalizing symptoms, but might also be particularly aware of symptoms pertaining to withdrawnness, depression, and somatic complaints in the long-term. These internalizing symptoms should not be neglected and appropriate support should be considered, even in the absence of externalized behaviors. Persistence of internalizing and externalizing problems 7 years after severe TBI underlines the importance of follow-up interventions aimed at behavioral adjustment. During follow-up, it is important to organize and implement serial assessments of neuropsychological and general functioning, educational attainment, and school issues, as well as mood and behavior, in order to detect and quantify disorders, and to implement timely, individualized, patient- and family-centered targeted interventions. [ABSTRACT FROM AUTHOR]

Purpose: A scoping review of randomized controlled trials (RCTs) of parenting and family-based interventions that aim to reduce severe and persistent conduct problems among 10–17 year-olds. The review also examined feasibility for conducting a network meta-analysis of common therapy elements measured by RCTs. Materials and methods: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA- ScR). Searches were conducted in ERIC, PsycINFO, and MEDLINE without limits on publication year, language or publication country. Study methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for RCTs. Results: Twenty-five eligible RCTs were identified. The studies trialed nine interventions, with Multisystemic Therapy (MST) being the most evaluated (N = 10), followed by Functional Family Therapy (FFT, N = 4), and Treatment Foster Care Oregon (TFCO, N = 3). Only 10 of the 25 RCTs revealed treatment effect on conduct problems, including 6 of 9 MST, 1 of 4 FFT and all 3 TFCO trials. Discussion: Surprisingly few RCTs of parenting and family-based interventions have been carried out exclusively with this population. Available data suggests that MST and FFT have uncertain effectiveness for reducing severe and persistent conduct problems. While the quality of the reviewed studies was generally high, only two reported substantive data on common therapy elements. Conclusion: There is need for more RCTs of parenting and family-based interventions delivered for older children and adolescents with severe and persistent conduct problems. Future RCTs should systematically measure common therapy elements with a view to advancing intervention science. [ABSTRACT FROM AUTHOR]

Although bidirectional associations between parenting and adolescents' social and emotional outcomes have been investigated, how parental warmth and harsh parenting as two different parenting dimensions, adolescents' prosocial behaviors, and emotional problems were longitudinally and bidirectionally related at between- and within-person levels remains unclear. With a three-wave longitudinal design, the present study examined these associations by employing the random-intercept cross-lagged panel model. Data from 606 Chinese adolescents (Mage = 13.80 years, SD = 0.52, at T1; 45.7% girls) were collected at six-month intervals over one year, and participants completed questionnaires assessing their perception of parenting, prosocial behaviors, and emotional problems online. The results indicated that parental warmth and harsh parenting were significantly associated with adolescents' prosocial behaviors and emotional problems at the between-person level. At the within-person level, adolescents' more prosocial behaviors at T1 predicted later within-person decreases in their emotional problems at T2, which in turn predicted subsequent increased prosocial behaviors and more parental warmth at T3. Additionally, a higher level of harsh parenting at T2 unidirectionally predicted more adolescents' emotional problems at T3. These findings highlighted the developmental cascade processes among adolescents' prosocial behaviors, emotional problems, and parenting and the importance of fostering adolescents' prosocial behaviors in reducing their emotional problems and then promoting subsequent psychosocial adjustment and parent-child bonding. [ABSTRACT FROM AUTHOR]

Although studies have highlighted the role played by couple and parental relationships for children's psychosocial adjustment, especially in challenging situations, research on these two relationship domains has largely developed separately and mostly focussed on negative couple processes. However, Family Systems Theory highlights how these subsystems are interconnected, and studies inspired by this theoretical framework provide evidence of how the quality of the interparental relationship predicts the parent–child relationship. This study focussed on the association between two relational resources (dyadic coping and parent–child relationship quality) and children's emotional difficulties during the outbreak of the COVID‐19 pandemic in Italy. Five hundred ninety‐one Italian parents filled in an online self‐report questionnaire. A path analysis model was estimated to test the mediating role of parent–child relationship quality in the association between partner positive dyadic coping and children's emotional difficulties. The findings showed both a direct effect and an indirect effect of partner positive dyadic coping on children's emotional difficulties, because parent–child relationship quality partially mediated this association. Enhancing parents' ability to cope together with stress and the quality of the parent–child relationship might contribute to decrease children's vulnerability to emotional difficulties in challenging times. [ABSTRACT FROM AUTHOR]

The Treatment Programme for Families with Children in Andalusia is fundamentally aimed at promoting the integral development of children and adolescents through the strengthening of parental competences and family preservation strategies. In the last 20 years, this programme has been applied to over 75 000 families, involving about 150 000 children and adolescents. The aim of this study was to analyse the effects of this family intervention programme on the quality of life and behaviour problems of the children. This quasi‐experimental and longitudinal study had two non‐randomized groups (intervention group and comparison group) and two evaluation measures (pre‐treatment and post‐treatment). The intervention group was constituted by 297 families (540 children) who had participated in the programme. The comparison group consisted of 95 families (138 children) at a similar risk level, although these families had not participated in the programme. The results showed a significant improvement in the quality of life of the children of the families that belonged to the intervention group, which was significantly greater than the evolution detected in the children of the families that belonged to the comparison group. The results of efficacy and efficiency of this type of practice constitute a quality criterion of evidence‐based programmes and a requirement to maintain public investment. [ABSTRACT FROM AUTHOR]

Mental health needs in school are increasing and can affect every student. School nurses are in a perfect position to support social-emotional learning and implement coping strategies to aid in student success. This article features the implementation of social-emotional interventions in the school health office for all students using the multitiered systems of support (MTSS) framework. MTSS is an evidence-based framework that integrates prevention and tiered intervention with data-based problem-solving to meet the academic and behavioral needs of students. Through a tiered approach, all students receive the support they need to understand their emotions, recognize how strong emotions affect physical health, and how to cope. Because maladaptive coping can have an adverse effect on academics, social-emotional wellness is essential for students to be healthy, safe, and ready to learn. [ABSTRACT FROM AUTHOR]

Developing postadoption interventions to prevent parenting stress and promote parents' well-being is urgent. Mindful parenting-based interventions show promise in achieving these goals and are well received by adoptive parents (APs). However, face-to-face interventions face significant barriers. E-health tools offer a solution by improving accessibility and flexibility and reducing long-term costs. Our main aim is to develop and assess the preliminary efficacy of a web-based mindful parenting postadoption intervention, AdoptMindful2Care@Web, by using a user-centered approach to ensure its effectiveness and cost efficiency. First, two quantitative surveys will be conducted to assess the needs and preferences of APs and gather input from adoption professionals. Then, a prototype version of the intervention will be created and tested for usability with the APs via the Think-Aloud method. Finally, a pilot version will undergo a two-arm pilot randomized controlled trial to assess its feasibility, acceptability, and preliminary efficacy via self-report questionnaires. By developing AdoptMindful2Care@Web employing a user-centered approach, we hope to provide an effective intervention that is adjusted to the reality of its users and the surrounding context. In doing so, we will be able to promote AP access to specialized mental health care efficiently. [ABSTRACT FROM AUTHOR]

Objective Empirical evidence underscores an association between parental stress and emotional and behavioral problems in offspring. However, a comprehensive systematic review or meta-analysis on this topic is lacking. Thus, this study aims to address the scientific inquiry: Is there a relationship between parental stress and emotional/behavioral problems in children? Sources This systematic review with a meta-analysis surveyed PubMed, PsycINFO, and the Biblioteca Virtual em Saúde between August and September 2021. The present search combined terms (school-age children) AND (parental stress OR parenting stress OR family stress) AND (emotional and behavioral problems OR internalizing and externalizing problems). Eligibility criteria encompassed cross-sectional, cohort, and case-control studies published within the last five years, exploring the association between parental stress (stressful life events and parenthood-related stress disorders) and emotional/behavioral problems in school-age children. PROSPERO ID CRD42022274034. Summary of the findings Of the 24 studies meeting all inclusion criteria (n = 31,183) for the systematic review, nine were eligible for inclusion in the meta-analysis. The meta-analysis revealed an association between parental stress and emotional problems (COR: 0.46 [95 % CI: 0.27 - 0.61], p < 0.001, Heterogeneity = 89 %) as well as behavioral problems (COR: 0.37 [95 % CI: 0.27 - 0.46], p < 0.001, Heterogeneity = 76 %). Conclusions These findings indicate that parental stress predicts emotional/behavioral problems in school-age children. Since these problems are related to long-term negative effects in adulthood, these results are crucial for preventing mental health problems in offspring and for screening and managing parental stress. [ABSTRACT FROM AUTHOR]

AbstractThis study assessed the impact of Parent-Child Interaction Therapy (PCIT) on caregiver and child outcomes in Türkiye using a non-concurrent multiple baseline design (N = 3). Improvements in child disruptive behavior frequency were observed, with a large effect across participants (Tau-U = −0.74) and perceived problematic child behaviors (Tau-U = −0.87). School refusal, anxiety symptoms, and child emotion regulation improved with reliable change indices indicating clinically significant improvements (>1.96). Clinically significant decreases (RCI >1.96) in parenting stress and parent emotion regulation difficulties were also observed. Parents demonstrated improvements in parenting skills, as outlined by the PCIT protocol. This study highlights PCIT’s efficacy within a novel cultural context. [ABSTRACT FROM AUTHOR]

AbstractThis study determined prevalence and late-infancy predictors of persistent externalizing problems during early-childhood for screening in clinical practice. 1353 primary-caregivers with 8-month infants were recruited systematically from universal well-child centers and followed to 4–5 years (‘Families in Mind’ population-based randomized trial). Externalizing problems were measured by Child Behavior Checklist at 2, 3 and 4–5 years; child/family predictors at 8–12 months. Four percent of toddlers developed persistent externalizing problems of clinical concern (≥2 time-points). Key late-infancy predictors were primary-caregiver distress, harsh discipline and low nurturing. Findings suggest benefits of screening these family factors in late-infancy via universal services to identify early-starters’. [ABSTRACT FROM AUTHOR]

Background: Proximal and distal factors interact to shape children's development and well-being. The present study aimed to examine socioeconomic status (SES), linguistic skills, and language background as concurrent predictors of socio-emotional and behavioural outcomes in heritage bilingual and monolingual children attending preschool. Methods: Parents of 1810 children (mean age = 63.42 months ± 7.36), attending preschool in Italy, completed the Four Factor Index of SES and the Strengths and Difficulties Questionnaire (SDQ). Teachers (n = 99) completed a questionnaire on children's linguistic skills and emotional and behavioural profiles. A subsample of 995 children was administered an expressive vocabulary task in Italian. Results: Regression analyses showed that linguistic skills were the only concurrent predictor of conduct problems, as well as the dominant predictor of hyperactivity/impulsivity, peer problems, and better prosocial behaviour. SES was negatively related to ADHD traits, peer problems, and prosocial behaviour. Finally, heritage bilingualism background was associated, although not as a primary predictor, with increased emotional problems, peer relationship problems, and lower teacher-rated emotional and behavioural skills. However, it was the main factor positively associated with prosocial behaviour. Conclusions: The implications of these findings for research in this area and for educational policy are discussed, highlighting the need for a multidimensional perspective that includes linguistic skills and SES in the assessment of children's emotional and behavioural outcomes. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultsConclusions\nIMPLICATIONS OF REHABILITATIONFamilies experience stress and burden following their child’s traumatic brain injury (TBI). Parenting styles are related to parent stress and child behavior problems and executive dysfunction. Parent-child interactions are shown to be a promising intervention target. We aimed to examine the preliminary efficacy of Gaining Real life skills Over the Web (GROW) in improving responsive parenting and reducing parent stress and depression in parents of children ages 0-4 who experienced TBI.Participants (n = 11) were parents of children four years old or younger, at the time of enrollment, and previously hospitalized overnight for TBI. Parent-reported measures included the Center for Epidemiologic Studies Depression Scale, Parenting Stress Inventory—Short Form, and Patient-Reported Outcomes Measurement Information System. Recordings of parent-child interactions were coded using the Play and Learning Strategies coding scheme. Study hypotheses were analyzed using independent samples t-tests, chi square analyses, and linear mixed models.Parental warmth (t=-3.64, p = 0.001, d=.97), responsiveness (t=-2.09, p = 0.047, d = 0.70), and verbal stimulation (t=-2.30, p = 0.029, d = 0.75) increased significantly from pretreatment to posttreatment. Improvements in parental warmth were maintained 3 months posttreatment (t=-3.15, p = 0.004, d = 1.16). There were no significant changes in depression, parental stress, or quality of life.Results provide preliminary support for the efficacy of GROW in improving responsive parenting for children following early TBI. Future directions include tailoring GROW to better fit the needs of families and testing the utility through a randomized control trial.Traumatic Brain InjuryTraumatic brain injury (TBI) is a leading cause of childhood disability, and children who experience TBI under the age of 7 are more susceptible to short- and long-term neurocognitive difficulties.Children who experience TBI under the age of 7 also demonstrate less rehabilitation in skills essential for school readiness, academic success, and emotional well-being.The stress and burden experienced by a family from their child’s TBI influences the child’s rehabilitation, making responsive parenting a promising target for intervention following early childhood TBI.In a pilot study sample, this study demonstrates improvements in responsive parenting skills and no worsening effects on parent depression, stress, or quality of life following participation in an intervention following a child’s early TBI.Rehabilitation professionals should consider targeting responsive parenting skills given the benefit to a child’s recovery following an early TBI and the low likelihood of adverse effects on parent functioning.Traumatic brain injury (TBI) is a leading cause of childhood disability, and children who experience TBI under the age of 7 are more susceptible to short- and long-term neurocognitive difficulties.Children who experience TBI under the age of 7 also demonstrate less rehabilitation in skills essential for school readiness, academic success, and emotional well-being.The stress and burden experienced by a family from their child’s TBI influences the child’s rehabilitation, making responsive parenting a promising target for intervention following early childhood TBI.In a pilot study sample, this study demonstrates improvements in responsive parenting skills and no worsening effects on parent depression, stress, or quality of life following participation in an intervention following a child’s early TBI.Rehabilitation professionals should consider targeting responsive parenting skills given the benefit to a child’s recovery following an early TBI and the low likelihood of adverse effects on parent functioning. [ABSTRACT FROM AUTHOR]

Frightening maternal behavior is linked to infant disorganization, which predicts child behavioral problems. We examined continuity in frightening maternal behavior across the first 2 years by developing a new measure of anomalous/frightening (AN/FR) behavior that incorporates changes in parent–child interactions as children acquire symbolic representation. Maternal AN/FR behavior in toddlerhood also was examined in relation to later internalizing and externalizing symptoms. First-time mothers (N = 125) completed the Adult Attachment Interview (AAI) prenatally, and mother–child dyads were observed interacting at 8 months, in Strange Situations at 12–15 months, and playing at 24 months. Teachers rated children’s behavior problems at 7 years. Mothers classified as Unresolved on the AAI displayed more Frightening (FR) behavior at 8 months. Mothers’ FR behavior predicted both attachment disorganization at 12–15 months and maternal AN/FR behavior at 24 months, which then predicted children’s internalizing symptoms at age 7. Infant disorganization was indirectly related to internalizing symptoms, mediated by maternal AN/FR behavior. [ABSTRACT FROM AUTHOR]

Background: Even though mental health problems and alcohol use remain major challenges facing adolescents, our understanding of their developmental progressions primarily stems from cohorts coming 1 of age in the early 2000's. We aimed to examine and describe normative developmental trajectories of depression, conduct problems, and alcohol use across adolescent years among more recent cohorts of Norwegian youth born in the 21st century. Methods: Multilevel mixed linear models for symptoms of depression and conduct disorder, and multilevel mixed logistic models for depressive disorder, conduct problems, any alcohol use, and risky drinking, were estimated with longitudinal data from a nationwide sample N = 3436 (55% girls) of Norwegian adolescents (mean age 14.3 [SD = 0.85] in 2017). We compared models with linear, quadratic, and cubic change with age, and models that tested moderation by sex and centrality (rural vs. urban communities). Results: Average symptoms and the rate of depressive disorder increased sharply from age 13 to age 19, but both the initial levels and the rates of change were greater for girls than for boys. Average symptoms of conduct disorder and the rate of conduct problems increased in early adolescence and were greater for boys than girls. The rates of any alcohol use and risky drinking both increased sharply from age 14, but there were no notable sex differences either in the initial levels or rates of change over time. Adolescents from more rural communities had greater rates of any drinking in mid-adolescence, but there were no other effects of centrality. Conclusions: This study provides a much-needed update concerning normative developmental trajectories of depression, conduct problems, and alcohol use among millennium cohorts. Consistent with prior studies, we observed significant increases in all outcomes across adolescence, with depression being both greater and more prevalent among girls and conduct problems being both greater and more prevalent among boys. Consistent with the emerging evidence, we observed no sex differences in alcohol use. Finally, there were no differences in the examined developmental trajectories as a function of centrality. These findings underscore the importance of early prevention and treatment of mental health and substance use problems. [ABSTRACT FROM AUTHOR]

The current study aims to advance knowledge on the causal interrelationship between childhood CU traits and lying both at a between- and a within-person perspective across a significant developmental period of mid-childhood to mid-adolescence. Cross-lagged panel models and Random-intercept cross-lagged panel models were used to investigate the prospective associations between lying and the distinct subcomponents of CU traits, including Callousness, Uncaring, and Unemotional in a sample of 719 children (T1; Mage = 10.73 years, SDage = 1.38, range = 7–15 years, 54.4% girls) across four assessment points. Results supported large vulnerability effects at the between-person level across time, indicating that CU traits predominantly influence the subsequent development of lying, with Callousness and Uncaring showing most profound effects on subsequent developmental processes of lying. At the within-person level, fluctuations in CU traits and lying were overall meaningfully related, but no causal relationship could be empirically determined. These findings provide a differentiated etiological viewpoint on the intertwinement of CU traits and lying at a young age, and underscore the importance of an early identification of children with callous and uncaring tendencies in order to prevent more persistent lying in adolescence. [ABSTRACT FROM AUTHOR]

Children with high Callous-Unemotional (CU) traits show deficits in recognizing and processing facial expressions. Alterations in emotion recognition have been linked to a higher synaptic concentration of monoaminergic neurotransmitters. The current study investigated the relationship between the MAOA-Low-activity alleles and the ability to recognize and process facial expressions in 97 male children (8–12 years old) diagnosed with disruptive behavior disorder. Participants completed a computerized emotion-recognition task while an eye-tracking system recorded the number (Fixation Count, FC) and length (Fixation Duration, FD) of fixations to the eye region of the emotional stimuli. Children with high CU traits exhibited lower scores in recognition of sadness and anger, and lower FC and FD for sadness and fear than children with low CU traits. Children carrying the MAOA-Low-activity alleles displayed lower FD for sadness, and FD and FC for fear than those carrying the MAOA-High-activity alleles. These genetic effects appeared even stronger in children with CU traits. Moderation analysis revealed that CU traits were associated with lower FC and FD for fear, and lower FD for sadness, probably due to the MAOA-Low-activity alleles. Our findings, although to be replicated, suggest MAOA-Low-activity alleles as potential genetic biomarkers to identify CU children in need of training focused on emotion processing. [ABSTRACT FROM AUTHOR]

Engagement behaviors are crucial for school success and are often targeted for improvement in school-based interventions. It may be helpful for both researchers and school-based practitioners to understand the likely impacts of interventions on engagement behaviors (e.g., to understand the extent to which engagement behaviors might change with treatment). For single-case studies designed to answer demonstration questions (i.e., including a baseline condition) and that were conducted in elementary classroom settings (N = 131), we calculated log response ratio and within-case standardized mean difference effect sizes for engagement dependent variables to establish benchmarks. We described differences based on study characteristics (functional relation determination, publication status, primacy of outcome), disability status of participants, and implementation characteristics (group size, implementer). Effect sizes (645 A-B comparisons) were heterogenous and varied based on functional relation determination, disability status, and implementation variables. More research is needed about additional variables that might explain heterogenous outcomes, especially for children with autism and behavioral disorders. [ABSTRACT FROM AUTHOR]

Although internationally adopted children experience elevated sleep problems and psychosocial difficulties, little research has evaluated predictors and correlates of sleep issues in this population. The current study aims to address gaps in current research by examining associations between pre-adoptive risk, sleep disturbance, emotion lability/negativity, and internalizing and externalizing behavior in a sample of internationally adopted children. Parents completed questionnaires about the children's (N = 109; M age = 7.9, SD = 1.5; 39.6% male, 60.4% female) history, behavior, and functioning. Results reveal that sleep difficulties and emotion lability/negativity later in childhood mediated the relation between pre-adoptive conditions and internalizing and externalizing behavior in a sample of internationally adopted children. Future studies of internationally adopted children are needed to continue exploring trajectories of sleep problems and other self-regulatory difficulties in this population. [ABSTRACT FROM AUTHOR]

Objective: We tested if baseline disruptive child behavior problem severity predicts parental attendance at sessions of a parenting group program. Method: We used a database of randomized trials of the Incredible Years parenting program in Europe and restricted the sample to participants randomized to the intervention arm. Using baseline Eyberg Child Behavior Inventory scores, we distinguished between trial-level problem severity and child-level problem severity, compared linear and quadratic functional forms at both levels, and considered cross-level interactions, all in a multilevel Poisson regression framework. Results: Drawing on 918 participants in 12 trials, we found that within trials, parents of children with the least and most severe problems attended fewer sessions. Between trials, each additional 10-point increase in the Eyberg Child Behavior Inventory trial mean predicted an 11% increase in attendance. Models including child sex, age, or family low-income did not change coefficients or their interpretation. Conclusions: Our findings suggest that although generally attendance is higher in parents of children with more challenging behavior, it seems difficult for group programs to keep families with the least or most severe problems engaged. Our findings call for the need to better understand the conditions under which lower attendance translates into equivalent or lesser program benefits. What is the public health significance of this article?: This analysis suggests that in the Incredible Years parenting program, families with the least and most severe child behavior problems attend the fewest sessions. A greater focus on keeping these families' engagement may result in larger program benefits. [ABSTRACT FROM AUTHOR]

Background: The Sensitivity to Threat and Affiliative Reward (STAR) model proposes low threat sensitivity and low affiliation as risk factors for callous‐unemotional (CU) traits. Preliminary evidence for the STAR model comes from work in early childhood. However, studies are needed that explore the STAR dimensions in late childhood and adolescence when severe conduct problems (CP) emerge. Moreover, it is unclear how variability across the full spectrum of threat sensitivity and affiliation gives rise to different forms of psychopathology beyond CU traits. Methods: The current study addressed these gaps using parent‐ and child‐reported data from three waves and a sub‐study of the Adolescent Brain Cognitive Development Study® of 11,878 youth (48% female; ages 9–12). Results: Consistent with the STAR model, low threat sensitivity and low affiliation were independently related to CU traits across informants and time. Moreover, there was significant interaction between the STAR dimensions, such that children with lower sensitivity to threat and lower affiliation had higher parent‐reported CU traits. Unlike CU traits, children with higher threat sensitivity had higher parent‐reported CP and anxiety. Finally, children with lower affiliation had higher parent‐reported CP, anxiety, and depression. Results largely replicated across informants and time, and sensitivity analysis revealed similar findings in children with and without DSM‐5 defined CP. Conclusions: Results support the STAR model hypotheses as they pertain to CU traits and delineate threat sensitivity and affiliation as independent transdiagnostic risk factors for different types of psychopathology. Future research is needed to develop fuller and more reliable and valid measures of affiliation and threat sensitivity across multiple assessment modalities. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the cognitive, behavioural and affective processes involved in therapeutic change for young people with epilepsy and mental health difficulties receiving an integrated mental health intervention. Methods: As part of a mixed methods convergent design, qualitative data were gathered in parallel to quantitative data at two timepoints in a randomised controlled trial testing the Mental Health Intervention for Children with Epilepsy in addition to usual care. Twenty-five young people and/or their families were interviewed before and after the intervention about the young person's mental and physical health, and their experience of therapy. Interview data were analysed inductively, idiographically and longitudinally using Interpretative Phenomenological Analysis combined with Framework Analysis. Results: The young people's emotional and behaviour problems improved, mirroring the trial's quantitative outcomes. Their anxiety decreased and behaviour improved as they acquired tools and understanding through therapy. Problems, like aggressive behaviours and emotional outbursts, were also reduced, with young people gaining increased awareness and ability to self-regulate and parents learning to contain their child's impulsive behaviours. Conclusions: The qualitative findings complement the MICE trial's significant positive quantitative results by providing insight and context to the therapeutic change, providing vivid insight into the mechanisms of therapy for individual families. Plain language summary: This study involves young people with epilepsy and mental health difficulties who received an integrated mental health intervention called the Mental Health Intervention for Children with Epilepsy (MICE). The effectiveness of the MICE intervention (in addition to usual care) was assessed by comparing it to only usual care. This article reports on the changes in the behaviour, thinking, feeling of the young people after they received therapy. The research data was qualitative, using transcripts from interviews with 25 young people and/or their families. There was also some quantitative data, in the form of questionnaires. Both types of data were gathered at two different time points and compared over time. Then the results from the two types of data were considered together in a so-called mixed methods approach. During the qualitative interviews, participants were asked about the young person's mental and physical health, as well as their therapy experiences. The interview data were analysed using an in-depth approach to the analysis. This article describes improvements in emotional and behavioural problems among the young participants, which align with the positive mental health outcomes observed in the trial's quantitative data. Participant quotes before and after the intervention reveal reduced anxiety and improved behaviour as the therapy gave the young people new tools and understanding. Parents of young people with intellectual disabilities also felt more confident in managing their children's fears. Aggressive behaviours and emotional outbursts decreased, and young people developed greater self-awareness and self-control. The qualitative findings provide context and insight into the therapeutic change observed in the MICE trial. Understanding the mechanisms of therapy is crucial. In summary, this study sheds light on how therapy positively impacts young people's mental health and behaviour, with benefits for both the young people and their families. [ABSTRACT FROM AUTHOR]

Although the impact of parental obsessive-compulsive disorder (OCD) on children is well known, there is a still need to investigate additional psychopathological effects that parental OCD may have on children. To our knowledge, the relationship between Cognitive Disengagement Syndrome (CDS), previously referred to as Sluggish Cognitive Tempo CDS in children and parents' OCD has not been investigated to date. In this study, we examined the relationship between parental OCD and children's CDS, while adjusting for parental anxiety, depression, as well as symptoms of internalization, externalization, and Attention Deficit Hyperactivity Disorder (ADHD) in their children. 50 parents with OCD and 45 healthy parents were assessed through Yale-Brown Obsessive-Compulsive Scale, Beck Depression Inventory, and Beck Anxiety Inventory (BAI). The children were applied Child Behavior Checklist, Children ADD/ADHD DSM-IV Based Diagnostic Screening, and Barkley Child Attention Scale (BCAS). BCAS showed significant correlations with BAI (r = 0.280, p =.049), child ADHD-hyperactivity/impulsivity (r = 0.407, p =.003), and ADHD-inattention (r = 0.628, p <.001). The severity of ADHD-inattention (β = 0.618, p =.001) and parental OCD (β = 0.275, p =.016) were significant predictors of CDS severity in the children. Our findings may suggest a significant association between the severity of CDS and ADHD-inattention in children and parental OCD, even after controlling for parental anxiety. Plain language summary: Obsessive-Compulsive Disorder (OCD) can significantly disrupt many facets of children's emotional, social, academic and cognitive development. To our knowledge, the relationship between Cognitive Disengagement Syndrome (CDS), previously referred to as Sluggish Cognitive Tempo CDS in children and parents' OCD has not been investigated to date. In this study, we examined the relationship between parental OCD and children's CDS, while adjusting for parental anxiety, depression, as well as symptoms of internalization, externalization, and Attention Deficit Hyperactivity Disorder (ADHD) in their children. 50 parents with OCD and 45 healthy parents were assessed through Yale-Brown Obsessive-Compulsive Scale, Beck Depression Inventory, and Beck Anxiety Inventory (BAI). The children were applied Child Behavior Checklist, Children ADD/ADHD DSM-IV Based Diagnostic Screening, and Barkley Child Attention Scale (BCAS). BCAS showed significant correlations with BAI, child ADHD-hyperactivity/impulsivity, and ADHD-inattention. The severity of ADHD-inattention and parental OCD were significant predictors of CDS severity in the children. Our findings may suggest a significant association between the severity of CDS and ADHD-inattention in children and parental OCD, even after controlling for parental anxiety. The children with parents who have OCD may alleviate the fear and anxiety arising from negative parental attitudes by exhibiting cognitive symptoms. Certain parental styles in OCD patients may predispose their children to display an impaired pattern of social interaction, including social isolation and withdrawal. [ABSTRACT FROM AUTHOR]

Caregivers of children with autism spectrum disorder (ASD) often report higher rates of depression and the related negative thought patterns that may precede a clinical diagnosis. These negative thought patterns are referred to as depressive cognitions. Depressive cognitions are exacerbated by child problem behaviors (CPB) but may be impacted by parental resilience. The current study examines relations between CPB and depressive cognitions and the role of resilience as a moderator among caregivers of children with ASD (n = 287) and a sample of caregivers of children who are typically developing (n = 207). Significant positive associations were found between CPB and depressive cognitions for caregivers of children with ASD and who are typically developing. A moderation analysis revealed that, among the ASD sample, the model accounted for 33% of the variance in caregiver depressive cognitions (R2 = 0.33, SE = 35.52, p < 0.001). The interaction of child problem behaviors and caregiver resilience on caregiver depressive cognitions was statistically significant (B = − 0.016, SE = 0.007, p = 0.037), thus resilience was a significant moderator, for caregivers of children with ASD. Resilience serves as a protective factor in the relationship between child problem behavior and caregiver depressive cognitions for caregivers of children with ASD only. This finding highlights the importance of assessing and supporting resilience among caregivers of children with ASD. Interventions addressing child behavior would benefit from additional components to bolster caregiver resilience to enhance caregiver mental health and protect against depressive cognitions. [ABSTRACT FROM AUTHOR]

Prior research has demonstrated that cognitive inflexibility is associated with anxiety in autistic individuals. Everyday patterns of behavioral inflexibility (e.g. observable inflexible behavior in the context of the need to change or adapt and that is manifested in real-world everyday settings) is common in autism and can be distinguished from performance on discrete cognitive tasks that tap flexible attention, learning, or decision-making. The purpose of this study was to extend this prior work on inflexibility in autism but with measures specifically developed with input from stakeholders (caregivers and clinicians) for autistic youth designed to measure everyday behavioral inflexibility (BI). We characterized anxiety in a large sample of autistic (N = 145) and non-autistic youth (N = 91), ages 3 to 17 years, using the Parent Rated Anxiety Scale for Autism Spectrum Disorder (PRAS-ASD). Further, we sought to understand how BI, measured via the Behavioral Inflexibility Scale (BIS), predicted anxiety compared to other variables known to increase anxiety in youth (chronological age, IQ, autism diagnosis, assigned sex at birth). Autistic youth had higher parent-related anxiety and BI compared to non-autistic youth. BI was the strongest predictor of anxiety scores, irrespective of diagnosis. Overall, our findings highlight the importance of BI to the understanding of anxiety in autistic youth. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: US children experience lead poisoning, which has detrimental health effects and significant individual and societal costs. This study aimed to describe the sociodemographic and hospitalization characteristics of children hospitalized for lead poisoning and assess the proportion of inpatients who received blood lead testing and appropriate follow-up testing before hospitalization. METHODS: 2015-2021 hospital discharge data were linked to lead surveillance data for Pennsylvania children aged 0 to 5 years. Demographics, hospitalization characteristics, and lead testing data from children with a primary diagnosis code of lead poisoning were used. The number of hospitalizations, associated hospital length of stay and charges, and the proportion of inpatients who received lead testing and follow-up testing after identification of high blood lead levels before hospitalization were analyzed by selected characteristics. RESULTS: During the study period, there were 93 children hospitalized for lead poisoning, incurring 443 inpatient days and approximately 6 million dollars in inpatient charges. Of these inpatients, 69.9% were males, 36.6% were non-Hispanic Black, 67.7% were aged 0 to 2 years, 14% had repeated admissions, and 88.2% of admissions were paid by Medicaid. In addition, 20.4% did not have lead testing, and 34.4% had appropriate follow-up testing before hospitalization. Non-Hispanic whites and children with developmental, behavioral, and emotional disorders had relatively low proportions of having appropriate follow-up testing. CONCLUSIONS: Severe childhood lead poisoning is a significant health and economic burden, especially among children with Medicaid. Further improvements in blood lead testing and follow-up testing can help prevent childhood lead poisoning. [ABSTRACT FROM AUTHOR]

This scoping review was conducted to synthesize and analyze the rationale and processes involved in implementing play therapy programs to help children who have been exposed to domestic violence. Participants of reviewed play therapies were commonly living in shelters, had experienced child maltreatment and/or witnessed family violence, and exhibited psycho-social/behavioral problems. Key steps of play therapies include using reinforcement to provide an appropriate outlet for overwhelming emotions and/or problematic behaviors, identifying modifiable behaviors underlying cognitive distortions, cognitive restructuring/re-framing, behavioral correction, and learning coping and interpersonal skills. Parents' education, children's improvement, and the advantages/concerns of play therapy are also discussed. [ABSTRACT FROM AUTHOR]

The mental health and wellbeing of children and young people who have been in care, primarily foster care, kinship care or residential care, remains a public health priority. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) synthesized evidence for the effectiveness of interventions targeting: subjective wellbeing; mental, behavioral and neurodevelopmental disorders; and suicide-related outcomes. Searches were conducted in 16 bibliographic databases and 22 websites between 1990 and 2022. This was supplemented by citation tracking, screening of relevant systematic reviews, and expert recommendation. We identified 35 interventions, with 44 evaluations via randomized controlled trials. Through meta-analyses, we found that interventions have a small beneficial impact on a variety of mental health outcomes in the short term (0–6 months). Interventions improved total social, emotional, and behavioral problems (d = −0.15, 95% CI [−0.28, −0.02]), social-emotional functioning difficulties (d = −0.18, 95% CI [−0.31, −0.05]), externalizing problem behaviors (d = −0.30, 95% CI [−0.53, −0.08]), internalizing problem behaviors (d = −0.35, 95% CI [−0.61, −0.08]); and depression and anxiety (d = −0.26, 95% CI [−0.40, −0.13]). Interventions did not demonstrate any effectiveness for outcomes assessed in the longer term (>6 months). Certainty of effectiveness was limited by risk of bias and imprecision. There was limited available evidence for interventions targeting subjective wellbeing and suicide-related outcomes. Future intervention design and delivery must ensure that programs are sufficient to activate causal mechanisms and facilitate change. Evaluation research should use a robust methodology. PROSPERO Registration: CRD42020177478 [ABSTRACT FROM AUTHOR]

Adolescent aggressive behavior has increasingly become a central issue affecting the safety of both school campuses and the broader society. Despite the existence of numerous community interventions targeting this issue, there has been a paucity of efforts to consolidate the findings on the effectiveness of community-based programs in preventing aggressive behavior. This meta-analysis sought to address this gap by reviewing and assessing the impact of community-based initiatives on reducing adolescent aggression. A thorough search was carried out on 12 electronic databases: EBSCO, ERIC, PubMed, PsycINFO, MEDLINE, EMBASE, Scopus, Web of Science, ProQuest Dissertations and Theses, the China National Knowledge, Wanfang Databases, and China Science and Technology Journal Database. Sixteen studies were finalized, and meta-analyses were performed using a random effect model on RevMan v5.4 software developed by Cochrane. The analysis encompassed 16 published studies, involving a total of 2,585 participants. The key components of existing programs for aggression reduction included providing behavioral skills and training for adolescents, employing a problem-solving approach to address behavioral issues, offering psychological treatment, and emphasizing community supervision. The results indicate a significant positive effect of community-based interventions on aggression reduction (standardized mean difference = −0.26, 95% confidence intervals [−0.39, −0.13], Z = 3.84, p <.001). The subgroup analyses revealed that the intervention's effectiveness was moderated by the duration of the intervention, its theoretical foundation, and the sample size. This study furnishes empirical evidence supporting the enhancement of policies and practices to foster community engagement in mitigating aggressive behavior. [ABSTRACT FROM AUTHOR]

Childhood epilepsy is a chronic neurological disorder that poses risks for additional emotional, developmental, and behavioral comorbidities. To improve the quality of life for children with epilepsy (CWE), overall well-being needs to be addressed, including understanding how flourishing and family resilience are related to CWE, CWE and emotional, developmental, or behavioral comorbidities (CWE plus), and typical peers. Data from the 2018–2019 National Survey of Children's Health, a nationally representative, cross-sectional survey, was used to evaluate flourishing and family resilience among CWE, CWE plus, and typical peers aged 6–17 (N = 31,419). The study found that health status significantly predicted flourishing over and above sociodemographic factors. CWE were 2.71 times less likely to flourish and CWE plus were 16.13 times less likely to flourish than typical peers. The study also found that health status significantly predicted family resilience over and above sociodemographic factors. CWE were not significantly less likely than typical peers to show family resilience, but CWE plus were 1.97 times less likely to show family resilience when compared to typical peers. The findings that CWE plus were both significantly less likely to flourish and be a part of a family that demonstrates family resilience have important implications. [ABSTRACT FROM AUTHOR]

Research has shown links between emotion regulation strategies and child mental health. However, it is not well known how the characteristics of children may moderate these links. The aim of this study was to explore whether environmental sensitivity—the ability to perceive and process information about the environment—moderates links between emotion regulation strategies (cognitive reappraisal and expressive suppression) and children's emotional and behavioral problems. The study included 1381 children (M age = 10.53, 51% girls) who gave information about their emotion regulation and environmental sensitivity, and whose teachers reported on their emotional and behavioral problems. The results showed that suppression predicted a higher amount of problems for girls regardless of their sensitivity level. For boys, environmental sensitivity moderated this link. Among more environmentally sensitive boys, the association between suppression usage and emotional and behavioral problems was stronger than among less sensitive boys. These results show that the effects of suppression may be exacerbated depending on the child's gender and environmental sensitivity. [ABSTRACT FROM AUTHOR]

This study aimed to examine independent and interactive contributions of parenting behaviors (e.g., physical punishment, inductive discipline, warm responsiveness) and child effortful control on child externalizing problems during early and middle childhood. Participants were 241 children (123girls) of middle-income families in the U.S. who were primarily European Americans (91%) and at risk for school-age problem behaviors. Data were collected at ages 3, 6, and 10 using multiple methods, informants, and contexts. Results of hierarchical regression analyses indicated both independent and interactive influences of parenting behaviors and child effortful control on children's externalizing behaviors. Importantly, effortful control buffered the negative influence of physical punishment, but not other parenting behaviors, such that physical punishment was associated with external behaviors at 6 years only for children with poorer effortful control abilities. The results highlight both parental discipline strategies and child effortful control as promising targets for early identification and prevention of future problem behaviors. Summary: Parenting and child effortful control have long been topics of research on child development. However, relatively little is known about the long-term effects of early parenting in the context of effortful control and the possibility that those processes may differ across different dimensions of parenting (i.e., warm responsiveness, inductive discipline, and physical punishment) Therefore, this study aimed to examine independent and interactive contributions of parenting behaviors and child effortful control on child externalizing problems during early and middle childhood. Participants were 241 children (123girls) of middle-income families who were at risk for school-age problem behaviors. Data were collected using multiple methods, informants, and contexts. Specifically, child effortful control at 3 years was measured using multiple tasks, and parenting at 3 years was assessed via maternal report during home interview. Teachers contributed ratings of child externalizing behaviors at 3, 6, and 10 years. Results indicated both independent and interactive influences of parenting behaviors and child effortful control on children's externalizing behaviors. Importantly, effortful control buffered the negative influence of physical punishment, but not other parenting behaviors, such that physical punishment was associated with external behaviors at 6 years only for children with poorer effortful control abilities. Moreover, parents' use of physical punishment at age 3 showed a long-lasting association with children's problem behaviors at ages 6 and 10 years. The findings suggest that children with more advanced effortful control may be less susceptible to long-term detrimental contribution of physical punishment, although by no means they are protected from harmful effects of punitive discipline. This study provides more sophisticated explanations on the influence of early parenting and child effortful control on externalizing behaviors spanning early to middle childhood. The results also highlight different parental discipline strategies and child effortful controls as promising targets for early identification and prevention of children's future problem behaviors in childhood. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had a substantial impact on children and families worldwide. Children's mental health has been at the forefront of pandemic research, with several observational studies documenting its decline. Limited person-centred research exists, however, investigating the diverse mental health responses of vulnerable children during COVID-19. Objective: The purpose of this study is to examine the profiles of 289 low-income children's mental health transitions from pre-COVID-19 to during COVID-19. Methods: Mothers' reports of children's mental health using the Strengths and Difficulties Questionnaire from before ( X ¯ = 2.73 years, SD = 0.23) and during ( X ¯ = 5.31 years, SD = 0.59) COVID-19 were used. Results: Three comparable profile solutions were identified pre- and early during the pandemic. Latent transition analysis revealed diverse patterns of children's mental health trajectory from prior to during COVID-19. Based on transition probabilities, the majority of children in the Average Levels of Internalizing/Externalizing Problems and Externalizing Problems profiles pre-pandemic showed stability in profile membership. Interestingly, most children in the high levels of Internalizing/Externalizing Problems profile pre-pandemic experienced some improvement in their mental health. Pre-pandemic maternal mental health and parenting had significant associations with children's profile membership at both time points. Conclusions: Our findings reveal the heterogeneity in children's mental health responses in times of large-scale crises. They also identify how pre-existing maternal risk factors may underlie the diverse experiences of children who underwent declining, stable, or improving mental health profiles during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Child and family routines were significantly disrupted by the COVID-19 pandemic stay-at-home orders, leaving individuals isolated from school, work, and peer networks. This work examines how social support from family/friends and systems was connected to associations between parental stress and child behavior problems. Data was collected between January and March of 2021 from 195 parents of children in elementary school who were primarily in remote learning due to the pandemic. Hierarchical linear regression models indicated that younger child age and child gender were associated with parental stress in step 1; only child age remained significant when child behavior problems were added. Support from family, but not external systems, attenuated associations between child characteristics and behavior on parental stress, though child behavior problems remained consistent with parental stress even when support was present. Exploring parental stressors and investing in support networks may protect children and families from immediate and ongoing challenges. [ABSTRACT FROM AUTHOR]

This study examined the serial mediating effects of negative parenting and children's mastery motivation on the relationship between family socioeconomic status (SES) and internalizing and externalizing problem behaviors in Chinese preschoolers. A sample of 669 Chinese children between 3 and 6 years (Mage = 4.83, SDage = 0.87, 50.4% girls) was recruited from 12 public kindergartens in a coastal city in southeastern China based on a stratified random sampling procedure. Their parents completed the Multidimensional Assessment of Parenting Scale (MAPS), Dimensions of Mastery Questionnaire for Preschool Children (DMQ 18), and Children's Problem Behaviors Scale (CPBS). Research Findings: (1) family SES was significantly related to reduced negative parenting and children's problem behaviors as well as increased children's mastery motivation; (2) family SES affected children's problem behaviors indirectly through the single mediating path of negative parenting and the single mediating path of children's mastery motivation; and (3) negative parenting and children's mastery motivation were identified the serial mediators between family SES and children's problem behaviors. Practice or Policy: This study has demonstrated how family SES would interact with negative parenting practices concerning early childhood development. The findings also indicated that strategies that assist parents in adopting positive parenting practices or facilitate the development of mastery motivation in children might reduce the occurrence of children's problem behaviors. [ABSTRACT FROM AUTHOR]

Background: Sleep disorders have been poorly described in congenital (CDM) and childhood (ChDM) myotonic dystrophy despite being highly burdensome. The aims of this study were to explore sleep disorders in a cohort of Italian CDM and ChDM and to assess their association with motor and respiratory function and disease-specific cognitive and behavioral assessments. Methods: This was an observational multicenter study. Reported sleep quality was assessed using the Pediatric Daytime Sleepiness Scale (PDSS) and Pediatric Sleep Questionnaire (PSQ). Sleep quality was correlated to motor function (6 min walk test, 6MWT and grip strength; pulmonary function (predicted Forced Vital Capacity%, FVC% pred.); executive function assessed by BRIEF-2; autism traits assessed by Autism Spectrum Screening Questionnaire (ASSQ) and Repetitive Behavior Scale-revised (RBS-R); Quality of life (PedsQL) and disease burden (Congenital Childhood Myotonic Dystrophy Health Index, CCMDHI). Results: Forty-six patients were included, 33 CDM and 13 ChDM, at a median age of 10.4 and 15.1 years. Daytime sleepiness and disrupted sleep were reported by 30% children, in both subgroups of CDM and ChDM. Daytime sleepiness correlated with autism traits in CDM (p < 0.05). Disrupted sleep correlated with poorer executive function (p = 0.04) and higher disease burden (p = 0.03). Conclusions: Sleep issues are a feature of both CDM and ChDM. They correlate with behavioral issues and impact on disease burden. [ABSTRACT FROM AUTHOR]

ObjectiveMethodResultsConclusionsParent–Child Interaction Therapy (PCIT) is a parenting program in which caregivers must achieve “skill criteria” in using Do Skills and avoiding Don’t Skills to complete treatment. Despite PCIT’s emphasis on these skills, little is known about how Latinx caregivers acquire these Western-based parenting practices and whether cultural mismatches lead to inequities in outcomes. This study compared the trajectories of change in PCIT skills and treatment outcomes of Latinx and non-Latinx White families.We analyzed weekly treatment data from 64 families (20.3% Spanish-speaking Latinx, 51.6% English-speaking Latinx, 28.1% non-Latinx White) served in community clinics. Caregivers were mostly females (95.3%), on average 35.13 years old, and lived in poverty (77.6%). PCIT skills were coded using the Dyadic Parent–Child Interaction Coding System, and child behavior problems were reported using the Eyberg Child Behavior Inventory.Latinx and non-Latinx White caregivers acquired Do Skills similarly during treatment. In contrast, some Latinx caregivers began treatment using significantly more Don’t Skills and needed more sessions to achieve some aspects of PCIT skill criteria compared with non-Latinx White caregivers. Latinx families also experienced similar or even more pronounced reductions in child behavior problems than non-Latinx White families. There were no significant differences in the percentage of caregivers who achieved PCIT skill criteria or left treatment prematurely.This study provides evidence that strictly defined PCIT skill criteria may lead to inequities in treatment length for some Latinx families. Informed by these findings, we propose data-driven adaptations to improve the cultural fit of PCIT for Latinx groups. [ABSTRACT FROM AUTHOR]

Background: Evidence-based parenting programs delivered using online technology are an important way to enhance programuptake. To date, programs that address emotion socialization processes, such as Tuning in to Kids, have always been delivered in person, via group or one-to-one delivery. This study used a randomized control design to examine the effcacy of the self-paced Tuning in to Kids OnLine (TIKOL). Method: Participants were 150 parents of children aged 4-10 years old with challenging behaviors, randomized into intervention or 10-month waitlist control. Parents and teachers completed questionnaires at baseline and 6 months after the intervention (equivalent time points for controls) measuring parent wellbeing, parent emotion socialization, parent effcacy, child behavior, and anxiety. Results: Analyses, using mixed methods multilevel modeling, showed that intervention parents reported significantly reduced emotion dismissiveness and increased emotion coaching, empathy and effcacy compared to controls who did not. Parents participating in TIKOL also reported that their children's behavior problems and anxiety were significantly improved. Greater engagement (modules watched and duration of support calls) was associated with more significant improvements. Conclusion: Findings provide preliminary support for the effcacy of TIKOL in improving parents' emotion socialization and reducing child behavior problems and anxiety, especially when efforts to support online engagement are utilized. Further evaluation using independent observations and a sample representing a wider demographic would strengthen these findings. [ABSTRACT FROM AUTHOR]

Background: Sleep problems are common in early childhood and may be affected by parental adverse childhood experiences (ACEs). However, few studies have examined the longitudinal effect of parental ACEs on offspring sleep problems and the underlying mechanism. This study examined parents' psychological distress and harsh discipline (psychological aggression and corporal punishment) as mediators in the longitudinal pathway from parental ACEs to offspring sleep problems. Methods: The participants included 617 3-year-old children (mean age of 43.13 months, SD = 3.82) and their parents (mean age of 33.24 years, SD = 4.01) from Wuhu, China. The participants completed an online questionnaire on ACEs, psychological distress, and demographic characteristics in September 2022 (Time 1). Parents completed another online questionnaire in September 2023 (Time 2) on harsh discipline and offspring sleep problems. A path model was used to examine the associations. Results: Parental ACEs did not directly predict offspring sleep problems. Psychological distress (β = 0.041, 95% CI [0.005, 0.111]) and harsh discipline in the form of psychological aggression (β = 0.019, 95% CI [0.006, 0.056]) separately mediated the relationship between parental ACEs and offspring sleep problems. Psychological distress and psychological aggression also played a serial mediating role in the association of parental ACEs with offspring sleep problems (β = 0.014, 95% CI [0.007, 0.038]). Conclusions: Our findings showed the importance of psychological distress and psychological aggression in the intergenerational effect of trauma on offspring sleep problems. Specific interventions aimed at improving mental health and parenting practices should be provided for parents who were exposed to ACEs. [ABSTRACT FROM AUTHOR]

Research has long emphasized the adverse effects of poverty on children; however, within‐family processes of how safety nets offset the effects of poverty differ by race and ethnicity are unclear. Guided by the context‐sensitive family stress model, the current study investigated within‐family processes among safety nets, maternal parenting stress, and child behavioral problems among low‐income families and revealed differences in these processes among Hispanic, Black, and White mothers. Using The Future of Families and Child Wellbeing Study (FFCWS), participants included 2251 low‐income mothers and their children, repeatedly surveyed when children were 1, 3, 5, and 9 years old. Mothers reported their public and private safety nets, their parenting stress levels, and children's behavioral problems at each time point. Multilevel models revealed within‐family mediation pathways from mothers' perceived private safety net supports, maternal parenting stress, and child externalizing and internalizing problems, but only for Black, not for White or Hispanic mothers. Prospective within‐family associations were found between receiving a high number of public safety net programs and higher child externalizing problems, as well as between receiving private safety nets and higher maternal parenting stress and higher child behavioral problems. Findings were discussed in light of the context‐sensitive family stress model, with implications for theory and intervention practices. [ABSTRACT FROM AUTHOR]

AbstractThe detection rate of children’s behavioral problems is on the rise throughout the world, reaching 18.8% in China. Maternal depressive symptoms is one of the main causes of children’s behavioral problems. Our study explored the moderating roles and the specific moderating mechanism of children’s emotion regulation and teacher-student relationship quality in the association between maternal depressive symptoms and children’s behavioral problems based on the resilience framework and the multiple moderating model. A cross-sectional survey on mothers and teachers of Chinese primary school students in grades 1 to 3 in suburban Beijing was conducted to investigate children’s behavioral problems, emotion regulation, teacher-student relationship quality, maternal depressive symptoms, and demographic characteristics (n = 300) in this study. Pathway analysis and the Johnson-Neyman method were used to determine the moderating roles and the specific moderating mechanism of emotion regulation and teacher-student relationship quality. Results showed that emotion regulation and teacher-student relationship quality played moderating roles in the association between maternal depressive symptoms and children’s behavioral problems and the moderating mechanism was the additive moderating model. To be specific, emotion regulation and teacher-student relationship quality played moderating roles parallelly. Emotion regulation could moderate the negative effect of maternal depressive symptoms on both internalizing and externalizing behavioral problems in children. Meanwhile, teacher-student relationship quality could moderate the negative effect of maternal depressive symptoms on children’s externalizing behavioral problems. The study highlighted the value of children’s emotion regulation and teacher-student relationship quality against adverse family environments and gave an orientation for intervention. [ABSTRACT FROM AUTHOR]