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AbstractObjective: Approximately 50% of children with autism exhibit severe tantrums, defiance, and/or aggression. We propose that the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS)-a standardized clinical observation modeled after, and complementary to, the Autism Diagnostic Observation Schedule (ADOS)-could enhance earlier identification of disruptive behavior (DB) in autism populations and inform treatment planning. Methods: We adapted the DB-DOS for children with autism based on expert input and preliminary feasibility testing to accommodate varying cognitive and social communication capacities and increase the likelihood of observing DB in this population. Thereafter, we concurrently administered the modified DB-DOS and the ADOS to 12 children with autism aged 36 to 50 months. Results: Overall, children exhibited greater DB, especially behavioral regulation challenges, during the DB-DOS than during the ADOS. Conclusion: The use of a developmentally sensitive standardized observation tool that presses for DB to complement standardized observations such as the ADOS shows promise for enabling more precise research on targeted DB interventions. Such a tool holds promise as a reliable and efficient method of identifying comorbid DB disorders in the autism population.

There are numerous tools available to assess coping strategies used by children and adolescents. Many of the existing measures are widely used within diverse settings, often outside of the populations within which the measures were developed. Given the varying use of coping strategies among different populations, there is a need to ascertain the validity and reliability of measurement tools used within particular settings. The current study examines the initial psychometrics of the Self-Report Coping Measure (SRCM), originally developed by Causey and Dubow ("J Clin Child Adolesc Psychol" 21(1): 47-59, 1992), and investigates the psychometric properties of the SRCM in a school-based, low-income, minority urban sample within six elementary schools. Students in 3rd through 8th grade (N = 298) completed the SRCM as part of a larger implementation trial. Confirmatory factor analysis was utilized to assess for fit with four previously validated models of coping factor structure. None provided adequate fit. Consequently, we conducted exploratory analyses, which suggested a three-factor solution with 28 items. Evaluation of convergent validity via correlations with subscales on the Teacher Report Form provided initial support for the validity of the scale. We then examined coping strategy use descriptively in this low-income, school-based population. No differences were found by race/ethnicity or gender; however, children in higher grade levels were less likely to use coping strategies across all factors, including both adaptive and maladaptive strategies. Implications and limitations for use of the SRCM in a low-income, minority school-based population are discussed.

The study was conducted mainly to examine the convergent validity of the Patient Reported Outcome Measurement Information System-Pediatric Physical Activity instrument (PROMIS®®®-PA) with step counts from wearable devices and another validated self-reported outcome measure. As a secondary aim, we explored the effect of different recall time frames (7-day, end-of-day [EoD], and ecological momentary assessment [EMA] time frames during the day) in terms of their feasibility and associations with each other and with step counts. This was a prospective cohort study that examined the associations between measures of PA in school-age children and adolescents (n = 84, aged 10–20). The participants wore Fitbit devices for 7 consecutive days, and then completed the 7-day-recall PROMIS-PA short form and Youth Activity Profile (YAP). Additional analyses were completed in a sub-sample (n = 25, aged 11–18 years) using the PROMIS-PA for the EMA at five intervals during the day (shorter form) and at the EoD. In the total sample, the PROMIS-PA results showed positive moderate correlations with the YAP and average daily steps (r = 0.533, p < 0.001 and r = 0.346, p = 0.002, respectively). In the sub-sample, the 7-day PROMIS-PA was highly correlated with the averaged EMA or EoD ratings for the week, and moderately correlated with the daily step counts. These findings support the validity of the PROMIS-PA as a measure of self-reported physical activity. Adolescents demonstrated higher compliance rates and preference for the 7-day recall and EoD assessments compared to more frequent EMA reporting. [ABSTRACT FROM AUTHOR]

Background: To enhance the impact of school nutrition programs on children's health, more information is needed on the associations between healthy and unhealthy food offerings during school lunch periods and children's eating behavior. The purpose of this study is to evaluate the contributions of food offerings and participation in school lunch programs on children's overall (both in- and out-of-school) eating behavior. Methods: A cross-sectional observational study was conducted in which 2039 students in 12 elementary and 10 middle schools reported their eating behavior and the frequencies with which they purchased meals and a la carte items in the school cafeteria. Food service managers from each school provided information on the availability of foods and beverages during school lunch periods. Multilevel regression analyses were conducted to identify school- and student-level predictors of children's eating behavior. Results: The availability of nutritious foods during school lunch periods was associated with healthier eating behavior among students. However, this effect was observed only among children who infrequently purchased a la carte food items, and not among those who were frequent purchasers. Conclusion: Increased availability of fruits, vegetables, whole grains, and low-fat dairy products as components of school meals may be an effective strategy to promote healthy eating behaviors among children. Improving the nutrition standards for foods offered in competition with federally reimbursable school meals may enhance the positive effects of school meal programs on student eating behavior. (Contains 1 figure and 2 tables.)

Background: This study was conducted to empirically evaluate specific human, curricular, and material resources that maximize student opportunities for physical activity during physical education (PE) class time. A structure-process-outcome model was proposed to identify the resources that influence the frequency of PE and intensity of physical activity during PE. The proportion of class time devoted to management was evaluated as a potential mediator of the relations between resource availability and student activity levels. Methods: Data for this cross-sectional study were collected from interviews conducted with 46 physical educators and the systematic observation of 184 PE sessions in 34 schools. Regression analyses were conducted to test for the main effects of resource availability and the mediating role of class management. Results: Students who attended schools with a low student-to-physical educator ratio had more PE time and engaged in higher levels of physical activity during class time. Access to adequate PE equipment and facilities was positively associated with student activity levels. The availability of a greater number of physical educators per student was found to impact student activity levels by reducing the amount of session time devoted to class management. Conclusion: The identification of structure and process predictors of student activity levels in PE will support the allocation of resources and encourage instructional practices that best support increased student activity levels in the most cost-effective way possible. Implications for PE policies and programs are discussed. (Contains 2 tables and 1 figure.)

Positive Behavioral Interventions and Supports (PBIS) is a universal, school-wide prevention strategy that is currently implemented in over 7,500 schools across the nation to reduce disruptive behavior problems through the application of behavioral, social learning, and organizational behavioral principles. PBIS aims to alter school environments by creating improved systems and procedures that promote positive change in student behavior by targeting staff behaviors. The present study examined the impact of PBIS on school organizational health using data from a large randomized controlled trial of PBIS conducted in 37 elementary schools. Longitudinal multilevel analyses on data from 2,507 staff revealed a significant effect of PBIS on staff reports of the schools' overall organizational health, resource influence, and staff affiliation over a 3-year period. This study indicated that changes in school organizational health are important consequences of the PBIS whole-school prevention model, and might in turn be a potential mediator of the effect of PBIS on student performance. (Contains 2 tables and 1 figure.)

High fidelity implementation of school-wide PBIS has been linked with improvements in student and staff behavior, but less is known about which aspects of the model may be present in schools prior to training, and whether some features of PBIS are implemented faster than others. The present study examines the progression of school-wide PBIS implementation using School-wide Evaluation Tool data collected across three years from 21 schools randomly assigned to receive training in PBIS and 16 schools not trained in PBIS. Trained schools evidenced significantly higher levels of implementation fidelity. Non-trained schools showed some increases, but lagged behind trained schools on all subscales except "Systems for Responding to Violations." Findings suggest that program trainers and behavior support coaches should concentrate initial efforts on strategies for "Defining and Teaching Expectations," whereas less time may be needed for developing "Systems for Responding to Violations." Recommendations for high fidelity implementation of school-wide PBIS are provided. (Contains 1 figure and 2 tables.)

To describe the development and psychometric evaluation of the Core Competency Measure (CCM), an instrument designed to assess professional competencies as defined by the Maternal Child Health Bureau (MCHB) and targeted by Leadership Education in Neurodevelopmental and Related Disabilities (LEND) programs. The CCM is a 44-item self-report measure comprised of six subscales to assess clinical, interdisciplinary, family-centered/cultural, community, research, and advocacy/policy competencies. The CCM was developed in an iterative fashion through participatory action research, and then nine cohorts of LEND trainees (N = 144) from 14 different disciplines completed the CCM during the first week of the training program. A 6-factor confirmatory factor analysis model was fit to data from the 44 original items. After three items were removed, the model adequately fit the data (comparative fit indices = .93, root mean error of approximation = .06) with all factor loadings exceeding .55. The measure was determined to be quite reliable as adequate internal consistency and test-retest reliability were found for each subscale. The instrument's construct validity was supported by expected differences in self-rated competencies among fellows representing various disciplines, and the convergent validity was supported by the pattern of inter-correlations between subscale scores. The CCM appears to be a reliable and valid measure of MCHB core competencies for our sample of LEND trainees. It provides an assessment of key training areas addressed by the LEND program. Although the measure was developed within only one LEND Program, with additional research it has the potential to serve as a standardized tool to evaluate the strengths and limitations of MCHB training, both within and between programs. Keywords Interdisciplinary training * Family-centered care * Cultural competency * Measurement development * Participatory action research, Introduction The Health Resources and Services Administration's Maternal Child Health Bureau (MCHB) is one of the leading sponsors of Maternal and Child Health (MCH) Training. In 2004, MCHB developed a [...]