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Complex motor stereotypies are rhythmic, repetitive, fixed, and non-goal directed movements (e.g., bilateral flapping/waving movements of the hands/arms). Movements typically begin in early childhood and can occur in otherwise normally developing ("primary") or autistic ("secondary") children. Stereotypies persist, occur multiple times a day, have prolonged durations, can be socially stigmatizing, and may lead to bullying and isolation. Prior behavioral treatment studies have focused on older children (ages 6–12) and report modest reductions in stereotypy (i.e., between 14% and 33%). The current study involves the functional assessment and treatment of five children with Primary Complex Motor Stereotypy using a modified awareness training procedure, differential reinforcement of other behavior, and schedule thinning in a nonconcurrent multiple baseline design. Results suggest a 99% reduction of motor stereotypy from baseline across all participants. [ABSTRACT FROM AUTHOR]

Purpose : Few cost-effectiveness studies have been conducted on social-emotional interventions for students in preschool settings. The current study is a cost-effectiveness analysis of the First Step Next (FSN) intervention for preschool students. Method : Our approach involved a secondary analysis of a randomized control trial that utilized the ingredients method to estimate costs (Levin & McEwan, 2001). In addition, effect sizes were used to generate incremental cost-effectiveness ratios representing the cost of improving student outcomes by one standard deviation (1 SD). Results : FSN was more cost-effective for improving behavior in the school setting than in the home setting, with an average cost per 1 SD improvement of $3,833 and $6,329, respectively. Additionally, the intervention had greater cost-effectiveness for social skill-related outcomes than problem behavior-related outcomes among preschool students. Discussion : This study advances our understanding of the costs and outcomes of practices designed to improve the school success of our youngest learners. [ABSTRACT FROM AUTHOR]

Purpose: Adolescents in residential treatment (RT) encounter multiple obstacles upon discharge that can make maintaining treatment gains in the community challenging. This study examined relationships among parenting (sense of competence, practices), household chaos, and adolescent behavior problems in a sample of parents with adolescents in RT. Method: This exploratory cross-sectional study used convenience sampling to recruit 71 parents through Facebook. After providing informed consent, parents completed a battery of self-report instruments. Data were analyzed using descriptive statistics and linear regression. Results: Parents reported several strengths, including high involvement and consistent discipline, and low levels of corporal punishment. Parental sense of competence was relatively high, and household chaos was moderate. Adolescent inattention behaviors were positively associated with inconsistent discipline, corporal punishment, and parental sense of competence. Adolescent internalizing behaviors were positively associated with parent involvement and positive parenting and negatively associated with household chaos. Adolescent externalizing behaviors were positively associated with inconsistent discipline, corporal punishment, and parental sense of competence. Discussion: Findings suggest that there are numerous parenting strengths; however, some aspects of parenting could be promoted through evidence-based interventions such as parent training. Future research should also comprehensively study the home environment beyond self-report to understand environmental factors that may promote or inhibit adolescent behavior problems. [ABSTRACT FROM AUTHOR]

Objective: The objective was to describe mental health service and psychotropic medicine use among a cohort of Aboriginal young people and quantify their relation to sociodemographic, family and health factors. Methods: In a prospective cohort study with data linkage, 892 Aboriginal children aged 0–17 years living in urban and regional areas of New South Wales, Australia, were included. We assessed mental health–related service use, paediatric service use and psychotropic medicine dispensing claims covered by the Australian Government Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme from July 2012 to June 2017. Results: Most children (71%) did not have a record of mental health service or psychotropic medication use. 18.7% had ⩾1 mental health–related service claim; 26.7% had ⩾1 paediatric service claim; and 20.3% had ⩾1 psychotropic medicine dispensing claim. General practitioner services were the most accessed mental health–related service (17.4%) and 12.7% had been dispensed attention-deficit hyperactivity disorder medicines. Child characteristics associated with treatment included emotional and behavioural problems (prevalence ratio: 1.97, 95% confidence interval = [1.46, 2.64] for mental health services; prevalence ratio: 2.87, 95% confidence interval = [2.07, 3.96] for medicines) and risky behaviour (prevalence ratio: 1.56, 95% confidence interval = [1.12, 2.16] for mental health services; prevalence ratio: 2.28, 95% confidence interval = [1.54, 3.37] for medicines). Parent-related factors included chronic illness (prevalence ratio: 1.42, 95% confidence interval = [1.03, 1.95] for mental health services; prevalence ratio: 2.00, 95% confidence interval = [1.49, 2.69] for medicines) and functional limitations (prevalence ratio: 1.61, 95% confidence interval = [1.16, 2.24] for mental health services; prevalence ratio: 1.86, 95% confidence interval = [1.34, 2.59] for medicines). Conclusions: Most Aboriginal children and young people did not have claims for mental health services or medicines. Aboriginal children with emotional and behavioural problems, or parents with health problems were more likely to have mental health service or medicine claims. [ABSTRACT FROM AUTHOR]

Disruptive behavior disorders [including conduct disorder (CD) and oppositional defiant disorder (ODD)] are common childhood and adolescent psychiatric conditions often linked to altered arousal. The recommended first-line treatment is multi-modal therapy and includes psychosocial and behavioral interventions. Their modest effect sizes along with clinically and biologically heterogeneous phenotypes emphasize the need for innovative personalized treatment targeting impaired functions such as arousal dysregulation. A total of 37 children aged 8–14 years diagnosed with ODD/CD were randomized to 20 sessions of individualized arousal biofeedback using skin conductance levels (SCL-BF) or active treatment as usual (TAU) including psychoeducation and cognitive–behavioral elements. The primary outcome was the change in parents´ ratings of aggressive behavior measured by the Modified Overt Aggression Scale. Secondary outcome measures were subscales from the Child Behavior Checklist, the Inventory of Callous-Unemotional traits, and the Reactive-Proactive Aggression Questionnaire. The SCL-BF treatment was neither superior nor inferior to the active TAU. Both groups showed reduced aggression after treatment with small effects for the primary outcome and large effects for some secondary outcomes. Importantly, successful learning of SCL self-regulation was related to reduced aggression at post-assessment. Individualized SCL-BF was not inferior to active TAU for any treatment outcome with improvements in aggression. Further, participants were on average able to self-regulate their SCL, and those who best learned self-regulation showed the highest clinical improvement, pointing to specificity of SCL-BF regulation for improving aggression. Further studies with larger samples and improved methods, for example by developing BF for mobile use in ecologically more valid settings are warranted. [ABSTRACT FROM AUTHOR]

Effective treatment of challenging behaviors in young children with autism spectrum disorder requires identifying consequences that maintain the behavior under specific environmental circumstances. Assessment strategies help to identify environmental factors setting the occasion for the behaviors to continue to occur. Many studies have used antecedent–behavior–consequence (ABC) data collection strategies, but few have examined its ability to effectively identify the function. Research supports the use of the trial-based functional analysis (TBFA) but few studies examine its effectiveness in the home setting. The current study attempted to answer which assessments might work best in the home setting. Treatment was implemented for each participant based on the results of their assessments. All assessments identified the function of behavior as verified by function-based treatments, but the ABC assessment identified additional functions for three of the participants while the TBFA was more precise. Implications and limitations are reviewed, along with future directions for behavioral assessment in the home. [ABSTRACT FROM AUTHOR]

The article describes the case of a 14-year old boy who underwent psychotherapy along with aromatherapy to prevent aggressive and oppressive behavior, criminal behavior and drug and alcohol abuse. It describes the patient's emotional and physical association to different essential oils, the memories that the aromas evoked, and the psychotherapeutic effect of the aromatherapy session.

A best-evidence synthesis and meta-analysis were conducted to evaluate interventions designed to decrease noncompliance in early childhood settings. Studies were examined for quality, intervention components, and outcomes for young children (ages 2–8 years) across settings. Results indicated most designs were high-quality and produced desired outcomes. However, participant inclusion criteria were commonly underreported, and social and ecological validity data were absent. Thus, for whom noncompliance interventions are effective, appropriate, feasible, or preferred is largely unknown. Contrary to prior evidence from the broader challenging behavior literature, function-based assessments had no impact on intervention outcomes. Reasons for this finding are explored, including the narrow application of function-based assessment findings to compliance interventions. Future implications for research and practice are presented. [ABSTRACT FROM AUTHOR]

In this secondary systematic review of single-case and controlled group design intervention studies conducted with transition-age autistic youth, we examined features of 48 studies with 273 participants that measured at least one "problem behavior" outcome (Prospero registration number: 231764). We searched 11 databases for relevant studies, and the final search date was November 2022. Our primary aims were to determine how problem behaviors were defined and selected for reduction, how functions were determined, and the interventions used to address them. Studies were coded and codes were tabulated and converted to percentages to answer each research question. Thirty-eight percent of studies defined problem behavior, and 88% of studies implemented behavioral strategies to reduce problem behaviors. Behaviors with low potential for harm constituted the majority of the 67 outcome variables (61%), while behaviors with high potential for harm were a minority (39%). The most common intervention target was stereotypic behavior. Fewer than half of studies: reported procedures for selecting behaviors, reported procedures to determine behavior function, or ascribed functions to behaviors. We were unable to report on some demographic features of participants (e.g. race/ethnicity) because they were rarely reported in primary studies. We conclude that problem behavior is poorly conceptualized in this research. In a previous study, we looked at research done on strategies to support autistic people who were between 14 and 22 years old. For this study, we looked at all of the studies in our previous study that tried to decrease or stop autistic people from doing certain things—many researchers call these things "problem behavior." There were 48 studies that tried to reduce problem behavior, and most of them used strategies like prompting and reinforcement to try get autistic people to change their behavior. We found many things wrong with these studies. Most of them did not define the group of behaviors they were trying to stop autistic people from doing. None of the studies looked at whether any side effects happened when they tried the strategy they were studying. Also, most of the studies tried to stop autistic people from doing behaviors that probably were not harmful, like stereotypic behavior. Most of the studies did not say how they decided that the behaviors they tried to stop were a problem for the autistic people in the study, and most studies did not try to figure out why the autistic people in the study did the behaviors the researchers were trying to stop them from doing. [ABSTRACT FROM AUTHOR]

The Alabama parenting questionnaire (APQ) is a commonly used instrument for assessing parenting practices and evaluating treatment outcomes of parent‐training interventions targeting child conduct problems. In the present study we translated and developed a Swedish version of the APQ parent version and tested it on a community sample of 799 parents of children between 6 and 15 years with diverse socioeconomic backgrounds. Data were collected through an online survey distributed through school newsletters and social media. Exploratory factor analysis (EFA) suggested a five‐factor model with 23 items. Four of these factors correspond to the subscales suggested in the original version of the APQ: inconsistent discipline, poor monitoring, involvement, and positive parenting. The fifth subscale from the original APQ, corporal punishment, did not show up as a factor in our data sample. Instead, a new factor, which we refer to as contingency management, was revealed. A confirmatory factor analysis further suggested some misalignment between the original APQ subscale structure and our sample, which we interpret as a signal that the instrument may need refinement to better reflect contemporary parenting methods in diverse cultural contexts. Despite this limitation, and with the exclusion of the corporal punishment subscale, which should be employed judiciously, our results suggest that the Swedish version of the APQ can be a useful instrument in measuring parenting practices in Sweden. We present norm data stratified by child age, which practitioners and researchers can use as a reference for assessment of parenting practices in the Swedish population. [ABSTRACT FROM AUTHOR]

We conducted a functional analysis of severe problem behavior (aggression, disruption, and self‐injury). The analysis examined four potential socially mediated functions: attention, escape, receipt of tangible items, and restoration of environmental items. Restoration involved the experimenter replacing missing puzzle pieces, ring stacker rings, and shape sorter blocks without giving the items to the participant. An initial multielement functional analysis, followed by a brief pairwise comparison identified restoration of environmental items as the variable maintaining the participant's problem behavior. Subsequently, we conducted brief functional communication training to teach the participant to mand for restoration of disturbed items in the absence of problem behavior. [ABSTRACT FROM AUTHOR]

Basic and retrospective translational research has shown that the magnitude of resurgence is determined by the size of the decrease in alternative reinforcement, with larger decreases producing more resurgence. However, this finding has not been evaluated prospectively with a clinical population. In Experiment 1, five participants experienced a fixed progression of reinforcement schedule‐thinning steps during treatment of their destructive behavior. Resurgence occurred infrequently across steps and participants, and when resurgence did occur, its clinical meaningfulness was often minimal. In Experiment 2, five new participants experienced these same schedule‐thinning steps but in a counterbalanced order. Resurgence occurred most often and was generally largest with larger decreases in alternative reinforcement programmed earlier in the evaluation. Large decreases in alternative reinforcement may be more problematic clinically when they occur earlier in treatment. Whether larger transitions can be recommended in the clinic following the success of smaller ones will require additional research. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Establish the longitudinal cross-lagged associations between maltreatment exposure and child behavior problems to promote screening and the type and timing of interventions needed. METHODS: The Longitudinal Studies of Child Abuse and Neglect, a multiwave prospective cohort study of maltreatment exposure, enrolled children and caregivers (N = 1354) at approximately age 4 and followed them throughout childhood and adolescence. Families completed 7 waves of data collection with each wave occurring 2 years apart. Maltreatment was confirmed using official case records obtained from Child Protective Services. Six-month frequencies of behavior problems were assessed via caregiver-report. Two random-intercept, cross-lagged panel models tested the directional relations between maltreatment exposure and externalizing and internalizing behaviors. RESULTS: Maltreatment exposure predicted increases in externalizing behaviors at ages 8 (b = 1.06; 95% confidence interval [CI] 0.14-1.98), 12 (b = 1.09; 95% CI 0.08-2.09), and 16 (b = 1.67; 95% CI 0.30-3.05) as well as internalizing behaviors at ages 6 (b = 0.66; 95% CI 0.03-1.29), 12 (b = 1.25; 95% CI 0.33-2.17), and 14 (b = 1.92; 95% CI 0.76-2.91). Increases in externalizing behaviors predicted maltreatment exposure at age 12 (odds ratio 1.02; 95% CI 1.00-1.05). CONCLUSIONS: Maltreatment exposure is robustly associated with subsequent child behavior problems, strengthening inferences about the directionality of these relations. Early screening of externalizing behaviors in pediatric settings can identify children likely to benefit from intervention to reduce such behaviors as well as prevent maltreatment exposure at entry to adolescence. [ABSTRACT FROM AUTHOR]

More than a third of all sexual crimes are committed by adolescents. In addition, many adolescents struggle with problematic sexual behaviors (PSB) that may not rise to a criminal offense, but cause harm to themselves and those around them. A significant number of these adolescents also have histories of their own trauma; yet there are no treatment models that integrate both PSB and trauma into one comprehensive treatment for this population. This qualitative study's aim was to use the expertise of clinicians who work with adolescents with PSB as well as clients and their caregivers who had completed PSB treatment to understand what they believe are the necessary components and elements needed for an integrated model that seeks to simultaneously address both PSB and the consequences of traumatic experiences. Twenty-six mental health professionals and one former client and his caregiver participated in focus groups (three with clinicians and one with the caregiver and former client) to share their experiences and expertise regarding an integrated model. The thematic analysis procedure yielded six major themes: family, external systems, treatment structure, therapeutic themes, specialized PSB targets, and trauma and PSB integration. Each of these major themes was comprised of subthemes that are presented as well. Implications for practice and future research are discussed, including that clinicians could benefit from guidance and structure to assist them in structuring their interventions to address the multiple needs of their clients that seek to reduce their risk of reoffending while simultaneously enhancing the quality of their lives. [ABSTRACT FROM AUTHOR]

Introduction: Children living in rural, regional and remote locations experience challenges to receiving services for mental illness and challenging behaviours. Additionally, there is a lack of clarity about the workforce characteristics to address the needs of this population. Objective: To scope the literature on the rural, regional and remote child mental health and behavioural workforce and identify barriers and enabling mechanisms to mental health service provision. Design: A scoping review utilising the Joanna Briggs Institute methodology. A database search was undertaken using Medline, CINAHL, PsycINFO, ProQuest and Scopus to identify papers published 2010–2023. Research articles reporting data on mental health workforce characteristics for children aged under 12 years, in rural, regional or remote locations were reviewed for inclusion. Findings: Seven hundred and fifty‐four papers were imported into Covidence with 22 studies being retained. Retained studies confirmed that providing services to meet the needs of children's mental health is an international challenge. Discussion: The thematic analysis of the review findings highlighted four workforce strategies to potentially mitigate some of these challenges. These were: (1) The use of telehealth for clinical services and workforce upskilling; (2) Role shifting where non mental health professionals assumed mental health workforce roles; (3) Service structure strategies, and (4) Indigenous and rural cultural factors. Conclusion: A range of potential strategies exists to better meet the needs of children with mental health and behavioural issues. Adapting these to specific community contexts through co‐design and production may enhance their efficacy. [ABSTRACT FROM AUTHOR]

Students with visual impairments (VI) and multiple disabilities (MD) often exhibit challenging behavior, yet school staff's use of evidence-based practices in behavior management is reportedly low. In this article, we share the results of a collaborative professional development (PD) aimed at increasing school staff buy-in and use of individualized positive behavior interventions and supports (I-PBIS) with students with VI and MD. Ten staff, including teachers, paraeducators, and related services, working in a self-contained school for students with VI participated in four weekly, collaborative small group modules on research-based I-PBIS strategies. The Covid-19 pandemic occurred mid-study, which affected implementation of the program and collection of outcome data; however, pre- to post-PD participants' supportive beliefs regarding I-PBIS increased significantly. Participant-reported knowledge and use of I-PBIS also increased but did not reach significance. In addition, participants found the PD highly acceptable and useful in their work with students with VI and MD who engage in challenging behavior. Implications for increasing school staff support for and use of I-PBIS with students with VI and MD are discussed. [ABSTRACT FROM AUTHOR]

Different types of childhood maltreatment have negative effects on individual mental and behavioural outcomes. However, most of previous studies investigated their effects separately. Little is known about the effects of co‐occurring maltreatment profiles on adolescents' developmental outcomes and the potential protective factor. The current study sought to identify distinct profiles of childhood maltreatment and examine the effects of profiles of childhood maltreatment on internalising and externalising problems and the protective role of resilience based on two‐wave longitudinal data, which was collected from a sample of 670 Chinese adolescents (Mage = 15.50, SDage = 0.75, 48.4% boys). Four profiles of childhood maltreatment, that is, No maltreatment (67.9%), High neglect (23.0%), High abuse and neglect/Low sexual abuse (5.0%), and Multi‐maltreatment (4.1%), were identified. Adolescents in High neglect, High abuse and neglect/Low sexual abuse, and Multi‐maltreatment profiles were more likely to report internalising and externalising problems. Further, significant moderating effects of resilience only emerged for the association between the High neglect profile and internalising problems, such that high levels of resilience may weaken the association between the High neglect profile and internalising problems. Our findings revealed the importance and utility of identifying maltreatment profiles to tailor treatment based on specific maltreatment experiences. Resilience‐oriented intervention could be considered for Chinese adolescents who have experienced high neglect. [ABSTRACT FROM AUTHOR]

Functional communication training (FCT) in the treatment of escape‐maintained problem behavior for children with disabilities often includes extinction for problem behavior, which is difficult for educators to implement in classroom settings. This study evaluated the effects of FCT with concurrent schedules, as an alternative to extinction, for two children with disabilities and multiply maintained problem behavior including escape functions. FCT with concurrent schedules reduced problem behavior for one participant and increased mands for both participants. The mixed effects across participants and behaviors may inform boundary conditions for FCT with concurrent schedules. [ABSTRACT FROM AUTHOR]

Research exists to support the efficacy of the Interview‐Informed Synthesized Contingency Analysis (IISCA) and skill‐based treatment (SBT) to address problem behavior within a clinical setting. However, limited research is available to support their use in a classroom setting and especially as a tool to avoid the display of problem behavior altogether. In the current study, the IISCA, informed by an open‐ended interview, was conducted with a single participant in the classroom after a prolonged absence from school due to COVID‐19. Results of the IISCA were used to determine the multiple contingencies that were likely to evoke problem behavior upon re‐introduction of academic task demands. A skill‐based treatment was then developed based on these contingencies, which involved teaching the participant functional communication, delay tolerance, and following academic instruction in relevant contexts. After 25 treatment sessions, the participant had acquired and maintained all of these skills, including the ability to functionally communicate, tolerate removal of preferred items, and follow educational instructions within the typical classroom routine. This study shows the applicability of the IISCA and SBT when implemented within the classroom setting and when used to reintroduce educational instruction to an individual with autism after a prolonged break from school. [ABSTRACT FROM AUTHOR]

Background: While parent management training (PMT) has been shown to be an effective treatment for adolescents with externalizing concerns, evidence suggests that effectiveness is not equitable across all types of families. Research suggests that caregiver psychopathology may adversely affect PMT success for adolescents. However, it remains unclear whether research on caregiver psychopathology is integrated within adolescent PMT resources (e.g., treatment manuals). Objective: A scoping review of commercially available, clinician focused PMT resources was conducted to assess for information on caregiver psychopathology and clinical guidance for addressing caregiver psychopathology. Methods: A search for commercially available resources was conducted among national treatment databases and book resource websites. Information on caregiver psychopathology was extracted from individual sessions of the PMT resources. Results: Seven treatment resources met inclusion criteria. The majority of the treatment resources made at least one explicit comment that caregiver psychopathology may impact the course of treatment. There was very limited mention of caregiver psychopathology in skill building sections of the resources. Conclusions: While most resources mentioned caregiver psychopathology, these comments lacked breadth and depth in providing clinicians with recommendations on how to tailor treatment to caregivers' needs. Recommendations are provided for how PMT programs might be improved in the future to support clinicians when faced with caregiver psychopathology by recognizing inequities and lack of diversity in resource development, using a transdiagnostic perspective (including a transdiagnostic approach to assessment of caregiver psychopathology), and integrating caregiver skill development. [ABSTRACT FROM AUTHOR]

Secondary analysis of the Early Head Start Family and Child Experiences Survey 2018 data set (Baby FACES 2018) explored links between family risk events and referral-making and referral uptake among families receiving Early Head Start (EHS) services. Referrals to both behavioral health and entitlement programs were considered. Results showed that referrals to behavioral health programs were much more likely to be given to families receiving care from home-based care than center-based care, and that referrals were slightly more likely to be given to families who did not have any family risk events. Several factors also moderated the relationship between family risk and referrals, including perceived closeness of the parent/caregiver–EHS staff relationship, family conflict, and caregiver depression. There were no observed effects for referrals to entitlement programs. Caregiver depression weakened the link between family risk and service uptake for entitlement programs. [ABSTRACT FROM AUTHOR]

Background: Arabs with intellectual disabilities and/or autism may exhibit challenging behaviour that affects them and their caregivers. Early, appropriate intervention may reduce these effects. This review synthesised and critically appraised challenging behaviour intervention research for this population. Methods: All published empirical research on challenging behaviour interventions for Arabs with intellectual disabilities and/or autism was included. In September 2022, 15 English and Arabic databases yielded 5282 search records. Studies were appraised using the MMAT. Review findings were narratively synthesised. Results: The 79 included studies (n = 1243 participants) varied in design, intervention, and evaluation method. Only 12.6% of interventions were well‐designed and reported. Arab interventions primarily targeted children, were applied collectively on small samples, lacked individualised assessment, and were based on an inconsistent understanding of challenging behaviour. Conclusion: The evidence base on interventions for Arabs with intellectual disabilities and/or autism and challenging behaviour needs strengthening. Attention should be given to culturally relevant adaptations. [ABSTRACT FROM AUTHOR]

Parent and family characteristics are important considerations in the etiology and treatment of childhood disruptive behavior problems. The current study investigated the psychometric properties of the General Functioning (GF) scale of the McMaster Family Assessment Device (FAD) in families referred for treatment of childhood disruptive behavior difficulties. Participants included 459 families with a child between the ages of 6 and 12 years who were referred for treatment of disruptive behavior. Prior to treatment, mothers and/or fathers completed questionnaires assessing family functioning, child psychopathology and associated functional impairment, parenting behavior, and parent psychopathology. The factor structure, internal consistency, and concurrent validity of three versions of the FAD GF scale were examined, including a one-factor, 12-item model, a one-factor, 6-item model, and a 3-factor, 12-item model. All three models had adequate fit based on confirmatory factor analysis. Across models, family dysfunction scores had small positive associations with child psychopathology, functional impairment, inconsistent parenting behaviors, and parents' history of internalizing disorders, and small negative associations with positive parenting behaviors, providing evidence for the concurrent validity of the scale. The FAD GF scale provides a valid and reliable measure of family dysfunction in families experiencing disruptive child behavior. Researchers and clinicians may consider using an abbreviated 6-item version of the scale or a three-domain version of the scale as valid alternatives to the standard 12-item administration and scoring. [ABSTRACT FROM AUTHOR]

This article describes child‐oriented family therapy (COF), a family therapy approach to early psychological and behavioral problems that is widely applied in northern Europe and has been adopted by countries with different cultures, such as Germany and China. This article explains the theoretical background, setting, characteristics, development and effective factors of this method and explores relevant research. In addition, the application of this method in China and reflections on its applicability to families in different cultures are presented. A clinical case is provided to illustrate the core therapeutic principles of COF. Since the application of COF interventions to families with children in Asian cultures remains understudied, the widespread availability of COF and adaptation to local conditions could facilitate training and research achievements in this field. [ABSTRACT FROM AUTHOR]

Background: The needs of parents of children with developmental disabilities (DD) in disadvantaged families are frequently unmet by service providers. This service gap likely diminishes the therapeutic gains of children's treatment. Catering to the psychological needs of both children and parents is important. The present study evaluates the effectiveness of a person‐centred psychotherapy programme for children with DD and parents in disadvantaged families in reducing parenting stress and promoting positive children's behaviours. Method: Fifteen parent–child dyads participated in a person‐centred psychotherapy programme consisting of eight 1‐hr child‐centred play therapy (CCPT) sessions and four 1‐hr person‐centred therapy (PCT) sessions. The parents completed a quantitative questionnaire before and after the programme. Results: The results indicated a significant reduction in children's conduct problems, with a large effect size, and in the levels of parental distress, parent–child dysfunctional interaction and difficulty in controlling their child's behaviours, with large effect sizes after the interventions. Conclusions: This study provides positive evidence for the effectiveness of the person‐centred intervention programme. The results imply that individual humanistic therapy sessions are essential and effective to cater to parents' needs. Service providers can provide PCT to parents when delivering child services. [ABSTRACT FROM AUTHOR]

Problem: Despite their relevance to assessment and clinical decision‐making in behavioral health, measurement tools are still rarely used in clinical settings. With an increase in undiagnosed and untreated mental health problems in children and adolescents, a southeastern US Community Health System was the ideal setting for the implementation of a behavioral health assessment tool. Methods: This quality improvement project was conducted to address the question: "Among mental health clinicians at the Community Health System, will the use of the DSM‐5 parent/guardian‐rated level 1 cross‐cutting symptom measure 6−17 (CCSM) improve diagnosis and treatment choices of children with mental health conditions, over a 4‐week period?" A convenience sample was recruited from among behavioral health counselors working at various out‐patient clinics and school‐based counseling sites in the Community Health System. After nurse‐led training on use of the CCSM, including a PowerPoint intervention and individual coaching sessions, the five clinical participants were encouraged to use the CCSM screening tool on their patients presenting for mental health assessment. Knowledge of the tool was assessed using a pre‐ and post‐training survey. Completed screening tools were collected from participants over the 4‐week duration of the project. Findings: A chart audit comparing the project period with the previous year showed an increase in diagnosis and treatment in 6−17 year‐old patients at the outpatient clinic. Conclusions: This project demonstrated the usefulness of the CCSM for behavioral health assessment in the child/adolescent population at the Community Health System and supported use of the intervention in other clinics. [ABSTRACT FROM AUTHOR]

Background: The effective treatment of child conduct problems is understood to rely on a range of therapist competencies, yet these have rarely been an explicit focus of research. In this practitioner review, we examine core competencies for the delivery of evidence‐based parenting interventions for conduct problems in early‐to‐middle childhood. These are examined in light of research into the common elements shared by these interventions, literature regarding common challenges in these interventions, and conceptualisations of such competencies in other fields of mental health. Methods: We report on the development of a novel consensus‐based model of core competencies for evidence‐based practice in this field, based on consultation with an international expert panel. This includes competencies as they apply to complex presentations of conduct problems. Results: Despite considerable variation among widely disseminated programmes in terms of content, format and skills‐training practices, there is strong consensus among practitioners regarding core competencies. These relate to three broad domains: (a) generic therapeutic competencies; (b) parenting intervention competencies; (c) specific parenting skills/techniques. Conclusions: Practitioners working with conduct problems, particularly complex presentations thereof, require competencies for engaging not only mothers, but fathers and diverse/non‐traditional caregivers and other stakeholders, in evidence‐based parenting interventions. Moreover, the successful delivery of these interventions necessitates competencies that extend beyond behaviour management and encompass broader aspects of the family system and the wider ecology of the child. [ABSTRACT FROM AUTHOR]

A comprehensive review of the economic evidence on parenting interventions targeting different aspects of child health is lacking to support decision-making. The aim of this review is to provide an up to date synthesis of the available health economic evidence for parenting interventions aiming to improve child health. A systematic review was conducted with articles identified through Econlit, Medline, PsychINFO, and ERIC databases. Only full economic evaluations comparing two or more options, considering both costs and outcomes were included. We assessed the quality of the studies using the Drummond checklist. We identified 44 studies of varying quality that met inclusion criteria; 22 targeting externalizing behaviors, five targeting internalizing problems, and five targeting other mental health problems including autism and alcohol abuse. The remaining studies targeted child abuse (n = 5), obesity (n = 3), and general health (n = 4). Studies varied considerably and many suffered from methodological limitations, such as limited costing perspectives, challenges with outcome measurement and short-time horizons. Parenting interventions showed good value for money in particular for preventing child externalizing and internalizing behaviors. For the prevention of child abuse, some programs had the potential of being cost-saving over the longer-term. Interventions were not cost-effective for the treatment of autism and obesity. Future research should include a broader spectrum of societal costs and quality-of-life impacts on both children and their caregivers. [ABSTRACT FROM AUTHOR]

Behavioral parent training (BPT) is a highly efficacious evidence-based treatment for children with externalizing behavior problems, yet parents often do not attend this treatment or discontinue prematurely. The recent proliferation of parenting apps is a promising alternative for helping parents address child behavior difficulties; however, there is scant research examining evidence-based support for these apps. The purpose of the current study was to examine if, and to what extent, parenting apps include core BPT techniques. Each of the six BPT techniques was broken down into components considered essential for teaching each strategy effectively. Seventy-three parenting apps met criteria for inclusion based on keyword searches for child behavior difficulties and parenting in app stores. Findings revealed little evidence-based support for parenting apps. Specifically, the mean number of BPT techniques was limited, with approximately 75% of apps including two or fewer of the six BPT techniques and none including all six techniques. Reinforcement was included most often (84% of apps), followed by punishment (64%). Direct commands had the highest mean percentage of components across BPT techniques yet was included in the fewest number of apps (4%). The results highlight the need for increased evidence-based BPT content for parenting apps. Recommendations include an app classification system and thorough examination of parenting apps before suggesting them to clients. Highlights: This study examined the level of evidence-based BPT content in parenting apps. Results suggest limited BPT content in apps. Reinforcement and punishment were the most common BPT techniques found in apps, while direct commands was the BPT technique included the least in apps. [ABSTRACT FROM AUTHOR]

Background: Conduct disorders (CD) are among the most frequent psychiatric disorders in children and adolescents, with an estimated worldwide prevalence in the community of 2–4%. Evidence-based psychological outpatient treatment leads to significant improvement in about two-thirds of cases. However, there seems to be considerable variation in rates of CD diagnoses and implementation of evidence-based interventions between nations. The aim of this study was to compare administrative prevalence and treatment patterns for CD in children and adolescents seen in health care systems across four Western countries (Denmark, Germany, Norway, and the USA). Methods: Cross-sectional observational study using healthcare data to identify children and adolescents (aged 0–19 years) with an ICD-10 code for CD within the calendar year 2018. Within each country's study population, the prevalence of CD, psychiatric comorbidity, psychopharmacological treatment, and psychiatric hospitalisation was calculated. Results: The prevalence of diagnosed CD differed 31-fold between countries: 0.1% (Denmark), 0.3% (Norway), 1.1% (USA) and 3.1% (Germany), with a male/female ratio of 2.0–2.5:1. The rate of psychiatric comorbidity ranged from 69.7 to 86.1%, with attention-deficit/hyperactivity disorder being most common. Between 4.0% (Germany) and 12.2% (USA) of youths with a CD diagnosis were prescribed antipsychotic medication, and 1.2% (Norway) to 12.5% (Germany) underwent psychiatric hospitalisation. Conclusion: Recognition and characteristics of youths diagnosed with CD varied greatly by country. In some countries, the administrative prevalence of diagnosed CD was markedly lower than the average estimated worldwide prevalence. This variation might reflect country-specific differences in CD prevalence, referral thresholds for mental health care, diagnostic tradition, and international variation in service organisation, CD recognition, and availability of treatment offers for youths with CD. The rather high rates of antipsychotic prescription and hospitalisation in some countries are remarkable, due to the lack of evidence for these therapeutic approaches. These findings stress the need of prioritising evidence-based treatment options in CD. Future research should focus on possible reasons for inter-country variation in recognition and management of CD, and also address possible differences in patient-level outcomes. [ABSTRACT FROM AUTHOR]

Few studies have investigated caregiver choice surrounding the modality for behavior therapy for pediatric challenging behavior. This preliminary study sought to (1) understand the factors impacting consumer decisions regarding virtual or in-person behavior therapy and (2) evaluate the associated clinical outcomes using a quasi-experimental design. Forty nine participants received behavioral services for the assessment and treatment of tantrum behaviors. Paired sample t-tests and a one-way ANOVA were conducted to evaluate outcomes. Results suggest choices were most frequently based on caregiver perceptions regarding speed of improvement; modality changes were most associated with failure to make progress. Implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Primary mental health admissions are increasing across US children's hospitals. These patients may experience agitation requiring pharmacologic restraint. This study characterized pharmacologic restraint use in medical inpatient units by primary mental health diagnosis. METHODS: This retrospective, cross-sectional study used the Pediatric Health Information System database. The study included children aged 5 to 17 years admitted with a primary mental health diagnosis between 2016 and 2021. Rates of pharmacologic restraint use per 1000 patient days were determined for 13 mental health diagnoses and trended over time with Poisson regression. RESULTS: Of 91 898 hospitalizations across 43 hospitals, 3% of admissions and 1.3% of patient days involved pharmacologic restraint. Trends in the rate of pharmacologic restraint use remained stable (95% confidence interval [CI], 0.7--2.1), whereas the incidence increased by 141%. Diagnoses with the highest rates of pharmacologic restraint days per 1000 patient days included autism (79.4; 95% CI, 56.2--112.3), substance-related disorders (45.0; 95% CI, 35.9--56.4), and disruptive disorders (44.8; 95% CI, 25.1--79.8). The restraint rate significantly increased in disruptive disorders (rate ratio [RR], 1.4; 95% CI, 1.1--1.6), bipolar disorders (RR, 2.0; 95% CI, 1.4--3.0), eating disorders (RR, 2.4; 95% CI, 1.5--3.9), and somatic disorders (RR, 4.2; 95% CI, 1.9--9.1). The rate significantly decreased for autism (RR, 0.8; 95% CI, 0.6--1.0) and anxiety disorders (RR, 0.3; 95% CI, 0.2--0.6). CONCLUSIONS: Pharmacologic restraint use among children hospitalized with a primary mental health diagnosis increased in incidence and varied by diagnosis. Characterizing restraint rates and trends by diagnosis may help identify at-risk patients and guide targeted interventions to improve pharmacologic restraint utilization. [ABSTRACT FROM AUTHOR]

Background: Increasingly, health services are adopting short‐term consultative therapy models, such as single session therapy, to cope with increased service demands, finite budgets and changing consumer expectations. Within the paediatric sub‐specialty of child development and behaviour, allied health clinicians are central to supporting families to understand their children, provide therapeutic interventions and help achieve optimal developmental and health outcomes. This study aimed to describe parents'/caregivers' engagement during advanced allied health consultations utilizing a single session therapy framework for managing neurodevelopmental and behavioural concerns in children. Methods: Between March to June 2021, 14 parents participated in a qualitative study involving focus groups. Reflexive thematic analysis was used to code and interpret the data to understand and explore families' engagement in single session therapy. Results: Three overarching themes relating to parents' engagement during consultations emerged from the data: connection with the clinician, parental attributes and organizational influences. Clinician connection was the prominent construct that enhanced parent attributes and the positive perception of the organization in an ongoing manner. There was a complex interplay between the behavioural and affective components of the clinician, parents and the organization to create mutual presence, valued time, understanding and action. Conclusions: This study demonstrates the importance of clinician connection, parental attributes and organizational influences to enhance engagement in therapeutic consultations. These factors are interrelated and are a complex blend of behaviour and internal states and highly individualized for each family. Understanding how services can continue to engage families is integral to ongoing sustainability and overall health and well‐being. [ABSTRACT FROM AUTHOR]

Background: Given the robust evidence base for the efficacy of evidence‐based treatments targeting youth anxiety, researchers have advanced beyond efficacy outcome analysis to identify mechanisms of change and treatment directionality. Grounded in developmental transactional models, interventions for young children at risk for anxiety by virtue of behaviorally inhibited temperament often target parenting and child factors implicated in the early emergence and maintenance of anxiety. In particular, overcontrolling parenting moderates risk for anxiety among highly inhibited children, just as child inhibition has been shown to elicit overcontrolling parenting. Although longitudinal research has elucidated the temporal unfolding of factors that interact to place inhibited children at risk for anxiety, reciprocal transactions between these child and parent factors in the context of early interventions remain unknown. Method: This study addresses these gaps by examining mechanisms of change and treatment directionality (i.e., parent‐to‐child vs. child‐to‐parent influences) within a randomized controlled trial comparing two interventions for inhibited preschoolers (N = 151): the multicomponent Turtle Program ('Turtle') and the parent‐only Cool Little Kids program ('CLK'). Reciprocal relations between parent‐reported child anxiety, observed parenting, and parent‐reported accommodation of child anxiety were examined across four timepoints: pre‐, mid‐, and post‐treatment, and one‐year follow‐up (NCT02308826). Results: Hypotheses were tested via latent curve models with structured residuals (LCM‐SR) and latent change score (LCS) models. LCM‐SR results were consistent with the child‐to‐parent influences found in previous research on cognitive behavioral therapy (CBT) for older anxious youth, but only emerged in Turtle. LCS analyses revealed bidirectional effects of changes in parent accommodation and child anxiety during and after intervention, but only in Turtle. Conclusion: Our findings coincide with developmental transactional models, suggesting that the development of child anxiety may result from child‐to‐parent influences rather than the reverse, and highlight the importance of targeting parent and child factors simultaneously in early interventions for young, inhibited children. [ABSTRACT FROM AUTHOR]

Through research and models authors tried to explain factors that contribute to someone's readiness for behavior change, emphasizing the importance of support from relevant others. Since this is especially important when it comes to children and youth with behavioral and emotional problems and their parents, the research question of this study was to explore how parental readiness for change and their support affected readiness for change of children. The sample consisted of 112 pairs of children and parents (N = 224). All participants assessed their readiness for change in relation to a specific problem due to which they were involved in the psychosocial intervention. Parents assessed their readiness to give support while children assessed their perception of parental support and self-efficacy. Qualitative and quantitative methods of data analysis were used. Results show similar patterns in children and parents in describing problems either through naming specific problems that bother the child or through describing circumstances that cause problems. Denial of the problem was present to a small extent. Contrary to the assumption that a child's higher readiness for change would be significantly contributed by age, self-efficacy, and levels of family and child risk, only the child's perception of parental support proved significant in the hierarchical linear multiple regression model (t = 4.670**; ΔR2 = 0.248). Results emphasize the importance of parents' engagement and active participation in interventions aimed at changing behavior problems of their children. [ABSTRACT FROM AUTHOR]

This study evaluated the interrater reliability, convergent and divergent validity, incremental validity, and clinical prognostic utility of the Clinical Assessment of Prosocial Emotions (CAPE; Frick, 2013) for assessing limited prosocial emotions (LPE). Participants were 232 young children (Mage = 3.94 years, SD = 1.46, range = 2–8; 74.6% boys) clinic-referred for conduct problems. We scored the CAPE using binary and dimensional scoring approaches and measured outcomes using parent-report and child laboratory measures. CAPE LPE symptom ratings had good interrater reliability. Children diagnosed with pretreatment LPE had more severe externalizing problems and lower empathy than children without LPE but did not differ in emotion recognition accuracy or anxiety. Dimensional CAPE symptom sum scores were associated with criterion variable scores in expected ways and offered incremental validity beyond scores on the parent-report Inventory of Callous-Unemotional Traits for predicting conduct problem severity, aggression, empathy deficits, and global emotion recognition accuracy. Among children who completed parent management training (n = 44), those diagnosed with LPE ended treatment with more severe aggressive behavior than those without LPE. Overall, children diagnosed with CAPE LPE have severe externalizing problems and achieve reduced benefits from standard parent management training, supporting the need for tailored and intensive interventions to maximize treatment outcomes. Public Significance Statement: Limited prosocial emotions (LPE) diagnosed using the Clinical Assessment of Prosocial Emotions (CAPE) identifies young clinic-referred children between 2 and 8 years old with more severe externalizing problems that do not normalize with traditional forms of parent management training, supporting the need for tailored and intensive interventions to maximize outcomes. [ABSTRACT FROM AUTHOR]

Healthy family functioning is important for successful adolescent development and serves as a protective factor against adolescent behavior problems. When adolescent behavior problems exist, family therapy can help promote warmth and cohesiveness in the family, which results in healthier family functioning. Furthermore, family therapy is the gold standard for treating adolescent behavior problems. However, most of the research on family therapy for adolescents are with manualized models that have difficulty being implemented in usual care. The purpose of this study was to compare the effectiveness of family therapy in improving family functioning as compared to individually-based treatments, all of which were offered in usual care settings. Participants were 205 adolescents and their caregivers living in a large, metropolitan area. Data were collected at four time points (baseline, 3-, 6-, and 12-month follow-up) and analyzed using latent growth curve modeling. Family functioning was assessed by separate caregiver and adolescent reports of cohesion and conflict subscales on the Family Environment Scale and caregiver-reported parent-adolescent domain of the Stress Index for Parents of Adolescents. Across treatments, caregivers reported improvement in family cohesion and decreases in family conflict and parental stress. Similarly, adolescents across treatments reported a decrease in family conflict but no concomitant increase in family cohesion. Overall, there was no between-treatment differences in overall change with both conditions showing improvement in family functioning. Results indicate that both family therapy and non-family treatment in usual care for adolescent behavior problems are effective for improving family functioning, suggesting that existing treatment services are viable options for adolescent behavioral health when offered under monitored conditions. [ABSTRACT FROM AUTHOR]

Young children are particularly vulnerable to traumatic events and the development of posttraumatic stress symptoms, including comorbid disruptive behaviors. Fortunately, several evidence-based interventions have been shown to be effective at decreasing both posttraumatic stress symptoms and disruptive behaviors in young children. This paper provides an overview of three such interventions—Child-Parent Psychotherapy (CPP), Parent-Child Interaction Therapy (PCIT), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). An illustrative case study is used to compare how each intervention addresses disruptive behaviors, with a focus on theoretical underpinnings, model similarities, and model differences. The models each have empirical evidence for the treatment of disruptive behavior in young children, and therefore, may be appropriate for treating children with a history of trauma exposure and comorbid disruptive behaviors. Child, caregiver, and environmental factors are essential to consider when identifying an evidence-based intervention for this population. [ABSTRACT FROM AUTHOR]

For many children of color, the cumulative impact of pre-existing stressors, disparities, and pandemic-related losses has contributed to a toxic level of stress. Toxic stress can disrupt healthy brain development making children vulnerable to physical and mental health problems. School nurses are the primary health professionals who interact with children daily during the academic year, which positions them to identify risk factors within the social determinants of health that contribute to the development of toxic stress. The Toxic Stress Schema (TSS) provides a framework for assessment and care planning related to social determinants of health and potential sources of stress and/or buffering support for the physical and mental well-being of children. A case study approach is used to demonstrate the application of the TSS to school nursing and provide the basis for conceptualizing a plan of care and identifying resources to support the child's physical and mental health. [ABSTRACT FROM AUTHOR]

Purpose: This tutorial highlights the challenges and opportunities school-based speech-language pathologists (SLPs) face related to engagement with the multitiered systems of support (MTSS) framework in their public school work practices. It positions SLP involvement in MTSS as an area where a gap between research and practice exists and highlights key ways for SLPs to overcome barriers to support student success within this framework. Method: This tutorial provides a general description of the MTSS framework and highlights the immediate applicability of the framework to SLP school practices. Key considerations are offered for SLPs ready to take concrete steps related to implementing the MTSS framework. Hypothetical cases are used to illustrate how school-based SLPs can use these considerations to guide meaningful but realistic changes. Results: Ongoing concerns about the impact of the pandemic on student outcomes and growing awareness of systemic inequities in education are prompting SLPs to move beyond asking if they should be involved in MTSS to focusing on how they should be engaged with this framework. This tutorial provides five key considerations for SLPs to realistically deepen their engagement with MTSS and overcome the research--practice gap in this area. Conclusion: This tutorial provides a resource for SLPs to take concrete and immediate steps to support at-risk students through MTSS given the needs at this unique moment in time when concerns about learning loss and achievement gaps are front and center in public schools. [ABSTRACT FROM AUTHOR]

The article evaluates recent research on combined treatment for ADHD in children, emphasizing the importance of psychosocial interventions alongside medication, particularly in addressing functional impairments. Topics include the dosing and sequencing of combined treatment, the impact on functional outcomes and the need for individualized approaches based on child and family characteristics.

In the article, the author discusses behavioral health issues, particularly how to prevent and treat childhood trauma. Other topics include how trauma could worsen anger in adulthood and could cause mental health disorders like anxiety, depression and phobias, an d the possible public effects of trauma like drug use, gun violence, and school shootings.

Transitions from one daily activity to the next can occasion problem behavior (e.g., aggression). Inspired by clinical descriptions of children with autism, we compared the effects of fixed‐sequence and variable‐sequence transitions on problem behavior using a multiple baseline across participant design. In the fixed‐sequence condition, participants were exposed to the same sequence of activities. In the variable‐sequence condition, the sequence of activities was varied semi‐randomly. Results showed that transition‐related problem behavior was more likely to occur in the variable‐sequence condition. Advance notice of the upcoming transition, in the form of auditory and visual cues, was effective at reducing transition‐related problem behavior in the variable‐sequence condition for two participants. Results are discussed in light of the effect of uncertainty of outcomes, and suggestions for future cross‐disciplinary research are provided. [ABSTRACT FROM AUTHOR]

The Reinforcer Assessment for Individuals with Severe Disabilities (RAISD) and multiple‐stimulus without replacement preference assessment (MSWO) are evidence‐based tools used to determine preferences indirectly through interview and observation of choice making, respectively. Often, the RAISD is used to inform the stimulus array of the MSWO. However, reports frequently vary between informants. This can lead to discrepant identification of putative reinforcers and therefore has the potential for weaker or ineffective reinforcement‐based treatments. The purpose of this study was to compare RAISD and MSWO outcomes across informants (adolescent, caregiver, and teacher) and evaluate the convergent validity between the two measures. The results indicated that across participants, RAISD and MSWO results rarely produced convergent validity. Implications for practitioners and researchers are discussed. [ABSTRACT FROM AUTHOR]

Education researchers, policy makers, and practitioners have emphasized the role that social-emotional learning and self-regulation play in children's adjustment and connection to school, particularly as they transition from pre-school to kindergarten and the primary grades. A pretest–posttest cluster-randomized efficacy trial of the Social-Emotional Learning Foundations (SELF) curriculum for kindergarten–first-grade students found positive main effects on assessments of self-regulation, social-emotional learning, social-emotional vocabulary, and general behavioral functioning. This study is a secondary analysis using structural equation modeling to explore whether SELF effects on school adjustment were mediated by its effects on language and/or self-regulation–related outcomes. Findings replicated direct effects of treatment but did not support hypothesized mediators. In contrast, direct effects of treatment on measures of competent school functioning and internalizing behavior were mediated by outcome effects on a standardized measure of social-emotional learning competence. Study findings underscore the fundamental importance of social-emotional learning to school success and suggest related measurement issues in social-emotional learning and topics for further research. [ABSTRACT FROM AUTHOR]

Approximately 20–40% of adolescents have diagnosable emotional and behavior problems. Of those youth with emotional and behavioral disorders, 55 to 80% do not receive needed mental health treatment. Youth with untreated emotional and behavioral problems are more likely to get into automobile accidents, have a drug/alcohol problem, drop out of high school, be arrested/incarcerated, or experience subsequent health or emotional and behavioral problems (Barkley, et al., 2008). Also, half of children treated with medication do not follow the medication regimen as prescribed or discontinue their medication altogether and more than half of families enrolled in evidence-based behavior therapy drop out. As such, other adjunctive approaches have been considered, such as exercise. The preferences children have for therapy are not well known, but their perceptions of treatments likely impact their engagement. The current pilot study sought to examine children's preferences for medication, behavior therapy, exercise and some combination of these using a discrete choice experiment, a conjoint analysis technique. Participants were 44 children enrolled in a recreational and academic summer program, with 50% of the children previously meeting criteria for ADHD and/or scoring high in ADHD. Children prioritized behavioral outcomes and opportunities to engage in outdoor exercise at a highly intense level (e.g., running and swimming as fast as can, jumping). Simulation analyses or forecasting tools showed that children also preferred therapy that included exercise, and children preferred non-medication therapy that included exercise and group meetings with other children. Findings suggest that exercise added onto medication treatments, exercise added to therapy, and therapy that includes group meetings with other children have the potential to increase appeal of intervention and engagement in that intervention, which in turn might link to improved children's mental health outcomes. Finally, chi-square analyses showed that children previously treated with medication preferred medication, while children who were medication naïve preferred group therapy with exercise. Implications for child engagement in evidence-based therapies and modifications to evidence-based therapies are discussed. Highlights: Children preferred therapies that included exercise and group meetings with other children. Exercise added to therapy was preferred to that without exercise. Exercise added to these therapies has the potential to increase uptake. [ABSTRACT FROM AUTHOR]

Background & Aims Evidence has shown that the inability to regulate and understand emotions causes various behavioral problems in children with autism spectrum disorder (ASD). This study aims to investigate the effect of an emotion labeling (EL)-based training on the behavioral disorders of children with ASD. Materials & Methods This is a quasi-experimental single-subject study ABA method. Five boys with high functioning autism were purposefully included in the study after one week of sampling in 2022. For each child, the Let’s Face It software was used individually to recognize basic emotion expressions (6 types) in three sessions followed by teaching EL at 8 sessions for 4 weeks, two sessions per week. The data collection tool was a demographic form and the test of behavioral disorders of children with ASD. The collected data at five phases were analyzed in SPSS software, using descriptive statistics, and Friedman’s test. Results According to the result of Friedman test, there was a significant difference between the first and third phases (P=0.037) and the third and fourth phases (P=0.019) of behavioral disorders measurement. The EL training significantly reduced the behavioral disorders of patients (P=0.030). Conclusion It seems that the EL-based training can reduce the behavioral disorders of children with ASD. [ABSTRACT FROM AUTHOR]

Child temperament has long been viewed as a potential susceptibility factor in the link between parenting and child disruptive behavior (CDB). Specifically, the idea is that children with higher negative emotionality, surgency, and lower effortful control are more affected by their received parenting, but experimental evidence is scarce. Also, others have argued that child temperament might not be a susceptibility factor but a factor that can change through parents' participation in a parenting intervention. To test both hypotheses, we analyzed pretest, posttest, and 4-month follow-up data from 386 mostly Dutch parents, mainly mothers (92%; Mage = 38.1, SD = 4.8) with children (Mage= 6.31, SD= 1.33; 54.2% boys). The children had above-average disruptive behavior (i.e., ≥75th percentile Eyberg Child Behavior Inventory questionnaire; Eyberg & Pincus, 1999). The families participated in a randomized controlled trial of the Incredible Years (IY) parenting program. Hierarchical regression analyses showed that child temperament did not moderate IY intervention effects on CDB. Furthermore, parallel process analyses showed that the IY intervention led to direct, simultaneous decreases in both negative emotionality and CDB. These findings counter the widely held belief that temperament traits are static, unchangeable modulators of the links between parenting and CDB. Instead, child temperament (negative emotionality) can at least partly be influenced by parents' participation in a parenting program. Public Significance Statement: In this randomized controlled trial of the Incredible Years (IY) parenting intervention, we found that the intervention is effective, regardless of child temperament (i.e., negative emotionality, effortful control, and surgency). We did, however, find a first indication that child temperament, like disruptive behavior, may itself change as an outcome of a parenting intervention. These findings indicate that the trait of negative emotionality can be influenced by parents' participation in the IY parenting program. [ABSTRACT FROM AUTHOR]

Introduction: Divorce is one of the most important causes of tension and pressure on children. Aim: The research aimed to develop of early intervention program based on cognitive behavioral theory for divorced children with emotional-behavioral disorders and its effectiveness in aggression of divorced children. Method: The research scheme was mixed (qualitative-quantitative). The statistical population in qualitative part consisted of articles and documents related to divorced children and all the professors and specialists in children’s psychological disorders and quantitative part consists of all the girls of divorced families of Astaneh-ashrafiyeh in 2022. Moreever 30 people were selected by purposive sampling and randomly replaced in experimental and control groups. The intervention program was performed in 12 sessions of 90 minutes, two session per week for experimental group. Instruments included Achenbach’s Children Behavioral Check list (2001) and Shahim’s Primary School Aggression Questionnaire (2006). The data in the qualitative part were analyzed by thematic analysis and in the quantitative part by multivariate analysis of covariance. Result: The results showed the content validity of the intervention program was equal to 0.75 up to 1 and there is significant difference between the pre-test and post-test scores of the groups in aggression (P<0.01). In general, the early intervention program based on cognitive-behavioral theory for divorced children with emotional-behavioral disorders is effective on aggression in divorced children (P<0.01). Conclusion: Based on findings developed intervention program was effective in aggression of divorced children. Therefore, this intervention program can be used as an effective intervention to reduce aggression of divorced children. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in South-West Nigeria and to assess the impact of a problem-solving skills and attributional retraining (PSSAR) intervention with this population. Design/methodology/approach: In total, 787 male students from two schools were screened for conduct disorder. All participants who met criteria for the disorder were allocated to either treatment (n = 55) or control (n = 47) groups. Outcome measures comprised the strengths and difficulties questionnaire (SDQ; teacher and student versions) and the teacher rating of students' aggressive behaviors. Findings: Of the sample, 13% were found to present with difficulties that met criteria for conduct disorder. The presence of these difficulties correlated with several demographic variables, including parental conflict and alcohol use. A statistically significant reduction in mean scores was observed for the treatment group in the student rating of the SDQ emotional subscale and total difficulties scores. Teacher ratings were less consistent in that conduct problems, prosocial behavior and total difficulties increased following the intervention, whereas peer problems and aggressive behavior were reported by teachers to reduce. No statistically significant change was found in the outcome measures for the control group. Practical implications: In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. Originality/value: In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. This study's findings offer some preliminary support for the PSSAR intervention for conduct disorder in this context and indicate areas for further research. [ABSTRACT FROM AUTHOR]