Achenbach System Of Empirically Based Assessment Research Articles

Thomas Max Achenbach (1940-2023).

Memorializes Thomas Max Achenbach (1940-2023). He is known for groundbreaking contributions to developmental psychopathology, a field that was shaped in part by his 1974 book with that title, and for creating the Achenbach System of Empirically Based Assessment (ASEBA), arguably the world's most widely used suite of procedures for assessing child, youth, adult, and older adult strengths and emotional and behavioral problems. His research revealed robust broadband syndromes of psychopathology, giving rise to the terms "internalizing" and "externalizing." The Child Behavior Checklist, the first measure of the ASEBA suite, has been translated into more than 110 languages and is used in science and clinical service settings around the world. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Emotional and behavioural problems of left behind children in Lithuania: a comparative analysis of youth self-reports and parent/caregiver reports using ASEBA.

Children being left behind (LBC) in their home countries due to parental emigration is a global issue. Research shows that parents' emigration negatively affects children's mental health and well-being. Despite a high number of LBC, there is a dearth of data from Eastern European countries. The present study aims to collect and analyse self-reported data on LBC emotional and behavioural problems and compare children's reports with those of parents/caregivers. A cross-sectional study was conducted in 24 Lithuanian schools, involving parents/caregivers and their children aged 12 to 17. We employed self-reported measures, including the Achenbach System of Empirically Based Assessment (ASEBA) tools -Child Behaviour Checklist (CBCL 6/18) and Youth Self Report (YSR 11/18), to evaluate the emotional and behavioural problems of the children. These instruments had been translated, standardised, and validated for the Lithuanian population. Data collection took place between January 2022 and April 2023. In addition to descriptive analysis, multivariate regression was used to adjust for various sociodemographic factors. A total of 760 parents/caregivers and 728 of their children participated in the study. LBC exhibited higher total problem scores (57.7; 95% CI 52.0-63.4) compared to non-LBC (47.1; 95% CI 44.7-49.4). These differences were consistent across all YSR 11/18 problem scales. However, no significant differences were observed in CBCL 6/18 scores. Furthermore, LBC self-reported a higher total problem score (57.7; 95% CI 52.0-63.4) compared to their parents/caregivers (24.9; 95% CI 18.9-30.9), and this pattern persisted across all scales. Being female, having school-related problems and having LBC status were associated with higher YSR 11/18 scores in the multivariable regression, while female gender, living in rural areas, school-related problems, and having hobbies were associated with higher CBCL 6/18 scores. This study highlights that LBC report more emotional and behavioural challenges than their non-LBC peers, while parent/caregiver assessments show lower problem scores for LBC. Gender, living environment, school-related issues, and engagement in hobbies have influenced these outcomes. These findings underscore the multifaceted nature of the experiences of LBC and the importance of considering various contextual factors in understanding and addressing their emotional and behavioural well-being.

Twenty years of emotional-behavioral problems of community adolescents living in Italy measured through the Achenbach system of empirically based assessment (ASEBA): a systematic review and meta-analysis.

This is a systematic review and meta-analysis of emotional and behavioral problems among Italian community adolescents in the last 20 years, as assessed through the ASEBA questionnaires CBCL 6-18, YSR 11-18 and TRF 6-18. Research questions address: (1) pooled means of problems' scores in questionnaires scales; (2-3) variations in scores according to sociodemographic and time-related factors, and studies' quality; (4) trends in research with ASEBA instruments along with other outcomes, e.g., psychopathological symptoms. A systematic literature review of Scopus, EBSCO, PubMed, Web of Science, and ProQuest databases using the PRISMA 2020 guidelines was conducted on November, 2021, and of grey literature on December, 2021. The quality of studies was assessed through the Newcastle-Ottawa Scale. Forty-four studies were eligible for the systematic review, of which 34 were included for meta-analysis. Results showed that: (1) emotional-behavioral problems were higher when assessed by the CBCL and lower when assessed by the YSR compared to normative data; (2) there were no gender and age differences, except for higher scores of Anxious/Depression symptoms, in girls. (3) internalizing and attention problems increased over the last two decades. (4) major trends of Italian research investigate adolescents' emotional behavioral problems concerning attachment, comorbid symptoms, especially internet addictions, and eating disorders. Despite some limitations (e.g., low-medium quality of most studies, no data on the TRF, under-representation of some geographical areas, some search-related choices), these data provides Italian practitioners and international researchers of some parameter to evaluate Italian adolescents emotional-behavioral problems. Registered on PROSPERO N. CRD42022299999.

Childhood and Adolescence Gender Role Nonconformity and Gender and Sexuality Diversity in Young Adulthood

Sexuality- and gender-diverse youth experience disproportionate health and social adversity. Accurate early-life indicators are important for development of supportive approaches. To examine whether commonly used items measuring childhood conformity to gender roles are associated with sexual orientation in young adulthood. This single-center, prospective cohort study (the Raine Study) assessed 2868 children of 2900 women who were recruited during pregnancy from August 1, 1989, to April 30, 1992, with follow-up ongoing. The Achenbach System of Empirically Based Assessment (ASEBA) Child Behavior Checklist, Teacher Report Form, and Youth Self-Report tools were used to survey parents, teachers, and youths to examine gender diversity among the participating youths. Parents were followed up at years 5, 8, 10, 14, and 17, adolescents at years 14, 17, and 27, and teachers at years 10 and 14. Data were analyzed from August 1, 2020, to July 31, 2023. Parent and teacher report that a child "behaves like the opposite sex" (gender role behavior), and parent and self-report that a child "wishes to be the opposite sex" (gender role wish), in response to assessment items. Year 27 self-reported sexual identity, attraction, and behavior. Of the 2868 children in the original birth cohort, 1154 (40.2%) participated in the year 27 follow-up, of whom 608 (52.7%) were recorded female at birth and 546 (47.3%) were recorded male at birth. Of these, 582 who were recorded female at birth continued to identify as female (cisgender) (95.7%), and 515 recorded male at birth continued to identify as male (cisgender) (94.3%); 47 (4.1%) did not complete the questionnaire. Of cisgender participants, 76 of 605 women (12.6%) and 52 of 540 men (9.6%) had a diverse sexual identity, 204 of 605 women (33.8%) and 77 of 540 men (14.3%) were same-gender attracted, and 100 of 605 women (18.6%) and 39 of 540 men (7.2%) had ever engaged in same-gender sexual behavior. Across all follow-ups, after adjusting for gender, nonconforming gender role behavior was consistently associated with diverse sexual identity and behavior (adjusted odds ratio [aOR] for identity, 2.8; 95% CI, 1.9-4.2; behavior aOR, 2.4; 95% CI, 1.6-3.5). Self-reported gender role wish was consistently associated with diverse sexual orientation (identity aOR, 2.3; 95% CI, 1.4-3.8; attraction aOR, 1.7; 95% CI, 1.1-2.5; behavior aOR, 1.9; 95% CI, 1.2-2.9). In this cohort study, ASEBA gender role nonconformity was associated with diverse sexual orientation, beginning in early childhood. Findings suggest that the ASEBA measures should not be used to infer sexual orientation or gender diversity in clinical or research settings; asking direct questions may provide more accurate data.

Psychometric properties and cross-cultural comparison of the Arabic version of the Child Behavior Checklist (CBCL), Youth Self Report (YSR), and Teacher’s Report Form (TRF) in a sample of Egyptian children

BackgroundThe Achenbach System of Empirically Based Assessment (ASEBA) forms are among the most studied instruments for assessing behavioral, emotional, social, and thought problems in children and adolescents worldwide. Although ASEBA instruments have been translated into Arabic, fewer studies have investigated their psychometric properties and norms in Arabic speaking societies than in other societies.MethodsRevisions were made to the Modern Standard Arabic (MSA) translations of the Child Behavior Checklist for Ages 6–18 (CBCL/6–18), the Teacher’s Report Form (TRF), and the Youth Self-Report (YSR). Parents of 6–18-year-olds who came to the general pediatric clinic in Tanta University Hospital during a 2-year period for routine check-ups were invited to fill out the CBCL/6–18 (N = 595), while 11–18-year-olds were invited to fill out the YSR (N = 409). TRFs were filled out by teachers (N = 329).ResultsConfirmatory factor analyses supported the previously reported eight-factor syndrome structure of the forms with good psychometric properties and moderate cross-informant correlations. The mean CBCL/6–18 and YSR Total Problem scores qualified for the previously established ASEBA Multicultural Norm Group 2, while the mean TRF Total Problem score qualified for group 3.ConclusionsThe good psychometric properties and the identification of Multicultural Norm Groups for scores obtained with the Arabic translations of ASEBA forms in Egyptian society support use of the ASEBA for assessment and outcome evaluations of behavioral, emotional, social, and thought problems among Egyptian youth.

Effectiveness of Group Training Based on Choice Theory on Internalizing Problems, Empathy, and Identity Transformations Among Male Adolescents

Background: Choice theory stems from psychological concepts like self-concept, successful identity, and quality of the world. The theory encourages adolescents to accept the responsibility for their choices on the one hand and predict the effect of such decisions on their lives on the other hand. The present study aimed to investigate the effectiveness of choice theory-based group training in internalizing problems, empathy, and identity transformation among male adolescents. Methods: This quasi-experimental study has a pre-test-post-test and 1.5 months follow-up design with a control group. The statistical population included all male adolescents studying in Qazvin City, Iran, in the 2020-2021 academic year. The sample included 28 male adolescents selected through convenience sampling and randomly assigned to the experimental and control groups (n=14). The experimental group received 8 sessions of 90-minute group training based on choice theory, while the control group did not receive any intervention. We gathered data using the empathy scale, Achenbach system of empirically based assessment (ASEBA), and aspects of identity questionnaire. Mixed repeated analyses of variance, the independent t test, and the Chi-square test were used for data analysis in SPSS software, version 24. Results: The findings indicated that the group training based on choice theory was effective in promoting internalizing problems (F=30.61, P<0.001), empathy (F=21.35, P<0.001), and identity transformation (F=50.2, P<0.001). In addition, these effects were sustainable until the follow-up period. Conclusion: This research indicated that group training based on choice theory was effective in internalizing problems, empathy, and identity transformation among male adolescents. It is recommended that school counselors consider the principles and concepts of this intervention as an educational mission and executive task for male adolescents.

Comparing the effectiveness of behavioral counseling model and treatment based on parent-child relationship on externalizing symptoms of Children with attention deficit/hyperactivity disorder

Aim: The purpose of this study was to compare the effectiveness of joint behavioral counseling model and treatment based on parent-child relationship on externalizing symptoms in students with attention deficit/hyperactivity disorder. Method: The research method was a quasi-experimental type with a pre-test-post-test design with a control group. If the diagnosis of attention deficit/hyperactivity disorder was given, Achenbach System of Empirically Based Assessment (ASEBA) and Children’s Behaviour Checklist (CBCL) were administered to diagnose externalizing problems. Among those who had externalizing symptoms in the Achenbach questionnaire, 45 people were selected to participate in the research and were randomly divided into three groups of 15 people. The experimental groups were trained for one hour per week for 10 weeks, while the control group did not receive any training. The mixed analysis of variance statistical test was used to analyze the data. Results: The findings showed that there is no significant difference between the mean externalization score of CPRT and CBC experimental groups (p < 0.05), but this difference is significant between the CPRT and CBC experimental group and the control group (p < 0.05). Conclusion: It can be concluded that both methods of joint behavioral counseling model and treatment based on parent-child relationship have been effective on externalizing symptoms in students with attention deficit/hyperactivity disorder.

Are the children alright? A systematic review of psychological adjustment of children conceived by assisted reproductive technologies.

The present systematic review aims to assess the psychological adjustment of children born through assisted reproductive technologies (ARTs) and to screen for clinical problems when compared with normative data from the standardized indexes of mental health. Following PRISMA guidelines, the search was conducted from inception through September 2021 using APA PsycInfo, APA PsycArticles, Psychology and Behavioural Sciences Collection, Academic Search Complete, Pubmed, Scopus, Web of Science, Scielo, and RCAAP. Search terms related to ART and children's psychological adjustment were combined to Boolean operators to identify relevant published studies in English, French, Italian, Portuguese and Spanish. Peer-reviewed studies focused on the psychological adjustment of ART children aged between the 3 and 11years were included. From a total of 337 results, 45 papers were eligible to be included in this review. Data extraction was performed independently by two authors and revised and confirmed by other two authors. All children scored below the clinical range for psychiatric symptoms when compared with normative data for the Strengths and Difficulties Questionnaire (SDQ) or the Achenbach System of Empirically Based Assessment (ASEBA), regardless of type of ART and different family configurations. Further, some evidence suggests that surrogacy children with gay fathers present the lowest levels of psychological problems when compared to normative data. These findings enable practitioners to develop an informed view of ART children mental health outcomes to help parents find more adaptive strategies to navigate their chosen pathways in healthier ways.

3.74 Validation of the Child Behavior Checklist and Achenbach Test Observation Form for Use With american indian Children in the Navajo Nation

There are virtually no psychiatric screening or diagnostic instruments validated for use with American Indian Children in the Navajo Nation, the largest American Indian reservation in the United Sates. In order to begin to remedy this problem, we completed a preliminary study examining the validity and reliability of the Child Behavior Checklist (CBCL) and the Achenbach System of Empirically Based Assessment (ASEBA) Test Observation Form (TOF) for American Indian children in the Navajo Nation. The CBCL is a parent report to screen for developmental psychopathology, whereas the TOF is a companion form, completed by trained assessors, to rate observed behaviors in 2- to 18-year-old children.

Multi-layer relationships between psychological symptoms and life adaptation among humidifier disinfectant survivors.

In April 2011, the Korea Centers for Disease Control and Prevention (CDC) announced the results of an epidemiological investigation that an unknown cause of lung disease that occurred throughout Korea was caused by humidifier disinfectants. The unprecedented social catastrophe caused by humidifier disinfectants, a household chemical, has so far reported 1,784 deaths and 5,984 survivors in South Korea. This study was designed to investigate the multi-layer relationships between psychological symptoms and adaptive functioning in survivors of the Humidifier disinfectants in South Korea caused by chemical toxic substances. Specifically, this study aimed to explore how psychological symptoms affect actual interpersonal relationships and job adjustment with two variable sets, six internalizing and externalizing subscales, and three adaptation subscales. A total of 224 survivors recruited from a program to support humidifier disinfectant survivors by the government participated in this study. This research was approved by the Institutional Review Board of one of the Universities in South Korea. The age range of the participants was 18–73 years (M = 42.23, SD = 10.90), 37.1% (n = 83) were male, and 62.9% (n = 141) were female. The participants responded to the Adult Self-Report (ASR) of the Achenbach System of Empirically Based Assessment (ASEBA). A Canonical Correlation Analysis (CCA) generated three unique patterns in the relationships between psychological symptoms and adaptive functions. Humidifier disinfectant survivors in the first pattern were more vulnerable to psychological symptoms and showed maladaptive functioning in life. Survivors in the second pattern showed intrusive behaviors and appeared to be adaptive in relationships with friends. Finally, survivors in the third pattern showed aggressive behaviors and reported poor partner relationships while showing good relationships with friends. The practical implications of the interventions are also discussed.

ADHD symptoms and use of anabolic androgenic steroids among male weightlifters.

Use of anabolic androgenic steroids (AAS) is associated with adverse health effects. The factors that predispose to AAS use among athletes are poorly understood, but attention deficit/hyperactivity disorder (ADHD), which is known to occur among athletes more often than in the general population, is associated with risk behaviors, including substance abuse. We aimed to see if AAS use in male weightlifters was associated with ADHD symptoms, and test the link between ADHD symptoms and cognitive performance. Hundred and forty male weightlifters, 72 AAS users and 68 weightlifting controls (WLC), completed the Achenbach system of empirically based assessment (ASEBA) for ADHD symptoms and underwent cognitive examination. Self-reported ADHD symptom scores were significantly higher among AAS users compared to WLC, and scores in the range indicating clinically important ADHD was significantly more common in the AAS-using group. Age of onset of AAS use correlated inversely with ADHD scale score (r = − 0.35; p = 0.003). ADHD score correlated inversely with cognitive scores for working memory (r = − 0.25, p < 0.001), processing speed (r = − 0.24, p < 0.001), verbal learning and memory (r = − 0.19, p = 0.03), and problem solving (r = − 0.20, p = 0.02). AAS use among weightlifters is associated with ADHD symptoms and corresponding lower cognitive performance. Recognising a relationship between ADHD symptoms and AAS use may guide drug prevention strategies in sports.

Emotional Dysregulation in Adults from 10 World Societies: An Epidemiological Latent Class Analysis of the Adult-Self-Report

Background/ObjectiveEmotional dysregulation (ED) is a dimensional psychological domain, previously operationalized by instruments of the Achenbach System of Empirically Based Assessment (ASEBA) for children and adolescents; however, its cross-cultural and bottom-up characteristics among adult populations are still unknown. MethodWe examined scores obtained on the Adult Self-Report (ASR) by 9,238 18- to 59-year-olds from 10 societies that differed in social, economic, geographic, and other characteristics. A Latent Class Analysis was performed on the data from each society. ResultsIn each society, a dysregulated class (DYS) was identified, which was characterized by elevated scores on most ASR syndromes. The mean prevalence of DYS was 9.2% (6.1-12.7%). The best models ranged from three to five latent classes in the different societies. ConclusionsAlthough the number of identified classes and the prevalence of ED varied across societies, a DYS class was found in each society, suggesting the need to adopt a dimensional view of psychopathology and a cross cultural perspective also in adult populations.

A Comparative Study to assess the behavioral problems of school children among three generation family and nuclear family in selected community, Thrissur

A comparative study to assess the behavioral problems of school children among three generation family and nuclear family in selected community, Thrissur. The objectives of the study were to assess the behavioral problems of school children among three generation family and nuclear family, compare the behavioral problems of school children among three generation family and nuclear family and associate the behavioral problems of school children with their selected demographic variables. The conceptual framework utilized in this study was Ludwig Von Bertalanffy General System Theory. Purposive sampling technique was used to select the samples. The participants were 100 children in the age group of 6-10 years, out of which, 50 were in three generation family and 50 were in nuclear family who fulfilled the inclusion criteria at Thrikkur Panchayath, Thrissur. The tool consisted of structured questionnaire to collect demographic data include age of child, gender, religion, occupation of father, occupation of mother, number of siblings, birth order of the child and modified behavior rating scale of Achenbach System of Empirically Based Assessment (ASEBA) and Eyberg Child Behavior Inventory (ECBI) was used to assess the behavioral problem of children. Reliability and validity of the tool was established. The pilot study was done for 10 subjects and found to be feasible. The main study was conducted from 10th February to 7th March 2020.The study findings revealed that in three generation family majority 92% of children had no behavioral problems and only 8% of children had mild behavioral problems. While in nuclear family, 36% of children had no behavioral problems, 52% of children had mild behavioral problems and 12% of children had moderate behavioral problems. The mean score of the behavioral problems in three generation family and in nuclear family was 19.80 and 56.54 respectively. Comparison of behavioral problems, p value of behavioral problem was 0.000 which was less than 0.05 (p value &lt; 0.05). These findings revealed a significant difference in the behavioral problem of school children among three generation family and nuclear family. Association of behavioral problems of school children with their demographic variables revealed that there was an association of behavioral problems of school children with occupation of mother in three generation family.

Academic achievement and emotional and behavioural problems: The moderating role of gender.

The present study aimed to explore the association between academic achievement and emotional and behavioural problems and the moderation role of gender in this association. 1350 Portuguese school-aged children and adolescents from first to ninth grade (6–15-year-old), part of a national representative sample, were assessed by teachers and parents with questionnaires from the Achenbach System of Empirically Based Assessment (ASEBA). Results show that academic achievement significantly predicts child and adolescent’s internalizing, externalizing, and total problems. Gender moderates the association between academic achievement and child and adolescent’s externalizing and total problems, both at school and in the family context. The results underscore the relevance of academic achievement in children and adolescent’s emotional and behavioural problems, and particularly in boys.

Psychometric properties of the caregiver-teacher report form in a sample of Norwegian preschool children

Purpose The caregiver-teacher report form (C-TRF) is included in the Achenbach system of empirically based assessment (ASEBA) and widely used to measure child psychopathology. In Norway, the C-TRF is frequently used by the Educational and Psychological Counselling Service or for referrals to special health services, however, its psychometric properties in the Norwegian context have not yet been explored. The aim of this study was to investigate the internal consistency of the C-TRF and its factorial validity in a Norwegian preschool context. Method This study is based on baseline data from the project Children in Central Norway, where a total of 169 preschool teachers reported on the C-TRF for 1430 children aged 1–6 years. Results The findings indicate promising psychometric properties for the C-TRF in terms of internal consistency and factorial validity, however, the somatic complaints scale seems problematic because of its poor psychometric properties. Conclusion Users of the C-TRF can be confident in the instrument’s applicability in a Norwegian context, however, careful considerations when applying the somatic complaints scale in clinical decision making is warranted.

Universal Screening in Positive School Mental Health Using the ASEBA Methodology for Teachers: A Pilot Epidemiological Study.

School-based detection and intervention are critical components in ensuring positive mental health in children, with teachers playing an essential role in assessing students’ well-being. The current research aims to be a pilot epidemiological study on positive school mental health in Malaga, Spain, using the Achenbach System of Empirically Based Assessment (ASEBA). Data were collected in the COVID-19 pre-pandemic setting, using the Caregiver-Teacher Report Form (C-TRF) and the Teacher Report Form (TRF) in a sample of 420 children, who were between 5 and 8 years old at the time of the data collection. In 5-year-old children, the DSM-oriented scale with the highest clinical prevalence corresponds to attention deficit and hyperactivity problems (1.13%). In this same sub-sample, clinical levels of externalizing problems (4.52%) were non-significantly more common than internalizing conditions (1.69%). As for children between 6 and 8 years old, the DSM-oriented scale with the highest prevalence of clinical scores corresponds to anxiety problems (4.12%) and conduct problems (2.88%). Clinical levels of externalizing problems (9.47%) were non-significantly more prevalent than internalizing problems (6.58%). The results present 95% confidence intervals prevalence data in the general population and sex-differentiated descriptive statistics. The results are discussed according to their implication for school mental health.

Effects of Parental Acceptance-Rejection on Children's Internalizing and Externalizing Behaviors: A Longitudinal, Multicultural Study.

Grounded in interpersonal acceptance-rejection theory, this study assessed children's (N=1,315) perceptions of maternal and paternal acceptance-rejection in nine countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States) as predictors of children's externalizing and internalizing behaviors across ages 7-14 years. Parenting behaviors were measured using children's reports on the Parental Acceptance-Rejection Questionnaire. Child externalizing and internalizing behaviors were measured using mother, father, and child reports on the Achenbach System of Empirically-Based Assessment. Using a multilevel modeling framework, we found that in cultures where both maternal and paternal indifference/neglect scores were higher than average-compared to other cultures -children's internalizing problems were more persistent. At the within-culture level, all four forms of maternal and paternal rejection (i.e., coldness/lack of affection, hostility/aggression, indifference/neglect, and undifferentiated rejection) were independently associated with both externalizing and internalizing problems across ages 7-14 even after controlling for child gender, parent education, and each of the four forms of parental rejection. Results demonstrate that the effects of perceived parental acceptance-rejection are panculturally similar.

Motor Skills Abilities And Behavioural Aspects of Military Students In Pandemic Circumstances

The purpose of the research is to point out the correlations between motor skills and behavioral characteristics of military high school students during COVID 19 pandemic. The research was held from 8th to 12th March 2021 on a group of 44 Romanian students (9 girls and 35 boys), age average 17.6 and consisted in testing the motor abilities by undergoing a tactical trail with 10 stages and filling in the Achenbach System of Empirically Based Assessment (ASEBA) questionnaires. Data were analyzed with PASW Statistic18 by using correlation analyses, and the significance level was set at P&lt;0.05 and P&lt;0.01. The results reveal that, statistically, the recorded time correlates positively with Somatic Complaints, Thought Problems and Internalizing scale. The total time statistically corelates with Thought Problems. The military students reported poorer motor skills abilities during pandemic. They seemed to have a sedentary lifestyle with more internalized problems and less workout.

Frequency and Correlates of Picky Eating And Overeating in School-aged Children: A Portuguese Population-based Study

Using the Achenbach System of Empirically Based Assessment (ASEBA) battery in a non-clinical Portuguese population-based study, we aimed to examine a broad spectrum of emotional and behavioral problems and competencies, including picky eating and overeating behaviors in children and youth. Overall, 2687 children from 6 to 18 years old were evaluated by their parents, teachers and, in the case of children older than 11 years old, by themselves. Picky eating and overeating were assessed using the Child Behavior Checklist (CBCL) and Youth Self Report (YSR). The frequency of picky eating and overeating was 23.1% and 24%, respectively. Picky eaters, compared with over eaters and non-picky/non-over eaters, tended to belong to the younger group of participants, and in turn, over eaters tended to belong to the older group. Overeating was significantly associated with overweight, which also emerged as a predictor of belonging to the overeating group. Both picky eaters and over eaters scored significantly higher on all emotional and behavioral problems and DSM-5-oriented subscales. The results of two independent binary logistic regression analyses indicated that internalizing and externalizing problems, together with the total problems score emerged as a predictor for both groups, including picky eater and overeater school-aged children. In accordance with previous studies, our results also supported the possibility that a broader pattern of potentially non-adaptive emotional and behavioral problems could also be associated with both pickiness and excessive eating.

A Pilot Study of Two Different Constraint-Induced Movement Therapy Interventions in Children With Hemiplegic Cerebral Palsy After Botulinum Toxin Injection During Preschool Education.

Introduction: To establish a pilot study on applying two low dose (40 h) constraint-induced movement therapy (CIMT) interventions in children with hemiplegic cerebral palsy (CP) after botulinum toxin (BoNT-A) injection during preschool education.Methods: Five children with spastic CP (mean age: 5.31 years; Gross Motor Function Classification System level I and II) undergoing regular BoNT-A injections and rehabilitation programs were included. Participants were randomly allocated to one of two CIMT programs (40 h): a 2-week 4-hours/day CIMT program and a 4-week 2-hours/day CIMT program. One CIMT program was performed 1 month after a BoNT-A injection, and then the second program was implemented with the next injection. The outcomes were measured by changes in Goal Attainment Scaling (GAS), the grasp and Visual-Motor Integration (VMI) test in Peabody-Developmental Motor Scales (PDMS), the self-care scale on the Functional Skill Scale, and the Caregiver Assistance in Chinese Version of Pediatric Evaluation of Disability Inventory (PEDI-C), Anxiety and Oppositional Defiance Problems of Achenbach System of Empirically-Based Assessment before and after the CIMT interventions, and at every 2 months' follow-up thereafter.Results: The mean age of the participants was 5.31 years, BMI was 16.7 (kg/m2), VIQ was 86.4 ± 8.5, and dose of BoNT-A injection in the upper limb was 42 ± 26.6 units. Grasp, VMI, and self-care on the Functional Skill Scale were significantly better in the 4-week 2-hours/day CIMT program (p < 0.001, p = 0.001, p < 0.001). GAS, grasp, VMI, two 2 self-care scales of PEDI were significantly improved after the CIMT programs, and improvement continued for up to 4 months after the programs. There was no clinical evidence showing changes in the scores for anxiety and oppositional defiance problems during the study period.Conclusions: The preliminary findings, although limited, suggest a potential therapeutic role for the school-based CIMT program after BoNT-A injection. The 4-week 2-hours/day CIMT program might be better than a 2-week 4-hours/day program in terms of self-care and hand function when performed in kindergarten in this pilot study. Furthermore, this pilot study provides valuable information; therefore, it is crucial to include more CP children and blinded assessors for hand function and ADL in the future study.