Achenbach Teacher Research Articles

The Potential Emergence of "Education as Mental Health Therapy" as a Feasible Form of Teacher-Delivered Child Mental Health Care in a Low and Middle Income Country: A Mixed Methods Pragmatic Pilot Study.

Objective: We assessed task-shifting children's mental health care to teachers as a potential approach to improving access to child mental health care.Methods: In Darjeeling, India, we conducted a single-arm, mixed-methods feasibility study with 19 teachers and 36 children in five rural primary schools to determine whether teachers can deliver transdiagnostic mental health care to select children-in-need with fidelity to protocol, to assess which therapeutic options teachers chose to use within the protocol, and to evaluate for a potential signal of efficacy.Results: Participation rates for intervention activities were >80%. A majority of teachers met or exceeded quality benchmarks for all intervention activities. Teachers chose to deliver teacher-centric techniques, i.e., techniques that only teachers could deliver given their role in the child's life, 80% of the time. Children improved in mental health score percentiles on the Achenbach Teacher Report Form. Key facilitators included the flexibility to adapt intervention activities to their needs, while identified barriers included limited time for care delivery.Conclusion: Findings support the feasibility of task-shifting children's mental health care to classroom teachers in resource-limited schools. Fidelity to protocol appeared feasible, though the freedom to choose and adapt therapeutic techniques may also have enhanced feasibility. Surprisingly, teachers consistently chose to deliver teacher-centric therapeutic techniques that resulted in a potential signal of efficacy. This finding supports the potential emergence of “education as mental health therapy” (Ed-MH) as a new therapy modality. Continued investigation is required to test and refine strategies for involving teachers in the delivery of transdiagnostic mental health care.

Teacher Nomination of School-aged Children for Mental Health Services in a Low and Middle Income Country

ABSTRACT Background: Knowledgeable in child development, primary school teachers in low- and middle-income countries (LMICs) have the potential to identify their students needing mental health care. Objective: We evaluated whether teachers in Darjeeling, India can accurately nominate school-aged children for mental health services after training and aided by a novel tool. Methods: In 2018, 19 primary school teachers from five low-cost private (LCP) schools in rural Darjeeling were trained to nominate children needing care. Teachers evaluated all of their students aided by a novel tool, ‘Behavior Type and Severity Tool’ (BTST), completed the Achenbach Teacher Report Form (TRF) as a mental health status reference standard, and nominated two students for care. Sensitivity and specificity of being nominated compared to TRF overall and subdomain scores were calculated. BTST performance was determined by comparing BTST and TRF scores and creating Receiver Operating Characteristic curves to determine optimal cutoffs. Multivariable regression models were used to identify demographic predictors of teacher accuracy using the BTST. Results: For students demonstrating a clinical or borderline score in at least one TRF subdomain, the sensitivity (72%) and specificity (62%) of teacher nomination were moderately high. BTST overall scores and TRF Total Problem scores were correlated (Spearman’s ρ = 0.34, p < 0.0001), as were all subdomains. For the TRF Total Problem score, a maximum Youden’s J of 0.39 occurred at BTST cutoff >4 for borderline struggles and 0.54 at the BTST cutoff >6 for clinical struggles. Younger teacher age, less education, less formal education training, and more years of experience were positively associated with teacher accuracy. Conclusions: With training and a simple decision support tool, primary school teachers in an LMIC nominated students for mental health services with moderate accuracy. With the BTST being weakly accurate, teachers’ judgment largely accounted for the moderate accuracy of nominations.

Taijiquan and qigong as a mindfulness cognitive-behavioural based therapy on the treatment of cothymia in school-age children – A preliminary study

IntroductionThe development and well-being of children are directly linked to several aspects. Among those aspects, physical activity, an adequate nutrition, and a healthy mind, seem to be of crucial importance. Psychopathologies, such as anxiety and depression, have a negative impact on life, especially when co-occurring (mixed-anxiety depression disorder/cothymia), and the clinical implications include a higher risk of suicide and psychiatric hospitalization, elevated disability, decreased compliance with medical treatment, and considerably increased usage of medical services. Thus, research in conventional and nonconventional modalities is necessary to address this issue. The main objective of this study was to understand if TJQ and QG could be effective as a mindfulness cognitive-behavioural based therapeutic tool with body movement, for the treatment of children suffering from cothymia. MethodsIn this small study, six selected children, four males and two females aged between 7 and 11 years old, were taught a set of exercises of TaijiQuan (TJQ) and Qi Gong (QG). To obtain the results, the Achenbach Teacher's Report Form (TRF) was applied at the beginning of the experimental period, as well as at the ending of the experimental period. The resulting scores were analysed to observe the difference between both moments of evaluation. ResultsResults showed some improvements in symptoms, with an average improvement of 46%. ConclusionTJQ and QG seem to be a promising complementary therapeutic tool in cognitive-behavioural approaches for children who suffer from cothymia, as well as prevention and control for children who may not display symptoms at a clinical level. However, further research is needed in order to understand the full potential of these therapeutic exercises.

Effectiveness of a School-Based Mindfulness Intervention on Children’s Internalizing and Externalizing Problems: the Gaia Project

Studies examining the effectiveness of school-based mindfulness interventions on children’s emotional/behavioral problems when delivered by school teachers and professionals are still limited. The present study reports the effectiveness of Gaia, a 12-week program integrating a mindfulness approach into an ecological paradigm. To evaluate the effectiveness of the intervention, we conducted a cluster randomized controlled trial that compared outcomes for children assigned to the experimental group (E.G., Gaia program) with those of the control group (C.G.) using hierarchical linear modeling. The intervention was led by instructors within the school curriculum. Emotional/behavioral problems were assessed with the Achenbach Teacher’s Report Form at pre-test and post-test. Four hundred participants aged 6–12 years were recruited from six primary schools (E.G., n = 232; C.G., n = 168). Teacher-report comparisons revealed that, relative to controls, the E.G. showed significant decreases in total problems, internalizing, externalizing, and in most narrow-band scales at post-intervention. The effect sizes were medium for total problems, externalizing, and attention problems, small to medium for rule-breaking behavior and aggressive behavior, while they resulted small for internalizing and anxiety/depression. While 7.76% of the E.G. showed clinical/borderline levels of total problems before the intervention, 3.87% of this group still showed clinical/borderline levels after the intervention, whereas no children deteriorated, with a significant difference in the direction of change. Findings from this study indicate that the Gaia program can be delivered by school instructors during a regular curriculum and the intervention is promising for reducing children’s emotional and behavioral problems.

Sleep disturbances and their co‑occurrence with emotional and behavioural problems in elementary school children

Sleep disturbances are likely to be associated with emotional and behavioural problems in children. The goal was to evaluate co-occurrences between sleep disturbances and behavioural and emotional problems in elementary school children by means of network analysis. The study was performed in St. Petersburg in 2017 and comprised 186 typically developing children (92 boys, 94 girls) aged 6 to 8 (median 7) years. The mothers were requested to fill in the Child Sleep Habit Questionnaire (CSHQ) aimed to measure certain sleep troubles in children. The teachers were approached with the Achenbach Teacher Report Form for Ages 6–18 years aimed to find major emotional and behavioural disturbances. The EBICglasso (Extended Bayesian Information Criterion graphical least absolute shrinkage and selection operator) algorithm was used to estimate a regularized graphical model and to find the most important associations. There were 14 nodes in the network with 26 non-zero edges. Some variables had strong connections. The daytime sleepiness scale had the highest betweenness score (normalized value 2.54), and it bridged sleep problems and the signs of emotional/behavioural disturbances. Other variables with high betweenness scores were parasomnias (normalized value 1.14), acting as the bridge that connects other features of sleep problems, and depressive problems (normalized value 1.46), bridging the nodes related to emotional/behavioural disturbances. These clinical signs may play important roles in the network and should be regarded cautiously as possible indicators of co-occurring sleep and emotional disturbances. Network analysis offers the potential for insight into structural relationships among core psychological processes related to sleep disturbances in children.

Effects of taijiquan and qigong practice over behavioural disorders in school-age children: A pilot study

Child development and wellness are strictly dependent on several factors among them physical activity, a proper nutrition and, of critical importance, a healthy mind. Psychopathologies like attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) have a direct negative impact on social, academic or occupational functioning of the affected children. If left untreated, these pathologies may progress to adulthood, thus requiring research strategies on conventional and nonconventional modalities of treatment. In this pilot study, conducted during the academic year 2015/2016, a combination of exercises of TaijiQuan (TJQ) and Qi Gong (QG) were taught to four selected children, three males and one female, aged between 6 and 10, suffering from the above mentioned behavioural disorders. The main goal was to understand if it is possible to achieve any kind of improvement in their condition, by evaluating the scores of the Achenbach Teacher's Report Form (TRF) in the beginning and ending of the experimental period. Results showed very interesting improvements in symptoms of CD, ODD and ADHD-HI (hyperactive-impulsive), while ADHD-PI (predominantly inattentive) showed only minor improvements. The overall symptom improvement was 43% across pathologies, which demonstrates that TJQ and QG may be a promising treatment of symptoms for children with behavioural disorders. More research is needed with controlled experimental designs and statistically representative samples in order to fully comprehend the versatility of these modalities.

A Longitudinal Examination of the Relation Between Internalizing Problem Behaviors and Early Adolescent Cigarette Smoking

ABSTRACTObjective: The purpose of the present study was to investigate the longitudinal relation between internalizing problem behaviors (measured with the anxious/depressed and somatic complaints subscales of the Achenbach Teacher's Report Form) and self-reported cigarette smoking behavior and intentions during early adolescence. In addition, a possible mediating role of perceived harm was investigated. Methods: Sixth graders and their teachers were surveyed in the sixth grade and students were surveyed again in the seventh grade. Smoking behavior and intentions were assessed with five items including lifetime use, 30-day use, tobacco user status (nonsmoker to heavy smoker), and two intentions/behavioral expectations items. In addition to perceived harm from smoking, reasons for smoking and reasons for not smoking were included on the survey. Results: As hypothesized, teacher reports of sixth-grade internalizing problem behaviors were negatively related to seventh-grade smoking behavior and intentions. Moreover, perceived harm from smoking was negatively related to smoking and intentions. The hypothesized mediating role of perceived harm in the internalizing to smoking relationship was not supported. Conclusions: Potential differences in the relation between internalizing and smoking across adolescence are discussed. Specifically, the results of the present study and an examination of prior literature suggest that in early adolescence internalizing problems are negatively related to cigarette smoking, whereas in middle and late adolescence the opposite is true.

Teachers' Ratings of Preschool Children's Behaviour: Inter-teacher Agreement and Variation in their Agreement

TEACHER RATING SCALES ARE an efficient, practical way to gather information on children's behaviour problems in school. Previous research has reported on agreement between parents' and teachers' reports, but less attention has been paid to inter-teacher agreement in young children, to the distinction between relative and absolute agreement, or to variability in teachers' agreement. In the present study, 26 United States teachers of three- to five-year-olds reported on the behaviour of 132 children in their classrooms, with the widely used Achenbach Teacher Report Form. Stronger agreement was seen on ratings of externalising than internalising behaviour. Absolute agreement was not always high even when teachers showed close relative agreement. Agreement varied significantly across informant pairs, suggesting that some teacher pairs rate children's behaviour in very similar ways, while others agree very little. Agreement was stronger in higher-SES than lower-SES classrooms.

The impact of maternal age on the effects of prenatal alcohol exposure on attention.

Prenatal exposure to alcohol has a variety of morphologic and neurobehavioral consequences, yet more than 10% of women continue to drink during pregnancy, placing their offspring at risk for fetal alcohol spectrum disorders (FASD). Identification of at-risk pregnancies has been difficult, in part, because the presence and severity of FASD are influenced by factors beyond the pattern of alcohol consumption. Establishing maternal characteristics, such as maternal age, that increase the risk of FASD is critical for targeted pregnancy intervention. We examined the moderating effect of maternal age on measures of attention in 462 children from a longitudinal cohort born to women with known alcohol consumption levels (absolute ounces of alcohol per day at conception) who were recruited during pregnancy. Analyses examined the impact of binge drinking, as average ounces of absolute alcohol per drinking day. Smoking and use of cocaine, marijuana, and opiates were also assessed. At 7 years of age, the children completed the Continuous Performance Test, and their teachers completed the Achenbach Teacher Report Form. After controlling for covariates, stepwise multiple regression analyses revealed a negative relation between levels of prenatal binge drinking and several measures of attention. The interaction between alcohol consumption and maternal age was also significant, indicating that the impact of maternal binge drinking during pregnancy on attention was greater among children born to older drinking mothers. These findings are consistent with previous findings that children born to older alcohol-using women have more deleterious effects of prenatal alcohol exposure on other neurobehavioral outcomes.

Short Stature in a Population-Based Cohort: Social, Emotional, and Behavioral Functioning

The goal was to determine whether there were significant differences between children of normative versus short stature in behavioral functioning and peer relationships, according to teacher and child reports. The study included 712 boys and girls in the sixth grade, from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Main outcome measures included Achenbach Teacher's Report Form internalizing, externalizing, and total scores; Children's Depression Inventory scores (child report); Life Orientation Test-Revised scores (child report); Child Behavior with Peers questionnaire asocial with peers, excluded by peers, and peer victimization subscale scores (teacher report); peer social support and victimization scores (child report); and relationships with peers score (teacher report). In bivariate comparisons, these outcomes were compared for children of relatively short (height of <10th percentile) versus nonshort (height of > or =10th percentile) stature, and effect sizes were calculated. Multivariate linear regression models adjusted for maternal education, income/needs ratio, race, and gender. Effect sizes ranged from 0.00 to 0.35. Short children reported marginally higher levels of self-perceived peer victimization, compared with their nonshort peers. There were no significant differences in the rest of the outcomes for children of short versus nonshort stature, in either unadjusted or adjusted models. Although short children from a population-based sample reported marginally higher levels of self-perceived peer victimization, they did not differ from their nonshort peers in a range of social, emotional, and behavioral outcomes.

Comparing the psychometric properties of multiple teacher report instruments as predictors of bipolar disorder in children and adolescents

The psychometric properties of four teacher report measures and their utility for accurate diagnosis of pediatric bipolar spectrum disorders (BPSDs) were examined. Participants were 191 youth (65% male; 62% African-American; 23% diagnosed with a BPSD), age 5-18 (M=10.16, SD=3.27) years, 70% recruited from a community mental health center and 30% recruited from a mood disorders clinic. Teachers "who knew the child best" were asked to complete the Achenbach Teacher Report Form (TRF) as well as teacher versions of the General Behavior Inventory (T-GBI), the Child Mania Rating Scale (CMRS-T), and the Young Mania Rating Scale (T-YMRS). Teacher response rates and missing data varied significantly depending on the age of the child. Exploratory factor analysis identified stable and interpretable factors; however, receiver operating characteristic (ROC) and logistic regression analyses showed that teacher report measures were not able to discriminate BPSD cases from non-BPSD cases, or from attention deficit hyperactivity disorder (ADHD) cases. Teacher report appears to be insufficiently specific or sensitive to BPSD for clinical diagnostic use, although teacher scales might have research utility.

Mental health of Bosnian refugee children: A comparison of clinician appraisal with parent, child and teacher reports

This study compares clinician appraisal of Bosnian refugee children with independent parent, child and teacher reports. From whom and by what means can children “at risk” be reasonably identified? Forty-eight Bosnian refugee children (aged 7–20), resettled in Sweden 1994–95, were assessed clinically by means of a semi-structured interview. Thereafter, standardized mental health questionnaires were administered to parents (Achenbach's Child Behavior Checklist), children (Achenbach's Youth Self-Report and Macksoud's Posttraumatic Stress Reaction Checklist) and teachers (clinician designed School Competence Scale and Achenbach's Teacher's Report Form). On clinician interview, nearly half of the children (48%) were identified with one or more mental health problem “demanding further attention”. Depressiveness was the single most prevalent symptom (31%); followed by post-traumatic stress (23%), and anxiety-regressiveness (15%). At the same time, 75% of the children were rated by teachers as “quite competent” in school. Parent, child and clinician appraisals of primary school children showed broad similarities. Teachers reported a similar prevalence of child distress, but identified different symptoms and different children demanding attention. Evaluation of teenage youths showed greater disparity: teenagers labeled their own symptoms more often as post-traumatic stress reactions and teachers identified few youths in need of attention. Inter-relatedness among parent, child and clinician appraisals supports the robustness of our semi-structured interview. At the same time, apartness of teacher report underscores the need to incorporate an outside-world vantage point in the process of risk assessment. Also, a more concrete presentation of post-traumatic stress reactions and a higher “further attention” threshold for inward emotional problems seem called for.

Convergent Validity with the BERS-2 Teacher Rating Scale and the Achenbach Teacher’s Report Form: A Replication and Extension

In the present study, we sought to extend instrument validation research for a strength-based emotional and behavior rating scale, the Teacher Rating Scale of the Behavior and Emotional Rating Scale-Second Edition (BERS-2; Epstein, M. H. (2004). Behavioral and emotional rating scale (2nd ed.). Austin, TX: PRO-ED) through the use of convergent validation techniques. The associations between the strength-based domains of the BERS-2 were examined in relation to problem syndrome subscales of the Teacher’s Report Form (TRF; Achenbach, T. M. (1991b). Manual for the teacher’s report form and 1991 profile. Burlington: University of Vermont, Department of Psychiatry). Both measures were conducted with 58 students with emotional disturbance in grades 2 through 12. The overall convergent validity of the BERS-2 and the TRF was strong, particularly for TRF externalizing problems and associated syndromes. However, less evidence emerged for the convergence of domain subscales characterized by behaviors of an internalizing nature. These results provide further support for the use of the BERS-2 in the assessment of the social and behavioral functioning of students with emotional disturbance.

Teacher and Parent Ratings of Children With Depressive Disorders

The fields of child psychology and psychiatry have not yet established the clinical presentation in school of children and adolescents who have been diagnosed as having a depressive disorder. To address this issue, the authors used teacher ratings on scale oriented to the third, revised edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-III-R). Based on DSM-III- R diagnoses generated from interviews—using the Schedule for Affective Disorders and Schizophrenia for School Age Children, Epidemiological Version (K-SADS-E)—of parents and children ages 6 to 18 years old ( N = 153), the authors formed three groups of children: Depressed, Attention-Deficit/ Hyperactivity Disorder, and Control. They then used the DSM-oriented scales of Achenbach's Teacher's Report Form and the Child Behavior Checklist, the latter completed by parents, to compare the children in each group.Teacher— parent agreement on the scales was consistent with the results from past studies.Teacher ratings distinguished among the groups almost identically to parent ratings; in particular, the Affective Problems scales significantly differentiated the Depressed group from the other two groups. Furthermore, teachers rated substantial numbers of members of the Depressed group with serious levels of both affective and anxious symptoms. Overall, teacher accuracy in identifying children with depression was 66% on the Affective Problems scales. In addition, the ratings identified two subgroups of the Depressed group: Parent-Identified Only and Teacher/Parent-Identified. Consequently, teachers appear to make clinically relevant ratings of depression in children that may enhance the diagnosis and treatment monitoring of depressive disorders in children and adolescents.

The Role of Providers in Mental Health Services Offered to American-Indian Youths

The Role of Providers in Mental Health Services Offered to American-Indian Youths

Evaluation of a classroom program of creative expression workshops for refugee and immigrant children

This evaluative study assessed the effect of a creative expression program designed to prevent emotional and behavioral problems and to enhance self-esteem in immigrant and refugee children attending multiethnic schools. The 12-week program involved 138 children, aged 7 to 13, registered in both integration classes designed for immigrant children and regular classes at two elementary schools. Pretest and posttest data were collected from the children themselves and from their teacher. Teachers used Achenbach's Teacher's Report Form to assess the emotional and behavioral symptoms of their pupils whereas children self-reported their symptoms with the Dominic, a computerized questionnaire. Self-esteem was measured with the Piers-Harris Self-Concept Scale administered by interviewers to the children. At the end of the program, the children in the experimental groups reported lower mean levels of internalizing and externalizing symptoms and higher mean levels of feelings of popularity and satisfaction than the children in the control groups, when controlling for baseline data. In integration classes, the effect on self-esteem was especially notable in boys. The intervention's effect on internalizing and externalizing symptoms was not modified by gender, age or fluency in the mainstream language. The study provides some evidence that creative workshops in the classroom can have a beneficial effect on the self-esteem and symptomatology of immigrant and refugee children from various cultures and backgrounds. These quantitative results support previous qualitative analysis showing that the workshops participate in the reconstruction of a meaningful personal world while simultaneously strengthening the link of the child to the group. They also transform the teachers' perceptions of newcomers by placing an emphasis on their strength and their resilience, while not negating their vulnerabilities.

Early motherhood and disruptive behaviour in the school‐age child

To determine the significance of young maternal age, family adversity and maternal behaviour during mother-toddler interaction in the prediction of child disruptive behaviour at age eight. From an ongoing longitudinal study of infants at risk for later psychopathology (n = 362), 72 young mothers aged between 15 and 24 y (median 22 y) at first birth were compared with 197 primiparous older mothers ranging in age from 25 to 41 y (median 29 y). Family adversity at childbirth was assessed using a modified version of Rutter's Family Adversity Index (FAI) and measures of child disruptive behaviour at age eight were obtained using Achenbach's Teacher Report Form (TRF). An observational procedure was used to assess maternal behaviour during mother-child interaction at the age of 2 y. Young mothers encountered more adverse family characteristics and were more inadequate, restrictive and more negative during interaction with their toddlers. Their school-aged children showed higher scores on all disruptive behaviour scales of the TRF. Hierarchical regression analyses revealed that family adversity and maternal behaviour during toddler interaction could account for most of the association between early motherhood and child disruptive behaviour. The impact of young motherhood on child mental health is not confined to teenage mothers and is mainly attributed to psychosocial and interactional factors.

Arterial switch with full-flow cardiopulmonary bypass and limited circulatory arrest: Neurodevelopmental outcome

Objectives Neonatal cardiac surgery has been associated with unfavorable neurodevelopmental events. We investigated a patient cohort operated on predominantly with full-flow cardiopulmonary bypass (150 mL · kg −1 · min −1, α-stat, α-blockade, median arrest = 6 minutes, temperature of 22°C) as the major support strategy for neonatal arterial switch operations (transposition of the great arteries and intact ventricular septum). Methods Seventy-four patients and “best-friend” control subjects were assessed 109 months (range, 48-166 months) postoperatively with general medical and neurologic evaluation, IQ testing, formal movement scores, and detailed parent-teacher behavioral-social reports. Fetal, neonatal, and perioperative data were collated. Results The prevalence of perioperative seizures was 6.8% (4/5 cases occurring preoperatively). The incidence of all perioperative neurologic abnormalities was 20%. Patients who had a neurologic event were (as a group) older at the time of operation and had a lower arterial blood pH before the operation. Selected perioperative factors (not related directly to cardiopulmonary bypass variables) predicted early (before discharge) neurologic outcome in a multivariate model. At late assessment, patients were more likely than control subjects to have a mild neurologic abnormality ( P = 0.002). Full-scale IQ scores (Wechsler Preschool and Primary Scale of Intelligence and Wechsler Intelligence Scale for Children—Third Edition) were higher in control subjects (101.9 [SD = 13] vs 108.6 [SD = 12], P = .0007), with both groups having scores greater than the population-based test means. Full-scale IQ scores related most significantly to years of paternal education (β = 1.51, P = .0078) but were also influenced by perioperative neurologic abnormalities, birth weight, and circulatory arrest time. Patients had higher motor impairment scores (Movement Assessment Battery) than control subjects ( P = .0004). Parents (Achenbach Child Development Checklist) assigned higher total social-behavioral competence scores to control subjects ( P = .05). Teachers (Achenbach Teacher Report Form) suggested that patients were more likely to be perceived as having various speech and expressive language problems, as well as minor behavioral problems. Conclusion With the perioperative strategies used, not all survivors can be considered (neurodevelopmentally) normal at late follow-up, although the risk of important impairment is low. Perioperative events might have long-term prognostic value. On the basis of this study and published data regarding other strategies, continued application of full-flow cardiopulmonary bypass is justified, with the proviso that further investigation is required.

Effects of phenobarbital and multiple-dose corticosteroids on developmental outcome at age 7 years

Objective To determine the effects of phenobarbital and repeated antenatal steroid use on the primary outcome (intelligence and achievement) and secondary outcomes (behavior and head circumference) at age 7 years. Methods This study was a secondary analysis of a double-blind clinical trial (phenobarbital–vitamin K versus placebo). Intelligence (Wechsler Intelligence Scale for Children, third edition), achievement (Wide Range Achievement Test, third edition), and behavioral (Achenbach Teacher’s Report Form and the Child Behavioral Check List) testing and head circumference measurement were performed on 7-year-old children whose mothers participated in a trial to determine if antenatal phenobarbital and vitamin K prevented severe intracranial hemorrhage. Antenatal steroid therapy in these women was repeated weekly. Results Two hundred ninety-nine of 372 newborns (80%) whose mothers participated in the trial were followed up at age 7 years. Comparing mean (± standard deviation [SD]) Wechsler Intelligence Scale for Children scores in the placebo versus treatment groups, there were no differences ( P > .4) in Full Scale IQ (100.3 ± 14.2 versus 100.6 ± 14.2), Performance IQ (100.3 ± 14.6 versus 101.5 ± 15.6), and Verbal IQ (100.2 ± 14.9 versus 99.6 ± 13.7). Comparing mean (± SD) Wide Range Achievement Test standardized scores in the placebo versus treatment groups, there were no differences ( P > .4) in Reading (97.3 ± 13.9 versus 98.0 ± 14.9), Spelling (95.8 ± 12.7 versus 95.3 ± 13.3), Mathematics (95.9 ± 13.8 versus 94.5 ± 14.5), or head circumference measurements (20.3 ± 0.6 cm versus 20.4 ± 0.6, P > .2). Similarly, there were no differences in the mean Achenbach Teacher’s Report Form and Child Behavioral Check List scores between the placebo and treatment groups. Conclusion Antenatal phenobarbital and repetitive antenatal corticosteroid therapy was not associated with adverse effects on intelligence, achievement, behavior, or head circumference at age 7 years.

Depression in early adolescence: relation to externalising and internalising behaviour.

The relationship between depression, on the one hand, and externalising and internalising behaviour, on the other, in 151 adolescents (79 boys and 72 girls) was examined with respect to the possible moderating role of sex-role stereotyping. The Reynolds Adolescent Depression Scale, the Achenbach Teacher Report Form, and the Australian Sex-Role Scale were used to assess the hypothesis that adolescents adapt to the experience of depression in gender-appropriate ways. A regression analysis indicated that the pattern of relationships was different for boys and girls. The hypothesis was supported for boys and externalising behaviour but not for girls and internalising behaviour.