Adaptive Functioning In Children Research Articles

Teacher‐delivered resilience‐focused intervention in schools with traumatized children following the second Lebanon war

The 2006 Lebanon War exposed children in the north of Israel to daily rocket attacks. To cope with the massive psychological needs, a teacher-delivered protocol focusing on enhancing personal resilience was implemented. Children were assessed for risk factors, symptoms, and adaptation before the 16-week program (Time 1; n = 983) and after its completion (Time 2; n = 563). At a 3-month follow-up (Time 3; n = 754) children were assessed together with a waiting-list comparison group (n = 1,152). Participating children showed a significant symptom decrease at Time 2 and significantly fewer symptoms than the control group at Time 3. Six or more risk factors were associated with greater symptoms and parental concern about the child's adaptive functioning. Teachers are valuable cost-effective providers for clinically informed interventions after mass trauma and disaster.

The Relationships Among Adaptive Behaviors of Children with Autism, Family Support, Parenting Stress, and Coping

Background: As the number of children diagnosed with autism continues to rise, resources must be available to support parents of children with autism and their families. Parents need help as they assess their unique situations, reach out for help in their communities, and work to decrease their stress levels by using appropriate coping strategies that will benefit their entire family.Methods: A descriptive, correlational, cross-sectional study was conducted with 75 parents/primary caregivers of children with autism. Using the McCubbin and Patterson model of family behavior, adaptive behaviors of children with autism, family support networks, parenting stress, and parent coping were measured. Findings and Conclusions: An association between low adaptive functioning in children with autism and increased parenting stress creates a need for additional family support as parents search for different coping strategies to assist the family with ongoing and new challenges. Professionals should have up-to-date knowledge of the supports available to families and refer families to appropriate resources to avoid overwhelming them with unnecessary and inappropriate referrals.

Adaptive functioning in children in the first six months after surgery for brain tumours

Purpose. To examine the adaptive functioning of children who underwent surgery for brain tumours with a view to analyse the related acute impairments and to describe their short-term outcome.Method. We investigated adaptive functioning in 25 children (ranging from 2 to 18 years of age) for 40 days and again 3 and 6 months after they underwent surgery for various brain tumours. The Vineland Adaptive Behaviour Scales (VABS) were used to assess their adaptive functioning, considering the four main domains and all the subdomains.Results. The results remained stable over the follow-up period considered. The domain in which the scores were most severely affected was Daily Living, followed by the Socialisation and Communication domains. Within the Communication domain, the abilities investigated in the Receptive subdomain revealed the worst impairments. Within the Daily Living domain, impairments were most evident in the children's capacity to take care of themselves and handle domestic activities. In the Socialisation domain, Play and Leisure Time, and Interpersonal Relationships were the subdomains most severely impaired.Conclusions. These findings are relevant because identifying children's adaptive functioning difficulties sooner could help their rehabilitation to be tailored and thus have a positive fallout on their long-term outcome.

Phenotypic Overlap Between Core Diagnostic Features and Emotional/Behavioral Problems in Preschool Children with Autism Spectrum Disorder

This study examined the phenotypic overlap between core diagnostic features and emotional/behavioral problems in a sample of 335 preschool children with autism spectrum disorder (ASD). Results from principal component analysis (2 components; 49.70% variance explained) suggested substantial phenotypic overlap between core diagnostic features and emotional/behavioral problems. Component I, Emotional Behavioral Repetitive Problems, was independent of the children's intellectual, adaptive functioning, and structural language abilities. Component II, Social Communication Deficits, was negatively related to the children's intellectual, adaptive functioning, and structural language abilities. Both components were positively related to parental stress. This exploratory study contributes to our understanding of the ASD phenotype and provides further support for including emotional/behavioral problems as part of the clinical characterization of children with ASD.

The development of a diagnostic instrument to measure social information processing in children with mild to borderline intellectual disabilities

A growing interest exists in the measuring of social adaptive functioning in children with mild to borderline intellectual disabilities (MBID), but valid instruments to measure this construct are lacking. The aim of the present study was to develop such an instrument and to examine it on its discriminate validity. In 141 children aged 8–12 years a new test battery was examined in four groups either with MBID, behaviour problems or both, and typically developing peers. The results show that children with either MBID or behaviour problems or both show more hostile intent attributions, set more internal revenge goals, generate more aggressive and fewer assertive responses, feel more confident in inadequate responses en select fewer assertive responses, than their typically developing peers. Children with MBID are characterized by relying on earlier experiences in encoding information, a small response repertoire, positive evaluation of submissive but not assertive responses, and the selection of aggressive responses. In addition, they have more problems with perspective taking, problem recognition, interpretation in general, inhibition, working memory, and emotion recognition, than their typically developing peers. Further, children with MBID and behaviour problems have more difficulties in social information processing when the information in social situations is more complex. It is concluded that the tasks of the test battery can discriminate between groups, and after further development of the material, can be used to obtain information on the competencies and disabilities in social information processing and social cognitive skills, in order to be able to offer adequate treatment to these children.

Factors associated with caregiving burden and maternal pessimism in mothers of adolescents with an autism spectrum disorder in Taiwan

Relative to the United States and other western countries, less research has focused on factors associated with caregiving burden and maternal pessimism in Taiwanese mothers of adolescents with an autism spectrum disorder (ASD). The characteristics of 50 adolescents with an ASD living at home in Taiwan and its association with caregiving burden and maternal pessimism were examined. The age range of adolescents with an ASD was from 10 to 18. Mothers, aged 35 to 55 years, completed self-report written questionnaires regarding their child's adaptive functioning and their own perceptions of caregiving burdens and concerns. Findings indicated that functional independence, severe maladaptive behaviours and severity of autism were predictive of maternal caregiving burden. Maternal pessimism was associated with functional independence and severity of autism. The findings of this study indicated that occupational therapy practitioners could focus on training functional independence of the individual with an ASD to meet the family's need in Taiwan. Researchers should pay significant attention to the lifespan issues of autism in Taiwanese families. The major limitations of this study were small sample size and without a comparison group. Future research using larger samples with a comparison group is needed.

Developmental trajectories of respiratory sinus arrhythmia and preejection period in middle childhood

Autonomic nervous system (ANS) activity has been linked repeatedly to children's socioemotional and behavioral adaptive functioning and development, yet the literature on how various indexes of ANS activity develop in childhood is sparse. We utilized latent growth modeling to investigate the development of respiratory sinus arrhythmia (RSA), an established index of parasympathetic nervous system (PNS), and preejection period (PEP), a marker of sympathetic nervous system (SNS) influence on the heart, in children aged 8-10 years. At age 8, 251 children (128 girls, 123 boys; 162 European American, 89 African American) participated. Longitudinal data were collected during two additional waves when children were 9 and 10 years of age, with a 1-year lag between each wave. Children's RSA and PEP exhibited significant stability over time. Marginally significant variability was found among children in how RSA changed over time (slope), but there was no significant interindividual variability in PEP changes over development. A conditional growth curve model (i.e., one with predictor variables) showed that initial levels of RSA and PEP and the slope of RSA over time were predicted by several demographic factors including the child's sex and race; RSA of European American children showed significant increases over time while African American children had higher initial RSA but no significant change over time. Findings extend basic knowledge in developmental biopsychology and have implications for research focusing on ANS measures as important predictors, moderators, and mediators of childhood adaptation.

Autoimmune disease in mothers with the FMR1 premutation is associated with seizures in their children with fragile X syndrome

An increased prevalence of autoimmune diseases in family members of children with autism spectrum disorders (ASD) has been previously reported. ASD is also a common problem co-occurring in children with fragile X syndrome (FXS). Why ASD occurs in some individuals with FXS, but not all, is largely unknown. Furthermore, in premutation carrier mothers, there is an increased risk for autoimmune diseases. This study compared the rate of ASD and other neurodevelopmental/behavioral problems in 61 children with FXS born to 41 carrier mothers who had autoimmune disease and in 97 children with FXS of 78 carrier mothers who did not have autoimmune disease. There were no significant differences in the mean age (9.61 ± 5.59 vs. 9.41 ± 6.31, P = 0.836), cognitive and adaptive functioning in children of mothers with and without autoimmune disease. Among children whose mothers had autoimmune disease, the odds ratio (OR) for ASD was 1.27 (95% CI 0.62–2.61, P = 0.5115). Interestingly, the OR for seizures and tics was 3.81 (95% CI 1.13–12.86, P = 0.031) and 2.94 (95% CI 1.19–7.24, P = 0.019), respectively, in children of mothers with autoimmune disease compared to children of mothers without autoimmune disease. In conclusion, autoimmune disease in carrier mothers was not associated with the presence of ASD in their children. However, seizures and tics were significantly increased in children of mothers with autoimmune disease. This suggests a potential new mechanism of seizure and tic exacerbation in FXS related to an intergenerational influence from autoimmunity in the carrier mother.

Predicting Functional Outcome for Children on Admission After Burn Injury: Do Parents Hold the Key?

In this study, a predictive model about recovery postburn was developed for purposive case selection using explanatory case methodology. Seven cases (each comprising a child, caregiver, and teacher) participated. Children were aged 6 to 13 years with between 2% and 35% TBSA burned. Caregivers completed assessments of premorbid family and child-adaptive functioning, and family, parental, and child functioning during acute and postacute treatment periods. Teachers completed assessment of premorbid and postacute child-adaptive functioning. Children and their respective caregivers were interviewed to obtain further insights into outcomes. Assessments and interviews were completed before skin healing, on skin healing, and at 6 months postburn injury. Descriptive analysis of the quantitative data and content analysis of qualitative data was undertaken for individual cases and across all cases. In keeping with the explanatory case methodology, replication logic was applied to each case to determine the extent to which theoretical propositions based on the predictive model were supported. Findings suggest that children whose parents had high state anxiety in combination with ineffective coping strategies seemed most at risk of a nonadaptive outcome after a burn injury. There was little support for the rival explanations that child and family functioning or injury severity most consistently predicted outcome postburn injury.

Exploring the Relationship between Exposure to Violence, Perceptions of Neighborhood Safety, and Children's Adaptive Functioning: Clinical and Community Implications

This study explored the relationship of exposure to violence and children's perceptions of neighborhood safety and children's adaptive functioning. It used a cross-sectional quadi-experimental design of 300 inner-city children and a bttery of standardized measures, which included the Child Maltreatment Classification Scheme, Exposure to Community Violence Scale, the Domains of Safety Subscale for Neighborhood, and the Child Behavior Checklist-Teacher's Report form. Hierarchal regression analysis revealed that child maltreatment history and perceptions of neighborhood safety were significantly related to children's overall adaptive functioning. Social workers can help by engaging in efforts to increase neighborhood safety and reinforcing positive adaptive psychosocial functioning of children at risk or exposed to violence.

Active seizures are associated with reduced adaptive functioning in children with epilepsy

Children with epilepsy are at risk of suboptimal adaptive functioning. Research has not yet established how specific seizure and treatment variables may affect adaptive functioning, which would allow clinicians to better identify at-risk children. This study sought to determine the seizure and treatment variables predictive of adaptive functioning. Forty-six children with epilepsy participated in this study. Using multiple regression, active seizures (one or more seizures in the prior year) significantly predicted scores on the General Adaptive Composite of the Adaptive Behavior Assessment System-II. The active seizures variable uniquely explained 19% of the variance in adaptive functioning, with children with active seizures demonstrating significantly poorer adaptive functioning. The number of current AEDs, past AEDs, seizure types, age at seizure onset, and temporal lobectomy were not significant predictors. Post hoc analyses that divided the active seizures group according to seizure frequency in the prior month did not find significant differences in adaptive functioning. The results of this study suggest that children with seizures that are not fully controlled are at greater risk of suboptimal adaptive functioning.

The Behavioral Phenotype of School-Age Children with Shwachman Diamond Syndrome Indicates Neurocognitive Dysfunction with Loss of Shwachman-Bodian-Diamond Syndrome Gene Function

To investigate the cognitive, behavioral and adaptive functioning of children with Shwachman-Diamond syndrome (SDS). Thirty-two children with SDS (6-17 years) were evaluated by use of standardized neuropsychological tests. Results were compared with normative data, unaffected siblings (n = 13), and age-and sex-matched children with cystic fibrosis (CF; n = 20). Although intragroup variability in performance was evident, children with SDS displayed weaker overall intellectual reasoning, higher-order language skills, perceptual reasoning, visual-motor processing speed, visual motor- integration, visual executive problem-solving, attention, and aspects of academic achievement, as well as lower functional level of independence relative to the general population. Significant issues with behavior were also identified, including prior formal diagnoses and social problems. Lower abilities were found relative to sibling and CF control subjects and were not associated with secondary complications of SDS, age, or sex. Neurocognitive deficits in subjects with SDS are largely independent of family environment and having a chronic illness and are likely the consequences of Shwachman-Bodian-Diamond syndrome gene dysfunction. There is a need for a broad-based approach to the assessment of cognitive function and appropriate remediation of individuals with SDS.

Relations between Emotion Regulation and Adaptive Functioning in Children and Adolescents with Williams Syndrome

Relations between Emotion Regulation and Adaptive Functioning in Children and Adolescents with Williams Syndrome

Children's expressed emotions when disclosing maltreatment

Objective Our goal was to examine children's expressed emotions when they disclose maltreatment. Little scientific research exists on this topic, and yet children's emotional expressions at disclosure may inform psychological theory and play a crucial role in legal determinations. Method One hundred and twenty-four videotaped forensic interviews were coded for children's emotional displays. In addition, children's trauma-related symptoms (depression, dissociation, and PTSD) and global adaptive functioning were assessed, and abuse type and frequency were documented. Results Most children in the sample evinced neutral emotion during disclosure. However, stronger negative reactions were linked to indices of psychopathology. Number of abuse experiences was inversely related to negative emotional displays. Conclusion Fact finders may profit from knowing that maltreated children do not necessarily cry or display strong emotion when disclosing maltreatment experiences. Nevertheless, predictors of greater negative affect at disclosure can be identified: fewer abuse experiences; higher global adaptive functioning; and for sexually abused children, greater dissociative tendencies. Practice implications Although further research is needed, practitioners should consider that children who disclose abuse may display relatively neutral affect despite having experienced maltreatment.

Applying the polyvagal theory to children's emotion regulation: Social context, socialization, and adjustment

Effective emotion regulation is essential for children's positive development. Polyvagal theory provides a framework for understanding how parasympathetic regulation of cardiac activity contributes to children's adaptive versus maladaptive functioning. Maintenance of cardiac respiratory sinus arrhythmia (RSA) under social challenge should support emotion regulation and behavioral adjustment. Children's effective parasympathetic regulation and behavioral adjustment should be supported by appropriate parental socialization. These proposals were evaluated in a short-term longitudinal study of 94 preschool-aged children. Parenting and basal RSA were measured at home, then 6–10 months later behavioral adjustment and RSA in lab baseline and socially challenging contexts were measured. Children with relatively higher RSA in social challenge than at baseline (ΔRSA) had fewer internalizing problems (IP) and externalizing problems (EP), and better behavioral self-regulation (SR). Mothers who used more negative control had children with lower ΔRSA, more IP and EP, and less SR. Structural equation modeling showed that vagal regulation mediated associations between maternal negative control and children's adjustment; maternal negative control did not predict EP or SR after accounting for ΔRSA. Associations were consistent across boys and girls, with one exception: Higher ΔRSA was significantly associated with fewer EP in boys only. These findings suggest that the practical significance of physiological regulation might be best revealed in ecologically valid procedures, and that children's physiological mechanisms of emotion regulation are shaped by their experiences of parental socialization.

Parent Report of Attention Problems Predicts Later Adaptive Functioning in Children with Brain Tumors

Children with brain tumors are at risk for psychological and behavioral difficulties. This study examined the ability of parent report of attention problems, withdrawal, anxiety, and depression, as well as IQ, to predict later adaptive functioning in 42 children treated for brain tumors. Age at diagnosis, SES, gender, and scores on the Neurological Predictor Scale (NPS) also were examined as predictors. Parent report of attention problems, SES, and NPS were significant predictors of later adaptive functioning across domains. This finding highlights the ability of parent report of attention problems to predict later adaptive functioning in children treated for brain tumors.

Attention mediates radiation's impact on daily living skills in children treated for brain tumors

Radiotherapy is associated with an increased survival rate in children with brain tumors, but also with cognitive decline. This study examined the time-dependent effects of radiation treatment on adaptive functioning in children with brain tumors. The potentially mediating effects of attention span (Trial 1 of the Rey Auditory Verbal Learning Test [RAVLT]) assessed within 7 years of diagnosis were explored. Twenty-two children treated with cranial radiation for third ventricle or cerebellar tumors were included in this archival study. The mean age at diagnosis was 7.62 years (SD = 4.78) and 10.16 years (SD = 3.83) at evaluation. We examined the extent to which auditory attention span was able to mediate the relationship between time elapsed since the initiation of radiation treatment (M = 2.43 years; SD = 2.37) and adaptive functioning (Vineland Adaptive Behavior Scales [VABS]). Attention span was found to mediate the relationship between time since the initiation of radiation and daily living skills. These findings were shown to be specific to attention and not a reflection of generalized neuropsychological decline, nor were they a result of increasing time since diagnosis in and of itself. The results of this study suggest that time since radiation may directly decrease attention and poor attention in turn may be associated with lower adaptive functioning on tasks of daily living.

Effects of a Psychosocial Family-Based Preventive Intervention on Cortisol Response to a Social Challenge in Preschoolers at High Risk for Antisocial Behavior

Salivary cortisol levels during social challenge relate to adaptive functioning in children and adults. Low cortisol levels have been related to conduct problems and antisocial behavior. Although studies in rodents implicate early-life social experience in cortisol regulation, no studies with humans have examined the effects of an experimentally manipulated early-life social experience on cortisol regulation. To examine the effects of experimental manipulations of social experience on cortisol response to a social challenge in preschoolers at risk for antisocial behavior. Randomized controlled trial. Department of Child and Adolescent Psychiatry, New York University School of Medicine. Ninety-two preschool-age siblings of youths adjudicated for delinquent acts. Intervention Family-based intervention included 22 weekly group sessions for parents and preschoolers and 10 biweekly home visits conducted during a 6- to 8-month period. Salivary cortisol levels before and after a social challenge (entry into an unfamiliar peer group). Relative to controls, children in the intervention condition had increased cortisol levels in anticipation of the peer social challenge. Increases were relative to both preintervention cortisol levels during the challenge and cortisol levels in the home, which were not altered by the intervention. A family-based preventive intervention for children at high risk for antisocial behavior alters stress response in anticipation of a peer social challenge. The experimentally induced change in cortisol levels parallels patterns found in normally developing, low-risk children.

Disciplinary Style and Child Abuse Potential: Association with Indicators of Positive Functioning in Children with Behavior Problems

Reduction of ineffective parenting is promoted in parent training components of mental health treatment for children with externalizing behavior disorders, but minimal research has considered whether disciplinary style and lower abuse risk could also be associated with positive functioning in such children. The present study examined whether lower dysfunctional disciplinary style and child abuse risk was associated with children's positive self-concept, adaptive attributional style, and hopefulness. Recruited from children undergoing treatment for disruptive behavior disorders, 69 mother-child dyads participated, with maternal caregivers reporting on their disciplinary style and abuse potential and children reporting independently on their positive functioning (adaptive attributional style, overall self-concept, and hopelessness). Findings supported the hypothesized association, with lower scores on mothers' dysfunctional discipline style and abuse potential significantly predicting children's reported positive functioning. Future research directions pertaining to more adaptive functioning in children with behavior problems are discussed.

Development of a parent training program for children with pervasive developmental disorders

AbstractParent delivered interventions based on applied behavior analysis (ABA) for children with Pervasive Developmental Disorders (PDDs) have been evaluated using primarily single‐subject design methodology or small case series. While the results of these evaluations are encouraging, an important next step is to standardize the interventions to allow for replication across sites, in studies with large samples and measures of long‐term, clinically meaningful outcomes such as improvements in children's functioning and their relationships with parents. Accordingly, the Research Units on Pediatric Psychopharmacology and Psychosocial Interventions (RUPP Autism Network) assembled a detailed manual for a structured behavioral parent training (PT) program, developed treatment fidelity and training procedures, and conducted a pilot, feasibility study. The PT program is part of a large scale, multisite study intended to determine the efficacy of combined pharmacological treatment and behavioral intervention to improve behavior and adaptive functioning in children with PDD. This paper discusses the rationale for this project. A companion paper provides the results of our feasibility study on the PT program. Copyright © 2007 John Wiley & Sons, Ltd.