At-risk Preschoolers Research Articles

Family skill development for attention deficit hyperactivity disorder behavior problem alleviation model in at-risk preschool children: a mixed methods study

Introduction: Attention Deficit Hyperactivity Disorder is the most prevalent childhood mental health problem. This study examined families caring for children with ADHD and created a model to alleviate behavior problems in at-risk preschoolers. Methods: This exploratory sequential mixed-methods study comprised two phases. Phase 1 included a qualitative retrospective survey that examined family experiences in caring for ADHD children. This involved in-depth interviews with 14 family caregivers (FCGs) and utilized thematic content analysis. Phase 2 involved creating, implementing, and evaluating a family skill development model using a quasi-experimental design. Thirty FCG- ADHD at-risk preschool child dyads, utilizing services at two Child Development Clinics, were paired and equally divided into experimental and control groups. Data analysis used repeated measures ANOVA and covariances (ANCOVA). Results: The study FCGs reported that family-child interactions and positive parenting alleviated the ADHD at-risk preschool child’s behavior problems. The Family Skill Development for ADHD Behavior Problem Alleviation Model was constructed and validated. Results from within-group comparisons showed significant improvements in the experimental group, with reduced behavior problems (p<0.05, ηp2=0.28) in ADHD at-risk children, improved caregiver behaviors to alleviate the child’s behavior problems (p<0.01, ηp2=0.37), and enhanced family functions (p< 0.001, ηp2=0.42). Conclusions: The model significantly aids families in alleviating behavior problems in ADHD at-risk children, improving family functions and caregivers’ efforts to address the children’s behavioral issues. It is a promising parental intervention model for fostering healthy families and reducing behavior problems in ADHD-at-risk preschool children in northeastern Thailand and similar contexts.

Prevalence of Comprehensive Eye Examination in Preschool Children With Eye Conditions

IntroductionThe study's purpose is to assess the prevalence of comprehensive eye examinations (CEE) in multi-ethnic preschool children, including children with visually significant eye conditions, and identify factors associated with CEE. MethodsA sample of 9,197 African American (AA), Hispanic (HS), Asian American (AS), and non-Hispanic White (NHW) 6- to 72-month-old children was recruited for the Multi-Ethnic Pediatric Eye Disease Study from 2003-2011. Logistic regression performed in 2022 identified independent factors associated with parent-reported history of CEE. The proportion of children with previous CEE and the proportion with undetected amblyopia or strabismus were measured. ResultsCEE prevalence was 6.3% overall, and 38.3%, 24.8%, 19.1%, 15.1%, and 9.8% among children with strabismus, amblyopia, significant anisometropia, hyperopia, and astigmatism, respectively. Children without prior CEE were more likely to have undetected amblyopia or strabismus than those with CEE history (Ps<0.001). CEE prevalence was higher among older children. Prevalence varied by race/ethnicity, with 8.1%, 7.9%, 6.3%, and 4.9% of NHW, AS, AA, and HS children having had prior CEE, respectively; however, the differences did not remain after adjusting for other associated factors. Older age, a primary caregiver with a college/university degree or higher, having vision insurance, gestational age <33 weeks, neurodevelopmental disorder diagnosis, strabismus, and ocular disease history were all associated with a relatively higher CEE prevalence in multivariable analyses (P≤0.003 for all). ConclusionsCEE was uncommon among preschool children, including those with treatable vision disorders. Interventions, like parent education and vision insurance, are needed to improve CEE access and utilization for at-risk preschool children.

A Randomized Controlled Trial of the Effectiveness and Mechanisms of Change in a School-Based Intervention Combining Universal and Indicated Prevention for Preschoolers’ Behavior Problems

ABSTRACT The Social-Emotional Prevention Program (SEP) is a multi-focused intervention combining universal and indicated intervention strategies delivered face-to-face and through the use of technology. The study’s objectives were to assess comparatively SEP effectiveness as a function of preschoolers’ baseline risk of externalizing problems and to evaluate its hypothesized mechanisms of action. A randomized controlled trial (RCT) was conducted with five schools assigned to either the intervention or to a comparison condition (wait-list control). Structural equation models (SEM) and complier average causal effects (CACE) were conducted to evaluate program effectiveness and mechanisms of change. Research Findings: SEP participation was associated with improved social-emotional competence irrespective of baseline risk and at-risk preschoolers were more likely to exhibit reductions in externalizing problems. However, perceptions about which risk group benefited more varied as a function of rater. Patterns for SEP mechanisms of action suggest that these were similar across risk status with both child emotion regulation and parental emotion socialization practices emerging as paths to improved social-emotional competencies. Practice and Policy: The present findings add to the extant evidence suggesting that multi-focused programs combining universal and indicated prevention strategies could be successfully delivered in schools to promote social-emotional learning.

Using the Preschool Life Skills Program to Support Skill Development for Children with Trauma Histories.

The Preschool Life Skills (PLS) program has a wealth of evidence demonstrating efficacy in remediating important social and learning-to-learn skill deficits in at-risk preschoolers. Those same skill deficits also are common in older children in foster or residential care, most of whom have experienced some sort of trauma or other adverse childhood events. This study sought to evaluate individualized PLS curricula for two boys with substantial trauma histories and demonstrate how the PLS program could be delivered within a trauma-informed framework. We delivered the program and evaluated skill acquisition in a one-to-one setting in a UK-based clinic, and asked caregivers to assess skills at home. Results showed that both boys acquired skills targeted in their individual curriculum, but maintenance was sometimes inconsistent. Social validity assessments suggested that both boys enjoyed the training but were less definitive about its overall benefits. Caregivers rated the program highly and reported skill improvements at home. We discuss the implications of these findings in terms of adapting the PLS program to children with trauma histories.

Protocol for a randomized control trial of the Building Regulation in Dual Generations Program (BRIDGE): preventing the intergenerational transmission of mental illness in at-risk preschool children

BackgroundSince the onset of the COVID-19 pandemic, the worldwide prevalence of maternal depression has risen sharply; it is now estimated that one quarter of mothers experience clinically significant depression symptoms. Exposure to maternal depression during early childhood increases the risk for the development of childhood mental illness (MI) in offspring, with altered parenting practices mediating the association between maternal depression and child outcomes. Dual-generation interventions, which aim to simultaneously treat parent and child mental health, show promise for improving outcomes for mothers with depression and their young children. The Building Regulation in Dual Generations (BRIDGE) program combines Dialectical Behavior Therapy (DBT) and parenting skills training to concurrently treat maternal depression and improve parenting practices. In pilot within-group studies, BRIDGE has led to large reductions in maternal depression and child MI symptoms. The aim of the current study is to evaluate the efficacy of BRIDGE in reducing maternal depression and child MI symptoms (primary outcomes) as well as parenting stress and harsh parenting (secondary outcomes).MethodsA three-armed randomized control trial with equal group sizes will be conducted to compare the efficacy of (1) BRIDGE (DBT + parenting skills), (2) DBT skills training, and (3) services-as-usual. Participants (n = 180) will be mothers of 3- to 5-year-old children who report elevated depression symptoms. Those randomized to BRIDGE or DBT skills training will complete a 16-week group therapy intervention. Assessments will be administered at pre-intervention(T1) post-intervention (T2), and 6-month follow-up (T3).DiscussionDual-generation programs offer an innovative approach to prevent the intergenerational transmission of mental illness. The current study will add to the evidence base for BRIDGE by comparing it to a stand-alone mental health intervention and a services-as-usual group. These comparisons will provide valuable information on the relative efficacy of including parenting support in a mental health intervention for parents. The results will contribute to our understanding of how maternal depression affects children’s development and how intervening at both a mental health and parenting level may affect child and family outcomes.Trial registrationName of registry: Clinical Trials Protocol Registration and Results System; trial registration number: NCT05959538; date of registry: July 24, 2023; available: https://classic.clinicaltrials.gov/ct2/show/NCT05959538

Home representations of at-risk children in an emergency shelter

ABSTRACT Background Research is limited about the home representations of at-risk preschool children staying in emergency shelter care. Aims To examine representations of home in the house drawings and play narratives of eight at-risk children aged 5–6.5 years, in emergency shelter care. The one-on-one sessions held with the children has a uniform structure of a drawing task followed by play, forming an intermodal transfer. Methods The qualitative data analysis of the drawing processes, the drawings and observation of the dramatic play is based on phenomenological and thematical approaches. Results Three main themes were found: the house as a threatening space; expressions of difficulties in creating and maintaining the potential space; the added value of using drawing and play in the context of difficulties in creating or maintaining the potential space. Implications for practice and future research The study’s findings illustrate the potential advantage of intermodal transfer – this apparently allowed them to move between languages of expression, and offered them different opportunities for emotional regulation. In addition, the different layers of information that were expressed can help art therapists to support the child’s mentalization process. Future research is encouraged to further examine home representations of at-risk children with larger sample using intermodal transfer. Conclusions The study’s findings demonstrate the paradox that is bound within the invitation to draw/play about painful contents in art therapy, and the possible advantage in using intermodal transfer to mend the potential space’s interruptions and to enable further expression and working through. Plain-language summary The present study sought to examine home representations of eight maltreated children (age 5–7 years) staying in an emergency shelter in Israel, following domestic violence, abuse, and neglect. During individual meetings with the first author, the children were invited to draw a house using coloured pencils, and then to play the events happening in the drawn house, using a set of tiny animal figures, and a magic wand. Qualitative analyses of the data identified three main themes: the first was the house as a threatening space that exposes the figures to negative events such as rejection, injury and death; the second theme identified the children’s play/creative-space as interrupted and fragmentary; for example, there were pauses in the drawing process and/or play due to repetitive behaviours such as sharpening pencils; the third theme was the potential advantage of movement between drawing and play mediums that enables these children to express themselves despite interruptions in the play/creative space. Thus, we suggest that the invitation to engage in two expressive mediums during art therapy sessions may enable the child to move back and forth between them, while creating additional opportunities for expressing the unbearable on one hand and keeping a safe distance from these contents on the other. We recommend future research based on a session that provides access to different creative mediums, thus enabling further exploration of at-risk children’s expressiveness; a better understanding of the experiences of these children; and a better grasp of their needs in therapeutic contexts.

Effects of an Online Emotion Socialization Intervention for Parents of At-Risk Preschoolers Enrolled in Head Start During a Global Pandemic

Children from low-income families experience greater developmental risk factors, suggesting the need for evidence-based social-emotional interventions to support children and their families. This study explored the engagement, effectiveness, and acceptability of an unstudied online version of an evidence-based emotion-focused intervention – Tuning in to Kids Online (TIKOL). This pilot study within a small Head Start sample demonstrated that parents watched, on average, 97% of the ten modules across the program duration, and all reported using “quite a few” of the parenting skills taught. Outcome data revealed significant improvements in employing an emotion coaching parenting style. Distressing reactions and parent-reported child conduct problems both decreased. There were no significant reductions in emotion dismissing beliefs. High levels of treatment acceptability were reported. Treatment engagement, effectiveness, and acceptability findings from this pilot TIKOL intervention study support the need to study this accessible, online version of a well-supported parenting program approach.

The Impact of a High-Dosage Tutoring Program on Reading Achievement of Beginning Readers: A Multi-Level Analysis

The purpose of this randomized control trial (RCT) was to examine the impact of one-to-one high-dosage tutoring on reading achievement of kindergarten and first grade students, many at risk of reading failure. This nearly two-year study collected reading assessment data from 185 students, from across 13 classrooms, randomly assigned to either the one-to-one high-dosage tutoring group or the teacher-instruction-only group. Treatment students received tutoring support 2-3 times per week across the school year from specially trained tutors using a digital literacy platform. Tutoring focused on sequenced skills beginning with letter identification and sounds and moved to reading stories. The results of the Hierarchical Linear Modeling (HLM) analysis, from both Chapter One assessments as well as the nationally recognized assessments, indicate that Chapter One’s high impact tutoring program is highly effective in helping at-risk kindergarten and first grade students achieve reading proficiency. Tutored students outperformed non-tutored students on multiple measures of reading achievement.

Maternal invalidation and child RSA reactivity to frustration interact to predict teacher-reported aggression among at-risk preschoolers.

Aggression is a transdiagnostic indicator of risk and represents one of the most common reasons children are referred for mental health treatment. Theory and research highlight the impact of maternal invalidation on child aggression and suggest that its influence may vary based on differences in child physiological reactivity. Moreover, the interaction between these risk factors may be particularly pronounced among children of mothers with emotion regulation (ER) difficulties. The current study examined the independent and interactive effects of maternal invalidation and child physiological reactivity to frustration on teacher-reported aggression in an at-risk sample of preschool children. Participants included 77 mothers (Mage = 33.17 years, s.d. = 4.83; 35% racial/ethnic minority) and their children (Mage = 42.48 months; s.d. = 3.78; 56% female; 47% racial/ethnic minority). Groups of mothers with and without clinician-rated ER difficulties reported on maternal invalidation, and child respiratory sinus arrhythmia (RSA) was assessed continuously during a frustration task as an indicator of physiological reactivity. Teachers or daycare providers reported on child aggression. Results demonstrated positive associations between maternal ER difficulties and both maternal invalidation and child RSA reactivity to frustration. As expected, the interaction between maternal invalidation and child RSA reactivity was significant, such that higher maternal invalidation and greater child RSA reactivity to frustration predicted more aggression in a daycare or preschool setting. Importantly, this effect was demonstrated while controlling for demographic covariates and baseline RSA. Findings are in line with diathesis-stress and biosocial models of risk and point to multiple targets for prevention and early intervention.

Internalizing and Externalizing Problems Among At-Risk Preschoolers: The Mediating Role of Maternal Invalidation.

Children of parents with emotion regulation (ER) difficulties may be at heightened risk for internalizing and externalizing problems, and maternal invalidation may explain this association. The current study used a cross-informant design to test the indirect effect of clinician-rated maternal ER difficulties on teacher-reported internalizing and externalizing problems through maternal invalidation. This risk pathway was tested in two groups of preschoolers: children of mothers with ER difficulties and children of mothers without ER difficulties (healthy controls; HC). Participants were 85 mothers (Mage =33.30 years; 36% racial/ethnic minoritized status) and their children (Mage =4234 months; 47% racial/ethnic minoritized status). Maternal ER difficulties had a significant indirect effect on child internalizing problems and externalizing problems, specifically aggressive behavior, through maternal invalidation. Specifically, mothers with ER difficulties reported more maternal invalidation, and their children exhibited more internalizing problems and aggressive behavior in a preschool/daycare setting, pointing to multiple avenues for prevention and intervention.

The Impact of Childhood Social Skills and Self-Control Training on Economic and Noneconomic Outcomes: Evidence from a Randomized Experiment Using Administrative Data

A childhood intervention to improve the social skills and self-control of at-risk kindergarten boys in the 1980s had positive impacts over the life course: higher trust and self-control as adolescents; increased social group membership, education, and reduced criminality as young adults; and increased marriage and employment as adults. Using administrative data, we find this intervention increased average yearly employment income by about 20 percent and decreased average yearly social transfers by almost 40 percent. We estimate that $1 invested in this program around age 8 yields about $11 in benefits by age 39, with an internal rate of return of around 17 percent. (JEL I21, I26, I28, J13, J24, J31, Z13)

Task difficulty and private speech in typically developing and at-risk preschool children.

Private speech is a cognitive tool to guide thinking and behavior, yet its regulatory use in atypical development remains equivocal. This study investigated the influence of task difficulty on private speech in preschool children with attention or language difficulties. Measures of private speech use, form and content were obtained while 52 typically developing and 25 developmentally at-risk three- to four-year-old children completed Duplo construction and card sort tasks, each comprising two levels of challenge. In line with previous research, developmentally at-risk children used less internalized private speech than typically developing peers. However, both typically developing and at-risk children demonstrated a similar regulatory private speech response to difficulty with no systematic evidence of group difference. This was captured by an increase in all utterances, reduced private speech internalization, and more frequent forethought and self-reflective content. Results support the hypothesis of delayed private speech internalization but not regulatory deviance in atypical development.

Evaluating the Effectiveness of a Volunteer One-on-One Tutoring Model for Early Elementary Reading Intervention: A Randomized Controlled Trial Replication Study

This study examines the impacts of two AmeriCorps programs, Minnesota Reading Corps and Wisconsin Reading Corps, where AmeriCorps volunteers provide literacy tutoring to at-risk kindergarten through third-grade (K–3) students utilizing a response-to-intervention framework. This evaluation replicates a prior randomized controlled trial evaluation of the program 4 years later and for the first time evaluates the program model replicated in Milwaukee, Wisconsin. The results of the two evaluations showed that kindergarten and first-grade students who received a single semester of Reading Corps tutoring achieved significantly higher literacy assessment scores, and demonstrated meaningful and significant effects after a full-school year of the intervention for second- and third-grade students.

Teaching Parents of At-Risk Preschoolers to Employ Elaborated and Non-Elaborated Vocabulary Instruction During Shared Storybook Reading

ABSTRACT This study examines the influence of a parent workshop intervention on vocabulary acquisition of at-risk preschool children during parent-child shared storybook reading. Sixty-nine parents were randomly assigned to either treatment or control group. In the treatment condition, parents were taught to implement elaborated vocabulary instruction (definitions, synonyms, and examples) and non-elaborated vocabulary instruction (simple definitions only) during shared storybook reading (SSR). In the control group (stories only), parents read the same storybooks as the treatment families but did not provide direct vocabulary instruction. Children’s vocabulary learning was assessed using a researcher-designed assessment, Big Words for Little People (BWLP), at three time points during the study: before, after, and 14 days following the end of the intervention. The results suggest that meaningful explanations of unfamiliar words during parent-child shared storybook reading may be a viable strategy for fostering vocabulary learning, which is critical for later reading achievement.

Can Temperament Predict School Readiness in At-Risk Kindergarteners? A Combination of Variable-Oriented and Person-Oriented Approaches

ABSTRACT Research Findings: In this study, a combination of variable-oriented and person-oriented statistical analyses was used to examine the links between three temperament factors (negative affectivity, surgency/extraversion, effortful control) evaluated before entry into kindergarten and the cognitive and socioemotional dimensions of school readiness measured at the end of kindergarten. The sample included 98 children considered to be at risk because of their poor school readiness seven months before kindergarten entry. Multiple linear regressions showed that the temperament factors were associated differentially with the school readiness dimensions at the end of kindergarten. Three school readiness profiles (moderate cognitive and socioemotional risk, high socioemotional risk, high cognitive risk) were identified through latent profile analyses. A multinomial logistic regression showed that the temperament factors helped predict membership in the profiles. Practice or policy: Temperament thus represents an important determinant of school readiness and could be used to identify, within an at-risk population, children who are likely to present risks of a different nature at the end of kindergarten. Prevention programs and closer supervision during the transition to school could then be offered to these children.

Measuring Listening Comprehension and Predicting Language Development in At-Risk Preschoolers

ABSTRACT Listening comprehension involves the ability to understand and extract meaning from spoken sentences, stories, and instruction. This skill is vital for young children and has long-term effects on school achievement, employability, income, and participation in society. There is a lack of measures of young children’s listening comprehension skills. We report on a new measure of listening comprehension (LURI) that we tested in a group of at-risk preschoolers. Using IRT (Item Response Theory) analysis, we examined the psychometric properties of the instrument. Moreover, in a series of regressions, we found that the LURI measure predicted a range of other language skills better than standardized measures. Thus, the LURI test is a reliable and valid measure of listening comprehension. Assessing listening comprehension is a time-effective way of measuring a skill critically important to language development and represents the product of a range of different oral language processes.

Improving phonological awareness with Talking Tables in at-risk kindergarten readers

BackgroundFor young children experiencing phonological awareness (PA) difficulties, the need for early and targeted intervention to prevent reading disability is unequivocal. There are very few studies, however, on the efficacy of PA interventions delivered at school. AimsThis study examined the impact of an early PA intervention embedded within an oral language program designed for at-risk kindergartners. MethodsUsing a quasi-experimental pretest/posttest design, at-risk readers from four schools received either the 10-week intervention in small groups, three times a week for 30 min as a supplement to the regular classroom curriculum or served as controls not participating in the intervention and receiving the usual classroom instruction. ResultsChildren in the intervention group demonstrated a greater use of phonological awareness at posttest on overall composites of phonological processing, and on several individual accuracy and fluency measures targeting skills at the phoneme level. ConclusionsThe results add to accumulating evidence on the efficacy and effectiveness of teacher-delivered school-based early literacy interventions.

Effects of child-centered play therapy (CCPT) on disruptive behavior of at-risk preschool children in Head Start.

Effects of child-centered play therapy (CCPT) on disruptive behavior of at-risk preschool children in Head Start.

The Fast Track intervention’s impact on behaviors of despair in adolescence and young adulthood

How to mitigate the dramatic increase in the number of self-inflicted deaths from suicide, alcohol-related liver disease, and drug overdose among young adults has become a critical public health question. A promising area of study looks at interventions designed to address risk factors for the behaviors that precede these -often denoted-"deaths of despair." This paper examines whether a childhood intervention can have persistent positive effects by reducing adolescent and young adulthood (age 25) behaviors that precede these deaths, including suicidal ideation, suicide attempts, hazardous drinking, and opioid use. These analyses test the impact and mechanisms of action of Fast Track (FT), a comprehensive childhood intervention designed to decrease aggression and delinquency in at-risk kindergarteners. We find that random assignment to FT significantly decreases the probability of exhibiting any behavior of despair in adolescence and young adulthood. In addition, the intervention decreases the probability of suicidal ideation and hazardous drinking in adolescence and young adulthood as well as opioid use in young adulthood. Additional analyses indicate that FT's improvements to children's interpersonal (e.g., prosocial behavior, authority acceptance), intrapersonal (e.g., emotional recognition and regulation, social problem solving), and academic skills in elementary and middle school partially mediate the intervention effect on adolescent and young adult behaviors of despair and self-destruction. FT's improvements to interpersonal skills emerge as the strongest indirect pathway to reduce these harmful behaviors. This study provides evidence that childhood interventions designed to improve these skills can decrease the behaviors associated with premature mortality.

Feasible Implementation Strategies for Improving Vocabulary Knowledge of High-Risk Preschoolers: Results From a Cluster-Randomized Trial.

Purpose Many children begin school with limited vocabularies, placing them at a high risk of academic difficulties. The goal of this study was to examine the effects of a vocabulary intervention program, Story Friends, designed to improve vocabulary knowledge of at-risk preschool children. Method Twenty-four early-childhood classrooms were enrolled in a cluster-randomized design to evaluate the effects of a revised Story Friends curriculum. In each classroom, three to four preschoolers were identified as having poor language abilities, for a total of 84 participants. In treatment classrooms, explicit vocabulary instruction was embedded in prerecorded storybooks and opportunities for review and practice of target vocabulary were integrated into classroom and home practice activities. In comparison classrooms, prerecorded storybooks included target vocabulary, but without explicit instruction, and classroom and home strategies focused on general language enrichment strategies without specifying vocabulary targets to teach. Intervention activities took place over 13 weeks, and 36 challenging, academically relevant vocabulary words were targeted. Results Children in the treatment classrooms learned significantly more words than children in the comparison classrooms, who learned few target words based on exposure. Large effect sizes (mean d = 1.83) were evident as the treatment group averaged 42% vocabulary knowledge versus 11% in the comparison group, despite a gradual decline in vocabulary learning by the treatment group over the school year. Conclusions Findings indicate that a carefully designed vocabulary intervention can produce substantial gains in children's vocabulary knowledge. The Story Friends program is feasible for delivery in early childhood classrooms and effective in teaching challenging vocabulary to high-risk preschoolers. Supplemental Material https://doi.org/10.23641/asha.13158185.