Behavior Checklist Research Articles

Radiographic severity is associated with worse executive function in metopic craniosynostosis.

Children with metopic synostosis have been found to have more neurocognitive and behavioral difficulties. The variables that may affect future neurodevelopmental outcomes, including presenting morphologic severity, have not been fully studied. In the largest study to date, we aimed to assess what portends worse neurocognitive and behavioral outcomes at school age. Children 6-18 years old with surgically corrected metopic nonsyndromic craniosynostosis underwent neurocognitive testing. Parents completed behavior rating surveys about their child: Conners-3 (ADHD), Social Responsiveness Scale-2 (autism spectrum disorder), Behavior Rating Inventory of Executive Function-2 (BRIEF-2: executive function), and Child's Behavior Checklist (overall behavior). The endocranial bifrontal angle (EBA), adjusted EBA (aEBA), frontal angle (FA), and AI-derived metopic severity score (MSS) were determined on pre-operative CT images. Multivariate linear regressions were used to evaluate the association of age at surgery and severity. There were 87 children who underwent neurocognitive testing (average age 10.9 ± 3.3 years) of whom 67 also completed behavioral assessments. Greater phenotypical severity of metopic synostosis (lower FA, aEBA, and EBA) was associated with worse scores on the subscales of the BRIEF-2 (executive function) and executive subscale of the Conners-3. Increasing age at surgery was associated with worse executive function subscale scores of the Conners-3 when controlling for each severity measurement and sociodemographic risk. Children with greater phenotypic severity of metopic synostosis have worse executive function at school age. The majority of children with metopic synostosis have signs of ADHD. Later surgeries (greater than 12months) may impact executive functioning, regardless of the degree of severity. Future research should aim at identifying the direct structural changes to the brain.

Preliminary development of a measure of parental behavioral responses to everyday pains in young children: the PREP.

Everyday pains are experienced frequently by young children. Parent responses shape how young children learn about and experience pain. However, research on everyday pains in toddlers and preschoolers is scarce, and no self-report measures of parent responses to their child's pain exist for this age group. The objective of this study was to develop a preliminary self-report measure of parent behavioral responses to everyday pains in the toddler and preschool years (the PREP) and examine its relationship with child age, sex, and parent and child distress. Items for the PREP were based on a behavioural checklist used in a past observational study of caregiver responses to toddler's everyday pains. Parents (N = 290; 93% mothers) of healthy children (47.9% boys) between 18 and 60 months (Mage = 34.98 months, SD = 11.88 months) completed an online survey of 46 initial PREP items, demographic characteristics, and their child's typical distress following everyday pains. An exploratory factor analysis was performed on the PREP items that describe observable actions parents may take in response to their young child's everyday pains. The final solution included 10 items across 3 factors: Distract, Physical Soothe, and Extra Attention and explained 60% of the model variance. All PREP subscales were related to child distress; only Physical Soothe and Extra Attention were related to parent distress. This study was a preliminary step in the development and testing of a new self-report measure of parental responses to everyday pains during early childhood.

Behavior problems 7 years after severe childhood traumatic brain injury: Results of the Traumatisme Grave de L'Enfant study.

To investigate the occurrence of behavioral problems 7 years after severe pediatric traumatic brain injury (TBI), and their evolution from 3 months to 7 years postinjury. Thirty-four participants, 38% girls, M (SD) age at injury 7.6 (4.7) years, age at assessment 15 (4.6) years, underwent comprehensive assessments 7 years after severe TBI from March 2014 to March 2016 and were matched to a control group by age, gender, and parental education. A subgroup of 20 participants had available behavioral assessments at 3, 12, and 24 months postinjury. Internalizing, externalizing, and total behavioral problems were assessed with self- and parent reports of the Achenbach's Behavioral Checklist. Additional data included sociodemographic background, initial injury severity, and specific outcomes assessed concurrently 7 years postinjury. Compared to controls: (a) a significant proportion of participants with severe TBI fell above the clinical cutoff for self- (42%) and parent-reported (36%) externalizing problems, but not for self- (33%) or parent-reported (45%) internalizing problems; (b) withdrawn/depressed, intrusive behavior, and somatic complaints were significantly higher in self-reports; and (c) rule-breaking behavior, attention, and social problems were significantly higher in parent reports. Parent-reported internalizing problems were associated with older age at injury, whereas externalizing problems correlated with greater injury severity and concurrent levels of greater overall disability, lower intellectual ability, and poorer family functioning. In multiple hierarchical regression analyses, overall disability and worse family functioning significantly predicted externalizing problems. Parent-reported internalizing and externalizing problems persisted over time. These results highlight the importance of long-term follow-up and individualized behavioral interventions for children who sustained severe TBI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effectiveness of training mothers with regard to pediculosis preventive behavior among school students: A Protection Motivation Theory study.

Lice infestation is considered as a reemerging problem as well as a health challenge. Based on Protection Motivation Theory, the present study was conducted to investigate the effectiveness of training mothers in regard to pediculosis preventive behavior among school students. In a critical trial, 180 mothers of primary school daughters were assessed in two study groups in the Iranian city of Qom in 2021. They received training intervention in a course of four ninety-minute sessions during four weeks. After six months, the post-test questionnaire and the checklist were completed by them. The data were gathered using a valid and reliable questionnaire. Finally, data analysis was performed using SPSS 20. After the training intervention, a significant difference was observed within the intervention group in scores of the prevention motivation constructs (P<0.001). Besides, there was a significant difference between the mean scores of the preventive behavior of the mothers and daughters in the intervention group before the training intervention and six months after it (P<0.001). However, no significant difference was seen before and after the intervention in the control group (P>0.05). Additionally, no significant differences were observed between the intervention and control groups (P<0.001) in terms of comparing the mean score differences of all the constructs of protection motivation theory, the mothers' behavior and the daughters' behavior checklist. The results indicate the effectiveness of training mothers based on Protection Motivation Theory in regard to pediculosis. Therefore, it seems that in developing training programs, utilizing this theory could prove useful to bring about changes in the individuals' behavior regarding the prevention of pediculosis.

Measurement and stratification of nonsuicidal self-injury in adolescents

BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in adolescents. In survey and interview studies assessing NSSI, methods of assessment have been shown to influence prevalence estimates. However, knowledge of which groups of adolescents that are identified with different measurement methods is lacking, and the characteristics of identified groups are yet to be investigated. Further, only a handful of studies have been carried out using exploratory methods to identify subgroups among adolescents with NSSI.MethodsThe performance of two prevalence measures (single-item vs. behavioral checklist) in the same cross-sectional community sample (n = 266, age M = 14.21, 58.3% female) of adolescents was compared regarding prevalence estimates and also characterization of the identified groups with lifetime NSSI prevalence. A cluster analysis was carried out in the same sample. Identified clusters were compared to the two groups defined using the prevalence measures.ResultsA total of 118 (44.4%) participants acknowledged having engaged in NSSI at least once. Of these, a group of 55 (20.7%) adolescents confirmed NSSI on a single item and 63 (23.7%) adolescents confirmed NSSI only on a behavioral checklist, while denying NSSI on the single item. Groups differed significantly, with the single-item group being more severely affected and having higher mean scores on difficulties in emotion regulation, self-criticism, number of methods, higher frequency of NSSI, higher rates of suicidal ideation and suicidal behavior and lower mean score on health-related quality of life. All cases with higher severity were not identified by the single-item question. Cluster analysis identified three clusters, two of which fit well with the groups identified by single-item and behavioral checklist measures.ConclusionsWhen investigating NSSI prevalence in adolescents, findings are influenced by the researchers’ choice of measures. The present study provides some directions toward what kind of influence to expect given the type of measure used, both with regards to the size of the identified group and its composition. Implications for future research as well as clinical and preventive work are discussed.

Prevalence of emotional-behavioral disorders with and without comorbidity in 6-8 year old children: the role of mother's reaction to child's negative emotions

Introduction: In the early years of schooling, factors such as being far from parents for 5 hours, academic and social demands can be stressful for children and provide the conditions for creating or intensify some mental disorders. Therefore, it is important to investigate the prevalence of emotional-behavioral disorders and their related factors at this age. Aim: The purpose of the present study was to investigate the prevalence of emotional-behavioral disorders with and without comorbidity in children aged 6 to 8 years, and also to predict the severity of these disorders based on the mother's reaction to the child's negative emotions. Method: The research method was descriptive-analytical. The population included all the first and second grade primary school students of Malayer city in the academic year 2017-2018, and 454 people were selected by cluster sampling method. In order to collect data, the Child's Behavior Checklist (2002) and the Child's Reaction to Negative Emotions Questionnaire (1990) were used. Data were analyzed through SPSS version 22 software and stepwise linear regression model was employed. Results: The findings of the present study revealed that, the pure prevalence of emotional and behavioral disorders in these children was 8.6% and prevalence with comorbidity of these disorders was 7.3%. In addition, mother's reactions to children's negative emotions could predict the severity of children's emotional-behavioral problems (P=0.001). Conclusion: In the age range of 6 to 8, the comorbidity of emotional and behavioral disorders of these children is high and the mother's supportive or unsupportive reactions to the child's negative emotions play a significant role in it, so it is suggested that child psychologists and psychiatrists pay special attention to these findings in diagnostic interviews and treatment strategies.

Token Economy to Reduce Aggressive Behavior in Adolescent with Intellectual Disabilities

Aggressive behavior is often found in individuals with intellectual disabilities (ID). Aggressive behavior arises due to low cognitive capacity so that the ability of individuals with ID to understand situations or the environment has limitations on the other side. The process of understanding the situation and realizing how to respond is very important so that individuals can adapt well to the environment. On the other hand, realizing adaptive behavior in individuals with ID is quite difficult. This research attempts to give an overview of the token economy to reduce aggressive behavior in hitting, shouting, and countering. This study aims to look at the effectiveness of token economy in reducing aggressive behavior in adolescents with ID. The research method used was single case experimental design. Data were obtained through observation, interviews, and psychological tests. Pretest and posttest were carried out on aggressive behavior before and after the treatment. The results of the token economy treatment showed a decrease in aggressive behavior on the subject as a whole (calculated based on a behavioral checklist), both in hitting (formerly 6 to 0), shouting (formerly 9 to 0,2), and countering behavior (formerly 6 to 0.2). There was a decrease from 24 to 3 based on the CBLC score after the treatment. Thus, it can be concluded that the token economy has proven effective in reducing aggressive behavior in adolescent with intellectual disabilities.&#x0D; Keywords: aggression, intellectual disability, token economy

בדיקת תוקף של מטלה ביצועית בלתי מובנית (UPT), למדידת תפקודים ניהוליים בקרב ילדים

Background: Executive Functions (EFs) are assessed by performance-based measures in clinical settings and rating scales in ecological settings. Research has shown a lack of a correlation between both methods. In order to bridge the gap, the Unstructured Performance-Based Task (UPT) was developed. This assessment includes 42 questions randomly presented on a large piece of paper and is accompanied by a behavioral checklist. Aim: To examine the construct validity of the UPT and the behavioral checklist by examining group differences in UPT scores between children with and without Attention Deficit Hyper Disorder (ADHD) and EF deficits A further aim is to examine associations between the UPT and performance-based measures and rating scales. Method: The UPT was translated and culturally adapted for Hebrew speaking children in Israel. Participants were 42 children (aged 8-11 years), 21 with ADHD and EF deficits and 21 without a diagnosis or EF deficit. Parents completed a sociodemographic questionnaire, the Performance Skills Questionnaire, and the Behavior Rating Inventory of Executive Function (BRIEF) to assess EF deficits in ecological settings. Children completed the UPT and other widely used assessments: Digit Span Forward and Backward, Verbal Working Memory, Trail Making Test, and Tower of Hanoi. Results: Significant differences were found between groups in some of the UPT measures and the behavioral checklist. Associations were found between some UPT measures and the behavioral checklist and performance-based EF measures, as well as the BRIEF rating scale. Conclusions: The measures of Total Correct Items, Total Blank Items, and completion time in UPT may be valid for EFs assessment. The behavioral checklist may be a valid assessment for behavior in ecological settings. The UPT may assist in identifying EF deficits in children and setting goals in Occupational Therapy interventions.

The Effectiveness of Training Mothers with regard to Pediculosis Preventive Behavior among School Students; A Protection Motivation Theory Study

ABSTRACT Background &amp; objectives: Today, lice infestation is considered as a reemerging problem as well as a health challenge. Based on Protection Motivation Theory, the present study was conducted to investigate the effectiveness of training mothers in regard to pediculosis preventive behavior among students. Methods: In a critical trial, 180 mothers of primary school daughters were assessed in two study groups in the Iranian city of Qom in 2021. They received training intervention in the course of four ninety-minute sessions during four weeks. After six months, the post-test questionnaire and the checklist were completed by them. The data were gathered using a valid and reliable questionnaire. Finally, the data analysis was performed using SPSS 20. Results: After the training intervention, a significant difference was observed within the intervention group in scores of the prevention motivation constructs (P&lt;0/001). Besides, there was a significant difference between the mean scores of the preventive behavior of the mothers and daughters in the intervention group before the training intervention and six months after it (P&lt;0/001). However, no significant difference was seen before and after the intervention in the control group (P&gt;0/05). Additionally, no significant differences were observed between the intervention and control groups (P&lt;0/001) in terms of comparing the mean score differences of all the constructs of protection motivation theory, the mothers’ behavior and the daughters’ behavior checklist. Interpretation &amp; conclusion: The results indicate the effectiveness of training mothers based on Protection Motivation Theory in regard to pediculosis. Therefore, it seems that in developing training programs, utilizing this theory could prove useful to bring about changes in the individuals’ behavior regarding the prevention of pediculosis.

Risk of ADHD, Autism Spectrum Disorder, and Executive Function Impairment in Metopic Craniosynostosis.

Favorable behavioral interactions are critical for academic and interpersonal success. An association between metopic synostosis and behavioral impairments has not been fully elucidated. Behavioral dysfunction in school age children with surgically corrected metopic synostosis was evaluated using targeted testing to detect the most common behavioral abnormalities in this population. Parents of children 6-18 years old with metopic synostosis completed the Conners Short 3 rd edition (Conners-3: ADHD), Social Responsiveness Scale 2 nd edition (SRS-2: autism spectrum disorder), Behavior Rating Inventory of Executive Function 2 nd edition (BRIEF-2: executive functioning), and Child's Behavioral Checklist (CBCL: behavioral/emotional functioning). Children also completed neurocognitive testing. Multivariable regression was used to determine predictors of clinically significant behavioral impairments. 60 children were enrolled. Average age at surgery was 9.2 ± 7.9 months, with an average age at assessment of 10.3 ± 3.5 years. Nearly half of patients demonstrated symptoms associated with ADHD, demonstrated by reaching or exceeding borderline clinical levels for inattention and hyperactivity subscales of the Conners-3. Greater age at surgery was associated with worse executive function, measured by reaching or exceeding clinically significant levels of the executive function subscale of the Conners-3 (p=0.04) and subscales of the BRIEF-2 (behavioral regulator index [p=0.05], cognitive regulatory index [p=0.03], and global executive composite [p=0.04]). Nearly half of patients with surgically corrected metopic synostosis reached borderline clinical scores for inattention and hyperactivity. Greater age at surgery was associated with worse executive function. Prompt surgical correction of metopic synostosis may portend improved long-term emotional and behavioral function.

A Novel Knowledge-augmented Model Customization Approach for Arabic Offensive Language Detection

Multiple attempts to develop systems for detecting online Arabic offensive language have been explored in previous studies. However, most of these attempts do not consider the variation of Arabic dialects, cultures, and offensive phrases. In contrast, this study aims to extract knowledge from multiple offensive language datasets to build a cross-dialect and culture knowledge-based repository. This knowledge-based repository is utilized to develop novel system architecture based on customizing the AraBERT model in a unique method to preserve dialectal knowledge and offensive cultural knowledge within the contextual word embedding of BERT architecture. Performance evaluation procedures consist of statistical evaluation metrics and a behavioral checklist. Results report more effective predictions by the customized model than the uncustomized one, particularly for offensive text. The customization process allows the model to gain more knowledge of informal text in general, and a better understanding of dialectal Arabic.

PSVI-11 Genome-Wide Association Study for 4 Behavior Traits in a Population of Labrador Retrievers Bred as Guide Dogs

Abstract The objective of this study was to assess the genetic architecture and investigate genomic regions associated with Body Handling, Harness sensitivity, Self-modulation, and Noise sensitivity in Labrador Retrievers used as guide dogs. A single-step genome-wide association study (ssGWAS) was used for this purpose. Phenotypic data were collected in 4,841 Labrador Retrievers with ages ranging from 3 months to 2.5 years, for all four traits. Phenotypes were selected from the Behavior Checklist, which is a scoring tool used by a skilled scorer to describe aspects of behavior observed during a variety of assessments including formal tests and while training or observing another handler working with the dog. The pedigree file contained 23,593 animals with birth years ranging from 1991 to 2019 from two populations with related ancestors. Genomic data were available for 457 individuals and were obtained by selecting 250K SNPs from whole genome sequences. Associations were calculated as the percentage of variance explained by windows of 80 adjacent SNPs. SNP variances were calculated based on SNP effects that were obtained by back-solving genomic estimated breeding values obtained with the single-step GBLUP method in a genomic selection program with the same population. Additionally, the genomic relationship matrix was modified under a weighted ssGBLUP (wssGBLUP) approach that allowed SNPs to have different distributions. Manhattan plots were generated with the variance explained by SNP windows for 3 iterations of wssGBLUP. After visual inspection of the Manhattan plots, the R package GALLO was used to annotate the genes located within the peaks that explained 0.6% or more of the genetic variance. The maximum amount of variance explained by a window of 80 SNPs was 1.1% for Body Handling. This trait presented three other regions explaining more than 0.6% of the genetic variance. Harness sensitivity presented four peaks above the threshold, with the major one explaining 0.75% of the genetic variance. Self-modulation and Noise sensitivity both had their major peak explaining 0.95% of the genetic variance and presented four and three regions above the threshold, respectively. The genes annotated in the candidate regions were not specifically related to behavior, nor were they involved in any pathway with biological relevance to the phenotypes. Moreover, some of the regions were not annotated, and no associated genes were found. The traits studied in this project were shown to be polygenic and complex, and that explains the lack of major genes. It is expected that the quality of associations will improve as the sample size increases. The next steps of this project are to increase the number of genotyped animals, increase the number of markers, and adopt alternative annotation and enrichment tools for the post-GWAS analysis.

Sleep problems at ages 8–9 and ADHD symptoms at ages 10–11: evidence in three cohorts from INMA study

Sleep problems and attention deficit hyperactivity disorder (ADHD) are interrelated during childhood and preadolescence. The objective of this work is assessing if sleep problems at ages 8–9 represent an alarm sign for presenting ADHD problems at ages 10–11 in three cohorts from INMA Study. Participants were 1244 children from Gipuzkoa, Sabadell, and Valencia cohorts. Sleep problems were assessed (ages 8–9) with the sleep items of the Child’s Behaviour Checklist (CBCL), and ADHD problems were collected through the Conner’s Parent Rating Scales-Revised: Short Form (CPRS-R:S) (age 10–11). Minimally and fully adjusted negative binomial models were fitted for each CPRS-R:S scale. Linearity of the relationship was assessed with generalized additive models (cubic smoothing splines with 2, 3, and 4 knots). For sensitivity analyses, children with previous symptoms, those born preterm and small for gestational age, and cases with extreme values, were excluded. Sleep problems presented IRR (95% CI) of 1.14 (1.10–1.19), 1.20 (1.14–1.26), 1.18 (1.11–1.25), and 1.18 (1.13–1.23) for opposition, inattention, hyperactivity, and ADHD scales, respectively. Fully adjusted models slightly decreased the IRR, but the association remained similar and significant. Sensitivity analyses showed similar results to fully adjusted models with only hyperactivity shown a slight decrease on significance (p = 0.051) when ADHD cases at age 9 were excluded. Conclusion: Sleep problems are an alarm sign for later neurodevelopment problems such as ADHD. Healthcare systems could take advantage implementing policies to pay special attention on the sleep habits and sleep hygiene. This could contribute to add evidence to public health programmes such as the Healthy Child Programme.What is Known:• Sleep problems and Attention Deficit Hyperactivity Disorder (ADHD) are common problems during childhood and preadolescence, with prevalences of 20-40% and 3.0-7.5%, respectively.• Sleep problems are even more common in children with ADHD condition.What is New:• Sleep problems at ages 8-9 increased the risk of ADHD symptoms at ages 10-11.• This association remained strong even when considering child’s previous (5 years) and concurrent (8-9 years) ADHD symptoms, and other clinical conditions, such as being born preterm or small for gestational age.

When Mindfulness is Insufficient: The Moderated Moderating Effects of Self-Harm and Negotiable Fate Beliefs on the Association Between Mindfulness and Adolescent Psychological Distress in Disasters

The coronavirus disease 2019 (COVID-19) pandemic has increased the risk of psychological distress among adolescents. Moreover, adolescents in 70 countries have suffered simultaneously from the COVID-19 pandemic and flood disasters. Research on the protective role of mindfulness on psychological distress is warranted; moreover, the practical needs arising from disasters require a deeper understanding of the potentially complex interplay between mindfulness and psychological distress. Using social–ecological systems theory, this study examined the moderating effects of self-harm and negotiable fate on the relationship between mindfulness and psychological distress in adolescents suffering from concurrent dual disasters (COVID-19 and flood disasters). High school adolescents ( N = 1679; 49.3% adolescent boys) in Zhengzhou, China, completed the Child and Adolescent Mindfulness Measure, Suicide Thoughts and Behaviors Checklist, Negotiable Fate Questionnaire, and Depression Anxiety Stress Scales-21. A three-way interaction model was developed. The results indicate that mindfulness has a significant negative relationship with psychological distress during disasters. Moreover, self-harm and negotiable fate significantly moderated the negative associations between mindfulness and psychological distress in adolescents enduring concurrent dual disasters (three-way interaction effects model). These findings highlight the significance of the interactions between different ecological system factors in the negative associations between mindfulness and psychological distress amid disasters.

Correlation Analyses Between Childhood Behavioral Disturbance and Maternal Alexithymia: An Observational Study.

Caregivers' responses have an impact on children's emotional and behavioral development. The inability of caregivers to perceive their own emotions affects their responses to children. This study aims to examine the relationship between a mother's difficulties in emotional expression and children's emotional and behavioral disorders. A total of 78 cases, aged between 3 and 15 years old, were included in this study. The mothers completed the Taiwan version of the "Toronto Alexithymia Scale" (TAS) and "Children's Behavior Checklist" (CBCL) questionnaires, which served as research tools. TAS consists of three factors: difficulty in distinguishing emotions (Factor 1, F1), difficulty in expressing feelings (Factor 2, F2), and an externally oriented thinking style (Factor 3, F3). CBCL represents a child's behavior profile. The Mann-Whitney test and correlation analyses were used for follow-up analysis. Our analysis revealed that F1, F2, F3, and total scores of TAS (TAS-Total) correlate positively with the somatic complaint subscale of CBCL (F1: p = 0.003; F2: p = 0.002; F3: p = 0.034, TAS-Total p=0.002). Additionally, TAS-F1 was positively correlated with the internalizing problems subscale of CBCL (p = 0.020) and the withdrawn (WD) subscale of CBCL (p = 0.044). We also found a significant association between TAS-F1 and WD of CBCL in boys alone (p = 0.022). However, we observed a negative association between TAS-F3 and the social problems subscale of CBCL in boys alone (p = 0.038). Mothers with alexithymic features are more likely to have children who internalize emotions, leading to withdrawal and somatic expression. Boys tend to exhibit withdrawal traits associated with internalization. This study provides initial evidence of a partial correlation between maternal alexithymia and children's emotional and behavioral disorders, emphasizing the importance of investigating caregivers' emotional traits for a better understanding of children's development in the future.

An online self-guided cognitive intervention for unwanted intrusive thoughts about harming infants in new parents: initial randomised controlled trial with mediation analysis

ABSTRACT Approximately one-fifth of new parents struggle with unwanted intrusive thoughts (UITs) about intentionally harming their child. This study evaluated the initial efficacy, feasibility and acceptability of a novel online self-guided cognitive intervention for new parents with distressing UITs. Self-recruited parents (N = 43, 93% female, age 23–43 years) of children 0–3 years reporting daily distressing and impairing UITs were randomized to the 8-week self-guided online cognitive intervention or to waiting-list. The primary outcome was change on the Parental Thoughts and Behaviour Checklist (PTBC) from baseline to week 8 (post-intervention). The PTBC and negative appraisals (mediator) were assessed at baseline, weekly, post-intervention and at the 1-month follow-up. Results showed that the intervention led to statistically significant reductions in distress and impairment associated with UITs at post-intervention (controlled between-group d = 0.99, 95% CI 0.56 to 1.43), which were maintained at the 1-month follow-up (controlled between-group d = 0.90, 95% CI 0.41 to 1.39). The intervention was deemed to be feasible and acceptable by the participants. Change in negative appraisals mediated reductions in UITs but the model was sensitive to mediator-outcome confounders. We conclude that this novel online self-guided cognitive intervention can potentially reduce the distress and impairment associated with UITs in new parents. Large-scale trials are warranted. Abbreviations: UITs: Unwanted Intrusive Thoughts PTBC: Parental Thoughts and Behaviour Checklist.

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

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

Using an OSCE/OSTE as an Innovative Skills Assessment for Faculty Development in Diversity, Equity, and Inclusion.

Purpose: In response to the twin pandemics of COVID-19 and racial inequity, our health professions have awakened to the impact of structural racism on health care. While the current generation of trainees is facile with cultural humility, the generation of faculty lags. 1,2 Faculty development programs aimed at closing this gap are essential. 3 Most studies of cultural competency training focus on outcomes limited to practitioner knowledge acquisition and attitudes, not skills. 4 In implementing a year-long faculty development program in diversity, equity, and inclusion (DEI), we asked ourselves: Is it possible to assess faculty’s skills of antiracism and allyship to engage learners using an OSCE (observed structured clinical examination)? Method: Our faculty development in DEI, grounded in longitudinal community of practice, uses appreciative inquiry, critical reflection, and skill building. We designed a mid-program OSCE and OSTE (observed structured teaching examination) to assess skill acquisition. In the OSCE, participants conduct an advising session with a trainee underrepresented in medicine who is experiencing stereotype threat. In the OSTE, participants facilitate a teaching session on COVID-19 vaccine hesitancy. Fourth-year students, trained as standardized learners, completed behavioral checklists. Faculty participants self-assessed using the same behavioral checklists. Faculty development leaders served as observers and led global feedback discussions with the faculty and learners who then completed surveys for reflection. Results: In the advising OSCE, faculty demonstration of the 8 core skills ranged from 17% to 100% (average 63%). While 17% of the faculty named stereotype threat, 100% implemented one strategy to mitigate it. While 50% elicited a personal narrative from the learner, 67% were able to disclose their own “location of self.” While 58% inquired about experiences of bias, 83% responded with empathy after hearing them. The standardized learner reported comfort with 58% of the faculty as an advisor. In the vaccine hesitancy OSTE, faculty demonstration of the 12 core skills ranged from 33% to 100% (average 78%). Only 33% named their “location of self” yet the standardized learners reported comfort with 100% of the faculty as small-group leaders. Ninety-two percent of the faculty taught the sociopolitical construct of race and connected historical racism to vaccine hesitancy. Seventy-five percent of the faculty used one core skill of establishing psychological safety, and 67% created ground rules distinguishing safe from brave spaces. The kappa coefficient ranged from 0.26 to 0.88, depending on the learners involved. One hundred percent of the faculty and standardized learners agreed that the OSCE/OSTE was valuable, the stations were relevant and appropriate, they were able to identify strengths and weaknesses, and the experience made them feel positive about efforts to improve the learning environment. One hundred percent agreed that logistics went smoothly. Discussion: We discovered that OSCE/OSTEs for the assessment of DEI skill acquisition are not only feasible but also valuable, to faculty participants, program leaders, and standardized learners. We identified gaps in the curriculum and a need for better training for interrater reliability. We also identified potential future facilitators. Finally, our student participants were impressed with the quality of the curriculum and assessment. This message, organically shared among all students, was an unintended benefit to the school. Significance: To our knowledge, this OSCE/OSTE is the first of its kind to formatively assess DEI skills. While success on a behavioral checklist is still a proxy for how faculty behave in the actual learning environment, it goes a long way toward identifying skill acquisition. We plan to refine this assessment mid-program and implement an end-of-program OSCE/OSTE for skills of apology, upstanding and leveraging privilege. We will make our materials available as a free open-access medical education resource. Acknowledgments: The authors wish to thank Treisha Green and Kelly Conlon for their assistance with this project, as well as all the ZSOM students who volunteered their time to play standardized learners.

Children Exposed to Intimate Partner Violence During Confinement: Characteristics by Age and Sex.

The COVID-19 pandemic and restrictions imposed to stop its advance have affected the entire population. Children living with difficulties or in vulnerable situations prior to the pandemic might have suffered an even greater impact. This present study examines the psychological impact of quarantine on children and adolescents exposed to intimate partner violence against their mothers. Participants were 185 mothers who reported 269 children, as well as 108 children who self-reported. An emotional and behavioral checklist was administered to both mothers and children throughout confinement. Results show mothers observed changes in their children’s psychological state. Children, in turn, reported an increase in different variables. Mothers reported a higher percentage of overall increase for both general and severe symptoms than their children. Differences were found by sex and age. Future research with similar population groups is necessary to establish the support and intervention children require in similar contexts, as well as to clarify possible causes of differences found by age and sex.

Beneficial Effects of Repeated Washed Microbiota Transplantation in Children With Autism.

ObjectiveWhile fecal microbiota transplantation is demonstrated to improve symptoms of autism spectrum disorder (ASD), it remains unclear whether additional treatment courses yield better results. This study sought to evaluate the efficacy of repeated washed microbiota transplantation (WMT) in children with ASD.MethodsRetrospective data from children who were serially treated with WMT, including ASD symptoms, sleep disorders, gastrointestinal (GI) symptoms, and white blood cell (WBC) and globulin levels were obtained. The effect of WMT on children with ASD and whether additional WMT courses led to a further improvement in symptoms were assessed.ResultsAberrant Behavior Checklist (ABC), Childhood Autism Rating Scale, and Sleep Disturbance Scale for Children (SDSC) scores, the proportion of children with constipation and abnormal fecal forms, and WBC and globulin levels were all significantly lower in ASD children after WMT. More WMT treatment courses led to significantly lower scores on the ABC and SDSC.ConclusionWMT significantly improved ASD and GI symptoms and sleep disorders in children with ASD, and reduced systemic inflammation. Additional WMT courses led to more obvious improvements in ASD symptoms within three treatment courses.