Behavior In Preschool-aged Children Research Articles

Mapping the duration and severity of preschool-aged children's depressive moods and behaviors.

Depressive moods and behaviors are developmentally normative, yet potentially impairing, in preschool-aged children. In addition to frequency, duration of behavior is an important parameter to consider when characterizing risk for worsening mood dysregulation. The goal of this study was to identify the duration and severity of depressive moods and behaviors and associations with impairment in a large community sample of preschool-aged children using an online parent-report daily diary. Primary caregivers (N = 900) of 3-5-year-old children reported the daily duration of each instance of seven depressive moods and behaviors for 14 days. We used item response theory analyses to examine duration item characteristics. Moods and behaviors occurred at specific durations to be considered psychometrically severe/rare; for example, instances of sadness had to last an average total of 32 min per day or more, irritability at least 38 min, tantrums at least 30 min, and tearfulness/sensitivity at least 35 min. Longer durations of mood and behavior were associated with daily impairment, as well as older child age and less parental education. To our knowledge, this is the first study to delineate specific duration ranges for depressive moods and behaviors in preschool-aged children. These data, coupled with information about the frequency of mood-related behaviors, can assist child practitioners in differentiating normative patterns from less normative mood problems to evaluate which children may be at risk. Future work should identify the duration of depressive moods and behaviors in early childhood that predict clinically significant psychopathology over time.

THE RELATIONSHIP OF PARENTS USING THERAPEUTIC COMMUNICATION WITH TEMPER TANTRUM BEHAVIOR IN PRESCHOOL CHILDREN AT RT 021 RW 006 SUKAJAYA VILLAGE

Temper tantrum is an outburst of emotion that is out of control and out of control. The signs and symptoms of this temper tantrum vary, ranging from just whining, crying, screaming, rolling on the floor, kicking, hitting. The impact of this temper tantrum is quite dangerous. For example, a child who vents his frustration by rolling on a hard floor can cause injury to the child. According to data from the Indonesian Ministry of Health, the number of children aged 2-4 years in Indonesia who experience temper tantrums is quite large, which is around 19.39 million people. This study aims to determine the relationship between parents using therapeutic communication with temper tantrum behavior in preschool children in RT 021 RW 006 Sukajaya Village. This study used an analytical observational design with a cross sectional design. Sampling using non-probabilty sampling purposive sampling type with a total of 110 respondents. It was found that the results of the Chi Square test had a significant value of 0.045 < a value (0.05). There is a relationship between parents using therapeutic communication with temper tantrum behavior in preschool age children in RT 021 RW 006 Sukajaya Village. There is a relationship between parents using therapeutic communication with temper tantrum behavior in preschool age children in RT 021 RW 006 Sukajaya.

The Day-Level Association Between Child Care Attendance and 24-Hour Movement Behaviors in Preschool-Aged Children.

Twenty-four hour movement behaviors (ie,physical activity [PA], screen time [ST], and sleep) are associated with children's health outcomes. Identifying day-level contextual factors, such as child care, that positively influence children's movement behaviors may help identify potential intervention targets, like improving access to child care programs. This study aimed to examine the between- and within-person effects of child care on preschoolers' 24-hour movement behaviors. Children (N = 74, 4.7 [0.9]y, 48.9% girls, 63.3% White) wore an Axivity AX3 accelerometer on their nondominant wrist 24hours per day for 14days to measure PA and sleep. Parents completed surveys each night about their child's ST and child care attendance that day. Linear mixed effects models predicted day-level 24-hour movement behaviors from hours spent in child care. Children spent an average of 5.0 (2.9)hours per day in child care. For every additional hour of child care above their average, children had 0.3hours (95%CI,-0.3 to -0.2) less ST that day. Between-person effects showed that compared with children who attended fewer overall hours of child care, children who attended more hours had less overall ST (B = -0.2h; 95% CI, -0.4 to 0.0). Child care was not significantly associated with PA or sleep. Child care attendance was not associated with 24-hour PA or sleep; however, it was associated with less ST. More research utilizing objective measures of ST and more robust measures of daily schedules or structure is necessary to better understand how existing infrastructure may influence preschool-aged children's 24-hour movement behaviors. In addition, future research should consider how access to child care may influence child care attendance.

PERBEDAAN PERILAKU MALADAPTIF PADA ANAK USIA PRASEKOLAH DITINJAU DARI JENIS KELAMIN DAN TINGKAT PENDIDIKAN ORANG TUA

This research is motivated by the phenomenon of maladaptive behavior in preschool children. Preschool age has an important role in preparing children to enter education. Maladaptive behavior is influenced by several factors including environmental, genetic and psychological. The study aims to determine differences in maladaptive behavior in preschool-age children in terms of gender and parental education level. This type of research is quantitative comparison. The population was 205, namely mothers who have preschool children aged 3-6 years. The sample determination used a saturated sample technique where the entire existing population was used as a research sample. The variables in this study are maladaptive behavior and demographic variables of gender and education level of parents. The research data collection technique used a maladaptive behavior scale adapted from the Strength and Difficulties Questionare (SDQ). The data analysis technique uses Regression Test with the help of JASP 16.0. The results showed that there was no significant influence between gender on maladaptive behavior that was raised (Mann-Whitney 4954.000, p = 0.495> 0.05) and there was a significant influence between the level of parental education on maladaptive behavior that was raised (Kruskal-Wallis 10.202, p = 0.001 <0.05).

What's in the Box? Preschoolers Consider Ambiguity, Expected Value, and Information for Future Decisions in Explore-Exploit Tasks.

Self-directed exploration in childhood appears driven by a desire to resolve uncertainties in order to learn more about the world. However, in adult decision-making, the choice to explore new information rather than exploit what is already known takes many factors beyond uncertainty (such as expected utilities and costs) into account. The evidence for whether young children are sensitive to complex, contextual factors in making exploration decisions is limited and mixed. Here, we investigate whether modifying uncertain options influences explore-exploit behavior in preschool-aged children (48-68 months). Over the course of three experiments, we manipulate uncertain options' ambiguity, expected value, and potential to improve epistemic state for future exploration in a novel forced-choice design. We find evidence that young children are influenced by each of these factors, suggesting that early, self-directed exploration involves sophisticated, context-sensitive decision-making under uncertainty.

THE RELATIONSHIP BETWEEN MOTHER'S PARENTING PATTERNS AND DIFFICULT EATING BEHAVIOR IN PRE-SCHOOL AGE CHILDREN

Background: Factor one mother complained that her child was very difficult to eat and only wanted to eat food when gathering with friends or invited to refresh. Objective: The purpose of the study was to determine the relationship between maternal parenting and difficult eating behavior in preschool age children in Pertiwi Kindergarten, Mancar Village, Peterongan District, Jombang Regency. Methods: The research design used correlational analysis with a cross sectional approach. The population of all mothers who have children in Pertiwi Kindergarten is 36 respondents with a total sampling technique so that a sample of 36 respondents is obtained. Collecting data using a questionnaire. The statistical test used in this study was Spearmen Rank Test. Result: The results showed that the permissive mother's parenting style with difficult eating behavior in children was mostly sufficient as many as 19 people (52.8). While the behavior of difficult eating in children with an authoritarian parenting pattern is as small as 3 people (8.3%). Spearmen Rank test showed value 0.000 (r value < 0.05). Then H1 is accepted, which means that there is a relationship between maternal parenting patterns and difficult eating behavior in preschool-aged children in Pertiwi Kindergarten, Mancar Village, Jombang Regency. Conclusion: Good parenting patterns for children who have difficulty eating so that nutritional factors do not occur are expected to provide interesting food so that children do not get bored with the food provided, limit the consumption of snacks and snacks that make children full before eating the main meal, and provide types of food that are suitable for children. nutrition for children. Trying to get children to eat by feeding and teaching children to eat new types of food.

The Relationship Practice Parenting and Elimination Behavior, Applied Health Promotion Model (HPM) in Pre-School Children in JABODETABEK: A Cross-Sectional Study

Background
 The practice of parenting for preschool age children is not yet in demand by parents. The application of the health promotion model (HPM) is a commitment to changing elimination behavior in the process of urinating and defecating.
 Objectives
 The objective of this study was to determine behavior health promotion model (HPM) is associated with toilet training in preschool children. 
 Methods
 Desain cross-sectional quantitative study used 70 respondents in the areas of Jakarta, Bogor, Depok, Tangerang, and Bekasi (JABODETABEK). Using a Google Form questionnaire from September 12 -17 September 2022 distributed online.
 Result
 Of the 70 participants, There was no parenting practice, and the elimination behavior of preschool age children was low, 39 (75.5%). Practice parenting has been done already, and the elimination behavior of preschool, high 13 (72.2%). There was a relationship between practice parenting and elimination behavior using the applied health promotion model (HPM) in preschool children, P-value of 0.001. Participation in parenting practice was 7.8 more effective against high elimination behavior in preschool age children.
 Conclusion 
 Parenting practice activity supported the success of preschool children's elimination behavior. Implementation of the health promotion model (HPM) in stages according to the child's growth and development.

Association of indoor dust microbiota with cognitive function and behavior in preschool-aged children

BackgroundChildhood cognitive development depends on neuroimmune interactions. Immunomodulation by early-life microbial exposure may influence neuropsychological function. In this study, we investigate the association between residential indoor microbiota and cognition and behavior among preschoolers.ResultsIndoor-settled dust bacterial and fungal characteristics were assessed using 16S and ITS amplicon sequencing (microbial diversity) and qPCR measurements (microbial loads). Child behavior was assessed using four scales: peer relationship, emotional, conduct, and hyperactivity was assessed by the Strengths and Difficulties Questionnaire (SDQ). Cognitive function was assessed using four tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB) software. The first two tasks were designed to assess attention and psychomotor speed (Motor Screening (MOT) and Big/Little Circle (BLC)) and the last two to evaluate the child’s visual recognition/working memory (Spatial Span (SSP) and Delayed Matching to Sample (DMS)). Among the 172 included children (age 4–6 years), we observed a 51% (95%CI;75%;9%) lower odds of children scoring not normal for hyperactivity and a decrease of 3.20% (95%CI, −6.01%; −0.30%) in BLC response time, for every IQR increase in fungal Shannon diversity. Contrarily, microbial loads were directly associated with SDQ scales and response time. For example, a 2-fold increase in Gram-positive bacterial load was associated with 70% (95%CI 18%; 156%) higher odds of scoring not normal for hyperactivity and an increase of 5.17% (95%CI 0.87%; 9.65%) in DMS response time.ConclusionsOur findings show that early-life exposure to diverse indoor fungal communities is associated with better behavioral and cognitive outcomes, whereas higher indoor microbial load was associated with worse outcomes.-hh8RCLyRPCU1iX3VFx5YbVideo

The roles of sleep and eating patterns in adiposity gain among preschool-aged children

Short sleep durations are related to risks for obesity in preschool children. However, the underlying mechanism or mechanisms are not clear. We evaluated the relationships between sleep characteristics and body composition, energetics, and weight-regulating behaviors in preschool-aged children, as well as the longitudinal associations between children's sleep and eating patterns and body composition at a 1-year follow-up. Data were drawn from a longitudinal study of 118 children aged 3-5 years. Sleep (duration, midpoint, regularity) and physical activity (PA) were measured by accelerometry over 6 consecutive days; total energy expenditure (TEE) was measured using the doubly labeled water method; body composition (fat mass, fat-free mass, and percent body fat) was measured by DXA; and dietary intake (energy intake, timing) was measured using two 24-hour recalls. Multivariable regression was used to estimate interindividual associations of sleep parameters with body composition, PA, TEE, and dietary outcomes and to examine the relationships between sleep and dietary behaviors and body composition 1 year later. Cross-sectionally, later sleep midpoint is associated with having a greater fat mass (0.33; 95% CI: 0.05, 0.60) and a higher percent body fat (0.92; 95% CI: 0.15, 1.70). Later sleep midpoint was associated with delayed morning mealtimes (0.51; 95% CI: 0.28, 0.74) and evening mealtimes (0.41; 95% CI: 0.29, 0.53), higher nighttime energy intakes (45.6; 95% CI: 19.7, 71.4), and lower morning energy intakes (-44.8; 95% CI: -72.0, -17.6). Longitudinally, shorter sleep duration (-0.02; 95% CI: -0.03, 0.00) and later meal timing (0.83; 95% CI: 0.24, 1.42) were associated with higher percent body fat measurements 1 year later. Shorter sleep duration and later meal timing are associated with adiposity gains in preschoolers.

Factors Associated With Trajectories of Externalizing Behavior in Preschoolers.

More media exposure and life stressors are associated with higher levels of externalizing behaviors in young children; however, their joint impact on externalizing behavior trajectory is unknown. This study assessed the relationship of stressful life events (SLE), media exposure, and additional demographic and family variables on the trajectory of externalizing behaviors in preschool-aged children. Participants were children ages 3 to 5 years from a large, 18-month duration, randomized control trial to reduce inappropriate media exposure. The sample was recruited from community pediatrics' practices. Intervention and control groups were collapsed, with study arm a covariate. Latent growth modeling (LGM) was conducted, with main outcome of externalizing behaviors at 6, 12, and 18 months after study initiation.Primary exposures of interest were total daily media hours, SLE, intimate partner violence, and harsh parenting. Final analyses included 613 children. LGM without covariates revealed a significant decrease in mean externalizing score between baseline and 18 months. LGM with covariates revealed that individuals with more media exposure exhibited more externalizing behaviors and SLE significantly predicted a slower decline in externalizing behaviors. Externalizing behavior at 18 months was significantly predicted by SLE, child age, white non-Hispanic race, and harsh parenting. Exposure to a greater number of stressful life eventsappears to slow the age-appropriate decline in externalizing behaviorsfor preschool-aged children, while harsh parenting and media exposure are associated with more externalizing behavior. Findings highlight the importance of screening and surveillance in primary care and the need for early intervention efforts targeted to these risks.

Razumijevanje rizičnih ponašanja djece: Perspektive odgajatelja i stručnih suradnika dječjeg vrtića

The overall aim of this paper is to investigate, describe, and compare the understanding of the concept of risk behaviors in preschool-aged children from two perspectives (preschool teachers’ and expert associates’ perspectives). The paper presents the results of a qualitative analysis of focus groups with preschool teachers and expert associates from 31 kindergartens in Rijeka who provided a description and interpretation of their understanding of the concept of risk behaviors in children with whom they worked or are currently working. For the analysis of the focus group transcript, we applied a thematic analysis according to Clarke and Braun (2013), which isolated two topics: “phenomenology and criteria for assessing risk behaviors” and “etiological factors.” Among the described phenomena and assessment criteria, preschool teachers and expert associates provided similar responses: forms/types of risk behaviors as well as general and specific criteria for assessing risk behaviors. Among the etiologic factors, they notice factors in all ecological areas and the child himself. The results showed a relative alignment of the two perspectives, while certain specifics in both topics can be recognized between preschool teachers and professionals, which is likely due to the differences in their initial education. The contribution of the work is in considering risky behaviors of kindergarten children and their perception by the professionals who work with them and, in practical terms, in the implication of joint team and coordinated action and individual approach to each child and family in the prevention and intervention of behavioral problems. Key words: child; early and preschool age; emotional-behavioral problems EBD; kindergarten; risk behaviors

Associations Between the Gut Microbiota and Internalizing Behaviors in Preschool Children.

Emerging evidence points toward a connection between mental health and the gut microbiota and its metabolites (e.g., short-chain fatty acids). It is unknown whether the gut microbiota is associated with the development of mental health problems (e.g., internalizing or externalizing behaviors) in preschool children. The objective of this study was to evaluate associations between the gut microbiota and internalizing and externalizing behaviors in preschool-aged children. A community sample of 248 typically developing children (3-5 years of age) provided a stool sample for gut microbiota and SCFA analysis. Parents reported child internalizing and externalizing behaviors using the Child Behavior Checklist. Associations between child behaviors and gut microbiota measures were analyzed using Spearman correlations followed by an adjustment for multiple testing, with subanalysis conducted in children clinically "at risk" for behavioral problems compared with those who were not. There was a correlation between Shannon alpha diversity with internalizing behaviors (rs = -0.134, p = .035) and its subscale somatic complaints (rs = -0.144, p = .023). In addition, children clinically "at risk" for internalizing problems had decreased alpha diversity (U = 551, p = .017). Internalizing behaviors correlated with valerate and isobutyrate (rs = -0.147, p = .021; rs = -0.140, p = .028, respectively). Furthermore the somatic complaints subscale additionally correlated with acetate and butyrate (rs = -0.219, p = .001; rs = -0.241, p < .001, respectively). These findings were also present in children "at risk" for internalizing problems (U = 569, p = .026; U = 571, p = .028) and somatic complaints (U = 164, p = .004; U = 145, p = .001). These analyses reveal novel associations between internalizing behaviors and the gut microbiota in preschool children. Furthermore, a relationship between somatic complaints and acetate and butyrate was identified, indicating that interventions that increase SCFA production warrant future investigation.

Sleep and Behavior 24 Months After Early Tonsillectomy for Mild OSA: An RCT.

The Preschool Obstructive Sleep Apnea Tonsillectomy and Adenoidectomy study is a prospective randomized controlled study of children aged 3 to 5 years. This follow-up evaluated postoperative outcomes 24 months after randomization. Baseline, 12-month, and 24-month assessments included intellectual ability, polysomnography, audiology, a pediatric sleep questionnaire, the parent rating scale of the Behavior Assessment System for Children, and the Behavior Rating Inventory of Executive Functioning. In total, 117 (55% male) of 190 children, 61.6% of those initially randomly assigned, attended 24-month follow-up; 62 of 99 were assigned T/A within 2 months (eT/A); and 55 of 91 were assigned to T/A after the 12-month follow-up (T/A12). Intellectual ability, our primary outcome, did not differ according to the timing of T/A. Exploratory analyses revealed changes in both groups after T/A, including fewer children having day sleeps (eT/A from baseline 97% to 11%, T/A12 from 36% at 12 months to 9%), improved symptom scores (eT/A 0.62 to 0.25, T/A12 0.61 to 0.26; P < .001), improved behavior T-scores (eT/A 71.0 to 59.9, T/A12 63.6 to 50.5; P < .001), and improved polysomnography (obstructive apnea-hypopnea index eT/A 1.9 to 0.3 per hour, T/A12 1.3 to 0.3; P < .001). The eT/A group revealed temporary postoperative improvement of Woodcock-Johnson III subscales (sound blending and incomplete word scores) and behavioral withdrawal. T/A for mild obstructive sleep apnea led to large improvements in sleep and behavior in preschool-aged children, regardless of the timing of surgery.

Non-random acts of kindness: Joint music making increases preschoolers’ helping and sharing with an adult

Research has shown that musical engagement promotes prosocial behavior in preschool-aged children under some conditions but not others. The current study tested whether an active musical interaction between a preschooler ( Mage: 56 months), an experimenter, and a research assistant would result in more sharing and helping behavior than a matched, non-musical interaction, while examining the extent to which a naturalistic musical interaction actually produced interpersonal movement synchrony. Verbal content was also manipulated (didactic/neutral). The results showed that musical play was associated with more spontaneous helping and overall sharing than non-musical play. Analysis of synchrony and joint movement within the experimental interaction showed that musical play resulted in significantly more joint movement and interpersonal synchrony than non-musical play, but that even in musical conditions, joint movement was only synchronized for a fraction of the length of the interaction. There was no evidence of an effect of verbal content on children’s behavior, despite uniformly high retention for the content of the song or poem across conditions. These findings provide further evidence that music making can facilitate prosocial behavior in preschoolers, regardless of lyrical content, and that joint movement may play a more significant role than precise movement synchrony in preschoolers’ musical engagement.

Digit ratio, a proposed marker of the prenatal hormone environment, is not associated with prenatal sex steroids, anogenital distance, or gender-typed play behavior in preschool age children.

Prenatal hormones have been proposed as key factors impacting child development as well as long-term health and disease. Digit ratio (the ratio of the lengths of the second to fourth digits; 2D:4D) has been proposed as a sexually dimorphic, noninvasive marker of prenatal androgen exposure that can be reliably measured in children and adults. To date, few longitudinal pregnancy cohort studies have examined childhood digit ratio in relation to other relevant measures including prenatal hormones and androgen-sensitive outcomes. To augment the current literature on this topic, we measured right-hand digit ratio in 4-year-old children participating in The Infant Development and the Environment Study, a multicenter longitudinal cohort study that has been following mother-child dyads since the first trimester of pregnancy (n = 321). We assessed sex differences in digit ratio and fit multivariable linear regression models to examine digit ratio in relation to: (1) child sex; (2) maternal sex steroid hormone concentrations in early pregnancy; (3) newborn anogenital distance, another proposed measure of sensitivity to prenatal androgens; and (4) gender-typical play behavior as measured by the Preschool Activities Inventory (PSAI) at age 4. We observed no sex difference in digit ratio; the mean 2D:4D was 0.97 ± 0.05 mm in both sexes. Furthermore, digit ratio was not associated with maternal sex steroid concentrations in early pregnancy, anogenital distance in either sex, or PSAI scores in either sex in covariate-adjusted models. In conclusion, we observed no evidence that early childhood digit ratio was associated with child sex or hormone-sensitive measures in this cohort.

Even ‘Child-Friendly’ Apps Routinely Share Data

Back to table of contents Previous article Next article Clinical & ResearchFull AccessEven ‘Child-Friendly’ Apps Routinely Share DataNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:16 Nov 2020https://doi.org/10.1176/appi.pn.2020.11a32AbstractNew analysis shows that most apps played by preschoolers transmit user data to third-party companies in defiance of federal guidelines. Psychiatrists should be cognizant that mental health apps for young patients also pose privacy risks.iStock/SDI ProductionsA study recently published in JAMA Pediatrics reported that about two-thirds of apps played by a cohort of young children transmitted user information to third parties for advertising purposes. Though the study focused on entertainment apps used by healthy preschoolers, the findings that federal privacy rules for apps are not being enforced should serve as a red flag for mental health professionals who treat children.Under the Children’s Online Privacy Protection Act (COPPA), platforms and creators of digital products must obtain verifiable consent from parents before collecting and sharing personally identifiable information from children under age 13 from a phone or other device. Many apps used by children can circumvent COPPA regulations by claiming they are meant for a general audience, but Jenny Radesky, M.D., a professor of pediatrics at the University of Michigan Medical School, found that even apps billed as “child friendly” run afoul of COPPA.Radesky and colleagues assessed data from an ongoing longitudinal study of how mobile media use affects development and behavior in preschool-aged children. As part of that study, parents were instructed to download a passive sensing app onto in their devices, which logged when and for how long apps were being used over a nine-day period. Radesky’s analysis included 124 preschoolers who used Android devices (her team’s transmission testing software is Android based); together this group of children used 451 apps.Of the apps tested by the preschoolers, 303 (67%) transmitted some information (such as device location or device serial number) to one or more third parties. While apps designated as “Designed for Families (DFF)” by Google were better, they were far from perfect; 56% of DFF apps still transmitted some data, compared with 73% of non-DFF apps.Radesky told Psychiatric News that the data transmitted on younger children’s app activities typically include such information as how often they use the app, how often they make in-app purchases, and how often they answer things correctly or wrong. “As children get older, however, they start sharing more personal items about themselves through games or social media, which increases the sensitivity of the transmitted information,” she said.The data gleaned from mental health apps may be even more personal. “These apps promise to help you manage your health condition or motivate behavior change, but that involves inputting very private information,” she said. “I worry that children’s psychological vulnerabilities—say, anxiety or body image concerns—are passively manifested in some online behaviors, such as which videos they watch.” Third parties acquiring data from apps might exploit such behavior for advertising gains—such as selling diet products.Data suggest many mental health apps share data with third parties in a similar manner to entertainment apps, said John Torous, M.D. He is the director of digital psychiatry at Beth Israel Deaconess Medical Center in Boston and a member of APA’s App Advisor Expert Panel.In 2019, Torous and colleagues published a study showing that nearly 90% of the top-ranked free apps for depression or smoking cessation transmitted data to analytics or advertising services by Facebook or Google. Less than half of these apps fully disclosed this information in their privacy policy.“When discussing apps with families, I always go with the basic assumption that the child’s data will be transmitted somewhere, and that becomes part of the risk-benefit analysis when we decide if a certain app might be helpful in therapy,” said Meredith Gansner, M.D., a child and adolescent psychiatrist at Boston area’s Cambridge Health Alliance and an instructor at Harvard Medical School. “It’s akin to the side effects of a medication, although in this case we are not sure of the outcome since we don’t exactly know what the companies are doing with the user data. That uncertainty is actually the scary part.”Still, as an attending psychiatrist at a safety-net health system, Gansner knows that apps can be a valuable tool for families with fewer resources, so she does not dismiss apps as an option for any child, regardless of age.Radesky said that in general, she has stopped recommending commercially available apps (including pediatric mental health apps such as behavior trackers or visual timers for children with autism spectrum disorder) in her clinical practice.Before recommending apps to patients, she recommends physicians first vet data transmission details as best they can. “This information is intentionally obscured for consumers, so even a thorough reading of an app’s privacy policy won’t give you all the answers.”She said physicians at large hospitals or academic centers might check whether their information technology personnel would offer to vet potential apps. Physicians and parents can also find children’s app reviews on advocacy sites such as Common Sense Media or databases from digital privacy watchdogs; for instance, researchers at the University of California, Berkeley, recently set up a website called AppCensus that tests what type of data is being shared by a variety of apps, including mental health apps.Another option is APA’s new App Advisor tool. Torous said that an independent reviewer recently evaluated several app evaluation models and found that APA’s tool offers a robust assessment of privacy risks compared with others. ■“Data Collection Practices of Mobile Applications Played by Preschool-Aged Children” is posted here.“Assessment of the Data Sharing and Privacy Practices of Smartphone Apps for Depression and Smoking Cessation” is posted here. ISSUES NewArchived

Machine learning-based prediction of persistent oppositional defiant behavior for 5 years

Background Early detection of oppositional defiant behavior is warranted for timely intervention in children at risk. This study aimed to build a predictive model of persistent oppositional defiant behavior based on a machine learning algorithm. Methods With nationwide cohort data collected from 2012 to 2017, a tree-based ensemble model, random forest, was exploited to build a predictive model for persistent oppositional defiant behavior. The persistent oppositional defiant behavior was defined by the presence of oppositional defiant behavior for all the five years. The area under the receiver operating characteristic curve (AUC), overall accuracy, sensitivity, specificity, and Matthew’s correlation coefficients (MCC) were measured. Results Data of 1,323 children were used for building the machine learning-based predictive model. The baseline mean ± standard deviation month-age of the participants was 51.0 ± 1.2 months. The proportion of persistent oppositional defiant behavior was 0.98% (13/1323). In the hold-out test set, the overall accuracy, AUC, sensitivity, specificity, and MCC were 0.955, 0.982, 1.000, 0.954, and 0.417, respectively. Conclusion Our study demonstrated that the machine learning-based approach is useful for predicting persistent oppositional defiant behavior in preschool-aged children.

Sleep Problems Influence Emotional/Behavioral Symptoms and Repetitive Behavior in Preschool-Aged Children With Autism Spectrum Disorder in the Unique Social Context of China.

Sleep disturbances are common in people with autism spectrum disorder (ASD), but research on this topic is still limited in China. In the current study, we evaluated the prevalence of sleep problems in preschool-aged children with ASD and to examine the correlations between sleep disturbances and emotional/behavioral symptoms and repetitive behavior in the unique social context of China. This study recruited 475 preschool-aged children aged 3–6 years old, including 252 children with ASD (mean age 5.13 ± 1.15, 80.6% male) and 223 age-matched typically developing (TD) children (mean age 5.12 ± 0.97, 74.9% male). The parents of all children completed a sociodemographic questionnaire and the Childhood Sleep Habits Questionnaire. The parents of 114 ASD children completed the Strengths and Difficulties Questionnaire (SDQ) and the Repetitive Behavioral Questionnaire-2 (RBQ-2). The prevalence of sleep problems in preschool-aged children with ASD in this study was 81.7%, which was higher than that in TD children (61.0%). The scores for bedtime resistance, sleep anxiety, sleep duration, parasomnias, and sleep onset delay in the ASD group were significantly higher than those in the TD group (t=−7.664, P=0.000; t=−10.477, P=0.000; t=−4.133, P=0.000; Z=−3.916, P=0.000; Z=−7.093, P=0.000; respectively). Sleep onset delay explained 17.3% of the variance (adjusted R2 = 0.173) in the total SDQ score of children with ASD, and bedtime resistance explained a large proportion of total RBQ-2 score variance (adjusted R2 = 0.206). The high rate of sleep disturbances in preschool-aged children with ASD emphasizes the importance of screening for sleep problems in this population. Attention should also be directed toward formulating good sleep hygiene practices for preschool-aged children in the particular social context and cultural setting of China.

Utilizing the RE-AIM framework to determine effectiveness of a preschool intervention program on social-emotional outcomes

Social-emotional issues in preschoolers continue to be an area of concern across the nation. Models to determine effective implementation practices are needed. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework is one model that can be used to evaluate program implementation in preschool settings. The Jump Start program provided short-term intervention to children in low-income preschools from multiethnic backgrounds. The goal was to promote prosocial behaviors while minimizing problem behaviors. Various evidenced-based practices (i.e., I Can Problem Solve, play therapy, Pyramid Model) were utilized. 305 children from 73 childcare centers participated in the program. The majority of participants were from ethnic minority backgrounds and resided in high-poverty areas of the county. The RE-AIM framework was utilized to determine program outcomes. Results showed successes on each level of RE-AIM with an at-risk population. The Jump Start program significantly increased positive behaviors and decreased challenging behaviors in preschool-aged children. Results indicated medium to large effect sizes. One year following program participation, the majority of children who participated in the program were at decreased risk of special education services and expulsion.

Child-Adult Relationship Enhancement in Primary Care: A Randomized Trial of a Skill-Based Parent Training with Parent Mentor Adaptation.

Child-Adult Relationship Enhancement in Primary Care (PriCARE) is a 6-session group training designed to teach positive parenting skills. Parent engagement in such programs is a common implementation barrier. Our objectives were to (1) examine the impact of a peer mentor on attendance and stigma and (2) replicate a previous study by measuring PriCARE's impact on child behavior and parenting practices. Parents of 2- to -6-year-old children without specific behavior problems were randomized to mentored PriCARE (n = 50), PriCARE (n = 50), or control (n = 50). Stigma was measured at 10 weeks. Child behavior and parenting practices were measured at baseline and 10 weeks using the Eyberg Child Behavior Inventory (ECBI) and Parenting Scale (PS). Analysis of variance models were used to examine differences across groups. There was no significant difference in attendance between mentored PriCARE and PriCARE arms (mean 3.80 vs 3.36 sessions, p = 0.35). Parents randomized to the mentor reported lower stigma (3.75 vs 5.04, p = 0.02). Decreases in the mean ECBI scores between 0 and 10 weeks were greater in the PriCARE arms (n = 100) compared with the control arm (n = 50), reflecting larger improvements in behavior [intensity: -7 (-2 to -13) vs 4 (-3 to 12) to p = 0.014; problem: -3 (-1 to -4) vs 1 (-1 to 3) to p = 0.007]. Scores on all PS subscales reflected greater improvements in parenting behaviors in PriCARE arms compared with control (all p < 0.04). Adapting PriCARE with a peer mentor may decrease stigma but does not improve program attendance. PriCARE shows promise in improving behavior in preschool-aged children and increasing positive parenting practices.