Child Behaviour Problems Research Articles

The Effects of Social Support and Teacher Efficacy on Child Care Teacher’s Strategies for Addressing Early Childhood Behavior Problems

The Effects of Social Support and Teacher Efficacy on Child Care Teacher’s Strategies for Addressing Early Childhood Behavior Problems

Psychopathic Personality Works Better than CU Traits for Predicting Fearlessness and ADHD Symptoms among Children with Conduct Problems

Children with early-onset conduct problems (CP) are at great risk for future behavior problems, and this risk seems to increase when CP co-occur with psychopathic traits. Even though studies are indicating that the entire psychopathic personality construct may be more useful in designating a meaningful subgroup of children with CP, research on psychopathic traits and CP in childhood have mainly focused on the role of callous unemotional (CU) traits. Prospective longitudinal data of 1867 3- to 5-year-olds (47% girls) followed annually for two years was used to compare groups of children with different combinations of CP and psychopathic traits on fearlessness and Attention-Deficit Hyperactivity Disorder (ADHD) symptoms. Children with CP and psychopathic personality had higher baseline and stable levels of ADHD symptoms than children with CP only or children with CP and concurrent CU traits, while baseline levels of fearlessness did not differ. They were also more likely to display stable levels of the risky combination of CP and ADHD symptoms. Results were similar for boys and girls. Findings indicate that there are reasons to consider other traits and behaviors as specifiers for subgroups of children with CP over and above CU traits, in order to optimize both diagnostic practice and treatment outcomes.

Behavioural and emotional disorders in childhood: A brief overview for paediatricians

Mental health problems in children and adolescents include several types of emotional and behavioural disorders, including disruptive, depression, anxiety and pervasive developmental (autism) disorders, characterized as either internalizing or externalizing problems. Disruptive behavioural problems such as temper tantrums, attention deficit hyperactivity disorder, oppositional, defiant or conduct disorders are the commonest behavioural problems in preschool and school age children. The routine Paediatric clinic or Family Medicine/General Practitioner surgery presents with several desirable characteristics that make them ideal for providing effective mental health services to children and adolescents. DSM-5 and ICD-10 are the universally accepted standard criteria for the classification of mental and behaviour disorders in childhood and adults. The age and gender prevalence estimation of various childhood behavioural disorders are variable and difficult to compare worldwide. A review of relevant published literature was conducted, including published meta-analyses and national guidelines. We searched for articles indexed by Ovid, PubMed, PubMed Medical Central, CINAHL, EMBASE, Database of s and Reviews, and the Cochrane Database of Systematic reviews and other online sources. The searches were conducted using a combination of search expressions including “childhood”, “behaviour”, “disorders” or “problems”. Childhood behaviour and emotional problems with their related disorders have significant negative impacts on the individual, the family and the society. They are commonly associated with poor academic, occupational, and psychosocial functioning. It is important for all healthcare professionals, especially the Paediatricians to be aware of the range of presentation, prevention and management of the common mental health problems in children and adolescents.

Mitigating the effect of persistent postnatal depression on child outcomes through an intervention to treat depression and improve parenting: a randomised controlled trial

Maternal postnatal depression occurs following 10-15% of births and is associated with a range of negative child outcomes. Risks to children are particularly increased when postnatal depression is persistent. We aimed to examine whether a parenting video-feedback therapy (VFT) intervention versus a control treatment of progressive muscle relaxation (PMR), both added to cognitive behavioural therapy (CBT) for persistent postnatal depression, would lead to improved child outcomes at age 2 years. In this two-arm, parallel-design, individually randomised controlled trial, we recruited a community sample of women aged 18 years or older living within 50 miles of Oxford, UK, between 4·5 and 9·0 months post partum. All participants met diagnostic criteria for current major depressive disorder that had persisted for at least 3 months and had infants at 35 or more weeks of gestation, with a birthweight of 2000 g or greater, and without serious neonatal complications. Through a centralised service, women were randomly assigned by use of a minimisation algorithm, to receive either VFT or PMR, balanced for child sex, temperament, age, socioeconomic status, and severity of depression. Both groups also received CBT for depression. Primary outcomes were child cognitive development, language development, behaviour problems, and attachment security at age 2 years. There were 11 home-based treatment sessions before child age 1 year, followed by two booster sessions in the second year. Assessors were masked to treatment group allocation. All analyses were done according to the intention-to-treat principle. This trial is registered with the ISRCTN registry, number ISRCTN07336477. Between March 18, 2011, and Dec 9, 2013, we randomly assigned 144 women, 72 to each group. Primary outcome data were available for 62-64 (86-89%) VFT and 67-68 (93-94%) PMR participants. There were no group differences in child outcome (cognitive development, adjusted difference -1·01 [95% CI -5·11 to 3·09], p=0·63; language development, 1·33 [-4·16 to 6·82], p=0·63; behaviour problems, -1·77 [-4·39 to 0·85], p=0·19; attachment security, 0·02 [-0·06 to 0·10], p=0·58), with both groups achieving scores similar to non-clinical norms on all outcomes. There were six serious adverse events: five in the VFT group (in two participants) and one in the PMR group. None was treatment-related. The effect of persistent postnatal depression on children is a major public health issue. For both treatment groups there was sustained remission from depression, and child development outcomes were in the normal range. The precise mechanisms accounting for the observed positive child outcomes cannot be ascertained from this study. Wellcome Trust.

An Imbalance of Approach and Effortful Control Predicts Externalizing Problems: Support for Extending the Dual-Systems Model into Early Childhood.

Although the association between deficits in effortful control and later externalizing behavior is well established, many researchers (Nigg Journal of Child Psychology and Psychiatry, 47(3-4), 395-422, 2006; Steinberg Developmental Review, 28(1), 78-106, 2008) have hypothesized this association is actually the product of the imbalance of dual systems, or two underlying traits: approach and self-regulation. Very little research, however, has deployed a statistically robust strategy to examine that compelling model; further, no research has done so using behavioral measures, particularly in longitudinal studies. We examined the imbalance of approach and self-regulation (effortful control, EC) as predicting externalizing problems. Latent trait models of approach and EC were derived from behavioral measures collected from 102 children in a community sample at 25, 38, 52, and 67months (2 to 5 ½years), and used to predict externalizing behaviors, modeled as a latent trait derived from parent-reported measures at 80, 100, 123, and 147months (6 ½ to 12years). The imbalance hypothesis was supported: Children with an imbalance of approach and EC had more externalizing behavior problems in middle childhood and early preadolescence, relative to children with equal levels of the two traits.

Screening for disruptive behaviour problems in preschool children in primary health care settings

[This corrects the article DOI: 10.1093/pch/pxx128.]

Society Pays Big Time for Adults with Childhood Conduct Problems

Longitudinal studies of childhood conduct disorders have historically examined clinical populations. These researchers conducted a first-ever

Parenting a Child with Phenylketonuria: AnInvestigation into the Factors That Contribute toParental Distress.

Phenylketonuria (PKU) is an inherited metabolic condition that can lead to the onset of intellectual disabilities if not strictly managed through a low-protein diet. Parents are responsible for supervising their child's treatment for PKU, which may impact on their experience of distress. This cross-sectional study aimed to identify the factors that contribute to distress in parents who care for a child with PKU, distinct from parents in the general population. Thirty-eight parents of children and adolescents with PKU and 32 parents in the general population completed the questionnaires measuring parental psychological resilience, child behaviour problems, perceived social support and distress. Parents of children with PKU also completed measures of their child's care dependency and behaviour related to developmental and intellectual disabilities. The findings revealed no statistically significant differences in distress between the groups, but parents of children with PKU reported more child behaviour problems. Multiple regression analysis identified that parental psychological resilience and child anxious behaviour explained 35% of the variance in distress for parents of children with PKU. By comparison, parental psychological resilience and generic child behaviour only accounted for 19% of the variance in distress for parents in the general population. This has implications for developing interventions in clinical settings that aim to reduce parents' distress by enhancing their psychological resilience and supporting them to manage child behaviour difficulties, particularly anxious behaviour. Future research should include larger, more diverse samples and use longitudinal study designs.

Effectiveness of Behaviour Modification Strategies in School Going Children for Specific Classroom Behaviour

Background: It has been seen that normal children have some behavioural problems that may affect their academic performance, despite of having no disability. The prevalence of such behaviour problems in children is alarmingly high. The number of affected children and adolescents is still staggering. Specially, in set ups where, there are very less number of teachers available for students, who are unable to pay attention on these behavioural issues of children. Thus, these problems are been overlooked, which in long run can create difficulties in shaping the future of the children. Hence, there is a need to pay attention by helping the children with the behavioural problems. There are some studies which show that behaviour therapy works to change problematic behaviours in children. Thus these strategies will help the children to change their specific behavioural problems and adapt to the social environment more efficiently.Methodology: 78 participants were examined for the study. Their particular problematic behaviours were selected and the interventions for them were set. Intervention was given for a period of 8 weeks, twice per week and the session lasted for a period of 40-45 minutes. Daily assessment was taken on time sampling and frequency recording forms. Behaviour Modification was applied.Results: Baseline data of Time sampling and frequency recording was collected and recorded on the first day before starting the intervention then at fourth week and then at eighth week. The results for the study were analysed through comparison of the results at baseline, fourth week and eighth week readings. The percentage increase or decrease in the behaviours was recorded according to the time sampling and frequency recordingConclusion: Behaviour Modification Strategies are effective technique to reduce problem behaviours shown by students in the classroom.

Childhood psychopathic personality and callous–unemotional traits in the prediction of conduct problems.

This study analyzed data from a prospective longitudinal study of Swedish preschoolers to examine whether psychopathic traits and concurrent conduct problems predict future conduct problems (CP) across 1- and 2-year follow-ups into early childhood. We tested the predictive ability of psychopathic traits while controlling for concurrent CP, and also by combining psychopathic traits with concurrent CP. A community sample of 1,867 preschoolers (47% girls) ages 3 to 5 years at baseline was recruited from a Swedish medium-sized municipality. Results from multivariate regression analyses showed that psychopathic traits alone (without co-occurring CP) did not consistently predict continuing childhood CP, but did so, among both boys and girls, in combination with concurrent conduct problems. It is important to note that, the combination of concurrent CP and the entire psychopathic personality, that is, a 3-dimensional psychopathic construct, was a stronger predictor of continuing childhood CP than the combination of concurrent CP and Callous-Unemotional (CU) traits among boys but not among girls. (PsycINFO Database Record

Links between sleep and daytime behaviour problems in children with Down syndrome.

In the general population, sleep problems have an impact on daytime performance. Despite sleep problems being common among children with Down syndrome, the impact of sleep problems on daytime behaviours in school-age children with Down syndrome is an understudied topic. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports of daytime behaviour problems among school-age children with Down syndrome. Thirty school-age children with Down syndrome wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Their parent and teacher completed a battery of measures to assess daytime behaviour. Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire, but not actigraph-measured sleep efficiency, was predictive of parent and teacher behavioural concerns on the Nisonger Child Behaviour Rating Form and the Vanderbilt ADHD Rating Scales. Actigraph-measured sleep period and parent-reported sleep duration on the Children's Sleep Habits Questionnaire was predictive of daytime parent-reported inattention. Actigraph-measured sleep period was predictive of parent-reported hyperactivity/impulsivity. The study findings suggest that sleep problems have complex relationships to both parent-reported and teacher-reported daytime behaviour concerns in children with Down syndrome. These findings have implications for understanding the factors impacting behavioural concerns and their treatment in school-age children with Down syndrome.

Factors that influence parent recruitment into prevention programs in early childhood: A concept map of parents', practitioners', and administrators' points of view

Given that parents are the main carriers of change in their child, their participation in programs for preventing behavior problems in early childhood represents a key element in ensuring the success of the intervention. That said, although at-risk families benefit the most from this type of program, they are identified as being hard to reach. This study aims at identifying the factors that influence parent recruitment based on the points of view of the actors concerned. To this end, a concept mapping operation was performed, which involved parents (n=19), practitioners (n=19), and administrators (n=13) from community and public organizations. The participants generated 131 statements to complete the following sentence: In your opinion, parents would enroll more in prevention activities for their child if…. These 131 statements were classified into 12 groups representing the factors that influence parent recruitment, all of which were considered relatively important (between 3.51 and 4.42 on 5). The participants also agree on an understanding of recruitment that tends toward an ecological model. This study shows that parent recruitment into prevention programs targeting behavior problems in early childhood is complex and multifactorial (including factors that concern parents, practitioners, services, organizations, and policies). Because the map shows that the influencing factors in recruitment appear to be interrelated, they should all be considered to increase the chances of reaching at-risk families.

Childhood behaviour problems show the greatest gap between DNA-based and twin heritability

For most complex traits, DNA-based heritability (‘SNP heritability’) is roughly half that of twin-based heritability. A previous report from the Twins Early Development Study suggested that this heritability gap is much greater for childhood behaviour problems than for other domains. If true, this finding is important because SNP heritability, not twin heritability, is the ceiling for genome-wide association studies. With twice the sample size as the previous report, we estimated SNP heritabilities (N up to 4653 unrelated individuals) and compared them with twin heritabilities from the same sample (N up to 4724 twin pairs) for diverse domains of childhood behaviour problems as rated by parents, teachers, and children themselves at ages 12 and 16. For 37 behaviour problem measures, the average twin heritability was 0.52, whereas the average SNP heritability was just 0.06. In contrast, results for cognitive and anthropometric traits were more typical (average twin and SNP heritabilities were 0.58 and 0.28, respectively). Future research should continue to investigate the reasons why SNP heritabilities for childhood behaviour problems are so low compared with twin estimates, and find ways to maximise SNP heritability for genome-wide association studies.

Screening for disruptive behaviour problems in preschool children in primary health care settings

Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some noncompliance, temper tantrums and aggression between 2 and 5 years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when accompanied by functional impairment and/or significant distress, should be identified because early intervention can improve outcome trajectories. This position statement provides an approach to early identification using clinical screening at periodic health examinations, followed by a systematic mental health examination that includes standardized measures. The practitioner should consider a range of environmental, developmental, family and parent-child relationship factors to evaluate the clinical significance of disruptive behaviours. Options within a management plan include regular monitoring, accompanied by health guidance and parenting advice, referral to parent behaviour training as a core evidence-based intervention, and referral to specialty care for preschool children with significant disruptive behaviours, developmental or mental health comorbidities, or who are not responding to first-line interventions.

Program Components of Psychosocial Interventions in Foster and Kinship Care: A Systematic Review.

Foster children frequently experience early trauma that significantly impacts their neurobiological, psychological and social development. This systematic review examines the comparative effectiveness of foster and kinship care interventions. It examines the components within each intervention, exploring their potential to benefit child and carer well-being, particularly focussing on child behaviour problems, and relational functioning. Systematic searches of electronic databases included PsycINFO, MEDLINE, Web of Science Core Collection, the Cochrane Collaborations Register of Controlled Trials (CENTRAL) and Scopus to identify randomised or quasi-randomised trials of psychosocial foster/kinship care interventions, published between 1990 and 2016. Seventeen studies describing 14 interventions were included. Eleven studies reported comparative benefit compared to control. Overall, effective interventions had clearly defined aims, targeted specific domains and developmental stages, provided coaching or role play, and were developed to ameliorate the effects of maltreatment and relationship disruption. Interventions effective in reducing behaviour problems included consistent discipline and positive reinforcement components, trauma psychoeducation, problem-solving and parent-related components. Interventions effective in improving parent-child relationships included components focussed on developing empathic, sensitive and attuned parental responses to children's needs. Given the prevalence of both behaviour problems and relational difficulties in foster families, targeting these needs is essential. However, interventions have tended to measure outcomes in either behavioural or relational terms. A more coordinated and collaborative research approach would provide a better understanding of the association between parent-child relationships and child behaviour problems. This would allow us to develop, deliver and evaluate programs that combine these components more effectively. Protocol Registration Number: PROSPERO CRD42016048411.

The effects of child maltreatment on childhood behaviour problems in South Korea: findings from the fifth Korea Child and Youth Panel Survey (the 2014 KCYPS)

The study examines the effects of child maltreatment on children behavioural problems in South Korea. We found that 11.5% of children experienced physical abuse, 28.7% experienced emotional abuse and about 35% experienced neglect. After controlling for all socio-demographic factors, children who experienced physical abuse, emotional abuse and neglect were more likely to develop internalised as well as externalised behavioural problems such as depression, aggression, underage smoking, underage drinking and engaging in cyber delinquency. The results point towards a need to develop social welfare interventions to mitigate physical/emotional abuse and neglect so as to prevent behavioural problems in South Korean children.

Evaluation of Positive Parenting Programme (Triple P) in Singapore: Improving parenting practices and preventing risks for recurrence of maltreatment

Caregivers of children in the child welfare system (CWS) often need more support in their parenting efforts. Some of these caregivers only need parenting related advices, whereas others may need more intensive training to prevent recurrence of maltreatment. Few parenting interventions can be delivered to both groups of caregivers with satisfying results. This study investigated the treatment change associated with Positive Parenting Programme (Triple P) on 83 caregivers who completed either the Level 4 version or the Level 5 (Pathways) version of the programme (mean age=40.6years). Repeated measure analysis showed significant improvement in common outcomes such as parenting practices, children's behaviour problems, parental satisfaction, and parents' psychological adjustment for both groups of caregivers. However, changes on Level 5 (Pathways) specific outcomes were not statistically significant. Further analysis suggested this lack of change may be due to the distinct profiles of dropouts in Level 5 Triple P. Study limitation and its implication for future research as well as programme development was also discussed.

Community Violence Exposure and Conduct Problems in Children and Adolescents with Conduct Disorder and Healthy Controls.

Exposure to community violence through witnessing or being directly victimized has been associated with conduct problems in a range of studies. However, the relationship between community violence exposure (CVE) and conduct problems has never been studied separately in healthy individuals and individuals with conduct disorder (CD). Therefore, it is not clear whether the association between CVE and conduct problems is due to confounding factors, because those with high conduct problems also tend to live in more violent neighborhoods, i.e., an ecological fallacy. Hence, the aim of the present study was: (1) to investigate whether the association between recent CVE and current conduct problems holds true for healthy controls as well as adolescents with a diagnosis of CD; (2) to examine whether the association is stable in both groups when including effects of aggression subtypes (proactive/reactive aggression), age, gender, site and socioeconomic status (SES); and (3) to test whether proactive or reactive aggression mediate the link between CVE and conduct problems. Data from 1178 children and adolescents (62% female; 44% CD) aged between 9 years and 18 years from seven European countries were analyzed. Conduct problems were assessed using the Kiddie-Schedule of Affective Disorders and Schizophrenia diagnostic interview. Information about CVE and aggression subtypes was obtained using self-report questionnaires (Social and Health Assessment and Reactive-Proactive aggression Questionnaire (RPQ), respectively). The association between witnessing community violence and conduct problems was significant in both groups (adolescents with CD and healthy controls). The association was also stable after examining the mediating effects of aggression subtypes while including moderating effects of age, gender and SES and controlling for effects of site in both groups. There were no clear differences between the groups in the strength of the association between witnessing violence and conduct problems. However, we found evidence for a ceiling effect, i.e., individuals with very high levels of conduct problems could not show a further increase if exposed to CVE and vice versa. Results indicate that there was no evidence for an ecological fallacy being the primary cause of the association, i.e., CVE must be considered a valid risk factor in the etiology of CD.

From Childhood Conduct Problems to Poor Functioning at Age 18 Years: Examining Explanations in a Longitudinal Cohort Study

ObjectiveChildhood conduct problems are associated with poor functioning in early adulthood. We tested a series of hypotheses to understand the mechanisms underlying this association.MethodWe used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 twins born in England and Wales in 1994 and 1995, followed up to age 18 years with 93% retention. Severe conduct problems in childhood were assessed at ages 5, 7, and 10 years using parent and teacher reports. Poor functioning at age 18 years, including cautions and convictions, daily cigarette smoking, heavy drinking, and psychosocial difficulties, was measured through interviews with participants and official crime record searches.ResultsParticipants 18 years old with versus without a childhood history of severe conduct problems had greater rates of each poor functional outcome, and they were more likely to experience multiple poor outcomes. This association was partly accounted for by concurrent psychopathology in early adulthood, as well as by early familial risk factors, both genetic and environmental. Childhood conduct problems, however, continued to predict poor outcomes at age 18 years after accounting for these explanations.ConclusionChildren with severe conduct problems display poor functioning at age 18 years because of concurrent problems in early adulthood and familial risk factors originating in childhood. However, conduct problems also exert a lasting effect on young people’s lives independent of these factors, pointing to early conduct problems as a target for early interventions aimed at preventing poor functional outcomes.

A twin study exploring the association between childhood emotional and behaviour problems and specific psychotic experiences in a community sample of adolescents.

BackgroundChildhood emotional and behaviour problems are antecedents for later psychopathology. This study investigated genetic and environmental influences shaping the longitudinal association between childhood emotional and behaviour problems and specific PEs.MethodIn a community‐based twin sample, parents reported on emotional and behaviour problems when twins were ages 7 and 12 years. At age 16 years, specific PEs were measured using self‐reports and parent reports. Structural equation model‐fitting was conducted.ResultsChildhood emotional and behaviour problems were significantly associated with paranoia, cognitive disorganisation and parent‐rated negative symptoms in adolescence (mean r = .15–.38), and to a lesser extent with hallucinations, grandiosity and anhedonia (mean r = .04‐.12). Genetic influences on childhood emotional and behaviour problems explained significant proportions of variance in adolescent paranoia (4%), cognitive disorganisation (8%) and parent‐rated negative symptoms (3%). Unique environmental influences on childhood emotional and behaviour problems explained ≤1% of variance in PEs. Common environmental influences were only relevant for the relationship between childhood emotional and behaviour problems and parent‐rated negative symptoms (explaining 28% of variance) and are partly due to correlated rater effects.ConclusionsChildhood emotional and behaviour problems are significantly, if weakly, associated with adolescent PEs. These associations are driven in part by common genetic influences underlying both emotional and behaviour problems and PEs. However, psychotic experiences in adolescence are largely influenced by genetic and environmental factors that are independent of general childhood emotional and behaviour problems, suggesting they are not merely an extension of childhood emotional and behaviour problems.