Behavior Problems In Young Children Research Articles

Cognitive and Behavioral Outcomes of Snoring Among Adolescents

Snoring is central to sleep-disordered breathing (SDB), which arises from nocturnal upper airway resistance. Habitual snoring is associated with cognitive and behavioral problems in young children, but less is known about these associations in adolescents. To assess the longitudinal associations of snoring with cognition and problem behaviors among adolescents. This cohort study was a secondary analysis of the Adolescent Brain Cognitive Development (ABCD) Study dataset (release 5.0), which enrolled 11 875 children and a parent or caregiver from June 1, 2016, to October 15, 2018, at 21 participating US research institutions and followed-up for 5 years. The analysis was performed between December 2023 and April 2024. Parent-reported snoring categorized as none, nonhabitual (<3 nights/week), and habitual (≥3 times/week). Cognition was assessed using 5 measures from the National Institutes of Health Toolbox (NIH-TB), and caregiver-reported problem behaviors were assessed using the Child Behavior Checklist (CBCL), including Total Problems, Internalizing Problems, and Externalizing Problems. Longitudinal associations of snoring with these assessment measures were analyzed using linear mixed-effects models stratified by obesity. Model fits were assessed after including the fixed-effects of age, sex at birth, race, family income, follow-up time, visit type, and the random-effects of site and identification number. The study included data from 11 862 children at year 1 (mean age, 119.0 months [95% CI, 118.8 to 119.1 months]; 6164 male [52.2%]) and 11 198, 10 870, 10 064, and 4668 children at years 2 to 5, respectively. The proportion of habitual snorers decreased from 811 participants (6.8%) in year 1 to 150 participants (3.2%) in year 5. Snoring was not associated with any of the NIH-TB scores. A statistically significant association of snoring was identified with all CBCL scales. The largest-magnitude association was of snoring with the CBCL Total Problems scale among adolescents with obesity (β = 3.18; 95% CI, 2.59-3.77). In this cohort study analyzing associations of snoring with cognitive test scores and problem behaviors based on the ABCD dataset, the prevalence of snoring declined over time; snoring in adolescents was associated with problem behaviors but not cognitive deficits. These findings may aid shared decision-making regarding treatment options such as adenotonsillectomy for adolescents with SDB.

영유아 문제행동지도를 위한 긍정적 행동지원 프로그램의 효과성 연구

The purpose of this study is to examine the changes in teachers' instructional efficacy and perceptions of positive behavior support(PBS) by implementing a teacher education program based on PBS for teachers who experience difficulties in managing problem behaviors in early childhood education settings. The program was conducted with six preschool teachers in G Metropolitan City, and its effects were analyzed both quantitatively and qualitatively. The results are as follows: First, there was a significant difference in teachers' instructional efficacy in managing problem behaviors before and after the program, with personal efficacy showing the most significant difference. Second, only rule selection and guidance factors showed significant differences in the implementation of PBS. Third, there was no significant change in perceptions of PBS. Fourth, the changes in teachers' experiences and perceptions after implementing PBS were examined through interviews, which confirmed that teachers' understanding of young children's problem behaviors and their perceptions of these behaviors had positively changed. This study suggests further research to verify the actual positive changes in children's behavior as it serves as an exploratory study into the prevention of problem behaviors and the promotion of creativity through positive behavior support.

Social-emotional and behavioural problems in young children of healthcare worker mothers during the COVID-19 outbreak: a case-control study

BackgroundThe pandemic has had a significant impact on the daily lives of children and their families, particularly the children of health care workers, due to changes in family routines as a result of their parents’ work schedules. We aimed to explore the socioemotional and behavioural (SEB) problems of children of healthcare worker mothers (HCWM) during the COVID-19 pandemic and compare them with age-matched children and their mothers from other occupations.MethodA case-control study design was applied, and a snowball approach was used to enrol volunteered participants aged between 6 and 36 months of age, through a Google survey. We used the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) questionnaire to assess children’s SEB problems and a Brief Symptom Inventory (BSI) to evaluate the psychological distress of mothers. Differences in BITSEA, BSI and MSPSS scores were examined using chi-square and Mann-Whitney U tests, as appropriate. A logistic regression model was used to identify independent predictors of children’s behavioural and emotional problems.ResultsIn total, 600 questionnaires were analysed. It was observed that children in the HCWM group were separated from their mothers more often and for longer periods of time than their counterparts (p < 0.010, p = 0.002). Changes in the child’s structured outdoor activities during the pandemic period were more likely to be observed in the HCWM group (p < 0.05). The percentage of children with the BITSEA problem subscale above the subclinical cut-off, externalizing and dysregulation scores were significantly higher in the HCWM group (p = 0.044, p = 0.031, and p = 0.016). Moreover, each point increase in BSI global index scores (p < 0.001, RR:3.34, 95%CI:1.91–5.82) was found as a risk factor for clinically significant SEB problems.ConclusionOverall, the current study suggests HCWM’s have experienced occupational inequality, and young children of HCWM’s were at increased risk for externalizing and dysregulation problems during the pandemic. Maternal psychological stress had a significant impact on their children’s socio-emotional well-being.

Executive dysfunction as a possible mediator for the association between excessive screen time and problematic behaviors in preschoolers.

Excessive screen time in children is a growing concern for parents and healthcare providers worldwide because it frequently leads to behavioral problems. Although executive dysfunction is proposed to be one of the contributing factors to maladaptive behaviors, little is known about the link between screen time and behaviors. This study aimed to identify whether executive dysfunction contributes to the negative behaviors of children exposed to excessive screen time. A cross-sectional study was conducted on preschool-aged children from public and private schools in Chiang Mai, Thailand. The parents/guardians of each child completed the questionnaires regarding clinical characteristics and screen time use, the Behavior Rating Inventory for Executive Function-Preschool (BRIEF-P), and the Strengths and Difficulties Questionnaire (SDQ). Children with more than one hour of media exposure per day were considered to have excessive screen time. Multivariable Gaussian regression was analyzed to compare the BRIEF-P and SDQ scores between the excessive and appropriate screen time groups. Causal mediation analysis was performed to examine the effects of total screen time on increasing behavioral problems with executive functioning as a mediator. A total of 1,126 preschoolers were included in the analyses. After controlling for age, sex, socioeconomic status, and maternal education, the excessive screen time group had significantly higher BRIEF-P global executive composite score than the appropriate screen time group (mean difference of global executive composite score = 1.49, 95% CI [0.12, 2.86], and p = 0.033). Concurrently, there were significant differences in externalizing behavior subscales and SDQ total difficulties scores between the excessive and appropriate screen time groups (mean difference of total difficulties score = 0.90, 95% CI [0.29, 1.50], and p = 0.004). A significant average causal mediation effect (ACME) of screen time on behavioral problems mediated through executive functioning was β = 0.28, 95% CI [0.13-0.44], which was more than half of the total effect (54.9%, 95% CI [37.4-100%]). The current study suggests that the increase in behavioral issues in preschoolers might be partly explained by the direct effect of excessive screen time and the mediating effect of impaired executive functioning. Our results may raise concerns about the necessity to limit screen time and monitor for executive function deficits and behavioral problems in young children with high screen time.

어머니의 사회경제적 배경에 따른 양육 특성이 유아의 문제행동에 미치는 영향

Objectives The purpose of this study is to investigate the discrimination of mothers' parenting characteristics according to socioeconomic background and analyze the effects of parenting characteristics on the young children's problem behaviors.&#x0D; Methods It was analyzed the socioeconomic background, parenting characteristics, and problem behavior of 2,150 mothers with 5-year-old children, using the 7th panel data of the Panel Study on Korean Children. Using the program SPSS 21.0, the mean differences in parenting characteristics according to the mother's socioeconomic background were analyzed using t-test and one-way ANOVA. In addition, after analyzing the correlation between the mother's parenting characteristics and the young children's problem behavior, hierarchical multiple regression analysis was conducted to analyze the influence of the mother's parenting characteristics on the young children's problem behavior.&#x0D; Results Mothers' parenting characteristics differed depending on the mother's age, education level, and household income level, and the correlation between parenting characteristics and young children's problem behavior was low. As a result of analyzing the factors affecting children's internalizing problem behavior, the higher the income in the socioeconomic background, the less internalizing problem behavior, and among parenting characteristics, the higher the parenting stress and the less parent-child interaction, the more internalizing problem behavior increased. As a result of the analysis of externalizing problem behavior, it was found that for male young children, the greater the parenting stress, and the less paternalistic parenting behavior and parent-child interaction, the more the infant's externalizing problem behavior increased.&#x0D; Conclusions System establishment and policy support are required to minimize the interdependence and connection between socioeconomic background, parenting characteristics, and problem behavior. Additionally, because mothers' parenting stress has the greatest impact on their children's problem behavior, mothers should seek ways to reduce stress themselves. Additionally, a consensus on co-parenting must be formed at the community and government levels, breaking away from the framework that childrearing is the mother's responsibility.&#x0D;

Effect of Banking Time Intervention on Child-Teacher Relationships and Problem Behaviors in China: A Multiple Baseline Design.

A positive child-teacher relationship is a crucial means of addressing problem behaviors in young children. In recent years, there has been an increase in factors triggering problem behaviors in young children. It is particularly important to employ universally applicable and scientifically effective strategies to improve child behavior. Banking Time, as an emerging variant of play therapy, aims to enhance child behavior by establishing an intimate child-teacher relationship. This study conducted a multiple-baseline experiment involving eight four-year-old children and their teachers from China, exploring the effectiveness of Banking Time in enhancing child-teacher relationships and subsequently improving child behavior from dual perspectives, utilizing tools such as the Student-Teacher Relationship Scale and Conners' Comprehensive Behavior Rating Scales-Teacher Assessment Report. Visual analysis and statistical analysis results indicate a strong positive impact of Banking Time on child-teacher relationships and a slight inhibitory effect on child problem behaviors. The implementation of Banking Time provides valuable insights into specific paths and strategies for promoting teachers' professional development.

Efficacy of parent-child interaction therapy for children born premature.

Premature children are known to be at a high risk of developing behavioral problems. This study examined the effectiveness of parent-child interaction therapy (PCIT) in reducing behavioral problems in young children born premature. The study included 18 child-parent pairs with children born at less than 35 weeks of gestation (range: 23-34 weeks, median: 31.0 weeks) and aged 27-52 months (median: 38.0 months). They were assigned to either the PCIT group (n = 7) or the non-PCIT group (n = 11) based on maternal desire for treatment. The study was designed to examine the effects of PCIT. Specifically, the Eyberg Child Behavior Inventory (ECBI) intensity score, ECBI problem score, and Parenting Stress Index Short Form (PSI-SF) scores were compared before treatment and after 6 months. In the PCIT group, the mean ECBI intensity score was 135.7 (SD = 13.5; T-score = 64) at baseline and 90.1 (SD = 15.5; T-score = 46) at post-assessment, the mean ECBI problem score was 9.8 (SD = 1.9; T-score = 54) at baseline and 4.4 (SD = 3.1; T-score = 44) at post-assessment, the mean PSI-SF total score was 60.1 (SD = 4.8; 95%tile) at baseline and 49.6 (SD = 5.6; 85%tile) at post-assessment, showing a significant improvement (ECBI intensity scores: p < 0.001, d = 2.03; ECBI problem scores: p < 0.001, d = 1.94; PSI-SF total scores: p = 0.004, d = 0.86). On the other hand, none of the scores showed significant change in the non-PCIT group. The PCIT can be considered as a potential treatment option for behavioral problems in young children born premature.

How food insecurity affects children's behavior problems in early childhood: The nutrition and family stress pathways.

This study examines how household food insecurity shapes young children's behavior problems in Singapore. The analysis is based on two waves of data collected before and during COVID-19 from a nationally representative sample of 2,601 children in the Singapore Longitudinal Early Development Study (SG-LEADS, Mage = 4.5 at wave 1, Mage = 6 at wave 2). Results based on propensity score matching, fixed effects analysis and lagged-variable models show a positive association between household food insecurity and children's behavior problems both concurrently and over a two-year period. Two mediating pathways of this association are identified-children's dietary intake and family stress. Children in food-insecure households tend to consume fewer vegetables and more sugar-sweetened beverages and carbohydrates, which is associated with elevated behavior problems. Parents in food-insecure households exhibit greater emotional distress, diminished parental warmth, and increased punitive parenting practices, also contributing to their children's behavior problems. The family stress pathway has a stronger explanatory power than the nutrition pathway on children's behavior problems. This study reveals that food insecurity is a risk factor for children's behavior problems in early childhood which can lead to later developmental vulnerabilities for children in financially deprived families.

The link between hours of center-based childcare and child development in 3- to 6-year-olds: Evidence from Singapore

This study examined how the number of hours of early childhood education (ECE) is associated with young children's behavior problems and early academic achievement in Singapore, a non-WEIRD (“Western, educated, industrialized, rich, democratic”) country with families using long ECE hours. We drew data from the Singapore Longitudinal Early Development Study. Participants were 3- to 6-year-old children (N = 2,452). General linear models and spline regressions were utilized to analyze how ECE hours were associated with children's behavior problems and early academic achievement while controlling for child and family characteristics. On average, Singaporean children stayed 41.07 hours per week in ECE centers, with 38 % of the sampled children spending more than 50 hours per week in ECE centers. Notably, we found an inverted-U-shaped relation between ECE hours and child outcomes with a turning point of approximately 35–40 hours per week. Before the turning point, a greater number of hours in ECE was associated with more externalizing problems and higher academic achievement. However, after this point, a greater number of hours was associated with fewer behavior problems, both externalizing and internalizing, as well as poorer academic achievement. These findings demonstrate a complex nonlinear association between ECE hours and child outcomes in a context of children spending prolonged hours in centers.

어머니의 양육태도와 유아의 정서조절능력이 유아의 문제행동에 미치는 영향

Objectives In this study, we aimed to examine how maternal parenting attitudes and young children's emotion regulation abilities influence problem behaviors in young children.&#x0D; Methods For the study, 291 young children aged 3-5 years old and 291 mothers enrolled in a daycare center located in G city were surveyed from December 12, 2022 to January 8, 2023. A questionnaire survey was conducted on attitude, emotional regulation ability of young children, and problem behaviors of young children. For the collected data, Pearson's correlation analysis was performed to analyze the correlation between each variable using the SPSS 21.0 program, and multiple regression analysis was performed to analyze the effect relationship of the variables.&#x0D; Results The analysis results are as follows. Firstly, it was found that the mother's parenting attitude and the young children's emotional regulation ability were correlated with the young children's problem behavior. Secondly, in the relative explanatory power of independent variables that affect young children's intrinsic problem behaviors, negative emotional expression, affectionate, controlling, and rejecting influences in the order shown. In the relative explanatory power of independent variables that affect extrinsic problem behaviors of young children, affectionate, negative emotional expression, controlling, and positive emotional expression were found to have an effect in the order.&#x0D; Conclusions This study provides valuable information on the variables affecting young children's problem behaviors, such as maternal parenting attitudes and young children's emotion regulation abilities. It can serve as foundational data to enhance maternal parenting attitudes and young children's emotion regulation abilities, which, in turn, may help improve young children's problem behaviors.&#x0D;

부부갈등, 어머니 우울, 유아 사회적유능감, 유아 외현화 문제행동 간의 구조분석

Objectives This study examined the structural analysis between marital conflict, maternal depression, young children’s social competence, young children’s externalizing problem behavior: It also determined the mediating effect of young children’s social competence in the effect of marital conflict and maternal depression on young children’s externalizing problem behavior.&#x0D; Methods For this, this study used data from the 7th year of the Panel Study on Korean Children. This study ana-lyzed the structural equation model through the AMOS 26.0 program to verify the structural relationship between variables, and used the bootstrap method to examine the mediating effect.&#x0D; Results First, it has been confirmed that marital conflict has a direct negative effect on social competence. Second, marital conflict and depression had a direct positive effect on externalizing problem behavior. Third, social competence had a direct negative effect on externalizing problem behavior. Fourth, social competence had a me-diating effect in the effect of marital conflict on externalizing problem behavior.&#x0D; Conclusions Through the results of this study, we would like to present educational implications for preventing and reducing externalizing problem behavior in young children.

Preliminary Investigation of the Influence of Treatment Regimen on Outcomes in Behavioral Parent Training

Caregiver engagement and implementation of behavioral strategies are essential to effective interventions targeting childhood behavior problems. The aim of this preliminary investigation was to better understand caregiver decision-making when selecting different treatment regimens in an open trial format. Treatment packages included: (1) an intensive treatment program (ITP), involving a compressed 20-hour intervention occurring 2 hours per day for 10 days; and (2) a standard dosage treatment as usual (TAU) behavioral treatment program, involving weekly 50-minute appointments. Sixty-seven families with a child between 4–11 years old (M age = 5.82) with clinically significant problem behaviors self-referred to a hospital-based outpatient behavior therapy program. Results suggest that while caregivers chose a standard treatment regimen at a ratio of 2:1, compressed treatment (ITP) was associated with increased caregiver engagement and more significant reductions in child target behavior using both direct and indirect measures. Findings provide preliminary support for the use of high dosage treatment regimens as a means of increasing caregiver engagement and in the reduction of problem behavior in young children.

Types and Predictors of Young Children’s Problem Behaviors Following the Birth of a Sibling

Objectives: To verify the predictors that affect problem behavior trajectories, this study examines how the problem behavior patterns of young children change over time before and the birth of their younger sibling, and the types of trajectories they are classifien into.Methods: The participants were 202 pregnant mothers who had a child over 18 months old. Questionnaires on the child’s problem behaviors were conducted one month before, one month after, and the three months after childbirth. A growth mixture model and logistic regression analyses were performed for classification and predictive analytics.Results: A total of three latent groups of children’s internalizing and externalizing problem behaviors were identified: group at low risk for problem behaviors, group at potential risk for problem behaviors and group at high risk for rising problem behaviors. Logistic regression analyses revealed that children’s temperamental emotionality and sociality, mother’s warm and encouraging behaviors, and depression were significantly associated with trajectory classes of problem behaviors.Conclusion: Our results suggest that to mediate problem behaviors in young children when a younger sibling is born, a variety of supports that consider their individual characteristics and provide affectionate parenting behavior are needed.

Associations Between Parenting Behaviors and Behavioral Problems in Young Children With Developmental Delays.

Children with developmental delays (DD) are at heightened risk for developing behavior problems, which contribute to parenting stress and caregiving burden. There is an established relation between parenting behaviors and child developmental outcomes with less known about parent-child interactions in young children with DD. The present study examined the associations between parenting behaviors and child behavior in a sample of 180 families with preschool-aged children with DD. Results indicated that caregivers' harsh and coercive behaviors were associated with observed challenging behavior in children. Child age, as well as the number of commands issued by caregivers were associated with noncompliance in children. The significance and limitations of these findings are discussed, as well as recommendations for interventions and future research.

Behavior Problems in Low-Income Young Children Screened in Pediatric Primary Care

Screening of behavior problems in young children in pediatric primary care is essential to timely intervention and optimizing trajectories for social-emotional development. Identifying differential behavior problem trajectories provides guidance for tailoring prevention and treatment. To identify trajectories of behavior problems in children 2 to 6 years of age screened in pediatric primary care. This retrospective cohort study identified trajectories of behavior problems and demographic and clinical correlates. Data were collected as part of routine care in 3 pediatric primary care offices and 3 school-based health centers in Ohio serving a primarily low-income population. In total, 15 218 children aged 2 to 6 years with well-child visits between July 13, 2016, and January 31, 2022, were included. Caregivers completed the Strengths and Difficulties Questionnaire (SDQ) at annual well-child visits. Trajectory groups were identified using latent growth mixture modeling of SDQ total difficulties scores, and relative risk ratio (RRR) of various demographic (eg, race) and clinical (eg, depression in caregiver) variables were assessed by multinomial logistic regression analysis. Of 15 281 children (51.3% males), 10 410 (68.1%) were African American or Black, 299 (2.0%) were Asian, 13 (0.1%) were American Indian or Alaska Native, 876 (5.7%) were multiracial, 26 (0.2%) were Native Hawaiian and Other Pacific Islander, 2829 (18.5%) were White, and 39 (0.02%) were categorized as other. In addition, 944 (6.2%) identified as Hispanic and 14 246 (93.2%) as non-Hispanic. Four behavior problem trajectory groups reflecting severity were identified: low-stable (LS; 10 096 [66.1%]), moderate-decreasing (MD; 16.6%), low-increasing (LI; 13.1%), and high-increasing (HI; 4.3%). Relative to the LS group, patients in each elevated group were more likely to be male (HI RRR, 1.87 [95% CI, 1.55-2.26]; MD RRR, 1.55 [95% CI, 1.41-1.71]; and LI RRR, 1.94 [95% CI, 1.70-2.21]), White (HI RRR, 2.27 [95% CI, 1.83-2.81]; MD RRR, 1.28 [95% CI, 1.13-1.45]; and LI RRR, 1.54, [95% CI, 1.32-1.81]), publicly insured (HI RRR, 0.49 [95% CI, 0.28-0.84]; MD RRR, 0.56 [95% CI, 0.43-0.73]; and LI RRR, 0.50 [95% CI, 0.35-0.73]), have a social need (HI RRR, 3.07 [95% CI, 2.53-3.73]; MD RRR, 2.02 [95% CI, 1.82-2.25]; and LI RRR, 2.12 [95% CI, 1.84-2.44]), and have a caregiver with depression (HI RRR, 1.66 [95% CI, 1.38-2.00]; MD RRR, 1.44 [95% CI, 1.31-1.58]; and LI RRR, 1.39 [95% CI, 1.23-1.58]). Relative to the LI group, patients in the MD group were less likely to be male (RRR, 0.80; 95% CI, 0.68-0.93). The substantial portion of young children with increased behavior problems observed in this cohort study underscores the need for screening in pediatric primary care. Caregivers with depression and family social needs warrant prioritization in early prevention and treatment to alter elevated trajectories.

The Relationship between Paternal Alexithymia and Children's Internalizing and Externalizing Behavioral Problems during Early Childhood.

The literature has long recognized that parental emotional competence, that is, the ability to express, understand, and regulate emotions, plays a key role in children's development from early childhood. Nevertheless, the effect of parental alexithymia, which can be understood as a deficit in emotional competence, has not been thoroughly studied. In particular, the association between paternal alexithymia and behavioral problems in young children is still a neglected area of research. This study aims to investigate the association between paternal alexithymia and children's internalizing and externalizing problems during the first three years of life, including whether overreactive parenting practices mediate the effect of alexithymia on children's behavioral problems. A sample of 203 fathers of children aged 18-36 months were administered the TAS-20, the Overreactivity subscale of the Parenting Scale, and the Child Behavior Checklist (CBCL)/1½-5. The data indicate that paternal alexithymia is a predictor of children's internalizing and externalizing behavioral problems and that paternal overreactivity mediates the effect of alexithymia. These results highlight the importance of preventing parental alexithymia and involving fathers in parenting support programs aimed at ensuring children's mental health and adjustment.

Telehealth Treatment of Behavior Problems in Young Children With Developmental Delay

Early behavior problems in children with developmental delay (DD) are prevalent and impairing, but service barriers persist. Controlled studies examining telehealth approaches are limited, particularly for children with DD. To evaluate the efficacy of a telehealth parenting intervention for behavior problems in young children with DD. A randomized clinical trial was conducted from March 17, 2016, to December 15, 2020, in which children with DD and externalizing behavior problems were recruited from early intervention and randomly assigned to a telehealth parenting intervention or control group and evaluated through a 12-month follow-up. Most children were from ethnic or racial minoritized backgrounds. Over one-half of children were in extreme poverty or low income-need ratio categories. Internet-delivered parent-child interaction therapy (iPCIT), which leverages videoconferencing to provide live coaching of home-based caregiver-child interactions. Families received 20 weeks of iPCIT (provided in English or in Spanish) or referrals as usual (RAU). Observational and caregiver-report measures of child and caregiver behaviors and caregiving stress were examined at preintervention, midtreatment, and postintervention and at 6- and 12-month follow-ups. The sample included a total of 150 children (mean [SD] age, 36.2 [1.0] months; 111 male children [74%]) and their caregivers with 75 each randomly assigned to iPCIT or RAU groups. Children receiving iPCIT relative to RAU displayed significantly lower levels of externalizing problems (postintervention Cohen d = 0.48; 6-month Cohen d = 0.49; 12-month Cohen d = 0.50) and significantly higher levels of compliance to caregiver direction after treatment. Of those children with data at postintervention, greater clinically significant change was observed at postintervention for children in the iPCIT group (50 [74%]) than for those in the RAU group (30 [42%]), which was maintained at the 6-month but not the 12-month follow-up. iPCIT did not outperform RAU in reducing caregiving stress, but caregivers receiving iPCIT, relative to RAU, showed steeper increases in proportion of observed positive parenting skills (postintervention odds ratio [OR], 1.10; 95% CI, 0.53-2.21; 6-month OR, 1.31; 95% CI, 0.61-2.55; 12-month OR, 1.64; 95% CI, 0.70-3.07) and sharper decreases in proportion of observed controlling/critical behaviors (postintervention OR, 1.40; 95% CI, 0.61-1.52; 6-month OR, 1.72; 95% CI, 0.58-1.46; 12-month OR, 2.23; 95% CI, 0.53-1.37). After treatment, iPCIT caregivers also self-reported steeper decreases in harsh and inconsistent discipline than did than RAU caregivers (postintervention Cohen d = 0.24; 6-month Cohen d = 0.26; 12-month Cohen d = 0.27). Results of this randomized clinical trial provide evidence that a telehealth-delivered parenting intervention with real-time therapist coaching led to significant and maintained improvements for young children with DD and their caregivers. Findings underscore the promise of telehealth formats for expanding scope and reach of care for underserved families. ClinicalTrials.gov Identifier: NCT03260816.

Emotion Dysregulation Mediates the Relationship Between Sensory Processing and Behavior Problems in Young Children with Autism Spectrum Disorder: A Preliminary Study.

Emotion dysregulation is one of the challenges that children with autism spectrum disorder (ASD) and their families face. It is unclear whether emotion dysregulation plays a mediating role in the relationship between sensory processing patterns and problem behaviors among these children. This study examined the relations between emotion dysregulation, behavioral problems, and sensory processing patterns among fifty-seven young children with ASD. Behavioral problems and sensory processing patterns were moderately to strongly correlated with emotion dysregulation. The relationship between sensory processing patterns and behavioral problems was significant with emotion dysregulation as a mediator. These findings help identify the relationship between emotion dysregulation, sensory processing patterns, and behavioral problems to facilitate the planning of intervention strategies for young children with ASD.

Parental Cannabis Use, Negative Parenting, and Behavior Problems of Young Children

Introduction: Cannabis use in the United States is increasingly accepted and legal. Rise in use among childbearing aged adults is potentially concerning, as the impacts of parental cannabis use on children are largely unknown, especially for young children. This study examined whether cannabis use is associated with increased risk for negative parenting and child emotional and behavioral problems among the parents of young children. Methods: We conducted a cross-sectional survey of parents and child behavior, recruited through five primary care practices in three states. Parents of children aged 1.5–5 years reported on family demographics, last 6-months cannabis use, negative parenting, parent mental health, parents’ adverse childhood experiences (ACEs), and child emotional/behavioral problems. We conducted hierarchical regressions to determine if parental cannabis use predicts negative parenting and/or child emotional/behavioral problems when controlling for other risk factors. Results: Of 266 responding parents, 34 (13%) reported cannabis use in the last 6 months. Parents who endorsed cannabis use reported significantly more negative parenting, ACEs, anxiety, depression, and child emotional/behavioral problems. Adjusting for the effects of other risk factors, cannabis use significantly predicted more negative parenting, but was not uniquely and significantly associated with child emotional/behavioral problems. Conclusion: Parental cannabis predicted negative parenting, which in turn predicted early childhood emotional/behavioral problems; however, parental cannabis use did not predict child emotional/behavioral problems when other risk factors were considered. Further research is needed to elucidate the nature and direction of relationships between parent cannabis use, negative parenting, child psychological outcomes, and other risk factors.

Behavioral Parent Training for Families With Young Deaf or Hard of Hearing Children Followed in Hearing Health Care.

It is well established that individuals with a communication disability, including being deaf or hard of hearing (DHH), experience inequities in health services and outcomes. These inequities extend to DHH children's access to psychosocial evidence-based interventions (EBIs). Behavioral parent training is an EBI that can be used to improve caregiver and child outcomes. Despite being supported by decades of effectiveness research, this EBI is rarely accessed by, or studied with, caregivers of DHH children. The purpose of this article is to describe a program of stakeholder-engaged research adapting and assessing behavioral parent training with caregivers of young DHH children followed in hearing health care, aimed at reducing inequities in access to this EBI. The first section briefly summarizes the literature on disruptive behavior problems in young children, with a focus on preschool-age DHH children. The evidence base for behavioral parent training is described. Next, the gaps in knowledge and practice regarding disruptive behaviors among DHH children are highlighted, and the potential integration of behavioral parent training into the standard of care for this population is proposed. Young DHH children who use hearing aids and/or cochlear implants experience disruptive behavior problems at rates at least as high as typically hearing children, but their access to EBIs is limited, and behavioral parent training programs tailored to this population have not been rigorously tested. Caregivers and hearing health care service providers affirm the potential benefits of behavioral parent training and were partners in adapting this EBI. This research highlights several principles and approaches essential for reducing inequities and improving the quality of life not only for DHH children and their families but also for individuals with communication disabilities more broadly: engagement of key stakeholders in research, collaboration across disciplines, and using implementation science methods and models to design for implementation, dissemination, and sustainment. Presentation Video: https://doi.org/10.23641/asha.21215900.