Behavior Problem Children Research Articles

Computerized adaptive testing to screen pre-school children for emotional and behavioral problems.

Questionnaires to detect emotional and behavioral (EB) problems in preventive child healthcare (PCH) should be short; this potentially affects their validity and reliability. Computerized adaptive testing (CAT) could overcome this weakness. The aim of this study was to (1) develop a CAT to measure EB problems among pre-school children and (2) assess the efficiency and validity of this CAT. We used a Dutch national dataset obtained from parents of pre-school children undergoing a well-child care assessment by PCH (n = 2192, response 70%). Data regarded 197 items on EB problems, based on four questionnaires, the Strengths and Difficulties Questionnaire (SDQ), the Child Behavior Checklist (CBCL), the Ages and Stages Questionnaire: Social Emotional (ASQ:SE), and the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). Using 80% of the sample, we calculated item parameters necessary for a CAT and defined a cutoff for EB problems. With the remaining part of the sample, we used simulation techniques to determine the validity and efficiency of this CAT, using as criterion a total clinical score on the CBCL. Item criteria were met by 193 items. This CAT needed, on average, 16 items to identify children with EB problems. Sensitivity and specificity compared to a clinical score on the CBCL were 0.89 and 0.91, respectively, for total problems; 0.80 and 0.93 for emotional problems; and 0.94 and 0.91 for behavioral problems. Conclusion: A CAT is very promising for the identification of EB problems in pre-school children, as it seems to yield an efficient, yet high-quality identification. This conclusion should be confirmed by real-life administration of this CAT. What is Known: • Studies indicate the validity of using computerized adaptive test (CAT) applications to identify emotional and behavioral problems in school-aged children. • Evidence is as yet limited on whether CAT applications can also be used with pre-school children. What is New: • The results of this study show that a computerized adaptive test is very promising for the identification of emotional and behavior problems in pre-school children, as it appears to yield an efficient and high-quality identification.

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Background -Continued advances in neonatal intensive care have led to increased rates of survival in ELBW children (gestational age (birth weight <1000gm respectively). However, the surviving ELBW cohorts are at higher risk than term-born normal birth weight (NBW ≥2500 g) children for neurodevelopment, behavior and motor problems. Aim -To evaluate motor, neurodevelopmental and behavior problems in a regional cohort of extremely low birth weight children during first four years of life.Methods –A Case Control study was done on 30 children aged between 3-4 years born ELBW attending neonatology OPD and they were compared with 30 age- matched controls for motor, neurodevelopment and behavioral problems using PBS, Bayley Scales of Infant and Toddler Development Third edition(Bayley-III) and CPMS.Results-Bayleys motor and cognition evaluation revealed that mean score was lower in ELBW as compared to NBW group (p-<0.05). Scores of Bayleys language component , however was not statistically different between two groups.The Paediatric Balance Scale ( PBS) and CPMS SCALE also revealed lower score in the ELBW group (p-<0.05)). Conclusion-ELBW children are a group of high-risk children who face multiple impairments, especially cognitive, behavioral and interpersonal challenges of the classroom and therefore need multidisciplinary follow-up and early developmental intervention for optimal outcome. Motor, neurodevelopment and behavioral problems of all ELBW infants must be monitored after discharge to ensure that families receive appropriate support and intervention services to optimize outcome potential.

Behavior problems associated with brain heterotopia

IntroductionBrain heterotopia represent a group of rare malformations with a heterogeneous phenotype, ranging from asymptomatic to severe clinical picture (resistant epilepsy, severe developmental delay). The etiology is multifactorial, including both genetic and environmental factors.ObjectivesIn this paper we present our experience regarding behavior problems in patients with heterotopia.MethodsA cohort of 16 pediatric patients with brain heterotopia, six females and ten males, with age at last follow-up ranging from 2 months to 24 years were investigated by clinical examination, electroencephalographic studies, brain imaging, and genomic tests. Specific psychological tests and psychiatric evaluation were performed in all children for behavior problems assessment.ResultsSix individuals presented behavioral problems: autism (three patients) and hyperkinesia with attention deficit (three patients). All of them had intellectual disability or learning problems; five patients had epilepsy, with drug-resistant seizures in four cases. In two cases the behavioral problems occurred before the onset of epileptic seizures.ConclusionsBehavior problems are important features in patients with brain heterotopia, making the management of these patients more difficult, especially when they occur in association with drug-resistant epilepsy. Acknowledgements: This work was supported partially by grants of the Romanian National Authority for Scientific Research and Innovation CCCDI – UEFISCDI, Projects COFUND-ERANET E-RARE 3-HETER-OMICS-2 Number 87/2019 and 88/2019 within PNCDI III.DisclosureNo significant relationships.

Computerized adaptive testing to screen children for emotional and behavioral problems by preventive child healthcare

BackgroundQuestionnaires to detect emotional and behavioral problems (EBP) in Preventive Child Healthcare (PCH) should be short which potentially affects validity and reliability. Simulation studies have shown that Computerized Adaptive Testing (CAT) could overcome these weaknesses. We studied the applicability (using the measures participation rate, satisfaction, and efficiency) and the validity of CAT in routine PCH practice.MethodsWe analyzed data on 461 children aged 10–11 years (response 41%), who were assessed during routine well-child examinations by PCH professionals. Before the visit, parents completed the CAT and the Child Behavior Checklist (CBCL). Satisfaction was measured by parent- and PCH professional-report. Efficiency of the CAT procedure was measured as number of items needed to assess whether a child has serious problems or not. Its validity was assessed using the CBCL as the criterion.ResultsParents and PCH professionals rated the CAT on average as good. The procedure required at average 16 items to assess whether a child has serious problems or not. Agreement of scores on the CAT scales with corresponding CBCL scales was high (range of Spearman correlations 0.59–0.72). Area Under Curves (AUC) were high (range: 0.95–0.97) for the Psycat total, externalizing, and hyperactivity scales using corresponding CBCL scale scores as criterion. For the Psycat internalizing scale the AUC was somewhat lower but still high (0.86).ConclusionsCAT is a valid procedure for the identification of emotional and behavioral problems in children aged 10–11 years. It may support the efficient and accurate identification of children with overall, and potentially also specific, emotional and behavioral problems in routine PCH.

Patterns and prediction of behavior problems during the toddler and preschool periods in preterm children

There are few studies of behavior problems in preterm children prior to 2 years old and the changes that occur over time. The aims of this study were to examine the patterns and prediction of behavior problems and the effects of gender and socioeconomic status (SES) on behavior problems in preterm children at the toddler and preschool periods. Parents of 124 very low birthweight preterm children completed a standardized behavior questionnaire at 18 months corrected age and 3 years old. At both times, scores were significantly higher on Attention and Withdrawn Problems than on other behavior problem syndromes. There was a significant overall increase in Externalizing and Internalizing behavior problem scores between 18 months and 3 years, particularly in Internalizing problems. Overall prediction for normal versus not-normal categorization (≥1 standard deviation) on behavior problem and broad-spectrum scales ranged from 77% to 90% and was higher for children in the normal than not-normal categories. Boys had higher Internalizing Problems at 18 months and higher Externalizing Problems at 3 years. Children from low SES families had higher Internalizing and Total Behavior problems at 18 months and higher Internalizing, Externalizing, and Total Behavior problems at 3 years. Screening preterm children for behavior problems before 2 years old appears useful for early intervention of such problems.

Frequencies of Behavioral Problems Reported by Parents and Teachers of Hearing-Impaired Children With Cochlear Implants.

Background: Internalizing and externalizing behavioral problems were frequently reported in profoundly hearing-impaired (HI) children with hearing aids. Due to the positive effect of cochlear implants (CIs) on hearing and language development, a positive effect on behavioral problems was expected. However, there is no consensus about the frequency of behavioral problems in CI children, and studies are often based on one informant with the risk of missing behavioral problems in other contexts.Aims: The first aim of this study was to investigate the frequency of behavioral problems in children with CIs as compared to a hearing normative sample. The second aim was to measure the agreement between the parents’ and teachers’ rates on the behavioral problem scales. And the third aim was to investigate the relation between speech perception, language skills and the frequencies of reported behavioral problems.Methods: Of 71 CI children, 51% were girls and 49% were boys, and the mean age was 8.6 (SD = 3.3). Behavior was reported by parents using the Child Behavior Checklist (CBCL) and by teachers using the Teacher Report Form (TRF). Frequencies of behavioral problems of CI children (6–16 years) were compared to a normative sample with the chi square test. Parent-teacher agreement was measured with the intraclass correlation coefficient (ICC 2,1). Next CI children were divided into four ability level categories regarding speech perception and language skills. Frequencies of behavioral problems were compared between the categories with the chi square test.Results: Parents and teachers of CI children reported similar frequencies of behavioral problems to the normative sample. Fair to low parent-teacher agreements were found on the behavioral problem scales. A significantly higher frequency of behavioral problems was reported in children with low speech perception and receptive vocabulary at school.Conclusion: Parents and teachers report similar frequencies of behavioral problems children with CIs compared to a hearing normative sample. Children with lower speech perception and language levels are more at risk of developing behavioral problems at school. Adequate speech perception and language levels are found to be protective factors for the development of behavior.

How APA’s Collaborative Care Training is Leading to Improved Care

How APA’s Collaborative Care Training is Leading to Improved Care

Incorporating Well-Adjusted Peers in a Conduct Problems Prevention Program: Evaluation of Acceptability, Fidelity, and Safety of Implementation

In order to prevent iatrogenic effects associated with interventions that aggregate youth with behavior problems and to promote the integration of these youth into normative peer groups, a comprehensive evidence-based prevention program, Early Risers “Skills for Success” (August et al. in Preventing substance abuse: science-based programs for children and adolescents, American Psychological Association, Washington, 2007), was augmented to include well-adjusted children in a strategic peer affiliation component, or buddy system. A total of 190 kindergartners and first graders from five schools in a Midwestern US city were randomly assigned by school to receive the program or serve as controls. In the first summer program component, the children received 72 h of programming in academics, social skills, and creative arts, all within a highly structured social environment. The feasibility of the program was investigated through examination of acceptability, fidelity, and safety of programming, with special attention to acceptability and safety for well-adjusted peer mentors. Results showed that intervention fidelity, as measured by independent observers, was high. Acceptability was high as well, with no differences in attendance between well-adjusted children and children with behavioral problems. There was no evidence of iatrogenic effects or other unsafe outcomes: Peer-reported victimization did not increase, and well-adjusted children did not increase in aggression. In contrast, both well-adjusted children and their peers with behavior problems increased in teacher-rated social skills, and well-adjusted children increased in leadership. The results suggest that the pairing of well-adjusted children with behavior-problem children in a highly structured program such as Early Risers is a feasible program tactic in which the well-adjusted children may also derive some benefit.

Feasibility of Screening for Preschool Behavioral and Emotional Problems in Primary Care Using the Early Childhood Screening Assessment.

The American Academy of Pediatrics recommends screening young children for behavioral and emotional problems (BEP) during primary care visits. Because of time constraints, few primary care providers (PCPs) use standardized screening tools to detect BEP. The Early Childhood Screening Assessment (ECSA) is a brief screening tool developed specifically to meet the needs of pediatric primary care providers (PCPs). The ECSA has established psychometric properties, but the feasibility and acceptability of the ECSA have not been established. This study examines the degree to which PCPs would incorporate ECSA screening and how PCPs value the ECSA as a tool to detect children with BEP. Twenty-seven pediatric PCPs were trained to implement ECSA screening. Six months after training, 96% of PCPs reported that the ECSA was practical for use at well-visits, 70% were still screening and 89% agreed that it helped detect more cases of BEP than by routine history-taking alone.

Experiencing early childhood programs that promote students' developmental and educational outcomes

This study aimed to investigate the effect of passing preschool course on boy and girl first grade students adaptive behavior and academic achievement with the intelligence control. The research method was ex-post facto. The populations studied in this research concluded all first elementary school boys and girls students(N= 1800) in Behbahan city in the academic year of 2012-2013 . The study sample consisted of 320 first grade students selected by stratified sampling technique . They were divided into two groups of students who have passed the pre-school period (160 total, 80 boy and 80 girl ) and the students who have not passed it (160 total, 80 boy and 80 girl ). The Rutter Children’s Behaviour Questionnaire (Rutter, 1967) is a form by behavioral problems children aged between 6 to 13 identified by teachers or parents was completed by only teachers in this study . student academic performance was measured through their correct answers to the standard questions developed by Department of Education with regard to content and purpose of the training of first class . Raven’s colored Progressive Matrices Test ( Raven et al., 1990) was also used in this research . Results showed that first-grade girl students who have passed the pre-school had significantly higher academic performance and adaptive behavior than those students who have not passed with the intelligence control . Similarly , significant difference was found between first-grade boy students who have passed the pre-school and the students who have not passed it in terms of academic performance and adaptive behavior with controlling IQ. Key words: Preschool course, Academic Achievement, adaptive behavior intelligence

Renovation and Rejuvenation of Education system

Passing preschool course on boy and girl first grade students adaptive behavior and academic achievement with the intelligence control. The research method was ex-post facto. The populations studied in this research concluded all first elementary school boys and girls students(N= 1800) in Behbahan city in the academic year of 2012-2013 . The study sample consisted of 320 first grade students selected by stratified sampling technique . They were divided into two groups of students who have passed the pre-school period (160 total, 80 boy and 80 girl ) and the students who have not passed it (160 total, 80 boy and 80 girl ). The Rutter Children’s Behaviour Questionnaire (Rutter, 1967) is a form by behavioral problems children aged between 6 to 13 identified by teachers or parents was completed by only teachers in this study. student academic performance was measured through their correct answers to the standard questions developed by Department of Education with regard to content and purpose of the training of first class . Raven’s colored Progressive Matrices Test ( Raven et al., 1990) was also used in this research . Results showed that first-grade girl students who have passed the pre-school had significantly higher academic performance and adaptive behavior than those students who have not passed with the intelligence control. Similarly, significant difference was found between first-grade boy students who have passed the pre-school and the students who have not passed it in terms of academic performance and adaptive behavior with controlling IQ. Key words: Preschool course, Academic Achievement, adaptive behavior intelligence

The Identification of Several Problems in Group Behavior of Children with Divorced Parents in the District of Elbasan

The aim of this study is to explore the problems in group behavior of children with divorced parents based on their age, gender and location. This qualitative study is concentrated on analysing the problems in group behavior of children with divorced parents, aged from 6 to 18 yeard old. The identification of these group behavior problems was conducted using the SDQ questionnaire (Goodman, 1997). The data used in the study were assembled by the reporting of 400 children with divorced parents during the scholastic year 2011-2012 in primary, middle and secondary public schools in the district of Elbasan. The statistical processing of the data was carried out using the SPSS 20 program and alpha of Cronbah is .78. The results of this study pointed out that the main behavioral problems children display in a group are: they prefer to stay alone, they do not have friends, they do not wish to play with their peers. This study also shows that there is a link between the behavior of children in a group and parental divorce. At the end of this paper, several recommendations regarding the improvement of the behavior of children with divorced parents in a group environment are given to the parents, teachers and guardians of these children. DOI: 10.5901/ajis.2015.v4n2s2p280

Polymorphisms in the maternal sex steroid pathway are associated with behavior problems in male offspring

Slight perturbations in maternal sex steroid production and metabolism may interfere with normal fetal neurodevelopment. The balance of maternal estrogens and androgens may have direct fetal effects, may influence the fetal hypothalamic-pituitary-gonadal axis, or may alter local hormonal activity within the fetal brain. We investigated maternal functional polymorphisms of CYP17, CYP19, and CYP1B1, which control three major enzymatic steps in sex steroid biosynthesis and metabolism, in relation to childhood behaviors. The Mount Sinai Children's Environmental Health Study enrolled a multiethnic urban pregnancy cohort from 1998 to 2002 (n=404). DNA was obtained from maternal blood (n=149) and from neonatal cord blood (n=53). At each visit, mothers completed the Behavior Assessment System for Children, a parent-reported questionnaire used to evaluate children for behavior problems. We focused on problem behaviors more commonly associated with attention deficit-hyperactivity disorder (Hyperactivity, Attention Problems, Externalizing Behaviors, Conduct Disorder, Poor Adaptability) to determine whether maternal genetic variants in sex steroid production and metabolism influence sexually dimorphic behaviors in offspring. The more active gene variants were significantly associated with Attention Problems and poorer Adaptive Skills in male compared with female offspring. The CYP19 variant allele was also significantly associated with worse scores for boys on the Hyperactivity, Externalizing Problems Composite, and Adaptive Skills Composite scales (P<0.05). We observed maladaptive behaviors in the male offspring of mothers who carried functional polymorphisms in the sex steroid pathway. The strongest associations were in domains commonly affected in attention deficit-hyperactivity disorder.

Moderators and Predictors of Clinical Outcome in a Randomized Trial for Behavior Problems in Pediatric Primary Care

To evaluate putative moderator, predictor, and treatment parameter variables in relation to three outcomes in a clinical trial that compared a modular protocol for on-site, nurse-administered intervention (PONI) and enhanced usual care (EUC) for pediatric behavioral problems in primary care. Patients were 163 clinically referred children for behavior problems in six primary care offices. PONI consisted of seven treatment modules adapted from prior treatment trials with this population, whereas EUC involved a facilitated referral to a community provider. Outcome measures were based on standardized scales reflecting one parent-rated aggregate (child dysfunction) and one child-rated aggregate (child health), and diagnostic interviews with both informants (remission in oppositional defiant disorder). Moderator analyses revealed that PONI was more effective than EUC in reducing child dysfunction by 12-month follow-up among Caucasian children, whereas EUC was more effective than PONI among non-Caucasian children. In the full sample, child health improvement was predicted by the severity of the child's depression and anxiety, and level of family conflict. Duration of child exposure to cognitive-behavioral treatment in PONI was related to greater improvement in overall child health, but other treatment parameters were unrelated to outcome. These few significant relationships notwithstanding the findings indicate that the two treatments had robust effects on several outcomes and across selected child, parent, family, and treatment variables. The findings extend efforts to incorporate mental health services in pediatric practice.

Stigmatizing Experiences of Parents of Children With a New Diagnosis of ADHD

The experiences of parents of a child who received an initial diagnosis of attention-deficit hyperactivity disorder (ADHD) were examined to determine the ways in which they may have encountered stigmatizing situations. Forty-eight parents of children aged six to 18 years were interviewed about their experiences leading up to their child's ADHD diagnosis, including their decisions to seek treatment. All interviews were recorded, transcribed, and analyzed using grounded theory methods. Codes were identified using a constant comparative approach, which led to theoretically defined thematic constructs of stigma. Stigmatizing experiences were noted by 77% of the sample. Nearly half (N=21, 44%) were concerned about how society would label their child, 40% (N=19) felt social isolation and rejection, and 21% (N=10) perceived health care professionals and school personnel as being dismissive of their concerns. Parents' own attitudes about ADHD treatment were shaped by their exposure to negative media (N=10, 21%), their mistrust of medical assessments (N=8, 17%), and the influence of general public views (N=3, 6%). These stigmatizing views were related to parental concerns about the impact that diagnosis and treatment would have on their child's self-esteem and opportunities for future success. The range of ways in which parents in the study experienced stigma highlights the need for multiple perspectives for community outreach and public health programs that are aimed at addressing and eliminating mental health stigma. Even though stigma is a well-established barrier to mental health service use, the anticipated benefits of treatment may outweigh parents' experiences with stigma.

An analysis of the connection of 1010 Guangzhou behavior problem children and family functionality

Objective Investigating the incidence of children behavior problem, and its connection with the function of a family.Methods Investigate of 1022 school student ages from 6 to 12 years in urban city of Guangzhou by adopting the Achenbach Children Behavior Checklist (CBCL, Chinese version) and the Family Assessment Device (FAD).Results The detecting rate of school students who were identified with behavior problem was 17.42 percent in city of Guangzhou. The factor of the children behavior problem has positive association with role, emotional involvement, affective reaction and the general purpose of the function of a family;meanwhile the male children's behavioral control, as well as the female children's communication were positive associated with part of the raw score of CBCL. Conclusions The improvement of the family functionality is the key factor to the increasingly children behavior problem prevention. Key words: Children behavior problem; Detecting Rate; Family functionality

Successful Child Psychotherapy of Attention Deficit/Hyperactive Disorder: An Agitated Depression Explanation

Science tries to explain phenomena in ways that are demonstrable and replicable to develop logical, coherent, parsimonious, and predictive theoretical systems. Yet hyperactive children are given stimulants to "calm" them down, despite the fact that science would predict stimulants would increase hyperactivity. Bradley (1937, 1950) observed that half of the behavior-problem children to whom he administered a stimulant for one week became subdued. He called this finding paradoxical, speculating that inhibitory centers of the central nervous system were stimulated. While Bradley's assertion of a paradoxical reverse effect in children may be an empirical observation, it is not an explanation. The Attention Deficit/Hyperactive Disorder (ADHD) is inferred to exist from hyperactive behavior, which in turn, is inferred to be neurological in origin, a circular argument. An inevitable consequence of the belief in the hypothetical neurological etiology of ADHD is that children are typically given stimulants. Using the case of a seven-year old child, described as experiencing ADHD, who was treated successfully without medication as an illustration, the author provides an alternative, more parsimonious explanation of the etiology, suggesting that ADHD is related to agitated depression.

Stigmatizing Attitudes and Beliefs About Treatment and Psychiatric Medications for Children With Mental Illness

Data on community responses to two treatment issues critical for children and adolescents with mental health problems are addressed: stigma associated with receiving mental health care and the willingness to use psychiatric medication. Using a representative sample of the U.S. population, the investigators interviewed 1,393 noninstitutionalized adult participants in the National Stigma Study-Children (NSS-C) (response rate 70%; margin of error +/- 4%). Many respondents believed that stigma results from mental health treatment during childhood (45% reported likely rejection at school) and that stigma continues to have negative ramifications into adulthood (43%). More than half (57%) were skeptical about confidentiality, and more than one-third (35%) expected parents of children with mental illness to experience self-stigma. Most respondents believed that psychiatric medications affect development (68%), give children a flat, "zombie"-like affect (53%), and delay solving "real" behavior-related problems (66%). Most (86%) believed that physicians overmedicate children for common behavioral problems. Women and persons with more education rather than less perceived less stigma resulting from treatment but reported more negative views on medication. Beliefs in medication efficacy and trust in physicians were associated with more positive cultural beliefs. Data on the contemporary cultural context surrounding treatment for children's mental health issues revealed substantial stigma concerns, particularly surrounding medication options. These beliefs and attitudes cannot be easily inferred from adults' sociodemographic characteristics.

Parental ratings of behavioral adjustment in two samples of adopted Chinese girls: Age-related versus socio-emotional correlates and predictors

Parental ratings of 695 adopted Chinese girls' internalizing, externalizing, and total problem behaviors were analyzed in 4 stages to: (1) Compare adjustment profiles of Chinese adoptee samples with relevant US normative data; (2) analyze age differences in behavioral adjustment differences of Chinese adoptees; (3) examine interrelationships among the 3 behavior problem scores and child's age at adoption, current age, pre-adoption neglect, and post-adoption initial rejection behaviors; and (4) explore the degree to which the 4 child-level independent variables worked individually or collectively to predict behavioral adjustment outcomes. Chinese adoptees had better adjustment scores than normative samples from the U.S. Preschool-age adoptees had better adjustment scores than school-age adoptees. No relationships were observed between the age-related variables and behavioral adjustment measures. However, pre-adoption neglect and post-adoption initial rejection behaviors were predictors of behavioral adjustment scores. The implications of these findings for future research, clinical practice and parenting education were discussed.

Child and Family Predictors of Therapy Outcome for Children with Behavioral and Emotional Problems

This study investigated the characteristics of 106 children primarily referred for externalizing behavior problems and their families, and assessed the prediction of treatment outcome following a standardized short-term, cognitive behavioral group program. Exploring Together comprised a children's group (anger management, problem-solving and social skills training), a parents' group (parenting skills training, dealing with parents' personal, relationship and family-of-origin issues), and a combined children's and parents' group (to target parent-child interactions). The main predictors of reductions in externalizing and internalizing behaviors at home following treatment were children's pre-existing levels of these behavioral and emotional problems (children with higher levels improved most), and positive parent-child interaction. Higher pre-existing levels of behavioral and emotional problems and low levels of attention problems predicted greater improvement in post-treatment school behaviors. Implications of the findings for improving interventions for childhood behavioral and emotional problems are discussed.