Challenging Behaviour Research Articles

Family and Friends: Key Influences on Teenage Traits and Behaviors

The teenage years are a critical period of development, characterized by significant physical, emotional, and psychological changes. During this time, adolescents are particularly impressionable, with their traits and behaviors heavily shaped by the relationships they maintain. Among these relationships, the influences of family and friends are paramount, serving as the primary socializing agents that guide decision-making, value formation, and identity development. The study examines how family dynamics, including parental affection, communication, and behavioral control, influence adolescent development. The study also examines the influence of peer relationships, highlighting how friendships can reduce or exacerbate behavioral problems. By analyzing both direct and indirect effects, the study found that positive family interactions and supportive friendships are important for healthy adolescent development. Conversely, negative influences from any context can lead to increased risk-taking behavior and emotional challenges. The findings highlight the importance of fostering strong, positive relationships within both the family and peer groups to support adolescent development and well-being. The research is conducted by survey with 466 teenagers to find out the influence of family and friends on their adolescence development. The research aims to identify the roles that family and peers play during this crucial period and to provide recommendations for enhancing their positive impact on adolescents.

Understanding caregivers' needs: supporting families of autistic children

Parenting a child with autism spectrum disorder (ASD) poses significant emotional, financial, and social challenges to caregivers. This paper examines the experiences of caregivers, highlighting their increased stress, burnout, and mental health concerns. The importance of accessible information resources, respite care services, emotional support networks, and financial assistance programs is emphasized. Effective strategies for supporting caregivers include educating them about ASD symptoms, treatments, and therapies, teaching coping mechanisms for managing challenging behaviors, and promoting collaboration between healthcare providers and caregivers. Policy implications are discussed, including advocating for legislative modifications that prioritize caregiver needs, promoting inclusionary practices within educational systems, and increasing funding for early intervention programs and caregiver support services. The implementation of parent training programs, collaborative relationships between educators and caregivers, and professional development opportunities for educators are also recommended. This study aims to inform policymakers, healthcare professionals, and educators about the critical role of caregiver support in improving outcomes for children with ASD. By addressing caregiver needs and providing comprehensive support, we can enhance the well-being of both caregivers and children with ASD.

Comorbid mental illness and intellectual disability: impact on employment

Objectives In the general population, studies have revealed that mental health concerns negatively impact employment. Research has also begun to reveal similar negative employment outcomes among individuals with an intellectual disability and co-occurring mental health disorder. This study sought to expand upon these findings and examine whether specific diagnoses relate to inclusive employment. Methods We conducted Chi-square tests to examine if reported diagnoses and challenging behaviors related to paid community employment among 378 individuals with an intellectual disability in Pennsylvania who participated in the Independent Monitoring for Quality program. We selected participants from a statewide database compiled via stratified random sampling and structured interview. Results We found statistically significant differences in community-based employment rates between those with and without a mood disorder (χ 2 (2) = 6.07; p = 0.01) and behavior challenges (χ 2 (2) = 5.04; p = 0.03). Anxiety disorders approached statistical significance (χ 2 (2) = 3.73; p = 0.05). Conclusions The significant relationships between employment and mental health is consistent with studies in the general population. We discuss diagnostic challenges and limitations of this study, proposing future research explore a transdiagnostic approach to targeting mental health concerns for those with an intellectual disability.

A Critical Study of Psychology of Retail Investors

This research critically examines the psychology of retail investors, focusing on the behavioural finance approach to investment decision-making. Behavioral finance challenges the traditional assumption that investors are always rational, proposing instead that psychological, social, and cultural factors influence financial behaviours. The study aims to explore how demographic factors such as gender, age, and investment experience, along with macroeconomic conditions like interest rates and inflation, shape retail investors' decision-making processes. By analysing both quantitative and qualitative data from surveys and questionnaires, the study seeks to uncover patterns in how emotions, cognitive biases, and social networks affect investment choices across different groups. The scope of this research extends to identifying significant variations in investment behaviour based on demographics and cultural influences. Moreover, the study will test hypotheses related to gender differences in the influence of peers and interest rate changes on investment decisions. Through a mixed-methods approach, this research aspires to provide valuable insights for financial institutions and individual investors, enhancing their understanding of the psychological drivers behind market behaviour and investment strategies.

Kendra's journey: an intrinsic case study of a deaf autistic child.

This study used an intrinsic case study to investigate how interventions from applied behavior analysis impacted language development, academic progress, and the reduction of severe challenging behaviors for an 8-year-old child who is Deaf and autistic. 3 main themes were identified: language acquisition, behavioral change strategies, and academic performance. Additionally, 2 common threads wove in and out of each and connected all 3 themes: language access and qualified providers, including Deaf professionals. This study expands the literature about using behavioral strategies with children who are Deaf and autistic and discusses implications for clinical and educational practice.

A review of the risk factors for Autism

Abstract Background Autism Spectrum Disorder (or Autism) is a neurodevelopmental and neurological condition, with prevalence of 1 in 100 children globally. This review examines the most common factors associated with Autism. Methods We conducted a scoping review of factors associated with an increased risk of developing Autism. These included genetic predisposition, parental age, gender, birth complications and morbidities due to other medical conditions. Results Evidence from twin studies shows a 90% genetic predisposition towards Autism - with 102 genes strongly associated with Autism, including SCN1A and SLC6A1. There are also genetic syndromes and chromosomal disorders associated with Autism, including Fragile X syndrome and Tuberous Sclerosis complex (TSC). Several studies have demonstrated an increased risk with advanced parental age (>35 years) (e.g., fathers >50 years are 2.2 times more likely to have a child with Autism than those <30 years). Other factors include infections during pregnancy (e.g. immune dysfunction) and gestational diabetes. Prematurity, such as low birth weight (<1500g) and low gestational age (<32 weeks) are also associated with an increased risk of Autism. With regard to gender, boys are more likely to be diagnosed with Autism - gender ratio of 3:1 and 4:1 has been reported in different populations. Abnormalities in brain development during early prenatal or postnatal periods may increase the risk of Autism. These abnormalities can lead to social, communication, and behavioural challenges characteristic of Autism. Conclusions Autism is a complex and heterogeneous condition that likely arises from a combination of factors such as genetic susceptibility and pre- and postnatal factors. An understanding of these factors is important for early detection, intervention, and support for children to improve their quality of life and reduce morbidity. Key messages • Risk factors associated with an increased risk of developing Autism include genetic predisposition, parental age, gender, birth complications and other comorbidities. • There is need to increase awareness of the risk factors of Autism to improve quality of life.

The Role of Ibuprofen and Midazolam in Pediatric Dentistry: A Retrospective Study and Neurophysiological Considerations

Background: Managing anxiety and behavior during pediatric dental procedures is challenging. This study examines the effects of combining ibuprofen with midazolam sedation using both behavioral management and clinical hypnosis to improve patient cooperation and reduce post-treatment pain. Methods: A retrospective cohort study of 311 children (mean age 74.2 months, standard deviation (SD) = 24.7) was conducted. Patients received either midazolam with ibuprofen (n = 156) or midazolam only (n = 155). Behavior was assessed using the Venham Behavior Rating Scale and anxiety with the Dental Subscale of Children’s Fear Survey Schedule (CFSS-DS) and the Inventory of Stressful Situations (ISS) questionnaires. Statistical analyses included Mann–Whitney U tests and correlation analyses. Results: Ibuprofen did not significantly improve behavior during procedures (drinking phase 0.61, SD 1.31, p = 0.13; before treatment 0.25, SD 0.93, p = 0.53, anesthesia 1.21, SD 1.55, p = 0.29; after treatment 0.51, SD 1.22, p = 0.68), indicating that pharmacological pain management alone is insufficient to address behavioral challenges. Ibuprofen significantly reduced post-treatment pain, with 7.2% of cases reporting pain in the non-ibuprofen group compared to none in the ibuprofen group (p < 0.05). Conclusions: Ibuprofen had no effect on intraoperative behavior and only a limited effect on post-procedural pain, mainly for more invasive procedures. This study highlights the integration of sedation with behavioral strategies, such as clinical hypnosis, to manage anxiety and improve patient cooperation, aiming to enhance treatment outcomes using this integrative approach to pediatric dentistry. Further research is needed to optimize these strategies and verify them in a prospective setting.

Progressive Functional Analysis and Function-Based Intervention Via Telehealth: A Replication and Extension.

The purpose of this study was to evaluate a progressive functional analysis (FA) model and function-based intervention delivered by caregivers with coaching via telehealth. Children diagnosed with autism and at least one caregiver (e.g., parent) participated in the study. We conducted three assessments prior to and following intervention: a researcher-developed 10-min observation, the Parental Stress Index, and the externalizing section of the Vineland Adaptive Behavior Rating Scales, Third Edition (VABS-3). We included 47 participants in the present evaluation of the progressive FA model. We identified the function of challenging behavior for 36 participants. A function was not identified for nine participants who exhibited low or no challenging behavior during the assessment; the results were inconclusive for two participants. For the 17 participants who participated in the intervention evaluation phase, each of the participants achieved the mastery criterion, which was an 80% reduction in challenging behavior for most participants. Additionally, there was a statistically significant decrease in the VABS-3 externalizing behavior measure from pre- to post-assessment, although neither of the other pre-post measures resulted in statistically significant changes. This study replicates and extends previous research, supporting the use of progressive FA model and function-based interventions to improve challenging behavior.

Associations Between Adverse Childhood Experiences, Adolescent Behavioral Health Challenges, and High School Dropout.

Adverse childhood experiences (ACEs) are associated with behavioral health challenges and high school dropout, and behavioral health is associated with high school dropout. Less is known about the role of behavioral health challenges in the relationship between ACEs and high school dropout. Using data from the Panel Study of Income Dynamics (2013) and its 2014 Childhood Retrospective Circumstances Study supplement, the current study conducts mediational path analysis to examine the direct and indirect effects of cumulative ACEs on high school dropout via adolescent depression, anxiety, and substance use. Experiencing more ACEs was associated with depression, anxiety, and substance use. Only depression and substance use were associated with high school dropout. There was a significant direct effect between increased ACEs and high school dropout and significant indirect effects via depression and substance use, but not anxiety. Adolescent behavioral health interventions to address the long-term effects of ACEs may also support academic achievement. School-based interventions, particularly those aligned with trauma-sensitive school frameworks and engaging various school personnel, including school nurses, should be considered. Community- and policy-level interventions aimed at primary prevention of ACEs are also needed.

Cultural Adaptation of RUBI Intervention with Korean Families(K-RUBI): A Mixed Method Study.

Challenging behaviors of young autistic children remain a major parenting challenge for many of their family members, including caregivers. Caregivers from underrepresented cultural or linguistic backgrounds may experience exacerbated difficulties related to challenging behaviors due to limited access to culturally sustaining and responsive interventions. Evidence-based behavior parent training programs, such as RUBI, are highly effective in increasing caregivers' capacity in preventing and responding to these behaviors in naturalistic settings using behavior analytic principles. Therefore, the purpose of this study was to examine the effectiveness, acceptability, and feasibility of the culturally adapted RUBI program with underserved families. We conduct a convergent mixed-methods study using a pilot randomized controlled trial with a waitlist control group and focus group interviews with 31 Korean families of young children with or suspected of autism. The Korean RUBI underwent rigorous cultural adaptation using the Cultural Adaptation Checklist, including the use of multiple community advisory boards to inform cultural adaptation. Both quantitative and qualitative findings revealed significant improvements in parents' confidence and knowledge in behavioral principles and decrease in severity of challenging behaviors, which suggest clinical utility of RUBI in an underrepresented, low-resourced community. A culturally adapted intervention for a different population can be perceived as a newly constructed intervention. This study provides insight on the systematic process of cultural adaptation of an established autism intervention and effectiveness, feasibility, and acceptability of RUBI.

Feasibility, Experiences and Short-Term Outcomes on Challenging Behaviour and Well-Being of a Partially Online Music Intervention Pilot Study for Adults With Intellectual Disabilities.

During the COVID-19 pandemic we implemented a partially online music intervention to examine the feasibility, experiences and short-term outcomes on the challenging behaviour and well-being of adults with intellectual disabilities. This mixed-methods study included 10 participants with mild or moderate intellectual disabilities who received 16 one-hour individual music sessions in 10 weeks, either face-to-face or online. Data on feasibility and experiences from participants and music workers were collected and analysed using inductive thematic analysis. Challenging behaviour and well-being were measured before and after intervention. Overall experiences were positive and concerned appreciation, positive feelings, musical abilities, attention span, relatedness and personalisation. Online experiences varied, but most participants preferred face-to-face over online sessions. After the intervention, challenging behaviour scores were better than before. Engaging in a partially online music intervention is feasible for people with intellectual disabilities and seems to improve challenging behaviour. Experiences are discussed and recommendations for future online sessions are provided.

Evaluation of resurgence following differential reinforcement of alternative behavior with and without extinction in a human operant model.

One of the most common treatments for severe challenging behavior involves placing the challenging behavior on extinction and differentially reinforcing an alternative response (DRA). However, extinction is not always feasible and may be unsafe or impractical to implement in some circumstances. Thus, implementing a DRA without extinction intervention may be necessary for some cases. Currently, the extent to which DRA without extinction produces durable treatment outcomes, particularly as it relates to the resurgence of challenging behavior, is unclear. The present study investigated resurgence following DRA with and without extinction using a three-phase resurgence evaluation in a translational human operant model with college students as participants. All participants demonstrated resurgence across both experimental groups. Although there were no statistically significant differences in the prevalence, magnitude, or persistence of resurgence between groups, levels of resurgence magnitude were relatively higher in the DRA-without-extinction group than in the DRA-with-extinction group. Clinical implications of these findings and directions for future human operant investigations of resurgence are discussed.

Supporting emotion regulation in children on the autism spectrum: co-developing a digital mental health application for school-based settings with community partners.

KeepCalm is a digital mental health application, co-designed with community partners, that incorporates wearable biosensing with support for teams to address challenging behaviors and emotion dysregulation in children on the autism spectrum. We followed a user-centered design framework. Before app development, we conducted design workshops, needs assessment interviews, a systematic review, and created an Expert Advisory Board. Once we had a working prototype, we recruited 73 participants to test and help improve the app across five testing cycles. Participants rated the app across testing cycles as highly acceptable, appropriate, feasible, and with good usability. Qualitative data indicated that KeepCalm helped teachers (a) be aware of students' previously unrealized triggers, especially for nonspeaking students; (b) prevent behavioral episodes; (c) communicate with parents about behaviors/strategies; and (d) equipped parents with knowledge of strategies to use at home. We learned that in order to make the app acceptable and appropriate we needed to make the app enjoyable/easy to use and to focus development on novel features that augment teachers' skills (e.g., behavioral pattern and stress detection). We also learned about the importance of maximizing feasibility, through in-person app training/support especially regarding the wearable devices, and the importance of having aides involved. Our findings have informed plans for wider-scale feasibility testing so that we may examine the determinants of implementation to inform adaptations and refinement, and gather preliminary efficacy data on KeepCalm's impact on reducing challenging behaviors and supporting emotion regulation in students on the autism spectrum.

Online peer mentoring for youth with learning differences.

Youth with learning differences (e.g., specific learning disorder and attention deficit hyperactivity disorder) encounter exacerbated psychological and behavioral challenges compared to typically developing peers. Peer mentoring has proven beneficial in addressing such challenges, yet there is limited research on the efficacy of online peer mentorship programs for this population. This study investigates the effects of an online peer mentoring program on mentees' mental health, wellbeing, and behavior across 10 outcomes: anxiety, depression, fear, cognitive challenges, behavioral concerns, executive function, sleep difficulties, self-care, interpersonal skills, and self-esteem/self- confidence. Parents retrospectively reported on their child's mental health, wellbeing, and behavior prior to and since receiving online mentorship. Results indicated significant improvements across all outcomes following online mentorship. These findings highlight the effectiveness of online peer mentorship programs, emphasizing its potential as a valuable tool for supporting youth with learning differences.

Readiness Framework for Behavioral Strategies: Assessing Low-Intensity Approaches Prior to High-Intensity Interventions

Challenging behavior can impact the learning environment and prevent educators and students from demonstrating behavioral and academic success. Schools and districts may implore a framework of tiered systems of support to respond to students struggling behaviorally or academically. These systems provide a decision-making process to aid educators’ use of low-intensity strategies before utilizing high-intensity strategies. This process can help school teams use their time and resources efficiently. This article presents a flowchart outlining guiding questions within a problem-solving process as the first step in remedying behavior of concern. This flowchart can be utilized by schools with an existing tiered framework or can support the decision-making process for schools that do not utilize a tiered system of support. A vignette is also included to demonstrate its practical use in the classroom.

Psychological conditions of caregivers of adult subjects with Prader-Willi syndrome

BackgroundPrader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder. Individuals with PWS face a range of cognitive, behavioral, and emotional challenges that require comprehensive and lifelong care, posing significant demands on their caregivers. The study is not only aimed to assess the psychological conditions of caregivers of adult subjects with PWS focusing on psychological distress and coping, but also to shed light on a crucial yet often overlooked aspect of healthcare. This study aims to compare the psychological well-being of individuals with PWS and their caregivers, providing valuable insights that can potentially improve the quality of care for these individuals. The sample recruited at the Division of Auxology, IRCCS Istituto Auxologico Italiano, was composed of 30 adult subjects with PWS (11 men and 19 women; mean age ± SD: 36.4 ± 10.31 years; mean Body Mass Index (BMI): 35.7 ± 8.92: kg/m2) and their caregivers (10 men and 20 women). To assess the psychological condition of caregivers, the Italian-validated versions of the Depression Anxiety and Stress Scale (DASS-21) and the Coping Orientation to the Problems Experiences (COPE) were used, while to assess the psychological well-being of individuals with PWS and their caregivers, the Italian validated version of the Psychological General Well-Being Index (PGWBI) was used.ResultsDepression (p < 0.001), Stress (p = 0.050), and Total score (p = 0.009) of DASS 21 were higher in the caregivers of subjects with PWS than in the general population. PGWBI scores of caregivers were significantly lower than in individuals with PWS in Positive Well-being (p < 0.001), General Health (p = 0.006), Vitality (p = 0.004), and the total score (p = 0.006). The depression subscale of PGWBI was higher in caregivers than in subjects with PWS. Correlations between the subscales of COPE and the total score of PGWBI in caregivers revealed that the Avoidance subscale of COPE had a negative significant correlation with the total score of PGWBI (p = 0.003).ConclusionsOur results highlighted several critical insights into the profound emotional and psychological challenges faced by the caregivers of individuals with PWS.

Lifetime History of Head or Traumatic Brain Injury Before Age 9 and School Outcomes: Results From the Adolescent Brain Cognitive Development Study.

Limited information about school outcomes among children (especially early childhood) with lifetime history of head injury, including traumatic brain injury (TBI), may inhibit efforts to support their academics and physical and mental health. Baseline data (2016-2018) from the Adolescent Brain Cognitive Development (ABCD) study were analyzed to describe associations between parent-proxy reported lifetime history of head injury or TBI before age 9 and school outcomes and behavioral challenges among 9- and 10-year-old children. Having a lifetime history of head injury before age 9 was associated with increased odds of parent-perceived poor school performance (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.14-1.81), a drop in grades (AOR = 1.28, 95%CI = 1.06-1.54), recent receipt of detentions or suspensions (AOR = 1.29, 95%CI = 1.02-1.65), and receipt of special educational services (AOR = 1.23, 95%CI = 1.08-1.41). Of those with a lifetime history of head injury, males displayed poorer school outcomes and greater behavioral challenges than females. Similar associations were observed between lifetime history of TBI before age 9 and worse school outcomes, with males continuing to demonstrate stronger associations. These findings underscore the importance of screening for history of head injury and TBI and providing training for school professionals to help ensure students with a history of head or traumatic brain injury have appropriate supports in place.

Implementing a Positive Behavior Support Program for Young Children with Autism in Public Agencies: A Social Validity Evaluation from Parents, Practitioners, and Administrators.

Challenging behaviors in young children with autism and intellectual disabilities pose significant barriers to learning and inclusion. The Prevent-Teach-Reinforce for Young Children (PTR-YC) program is an evidence-based intervention that addresses these behaviors according to Positive Behavior Intervention Support principles. It is essential to assess the social validity of an intervention, when implemented into a public service system, to ensure sustainability and relevance to stakeholders. The present study aimed to document the social validity of PTR-YC from the point of view of three key informants: parents, practitioners, and administrators. Sixty-one participants were interviewed about their experience with PTR-YC (9 administrators, 31 practitioners, and 20 families). Semi-structured interviews assessed three fundamental components of social validity (Wolf, 1978): (a) social relevance of intervention goals, (b) social appropriateness of intervention procedures, and (c) social importance of intervention effects. Participants' responses were subjected to thematic analysis. Intervention goals, namely family participation in the clinical process, strategies that focuses on prevention, and teaching alternative adaptive behaviors, were identified as relevant. Participants appreciated the program's clear, structured, and turnkey clinical process, its parent-practitioner collaboration, and its consistency with practices already in place in the field. Positive instrumental outcomes (e.g., knowledge, competencies, self-efficacy) and ultimate outcomes (e.g., decrease in challenging behavior) of the intervention were reported on children, families, and practitioners. This study represents the first in-depth evaluation of the social validity of PTR-YC in specialized public services for autism and demonstrates its appropriateness for universal implementation in this sector.

The Institutionalisation of Power-Sharing in Zanzibar: Strengths and Challenges

Abstract In 2010, Zanzibar presented a distinctive example of power-sharing in Africa. The introduction of power-sharing governance system was preceded by a referendum, which set the stage for a subsequent constitutional amendment to facilitate this governance approach on the Island. This model was adopted to address the region’s longstanding and entrenched political issues. Despite the strong base of its adoption, power sharing has shown ups and downs throughout its life, passing through the boycott from 2015 to 2020 and the 2020 electoral violence. This study examines the strengths and challenges of power-sharing in Zanzibar, focusing on its potential path for its institutionalization. The study used a qualitative research design, with interviews and documentary reviews as data collection methods. The findings indicate that while power-sharing in Zanzibar benefits from robust public support, which complicates efforts to eliminate or alter it, the system encounters various institutional and behavioral challenges that impede its full institutionalization.

BEHAVIOURAL PATTERNS OF CHILDREN IN KADUNA STATE ORPHANAGES: A COMPARATIVE ANALYSIS

Background The plight of orphans, exacerbated by conflict, disease, and socioeconomic factors, remains a pressing global issue, particularly in sub-Saharan Africa. Nigeria, notably impacted by the HIV/AIDS epidemic, terrorism, and natural disasters, has witnessed a substantial increase in orphan populations. These children face severe challenges, including child abuse, malnutrition, limited access to education, stigmatization, and a range of psychological and behavioural disorders. Despite some interventions, orphanages primarily address material needs, often neglecting comprehensive medical, social, and psychosocial support. This study explores the behavioural patterns of orphans in Kaduna, Nigeria, and examines how their medical and social challenges compare across various orphanages. Methodology A cross-sectional, comparative analysis was conducted among 100 orphans from selected orphanages in Kaduna. Data were collected through interviewer-administered questionnaires assessing socio-demographics, medical conditions, behavioural patterns, stigma, psychosocial status, and coping strategies. Results The mean age of respondents was 10 years, with 68% being male. Nutritional issues were prevalent, with 53.7% classified as underweight despite 54.9% reportedly consuming balanced diets. Medical concerns were significant, with 33.7% showing clinical signs of illness and 46.7% not fully immunized. Behavioural issues were prominent, including hyperactivity symptoms (27.0%), enuresis (22.3%), and depressive symptoms (1.8%). Socially, most respondents (83.3%) reported positive peer relationships, though bullying (11.4%) and stigmatization (9%) were also observed. Educational access was generally high, with only 2.2% not attending school. However, social support systems varied, with 35.2% reporting strong support and 46.8% adapting their goals as a coping mechanism. Conclusion The findings highlight the complex medical and behavioural challenges faced by orphans in Kaduna's orphanages, underscoring the need for integrated interventions that provide medical, psychosocial, and educational support. A holistic approach is crucial to improving their overall well-being and future prospects.