Child Behavior Checklist For Ages Research Articles

Measuring Behavior Problems in Children from Low-Income Families: A Rasch Analysis of the Child Behavior Checklist for Ages 1½–5

The Child Behavior Checklist for Ages 1.5–5 (CBCL/1½ –5) has been widely used by researchers and clinicians in the field of special education and psychology. The purpose of this study was to examine the psychometric properties of the CBCL/1½-5 with a sample of preschool children from low-income families using the Rasch model. Participants included 244 children enrolled in a Head Start program. Findings suggested that both the Internalizing and Externalizing subscales are unidimensional and demonstrated local independence successfully, after misfit items were removed to fit the Rasch model. Both subscales operated well with high item reliability and low to medium person reliability, indicating that both subscales have stable item difficulty orders from sample to sample but weaker capacity to distinguish children with mild problem behaviors from those with more severe problems. Differential item functioning was found for a few items across child gender. Considering the length of the item sets, it is appropriate to use the subscale scores to compare the differences in problem behaviors between boys and girls. Overall, the CBCL/1½ –5 has adequate psychometric properties for detecting problem behaviors in preschool children from low-income families. Implications were discussed.

Effect of screen time on behavior of pre-schoolers in Islamabad.

Early years of childhood form the basis of intelligence, personality, social behaviour, and capacity to learn and nurture oneself as an adult. Our objective was to find out the effects of screen time on behavior of pre-schoolers, which could provide scientific grounds to the control of digital screen time. A cross sectional survey was conducted in four private preschools of Islamabad from June -November 2021. A sample size of 200 children ages three-five years were selected through multistage random sampling using a parental questionnaire. Children were grouped based on daily screen time of ≤60 minutes or >60 minutes. Analysis was made based on the Child behavior checklist for ages eighteen months-five years results. Cronbach's alpha coefficient was found to be 0.925. It was analyzed using SPSS version 22. Chi-square test, independent sample t-test and multi linear regression were applied to determine the association and significance levels between the variables. Study results indicate increased screen time was statistically significant with child's age, education level and employment status of mothers. It was observed that pre-schoolers with screen time of > 60 minutes tend to suffer more from withdrawal syndrome (11.94±3.91, p = 0.014) sleep problems (10.97±3.20, p = 0.010) and Autism spectrum problems (17.66±5.89, p = 0.047) as compared to pre-schoolers with screen time ≤60 minutes. Strongest predictor of outcome variable was found to be mothers education level (ß = 21.53). Study findings revealed that excessive screen time has deleterious effect and is associated with behavioural problems of pre-schoolers.

Machine learning-based brief version of the Caregiver-Teacher Report Form for preschoolers

BackgroundThe Caregiver-Teacher Report Form of the Child Behavior Checklist for Ages 1½–5 (C-TRF) is a widely used checklist to identify emotional and behavioral problems in preschoolers. However, the 100-item C-TRF restricts its utility. AimsThis study aimed to develop a machine learning-based short-form of the C-TRF (C-TRF-ML). Methods and proceduresThree steps were executed. First, we split the data into three datasets in a ratio of 3:1:1 for training, validation, and cross-validation, respectively. Second, we selected a shortened item set and trained a scoring algorithm using joint learning for classification and regression using the training dataset. Then, we evaluated the similarity of scores between the C-TRF-ML and the C-TRF by r-squared and weighted kappa values using the validation dataset. Third, we cross-validated the C-TRF-ML by calculating the r-squared and weighted kappa values using the cross-validation dataset. Outcomes and resultsData of 363 children were analyzed. Thirty-six items of the C-TRF were retained. The r-squared values of C-TRF-ML scores were 0.86–0.96 in the cross-validation dataset. Weighted kappa values of the syndrome/problem grading were 0.72–0.94 in the cross-validation dataset. Conclusions and implicationsThe C-TRF-ML had about 60 % fewer items than the C-TRF but yielded comparable scores with the C-TRF.

Maternal postnatal bonding disorder and emotional/behavioral problems in preschool children: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

BackgroundAlthough there is evidence that maternal perinatal mental disorders are associated with emotional/behavioral problems in children, the long-term impacts of postnatal bonding disorder remain unclear. We aimed to examine the associations between maternal postnatal bonding disorder and emotional/behavioral problems in preschool children. MethodsWe analyzed data from 7220 mother–child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Maternal bonding disorder was defined as Mother-to-Infant Bonding Scale score ≥5 at 1 month after delivery. The Child Behavior Checklist for Ages 1½–5 was used to assess emotional/behavioral problems, and its subscales were used to assess internalizing and externalizing problems in children at 4 years of age. Multiple logistic regression analyses were conducted to examine the associations of postnatal bonding disorder with emotional/behavioral, internalizing, and externalizing problems after adjustment for age, education, income, parity, prenatal psychological distress, postnatal depressive symptoms, child's sex, preterm birth, and birth defects. ResultsThe prevalence of postnatal bonding disorder was 14.8 %. Postnatal bonding disorder was associated with an increased risk of emotional/behavioral problems in children: the odds ratio (OR) was 2.06 (95 % confidence interval [CI], 1.72–2.46). Postnatal bonding disorder was also associated with increased risks of internalizing problems and externalizing problems in children: the ORs were 1.69 (95 % CI, 1.42–2.02) and 1.90 (95 % CI, 1.59–2.26), respectively. LimitationsBonding and problems were self-reported. ConclusionsBonding disorder at 1 month after delivery was associated with an increased risk of emotional/behavioral problems in children at 4 years of age.

Association of maternal psychological distress and the use of childcare facilities with children's behavioral problems: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

BackgroundChildcare facilities are a factor that lowers the established association of mother’s postnatal psychiatric symptoms with children's behavioral problems. However, no studies have considered the prenatal psychiatric symptoms yet. This study examined whether the use of childcare facilities moderates the association of maternal psychological distress in early pregnancy and at two years postpartum with behavioral problems in children aged four years.MethodsThe present study was based on the data from 23,130 mother–child pairs participating in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. K6 was used to classify maternal psychological distress in early pregnancy and at two years postpartum into four categories: none in both prenatal and postnatal periods (none), only the prenatal period (prenatal only); only the postnatal period (postnatal only); both prenatal and postnatal periods (both). The children's behavioral problems were assessed using the Child Behavior Checklist for Ages 1½–5 (CBCL) aged four years. The clinical range of the externalizing, internalizing, and total problem scales of the CBCL was defined as having behavioral problems. To examine whether availing childcare facilities moderates the association between maternal psychological distress and children's behavioral problems, we conducted a stratified analysis based on the use of childcare facilities or not, at two years of age. The interaction term between maternal psychological distress and use of childcare facilities was included as a covariate in the multivariate logistic regression analysis to confirm the p-value for the interaction.ResultsThe prevalence of the clinical ranges of externalizing problems, internalizing problems, and clinical range of total problems were 13.7%, 15.4%, and 5.8%, respectively. The association of maternal psychological distress with a high risk of children's behavioral problems was significant; however, the association between prenatal only psychological distress and externalizing problems in the group that did not use childcare facilities was not significant. Interactions between the use of childcare facilities and maternal psychological distress on behavioral problems in children were not significant.ConclusionsUse of childcare facilities did not moderate the association of maternal psychological distress in early pregnancy and at two years postpartum with behavioral problems in children aged four years.

Cognitive and motor development in preterm children from 6 to 36 months of age: Trajectories, risk factors and predictability

BackgroundAlthough numerous studies have examined the development of preterm children born very low birth weight (VLBW, birth body weight < 1500 g), variations of developmental progress within individuals have rarely been explored. The aim of this research was to examine the cognitive and motor trajectories in preterm children born VLBW at early ages and to assess the risk factors and predictability of these trajectories. MethodFive hundred and eighty preterm infants born VLBW from three cohort studies (2003 to 2014) were prospectively assessed their mental and motor development using the Bayley Scales at 6, 12, 24, and 36 months, and cognitive, motor and behavioral outcomes using the Movement Assessment Battery for Children and the Child Behavior Checklist for Ages 1.5–5 at 4 years of age. ResultsPreterm children born VLBW manifested three cognitive patterns (stably normal [64.0 %], deteriorating [31.4 %], and persistently delayed [4.6 %]) and four motor patterns (above average [6.3 %], stably normal [60.0 %], deteriorating [28.5 %], and persistently delayed [5.2 %]) during 6–36 months. Low birth body weight, stage III-IV retinopathy of prematurity and low parental socio-economic status were associated with the deteriorating patterns; prolonged hospitalization and major brain damage were additionally associated with the persistently delayed patterns. Furthermore, the cognitive and motor deteriorating pattern was each predictive of cognitive and motor impairment at 4 years of age; whereas, the persistently delayed patterns were predictive of multiple impairments. Conclusion and implicationsPreterm children born VLBW display heterogeneous trajectories in early cognitive and motor development that predict subsequent developmental and behavioral outcomes.

Associations between prenatal exposure to perfluoroalkyl substances and neurobehavioral development in early childhood: A prospective cohort study

Findings from epidemiological studies on the associations between prenatal perfluoroalkyl substances (PFASs) exposure and children's neurodevelopment were inconclusive, and most studies did not account for the co-exposure to multiple PFASs with strong inter-correlations. The present study aimed to assess the effects of prenatal multiple PFAS exposure on children’s neurobehavioral development based on 614 mother-infant pairs in the Shanghai-Minhang Birth Cohort Study. Eight PFAS concentrations were measured in maternal plasma at 12–16 weeks of gestation. Children’s neurobehavioral development at 2 and 4 years of age was assessed by the Child Behavior Checklist for Ages 1.5–5. In Bayesian kernel machine regression (BKMR) analyses that could address the inter-correlations between multiple PFASs, PFAS mixture appeared to be associated with fewer Somatic Complaints and more Externalizing Problems in boys, but more Somatic Complaints and Sleep Problems in girls. There were suggestive associations of PFNA and PFOS with decreased risk of Somatic Complaints and of PFUdA and PFTrDA with increased risk of Externalizing Problems in boys; trends of increased risk in girls were observed between PFUdA and Somatic Complaints and between PFTrDA and Sleep Problems. Overall, we found no clear evidence that prenatal exposure to PFASs had negative effects on neurobehavioral development in children. However, the modest associations still suggested the potential developmental neurotoxicity of prenatal PFAS exposure.

Associations between Maternal and Offspring Hair Cortisol Concentrations and Child Behavioral Symptoms in Mother-Child Pairs with Perinatal Mental Disorders.

Maternal perinatal mental disorders (PMD) are associated with developmental and behavioral problems in children, probably mediated by the programming of the hypothalamic–pituitary–adrenal (HPA) axis. Increased cortisol concentrations during the antenatal and perinatal periods have been related to long-term effects on children’s behavior and stress response. We aimed to investigate the association of hair cortisol concentrations (HCC) between mothers, with (n = 16) and without PMD (n = 30), and their children, aged between 18 and 48 months. Participants were evaluated with a clinical interview and questionnaires for the Depression Anxiety Stress Scale and the Child Behavior Checklist for ages 1½–5. Maternal and child HCCs were compared between the two groups. Children of the PMD group had increased symptoms of attention deficit hyperactivity disorder. A positive linear association between maternal and child HCC was observed only in the total sample of mother–child dyads and the control group. In the PMD group, children’s HCCs were significantly associated with child anxiety/depression symptoms. Aggressive behavior and oppositional/defiant problems correlated significantly with children’s own HCCs, and their mother’s too. These findings suggest that a chronic dysregulation of maternal and child HPA axis and their associations in the PMD dyads may underlie the linkage among prolonged maternal stress, child behavioral/emotional problems and stress responses.

Psychosocial adaptation to precocious puberty: A nursing support program.

This study aimed to determine the effects of a nursing support program (NSP) based on the Roy Adaptation Model on the psychosocial adaptation of girls with precocious puberty and their mothers. This study adopted a pre-post design. It included 26 girls diagnosed with precocious puberty and their mothers. Data were collected using a Demographic Information Form; the Child Behavior Checklist for Ages 6-18; and the Depression, Anxiety, and Stress Scale. Participants were then enrolled in a NSP based on the Roy Adaptation Model. The same measures were administered at the end of the support program to the participants. It was determined that at the beginning of the program, approximately one-third of the mothers had depression, 15% anxiety, and approximately 20% experienced stress. Mothers' anxiety and stress levels and girls' anxiety/depression and total problem scores significantly decreased after the NSP. The NSP designed for this study positively affected the psychosocial problems of girls with precocious puberty and their mothers.

Prenatal Androgen Exposure and Traits of Autism Spectrum Disorder in the Offspring: Odense Child Cohort.

Fetal androgen exposure may be associated with autism spectrum disorder (ASD). We studied 1777 mother-child pairs in the prospective Odense Child Cohort. Prenatal androgen exposure was assessed by maternal 3rd trimester testosterone concentrations, maternal polycystic ovary syndrome (PCOS), and 3months offspring anogenital distance. ASD traits were assessed at age 3years with the ASD-symptom scale of the Child Behavior Checklist for ages 1½-5years. Maternal testosterone was positively associated with traits of ASD in boys (p < 0.05). Maternal PCOS was associated with increased offspring ASD traits (p = 0.046), but became non-significant after excluding parental psychiatric diagnosis. Offspring anogenital distance was not linked to ASD traits. Higher prevalence of ASD in boys could be linked to higher susceptibility to fetal androgen exposure.

Developmental and Behavioral Consequences of Intrauterine Anti-Seizure Medication Exposure.

In this cross-sectional study, whether there is a difference in the prevalence of developmental/behavioral problems in children of those who received mono/polytherapy during pregnancy; How Valproic Acid (VPA) exposure affects developmental/behavioral characteristics compared to other antiseizure medications (ASM) was also investigated. 64 children of 46 women with epilepsy (WWE) with children aged 0-18 years were included. Ankara Development and Screening Inventory (ADSI) for their children up to the age of six and The Child Behavior Checklist for Ages 4-18-CBCL/4-18 scale was applied for the ages of 6-18. Children exposed to prenatal ASM were divided into two groups as polytherapy and monotherapy. Children exposed to monotherapy were investigated by drug exposure, as well as exposure to VPA and other ASMs. Chi-square test was used to compare qualitative variables. When monotherapy and polytherapy groups were compared, a significant difference was found in the language cognitive development area of the ADSI (p=0.015) and in terms of the sports activity variable in CBCL/4-18 (p=0.039). When the VPA monotherapy and other ASM monotherapy groups were compared, a significant difference was found in terms of sports activity in CBCL-4-18 (p=0.013). It was found that language and cognitive development can be delayed, the level of engagement in sports activities can be reduced in children exposed to polytherapy. The rate of doing sports activities in valproic acid monotherapy exposure may decrease.

How did the pandemic affect the socio-emotional well-being of Chilean schoolchildren? A longitudinal study.

This study investigated the repercussions of coronavirus disease (COVID-19) and the subsequent quarantine on the emotional well-being of children in their initial years of formal schooling, with particular emphasis on children with special educational needs (SEN) and children from high and low socioeconomic statuses (SES). This longitudinal study employed the Child Behavior Checklist for ages 6-18 (CBCL) completed by the students' guardians at least once during 2018-2019 and again during 2020. The results showed differences in internalizing and externalizing problems after 8 months of quarantine and a significant increase in students fitting clinical or borderline categories given by the CBCL itself. The results are described in detail for four groups considering the combination of SEN and SES characteristics, showing the importance of their intersectionality, especially between low SES and SEN. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Neurodevelopmental profile of HIVEP2-related disorder.

To characterize the neurodevelopmental profile and systemic features of HIVEP2-related disorder. This study used retrospective medical history and standardized assessment data from Simons Searchlight to describe the clinical characteristics of 12 individuals (eight males, four females; age range 3y 3mo-12y 8mo; mean age [SD] 7y 7mo [2y 11mo]) with pathogenic HIVEP2 variants, focusing on their levels of adaptive functioning, autism symptomology, and emotional and behavioral characteristics. Common features included neonatal complications, hypotonia, developmental delay, intellectual disability, language impairment, gastroesophageal reflux, and strabismus. A minority of individuals had epilepsy, microcephaly, or a movement disorder. Based on the Vineland Adaptive Behavior Scales, Second Edition, affected individuals showed impairments in adaptive behavior (mean composite standard score [SD] 56.4 [10.2]; n=8). The cohort also had significant impairments in social problems, as measured by the Social Responsiveness Scale, Second Edition (mean total score [SD] 76.4 [11.3]; n=10) and clinically significant emotional and behavioral difficulties, as measured by the Child Behavior Checklist for ages 6-18 (mean total T score [SD] 66.9 [8.2]; n=8). These results show that individuals with HIVEP2-related disorder have impairments in adaptive and social-related behaviors as well as difficulties in emotional and behavioral symptoms.

Predictors of Depressive Symptoms in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: A One-Year Follow-Up Study.

This 1-year follow-up study examined the predictive values of the demographics, depressive symptoms, stress-coping orientations, and perceived family support of caregivers as well as the internalizing, externalizing and ADHD symptoms of children with attention-deficit/hyperactivity disorder (ADHD) at baseline on the depressive symptoms of the caregivers after 1 year. A total of four hundred caregivers of children with ADHD were recruited. The baseline levels of the caregivers’ depressive symptoms, stress-coping orientations, and perceived family support and the internalizing and externalizing problems of the children were assessed using the Center for Epidemiological Studies Depression Scale, the Coping Orientation to Problems Experienced, Family Adaptation, Partnership, Growth, Affection, Resolve Index, and the Child Behavior Checklist For Ages 6–18, respectively. Their predictions for the caregiver’s depressive symptoms 1 year after the baseline were examined using linear regression analysis. In total, 382 caregivers of children with ADHD underwent the follow-up assessment 1 year from the baseline. A marital status of being separated or divorced, less effective coping and depressive symptoms orientation, and children with internalizing problems and ADHD symptoms at baseline were positively associated with the caregivers’ depressive symptoms at follow-up, whereas the caregivers’ perceived family support and an emotion-focused coping orientation at baseline were negatively associated with depressive symptoms at follow-up. Multiple characteristics of the caregivers and children with ADHD at baseline predicted the caregivers’ depressive symptoms 1 year later.

Safety and Outcomes in Infants Born to Mothers Participating in Retosiban Treatment Trials: ARIOS Follow-up Study.

Retosiban, an oxytocin receptor antagonist, was developed for treating spontaneous preterm labor (sPTL) in women with intact membranes. This ARIOS follow-up study aimed to characterize clinical safety, morbidity, and mortality of infants exposed to retosiban or comparator over 2 years. ARIOS prospectively assessed outcomes in infants whose mothers received at least one dose of retosiban or comparator (placebo/atosiban) in two Phase 3 sPTL trials. Both trials were terminated prematurely owing to poor enrolment. Infants could be enrolled into ARIOS from 28 days after estimated due date until hospital discharge or up to 9 months (corrected age). An internally developed questionnaire detailing medical conditions, mortality and resource use (Child Health Inventory; CHI), Ages and Stages Questionnaire-3 (ASQ-3), Modified Checklist for Autism in Toddlers-Revised with Follow-Up, and Child Behavior Checklist for Ages 1.5 to 5 were completed remotely by parents or legal guardians at prespecified intervals. Serious adverse events (SAEs) were primarily captured via CHI. No comparative statistical analysis was conducted between treatment arms. A total of 49 (86%) infants who had received retosiban and 49 (78%) infants who had received a comparator were enrolled in ARIOS. No deaths occurred during the study. Nine infants experienced SAEs: 6/49 (12.2%) infants in the comparators group and 3/49 (6.1%) in the retosiban group. Of the nine SAEs, seven were due to infections, three, and four in the retosiban and comparators groups, respectively. Based on ASQ-3 score, the incidence of neurodevelopmental delay at 18 and 24 months were 0/18 (0%) and 2/25 (8%) with retosiban and 7/22 (31.8%) and 3/21 (14.3%) with comparator, respectively. The current study showed no unexpected adverse outcome or impairment with retosiban based on safety monitoring and neurodevelopment assessments. No further follow-up is intended owing to the discontinuation of clinical development of retosiban. · There is a need for an effective and safe treatment for sPTL.. · ARIOS was a follow-up study of two Phase 3 trials in sPTL.. · There were no safety concerns with retosiban treatment.. · Slow recruitment led to termination of the Phase 3 trials..

Self-Reported Depressive Symptoms and Suicidality in Adolescents with Attention-Deficit/Hyperactivity Disorder: Roles of Bullying Involvement, Frustration Intolerance, and Hostility.

This study examined the relationships of cyberbullying and traditional bullying victimization and perpetration, perceived family function, frustration discomfort, and hostility with self-reported depressive symptoms and suicidality in adolescents diagnosed as having attention-deficit/hyperactivity disorder (ADHD). Both the self-reported severity of depressive symptoms on the Center for Epidemiological Studies Depression Scale and the occurrence of suicidal ideation or a suicide attempt on the suicidality module of the Kiddie Schedule for Affective Disorders and Schizophrenia were assessed in 195 adolescents with ADHD. The adolescents completed the Cyberbullying Experiences Questionnaire, Chinese version of the School Bullying Experience Questionnaire, Frustration–Discomfort Scale, Buss–Durkee Hostility Inventory, and Family APGAR Index. Caregivers completed the ADHD problems component of the Child Behavior Checklist for Ages 6–18. Multiple regression analyses were used to examine the correlates for each of self-reported depressive symptoms and suicidality. The results showed that after the effects of gender, age, ADHD symptoms, and family function were controlled, greater frustration discomfort and bullying perpetration significantly predicted self-reported depressive symptoms. Being cyberbullying victims and displaying hostility significantly predicted the risk of suicidality. Various types of bullying involvement, frustration intolerance, and hostility significantly predicted self-reported depressive symptoms and suicidality in adolescents with ADHD. By monitoring and intervening in these factors, we can reduce the risk of depression-related problems and suicidality in adolescents with ADHD.

Perceived parenting attitudes in relation to ADHD symptoms and aggressive behaviors in a sample of Egyptian children with ADHD

BackgroundExternalizing behaviors are common in children with attention-deficit hyperactivity disorder (ADHD). This study was aiming to investigate the perceived parenting attitudes in children with ADHD and their correlates to the severity of symptoms and associated aggressive behaviors in those children. Accordingly, 140 children with ADHD were assessed using Mini International Neuropsychiatric Interview for Children; Conners’ Parent Rating Scale-Revised, Long Version; the problem scale of the Child Behavior Checklist for ages 4–18; and the Perceived Parenting Attitude Scale.ResultsAssessment of associated behavioral problems in the participants revealed the presence of significant aggressive and externalizing problems. The participants perceived a similar attitude between their mothers and fathers. No significant association is found between severity of ADHD symptoms and perceived parenting attitudes, while consistency in parenting in both mothers and fathers was positively correlated to the aggressive behaviors of the participants.ConclusionsAggression is a common symptom associated with ADHD that should be identified and addressed. Although the current study has revealed that consistency in parenting is positively correlated to the aggression in ADHD children, yet children with ADHD might have a positive illusory bias in their social self-perceptions making it difficult to account for the reliability of their perceived parenting attitudes; hence, it remains to be clarified whether perceived parents’ attitudes are attributed to children’s aggression or to children’s perception caused by the previously mentioned illusory bias. For future research, it is highly recommended to assess parenting from the parents’ and their children’s points of view.

Effects of COVID-19 Lockdown on the Emotional and Behavioral Profiles of Preschool Italian Children with and without Familial Risk for Neurodevelopmental Disorders.

The effects of COVID-19 containment measures on the emotional and behavioral development of preschoolers are not clear. We investigated them within an ongoing longitudinal project including typically developing children (TD) and children at high familial risk for neurodevelopmental disorders (HR-NDD) who were potentially more vulnerable. The study included ninety children aged 2–6 years (TD = 48; HR-NDD = 42). Before the emergency phase (T0), all children received a clinical assessment, including the parent questionnaire Child Behavior Checklist for Ages 1.5–5 (CBCL 1.5–5). The same questionnaire was filled out again during the emergency (T1), together with an ad-hoc questionnaire investigating environmental factors characterizing the specific period. Changes in the CBCL profiles between T0 and T1 were evaluated. Overall, irrespective of familial risk, the average T-scores on specific CBCL scales at T1 were higher than at T0. Associations emerged between delta scores reflecting worsening scores on specific CBCL scales and clinical and environmental factors. Our results confirmed the negative impact of the lockdown on preschool children’s emotional/behavioral profiles, and highlight the need for strategic approaches in the age range of 2–6 years, especially for more susceptible children owing to environmental factors and pre-existing emotional problems.

Vocal folds nodules among Egyptian children and adolescents: Behavior aspects

Objective: This study aimed to verify the relationships between voice, and behavior in children and adolescents with and without dysphonia based on parents’ reports and perceptual voice analysis by Phoniatricans.Study Design: This is a case control study.Patients and Methods: The study involved 51 of dysphonic school-age children and adolescents and 62 vocally normal controls aged from 6-18 years. Participants were assessed with auditory perceptual voice analysis, clinical laryngoscopic examination (CLE). Parents of all participants completed the Child Behavior Checklist for ages 6–18 years (CBCL)..Results: Children and adolescents with dysphonia scored higher on Internalizing, Externalizing, Anxiety/depression, Withdrawal/depression, Somatic complaints, Social problems, Attention problems, Rule-breaking, and Aggressive behavior. Children and adolescents with vocal problem scored lower on Activities, Social, School, and thought problems. Correlation analysis between dysphonia severity and CBCL scores demonstrated significant positive correlation in the following scales (Internalizing scale r=0.549; P=0.001, externalizing scale (r=0.370; P= 0.001 and total Behavior scales (r= 0.581; P=0.00), school scale score (r= 0.288; P=0.002), and total Competence indicators (r= 0.230; P= 0.014), withdrawal/depression, social problems, rule-breaking, and aggressive behavior .Conclusion: Vocal fold nodules may be a risk for behavior problems due to the higher scores on behavior problems scales in children and adolescents, especially internalization and externalization aspects and significant positive correlation found between dysphonia severity and CBCL scores. Early interventions of these problems are needed to prevent the persistence of such problems, and reduce its negative impact.

Structural validity of the Child Behavior Checklist (CBCL) for preschoolers with neurogenetic syndromes

BackgroundPsychologists routinely use the Child Behavior Checklist for Ages 1½–5 (CBCL) to assess challenging behaviors of preschoolers with developmental disabilities. However, the CBCL has not been thoroughly validated in neurogenetic syndromes (NGS). AimWe investigated the structural validity of the CBCL in NGS. MethodsBased on 152 preschoolers with Angelman, fragile X, Prader-Willi, and Williams syndromes, we employed confirmatory factor analysis (CFA) to evaluate the goodness-of-fit of CBCL narrowband, broadband, and DSM-oriented scales. ResultsCFA models largely supported the unidimensionality of most narrowband scales and the two-factor structure of internalizing and externalizing broadband scales. However, there was limited evidence for the unidimensionality of most DSM-oriented scales. ConclusionsPsychologists may consider using the CBCL as a psychometrically sound narrowband and broadband measure of challenging behaviors but should exercise caution when interpreting DSM-oriented scales for preschoolers with NGS. Our findings underscore a continued need to enhance assessment measures for identifying early precursors of child psychopathology in pediatric populations with atypical developmental trajectories.