Child Behavior Checklist Research Articles

Identifying the Types of Trajectories for Each of the Five Child Behavior Checklist Sub-Concepts

Identifying the Types of Trajectories for Each of the Five Child Behavior Checklist Sub-Concepts

Stratification of Gut Microbiota Profiling Based on Autism Neuropsychological Assessments

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. Investigations of gut microbiota (GM) play an important role in deciphering disease severity and symptoms. Overall, we stratified 70 ASD patients by neuropsychological assessment, based on Calibrated Severity Scores (CSSs) of the Autism Diagnostic Observation Schedule-Second edition (ADOS-2), Child Behavior Checklist (CBCL) and intelligent quotient/developmental quotient (IQ/DQ) parameters. Hence, metataxonomy and PICRUSt-based KEGG predictions of fecal GM were assessed for each clinical subset. Here, 60% of ASD patients showed mild to moderate autism, while the remaining 40% showed severe symptoms; 23% showed no clinical symptoms, 21% had a risk of behavior problems and 56% had clinical symptoms based on the CBCL, which assesses internalizing problems; further, 52% had no clinical symptoms, 21% showed risk, and 26% had clinical symptoms classified by CBCL externalizing problems. Considering the total CBCL index, 34% showed no clinical symptoms, 13% showed risk, and 52% had clinical symptoms. Here, 70% of ASD patients showed cognitive impairment/developmental delay (CI/DD). The GM of ASDs with severe autism was characterized by an increase in Veillonella, a decrease in Monoglobus pectinilyticus and a higher microbial dysbiosis index (MDI) when compared to mild-moderate ASDs. Patients at risk for behavior problems and showing clinical symptoms were characterized by a GM with an increase of Clostridium, Eggerthella, Blautia, Intestinibacter, Coprococcus, Ruminococcus, Onthenecus and Bariatricus, respectively. Peptidoglycan biosynthesis and biofilm formation KEGGs characterized patients with clinical symptoms, while potential microbiota-activated PPAR-γ-signaling was seen in CI/DD patients. This evidence derived from GM profiling may be used to further improve ASD understanding, leasing to a better comprehension of the neurological phenotype.

Delayed Milestones and Demographic Factors Relate to the Accuracy of Autism Screening in Females Using Spoken Language.

Examine how milestone development, demographics, and emotional/behavioral functioning predict autistic females meeting the cutoff on a commonly used Autism screening tool (Social Communication Questionnaire: SCQ). We hypothesized that autistic girls with fewer developmental delays, whose parents have lower education, or are Black or Multiracial would be less likely to meet the SCQ cutoff. Further, those with more symptoms of Withdrawal/Depression, Social Problems, Thought Problems, and Attention Problems on the (Child Behavioral Checklist: CBCL) would be more likely to screen positive. A subset of participants enrolled in a large national cohort (SPARK) were included (5,946 autistic females). A cutoff score on the SCQ of 11was used to form groups: Meet (M: N = 5,186) and Not Meeting (NM: N = 760). Autistic girls who had delayed toileting and motor milestones and whose parents attained higher education were more likely to screen positive. Girls who scored within the clinical range on the CBCL Thought Problems and Attention Problems syndrome scales were more likely to screen positive. Race and reported symptoms on the Withdrawn/Depressed and Social Problems syndrome scales did not relate to screening status. Results further support the existing literature suggesting that autistic girls must present with more significant delays/symptoms to be screened and diagnosed with autism, which can could impact their access to early intervention services and future skill development. Future research should examine additional factors that specifically put females at a disadvantage for being accurately identified, particularly for those who are speaking and/or of average cognitive ability.

Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study

BackgroundDespite the ubiquity of adolescent screen use, there are limited longitudinal studies that examine the prospective relationships between screen time and child behavioral problems in a large, diverse nationwide sample of adolescents in the United States, which was the objective of the current study.MethodsWe analyzed cohort data of 9,538 adolescents (9–10 years at baseline in 2016–2018) with two years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. We used mixed-effects models to analyze associations between baseline self-reported screen time and parent-reported mental health symptoms using the Child Behavior Checklist, with random effects adjusted for age, sex, race/ethnicity, household income, parent education, and study site. We tested for effect modification by sex and race/ethnicity.ResultsThe sample was 48.8% female and racially/ethnically diverse (47.6% racial/ethnic minority). Higher total screen time was associated with all mental health symptoms in adjusted models, and the association was strongest for depressive (B = 0.10, 95% CI 0.06, 0.13, p < 0.001), conduct (B = 0.07, 95% CI 0.03, 0.10, p < 0.001), somatic (B = 0.06, 95% CI 0.01, 0.11, p = 0.026), and attention-deficit/hyperactivity symptoms (B = 0.06, 95% CI 0.01, 0.10, p = 0.013). The specific screen types with the greatest associations with depressive symptoms included video chat, texting, videos, and video games. The association between screen time and depressive, attention-deficit/hyperactivity, and oppositional defiant symptoms was stronger among White compared to Black adolescents. The association between screen time and depressive symptoms was stronger among White compared to Asian adolescents.ConclusionsScreen time is prospectively associated with a range of mental health symptoms, especially depressive symptoms, though effect sizes are small. Video chat, texting, videos, and video games were the screen types with the greatest associations with depressive symptoms. Future research should examine potential mechanisms linking screen use with child behavior problems.

GAIA therapeutic farm: Prospective study on multidisciplinary care efficacy.

The therapeutic farm "GAIA" in Sidi Thabet is a non-profit organization created in 2009, situated in the North-Western suburbs of the capital Tunis/Tunisia. Its main aims are the day-care for and the socio-professional integration of children and young adults between age 6 and 30 with diverse types of disability through multiple activities, such as pet assisted therapy and horticulture. to assess the potential benefits of therapeutic on-farm management. We conducted a prospective study including 50 children and young adults aged 7 to 30 years with intellectual disabilities and/or autism spectrum disorders. Study participants were evaluated before inclusion and after 10 months of care using a self-established questionnaire collecting socio-demographic and clinical variables, an evaluation of competences, and the Child Behavior Checklist (CBCL). Mean sub scores (externalization/internalization) of CBCL decreased significantly (p<0.002). Competences were significantly improved in the following domains: understanding of verbal language, gross and fine motor skills, body hygiene, spatial and temporal orientation, preschool and school learning achievements and social integration. These positive initial results should encourage the further development of this initiative with support of the community.

Occupational exposure to organic solvents during pregnancy and child behavior from early childhood to adolescence

BackgroundOrganic solvents are used in formulating an extensive range of products for professional use. Animal and human studies suggest that in utero solvent exposure may affect neurodevelopment. Our objective was to assess the association between occupational exposure to solvents during pregnancy and child behavior aged 2–12 years.MethodsThe French mother-child cohort PELAGIE (2002–2006) included 3,421 women recruited in early pregnancy. Occupational exposure to solvents was self-reported. For 459 children, parents used a questionnaire derived from the Child Behavior Checklist and the Preschool Social Behavior Questionnaire to assess their child’s behavior, at age 2, and the Strengths and Difficulties Questionnaire at ages 6 and 12. A cross-lagged structural equation modeling approach was used to assess direct and indirect associations between exposure and child behavior.ResultsAt age 2, an increased externalizing behavior score was suggested with prenatal exposure to solvents (mean change in standardized score (95%CI): 0.28 (-0.01, 0.57) for occasional exposure and 0.23 (-0.05, 0.51) for regular exposure). At ages 6 and 12, distinct sex-specific patterns were observed: among boys, no association with externalizing behavior was observed, while among girls, an association was seen for both occasional and regular exposure (total effect at age 12: 0.45 (0.06,0.83) and 0.40 (0.03, 0.76), respectively). For both sexes, occasional exposure may be associated with internalizing behavior at ages 6 and 12 (total effect at age 6: 0.37 (0.06, 0.68) and at age 12: 0.27 (-0.08, 0.62)).ConclusionsOccupational exposure to solvents during pregnancy may impact child behavior through either direct or cumulative effects during childhood; these associations may persist until early adolescence, especially among girls.

Intergenerational transmission of comorbid internalizing and externalizing psychopathology at age 11: Evidence from an adoption design for general transmission of comorbidity rather than homotypic transmission.

Psychopathology is intergenerationally transmitted through both genetic and environmental mechanisms via heterotypic (cross-domain), homotypic (domain-specific), and general (e.g., "p-factor") pathways. The current study leveraged an adopted-at-birth design, the Early Growth and Development Study (57% male; 55.6% White, 19.3% Multiracial, 13% Black/African American, 10.9% Hispanic/Latine) to explore the relative influence of these pathways via associations between adoptive caregiver psychopathology (indexing potential environmental transmission) and birth parent psychopathology (indexing genetic transmission) with adolescent internalizing and externalizing symptoms. We included composite measures of adoptive and birth parent internalizing, externalizing, and substance use domains, and a general "p-factor." Age 11 adolescent internalizing and externalizing symptom scores were the average of adoptive parent reports on the Child Behavior Checklist (n = 407). Examining domains independently without addressing comorbidity can lead to incorrect interpretations of transmission mode. Therefore, we also examined symptom severity (like the "p-factor") and an orthogonal symptom directionality score to more cleanly disentangle transmission modes. The pattern of correlations was consistent with mostly general transmission in families with youth showing comorbid internalizing and externalizing symptoms, rather than homotypic transmission. Findings more strongly supported potential environmental or evocative mechanisms of intergenerational transmission than genetic transmission mechanisms (though see limitations). Parent-specific effects are discussed.

Routine third-trimester ultrasonography and child neurodevelopmental outcomes: a follow-up of a pragmatic cluster-randomised controlled trial

ABSTRACT Aims/Background Routine third-trimester ultrasonography is increasingly conducted to screen for foetal growth restriction (FGR) and reduce adverse perinatal and child neurodevelopmental outcomes using timely obstetric management. While it did not reduce adverse perinatal outcomes in previous trials, evidence regarding its association with child neurodevelopmental outcome is absent. We examined whether routine third-trimester ultrasonography is positively associated with child developmental and behavioural/emotional outcomes compared to usual care. Design/Methods Dutch mothers with a low-risk pregnancy participating in a subsample (n = 1070) of a nationwide cluster-randomised trial reported infant (age 6 months) and toddler (age 28 months) developmental milestones (Ages and Stages Questionnaire) and toddlers’ internalising and externalising problems (Child Behavior Checklist). Usual care (n = 380) comprised selective ultrasonography. The intervention strategy (n = 690) included two routine third-trimester ultrasounds next to usual care. Both strategies applied the same interdisciplinary protocol for FGR detection and management. Results Adjusted linear mixed-level regressions revealed that routine third-trimester ultrasonography was positively but modestly related to z-standardised infant developmental milestones at 6-month follow-up, B = 0.20, 95%CI [0.07; 0.32], p = 0.003, compared to usual care. At 28-month follow-up, these strategies did not differ in child developmental outcome and internalising and externalising problems. Conclusion Routine third-trimester ultrasonography was positively but modestly associated with infant development. In toddlerhood, routine ultrasonography was not related to child developmental and behavioural/emotional outcomes. Overall, these findings do not support the implementation of routine third-trimester ultrasonography for low-risk pregnant women for reasons concerning children’s early neurodevelopmental outcomes.

Exploring correlations between Conners' Continuous Performance Test and subjective measures of attention deficit hyperactivity disorder symptoms in a paediatric clinical sample.

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental condition characterised by inattention and/or hyperactivity-impulsivity. The ADHD symptoms are often evaluated and quantified using various assessment tools, such as the Conners' Continuous Performance Test II (CCPT-II), ADHD Rating Scale (ADHD-RS), Child Behaviour Checklist (CBCL), Clinical Global Assessment Scale (CGAS) and Clinical Global Impression Scale (CGIS). This study sought to compare CCPT-II with parent- and clinician-rated rating scales (ADHD-RS, CBCL, CGAS and CGIS) in measuring the core ADHD symptoms within the paediatric ADHD population. The data, gathered from a large-scale randomised controlled trial involving 172 children aged 6-12 years with ADHD, was pooled, and a Pearson correlation analysis was conducted. No significant correlations were observed between CCPT-II and ADHD-RS, as well as the various subscales of CBCL, CGAS and CGIS. While CCPT-II may offer insights into ADHD symptomatology, its relationship with parent- and clinician-rated rating scales such as ADHD-RS, CBCL, CGAS and CGIS appears limited. Further research is warranted to elucidate the nuances of these assessment tools and their roles in evaluating ADHD.

State-level variation in the prevalence of child psychopathology symptoms in the US: Results from the ABCD study

ObjectiveTo estimate the prevalence of clinically meaningful youth mood, anxiety, behavioral, and attention symptoms across US states. MethodData are drawn from the Adolescent Brain Cognitive Development (ABCD) study baseline wave, which included 11,876 children ages 9-10. Statistical weighting strategies generated projected state-specific prevalence estimates for the 17 states where ABCD collected data based on state socio-demographics. Twenty dimensions of mental health were assessed with the Child Behavior Checklist using recommended cut-scores to assess clinical and sub-threshold symptoms. ResultsPsychopathology symptom prevalence varied by state and outcome. Projected prevalence of internalizing problems ranged from 11.0% [95% CI: 9.8%, 12.2%; Oklahoma] to 7.9% [95% CI: 6.9%, 9.0%; Maryland] across states. Projected prevalence of externalizing problems ranged from 6.9% [95% CI: 6.1%, 7.8%; South Carolina] to 4.5% [95% CI: 3.7%, 5.4%; California]. Regions with high symptoms included sections of the South (e.g., Oklahoma, South Carolina) and Vermont. Conduct problems had the most variability across states (i.e., greatest state-level prevalence 91% higher than the lowest). Attention problems had the least variability across states (greatest state-level prevalence 26% higher than the lowest). ConclusionsClinically meaningful psychopathology symptoms are common in children across the US, with substantial state-level variability in prevalence. Understanding variability in the prevalence of psychopathology symptoms across the US can help to inform resource allocation to increase the availability of youth mental health services.

Adverse Childhood Experiences and Socio-Emotional Outcomes of Children Born Very Preterm

ObjectiveTo examine whether adverse childhood experiences (ACEs) confer risk for socio-emotional problems in children born very preterm (VPT) Study designAs part of a longitudinal study, 96 infants born VPT at 23-30 weeks of gestation were recruited from a level III neonatal intensive care unit and underwent follow-up at ages 2 and 5 years. Eighty-three full-term (FT, 37-41 weeks gestation) children were recruited from an adjoining obstetric service and the local community. ACEs were assessed with the Child Life Events Scale at age 2 and Preschool Age Psychiatric Assessment at age 5. At age 5, internalizing, externalizing, and Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms were assessed with the Child Behavior Checklist and Conner’s Rating Scale-Revised, respectively. Covariates including socioeconomic disadvantage, maternal distress, and parent ADHD symptoms were assessed at the 2- and/or 5-year follow-up. Mediation and moderation analysis, accounting for family clustering, examined associations between birth group, ACEs, and socio-emotional outcomes. ResultsAfter covariate adjustment, children born VPT experienced more ACEs (p<0.001), particularly medical ACEs (p<0.01), and had worse ADHD and internalizing outcomes (p<.05) than FT children. ACEs mediated the association between birth group and ADHD outcomes (95% CIs: 0.11 – 4.08). There was no evidence of mediation for internalizing outcomes. Higher parent ADHD symptoms (p<.001) and maternal distress (p<.05) were associated with poorer internalizing outcomes. ConclusionsScreening for childhood ACEs should be embedded in the follow-up care of children born VPT and their families. Strategies to screen for and address parent psychosocial functioning may be important to support children’s socio-emotional development.

The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder

Objective: The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). Method: This study included 842 children aged 8–12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. Results: According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. Conclusion: This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.

Youth exposure to violence and victimization in a South African community sample

Background: Studies show that youth in low socioeconomic communities suffer significant disturbances in mental and emotional health because of exposure to violence and peer victimisation, manifesting in internalising disorders such as depression, anxiety and traumatic stress.Aim: To examine the relation between risks and exposure to community violence and peer victimisation.Setting: Low socioeconomic communities in Durban, KwaZulu-Natal.Methods: Data were collected via school and home interviews with youth and maternal caregivers using standardised schedules and instruments. These included the Demographics and Questions about Child’s Health schedule, the Family History of Risk Questionnaire, the Child Behaviour Checklist, the Social Experiences Questionnaire and the Survey of Children’s Exposure to Violence. Youth sample comprised 256 participants, with age range from 9 to 18 years, and 65% being female.Results: Sociodemographic risks were significantly associated with lifetime witnessing violence, victimisation and hearing about violence. Low maternal education was associated with overt peer victimisation and cyber-victimisation. Internalising conditions such as worry and oversensitivity, fear and concentration, youth anxiety and maternal anxiety were also significantly associated with violence exposure and peer victimisation.Conclusion: Predisposing risks for exposure to violence and victimisation occur in all domains, suggesting that interventions should target these domains to minimise their impact. Co-occurring experience of violence at the personal, proximal and distal levels perpetuate a cyclical loop of violence, intersecting and influencing each other.Contribution: Risk factors such as anxious attachment, avoidant attachment and anxiety, conceptually often seen as maladaptive outcomes, also serve as predisposing risks for violence exposure.

Satisfaction in mental health care: Examining psychometric properties of experience of service questionnaire.

Measuring satisfaction with psychological health services is important in clinical settings to evaluate the benefits of treatment. Past research has shown that relationship with therapist is at the core of satisfaction reports. However, measurement tools focusing on patients' psychological health care experiences are rather scarce. The objective of this study is to adapt the Experience of Service Questionnaire (ESQ) Parent form and examine its psychometric properties in a Turkish population. ESQ Parent form was presented to parents (N = 265) of children who have received treatment at a university's psychological counseling center. Child Behavior Checklist (CBCL) was gathered from parents pre- and post-treatment to measure symptomatic gains and investigate their associations with satisfaction with treatment. Confirmatory factor analysis comparing two different constructs showed that the 2-factor structure had a better fit. In addition, participants showing higher therapeutic gains showed significantly higher satisfaction in ESQ. This study is the first to measure satisfaction in psychological health care settings in Turkey, and therefore aims to contribute to a gap in the field. Results indicate a significant association between treatment outcome and satisfaction levels. Also, adapted measurement tool demonstrates adequate reliability and validity scores supporting its use in clinical settings.

Longitudinal interactions between maternal depression symptoms and familial stressful life events on child anxiety symptoms at 5years of age.

In the current study we identified salient parental factors for child anxiety symptoms by considering the role of stressful life events, maternal anxiety symptoms, maternal depressive symptoms, and maternal neuroticism. Families (N=399) in an urban area in the United States were participants in a longitudinal study beginning in infancy. Mothers completed measures of stressful life events (Revised Life Events Questionnaire at all visits), maternal anxiety and depressive symptoms (State-Trait Anxiety Inventory and Beck Depression Inventory, respectively, at infancy between 5 and 12months, at 2years, and at 3years), maternal neuroticism (NEO Five-Factor Inventory at infancy), and child anxiety symptoms (Child Behavior Checklist 1.5-5 at 5years). Linear mixed models (LMMs) were used in analyses. Maternal depressive symptoms from infancy through 3years were associated with child anxiety symptoms; other main effects modeled (stressful life events, maternal anxiety symptoms, maternal neuroticism) were not associated with child anxiety symptoms. There was a significant interaction effect between stressful life events and maternal depression. Stressful events from infancy through 5years of age increased risk for child anxiety symptoms at 5years if the child's mother had a mild mood disturbance or depression, but not for children with non-depressed mothers.

A Longitudinal Study of Aggression in People with Autism and Other Neurodevelopmental Disabilities.

Aggression is common in autism and neurodevelopmental disorders, but longitudinal research on aggression is lacking. We longitudinally tracked aggression in 254 individuals from toddlerhood to emerging adulthood. Our sample included participants with a range of cognitive abilities, with 39.9% classified as more-cognitively-abled (MCA; IQ ≥ 70) and 60.1% as less-cognitively-abled (LCA; IQ < 70). Aggression Composite scores were derived from data from the autism diagnostic observation schedule, autism diagnostic interview-revised, and child behavior checklist at ages 2, 9, and 18. Fifty-four percent, 69%, and 42% of the sample showed aggression in toddlerhood, school age, and emerging adulthood, respectively. LCA individuals had higher rates of aggression in school age (80%) and emerging adulthood (58%) compared to MCA individuals (48 and 22%, respectively). Longitudinal aggression profiles revealed distinct patterns of change over time: 31% displayed persistent aggression, 25% increased, 23% decreased, and 13% never displayed aggression. Higher autism symptoms, lower VIQ, NVIQ, and less-developed adaptive skills correlated with more aggression cross-sectionally. Nonverbal IQ and repetitive behaviors related to aggression longitudinally: people in decreasing or absent profiles had higher NVIQ and fewer RRBs than those with persistent or increasing profiles. Participants with aggression at 9 were four times likelier to exhibit aggression at 18. Aggression is common in autism and NDDs, peaking around age 9, and declining in emerging adulthood. Patterns of change varied widely, with evidence that higher NVIQ and fewer RRBs may be protective. Findings have implications for clinical practices, highlighting important developmental periods and high-risk subgroups.

Study of impact of screen exposure time on behavioural and growth parameters in urban Indian children

Background: The American academy of paediatrics (AAP) recommends 2 hours of screen time (ST) daily for children and teenagers, with no exposure for those under 2 years old. However, research shows children often exceed these limits, leading to behavioural issues, obesity, and unhealthy eating habits. This study aimed to evaluate STs impact on behaviour, growth, and eating habits in children aged 1.5 to 8 years. Methods: This cross sectional, observational study, conducted in the paediatric department, enrolled 401 children aged 1.5 to 8 years. Demographic details, weight, height, and BMI of the children were recorded. Parents provided information of their child's ST, screens at home, their own ST, and child’s eating habits. Behavioural parameters were evaluated using the child behaviour checklist (CBCL). Internalizing and Externalizing behaviours were also recorded in which internalizing factors comprised of anxious and somatic behaviours, while externalizing factors encompassed aggression and rule-breaking behaviours. Data analysis was performed using SPSS V.23. Results: In our study, 401 children were enrolled, comprising 233 females (58.10%) and 168 males (41.90%). Out of 401, 201 (50.12%) exceeded 2 hours of ST, while 159 (39.65%) had 1 to 2 hours, and only 41 (10.22%) had less than 1 hour. There was a strong significant association between children's ST and their internalizing (p=0.00034), externalizing (p=0.009), withdrawn (p=0.001), rule breaking (p=0.03) and aggressive (p&lt;0.01) behaviour. Additionally, children weight had a positive correlation between ST and BMI (p=0.015). Conclusions: Excessive ST use correlates well with higher BMIs, behavioural issues like withdrawal, somatic complaints, rule-breaking, aggression. Urgent interventions are needed to reduce ST and promote healthier lifestyles among children, involving parents, caregivers, and policymakers.Top of Form

Behavioural Problems in Preadolescence: Does Nutritional Status Have a Role?

Malnutrition in children and adolescents is a global issue particularly in low- and middle-income countries, while behavioural problems are becoming a growing public health concern in the area of child and adolescent mental health, with very few studies examining their association in preadolescence. This study aimed to assess the epidemiological relationship between malnutrition and behavioural problems in preadolescence. A school based, cross-sectional survey was conducted in Karachi, Pakistan. Total 660, 11- to 12-year-old preadolescents were selected from a middle-class, coeducational school chain. Sociodemographic questionnaires and an officially adapted version of Youth Self-Report Form (YSR), which is the child and adolescent reported version of the Child Behavior Checklist (CBCL), were used to collect data, along with anthropometric assessments following the WHO protocol. Thin and stunted preadolescents had significantly higher odds of internalizing problems (AOR = 2.05, p = 0.003 and AOR = 2.09, p = 0.039, respectively) than normal ones. Overnutrition was not associated with any behavioural issues. According to the Composite Index of Anthropometric Failure, 40% of preadolescents had at least one type of malnutrition and among them about 3% had co-occurring malnutrition (stunted and thin or overweight). They significantly had higher risk of being associated with the internalizing problems (AOR 2.92, p = 0.027). The effect was considerably higher than that associated with stunted or thin only, highlighting the cumulative impact of the co-occurring malnutrition on the internalizing problems. Our study concludes that overnutrition and undernutrition are prevalent in preadolescents, with significant association of undernutrition with internalizing problems. Moreover, our study is the first that reports that the co-occurrence of malnutrition is significantly associated with increased risk of internalizing problems. This study highlights the importance of the link between physical and mental health and emphasizes the need for holistic interventions and programmes for addressing preadolescents' issues.

The Impacts of Co-Occurring Developmental Language Disorder on the Academic, Interpersonal, and Behavioral Profiles of Children With Attention-Deficit/Hyperactivity Disorder

Purpose: Attention-deficit/hyperactivity disorder (ADHD) is a multifactorial disorder that has been linked to increased risk for behavioral, academic, and interpersonal problems. Developmental language disorder (DLD) has also been linked to poor outcomes in these areas. The presence of co-occurring disorders in children's profiles is generally associated with poorer outcomes relative to profiles consisting of only one disorder. This study investigated the extent to which co-occurring DLD in children already identified with ADHD presented increased risk for severity of their primary ADHD symptoms, the presence of secondary behavioral problems, and/or increased problems in the tertiary areas of academic performance and interpersonal interactions. Method: Data from 90 children from combined community-based and clinically based study samples were used in this retrospective study. Behavioral, academic, and social attributes were assessed from parent ratings on the Child Behavior Checklist. Results: Results indicated primary symptoms of ADHD and related tertiary interpersonal consequences were not increased when co-occurring DLD was present. However, the co-occurrence of DLD on ADHD resulted in increased risk for secondary externalizing problems and deficits in academic performance. Conclusions: Outcomes highlight the need for high-quality collaborations among clinical professionals, school-based professionals, and parents to ensure the complex needs of children with ADHD are adequately addressed. Children with ADHD who have elevated externalizing behaviors and who are struggling academically should be tested for possible co-occurring DLD.

Transdiagnostic Symptom Domains are Associated with Head Motion During Multimodal Imaging in Children.

Head motion is a challenge for neuroimaging research in developmental populations. However, it is unclear how transdiagnostic symptom domains including attention, disruptive behavior (e.g., externalizing behavior), and internalizing problems are linked to scanner motion in children, particularly across structural and functional MRI. The current study examined whether transdiagnostic domains of attention, disruptive behavior, and internalizing symptoms are associated with scanner motion in children during multimodal imaging. In a sample of 9,045 children aged 9-10 years in the Adolescent Brain Cognitive Development (ABCD) Study, logistic regression and linear mixed-effects models were used to examine associations between motion and behavior. Motion was indexed using ABCD Study quality control metrics and mean framewise displacement for the following: T1-weighted structural, resting-state fMRI, diffusion MRI, Stop-Signal Task, Monetary Incentive Delay task, and Emotional n-Back task. The Child Behavior Checklist was used as a continuous measure of symptom severity. Greater attention and disruptive behavior problem severity was associated with a lower likelihood of passing motion quality control across several imaging modalities. In contrast, increased internalizing severity was associated with a higher likelihood of passing motion quality control. Increased attention and disruptive behavior problem severity was also associated with increased mean motion, whereas increased internalizing problem severity was associated with decreased mean motion. Transdiagnostic domains emerged as predictors of motion in youths. These findings have implications for advancing development of generalizable and robust brain-based biomarkers, computational approaches for mitigating motion effects, and enhancing accessibility of imaging protocols for children with varying symptom severities.