Child Behavior Problems Research Articles

The Role and Function of Single Parents in Special Needs Children to Combat Loneliness

Introduction: Caring for children with special needs often poses various challenges, including coping with stress in parenting. Single parents have an even increased vulnerability to stressful conditions in parenting, especially from feelings of loneliness and alienation. This literature review aims to obtain an effective intervention model for overcoming loneliness for single parents with special needs children. Methods: Various studies were searched with the keywords “role of a single parent,” “function of a single parent,” “children with special needs,” and “loneliness.” Selected studies are evaluated and critically reviewed. Results: Various challenges of parenting children with special needs include stigma, efforts to overcome communication and behavior problems of children, adjustments to parenting according to special needs conditions, economic burdens, and intrapersonal problems of single parents. These challenges can be significant stressors that further degrade the quality of life of single parents and their children. However, they can be opportunities for personality development and parenting skills through self-care efforts and seeking psychiatric help, including efforts to find a community that understands the experience of being a single parent. Conclusions: Efforts to help single parents cope with loneliness include improving self-efficacy, emotional stability, positive parenting, and social intelligence by being part of a supportive community. Keywords: Single Parent, Children, Special Needs, Loneliness, Psychological Wellbeing

Effects of postpartum PTSD on maternal mental health and child socioemotional development - a two-year follow-up study

BackgroundPostpartum posttraumatic stress disorder (PP-PTSD) is a prevalent, yet often unrecognized mental health problem, particularly in low- and middle-income countries. Moreover, the long-term effects of PP-PTSD symptoms on maternal well-being and child socioemotional development beyond the first year postpartum remain largely unknown. This study focused on the association between PP-PTSD symptoms within one year after childbirth and maternal depressive symptoms and child behavioral problems two years later.MethodsRussian women (n = 419) completed the City Birth Trauma Scale and the Edinburgh Postnatal Depression Scale evaluating symptoms of PP-PTSD and postpartum depression (PPD) via a web-based survey. Mothers also filled in the Beck Depression Inventory that assessed their depressive symptoms and the Child Behavior Checklist that assessed child’s behavioral problems 2.24 years later.ResultsThe regression analysis showed a significant association between PP-PTSD and elevated depressive symptoms 2 years later even after adjustment for PPD (β = 0.19, 95% Confidence Interval 0.11, 0.26, p < 0.01). Children of mothers with higher PP-PTSD symptoms had higher internalizing, externalizing, and total behavioral problems, independent of PPD and concurrent depressive symptoms (β > 0.12, p < 0.01 for all).ConclusionsChildbirth-related PTSD presents risk for maternal psychological well-being and child socioemotional development beyond comorbidity with maternal depression. Raising awareness about PP-PTSD among families, communities, healthcare providers, and policymakers is essential in order to decrease stigma of childbirth-related distress, particularly, in low- and middle-income countries like Russia, improve support system during the postpartum period, promote mother–infant bonding in affected women, and, thus, prevent long-term consequences of traumatic childbirth for maternal and child mental health outcomes.Clinical trial numberNot applicable.

Parenting Stress, Child Behavior Problems, and Household Chaos: Examining Parenting in Early Head Start Families

Parenting Stress, Child Behavior Problems, and Household Chaos: Examining Parenting in Early Head Start Families

Possible sleep bruxism and hair cortisol in children: A birth cohort study.

This study aimed to test for an association between hair cortisol, as an indicator of chronic stress, and possible sleep bruxism among children participating in the 2015 Pelotas Birth Cohort Study. Data from 3229 children were analysed. Possible sleep bruxism was identified based on caregivers' reports when the child was 4 years old. Trained fieldworkers collected hair samples from children, and a standardized protocol was used for hormone extraction and cortisol quantification from the hair. Information on socioeconomic, demographic, psychological and behavioural characteristics was gathered through questionnaires. Poisson regression with robust variance was used to evaluate the impact of hair cortisol concentration on the occurrence of possible sleep bruxism, guided by a directed acyclic graph. The prevalence of possible sleep bruxism was 21.46% (n = 693); median hair cortisol concentration was 7.8 pg mg-1. Hair cortisol concentration was not found to be associated with the occurrence of sleep bruxism. However, the presence of sleep bruxism was linked to higher maternal education (p = 0.027), maternal stress level (p = 0.032), excessive use of electronic devices (p = 0.007), and child emotional and behavioural problems (p = 0.003). Furthermore, female sex was associated with a lower frequency of possible sleep bruxism (p = 0.003). There was no association between chronic stress, as measured by hair cortisol concentration, and the occurrence of possible sleep bruxism. This study underscores the role of sociodemographic factors and children's mental health in the occurrence of sleep bruxism among children in this population.

The associations between child behavioral problems, parents’ emotional regulation difficulties, and parental burnout among Israeli parents of children with autism during wartime

IntroductionParents of children with Autism Spectrum Disorder (ASD) face heightened challenges during crises like war, leading to parental burnout (PB). Wartime demands may exacerbate the children’s behavioral difficulties, which associated with PB. Successful emotional regulation (ER) is considered a protective factor for PB. This study aimed to explore the associations between the child behavioral problems, parent’s ER difficulties and PB among parents of children ASD during wartime.Methods92 parents completed demographic, Parental Burnout, Difficulties in Emotion Regulation, and Child Aberrant Behavior questionnaires. In addition, 18 parents of children with ASD aged 6–21 were semi-interviewed.ResultsDuring wartime, child behavioral problems and parents’ ER difficulties were positively correlated with PB, contributing beyond background characteristics and other changes following the war. Parent ER difficulties serve as a mediation variable and did not function as a moderation variable between child behavioral problems and PB.DiscussionThis study emphasizes the increased vulnerability of parents of children with ASD during wartime, highlighting the need for a deeper understanding of how these circumstances affect parental risk and resources. Effective interventions should target emotional regulation and address child behavioral issues, necessitating prioritized support for affected families despite wartime challenges.

The Prevalences of Behavioral Problems in Children and adolescents in Chengdu, Sichuan, China and Associated Risk Factors: A Multi-Center Cross-Sectional Study

ABSTRACT This study aimed to investigate the prevalence of behavioral problems in children and adolescents in Chengdu, Sichuan, China and the associated risk factors. A questionnaire survey was conducted with the students and their parents or caregivers from five primary and middle schools to investigate the parent–child relationship, family financial situations, health risk behaviors, and behavioral problems. A total of 8157 questionnaires were distributed, and 7928 (97.19%) valid questionnaires were returned. Among the 7928 valid questionnaires, 3846 were completed by female students and their parents or caregivers, and 4082 were completed by male students and their parents or caregivers. The average age of the surveyed students was 10.62 years. The prevalence rate of behavioral problems in children and adolescents was 13.79%, and the prevalence rate of behavioral problems significantly varied by gender and age. The female students had a higher prevalence rate of behavioral problems than male students (14.6% versus 13.0%). The students aged 12–16 years had a higher prevalence rate of behavioral problems than those aged 6–11 years (16.4% versus 12.2%). A correlation between behavioral problems and weekly pocket money was detected in the children and adolescents. Poor parent–child relationships, excessive screen time for both parents and children, short duration of sleep, and excessive intake of sugar-sweetened beverages could lead to a significant increase to the risk of developing behavioral problems in children and adolescents. Health-risky behaviors in children and adolescents were closely correlated to their behavioral problems. More attention should be paid to encouraging children and adolescents to live healthy lifestyles and tackling their behavioral problems.

Family events and child behavior in late childhood: a cross-sectional study

BackgroundChildren’s social behavior develops through diverse experiences. However, the relationship between children’s experiences of celebratory events and their behavioral development has not been previously quantified. Therefore, this study aimed to quantitatively explore this relationship.MethodsIn 2020, a self-reported questionnaire was completed by 653 sixth-grade students (aged 11–12 years) and/or their caregivers in Nagoya, Aichi, a major metropolitan area in Japan. The main items surveyed were children’s experiences with events celebrated by their family and their behavioral development. The Strengths and Difficulties Questionnaire was used to assess children’s behavior. This questionnaire identifies behavioral and emotional problems and prosocial behavior. Multiple regression analysis was conducted with the number of family events experienced by children as the explanatory variable and their emotional and prosocial behavior as the objective variables.ResultsChildren from families who participated in fewer family events tended to have higher problematic behavior risk scores and lower prosociality scores compared with their counterparts. Compared with children who participated in more than 20 family events, those who participated in fewer than 10 family events had more than three times the risk for exhibiting problem behaviors (odds: 3.558, 95% CI: 1.252–10.111, p = .017) and prosocial problems (odds: 3.184, 95% CI: 1.726–5.876, p < .001). Conversely, children from families who participated in more family events tended to have lower problematic behavior risk scores and higher prosociality scores.ConclusionsA higher number of family events may reduce the risk of behavioral problems in children and increase their prosociality. Enjoying family events may be beneficial for social adjustment.

The relationship between personal networks of parents and children's behavioral and school‐related problems in family interventions

AbstractStudies in the field of child welfare services have shown that children's externalizing problems are linked to the immediate social relationships in which they are embedded. However, most studies that examined this association focused on specific dyads or general social support, ignoring more diverse and complex patterns of relationships in which children are embedded. Therefore, this study used Social Network Analysis to analyze how compositional and structural properties of parents' personal networks predict externalizing problems of children in vulnerable family contexts. The sample consists of 70 parents who were enrolled in a home‐based family intervention in Switzerland. A hierarchical cluster analysis revealed three clusters based on the network composition: mixed, child‐oriented, and family of orientation. Child behavior problems were associated with the network clusters; school‐related problems, on the other hand, were additionally linked with support density in the personal networks of parents. The results show that children in vulnerable families are embedded in diverse network compositions and relational structures, which influence their externalizing problems in different ways.

Long-term characterization of behavior phenotypes in children with seizures: Analytic approach matters.

Behavioral problems in children with new onset epilepsies have been well established in the literature. More recently, the literature indicates the presence of unique behavioral patterns or phenotypes in youth with epilepsy that vary significantly in vulnerability and resilience to behavioral problems. This study contrasts the interpretation of behavioral risk as inferred from cross-sectional versus latent group analytic perspectives, as well as the presence, consistency, stability, and progression of behavioral phenotypes in youth with new onset epilepsy and sibling controls over 3 years. Three hundred twelve participants (6-16 years old) were recruited within 6 weeks of their first recognized seizure along with 223 unaffected siblings. Each child's behavior was recorded by parents and teachers frequently over 36 months using the Child Behavior Checklist (CBCL), and each child completed self-report measures of depression symptoms over 36 months. Measures were evaluated cross-sectionally and longitudinally to identify clusters with prototypical behavioral trajectories. Cross-sectional analyses exhibited a pattern of generalized and undifferentiated behavioral problems compared to sibling controls at baseline and prospectively. In contrast, latent trajectory modeling identified three distinct behavior phenotype clusters across all raters (parents, teachers, and youth) over baseline and longitudinal assessments. CBCL Cluster 1 (~30% of youth with epilepsy) exhibited behavior similar to/better than controls, Cluster 2 (~50%) exhibited moderate behavior issues, and Cluster 3 (~20%) exhibited the most pronounced/problematic behavior, falling into Achenbach's clinically relevant behavior range. Behavior within clusters remained stable and consistent. Teachers' and children's behavior assessments corresponded to these cluster groupings consistently over 36 months. Predictors of cluster membership include seizure syndrome type and social determinants of health. This study demonstrates the varying public health perspectives of behavioral risk in youth with epilepsy that result as a function of analytic approach as well as the presence of distinct latent behavioral trajectory phenotypes over time in youth with new onset epilepsy.

Does early skin-to-skin contact have a long-term effect on the emotional and behavioral development of very preterm infants?

Premature birth may impair a sensitive, responsive, enjoyable, and regulating parenting style, potentially leading to behavioral, cognitive, and emotional deficits in children. Additionally, the emotional bond between the parent and infant may be disturbed due to the restrictions and difficulties at the neonatal intensive care unit (NICU), further negatively impacting child development. Skin-to-skin contact (SSC) directly after birth is strongly recommended also for preterm or low birth weight infants since there is high-certainty evidence that SSC has positive effects on neonatal and maternal health as well as on the quality of the parent-child relationship. The aim of this study was to examine the effect of skin-to-skin contact immediately after childbirth on the development of emotional and behavioral problems in children born preterm entering school. This study is part of a randomized controlled delivery room skin-to-skin study (Deisy Study). A total of 33 children (aged 6-8 years) were assessed at school start. The German version of the CBCL/6-18R was used to evaluate the presence of behavior problems. The perceived parental stress 6 months after discharge was the variable that most contributed to the variance explanation. SSC immediately after childbirth was not significant in the prediction of emotional and behavioral problems at school start. The study was conducted in a small study group. Partners' variables were not included. Information regarding sociodemographic variables and bonding quality was collected 6 months (corrected age) after birth. The measurement of children's behavioral problems is not objective and corresponds to the parents' perception. https://clinicaltrials.gov, deisy study NCT01959737, deisy follow up NCT03366285.

Trends in Childhood Behavioral, Mental, and Developmental Problems (2019-2022) Using the National Survey of Children's Health.

This study examines nationwide prevalence of US childhood behavioral, mental, and developmental problems in the 6-11 age group category between 2019 and 2022, and several key metrics related to caregiver social determinants of health. We used NSCH data for 6-11-year-old children for the years 2019-2022. Summary statistics for the selected sample were generated and binary logistic regressions were conducted for each severity level binary variable for each study year with caregiver mental or emotional health as a covariate. Our study found significant associations between severe childhood anxiety and "fair" or "poor" caregiver rankings of mental and emotional health for both the 2020 and 2022 survey years. Our study also found that caregiver mental and emotional health may play a role in childhood ADD and ADHD prevalence rates as caregivers who ranked their mental health as "fair" or "good" had significantly higher odds of having a child with severe ADD or ADHD than caregivers who reported "excellent" mental and emotional health. These findings support prospects of an increase in the need for developmental health services, thus necessitating efforts towards effective allocation and focus of developmental treatment programs tailored to children and pediatric population groups.

Telehealth delivery of GenerationPMTO in the public mental health system: A pragmatic, noninferiority study.

Telehealth is a promising means for expanding access to mental health treatment. Yet, more research is needed to ensure that telehealth service delivery is no less effective than in-person treatment in real-world service delivery contexts. In the current study, we compared telehealth delivery of the GenerationPMTO parenting intervention to in-person delivery in the context of the public mental health system. Using a noninferiority approach with a sample of n = 1452 caregivers, we found telehealth delivery to be noninferior to in-person delivery on all caregiver outcomes: parenting practices, parenting confidence, and caregiver depressive symptoms. We were unable to conclude that telehealth delivery was noninferior to in-person delivery for child behavior problems. Our findings add to the literature suggesting the utility of using telehealth to provide services to families-particularly for delivering evidence-based parenting interventions to enhance caregiver outcomes. Implications for couple and family therapy are discussed.

Relations Between Academic and Behavioral Adaptations: The Antecedent Effects of Executive Function.

Using a large sample (n = 1163) from the National Institute of Child Health and Development Study of Early Child Care and Youth Development, the Random Intercept Cross-Lagged Panel Model was employed to unpack the between-person and within-person aspects in the relations between children's academic performance and externalizing/internalizing behaviors during primary school and examined the predictive role of early executive function. Results showed that the reciprocal relations between state-level fluctuations in children's behavioral problems and academic performance were largely unsupported. Children with more advanced early executive function were found to have better academic performance and fewer behavioral problems throughout primary school, supporting the antecedent role of early executive function. These findings suggest that fostering executive function skills early on could be a key strategy for improving both academic outcomes and behavioral adjustment in children.

Gestational phthalate exposure and behavioral problems in preschool-aged children with increased likelihood of autism spectrum disorder

BackgroundExperimental studies have shown associations between gestational phthalate exposure and behavioral problems among offspring; however, epidemiological evidence is still mixed. This study aims to investigate whether gestational phthalate exposure is associated with behavioral problems in preschool-aged children. MethodsParticipants include 178 mother-child pairs from MARBLES (Markers of Autism Risk in Babies – Learning Early Signs), a cohort with high familial likelihood of autism spectrum disorder (ASD). We quantified 14 phthalate metabolites in multiple maternal urine samples collected during the 2nd and 3rd trimesters. Preschool behavior problems were assessed using the Child Behavioral Checklist (CBCL), a standardized instrument for evaluating behavior problems of children aged 1.5–5 years. To examine associations of CBCL scores with both individual phthalate biomarker concentrations and their mixture, we used negative binomial regression and weighted quantile sum regression. ResultsOverall, maternal phthalate biomarker concentrations were not associated with child behavior problems. Monoisobutyl phthalate (MiBP) concentrations were inversely associated with child anxious/depressed symptoms and somatic complaints. Mono-hydroxy-isobutyl phthalate (MHiBP) and monobenzyl phthalate (MBzP) were also inversely associated with somatic complaints. When assessing trimester-specific associations, more behavior problems were associated with the 2nd trimester biomarker concentrations: mono(3-carboxypropyl) phthalate (MCPP) and monocarboxyisononyl phthalate (MCNP) were positively associated with somatic complaints. All associations became non-significant after false discovery rate correction. No association between a mixture of phthalates and CBCL scores was found. ConclusionsOur study observed no clear evidence of gestational phthalate exposure on child behavior problems. However, our findings based on the biomonitoring assessment of multiple samples per participant could improve our understanding of gestational phthalate exposure in association with behavior problems in preschool-aged children.

Феноменология травматического стресса «нормотипичных» родителей и посттравматическая симптоматика

&lt;p&gt;&lt;strong&gt;Aim.&lt;/strong&gt; The present study explored the subjective picture of traumatic events in parenting life. The study examined its characteristics during different periods of the child's life and investigated the likelihood and content of parental post-traumatic stress (PTS). &lt;strong&gt;Materials and Methods&lt;/strong&gt;. The research sample consisted of 89 participants. All participants had one to four children over the age of 20. The average age of the participants was 49,56 years (SD=6,8). A semi-structured interview method developed by the author was used. This method allowed for a retrospective examination of traumatic stress events in parenting life. Techniques such as &amp;laquo;Lifeline&amp;raquo;, scaling, and &amp;laquo;stress thermometer&amp;raquo; were included. The scale for assessing the impact of traumatic events (D. S. Weiss, C. R. Marmar, and T. J. Metzler, adapted by N.V. Tarabrina) was also utilized&lt;strong&gt;. Results and Conclusions&lt;/strong&gt;. A typology of traumatic stressors in parenting life was proposed, and their phenomenology was described. The majority of stressors were associated with threats to the health or life of the child at an early age. In the preschool and adolescent periods of the child's development, behavioral and emotional problems of the children become traumatic stressors for parents. Emotional disorders, particularly anxiety, predominated in the manifestations of traumatic stress in parents. Some parents who reported traumatic events (n=56) indicated the presence of PTS symptoms. 19% of parents noted a high intensity of these symptoms, experiencing physiological arousal and hyper-vigilance.&lt;/p&gt;

The effectiveness of group play therapy using sand on social skills and behavioral problems of 5-9-year-old children in Tehran

This research was conducted with the aim of investigating the effectiveness of group play therapy using sand on children's social skills and behavioral problems. The statistical population included all children aged 5 to 9 years in Tehran in 1403, and among them 30 students were selected by available sampling according to the entry criteria and placed in two experimental and control groups. Then, at first, the subjects were measured by Babadi and Meshkani's life skills questionnaire (1389) and Shahim and Yousefi's children's behavioral problems questionnaire (1378) and after receiving group play therapy training using sand according to the protocol, the subjects again They completed the questionnaires. The research findings were analyzed by SPSS software using covariance analysis method and the results indicated the high effectiveness of group play therapy using sand on improving social skills and reducing children's behavioral problems

Harsh parenting, amygdala functional connectivity changes across childhood, and behavioral problems.

Harsh parenting in early childhood is related to offspring's adverse behavioral outcomes. Due to the scarcity of longitudinal neuroimaging data, few studies have explored the neurobiological underpinnings of this association, focusing on within-person variability. This study examined the temporal associations among harsh parenting, later behavioral problems, and the developmental trajectories of amygdala volume and amygdala resting-state functional connectivity (RSFC) profiles, using longitudinal neuroimaging data. The study was embedded in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. T1-weighted (296 children, 642 scans) and resting-state functional scans (256 children, 509 scans) were collected at ages 4.5, 6, 7.5, and 10.5 years. Amygdala volume and RSFC between the amygdala and six brain regions that have leading roles in emotional regulation were extracted. Harsh parenting at 4.5 years and child behavioral problems at 10.5 years were assessed via parent-report questionnaires. Linear regression and linear mixed models were applied. Harsh parenting was associated with more severe externalizing problems in girls (β = 0.24, 95% CI 0.08-0.40) but not boys (pint = 0.07). In the overall sample, harsh parenting was associated with the developmental trajectories of amygdala-ACC, amygdala-OFC, and amygdala-DLPFC RSFC. In addition, the developmental trajectory of amygdala-ACC RSFC mediated the harsh parenting-externalizing problems association in girls (indirect effect = 0.06, 95% CI 0.01-0.14). Harsh parenting in early childhood was associated with amygdala neurocircuitry development and behavioral problems. The developmental trajectory of amygdala-ACC RSFC is a potential neural mechanism linking harsh parenting and externalizing problems in girls.

Maternal support in preschool and child behavior problems: The mediating role of childhood emotion knowledge.

Children's emotion knowledge encompasses abilities to recognize and label emotions in the service of positive adaptation. Drawing on a sociodemographically diverse sample of 250 children (50% female sex assigned at birth; Mage_W1 = 49.02 months, SD = 2.99) and their maternal caregivers (55.6% Latina; 37.6% poverty), this study evaluated a multiple mediation model to integrate heretofore distinct bodies of research examining (a) parenting effects on the development of emotion knowledge and (b) emotion knowledge effects on socioemotional adaptation. Observations of maternal supportive presence at age 4 predicted increases in children's emotion recognition and labeling from ages 4 to 8. However, only emotion labeling skills explained children's behavioral adjustment outcomes with a significant pathway from supportive parenting at age 4 to fewer externalizing and internalizing behavior problems at age 10 via improved emotion labeling skills. These findings suggest that emotion knowledge, particularly labeling skills, partially explains the protective impact of supportive parenting on behavioral adaptation across childhood. Prevention and intervention efforts should target both supportive parenting practices and emotion knowledge skill development to support children's socioemotional functioning and reduce behavior problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mobile App-Assisted Parent Training Intervention for Behavioral Problems in Children With Autism Spectrum Disorder: Pilot Randomized Controlled Trial.

In children with autism spectrum disorder (ASD), problem behaviors play a dysfunctional role, causing as much difficulty with daily living and adjustment as the core symptoms. If such behaviors are not effectively addressed, they can result in physical, economic, and psychological issues not only for the individual but also for family members. We aimed to develop and evaluate the feasibility of a mobile app-assisted parent training program for reducing problem behaviors in children with ASD. This open-label, single-center, randomized controlled trial was conducted among parents of children with ASD aged 36-84 months. Participants were recruited from the Department of Psychiatry at Seoul National University Hospital. Participants were randomly assigned (1:1) by a blinded researcher. Randomization was performed using a stratified block randomization (with a block size of 4). Parents in the intervention group completed the mobile app-assisted parent training program at home over a 12-week period. They continued to receive their usual nondrug treatment in addition to the mobile app-assisted parent training program. The control group continued to receive their usual nonpharmaceutical treatment for 12 weeks without receiving the parent training program intervention. The primary outcome measure was the median change in the Korean Child Behavior Checklist (K-CBCL) scores from before to after the intervention. Lower scores on the K-CBCL indicated a decrease in overall problem behavior. Between November 9, 2022, and December 8, 2022, 64 participants were enrolled. Overall, 42 children (intervention group median age: 49, IQR 41-52.5 months; control group median age: 49, IQR 42-58 months) of the participants joined the program. The intervention group included 20 (48%) participants and the control group included 22 (52%) participants. In the intervention group, the K-CBCL total scores showed a decrease after the intervention, with a median difference of -0.5 (95% CI -4.5 to 3). Pervasive developmental disorder scores also showed a decrease, with a median difference of -2.1 (95% CI -8.5 to 2.5). However, there was no significant difference in Clinical Global Impression-Severity of Illness scores after the intervention for both the control and intervention groups. Scores on the Korean version of the Social Communication Questionnaire showed a further decrease after the intervention in the intervention group (median difference -2, 95% CI -4 to 1). Caregivers' stress evaluated using the Korean Parenting Stress Index Fourth Edition-Short Form did not show any significant differences between the control and intervention groups. There were no adverse events related to study participation. The findings demonstrated the feasibility of using mobile devices for evidence-based parent training to reduce problem behaviors in children with ASD. Mobile devices' accessibility and flexibility may provide a viable alternative for offering early intervention for problem behaviors in children with ASD. CRIS KCT0007841; https://cris.nih.go.kr/cris/search/detailSearch.do?&seq=23112.

Factors Associated with the Rate of Initial Parental Engagement in a Parenting Program Aimed at Preventing Children's Behavioural Problems.

Parenting programs have been shown to be effective in preventing and reducing externalising problems in young children. Despite their efficacy, the low rate of initial parental engagement in these programs is a major challenge for clinicians and researchers. Few studies have examined factors associated with rates of initial engagement in parenting prevention programs, most probably due to limited data on families refusing intervention. The purpose of this study was to examine the sociodemographic characteristics as well as child and parent characteristics in the prediction of parents' refusal to engage in a randomised control trial (RCT) evaluating the parenting program ÉQUIPE (French version of COPE) offered as a prevention intervention to families with preschool children (4-5years) who showed low self-control at the age of 2years. A total of 268 families were recruited from a longitudinal community sample followed from pregnancy (3D study), with 162 parents accepting to be randomised to a control or intervention group and 106 families refusing to engage in the RCT. Of the 83 families randomised to the intervention condition, 32 accepted, and 51 refused to participate in the intervention before or during the transition to formal schooling. ANOVAs and logistic regressions were used to examine factors associated with parents' refusal to engage in (1) the RCT and (2) the intervention. Results showed that parents who reported lower scores on perceived parental efficacy and higher perceived relationship quality had higher odds of refusing to participate in the study. Also, participating parents who refused to participate in the intervention were more likely parents of girls and reported significantly higher parental efficacy and impact. The findings of the current study could guide clinicians and researchers in improving parental recruitment strategies.