Development Of Behavior Problems Research Articles

Caregiver stress and cultural identity in families of preschoolers with developmental delay and behavioral problems.

Research on families of young children with developmental delay and disruptive behavior problems has failed to examine caregiver stress in the context of cultural factors. Families of 3-year-old children with developmental delay and behavior problems were recruited from Early Intervention sites. All caregivers in the current analysis (n=147) were from immigrant and/or cultural minority backgrounds. Regarding income-to-needs, most families (57.8%) fell into the extreme poverty, poor, or low-income categories. Caregivers reported on their own experiences of acculturation and enculturation as well as their child's problems. Path analyses revealed that higher caregiver acculturation was associated with less parenting-specific stress, and higher caregiver enculturation was associated with less caregiver general stress. Severity of child problems was associated with more parenting-specific stress and general stress. Exploratory analysis yielded significant differences in associations between acculturation, enculturation, and caregiver stress in Black/African American caregivers versus Hispanic White caregivers. Findings suggest that among cultural minority caregivers of young children with developmental and behavioral problems, acculturation and enculturation may influence caregiver stress. While the cross-sectional nature of the study precludes causal conclusions, clinicians should consider how cultural factors can be harnessed to strengthen caregiver resiliency and improve engagement in parenting interventions.

Association of Birth Order With Mental Health Problems, Self-Esteem, Resilience, and Happiness Among Children: Results From A-CHILD Study.

Objective: This study aimed to investigate the association of birth order with mental health problems, self-esteem, resilience, and happiness among children aged 9–10 years.Methods: This was a cross-sectional study using data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, which was a population-based study of children in fourth grade in public schools in Adachi City, Tokyo, Japan in 2018 (N = 3,744). Parent-rated Strengths and Difficulties Questionnaire (SDQ) and self-rated resilience, happiness, and self-esteem score were used to assess child mental health. Multiple regression analysis for continuous outcomes and logistic regression for dichotomous outcomes were used to examine the association of birth order with mental health problems, resilience, happiness, and self-esteem. The analysis was controlled for child sex, mother's age, mother's education, caregiver's depressive symptoms, household income, and living with grandparents.Results: Last-borns showed the lowest total difficulties score in the SDQ, while only children showed the highest (p < 0.001). The highest prosocial behaviors score was found among last-borns (p < 0.001). Resilience score was also highest among last-borns, followed by first-borns, middle-borns, and only children. The lowest happiness score was found among middle-borns. Self-esteem score did not differ by sibling types. These associations were similar in the adjusted model and dichotomized outcomes model.Conclusions: Differential impacts of birth order on child mental health, for both positive and negative sides, were found. Further research is warranted to elucidate the mechanism of the association between birth order and the development of behavior problems and the positive aspects such as resilience, happiness, and self-esteem among children.

EP347 - Novel interstitial 2q12.3q13 microdeletion predisposes to developmental delay and behavioral problems

eP347 - Novel interstitial 2q12.3q13 microdeletion predisposes to developmental delay and behavioral problems

Generation of a human induced pluripotent stem cells (MUi015-A) from skin fibroblast of retinoblastoma patient with 13q deletion syndrome.

The 13q deletion syndrome is a rare chromosomal disorder caused by loss of the long arm of chromosome 13, and usually entails developmental delay, intellectual disability, behavioral problems and distinctive facial features. In this study, we successfully generated a human iPSC line (MUi015-A) from skin fibroblasts of a patient who had large deletion of chromosome 13, del(13)(q14q22). The MUi015-A line exhibited embryonic stem cell characteristics with consistent pluripotency marker expression and the capability of differentiating into three germ layers. The cell line provides a good tool in studying pathophysiology of the tumors, drug testing and gene therapy.

Externalizing behavior and stress system functioning in infants exposed to early adversity: A multi-system exploration.

Children who experience early adversity often show alterations across multiple stress response systems, including the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Changes in the diurnal rhythm of salivary cortisol (a marker of HPA axis functioning) and alpha-amylase (a marker of ANS functioning) may increase their probability of developing behavior problems. The goal of this study is to examine how these analytes may interact to predict externalizing behavior in infants exposed to early stress. Participants included 179 parents and their 6- to 20-month old infants recruited from a low-income neighborhood. Parents reported on their infants' externalizing behaviors and collected saliva samples from their children at wake-up and bedtime over three days. Diurnal cortisol and alpha-amylase were modeled using latent difference scores. Four models were tested examining the effects of cortisol and alpha-amylase morning values and slopes, as well as their interactions, on externalizing behavior. Results showed a significant interaction effect of cortisol and alpha-amylase morning values, such that low morning cortisol was associated with decreased externalizing behavior when morning alpha-amylase was high but not low. These findings highlight the importance of examining multiple systems when characterizing the physiological correlates of externalizing behavior among infants experiencing adversity.

Health implications of maltreated children exposed to domestic violence

Domestic violence affects thousands of children in the United States every year. We aimed to obtain an association between caregiver suffrage of domestic violence and adverse health outcomes among maltreated children in the United States. Data from the National Child Abuse and Neglect Data System, a total sample of 3,459,625, was analyzed. Descriptive, bivariate, and logistic regression analysis was conducted to estimate the effect of domestic violence on maltreated children’s health outcomes such as children’s alcohol and drug use, mental developmental delay, emotional disturbances, visual or hearing impairment, learning, and physical disabilities, behavioral problems, and other medical conditions. Exposure to caregiver domestic violence was reported in 13% of cases (n = 276,770). Domestic violence was associated with gender, child’s age, race, ethnicity, and living arrangement (p = 0.001 for all). Adjusted logistic regression showed higher odds of children’s alcohol use (1.62, 95%CI 1.44–1.82), mental developmental delay (1.26 95%CI 1.11–1.42), emotional disturbances (1.13, 95%CI 1.05–1.22), learning disability (1.13, 95%CI 1.04–1.22), and behavioral problems (1.18, 95%CI 1.12–1.24) among those children whose caregivers were exposed to domestic violence. Domestic violence is a fundamental problem in the US that can lead to detrimental health and developmental issues in children.

“What we see and what we hear:” Combining children’s drawings with child and educator interviews to assess child well-being in Child Support Grant (CSG) beneficiaries in South Africa

ABSTRACT Child well-being is particularly relevant to South African social workers given the country’s high rates of violence, poverty, inequality, unemployment, HIV/AIDS, and poor schooling outcomes. Guided by a social constructivist theoretical lens, and located within an interpretive qualitative research design, the aim of the study was to determine whether children’s drawings and teacher interviews can differentiate qualitatively between children with positive well-being and those with compromised well-being. Children aged 6–8 years whose parents/caregivers were recipients of Child Support Grants (CSGs) were asked to draw a picture of themselves and their families and teachers were asked about the children’s functioning. Findings from triangulation of drawings and interviews suggested that while a firm diagnosis of emotional, behavioral, or cognitive disorder could not be reached, it was possible to differentiate between children with positive well-being and those whose well-being appeared to be compromised by developmental delay, learning difficulties, emotional problems, behavioral problems, and/or social issues. It is therefore recommended that social workers make greater use of children’s drawings and educator interviews as assessment tools. However, one should not rely solely on children’s drawings, but should rather combine drawings with child and educator interviews. Findings also highlight the need for South African social workers to develop indicators that are culturally and ecologically applicable to African children.

Health, social and legal outcomes of individuals with diagnosed or at risk for fetal alcohol spectrum disorder: Canadian example

BackgroundFetal Alcohol Spectrum Disorder (FASD) is a leading cause of lifelong developmental and physical disabilities and behavioural problems. This study describes the characteristics of individuals diagnosed with or at risk for FASD in British Columbia, Canada. MethodsA retrospective chart review and cross-sectional analysis were conducted on records of individuals diagnosed or at risk for FASD at the Asante Centre from January 2015 to July 2019. Descriptive statistics results were stratified by age, sex, and involvement with the criminal justice and child welfare systems. Logistic regression was used to investigate potential associations. Results161 individuals with diagnosed or at risk for FASD, (53 % male; mean age = 15.7 years, SD = 9.1) were included in the analysis. High levels of psychological/developmental disabilities (78 %), physical comorbidities (38 %), substance use (50 %), and involvement in child welfare (75 %) and criminal justice systems (30 %) were found across the entire group. Individuals over 20 reported the greatest proportion of any past substance (60.9 %), alcohol use (39.1 %) and stimulant use (30.4 %), compared to individuals aged 10–19 (41.3 %; 12.0 %; 14.1 %, respectively). Involvement with the child welfare system was associated with higher chances of having anxiety (OR 4.1; 95 % CI: 1.25–15.00). Involvement with the criminal justice system was associated with higher rates of past substance and cannabis use. ConclusionIndividuals with FASD demonstrate a significant need for access to mental health and addiction services, especially among those with involvement in the child welfare and criminal justice systems. These findings point to the importance of improving policies to support the unique needs of individuals with FASD.

The role of parental playfulness as a moderator reducing child behavioural problems among children with intellectual disability in Israel

BackgroundPlayfulness is well known to be vital for child development. However, not much is known regarding parental playfulness. We set out to investigate the role of parental playfulness in children with intellectual disabilities (ID) and typical development (TD) living in Israel. Specifically, we examined 1) differences in parental playfulness between groups and 2) parental playfulness as a moderator in the link between developmental status and behavioural problems (BP). MethodOne hundred forty-two families living in Israel and their children (48 % with ID) aged 4–7 years participated in the study. Parent-child play interaction was videotaped and coded for parental playfulness. Parents reported on child BP using the CBCL questionnaire. ResultsParents in the ID group showed lower levels of playfulness compared to parents in the TD group. Father’s playfulness acted as a moderator in the link between developmental status and child BP. ConclusionsThese results highlight the unique role of father’s playfulness in the developmental status of a child diagnosed with ID.

Parenting Behavior at 18 Months Predicts Internalizing and Externalizing Problems at 6 Years in Moderately Preterm and Full Term Children.

Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother–child interaction quality mediate the association between birth status and child behavior problems. Participants were 120 MPT children and 100 FT children. At 18 months of age, mothers reported on their parenting behavior (support and structure), and mother–child interaction (sensitivity and limit-setting) was observed. At 6 years of age, mothers reported on children’s behavior problems. Using structural equation modeling, birth status was found to predict attention problems, but not internalizing and externalizing problems. Mothers of MPT children set less appropriate limits than mothers of FT children at 18 months of age. More maternal structure at 18 months predicted fewer internalizing and externalizing problems, but not attention problems, at 6 years. These associations between parenting behavior, mother–child interaction quality, and child behavior problems were similar for MPT and FT children. Our findings indicate that maternal structure in toddlerhood is an important predictor of later internalizing and externalizing problems for both MPT and FT children.

Association between children's sleep patterns and problematic behaviors at age 5.

Night-shift lifestyles affect children as well as adults, and are associated with sleep and behavioral problems among children. This study aimed to investigate associations among sleep patterns, individual/environmental factors, and problematic behaviors in children at age 5years. Data for sleep patterns, individual / environmental factors, and problematic behaviors for 8,689 5-year-old children were collected from health-checkup records. Problematic behaviors investigated were anxious behavior (being afraid, difficulty being separated from the mother), developmental behavior (violence, restlessness, rebellious behavior, restrictive diet, stereotypic play), personal habits (thumb-sucking, nail-biting, tic, masturbation), and excretory problems. The relationships between sleep patterns (bedtime, sleep duration) and the presence of these behaviors were analyzed. Individual / environmental factors that affected problematic behaviors were statistically identified using a tree-form model. Late bedtime and short sleep duration showed significant adverse effects on children's problematic behaviors - odds ratio (OR): 1.07, 95% confidence interval (CI): 1.03-1.11 and OR: 0.92, 95% CI: 0.87-0.97, respectively. Long television watching time, abnormality at birth, and lack of father's support also showed significant adverse effects on problematic behaviors (OR: 2.34, 95% CI: 1.87-2.94), and significantly affected late bedtime and short sleep duration. There were significant associations among sleep patterns, individual / environmental factors, and problematic behaviors in 5-year-old children. Improving children's sleep patterns, reducing the duration of television watching, and improving support from fathers may reduce problematic behaviors.

Effects of MBSR Parent Intervention on Internalizing Problems in Children: ASD Status as a Moderator

ABSTRACT Introduction Children with developmental delays (DD), particularly autism spectrum disorders (ASD), are at high risk for increased levels of behavior problems and developing internalizing problems. While previous literature has highlighted the impact of parental stress on the development of behavioral problems broadly in children with DD, research on the relation between parenting stress and internalizing problems in children with ASD is scarce. Growing evidence has supported Mindfulness-Based Stress Reduction (MBSR) as an effective intervention for reducing stress among parents of children with DD. These reductions in parent stress are also associated with subsequent reductions in their children’s behavior problem; however, to our knowledge, the effects of MBSR and reductions in parent stress on internalizing problems in children with DD have not been examined. Method The current study utilized data from Mindful Awareness for Parenting Stress (MAPS) which consisted of families of 80 preschool children with developmental delays (DD) whose parents reported high levels of stress. Specifically, we investigated whether decreases in parenting stress as a result of engagement in a MBSR intervention would lead to reductions in internalizing behavior problems among children with DD, and whether this relation was moderated by the child’s ASD status. Additionally, we examined whether individual increases in the mindful facets of acting with awareness and nonjudgment, from pre- to post- treatment, would lead to reductions in internalizing problems among children with DD, and whether this relation was moderated by the child’s ASD status. Results Children of parents in the MBSR treatment group had greater reductions in internalizing problems compared to children whose parents were in the waitlist-control group, b= −5.71, p <.05. We also found that children of parents who reported greater increases in acting with awareness post-treatment had a greater reduction in internalizing problems, b= −2.57, p<.05. Additionally, children whose parents had greater increases in nonjudgment post-treatment had a greater reduction in internalizing problems, b= −1.85, p<.05. However, ASD status was not a significant moderator in either analysis, ps >.05. Conclusions These findings have important implications regarding the relation between parenting stress and internalizing problems in children with DD. This treatment offers a novel approach to treating comorbid internalizing problems in children with DD. Parents’ use of MBSR provides a method of early intervention, which may ameliorate the development of internalizing problems over time. The current study helps to inform future parenting interventions by highlighting the importance of addressing specific facets of mindfulness in interventions which may lead to greater reductions in internalizing problems in vulnerable populations such as children with DD Figure 1.

Inherited cases of CNOT3-associated intellectual developmental disorder with speech delay, autism, and dysmorphic facies.

De novo pathogenic variants in CNOT3 have recently been reported in a developmental delay disorder (intellectual developmental disorder with speech delay, autism, and dysmorphic facies [IDDSADF, OMIM: #618672]). The patients present with a variable degree of developmental delay and behavioral problems. To date, all reported disease-causing variants occurred de novo and no parent-child transmission was observed. We report for the first time autosomal dominant transmissions of the CNOT3-associated developmental disorder in two unrelated families. The clinical characteristics in our patients match the IDDSADF features reported so far and suggest substantial variability of the phenotype within the same family.

Early developmental, behavioral, and quality of life outcomes following abusive head trauma in infants

BackgroundDevelopmental delays following pediatric abusive head trauma are common. ObjectiveTo assess early developmental, behavioral, and quality of life outcomes following infant abusive head trauma and evaluate injury severity and early therapeutic intervention as potential predictors. Participants and settingInfants under 12 months old who were admitted to a large pediatric hospital with abusive head trauma between October 2010 and October 2017 and followed at a multidisciplinary post-injury clinic were included. MethodsInjury severity groups were classified based on days in the Pediatric Intensive Care Unit. Participation in early intervention services and/or physical or occupational therapy by the first clinic visit was documented. Development was assessed using the Mullen Scales of Early Learning, which 47 patients completed at approximately 6 month intervals up to 3 years of age (an average of 19 months post-injury). Behavior and quality of life were assessed around age 2 using the Child Behavior Checklist (n = 24) and PedsQL™ (n = 27), respectively. ResultsOverall cognitive development, fine motor function, and expressive language significantly declined with age up to 3 years (p < 0.05). The changes in these developmental scales with age differed significantly between injury severity groups (p < 0.05). Internalizing behaviors were also greater in patients with moderate than mild injuries (t = 2.37, p = 0.037). Quality of life was comparable to healthy populations. Early therapeutic intervention was not significantly associated with developmental, behavioral, or quality of life outcomes (p > 0.05). ConclusionsLong-term comprehensive follow-up is recommended for children following abusive head trauma, as developmental delays and behavioral problems may present at later ages.

Electroclinical spectrum of childhood epilepsy secondary to neonatal hypoglycemic brain injury in a low resource setting: A 10-year experience

PurposeNeonatal hypoglycemic brain injury (NHBI) is being increasingly recognized as an important cause of drug resistant childhood epilepsy in low resource settings. We report the electro-clinical spectrum of children with epilepsy secondary to NHBI. MethodsThis was a retrospective study of children enrolled in the Epilepsy Clinic from January 2009 to August 2019. Data of children who had developed epilepsy after documented symptomatic neonatal hypoglycemia was collected. Details of clinical profile, seizure types, neurodevelopmental co-morbidities, EEG, neuroimaging findings and seizure outcomes were noted. ResultsOne hundred and seventy children were enrolled. The mean age at seizure onset was 10.3 months (SD 0.5 months). The seizures types were epileptic spasms (76.5%), focal with visual auras (11.2%), bilateral tonic clonic (7.1%), myoclonic (3.5%) and atonic seizures (1.8%). The EEG findings included classical hypsarrhythmia (49.4%), hypsarrhythmia variant (27.1%), focal occipital or temporo-occipital spike wave discharges (10.6%), multifocal discharges (4.7%), diffuse slow spike and wave with bursts of fast rhythms (2.4%), continuous spike waves during sleep (1.2%) and normal EEG (4.7%). MRI showed gliosis with or without encephalomalacia in the occipital lobe with or without parietal lobe in 96.5% of the patients. Co-morbidities included global developmental delay (91.2%), cerebral palsy (48.7%), vision impairment (48.2%), microcephaly (38.2%), hearing impairment (19.4%), and behavioural problems (16.5%). Drug resistant childhood epilepsy was seen in 116 (68.2%) patients. ConclusionsOur study highlights the varied electroclinical and radiological spectrum and the adverse epilepsy and neurodevelopmental outcomes associated with NHBI.

Parental perinatal depression and offspring psychotic experiences

Maternal depression is common, both during pregnancy and postnatally, affecting about 15% of mothers in high-income countries and more than 20% of mothers in low-income and middle-income countries.1,2 The offspring of mothers with depressive symptoms during the perinatal period have been found to be at an increased risk of many adversities, including developmental delays, behavioural problems, and psychopathology.3–6 The perinatal period offers a promising time window for aetiological studies and for preventive interventions to reduce the incidence of mental disorders in offspring.

Parent survey of sleep problems among children with CHARGE syndrome

Sleep problems are common among children, especially those with developmental disabilities, visual impairments, and behavioral problems. Past research has indicated a particularly high prevalence of clinically-relevant sleep problems for children with CHARGE syndrome, who often possess all three of these qualities. To gather additional information regarding the nature of these sleep problems and how they are most commonly treated amongst parents, an explorative survey was conducted with 30 parents of children with CHARGE syndrome with comorbid sleep problems using the Sleep Disturbance Scale for Children, as well as demographic and sleep questionnaires developed for use in this study.Our findings indicated that problems of sleep initiation and maintenance were most commonly reported, consistent with previous research. Parents most often reported the following factors suspected of contributing to sleep problems: self-regulation difficulties, teeth grinding, hormonal imbalance, problem behaviors, and anxiety. The most commonly administered treatments were reported to be the use of positive bedtime routines, melatonin treatment, the use of a weighted blanket, and prescription medications, respectively. While parents reported overall that they felt all three of these intervention strategies were slightly effective at improving their child’s sleep problem, the use of positive bedtime routines and melatonin treatment were perceived as more effective by parents. These results aid professionals in the selection of future research and intervention strategies to recommend for parents of children with CHARGE syndrome.

Early neurodevelopmental characterization in children with cobalamin C/defect.

Cobalamin C (cblC) defect is the most common inherited disorder of cobalamin metabolism. Developmental delay, behavioral problems, and maculopathy are common, but they have not been systematically investigated. The aim of this study was to define early neurodevelopment in cblC patients and the possible contribution of different factors, such as mode of diagnosis, age at diagnosis, presence of brain lesions and epilepsy. Children up to the age of 4 years with a visual acuity ≥1/10 were evaluated using the Griffiths' Mental Development Scales. Eighteen children were enrolled (age range 12-48 months). Four were diagnosed by newborn screening (NBS); in the others mean age at diagnosis was 3.5 months (range 0.3-18 months). Eight had seizures: three in the first year, and five after the second year of life. Fourteen had brain lesions on magnetic resonance imaging (MRI). Neurovisual assessment evidenced low visual acuity (<3/10) in 4/18. NBS diagnosed patients had higher general and subquotients neurodevelopmental scores, normal brain MRI, and no epilepsy. The others showed a progressive reduction of the developmental quotient with age and language impairment, which was evident after 24 months of age. Our findings showed a progressive neurodevelopmental deterioration and a specific fall in language development after 24 months in cblC defect. The presence of brain lesions and epilepsy was associated with a worst neurodevelopmental outcome. NBS, avoiding major disease-related events and allowing an earlier treatment initiation, appeared to have a protective effect on the development of brain lesions and to promote a more favorable neurodevelopment.

Educare bambini e ragazzi con Disturbo dello Spettro dell’Autismo attraverso la mediazione delle figure parentali: il Parent Management Training a distanza

Parent Management Training (PMT) is a support intervention whose effectiveness has been amply demonstrated by international literature;it aims to provide tools for families of children and young people with developmental disorders and behavioral problems in the management of children in everyday life contexts. This study wanted to analyze the effectiveness of the PMT, involving a group of Italian families with children with autism, who undertook the path, both individual and group, carried out in telematic mode, during the lockdown caused by the health emergency Covid-19. Semi-structured interviews were used to analyze the quality and effectiveness of these support pathways in videoconference. The results testify the goodness of PMT programs both in the psychological support to the parents involved, and in the behavioral management of their children. The research showed that the quality of the distance support experience is conditioned by the communicative and socio-relational skills of the professionals who have conducted such support paths.

Observer-rated environmental sensitivity moderates children's response to parenting quality in early childhood.

According to several developmental theories some children are more sensitive to the quality of their environment than others, but most supporting empirical evidence is based on relatively distal markers of hypothesized sensitivity. This study provides evidence for the validity of behaviorally observed Environmental Sensitivity as a moderator of parenting effects on children's early development in a sample of 292 children (Mage = 3.74; SD = 0.26) and their mothers. Sensitivity was coded using a newly developed observational measure for the specific and objective assessment of Environmental Sensitivity, the Highly Sensitive Child-Rating System (HSC-RS). HSC-RS factorial structure, associations with temperament traits, and interactions with parenting quality in the prediction of socioemotional child outcomes are reported. Findings supported a 1-factor solution. Observed sensitivity was relatively distinct from observed temperament and interacted with both low and high parenting quality in the development of behavior problems and social competence at ages 3 and 6. (PsycINFO Database Record (c) 2019 APA, all rights reserved).