Difficult Behaviour Research Articles

Career confidential: Principal ticked off about TikTok challenges

Phyllis Fagell offers advice to educators who are trying to support students who are demonstrating difficult behavior when returning to school after the COVID-19 pandemic. A principal is frustrated at the vandalism occurring at his middle school in response to TikTok challenges and wants to know the most appropriate way to hold students accountable. A teacher is having trouble reaching a student who refuses to engage in class, and his mother and the school social worker are also at a loss for ideas.

Family Impact During the Time Between Autism Screening and Definitive Diagnosis

Over the past 10years, identification of Autism Spectrum Disorder (ASD) risk has dramatically increased due to the wide-spread implementation of screening programs; yet, there is limited understanding about parent perceptions and experiences during the time period when risk is identified, but prior to receiving a formal diagnosis-a period that can last months to years given the long wait-lists for formal ASD evaluations. The current study aimed to examine parent perceptions of family impact (i.e., the impact their child's behaviors have on the family) between the time of risk-identification and formal diagnosis among 277 children identified as at-risk for ASD through screening positive in primary care. We aimed to compare family impact among those whose child met diagnostic criteria for ASD and those who did not. Parents of children who received a non-ASD diagnosis reported a higher baseline level of family impact (F[1, 274] = 5.82, p = .017); however, perceived difficult child behavior was a stronger predictor of family impact (t[6] = 13.11, p < .001) than later diagnostic group (t[6] = -2.10, p = .037), and child functioning did not predict family impact (t[6] = -0.31, p = .76). These results suggest that in this population, perceived difficult child behavior is a stronger predictor of family impact than later diagnostic category and should be considered an important factor in family support.

Preventing patient violence in hospitals: Applying critical decision method interviews to understand how skilled staff think and act differently

AimsOur aims were to understand how hospital staff who are skilled at managing aggressive patients recognize and respond to patient aggression and to compare the approaches of skilled staff to the experiences of staff who were recently involved in incidents of patient violence. BackgroundViolence from patients toward staff is prevalent and increasing. There is a need for greater understanding of effective approaches to managing patient aggression in a wide variety of hospital settings. MethodsWe conducted grounded theory qualitative research applying Critical Decision Method interviews at two hospitals. Skilled staff and incident-involved staff were asked to describe experiences involving aggressive patients and the data were analyzed qualitatively. ResultsOur interviews (N = 23) identified positive approaches and challenges to managing aggressive patients. Positive approaches included: maintaining empathy for the patient, allowing the patient time and space, exhibiting a calm demeanor, not taking things personally, and implementing strategies to build trust. Challenges included: inadequate psychiatric resources, balancing priorities between patients with urgent physical needs and those exhibiting difficult behaviors, and perceiving pressure to de-escalate situations quickly. Incident-involved staff were more likely to describe the challenges listed above and a limited tolerance for patients whose behavior they perceived as unjustified or detracting from other patients' care. ConclusionThe Critical Decision Method proved valuable for highlighting nuanced understandings of skilled staff that sometimes contrasted with perceptions of incident-involved staff. Our findings support investigation of novel approaches to training such as peer coaching and improving empathy through increased understanding of mental illnesses and addiction.

Linear Stability-Based Smooth Reynolds-Averaged Navier–Stokes Transition Model for Aerodynamic Flows

The inclusion of transition to turbulence effects in computational fluid dynamics simulations makes it possible to design laminar flow airframes. It also increases the level of physical representations for simulations of standard airframes because laminar flow regions may be present in parts of the aircraft in multiple flight conditions. Modified Reynolds-averaged Navier–Stokes (RANS) models that consider transition effects became popular in the last decade and indicated favorable agreement with experimental data. However, these models present more difficult convergence behavior when compared with fully turbulent RANS approaches. To address this issue, an approximate Newton–Krylov solver is leveraged to solve the transitional flow over aeronautical configurations using a flow-stability-based, smooth RANS transition model. The amplification factor transport (AFT) model is modified to create a smooth variant, referred to as AFT-S. Strategies have been developed to obtain representative physical solutions that exhibit good agreement with experimental data. The convergence behavior for the transition RANS model is also addressed, and its impact on the numerical results is assessed. These results constitute the first in-depth investigation on the numerical behavior of an AFT-type transition model.

An individualized telephone-based care support program for rural family caregivers of people with dementia: study protocol for a cluster randomized controlled trial

BackgroundThere are about 9.5 million people with dementia in China. Up to 99% of them are cared for by their family caregivers. Family caregivers are confronted with considerable difficulties and challenges while providing care. They often experience high levels of emotional, physical, financial, and social burdens. Caregivers in rural areas experience an even higher level of burden compared to their counterparts in urban areas due to fewer health resources for dementia care. However, so far, no intervention study has been conducted to support family caregivers in rural areas of China. The aim of this proposed study is to adapt and evaluate an evidence-based and culturally-tailored individualized telephone-based care support (ITBCS) program for family caregivers of people with dementia in rural China.MethodsA cluster randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the ITBCS compared with usual care for Chinese rural family caregivers of people with dementia. A total sample of 168 rural family caregivers will be recruited. The intervention components consist of a 3-month intensive telephone-based care support intervention followed by telephone-based follow-up consultations for 6 months. The control group will receive usual care services available for them. Outcome measures include carers’ subjective burden, depressive symptoms, health-related quality of life, social support, caregiving self-efficacy, and care recipients’ difficult behaviours and competence in activities of daily living at 3, 9 and 15 months after baseline. The potential cost-effectiveness of the ITBCS compared with usual care will be assessed as well.DiscussionIf effective, the ITBCS program can be adapted and used in rural areas of China as a blueprint to improve the quality of home-based care for people with dementia. Findings from the present study are significant for developing evidence-based dementia care policy in rural China.Trial registrationChinese Clinical Trial Registry, ChiCTR2000038821, Registered 4 April 2020, http://www.chictr.org.cn/showprojen.aspx?proj=62268.

Symptoms of Autism, Comorbid Mental Health Conditions and Challenging Behaviors among Toddlers with Down Syndrome at Low Risk for ASD-Characterization Using the BISCUIT-Parts 1-3.

Background: Autism spectrum disorder (ASD) may coexist with Down syndrome (DS). Most studies on this topic involve school-age children, adolescents, or adults with DS. This study looked at ASD symptoms, other mental health problems, and challenging behaviors in toddlers with DS at low risk of ASD. Methods: We used screening tools for autism in toddlers; BISCUIT–Parts 1–3 and Q-CHAT. We compared four groups of children aged 17–37 months: DS, ASD, Atypical Development (AD), and Typically Developing (TD). Results: Children with DS showed lower symptoms of ASD than children with ASD (without DS) and higher than TD children, except for repetitive behaviors/restricted interests. For comorbid mental health problems and difficult behaviors, children with DS scored lower than children with ASD. There were no differences between children with DS and TD children in this regard. Conclusions: The study results indicate that BISCUIT–Parts 1–3 are valid instruments to differentiate toddlers with DS from toddlers with ASD. However, they also show that toddlers with DS at low ASD risk are a very heterogeneous group when the ASD symptoms are considered. Autistic characteristics should be taken into account in supporting young children with this genetic condition.

Full densification of zirconium carbide ceramics sintered under high pressure at low temperature

AbstractZirconium carbide (ZrC) ceramic is one of the most important and promising materials with a high melting point. However, its low diffusion coefficient affects its densification behavior, which dramatically limits its engineering application. For polycrystal ceramic materials, sintering by thermal diffusion is the most widely used method for consolidation. But in view of the difficult densification behavior of ZrC, it is necessary to develop new sintering methods together with another driving force. In the study, we reported an ultra‐high‐pressure sintering strategy to fully densify ZrC ceramic under 1.7 GPa at 1600℃. The sintered sample exhibited high density, fine grain size, excellent mechanical properties, and a large number of crystal defects, including dislocation networks and walls, which were similar to those in deformed metals. Its hardness increased to 2057.44 HV0.1 because of its unique microstructure.

School Teachers’ Perception of Problematic Parent Behaviour

This paper is part of the Doctoral work of the first author completed under the supervision of the second. The study’s sample comprised 252 male and female primary and secondary level school teachers of private and public schools of Patna (Bihar). Though the purpose of the Doctoral work was to study the relationship between the ‘difficult parent behavior’ and the ‘school teachers’ stress,’ this presentation shall address the school teacher’s perception of the problematic parent behaviour. The difficult parent behavior was studied with the help of descriptions of behaviours likely to be shown by the problematic parents developed by the Hoge school of the Educational Faculty of Utrecht, Netherlands (2007). Analysis of the data included extracting factors from the school teachers’ ratings for the ‘frequency of occurrence’ of the behaviours displayed by the problematic parent. Additionally, qualitative data was collected from the school teachers with the help of three open ended questions. Factor analysis helped extract five factors of the problematic parent behavior that were named, Domineering Parent, concerned without Action Parent, Excessively Concerned Parent, Indifferent Parent and Imposing Parent. Further, thematic analysis of the descriptive content of the open-ended questions, helped arrive at six themes of difficult parent behaviours namely, Imposing/Blaming Parent, Concerned without Action Parent, Uncooperative Parent, Irresponsible Parent Rude/Disrespectful Parent and High Expectation Parent.

Effect of Using Smart Mobile Device on Child Prosocial and Difficult Behaviors in School Age; Parents’ Perception

Background: The time that children spend using digital devices is increasing rapidly with the developmentof new portable and instantly accessible technology. Mobile devices are embedded in and dominate the dailylives of young children. Research Aims: assess the effect of using smart mobile device on child Prosocialand difficult behaviors in school age. Methodology: A cross sectional research design was utilized at August2019 - January 2020. Convenience sample include the 400 school children. An online survey by usingGoogle form, which contains three parts (characteristics of parents, children and Strengths and DifficultiesQuestionnaire). Results: revealed that47.2% and 47.7% of studied children had abnormal emotionalsymptoms and conduct problems. In addition (34.5%) of studied children was normal related peer problemsdomain. Also, (51.2%) of them was abnormal related hyperactivity. While, (30%) of studied children hadnormal Prosocial behavior. Conclusions: the current study concluded that about half of studied children hadabnormal Prosocial and difficult behaviors and less than one quarter of them had borderline Prosocial anddifficult behaviors. While, less than one third of them had normal Prosocial and difficult behaviors.

Factors associated with school achievement of children aged 8-10 years in rural Bangladesh: Findings from a post hoc analysis of a community-based study.

BackgroundEducation is one of the most important human capitals. Investment in education at early age returns best. A lot of factors influence children’s educational achievement. Studies in developed countries well established the relation of school achievement with its associated variables. But information is lack on what factors play important role for school achievement at early age in low resource settings like Bangladesh. We aimed to find factors associated with school achievement in rural Bangladesh.MethodThe data were acquired from a long-term follow up study, conducted in 8–10 years old children (n = 372). We used a locally developed school achievement tool based on Wide Range Achievement Test-4 to measure reading, spelling and math computation, Wechsler abbreviated scale of intelligence to measure intelligence Quotient (IQ), Digit span forward and backward for short term memory, and locally available Strength and Difficulties Questionnaire to measure behaviour. Socioeconomic and anthropometric information of the mothers and children were also collected. Multicollinearity of the data was checked. Unadjusted and adjusted multiple linear regression analysis was performed.FindingsYears of schooling and short-term memory were positively related to reading, spelling and math computation. For years of schooling it was-reading B = 8.09 (CI 5.84, 10.31), spelling 4.43 (4.33, 8.53) and math computation 5.23 (3.60, 6.87) and for short term memory- reading 3.56 (2.01,5.05), spelling 4.01 (2.56, 5.46) and math computation 2.49 (1.37, 3.62). Older children had lower scores of reading -0.48 (-0.94, -0.02), spelling -0.41 (-0.88, -0.02) and math computation -0.47 (-0.80, -0.14). Children’s IQ predicted reading 0.48 (0.14, 0.81) and spelling 0.50 (0.18, 0.82) skills. Mother and father’s education predicted Spelling 0.82 (0.16, 1.48) and reading 0.68 (0.06, 1.30) capacity respectively. Children enrolled in private schools had higher reading 10.28 (5.05, 15.51) and spelling 6.22 (1.31, 11.13) than those in the government schools. Children with more difficult behaviour tended to have lower scores in reading -0.51 (-0.96, -0.05).ConclusionChildren’s school achievement is influenced by their IQ, years of schooling, type of school and parents’ education. Therefore, intervention should be made to focus specifically on these variables and establish the effect of this intervention through robust research design.

Provision of Oral Health Care by Dentists to Community-Dwelling Older Patients

BackgroundResearch into oral health care for older people has shown that dental care in general decreases with increasing age and frailty and, therefore, oral health care provision may be complex. The aim of this study is to identify the oral health care dentists provide to community-dwelling older people and which barriers they experience in doing this. MethodsIn this cross-sectional study, a representative sample of dentists in the Netherlands was asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to fill out a questionnaire. The relationship between experienced barriers in providing oral health care to older patients and characteristics of the dentists and the patients was studied by means univariate and multivariate logistic regression analysis. ResultsIn total, 923 dentists were asked to participate in the study. Data were available for 39.4% dentist–patient pairs. In most cases (87.4%), oral health care was focussed on conservation of the dentition. In all, 14.0% of the dentists experienced barriers in providing oral health care for older people. Some patient factors increase the risk of experiencing barriers, eg, the more difficult behaviour of older patients and the greater disease burden. ConclusionsOral health care was mostly focussed on conservation of the dentition, and dentists especially experience barriers in oral health provision to older patients if they are already frail.

Classroom behavioural climate in inclusive education – a study on secondary students’ perceptions

AbstractPrevious studies pointed out that dealing with difficult behaviour is perceived by teachers as a major challenge in inclusive settings. However, research on the students' perception of the classroom behavioural climate (CBC) is rare. Therefore, this study aims to examine students’ perceptions of CBC and to identify predictors of CBC as well as associated variables. The sample consists of 650 German students from secondary schools (5th‐9th grade) of whom 83 students are diagnosed with special educational needs (SEN). CBC was measured via four subscales (‘students’ possibilities to study and concentrating on teaching’, ‘disruptive behaviour’, ‘physical and psychological safety’ and ‘caring for the physical environment’). Results show significant differences in students’ perceptions of CBC between students from different school tracks. Furthermore, gender (being male) and SEN (having a) predict the perception of ‘physical and psychological safety’. Additionally, social inclusion, emotional experience as well as teacher support and care are associated with CBC. Accordingly, a positive CBC is important for the successful implementation of inclusive education: while diversity in classrooms is a challenge for behavioural climate, poor behavioural climate may also pose specific barriers to learning for some students with SEN and thus is a general challenge for equity in inclusive classrooms.

Political message matching and green behaviors: Strengths and boundary conditions for promoting high-impact behavioral change

Matching messages to characteristics of individuals is a frequently used technique in persuasion research. However, these interventions rarely target high-impact, difficult sustainability behaviors. In four studies, we present participants with persuasive messages consistent (or inconsistent) with their political beliefs; these messages advocate for a variety of pro-environmental attitudes and behaviors (e.g., voting, diet). Generally, we find that messages consistent with an individual's political orientation elicit more pro-environmental attitudes and behavioral intentions, but these matching effects are limited only to the attitudinal and behavioral domains specifically mentioned in the message (i.e. there is no spillover into other attitudinal or behavioral domains). Practical implications and future directions are discussed.

The impact of a relationship-building strategy on teachers’ perceptions of preschooler behavior: a 2 X 10 approach

ABSTRACT This study examines the impact of the 2 × 10 relationship-building strategy (consisting of a two-minute conversation with a child once a day for 10 days). Participants were four preschool teachers and eight preschool children from a university-based lab school. Teachers completed pre- and post-intervention scales (Strengths and Difficulties Questionnaire and Student Teacher Relationship Scale) as well as journal entries for each interaction and six follow-up questions. Results showed a statistically significant change in teachers’ closeness to their students and a decrease in difficult behaviors that was not statistically significant. Additionally, teacher perceptions were positive regarding the development of relationships using this brief intervention.

Remote Support for Adults with Intellectual Disability During COVID-19: From a Caregiver's Perspective.

The reality of people with ID changed during the pandemic COVID‐19. Most institutions supporting people with ID switched to remote work. This required some major adaptation to these individuals' new realities, their immediate families, and facility staff. Supporting and monitoring the quality of life of individuals with disabilities and their family members during a crisis is an essential topic of current research. This research project aimed to explore the experiences of parents of adults with ID in relation to remote support provided by public support agencies. In a qualitative study, the authors used semistructured individual interviews with caregivers of people with ID. Data analysis distinguished the following categories: parents as therapists, organization difficulties, material problems, lack of social contacts, positive solutions, and difficult behavior. The results show the difficulties of parents in balancing professional, domestic, and supporting tasks. The study was the first in Poland to report on the qualitative assessment of remote support for people with ID during COVID‐19. Further, more extensive research is needed to search for solutions that respect the rights of people with disabilities to professional support.

What is my child telling me? Reducing stress, increasing competence and improving psychological well-being in parents of children with a developmental disability

High levels of stress in parents of children with a developmental disability have been extensively documented. These heightened stress levels seem independent of diagnosis and are better explained by the level of challenging behavior of the children. Furthermore, the relationship between stress level and difficult behavior appears reciprocal. The negative impact of stress on parents’ skill development, response to difficult behavior, sense of competence, well-being and the child’s developmental outcomes have also been thoroughly detailed. The Parent Child Relationally Informed - Early Intervention (PCRI-EI) aims to expand the response repertoires of parents to help address the challenges of parenting a child with a developmental disability, including through reducing parental stress. The current study presents a quasi-experimental assessment of the efficacy of PCRI-EI in reducing stress levels and increasing sense of competency and psychological well-being in a sample of 22 parents of children with a variety of disabilities presenting to a community early childhood development service. Statistically and clinically significant changes in overall stress levels (Parenting Stress Index), psychological well-being (K6) and sense of competence (PSOC) were observed across time.

Trust, Consistency, Engagement: Meeting the Complex Needs of Younger Residents and Staff Who Care for Them

Trust, Consistency, Engagement: Meeting the Complex Needs of Younger Residents and Staff Who Care for Them

Adapting Behavioral Interventions for a Changing Public Health Context: A Worked Example of Implementing a Digital Intervention During a Global Pandemic Using Rapid Optimisation Methods.

Background: A rigorous approach is needed to inform rapid adaptation and optimisation of behavioral interventions in evolving public health contexts, such as the Covid-19 pandemic. This helps ensure that interventions are relevant, persuasive, and feasible while remaining evidence-based. This paper provides a set of iterative methods to rapidly adapt and optimize an intervention during implementation. These methods are demonstrated through the example of optimizing an effective online handwashing intervention called Germ Defense.Methods: Three revised versions of the intervention were rapidly optimized and launched within short timeframes of 1–2 months. Optimisations were informed by: regular stakeholder engagement; emerging scientific evidence, and changing government guidance; rapid qualitative research (telephone think-aloud interviews and open-text surveys), and analyses of usage data. All feedback was rapidly collated, using the Table of Changes method from the Person-Based Approach to prioritize potential optimisations in terms of their likely impact on behavior change. Written feedback from stakeholders on each new iteration of the intervention also informed specific optimisations of the content.Results: Working closely with clinical stakeholders ensured that the intervention was clinically accurate, for example, confirming that information about transmission and exposure was consistent with evidence. Patient and Public Involvement (PPI) contributors identified important clarifications to intervention content, such as whether Covid-19 can be transmitted via air as well as surfaces, and ensured that information about difficult behaviors (such as self-isolation) was supportive and feasible. Iterative updates were made in line with emerging evidence, including changes to the information about face-coverings and opening windows. Qualitative research provided insights into barriers to engaging with the intervention and target behaviors, with open-text surveys providing a useful supplement to detailed think-aloud interviews. Usage data helped identify common points of disengagement, which guided decisions about optimisations. The Table of Changes was modified to facilitate rapid collation and prioritization of multiple sources of feedback to inform optimisations. Engagement with PPI informed the optimisation process.Conclusions: Rapid optimisation methods of this kind may in future be used to help improve the speed and efficiency of adaptation, optimization, and implementation of interventions, in line with calls for more rapid, pragmatic health research methods.

An Innovative Model of Behavior Management to Address Behavioral Emergencies in the Acute Medical Inpatient Setting: Pilot Data.

Workplace violence in healthcare is a significant and costly problem. The majority of violent events that occur in the medical inpatient setting are perpetrated by patients against staff and occur during a behavioral emergency. The primary purpose of this study was to evaluate the impact of an innovative model of behavior management on occurrence of behavioral emergencies and staff comfort and competence in managing difficult patient behaviors. This model consists of primary, secondary, and tertiary interventions provided by a clinical psychologist which include proactive training for hospital staff and consultation-liaison services for behavior management. Forty-six staff at the University of Virginia Medical Center completed a 1-h training on preventing and managing difficult patient behavior. Self-report data on comfort and competence in managing challenging patient behaviors was collected at baseline, immediately following the intervention, and one and three months post-intervention. Behavioral emergencies were tracked for the intervention unit and a comparison unit. The occurrence of behavioral emergencies decreased by 50% in the three months following the intervention compared to a 142% increase on the comparison unit. Staff reported the greatest increase in confidence from baseline to three months post-intervention on caring for patients with psychiatric illnesses, managing verbal abuse, being supported by medical center leadership, having clear roles and responsibilities, and effectiveness of the skills and strategies used to manage difficult patient behavior. The results of this study provide preliminary support for the use of a comprehensive model for managing the behavioral needs of medical inpatients.

The Use of Robots in Experimental Animal Studies

The use of robots in experimental psychology and behavioral neuroscience is emerging as a fundamental method in behavioral experiments using animal models. Utilizing robots in animal experiments provides a substantial advantage for delivering specific stimuli to animals in a selective manner, teaching them different and relatively difficult behaviors, and manipulating group activity. In addition to using individual robots and animals together in behavioral paradigms, biohybrid organisms are created by integrating certain robotic systems with animals. Enabling animals to be controlled by external inputs like robots and enabling robots to be controlled by animals lead to the development of new experimental methods in behavioral animal studies. In addition, artificial intelligence and robotic learning models utilize animal behavior and basic working principles of the nervous system, and the emerging technology can be used in behavioral testing. This review investigates the use of robots and animals in experimental psychology and behavioral neuroscience under three headings. Behavioral tasks that contain animal-robot interactions (1) are discussed, together with biohybrid organisms created by integrating robots into the animals (2) and biology-inspired robotic systems (3). The theoretical and technical contributions of this novel technology and the resulting applications are evaluated. Keywords: Experimental psychology, behavioral neuroscience, animal models, robotics