Early Behavior Problems Research Articles

Service Utilization for Parent Management of Early Childhood Behavior Problems in a Private Outpatient Behavioral Clinic: The Impact of Out-of-Pocket Cost, Travel Distance, and Initial Treatment Progress.

Poorly-managed early childhood disruptive behavior disorders (DBDs) have costly psychological and societal burdens. While parent management training (PMT) is recommended to effectively manage DBDs, appointment adherence is poor. Past studies on influential factors of PMT appointment adherence focused on parental factors. Less well studied are social drivers relative to early treatment gains. This study investigated how financial and time cost relative to early gains influence PMT appointment adherence for early childhood DBDs in a clinic of a large behavioral health pediatric hospital from 2016 to 2018. Using information obtained from the clinic's data repository, claims records, public census and geospatial data, we assessed how owed unpaid charges, travel distance from home to clinic, and initial behavioral progress influences total and consistent attendance of appointments for commercially- and publicly-insured (Medicaid and Tricare) patients, controlling for demographic, service, and clinical differences. We further assessed how social deprivation interacted with unpaid charges to influence appointment adherence for commercially-insured patients. Commercially-insured patients had poorer appointment adherence with longer travel distances, or having unpaid charges and greater social deprivation; they also attended fewer total appointments with faster behavioral progress. Comparatively, publicly-insured patients were not affected by travel distance and had higher consistent attendance with faster behavioral progress. Longer travel distance and difficulty paying service costs while living in greater social deprivation are barriers to care for commercially-insured patients. Targeted intervention may be needed for this specific subgroup to attend and stay engaged in treatment.

Maternal Mindfulness During Pregnancy and Early Child Social-Emotional Development and Behavior Problems: The Potential Mediating Role of Maternal Mental Health

ObjectivesDuring the perinatal period, women are exposed to major changes, holding possible adverse effects on psychological well-being and child development. An effective way of coping with these challenges and adjustments could be mindfulness. The current study examined associations of mindfulness facets during pregnancy with toddler’s social-emotional development and behavior problems, as well as potentially mediating effects of maternal mental health.MethodA total of 167 women completed questionnaires during pregnancy, the postpartum period, and 2 and 3 years after childbirth, assessing dispositional mindfulness, pregnancy distress, symptoms of anxiety and depression, child social-emotional development, and child behavior problems.ResultsThere was a positive association between maternal non-reacting mindfulness skills and child social-emotional development at 2 years of age, regardless of mothers’ perinatal mental health, whereas other mindfulness facets were unrelated. Pregnancy distress mediated the association between maternal non-judging skills during pregnancy and child externalizing problem behavior, but no other mediating effects were found.ConclusionsNon-reacting skills in mothers during pregnancy may have favorable implications for child social-emotional development. Due to the relatively high number of tests that were conducted, the mediating effect of pregnancy distress must be interpreted with caution.

The Prognostic Usefulness of Multiple Specifiers for Subtyping Conduct Problems in Early Childhood

To better describe and treat children with conduct problems (CP), grandiose-manipulative and daring-impulsive traits are proposed for subtyping CP, instead of using only a callous-unemotional specifier. However, the acclaimed benefits of having multiple specifiers for CP remain largely untested and therefore highly speculative. To fill this gap, this study tested longitudinal relations between these 3 specifiers and developmental outcomes in childhood and adolescence, independent of early childhood CP. Longitudinal data from 2 community studies were used. Teacher ratings were used to measure CP and the specifiers in 3- to 5-year-olds from Sweden (n= 2,064) and Spain (n= 2,055). Developmental outcomes were assessed by multiple informants (ie, teachers, parents, and children) 1 to 8 years later. Early childhood CP were predictive of all outcomes. Callous-unemotional traits predicted low levels of social competence and prosocial behavior, independent of CP (and age, gender, and socioeconomic status). Grandiose-manipulative and daring-impulsive traits were predictive of aggression and violent delinquency, respectively, independent of CP, but also of higher levels of prosocial behavior or social competence. The 3 specifiers are predictive of different outcomes, independent of CP, which is thought to form the basis for developing specifiers for CP. Findings tentatively challenge the centrality of callous-unemotional traits for subtyping CP, but it is premature to conclude that grandiose-manipulative and daring-impulsive specifiers are needed in future revisions of DSM and ICD. Efforts to systematically evaluate the utility of these specifiers should be welcomed to inform ongoing debates on this matter.

Child-oriented family therapy in China: A cross-cultural application of integrative family therapy targeting children aged 4-10.

This article describes child-oriented family therapy (COF), a family therapy approach to early psychological and behavioral problems that is widely applied in northern Europe and has been adopted by countries with different cultures, such as Germany and China. This article explains the theoretical background, setting, characteristics, development and effective factors of this method and explores relevant research. In addition, the application of this method in China and reflections on its applicability to families in different cultures are presented. A clinical case is provided to illustrate the core therapeutic principles of COF. Since the application of COF interventions to families with children in Asian cultures remains understudied, the widespread availability of COF and adaptation to local conditions could facilitate training and research achievements in this field.

Relations between Children’s and Parents’ Behavior in Adoptive Families – A Longitudinal Analysis

Despite decades of research on adopted children’s development, little research has examined the mutual relationship between children’s and parents’ post-adoption behavior. The current study used data from a longitudinal study to examine transactional processes between children’s psychosocial adjustment, parenting styles, and parenting stress in a sample of 67 adoptive families. Children’s early behavioral problems predicted later positive parenting, inconsistent parenting, and parenting stress. The findings underline the importance of pre-adoption training for adoptive parents, realistic information on adoptees’ adjustment problems, and continuous post-adoption support.

Factors predicting secondary school language course enrollment and performance among U.S. heritage speakers of Spanish.

While a growing body of research indicates that Spanish language courses can promote Spanish maintenance and lead to overall improved educational outcomes among heritage speakers, there is little empirical or longitudinal evidence of factors that shape their enrollment in Spanish language courses at the secondary level. To address this issue, the current study takes a large-scale, longitudinal approach to investigate rates of enrollment in secondary school (6th-12th grade) Spanish and other non-English language courses, as well as factors that predict heritage speakers' enrollment and performance in non-English language courses. We analyzed subsample data from the Miami School Readiness Project (MSRP), a large-scale, longitudinal study consisting of 17,341 heritage speakers of Spanish (47% female, 95.4% Hispanic/Latino, 82.8% received free/reduced-price lunch, and 18.3% with a disability) who were followed from 4 years old until the end of high school. In general, Heritage speakers enrolled in Spanish language courses at a higher rate than other non-English language courses (52.2 and 25.3%, respectively). Enrollment patterns varied across different type of languages and grade level. Student-level factors including disability status, poverty status, early behavioral problems, and prior academic achievement significantly predicted students' enrollment in Spanish and performance in non-English language courses. Findings shed light on the long-term patterns of language study of this growing segment of the US school population with implications for future research and school policies that seek to improve heritage language learning and maintenance as well as equitable access to language education for language-minority students.

Externalizing and internalizing problems as predictors of alcohol-related harm and binge drinking in early adolescence: The role of gender

BackgroundExternalizing problems are commonly associated with alcohol outcomes in adolescence. Nevertheless, findings regarding internalizing problems are mixed, and fewer longitudinal studies have considered the both problems concomitantly and the role of gender. We examined the role of externalizing and internalizing problems in predicting adolescent alcohol-related harm and binge drinking, taking into account the gender differences. We also evaluated if externalizing problems could moderate the association between internalizing problems and alcohol outcomes. MethodWe used longitudinal data from 2368 8th grade students across 37 public schools in three Brazilian cities. Linear and logistic regressions were performed to analyze the association between alcohol outcomes and the independent variables (externalization and internalization scores, and sociodemographic variables) according to gender. We also tested the same model with an interaction term between externalizing*internalizing. ResultsOur results suggest that externalizing problems predict adolescents' binge drinking in both genders; it also may predict adolescents' alcohol-related harms, but only in boys. Internalizing problems seem to be a gender-specific risk factor for binge drinking among girls. All findings are independent of comorbid problems and sociodemographic variables. LimitationThe findings should be considered taking into account the short follow-up period from risk factors to the outcomes. ConclusionOur results highlight the contribution of internalizing and externalizing problems to the development of alcohol-related harm and binge drinking in early adolescence and the need for interventions to prevent early behavioral problems that consider the role played by gender.

Cessation of dangerousness status in Brasília, Brazil: An analysis of 144 reports from Federal District Medical Examiner's Office in the last 10years.

The aim of this study is to evaluate factors related to cessation of dangerousness of individuals under safety measures, through the study of psychiatric reports. This is a cross-sectional study, conducted through a retrospective analysis of expert psychiatric dangerousness cessation reports issued by the Federal District Coroner's Office, Brasília, Brazil. By examining official files, information was extracted from the reports (socio-demographic data, clinical characteristics, type of crime, historical characteristics and the search for items related to risk assessment present in instruments such as Historical, Clinical and Risk Management [HCR-20], Psychopathy Checklist - Revised [PCL-R], Two-Tiered Violence Risk Scale [TTV], Short-Term Assessment of Risk and Treatability [START] and others) and submitted to statistical analysis and then compared to other studies on the subject. The items most considered by the experts were those referring to PCL-R, START and the "non static" part of HCR-20 and TTV. For the non-cessation of dangerousness, we've found: absence of remorse, fragile behavioral control, early behavioral problems, juvenile delinquency. For the cessation of dangerousness, we've found: presence of social skills, balanced emotional state, presence of social support, adherence to rules, good coping strategies, involvement with treatment and adherence. The systematization and standardization of forensic psychiatric reports needs to be established and the use of risk assessment instruments are essential to support better decisions by the experts.

Trajectories of medical service use among girls and boys with and without early-onset conduct problems.

Children with conduct problems (CP) have been found to be heavy and costly medical service users in adulthood. However, there is little knowledge on how medical service use develops during childhood and adolescence among youth with and without childhood CP. Knowing whether differences in developmental trajectories of medical service use for specific types of problems (e.g., injuries) are predicted by childhood CP would help clinicians identify developmental periods during which they might intensify interventions for young people with CP in order to prevent later problems and associated increased service use. Participants were drawn from an ongoing longitudinal study of boys and girls with and without childhood CP as rated by parents and teachers. Medical service use was assessed using administrative data from a public single payer health plan. Latent growth modeling was used to estimate the mean trajectory of four types of medical visits (psychiatric, injury-related, preventative, total visits) across time and evaluate the effect of CP and other covariates. Support the hypothesis that early CP predicts higher medical service use at nine years old, and that this difference persists in a chronic manner over time, even when controlling the effects of ADHD and family income. Girls had fewer medical visits for psychiatric reasons than boys at baseline, but this difference diminished over time. Clinicians should be aware that childhood CP already predicts increased medical service use in elementary school. Issues specific to different contexts in which injuries might occur and sex differences are discussed.

Functional Communication Training for Toddlers At-Risk for Autism with Early Problem Behavior

Functional Communication Training for Toddlers At-Risk for Autism with Early Problem Behavior

Toddler behavior problems amid household chaos: Is responsive parenting protective for everyone?

AbstractObjectiveThis study examined household chaos and children's behavior problems, exploring emotionally responsive parenting as a potential protective factor for children in Early Head Start (EHS) while considering child race and ethnicity as well as several socioeconomic and household contextual factors.BackgroundHousehold chaos relates to children's difficulty with self‐regulation and behavior problems. Emotionally responsive parenting could protect against the negative effects of chaos for children. However, both the perception of chaos and impact of parenting behaviors on children's behavior may vary with race, ethnicity, crowding in the home, and other contextual factors.MethodThis study examined relations among chaos, observed emotional responsivity, and toddler's subsequent behavior problems among EHS Family and Child Experiences Study participants.ResultsChaos was associated with more behavior problems, and three‐way interaction findings indicated significant group differences by race and ethnicity in the relation between chaos and parenting on behavior problems. Behavior problems were also higher in lower socioeconomic contexts, and with child exposure to violence.ConclusionChaos and parenting both influence children's early behavior problems, with distinct findings by race, ethnicity, socioeconomic, and other contextual factors.ImplicationsThese findings may reflect differing perceptions and effects of chaos and parenting, with important implications for research and prevention.

Prenatal cannabis exposure predicts attention problems, without changes on fMRI in adolescents

ObjectivesWe hypothesized that prenatal cannabis exposure (PCE) would be associated with increased attention problems and altered neurocognition in young adolescents. MethodsData were obtained from the Adolescent Brain Cognitive Development (ABCD study®), a cohort of approximately 12,000 children. Presence or absence of PCE after knowledge of pregnancy was measured by caregiver report. All participants with PCE (N = 224) were included and compared to two control groups; those matched on tobacco and alcohol exposure and those without prenatal tobacco or alcohol exposures. Outcomes were measured with the ABCD baseline assessment when participants were 9–10 years old and included attention, internalizing, externalizing and total problems scales on the Child Behavior Checklist (CBCL). Teacher reports were used when available. Mixed effects modeling assessed the association between PCE and outcomes controlling for parental psychopathology, prematurity and socioeconomic status. For participants with available data, patterns of brain activity during three fMRI tasks (the Stop Signal Task measuring response inhibition, the Monetary Incentive Delay (MID) task measuring reward processing and the EN-Back task measuring working memory) were analyzed using Permutation Analyses of the Linear Model. ResultsCompared to both control groups, participants with PCE had significantly higher attention problems, externalizing, and total problem scores. PCE did not impact cognitive performance or patterns of brain activation during fMRI tasks. ConclusionsThere are long-term associations between PCE and early adolescent attention and behavioral problems. These are not reflected in cognitive performance or task fMRI measures, a finding that is consistent with reports that fewer than half of children with ADHD have any specific cognitive deficit (Nigg et al., 2005; Willcutt et al., 2005). The young age of the sample may also relate to this finding and future investigation of neurodevelopmental trajectories of youth with PCE is warranted.

Behavioral Considerations in Management Accounting Theory and Practice

The paper explores the question of what the future of behavioral accounting research in management accounting is. It contributes to the Bulgarian accounting theory by highlighting behavioral problems as an important research area for the future development of management accounting. More generally the paper contributes to the existing literature with the deductive justification of behavioral considerations being an integral and fundamental part of the theory and practice of management accounting. The first and second sections examine the early behavioral problems of the Anglo-Saxon practice and theory of accounting in general and management accounting in particular. The third section describes various behavioral issues discussed in Bulgarian accounting literature. The last section argues that the impact of the management accounting function – its contribution to the development and implementation of the strategy – depends heavily on the influence of management accounting information on the subjective mental representations of its primary users.

Ridurre i problemi comportamentali nei bambini piccoli attraverso il video-feedback. Trial clinico randomizzato pragmatico

Reducing behavioural problems in young children through vi- deo feedback. A pragmatic randomized clinical trial The use of videofeedback technique at home (Video-feedback In- tervention to promote Positive Parenting and Sensitive Discipli- ne - VIPP-SD) is evaluated. This is the first video-feedback RCT carried out in a primary care setting. 300 families with children aged 12-36 months who had an upper range score for behaviour problems (Strengths and Difficulties Questionnaire - SDQ) were involved. The intervention proved to be effective in reducing early behavioural problems in 1 and 2 year old children. The benefits of the intervention are seen in behavioural problems rather than in attention problems and are more evident when the initial symp- toms are worse. No appreciable differences were recorded for all the outcomes concerning parents (educational practices, mood, anxiety, functioning of the parental couple).

The Apple of Dad’s Eye: Paternal Affective Attitudes Predicting Early Childhood Behavior Problems

ABSTRACT Objective The Family Affective Attitude Rating Scale (FAARS) uses an audio-recorded speech sample to measure parents’ affective attitudes toward their children. The present study investigated the psychometric properties of this scale for use with fathers, concurrent predictors of paternal affective attitudes (parental depressive symptoms, inter-parental relationship quality, observed paternal parenting), and associations between fathers’ positive and negative affective attitudes toward their two-year-old children and children’s behavior problems one year later. Methods Participants were a sample (N = 226) of families from the Early Steps Multisite Study, a longitudinal study of low-income parents and children. Participants were racially and ethnically diverse (65% white; 23% Black or biracial; 12% Latinx). Results Initial validation results support the reliability and validity of FAARS coding in fathers of preschoolers, a previously untested group. Both maternal and paternal depressive symptoms and interparental relationship quality were significantly associated with fathers’ affective attitudes toward their children. Further, fathers’ positive affective attitudes predicted lower mother-reported child behavior problems one year later, controlling for a host of demographic covariates, fathers’ observed parenting, mothers’ affective attitudes, and child baseline behavior problems. Conclusions Results indicate that fathers’ positive attitudes toward their young children are a unique and robust predictor of lower levels of early behavior problems.

Neighborhood influences on early childhood behavioral problems: Child maltreatment as a mediator

BackgroundA sizable number of previous research investigated the influences of untreated behavior problems in children's early age, as well as how different environmental factors affect child behavior problems (King et al., 2004; Vaillancourt et al., 2013). However, few studies focused on the influences of different types of neighborhood factors on early childhood internalizing and externalizing symptoms via adverse childhood experiences. ObjectiveThis study aims to capture the specific pathways from neighborhood structural factors and process factors to early childhood internalizing and externalizing symptoms. Participants and settingThe restricted version of the Fragile Family Child Wellbeing Study (FFCWS) dataset at ages 3 and 5 were used, and 2722 children were included in the final model. MethodsThe Structural Equation Model was used to estimate the pathways from neighborhood structural and process factors to early childhood internalizing (INT) and externalizing (EXT) symptoms. Neighborhood structural factors were measured at the census tract level. Neighborhood collective efficacy, child maltreatment experiences, and early childhood internalizing, and externalizing symptoms were reported by the focal child's mother. ResultsNeighborhood process factors and structural factors showed both direct and indirect effects on early childhood EXT and INT differently. Emotional assault and neglect worked as mediators in this relationship. ConclusionsFindings emphasize the importance for researchers and practitioners to involve neighborhood context when assisting children with early childhood behavior problems. Implications for research and interventions are further discussed.

Child-father attachment in early childhood and behavior problems: A meta-analysis.

This meta-analytic study examined the associations between child-father attachment in early childhood and children's externalizing and internalizing behavior problems. Based on 15 samples (N=1,304 dyads), the association between child-father attachment insecurity and externalizing behaviors was significant and moderate in magnitude (r=0.18, 95% CI: 0.10, 0.27 or d=0.37, 95% CI: 0.20, 0.55). No moderators of this association were identified. Based on 12 samples (N=1,073), the association between child-father attachment insecurity and internalizing behaviors was also significant, albeit smaller in magnitude (r=0.09, 95% CI: 0.02, 0.15; or d=0.17, 95% CI: 0.03, 0.31). Between-study heterogeneity was insufficient to consider moderators. When compared to the effect sizes of prior meta-analyses on child-mother attachment and behavior problems, the quality of the attachment relationship with fathers yields a similar magnitude of associations to children's externalizing and internalizing behaviors. Results support the need to consider the role of the attachment network, which notably includes attachment relationships to both fathers and mothers, to understand how attachment relationships contribute to child development.

Video feedback combined with coordination meetings in school to reduce early disruptive behaviour problems (DBP)-A 1-year follow-up randomised controlled trial.

To compare long-term effects of a systemic school-based intervention, Marte Meo and Coordination Meetings (MAC), targeting 3- to 12-year-old children displaying disruptive behaviour problems (DBP) in preschool or school, and service as usual (SAU). In addition, to examine whether social status (SS) affected the outcomes. In a randomised controlled design, teachers' and parents' ratings of 99 children's DBPs and mental health were collected before intervention and 1year after post-test. A significant time effect in school was found in both interventions, notably larger than at post-test in an earlier study. There was no difference between groups, SAU catching up with MAC. From teachers' reports, 53-70% of the children showed a positive change. SS did not affect the outcomes. School provides an already established setting to detect and intervene when young children begin to display DBP. Even if a long-term positive change in MAC did show more rapidly than in SAU, both interventions were equivalent for children from diverse social backgrounds.

At-risk early adolescents profiles in the community: A cluster analysis using the strengths and difficulties questionnaire

Early adolescence, with its several changes and demands, represents a delicate period of life. Several studies highlighted that during early adolescence, emotional and behavioral problems tend to increase. Using a person-centered approach, the present study explored the emotional and behavioral functioning profiles in a sample of Italian preadolescent students. Participants were 2959 youths (1533 males and 1426 females; age 10–14 years); they completed the Strengths and Difficulties Questionnaire (SDQ) and the Inventory of Callous Unemotional traits (ICU). Findings revealed four different profiles: "no psychopathology" (41.5%), "low psychopathology with sub-threshold hyperactivity" (33%), "predominantly internalizing" (19%), and "predominantly externalizing" (6.5%). The two latter clusters are characterized by high levels of SDQ Total Score. The “predominantly internalizing” is distinguished by a higher prevalence of females, and the “predominantly externalizing” by a higher prevalence of males and higher CU traits. A person-oriented approach allowed for identifying subgroups of early adolescents who may significantly vary in their configuration of internalizing and externalizing problems. Such subgroups may reflect youths for whom the creation of prevention and intervention programs could be more tailored.

Early life stress and behavior problems in early childhood: Investigating the contributions of child temperament and executive functions to resilience.

This preregistered study examined whether child temperament and executive functions moderated the longitudinal association between early life stress (ELS) and behavior problems. In a Dutch population‐based cohort (n = 2803), parents reported on multiple stressors (age 0–6 years), child temperament (age 5), and executive functions (age 4), and teachers rated child internalizing and externalizing problems (age 7). Results showed that greater ELS was related to higher levels of internalizing and externalizing problems, with betas reflecting small effects. Lower surgency buffered the positive association of ELS with externalizing problems, while better shifting capacities weakened the positive association between ELS and internalizing problems. Other child characteristics did not act as moderators. Findings underscore the importance of examining multiple protective factors simultaneously.