Emotional And Behavioural Difficulties Research Articles

Associations Between Preadoption Maltreatment and Adoptees’ Emotional and Behavioral Difficulties: The Buffering Role of Mindful Parenting

ObjectivesThe main goal of this study was to explore the association between preadoption maltreatment and postadoption child emotional and behavioral difficulties (EBD), while examining the potential buffering role of adoptive parents’ mindful parenting on this association. The potential moderating role of the child’s current age, of the time passed since the adoptive placement, and of the parents’ sex was also explored within the buffering role of mindful parenting.MethodThis cross-sectional study comprised a sample of 277 parents (76.2% females) with adoptive children aged 2 to 17 years.ResultsExperiencing preadoption maltreatment and more diverse types of maltreatment were associated with higher EBD among adoptees as perceived by the parents. Mindful parenting had a buffering role in the association between preadoption maltreatment and EBD for adoptees up to 8 years of age and an independent direct explanatory role on EBD for adoptees of all other ages.ConclusionsIntervening with adoptive parents through mindful parenting programs seems to be relevant to promote adoptees’ mental health.PreregistrationThis study is not preregistered.

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents.

Mindfulness-enhanced parenting programmes for improving the psychosocial outcomes of children (0 to 18 years) and their parents.

Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children

Sleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified. To examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs). This cohort study used data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023. Sleep disturbances were assessed using the Children's Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire. Occurrence of incident and resolved EBDs at the 2-year follow-up. The cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P < .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P < .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P < .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P < .001) were higher than among the group with no sleep disturbances. In this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.

The role of teachers in the bullying involvement of students with emotional and behavioral difficulties

Previous research suggests that students with emotional and behavioral difficulties (EBD) are more vulnerable to becoming directly involved in bullying dynamics. To date, no study has tested the role of teachers' emotional support and positive teacher-student relationship climates in EBD students' bullying involvement. This study tests whether the relationships between students' EBD and students' bullying involvement is mediated by teachers' emotional support and the quality of the teacher-student relationship climate. Results indicate that only teachers' collaborative efforts to improve school relationship climates are important mechanisms for explaining EBD students’ bullying involvement.

Health-related quality of life of children with first onset steroid-sensitive nephrotic syndrome

This study assessed HRQoL and emotional and behavioral difficulties (EBD) and associated variables in children with first onset SSNS. While relapsing steroid-sensitive nephrotic syndrome (SSNS) in children is associated with lower health-related quality of life (HRQoL), little is known about first onset. Four weeks after onset, children (2–16 years) and/or their parents who participated in a randomized placebo-controlled trial, completed the Pediatric Quality of Life Inventory 4.0 (PedsQL) and Strengths and Difficulties Questionnaire (SDQ) to measure HRQoL and EBD, respectively. Total and subscale scores and the proportion of children with impaired HRQoL (> 1 SD below the mean of the reference group) or SDQ clinical scores (< 10th and > 90th percentile) were compared to the Dutch general population (reference group). Regression analyses were used to identify associated variables. Compared to the reference group, children 8–18 years reported significantly lower total HRQoL, and physical and emotional functioning. A large proportion (> 45%) of these children had impaired HRQoL. There were no differences in HRQoL between children 2–7 years and the reference group, except for higher scores on social functioning (5–7 years). Similar proportions of SSNS and reference children scored within the clinical range of SDQ subscales. Age, sex, and steroid side-effects were negatively associated with HRQol and/or EBD. Conclusion: This study showed that HRQoL and EBD are affected in children of different ages with first onset SSNS. This calls for more awareness from healthcare providers and routinely monitoring of HRQoL and EBD in daily clinical care to prevent worsening of symptoms. Clinical trial registry: Netherlands Trial Register (https://trialsearch.who.int/; NTR7013), date of registration: 02 June 2018.What is Known:• Health-related quality of life (HRQoL) is lower and emotional and behavioral difficulties (EBD) is more affected in children with frequently-relapsing and steroid-dependent nephrotic syndrome.What is New:• HRQoL and EBD are affected in children with first onset steroid-sensitive nephrotic syndrome compared to a reference group of the Dutch general population.• To what extent HRQoL and EBD are affected depends on the age of the patient.

Students with emotional and behavioural difficulties in Irish post-primary schools: a role for occupational therapy

Purpose Higher levels of participation in school are linked to greater academic performance, better health and well-being and positive long-term outcomes for young people. Evidence shows that for students with emotional and behavioural difficulties (EBD), participation in school-based occupations is often restricted in comparison to their peers. Given the recent advancements towards introducing a new model of school-based occupational therapy in Ireland, this paper aims to discuss how occupational therapy can support students with EBD to increase their participation within the post-primary school context. The opinions in this paper are derived from the authors’ experience in the development of this practice in the Republic of Ireland. Design/methodology/approach The authors reviewed current literature and reflected on current practice to describe the unique role of occupational therapy in supporting students with EBD in the school environment. Findings Occupational therapists have potential to play a key role in school-based support for students with EBD. The authors describe how occupational therapists can promote whole school understanding of EBD and enable skill development, self-regulation, participation and school belonging, among youths with EBD. There is a significant lack of literature guiding practice in this area. Further research is required to explore professional issues and identify best practice. Originality/value This paper aims to provoke consideration of how school-based occupational therapists can play a crucial role in supporting students with EBD who are otherwise at risk of occupational injustice.

The Techniques/Methods Used by School Psychologists to Assess Children with Emotional and Behavioural Difficulties

The main aim of this research was to investigate the current methods used by the Libyan school psychologists for children referred to them as having emotional and behavioural difficulties (EBD), and to make comparisons, where possible, with previous research. The data presented is taken from an adapted questionnaire which was based closely on that of McCall (1993). Analysis of responses from 8 schools from the two main Libyan cities (Tripoli &amp; Benghazi) indicated that traditional methods are in common usage among school psychologists. Intelligent tests e.g. attainment and reading tests were used more than observation assessing the children referred. Family factors were found to be the main causes of producing behavioural problems e.g. the dynamics of relationships within the family. The greater number of children referred were found at the primary level with a larger number of boys than girls. The outcome showed tendency among teachers to remove EBD children from the main setting, though their difficulties are learning based.

A cross-sectional study on the impact of parental educational level and gender differences on emotional and behavioural difficulties in adolescents in Qatar

ABSTRACT Heterogeneous findings on the prevalence of emotional and behavioural difficulties (EBD) have been reported in Middle Eastern countries. Moreover, the prevalence of EBD among adolescents in Qatar is unknown, making it difficult to implement the necessary educational or psychosocial programs. This study used a cross-sectional methodology to assess emotional and behavioural problems among 533 high school students from the public government schools. Only 10.6% of the students were found to have EBD, and the prevalence varied significantly in different EBD subscales, as identified using the Strengths and Difficulties Questionnaire (SDQ). The reliability of the scales was good. The population of this study had lower mean EBD scores than those reported in three other Middle Eastern countries. There were significant differences in EBD between males and females, with a higher prevalence in females. No effect of parental education was observed, suggesting that in a society with high economic stability and an excellent social structure, parental education may not be an independent factor influencing the EBD in adolescents. More studies are needed to confirm this hypothesis; however, the findings of the current study will be of importance in establishing the use of the SDQ as a tool for gauging EBD and prioritising necessary interventions.

Emotional and behavioural function in children with language problems- a longitudinal, population- based study

ABSTRACT This longitudinal, population-based study investigated associations between language problems (LP) and emotional and behavioural difficulties (EBD). Parents and teachers gave information about LP and EBD when the children were 7–9 (T1) and 11–13 years old (T2). Self-reports of EBD were included at T2. In line with findings from clinically referred samples, children with LP scored higher than controls on all measures of EBD at both time-points. A subgroup with persistent LP showed more severe EBD than a subgroup with transient LP. Hyperactivity and peer problems at T1 were significantly associated with the risk of persistent LP. Boys in the persistent subgroup had more severe behaviour problems as reported by all informants, whereas self-reports revealed more severe emotional problems in girls with LP. The profound and consistent reports across informants of EBD in children with LP emphasise the importance of providing both mental health and language support in childhood as well as in adolescence. Addressing symptoms associated with Attention Deficit Hyperactivity Disorder and social problems may be of especial importance to improve LP outcome. The complexity of problems encountered underlines the need for a combined expertise and multidisciplinary approach to language impairment in youth.

Impact of child emotional and behavioural difficulties on educational outcomes of primary school children in Ethiopia: a population-based cohort study

BackgroundThe relationship between child emotional and behavioural difficulties (EBD) and educational outcomes has not been investigated in prospective, community studies from low-income countries.MethodsThe association between child EBD symptoms and educational outcomes was examined in an ongoing cohort of 2090 mother–child dyads. Child EBD was measured when the mean age of children was 6.5 years, SD 0.04 (T0) and 8.4, SD 0.5 years (T1) using the Strength and Difficulties Questionnaire (SDQ). Educational outcomes were obtained from maternal report (drop-out) at T1 and from school records at when the mean age of the children was 9.3 (SD 0.5) years (T2).ResultAfter adjusting for potential confounders, child EBD symptoms at T1 were associated significantly with school absenteeism at T2: SDQ total score: Risk Ratio (RR) 1.01; 95% confidence interval (CI) 1.01, 1.02; SDQ high score (≥ 14) RR 1.36; 95% CI 1.24, 1.48; emotional subscale RR 1.03; 95% CI 1.01, 1.04; hyperactivity subscale RR 1.03; 95% CI 1.02, 1.04 and peer problems subscale (RR 1.02; 95% CI 1.00, 1.04). High SDQ (β = − 2.89; 95% CI − 5.73, − 0.06) and the conduct problems sub-scale (β = − 0.57; 95% CI − 1.02, − 0.12) had a significant negative association with academic achievement. There was no significant association between child EBD and school drop-out.ConclusionProspective associations were found between child EBD symptoms and increased school absenteeism and lower academic achievement, suggesting the need for child mental health to be considered in interventions targeting improvement of school attendance and academic achievement in low-income countries.

Attitudes to pupils with EBD: an implicit approach

ABSTRACT Research has shown that the attitudes of teachers towards pupils can influence their academic and social behaviour. In the context of special education needs (SEN), the same processes likely apply, and there is evidence that teachers’ attitudes influence the success of inclusive initiatives. While the literature on attitudes to pupils with SEN is limited, there is also a heavy reliance on self-reported methodologies that are susceptible to presentation bias. Across two studies, the current research employed the Implicit Relational Assessment Procedure (IRAP) to measure the implicit attitudes of teachers in training (N = 20), primary school teachers (N = 20), and post-primary teachers (N = 20) and a group of controls (N = 20) towards pupils with Emotional and Behavioural Difficulties (EBD), versus the implicit attitudes of primary school teachers (N = 20) and post-primary teachers (N = 20) towards typically-developing pupils. Results indicated that teachers possessed greater negative implicit and explicit attitudes towards pupils with EBD, when compared to typically-developing pupils.

Evaluation of an Online Sexual Health Program among Adolescent Girls with Emotional and Behavioral Difficulties.

Adolescent girls with emotional and behavioral difficulties (EBDs) have a heightened risk of negative sexual health, including HIV, other sexually transmitted infections (STIs), and unplanned pregnancy. Few evidence-based sexual health interventions are available for adolescent girls with EBDs. This study tested the feasibility, acceptability, and efficacy of a brief, online sexual health program called HEART (Health Education and Relationship Training). Forty-seven participants (M-age = 15.79; SD = 1.71; 62% Black, 23% Hispanic) recruited from community-based organizations in the southeastern U.S. were compared to a non-equivalent comparison group who received an attention-matched intervention. Findings support the feasibility of participant recruitment and program administration in community-based settings. Participants completed HEART in 44 minutes and experienced few technological difficulties. HEART was highly acceptable: most participants liked, learned from, and were engaged with the program. Further, 92% would recommend HEART to a friend and 98% would use what they learned in the future. At posttest, intervention participants had significantly higher communication intentions, communication skills, STI/HIV knowledge, sexual self-efficacy, condom attitudes, and condom norms than the comparison group (ps < .003; effect size ds = .38-1.65). Significant improvement in condom intentions was observed when comparing pretest to posttest scores among intervention participants only, t(46) = -3.21, d = 0.47. Findings support the feasibility, acceptability, and efficacy of HEART among adolescent girls with EBDs in community-based settings. This study also addresses the growing need for research into the transferability of sexual health interventions to facilitate evidence-based decision-making about program dissemination and implementation.

Motor problems in children with severe emotional and behavioural difficulties.

There is growing evidence that children with motor difficulties are at risk of psychosocial problems and vice versa. However, it is not clear how far different aspects of motor function are predictive of psychosocial well-being in the context of other powerful factors, such as family upset, that are known to affect psychosocial development. To investigate the role of basic motor skills and primary reflex persistence in young children with severe emotional and behavioural difficulties (EBD). From a total sample of 225 children, three groups were selected: children excluded from school (severe EBD) (n=29), a male comparison group (n=38), and a female comparison group (n=45). The groups were matched (at group level) on age, IQ, and level of social disadvantage. All of the selected children completed a range of standardized motor, cognitive, social, and behavioural measures, as well as a clinical protocol for primary reflex persistence. Children with severe EBD had significant levels of motor difficulties, primary reflex persistence, and family upset, as well as significant literacy problems, attention deficits, and raised levels of hyperactivity/impulsivity relative to the comparison groups. A hierarchical multiple regression analysis revealed that basic motor skills, primary reflex persistence, family upset, hyperactivity, and literacy were all significant predictors of psychosocial functioning. The findings suggest that motor difficulties and primary reflex persistence may act as independent stressors of psychosocial functioning in children with EBD. We suggest that specific movement interventions should be adopted to complement existing provision for children at risk of psychosocial problems.

Negative Cognition, Emotional and Behavioural Difficulties, Negative Life Events and Depressive Symptoms among Adolescents in Oman

Knowledge on Omani adolescents’ vulnerability to depression is very limited. The current study examines the associations between Omani adolescents’ depressive symptoms (DS) and three central constructs: negative cognition (NC), as reflected by the individual’s view of self (VoS), view of the world (VoW) and view of the future (VoF), emotional and behavioral difficulties (EBDs), and negative life events (NLE). The Symptom Check List (SCL-90R), Strengths and Difficulties Questionnaire (SDQ), Cognitive Triad Inventory for Children (CTI-C), and Negative Life Events Checklist (NLEC) were administered to a sample of 486 students aged between 13 and 16 from high schools in the southern region of Oman. A path analysis tested the effects of NC, EBDs, and NLE on Omani adolescents’ DS. Findings revealed that EBDs and NLE have direct effects on Omani adolescents’ DS. Similarly, the hypothesis that NC has direct effects on DS was partially supported. Our hypothesis, that EBDs and NLE may confer vulnerability to DS among Omani adolescents through NC, received partial support. The cognitive vulnerability hypothesis of depression is partially supported in an Arab sample. It could be argued that the hypothesis is culturally bound.

Emotional and Behavioral Difficulties, Communication, Intelligence, and Reasoning in Children with Hearing Difficulties

This study aims to investigate whether emotional and behavioral difficulties (EBD) differ between children with cochlear implants (CIs) or hearing aids (HAs), according to multi-informant ratings. Methods: A battery of psychological measures (e.g., Strengths and Difficulties Questionnaire (SDQ), Illinois Test of Psycholinguistic Abilities (ITPA), Peabody Image Vocabulary Test (PPVT), and Raven Progressive Matrices Test (RPM), was administered to children with CIs or HAs. The study involved 187 children with CIs, 113 children with HAs, 176 fathers and mothers, and 300 schoolteachers. Results: Significant disagreements were found between children, parents, and schoolteachers with regard to SDQ ratings. Total SDQ difficulties score correlated poorly with other outcomes (e.g., total ITPA, final PPVT, and final RPM). Regression linear analyses showed six socio-demographic and linguistic covariates that significantly predicted children’s total SDQ difficulties score. Conclusion: Several independent variables were found to be associated with children’s total EBD scores. This article highlights the importance of providing professionals with sufficient training so that they are knowledgeable about the procedures they are to use to support children with EBD (e.g., developing and implementing instructional approaches for school students with EBD).

Comparing parent and teacher ratings of emotional and behavioural difficulties in 5-year old children who are deaf or hard-of-hearing

ABSTRACTChildren who are deaf or hard of hearing (DHH) are at higher risk of developing mental health problems. This study reports on the parent and teacher ratings of emotional and behavioural difficulties (EBD) in 5-year old DHH children. It explores the similarities and differences between informants, and the risk and protective factors associated with parent and teacher-ratings of EBD. Parents and teachers of 224 DHH children completed questionnaires on children's EBD and functional auditory behaviour. Children completed standardized assessments of non-verbal cognitive and language abilities. On average, parent- and teacher-rated EBD were 0.42 and 0.20 standard deviations higher than typically developing children. Parents reported more behavioural problems (hyperactivity and conduct), whereas teachers reported poorer prosocial behaviour. Inter-rater correlations were generally low to moderate (0.29 to 0.50). Overall, children with additional disabilities, lower non-verbal cognitive ability, and poor functional auditory behaviour were at higher risk of EBD. Language ability was only a significant predictor of teacher-rated EBD for children with hearing aids but not cochlear implants. Differences in informant-ratings emphasize the need for a multi-informant approach to get a global perspective on the psychopathology of DHH children. The findings indicate that parents may need assistance with managing behavioural problems at home, and teachers should facilitate more opportunities to practice prosocial behaviour at school. Intervention efforts should focus on facilitating good functional listening skills, as this may in turn, improve the mental health of young DHH children.

Pre-service educators’ dispositions toward inclusive practices for students with emotional and behavioural difficulties

ABSTRACTIn response to challenging behaviour from students with emotional and behavioural difficulties (EBD), teachers around the world often label students as challenging, defining them by their disability. Negative views of students with EBD are a barrier to their inclusion and a major challenge for policy in the United States and elsewhere associated with access to the education system for students with disabilities. Pre-service teacher education has been highlighted as an optimum time to instil in pre-service educators a more equitable disposition toward behaviour management and inclusive practices. Therefore, the purpose of the current mixed-methods study was to assess whether or not an undergraduate course focused on relationship-based approaches to positive behaviour support could impact pre-service educators’ dispositions toward inclusive classroom practices for students with EBD. Survey results from 41 pre-service educators indicated that participants made significant improvements in their knowledge and understanding of compassionate behaviour management, intentional relationship building, and establishment of a welcoming classroom environment. Analysis of participants’ written responses to open-ended questions revealed several themes regarding changes in dispositions toward students with EBD. Implications for pre-service educator preparation and inclusion of students with EBD are discussed.

Rock drumming enhances motor and psychosocial skills of children with emotional and behavioral difficulties

Objectives: Drumming may have therapeutic and learning benefits but there exists little causal evidence regarding the benefits for children with emotional and behavioral difficulties (EBD) such as Autistic Spectrum Disorder.Methods: Six EBD pupils (EBD Drum) and six peers (Peer Drum) were given 2, 30-min rock drumming lessons per week, over 5 weeks. Six matched individuals received no drumming instruction (3 = EBD Control; 3 = Peer Control). An exploratory, mixed-methods analysis was used to explore quantitative changes in skills and qualitative perspectives of the teaching staff. All pupils were tested two times (pretest and posttest) on drumming ability and Motor skills (Movement Assessment Battery for Children, version 2). Teacher’s rating of social behavior (Strength and Difficulties Questionnaire; SDQ) was tested two times (pretest and retention). Results: Significant differences in total SDQ difficulties between the four groups (χ2(3) = 8.210, p = 0.042) and the hyperactivity subscale (χ2(3) = 10.641, p = 0.014) were observed. The EBD Drum group had greater reductions in total difficulties compared to the Peer Drum (p = 0.009) group and specifically greater reductions in hyperactivity compared to Peer Drum (p = 0.046) and the EBD Control (p = 0.006) group. In follow-up interviews, staff spoke positively about changes in pupil’s attitudes toward learning and social confidence.Conclusions: The positive changes to social and behavioral skills reported in this pilot study are similar to those recorded for other music modalities.

Concomitant Exposure to Animal Maltreatment and Socioemotional Adjustment among Children Exposed to Intimate Partner Violence: a Mixed Methods Study.

This study uses a mixed-methods approach to examine how patterns of exposure to animal maltreatment (AM) are related to socioemotional adjustment among children (N=291) recruited from intimate partner violence (IPV) services. First, latent profile analysis (LPA) was used to identify subgroups of children with similar patterns of socioemotional functioning. Next, qualitative data from mothers and children were analyzed to identify thematic patterns in AM exposure among two subgroups of children identified through the LPA: Asymptomatic children and children with Emotional and Behavioral Difficulties (EBD). Seven themes were identified. Overall, EBD children, when compared to Asymptomatic children, were more likely to: a) have been exposed to severe forms of violence against animals, b) have experienced direct victimization by an IPV perpetrator following an effort to protect a pet, and c) express justification and normalization of violence against pets. Implications of our findings for research and clinical practice are discussed.

One of the gang? Peer relations among students with special educational needs in Irish mainstream primary schools

Internationally and in Ireland, the adoption of inclusive education frameworks have been broadly welcomed, particularly by parents of children with special educational needs (SEN). Mainstreaming these children is generally viewed as positive primarily because of the social factors associated with attending mainstream schools for children with SEN. Despite this commonly held view, there is increasing evidence to show that children with SEN have difficulties participating in mainstream environments. Using data from the Growing Up in Ireland study of 8,578 nine year olds, this paper examines whether peer relations differ among typically developing students and students with different types of SEN. We focus on the quantity and quality of peer relations using data on the child’s number of friends and, using the Strengths and Difficulties Questionnaire, the quality of relations with their peers. These measures are examined by controlling for a range of individual, home and school-level factors simultaneously in a regression model. Our findings show that, all else being equal, students with SEN, particularly those with emotional and behavioural difficulties (EBD), are more likely to have fewer friends and experience negative peer relationships compared to their peers without any additional needs. Based on these findings, we argue that specific interventions may be needed to promote positive peer experiences for children with SEN in mainstream education.