Management Of Behavioral Problems Research Articles

영유아 문제행동지도를 위한 긍정적 행동지원 프로그램의 효과성 연구

The purpose of this study is to examine the changes in teachers' instructional efficacy and perceptions of positive behavior support(PBS) by implementing a teacher education program based on PBS for teachers who experience difficulties in managing problem behaviors in early childhood education settings. The program was conducted with six preschool teachers in G Metropolitan City, and its effects were analyzed both quantitatively and qualitatively. The results are as follows: First, there was a significant difference in teachers' instructional efficacy in managing problem behaviors before and after the program, with personal efficacy showing the most significant difference. Second, only rule selection and guidance factors showed significant differences in the implementation of PBS. Third, there was no significant change in perceptions of PBS. Fourth, the changes in teachers' experiences and perceptions after implementing PBS were examined through interviews, which confirmed that teachers' understanding of young children's problem behaviors and their perceptions of these behaviors had positively changed. This study suggests further research to verify the actual positive changes in children's behavior as it serves as an exploratory study into the prevention of problem behaviors and the promotion of creativity through positive behavior support.

Behavioral Patterns Toward Preventive Dental Care at School Dental Camps: An Observational Study in Bengaluru.

Background Dental behavior management problems of children towards preventive dental careat school dental camps in India remain largely undocumented. This study aimed to assess such behavior patternsin preschool and school-age children at a school dental health camp. Materials and methods The cross-sectional study included 462 children, with 261 children each in the preschool (three to five years old) and school (six to 12 years old) age groups in Bengaluru. On the school dental camp day, theirbehavior and anxiety were gauged using the Frankl Behavior Rating Scale and the Raghavendra, Madhuri, and Sujata Pictorial Scale, respectively. The Chi-square test was used to uncover predictive variables for children's behavior patterns towardpreventivedental procedures at the dental school camps. Results A high prevalence of definitely negative Frankl Behavior Rating Scale ratings (59%, n=272) and dental anxiety (53%, n=245) were noted among the participants. Age, sex, the area of residence of the child, and the previous history of dental visits and treatment were predictors of their behavior at a school dental camp setup. Conclusion The present study gives an insight into the behavior of children towards preventive dental care at a school dental campin a mobile dental van, stressing the need for behavior assessment before the treatment.

The Impact of Molar Incisor Hypomineralisation on Children and Adolescents: A Narrative Review

Molar incisor hypomineralisation (MIH) is a qualitative developmental enamel defect with a prevalence of 13% worldwide. This review aims to outline the current evidence regarding the impact of MIH on children’s oral health and, more broadly, their day-to-day activities. MIH is associated with negative sequelae, including hypersensitivity, post-eruptive breakdown, the rapid development of carious lesions and poor aesthetics. Other concerns pertain to the clinical management of MIH and include difficulty in achieving local anaesthesia, increased dental fear and anxiety (DFA) and increased behaviour management problems. Oral health-related quality of life (OHRQoL) is the most standardised measure of patient impact; however, no instruments have been validated for use in MIH populations. The few existing observational studies investigating the impact of MIH on OHRQoL in children have produced conflicting results. Interventions to alleviate hypersensitivity and improve aesthetics had a positive impact on the OHRQoL of MIH-affected children. Multiple methodological issues make it difficult to measure the impact of MIH, including heterogeneity in the MIH severity classification, an overlap in the indices used to diagnose dental caries and MIH as well as the subjectivity of outcome measures for hypersensitivity and DFA.

Effects of Sensory Integration to Manage Behavior Problems of Children with Autism Spectrum Disorder

Background: Play is an occupation that promote learning and socializing among children, physical play involves different gross motor skills and stimulate sensory processing specifically proprioception and vestibular. The objective of the study is to evaluate the impact of sensory based sports on sensory pattern of children and to discover the effect of sensory smart sports on proprioception and vestibular for behavior management. Methods: 62 Children with ASD mild to moderate were enrolled in the study from different rehab institutes from Karachi such as psyche care, learning hands and exceptional mind. The participants have definite and probable score at their proprioception and vestibular processing component at sensory profile with poor emotional and behavior regulation. They were involved in sensory smart sports for six months than reassessed on the same domain of sensory profile to check the behavior management. Results: Significant mean variance was obtained between the pre and post score range at proprioception and vestibular processing leading. Conclusion: Sensory integration therapy is always being use as therapeutic tool as one of the most effective intervention in management of Autism. The implementation of sensory integration ideation in sports through games culturally intact can be applied to developand sustain interest, focus and above all develop good behavior. Keywords: Sensory Integration Therapy, Autism, Proprioception, Vestibular, Behavior, Sensory Smart Sport.

Blended Learning for Enhancing Nursing Students' Confidence in Managing Psychiatric Nursing Problems.

The purpose of the study was to understand the effectiveness of a blended learning model for improving nursing students' confidence in the management of psychiatric care problems. A pretest-posttest design was used with 94 third-year student participants. Students' self-confidence in managing problem behaviors improved from pretest scores. The experimental group demonstrated significant improvement ( p < .05) in areas including distinguishing between delusion and disturbance, distinguishing and controlling behavioral disturbance, practicing gentle and firm interactions, showing empathy, interview guiding, accepting the responsibility of the team, and confidently enforcing constraints. Audiovisual teaching materials provided in the intervention had significant effects.

Factors in the Development of Somatoform Disorders Among Children: A Case-Control Study.

Introduction Somatoform disorders (SFDs) are a spectrum of diseases mainly manifesting with physical symptoms of no recognizable etiology. These disorders are believed to be primarily influenced and exacerbated by psychological factors. Given the connection between parental sociodemographics and psychological factors and SFDs, there is a pressing need to investigate this area further, particularly concerning parents and their children affected by somatoform disorders. Aims and objectives The aims and objectives of this study are as follows: i) study the determinants of SFDs, namely, parent handling of child, parent-child relationship, parenting with respect to attending to the needs of children, and intelligence quotient (IQ) of parents, and ii) compare host factors to the factors matched in control subjects. Materials and methods We adopted purposive sampling in our case-control study. The study sample was obtained from the psychiatry department of the Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India, from September 2020 to December 2022, once a week, every Monday. Children manifesting SFD manifestations that are among the chief complaints were included in our study. Results A total of 115 cases were included in our study based on inclusion criteria. The study compared sociodemographic characteristics, intelligence quotient (IQ), parental characteristics, parental handling, parent-child relationships, and parenting practices between a patient group and a control group. The results showed no significant differences in sex, religion, occupation, domicile, and socioeconomic status in both control and patient groups. However, significant differences were found in parental characteristics, such as lower mean age, education, and IQ, in the patient group. This difference between the patient and control groups with respect to the parental handling questionnaire was statistically significant for the domain of "praise," "talk," "feel better," "comes to you," "unduly strict" items, "frequently reprimanded," "tried to control everything," creative activities, protectiveness, education, neglecting, objective punishment, housing, medical care, demanding, symbolic reward, loving, objective reward, food, parent-to-child communication, clothing, support, routine, recreation, social activities, rules, managing problem behavior, guidance for career, and security. Conclusion Parents were deficient in terms of years of education, occupational status, IQ, parental handling, parent-child relationship, and parenting with respect to the children's needs. These findings offer insights into the sociodemographic and psychological factors contributing to the patient group's condition.

Playing it down - effectiveness of clay therapy, origami and building blocks in the management of dental anxiety among children aged 6-10 years

Background: Children experience dental anxiety during their first dental visit, which affects the quality of dental treatment and gives rise to behaviour management problems. Clay, origami and building blocks have been effective in alleviating hospitalization anxiety in pediatric patients. These successful techniques in hospitalized pediatric patients have seldom been used in the dental set up. Therefore, the aim of this study is to assess and compare the efficacy of clay therapy, origami and building blocks in the management of dental anxiety in children aged 6-10 years. Methods: Sixty children aged 6-10 years, with no previous dentist exposure, with Frankl’s behaviour rating 2 or 3 having dental caries with international caries detection and assessment system (ICDAS) score 3 requiring restorations without local anesthesia were selected and divided into four groups. Group 1 – clay therapy; group 2 - building blocks; group 3 – origami; and group 4 – tell show do. Pulse rate, facial image scale (FIS) and face, leg, activity, cry, consolability (FLACC) behaviour scales were used to quantify anxious behaviour. Operator compliance and parent acceptance was rated on the Likert scale. Results: The results showed lower mean pulse rates, lower FIS and FLACC scores, and better operator compliance and parental acceptance in clay therapy, origami and building blocks groups than in the conventional tell-show-do group. The most significant reduction in all the parameters was seen in the clay therapy group. Conclusions: Clay therapy, origami and building blocks can be used as an effective means to reduce dental anxiety in children.

Psychotropic medication for problem behaviours in intellectual disability and autism spectrum disorder: the need for caution

SUMMARYMany persons with intellectual developmental disorders and/or autism spectrum disorder presenting problem behaviours undergo pharmacotherapy without receiving an appropriate psychiatric assessment and diagnosis. Instead, prescription of psychotropic medication should have specific aims and involve interdisciplinary assessment, personalisation and patient and family participation. Current knowledge about pharmacological management of problem behaviours in this population is limited, necessitating extreme caution in clinical practice and more research into the complex interrelated factors that affect presentation, course and treatment response.

Prevention and reduction of school deviance through programs of psychosocial rehabilitation of pupils

In the school environment, interventions focused on positive things are effective in managing deviant behavior problems among students. The ideal objective is for the school to begin to adopt systemic changes that involve managing problem behaviors in a positive and preventive manner and with the help of the other factors involved, with the aim of fostering a collaborative partnership between adults and children, which encourages the latter to solve the problems that affect their lives. The best solutions must be found to lead to the improvement of communication relationships, to help children, adults learn, and model positive skills related to human nature: empathy, honesty, to help them understand that inappropriate behavior that can affect others and that the solution is to solve problems without conflict.

Influence of Child's Temperament on Behaviour Management Problems in the Dental Office: A Literature Review.

A child's temperament could have an influence on his/her behaviour in the dental environment. This review aims to present the main temperament surveys and their clinical use and to discuss the relationship between certain temperament dimensions and Dental Behaviour Management Problems (DBMP). A literature search was conducted in Medline/PubMed, ScienceDirect, Wiley Online Library and Cochrane library electronic databases for publications, up to June 2022, investigating the link between child's temperament and DBMP. From 733 potentially eligible studies, 12 were included in qualitative synthesis. According to studies using the Child Behaviour Questionnaire (CBQ) scale, the most impactful dimensions are activity, extraversion and surgency, high-intensity pleasure and attention control. For those using the Emotionality-Activity-Sociability (EAS) scale, emotionality and shyness have a statistically significant positive linear correlation with dental anxiety and DBMP. It has yet to be determined whether the use and interpretation of these questionnaires can be carried out in a daily clinical situation as an aid to sharpen the indications for the several levels of sedation.

Do patients with molar incisor hypomineralization have more dental anxiety and behavior management problems? A systematic review with meta-analysis.

This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and dental behavior management problems (DBMPs) than those without MIH (Prospero CDR42020203851). Unrestricted searches were performed in PubMed, Scopus, Web of Science, Lilacs, BBO, Embase, Cochrane Library, APA PsycINFO, Open Grey, and Google Scholar. Observational studies evaluating DFA and/or DBMPs in patients with and without MIH were eligible. Reviews, case reports, interventional studies, and those based on questionnaires to dentists were excluded. The methodological quality assessment was based on the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to synthesize data on DFA. The certainty of evidence was performed according to GRADE. Seven studies that evaluated a total of 3,805 patients were included. All of them presented methodological issues, mainly in the comparability domain. Most studies observed no significant difference in DFA between children with and without MIH. The meta-analysis did not show a significant effect of MIH on the standardized units for the DFA scores (SMD = 0.03; 95%CI: -0.06-0.12; p = 0.53; I2 = 0%). Synthesis including only the results for severe cases of MIH also did not show a significant effect of the condition on DFA scores (MD = 8.68; 95%CI: -8.64-26.00; p = 0.33; I2 = 93%). Two articles found DBMPs were significantly more frequent in patients with MIH. The overall certainty of evidence was very low for both outcomes assessed. The current evidence suggests no difference in DFA between children with and without MIH; DBMPs are more common in patients with MIH. This information should be viewed with caution because of the very low quality evidence obtained.

Do preterm-born children and adolescents have greater need for dental care as compared to full term-born controls?

BackgroundPreterm birth has been shown to cause various long-term health issues. Children who were born preterm have also been observed to have more dental behaviour management problems (DBMP) during dental examinations and treatment than children born full term. It is known that dental radiographic examinations can be uncomfortable and cause anxiety in paediatric patients. Thus, our aims were to retrospectively compare dental care related examinations and treatments carried out in three different age intervals (3–6 years, 7–12 years, and 13–19 years) among preterm- and full-term born children and adolescents.MethodsThe present study included 311 patient files: 122 very preterm–born and 33 extremely preterm–born children and adolescents (< 32 gestational weeks). A matched control group of 156 full term–born children and adolescents (≥ 37 gestational weeks) was analysed for comparison. Various factors, including DBMP, missed appointments, dental caries, and radiographic examinations, were retrieved from the dental records for three age intervals: 3–6 years, 7–12 years, and 13–19 years.ResultsExtremely preterm–born children missed significantly more dental appointments and presented with more DBMP during dental examinations and treatment than full term–born children in the 3–6-year age group; the same was observed for the very preterm–born in the 7–12-year age group. No significant differences in DBMP during bitewing and periapical examinations or in number of bitewing, periapical and panoramic radiographs occurred between the groups in any age interval.ConclusionPreterm–born children and adolescents may need more flexibility in booking and receive reminders for scheduled visits with the general dental team. Due to the non-significant differences in dental care related oral examinations and treatments, the same dental care service may be applied to the preterm- and full-term born children and adolescents.

Managing problem behavior and the role of metacognitive skills

Managing problem behavior and the role of metacognitive skills

Randomized Controlled Trial on an Online Training to Support Caregivers of Young Children with Intellectual and Developmental Disability managing Problem Behaviors at Home

Randomized Controlled Trial on an Online Training to Support Caregivers of Young Children with Intellectual and Developmental Disability managing Problem Behaviors at Home

Efficacy of Risperidone and Methylphenidate for Problem Behaviors and Core Symptoms in Autism Spectrum Disorder: A Randomized Trial

Background: Risperidone and methylphenidate are commonly used drugs to manage problem behaviors in individuals with autism spectrum disorder (ASD). Studies report that these 2 drugs may be helpful in improving core symptoms of ASD as well. Aim: To assess and compare the efficacy and safety profile of risperidone and methylphenidate for problem behaviors and core symptoms in children and adolescents with ASD. Setting and Design: An 8-week, prospective, interventional, randomized, and open-label trial carried out in a tertiary care hospital of northern India. Materials and Methods: Forty subjects with a diagnosis of ASD according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition were randomized to risperidone and methylphenidate groups. Childhood Autism Rating Scale, Second Edition, Indian Scale for Assessment of Autism, and Nisonger Child Behavior Rating Form were used for assessments. Adverse effects, physical, and laboratory parameters were monitored regularly. Statistical Analysis: Tests applied include chi-square test, repeated measures Analysis of Variance, and Student t test, and nonparametric tests for skewed data. Data was analyzed using SPSS Version 22.0. Level of significance was set at 0.05. Results: Both drugs improved inattention, hyperactivity, and stereotypies. Methylphenidate reduced self-isolation, and risperidone improved emotional dysregulation, aggression, and self-injury. Adverse effects were seen in 55% of methylphenidate group (commonly decreased appetite and irritability) and 40% of risperidone group (commonly sedation and increased appetite). Improvement in stereotypy with both drugs and self-isolated behavior with methylphenidate indicates a possible role in improving core symptoms of ASD. Conclusion: Both drugs were beneficial in the management of behaviors associated with ASD. Further research to establish their role in reducing core symptoms and long-term safety is warranted.

Behaviour management problems in Finnish children with operated congenital heart disease: a practice-based study

PurposeThis retrospective, practice-based study investigates behaviour management problems (BMPs) in dental care among Finnish children with operated congenital heart disease (CHD).MethodsAll the heart-operated children born between the years 1997 and 1999 were identified in the national ProCardio database (n = 570). Primary dental care records were requested from this population and were eventually received from 211 patients. Information on gender, diagnosis, number of heart operations and perioperative care were collected from the ProCardio database, and the CHDs were categorised as shunting/stenotic/complex/other defects. Data on BMP/dental fear, oral conscious sedation, dental general anaesthesia (DGA) and past and present caries indices at 6, 12 and 15 years (d/D, dmft/DMFT) were assessed.ResultsNotes on behaviour management problems or dental fear were found in 19% of the study population. BMPs in dental care were more frequent among boys. Children with re-operations, longer post-operative intensive care stay and hospitalisation, and complications had not more BMP than others. Those children diagnosed with syndromes had more BMP often than the rest. Past and present caries experience were significantly associated with BMP, need of oral conscious sedation and DGA. Oral conscious sedation, nitrogen oxide sedation and dental general anaesthesia were used in 17/211, 2/221 and 24/211 CHD patients, respectively.ConclusionDental caries remains a main factor associated with BMP in the CHD population. Need for oral conscious sedation and DGA were rather common. To maintain a good oral health and to avoid development of BMP, CHD children benefit from focus in health promotion and preventive care.

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model.

Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.

Impact of dental caries on oral health-related quality of life in children with dental behavior management problems.

The aim of this cross-sectional study was to evaluate the impact of dental caries and sociodemographic factors on the oral health-related quality of life (OHRQoL) of children with dental behavior management problems (DBMP) and their families. One hundred and thirty-four dyads of caregivers and children participated. The impact of OHRQoL was assessed using the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). Socioeconomic variables were obtained from an interview. Dental caries was assessed using the dmft index. The total B-ECOHIS score was categorized as low, medium, or high impact, and its association with the independent variables was determined based on bivariate tests and a multivariate model. The median score for B-ECOHIS was 13 (range: 1-40). The negative impact was reflected mainly by complaints of oral/dental pain, difficulty in eating and parental guilt. The number of teeth with caries was significantly higher among children who experienced a high negative impact on OHRQoL (mean 9.2 [standard deviation 3.5]; p = 0.003) than those who had a low negative impact (7.0 [3.3]). The final adjusted model showed that dental caries remained independently associated with poor OHRQoL (b = 0.100; x2 Wald 4.205; p = 0.040). A greater impact on OHRQoL was experienced by children with DBMP and greater caries experience.

Beta test of a mobile health application for dementia caregivers

AbstractBackgroundDementia caregivers are at risk for negative health outcomes. Caregiver interventions to address this risk are limited by time and personnel constraints. Mobile technology is one means of reaching many caregivers while mitigating these constraints. The aim of the current project was to obtain initial data from a month‐long beta test of a new mobile health tablet App for dementia caregivers.MethodA purposive sample of community‐dwelling dementia caregivers was given access to the CARE‐Well (Caregiver Assessment, Resources, and Education) App for one month. The App consisted of 6 primary sections: (1) Self‐Assessment of Stress and Care Recipient Behavioral Problems; (2) Psychoeducation; (3) Goal Diary; (4) Managing Behavior Problems; (5) Online Message Forum; and (6) Video Library. Feedback was collected from caregivers in a qualitative interview following study completion. Data were analyzed via a mixed‐methods approach.ResultCaregivers (n = 10) were White, in their mid‐60s (M = 66.2, SD = 12.12), and well educated (M = 16.00 years, SD = 1.63). Care recipients had either mild (80%) or moderate dementia (20%), and 90% had probable Alzheimer’s disease. The average total time spent on the App across all participants was 754.29 minutes (SD = 1584.12). The most heavily used (in minutes) sections of the App were: Managing Behavior Problems (M = 592.10, SD = 1595.75), Video Library (M = 54.33, SD = 88.18) and Psychoeducation (M = 53.18, SD = 54.50). Qualitative feedback was predominantly positive. Caregivers reported Managing Behavior Problems to be the most helpful section followed by Psychoeducation and Online Message Forum. Caregivers reported difficulty with or disinterest in the Goal Diary section. In general, caregivers reported that the App would have been more helpful earlier in their care recipient’s illness.ConclusionResults indicated that caregivers regularly used the App and provided mostly positive responses to content. Findings highlighted the importance of user feedback and an iterative approach for developing digital health technology for dementia caregivers. Future interventions that are introduced earlier in the disease process may be well‐received and more beneficial to a wider range of dementia caregivers and their care recipients.

Longitudinal study of the cascading effects of racial discrimination on parenting and adjustment among African American youth

ABSTRACT Attachment theory posits that parenting plays akey role in children’s attachment and subsequent development. Given the normativity of racial discrimination on everyday life experiences of African American families, there is a need to integrate historical and socio-environmental processes in studies to understand how minoritized parents raise secure and stable children. Results from the current study revealed direct associations between mothers’ reports of discrimination and heightened depression and anxiety. Maternal discriminatory experiences were indirectly associated with more negative parenting and compromised parent-child relationship quality, through mothers’ psychological functioning. Elevated emotional and behavioral management problems among youth were directly associated with exposure to racial discrimination. Exposure to discrimination during middle childhood facilitated adapted or learned strategies to manage similar situations as youth transitioned into adolescence, with reduced patterns of depressive symptomology. No significant gender effects emerged. Implications for theoretical advancement and future research are provided.