Child Behavior Checklist Parent Research Articles

Psychopathology and Adaptive Functioning in Children, Adolescents, and Young Adults with Noonan Syndrome.

The objective of this study was to examine psychopathology and its impact on adaptive functioning in a sample of patients affected by Noonan syndrome (NS), a genetically heterogeneous condition with systemic manifestations. Forty-two subjects affected by NS (23 males and 19 females), aged 5 to 21 years (mean 12.6 ± SD 5.1), were assessed for nonverbal cognitive abilities, with dimensional measures of psychopathology, adaptive functioning, and family quality of life. The nonverbal intelligence quotient (IQ) mean was 99.4 ± SD 22.2, with 3 subjects (8%, 95% confidence interval [CI], 1.6%-20.9%) showing cognitive impairment (IQ<70). The Parent Child Behavior Checklist (CBCL) total psychopathology score was in the clinical range in 10% of sample and borderline in another 10%. On the Conners' Parent Rating Scales, scores suggestive of attention-deficit/hyperactivity disorder (ADHD) were in the clinical range in 20%. On the autism quotient, autism spectrum disorder symptoms were reported in 10%. Higher scores on the Adaptive Behavioral Assessment System-Second Edition and on the World Health Organization Quality of Life (26 items) were associated with lower problems on the CBCL (r = -0.63, 95% CI, -0.78 to -0.40 and r = -0.48, 95% CI, -0.69 to -0.20, respectively). Psychopathology was common in patients with NS and negatively correlated with global functioning and family quality of life. Treatable psychopathology, such as ADHD, may constitute a treatment target for improving adaptive functioning.

Humanistic Counseling with Latinx Youth from Low-income Communities

ABSTRACT The present study investigated the influence of a humanistic school-based mental health counseling intervention (HSBMHCI) on Latinx students’ (N = 18) behavioral and emotional problems at three Title I elementary schools. Upon completion of the 10-week HSBMHCI, the study employed a single-group, pretest-posttest design to examine change in the participants’ scores for internalizing and externalizing behaviors per both parent and teacher reports. Results identified that based on Child Behavior Checklist parent reports, the participants’ internalizing (ƞ2 = .497), externalizing (ƞ2 = .401), and total problem (ƞ2 = .575) scores exhibited significant improvement over time. However, teacher reports identified no change in the participants’ problem scores. In addition, no correlation was identified between parent and teacher report scores at posttest.

Perampanel tolerability in children and adolescents with focal epilepsy: Effects on behavior and executive functions

ObjectivesPerampanel (PER) is a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptor antagonist recently approved for focal and generalized epilepsies as an add-on therapy. It is well tolerated and effective as treatment of various pediatric epilepsy syndromes; PER does not seem to negatively affect the cognitive profile of children and adolescents, but its influence on executive functions is still to be assessed. MethodsOur sample included 37 children aged 12–18 years, with focal pharmacoresistant epilepsy already in therapy with 2 or 3 antiepileptic drug (AED); PER was added with 1 mg/week increments up to a dose of 2–4 mg/day. Changes in executive functions were assessed by the EpiTrack Junior test. Emotional and behavioral aspects were evaluated through the interview for parents Child Behavior Checklist (CBCL). Both tests were performed before taking PER and after 6 and 12 months of treatment. ResultsAfter 12 months of PER in 22/30 patients, global score of the EpiTrack Junior test remained almost unchanged; in 7/30 patients, this score improved. The CBCL did not show significant changes in emotional or behavioral problems. ConclusionsAdjunctive treatment with PER did not negatively affect executive functions that could also be improved. No emotional/behavioral negative effects have been reported, and this suggests a good tolerability in the middle/long term.

An Emotion Focused Family Therapy workshop for parents with children 6-12 years increased parental self-efficacy

ABSTRACTIn this pilot study, we examined whether a 2-day Emotion-Focused Family Therapy workshop strengthened parental self-efficacy, satisfaction and beliefs regarding their ability to help their children regulate emotions and reduce the children’s symptoms of behavioural- or psychological difficulties. Twenty-three caretakers with 17 children (9 boys) aged 6 to 12 years old completed the workshop. Pre, post and 3-month follow-up data on the Parents` Beliefs About Children`s Emotions – Guidance scale and Parenting Sense of Competence scale, as well as pre and 3-month follow-up data on the Child Behaviour Checklist parent form, were used to assess the effects of the intervention. Parental self-efficacy significantly increased, the caretakers` satisfaction in the parenting role significantly increased but faded after 3 months and the caretakers` beliefs that children can guide their emotions on their own were significantly reduced. Finally, oppositional defiant problems in the children significantly declined.

A Comparative Study on the Effectiveness of Individual and Group Play Therapy on Symptoms of Oppositional Defiant Disorder among Children.

BackgroundThis research compared the effectiveness of play therapy provided individually or in groups for oppositional defiant disorder (ODD) symptoms among children.MethodsThis was a randomized controlled trial that used a multi-stage random sampling method. Participants included 45 children aged 6 to 10 years old with ODD, all of whom had been referred to medical consultation centers in Ahvaz, Iran in 2012. Experimental groups consisted of 15 children receiving individual play therapy and 15 receiving group play therapy, while the control group consisted of 15 randomly selected children. Data were collected using the child behavior checklist parent report form and teacher report form, along with clinical interviews with the parents. Play therapy took place weekly for eight total sessions; individual sessions lasted 45 minutes each, while group sessions were each 60 minutes in duration. Participants were assessed in three stages, including preintervention, post-intervention, and at 2-month follow-up. PASW SPSS ver. 18.0 software (SPSS Inc., Chicago, IL, USA) and analysis of covariance analysis methods were used to analyze data.ResultsResults showed meaningful decreases in ODD symptoms in the experimental groups in comparison with the control group, based on parent reporting (P≤0.001 and F=129.40) and the teacher reports additionally showed meaningful decreases in ODD symptoms in the experimental groups compared to the control group, (P≤0.001 and F=93.14). Furthermore, the effects were maintained after 2 months.ConclusionThis research supports the efficacy of individual and group play therapy for the treatment of ODD in children, as well as the consistency of the effects at 2-month follow-up.

Parent and Teacher Reports of Comorbid Anxiety and ADHD Symptoms in Children with ASD

This study examined the prevalence of ADHD symptoms and anxiety as reported by parents and teachers for 180 preschool children (ages 4-5) and school-aged children (ages 6-7) with ASD using the Child Behavior Checklist-Parent and Teacher Report Forms (Achenbach and Rescorla, Manual for ASEBA school-age forms & profiles, Research Center for Children, Youth, and Families, University of Vermont, Burlington, VT, 2001). Parents reported elevated anxiety symptoms in 31% of preschool children and 50% of school-aged children, while teachers reported lower rates of 5 and 30%, respectively. Parents reported elevated ADHD symptoms in 22% of preschool children and 45% of school-aged children, while teachers reported elevations in 20 and 24%, respectively. There was low concordance between parents and teachers, with teachers reporting fewer problems overall. Specific behaviors endorsed by parents and teachers are also discussed.

Etiology of Stability and Growth of Internalizing and Externalizing Behavior Problems Across Childhood and Adolescence.

Internalizing and externalizing behaviors are heritable, and show genetic stability during childhood and adolescence. Less work has explored how genes influence individual differences in developmental trajectories. We estimated ACE biometrical latent growth curve models for the Teacher Report Form (TRF) and parent Child Behavior Checklist (CBCL) internalizing and externalizing scales from ages 7 to 16years in 408 twin pairs from the Colorado Longitudinal Twin Study. We found that Intercept factors were highly heritable for both internalizing and externalizing behaviors (a2=.61-.92), with small and nonsignificant environmental influences for teacher-rated data but significant nonshared environmental influences for parent-rated data. There was some evidence of heritability of decline in internalizing behavior (Slopes for teacher and parent ratings), but the Slope genetic variance was almost entirely shared with that for the Intercept when different than zero. These results suggest that genetic effects on these developmental trajectories operate primarily on initial levels and stability, with no significant unique genetic influences for change. Finally, cross-rater analyses of the growth factor scores revealed moderate to large genetic and environmental associations between growth factors derived from parents' and teachers' ratings, particularly the Intercepts.

Parental reports of behavioural outcome among paediatric leukaemia survivors in Malaysia: a single institution experience.

To determine the behavioural impact of chemotherapy in survivors of acute lymphoblastic leukaemia (ALL) treated with chemotherapy only and to identify treatment-related or sociodemography-related factors that might be associated with behavioural outcome. We examined 57 survivors of childhood ALL, who were off treatment for at least 2 years and were in remission, aged 4-18 years, and 221 unrelated healthy controls. The Child Behaviour Checklist (CBCL) parent report was used either in English or in Bahasa Malaysia (the national language of Malaysia) to assess the behavioural outcome. Childhood ALL survivors had significantly higher scores on externalising behaviour on the CBCL parent report than did controls. Higher problem scores were found in ALL survivors with single parents on 'total problems' (P = 0.03) and subscales 'withdrawn' (P = 0.03), 'social problems' (P < 0.01) and 'delinquent behaviour' (P = 0.03) than in survivors with married parents. Significant associations were seen between a lower education level of the father and the variables representing internalising (withdrawn, anxious/depressed) and externalising (aggressive behaviour). We observed trends on higher scores in all scales in ALL survivors with single parents than in controls with single parents or with fathers with low education level, especially primary education only. Malaysian childhood ALL survivors had a significantly increased risk for externalising behavioural problems, and there was a trend towards increased risk of problems in many other behavioural scales. Understanding the sociocultural dimension of patients' health is important to be able to design the most appropriate remedy for problem behaviours detected in this multi-ethnic population.

The Caffeine for Apnea of Prematurity (CAP) Trial: Preliminary Outcomes at 5 Years

Background: The CAP trial enrolled 2006 infants with birth weights 500-1250 g who were randomly assigned to caffeine therapy or placebo for apnea of prematurity (N Engl J Med 2006; 354: 2112 and 2007; 357:1893). Objective: To reassess CAP trial participants at 5 years. Design and methods: The main outcome at 5 years was a composite of death or survival with disability in one of 6 domains including neuromotor function, cognition, behaviour, and general health. Standardized tests included the Gross Motor Function Classification System (GMFCS), the Wechsler Preschool and Primary Scale of Intelligence, and the Child Behavior Checklist Parent Form. Results: A total of 1932 children were eligible for the present study. Vital status was ascertained for 1810 children (94%). Adequate data for the composite outcome of death or disability were available for 1641 children (85%). Table 1 shows the results for the composite outcome and for 5 of its components. Conclusions: Observed rates of functional outcomes at 5 years still favoured caffeine therapy for apnea of prematurity over placebo treatment. However, cognitive impairment was no longer reduced in caffeine-treated infants.

The Dimensional Nature of Externalizing Behaviors in Adolescence: Evidence from a Direct Comparison of Categorical, Dimensional, and Hybrid Models

Researchers have recognized the importance of developing an accurate classification system for externalizing disorders, though much of this work has been framed by a priori preferences for categorical vs. dimensional constructs. Newer statistical technologies now allow categorical and dimensional models of psychopathology to be compared empirically. In this study, we directly compared the fit of categorical and dimensional models of externalizing behaviors in a large and representative community sample of adolescents at two time points separated by nearly 2.5years (N = 2027; mean age at Time 1 = 11.09years; 50.8% female). Delinquent and aggressive behaviors were assessed with child and parent Child Behavior Checklist reports. Latent trait, latent class, and factor mixture models were fit to the data, and at both time points, the latent trait model provided the best fit to the data. The item parameters were inspected and interpreted, and it was determined that the items were differentially sensitive across all regions of the dimension. We conclude that classification models can be based on empirical evidence rather than a priori preferences, and while current classification systems conceptualize externalizing problems in terms of discrete groups, they can be better conceptualized as dimensions.

Reliability of the Luganda version of the Child Behaviour Checklist in measuring behavioural problems after cerebral malaria

BackgroundNo measure of childhood behaviour has been validated in Uganda despite the documented risks to behaviour. Cerebral malaria in children poses a great risk to their behaviour, however behavioural outcomes after cerebral malaria have not been described in children. This study examined the reliability of the Luganda version of the Child Behaviour Checklist (CBCL) and described the behavioural outcomes of cerebral malaria in Ugandan children.MethodsThe CBCL was administered to parents of 64 children aged 7 to 16 years participating in a trial to improve cognitive functioning after cerebral malaria. These children were assigned to the treatment or control group. The CBCL parent ratings were completed for the children at baseline and nine weeks later. The CBCL was translated into Luganda, a local language, prior to its use. Baseline scores were used to calculate internal consistency using Cronbach Alpha. Correlations between the first and second scores of the control group were used to determine test-retest reliability. Multicultural norms for the CBCL were used to identify children with behavioural problems of clinical significance.ResultsThe test-retest reliability and internal consistency of the Internalising scales were 0.64 and 0.66 respectively; 0.74 and 0.78 for the Externalising scale and 0.67 and 0.83 for Total Problems. Withdrawn/Depressed (15.6%), Thought Problems (12.5%), Aggressive Behaviour (9.4%) and Oppositional Defiant Behaviour (9.4%) were the commonly reported problems.ConclusionThe Luganda version of the CBCL is a fairly reliable measure of behavioural problems in Ugandan children. Depressive and thought problems are likely behavioural outcomes of cerebral malaria in children. Further work in children with psychiatric diagnoses is required to test its validity in a clinical setting.

Longitudinal Behavioral and Academic Adjustment in Children with HIV Infection

This study investigated; the behavioral adjustment and academic status of children with HIV infection through serial evaluations over a ten-year period. The parents of children were assessed with Achenbach Child Behavior Checklist Parent Forms and the children were administered the Woodcock-Johnson Tests of Academic Achievement at regular intervals as part of their treatment in the HIV Program of a children’s hospital. Children with HIV were found to have behavioral adjustment within normal limits over time. Aggressive behavior was noted to decrease over time. Academic achievement mirrored IQ status, unlike other studies, which have reported poorer achievement than expected for IQ. Math skills appeared to improve over time. Thus, these findings suggest children with HIV infection did not show significant behavioral disturbance across time, however, aggressive behavior appeared to decrease. Academic achievement was stable over time.

Open-Label Amantadine in Children with Attention-Deficit/Hyperactivity Disorder

The purpose of this study was to explore the possible efficacy and tolerability of amantadine in the treatment of attention-deficit/hyperactivity disorder (ADHD) in stimulant-naïve children. Twenty four children (5-13 years old) with Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) ADHD (4 inattentive, 2 hyperactive, and 18 combined type) entered a 6-week open-label treatment with amantadine (50-150 mg) given as a single morning dose. Parent and teacher ADHD rating scales and the parent Child Behavior Checklist (CBCL) were administered at baseline and at week 6. Twenty three subjects completed the 6-week treatment. One child dropped out at week 2 because of persistent headache, and another 12 children reported adverse effects, most commonly transient appetite decrease. The parent ADHD score decreased from mean 41.04 +/- D 6.9 at baseline to 28.9 +/- 8.7 at week 6 (p < 0.001, effect size d = 1.5), and the teacher ADHD score from 35.8 +/- 9.6 to 26.2 +/- 9.5 (p < 0.001, effect size d = 1.0). Response rate (a 25% or greater decline in ADHD score) was 58% based on parents and 46% based on teachers. These data suggest that amantadine has acceptable acute tolerability at single doses up to 150 mg/day and is possibly efficacious in decreasing ADHD symptoms, although its activity appears to be more modest than that of stimulant medications.

Treating depressive symptoms in schoolchildren

Although studies on sub-threshold depression in childhood and adolescence have demonstrated an at risk profile that merits further attention, only few investigators examined the impact of therapy with these children. In this study, twenty elementary schoolchildren (aged 10-12) with moderate depressive symptoms were randomly assigned to an eighteen-session cognitive-behavioural treatment programme or to a waiting list (WL) control group (= Study 1). The key components of the programme "Taking Action" used in the study were: affective education, problem-solving, cognitive restructuring and engaging in enjoyable activities. Child self-reports and parent reports were used to evaluate the outcome. Paired t-tests comparing the 4-months follow-up results with baseline measurements, revealed a significant improvement on the Children Depression Inventory and on the Self-Perception Profile for Children, but only in the treatment group. Afterwards, the WL control group was treated as well. All children were followed in a long-term follow-up study (= Study 2). Analyses at the 12 month stage of the follow-up study showed a further improvement of the scores on the Self-Perception Profile. Moreover, a significant decrease was found on the Children Depression Inventory, the State-Trait Anxiety Inventory and the Child Behaviour Checklist parent measure. It was concluded that the protocol is suitable for European children. The most remarkable findings in this pilot study are discussed.

Does the Child Behavior Checklist Reveal Psychopathological Profiles of Children With Focal Unilateral Cortical Lesions?

Psychopathological profiles were investigated in children with focal unilateral radiologically documented cortical lesions (15 right lesions and 22 left lesions). The 8 clinical subscales of the Child Behavior Checklist Parent Form (CBCL-P) and the Internalizing and Externalizing subscales were the dependent measures. The Internalizing and Externalizing scores did not dissociate as a function of lesion side. There were more Internalizing than Externalizing symptoms. Only the Attention Problems subscale yielded a significant difference as a function of lesion side; children with left lesions unexpectedly presented more problems. No significant differences were observed as a function of frontal versus nonfrontal lesion site, gender, or neurological variables on the Child Behavior Checklist (CBCL) subscales. Although sensitive to the presence of a focal lesion, the CBCL-P scarcely or misleadingly reflects any of the characteristics of focal unilateral cortical lesions in children. As suggested by the literature, most of the CBCL elevations in children with brain lesions could derive from the parent's and child's emotional response to any threatening medical condition.

Exposure to Violence

Inner-city children are frequently exposed to violence; however, there are few data regarding the psychological and academic correlates of such exposure in young children at school entry. To document exposure to violence in inner-city children aged 7 years; assess their feelings of distress; and evaluate the relationships of exposure to violence with school performance, behavior, and self-esteem. A study center in an inner-city hospital. One hundred nineteen inner-city children evaluated at age 7 years; 119 caregivers (biological and foster). As part of a longitudinal study, children were administered the following by a masked examiner: Things I Have Seen and Heard (TISH) to assess exposure to violence; Levonn, a cartoon-based interview for assessing children's distress symptoms; and the Culture-Free Self-Esteem Inventory, Second Edition. School performance was assessed by school reports and child behavior by the Child Behavior Checklist (CBCL), the Parent Report Form, and the Teacher Report Form. Caregivers for children were administered the parent report version of the Checklist of Children's Distress Symptoms (CCDS-PRV) as well as the CBCL Parent Report Form. Exposure to violence (TISH); feelings of distress (Levonn); school performance; behavior (CBCL Parent Report Form and CBCL Teacher Report Form); and self-esteem (Culture-Free Self-Esteem Inventory). We found that these children were frequently exposed to violence. For example, 75% had heard gun shots, 60% had seen drug deals, 18% had seen a dead body outside, and 10% had seen a shooting or stabbing in the home (TISH). Many showed signs of depression and anxiety; eg, 61% worried some or a lot of the time that they might get killed or die and 19% sometimes wished they were dead (Levonn). Higher exposure to violence (TISH Total Violence score) was correlated with higher Levonn composite scores for depression and anxiety and with lower self-esteem (P< or =.04), and was also associated with lower grade point average and more days of school absence (P< or =.02). Caregiver assessment of child anxiety correlated poorly with child report of anxiety (P =.58). Young inner-city children have a high exposure to violence by age 7 years; many show signs of distress that frequently are not recognized by caregivers. Further, higher exposure to violence in children correlates with poorer performance in school, symptoms of anxiety and depression, and lower self-esteem.

Behavioral Effects of Early Focal Brain Damage

Thirty-nine children, 4-15 years of age, were evaluated using the Achenbach Child Behavior Checklist parent questionnaire to assess behavioral or emotional problems resulting from pre- or perinatal unilateral brain damage, in a study at UCSD School of Medicine, La Jolla, CA.

Cross-setting consistency in early adolescent psychopathology: deviant friendships and problem behavior sequelae.

This study examines adult reports of externalizing and internalizing psychopathology at home and school in a sample of 224 high-risk adolescent boys and girls (average age 12 years). Four groups of young adolescents were defined, based on the consistency of the teacher and parent Child Behavior Checklist reports: normal, internalizing, externalizing only, and comorbid. Group comparisons revealed the comorbid and externalizing groups were more engaged in a deviant peer group and were observed in higher levels of deviancy training with their friends, compared to other young adolescent groups. In general, elevated levels of arrest, drug use, and sexual promiscuity were associated with cross-setting consistency in externalizing disorders. Comorbid youth, however, showed the highest levels of sexual promiscuity in middle adolescence, compared to all other groups. These findings are consistent with a developmental account of adolescent maladjustment and suggest that emotional disturbance in early adolescence might exacerbate youth vulnerability, especially to deviancy training within friendships.

Comparison of Korean-American adoptees and biological children of their adoptive parents: a pilot study.

This study compared a small group of Korean-American adoptees with their adoptive siblings who are biological children of the adoptive parents with respect to their psychosocial adjustment. Eighteen Korean-American adoptees were compared with nine biological children by a structured demographic, medical, clinical survey form and the Child Behavior Checklist-Parent Form (CBCL-P). The parents did not raise any more concerns about the adjustment of adopted children than their biological children. On the CBCL-P, the two groups did not differ significantly in competence T-scores, total behavioral problems, broad and T-scores and the total number of problem behaviors except for lower social competence in adopted children and a higher internalization score in biological children. In conclusion, the international adoptees, the Korean-American children have adjusted well during their early childhood after early adoption. Further studies employing a larger sample are warranted to better understand the international adoption practice.

SHORT-TERM SAFETY AND EFFICACY OF AN APPETITE SUPPRESSANT IN CHILDHOOD OBESITY • 410

Child-onset obesity is a serious individual and public health problem. Existing therapy using diet, exercise, and behavior modification (DEBM) has had limited success, particularly for low-income families with limited resources and access. Adult studies show appetite suppressant medication (ASM) is safe and effective, but there are no adequate studies in children. We performed a randomized, double-blind, placebo-controlled, crossover study with good statistical power, to see if ASM (phentermine 15 mg orally once every morning before breakfast) with DEBM is safe and effective in children ages 7-12 with body mass index (BMI) > 95th percentile for age and sex. 35 patients have completed the study. Each received weekly extensive DEBM beginning at least 2 weeks before ASM/placebo and continuing throughout the study. Group 1 was treated with ASM for 2 months then placebo for 2 months, Group 2 was treated with placebo then crossed over to ASM. The BMI change was-1.24 kg/M2 for Group 1 and -0.23 for Group 2 (P < 0.0008, t-test) during the first 2 months before crossover. After crossover, the change in BMI was +0.91 for Group 1 and -0.69 for Group 2 (P < 0.0004). BMI changes were also significant controlling for age, sex, and height (i.e., after conversion to z-scores). Extensive monitoring of mood, cognition, and school performance using the Teacher and Parent Child Behavior Checklist, Profile of Mood States, and Continuous Performance Test, pre-, during, and after ASM showed no adverse effects. Height velocity was unaffected, and troublesome side-effects were minimal. This study shows that ASM is safe and effective short-term, and appears to be more potent than DEBM. Successful completion of this short-term study clears the way for long-term trials similar to those completed in adults showing safety and efficacy for up to 4 years of continuous use.