Parent Ratings Of Children Research Articles

Parent ratings of children’s daily functioning in a mixed clinical sample

Parent questionnaires pertaining to executive and emotional/behavioral functioning are routinely included in neuropsychological evaluations to complement face-to-face cognitive tests. We evaluated in a clinical sample of 198 6–16 year-old children the degree of overlap and divergence between two common parent rating scales: the Behavior Assessment System for Children—Third Edition (BASC–3) and the Behavior Rating Inventory of Executive Function—Second Edition (BRIEF–2). This sample was 66% male, 70% white, and included both neurological diagnoses (e.g., 33% traumatic brain injury, 12% cerebral palsy) and neurodevelopmental ones (e.g., 10% attention-deficit/hyperactivity disorder). Inter-correlations between composite indices from the respective instruments were moderate (.41–.77). They disagreed about the presence or absence of impairment in 26% of the cases. Cluster analysis revealed four subtypes: Cluster 1 had mild externalizing and executive concerns, Cluster 2 had global emotional/behavioral and executive concerns, Cluster 3 had normal functioning, and Cluster 4 had mild internalizing and executive concerns. Clusters 2 and 3 differed in age and parental education, whereas Clusters 1 and 4 differed in Full Scale IQ. We conclude that BASC–3 and BRIEF–2 provide complementary information about a child’s functioning that can inform treatment of neurobehavioral dysfunction. Elevations as well as patterns of the respective profiles on these instruments may help direct such treatment (e.g., cognitive rehabilitation, behavioral management and/or psychotherapy).

What teachers and parents can add to personality ratings of children: Unique associations with academic performance in elementary school

Adults’ ratings of children’s personality have been found to be more closely associated with academic performance than children’s self-reports. However, less is known about the relevance of the unique perspectives held by specific adult observers such as teachers and parents for explaining variance in academic performance. In this study, we applied bifactor (S–1) models for 1411 elementary school children to investigate the relative merits of teacher and parent ratings of children’s personalities for academic performance above and beyond the children’s self-reports. We examined these associations using standardized achievement test scores in addition to grades. We found that teachers’ unique views on children’s openness and conscientiousness had the strongest associations with academic performance. Parents’ unique views on children’s neuroticism showed incremental associations above teacher ratings or self-reports. For extraversion and agreeableness, however, children’s self-reports were more strongly associated with academic performance than teacher or parent ratings. These results highlight the differential value of using multiple informants when explaining academic performance with personality traits.

Childhood vaccination as a protective factor for developmental psychopathology

BackgroundsDespite multiple studies demonstrating no relationship between childhood vaccination and increasing Autism Spectrum Disorder (ASD) prevalence, parental fear for vaccination and subsequent refusal to vaccinate their children continue, resulting in recent outbreaks of childhood infections such as measles in the US. We examine the relationship between the completion of 6 recommended vaccinations in childhood and the likelihood for having developmental psychopathology. MethodsTwo large-scale South Korean epidemiologic samples were used to examine whether completion of childhood vaccinations decrease likelihood of having ASD as assessed by Autism Spectrum Screening Questionnaire (ASSQ) and behavioral problems scores. Parental reports on vaccination completion were categorized in groups: <3, 4−5, & 6. The primary outcome is the likelihood of having ASD and/or, internalizing, and externalizing behavioral symptoms. Likelihood of having ASD was categorized as: low (ASSQ < 10), intermediate (ASSQ = 10–14), and high (ASSQ ≥ 15). The risk for externalizing/internalizing symptoms was assessed with the Behavior Assessment System for Children-Parent Rating Scale. We examined the hypothesis in a Discovery Sample (DS) (N = 10,006) and verified findings in a Replication Sample (RS) (N = 29,381). Results84.3 % of DS and 80.1 % of RS participants were fully vaccinated. In the DS, after adjusting for demographics and confounders, children with incomplete-vaccinations were at greater risk for ASD when compared to those fully vaccinated (adjusted odds ratio [aOR] = 1.42, 95 % Confidence Interval [CI] 1.17−1.73 with 4−5 vaccinations; aOR = 2.33, CI 1.53−3.56 with vaccination <3). The DS finding was confirmed in the RS (aOR = 1.44, CI 1.32−1.58 with 4−5 vaccinations and aOR = 2.19, CI 1.80−2.67 with < 3 vaccinations). In the DS, those with incomplete-vaccinations were at a greater risk for internalizing and externalizing symptoms. ConclusionsWe replicate our own and prior findings that vaccination does not increase ASD risk. Further, completing recommended vaccinations may offer protection against the risk of having ASD and other developmental psychopathology.

The relation between parent ratings and direct assessments of preschoolers’ numeracy skills

This study examines whether parent ratings of children's numeracy skills are more related to direct assessments of corresponding skills, broad numeracy, or other cognitive skills, to inform how to best utilize parent ratings in research. Children in the sample (N = 129) ranged from 3.07 to 5.95 years old and 52.3% were male. Most (81%) of the children were White. Parents rated their children's counting, arithmetic, and numeral identification skills. Children were directly assessed on these skills, broad numeracy, and other cognitive skills (i.e., expressive vocabulary, executive function). Parent ratings of children's numeracy abilities varied in terms of whether they were more related to directly assessed corresponding skills or broad numeracy abilities. Aggregated parent ratings predicted broad numeracy abilities more than other cognitive skills, providing evidence for discriminant validity. Findings inform how parent ratings may be used when children cannot be directly assessed, such as when large-scale parent surveys are used.

Predictor Selection Using Lasso to Examine the Association of Motor Proficiency, Postural Control, Visual Efficiency, and Behavior With the Academic Skills of Elementary School-Aged Children

The associations between motor proficiency, postural control, and visual efficiency with teacher and parent ratings of children’s behavior and academic skills were examined among a sample of elementary school-aged children (N = 50). Teacher and parent ratings of students’ academic skills were analyzed separately to examine the predictive nature of measures of motor proficiency. Spearman rank order correlations reported low to moderate relationships between motor proficiency, postural control, and children’s behavior (e.g., ADHD inattention) and academic skills. The least absolute shrinkage and selection operator (lasso) procedure is demonstrated as an approach for variable selection of measures of children’s motor proficiency, postural control, and visual efficiency to predict academic skills. For teacher and parent ratings of academic skills, ADHD symptom of inattention was the strongest model predictor, whereas directional control (postural control) was also a predictor for parent ratings. Study findings shed light on practical and methodological factors associated with motor skills in educational contexts.

Associations of Army Fathers' PTSD Symptoms and Child Functioning: Within- and Between-Family Effects.

This study examined the within-family and between-family associations between fathers' military-related PTSD symptoms and parent ratings of children's behavioral and emotional problems. The sample included married couples (N=419) with children composed of a civilian wife and an active-duty husband serving in the U.S. Army. Results indicate that changes in fathers' PTSD symptoms over time were associated with corresponding changes in both mothers' and fathers' reports of child behavioral and emotional problems. These within-family findings were independent from between-family effects, which showed that higher average PTSD symptomatology was associated with more overall behavioral and emotional problems for children. This study uses advances in statistical methodologies to increase knowledge about how PTSD symptoms and child problems are related, both across different families and over time within families.

Emotional and behavioural problems in children with Developmental Coordination Disorder: Exploring parent and teacher reports

BackgroundAlthough characterised by motor impairments, children with Developmental Coordination Disorder (DCD) also show high rates of psychopathology (anxiety, depression, low self-esteem). Such findings have led to calls for the screening of mental health problems in this group. AimsTo investigate patterns and profiles of emotional and behavioural problems in children with and without DCD, using the Strengths and Difficulties Questionnaire (SDQ). Methods and proceduresTeachers and parents completed SDQs for 30 children with DCD (7–10 years). Teacher ratings on the SDQ were also obtained from two typically-developing (TD) groups: 35 children matched for chronological age, and 29 younger children (4–7 years) matched by motor ability. Outcomes and resultsGroup and individual analyses compared parent and teacher SDQ scores for children with DCD. Teacher reports showed that children with DCD displayed higher rates of emotional and behavioural problems (overall, and on each subscale of the SDQ) relative to their TD peers. No differences were observed between the two TD groups. Inspection of individual data points highlighted variability in the SDQ scores of the DCD group (across both teacher and parent ratings), with suggestions of elevated hyperactivity but comparably lower levels of conduct problems across this sample. Modest agreement was found between teacher and parent ratings of children with DCD on the SDQ. Conclusions and implicationsThere is a need to monitor levels of emotional and behavioural problems in children with DCD, from multiple informants.

Cross-lagged relations between teacher and parent ratings of children's task avoidance and different literacy skills.

Task avoidance is a significant predictor of literacy skills. However, it remains unclear whether the relation between the two is reciprocal and whether it is affected by the type of literacy outcome, who is rating children's task avoidance, and the children's gender. The purpose of this longitudinal study was to examine the cross-lagged relations between teacher and parent ratings of children's task avoidance and different literacy skills. One hundred and seventy-two Greek children (91 girls, 81 boys) were followed from Grade 1 to Grade 3. Children were assessed on reading accuracy, reading fluency, and spelling to dictation. Parents and teachers rated the children's task-avoidant behaviour. Results of structural equationmodelling showed that the cross-lagged relations varied as a function of the literacy outcome, who rated the children's task avoidance, and children's gender. Earlier reading and spelling performance predicted subsequent parent-rated task avoidance, but parent-rated task avoidance did not predict subsequent reading and spelling performance (with the exception of spelling in Grade 3). Teacher-rated task avoidance and reading fluency/spelling had a reciprocal relationship over time. In addition, the effects of teacher-rated task avoidance on future spelling were significantly stronger in boys than in girls. This suggests that poor reading and spelling performance can lead to subsequent task avoidance in both classroom and home situations. The fact that task avoidance permeates across different learning environments is alarming and calls for joint action from both parents and teachers to mitigate its negative impact on learning.

The Relationship Between Parent Trait Anxiety and Parent-reported Pain, Solicitous Behaviors, and Quality of Life Impairment in Children With Cancer.

Pain-related disability in youth has been shown to be associated with parental psychological distress and solicitous behaviors. This study sought to investigate how parental anxiety may impact children's functioning with respect to pain and health-related quality of life in a sample of children with cancer. A total of 353 parents of children treated for cancer completed measures of anxiety, behavioral responses to children's pain, and of their child's quality of life and pain. Children ages 8 to 18 completed measures of their own quality of life and pain. Parent anxiety was significantly associated with parent ratings of children's pain severity (P=0.004) and frequency (P=0.008), as well as parent solicitous responses (P=0.041) and child quality of life. Regression analysis revealed that parent anxiety significantly predicted solicitous behaviors (P=0.006), pain frequency (P=0.043), and child quality of life (P ≤ 0.004). These findings suggest parent anxiety plays a significant role in parent perception of children's pain and quality of life in pediatric cancer patients. Future research is needed to further clarify the nature of these relationships, which will help identify how parent anxiety may be an important target for pain management in children with cancer.

Perinatal Phosphatidylcholine Supplementation and Early Childhood Behavior Problems: Evidence for CHRNA7 Moderation

α7-Nicotinic receptors are involved in the final maturation of GABA inhibitory synapses before birth. Choline at levels found in the amniotic fluid is an agonist at α7-nicotinic receptors. The authors conducted a double-blind placebo-controlled trial to assess whether high-dose oral phosphatidylcholine supplementation during pregnancy to increase maternal amniotic fluid choline levels would enhance fetal development of cerebral inhibition and, as a result, decrease childhood behavior problems associated with later mental illness. The authors previously reported that newborns in the phosphatidylcholine treatment group have increased suppression of the cerebral evoked response to repeated auditory stimuli. In this follow-up, they report parental assessments of the children's behavior at 40 months of age, using the Child Behavior Checklist. At 40 months, parent ratings of children in the phosphatidylcholine group (N=23) indicated fewer attention problems and less social withdrawal compared with the placebo group (N=26). The improvement is comparable in magnitude to similar deficits at this age associated with later schizophrenia. The children's behavior is moderated by CHRNA7 variants associated with later mental illness and is related to their enhanced cerebral inhibition as newborns. CHRNA7, the α7-nicotinic acetylcholine receptor gene, has been associated with schizophrenia, autism, and attention deficit hyperactivity disorder. Maternal phosphatidylcholine treatment may, by increasing activation of the α7-nicotinic acetylcholine receptor, alter the development of behavior problems in early childhood that can presage later mental illness.

B-34The Relationship between Attention Deficit Hyperactivity Disorder Symptomatology and the Behavior Assessment System for Children Parent Rating Scale

B-34The Relationship between Attention Deficit Hyperactivity Disorder Symptomatology and the Behavior Assessment System for Children Parent Rating Scale

Long-Term Cognitive and Functional Outcomes in Children with Mucopolysaccharidosis (MPS)-IH (Hurler Syndrome) Treated with Hematopoietic Cell Transplantation.

The long-term cognitive and functional outcomes of children with mucopolysaccharidosis type I (MPS-IH) post-hematopoietic cell transplant (HCT) are not well documented, and the role of genetic and treatment factors in these outcomes has yet to be defined. In this multi-site, international study, we (1) characterize the cognitive and functional status of 47 individuals (ages 2-25, mean of 10.6 years) with MPS-IH who are 1-24 years post HCT (mean = 9 years) and (2) examine contributions of genotype, transplant characteristics, and sociodemographic factors to cognitive ability, adaptive behavior, and quality of life. The overall cognitive ability of our sample was mildly impaired, more than two standard deviations below general population norms. Parent reported adaptive behaviors (i.e., communication, daily living, and motor skills) were similarly impaired with a relative strength in socialization. Quality of life, as reported by parents, fell more than two standard deviations below population norms for physical functioning; however, psychosocial quality of life (emotional well-being) approximated population norms. In linear regression analysis, adjusted for demographic and treatment factors, mutation severity was associated with lower cognitive ability (p = 0.005) and adaptive functioning (p = 0.004), but not parent ratings of children's quality of life. Older age at HCT was associated with poorer physical quality of life (p = 0.002); lower socioeconomic status (p = 0.028) and unrelated bone marrow HCT (p = 0.010) were associated with poorer psychosocial quality of life. Implications for screening and early intervention for children at risk for poorer cognitive and functional outcomes are described.

A Comparison of Self-vs Parent Reports of Generalised Anxiety Disorder Symptomatology Across Six Age Groups for Boys with an ASD

Although there are reported differences in child vs parent-ratings of children’s anxiety in the wider population, no reports have been published of these differences across age groups in children with an Autism Spectrum Disorder (ASD). This study investigated the extent and nature of parent–child disagreement on ratings of Generalised Anxiety Disorder (GAD) in a sample of 140 high-functioning boys with an ASD aged 6 to 18 years and one of their parents. Results indicated that, after a peak at ages 7 to 8 years, GAD decreased for ages 9 to 18 years. There were statistically significant differences between parents’ and sons’ ratings for the total GAD score and for several of the individual GAD symptoms, although the clinical impact of those differences was limited. Some minor variation in those differences was present according to the age of the boys with an ASD. Suggestions are made for the valid assessment of GAD in boys with an ASD.

Measuring self-regulation in a physically active context: Psychometric analyses of scores derived from an observer-rated measure of self-regulation

The purpose of this study is to report psychometric properties of scores obtained using a novel observer-rated measure of children's self-regulation, the Response to Challenge Scale (RCS). The RCS was developed to rate children's self-regulatory abilities in a physically active context (e.g., while completing a physical challenge course). The RCS and other study measures were administered in a private school sample of 207 children. Analyses of score distributions indicated that the RCS was able to capture variance among children in self-regulatory abilities; the distribution was normal for the Affective, Cognitive, and Total Self-Regulation scales. Validity analyses revealed significant positive correlations between Cognitive, Affective, Motor, and Total Self-Regulation and executive function task performance; significant negative correlations between Cognitive Regulation and teacher-rated hyperactivity and inattention; significant negative correlations between Affective, Motor, and Total Self-Regulation and teacher ratings of peer problems; and significant positive correlations between Cognitive and Affective Regulation and parent ratings of prosocial behavior. Parent and teacher rated Total Difficulties scores were both negatively correlated with RCS Total Self-Regulation scores. Results suggest that it is possible for observers to rate self-regulatory abilities in the context of physical activities, and that these ratings correspond with performance on tasks requiring executive function as well as teacher and parent ratings of children's difficulties.

English

Introduction Substantial overlap exists between autism spectrum disorder and attention deficit hyperactivity disorder at multiple levels. Aetiologically, similarity exists in genetic liability for the two disorders. Phenotypically, comorbidity exists between autism spectrum disorder and symptoms of attention deficit hyperactivity disorder with rates varying between 28% and 92% and both groups have similar problems with social cognition. The aim of this study was to discuss behaviour profiles of children with attention deficit hyperactivity disorder and autism spectrum disorder on the parent PDD Behaviour Inventory. Materials and methods Parent ratings of children with autism spectrum disorder (with and without attention deficit hyperactivity disorder behaviours) were compared with parent ratings of children with attention deficit hyperactivity disorder behaviours who did not have autism spectrum disorder (the attention deficit hyperactivity disorder group) using the PDD Behaviour Inventory, a rating instrument that is agestandardised on children with autism spectrum disorder and which assesses both maladaptive behaviours and adaptive skills. Results The attention deficit hyperactivity disorder group’s maladaptive behaviours were rated as more severe than the autism spectrum disorder group, especially on those domains assessing fears and aggression. Further, the attention deficit hyperactivity disorder group was rated as having greater severity of fears and aggression when compared with those in the autism spectrum disorder group who also had comorbid attention deficit hyperactivity disorder behaviours. By contrast, the attention deficit hyperactivity disorder group was rated as having better expressive language ability than the autism spectrum disorder group (especially when compared with those in the autism spectrum disorder group with comorbid attention deficit hyperactivity disorder behaviours). It is hypothesised that the increased severity of fears and aggression in the attention deficit hyperactivity disorder group may reflect their relatively increased ability to communicate these problems to others. Conclusion These data extend findings from previous studies and suggest that a unique attention deficit hyperactivity disorder profile may exist for children with attention deficit hyperactivity disorder on the PDD Behaviour Inventory.

Parent reports of young children's sensory characteristics are related to children's food neophobia

Neophobia in young children has been associated with lack of dietary variety and less than optimal nutrient intakes. Underlying characteristics that may predispose a child to neophobia have not been widely studied in typically developing children. In an intervention study designed to prevent early childhood obesity in rural Colorado (The Colorado LEAP Study), parental reports of children's oral sensory issues (Oral Sensory Profile; OSP) and children's neophobia (Negative Reactions to Food Scale; NEO) were assessed and child weight outcome (BMIzb) was measured at baseline. Preschool‐aged children (n=214; 120 girls, 94 boys; 56.1 ± 4.2 mo; BMIzb = 0.51 ± 1.4) and parents (n=161, 48 Hispanic [H], 113 NonHispanic White [NHW]) participated in data collection. No differences were noted in children's mean OSP or in NEO by, parents’ income or education, or sex of child; however Hispanic parents reported lower child OSP scores (OSPH = 29.7, OSPNHW=33.2, t=−2.8, p=.006). Parent ratings of children's OSP and NEO were significantly correlated (r−0.53= p&lt;.001). That is, more atypical scores of children's oral sensory characteristics were related to higher neophobia ratings. Children's OSP and NEO were not related to their BMIzb scores. Children's oral sensory characteristics, in addition to mere exposure and development effects, may contribute to young children's food preferences and selection.Supported by USDA AFRI Grant #2010–85215‐20648

Effects of Developmentally Appropriate Practices on Social Skills and Problem Behaviors in 1st Through 3rd Grades

The guidelines published by the National Association for the Education of Young Children on the use of developmentally appropriate practices (DAP) have, over the last two decades, had an important influence on young children's educational experiences. The efficacy of these guidelines for changing children's outcomes has been examined by only a handful of studies and with mixed results. This study looks at the effects of classroom and school-level use of classroom elements of DAP in 1st, 2nd, and 3rd grades on parent ratings of children's social skills at the end of the year, controlling for ratings of the same construct at the end of the previous year, gender, and ethnicity with a sample of between 1,145 and 2,111 students each year. Differential effects of DAP for males and females and for children of different ethnic backgrounds also were examined. Despite high power, no consistent effects of DAP were observed and no interactions found, suggesting that DAP does not affect parents' ratings of social skills in 1st through 3rd grades. The importance of these results, in light of other work on the effects of DAP, is discussed.

Competence and emotional/behavioural problems in 7–16-year-old Norwegian school children as reported by parents

Background: Previous studies from Nordic countries suggest that parent ratings of children's emotional and behavioural problems using the Child Behavior Checklist (CBCL) are among the lowest in the world. However, there has been no Norwegian population study with acceptable response rates to provide valid Norwegian reference data. Aims: Firstly, to compare CBCL Internalizing, Externalizing, Total Problems and Competence scores of Norwegian children and adolescents with those from 1) previous Norwegian studies, 2) other Nordic countries, and 3) international data. Secondly, to present Norwegian reference data in order to perform these comparisons. Thirdly, to investigate the effects of age, gender, socio-economic and urban/rural status on the CBCL. Methods: A stratified cluster sample of 2582 school children (1302 girls and 1280 boys) was identified from the general Norwegian population and their parents were asked to complete the CBCL. Results: The response rate was 65.5%. The mean Total Problems score for the whole sample was 14.2 (standard deviation, s = 14.1). Girls were rated as having greater Competence and fewer Total Problems than boys. Younger children had more Total Problems than adolescents. Parents with low education reported more child Total Problems and lower Competence than those with high education. All effect sizes were small, except for the effect of parental education on child Competence, which was moderate. Conclusions: Total Problems scores were lower than in other societies. The data from this study obtained from one county in central Norway provide an important reference for clinical practice and treatment outcome research.

Children's Problems Predict Adults' DSM-IV Disorders Across 24 Years

The goal of this study was to determine continuities of a broad range of psychopathology from childhood into middle adulthood in a general population sample across a 24-year follow-up. In 1983, parent ratings of children's problems were collected with the Child Behavior Checklist (CBCL) in a general population sample of 2,076 children and young adolescents aged 4 to 16 years. In 2007, 24 years later, 1,339 of these individuals were reassessed with the CIDI, a standardized DSM-IV interview. We used univariate logistic regression analyses to determine the associations between children's problems and adults' psychiatric disorders. Parent reported total problems scores in the deviant range (>85th percentile) predicted disruptive disorders in adulthood (odds ratio [OR] = 1.7, 95% confidence interval [95% CI] = 1.1-2.8). Adjusted for sex, age, and socioeconomic status in all analyses, deviant levels of parent-reported childhood anxiety predicted anxiety disorders in middle adulthood (OR = 1.6, 95% CI = 1.0-2.5). Conduct problems (i.e., cruelty to animals, lies) predicted both mood disorders (OR = 2.3, 95% CI = 1.1-4.8) and disruptive disorders (OR 2.1, 95% CI = 1.3-3.4), whereas oppositional defiant problems predicted only mood disorders (OR = 2.3, 95% CI = 1.0-5.2). Attention-deficit/hyperactivity problems did not predict any of the DSM-IV disorders in adulthood (OR = 0.8, 95% CI = 0.5-1.2). Children with psychopathology are at greater risk for meeting criteria for DSM-IV diagnoses in adulthood than children without psychopathology, even after 24 years. Moreover, different types of continuities of children's psychopathology exist across the lifespan. We found that anxious children, oppositional defiant children, and children with conduct problems are at greater risk for adult psychopathology. Effective identification and treatment of children with these problems may reduce long-term continuity of psychopathology.

Attention-Worthy Association: Prenatal Phthalate Exposure and Later Child Behavior

Vol. 118, No. 4 NewsOpen AccessAttention-Worthy Association: Prenatal Phthalate Exposure and Later Child Behavior Julia R. BarrettMS, ELS Julia R. Barrett Search for more papers by this author Published:1 April 2010https://doi.org/10.1289/ehp.118-a172bAboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit Human exposure to phthalates is ubiquitous due to widespread commercial use. Although the compounds are reported to be rapidly metabolized, concentrations in the body appear to remain fairly stable due to ongoing exposure. The United States and Europe have banned some phthalates from consumer products primarily on the basis of reproductive toxicity data. However, not all phthalates are regulated; meanwhile, research indicates toxicity may extend to other endocrine targets such as the thyroid gland, which is critical for proper neurodevelopment. A new study now reports an association between prenatal exposure to certain phthalates and adverse effects on test scores used to evaluate children’s behavior and executive functioning [EHP118:565–571; Engel et al.].The prospective study was based on a multiethnic cohort of 404 women recruited during their first pregnancy for the Mount Sinai Children’s Environmental Health Study between 1998 and 2002. Each woman completed medical, sociodemographic, and lifestyle questionnaires and provided a urine sample between 25 and 40 weeks of pregnancy, which was used to measure phthalate metabolites. Metabolites were grouped according to their molecular weights.When their children were approximately 4.5–5.5, 6–6.5, and 7–9 years old, 188 of the women completed the Behavior Rating Inventory of Executive Functioning (BRIEF) and the Behaviors Assessment System for Children-Parent Rating Scales (BASC-PRS), standardized forms used in clinical and research assessments of children’s executive functioning and behavior. Executive functions encompass planning to achieve goals, controlling attention and emotion, inhibiting inappropriate behaviors, and extrapolating from life experiences. Problematic behaviors assessed included hyperactivity, aggression, poor conduct, and issues with anxiety, attention, and adaptability.High-molecular-weight phthalates—like those found in medical tubing and vinyl floor and wall coverings—were not associated with altered scores derived from the parent-report forms aside from a small association with reduced emotional control. However, low-molecular-weight phthalates—like those found in personal care products such as perfume, shampoo, cosmetics, and nail polish—were significantly associated with increased scores for aggression, attention and conduct problems, and depression.The BASC-PRS includes a scale to help researchers weed out inaccurate assessments. The higher the resulting F-score, the more likely the assessment is to reflect an excessively negative evaluation of the child, a failure to follow instructions, random responding, or difficulty reading. When parent-report forms were restricted to those with F-scores of 0 or 1 (leaving 161 children in the analyses), most associations remained strong for boys but not girls. The sole exception was conduct problems, which remained significant for both girls and boys.The behavioral problems assessed in this study are relevant to conditions such as oppositional defiant disorder, conduct disorder, and attention deficit/hyperactivity disorder. Diagnosing these conditions requires extensive testing beyond the scope of this study. Furthermore, this study cannot confirm that phthalate exposure caused these problems via altered thyroid function—or any other mechanism. However, thyroid-related phthalate toxicity makes a connection biologically plausible and underscores an urgent need to further investigate the effects of phthalates on neurodevelopment.Low-molecular-weight phthalates are found in many personal care products.FiguresReferencesRelatedDetails Vol. 118, No. 4 April 2010Metrics About Article Metrics Publication History Originally published1 April 2010Published in print1 April 2010 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.