Child Behavior Rating Research Articles

The impact of children’s attentional behaviour and parent–child interaction on children’s self regulation skills

ABSTRACT This study aims to examine the predictive role of parent–child interaction on children's self-regulation skills during the preschool period. The study was conducted on a sample consisting of 219 children aged 5–6 and their mothers, selected using convenience sampling method. In the research, mothers’ interactions with their children were evaluated using the Maternal Behavior Rating Scale, while children’s interactions with their mothers were assessed using the Child Behavior Rating Scale, and children’s self-regulation skills were evaluated based on performance using the Preschool Self-Regulation Assessment. The findings indicate that interaction elements predicting children’s self-regulation skills at a high and positive level include children’s attention, as well as mothers’ sensitive-responsive behaviors. The interaction element predicting self-regulation skills at a negative level is mothers’ focus on achievement and directive behaviour. In contrast, neither the children’s initiation of interaction nor the mothers’ emotional and expressive behaviors were significant predictors of the children’s self-regulation skills. The results were discussed in light of existing literature and suggestions for future research were provided.

Long-Term Effectiveness of Off-Label Risperidone Treatment in Children and Adolescents: A Randomized, Placebo-Controlled Discontinuation Study.

Objectives: Risperidone is commonly prescribed off-label in children and adolescents to manage disruptive behavior. This study aimed to investigate continued benefits of risperidone after at least 1 year of treatment and effects of discontinuation on physical health. Methods: Thirty-five youths (aged 6-18 years, intelligence quotient [IQ] >70) who were treated with risperidone for at least 1 year in regular clinical practice receiving outpatient care were randomly assigned to double-blind continuation of risperidone during 16 weeks or continuation for 2 weeks, gradual dose lowering over 6 weeks, and placebo for 8 weeks. Primary outcome was the total Disruptive Behavior (D-total) score of the parent-reported Nisonger Child Behavior Rating Form-Typical IQ (NCBRF-TIQ). Secondary outcome measures were the clinician-rated Clinical Global Impressions-Improvement scale (CGI-I), the parent, child, and teacher-rated Strengths and Difficulties Questionnaire (SDQ), the parent-rated Retrospective Modified Overt Aggression Scale (R-MOAS), and several health parameters (Udvalg for Kliniske Undersøgelser Side Effect Rating Scale [UKU-SERS], dyskinesia, akathisia, parkinsonism, body mass index (BMI), waist circumference, and laboratory outcomes). Mixed models for repeated measures were conducted for continuous outcomes and a chi-square test for the CGI-I. Results: Discontinuation of risperidone, as compared with continuation, was not associated with significant changes in parent-reported disruptive behaviors. However, discontinuation was related to significant deterioration in parent-rated verbal aggression, teacher-rated behavioral functioning, clinician-rated general functioning, and significant improvements in weight, BMI, waist circumference, and glucose, insulin, and prolactin levels. Although 56% of participants in the discontinuation group experienced relapse, causing premature withdrawal from the study, 44% was able to successfully discontinue risperidone. Conclusion: Discontinuation of risperidone was associated with deterioration on some, but not all behavioral measures according to this explorative study. Discontinuation was associated with important health gains. Despite long-term benefits of risperidone, attempts to withdraw risperidone should be undertaken in individual children. This is a crucial step in preventing harm and fostering health.

Examination of quality of life and psychiatric symptoms in childhood Graves' disease.

The aim of our study is to examine the emotional, behavioral problems, and psychiatric symptoms of children diagnosed with Graves' disease (GD), to assess their quality of life, and to compare with control group. The research was planned as a cross-sectional study and included 16 patients with GD (13 female and three male) and 29 healthy children for control group (19 female and 10 male). Sociodemographic form, Pediatric Quality of Life Inventory, Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), Strengths and Difficulties Questionnaire (SDQ), Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S), and Affective Reactivity Index scale were applied to the children and their families. Eighty one percent of GD group (GG) (n=13, mean age 15.1±2.2) and 66 % of control group (CG) (n=19, 14.6±2.2) were girls. No significant difference was found between GG and CG in terms of quality of life, anxiety, and depression scores. GG had higher scores in affective reactivity index, SDQ-P total score, and T-DSM-IV-S total scores (p values 0.039; 0.009; 0.023, respectively). While no significant difference was detected in the T-DSM-IV-S-inattention and hyperactivity scores, significantly higher scores were detected in oppositional defiance and conduct disorder scores (pvalues 0.172; 0.294; 0.019; 0.027, respectively). In children with GD, irritability, oppositional defiant, and conduct disorder symptoms have been detected. Children with these mental health symptoms experience behavioral and emotional difficulties in their daily lives. It is important to follow up children with GD for possible comorbid psychiatric disorders.

Evaluation of Neurocognitive Functions of Children and Adolescents Diagnosed with Pediatric Bipolar Disorder and Disruptive Mood Dysregulation and at High Risk for Bipolar Disorder

IntroductionPediatric Bipolar Disorder (BPD) is a chronic psychiatric disorder that alters normal and psychological development processes among patients. Although cognitive deficits in BPD have identified in recent studies, little is known about the developmental trajectory of these deficits. DMDD is a newly defined diagnosis included in the DSM-V. Since it added a new dimension to the clinical spectrum but few studies conducted on DMDD, there are some conflicting discussions in the literature about how to distinguish this disorder from other childhood psychiatric disorders and how to treat it.ObjectivesThe aim of this study was to determine the phenomenological and neuropsychological differences between children and adolescents with a diagnosis of BPD (Pediatric Bipolar Disorder), DMDD (Disruptive Mood Dysregulation Disorder), and children and adolescents who are genetically at high risk for Bipolar Disorder (BD), and healthy controls (HCs) who do not have any psychiatric diagnosis, to investigate endophenotypes that may be predictive for BD.MethodsOur study sample consists of four groups, the BPD group (n=30), the Risk group (n=25), the DMDD group (n=36), and the Healthy Control group (n=29). All participants were evaluated by the “Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Now and Lifetime Pattern (K-SADS-PL)”. “Young Mania Rating Scale/Parent Form (YMRS-ABF), Conner’s Parent Rating Scale (CPRS-48), Child and Adolescent Behavior Rating Scale (CBCL)” scales were filled by parents, and “Child Depression Inventory (CDI), Youth Self-Report Form for 11-18 Years Olds (YSR)” scales were filled by children and adolescents. Neurocognitive test battery was applied to each participant: Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), Stroop Color and Word Test (SCWT), Trait Making Test A and B sections (TMT-A/B), California Verbal Learning Test-Child version (CVLT-C).ResultsWhile it was determined that the cases in the BPD and DMDD groups performed significantly worse in CPT, SCWT, CVLT-C, TMT A/B tests compared to healthy controls, it was found that the subjects in the Risk group performed worse at the CPT test than healthy controls. In addition, the cases in the BPD, Risk and DMDD groups reported more clinical and behavioral problems than the healthy controls.ConclusionsThere is a significant deterioration in the areas of continuous attention, processing speed, cognitive flexibility, response prevention, verbal memory and working memory in the BPD and DMDD groups, and in the continuous attention area in the Risk group compared to healthy controls. Prospective follow-up and imaging studies using larger samples and a larger neurocognitive test battery in the future will better reveal the neuropsychological characteristics of the BPD, Risk and DMDD groups.Disclosure of InterestNone Declared

School Readiness in Preschool-Age Children with Critical Congenital Heart Disease.

This study examined the nature, variability, and predictors of school readiness difficulties in young children with critical congenital heart disease (CCHD). We hypothesized that, compared to a community control (CC) group, children with CCHD would score less well on measures of readiness and that readiness would be associated with CCHD-related risk factors. Children (60 CCHD and 60 CC) were 4 to 5 years of age and not yet attending kindergarten. Readiness measures included tests of cognition, executive function, motor ability, and pre-academic skills. Caregivers provided child behavior ratings. Analyses examined group differences in readiness, readiness profiles, and associations of readiness with CCHD-related medical risk factors. The CCHD group had lower scores than the CC group on testing and higher caregiver ratings of problems in social communication, as well as higher rates of deficits on several of the measures. Latent class analysis provided evidence for different readiness profiles, with more children with CCHD displaying profiles characterized by weaknesses in readiness. CCHD-related medical risk factors associated with readiness problems in the CCHD group included a co-morbid genetic disorder, postnatal diagnosis of CCHD, major perioperative complication, and longer periods of hospitalizations, cardiopulmonary bypass, and aortic cross-clamp placements. Findings document multiple problems in school readiness in young children with CCHD. Deficits vary across individuals and are associated with higher medical risk. Results confirm the importance of screening for school readiness in these children and suggest areas to target in designing screening measures and providing early childhood interventions.

HTKS-Kids: A tablet-based self-regulation measure to equitably assess young children's school readiness.

Technology advances make it increasingly possible to adapt direct behavioral assessments for classroom use. This study examined children's scores on HTKS-Kids, a new, largely child-led version of the established individual research assessment of self-regulation, Head-Toes-Knees-Shoulders-Revised task (HTKS-R). For the HTKS-Kids tablet-based assessment, which was facilitated by children's preschool teachers, we examined (1) preliminary reliability and validity; (2) variation in scores predicted by child age and background characteristics; and (3) indication that HTKS-Kids provides different information from teacher ratings of children. Participants included n = 79 4-year-old children from two urban areas in upstate New York, USA. Average parent education was 12.5 years, ranging 3-20. A researcher administered the HTKS-R to individual children, and teachers (eight white, two Latino) were trained to use the HTKS-Kids tablet-based assessment and asked to play once with each study child. Teachers also rated each child on 10 Child Behavior Rating Scale (CBRS) items about classroom self-regulation. We found evidence that (1) the HTKS-Kids captures variation in children's self-regulation and correlates positively with established measures, (2) parent education was the best predictor of HTKS-Kids scores, and (3) teachers rated Black children significantly worse and white children better on the CBRS, with the magnitude of group differences similar to the contribution of parent education. In contrast, Black and white children showed no score differences on HTKS-Kids. The HTKS-Kids is a promising new tablet-based assessment of self-regulation that could replace or supplement traditional teacher ratings, which are often subject to implicit bias.

Okul Öncesi Çocuklarda Sosyal-Duygusal Uyumun Davranış Düzenleme ve Sosyal Becerilerle İlişkisinde Duygusal Kararsızlık ve Duygu Düzenlemenin Aracı Rolü

Self-regulation is defined as an individual's ability to control and regulate their own behavior; this skill, forming the foundation of social adjustment, influences one's ability to interact with their environment and manage relationships. Emotion regulation, on the other hand, involves the ability to manage emotional responses and is believed to establish a critical connection between social adjustment and self-regulation. In this study, the aim is to determine the mediating role of emotion regulation in the relationship between behavioral regulation, social skills, and social-emotional adjustment skills using two different models.The study included a total of 216 children aged 5 and 6. Data were collected using the Socio-Demographic Information Form, Emotion Regulation Scale (ERS), Child Behavior Rating Scale (CBRS), and Marmara Social-Emotional Adaptation Scale (MSEAS). When socio-demographic variables were evaluated in terms of social competence and social-emotional adjustment scores according to gender, significant differences were found in favor of girls. Significant differences were also found in favor of children with working mothers when evaluated based on the mother's employment status. There were moderate significant correlations found between emotion regulation, child behavior assessment, and social-emotional adjustment. According to the mediation analyses, there was a partial mediating effect of emotion variability/negativity and emotion regulation in the relationship between behavior regulation and social-emotional adjustment. Similarly, there was a partial mediating effect of emotion variability/negativity and emotion regulation in the relationship between social competence and social-emotional adjustment. It is thought that the finding that children's emotion regulation and emotion variability/negativity mediate the relationship between social-emotional adjustment, social competence, and behavior regulation will contribute to the literature.

Comparison of Toxoplasma Gondii IgG Antibody Levels in Children and Adolescents with OCD and ADHD with Healthy Controls: A Cross-Sectional Study

Objective: This study was aimed to examine if there is a relation between IgG levels of T. gondi and OCD or ADHD symptoms. Method: Of 42 children with OCD, 31 with ADHD and 28 healthy control were included. Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Moudsley Obession-Compulsion Inventory (MOCI), Child Depression Inventory (CDI), and Screen of Children for anxiety related disorders (SCARED), The Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) and The Conners’ Parent Rating Scale-48 (CPRS-48) were applied. Toxo gondii IgG values ≥3.0 IU/mL were considered to be reactive. SPSS 17.0 was used for analysis. p<.05 was accepted as significant. Results: The mean age was 12.1 years. Of 56.4% (n = 57) were boys. Depression and anxiety symptoms were similar in OCD and controls, but were significantly lower in ADHD. All children with OCD had negative (100%) for IgG levels of T. gondii, whereas 78.6% of controls and 90.3% of children with ADHD had negative for IgG levels of T. gondii. Toxo IgG seropositivity of the control was significantly higher than that of the OCD. Toxo IgG levels were positively correlated with Turgay’s ADHD-Conduct disorder subscale scores in ADHD group (r=.650, p<.001). In the OCD and the control groups, there was no correlation between IgG levels and CDI, SCARED, ADHD scales (for all variables, p>.05). Conclusion: To conclude, this study did not verify a relationship between the seropositivity of T. gondii with OCD and ADHD. Further studies are needed longitudinal follow-up and extended series of patients.

Evaluation of Factors Affecting Hearing Aid Use in Children.

The purpose of this study was to determine the factors affecting hearing aid use in children and investigate how these factors affected their subjective auditory performance. The study was carried out with 34 children aged three to six years who had mild or moderate sensorineural hearing loss and had used a bilateral hearing aid for at least six months. The daily hearing aid usage times of children were collected with the help of data logging software. Parent-child interactions were assessed with the Maternal Behavior Rating Scale (MBRS) and Child Behavior Rating Scale (CBRS) scores. To assess the parents' levels of knowledge about hearing devices, the Hearing Aid Awareness Question Form for Parents, which was prepared by the researchers, was used. Finally, to evaluate the subjective hearing performance of the children, the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) survey was implemented. Strong and significant correlations were found between the MBRS and CBRS scores, the results obtained from some questions in the Hearing Aid Awareness Question Form for Parents, the overall PEACH score, the QUIET subscale score, and the NOISE subscale score (p<0.001). According to the multivariate linear regression analyses, it was observed that the use of the pediatric clip hearing aids holder (question 17) had a significant effect in decreasing both the overall PEACH score (β=-3.07, p=0.008) and the PEACH-NOISE subscale score (β=-1.88, p=0.012). A unit increase in the score given to question 24 of the Hearing Aid Awareness Question Form for Parents (i.e., using the hearing aids longer) caused a 2.35-fold increase in the PEACH-NOISE subscale score, a 1.74-fold increase in the PEACH-QUIET subscale score, and a 4.06-fold increase in the overall PEACH score. Parent-child interaction and parents' knowledge about hearing aid use are important factors affecting hearing aid use in children. These factors also affect the children's subjective auditory performance. Parents should be given detailed information about hearing aid use and be more sensitive and responsive in their interactions with their children.

Onset of Inattention and Hyperactivity in Children and Adolescents With Epilepsy 6 months After the Diagnosis.

Complete or major symptoms of ADHD are often present in epilepsy. This study evaluated inattention and hyperactivity symptoms over the first 6 months in newly diagnosed pediatric epilepsy without comorbid ADHD. Children and adolescents with newly diagnosed epilepsy were followed for 6 months after starting antiseizure medications. The Nisonger Child Behavior Rating Form (NCBRF), Adverse Event Profile (AEP), and the Revised Wechsler Intelligence Scale for Children were used. There was a marked increase in attention difficulties while a moderate increase in hyperactivity levels. AEP scores, changes in non-verbal aspects of intelligence, levels of hyperactivity at the follow-up, and attention at baseline were significant predictors for inattention. In contrast, only levels of hyperactivity at the baseline and inattention at the follow-up were significant predictors for hyperactivity. Significant inattention and hyperactivity levels originated 6 months after the diagnosis of epilepsy and starting antiseizure medication.

The Effects of Child and Adolescent Attention Deficit / Hyperactivity Disorder and Associated Executive Function Deficits on Family Functioning

Objective: In this study, we aimed to investigate the effects of ADHD and associated executive dysfunctions on family functioning and enrolled children aged between 8- 17 years old diagnosed with ADHD at the study center. The control group was formed of children attending well-child visits at the study center. Method: Executive functions were measured via the Stroop test- TBAG form while the Family Assessment Device (FAD) was used to assess family functioning. Diagnoses were ascertained with K-SADS-PL and symptom severity was reported by parents via the Turgay DSM-IV–Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Descriptive, bivariate, and multivariate methods were used in analyses. P was set at 0.05 (Holm-Bonferroni procedure was used to control for family-wise error rate). Results: Families of children with ADHD performed significantly worse compared to controls in communication, affective responses, affective involvement, behavior control and general functioning. FAD- affective involvement scores of families of girls with ADHD were significantly elevated compared to males. ADHD subtypes, comorbidity and their interaction did not display significant effects on family functioning. Correlation analyses revealed that severity of oppositional and conduct disorder symptoms affected family functioning in various domains. In regression analyses, selective and focused attention and resistance to interference domains of Stroop-TBAG test did not significantly predict family functioning, although there was a signal that processing speed in resistance to interference domain may be important. Conclusion: ADHD diagnosis in children may affect multiple domains of family functioning. Parents of female children with ADHD may experience greater family dysfunction, especially in affective involvement. Severity of oppositionality and behavior problems rather than subtypes and comorbidity seem to affect family functioning in ADHD. Contributions of different facets of executive functions to family functioning in ADHD should be evaluated with different neuropsychological tasks.

Comparison of Leptin, Leptin Receptor, Vitamin D and Brain-Derived Neurotrophic Factor Levels in Major Depressive Disorder and Attention Deficit and Hyperactivity Disorder in Children and Adolescents

Objective: Data on effects of vitamins, hormones and neurotrophic factors on the etiology of attention deficit hyperactivity disorder (ADHD) and major depressive disorder (MDD) in children is limited. We hypothesized that serum vitamin D, brain-derived neurotrophic factor (BDNF), leptin, and leptin receptor levels are different in these patients, and that aforementioned biomarkers may affect symptom severity and risk of suicide. Methods: This study included 33 ADHD, 29 MDD patients and 35 healthy controls. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was used to assess the severity of ADHD, while Children Depression Inventory (CDI) and the Suicide Probability Scale (SPS) were used to measure the severity of depression and suicide risk in the MDD group. Serum vitamin D, BDNF, leptin, and leptin receptor levels were measured from participants’ venous blood samples. Results: Vitamin D and leptin receptor levels were significantly higher in the control group than in the patient groups, and leptin levels were significantly higher in the ADHD group than in the MDD and control groups. There was no difference between the groups in terms of BDNF levels. No significant correlations between ADHD duration, subtype, severity, depression severity, suicide risk, and vitamin D, BDNF, leptin, and leptin receptor levels were found. Conclusion: Although current research supports that BDNF, vitamin D, leptin, and leptin receptor levels may be involved in the etiopathogenesis of MDD and ADHD, large-scale studies are needed to better evaluate the effects of these factors.

The gut microbiome and child mental health: A population-based study

The link between the gut microbiome and the brain has gained increasing scientific and public interest for its potential to explain psychiatric risk. While differences in gut microbiome composition have been associated with several mental health problems, evidence to date has been largely based on animal models and human studies with modest sample sizes. In this cross-sectional study in 1,784 ten-year-old children from the multi-ethnic, population-based Generation R Study, we aimed to characterize associations of the gut microbiome with child mental health problems. Gut microbiome was assessed from stool samples using 16S rRNA sequencing. We focused on overall psychiatric symptoms as well as with specific domains of emotional and behavioral problems, assessed via the maternally rated Child Behavior Checklist. While we observed lower gut microbiome diversity in relation to higher overall and specific mental health problems, associations were not significant. Likewise, we did not identify any taxonomic feature associated with mental health problems after multiple testing correction, although suggestive findings indicated depletion of genera previously associated with psychiatric disorders, including Hungatella, Anaerotruncus and Oscillospiraceae. The identified compositional abundance differences were found to be similar across all mental health problems. Finally, we did not find significant enrichment for specific microbial functions in relation to mental health problems. In conclusion, based on the largest sample examined to date, we do not find clear evidence of associations between gut microbiome diversity, taxonomies or functions and mental health problems in the general pediatric population. In future, the use of longitudinal designs with repeated measurements of microbiome and psychiatric outcomes will be critical to identify whether and when associations between the gut microbiome and mental health emerge across development and into adulthood.

Using a Delphi Process to Update the Nisonger Child Behavior Rating Form.

The Nisonger Child Behavior Rating Form (NCBRF) was developed to specifically screen psychopathology and problem behavior in children and adolescents with IDD. This study aimed to update the NCBRF to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and screen for the most prevalent psychopathologies that affect children and adolescents with IDD. The authors re-aligned the existing items to fit within a DSM-5 framework, and then used the Delphi method with a panel of experts in IDD to evaluate the NCBRF items. The revision process included deleting and revising existing items and formulating new items. We obtained a final item pool after three iterations. The Delphi process and resulting item pool are described in this article.

Evaluation of the Relationship Between Head Trauma and Attention-Deficit/Hyperactivity Disorder in Primary School Children Admitted to the Emergency Department.

Head trauma causes a significant number of deaths as well as temporary and permanent disabilities every year. In this study, the prevalence of attention-deficit/hyperactivity disorder (ADHD) in primary school children who visited the emergency department (ED) for mild head trauma and the role of ADHD in mild head trauma of this age group were investigated. It was performed with 134 children of primary school age (6-12 years) who were admitted to the ED with mild head trauma and 134 children (control group) who presented with complaints other than head trauma. Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was used to evaluate the children for suspected ADHD. According to this scale, some children were referred to the child and adolescent psychiatry department (CAPD) for further evaluation. At the CAPD outpatient clinics, the children who were referred from the ED were examined in detail according to the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition , for possible diagnosis of ADHD. After evaluation of their sociodemographic characteristics and the ADHD test scores that were recorded, the diagnosis of ADHD in these children was established or ruled out. It was observed that 41 of the 134 children (30.60%) who presented to the ED with mild head trauma and 12 of the 134 children (8.96%) in the control group were diagnosed with ADHD ( P = 0.0001). When ADHD is corrected for sex, 29 of the 41 cases (70.7%) diagnosed with ADHD were boys and 12 (29.3%) were girls ( P = 0.000). According to the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition , when the patients who had been diagnosed with ADHD were grouped according to the ages of the children, no statistically significant difference was found between the groups in terms of ADHD ( P = 0.097). The prevalence of ADHD has been found to be higher in children of primary school age who present to the ED with mild head trauma. Hence, it can be deduced that the diagnosis of childhood ADHD increases the risk of presenting to the ED with head trauma. We believe that it is very important to keep the possible diagnosis of ADHD in mind and to refer that cases to the CAPD in case of high clinical suspicion, especially in primary school boys who are admitted to the ED with mild head trauma. We believe that in this way, morbidity and mortality due to head trauma in this age group can be significantly reduced.

The Effects of Resistance Training on Physical Fitness and Neuromotor-Cognitive Functions in Adults With Down Syndrome.

Adults with Down syndrome are an underserved population at high risk for a host of different pathologies from aging and lack of activity.PurposeTo examine the effects of a 10-week resistance training program on measures of motor behavior, cognitive function, mood, and physical fitness.MethodsParticipants (n = 11) were men and women clinically diagnosed with Down syndrome (age: 25.8 ± 6.4 years; height: 151.5 ± 8.3 cm; weight: 67.5 ± 13.0 kg; IQ: 58.3 ± 19.7 units). After familiarization of testing procedures, subjects performed The Arizona Cognitive Test Battery for Down Syndrome, TGMD-2, lower and upper body strength assessments, and body composition via DXA testing, while parental guardians completed cognitive and mood survey assessments (Cognitive Scale for Down Syndrome, Behavioral Rating Inventory of Executive Function, NiSonger Child Behavior Rating Form, Scales of Independent Behavior-Revised, Child Eating Behavior Questionnaire, Social Communication Questionnaire, and Mood and Feelings Questionnaire) at pre and post 10 weeks of periodized resistance training.ResultsSignificant (P ≤ 0.05) improvements in locomotor skills and object control skills were observed post-training. Both locomotor skills (e.g., sprint, gallop, leaping, broad jump) and object control skills (e.g., baseball catch, underhand roll, basketball dribble) were all significantly improved. Facets of cognitive performance significantly improved, specifically executive function and visuospatial working memory capacity, and frontal lobe activity. Mood disturbances significantly decrease. All aspects of physical strength and endurance were improved, i.e., leg press, bench press, sit-ups, push-ups, and chair sit-to-stand post-training. Lean tissue mass was significantly increased post-training.ConclusionThis study dramatically demonstrates that life enhancements for individuals with Down syndrome are achievable with a properly designed resistance training program.

Discrepancies between mother and father ratings of child behavior after early mild traumatic brain injury

ABSTRACT Mild traumatic brain injuries (mTBI) are highly prevalent during early childhood and can lead to behavioral difficulties. Parent report questionnaires are widely used to assess children’s behavior, but they are subject to parental bias. The aim of this study was to investigate parental discrepancies in internalized and externalized behavior ratings of children who sustain mTBI in early childhood (i.e., between 18 and 60 months) and to determine if parenting stress or family burden related to the injury contribute to parental discrepancies. Mothers and fathers of 85 children with mTBI, 58 orthopedic injured (OI), and 82 typically developing children (TDC) completed the Child Behavior Checklist 6 months after the injury. The primary caregiver completed the Parental Distress subscale of the Parenting Stress Index and the Family Burden of Injury Interview. Mothers reported more internalized and externalized behavior problems than fathers in the mTBI group. No group difference was found in the OI or TDC groups. Neither parenting stress nor family burden related to the injury predicted discrepancies in behavior ratings. Mothers’ and fathers’ perceptions of behavior after their young child sustains mTBI appear to differ, suggesting that both parents’ views are useful in understanding outcome. This difference was not found in either of the comparison groups indicating that factors related to mTBI may underlie the rating discrepancies.

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.

The impact of food allergy on mental health in school-age children

Few studies were suggesting that allergic diseases are associated with mental health in children. Therefore, we aimed to analyze the effect of food allergy on the Child Behavior Rating Scale (CBCL) in a general population-based birth cohort study.

Evaluation of Adolescents with Restless Legs Syndrome: Relation to School Success

Restless Legs Syndrome (RLS), which may be a missed diagnosis in children, is seen at an important frequency. The aim of this study was to investigate the clinical characteristics of patients with RLS and to show the effect of RLS on school success. Forty-three patients with RLS and 43 healthy volunteers were included to the study. Blood samples were taken to measure ferritin. The averages of school exam scores were recorded. The patient group was classified as mild, moderate, severe, and very severe according to the RLS rating scale. The daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS). The"Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S)" was completed by parents, and patients' inattention, and hyperactivity-impulsivity scores were compared with the control group. According to the RLS rating scale scores 25.6% (n:11) were evaluated as mild, 60.5% (n:26) were moderate and 14% (n:6) were severe. The mean ferritin level was significantly lower in the patient group. The mean score of inattention and hyperactivity-impulsivity in the patient group to be significantly higher than the control. The mathematics and science course mean grades were significantly lower in the patient group than the controls (66.7±17.7 vs 74.2±11.7). ESS scores were found to be significantly higher in the patient group. In this study, RLS has been found associated with ADHD and iron deficiency, similar to previous studies. There are not many studies on the effects of RLS in children on daily life and this study has objectively shown that RLS reduces patients' school achievement