Reducing Problem Behavior Research Articles

POSITIVE PARENT TRAINING TO REDUCE DISRUPTIVE BEHAVIOR

The objectives are to: 1) describe parent-child interaction patterns that foster the development of oppositional and defiant behavior; and 2) review positive parenting practices that reduce behavior problems and improve overall child development and functioning. Disruptive behavior disorders are early-onset and high-prevalence conditions. Parent behavior management training (PBMT) is one of the strongest evidence-based interventions in all of child and adolescent psychiatry. However, PBMT is not readily available in clinical practice and is not routinely provided in clinical training programs.

An Evaluation of Ethnicity-Matching for Caregiver Telehealth Training in India.

Telehealth has become an increasingly viable service delivery option for function-based treatment of problem behavior (Lindgren et al., 2016). However, few applications have occurred with participants outside the United States and little research exists evaluating the role that culture plays in service delivery. In the current study, we compared functional analyses and functional communication training delivered via telehealth by ethnically matched and ethnically distinct trainers to six participants in India. We measured the effectiveness using a multiple baseline design while collecting supplemental measures of sessions to criterion, cancellations, treatment fidelity, and social validity. We directly assessed preference for the ethnically matched and ethnically distinct trainers using a concurrent chains arrangement. Sessions with both trainers were effective in reducing problem behavior and increasing functional verbal requests for participating children, and treatment fidelity was high across training modalities. There were no major differences in sessions-to-criterion or cancellations across trainers. However, all six caregivers demonstrated greater preference for sessions with the ethnically matched trainer.

중학생의 CU특질이 문제행동에 미치는 영향 연구

This study aims to investigate the effect of CU characteristics of middle school students on problem behavior and to verify the mediating effect of stress in the family. This was intended to provide a foundation for counseling teachers in schools to provide useful data for counseling by reducing problem behavior of adolescents and stress that may occur at home. In order to achieve the purpose of the study, a preliminary survey of 60 copies of middle school students in Seoul related to this researcher showed high reliability with Cronbach's α value of .88. From June 3 to June 20, 2020, 481 copies of the questionnaire were distributed by visiting and commissioning middle schools in person. In this study, a correlation analysis was conducted using the SPSS 21.0 statistical program, and an independent sample t-test was conducted to verify the difference in major variables according to gender. The analysis results accordingly are as follows. First, it was confirmed that the CU characteristics of middle school students had a significant and positive effect on problem behavior. Second, it was confirmed that the CU characteristics of middle school students had a significant positive effect on family relationship stress. Third, it was found that the family relationship stress of middle school students had a significant positive effect on problem behavior. Fourth, the CU characteristics of middle school students partially mediated the relationship between family relationship stress and problem behavior.

Statistical Power of Piecewise Regression Analyses of Single-Case Experimental Studies Addressing Behavior Problems

In intervention research, single-case experimental designs are an important way to gain insights into the causes of individual changes that yield high internal validity. They are commonly applied to examine the effectiveness of classroom-based interventions to reduce problem behavior in schools. At the same time, there is no consensus on good design characteristics of single-case experimental designs when dealing with behavioral problems in schools. Moreover, specific challenges arise concerning appropriate approaches to analyzing behavioral data. Our study addresses the interplay between the test power of piecewise regression analysis and important design specifications of single-case research designs. Here, we focus on the influence of the following specifications of single-case research designs: number of measurement times, the initial frequency of the behavior, intervention effect, and data trend. We conducted a Monte-Carlo study. First, simulated datasets were created with specific design conditions based on reviews of published single-case intervention studies. Following, data were analyzed using piecewise Poisson-regression models, and the influence of specific design specifications on the test power was investigated. Our results indicate that piecewise regressions have a high potential of adequately identifying the effects of interventions for single-case studies. At the same time, test power is strongly related to the specific design specifications of the single-case study: Few measurement times, especially in phase A, and low initial frequencies of the behavior make it impossible to detect even large intervention effects. Research designs with a high number of measurement times show robust power. The insights gained are highly relevant for researchers in the field, as decisions during the early stage of conceptualizing and planning single-case experimental design studies may impact the chance to identify an existing intervention effect during the research process correctly.

Early Identification, Assessment and Interventions in Children with Developmental Disabilities: A Review on Autism

Developmental disabilities are a set of disorders which occur during the child’s developmental stages affecting his or her language, physical and mental abilities or behavior. These include autism and other related disorders which all negatively influence the way the child achieves normal developmental milestones. Nurses are expected to work in collaboration with parents and other health care professionals to monitor each child’s growth and development during each well-child visit or Infant Welfare Clinics (IWC) as well as during illness episodes. Generally, parents’ concerns regarding developmental delays are discussed and the child is followed up accordingly through developmental screening. A brief test is conducted on the child while the parent/caregiver completes a questionnaire or checklist regarding the child’s developmental history. The American Academy of Pediatrics (AAP) recommends that developmental and behavioral screening be conducted for all children during regular IWC or well-child visits at nine, 18 and 30-months. Early diagnosis together with early treatment can make a major difference in a child’s life and also decrease the possibility for costly interventions in future. Several programs have been designed to deal with the variety of social and behavioral difficulties associated with autism, focusing on reducing problem behaviors in children with autism. Once an individual is given a confirmed autism diagnosis by a qualified professional, the parents need to seek further information immediately on how to support their child. Early intervention treatment services have been shown to greatly improve a child’s development. Thus, diagnosing autism early and instituting treatment and support promptly is mandatory for better prognosis.

유아기 자녀의 문제행동, 어머니 원가족 건강성, 자기분화, 부부갈등 간 구조적 관계

Objectives The purpose of this study is to reveal the structure and influence between the mother's role in the family-of-origin health, mother's differentiation of self, marital conflict, and problem behavior of early childhood. Methods For this purpose, a questionnaire was distributed to 435 children attending early childhood education institutions located in S and G to measure the variables of childhood child problem behavior, mother's family-of-Origin health, mother's differentiation of self, and marital conflict. In the structural equation model, the independent variable was the mother's family-of-Origin health as the mediating variable, differentiation of self and marital conflict dependent variables were selected as the externalization problem behavior and internalization problem behavior of early children. Results Mothers’ family-of-Origin health had a positive effect on the level of mother’s differentiation of self, and mother’s differentiation of self had a negative effect on children’s externalizing and internalizing problem behaviors. Couple conflict had a positive effect on the externalization and internalization problem behaviors of children in early childhood. Mothers' family-of-Origin health fully mediated the level of mother's differentiation of self in the externalizing and internalizing problem behaviors of children in early childhood. In addition, it was found that marital conflict and mother differentiation of self between the and the externalization and internalization problem behaviors of the infant children had an indirect effect on the externalization and internalization problem behavior of early childhood. Conclusions For this reason, it was verified that differentiation of self in the mother is an important factor in preventing and reducing problem behavior of early childhood, Based on the results of this study, various measures were sought to prevent and reduce problem behavior of early childhood.

유아기 자녀의 문제행동, 어머니 원가족 건강성, 자기분화, 부부갈등 간 구조적 관계

Objectives The purpose of this study is to reveal the structure and influence between the mother's role in the family-of-origin health, mother's differentiation of self, marital conflict, and problem behavior of early childhood. Methods For this purpose, a questionnaire was distributed to 435 children attending early childhood education institutions located in S and G to measure the variables of childhood child problem behavior, mother's family-of-Origin health, mother's differentiation of self, and marital conflict. In the structural equation model, the independent variable was the mother's family-of-Origin health as the mediating variable, differentiation of self and marital conflict dependent variables were selected as the externalization problem behavior and internalization problem behavior of early children. Results Mothers’ family-of-Origin health had a positive effect on the level of mother’s differentiation of self, and mother’s differentiation of self had a negative effect on children’s externalizing and internalizing problem behaviors. Couple conflict had a positive effect on the externalization and internalization problem behaviors of children in early childhood. Mothers' family-of-Origin health fully mediated the level of mother's differentiation of self in the externalizing and internalizing problem behaviors of children in early childhood. In addition, it was found that marital conflict and mother differentiation of self between the and the externalization and internalization problem behaviors of the infant children had an indirect effect on the externalization and internalization problem behavior of early childhood. Conclusions For this reason, it was verified that differentiation of self in the mother is an important factor in preventing and reducing problem behavior of early childhood, Based on the results of this study, various measures were sought to prevent and reduce problem behavior of early childhood.

Mindfulness for adults with autism spectrum disorder and intellectual disability: A pilot study.

The present study aims to examine the effects of the MindfulTEA program, an Mindfulness-based Interventions (MBIs) specifically designed for adults with Autism Spectrum Disorder (ASD) and Intellectual Disability, to reduce behavioural problems. MBIs are effective in improving well-being in people with high-functioning ASD, but little is known about the impact of the MBIs on people with ASD and intellectual disability associated. Fourteen adults (age 18 to 44) with ASD and intellectual disability participated in the program. Results showed a significant decrease in self-injurious and aggressive/destructive behaviours after the MBI. Stereotyped behaviour did not show significant change. Results suggest that the MindfulTEA program could effectively reduce some types of behaviour problems in people with ASD and intellectual disability. MBIs could be a useful alternative to traditional behaviour management interventions for reducing behaviour problems in this population.

Parent Child Interaction Training (PCIT) in Zurich, Switzerland - Experiences and Results of the first two years

IntroductionParent Child Interaction Training PCIT (Zisser & Eyberg, 2010; Briegel, 2016) is an evidence-based treatment of oppositional defiant disorder in preschool children. However, it is implemented in few institutions in Europe. The advantage of PCIT is the involvement of both child and parents with direct coaching of the parents.ObjectivesWe will give an overview of 20 treatment courses we have conducted since the introduction of PCIT at the Zurich University Hospital for Child and Adolescent Psychiatry. First, a descriptive analysis of our sample will be conducted. The influence of sample characteristics and intensity of training on the reduction of behavioral problems will be analyzed.MethodsParents attend the training for at least 6 months with regular sessions. The transfer into everyday life is achieved by daily homework. We use the Eyberg Child Problem Behavior Inventory as pre-post measurements. The ECBI is filled out by the parents before each session and also enables a progress analysis.ResultsThree times more boys participated than girls. Problem behavior was significantly reduced after the play training phase. There was also a significant overall pre-post effect. The effect seemed to be independent of the parental problem score before training and of the number of play-training sessions.ConclusionsParents and children clearly benefit from the play training. For the following cooperation training, the problem load experienced by the parents seems to be more relevant than the intensity of the child’s problem behavior as assessed by them. This is to be examined in the future.DisclosureNo significant relationships.

Emotion-focused Cognitive-Behavioral Therapy for externalizing disorders in children and adolescents : an attempt to resolve emotion regulation difficulties

IntroductionDeficient emotion regulation is a common and impairing area of difficulty among children and adolescents with externalizing disorders. Emotion focused cognitive behavioral therapy ECBT is a form of CBT that is suggested to be employed to improve dysregulation of anxiety and other kind of emotions in anxious youth.ObjectivesExamine the efficacy of an Emotion-focused Cognitive-Behavioral Therapy (ECBT) inspired program on emotional regulation difficulties and behavioral problems in children and adolescents with externalizing disordersMethodsWe conducted a cross-sectional comparative experimental study. Subjects were 50 patients exhibiting behavioral disorders aged 9 to 18 years , with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD).Participants were assigned to ECBT and control groups. ECBT group contributed in 12-h weekly sessions within ECBT-inspired program. The control group received standard care. To assess emotion-related competencies, children were administered the emotion regulation questionnaire (ERQ-CA) and the alexithymia questionnaire for children(AQC). Parents completed the Child Behavior Checklist(CBCL) to measure youth externalizing problems. Tests were administered in pre- and post-test to all subjects. Both groups were matched for age, sex and educationnal level. Comparison of pre- and post-test results was performed using the Student’s t-test.ResultsECBT demonstrated a significant difference in the reduction of behavioral problems. ECBT effectively increased adaptive emotion regulation strategies (cognitive reappraisal) in the post-test. ECBT also reduced alexithymia scores, particularly difficulty identifying feelings, and externally oriented thinking.ConclusionsECBT demonstrated promising initial effectiveness in addressing emotion regulation deficits of children with externalizing behaviorsDisclosureNo significant relationships.

Long-term associations between early-life family functioning and preadolescent white matter microstructure.

Causes of childhood behavior problems remain poorly understood. Enriched family environments and corresponding brain development may reduce the risk of their onset, but research investigating white matter neurodevelopmental pathways explaining associations between the family environment and behavior remains limited. We hypothesized that more positive prenatal and mid-childhood family functioning - a measure of a family's problem solving and supportive capacity - would be associated with two markers of preadolescent white matter neurodevelopment related to reduced behavior problems: higher global fractional anisotropy (FA) and lower global mean diffusivity (MD). Data are from 2727 families in the Generation R Study, the Netherlands. Mothers reported family functioning (McMaster Family Assessment Device, range 1-4, higher scores indicate healthier functioning) prenatally and in mid-childhood (mean age 6.1 years). In preadolescence (mean age 10.1), the study collected diffusion-weighted scans. We computed standardized global MD and FA values by averaging metrics from 27 white matter tracts, and we fit linear models adjusting for possible confounders to examine global and tract-specific outcomes. Prenatal and mid-childhood family functioning scores were moderately correlated, r = 0.38. However, only prenatal family functioning - and not mid-childhood functioning - was associated with higher global FA and lower global MD in preadolescence in fully adjusted models: βglobal FA = 0.11 (95% CI 0.00, 0.21) and βglobal MD = -0.15 (95% CI -0.28, -0.03) per one-unit increase in functioning score. Sensitivity and tract-specific analyses supported these global findings. These results suggest high-functioning prenatal or perinatal family environments may confer lasting white matter neurodevelopmental benefits into preadolescence.

School-Wide Positive Behavior Interventions and Supports in Rural and Urban California Schools: Effects on Fidelity of Implementation and Suspension Outcomes

Evidence suggests that implementing School-Wide Positive Behavior Interventions and Supports (SWPBIS) with fidelity can reduce behavior problems in schools and, concomitantly, the use of school suspensions. Few studies have explored differences in SWPBIS implementation fidelity and outcomes between rural and urban schools, but research suggests urban locale may moderate the effectiveness of particular interventions. Therefore, the purpose of this study was to assess differences in SWPBIS implementation fidelity and suspension outcomes between rural and urban schools in California during the 2017–2018 school year. Using several subsets of this sample, we applied linear and multinomial regression and multilevel modeling to determine differences between locales. Results suggest no differences in the likelihood of implementing Tier 1 or Tiers 1 and 2 with fidelity between rural and urban schools. However, rural schools are significantly more likely to implement all three tiers of SWPBIS with fidelity. When comparing rural and urban schools and suspension outcomes, we found that urban schools implementing all three tiers were less likely to use out-of-school suspensions for all students and for students with disabilities. Limitations and implications are discussed.

Comparative effectiveness of parent-child interaction therapy based on trauma exposure and attrition.

To determine whether Parent-Child Interaction Therapy (PCIT) is as effective at reducing behavior problems for children with a history of trauma and for those who do not complete therapy. Retrospective chart review of patients between 2.5 and 6.5 years of age who participated in PCIT between January 1, 2012, and December 1, 2019, at a child advocacy center within a large Midwestern children's hospital was performed. Demographics, trauma history, and Eyberg Child Behavior Inventory (ECBI) and parenting confidence scores were collected. Changes in child behavior and parenting confidence over time were compared between patients with and without trauma exposure using separate generalized estimating equation models for those who did and did not complete PCIT. Of the 212 PCIT participants, 116 (54.72%) had a trauma history and 96 (45.28%) did not, and 98 (46.23%) completed PCIT and 114 (53.77%) did not. Patient demographics were fairly diverse and representative of the region. Patients with trauma exposure were significantly less likely to complete PCIT (38.79%) than patients without trauma exposure (55.21%). ECBI intensity scores significantly decreased over time among both patients who did and did not complete PCIT. The change in ECBI intensity scores over time did not differ between patients with and without trauma exposure regardless of whether or not they completed PCIT. Parenting confidence significantly improved over time regardless of trauma exposure or attrition. Standard PCIT can be used effectively with children with trauma exposure and results in significant improvement even for those who do not complete therapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Practitioner's Guide for Selecting Functional Communication Responses.

Functional communication training (FCT) is an effective and widely used procedure to reduce problem behaviors. The purpose of FCT is to replace a problem behavior with a socially appropriate and communicative behavior - the functional communication response (FCR), which produces the same reinforcer as the problem behavior. Recent reviews of FCT have focused on providing overall recommendations for how the procedure should be implemented. A relatively small body of literature has been devoted to the selection of the FCR. The purpose of this article is to propose a set of considerations for practitioners in selecting FCRs.

Predictors of Suicide Attempt among Middle School Students with Suicidal Ideation: Analysis of Data from the 15th (2019) Korea Youth Risk Behavior Web-based Survey

Purpose: This study aimed to identify the factors influencing suicide attempts among middle school students with suicidal ideation.Methods: Data were from the 2019 Youth Health Risk Behavior Web-based survey collected by the Korea Centers for Disease Control and Prevention. The data were analyzed using the SPSS program.Results: Participants were 29,384 middle school students, there were 14.1% of suicide ideation, and 22.2% of them attempted suicide. Among the students with suicidal thoughts, suicide attempts were higher in those who had experiences of alcohol drinking, smoking, substance abuse, and sexual intercourse.Conclusion: Therefore, to prevent suicide accidents among middle school students, there is a need for strategies that would reduce problem behavior such as alcohol drinking, smoking, sexual intercourse, and substance abuse. For middle school students who have already experienced problem behavior, efficient plans should be established for screening, prevention, and treatment of the high-risk groups in suicide attempts.

A French community-based intervention for parents of French-Canadian children with behavior problems: The EQUIPE program

ObjectivesBehavior problems are one of the most common reasons for seeking mental health services in pediatric populations. The objectives are to evaluate the effects of the EQUIPE program (Étude Québécoise d’Intervention pour les Parents d’Enfants avec des problèmes de comportement) and to analyze the impact of the severity of behavior problems and of parental characteristics. MethodsThis program was translated from the Community Parent Education Program. The effects of EQUIPE, as compared to a control group, were evaluated by using Child Behavior Checklist and Parent Stress Index questionnaires before (T0) and after the intervention program (T1), and at 6 (T2) and 12months (T3) follow-up visits. ResultsIn total, 533 participants were enrolled in intervention (n=465) (with “severe” or “mild” subgroups according to CBCL-T score) and a control group (n=68). In the two groups, the results showed a statistically significant decrease in Child Behavior Checklist and Parent Stress Index total scores at T1, T2 and T3, with the exception of Child Behavior Checklist total scores in the control group at T2. In the intervention group Child Behavior Checklist total scores were significantly higher in the “severe”; which was not the case for Parent Stress Index total scores at T2 and T3. DiscussionSocioeconomic characteristics, family details, parental medical history and the age of the children appeared to influence changes in Child Behavior Checklist and Parent Stress Index total scores. ConclusionThe EQUIPE program is an effective intervention for reducing behavior problems and parents’ stress in a French-Canadian population.

The Effects of Emotion Regulation Treatment on Disruptive Behavior Problems in Children: A Randomized Controlled Trial

Disruptive behavior problems are a frequent reason for children’s referrals to psychological services and can have negative effects on social and academic functioning. Most treatment programs involve parents as recipients and implementation of intervention programs in school is low. Deficits in emotion regulation have recently been implicated in the development of disruptive behavior disorders, making child directed early intervention programs focusing on increasing emotion regulation skills feasible. The purpose of this study was to assess the effects of Tuning Your Temper, a brief cognitive behavioral program for children with disruptive behavior problems, in a randomized controlled trial. A total of 125 children with disruptive behavior problems at school, aged 6–11 years old were randomized to either intervention or wait-list control condition. Treatment was conducted at school. Assessments included teacher and parent ratings on the Strengths and Difficulties Questionnaire (SDQ) and the Disruptive Behavior Rating Scale (DBRS) pre- and post-treatment and at 6-month follow-up. Results showed a significant reduction in behavior problems for the treatment condition on both measures and effects were maintained at 6-month follow-up. Results were more robust for teacher ratings, with medium to large effect sizes. Tuning Your Temper appears to be a promising early intervention program for children with disruptive behavior problems at school.

Functional analysis patterns of automatic reinforcement: A review and component analysis of treatment effects.

Functional analysis (FA) conditions include different antecedent or consequent events that may disrupt responding. Thus, varying patterns of FA differentiation may predict treatment outcomes of problem behavior maintained by automatic reinforcement. These patterns could be used to inform the development of individualized interventions. An approach to classifying these patterns is to categorize FA outcomes as attention condition lowest, demand condition lowest, and play condition lowest, according to the condition in which problem behavior is most disrupted. In Study 1, we applied this criterion to 120 datasets finding that 60% could be classified using this method, whereas 89% of datasets showed a disruption of 50% or higher. In Study 2, we conducted a treatment component analyses for 3 individuals whose FAs each exhibited one of the 3 distinct patterns. The results indicated that specific elements of the FA conditions could reduce problem behavior. The predictive utility of these disruption patterns is discussed.

The Efficacy of Visual Activity Schedule Intervention in Reducing Problem Behaviors in Children With Attention-Deficit/Hyperactivity Disorder Between the Age of 5 and 12 Years: A Systematic Review.

ObjectivesChildren with attention-deficit/hyperactivity disorder (ADHD) tend to be noisy and violate rules with their disruptive behaviors, resulting in greater difficulties with off-task behaviors and being at risk for social refusal. The visual activity schedule (VAS) intervention program is a frequently used method to teach multiple skills involving on-task, use of schedules, transition behaviors, social initiation, independent play skills, classroom skills, and academic skills. The current systematic review aimed to examine the efficacy of using VAS intervention in reducing problem behaviors in children with ADHD between 5 and 12 years of age.MethodsSystematic searches were conducted using two electronic databases (PubMed and Scopus) to identify relevant studies published in English between 2010 and 2020. Four studies met the inclusion criteria: two studies examined the effect of schedule-based tasks and the use of an iPad on classroom skills, while the other two examined randomized clinical trials (RCTs) of psychosocial treatment for ADHD inattentive type and a cross-sectional study examined the impact of the group size on task behavior and work productivity in children with ADHD.ResultsThe findings indicate that the interventions used in all four studies could lead to increased satisfaction among participants and parents, as well as a reduction in problem behavior. In terms of the research indicators, the RCT had low quality, while the others were of high quality.ConclusionA larger number of studies and the ADHD clinical population would help to increase the generalizability of future reviews of treatments in this context.

A functional communication training for developing verbal behavior and treatment of challenging behavior in individuals with autism spectrum disorders

Communication problems are one of the symptoms of autism spectrum disorders. Challenging behaviors may be a form of communication with the environment, and when other forms of communication are not available, they may be the only way to meet their needs. The purpose of this article is to demonstrate the potential use of functional communication training in reducing problem behaviors of individuals with ASD, as well as developing acceptable ways of communication. In a research process based on behavior analysis, the method of single-subject experiment with multiple-baseline design was used. The results of the study show that the research participants developed communication skills on the basic level, and the frequency of their challenging behaviors has significantly decreased.