Treatment Of Behavior Problems Research Articles

Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the INTERFEAR Model in a Community Sample in Spain

Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child’s fearlessness and callous–unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous–unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; Mage = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.

Family engagement in a behavioral parenting intervention: A randomized comparison of telehealth versus office-based treatment formats.

Despite effective treatment options, many families-especially those from marginalized backgrounds-lack access to quality care for their children's behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Although telehealth-delivered parenting interventions are associated with positive clinical outcomes, limited research has examined whether telehealth formats improve treatment engagement relative to office-based care. The present study is the first controlled comparison of engagement across office-based parent-child interaction therapy (PCIT) and internet-delivered PCIT (iPCIT). Children ages 3-5 years, and their caregiver(s) (N = 40) participated in a randomized trial comparing iPCIT to office-based PCIT in the treatment of behavioral problems. Analyses examined the effects of treatment format on engagement (i.e., missed sessions, premature treatment discontinuation, homework completion, therapeutic alliance, and treatment satisfaction). Logistic and linear regressions further explored whether treatment format moderated the effects of common predictors of treatment engagement (i.e., family economic means, racial/ethnic background, caregiver stress). iPCIT improved attendance rates relative to office-based PCIT, especially for families from minoritized racial/ethnic backgrounds. At the same time, among families with relatively higher levels of caregiver stress, office-based PCIT was associated with lower dropout rates and improved treatment alliance and satisfaction, relative to iPCIT. This study provides the first experimental support that telehealth formats can improve treatment attendance in behavioral parenting interventions. Findings highlight nuances in treatment engagement across treatment formats that reveal limits to the extent telehealth transcends engagement concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Bimbingan Konseling Pada Anak Usia Dini

Guidance and counseling for early childhood is an assistance effort carried out by teachers/supporters for early childhood so that children can grow and develop optimally and be able to overcome the problems they face. The research was carried out in a qualitative manner using a literature study approach. Research results: Through counseling, children are taught skills that enable them to become independent individuals, able to make decisions, and be responsible for their own actions. The main objective of providing guidance and counseling is to anticipate or take preventive action against the emergence of problematic behavior. Of course, prevention will be much easier than cure. This principle will also be applied in counseling guidance in the Early Childhood Education environment. In other words, preventing problem behavior in children is much easier than treating problem behavior in adults.

Exploring the Role of Standardized Instruments and Consultation in Reducing Racial/Ethnic Disparities in Treatment for Behavioral Problems

This study was part of a larger study of Partnering for Success, a federally funded initiative focused on providing evidence-based outpatient mental health treatment to children involved with or at risk for involvement with the child welfare system. With a sample of 782 children, the study explored strategies that therapists can use to reduce racial and ethnic disparities in treatment for behavioral problems in children. The results provide promising evidence that racial and ethnic disparities in treatment receipt for behavioral problems are reduced when therapists administer and adhere to the results of standardized screening instruments and participate in clinical consultation.

Translational evaluation of on/off alternative reinforcement cycling.

Cycling between the availability and unavailability of reinforcement for alternative responding has successfully reduced resurgence in basic laboratory evaluations, but this approach represents a marked departure from current standards of care when treating problem behavior, warranting careful translation before its use clinically. Therefore, with extinction arranged for target responding across groups in Phase 2, we evaluated the effects of cycling between the availability and unavailability of differential reinforcement of alternative behavior (DRA) using a computer-based task with adult humans recruited through Amazon MTurk. Two control groups experienced constant DRA in Phase 2, with one group experiencing a dense DRA schedule and another group experiencing a lean DRA schedule. The cycling DRA group tended to show greater reductions in target responding and improved discrimination in Phase 2 and less target responding across Phases 2 and 3 than the lean DRA and dense DRA groups. These preliminary findings suggest that on/off DRA cycling procedures may produce more desirable treatment outcomes than constant DRA without producing negative side effects; however, further research is needed to confirm these possibilities.

Concurrent schedules of differential reinforcement of alternative behavior in the treatment of problem behavior without extinction.

Differential reinforcement of alternative behavior (DRA) without extinction is an effective intervention for reducing problem behavior maintained by socially mediated reinforcement, particularly when implementing dense schedules of reinforcement for appropriate behavior. Thinning schedules of reinforcement for an alternative response may result in resurgence of problem behavior. Resurgence may be of particular concern in the treatment of problem behavior without extinction because problem behavior that resurges is also likely to encounter reinforcement and thus can be expected to maintain. In the present investigation, we compared the effectiveness of single and concurrent DRA schedules in decreasing the probability of resurgence when problem behavior continues to produce reinforcement throughout all phases of the evaluation. Concurrent DRA schedules reduced or eliminated the likelihood of resurgence compared with a single DRA schedule during a treatment challenge.

Assessment and treatment of problem behavior with multiple functions for individuals with disabilities: A systematic review of the literature and discussion.

Assessment and treatment of problem behavior with multiple functions for individuals with disabilities: A systematic review of the literature and discussion.

Functional analysis: what have we learned in 85 years?

Even though the term "functional analysis" (FA) is prevalent in the current behavioral literature, the concept and process have roots in the early days of basic research in behavior analysis. Furthermore, the methodology developed in the field of FA has been one of the most significant advances in research on challenging behaviors over the past four decades. The current article reviews the history of the term "functional analysis" and research related to experimental FA. The aim is to summarize what the field of behavior analysis has learned about this powerful methodology. FA is considered a gold standard of functional assessment. However, several arguments about limitations relating to methodological issues in FA and its ecological validity have been put forward. Some of these shortcomings include constraints on the time available for assessment, the risk posed by severe problem behavior, and the inability to exert tight control over environmental conditions. The literature on the subject clearly shows that refinements have been aimed not only at improving some of the methodological characteristics of FA but also at adapting the strategy for real-world application. Practical functional assessment (known as interview-informed synthesized contingency analysis [IISCA]) is a contemporary approach to assessing and treating problem behavior. Recent research on IISCA offers empirical support for the practical functional assessment and skill-based treatment model, confirming that it can obtain sustainable and socially meaningful reductions in problem behavior. Nevertheless, more research is needed to address procedural variations in, and the utility and social validity of, IISCA.

What works in the psychological treatment of child conduct problems? An umbrella review of meta-analytic studies

Conduct problems (CP) constitute a major field for child clinical psychology, in terms of not only prevalence, but also developmental, social, and clinical relevance. This study carried out an umbrella review of meta-analyses on the efficacy of treatment/indicated prevention of child CP (mean age range up to 12 years). Following a registered protocol, several databases (i.e., Web of Science, PsycINFO, PROSPERO, and The Cochrane Library) were searched for meta-analyses published from January 2002 to March 2022. Nine meta-analytic publications met the required criteria, and the main characteristics and findings of the studies were systematically described. Weighted effect sizes (ESs) were calculated through RStudio program. Analyses of heterogeneity, publication bias, quality (AMSTAR-2), and credibility were also conducted. Results indicate that parent training has been the most studied intervention, with a weighted ES of d = -0.49 (95% CI -.67 to -.32). The reviewed studies identified several moderators for the efficacy of parent training, including individual (severity of CP), family (financial disadvantage), and intervention (delivery format) characteristics. Results from child-centered play therapy were also analyzed, d = -.34 (95% CI -.40 to -.28), but the reduced number of meta-analyses and the weakness detected by quality assessment suggest the need of cautiously considering the pooled effects. In general, evidence seems to be suggestive of the efficacy of treatment of CP, particularly for parent training. Nevertheless, efficacy seems to be moderate, heterogeneity indexes are high, and quality assessments of meta-analyses are often suboptimal. This study suggests several avenues to strengthen knowledge in this field

Clinical predictors of psychotropic medication prescription in children with ASD of the ELENA cohort.

Psychotropic drugs are often used to treat behavior problems in ASD with some evidence supporting efficacity (e.g.: risperidone and irritability) but also significant side effects at the short and longer-term. It is then essential to know better the factors associated with the prescription of these medications and potentially implement early behavioral and psychosocial intervention or cognitive remediation before to use medication. We designed a case-control study based on the population of the ELENA cohort to assess the factors associated with early psychotropic drugs use in children with ASD. Externalized behavior symptoms (measured by the Child Behavior Checklist) is the leading risk factor during the first years of follow-up (aOR = 2.8; CI [1.04; 7.67]; p = 0.04). Age, gender, autism severity, adaptive behaviors, or internalized behaviors were not associated with psychotropic medication prescription. Low IQ and parents who had received training tended to increase the risk of psychotropic medication prescription during follow-up but were not statistically significant. These findings underscore the need for early identification of symptoms of externalizing behaviour, early appropriate information for parents about treatment with and without medication, early analysis of externalising behaviour and targeted treatments.

특수교육지원센터 초임교사가 순회교육 과정에서 경험하는 어려움과 지원요구

Objectives The purpose of this study was to conduct a qualitative study and deeply examine the challenges and support needs experienced by beginning teachers in special education support centers during itinerant education. Methods To this end, snowball sampling was conducted to target 5 beginning teachers working in special education support centers in Jeollabuk-do Province as the research participants. This study intended to closely investigate the experience of beginning teachers that implement itinerant education in special education support centers, so a semi-structured interview was developed with 3 domains and 12 components about the ‘operation status of itinerant education,’ ‘challenges of itinerant education,’ and ‘support needs for itinerant education.’ Based on the semi-structured interview, 1-2 sessions of in-depth interview, which is a qualitative study, were conducted and the collected data were analyzed with inductive analysis through the three coding processes that consisted of transcription, coding, and meaning generation. Results The analysis result showed that the struggles of the beginning teachers can be classified into 4 upper categories and 13 sub-categories. The first upper category is ‘a lack of expertise’ and recognized the lack of expertise as a teacher such as establishing itinerant education activity plans, classes, and interventions for behavior problems. The second upper category is ‘psychological conflicts from relationships’ and beginning teachers experienced challenges in their relationships with inclusive teachers, guardians, and the students during the itinerant education. The third upper category was the ‘barren road for self-development’ as there were limits in the training for itinerant education or human resource. The fourth upper category is the ‘poor environment and administrative⋅financial support’ and there were insufficient environmental conditions for itinerant education and administrative⋅financial support. The support needs of the beginning teachers can be categorized into 3 upper categories and 6 sub-categories. The first upper category is for ‘teachers to develop’ through efforts for the growth of teachers' expertise such as training and professional learning community. The second upper category is ‘a school that collaborates and communicates.’ The beginning teachers emphasized the need to cooperate and communicate with the inclusive teachers and the school parents. The third upper category is ‘effective administrative⋅financial support’ as there were demands of appropriate administrative⋅financial support to perform the duties effectively. Conclusions The study results can be applied as the base data of policy support plans for the itinerant education of the beginning teachers in special education support centers and also to examine the measures required for the beginning teachers to develop into professional itinerant teachers.

Cat-human bond: Satisfaction and behavioural complaints among Italian respondents

The present is a study of the data collected through an online survey which investigated satisfaction of Italian cat-caretakers with their pet, considering health and behavioural complaints. The survey was advertised using social media and a virtual snowball sampling method was applied. The questionnaire collected information about caretaker’s demographics, their cat’s origin, health problems and behavioural complaints, and their satisfaction with the cat. 6096 respondents completed the questionnaire. Logistic regression was applied and some cats’ and caretakers’ demographics predicted both the presence of behavioural problems and the assignment of maximum score in satisfaction. House soiling was the most frequently reported behavioural complaint (4.7%) and it was predicted by both management factors (i.e., number of cats in the household, p < 0.05), and cat-related ones (e.g., cat’s age, anxiety level, and health problems, all p < 0.001). House soiling, aggression (both intra and inter-species), fear, hyperactivity and eating disorders decreased caretakers’ satisfaction (all p < 0.001), whereas the presence of what respondents identified as health problems did not. Moreover, some cat features as “being affectionate” increased the caretaker’s satisfaction (p < 0.001). The results of this study highlighted the impact of behavioural complaints on the cat caretaker’s satisfaction with their pet, supporting the need of prevention and/or treatment of behavioural problems or inappropriate behaviours to avoid unsatisfactory relationship between cats and their caretaker and to improve cat welfare.

Problem behavior maintained by a precurrent relation

AbstractDifferential reinforcement of alternative behavior is a well‐established treatment for problem behavior in which the functional reinforcer is delivered after the occurrence of a replacement behavior and withheld after the occurrence of problem behavior. However, sometimes problem behavior continues to occur under these conditions, raising a question as to why problem behavior might maintain when its reinforcer is withheld. This study examined the possibility that problem behavior could be maintained indirectly in a precurrent relation. A functional analysis was conducted to identify a response‐response relation between self‐injurious behavior (SIB) and an alternative response. The results suggest that SIB was maintained by its relation with the alternative response.

Temporal stability of parent-reported behavior problems in late talkers over 2 years: a prospective case-control study from toddlerhood to preschool age

BackgroundLate talking (LT) in toddlers is a risk factor for language weakness that may interfere with the development of using language to regulate behavior and emotion and contribute to the development of behavior problems from early childhood. This study examined the temporal stability of parent-reported behavior problems among Mandarin-speaking LT toddlers from ages 2 to 4 in Taiwan.MethodsThirty-one LT and 31 typical language development (TLD) toddlers were assessed for their vocabulary production at age 2 with the Words and Sentences Forms of the MacArthur-Bates Communicative Developmental Inventories Toddler Form (Taiwan version). Additionally, participants’ receptive and expressive language abilities were assessed using the receptive and expressive language subscales of the Bayley Scales of Infant and Toddler Development, Third Edition. At age 4, the Child Language Disorder Scale-Revised was applied and included the two core subtests for auditory comprehension and expressive communication. At ages 2 and 4 years, behavior problems were assessed with the Child Behavior Checklist.ResultsThere was a higher percentage of participants with persistent behavior problems among LT toddlers than among TLD toddlers. Moreover, toddlers with larger vocabularies were less likely to develop withdrawal behaviors by preschool age.ConclusionsThis study supported the temporal stability of parent-reported behavior problems among LT toddlers across early childhood. Early identification of and intervention for behavior problems associated with LT in toddlerhood is essential to alleviate their behavior problems later in preschool years.

Assessment of behavioural problems in preschool and school going children with epilepsy.

IntroductionChildren with epilepsy are at greater risk of developing psychiatric and behavioural disorders such as attention deficit/hyperactivity disorder (ADHD), conduct disorder, autism spectrum disorder (ASD), as well as affective and aggressive disorders than normal children which may affect the well- being and quality of life of the child.Aim and ObjectivesThis study aims at identifying behavioural problems in children with epilepsy enabling early diagnosis and intervention. The objectives were to assess the presence and type of behavioural problems in children with epilepsy.MethodsA prospective cross-sectional study was conducted on children who were diagnosed as epilepsy in two age groups of 1.5–5 years and 6–18 years recruited by non-probability convenience sampling. Data regarding seizure semiology, clinical features and treatment were obtained. Children underwent IQ assessment, electroencephalogram and brain neuroimaging. Child Behaviour Check List (CBCL) was administered to parents or primary caregivers after obtaining informed consent. Results were analyzed for presence of behavioural problems using SPSS-23.ResultsIn the study, out of 50 study subjects, 72% were between 6–18 years. 60% children had generalised seizures, 58% children had epilepsy for <2 years and abnormal EEG was present in 80% children. 6% children had behavioural problems and 4% had borderline presentations. Co-relation of behavioural problems with age was statistically significant with p value 0.027. Behavioural problems identified were aggressiveness and anxiety.ConclusionChildhood epilepsy is associated with behavioural problems along with other co-morbidities warranting a search during follow-up visits.Take-home messageEarly identification and treatment of behavioural problems in children with epilepsy by periodic assessment during follow up visits, careful selection of combination of drugs and appropriate dose can improve the overall outcome in children taking antiepileptic drugs (AEDs) for epilepsy.

Tier 2 Social and Emotional Learning Interventions of a Multi-Tier System of Support: Literature Review

There are many students who face barriers and difficulties to display social emotional learning competencies. As result of lacking these skills, students become less connected to school as they proceed from elementary to middle to high school and negatively impact their academic performance, behavior, and health. Research shows that small group instruction is highly effective in helping students master essential skills and tasks. The purpose of this paper is to review social and emotional learning interventions at Tier 2 of a Multi-Tier System of Support (MTSS). The secondary intervention tier utilizes targeted interventions in small groups identified by support team and then employ them by using effective strategies that directly target a skill deficit. This paper includes a review of evidence-based practices for improving social-emotional outcomes and interventions for behavioral problems. Keywords : social-emotional learning, multi-tier system of support, tier 2, and evidence-based practice. DOI: 10.7176/JEP/12-36-02 Publication date: December 31 st 2021

Relationship of withdrawn, anxious/depressed and attention problems to cognitive performance in preterm children at 18 months and 36 months of age

ObjectiveA positive significant association has been found between behavior problems and lower cognition in very low birthweight (VLBW) preterm children at school age, but there is relatively little information about whether such an association exists in toddlers and on the continuity of this association. The aim of this study was to assess if there is a relationship between behavior problems and cognitive performance in VLBW preterm children at 18 months post conception and 3 years old, independent of socioeconomic status and sex. MethodParents of 124 preterm children completed a behavior rating questionnaire (Child Behavior Checklist 1.5–5) to measure behavior problems characteristic of preterm children (Withdrawn, Anxious/Depressed, and Attention Problems). Children completed the Cognitive Scale of the Bayley Scales of Infant Development-III at 18 months and the Wechsler Preschool and Primary Scale (III or IV) at 36 months old. Socioeconomic status (SES), sex, and diagnoses of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) at 3 years were recorded for each child. ResultsWithdrawn problems at 18 months were associated with lower cognitive scores at 18 months and both Withdrawn problems at 18 months and 36 months were associated with lower cognitive scores at 36 months. Increases in Attention Problems scores from 18 to 36 months were associated with decreases in cognitive scores over that period. Lower SES was associated with lower cognitive scores at 36 months and decreases in cognitive scores between 18 and 36 months. Sex was not related to behavior problems or cognition. Diagnoses of ASD and ADHD were significantly associated with increased Withdrawn behavior and Attention Problems, respectively. ConclusionsThe early association of Withdrawn behaviors with less favorable cognitive performance at 18 months and 36 months and the relationship between increases in Attention Problems with decreases in cognitive scores between the toddler and preschool period indicate the need for early assessment of and intervention for behavior problems, as well as concurrent cognitive delays, in VLBW preterm children.

Using psychopharmacology in the treatment of problem behaviours in dogs and cats

Behaviourally-active medication can play an important role in improving the welfare of cats and dogs in both the short and longer term. Drugs can be used to reduce fear, anxiety and panic in the short term, such as to help noise-sensitive dogs cope better with events such as firework displays, or to help fearful dogs and cats cope better with visits to the vets or groomers. Drugs can also play an important role in longer-term reduction of negative emotional states, particularly fear and anxiety, as long as they are used in conjunction with a comprehensive behaviour modification plan. This article outlines some of the behaviourally-active drugs most commonly used to treat dogs and cats in the UK, as well as some of the considerations needed for using medication as part of behaviour modification in cats and dogs.

Assessing assistive devices for manipulation: Design universality and users' perception

Although alienation toward parents is important for children (for current mental health status or later interpersonal relationships in adulthood), it is undervalued and even lacks a standardized tool of assessment. Moreover, the large number of left-behind children in China is a cause of public concern. However, their experienced alienation toward their parents remains unclear, which may be important for early detection or intervention for behavioral problems in this population. Hence, the current study aimed to develop an alienation inventory for children and then use it to investigate the experienced alienation toward parents in Chinese left-behind children.Two studies were carried out. Study 1 was designed to develop a standard inventory of alienation toward parents (IAP). In study 2, 8361 children and adolescents (6704 of them were left-behind status) of the Chongqing area, aged between 8 and 19 years old, were recruited for investigation. All participants were surveyed with a standard sociodemographic questionnaire, children's cognitive style questionnaire, children's depression inventory, adolescent self-rating life events checklist, and newly built IAP in study 1.In study 1, we developed a two-component (communication and emotional distance) and 18-item (9 items for maternal or paternal form, respectively) IAP questionnaire. In study 2, exploratory factor analysis indicated an expected two-factor structure of IAP, which was confirmed by confirmatory factor analysis. The Cronbach's alpha coefficients showed a good reliability (0.887 and 0.821 for maternal and paternal form, respectively). Children with absent mother experienced the highest alienation toward parents. Boys as well as children aged 8–10 years old experienced higher alienation toward parents. Poor communication with parents (sparse or no connection), level of left-behind condition (parents divorced, been far away from parents), and psychosocial vulnerability (stressful life events, negative cognitive style) were risk factors of alienation toward parents.The current study develops a two-factor (communication and emotional distance) IAP, which offers a reliable tool to assess experienced alienation of affection toward parents in children aged between 8 and 19 years old. Our result is the first investigation of experienced alienation and potential influential factors in Chinese left-behind children. The findings that children with absent mother experience higher alienation toward parents, as well as three recognized risk factors for alienation of affection toward parents (poor communication with absent parents, worse left-behind condition, and psychosocial vulnerability), give valuable guidance for parents who intend to leave or who are already leaving as well as for government policymaking.

Evaluating the utility of interview-informed synthesized contingency analyses in informing the treatment of problem behavior among children with autism spectrum disorder

ABSTRACT Although functional analysis is a widely researched tool for determining behavioral function, traditional formats are associated with limitations that often preclude their incorporation into practice. The interview-informed synthesized contingency analysis (IISCA) was developed to address such limitations. This study investigated the effectiveness and efficiency of the IISCA in determining the function of problem behavior for three non-vocal children with autism spectrum disorder and intellectual disabilities in a school setting. The effectiveness of the skill-based treatment process associated with the IISCA was also evaluated, as were the acceptability of these treatment procedures and the fidelity with which they were implemented. The IISCAs yielded differentiated outcomes immediately for two participants and following a secondary analysis for the third participant. Assessment results informed the design of treatments involving functional communication training and delay- and denial-tolerance training evaluated using a changing-criterion design. Implications and limitations are discussed and recommendations for future research are offered.