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Elective mutism in a first grader: the remediation of a complex behavioral problem.

Teachers frequently deal with unusual and perplexing behavioral problems in their classes. This study demonstrates how spontaneous and prompted speech were produced in a six-year-old mute by a first-grade teacher and her aide. A reinforcement system for peer-prompted speech and spontaneous speech was employed in three separate school classes in a multiple-baseline fashion. The reinforcement system produced prompted and spontaneous speech in each situation. Postchecks in the second grade indicated the child was still speaking and conversing spontaneously with his peers. This study suggests a method that teachers can use in the classroom to deal with this severely handicapping condition.

Behavior Therapy

Parental and family predictors of behavior problems in inner-city black children.

Studied contributions of maternal psychological distress, family stress load, maternal and family risk factors, and family coping strategies in predicting behavior problems in 441 inner-city black primary-grade children. Results indicated maternal psychological distress and high family stress load were associated with high child behavior problems. Family coping strategies offered no protection against risk, while coping with life difficulties by reframing them was detrimental to child behavioral adjustment. Active help-seeking strategies (i.e., family mobilization, acquiring social supports) served to moderate the effects of maternal psychological distress and family risk attributes for boys, but exacerbated the effects of dysfunctional maternal social and psychiatric histories for girls. Implications for understanding vulnerability and resilience in inner-city black children and recommendations for future research are discussed.

Adaptation, Psychological

Primary prevention of behavior problems in Mexican-American children.

A primary prevention program, the Houston Parent-Child Development Center, directed towards infants and their parents, has effectively reduced the frequency of behavior problems for these children 5 to 8 years after the program's completion. Teacher ratings showed significantly fewer acting-out, aggressive behaviors for program children. Ratings of classroom behaviors found program children significantly less hostile and more considerate than control boys. This appears to be the first primary prevention program to have demonstrated effectiveness in reducing behavior problems over such a long time.

Aggression

The Nursing Home Behavior Problem Scale.

Nursing home patients frequently have serious disturbances of behavior that can lead to use of chemical or physical restraints. To support research into better management of these problems, we developed the Nursing Home Behavior Problem Scale (NHBPS), a 29-item inventory of serious behavior problems designed to be completed by nurses and nursing assistants. NHBPS scores were obtained for two samples of nursing home residents: 431 in Tennessee and 122 in Texas. The interrater correlation was .754 in the Tennessee sample and .827 in the Texas sample. The NHBPS had a correlation of -.747 with the NOSIE scale and .911 with the CMAI. There was a pronounced association of increased NHBPS scores with mental impairment and use of sedative drugs or restraints. These data suggest the NHBPS is a useful research instrument for measuring serious behavior problems in nursing home residents.

Behavior

A multivariate risk model for childhood behavior problems.

In a study of 306 children whose parents have a mental illness, the relationship between coping skills and environmental assets and deficits determined the degree of behavior problems among these high-risk children. Two environmental stressors (proportion of mentally ill family members and mother-child discord), two coping skills (activity competence and school competence), and an interaction (between proportion of mentally ill family members and activity competence) were found to explain 40% of the variance in child behavior problems.

Adaptation, Psychological

Behavior problems in children requiring inpatient rehabilitation treatment for asthma.

Forty-eight asthmatic children (age 6-16 years), inpatients at the Hugh McMillan Medical Centre, were rated by their parents on their behavior using Achenbach's Child Behaviour Checklist. Completed checklists were used to determine normalized T scores for behavior syndromes, and these were compared against norms for clinically referred and nonreferred children. Behavior problems were elevated compared with nonreferred children for both boys and girls, with boys scoring at a clinical level. While many behavior problems were recognized, somatic complaints was a prominent syndrome, particularly for those in the 6-11-year age group.

Adolescent

Adoption and children with learning and behavior problems.

One representative case study is used to illustrate the complex interaction of factors that can lead to tragic family dysfunction when an adopted child has learning and behavior problems. The presence of neurodevelopmental problems in an adopted child, special adoption issues and interparental and intraparental conflicts combine to place the child and his family at high risk. The child's neurodevelopmental difficulties are expressed primarily as subtle learning and behavior problems which make him a focus for parental conflict. In addition, the adoption issues of difference, impermanence, feelings of mutual obligation and fear of abandonment are generally poorly understood and form the basis for the development of unique interactional patterns of communication. Finally, in the families studied, it was often found that the adopting parents had serious personal and/or marital difficulties.

Adolescent

A follow-up study of preschool children evaluated for developmental and behavioral problems.

Parents and teachers of preschool children evaluated for developmental and behavioral problems in a tertiary pediatric clinic were surveyed an average of 15 months after the initial visit to determine whether they thought the original presenting problem(s) were still present. In 46 percent of cases in which there was an initial concern about behavior, parents continued to be concerned. In contrast, only 24 percent of responding parents continued to be concerned about developmental problems. In more than half of the cases in which parents were no longer concerned, especially about behavior, teachers indicated that there continued to be problems. Age and sex of children were not related to outcome. The higher the socioeconomic status of parents, the more likely the parents were to report persistent developmental problems. Children with persistent problems tended to have difficult temperament characteristics. This study suggests that it is difficult to predict which problems will persist and that there are varying viewpoints as to the nature and existence of these problems.

Child

The effects of maternal working conditions and mastery on child behavior problems: studying the intergenerational transmission of social control.

We assess the impact of maternal sense of mastery and maternal working conditions on maternal perceptions of children's behavior problems as a means to study the transmission of social control across generations. We use a sample of 521 employed mothers and their four-to six-year-old children from the National Longitudinal Survey's Youth Cohort in 1986. Regarding working conditions, we consider mother's hourly wage, work hours, and job content including involvement with things (vs. people), the requisite level of physical activity, and occupational complexity. We also consider maternal and child background and current family characteristics, including marital status, family size, and home environment. Maternal mastery was related to fewer reported behavior problems among children. Lower involvement with people and higher involvement with things, as well as low physical activity, were related significantly to higher levels of perceived problems. In addition, recent changes in maternal marital status, including maternal marriage or remarriage, increased reports of problems; stronger home environments had the opposite effect. We interpret these findings as suggesting how maternal experiences of control in the workplace and personal resources of control can influence the internalization of control in children.

Adult

An analysis of the hyperactive syndrome: a comparison of hyperactive, behavior problem, asthmatic, and normal children.

In an attempt to determine whether the commonly described deficits associated with hyperactivity--inappropriate activity, short attention span, low frustration tolerance, and impulsivity--are unique to this population, hyperactive, behavior problem, asthmatic, and normal control children were studied. The test most often used in research with hyperactives were administered. Hyperactives, when compared to normals, did show deficits in the aforementioned areas. However, when compared to the behavior problem and asthmatic children only the attentional deficits clearly differentiated hyperactives from the other children.

Asthma

Behavior problems of peer-neglected and peer-rejected elementary-age children: parent and teacher perspectives.

Rejected, neglected, popular, and average-status children were selected on the basis of positive and negative sociometric measures from a total sample of 870 8- and 11-year-old children. Teachers completed the School Behavior Checklist and parents completed the Child Behavior Checklist for selected children. No age or sex differences were found. On both scales, rejected children were found to exhibit more behavior problems than neglected, popular, or average children. Neglected children did not exhibit more behavior problems than children of average status.

Child

The consequents of problem behavior in toddler children.

Three hundred children (ages 18-27 months) were observed as they entered peer play groups consisting of 12-15 children and 2-3 caregivers. One hundred and sixty-eight of the children were boys and 142 were girls. A schedule was used that allowed the observer to code the child's behavior and the reaction of peers and caregivers to that behavior. Four different categories of child problems were selected for study: conduct problems with aggression, withdrawn undersocialized behaviors, separation anxiety, and dependent personality. Three different questions were asked concerning the persistence and consequences of problem behaviors in toddler children: Do the behaviors persist over a period of 1 year to 2 years; what kinds of reactions does a child who is engaged in the behaviors defined in these categories receive from peers and teachers; and how do the reactions received from peers and teachers of problem children compare to those of the average of their own class? The stability of problem behaviors and the reactions received by the child were related to gender of the child and sex-appropriateness of the behavior.

Aggression

Teachers' perceptions of problem behavior in general and special education.

The study investigated the behavioral ratings of regular classroom and special education teachers and sought to examine the degree to which these educators agreed or disagreed in their perceptions of the problem behavior and adaptive functioning of a group of 31 adolescents who had recently been identified as seriously emotionally disturbed. Results are discussed in relation to the literature on teacher tolerance of problem behavior and the effects of classroom setting upon teacher judgments.

Adolescent

Minor neurological dysfunction is more closely related to learning difficulties than to behavioral problems.

In a group of 570 nine-year-old children (315 boys and 255 girls) without an overtly handicapping neurological condition, relationships were studied between the presence of minor neurological dysfunction (MND) on the one hand and cognitive and behavioral problems on the other hand. The aim of the study was to investigate whether MND was more closely related to learning problems than to behavioral difficulties. The group was a subpopulation of the birth cohort of the Groningen Perinatal Project in the Netherlands, in which perinatal developmental relationships are studied. The age-specific and standardized neurological examination technique of Touwen (1979) was used, resulting in a description of the neurological condition in terms of the number of deviant clusters. The absence of deviant clusters indicated a normal neurological condition (n = 418); children with one or two deviant clusters were classified as MND-1 (n = 86) and those with more than two deviant clusters as MND-2 (n = 66). The presence and severity of MND was significantly related to poor performance on standardized reading, spelling, and arithmetic tests. MND was also related to ratings of distractible behavior on parent and teacher questionnaires, but to a lesser extent than the cognitive problems. Ratings of so-called "troublesome" and "timid" behavior were not related to MND. Our conclusion is that learning problems are more closely related to MND than are behavioral difficulties. This has implications for prevention and intervention: In the former the focus should be more on biological hazards, in the latter on environment and rearing attitudes.

Attention Deficit Disorder with Hyperactivity

Factorial dimensions of the Revised Behavior Problem Checklist: replication and validation within a kindergarten sample.

The factor structure of the Revised Behavior Problem Checklist (RBPC) was examined in a large sample of suburban kindergarten children. Teacher-rated dimensions of Conduct Disorder, Attention Problems-Immaturity, Anxiety-Withdrawal, and Psychotic Behavior were closely replicated, and a new factor labeled Unmotivated-Isolated was also revealed. These principal components were consistent across gender and across subsamples of children differing as to risk status for learning failure. Evidence was found for the divergent validity of the externalizing dimensions of Conduct Disorder and Attention Problems-Immaturity with respect to criterion measures of alternative behavior ratings, cognitive functioning, and academic achievement. Parent-rated components of Conduct Disorder, Attention Problems-Immaturity, Hyperactive-Impatient, Tense-Withdrawn, Anxiety, and Passive-Conforming were less clearly validated, and parent-teacher agreement was modest. It was concluded that the RBPC shows promise for the assessment of preschool-aged children and that narrow-band externalizing dimensions of inattentive versus conduct-disordered behavior are reasonably distinct at this age.

Anxiety Disorders

Validity of case manager reports of clients' functioning in the community: independent living, income, employment, family contact, and problem behaviors.

Validity of case manager reports of client functioning in the community was assessed by examining the correspondence between case manager reports and client reports of several widely-used indicators of client well-being, including independent living, income, employment, family contact, and problem behaviors. Effects of how well case managers knew their clients and of using telephone interviews vs. self-administered questionnaires to gather case manager data were also investigated. Data were gathered from 6 case managers and 55 of their seriously mentally ill clients in a rural Wisconsin Community Support Program. Indicators of independent living and employment displayed reasonably good agreement and support the use of case manager reports in research. Indicators of income and problem behaviors produced lower levels of client-case manager agreement at least in part because client reports proved an inadequate criterion for these measures.

Activities of Daily Living

The Turner syndrome: cognitive deficits, affective discrimination, and behavior problems.

Individuals with sex chromosomal anomalies are known to be at increased risk for learning problems and in some cases social or behavioral problems. Girls with an absent or structurally abnormal second sex chromosome (the Turner syndrome) have been found to have cognitive problem solving deficits and immature, inadequate social relationships. The present study attempted to link cognitive and social problems by assessing the girls' ability to process affective cues. 17 girls with karyotypes consistent with a diagnosis of Turner syndrome were compared to a group of 16 short-stature girls of comparable age, verbal intelligence scores, height, and family socioeconomic status on the Affective Discrimination Task, which required interpretation of affective intention from facial expression. The results revealed that the Turner syndrome girls were less accurate at inferring facial affect than the short-stature controls. Analyses revealed that the Turner syndrome girls performed more poorly on spatial, attentional, and short-term memory cognitive tasks and had more psychosocial problems than the short-stature controls. Ability to discriminate facial affect may be another area of cognitive weakness for girls with the Turner syndrome and may underlie the psychosocial problems found in this sample.

Adolescent

The impact of the "I'm Special" Program on student substance abuse and other related student problem behavior.

There has been a proliferation of school-based substance abuse prevention programs geared toward reducing or delaying the onset of student use of illegal drugs. But the field has shown a general absence of evaluation dealing with the behavior consequences of these practices. This article fills this gap by using the case of the "I'm Special" Program (ISP) targeted for fourth grade students. Using a quasi-experimental design, a comparison is made between the substance using and other problem behavior of students who have been exposed to the ISP and those who have not during their later school years in grades 5 through 12. At the aggregate level, the proportions of current substance users and the incidence of their related problem behavior were significantly lower among the ISP graduates than those who have not been exposed to the program. In particular, there were consistently lower proportions of current substance users among the ISP recipients than the non-recipients in grades 5-7. However, the impact of the ISP seems to diminish significantly in and around ninth grade. During the senior high level, the pattern revealed is almost random. And, in some drug categories, it has been speculated that the ISP students were trying to "catch up" with what they may have missed out on during earlier grade levels.

Adolescent