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PubMed1982

Child behavior management training for parents of chronically ill children: a professional activity in need of research.

Parents of chronically ill children are often referred to professionals for help in managing problematic behaviors of the children. One very popular treatment approach is to train such parents in child behavior management skills. Surprisingly, hardly any research has been reported upon the development, implementation, or evaluation of child behavior management training in such cases. Some research strategies are suggested.

Adult↗
PubMed2003

Making faces: testing the relation between child behavior problems and mothers' interpretations of child emotion expressions.

We examined the relations between preschool boys' behavior problems and mothers' interpretations of children's emotion expressions. A sample of 31 mothers of oppositional boys and 28 control mothers responded to standard stimuli depicting child emotional reactions to maternal control attempts; mothers were instructed to think of the stimuli as either (a) their own child or (b) an unfamiliar child. Mothers of oppositional boys were more likely to generate negative interpretations than were control mothers when thinking of their own children; however, this difference did not generalize to the explicitly unfamiliar child condition. Mothers of oppositional boys demonstrated negative and comparison mothers demonstrated positive interpretive tendencies toward their own children. Findings suggest that child emotion cues may trigger biased maternal cognitions even in the absence of child misbehavior.

Adult↗
PubMedDate not supplied

Intergenerational health disparities: socioeconomic status, women's health conditions, and child behavior problems.

OBJECTIVE: Relatively little is known about the intergenerational mechanisms that lead to social disparities in child health. We examined whether the association between low socioeconomic status (SES) and child behavior problems is mediated by maternal health conditions and behavior. METHODS: Prospective cohort data (1979-1998) on 2,677 children and their mothers were obtained from the National Longitudinal Survey of Youth. SES, the Child Behavior Problems Index (BPI), and maternal smoking, depressive symptoms, and alcohol use before, during, and after pregnancy were examined. RESULTS: Lower income and lower maternal education were associated with increased child BPI scores. Adjustment for maternal smoking, depressive symptoms, and alcohol use attenuated the associations between SES and child BPI by 26% to 49%. These maternal health conditions often occurred together, persisted over time, and were associated with the mother's own childhood SES and pre-pregnancy health. CONCLUSIONS: Social disparities in women's health conditions may help shape the likelihood of behavior problems in the subsequent generation. Improved public health programs and services for disadvantaged women across the lifecourse may not only address their own urgent health needs, but reduce social disparities in the health and well-being of their children.

Adolescent↗
PubMed2005

When more is not better: the role of cumulative risk in child behavior outcomes.

BACKGROUND: Cumulative risk research has established the deleterious effects of co-occurring risk factors on child behavior outcomes. However, extant literature has not addressed potential differential effects of cumulative risk at different points in development and has left open questions about whether a threshold model or a linear risk model better describes the impact of cumulative risk on behavior outcomes. The current study examined the impact of cumulative risk factors (i.e., child maltreatment, inter-parental violence, family disruption, low socioeconomic status, and high parental stress) in early and middle childhood on child behavior outcomes in adolescence. METHODS: Using data from an ongoing longitudinal study of at-risk urban children (N=171), the cumulative effects of these five risk factors across early and middle childhood were investigated. RESULTS: The findings support the cumulative risk hypothesis that the number of risks in early childhood predicts behavior problems in adolescence. Evidence for a linear but not a threshold model of cumulative risk was found; the more risks present, the worse the child outcome. Moreover, the presence of multiple risks in early childhood continues to explain variations in predicting adolescent behavior outcomes even after including the effects of risk in middle childhood. CONCLUSIONS: The results support the need for comprehensive prevention and early intervention efforts with high-risk children, such that there does not appear to be a point beyond which services for children are hopeless, and that every risk factor we can reduce matters.

Adolescent↗
PubMed1989

Child behavior profile types in a general population sample of boys 6 to 11 years old.

Characteristics of Child Behavior Profile (CBP) types were studied in a general population sample of 202 boys aged 6 to 11 years. Parents completed the Child Behavior Checklist and teachers simultaneously rated the Teacher's Report Form. Overall, 39.7% of the boys were classified within a CBP type: 28.8% Internalizing and 10.9% Externalizing. The most common specific type was Somatic Complaints. Teachers rated the Externalizing CBP boys as showing robust externalizing behaviors in school. Also, boys with Externalizing profile types showed severe degrees of psychopathology in both home and school environments. An intraclass correlation of .35 or greater was found to identify boys with sufficiently severe psychopathology to warrant further clinical evaluation. Findings in this general population sample appear consistent with previous results in outpatient samples, and extend our understanding of the validity and clinical value for CBP types.

Child↗
PubMed1999

[Applicability of the Child Behavior Checklist in developmentally delayed children].

OBJECTIVES: The Child Behavior Checklist is used to assess behavioral problems in a large unselected sample of children. In the present study we assess the usefulness of the CBCL in the evaluation of the typical behavioral problems usually reported in children with developmental disorders. METHODS: We examined two groups of children which both had language or communication problems. The first group consisted of 34 children with infantile autism, the second group consisted of 34 age-, sex- and IQ-matched children with a specific developmental speech and language disorder. The CBCL was filled out by the parents in both groups as part of the routine diagnostic procedures. RESULTS: Half of the language-impaired children have Total Behavioral Problem scores within the clinical range. Problems are mainly reported on the scales: "Attention Problems", "Social Problems" and "Withdrawn". Two-thirds of the autistic children have deviant scores on the syndrome scales mentioned above. 32 out of 34 autistic children score within the clinical range on the scale "Thought Problems", whereas only one language-impaired child does so. Single item analysis shows a high prevalence of developmental problems (speech problems, enuresis ...) in both groups. CONCLUSION: The CBCL records characteristic behavioral problems in children with developmental disorders. The problematic behaviors are shown on the syndrome scale level as well as on the single item level. Children with developmental disorders and high scores on the "Thought Problems" scale of the CBCL should be evaluated for the presence of a possible pervasive developmental disorder.

Adolescent↗
PubMedDate not supplied

Expanding child behavior management technology in pediatric dentistry: a behavioral science perspective.

Changing attitudes on the part of dentists and parents alike have resulted in increasing interest by dentists to develop additional child behavior management techniques. Collaborative research between dentists and behavioral psychologists has been encouraged by the American Academy of Pediatric Dentistry (AAPD) to address these concerns, but additional research is needed. This paper describes three techniques that, from a behavioral science perspective, offer promise for pediatric dentists managing disruptive children. In addition to scientific appeal, these techniques appear to have potential for acceptance and incorporation into the dental operatory. Although early research suggests these procedures can fit easily into routine practice, are time and cost efficient, and are relatively easy to learn, additional research is needed to clearly establish their external validity, cost efficiency, and ease of implementation. The discussion focuses on issues relevant to incorporating new technology into the dental school curriculum and disseminating it to practicing dentists.

Behavior Therapy↗
PubMedDate not supplied

Epilepsy-related ambiguity in rating the child behavior checklist and the teacher's report form.

Although the child behavior checklist (CBCL) and the teacher's report form (TRF) were not designed for diagnosing psychopathology in children with chronic illnesses, they have become extensively used research tools to assess behavioural problems in paediatric populations, including children with epilepsy. When applied to children with epilepsy, items like "staring blankly" or "twitching" can be rated on the basis of seizure features rather than behaviour and, hence, render behavioural scores ambiguous. The aims were detection, and evaluation of the impact, of CBCL and TRF items eliciting ambiguity when applied to children with "epilepsy only" (idiopathic or cryptogenic epilepsy, attending normal schools). Experts identified items that give rise to interpretational ambiguity of the ratings in epilepsy. By treating ratings on these items as missing values, their effect was evaluated in CBCL and TRF scores of 59 schoolchildren with "epilepsy only" and age and gender matched healthy classmates. Seven items of the CBCL gave rise to ambiguity of which items 5 co-occur on the TRF. Rescoring reduced psychopathology scores in children with "epilepsy only", but not in those of healthy children: the percentage of patients trespassing the clinical cut off score, on at least one of the subscales, reduced from 46 to 23% on the CBCL and from 18 to 15% on the TRF. Parents and teachers run the risk of confusing behaviour and seizure features when filling out the CBCL and TRF. In "epilepsy only", prevalence estimates of psychopathology based on the CBCL and TRF, should be considered with some reserve.

Attention↗
PubMed1987

Use of T scores on the revised child behavior profile with inpatients.

The assignment of T values to raw scores on the behavior problem scales of the Revised Child Behavior Profile (RCBP) was examined. RCBP T scores below 70T are normalized standard scores. Therefore, the T scores below 70T are comparable within each scale and from one scale to another. In contrast, RCBP T scores above 70T are not standard scores. Therefore, they cannot be compared appropriately to other scores. The lack of intrascale and interscale comparability of RCBP T scores above 70 is especially problematic for the study of inpatients whose scores tend to fall in the unscaled region above 70T. Therefore, it is recommended that for studies of inpatients, raw scores on the behavior problem scales should be transformed to standard scores by use of the mean and standard deviation of an appropriate comparison group. Then, for purposes of interpretation, scores that fall in the upper ranges of the inventory can be compared appropriately to other scores on the same scale or to scores on other scales of the RCBP.

Child↗
PubMed1992

Beyond beliefs: parent and child behaviors and children's perceived academic competence.

Examined the relations of parent and child behaviors with children's perceptions of their academic competence. 74 high-achieving third-grade children, with varying levels of perceived academic competence, were observed working with mothers and fathers both on solvable tasks (Period 1) and during a period that included some unsolvable tasks (Period 2). Results indicated that children's perceived academic competence was positively related to father warmth, both at Period 1 and at Period 2. Children's perceived academic competence was also positively related to their own behavior when working with fathers at Period 2. Specifically, children with higher perceived academic competence showed more emotional restraint and were more self-reliant when working on tasks at Period 2 than were children with lower perceived academic competence. The results indicate that there are systematic, observable correlates of children's self-reports of their perceived academic competence.

Achievement↗
PubMed2004

Nonabusive physical punishment and child behavior among African-American children: a systematic review.

BACKGROUND: The use of nonabusive physical punishment as a form of discipline has been greatly debated in the scientific and popular literature. Impact on child behavioral outcomes has frequently been found; however, the effects of its use are not clear, particularly for African-American children. This systematic review of the literature examined the impact of exposure to nonabusive physical punishment on the behavior of African-American children. METHODS: A search was conducted of PubMed and Psyclnfo from 1970 to 2000 using the key terms: corporal punishment, physical punishment, disciplinary practices, and discipline and parenting. Studies that described ethnicity of the population and included a majority of a well-described African-American population were included. Each study was required to include measurable data on child behavioral outcomes and at least one measure of discipline that assessed use of nonabusive physical punishment in children 0-14 years of age. RESULTS: All seven included studies used lower socioeconomic status (SES) and/or urban African-American populations. Study design and rural versus urban populations differentiated beneficial and detrimental outcomes. In all longitudinal studies, African-American children had beneficial or neutral outcomes. DISCUSSION: This review suggests that it is possible that there are benefits to nonabusive physical punishment for African-American children. However, needed are further longitudinal studies that better assess the multiple confounders that impact the use of discipline, such as SES, parental education level, and exposure to community or domestic violence.

Black or African American↗
PubMedDate not supplied

Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes: a prospective study.

OBJECTIVE: This prospective study examined how child behavior problems and family functioning predict adherence behavior and glucose regulation (glycemic control) in a sample of economically disadvantaged children. METHODS: Children with type 1 diabetes (N = 116; 58.6% African American) were assessed for externalizing and internalizing behavior problems and family adaptability and cohesion and followed for a mean of 3.8 years. Glycemic control (glycosylated hemoglobin [HbA1c]) was assessed at baseline and follow-up, and adherence was assessed at follow-up. RESULTS: Analyses controlled for baseline HbA1c and years to follow-up. Multivariate analyses indicated that better adherence was predicted by high family cohesion. Better glycemic control was predicted by high family cohesion, the absence of externalizing behavior problems, and the presence of internalizing behavior problems. In addition, tests of moderation indicated that better follow-up glycemic control occurred among girls from high cohesion families and younger children from low adaptability families. Although better adherence predicted better glycemic control, adherence did not mediate the relationships of behavior problems or family functioning with glycemic control. CONCLUSIONS: A child's behavior problems and family functioning may influence both adherence to the diabetes regimen and glycemic control several years later, suggesting the potential value of interventions that address child behavior and family functioning.

Adaptation, Psychological↗
PubMedDate not supplied

Dentists' characteristics and child behavior management techniques.

Dentists believe that children's behaviors in the operatory may cause problems, demanding time, attention, and skill. This study explored relationships among several demographic, structural, and attitudinal practitioner characteristics hypothesized to influence dentists' choice of seventeen child behavior management techniques used with nonhandicapped preschool patients. A sixty-item questionnaire was mailed to a random sample of 366 dentists and all thirty-four pedodontists licensed in Minnesota (N = 400), yielding a 67.5 percent response rate. Data were analyzed to determine frequency distributions for all variables, as well as to analyze relationships among seventeen management strategies and all practitioner characteristics. Pearson correlations and chi square tests of significance were used. Findings indicated that the majority of respondents held a negative view of parental involvement in managing preschoolers' behaviors in the operatory. Respondents' stronger agreement with certain authoritarian attitudes, as well as greater degrees of some measures of productivity, were related to higher frequencies of use of physical restraints and nitrous oxide. Many beliefs regarding child behavior management may be based upon professional dogma, particularly those which focus on the importance of establishing authority and control over the child patient, and perhaps, even the parent. Dentistry actively promotes individual acceptance of personal responsibility for one's own oral health, but it appears that the dental care delivery setting for children does not presently reinforce or support this message. If children are expected, as adults, to take responsibility for making wise decisions about oral health and care-seeking behaviors, such decision-making skills need to be fostered during childhood.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

[Behavioral symptoms of children and adolescents in Germany, the Netherlands and USA. A cross-cultural study with the Child Behavior Checklist].

The goal of the study was a cross-cultural comparison of the parent ratings of behavior problems of children and adolescents aged 4-18 years in Germany, The Netherlands and the United States using the Child Behavior Checklist (CBCL). The analyses were undertaken in a German community sample (n = 1622) and a Dutch community sample (n = 2076). The results were compared with the data published by Achenbach for the national US sample. The analyses were based on the scales of the 1991 CBCL version and were performed for four age and sex groups (4- to 11-year-old boys/girls and 12- to 18-year-old boys/girls). In general, relatively minor differences could be detected between the three random samples. The range in the different samples was between -0.04 and 0.35, which is in line with other cross-cultural analyses using the CBCL. As long as no representative norms for Germany are available, the American norms can serve as an orientation for German studies using the CBCL.

Adolescent↗
PubMed1992

Psychiatric comorbidity in attention deficit disorder: impact on the interpretation of Child Behavior Checklist results.

Studies have investigated associations between the Child Behavior Checklist (CBCL) and clinical diagnoses without assessing the impact of comorbidity on these results. This study evaluates associations between parental reports from the CBCL and a structured diagnostic interview in children with attention deficit disorder with hyperactivity (ADDH) stratified by the presence (ADDH+) or absence (ADDH-) of psychiatric comorbidity. Interview-defined ADDH children scored significantly worse on all scales of the CBCL compared with scores from interview-defined non-ill comparisons. However, these findings were accounted for by the subgroup of children with ADDH+. The results indicate a good correspondence between CBCL-based ratings and interview-defined diagnoses. These findings also suggest that the CBCL may be a good screening instrument, not only for ADDH but also for comorbid psychiatric disorders.

Adolescent↗
PubMed1988

Use of the Child Behavior Checklist in an Israeli adolescent psychiatric unit.

This article deals with the Hebrew version of an instrument for the diagnosis of psychopathology in young adolescents: the Child Behavior Checklist and the associated Child Behavior Profile developed by Achenbach (1978). We report on a study of the reliability and validity of the checklist and its suitability for use with severely disturbed adolescents in Israel. Parents of 130 adolescents, 89 healthy and 41 sick, participated in the research. The scales were found to be valid in that two-thirds of the items were correctly assigned by clinicians in Israel to their respective scales; it is internally consistent as measured by the Cronbach coefficient; and it is reliable in distinguishing between patient and control groups. Scores for control adolescents in Israel were found to be very similar to norms in the United States, the Netherlands and Chile. This finding may have important implications for cross-cultural research.

Adolescent↗