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Screening of child behavior problems for prevention programs at school entry. The Conduct Problems Prevention Research Group.

Targeted programs designed to prevent conduct problems in childhood and adolescence rely on screening systems to identify high-risk individuals. This study examines the proximal usefulness of a multiple-gating approach to screening, using teacher and parent ratings in a 2-step procedure with a sample of 382 kindergarten children. The study explored differences in the accuracy of the 2 steps of screening information and whether parents' reports of parenting practices augments the prediction of negative outcomes. The 2-step screening system was found to effectively predict negative behavior outcomes over 1 year later, although some false-positive and false-negative predictions were evident. The Parenting Practices Screen did not substantially add to prediction accuracy. The discussion emphasizes the potential contributions and problems of using screening measures.

Child Behavior Disorders↗

Treatment of behavior problems in preschoolers: a review of parent training programs.

The literature for parent training interventions with conduct-problem preschool-aged children is reviewed. Although previous reviews have identified the preschool years as a critical point for intervention [J. Clin. Psychol. 21 (1992) 306; School Psychol. Rev. 22 (1993) 437], there still remains a paucity of well-designed outcome studies that have focused exclusively on preschoolers. Interventions that utilize parents as active sources of change remain predominant. The review reveals the need for further research to improve accessibility and delivery of interventions. Treatments that have undergone modification in their delivery format (e.g., use of telephone and videotape) were also identified and critically evaluated. Results of the review indicate that many studies are still accompanied by methodological limitations. Although promising interventions exist for young conduct-problem children, it is recommended that treatment effectiveness for preschoolers be evaluated more rigorously.

Behavior Therapy↗

Using parents' concerns to detect and address developmental and behavioral problems.

PURPOSE: Half of all children with disabilities are not identified before school entrance, precluding their participation in early intervention programs with known value in reducing high school dropout rates, increasing employment, delaying child-bearing, and reducing criminal behavior. Screening tests that can greatly improve detection rates have not been popular in primary care. This article describes an alternative approach in an evidence-based technique relying on professional elicitation and interpretation of parents' concerns. POPULATION: 971 children from pediatric practices, day-care centers, public schools, and their siblings. CONCLUSIONS: Research shows that parents' concerns are as accurate as quality screening tests and that parents are equally able to raise important concerns regardless of differences in education and child-rearing experience. Parents' concerns can be elicited quickly, and 92% of parents can answer questions in writing while in exam or waiting rooms. Parents' concerns can help make a range of other important decisions about children's developmental and behavioral needs.

Child↗

The transition to adolescence: the role of gender and stress in problem behavior and competence.

The differential change of boys and girls across pre-adolescence, early adolescence, and middle adolescence was examined. The participants were 259 children, their mothers, and their social studies teachers. The children completed a measure of internalizing problems and adults completed measures of the child's externalizing and internalizing problems and competence. Relative to girls, boys had more problems and less competence at pre-adolescence and/or less problems and more competence by mid-adolescence. A stressor, parental divorce, did not exacerbate the gender by developmental age period interaction. The differential vulnerability of boys and girls at different developmental periods is considered.

Achievement↗

Aggressive behavior problems.

Accurate diagnosis of the cause of aggression in horses is essential to determining the appropriate course of action. The affective forms of aggression include fear-induced, pain-induced, intermale, dominance, protective, maternal, learned, and redirected aggressions. Non-affective aggression includes play and sex-related forms. Irritable aggression and hypertestosteronism in mares are medical problems, whereas genetic factors, brain dysfunction, and self-mutilation are also concerns.

Affect↗

[Deafness, mutism and behavior problems caused by bitemporal cerebral lesions].

The case of a 29 years old woman with bilateral ischemic lesions in superior temporal and temporo-parietal areas is presented. An important speech reduction evolving toward muteness is associated to cortical deafness and behavior perturbations. The study of symbolic functions shows the partial respect of occipital activities and connexions between visual system and areas supporting graphism and manual praxia. The mechanisms of cortical deafness and secondary muteness is discussed, with reference to the previous descriptions.

Adult↗

[Hygiene as a behavior problem].

The subject of the study is a systematizing analysis of present research concerned with the barriers which prevent scientific findings about hygiene from being carried out and which hamper the obvious adoption of hygienically and psycho-hygienically relevant prophylactic measures. A general interpretive model with explanatory value for health- and hygiene-related behavior is being developed. Future studies will particularly have to clarify what significance and what interpretative relevance do the diverse influencing factors have for a particular person in a particular position and situation and how in the course of one's biography even something like lifestyles of hygienic behavior develop and change. For the necessity of improvement as regards the hygienic status in various realms of life the knowledge about existing barriers is a basic essential. The following quantities and constructs pass into the theoretic interpretive model which should also provide the basis for further evolvement of theories as well as the starting point for specific research hypotheses but not least for the development of specific research and evaluation designs: Standard of information, informational behavior and quality of information. The individual risk assessment: A function of the subjective importance and probability that benefit and cost factors of prophylactic behavior will occur. Additional influencing factors essential to the development of a desirable health- and hygiene-related behavior are: Objective shortcomings with regard to prophylaxis: deficits of the hygienic research including the deficits concerning the development of feasible and universally applicable disinfection methods. Hazards connected to prophylaxis: Objective risks with regard to prophylaxis (disinfection methods which may cause allergies, which involve problems with the compatibility of materials and so forth) and psychological risks (impaired relations between physician and patient due to the wearing of a mouth guard in dental practice, and others) are being differentiated. The degree importance attached to hygiene in organisations: prerequisites for this are: matters of hygiene as features characteristic of a specific job and as a part of employee evaluation, laying down of responsibilities and spheres of competence in matters of hygiene, normative binding character of job-related hygienic guidelines, exemplary behavior of the management.(ABSTRACT TRUNCATED AT 400 WORDS)

Attitude to Health↗

Patient race and ethnicity in primary care management of child behavior problems: a report from PROS and ASPN. Pediatric Research in Office Settings. Ambulatory Sentinel Practice Network.

BACKGROUND: Minority persons have less access to many specialty treatments and services, possibly because of clinician biases. It is not clear whether any such biases exist in primary care settings, especially for children with psychosocial problems. OBJECTIVES: The objective was to compare primary care recognition and treatment of pediatric psychosocial problems among African American, Hispanic American and European American patients. DESIGN: A survey was made of parents and respective clinicians in primary care offices in two large practice-based research networks (PROS and ASPN) from 44 states, Canada, and Puerto Rico. Mixed regression analyses were employed to control for patient, clinician, and practice effects. SUBJECTS: The subjects were 14,910 children aged 4 to 15 years seen consecutively for non-emergent care by 286 primary care clinicians in office-based practice. MEASURES: Measures were parents' report for sociodemographics and behavioral symptoms using the Pediatric Symptom Checklist, and clinicians' report of psychosocial problems, type, management, and severity. RESULTS: Of the sample, 8.0% were African American youth, 9.5% were Hispanic American youth, and 82.5% were European American youth. After controlling for other factors, race and ethnicity were not associated with any differences in psychotropic drug prescribing, counseling, referral, or recognition of psychosocial problems. Clinicians reported spending slightly more time with minority patients. CONCLUSION: Race and ethnic status were not related to receipt of mental health services for children in primary care offices, suggesting that clinician biases may not be the primary cause of the racial differences in services noted earlier research. Improving services for minority youth may require increasing access to office-based primary care.

Adolescent↗

Observational data on time use and behavior problems in the nursing home.

A 3-month observational study of 24 agitated and severely cognitively impaired nursing home residents was conducted to document the typical ways in which residents spend their time and how time use relates to the manifestation of agitated behaviors. We found that these residents were involved in no activity during 63% of the observations. In addition, residents spent little time in structured activities (e.g., music therapy) or social activities (e.g., receiving visitors). Yet data analysis revealed that residents manifested a greater number of agitated behaviors when they were unoccupied and fewer agitated behaviors when involved in structured or social activities. We discuss implications for caregivers.

Activities of Daily Living↗