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Choice-making treatment of young children's severe behavior problems.

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.

Behavior Therapy↗

Behavioral distinctions in children with reading disabilities and/or ADHD.

OBJECTIVE: To investigate behavioral distinctions between children with reading disabilities (RD) and attention-deficit hyperactivity disorder (ADHD). METHOD: A four-group mixed design consisting of children with reading disabilities only (RD only), reading disabilities and ADHD (RD/ADHD), ADHD only, and a comparison group was used. Differences between parent reports, from age 5 to 15 years, and teacher reports, from age 5 to 13 years, were examined on measures of hyperactive and antisocial behaviors. RESULTS: The analyses indicated that, at home, children from the ADHD only and RD/ADHD groups exhibited significantly more hyperactive behaviors than children from the RD only and comparison groups. At school, children from the RD only, ADHD only, and RD/ADHD groups typically exhibited significantly more hyperactive and antisocial behaviors than children from the comparison group. With regard to antisocial behaviors, children from the RD/ADHD group exhibited significantly more antisocial behaviors than children from any other group. CONCLUSIONS: The results of the study indicate that children from these groups may exhibit either a "pervasive" or "situational" presentation of behavioral problems, a finding which suggests that in conducting an evaluation of ADHD it is important to obtain both parent and teacher reports of problem behaviors.

Adolescent↗

Psychiatric aspects of learning difficulties.

This article describes the process of clinical assessment that may lead to differential treatment of psychiatric-related learning difficulties. The authors review differences in information processing among individuals with attention, affective, and primary thought disorders.

Adult↗

Sleep-disordered breathing and behavior in three risk groups: preliminary findings from parental reports.

Sleep-related breathing disorders may cause excessive daytime sleepiness, cognitive impairment, and behavior problems in children and adolescents. Adenotonsillar enlargement (AT) is known to be a significant risk factor for these disorders, which have also been reported in several patients with Down syndrome (DS). Children with attention deficit disorder/hyperactivity (ADD) show behavior problems that may be related to disturbed nocturnal sleep in some. To evaluate the relationships among these disorders and symptoms, parents of 29 school-aged children with AT, 70 with DS and 48 of their siblings (DS-SIB), and 21 with ADD completed a 20-item screening questionnaire covering nocturnal sleep symptoms and daytime behavior problems. Nocturnal symptoms of sleep-related breathing disorders--snoring, breathing pauses during sleep--were reported more commonly by parents of AT and DS children. However, parents of two of the ADD children reported significant signs of sleep-related breathing disorders. Daytime behavior problems were more common in ADD and AT than in the DS group. Bedwetting reports did not distinguish groups. Direct comparisons of DS and DS-SIB groups showed that more DS were mouth breathers, snored, stopped breathing at night, and were sleepy in the daytime. These findings underscore the importance of obtaining a history of nocturnal sleep from parents of children with AT and DS, as well as those with disrupted daytime behavior.

Adenoids↗

Psychometric properties of the strengths and difficulties questionnaire.

OBJECTIVE: To describe the psychometric properties of the Strengths and Difficulties Questionnaire (SDQ), a brief measure of the prosocial behavior and psychopathology of 3-16-year-olds that can be completed by parents, teachers, or youths. METHOD: A nationwide epidemiological sample of 10,438 British 5-15-year-olds obtained SDQs from 96% of parents, 70% of teachers, and 91% of 11-15-year-olds. Blind to the SDQ findings, all subjects were also assigned DSM-IVdiagnoses based on a clinical review of detailed interview measures. RESULTS: The predicted five-factor structure (emotional, conduct, hyperactivity-inattention, peer, prosocial) was confirmed. Internalizing and externalizing scales were relatively "uncontaminated" by one another. Reliability was generally satisfactory, whether judged by internal consistency (mean Cronbach a: .73), cross-informant correlation (mean: 0.34), or retest stability after 4 to 6 months (mean: 0.62). SDQ scores above the 90th percentile predicted a substantially raised probability of independently diagnosed psychiatric disorders (mean odds ratio: 15.7 for parent scales, 15.2 for teacher scales, 6.2 for youth scales). CONCLUSION: The reliability and validity of the SDQ make it a useful brief measure of the adjustment and psychopathology of children and adolescents.

Adolescent↗

Behavioral profiles in 4-5 year-old children: normal and pathological variants.

Normal and psychopathological patterns of behavior symptoms in pre-school children were described by a classification approach using cluster analysis. The behavior of 406 children, average age 4 years 9 months, from the general population was evaluated at home visits. Seven clusters were identified based on empirically defined dimensions: attention, hyperactivity, aggressiveness, social relationship problems, sleeping problems, eating problems, depression and anxiety. Clusters scoring high in inattention, hyperactivity, aggressiveness, and social relationship problems but low in depression and anxiety were found and could indicate early onset conduct disorder. The approach of analysing patterns of symptoms expands the basis on which normal and psychopathological patterns are distinguished.

Aggression↗

Lithium carbonate treatment of select behavior disorders in children suggesting manic-depressive illness.

Twelve children with severe chronic behavior disorders who benefited from treated with lithium carbonate over an extended period of time (6 to 33 months) are described. Behavioral features common to all included hostility, aggressiveness, and distractibility. Nine had cyclic mood swings, with periods of withdrawal and periods of manic excitement; six of these had neurovegetative disorders. These nine children may have manic-depressive disease of childhood. Three children had no cyclic symptoms, though their hostile and aggressive behavior was similar to that of the cyclic group; they responded similarly to lithium. Family histories were strongly positive for manic-depressive disease, depression, and alcoholism. A double-blind placebo-controlled crossover study in four patients supported the specific behavioral effect of lithium.

Adolescent↗

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↗

Psychiatric status of adolescents who had extreme temperaments at age 7.

Two temperamentally extreme (extremely easy and extremely difficult) subgroups of children were selected at the age of 7 years from a large random sample of the general population of Quebec City. The clinical status, family functioning, IQ, and academic performance of these children were reassessed at 12 and 16 years of age. Findings suggest that extreme temperament at age 7 predicts psychiatric status in preadolescence and adolescence only when family functioning is also taken into account. The adolescents who had been temperamentally difficult children and who were living in families with dysfunctional behavior control displayed more clinical disorders.

Achievement↗

The effects of father involvement in parent training for conduct problem children.

Thirty families who received parent training for conduct-disordered children were divided into two groups, father-involved families and father-absent families. Immediately post-treatment both groups reported significant improvements in their children's behaviors. Behavioral data showed significant increases in mother praises and reductions in mother negative behaviors, child noncompliance and deviancy. One year later the children continued to show reductions in noncompliance and deviance. However, significantly more of the mother-child dyads who maintained behavioral improvements came from father-involved families.

Attitude↗

Associations of symptoms of anxiety disorders and self-reported behavior problems in normal children.

61 children, aged between 14 and 18 years, completed the Screen for Child Anxiety Related Emotional Disorders, a scale of anxiety disorders symptoms, and the Youth Self-report, a measure of internalizing, i.e., emotional, and externalizing, i.e., behavioral, problems. Analysis showed that, with the exception of the Social Phobia and the Specific Phobia subscales, Screen total and subscale scores were significantly related to Internalizing problems (rs between .40 and .77). Thus, the more frequently children reported Anxiety Disorder symptoms, the more often they reported emotional problems. Furthermore, in particular, anxious-depressed problems as measured by the Youth Self-report were significantly associated with scores on Screen scales. These results further support the concurrent validity of the Screen.

Adolescent↗

Psychometric properties of the children's atypical development scale.

The Children's Atypical Development Scale (CADS) is a 53-item rating scale designed to measure unusual behaviors in children. Principal-factor analysis on a clinic-referred and pediatric sample of 474 children resulted in a four-factor solution: Communication Deficits, Lability, Social Relatedness Deficits, and Preoccupation. The CADS is internally consistent and has adequate temporal stability. CADS factor scores were differentially associated with parent and teacher rating scales, IQ, and Continuous Performance Test errors. The scale shows promise as a clinical and research tool for assessing atypical behaviors associated with pervasive developmental disorder and other neurobehavioral disorders.

Adolescent↗

A construct validity study of the Missouri Children's Behavior Checklist with developmentally disabled children.

Evaluated the construct validity of the MCBC scales and behavior profiles by determining the relationship between the MCBC and the clinical findings and recommendations that resulted from an interdisciplinary evaluation of children (N = 217) referred to a clinic for developmental disabilities. There were few differences in MCBC scale means and percentage occurrences of behavior profiles as a function of demographic factors and broad diagnostic categories. Substantial association was found between the MCBC and clinical findings of behavior problems. The association of the MCBC and clinical findings suggestive of affective problems was not as substantial, which suggests a need to augment the sensitivity of the MCBC in this area. The findings also suggested both the potential and the need for evolving additional MCBC behavior profiles that would reflect additional clinically meaningful subgroups among developmentally disabled children.

Adolescent↗