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Neurobehavioral consequences of prenatal alcohol exposure: an international perspective.

This article represents the proceedings of a symposium at the 2002 Research Society on Alcoholism/International Society for Biomedical Research on Alcoholism meeting in San Francisco, CA. The organizers were Edward P. Riley and Sarah N. Mattson, and the chairperson was Edward P. Riley. The presentations were (1) Neurobehavioral deficits in alcohol-exposed South African infants: preliminary findings, by Sandra W. Jacobson, Christopher D. Molteno, Denis Viljoen, and Joseph L. Jacobson; (2) A pilot study of classroom intervention for learners with fetal alcohol syndrome in South Africa, by Colleen Adnams, M. W. Rossouw, M. D. Perold, P. W. Kodituwakku, and W. Kalberg; (3) Differential effects of prenatal alcohol exposure on fluid versus crystallized intelligence, by P. W. Kodituwakku, W. Kalberg, L. Robinson, and P. A. May; (4) Neurobehavioral outcomes of prenatal alcohol exposure: early identification of alcohol effects, by Claire D. Coles; (5) Fetal alcohol syndrome in Moscow, Russia: neuropsychology test performance, by Sarah N. Mattson, E. P. Riley, A. Matveeva, and G. Marintcheva; and (6) Long-term follow-up of Finnish children exposed to alcohol in utero in various durations, by Marit I. Korkman and I. Autti-Rämö. The discussant was Ting-Kai Li.

Adolescent↗

Emotional and behavioral difficulties and impairments in everyday functioning among children with a history of attention-deficit/hyperactivity disorder.

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) affects 3% to 7% of school-aged children and has been associated with a variety of comorbid mental illnesses and functional impairments, largely in clinical samples. However, little is known about the spectrum of emotional and behavioral problems and areas of impairment among children with a history of ADHD in nonclinical, nationally representative samples. METHODS: Data were analyzed from the 2003 National Health Interview Survey, an ongoing, computer-assisted, random-sample, personal-interview survey of the noninstitutionalized U.S. population. We examined the associations between history of parent-reported ADHD diagnosis and levels of parent-reported emotional and behavioral difficulties and related impairments among a nationally representative sample of U.S. children aged 4 to 17 years (n = 8681). The extended version of the Strengths and Difficulties Questionnaire was used to measure and score levels of difficulty and impairment. RESULTS: Approximately 5.9% of children had a history of ADHD diagnosis. Children with a history of ADHD were 6 times as likely as those without ADHD to have a high level of overall difficulties including emotional, conduct, and peer problems and were 9 times as likely to manifest a high level of impairment including interference with home life, friendships, classroom learning, and leisure activities. CONCLUSION: This study documents the significant level of current emotional and behavioral difficulties and impairments in everyday functioning experienced by children with a history of ADHD diagnosis, suggesting that people involved with the care of children--parents, health care providers, and teachers--need to be informed about the signs, symptoms, and appropriate treatment of ADHD and other comorbid disorders.

Adolescent↗

Understanding urban child mental health l service use: two studies of child, family, and environmental correlates.

The results of two studies identifying child, family, and environmental correlates of initial and ongoing mental health service use by urban minority children and their families are presented. In the first study, data from a sample of 405 adult caregivers of children revealed no predictive power of child demographic characteristics in relation to initial or ongoing service usage. Only parental ratings of child impulsive-hyperactive behavior were significantly related to ongoing involvement in services. In the second study, a new sample of 100 urban caregivers of children was interviewed. Parental discipline efficacy and attitudes about mental health services were found to relate significantly to initial attendance. Relative to ongoing service use, level of family stress, presence of another adult in the home, and parental discipline efficacy were significant. Implications for research and child mental health service organizations are highlighted.

Adolescent↗

Parents' reports of their children's challenging behaviors: results of a statewide survey.

Parents of children with autism and related disabilities were surveyed about their children's challenging behaviors and resources they felt would be helpful in managing these behaviors. Responses indicated a high frequency of challenging behaviors, including many aggressive and other destructive behaviors occurring more frequently than once per day. Teachers, family members, and published materials were identified as the most helpful of currently available resources; contingency management, as the most successful management approach. Respondents noted many additional needed resources. Results were discussed in relation to continuing research on families' needs, strengths, and judgments pertaining to the demands related to disabilities and challenging behaviors.

Adolescent↗

Praising child compliance: reinforcement or ritual?

Praising child compliance is a common therapeutic recommendation to parents with noncompliant children. There are currently no studies documenting the independent contribution of the praise component to successful parent training programs. Three projects were designed to evaluate the hypotheses underlying the use of contingent praise routines. Namely, it has been suggested that conduct-disordered children are relatively unresponsive to adult approval at pretreatment, yet become responsive by posttreatment. In contrast to the hypotheses, data indicated that child compliance levels were not associated with child responsivity to maternal social reinforces; noncompliant children were responsive to maternal praise both before and after treatment; child responsivity to maternal praise did not covary with successful treatment; previously noncompliant but successfully treated children continued to comply to maternal instructions after contingent praise was withdrawn; a nonclinic child demonstrated extensive compliance persistence in the absence of contingent praise. Praising child compliance appeared to be more of a polite ritual than an active therapeutic component for altering noncompliance.

Behavior Therapy↗

A multivariate analysis of the revised Conners' Teacher Rating Scale with low-income, urban preschool children.

The present investigation addressed the utility of the revised Conners' Teachers Rating Scale (CTRS-28) with low-income urban preschool children. CTRS-28 ratings for a large sample of preschool children from an urban Head Start program were analyzed using exploratory factor analysis. Analyses yielded a 3-factor structure: Conduct problems, Hyperactivity, and Passivity. Further analyses cross-validated this structure for males and females and supported its integrity. Multimethod, multisource validity analyses substantiated the CTRS-28 dimensions. The Play Disruption factor of the parent and teacher Penn Interactive Peer Play Scales (PIPPS) provided convergent validity for the Conduct and Hyperactivity factors of the CTRS-28, whereas the Play Interaction factor revealed divergent validity. The Play Disconnection factor of the PIPPS validated the CTRS-28 Passivity factor. The Q-Sort Emotional Regulation scale provided divergent validity for the Conduct and Hyperactivity factors and likewise the Q-Sort Autonomy scale provided divergent validity for the Passivity factor. Age and sex differences were assessed across the 3 factors of the derived preschool structure. A main effect was found for sex and age indicating that boys displayed higher levels of Hyperactivity and Passivity problems than girls did. Similarly, 4-year-old children demonstrated higher levels of Passivity problems than did 5-year-old children.

Black or African American↗

Genesis and evolution of behavioral disorders: from infancy to early adult life.

The New York Longitudinal Study has followed the behavioral development of 133 subjects from early infancy to early adult life. Special attention has been given to the systematic clinical evaluation and follow-up of all subjects presenting any evidence of behavior disorder. The authors present incidence and outcome data, define the concept of temperament, and briefly discuss conceptual issues and empirical findings. They found the "goodness of fit" (consonance between the individual and the environment) concept useful in tracing developmental sequences. The authors summarize quantitative analyses identifying significant group correlations between antecedent variables and early adult outcome and suggest a tentative classification of the idiosyncratic factors also evident in the clinical course of individual subjects, with case illustrations.

Adaptation, Psychological↗

Nausea during pregnancy: relation to early childhood temperament and behavior problems at twelve years.

Associations between maternal nausea during pregnancy and child behavioral outcomes were investigated in a large birth cohort. Generally, 2nd- and 3rd-trimester nausea were more predictive of child outcomes than 1st-trimester nausea. Children whose mothers reported nausea in middle or late pregnancy had lower sensory thresholds and higher levels of activity and emotional intensity in infancy and were reported to be lower in task persistence at age 5. At age 12, these children were viewed by teachers as more careless with their school work and as having more attentional and learning problems.

Age Factors↗

Longitudinal relationships between sibling behavioral adjustment and behavior problems of children with developmental disabilities.

Siblings of children with developmental disabilities were assessed twice, 2 years apart (N = 75 at Time 1, N = 56 at Time 2). Behavioral adjustment of the siblings and their brother or sister with developmental disability was assessed. Comparisons of adjustment for siblings of children with autism, Down syndrome, and mixed etiology mental retardation failed to identify group differences. Regression analysis showed that the behavior problems of the child with developmental disability at Time 1, but not the change in their behavior over time, predicted sibling adjustment over 2 years. There was no evidence that this putative temporal relationship operated bidirectionally: sibling adjustment did not appear to be related to the behavior problems of the children with developmental disabilities over time.

Adaptation, Psychological↗

Preschool behavior problems: stability and factors accounting for change.

From a sample of high risk children, groups of acting out, withdrawn, and normal preschool children were identified and followed through first, second, and third grade. A high degree of stability of developmental adaptation was found for each group. Examination of the exceptions to predicted outcomes indicated that discontinuity of development was accounted for by level and change in maternal depressive symptomatology, life circumstances, stressful life events experienced by the family, and quality of the home environment. Level of maternal depression appeared to directly affect the quality of care she provided her child, and indirectly affected the quality and organization of the home environment.

Achievement↗

Modes of entry into services for young children with disruptive behaviors.

The authors undertook this study to describe Latina mothers' professional help seeking for their young children's disruptive behaviors. They interviewed 62 Cuban, Puerto Rican, and Dominican first-time help seekers and found four modes of entry: (a) coercion, (b) acceptance of offered referral, (c) responsive and resourceful help seeking subsequent to school reports of behavior problems, and (d) a laborious and convoluted path that was characteristic of 52% of the sample. Schools, maternal and child characteristics, and social network forces played significant roles for all mothers, but the final determinants of service entry varied by the mode of entry followed. Findings suggest that problem labeling is not a necessary precursor to service entry and that direct referrals might effectively shortcut the help-seeking process. Finally, the process that underlies service entry would be described more aptly as a Theory of Affective Action than a Theory of Reasoned Action.

Adult↗

Dimensions of behavior in children with speech andlanguage disorders.

The behavioral symptoms of a population of children with speech and language disorders (with a mean age of approximately 6 years) were studied with a teacher and a parent questionnaire. A factor analysis produced similar factors for both questionnaires: Hyperactivity-Conduct, Affect, and Language. An Asocial factor was also found with the teacher questionnaire. The factors of this study were in good agreement with the general factors of "Aggression" and "Withdrawal" found in other quantitative studies. Mean factor score profiles were reported for this unique population of children.

Adolescent↗

Situational variation in problem behavior at home and school in attention deficit disorder with hyperactivity: a factor analytic study.

The present investigation assesses situational variation in problem behaviors of children with Attention Deficit Disorder with Hyperactivity. Principal-component factors (VARIMAX rotation) were computed for the Home/School Situations Questionnaires (HSQ/SSQ). For the HSQ, four factors emerged, accounting for 61% of variance. For the SSQ, three factors emerged, accounting for 68% of variance. Factors were similar to those previously derived with non-referred children. To assess discriminative power, factors were compared (t-tests) to previous data. All factors significantly discriminated ADD/H from non-referred children. These data suggest the factors add to the utility of the HSQ/SSQ in assessing ADD/H.

Attention Deficit Disorder with Hyperactivity↗