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PubMed1985

Use of a child behavior checklist in the psychosocial assessment of children with epilepsy.

Children with epilepsy are faced with many of the same psychosocial stressors as other chronically ill children, and a proper assessment is vital. The purpose of this study was to determine whether the Child Behavior Checklist of Achenbach and Edelbrock could be used as a practical and objective tool for evaluating the psychosocial needs of children with epilepsy. Thirty-eight children were randomly selected from the Neurology outpatient clinic at the Children's Hospital of Eastern Ontario. Questionnaires were completed by the mothers during their waiting period. Results demonstrated the highest risk of maladjustment was within social functioning. As children reach adolescence, adjustment problems are mostly related to school. Although as a group, our sample did not differ from norms for behavior problems, there was evidence to suggest behavioral maladjustment for individual children. The checklist appears to be a good screening tool for maladjustment that could be included as part of the pediatrician's comprehensive assessment of children with epilepsy.

Adolescent↗
PubMedDate not supplied

Increase in child behavior problems resulting from maternal smoking during pregnancy.

In this article, the authors investigated the effect of maternal smoking during pregnancy on behavioral problems, which were not mediated by lower birth weight, in offspring at 3 y of age. The authors used the Child Behavior Checklist for ages 2-3 y (CBCL/2-3; Achenbach, Edelbrock and Howell) to assess behavioral problems in 1,377 2- to 3-y-old healthy twin pairs. Soon after the birth of twins, the authors collected pre- and perinatal information, including smoking habits of the mother during pregnancy. The question "Did you smoke during pregnancy?" could be answered by choosing one of three possible options: (1) never, (2) sometimes, or (3) regularly. The authors analyzed the effect of maternal smoking on the Child Behavioral Checklist total score and on several subscale scores for first- and second-born twins separately, and they adjusted for the possible confounding effects of birth weight, socioeconomic status, maternal age, and having been breast- or bottle-fed. There was a significant effect of maternal smoking on so-called externalizing behavior problems (oppositional, aggressive, overactive), but not on internalizing behavior problems (withdrawn, depressed, anxious), in both first- and second-born twins. The authors primarily attributed the enhanced externalizing problems to increased aggression. Although boys had higher externalizing (and aggression) scores than girls, the effect of maternal smoking was the same for boys and girls. The authors also discuss whether maternal smoking causes externalizing behavior problems.

Birth Weight↗
PubMedDate not supplied

Psychosocial predictors of maternal depressive symptoms, parenting attitudes, and child behavior in single-parent families.

The purposes of the study were to identify psychosocial predictors of depressive symptoms among low-income, single mothers and to investigate the effects of maternal psychosocial factors, depressive symptoms, and parenting attitudes on children's behavior. In-home interviews were conducted with 225 mothers to obtain data on their everyday stressors, coping strategies, social resources, depressive symptoms, and parenting attitudes, as well as reports of their children's behavior. High depressive symptoms occurred among 59.6% of the women. Higher depressive symptoms were associated with greater everyday stressors, fewer social resources, and greater use of avoidance coping. Neither social resources nor coping strategies buffered the relationship between everyday stressors and depressive symptoms. Maternal depressive symptoms predicted parenting attitudes. Parenting attitudes, in turn, predicted child behavior. These findings suggest that depressive symptoms are indirectly associated with mothers' reports of child behavior through their influence on parenting attitudes.

Adaptation, Psychological↗
PubMed2004

Parent identification of early emerging child behavior problems: predictors of sharing parental concern with health providers.

OBJECTIVES: To better understand the predictors of parental discussions with pediatric care providers (pediatricians, psychologists/psychiatrists, social workers, early intervention providers, or other medical specialists) regarding early child behavior problems and to suggest strategies for eliciting early identification from parents in health care settings. DESIGN: A cross-sectional survey of parents of children from a representative healthy birth cohort. The survey included the Infant-Toddler Social Emotional Assessment, measurement of parental worry regarding problematic behavior, and demographic factors. SETTING: Fifteen urban and suburban towns in the northeastern United States. PARTICIPANTS: The study sample consisted of all parents of 11- to 39-month-olds (n = 269) who exceeded the 90th percentile on 1 or more Infant-Toddler Social Emotional Assessment problem domain scores (representing elevated problematic behavior symptoms) from an original sample of 1278. RESULTS: Few parents (17.7%) who reported elevated problematic behavior spoke to a provider about such problems. In adjusted models, speaking to a provider was associated with reported worry about behavior (odds ratio [OR], 3.47 [95% confidence interval (CI), 1.74-6.92]) and with low reported child social-emotional competence (OR, 2.68 [95% CI, 1.23-5.84]). In adjusted models, worry was most likely among parents who reported low child competence (OR, 2.18 [95% CI, 1.07-4.22]) and disruption in family routines attributed to the child's behavior (OR, 2.38 [95% CI, 1.31-4.33]). CONCLUSIONS: Parental worry is a robust predictor of help seeking among parents of children with behavioral problems. Further, lags in social competence contribute to both parental worry and help seeking. These findings, in conjunction with previous evidence that child behavior problems amenable to early intervention are often unidentified, suggest that systematic inquiry by health care providers about parental concerns is important in the identification of early emerging behavioral health problems.

Adult↗
PubMed1999

Problems reported by parents of children in multiple cultures: the Child Behavior Checklist syndrome constructs.

OBJECTIVE: The purpose of this study was to compare syndromes of parent-reported problems for children in 12 cultures. METHOD: Child Behavior Checklists were analyzed for 13,697 children and adolescents, ages 6 through 17 years, from general population samples in Australia, Belgium, China, Germany, Greece, Israel, Jamaica, the Netherlands, Puerto Rico, Sweden, Thailand, and the United States. RESULTS: Comparisons of nine cultures for subjects ages 6 through 17 gave medium effect sizes for cross-cultural variations in withdrawn and social problems and small effect sizes for somatic complaints, anxious/depressed, thought problems, attention problems, delinquent behavior, and aggressive behavior. Scores of Puerto Rican subjects were the highest, whereas Swedish subjects had the lowest scores on almost all syndromes. With great cross-cultural consistency, girls obtained higher scores than boys on somatic complaints and anxious/depressed but lower scores on attention problems, delinquent behavior, and aggressive behavior. Although remarkably consistent across cultures, the developmental trends differed according to syndrome. Comparison of the 12 cultures across ages 6 through 11 supported these results. CONCLUSIONS: Empirically based assessment in terms of Child Behavior Checklist syndromes permits comparisons of problems reported for children from diverse cultures.

Adolescent↗
PubMed1999

Syndrome dimensions of the child behavior checklist and the teacher report form: a critical empirical evaluation.

The construct representation of the cross-informant model of the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) was evaluated using confirmatory factor analysis. Samples were collected in seven different countries. The results are based on 13,226 parent ratings and 8893 teacher ratings. The adequacy of fit for the cross-informant model was established on the basis of three approaches: conventional rules of fit, simulation, and comparison with other models. The results indicated that the cross-informant model fits these data poorly. These results were consistent across countries, informants, and both clinical and population samples. Since inadequate empirical support for the cross-informant syndromes and their differentiation was found, the construct validity of these syndrome dimensions is questioned.

Child↗
PubMed1979

Identification of typologies derived from child behaviors in the hospital as predictors of psychological upset.

This study proposed to measure objectively the behaviors of children in the hospital setting in order to combine the data on the particular aspects of behaviors or symptoms into global measures or typologies of psychological upset. It attempts to offer a good, single measure for predicting behavior of children in psychological upset. Thirty-one subjects in this study, observed in the hospital setting, are clustered together to identify typologies derived from child behaviors in the hospital. These children were divided into three factors which correspond with the three stages of hospitalization: Factor I typified Stage III -- Denial; Factor II typified Stage II -- Despair; and Factor III typified Stage I -- Protest. The study offers direction to objectively and systematically evaluate the effects of hospitalization on children. It also suggests that observational ratings of child behaviors in the hospital may be accurate predictors of the degree of psychological upset a child is experiencing at a certain point in time. It also has particular implications for strategies which hospital staff could employ when they observe particular stages that children manifest.

Adaptation, Psychological↗
PubMed2005

Child behavior and parent management strategies at mealtimes in families with a school-age child with cystic fibrosis.

Parent and child mealtime behaviors in school-age children with cystic fibrosis (CF; n = 28) and children without CF (n = 28) were examined during dinner meals by using multivariate analysis of variance. Parents of children with CF were found to differ from comparison parents in the frequency and rate of child management strategies. No differences were found in child behaviors. As the meal progressed, children displayed an increase in behaviors incompatible with eating, and parents increased behaviors to encourage eating. Slow eaters (> 20 min) with CF consumed more calories at the dinner meal than fast eaters (< 20 min) but did not achieve a higher daily caloric intake. Interventions targeting improvement of parent- child interactions during the mealtime are needed to achieve optimal dietary intake.

Child↗
PubMedDate not supplied

Challenges of managing child behavior in the 21st century dental setting.

This paper discussed factors influencing behavior management of the child dental patient. Pediatric dentists are affected by changes in: (1) society; (2) marketing and media; (3) communications and technology; and (4) parenting practices. Behavior of pediatric patients reflects fewer boundaries, less discipline and self-control, and lowered behavioral expectations by parents and contemporary culture. The insurance industry, regulatory bodies, legal system, dental staff, and pediatric dentist education are other influences on behavior management. Responses of the American Academy of Pediatric Dentistry (AAPD), which could support the pediatric dentist in the changing environment, include: (1) research; (2) continuing education for staff and dentists; (3) development of Internet accessible materials for the public; (4) legislative activity; (5) partnering with pediatric medicine to develop new behavior management strategies; (6) establishment of an AAPD Council on Child Behavior; and (7) ongoing critical reassessment of behavior issues by the AAPD.

Behavior Control↗
PubMed1978

Continuities in maternal reports and child behaviors over time in hyperactive and comparison groups.

Maternal reports, observations of nursery and elementary school behavior, and teacher ratings of problems were available for hyperactive and control children who had participated in a longitudinal study. This paper examines consistencies in maternal reports and child behaviors over time, and their relationship to teacher ratings in elementary school. Maternal reports of infant sleep difficulties were related to maternal ratings of hyperactivity at 4 1/2 and 6 1/2 years. Maternal ratings of activity at 4 1/2 were predictive of 6 1/2-year ratings of hyperactivity and conduct problems. In addition, behavior in a research nursery at 4 1/2 predicted teacher ratings of problems and classroom behavior in grade two. Hyperactive preschoolers who left the table most during structured activities were more often out-of-seat and off-task in school. Controls who were more aggressive in the nursery were more disruptive in the classroom. These data indicate continuities in both maternal reports and child behaviors.

Age Factors↗
PubMed1980

A typology of child behavior profile patterns: distribution and correlates for disturbed children aged 6--16.

This article reports the construction of a typology of behavior problem patterns, as scored on the Child Behavior Profile. Hierarchical cluster analysis was used to identify reliable profile patterns that characterize clinically referred boys and girls aged 6-11 and 12-16. Procedures for classifying the profiles of individual children were developed and good agreement was obtained between classifications based on rating by mothers and a clinician. The distribution of profile patterns was determined for each age and sex group. Children classified by different patterns were found to differ significantly in age, race, school performance, and amount and quality of participation in activities and social relationships. Issues in the application of cluster analysis to behavioral data were analyzed and various options for the classification of individual cases were compared.

Adolescent↗
PubMed1995

Mother-child interaction quality as a partial mediator of the roles of maternal depressive symptomatology and socioeconomic status in the development of child behavior problems. Conduct Problems Prevention Research Group.

This investigation examined the relation between maternal depressive symptomatology and the development of externalizing behavior problems in children by incorporating mother-child interaction quality into a series of models. A representative sample of 376 first-grade boys and girls (mean age = 6.52) from diverse backgrounds (234 from the lowest 2 socioeconomic classes) and their mothers completed an interaction task designed to measure the quality of mother-child interaction. Latent variable structural equations analyses revealed that mother-child interaction quality partially mediated the relation between maternal depressive symptomatology and child behavior problems even when the effects of socioeconomic status on both variables were taken into account. Although this model held for boys, girls, and Caucasians, the relation between maternal depression and interaction quality was not significant for African-Americans. Further investigation is required to understand the lack of generalizability of the model to African-American mother-child dyads.

Child↗
PubMed2006

The equivalence of the Child Behavior Checklist/1 1/2-5 across parent race/ethnicity, income level, and language.

This study examined the equivalence of the Child Behavior Checklist/1 1/2-5 (CBCL/1 1/2-5) in 682 parents of 2- to 4-year-old children stratified by parent race/ethnicity (African American, Latino, and non-Latino White), family income (low vs. middle-upper), and language version (Spanish vs. English). Externalizing Scale means differed by income and child gender. Internalizing Scale means differed by income and parent race/ethnicity. Differential item analyses showed that few items functioned differently by racial/ethnic, language, and income group. A confirmatory factor analysis demonstrated that the Externalizing Scale provided a good fit with the data across racial/ethnic and income groups. However, model fit was improved for the Internalizing Scale when factor weights were allowed to vary. Findings support the equivalence of the CBCL/1 1/2-5 when used with parents of low-income preschool children from African American and Latino backgrounds, although further study of the factor structure for the Internalizing Scale is recommended.

Adult↗
PubMed1997

Behavioral and emotional problems in young preschoolers: cross-cultural testing of the validity of the Child Behavior Checklist/2-3.

The cross-cultural validity of the Child Behavior Checklist for Ages 2-3 (CBCL/2-3) was tested in three Dutch samples of children referred to mental health services, from the general population, and from a twin study. Six scales were derived from factor analyses and labeled Oppositional, Aggressive, and Overactive, which constituted a broadband Externalizing grouping; Withdrawn/Depressed and Anxious, which constituted a broadband Internalizing grouping; and Sleep Problems. Internal consistencies of the scales, their test-retest reliabilities, interparent agreement, discriminative power, predictive relations with problem ratings 2 years later, and relations to other instruments designed to measure general development and behavior problems were adequate, and highly comparable to psychometric properties in American samples. It was concluded that across languages and cultures behavioral/emotional problems of young preschoolers may be adequately assessed with the CBCL/2-3.

Chi-Square Distribution↗
PubMed1992

Analysis of the effects of task preferences, task demands, and adult attention on child behavior in outpatient and classroom settings.

Two studies were conducted with children who displayed behavior problems to evaluate the effects of task preference, task demands, and adult attention on child behavior. In Study 1, we conducted brief functional analyses in an outpatient clinic to identify variables that facilitated appropriate behavior. For 8 of 10 children, distinct patterns of performance occurred; 3 children displayed improved behavior with changes in task demands, 1 child displayed improved behavior with a preferred task, and 4 children displayed improved behavior with changes in adult attention. In most cases, the children's parents carried out the assessments with adequate procedural integrity. In Study 2, we applied similar assessment methods to a classroom setting over an extended period of time. We identified independent variables controlling appropriate, on-task, and academic behavior for 2 children on two tasks, with slightly different treatment procedures across tasks for both children. In addition, the results of brief functional analyses for both children corresponded to the extended classroom assessments.

Adjustment Disorders↗