The Eyberg Child Behavior Inventory: Factorial invariance in problem behaviors across gender and age

The Eyberg Child Behavior Inventory (ECBI) assesses problem behaviors in children, and is a widely used instrument in both clinical work and research. Evidence suggests that the short ECBI version, comprising 22 items, can be reduced into the three oblique factors: Oppositional defiant behavior; Conduct problem behavior; and Inattentive behavior. The present study aimed to evaluate this three-factor model in a Norwegian sample of 554 children, and examine multi-group invariance across gender and age. Consistent with previous research, results confirmed a tripartite model, with the same residual covariances and cross-loading appearing across groups. Multi-group confirmatory factor analysis demonstrated partial measurement invariance across gender and age. Overall, findings support a meaningful comparison of the short ECBI across gender and age. The study makes a contribution to the generalizability issue of the ECBI.

Early adversity, hypocortisolism, and behavior problems at school entry: A study of internationally adopted children

The hypothalamic-pituitary-adrenal (HPA) axis is influenced by early life adversity; however, less is known about the potential for recovery following marked improvements in care. The present study examined longitudinal changes in children's cortisol reactivity in the laboratory (4 assessments over 2 years) after adoption. Post-institutionalized (N=65) and post-foster care children (N=49) demonstrated blunted reactivity relative to non-adopted peers (N=53). Furthermore, post-institutionalized children exhibited no evidence of expected adaptation to repeated sessions in the 2 years following adoption. As evidenced by blunted cortisol reactivity, flatter diurnal slope, and lower home morning cortisol, we found support for hypocortisolism among children experiencing adverse early care. Hypocortisolism served as a mediator between adversity and teacher-reported attention and externalizing problems during kindergarten. Early adversity appears to contribute to the down-regulation of the HPA axis under both basal and stress conditions.

Acceptance and Commitment Therapy for Individuals with Disabilities: A Behavior Analytic Strategy for Addressing Private Events in Challenging Behavior

Applied behavior analysts work with many populations including individuals with developmental and intellectual disabilities. Although behavior analysts have a variety of empirically supported treatments to implement when working with individuals with disabilities, sometimes, other variables may adversely impact treatment effectiveness. The degree to which problematic thoughts and feelings (private events) influence behavior may be a variable that contributes to treatment efficacy. Traditional behavior analytic services are not always equipped to successfully address the private events influencing client behavior. In such cases, it may be beneficial for behavior analysts to consider additional philosophically aligned treatments for private events. One such treatment, acceptance and commitment therapy, may be a useful tool for behavior analysts to incorporate into their toolbox in order to help clients. The purpose of this paper is to introduce behavior analysts to a potential solution to the problem of effectively addressing private events in behavior analytic services. We then propose a model for thinking about private events in relation to clients with disabilities and present a guide for taking steps to address private events in the clinical setting. We conclude this paper with a call for research and present a possible research agenda for behavior analysts.

Association Between Parental Social Interaction and Behavior Problems in Offspring: a Population-Based Study in Japan

PURPOSE

Research in parental social support has chiefly examined received social support. Studies have suggested that provided social support may also be protective for child mental health problems. We aim to investigate the association between parental social interaction (both received and provided social support) and offspring behavior problems.

METHODS

We analyzed the data of 982 households, including 1538 children aged 4 to 16 years, from the Japanese Study of Stratification, Health, Income, and Neighborhood (J-SHINE) survey conducted over 2010-2011. We used a 5-point Likert scale to assess social interaction including parental emotional and instrumental support received from and provided to the spouse, other co-residing family members, non-co-residing family members or relatives, neighbors, and friends. Behavior problems in offspring were assessed using parental responses to the Strengths and Difficulties Questionnaire. Associations between parental social interaction and behavior problems were analyzed using ordered logistic regression.

RESULTS

We found that higher maternal social interaction is significantly associated with lower odds of both difficult and prosocial behavior problems, while the same associations were not found for paternal social interaction. Further, maternal provided social support showed an independent negative association with prosocial behavior problems in offspring, even when adjusted for received maternal social support and paternal social interaction.

CONCLUSIONS

This study showed that maternal social interaction, but not paternal social interaction, might have a protective effect on offspring behavior problems. Further study is required to investigate the effect of the intervention to increase social participation among mothers whose children have behavior problems.

A Proposed Model for Selecting Measurement Procedures for the Assessment and Treatment of Problem Behavior

Practicing behavior analysts frequently assess and treat problem behavior as part of their ongoing job responsibilities. Effective measurement of problem behavior is critical to success in these activities because some measures of problem behavior provide more accurate and complete information about the behavior than others. However, not every measurement procedure is appropriate for every problem behavior and therapeutic circumstance. We summarize the most commonly used measurement procedures, describe the contexts for which they are most appropriate, and propose a clinical decision-making model for selecting measurement produces given certain features of the behavior and constraints of the therapeutic environment.

Functional analysis and treatment of problem behavior exhibited by children with fragile X syndrome

The efficacy of function-based interventions for the treatment of severe problem behavior exhibited by individuals with intellectual and developmental disabilities (IDD) is well established. However, few studies have reported on behavioral interventions in fragile X syndrome (FXS) specifically. The present study is a consecutive case-series analysis that reports on functional analysis and treatment of problem behavior of nine children with FXS. Assessment findings were consistent with previous research indicating that among individuals with FXS, problem behavior is more commonly maintained by escape from demands and access to tangible items, relative to the broader population of individuals with IDD. Functional analysis-based behavioral interventions resulted in a mean reduction in problem behavior of 95.2% across the nine participants. Additionally, generalization of treatment effects from controlled clinical settings to home, school, and community was demonstrated. The current findings suggest that function-based behavioral interventions shown to be effective with the broader population of individuals with IDD are also effective for individuals with FXS. Our results in combination with those of previous studies describing functional analysis outcomes provide additional evidence for a unique functional behavioral phenotype for severe problem behavior in individuals with FXS. Implications of study findings for early intervention and prevention of problem behavior in children with FXS are discussed.

Anger, Anger Expression Types, Problem Behaviors, and Suicide Probability in Adolescent Women using Cluster Analysis

PURPOSE

This cross-sectional study was designed to identify anger-expression types of adolescent women and investigate the relationship between the identified anger-expression types and their problem behaviors and suicide probability.

METHODS

The participants were 942 students at two female high school located in Gwangju. The data were analyzed using descriptive statistics, cluster analysis, t-test, ANOVA, and Scheffe multiple comparison test.

RESULTS

Cluster analysis revealed 4 distinct anger expression types; Anger-out, Low anger expression, Anger-control, and Anger-in/out types. Female adolescent women had a higher level of trait anger or who frequently used the anger-in/out type reported internalized-externalized problem behaviors and suicide probability more frequently compared to those who frequently used the other three types of anger expression.

CONCLUSION

Female adolescent women who had the low anger expression type and anger control type managed anger most effectively. The findings suggest the necessity of a development of the program for lowering the trait anger level and controlling the unfavorable anger expression types such as the anger-in/out.

Training Staff to Avoid Problem Behavior Related to Restricting Access to Preferred Activities

Some training programs for staff working with individuals with intellectual disabilities fail to equip staff with the practical skills necessary to prevent behavioral episodes. The current research describes the results of a staff training program that, following traditional didactic training, used a card game followed by role-play training to increase staff competence in managing problem behavior. The card game and role-play training was based on behavioral episodes that had occurred previously in the research setting. Post-training observations showed that treatment integrity of trained staff improved.

Neonatal glucocorticoid treatment: long-term effects on the hypothalamus-pituitary-adrenal axis, immune system, and problem behavior in 14-17 year old adolescents

Neonatal glucocorticoid (GC) treatment is used to prevent bronchopulmonary dysplasia (BPD) in prematurely born babies. In the 1990s, treatment regimens with relatively high doses of dexamethasone (DEX) were common. As an alternative, hydrocortisone (HC) was used. Earlier, we compared long-term effects of both GCs in children aged 7-10 and detected adverse effects of neonatal DEX treatment, but not of HC, on a range of outcomes. The aim of the current cohort study was to investigate whether long-term effects of neonatal DEX were maintained and whether effects of HC remained absent at adolescent age (14-17years). We compared 71 DEX-treated and 67 HC-treated adolescents. In addition, 71 adolescents who were not neonatally treated with GCs participated. All were born <32weeks of gestation. DEX-treated girls showed increased adrenocorticotropic hormone (ACTH) and cortisol responses in the Trier Social Stress Test. The cortisol awakening response was lower in HC-treated participants compared to untreated participants. Negative feedback function of the HPA-axis in the dexamethasone suppression test did not differ between groups. In contrast to our observations at the age of 7-10years, we did not observe group differences in mitogen-induced cytokine production at the age of 14-17years. DEX-treated girls showed more social problems and anxious/depressed behavior than HC-treated girls. Untreated girls showed more problem behavior as well. In conclusion, our results suggest that, especially in girls, neonatal DEX has a programming effect on the HPA-axis and on the ability to adjust to the environment. The loss of group differences on immune system measures indicate that potentially negative effects detected at a younger age subsided.

Factors Promoting Mental Health of Adolescents Who Have a Parent with Mental Illness: A Longitudinal Study

BACKGROUND

Children of parents with mental illness have an elevated risk of developing a range of mental health and psychosocial problems. Yet many of these children remain mentally healthy.

OBJECTIVE

The present study aimed to get insight into factors that protect these children from developing internalizing and externalizing problems.

METHODS

Several possible individual, parent-child, and family protective factors were examined cross-sectionally and longitudinally in a sample of 112 adolescents. A control group of 122 adolescents whose parents have no mental illness was included to explore whether the protective factors were different between adolescents with and without a parent with mental illness.

RESULTS

Cross-sectional analyses revealed that high self-esteem and low use of passive coping strategies were related to fewer internalizing and externalizing problems. Greater self-disclosure was related to fewer internalizing problems and more parental monitoring was related to fewer externalizing problems. Active coping strategies, parental support, and family factors such as cohesion were unrelated to adolescent problem behavior. Longitudinal analyses showed that active coping, parental monitoring, and self-disclosure were protective against developing internalizing problems 2 years later. We found no protective factors for externalizing problems. Moderation analyses showed that the relationships between possible protective factors and adolescent problem behavior were not different for adolescents with and without a parent with mental illness.

CONCLUSIONS

The findings suggest that adolescents' active coping strategies and parent-child communication may be promising factors to focus on in interventions aimed at preventing the development of internalizing problems by adolescents who have a parent with mental illness.

Dutch adolescents from lesbian-parent families: how do they compare to peers with heterosexual parents and what is the impact of homophobic stigmatization?

In this study, we compared internalizing and externalizing problem behavior of 67 Dutch adolescents (M(age) = 16.04) in planned lesbian families who were matched with 67 adolescents in heterosexual-parent families. We also examined whether homophobic stigmatization was associated with problem behavior in adolescents with lesbian mothers after taking into account demographic characteristics, mothers' scores on emotional involvement, and adolescents' earlier problem behavior (measured at age 4-8 years old). Standardized instruments measuring problem behavior were completed by parents and adolescent offspring, and questions about stigmatization were answered by adolescents with lesbian mothers. The results revealed no differences in internalizing and externalizing problem behavior associated with family type. Offspring in lesbian families who reported more experiences of homophobic stigmatization also demonstrated more internalizing and externalizing problem behavior.

A quantitative examination of punishment research

The current review examined 368 articles, published between 1967 and 2013, which evaluated punishment-based procedures for the treatment of challenging behavior among persons with developmental disabilities and quantitatively analyzed: (a) the amount of research that has assessed different types of punishment procedures; (b) the characteristics of the participants, behaviors, and treatments included in these studies, and (c) the relative efficacy of the various punishment procedures in general and with regard to the inclusion of reinforcement-based components, method of treatment selection and development, and function of the targeted challenging behaviors. Further, the study evaluated the included studies for the presence of important quality indicators. It was intended that such an analysis would provide a useful overview of the extant research on punishment procedures as a behavior reduction technique. Suggestions regarding research methodology and areas for further investigation are made for future research evaluating punishment-based interventions.

Social deprivation and the HPA axis in early development

Growing evidence suggests that early social deprivation impacts the activity of the hypothalamic-pituitary-adrenocortical axis. Early adverse care in the form of institutional or orphanage care provides a human model for early social deprivation. The present study examined changes in diurnal cortisol during the transition to family care in the first 2 years post-adoption. Children adopted between 15 and 36 months from institutional care were examined four times during their first 2 years post-adoption (N=58). Comparison groups included same-aged peers reared in their birth families (N=50) and children adopted during their first year from overseas foster care (N=47). Children provided daily cortisol samples at roughly 2, 9, 17, and 25 months post-adoption. Post-institutionalized and post-foster care children exhibited less steep diurnal cortisol compared to non-adopted same-aged peers; these differences did not diminish across the 2 year period. For post-institutionalized children, lower social care quality in institutions was associated with less steep cortisol slopes. Lastly, shallower diurnal cortisol was a mediator between adoption status and increased behavioral problems 2 years post-adoption. Consistent with the non-human primate literature, early social deprivation may contribute to early programming of the HPA axis.

Environmental risk factors associated with the persistence of conduct difficulties in children with intellectual disabilities and autistic spectrum disorders

We investigated the association between exposure to environmental risks in early childhood and the prevalence and persistence of conduct difficulties (CD) in children with intellectual disability (ID) who did not have autistic spectrum disorder (ASD), children with ASD and typically developing (TD) children. Results indicated that: (1) exposure to risk was associated with elevated prevalence of CD at age three and, for TD children and children with ID, increased risk of CD persisting to ages five and seven; (2) at all levels of risk, children with ASD were more likely to show persistent CD than other children; (3) children with ID were no more likely to show persistent CD than TD children at low levels of exposure to environmental risk.

Efficacy of behavioral interventions for reducing problem behavior in persons with autism: an updated quantitative synthesis of single-subject research

Problem or challenging behaviors are highly prevalent among persons with autism and bring along major risks for the individual with autism and his/her family. In order to reduce the problem behavior, several behavioral interventions are used. We conducted a quantitative synthesis of single-subject studies to examine the efficacy of behavioral interventions for reducing problem behavior in persons with autism. Two hundred and thirteen studies representing 358 persons with autism met the inclusion criteria and were included in the statistical analyses. Overall, we found that behavioral interventions were on average effective in reducing problem behavior in individuals with autism, but some interventions were significantly more effective than others. The results further showed that the use of positive (nonaversive) behavioral interventions was increasing over time. The behavioral interventions were on average equally effective regardless of the type of problem behavior that was targeted. Interventions preceded by a functional analysis reduced problem behavior significantly more than interventions not preceded by a functional analysis. Finally, treatment and experimental characteristics, but not participant characteristics, were statistically significant moderators of the behavioral treatment effectiveness.

Using tablet assisted Social Stories™ to improve classroom behavior for adolescents with intellectual disabilities

The present study examined the use of tablet assisted Social Stories™ intervention for three high school students with severe intellectual disabilities whose problem behavior interfered with their learning and caused classroom disruptions. A multiple probe design across participants was employed to test the impact of the tablet assisted SS on the participants' target behaviors. During intervention, the participants read the Social Stories that were created on Prezi and accessed via Quick Response (QR) codes using a Galaxy Tap smart tablet before participating in an academic period. Data indicated that the SS intervention decreased disruptive behavior and increased academic engagement in all three participants. All three demonstrated generalization of behaviors to a nontargeted academic period and maintenance of improved behaviors at the 2-week follow-up.

General and substance-specific predictors of young adult nicotine dependence, alcohol use disorder, and problem behavior: replication in two samples

BACKGROUND

This paper presents two replications of a heuristic model for measuring environment in studies of gene-environment interplay in the etiology of young adult problem behaviors.

METHODS

Data were drawn from two longitudinal, U.S. studies of the etiology of substance use and related behaviors: the Raising Healthy Children study (RHC; N=1040, 47% female) and the Minnesota Twin Family Study (MTFS; N=1512, 50% female). RHC included a Pacific Northwest, school-based, community sample. MTFS included twins identified from state birth records in Minnesota. Both studies included commensurate measures of general family environment and family substance-specific environments in adolescence (RHC ages 10-18; MTFS age 18), as well as young adult nicotine dependence, alcohol and illicit drug use disorders, HIV sexual risk behavior, and antisocial behavior (RHC ages 24, 25; MTFS age 25).

RESULTS

Results from the two samples were highly consistent and largely supported the heuristic model proposed by Bailey et al. (2011). Adolescent general family environment, family smoking environment, and family drinking environment predicted shared variance in problem behaviors in young adulthood. Family smoking environment predicted unique variance in young adult nicotine dependence. Family drinking environment did not appear to predict unique variance in young adult alcohol use disorder.

CONCLUSIONS

Organizing environmental predictors and outcomes into general and substance-specific measures provides a useful way forward in modeling complex environments and phenotypes. Results suggest that programs aimed at preventing young adult problem behaviors should target general family environment and family smoking and drinking environments in adolescence.

Persons with multiple disabilities increase adaptive responding and control inadequate posture or behavior through programs based on microswitch-cluster technology

Study I used typical microswitch-cluster programs to promote adaptive responding (i.e., object manipulation) and reduce inappropriate head or head-trunk forward leaning with a boy and a woman with multiple disabilities. Optic, tilt, and vibration microswitches were used to record their adaptive responses while optic and tilt microswitches monitored their posture. The study included an ABB(1)AB(1) sequence, in which A represented baseline phases, B represented an intervention phase in which adaptive responses were always followed by preferred stimulation, and B(1) represented intervention phases in which the adaptive responses led to preferred stimulation only if the inappropriate posture was absent. Study II assessed a non-typical, new microswitch-cluster program to promote two adaptive responses (i.e., mouth cleaning to reduce drooling effects and object assembling) with a man with multiple disabilities. Initially, the man received preferred stimulation for each cleaning response. Then, he received stimulation only if mouth cleaning was preceded by object assembling. The results of Study I showed that both participants had large increases in adaptive responding and a drastic reduction in inappropriate posture during the B(1) phases and a 2-week post-intervention check. The results of Study II showed that the man learned to control drooling effects through mouth cleaning and used object assembling to extend constructive engagement and interspace cleaning responses functionally. The practical implications of the findings are discussed.

A systematic review and evaluation of response redirection as a treatment for challenging behavior in individuals with developmental disabilities

Response redirection is widely used in clinical practice as a treatment for repetitive behavior or stereotypy in persons with developmental disabilities. However, to date the procedure has received comparatively little empirical evaluation. The current review sought to examine the literature describing the efficacy of response redirection alone, response interruption and redirection (RIRD), and multi-element treatment packages incorporating response redirection, as interventions for challenging behavior in individuals with developmental disabilities. Additionally, the status of response redirection, and RIRD, as evidence-based practice was evaluated in accordance with Reichow's (2011) recently developed criteria. Results indicated that interventions involving response redirection or RIRD typically led to large decreases in challenging behavior but did not result in behavioral suppression. On the basis of the current literature and in accordance with Reichow's criteria, interventions incorporating response redirection do not yet constitute evidence-based practice. The implications of these findings, for both research and practice, are discussed.

Using ABC narrative recording to identify the function of problem behavior: a pilot study

Many professionals report using ABC narrative recording to identify the function of problem behavior in children with developmental disabilities, but research has not established whether their analyses yield valid results. Thus, the purpose of this study was to examine whether the function identified by expert reviewers using ABC narrative recordings would match the one identified by a functional analysis (FA) and the Questions About Behavioral Function (QABF) scale in four children with developmental disabilities. The functions identified by all twelve experts using the ABC narrative recordings matched at least one of the functions identified by the FA for three of four participants. The experts' analyses also agreed with the informant-based assessment at a statistically significant level for two of three participants with a conclusive QABF. Altogether, the results suggest that ABC narrative recording may be useful to generate hypotheses to identify the function of problem behavior, but that more research is needed before recommending its use as a standalone functional behavior assessment.

Effects of PROSPER on the influence potential of prosocial versus antisocial youth in adolescent friendship networks

OBJECTIVES

We test the hypothesis that an evidence-based preventive intervention will change adolescent friendship networks to reduce the potential for peer influence toward antisocial behavior. Altering adolescents' friendship networks in this way is a promising avenue for achieving setting-level prevention benefits such as expanding the reach and durability of program effects.

METHODS

Beginning in 2002, the Promoting School-University Partnerships to Enhance Resilience (PROSPER) randomized control trial assigned two entire sixth-grade cohorts of 14 rural and small town school districts in Iowa and Pennsylvania to receive the intervention and of 14 to control. A family-based intervention was offered in sixth grade and a school-based intervention was provided in seventh grade. More than 11,000 respondents provided five waves of data on friendship networks, attitudes, and behavior in sixth through ninth grade. Antisocial influence potential was measured by the association between network centrality and problem behavior for each of 256 networks (time, grade cohort, and school specific).

RESULTS

The intervention had a beneficial impact on antisocial influence potential of adolescents' friendship networks, with p < .05 for both of the primary composite measures.

CONCLUSIONS

Current evidence-based preventive interventions can alter adolescents' friendship networks in ways that reduce the potential for peer influence toward antisocial behavior.

Opening the "Black Box": family check-up intervention effects on self-regulation that prevents growth in problem behavior and substance use

Family-school interventions are a well-established method for preventing and remediating behavior problems in at-risk youth, yet the mechanisms of change underlying their effectiveness are often overlooked or poorly understood. The Family Check-Up (FCU), a school-based, family-centered intervention, has been consistently associated with reductions in youth antisocial behavior, deviant peer group affiliation, and substance use. The purpose of this study was to explore proximal changes in student-level behavior that accounts for links between implementation of the FCU and changes in youth problem behavior. Data were drawn from a randomized controlled trial study of the efficacy of the FCU among 593 ethnically diverse middle school students followed longitudinally from 6th through 8th grades. Latent growth curve analyses revealed that random assignment to the FCU intervention condition was related to increased mean levels of students' self-regulation from 6th to 7th grades, which in turn reduced the risk for growth in antisocial behavior, involvement with deviant peers, and alcohol, tobacco, and marijuana use through the 8th grade. Overall, these findings highlight the robust implications of self-regulation as a proximal target for family-centered interventions.