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Hattangadi N, Kay T, Parkin PC, Birken CS, Maguire JL, Szatmari P, van den Heuvel M, Borkhoff CM, Charach A. Screening Accuracy of the Parent-Report Preschool Strengths and Difficulties Questionnaire in Primary Care. Acad Pediatr 2024; 24:800-809. [PMID: 37907129 DOI: 10.1016/j.acap.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To evaluate the screening test accuracy and reliability of the parent-report preschool Strengths and Difficulties Questionnaire (P-SDQ) in primary care settings. METHODS Children 24 to 48 months were recruited at scheduled primary care visits in Toronto, Canada. Parents completed the P-SDQ at baseline, 2, and 12 weeks. At 12 weeks, parents were invited to a semistructured diagnostic phone interview, the Preschool Age Psychiatric Assessment (PAPA). Criterion validity between baseline P-SDQ scores (Total Difficulties Score [TDS], internalizing and externalizing subscale) and Diagnostic and Statistical Manual, 5th edition diagnoses on PAPA was evaluated using area under the curve (AUC) and calculating screening test properties (sensitivity and specificity). Test-retest reliability at baseline and 2 weeks was evaluated using intraclass correlation coefficient. RESULTS A total of 183 children were enrolled, mean age 39.3 (SD 7.4) months, 46.4% male, 120 (66%) completed P-SDQ at 2 weeks, 107 (58%) completed PAPA at 12 weeks. Of those with a PAPA, 26 (24%) had any psychiatric diagnosis, 17 (16%) had internalizing disorders and 4 (4%) had externalizing disorders. TDS identified any diagnosis with AUC = 0.67 (95% confidence intervals (CI): 0.55, 0.79); internalizing subscale identified internalizing disorders with AUC = 0.61 (95% CI: 0.47, 0.74); externalizing subscale identified externalizing disorders with AUC = 0.77 (95% CI: 0.60, 0.94). Sensitivity and specificity, and test-retest reliability were satisfactory for TDS and externalizing subscale, and less satisfactory for the internalizing subscale. CONCLUSIONS The externalizing subscale has sufficient accuracy and reliability to identify children aged 2 to 4 years at risk for attention deficit/hyperactivity disorder and disruptive behavior disorders in primary care.
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Affiliation(s)
- Nayantara Hattangadi
- Department of Psychiatry (N Hattangadi, T Kay, P Szatmari, and A Charach), Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tatjana Kay
- Department of Psychiatry (N Hattangadi, T Kay, P Szatmari, and A Charach), Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychology, Toronto Metropolitan University, Canada
| | - Patricia C Parkin
- Pediatric Outcomes Research Team (PORT) (PC Parkin, CS Birken, Mv den Heuvel, and CM Borkhoff), Division of Pediatric Medicine and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation (PC Parkin, CS Birken, JL Maguire, CM Borkhoff, and A Charach), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics (PC Parkin, CS Birken, JL Maguire), Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Joannah & Brian Lawson Centre for Child Nutrition (PC Parkin, CS Birken, JL Maguire, and Mv den Heuvel), Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S Birken
- Pediatric Outcomes Research Team (PORT) (PC Parkin, CS Birken, Mv den Heuvel, and CM Borkhoff), Division of Pediatric Medicine and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation (PC Parkin, CS Birken, JL Maguire, CM Borkhoff, and A Charach), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics (PC Parkin, CS Birken, JL Maguire), Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Joannah & Brian Lawson Centre for Child Nutrition (PC Parkin, CS Birken, JL Maguire, and Mv den Heuvel), Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation (PC Parkin, CS Birken, JL Maguire, CM Borkhoff, and A Charach), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics (PC Parkin, CS Birken, JL Maguire), Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Joannah & Brian Lawson Centre for Child Nutrition (PC Parkin, CS Birken, JL Maguire, and Mv den Heuvel), Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; The Centre for Urban Health Solutions (JL Maguire), Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Pediatrics (JL Maguire), St. Michael's Hospital, Toronto, Ontario, Canada
| | - Peter Szatmari
- Department of Psychiatry (N Hattangadi, T Kay, P Szatmari, and A Charach), Hospital for Sick Children, Toronto, Ontario, Canada; Department of Psychiatry (P Szatmari and A Charach), Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (P Szatmari), Toronto, Ontario, Canada
| | - Meta van den Heuvel
- Pediatric Outcomes Research Team (PORT) (PC Parkin, CS Birken, Mv den Heuvel, and CM Borkhoff), Division of Pediatric Medicine and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics (PC Parkin, CS Birken, JL Maguire), Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Joannah & Brian Lawson Centre for Child Nutrition (PC Parkin, CS Birken, JL Maguire, and Mv den Heuvel), Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Pediatric Outcomes Research Team (PORT) (PC Parkin, CS Birken, Mv den Heuvel, and CM Borkhoff), Division of Pediatric Medicine and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation (PC Parkin, CS Birken, JL Maguire, CM Borkhoff, and A Charach), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute (CM Borkhoff), Women's College Hospital, Toronto, Ontario, Canada
| | - Alice Charach
- Department of Psychiatry (N Hattangadi, T Kay, P Szatmari, and A Charach), Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation (PC Parkin, CS Birken, JL Maguire, CM Borkhoff, and A Charach), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry (P Szatmari and A Charach), Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Laugen NJ, Midtli H, Löfkvist U, Stensen K. Psychometric properties of the Norwegian version of the Strength and Difficulties Questionnaire in a preschool sample. Nord J Psychiatry 2024:1-7. [PMID: 38739484 DOI: 10.1080/08039488.2024.2351046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE The Strength and Difficulties Questionnaire (SDQ) is widely used internationally, however less so in preschool populations and validations studies are thus needed. This study examined the psychometric properties of the Norwegian version parent report of the SDQ - preschool version (SDQ 2-4). MATERIALS AND METHODS Parents of 289 Norwegian children in the age span 1-6 years old filled out the SDQ 2-4, the Child Behavior Checklist (CBCL), and background information. Internal consistency, factor structure, and convergent validity were assessed. RESULTS The results showed satisfying internal consistency for the total difficulties score, but worse for some of the subscales. The five-factor structure showed a good fit. Good convergent and divergent validity was found in terms of correlations with CBCL. Sex differences were found on all scales, boys scoring higher on all problem scales. CONCLUSIONS The SDQ 2-4 can be a promising instrument to screen for emotional and behavioral difficulties among Norwegian preschoolers, particularly in high-risk populations.
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Affiliation(s)
- Nina Jakhelln Laugen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hege Midtli
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrika Löfkvist
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Kenneth Stensen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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Owais S, Ospina MB, Ford C, Hill T, Savoy CD, Van Lieshout R. Screen Time and Socioemotional and Behavioural Difficulties Among Indigenous Children in Canada: Temps d'écran et difficultés socio-émotionnelles et comportementales chez les enfants autochtones du Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:337-346. [PMID: 38151919 PMCID: PMC11032090 DOI: 10.1177/07067437231223333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To describe screen time levels and determine their association with socioemotional and behavioural difficulties among preschool-aged First Nations, Métis, and Inuit children. METHOD Data were taken from the Aboriginal Children's Survey, a nationally representative survey of 2-5-year-old Indigenous children in Canada. Socioemotional and behavioural difficulties were defined using parent/guardian reports on the Strengths and Difficulties Questionnaire. Multiple linear regression analyses were conducted separately for First Nations, Métis, and Inuit participants, and statistically adjusted for child age, child sex, and parent/guardian education. Statistical significance was set at P < 0.002 to adjust for multiple comparisons. RESULTS Of these 2-5-year-old children (mean [M] = 3.57 years) 3,085 were First Nations (53.5%), 2,430 Métis (39.2%), and 990 Inuit (7.3%). Screen time exposure was high among First Nations (M = 2 h and 58 min/day, standard deviation [SD] = 1.89), Métis (M = 2 h and 50 min [SD = 1.83]), and Inuit children (M = 3 h and 25 min [SD = 2.20]), with 79.7% exceeding recommended guidelines (>1 h/day). After adjusting for confounders, screen time was associated with more socioemotional and behavioural difficulties among First Nations (total difficulties β = 0.15 [95% CI, 0.12 to 0.19]) and Métis (β = 0.16 [95% CI, 0.12 to 0.20]) but not Inuit children (β = 0.12 [95% CI, 0.01 to 0.23]). CONCLUSIONS Screen time exposure is high among Indigenous children in Canada, and is associated with more socioemotional and behavioural difficulties among First Nations and Métis children. Contributing factors could include enduring colonialism that resulted in family dissolution, lack of positive parental role models, and disproportionate socioeconomic disadvantage. Predictors of poor well-being should continue to be identified to develop targets for intervention to optimize the health and development of Indigenous children.
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Affiliation(s)
| | - Maria B. Ospina
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Camron Ford
- Bachelor of Medical Sciences Program, Western University, London, Canada
| | - Troy Hill
- McMaster Alumni Association, McMaster University, Hamilton, Canada
| | - Calan D. Savoy
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Ryan Van Lieshout
- McMaster University, Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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Anns F, Waldie KE, Peterson ER, Walker C, Morton SMB, D'Souza S. Behavioural outcomes of children exposed to antidepressants and unmedicated depression during pregnancy. J Affect Disord 2023; 338:144-154. [PMID: 37295656 DOI: 10.1016/j.jad.2023.05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Antenatal exposure to both antidepressants and maternal depression has been associated with child behavioural difficulties. However, previous research has not adequately distinguished between the effects of the antidepressants and the underlying maternal depression. METHODS Child behavioural difficulties were assessed using the Strengths and Difficulties Questionnaire at 2-, 4.5-, and 8-years of age by mothers in the Growing Up in New Zealand study (N = 6233 at 2-years; N = 6066 at 4.5-years; N = 4632 at 8-years). Mothers were classified as either on antidepressants, unmedicated depression, or neither based on self-reported antidepressant intake during pregnancy and the Edinburgh Postnatal Depression Scale. Hierarchical multiple logistic regressions were used to examine whether antenatal exposure to antidepressants and unmedicated depression had a differential association with child behavioural outcomes relative to no exposure. RESULTS When later life depression in the mother and a range of birth and sociodemographic variables were accounted for, neither antenatal exposure to unmedicated depression or antidepressants remained associated with an increased risk of behavioural difficulties at the ages investigated. However, maternal later life depression was associated with behavioural difficulties in the fully adjusted analyses at all three ages investigated. LIMITATIONS The current study relied on mother-report of child behaviour which may be susceptible to bias due to maternal mental health problems. CONCLUSIONS Adjusted results did not show an adverse association between antenatal antidepressant exposure or unmedicated depression in relation to child behaviour. Findings also suggest that efforts to improve child behaviour need to include more family-based approaches that support maternal wellbeing.
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Affiliation(s)
- Francesca Anns
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Caroline Walker
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand; INSIGHT, University of Technology Sydney, Sydney, Australia
| | - Stephanie D'Souza
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand; School of Social Sciences, The University of Auckland, Auckland, New Zealand.
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Slykerman RF, Neumann D, Underwood L, Hobbs M, Waldie KE. Age at first exposure to antibiotics and neurodevelopmental outcomes in childhood. Psychopharmacology (Berl) 2023; 240:1143-1150. [PMID: 36930273 PMCID: PMC10101895 DOI: 10.1007/s00213-023-06351-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
RATIONALE Viral illnesses in children are common and are frequently treated with antibiotic medication. Antibiotics reduce the diversity and composition of the gut microbiota, leading to poor developmental outcomes. OBJECTIVES To investigate the relationship between age at first exposure to antibiotics and cognitive and behavioural development at 4.5 years while controlling for multiple confounders, including otitis media. METHODS Study participants were 5589 children enrolled in the broadly generalisable Growing Up in New Zealand cohort study, with antibiotic exposure data, maternal antenatal information, and age 4.5-year behaviour and cognitive outcome data. Children were categorised as first exposed to antibiotics according to the following mutually exclusive ages: 0-2 months; 3-5 months; 6-8 months; 9-11 months; 12-54 months or not exposed by 54 months. Developmental outcome measures included the Strengths and Difficulties Questionnaire, Luria hand clap task, and the Peabody Picture Vocabulary Test-III. RESULTS In univariate analysis, there was an evident dose-response relationship where earlier exposure to antibiotics in the first year of life was associated with behavioural difficulties, lower executive function scores, and lower receptive language ability. After adjusting for confounders, pairwise comparisons showed that first antibiotic exposure between birth and 3 months or between 6 and 9 months was associated with lower receptive vocabulary. Antibiotic exposure at any age prior to 12 months was associated with increases in behavioural difficulties scores at 4.5 years. CONCLUSIONS Following adjustment for socioeconomic factors and otitis media, there is evidence that antibiotic exposure during potentially sensitive windows of development is associated with receptive language and behaviour later in childhood.
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Affiliation(s)
- Rebecca F Slykerman
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Denise Neumann
- School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Growing UP in New Zealand, Centre for Longitudinal Research, University of Auckland, Auckland, New Zealand
| | - Mark Hobbs
- Growing UP in New Zealand, Centre for Longitudinal Research, University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand
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Al-Hendawi M. Validation of the Arabic Version of Strengths and Difficulties Questionnaire in Early Childhood Education in Qatar. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010146. [PMID: 36670696 PMCID: PMC9856877 DOI: 10.3390/children10010146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
This study examined the validity of the Arabic version of the Strengths and Difficulties Questionnaire (SQD, teacher version) among a sample of young children in Qatar. Teachers rated 502 children aged four to five years from public preschools using the SDQ teacher version. The factor structure of the SDQ was analyzed using exploratory and confirmatory factor analyses. I calculated Cronbach's alpha coefficient and item-total correlations to determine the reliability of the five subscales and overall SDQ. The findings showed acceptable reliability, with the exception of the Peer Problems Scale. Common fit statistics-including the comparative fit index, non-normed fit index, and goodness-of-fit index-were used for the confirmatory factor analysis. In general, satisfactory psychometric characteristics were observed for the preschool SDQ, suggesting that the questionnaire could be administered to preschool-age children in Qatar.
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Affiliation(s)
- Maha Al-Hendawi
- Department of Psychological Science, College of Education, Qatar University, Doha P.O. Box 2713, Qatar
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Neumann D, Peterson ER, Underwood L, Morton SMB, Waldie KE. The Association Between Persistence and Change in Behavioral Difficulties During Early to Middle Childhood and Cognitive Abilities at Age 8. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01453-1. [PMID: 36372805 DOI: 10.1007/s10578-022-01453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 07/25/2022] [Accepted: 09/26/2022] [Indexed: 11/15/2022]
Abstract
We investigated the association between persistence and change in behavioral difficulties during early to middle childhood and several cognitive outcomes. We observed 3904 8-year-olds enrolled in the longitudinal study Growing Up in New Zealand (50% male/female; 23% Māori, 9% Pacific Peoples, 13% Asian, 2% Middle Eastern/Latin American/African, 9% Other, 43% European). The NIH Toolbox Cognition Battery was used to assess cognitive functioning at 8 years and the Strengths and Difficulties Questionnaire for behavioral difficulties at 4.5 and 8 years. Multivariate logistic regression analyses were conducted, controlling for well-known sociodemographic confounders. Children with persistent or later onset of behavioral difficulties were at higher risk for poorer vocabulary, reading, inhibitory control/attention, episodic memory, working memory and processing speed at age 8 compared to children with no or improved difficulties. Our study supports the importance of addressing both cognitive and behavioral aspects when planning educational programmes and interventions in early and middle childhood.
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Affiliation(s)
- Denise Neumann
- School of Psychology, Faculty of Science, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand.
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.
- School of Population Health, The University of Auckland, Auckland, New Zealand.
| | - Elizabeth R Peterson
- School of Psychology, Faculty of Science, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, Faculty of Science, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
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The Infant Health Study - Promoting mental health and healthy weight through sensitive parenting to infants with cognitive, emotional, and regulatory vulnerabilities: protocol for a stepped-wedge cluster-randomized trial and a process evaluation within municipality settings. BMC Public Health 2022; 22:194. [PMID: 35090411 PMCID: PMC8796192 DOI: 10.1186/s12889-022-12551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Child mental health problems are a major public health concern associated with poor mental and physical health later in development. The study evaluates a new community-based intervention to promote sensitive parenting and reduce enduring mental health problems and unhealthy weight among vulnerable infants aged 9-24 months. Methods We use a step-wedge cluster randomized controlled trial design conducted within a home visiting program offered by community health nurses to infant families in Denmark. Sixteen municipalities are randomly allocated to implement the intervention starting at three successive time points from May 1, 2022 to January 1, 2023. A total of 900-1000 families will be included. A standardized program, Psykisk Udvikling og Funktion (PUF), is used to identify infants with major problems of eating, sleep, emotional or behavioral regulation or developmental problems. The intervention builds on the Video-Feedback Intervention to Promote Positive Parenting (VIPP) program, adapted to the PUF-context and named the VIPP-PUF. Children will be followed up at ages 18 and 24 months. Primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at child age 24 months. The other outcome measures include body mass index z-scores, the Ages and Stages Questionnaire Social-Emotional (ASQ:SE2); the Child Behavior Checklist (CBCL 1½ -5); Eating behavior Questionnaires; the Being a Mother-questionnaire (BaM13); the Parental Stress Scale (PSS); and the WHO-5 well-being index (WHO-5). Data on child and family factors are obtained from National registries and the Child Health Database. Quantitative measures are applied to examine the effectiveness of the VIPP-PUF intervention and the implementation process. Qualitative measures include interviews with CHNs, parents and municipality stakeholders to explore factors that may influence the adherence and effectiveness of the intervention. Discussion The study examines a service-setting based intervention building on the promotion of sensitive parenting to vulnerable infants. We use a mixed methods approach to evaluate the intervention, taking into account the influences of COVID-19 pandemic running since March 2020. Overall, the study has potential to add to the knowledge on the possibilities of prevention within the municipality child health care to reduce the risk of mental health problems and unhealthy weight in early childhood. Trial registration www.ClinicalTrials.gov; IDNCT04601779; Protocol ID 95-110-21307. Registered 25 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12551-z.
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Saleem S, Burns S, Falenchuk O, Varmuza P, Perlman M. Heterogeneity in maternal and child mental health responses to the COVID-19 pandemic. EARLY CHILDHOOD RESEARCH QUARTERLY 2021; 59:203-214. [PMID: 34955597 PMCID: PMC8685196 DOI: 10.1016/j.ecresq.2021.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/23/2021] [Accepted: 12/15/2021] [Indexed: 05/10/2023]
Abstract
We used latent profile analysis on a longitudinal dataset to examine changes in maternal and child mental health during COVID-19 and factors that may protect against declines in mental health. Participants were 183 low-income mothers (M = 36 years) with young children (M = 5.31 years) in the City of Toronto with data collected prior to and during the pandemic in 2020. Mothers reported on their own stress, anxiety and depression and their children's emotional, conduct, hyperactivity, peer, and prosocial problems at both timepoints. We found heterogeneity in mental health changes, with 5 distinct patterns of change for mothers, and 4 distinct patterns of change for children during COVID-19. The majority (83%) of mothers experienced significant declines in at least one aspect of mental health. In contrast, the majority of children (65%) experienced either no change or improvements in mental health. Interestingly, patterns of change across these groups were not differentiated by demographic characteristics such as income, education, and family composition. However, for mothers, a higher degree of satisfaction with social support was associated with membership in a profile with better mental health both prior to, and during the pandemic. For children, having a stable history of early childhood education, and care was associated with membership in a profile that showed improvements in mental health during the pandemic. We discuss how our results support the need for proactive and global interventions for at-risk families with raised mental health concerns, and the benefits that stable early childhood education and care may provide for young children.
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Affiliation(s)
- Sumayya Saleem
- Ontario Institute for Studies in Education - University of Toronto, 252 Bloor Street West, Toronto M5S 1V6, Canada
| | - Samantha Burns
- Ontario Institute for Studies in Education - University of Toronto, 252 Bloor Street West, Toronto M5S 1V6, Canada
| | - Olesya Falenchuk
- Ontario Institute for Studies in Education - University of Toronto, 252 Bloor Street West, Toronto M5S 1V6, Canada
| | - Petr Varmuza
- Ontario Institute for Studies in Education - University of Toronto, 252 Bloor Street West, Toronto M5S 1V6, Canada
| | - Michal Perlman
- Ontario Institute for Studies in Education - University of Toronto, 252 Bloor Street West, Toronto M5S 1V6, Canada
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Costa D, Biddle L, Bozorgmehr K. Association between psychosocial functioning, health status and healthcare access of asylum seekers and refugee children: a population-based cross-sectional study in a German federal state. Child Adolesc Psychiatry Ment Health 2021; 15:59. [PMID: 34641919 PMCID: PMC8513294 DOI: 10.1186/s13034-021-00411-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The mental health condition and healthcare needs of asylum seeking and refugee (ASR) children may go unrecognized if barriers to healthcare access exist accompanied by exclusive focus on somatic illness. We analysed the relationship between psychosocial functioning, health status and healthcare access of ASR children. METHODS During 2018, 560 ASR adults in 58 collective accommodations in Germany's 3rd largest federal state were randomly sampled and assessed. The parent-reported Strengths and Difficulties Questionnaire (SDQ) was used to assess child psychosocial functioning. SDQ dimensions (Emotional, Conduct, Peer, Hyperactivity, Prosocial, Total) were compared by demographics (sex, age, region of origin, time since arrival, subjective social status), health status (long-lasting illness, physical limitation, pain) and healthcare access (utilization: paediatrician, specialist, dentist, psychologist, hospital/emergency department, prescribed medicines; and unmet needs: for paediatrician/specialist, reduced spending to cover healthcare cost). Age and sex-adjusted odds ratios (AOR, 95%CI-Confidence Intervals) for scoring in borderline/abnormal ranges in SDQ dimensions were estimated through logistic regression depending on children' health status and healthcare access. RESULTS We analysed parents' answers pertaining to 90 children aged 1-17 years old, 57% of which were girls and 58% with (Eastern or Western) Asian nationality. Scoring in the borderline/abnormal range of the SDQ Total Difficulties score was associated with feeling bodily pain (compared to no pain, AOR, 95%CI = 3.14, 1.21-8.10) and with an unmet need for a specialist during the previous year (4.57, 1.09-19.16). Borderline/abnormal SDQ Emotional scores were positively associated with a long-lasting illness (5.25, 1.57-17.55), physical limitation (4.28, 1.49-12.27) and bodily pain (3.00, 1.10-8.22), and negatively associated with visiting a paediatrician (0.23, 0.07-0.78), specialist (0.16, 0.04-0.69), and the emergency department (0.27, 0.08-0.96). CONCLUSION Poor psychosocial functioning among ASR children is associated with somatic problems, unmet medical needs, and lower healthcare utilisation. Somatic clinical encounters with ASR should include children' mental health symptomatology assessment, especially in those with worst physical health conditions.
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Affiliation(s)
- Diogo Costa
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.o. Box 10 01 31, 33501, Bielefeld, Germany.
| | - Louise Biddle
- Section of Health Equity Studies & Migration, Dept. of General Practice & Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Kayvan Bozorgmehr
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, P.o. Box 10 01 31, 33501, Bielefeld, Germany
- Section of Health Equity Studies & Migration, Dept. of General Practice & Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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11
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Patel J, Smith R, O'Farrelly C, Iles J, Rosan C, Ryan R, Ramchandani P. Assessing behavior in children aged 12-24 months using the Strengths and Difficulties Questionnaire. INFANCY 2021; 26:724-734. [PMID: 34288359 DOI: 10.1111/infa.12425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 05/12/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
Behavioral and emotional problems in infants and toddlers are common, often persist and put children at risk of later mental health problems. Reliable, efficient, and sensitive tools are needed to identify young children who may benefit from further assessment and support. The Strengths and Difficulties Questionnaire (SDQ), offers a brief, convenient means of screening for early problems, however, it lacks psychometric validation in infants. The aim of this study was to assess the validity and reliability of the SDQ in children aged 12-24 months. Ninety-three participants, with children aged 12-24 months, completed the SDQ and Child Behavior Checklist (CBCL) online. Concurrent validity of the SDQ was assessed through comparison with the CBCL. The results demonstrated that key subscales of the SDQ and CBCL were significantly correlated (r range= -.19 to -.57). Key SDQ subscales showed moderate reliability (Cronbach's alpha range = .38-.79, mean inter-item correlation range = .06-.43). The SDQ shows promising reliability and validity as a measure for rating the behavior of 12-24-months-old children, particularly for externalizing symptoms. Further research is needed to assess its predictive utility.
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Affiliation(s)
- Jinal Patel
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ria Smith
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Jane Iles
- Centre for Psychiatry, Imperial College London, London, United Kingdom
| | - Camilla Rosan
- Centre for Psychiatry, Imperial College London, London, United Kingdom
| | - Rachael Ryan
- Centre for Psychiatry, Imperial College London, London, United Kingdom
| | - Paul Ramchandani
- Centre for Psychiatry, Imperial College London, London, United Kingdom
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12
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Wallander JL, Berry S, Carr PA, Peterson ER, Waldie KE, Marks E, D'Souza S, Morton SMB. Patterns of risk exposure in first 1,000 days of life and health, behavior, and education-related problems at age 4.5: evidence from Growing Up in New Zealand, a longitudinal cohort study. BMC Pediatr 2021; 21:285. [PMID: 34140013 PMCID: PMC8212450 DOI: 10.1186/s12887-021-02652-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/08/2021] [Indexed: 01/01/2023] Open
Abstract
Background Children who are high priority candidates for early intervention need to be identified to reduce their risk for experiencing problems in development. Those exposed to multiple risk factors are more likely to exhibit problems in development than those exposed to a single or no risk factor. We examined the longitudinal associations between persistence and timing of exposure to cumulative risk (CR) on three occasions by age 2 and problems in development at age 4.5 in health, behavior, and education-related domains. Methods Data are from Growing Up in New Zealand (NZ), a prospective longitudinal study of a birth cohort first assessed during their last trimester in 2009–10 and followed at ages 9 months and 2 and 4.5 years. All women with an expected delivery date in a 12-month period who resided within a defined region were invited to participate, with no additional eligibility criteria. Exposure was measured for 12 sociodemographic and maternal health risk factors at third trimester and ages 9 months and 2 years, from which developmental trajectories were constructed capturing persistence and timing of CR exposure. Ten developmental outcomes were measured at age 4.5 to classify problems in overall health status, obesity, and injuries; internalizing and externalizing behavior problems; and letter naming, counting forward and backward, and expectations for starting school and completing education. Results Analyses of data from 6156 children (49% female, 33% Non-European ethnicity) who participated in the 4.5-age assessment uniformly showed associations between exposure to more than consistently zero CR across early development and higher prevalence of being classified with problems for 9 of 10 outcomes. Persistent exposure to a CR ≥ 4 was generally associated with a higher prevalence of problems for 7 of 10 outcomes, whereas the timing of first exposure to CR ≥ 4 showed a less consistent association with problem outcomes. Conclusions These findings are concerning because over 50% of NZ children are exposed to at least one of these risk factors at some point in early development. Routine screening of most of these risk factors during pregnancy is feasible and can identify priority candidates for intervention.
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Affiliation(s)
- Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California, 5400 North Lake Rd., Merced, CA, 95343, USA.
| | | | - Polly Atatoa Carr
- National Institute of Demographic and Economic Analysis, University of Waikato, Hamilton, New Zealand
| | - Elizabeth R Peterson
- Faculty of Science, School of Psychology, University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- Faculty of Science, School of Psychology, University of Auckland, Auckland, New Zealand
| | - Emma Marks
- School of Population Health and Centre for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Stephanie D'Souza
- COMPASS Research Centre, Faculty of Arts, University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- School of Population Health and Centre for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand
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13
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O'Farrelly C, Barker B, Watt H, Babalis D, Bakermans-Kranenburg M, Byford S, Ganguli P, Grimås E, Iles J, Mattock H, McGinley J, Phillips C, Ryan R, Scott S, Smith J, Stein A, Stevens E, van IJzendoorn M, Warwick J, Ramchandani P. A video-feedback parenting intervention to prevent enduring behaviour problems in at-risk children aged 12-36 months: the Healthy Start, Happy Start RCT. Health Technol Assess 2021; 25:1-84. [PMID: 34018919 PMCID: PMC8182442 DOI: 10.3310/hta25290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Behaviour problems emerge early in childhood and place children at risk for later psychopathology. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of a parenting intervention to prevent enduring behaviour problems in young children. DESIGN A pragmatic, assessor-blinded, multisite, two-arm, parallel-group randomised controlled trial. SETTING Health visiting services in six NHS trusts in England. PARTICIPANTS A total of 300 at-risk children aged 12-36 months and their parents/caregivers. INTERVENTIONS Families were allocated in a 1 : 1 ratio to six sessions of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) plus usual care or usual care alone. MAIN OUTCOME MEASURES The primary outcome was the Preschool Parental Account of Children's Symptoms, which is a structured interview of behaviour symptoms. Secondary outcomes included caregiver-reported total problems on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The intervention effect was estimated using linear regression. Health and social care service use was recorded using the Child and Adolescent Service Use Schedule and cost-effectiveness was explored using the Preschool Parental Account of Children's Symptoms. RESULTS In total, 300 families were randomised: 151 to VIPP-SD plus usual care and 149 to usual care alone. Follow-up data were available for 286 (VIPP-SD, n = 140; usual care, n = 146) participants and 282 (VIPP-SD, n = 140; usual care, n = 142) participants at 5 and 24 months, respectively. At the post-treatment (primary outcome) follow-up, a group difference of 2.03 on Preschool Parental Account of Children's Symptoms (95% confidence interval 0.06 to 4.01; p = 0.04) indicated a positive treatment effect on behaviour problems (Cohen's d = 0.20, 95% confidence interval 0.01 to 0.40). The effect was strongest for children's conduct [1.61, 95% confidence interval 0.44 to 2.78; p = 0.007 (d = 0.30, 95% confidence interval 0.08 to 0.51)] versus attention deficit hyperactivity disorder symptoms [0.29, 95% confidence interval -1.06 to 1.65; p = 0.67 (d = 0.05, 95% confidence interval -0.17 to 0.27)]. The Child Behaviour Checklist [3.24, 95% confidence interval -0.06 to 6.54; p = 0.05 (d = 0.15, 95% confidence interval 0.00 to 0.31)] and the Strengths and Difficulties Questionnaire [0.93, 95% confidence interval -0.03 to 1.9; p = 0.06 (d = 0.18, 95% confidence interval -0.01 to 0.36)] demonstrated similar positive treatment effects to those found for the Preschool Parental Account of Children's Symptoms. At 24 months, the group difference on the Preschool Parental Account of Children's Symptoms was 1.73 [95% confidence interval -0.24 to 3.71; p = 0.08 (d = 0.17, 95% confidence interval -0.02 to 0.37)]; the effect remained strongest for conduct [1.07, 95% confidence interval -0.06 to 2.20; p = 0.06 (d = 0.20, 95% confidence interval -0.01 to 0.42)] versus attention deficit hyperactivity disorder symptoms [0.62, 95% confidence interval -0.60 to 1.84; p = 0.32 (d = 0.10, 95% confidence interval -0.10 to 0.30)], with little evidence of an effect on the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. The primary economic analysis showed better outcomes in the VIPP-SD group at 24 months, but also higher costs than the usual-care group (adjusted mean difference £1450, 95% confidence interval £619 to £2281). No treatment- or trial-related adverse events were reported. The probability of VIPP-SD being cost-effective compared with usual care at the 24-month follow-up increased as willingness to pay for improvements on the Preschool Parental Account of Children's Symptoms increased, with VIPP-SD having the higher probability of being cost-effective at willingness-to-pay values above £800 per 1-point improvement on the Preschool Parental Account of Children's Symptoms. LIMITATIONS The proportion of participants with graduate-level qualifications was higher than among the general public. CONCLUSIONS VIPP-SD is effective in reducing behaviour problems in young children when delivered by health visiting teams. Most of the effect of VIPP-SD appears to be retained over 24 months. However, we can be less certain about its value for money. TRIAL REGISTRATION Current Controlled Trials ISRCTN58327365. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 29. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Christine O'Farrelly
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
| | - Beth Barker
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
| | - Hilary Watt
- School of Public Health, Imperial College London, London, UK
| | - Daphne Babalis
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Marian Bakermans-Kranenburg
- Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sarah Byford
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Poushali Ganguli
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Ellen Grimås
- Division of Psychiatry, Imperial College London, London, UK
| | - Jane Iles
- Division of Psychiatry, Imperial College London, London, UK
- School of Psychology, University of Surrey, Guildford, UK
| | - Holly Mattock
- Division of Psychiatry, Imperial College London, London, UK
| | | | | | - Rachael Ryan
- Division of Psychiatry, Imperial College London, London, UK
| | - Stephen Scott
- Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Jessica Smith
- Division of Psychiatry, Imperial College London, London, UK
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Eloise Stevens
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
| | - Marinus van IJzendoorn
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jane Warwick
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Paul Ramchandani
- Division of Psychiatry, Imperial College London, London, UK
- Centre for Research on Play in Education, Development, and Learning, Faculty of Education, University of Cambridge, Cambridge, UK
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14
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Thompson JMD, Slykerman RF, Wall CR, Murphy R, Mitchell EA, Waldie KE. Factor structure of the SDQ and longitudinal associations from pre-school to pre-teen in New Zealand. PLoS One 2021; 16:e0247932. [PMID: 33705464 PMCID: PMC7951836 DOI: 10.1371/journal.pone.0247932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/16/2021] [Indexed: 11/20/2022] Open
Abstract
Objective The objective of this study was to assess the validity of the Strengths and Difficulties Questionnaire in a cohort of New Zealand children followed from birth to the age of eleven. The study also aimed to assess the stability of the child data in relation to behavioural outcomes during this period. Methods Children in the Auckland Birthweight Collaborative Study were assessed at approximately 3½, 7 and 11 years of age. At all time-points parents completed the parent version of the Strengths and Difficulties Questionnaire, and the children themselves completed the self-report version at 11 years of age. The validity and internal consistency were assessed using exploratory factor analysis, Cronbach’s alpha, and McDonald’s Omega. Cross tabulations and Chi-square statistics were used to determine whether Total Difficulty scores, as per accepted cut-offs, remained stable over time (between normal and abnormal/borderline categories). Results The factor structure remained relatively consistent across all three time-points, though several questions did not load as per the originally published factor analysis at the earliest age. The internal consistency of the Strengths and Difficulties Questionnaire was good at all time-points and for parent- and child-completed versions. There was low agreement in the total scores between time points. Conclusions The factor analysis shows that the Strengths and Difficulties Questionnaire has a similar factor structure, particularly in older ages, to that previously published and shows good internal consistency. At the pre-school follow up, a larger than expected proportion of children were identified with high scores, particularly in the conduct sub-scale. Children’s behaviour changes over time, with only poor to moderate agreement between those identified as abnormal or borderline over the longitudinal follow up.
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Affiliation(s)
- John M. D. Thompson
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Rebecca F. Slykerman
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Clare R. Wall
- Discipline of Nutrition, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Rinki Murphy
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Edwin A. Mitchell
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Karen E. Waldie
- School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand
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15
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Corkin MT, Peterson ER, Henderson AM, Waldie KE, Reese E, Morton SM. Preschool screen media exposure, executive functions and symptoms of inattention/hyperactivity. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2021. [DOI: 10.1016/j.appdev.2020.101237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Gustafsson BM, Gustafsson PA, Granlund M, Proczkowska M, Almqvist L. Longitudinal pathways of engagement, social interaction skills, hyperactivity and conduct problems in preschool children. Scand J Psychol 2020; 62:170-184. [PMID: 33314170 PMCID: PMC8048902 DOI: 10.1111/sjop.12700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/26/2020] [Indexed: 11/26/2022]
Abstract
Preschool children's engagement/social interaction skills can be seen as aspects of positive functioning, and also act as protective aspects of functioning. On the other hand, hyperactivity/conduct problems are risk aspects that negatively affect children's everyday functioning. Few studies have investigated such orchestrated effects on mental health in young children over time. The aims of the study are first, to identify homogeneous groups of children having similar pathways in mental health between three time points. Second, to examine how children move between time points in relation to risk and protective factors. Alongitudinal study over 3 years, including 197 Swedish preschool children was used. Questionnaire data collected from preschool teachers. Statistical analysis using person-oriented methods with repeated cluster analyses. Children high in engagement/social skills and low in conduct problems continue to function well. Children with low engagement/social skills exhibiting both hyperactivity and conduct problems continue to have problems. Children with mixed patterns of protective factors and risk factors showed mixed outcomes. The stability of children's pathways was quite high if they exhibited many positive protective factors but also if they exhibited many risk factors. Children exhibiting a mixed pattern of protective and risk factors moved between clusters in a less predictable way. That stability in mental health was related to the simultaneous occurrence of either many protective factors or many risk factors supports the notion of orchestrated effects. The results indicate that early interventions need to have a dual focus, including both interventions aimed at enhancing child engagement and interventions focused on decreasing behavior problems.
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Affiliation(s)
- Berit M Gustafsson
- Center for Social and Affective Neuroscience Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Division of Psychiatrics & Rehabilitation/Region Jönköping, Psychiatric Clinic, Högland Hospital, Jonkoping, Sweden.,CHILD research environment, SIDR, Jönköping University, Jonkoping, Sweden
| | - Per A Gustafsson
- Center for Social and Affective Neuroscience Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Department of Child and Adolescent Psychiatry, Linköping University, Linköping, Sweden
| | - Mats Granlund
- CHILD research environment, SIDR, Jönköping University, Jonkoping, Sweden.,Dept. Of Special Education, Oslo University, Norway
| | - Marie Proczkowska
- Center for Social and Affective Neuroscience Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Lena Almqvist
- CHILD research environment, SIDR, Jönköping University, Jonkoping, Sweden.,School of Health, Care, and Social Welfare, Mälardalen University, Västerås, Sweden
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17
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Hattangadi N, Cost KT, Birken CS, Borkhoff CM, Maguire JL, Szatmari P, Charach A. Parenting stress during infancy is a risk factor for mental health problems in 3-year-old children. BMC Public Health 2020; 20:1726. [PMID: 33198683 PMCID: PMC7670792 DOI: 10.1186/s12889-020-09861-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although research on the relationship between parent and child mental health is growing, the impact of early parenting stress on preschool-aged children's mental health remains unclear. The objective was to evaluate the association between parenting stress during infancy and mental health problems in 3-year-old children. METHODS A prospective cohort study of healthy preschool-aged children recruited from 9 primary care practices in Toronto, Canada was conducted through the TARGet Kids! primary care practice-based research network. Parenting stress was measured when children were between 0 to 16 months of age, using the Parent Stress Index Short Form, PSI-SF. Parent-reported child mental health problems were measured at 36 to 47 months using the preschool Strengths and Difficulties Questionnaire, total difficulties score (TDS). Hierarchical linear regression analysis was used to investigate the association between standardized PSI-SF and TDS, adjusted for child age, sex, temperament, sleep duration and household income. To strengthen clinical interpretation, analysis was repeated using adjusted multivariable logistic regression (TDS dichotomized at top 20%). RESULTS A total of 148 children (mean ± SD age, 37.2 ± 1.7 months, 49% male) were included in the analysis. Parenting stress during infancy (11.4 ± 3.1 months of age) was significantly associated with mental health problems in 3-year-old children (β = 0.35; 95% CI = 0.20-0.49, p < 0.001). Higher parenting stress was also associated with increased odds of higher TDS (OR = 2.26, 95% CI = 1.69-2.83, p < 0.01). CONCLUSION Healthy preschool-aged children with parents reporting parenting stress during infancy had a 2 times higher odds of mental health problems at 3 years.
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Affiliation(s)
| | - Katherine T Cost
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Catherine S Birken
- Division of Pediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Cornelia M Borkhoff
- Division of Pediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Jonathon L Maguire
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
- The Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Alice Charach
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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18
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Wallander JL, Berry S, Carr PA, Peterson ER, Waldie KE, Marks E, D'Souza S, Morton SMB. Patterns of Exposure to Cumulative Risk Through Age 2 and Associations with Problem Behaviors at Age 4.5: Evidence from Growing Up in New Zealand. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1277-1288. [PMID: 30790213 DOI: 10.1007/s10802-019-00521-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Exposure to cumulative risk (CR) has important implications for child development, yet little is known about how frequency, persistence, and timing of CR exposure during early childhood predict behavioral problems already before school start. We examine prospective longitudinal associations between patterns of CR exposure from third trimester through 2 years and subsequent behavior problems at 4.5 years. In 6156 diverse children in the Growing Up in New Zealand longitudinal study, the presence of 12 risk factors, spanning maternal health, social status, and home and neighborhood environment, defined CR and were assessed at last trimester and 9 months and 2 years of age. At child age 4.5 years, mothers completed the Strengths and Difficulties Questionnaire, where a score ≥ 16 indicated an abnormal level of problem behaviors (ALPB). Children exposed to a CR ≥ 1 at least once in early development, compared to those with consistent CR = 0, showed a significantly higher likelihood of ALPB at 4.5 years. Consistent high exposure to CR ≥ 4 across all three assessments had the highest prevalence (44%) of ALPB at age 4.5. Children with high CR exposure on two of three, compared to on all three, time points in early development did not evidence a significantly reduced prevalence (32%-41%) of ALPB. The common co-occurrence of risk factors and their significant developmental impact when accumulated early in life underscore the need for systematic multisector intervention and policy implementation during pregnancy and shortly after birth to improve outcomes for vulnerable children.
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Affiliation(s)
- Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced, 5400 North Lake Rd., Merced, CA, 95343, USA.
| | - Sarah Berry
- School of Population Health and Center for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Polly Atatoa Carr
- School of Population Health and Center for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Emma Marks
- School of Population Health and Center for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand
| | - Stephanie D'Souza
- School of Psychology, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- School of Population Health and Center for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand
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19
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Sjölander I, Borgström A, Larsson J, Smedje H, Friberg D. Randomised trial showed no difference in behavioural symptoms between surgical methods treating paediatric obstructive sleep apnoea. Acta Paediatr 2020; 109:2099-2104. [PMID: 32017246 DOI: 10.1111/apa.15210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/14/2020] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
AIM Our previous randomised controlled trial of children with obstructive sleep apnoea (OSA) showed no significant differences between adenotonsillectomy (ATE) and adenotonsillotomy (ATT) in improving nocturnal respiration and quality of life after 1 year. The aim of this report was to evaluate the effects on behavioural symptoms using the Strengths and Difficulties Questionnaire (SDQ). METHODS Children between 2 and 6 years with OSA were randomised to ATT or ATE. Parents, blinded to method, answered the SDQ while their child underwent polysomnography before and 1 year after surgery. Differences between the total SDQ scores were analysed between the treatment groups. RESULTS The SDQ was filled out in 87% of the cases preoperatively, and in 86% postoperatively. At follow-up, the mean total SDQ score was 9.6 SD ± 5.1 in the ATE group (n = 31), and 8.2 ± 6.7 in the ATT group (n = 37), P = .09. The mean total SDQ score for all was preoperatively 10.6 ± 5.0, and postoperatively 8.8 ± 6.0, P = .0002. CONCLUSION There were no significant differences in SDQ scores between the groups at follow-up, indicating that the more conservative ATT is a treatment option in paediatric OSA. The whole group of patients showed a significant improvement after surgery.
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Affiliation(s)
- Isabella Sjölander
- Department of Surgical Sciences, Otorhinolaryngology‐Head and Neck Surgery Uppsala University Uppsala Sweden
| | - Anna Borgström
- Department of Clinical Science, Intervention and Technology CLINTEC Karolinska Institutet Stockholm Sweden
| | - Jan‐Olov Larsson
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Hans Smedje
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Danielle Friberg
- Department of Surgical Sciences, Otorhinolaryngology‐Head and Neck Surgery Uppsala University Uppsala Sweden
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D'Souza S, Underwood L, Peterson ER, Morton SMB, Waldie KE. The Association Between Persistence and Change in Early Childhood Behavioural Problems and Preschool Cognitive Outcomes. Child Psychiatry Hum Dev 2020; 51:416-426. [PMID: 31907733 DOI: 10.1007/s10578-019-00953-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The link between behavioural and cognitive difficulties is well established. However, research is limited on whether persistence and change in behavioural difficulties relates to cognitive outcomes, particularly during preschool. We used a large New Zealand birth cohort to investigate how persistence and change in serious behavioural problems from ages 2 to 4.5 years related to measures of cognitive delay at 4.5 years (n = 5885). Using the Strengths and Difficulties total problems score at each time point, children were categorised as showing no difficulties, improved behaviour, concurrent difficulties, and persistent difficulties. Cognitive measures assessed included receptive language, early literacy ability, and executive control. Our results showed that children with concurrent and persistent behavioural difficulties were at a greater risk of showing delays within specific cognitive domains relative to children with no difficulties and were also more likely to show comorbid delays across multiple cognitive domains.
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Affiliation(s)
- Stephanie D'Souza
- School of Psychology, The University of Auckland, Auckland, New Zealand. .,Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand. .,COMPASS Research Centre, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand.,Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, The University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand.,School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research - He Ara Ki Mua, The University of Auckland, Auckland, New Zealand
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21
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Cormier E, Park H, Schluck G. eMental Health Literacy and Knowledge of Common Child Mental Health Disorders among Parents of Preschoolers. Issues Ment Health Nurs 2020; 41:540-551. [PMID: 32400237 DOI: 10.1080/01612840.2020.1719247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The purpose of the study was to assess the eMental health literacy of parents of preschool children and explore the relationships between their eMental health literacy skills and their knowledge of common child mental health disorders and their child difficulties. Online survey data were collected using Mechanical Turk (MTurk). Parents of preschool children completed questionnaires related to internet-based mental health information seeking behavior, knowledge of common child mental health disorders using case vignettes, and child difficulties. Data were analyzed using descriptive statistical methods. eMental health literacy of parents was high but knowledge of the child mental health disorders was low. Only 14% of parents correctly identified all three disorders; 41.1% identified attention deficit hyperactivity disorder (ADHD), 64.9% recognized autism spectrum disorder (ASD), and 19.1% identified separation anxiety disorder (SAD). Parents with high eMental health literacy (≥30) were more likely to endorse professional help and seek information on how to manage problem behaviors for all three disorders. Parents with low eMental health literacy (<30) were more likely to have a child with a high risk of a mental health disorder. The findings will be used to inform educational initiatives on the use of online resources and recognition of child mental health disorders to promote early intervention and appropriate help seeking.
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Affiliation(s)
- Eileen Cormier
- Florida State University College of Nursing, Tallahassee, Florida, USA
| | - Hyejin Park
- Florida State University College of Nursing, Tallahassee, Florida, USA
| | - Glenna Schluck
- Florida State University College of Nursing, Tallahassee, Florida, USA
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22
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Vaezghasemi M, Eurenius E, Ivarsson A, Richter Sundberg L, Silfverdal SA, Lindkvist M. Social-emotional problems among Swedish three-year-olds: an Item Response Theory analysis of the Ages and Stages Questionnaires: Social-Emotional. BMC Pediatr 2020; 20:149. [PMID: 32247313 PMCID: PMC7126409 DOI: 10.1186/s12887-020-2000-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 02/25/2020] [Indexed: 11/12/2022] Open
Abstract
Background There is enough evidence to believe that young children’s social-emotional problems can have a long-term effect if extra support is not given early. Therefore, early identification of such problems and any differences between boys and girls are of importance. We utilized the 36-month interval of the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) among 3-year-olds aiming: 1) to report the normative values of social-emotional problems for Swedish boys and girls; 2) to identify ASQ:SE items that are most commonly endorsed by children with high level of social-emotional problems (high score on ASQ:SE); 3) to assess whether certain ASQ:SE items differ between boys and girls at the same level of social-emotional problems; and 4) to examine whether ASQ:SE performs well in identifying children with high level of social-emotional problems (high score on ASQ:SE). Method During 2014–2017, data were collected from 7179 three-year-old children (boys = 3719, girls = 3460) through Child Health Care in the Region Västerbotten in the northern part of Sweden. Unidimensionality was assessed by Confirmatory Factor Analysis and goodness-of-fit was reported. Item Response Theory was used to answer the aims of the study. Results Items regarding interest in sexual words, too little sleep, disinterest in things around, unhappiness and self-injury were more commonly endorsed by children with high levels of social-emotional problems, as reported by their parents. For the same level of social-emotional problem, girls were more likely to demonstrate difficulties in occupying themselves, clinging behaviour and repetitive behaviour. On the other hand, boys were more likely to score high in items regarding destruction of things on purpose, difficulty to name friends and to express feelings. We have also found that the ASQ:SE is suitable for identifying children with high level of social-emotional problems. Conclusion The salient point of our study was to increase knowledge about Swedish children’s social-emotional problems at 3-years of age based on the psychometric characteristics of the ASQ:SE using Item Response Theory model. The gender differences as well as those items that occurred at high levels of social-emotional problems should be of concern for everyday practice in Child Health Care.
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Affiliation(s)
- Masoud Vaezghasemi
- Department of Epidemiology and Global Health, Umeå University, SE-901 85, Umeå, Sweden.
| | - Eva Eurenius
- Department of Epidemiology and Global Health, Umeå University, SE-901 85, Umeå, Sweden
| | - Anneli Ivarsson
- Department of Epidemiology and Global Health, Umeå University, SE-901 85, Umeå, Sweden
| | | | | | - Marie Lindkvist
- Department of Epidemiology and Global Health, Umeå University, SE-901 85, Umeå, Sweden
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23
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Runge RA, Soellner R. Measuring children's emotional and behavioural problems: are SDQ parent reports from native and immigrant parents comparable? Child Adolesc Psychiatry Ment Health 2019; 13:46. [PMID: 31798684 PMCID: PMC6882192 DOI: 10.1186/s13034-019-0306-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 11/16/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The number of immigrants worldwide is growing and migration might be a risk factor for the mental health of children. A reliable instrument is needed to measure immigrants' childrens mental health. The aim of the study was to test the measurement invariance of the parent version of the Strengths and Difficulties Questionnaire (SDQ) between German native, Turkish origin and Russian origin immigrant parents in Germany. The SDQ is one of the most frequently used screening instruments for mental health disorders in children. METHODS Differential Item Functioning (DIF) was tested in samples matched by socio-economic status, age and gender of the child. A logistic regression/item response theory hybrid method and a multiple indicators- multiple causes model (MIMIC) was used to test for DIF. Multi Group Confirmatory Factor analysis (MGCFA) was used to test for configural invariance. Parent reports of 10610 German native, 534 Russian origin and 668 Turkish origin parents of children aged 3-17 years were analysed. RESULTS DIF items were found in both groups and with both methods. We did not find an adequate fit of the original five factor model of the SDQ for the Turkish origin group, but for the Russian origin group. An analysis of functional equivalence indicated that the SDQ is equally useful for the screening of mental health disorders in all three groups. CONCLUSION Using the SDQ in order to compare the parent reports of native and immigrant parents should be done cautiously. Thus, the use of the SDQ in epidemiological studies and for prevention planning is questionable. However, the SDQ turns out to be a valid instrument for screening purposes in parents of native and immigrant children.
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Affiliation(s)
- Ronja A. Runge
- 0000 0001 0197 8922grid.9463.8Institut für Psychologie, Stiftung Universität Hildesheim, Universitätsplatz 1, 31141 Hildesheim, Germany
| | - Renate Soellner
- 0000 0001 0197 8922grid.9463.8Institut für Psychologie, Stiftung Universität Hildesheim, Universitätsplatz 1, 31141 Hildesheim, Germany
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D'Souza S, Crawford CN, Buckley J, Underwood L, Peterson ER, Bird A, Morton SMB, Waldie KE. Antenatal determinants of early childhood talking delay and behavioural difficulties. Infant Behav Dev 2019; 57:101388. [PMID: 31634704 DOI: 10.1016/j.infbeh.2019.101388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022]
Abstract
The determinants of talking delay alone or its comorbidity with behavioural difficulties was examined in 5768 two-year-old members of the Growing Up in New Zealand longitudinal study. Using the MacArthur-Bates Communicative Development inventories and the total difficulties score from the preschool Strengths and Difficulties Questionnaire, a composite measure was created so that children were categorised as showing no language or behavioural concerns (72.5%), behavioural only difficulties (6.1%), language only difficulties (18.1%), and comorbid language and behavioural difficulties (3.3%). Analyses revealed that antenatal factors such as maternal perceived stress, inadequate folate intake, vitamin intake, alcohol consumption during the first trimester and maternal smoking all had a significant effect on child outcomes. In particular, low multivitamin intake and perceived stress during pregnancy were associated with coexisting language and behavioural difficulties. These findings support international research in showing that maternal factors during pregnancy are associated with developmental outcomes in the early childhood period, and demonstrate these associations within a NZ context. Interventions which address maternal stress management and health behaviours during pregnancy could be beneficial to offspring development.
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Affiliation(s)
- Stephanie D'Souza
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | | | - Jude Buckley
- School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Amy Bird
- School of Psychology, University of Wollongong, NSW, Australia
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.
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25
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Gridley N, Blower S, Dunn A, Bywater T, Bryant M. Psychometric Properties of Child (0-5 Years) Outcome Measures as used in Randomized Controlled Trials of Parent Programs: A Systematic Review. Clin Child Fam Psychol Rev 2019; 22:388-405. [PMID: 30806864 PMCID: PMC6669186 DOI: 10.1007/s10567-019-00277-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This systematic review is one of the three which sought to identify measures commonly implemented in parenting program research, and to assess the level of psychometric evidence available for their use with this age group. This review focuses specifically on measures of child social-emotional and behavioral outcomes. Two separate searches of the same databases were conducted; firstly to identify eligible instruments, and secondly to identify studies reporting on the psychometric properties of the identified measures. Five commercial platforms hosting 19 electronic databases were searched from their inception to conducted search dates. Twenty-four measures were identified from Search 1: a systematic search of randomized controlled trial evaluations of parenting programs. For Search 2, inclusion/exclusion criteria were applied to 21,329 articles that described the development and/or validation of the 24 measures identified in Search 1. Thirty articles met the inclusion criteria. resulting in 11 parent report questionnaires and three developmental assessment measures for review. Data were extracted and synthesized to describe the methodological quality of each article using the COSMIN checklist alongside the overall quality rating of the psychometric property reported for each measure. Measure reliability was categorized into four domains (internal consistency, test-re-test, inter-rater, and intra-rater). Measure validity was categorized into four domains (content, structural, convergent/divergent, and discriminant). Results indicated that supporting evidence for included measures is weak. Further work is required to improve the evidence base for those measures designed to assess children's social-emotional and behavioral development in this age group. PROSPERO Registration number: CRD42016039600.
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Affiliation(s)
- Nicole Gridley
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- Carnegie School of Education, Leeds Beckett University, Leeds, UK
| | - Sarah Blower
- Department of Health Sciences, University of York, York, YO10 5DD, UK.
| | - Abby Dunn
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Tracey Bywater
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Maria Bryant
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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26
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D’Souza S, Underwood L, Peterson ER, Morton SMB, Waldie KE. Persistence and change in behavioural problems during early childhood. BMC Pediatr 2019; 19:259. [PMID: 31349812 PMCID: PMC6659228 DOI: 10.1186/s12887-019-1631-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Behavioural problems and psychopathology can present from as early as the preschool period. However there is evidence that behavioural difficulties may not be stable over this period. Therefore, the current study was interested in evaluating the persistence and change in clinically relevant behavioural problems during early childhood in a population-based New Zealand birth cohort. METHODS Behaviour was assessed in 5896 children when they were aged 2 and 4.5 years using the Strengths and Difficulties Questionnaire (SDQ). Correlations and mean differences in subscale and total difficulties scores were examined. Scores were then dichotomised into normal/borderline and abnormal ranges to evaluate the persistence and change in significant behavioural problems. Chi-square analyses and ANOVAs were used to determine the association between sociodemographic and birth variables, and preschool behavioural stability. RESULTS Raw scores at ages 2 and 4.5 years were moderately correlated, with most measures showing a small but significant decrease in mean scores over time. The majority of children who showed abnormal behaviour at 2 years improved at 4.5 years (57.9% for total difficulties). However, a notable proportion persisted in their difficulties from 2 to 4.5 years (42.1% for total difficulties). There was a small percentage of children who were categorised as abnormal only at 4.5 years. Children with difficulties at one or both time points had a greater proportion who were the result of an unplanned pregnancy, lived in highly deprived urban areas, and had mothers who were younger, of Māori and Pacific ethnicity and were less educated. CONCLUSIONS Not all children who show early behavioural difficulties persist in these difficulties. Those whose difficulties persist were more likely to experience risk factors for vulnerability relative to children with no difficulties. Results suggest that repeated screening for early childhood behavioural difficulties is important.
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Affiliation(s)
- Stephanie D’Souza
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Elizabeth R. Peterson
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Susan M. B. Morton
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Karen E. Waldie
- School of Psychology, University of Auckland, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand
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27
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Nathan K, Robertson O, Atatoa Carr P, Howden-Chapman P, Pierse N. Residential mobility and socioemotional and behavioural difficulties in a preschool population cohort of New Zealand children. J Epidemiol Community Health 2019; 73:947-953. [DOI: 10.1136/jech-2019-212436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 06/15/2019] [Accepted: 06/22/2019] [Indexed: 11/04/2022]
Abstract
BackgroundFindings regarding early residential mobility and increased risk for socioemotional and behavioural (SEB) difficulties in preschool children are mixed, with some studies finding no evidence of an association once known covariates are controlled for. Our aim was to investigate residential mobility and SEB difficulties in a population cohort of New Zealand (NZ) children.MethodsData from the Integrated Data Infrastructure were examined for 313 164 children born in NZ since 2004 who had completed the Before School Check at 4 years of age. Residential mobility was determined from address data. SEB difficulty scores were obtained from the Strengths and Difficulties Questionnaire administered as part of the Before School Check.ResultsThe prevalence of residential mobility was 69%; 12% of children had moved ≥4 times. A linear association between residential mobility and increased SEB difficulties was found (B=0.58), which remained robust when controlling for several known covariates. Moves >10 km and moving to areas of higher socioeconomic deprivation were associated with increased SEB difficulties (B=0.08 and B=0.09, respectively), while residential mobility before 2 years of age was not. Children exposed to greater residential mobility were 8% more likely to obtain SEB difficulties scores of clinical concern than children exposed to fewer moves (adjusted OR 1.08).ConclusionThis study found a linear association between residential mobility and increased SEB difficulties in young children. This result highlights the need to consider residential mobility as a risk factor for SEB difficulties in the preschool years.
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Eurenius E, Richter Sundberg L, Vaezghasemi M, Silfverdal S, Ivarsson A, Lindkvist M. Social-emotional problems among three-year-olds differ based on the child's gender and custody arrangement. Acta Paediatr 2019; 108:1087-1095. [PMID: 30496622 PMCID: PMC6590218 DOI: 10.1111/apa.14668] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/13/2018] [Accepted: 11/26/2018] [Indexed: 12/03/2022]
Abstract
AIM The aim of this study was to investigate mental health with respect to social-emotional problems among three-year-olds in relation to their gender, custody arrangements and place of residence. METHODS A cross-sectional population-based design was used, encompassing 7179 three-year-olds in northern Sweden during the period 2014-2017 from the regional Salut Register. Descriptive and comparative analyses were performed based on parents' responses on the Ages and Stages Questionnaires: Social-Emotional, supplemented with items on gender, custody arrangement and place of residence. RESULTS Parental-reported social-emotional problems were found in almost 10% of the children. Boys were reported to have more problems (12.3%) than girls (5.6%; p < 0.001). Parents were most concerned about children's eating habits and interactions at mealtimes. Parents not living together reported more problems among their children than those living together (p < 0.001). When stratifying by custody arrangement, girls in rural areas living alternately with each parent had more problems compared to those in urban areas (p < 0.008). CONCLUSION Gender and custody arrangements appear to be important factors for social-emotional problems among three-year-olds. Thus, such conditions should receive attention during preschool age, preferably by a systematic preventive strategy within Child Health Care.
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Affiliation(s)
- Eva Eurenius
- Department of Public Health and Clinical Medicine, Epidemiology and Global HealthUmeå UniversityUmeåSweden
| | - Linda Richter Sundberg
- Department of Public Health and Clinical Medicine, Epidemiology and Global HealthUmeå UniversityUmeåSweden
| | - Masoud Vaezghasemi
- Department of Public Health and Clinical Medicine, Epidemiology and Global HealthUmeå UniversityUmeåSweden
- Department of Social WorkUmeå UniversityUmeåSweden
| | | | - Anneli Ivarsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global HealthUmeå UniversityUmeåSweden
| | - Marie Lindkvist
- Department of Public Health and Clinical Medicine, Epidemiology and Global HealthUmeå UniversityUmeåSweden
- Department of StatisticsUmeå UniversityUmeåSweden
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29
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Stülb K, Messerli-Bürgy N, Kakebeeke TH, Arhab A, Zysset AE, Leeger-Aschmann CS, Schmutz EA, Meyer AH, Kriemler S, Jenni OG, Puder JJ, Munsch S. Prevalence and Predictors of Behavioral Problems in Healthy Swiss Preschool Children Over a One Year Period. Child Psychiatry Hum Dev 2019; 50:439-448. [PMID: 30368619 DOI: 10.1007/s10578-018-0849-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Behavioral problems impair children's health but prevalence rates are scarce and persistence rates vary due to divergence in age ranges, assessment methods and varying environmental factors. The aim of this study was to assess prevalence rates of behavioral problems, their persistence over a 1-year period, and the impact of child- and parent-related factors on behavioral problems. 555 2-6-year-old healthy preschool children were assessed at baseline and 382 of the initial sample at 1-year follow-up. Assessment included questionnaires concerning behavioral problems and their potential predictors (e.g. socio-economic status or parenting style). Altogether, nearly 7% of these children showed clinically relevant behavioral problems, and 3% showed persistent symptoms. Low SES, inconsistent parenting and corporal punishment were positively associated with behavioral problems. The prevalence rates of behavioral problems in Swiss preschoolers are similar to other European countries, but persistence is still rather low within preschool age. These findings need further confirmation in longitudinal studies.
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Affiliation(s)
- Kerstin Stülb
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.A. de Faucigny 2, 1700, Fribourg, Switzerland
| | - Nadine Messerli-Bürgy
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.A. de Faucigny 2, 1700, Fribourg, Switzerland.,Department of Psychology-Clinical Child Psychology and Biological Psychology, University of Fribourg, Rue P.A. de Faucigny 2, 1700, Fribourg, Switzerland.,Obstetric Service, Lausanne University Hospital, Ave de Sallaz 82, 1011, Lausanne, Switzerland
| | - Tanja H Kakebeeke
- Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Amar Arhab
- Obstetric Service, Lausanne University Hospital, Ave de Sallaz 82, 1011, Lausanne, Switzerland
| | - Annina E Zysset
- Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Claudia S Leeger-Aschmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Einat A Schmutz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Andrea H Meyer
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.A. de Faucigny 2, 1700, Fribourg, Switzerland.,Department for Psychology, University of Basel, Missionsstrasse 62A, 4055, Basel, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
| | - Oskar G Jenni
- Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Jardena J Puder
- Obstetric Service, Lausanne University Hospital, Ave de Sallaz 82, 1011, Lausanne, Switzerland
| | - Simone Munsch
- Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.A. de Faucigny 2, 1700, Fribourg, Switzerland.
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30
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Hutton JS, Justice L, Huang G, Kerr A, DeWitt T, Ittenbach RF. The Reading House: A Children's Book for Emergent Literacy Screening During Well-Child Visits. Pediatrics 2019; 143:peds.2018-3843. [PMID: 31147486 DOI: 10.1542/peds.2018-3843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The American Academy of Pediatrics recommends literacy promotion and developmental assessment during well-child visits. Emergent literacy skills are well defined, and the use of early screening has the potential to identify children at risk for reading difficulties and guide intervention before kindergarten. METHODS The Reading House (TRH) is a children's book designed to screen emergent literacy skills. These are assessed by sharing the book with the child and using a 9-item, scripted scoring form. Get Ready to Read! (GRTR) is a validated measure shown to predict reading outcomes. TRH and GRTR were administered in random order to 278 children (mean: 43.1 ± 5.6 months; 125 boys, 153 girls) during well-child visits at 7 primary care sites. Parent, child, and provider impressions of TRH were also assessed. Analyses included Rasch methods, Spearman-ρ correlations, and logistic regression, including covariates age, sex, and clinic type. RESULTS Psychometric properties were strong, including item difficulty and reliability. Internal consistency was good for new measures (rCo- α = 0.68). The mean TRH score was 4.2 (±2.9; range: 0-14), and mean GRTR was 11.1 (±4.4; range: 1-25). TRH scores were positively correlated with GRTR scores (r s = 0.66; high), female sex, private practice, and child age (P < .001). The relationship remained significant controlling for these covariates (P < .05). The mean TRH administration time was 5:25 minutes (±0:55; range: 3:34-8:32). Parent, child, and provider impressions of TRH were favorable. CONCLUSIONS TRH is a feasible, valid, and enjoyable means by which emergent literacy skills in 3- and 4-year-old children can be directly assessed during primary care.
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Affiliation(s)
- John S Hutton
- Divisions of General and Community Pediatrics and .,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Laura Justice
- Schoenbaum Family Center and Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio
| | | | - Amy Kerr
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Thomas DeWitt
- Divisions of General and Community Pediatrics and.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
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31
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Construct validity of a service-setting based measure to identify mental health problems in infancy. PLoS One 2019; 14:e0214112. [PMID: 30921359 PMCID: PMC6438593 DOI: 10.1371/journal.pone.0214112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/07/2019] [Indexed: 11/19/2022] Open
Abstract
Accumulating research document the needs of intervention towards mental health problems in early childhood. The general child health surveillance offers opportunities for early detection of mental health vulnerability, conditioned the availability of feasible and validated measures. The Copenhagen Infant Mental Health Questionnaire, CIMHQ, was developed to be feasible for community health nurses and comprehensive regarding the range of mental health problems seen in infancy. Previous testing of the CIMHQ has documented feasibility and face validity. The aim was to investigate the construct validity of the general population measure by using the Rasch measurement models, and to explore the differential functioning of the CIMHQ relative to a number of characteristics of the infants, local independence of items, and possible latent classes of infants. CIMHQ was tested in 2,973 infants from the general population, aged 9-10 months. The infants were assessed by community health nurses at home visits, in the period from March 2011 to December 2013. Rasch measurement models were used to investigate the construct validity of the CIMHQ. Analyses showed an overall construct valid scale of mental health problems, consisting of seven valid subscales of specific problems concerning eating, sleep, emotional reactions, attention, motor activity, communication, and language, respectively. The CIMHQ fitted a graphical loglinear Rasch model without differential item function. Analyses of local homogeneity identified two latent classes of infants. A simple model with almost no local dependency between items is proposed for infants with few problems, whereas a more complicated model characterizes infants with more problems. The measure CIMHQ differentiates between infants from the general population with few and more mental health problems, and between subgroups of problems that potentially can be targets of preventive intervention.
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D'Souza S, Waldie KE, Peterson ER, Underwood L, Morton SMB. Antenatal and Postnatal Determinants of Behavioural Difficulties in Early Childhood: Evidence from Growing Up in New Zealand. Child Psychiatry Hum Dev 2019; 50:45-60. [PMID: 29860616 DOI: 10.1007/s10578-018-0816-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Behavioural difficulties during early childhood have significant implications for multiple outcomes later in life. Child behavioural difficulties at 2 years of age (N = 6246) were assessed by mothers enrolled in a longitudinal, population-based New Zealand cohort study. 10.1% of children had total difficulties scores in the abnormal range on the preschool version of the Strengths and Difficulties Questionnaire. After controlling for maternal education, poverty, and child's birth age/weight, several antenatal and postnatal maternal health and family risk factors were significant for: (i) emotional problems (antenatal maternal perceived stress, lack of periconceptional folate, and moderate to severe maternal postnatal anxiety); (ii) hyperactivity-inattention (antenatal maternal perceived stress, mothers' antenatal exposure to secondhand smoke, moderate to severe maternal postnatal anxiety, and low maternal self-evaluation); (iii) conduct problems and total difficulties (antenatal maternal perceived stress, verbal inter-parental conflict and low maternal self-evaluation). The identification of risk and protective factors associated with early childhood difficulties are vital for guiding intervention and prevention efforts.
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Affiliation(s)
- Stephanie D'Souza
- School of Psychology, Faculty of Science, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.,Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, Faculty of Science, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. .,Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.
| | - Elizabeth R Peterson
- School of Psychology, Faculty of Science, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.,Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.,School of Population Health, The University of Auckland, Auckland, New Zealand
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Bywater T, Berry V, Blower SL, Cohen J, Gridley N, Kiernan K, Mandefield L, Mason-Jones A, McGilloway S, McKendrick K, Pickett K, Richardson G, Teare MD, Tracey L, Walker S, Whittaker K, Wright J. Enhancing Social-Emotional Health and Wellbeing in the Early Years (E-SEE): a study protocol of a community-based randomised controlled trial with process and economic evaluations of the incredible years infant and toddler parenting programmes, delivered in a proportionate universal model. BMJ Open 2018; 8:e026906. [PMID: 30573493 PMCID: PMC6303737 DOI: 10.1136/bmjopen-2018-026906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Behavioural and mental disorders have become a public health crisis and by 2020 may surpass physical illness as a major cause of disability. Early prevention is key. Two Incredible Years (IY) parent programmes that aim to enhance child well-being and development, IY Infant and IY Toddler, will be delivered and evaluated in a proportionate universal intervention model called Enhancing Social-Emotional Health and Wellbeing in the Early Years (E-SEE) Steps. The main research question is: Does E-SEE Steps enhance child social emotional well-being at 20 months when compared with services as usual? METHODS AND ANALYSIS E-SEE Steps will be delivered in community settings by Early Years Children's Services and/or Public Health staff across local authorities. Parents of children aged 8 weeks or less, identified by health visitors, children's centre staff or self-referral, are eligible for participation in the trial. The randomisation allocation ratio is 5:1 (intervention to control). All intervention parents will receive an Incredible Years Infant book (universal level), and may be offered the Infant and/or Toddler group-based programme/s-based on parent depression scores on the Patient Health Questionnaire or child social emotional well-being scores on the Ages and Stages Questionnaire: Social Emotional, Second Edition (ASQ:SE-2). Control group parents will receive services as usual. A process and economic evaluation are included. The primary outcome for the study is social emotional well-being, assessed at 20 months, using the ASQ:SE-2. Intention-to-treat and per protocol analyses will be conducted. Clustering and hierarchical effects will be accounted for using linear mixed models. ETHICS AND DISSEMINATION Ethical approvals have been obtained from the University of York Education Ethics Committee (ref: FC15/03, 10 August 2015) and UK NHS REC 5 (ref: 15/WA/0178, 22 May 2015. The current protocol is Version 9, 26 February 2018. The sponsor of the trial is the University of York. Dissemination of findings will be via peer-reviewed journals, conference presentations and public events. TRIAL REGISTRATION NUMBER ISRCTN11079129; Pre-results.
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Affiliation(s)
- Tracey Bywater
- Department of Health Sciences, University of York, York, UK
| | - Vashti Berry
- College of Medicine and Health, University of Exeter Medical School, Exeter, Devon, UK
| | | | - Judith Cohen
- Hull Health Trials Unit, University of Hull, Hull, UK
| | - Nicole Gridley
- Carnegie School of Education, Leeds Beckett University, Leeds, UK
| | - Kathleen Kiernan
- Department of Social Policy and Social Work, University of York, York, UK
| | - Laura Mandefield
- Clinical Trials Research Unit (CTRU), University of Sheffield, Sheffield, UK
| | | | - Sinead McGilloway
- Centre for Mental Health and Community Research, National University of Ireland, Maynooth, Ireland
| | - Kirsty McKendrick
- Clinical Trials Research Unit (CTRU), University of Sheffield, Sheffield, UK
| | - Kate Pickett
- Department of Health Sciences, University of York, York, UK
| | | | - M Dawn Teare
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Louise Tracey
- Department of Education, University of York, York, UK
| | - Simon Walker
- Centre for Health Economics, University of York, York, UK
| | - Karen Whittaker
- School of Nursing, University of Central Lancashire, Preston, UK
| | - Jessica Wright
- Clinical Trials Research Unit (CTRU), University of Sheffield, Sheffield, UK
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Nystrand C, Ssegonja R, Sampaio F. Quality of life and service use amongst parents of young children: Results from the Children and Parents in Focus trial. Scand J Public Health 2018; 47:774-781. [PMID: 30253689 DOI: 10.1177/1403494818801640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Aim: The aim of this study was to assess the quality of life (QoL) and service use of parents who have preschool-aged children, and whether the mental-health problems of parents and their children predict these outcomes. Methods: Cross-sectional data were gathered in 2015-2016 in Uppsala County in Sweden where 3164 parents of children aged three- to five-years-old were asked to self-report their own and their children's mental-health status and service use in the past 12 months. Data from the General Health Questionnaire were used to derive health-related quality of life (HRQoL) measures for adults. Results: Very few parents reported mental-health problems, while approximately 15% of the sample used any type of parental support and/or psychological health-care service. Families without problems used the least amount of resources. Parents' own mental-health problems predicted usage of both psychotherapy and couples' therapy, while child problems predicted the former but also the use of a parenting program. Parental HRQoL was predicted by mental-health problems, and all families with at least one individual experiencing problems rated their QoL lower than families without problems. Conclusions: Parental service use and HRQoL is associated not only with their own mental-health status but also with their children's mental-health problems.
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Affiliation(s)
- Camilla Nystrand
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Richard Ssegonja
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, Sweden
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Schoeps A, Peterson ER, Mia Y, Waldie KE, Underwood L, D'Souza S, Morton SMB. Prenatal alcohol consumption and infant and child behavior: Evidence from the Growing Up in New Zealand Cohort. Early Hum Dev 2018; 123:22-29. [PMID: 30036725 DOI: 10.1016/j.earlhumdev.2018.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND High levels of alcohol exposure during pregnancy can damage developing brains and influence child behavior and learning. AIM To examine the effects of lower levels of alcohol and very early exposure to alcohol on infant temperament and child behavior. STUDY DESIGN, SUBJECTS, AND OUTCOME MEASURES The Growing Up in New Zealand study involves a prospective birth cohort of 6822 pregnant women of whom 6156 provided information on their child's temperament using the Infant Behavior Questionnaire-Revised (IBQ-R VSF) at 9 months and their child's behavior using the Strengths and Difficulties Questionnaire at 2 years. RESULTS A series of adjusted linear regression models controlling for socio-demographic factors found alcohol consumption during pregnancy was most consistently related to Lower Positive Affect, Affiliation/Regulation, and Orienting Capacity temperament scores. Mothers who stopped drinking after becoming aware of their pregnancy, but had an unplanned pregnancy (hence may have a baby exposed to alcohol for longer), also reported infants with lower Orienting Capacity, Affiliation/Regulation, and Fear temperament scores compared to those that did not drink. Children whose mothers drank four or more drinks per week during pregnancy were more likely to report their child as having conduct problems, with higher total difficulties scores at age 2. CONCLUSIONS Alcohol consumption during pregnancy has a negative effect especially on infant temperament, even if small amounts of alcohol are consumed. Our findings have implications for men and women who drink, medical professionals, and for the availability of contraception to those who drink, but do not plan to get pregnant.
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Affiliation(s)
- Anja Schoeps
- Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
| | - Elizabeth R Peterson
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Yasmine Mia
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Karen E Waldie
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Stephanie D'Souza
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, University of Auckland, Private Bag 92019, Auckland, New Zealand; School of Population Health, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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Ammitzbøll J, Thygesen LC, Holstein BE, Andersen A, Skovgaard AM. Predictive validity of a service-setting-based measure to identify infancy mental health problems: a population-based cohort study. Eur Child Adolesc Psychiatry 2018; 27:711-723. [PMID: 29052014 DOI: 10.1007/s00787-017-1069-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 10/12/2017] [Indexed: 12/01/2022]
Abstract
Measures to identify infancy mental health problems are essential to guide interventions and reduce the risk of developmental psychopathology in early years. We investigated a new service-setting-based measure the Copenhagen Infant Mental Health Screening (CIMHS) within the general child health surveillance by community health nurses (CHN). The study population of 2973 infants was assessed by CIMHS at age 9-10 months. A subsample of 416 children was examined at age 1½ years, using parent interviews including the Child Behavior Checklist (CBCL 1½-5), Check List of Autism and Toddlers (CHAT), Infant-Toddler Symptom Checklist (ITSCL), and the Bayley Scales of Infant and Toddler Development (BSID) and observations of behavior, communication, and interaction. Child mental disorders were diagnosed according to ICD-10 and parent-child relationship disorders according to DC:0-3R. Statistical analyses included logistic regression analyses adjusted and weighted to adjust for sampling and bias. CIMHS problems of sleep, feeding and eating, emotions, attention, communication, and language were associated with an up to fivefold increased risk of child mental disorders across the diagnostic spectrum of ICD-10 diagnoses. Homo-type continuity was seen in problems of sleep and feeding and eating being associated with a threefold increased risk of disorders within the same area, OR 3.0 (95% CI 1.6-5.4) and OR 2.7 (95% CI 1.7-4.2), respectively. The sensitivity at high CIMHS problem scores was 32% and specificity 86%. In summary, CIMHS identify a broad range of infants' mental health problems that are amenable to guide intervention within the general child health surveillance.
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Affiliation(s)
- Janni Ammitzbøll
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark.
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark
| | - Bjørn E Holstein
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark
| | - Anette Andersen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark.,Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
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Øvergaard KR, Oerbeck B, Friis S, Pripp AH, Biele G, Aase H, Zeiner P. Attention-Deficit/Hyperactivity Disorder in Preschoolers: The Accuracy of a Short Screener. J Am Acad Child Adolesc Psychiatry 2018; 57:428-435. [PMID: 29859558 DOI: 10.1016/j.jaac.2018.03.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/08/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Although early and accurate screening is required for the remediation of attention-deficit/hyperactivity disorder (ADHD), possible gender differences have not been extensively studied. We examined the classification accuracy of the parent and preschool teacher version of the Strengths and Difficulties Questionnaire (SDQ) hyperactivity-inattention (HI) subscale in girls and boys. METHOD The study was part of the Norwegian Mother and Child Cohort Study (MoBa). Parents and preschool teachers rated a total of 238 girls and 276 boys (mean age 3.5 years) with the SDQ HI subscale. Blinded to the parent and teacher ratings, interviewers classified the children by ADHD diagnoses with the Preschool Age Psychiatric Assessment Interview. RESULTS Areas under the curves for the parent HI subscale scores were good for both girls and boys (0.87 and 0.80, respectively). Preschool teacher classifications were fair (0.76) for girls and poor (0.62) for boys, a significant difference (p = .017). The subscale accurately identified children without ADHD at low parent scores (≤4), and fairly accurately identified ADHD at high scores (≥9), with maximum probabilities of finding true cases of 0.75 in girls and 0.55 in boys. Intermediate scores gave the best balance between sensitivity and specificity with low probabilities of correctly identifying children with ADHD. CONCLUSION The parental SDQ HI subscale was useful for screening for ADHD in preschool girls and boys. For preschool teachers, the subscale was useful for screening girls.
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Affiliation(s)
| | | | - Svein Friis
- Oslo University Hospital, and the Institute of Clinical Medicine, University of Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Norway
| | - Guido Biele
- Norwegian Institute of Public Health, Oslo, Norway
| | - Heidi Aase
- Norwegian Institute of Public Health, Oslo, Norway
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D'Souza S, Waldie KE, Peterson ER, Underwood L, Morton SMB. The Strengths and Difficulties Questionnaire: Factor Structure of the Father-Report and Parent Agreement in 2-Year-Old Children. Assessment 2017; 26:1059-1069. [PMID: 29214848 DOI: 10.1177/1073191117698757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is limited research on the preschool version of the Strengths and Difficulties Questionnaire (SDQ), and comparisons between mothers and fathers as informants and whether the factor structure shows measurement invariance across parents is lacking. Our study involved mothers (n = 6,246) and fathers (n = 3,759) of 2-year-old children from the Growing Up in New Zealand birth cohort. Confirmatory factor analysis was used to evaluate the factor structure of the SDQ and test for measurement invariance across mothers and fathers. For fathers, we found support for a modified five-factor model that accounts for a positive construal method effect. Internal consistency was good for measures except peer problems. Full measurement invariance of this modified model was found across mothers and fathers, and parents showed moderate agreement in their SDQ ratings (0.34 ≤ r ≤ 0.44). More research is needed on whether mother- and father-reports differ in sensitivity when screening for early childhood psychiatric disorders.
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Affiliation(s)
- Stephanie D'Souza
- 1 School of Psychology, The University of Auckland, Auckland, New Zealand.,2 Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- 1 School of Psychology, The University of Auckland, Auckland, New Zealand
| | | | - Lisa Underwood
- 2 Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- 2 Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.,3 School of Population Health, The University of Auckland, Auckland, New Zealand
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