Does Preschool Self-Regulation Predict Later Behavior Problems in General or Specific Problem Behaviors?

Dimensionality of Oppositional Defiant Disorder Symptoms Across Elementary-School Grades

Various models of the dimensionality of behaviors associated with Oppositional Defiant Disorder (ODD) have been proposed or reported. Many of these models describe ODD-related behaviors in either two- or three-factor models. The purpose of the study was to determine which of the models of ODD-related behaviors demonstrated the best fit using teacher report of 15,521 children across eight grade levels and to examine measurement invariance of the model across grades. Confirmatory factor analyses were conducted to determine which of the models demonstrated best fit of teacher-reported ODD-related behaviors across eight grades. A two-factor model from a preliminary analysis of a subset of the current data demonstrated a better model fit than any of the existing six models examined and demonstrated measurement invariance across all grades. Across all of the models, affective and behavioral symptoms loaded onto separate factors, which may be an important consideration to inform future clinical and empirical work.

Aggressive behaviors predict greater intraindividual reaction time variability in children: Evidence from cross-lagged panel models

Deficits in attentional control or inhibitory control are distinct features of childhood aggressive behaviors. Lower attentional control or inhibitory control is considered to predict more aggressive behaviors, while few studies have documented the possible predictive effects of aggressive behaviors on attentional control or inhibitory control. The present study examined the bidirectional relations between aggressive behaviors and both inhibitory control and attentional control in 169 Chinese primary school children (75 girls, Mage  = 7.15, SDage  = 0.33), annually for 3 years starting at age 7. The No-go accuracy on a Go/No-go task was used as the index of inhibitory control, and the intraindividual reaction time variability (IIRTV) of correct Go trials indicated attentional control. The aggressive behaviors subscale of the child behavior checklist-Chinese version was used to assess the children's aggressive behaviors. The results demonstrated a significant and stable predictive effect of previous aggressive behaviors on subsequent attentional control, with more aggressive behaviors predicting greater IIRTV at both the between-child and within-child levels. No significant effects of inhibitory control or attentional control on aggressive behaviors or sex-specific patterns were found. The findings suggest the negative impact of childhood aggressive behaviors on attentional control and underscore the importance of early prevention and intervention for childhood aggressive behaviors.

A meta-analysis of the validity of the Head-Toes-Knees-Shoulders task in predicting young children's academic performance

The present study represents the first meta-analytic synthesis of the utility of a widely used early-childhood self-regulation measure, the Head-Toes-Knees-Shoulders task, in predicting children's academic achievement. A systematic review of the literature yielded 69 studies accessed from peer reviewed journals representing 413 effect sizes and 19,917 children meeting the complete set of inclusion and exclusion criteria. Robust variance analysis demonstrated that the Head-Toes-Knees-Shoulders task was a consistent predictor of children's academic achievement across literacy, oral language, and mathematical outcomes. A moderator analysis indicated that in accordance with prior research, the Head-Toes-Knees-Shoulders task was more strongly associated with children's mathematics performance relative to their performance on language and literacy measures. The results of this meta-analysis suggest that the Head-Toes-Knees-Shoulders task demonstrated statistically significant, positive associations with children's overall academic performance. These associations remained stable across different participant and measurement factors and are comparable to meta-analyses examining the self-regulation and academic association with multiple measures of self-regulation and executive function.

Measurement of Self-regulation in Preschool and Elementary Children: A Scoping Review

AIMS

This scoping review sought to identify and characterize measurement of self-regulation in preschool and elementary aged children.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review (ScR) guidelines were applied. Databases from the fields of allied health, education, medicine, and social sciences were searched including: CINAHL, Education Database (ProQuest), Education Research Complete, EMBASE, ERIC, iNFORMIT Combined, Medline, PsychINFO, Social Sciences (ProQuest), Teacher Reference Center, and Web of Science. Articles published between 2015 and 2020 were included. Dual review was utilized at all stages and a third reviewer resolved any conflicts.

RESULTS

Sixty-seven studies were included in this review. A range of observational, self-report, teacher report, caregiver report, and observational measures of self-regulation were identified. Included studies were primarily published in education and psychology disciplines, with no studies by occupational therapists identified.

CONCLUSIONS

Although a range of measures were identified in this scoping review, the results highlight the lack of consensus regarding self-regulation measurement that occupational therapists use to design and implement therapy programs to address child emotional and behavioral needs.

A Validation Study of the BRIEF-2 Among Kindergarteners and First Graders At-Risk for Behavior Problems

Early identification of executive dysfunction and timely school-based intervention efforts are critical for students at risk for problematic behaviors during early elementary school. The original Behavior Rating Inventory of Executive Functioning (BRIEF) was designed to measure real-world behavioral manifestations of executive functioning, neurocognitive processes critical for school success. With the updated BRIEF-2, independent validation is needed with kindergarten and first grade students at risk for emotional and behavioral disorders. Thus, using item level analyses, we examined the factor structure of the BRIEF-2 Teacher Rating form with 1,112 students. Results indicated little evidence for the original three-index model and supported a modified two-index model, with a Cognitive Regulation Index and an overall Behavior-Emotion Regulation Index. Criterion related validity indicated positive relationships with performance-based executive functioning (Head-Toes-Knees-Shoulders) and later internalizing and externalizing behaviors. We discuss implications of findings for early identification and school-based intervention efforts, as well as future research.

Negative Emotionality and Internalizing Behaviors in Preschool Children: Moderating Role of Inhibitory Control

Negative emotionality in childhood is typically positively associated with internalizing behaviors, whereas inhibitory control is negatively associated with internalizing behaviors. Recent work, however, has also found that inhibitory control paradoxically increases risk for internalizing behaviors in the context of some reactive temperamental styles. The purpose of the present study was to examine whether inhibitory control moderated the association between negative emotionality and prospective internalizing behaviors in typically developing preschoolers (N = 104, 51 girls, M_age = 3.46 years, SD_age = 0.19). We found that negative emotionality at T1 was only positively associated with internalizing behaviors at T2 in preschoolers with relatively higher inhibitory control. Our results suggest that relatively high levels of inhibitory control may be less adaptive for children who also have relatively high levels of negative emotionality. Findings are discussed in the context of cognitive overcontrol in understanding risk for internalizing behaviors before formal school entry.

Promote Positive Behaviors in Preschoolers by Implementing an Innovative Educational Program for the Training and Development of Social and Emotional Skills (DeCo-S.E.)

The purpose of our research is to determine emotional and behavioural modelling in an emotionally safe environment in a group of kindergarten preschoolers, following the application of an innovative curriculum project, designed and implemented for the first time, Educational Program for the training and development of social and emotional skills (DeCo-S.E.). Eighteen teachers, involved in the research, were divided into two samples: the experimental group (EG) consisting of 10 preschool teachers who were trained to take up the DeCo-S.E. program, and the control group (GC) including eight preschool teachers who applied the classic educational strategies. The DeCo-S.E. program is aimed at developing social and emotional skills (emotion identification, frustration tolerance), reducing behavior problems, and solving problems with peers as part of the training process. The study also included 142 children in their last year at kindergarten, aged X ± SD 5.87 ± 2.87 years old, divided into two groups: the EG consisting of 74 children to whom the experimental program was implemented and the GC comprising 72 children who did not take part in the training program. In the present study, we applied only the Preschool and Kindergarten Behavior Scales for Teachers (PKBS-2) questionnaire to children in the pre- and post-experimental phases. The results were processed with the statistical software SPSS 22. The analysis of the scores of the questionnaire applied to the children highlighted a significant improvement in EG on both scales. The study reveals the effectiveness of the Development of social and emotional skills programs in preschool children has proven its effectiveness by reducing undesirable/maladaptive behaviours and positively developing socio-emotional skills in preschool children.

The unique relevance of executive functions and self-regulation behaviors for understanding early childhood experiences and preschoolers' outcomes in rural Pakistan

Performance-based measures of children's executive functions (EFs) do not capture children's application of these skills during everyday emotionally-laden and socially-mediated interactions. The current study demonstrates the value of using assessor report of self-regulation behaviors (inhibitory control and positive affect/engagement) in addition to EF tasks when studying early childhood experiences and development in a rural lower-middle-income country setting. In a sample of 1302 disadvantaged 4-year-olds living in rural Pakistan, we found that directly assessed EFs were significantly related to assessor observations of children's inhibitory control and positive affect/engagement during a structured assessment protocol. However, EFs and two types of self-regulation behaviors demonstrated unique associations with children's (1) contextual experiences, as indexed by family socio-economic resources, participation in parenting interventions, and children's physical growth; and (2) age-salient developmental outcomes, as indexed by direct assessment of pre-academic skills and maternal report of prosocial behaviors and behavior problems. First, family wealth uniquely predicted only observed positive affect/engagement, whereas maternal education uniquely predicted only EFs. Second, children's antecedent linear growth was a significant predictor of both EFs and positive affect/engagement, but exposure to an enhanced nutrition intervention during the first 2 years of life and preschoolers' hair cortisol concentration were associated only with observed self-regulation behaviors. Finally, both EFs and observed positive affect/engagement uniquely predicted children's pre-academic skills. In contrast, only assessors' ratings of positive affect/engagement uniquely predicted maternal report of prosocial behaviors and only assessors' ratings of inhibitory control uniquely predicted maternal report of behavioral problems.

Executive function training for kindergarteners after the Great East Japan Earthquake: intervention effects

Japan’s Social Thinking and Academic Readiness Training (START) program Academic Readiness (AR) lesson aims to improve self-regulation, executive function, and behavior problems in kindergarten children, but the effects of the START program AR lessons in unfavorable circumstances are unclear. Therefore, this study investigated the effects of the START program AR lesson in affected areas after the Great East Japan Earthquake. A cluster randomized trial was conducted with 111 5-year-old children in two kindergartens in Miyagi Prefecture to evaluate the effectiveness of the six-week AR lesson. One kindergarten was randomly chosen to implement the AR lesson, and the other maintained standard education. In the intervention group, trained classroom teachers provided the children with a 20-min AR lesson once a week. Executive function, behavioral self-regulation, and internalizing and externalizing problem behaviors were measured before and after the six-week intervention. The intervention group showed improved inhibitory control and enhanced behavioral self-regulation compared with the standard practice group. In addition, teachers’ evaluations showed that children’s internalizing and externalizing problem behaviors improved significantly. The results indicate that the START program AR lesson was effective in enabling teachers to help students improve executive function, self-regulation, and problematic behaviors. Therefore, educators and policy-makers should consider implementing the START program AR lesson in kindergartens after a disaster.

Role of endocrine disrupting chemicals in children's neurodevelopment

Environmental stressors, like endocrine disrupting chemicals (EDC), are considered important contributors to the increased rates of neurodevelopmental dysfunctions. Considering the cumulative research on adverse neurodevelopmental effects associated with prenatal exposure to EDC, the purpose of this study was to review the available limited literature about the effects of postnatal exposure to EDC on child neurodevelopment and behaviour. Despite widespread children's exposure to EDC, there are a limited number of epidemiological studies on the association of this exposure with neurodevelopmental disorders, in particular in the postnatal period. The available research suggests that postnatal EDC exposure is related to adverse neurobehavioral outcomes in children; however the underlying mechanisms of action remain unclear. Timing of exposure is a key factor determining potential neurodevelopmental consequences, hence studying the impact of multiple EDC co-exposure in different vulnerable life periods could guide the identification of sensitive subpopulations. Most of the reviewed studies did not take into account sex differences in the EDC effects on children neurodevelopment. We believe that the inclusion of sex in the study design should be considered as the role of EDC on children neurodevelopment are likely sex-specific and should be taken into consideration when determining susceptibility and potential mechanisms of action.

[Structural Equation Modeling of the Interaction between Mothers and Preschool-Age Children]

PURPOSE

This study aimed to identify the factors influencing the interaction between mothers and preschool-age children and construct a structural equation model based on the factors identified.

METHODS

The data were collected from the mothers of children aged three to six years enrolled in kindergartens in Seoul, Gyeonggi, Chungbuk, and Jeonbuk. A total of 328 questionnaires were used for the analysis. Analysis was performed using SPSS 26.0 and AMOS 26.0 programs.

RESULTS

The child's self-regulation (β = .42, p < .001) had the most significant influence on the interaction between mothers and preschool children, followed by the mother's parenting stress (β = -.23, p =.008), social support (β = .17, p < .001), and the child's active temperament (β = .15, p < .001). The child's gender, emotional temperament, social temperament, and mother's education level had indirect influences.

CONCLUSION

These results suggest that interventions considering the child's temperament, mother's parenting stress, and social support are required to promote the interaction between preschool-age children and mothers.

Strengthening Executive Function and Self-Regulation Through Teacher-Student Interaction in Preschool and Primary School Children: A Systematic Review

Executive functions (EF) and self-regulation (SR) are fundamental for children's learning, school functioning and academic achievement. EF/SR fail to develop to its full potential if contextual stimulation is not adequately presented. This is evident in the training programmes directly and exclusively targeting EF/SR stimulation, which lack durable and transferable effects. Therefore, recent research has shifted the attention towards malleable environmental factors; more specifically, to the role of school and classroom environment as an important developmental context for promoting children's EF/SR skills and, in turn, their cognition and behaviour. Numerous observational studies have shown a correlation between the quality of teacher-student relationship (TSR) at the dyadic level or teacher-student interaction (TSI) at the classroom level and children's EF/SR skills. To explore the direction of this association, the objective of this systematic literature review was to examine the causal effect of experiments and interventions that aim to improve children's EF/SR by manipulating the TSI. Overall, the results from 18 included studies indicated that children in treatment groups show higher gains, albeit small-sized, in EF/SR performance compared to controls. Furthermore, TSI manipulation seemed to affect children's SR skills more strongly than children's EF skills. More importantly, the findings revealed the largest effects of these manipulations in children considered vulnerable or disadvantaged, suggesting that the cognitive deficits can be minimised if these children are supported appropriately. Given high study heterogeneity, this review highlights the need for more research (and interventions) explicitly investigating TSI and TSR and their potential impact on EF and SR in children. This study aims to provide information as to which specific aspects need to be examined more closely, instructing further development and implementation of efficient and effective interventions in education.

Executive function as a mechanism linking socioeconomic status to internalizing and externalizing psychopathology in children and adolescents

INTRODUCTION

The association between low socioeconomic status (SES) in childhood and increased risk for psychopathology is well established, but the mechanisms explaining this relationship are poorly understood. Here, we investigate the potential role of difficulties in executive functioning (EF) as a mechanism linking childhood and adolescent SES with externalizing and internalizing psychopathology.

METHODS

We examined whether difficulties with EF mediated the association between SES and externalizing and internalizing psychopathology in two cross-sectional samples of children and adolescents (Study 1: N = 94, ages 6-18, 51.1% male; Study 2: N = 259, ages 8-16, 54.1% male) from diverse SES backgrounds in the United States. EF was measured through behavioral tasks and parent-reported behavioral regulation (BR).

RESULTS

In both samples, children and adolescents from lower SES families were more likely to experience both externalizing and internalizing psychopathology than youth from more advantaged backgrounds and exhibited greater EF difficulties - they had lower performance on a task measuring inhibitory control and lower parent-rated BR. Reduced inhibitory control and BR, in turn, were associated with higher externalizing and internalizing psychopathology. In Study 1, difficulties with BR mediated the association of low-SES with both externalizing and internalizing psychopathology. In Study 2, low inhibitory control mediated the association between low-SES and externalizing psychopathology. These findings largely persisted after adjusting for exposure to violence, a form of adversity that is common in children from low-SES backgrounds.

CONCLUSIONS

These findings suggest that reduced EF may be an underlying mechanism through which low-SES confers risk for psychopathology in children and adolescents.

Executive function mediates the link between externalizing behavior and HbA1c in children and adolescents with type 1 diabetes: A cross-national investigation

OBJECTIVE

Externalizing behavior (i.e., conduct problems, hyperactivity) and executive function (EF) problems in children and adolescents with type 1 diabetes (T1D) have been associated with worse diabetes-related and psychosocial outcomes but have not been examined in relationship to each other. We aimed to examine whether externalizing behavior is associated with HbA1c and whether this relationship is mediated by EF problems, specifically metacognition (i.e., ability to initiate, plan, organize and monitor behavior) and behavioral regulation (i.e., impulse control, regulation of emotion and behavior).

RESEARCH DESIGN AND METHODS

Cohorts of Belgian and Dutch parents of children and adolescents (6-18 years) with T1D filled out questionnaires on externalizing behavior (Strengths and Difficulties Questionnaire; SDQ) and EF (Behavior Rating Inventory of Executive Function; BRIEF) composite scales. Treating physicians collected HbA1c values. Mediation analyses were performed separately for the BRIEF composite Metacognition and Behavior Regulation scales, correcting for age, sex and diabetes duration.

RESULTS

The 335 parents of children and adolescents with T1D (mean age 12.3 ± 2.8 SD; mean HbA1c 7.6% ± 1.1 SD [60 mmol/mol ± 12.0 SD]; mean diabetes duration 5.3 ± 3.6 SD; 49.6% female) participated. Analyses showed that the association between externalizing behavior and HbA1c is mediated by metacognition (ab path Point estimate = 0.05 BCa CI 95% 0.02-0.08), and not behavioral regulation.

CONCLUSIONS

Results uncovered the influence externalizing behavior may have on EF problems in the metacognition domain, which in turn seem to influence HbA1c. Clinicians should be mindful of these EF problems when working with children and adolescents displaying externalizing behavior, and not only target behavioral but also cognitive processes.

Relations between executive functions and academic outcomes in elementary school children: A meta-analysis

The primary goal of this study was to examine developmental patterns among the relations between components of executive function (EF; working memory [WM], inhibitory control, shifting), and academic outcomes (reading, mathematics, language) in elementary school-age children. These relations were examined within the context of the development of EF and of academic skills utilizing an extension of the unity and diversity, intrinsic cognitive load, and dual process theories. Using meta-analytic methods, we summarized results from 299 studies from 293 articles/dissertations, representing 65,605 elementary school-age children (42-191 months old [M = 101 months, SD = 24.49 months]). Results indicated that accounting for general EF (by including the correlations among EF tasks in meta-analytic path models and accounting for effects between all three EF components and academic outcomes simultaneously) produced weaker relations between EF and academic skills than the bivariate relations which have been reported in prior meta-analytic reviews. However, although reduced, all relations between EF and academic outcomes remained significant throughout elementary school. Whereas WM was consistently moderately associated with reading, math, and oral language across development, the developmental trends for the relations between inhibitory control and shifting with academic outcomes varied based upon the academic skill examined. On the academic side, whereas the relations between reading and language skills with EF components varied throughout elementary school, few developmental changes were found in the relations between EF components and math skills across elementary school. Future directions and implications of findings for the conceptualization of the impact of EF on academics are discussed within the context of relevant theoretical models. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Feasibility of the "Omega Kid" Study Protocol: A Double-Blind, Randomised, Placebo-Controlled Trial Investigating the Effect of Omega-3 Supplementation on Self-Regulation in Preschool-Aged Children

Self-regulation, the regulation of behaviour in early childhood, impacts children's success at school and is a predictor of health, wealth, and criminal outcomes in adulthood. Self-regulation may be optimised by dietary supplementation of omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs). The aim of the "Omega Kid" study is to investigate the feasibility of a protocol to investigate whether n-3 LCPUFA supplementation enhances self-regulation in preschool-aged children. The protocol assessed involved a double-blind, randomised, placebo-controlled trial of 12 weeks duration, with an intervention of 1.6 g of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day (0.3 g EPA and 1.3 g DHA) in a microencapsulated powder compared to placebo. Children (n = 78; 40 boys and 38 girls) aged 3-5 years old were recruited and randomly allocated to the treatment (n = 39) or placebo group (n = 39). The HS-Omega-3 Index^® served as a manipulation check on the delivery of either active (n-3 LCPUFAs) or placebo powders. Fifty-eight children (76%) completed the intervention (28-30 per group). Compliance to the study protocol was high, with 92% of children providing a finger-prick blood sample at baseline and high reported-adherence to the study intervention (88%). Results indicate that the protocol is feasible and may be employed in an adequately powered clinical trial to test the hypothesis that n-3 LCPUFA supplementation will improve the self-regulation of preschool-aged children.

The Relationship between Emotion Regulation and Emotion Knowledge in Preschoolers: A Longitudinal Study

Numerous studies have shown the important role of both emotion regulation (ER) and emotion knowledge (EK) in child development. Despite the number of studies carried out on both variables, there is practically no research on the developmental relationship between these two constructs. We present a longitudinal study to explore the relationship between EK and ER in preschoolers in which we measured these variables over 3 academic years in a cohort of 108 preschool children using the Test of Emotion Comprehension (TEC) and the Emotion Regulation Checklist (ERC). The ERC is divided into 2 subscales: Emotional Regulation (ER) and Lability/Negativity (L/N). Two cross-lagged models were constructed in order to examine the predictive power of ER and L/N on EK across the three time points. The results suggest that ER is an ability that precedes and predicts EK during preschool years. We also discuss the theoretical and practical implications of these findings.

Prenatal risk and physical aggression during the first years of life: The gender-specific role of inhibitory control

Prenatal risk and a lack of inhibitory control have consistently been related to the development of physical aggression in older children. This study examined whether inhibitory control mediated the relation between prenatal risk and aggression in infants and toddlers. The role of gender in this mediation model was also examined. The sample consisted of 161 mother-child dyads (83 boys). A prenatal cumulative risk score was created from a number of well-established risk factors including maternal psychopathology, substance use, and social and socioeconomic disadvantages. At 12 months, children performed an inhibitory control task. Physical aggression was assessed through maternal reports at 12 and 20 months of age. Results showed that higher prenatal risk was associated with more physical aggression. Inhibitory control mediated this association at both 12 and 20 months: higher prenatal risk was related to lower inhibitory control, which in turn led to higher aggression. At 20 months, gender moderated the mediation effect: the mediating role of inhibitory control was only found for girls. These results suggest that even before 2 years of age, inhibitory control is an important construct involved in the relation between prenatal risk and physical aggression.

Longitudinal associations between inhibitory control and externalizing and internalizing symptoms in school-aged children

Inhibitory control (IC) deficits have been associated with psychiatric symptoms in all ages. However, longitudinal studies testing the direction of the associations in childhood are scarce. We used a sample of 2,874 children (7 to 9 years old) to test the following three hypotheses: (a) IC deficits are an underlying risk factor with a potentially causal role for psychopathology, (b) IC deficits are a complication of psychopathology, and (c) IC deficits and psychopathology are associated at the trait level but not necessarily causally related. We used the go/no-go task to assess IC, the parent-rated Strengths and Difficulties Questionnaire to evaluate externalizing/internalizing symptoms, and the random intercepts cross-lagged panel model to test the hypotheses. The results showed no support for the underlying risk factor hypothesis, suggesting that IC unlikely has a causal role in this age group's psychopathology. The complication hypothesis received support for externalizing symptoms, suggesting that externalizing symptoms may hamper the normal development of IC. IC deficits and both externalizing and internalizing symptoms were correlated at the trait level, indicating a possible common origin. We suggest that it may be useful to support children with externalizing symptoms to promote and protect their IC development.

Sex Differences in the Association between Household Chaos and Body Mass Index z-Score in Low-Income Toddlers

Background: Associations between household chaos and childhood overweight have been identified, but the mechanisms of association are not clearly established in young children, with some studies linking higher chaos to increased obesity risk, whereas other studies link higher chaos to lower obesity risk. Given the lack of consistent findings and early sex differences in vulnerability to chaos, we examined child sex as a moderator of the chaos-child overweight association. We also tested these associations with self-regulation, as self-regulation has been implicated in understanding the chaos-obesity risk association in low-income toddlers. Methods: Parent-reported household chaos and observed child self-regulation were collected at baseline [n = 132; M age 23.0 months (standard deviation 2.8)]. Children's body mass index z-score (BMIz) was measured at 33 months. Multivariate linear regression models were used to assess whether child sex moderated the chaos-BMIz association. A three-way interaction between chaos, child sex, and self-regulation was also tested. Results: Child sex moderated the chaos-BMIz association (b = -0.11, p = 0.04) such that chaos was positively associated with BMIz among boys (b = 0.12, p = 0.003), but unrelated in girls (b = 0.01, p = 0.78). A three-way interaction with self-regulation indicated that a positive chaos-BMIz association existed only for boys with average (b = 0.12, p = 0.004) and low (b = 0.22, p < 0.001) self-regulation. Conclusions: Boys with poor self-regulation may be particularly vulnerable to obesogenic effects of chaotic households.

Neurobehavioral Outcomes in School-Aged Children with Primary Snoring

OBJECTIVE

We assess behavioral and attentional problems and neurocognitive functioning in school-aged children with primary snoring (PS).

METHODS

Seventeen children with PS and 27 non-snoring peers aged 6-10 years took part in the study. All children underwent a polysomnography (PSG) at the Sleep Laboratory. Snoring was defined by parents and with PSG. Children with obstructive sleep apnea were excluded. The parents completed the Sleep Disturbance Scale for Children. Parents and teachers assessed behavioral and attentional problems with the Child Behavior Checklist and the Conners' Rating Scale-Revised. Neuropsychological assessment included the Wechsler Intelligence Scale for Children and the Developmental Neuropsychological Assessment (NEPSY test).

RESULTS

The PS group had significantly more parent-reported internalizing, total, and attentional problems than the control group. Teachers did not report behavioral problems in the PS group. The PS and control groups had equal IQ scores and similar core neurocognitive functions, except for one visuospatial subtest. The PS group had significantly more inspiratory flow limitation and increased diaphragmatic electromyography compared with the controls. Parents reported significantly more daytime sleepiness in the PS group. Daytime sleepiness and snoring time were consistently associated with more behavioral and attentional problems. Flow limitation and more oxygen saturation values under 90% were associated with attentional problems, higher oxygen desaturation index, and lower mean oxygen saturation percentage with reduced language functions.

CONCLUSIONS

Snoring with an increase in respiratory effort without apneas and hypopneas and parent-reported daytime sleepiness may be linked to daytime symptoms. School-aged children with PS are at risk for behavioral and attentional problems, but not cognitive impairments.

Selbstregulation als Mediator für den Zusammenhang zwischen Erziehung und der Entwicklung von Verhaltensproblemen und sozial-emotionalen Kompetenzen bei Grundschulkindern

Zusammenfassung. Der Einfluss elterlicher Erziehung auf die Entwicklung von externalisierenden Verhaltensproblemen und sozial-emotionalen Kompetenzen bei Kindern wurde in vielzähligen Studien hervorgehoben. Zu den erklärenden Mechanismen für diese Zusammenhänge liegen bisher nur wenige Erkenntnisse vor. Das Ziel dieser Studie ist es, die Rolle der kindlichen Selbstregulation als möglichen Mediator für den Einfluss von den Erziehungsstilen Liebe, Strenge und Selbstständigkeit auf die Entwicklung von sozial-emotionalen Kompetenzen und externalisierenden Problemverhaltensweisen zu untersuchen. Die vorliegenden Pfadanalysen basieren auf Fragebogendaten über N = 445 Kinder und ihre Familien. Die Ergebnisse dieser Studie zeigen indirekte Effekte für die Zusammenhänge zwischen dem Erziehungsstil und kindlichen Verhaltensproblemen und Kompetenzen auf. Die Fähigkeit zur Selbstregulation kann in dieser Beziehung als eine Art Weiche für die Entwicklung von Kindern verstanden werden.

The longitudinal interplay of emotion understanding, theory of mind, and language in the preschool years

Emotion comprehension (EC), theory of mind (ToM), and language are particularly important aspects of child development. In recent years, there has been increasing interest in understanding how these three variables are related to preschool children. However, results have been contradictory, and it is not clear how EC, ToM, and language are associated. The aim of this study was to analyze the relationships among EC, ToM, and language through a longitudinal study. Participants were 105 children (49 girls and 56 boys). EC, ToM, and language skills were assessed when children were 3, 4, and 5 years old. The cross-lagged model confirmed that EC preceded ToM in time. The half-longitudinal model showed that linguistic skills at 4 years old mediated the relationship between EC at 3 years old and ToM at 5 years old. These findings provide important insights into the complex relationships among EC, ToM, and language. Developmental, educational, and clinical implications of the results are discussed.

Executive Functions and Externalizing Symptoms: Common and Unique Associations

In discussing the four papers in this special issue, we provide our perspective on the authors' contributions and suggest directions for future research. First, we highlight the usefulness of the bi-factor model for investigating relations among specific aspects of executive functions (EFs) and externalizing symptoms. Next, we examine the role of EFs as a protective factor that can moderate the relation between risk factors - specifically, callous-unemotional behaviors - on externalizing symptoms. And finally, we address the contributions of innovative measurement approaches to understanding the relations between EFs and externalizing symptoms, using the state-space grid methodology as an example.

Dimensions of deprivation and threat, psychopathology, and potential mediators: A multi-year longitudinal analysis

Prior research demonstrates a link between exposure to childhood adversity and psychopathology later in development. However, work on mechanisms linking adversity to psychopathology fails to account for specificity in these pathways across different types of adversity. Here, we test a conceptual model that distinguishes deprivation and threat as distinct forms of childhood adversity with different pathways to psychopathology. Deprivation involves an absence of inputs from the environment, such as cognitive and social stimulation, that influence psychopathology by altering cognitive development, such as verbal abilities. Threat includes experiences involving harm or threat of harm that increase risk for psychopathology through disruptions in social-emotional processing. We test the prediction that deprivation, but not threat, increases risk for psychopathology through altered verbal abilities. Data were drawn from the Child Development Project (N = 585), which followed children for over a decade. We analyze data from assessment points at age 5, 6, 14, and 17 years. Mothers completed interviews at age 5 and 6 on exposure to threat and deprivation experiences. Youth verbal abilities were assessed at age 14. At age 17, mothers reported on child psychopathology. A path analysis model tested longitudinal paths to internalizing and externalizing problems from experiences of deprivation and threat. Consistent with predictions, deprivation was associated with risk for externalizing problems via effects on verbal abilities at age 14. Threat was associated longitudinally with both internalizing and externalizing problems, but these effects were not mediated by verbal abilities. Results suggest that unique developmental mechanisms link different forms of adversity with psychopathology. (PsycINFO Database Record

Talking Tots and the Terrible Twos: Early Language and Disruptive Behavior in Toddlers

OBJECTIVE

The goal of this article is to investigate the association between the 2 most commonly reported parental concerns about young children-disruptive behavior (e.g., irritable, aggressive, and noncompliant behaviors) and language delay in toddlers. To test for salient subgroup differences, individual differences by the sex of the child and family poverty status were examined.

METHODS

Participants included 1259 mothers of children between 18 and 36 months of age. Mothers completed questions about their child's language development and disruptive behavior. Information regarding poverty status as well as child age and sex were also collected.

RESULTS

Stronger language skills were associated with fewer disruptive behaviors for children between 18 and 36 months of age. This negative association was stronger for females than for males (b = -0.243; t[1251] = -3.555; p < 0.001) and stronger for children living in poverty than for those above the poverty line (b = -2.04; t[1251] = -2.531; p = 0.011).

CONCLUSION

Findings from our study suggest a developmental co-occurrence pattern that begins at a very early age. Individual differences suggest that there is substantial heterogeneity in these patterns; longitudinal investigation is needed to uncover causal pathways and underlying mechanisms. Awareness of the association between these 2 developmental domains, about which parents frequently express concerns, is critical to maximizing early detection and intervention.

Effects of the EXAT neuropsychological multilevel intervention on behavior problems in children with executive function deficits

This is a clinical intervention study of children with executive function (EF) deficits. A neuropsychological multimodal group intervention called EXAT (rehabilitation of EXecutive function and ATtention) was developed at the Psychology Clinic of the University of Tampere. Based on the principles of neuropsychological rehabilitation and behavioral modification, EXAT combines child group training, parent training, and teacher consultations. The aims of this study were to investigate behavior problems before and after the intervention in children attending EXAT and in controls, and to compare intervention effects in hyperactive, inattentive, and EF subgroups based on the primary deficit described in the referral. The participants were 86 children (6-12 years) with a mean IQ of 91.4 attending EXAT and 45 controls. The participants' parents and teachers completed the Conners' Rating Scales-Revised. In addition, the Strengths and Difficulties Questionnaire was completed by the parents attending EXAT. The parents reported statistically significant decreases with medium effect sizes for the CPRS-R subscales for impulsivity, hyperactivity, and oppositional behavior. In the controls within the same time interval, there was increase in restless and impulsive behavior, and a decrease in total problems. The teachers reported positive changes after the intervention in ADHD symptoms and anxiousness/shyness, but the effects sizes were small. The intervention effects were larger in the hyperactive subgroup. Positive intervention effects were related to a younger age, lower IQ, and simultaneous learning support. In conclusion, EXAT - a structured multilevel group intervention - has positive effects on children's behavior regulation skills by decreasing impulsivity and restless behavior.

Prenatal and postnatal polybrominated diphenyl ether (PBDE) exposure and measures of inattention and impulsivity in children

Exposure to polybrominated diphenyl ethers (PBDEs) during fetal development may be associated with deficits in attention and impulse control. However, studies examining postnatal PBDE exposures and inattention and impulsivity have been inconsistent. Using data from 214 children in the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort with enrollment from 2003 to 2006 in the Greater Cincinnati Area, we investigated the relationship of both prenatal and postnatal PBDE exposures with attention and impulse control. Serum PBDEs were measured at 16±3weeks of gestation and during childhood at 1, 2, 3, 5, and 8years. We assessed children's attention and impulse control using the Conners' Continuous Performance Test-Second Edition (CPT-II) at 8years. We used multiple informant models to estimate associations of repeated PBDE measures with inattention and impulsivity. There was a pattern of associations between PBDEs and poorer performance on CPT-II measures of attention. For BDE-153, adverse associations extended to exposures at preschool and kindergarten ages; ten-fold increases in exposure were associated with higher omission errors (BDE-153 at 3years: β=4.0 [95% CI: -2.4, 10.5]; at 5years: β=4.6 [95% CI: -2.8, 12.0]; at 8years: β=4.1 [95% CI: -3.4, 11.5]). Longer hit reaction times, indicated by the exponential part of the hit reaction curve, were also observed with 10-fold increases in BDE-153 during the prenatal period and throughout childhood (Prenatal: β=15.0 milliseconds (ms) [95% CI: -15.8, 45.8]; 5years: β=20.6ms [95% CI: -20.8, 61.9]; 8years: β=28.6ms [95% CI: -12.1, 69.4]). Significant impairment in discriminability, as indicated by detectability (d'), between targets and non-targets was also noted with 5 and 8-year PBDE concentrations. Associations between PBDEs and inattention significantly differed by child sex, with males performing more poorly than females with regard to omission errors and measures of reaction times. Collectively, these results do not strongly support that PBDEs are associated with poorer impulse and attention control among 8year old children. However, there may be a possible relationship between prenatal and concurrent PBDEs and inattention, which requires additional research.