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Ferrara AM, Panlilio CC, Tirrell-Corbin C. Exploring School Professionals' Definitions of Childhood Trauma. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:783-793. [PMID: 37593060 PMCID: PMC10427587 DOI: 10.1007/s40653-023-00550-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Little is known about school professionals' definitions of trauma outside of the context of trauma-informed school trainings. METHODS The present study used thematic analysis to explore school professionals' open-ended definitions of childhood trauma (N = 1271). Follow-up chi-square tests of independence were used to investigate differences in professionals' definitions based on their professional role and education. RESULTS Five themes were identified: effects of trauma, events of trauma, solutions to trauma, emotional responses, and no knowledge. Effects of trauma and events of trauma contained ten and five subthemes, respectively. School professionals who identified long-term effects of trauma on students most commonly listed general negative effects (e.g., "An experience or event that can negatively impact that child") instead of effects on specific domains such as behavior or emotions (e.g., "An experience that negatively impacted a child emotionally"). School professionals who identified an event of trauma most commonly provided examples of trauma (e.g., child maltreatment) or a general definition of trauma. School professionals' roles and education were somewhat related to their definitions of childhood trauma. Findings suggest that childcare providers and professionals without a bachelor's degree have gaps in their knowledge of child trauma. CONCLUSIONS These results suggest school professionals have some foundational knowledge about trauma, but it is not universal. To best serve school professionals working with this vulnerable population of students, researchers and practitioners should design future trauma-informed professional development opportunities around school professionals' prior knowledge and understanding of trauma as well as their potential misunderstandings of trauma.
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Affiliation(s)
- Amanda M. Ferrara
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, 228 CEDAR Building University Park, Pennsylvania, PA 16802 USA
| | - Carlomagno C. Panlilio
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, 228 CEDAR Building University Park, Pennsylvania, PA 16802 USA
| | - Christy Tirrell-Corbin
- Department of Human Development and Quantitative Methodology, University of Maryland, 3304 Benjamin Building College Park, Maryland, MD 20742 USA
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Panlilio CC, Dube SR, Corr C. A framework for promoting learning and development in the context of adversity: An introduction to the special issue. CHILD ABUSE & NEGLECT 2023; 142:106176. [PMID: 37059648 DOI: 10.1016/j.chiabu.2023.106176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
- Carlomagno C Panlilio
- Department of Educational Psychology, Counseling, and Special Education, Child Maltreatment Solutions Network, Social Science Research Institute, The Pennsylvania State University, University Park, PA, USA.
| | - Shanta R Dube
- Department of Public Health, Levine College of Health Sciences, Wingate University, Wingate, NC, USA
| | - Catherine Corr
- Department of Special Education, University of Illinois, Urbana-Champaign, IL, USA
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Mullins C, Panlilio CC. Adversity, Engagement, and Later Achievement: The Role of Emotion Regulation and Parent-Child Relationship Quality. CHILDREN AND YOUTH SERVICES REVIEW 2023; 148:106862. [PMID: 36936747 PMCID: PMC10022495 DOI: 10.1016/j.childyouth.2023.106862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Students who have experienced adversity tend to demonstrate poorer academic outcomes than their non-maltreated peers. Academic engagement, a multidimensional, motivational construct, associated with a myriad of positive academic outcomes is an important academically-related mechanism that can be leveraged to improve the outcomes of this population. Objective The present study aimed to better understanding of how engagement develops in the context of adversity by exploring the effects emotion regulation skills and parent-child relationships have on engagement development. Participants and setting Analyses were conducted on 795 participants in the NSCAW dataset. Methods Path analysis was used to estimate mediation and moderated mediation models. Results Emotion regulation skills significantly mediated the effect experiencing trauma symptoms had on engagement. Parent-child relationship quality moderated the mediation effect emotion regulation skills had on the relationship between experiencing trauma symptoms and engagement. Conclusions Emotion regulation skills and parent-child relationship quality are potential intervention targets to improve engagement for students who have experienced adversity.
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Affiliation(s)
- Casey Mullins
- University of Miami, Department of Psychology, Department of Educational Psychology, Counseling, and Special Education
| | - Carlomagno C. Panlilio
- The Pennsylvania State University’ Department of Educational Psychology, Counseling, and Special Education
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Yoon S, Pei F, Logan J, Helsabeck N, Hamby S, Slesnick N. Early childhood maltreatment and profiles of resilience among child welfare-involved children. Dev Psychopathol 2023; 35:711-723. [PMID: 35129106 PMCID: PMC9357229 DOI: 10.1017/s0954579421001851] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Given the high burden of child maltreatment, there is an urgent need to know more about resilient functioning among those who have experienced maltreatment. The aims of the study were to: 1) identify distinct profiles of resilience across cognitive, emotional, behavioral, and social domains in young children involved in the child welfare system; and 2) examine maltreatment characteristics and family protective factors in relation to the identified resilience profiles. A secondary analysis was conducted using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Latent profile analysis was performed on a sample of 827 children aged 3-5 years (46% girls, Mean age = 3.96). Three distinct resilience profiles were identified: 1) low cognitive resilience (24%); 2) low emotional and behavioral resilience (20%); and 3) multidomain resilience (56%). Caregiver cognitive stimulation, no out-of-home placement, higher caregiver education level, older child age, and being a girl were associated with the multidomain resilience profile. The findings provide empirical support for the multifaceted nature of resilience and suggest that practitioners need to help children achieve optimal and balanced development by assessing, identifying, and targeting those domains in which children struggle to obtain competence.
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Affiliation(s)
- Susan Yoon
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Fei Pei
- College of Social Work, The Ohio State University, Columbus, OH, USA
- School of Social Work, Falk College, Syracuse University, Syracuse, NY, USA
| | - Jessica Logan
- Quantitative Research, Evaluation and Measurement, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Nathan Helsabeck
- Quantitative Research, Evaluation and Measurement, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Sherry Hamby
- Department of Psychology, The University of the South, Sewanee, TN, USA
- Life Paths Research Center, Sewanee, TN, USA
| | - Natasha Slesnick
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
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The Longitudinal Associations of Household Economic Pressure and Home Chaos with Children’s Executive Functioning, Word Reading, and School Readiness. CHILD & YOUTH CARE FORUM 2023. [DOI: 10.1007/s10566-023-09733-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Cheng F, Hu C, Zhang W, Xie H, Shen L, Wang B, Hu Z, Wang Y, Yu H. The influence of parenting style and coping behavior on nonsuicidal self-injury behavior in different genders based on path analysis. PeerJ 2022; 10:e14507. [PMID: 36523466 PMCID: PMC9745924 DOI: 10.7717/peerj.14507] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 11/13/2022] [Indexed: 12/14/2022] Open
Abstract
Background Nonsuicidal self-injury (NSSI) behaviors-an important factor that profoundly affects the physical and mental health of young people-are induced by complex and diverse factors, while showing significant differences at the gender level. We examined mediating behaviors among parenting styles, students' coping styles, and endogenous and exogenous influencing variables of adolescents' NSSI behaviors. Methods In this cross-sectional study, Secondary school students in Ningbo, Zhejiang Province, China (n = 2,689; F/M:1532/1157) were surveyed for basic attributes, parenting styles, coping styles, and NSSI behaviors. After the initial screening of the sample data, several external derivatives were screened based on the single factor analysis method. On this basis, the construction of path analysis models under multivariate multiple elicitations was carried out. Results The overall prevalence of NSSI was 15.16%, and the incidence of NSSI in boys was lower than that in girls (OR = 0.334, 95% CI [0.235-0.474]). The path analysis model data fit well; the indicators of female and male part are: CFI = 0.913/0.923, GFI = 0.964/0.977, SRMR = 0.055/0.047, RMSEA = 0.097/0.069 with 90% confidence interval (CI) [0.084-0.111]/[0.054-0.084]. For female, when negative coping style and extreme education affect NSSI respectively, the standardized path coefficient values are 0.478 (z = 20.636, P = 0.000 < 0.01) and 0.151 (z = 6.524, P = 0.000 < 0.01) respectively, while for male, the corresponding values become 0.225 (z = 7.057, P < 0.001) and 0.104 (z = 3.262, P < 0.001). Conclusion In particular, we investigated the mediating effects of gender-specific NSSI influences and found that NSSI behaviors were strongly associated with environmental variables and individual factors, especially family parenting style and adolescent coping style, which influenced NSSI in a gender-specific manner. The results showed that males were the target of both positive and negative parenting styles, whereas females were more likely to choose negative coping styles directed towards emotions in response to external stimuli, and instead showed a more significant predisposition towards NSSI behaviors. This phenomenon seems to be influenced by multilevel factors such as sociocultural, individual value identity, and physiological structure differences. In the path analysis model with the introduction of mediating effects, the influence of gender differences on NSSI behavior becomes more pronounced under the interaction of multiple factors: women seem to be more significantly influenced by the external derivatives in the internal derivatives than male subjects, and are more likely to trigger NSSI behavior under the interaction of multiple factors. These findings effectively reveal the significant role of different end-influencing factors in NSSI behaviors at the level of gender differences, which can provide effective theoretical support to prevent and treat NSSI behaviors in adolescents.
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Affiliation(s)
- Fang Cheng
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, China
| | - Changzhou Hu
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, China
| | - Wenwu Zhang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, China
| | - Huabing Xie
- Department of General Medicine, People’s Hospital of Wuhan University, Wuhan, China
| | - Liangliang Shen
- School of Chemical Engineering, Dalian University of Technology, Dalian, China
| | - Beini Wang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, China
| | - Zhenyu Hu
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, China
| | - Yucheng Wang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, China
| | - Haihang Yu
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, China
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Ferrara AM, Mullins CA, Ellner S, Van Meter P. Early child maltreatment and reading processes, abilities, and achievement: A systematic review. CHILD ABUSE & NEGLECT 2022:105857. [PMID: 36089407 DOI: 10.1016/j.chiabu.2022.105857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 08/08/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Children with maltreatment histories demonstrate weaker reading abilities compared to their peers. However, the differential processes driving this effect remain unclear. Prior studies focused on social and behavioral factors explaining this effect, yet reading research has shown that one's ability to comprehend written text is driven by a set of underlying dynamic and interactive cognitive abilities. OBJECTIVE This systematic review sought to understand what theoretical or conceptual frameworks researchers cited as guiding their studies, what reading processes and abilities were studied as outcomes, how reading processes or abilities were measured, and what constructs were included to help understand the relationship between maltreatment and reading. METHOD Three databases were searched for empirical peer-reviewed journal articles. Articles retained using inclusion and exclusion criteria were coded based on their sample characteristics, reference to theoretical or conceptual frameworks, reading processes and abilities measured, and included predictors of reading. Procedures were documented using the reporting items for systematic reviews and meta-analyses (PRISMA) statement (Moher et al., 2009). RESULTS Twenty-seven studies were included in the final systematic review. Those that discussed theoretical or conceptual frameworks focused on the social and behavioral predictors of reading. Many studies (51.9 %) examined effects of maltreatment on reading achievement, rather than specific reading processes or abilities. Most studies (92.6 %) used at least one standardized reading measure. However, only four studies included cognitive abilities as potential predictor variables. CONCLUSIONS Future research could benefit from investigating specific cognitive and reading-related processes, using measures to examine specific reading processes leading to breakdowns in reading achievement, and incorporation of reading theories to drive research questions and methods.
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Affiliation(s)
- Amanda M Ferrara
- 125 CEDAR Building, The Pennsylvania State University, Department of Educational Psychology, Counseling, and Special Education, University Park, PA 16802, USA.
| | - Casey A Mullins
- 125 CEDAR Building, The Pennsylvania State University, Department of Educational Psychology, Counseling, and Special Education, University Park, PA 16802, USA.
| | - Samantha Ellner
- 125 CEDAR Building, The Pennsylvania State University, Department of Educational Psychology, Counseling, and Special Education, University Park, PA 16802, USA.
| | - Peggy Van Meter
- 226 CEDAR Building, The Pennsylvania State University, Department of Educational Psychology, Counseling, and Special Education, University Park, PA 16802, USA.
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Trauma-Informed Attitudes, Teacher Stress, and Expulsion Decision Risk in Preschool Classrooms. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-022-09513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Stoop TB, Cole PM. Listening in: An Alternative Method for Measuring the Family Emotional Environment. Clin Child Fam Psychol Rev 2022; 25:151-165. [PMID: 35201541 PMCID: PMC8957590 DOI: 10.1007/s10567-022-00392-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/03/2022]
Abstract
The family emotional environment influences children's development of emotion regulation in various ways. Children's difficulties with effectively regulating emotions, in turn, can contribute to the development of psychopathology. However, the pathways that explain how environmental emotion-including overheard emotion among family members-influences children's development of healthy or problematic emotion regulation are unclear. In this article, we briefly discuss the most common methods (e.g., questionnaires, laboratory observations) used to assess emotion in the family. We consider the benefits and limitations of these methods and discuss the need for objective measurement of the family emotional environment. We include a description of the Electronically Activated Recorder (EAR), which provides unobtrusive, extended sampling of the emotional tone of family interaction in the home. We present preliminary evidence of its use with 7- and 8-year-old and their families during one day at home. The method reveals that objectively assessed parent-to-parent interactions that are negatively toned, but not parental self-report of conflict or expressivity, are associated with children's self-reported emotional reactions to hearing independently recorded clips of their mothers' voices during simulated angry interactions. The finding suggests unique contributions of objective, unobtrusive, extended measurement of the family emotional environment to understanding aspects of children's emotional development that may not be captured with other commonly used methods. We discuss future directions that explore how EAR may be used to further our knowledge of the pathways between environmental emotion as a risk factor that influences children's emotional functioning and their psychological well-being.
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Conceptualizing Emotion Regulation and Coregulation as Family-Level Phenomena. Clin Child Fam Psychol Rev 2022; 25:19-43. [PMID: 35098427 PMCID: PMC8801237 DOI: 10.1007/s10567-022-00378-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 11/05/2022]
Abstract
The ability to regulate one’s emotions is foundational for healthy development and functioning in a multitude of domains, whereas difficulties in emotional regulation are recognized as a risk factor for a range of adverse outcomes in childhood, adolescence, and adulthood. Caregivers play a key role in cultivating the development of emotion regulation through coregulation, or the processes by which they provide external support or scaffolding as children navigate their emotional experiences. The vast majority of research to date has examined coregulation in the context of caregiver–child dyads. In this paper, we consider emotion regulation and coregulation as family-level processes that unfold within and across multiple family subsystems and explore how triadic and whole family interactions may contribute to the development of children’s emotion regulation skills. Furthermore, we will examine the implications of a family-centered perspective on emotion regulation for prevention of and intervention for childhood emotional and behavioral disorders. Because emotion regulation skills undergo such dramatic maturation during children’s first several years of life, much of our focus will be on coregulation within and across the family system during early childhood; however, as many prevention and intervention approaches are geared toward school-aged children and adolescents, we will also devote some attention to later developmental periods.
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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Panlilio CC, Harring JR, Harden BJ, Morrison CI, Duncan AD. Heterogeneity in the dynamic arousal and modulation of fear in young foster children. CHILDREN AND YOUTH SERVICES REVIEW 2020; 116:105199. [PMID: 32831446 PMCID: PMC7430554 DOI: 10.1016/j.childyouth.2020.105199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Guided by emotional security theory, we explored how child and context-related factors were associated with heterogeneity in young foster children's organized patterns of fear response to distress. Results from group-based trajectory modeling used to analyze observational data from a fear-eliciting task showed that children from our sample (mean age = 62 months, SD = 9) were classified into 3 specific fear regulation patterns differentiated by the emotional response parameters of onset intensity, peak intensity, and rise time. A descriptive examination of child's emotion knowledge, aggressive behaviors, and attention problems, as well as length of time in current foster home, placement transitions, and caregiver responsiveness and modeling showed class-specific differences in means. Moreover, the likelihood of class membership was significantly predicted by children's emotion knowledge, aggressive behaviors, and foster mothers' responsiveness and modeling of appropriate boundaries. Results show promising support for the implementation of individualized, child-directed interventions targeting specific patterns of response parameters of emotion regulation for young foster children. Further, parenting intervention services need to promote the emotion socialization skills of foster parents that are tailored toward each specific trajectory pattern of emotion arousal and modulation.
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Affiliation(s)
- Carlomagno C. Panlilio
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, USA
| | - Jeffrey R. Harring
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
| | - Brenda Jones Harden
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
| | - Colleen I. Morrison
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
| | - Aimee Drouin Duncan
- Department of Human Development & Quantitative Methodology, University of Maryland, College Park, USA
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Fung WK, Chung KKH, Lam ICB, Li NX. Bidirectionality in kindergarten children's school readiness and emotional regulation. SOCIAL DEVELOPMENT 2020. [DOI: 10.1111/sode.12434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Wing Kai Fung
- Department of Early Childhood Education The Education University of Hong Kong Hong Kong China
| | - Kevin Kien Hoa Chung
- Department of Early Childhood Education The Education University of Hong Kong Hong Kong China
| | - Ian Chun Bun Lam
- Department of Early Childhood Education The Education University of Hong Kong Hong Kong China
| | - Nicky Xiaomin Li
- Department of Early Childhood Education The Education University of Hong Kong Hong Kong China
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Whitgob EE, Loe IM. Impact of Chronic Medical Conditions on Academics of Children in the Child Welfare System. Front Public Health 2018; 6:267. [PMID: 30294595 PMCID: PMC6158376 DOI: 10.3389/fpubh.2018.00267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/28/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: Children in the Child Welfare System (CWS) are at high risk for multiple adverse outcomes. Since involvement in CWS and having a chronic medical condition are both risk factors for poor academic achievement, a logical view is that the combination is additive, increasing the odds of poor performance. However, several factors may complicate such an association. This study explores negative and positive factors that could affect academic achievement in children in CWS with chronic medical conditions. Method: In a secondary data analysis of a nationally representative, longitudinal sample of children in CWS (N = 5,501), subjects were divided into three groups based on chronic medical condition: High Prevalence, Low Severity (HPLS; asthma, eczema, allergy, diabetes), Other (OTH; all other chronic conditions, including those with primary central nervous system involvement), and NONE (children with no chronic condition). Using weighted analyses, hierarchical logistic regression models addressed factors associated with academic achievement. Predictor variables included chronic condition group, sex, income level, case substantiation, home placement, and school engagement. Intelligence quotient was a covariate. Outcome variables were strong performances for reading and math, defined by standard score ≥85. Results: In TOTAL group, 80% had strong reading; more in HPLS (85%) vs. NONE (79%) and OTH (80%), adjusted F = 433, p < 0.001. In TOTAL group, 67% had strong math; more in NONE (68%) and HPLS (68%) vs. OTH (60%), adjusted F = 1,278, p < 0.001. Models predicting to strong reading and math achievement were significant, R 2 = 0.51, p < 0.001 and R 2 = 0.43, p < 0.001, respectively. HPLS had increased odds of strong reading achievement (aOR 1.3, 95% CI 1.3-1.4); both HPLS and OTH had lower odds of strong math achievement (aOR 0.87 and 0.76), p < 0.001, respectively. Male sex had lower odds of strong reading (aOR 0.44) and math achievement (aOR 0.62); positive school engagement had higher odds of strong reading (aOR 1.18) and math achievement (aOR 2.04), all p < 0.001. Conclusion: If true, our findings challenge the general belief that chronic illness can only be associated with negative outcomes and that cumulative adversities are simply additive in terms of risk. Increased contact with the medical system may provide an opportunity for improving reading achievement for children in CWS and promoting positive school engagement.
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Lynch FL, Dickerson JF, Pears KC, Fisher PA. Cost Effectiveness of a School Readiness Intervention for Foster Children. CHILDREN AND YOUTH SERVICES REVIEW 2017; 81:63-71. [PMID: 29276324 PMCID: PMC5737933 DOI: 10.1016/j.childyouth.2017.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Many young children in foster care suffer from emotional and behavior problems due to neglect and abuse. These problems can lead to difficulties in school, and functioning in school is linked to long-term health and development. Early intervention to reduce emotional and behavioral issues can help children successfully transition to school, which can improve long-term outcomes. However, communities need information on relative costs and benefits associated with programs to make informed choices. The objective of this study was to assess cost effectiveness, over 12 months, of the Kids in Transition to School (KITS) intervention compared to usual services available to children in a foster care control group (FCC). METHOD Randomized controlled trial of 192 children in foster care entering kindergarten who were randomized to KITS (n = 102) or FCC (n = 90). KITS includes school readiness groups and parent training over 4 months. Main outcomes were days free from internalizing symptoms (IFD), days free from externalizing behavior (EFD), intervention costs, public agency costs, and incremental cost effectiveness. RESULTS KITS significantly increased IFD and EFD compared to FCC. Average total cost of the intervention was $932 per family. The intervention did not significantly impact usual services. Average incremental cost effectiveness was $64 per IFD and $63 per EFD. CONCLUSIONS The cost of KITS is comparable to, or less than, similar programs, and the intervention is likely to provide significant emotional and behavioral benefits and improvements in school readiness for young children in foster care.
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Affiliation(s)
- Frances L Lynch
- Center for Health Research, Kaiser Permanente Northwest, Portland
| | - John F Dickerson
- Center for Health Research, Kaiser Permanente Northwest, Portland
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