A Randomized Trial Examining the Effects of Conjoint Behavioral Consultation and the Mediating Role of the Parent–Teacher Relationship

Autism spectrum disorder: pathogenesis, biomarker, and intervention therapy

Autism spectrum disorder (ASD) has become a common neurodevelopmental disorder. The heterogeneity of ASD poses great challenges for its research and clinical translation. On the basis of reviewing the heterogeneity of ASD, this review systematically summarized the current status and progress of pathogenesis, diagnostic markers, and interventions for ASD. We provided an overview of the ASD molecular mechanisms identified by multi-omics studies and convergent mechanism in different genetic backgrounds. The comorbidities, mechanisms associated with important physiological and metabolic abnormalities (i.e., inflammation, immunity, oxidative stress, and mitochondrial dysfunction), and gut microbial disorder in ASD were reviewed. The non-targeted omics and targeting studies of diagnostic markers for ASD were also reviewed. Moreover, we summarized the progress and methods of behavioral and educational interventions, intervention methods related to technological devices, and research on medical interventions and potential drug targets. This review highlighted the application of high-throughput omics methods in ASD research and emphasized the importance of seeking homogeneity from heterogeneity and exploring the convergence of disease mechanisms, biomarkers, and intervention approaches, and proposes that taking into account individuality and commonality may be the key to achieve accurate diagnosis and treatment of ASD.

Social factors associated with self-reported changes in mental health symptoms among youth in the COVID-19 pandemic: a cross-sectional survey

BACKGROUND

Children and youth experienced marked impacts on day-to-day life in the COVID-19 pandemic that were associated with poorer familial and friend relationships, and greater mental health challenges. Few studies provide self-report data on mental health symptoms from children and youth themselves. We sought to examine the associations between social factors and child and youth self-reported symptoms of worsened mood, anxiety, and irritability during the COVID-19 pandemic.

METHODS

A nationally representative cross-sectional survey was administered online to collect self-report data across 10 Canadian provinces among children (11-14 years) and youth (15-18 years), April-May 2022. Age-appropriate questions were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. Associations between a priori defined social factors (e.g., relationship quality) and respondent self-reported mental health were evaluated using ordinal logistic regression models adjusted for age, sex, and geographic location.

RESULTS

We analyzed data from 483 (51.7%) children (11-14 years; 227, 47.0% girls) and 450 (48.3%) youth (15-18 years; 204, 45.3% girls). The parents of most children and youth had resided in Canada for over 20 years (678, 72.7%). Over one-quarter of children and youth self-identified as Black, Indigenous, or a Person of Color (134, 27.7%; 134, 29.8%, respectively). Over one-third of children and youth self-reported symptoms of worsened mood (149, 30.9%; 125, 27.8%, respectively), anxiety (181, 37.5%; 167, 37.1%, respectively), or irritability (160, 33.1%; 160, 35.6%, respectively) during, compared to pre-pandemic. In descending order of odds ratios (OR), for children and youth, worsened familial relationships (during compared to pre-pandemic) was associated with the self-reported symptoms of worsened mood (child: OR 4.22, 95%CI 2.51-6.88; youth: OR 6.65 95%CI 3.98-11.23), anxiety (child: OR 4.24, 95%CI2.69-6.75; youth: OR 5.28, 95%CI 3.17-8.86), and irritability (child: OR 2.83, 95%CI 1.76-4.56; youth: OR 6.46, 95%CI 3.88-10.90).

CONCLUSIONS

Self-reported data from a nationally representative sample of children and youth suggest strong associations between social factors and mental health during the COVID-19 pandemic. Interventions targeting child and youth familial relationships may positively impact child and youth mental health.

"They Were Saying That I Was a Typical Chinese Mum" : Chinese Parents' Experiences of Parent-Teacher Partnerships for Their Autistic Children

Effective parent-teacher partnerships improve outcomes for autistic students. Yet, we know little about what effective partnerships look like for parents of autistic children from different backgrounds. We conducted interviews with 17 Chinese parents of autistic children attending Australian kindergartens/schools to understand their experiences. Parents appreciated the acceptance, opportunities and supports they received in Australia. They had high expectations of children; expectations not often shared by educators. Parents were respectful of teachers' expertise and polite and undemanding in interactions. Nevertheless, parents were frustrated by inconsistent teaching quality and inadequate communication. Navigating systems was also challenging and parents faced discrimination from teachers and their community. Recommendations include fostering open home-school communication, proactively seeking parents' expertise about children and explicitly scaffolding parents' self-advocacy.

Examining Conjoint Behavioral Consultation to Support 2e-Autism Spectrum Disorder and Gifted Students in Preschool with Academic and Behavior Concerns

Conjoint behavioral consultation (CBC), as adjusted for 2e children with academic and behavioral difficulties, was the focus of this single-subject design study. Three young children from a preschool participated, together with their parents and teachers. Academic enablers for students-intervention, maintenance, and generalization phases; academic and behavioral competencies-intervention, maintenance, and generalization phases; and teachers', parents', and students' perceptions of the intervention's social validity data were collected among the outcome measures. Findings from multiple participant-related probes pointed to constructive improvements in the phases of intervention, maintenance for listening behavior, and improved on-task skill in intervention, maintenance, and generalization. Additionally, during the consultation, parents and teachers noted improvements in the outcomes of the target behavior such as rhythm keeping, picture-word matching, writing the pictured concept in Turkish, writing the pictured concept in English, short personal story writing, short personal story telling, and verbal math problem solving, and each stakeholder gave the intervention a grade for its social validity. Limitations, potential routes for future study, and implications for preschool CBC intervention are highlighted.

Referring students for professional psychological help: A qualitative study of teachers' experience in Hong Kong

Teachers have frequent interaction with students and are well positioned to refer students for mental health assistance when needed. Twelve secondary schoolteachers in Hong Kong were interviewed about their experience referring students to mental health professionals (MHPs). Using consensual qualitative research, multiple factors were found to influence teachers' referral decisions, including problem severity, students' willingness, stigma of help-seeking, parent/guardian's beliefs, teacher-parent/guardian relationship, MHPs' effectiveness and availability, quality of interaction with MHPs, and teachers' self-efficacy in handling student issues. Based on the findings, we propose a conceptual model of factors influencing teachers' referral decisions. Implications for research, practice, and training are discussed.

Instructional coaching actions that predict teacher classroom practices and student achievement

Although there is emerging evidence supporting the efficacy of instructional coaching models used to support teachers in schools, additional research is necessary to investigate the individual contributions of coaching actions for specific approaches. This study investigated the extent to which three coaching actions-modeling, practice, and feedback-provided during data-driven coaching predicted (a) teachers' intervention implementation fidelity, (b) teachers' use of evidence-based classroom strategies, and (c) class-wide student achievement. In addition, the study explored the potential mediating influence of teachers' intervention implementation fidelity on the relationship between coaching actions and teachers' use of evidence-based strategies. Participants included 16 instructional coaches, one from each of 16 high-poverty charter schools, and 133 coached K-12 classroom teachers assigned to 3649 students. Results from multiple regression analyses indicated that the provision of practice opportunities during coaching was a statistically significant predictor, with greater practice opportunities associated with greater teacher intervention implementation fidelity and greater class-wide student English Language Arts (ELA) and math achievement. Feedback during coaching predicted student ELA but not math achievement. Both practice and feedback opportunities predicted better teacher use of evidence-based classroom strategies. In addition, teachers' intervention implementation fidelity mediated the relationship between teacher practice opportunities and teachers' use of evidence-based classroom strategies. Modeling was not found to be a statistically significant predictor. Study limitations and implications for practice and future research are described.

Recommendations for Diversifying Racial and Ethnic Representation in Autism Intervention Research: A Crossover Review of Recruitment and Retention Practices in Pediatric Mental Health

Disparities in diagnosis and access to healthcare and therapeutic services are well-documented for children with autism spectrum disorder (ASD) from minoritized races and ethnicities, but there is little empirical research to guide the selection and implementation of interventions and practices that will effectively support racially/ethnically diverse children with ASD and their families. This cross-over systematic review summarizes parent-mediated intervention research of children with or at risk for mental health disorders to identify potentially effective recruitment and retention strategies for diverse participants in parent-mediated intervention research for children with autism. Electronic database keyword, lead author name searches in PyschNet, MEDLINE, and ancestral searches were conducted to identify 68 relevant articles that used experimental designs to evaluate the effects of parent-mediated interventions on children with or at risk for mental health disorders. Articles were coded for participant demographics; intervention setting and type, recruitment and retention strategies, cultural adaptation of intervention, and reported attrition. Findings are discussed and applied to practices in autism parent-mediated intervention research. Suggestions for future research and limitations are discussed.

Examining conjoint behavioral consultation to support students in middle school with social, emotional, and behavior concerns

The purpose of this study was to conduct a small-scale pilot study of Conjoint Behavioral Consultation (CBC), modified for middle school students with social, emotional, and behavioral concerns. Participants were 30 middle school students with social, emotional, and behavioral concerns, along with their parents and teachers. Participants were randomized to a CBC or school-as-usual control condition. Outcome measures included (a) teacher-report of student academic enablers and social, emotional, and behavioral competencies; (b) parent-, teacher-, and student report of target behavior outcomes; (c) parent- and teacher-report of the parent-teacher relationship; and (d) parent- and teacher-report competence in problem-solving. In addition, parents, teachers, and students reported their perceptions of the intervention. Findings suggested greater improvements in the intervention condition relative to the school-as-usual condition on teacher-report of student interpersonal skills, teacher-report of the parent-teacher relationship, and parent-report of competence in problem-solving. In addition, parents, teachers, and students reported improvements in the target behavior outcomes during the consultation and each stakeholder rated the intervention favorably. Limitations, future research directions, and implications for family-school interventions in middle school are discussed.

Association Among Parent–Teacher Relationship, Autonomy Support, and Career Development of High School Students Across School Types

The parent–teacher system is influential in promoting students’ career development. Guided by the systems theory framework of career development and spillover theory, this study examined the direct association between parent–teacher relationships and high school students’ career development. Furthermore, it analyzed the indirect effect of parent–teacher relationship on career development through parents’ and teachers’ support for students’ autonomy and the moderating role of the type of school. Data analyses were conducted on 1,452 students (46.5% males) in Grade 10 (aged approximately 15–16 years) from an academically oriented high school (53.0%) and a vocational high school (47.0%) in Beijing. The students completed questionnaires on the parent–teacher relationship, parent autonomy support, teacher autonomy support, and career development. The results indicated that the parent–teacher relationship predicted career development directly as well as indirectly through parent autonomy support. Moreover, there was no difference in the results of the structural equation model analysis among students in academically oriented and vocational high schools. Last, further implications and limitations are discussed.

"There's no off-switch for us:" Head start family engagement amidst COVID-19

Head Start center closures as a result of the COVID-19 pandemic required providers to innovate to continue engaging families and building relationships. Family Engagement has long been a pillar of Head Start's holistic approach to working with children and families in poverty. The present study provides a unique qualitative, longitudinal perspective of 20 Illinois-based Head Start/Early Head Start center directors regarding their engagement and communication strategies with families prior to, during, and after state-mandated center closures. Findings indicate that staff developed novel approaches to working with families within the context of COVID-19, some of which may have an important place in a post-pandemic world.

School climate and academic performance of Italian students: the role of disciplinary behaviour and parental involvement

Educational researchers have increasingly recognised the importance of school climate as a malleable factor for improving academic performance. In this perspective, we exploit the data collected by the Italian Institute for the Evaluation of the Education System (INVALSI) to assess the effect of some school climate related factors on academic performance of tenth-grade Italian students. A Multilevel Bayesian Structural Equation Model (MBSEM) is adopted to highlight the effect of some relevant dimensions of school climate (students’ disciplinary behaviour and parents’ involvement) on academic performance and their role on the relationships between student socioeconomic status and achievement. The main findings show that disciplinary behaviour, on the one hand, directly influences the level of competence of the students, and, on the other hand, it partly mediates the effect of socioeconomic background whereas parents’ involvement does not appear to exert any significant effect on students’ performance.

The impact of the COVID-19 school closures on families with children with disabilities: A qualitative analysis

The unprecedented school closures in response to COVID-19 have been associated with a number of negative impacts on students and their families. In addition to these difficulties, parents of students with disabilities are faced with prepandemic stresses and challenges that may be exacerbated by the school closures. This qualitative study aimed to investigate the experiences and struggles of parents of children identified with a disability during the COVID-19 school closures. The 15 participants were parents of children with a range of disabilities, including Autism, Down Syndrome, ADHD, and learning disabilities. The analyses revealed four major themes: school connection, virtual learning, potential impacts for students, and managing change. The experiences of these caregivers during the COVID-19 school closures and subsequent shift to remote learning have implications for educational and treatment planning. Recommendations for how school psychologists and school teams may best support students with disabilities and their families are included.

Mixed-Method Examination of Latinx Teachers' Perceptions of Daily Behavioral Report Card Interventions to Support Students with ADHD

Daily behavioral report cards (DRC) are an efficacious intervention for children with ADHD, yet there is little information on Latinx teachers' perceptions about ADHD and preferences related to behavioral treatment. The purpose of the current study was to examine the feasibility and acceptability of behavioral consultation with Latinx teachers and students, with a particular focus on the DRC. Participants (n = 23) included elementary school teachers (100% Hispanic/Latinx, 96% female) working with predominantly Hispanic/Latinx students. We leveraged a convergent, mixed-method design to evaluate feasibility, acceptability, as well as several potentially associated factors (i.e., perceptual, practical/logistical, individual, and cultural factors). Quantitative and qualitative measures and analyses were guided by the Consolidated Framework for Intervention Research. We found that Latinx teachers' Daily Report Card (DRC) completion rates (80%) were comparable to previous studies with predominantly non-Latinx white teachers and students. Quantitative indicators of acceptability were also similar to the prior literature. Few variables were associated with DRC completion rates, with the exception of teacher self-report of stress and satisfaction, which were both positively associated with completion rates. Qualitative findings expanded quantitative trends; thematic analyses revealed two overarching themes, that (1) teachers' attitudes toward behavioral interventions matter a great deal, and that (2) teachers' perceived behavioral control over DRC implementation depends a lot on the environment. Findings highlight the importance of stakeholders' perspectives, including teachers, in translating research to practice in real world settings.

Harnessing Home-School Partnerships and School Consultation to Support Youth With Anxiety

Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time- and staff-intensive programs. Such programs often leave teachers and caregivers feeling ill-equipped to support the student with anxiety throughout the natural course of the school day. Given the heavy demands placed on teachers and documented burnout among school professionals, providing effective school supports requires collaborative partnerships among outpatient therapists/specialists, school personnel, and caregivers. Drawing from literature on collaborative models for externalizing problems, we offer recommendations for outpatient therapists and specialists working to implement evidence-based supports in school settings and promote home-school partnerships to benefit youth with anxiety in the school setting. Our recommendations touch upon several components of such school consultation, including (a) identification of key parties involved, (b) conducting a needs assessment, (c) collaborative goal setting and development of a fear hierarchy, (d) plan development and implementation (e.g., facilitating a school-based exposure mindset, promoting home-school communication, enhancing school relationships), and (e) progress monitoring and ongoing support. We conclude with a case example to bring these recommendations to life.

Behavior Support Coaching for a Paraprofessional Working With First-Grade Students Exhibiting Disruptive Behavior Problems in an Urban High-Poverty Elementary School

Despite receiving little to no training in behavior management, paraprofessionals often support young students with or at risk of disruptive behavior disorders in elementary schools. The Behavior Support Coaching for Paraprofessionals (BSC-P) is a new evidence-based data-driven approach for enhancing paraprofessionals’ skills in identifying behavior needs, setting goals, and selecting and implementing evidence-based interventions for improving student disruptive behaviors. The current case study presents the application of the BSC-P (eight sessions over 3 months) with a paraprofessional and teacher who support two first-grade students exhibiting disruptive behaviors in an urban high-poverty elementary school. Implemented evidence-based interventions include say, show, check, a token economy, and antecedent modification. Findings revealed increased paraprofessional intervention fidelity, improved student classroom engagement (effect sizes of 3.77 and 2.10), and decreased student inappropriate verbal and physical behavior (effect sizes of 1.34 and 1.88, respectively).

Teachers' Views on the Participation of Parents in the Transition of their Children from Kindergarten to Primary School

Internationally, a great number of researchers have pointed out the significance of school–family relationship in the process of children’s transition to primary schools. However, only recently has it been a subject of research in Greece. The purpose of this particular research, which has a sample of 1602 pre-primary and primary school teachers, is to investigate teachers’ viewpoints on the role of parents in the process of their children’s transition to primary school. Data has been collected through the use of questionnaires. Statistical analysis has shown that the overwhelming majority of teachers consider cooperation with parents as necessary. They indicate that the most important factors for successful transition are parents’ level of trust in teachers, their views on schools and learning, and their support for the new situation their child experiences. As far as the most appropriate practices are concerned, almost all teachers mention updating parents at the beginning of the school year, while many suggest that parents and children visit primary schools and that common meetings of both kindergarten and primary school teachers with parents take place before school begins. It therefore seems that teachers acknowledge the role of parents in the process of transition and suggest appropriate practices for their participation.

Promoting Executive Functioning in Children with Autism Spectrum Disorder Through Mixed Martial Arts Training

The present study evaluated the effectiveness of a mixed martial arts (MMA) intervention in improving executive functions (EFs) in a sample with autism spectrum disorder (ASD). School-aged children with ASD were randomly assigned to a MMA intervention group or a waitlist control (WLC) group. The intervention featured a 26-class program over a 13-week period; the WLC group did not participate in any martial arts between pre- and post-test. Results indicated that the MMA group had significantly better EFs at post-test compared to the WLC group. The intervention appeared to be efficacious in meeting its goals of improving the executive functioning of children with ASD. The present study extends the current literature on the malleability of EFs among children with ASD.

Parent involvement and children's externalizing behavior: Exploring longitudinal bidirectional effects across gender

The current study longitudinally examined potential bidirectional associations between parents' home-based involvement, school-based involvement, and home-school communication and their children's externalizing behavior across child gender. Using the Early Childhood-Longitudinal Study - Kindergarten Cohort of 1998-99, three sets of analyses were conducted examining home involvement (n = 16,555), school involvement (n = 12,011), and home-school communication (n = 16,555). Cross-lagged panel analyses indicated a small effect of school-based involvement in kindergarten on externalizing behavior in the first grade but no other significant effects with no differences in patterns across gender. The utilized methodology also enabled an examination of longitudinal trends in different types of parent involvement across gender, which revealed important developmental differences in average parent involvement. Ultimately, the results of this study did not indicate robust unidirectional or bidirectional effects between parent involvement and student externalizing behavior. These findings are an important step forward in understanding the family variables influencing student behavior at school.

Parent-teacher problem solving about concerns in children with autism spectrum disorder: The role of income and race

Problem solving between parents and teachers is critical to maximizing student outcomes. The current study examined the associations among the different components of problem solving, as well as the relationship between various characteristics and problem solving in parents and teachers of children with autism spectrum disorder (ASD). Participants were 18 teachers and 39 parents of children with ASD. Parents and teachers completed a demographic survey, phone interview, and dyad observation. Results indicated that parent and teacher problem solving strategies were correlated with each other. Lower-income parents and parents interacting with White teachers displayed less problem solving. Findings suggest that school-based service delivery models to improve problem solving should consider both skill development, as well as the sociodemographic characteristics that parents and teachers bring to their interactions.

Parent Educational Involvement in Middle School: Longitudinal Influences on Student Outcomes

The present study examined influences of 6^th grade student-reported parent educational involvement on early adolescent peer group affiliations at 7^th and 8^th grade. In addition, student gender and ethnicity were explored as possible moderators. Drawn from a large effectiveness trial, participants in this study were 5,802 early adolescents across twenty middle schools in the Northwest region of the United States. Findings suggested that specifically parent's educational involvement in 6^th grade predicted increases in positive peer affiliation, when controlling for a general score of parent monitoring practices. The relation between parent educational involvement and peer affiliation varied by student ethnicity but not by gender. Findings suggest the social benefits of parent's engagement with the school context on early adolescent development.

Partners in School: An Innovative Parent-Teacher Consultation Model for Children with Autism Spectrum Disorder

Little research examines the best ways to improve communication between parents and teachers of children with Autism Spectrum Disorder (ASD) and its effect on child outcomes. The present study tests an innovative parent-teacher consultation model, entitled Partners in School. The goal of Partners in School is to improve parent-teacher communication aboutevidence-based practices (EBPs), and subsequently, outcomes for children with ASD. Participants were 26 teachers and 49 parents of children with ASD from a large urban public school district. Parents and teachers completed measures of their communication and child outcomes prior to and after receiving consultation through Partners in School. Results indicated that parents and teachers perceived improvements in child outcomes after participation inPartners in School. Changes in parent-teacher communication also were associated with changes in some child outcomes. Discussionhighlights the important role of communication inconsultations targeting family-school partnerships for children with ASD.

The efficacy of conjoint behavioral consultation in the home setting: Outcomes and mechanisms in rural communities

This study reports the results of a randomized controlled trial examining the effect of Conjoint Behavioral Consultation (CBC), a family-school partnership intervention, on children's behaviors, parents' skills, and parent-teacher relationships in rural community and town settings. Participants were 267 children, 267 parents, and 152 teachers in 45 Midwestern schools. Using an Intent to Treat approach and data analyzed within a multilevel modeling framework, CBC yielded promising results for some but not all outcomes. Specifically, children participating in CBC experienced decreases in daily reports of aggressiveness, noncompliance, and temper tantrums; and increases in parent-reported adaptive skills and social skills at a significantly greater pace than those in a control group. Other outcomes (e.g., parent reports of internalizing and externalizing behaviors) suggested a nonsignificant effect at post-test. CBC parents reported using more effective parenting strategies, gaining more competence in their problem-solving practices, and feeling more efficacious for helping their child succeed in school than parents in the control group. Parents participating in CBC also reported significant improvements in the parent-teacher relationship, and the parent-teacher relationship mediated the effect of CBC on children's adaptive skills. Implications for practice in rural communities, study limitations, and directions for future research are discussed.

Testing the feasibility of a briefer school-based preventive intervention with aggressive children: A hybrid intervention with face-to-face and internet components

This study describes the results from a feasibility study of an innovative indicated prevention intervention with hybrid face-to-face and web-based components for preadolescent youth. This intervention includes a considerably briefer set of face-to-face sessions from the evidence-based Coping Power program and a carefully integrated internet component with practice and teaching activities and cartoon videos for children and for parents. The Coping Power - Internet Enhanced (CP-IE) program introduces a set of cognitive-behavioral skills in 12 small group sessions for children delivered during the school day and 7 group sessions for parents. Eight elementary schools were randomly assigned to CP-IE or to Control, and six children at each school were identified each year based on 4th grade teacher ratings of aggressive behavior. Path analyses of teacher-rated disruptive behavior outcomes for 91 fifth grade children, across two annual cohorts, indicated Control children had significantly greater increases in conduct problem behaviors across the 5th grade year than did CP-IE children. This much briefer version of Coping Power provided beneficial preventive effects on children's behavior in the school setting similar to the effects of the longer version of Coping Power. The website materials appeared to successfully engage children, and parents' use of the website predicted children's changes in conduct problems across the year.