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Chong YY, Chien WT, Mou HY, Leung SP, Wong OY, Lam SY. Acceptance and Commitment Therapy Eczema Management Program for Children With Eczema: A Pilot Randomised Controlled Trial. Clin Exp Allergy 2025. [PMID: 39900107 DOI: 10.1111/cea.70003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 01/17/2025] [Accepted: 01/22/2025] [Indexed: 02/05/2025]
Abstract
INTRODUCTION Eczema significantly affects the quality of life of affected children and their families, with psychological stress often overlooked. Acceptance and Commitment Therapy (ACT) provides a supplementary approach to address these psychological challenges and enhance overall care. OBJECTIVE This pilot randomised controlled trial aimed to examine the feasibility, acceptability and preliminary effectiveness of the Family ACT-based Eczema Management Program (FACT-EMP). METHODS Parents and children aged 6-12 diagnosed with eczema from three outpatient clinics in Hong Kong were randomly assigned to either the FACT-EMP group, receiving four weekly ACT-based sessions plus eczema management education, or a waitlist control group receiving routine care. Feasibility and acceptability were assessed through recruitment, retention and completion rates, supplemented by focus group feedback on parental experiences. Primary clinical outcomes were children's eczema Severity Scoring of Atopic Dermatitis (SCORAD) and parental self-efficacy. Secondary outcomes included parental distress, quality of life, psychological flexibility and self-compassion of both parents and children. RESULTS From July 2021 to June 2023, 181 of 944 screened parent-child dyads met the inclusion criteria, and 78 were randomised and analysed (parents' mean [SD] age, 41.3 [11.0] years; 70 mothers [89.7%]; children's mean [SD] age, 8.3 [1.9] years; 53 boys [67.9%]). Recruitment, retention and completion rates were 43.1%, 87.2% and 76.9%, respectively. No significant between-group differences in SCORAD scores were observed immediately post-intervention. At 3-month post-intervention, SCORAD scores decreased significantly more in the FACT-EMP group than in the waitlist control group (adjusted mean difference, aMD, -7.73; 95% CI, -13.92 to -1.54). Parental self-efficacy scores also improved significantly more in the FACT-EMP group than the control, with an aMD of 18.69 (95% CI, 13.80 to 33.58) immediately post-intervention and 28.90 (95% CI, 13.93 to 43.84) at 3 months. CONCLUSION FACT-EMP is potentially feasible, acceptable and effective in improving children's eczema symptoms and enhancing parents' self-efficacy in disease management over 3 months. TRIAL REGISTRATION NCT04919330.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huan Yu Mou
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sui Ping Leung
- Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong SAR, China
| | - Oi Yin Wong
- Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong SAR, China
| | - Shu Yan Lam
- Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong SAR, China
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McCusker CG, Raleigh N. Transactional processes matter: experiences between parents of children with acquired brain injury and health and education providers. Disabil Rehabil 2024; 46:4458-4465. [PMID: 37921643 DOI: 10.1080/09638288.2023.2278168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/25/2023] [Accepted: 10/28/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE Little is known about how parents' transactions with health and educational professionals shape their experience of these systems, and impact on capacities to support their child with acquired brain injury (ABI). We explored experiences of specific transactions and perceptions of impact. METHODS A focus group and individual interviews were conducted with seven parents of children in the chronic phase of recovery following ABI. Thematic analysis was used to interpret the data. RESULTS Four superordinate themes were identified: "These Encounters Matter," "A Person not a Number-Interpersonal Skills that Count," "The Blind Leading the Blind," and "Becoming the Backbone." Findings highlighted that these transactions mattered to parents, promoting either distress or empowerment. Positive outcomes were characterized by transactions related to communication, empathy, trust, collaboration, and connection. However, there was a perception of the "blind leading the blind" and that ultimately parents needed to enter such transactions armed with knowledge and their own therapeutic goals. CONCLUSIONS Our findings unpack contextual and transactional elements of parents' experiences with health and education professionals which empower or distress. Understanding and improving these processes is important, given the central role families play in child outcomes following ABI. Implications for clinical practice are discussed.
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Affiliation(s)
| | - Niamh Raleigh
- School of Applied Psychology, University College Cork, Cork, Ireland
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Chavez Arana C, van IJzendoorn MH, Serrano-Juarez CA, de Pauw SSW, Prinzie P. [Formula: see text] Interventions to improve executive functions in children and adolescents with acquired brain injury: a systematic review and multilevel meta-analysis. Child Neuropsychol 2024; 30:164-187. [PMID: 36718104 DOI: 10.1080/09297049.2023.2172150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/17/2023] [Indexed: 02/01/2023]
Abstract
To investigate the effectiveness of interventions aiming to improve hot and cold executive functions (EFs) in children and adolescents with acquired brain injury (ABI) and to examine whether characteristics of the intervention, participants, etiology of ABI (Traumatic-brain-injury [TBI] or non-TBI), time of assessment, or study quality moderate intervention effects. Whereas cold EFs refer to purely cognitive EFs, hot EFs refer to the affective aspects of these cognitive skills. A total of 970 participants from 23 randomized-controlled-trial studies (112 effect sizes [ES]) were included. A three-level random effects approach (studies, ES, individual participants) was used. Moderation analyses were conducted through meta-regressions. The three-level random effects model showed a better fit than the two-level model. Almost all individual studies showed non-significant ES across outcomes but in combination interventions were effective (Cohen's d = 0.38, CI 0.16 ~ 0.61). Lower methodological quality, inclusion of participants with non-TBI, and parental participation predicted larger ES. Participants' age, time of assessment, number of sessions, and focus on hot or cold EFs were not related to ES. We found no evidence of publication bias. Interventions are effective with small to medium ES according to conventional criteria. Intervention effects do not seem to fade away with time. Parent participation in the intervention is important to improve EFs. The efficacy of interventions seems larger when non-TBI is part of the etiology of ABI. Variation between studies is relevant for tracing the effective intervention characteristics. Most studies are conducted in adolescence, and studies in early childhood are needed.
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Affiliation(s)
- Clara Chavez Arana
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University of Rotterdam, Rotterdam, The Netherlands
| | - Marinus H van IJzendoorn
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University of Rotterdam, Rotterdam, The Netherlands
- Research Department of Clinical, Education and Health Psychology, Faculty of Brain Sciences, UCL, University of London, London, UK
| | - Carlos A Serrano-Juarez
- Laboratorio de Neurometría, FES Iztacala, Universidad Nacional Autónoma de México, State of Mexico, Mexico
| | - Sarah S W de Pauw
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Peter Prinzie
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University of Rotterdam, Rotterdam, The Netherlands
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Schlebusch L, Chambers N, Rosenstein D, Erasmus P, de Vries PJ. Supporting caregivers of children with developmental disabilities: Findings from a brief caregiver well-being programme in South Africa. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:199-214. [PMID: 36352758 DOI: 10.1177/13623613221133182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
LAY ABSTRACT Young children with developmental disabilities and delays who live in low- and middle-income countries are at significant risk of not reaching their full potential. We know that daily interactions with their caregivers (parents or other people taking care of them) play an important role in promoting their development. However, having a child with developmental disabilities can have a negative impact on carers' mental health and well-being, which in turn can influence their capacity to care for their children. To date, very little attention has been given to the caregivers' capacity to care. The World Health Organization developed a Caregiver Skills Training programme which includes a brief, three-session module that focuses on improving caregivers' well-being and mental health. This well-being programme is based on acceptance and commitment therapy. Acceptance and commitment therapy shows increasing evidence of helping people respond to their stressors, thoughts, feelings and experiences a little differently and commit to small changes that are in line with their personal values. Acceptance and commitment therapy has shown promise in improving feelings of well-being in caregivers of children with developmental disabilities. We adapted the World Health Organization Caregiver Skills Training Caregiver well-being module to suit the South African context. The resultant 'Well Beans for Caregivers' was then delivered to caregivers from a rural, low-resource setting in South Africa. We found the intervention easy to implement, highly acceptable to caregivers and showed promising impacts on caregivers' well-being and mental health. This intervention has the potential to be implemented widely and sustainably to build caregivers' capacity to care for their children.
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McKay D, O'Donohue W. Conceptual, Psychometric, Methodological and Value Problems in Acceptance and Commitment Therapy: Introduction to the Special Section, "A Critical Appraisal of Acceptance and Commitment Therapy". Behav Ther 2023; 54:929-938. [PMID: 37863585 DOI: 10.1016/j.beth.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 10/22/2023]
Abstract
There is a voluminous and expanding literature regarding ACT, from descriptions of its theory to its stated roots in relational frame theory, the particulars of its therapy techniques and exercises, favored metaphors, randomized controlled trials, to many self-help books for a wide variety of problems. The therapy is widely marketed through workshops and many self-help books. ACT is associated with its own journal and its own professional organization, the Association for Contextual Behavioral Science (ACBS). This literature is interpreted by ACT proponents as demonstrating the causal efficacy of ACT for a wide range of problems and, at times, even being superior to treatment as usual, which are often more traditional forms of cognitive behavior therapy (CBT). This special section contains a series of 6 papers examining these claims. Correctly understanding and evaluating the claims of ACT proponents is warranted because these can have direct implications for treatment decisions by therapists attempting to deliver the most effective treatment for their clients' problems. The papers, individually and as a whole, urge considerable caution, particularly because much of its research has involved serious measurement problems, problematic research designs, and a unique and problematic conceptualization and perhaps the practice of values and ethics. These papers call for methodological improvements and a commitment to more traditional values associated with science so that ACT can be more fairly evaluated to accurately understand its assets and limitations.
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Gur A, Reich A. Psychological flexibility of parents of children with disabilities: A systematic literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104490. [PMID: 36966545 DOI: 10.1016/j.ridd.2023.104490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Psychological flexibility, a popular concept in clinical psychology, is still evolving in the context of studying parents of children with disabilities. This study systematically reviewed the literature on the psychological flexibility of parents of children with disabilities to identify contributions of the literature and make recommendations for practice and future study. MATERIALS AND METHODS The systematic review was conducted according to the PRISMA guidelines and identified studies on the psychological flexibility of parents of children with disabilities using five electronic databases: PsychNet, PubMed, ERIC, Social Services Abstracts, and EBSCO. Twenty-six articles met the criteria and were included. A thematic analysis was conducted to extract major themes. RESULTS Three major themes emerged from the data: (1) psychological flexibility is associated with various aspects of mental health; (2) psychological flexibility is associated with parental functioning in caring for children with a disability; (3) acceptance and commitment therapy (ACT) based interventions effectively enhance the psychological flexibility of parents of children with disabilities. CONCLUSIONS The study concludes that psychological flexibility is extremely relevant to disability studies and should be further explored in relation to different parental well-being and functioning aspects. Professionals are encouraged to incorporate principles of acceptance and commitment therapy into their work with parents of children with disabilities.
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Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Upper Galilee, Israel.
| | - Ari Reich
- Faculty of Education, Bar Ilan University, Ramat Gan, Israel
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Okajima J, Okajima I. Psychometric Properties of the Japanese Version of the Parental Acceptance and Action Questionnaire in Parents with Infants and Toddlers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095674. [PMID: 37174194 PMCID: PMC10178238 DOI: 10.3390/ijerph20095674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
We aimed to examine the reliability and validity of the Parental Acceptance and Action Questionnaire-Japanese version (PAAQ-J). We considered a total of 2000 mothers with infants and toddlers aged 0-3 years and evaluated their scores on the PAAQ-J Acceptance and Action Questionnaire-II (AAQ-II) and Hospital Anxiety and Depression Scale (HADS). We conducted an exploratory factor analysis, creating a PAAQ-J with 12 items and three factors (α = 0.80): Inaction-Behavior, Inaction-Cognition, and Unwillingness, with α of 0.84, 0.72 and 0.68, respectively. The test-retest reliability examination results showed that the interclass correlation coefficient was 0.49, with 95% CI between 0.44 and 0.54. The correlation coefficient of PAAQ-J was 0.57, 0.32, and 0.33 with AAQ-II, and HADS-depression and HADS-anxiety, respectively. PAAQ-J's validity to adequately evaluate an individual's avoidance of experiences regarding childcare and their psychological flexibility was proven. Since the original PAAQ was for 6-18-year-old children with anxiety symptoms, it is necessary to examine its reliability and validity not only for infants and toddlers, but also for parents of older children and adolescents in the future.
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Affiliation(s)
- Junko Okajima
- Department of Psychology, Rikkyo University, Saitama 352-8558, Japan
- Department of Rehabilitation, University of Tokyo Health Sciences, Tokyo 206-0033, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo 173-8602, Japan
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Sasaki N, Imamura K, Nishi D, Watanabe K, Asaoka H, Sekiya Y, Tsuno K, Kobayashi Y, Obikane E, Kawakami N. The effect of internet-based acceptance and commitment therapy (iACT) on psychological well-being among working women with a pre-school child: A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Jenkin T, Anderson VA, D'Cruz K, Scheinberg A, Knight S. Family-centred service in paediatric acquired brain injury rehabilitation: Bridging the gaps. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1085967. [PMID: 36619530 PMCID: PMC9816340 DOI: 10.3389/fresc.2022.1085967] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
Background Children and adolescents who sustain an acquired brain injury (ABI) can experience acute and ongoing difficulties in a range of cognitive and functional domains, and their families often experience significant life changes and challenges. Family-centred service is therefore considered best practice in paediatric ABI rehabilitation. Despite widespread acceptance of family-centred service in this context, recent literature indicates that family needs are often unrecognised and unmet following paediatric ABI. Although family-centred service was introduced in the field of developmental disability over five decades ago, there remains a lack of clarity about how this approach is implemented in practice. Additionally, limited literature has discussed the implementation of family-centred service in paediatric ABI rehabilitation despite key differences between ABI and developmental disability, including nature and timing of onset, rehabilitation foci, and impacts on families. Aims In this review, we aim to: (i) outline common sequelae of paediatric ABI with a focus on family outcomes; (ii) summarise paediatric rehabilitation and highlight opportunities for family support and involvement; (iii) discuss and synthesise literature across paediatric ABI rehabilitation and family-centred service to highlight gaps in knowledge and practice; and (v) identify clinical implications and future research directions. Conclusions There is a clear need for greater clarity and consensus regarding the implementation of family-centred service in paediatric ABI rehabilitation. This review highlights the importance of providing professional development opportunities for clinicians to increase competency in practising in a family-centred manner, and opportunities to actively involve, empower and support families within rehabilitation. This review also emphasises the importance of services implementing relevant supports to address family needs where possible and developing clear referral pathways so that families can access further support elsewhere when needed.
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Affiliation(s)
- Taylor Jenkin
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Vicki A. Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
- Brain and Mind, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Psychology Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Kate D'Cruz
- Summer Foundation, Melbourne, VIC, Australia
| | - Adam Scheinberg
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sarah Knight
- Neurodisability & Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
- Victorian Paediatric Rehabilitation Service, The Royal Children's Hospital, Melbourne, VIC, Australia
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Crumlish L, Wallace SJ, Copley A, Rose TA. Exploring the measurement of pediatric cognitive-communication disorders in traumatic brain injury research: A scoping review. Brain Inj 2022; 36:1207-1227. [PMID: 36303459 DOI: 10.1080/02699052.2022.2111026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 03/30/2022] [Accepted: 08/03/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To synthesize information about the constructs measured, measurement instruments used, and the timing of assessment of cognitive-communication disorders (CCDs) in pediatric traumatic brain injury (TBI) research. METHODS AND PROCEDURES Scoping review conducted in alignment with Arksey and O'Malley's five-stage methodological framework and reported per the PRISMA extension for Scoping Reviews. Inclusion criteria: (a) cohort description, case-control, and treatment studies; (b) participants with TBI aged 5-18 years; (c) communication or psychosocial outcomes; and (d) English full-text journal articles. The first author reviewed all titles, abstracts, and full-text articles; 10% were independently reviewed. OUTCOMES AND RESULTS Following screening, a total of 687 articles were included and 919 measurement instruments, measuring 2134 unique constructs, were extracted. The Child Behavior Checklist was the most used measurement instrument and 'Global Outcomes/Recovery' was the construct most frequently measured. The length of longitudinal monitoring ranged between ≤3 months and 16 years. CONCLUSIONS AND IMPLICATIONS We found considerable heterogeneity in the constructs measured, the measurement instruments used, and the timing of CCD assessment in pediatric TBI research. A consistent approach to measurement may support clinical decision-making and the efficient use of data beyond individual studies in systematic reviews and meta-analyses.
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Affiliation(s)
- Lauren Crumlish
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Queensland Aphasia Research Centre, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Queensland Aphasia Research Centre, Australia
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Cermak CA, McCabe SA, Kuchurean B, Schaefer J, Tendera A, Beal DS. Parent Interventions Improve Behavior After Pediatric Traumatic Brain Injury: A Systematic Review and Meta-analysis. J Head Trauma Rehabil 2022; 37:293-302. [PMID: 35125430 DOI: 10.1097/htr.0000000000000766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine child behavior change scores from randomized controlled trials (RCTs) of parent interventions for pediatric traumatic brain injury (TBI). METHODS MEDLINE, EMBASE, PsycINFO, and CINAHL were searched to identify studies that examined parent interventions for pediatric TBI. Inclusion criteria included (i) a parent intervention for children with TBI; (ii) an RCT study design; (iii) statistical data for child behavior outcome(s); and (iv) studies that were published in English. RESULTS Seven studies met inclusion criteria. All interventions reported improved child behavior after pediatric TBI; however, child and parent factors contributed to behavior change scores in some interventions. Factors found to contribute to the level of benefit included age of child, baseline behavior levels, sociodemographics (eg, parent income, parent education), and parent mental health. CONCLUSION Improved child behavior outcomes resulting from parent interventions for pediatric TBI are well supported by the evidence in the peer-reviewed literature. Clinicians are encouraged to consider child and parent factors as they relate to child behavior outcomes.
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Affiliation(s)
- Carly A Cermak
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada (Drs Cermak, Tendera, and Beal and Mss McCabe, Kuchurean, and Schaefer); Rehabilitation Sciences Institute (Drs Cermak and Beal), and Department of Speech-Language Pathology, Faculty of Medicine (Ms Kuchurean and Dr Beal), University of Toronto, Toronto, Ontario, Canada
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Perkins A, Gracey F, Kelly G, Jim J. A new model to guide identity-focused multidisciplinary rehabilitation for children and young people following acquired brain injury: I-FoRM. Neuropsychol Rehabil 2022; 32:1928-1969. [PMID: 35895321 DOI: 10.1080/09602011.2022.2100794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
A complexity of biological, psychological, environmental and systemic factors influences a child's adaption after acquired brain injury (ABI), all of which transform as the child matures. Multidisciplinary rehabilitation teams are challenged by balancing family system needs and the child's needs, whilst promoting the child's functional skills in difficult or unappealing tasks. This paper presents the conceptual basis for a model for use in childhood ABI neurorehabilitation to address these challenges. A non-systematic narrative review of literature pertinent to integrated neurorehabilitation of pediatric ABI was conducted. Contemporary models of adult and pediatric psychosocial adaptation involving identity following ABI were reviewed. Key findings were then synthesized with models of pediatric resilience and self-concept development. The resulting model describes a cyclical adaptation process whereby the child learns experientially about their self and their world after ABI. Processes of identity development play a central role - particularly emotive processes of self-evaluation - by influencing the child's motivation for participation, tolerance for challenge, self-regulation and emerging self-awareness. The model directs clinicians to use the psychosocial processes of identity development to enhance the child's willingness and capacity to engage in the daily challenges of rehabilitation. Further systematic development and evaluation of the model is needed.
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Affiliation(s)
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK.,Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Jenny Jim
- The Children's Trust, Tadworth, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Whittingham K, Sheffield J, Mak C, Wright A, Boyd RN. Parenting Acceptance and Commitment Therapy: An RCT of an online course with families of children with CP. Behav Res Ther 2022; 155:104129. [DOI: 10.1016/j.brat.2022.104129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/09/2022] [Accepted: 05/21/2022] [Indexed: 11/02/2022]
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Lamond B, Roberts SD, Miller SP, Wade SL, Williams TS. Psychosocial Intervention Outcomes for Children with Congenital and Neonatal Conditions: Systematic Review. J Pediatr Psychol 2022; 47:1003-1018. [PMID: 35472174 DOI: 10.1093/jpepsy/jsac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/14/2022] Open
Abstract
There has been a historic lack of psychosocially geared treatment studies for congenital and neonatal conditions that impact brain development, despite well-established knowledge that these conditions impact cognitive development, quality of life (QoL), mental health, and academic success. OBJECTIVE The aim of the present study was to systematically investigate the research literature focusing on the effects of interventions in psychosocially geared programs for children with neonatal brain injury on school and psychological outcomes. METHODS Psychosocially geared programs broadly refer to interventions to improve parenting and school functioning, or child behavior, as well as other interventions that have a psychological component but may be more physically oriented, such as goal-directed physiotherapy. A comprehensive search of PubMed, Medline, PsychINFO, and Embase was completed between June and July 2020. The methodological quality of included articles was assessed using the Cochrane Risk of Bias Tool for Randomized Trials (RoB-2). RESULTS AND CONCLUSION Twenty studies met the inclusion criteria and demonstrated adequate risk of bias (i.e., low risk of bias or some concerns). The studies included family (n = 2), parenting (n = 7), and child (n = 10) interventions. There is some evidence supporting the effectiveness of psychosocial interventions for children with neonatal brain injury and their families on academic outcomes, behavior, and QoL, indicated by positive intervention effects in 65% (n = 13) of studies.
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Affiliation(s)
- Bronwyn Lamond
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Canada.,Department of Applied Psychology and Human Development, The University of Toronto, Canada
| | - Samantha D Roberts
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Canada.,Department of Psychology, York University, Canada
| | - Steven P Miller
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Canada.,BC Children's Hospital & Sunny Hill Health Centre, Canada
| | - Shari L Wade
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, USA
| | - Tricia S Williams
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Canada.,Department of Pediatrics, The University of Toronto, Canada
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Jefferies M, Peart T, Perrier L, Lauzon A, Munce S. Psychological Interventions for Individuals With Acquired Brain Injury, Cerebral Palsy, and Spina Bifida: A Scoping Review. Front Pediatr 2022; 10:782104. [PMID: 35386256 PMCID: PMC8978581 DOI: 10.3389/fped.2022.782104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/10/2022] [Indexed: 11/20/2022] Open
Abstract
Background With current medical advancements, more adolescents with neurodevelopmental disorders are transitioning from child- to adult-centred health care services. Therefore, there is an increasing demand for transitional services to help navigate this transition. Health care transitions can be further complicated by mental health challenges prevalent among individuals with cerebral palsy (CP), spina bifida (SB), and childhood onset acquired brain injury (ABI). Offering evidence-based psychological interventions for these populations may improve overall outcomes during transition period(s) and beyond. The objective of this scoping review is to identify key characteristics of psychological interventions being used to treat the mental health challenges of adolescents and adults with CP, SB, and childhood onset ABI. Methods Methodological frameworks by Arksey and O'Malley, and Levac and colleagues were used to explore studies published between 2009 and 2019. Included studies were required to be written in English and report on a psychological intervention(s) administered to individuals at least 12 years of age with a diagnosis of CP, SB, or childhood onset ABI. All study designs were included. Results A total of 11 studies were identified. Of these, eight reported psychological interventions for childhood onset ABI, while three reported on CP. No studies reporting on SB were identified. Commonly used interventions included acceptance and commitment therapy (ACT), psychotherapy, and cognitive behavioral therapy (CBT). Conclusions There are a limited number of studies investigating psychological interventions for individuals with childhood onset ABI and CP, and none for individuals with SB. Further research into effective psychological interventions for these populations will improve mental health outcomes and transitional services.
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Affiliation(s)
- Morgan Jefferies
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Taylor Peart
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Laure Perrier
- University of Toronto Libraries, University of Toronto, Toronto, ON, Canada
| | - Andrea Lauzon
- LIFESpan Service, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- LIFESpan Service, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Sarah Munce
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- LIFESpan Service, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
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Lamson AL, Hodgson JL, Pratt KJ, Mendenhall TJ, Wong AG, Sesemann EM, Brown BJ, Taylor ES, Williams-Reade JM, Blocker DJ, Harsh Caspari J, Zubatsky M, Martin MP. Couple and family interventions for high mortality health conditions: A strategic review (2010-2019). JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:307-345. [PMID: 34741539 DOI: 10.1111/jmft.12564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
The earliest publications in the field of marriage and family therapy introduced interventions conducted with families experiencing complex health conditions. This strategic review captures an evaluation of efficacy for 87 couple and family interventions published between 2010 and 2019 with a focus on the leading causes of mortality in the United States. These health conditions include chromosomal anomalies and accidents with infants aged 0-4 years; accidents and cancer among children aged 5-14; accidents among adolescents aged 15-24; and heart disease, cancer, accidents, chronic lower respiratory diseases, stroke, Alzheimer's disease, diabetes, influenza/pneumonia, and nephritis/nephrosis among adults 25 and older. Results support the need for greater inclusion of couples and families in assessments and interventions. The greatest chasm in efficacy research was with minoritized couples and families. Implications include ways to initiate couple and family interventions in the context of health conditions with attention given to accessibility, recruitment, retention, and evaluation.
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Affiliation(s)
- Angela L Lamson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Jennifer L Hodgson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Keeley J Pratt
- Department of Human Services, Human Development and Family Science Program, Couple and Family Therapy Specialization, College of Education & Human Ecology, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Tai J Mendenhall
- Department of Family Social Science, University of Minnesota, Saint Paul, Minnesota, USA
| | - Alison G Wong
- Department of Marriage and Family Therapy, Fuller School of Psychology and Marriage and Family Therapy, Pasadena, California, USA
| | | | - Braden J Brown
- Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Athletics Department, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Erika S Taylor
- Department of Family Medicine, Behavioral Medicine Section, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | - Daniel J Blocker
- Pomona Valley Family Medicine Residency, Pomona Valley Hospital Medical Center, Pomona, California, USA
| | - Jennifer Harsh Caspari
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Max Zubatsky
- Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Matthew P Martin
- Doctor of Behavioral Health Program, College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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17
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Byrne G, Ghráda ÁN, O'Mahony T, Brennan E. A systematic review of the use of acceptance and commitment therapy in supporting parents. Psychol Psychother 2021; 94 Suppl 2:378-407. [PMID: 32406169 DOI: 10.1111/papt.12282] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 04/03/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Acceptance and commitment therapy (ACT) has accrued a growing evidence-base for a wide variety of psychological difficulties. Given that ACT promotes broad and flexible repertoires of behaviour as well as neutralizing the ubiquitous psychological processes theorized to be responsible for much human suffering, such an approach may hold promise. The use of ACT-informed parenting interventions offers another alternative to solely behavioural approaches but it remains relatively understudied and in need of further exploration. DESIGN The current systematic review, which searched four databases, aimed to collate all ACT interventions that included parental therapeutic components in the treatment of various child presenting difficulties. The review also rated the methodological rigour of the ACT evidence-base for this type of treatment format. RESULTS Twenty-seven individual studies covering a broad spectrum of presenting problems were included, comprising of 1,155 participants. A large proportion of studies were within-group designs with a smaller number using randomized controlled trials. The majority of studies reported improvements on either parent report symptoms regarding child physical or psychological functioning as well as parent-reported measures of stress, depression, and anxiety. Similar improvements were noted on a number of ACT mechanisms of change outcomes, including mindfulness, acceptance, and cognitive fusing. These gains were evident for parents of children with neurodevelopmental disorders, chronic pain, and significant physical health difficulties. Maintenance or further treatment gains were often reported at follow-up. These positive findings are tempered by low levels of methodological rigour common in some of the studies included. CONCLUSIONS Despite these limitations, ACT holds promise as a transdiagnostic intervention that can help with the parenting of children with a range of psychological and physical difficulties. PRACTITIONER POINTS ACT has accrued a relatively strong evidence base for a range of psychological difficulties. Despite some methodological shortcomings, ACT shows promise as an intervention to help parents manage stress and difficulties especially in relation to children with autism, chronic pain, and physical health needs. Further research is required in comparing ACT to more established treatments and helping consolidate initial positive findings.
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Affiliation(s)
- Gary Byrne
- Health Service Executive, Dublin, Ireland
| | | | | | - Emma Brennan
- School of Psychology, Trinity College, Dublin, Ireland
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18
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Sasaki N, Imamura K, Nishi D, Watanabe K, Sekiya Y, Tsuno K, Kobayashi Y, Kawakami N. Internet-based acceptance and commitment therapy programme 'Happiness Mom' for well-being: a protocol for a randomised controlled trial. BMJ Open 2021; 11:e042167. [PMID: 33637541 PMCID: PMC7919564 DOI: 10.1136/bmjopen-2020-042167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This randomised controlled trial (RCT) aims to examine the effects of an internet-delivered acceptance and commitment therapy (iACT) programme ('Happiness Mom') on the psychological well-being of working mothers. METHODS AND ANALYSIS The target population of the RCT will be employed mothers with at least one preschool child. Participants who fulfil the study's eligibility criteria will be randomly assigned either to an iACT intervention group (n=200) or to a wait-list control group (n=200). Participants in the intervention groups will be asked to complete the programme within 12 weeks of the baseline survey. The intervention programme contains eight modules based on ACT. Primary outcomes are six components of psychological well-being, based on Ryff's theory. Secondary outcomes are intention to leave their job, work engagement, work performance, sick leave days, psychological distress, euthymia, positive emotions, job and life satisfaction, social support and parental burn-out. ETHICS AND DISSEMINATION Ethical approval for this study has been obtained from the Research Ethics Review Board of Graduate School of Medicine, the University of Tokyo (No. 2019134NI). If the intervention programmes are found to be significantly beneficial, the programmes can be made available for all working mothers with preschool children in Japan. DISCUSSION This study will contribute to the development of an internet-based self-care programme that is effective, feasible, low cost and accessible to improve the well-being of working mothers. TRIAL REGISTRATION NUMBER UMIN000039918.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Yuki Sekiya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | - Yuka Kobayashi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
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19
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Jin X, Wong CL, Li H, Chen J, Chong YY, Bai Y. Acceptance and Commitment Therapy for psychological and behavioural changes among parents of children with chronic health conditions: A systematic review. J Adv Nurs 2021; 77:3020-3033. [PMID: 33626192 DOI: 10.1111/jan.14798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/12/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022]
Abstract
AIMS To systematically identify the application of Acceptance and Commitment Therapy among parents of children with chronic health conditions and determine its effectiveness in parental psychological flexibility, psychological distress and parenting behaviour. DESIGN Systematic review. DATA SOURCES Nine databases (i.e. MEDLINE, PubMed, Embase, Cochrane Library, CINAHL, PsychINFO, Web of Science, China National Knowledge Infrastructure and WanFang Data) were systematically searched from inception to October 2019. REVIEW METHODS Quality of studies was appraised by using the Joanna Briggs Institute critical appraisal checklist. Findings were synthesized narratively. This work was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. RESULTS Eight studies involving 485 parents were included. Results indicated that Acceptance and Commitment Therapy significantly improved parental psychological flexibility and reduced psychological distress compared with usual care and waitlist, but was not significantly different from active treatments. Limited studies have provided very preliminary evidence that Acceptance and Commitment Therapy can significantly improve dysfunctional parenting behaviour than usual care and waitlist. High attrition rate at follow-up made the overall confidence of maintained effect relatively low. CONCLUSION This review provides preliminary evidence that Acceptance and Commitment Therapy is beneficial for improving psychological flexibility, psychological distress and parenting behaviour among parents of children with chronic health conditions. Future studies with rigorous designs and large sample sizes are warranted to verify the evidence and explore its long-term efficacy. IMPACT Acceptance and Commitment Therapy has been increasingly applied to parents of children with chronic health conditions. This review provides positive evidence of its effects on psychological and behavioural outcomes among these parents. This work will help healthcare professionals and researchers with their practice and further research.
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Affiliation(s)
- Xiaohuan Jin
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jieling Chen
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yang Bai
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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20
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Bakula DM, Wetter SE, Peugh JL, Modi AC. A Longitudinal Assessment of Parenting Stress in Parents of Children with New-Onset Epilepsy. J Pediatr Psychol 2021; 46:91-99. [PMID: 33053164 PMCID: PMC7819715 DOI: 10.1093/jpepsy/jsaa091] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Parents of children with newly diagnosed epilepsy may experience elevated parenting stress. The present study examined trajectories of parenting stress over time and identified modifiable predictors of these trajectories. METHODS Parents of youth with epilepsy (N = 102; 2-12 years old) completed questionnaires 1, 4, 13, 19, and 25-months post-diagnosis, including measures of parenting stress, family functioning, child psychosocial functioning, sociodemographics, and perceived stigma. Latent growth curve models (LGCM) were used to examine domains of parenting stress over time. RESULTS At baseline, 25-48% of parents reported elevated parenting stress. LGCMs revealed that the parent and child domains of parenting stress were generally stable across time. However, life stress was more variable across time, and parents with higher initial life stress had a greater reduction in life stress over time. Socioeconomic status was identified as a non-modifiable predictor of life stress. Family functioning was associated with greater parenting stress in the parent domain. Child psychosocial functioning was associated with greater parenting stress in the parent and child domains. CONCLUSIONS Parenting stress was elevated for a subset of families and appeared to be relatively stable over time, with the exception of life stress, which was more variable. With early screening, child factors and parent appraisals of epilepsy may be valuable targets for clinical intervention with families of children with epilepsy.
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Affiliation(s)
- Dana M Bakula
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - Sara E Wetter
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - James L Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center
- University of Cincinnati, College of Medicine
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21
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Moore DA, Nunns M, Shaw L, Rogers M, Walker E, Ford T, Garside R, Ukoumunne O, Titman P, Shafran R, Heyman I, Anderson R, Dickens C, Viner R, Bennett S, Logan S, Lockhart F, Thompson Coon J. Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses. Health Technol Assess 2020; 23:1-164. [PMID: 31122334 DOI: 10.3310/hta23220] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2). DATA SOURCES For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted. REVIEW METHODS The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen's d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography. An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. RESULTS Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive-behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention-LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research. LIMITATIONS Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis. CONCLUSIONS There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project. STUDY REGISTRATION This study is registered as PROSPERO CRD42011001716. FUNDING The National Institute for Health Research (NIHR) Health Technology Assessment programme and the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
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Affiliation(s)
- Darren A Moore
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Michael Nunns
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Liz Shaw
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Morwenna Rogers
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Erin Walker
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tamsin Ford
- Child Mental Health Group, University of Exeter Medical School, Exeter, UK
| | - Ruth Garside
- The European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK
| | - Obi Ukoumunne
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Penny Titman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- University College London Institute of Child Health, London, UK
| | - Isobel Heyman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rob Anderson
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Chris Dickens
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Russell Viner
- University College London Institute of Child Health, London, UK
| | - Sophie Bennett
- University College London Institute of Child Health, London, UK
| | - Stuart Logan
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Fiona Lockhart
- Biomedical Research Centre Patient & Public Involvement Group, University College London Hospitals, London, UK
| | - Jo Thompson Coon
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
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Whittingham K, McGlade A, Kulasinghe K, Mitchell AE, Heussler H, Boyd RN. ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy): a randomised controlled trial of an innovative intervention for infants at risk of autism spectrum disorder. BMJ Open 2020; 10:e034315. [PMID: 32819928 PMCID: PMC7440709 DOI: 10.1136/bmjopen-2019-034315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 05/04/2020] [Accepted: 06/08/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with impacts on behaviour, cognition, communication, social interaction and family mental health. This paper reports the protocol of a randomised controlled trial (RCT) of a very early intervention, ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy), for families of infants at risk of ASD. METHODS AND ANALYSIS We aim to recruit 66 mothers of infants at risk of ASD (ie, infants with a sibling or parent diagnosed with ASD) to this RCT. Families will be randomly assigned to care-as-usual or ENACT. ENACT is a very early intervention, leveraging parent-child interactions to improve early social reciprocity, while supporting parental mental health and the parent-child relationship through Acceptance and Commitment Therapy. Intervention content is delivered online (approximately 8 hours) and supported by more than 7 consultations with a clinician. Parents will perform the social reciprocity intervention with their child (30 min per day). Assessments at four time points (baseline, 3 months, 6 months, and 12 months corrected age) will assess parent-infant interaction, parental mental health, infant development and early ASD markers. Analysis will be by intention to treat using general linear models for RCTs. ETHICS AND DISSEMINATION This protocol has been approved by the Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/50131) and the University of Queensland Human Research Ethics Committee (2019000558). If efficacy is demonstrated, the intervention has the potential for wide and accessible dissemination. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12618002046280).
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Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrea McGlade
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kavindri Kulasinghe
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy E Mitchell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Honey Heussler
- Mater Medical Research Institute, South Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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23
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Chong YY, Mak YW, Loke AY. The role of parental psychological flexibility in childhood asthma management: An analysis of cross-lagged panel models. J Psychosom Res 2020; 137:110208. [PMID: 32798834 DOI: 10.1016/j.jpsychores.2020.110208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 06/24/2020] [Accepted: 07/26/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This is a secondary analysis of a previously reported randomized controlled trial, aimed at examining the mediating role of parental psychological flexibility (PF) in an Acceptance and Commitment Therapy (ACT)-based childhood asthma management program for parents. METHODS The participants were 168 parents (mean age (SD) = 38.40 (5.90) years; 88.1% mothers) and their children who had been diagnosed with asthma (mean age (SD) = 6.81 (2.50) years; 62% boys). They were randomly allocated to either the program composed of a four-session, group-based ACT plus asthma education (ACT Group) or to a group-based asthma education talk plus three telephone follow-ups (Control Group). The parents underwent assessments at baseline, and immediately, 3-months, and 6-months after the intervention for the following outcomes: PF (Acceptance and Action Questionnaire-II), psychological distress of the parents (Depression Anxiety Stress Scale-21); and the asthma symptoms and use of inhaled bronchodilators of their children. RESULTS Cross-lagged panel models showed that the improvement in parental PF at post-intervention mediated the effect of ACT on reducing parental psychological distress (all beta coefficients (βs) ranged from -2.20 to - 2.30, all Ps < 0.01) and childhood asthma symptoms in terms of daytime symptoms (β = -0.22, 95% CI [-0.52, -0.02], P = 0.04), nighttime symptoms (β = -0.17, 95% CI [-0.33, -0.02], P = 0.04), and the use of bronchodilators (β = -0.22, 95% CI [-0.48, -0.02], P = 0.03) at 6-months post-intervention. CONCLUSION ACT makes a unique contribution to improving the health outcomes of parents and their children diagnosed with asthma through fostering parental PF.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| | - Yim Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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24
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Chavez Arana C, Catroppa C, Yáñez-Téllez G, Prieto-Corona B, de León MA, García A, Gómez-Raygoza R, Hearps SJC, Anderson V. A Parenting Program to Reduce Disruptive Behavior in Hispanic Children with Acquired Brain Injury: A Randomized Controlled Trial Conducted in Mexico. Dev Neurorehabil 2020; 23:218-230. [PMID: 31345088 DOI: 10.1080/17518423.2019.1645224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Children with acquired brain injury (ABI) are at risk of impairments in self-regulation and disruptive behavior. We aimed to investigate the effectiveness of the Signposts program to reduce disruptive behavior and improve self-regulation in Hispanic children with ABI, and reduce parental stress and improve parenting practices. Using a randomized controlled trial design, we assigned children (n = 71) and their parents to Signposts or generic telephone support. Blinded assessors conducted assessments at pre-intervention, immediately post-intervention, and at 3 months post-intervention. Signposts was effective in reducing dysfunctional parenting practices. Further, when analyzing participants at risk of behavioral disturbance (n = 46), Signposts was effective in reducing child disruptive behavior in the home environment and emotional self-regulation. No differences were found for parental stress, parent sense of competence, child disruptive behaviors at school, and child cognitive and behavioral self-regulation. The reduction in disruptive behavior was associated with the implementation of authoritative parenting practices (external regulation), and not associated with child self-regulation.
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Affiliation(s)
- Clara Chavez Arana
- Universiteit Leiden, Faculteit der Sociale Wetenschappen, Instituut Psychologie, Netherlands.,The University of Melbourne, Melbourne, Victoria, Australia.,Universidad Nacional Autónoma de México, FES Iztacala, Mexico City, Mexico
| | - Cathy Catroppa
- The University of Melbourne, Melbourne, Victoria, Australia.,Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Australia.,Royal Children´s Hospital, Melbourne, Australia
| | | | | | - Miguel A de León
- Iskalti Centre of Psychological and Educational Support S.C., Mexico City, Mexico
| | - Antonio García
- Unit of High Specialty "La Raza" IMSS, Mexico City, Mexico
| | | | - Stephen J C Hearps
- Universidad Nacional Autónoma de México, FES Iztacala, Mexico City, Mexico
| | - Vicki Anderson
- Universidad Nacional Autónoma de México, FES Iztacala, Mexico City, Mexico.,Child Neuropsychology, Murdoch Childrens Research Institute, Melbourne, Australia.,Royal Children´s Hospital, Melbourne, Australia
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25
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Aguilar-Raab C. Mindfulness- and Compassion-Based Interventions in Relational Contexts. SYSTEMIC RESEARCH IN INDIVIDUAL, COUPLE, AND FAMILY THERAPY AND COUNSELING 2020. [DOI: 10.1007/978-3-030-36560-8_13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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26
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Yehene E, Golan S, Brezner A, Gerner M, Landa J. Exploring the role of perceived vs. observed behavioral outcomes in parental grief reaction following pediatric acquired brain injury. NeuroRehabilitation 2019; 45:11-18. [PMID: 31403959 DOI: 10.3233/nre-192751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pediatric acquired brain injury may result in a significant gap between the "pre" and "post-injury" child. OBJECTIVE We aimed to quantitatively explore the mechanism underlying parents' loss experience by examining the mediating role of behavioral outcomes (observed-problems and perceived-change) in the relationship between injury severity and grief. METHOD The study employed a cross-sectional retrospective design and comprised 40 parents of children (aged 3-18 years) with moderate-severe brain injury. Data for each parent included an adapted version of the Two-Track Bereavement Questionnaire and Socio-demographics; Data for each child included the child's Information Processing Speed Index; the Child Behavioral Checklist and Parental Perception of Behavioral Changes scale. RESULTS Slowed information processing speed was significantly associated with elevated ratings on both measures of behavioral outcomes and with intensified grief. Mediation analyses revealed that parental perceived behavioral change, significantly mediate the relationship between information processing speed and grief; the Child Behavioral Checklist total score also mediated the same relationship but only in 90% confidence interval. CONCLUSIONS Findings reveal the adverse impact of behavioral outcomes on grief and suggest parents' loss experience to be stemming primarily from their subjective perception over their "changed-child", rather than the observed problems. Implications for clinical practice are discussed.
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Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, The Academic College of Tel Aviv - Yaffo, Israel.,Department of Pediatric Rehabilitation, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
| | - Sapir Golan
- School of Behavioral Sciences, The Academic College of Tel Aviv - Yaffo, Israel
| | - Amichai Brezner
- Department of Pediatric Rehabilitation, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
| | - Maya Gerner
- Department of Pediatric Rehabilitation, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
| | - Janna Landa
- Department of Pediatric Rehabilitation, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Yaffo, Israel
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Jones KM, Barker-Collo S, Parmar P, Starkey N, Theadom A, Ameratunga S, Feigin VL. Trajectories in health recovery in the 12 months following a mild traumatic brain injury in children: findings from the BIONIC Study. J Prim Health Care 2019; 10:81-89. [PMID: 30068456 DOI: 10.1071/hc17038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION There is growing consensus that adverse child outcomes may be evident in the early recovery phase following mild traumatic brain injury (TBI). However, controversy remains around the nature of children's longer-term recovery. AIM To examine child cognitive, behavioural and quality-of-life outcomes over 12 months following mild injury, and to identify prognostic factors associated with outcomes. METHODS A prospective sample of 222 children (aged 2-15 years at injury) with mild TBI was assessed using a cognitive testing battery and parent-report questionnaires at ≤ 14 days, 1, 6 and/or 12-months post-injury. RESULTS Parents reported significant improvements in their child's behavioural adjustment between baseline and 6 months (P = 0.003), with further improvements at 12 months following injury (P = 0.001). Cognitive recovery and quality-of-life improvements were more gradual with minimal changes in the first month (P > 0.05), but significant improvements by 12-months post-injury (P = 0.03, P = 0.02, respectively). Time since injury, male gender, living rurally and parent anxiety were associated with extent of recovery beyond the acute period. CONCLUSIONS Children's recovery from mild TBI continues beyond the initial 6 months following injury. Health-care providers need to be vigilant about the varying trajectories in children's recovery from TBI. On-going monitoring of children following injury will enable timely and proactive responses to persistent difficulties, with a view to minimising longer-term adverse consequences.
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Affiliation(s)
- Kelly M Jones
- National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Suzanne Barker-Collo
- School of Psychology, Tamaki Campus, The University of Auckland, Auckland, New Zealand
| | - Priya Parmar
- National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Nicola Starkey
- School of Psychology, Faculty of Arts & Social Sciences, The University of Waikato, Hamilton, New Zealand
| | - Alice Theadom
- National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Shanthi Ameratunga
- School of Population Health, Faculty of Medical & Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
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28
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Chavez-Arana C, Catroppa C, Carranza-Escárcega E, Godfrey C, Yáñez-Téllez G, Prieto-Corona B, de León MA, Anderson V. A Systematic Review of Interventions for Hot and Cold Executive Functions in Children and Adolescents With Acquired Brain Injury. J Pediatr Psychol 2019; 43:928-942. [PMID: 30124957 DOI: 10.1093/jpepsy/jsy013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/23/2018] [Indexed: 11/13/2022] Open
Abstract
Objective We investigated interventions, which aimed to improve cold and hot executive functions (EFs) in children and adolescents with a diagnosis of acquired brain injury (ABI). Methods The following electronic databases were searched: Medline, CINAHL, PsycINFO, and Pubmed. The database filters limited the search to articles published between 1990 and July 2017 in English or Spanish, including children and adolescents. Articles were read and classified according to the levels of evidence of the Australian National Health and Medical Research Council and the Downs and Black checklist was used for Measuring Study Quality. Results Thirty studies are reported in this systematic review. Level of evidence, quality of the studies, characteristics of the participants, interventions implemented, and outcomes are described. Conclusions The study of rehabilitation for executive dysfunction in children with ABI is emerging. Although few high-quality intervention studies exist in this area, which limits conclusions regarding intervention efficacy, results of existing studies suggest that education for parents may be an important component of intervention. Moreover, caregiver involvement may improve the effectiveness of hot EFs rehabilitation interventions, while high intervention session frequency may be important in improving cold EFs. Positive behavior supports and specific training based on a cognitive model provided some promising findings, which require further evaluation.
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Affiliation(s)
- Clara Chavez-Arana
- Child Neuropsychology, Murdoch Children's Research Institute.,University of Melbourne.,FES Iztacala, Universidad Nacional Autónoma de México
| | - Cathy Catroppa
- Child Neuropsychology, Murdoch Children's Research Institute.,University of Melbourne
| | | | - Celia Godfrey
- Child Neuropsychology, Murdoch Children's Research Institute
| | | | | | | | - Vicki Anderson
- Child Neuropsychology, Murdoch Children's Research Institute.,University of Melbourne
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Salomone E, Pacione L, Shire S, Brown FL, Reichow B, Servili C. Development of the WHO Caregiver Skills Training Program for Developmental Disorders or Delays. Front Psychiatry 2019; 10:769. [PMID: 31780960 PMCID: PMC6859468 DOI: 10.3389/fpsyt.2019.00769] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/24/2019] [Indexed: 12/29/2022] Open
Abstract
Globally, 52.9 million children under the age of 5 experience a developmental disability, such as sensory impairment, intellectual disability, and autism spectrum disorders. Of these 95% live in low-and-middle-income countries. Most of these children lack access to care. In light of the growing evidence that caregivers can learn skills to support their children's social communication and adaptive behavior and to reduce their challenging behavior, the World Health Organization developed a novel Caregiver Skills Training Program (CST) for families of children with developmental disorders or delay to address such treatment gap. This report outlines the development process, content, and global field-testing strategy of the WHO CST program. The CST program is designed to be feasible, scalable, and adaptable and appropriate for implementation in low-resource settings by nonspecialists. The program was informed by an evidence review utilizing a common elements approach and was developed through extensive stakeholder consultation and an iterative revision process. The program is intended for a global audience and was designed to be adapted to the cultural, socioeconomic, geographic, and resource context in which it is used to ensure that it is comprehensible, acceptable, feasible, and relevant to target users. It is currently undergoing field-testing in more than 30 countries across all world regions.
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Affiliation(s)
- Erica Salomone
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Laura Pacione
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
- Department of Psychiatry, Division of Child and Youth Mental Health, University of Toronto, Toronto, ON, Canada
| | - Stephanie Shire
- Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, United States
| | - Felicity L. Brown
- Research and Development Department, War Child Holland, Amsterdam, Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Brian Reichow
- Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, Gainesville, FL, United States
| | - Chiara Servili
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Ruane A, Carr A, Moffat V, Finn T, Murphy A, O'Brien O, Groarke H, O'Dwyer R. A randomised controlled trial of the Group Stepping Stones Triple P training programme for parents of children with developmental disabilities. Clin Child Psychol Psychiatry 2019; 24:728-753. [PMID: 30764646 DOI: 10.1177/1359104519827622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The central aim of this study was to examine the effectiveness of Group Stepping Stones Triple P (GSSTP) in an Irish context for families of children with both developmental disabilities and internalising and externalising behavioural problems. Parents of 84 children (mean age = 5.73; SD = 2.06) with developmental disabilities and co-occurring behaviour problems attending Irish public health services were randomly assigned to a 9-week GSSTP group or a waiting list control (WLC) group. All parents completed self-report measures before (Time 1) and after (Time 2) the programme and parents in the GSSTP group were assessed at 3- to 5-month follow-up (Time 3). At Time 2, clinical improvement and reliable change rates on the primary dependent variables (summary scales of the Developmental Behaviour Checklist and Strengths and Difficulties Questionnaire) were significantly higher in the GSSTP group than in the WLC group. At Time 2, mean scores of the GSSTP group showed significant, small to medium improvements relative to the WLC group on parent-reported child behaviour problems, parenting skills and confidence, and parental adjustment. Most of these improvements were maintained at 3- to 5-month follow-up. These results indicate that GSSTP is a promising intervention for improving child behaviour and parenting outcomes in a mixed-disability group in an Irish context.
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Affiliation(s)
- Ailbhe Ruane
- School of Psychology, University College Dublin, Ireland.,Health Service Executive, Ireland
| | - Alan Carr
- School of Psychology, University College Dublin, Ireland
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Yehene E, Brezner A, Ben-Valid S, Golan S, Bar-Nadav O, Landa J. Factors associated with parental grief reaction following pediatric acquired brain injury. Neuropsychol Rehabil 2019; 31:105-128. [PMID: 31556807 DOI: 10.1080/09602011.2019.1668280] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present study investigated factors associated with parental grief reaction (PGR) following pediatric acquired brain injury (ABI), and compared PGR to the one exhibited following child death. Fifty-seven parents of 51 children (aged 3-18) whose ABI occurred 1-14 years before participation, completed the multi-scale Two-Track Bereavement Questionnaire; a socio-demographic questionnaire; and a scale assessing perceived behavioural changes in the child. Results from regression analysis indicated that time since injury had no impact on parents' grief other than having an adverse impact on their overall coping and functioning; A higher amount of weekly caring hours predicted only a greater traumatic perception of the loss; Older children's ages but mostly greater parental-perceived behavioural changes, predicted greater PGR on most scales. PGR was compared with the pre-existing data of bereaved parents who completed the same grief questionnaire. Although grief response patterns and intensity were similar in both groups, significant differences were found on scales assessing the continuing bond with the child: relational active grief, close and positive relationship, and conflictual relationship. Our findings indicate that parental grief is multi-dimensional following pediatric ABI and illuminate the interplay between elements characterizing parents' nonfinite vs. finite loss experience.
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Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, Tel-Aviv, Israel.,Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel
| | - Amichai Brezner
- Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel
| | - Shani Ben-Valid
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, Tel-Aviv, Israel
| | - Sapir Golan
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yafo, Tel-Aviv, Israel
| | - Ofri Bar-Nadav
- International Center for the Study of Loss, Bereavement and Human Resilience, Department of Psychology, University of Haifa, Haifa, Israel
| | - Janna Landa
- Pediatric Rehabilitation Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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32
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Szabo TG. Acceptance and Commitment Training for reducing inflexible behaviors in children with autism. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hahs AD, Dixon MR, Paliliunas D. Randomized controlled trial of a brief acceptance and commitment training for parents of individuals diagnosed with autism spectrum disorders. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2018.03.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Law E, Fisher E, Eccleston C, Palermo TM. Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database Syst Rev 2019; 3:CD009660. [PMID: 30883665 PMCID: PMC6450193 DOI: 10.1002/14651858.cd009660.pub4] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Psychological therapies for parents of children and adolescents with chronic illness aim to improve parenting behavior and mental health, child functioning (behavior/disability, mental health, and medical symptoms), and family functioning.This is an updated version of the original Cochrane Review (2012) which was first updated in 2015. OBJECTIVES To evaluate the efficacy and adverse events of psychological therapies for parents of children and adolescents with a chronic illness. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, and trials registries for studies published up to July 2018. SELECTION CRITERIA Included studies were randomized controlled trials (RCTs) of psychological interventions for parents of children and adolescents with a chronic illness. In this update we included studies with more than 20 participants per arm. In this update, we included interventions that combined psychological and pharmacological treatments. We included comparison groups that received either non-psychological treatment (e.g. psychoeducation), treatment as usual (e.g. standard medical care without added psychological therapy), or wait-list. DATA COLLECTION AND ANALYSIS We extracted study characteristics and outcomes post-treatment and at first available follow-up. Primary outcomes were parenting behavior and parent mental health. Secondary outcomes were child behavior/disability, child mental health, child medical symptoms, and family functioning. We pooled data using the standardized mean difference (SMD) and a random-effects model, and evaluated outcomes by medical condition and by therapy type. We assessed risk of bias per Cochrane guidance and quality of evidence using GRADE. MAIN RESULTS We added 21 new studies. We removed 23 studies from the previous update that no longer met our inclusion criteria. There are now 44 RCTs, including 4697 participants post-treatment. Studies included children with asthma (4), cancer (7), chronic pain (13), diabetes (15), inflammatory bowel disease (2), skin diseases (1), and traumatic brain injury (3). Therapy types included cognitive-behavioural therapy (CBT; 21), family therapy (4), motivational interviewing (3), multisystemic therapy (4), and problem-solving therapy (PST; 12). We rated risk of bias as low or unclear for most domains, except selective reporting bias, which we rated high for 19 studies due to incomplete outcome reporting. Evidence quality ranged from very low to moderate. We downgraded evidence due to high heterogeneity, imprecision, and publication bias.Evaluation of parent outcomes by medical conditionPsychological therapies may improve parenting behavior (e.g. maladaptive or solicitous behaviors; lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.28, 95% confidence interval (CI) -0.43 to -0.13; participants = 664; studies = 3; SMD -0.21, 95% CI -0.37 to -0.05; participants = 625; studies = 3; I2 = 0%, respectively, low-quality evidence), chronic pain post-treatment and follow-up (SMD -0.29, 95% CI -0.47 to -0.10; participants = 755; studies = 6; SMD -0.35, 95% CI -0.50 to -0.20; participants = 678; studies = 5, respectively, moderate-quality evidence), diabetes post-treatment (SMD -1.39, 95% CI -2.41 to -0.38; participants = 338; studies = 5, very low-quality evidence), and traumatic brain injury post-treatment (SMD -0.74, 95% CI -1.25 to -0.22; participants = 254; studies = 3, very low-quality evidence). For the remaining analyses data were insufficient to evaluate the effect of treatment.Psychological therapies may improve parent mental health (e.g. depression, anxiety, lower scores are better) in children with cancer post-treatment and follow-up (SMD -0.21, 95% CI -0.35 to -0.08; participants = 836, studies = 6, high-quality evidence; SMD -0.23, 95% CI -0.39 to -0.08; participants = 667; studies = 4, moderate-quality evidence, respectively), and chronic pain post-treatment and follow-up (SMD -0.24, 95% CI -0.42 to -0.06; participants = 490; studies = 3; SMD -0.20, 95% CI -0.38 to -0.02; participants = 482; studies = 3, respectively, low-quality evidence). Parent mental health did not improve in studies of children with diabetes post-treatment (SMD -0.24, 95% CI -0.90 to 0.42; participants = 211; studies = 3, very low-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent mental health.Evaluation of parent outcomes by psychological therapy typeCBT may improve parenting behavior post-treatment (SMD -0.45, 95% CI -0.68 to -0.21; participants = 1040; studies = 9, low-quality evidence), and follow-up (SMD -0.26, 95% CI -0.42 to -0.11; participants = 743; studies = 6, moderate-quality evidence). We did not find evidence for a beneficial effect for CBT on parent mental health at post-treatment or follow-up (SMD -0.19, 95% CI -0.41 to 0.03; participants = 811; studies = 8; SMD -0.07, 95% CI -0.34 to 0.20; participants = 592; studies = 5; respectively, very low-quality evidence). PST may improve parenting behavior post-treatment and follow-up (SMD -0.39, 95% CI -0.64 to -0.13; participants = 947; studies = 7, low-quality evidence; SMD -0.54, 95% CI -0.94 to -0.14; participants = 852; studies = 6, very low-quality evidence, respectively), and parent mental health post-treatment and follow-up (SMD -0.30, 95% CI -0.45 to -0.15; participants = 891; studies = 6; SMD -0.21, 95% CI -0.35 to -0.07; participants = 800; studies = 5, respectively, moderate-quality evidence). For the remaining analyses, data were insufficient to evaluate the effect of treatment on parent outcomes.Adverse eventsWe could not evaluate treatment safety because most studies (32) did not report on whether adverse events occurred during the study period. In six studies, the authors reported that no adverse events occurred. The remaining six studies reported adverse events and none were attributed to psychological therapy. We rated the quality of evidence for adverse events as moderate. AUTHORS' CONCLUSIONS Psychological therapy may improve parenting behavior among parents of children with cancer, chronic pain, diabetes, and traumatic brain injury. We also found beneficial effects of psychological therapy may also improve parent mental health among parents of children with cancer and chronic pain. CBT and PST may improve parenting behavior. PST may also improve parent mental health. However, the quality of evidence is generally low and there are insufficient data to evaluate most outcomes. Our findings could change as new studies are conducted.
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Affiliation(s)
- Emily Law
- Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
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How Do Parents Influence Child Disruptive Behavior After Acquired Brain Injury? Evidence From a Mediation Model and Path Analysis. J Int Neuropsychol Soc 2019; 25:237-248. [PMID: 30864536 DOI: 10.1017/s1355617718001236] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Children with acquired brain injury (ABI) can present with disruptive behavior, which is often a consequence of injury and parent factors. Parent factors are associated with child disruptive behavior. Furthermore, disinhibition in the child also leads to disruptive behavior. However, it is unclear how these factors interact. We investigated whether parental factors influence child disruptive behavior following ABI and how these factors interact. METHODS Parents of 77 children with ABI participated in the study. Parent factors (executive dysfunction, trait-anxiety), potential intervention targets (dysfunctional parenting practices, parental stress, child disinhibition), and child disruptive behavior were assessed. A hypothetical model based on the literature was tested using mediation and path analysis. RESULTS Mediation analysis revealed that child disinhibition and dysfunctional parenting practices mediated the association of parent factors and child disruptive behavior. Parents' executive dysfunction mediated the association of dysfunctional parenting practices, parental stress and parent trait-anxiety. Parenting practices mediated the association of executive dysfunction and child disruptive behavior. Path analysis indices indicated good model adjustment. Comparative and Tucker-Lewis Index were >0.95, and the root mean square error of approximation was 0.059, with a chi-square of 0.25. CONCLUSIONS A low level of parental trait-anxiety may be required to reduce dysfunctional parenting practices and child disinhibition. Impairments in child disinhibition can be exacerbated when parents present with high trait-anxiety. Child disinhibition is the major contributor of disruptive behavior reported by parents and teachers. The current study provides evidence of parent anxiety and child disinhibition as possible modifiable intervention targets for reducing child disruptive behavior. (JINS, 2019, 25, 237-248).
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Ruane AI, Carr A. Systematic Review and Meta-analysis of Stepping Stones Triple P for Parents of Children with Disabilities. FAMILY PROCESS 2019. [PMID: 29520764 DOI: 10.1111/famp.12352] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The aim of this systematic review and meta-analysis was to examine the effectiveness of Stepping Stones Triple P (SSTP) parent training programs on child behavior problems and parenting outcomes in families of children with developmental disabilities. Sixteen suitable studies including data from over 900 families were identified in a search for English language published and unpublished controlled outcome studies. SSTP has five levels on a graded continuum of increasing intensity targeting families with differing degrees of treatment need from low intensity media-based parenting information campaigns at level 1, through brief interventions at levels 2 and 3, to more intensive parent training and family therapy interventions at levels 4 and 5. Analyses were conducted on the combination of all levels of SSTP and separately for each level. For combined levels, significant overall effect sizes were found for parent-reported child problems (d = 0.46), researcher observed child behavior (d = 0.51), parenting style (d = 0.70), parenting satisfaction/self-efficacy (d = 0.44), parental adjustment (d = 0.27), and coparental relationship (d = 0.26), but not researcher-observed parent behavior. Strong support was found for level 4 SSTP as an effective intervention for improving child and parent outcomes in families of children with disabilities who have clinically significant problems. Less intensive SSTP interventions for cases with circumscribed difficulties yielded fewer significant treatment effects, and there were relatively few studies of such interventions.
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Affiliation(s)
- AIlbhe Ruane
- Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland
| | - Alan Carr
- Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland
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Chong YY, Mak YW, Leung SP, Lam SY, Loke AY. Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT. Pediatrics 2019; 143:peds.2018-1723. [PMID: 30659063 DOI: 10.1542/peds.2018-1723] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Few trials have been conducted to address the psychological difficulties of parents in managing their child's asthma. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help parents to accept these psychological difficulties and improve their management of childhood asthma. METHODS In this randomized controlled trial, a 4-session, group-based ACT plus asthma education (ACT group) was compared with an asthma education talk plus 3 telephone follow-ups (control group) to train parents of children diagnosed with asthma. The use of health care services due to asthma exacerbations in children and the psychological well-being of their parents were assessed before, immediately after, and at 6 months after the intervention. RESULTS A total of 168 parents and their children aged 3 to 12 years with asthma were consecutively recruited in a public hospital in Hong Kong. When compared with the control group, children whose parents were in the ACT group made significantly fewer emergency department visits (adjusted 6-month incidence rate ratio = 0.20; confidence interval [CI] 0.08 to 0.53; P = .001) due to asthma exacerbations at 6 months postintervention. These parents also reported a decrease in psychological inflexibility (mean difference = -5.45; CI -7.71 to -3.30; P = .014), less anxiety (mean difference = -2.20; CI -3.66 to -0.73; P = .003), and stress (mean difference = -2.50; CI -4.54 to -0.47; P = .016). CONCLUSIONS Integrating ACT into parental asthma education was effective at decreasing parental anxiety and stress and reducing the asthma-related emergency department visits of children at 6 months postintervention.
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Affiliation(s)
- Yuen-Yu Chong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and
| | - Yim-Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and
| | - Sui-Ping Leung
- Department of Pediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong, China
| | - Shu-Yan Lam
- Department of Pediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and
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Wade SL, Kaizar EE, Narad M, Zang H, Kurowski BG, Yeates KO, Taylor HG, Zhang N. Online Family Problem-solving Treatment for Pediatric Traumatic Brain Injury. Pediatrics 2018; 142:e20180422. [PMID: 30413559 PMCID: PMC6317641 DOI: 10.1542/peds.2018-0422] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To determine whether online family problem-solving treatment (OFPST) is more effective in improving behavioral outcomes after pediatric traumatic brain injury with increasing time since injury. METHODS This was an individual participant data meta-analysis of outcome data from 5 randomized controlled trials of OFPST conducted between 2003 and 2016. We included 359 children ages 5 to 18 years who were hospitalized for moderate-to-severe traumatic brain injury 1 to 24 months earlier. Outcomes, assessed pre- and posttreatment, included parent-reported measures of externalizing, internalizing, and executive function behaviors and social competence. RESULTS Participants included 231 boys and 128 girls with an average age at injury of 13.6 years. Time since injury and age at injury moderated OFPST efficacy. For earlier ages and short time since injury, control participants demonstrated better externalizing problem scores than those receiving OFPST (Cohen's d = 0.44; P = .008; n = 295), whereas at older ages and longer time since injury, children receiving OFPST had better scores (Cohen's d = -0.60; P = .002). Children receiving OFPST were rated as having better executive functioning relative to control participants at a later age at injury, with greater effects seen at longer (Cohen's d = -0.66; P = .009; n = 298) than shorter (Cohen's d = -0. 28; P = .028) time since injury. CONCLUSIONS OFPST may be more beneficial for older children and when begun after the initial months postinjury. With these findings, we shed light on the optimal application of family problem-solving treatments within the first 2 years after injury.
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Affiliation(s)
- Shari L Wade
- Departments of Rehabilitation Medicine,
- Departments of Pediatrics and
| | | | | | - Huaiyu Zang
- Statistics, and
- Mathematical Sciences, University of Cincinnati, Cincinnati, Ohio
| | - Brad G Kurowski
- Departments of Rehabilitation Medicine
- Departments of Pediatrics, Neurology, and Rehabilitation, College of Medicine, and
| | - Keith Owen Yeates
- Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, and
- Department of Psychology, University of Calgary, Calgary, Canada; and
| | - H Gerry Taylor
- Department of Pediatrics, Research Institute, Nationwide Children's Hospital, Columbus, Ohio
- The Ohio State University, Columbus, Ohio
| | - Nanhua Zhang
- Departments of Pediatrics and
- Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Maughan AL, Weiss JA. Parental Outcomes Following Participation in Cognitive Behavior Therapy for Children with Autism Spectrum Disorder. J Autism Dev Disord 2018; 47:3166-3179. [PMID: 28762160 DOI: 10.1007/s10803-017-3224-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Children with autism spectrum disorder (ASD) benefit from parent involvement in their therapy, and there is evidence that this involvement may improve parent functioning as well. We examined changes in parent mental health, parenting, and expressed emotion, following participation in a randomized controlled trial of cognitive behavior therapy for 57 children with ASD. Post-intervention, improvements occurred in the treatment group in parent depression and emotion regulation, compared to waitlisted parents. Treatment effects also occurred across all parents in depression, emotion regulation, perceptions of their children and mindful parenting. Though preliminary, these results have implications for intervention development and evaluation by focusing on parent outcomes in child treatment.
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Affiliation(s)
- Andrea L Maughan
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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Flujas-Contreras JM, Gómez I. Improving flexible parenting with Acceptance and Commitment Therapy: A case study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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41
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Gillard D, Flaxman P, Hooper N. Acceptance and Commitment Therapy: Applications for Educational Psychologists within Schools. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2018. [DOI: 10.1080/02667363.2018.1446911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Duncan Gillard
- Educational Psychology Service, Trading with Schools (City Hall) , Bristol, UK
| | - Paul Flaxman
- Department of Psychology, City University London , London, UK
| | - Nic Hooper
- Department of Psychology, University of the West of England , Bristol, UK
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Garcia YA, Grau IA. Entrenamiento Conductual y Atención Plena sobre el Estrés Parental y Relación Padre-Hijo. PSICOLOGIA: TEORIA E PESQUISA 2018. [DOI: 10.1590/0102.3772e3323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMEN El objetivo principal de este estudio fue evaluar la efectividad de un procedimiento tradicional a padres combinado con uno de atención plena en la reducción del estrés parental e incremento en interacción positiva padre-hijo. Se utilizó un diseño pre test - pos test de un solo grupo. Durante el pre test y pos test se aplicaron el PSI, FFMQ y PCRI-M para evaluar el estrés parental, atención plena y relación padre-hijo, respectivamente. La intervención duró ocho semanas en que se implementó un procedimiento de entrenamiento de padres y uno de atención plena. Los resultados muestran que el entrenamiento combinado fue efectivo en la reducción del estrés parental, el incremento del uso de la atención plena y la mejora en la relación padre-hijo.
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Affiliation(s)
- Yors Alexander Garcia
- Fundacion Universitaria Konrad Lorenz, Colombia; The Chicago School of Professional Psychology, USA
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43
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Chavez-Arana C, Catroppa C, Yáñez Téllez G, Godfrey C, Prieto-Corona B, de León MA, García A, Anderson V. Feasibility and effectiveness of a parenting programme for Mexican parents of children with acquired brain injury-Case report. Brain Inj 2017; 32:276-285. [DOI: 10.1080/02699052.2017.1394491] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Clara Chavez-Arana
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
- Universidad Nacional Autónoma de México, FES Iztacala, Mexico City, Mexico
| | - Cathy Catroppa
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
- Royal Children’s Hospital, Child Neuropsychology, Melbourne, Victoria, Australia
| | | | - Celia Godfrey
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
- Royal Children’s Hospital, Child Neuropsychology, Melbourne, Victoria, Australia
| | | | - Miguel A. de León
- Iskalti Centre of Psychological and Educational Support S.C., Mexico City, Mexico
| | - Antonio García
- Unit of High Specialty “La Raza” IMSS, Paediatric Neurosurgery, Mexico City, Mexico
| | - Vicki Anderson
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
- Royal Children’s Hospital, Child Neuropsychology, Melbourne, Victoria, Australia
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Randomized Clinical Trial of Online Parent Training for Behavior Problems After Early Brain Injury. J Am Acad Child Adolesc Psychiatry 2017; 56:930-939.e2. [PMID: 29096775 DOI: 10.1016/j.jaac.2017.09.413] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/28/2017] [Accepted: 09/07/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of Internet-based Interacting Together Everyday: Recovery After Childhood TBI (I-InTERACT) versus abbreviated parent training (Express) or access to online resources (internet resources comparison [IRC]) in improving parenting skills and decreasing behavior problems after early traumatic brain injury (TBI). METHOD In this randomized, controlled, clinical trial, 113 children 3 to 9 years old previously hospitalized for moderate to severe TBI were randomly assigned to receive Express (n = 36), I-InTERACT (n = 39), or IRC (n = 38). Express included 7 online parent skills sessions, and I-InTERACT delivered 10 to 14 sessions addressing parenting skills, TBI education, stress, and anger management. The 2 interventions coupled online modules with therapist coaching through a Health Insurance Portability and Accountability Act-compliant Skype link. The IRC group received access to online TBI and parent skills resources. Co-primary outcomes were blinded ratings of parenting skills and parent report of behavior problems and problem intensity on the Eyberg Child Behavior Inventory (ECBI). Outcomes were assessed before treatment and 3 and 6 months after treatment, with the latter constituting the primary endpoint. RESULTS The Express and I-InTERACT groups displayed higher levels of positive parenting at follow-up. Only the I-InTERACT group had lower levels of negative parenting at 6 months. The Express group had lower ECBI intensity scores than the IRC group. Baseline symptom levels moderated improvements; children in the Express and I-InTERACT groups with higher baseline symptoms demonstrated greater improvements than those in the IRC group. Changes in parenting skills mediated improvements in behavior in those with higher baseline symptoms. CONCLUSION Brief online parent skills training can effectively decrease behavior problems after early TBI in children with existing behavioral symptoms. Clinical trial registration information-Internet-based Interacting Together Everyday, Recovery After Childhood TBI (I-InTERACT)-RRTC; http://clinicaltrials.gov/; NCT01214694.
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Tyerman E, Eccles FJR, Gray V. The experiences of parenting a child with an acquired brain injury: A meta-synthesis of the qualitative literature. Brain Inj 2017; 31:1553-1563. [PMID: 28750173 DOI: 10.1080/02699052.2017.1341999] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To systematically review and then synthesize the qualitative literature on the experience of parenting a child with an acquired brain injury (ABI). DESIGN Systematic literature review and meta-synthesis Methods. A systematic search of the literature was conducted in four databases. Papers which met the inclusion criterion were assessed for quality using the Critical Skills Appraisal Programme (CASP) tool and then synthesized according to Noblit and Hare's (1988) guidelines for meta-ethnography. RESULTS Of the 4855 papers retrieved, 17 met the inclusion criteria. Synthesis resulted in three themes: (1) Disconnection: Cut off from internal emotions and isolated from others; (2) Seeking understanding and support to manage in an insecure world; and (3) New parent to a different child. CONCLUSIONS Having a child with an ABI leads to many challenges for parents. These include feeling insecure, isolated from others and struggling to adapt to the different roles required to parent their different child. Clinical implications highlight the need for specialist support that is ongoing after discharge, including specialist knowledge and understanding of ABI and opportunities for peer support.
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Affiliation(s)
- Emma Tyerman
- a Division of Health Research, Faculty of Health and Medicine , Lancaster University , Lancaster , UK
| | - Fiona J R Eccles
- a Division of Health Research, Faculty of Health and Medicine , Lancaster University , Lancaster , UK
| | - Victoria Gray
- b Psychological Services (Paediatrics) , Alder Hey Children's NHS Foundation Trust , Liverpool , UK
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Hinton S, Sheffield J, Sanders MR, Sofronoff K. A randomized controlled trial of a telehealth parenting intervention: A mixed-disability trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 65:74-85. [PMID: 28458049 DOI: 10.1016/j.ridd.2017.04.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 03/31/2017] [Accepted: 04/05/2017] [Indexed: 05/12/2023]
Abstract
BACKGROUND The quality of parenting a child receives has a major impact on development, wellbeing and future life opportunities. AIMS This study examined the efficacy of Triple P Online - Disability (TPOL-D) a telehealth intervention for parents of children with a disability. METHODS Ninety-eight parents and carers of children aged 2-12 years diagnosed with a range of developmental, intellectual and physical disabilities were randomly assigned to either the intervention (51) or treatment-as-usual (47) control group. RESULTS At post-intervention parents receiving the TPOL-D intervention demonstrated significant improvements in parenting practices and parenting self-efficacy, however a significant change in parent-reported child behavioral and emotional problems was not detected. At 3-month follow up intervention gains were maintained and/or enhanced. A significant decrease in parent-reported child behavioral and emotional problems was also detected at this time. CONCLUSIONS The results indicate that TPOL-D is a promising telehealth intervention for a mixed-disability group.
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Affiliation(s)
- Sharon Hinton
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Jeanie Sheffield
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Matthew R Sanders
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
| | - Kate Sofronoff
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, 4072, Australia.
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47
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Kanstrup M, Wicksell RK, Kemani M, Wiwe Lipsker C, Lekander M, Holmström L. A Clinical Pilot Study of Individual and Group Treatment for Adolescents with Chronic Pain and Their Parents: Effects of Acceptance and Commitment Therapy on Functioning. CHILDREN-BASEL 2016; 3:children3040030. [PMID: 27854323 PMCID: PMC5184805 DOI: 10.3390/children3040030] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/31/2016] [Accepted: 11/07/2016] [Indexed: 11/16/2022]
Abstract
Pediatric chronic pain is common and can result in substantial long-term disability. Previous studies on acceptance and commitment therapy (ACT) have shown promising results in improving functioning in affected children, but more research is still urgently needed. In the current clinical pilot study, we evaluated an ACT-based interdisciplinary outpatient intervention (14 sessions), including a parent support program (four sessions). Adolescents were referred to the clinic if they experienced disabling chronic pain. They were then randomized, along with their parents, to receive group (n = 12) or individual (n = 18) treatment. Adolescent pain interference, pain reactivity, depression, functional disability, pain intensity and psychological flexibility, along with parent anxiety, depression, pain reactivity and psychological flexibility were assessed using self-reported questionnaires. There were no significant differences in outcomes between individual and group treatment. Analyses illustrated significant (p < 0.01) improvements (medium to large effects) in pain interference, depression, pain reactivity and psychological flexibility post-treatment. Additionally, analyses showed significant (p < 0.01) improvements (large effects) in parent pain reactivity and psychological flexibility post-treatment. On all significant outcomes, clinically-significant changes were observed for 21%–63% of the adolescents across the different outcome measures and in 54%–76% of the parents. These results support previous findings and thus warrant the need for larger, randomized clinical trials evaluating the relative utility of individual and group treatment and the effects of parental interventions.
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Affiliation(s)
- Marie Kanstrup
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Rikard K Wicksell
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Mike Kemani
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Camilla Wiwe Lipsker
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden.
- Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden.
| | - Linda Holmström
- Functional Area Medical Psychology, Functional Unit Behavioral Medicine, Karolinska University Hospital Solna, P8:01, 171 76 Stockholm, Sweden.
- Department of Women's and Children's health, Karolinska Institutet, H2:00, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden.
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48
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Graham CD, Gouick J, Krahé C, Gillanders D. A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions. Clin Psychol Rev 2016; 46:46-58. [DOI: 10.1016/j.cpr.2016.04.009] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/07/2016] [Accepted: 04/07/2016] [Indexed: 12/21/2022]
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Kirby JN. The role of mindfulness and compassion in enhancing nurturing family environments. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/cpsp.12149] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wade SL, Zhang N, Yeates KO, Stancin T, Taylor HG. Social Environmental Moderators of Long-term Functional Outcomes of Early Childhood Brain Injury. JAMA Pediatr 2016; 170:343-9. [PMID: 26902662 PMCID: PMC5488264 DOI: 10.1001/jamapediatrics.2015.4485] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Pediatric traumatic brain injury (TBI) contributes to impairments in behavior and academic performance. However, the long-term effects of early childhood TBI on functioning across settings remain poorly understood. OBJECTIVE To examine the long-term functional outcomes of early childhood TBI relative to early childhood orthopedic injuries (OIs). We also examine the moderating role of the social environment as defined by parent report and observational measures of family functioning, parenting practices, and home environment. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal, observational cohort study conducted at each child's home, school, and hospital, including 3 children's hospitals and 1 general hospital in the Midwest. Patients were enrolled in the initial study between January 2003 and October 2006. Follow-ups were completed between January 2010 and April 2015. Fifty-eight children who sustained a TBI (67% of original enrolled cohort) and 72 children who sustained an OI (61% of the original enrolled cohort) were prospectively followed up from shortly after injury (between the ages of 3 and 7 years at enrollment) to an average of 6.7 years after injury, with assessments occurring at multiple points. MAIN OUTCOMES AND MEASURES Long-term functional outcomes in everyday settings, as assessed through the Child and Adolescent Functional Assessment Scale (CAFAS). RESULTS Of the 130 children included, the median age for those with OIs was 11.72 years and 11.97, 12.21, and 11.72 years for those with complicated mild, moderate, and severe TBIs, respectively. Children with moderate and severe TBI were rated as having more functional impairments in multiple domains than those with OIs (P < .05). Children with complicated mild TBI had greater impairments in school (odds ratio = 2.93; 95% CI = 1.10-7.82) and with thinking (odds ratio = 15.72; 95% CI = 3.31-74.73) than those with OIs. Functional impairments in children with TBI were more pronounced among children from families with higher levels of permissive (mean CAFAS of 49.71, 35.74, 58.14, and 16.16 for severe TBI, moderate TBI, complicated mild TBI, and OI, respectively, with significant difference between severe TBI and OI [difference = 33.55; P < .001] and complicated mild TBI and OI [difference = 41.98; P < .001]) or authoritarian (mean CAFAS of 56.45, 41.80, 54.90, and 17.12 for severe TBI, moderate TBI, complicated mild TBI, and OI, respectively, with significant difference between severe TBI and OI [difference = 39.33; P < .001], moderate TBI and OI [difference = 24.68; P = .003], and complicated mild TBI and OI [difference = 37.78; P < .001]) parenting or with fewer home resources (mean CAFAS of 69.57, 47.45, 49.00, and 23.81 for severe TBI, moderate TBI, complicated mild TBI, and OI, respectively, with significant difference between severe TBI and OI [difference = 45.77; P < .001], moderate TBI and OI [difference = 23.64; P < .001], and complicated mild TBI and OI [difference = 25.20; P < .001]). CONCLUSIONS AND RELEVANCE Even children with relatively mild early TBI experience long-term functional impairments, particularly in the context of less favorable home environments. These findings suggest that improving parenting skills and the quality of the home environment may promote functional recovery following early TBI.
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Affiliation(s)
- Shari L Wade
- Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio2University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Nanhua Zhang
- University of Cincinnati College of Medicine, Cincinnati, Ohio3Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada5Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada6Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary
| | - Terry Stancin
- Division of Child & Adolescent Psychiatry & Psychology, Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio8MetroHealth Medical Center, Cleveland, Ohio
| | - H Gerry Taylor
- Division of Developmental and Behavioral Pediatrics and Psychology, Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio10Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio
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