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Green R, Linga-Easwaran J, Goodman C, Taylor M, Fabiano GF, Miller SP, Williams TS. Positive parenting practices support children at neurological risk during COVID-19: a call for accessible parenting interventions. Front Psychol 2024; 15:1328476. [PMID: 38650902 PMCID: PMC11033430 DOI: 10.3389/fpsyg.2024.1328476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
Children and youth with neurological and/or neurodevelopmental conditions were at high risk for behavioral and mental health challenges during the COVID-19 pandemic. Positive and responsive parenting practices may be one way to prevent and manage potential difficulties in families. We aimed to identify whether positive parenting practices were associated with reduced behavioral concerns in children at neurological risk during the late stages and aftermath of the COVID-19 pandemic. In addition, we examined whether ongoing parental stress, anxiety, and depression impacted parenting practices during this time period. Families (N = 179) with children 4 to 15 years old (M = 7.11y, SD = 2.02) diagnosed with neurological (84.3%), neurodevelopmental (54.8%) or comorbid neurological and/or neurodevelopmental conditions (21.2%) were contacted to complete online questionnaires regarding demographics, parent stress, child behavior, COVID-19 conditions, and parenting practices. Multivariable linear regression (MLR) analyses examined the association between positive parenting practices and parenting competency measures with child behavioral outcomes, controlling for relevant covariates, including COVID-19 related stress. MLR were also run to determine whether parental mental health impacted parenting practices. More positive parenting practices predicted fewer child problem behaviors and lower intensity of problem behaviors. Similarly, a higher sense of satisfaction with parenting competence also predicted fewer child problem behaviors and lower intensity of problem behaviors. In addition, higher reported parental depression, anxiety, and stress significantly predicted fewer reported positive parenting practices. Findings points to the promising application of positive parenting interventions to support vulnerable families, as well as the need for parental mental health intervention to support parenting practices.
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Affiliation(s)
- Rivka Green
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Janaksha Linga-Easwaran
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Carly Goodman
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Marin Taylor
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Giulia F. Fabiano
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Steven P. Miller
- Department of Pediatrics, Faculty of Medicine, BC Children's Hospital, Vancouver, BC, Canada
| | - Tricia S. Williams
- Department of Psychology, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Deotto A, Fabiano GF, Chung BYT, Wade SL, Anagnostou E, Crosbie J, Kelley E, Nicolson R, Andrade BF, Miller SP, Williams TS. Stepping up to COVID-19: A Clinical Trial of a Telepsychology Positive Parenting Program Targeting Behavior Problems in Children With Neurological Risk. J Pediatr Psychol 2023:jsad032. [PMID: 37316980 DOI: 10.1093/jpepsy/jsad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To evaluate the feasibility, acceptability, and preliminary efficacy of a stepped-care parenting program implemented during COVID-19 among families of behaviorally at-risk children with neurological or neurodevelopmental disorders aged 3-9 years. METHODS Stepped-care I-InTERACT-North increased psychological support across 3 steps, matched to family needs: (1) guided self-help (podcast), (2) brief support, and (3) longer-term parent support. The intervention was provided by clinicians at The Hospital for Sick Children. Recruitment occurred via hospital and research cohort referral. A single-arm trial using a pragmatic prospective pre-post mixed-method design was utilized to assess accrual, engagement, acceptability, and preliminary efficacy. RESULTS Over 15 months, 68 families enrolled (83% consent rate) and 56 families completed stepped-care (Step 1 = 56; Step 2 = 39; Step 3 = 28), with high adherence across Steps (100%, 98%, and 93%, respectively). Parents reported high acceptability, reflected in themes surrounding accessibility, comprehension, effectiveness, and targeted care. Positive parenting skill increases were documented, and robust improvement in child behavior problems was apparent upon Step 3 completion (p =.001, d = .390). Stepped-care was as effective as traditional delivery, while improving consent and completion rates within a pandemic context. CONCLUSIONS This stepped-care telepsychology parenting program provides a compelling intervention model to address significant gaps in accessible mental health intervention while simultaneously balancing the need for efficient service. Findings inform program scalability beyond COVID-19 and emphasize the value of stepped-care intervention in delivering and monitoring mental health treatment.
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Affiliation(s)
- Angela Deotto
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
| | - Giulia F Fabiano
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Beryl Y T Chung
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Shari L Wade
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Evdokia Anagnostou
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queens University, Kingston, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada
| | - Brendan F Andrade
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Steven P Miller
- Faculty of Medicine, BC Children's Hospital, Vancouver, BC, Canada
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tricia S Williams
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Gicas KM, Parmar PK, Fabiano GF, Mashhadi F. Substance-induced psychosis and cognitive functioning: A systematic review. Psychiatry Res 2022; 308:114361. [PMID: 34979380 DOI: 10.1016/j.psychres.2021.114361] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/15/2022]
Abstract
Longitudinal studies of substance-induced psychosis (SIP) suggest that approximately 11-46% of persons will progress to schizophrenia with differential risk of progression depending on the type of substance used. The findings suggest SIP may be a distinct variant of a psychotic disorder, yet SIP is understudied and the disease expression is not well characterized, particularly the cognitive phenotype. There is some evidence for cognitive dysfunction in SIP, but a synthesis of this literature has not been undertaken. We systematically reviewed all empirical research (up to December 31, 2020) that examined cognition in SIP using clinical neuropsychological measures. The cognitive outcomes are summarized by type of SIP (methamphetamine, other stimulants, alcohol, cannabis, undifferentiated). There was evidence for global and domain-specific cognitive dysfunction in SIP compared to controls and non-psychotic persons who use substances. Impairments were of similar magnitude compared to persons with schizophrenia. Delineation of a specific cognitive profile in SIP was precluded by lack of literature with comparable study designs and outcomes. Variation in visual-based cognition may be a distinct feature of SIP, but this requires further investigation. More rigorously controlled studies of cognition in SIP are needed to inform differential diagnosis and identify the unique clinical needs of this population.
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Bohn MK, Fabiano GF, Adeli K. Electronic tools in clinical laboratory diagnostics: key examples, limitations, and value in laboratory medicine. J LAB MED 2021. [DOI: 10.1515/labmed-2021-0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Electronic tools in clinical laboratory diagnostics can assist laboratory professionals, clinicians, and patients in medical diagnostic management and laboratory test interpretation. With increasing implementation of electronic health records (EHRs) and laboratory information systems worldwide, there is increasing demand for well-designed and evidence-based electronic resources. Both complex data-driven and simple interpretative electronic healthcare tools are currently available to improve the integration of clinical and laboratory information towards a more patient-centered approach to medicine. Several studies have reported positive clinical impact of electronic healthcare tool implementation in clinical laboratory diagnostics, including in the management of neonatal bilirubinemia, cardiac disease, and nutritional status. As patients have increasing access to their medical laboratory data, it is essential that accessible electronic healthcare tools are evidence-based and user-friendly for individuals of varying digital and medical literacy. Indeed, studies suggest electronic healthcare tool development processes significantly lack the involvement of relevant healthcare professionals and often present misinformation, including erroneous calculation algorithms or inappropriate interpretative recommendations. The current review provides an overview of the utility of available electronic healthcare tools in clinical laboratory diagnostics and critically reviews potential limitations and benefits of their clinical implementation. The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) online database is also detailed as an example of a pediatric diagnostic tool with widespread global impact.
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Affiliation(s)
- Mary Kathryn Bohn
- Molecular Medicine and Clinical Biochemistry , The Hospital for Sick Children , Toronto , ON , Canada
- Laboratory Medicine and Pathobiology , University of Toronto , Toronto , ON , Canada
| | - Giulia F. Fabiano
- Molecular Medicine and Clinical Biochemistry , The Hospital for Sick Children , Toronto , ON , Canada
| | - Khosrow Adeli
- Molecular Medicine and Clinical Biochemistry , The Hospital for Sick Children , Toronto , ON , Canada
- Laboratory Medicine and Pathobiology , University of Toronto , Toronto , ON , Canada
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Kian T, Parmar PK, Fabiano GF, Pathman T. Tell Me About Your Visit With the Lions: Eliciting Event Narratives to Examine Children's Memory and Learning During Summer Camp at a Local Zoo. Front Psychol 2021; 12:657454. [PMID: 34305722 PMCID: PMC8295724 DOI: 10.3389/fpsyg.2021.657454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/14/2021] [Indexed: 12/04/2022] Open
Abstract
School-aged children often participate in school field trips, summer camps or visits at informal learning institutions like zoos and museums. However, relatively little is known about children’s memory and learning from these experiences, what types of event details and facts are retained, how retention varies across age, and whether different patterns are observed for different types of experiences. We aimed to answer these questions through a partnership with a local zoo. Four- to 10-year-old children (N = 122) participated in a weeklong summer camp, during which they engaged in dynamic events, including visits to zoo animals. On the last day of camp, we elicited autobiographical event narratives for two types of experiences: a child-selected animal event (visit to their favorite animal) and an experimenter-selected animal event. We coded event narratives for length and breadth using previously used autobiographical memory (AM) narrative coding schemes. In addition, we created a coding scheme to examine retention of semantic information (facts). We report the types of autobiographical event details and facts children recalled in their narratives, as well as age group differences that were found to vary depending on the type of information and type of event. Through this naturalistic, yet controlled, study we gain insights into how children remember and learn through hands-on activities and exploration in this engaging and dynamic environment. We discuss how our results provide novel information that can be used by informal learning institutions to promote children’s memory and retention of science facts.
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Affiliation(s)
- Tida Kian
- Memory Development Laboratory, Department of Psychology, York University, Toronto, ON, Canada
| | - Puneet K Parmar
- Memory Development Laboratory, Department of Psychology, York University, Toronto, ON, Canada
| | - Giulia F Fabiano
- Memory Development Laboratory, Department of Psychology, York University, Toronto, ON, Canada
| | - Thanujeni Pathman
- Memory Development Laboratory, Department of Psychology, York University, Toronto, ON, Canada.,LaMarsh Centre for Child and Youth Research, York University, Toronto, ON, Canada
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