Altered topological structure of the brain white matter in maltreated children through topological data analysis

Childhood maltreatment may adversely affect brain development and consequently influence behavioral, emotional, and psychological patterns during adulthood. In this study, we propose an analytical pipeline for modeling the altered topological structure of brain white matter in maltreated and typically developing children. We perform topological data analysis (TDA) to assess the alteration in the global topology of the brain white matter structural covariance network among children. We use persistent homology, an algebraic technique in TDA, to analyze topological features in the brain covariance networks constructed from structural magnetic resonance imaging and diffusion tensor imaging. We develop a novel framework for statistical inference based on the Wasserstein distance to assess the significance of the observed topological differences. Using these methods in comparing maltreated children with a typically developing control group, we find that maltreatment may increase homogeneity in white matter structures and thus induce higher correlations in the structural covariance; this is reflected in the topological profile. Our findings strongly suggest that TDA can be a valuable framework to model altered topological structures of the brain. The MATLAB codes and processed data used in this study can be found at https://github.com/laplcebeltrami/maltreated.

Positive reading achievement outcomes in children who experience out-of-home care: Characteristics and predictors

BACKGROUND

Children who enter out-of-home care ('care') are at increased risk for low academic achievement. Nonetheless, some children who have experienced out-of-home care achieve highly. Several qualitative studies of academically successful young adults with care histories have highlighted factors that may contribute to positive outcomes; however longitudinal cohort research is needed to identify characteristics and predictors of higher achieving younger children who experienced care.

OBJECTIVE

To describe characteristics and circumstances of children with higher reading achievement who had entered care, and predictors of higher achievement.

PARTICIPANTS AND SETTING

The study included 778 children from the Pathways of Care Longitudinal Study (POCLS) in New South Wales, Australia.

METHODS

Prospective cohort data from interviews and linked administrative child protection and education data were used to identify factors associated with higher Year 3 reading achievement among Aboriginal and non-Aboriginal children that may assist in improving outcomes.

RESULTS

Although a lower proportion than the general population, almost half (46 %) of children who entered care were in the higher achievement group. Higher achieving students were a diverse group and faced many adversities commonly found among children who experienced care generally. Multivariable logistic regression showed higher achievement in the cohort was significantly associated with: average or above cognitive ability, low externalizing behaviour, highly-educated carers, and non-Aboriginal students. Several supports and services were associated with higher achievement, but inconsistently across analyses.

CONCLUSIONS

Results indicate potential interventions could target cognitive ability, wellbeing and environmental factors, and involve interventions directly with children and via carers to improve student outcomes.

Therapeutic alliance over the course of child trauma therapy from three different perspectives

In a multi-site, controlled study with follow up, we looked at the therapeutic alliance in child trauma therapy. Parent, child, and therapist ratings were used to examine how therapeutic alliance changes over the course of Trauma Focused Cognitive Behavior Therapy (TF-CBT), an intervention that uses an exposure based method called a trauma narrative. Participants were 65 children and their caregivers in a community based trauma therapy program in Canada. Children in treatment underwent TF-CBT, including the trauma narrative asking them to write out and process their trauma story in detail. Results indicated that despite how hard it was for children to participate in this intensive treatment method, children, therapists and parents reported positive ratings of the therapeutic alliance throughout treatment. Furthermore, child and therapist's ratings of alliance became significantly more positive from therapy start to finish.

A study of Attachment Disorders in young offenders attending specialist services

Attachment disorders, specifically Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) are disorders associated with neglect and abuse in which people have significant difficulties relating to others. This study aims to explore Attachment Disorder symptoms and diagnoses in young offenders and factors that may be associated with them such as mental health problems. A cross-sectional design was used with 29 young people who were known to Intensive Services, aged 12-17 (M=16.2, SD=1.3), 29 carers and 20 teachers. They completed measures investigating symptoms of Attachment Disorders and psychopathology. Eighty-six percent of the young people had experienced some form of maltreatment and the rates of an actual or borderline Attachment Disorder was 52%. A positive correlation between Attachment Disorder symptoms and other mental health problems (as rated by carer-report Strengths and Difficulties Questionnaire Total Difficulties Score), accounting for 36% of the variance was found, with a large effect size (r_s=0.60). Attachment Disorder symptoms were associated with hyperactivity and peer relationship problems.

Behavior problems of children in foster care: Associations with foster mothers' representations, commitment, and the quality of mother-child interaction

This study investigated different environmental and contextual factors associated with maltreated children's adjustment in foster care. Participants included 83 children (52 boys), ages 1-7 years, and their foster caregivers. Quality of interaction with the foster caregiver was assessed from direct observation of a free-play situation; foster caregiver attachment state of mind and commitment toward the child were assessed using two interviews; disruptive behavior symptoms were reported by foster caregivers. Results showed that quality of interaction between foster caregivers and children were associated with behavior problems, such that higher-quality interactions were related to fewer externalizing and internalizing problems. Foster caregivers' state of mind and commitment were interrelated but not directly associated with behavior problems of foster children. Type of placement moderated the association between foster caregiver commitment and foster child behavior problems. Whereas greater foster caregiver commitment was associated with higher levels of adjustment for children in foster families (kin and non-kin), this was not the case in foster-to-adopt families. Finally, the associations between foster child behavior problems and history of maltreatment and placement related-risk conditions fell below significance after considering child age and quality of interaction with the foster caregiver. Findings underscore the crucial contribution of the foster caregiver-child relationship to fostering child adjustment and, thereby, have important implications for clinical services offered to this population.

High accuracy but low consistency in children's long-term recall of a real-life stressful event

The accuracy and consistency of children's memories of their removals from their biological families by the Child Protective Services (CPS) was investigated. A researcher was present during the removals and documented what happened. A total of 37 maltreated children, aged 3 to 12 years, were interviewed 1 week and 3 months after the removals. The accuracy of the memory reports was high at both time points, but their consistency was fairly low; in all age groups (3-6, 7-10, and 11-12 years), a high percentage of new accurate information was reported during the second interview and a high percentage of the accurate information reported in the first interview was omitted in the second interview. Older children were significantly more consistent in their memory reports than younger children. The results show that low consistency in memory does not imply memory inaccuracy and has implications for the interpretation of successive interviews of children in forensic contexts.

Functional outcomes of maltreated children and adolescents in a community-based rehabilitation program in Brazil: six-month improvement and baseline predictors

This study sought to implement outcomes monitoring and to review outcome data from a community-based rehabilitation program for maltreated children and adolescents in São Paulo, Brazil. Maltreated children and adolescents (N=452) were enrolled in The Equilibrium Program (TEP), a multidisciplinary community-based rehabilitation program. About half (n=230) of the participants were successfully evaluated using the Children's Global Assessment Scale (C-GAS) at entry, 3, and/or 6 months later. Analysis of outcomes used hierarchical linear modeling of functional change from baseline. With a baseline C-GAS score of 51.7 (SD=14.22), average improvement was 2.8 and 5.5 points at 3 and 6 months, respectively (reflecting small to moderate effect sizes=0.20 and 0.39). Improvement was associated with Problems related to upbringing (p<.02) at entry and absence of Physical abuse (p<.05) and Negative life events in childhood (p<.05) but was not associated with sociodemographics or any specific psychiatric diagnosis. This study showed that outcomes monitoring is feasible in a community-based program in a developing country. Although there was no untreated control group for comparison and specific evidence-based treatments were not used, it is notable that significant improvement, with small to moderate effect size, was observed.