A Narrative Review on Prevention and Early Intervention of Challenging Behaviors in Children with a Special Emphasis on COVID-19 Times

Background

COVID-19 and the measures stemming from efforts to control it have affected the psychosocial wellbeing of children and adolescents. The increasing trend of challenging behavior has exerted further pressure on parents and schools. Understanding socioemotional development and interrelating triggers is the key to management. Early interventions prevent the future threat of mental illness and risky acts. Effective strategies are ones that primarily focus on strengthening parent-child interactions.

Aim

The purpose of this paper is to review the literature on the (i) psychosocial and behavioral impacts of COVID-19 on children/adolescents and (ii) approaches to identify determinants of challenging behaviors as a principal guide to effective interventional strategies for children and their families.

Methodology

Electronic database searches of PubMed, ScienceDirect, Medline, and Scopus were conducted to identify studies meeting the inclusion criteria that address the impact of COVID-19 on behaviors, contributing factors, and management in the context of families/schools. The content of the selected articles was themed under five categories, namely the developmental milestones, the Pyramid Model, the Positive Behavioral Support, the management strategies, and the impact of COVID-19 on children/adolescents' behavior.

Results

The present review demonstrates considerable influence of COVID-19 on children and adolescents' behavior and mental wellbeing. It stresses the importance of early family-based interventions focusing on the triggers of challenging behavior. Functional Behavioral Assessment and Behavioral Intervention Plan provide a systematic analysis with a strategic plan that support children's self-regulation and socioemotional intelligence. Regular behavioral screening is vital to promote prevention and early management.

Conclusion

Managing behavioral difficulties remains an area of deficit for parents, teachers, and health care providers. With a quality support, parents and schools will be able to clearly characterize the challenging behavior, understand the causes, reinforce parent-child interactions, and consequently, gain the strategic skills required to apply it within natural settings. Timely interventions will limit the risk of future misconduct and mental disorders.

Examining the Impact of Pyramid Model Implementation to Deepen Social and Emotional Supports for Enrolled Children Within Early Intervention

Background/Objectives: Early social and emotional well-being is crucial for child development with life-long outcomes. The Individuals with Disabilities Education Act (IDEA) Part C Early Intervention system, which federally mandates special education services for children ages birth to three, is one place where identifying and addressing early social emotional needs could be strengthened. Focusing on an implementation science approach, the Pyramid Model (PM) is examined to see how the model's targeted implementation efforts over many years enhance a system's capacity to identify and address social and emotional well-being in one state over five years. Methods: Implementation science methods were used to evaluate the impact of PM implementation over time in four independently operating sites within one state, emphasizing the use of coaching to support practice change, as well as fidelity tools and examination of system changes over time. Results: All sites increased capacity for PM implementation. Results varied by site but all sites were able to demonstrate improvement and higher fidelity implementation by the last year. Conclusions: The PM is an effective model to use within IDEA Part C programs to enhance capacity to identify and address social and emotional needs of children and families receiving services. Implementation factors are needed for success, including leadership support, organizational dynamics (e.g., creating dedicated time for staff to engage in training, external and internal coaching, and case reviews), committed funding, and dedicated support for implementation and evaluation.