Children with fetal alcohol spectrum disorders: problem behaviors and sensory processing

OBJECTIVE: This study describes the sensory-processing and behavior profiles of a clinic-referred sample of children with fetal alcohol spectrum disorders (FASD) and examines the relationship between sensory processing and behavior. METHODS: Outcomes on the Short Sensory Profile (SSP) and Child Behavior Checklist (CBCL) for 44 children, ages 5 to 10 years, were assessed and compared using retrospective data analysis. RESULTS: A high proportion of the children demonstrated deficits in sensory processing and problem behaviors as measured by the SSP and the CBCL. Moreover, the correlation between the SSP and CBCL total scores (r = -.72) was significant. CONCLUSION: Results provide evidence that children with FASD demonstrate problem behaviors and sensory-processing impairments as reported by parents and that sensory-processing deficits co-occur with problem behaviors at a high rate in this population. This finding suggests that deficits in sensory processing may affect the ability of children with FASD to respond adaptively to their environments.     

认知疗法在改善学龄期白血病患儿心理行为中的应用

目的探讨认知疗法在改善学龄期白血病患儿心理行为中的应用方法和效果。方法采用儿童行为评定量表（Achenbach,s Child Behavior Checklist,CBCL）对88例白血病患儿心理行为进行调查;并对行为异常的患儿实施认知疗法的干预．比较干预前后患儿CBCL测评结果。结果学龄期白血病男性患儿与女性患儿的心理行为得分超出正常值上限的分别为25．00％和22．92％,显著高于常模的12．93％（P〈0．05）。干预前后男性患儿在活动能力、社交能力、学校能力、社会能力、分裂样、抑郁、社会不良、躯体诉述、攻击性行为因子及行为问题总分比较,差异具有统计学意义（均P〈0．05）。干预前后女性患儿在社会能力、抑郁、社会退缩、躯体诉述、分裂样、多动因子及行为问题总分比较,差异具有统计学意义（均P〈0．05）。结论认知行为疗法可改善学龄期白血病患儿的心理行为。     

The Mental Health of Homeless School-Age Children

PROBLEM: The mental health of homeless school-age children. METHODS: A convenience sample of 46 homeless children between the ages of 8 and 12 years completed the Children's Depression Inventory (CDI) and each child's mother completed the Child Behavior Checklist (CBCL). FINDINGS: Fifty-seven percent of the children had depressive symptoms and 26% needed additional evaluation for mental health problems. Overall, the CDI and CBCL scores indicated that gender or ethnicity are not related to the children's mental health. CONCLUSIONS: The mental health of homeless schoolage children should be assessed, as they may be at risk for mental health problems.     

农村与城市儿童个性行为特征对比研究

目的探讨农村与城市儿童的个性行为特征。方法对90名农村儿童和90名城市儿童采用艾森克个性问卷测评个性,采用儿童行为量表评定行为特征,并进行对比分析。结果农村组儿童与城市组儿童艾森克个性问卷各项因子分均无显著性差异;儿童行为量表评定结果显示,农村组女童退缩、社交因子分与男童违纪、攻击和外向因子分显著高于城市组,差异显著(P<0.05)。结论农村儿童行为问题较突出,女童主要表现为社交困难、孤僻退缩,男童主要为外向、违纪和攻击行为等。这些问题可能与其不同的生活方式、文化教养有关。     

Behavioral Disturbances Among Medically Hospitalized School-Age Children

The purpose of this study was to examine the behavioral disturbances of medically hospitalized school-age children. Seventy-six school-age children, between the ages of 8 and 12, were the subjects. The children's usual prehospital behavior was reported by their mothers who completed the Child Behavior Checklist (CBCL). The hospitalized children were compared with the standardized nonclinical norms on the CBCL. Fifty-one percent of the children scored in the clinical range on one or both of the broad bands measuring behavioral disturbances: 21% on externalizing symptoms and 47% on internalizing symptoms. Total behavior problems and externalizing behavior were slightly associated with low socioeconomic status but not with the number of previous hospitalizations. Internalizing problems were not related to socioeconomic status nor the number of previous hospitalizations. The need for specialized mental health services to this population is discussed.     

Behaviors of children following a randomized controlled treatment program for their abused mothers

OBJECTIVE: To determine if a treatment program offered to abused mothers positively affects the behaviors of their children. METHODS: A randomized, two-arm, clinical trial was used to measure child behavior at 6, 12, 18, and 24 months following the application of two levels of abuse treatment services to abused mothers: (1) abuse assessment and receipt of a wallet-size referral card, or (2) abuse assessment, receipt of a wallet-size referral card, and nurse case management sessions. The setting was public primary care clinics. The participants were 233 women who reported physical or sexual abuse within the preceding 12 months, and who had at least one child, ages 18 months to 18 years, living with them. Outcome measures were scores on the Child Behavior Checklist (CBCL) at baseline, 6, 12, 18, and 24 months. CBCL scores for a clinically-referred sample of children served as a comparison group. RESULTS: All children improved significantly (p < .001) on CBCL scores from intake to 24 months, regardless of which treatment protocol their mother received. By 24 months, the majority of children and adolescents had scores significantly less than the referred norms. Children ages 18 months to 5 years showed the most improvement and teenagers showed the least improvement. CONCLUSIONS: Disclosure of abuse, such as that which happens during abuse assessment, was associated with the same improvement in child behavior scores as a nurse case management intervention. Routine abuse assessment and referral have the potential to positively improve the behavioral functioning of children exposed to domestic violence.     

Behavioral and mental health problems in low-income children with special health care needs

This study examined caregiver perceptions of mental health problems and counseling needs in low-income children with special health care needs (CSHCN). Interviewers collected data from 257 caregivers of CSHCN (61% males; 60% African American; Mean age = 8.4 years) attending six Midwestern inner-city health clinics. Measures included the Child Behavior Checklist (CBCL) and an investigator-designed questionnaire. CBCL T-scores indicated that 38% of CSHCN had a behavioral or mental health problem, but only 26% of caregivers perceived the need for treatment or counseling. CSHCN should be assessed and referred appropriately for behavioral and mental health problems during routine health care visits.     

Effects of Behavior Problems,Family Functioning,and Family Coping on Parent Stress in Families with a Child with Smith-Magenis Syndrome

Smith Magenis Syndrome (SMS) is a rare genetic syndrome most commonly caused by a microdeletion on chromosome 17 p11.2. It is associated with a pattern of physical, developmental, and behavioral characteristics including intellectual disability, sleep disturbance, and a variety of behavior problems. The purpose was to examine the relationship between maladaptive behaviors in children with SMS and parent stress, and to determine whether family functioning and effective parent coping strategies may alleviate the impact of child maladaptive behaviors on parent stress. Data were collected on 25 individuals with SMS ages 1.4 to 19.4 years old. Parents were interviewed using the Vineland Adaptive Behavior Scale (VABS; Sparrow et al. 1984), the Achenbach Child Behavior Checklist (CBCL; Achenbach 1991), the Family Assessment Device-General Functioning Scale (Epstein et al. 1983), the Family Crisis Oriented Personal Evaluation Scales (McCubin et al. 1991), the Parental Stress Index-3rd edition (Abidin 1995), and the Stress Index for Parents of Adolescents (Abidin 1995). Using multiple hierarchical regression analyses we found that maladaptive behaviors (CBCL internalizing and externalizing behaviors) affected parent stress; however, we also saw that parent stress was alleviated in well-functioning families. Maladaptive behaviors did not have a significant negative impact on life stress.     

Parent-Reported Problem Behavior Among Children With Sensory Disabilities Attending Elementary Regular Schools

Parent-reported problem behaviors of 94 children with visual and auditory disabilities, attending elementary regular schools, were compared with problems reported in a general population sample of nondisabled children. Both samples were matched by means of a pairwise matching procedure, taking into account age and sex. Problem behavior was measured by Achenbachs (1991) CBCL (Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile, University of Vermont, Department of Psychiatry, Burlington, VT). No significant main effects of type, degree, and nature of disability were found on the CBCL Total Problems scale, nor on the syndrome scales. In general, children with sensory disabilities attending elementary regular schools did not show more problems in comparison to nondisabled children. Merely on the Social Problems scale there was a significant difference between both samples, the children with sensory disabilities getting higher scores than their nondisabled peers. Further, children with sensory disabilities ran considerable risks of developing deviant scores on the Social Problems and the Thought Problems syndromes, the odds being respectively 3.2 and 5.2 times higher than in the general population sample. To optimize the benefits from placement in integrated classrooms for children with sensory disabilities, school counselors and teachers should not only focus on the academic achievements of these children, but also on their social skills and peer sociometric status.     

Impact of Marital Quality and Parent-Infant Interaction on Preschool Behavior Problems

Abstract This study examined the relationships between parent interactions with healthy term and preterm infants at 12 months of age, marital quality, family socioeconomic status, and preschool behavior problems. Eighty mothers and 74 fathers were observed in the home during an interaction with their child (Nursing Child Assessment Teaching Scale). and this group of parents completed the Dyadic Adjustment Scale questionnaire (marital quality) 12 months after the child was discharged from the hospital. Each parent completed the Eyberg Child Behavior Inventory when their child was four years of age. The parent and infant interaction scores were not predictive of later child behavior problems. Maternal perceptions of marital quality at 12 months predicted the frequency (Eyberg Intensity score) and impact (Eyberg Problem score) of the child's problematic behaviors reported by mothers. Marital quality and family socioeconomic status predicted the impact of behavior problems for fathers. There were no significant differences between preterm and term children or between boys and girls in the frequency or impact of problematic behaviors. Mothers reported a significantly greater frequency of behavior problems than fathers of the same children. The implications of these findings for nurses who work with families and young children are discussed.     

Sleep of children of abused women in transitional housing

Children of abused women have been reported to experience a variety of behavioral problems including disturbed sleep. Sleep is essential for health, growth, and development. Yet, to date no one has described the sleep behaviors of these children. The purpose of this study was to describe the sleep-related behaviors of children of abused women living in transitional housing programs. A convenience sample of mothers (N = 32) residing in transitional housing programs for abused women was recruited. Using the Sleep Behavior Scale (Fisher, Pauley, & McGuire, 1989), data were gathered from the mothers on 43 children 2 to 18 years of age. Approximately one-third of the children in this study were reported to experience sleep-related behavior problems four or more times per week. Some of these behaviors were likely to be burdensome to abused women. Behavioral interventions, however, offer promise for these children and their mothers.     

综合治疗Tourette综合征14例临床分析

目的:探讨Tourette综合征(TS)综合治疗后临床症状的改善与认知功能是否相一致,为探讨改善TS患儿身心健康受挫的有效途径提供一些线索。方法:给予14例TS患儿常规剂量、方法服用泰必利并辅予心理干预指导,于治疗前、治疗3个月后用耶鲁综合抽动严重程度量表(YGTSS)评估TS病情程度;并采用Achenbach儿童行为量表(家长用)评定患儿治疗前后的行为问题;用P300检测方法评估认知功能。结果:(1)综合治疗后,Achenbach儿童行为量表各项评分及YGTSS严重程度量表评分均较治疗前有显著降低。(2)综合治疗后TS儿童的P300潜伏期较干预前缩短,P300波幅较干预前提高。结论:综合治疗可促进TS儿童抽动症状、认知功能、心理及情绪的全面改善。     

Behaviour among children of substance‐abusing women attending a Special Child Welfare Clinic in Norway,as assessed by Child Behavior Checklist (CBCL)

Scand J Caring Sci; 2013; 27; 285–294 Behaviour among children of substance‐abusing women attending a Special Child Welfare Clinic in Norway, as assessed by Child Behavior Checklist (CBCL) Background: A Special Child Welfare Clinic (SCWC) in Norway provides care for pregnant women with substance abuse problems. Treatment is given without substitution. This investigation assesses the behaviour of the children between the ages 6 and 13 years of women who attended the clinic. It also explores the correlation between the behaviour and a neuropsychological screening performed one and a half year earlier. The study was set up to investigate the influence of prenatal substance exposure. Method: Thirty‐eight SCWC children and 63 children in a comparison group were scored by Child Behavior Check List (CBCL). Twenty‐one (55%) SCWC mothers were classed as short‐term users (ceased substance abuse before the end of first trimester), and 17 (45%) were classed as long‐term users (continued a moderate substance abuse throughout pregnancy). Thirteen (77%) of the children of the long‐term users were living in foster homes at the time of the investigation. Results: SCWC children were scored within normal ranges for most items, but their scores were significantly worse than those of the comparison group. Children of short‐term users were given lower scores than comparisons on more issues in CBCL than were children of long‐term users. The SCWC children were breastfed for a shorter time (p = 0.023) and had moved house more often (p < 0.001) than comparisons. SCWC children living with their biological mothers received more special education or remedial classes (p ≤ 0.001) than children of the comparisons. Conclusion: Most children of long‐term users were living in foster homes. Notably, children of short‐term users, that is, children living with their biological mothers, were given lower scores than comparisons in CBCL. Children of short‐term users were more likely to receive special education than children of comparisons. More research is needed on how to reveal parenting problems and how to guide mothers with previous or present substance abuse problems.     

The effects of orff-based music therapy and social work groups on childhood grief symptoms and behaviors

This study evaluated and compared the effects of Orff-based music therapy, social work, and wait-list control groups on behavioral problems and grief symptoms of bereaved school-aged children. Social work and music therapy sessions were provided weekly for one hour over an eight-week period. Participants (N = 26) attended three different public elementary schools, and each school was randomly assigned to one of the conditions. Pre and posttest measures consisted of the Behavior Rating Index for Children (BRIC) and the Bereavement Group Questionnaire for Parents and Guardians (BP). The BRIC measured behavioral distress and the BP measured grief symptoms prior to and following participation in the assigned conditions. Statistical analyses indicated that participants in the music therapy group significantly improved in the behaviors and grief symptoms, and those in the social work group experienced a significant reduction in their behavioral problems but not their grief symptoms. Participants in the wait-list control group made no significant improvements in either their grief symptoms or behavioral problems. A reduction in behavioral distress as measured by the BRIC and a reduction in grief symptoms as measured by the BP is the most desired outcome. This study supports the use of Orff-based music therapy interventions for bereaved children in a school-based grief program. Recommendations for future research are included.     

A comparison of parental coping styles ollowing the death of adolescent nd preadolescent children

The impact of children's death from cancer on parental coping styles and psychological well-being was studied retrospectively. Furthermore, parents who had lost younger children (3-9 years old) and parents who had lost older children (13-19 years old) were compared. The parents had been bereaved from three months to three years. In general, bereaved parents showed less expression of emotions than the Dutch norm group. Parents of older children were found to engage in less active problem focusing. Of the 33 parents studied, 14 appeared to have mental health problems as measured by the General Health Questionnaire. When mental health problems occurred, they tended to be reported by both members of a couple. Surprisingly, there appeared to be no differences in mean mental health scores between the Dutch norm group and the group of bereaved parents, nor were there differences between the parents of younger and older children.     

Impact of sibling death on children's behavior

Research has indicated that siblings of deceased children demonstrate a variety of behavioral problems as a result of the death. The purpose of this study was to determine the relationship of selected factors and children's behavior during the first year following the siblings' deaths.

The sample included 33 boys and 32 girls ages 4 to 16 years who were the siblings of deceased children. Data on their behavior was obtained by an interview with the mothers using a standardized tool, the Child Behavior Checklist. Results showed that the bereaved children displayed significantly more behavior problems in comparison to standardized norms. The variables of age, place of death, family size, ill child's diagnosis, sex and age of deceased child, and funeral attendance were related to behavior problems in the surviving children.     

Evaluation of internal behaviors of children with congenital heart disease

This study was designed to determine how internal behaviors of children with congenital heart disease were handled by their mothers. The study group included the mothers of 96 children randomly selected (ages ranging from 4 to 11 years) who were being monitored at the Institute of Cardiology. A 21-item questionnaire was administered to obtain information about the mother and the child. Internal subsets of the Child Behavior Check List (CBCL)/4-18 were performed, including withdrawn aggressive behaviors, somatic complaints, and anxiety/depression tests. The results showed that factors influencing withdrawn aggressive behavior were low parent education (p =.000), poor economic status of the family (p =.02), and aggravation of the hemodynamic status of the disease (p =.003). The factors influencing somatic complaints were low parent education (p =.000) and severity of the hemodynamic status of the disease (p =.02). An increase in the number of children in the family seemed to have an effect on anxiety/depression levels (p =.009).