Expressed Emotion about children: reliability and validity of a Camberwell Family Interview for Childhood (CFI‐C)

A Camberwell Family Interview for Childhood (CFI‐C) was developed by adding questions about the family impact of the child's problems to a semi‐structured interview on child psychiatric symptoms. The whole CFI‐C took under an hour to administer; the questions about family impact added 15–20 minutes. The inter‐rater reliability was good (kappa 0.64–1.0). Mothers of 25 boys aged four to nine years referred with disruptive behaviour, and 25 matched controls were interviewed twice in five months. Test‐retest stability was fair to good (kappa 0.36–1.0). Discriminant validity between referred and control samples was strong for critical comments, positive comments and warmth, but not significant for emotional overinvolvement or hostility. The same three scales showed strong discriminant validity between child symptom domains, being strongly correlated with conduct symptoms (kappa = 0.49–0.71) but not emotional symptoms (kappa = 0.10–0.17). Sensitivity to change with treatment was shown by a reduction in the mean number of critical comments from 4.7 to 2.9, an increase in positive comments from 2.3 to 3.9, and an increased score on the warmth scale from 2.1 to 2.6. The CFI‐C is a useful instrument for the study of the relationship between parenting style and child psychiatric symptoms. Copyright © 2000 Whurr Publishers Ltd.     

Seasonal changes in sleep and behavioral problems in a pubescent case with autism.

This study reports on the seasonal changes in sleep problems and behavioral problems in a pubescent case with autism. His care diary, kept for 1 year, showed seasonal changes of sleep and behavioral problems, and that his behavioral problems preceded his sleep problems.     

Etiologic problems of so-called idiopathic Parkinson's disease

In a previous study (1963) major quantitative and, even more importantly, early qualitative RNA alterations were observed in the glia rather than the neuron in cases of idiophatic Parkinson disease. The present study considers the causes of these major RNA changes. In the light of the most recent virological work and especially of the conclusions reached by Mins, the severe glial RNA changes may be due to a primary penetration of this tissue by a slow virus of the RNA type, probably an influenza virus remotely related to the measles virus.

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Sommario Gli autori in un precedente lavoro (1963) osservarono notevoli alterazioni del R.N.A. quantitative, ma soprattutto qualitative e precoci, specialmente nella glia, rispetto al neurone, in casi di morbo di Parkinson così detto idiopatico. In questa nota gli Autori prendono in considerazione il problema dell'origine di queste notevoli alterazioni del R.N.A. In base alle più recenti conoscenze di virologia e in particolare alle conclusioni dei lavori di Mins ritengono che le gravi alterazioni del R.N.A. gliale possono essere conseguenti ad una primaria penetrazione in questo tessuto di un virus lento del tipo R.N.A. probabilmente influenzale che può avere anche una lontana parentela con il virus del morbillo.

     

Behavioural and emotional problems in children with intellectual disability attending special schools in Cape Town, South Africa

A sample of 355 children with intellectual disability (ID) attending special schools in Cape Town, South Africa, were assessed on the Developmental Behavioural Checklist – Teacher Version (DBC‐T). A prevalence rate of 31% for psychopathology was found. Boys manifested more behaviour problems than girls, especially in relation to disruptive, self‐absorbed and antisocial behaviours. Children with severe and profound levels of ID showed more behavioural difficulties than those in the mild and moderate categories. Specific behaviour problems were self‐absorbed and autistic behaviours in children with profound ID, communication problems and anxiety in those with severe ID and antisocial behaviour in children with mild ID. Epilepsy, but not cerebral palsy was associated with higher total behaviour scores. Ambulant children were more disruptive and antisocial, while non‐ambulant children were more anxious. Non‐verbal children had higher scores on all of the subscales except for disruptive behaviour.     

Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders

Eating and feeding problems, most commonly food selectivity or picky eating, are common among children with ASD. While these behaviors are typically addressed through occupational or behavior-based therapeutic approaches, increasing evidence shows than in many cases, such eating and feeding problems may be organic and stem from some form of underlying gastrointestinal dysfunction. This review highlights the literature on eating/feeding problems in children with ASD, as well as the contributing factors to eating problems and their nutritional implications in this population. In addition, the various manifestations and origins of gastrointestinal dysfunction in ASD are included. Ten relevant studies that address eating and feeding problems and gastrointestinal (GI) symptoms and dysfunction in children with ASD and the possible mechanisms underlying the eating/feeding problems in children with ASD are discussed. This review suggests a strong relationship and significant correlations between eating problems and gastrointestinal dysfunction. Further exploration of their relationship and etiology for the development of interventions are recommended.     

Brief Manual for the care of disabled children after disasters

Disabled children develop various somatic and behavioral problems after disasters. This manual describes the common or characteristic problems of these children, the probable backgrounds of such problems, and the practical care and treatment of them.     

Affective problems,gastrointestinal symptoms,sleep problems,and challenging behaviour in children and adolescents with autism spectrum disorder

BackgroundPeople with autism spectrum disorder (ASD) can experience affective problems, gastrointestinal (GI) symptoms, sleep problems, and challenging behaviour. This study identified the frequency of affective problems and explored how they related to co-occurring conditions in children and adolescents with ASD.MethodParticipants were children and adolescents diagnosed with ASD using DSM-IV-TR criteria (n = 95), 40 % (n = 38) of whom also had a diagnosis of intellectual disability (ID). The following scales were completed by the participants’ parents or guardians: Child Behaviour Checklist (CBCL), Gastrointestinal Symptoms Inventory, Children’s Sleep Habits Questionnaire (CSHQ), and the Behaviour Problems Inventory-Short Form (BPI-S). Pearson’s correlations and independent sample t-tests were used to examine the relationships between variables. Two hierarchal multiple regressions examined predictors for affective problems in preschool and school-aged children with ASD.ResultsParticipants scored in the clinical range (69.5 %) and borderline range (10.5 %) for affective problems. Significant positive relationships were found between affective problems and sleep problems, GI symptoms, and challenging behaviour. ID and gender predicted affective problems in preschool aged children. In school-aged children, affective problems were predicted by ID, sleep problems, and aggressive/destructive behaviour severity. However, only 25 % of the variance in affective problems was accounted for.ConclusionsFuture research is needed to understand how affective problems are impacted by co-occurring conditions in children and adolescents with ASD. Affective problems are prevalent in this population and the quality of life for individuals may be improved if practitioners consider co-occurring conditions during clinical practice.     

The association between behavioural and emotional problems and age in adults with Down syndrome without dementia: Examining a wide spectrum of behavioural and emotional problems

The literature on the association between behavioural and emotional problems and ageing in adults with Down syndrome (DS) without dementia is limited and has generally not reported on a wide range of behavioural and emotional problems. This research aimed to extend the field by examining the associations between age and a wide spectrum of behavioural and emotional problems in adults with DS without dementia. A preliminary analysis of the association between potential covariates and behavioural and emotional problems was also undertaken.Parents and caregivers completed a questionnaire on behavioural and emotional problems for 53 adults with DS aged between 16 and 56 years. Twenty-eight adults with DS and their caregivers were part of a longitudinal sample, which provided two time points of data approximately four years apart. Additionally, 25 participants with DS and their caregivers were from a cross sectional sample, which provided one time point of data. Random effects regression analyses were used to examine the patterns in item scores for behavioural and emotional problems associated with age.No significant associations between age and the range or severity of any behavioural and emotional items were found. This suggested a more positive pattern for ageing adults with DS than has been previously described. Given that behavioural and emotional problems were not associated with age, investigation into other factors that may be associated with the behavioural and emotional difficulties for adults with DS is discussed.     

Sixteen-year comparisons of parent-reported emotional and behaviour problems and competencies in Norwegian children aged 7–9 years

Abstract

Background: Studies about changes in the prevalence of emotional and behaviour problems across time are lacking, especially among younger children. Aim: To determine if the level of parent-reported emotional and behaviour problems and competencies in young Norwegian school children had changed across a 16-year time interval. Methods: We compared parent reports obtained by the Child Behavior Checklist in two samples of children aged 7–9 years from the general population assessed in 1991 and 2007. Results: The results demonstrated overall stability or slight decreases of emotional and behaviour problems and a significant increase in competencies, mainly due to increased activity and social competence scores in the 2007 sample. Boys obtained higher scores than girls in Total Problems, Externalizing and Attention problems at both time points and there was a high stability of the rank order of items. Conclusions: The findings suggest stability in child emotional and behaviour problems, and an increase of competencies across the period.     

Drug trajectories among youth undergoing treatment: The influence of psychological problems and delinquency

Previous research has documented associations of addiction with delinquency and psychological problems. However, few studies have evaluated their influence on adolescent's drug use trajectories. The current study aims to examine the influence of these factors on the recovery trajectories of 199 youths aged 15.6 years on average admitted to inpatient and outpatient addiction treatment centers, followed up three and six months later. Results indicate that youth who show higher severity of drug abuse exhibit greater improvement than youth with a lower severity of drug abuse at the onset of treatment. Although psychological problems were associated with baseline drug use, they did not influence drug use trajectory over time. Only delinquency influenced the recovery trajectories of these youth. Results suggest that a high level of delinquency can have a significant effect on the drug recovery process of adolescents and that interventions should attempt to reduce both drug use and delinquency.     

Ungrammatical utterances and disfluent speech as causes of comprehension problems in interactions of preadolescents with high functioning autism

This study describes the role of ungrammatical utterances and disfluent speech in the creation of comprehension problems between the participants in group therapy sessions of preadolescents with autism. The speech of the autistic preadolescents included frequent disfluencies and morpho-syntactic problems, such as wrong case endings, ambiguous pronominal references, grammatically incoherent syntactic structures and inaccurate tenses, which caused problems of comprehension. Three different interactional trajectories occurred when solving the potential problems of comprehension following the morpho-syntactically disfluent turns. First, the disfluent turn sometimes led to a clarification request by a co-participant, either a therapist or another participant with ASD. The preadolescents with ASD showed interactional skilfulness in requesting clarification when faced with comprehension problems. Second, in contrast, other occurrences included one or several self-repairs by the speaker with ASD. In these cases, the other group participants either did not react or they encouraged the speaker to continue using discourse particles. If the self-repairing disfluencies led to a persisting problem of comprehension, the therapists sometimes intervened and resolved the problem. However, direct interventions by the therapists were infrequent because the participants with ASD were mostly able to resolve the comprehension problems by themselves. Third, some disfluent and/or grammatically incorrect turns were not treated as problematic by the co-participants nor by the speaker himself.

Abbreviations: ADE: Adessive; ALL: Allative; CLI: clitic; GEN: Genitive; INE: Inessive; NOM: Nominative; PER: person; PL: plural; PRT: particle; SG: singular     

Behaviour/mental health problems in young adults with intellectual disability: the impact on families

Background The present authors studied the impact of dual diagnosis [i.e. intellectual disability (ID) and mental disorder] in young adults on their mothers’ perceived levels of stress and decisions about placement. Methods The mothers of 103 young adults with severe ID were interviewed using a 2–3‐h in‐depth protocol of measures designed to assess their child’s adaptive functioning, maladaptive behaviour, mental health problems and negative impact on the family, as well as their own thoughts on out‐of‐home placement. The Scales of Independent Behavior – Revised Problem Behavior Scale assessed problem behaviours and the Reiss Screen assessed mental disorder. Results These measures were highly correlated (r = 0.64), but tapped some different domains of maladaptive behaviour and proved to be most predictive when employed together. Behaviour and/or mental health (B/MH) problems significantly predicted the mothers’ perceived negative impact of the young adult on the family, even after controlling for other young adult characteristics. These problems also predicted the family’s steps toward seeking out‐of‐home placement, as did better young adult health and the mother’s higher educational attainment; stress did not predict additional variance in placement once these variables were accounted for. Conclusions The discussion focuses on the implications for service provision to families of young adults with B/MH problems.     

Psychopathology in Children with Intellectual Disability: Risk Markers and Correlates

The purpose of this literature review was to summarize studies examining risk factors, markers, and correlates of psychopathology in youngsters with intellectual disability. A total of 26 studies met inclusion criteria and were reviewed. Due to the limitations of research methods (i.e., not establishing precedence), no risk factors were identified. The majority of variables examined were risk markers (i.e., age, sex, level of functioning). The most consistent age finding was that hyperactivity and/or conduct disorder symptoms were negatively associated with age. Sex effects were equivocal but suggested that boys had more disruptive behavior problems than girls. Specific patterns emerged in regard to level of functioning. Those with milder delays were more likely to have disruptive and emotional disorders. Conversely, those with more severe delay had higher rates of stereotypy, self-injury, and social isolation and were less likely to show symptom improvement over time. This review also identified correlates of emotional and problem behavior such as parent psychopathology and stress and dysfunctional home environment. Parallels were drawn with the general child psychopathology field and further research directions were discussed.     

Behavior Problems of Children with Down Syndrome and Life Events

Behavior problems of 44 children with Down syndrome between the ages of 6 and 15 and 44 controls without mental retardation matched for age, sex, and socioeconomic status were compared on the basis of mother and teacher ratings. Ratings from both sources indicated that children with Down syndrome had more behavior problems, in particular attention deficit, noncompliance, thought disorder, and social withdrawal. Life events from the past year were significantly associated with mother but not teacher ratings of Down syndrome behavior problems.     

Child and Family Predictors of Therapy Outcome for Children with Behavioral and Emotional Problems

This study investigated the characteristics of 106 children primarily referred for externalizing behavior problems and their families, and assessed the prediction of treatment outcome following a standardized short-term, cognitive behavioral group program. Exploring Together comprised a children’s group (anger management, problem-solving and social skills training), a parents’ group (parenting skills training, dealing with parents’ personal, relationship and family-of-origin issues), and a combined children’s and parents’ group (to target parent–child interactions). The main predictors of reductions in externalizing and internalizing behaviors at home following treatment were children’s pre-existing levels of these behavioral and emotional problems (children with higher levels improved most), and positive parent–child interaction. Higher pre-existing levels of behavioral and emotional problems and low levels of attention problems predicted greater improvement in post-treatment school behaviors. Implications of the findings for improving interventions for childhood behavioral and emotional problems are discussed     

Predicting parents’ intentions to seek help for young children’s mental health

One in five school-age children has mental health problems, yet less than a quarter access professional help. Early childhood presents a window for prevention. This study implemented the ‘Theory of Planned Behaviour’ to explore parents’ intentions to seek professional help for young children’s behaviour and emotional problems. Participants were 442 parents of 6-year-old children, recruited as a population sample in infancy. The ‘Theory of Planned Behaviour’ measured parents’ personal intentions, attitudes and beliefs about seeking professional help for young children’s mental health. Although many parents (84%) had positive intentions to seek help if their young child were in need, a proportion (16%) was ambivalent/unlikely to do so. Specific beliefs distinguishing parents with positive intentions were that professionals would provide expert strategies with empathy and understanding, with appointments providing value for time and money. Community mental health initiatives could target these beliefs in facilitating better access for young children in need.     

Prevalence of selected clinical problems in older adults with autism and intellectual disability

Background

Originally described as a disorder of childhood, evidence now demonstrates the lifelong nature of autism spectrum disorder (ASD). Despite the increase of the population over age 65, older adults with ASD remain a scarcely explored subpopulation. This study set out to investigate the prevalence of clinically relevant behaviors and medical problems in a sample of US adults aged 30 to 59 with ASD and intellectual disability (ID), in comparison to those with ID only.

Methods

A cross-sectional study, with both an exploratory and replication analysis, was conducted using National Core Indicators (NCI) multi-state surveys from 2009 to 2010 and 2010 to 2011. There were 4,989 and 4,261 adults aged 30–59 with ID examined from the 2009 to 2010 and 2010 to 2011 samples, respectively. The two consecutive annual samples consisted of 438 (9%) and 298 (7%) individuals with ASD and ID. Variables were chosen from the NCI data as outcomes, including medication use for behavior problems, severe or aggressive behavior problems and selected medical conditions.

Results

No age-associated disparities were observed between adults with ASD and ID versus adults with ID only in either sample. For the 2009 to 2010 sample, the prevalence of support needed to manage self-injurious, disruptive and destructive behavior in subjects with ASD and ID ranged from 40 to 60%. Similarly, the prevalence estimates of self-injurious, disruptive and destructive behavior were each almost double in adults with ASD and ID relative to those with ID only. These results were replicated in the 2010 to 2011 sample.

Conclusions

The findings of this study highlight the urgent need for research on the nature and treatment of severe behavior problems in the rapidly increasing population of older adults with ASD. They also suggest the importance of developing policies that expand our capacity to care for these individuals.