Amy E. Mitchell

Pediatric Feeding: A Transdisciplinary Team's Perspective.

Transdisciplinary teaming is a useful means of assisting families of children with special needs and can be adapted specifically to addressing the complex problems of children with feeding disorders. In this article, a review of the principals of the transdisciplinary team approach is presented, followed by a description of the pediatric feeding team at the University of South Alabama Childrens and Womens Hospital. Case studies are provided for illustrative purposes, followed by a discussion of the advantages and challenges that result from using a transdisciplinary team in the evaluation and treatment of feeding disorders.

Nice to watch? Students evaluate online lectures

Many clinical teachers who previously gave face‐to‐face lectures now record presentations for students to view asynchronously online. These teachers need to understand student expectations of online lectures (OLLs), and their place in the overall ‘ecology’ of student learning resources, in order to ensure that students watch, and learn from, their lectures.

Associations between parental factors and child diabetes-management-related behaviors

Objective: Adherence to diabetes-management regimens in children requires teamwork and consistency from both parents and children. This study investigated a mediational model developed to understand the relationship between different modifiable parent factors influencing child diabetes-related behaviors. Methods: We recruited 186 parents of children aged 2 to 10 years with Type 1 diabetes to complete self-report questionnaires on child diabetes behavior, parental self-efficacy with managing the childs behavior, parent diabetes self-efficacy, parent adjustment, condition management effort, parent perception of their diabetes knowledge, and parenting behavior. We used structural equation modeling in AMOS to test our hypothesized model of interrelationships between variables associated with child diabetes behavior. Results: The hypothesized model provided good fit to the data. We found that parent perception of low levels of diabetes knowledge and higher levels of condition management effort, and parent adjustment difficulties were associated with lower parental self-efficacy with diabetes management. This was further linked with lower levels of parental self-efficacy with managing their childs diabetes behavior, and consequently, higher extent of child diabetes behavior problems. Contrary to our expectations, we did not find a significant effect of parenting behavior on child diabetes behavior problems, either directly or indirectly via parent self-efficacy for managing childs behavior. Conclusion: Our findings shed light on the mechanisms through which different parenting factors interact and are associated with diabetes behavior in children. These factors can be targeted through parenting interventions to improve childs cooperation with diabetes-management tasks and reduce barriers to effective management.

Randomized controlled trial of Triple P for parents of children with asthma or eczema: Effects on parenting and child behavior.

Objective: Parents play an important role in children’s illness management, in promoting child adjustment and reducing behavior problems. Little research has focused on the evaluation of parenting interventions in the context of childhood chronic illness. The aim of this study was to test the efficacy of a brief, group parenting intervention (Healthy Living Triple P) in improving parenting skills and parent adjustment, and reducing child behavioral and emotional difficulties in the context of childhood asthma and eczema. Method: One hundred seven parents of children with a diagnosis of asthma and/or eczema were randomly assigned to intervention (n = 52) or care as usual (CAU; n = 55). Parents completed self-report measures of their child’s behavioral and emotional adjustment, their own parenting, and their own level of adjustment at pre- and postintervention and at 6-month follow-up. Parent–child interactions were observed and coded at each time point. The intervention consisted of 2 group sessions of 2 hr each delivered by trained, accredited practitioners. Results: Attrition was low, with T2 and T3 assessment completed by 84.6% and 80.8% of intervention families and 92.7% and 81.8% of CAU families, respectively. Intention-to-treat analyses indicated that overall parent-reported ineffective parenting as well as parental overreactivity reduced as a result of intervention. Parent report of child behavior problems also decreased, but there were no changes in children’s emotional adjustment. No changes in observed parent or child behavior were found. Stress reduced for parents in the intervention group compared to the CAU group, but there were no changes in parental anxiety or depression. Effects showed evidence of reliable and clinical change and were maintained at 6-month follow-up. Conclusions: The intervention shows promise as an addition to clinical services for children with asthma and eczema and may have broader application to other chronic health conditions.

Bidirectional relationships between psychological health and dermatological conditions in children

Dermatological conditions are common among children. They are a frequent cause of presentation to health care services and a leading contributor to burden of disease. Evidence supports the notion that bidirectional relationships exist between children’s physical and psychological health, whereby the child’s dermatological condition can impact their psychological health and well-being, while, in the reverse direction, psychological factors (eg, stress) can impact the severity and course of the child’s skin disease. The psychological impact of dermatological conditions in childhood needs to be taken into account during the assessment, planning, and treatment phases of management. Likewise, the potential effect of children’s emotional and behavioral difficulties on management, particularly in terms of the impact on parents’ ability to implement their child’s treatment plan, should be considered. This literature review summarizes the current evidence for the relationships between three common chronic dermatological conditions of childhood – atopic dermatitis, psoriasis, and urticaria – and psychological adjustment and quality of life in childhood. Overall, a general paucity of research in the pediatric context – combined with limitations in terms of study design, variability in operationalization of constructs, and heterogeneity in measurement of outcomes – makes it difficult to draw firm conclusions in this area. Based on the available research, implications for successful long-term management of these conditions are discussed in terms of integrating psychological and parenting support with medical management to improve adherence, reduce disease severity, and improve quality of life for children and their families.

Development and Validation of a Measure Assessing Child Diabetes Behavior: The Diabetes Behavior Checklist

ABSTRACT Previous research in pediatric diabetes management has focused on general child behavior, which is linked with treatment adherence and health outcomes in children with type 1 diabetes. Little is known about child diabetes behavior problems specifically. The current study aimed to develop and validate a measure of diabetes-specific child behavior problems, and parents’ confidence in managing these behaviors. Participants were a community sample of 186 parents of children aged 2–10 years with type 1 diabetes, recruited via online parenting forums and advertisements placed in school and childcare newsletters throughout Australia. The measure demonstrated excellent internal consistency and evidence of construct validity, and factor analyses revealed a 3-factor and a 1-factor structure for the Extent and Confidence scales, respectively. This study provides preliminary evidence of validity of the Diabetes Behavior Checklist. The implications of these findings for intervention development are discussed.

Corrigendum to "Effects of Triple P parenting intervention on child health outcomes for childhood asthma and eczema: Randomised controlled trial" [Behav. Res. Ther. 83 (2016) 35-44].

The authors regret for the error at the following sentence. 1 Sentence ‘The modified Parents’ Self-Efficacy with Eczema Care Index (PASECI; α = 0.96 Charman, Venn, & Williams, 2004)’ needs to be corrected to ‘The modified Parents’ Self-Efficacy with Eczema Care Index (PASECI; alpha = 0.96; Mitchell & Fraser (2011) adapted from the original version of PASECI (see Ersser et al., [2015])).’2 Sentence ‘Weekly scores were averaged to calculate mean eczema severity (Patient-Oriented Eczema Measure; POEM; Mitchell & Fraser, 2011),…’ needs to be corrected to ‘Weekly scores were averaged to calculate mean eczema severity (Patient-Oriented Eczema Measure; POEM; Charman, Venn, & Williams, 2004) ….3 An additional reference needs to be added to the reference listErsser, S.J., Farasat, H., Jackson, K., Gardiner, E., Shepperd, Z.A., Cowdell, F. (2015). Parental self-efficacy and the management of childhood atopic eczemadevelopment and testing of a new clinical outcome measure. British Journal of Dermatology, 173(6), 1479–1485 http://dx.doi.org/10.1111/bjd.14175.The authors would like to apologise for any inconvenience caused.