Angelika H. Claussen

Physical and Psychological Maltreatment: Relations Among Types of Maltreatment

Maltreatment has serious consequences for the development of children. The reason for the negative outcomes is not, however, fully understood. This study investigated the hypotheses that psychological maltreatment would be present in almost all cases of physical maltreatment and that it would be more related to detrimental outcomes for children than would severity of injury. A sample of 175 maltreated children, 39 children in mental health treatment, and 176 normative children was assessed for type and severity of maltreatment. Both hypotheses were supported. In addition, evidence is provided that psychological maltreatment can occur alone, that assessments of parental psychologically maltreating behavior and negative child outcomes are highly correlated, and that child age and gender are unrelated to psychological maltreatment in young children whereas family income is related. Implications for investigation and treatment are considered.

Physical and psychological maltreatment in middle childhood and adolescence

Although maltreatment is known to have detrimental effects on socioemotional development, the relation of those effects to type of maltreatment and child age is not clear. Most studies either focus solely on physical abuse or do not differentiate among types of maltreatment. Furthermore, most concentrate on young children. Studies of psychological maltreatment in young children indicate that physical abuse and psychological maltreatment tend to co-occur, severity of injury is not related to severity of psychological maltreatment or to developmental problems, and severity of psychological maltreatment is related to developmental outcomes. The present study investigated (a) relations among types of physical and psychological maltreatment and (b) their effect on development in an ethnically diverse sample of maltreated school-age children and adolescents. The results indicated that, as in young children, physical and psychological maltreatment co-occurred in most cases. As with young children, severity of emotional abuse was related to severity of physical neglect in school-age children; among adolescents, however, it was related to severity of physical injury. Moreover, severity of emotional abuse was related to both behavior problems and depression. The differences between the patterns of effects for school-age children and those for adolescents are discussed, as are implications of the findings for intervention.

Infant joint attention skill and preschool behavioral outcomes in at-risk children

This study examined whether infant joint attention (JA) skills predicted social behaviors in a sample of at-risk preschool children (n = 30) with a history of prenatal exposure to cocaine. JA behaviors were assessed with the Early Social and Communication Scales at 12, 15, and 18 months of age. Three classes of JA were measured: Initiating JA (IJA), Responding to JA (RJA), and Requests. Behavioral outcomes were measured at 36 months and included ratings of disruptive and withdrawn behaviors and social competence. JA behaviors were related to behavioral outcomes after controlling for language and cognitive ability. The functionally distinct uses of JA were differentially related to behavioral outcome. IJA negatively predicted disruptive behaviors, whereas Requests positively predicted disruptive behaviors. Infant RJA negatively predicted withdrawn behaviors and positively predicted social competence. These results are interpreted in the context of competing theories that attempt to explain variability in the expression of JA skills in the second year of life.

Joint attention and disorganized attachment status in infants at risk

The development of joint attention skills is a major milestone of infancy. Recent research suggests that the development of these skills may be affected by disorganized (D) attachment. This hypothesis was examined in a longitudinal study of attachment and joint attention skill development in a sample of infants at risk for developmental-behavioral morbidity. The results revealed that toddlers with D classifications initiated joint attention with an experimenter significantly less often than did secure, or even other insecure, toddlers. However, no group differences in the capacity to respond to the joint attention bids of others were observed in this study. These data suggest that a disturbance in the tendency to initiate episodes of joint attention with others may be indicative of early social-cognitive and social-emotional disturbance among infants affected by disorganized attachment status. Theory and research is reviewed to suggest that an early impairment in joint attention facility may make a significant contribution to risk for negative cognitive and emotional outcomes among these infants.

Effects of Three Levels of Early Intervention Services on Children Prenatally Exposed to Cocaine

Cocaine use during pregnancy is a high-risk indicator for adverse developmental outcomes. Three levels of intervention (center, home, and primary care) were compared in a full service, birth to age 3, early intervention program serving children exposed to cocaine prenatally. Data were collected on 130 children from urban, predominantly poor, primarily minority families. At 36 months, statistically significant, moderate to large intervention effects were found for cognition, receptive and expressive language, and gross motor development. Small effects were observed for behavior problems, and no statistically significant effects were found for fine motor or prosocial skills. Center-based care was most effective for improving language. These findings provide support that the center- and home-based early intervention programs examined in this study had positive effects on children at risk due to prenatal cocaine exposure.

Evidence Base Update for Psychosocial Treatments for Disruptive Behaviors in Children

This article reviews the state of the science on psychosocial treatments for disruptive behaviors in children, as an update to Eyberg, Nelson, and Boggs (2008). We followed procedures for literature searching, study inclusion, and treatment classification as laid out in Southam-Gerow and Prinstein (2014), focusing on treatments for children 12 years of age and younger. Two treatments (group parent behavior therapy, and individual parent behavior therapy with child participation) had sufficient empirical support to be classified as well-established treatments. Thirteen other treatments were classified as probably efficacious. Substantial variability in effectiveness of different programs within the same treatment family has been previously documented; thus, a particular level of evidence might not hold true for every individual program in a treatment family. Systematic investigations of implementation, dissemination, and uptake are needed to ensure that children and families have access to effective treatments. Investigations into how to blend the strengths of the effective approaches into even more effective treatment might also lead to greater impact.

Responsiveness and attention during picture‐book reading in 18‐month‐old to 24‐month‐old toddlers at risk

The purpose of this research was to examine the spontaneous responsiveness and attention during picture‐book reading in 18‐month‐old to 24‐month‐old children from at‐risk backgrounds. Twenty‐five, 18‐month‐old children in an early intervention program were randomly assigned to a read condition or play condition for six months. At each seventh session, all children, regardless of condition, were videotaped during reading. Videotapes were scored for children’s spontaneous responses such as pointing and labeling as well as mean duration of joint attention. Primary caregivers completed language measures for children at 18 and 24 months of age. Overall, there was large variability in the level of children’s spontaneous responses and attention during reading. Responsiveness increased from observation 3 to observation 4, whereas joint attention increased from observation 1 to observation 2. There were no differences in responsiveness and joint attention measures for the children in the read and play conditions. Measures of joint attention during reading from 18 to 24 months of age were related to language measures at 24 months. Implications for this research include a closer examination of individual differences in young children’s participation in picture‐book reading.

Early Intervention with Children Prenatally Exposed to Cocaine: Expansion with Multiple Cohorts

Prenatal cocaine exposure is an indicator for adverse developmental outcomes. To prevent developmental disabilities, an early intervention program for children birth to 3 years was developed that included three groups: center-based, home-based, and primary care comparison. The intervention was implemented across 10 years and data were collected on 342 children and families who were primarily urban, poor, and members of traditionally underrepresented groups. At 36 months of age, center and home-based intervention participants had more advanced cognitive and language abilities and fewer behavior problems than the primary care group participants. In addition, center-based participants had more advanced language abilities than home-based participants. The findings indicate that the early intervention impact is sustainable over time and has a positive effect on children at risk due to prenatal cocaine exposure.

Legacy for ChildrenTM: a pair of randomized controlled trials of a public health model to improve developmental outcomes among children in poverty

BackgroundOne in five Americans under age 18 lives in a family below the Federal poverty threshold. These more than 15 million children are at increased risk of a wide variety of adverse long-term health and developmental outcomes. The early years of life are critical to short- and long-term health and well-being. The Legacy for ChildrenTM model was developed in response to this need and marries the perspectives of epidemiology and public health to developmental psychology theory in order to better address the needs of children at environmental risk for poor developmental outcomes.Methods/designThe Legacy for ChildrenTM group-based parenting intervention model was evaluated as a pair of randomized controlled trials among low-income families in Miami and Los Angeles. The study was designed to allow for site-stratified analysis in order to evaluate each model implementation separately. Evaluation domains include comprehensive assessments of family, maternal, and child characteristics, process outcomes, and prospective programmatic cost. Data collection began prenatally or at birth and continues into school-age.DiscussionThe societal costs of poor developmental outcomes are substantial. A concerted effort from multiple sectors and disciplines, including public health, is necessary to address these societal concerns. Legacy uses a public health model to engage parents and promote overall child well-being in families in poverty through rigorous evaluation methodologies and evidence-based intervention strategies. This study collects rich and modular information on maternal and child outcomes, process, and cost that will enable a detailed understanding of how Legacy works, how it can be refined and improved, and how it can be translated and disseminated. Taken together, these results will inform public policy and help to address issues of health disparities among at-risk populations.Trial registrationNCT00164697

Identifying Young Children with Mild Cognitive Deficiencies.

Sixty-two 4- and 5-year-old exceptional children, with either mild mental retardation or learning disabilities, were matched on age, sex, and ethnicity with children who were making normal progress. All 62 pairs were presented a minibattery that included 6 cognitive tasks: two memory, three oddity, and a word definition task. The exceptional group performed more poorly than their normal matches on all dependent measures. Discriminant function analyses resulted in classification accuracy levels for the normally achieving group of no less than 89%. Ninety-seven percent of preschoolers with mild mental retardation were correctly identified, as were 84% of children classified as learning disabled. When the two groups with mild cognitive deficiencies were combined, 90% of the children with special educational needs were correctly classified. Cutoff scores applied to frequency distributions were associated with similar levels of accuracy. These results support the contention that a screening test composed of a broad array of cognitive measures should enable more effective identification of young children with mild mental retardation or learning disabilities.