Ariel A. Williamson

A pilot randomized trial of community-based parent training for immigrant Latina mothers.

This paper reports on the development and piloting of the Madres a Madres (Mothers to Mothers) program, a new, community-based parent training program designed for immigrant Latina mothers and their children. Promotoras, or female community health workers of Latina background, delivered the program in a home visitation format. A total of 194 mothers and 194 focal children (87 male, 107 female) ages 7–12 were randomized to the intervention (113 mother–child dyads) or wait-list control condition (81 mother–child dyads) over the study period. Outcomes of interest were mother-reported parenting skills, broad family functioning, and child externalizing and internalizing behaviors. Data collection occurred at pretest, 3-month posttest, and 9-month follow-up periods. Multilevel growth models revealed increases in intervention mothers’ reported parenting skills, family support, and family organization, and reductions in child internalizing behavior from pretest to follow-up, relative to the control condition. Outcomes did not vary by focal child age, gender, nativity status, or mother acculturative status (years in the United States). Findings are discussed in the context of future directions for research on the Madres a Madres program and on the implementation and dissemination of empirically-supported parent training practices to culturally diverse families.

Consequences of Obstructive Sleep Apnea in Children

Obstructive sleep apnea syndrome (OSAS) has various negative health and behavioral consequences in the pediatric population. As shown in adults, there are metabolic derangements such as obesity, insulin sensitivity, dyslipidemia, and metabolic syndrome, as well as cardiovascular derangements like hypertension, chronic inflammation, endothelial dysfunction, ventricular size/function abnormalities, and even elevated pulmonary arterial pressures, that can be seen in children with OSAS. The first two sections will discuss the metabolic and cardiovascular consequences on OSAS in children. The last section summarizes selected studies and reviews on the behavioral, neurocognitive and academic consequences of OSAS in children.

Narrative Focus Predicts Symptom Change Trajectories in Group Treatment for Traumatized and Bereaved Adolescents

Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students’ narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each students narrative was coded using transcripts of members’ narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre–post improvement in either PTSD symptoms or MG reactions. Students whose narratives focused on loss both reported higher starting levels and showed steeper rates of decline in MG reactions than students whose narratives focused on trauma. In contrast, students whose narratives focused on trauma reported higher starting levels of PTSD than students who narrated loss experiences. However, narrative focus was not significantly linked to the rate at which PTSD symptoms declined over the course of treatment. This study provides preliminary evidence that TGCT-A treatment components are associated with reduced PTSD symptoms and MG reactions. Loss-focused narratives, in particular, appear to be associated with greater decreases in MG reactions.

Sleep Patterns among South Korean Infants and Toddlers: Global Comparison

The purpose of this study was to examine sleep patterns in a large sample of infants and toddlers (ages birth to 36 months) in Korea, and to compare sleep patterns, sleep problems, sleep ecology, and parental behaviors to global sleep data on young children in both predominately Asian (P-A) and predominately Caucasian (P-C) countries/regions. We additionally examined parent and child demographic information, parental behaviors, and aspects of the sleep ecology as predictors of sleep patterns among infants and toddlers in Korea. Parents/caregivers of 1,036 Korean infants and toddlers completed an expanded, internet-based version of the brief infant sleep questionnaire. Consistent with other studies of sleep in early childhood, sleep/wake patterns became increasingly consolidated with older child age for the Korea sample. Compared to both P-A and P-C infants and toddlers, children in Korea had the latest bedtimes, shortest total sleep and daytime sleep durations, and the least frequent rates of napping. Even though half of parents perceive their children’s sleep problematic, parental perceptions of severe child sleep problems were the lowest. Within Korea, breastfeeding and bottle-feeding at sleep resumption were associated with increased nocturnal awakenings. Evening television viewing was associated with later bedtimes, which may have implications for sleep hygiene recommendations in clinical practice. The current study provides important information about sleep/wake patterns, parental behaviors, and aspects of the sleep ecology for infants and toddlers for physicians to support healthy sleep in Korea.

Ethical and legal issues in integrated care settings: Case examples from pediatric primary care.

There is a growing recognition that integrated primary care (IPC) services can address longstanding sociodemographic disparities in access to and utilization of behavioral health services. At the same time, there has been increasing attention to the complex ethical and legal considerations that can emerge for psychologists working in these interdisciplinary settings. There are challenging ethical dilemmas that arise when providing services to youth and their caregivers involved in IPC services. Unfortunately, although some ethical guidelines and case illustrations relevant to IPC are available, very few focus on the pediatric IPC context. The purpose of this article is to examine salient ethical and legal dilemmas that may emerge in pediatric IPC practice. These issues are examined through the use of 4 case illustrations that collectively address issues related to consent for services among pediatric populations, confidentiality, scope of practice for the pediatric IPC psychologist, and multiple relationships. We apply an adapted ethical decision-making framework (Kanzler, Goodie, Hunter, Glotfelter, & Bodart, 2013) to highlight practice points drawn from each of these cases. Throughout this article, we reference the American Psychological Association’s 2010 ethics code and 2015 guidelines for primary care practice competencies, while highlighting clinical practice points and directions for future research. We also discuss similarities and differences between the American Psychological Association (APA, 2010) and American Medical Association (AMA, 2012) ethics codes and standards of care.

Benefits of a bedtime routine in young children: Sleep, development, and beyond

This paper presents a conceptual model and reviews the empirical evidence to support a nightly bedtime routine as a key factor in the promotion of not only healthy sleep, but also of broad development and wellbeing in early childhood. A bedtime routine embodies the characteristics of nurturing care and early child stimulation, which are deemed to be essential for positive outcomes, especially for at-risk children. Furthermore, common, adaptive components of a bedtime routine can contribute to an array of positive developmental outcomes beyond improved sleep, inclusive of language development, literacy, child emotional and behavioral regulation, parent-child attachment, and family functioning, among other outcomes. These bedtime routine components include activities in the broad domains of nutrition (e.g., feeding, healthy snack), hygiene (e.g., bathing, oral care), communication (e.g., reading, singing/lullabies) and physical contact (e.g., massage, cuddling/rocking). A bedtime routine can provide multiple benefits to child and family functioning at a time of day that many parents are present with their children. Although additional research on hypothesized routine-related child outcomes and mechanisms of action are needed, promoting a bedtime routine may be a feasible and cost-effective method to promote positive early childhood development worldwide, particularly for socioeconomically disadvantaged and other at-risk young children.

Brief report: Piloting the Positive Life Changes (PLC) program for at-risk adolescents

The purpose of this study was to pilot the Positive Life Changes (PLC) program, a comprehensive cognitive-behavioral intervention for at-risk adolescents that aims to promote social competencies and to prevent aggression. The program was piloted in 4 intervention groups with a sample of 31 self-referred adolescents (M age 15.64) attending an alternative high school. Questionnaires at pretest and 6-week posttest included five social competencies that represent an expansion of social information-processing (SIP) skills, a measure of aggressive behavior, and a new measure of aggression propensity. Three-level hierarchical linear models showed increases in three social competencies and reductions in physical and verbal aggression propensity from pretest to posttest. Number of program sessions attended did not moderate pretest-posttest change. Findings are discussed in the context of program implementation and future research in school and community settings.

Competencies and Training Guidelines for Behavioral Health Providers in Pediatric Primary Care

This article focuses on the cross-discipline training competencies needed for preparing behavioral health providers to implement integrated primary care services. After a review of current competencies in the disciplines of child and adolescent psychiatry, psychology, and social work, cross-cutting competencies for integrated training purposes are identified. These competencies are comprehensive and broad and can be modified for use in varied settings and training programs. An existing and successful integrated care training model, currently implemented at Childrens Hospital of Philadelphia, is described. This model and the training competencies are discussed in the context of recommendations for future work and training.

Adaptation of the Participant Role Scale (PRS) in a Spanish Youth Sample Measurement Invariance Across Gender and Relationship With Sociometric Status

In recent years, bullying research has transitioned from investigating the characteristics of the bully–victim dyad to examining bullying as a group-level process, in which the majority of children play some kind of role. This study used a shortened adaptation of the Participant Role Scale (PRS) to identify these roles in a representative sample of 2,050 Spanish children aged 8 to 13 years. Confirmatory factor analysis revealed three different roles, indicating that the adapted scale remains a reliable way to distinguish the Bully, Defender, and Outsider roles. In addition, measurement invariance of the adapted scale was examined to analyze possible gender differences among the roles. Peer status was assessed separately by gender through two sociometric procedures: the nominations-based method and the ratings-based method. Across genders, children in the Bully role were more often rated as rejected, whereas Defenders were more popular. Results suggest that although the PRS can reveal several different peer roles in the bullying process, a more clear distinction between bullying roles (i.e., Bully, Assistant, and Reinforcer) could better inform strategies for bullying interventions.

Development and Validation of the Coping With Acculturative Stress in American Schools (CASAS-A) Scale on a Latino Adolescent Sample

The psychometric properties of the Coping With Acculturative Stress in American Schools (CASAS-A) scale were examined using a sample of 148 Latino middle school students. CASAS-A is a self-report scale designed to identify students in need of culturally responsive social–emotional interventions due to having high levels of school-related acculturative stress. Confirmatory factor analysis (CFA), analyses of internal consistency, correlations with related measures, and group differences among Latino English Language Learners (ELLs) and non-ELLs were examined. The CFA results indicate that the data fit the hypothesized factor structure. The results also support adequate levels of reliability and validity. In addition, significant group differences were found between Latino ELLs and non-ELLs, with Latino ELLs reporting higher levels of acculturative stress in CASAS-A. Implications for future research, as well as recommendations for practitioners who implement culturally responsive interventions, are discussed.