Bruce L. Baker

Behavior Problems and Parenting Stress in Families of Three-Year-Old Children With and Without Developmental Delays

Children and adolescents with mental retardation are at heightened risk for mental disorder. We examined early evidence of behavior problems in 225 three-year-old children with or without developmental delays and the relative impact of cognitive delays and problem behaviors on their parents. Staff-completed Bayley Behavior Scales and parent-completed Child Behavior Checklists (CBCLs) showed greater problems in children with delays than in those without delays. Children with delays were 3 to 4 times as likely to have a total CBCL score within the clinical range. Parenting stress was higher in delayed condition families. Regression analyses revealed that the extent of child behavior problems was a much stronger contributor to parenting stress than was the childs cognitive delay.

Parenting Stress and Child Behavior Problems: A Transactional Relationship Across Time

Parenting stress and child behavior problems have been posited to have a transactional effect on each other across development. However, few studies have tested this model empirically. The authors investigated the relationship between parenting stress and child behavior problems from ages 3 to 9 years old among 237 children, 144 of whom were typically developing and 93 who were identified as developmentally delayed. Behavior problems and parenting stress covaried significantly across time for both groups of children. Cross-lagged panel analyses generally supported a bidirectional relationship between parenting stress and child behavior problems for mothers and fathers.

Applications of the Expressed Emotion Construct to Young Children with Externalizing Behavior: Stability and Prediction over Time

We explored the utility of the Expressed Emotion (EE) construct with a community sample of young children (N = 91), studying the stability of EE scores over a 2-year period and the extent to which EE was associated with simultaneous and subsequent disruptive behavior. As part of a longitudinal study, families were assessed when the child was in preschool, 1st grade, and 3rd grade. Maternal EE was measured at preschool and 1st grade using the Five Minute Speech Sample and behavior ratings were obtained using the Child Behavior Checklist. At 3rd grade, the Diagnostic Interview Schedule for Children was used to determine DSM-IV diagnoses. The stability of the EE rating over the 2-year period from preschool to 1st grade was statistically significant although modest. At 1st grade, EE ratings were significantly related to the extent of externalizing behavior problems. Regression analyses that controlled for maternal stress levels determined that preschool EE ratings predicted classification of ADHD over 4 years later, at 3rd grade. The relationships between EE and child problem behavior were almost exclusively determined by the EE criticism dimension; the emotional overinvolvement dimension was not related to child behavior. The implications of these findings are discussed.

Behavior problems and peer rejection in preschool boys and girls

Abstract The authors tested the hypothesis that deviant behaviors within a preschool peer group would be linked with peer rejection, irrespective of child gender. Seventy-six children, aged 3 to 5 years, participated. Teachers rated childrens behavior on the Child Adaptive Behavior Inventory, and children provided sociometric ratings. For a subsample of children (n = 47), observers coded aggressive, noncompliant, and withdrawn behavior using a time-sampling system. For both boys and girls, noncompliance, hyperactivity, and social withdrawal were associated with peer rejection; overt aggression was associated with peer rejection for boys, but not for girls. Analysis revealed that approximately half of the variance in sociometric and teacher ratings of peer rejection was accounted for by aggression and social withdrawal for both boys and girls. The results suggest that the association between behavior problems and peer rejection emerges at a very early age.

Prediction of social skills in 6-year-old children with and without developmental delays: contributions of early regulation and maternal scaffolding.

Childrens emotion dysregulation and maternal scaffolding at age 4 were examined as predictors of social skills at age 6, for 66 children with and 106 without early developmental delays. Observed scaffolding and regulation during frustrating laboratory tasks related to later mother, father, and teacher social-skill ratings for children with delays and were stronger predictors of social skills within this group than were developmental level and early behavior problems. In contrast, fewer associations were found for typically developing children, with early behavior problems providing the only unique prediction to social skills. Data support a model in which dysregulation partially mediates the association between developmental status and social-skill outcomes. Implications for research, prevention, and early intervention are discussed.

Predicting maternal parenting stress in middle childhood: the roles of child intellectual status, behaviour problems and social skills

BACKGROUND Parents of children with intellectual disabilities (ID) typically report elevated levels of parenting stress, and child behaviour problems are a strong predictor of heightened parenting stress. Interestingly, few studies have examined child characteristics beyond behaviour problems that may also contribute to parenting stress. The present longitudinal study examined the contribution of child social skills to maternal parenting stress across middle childhood, as well as the direction of the relationship between child social skills and parenting stress. METHOD Families of children with ID (n = 74) or typical development (TD) (n = 115) participated over a 2-year period. Maternal parenting stress, child behaviour problems and child social skills were assessed at child ages six and eight. RESULTS Child social skills accounted for unique variance in maternal parenting stress above and beyond child intellectual status and child behaviour problems. As the children matured, there was a significant interaction between child social skills and behaviour problems in predicting parenting stress. With respect to the direction of these effects, a cross-lagged panel analysis indicated that early parenting stress contributed to later social skills difficulties for children, but the path from childrens early social skills to later parenting stress was not supported, once child behaviour problems and intellectual status were accounted for. CONCLUSION When examining parenting stress, child social skills are an important variable to consider, especially in the context of child behaviour problems. Early parenting stress predicted child social skills difficulties over time, highlighting parenting stress as a key target for intervention.

Mental Disorders in Five-Year-Old Children With or Without Developmental Delay: Focus on ADHD

Epidemiological studies of children and adolescents with intellectual disability have found 30 to 50% exhibiting clinically significant behavior problems. Few studies, however, have assessed young children, included a cognitively typical comparison group, assessed for specific disorders, and/or studied family correlates of diagnosis. We assessed 236 5-year-old children—95 with developmental delay (DD) and 141 with typical development—for clinical diagnoses using a structured interview. Every disorder assessed was more prevalent in the DD group. The percent of children meeting criteria for Attention Deficit Hyperactivity Disorder (ADHD) most highly differentiated the two groups (ratio = 3.21:1). There was high stability from externalizing behavior problems at age 3 to ADHD diagnoses at age 5 in both groups. In regression analyses, parenting stress at child age 3 related to later ADHD diagnosis in both groups and maternal scaffolding (sensitive teaching) also predicted ADHD in the DD group.

Empirical support for a treatment program for families of young children with externalizing problems

We evaluated the efficacy of a manualized multimodal treatment program for young externalizing children. Families were assigned randomly to an immediate 12-week parent and child treatment condition (n = 24) or to a delayed-treatment condition (n = 23). Parents had high attendance, high satisfaction with treatment, and increased knowledge of behavior management principles. Relative to the waitlist condition, treatment parents reported statistically and clinically significant reductions in child behavior problems, improved parenting practices (i.e., increased consistency, decreased power assertive techniques), an increased sense of efficacy, and reduced parenting stress. There was a trend toward parents improving their attitudes toward their children. In considering the process of change, we found evidence that improved parenting practices mediated reductions in child behavior problems and that child improvements mediated changes in parent attitudes and stress. Five months following treatment, teachers reported significant improvements in child behaviors, whereas parents reported that reductions in child behavior problems and parenting stress were maintained.

Self-directed desensitization for acrophobia

Abstract Acrophobic outpatients received therapist- or self-directed (tape-recorded) desensitization in a study of (a) treatment effectiveness with diminished therapist contact ; (b) subject characteristics ‘predicting’ outcome; and (c) generalization of change. At Post-test, treated Ss (N=16) had improved significantly more than Waiting List Ss (N=13) on self-report measures of acrophobia and general anxiety, while the treatment methods were equally effective. An 8-month follow-up found that self-directed Ss had attempted more specific behavioral situations than therapist-directed Ss, and showed additional gains on self-report measures while therapist-directed Ss maintained post-test levels. Results suggested: (a) desensitization provides effective treatment even with reduced therapist contact; (b) some subject characteristics relate to outcome and (c) treatment effects generalize to other anxiety indices.

Effectiveness of alternative parent training formats.

Alternative formats were compared for training parents of retarded children to teach self-help skills and manage problem behaviors. Sixty-six families with moderately to severely retarded children ages 3-13 were assigned for 3 months to group parent training (n = 37), individual parent training (n = 16), or delayed training control (n = 13). Measures administered before and after training evaluated: (1) parent knowledge of behavior modification, (2) a behavior sample of parent teaching, and (3) child self-help skills and behavior problems. Trained families gained significantly more than control families on parent measures but not on the child self-help skill measure. Group and individually trained families demonstrated almost identical gains. At a 6-month follow-up, group and individually trained families continued to show equal performance. Group training requires about half the professional time per family as individual training, and therefore seems a more cost-effective approach.