Karen S. Budd

Clinical assessment of parents in child protection cases: An empirical analysis.

We investigated the content and legal relevance of clinical evaluations of parents conducted in child abuse and neglect cases. The sample consisted of 190 mental health evaluation reports, randomly selected from major providers, that had been completed on parents involved in a large, urban juvenile court system. We coded evaluations on 170 objective and qualitative characteristics in order to assess for criteria recommended in the forensic literature. We compared evaluations across groups categorized by type (e.g., psychological, psychiatric, bonding/parenting, substance abuse) and where the assessments were performed (outside or inside the court). We found numerous substantive failures to meet those criteria for forensic relevance. Evaluations of parents typically were completed in a single session, rarely included a home visit, used few if any sources of information other than the parent, often cited no previous written reports, rarely used behavioral methods, stated purposes in general rather than specific terms, emphasized weaknesses over strengths in reporting results, and often neglected to describe the parents caregiving qualities or the childs relationship with the parent. Some relevant differences were evident across assessment groups, pointing to examples of more thorough, parenting-specific evaluation practices. We recommend ways to improve current practices in forensic parenting assessment.

Effectiveness of Teacher- Child Interaction Training (TCIT) in a Preschool Setting

This research addressed the need for trained child care staff to support optimal early social-emotional development in urban, low-income, ethnic minority children. We evaluated effectiveness of Teacher-Child Interaction Training (TCIT), an approach adapted from Eyberg’s Parent-Child Interaction Therapy (PCIT). TCIT focuses on increasing preschool teachers’ positive attention skills and consistent discipline in order to enhance children’s psychosocial functioning and prevent mental health problems. A total of 12 teachers participated in small-group workshop sessions with in vivo coaching on their use of skills in the classroom. A multiple-baseline design across four classrooms (3 teachers each) evaluated effects of training on teacher behaviors during weekly classroom observations. Findings indicated systematic increases in trained skills during intervention, and consumer evaluations showed that the training was rated positively. Our results suggest that TCIT is a promising approach for enhancing positive teacher-child interactions in a preschool setting and should receive further investigation.

Psychosocial correlates of child abuse potential in multiply disadvantaged adolescent mothers

OBJECTIVE This study had two aims: First to examine psychosocial correlates of child maltreatment risk, and second to assess the validity of the CAP Inventory (Milner, 1986) with multiply disadvantaged teenage mothers. METHOD Participants were 75 adolescent mothers who were wards of the Illinois child protection system. Mothers (aged 14-18) and infants participated in home-based psychosocial assessment of personal and parenting functioning. Group comparisons examined differences for mothers with elevated versus normal versus invalid CAP scores due to faking good. RESULTS Findings indicated that abuse risk groups differed on emotional distress, social support satisfaction, reading achievement, and years of education, but not on parenting beliefs or quality of child stimulation. Differences favored the normal over the elevated risk group in all significant comparisons, whereas mothers with elevated faking good differed from normals only in lower reading achievement. Multiple regression analysis highlighted emotional distress, support dissatisfaction, and low achievement as significant predictors of greater abuse risk. CONCLUSIONS Despite sharing multiple disadvantages, adolescent wards are a heterogeneous group who show different levels of psychosocial functioning corresponding to levels of child maltreatment risk. The findings provide support for the concurrent validity and clinical applicability of the CAP Inventory with disadvantaged teenage mothers.

Promoting Positive Interactions in the Classroom: Adapting Parent-Child Interaction Therapy as a Universal Prevention Program

The adaptation of Parent-Child Interaction Therapy (PCIT), an empirically-supported dyadic parent training intervention, to a preschool setting may provide an opportunity to enhance the well-being of both teachers and children by improving the teacher-child relationship and supplying teachers with effective tools for behavior management. The current article describes the development and implementation of a Teacher-Child Interaction Training (TCIT) program, based on the PCIT model, to a preschool setting serving primarily low-income, urban, ethnic minority youth. We discuss the rationale for applying PCIT as a prevention program, prior research on adaptations of PCIT to educational settings, application of community psychology principles and strategies in adapting PCIT to the classroom, core TCIT program components, evaluation of effectiveness, issues in sustainability, and resources for successfully implementing the program.

Broadening the parameters of investigation in treating young children's chronic food refusal *

We evaluated the relationship of contextual variables and contingent mother-child interactions to feeding behaviors at home for 3 children (ages 18 to 43 months) with chronic food refusal problems. Previous research suggests that contingent attention (i.e., specific prompts, approval) affects feeding, but contextual variables (i.e., mealtime location, seating arrangement, number of meals and snacks offered daily, persons present during meals) have not been systematically examined. Using a nonconcurrent multiple baseline design across mother-child dyads, we assessed the effects of parent training in contingency management skills on maternal contingent attention, child food intake, and contextual variables of mealtimes. Parent training resulted in planned increases in contingent attention and child acceptances of target foods for each dyad. Concomitant with this training, 2 children showed positive changes in contextual variables (e.g., reduced frequency of daily meals and snacks to a recommended level, increased proportion of meals eaten at a table), and 1 child evidenced mild deterioration in contextual variables. A second parent training condition directed at correcting specific ecological parameters with 2 dyads effectively modified these variables, but its impact on child food acceptance was unclear. These findings suggest that some contextual conditions covary with childrens feeding patterns and should be monitored in planning and evaluating feeding intervention.

Evaluating Parents in Child Protection Decisions: An Innovative Court-Based Clinic Model

Providing relevant, timely forensic evaluations is challenging because of the differing worlds of mental health and law. In this study, the authors evaluated an innovative, court-based clinic model for improving acquisition and use of clinical information in juvenile court in a 3-year pilot project prior to wide-scale implementation. The authors investigated the extent to which 170 evaluations of parents in the child protection division met criteria recommended in the forensic literature by comparing reports across four groups categorized by source (inside or outside court; part of pilot project or not). Findings suggested greater use of recommended practices and more timely, consistent reports by the pilot clinic. The findings provide preliminary support for the model and guidance for improving forensic evaluations in child protection.

Limitations of Operant Practice in the Study of Disease

This article examines the practice of operant psychology in light of its evolutionary development and its extension into other scientific fields, most notably medicine. It asks whether insistence on the primacy of behavior, empiricism, observability, and direct physical causality benchmarks of the behavioral approach-limit the application of operant models to problems of disease. Several areas of current behavioral research in which extensions of the operant paradigm have been necessary in light of new data are reviewed. A selective review of biopsychosocial research suggests that diverse variables often interact in complex or idiosyncratic patterns to affect disease expression. In some cases, biological factors limit the extent of available behavior change, whereas in other cases behavioral strategies offer the potential to modify physiological systems. Our review indicates that scientific advances call for an expanded operant approach that incorporates multicausality, indirect mechanisms of control, and multielemental analysis. Nevertheless, given the broad analytic view of the operant paradigm, it offers a rich conceptual framework for exploration of behavioral medicine issues in concert with related scientific disciplines.

Common Feeding Problems in Young Children

Even before a baby is born, parents watch carefully for signs of their expectant child’s health and development. The growing emphasis on prenatal care reflects a greater awareness of the effects of maternal health behaviors on the unborn child. However, concerns and questions about the child’s developmental progress do not abate after birth. In fact, the most common questions asked of pediatricians by parents of infants and toddlers concern what is normal for a child at different ages (Reisinger & Bires, 1980; Riter, personal communication, October, 1995). Parents typically ask, “When will my child develop a stable sleep schedule?”; “When should I begin potty training my child?”; and “When will my child [reach a particular developmental milestone]?”

Cross-Generational Parenting Influences on Psychosocial Functioning of Adolescent Mothers in Substitute Care

This study examined the cross-generational influence of adolescent parenthood on psychosocial functioning with a random sample of adolescent mothers in state substitute care due to child abuse or neglect in their family of origin. Participants reported if their main parenting figure was an adolescent parent or not, their educational attainment, and their level of parenting stress. Participants whose main parenting figure was an adolescent parent reported significantly higher parenting stress and lower educational attainment than participants whose main parenting figure was not an adolescent parent. The two groups of adolescent mothers did not differ in their childbearing history or past substitute care experience. These findings highlight the need for research and interventions to address cross-generational influences on educational and parenting difficulties among teenage mothers in substitute care.

Parenting Issues and Interventions with Adolescent Mothers

Adolescent parenthood and child maltreatment rank as two of this country’s leading contemporary social problems. Both problems seem, thus far, to be impervious to effective control, despite formidable efforts at prevention and intervention over the past quarter-century (Children’s Defense Fund, 1996; National Research Council, 1993; Weatherley, 1991). In addition to their shared status as social morbidities, the two conditions converge in some families. Because few adolescents are ready to independently assume the responsibilities of childrearing, teen mothers, particularly those with limited social and economic resources, are vulnerable to conditions that can escalate into child maltreatment. Thus, a chapter focusing on disadvantaged adolescent mothers is appropriate in a volume on child abuse.