Larissa N. Niec

Characteristics of young children with sexual behavior problems: a pilot study

Sexual behavior problems (SBP) have been increasingly recognized in young children. Despite rising awareness, previous research has focused on school-age children with SBP and adolescent sex offenders. The purpose of the current study was to investigate the history, adjustment, and social environment of preschool children with SBP. Thirty-seven young children with SBP were evaluated. As expected, significant emotional and behavior problems were evident, and caregivers reported high levels of stress related to parenting. Contrary to findings among school-age samples, more of the children were female (65%) than male (35%). Many (62%) did not have substantiated histories of sexual abuse. Many children had experienced physical abuse (47%) and/or witnessed interparental violence (58%). Only four (11%) had no known history of sexual abuse, physical abuse, or witnessing domestic violence. Although further research is necessary, results supported the need to consider the developmentally unique presentation of young children with SBP.

Children's internal representations, empathy, and fantasy play: a validity study of the SCORS-Q.

The authors investigated relationships among internal representations, empathy, and affective and cognitive processes in fantasy play to test the validity of the Social Cognition and Object Relations Scale Q-Sort (SCORS-Q; D. Westen, 1995) with children. Eighty-six 8-10-year-olds were administered 8 Thematic Apperception Test cards, a standardized play task, and a self-report empathy measure. Teachers rated childrens empathy and helpfulness. As predicted, internal representations were related to empathy, helpfulness, and quality of fantasy play. Developmental differences on the SCORS-Q were consistent with object relations theory and with results from the original SCORS. The findings support the value of internal representations as a means of understanding childrens interpersonal functioning and contribute to the validity of the SCORS-Q for use with children.

Coaching Parents to Change: The Impact of In Vivo Feedback on Parents' Acquisition of Skills

Behavioral parent training (BPT) includes a variety of evidence-based treatments with diverse techniques to alter parent behavior. Parent–Child Interaction Therapy is an innovative BPT with its use of in vivo feedback (i.e., “coaching”) during parent–child interactions. An experimental design was used to assess whether coaching without elaborate didactic improves parenting. Sixty mothers with children 2 to 7 years old were recruited from the community and randomly assigned to a coaching or no coaching group. After a baseline assessment, all dyads participated in two play interactions 1 week apart during which parents in the coaching group were provided with in vivo feedback. Coached parents displayed significant improvements in skills, and coaching predicted skill gains beyond the influence of baseline ability. Findings suggest that providing parents with feedback through in vivo coaching is an important mechanism of change.

Treatment for preschool children with interpersonal sexual behavior problems: a pilot study.

This pilot study evaluated a 12-week group treatment program for preschool children with interpersonal sexual behavior problems (SBP; N = 85; 53 completed at least 8 sessions). Many children presented with co-occurring trauma symptoms and disruptive behaviors. In intent-to-treat analysis, a significant linear reduction in SBP due to number of treatment sessions attended was found, an effect that was independent of linear reductions affiliated with elapsed time. Under the assumption that treatment can have an incremental impact, more than one third of the variance was accounted for by treatment effects, with female and older children most favorably impacted. Caregivers reported increase in knowledge, satisfaction, and usefulness of treatment. In addition to replication, future research is needed to examine (a) effects of environment change and time on SBP, (b) stability of treatment effects, and (c) best practices to integrate evidence-based treatments for comorbid conditions.

Cognitive Behavioral Principles Within Group Mentoring: A Randomized Pilot Study.

This study evaluated the effectiveness of a group mentoring program that included components of empirically supported mentoring and cognitive behavioral techniques for children served at a community mental health center. Eighty-six 8- to 12-year-old children were randomly assigned to either group mentoring or a wait-list control group. Group mentoring significantly increased childrens reported social problem-solving skills and decreased parent-reported child externalizing and internalizing behavior problems after controlling for other concurrent mental health services. Attrition from the group mentoring program was notably low (7%) for children. The integration of a cognitive behavioral group mentoring program into childrens existing community mental health services may result in additional reductions in externalizing and internalizing behavior problems.

Group Parent-Child Interaction Therapy: A Randomized Control Trial for the Treatment of Conduct Problems in Young Children

OBJECTIVE Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems. METHOD Eighty-one families with 3- to 6-year-old children (71.6% boys, 85.2% White) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, Group PCIT. Parents completed standardized measures of childrens conduct problems, parenting stress, and social support at intake, posttreatment, and 6-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System. RESULTS Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their childrens conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in Group PCIT did not experience greater social support or treatment adherence. CONCLUSIONS Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of Group PCIT in community settings. (PsycINFO Database Record

Successful Therapist–Parent Coaching: How In Vivo Feedback Relates to Parent Engagement in Parent–Child Interaction Therapy

Although behavioral parent training is considered efficacious treatment for childhood conduct problems, not all families benefit equally from treatment. Some parents take longer to change their behaviors and others ultimately drop out. Understanding how therapist behaviors impact parental engagement is necessary to improve treatment utilization. This study investigated how different techniques of therapist in vivo feedback (i.e., coaching) influenced parent attrition and skill acquisition in parent–child interaction therapy (PCIT). Participants included 51 parent–child dyads who participated in PCIT. Children (age: M = 5.03, SD = 1.65) were predominately minorities (63% White Hispanic, 16% African American or Black). Eight families discontinued treatment prematurely. Therapist coaching techniques during the first session of treatment were coded using the Therapist–Parent Interaction Coding System, and parent behaviors were coded with the Dyadic Parent–Child Interaction Coding System, Third Edition. Parents who received more responsive coaching acquired child-centered parenting skills more quickly. Therapists used fewer responsive techniques and more drills with families who dropped out of treatment. A composite of therapist behaviors accurately predicted treatment completion for 86% of families. Although group membership was correctly classified for the treatment completers, only 1 dropout was accurately predicted. Findings suggest that therapist in vivo feedback techniques may impact parents’ success in PCIT and that responsive coaching may be particularly relevant.

A Comparison of Friendship Quality and Social Functioning Among Children With Perinatally Acquired HIV, Children With Persistent Asthma, and Healthy Children of HIV-Positive Mothers

OBJECTIVE To examine the friendships and social expectations of children with perinatally acquired HIV and compare them to children with moderate to severe persistent asthma and healthy children of HIV-positive mothers. METHODS 70 children (ages 8-14 years) were recruited from pediatric allergy and immunology multidisciplinary clinics and hospital-based HIV-support programming. Children completed measures of friendship quality and interpersonal functioning. Caregivers completed a measure of child psychosocial functioning. RESULTS Children with asthma, not HIV, demonstrated poorer indicators of friendship and the most negative social expectations of the three groups. Children with HIV maintained best friendships and rated themselves as socially well-adjusted. CONCLUSIONS Comprehensive multidisciplinary services and ancillary supports may have buffered against stressors and facilitated positive psychosocial outcomes in children with HIV. Children with asthma displayed higher disease activity, possibly contributing to poorer outcomes. Results suggest a need to better understand the protective factors that enhance social functioning in children with HIV.

Mentoring youth with psychiatric disorders : The impact on child and parent functioning

ABSTRACT This study examined the effectiveness of a behavioral mentoring program aimed at serving youth with psychiatric disorders. Participants included 30 youth (8–12 years old) receiving services in a mentoring program for a mental health population and 30 wait-listed youth and their maternal caregivers. Participating in mentoring services was related to higher family functioning across a number of domains including child behavior, parenting stress, perceived parent social support, and perceived parent-child relationship quality. As predicted, parenting stress mediated the relationship between mentoring and childrens externalizing behavior problems. Results suggest that mentoring services may be a useful adjunct service for highly stressed families with children with emotional and behavioral disorders.

The Contribution of the Dyadic Parent-Child Interaction Coding System (DPICS) Warm-Up Segments in Assessing Parent-Child Interactions.

This study evaluated the inclusion of uncoded segments in the Dyadic Parent-Child Interaction Coding System, an analogue observation of parent-child interactions. The relationships between warm-up and coded segments were assessed, as well as the segments’ associations with parent ratings of parent and child behaviors. Sixty-nine non-referred parent-child dyads engaged in the observation. Parents completed measures about their parenting and childrens behaviors. Significant differences were observed between the first situations warm-up and coded segments, whereas minimal differences were found for the second situation. Findings suggest that the second warm-up segment may not be necessary for optimal assessment of parent-child interactions.