Lucy Thompson

Dyslexia and psycho-social functioning: an exploratory study of the role of self-esteem and understanding

Individuals with dyslexia may have lower self-esteem and exhibit more emotional and behavioural difficulties than those without reading problems. However, the nature of any relationship between self-esteem and psychopathology remains unknown. This exploratory study assessed levels of self-esteem using the Self-Perception Profile for Children (Manual for the Self-Perception Profile for Children. University of Denver, CO: Denver; 1985) and psycho-social adjustment using the Strengths and Difficulties Questionnaire (J. Child Psychol. Psychiatry, 1997; 38: 581-586) and examined child and parent understanding, attitudes and the perceived impact of reading difficulties on daily life. Sixty-eight children assessed as dyslexic on the basis of discrepancy scores (mean age 11.2 years; 44 male), and their parents, participated. No global self-esteem deficit was found, but the mean score for both child and parent-rated scholastic competence was significantly lower than that of the general population. Rates of social, emotional and behavioural difficulties were significantly higher than in the general population and were correlated with self-esteem. For children who had high global self-worth, both children and their parents had more positive attitudes towards their reading difficulties and were less likely to perceive a negative impact on relationships. The association between academic self-esteem and emotional symptoms is consistent with the proposed link between dyslexia and internalizing difficulties. Good self-esteem and a good understanding of dyslexia may help children avoid some of these difficulties. Further research with larger more representative samples is necessary as understanding the factors that promote successful psycho-social adjustment is essential to the development of effective prevention and intervention strategies.

Disruptive behaviour disorders: a systematic review of environmental antenatal and early years risk factors

Disruptive behaviour disorders (DBDs), including attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) are chronic disorders with significant overlap in aetiology and presentation. An integrative examination of environmental risk factors is lacking. Six literature searches of web-based bibliographic databases were completed to identify literature on DBDs in general and five disorders in particular: CD, ODD, ADHD, deficits of attention, motor control and perception, and reactive attachment disorder. Searches were filtered to focus on studies including diagnostic assessment, focussing on environmental risk and protective factors in the first 4 years of life. The database searches generated 9806 papers of which 47 were reviewed after filters had been applied. The evidence suggests links between a number of early life risk factors and DBDs, including prenatal cigarette smoking and alcohol use, prenatal viral illness, maternal stress and anxiety, low birthweight, peri-partum and early neonatal complications, parental stress and parenting styles in infancy, early deprivation, adoption and separation. Despite the understanding that there is sharing of risk factors between the DBDs, there has been a disproportionate focus on the role of certain risk factors at the expense of others and the field is weakened by difficulties in controlling for all potential confounding variables.

Assessing wellbeing at school entry using the Strengths and Difficulties Questionnaire: professional perspectives

Background Emotional and behavioural disorders in early childhood are related to poorer academic attainment and school engagement, and difficulties already evident at the point of starting school can affect a child’s later social and academic development. Successful transfer from pre-school settings to primary education is helped by communication between pre-school staff and primary school teachers. Typically, in Scotland, pre-school establishments prepare individual profiles of children before they start school around the age of five years, highlighting their strengths and development needs, for transfer to primary schools. There is, however, no consistent approach to the identification of potential social, emotional and behavioural problems. In 2010, in one local authority area in Scotland, the Strengths and Difficulties Questionnaire (SDQ) was introduced for children about to start school as a routine, structured, component of the transition process to help teachers plan support arrangements for classes and individual children. The SDQ assesses emotional, conduct, hyperactivity/ inattention and peer-relationship problems as well as pro-social behaviour. In order to be an effective means of communicating social and emotional functioning, the use of instruments such as the SDQ needs to be practicable. Finding out the views of pre-school education staff with experience of assessing children using the SDQ was, therefore, essential to establish its future utility. Aim The purpose of this study was to explore the views of pre-school education staff about assessing social and emotional wellbeing of children at school entry using the SDQ. The objectives were to examine the opinions of pre-school workers about completing the SDQ and to elicit their thoughts on the value of doing this and their perceptions of the usefulness of the information collected. Method Pre-school establishments were approached using a purposive sampling strategy in order to achieve a mix of local authority (n=14) and ‘partnership’ establishments (n=8) as well as different socio-economic areas. Semi-structured interviews (n=25) were conducted with pre-school head teachers (n=14) and child development officers (n=11) in order to explore the process of completing the SDQ along with perceptions of its value. The interviews were transcribed verbatim and analysed thematically. Results In general, staff in pre-school establishments viewed the use of the SDQ positively. It was seen as a chance to highlight the social and emotional development of children rather than just their academic or educational ability. Most felt that the SDQ had not identified anything they did not already know about a child. A minority, nevertheless, suggested that a previously unrecognised potential difficulty was brought to light, most commonly emotional problems. Completing the SDQ was felt to be relatively straightforward even though the staff felt under pressure from competing priorities. Concerns were, however, raised about the potential of labelling a child at an early stage of formal education. Conclusion The findings from this small scale study suggest that, from the point of view of pre-school education staff, it is feasible to assess children systematically for social and behavioural problems as part of the routine transition process at school entry.

Rebuilding relationships: a pilot study of the effectiveness of the Mellow Parenting Programme for children with Reactive Attachment Disorder.

Mellow Parenting is an intensive parenting programme which has been shown to be effective in improving the psychosocial functioning of very vulnerable babies and preschool children. We used a complex interventions model to evaluate its use with school-age children with Reactive Attachment Disorder (RAD), a serious disorder of social functioning associated with maltreatment. The programme had a positive effect on mothers’ mental health, but had no measurable effects on symptoms of RAD or on parent—child interaction, although the variation between families after the group suggested that some had responded more than others. Mellow Parenting is an effective programme for vulnerable families with younger children and may be a useful adjunct in the treatment of school-age children with RAD, but it cannot be considered a definite treatment for RAD in this age group. The search continues for safe and effective treatments for RAD in school-age children.

Violence is Rare in Autism: When It Does Occur, Is It Sometimes Extreme?

ABSTRACT A small body of literature has suggested that, rather than being more likely to engage in offending or violent behavior, individuals with autism spectrum disorder (ASD) may actually have an increased risk of being the victim rather than the perpetrator of violence (Sobsey, Wells, Lucardie, & Mansell, 1995). There is no evidence that people with ASD are more violent than those without ASD (Im, 2016). There is nevertheless a small subgroup of individuals with ASD who exhibit violent offending behaviours and our previous work has suggested that other factors, such as adverse childhood experiences, might be important in this subgroup (Allely, Minnis, Thompson, Wilson, & Gillberg, 2014). Fitzgerald (2015) highlights that school shootings and mass killings are not uncommonly carried out by individuals with neurodevelopmental disorders, with frequent evidence of warning indicators. The aim of the present review is to investigate this in more detail using the 73 mass shooting events identified by Mother Jones (motherjones.com) in their database for potential ASD features. There are 73 mass shooting events but there are two events where there is a pair of shooters which meant that 75 mass shooter cases were investigated. This exercise tentatively suggests evidence of ASD in six of 75 included cases (8%) which is about eight times higher when compared to the prevalence of ASD found in the general population worldwide (motherjones.com). The 8% figure for individuals with ASD involved mass killings is a conservative estimate. In addition to the six cases which provide the 8% figure, there were 16 other cases with some indication of ASD. Crucially, ASD may influence, but does not cause, an individual to commit extreme violent acts such as a mass shooting episode.

Language Delay Is Not Predictable from Available Risk Factors

Aims. To investigate factors associated with language delay in a cohort of 30-month-old children and determine if identification of language delay requires active contact with families. Methods. Data were collected at a pilot universal 30-month health contact. Health visitors used a simple two-item language screen. Data were obtained for 315 children; language delay was found in 33. The predictive capacity of 13 variables which could realistically be known before the 30-month contact was analysed. Results. Seven variables were significantly associated with language delay in univariate analysis, but in logistic regression only five of these variables remained significant. Conclusion. The presence of one or more risk factors had a sensitivity of 89% and specificity of 45%, but a positive predictive value of only 15%. The presence of one or more of these risk factors thus can not reliably be used to identify language delayed children, nor is it possible to define an “at risk” population because male gender was the only significant demographic factor and it had an unacceptably low specificity (52.5%). It is not possible to predict which children will have language delay at 30 months. Identification of this important ESSENCE disorder requires direct clinical contact with all families.

Matching parenting support needs to service provision in a universal 13-month child health surveillance visit.

BACKGROUND The Glasgow Parenting Support Framework is an intervention to support families with preschool children. It provides structured support through universal and targeted interventions. Two routine family visits by health visitors have been piloted, one involving a home assessment when the child is 13 months old. AIMS To establish the need for parenting support in the population at 13 months and whether or not the home assessment improved the match of service provision to need. METHODS Health visitors were asked to collect data on existing problems and service provision to families, the mental state of the childs principal carer, an observation of the parent-child relationship and details of management plans. Data from the Child Health Surveillance System were also used. RESULTS Data were obtained for 549 families. Nine families were noted to have problems in the parent-child relationship. Carers in these families had poorer mental health. In all, 20% of families had a revisit scheduled: they were also more likely to have poor mental health. All families with possible problems in the relationship had a revisit scheduled. Depression scores measured during the pilot were a significant predictor of revisiting and referral, with an odds ratio of 1.37 for every one point increase in score on the Adult Wellbeing Scale depression subscale. CONCLUSIONS Current service provision matches need to some extent but routine visits focused on parenting difficulties at 13 months, particularly parental depression, may help to identify families needing support who would not otherwise have received it.

Mellow Parenting: systematic review and meta-analysis of an intervention to promote sensitive parenting.

To review and meta‐analyse Mellow Parenting interventions for parent–child dyads at high risk of adverse developmental outcomes.

Early parental physical punishment and emotional and behavioural outcomes in preschool children

OBJECTIVE To determine whether there is an association between being smacked by your main caregiver in the first two years and emotional and behavioural problems at age four. METHODS DESIGN Secondary analysis of data from the Growing Up in Scotland Prospective Study (GUS). SETTING Scotland, UK. PARTICIPANTS GUS birth cohort children, whose main caregiver had no concerns about their behaviour at 22 months. EXPOSURE Ever smacked by main caregiver in first 22 months, as measured by caregiver self-report at 22 months. MAIN OUTCOME Emotional and behavioural problems as measured by parental assessment and the Strengths and Difficulties Questionnaire (SDQ) at 46 months. RESULTS Preschool children exposed to main caregiver smacking in the first two years were twice as likely to have emotional and behavioural problems as measured by parental assessment [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.9-3.2; absolute risk reduction (ARR) 17.8%, 95% CI 12.1-23.5] and SDQ (OR 2.5, 95% CI 1.7-3.7; ARR 7.5%, 95% CI 3.7-11.5), as children never smacked by their main caregiver. The association remained significant after adjusting for child age and sex, caregiver age, sex, ethnicity, educational attainment and mental health status, sibling number, structural family transitions and socioeconomic status (adj. OR 2.4, 95% CI 1.8-3.2 for parental assessment and adj. OR 2.2, 95% CI 1.4-3.5 for SDQ). CONCLUSIONS Parental use of physical punishment in the first two years may be a modifiable risk factor for emotional and behavioural difficulties in preschool children.

Associations between social isolation, pro-social behaviour and emotional development in preschool aged children: a population based survey of kindergarten staff

BackgroundThe impact of peer relationships has been extensively reported during adolescence, when peer influence is generally considered to be at its greatest. Research on social isolation during childhood has found associations with school achievement, future relationships and adult mental health. Much of the evidence is derived from either parent or child-rated assessment of peer relationships, each of which have their limitations.MethodsWe report findings from Goodmans Strengths and Difficulties Questionnaire (SDQ), completed by staff in preschool establishments for over 10,000 children in their preschool year (aged 4–5), linked with routine demographic data. Correlations between scores and demographics were explored. Regression models examined the independent relationships between three social isolation variables, taken from the SDQ Peer Relationship Problems, Pro-social Behaviour and Emotional Symptoms subscales, controlling for demographics.ResultsThere were substantial overlaps between problem scores. Regression models found all social isolation variables to be significantly correlated with social and emotional functioning. Different types of social isolation appeared to relate to different psychological domains, with unpopularity having a stronger relationship with poor pro-social skills, whereas being solitary was more strongly linked to poorer emotional functioning.ConclusionsSocial isolation does have a significant association with reported child social and emotional difficulties, independent of demographic characteristics. The analysis highlights the complexity of measuring social isolation in young children. Different types of social isolation were found to have relationships with specific areas of social and emotional functioning.