mary Ros

Parent Training for Children With or at Risk for Developmental Delay: The Role of Parental Homework Completion.

This study investigated the extent to which parental homework completion during behavioral parent training (BPT) for children with or at risk for developmental delay contributed to parenting and child outcomes. Parents of 48 children (Mage=44.17 months, SD=14.29; 73% male; 72% White) with developmental delay (IQ<75) or at risk for developmental delay (due to premature birth) with co-occurring clinically elevated externalizing behavior problems received Parent-Child Interaction Therapy (PCIT) as part of two previously completed randomized controlled trials. Parental homework completion was measured using parental report of home practice of treatment skills collected weekly by therapists. Parents also reported on child externalizing behavior problems and levels of parenting stress, while parenting skills were observed during a 5-min child directed play and child compliance was observed during a 5-min cleanup situation. Results indicated that higher rates of parental homework completion predicted parenting outcomes (i.e., increased positive parenting skills and decreased levels of parenting stress) and child outcomes (i.e., lower levels of externalizing behavior problems). Additionally, although limited by temporal precedence, there was an indirect effect of reductions in parenting stress on the negative association between parental homework completion and child externalizing behavior problems. These findings highlight the importance of parents practicing skills learned during BPT for optimizing treatment outcome. Parenting stress was also identified as a potential mechanism by which high levels of parental homework completion contributed to reductions in child externalizing behavior problems.

Social Functioning in Children With or At Risk for Attention Deficit/Hyperactivity Disorder: A Meta-Analytic Review

Considerable work has demonstrated significant impairment in social functioning for children with attention deficit/hyperactivity disorder (ADHD). The social functioning profiles of children with ADHD are marked by impairments across diverse domains as they tend to experience greater rates of peer rejection, have lower levels of social skills, and have impaired social cognitions. The purpose of this study was to (a) quantitatively examine the association between ADHD and deficits across several domains of social functioning (peer functioning, social skills, social information processing), (b) examine differences in the magnitude of such associations, and (c) examine the effect of potential moderators. A meta-analysis of 109 studies (n = 104,813) revealed that children with ADHD have the most impairment within the peer functioning domain (weighted effect size [ES] r = .33) followed by significantly smaller effects within the social skills (weighted ES r = .27) and social information-processing domains (weighted ES r = .27). When examining potential moderators, results revealed that the association between ADHD and deficits within the social skills domain was weaker among studies that controlled for co-occurring conduct problems (CP). Studies that utilized sociometric and teacher reports of peer status reported the largest effects within the peer functioning domain. In addition, studies that utilized the “gold standard” approach to diagnosing ADHD documented the largest effects within both the social skills and peer functioning domains. Last, studies utilizing younger samples revealed the largest effects for deficits within the peer functioning domain. Theoretical and clinical implications are discussed.

Self-regulation assessment among preschoolers with externalizing behavior problems.

This study examined the construct validity and clinical utility of a brief self-regulation assessment (Head-Toes-Knees-Shoulders, HTKS) among a clinical sample of children with externalizing behavior problems (EBP). Participants for this study included 101 preschool children (72% male; Mage = 5.10 years; 79% Hispanic) with at-risk or clinically elevated levels of EBP. Self-regulation measures included the HTKS task, 4 standardized subtests from the Automated Working Memory Assessment (AWMA), parent and teacher reports of childrens executive functioning (EF), and childrens self-regulation performance across a series of executive functioning classroom games conducted as part of a summer treatment camp. Additional outcomes included school readiness as measured by standardized achievement tests, and parent and teacher reports of kindergarten readiness and behavioral impairment related to academic functioning. Performance on the HTKS task was moderately correlated with childrens performance on the standardized working memory tasks and observed self-regulation performance in the classroom. Low to moderate correlations were observed between performance on the HTKS task and parent report of childrens EF difficulties, as well as parent and teacher reports of childrens kindergarten readiness and behavioral impairment related to academic functioning. Moderate to high correlations were observed between performance on the HTKS task and standardized academic outcomes. These findings highlight the promise of the HTKS task as a brief, ecologically valid, and integrative EF task tapping into both behavioral and cognitive aspects of self-regulation that are important for children with EBPs success in school.

Executive Functioning and School Readiness Among Preschoolers With Externalizing Problems: The Moderating Role of the Student–Teacher Relationship

ABSTRACT Research Findings: The objective of this study was to examine the student–teacher relationship as a potential moderator of the link between executive functioning (EF) and children’s early school readiness among a clinical sample of preschoolers with externalizing behavior problems (EBP). Participants for the study included 139 preschool children (75.54% boys, M age = 5.01 years, 84.94% Hispanic/Latino) with at-risk or clinically elevated levels of EBP. The student–teacher relationship was assessed using the Student–Teacher Relationship Scale. School readiness data were composed of standardized achievement test scores and teacher reports of kindergarten readiness. EF was measured via parent and teacher reports along with standardized measures of EF, including the Head–Toes–Knees–Shoulders task and 4 standardized subtests from the Automated Working Memory Assessment. Poorer student–teacher relationship quality was predictive of lower teacher-reported kindergarten readiness and higher academic impairment. Main effects were qualified by an interaction between EF and student–teacher relationship quality such that worse EF (parent/teacher reports and standardized performance) was only associated with lower teacher-rated kindergarten readiness for children with poorer student–teacher relationship quality. Practice or Policy: EF appears to be an important predictor of school readiness for preschool children with EBP, particularly for children experiencing poorer student–teacher relationships.

Comparing working memory in bilingual and monolingual Hispanic/Latino preschoolers with disruptive behavior disorders

The current study examined differences in working memory (WM) between monolingual and bilingual Hispanic/Latino preschoolers with disruptive behavior disorders (DBDs). A total of 149 children (Mage = 5.10 years, SD = 0.53; 76% male) with elevated levels of DBDs, as indicated by their parents or teachers, were recruited to participate in an 8-week summer program prior to the start of kindergarten (Summer Treatment Program for Pre-Kindergarteners). Prior to the start of treatment, parents completed several measures about their childrens behavior and executive function, and children were administered two subtests of the Automated Working Memory Assessment to examine their current WM capabilities. After controlling for demographic variables (i.e., age, sex, socioeconomic status, IQ, and diagnostic status), no significant differences were observed between bilingual and monolingual children in verbal WM performance (β = .03, p > .05). However, children who were bilingual did perform better than monolinguals on spatial WM tasks (β = .23, p < .01). Finally, parent reports of WM corroborated these findings such that bilingual children were reported as having fewer WM problems by parents (β = -.19, p < .05) and teachers (β = -.22, p < .05). Whereas WM deficits are often found among children with DBDs, the current findings suggest that bilingualism may serve as a protective factor for preschoolers with DBDs.

Parent Perceptions of Medication Treatment for Preschool Children with ADHD

This study sought to examine parent perceptions of medication use for 151 preschool children (Mage = 5.05 years, 78% male, 82% Hispanic/Latino) with or at-risk for ADHD who were medication naive. Parents completed questionnaires regarding family background and perceptions of medication treatment. Parents and teachers completed ratings of child diagnostic symptomatology, behavioral functioning, and functional impairment. Results indicate that only 45% of parents were open to the possibility of medication. No associations were found between child demographics, severity of ADHD symptoms, or level of functional impairment and parental openness to medication. On the other hand, children of parents who were open to medication tended to have higher levels of oppositionality and aggression (as reported by parents but not teachers) compared with children of parents who were not open to medication. These findings are discussed in the context of early intervention given their implications for a variety of treatment providers.

Parental Homework Completion and Treatment Knowledge During Group Parent–Child Interaction Therapy

The purpose of this study was to examine how parental homework completion, session attendance, and treatment knowledge influenced parenting practices and confidence in using learned skills during behavioral parent training (BPT). Parents of 54 preschoolers (Mage = 5.07, 82% Hispanic/Latino) with externalizing behavior problems participated in an 8-week group BPT program. Pre-and posttreatment measures included parent-reported parenting practices and a treatment knowledge quiz. Parental homework completion, or home practice of skills, was reported by parents and collected weekly. Increases in positive parenting and decreases in negative parenting were observed (Cohen’s d = .63 and .70, respectively), as well as increases in treatment knowledge (d = 1.46). Treatment knowledge moderated the association between parental homework completion and negative parenting as well as parenting skill-use confidence. Increased parental homework completion was only associated with decreases in negative parenting and increases in skill-use confidence for families with high treatment knowledge. Parental homework completion also moderated the association between session attendance and negative parenting, such that lower session attendance was only associated with higher negative parenting for families that had low parental homework completion. Findings highlighted the potential impact that parents’ reports of home practice may have on improving parenting.