Terri L. Shelton

Parenting stress among families of children with Attention Deficit Hyperactivity Disorder

Prior research has shown that parenting stress levels can be quite high among families of children with attention deficit hyperactivity disorder (ADHD). This study investigated the degree to which such stress was related not only to the childs ADHD, but also to various other child, parent, and family-environment circumstances. Multimethod assessments were conducted on 104 clinic-referred children with ADHD. Data collected from these subjects were entered into hierarchical multiple-regression analyses, utilizing the Parenting Stress Index as the criterion. The results showed that child and parent characteristics accounted for a substantial portion of the variance in overall parenting stress. The childs oppositional-defiant behavior and maternal psychopathology were especially potent predictors. The severity of the childs ADHD, the childs health status, and maternal health status also emerged as significant predictors. These findings are discussed in terms of their impact upon the clinical management of children with ADHD.

Parent training for Attention Deficit Hyperactivity Disorder: Its impact on parent functioning

This study examined changes in parent functioning resulting from parental participation in a behavioral parent training (PT) program specifically designed for school-aged children with attention-deficit hyperactivity disorder (ADHD). Relative to wait list controls, subjects who completed the nine-session PT program showed significant posttreatment gains in both child and parent functioning, which were maintained 2 months after treatment. In particular, there were PT-induced reductions in parenting stress and increases in parenting self-esteem, which accompanied parent-reported improvements in the overall severity of their childs ADHD symptoms. In addition to their statistical importance, these findings are discussed in terms of their clinical significance, utilizing methods developed by Jacobson and Truax (1991).

Regulatory Contributors to Children’s Kindergarten Achievement.

The present study sought to examine whether preschool childrens emotion regulation, problem behaviors, and kindergarten behavioral self-regulation in the classroom were predictors of kindergarten achievement scores. The children (N = 122, 47% male and 63% European American) who were participating in an ongoing longitudinal study, were seen at both a preschool and kindergarten assessment. The present study examined the relation between parent report, teacher report, and laboratory measures of regulation and childrens achievement test scores. Childrens emotion regulation and behavioral self-regulation in the classroom were related to all measures of achievement. The relation between preschool emotion regulation and kindergarten achievement was mediated by behavioral self-regulation in the kindergarten classroom. In addition, all measures of regulation were correlated, suggesting that some children who have difficulty regulating their behavior in one setting (such as home) may also have difficulty with regulation in other settings (such as school).

Predicting Stability and Change in Toddler Behavior Problems: Contributions of Maternal Behavior and Child Gender

This study examined the stability and continuity of early-identified behavior problems and the factors associated with this stability. Children and their mothers (N=125) were seen when the children were 2 and 4 years of age. Maternal reports of child externalizing behavior and laboratory observations of child noncompliance were stable from age 2 to age 4. Early externalizing behaviors decreased over time; however, child noncompliance in the laboratory did not. Although few associations were found between maternal positive behavior and child behavior problems, maternal controlling behavior was related to increases in child behavior problems, particularly at high levels of both prior noncompliance and prior maternal control. Child noncompliance was predictive of increases in maternal controlling behavior over time.

Psychiatric and psychological morbidity as a function of adaptive disability in preschool children with aggressive and hyperactive-impulsive-inattentive behavior

Children with high levels of aggressive-hyperactive-impulsive-inattentive behavior (AHII; n = 154) were subdivided into those with (n = 38) and without (n = 116) adaptive disability (+AD/−AD) defined as a discrepancy between expected versus actual adaptive functioning. They were compared to each other and a control group of 47 normal children. Both AHII groups were more likely to have attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder than control children; more symptoms of general psychopathology; greater social skills deficits; more parental problems; and lower levels of academic achievement skills. Compared to AHII − AD children, AHII + AD children had (1) more conduct disorder; (2) greater inattention and aggression symptoms; (3) more social problems, less academic competence, and poorer self-control at school; (4) more severe and pervasive behavior problems across multiple home and school settings; and (5) parents with poorer child management practices. Thus, adaptive disability has utility as a marker for more severe and pervasive impairments in AHII children.

Parent Involvement and Student Academic Performance: A Multiple Mediational Analysis

Parent involvement in a childs education is consistently found to be positively associated with a childs academic performance. However, there has been little investigation of the mechanisms that explain this association. The present study examines two potential mechanisms of this association: the childs perception of cognitive competence and the quality of the student–teacher relationship. This study used a sample of 158 seven-year-old participants, their mothers, and their teachers. Results indicated a statistically significant association between parent involvement and a childs academic performance, over and above the impact of the childs intelligence. A multiple mediation model indicated that the childs perception of cognitive competence fully mediated the relation between parent involvement and the childs performance on a standardized achievement test. The quality of the student–teacher relationship fully mediated the relation between parent involvement and teacher ratings of the childs classroom academic performance. Limitations, future research directions, and implications for public policy initiatives are discussed.

Multimethod psychoeducational intervention for preschool children with disruptive behavior : Two-year post-treatment follow-up

This paper describes the 2-year post-treatment follow-up of preschool children identified as having high levels of disruptive behavior at kindergarten entry. They were assigned to four treatment conditions: A no-treatment group, parent-training only, treatment classroom only, and the combination of parent training with the treatment classroom. Interventions lasted the entire kindergarten academic year. Initial post-treatment results reported previously indicated no effects for the parent-training program but some efficacy for the classroom intervention program. For this report, the disruptive behavior (DB) children were subdivided into those who did (n = 74) and did not (n = 77) receive the treatment classroom. Two-year post-treatment follow-up results indicated no differences between the classroom treated and untreated DB groups. These groups also failed to differ in the percentage of children using available treatments across the follow-up period. The DB children in both groups had significantly more symptoms of ADHD and ODD than a community control group (N = 47) at follow-up. They also received higher ratings of externalizing problems on the parent Child Behavior Checklist, more severe ratings of behavior problems at home, and ratings of more pervasive behavior problems at school, and had poorer academic skills. Results suggested that early intervention classrooms for DB children may not produce enduring effects once treatment is withdrawn, and that better approaches are needed for identifying those DB children at greatest risk for later maladjustment.

Using Mental Health Consultation to Decrease Disruptive Behaviors in Preschoolers: Adapting an Empirically-Supported Intervention

BACKGROUND This study examined the effectiveness of an adaptation of an empirically-supported intervention delivered using mental health consultation to preschoolers who displayed elevated disruptive behaviors. METHOD Ninety-six preschoolers, their teachers, and their primary caregivers participated. Children in the intervention group received individualized mental health consultation focused on providing teachers with behaviorally-based, empirically-supported strategies for decreasing disruptive behaviors within the classroom. Caregivers were invited to participate in parent training (35% attendance). Effectiveness was assessed in contrast to an assessment/attention comparison group where typical treatment was available. RESULTS This treatment approach was more effective than the comparison condition in decreasing child disruptive behavior, increasing the use of appropriate teacher strategies, and increasing the use of appropriate parenting practices. CONCLUSION Adapting empirically-supported treatments for use in mental health consultation may be a way to bridge the gap between research and clinical practice and increase effectiveness of mental health consultation in treating disruptive disorders in young children.

Preschool children with disruptive behavior: Three-year outcome as a function of adaptive disability

A significant discrepancy between intelligence and daily adaptive functioning, or adaptive disability (AD), has been previously found to be a associated with significant psychological morbidity in preschool children with disruptive behavior (DB). The utility of AD as a predictor of later developmental risks was examined in a 3-year longitudinal study of normal (N = 43) and DB preschool children. The DB children were grouped into those with AD (DB+AD; N = 28) and those without AD (DB-only; N = 98). All children were followed with annual evaluations to the end of second grade. Both DB groups demonstrated substantial and pervasive psychological and educational morbidity at 3-year follow-up. In comparison to DB-only children, DB+AD children had more symptoms of attention-deficit hyperactivity disorder (ADHD) and conduct disorder (CD), more severe and pervasive behavior problems at home, more parent-rated externalizing and internalizing, and lower academic competence and more behavioral problems at school. Parents of DB+AD children also reported greater parenting stress than did parents in the other groups. A significant contribution of AD to adverse outcomes in the DB group remained on some measures even after controlling for initial severity of DB. AD also contributed significantly to CD symptoms at follow-up after controlling for initial DB severity and initial CD symptoms. The results corroborate and extend earlier findings of the utility of AD as a risk indicator above severity of DB alone. They also imply that AD in the context of normal intellectual development may arise from both the deficient self-regulation associated with ADHD and from disrupted parenting. with exposure to kindergarten moderating these adverse effects.

An Attribution Training Program with Learning Disabled Children

Based on the success of attribution training programs in alleviating learned helplessness and upon current research suggesting that some learning disabled children may be experiencing learned helplessness, it was the purpose of the present investigation to determine whether altering causal attributions for failure would enable helpless learning disabled children to deal more effectively with failure in an experimental reading situation. Sixteen “helpless” learning disabled students were assigned to an attribution training group or to an assessment control group. The results revealed that following training, the subjects in the attribution training group demonstrated greater reading persistence, showed significant increases in effort attributions for failure as well as more internal attributions for achievement situations when compared to subjects in the control group. Treatment gains for effort attributions and for reading persistence were maintained at follow—up. Implications for remedial programs are discussed.