Parental perceptions of adverse educational outcomes among children diagnosed and treated for ADHD: A call for improved school/provider collaboration

An Erratum has been published for this article in Psychology in the Schools 42(2) 2005, 227 [ ]. This research utilized parent report to examine the prevalence of attention deficit hyperactivity disorder (ADHD), related treatment, and associated educational outcomes among elementary school children in southeastern Virginia. In a representative sample of elementary school children, 17% had been diagnosed with ADHD. The majority of diagnosed children had been medicated for ADHD (84%). More than one third of students taking medication had received no other interventions for ADHD. Over half of the diagnosed students received behavioral therapy and almost half received a combination of medical and behavioral interventions. Children diagnosed with ADHD were 3 to 7 times ( p values < 0.001) more likely than other children to receive special education, be expelled or suspended, and repeat a grade. Based on parental opinion, children diagnosed with ADHD are at high risk for school failure. Results are discussed in terms of distinctions between clinical efficacy/effectiveness and schoolwide and public health interventions implemented in the study region. © 2002 John Wiley & Sons, Inc.     

Preterm Children at Early Adolescence and Continuity and Discontinuity in Maternal Responsiveness from Infancy

Patterns in mother-child interaction from infancy to age 12 were investigated in a prospective, longitudinal study of 44 English-speaking mothers and their preterm children. Maternal responsiveness was assessed by home observations during infancy and the Family Interaction Q-Sort at age 12, derived from 2 structured laboratory situations requiring cooperation of mother and child. A cluster of maternal behaviors of critical control toward the toddler was assessed at age 2 years. Children of mothers who were consistently more responsive during both infancy and early adolescence, as well as children whose mothers became more responsive by age 12, achieved higher IQ and arithmetic scores, had more positive self-esteem, and their teachers reported fewer behavioral and emotional problems than children of mothers who were consistently less responsive both during infancy and at age 12. Continuity in parenting behaviors was related to control and criticism beginning in the toddler period and not to degree of responsiveness to the infant.     

Child perpetrators--children who molest other children: preliminary findings

While the seriousness of sexual abuse by adolescents is finally beginning to receive adequate attention from the professional community, the existence of child perpetrators is largely dismissed and denied. Forty-seven boys between the ages of 4 and 13 are described who have molested children younger than themselves. Coercion was involved in all of the cases included in this study. These children had been treated in a program especially designed for child perpetrators at Children's Institute International in Los Angeles. Prior to their own sexually abusive behaviors, 49% of these boys had been sexually abused and 19% physically abused. The children all knew the people who victimized them. These male child perpetrators all knew the children they molested. In 47% of the cases the sexual abuse was of a sibling. The average number of victims of these children was 2.1 with a range of 1 to 7. The mean age at the time of perpetration was 8 years, 9 months. The mean age of the victims of these children was 6 years, 9 months. There was a history of sexual and physical abuse in the majority of the families of these children, as well as a history of substance abuse. This population is compared to adolescent perpetrators.     

The behavioral and emotional problems of former unaccompanied refugee children 3-4 years after their return to Vietnam

OBJECTIVE: The objective of this study was to examine the behavioral and emotional problems of former unaccompanied refugee children who had repatriated to Vietnam from refugee centers in Hong Kong and South East Asia. The children were compared with a matched sample of children who had never left Vietnam. METHOD: The participants consisted of 455 Vietnamese children aged between 10 and 22 years; 238 of the children had formerly resided in refugee camps without their parents. Data were collected using the Achenbach Youth Self-Report, the Cowen Perceived Self-Efficacy scale, a Social Support scale as well as an Exposure to Trauma scale. RESULTS: No significant difference was found between the two groups of children on the YSR Total Score. The former refugee children had significantly lower Externalizing scores and failed marginally to report significantly higher Internalizing scores than the local children. The study showed that the perceived self-efficacy, number of social supports and experience of social support did not differ between the two groups of children. Further analysis showed that a significant interaction between the immigration status of the children and the children's subjective perception of their current standard of living explained the differences in the YSR. CONCLUSION: The results suggest that the experience of living without parents in a refugee camp does not lead to increased behavioral and emotional problems in the immediate years after repatriation.     

Early Histories of School‐Aged Children With Attention‐Deficit/ Hyperactivity Disorder

In a prospective study of developmental outcomes in relation to early‐life otitis media, behavioral, cognitive, and language measures were administered to a large, diverse sample of children at 2, 3, 4, 6, and 9–11 years of age (N = 741). At 9–11 years of age, 9% of the children were categorized as having attention‐deficit/hyperactivity disorder (ADHD) based on parent report. Compared to the non‐ADHD group, the ADHD group had higher (i.e., less favorable) scores on parent and teacher versions of the Child Behavior Checklist at all ages. Children in the ADHD group also had lower scores on cognitive and receptive language measures in preschool. The findings support the concept that ADHD is a cognitive as well as a behavioral disorder.     

Prosocial and Aggressive Behavior: A Longitudinal Study

Developmental theorists have made strong claims about the fundamental prosocial or aggressive nature of the human infant. However, only rarely have prosocial behavior and aggression been studied together in the same sample. We charted the parallel development of both behaviors from infancy to childhood in a British community sample, using a two-construct, multimethod longitudinal design. Data were drawn from the Cardiff Child Development Study (CCDS), a prospective longitudinal study of a volunteer sample of parents and their firstborn children. A sample of 332 mothers was recruited from National Health Service (NHS) prenatal clinics and general practice clinics in Wales, UK, between Fall of 2005 and Summer of 2007. Potential participants represented the full range of sociodemographic classifications of neighborhoods. Participating families were divided about equally between middle- and working-class families, were somewhat more likely to have sons than daughters, and the majority (90%) were in a stable partnership. In response to standard categories recommended for use in Wales at the time, the majority (93%) of mothers reported themselves as Welsh, Scottish, English, or Irish; most others named a European or South Asian nationality. Of the 332 families agreeing to participate, 321 mothers (M_age = 28 years) and 285 partners (M_age = 31 years) were interviewed during the pregnancy and 321 of the families contributed data at least once after the child's birth. After an initial home visit at 6 months, data collection occurred in four additional waves of testing when children's mean ages were approximately 1, 1.5, 2.5, and 7 years. Data collection alternated between family homes and Cardiff University. Of those families seen after the child's birth, 89% were assessed at the final wave of testing. Data collection ended in 2015. Methods included direct observation, experimental tasks, and collection of reports from mothers, fathers, other relatives or family friends, and classroom teachers. Interactions with a familiar peer were observed at 1.5 years. Interactions with unfamiliar peers took place during experimental birthday parties at 1 and 2.5 years. At 7 years, parents were interviewed, parents and teachers completed questionnaires, and the children engaged in cognitive and social decision-making tasks. Based on reports from parents and other informants who knew the children well, individual differences in both prosocial behavior and aggression were evident in children. Both types of behavior showed stability across the second and third years. The association between prosocial behavior and aggression changed over time: at 1.5 years, they were not significantly related (the association approached zero), but they became negatively correlated by 3 years. Different patterns were seen when children played with familiar versus unfamiliar peers. At 1.5 years, when children were observed at home with a familiar peer, prosocial behavior and aggression were unrelated, thus showing a pattern of results like that seen in the analysis of informants' reports. However, a different pattern emerged during the experimental birthday parties with unfamiliar peers: prosocial behavior and aggression were positively correlated at both 1 and 2.5 years, contributing to a general sociability factor at both ages. Gender differences in prosocial behavior were evident in informants' reports and were also evident at the 1-year (though not the 2.5-year) birthday parties. In contrast, gender differences in both prosocial behavior and aggression were evident by 7 years, both in children's aggressive decision-making and in their parents' and teachers' reports of children's aggressive behavior at home and school. By age 7, children's aggressive decision-making and behavior were inversely associated with their verbal skills, working memory, and emotional understanding. Some children had developed aggressive behavioral problems and callous-unemotional traits. A few (12%) met diagnostic criteria for conduct disorder or oppositional-defiant disorders, which had been predicted by early angry aggressiveness and lack of empathy for other people. Taken together, the findings revealed a gradual disaggregation of two ways in which children interact with other people. Individual differences in both prosocial behavior and aggression revealed continuity over time, with gender differences emerging first in prosocial behavior, then in aggression. Restrictions in the participant sample and the catchment area (e.g., all were first-time parents; all were drawn from a single region in the United Kingdom) mean that it is not possible to generalize findings broadly. It will be important to expand the study of prosocial behavior and aggression in other family and environmental contexts in future work. Learning more about early appearing individual differences in children's approaches to the social world may be useful for both educational and clinical practice.     

Post traumatic stress disorder reactions in children of war: a longitudinal study

OBJECTIVE: To establish rates of posttraumatic stress disorder (PTSD) reactions and general mental health problems in children who had experienced war trauma. METHOD: A longitudinal study in the Gaza strip with 234 children aged 7 to 12 years, who had experienced war conflict, at 1 year after the initial assessment, that is, during the peace process. Children completed the Child Post Traumatic Stress Reaction Index (CPTS-RI), while the Rutter A2 and B2 Scales were completed by parents and teachers. RESULTS: The rate of children who reported moderate to severe PTSD reactions at follow-up had decreased from 40.6% (N = 102) to 10.0% (N = 74). 49 children (20.9%) were rated above the cut-off for mental health problems on the Rutter A2 (parent) Scales, and 74 children (31.8%) were above the cut-off on the Rutter B2 (teacher) Scales. The total scores on all three measures had significantly decreased during the 1-year period. The total CPTS-RI score at follow-up was best predicted by the number of traumatic experiences recalled at the first assessment. CONCLUSIONS: PTSD reactions tend to decrease in the absence of further stressors, although a substantial proportion of children still present with a range of emotional and behavioral problems. Cumulative previous experience of war trauma constitutes a risk factor for continuing PTSD symptoms.     

The nature and correlates of underachievement among elementary schoolchildren in Hong Kong

This study investigated for the first time several characteristics of underachievement in a large sample of Hong Kong elementary schoolchildren. More males were identified as underachievers than females, but the ratio was substantially less than the two-to-one rate typically found in the American literature. The stability and persistence of underachievement increased during the elementary school years, and the stability of underachievement tended to be higher in subject matter that was relatively more difficult, which varied with gender. Underachievement became more specific to particular academic subjects rather than more general across the elementary grades. Parents and teachers, but not the children themselves, perceived that underachievers were more capable than same-grade nonunderachievers (who score lower on ability tests), although this awareness is more likely directed at male than female underachievers, which has been observed in other samples. In grades 1-4, teachers provided extra mentoring, communications, and support to underachievers. Thereafter, underachievers became more disruptive, impatient, and aggressive in school and perhaps at home. At that point, teachers became less supportive, offered less extra mentoring, and applied greater behavioral control over underachievers. Underachieving children also perceived that their parents became less supportive and used more discipline in grades 5-6 relative to grades 3-4. These correlates of underachievement suggests the existence of a syndrome of underachievement that separates underachievers from children who have the same grades but lower mental ability.     

Children’s Responses to Interparental Conflict: A Meta‐Analysis of Their Associations With Child Adjustment

A meta‐analysis examined the relations between children’s adjustment and children’s cognitive, affective, behavioral, and physiological responses to interparental conflict. Studies included children between 5 and 19 years of age. Moderate effect sizes were found for the associations between cognitions and internalizing and externalizing behavior problems and self‐esteem problems, negative affect and behavioral responses and internalizing behavior problems, and behavioral responses and self‐esteem problems. Small to moderate effect sizes were found for the associations between cognitions and relational problems, negative affect and behavioral responses and externalizing behavior problems, and physiological reactions and internalizing and externalizing behavior problems. Effect sizes were, with 1 exception, larger for internalizing than for externalizing behavior problems. Age significantly moderated the majority of effect sizes.     

Behavioral profiles of children with epilepsy: Parent and teacher reports of emotional,behavioral, and educational concerns on the BASC‐2

The Behavior Assessment Scale for Children – Second Edition (BASC‐2) was administered to 108 parents and 37 teachers of children with epilepsy (mean age of 10.6 years; 51% female, 49% male). Results demonstrated high mean scores on the Atypicality, Attention Problems, Withdrawal, and Adaptive Skills scales and a high percentage of At‐Risk or Clinically Significant scores on the majority of scales. Ratings were correlated with level of functioning, age of onset, and number of antiepileptic medications. In addition, children with poor seizure control had higher ratings on the Depression, Somatization, and Withdrawal scales, and children with temporal lobe seizures had higher scores on the Depression scale. These results confirm a high rate of behavioral concerns in children with epilepsy. © 2008 Wiley Periodicals, Inc.     

Four-year follow-up study of language impaired children

Children identified as normal or as specifically language impaired (SLI) were given speech, language, and intelligence testing on a longitudinal basis. Fourteen normal and 29 SLI children between the ages of 4 1/2 and 8 years were tested at Time 1. They were retested three to four years later when they were 8 to 12 years old. The results indicated that both the normal and the SLI children continued to develop skills in receptive and expressive language and speech articulation across the 3- to 4-year period intervening between evaluations. Overall, however, the SLI children appeared to develop language skills at a slower than normal rate and 80% of them remained language impaired at Time 2. In addition, the majority of the SLI children manifested reading impairment at Time 2, while none of the normal children did so. The implications for the educational management of SLI children are discussed. Research supported by the March of Dimes, Grant #12-84. Presented at the 32nd Annual Conference of The Orton Dyslexia Society, Baltimore, Maryland, November 1982.     

Charting the Relationship Trajectories of Aggressive, Withdrawn, and Aggressive/Withdrawn Children during Early Grade School

The premises examined in this longitudinal investigation were that specific behavioral characteristics place children at risk for relationship maladjustment in school environments, and that multiple behavioral risks predispose children to the most severe and prolonged difficulties. Aggressive, withdrawn, and aggressive/withdrawn children were compared to normative and matched control groups on teacher and peer relationship attributes, loneliness, and social satisfaction from kindergarten (M age = 5 years, 7 months; n = 250) through grade 2 (M age = 8.1; n = 242). Children's withdrawn behavior was neither highly stable nor predictive of relational difficulties, as their trajectories resembled the norm except for initially less close and more dependent relationships with teachers. Aggressive behavior was fairly stable, and associated with early-emerging, sustained difficulties including low peer acceptance and conflictual teacher-child relationships. Aggressive/withdrawn children evidenced the most difficulty: compared to children in the normative group, they were consistently more lonely, dissatisfied, friendless, disliked, victimized, and likely to have maladaptive teacher-child relationships. Findings are discussed with respect to recent developments in two prominent literatures: children at-risk and early relationship development.     

Early childhood maltreatment and trajectories of behavioral problems: Exploring gender and racial differences

The current study aimed to examine the trajectory of child behavior problems over time as a function of early maltreatment. We anticipated that early alleged maltreatment would have a substantial impact on both internalizing and externalizing behaviors. The impact of gender and racial differences in the trajectories were also examined. Using the LONGSCAN archived data, a total of 484 children were selected for the study from varying sites. Two groups were formed: children with early allegations of maltreatment from birth to age 4 and children without any report. Children included did not have further allegations of maltreatment from ages 4 to 12. Additionally, they must have completed a behavioral assessment using the Child Behavior Checklist at the age 4 baseline interview. Multilevel modeling using the SAS PROC MIXED procedure was used to examine the effects of early allegations of maltreatment on the trajectories of both internalizing and externalizing problems. Although race was not significant, gender was found to differ in trajectory of behavioral problems among children with early allegations of maltreatment. For boys, the impact of early maltreatment was strongest at the most proximal assessment of behavioral outcomes and then decreased gradually over the course of subsequent periods. For girls, although no significant impact was observed at each measurement point, the impact of early maltreatment increased and became pronounced over time. Findings support the importance of early intervention/prevention to decrease the likelihood of presenting behavioral problems in later childhood years with consideration to gender.     

Limitations on reliability: regularity rules in the English plural and past tense

Two studies investigated 3- to 5-year-olds' trust in a reliable informant when judging novel labels and novel plural and past tense forms. In Study 1, children ( N = 24) endorsed the names of new objects given by an informant who had earlier labeled familiar objects correctly over the names given by an informant who had labeled the same objects incorrectly. In Study 2, children ( N = 24) endorsed novel names given by an informant who had earlier expressed the plural of familiar nouns correctly over one who had expressed the plural incorrectly. But children overwhelmingly endorsed the regular plural and past tense forms of new words provided by the formerly unreliable labeler (Study 1) or morphologist (Study 2) rather than irregular forms of those words provided by the formerly reliable informant.     

Very Early Language Deficits in Dyslexic Children

At 2 1/2 years of age, children who later developed reading disabilities were deficient in the length, syntactic complexity, and pronunciation accuracy of their spoken language, but not in lexical or speech discrimination skills. As 3-year-olds, these children began to show deficits in receptive vocabulary and object-naming abilities, and as 5-year-olds they exhibited weaknesses in object-naming, phonemic awareness, and letter-sound knowledge that have characterized kindergartners who became poor readers in other studies. These late preschool differences were related to subsequent reading status as well as to prior language skills, but early syntactic proficiency nevertheless accounted for some unique variance in grade 2 achievement when differences at age 5 were statistically controlled. The language deficits of dyslexic children were unrelated to maternal reading ability and were not observed in children from dyslexic families who became normal readers. The implications of the results for etiological issues are discussed.     

Evening activities as a potential confound in research on the adrenocortical system in children

The relation among children's evening activities, behavioral characteristics, and activity of the hypothalamic-pituitary-adrenocortical axis was assessed in normally developing children ages 7 to 10 years. Salivary cortisol at bedtime was compared on evenings when children had structured activities outside of the home with unstructured evenings at home in relation to parental reports of children's behavioral characteristics. Participating in evening activities, particularly sport activities, was associated with small increases in bedtime cortisol levels in boys but not in girls. Differences in cortisol on activity versus no-activity nights were negatively related to children's social isolation. These results show that in studies with children, nights on which participants engage in sport activities should be avoided when collecting ambulatory measures of salivary cortisol concentrations.     

Child-Directed Speech Is Infrequent in a Forager-Farmer Population: A Time Allocation Study

This article provides an estimation of how frequently, and from whom, children aged 0–11 years (Ns between 9 and 24) receive one-on-one verbal input among Tsimane forager-horticulturalists of lowland Bolivia. Analyses of systematic daytime behavioral observations reveal < 1 min per daylight hour is spent talking to children younger than 4 years of age, which is 4 times less than estimates for others present at the same time and place. Adults provide a majority of the input at 0–3 years of age but not afterward. When integrated with previous work, these results reveal large cross-cultural variation in the linguistic experiences provided to young children. Consideration of more diverse human populations is necessary to build generalizable theories of language acquisition.     

Mental health problems of deaf Dutch children as indicated by parents' responses to the child behavior checklist

Emotional/behavioral problems of 238 deaf Dutch children ages 4-18 years were studied. Parental reports indicated that 41% had emotional/behavioral problems, a rate nearly 2.6 times higher than the 16% reported by parents of a Dutch normative sample. Mental health problems seemed most prevalent in families with poor parent-child communication. Deaf children ages 12-18 showed more problems with anxiety and depression and more social problems than those ages 4-11. Deaf children with relatively low intelligence showed more social problems, thought problems, and attention problems than those with relatively high intelligence. The authors stress the need to get information on deaf children's mental health functioning not just from parents but from other informants such as teachers and the children themselves. An expansion assessment of deaf children, and of special services and treatments for deaf children and adolescents with emotional/behavioral problems, is recommended.     

A longitudinal study of the effects of chronic maltreatment on children's behavioral and emotional problems

OBJECTIVE: The aim of the present longitudinal study was to examine the links between chronicity of maltreatment and child behavioral and emotional problems. METHOD: Forty-nine maltreated children (32 victims of continuous, or chronic, maltreatment; 17 victims of transitory maltreatment) and their mothers were evaluated in their homes three times over a period of 6 years: at the time of recruitment (T1), 3 years following the initial evaluation (T2) and 6 years following the initial evaluation (T3). The home visits were designed to obtain longitudinal assessments of different types of behavioral and emotional problems in the children, and of the mothers' self-reported potential for abuse to help determine the chronic/transitory aspect of the maltreatment situation. Child Protection Services (CPS) files were also consulted at each assessment time in order to obtain more accurate information regarding the chronic/transitory aspect of the maltreatment situation. RESULTS: The results show that over time the victims of chronic maltreatment (Chronic group; CH) had significantly more emotional problems (i.e., Anxiety/Depression) than those victims of transitory maltreatment (Transitory group; TR). There was also a tendency for CH children to exhibit more aggressive behavior and social withdrawal problems than the children in the TR group. Furthermore, at T3, the proportion of children in the CH group showing a clinical level of behavior problems in general was significantly higher than in the TR group. CONCLUSIONS: The study confirms that there are differences among maltreated children in levels of behavior and emotional problems and shows that chronicity must be taken into consideration in order to identify more clearly the impact of maltreatment on the child. Chronically maltreated children appear to be at high-risk for developing clinical levels of problems. The results also suggest that intervention efforts resulting in an improvement of the family situation (i.e., reduction or elimination of maltreatment), also lead to an improvement in the behavior of children.     

Behavioral Inhibition in Early Childhood and Adjustment in Late Adolescence in China

This study examined relations between behavioral inhibition in toddlerhood and social, school, and psychological adjustment in late adolescence in China. Data on behavioral inhibition were collected from a sample of 2-year-olds (initial N = 247). Follow-up data were collected at 7 years for peer relationships and 19 years for adjustment across domains. The results showed that early inhibition positively predicted later social competence and school adjustment. Peer relationships in middle childhood served as a protective factor in the development of depression of inhibited children. The results indicate the distinct functional meaning of behavioral inhibition in the Chinese context from a developmental perspective.