A Special Need for Others

__Abstract__ Children with psychiatric disorders are at risk for experiencing poor psychosocial, emotional, and behavioral adjustment after leaving school (Heijmens Visser, Van der Ende, Koot, & Verhulst, 2003; Wielemaker, 2009). These children thus need a good educational environment in order to optimally develop despite their impairments. Yet, some of these children have such complex special educational needs that they are placed in settings for special education. Especially these children could benefit from education that also targets their social, emotional, and behavioral skills in an educational environment that is adapted to their needs. Research has consistently shown that children’s social, emotional, and behavioral classroom adjustment is affected by the dynamic and reciprocal interplay between the child and his or her teacher and between the child and his or her peers (Pianta, Hamre, & Stuhlman, 2003; Gifford-Smith & Brownell, 2003). However, most of this research has been conducted in general education and not much is known about the social dynamics in special education. However, such information can contribute to improving the special educational environment. This thesis therefore focuses on the social classroom dynamics (i.e., the interplay between children, their teachers, and their peers) that are part of the environment shaping the classroom adjustment of children with psychiatric disorders in special education. In addition, to help improve the educational quality in special education settings, we implemented and examined the effects of an intervention, The Good Behavior Game, on children’s classroom adjustment, social classroom relationships, and teachers’ sense of competence and wellbeing. To give the reader a general introduction on the important topics of this thesis, this introduction starts with a discussion of special education from an international and national perspective. Next, the importance of positive teacher-child and peer relationships for children’s classroom adjustment is discussed. Subsequently, a short introduction to the Good Behavior Game is given, followed by an overview of the design of the study. Finally, the research questions of this thesis are introduced together with an outline of the different chapters

Neonatal predictors of cognitive ability in adults born very preterm : a prospective cohort study

Aim: To identify neonatal predictors to allow a developmental prognosis of the cognitive abilities of survivors born very preterm/very low birthweight (VLBW) into adult life. Method: The Bavarian Longitudinal Study is a prospective whole-population study that followed 260 infants born very preterm/VLBW from birth to adulthood. Regression analyses examined which neonatal factors predicted adult IQ. Results: Neonatal morbidity, neonatal treatment, and early social environment of infants born very preterm/VLBW explained 37.6% of the variance in adult IQ. Seven unique early-life predictors of lower adulthood IQ were found: respiratory distress syndrome, intraventricular haemorrhage, problems with mobility, mechanical ventilation, less parenteral nutrition, low/middle socioeconomic status, and poor early parent–infant relationships. Specifically, modifiable factors such as mechanical ventilation predicted a drop of 0.43 IQ points for each day of treatment, adjusted for initial respiratory problems. Good early parent–infant relationships predicted an approximately 5-point increase in adult IQ, adjusted for other significant predictors such as socioeconomic status. Interpretation: Mechanical ventilation, parenteral feeding, and early parenting were identified as significant modifiable factors that were strongly related to adult IQ. Mechanical ventilation policies have changed but there is scope for early interventions that focus on positive parenting, which may reduce the adverse effects of very preterm/VLBW birth on cognitive abilities

Attention problems in very preterm children from childhood to adulthood : the Bavarian longitudinal study

Background: Very preterm (VP; gestational age <32 weeks) and very low birth weight (VLBW; <1500 grams) is related to attention problems in childhood and adulthood. The stability of these problems into adulthood is not known. Methods: The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood. Data on attention were collected at 6, 8, and 26 years of age, using parent reports, expert behavior observations, and clinical ADHD diagnoses. Results: At each assessment, VP/VLBW individuals had significantly more attention problems, shorter attention span, and were more frequently diagnosed with ADHD than term-born comparisons. In both VP/VLBW and term-born individuals, overall, attention span increased and attention problems decreased from childhood to adulthood. Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals. Similarly, ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW, but not in term-born individuals. However, when those with severe disabilities were excluded, differences between VP/VLBW and term-born individuals reduced. Conclusions: Despite improvement in attention regulation from childhood to adulthood, children born very preterm remained at increased risk for attention problems in adulthood. In contrast, term-born children with clinical attention problems outgrew these by adulthood. As inattentive behavior of VP/VLBW children may be overlooked by teachers, it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children

Parent-Child Relationship, Well-Being and Home-Leaving during the Transition from High School to University

This prospective study examined changes in parent–child relationship quality and well-being during the transition to university. We also investigated whether living situation (i.e., moving out of the parental home) and motivation to leave home were related to these changes. The participants were 240 Turkish university students (65.4% female; Mage = 17.74 (0.53) at Time 1) participating in two measurement waves from 2017 to 2019. Results of Latent Change Score Models revealed that both autonomy support of fathers and perceived stress decreased over time, while other parent–child relationship qualities and life satisfaction remain relatively stable on average. First-year university students who left home showed less decline in stress than those still living at home. We did not find living situation and motivation to leave home to moderate changes in parent–child relationship quality and well-being. Furthermore, we found bidirectional associations mainly between parent–child relationship quality and life satisfaction and between conflict with mother and stress. These findings underline the importance of considering the changes in parent–child relationship quality and well-being in the transition to university in a family-oriented culture

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of different knee prostheses : the Knee Arthroplasty Trial (KAT)

Peer reviewedPublisher PD

Infant regulatory problems, parenting quality and childhood attention problems

Background and aims To determine the combined impact of infant multiple/persistent regulatory problems (RPs), parenting quality and maternal mental health on childhood attention problems. Study design A prospective, population-based cohort study including 16 paediatric hospitals in Southern Bavaria (Germany). Subjects 1459 infants were followed from birth to 8 years of age. Outcome measures RPs were assessed at 5 and 20 months using interviews by trained paediatricians; parenting quality was assessed between birth and 5 months using parent interviews and nurses' observations; maternal mental health was assessed at birth and 5 months using standardized parents' interviews; childhood data on attention problems were collected at 8 years, using parent reports and expert behaviour observation ratings. Results After correction for gestational age, sex, and socioeconomic status, early RPs (β = 0.079) and low parenting quality (β = 0.175) predicted later attention problems (R2 = 0.272). Their impact was additive, such that infants with both multiple/persistent RPs and poor parenting quality showed the highest attention problems 8 years later. However, the impact of RPs on attention was strongest for preterm children. Maternal mental health was a significant moderator of the relationship between parenting quality and attention problems. With adequate maternal mental health, good parenting quality was related to lower attention problems, yet with mental health problems present, the effect of good parenting on attention problems diminished. Conclusions Guidance and support for parents of infants with multiple/persistent crying, sleeping or feeding problems may be essential to prevent the development of childhood attention problems, especially when maternal mental health problems are present

Early regulatory problems and parenting: life-long risk, vulnerability or susceptibility for attention, internalizing and externalizing outcomes?

Multiple or persistent crying, sleeping, or feeding problems in early childhood (regulatory problems, RPs) predict increased risk for self-regulation difficulties. Sensitive parenting may protect children from trajectories of dysregulation. Considering self-regulation from a life-course perspective, are children with early multiple and/or persistent RPs affected similarly by parenting as those without (main effects model, ME), or are they more vulnerable (diathesis-stress, DIA-S), or more susceptible (differential susceptibility theory, DST) to variations in sensitive parenting at age 6 years? Participants (N = 302) were studied prospectively from birth to 28 years. RPs were assessed from 5 to 56 months. Sensitive parenting was observed at 6 years. Attention regulation was observed at 8 and 28 years. Internalizing and externalizing problems were rated by parents at 8 years, and by adults at 28 years. Confirmatory-comparative modelling tested whether associations of sensitive parenting with outcomes at 8 and 28 years among individuals with early multiple and/or persistent RPs (n = 74) versus those without (n = 228) were best explained by ME, DIA-S, or DST models. Best fitting models differed according to age at assessment. For childhood attention regulation, the statistically parsimonious DIA-S provided the best fit to the data. At age 28, two additive main effects (ME, RP group and sensitive parenting) fit best. DIA-S and ME explained internalizing and externalizing problems. Using a comprehensive life-span approach, DIA-S and ME models but not DST explained how early RPs and sensitive parenting predicted attention, internalizing, and externalizing outcomes. Individuals with early RPs are vulnerable to insensitive parenting

Corrigendum to ‘Put your money where your feet are:The real-world effects of StepBet gamified deposit contracts for physical activity’ [Internet Interv., volume 31, March 2023, 100610] (Internet Interventions (2023) 31, (S2214782923000106), (10.1016/j.invent.2023.100610))

The authors regret that the Standard Deviation (SD) for those who failed their challenge (n = 19,693) was erroneously reported in the Abstract (page 1) and Table 2 of the Results section (page 6) as 3013 steps. The correct Standard Deviation that should have been reported there is 2993 steps. Furthermore, in the Results section under header 3.3 Exploratory Analyses (page 6) we erroneously state that exploratory analyses were performed on a subsample of 29,001 participants. The correct number that should have been reported there is 29,002 participants. The authors would like to apologise for any inconvenience caused.corrigendum voor DOI 10.1016/j.invent.2023.100610Design AestheticsApplied Ergonomics and Desig