Rapid white matter changes in children with conduct problems during a parenting intervention

Studies report that the microstructural integrity of the uncinate fasciculus (UF; connecting the anterior temporal lobe to the orbitofrontal cortex) is abnormal in adults with psychopathy and children with conduct problems (CP), especially those with high callous-unemotional (CU) traits. However, it is unknown if these abnormalities are 'fixed' or 'reversible'. Therefore, we tested the hypothesis that a reduction in CP symptoms, following a parenting intervention, would be associated with altered microstructural integrity in the UF. Using diffusion tensor imaging tractography we studied microstructural differences (mean diffusivity (MD) and radial diffusivity (RD)) in the UF of 43 typically developing (TD) and 67 boys with CP before and after a 14-week parenting intervention. We also assessed whether clinical response in CP symptoms or CU traits explained changes in microstructure following the intervention. Prior to intervention, measures of MD and RD in the UF were increased in CP compared to TD boys. Following intervention, we found that the CP group had a significant reduction in RD and MD. Further, these microstructural changes were driven by the group of children whose CU traits improved (but not CP symptoms as hypothesized). No significant microstructural changes were observed in the TD group. Our findings suggest, for the first time, that microstructural abnormalities in the brains of children with CP may be reversible following parenting intervention

Performance evaluation of a non-invasive one-step multiplex RT-qPCR assay for detection of SARS-CoV-2 direct from saliva

Polymerase chain reaction (PCR) has proven to be the gold-standard for SARS-CoV-2 detection in clinical settings. The most common approaches rely on nasopharyngeal specimens obtained from swabs, followed by RNA extraction, reverse transcription and quantitative PCR. Although swab-based PCR is sensitive, swabbing is invasive and unpleasant to administer, reducing patient compliance for regular testing and resulting in an increased risk of improper sampling. To overcome these obstacles, we developed a non-invasive one-step RT-qPCR assay performed directly on saliva specimens. The University of Nottingham Asymptomatic Testing Service protocol simplifies sample collection and bypasses the need for RNA extraction, or additives, thus helping to encourage more regular testing and reducing processing time and costs. We have evaluated the assay against the performance criteria specified by the UK regulatory bodies and attained accreditation (BS EN ISO/IEC 17,025:2017) for SARS-CoV-2 diagnostic testing by the United Kingdom Accreditation Service. We observed a sensitivity of 1 viral copy per microlitre of saliva, and demonstrated a concordance of > 99.4% between our results and those of other accredited testing facilities. We concluded that saliva is a stable medium that allows for a highly precise, repeatable, and robust testing method

Mothers' representations of their children with conduct problems

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Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice

OBJECTIVE: To see whether a behaviourally based group parenting programme, delivered in regular clinical practice, is an effective treatment for antisocial behaviour in children. DESIGN: Controlled trial with permuted block design with allocation by date of referral. SETTING: Four local child and adolescent mental health services. PARTICIPANTS: 141 children aged 3-8 years referred with antisocial behaviour and allocated to parenting groups (90) or waiting list control (51). INTERVENTION: Webster-Stratton basic videotape programme administered to parents of six to eight children over 13-16 weeks. This programme emphasises engagement with parental emotions, rehearsal of behavioural strategies, and parental understanding of its scientific rationale. MAIN OUTCOME MEASURES: Semistructured parent interview and questionnaires about antisocial behaviour in children administered 5-7 months after entering trial; direct observation of parent-child interaction. RESULTS: Referred children were highly antisocial (above the 97th centile on interview measure). Children in the intervention group showed a large reduction in antisocial behaviour; those in the waiting list group did not change (effect size between groups 1.06 SD (95% confidence interval 0.71 to 1.41), P<0.001). Parents in the intervention group increased the proportion of praise to ineffective commands they gave their children threefold, while control parents reduced it by a third (effect size between groups 0.76 (0.16 to 1.36), P=0.018). If the 31 children lost to follow up were included in an intention to treat analysis the effect size on antisocial behaviour was reduced by 16%. CONCLUSIONS: Parenting groups effectively reduce serious antisocial behaviour in children in real life conditions. Follow up is needed to see if the children's poor prognosis is improved and criminality prevented

Should parenting programmes to improve children's life chances address child behaviour, reading skills, or both? Rationale for the Helping Children Achieve trial

Behaviour problems and poor literacy levels are each independently associated with a lower quality of life in childhood, and carry forward to predict much poorer outcomes in adulthood. Longitudinal surveys show that the dimensions of parenting that influence child behaviour and child literacy differ. The aspects of parenting that promote good behaviour concern the quality of the relationship, for example giving warmth and encouragement while calmly enforcing clear limits. In contrast, the aspects that promote literacy are regular reading with the child in a manner that is sensitive to their ability level. To help children with difficulties, there are many evidence-based parenting programmes to improve parent-child relationship quality, but very few address literacy. This paper reviews evidence on these issues, illustrated by our own previous preventive trials that combined a parenting programme addressing relationships (Incredible Years; IY) with a new parenting programme addressing literacy (Supporting Parents on Kids Education; SPOKES). Because this combination improved both child behaviour and literacy, a new randomized controlled trial called Helping Children Achieve is underway to disentangle the mode of action of each component by comparing the effects of: (1) a relationship programme alone (IY); with (2) a literacy programme alone (SPOKES); (3) both combined; and (4) an information helpline (control group). The results are not yet known but should answer whether programmes that target relationships also improve child literacy, and whether programmes that target literacy also improve behaviour. The findings will inform strategies to reduce social inequality and help young children achieve their potential. © 2012 Copyright Taylor and Francis Group, LLC