Emotion Regulation in At-Risk Youth: The Influence of the Family Check-Up

The purpose of this study was to advance our understanding of the role of emotion regulation in the growth of conduct problems over time by examining whether increases in positive behavior support brought about by a family-centered intervention focusing on parenting were associated with more adaptive emotion regulation, and whether more adaptive emotion regulation at age 3 in turn mediated the association between improvements in positive behavior support from ages 2-3 and decreases in the growth of conduct problems from ages 2-4.The results indicated that emotion regulation at age 3 was significantly associated with growth in conduct problems from ages 2-4. However, neither the intervention nor positive behavior support was significantly associated with emotion regulation. Results provide support for the notion that emotion regulation plays an important role in the growth of conduct problems in early childhood, but do not support the hypotheses that a family-centered intervention would result in more adaptive child emotion regulation strategies or that such changes in emotion regulation would mediate previously reported intervention effects between parenting and reductions in growth of child conduct problems

EFFECTS OF THE FAMILY CHECK-UP INTERVENTION ON REDUCING GROWTH IN CONDUCT PROBLEMS IN TODDLERHOOD THORUGH SCHOOL AGE: MODERATORS AND MODERATED MEDIATION

Child conduct problems (CP), characterized by oppositionality, disruptiveness, aggression, and rule-breaking behavior, present a significant public health issue, as they are the most common reason children are referred for mental health services (Lavigne et al., 1996). Parenting interventions for child CP have been found to be efficacious, with meta-analyses demonstrating small to moderate effects (e.g., Lundahl et al., 2006; Reyno & McGrath 2006). The Family Check-Up (FCU), a preventive intervention combining aspects of motivational interviewing with parent training, is one intervention found to significantly reduce child CP. As not all children improve following parenting interventions (Webster-Stratton, 1990; Webster-Stratton & Hammond, 1997), exploring moderators is an important way to identify subgroups who may respond differentially (Gardner et al., 2009). Baseline level of child CP is one important potential moderator, as young children with elevated CP are at risk for long-term persistence (Campbell, Shaw, & Gilliom, 2000). The current study examined baseline CP as a moderator of effectiveness of the FCU utilizing latent growth curves of parenting and child behavior, group-based trajectory models, and parallel-process moderated mediation models to explore parenting and maternal depression as mediators. Participants included 731 mother-child dyads recruited at child age 2 and followed to child age 9.5, half assigned to the FCU. The study involved structured annual in-home assessments and measures of maternal depression, observed parenting, and child CP from different informants. Intervention families were given the opportunity for annual check-ups and additional sessions as desired. The FCU was effective in reducing growth in CP across child ages 2 to 9.5. Engagement in feedback sessions led to greater benefits in a few outcomes. Findings on baseline CP as a moderator varied, with some models demonstrating greater benefit for those with higher baseline problems and others demonstrating non-significant differences. Assignment to the FCU was not associated with group-based trajectory membership, although baseline CP distinguished trajectory group membership. Finally, moderated mediation models were partially supported, with differential effects for those with high baseline CP only found for some of the hypothesized pathways. Results highlight the importance of examining subgroups to elucidate the potential for differential responsiveness to intervention

Tutorial : applying machine learning in behavioral research

Machine-learning algorithms hold promise for revolutionizing how educators and clinicians make decisions. However, researchers in behavior analysis have been slow to adopt this methodology to further develop their understanding of human behavior and improve the application of the science to problems of applied significance. One potential explanation for the scarcity of research is that machine learning is not typically taught as part of training programs in behavior analysis. This tutorial aims to address this barrier by promoting increased research using machine learning in behavior analysis. We present how to apply the random forest, support vector machine, stochastic gradient descent, and k-nearest neighbors algorithms on a small dataset to better identify parents of children with autism who would benefit from a behavior analytic interactive web training. These step-by-step applications should allow researchers to implement machine-learning algorithms with novel research questions and datasets

Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective

Background Child disruptive behavioural problems are a large and costly public health problem. The Incredible Years® (IY) parenting programme has been disseminated across the UK to prevent this problem and shown to be effective in several trials. It is vital for policy to know for which families IY is most effective, to be sure that it helps reduce, rather than widen, socioeconomic inequalities. Individual trials lack power and generalisability to examine differential effects; conventional meta-analysis lacks information about within-trial variability in effects. Objectives To overcome these limitations by pooling individual-level data from the IY parenting trials in Europe to examine to what extent it benefits socially disadvantaged families. Secondary objectives examine (1) additional moderators of effects on child behaviour, (2) wider health benefits and potential harms and (3) costs, cost-effectiveness and potential long-term savings. Design Individual participant data meta-analysis of 14 randomised trials of the IY parenting intervention. Settings UK (eight trials), the Netherlands, Ireland, Norway, Sweden and Portugal. Participants Data were from 1799 families, with children aged 2–10 years (mean 5.1 years; 63% boys). Interventions IY Basic parenting programme. Main outcome measures Primary outcome was disruptive child behaviour, determined by the Eyberg Child Behavior Inventory Intensity scale (ECBI-I). Secondary outcomes included self-reported parenting practices, parenting stress, mental health, children’s attention deficit hyperactivity disorder (ADHD) and emotional symptoms. Results There were no differential effects of IY on disruptive behaviour in families with different levels of social/socioeconomic disadvantage or differential effects for ethnic minority families, families with different parenting styles, or for children with comorbid ADHD or emotional problems or of different ages. Some moderators were found: intervention effects were strongest in children with more severe baseline disruptive behaviour, in boys, and in children with parents who were more depressed. Wider health benefits included reduced child ADHD symptoms, greater parental use of praise, and reduced harsh and inconsistent discipline. The intervention did not improve parental depression, stress, self-efficacy or children’s emotional problems. Economic data were available for five UK and Ireland trials (maximum n = 608). The average cost per person of the IY intervention was £2414. The probability that the IY intervention is considered cost-effective is 99% at a willingness to pay of £145 per 1-point improvement on the ECBI-I. Estimated longer-term savings over 20 years range from £1000 to £8400 per child, probably offsetting the cost of the intervention. Limitations Limitations include a focus on one parenting programme; the need to make assumptions in harmonising data; and the fact that data addressed equalities in the effectiveness of, not access to, the intervention. Conclusions There is no evidence that the benefits of the IY parenting intervention are reduced in disadvantaged or minority families; benefits are greater in the most distressed families, including parents who are depressed. Thus, the intervention is unlikely to widen socioeconomic inequalities in disruptive behaviour and may have effects in narrowing inequalities due to parent depression. It was as likely to be effective for older as for younger children. It has wider benefits for ADHD and parenting and is likely to be considered to be cost-effective. Researchers/funders should encourage data sharing to test equity and other moderator questions for other interventions; further research is needed on enhancing equality of access to interventions

Effects of the Family Check-Up on reducing growth in conduct problems from toddlerhood through school age: An analysis of moderated mediation

Objective: The Family Check-Up (FCU) is a preventive intervention found to significantly reduce child conduct problems (CP). This study examined the extent to which parents reported that their child’s CP were a problem for them at baseline (baseline CP) as a moderator of FCU effects into middle childhood and moderated mediation models to explore positive parent-child dyadic interaction and maternal depressive symptoms as mediators. Method: Participants included 731 mother-child dyads followed from child ages 2 to 9.5 (49% female; 28% African American, 50% European American, 13% biracial, and 9% other; 13% self-reported as Hispanic), with half assigned to the FCU. Maternal depressive symptoms, observed parent and child behavior (positive dyadic interaction), and CP were assessed annually. Results: Support was found for baseline CP as a moderator of the FCU, with significant decreases in CP for children in the FCU demonstrating high baseline CP. The following associations did not differ between those with high versus low baseline CP. The FCU significantly increased positive dyadic interaction. Lower maternal depressive symptoms were associated with significantly lower CP. Conclusions: Findings add to existing evidence that preventive interventions are effective for high-risk families, and the FCU is especially beneficial for children whose parents report high levels of CP in early childhood. Further, the FCU significantly improved positive dyadic interaction for families of children with both high and low baseline CP

A Case Definition for Children with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

The case definition for chronic fatigue syndrome was developed for adults (Fukuda et al. 1994), and this case definition may not be appropriate for use with children and adolescents. The lack of application of a consistent pediatric definition for this illness and the lack of a reliable instrument to assess it might lead to studies which lack sensitivity and specificity. In this article, a case definition is presented that has been endorsed by the International Association of ME/CFS

Early Childhood Predictors of Severe Youth Violence in Low‐Income Male Adolescents

Using a cohort of 310 low-income male adolescents living in an urban community and followed prospectively from 18 months through adolescence (ages 15-18 years), the current study examined whether individual, family, and community risk factors from ages 18 to 42 months were associated with adolescents' violent behavior, as indexed by juvenile petitions. Results of multivariate analyses indicated that although family income was the only factor to discriminate those with no arrest record from those with nonviolent arrests, rejecting parenting, child oppositional behavior, emotion regulation, and minority status during the toddler period contributed unique variance in distinguishing male adolescents arrested for violent behavior compared to those never arrested and those arrested for nonviolent behavior. Implications for prevention efforts are discussed

Early Childhood Predictors of Severe Youth Violence in Low-Income Male Adolescents.

Using a cohort of 310 low-income male adolescents living in an urban community and followed prospectively from 18 months through adolescence (ages 15-18 years), the current study examined whether individual, family, and community risk factors from ages 18 to 42 months were associated with adolescents' violent behavior, as indexed by juvenile petitions. Results of multivariate analyses indicated that although family income was the only factor to discriminate those with no arrest record from those with nonviolent arrests, rejecting parenting, child oppositional behavior, emotion regulation, and minority status during the toddler period contributed unique variance in distinguishing male adolescents arrested for violent behavior compared to those never arrested and those arrested for nonviolent behavior. Implications for prevention efforts are discussed