Associations between Positive Childhood Experiences (PCEs), Discrimination, and Internalizing/Externalizing in Pre-Adolescents.

OBJECTIVE: This study aimed to investigate the relationships between four types of perceived discrimination (based on race and ethnicity, nationality/country of origin, gender identity, weight/body size), individually and cumulatively; positive childhood experiences (PCEs); and behavioral symptoms among pre-adolescent youth. METHODS: This study was a secondary analysis of data from the Adolescent Brain Cognitive Development (ABCD) Study, a US-based cohort study of pre-adolescent youth in the United States (N = 10,915). Our outcome was emotional/behavioral symptoms measured by the Child Behavior Checklist. Primary exposures were four types of discrimination, a count of 0-5 PCEs, and other adverse childhood experiences (ACEs). Multiple logistic regression models were used to estimate the relationship between perceived discrimination and clinical-range behavioral symptoms, including the role of PCEs and ACEs. RESULTS: Weight discrimination was the most frequent exposure (n = 643, 5.9%). Race and weight perceived discrimination were associated with clinical-range externalizing and internalizing symptoms, respectively, but these associations were non significant once other ACEs were added to models. Cumulative discrimination was associated with clinical-range Child Behavior Checklist (CBCL) scores, even when accounting for other ACEs (aOR=1.47, 95% CI=1.2-1.8). PCEs slightly reduced the strength of this relationship and were independently associated with reduced symptoms (aOR=0.82, 95% CI=0.72-0.93). CONCLUSIONS: Results of this national study suggest cumulative discrimination can exert emotional/behavioral health harm among youth. PCEs were independently associated with reduced behavioral symptoms. There is a need for further research on how to prevent discrimination and bolster PCEs by targeting upstream social inequities in communities.

Convergent and Discriminant Validity of the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) and the Vineland Adaptive Behavior Scales (VABS).

Behavior analysts frequently use the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) to assess the language and social skills of children with autism in everyday practice and in research. Despite the widespread use of the VB-MAPP, its psychometric characteristics have not been extensively investigated. To provide information about its convergent validity, we calculated correlations between scores earned by 235 children with autism on the VB-MAPP and the Vineland Adaptive Behavior Scale (VABS), a commonly used assessment with good reliability and validity. We obtained moderate or strong positive correlations between the VB-MAPP Milestones score and VABS Communication, Socialization, and Daily Living Skills subdomains. There was also a strong positive correlation between the VB-MAPP Milestones score and VABS overall raw score. These findings suggest that the VB-MAPP Milestones Assessment measures aspects of social and communicative behavior comparable to those indexed by these VABS subdomains which, like prior findings, supports the use of the Milestones Assessment. No significant relationship was observed between the VB-MAPP Barriers score and the VABS Internalizing, Externalizing, or overall Maladaptive Behavior scores. These findings, like prior findings, question the value of the VB-MAPP's Barriers Assessment as a measure of maladaptive behavior.

The Prevalence, Predictors, and Health Consequences of Disagreement in Reports of Child Maltreatment Exposure.

The purpose of this study was to examine the prevalence, predictors, and consequences of disagreement between prospective caregiver and retrospective child reports of childhood physical and emotional maltreatment. The design was a secondary analysis of data from the Avon Longitudinal Study of Parents and Children, a three-decade long UK-based birth cohort. Prospective caregiver reports were in poor to fair agreement with retrospective child reports for physical and emotional maltreatment exposure, with caregivers tending to underreport exposure. Disagreement between reporters was associated with increased risk of depressive symptoms and substance use severity, but decreased risk for mental health diagnoses. Screening measures of childhood maltreatment exposure should take caution against using measures from different reporters interchangeably (i.e., from mother versus child). Disagreement in reports may indicate unmet need for mental health evaluation.

Racial and Ethnic Disparities in Receipt of Pediatric Mental Health Care.

BACKGROUND: Studies suggest increasing mental health care needs among children but limited capacity to meet those needs, potentially leaving some needs unmet. There are no recent national studies examining the receipt of mental health treatment among children. We sought to identify the correlates of treatment receipt in a nationally representative sample of children in the United States. METHODS: We conducted a cross-sectional analysis of the 2019 National Health Interview Survey. Parents reported on their child's sociodemographic characteristics, general health care engagement, mental health using the Strengths and Difficulties Questionnaire, and whether their child received therapy or medication in the prior year. Weighted logistic regressions tested associations among child characteristics and receipt of mental health treatment while controlling for parental report of child mental health symptoms. RESULTS: Among 7168 children surveyed, 1044 (15%) received mental health treatment, equating to over 7 million US children. Hispanic children (adjusted odds ratio [AOR]: 0.46 [95% confidence interval (CI): 0.34-0.62]) and non-Hispanic Black children (AOR: 0.35 [95% CI: 0.23-0.54]) had lower odds of receiving treatment compared to non-Hispanic White children, controlling for mental health symptoms. Children with a well-child visit in the last year (AOR: 2.05 [95% CI: 1.20-3.52]) and whose usual place of care was a doctor's office (AOR 2.10 [95% CI: 1.33-3.34]) had higher odds of treatment receipt. CONCLUSIONS: Racially and ethnically minoritized children and those without primary care access have disproportionately low levels of receipt of mental health treatment. Interventions to meet the needs of these groups should be prioritized to reduce mental health disparities.