[Formula: see text] Interventions to improve executive functions in children and adolescents with acquired brain injury: a systematic review and multilevel meta-analysis.

To investigate the effectiveness of interventions aiming to improve hot and cold executive functions (EFs) in children and adolescents with acquired brain injury (ABI) and to examine whether characteristics of the intervention, participants, etiology of ABI (Traumatic-brain-injury [TBI] or non-TBI), time of assessment, or study quality moderate intervention effects. Whereas cold EFs refer to purely cognitive EFs, hot EFs refer to the affective aspects of these cognitive skills. A total of 970 participants from 23 randomized-controlled-trial studies (112 effect sizes [ES]) were included. A three-level random effects approach (studies, ES, individual participants) was used. Moderation analyses were conducted through meta-regressions. The three-level random effects model showed a better fit than the two-level model. Almost all individual studies showed non-significant ES across outcomes but in combination interventions were effective (Cohen's d = 0.38, CI 0.16 ~ 0.61). Lower methodological quality, inclusion of participants with non-TBI, and parental participation predicted larger ES. Participants' age, time of assessment, number of sessions, and focus on hot or cold EFs were not related to ES. We found no evidence of publication bias. Interventions are effective with small to medium ES according to conventional criteria. Intervention effects do not seem to fade away with time. Parent participation in the intervention is important to improve EFs. The efficacy of interventions seems larger when non-TBI is part of the etiology of ABI. Variation between studies is relevant for tracing the effective intervention characteristics. Most studies are conducted in adolescence, and studies in early childhood are needed.

Parenting a child with Down syndrome: A qualitative study on parents' experiences and behaviors from a self-determination theory perspective.

PURPOSE: Raising a child with Down syndrome (DS) brings unique challenges to parents' psychological functioning. Extensive quantitative research has shown that these parents tend to experience higher levels of parental stress and lower well-being. However, a more in-depth and balanced insight is essential to fully grasp the complexity of parenting a child with DS. To address this gap, this study uses a qualitative approach to explore the experiences and behaviors of parents raising a child with DS. DESIGN AND METHODS: By adopting the Self-Determination Theory as a comprehensive theoretical framework, this study attends to both opportunities and challenges for parents' psychological needs of autonomy, relatedness, and competence, and provides insights into how they support the psychological needs of their child with DS. Eleven in-depth interviews were conducted with parents of a child with DS (aged 4 to 23 years). RESULTS: Through thematic analysis, six themes of parental experiences and three themes of parenting behaviors were distinguished. CONCLUSIONS: The findings indicated that parents experience many opportunities for need satisfaction, predominantly in their need for relatedness. However, raising a child with DS also involves challenges for the parents' family relationships, personal freedom, professional ambitions, and feelings of competence. Regarding their parenting behaviors, parents considered stimulating independence, tuning into the child's mental world, and being patient as essential practices when raising a child with DS. PRACTICAL IMPLICATIONS: This study provides important clues to promote parents' well-being as well as their engagement in need-supportive parenting practices towards their child with DS.

Children with Autism Spectrum Disorder in Times of COVID-19: Examining Emotional and Behavioral Problems, Parental Well-Being, and Resilience.

This longitudinal study assessed the impact of the COVID-19 pandemic on children with autism spectrum disorder (ASD; n = 62; Mage = 13 years) by measuring emotional and behavioral problems before and during the pandemic, and by comparing this change to a matched sample of children without ASD (n = 213; Mage = 16 years). Moreover, we examined whether indicators of parental well-being promoted resilience of children with ASD. Results showed that the mean change in problems did not differ between children with and without ASD. Importantly, some children showed an increase in problems, while others showed resilience. Parental well-being indicators were not related to resilience among children with ASD. The interindividual variability in responses, particularly among children with ASD, highlights the need for personalized support.

Interrelated development of autism spectrum disorder symptoms and eating problems in childhood: a population-based cohort.

Eating problems, such as food selectivity or picky eating, are thought to be an epiphenomenon of autism spectrum disorders (ASD). Yet eating problems are also common in the general pediatric population and overlap with ASD symptoms. However, the temporal association between ASD symptoms and eating problems is poorly understood. This study examines the bidirectional association between ASD symptoms and eating problems across child development, and investigates whether these associations differ by child sex. Participants (N = 4,930) were from the population-based Generation R Study. Parents reported their child's ASD symptoms and eating problems using the Child Behavior Checklist at 5 assessments from toddlerhood to adolescence (1.5 to 14 years, 50% girls). A Random Intercept Cross-Lagged Panel Model was used to examine the lagged associations between ASD symptoms and eating problems at the within-person level, controlling for stable, trait-like differences at the between-person level. At the between-person level, there was a strong correlation between ASD symptoms and eating problems (ß = .48, 95% CI: 0.38 to 0.57). Controlling for these between-person effects, there was limited evidence for consistent, predictive effects of ASD symptoms and eating problems at the within-person level. Associations did not differ by child sex. Findings suggest that ASD symptoms and eating problems may represent a cluster of traits that are highly stable from early childhood to adolescence, which have a minimal reciprocal effect at the individual-level. Future research could focus on these trait-like qualities to inform the development of supportive, family-focused interventions.

A DAE perspective on the interface between adaptive and maladaptive personality development: A conceptual replication.

This study aimed to examine Dispositional, Adaptational, and Environmental (DAE) variables at the intersection of adaptive and maladaptive personality development as a conceptual replication of the DAE-model (Asendorpf & Motti-Stefanidi, European Journal of Personality, 32(3), 167-185, 2018). In a community sample of adolescents (N = 463; Mage = 13.6 years; 51% female) hypotheses-driven cross-lagged panel models were tested. Longitudinal associations between Dispositional (i.e., neuroticism, disagreeableness and unconscientiousness), Adaptational (i.e., social problems), and Environmental (i.e., perceived quality of the parent-child relationship) variables were investigated. The results partially support the DAE hypotheses. High levels of neuroticism, disagreeableness and social problems were found to predict the perceived quality of the parent-child relationship. In turn, the perceived quality of the parent-child relationship was found to predict levels of unconscientiousness and social problems. No mediation effects were found and, in contrast to DAE hypotheses, results did not indicate bidirectional influences between dispositions and adaptations. The results shed light on differential person-environment interactions that shape personality development and the importance of the perceived quality of the parent-child relationship. These findings provide insight in pathways of personality development, that may lead to personality pathology, and demonstrate the value of the DAE model as a structured guideline that provides testable hypotheses.

Coping, (mal)adaptive personality and identity in young adults: A network analysis.

Coping, personality, and identity are three well-known constructs within the field of psychology. Yet, findings regarding how these constructs relate to each other have been inconsistent. The present study employs network analysis to investigate coping, adaptive and maladaptive personality, and identity and how they are related, using data from the Flemish Study on Parenting, Personality, and Development (FSPPD; Prinzie et al., 2003; 1999-current). Young adults (N = 457; 47% male), aged between 17-23 years old, completed a survey on coping, adaptive and maladaptive personality, and identity. Results indicate clear associations between coping and both adaptive and maladaptive personality within the network, suggesting coping and personality are distinct, yet highly related constructs whereas identity proved largely unrelated. Potential implications and suggestions for future research are discussed.

A person-centered approach to resilience and vulnerability in emerging adulthood: Predictions from parenting and personality in adolescence.

In this person-centered study, we identified different profiles of resilience and vulnerability in emerging adulthood in response to previously experienced stressful life events. Additionally, we examined whether mothers' and fathers' parenting and participants' personality traits in adolescence predicted these profiles. Data from the Flemish Study on Parenting, Personality, and Development (N = 346 families) were used. At T1 (2004; Mage = 11 years), T2 (2007), and T3 (2009), mothers and fathers reported on their parenting and their child's personality. At T4 (2018; Mage = 25 years), emerging adults retrospectively self-reported the occurrence and impact of 22 stressful life events and rated current behavior problems and subjective well-being. Latent profile analysis revealed three profiles: Competent (71%; low stress, low behavior problems, high subjective well-being), Vulnerable (21%; average stress, high behavior problems, low subjective well-being), and Resilient (9%; high stress, average behavior problems, average subjective well-being). Emerging adults in the Resilient profile had experienced higher levels of maternal positive parenting and were less emotionally stable and conscientious than those in the Competent profile. Furthermore, emerging adults in the Vulnerable profile were less emotionally stable than their peers in the Competent profile. These findings reveal new insights into the heterogeneous patterns of emerging adults' adaptation following stressful life events.

Testing transactional processes between parental support and adolescent depressive symptoms: From a daily to a biennial timescale.

Transactional processes between parental support and adolescents' depressive symptoms might differ in the short term versus long term. Therefore, this multi-sample study tested bidirectional within-family associations between perceived parental support and depressive symptoms in adolescents with datasets with varying measurement intervals: Daily (N = 244, Mage = 13.8 years, 38% male), bi-weekly (N = 256, Mage = 14.4 years, 29% male), three-monthly (N = 245, Mage = 13.9 years, 38% male), annual (N = 1,664, Mage = 11.1 years, 51% male), and biennial (N = 502, Mage = 13.8 years, 48% male). Preregistered random-intercept cross-lagged panel models (RI-CLPMs) showed negative between- and within-family correlations. Moreover, although the preregistered models showed no within-family lagged effect from perceived parental support to adolescent depressive symptoms at any timescale, an exploratory model demonstrated a negative lagged effect at a biennial timescale with the annual dataset. Concerning the reverse within-family lagged effect, increases in adolescent depressive symptoms predicted decreases in perceived parental support 2 weeks and 3 months later (relationship erosion effect). Most cross-lagged effects were not moderated by adolescent sex or neuroticism trait level. Thus, the findings mostly support adolescent-driven effects at understudied timescales and illustrate that within-family lagged effects do not generalize across timescales.

Early Maternal Caregiving Capacities in Highly Vulnerable, Multi-Problem Families.

Caregiving capacities may be an important link between multi-problem circumstances and adverse child development. This study aims to assess caregiving capacities and their correlations in highly vulnerable, multi-problem families in Rotterdam, the Netherlands. Caregiving capacity (overall, emotional and instrumental) was prospectively assessed in 83 highly vulnerable women using video-observations of daily caregiving tasks, six week postpartum. Supporting data were collected at three time points: at inclusion, six weeks after inclusion and six weeks postpartum, and these included psychological symptoms, self-sufficiency, problematic life domains, home environment, income, depression, anxiety and stress. Pregnancy- and delivery-related information was collected from obstetric care professionals. Maternal caregiving scores averaged below adequate quality. Mothers living in an unsafe home environment (B = 0.62) and mothers with more problematic life domains (≤3 domains, B = 0.32) showed significantly higher instrumental caregiving capacities. Other variables were not related to caregiving capacities. Caregiving capacity in this highly vulnerable population was below adequate quality. However, in most cases there was no significant association between caregiving and the variables related to vulnerability. This means that a potential association between vulnerability and caregiving capacities might be driven by the interaction between several problems, rather than the type or number of problems.

Maternal age, autistic-like traits and mentalizing as predictors of child autistic-like traits in a population-based cohort.

BACKGROUND: Many empirical studies suggest that higher maternal age increases the likelihood of having an autistic child. However, little is known about factors that may explain this relationship or if higher maternal age is related to the number of autistic-like traits in offspring. One possibility is that mothers who have a higher number of autistic-like traits, including greater challenges performing mentalizing skills, are delayed in finding a partner. The goal of our study is to assess the relationship between maternal age, mentalizing skills and autistic-like traits as independent predictors of the number of autistic-like traits in offspring. METHODS: In a population-based study in the Netherlands, information on maternal age was collected during pre- and perinatal enrolment. Maternal mentalizing skills and autistic-like traits were assessed using the Reading the Mind in the Eyes Test and the Autism Spectrum Quotient, respectively. Autistic-like traits in children were assessed with the Social Responsiveness Scale. A total of 5718 mother/child dyads had complete data (Magechild = 13.5 years; 50.2% girls). RESULTS: The relationship between maternal age and autistic-like traits in offspring best fits a U-shaped curve. Furthermore, higher levels of autistic features in mothers are linked to higher levels of autistic-like traits in their children. Lower mentalizing performance in mothers is linked to higher levels of autistic-like traits in their children. LIMITATIONS: We were able to collect data on both autistic-like traits and the mentalizing skills test in a large population of mothers, but we did not collect these data in a large number of the fathers. CONCLUSIONS: The relationships between older and younger mothers may have comparable underlying mechanisms, but it is also possible that the tails of the U-shaped curve are influenced by disparate mechanisms.

Socio-economic determinants of healthcare costs in early life: a register-based study in the Netherlands.

BACKGROUND: Children with low socioeconomic status (SES) have an increased risk of a suboptimal start in life with ensuing higher healthcare costs. This study aims to investigate the effects of individual- (monthly household income) and contextual-level SES (household income and neighborhood deprivation), and perinatal morbidity (preterm birth and small for gestational age ((<10th percentile), SGA)) on healthcare costs in early life (0-3 years of age). METHODS: Individual-linked data from three national registries (Perinatal Registry Netherlands, Statistics Netherlands, and Healthcare Vektis) were obtained of all children born between 2011 and 2014 (N = 480,471) in the Netherlands. Binomial logistic regression was used to model annual healthcare costs as a function of their household income (per €1000), neighborhood deprivation index (range - 13.26 - 10.70), their perinatal morbidity and demographic characteristics. Annual healthcare cost were dichotomized into low healthcare costs (Q1-Q3 below €1000) and high healthcare costs (Q4 €1000 or higher). RESULTS: Children had a median of €295 annual healthcare costs, ranging from €72 to €4299 (5-95%). Binomial logistic regression revealed that for every €1000 decrease in monthly household income, the OR for having high healthcare costs is 0.99 (0.99-0.99). Furthermore, for every one-unit increase in neighborhood deprivation the OR for having high healthcare costs increase 1.02 (1.01-1.02). Finally, the model revealed an OR of 2.55 (2.48-2.61) for preterm born children, and an OR of 1.44 (1.41-1.48) for children SGA, to have high healthcare costs compared to their healthy peers. CONCLUSION: More neighborhood deprivation was directly related to higher healthcare costs in young children. On top of this, lower household income was consistently and independently related to higher healthcare costs. By optimizing conditions for low SES populations, the impact of low SES circumstances on their healthcare costs can be positively influenced. Additionally, policies that influence more timely and appropriate healthcare use in low SES populations can reduce healthcare costs further.

Expressed Emotion in Families of Children With and Without Autism Spectrum Disorder, Cerebral Palsy and Down Syndrome: Relations with Parenting Stress and Parenting Behaviors.

This study examined the family emotional climate as assessed by Five Minute Speech Samples and the relation with parenting stress and parenting behaviors among parents of children (6-17 years, 64.7% boys) with autism spectrum disorder, cerebral palsy, Down syndrome, and without any known disability (n = 447). The large majority of parents (79%) showed low levels of Expressed Emotion, an indicator of a positive family climate. In all groups, more Emotional Over-involvement, more Criticism and fewer expressions of Warmth were associated with higher levels of parenting stress. Across groups, Emotional Over-involvement was related to more autonomy-supportive parenting, Criticism to more psychologically controlling and overreactive parenting, and Warmth was associated with more responsive and less psychologically controlling and overreactive parenting.

Parenting and Child Personality as Modifiers of the Psychosocial Development of Youth with Cerebral Palsy.

This two-year longitudinal study addressed the joint contribution of parent-rated parenting behaviors and child personality on psychosocial outcomes in 118 families of children with Cerebral Palsy (M age Time 1 = 10.9 years old, 64.4% boys). Latent change modeling revealed intra-individual changes in children's psychosocial development as internalizing and externalizing behaviors increased from the first to the second assessment and psychosocial strengths increased from the second to the third assessment, whereas externally controlling and autonomy-supportive parenting behavior remained stable over time. Externally controlling parenting related to higher levels of, and increases in behavioral problems, with these associations being most pronounced among children low on Extraversion, Conscientiousness, or Imagination. Autonomy-supportive parenting related to higher levels of psychosocial strengths, with this association being most pronounced among children high on Emotional Stability.

Early life stress and behavior problems in early childhood: Investigating the contributions of child temperament and executive functions to resilience.

This preregistered study examined whether child temperament and executive functions moderated the longitudinal association between early life stress (ELS) and behavior problems. In a Dutch population-based cohort (n = 2803), parents reported on multiple stressors (age 0-6 years), child temperament (age 5), and executive functions (age 4), and teachers rated child internalizing and externalizing problems (age 7). Results showed that greater ELS was related to higher levels of internalizing and externalizing problems, with betas reflecting small effects. Lower surgency buffered the positive association of ELS with externalizing problems, while better shifting capacities weakened the positive association between ELS and internalizing problems. Other child characteristics did not act as moderators. Findings underscore the importance of examining multiple protective factors simultaneously.

Children's autistic traits and peer relationships: do non-verbal IQ and externalizing problems play a role?

BACKGROUND: Children with autism have difficulties in understanding relationships, yet little is known about the levels of autistic traits with regard to peer relationships. This study examined the association between autistic traits and peer relationships. Additionally, we examined whether the expected negative association is more pronounced in children with a lower non-verbal IQ and in those who exhibit more externalizing problems. METHOD: Data were collected in a large prospective birth cohort of the Generation R Study (Rotterdam, the Netherlands) for which nearly 10,000 pregnant mothers were recruited between 2002 and 2006. Follow up data collection is still currently ongoing. Information on peer relationships was collected with PEERS application, an interactive computerized task (M = 7.8 years). Autistic traits were assessed among general primary school children by using the Social Responsiveness Scale (M = 6.1 years). Information was available for 1580 children. RESULT: Higher levels of autistic traits predicted lower peer acceptance and higher peer rejection. The interaction of autistic traits with externalizing problems (but not with non-verbal IQ or sex) was significant: only among children with low externalizing problems, a higher level of autistic traits predicted less peer acceptance and more peer rejection. Among children exhibiting high externalizing problems, a poor peer acceptance and high level of rejection is seen independently of the level of autistic traits. CONCLUSION: We conclude that autistic traits-including traits that do not classify as severe enough for a clinical diagnosis-as well as externalizing problems negatively impact young children's peer relationships. This suggests that children with these traits may benefit from careful monitoring and interventions focused at improving peer relationships.

An 11-year prospective study of personality X parenting interactions as predictors of self-efficacy in young adults: diathesis-stress or differential susceptibility?

BACKGROUND: Self-efficacy, individuals' beliefs regarding their capacities to perform actions or control (potentially stressful or novel) events, is thought to be important for various life domains. Little however is known about its early precursors. This study examined the predictive effects of childhood personality and parental behaviors (i.e., overreactive discipline and warmth) for general self-efficacy in young adulthood. Furthermore, it was examined whether personality and parenting behaviors interacted and whether these interactions supported the diathesis-stress or differential susceptibility model. These aims were examined in an 11-year prospective study of 336 participants (Mage at T1 = 10.83 years, range = 9-12 years, 53.9% girls). Personality and parental behaviors were reported at T1 by both mothers and fathers, whereas self-efficacy was self-reported at T2 11 years later. Hypotheses were tested in Mplus using multilevel structural equation modeling. RESULTS: Results revealed that (only) emotional stability, and not parenting, predicted higher self-efficacy 11 years later. Benevolence functioned as a susceptibility marker in the association between overreactivity and self-efficacy. CONCLUSIONS: The results show that childhood emotional stability is an important long-term predictor of self-efficacy, even into emerging adulthood. Moreover, the integration of individual differences in models of parenting effects may further improve our understanding of early adults' adjustment.

Components associated with the effect of home visiting programs on child maltreatment: A meta-analytic review.

BACKGROUND: Home visiting programs are widely endorsed for preventing child maltreatment. Yet, knowledge is lacking on what and how individual program components are related to the effectiveness of these programs. OBJECTIVE: The aim of this meta-analysis was to increase this knowledge by summarizing findings on effects of home visiting programs on child maltreatment and by examining potential moderators of this effect, including a range of program components and delivery techniques. METHODS: A literature search yielded 77 studies (N=48,761) examining the effectiveness of home visiting programs, producing 174 effect sizes. In total, 35 different program components and delivery techniques were coded. RESULTS: A small but significant overall effect was found (d=0.135, 95 % CI (0.084, 0.187), p<0.001). Programs that focused on improving parental expectations of the child or parenthood in general (d = 0.308 for programs with this component versus d = 0.112 for programs without this component), programs targeting parental responsiveness or sensitivity to a child's needs (d = 0.238 versus d = 0.064), and programs using video-based feedback (d = 0.397 versus d = 0.124) yielded relatively larger effects. Providing practical and instrumental assistance was negatively associated with program effectiveness (d=0.044 versus d = 0.168). Further, program effects were larger when percentages of non-Caucasians/non-Whites in samples and follow-up durations increased. CONCLUSIONS: In general, home visiting programs can prevent child maltreatment only to a small extent. However, implementing specific components and techniques can improve program effectiveness.

Moderation of associations between interparental stress and (mal)adaptation by adolescents' personality: Contrasting differential susceptibility and diathesis-stress models.

OBJECTIVE: This study aimed to contrast differential susceptibility and diathesis-stress models in examining adolescents' Big Five personality dimensions as moderators of longitudinal associations between interparental stress and (mal)adaptation in emerging adulthood (i.e., self-efficacy, externalizing and internalizing behavior). METHOD: Data from the large longitudinal Flemish Study on Parenting, Personality and Development were used (475 families, adolescents' Mage  = 15.82, SDage  = 1.15), with both parents reporting on their interparental stress and mothers reporting on the adolescent's personality and in 2009, and emerging adults reporting on their own (mal)adaptive functioning in 2009 and 2015 and their personality in 2015. RESULTS: Multivariate models showed that extraversion, benevolence, emotional stability and imagination were uniquely related to (mal)adaptation across the 6-year interval. In general, our results exhibited no consistent moderating role for adolescents' personality. Only for girls, high levels of extraversion functioned as a "susceptibility maker" in associations between father's interparental stress and self-efficacy, and, low levels of emotional stability functioned as a "vulnerability marker" in associations between parents' interparental stress and self-efficacy. CONCLUSIONS: The interaction effects as well as their (restricted) generalizability across gender should be replicated before drawing firm conclusions. Adolescents' personality characteristics were important predictors of (mal)adaptation during the transition into emerging adulthood.

Negative Controlling Parenting and Child Personality as Modifiers of Psychosocial Development in Youth with Autism Spectrum Disorder: A 9-Year Longitudinal Study at the Level of Within-Person Change.

This nine-year longitudinal study addresses the joint contribution of parent-rated negative controlling parenting and child personality on psychosocial outcomes in 141 families of children with autism spectrum disorder (83% boys, mean age Time 1 = 10.1). Latent change modeling revealed substantial variation in within-person change in parenting and psychosocial outcomes across a six- and three-year-interval. Over time, negative controlling parenting and child personality were consistently related to externalizing problems, whereas child personality was differentially related to internalizing problems and psychosocial strengths. Three personality-by-parenting interactions were significant, suggesting that children with less mature personality traits show more externalizing behaviors in the presence of controlling parenting. This study identified both parenting and child personality as important modifiers of developmental outcomes in youth with autism.

Daily parenting of children with cerebral palsy: The role of daily child behavior, parents' daily psychological needs, and mindful parenting.

The purpose of this study was to advance the current understanding of the daily dynamics that are involved in raising a child with Cerebral Palsy (CP). Specifically, we examined the role of mindful parenting and of day-to-day variation in parents' psychological needs and child behavior in explaining day-to-day variation in parents' autonomy-supportive, psychologically controlling, and responsive parenting behavior. Parents (N = 58) of children with CP (Mage = 12.68 years) participated in a 7-day diary study. Multilevel analyses indicated that parents' autonomy-supportive, psychologically controlling, and responsive behaviors fluctuate considerably between days. Further, daily fluctuations in both child behavior and parents' own psychological needs were found to be associated with this daily variability in parenting. In addition, interindividual differences in mindful parenting were associated positively with parents' responsiveness and negatively with psychologically controlling parenting across the week. These findings point towards the changeability of parenting behavior among parents of a child with CP and suggest that interventions targeting parenting behavior in the context of CP will be most effective when taking into account both the parents' and the child's functioning.