Problems most concerning to parents of children with ADHD and emotional dysregulation in a randomized controlled trial of multinutrients: MADDY secondary analysis.

OBJECTIVE: With dual focus on structured, objective quantification of parent observations of child's behavior and identifying behaviors most amenable to change, this report examines Parent Target Problems (PTP) as a secondary outcome in a randomized clinical trial (RCT) of children with attention-deficit/ hyperactivity disorder (ADHD) in which one primary outcome, Clinical Global Impression-Improvement, showed a significant advantage of multinutrients over placebo and the other, Likert-type parent ratings, showed significant improvement in both groups, without significant difference between them. METHOD: In a multisite 8-week RCT of broad-spectrum micronutrients ("multinutrients"), parents of children ages 6-12 (N = 126, 73% male, 88% white) with ADHD and emotional dysregulation nominated their child's most concerning problem(s) at baseline and quantified them by frequency, duration, impairment, and consequences. At subsequent visits, parents re-quantified the problem(s). Blinded child psychiatrists independently reviewed the PTPs and rated change at two timepoints compared to baseline. PTPs were grouped into 9 categories. Mean ratings were compared between active and placebo groups and explored by category. RESULTS: By week 8, a significant separation favored multinutrients: 38% of the multinutrient group were "definitely improved" or better, compared to 25% of the placebo group, and ratings of "no change" or "worse" occurred in 35% with placebo versus 23% with multinutrients (p = 0.04). Inattention (72.2%) and emotional dysregulation (69.1%) were the most frequently reported PTP categories. Inattention and internalizing symptoms improved more with multinutrients than placebo (p = 0.01, d = 0.55; p = 0.03, d = 0.80, respectively). The multinutrient advantage was not significant for 7 other symptoms, including hyperactivity/impulsivity, aggression, autistic symptoms, or emotional dysregulation/irritable oppositionality. CONCLUSIONS: This secondary analysis found that the multinutrients, compared to placebo, were associated with improvements in parental concerns overall, and in two domains specifically: inattention and internalizing symptoms (anxiety/depression), but not in seven domains: hyperactivity/impulsivity, aggression, autistic symptoms or physiological symptoms, peer relationships or emotional dysregulation/irritable oppositionality.

An examination of measures of young children's interest in natural object categories.

Developmental research utilizes various different methodologies and measures to study the cognitive development of young children; however, the reliability and validity of such measures have been a critical issue in all areas of research practices. To address this problem, particularly in the area of research on infants' interests, we examined the convergent validity of previously reported measures of children's interests in natural object categories, as indexed by (1) parents' estimation of their child's interest in the categories, (2) extrinsic (overt choices in a task), (3) intrinsic (looking time toward objects), and (4) physiological (pupil dilation) responses to objects of different categories. Additionally, we also examined the discriminant validity of all the aforementioned measures against the well-established and validated measure of parents' estimations of children's vocabulary knowledge. Children completed two tasks: (a) an eye-tracking task, where they were presented with images from a range of defined categories, which collected indices of looking time and pupillary activity; (b) a sticker-choice task, where they were asked to choose between two sticker-images from two different categories belonging to the range of categories assessed in the previous task. Parents completed two questionnaires to estimate (i) their child's interests and (ii) vocabulary knowledge in the categories presented. We first analyzed the discriminant validity between the two parent measures, and found a significant positive association between them. Our successive analyses showed no strong or significant associations between any of our measures, apart from a significant positive association between children's looking time and parents' estimations of children's vocabulary knowledge. From our findings, we conclude that measures of infants' interests thus far may not have sufficient reliability to adequately capture any potential relationship between these measures, or index different components of interest in young children. We suggest next steps for further validation studies in infant research.

Genetic and phenotypic evidence of the predictive validity of preschool parent reports of hyperactivity/impulsivity and inattention.

To determine the validity of parent reports (PRs) of ADHD in preschoolers, we assessed hyperactivity/impulsivity (HI) and inattention (IN) in 1114 twins with PRs at 1.5, 2.5, 4, 5, 14, 15, and 17 years, and teacher-reports at 6, 7, 9, 10, and 12. We examined if preschool PRs (1) predict high HI/IN trajectories, and (2) capture genetic contributions to HI/IN into adolescence. Group-based trajectory analyses identified three 6-17 years trajectories for both HI and IN, including small groups with high HI (N = 88, 10.4%, 77% boys) and IN (N = 158, 17.3%, 75% boys). Controlling for sex, each unit of HI PRs starting at 1.5 years and at 4 years for IN, increased more than 2-fold the risk of belonging to the high trajectory, with incremental contributions (Odds Ratios = 2.5-4.5) at subsequent ages. Quantitative genetic analyses showed that genetic contributions underlying preschool PRs accounted for up to a quarter and a third of the heritability of later HI and IN, respectively. Genes underlying 1.5-year HI and 4-year IN contributed to 6 of 8 later HI and IN time-points and largely explained the corresponding phenotypic correlations. Results provide phenotypic and genetic evidence that preschool parent reports of HI and IN are valid means to predict developmental risk of ADHD.

Improving access to assessments of early motor development in local languages: polish adaptation of the Early Motor Questionnaire.

A child's motor development progresses very dynamically. It is crucial to develop freely available parent-report measures of motor development that can be easily used globally to measure motor skills and identify children in need of interventions. This paper presents the adaptation and validation of the Early Motor Questionnaire, which consists of gross motor (GM), fine motor (FM), and perception-action integration (PA) subscales, to the Polish language (EMQ-PL). Study 1 (online, cross-sectional, N = 640) assessed psychometric properties of the EMQ-PL and its value in identifying children referred to physiotherapy. Results reveal excellent psychometric properties of the EMQ-PL and differences in GM and total age-independent scores between children that were and were not referred for physiotherapy. Study 2 (in-person assessment, longitudinal, N = 100) showed high correlations of GM and total scores with Alberta Infant Motor Scale. CONCLUSION: Overall, the EMQ can be easily adapted to local languages and has the potential for use as a screening tool in global health contexts. WHAT IS KNOWN: • Parent-report questionnaires - especially those available free of charge - can potentially improve the rapid assessment of motor skills in young children worldwide. • Translation, adaptation and validation of freely available parent-report measures of motor development to local languages are important for local populations. WHAT IS NEW: • Early Motor Questionnaire can be easily adapted to local languages and has the potential for use as a screening tool in global health contexts. • The polish version of the Early Motor Questionnaire has excellent psychometric properties and highly correlates with infants' age and Alberta Infant Motor Scale scores.

Validity of low-cost measures for global surveillance of physical activity in pre-school children: The SUNRISE validation study.

OBJECTIVES: To validate parent-reported child habitual total physical activity against accelerometry and three existing step-count thresholds for classifying 3 h/day of total physical activity in pre-schoolers from 13 culturally and geographically diverse countries. DESIGN: Cross-sectional validation study. METHODS: We used data involving 3- and 4-year-olds from 13 middle- and high-income countries who participated in the SUNRISE study. We used Spearman's rank-order correlation, Bland-Altman plots, and Kappa statistics to validate parent-reported child habitual total physical activity against activPAL™-measured total physical activity over 3 days. Additionally, we used Receiver Operating Characteristic Area Under the Curve analysis to validate existing step-count thresholds (Gabel, Vale, and De Craemer) using step-counts derived from activPAL™. RESULTS: Of the 352 pre-schoolers, 49.1 % were girls. There was a very weak but significant positive correlation and slight agreement between parent-reported total physical activity and accelerometer-measured total physical activity (r: 0.140; p = 0.009; Kappa: 0.030). Parents overestimated their child's total physical activity compared to accelerometry (mean bias: 69 min/day; standard deviation: 126; 95 % limits of agreement: -179, 316). Of the three step-count thresholds tested, the De Craemer threshold of 11,500 steps/day provided excellent classification of meeting the total physical activity guideline as measured by accelerometry (area under the ROC curve: 0.945; 95 % confidence interval: 0.928, 0.961; sensitivity: 100.0 %; specificity: 88.9 %). CONCLUSIONS: Parent reports may have limited validity for assessing pre-schoolers' level of total physical activity. Step-counting is a promising alternative - low-cost global surveillance initiatives could potentially use pedometers for assessing compliance with the physical activity guideline in early childhood.

Psychometric Properties of the Farsi Version of Eyberg Child Behavior Inventory (F-ECBI) in Iranian Population.

Objective: Eyberg Child Behavior Inventory (ECBI) is one of the most frequently used tools for measuring behavioral problems; however, no research has been done to evaluate its psychometric properties in Iran. Method : The present study sought for exploring the factor structure and psychometric properties of the F-ECBI in an Iranian sample. A total of 495 mothers (mean age = 33.83 years; SD = 4.78) who reported behavioral problems in their children aged 3 to 12 years (mean age = 6.36 years; SD = 2.66) were selected via convenience sampling in 2018-2019. The psychometric properties of F-ECBI, including reliability (Cronbach's alpha) and validity (exploratory and confirmatory factor analysis, and convergent validity) were assessed using SPSS version 25 and LISREL 8.80. Results: By performing EFA on the first sample part (n = 360), the examination of scree plot supported a 3-factor or 4-factor solution, and pattern matrix resulted in a 3-factor structure. The factors were called as "behavioral problems related to oppositional defiant", "behavioral problems related to inattentive", and "behavioral problems related to conduct", according to their content and the research. CFA was performed on the second part of the sample (n = 135) to test the fitness of the 3-factor solution. According to CFI (0.91), NFI (0.91), NNFI (0.90), IFI (0.91), PNFI (0.77), GFI (0.75) AGFI (0.70), PGFI (0.62) and chi-square (540.31) indexes, the model had acceptable fitness. Cronbach's alpha was employed to measure the internal consistency and it revealed to be at a good to excellent level (behavioral problems related to oppositional defiant = 0.88; behavioral problems related to inattentive = 0.84; behavioral problems related to conduct = 0.74). The 3-factors subscales were associated with total difficulties, internalizing and externalizing SDQ, indicating the good convergent validity of F-ECBI. Conclusion: The F-ECBI has good psychometric properties in Iran and can be employed as a useful instrument for measuring children's behavioral problems.

Parent-Child Discrepancies in Perceived Parental Favoritism: Associations with Children's Internalizing and Externalizing Problems in Chinese Families.

Previous studies have found discrepancies between parent and child reports of parental favoritism. Some studies have also found that these discrepancies have unique effects on children's psychosocial adjustment. Nonetheless, much is still unknown about discrepancies between parent-reports and child-reports of parental favoritism and how they are associated with children's development. The current study examines discrepancies in multi-informant reports on parental favoritism in relation to children's internalizing and externalizing problems. The sample consisted of 556 mother-child dyads and 554 father-child dyads (46% boys, Mage = 12.52 years, SDage = 1.18). Polynomial regression analyses and response surface analyses were used to disentangle the effects of parent-child discrepancies in perceived parental favoritism. The results indicate that children reported higher parental favoritism than their parents. And the highest internalizing and externalizing problems occurred when both the mother and the child reported high maternal favoritism, and when both the father and the child report high paternal favoritism. Therefore, these findings partly support the assumptions based on the operations triad model. The findings also highlight the importance of the discrepancy between child- and parent-reports on parental favoritism in the development of children's internalizing and externalizing problems.

What do bilingual infants actually hear? Evaluating measures of language input to bilingual-learning 10-month-olds.

Examining how bilingual infants experience their dual language input is important for understanding bilingual language acquisition. To assess these language experiences, researchers typically conduct language interviews with caregivers. However, little is known about the reliability of these parent reports in describing how bilingual children actually experience dual language input. Here, we explored the quantitative nature of dual language input to bilingual infants. Furthermore, we described some of the heterogeneity of bilingual exposure in a sample of French-English bilingual families. Participants were 21 families with a 10-month-old infant residing in Montréal, Canada. First, we conducted language interviews with the caregivers. Then, each family completed three full-day recordings at home using the Language Environment Analysis recording system. Results showed that children's proportion exposure to each language was consistent across the two measurement approaches, indicating that parent reports are reliable for assessing a bilingual child's language experiences. Further exploratory analyses revealed three unique findings: (a) there can be considerable variability in the absolute amount of input among infants hearing the same proportion of input, (b) infants can hear different proportions of language input when considering infant-directed versus overheard speech, (c) proportion of language input can vary by day, depending on who is caring for the infant. We conclude that collecting naturalistic recordings is complementary to parent-report measures for assessing infant's language experiences and for establishing bilingual profiles.

Associations Between the Developmental Coordination Disorder Questionnaire - Brazilian Version (DCDQ-BR) and Motor Competence in School-Age Children.

Aim: Parental screening of children's motor skills can be helpful for early identification of Developmental Coordination Disorder (DCD). The present study examined the associations between the Developmental Coordination Disorder Questionnaire - Brazilian version (DCDQ-BR) and motor competence in school-age children.Methods: 707 children (332 boys, 375 girls) aged between 6- to 10-years and one of their parents participated in the study. Parents completed the DCDQ-BR and children's motor competence was determined using the Bruininks-Oseretsky Test of Motor Proficiency - 2nd edition (BOT-2).Results: The agreement between the BOT-2 and DCDQ-BR results was comparable across age, ranging from 74-84 percent. In general, there were low- to moderate correlations between all aspects of the parent report and children's motor competence. Sensitivity and specificity of the DCDQ-BR were 70% and 81%, respectively. Overall, boys had higher motor competence than girls, but parent reports were similar for gender.Conclusions: Parental assessment of their child's motor ability is moderately associated with motor competence, and this association is similar for boys and girls, even though boys scored higher in motor competence. Our findings suggest that it may be possible to reduce the length of clinical assessment by only testing children that flag as suspect for DCD in the DCDQ-BR.

Timely Interventions for Children with ADHD through Web-Based Monitoring Algorithms.

The aim of this study was to evaluate an automated trigger algorithm designed to detect potentially adverse events in children with Attention-Deficit/Hyperactivity Disorder (ADHD), who were monitored remotely between visits. We embedded a trigger algorithm derived from parent-reported ADHD rating scales within an electronic patient monitoring system. We categorized clinicians' alert resolution outcomes and compared Vanderbilt ADHD rating scale scores between patients who did or did not have triggered alerts. A total of 146 out of 1738 parent reports (8%) triggered alerts for 98 patients. One hundred and eleven alerts (76%) required immediate clinician review. Nurses successfully contacted parents for 68 (61%) of actionable alerts; 46% (31/68) led to a change in care plan prior to the next scheduled appointment. Compared to patients without alerts, patients with alerts demonstrated worsened ADHD severity (ß = 5.8, 95% CI: 3.5⁻8.1 [p < 0.001] within 90 days prior to an alert. The trigger algorithm facilitated timely changes in the care plan in between face-to-face visits.

Dutch Norms for the Eyberg Child Behavior Inventory: Comparisons with other Western Countries.

The Eyberg Child Behavior Inventory (ECBI) is one of the most widely used and well-validated parent rating scales for children's disruptive behavior. This screening instrument is a short, targetted and easy to implement inventory with good psychometric properties and is normed for different countries, among which the United States, Spain, Sweden and Norway. The ECBI has been successfully used for research and clinical purposes, in several countries including The Netherlands. To date, Dutch studies have relied on Scandinavian or US norm scores. However, this may be problematic because of cross-cultural differences in the degree to which certain behaviors are seen as problematic by parents. The main goal of this paper therefore was to obtain norm scores for The Netherlands among 6462 Dutch children aged 4 to 8 years (Mage = 6.37 years; SD = 1.32; 50.6% boys). In line with previous research, we found small differences on the mean sum scores across children of different ages (intensity scale) and gender (intensity and problem scale). Therefore, Dutch norm scores were provided age- and gender specific. Our results showed that disruptive behavior of children in the most rural areas was reported as occurring less frequently and was seen as less problematic by parents compared to the disruptive behavior of children in less rural areas. Finally, we found that Dutch norm scores on the ECBI were significantly lower than US norm scores, and significantly higher on the intensity scale (but not the problem scale) than Norwegian and Swedish norm scores.

Disturbed sleep and activity in toddlers with early signs of attention deficit hyperactivity disorder (ADHD).

This study investigated whether early signs of attention deficit hyperactivity disorder (ADHD) in toddlers aged 2-3 years are associated with disturbed sleep and activity levels. Participants were recruited from the Odense Child Cohort, and children scoring above the 93rd percentile on the ADHD scale of the Child Behaviour Checklist 1½-5 were categorised as cases and compared with age- and gender-matched normal-scoring controls. Daytime and nocturnal activity for 24 children with ADHD traits (cases) and 25 healthy controls was assessed through 7 days of actigraphy, and parents completed the Children's Sleep Habits Questionnaire (CSHQ) and the ADHD Rating Scale IV Preschool Version (ADHD-RS). Cases differed significantly on actigraphic parameters by having fewer minutes of moderate-to-vigorous physical activity (MVPA), prolonged total sleep time, fewer sleep interruptions, and increased night-to-night variability. A significant association was found between fewer minutes of MVPA and higher parent-reported motor activity on the ADHD-RS. Furthermore, increased night-to-night variability was significantly associated with higher total scores on both CSHQ and ADHD-RS. The findings show that early signs of ADHD are associated with an irregular sleep pattern and lower daytime activity, as illustrated by actigraphy. Studies investigating early ADHD risk factors could lead to a preschool ADHD risk index to help guide future early intervention.

The association of mothers' and fathers' insomnia symptoms with school-aged children's sleep assessed by parent report and in-home sleep-electroencephalography.

OBJECTIVE: Sleep plays an essential role for children's well-being. Because children's sleep is associated with parental sleep patterns, it must be considered in the family context. As a first aim of the present study, we test whether parental insomnia symptoms are related to children's in-home sleep-electroencephalography (EEG). Second, we examine the association between parental insomnia symptoms and maternal and paternal perception of children's sleep using actor-partner interdependence models. METHODS: A total of 191 healthy children enrolled in public school and aged 7-12 years took part in the study. Ninety-six were formerly very preterm born children. Children underwent in-home sleep-EEG, and parents reported children's sleep-related behavior by using the German version of the Children's Sleep Habits Questionnaire. Further, parents completed the Insomnia Severity Index to report their own insomnia symptoms. RESULTS: Maternal but not paternal insomnia symptoms were related to less children's EEG-derived total sleep time, more stage 2 sleep, less slow wave sleep, later sleep onset time, and later awakening time. Mothers' and fathers' own insomnia symptoms were related to their reports of children's bedtime resistance, sleep duration, sleep anxiety, night wakings, and/or daytime sleepiness. Moreover, maternal insomnia symptoms were associated with paternal reports of children's bedtime resistance, sleep anxiety, and sleep-disordered breathing. The associations between parental insomnia symptoms and parents' perception of children's sleep could not be explained by children's objectively measured sleep. CONCLUSIONS: Mothers' insomnia symptoms and children's objective sleep patterns are associated. Moreover, the parents' own insomnia symptoms might bias their perception of children's sleep-related behavior problems.

Parent-Adolescent Discrepancies Regarding Adolescents' Peer-Related Loneliness: Associations with Adolescent Adjustment.

Because loneliness is a subjective experience, it is often examined using self-reports. Yet, researchers have started to use other-reports to examine loneliness. As previous research suggests that discrepancies between self- and other views might have important implications for adolescents' mental health, the current study examines discrepancies in multi-informant reports on adolescents' loneliness in relation with prosocial behavior, aggression, and adolescents' parent-related loneliness. The sample consisted of 374 mother-adolescent dyads and 318 father-adolescent dyads (41.80% male, M age = 15.67 years, SD = 1.25). Results indicated that informants used different reference points to assess adolescents' peer-related loneliness, but were otherwise comparable. Moreover, informant discrepancies were associated with greater adolescents' reported parent-related loneliness. The current study did not provide evidence that discrepancies were related to prosocial or aggressive behavior. The current study adds to the notion that other-reports on loneliness show substantial convergence with self-reports. In addition, this study indicates that the discrepancy between other- and self-reports on loneliness holds valuable information for adolescent socio-emotional adjustment.

Parent and Child Reporting of Corporal Punishment: New Evidence from the Fragile Families and Child Wellbeing Study.

This paper provides new evidence on parent and child reporting of corporal punishment, drawing on data from the Fragile Families and Child Wellbeing Study, a birth cohort study of families in 20 medium to large US cities. In separate interviews, 9 year olds and their mothers (N=1,180 families) were asked about the frequency of corporal punishment in the past year. Mothers and children were asked questions with slightly different response categorize which are harmonized in our analysis. Overall, children reported more high frequency corporal punishment (spanking or other physical punishment more than 10 times per year) than their mothers did; this discrepancy was seen in both African-American and Hispanic families (but not White families), and was evident for both boys and girls. These results suggest that reporting of frequency of corporal punishment is sensitive to the identity of the reporter and that in particular child reports may reveal more high frequency punishment than maternal reports do. However, predictors of high frequency punishment were similar regardless of reporter identity; in both cases, risk of high frequency punishment was higher when the child was African-American or had high previous levels of behavior problems.