The assessment of preschool children with ESSENCE symptoms: concordance between parents, preschool teachers and child psychologists.

BACKGROUND: It is important to detect children with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) in order to implement early intervention and support for the child and family. Standardized instruments for assessment in different contexts of behaviour problems, engagement and psychosocial health obtain an objective picture of the preschool child's mental health. AIM: To explore and compare parents', preschool teachers' and child health care psychologists' assessment of behaviour, everyday function, engagement, social interaction and psychosocial health in children with ESSENCE symptoms. METHOD: Parents of 152 children (114 boys and 38 girls, 4.5 ± 1 years) with ESSENCE symptoms, 155 preschool teachers and 8 child psychologists participated. Parents and preschool teachers assessed externalizing and internalizing behavioural problems using the Strengths and Difficulties Questionnaire (SDQ), including the SDQ supplement for assessing the impact of behavioral problems on daily function. Preschool teachers also assessed engagement and social interaction using the Children's Engagement Questionnaire (CEQ), and the child psychologists assessed psychosocial health with the Child Psychosocial Health Assessment (LillaLAPS) and template in conversations with parents of children with neurodevelopmental problems. RESULTS: Parents', preschool teachers' and child psychologists' assessment of the child's ESSENCE symptoms overall agreed. Both parents and preschool teachers see a strength in the child's social abilities. Differences in mean values show that parents assess more conduct, emotional symptoms and problems in daily life and more social skills, compared to the preschool teachers rating more peer problems. CONCLUSION: It is important to consider different contexts to identify the child's need for support in everyday life. Expanded use of validated screening instruments in clinical practice would promote detection of children not already identified as exhibiting neurodevelopmental problems.

The Premise, Promise, and Challenges of Intensive Assessment and Dynamic Quantitative Methods for Child and Adolescent Externalizing Problems.

This commentary discusses how papers from the Special Issue fill important gaps in the measurement and quantification of dynamic processes of child behaviors and parent-child interactions linked to child externalizing symptoms. After highlighting some of the innovative qualities of selected papers, challenges and future directions for the development of intensive measurement and dynamic quantitative methods are described. These topics follow from a developmental psychopathology framework that emphasizes measurement using both micro and macro methods, longitudinal research designs, and the recruitment of children that demonstrate clinically meaningful levels of externalizing problem behavior.

Revisiting implications of early family economic conditions for adolescent adaptations: An integrative cascade model.

Implications of family economic conditions (FECs) for child development have been extensively examined. What remains sparse is research spanning multiple life stages to delineate the far-reaching influences of early FECs for child subsequent development in different domains and how various family stress and investment processes jointly account for such association. To address these gaps, using data from 929 families in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD Early Child Care Research Network, 2001, 2005), this study examined how family income-to-needs ratio (FITNR) when children were 1-36 months old was associated with child language skills, social competence, externalizing, and internalizing problems at 6th grade. Parental investment and maternal/paternal depressive symptoms and sensitivity when children were 54 months old and in 3rd grade were tested as potential mediators. Results indicated that early FITNR shaped child cognitive, social, and behavioral adaptation in early adolescence indirectly through parental investment, depressive symptoms, and sensitive parenting in the preschool period and middle childhood. Parental investment, depressive symptoms, and sensitive parenting played such mediating roles above and beyond each other. Parental investment primarily accounted for the association between early FITNR and child later language skills, whereas parental depressive symptoms and sensitive parenting uniquely explained the associations between early FITNR and child subsequent internalizing symptoms, externalizing problems, social competence, and language skills. Theoretical/practical implications of such findings were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

[The Relationship between Social and Family Structures and Behavioral Problems in Preschool Children]. / Der Zusammenhang von sozialen und familiären Strukturen mit Verhaltensauffälligkeiten bei Vorschulkindern.

BACKGROUND: Behavioral problems in children are indicators of compromised mental health. Their development is influenced by family and social factors, with limited understanding of interactions among family structure, educational status, migration background, and parental employment concerning behavioral problems. These associations were investigated in children between 5-6 years of age. METHODS: Data (n=15,271) were collected between 09/2018 and 08/2019 in the federal state of Schleswig-Holstein as part of school entry examinations. Children's behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Statistical analyses included descriptive assessments and the calculation of a bivariate logistic regression model, with SDQ's outcomes "problematic" and "non-problematic" as dependent variables, and social and family factors as independent variables (gender, family structure, number of siblings, language proficiency, migration background, parental education level, parental employment, and sports participation in a sports club). RESULTS: Logistic regression analyses revealed that children living with single parents had a 2.1-fold (odds ratio; OR) higher likelihood [95% confidence interval (CI): 1.7-2.6] of displaying behavioral problems compared to children living with both biological parents. Only children had a 1.4-fold higher likelihood [95% CI: 1.2-1.8] compared to children with one or two siblings. Children with a unilateral migration background exhibited a lower likelihood of behavioral problems [OR: 0.58; 95% CI: 0.38-0.87] than children without a migration background. Children from families with low educational attainment had a 3-fold higher likelihood of behavioral problems [95% CI: 2.3-3.8] compared to those from high educational attainment families. When both parents (or the single parent) were employed at least part-time, there was a lower likelihood of behavioral problems [OR: 0.58; 95% CI: 0.47-0.71] in the child compared to situations where at least one parent was unemployed. CONCLUSIONS: This study identified sociodemographic factors associated with manifestation of behavioral problems. Particularly, single parents, families with lower educational levels and families with at least one unemployed parent should be targeted for intervention.

The Indivisibility of Parental and Child Mental Health and Why Poverty Matters.

PURPOSE: To ascertain to what extent parental and children's mental health wellbeing are inter-related over time. METHODS: We used a birth cohort study of 5,217 children in Scotland followed up from birth to adolescence. We fitted a Random Intercept Cross-lagged Panel Model for parental mental health and children's conduct problems and emotional symptoms. We included longitudinal patterns of poverty as the main covariate and some demographic control variables. RESULTS: The effects of parental mental health and child conduct problems and emotional symptoms on one another are roughly equal in early childhood. At younger ages, parents with poorer mental health tend to negatively affect their children's conduct and the conduct problems of a child seem to impact negatively on their parents' mental health. At older ages, it is children's emotional symptoms, but not conduct problems, that tend to have a reciprocal effect on parental mental health. Regarding structural inequalities, the effect of poverty on parents' and children's mental health is categorically the largest and continues to accrue throughout the whole period, intensifying mental health problems for both parents and children over time. DISCUSSION: Children's and parents' wellbeing is a bidirectional process. This interdependency needs to be acknowledged and addressed in policy. To foster children's wellbeing, we also need to foster parents' wellbeing. Furthermore, all interventions that address mental health and wellbeing in parents and children and that do not also tackle structural inequalities, such as poverty, will have limited success.

Commentary: Best practices and processes for assessment of autism spectrum disorder - the intended role of standardized diagnostic instruments.

Development of standardized diagnostic instruments has facilitated the systematic characterization of individuals with autism spectrum disorders (ASD) in clinical and research settings. However, overemphasis on scores from specific instruments has significantly detracted from the original purpose of these tools. Rather than provide a definitive "answer," or even a confirmation of diagnosis, standardized diagnostic instruments were designed to aid clinicians in the process of gathering information about social communication, play, and repetitive and sensory behaviors relevant to diagnosis and treatment planning. Importantly, many autism diagnostic instruments are not validated for certain patient populations, including those with severe vision, hearing, motor, and/or cognitive impairments, and they cannot be administered via a translator. In addition, certain circumstances, such as the need to wear personal protective equipment (PPE), or behavioral factors (e.g., selective mutism) may interfere with standardized administration or scoring procedures, rendering scores invalid. Thus, understanding the uses and limitations of specific tools within specific clinical or research populations, as well as similarities or differences between these populations and the instrument validation samples, is paramount. Accordingly, payers and other systems must not mandate the use of specific tools in cases when their use would be inappropriate. To ensure equitable access to appropriate assessment and treatment services, it is imperative that diagnosticians be trained in best practice methods for the assessment of autism, including if, how, and when to appropriately employ standardized diagnostic instruments.

Propiedades Psicométricas de la Escala de Evaluación Socioemocional Breve de Infantes y Niños (BITSEA) en una muestra de niños y niñas chilenos / Psychometric properties of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) in a sample of Chilean children

Introducción: La infancia temprana es una etapa crítica para la salud mental, por lo que es fundamental contar con herramientas eficaces para detectar tempranamente conductas infantiles relacionadas con psicopatología. Objetivo: Investigar las propiedades psicométricas de la Escala de Evaluación Socioemocional Breve de Infantes y Niños (BITSEA) en una muestra de infantes chilenos. Método: 289 padres de niños y niñas de entre 12 y 36 meses de edad completaron la BITSEA y el CBCL 1½-5. Resultados: Se encontró una confiabilidad aceptable para las puntuaciones de la subescala "problema socioemocional" (ω=0.84), y una confiabilidad baja para las puntuaciones de la subescala "competencia socioemocional" (ω=0.59). La estructura factorial fue adecuada y se observó una alta validez concurrente con otras escalas. El modelo confirmatorio mostró índices aceptables (CFI= 0.94; TLI= 0.94; SRMR= 0.07; RMSEA= 0.027). Conclusión: La BITSEA en esta muestra arrojó resultados similares a otros estudios, su aplicabilidad es prometedora para la detección temprana de problema socioemocional en la infancia temprana. Se sugiere continuar su estudio en muestra nacional representativa.

Introduction: Early childhood is a critical stage for mental health, and it is necessary to have effective tools for early detection of child behaviours related to psychopathology. Objective: to assess the psychometric properties of the Brief Infant and Toddler Social-Emotional Evaluation Scale (BITSEA) in a sample of Chilean children. Methods: 289 parents of infants and toddlers aged 12-36 months completed the BITSEA and the CBCL 1½-5. Results: Acceptable reliability was found for the "socioemotional problems" dimension (ω=0.84), and low reliability for the "socioemotional competence" subscale scores (ω=0.59). The factor structure was adequate and high concurrent validity with other scales was observed. The confirmatory model showed acceptable fit indices (CFI= 0.94; TLI= 0.94; SRMR= 0.07; RMSEA= 0.027). Conclusion: The BITSEA in this sample showed similar results to other studies, its applicability is promising for the early detection of socioemotional problems in early childhood. It is suggested to continue its study in a nationally representative sample.

Psychometric Assessment of the Eyberg Child Behavior Inventory in Children with Autism in Community Settings.

The Eyberg Child Behavior Inventory (ECBI) is a frequently used measure to assess interfering behaviors in children and psychometric properties have recently been examined in children with autism spectrum disorder (ASD). There is a need to confirm the identified factors and examine the factor structure in a racially/ethnically diverse, community-based sample. The current study conducts a psychometric analysis of the ECBI in a sample of children with ASD receiving publicly-funded mental health services. Data were collected from 201 children with ASD ages 5-13 years (60% Hispanic/Latinx) participating in a community effectiveness trial. Confirmatory factor analysis indicated poor model fit using previously identified factors and a new four-factor solution was identified. Clinical and research implications of these findings are discussed.

The Development of Young Peoples' Internalising and Externalising Difficulties Over the First Three-Years in the Public Care System.

Although we know there are high rates of mental health difficulties amongst young people in out-of-home care (i.e. social welfare-involved children), there is limited evidence on the longitudinal development of these problems, particularly from when they enter the care system. Using the routinely collected carer-reported strengths and difficulties questionnaire, we explored internalising (emotional and peer) and externalising (conduct and hyperactivity) difficulties for 672 young people across their first 3 years in the UK care system (2-16 yrs, 51% boys, 76% Caucasian). In all cases stable profiles (resilient or chronic) were most common, while changing profiles (recovery or delayed) were less common. Findings showed that entry into the care system is not enough of an intervention to expect natural recovery from mental health difficulties. Number of placements and being separated from siblings were associated with greater difficulties. Implications for child welfare and mental health systems are discussed.

Dimensional Assessment of Restricted and Repetitive Behaviors: Development and Preliminary Validation of a New Measure.

OBJECTIVE: This study aimed to provide initial validation of the Dimensional Assessment of Restricted and Repetitive Behaviors (DARB), a new parent-report measure designed to capture the full range of key restricted and repetitive behaviors (RRB) subdomains. METHOD: Parents of 1,892 children and adolescents with autism spectrum disorder (mean [SD] age = 10.81 [4.14] years) recruited from the SPARK (Simons Foundation Powering Autism Research for Knowledge) research match completed the DARB, several existing RRB instruments, and measures of social and communication impairments and anxiety. A subsample of 450 parents completed the DARB after 2 weeks to evaluate the test-retest stability. RESULTS: Exploratory graph analysis conducted in the exploratory subsample identified 8 dimensions that were aligned with hypothesized RRB subdomains: repetitive sensory motor behaviors, insistence on sameness, restricted interests, unusual interests, sensory sensitivity, self-injurious behaviors, obsessions and compulsive behaviors, and repetitive language. The confirmatory application of the exploratory structural equation modeling conducted in the confirmatory subsample showed that the derived factor structure had a good fit to the data. Derived factors had excellent reliability, convergent and divergent validity, and very strong test-retest stability and showed a distinct pattern of associations with key demographic, cognitive and clinical correlates. CONCLUSION: The DARB will be useful in a variety of research and clinical contexts considering the prominence and clinical impact of RRB in autism spectrum disorder. Strong preliminary evidence indicates that the new scale is comprehensive and captures a wide range of distinct RRB subdomains not simultaneously captured by any of the existing instruments.

Associations between error-related negativity and childhood anxiety risk differ based on socioeconomic status.

Children from lower socioeconomic status (SES) families are at increased risk for anxiety problems, though knowledge of the pathways by which SES predicts children's anxiety outcomes remains scant. Limited work suggests SES as a moderator of links between early development and anxiety outcomes but has not used a longitudinal framework or a multimethod approach. In this preregistered study, SES was tested as a simultaneous moderator of putatively biologically (error-related negativity [ERN]) and contextually (authoritarian parenting) based pathways of anxiety risk from ages 3 (Mage = 3.59), 4 (Mage = 4.57), and 5 (Mage = 5.52) [N = 121; 59% female]. Families were largely White and Non-Hispanic and reported a broad range of income (less than $15,000 to $90,001 or greater) from 2014 to 2017. We hypothesized that putatively biological pathways would be the strongest predictors of child outcomes at high SES and that putatively contextual pathways would be the strongest predictors of child outcomes at low SES. Consistent with expectations, smaller ERN across ages 3 and 4 was associated with greater anxious behaviors at age 5, but only at high SES. SES did not moderate parenting-based pathways of risk. Results are partially consistent with previous work suggesting that putatively biological pathways are more robust predictors of child outcomes at high SES than at low SES. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Socioeconomic and Racial/Ethnic Disparities in Recovery from Childhood Behavioral or Conduct Problems: Evidence from a Nationally Representative Sample of 3-17 Years Old US Children.

Our study provides nationally-generalizable evidence on the racial/ethnic and socioeconomic disparities in diagnosis and recovery from childhood behavioral or conduct problems. We pooled data from 4 years (2016-2019) of the National Survey of Children's Health (NSCH) for 3 to 17 years old US children (N = 114,476). We performed several logistic regression models using complex survey data analysis statistical methodologies to estimate nationally representative and generalizable results in the Stata MP 16 program. About 20.1% of 3-17 years old US children previously diagnosed with behavioral or conduct problems no longer had the current diagnosis (were recovered). Hispanic children [Odds ratio (OR) 0.77, 95% Confidence Interval (CI) 0.65-0-95], immigrant children or children of immigrant parents (first or second generation immigrant children), and children from high-income families [200-399% Federal Poverty Level (FPL)] were about 23%, 38%, and 21% less likely than non-Hispanic White children, children of US native parents, and children with a family income of below 100% FPL to be currently diagnosed with behavioral or conduct problems, respectively. Conversely, Non-Hispanic Black and Hispanic children were about 50% and 40% more likely than non-Hispanic White children to recover from a past diagnosis. Moreover, children from higher-income families (at or above 300% of FPL) were between 1.59 to 1.79 times more likely than those from low-income families (below 100% FPL) to recover from a past diagnosis. Racial/ethnic and socioeconomic disparities in diagnosing appear to persist in recovering from behavioral or conduct problems.

Percepções de familiares sobre uma rede de cuidados de saúde mental infantojuvenil / Family perceptions about a children's mental health network / Percepciones familiares sobre una red de atención de salud mental infantojuvenil

Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)

This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)

Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)

Parent reports of children's emotional and behavioral problems in a low- and middle- income country (LMIC): An epidemiological study of Nepali schoolchildren.

BACKGROUND: As epidemiological data on child mental health in low- and middle-income countries are limited, a large-scale survey was undertaken to estimate the prevalence and amount of child emotional and behavioral problems (EBP) in Nepal as reported by the parents. METHODS: 3820 schoolchildren aged 6-18 years were selected from 16 districts of the three geographical regions of Nepal, including rural, semi-urban and urban areas. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 years as screening instrument. Comparisons of child problems between genders and between the seven largest castes and ethnic groups were carried out by analysis of variance. Prevalence was computed based on American norms. RESULTS: Adjusted prevalence of Total Problems was 18.3% (boys: 19.1%; girls:17.6%). The prevalence of internalizing problems was higher than externalizing problems. The mean scores of Total, Externalizing, and Internalizing problems were 29.7 (SD 25.6), 7.7 (SD 8.0), and 9.1 (SD 8.1), respectively. The Khas Kaami (Dalit) group scored the highest, and the indigenous Tharu group scored the lowest on all scales. In the Mountains and Middle Hills regions, problem scores were higher in the rural areas, whereas in the Tarai region, they were higher in the urban areas. CONCLUSION: The prevalence and magnitude of emotional and behavioral problems in Nepali children were found to be high compared to findings in meta-analyses worldwide. Problem scores varied according to gender, castes /ethnic groups, and living areas. Our findings highlight the need for a stronger focus on child mental problems in a low-and middle-income country like Nepal.

Psychological impact of the SARS-CoV-2 pandemic in children with neurodevelopmental disorders and their families: evaluation before and during covid-19 outbreak among an Italian sample.

BACKGROUND: The SARS-CoV-2 pandemic forced parents and children to modify their habits with a radical change in the family routine and consequent increase in psychological stress. Children with a neurodevelopmental disorder (NDDs) are particularly vulnerable to new and unexpected situations; moreover, the parents of these children generally show high levels of psychological stress due to the greater commitment that this condition imposes on them. The aim of this study is to evaluate the disease status of NDDs children before and during SARS-CoV-2 pandemic and to evaluate the psychological effects related to measures of social distancing on these children and their families. MATERIALS AND METHODS: Seventy-one children with NDDs, were enrolled in this study and followed up at the Child Neuropsychiatry Unit of the University Hospital Consortium Corporation Polyclinic of Bari (Italy) along with their parents. Parents were evaluated before national lockdown (baseline) and recontacted during the SARS-CoV-2 emergency almost after a year. The changes in emotional/behavioral problems of children and parenting stress before and during the SARS-CoV-2 pandemic were assessed with Child Behaviour CheckList (CBCL) and Parent Stress Index - short form (PSI). RESULTS: The analysis of the emotional and behavioral problems of children with NDDs did not show statistically significant differences between the before and during the SARS-CoV-2 pandemic period. The evaluations conducted on parents highlights an increase in parental stress during the pandemic. Significant differences (p<0.05) were found in three subscales: Parenting Distress (PD) scale, Dysfunctional Interaction Parent-Child (P-CDI) scale and Defensive responding scale (DF). CONCLUSIONS: This study highlights the increase in parental stress and a more difficult parent-child interaction with NDDs in the period of lockdown due to the pandemic; identification of these risk targets can be useful for interventions in similar situations. Therefore, it is necessary to provide caregivers information to manage and overcome challenges experienced during a pandemic and providing psychological support for caregivers of children with NDDs.

[Differential Stability and Interrater-Dependencies in the Assessment of Psychopathological Symptoms: Longitudinal Analyses Based on the SDQ in Children with and without Specific Learning Disabilities]. / Differentielle Stabilität und Interrater-Dependenzen bei der Beurteilung psychischer Auffälligkeiten: Längsschnittliche Analysen mit dem SDQ bei Kindern mit und ohne Lernstörungen.

Differential Stability and Interrater-Dependencies in the Assessment of Psychopathological Symptoms: Longitudinal Analyses Based on the SDQ in Children with and without Specific Learning Disabilities A widely used open access instrument for screening of internalising and externalising problem behaviour is the Strengths and Difficulties Questionnaire (SDQ). For the use of the SDQ in clinical practice, information about its differential validity and applicability for follow-up assessments is relevant. Therefore, the aim was to study the SDQ regarding differential stability in the repeatedly collected child, parent and teacher reports. As the social context influences the perception of symptoms, we additionally explored the extent to which the child, parent and teacher reports influenced each other. Also, we studied differences in problem behaviour between children with and without specific learning disabilities and between girls and boys. To this end, 60 children from 5th and 6th grade with and without specific learning disabilities and their parents and teachers filled in the SDQ at three time points during secondary school. The results of the cross-lagged-panel-analyses showed substantial stability for almost all subscales. This shows that in their SDQ-reports, parents, children and teachers can separate the stable parts of problem behaviour from situational variations therein. Inter-rater dependencies between the different reports in the form of cross-delayed effects could be identified mainly from the adult to the child reports and clarify the caregiver's influence on the children's symptom perception. With respect to specific learning disabilities, the results showed differences only for the subscale related to hyperactivity: children with specific learning disabilities had more parent-reported, but less self-reported hyperactive symptoms than children without. Girls reported more emotional problems and boys more conduct problems and less prosocial behavior. Teacher and parents reported almost no differences between boys and girls. The results support the usefulness of the SDQ for repeated assessments in clinical practice.

Integrated Behavioral Health: Definitions and Contexts.

Most children and adolescents with behavioral and mental health concerns first present to their pediatricians. Although pediatricians are fully cognizant of the importance of addressing behavioral and mental health concerns, they often find it difficult to deliver such care effectively and efficiently within a typical practice setting. Integration of medical and behavioral health care has emerged as a model to deliver such care. In the pediatric primary care practice, integrated behavioral health has been shown to be a cost-effective way to deliver high-quality care. This article describes basic definitions and contexts of integrated pediatric behavioral health.

Physical health and emotional and behavioral problems in maltreated children according to family economic status: Health problems of maltreated children in Korea.

ABSTRACT: Low family income is a risk factor for child maltreatment. However, there has been no comparative study on the association between child maltreatment and family income. The objective of this study was to investigate the physical health and emotional and behavioral problems of maltreated children according to the economic status of their family.Cross-sectional nationwide studyData from 2012 to 2014 was extracted from the Korean National Child Abuse Registry (age <18 years) operated by the National Child Protection Agency (NCPA). Demographic characteristics and 34 physical health and emotional/behavioral problems of maltreated children were compared by family economic status. Family economic status was classified into 2 groups: families receiving the National Basic Livelihood Guarantee (NBLG) and those not receiving the guarantee (non-NBLG group).A total of 17,128 children were registered in the system. Mean age was 9.3 years (SD 4.8 years), 44.4% were females, and 29.2% were in the NBLG group. Poor hygiene, anxiety, and attention deficit were frequently reported physical and emotional health problems. Common behavioral problems included running away, rebelliousness/impulsivity/aggressiveness, maladjustment in school, learning problems at school, and frequent unauthorized absenteeism and truancy. Physical health problems (7 of 8 items) occurred more often in the NBLG group, and behavioral problems (6 of 17 items) occurred more often in the non-NBLG group.Children in Korea who are maltreated have different physical health, emotional, and behavioral problems depending on their family income level. These results can be useful in approaching the recognition of and interventions for child maltreatment.

A Saúde Coletiva e a Criança com Comportamentos Externalizantes: uma revisão de literatura / The Public Health and the Child Externalizing Behavior: a revision of literature

Resumo Os comportamentos externalizantes dizem de um conjunto de reações impulsivas que, exteriorizadas por crianças (ou adolescentes), produzem conflitos e, em padrão repetitivo e persistente, são associados a síndromes psicopatológicas e transtornos. Este artigo tem o objetivo de revisão de literatura sobre o tema, nos três eixos disciplinares da Saúde Coletiva. Segue o método de revisão sistemática, com enfoque empírico e formato narrativo, tomando a ciência como prática social e levantando aspectos qualitativos de literatura produzida entre 2009 e 2019. Os conhecimentos produzidos trazem recortes importantes sobre o tema, porém, o panorama alcançado revela um distanciamento discursivo entre os eixos da epidemiologia e das ciências sociais em saúde, aproximados precariamente no eixo da política, planejamento e gestão em saúde. Os modos de considerar a criança nas pesquisas se dão com o silenciamento infantil, priorizando percepções dos adultos sobre as crianças. Chega-se a considerações sobre a importância de uma efetiva interdisciplinaridade e de uma pedagogia da transdisciplinaridade capaz de transcender o lugar das especialidades e de reconhecer a criança, com a valorização das suas práticas e saberes, como ator central do conhecimento acerca de si mesma.

Abstract The externalizing behaviors refer to a set of impulsive reactions that exteriorized by children (or adolescents) produce conflicts and, in a repetitive and persistent pattern, are associated with psychopathological syndromes and disorders. This article has the objective of empirical review on the subject, in three disciplinary axes of Public Health. It follows the systematic review method, with an empirical focus and narrative format, taking science as social practice and raising qualitative aspects of literature produced between 2009 and 2019. The knowledge produced brings important cuts on the subject, however, the panorama reached reveals a discursive distance between the axes of epidemiology and of the social science, precariously approximated in the axis of health planning. The ways of considering the child in the research are with child silencing, prioritizing adults' perceptions about children. We come to considerations about the importance of effective interdisciplinarity and a pedagogy of transdisciplinarity capable of transcending the place of specialties and of recognizing the child, with the appreciation of his practices and knowledge, as the central actor of knowledge about himself.

[Burden of Children of Patients with Mental Illness - A High Risk Population that Needs Selective and Indicated Prevention?] / Belastung von Kindern psychisch erkrankter Eltern im Normgruppenvergleich ­ eine Hochrisikogruppe für selektive und indizierte Prävention?

OBJECTIVE: To determinate behavioral problems of children of parents with mental illness. Conclusions for prevention. METHODS: Inpatients from a psychiatric hospital (N = 399) with children (4-18 yrs.) evaluated their children's behavior with the Child Behavior Checklist (CBCL). RESULTS: Children of mentally ill parents showed significantly more behavioral problems than children of healthy parents. They had overall fewer behavioral problems compared to children with mental illness, however, behavioral problems were similar with respect to "social problems" (4-11 year-old boys, 12-18 year-old girls) and "somatic complaints" (12-18 year-old boys and girls). CONCLUSION: Results indicate a selective, partly indicated, need for prevention. The data point towards certain areas of behavioral problems that should be particularly targeted when planning such programs.