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OBJECTIVE: Naturalistic developmental behavioral interventions for children with autism spectrum disorder show evidence for effectiveness for specific social communication targets such as joint attention or engagement. However, combining evidence from different studies and comparing intervention effects across those studies have not been feasible due to lack of a standardized outcome measure of broader social communication skills that can be applied uniformly across trials. This investigation examined the usefulness of the Brief Observation of Social Communication Change (BOSCC) as a common outcome measure of general social communication skills based on secondary analyses of data obtained from previously conducted randomized controlled trials of 3 intervention models, Early Social Intervention (ESI), Early Start Denver Model (ESDM) and Joint Attention Symbolic Play Engagement and Regulation (JASPER). METHOD: The subset of datasets from the 3 randomized controlled trials was created to examine differences in the BOSCC scores between intervention and control groups over the course of the interventions. RESULTS: Based on 582 videos from 207 caregiver-child dyads, the BOSCC noted significant differences between intervention vs control groups in broad social communication skills within 2 of the 3 intervention models, which were longer in duration and focused on a broad range of developmental skills. CONCLUSION: The BOSCC offers the potential to take a uniform measurement approach across different intervention models to capture the effect of intervention on general social communication skills but may not pick up the effects of some brief interventions targeting proximal outcomes. CLINICAL TRIAL REGISTRATION INFORMATION: Comparing Parent-Implemented Interventions for Toddlers With Autism Spectrum Disorders; https://www. CLINICALTRIALS: gov/; NCT00760812. Intensive Intervention for Toddlers With Autism (EARLY STEPS); https://www. CLINICALTRIALS: gov/; NCT00698997. Social and Communication Outcomes for Young Children With Autism; https://www. CLINICALTRIALS: gov/; NCT00953095.
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BACKGROUND: Naturalistic Developmental Behavioral Interventions (NDBIs) for young children with autism spectrum disorder commonly involve caregiver-mediated approaches. However, to date, there is limited research on how caregivers' skills change, and, in turn, impact child outcomes. METHODS: We evaluated the NDBI strategy use of 191 caregivers prior to participation in NDBIs (or control groups) across multiple randomized controlled trials, using the Measure of NDBI Strategy Implementation, Caregiver Change (MONSI-CC). Clustering analyses were used to examine caregiver variability in NDBI strategy use at intervention entry. Generalized Linear Mixed Models were used to examine changes in caregiver strategy use over the course of intervention and its impact on changes in children's social communication. RESULTS: Using clustering analysis, we found that caregivers' baseline skills fit four profiles: limited, emerging, variable, and consistent/high, with few demographic factors distinguishing these groups. Caregivers starting with limited or emerging skills improved in their strategy use with intervention. Caregivers starting with more skills (consistent/high or variable) maintained higher skills over intervention. Children of caregivers in these groups who received target NDBIs improved in their social communication skills. CONCLUSIONS: Results suggested that caregiver skills improve through participation in NDBIs and may directly contribute to their children's outcomes, although more research on mediating factors is needed. Individualized approaches for caregivers and their children starting with differing skill profiles at intervention entry may be warranted.
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OBJECTIVE: This study examined emotion socialization and neural activity during frustration as predictors of emotion regulation (ER) difficulties, and the interplay of emotion socialization and neural activity, in children with and without hyperactivity/impulsivity (H/I). METHOD: At Time 1, neural activity (P1, N2, P3) during a frustration task, H/I symptoms, and emotion socialization were assessed in 68 children (aged 4-7 years old). At Time 2 (1.5-2 years later), child-report, maternal-report, and observation measures of ER difficulties were assessed. RESULTS: H/I symptoms moderated the relation between predictors and ER difficulties; there were significant relations for children with high, but not low, levels of H/I. Further, as emotion socialization quality increased, relations between event-related potentials and later ER difficulties became weaker. CONCLUSION: The processes underlying ER difficulties differ for children with H/I symptoms. High quality emotion socialization may have a protective effect for children whose neural patterns indicate risk for later ER difficulties.
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Trastorno por Déficit de Atención con Hiperactividad , Regulación Emocional , Trastorno por Déficit de Atención con Hiperactividad/psicología , Niño , Preescolar , Emociones/fisiología , Humanos , Conducta Impulsiva , SocializaciónRESUMEN
OBJECTIVE: ADHD and ODD are commonly co-occurring, but often studied individually. This study evaluated common trajectories of these disorders and explored how they co-develop in early childhood. METHOD: Community parents (N = 273) completed online surveys about their 2-year-old. Children's inattention, hyperactivity/impulsivity, and oppositional defiant disorder symptoms over 2 years were examined using latent class, dual trajectory, and cross-lagged analyses. RESULTS: Most children followed low symptom trajectories. A small portion showed high, moderate, or increasing trajectories. The hyperactive/impulsive domain of ADHD showed a declining symptoms group. Children in high ODD groups were likely to be in high ADHD symptom groups; the converse was true but probabilities were lower. Hyperactive/impulsive symptoms predicted ODD symptoms across time, more than vice versa. CONCLUSION: The study extends the small body of literature assessing early development of ADHD and ODD. Findings suggest that earlier intervention for symptoms of ADHD may mitigate risk of developing ODD.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Déficit de la Atención y Trastornos de Conducta Disruptiva/diagnóstico , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Preescolar , Cognición , Humanos , Conducta Impulsiva , PadresRESUMEN
Background: Mind-wandering has been linked to negative affect and depressive symptoms in adolescents. However, mind-wandering is an extremely broad and heterogenous cognitive construct. Some features of spontaneous thought may be related to increased negative affect, whereas others may improve affect, or have no emotional influence. We used ecological momentary assessment (EMA) to investigate the characteristics of spontaneous thoughts in adolescents and their differential relations with moment-to-moment affect. Method: One-hundred and sixteen adolescents (ages 13-18; Typical Mood (TM) = 58; Low Mood (LM) = 58) completed 5 days (2-3 times/day) of EMA (total 1,037 surveys) assessing current positive and negative affect (PA and NA) and dimensions of spontaneous thought. Multilevel models tested the relation between thought characteristics and affect. Results: Relative to the TM group, LM adolescents had a higher frequency of mind-wandering (38% vs. 56%) and negatively-valanced thoughts during episodes of mind-wandering (21% vs. 37%). Negatively-valenced, self-referential and past-oriented thoughts were each associated with higher NA, even when controlling for plausible confounds (e.g., engagement in an unpleasant activity or social interaction, depressive symptom severity). In contrast, task-focused and positively-valenced thoughts were uniquely linked to higher PA. Conclusion: Characteristics of spontaneous thought - including temporal orientation, self-referential quality, and task-relatedness - were differentially related to NA vs. PA in adolescents. If replicated, these findings could inform more nuanced assessments of and targeted interventions for specific dimensions of mind-wandering contributing to high NA vs. blunted PA in teens.
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Sympathomimetic drugs comprise a broad category of substances including both illicit and prescribed drugs that have deleterious effects when ingested or abused. The clinical syndromes that result from overstimulation of the sympathetic nervous system by reuptake inhibition of biogenic amines, such as norepinephrine and dopamine, carry significant morbidity. Recognition and awareness of the appropriate supportive measures are required to mitigate life-threatening complications of multiple organ systems. The sympathomimetic toxidrome is recognized by a constellation of symptoms including agitation, hyperthermia, tachycardia, and hypertension, and the primary treatment involves supportive care, including the liberal use of benzodiazepines.
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Hipertensión , Preparaciones Farmacéuticas , Benzodiazepinas , Humanos , Hipertensión/tratamiento farmacológico , Simpatomiméticos/efectos adversosRESUMEN
Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that shares a high comorbidity with anxiety disorders. However, the early development of comorbid ADHD and anxiety symptoms is not well-understood. In this study, the bidirectional relation between ADHD and anxiety symptoms was examined by testing two models of the development of ADHD and anxiety comorbidity: an anxiety effects model, which posits that anxiety symptoms contribute to the development of ADHD symptoms, and an ADHD effects model, which posits that ADHD symptoms contribute to the development of anxiety symptoms. Within the ADHD effects model, parenting practices were tested as mediators of this relation. Participants included children who were 3 years old at baseline (n = 258) and their caregivers who reported on their children's ADHD and anxiety symptoms annually for 3 years. The bidirectional relation of parent-reported anxiety and ADHD symptoms was tested using a series of cross-lagged models. Results indicated that ADHD symptoms predicted later anxiety symptoms, but anxiety symptoms did not predict later ADHD symptoms. Parenting practices did not mediate the relation between ADHD and anxiety symptoms within the ADHD effects model. These findings suggest that ADHD-anxiety comorbidity may develop in part because early symptoms of ADHD contribute to the development of anxiety symptoms; future research should be conducted to elucidate the mechanisms of this relation.
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Trastorno por Déficit de Atención con Hiperactividad , Ansiedad/epidemiología , Trastornos de Ansiedad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Niño , Preescolar , Comorbilidad , HumanosRESUMEN
Objective: We examined behavioral and neural markers of emotion competence in young children as predictors of psychopathology, and as mediators of the relation between hyperactivity/impulsivity (H/I) and psychopathology. Method: At Time 1 (T1), children (n = 49; ages 4-7 years) with and without H/I symptoms completed a frustration task. Frustration, observed emotion, and neural activity (P1, N2, and P3 event-related potentials) were measured. Symptoms of psychopathology were collected 18 months later (Time 2; T2). Results: T1 lability, negative affect, and frustration predicted T2 depression and aggression symptomatology, controlling for T1 symptoms. Children with difficulty allocating neural resources during and after frustration were at risk for depression, aggression, and anxiety symptoms, controlling for earlier symptoms. P3 amplitudes during recovery mediated the relation between H/I and later depression. Conclusion: Markers of emotion competence contribute to psychopathology symptoms, particularly in children at risk for attention-deficit/hyperactivity disorder (ADHD). Emotion competence skills may be useful intervention targets.
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Trastorno por Déficit de Atención con Hiperactividad , Ansiedad , Niño , Preescolar , Emociones , Humanos , Conducta Impulsiva , PsicopatologíaRESUMEN
The current study examined whether a variety of dimensions of executive function predicted trajectories of emotion dysregulation among preschool children with behavior problems. This study focused on 199 3-year-old children with parent-reported behavior problems who took part in a larger longitudinal study. Results revealed that response inhibition and working memory were not predictive of later emotion dysregulation. Gender differences emerged for delay aversion and attentional control. Boys who performed better on delay aversion tasks exhibited lower emotion dysregulation related to threat 2 years later, whereas girls who performed better on delay aversion tasks exhibited higher threat-related emotion dysregulation 2 years later. Better performance on a visual attention task significantly predicted decreasing threat-related emotion dysregulation slopes for boys but not for girls. Finally, girls who made more omission errors on a continuous performance task exhibited higher emotion dysregulation related to frustrative-nonreward 2 years later. Results suggest that specific facets of executive function may play an important role in difficulties with emotion dysregulation during the preschool years and that this pattern may differ across boys and girls.
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Regulación Emocional , Función Ejecutiva , Problema de Conducta/psicología , Atención , Preescolar , Emociones , Femenino , Humanos , Estudios Longitudinales , Masculino , Memoria a Corto Plazo , Pruebas Neuropsicológicas , Padres , Factores SexualesRESUMEN
The purpose of this study is to examine the psychometric properties of the 18 Diagnostic and Statistical Manual of Mental Disorders (DSM) symptoms of attention deficit/hyperactivity disorder (ADHD) in 2-year-old children. ADHD is typically diagnosed in elementary school, but research suggests that many children with ADHD first show symptoms during the toddler years. An important first step in identifying toddlers who are at high risk for developing ADHD is to better understand the properties of DSM symptoms of ADHD in young children. Parents of 2-year-old children (N = 434; 240 boys, 194 girls; M = 29.07 months, SD = 3.42) across the United States were recruited online through Amazon's Mechanical Turk to complete surveys about their children's ADHD symptoms and temperament. Confirmatory factor analysis showed that 2- and 3-factor models fit well. All but one verbal hyperactive/impulsive symptom loaded highly on their respective factors. Relations between ADHD symptoms and temperament traits provided some support for convergent and divergent validity of the symptoms. Finally, item response theory analyses showed that items showed moderate to high levels of discrimination between toddlers with high and low levels of ADHD symptoms. Psychometric properties in 2-year-old children were generally comparable to those in older children, with similar factor structure, good reliability and validity, and good though somewhat lower discrimination, particularly for verbal symptoms. The study provides support for conducting prospective studies to determine whether these symptoms have utility for identifying at-risk toddlers.
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Trastorno por Déficit de Atención con Hiperactividad/psicología , Psicometría/métodos , Anciano , Preescolar , Análisis Factorial , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
Perceived social support (PSS) has been related to physical and mental well-being in typically developing individuals, but systematic characterizations of PSS in autism spectrum disorder (ASD) are limited. We compared self-report ratings of the multidimensional scale of PSS (MSPSS) among age- and IQ-matched groups of adults (18-58 years) with cognitively high-functioning ASD (N = 41), or attention-deficit/hyperactivity disorder (ADHD; N = 69), and neurotypical controls (NC; N = 69). Accompanying group comparisons, we used machine learning random forest (RF) analyses to explore predictors among a range of psychopathological and socio-emotional variables. Relative to both ADHD and NC, adults with ASD showed lower MSPSS ratings, specifically for the friends subscale (MSPSS-f). Across ASD and ADHD, interindividual differences in autism severity, affective empathy, symptoms of anxiety related to social interactions, hyperactivity/impulsivity, and somatization best predicted MSPSS-f. These relationships did not differ between clinical groups. While group comparisons demonstrated greater impairment in individuals with ASD, analyzing individuals' characteristics revealed cross-diagnoses similarities in regard to their MSPSS-f relationships. This is consistent with the Research Domain Criteria framework, supporting a trans-diagnostic approach as on the path toward "precision medicine." Autism Res 2017, 10: 866-877. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno del Espectro Autista/psicología , Apoyo Social , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York , Autoinforme , Adulto JovenRESUMEN
The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children's ADHD.