ProVIA-Kids - outcomes of an uncontrolled study on smartphone-based behaviour analysis for challenging behaviour in children with intellectual and developmental disabilities or autism spectrum disorder.

Introduction: Challenging behaviour (CB) is a common issue among children with autism spectrum disorder or intellectual and developmental disability. Mental health applications are low-threshold cost-effective tools to address the lack of resources for caregivers. This pre-post study evaluated the feasibility and preliminary effectiveness of the smartphone app ProVIA-Kids using algorithm-based behaviour analysis to identify causes of CB and provide individualized practical guidance to manage and prevent CB. Methods: A total of 18 caregivers (M = 38.9 ± 5.0) of children with a diagnosis of autism spectrum disorder (44%), intellectual and developmental disabilities (33%) or both (22%) aged 4-11 years (M = 7.6 ± 1.8) were included. Assessments were performed before and after an 8-week intervention period. The primary outcome was the change in parental stress. Caregiver stress experience due to CB was also rated daily via ecological momentary assessments within the app. Secondary outcomes included the intensity of the child's CB, dysfunctional parenting, feelings of parental competency as well as caregivers' mood (rated daily in the app) and feedback on the app collected via the Mobile Application Rating Scale. Results: We observed increases in parental stress in terms of conscious feelings of incompetence. However, we also saw improvements in parental stress experience due to CB and overreactive parenting, and descriptive improvements in CB intensity and caregiver mood. Discussion: ProVIA-Kids pioneers behaviour analysis in a digital and automated format, with participants reporting high acceptance. Pilot results highlight the potential of the ProVIA-Kids app to positively influence child behaviour and caregiver mental health over a longer intervention period. Registration: The study was registered at https://www.drks.de (ID = DRKS00029039) on May 31, 2022.

Nutritional and Culinary Habits to Empower Families (n-CHEF): a feasibility study to increase consumption and home cooking of plant-based foods.

OBJECTIVE: To analyse the feasibility and acceptability of a culinary nutritional intervention aimed at increasing plant-based foods consumption in the context of the Mediterranean diet in parent-child dyads. DESIGN: The Nutritional and Culinary Habits to Empower Families (n-CHEF) is a 9-month feasibility study that included four culinary nutritional workshops (two face to face, two online) led by a chef and a dietitian-nutritionist. These workshops combined cooking with plant-based foods, with nutritional advice and experimental activities. The main outcomes were retention, quality of the intervention (monitoring workshops, acceptability and perceived impact) and changes in dietary and cooking habits. SETTING: Parent-child dyads, Spain. PARTICIPANTS: Parent-child (aged 10-14 years) dyads. RESULTS: Fifteen parent-child dyads were recruited, of which thirteen were retained during the 6-month follow-up. All but one parent-child dyads attended the four workshops. The overall assessment of the workshops was positive, although the online workshops were rated lower than the face to face. In general, parent-child dyads reported benefits in terms of nutrition and cooking aspects. Parents significantly increased their adherence to the Mediterranean diet, but non-significant changes were observed in children. However, children increased their consumption of vegetables and legumes and reduced snacks and ready meals. Parents also changed some of their culinary habits and increased their confidence in cooking at home. CONCLUSIONS: The n-CHEF showed that the culinary nutritional intervention had good levels of recruitment, retention and acceptability among parent-child dyads. In addition, dietary and culinary knowledge and habits can be improved, although further studies are needed to know the long-term effects in larger populations.

Associations Among Family Strengths, Depression and Life Satisfaction Between Disabled Children and Their Parent Caregivers: An Actor-Partner Interdependence Mediation Model.

AIM: To explore the actor-partner effect and mediating role of depression on family strength and life satisfaction among children with disabilities and their parent-caregiver dyads. DESIGN: A cross-sectional study using secondary data collected from the 2020 (third) Korea Disability and Life Dynamics Panel. METHODS: This study included 434 Korean dyads of children with disabilities and their parent caregivers. A dyadic analysis was performed using the actor-partner interdependence mediation model. RESULTS: The findings showed significant indirect actor effects of family strength on life satisfaction through depression for children with disabilities and their parent caregivers. The direct partner effects of one's family strengths on a partner's life satisfaction were statistically significant only for children. Additionally, significant indirect partner effects were observed in the association between parents' family strengths and children's life satisfaction through their own and their children's depression. The findings indicated that the life satisfaction of children with disabilities was more likely to be affected by their parent caregivers' perceived family strengths and depression. CONCLUSION: It is significant for health professionals to acknowledge the mediating and cross-over pathways linking family strengths to life satisfaction through depression and, thus, focus on family-based strategies to enhance life satisfaction among children with disabilities and their parent caregivers. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study highlights the need for family-oriented mental health interventions and education to promote life satisfaction among children with disabilities and their parent caregivers. IMPACT: Basic data were provided for establishing efficient healthcare education and counselling protocols and integrated family intervention programmes that can contribute to improving life satisfaction through the reduction of depression by strengthening the family strengths of disabled children-parent caregivers dyads. In future, studies should explore dyadic interdependence among children with disabilities and their parent caregivers. REPORTING METHOD: STROBE guidelines were followed for this study. PATIENT OR PUBLIC CONTRIBUTION: No public or patient contribution was required for this study.

Longitudinal pathways between parent depression and child mental health in families of autistic children.

Autistic children and their parents are at risk for mental health problems, but the processes driving these connections are unknown. Leveraging three data cycles (spaced M = 11.76 months, SD = 2.77) on 162 families with autistic children (aged 6-13 years), the associations between parent-child relationship quality (warmth and criticism), child mental health problems, and parent depression symptoms were examined. A complete longitudinal mediation model was conducted using structural equation modeling. Father depression mediated the link between child mental health problems and father critical comments (ß = -0.017, p = 0.018; CI [-.023 - -.015]). Father report of child mental health problems mediated the association between father depression and father critical comments (ß = 0.016, p = 0.040; CI [0.003-0.023]) as well as the association between father positive remarks and father depression (ß = -0.009, p = 0.032; CI [-0.010 - -0.009]). Additionally, father positive remarks mediated the connection between father depression and child mental health problems (ß = 0.022, p = 0.006; CI [0.019-0.034]). No mediation effects were present for mothers. Findings highlight that the mental health of parents and autistic children are intertwined. Interventions that improve the parent-child relationship may reduce the reciprocal toll of parent and child mental health problems.

Parent-child border separation and the road to repair: addressing a global refugee phenomenon.

As a result of the Department of Homeland Security's zero-tolerance policy (ZTP), over 5,000 children were separated from their parents at the U.S. southern border from 2017-2021, with over 1,000 still lacking confirmed reunifications. Separations also occur daily due to immigration raids, chaotic processing, and changing immigration policies. This article addresses the most fundamental question faced by families enduring such separations; how to mend attachment bonds that have been suddenly severed, especially within a population likely already traumatized. The paper begins by updating readers about separation in the United States and offers a concise summary of the consequences of child-parent separation. The paper then introduces Child-Parent Psychotherapy (CPP) as an intervention for affected families. This paper also uniquely applies CPP to older children and provides three case examples of its use in treating separated families. Finally, the paper offers general suggestions for supporting these families.

An evaluation of delivery of the parent Preschool Life Skills program via telehealth.

Using telehealth technology to deliver parent training in evidence-based intervention has been suggested to increase the accessibility of such interventions and improve skill acquisition and generalization. Within behavior analysis, global restrictions in response to the COVID-19 pandemic highlighted the need for the development of telehealth supports for families. The current research examined the online delivery of a parent-mediated implementation of the Preschool Life Skills program (PLS). Four parents completed the parent PLS program with their typically developing children (aged 3-5 years) via weekly videoconferencing sessions. A multiple-probe experimental design was employed to assess the effect of the intervention on children's preschool life skills and challenging behavior. Parental embedding of PLS strategies during daily activities was also evaluated. The results demonstrated increases in children's preschool life skills, decreases in challenging behavior, and evidence of parent acquisition and use of PLS strategies.

It's Not Just What Parents Say, It's Why They Say It: Students' Perceptions of Parents' Motives for Alcohol Communication.

OBJECTIVE: Previous work has investigated parents' reports of motives for communicating with their young adults about alcohol. While parents' self-reported motives may predict intentions to communicate, young adults' perceptions of their parents' motives may be important for understanding young adults' responses to parent alcohol communication. The present study was conducted to explore college students' perceptions of their parents' motives for alcohol communication and to investigate whether perceptions of these motives predict changes in alcohol consumption and related consequences during the transition to college. METHOD: First-year college students (N = 306) participated in a longitudinal survey study. Baseline measures at pre-matriculation (T1) included assessments of student perceptions of their parents' motives for alcohol communication and covariates (e.g., perceived peer descriptive drinking norms, parental modeling and alcohol communication, and drinking and consequences). At a 1-month follow-up (T2), students reported on their alcohol use and consequences. RESULTS: Controlling for other predictors of college student drinking, results indicate that for each one-unit increase in perceived parental reactive communication motives, the incidence rate of typical weekly drinking increased by 9%, and heavy episodic drinking (HED) increased by 21%. Conversely, the incidence rate of HED decreased by 27% for each one-unit increase in perceived maternal family history communication motives. CONCLUSIONS: These findings suggest that college students' perceptions of their parents' motives for alcohol communication can significantly influence their drinking behavior during the transition to college.

Fears and Worries at Nighttime in Young Children: Development and Psychometric Validation of a Parent-Report Measure (FAWN-YC).

This paper outlines the development and psychometric evaluation of the Fears and Worries at Nighttime-Young Children (FAWN-YC) scale; a parent-rated measure for children aged 3-5 years. Based on previous literature, it was hypothesised that the measure would be represented by a six-factor solution, with four clusters of fear types and two behavioural manifestations of fears. Exploratory factor analysis (EFA; N = 436) and confirmatory factor analysis (CFA; N = 383), resulted in a final 17 items that loaded onto 3 factors: Nighttime Fear Focus (8 items, α = 0.92), Bedtime/Sleep Avoidance and Interference (5 items, α = 0.90), and Dark Fear (4 items, α = 0.88). Evidence of convergent validity was found through strong associations between the total score and subscales of the FAWN-YC with measures of child anxiety, fear, sleep, externalizing and conduct problems. Furthermore, there was support for divergent validity (through a very weak to no relationship with a measure of prosocial behaviours), and evidence for temporal stability was also established with 2-week test-retest reliability. Overall, the results provide strong preliminary evidence for the reliability and validity of the FAWN-YC total score and subscales. Implications for the use of the measure in research and clinical practice are discussed.

Lagged and simultaneous effects of exposure to violence at home on child-to-parent violence: gender differences.

Introduction: Numerous studies have found that exposure to violence at home is a risk factor for child-to-parent violence. However, most of the available studies do not delimit a time frame for exposure to violence. This aspect is fundamental to differentiating lagged effects (compensation) from simultaneous effects (reciprocal). The purpose of this study is to clarify the relationship between lagged (before the age of 10) and simultaneous (last year) exposure to violence at home (direct victimization: parent-to-child violence and vicarious victimization: exposure to violence between parents) and child-to-parent violence, the possible differential reactive or instrumental motivation of these relationships and whether they differ based on the gender of children and parents. Method: The sample comprised 1,734 Spanish adolescents who lived with both parents (57.3% girls), aged between 13 and 17 years. The instruments used were the Child-to-Parent Violence Questionnaire and the Violence Exposure Scale. Results: Positive and significant relationships were found between child-to-parent violence and exposure to violence at home both during childhood and during the last year; however, the relationships were stronger in the latter. The most important predictors were direct parental victimization during the last year. Boys exerted more reactive violence toward the father concerning exposure to violence by the father toward the mother during the last year. In the case of girls, violence toward both father and mother is more reactive to most victimization experiences. Conclusions: The findings highlight the need to intervene in family contexts of violence to prevent child-to-parent violence.

Parent-adolescent communication on sexual and reproductive health issues and associated factors among secondary public-school students in Gondar town, northwest Ethiopia: an institution based cross-sectional study.

Introduction: Effective communication between adolescents and their parents is crucial for reducing sexual health problems. This open dialogue can help address misconceptions, provide accurate information, and foster a supportive environment where adolescents feel comfortable seeking guidance and discussing sensitive issues related to their sexual health. In Ethiopia, with its diverse ethnic and cultural background, effective communication between parents and adolescents about sexual and reproductive health (SRH) is crucial in reducing the likelihood of adolescents engaging in risky sexual behaviors. Despite the importance of such communications, there were no data showing the level of parent-adolescent communication (PAC) in secondary public schools in Gondar town. Therefore, this study aimed to determine the level of parent-adolescent communication on sexual and reproductive health issues along with its influencing factors, among secondary students in Gondar town, northwest Ethiopia. Methods: We employed an institution-based cross-sectional study design. A total of 424 students were recruited using a systematic random sampling technique, with a 100% response rate. We developed a structured questionnaire from the related literature to collect data from the participants of the study. The data were entered using EpiData version 4.6, and analyzed using SPSS version 25. A binary logistic regression model was fitted to identify associated factors. Results: The proportion of adolescents who had communicated with their parents was 37.7% (95% CI: 34.65-44.76). In a multivariable analysis at a 95% confidence interval (CI), variables such as being female (adjusted odds ratio (AOR) = 2.23; 95% CI: 1.09-7.45), belonging to grades 11-12 (AOR = 1.25; 95% CI: 1.19-6.98), living with parents/caregivers (AOR = 1.26; 95% CI: 1.07-5.66), having a positive attitude toward sexual health (AOR = 2.4; 95% CI: 1.34-7.82), having poor knowledge about SRH issues (AOR = 1.23; 95% CI: 1.04-7.81), and having good knowledge about the puberty period (AOR=1.23; 95% CI:1.04-7.89) were statistically associated with parent-adolescent communication. Conclusion and recommendations: This study found a low level of communication between parents and adolescents regarding sexual and reproductive health (SRH) issues. To address this challenge, it is crucial to implement evidence-based education on SRH topics, such as consent, healthy relationships, communication skills, STDs, contraception, and interpersonal dynamics. Enhancing parent-adolescent dialogue on SRH can be achieved by implementing peer education among senior students and training teachers in effective communication techniques. The study also recommended conducting qualitative research to explore the specific barriers affecting parent-adolescent communication.

Linking Parent-Adolescent Congruence in Perceived Parental Emotional Support to Adolescent Developmental Outcomes: The More, the Better?

Parents and their children can have congruent or incongruent perceptions of parenting, which has been shown to have downstream effects on certain adolescent outcomes. However, little is known about whether such effect holds for various domains of developmental outcomes or across adolescent boys and girls. Investigating 2268 parent-girl (Mage = 15.73, SDage = 0.29, 75.5% were mothers) and 2090 parent-boy (Mage = 15.75, SDage = 0.29, 71.8% were mothers) dyads from Hong Kong, this study examined the associations between parent-adolescent (in)congruence and adolescent emotional symptoms, positive emotions, and academic performance. Polynomial regression and response surface analyses revealed that both congruence and incongruence were linked to emotional symptoms and positive emotions in varying patterns, but only congruence was tied to academic performance. Associations between (in)congruence and developmental outcomes generally were similar between boys and girls. These findings underscore the importance of decomposing (in)congruence effects in family processes and emphasizing the complexity of adolescent development.

Parental genetic knowledge and attitudes toward childhood with genetic disorders.

Introduction: Genetics' integration with society sparks a multifaceted exploration in medicine, ethics, and psychology. This survey probes parental perspectives on childhood genetic disorders, aiming to gauge their understanding, attitudes, and implications. It seeks to inform healthcare, counseling, and policy endeavors by uncovering gaps in knowledge and attitudes. Understanding the psychological impact and familial dynamics of genetic information underscores the need for tailored support services amidst rapid advancements in genetic technologies and their ethical complexities. Methodology: It is a cross-sectional survey that assesses parental genetic knowledge and attitudes towards childhood genetic disorders. Data is collected by both paper and electronic formats. Data is cleaned in Excel and analyzed in IBM SPSS 29. Results: Our study included 138 participants, predominantly female (71.7%), with mean age 36.01 years (SD = 8.7). Most were Saudi (81.2%), with university education (65.9%). Notably, 73.2% reported consanguineous marriages. Regarding knowledge, 73.2% demonstrated good understanding of genetic disorders of child. Moreover, 47.8% and 34.1% claimed 40%-60% and 34.1% knowledge levels, respectively. Doctors were the primary information source (79.7%). Participants expressed moderate impact of genetic disorders on their child's life (65.9%) and family dynamics (45.7%). Satisfaction with medical care was high (41.3% rated it as excellent). Challenges accessing healthcare were reported by 52.9%. Positive experiences with genetic disorders were reported by 62.3%, with male participants more likely to report positive experiences (B = 0.888, p = 0.041). Improvement areas included treatment availability (39.1%) and advanced medical tests (20.3%). Notably, informing relatives about the genetic disease significantly predicted positive attitudes (B = 1.006, p = 0.008). Overall, obtaining information from doctors significantly enhanced knowledge (B = 2.296, p = 0.024). Conclusion: Our study shows significant associations between parental knowledge, attitudes towards genetic disorders, and healthcare experiences. It underscores the importance of informed decision-making and targeted interventions to address challenges and improve outcomes in managing childhood genetic disorders.

Evaluating Emotional Eating in Children from the Perspective of Parents: Psychometric Properties of the Parent Version of the Emotional Eating Scale Adapted for Children and Adolescents.

BACKGROUND: Emotional eating is associated with adverse health outcomes in children, including elevated weight status. Currently, there is not a well-validated parent-report measure of emotional eating for young children. This study assessed the reliability and validity of the 10-item parent version of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Short-Form. METHODS: The participants were 207 parents and 144 children from the southern United States. They completed the parent- and child-report EES-C Short-Form and responded to measures related to child eating behaviors, mood, and gratitude. RESULTS: The parent-report EES-C Short-Form demonstrated good internal consistency reliability (Cronbach's alpha = 0.94). Test-retest reliability was also supported, as evidenced by a medium correlation (ICC = 0.56, p < 0.001) between parent-rated emotional eating across two time points. Additionally, the measure demonstrated a significant correlation with a scale of emotional overeating (r = 0.25, p < 0.001)-a theoretically related construct. Supporting discriminant validity, the measure was not significantly related to a measure of parent-reported gratitude (r = 0.07, p = 0.30). A unidimensional model provided good fit for the data (CFI = 0.997, SRMR = 0.046). CONCLUSIONS: The results from the current study provide preliminary evidence supporting the reliability and validity of the parent version of the EES-C Short-Form. For the purpose of screening children in school or primary care settings, the EES-C Short-Form may be practical and helpful in identifying children who may be at risk of developing adverse health outcomes or more-severe eating disorder pathology.

Parental Self-Efficacy and Personal Time Help Explain Impact of Parent-Staff Interactions on Parental Distress and Bonding in the NICU.

OBJECTIVES: To identify factors that help explain associations between parent-staff interactions and: (1) parental depression, anxiety, and posttraumatic stress; and (2) parent-child bonding in the neonatal intensive care unit (NICU). STUDY DESIGN: Our cross-sectional mixed methods survey investigated the ways in which parental-staff interactions relate to parental distress and parent-child bonding. Parents with babies in the NICU (N = 165) completed validated measures and open-ended questions about their experiences with staff. Using a sequential explanatory approach, we examined: (1) whether and how parental self-efficacy and personal time mediated parent-staff interactions on distress and bonding; and (2) parental written accounts of experiences with staff. RESULTS: Multiple mediation analyses revealed that parent-staff interactions exhibited an: (1) indirect effect on parental depression (b = -.05, SE = .02, CI [-.10, -.01]), anxiety (b = -.08, SE = .04, CI [-.16, -.02]), and parent-child bonding (b = -.26, SE = .08, CI [-.43, -.11]) through parental self-efficacy; and (2) indirect effect on parental posttraumatic stress (b = -.08, SE = .04, CI [-.17, -.00], CSIE= -.06) through parental personal time. Thematic analyses revealed that emotional and instructional support from staff helped build parental self-efficacy. Trust with staff helped parents feel comfortable leaving the bedside and engage in basic needs (eg, eat, sleep). CONCLUSIONS: Family-staff dynamics are the foundation for high quality family-centered care. Staff who empower parents to participate in care, engage in parenting tasks, and take care of themselves may reduce their distress and improve relationships among staff, parents, and babies.

Feasibility of At-Home Hand Arm Bimanual Intensive Training in Virtual Reality: Case Study.

This single-participant case study examines the feasibility of using custom virtual reality (VR) gaming software in the home environment for low-dose Hand Arm Bimanual Intensive Training (HABIT). A 10-year-old with right unilateral cerebral palsy participated in this trial. Fine and gross motor skills as well as personal goals for motor outcomes were assessed before and after the intervention using the Box and Blocks Test, Nine-Hole Peg Test, and Canadian Occupational Performance Measure. Movement intensities collected via the VR hardware accelerometers, VR game scores, and task accuracy were recorded via the HABIT-VR software as indices of motor performance. The child and family were instructed to use the HABIT-VR games twice daily for 30 minutes over a 14-day period and asked to record when they used the system. The child used the system and completed the 14-hour, low-dose HABIT-VR intervention across 22 days. There was no change in Box and Blocks Test and Nine-Hole Peg Test scores before and after the intervention. Canadian Occupational Performance Measure scores increased but did not reach the clinically relevant threshold, due to high scores at baseline. Changes in motor task intensities during the use of VR and mastery of the VR bimanual tasks suggested improved motor efficiency. This case study provides preliminary evidence that HABIT-VR is useful for promoting adherence to HABIT activities and for the maintenance of upper extremity motor skills in the home setting.

Psychometric properties of the Child and Adolescent PsychProfiler v5: a measure for screening 14 of the most common DSM-5 disorders.

Introduction: The Child and Adolescent PsychProfiler version 5 (CAPP v5, 2014) is a measure for screening 14 common DSM-5 disorders in children and adolescents. The separation of Attention-Deficit/Hyperactivity Disorder (ADHD) and Specific Learning Disorder (SLD) by subtype results in 17 screening scales covering the 14 disorders. Theoretically then, the CAPP v5 should have a 17-factor structure, however, to date no published study has confirmed this. Additionally, there has been no comprehensive evaluation of the reliability and validity of the screening scales in this measure. These were examined across two different studies. Study 1 examined support for the 17-factor model of the parent-report version of the CAPP (CAPP-PRF) in a large group of adolescents from the general community. It also examined the internal consistency reliability and discriminant validity of the factors in this measure. Study 2 examined the validity of these factors in a clinic-referred group of adolescents. Methods: In Study 1, 951 parents completed the CAPP-PRF on behalf of their adolescents [mean (standard deviation) = 14.54 years (1.66 years)]. In Study 2, 173 parents completed the CAPP-PRF on behalf of their clinic-referred adolescent children [mean (standard deviation) = 14.5 years (1.84 years)]. Adolescents also completed a number of measures and tests for the purpose of assessing their behavior, IQ, and academic abilities. Results: The results in Study 1 supported a 17-factor model, and virtually all of the factors in this model showed acceptable reliability (alpha and omega coefficients), and discriminant validity. Study 2 demonstrated good support for the validity of the scales in the CAPP-PRF. Discussion: These findings indicate acceptable psychometric properties for the CAPP-PRF, and its utility for screening the more common DSM-5 disorders in children and adolescents.

Relationship between Perceived Family Resilience, Emotional Flexibility, and Anxiety Symptoms: a Parent-Adolescent Dyadic Perspective.

Family resilience is crucial for individual's psychological health. Previous studies explored the protective factors of anxiety at the individual level, with less attention paid to the impact of family interaction from a dyadic perspective. This study utilized the Actor-Partner Interdependence Mediation Model to investigate the relationship between family resilience, emotional flexibility, and anxiety symptoms. A sample of 2144 Chinese parent-adolescent dyads (36% upper grades of primary school, 64% secondary school, 49.39% girls; 70.38% mothers) was recruited. Perceived family resilience was inversely related to anxiety symptoms, directly or indirectly, through the mediation of emotional flexibility at the individual level. At the dyadic level, adolescents' perceived family resilience was significantly associated with parents' anxiety symptoms through their own or parents' emotional flexibility. Parents' perceived family resilience was inversely link to adolescents' anxiety symptoms through parents' emotional flexibility. Parents emotional flexibility also mediated the association between adolescents' perceived family resilience and their anxiety symptoms. These findings contribute to understanding the intricate dynamics of family resilience and psychological outcomes in parent-child relationships under adversity, emphasizing the need for child-centered interventions to improve family members' mental health.

Shared Delusion: Impact on the Parent-Child Relationship.

Folie à famille, also known as shared psychotic disorder among family members, is a rare and underdiagnosed psychiatric condition. This disorder, seldom discussed in the literature, is particularly notable for its impact on clinical management and parent-child relationships. The few reported cases have predominantly focused on adult populations, leaving a significant gap in understanding how this condition manifests and affects younger individuals and family dynamics. One area that remains largely unexplored in the literature is the intersection between attachment patterns and shared psychosis, particularly in the context of parent-child relationships. Understanding this intersection is crucial, as it can provide insights into the development and perpetuation of shared delusions within families. This article presents a case study of a school-aged female with autism spectrum disorder who exhibits a multi-generational shared delusion. This unique case highlights the complexities of diagnosing and managing shared psychotic disorders in children, especially when compounded by other developmental conditions. The treatment implications are profound, requiring a careful and nuanced approach to pharmacological and psychotherapeutic interventions.

Does hope mediate the relationship between parent's resolution of their child's autism diagnosis and parental stress.

Introduction: Resolution of a child's diagnosis, the process of accepting and adjusting to the reality of a child's significant diagnosis, has been often associated with decreased parental stress. Hope, a potential buffer against psychological distress, has been suggested as a potential explanation for this relationship. However, the mediating role of hope in the relationship between resolution of diagnosis and parental stress has not been explored. Methods: This study aimed to examine whether four types of hope (child, parental, societal, denial of diagnosis) mediated the relationship between resolution to an autism diagnosis and reduced parental stress. Participants included 73 parents (Mage = 43.22, SD = 7.69, female 97.3%) of autistic children (Mage = 11.15, SD = 4.56, male = 67.1%). Results: Resolution to diagnosis was negatively and significantly correlated with resolution to diagnosis, as well as child, parental and societal hope. These three hopes were also significantly and negatively correlated with parental stress. Importantly, when controlling for level of support and autism awareness, parental hope mediated the relationship between resolution to diagnosis and parental stress. Denial of diagnosis was not correlated with resolution or parental stress but did have significant but weak associate with the other hopes. Discussion: These findings suggest that hope based on parent's abilities to support their child and be supported themselves play an important role in parental stress once parents are more resolved to their child's diagnosis. Supporting parents to manage factors associated with supporting their child's needs, may benefit parents of autistic children.

Intervention for School Anxiety and Absenteeism in Children (ISAAC): Mixed-Method Feasibility Study of a Coach-Assisted, Parent-Focused Online Program.

The aftermath of the Covid-19 pandemic has seen an increase in persistent school absenteeism and Emotionally-Based School Avoidance (EBSA). However, suitable evidence-based psychological interventions are often unavailable. We aimed to assess the feasibility and acceptability of a new parent-focused online program, Intervention for School Anxiety and Absenteeism in Children (ISAAC), which has been co-designed with parents and practitioners. This exploratory mixed-method study recruited participants from three schools in southern England, enrolling N = 9 parents for whom a child, aged 5-11 years, was experiencing signs of EBSA. The intervention consisted of three web-based psychoeducational modules respectively addressing parental stress, accommodating parenting behaviors, and communication with school staff. Module completion was assisted by weekly calls with a non-specialist "coach." Feasibility was measured using indicators of retention, module participation, overall program completion and coaching fidelity. Acceptability was assessed using semi-structured interviews, module ratings and written qualitative feedback. We also explored baseline-post change in parent-reported measures of children's school avoidance, absences, anxiety, parental stress, accommodating parenting behaviors, and quality of parent-school communication. Overall, the intervention was feasible to deliver to parents with six (67%) participants completing the full intervention. Participants found the intervention acceptable across thematic domains of affective attitude, burden, coherence, self-efficacy and perceived effectiveness. Participants particularly appreciated the coach's support. We observed small to moderate reductions in school avoidance behaviours (d with Hedges correction = 0.36), child anxiety (d with Hedges correction = 0.33) and accommodating behaviours (d with Hedges correction = 0.44) at the post timepoint compared to baseline. In conclusion, ISAAC shows early promise with the potential to deliver scalable online support for families affected by emerging EBSA. Future research should move toward establishing effectiveness in a randomized controlled trial.