Multimodal Assessment of Emotion Dysregulation in Children with and without ADHD and Disruptive Behavior Disorders.

OBJECTIVE: We sought to explore if specific domains of emotion dysregulation (emotion regulation [EREG], emotional reactivity/lability [EREL], emotion recognition/understanding [ERU], and callous-unemotional [CU] behaviors) were uniquely associated with diagnostic classifications. METHOD: This study utilized a multimodal (parent/teacher [P/T] reports and behavioral observations) approach to examine emotion dysregulation in a sample of young children (68.7% boys; mean age = 5.47, SD = 0.77, 81.4% Latinx) with attention-deficit/hyperactivity disorder (ADHD Only; n = 46), ADHD + disruptive behavior disorders (ADHD+DBD; n = 129), and typically developing (TD) children (n = 148). RESULTS: All three diagnostic groups were significantly different from one another on P/T reports of EREG, EREL and CU. For the ADHD+DBD group, P/T reported worse EREG and EREL, and higher mean scores of CU, compared to both ADHD Only and TD groups. The ADHD+DBD group also performed significantly worse than the TD group (but not the ADHD Only group) on observed measures of EREG, EREL and ERU. P/T reported EREG, EREL and CU for the ADHD Only group were significantly worse than the TD group. Using multinomial logistic regression, P/T reported EREG, EREL, and CU were significantly associated with diagnostic status above and beyond observed measures of emotion dysregulation. The model successfully classified children with ADHD+DBD (91.3%) and TD (95.9%); however, children in the ADHD Only group were correctly identified only 45.7% of time. CONCLUSION: Our findings suggest that measures of emotion dysregulation may be particularly helpful in correctly identifying children with ADHD+DBD, but not necessarily children with ADHD Only.

Evaluating the Simple View of Reading for Children With Attention-Deficit/Hyperactivity Disorder.

The 'simple view of reading' is an influential model of reading comprehension which asserts that children's reading comprehension performance can be explained entirely by their decoding and language comprehension skills. Children with ADHD often exhibit difficulty across all three of these reading domains on standardized achievement tests, yet it is unclear whether the simple view of reading is sufficient to explain reading comprehension performance for these children. The current study was the first to use multiple indicators and latent estimates to examine the veracity of key predictions from the simple view of reading in a clinically-evaluated sample of 250 children with and without ADHD (ages 8-13, Mage=10.29, SD=1.47; 93 girls; 70% White/Non-Hispanic). Results of the full-sample structural equation model revealed that decoding and language comprehension explained all (R2=.99) of the variance in reading comprehension for children with and without ADHD. Further, multigroup modeling (ADHD, Non-ADHD) indicated that there was no difference in the quantity of variance explained for children with ADHD versus clinically-evaluated children without ADHD, and that the quantity of explained variance did not differ from 100% for either group. Sensitivity analyses indicated that these effects were generally robust to control for monomethod bias, time sampling error, and IQ. These findings are consistent with 'simple view' predictions that decoding and language comprehension are both necessary and together sufficient for explaining children's reading comprehension skills. The findings extend prior work by indicating that the 'simple view' holds for both children with ADHD and clinically-evaluated children without ADHD.

Individual Differences in Germ Spreading Behaviors Among Children With Attention-Deficit/Hyperactivity Disorder: The Role of Executive Functioning.

OBJECTIVE: Infectious diseases, such as coronavirus disease 2019 (COVID-19), are commonly transmitted by respiratory droplets and contact with contaminated surfaces. Individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely to be infected with COVID-19 and experience more hospitalizations than individuals without ADHD. The current study investigated the role of ADHD symptomatology and executive functioning (EF) in germ spreading behavior frequency among young children with and without ADHD and parenting responses to these behaviors. METHODS: Participants included 53 children diagnosed with ADHD and 47 typically developing (TD) children between the ages of 4-5 years (76% male; Mage = 4.62; 86% Hispanic/Latinx). Parents and teachers reported on children's ADHD symptomatology and children completed three EF tasks. Germ spreading behavior frequency (direct contact of hand to face and toy in mouth) and parenting responses (verbal and nonverbal behaviors) were observed during a 5-min parent-child play situation. RESULTS: Negative binomial regression analyses indicated that both ADHD diagnostic status and poor metacognition predicted both higher rates of toy to mouth (ß = 1.94, p < .001; ß = 0.03, p = .004) and face touching frequency (ß = 0.60, p = .03; ß = 0.03, p = .004), respectively. Additionally, poor attention and worse cognitive flexibility only predicted higher rates of toy to mouth frequency (ß = 0.09, p < .001; ß = -0.04, p = .001), respectively. CONCLUSIONS: Young children with ADHD are at high risk for spreading germs via putting toys in their mouth and touching their face. Particularly, high levels of inattention and poor EF appear to be associated with higher rates of germ spreading behaviors.

Does preschool children's self-regulation moderate the impacts of instructional activities? Evidence from a randomized intervention study.

There is strong evidence linking children's self-regulation with their academic and behavioral outcomes. These relations have led to the development of interventions aimed at improving academic outcomes by promoting self-regulation, based in part on the idea that self-regulation promotes the development of academic skills. Although a considerable number of studies have examined the degree to which interventions designed to improve aspects of self-regulation have a positive impact on academic outcomes, only a few studies have examined the degree to which children's self-regulation moderates the effects of academic interventions. The goal of this study was to examine whether self-regulation, indexed by a direct assessment of executive function and teacher-rated attention, moderated the uptake of early literacy interventions for 184 children (average age = 58 months, SD = 3.38; 66% Black/African American, 28% White; 59% male) at risk for reading difficulties who participated in a randomized controlled trial examining the efficacy of Tier 2 interventions in preschool. Multilevel models were used to examine the degree to which children's self-regulation moderated the impacts of the interventions. The results of this study provided little evidence that self-regulation moderated the impacts of the interventions and call into question the likelihood of a causal relation between self-regulation and academic achievement.

Addressing Mental Health and Trauma-Related Needs of Sheltered Children and Families with Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT).

Children and adolescents ("youth") experiencing homelessness are at a disproportionately high risk of exposure to potentially traumatic events (PTE). However, limited evidence exists as to what interventions are effective when implemented with this high-risk population. The purpose of this study was to (1) document the mental health and trauma-related needs of sheltered youth and their mothers, and (2) examine the feasibility/effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) administered within the context of a homeless shelter. Three hundred and twenty-one youth (Mage = 10.06 years, SD = 3.24 years, 56.4% male, 70.1% Black/African American, 34.6% Hispanic/Latinx) and their mothers were recruited from a homeless shelter and provided 10 weeks of TF-CBT, with the option for up to eight additional weeks of therapy based on clinical need. Families completed pre- and post-intervention assessments. Results demonstrated clinically elevated pre-intervention PTSD symptoms and rates of exposure to PTE in sheltered youth well above those previously reported in the general population. TF-CBT resulted in substantial reductions in both maternal and self-reported severity of youth PTSD symptomology, which were largely attributable to reductions in re-experiencing and arousal. Effectiveness of TF-CBT varied by age and the number of exposures to PTE. Overall, these findings illustrate the importance of assessing and addressing the mental health and trauma-related needs of sheltered youth and the feasibility and efficacy of embedding an evidence-based trauma-focused treatment protocol within a shelter environment. Additional implications of these findings are discussed.

Examining the Efficacy of Online Administration of a Time-Limited School Readiness Intervention in the Face of COVID-19.

Although the efficacy of online administration of behavioral parent training (BPT) programs is well-established, such programs address a single risk factor (behavioral functioning) for school readiness difficulties (comprised of academics, cognitive skills, and social, emotional, and behavioral functioning). The current study aims to examine the feasibility, acceptability, and efficacy of a telemedicine delivery of the School Readiness Parenting Program (SRPP), an integrative adaptation of PCIT designed to address the behavioral and academic domains of school readiness. The present study takes the first step towards validating an online administration of the SRPP as a treatment for early childhood disruptive behavior. Data were collected for 64 children ages 2-6 years (Mage = 4.63, SD = 0.86; 78.1% Hispanic/Latinx) and their families, who received either in-person administration of time-limited PCIT (PCIT-TL; n=30) or online administration of SRPP (n=34). A series of repeated measures ANOVAS were conducted to examine within and between group effects. Results revealed that both SRPP and PCIT-TL significantly reduced inattention (d's = -0.54 to -0.88), aggression (d's = -0.55 to -1.06), and behavioral symptomology (d's = -0.55 to -0.85) and produced significant gains in parental skills (d's = -1.47 to 2.99). Notably, online SRPP demonstrated greater improvement in positive parental verbalization, whereas PCIT-TL demonstrated greater reductions in parental stress. Overall, findings support the utility of online SRPP for addressing behavioral school readiness concerns.

Early intervention for families experiencing homelessness: A pilot randomized trial comparing two parenting programs.

OBJECTIVE: As part of a larger community-based, service-driven research project, the primary purpose of this pilot randomized study was to examine the feasibility and acceptability of delivering time-limited adaptations of parent-child interaction therapy (PCIT) and child-parent psychotherapy (CPP) within a sample of children experiencing homelessness. The secondary goal was to examine the promise of both interventions in improving parent/child outcomes. METHOD: One hundred forty-four young children (18 month-5 years old; Mage = 3.48, SD = 1.09; 43.1% female; 78.5% Black/African American; 27.1% Hispanic) and their mothers were recruited from a women's homeless shelter and randomly assigned to 12 weeks of either PCIT or CPP delivered by shelter clinicians on-site. Attendance, fidelity, and program satisfaction were obtained. Families completed pre- and postintervention assessments, including observational data on maternal verbalizations during a child-led play session. RESULTS: Both time-limited PCIT and time-limited CPP were successfully implemented with similarly high levels of intervention fidelity (>90%) and satisfaction by mothers (85%). Completion rates were similar across both time-limited PCIT (76.6%) and time-limited CPP (71.4%). Both time-limited CPP and PCIT resulted in decreases in children's posttraumatic stress, parental stress, and increases in maternal positive verbalizations. Only time-limited PCIT resulted in significant improvements in externalizing behavior problems in children and reductions in maternal negative verbalizations. CONCLUSIONS: Time-limited PCIT and CPP are acceptable, feasible, and hold significant promise for helping families within a homeless shelter environment and by extension, other transitional and/or shelter environments. A full randomized trial is warranted to determine which program may offer a more effective intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Are Reading Interventions Effective for At-Risk Readers with ADHD? A Meta-Analysis.

OBJECTIVE: Utilizing a multi-level meta-analytic approach, this review is the first to systematically quantify the efficacy of reading interventions for school-aged children with ADHD and identify potential factors that may increase the success of reading-related interventions for these children. METHOD: 18 studies (15 peer-reviewed articles, 3 dissertations) published from 1986 to 2020 (N = 564) were meta-analyzed. RESULTS: Findings revealed reading interventions are highly effective for improving reading skills based on both study-developed/curriculum-based measures (g = 1.91) and standardized/norm-referenced achievement tests (g = 1.11) in high-quality studies of children with rigorously-diagnosed ADHD. Reading interventions that include at least 30 hours of intervention targeting decoding/phonemic awareness meet all benchmarks to be considered a Level 1 (Well-Established) Evidence-Based Practice with Strong Research Support for children with ADHD based on clinical and special education criteria. CONCLUSIONS: Our findings collectively indicate that reading interventions should be the first-line treatment for reading difficulties among at-risk readers with ADHD.

"Factor structure and utility of the Behavior Rating Inventory of Executive Function-Preschool Version": Correction.

Reports an error in "Factor structure and utility of the Behavior Rating Inventory of Executive Function-Preschool Version" by Jamie A. Spiegel, Christopher J. Lonigan and Beth M. Phillips (Psychological Assessment, 2017[Feb], Vol 29[2], 172-185). In the original article, paraphrased references to the BRIEF-P test items originally provided in Table 2 have been removed by request of the copyright holder due to discrepancies between the APA guidelines and the copyright holder's internal policies. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2016-22451-001). Executive function (EF) is a domain general cognitive construct associated with a number of important developmental outcomes. The Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P) is intended to assess 5 distinct components of EF in preschool age children. In this study, a series of factor analyses was conducted with teacher-reported EF of 2,367 preschool students to assess the structure of the BRIEF-P, and the predictive relations between the resulting factors and children's academic abilities and behavioral self-regulation were assessed to test the construct and convergent validity of the BRIEF-P scores. Results yielded mixed findings concerning the structure of the BRIEF-P and validity of its resultant scores. Results of the factor analyses indicated that the items of the BRIEF-P did not map onto factors in the way that would be expected based on its item-to-subscale mapping. The best solutions were a 4-factor and a bifactor model. The 4-factor solution revealed substantial correlations between factors, and although the bifactor solution identified a General Self-Regulation factor that explained variance in responses across items, this general factor did not account for all of the overlap among specific factors. Analyses of the relations for the factors from the correlated-factors and the bifactor models indicated that the majority of the factors had limited convergent validity with academic ability or with a measure of behavior self-regulation. Overall, these findings call into question the validity of aspects of BRIEF-P. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Relations between executive functions and academic outcomes in elementary school children: A meta-analysis.

The primary goal of this study was to examine developmental patterns among the relations between components of executive function (EF; working memory [WM], inhibitory control, shifting), and academic outcomes (reading, mathematics, language) in elementary school-age children. These relations were examined within the context of the development of EF and of academic skills utilizing an extension of the unity and diversity, intrinsic cognitive load, and dual process theories. Using meta-analytic methods, we summarized results from 299 studies from 293 articles/dissertations, representing 65,605 elementary school-age children (42-191 months old [M = 101 months, SD = 24.49 months]). Results indicated that accounting for general EF (by including the correlations among EF tasks in meta-analytic path models and accounting for effects between all three EF components and academic outcomes simultaneously) produced weaker relations between EF and academic skills than the bivariate relations which have been reported in prior meta-analytic reviews. However, although reduced, all relations between EF and academic outcomes remained significant throughout elementary school. Whereas WM was consistently moderately associated with reading, math, and oral language across development, the developmental trends for the relations between inhibitory control and shifting with academic outcomes varied based upon the academic skill examined. On the academic side, whereas the relations between reading and language skills with EF components varied throughout elementary school, few developmental changes were found in the relations between EF components and math skills across elementary school. Future directions and implications of findings for the conceptualization of the impact of EF on academics are discussed within the context of relevant theoretical models. (PsycInfo Database Record (c) 2021 APA, all rights reserved).