Child characteristics associated with child quality of life and parenting stress in Angelman syndrome.

BACKGROUND: Angelman syndrome (AS) is a rare neurodevelopmental disorder characterised by severe intellectual disability, movement disorder, epilepsy, sleeping problems, and behavioural issues. Little is known on child health-related quality of life (HRQoL) in AS. AS family studies have reported elevated parenting stress and a high impact of the child's syndrome on the parent. It is unclear which factors influence child HRQoL and parenting stress/impact in AS. METHODS: We collected data prospectively through standardised clinical assessments of children with AS at the ENCORE Expertise centre for Angelman Syndrome at the Erasmus MC Sophia Children's Hospital. A linear regression analysis was conducted for the following outcome variables: (1) child HRQoL (Infant and Toddler Quality of Life Questionnaire); (2) the impact of the child's syndrome on the parent (Infant and Toddler Quality of Life Questionnaire); and (3) parenting stress (Parenting Stress Index). Predictor variables were child genotype, epilepsy, sleeping problems (Sleep Disturbance Scale for Children), cognitive developmental level (Bayley Cognition Scale), autistic features (Autism Diagnostic Observation Schedule) and emotional/behavioural problems (Child Behaviour Checklist). Covariates were sex, age and socio-economic status. RESULTS: The study sample consisted of 73 children with AS, mean age = 9.1 years, range = 2-18 years. Emotional/behavioural problems were the strongest significant predictor of lowered child HRQoL. Internalising problems were driving this effect. In addition, having the deletion genotype and higher age was related to lower child HRQoL. Sleeping problems were related to a higher impact of the child's syndrome on the parent. Finally, emotional/behavioural problems were associated with higher parenting stress. Cognitive developmental level, autistic features and epilepsy were not a significant predictor of child HRQoL and parenting stress/impact. CONCLUSIONS: These results suggest that interventions aimed at increasing child HRQoL and decreasing parenting stress/impact in AS should focus on child emotional/behavioural problems and sleeping problems, using a family-centred approach.

Do Attachment, Educator Characteristics and Youth-Educator Relationship Matter in 6-Month Changes of Institutionalized Adolescents?

OBJECTIVE: This longitudinal study involved youths in residential care due to previous adverse experiences and their educators, aiming to investigate the role of youths and educators' attachment, educators' psychopathology, and the quality of youth-educator relationship on change scores of youths' symptoms and youth-educator relationship security over 6 months. METHOD: Participants were 36 institutionalized youths (Mage = 16.50 ± 2.13) and their 25 main educators (Mage = 38.48 ± 5.75), assessed at baseline (T1) and 6 months later (T2). Youths were assessed in total, internalizing and externalizing problems via a multi-informant approach, and educators in psychopathology levels. Attachment representations of youths and educators were assessed through validated attachment interviews (Friends and Family Interview and Adult Attachment Interview), and both separately rated the youth-educator relationship. RESULTS: (1) Most cases remain stable over 6 months. (2) Educator narrative coherence and the quality of youth-educator relationship at baseline were correlated but not predictive of change in youths' symptoms. (3) Youths' higher attachment disorganization at baseline was the unique predictor of 14% variance of positive change in the youth-educator relationship security perceived by the youth. (4) Youth attachment avoidance uniquely predicted 37% of positive change variance in the youth-educator relationship security perceived by educators. CONCLUSION: In conclusion, attachment-based assessment of youths and educators can inform intervention to foster youth improvement.

Comparing Parent and Teacher Ratings of Emotional and Behavioural Difficulties in 5-year old Children who are Deaf or Hard-of-Hearing.

Children who are deaf or hard of hearing (DHH) are at higher risk of developing mental health problems. This study reports on the parent and teacher ratings of emotional and behavioural difficulties (EBD) in 5-year old DHH children. It explores the similarities and differences between informants, and the risk and protective factors associated with parent and teacher-ratings of EBD. Parents and teachers of 224 DHH children completed questionnaires on children's EBD and functional auditory behaviour. Children completed standardised assessments of non-verbal cognitive and language abilities. On average, parent- and teacher-rated EBD were 0.42 and 0.20 standard deviations higher than typically developing children. Parents reported more behavioural problems (hyperactivity and conduct), whereas teachers reported poorer prosocial behaviour. Inter-rater correlations were generally low to moderate (0.29 to 0.50). Overall, children with additional disabilities, lower non-verbal cognitive ability, and poor functional auditory behaviour were at higher risk of EBD. Language ability was only a significant predictor of teacher-rated EBD for children with hearing aids but not cochlear implants. Differences in informant-ratings emphasize the need for a multi-informant approach to get a global perspective on the psychopathology of DHH children. The findings indicate that parents may need assistance with managing behavioural problems at home, and teachers should facilitate more opportunities to practice prosocial behaviour at school. Intervention efforts should focus on facilitating good functional listening skills, as this may in turn, improve the mental health of young DHH children.

Relationship Between Neurodevelopmental Areas and Difficulties in Emotional-Behavioural Variables in Children With Typical Development Under 2 Years of Age: Sex Differences.

The aim of this study was to examine the relationship between neurodevelopmental areas and possible difficulties in emotional-behavioural variables, and to determine if sex moderated this relationship. A community sample of 231 boys and girls with typical development and with a mean age of 19.84 months was evaluated, using the Bayley-III and CBCL 1.5-5 scales. The main results confirmed: (1) better linguistic abilities in girls in both language areas (receptive communication and expressive communication), finding more evidence according to the Bayesian analysis in expressive communication; (2) in the emotional-behavioural area girls had higher scores in withdrawal; (3) significant negative correlations of low magnitude were found between the Bayley and CBCL scales, particularly in the areas of language and cognitive and internalising and externalising problems; (4) children with low cognitive abilities and those with poor receptive communication showed more inter and externalising difficulties; (5) no significant predictive value or moderating effect of sex was found, (6) the number of participants who simultaneously manifested significant deficits in both domains (neurodevelopmental and emotional-behavioural) was very reduced. Future research should corroborate these results and the characteristics of the relationship found at these early ages. Detecting the population at risk in the first two years of life would enable the implementation of interventions aimed at improving neurodevelopmental deficits and emotional-behavioural problems. Thus, identification of deficits in one domain should lead to evaluation of the other.

Patterns of intimate partner violence exposure across the first 10 years of life and children's emotional-behavioural outcomes at 10 years.

BACKGROUND: Childhood exposure to intimate partner violence (IPV) is associated with emotional-behavioural problems. However, little is known about children's emotional-behavioural outcomes following exposure to different long-term patterns of IPV. OBJECTIVE: The current study aimed to investigate the emotional-behavioural functioning of children at 10 years of age following exposure to different patterns of IPV across the first 10 years of life. PARTICIPANTS AND SETTING: Data for this study was drawn from the Mothers' and Young People's Study- a longitudinal study of 1507 first time mothers and their first born child. METHODS: Women were recruited during pregnancy from six public hospitals in Victoria, Australia. Data was collected during pregnancy, and at one, four and ten years postpartum. Four patterns of IPV exposure were previously identified: (a) minimal IPV exposure; (b) early IPV; (c) Increasing IPV; and (d) persistent IPV. Logistic regression was used to assess associations between IPV exposure and emotional-behavioural outcomes. RESULTS: Exposure to early, increasing, or persistent IPV was associated with increased odds of experiencing emotional-behavioural difficulties (OR 2.15-2.97). Children exposed to a persistent pattern of IPV experienced over 6 times the odds of conduct problems (OR = 6.15 CI = 2.3-16.44). CONCLUSIONS: Children exposed to early, increasing, or persistent IPV experienced increased odds of emotional-behavioural problems at age 10, regardless of the duration or type of violence they were exposed to. However, children exposed to persistent IPV across childhood appeared to experience the highest odds of emotional-behavioural difficulties.

Emotional and Behavioral Characteristics of Gifted Children and Their Families.

INTRODUCTION: To compare the quality of life, areas of social, emotional, behavioural and mental problems and family functionality of gifted children and children of normal intelligence. METHODS: The study included 49 gifted children aged 9-18 years and 56 age and gender-matched healthy children of normal intelligence. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL), and the Children's Depression Rating Scale were applied to all the cases. The Quality of Life Scale for Children, the Depression Scale for Children, the Trait-State Anxiety Inventory, and the Strengths and Difficulties Questionnaire- Adolescent Form were completed by all the participants. All the parents completed the Family Evaluation Scale, the Strengths and Difficulties Questionnaire- Parents Form and the Parents Form of the Quality of Life Scale for Children. RESULTS: Compared to children of normal intelligence, gifted children described themselves as more inattentive and lively, social functionality was reported to be low and they had a worse perception of their physical health status. Gifted boys were determined to have more depressive symptoms than gifted girls. The parents of boys of normal intelligence reported lower academic performance than the parents of giftedboys. This difference was not determined for girls between the cases and comparative groups. CONCLUSION: All the findings obtained in this study suggest that gifted children are at risk in respect of mental health. Therefore, to be able to become healthy adults in a biopsychosocial aspect, it is important for the future of gifted children that this status can be identified at an early age, that they can receive appropriate education, that support and counselling are provided for emotional needs and that parents and teachers are fully informed.