The Berkeley Puppet Interview: A Screening Instrument for Measuring Psychopathology in Young Children

Longitudinal Changes in Preschoolers' Self-reported Psychological and Social Problems: Feasibility, Reliability, and Cross-informant Agreement

For decades, parental reports were used to assess children's psychological symptoms and social problems. The Berkeley Puppet Interview (BPI) utilizes hand puppets to collect questionnaire-style interview data from children, allowing consideration of children's own perspective. The current longitudinal study compared the feasibility and reliability of preschoolers' self-report with BPI at age 4 (M = 4.03, SD = 0.16; 52% boy, 82% White American) and 5 (M = 5.22, SD = 0.36) as well as cross-informant agreement among children, mothers, alternate caregivers (> 90% biological fathers), and coders. Children completed Symptom, Prosocial, and Parenting scales of BPI and their parents completed surveys assessing similar constructs. Our findings revealed both similarities and changes across ages. Specifically, the reliability and cross-informant agreement of the broad Symptom and Parenting scales were promising at both timepoints; however, 4-year-olds showed lower internal consistency in Social scales. Recommendations for how to refine and utilize BPI appropriately in young children in future research and the importance of cross-informant design were discussed.

Longitudinal Changes in Preschoolers' Self-reported Psychological and Social Problems: Feasibility, Reliability, and Cross-informant Agreement

For decades, parental report was used to assess children's psychological symptoms and social problems. The Berkeley Puppet Interview (BPI) utilizes hand puppets to collect questionnaire-style data from children, allowing consideration of children's own perspective. The current longitudinal study compared the feasibility and reliability of preschoolers' self-report with BPI at age 4 (M = 4.03, SD =0.16; 52% boy, 82% White American) and 5 (M = 5.22, SD = 0.36; 51% boy, 85% White American) as well as cross-informant agreement among children, mothers (74% above college education), alternate caregivers (>90% biological fathers), and coders. Children completed symptomatology, social, and parenting scales of BPI and their parents completed surveys assessing similar constructs. Our findings revealed both similarities and changes across ages. Specifically, the reliability and cross-informant agreement of the broad symptomatology and parenting scales were promising at both timepoints; however, 4-year-olds showed lower internal consistency in social scales.

Parent-child relationship quality and child psychological adjustment in families created using egg donation: children's perspectives at age 5 years

STUDY QUESTION

What are children's perspectives of the quality of their relationships with their parents and their own psychological well-being in families created using egg donation?

SUMMARY ANSWER

Children's scores indicated good parent-child relationship quality and high levels of psychological well-being, with children in families created using egg donation rating their relationships with their mothers as higher in warmth/enjoyment than children in a comparison group of families created using IVF.

WHAT IS KNOWN ALREADY

Little is known about how children in families created through egg donation view their family relationships and their own psychological well-being. Research with 7-and-10-year-olds in anonymous egg donation families has indicated good parent-child relationship quality from children's perspectives, but studies have not involved younger children or those conceived following identity-release egg donation.

STUDY DESIGN, SIZE, DURATION

This study included 50 children who had been born through egg donation and a comparison group of 43 children conceived through IVF with the parents' own gametes. Data were collected between April 2018 and December 2019. The sample forms part of a larger longitudinal study examining family functioning in families created through fertility treatment.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Children were aged 5 years old and had been born into families with different-sex couple parents. All families were visited at home. Children were administered the Berkeley Puppet Interview, a standardized assessment of parent-child relationship quality and psychological well-being.

MAIN RESULTS AND THE ROLE OF CHANCE

Children in egg donation families rated their relationships with their mothers as higher in warmth and enjoyment than did children in IVF families. No differences were found between the two family types in children's ratings of the father-child relationship, or in children's ratings of their own psychological well-being.

LIMITATIONS, REASONS FOR CAUTION

It is possible that children who did not consent to take part in the research had less positive perceptions of their family and themselves than children who participated.

WIDER IMPLICATIONS OF THE FINDINGS

The findings are relevant to UK clinics offering identity-release egg donation, to parents who have used egg donation to create their family and to individuals and couples considering their fertility treatment options. That children in egg donation families were more similar than different to children in IVF families in their self-concept and perception of their family relationships should prove reassuring.

STUDY FUNDING/COMPETING INTEREST(S)

This research was supported by a Wellcome Trust Collaborative Award [208013/Z/17]. The authors have no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

The Perspective Matters: A Multi-informant Study on the Relationship Between Social-Emotional Competence and Preschoolers' Externalizing and Internalizing Symptoms

Recent research demands a multi-informant and multi-factorial assessment of preschool-age psychopathology. Based on a tripartite model, we tested the relationship between emotional and social competence and their contribution to externalizing and internalizing symptoms in a preschool-age community sample (N = 117, M = 4.67 years, SD = 2.75 months). We assessed teachers' (N = 109) and parents' (N = 77) perspective using the Strengths-and-Difficulties-Questionnaire and children's perspective using the Berkeley-Puppet-Interview and a standardized emotional-competence-test (MeKKi). We found externalizing symptoms being negatively related to prosocial behavior in teachers' and parents' reports and positively related to social initiative in teachers' reports. In teachers' reports only, a mediation effect of emotional competence via social competence on externalizing symptoms was shown. Children, but not caregivers, reported internalizing symptoms being positively related to prosocial behavior. These results highlight the importance of multiple informants and especially of children's self-perception in preschool-age psychopathology.

Behavioral observation of prosocial behavior and social initiative is related to preschoolers' psychopathological symptoms

Current research on preschool-age psychopathology suggests specific impairments in the two domains of social competence-prosocial behavior and social initiative-in children with externalizing and internalizing symptoms. While behavioral observation methods have been largely neglected in the past, they may extend the predominating questionnaire-based assessment as they allow for a precise and objective assessment of children's social behavior. In this study, we aimed to investigate whether prosocial behavior and social initiative measured in a limited resource task are related to externalizing and internalizing symptoms in a preschool-age community sample (N = 117, M = 4.67 years, SD = 2.75 months, females = 57). Externalizing and internalizing symptoms were rated by teachers (n = 109) and parents (n = 77) using the Strengths and Difficulties Questionnaire and by children using the Berkeley Puppet Interview (n = 97). Reduced prosocial actions were related to children's higher ratings of externalizing symptoms, while reduced social initiative actions were related to parents' higher ratings of internalizing symptoms. Prosocial behavior in the behavioral task was a marginally significant positive predictor of internalizing symptoms from children's perspective. These results highlight the value of behavioral observation measures and contribute to our understanding of interpersonal deficits already related to psychopathology at preschool age.

Self-reported problem behavior in young children with and without a DSM-disorder in the general population

BACKGROUND

Problem behavior of young children is generally not assessed with structured child interviews. This paper examined how information about problem behavior, obtained by structured interviews with six-year-old children, relates to DSM-disorders obtained from parents and to treatment referral.

METHODS

In a population-based cohort, caregivers of 1084 young children (mean age 6.7 years) were interviewed with the DSM-based Diagnostic Interview Schedule-Young Child version (DISC-YC), and they scored the Child Behavior Checklist (CBCL). Children themselves were interviewed about problem behavior using the semi-structured Berkeley Puppet Interview (BPI). Information regarding treatment referral to mental health services was obtained by parent-reported questionnaire when children were on average eight years old.

RESULTS

DSM-disorders and CBCL problems in the clinical range were cross-sectionally associated with higher levels of child self-reported problems. Associations were strongest in the externalizing domain (e.g. DISC-YC externalizing disorders with BPI externalizing scores: F(1, 416)=19.39, P<0.001; DISC-YC internalizing disorders with BPI internalizing scores: F(1, 312)=3.75, P=0.054). Moreover, higher BPI internalizing and externalizing problem scores predicted treatment referral two years later.

CONCLUSIONS

We conclude that systematically interviewing preschool and young elementary school-aged children should be an integral part of child assessment. This approach may contribute to a better understanding of child development and may predict future problems.