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Hao X, Zhu L, Guo Y, Lu J, Yan S, Tao F, Huang K. Association of gestational weight gain rate in pregnant women with children's cognitive and behavioral development: A birth cohort study. J Affect Disord 2024; 350:792-800. [PMID: 38244794 DOI: 10.1016/j.jad.2024.01.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/31/2023] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND The evidences on the relationship between gestational weight gain rate (GWGR) and children's cognitive and behavioral development have been limited. METHODS A total of 3273 singleton live birth mother-child pairs from the Ma'anshan Birth Cohort in China were included in the study. Maternal GWGR was calculated based on the weights measured at multiple antenatal checkups. Children's cognitive and behavioral development were assessed by Chinese version of Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition and Achenbach Child Behavior Checklist 1.5-5. Then generalized linear models were performed for analyses. RESULTS In the field of children's cognitive development, excessive GWGR in the second trimester was associated with increased visual space index (VSI), fluid reasoning index (FRI) and full scale intelligence quotient (FSIQ) scores, while excessive GWGR in the third trimester was associated with decreased VSI, working memory index (WMI) and FSIQ scores. In the field of children's behavioral development, excessive GWGR in the second trimester was associated with decreased aggressive behaviors and externalizing problems scores. LIMITATIONS Children's behavioral development was assessed by main caregivers and might cause a certain degree of bias. There might be other potential confounders that we did not take into account. CONCLUSIONS A high GWGR in the second trimester might be beneficial for children's cognitive and behavioral development, while a high GWGR in the third trimester might be harmful.
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Affiliation(s)
- Xuemei Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Linlin Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Yufan Guo
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Jingru Lu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Center, Ma'anshan 243011, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China
| | - Kun Huang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei 230032, China; Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China.
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Hao X, Guo Y, Lu J, Zhu L, Yan S, Tao F, Huang K. Sex-specific association between maternal mild anemia and children's behavioral development: a birth cohort study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02411-z. [PMID: 38517534 DOI: 10.1007/s00787-024-02411-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
There has been limited research on maternal anemia affecting children's behavioral development, with a lack of studies focusing on sex differences in this association. Based on the Ma'anshan Birth Cohort, 2132 mother-child pairs were included. Maternal anemia was evaluated based on the hemoglobin concentration and children's behavioral development was assessed by Achenbach Child Behavior Checklist 1.5-5. Binary logistic regression models indicated that compared with children born of mothers without anemia throughout pregnancy, maternal mild anemia during pregnancy or only anemia in the 3rd trimester was associated with increased risks of aggressive behaviors in boys. Maternal mild anemia only in the 2nd trimester was associated with increased risks of attention problems in boys. In girls, maternal mild anemia during pregnancy was associated with increased risks of withdrawn, internalizing problems and total problems. Girls born of mothers with mild anemia only in the 2nd trimester had higher risks of total problems. Maternal mild anemia in both 2nd and 3rd trimesters was associated with increased risks of internalizing problems in girls. Our study identified sex-specific effects of maternal mild anemia during pregnancy on children's behavioral development problems.
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Affiliation(s)
- Xuemei Hao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yufan Guo
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jingru Lu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Linlin Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Center, Ma'anshan, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China.
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Wu HY, Lin WY, Huang JP, Lin CL, Au HK, Lo YC, Chien LC, Chao HJ, Chen YH. Effects of mobile device use on emotional and behavioral problems in the CBCL among preschoolers: Do shared reading and maternal depression matter? PLoS One 2023; 18:e0280319. [PMID: 37450499 PMCID: PMC10348560 DOI: 10.1371/journal.pone.0280319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/27/2022] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Although mobile devices are used ubiquitously, studies on their detrimental effects on preschoolers are limited. Furthermore, no study has considered shared reading and mobile device usage simultaneously. Therefore, this study examined the effects of mobile devices and shared reading on preschoolers' development along with the effects of maternal depression on this association. MATERIALS AND METHODS Mothers of 202 children aged 2-5 years were recruited in Taiwan. Maternal self-reported questionnaires on mobile device usage, shared reading, and child's emotional and behavioral development were collected. Multiple linear regression models were used for analyses. RESULTS Mothers' higher usage time on mobile devices and an education level of college or less were significantly associated with the child's exceeding recommended use of mobile devices. Particularly among depressed mothers, preschoolers' exceeding recommended use of mobile devices was associated with more sleep (β = 9.87, 95% confidence interval [CI] = 1.34, 18.40) and attention (β = 7.20, 95% CI = 1.50, 12.91) problems, whereas shared reading was associated with less somatic complaints (β = -16.19, 95% CI = -32.22, -0.15) and withdrawn (β = -21.50, 95% CI = -40.52, -2.47), compared with their respective counterparts. CONCLUSION Our study suggested the beneficial effects of shared reading. Moreover, we highlighted the adverse effects of preschoolers' exceeding recommended use of mobile device on sleep and attention problems, especially for children of mothers with depression.
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Affiliation(s)
- Hsin-Yi Wu
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Wen-Yi Lin
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chen-Li Lin
- Department of Obstetrics and Gynecology, Taipei City Hospital, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Chun Lo
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
- Ph. D. program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
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Firstborn children’s sex specific emotions and behaviors during mothers’ second pregnancy after implementation of the universal two-child policy in China. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03750-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
The present cross-sectional study aimed to identify sex-specific characteristics and other factors for firstborn children’s emotions and behaviors during their mothers’ second pregnancy after the implementation of the two-child policy in China. Firstborn children aged 1.5–5 years old and their pregnant mothers were enrolled from two hospitals from March to September 2019 in our city. Mothers completed a self-designed questionnaire and Child Behavior Checklist during their routine prenatal examinations. Linear regression was used to explore potential factors influencing firstborn children’s behaviors and emotions towards their mother’s second pregnancy. A total of 880 firstborn children were included. There was no significant difference in internalizing/externalizing problem scores and prevalence between male and female firstborn children during their mothers’ second pregnancy. Children’s easy temperament, good parental relationship, and father’s authoritative and indulgent parenting styles were potential positive factors for both male and female firstborn children. Harmonious family environment, children’s age, father's accompaniment, and being informed by parents of the arrival of a sibling were only related to firstborn girls experiencing fewer emotional and behavioral problems. Mother’s education and seeking for firstborn children’s opinion about the new sibling were only related to firstborn boys experiencing fewer emotional and behavioral problems. There was no sex differences in internalizing/externalizing problems in firstborn children during their mother’s second pregnancy. Children’s temperament, family environment and fathers’ parenting styles were consistent influencing factors for both firstborn girls’ and boys’ emotions and behaviors.
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Teng Y, Li P, Yang M, Han Y, Yan S, Xu Y, Tao F, Huang K. Sex-Specific Effect of Thyroid Peroxidase Antibody and Thyroglobulin Antibody Exposure During Pregnancy on Preschoolers' Emotional and Behavioral Development: A Birth Cohort Study. Thyroid 2022; 32:1229-1242. [PMID: 35920111 DOI: 10.1089/thy.2022.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Background: Epidemiological and experimental studies suggest that thyroid peroxidase antibody (TPOAb)- and thyroglobulin antibody (TGAb)-positive exposure during gestation may contribute to offspring's adverse neural development. However, limited knowledge is available on the association between joint exposure on TPOAb and TGAb and children's emotional and behavioral development. Furthermore, the sex-specific effect on the developmental process of preschoolers' emotions and behaviors is unknown. The present research intends to examine the sex-specific effect of TPOAb- and TGAb-positive exposure in gestation on the developmental process of preschoolers' emotions and behaviors. Methods: A total of 2455 mother-child pairs were included from the Ma'anshan Birth Cohort study. The serum TPOAb and TGAb of pregnant women was measured retrospectively by electrochemical immunoassay during the follow-up period. Preschoolers' emotional and behavioral development was assessed by a child behavior checklist 1.5-5. Growth mixture modeling was adopted to fit thyroid antibody (TAb) trajectories. Poisson regression models were used, stratifying by sex, to examine the association between TAb trajectories, as well as four categories of maternal TAb exposure and preschoolers' emotional and behavioral problems. Results: Boys born to mothers with TPOAb positivity in the first, second, and third trimesters of pregnancy had an increased risk of autism spectrum problems after adjusting for confounders, with relative risk (RR) [confidence interval, CI] of 2.01 [1.24-3.27], 2.15 [1.08-4.26], and 2.13 [1.20-3.79], respectively. Maternal TGAb positivity and TPOAb negativity in the first trimester were associated with a high risk of attention-deficit/hyperactivity problems in boys (RR = 1.74 [CI 1.01-2.99]). The prevalence of depressive problems in girls was 33.3% after exposure to TPOAb alone in the third trimester of pregnancy. Exposure to TPOAb alone in the third trimester of pregnancy was associated with an increased risk of depressive problems in girls (RR = 1.78 [CI 1.09-2.90]). Conclusions: Maternal TPOAb positivity in all three trimesters was associated with the risk of autism spectrum problems in boys. Isolated maternal TGAb positivity in the first trimester was associated with attention-deficit/hyperactivity problems in boys, whereas isolated maternal TPOAb positivity in the third trimester was associated with depressive problems in girls.
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Affiliation(s)
- Yuzhu Teng
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle, Anhui Medical University (AHMU), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Peixuan Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle, Anhui Medical University (AHMU), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Mengting Yang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle, Anhui Medical University (AHMU), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Yan Han
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle, Anhui Medical University (AHMU), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Center (MCHC), Ma'anshan, China
| | - Yeqing Xu
- Ma'anshan Maternal and Child Health Center (MCHC), Ma'anshan, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle, Anhui Medical University (AHMU), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Kun Huang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Key Laboratory of Population Health Across Life Cycle, Anhui Medical University (AHMU), Ministry of Education of the People's Republic of China, NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University (AHMU), Hefei, China
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Li SJ, Tsao PN, Tu YK, Hsieh WS, Yao NJ, Wu YT, Jeng SF. Cognitive and motor development in preterm children from 6 to 36 months of age: Trajectories, risk factors and predictability. Early Hum Dev 2022; 172:105634. [PMID: 35921693 DOI: 10.1016/j.earlhumdev.2022.105634] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/01/2022] [Accepted: 07/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although numerous studies have examined the development of preterm children born very low birth weight (VLBW, birth body weight < 1500 g), variations of developmental progress within individuals have rarely been explored. The aim of this research was to examine the cognitive and motor trajectories in preterm children born VLBW at early ages and to assess the risk factors and predictability of these trajectories. METHOD Five hundred and eighty preterm infants born VLBW from three cohort studies (2003 to 2014) were prospectively assessed their mental and motor development using the Bayley Scales at 6, 12, 24, and 36 months, and cognitive, motor and behavioral outcomes using the Movement Assessment Battery for Children and the Child Behavior Checklist for Ages 1.5-5 at 4 years of age. RESULTS Preterm children born VLBW manifested three cognitive patterns (stably normal [64.0 %], deteriorating [31.4 %], and persistently delayed [4.6 %]) and four motor patterns (above average [6.3 %], stably normal [60.0 %], deteriorating [28.5 %], and persistently delayed [5.2 %]) during 6-36 months. Low birth body weight, stage III-IV retinopathy of prematurity and low parental socio-economic status were associated with the deteriorating patterns; prolonged hospitalization and major brain damage were additionally associated with the persistently delayed patterns. Furthermore, the cognitive and motor deteriorating pattern was each predictive of cognitive and motor impairment at 4 years of age; whereas, the persistently delayed patterns were predictive of multiple impairments. CONCLUSION AND IMPLICATIONS Preterm children born VLBW display heterogeneous trajectories in early cognitive and motor development that predict subsequent developmental and behavioral outcomes.
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Affiliation(s)
- Sin-Jie Li
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Rehabilitation, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Po-Nien Tsao
- Division of Neonatology, Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan.
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Wu-Shiun Hsieh
- Division of Neonatology, Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.
| | - Nai-Jia Yao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Suh-Fang Jeng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan.
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Cheng YL, Chu CL, Wu CC. How Do Children with Autism Spectrum Disorder and Children with Developmental Delays Differ on the Child Behavior Checklist 1.5–5 DSM-Oriented Scales? CHILDREN 2022; 9:children9010111. [PMID: 35053735 PMCID: PMC8774976 DOI: 10.3390/children9010111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 11/16/2022]
Abstract
The Child Behavior Checklist 1.5–5 (CBCL 1.5–5) is applied to identify emotional and behavioral problems on children with developmental disabilities (e.g., autism spectrum disorder [ASD] and developmental delays [DD]). To understand whether there are variations between these two groups on CBCL DSM-oriented scales, we took two invariance analyses on 443 children (228 children with ASD). The first analysis used measurement invariance and multiple-group factor analysis on the test structure. The second analysis used item-level analysis, i.e., differential item functioning (DIF), to discover whether group memberships responded differently on some items even though underlying trait levels were the same. It was discovered that, on the test structure, the Anxiety Problems scale did not achieve metric invariance. The other scales achieved metric invariance; DIF analyses further revealed that there were items that functioned differently across subscales. These DIF items were mostly about children’s reactions to the surrounding environment. Our findings provide implications for clinicians to use CBCL DSM-oriented scales on differentiating children with ASD and children with DD. In addition, researchers need to be mindful about how items were responded differently, even though there were no mean differences on the surface.
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Affiliation(s)
- Yi-Ling Cheng
- Department of Psychology, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
| | - Ching-Lin Chu
- Department of Educational Psychology & Counseling, National Pingtung University, Pingtung 900391, Taiwan
- Correspondence: (C.-L.C.); (C.-C.W.)
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, Kaohsiung 807378, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
- Correspondence: (C.-L.C.); (C.-C.W.)
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Chen YC, Tsai WH, Ho CH, Wang HW, Wang LW, Wang LY, Wang HH, Hwang YS. Atypical Sensory Processing and Its Correlation with Behavioral Problems in Late Preterm Children at Age Two. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6438. [PMID: 34198645 PMCID: PMC8296277 DOI: 10.3390/ijerph18126438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the prevalence rate of atypical sensory processing in late preterm (LP) and term children at two years of age and to further investigate the co-occurrence of atypical sensory processing and behavioral problems (internalizing/externalizing) in both groups of children. A total of 104 children (52 LP and 52 sex- and birth order-matched term children) were included. The primary caregivers were asked to complete the Infant/Toddler Sensory Profile-Chinese version and the Child Behavior Checklist 1.5-5Y-Chinese version (CBCL-C/1.5-5). We found that the LP group had a similar prevalence rate of atypical sensory processing to the term group. However, neonatal intensive care unit experience (r = -0.356, p = 0.013, with visual processing) and days of ventilation and supplementary oxygen (r = -0.392, p = 0.004, with low registration) after birth were significantly correlated with the atypical sensory processing of LP children. Both LP and term children with behavioral problems seemed to have a higher prevalence rate of atypical sensory processing than their peers without behavioral problems. However, when Bonferroni correction was used to control for the statistical errors of multiple comparisons, only in the LP group did the co-occurrence of atypical sensory processing (auditory and oral sensory processing and sensation avoiding) and behavioral problems reach significance. In conclusion, the influence of late preterm birth on sensory processing may become subtle at age two, with the exception of those LP children experiencing complicated medical management after birth. A high level of co-occurrence of atypical sensory processing and behavioral problems suggests that the administration of a sensory processing assessment may be helpful to clarify the cause of problematic behavior and to recommend an appropriate intervention for LP children with behavioral problems.
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Affiliation(s)
- Yu-Chin Chen
- Department of Pediatrics, Chi Mei Medical Center, Chiali, Tainan 72263, Taiwan;
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
| | - Wen-Hui Tsai
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 711301, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan;
| | - Hsuan-Wen Wang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei 11080, Taiwan;
| | - Lan-Wan Wang
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan 71073, Taiwan
| | - Lin-Yu Wang
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Center for General Education, Southern Taiwan University of Science and Technology, Tainan 71073, Taiwan
| | - Hsin-Hua Wang
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Department of Pediatrics, Chi Mei Hospital, Liouying, Tainan 73657, Taiwan
| | - Yea-Shwu Hwang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
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Liang SHY, Tsai HWJ, Wu YY, Lee YC, Chen VCH, Wang LJ, Chou WJ, Kelsen BA. Reliability and validity of the traditional Chinese translation of the brief infant-toddler social and emotional assessment. Early Hum Dev 2020; 151:105162. [PMID: 32916591 DOI: 10.1016/j.earlhumdev.2020.105162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 07/29/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Sophie Hsin-Yi Liang
- Chang Gung Memorial Hospital at Taoyuan- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Taoyuan, Taiwan
| | - Hsiao-Wei Joy Tsai
- Department of Special Education, National Taipei University of Education, Taipei, Taiwan
| | - Yu-Yu Wu
- YuNing Psychiatric Clinic, Taipei, Taiwan; Chang Gung Memorial Hospital at Linkao- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Taoyuan, Taiwan
| | - Yi-Chen Lee
- School of Occupational Therapy College of Medicine National Taiwan University, Taipei, Taiwan.
| | - Vincent Chin-Hung Chen
- Chang-Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Department of Psychiatry, Chiayi, Taiwan
| | - Liang-Jen Wang
- Chang Gung Memorial Hospital at Kaohsiung Medical Center- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Kaohsiung, Taiwan
| | - Wen-Jiun Chou
- Chang Gung Memorial Hospital at Kaohsiung Medical Center- Chang Gung University College of Medicine, Department of Child and Adolescent Psychiatry, Kaohsiung, Taiwan
| | - Brent Allan Kelsen
- National Taipei University, Language Center, New Taipei City, Taiwan; Department of Psychology, Auckland University of Technology, Auckland, New Zealand
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Lin YN, Iao LS, Lee YH, Wu CC. Parenting Stress and Child Behavior Problems in Young Children with Autism Spectrum Disorder: Transactional Relations Across Time. J Autism Dev Disord 2020; 51:2381-2391. [PMID: 32965625 DOI: 10.1007/s10803-020-04720-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This longitudinal study examined the transactional relations between parenting stress and both internalizing and externalizing behavioral problems in young children with autism spectrum disorder (ASD) over 1.5 years using a cross-lagged panel analysis. Participants included 75 young children with ASD (Time 1; mean age = 25.68 months) and their parents. Parenting stress that was related to parent's perceptions on child characteristics was found to predict externalizing behavioral problems in young children with ASD across two time points. However, behavioral problems in young children with ASD did not predict parenting stress. These findings provide implications for early intervention and family services for young children with ASD and their families.
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Affiliation(s)
- Yun-Nung Lin
- Department of Psychology, Kaohsiung Medical University, 8F, Chi-Shih Building, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan
| | - Lai-Sang Iao
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Yu-Han Lee
- Clinical Psychology Center, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, 8F, Chi-Shih Building, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan. .,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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11
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Prolonged touch screen device usage is associated with emotional and behavioral problems, but not language delay, in toddlers. Infant Behav Dev 2020; 58:101424. [PMID: 32120178 DOI: 10.1016/j.infbeh.2020.101424] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/25/2020] [Accepted: 01/26/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Touch screen devices are now ubiquitous, and their usage by young children is increasing. However, the effects of these devices on young children are still unknown. Therefore, this study aimed to address the associations of touch screen device exposure with symptomatic emotional and behavioral problems and language development in children between the ages of 18 and 36 months. METHOD A total of 161 primary caregivers of children between the ages of 18 and 36 months were recruited from the pediatric ward and outpatient clinic at a medical center in southern Taiwan. All caregivers were asked to fill out the Child Behavior Checklist for Ages 1½-5 (CBCL 1½-5) and a questionnaire on basic personal information and touch screen device usage, and they were also interviewed with the Communication and Language Screening Test for Birth to Three Chinese-Speaking Infant-Toddlers (CLST). Independent t-test and one-way ANOVA were used to examine the differences among the categories in the demographic variables and to characterize the touch screen device usage behaviors. Pearson's correlation was used to analyze the relationship between language delay and the extent of touch screen device exposure. After primary univariate analysis, we used multiple regression models to examine the relationships among the effects of touch screen device usage behaviors on children's emotional and behavioral problems and language development. RESULT The children's mean age was 25.63 months (SD = 5.35). Children who spent more time on touch screen devices were more likely to have emotional problems (β = .219, p < .010, 95 % CI: .279-1.518), anxious/depressive symptoms (β = .206, p < .050, 95 % CI: .170-1.244), somatic complaints (β = .291, p < .001, 95% CI: .455-1.462), social withdrawal symptoms (β = .194, p < .050, 95 % CI: 0.133-1.150), attention problems (β = .300, p < .001, 95 % CI: .432-1.267), and aggressive behaviors (β = .247, p < .010, 95 % CI: .967-3.983). The effects were not noted on language development (β = -.136, p < .100, 95 % CI: -2.595-.147). CONCLUSION Young children who spent more time on touch screen devices were more likely to have emotional problems, anxious/depressive symptoms, somatic complaints, social withdrawal symptoms, attention problems, and aggressive behaviors, but not language delay.
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Yang YC, Lu L, Jeng SF, Tsao PN, Cheong PL, Li YJ, Wang SY, Huang HC, Wu YT. Multidimensional Developments and Free-Play Movement Tracking in 30- to 36-Month-Old Toddlers With Autism Spectrum Disorder Who Were Full Term. Phys Ther 2019; 99:1535-1550. [PMID: 31392998 DOI: 10.1093/ptj/pzz114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/28/2019] [Accepted: 03/31/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND Few studies have investigated multidimensional developments and free-play movement performance in toddlers with an early diagnosis of autism spectrum disorder (ASD). OBJECTIVE This study compared cognitive, motor, and behavioral developments and free-play movement performance in toddlers with ASD who were full term (FT-ASD), toddlers who were full term and are typically developing (FT-TD), and toddlers who were born preterm and had a very low birth weight (VLBW-PT). DESIGN This was a prospective cross-sectional study. METHODS Forty-five 30- to 36-month-old age-matched toddlers were recruited and divided into FT-ASD, FT-TD, and VLBW-PT groups. Their developments were examined using the Mullen Scales of Early Learning; the Peabody Developmental Motor Scales, Second Edition; the Child Behavior Checklist for Ages 1.5 to 5; and the Repetitive Behavior Scale-Revised. In addition, the toddlers' free-play movements were tracked in laboratory settings using an automatic movement tracking system. RESULTS Toddlers with FT-ASD exhibited lower cognitive and motor scores and a higher degree of behavioral problems compared with toddlers with FT-TD or VLBW-PT. Furthermore, the movement tracking data in a free-play setting revealed that toddlers with FT-ASD displayed a higher degree of turning velocity, a higher moving time, and a higher frequency of moving toward the peripheral region compared with toddlers with FT-TD or VLBW-PT. Moreover, several motor developmental and movement-tracking indicators were found to correlate with behavioral problems and cognitive scores in toddlers with FT-ASD. LIMITATIONS The study results may have been affected by the small sample size, the cross-sectional design, and tracking only the whole body without subtle movements or segmental motions. CONCLUSIONS The findings suggest varied aspects of co-occurring developmental conditions and movement-based problems in toddlers with FT-ASD. Using standardized and sensitive measures for the early assessment of perceptuo-motor impairments is necessary for timely early intervention for such toddlers.
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Affiliation(s)
- Yu-Ching Yang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Lu Lu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Suh-Fang Jeng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
| | - Po-Nien Tsao
- Department of Pediatrics, National Taiwan University Children Hospital, Taipei, Taiwan
| | - Pou-Leng Cheong
- Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Yao-Jen Li
- Institute of Epidemiology and Prevention Medicine, National Taiwan University
| | - Shih-Ya Wang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University
| | - Hsiao-Ching Huang
- School and Graduate Institute of Psychology, National Taiwan University
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Room 317, Floor 3, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan; and Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital
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Tsai JM, Lu L, Jeng SF, Cheong PL, Gau SSF, Huang YH, Wu YT. Validation of the modified checklist for autism in toddlers, revised with follow-up in Taiwanese toddlers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 85:205-216. [PMID: 30579261 DOI: 10.1016/j.ridd.2018.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 11/17/2018] [Accepted: 11/24/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) is a two-stage screening scale for determining the risk of autism spectrum disorder (ASD) in toddlers. However, the validity of the M-CHAT-R/F for Asian populations has not yet been established. AIMS This study investigated the psychometric properties of the M-CHAT-R/F, Taiwan version (M-CHAT-R/F-T), among low- and high-risk Taiwanese toddlers aged 16-30 months. The associations among M-CHAT-R/F-T scores, developmental performance at 24 and 30 months, and ASD diagnosis prediction at 36 months were examined. METHODS AND PROCEDURES A two-stage screening of the M-CHAT-R/F-T was applied to a study sample comprising 25 toddlers with ASD and 71 atypically developing (ATD) and 221 typically developing (TD) toddlers. OUTCOMES AND RESULTS The M-CHAT-R/F-T exhibited acceptable internal consistency and test-retest reliability. The M-CHAT-R/F-T scores were significantly correlated with several syndrome scores of the Child Behavior Checklist for Ages 1.5-5 and were significantly higher among toddlers with ASD than among ATD or TD toddlers. Furthermore, M-CHAT-R/F-T scores were negatively correlated with developmental scores in the Mullen Scales of Early Learning at 24 and 30 months. Moreover, the screening exhibited acceptable predictive validity (sensitivity = 0.86; specificity = 0.96) for ASD diagnosis at 36 months. CONCLUSIONS AND IMPLICATIONS The findings indicate that the M-CHAT-R/F-T is a valid and reliable tool for the developmental screening of low- and high-risk Taiwanese toddlers in community and clinical settings.
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Affiliation(s)
- Jung-Mei Tsai
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Lu Lu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Suh-Fang Jeng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pou-Leng Cheong
- Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hsun Huang
- Department of Child and Adolescent Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
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Liang SHY, Chou JY, Wu YY, Lee CP, Kelsen BA, Lee YC. Validity and Reliability Study of the Chinese (Traditional) Version of the Devereux Early Childhood Assessment for Toddlers (DECA-T). Neuropsychiatr Dis Treat 2019; 15:3375-3385. [PMID: 31824161 PMCID: PMC6901051 DOI: 10.2147/ndt.s218943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/15/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Devereux Early Childhood Assessment for Toddlers (DECA-T), which is one of the few standardized, norm-referenced behavioral rating scales related to young children's mental health, resilience, and social-emotional development, was developed for toddlers aged between 18 and 36 months. OBJECTIVE The aim of this study was to test the clinimetric properties of the Chinese (Traditional) version of the DECA-T (C-DECA-T) using a classical test theory analysis and an item response theory analysis. METHODS Seventy-five community-based toddlers aged from 18 to 36 months and 50 clinic-based participants recruited in hospitals in northern Taiwan participated in this study. Social-emotional competence was assessed by the C-DECA-T and children's behavior problems were rated via the Child Behavior Checklist 1.5 to 5 (CBCL/1.5-5). Homogeneity of the C-DECA-T was assessed by Mokken analysis; sensitivity and specificity were assessed via receiver operating characteristic curve. RESULTS The results showed the C-DECA-T demonstrated good test-retest reliability (r=0.8) and high internal consistency (Cronbach's alpha = 0.94). Inter-rater reliability between father and mother was fair (ICC = 0.46). Convergent validity of the CBCL/1.5-5 total behavior problems (r=-0.26) demonstrated acceptable psychometric performance. The overall measure of the sampling adequacy of the C-DECA-T assessed by principal component analysis was 0.93. Mokken scale analysis showed the 36-items of the C- DECA-T formed a weak unidimensional scale (Hs =0.35), supporting its construct validity. The area under curve of the C-DECA-T in prediction of social-emotional disturbance was 0.70. The optimal cutoff of the Total Protective Factor score of the C-DECA-T was a T score of 40.1 (T40.1), with a sensitivity of 95% and a specificity of 68%. Item 2 ("show affection for a familiar adult") and item 33 ("calm herself/himself") provide a good amount of information for the assessment of social-emotional strength and needs of a toddler in clinical practice. CONCLUSION The C-DECA-T showed good psychometric properties. Our findings of high internal consistency of the three subscales and total score of the C-DECA-T suggest symptom manifestation of social-emotional competence and needs in Taiwanese toddlers is not culturally different from American toddlers. The clinimetric properties of the C-DECA-T examined by a classical test theory analysis approach and an item response theory analysis approach suggest that the C-DECA-T is a reliable and valid instrument for measuring social-emotional strength and needs in the population in Taiwan.
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Affiliation(s)
- Sophie Hsin-Yi Liang
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jen-Yu Chou
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Yu Wu
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taiwan, YuNing Psychiatric Clinic, Taipei, Taiwan
| | - Chin-Pang Lee
- Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Brent Allan Kelsen
- Language Center, National Taipei University, New Taipei City, Taiwan, Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - Yi-Chen Lee
- Department of Psychiatry, Chang-Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Chiayi, Taiwan
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Chen YC, Fortson BL, Tiano JD. Preliminary Validity of the Eyberg Child Behavior Inventory with Taiwanese Clinic-Referred Children. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:3816-3830. [PMID: 31118549 PMCID: PMC6527371 DOI: 10.1007/s10826-018-1236-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Eyberg Child Behavior Inventory (ECBI) has previously been shown to be a psychometrically sound instrument used to assess disruptive behaviors in children in the United States and in other cultures/countries but not in Taiwan. The purpose of this study was to examine the factor structure and to establish the discriminative validity of the ECBI with two groups of Taiwanese children: 70 clinic-referred children with clinically elevated externalizing behavior problems and 70 community-based matched comparison children. Exploratory factor analyses resulted in a six-factor model for the clinic-referred sample and a five-factStrengths and Difficultieor model for the matched comparison sample, indicating that the ECBI is not unidimensional. Adequate convergent and divergent validity also were established between the ECBI Intensity and Problem Scales and another measure of child externalizing (for assessing convergent validity) and internalizing (for determining divergent validity) behavior. The results of the present study suggest that the ECBI is a valid measure of assessing externalizing behavior problems in Taiwanese children. Future research may seek to refine the factor structure of the ECBI in a Taiwanese sample. Future studies are also needed to examine other psychometrics of the ECBI, replicate this study with a larger sample, and establish its normative data in Taiwan.
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Affiliation(s)
- Yi-Chuen Chen
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan
| | - Beverly L. Fortson
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Hou YM, Stewart L, Iao LS, Wu CC. Parenting stress and depressive symptoms in Taiwanese mothers of young children with autism spectrum disorder: Association with children's behavioural problems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:1113-1121. [PMID: 29790634 DOI: 10.1111/jar.12471] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 04/03/2018] [Accepted: 04/17/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study examined the severity of parenting stress and depressive symptoms in Taiwanese mothers of young children with autism spectrum disorder (ASD) compared to mothers of young children with developmental delay (DD). The associations between parenting stress, depressive symptoms, and children's behavioural problems were also tested. METHODS The study sample included 51 young children with ASD (mean age = 31 months), 51 young children with DD (mean age = 30 months) and their mothers. RESULTS The results confirmed that mothers of young children with ASD experienced higher levels of parenting stress and depressive symptoms than mothers of young children with DD. In addition, children's behavioural problems were robust predictors of parenting stress and depressive symptoms in mothers of young children with ASD, but not in mothers of young children with DD. CONCLUSION The findings indicated that one of the critical goals in early intervention for young children with ASD and their families is to reduce children's behavioural problems.
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Affiliation(s)
- Yuh-Ming Hou
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chai-Yi, Taiwan
| | - Lydia Stewart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Lai-Sang Iao
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Minatoya M, Araki A, Nakajima S, Sasaki S, Miyashita C, Yamazaki K, Yamamoto J, Matumura T, Kishi R. Cord blood BPA level and child neurodevelopment and behavioral problems: The Hokkaido Study on Environment and Children's Health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 607-608:351-356. [PMID: 28697388 DOI: 10.1016/j.scitotenv.2017.06.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/02/2017] [Accepted: 06/08/2017] [Indexed: 05/25/2023]
Affiliation(s)
- Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo 060-0812, Japan
| | - Atsuko Araki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo 060-0812, Japan
| | - Sonomi Nakajima
- School of Health Sciences, Sapporo Medical University, Minami 1, Nishi 17, Chuo-ku, Sapporo 060-0061, Japan
| | - Seiko Sasaki
- Department of Public Health, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo 060-0812, Japan
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo 060-0812, Japan
| | - Jun Yamamoto
- Institute of Environmental Ecology, Idea Consultants, Inc., 1334-5 Riemon, Yaizu, Shizuoka 421-0212, Japan
| | - Toru Matumura
- Institute of Environmental Ecology, Idea Consultants, Inc., 1334-5 Riemon, Yaizu, Shizuoka 421-0212, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo 060-0812, Japan.
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18
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Chen YC, Hwang-Gu SL, Ni HC, Liang SHY, Lin HY, Lin CF, Tseng YH, Gau SSF. Relationship between parenting stress and informant discrepancies on symptoms of ADHD/ODD and internalizing behaviors in preschool children. PLoS One 2017; 12:e0183467. [PMID: 29016602 PMCID: PMC5634535 DOI: 10.1371/journal.pone.0183467] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/04/2017] [Indexed: 12/02/2022] Open
Abstract
Parent and teacher ratings of child behaviors are often discrepant, and these discrepancies may be correlated with parenting stress. The present study explored whether various parenting stress factors are associated with discrepancies between parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD) as well as internalizing symptoms in preschool children. We recruited 299 Taiwanese preschool children (aged 4-6 years) from the community or via clinical referrals. A structural equation modeling was used to analyze the relationships among three factors derived from the Parenting Stress Index-Short Form and informant discrepancies on symptoms of inattention, hyperactivity/impulsivity, ODD, and internalizing behaviors. Scores reported by parents were higher for each of the symptoms examined than those reported by teachers, and the degree of agreement between informants ranged from low to moderate. The parental distress factor of parenting stress was associated only with parent ratings, whereas other factors of parenting stress-parent-child dysfunctional interaction and parents' stress resulted from their child's temperament-were correlated with both parent and teacher ratings. Only parental distress factor predicted informant discrepancies for all behavioral symptoms assessed. Our findings suggest that parental distress should be considered when parent rating scores show significant discrepancies from that of teacher rating scores.
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Affiliation(s)
- Yu-Chi Chen
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Shoou-Lian Hwang-Gu
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Hsing-Chang Ni
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Hsiang-Yuan Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chiao-Fan Lin
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Yu-Han Tseng
- Department of Psychology, Soochow University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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19
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Minatoya M, Itoh S, Araki A, Tamura N, Yamazaki K, Nishihara S, Miyashita C, Kishi R. Associated factors of behavioural problems in children at preschool age: the Hokkaido study on environment and children's health. Child Care Health Dev 2017; 43:385-392. [PMID: 27868227 DOI: 10.1111/cch.12424] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/27/2016] [Accepted: 10/09/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Finding associated factors with childhood behavioural problems as early as preschool age is important. Studies have revealed several factors including socioeconomic factors, which may vary among different cultural background and population. However, investigation in general Japanese population of preschool age has not been well demonstrated. Thus, the objective of this study was to examine associated factors of childhood behavioural problems using Strengths and Difficulties Questionnaire (SDQ) in a prospective birth cohort study. METHODS Total 3813 SDQ were distributed between October 2014 and December 2015 to the subpopulation of prospective birth cohort study, the Hokkaido Study on Environment and Children's Health. The subpopulation consisted of participants who had reached age 5 and were born between April 2008 and December 2010. Baseline questionnaire filled at recruitment and birth record were used to obtain participant information. Children with total difficulties score ≧ 13 were defined as likelihood of behavioural problems. A total of 2553 children with valid answers were included into the analysis. The response rate was 67.1%. RESULTS Number of children with likelihood of behavioural problems was 521 (20.4%). Boys showed more problematic scores than girls. Multivariate analysis found that maternal pre-pregnancy BMI ≧ 30 kg/m2 , primipara, maternal education lower than high school, family income during pregnancy < 3 million yen/year and boy gender were the factors associated with increased odds ratio of likelihood of child behavioural problems. CONCLUSIONS This study found that prenatal socioeconomic factors were associated with likelihood of child behavioural problems at preschool age in Japan.
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Affiliation(s)
- M Minatoya
- Center for Environmental and Health Sciences, Sapporo, Japan
| | - S Itoh
- Center for Environmental and Health Sciences, Sapporo, Japan
| | - A Araki
- Center for Environmental and Health Sciences, Sapporo, Japan
| | - N Tamura
- Center for Environmental and Health Sciences, Sapporo, Japan
| | - K Yamazaki
- Center for Environmental and Health Sciences, Sapporo, Japan
| | - S Nishihara
- Center for Environmental and Health Sciences, Sapporo, Japan
| | - C Miyashita
- Center for Environmental and Health Sciences, Sapporo, Japan
| | - R Kishi
- Center for Environmental and Health Sciences, Sapporo, Japan
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Kariuki SM, Abubakar A, Kombe M, Kazungu M, Odhiambo R, Stein A, Newton CRJC. Burden, risk factors, and comorbidities of behavioural and emotional problems in Kenyan children: a population-based study. Lancet Psychiatry 2017; 4:136-145. [PMID: 28137381 PMCID: PMC5285446 DOI: 10.1016/s2215-0366(16)30403-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/17/2016] [Accepted: 11/17/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Three-quarters of the burden of mental health problems occurs in low-and-middle-income countries, but few epidemiological studies of these problems in preschool children from sub-Saharan Africa have been published. Behavioural and emotional problems often start in early childhood, and this might be particularly important in Africa, where the incidence of perinatal and early risk factors is high. We therefore aimed to estimate the prevalence and risk factors of behavioural and emotional problems in young children in a rural area on the Kenyan coast. METHODS We did a population-based epidemiological study to assess the burden of behavioural and emotional problems in preschool children and comorbidities in the Kilifi Health and Demographic Surveillance System (KHDSS, a database formed of the population under routine surveillance linked to admissions to Kilifi County Hospital). We used the Child Behaviour Checklist (CBCL) to assess behavioural and emotional problems. We then determined risk factors and medical comorbidities associated with behavioural and emotional problems. The strength of associations between the risk factors and the behavioural and emotional problems was estimated using generalised linear models, with appropriate distribution and link functions. FINDINGS 3539 families were randomly selected from the KHDSS. Of these, 3273 children were assessed with CBCL. The prevalence of total behavioural and emotional problems was 13% (95% CI 12-14), for externalising problems was 10% (9-11), and for internalising problems was 22% (21-24). The most common CBCL syndrome was somatic problems (21%, 20-23), whereas the most common DSM-IV-oriented scale was anxiety problems (13%, 12-14). Factors associated with total problems included consumption of cassava (risk ratio 5·68, 95% CI 3·22-10·03), perinatal complications (4·34, 3·21-5·81), seizure disorders (2·90, 2·24-3·77), and house status (0·11, 0·08-0·14). Seizure disorders, burn marks, and respiratory problems were important comorbidities of behavioural and emotional problems. INTERPRETATION Behavioural and emotional problems are common in preschool children in this Kenyan rural area and are associated with preventable risk factors. Behavioural and emotional problems and associated comorbidities should be identified and addressed in young children. FUNDING Wellcome Trust.
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Affiliation(s)
- Symon M Kariuki
- KEMRI-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya.
| | - Amina Abubakar
- KEMRI-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya; Department of Public Health, Pwani University, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Martha Kombe
- KEMRI-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya
| | - Michael Kazungu
- KEMRI-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya
| | - Rachael Odhiambo
- KEMRI-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Charles R J C Newton
- KEMRI-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya; Department of Public Health, Pwani University, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
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Marković J, Rescorla L, Okanović P, Maraš JS, Bukurov KG, Sekulić S. Assessment of preschool psychopathology in Serbia. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 49-50:216-225. [PMID: 26720848 DOI: 10.1016/j.ridd.2015.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 11/08/2015] [Accepted: 11/27/2015] [Indexed: 06/05/2023]
Abstract
The utility of the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5) and the Caregiver-Teacher Report Form (C-TRF) to the Serbian children is largely unknown and has not been studied. An aim of this study was to examine rates and distribution of emotional and behavioral problems among 4 to 6-year-old children in the Serbia. Country differences between our Serbian sample and the original U.S. sample, gender differences, and cross-informant agreement between teachers and parents were also to be examined. The CBCL/1.5-5 and the C-TRF was completed by parents and teachers respectively on 512 preschoolers in the city of Novi Sad, Serbia. Internal consistency of the scales was analyzed using Cronbach alpha (α). The comparison of behavioral/emotional syndromes raw scores was performed by t test. CBCL/1.5-5 prevalence rate of the Total Problems score in the clinical range was 13.4%, while the C-TRF prevalence rate for girls was 9.8% and for boys 8.8%. Our findings revealed that parent reported more problems than teachers on almost all scales across gender with the mean cross-informant correlation of 0.24. This study documents gender differences, with boys scoring significantly higher than girls on all externalizing related problem scales on both questionnaires, but with no gender differences on internalizing problems on either questionnaire. Results support the applicability of the Serbian version of the CBCL/1.5-5 and C-TRF and can be recommended for use in clinical and research settings.
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Affiliation(s)
- J Marković
- Clinic of Psychiatry, Clinical Center of Vojvodina, Novi Sad, Serbia.
| | | | - P Okanović
- Center for Research and Education "TIM", Novi Sad, Serbia
| | - J Srdanović Maraš
- Clinic of Psychiatry, Clinical Center of Vojvodina, Novi Sad, Serbia; Medical Faculty, University of Novi Sad, Novi Sad, Serbia
| | - K Gebauer Bukurov
- Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Clinic of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - S Sekulić
- Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Clinic of Neurology, Clinical Center of Vojvodina, Novi Sad, Serbia
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Kariuki SM, Abubakar A, Murray E, Stein A, Newton CRJC. Evaluation of psychometric properties and factorial structure of the pre-school child behaviour checklist at the Kenyan Coast. Child Adolesc Psychiatry Ment Health 2016; 10:1. [PMID: 26793272 PMCID: PMC4719674 DOI: 10.1186/s13034-015-0089-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 12/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Behavioural/emotional problems may be common in preschool children living in resource-poor settings, but assessment of these problems in preschool children from poor areas is challenging owing to lack of appropriate behavioural screening tools. The child behaviour checklist (CBCL) is widely known for its reliability in identifying behavioural/emotional problems in preschool children, but it has not been validated for use in sub-Saharan Africa. METHODS With permission from developers of CBCL, we translated this tool into Ki-Swahili and adapted the items to make them culturally appropriate and contextually relevant and examined the psychometric properties of the CBCL, particularly reliability, validity and factorial structure in a Kenyan community preschool sample of 301 children. It was also re-administered after 2 weeks to 38 randomly selected respondents, for the purpose of evaluating retest reliability. To evaluate inter-informant reliability, the CBCL was administered to 46 respondents (17 alternative caretakers and 29 fathers) alongside the child's mother. Generalised linear model was used to measure associations with behavioural/emotional scores. We used structural equation modelling to perform a confirmatory factor analysis to examine the seven-syndrome CBCL structure. RESULTS During the first phase we found that most of the items could be adequately translated and easily understood by the participants. The inter-informant agreement for CBCL scores was excellent between the mothers and other caretakers [Pearson's correlation coefficient (r) = 0.89, p < 0.001] and fathers (r = 0.81; p < 0.001). The test-retest reliability was acceptable (r = 0.76; p < 0.001). The scale internal consistency coefficients were excellent for total problems [Cronbach's alpha (α) = 0.95] and between good and excellent for most CBCL sub-scales (α = 0.65-0.86). Behavioural/emotional scores were associated with pregnancy complications [adjusted beta coefficient (β) = 0.44 (95 % CI, 0.07-0.81)] and adverse perinatal events [β = 0.61 (95 % CI, 0.09-1.13)] suggesting discriminant validity of the CBCL. Most fit indices for the seven-syndrome CBCL structure were within acceptable range, being <0.09 for root mean squared error of approximation and >0.90 for Tucker-Lewis Index and Comparative Fit Index. CONCLUSION The CBCL has good psychometric properties and the seven-syndrome structure fits well with the Kenyan preschool children suggesting it can be used to assess behavioural/emotional problems in this rural area.
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Affiliation(s)
- Symon M. Kariuki
- KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230 (80108), Kilifi, Kenya ,Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Amina Abubakar
- KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230 (80108), Kilifi, Kenya ,Department of Psychology, Lancaster University, Lancaster, UK
| | | | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Charles R. J. C. Newton
- KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230 (80108), Kilifi, Kenya ,Department of Psychiatry, University of Oxford, Oxford, UK
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Chen YC, Fortson BL. Predictors of treatment attrition and treatment length in Parent-Child Interaction Therapy in Taiwanese families . CHILDREN AND YOUTH SERVICES REVIEW 2015; 56:28-37. [PMID: 26705373 PMCID: PMC4687451 DOI: 10.1016/j.childyouth.2015.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Parent-Child Interaction Therapy (PCIT) has been used successfully in the United States and in other countries around the world, but its use in Asian countries has been more limited. The present study is the first of its kind to examine the predictors of treatment attrition and length in a sample of Taiwanese caregivers and their children. It is also the first to examine PCIT outcomes in Taiwanese families. Maladaptive personality characteristics of the caregiver were the best predictor of attrition, followed by single-parent, removal of the child from the home, and lower levels of caregiver education. Treatment length was predicted by child minority status and parent-child interactions (i.e., parent commands and negative parent talk). In terms of outcomes, statistically significant treatment changes were noted for all treatment outcome variables at post-treatment and at 3-month follow-up. These findings suggest that PCIT is a promising intervention for this population. The predictors of treatment attrition and length can be used when Taiwanese caregiver-child dyads present for services so that additional assistance can be provided prior to or during treatment to increase adherence to the recommended number of treatment sessions for maximal impact. Future studies may replicate the present study with a larger clinical sample to examine the long-term effects of PCIT and to include a no-treatment control condition to afford a more robust empirical evaluation.
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Affiliation(s)
- Yi-Chuen Chen
- Department of Psychology, National Chung Cheng University, Taiwan
| | - Beverly L. Fortson
- Centers for Disease Control and Prevention, Division of Violence Prevention, Atlanta, GA, USA
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Magiati I, Ponniah K, Ooi YP, Chan YH, Fung D, Woo B. Self-reported depression and anxiety symptoms in school-aged Singaporean children. Asia Pac Psychiatry 2015; 7:91-104. [PMID: 24019243 DOI: 10.1111/appy.12099] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/06/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Few studies have examined anxiety and depression experiences of primary (middle) school-aged children from ethnically diverse backgrounds, and most have relied on parents or others as informants. The present study aimed to investigate self-reported anxiety and depression symptoms in Singaporean primary school-aged children. Age, gender, and ethnic differences and interactions were explored as well as similarities and differences between Singaporean children and US norms. METHODS A large representative community sample of 1655 8- to 12-year-old Singaporean children (Chinese, Malay, and Indian) completed the Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI) as part of a larger epidemiological study of mental health in Singaporean children. RESULTS Rates of clinically elevated symptoms of anxiety and depression were 9.3% and 16.9% on the MASC and the CDI, respectively. Separation and social anxieties were most common. Evidence of a gender difference in levels of emotional symptoms was most evident in Indian children, with girls reporting more symptoms than boys. The relationship between age and internalizing problems was weak. DISCUSSION A substantial minority of primary school-aged Singaporean children reported elevated anxious and depressive symptoms. Better understanding of the factors that contribute to the development and maintenance of these problems can help the development of culture-specific interventions and facilitate the planning of community-tailored services and initiatives.
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Affiliation(s)
- Iliana Magiati
- Department of Psychology, National University of Singapore, Singapore
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Ng S, Lin CC, Jeng SF, Hwang YH, Hsieh WS, Chen PC. Mercury, APOE, and child behavior. CHEMOSPHERE 2015; 120:123-30. [PMID: 25014903 DOI: 10.1016/j.chemosphere.2014.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 05/27/2014] [Accepted: 06/01/2014] [Indexed: 05/21/2023]
Abstract
Methylmercury (MeHg) is a neurotoxicant and may have an adverse impact on child behavior. However, this impact was found to be inconsistent in fish-eating populations. Although the positive effects of the nutrients provided by a fish diet may overcome the effect of MeHg, the possibility of genetic variants influencing an individual's response to MeHg has also been discussed. The role of the Apolipoprotein E (APOE) epsilon 4 allele (ε4) on MeHg related neurotoxicity is still unclear. In the present study, we investigated the role of APOE variants in the relationship between cord blood mercury (Hg) and child behavior. A total of 166 subjects were recruited at delivery, and their cord blood was collected for laboratory analyses of Hg and the APOE genotype. The Child Behavior Checklist (CBCL) was administered to the subjects when they reached the age of two years. An increase in cord blood Hg concentrations in APOE ε4 carriers was consistently associated with an increased score for all CBCL syndromes. After controlling for potential confounding factors, the group of ε4 carriers with an elevated cord blood Hg concentration had significantly higher scores in the syndrome categories of general internalizing, emotionally reactive, and anxiety/depression as well as CBCL total scores. Furthermore, general externalizing and aggressive syndromes were borderline significantly higher in this group. In conclusion, we suggest that APOE may modify the toxicity of MeHg. APOE ε4 carriers may be more vulnerable to the effects of MeHg on child behavior at the age of two years.
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Affiliation(s)
- Sharon Ng
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Ching-Chun Lin
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Suh-Fang Jeng
- The School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yaw-Huei Hwang
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Wu-Shiun Hsieh
- Department of Pediatrics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
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Wu YC, Leng CH, Hsieh WS, Hsu CH, Chen WJ, Gau SSF, Chiu NC, Yang MC, Hsu HC, Yu YT, Wu YT, Chen LC, Jeng SF. A randomized controlled trial of clinic-based and home-based interventions in comparison with usual care for preterm infants: effects and mediators. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2384-2393. [PMID: 24973546 DOI: 10.1016/j.ridd.2014.06.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/06/2014] [Accepted: 06/06/2014] [Indexed: 06/03/2023]
Abstract
This study examined the effects and mediators of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with usual care in very-low-birth-weight (VLBW) preterm infants on developmental and behavioral outcomes at 24 months of age (corrected for prematurity). In this randomized controlled trial, VLBW preterm infants received either CBIP (n=57), HBIP (n=63), or usual care (n=58) from hospitalization to 12 months. At 12 months, infant emotional regulation was assessed using the toy-behind-barrier procedure and dyadic interaction was observed during free play. At 24 months, infant developmental and behavioral outcomes were assessed using the Bayley Scales of Infant and Toddler Development- 3rd edition and the Child Behavior Checklist for Ages 1.5-5, respectively. Compared with infants under usual care, the CBIP-group infants showed higher cognitive composite scores (difference, 95% confidence interval (CI)=4.4, 0.8-7.9) and a lower rate of motor delay (odds ratio (OR), 95% CI=0.29, 0.08-0.99); the HBIP-group infants had lower sleep problem scores (difference, 95% CI=-1.4, -2.5 to -0.3) and a lower rate of internalizing problems at 24 months (OR, 95% CI=0.51, 0.28-0.93) (all p<.05). The CBIP's effect on cognitive outcome was attenuated when maternal or dyadic interactive behavior was considered; whereas the HBIP's effect on sleep and internalizing behavior was attenuated when duration of orientation to a toy or object was considered. In conclusions, interventions enhanced the cognitive, motor, and behavioral outcomes of VLBW preterm infants. The effects on cognitive and behavioral outcomes might be mediated by early-improved mother-infant interaction and infant emotional regulation, respectively.
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Affiliation(s)
- Ying-Chin Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Hon Leng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wu-Shiun Hsieh
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chyong-Hsin Hsu
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Wei J Chen
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ming-Chin Yang
- Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hui-Chin Hsu
- Department of Child and Family Development, University of Georgia, GA, USA
| | - Yen-Ting Yu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Chiou Chen
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Suh-Fang Jeng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan.
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Cross-cultural differences in the sleep of preschool children. Sleep Med 2013; 14:1283-9. [DOI: 10.1016/j.sleep.2013.09.002] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 09/02/2013] [Accepted: 09/03/2013] [Indexed: 11/18/2022]
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Fuchs S, Klein AM, Otto Y, von Klitzing K. Prevalence of emotional and behavioral symptoms and their impact on daily life activities in a community sample of 3 to 5-year-old children. Child Psychiatry Hum Dev 2013; 44:493-503. [PMID: 23111504 DOI: 10.1007/s10578-012-0343-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the study was to evaluate prevalence and impact of behavioral/emotional symptoms in preschoolers. The sample comprised 1,738 preschoolers with an age range between 37 and 63 months. Parents rated children's symptoms using the Strengths and Difficulties Questionnaire (SDQ) and the impact of perceived difficulties using the impact supplement of the SDQ. The prevalence of a total difficulties score in an abnormal/borderline range was 16.0 % that means lower than rates in schoolchildren. 8.6 % of the preschoolers were rated as symptomatic (borderline/abnormal) and their symptoms were rated as having some or considerable impact on their lives. Parents mostly reported problems of hyperactivity/inattention and their interference with learning abilities. All symptoms scales of the SDQ, except prosocial behavior, significantly explained impact of perceived difficulties. Parents of boys rated significantly higher levels of symptoms and impact. Low parental education was associated with more symptoms and higher impact.
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Affiliation(s)
- Sandra Fuchs
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
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