Active Direction: A new observational measure of African American parenting

A new observational measure of a culturally salient, supportive African American parenting style, Active Direction, was developed. Ratings were compared to standard qualitative ratings and across two ethnic groups. Active Direction represents the provision of structure to interactions in the form of corrective direction with clear and concise feedback that is assessed for supportiveness rather than simple content or tone. The 7-point rating item was examined in observations of African American (n = 172) and Hispanic American (n = 196) mother-child interactions collected at age 2.5 years in families from low-income households. Ratings were compared and associations to previously reported ratings of the interactions were examined. Active Direction was often observed among the African American mothers (81%) but rarely observed among the Hispanic mothers (16%), with a large effect size difference, supporting the hypothesis that Active Direction may represent a culturally specific approach to parenting for African American parents. Maternal behavior correlations of Active Direction with cognitive stimulation, intrusiveness, scaffolding, and calm authority and with child affiliative obedience and dyadic routines and rituals were significantly higher and detachment significantly lower in the African American compared to the Hispanic sample. The new measure of Active Direction, centered around culturally salient values and differences in both historical and lived experiences, addresses characteristics of parenting in African American families that are supportive of their children's development and provides a fruitful direction for future research.

Targeting Peer Contagion Dynamics in Children with ADHD: Effects from a Two-Site Randomized Controlled Trial

OBJECTIVE

Parental Friendship Coaching (PFC) teaches parents to coach their children in friendship skills. This paper examines whether PFC fosters positive peer contagion processes (i.e. dyadic mutuality) and reduces negative peer contagion processes (i.e. coercive joining) within the friendships of children with attention-deficit/hyperactivity disorder (ADHD).

METHOD

Participants were 134 families of children with ADHD and peer problems (age 6-11 years; 69% male; 72% white) at two Canadian sites, randomized to PFC or CARE (an active comparison intervention). Children were observed in the lab at baseline, post-treatment, and at 8-month follow-up during cooperation and competition tasks with a real-life friend. Amount and reciprocity of dyadic mutuality indicators (i.e. positive affect and positive behaviors) and coercive joining indicators (i.e. aggressive, controlling, and rule-breaking behaviors) between friends were coded.

RESULTS

Across treatment conditions, children showed an increase in the amount of dyadic mutuality during cooperation and a decrease in the amount of coercive joining during competition over time. Relative to CARE, PFC induced a reduced amount of coercive joining behaviors during cooperation at post-treatment and follow-up. However, PFC led to decreases in the reciprocity of positive affect during cooperation at post-treatment and to increases in the reciprocity of coercive joining during competition at follow-up relative to CARE. Moderation analyses suggest PFC was associated with better outcomes for children with externalizing comorbidity, and for those with a stable or a best friend.

CONCLUSIONS

Findings highlight the importance of transactional processes, contextual differences, externalizing comorbidities, and friendship status when assessing the efficacy of PFC.

Temporal Relationships Between Nursing Home Staff Care Approaches and Behaviors of Residents With Dementia During Mealtimes: A Sequential Analysis

Background and Objectives

Optimal dyadic interactions are critical to quality mealtime care and outcomes. Prior work supports associative relationships between staff approaches and individual mealtime behaviors, yet evidence on temporal relationships is limited. This study examined temporal associations between staff approaches and resident behaviors during mealtimes.

Research Design and Methods

Videotaped mealtime observations (N = 160) involving 36 staff and 27 residents (53 staff-resident dyads) in 9 nursing homes were analyzed. Sequential analyses using 5-, 10-, and 15-second time windows were conducted for resident positive, neutral, and challenging behaviors as antecedents as well as consequences of staff person-centered and task-centered approaches.

Results

Residents exhibited positive verbal (35.0%) and positive/neutral nonverbal (12.6%) behaviors, as well as challenging behaviors including functional impairments (27.7%) and resistive behaviors (24.7%). Staff primarily used person-centered approaches (54.1% verbal, 40.3% nonverbal); task-centered approaches were less frequent (5.6%). Immediately (within 5 seconds) after staff person-centered approaches, resident positive/neutral and resistive behaviors were more likely, and functional impairments less likely. After staff task-centered approaches, resident positive verbal and resistive behaviors were less likely. After resident positive/neutral behaviors, staff person-centered approaches were more likely. After resident functional impairments, staff person-centered verbal approaches were less likely, and task-centered approaches more likely. After resident resistive behaviors, all staff approaches were more likely. The strength of temporal relationships diminished in 10-second and 15-second time windows.

Discussion and Implications

Staff-resident positive interactions were associated with more subsequent positive interactions. Person-centered care was associated with fewer subsequent resident functional impairments and more subsequent resistive behaviors. Resident resistive behaviors were associated with more subsequent person-centered and task-centered care. Findings confirm the importance of facilitating positive staff-resident interactions and managing functional impairments using person-centered care. Resistive behaviors require additional awareness and attention beyond commonly used person-centered care approaches. Further investigation of temporal relationships is needed using larger diverse samples.

Longitudinal Structural and Diffusion-Weighted Neuroimaging of Young Children Born Preterm

BACKGROUND

Children born preterm are at risk for diffuse injury to subcortical gray and white matter.

METHODS

We used a longitudinal cohort study to examine the development of subcortical gray matter and white matter volumes, and diffusivity measures of white matter tracts following preterm birth. Our participants were 47 children born preterm (24 to 32 weeks gestational age) and 28 children born at term. None of the children born preterm had significant neonatal brain injury. Children received structural and diffusion weighted magnetic resonance imaging scans at ages five, six, and seven years. We examined volumes of amygdala, hippocampus, caudate nucleus, putamen, thalamus, brainstem, cerebellar white matter, intracranial space, and ventricles, and volumes, fractional anisotropy, and mean diffusivity of anterior thalamic radiation, cingulum, corticospinal tract, corpus callosum, inferior frontal occipital fasciculus, inferior longitudinal fasciculus, temporal and parietal superior longitudinal fasciculus, and uncinate fasciculus.

RESULTS

Children born preterm had smaller volumes of thalamus, brainstem, cerebellar white matter, cingulum, corticospinal tract, inferior frontal occipital fasciculus, uncinate fasciculus, and temporal superior longitudinal fasciculus, whereas their ventricles were larger compared with term-born controls. We found no significant effect of preterm birth on diffusivity measures. Despite developmental changes and growth, group differences were present and similarly strong at all three ages.

CONCLUSION

Even in the absence of significant neonatal brain injury, preterm birth has a persistent impact on early brain development. The lack of a significant term status by age interaction suggests a delayed developmental trajectory.

KappaAcc: A program for assessing the adequacy of kappa

Categorical cutpoints used to assess the adequacy of various statistics-like small, medium, and large for correlation coefficients of .10, .30, and .50 (Cohen, Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.)-are as useful as they are arbitrary, but not all statistics are suitable candidates for categorical cutpoints. One such is kappa, a statistic that gauges inter-observer agreement corrected for chance (Cohen Educational and Psychological Measurement, 20(1), 37-46, Cohen, Educational and Psychological Measurement 20:37-46, 1960). Depending on circumstances, a specific value of kappa may be judged adequate in one case but not in another. Thus, no one value of kappa can be regarded as universally acceptable and the question for investigators should be, are observers accurate enough, not is kappa big enough. A principled way to assess whether a specific value of kappa is adequate is to estimate observer accuracy-how accurate would simulated observers need to be to have generated a specific value of kappa obtained by actual observers, given specific circumstances. Estimating observer accuracy based on a kappa table the user provides is what KappaAcc, the program described here, does.

TEMPORAL RELATIONSHIPS OF PERSON- AND TASK-CENTERED DEMENTIA CARE AND MEALTIME BEHAVIORS: SEQUENTIAL ANALYSIS

Person-centered mealtime care is highly recommended in dementia care. While current research examined associative relationships between person- and task-centered care and resident mealtime behaviors, few studies evaluated their temporal associations. Videotaped mealtime observations (N=160) involving 36 staff and 27 residents (53 staff-resident dyads) in 9 nursing homes were coded. Staff person-centered and task-centered approaches were conceptualized as antecedents of resident positive behaviors, functional impairments, and resistive behaviors using 5-, 10-, and 15-second time windows. Immediately after staff person-centered approaches, resident positive and resistive behaviors were more likely (p range=<.001–.29) and functional impairments less likely (p range=<.001–.62) with diminished effects in time. Immediately after staff task-centered approaches, resident positive behaviors were less likely (p range=<.001–.09). Person-centered mealtime care should be individualized, context-based, and resident-oriented. Resident resistiveness to care may be behavioral responses to person-centered care indicating mismatch to individual preferences and needs, warranting adequate awareness and appropriate assessment.

Peer contagion dynamics in the friendships of children with ADHD

BACKGROUND

Friendships in middle childhood carry high developmental significance. The majority of children with attention-deficit/hyperactivity disorder (ADHD) have few friendships, unstable friendships, or poor relationship quality in any friendships they have. The current study used time-window sequential analysis to map the dynamics within the friendships of children with ADHD, specifically the peer contagion processes of dyadic mutuality and coercive joining.

METHODS

Participants were 164 dyads consisting of a target child with ADHD and peer problems (age 6-11 years; 68% male; and 73% white) and a reciprocated friend. Dyads were observed in the lab during a cooperative task eliciting verbal negotiation processes to decide how to share a limited resource and during a fast-paced, engrossing, and competitive task. Both tasks were designed to mirror the real-world interactions of friends. Sequences of dyadic mutuality (i.e., reciprocity of positive affect and positive behaviors) and coercive joining (i.e., reciprocity of aggressive, controlling, and rule-breaking behaviors) between target children and friends were coded.

RESULTS

Regarding dyadic mutuality, target children reciprocated their friends' positive affect in both tasks. They also reciprocated their friends' positive behaviors but only in the cooperative task. In contrast, they only reciprocated their friends' coercive joining behaviors in the competitive task. Medium to large reciprocity effects was found for 36%-53% (dyadic mutuality) and 38%-55% (coercive joining) of target children.

CONCLUSIONS

These results extend findings of peer contagion processes to the friendships of children with ADHD and suggest that contagion may vary according to interaction context (i.e., competition vs. cooperation). Understanding the spread of peer contagion may illuminate how children with ADHD and their friends influence each other's adjustment over time and may guide friendship-focused psychosocial interventions for this population.

Using the Theory of Planned Behavior to Understand How Crisis Intervention Team (CIT) Training Facilitates Police Officers' Mental Health Referrals

The Theory of Planned Behavior posits that behaviors are predicted by one's intention to perform them; intention is driven by attitude toward the behavior, subjective norm, and perceived behavioral control. We used this theory to predict Crisis Intervention Team (CIT)-trained and non-CIT officers' intention to facilitate referral of persons with suspected mental illnesses to mental health services. CIT-trained (n = 251) and non-CIT (n = 335) officers from six law enforcement agencies participated. CIT-trained officers had significantly greater scores on all constructs. Theory constructs fit the data well, and fit did not differ meaningfully between the two groups. Direct and indirect predictors together accounted for 28% and 21%, respectively, of variance in behavioral intention. Attitude was the strongest predictor. Intentions to facilitate mental health referrals may be driven by the same factors among CIT-trained and non-CIT officers, but CIT officers, even at a median of 22 months after training, have significantly higher scores on those factors.

Modeling the effects of Crisis Intervention Team (CIT) training for police officers: How knowledge, attitudes, and self-efficacy drive de-escalation skills and referral decisions

OBJECTIVE

Prior research on Crisis Intervention Team (CIT) training for police officers has demonstrated improvements in knowledge, attitudes, self-efficacy, and stigma, but how these factors work together to influence behavioral outcomes like de-escalation skills and referral decisions remains unstudied.

METHOD

251 CIT-trained and 335 non-CIT officers completed in-depth surveys measuring these six constructs. We used structural equation modeling to test fit of the data to our hypothesized model and made indicated changes to improve fit.

RESULTS

An alternate 8-path model (with three paths originally hypothesized being removed) fit reasonably well, and allowing path coefficients to differ for CIT and non-CIT groups resulted in models with similar fit statistics.

CONCLUSION

CIT training enhances knowledge and attitudes, both of which have beneficial effects on stigma. Though an important outcome itself, lower stigma does not have an effect on de-escalation skills and referral decisions, though self-efficacy clearly does.

A Longitudinal Study of Language Use During Early Mother-Child Interactions in Spanish-Speaking Families Experiencing Low Income

PURPOSE

This longitudinal study assessed continuity and stability of productive language (vocabulary and grammar) and discourse features (turn-taking; asking and responding to questions) during mother-child play.

METHOD

Parent-child language use in 119 Spanish-speaking, Mexican immigrant mothers and their children at two ages (M = 2.5 and 3.6 years) was evaluated from transcriptions of interactions.

RESULTS

Child productive language significantly increased over the year, whereas mothers showed commensurate increases in vocabulary diversity but very little change in grammatical complexity. Mother-child discourse was characterized by discontinuity: Mothers decreased their turn length and asked fewer questions while children increased on both measures. Rates of responding to questions remained high for both mothers and children even as children increased and mothers decreased over time. Mothers and children showed significant rank-order stability in productive language and measures of discourse. Mothers' rate of asking questions and children's responses to questions during the first interaction predicted children's receptive vocabulary a year later.

CONCLUSIONS

As children become more sophisticated communicators, language input remains important, with discourse features growing in relevance. Children's early opportunities to respond to parents' questions in the context of play benefit their language skills. This work extends the evidence base from monolingual English-speaking families and is interpreted in the context of prior research on parenting practices in U.S. families of Mexican origin.

John Lamont Peterson (1949-2021)

Memorializes John Lamont Peterson (1949-2021). After teaching at Claremont's McKenna College and Graduate School in the late 1970s and early 1980s, and realizing in particular the growing impact of the early AIDS epidemic on African American men, Dr. Peterson joined the Center for AIDS Prevention Studies (CAPS), a key program of the AIDS Research Institute at the University of California, San Francisco, where he served as a Research Scientist from 1986 to 1993. Known for his many contributions to understanding the predictors of HIV/AIDS risk reduction, the effects of behavioral interventions to reduce this risk behavior, and the social determinants of racial disparities in HIV infection, primarily among Black men who have sex with men, Dr. Peterson leaves a record of over 70 publications, nearly 20 books and book chapters, and over 100 conference presentations-many with students he mentored. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Culture, parenting, and language: Respeto in Latine mother-child interactions

The cultural value of respeto (respect) is central to Latine parenting. Yet, how respeto manifests in the interactions of Latine parents and their young children remains unexamined. Low-income Mexican immigrant Spanish-speaking mothers and their 2.5-year-old toddlers (N = 128) were video-recorded during play (M _age = 30.2 months, SD = 0.52), and two culturally informed items of respeto were coded: parent calm authority and child affiliative obedience. Respeto related to standard ratings of mother and child interactions (e.g., maternal sensitivity and child engagement) but also captured unique features of parent-child interactions. Respeto related to mothers' and toddlers' language production and discourse during the interaction, and explained unique variance in language variables above standard ratings of mother-child interaction. This is the first effort to document a culturally salient aspect of dyadic interaction in Mexican immigrant mothers and young children and to show that respeto relates to language use during mother- child interactions.

Auditory joint attention skills: Development and diagnostic differences during infancy

To date, joint attention skill assessments have focused on children's responses to multimodal bids (RJA) and their initiation of bids (IJA) to multimodal spectacles. Here we gain a systematic view of auditory joint attention skills using a novel assessment that measures both auditory and multimodal RJA and IJA. In Study 1, 47 typically developing (TD) children were tested 5 times from 12 to 30 months to document auditory joint attention skill development. In Study 2, 113 toddlers (39 TD, 33 autism spectrum disorder [ASD], and 41 non-ASD developmental disorders [DD]; average age 22.4 months) were tested to discern the effects of ASD. Our findings fit well within the established depiction of joint attention skills with one important caveat: auditory items were far more difficult to execute than multimodal ones. By 24 months, TD children passed multimodal RJA items at the near-ceiling level, an accomplishment not reached even by 30 months for auditory RJA items. Intentional communicative IJA bids also emerged more slowly to auditory spectacles than to multimodal spectacles. Toddlers with DD outperformed toddlers with ASD on multimodal RJA items but toddlers in both groups rarely passed any auditory RJA items. Toddlers with ASD often monitored their partner's attention during IJA items, albeit less often than toddlers with DD and TD toddlers, but they essentially never produced higher-level IJA bids, regardless of modality. Future studies should investigate further how variations in bids and targets affect auditory joint attention skills and probe the relation between these skills and language development.

The Quality of Mother-Toddler Communication Predicts Language and Early Literacy in Mexican-American Children from Low-Income Households

This longitudinal study documents the key role of early joint engagement in the language and early literacy development of Mexican-American children from low-income households. This rapidly growing population often faces challenges as sequential Spanish-English language learners. Videos of 121 mothers and their 2.5-year-old children interacting in Spanish for 15 min were recorded in 2009-2011 in the Dallas-Fort Worth metropolitan area. Researchers reliably rated general dyadic features of joint engagement-symbol-infused joint engagement, shared routines and rituals, and fluency and connectedness-that have been found to facilitate language development in young English-speaking children. The construct respeto, a valued aspect of traditional Latino parenting, was also rated using two culturally specific items-the parent's calm authority and the child's affiliative obedience. In addition, three individual contributions-maternal sensitivity, quality of maternal language input, and quality of child language production-were assessed. General features of joint engagement at 2.5 years predicted expressive and receptive language at 3.6 years and receptive language and early literacy at 7.3 years, accounting for unique variance over and above individual contributions at 2.5 years, with some effects being stronger in girls than boys. The level of culturally specific joint engagement did not alter predictions made by general features of joint engagement. These findings highlight the importance of the quality of early communication for language and literacy success of Mexican-American children from low-income households and demonstrate that culturally specific aspects of early interactions can align well with general features of joint engagement.

Continuity and Stability of Parenting of Infants by Women at Risk for Perinatal Depression

OBJECTIVE

The present study aimed to enhance understanding of continuity and stability of positive parenting of infants, across age and different settings in women with a history of depression who are at elevated risk for postpartum depression.

DESIGN

Mothers (N = 103) with a history of major depression and their infants were observed during 5-min play and feeding interactions when their infants were 3, 6, and 12 months of age. Summary scores representing mothers' positive parenting were computed separately for each age and context based on ratings of five parenting behaviors. Mothers' depressive symptom levels were assessed at each infant age.

RESULTS

Continuity (consistency of level) and stability (consistency of rank order) were assessed across age and context at both the group and individual level. Across-age analyses revealed continuity in the play context and discontinuity in the feeding context, albeit only at the group level, as well as weak to moderate stability. Across-context analyses revealed higher positive parenting scores in play than feeding at all time points as well as weak to moderate stability. Variations in positive parenting across age and context were independent of mothers' postpartum depressive symptom levels.

CONCLUSIONS

Findings based on normative samples may not generalize to women with a history of depression, who may benefit from interventions aimed at enhancing their positive parenting over the course of infancy, regardless of postpartum depressive symptom level. Results also underscore the importance of assessing parenting at multiple age points and across varying contexts.

Autism Adversely Affects Auditory Joint Engagement During Parent-toddler Interactions

This study documents the early adverse effects of autism spectrum disorder (ASD) on auditory joint engagement-the sharing of sounds during interactions. A total of 141 toddlers (49 typically developing [TD], 46 with ASD, and 46 with non-ASD developmental disorders [DD]; average age 22.6 months) were observed during a semi-naturalistic play session with a parent. Reactions to four types of sounds-speech about the child, instrumental music, animal calls, and mechanical noises-were observed before and as parents tried to scaffold joint engagement with the sound. Toddlers with ASD usually appeared aware of a new sound, often alerting to and orienting toward it. But compared to TD toddlers and toddlers with DD, they alerted and oriented less often to speech, a difference not found with the other sounds. Furthermore, toddlers with ASD were far less likely to spontaneously try to share the sound with the parents and to engage with the parent and the sound when parents tried to share it with them. These findings reveal how ASD can have significant effects on shared experiences with nonvisible targets in the environment that attract toddlers' attention. Future studies should address the association between auditory joint engagement difficulties and variations in multimodal joint engagement, sensory profiles, and ASD severity and the reciprocal influence over time of auditory joint engagement experience and language development. LAY SUMMARY: Like most toddlers, toddlers with autism spectrum disorder often alert when they hear sounds like a cat's meow or a train's rumble. But they are less likely to alert when they hear their own name, and they are far less likely to share new sounds with their parents. These findings raise important questions about how toddlers with autism spectrum disorder experience their everyday auditory world, including how they share it with parents who can enrich this experience.

Cognitive functions mediate the effect of preterm birth on mathematics skills in young children

Children born preterm are at risk for cognitive deficits and lower academic achievement. Notably, mathematics achievement is generally most affected. Here, we investigated the cognitive functions mediating early mathematics skills and how these are impacted by preterm birth. Healthy children born preterm (gestational age at birth < 33 weeks; n = 51) and children born full term (n = 27) were tested at ages 5, 6, and 7 years with a comprehensive battery of tests. We categorized items of the TEMA-3: Test for Early Mathematics Abilities Third Edition into number skills and arithmetic skills. Using multiple mediation models, we assessed how the effect of preterm birth on mathematics skills is mediated by spatial working memory, inhibitory control, visual-motor integration, and phonological processing. Both number and arithmetic skills showed group differences, but with different developmental trajectories. The initial performance gap observed in the preterm children decreased over time for number skills but increased for arithmetic skills. Phonological processing, visual-motor integration, and inhibitory control were poorer in children born preterm. These cognitive functions, particularly phonological processing, had a mediating effect on both types of mathematics skills. These findings help define and chart the trajectory of the specific cognitive skills directly influencing math deficit phenotypes in children born very preterm. This knowledge provides guidance for targeted evaluation and treatment implementation.

Associations Between Two Domains of Social Adversity and Recovery Among Persons with Serious Mental Illnesses Being Treated in Community Mental Health Centers

As mental health services are increasingly embracing the recovery model, we conducted a study to better understand how social adversity impacts recovery. We also examined how associations between social adversity and recovery are influenced (moderated or mediated) by symptom severity. Data on seven social adversity measures, eight recovery measures, and symptom severity were collected from 300 English-speaking participants, ages 18-65 years, with a diagnosis of a psychotic or mood disorder, from five community mental health agencies in diverse neighborhoods in Washington, D.C. We employed standard correlation, exploratory factor analyses, analysis of variance, and hierarchic regression procedures. Diagnostic category and gender impacted Home Environment Adversities (e.g., food insecurity, perceived neighborhood disorder), the diagnostic category-by-gender interaction influenced Social and Economic Adversities (e.g., years of education and income), and gender affected Recovery. Controlling for diagnostic category and gender, Social and Economic Adversities accounted for 1.7% of variance in Recovery, while Home Environment Adversities accounted for 8.6% (their joint influence was 3.4%). Although symptom severity did not moderate these associations, it partially mediated the effect of Social and Economic Adversities on Recovery, and substantially mediated the effect of Home Environment Adversities on Recovery. The extent to which patients with serious mental illnesses experience recovery may be meaningfully influenced not only by symptoms, but by their social and environmental circumstances.

Intervention focus moderates the association between initial receptive language and language outcomes for toddlers with developmental delay

This ex-post facto study reanalyzed data from Romski et al. to examine whether intervention focus moderated the relationship between pre-intervention standardized measures of receptive language and post-intervention standardized measures of receptive and expressive language age and observations of expressive target vocabulary size. In all, 62 toddlers with developmental delay were randomly assigned to augmented communication-input (AC-I), augmented communication-output (AC-O), or spoken communication (SC) interventions. AC-I provided augmented language input via spoken language and a speech-generating device (SGD); AC-O encouraged the production of augmented output via an SGD; and SC provided spoken input and encouraged spoken output without using an SGD. Intervention focus moderated the impact of initial receptive language on expressive language age and expressive target vocabulary size. Participants in AC-I, when compared to those in the other two interventions, had a significantly stronger relationship between initial receptive language and post-intervention expressive language age. For expressive target vocabulary size, participants in AC-O showed a strong relationship and those in AC-I a slightly weaker relationship between initial receptive language and expressive target vocabulary size; no significant relationship was found in the SC group. Results emphasize that different interventions may have distinct outcomes for children with higher or lower initial receptive language.

Sharing sounds: The development of auditory joint engagement during early parent-child interaction

Joint engagement-the sharing of events during social interactions-is an important context for early learning. To date, sharing topics that are only heard has not been systematically documented. To describe the development of auditory joint engagement, 48 child-parent dyads were observed 5 times from 12 to 30 months during seminaturalistic play. Reactions to 4 types of sounds-overheard speech about the child, instrumental music, animal calls, and mechanical noises-were observed before and as parents scaffolded shared listening and after the sound ceased. Before parents reacted, even 12-month-old infants readily alerted and oriented to the sounds; over time they increasingly tried to share new sounds with their parents. When parents then joined in sharing a sound, periods of auditory joint engagement often ensued, increasing from two thirds of 12-month observations to almost ceiling level at the 18- through 30-month observations. Overall, the developmental course and structure of auditory joint engagement and joint engagement with multimodal objects and events are remarkably similar. Symbol-infused auditory joint engagement occurred rarely at first but increased steadily. Children's labeling of the sound and parents' language scaffolding also increased linearly while child pointing toward it rose until 18 months and then declined. Future studies should address variations in the development of auditory joint engagement, whether autism spectrum disorder affects how toddlers share sounds, and the role auditory joint engagement may play in gestural and language development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Developmental differentiation of executive functions on the NIH Toolbox Cognition Battery

OBJECTIVE

The NIH Toolbox Cognition Battery (NTCB) is a brief computerized method for evaluating neuropsychological functions in children, adolescents, and adults. We examined how performance on the 2 executive function measures of cognitive flexibility and inhibitory control was related to performance on the other NTCB measures across development.

METHOD

Participants were 1,020 typically developing individuals between the ages of 3 and 21 from the Pediatric Imaging, Neurocognition, and Genetics Study who were divided into 5 age groups (3-6, 7-9, 10-13, 14-17, and 18-21). Scores were adjusted for sex, level of parental education, and family income.

RESULTS

Although the correlations between the 2 executive function measures were moderate and consistent across age groups, their correlations with the other 5 cognitive measures were highest in the youngest age group and decreased across the older age groups. Exploratory factor analysis revealed that all NTCB measures loaded onto a single factor for the 3- to 6-year-olds. Across the older age groups, the executive function and processing speed measures loaded onto one factor, and the vocabulary knowledge, oral reading, and working memory measures loaded onto a second factor.

CONCLUSIONS

These results indicate that younger children's performance on the NTCB is more intercorrelated and less differentiated, while performance on the NTCB executive function measures becomes more differentiated from performance on the other measures with development. These results support the hypothesis that executive functions become increasingly differentiated from other cognitive functions with development as the functional specialization of neural systems progresses throughout childhood and young adulthood. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

After Early Autism Diagnosis: Changes in Intervention and Parent-Child Interaction

This study documents the relation between an autism spectrum disorder (ASD) diagnosis, increases in intervention, and changes in parent-child interaction quality. Information about intervention and observations of interaction were collected before diagnosis and a half year after diagnosis for 79 low-risk toddlers who had screened positive for ASD risk during a well-baby checkup. Children diagnosed with ASD (n = 44) were 2.69 times more likely to increase intervention hours. After ASD diagnosis, the relation between intervention and interaction quality was complex: although increases in intervention and interaction quality were only modestly related, the overall amount of intervention after diagnosis was associated with higher quality interactions. Moreover, lower quality interactions before diagnosis significantly increased the likelihood that intervention would increase post-diagnosis.

An Expanded View of Joint Attention: Skill, Engagement, and Language in Typical Development and Autism

This study provides an expanded view of joint attention and its relation to expressive language development. A total of 144 toddlers (40 typically developing, 58 with autism spectrum disorder [ASD], 46 with developmental delay [DD]) participated at 24 and 31 months. Toddlers who screened positive for ASD risk, especially those subsequently diagnosed with ASD, had poorer joint attention skills, joint engagement during parent-toddler interaction, and expressive language. Findings highlight the dynamic relation between joint attention and language development. In the ASD and DD groups, joint engagement predicted later expressive vocabulary, significantly more than predictions based on joint attention skills. Joint engagement was most severely impacted when toddlers did not talk initially and improved markedly if they subsequently began to speak.

Police officers' volunteering for (rather than being assigned to) Crisis Intervention Team (CIT) training: Evidence for a beneficial self-selection effect

Officers' volunteering for Crisis Intervention Team (CIT) training-rather than being assigned-is assumed to be an important, beneficial self-selection bias. This bias remains poorly characterized, though CIT officers are more likely to be female and to have had exposure to the mental health field. We determined whether or not self-selection is beneficial with regard to knowledge, attitudes, and skills, as well as level of force used (i.e., no or low force versus any form of physical force) and disposition of subjects, in actual encounters. We compared CIT-trained officers who had volunteered with those who had been assigned using data from two prior, linked studies that compared CIT-trained and non-CIT officers on knowledge, attitudes, and skills (251 CIT-trained officers; 68% had volunteered), as well as behaviors (517 actual encounters provided by 91 CIT-trained officers; 70% had volunteered). Of 28 scores on knowledge, attitudes, and skills compared, six were statistically significantly different (p < .01) and another eight were marginally significant (.01 < p < .05). Furthermore, although CIT officers who had volunteered were more likely to report use of some form of physical force as we had defined it (which included the use of handcuffs), when they did so they were more likely to refer to treatment services and less likely to make an arrest. These effects were apparent even when taking into account effects of gender, having had exposure to the mental health field, empathy, and other covariates. In conclusion, we found evidence for benefits of self-selection/volunteering that should be further characterized, as it appears to be associated with better outcomes with regard to key attitudes, skills, and behaviors.

Extending Models of Sensitive Parenting of Infants to Women at Risk for Perinatal Depression

OBJECTIVE

Recognizing that not all mothers at risk for depression engage in insensitive parenting, this study examined predictors of individual differences in sensitive parenting of infants by mothers with histories of depression, who are at elevated risk for depression during the perinatal period.

DESIGN

We examined maternal personal characteristics, context, and early infant temperament as predictors of sensitive parenting. Seventy-six women with a history of major depression were followed through pregnancy and postpartum and observed during play and feeding interactions with their 12-month-old infants.

RESULTS

Maternal personal characteristics (recurrence of clinically significant depression symptom levels during pregnancy or postpartum and higher trait anxiety), context (lower social context and lower income), and early infant temperament (higher negative affectivity, surgency/extraversion, and orienting/regulation) are often associated with less sensitive parenting, with stronger and clearer associations for play than feeding and with some differences based on whether sensitivity was defined as affective matching or rated sensitivity.

CONCLUSIONS

The findings extend support for multi-determination of sensitive parenting of infants to women with histories of depression, albeit with small to medium effect sizes, and suggest ways to identify those who may be most at risk for insensitive parenting and the potential value of intervening in pregnancy to enhance subsequent sensitivity of parenting.

The Communication Play Protocol: Capturing Variations in Language Development

The Communication Play Protocol (CPP) is a semi-naturalistic, lab-based observational procedure that showcases parent-child interactions. This article reflects on how the CPP has matured since we described it over 25 years ago in the May 1999 issue of Perspectives. We emphasize how the CPP has provided us with a stable frame to observe both typically developing children and children with developmental challenges including autism spectrum disorder as they communicate with caregivers in a range of contexts. We also describe three versions of the CPP that have been designed to address different research questions and several methods including engagement state coding and rating items that have been used to extract data from video records of the CPP. We conclude that the CPP can provide both researchers and clinicians with a valuable way to systematically capture variations in language development.

The relationship of prenatal maternal depression or anxiety to maternal caregiving behavior and infant behavior self-regulation during infant heel lance: an ethological time-based study of behavior

BACKGROUND

Sensitive and responsive maternal caregiving behavior strengthens infant self-regulatory capacities (HL), but this regulatory role may be diminished in some mothers with second-trimester prenatal exposure to depression and/ or anxiety (MDA). This study examined maternal and infant behavior during infant heel lance (HL) when mothers had or did not have MDA. Ethological methods and micro-analytic approaches capable of distinguishing and comparing time-based patterning in maternal and infant behavior were used to clarify biological mechanisms, such as MDA, that may underlie observed behavior. Aims were to examine group differences in caregiving behavior between mothers with and without MDA 5 min Pre-HL and 5 min Post-H, and relationships between MDA, maternal caregiving behavior and infant pain behavior self-regulation, concurrently.

METHODS

At second trimester, mothers were assessed for symptoms of mild-severe depression or anxiety. Mothers whose scores exceeded predetermined cut-off scores on one or more of the mental health measures were allocated to the MDA-exposure group, those below to the non-MDA-exposure group. Reliable observers, blinded to MDA status and study phases, coded video records of the caregiving behavior of each study mother for the full duration of the 5 min Pre-HL and 5 min Post-HL study phases. Group differences and associations between mean measures of maternal mental health scores, time-based measures of maternal behavior, and time-based measures of infant pain behavior regulation (previously coded) were concurrently analyzed using comparative and correlational statistics.

RESULTS

MDA-exposed mothers spent significantly more time not embracing, engaging or responding to infant cues than maternal controls Pre-HL and Post-HL. MDA was associated with atypical maternal caregiving behavior, which in turn was related to atypical infant pain behavior self-regulation during and after the HL.

CONCLUSION

Our findings have implication for practice. We recommend inclusion of mothers with MDA and their infants in interventions that strengthen the early mother-infant interaction and mother's regulatory caregiving role. MDA and maternal caregiving behavior must be considered in future infant pain studies to examine if they confound effectiveness of mother driven caregiving interventions for neonatal pain. We highlight the importance of examining maternal mental health throughout the perinatal and postnatal trajectory, and particularly the newborn period.

Social Interaction Observed: Some Approaches to the Analysis of Behavior Streams

Systematic observation of social interaction, noting the presence or absence of predefined behaviors in an ongoing stream of behavior, can result in an overwhelming mass of data. The central thesis of this report is that a few simple conceptual and analytic tools greatly facilitate the handling of such data. Various ways of representing observational data are discussed, and implications are included showing analyses of mother-infant, monkey- monkey, and human adult-adult interaction.

Do beliefs about HIV treatments affect peer norms and risky sexual behaviour among African-American men who have sex with men?

We examined the association between perceptions about condom use among one's peers, beliefs about new HIV treatments, and HIV sexual risk behaviour among 849 young African-American men who have sex with men (MSM). Participants were randomly recruited from and anonymously interviewed in community venues in Atlanta, Georgia, USA, in cross-sectional samples between 1999 and 2002.

Data analyses indicated that 30% of the sample reported unprotected anal intercourse in the past three months; stronger peer condom norms predicted less-frequent risky sexual behaviour. However, the belief in less threat of HIV because of HIV treatments was not associated with either risky sexual behaviour or peer norms, and peer norms did not mediate the association between HIV treatment beliefs and unprotected anal intercourse.

These findings suggest that changing peer norms for condom use may reduce HIV risky sex in African-American MSM, regardless of their beliefs about HIV drug treatments.

Transforming Parent-Child Interaction in Family Routines: Longitudinal Analysis with Families of Children with Developmental Disabilities

The efficacy and consequential validity of an ecological approach to behavioral intervention with families of children with developmental disabilities was examined. The approach aimed to transform coercive into constructive parent-child interaction in family routines. Ten families participated, including 10 mothers and fathers and 10 children 3-8 years old with developmental disabilities. Thirty-six family routines were selected (2 to 4 per family). Dependent measures included child problem behavior, routine steps completed, and coercive and constructive parent-child interaction. For each family, a single case, multiple baseline design was employed with three phases: baseline, intervention, and follow-up. Visual analysis evaluated the functional relation between intervention and improvements in child behavior and routine participation. Nonparametric tests across families evaluated the statistical significance of these improvements. Sequential analyses within families and univariate analyses across families examined changes from baseline to intervention in the percentage and odds ratio of coercive and constructive parent-child interaction. Multiple baseline results documented functional or basic effects for 8 of 10 families. Nonparametric tests showed these changes to be significant. Follow-up showed durability at 11 to 24 months postintervention. Sequential analyses documented the transformation of coercive into constructive processes for 9 of 10 families. Univariate analyses across families showed significant improvements in 2- and 4-step coercive and constructive processes but not in odds ratio. Results offer evidence of the efficacy of the approach and consequential validity of the ecological unit of analysis, parent-child interaction in family routines. Future studies should improve efficiency, and outcomes for families experiencing family systems challenges.

Personality domains, duration of untreated psychosis, functioning, and symptom severity in first-episode psychosis

OBJECTIVES

Early-course psychotic disorders have been extensively studied in terms of phenomenology, but little is known about the influence of personality traits on clinical features of first-episode psychosis. The aim of this study was to explore how the "big five" personality domains (neuroticism, extraversion, openness, agreeableness, and conscientiousness) are associated with treatment delay (duration of untreated psychosis, DUP), functioning, and positive and negative symptom severity.

METHODS

Data for these analyses were obtained from 104 participants enrolled from psychiatric inpatient units in Atlanta, Georgia, between August 2008 and March 2011. The NEO Five-Factor Inventory (NEO-FFI) was used to assess personality domains, and all other variables were measured in a standardized and rigorous manner using psychometrically sound instruments. Correlational analyses and multiple linear regressions were carried out to examine the strength of associations between variables of interest.

RESULTS

Findings indicated that except for openness, all of the other personality variables contributed to some extent to the variance in DUP. Conscientiousness was positively correlated with functioning. Agreeableness was independently negatively associated with positive symptom severity and extraversion was independently negatively correlated with negative symptom severity.

CONCLUSIONS

We report the first evidence suggesting that DUP is in part driven by personality domains. Functioning and symptom severity are also associated with those domains. Personality should be taken into account in order to better understand the phenomenology of early-course psychotic disorders as well as treatment-seeking behaviors.

The Contribution of Early Communication Quality to Low-Income Children's Language Success

The disparity in the amount and quality of language that low-income children hear relative to their more-affluent peers is often referred to as the 30-million-word gap. Here, we expand the literature about this disparity by reporting the relative contributions of the quality of early parent-child communication and the quantity of language input in 60 low-income families. Including both successful and struggling language learners from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, we noted wide variation in the quality of nonverbal and verbal interactions (symbol-infused joint engagement, routines and rituals, fluent and connected communication) at 24 months, which accounted for 27% of the variance in expressive language 1 year later. These indicators of quality were considerably more potent predictors of later language ability than was the quantity of mothers' words during the interaction or sensitive parenting. Bridging the word gap requires attention to how caregivers and children establish a communication foundation within low-income families.

How parents introduce new words to young children: The influence of development and developmental disorders

This study documents how parents weave new words into on-going interactions with children who are just beginning to speak. Dyads with typically developing toddlers and with young children with autism spectrum disorder and Down syndrome (n=56, 23, and 29) were observed using a Communication Play Protocol during which parents could use novel words to refer to novel objects. Parents readily introduced both labels and sound words even when their child did not respond expressively or produce the words. Results highlight both how parents act in ways that may facilitate their child's appreciation of the relation between a new word and its referent and how they subtly adjust their actions to suit their child's level of word learning and specific learning challenges.

Developing and modifying behavioral coding schemes in pediatric psychology: a practical guide

OBJECTIVES

To provide a concise and practical guide to the development, modification, and use of behavioral coding schemes for observational data in pediatric psychology.

METHODS

This article provides a review of relevant literature and experience in developing and refining behavioral coding schemes.

RESULTS

A step-by-step guide to developing and/or modifying behavioral coding schemes is provided. Major steps include refining a research question, developing or refining the coding manual, piloting and refining the coding manual, and implementing the coding scheme. Major tasks within each step are discussed, and pediatric psychology examples are provided throughout.

CONCLUSIONS

Behavioral coding can be a complex and time-intensive process, but the approach is invaluable in allowing researchers to address clinically relevant research questions in ways that would not otherwise be possible.

Emotional engagements predict and enhance social cognition in young chimpanzees

Social cognition in infancy is evident in coordinated triadic engagements, that is, infants attending jointly with social partners and objects. Current evolutionary theories of primate social cognition tend to highlight species differences in cognition based on human-unique cooperative motives. We consider a developmental model in which engagement experiences produce differential outcomes. We conducted a 10-year-long study in which two groups of laboratory-raised chimpanzee infants were given quantifiably different engagement experiences. Joint attention, cooperativeness, affect, and different levels of cognition were measured in 5- to 12-month-old chimpanzees, and compared to outcomes derived from a normative human database. We found that joint attention skills significantly improved across development for all infants, but by 12 months, the humans significantly surpassed the chimpanzees. We found that cooperativeness was stable in the humans, but by 12 months, the chimpanzee group given enriched engagement experiences significantly surpassed the humans. Past engagement experiences and concurrent affect were significant unique predictors of both joint attention and cooperativeness in 5- to 12-month-old chimpanzees. When engagement experiences and concurrent affect were statistically controlled, joint attention and cooperation were not associated. We explain differential social cognition outcomes in terms of the significant influences of previous engagement experiences and affect, in addition to cognition. Our study highlights developmental processes that underpin the emergence of social cognition in support of evolutionary continuity.

Social discrimination and resiliency are not associated with differences in prevalent HIV infection in black and white men who have sex with men

OBJECTIVES

To examine the associations of homophobia, racism, and resiliency with differences in prevalent HIV infection in black and white men who have sex with men (MSM).

METHODS

The Involve[ment]t study is a cohort of black and white MSM aged 18-39 years in Atlanta, GA, designed to evaluate individual, dyadic, and community level factors that might explain racial disparities in HIV prevalence. Participants were recruited irrespective of HIV serostatus from community-based venues and from Internet advertisements and were tested for HIV. We assessed respondents' demographics, whether they had engaged in unprotected anal intercourse (UAI) within the past 6 months, and attitudes about perceived homophobia, perceived racism, and personal resiliency.

RESULTS

Compared with white MSM, black MSM were less likely to report UAI in the past 6 months [odds ratio (OR): 0.59, confidence interval (CI): 0.44 to 0.80], more likely to be HIV positive (OR: 5.05, CI: 3.52 to 7.25), and--among those HIV positive--more likely to report not being aware of their HIV infection (OR: 2.58, CI: 1.18 to 5.65). Greater perceived racism was associated with UAI in the black sample (partial odds ratio: 1.48, CI: 1.10 to 1.99). Overall, perceived homophobia, perceived racism, and resilience were not associated with prevalent HIV infection in our samples. Greater resilience was associated with less perceived homophobia in both black and white samples (Spearman r = -0.27, P < 0.001, for both).

CONCLUSION

Future studies of social discrimination at the institutional and network level, than at the individual level, may explain differences in HIV infection in black and white MSM.

The influence of neighborhood characteristics on police officers' encounters with persons suspected to have a serious mental illness

OBJECTIVE

Police officers' decisions and behaviors are impacted by the neighborhood context in which police encounters occur. For example, officers may use greater force and be more likely to make arrests in disadvantaged neighborhoods. We examined whether neighborhood characteristics influence police encounters with individuals suspected to have a serious mental illness, addictive disorder, or developmental disability.

METHOD

We obtained data on 916 encounters from 166 officers in six jurisdictions in Georgia, USA and abstracted geographical data pertaining to the location of these encounters from United States Decennial Census data. Encounters were nested within 163 census tracts. Officer-reported data covered general encounter characteristics, the officer's perception of the subject's condition, subject demographics, use of force, and disposition of the encounter (e.g., arrest v. referral or transport to treatment services). Geographical data included 17 variables representing population and housing characteristics of the census tracts, from which three indices pertaining to neighborhood income, stability, and immigration status were derived using factor-analytic techniques. We then examined associations of these indices with various encounter-related variables using multi-level analysis.

RESULTS

Encounters taking place in higher-income and higher-stability census tracts were more likely to be dispatch-initiated and take place in a private home compared to those in lower-income and lower-stability neighborhoods. In higher-income neighborhoods, encounters were more likely to involve a subject suspected to have a mental illness (as opposed to an addictive disorder or developmental disability) and less likely to involve a subject suspected to have alcohol problems. The officer's level of force used was not associated with neighborhood factors. Regarding disposition, although the likelihood of arrest was unrelated to neighborhood characteristics, encounters taking place in higher-immigrant neighborhoods were more likely to result in referral or transport to services than those in lower-immigrant neighborhoods.

CONCLUSION

Neighborhood characteristics are important to consider in research on police interactions with individuals with serious mental illnesses, addictive disorders, or developmental disabilities. Such research could inform departmental training policies and procedures based on the needs of the jurisdictions served.

The police-based crisis intervention team (CIT) model: I. Effects on officers' knowledge, attitudes, and skills

OBJECTIVE

Individuals with serious mental illnesses are very likely to interact with police officers. The crisis intervention team (CIT) model is being widely implemented by police departments across the United States to improve officers' responses. However, little research exists on officer-level outcomes. The authors compared officers with or without CIT training on six key constructs related to the CIT model: knowledge about mental illnesses, attitudes about serious mental illnesses and treatments, self-efficacy for deescalating crisis situations and making referrals to mental health services, stigmatizing attitudes, deescalation skills, and referral decisions.

METHODS

The sample included 586 officers, 251 of whom had received the 40-hour CIT training (median of 22 months before the study), from six police departments in Georgia. In-depth, in-person assessments of officers' knowledge, attitudes, and skills were administered. Many measures were linked to two vignettes, in written and video formats, depicting typical police encounters with individuals with psychosis or with suicidality.

RESULTS

CIT-trained officers had consistently better scores on knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions. Effect sizes for some measures, including deescalation skills and referral decisions pertaining to psychosis, were substantial (d=.71 and .57, respectively, p<.001).

CONCLUSIONS

CIT training of police officers resulted in sizable and persisting improvements in diverse aspects of knowledge, attitudes, and skills. Research should now address potential outcomes at the system level and for individuals with whom officers interact.

The police-based crisis intervention team (CIT) model: II. Effects on level of force and resolution, referral, and arrest

OBJECTIVE

The crisis intervention team (CIT) model is a widely implemented police-based program to improve officers' responses to individuals with behavioral disorders. The authors examined levels of force used by officers with or without CIT training and disposition decisions in a large sample of encounters with individuals whom they suspected of having a serious mental illness, a drug or an alcohol problem, or a developmental disability.

METHODS

A total of 180 officers (91 with CIT training and 89 without) in six departments reported on 1,063 encounters, including level of force and disposition (resolution at the scene, referral or transport to services, or arrest).

RESULTS

CIT training status was generally not predictive of level of force, although CIT-trained officers were significantly more likely to report verbal engagement or negotiation as the highest level of force used (odds ratio [OR]=2.00, p=.016). For CIT-trained officers, referral or transport was a more likely outcome (OR=1.70, p=.026) and arrest was less likely (OR=.47, p=.007) than for officers without CIT training; these findings were most pronounced when physical force was necessary. Analyses of disposition differences by officers' perceptions of subjects' primary problem (for example, mental illness only versus a drug or an alcohol problem) found some effects of CIT training status.

CONCLUSIONS

CIT training appears to increase the likelihood of referral or transport to mental health services and decrease the likelihood of arrest during encounters with individuals thought to have a behavioral disorder. Research should address subject- and system-level outcomes that complement this early evidence of successful prebooking jail diversion.

From interactions to conversations: the development of joint engagement during early childhood

This research traces the development of symbol-infused joint engagement during mother-child interactions into the preschool years. Forty-nine children, who had been previously observed as toddlers (L. B. Adamson, R. Bakeman, & D. F. Deckner, ), were systematically observed during interactions with their mothers at ages 3½, 4½, and 5½ during activities related to the past and future, internal states, and graphic systems. Although the amount of symbol-infused joint engagement reached a ceiling by 3½, its focus continued to become more complex and its form more balanced. Individual differences in children's symbol-infused joint engagement were stable across 4 years. These findings highlight both how joint engagement is transformed as conversational skills develop and how it remains rooted in earlier interactions and supported by caregiver's actions.

Effect of congenital heart defects on language development in toddlers with Down syndrome

BACKGROUND

Down syndrome (DS, OMIM #190685) is the most commonly identified genetic form of intellectual disability with congenital heart defect (CHD) occurring in 50% of cases. With advances in surgical techniques and an increasing lifespan, this has necessitated a greater understanding of the neurodevelopmental consequences of CHDs. Herein, we explore the impact of CHD on language development in children with DS.

METHODS

Twenty-nine children with DS were observed systematically in parent-child interactions using the Communication Play Protocol to evaluate their language use; they also completed the Mullen Scales of Early Learning and MacArthur Communication Development Inventory. Mean ages were 31.2 months for children with DS and CHD (DS + CHD, n = 12) and 32.1 months for children with DS and a structurally normal heart (DS - CHD, n = 17).

RESULTS

Compared with the DS - CHD controls, the DS + CHD group revealed lower scores in multiple areas, including fine motor skills and expressive and receptive vocabulary. Whereas most differences were not statistically significant, the Communication Development Inventory word count and symbol-infused joint engagement differed significantly (P < 0.01) and marginally (P = 0.09) between groups.

CONCLUSIONS

Finding that CHDs may account for part of the variation in language delay allows us to consider the specific mechanisms underlying the impact of CHDs on language acquisition in children with DS. Conclusions from this first study on early language outcomes of children with DS + CHD may be useful for clinicians in providing developmental surveillance and early intervention programmes with specific emphasis on language therapy as part of long-term follow-up for children with DS + CHD.

Rating parent-child interactions: joint engagement, communication dynamics, and shared topics in autism, Down syndrome, and typical development

A battery of 17 rating items were applied to video records of typically-developing toddlers and young children with autism and Down syndrome interacting with their parents during the Communication Play Protocol. This battery provided a reliable and broad view of the joint engagement triad of child, partner, and shared topic. Ratings of the child's joint engagement correlated very strongly with state coding of joint engagement and replicated the finding that coordinated joint engagement was less likely in children with autism. Ratings of other child actions, of parent contributions, and of shared topics and communicative dynamics also documented pervasive variations related to diagnosis, language facility, and communicative context.

Modalities of infant-mother interaction in Japanese, Japanese American immigrant, and European American dyads

Cultural variation in relations and moment-to-moment contingencies of infant-mother person-oriented and object-oriented interactions were compared in 118 Japanese, Japanese American immigrant, and European American dyads with 5.5-month-olds. Infant and mother person-oriented behaviors were related in all cultural groups, but infant and mother object-oriented behaviors were related only among European Americans. Infant and mother behaviors within each modality were mutually contingent in all groups. Culture moderated lead-lag relations: Japanese infants were more likely than their mothers to respond in object-oriented interactions; European American mothers were more likely than their infants to respond in person-oriented interactions. Japanese American dyads behaved like European American dyads. Interactions, infant effects, and parent socialization findings are set in cultural and accultural models of infant-mother transactions.

Mother-infant socioemotional contingent responding in families by adoption and birth

Contingencies of three maternal and two infant socioemotional behaviors that are universal components of mother-infant interaction were investigated at 5 months in 62 mothers (31 who had adopted domestically and 31 who had given birth) and their first children (16 males in each group). Patterns of contingent responding were largely comparable in dyads by adoption and birth, although the two groups of mothers responded differentially to the two types of infant signals. Mothers in both groups were more responsive than infants in social and vocal interactions, but infants were more responsive in maternal speech-infant attention interactions. Family type × gender statistical interactions suggested a possible differential role of infant gender in establishing mother-infant contingencies in families by adoption and birth.

Support for a dimensional view of autism spectrum disorders in toddlers

We examined whether clinically distinct subgroups can be derived from a sample of toddlers (n = 186) who failed the Modified Checklist for Autism in Toddlers, received a comprehensive clinical evaluation, and were diagnosed with an autism spectrum disorder (ASD). Three subgroups emerged from cluster analysis distinguished by (a) social, communication, and intellectual skills and (b) the rate and intensity of repetitive behaviors and abnormal sensory response. Preoccupations, compulsions, and rituals did not distinguish resultant subgroups. These results support a dimensional diagnostic view of ASDs in toddlers since subgroup differences were based on symptom severity rather than different symptom profiles. Results also identify specific types and levels of behavioral deficit relevant to toddler populations. Implications for early diagnosis are discussed.