A Comparison of Maternal versus Paternal Nonverbal Behavior During Child Pain.

Parental behavior plays a significant role in children's pain response. Prior research has found generally no differences between mothers' and fathers' verbal behavior during child pain. This study compared mothers' and fathers' nonverbal behavior during child pain. Nonverbal behavior of mothers (n = 39) and fathers (n = 39) of 39 children (20 boys) aged 8 to 12 years who participated in the cold pressor task (counterbalanced once with each parent) was coded. A range of nonverbal behaviors were coded, including distraction, physical proximity, physical comfort/reassurance, procedure-related attending behavior, and fidgeting. The most common behaviors parents engaged in were fidgeting, procedure-related attending behaviors, and physical proximity. Results indicated that the types of nonverbal behavior parents engage in did not differ between mothers and fathers. However, children of mothers who engaged in more physical comfort/reassurance reported higher levels of pain intensity, and children of mothers who engaged in more procedure-related attending behaviors had lower pain tolerance. Further, both mothers and fathers who engaged in higher levels of verbal nonattending behaviors also engaged in lower levels of nonverbal procedure-related attending behaviors. These findings further support the importance of considering the influence of mothers and fathers in children's pain, and provide novel insights into the role of nonverbal behavior.

"He says, she says": a comparison of fathers' and mothers' verbal behavior during child cold pressor pain.

UNLABELLED: Mothers' behavior has a powerful impact on child pain. Maternal attending talk (talk focused on child pain) is associated with increased child pain whereas maternal non-attending talk (talk not focused on child pain) is associated with decreased child pain. The present study compared mothers' and fathers' verbal behavior during child pain. Forty healthy 8- to 12-year-old children completed the cold pressor task (CPT)-once with their mothers present and once with their fathers present in a counterbalanced order. Parent verbalizations were coded as Attending Talk or Non-Attending Talk. Results indicated that child symptom complaints were positively correlated with parent Attending Talk and negatively correlated with parent Non-Attending Talk. Furthermore, child pain tolerance was negatively correlated with parent Attending Talk and positively correlated with parent Non-Attending Talk. Mothers and fathers did not use different proportions of Attending or Non-Attending Talk. Exploratory analyses of parent verbalization subcodes indicated that mothers used more nonsymptom-focused verbalizations whereas fathers used more criticism (a low-frequency occurence). The findings indicate that for both mothers and fathers, verbal attention is associated with higher child pain and verbal non-attention is associated with lower child pain. The results also suggest that mothers' and fathers' verbal behavior during child pain generally does not differ. PERSPECTIVE: To date, studies of the effects of parental behavior on child pain have focused almost exclusively on mothers. The present study compared mothers' and fathers' verbal behavior during child pain. The results can be used to inform clinical recommendations for mothers and fathers to help their children cope with pain.

Behavioral interventions for sleep problems in children with autism spectrum disorders: current findings and future directions.

OBJECTIVE: To examine behavioral interventions for sleep problems in children with autism spectrum disorders (ASD). METHODS: A systematic review evaluating all published studies examining the effectiveness of behavioral treatment of sleep problems in children with ASD is presented. RESULTS: Based on the Chambless criteria for treatment efficacy, both standard extinction and scheduled awakenings met criteria for possibly efficacious interventions for sleep problems in children with ASD. Some positive outcomes have been reported, but there has not been enough research examining graduated extinction, faded bedtime, stimulus fading and chronotherapy to make any firm conclusions regarding treatment efficacy for children with ASD. CONCLUSIONS: Although more rigorous research is required in order for any sleep interventions for children with ASD to be considered probably efficacious or well-established, the current literature should be used to guide clinical decisions and direct research questions.

Case study: A case-series evaluation of a behavioral sleep intervention for three children with autism and primary insomnia.

OBJECTIVE: To assess the effectiveness of a manualized multi-component behavioral sleep intervention for children with autism spectrum disorder (ASD) and primary insomnia. METHODS: Three children (2 males and 1 female, aged 8-9 years) participated. The intervention consisted of a treatment handbook for parents; a distance treatment approach was used in which parents had weekly telephone contact with a therapist. The main behavioral strategies employed were Faded Bedtime with Response Cost and positive reinforcement. Within a case-series design, both subjective (parent-report questionnaires and sleep diaries) and objective (actigraphy) measures were used to record changes in children's sleep and daytime behavior. RESULTS: For all 3 children, mean sleep onset latency was reduced following the intervention. These improvements were generally maintained at follow-up 12 weeks later. CONCLUSIONS: The current study provides preliminary evidence for the effectiveness of a manualized behavioral sleep intervention program for improving insomnia in children with ASD.

Heritability of individual depressive symptoms.

BACKGROUND: In attempting to understand the familial basis of depression, most studies have focused on broad indices of depression and mood change. Broad indices may not adequately reflect the heritable basis of depression because of an unexplored possibility that not all symptoms are heritable. METHODS: The heritability of individual depressive symptoms was estimated from a sample of 343 general population volunteer twin pairs who completed the Beck Depression Inventory, the Centre for Epidemiologic Studies Depression Scale and items from the Symptom Checklist assessing depressive symptoms. Principal component analysis of the items extracted 14 factors that represented a wide range of depressive symptomatology. RESULTS: The factors were differentially heritable (h2 range: 0.0-35.0%). The factors that have a heritable basis described endogenous or physiological functions (e.g. loss of appetite, libido/pleasure). Symptoms such as negative affect or tearfulness did not have a heritable basis, suggesting that these symptoms are responses to negative life events/experiences or a learned association to changes in physiologic function. LIMITATIONS: Relatively small size of the sample. CONCLUSIONS: Depressive symptoms are differentially heritable and the results suggest that future research, such as genotyping studies, separates heritable and non-heritable symptom clusters prior to analysis. This will help identify which genes are involved and what their function in depression may be, leading to the development of more targeted and effective therapies.