Internalization of Behavior Management Skills among Teachers in a Specialized School Serving Students with Neurodevelopmental Disorders.

Prior studies suggest that the fidelity of teachers' implementation of behavior management practices in the classroom diminish over time. Establishing how long it takes teachers to fully learn and sustain their independent use of these skills may aid in addressing implementation drift. The primary goals of this pilot study were twofold: (1) determine how long it takes teachers employed at a school serving students with Neurodevelopmental Disorders to internalize evidence-based behavior management practices (i.e., positive reinforcement, direct commands), and (2) establish whether some skills take longer than others for teachers to internalize. We also had the opportunity to evaluate whether a pre-determined threshold of skill internalization (e.g., 50% increase in skill use for three consecutive weeks) as defined in the extant literature translates into sustained skill implementation. Our results suggest that the length of standard teacher trainings may not be adequate given upwards of 2 months is required for the internalization of one skill and the time needed to reach internalization is dependent upon the skill taught and may deviate by at least 2 weeks across skills. However, given the variability observed in teachers' implementation of skills following internalization, this pre-determined threshold of skill internalization may be insufficient and requires further examination in future studies.

A Meta-Analytic Review of Randomized Controlled Trials of the Good Behavior Game.

The Good Behavior Game (GBG) is widely recognized as an evidence-based intervention that reinforces prosocial behaviors and discourages disruptive behaviors among students in the classroom setting. The current meta-analysis synthesized randomized controlled trials of the GBG to examine its impact on proximal student outcomes across seven studies representing 4,700 children. Although recent reviews focusing on single-case studies of the GBG have reported moderate to large treatment effects, our results were quite modest in comparison (hedges' g = 0.09-0.32). Treatment effect sizes also varied according to outcome and sex. The GBG significantly outperformed the comparison conditions for peer-rated conduct problems and shy/withdrawn behavior as well as teacher-rated conduct problems for which a greater effect was found for girls relative to boys. Moreover, the treatment effect in favor of the GBG for reading comprehension was specific to boys and not girls. No significant differences were found between the GBG and comparison conditions for inattention and teacher-rated shy/withdrawn behavior. These results suggest that the GBG may not be as impactful as originally reported and the intended population and treatment targets should be considered before its implementation in the classroom.

Sibling relationship quality and psychosocial outcomes among adult siblings of individuals with autism spectrum disorder and individuals with intellectual disability without autism.

Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability.

Parents' goals for ADHD care in a clinical pediatric sample.

OBJECTIVE: This report describes goals parents have for their children with attention deficit/hyperactivity disorder (ADHD) when coming for a pediatric visit. METHOD: Data were collected from 441 parents of children presenting to either a primary care pediatric practice or a developmental behavioral pediatric practice. Parents were asked to report their top 1 or 2 goals for improvement for their children, and responses were coded into 17 categories. These categories were further grouped into 7 goal composites and examined in relation to demographic characteristics of the families, office type, and symptomology. RESULTS: Goals related to reducing symptoms of inattention were most common, but goals were heterogeneous in nature. Goals were meaningfully, but modestly, related to symptomology. In several instances, symptoms of comorbid conditions interacted with symptoms of ADHD in relation to specific goals being reported. CONCLUSIONS: Parents' goals extended beyond ADHD symptoms. Pediatricians need an array of resources to address parents' goals.

Parenting practices and attention-deficit/hyperactivity disorder: new findings suggest partial specificity of effects.

OBJECTIVE: Examine the relations of attention-deficit/hyperactivity disorder (ADHD) diagnosis and symptom domains with parenting practices. METHOD: One hundred eighty-one children (ages 6-12 years) were assessed for ADHD and non-ADHD status via parent semistructured clinical interview (Diagnostic Interview Schedule for Children-IV) and parent and teacher standardized ratings. They included controls (n = 52), ADHD Inattentive type (n = 24), and ADHD Combined type (n = 71) as well as "not otherwise specified" cases (included in regressions only). Parents completed the Alabama Parenting Questionnaire and a structured interview (the Diagnostic Interview Schedule-IV) about their own ADHD symptoms. Symptom counts were created for oppositional defiant disorder (ODD), conduct disorder (CD), inattention, and hyperactivity-impulsivity to complement categorical analyses. RESULTS: In categorical analysis, maternal inconsistent discipline was associated with ADHD Combined type, even with child ODD and CD diagnosis and parent ADHD symptoms statistically controlled. Paternal low involvement was associated with ADHD regardless of subtype, even with ODD and CD covaried; however, the effect was marginal when paternal ADHD was covaried. In dimensional analysis of symptom counts, maternal inconsistent discipline was related to all behavior domains but none uniquely. Paternal low involvement and inconsistent discipline were related uniquely with child inattention and not other behavioral domains. CONCLUSIONS: Specific aspects of parenting are related to ADHD apart from ODD or CD and are not fully attributable to parental ADHD.