Up you get: Norwegian parents' reactions to children's negative emotions.

INTRODUCTION: Developmental research suggests that children learn to regulate their emotions and behavior through a process of emotion socialization. The main body of literature is based on samples from the United States, and very little is known about the socialization of emotions in Nordic settings. OBJECTIVES: The current study aimed to explore associations between mothers' and fathers' reactions to children's negative emotions and externalizing behavior problems in a Nordic cultural context, and to explore gender differences in these associations. METHODS: Parent-report data on the Coping with Children's Negative Emotions Scale (CCNES) and the Eyberg Child Behavior Inventory 6 (ECBI) was collected in a large sample of Norwegian preschool-aged children (mothers, n = 242; fathers, n = 183; N = 257; M = 54 months, SD = 4.54; 49% boys). Teacher-report data was collected using the Strengths and Difficulties Questionnaire (SDQ) conduct scale (n = 117). RESULTS: Both parents' supportive and non-supportive reactions were associated with child externalizing difficulties in expected directions as evidenced by path models, controlling for socioeconomic status and age. A pattern emerged in which non-supportive reactions to a greater extent predicted an increase in externalizing problems in girls, and supportive reactions predicted lower levels of externalizing problems in boys. CONCLUSION: Our findings supported the basic assumptions of emotion socialization theory in a Nordic cultural context in which parental supportive and non-supportive responses are related to child externalizing difficulties. Nordic parents are important socialization agents for their children, but their behaviors had a differential effect on boys' and girls' externalizing behavior problems.

Developmental trajectories of child and adolescent emotional problems: associations with early adult alcohol use behaviors.

BACKGROUND: Whether emotional problems during childhood and adolescence are longitudinally associated with adult alcohol use behaviors is unclear. This study examined associations between developmental trajectories of emotional problems and early adult alcohol use behaviors, while considering co-occurring conduct problems, developmental change/timing, sex differences, and potential confounds. METHODS: Participants were from the Twins Early Development Study (analytic N = 19,908 individuals). Emotional and conduct problems were measured by parent reports at child ages 4, 7, and 9 years and via self-reports at ages 9, 11, and 16 years on the Strengths and Difficulties Questionnaire. Alcohol use behaviors (alcohol consumption and alcohol-related problems) were self-reported by the twins on the Alcohol Use Disorders Identification Test at age 22 years. Piecewise latent growth curve models described nonlinear developmental trajectories of emotional and conduct problems from ages 4 to 16. At age 22, alcohol use was regressed on emotional and conduct problems' intercepts and slopes from piecewise latent growth curve model and sex differences in regression coefficients were tested. Using twin modeling, Cholesky decompositions and direct path models were compared to test whether significant phenotypic associations were best explained by direct phenotypic influences or correlated genetic and environmental influences. RESULTS: Emotional problems had different associations with alcohol-related problems versus alcohol consumption. After accounting for direct influences from conduct problems, emotional problems were not associated with alcohol-related problems, while emotional problems at age 9 were negatively associated with alcohol consumption in males. CONCLUSIONS: Overall, findings did not support emotional problems as prospective risk factors for severe alcohol use above and beyond risks associated with conduct problems. Sex- and age-specific links between emotional problems and alcohol consumption in early adulthood may be worthy of further exploration, particularly as twin analyses improved our confidence that such links may be underpinned by causal mechanisms.

Maternal Perceptions and Responsiveness to Cry in Armed Conflict Zones: Links to Child Behavior Problems.

Crying is a typical infant behavior that activates parental caregiving behaviors, acting as "human alarms" important for the infant's survival. When living under war-related threat, the auditory system may be sensitized given its importance for survival, potentially impacting maternal cry processing. Children living in armed-conflict zones are at increased risk for behavior problems, which may relate to both direct exposure and indirect effects through their parents' perceptions and behaviors. This hypothesis was examined in a sample of mothers and their first-born children (aged 10-45 months) living in the Gaza vicinity area in Israel, chronically exposed to missile alarms (high-exposure; n = 45), and a comparison group (low-exposure; n = 86). Group differences in child behavior problems and maternal perceptions of and responsiveness to cry were investigated. A moderated indirect-effect of maternal cry perceptions on child behavior problems via maternal responsiveness to cry was examined. In the high-exposure group, children had more externalizing problems and mothers rated cries as more aversive. Maternal cry perception was indirectly related to child behavior problems via responsiveness to cry only in the high-exposure group: higher perceptions of cry as aversive or the child as distressed were related to faster responding to crying, and faster cry responsiveness was linked with fewer behavior problems. Results suggest that in armed-conflict zones with auditory warning signals, the parental caring system may be easily activated by cries due to the strong association between alarms and threat. Furthermore, children may need their mothers to react faster when feeling distressed, possibly because of the surrounding threat.

Neurobehavioral Outcomes of Children with Antenatal Exposure to Antiseizure Medications.

OBJECTIVES: To evaluate the effect of antiepileptic medications prescribed to mothers during pregnancy on the development and behavior of children. METHODS: From the Kerala Registry of Epilepsy and Pregnancy, 98 children between the ages of 1½ to 2½ y were consecutively chosen. Children of mothers who did not have epilepsy during pregnancy and not exposed to antiseizure medications (ASMs) antenatally were selected as comparator group. Developmental assessment of the children was performed using Developmental Assessment Scale for Indian Infants (DASII) and Receptive-Expressive Emergent Language Scale (REELS). Behavior outcomes were assessed using Child Behavior Checklist. RESULTS: A significant delay in expressive language skills was seen in children exposed to antiseizure medication with an odds ratio of 2.539 (95% CI 1.10, 5.85, P = 0.026). A delay in expressive language skills was seen in polytherapy with clobazam (odds ratio 6.83; 95% CI 2.17, 21.56, P < 0.001). Also, delay was seen in receptive language skills in the same polytherapy group (odds ratio of 7.333; 95% CI 2.16, 24.92, P < 0.001). There were no statistically significant differences between study and comparative groups in motor and mental quotient domains and behavioral outcomes. CONCLUSIONS: The finding of speech delay in children exposed to ASMs is significant since individuals with a history of childhood speech or language disorders may experience long-term difficulties in mental health, social well-being, and academic outcomes.

The moderating role of psychological capital in the relationship between school-related stress and outcomes of academic achievement and behavior problems among students with health impairments.

Numerous researches have examined the relationship between school-related stress and outcomes of academic achievement and behavior problems; however, a very few studies were conducted to assess the moderating role of psychological capital in this relat.ionship, especially focusing on students with health impairments. The current study was carried out to investigate the association of school-related stress and psychological capital with academic achievement and behavior problems in students with health impairments, as well as the possible moderating influence of psychological capital in the school-related stress and outcomes relationships. The study involved 233 students with health impairments in Addis Ababa. Instruments used for the study include the Demographic Questionnaire, Perceived School-Related Stress Scale, Psychological Capital Questionnaire, Strengths and Difficulties Questionnaire, and school record reviews. Descriptive statistics, structural equation modeling, and multi-group structural equation modeling were utilized to analyze the data. Results revealed that school-related stress was significantly and negatively associated with academic achievement and positively with behavior problems. Psychological capital was significantly and positively associated with academic achievement and negatively with behavior problems. Higher levels of psychological capital had a significant moderating role in the relationships between school-related stress and both outcomes of academic achievement and behavior problems. The finding suggests that PsyCap is a positive resource to counteract the detrimental impacts of school-related stress on the academic achievement and behavior problems of students with health impairments.

Factors associated with behavioral euthanasia in pet dogs.

When pet dogs demonstrate certain serious problem behaviors, this may lead owners to choose behavioral euthanasia. However, research on behavioral euthanasia of pet dogs is sparse and previously published papers have not specifically sampled owners who made the decision to euthanize for behavior. The Behavioral Euthanasia in Pet Dogs Questionnaire was created to collect a wide range of information from dog owners who made behavioral euthanasia decisions. Using this survey, we explored the types of behaviors associated with behavioral euthanasia. Human-directed aggression, especially toward adults living in the household, was the most frequently reported reason for choosing behavioral euthanasia; followed by aggression toward other animals, especially other dogs living in the same household. The majority of dogs displaying human-directed or other animal-directed aggression were reported to have bitten and broken skin, and many of these had bitten in multiple or severe incidents. Most dogs had lived in their homes and displayed problem behaviors for over a year prior to behavioral euthanasia, and the euthanasia occurred at a variety of ages, from less than 1 year old to 18 years old. Additional research is required to understand environmental or nonbehavioral factors contributing to the behavioral euthanasia of companion animals, as well as the psychosocial and emotional impact of behavioral euthanasia on the human experience. Understanding the behavioral factors associated with behavioral euthanasia can direct resources toward problem behavior interventions, improve public education about animal behavior, and strengthen the human-animal bond.

Effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral problems in elementary school boys: a preliminary randomized controlled trial.

This study aimed to examine the effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral issues in elementary school boys. A randomized controlled trial design (pretest-posttest with a control group) was utilized. Thirty elementary school boys with school refusal issues were randomly assigned to intervention (n = 15) and control (n = 15) groups. The intervention group received ten sessions of cognitive-behavioral group play therapy. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire and Rutter's Children's Behavior Questionnaire were used as assessment tools. Mean scores for anxiety-based school refusal and behavioral problems in the intervention group showed a significant decrease (p < 0.001). Cognitive-behavioral group play therapy is a practical approach to reducing anxiety levels and behavior problems in children with anxiety-based school refusal in primary school grades.

The role of parental stress on emotional and behavioral problems in offspring: a systematic review with meta-analysis.

OBJECTIVE: Empirical evidence underscores an association between parental stress and emotional and behavioral problems in offspring. However, a comprehensive systematic review or meta-analysis on this topic is lacking. Thus, this study aims to address the scientific inquiry: Is there a relationship between parental stress and emotional/behavioral problems in children? SOURCES: This systematic review with a meta-analysis surveyed PubMed, PsycINFO, and the Biblioteca Virtual em Saúde between August and September 2021. The present search combined terms (school-age children) AND (parental stress OR parenting stress OR family stress) AND (emotional and behavioral problems OR internalizing and externalizing problems). Eligibility criteria encompassed cross-sectional, cohort, and case-control studies published within the last five years, exploring the association between parental stress (stressful life events and parenthood-related stress disorders) and emotional/behavioral problems in school-age children. PROSPERO ID CRD42022274034. SUMMARY OF THE FINDINGS: Of the 24 studies meeting all inclusion criteria (n = 31,183) for the systematic review, nine were eligible for inclusion in the meta-analysis. The meta-analysis revealed an association between parental stress and emotional problems (COR: 0.46 [95 % CI: 0.27 - 0.61], p < 0.001, Heterogeneity = 89 %) as well as behavioral problems (COR: 0.37 [95 % CI: 0.27 - 0.46], p < 0.001, Heterogeneity = 76 %). CONCLUSIONS: These findings indicate that parental stress predicts emotional/behavioral problems in school-age children. Since these problems are related to long-term negative effects in adulthood, these results are crucial for preventing mental health problems in offspring and for screening and managing parental stress.

Interviewing young offenders about child-on-child sexual abuse.

This study compared two versions of the NICHD Protocol for interviewing young suspected sexual offenders: the Revised Suspect Protocol (RSP) and the Standard Suspect Protocol (SSP). The RSP incorporated relevant evidence-based practices informed by research on the value of (a) effectively explaining the suspects' rights, (b) rapport building and support, and (c) appropriate questioning strategies. Interviewers using the RSP communicated the children's rights more effectively (reading them more often, checking, verifying, and correcting understanding) and provided more support. In the substantive phase, they remained supportive while recall prompts dominated the questioning. Compared to children in the SSP group, children in the RSP condition understood their rights better, were more responsive during rapport-building, and reacted to interviewer support in the substantive phase with increased responsiveness, which in turn, predicted reduced reluctance, increased emotional expression, and greater informativeness. They were also more likely to make full rather than partial confessions than children in the SSP group. Full confessions were positively predicted by the appropriate communication of legal rights, interviewer support, and reliance on open-ended prompts, thereby confirming the superiority of the RSP relative to the SSP.

Assessing Temperament Risk Factors in Late Childhood and Early Adolescence: Development and Validation of the Integrative Late Childhood Temperament Inventory.

Childhood temperament has a well-documented influence on later life outcomes, notably behavior problems, quality of interpersonal relationships, and academic achievement. However, there is at present a lack of brief measures that assess temperament characteristics which are represented across models of temperament in the late childhood and early adolescence period. To redress this gap, the aim of the current study was to develop and validate a short questionnaire that extends an earlier integrative measure of temperament, the Integrative Child Temperament Inventory (ICTI) to the late childhood period. The new measure (named Integrative Late Childhood Temperament Inventory, ILCTI) includes all five components of the ICTI (frustration, behavioral inhibition, attention/persistence, activity level, sensory sensitivity), plus affiliation. German- or English-speaking parents rated a total of 525 children, aged 8 to 14 years. Confirmatory factor analyses supported the predicted structure of the new measure. Examination of fit indices and psychometric analyses showed that 24 items are sufficient to capture all six dimensions reliably. Next to convergent validity with established measures of temperament and personality, we also present analyses of associations with measures of externalizing problems, internalizing problems, and school failure all of which support the instrument's clinical utility. Thus, despite its brevity, the ILCTI is a reliable and valid measure of late childhood temperament that can be helpful in assessing risk of developing behavior problems or school failure.

Exploring Gender Moderation: The Impact of Neighborhood Factors on Adolescent Internalizing and Externalizing Symptoms.

Limited previous studies investigated the influences of various types of neighborhood factors on adolescent behavior problems. Meanwhile, although previous theoretical frameworks suggested that gender played a significant role in terms of neighborhood impacts on adolescent behavioral problems, few studies investigated the gender differences in such neighborhood influences. Using the year 9 and year 15 data of the national dataset Future of Families and Child Wellbeing Study (FFCWS, overly sampled participants from low-income families), this study examined how the neighborhood structural and process factors can affect adolescent behavioral problems (internalizing and externalizing symptoms) and whether gender worked as a significant moderator for such relationships in the U.S. Structural equation models and multigroup SEM were estimated (N = 3411). Findings suggested that residential instability was associated with increased levels of internalizing symptoms among adolescents at age 15, whereas neighborhood social cohesion was linked to reduced levels of externalizing symptoms throughout adolescence. Furthermore, the moderating effects of gender were found for the association between residential instability and internalizing symptoms. Implications of such findings are further discussed.

Association of behaviors and asthma control in a sample of Lebanese adolescents with asthma.

BACKGROUND: The relationship between behavioral problems and asthma is bidirectional; while the presence of a chronic disease such as asthma might predispose the person to stress, anxiety, and other behavioral issues, behavioral problems might in turn cause uncontrolled asthma through nonadherence to asthma management strategies. In Lebanon, behavioral problems and uncontrolled asthma could be of significant concern for adolescents. Consequently, we found it necessary to evaluate association between behavioral problems and uncontrolled asthma in a sample of Lebanese adolescents. METHODS: Data for this cross-sectional study were collected using the snowball sampling technique in July 2023. The questionnaire was developed with Google Forms and distributed to participants via social media platforms and messaging applications. The Asthma Control Test (ACT) was used to check for uncontrolled asthma, and the Youth Self-Report (YSR) scale was used to assess behavioral problems. It yields nine subscales (anxious-depressed, withdrawn-depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, aggressive behavior, and other problems) and a total score. RESULTS: When taking each behavior score as an independent variable, older age was associated with lower ACT scores (more controlled asthma); F(15, 186) = 3.66, P = 0.014, and 95% Confidence Interval (CI) [-0.85, -0.10]. Living in a rural area, compared to urban was associated with higher ACT scores, P = 0.018, and 95% Confidence Interval (CI) [0.28, 2.94]. The intake of the COVID-19 vaccine, P = 0.003 and 95% CI [0.73, 3.55]; waterpipe smoking, P = 0.017 and 95% CI [0.38, 3.85]; and having more somatic complaints, P = 0.005 and 95% CI [0.04, 0.25], also were significantly associated with higher ACT scores (more uncontrolled asthma). When taking the total behavior score as an independent variable, higher YSR scores were associated with higher ACT scores (more uncontrolled asthma), F(10, 191) = 4.30, P = 0.038, and 95% CI [0.003, 0.10]. CONCLUSION: Our findings support the inclusion of mental health treatments for better asthma control and point to a link between behavioral issues and uncontrolled asthma. In a developing nation without a clear established strategy for asthma prevention, the findings of this study could help develop potentially beneficial public health treatments.

Measurement bias in caregiver-report of early childhood behavior problems across demographic factors in an ECHO-wide diverse sample.

Background: Research and clinical practice rely heavily on caregiver-report measures, such as the Child Behavior Checklist 1.5-5 (CBCL/1.5-5), to gather information about early childhood behavior problems and to screen for child psychopathology. While studies have shown that demographic variables influence caregiver ratings of behavior problems, the extent to which the CBCL/1.5-5 functions equivalently at the item level across diverse samples is unknown. Methods: Item-level data of CBCL/1.5-5 from a large sample of young children (N = 9087) were drawn from 26 cohorts in the Environmental influences on Child Health Outcomes program. Factor analyses and the alignment method were applied to examine measurement invariance (MI) and differential item functioning (DIF) across child (age, sex, bilingual status, and neurodevelopmental disorders), and caregiver (sex, education level, household income level, depression, and language version administered) characteristics. Child race was examined in sensitivity analyses. Results: Items with the most impactful DIF across child and caregiver groupings were identified for Internalizing, Externalizing, and Total Problems. The robust item sets, excluding the high DIF items, showed good reliability and high correlation with the original Internalizing and Total Problems scales, with lower reliability for Externalizing. Language version of CBCL administration, education level and sex of the caregiver respondent showed the most significant impact on MI, followed by child age. Sensitivity analyses revealed that child race has a unique impact on DIF over and above socioeconomic status. Conclusions: The CBCL/1.5-5, a caregiver-report measure of early childhood behavior problems, showed bias across demographic groups. Robust item sets with less DIF can measure Internalizing and Total Problems equally as well as the full item sets, with slightly lower reliability for Externalizing, and can be crosswalked to the metric of the full item set, enabling calculation of normed T scores based on more robust item sets.

Child behavior problems and parental psychological distress in Chinese families of children with autism: The putative moderating role of parental social support and cultural values.

The wellbeing of parents of children with autism residing in mainland China remains understudied. We aimed to examine whether and how parental perceived social support, individualism, and collectivism acted together to moderate the relationships between child behavior problems and parental psychological distress in Chinese parents of children with autism. With convenience and snowball sampling, data on 268 primary caregiver parents of children with autism were collected from an online cross-sectional survey. Linear regression analysis indicated that child behavior problems were significantly associated with increased psychological distress in Chinese parents of children with autism. There was no evidence to support the stress-buffering model of social support in moderation analysis of the association between child behavior problems and parental psychological distress. Nonetheless, increased social support was associated with lower levels of parental psychological distress. Moderated moderation analyses did not support a role for individualism or collectivism as a moderator of the putative buffering role of social support. However, there was evidence that parental individualism was associated with increased parental psychological distress. Our findings highlight that child behavior problems are a robust correlate of parental psychological distress, and parental social support may act as a compensatory factor promoting less psychological distress rather than having a protective role. The role of social support and cultural values in the wellbeing of parents of children with autism in China requires additional exploration, including longitudinal research designs.

Association of behaviors and asthma control in a sample of Lebanese adolescents with asthma

Background: The relationship between behavioral problems and asthma is bidirectional; while the presence of a chronic disease such as asthma might predispose the person to stress, anxiety, and other behavioral issues, behavioral problems might in turn cause uncontrolled asthma through nonadherence to asthma management strategies. In Lebanon, behavioral problems and uncontrolled asthma could be of significant concern for adolescents. Consequently, we found it necessary to evaluate association between behavioral problems and uncontrolled asthma in a sample of Lebanese adolescents. Methods: Data for this cross-sectional study were collected using the snowball sampling technique in July 2023. The questionnaire was developed with Google Forms and distributed to participants via social media platforms and messaging applications. The Asthma Control Test (ACT) was used to check for uncontrolled asthma, and the Youth Self-Report (YSR) scale was used to assess behavioral problems. It yields nine subscales (anxious–depressed, withdrawn–depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, aggressive behavior, and other problems) and a total score. Results: When taking each behavior score as an independent variable, older age was associated with lower ACT scores (more controlled asthma); F(15, 186) = 3.66, P = 0.014, and 95% Confidence Interval (CI) [-0.85, -0.10]. Living in a rural area, compared to urban was associated with higher ACT scores, P = 0.018, and 95% Confidence Interval (CI) [0.28, 2.94]. The intake of the COVID-19 vaccine, P = 0.003 and 95% CI [0.73, 3.55]; waterpipe smoking, P = 0.017 and 95% CI [0.38, 3.85]; and having more somatic complaints, P = 0.005 and 95% CI [0.04, 0.25], also were significantly associated with higher ACT scores (more uncontrolled asthma)...(AU)

Association of Magnesium, Iron, Copper, and Zinc Levels with the Prevalence of Behavior Problems in Children and Adolescents.

Magnesium (Mg), iron (Fe), copper (Cu), and zinc (Zn) are indispensable elements in children's growth and development. However, epidemiological evidence regarding essential elements and their mixed exposure to behavior problems remains in its infancy. The objective of the present study was to evaluate the association between essential elements and the manifestation of behavior problems, with an additional focus on the implications of their mixture. An electronic medical records review was performed among 4122 subjects aged 6-18 years who underwent examinations at Children's Hospital, Zhejiang University School of Medicine, between January 2019 and July 2022. The concentrations of essential elements were measured by atomic absorption spectrometry, and behavior problems were assessed by using the Conners' Parent Rating Scale (CPRS). A total of 895 (21.7%) children and adolescents were identified as having behavior problems. For single exposure, inversely linear dose-response relationships were identified between continuous Mg and Zn levels and the prevalence of behavior problems, and the prevalence ratios (PRs) in the categorical lowest tertile were 1.28 (95% confidence interval, CI: 1.07-1.54) for Mg and 1.31 (95% CI: 1.05-1.63) for Zn compared to the highest tertile. For mixture exposure, an inverse association between essential elements and behavior problems was also found, mainly contributed by Mg (posterior inclusion probability, PIP = 0.854). Whole blood levels of Mg and Zn were significantly inversely associated with behavior problems. The findings highlight the pivotal role of essential elements in behavior problems and emphasize the importance of maintaining adequate levels of essential elements during children's maturation.

Corrigendum: Confirmatory factor analysis and gender invariance of the Persian version of psychological control scale: association with internalizing and externalizing behavior problems.

[This corrects the article DOI: 10.3389/fpsyg.2023.1128264.].

Pathways from prenatal cocaine exposure to adult substance use and behavior.

This is a report from the most recent adult follow-up of the longest running cohort study of prenatal cocaine exposure (PCE), in which women were enrolled prenatally and offspring were assessed in infancy, childhood, adolescence, and young adulthood. In previous studies, PCE was linked to offspring behavior problems such as early substance use and externalizing behavior problems. The current analyses examine pathways from PCE to behavioral outcomes in offspring at the 25-year assessment. Prenatal cocaine exposure was moderate in this cohort; most women decreased or discontinued use after the first trimester. During the first and third trimesters, 38% and 11% used cocaine, respectively. This represents the most common pattern of PCE in non-treatment samples. At this phase, the adult offspring were, on average, 27.3 years old (range = 25-30), had 13.4 years of education, 83% were employed, 55% were Black, and 55% were female. Offspring who were exposed to cocaine during the first trimester were significantly more likely to use marijuana in the past year, report more arrests, and have poorer scores on a decision-making task, controlling for other prenatal substance exposure, demographic, and socioeconomic factors. In mediation analyses, there were indirect pathways from PCE to current marijuana use through early initiation of marijuana use and 21-year marijuana use, and through 15-year status offenses and 21-year marijuana use. There was also an indirect pathway from PCE to lifetime arrests through early initiation of marijuana use and 21-year Conduct Disorder, although the direct pathway from PCE to arrests also remained significant. These findings are consistent with those from previous phases and are an indication that there are detrimental associations with PCE that persist across developmental stages and into adulthood.

Correlation between aggression at the veterinary clinic and problem behaviors at home for cats in the USA.

OBJECTIVES: The aim of the study was to determine whether cats that exhibit aggression during veterinary visits are more likely to have behavior problems at home. METHODS: An online, anonymous, cross-sectional survey was developed and distributed to residents in the USA who were aged over 18 years and who were the primary owners of at least one cat. The survey collected information about cat and household factors, and utilized a validated questionnaire instrument for obtaining behavioral information of pet cats. RESULTS: Aggression at the veterinary clinic was reported in 42.6% of the cats. The frequency of aggression exhibited at the veterinary clinic was lower in cats that lived in multi-cat households. Most cats did not receive medications intended to reduce fear, anxiety and/or pain before veterinary visits. Aggression at the veterinary clinic was positively associated with behavior problems at home, including stranger-directed aggression, owner-directed aggression, resistance to restraint, familiar cat aggression, dog-directed aggression, house-soiling, separation-related behaviors and scratching claws on inappropriate surfaces indoors. CONCLUSIONS AND RELEVANCE: Cats that exhibit aggression at the veterinary clinic are more likely to exhibit aggression and anxiety-related behaviors at home. Veterinarians should screen cats that exhibit aggression at the veterinary clinic for behavior problems at home to institute prompt diagnosis and treatment.

Developmental, sensory and behavioral outcomes among infants and toddlers with prenatal alcohol exposure.

BACKGROUND: Prenatal alcohol exposure (PAE) can disrupt children's neurodevelopment and exert lasting influences on overall child well-being and family functioning. A comprehensive exploration of developmental outcomes in infants/toddlers with PAE seen for a diagnosis on the fetal alcohol spectrum can inform early identification and intervention. AIMS: To describe the prevalence and patterns of neurodevelopment, sensory processing, and emotional and behavioral functioning in a clinical sample of infants/toddlers with PAE. METHODS: In this retrospective analysis, clinical data from 125 infants/toddlers with PAE, aged 2-42 months, assessed at the University of Washington Fetal Alcohol Syndrome Diagnostic and Prevention Network clinic were analyzed. RESULTS: Seventy-four to 87% of infants/toddlers demonstrated delayed development in one or more domains of the Bayley Scales of Infant and Toddler Development (n = 125). Adverse developmental outcomes were significantly correlated with PAE and/or postnatal risk factors. All 93 infants/toddlers with a complete Infant/Toddler Sensory Profile obtained definite difference scores in at least one quadrant/section. Over half of infant/toddlers with a completed Child Behavior Checklist/1½- 5 had total problem scores in the borderline or clinical range. CONCLUSIONS: Findings suggest that several domains of child functioning may be vulnerable to the teratogenic impact of PAE, and that these delays are evident in the first years of life. Early screening, ongoing monitoring and comprehensive assessment is needed to facilitate earlier identification and guide clinical intervention.