Improving Antioxidant Capacity in Children With Autism: A Randomized, Double-Blind Controlled Study With Cysteine-Rich Whey Protein

Previous studies indicate that children with autism spectrum disorder (ASD) have lower levels of glutathione. Nutritional interventions aim to increase glutathione levels suggest a positive effect on ASD behaviors, but findings are mixed or non-significant. A commercially available nutritional supplement comprising a cysteine-rich whey protein isolate (CRWP), a potent precursor of glutathione, was previously found to be safe and effective at raising glutathione in several conditions associated with low antioxidant capacity. Therefore, we investigated the effectiveness of a 90-day CRWP intervention in children with ASD and examined whether intracellular reduced and oxidized glutathione improvements correlated with behavioral changes. We enrolled 46 (of 81 screened) 3–5-year-old preschool children with confirmed ASD. Using a double-blind, randomized, placebo-controlled design, we evaluated the effectiveness of daily CRWP (powder form: 0.5 g/kg for children <20 kg or a 10-g dose for those >20 kg), compared with placebo (rice protein mimicking the protein load in the intervention group), on glutathione levels and ASD behaviors assessed using different behavioral scales such as Childhood Autism Rated Scale, Preschool Language Scale, Social Communication Questionnaire, Childhood Behavioral Checklist and the parent-rated Vineland Adaptive Behavior Scale, 2nd edition (VABS-II). Forty children (CRWP, 21; placebo, 19) completed the 90-day treatment period. Improvements observed in some behavioral scales were comparable. However, the VABS-II behavioral assessment, demonstrated significant changes only in children receiving CRWP compared to those observed in the placebo group in the composite score (effect size 0.98; 95% confidence intervals 1.42–4.02; p = 0.03). Further, several VABS-II domain scores such as adaptive behavior (p = 0.03), socialization (p = 0.03), maladaptive behavior (p = 0.04) and internalizing behavior (p = 0.02) also indicated significant changes. Children assigned to the CRWP group showed significant increases in glutathione levels (p = 0.04) compared to those in the placebo group. A subanalysis of the VABS-II scale results comparing responders (>1 SD change from baseline to follow up) and non-responders in the CRWP group identified older age and higher levels of total and reduced glutathione as factors associated with a response. CRWP nutritional intervention in children with ASD significantly improved both glutathione levels and some behaviors associated with ASD. Further studies are needed to confirm these results.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/study/NCT01366859, identifier: NCT01366859.

Quantifying Severity of Preschool-Aged Children’s Internalizing Behaviors: A Daily Diary Analysis

A subset of preschool-aged children meets criteria for impairing and persistent anxiety and depression. However, the overlap between normative emotional development and impairing symptoms complicates assessments of internalizing problems in early childhood. Given the benefits of early identification/prevention and avoiding overpathologizing typical development, empirical information is needed to norm expression of internalizing behaviors. In this 14-day online diary study, 609 primary caregivers of 3- to 5-year-old children reported the frequency of children’s daily separation and social anxiety and depressive behaviors and impairment. Item response theory analyses quantified specific frequencies at which each behavior was psychometrically severe/rare. Patterns varied for each behavior; for example, distress when anticipating separation had to occur at least 10 times and sadness at least 35 times over 14 days to be considered severe. Most social anxiety behaviors had to occur approximately every other day to be considered severe. Parameters did not vary by child age or sex, and behaviors were significantly associated with impairment. These data provide empirical information for refining internalizing behavior assessment in preschool-aged children and can be used as benchmarks by child practitioners to assess the extent to which frequencies fall in the range of developmentally typical behavior versus those that may be more severe.

Child Externalizing and Internalizing Behavior and Parental Well-Being During the COVID-19 Pandemic

In this study we surveyed families’ experiences with parental depression, stress, relationship conflict, and child behavioral issues during six months of the COVID-19 pandemic through the COVID-19: Global Social Trust and Mental Health Study. The current analyses used data collected from online surveys completed by adults in 66 countries from April 17, 2020-July 14, 2020 (Wave I), followed by surveys six months later at Wave II (October 17, 2020-January 31, 2021). Analyses were limited to 175 adult parents who reported living with at least one child under 18 years old at Wave I. Parents reported on children’s level of externalizing and internalizing behavior at Wave I. At Wave II, parents completed self-reported measures of stress, depression, and inter-partner conflict. Child externalizing behavior at Wave I significantly predicted higher levels of parental stress and marginally predicted parental depression at Wave II, controlling for covariates. Child internalizing behavior at Wave I did not predict parental stress or depression, controlling for covariates. Neither child externalizing nor internalizing behavior predicted parental relationship conflict. The overall findings demonstrate that child behavior likely influenced parental stress and depression during the COVID-19 pandemic. Findings suggest that mental health interventions for children and parents may improve the family system during times of disaster.

Child Externalizing and Internalizing Behavior and Parental Well-Being During the COVID-19 Pandemic

Author Notes**This manuscript has been submitted for publication and is likely to be edited as part of the peer-review process. Correspondence regarding this paper should be addressed to Keri Ka-Yee Wong, [email protected].** AbstractIn this study we surveyed families’ experiences with parental depression, stress, relationship conflict, and child behavioral issues during six months of the COVID-19 pandemic through the COVID-19: Global Social Trust and Mental Health Study. The current analyses used data collected from online surveys completed by adults in 66 countries from April 17, 2020-July 14, 2020 (Wave I), followed by surveys six months later at Wave II (October 17, 2020-January 31, 2021). Analyses were limited to 175 adult parents who reported living with at least one child under 18 years old at Wave I. Parents reported on children’s level of externalizing and internalizing behavior at Wave I. At Wave II, parents completed self-reported measures of stress, depression, and inter-partner conflict. Child externalizing behavior at Wave I significantly predicted higher levels of parental stress and marginally predicted parental depression at Wave II, controlling for covariates. Child internalizing behavior at Wave I did not predict parental stress or depression, controlling for covariates. Neither child externalizing nor internalizing behavior predicted parental relationship conflict. The overall findings demonstrate that child behavior likely influenced parental stress and depression during the COVID-19 pandemic. Findings suggest that mental health interventions for children and parents may improve the family system during times of disaster.

Development of Brief Rating Scales for Progress Monitoring Internalizing Behavior

Prevalence estimates suggest that up to 20% of students in schools experience significant internalizing behaviors that impact behavioral, social, or academic functioning. School-based interventions have great potential to promote student mental health; however, validated and feasible brief assessments are needed to progress monitor students’ responses to these supports. The purpose of the current study was twofold: to (a) develop and validate teacher-completed brief rating scales for progress monitoring internalizing concerns in elementary-aged students and (b) determine the reliability of the resultant measures. First, item content was generated and subjected to evaluation by two panels of school-based consumers and researchers. Within the second phase of development, exploratory and confirmatory factor analyses were used to reduce the initial number of items and ensure that the items were indicators of one latent factor. Teachers in grades K–3 ( N = 307) each completed ratings for one randomly selected student in their classroom. Results of factor analysis for each scale indicated one-factor solutions for the 4-item Anxious/Depressed (ω = .88) and 4-item Socially Withdrawn (ω = .87) scales.

Interactions Between Child Personality and Parenting in Relation to Child Well-Being: Support for Diathesis–Stress and Differential Susceptibility Patterns

It is well-recognized that the individual characteristics of children moderate the effects of developmental conditions on the well-being of a child. The majority of interactions follow a diathesis–stress pattern; there is also evidence for differential susceptibility and vantage sensitivity models. The present study aimed to examine interactions between parenting and child personality in relation to the well-being of a Russian child and to evaluate the models for moderated relationships. Participants were primary caregivers of 370 children aged 2–7 years. Moderation effects were examined using hierarchical multiple regression and bivariate linear models. In order to differentiate between the models of environmental sensitivity, the analysis of regions of significance was used. Consistent with a diathesis–stress framework, the results revealed that among children low in conscientiousness and high in activity, punitive parenting was a risk factor for externalizing problems; among introverted and fearful children, punitive parenting was a risk factor for internalizing problems. Positive parenting/involvement was a protective factor for internalizing behavior, only for children low in openness. The findings also demonstrate the following evidence for the differential susceptibility model: children low in Beta higher-order personality trait (also known as plasticity or personal growth) showed more total problems when faced with low positive parenting, but fewer problems when experiencing high-quality parenting.

Domains of Ongoing Communication Between Former Spouses: Associations With Parenting Stress and Children’s Post-Divorce Well-Being

Using data from 708 divorced parents (52.4% mothers), we examined how ongoing communication (i.e., topics and frequency of communication) with former spouses was associated with parenting stress and child internalizing and externalizing behavior. Based on hierarchical multiple regression models, ongoing communication was not associated with parenting stress but was associated with child externalizing and internalizing behavior. Specifically, communicating about sex/romance was associated with more child externalizing behavior. Communication about self and family and communication about sex/romance were associated with more, but coparenting communication with less, child internalizing behavior. Overall, the results support recent suggestions by family scientists and clinicians that divorced parents should limit their communication to shared parenting issues. Discussing non-coparenting topics may lead to a post-divorce family system that undermines children’s well-being. Talking about having a sexual or romantic relationship with their former spouses may be harmful for children’s well-being.