Direct Measures of Medication Effects: Exploring the Scientific Utility of Behavior-Analytic Assessments

The purpose of the current study was to explore the scientific utility of two behavior analytic assessments (i.e., progressive ratio and demand assessments) for psychotropic medication evaluation. For a sample of 23 children with disabilities who were prescribed medication, we conducted a series of generalizability and optimization studies to identify sources of score variance and conditions in which stable estimates of behavior can be obtained. To inform construct validity, we calculated correlations between scores from each assessment and those from a standardized behavior rating scale (Aberrant Behavior Checklist-Second Edition; ABC-2). Results offer initial support for the scientific utility of progressive ratio scores. More research is needed to evaluate sensitivity to change and construct validity of scores from these and other behavior analytic assessments.

Application of virtual reality on non-drug behavioral management of short-term dental procedure in children

Background Due to the inherent characteristics of immersion, imagination, and interactivity in virtual reality (VR), it might be suitable for non-drug behavior management of children in dental clinics. The purpose of this trial was to measure the role of VR distraction on behavior management in short-term dental procedures in children. Methods A randomized clinical trial design was carried out on 120 children aged between 4 and 8 years to identify the comparative efficacy of VR and tell-show-do (TSD) to improve behavioral management during dental procedures. The primary outcomes were evaluated anxiety, pain, and compliance scores in perioperative children. The levels of operative anxiety and pain were assessed using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Wong Baker FACES Pain Rating Scale (WBFS), respectively. The Frankl Behavior Rating Scale (FBRS) was tested before and during dental procedures. The length of the dental procedure was compared between both groups after treatment. Results The average anxiety and behavioral scores of the VR group significantly reduced compared with the control. The decreased anxiety score for the VR group and control group were 8 (7, 11) and 5 (5, 7), p < 0.05. The compliance scores of the control group during treatment were 3 (2, 3), and the same in the VR intervention were 3 (3, 4), p = 0.02. A significant reduction in pain was observed when using VR distraction (p < 0.05). Comparing the length of the dental procedure, the VR group (19.0 2 ± 5.32 min) had a shorter treatment time than the control group (27.80 ± 10.40 min). Conclusion The use of VR significantly reduced the anxiety and pain of children and the length of the dental procedure and improved the compliance of children that underwent short-term dental procedures without an adverse reaction. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029802. Registered on February 14, 2020

The relationship between dental fear and cooperation of children during dental treatments with their parents’ general health

Objective: Dental fear is a common phenomenon in children and parents can have a key role in the development of child's dental anxiety. There is moderate evidence to support the relationship between the parental general health and children’s dental fear. The aim of this study was to investigate the relationship between dental fear and cooperation of children during dental treatment with the general health of parents.Methods: This cross-sectional descriptive study was done on 130 children aged 6 to 12 at the Department of Pediatric Dentistry, Guilan University of Medical Sciences from May to September 2020.The personality traits and general health of parents were assessed by using the General Health Questionnaire (GHQ-28). The Frankl's behavior rating scale and Children's Fear Survey Schedule Dental Subscale (CFSS-DS) were used to respectively assess the degree of cooperation during dental practices and children’s dental fear. Statistical approaches included T-test, Chi-square and Pearson Linear correlation. A significant level of differences was taken as P<0.05.Results: 69.3 % of children behaved positively and definitely positively during dental treatment. 56 boys and 74 girls with mean age of 9.13 ±2.02 years participated in this study. There was a significant correlation between the children's age with dental fear and cooperation level (P<0.001). There was no significant difference in dental fear score (P=0.63) and cooperation level (P=0.99) between boys and girls. There was not statistically significant relationship between the general health of the parents and the level of children's cooperation and dental fear during dental treatment (P>0.001).Conclusion: There was not relationship between parent's general health with children's dental fear and cooperation.

Unraveling the Optimum Latent Structure of Attention-Deficit/Hyperactivity Disorder: Evidence Supporting ICD and HiTOP Frameworks

Attention Deficit/hyperactivity disorder (ADHD) is conceptualized differently in the Diagnostic and Statistical Manual (DSM-5), the International Classification of Diseases-10 (ICD-10), and the Hierarchical Taxonomy of Psychopathology (HiTOP) frameworks. This study applied independent cluster confirmatory factor analysis (ICM-CFA), exploratory structure equation model with target rotation (ESEM), and the S-1 bi-factor CFA approaches to evaluate seven ADHD models yielded by different combinations of these taxonomic frameworks. Parents and teachers of a community sample of children (between 6 and 12 years of age) completed the Disruptive Behavior Rating Scale (for ADHD symptoms) and the Strengths and Difficulties Questionnaire (for validation). Our findings for both parent and teacher ratings provided the most support for the S-1 bi-factor CFA model comprised of (i) a g-factor based on ICD-10 impulsivity symptoms as the reference indicators and (ii) inattention and hyperactivity as specific factors. However, the hyperactivity-specific factor lacked clarity and reliability. Thus, our findings indicate that ADHD is best viewed as a disorder primarily reflecting impulsivity, though with a separable inattention (but no hyperactivity) component, i.e., “ADID (attention deficit/impulsivity disorder).” This model aligns with the HiTOP proposals.

STRUCTURED AND UNSTRUCTURED TIME AND RISKY BEHAVIOR OF ADOLESCENTS IN CONDITIONS OF SOCIAL CRISIS

The main objective of this research is to determine how much adolescents prefer certain types of structured free time and unstructured time (leisure time), as well as their connection with risky behavior of adolescents in social crisis. The sample consists of a number of adolescents (N = 287), 116 or 40.4% of male and 171 or 59.6% of female respondents, age from 18 to 24, average age is 20.44 years (AS = 20.44, SD = 2.75) living in the Autonomous Province of Kosovo and Metohija. Leisure and Leisure Assessment Questionnaire (constructed only for research purpose), Risk Behavior Rating Scale (RBRS), Scaar, 2009 were used in this research. The data was processed through descriptive statistics, correlation and regression analysis and the T-test. Results showed that adolescents mostly prefer internet as an unstructured activity and the least preferred is the theater as the structured one. A negative correlation was obtained between academic success and risky behavior, which indicates that if adolescents achieve better results in academic career, they have less propensity for risky behavior. According to the results, boys are more prone to risky behavior than girls, and risky behavior of adolescents can be predicted with 14% variance (significant predictors are unstructured leisure time and the gender of adolescents). Within our work, our objective is to bring attention to the importance of a structured way of spending leisure time regarding adolescents, with necessary engagement of experts from different areas.

ADAPTATION OF THE UKRAINIAN VERSION OF “STRENGTHS AND WEAKNESSES OF ADHD SYMPTOMS AND NORMAL BEHAVIOR RATING SСALE” (SWAN)

According to the literature sources and information obtained from the specialists in the field, we found the lack of diagnostic measures for attention deficit hyperactive disorder (ADHD). At present, the hyperactive children behavior correction system is being actively reformed in Ukraine. One of the aspects of its modernization is the improvement and updating of the methodological base, primarily, the diagnostic methodology one. ADHD rating scales are actively used at all stages of ADHD treatment from diagnosis to correction of behavior. That is why its arrears important to increase the number of methodological tools of a psychologist during diagnostics.Purpose: improvement and adapted of the “Strengths and Weaknesses of ADHD symptoms and Normal behavior” (J.M. Swanson) rating scale for the use in Ukraine.Methods: calculation of psychometric characteristics of the Ukrainian version of the SWAN scales: correspondence of the empirical data to the normal distribution law (Gaussian function), internal consistency and reliability of parallel forms (by correlation analysis by r-Pearson criterion).Results. We processed 76 questionnaires, the age category of children ranged from 6 to 13 years (class “The Intelligence of Ukraine”, children with existing CPR, inclusive and classic classes). Questionnaires were filled in by teachers who were able to observe students’ behavior. The following psychometric indicators of the Scale were calculated: internal consistency (r = 0.77 at p ≤ 0.01 for the scale “Inattention” and r = 0.86 at p ≤ 0.01 for the scale “Hyperactivity” and “Impulsivity”) and the reliability of parallel forms (between the scales “Inattention” and “Hyperactivity/Impulsivity” according to the “SWAN” rating scale method (r = 0.53 at р ≤ 0.01) and the sum of the points according to the scales “Hyperactivity” and “Impulsivity” in “Rating scale of ADHD” (Suxotina, N.K. & Egorova, T.I.) (r = 0.56 at р ≤ 0.01)).Conclusions. The obtained results are satisfactory, so the “Strengths and Weaknesses of ADHD symptoms and Normal behavior” rating scale is ready for use in Ukraine. We see further potential for the development of the problem in those goals that could not be realized due to the lack of resources and quarantine, namely: increasing the number of sample, checking retest reliability as well as expert and constructive validity.Key words: ADHD treatment, hyperactive children, inclusive education, impulsivity, inattention. На основі літературних джерел та інформації, отриманої від фахівців, встановлено відсутність засобів діагностики розладу дефіциту уваги з гіперактивністю (РДУГ). Нині в Україні активно реформується система корекції поведінки дітей. Однією зі сторін модернізації є покращення та оновлення методичної бази, перш за все діагностичної, і саме рейтингові шкали активно використовуються на всіх етапах лікування РДУГ: від діагностики до корекції. Саме тому актуально збільшити кількість інстру-ментів психолога під час діагностики.Мета статті полягає в адаптації американської «Рейтингової шкали сильних та слабких сторін РДУГ та нормальної поведінки» (Дж.М. Свонсон) до вітчизняного вжитку.Методи. Використано обрахування психометричних характеристик україномовної версії шкали «Рейтингової шкали сильних та слабких сторін РДУГ та нормальної поведінки», таких як відповідність емпіричного розкиду закону нормального розподілу (функція Гауса), внутрішня узгодженість та надійність паралельних форм (кореляційний аналіз за критерієм r-Пірсона).Результати. Оброблено 76 анкет, вік дітей становить від 6 до 13 років (клас «Інтелект України», діти із наявною ЗПР, інклюзивний та звичайний класи). Анкети заповнювали вчителі, які мали змогу спостерігати за поведінкою учнів протягом місяця. Обчислені внутрішня узгодженість (r = 0,77 за р ≤ 0,01 для шкали «Неуважність», r = 0,86 за р ≤ 0,01 для шкали «Гіперактивність та імпульсивність») та надійність паралельних форм (прокорельовано показники за шкалами «Неуважність» та «Гіперак-тивність/Імпульсивність» за методикою SWAN (r = 0,53 за р ≤ 0,01) із сумою показників за шкалами «Гіперактивність» та «Імпульсивність» за опитувальником «Шкала оцінки РДУГ» (r = 0,56 за р ≤ 0,01)).Висновки. Отримані результати є задовільними, тому методика готова до українського вжитку. Подальший потенціал розвитку проблематики вбачаємо у тих цілях, яких не змогли досягнути через брак ресурсів та карантин, а саме у перевірці ретестової надійності, експертної та конструктної валідності, збільшенні кількості вибірки.Ключові слова: адаптація опитувальника, гіперактивні діти, інклюзивна освіта, імпульсивність, неуважність.

Prevalence and risk factors of children’s dental anxiety in China: a longitudinal study

ObjectivesDental anxiety remains widespread among children, may continue into adulthood and affect their oral health-related quality of life and clinical management. The aim of the study was to explore the trend of children’s dental anxiety over time and potential risk factors.DesignLongitudinal study.MethodsChildren aged between 5 and 12 years were investigated with the Chinese version of face version of Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Frankl Behavior Rating scale from 2008 to 2017, and influential factors were explored.ResultsClinical data were available from 1061 children, including 533 (50.2%) male participants and 528 (49.8%) female participants. The total CFSS-DS scores ranged from 16 to 66, with a mean of 24.8±10.3. The prevalence of dental anxiety is 11.59%. No significant differences in total CFSS-DS scores between girls and boys were found. According to the Frankl scale, 238 children were allocated to the uncooperative group and the remaining 823 children were allocated to the cooperative group. Scores of CFSS-DS were negatively correlated with the clinical behaviour level of Frankl. Children aged 11–12 years old had significantly decreased scores compared with other age groups, and there was a decline in the scores of the group aged 8–10 years old over time. The factor analysis divided 15 items of CFSS-DS into four factors, and the total scores of ‘less invasive oral procedures’ items belonging to factor III decreased significantly over time in the group aged 8–10 years old.ConclusionsAge is a significant determinant for children’s dental anxiety, and dental anxiety outcomes have improved for Chinese children aged 8–10 years. This study is one of the few reports on changes of children’s dental anxiety in a new era of information, but the results may be extrapolated to other populations with caution.

The Effect of Pretreatment Conditioning by Mothers on Dental Behavior of Children: A Randomized Clinical Trial

Background: Behavior management techniques are an integral component of pediatrics dental visits. Objectives: This study aimed to evaluate the effect of child pretreatment conditioning by mothers on the dental behavior of children during dental treatment. Methods: Following a randomized clinical trial design, this study was conducted on 72 child-mother dyads, attending the pediatric dental department of Zahedan University of Medical Sciences (southeast of Iran). The children were 3 to 6 years old and required pulpotomy of one asymptomatic carious primary mandibular molar under inferior alveolar nerve block anesthesia. The dyads were randomly divided into control and intervention groups. Data on age and gender of children, mother’s age, and parents’ education were collected. Mothers in the intervention group received a brochure, containing information on how to prepare the child at home to better cope with the dental procedure. Those in the control group received no intervention. A one-month interval was set between the randomization and treatment. For both groups, an experienced pedodontist performed pulpotomy and stainless steel crown placement in a single session. The dental behavior of children during the operation was scored by a blind instructed and calibrated observer, using the Franckle behavior rating scale. Data were analyzed using the chi-square test, Fisher’s exact test, and Mann-Whitney U test in SPSS version 20 at a significance level of 0.05. Results: The child dental behavior in the intervention group was more frequently acceptable than their counterparts, and a significant difference was found between the groups (P = 0.047). The intervention was successful, regardless of the child's gender and age, mother’s age, and parents’ education (P > 0.05). Conclusions: Based on the results, dental practitioners can promote child behavior by engaging mothers to prepare their children before dental procedures.

The Comparison of Sensitivity to Reward and Punishment, Response Inhibition and Sustained Attention in Children with ADHD and SCT: Distinct Contribution of ADHD and SCT to Attention Problems Based on Cold and Hot Executive Circuits

Objectives: Recent studies have identified a disorder called Sluggish Cognitive Tempo (SCT) that has similarities with attention deficit / hyperactivity disorder (ADHD) in attention problems and often mistakenly labeled as ADHD. Attention problems also cause malfunctions in executive functions, often involving the hot circuit and the cold circuit. The purpose of this study was to compare the sensitivity to reward and punishment, response inhibition and sustained attention in children with ADHD and SCT. Methods: The design of the present study was in the frame of Casual Comparative. Participants comprised 100 boys (50 ADHD and 50 SCT) from elem entary schools in Tabriz in 1398-1399 academic years, which were selected through a screening method using the Child Behavior Rating Scale (SNAP-IV) and the SCT scale. Then, balloon analogue risk task (BART) was used to measure the sensitivity to reward and punishment and the continuous performance test was used to measure response inhibition and sustained attention. For data analysis Manova and SPSS 20 were used. Results: The results showed that children with ADHD had higher scores in sensitivity to reward and children with SCT had higher scores in sensitivity to punishment. Moreover, children with ADHD have deficits in response inhibition and children with SCT have deficits in sustained attention (P<0.0001). Conclusion: Based on the research Background and the findings of this study, it seems that children with SCT have deficits in hot executive circuit and children with ADHD have trouble in cold executive circuit.