Psychometric Properties of the ASEBA Child Behaviour Checklist and Youth Self-Report in Sub-Saharan Africa: A Systematic Review

Objective: Behavioural screening tools may be used to identify at-risk children in resource limited settings in sub-Saharan Africa. The ASEBA forms (Child Behaviour Checklist and Youth Self-Report) are frequently translated and adapted for use in sub-Saharan African populations, but little is known about their measurement properties in these contexts. Methods: We conducted a systematic review of all published journal articles that used the ASEBA forms with sub-Saharan African samples. We evaluated the reported psychometric properties, as well as the methodological quality of the psychometric evaluations, using COSMIN (COnsensus based Standards for the selection of health Measurement INstruments) guidelines. Results: Fifty-eight studies reported measurement properties of the ASEBA forms. Most studies came from Southern (n = 29, 50%) or East African (n = 25, 43%) countries. Forty-nine studies (84%) used translated versions of the tool, but details regarding the translation process, if available, were often sparse. Most studies (n = 47, 81%) only reported internal consistency (using coefficient alpha) for one or more subscales. The methodological quality of the psychometric evaluations ranged from very good to inadequate across all measurement properties, except for internal consistency. Conclusion: There is limited good quality psychometric evidence available for the ASEBA forms in sub-Saharan Africa. We recommend (i) implementing a standardised procedure for conducting and reporting translation processes, and (ii) conducting more comprehensive psychometric evaluations of the translated versions of the tools.

Relative predictive utility of the original and Autism-Specific Five-Minute Speech Samples for child behaviour problems in autistic preschoolers: A preliminary study

Many autistic children have co-occurring behavioural problems influencing core autism symptomology potentially relevant for intervention planning. Parental Expressed Emotion – reflecting critical, hostile and overprotective comments – contributes to understanding and predicting behaviour in autistic school-aged children, adolescents and adults and is typically measured using the Five-Minute Speech Sample. However, limitations exist for its use with parents of younger autistic children and so the Autism-Specific Five-Minute Speech Sample was adapted with the goal of better measuring parent Expressed Emotion in the context of childhood autism. The Autism-Specific Five-Minute Speech Sample has not yet been used to explore Expressed Emotion in parents of autistic preschoolers, nor has the relative predictive utility of the Autism-Specific Five-Minute Speech Sample and Five-Minute Speech Sample been evaluated in the same sample. We compared the two measures from speech samples provided by 51 Australian parents with newly diagnosed autistic preschoolers, including investigating their predictive value for concurrent and subsequent child internalising and externalising behaviour problems. While Autism-Specific Five-Minute Speech Sample Expressed Emotion and Five-Minute Speech Sample Expressed Emotion were associated in this sample, only Autism-Specific Five-Minute Speech Sample codes contributed significant predictive value for concurrent and subsequent child problem behaviour. These preliminary data strengthen the position that the Autism-Specific Five-Minute Speech Sample may better capture Expressed Emotion, than the Five-Minute Speech Sample, among parents of autistic preschool-aged children. Lay abstract Parental Expressed Emotion refers to the intensity and nature of emotion shown when a parent talks about their child, and has been linked to child behaviour outcomes. Parental Expressed Emotion has typically been measured using the Five-Minute Speech Sample; however, the Autism-Specific Five-Minute Speech Sample was developed to better capture Expressed Emotion for parents of children on the autism spectrum. In each case, parents are asked to talk for 5 min about their child and how they get along with their child. Parents’ statements are then coded for features such as number of positive and critical comments, or statements reflecting strong emotional involvement. While both the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample have been used with parents of autistic school-aged children, their relative usefulness for measuring Expressed Emotion in parents of preschool-aged children – including their links to child behaviour problems in this group – is unclear. We collected speech samples from 51 parents of newly diagnosed autistic preschoolers to investigate similarities and differences in results from the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample coding schemes. This included exploring the extent to which the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample, separately, or together, predicted current and future child behaviour problems. While the two measures were related, we found only the Autism-Specific Five-Minute Speech Sample – but not the Five-Minute Speech Sample – was related to child behavioural challenges. This adds support to the suggestion that the Autism-Specific Five-Minute Speech Sample may be a more useful measure of parental Expressed Emotion in this group, and provides a first step towards understanding how autistic children might be better supported by targeting parental Expressed Emotion.

Dental Anxiety Measurement of Children in Abbottabad Using Audio Visual System

Aim: To measure the anxiety and fear in children while visiting dentist and to observe effectiveness of audiovisual assistance to overcome anxiety Study design: Qualitative study Place and duration of study the study is done in Rehmat Memorial Hospital Abbottabad department of operative dentistry, affiliated with Women Medical and Dental College Abbottabad, from December 2014 to February 2017. Methods: Total two hundred children were observed aged between 5-8 years at Rehmat Memorial Hospital Abbottabad under controlled conditions showing cartoons on TV screen by using wireless headphones. There were two main groups divided into the controlled group and uncontrolled group containing one hundred participants in each group. Each patient's pulse rate, heart rate was recorded and live pulse rate was in sight by using wristband with pulse rate detector. Venham's picture test was used to check the correct reaction of the patient for the assessment of degree of anxiety more realistically. Results Controlled group n=100 and uncontrolled group n=100 patient aged 5-8 years treated for various procedures in different appointments. With mean age 6-7 years, Male to female ration of participants in controlled group was 34% and 66% and in uncontrolled group male and female ration was 45% and 55%. Significant reduction in anxiety was noted in controlled group distracted by audio visual stories and rhymes. Conclusion: Both groups were statistically evaluated and the result showed that audiovisual distraction can decrease the anxiety level in the controlled group but couldn't eliminate completely. This issue needs more studies and experiments to resolve anxiety in children completely. Keywords: Dental anxiety, Venham’s picture test, child behaviour

Impact of racism and discrimination on physical and mental health among Aboriginal and Torres Strait islander peoples living in Australia: a systematic scoping review

Background Racism is increasingly recognised as a significant health determinant that contributes to health inequalities. In Australia efforts have been made to bridge the recognised health gap between Aboriginal and Torres Strait Islander people and other Australians. This systematic scoping review aimed to assess, synthesise, and analyse the evidence in Australia about the impacts of racism on the mental and physical health of Aboriginal and Torrens Strait Islander peoples. Methods A systematic search was conducted to locate Australian studies in English published between 2000 and 2020. Five electronic databases were used: PubMed, CINAHL, Embase, Web of Science and the Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research. The search strategy included a combination of key words related with racism, mental health, physical health and Indigenous people. Data were extracted based on review questions and findings were synthesized in a narrative summary. Results Of total 338 searched studies from five databases, 12 studies met the inclusion criteria for narrative synthesis where eight were cross-sectional studies and four prospective cohorts. General mental health and general health perception were the most frequently studied outcomes followed by child behaviour, smoking and substance consumption and specific health conditions. The prevalence of racism varied between 6.9 and 97%. The most common health outcomes associated with racism were general poor mental health and poor general health perception. More specific health outcomes such as anxiety, depression, child behaviour, asthma, increased BMI and smoking were also associated with racism but were analysed by a limited number of studies. Three studies analysed psychological distress, negative mental health, sleeping difficulties and negative perceived mental health according to severity of exposition to racism. Conclusion Racism is associated with negative overall mental and negative general health outcomes among Aboriginal and Torres Strait Islander peoples. Strategies to prevent all forms and sources of racism are necessary to move forward to bridging the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Further research is needed to understand in more detail the impact of racism from an Aboriginal and Torres Strait Islander definition of health and wellbeing.