An exploratory study of child-centered play therapy with aggressive children.

Children exhibiting aggressive problem behaviors typically reach a peak of aggressive acts at an early age, providing evidence that early intervention for aggression is needed. Child-centered play therapy (CCPT) is 1 intervention that offers the child an environment in which aggression can be expressed and empathically responded to by a play therapist. Forty-one elementary school age children were assigned to a CCPT condition or a wait-list control group condition. Children who participated in 14 sessions of CCPT showed a moderate decrease in aggressive behaviors over children in the control group, according to effect sizes as reported by parents (N = 32). Teachers reported that both groups significantly improved over time (N = 41). Post hoc analysis revealed that children assigned to CCPT decreased aggressive behaviors statistically significantly and children assigned to control group demonstrated no statistically significant difference. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Head Start and urban children's school readiness: A birth cohort study in 18 cities.

We used longitudinal data from a birth cohort study, the Fragile Families and Child Wellbeing Study, to investigate the links between Head Start and school readiness in a large and diverse sample of urban children at age 5 (N = 2,803; 18 cities). We found that Head Start attendance was associated with enhanced cognitive ability and social competence and reduced attention problems but not reduced internalizing or externalizing behavior problems. These findings were robust to model specifications (including models with city-fixed effects and propensity-scoring matching). Furthermore, the effects of Head Start varied by the reference group. Head Start was associated with improved cognitive development when compared with parental care or other nonparental care, as well as improved social competence (compared with parental care) and reduced attention problems (compared with other nonparental care). In contrast, compared with attendance at pre-kindergarten or other center-based care, Head Start attendance was not associated with cognitive gains but with improved social competence and reduced attention and externalizing behavior problems (compared with attendance at other center-based care). These associations were not moderated by child gender or race/ethnicity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavior problem trajectories and first-grade cognitive ability and achievement skills: A latent growth curve analysis.

Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, the authors investigated whether there was evidence of intraindividual stability in behavior problems over time as well as whether children with higher levels of behavior problems at 24 months and more rapid increases in behavior problems prior to school entry performed more poorly on 1st-grade tests of cognitive ability and achievement than their peers. Three findings were noteworthy. First, there was evidence of both intraindividual and interindividual variability in behavior problems between 24 months and 1st grade. Second, children with higher initial levels of internalizing and externalizing behaviors at 24 months had lower cognitive ability and achievement scores in 1st grade. Finally, children with more rapid increases in internalizing behaviors over time had lower cognitive ability scores in 1st grade; this association did not exist for externalizing behaviors. Implications for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two case studies of child-centered play therapy for children referred with highly disruptive behavior.

This article presents two cases with strong evidence measures in which child-centered play therapy (CCPT) was provided for children referred for highly disruptive behavior, including attention problems and aggression. Apparent progress was evidenced on the Teacher Report Form (TRF) of the Child Behavior Checklist (Achenbach & Rescorla, 2001). One client had a waiting period equal to his treatment period in which ratings were stable before change across his treatment period. The cases provide opportunities to consider how CCPT may work differently for similar behavioral difficulties in individual children. Researchers conceptualized each client's areas of difficulty and apparent treatment effects as an expert panel, aided by indications from the TRF. Individual discussions are provided regarding rationales for apparent progress and why CCPT seemed to have been effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of child teacher relationship training on the children of focus: A pilot study.

Head Start teachers (n = 24) were assigned to either the experimental group or the active control group in this pilot study to determine the effects of child–teacher relationship training (CTRT) on 22 disadvantaged preschool children identified with behavioral problems. CTRT is based on the principles and procedures of child–parent relationship therapy (CPRT; Landreth & Bratton, 2006), a structured, time-limited approach that trains young children's caregivers to be active participants in an early mental health delivery system. Results indicate that children whose teachers participated in CTRT made statistically significant improvements in both externalizing behavior problems and total problems when compared with the active control group. Children in the CTRT group demonstrated a large treatment effect on their internalizing behavior problems compared with those in the active control group. The statistical, practical, and clinically significant results of this pilot study indicate that CTRT is a promising option for preschool children with clinically significant behavior problems. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Intensive group play therapy with child witnesses of domestic violence.

Describes the effectiveness of intensive sibling group play therapy with child witnesses of domestic violence in improving self-concept, reducing internalizing and externalizing behavior problems, and reducing overall behavior problems. A second objective of this study was to compare the effectiveness of intensive sibling group play therapy and intensive individual play therapy on the dimensions identified above. 10 children (aged 4–9 yrs) participated in the experimental group and 11 children (aged 4–10 yrs) served as controls. An analysis of covariance revealed children in the experimental group exhibited a significant reduction in total behavior problems, externalizing and internalizing behavior problems, aggression, anxiety, and depression, and a significant improvement in self- esteem. Intensive sibling group play therapy was found equally effective as intensive individual play therapy with child witnesses of domestic violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A validation study of the Penn Interactive Peer Play Scale with urban Hispanic and African American preschool children.

Investigated the psychometric properties of a Spanish and English version of the Penn Interactive Peer Play Scale (PIPPS) when employed with Spanish- and English-speaking teachers and students in an urban, Southeastern community. Psychometrically sound structures were obtained with the Spanish translation of the PIPPS in support of the three original dimensions named Play Interaction, Play Disruption, and Play Disconnection, which were derived from studies of African American preschool children in lower income, Northeastern communities. Concurrent validity was supported by significant correlations between the 3 Spanish PIPPS constructs and teacher ratings of externalizing and internalizing behavior problems. Significant group differences in classroom peer play interactions were also detected for children's gender and ethnicity. The independent emergence of comparable Spanish and English PIPPS factor structures across 2 distinct regional samples provides initial support for use of this measure in research with Hispanic preschool children from low-income backgrounds. Implications for school psychologists engaging in outreach to preschool programs servicing diverse groups of children are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The teacher-student relationship as a developmental context for children with internalizing or externalizing behavior problems.

Children with significant behavior problems are at risk for poor school adaptation and a host of deleterious school outcomes. Given the time children spend in school, there is a need to better understand the normative contexts and processes within schools that may enhance the positive adaptation of children with significant behavior problems. This study evaluated one such context, the teacher-student relationship, specifically, the degree of closeness and conflict in the relationship, between urban, American elementary schoolchildren with significant externalizing or internalizing behavior problems and their teachers. The results suggest that the qualities of the teacher-student relationship predict children's successful school adjustment. Having a relationship with a teacher characterized by warmth, trust, and low degrees of conflict was associated with positive school outcomes. Some moderation effects were noted, including differential effects for warmth on the reading achievement of children with externalizing distress, and conflict on the school adaptation of children with internalizing problems. Results are discussed in light of theory and school-based intervention and prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood ADHD symptoms and risk for cigarette smoking during adolescence: School adjustment as a potential mediator.

Although a large body of research suggests that children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for cigarette smoking during adolescence compared with their non-ADHD peers, much less research has examined why. The current study addressed this gap in the literature by examining middle school adjustment, broadly defined, as a possible mediator of the relation between childhood ADHD symptoms and cigarette smoking during middle adolescence (10th grade). Longitudinal data were collected from a community sample of 754 youth using self-report and parent report along with school records, and a novel statistical technique was used in the process of testing for mediation. Consistent with hypotheses, school adjustment was found to mediate the relation between childhood ADHD symptoms and later cigarette smoking, even after controlling for early externalizing problems. Results have implications for etiological theories of adolescent deviant behavior and suggest that successful smoking prevention programs targeting youth with ADHD should include a school adjustment component. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Problem-solving skills training and relationship therapy in the treatment of antisocial child behavior.

The present investigation evaluated the effects of cognitive-behavioral problem-solving skills training (PSST) and nondirective relationship therapy (RT) for the treatment of antisocial child behavior. Psychiatric inpatient children (N?=?56, ages 7–13) were assigned randomly either to PSST, RT, or to a treatment-contact control condition (in which children met individually with a therapist but did not engage in specific activities designed to alter antisocial behavior). Children were hospitalized during the period in which treatment was administered and discharged thereafter. The PSST condition led to significantly greater decreases in externalizing and aggressive behaviors and in overall behavioral problems at home and at school and to increases in prosocial behaviors and in overall adjustment than the RT and contact-control conditions. These effects were evident immediately after treatment and at a 1-year follow-up. The RT and control children did not consistently improve over the treatment and follow-up periods. Comparisons with nonclinical (normative) levels of functioning revealed that a significantly higher proportion of PSST children, compared with those in other conditions, fell within the normative range for prosocial behavior at posttreatment and at follow-up. Even so, the majority of PSST children and almost all RT and control children remained outside the normative range of deviant behavior. The implications of the results for further research for antisocial youth are highlighted. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial outcomes of children of unipolar depressed, bipolar, medically ill, and normal women: A longitudinal study.

The psychosocial functioning of children of unipolar depressed, bipolar, medically ill, and psychiatrically normal women was studied over a 2-yr period. 96 children aged 8–16 yrs were assessed at 6-mo intervals on Child Behavior Checklist behavior problems, social competence, internalizing and externalizing behaviors, academic performance, and school behavior. The children of unipolar mothers showed significantly poorer functioning on all measures as compared with the other 3 groups of children, including bipolar offspring. A greater proportion of children in the unipolar group also had relatively chronic, clinically significant problems in psychosocial functioning. Children of bipolar women did not differ from children of psychiatrically normal women. Results are discussed in terms of consequences of children's continuing exposure to maternal depression and attendant stressors, as well as the contribution of social and academic difficulties in a vicious cycle of maladjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential impact of play therapy on developmental levels of children.

The purpose of this preliminary study was to explore the impact of child-centered play therapy (CCPT) on children identified within J. Piaget's (1962) preoperational and concrete operations developmental stages. Using archival data, this study used a 3-wave repeated measures analysis of variance design to analyze the impact of CCPT on 24 children between the ages of 3 and 8 who received 19-23 individual CCPT sessions. On the basis of the child's age, children were evenly divided into 2 treatment groups of preoperational or operational developmental stage. A pretest, approximate midpoint, and posttest administration of the Parenting Stress Index (R. Abidin, 1995) was collected for use in the analysis. Preliminary results of this study revealed statistically significant differences in the impact of CCPT for children of different developmental stages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Play therapy with children exhibiting symptoms of attention deficit hyperactivity disorder.

Sixty elementary school age children qualified as symptomatic of attention deficit/hyperactivity disorder (ADHD) were randomly assigned to 1 of 2 treatment conditions: child-centered play therapy (CCPT) or reading mentoring (RM). All children participated in 16 individual 30-min sessions in the schools. Results indicated that children who participated in 16 sessions of CCPT and RM demonstrated statistically significant improvement on the ADHD and student characteristics domains, as well as the Anxiety/Withdrawal and Learning Disability subscales of the Index of Teaching Stress and the ADHD Index of the Conners Teacher Rating Scale--Revised: Short Form. Children who participated in CCPT demonstrated statistically significant improvement over RM children on the student characteristics domain and on the Emotional Lability and Anxiety/Withdrawal subscales of the Index of Teaching Stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School functioning in early adolescence: Gender-linked responses to peer victimization.

Research indicates that peer victimization contributes to poor school functioning in childhood and adolescence, yet the processes by which victimization interferes with school functioning are unclear. This study examined internalizing and externalizing problems as domain-specific mediators of the association between subtypes of peer victimization (relational, physical) and school functioning (engagement, achievement) with a cross-sectional sample of 337 early adolescents. School engagement was examined further as a proximal process that intervenes in the associations between internalizing and externalizing problems and achievement. Gender differences in these associations were assessed. As expected, internalizing problems showed stronger links with relational than with physical victimization and partially mediated the influence of both on engagement for girls but not boys. Externalizing problems partially mediated the influence of both subtypes of victimization on school functioning for girls and physical victimization for boys. Notably, engagement was a robust mediator of the contributions of internalizing problems and physical victimization to achievement for girls and externalizing problems to achievement for girls and boys. Findings also suggest that physical (but not relational) victimization partially mediates the link between internalizing and externalizing problems and school functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Academic underachievement, attention deficits, and aggression: Comorbidity and implications for intervention.

Although comorbidity with specific learning disabilities is less frequent than commonly reported, externalizing behavior disorders, particularly attention deficit hyperactivity disorder (ADHD), often overlap with various indices of academic underachievement during childhood. Furthermore, by adolescence, delinquency is clearly associated with school failure. Because the link between behavioral and learning problems often appears before formal schooling, and because the comorbid problems predict a negative course, early intervention is a necessity. Controlled treatment investigations with youngsters who show these combined problems are rare, and such studies present a host of methodologic and practical problems. Issues are discussed surrounding multimodality treatment programs and the potential for long-term interventions to break cycles of school failure and externalizing behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing links between childhood positive peer relations and externalizing outcomes through a randomized controlled intervention study.

In this study, the authors used a randomized controlled trial to explore the link between having positive peer relations and externalizing outcomes in 758 children followed from kindergarten to the end of 2nd grade. Children were randomly assigned to the Good Behavior Game (GBG), a universal classroom-based preventive intervention, or a control condition. Children’s acceptance by peers, their number of mutual friends, and their proximity to others were assessed annually through peer ratings. Externalizing behavior was annually rated by teachers. Reductions in children’s externalizing behavior and improvements in positive peer relations were found among GBG children, as compared with control-group children. Reductions in externalizing behavior appeared to be partly mediated by the improvements in peer acceptance. This mediating role of peer acceptance was found for boys only. The results suggest that positive peer relations are not just markers, but they are environmental mediators of boys’ externalizing behavior development. Implications for research and prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Monitoring two boys' processes through the stages of child-centered play therapy.

This article describes two boys' actions in child-centered play therapy (CCPT) through the lens of the typical stages in CCPT as described by Nordling and Guerney (1999). Both boys were referred for severe attention and aggression problems that had persisted for more than one school year at age six. While each boy engaged in CCPT in unique ways, the authors were able to clearly discern the stages in each boy's play. The authors assert for the value of play therapists' ability to discern stages in children's therapeutic play to monitor progress and determine readiness to end from an internal to the child gauge, as well as through the external gauges of behavior change reports from parents and teachers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Temperamental resistance to control increases the association between sleep problems and externalizing behavior development.

This study examined the moderating effects of temperamental resistance to control on the link between development of sleep problems and development of externalizing behaviors over a 5-year period. Resistance to control was assessed with mothers' retrospective reports of temperament in infancy, provided when children were 5 years of age. Sleep problems were assessed with mother reports on an annual basis from age 5 to age 9. Externalizing behaviors were assessed with teacher reports on an annual basis from age 5 to age 9. A cross-domain latent growth curve model indicated that sleep problem trajectories were positively associated with externalizing behavior trajectories only for children high in resistance to control. In addition, resistance to control was positively associated with initial (age 5) sleep problems and initial (age 5) externalizing behaviors. The authors speculate that the development of sleep problems promotes the development of behavior problems for resistant children, whose self-regulatory abilities are especially tenuous. Implications for prevention and treatment of conduct problems are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Helker and Ray (2009).

Reports an error in "Impact of child teacher relationship training on teachers’ and aides’ use of relationship-building skills and the effects on student classroom behavior" by Wendy Pretz Helker and Dee C. Ray (International Journal of Play Therapy, 2009[Apr], Vol 18[2], 70-83). There was an error in the abstract. In the current abstract the fourth sentence reads: Using a repeated measures design, results revealed that children in the experimental group (n 19) demonstrated a significant decrease (p .04) in Externalizing Problems between measurements 1 and 3 compared to children in the active control group (n 13). However, the fourth sentence should have read “Results of ANCOVA revealed a statistically significant difference (p .04) with a large effect size in externalizing scores between the experimental (n 19) and active control groups (n 13) at the end of treatment but no difference at the 10-week non-intervention follow-up.” (The following abstract of the original article appeared in record 2009-05645-003.) This study examined the impact of Child Teacher Relationship Training on educators’ use of relationship-building skills in the classroom and the effect on student behavior. Preschool-age children (3–4 years old) who scored in the Borderline/Clinical range on at least one scale of the Child Behavior Checklist-Caregiver/Teacher Report Form (C-TRF) qualified for the study (N = 32). In this quasi-experimental design, 12 teacher aide dyads (N = 24) were assigned to the experimental (n = 12) or active control groups (n = 12). Using a repeated measures design, results revealed that children in the experimental group (n = 19) demonstrated a significant decrease (p = .04) in Externalizing Problems between measurements 1 and 3 compared with children in the active control group (n = 13). A statistically significant relationship was found between educators’ higher use of relationship-building skills and students’ decrease in externalizing behaviors (p     

A tale of two methods: Comparing regression and instrumental variables estimates of the effects of preschool child care type on the subsequent externalizing behavior of children in low-income families.

We apply instrumental variables (IV) techniques to a pooled data set of employment-focused experiments to examine the relation between type of preschool childcare and subsequent externalizing problem behavior for a large sample of low-income children. To assess the potential usefulness of this approach for addressing biases that can confound causal inferences in child care research, we compare instrumental variables results with those obtained using ordinary least squares (OLS) regression. We find that our OLS estimates concur with prior studies showing small positive associations between center-based care and later externalizing behavior. By contrast, our IV estimates indicate that preschool-aged children with center care experience are rated by mothers and teachers as having fewer externalizing problems on entering elementary school than their peers who were not in child care as preschoolers. Findings are discussed in relation to the literature on associations between different types of community-based child care and children's social behavior, particularly within low-income populations. Moreover, we use this study to highlight the relative strengths and weaknesses of each analytic method for addressing causal questions in developmental research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)