Individual, Family, and Site Predictors of Youth Receipt of Therapy in Systems of Care Abstract Background The majority of youth with mental health needs do not receive therapy services to treat their disorder, and unmet need is particularly high among racial and ethnic minorities and economically disadvantaged families in the population at large. Investigating whether these patterns emerge within systems of care can reveal opportunities to expand therapy access and utilization. Objective This study examines multilevel predictors of receipt of therapy within the Children’s Mental Health Initiative (CMHI), the largest federally-funded effort in the United States to serve youth with significant emotional or behavioral disturbance, to determine whether disparities in therapy use persist within this specialized population that has been connected to a service array. Method Using data from 1604 youth aged 10–17 in 33 CMHI-funded system of care sites, the relationship between youth, family and site-level variables and the receipt of outpatient therapy in the first 6 months of service were examined using a multilevel model. Results Youth who were African American, had caregivers with less education, were in families at or below the poverty level, or lived in sites that served a higher rate of families below the poverty level were less likely to receive needed therapy services after controlling for age, gender, and symptomatology. Conclusions Despite the CMHI’s success in connecting the majority of enrolled youth to therapy services, treatment disparities persist along racial and socioeconomic lines. These findings identify youth and communities that may require additional strategies and attention to better connect youth to needed therapy services.

A Systematic Review of the Factor Structure of Anxiety Sensitivity Among Children: Current Status and Recommendations for Future Directions Abstract Background Child anxiety sensitivity (AS) is measured almost exclusively using the Childhood Anxiety Sensitivity Index (CASI). Yet, in the context of significant discrepancies regarding the CASI factors and how they are scored and reported, it remains unclear whether the CASI reliably and validly assesses the purported multifactorial AS construct. Objective This paper will: (1) provide a comprehensive summary of previous CASI factor analyses by which these factor structures were identified, (2) evaluate evidence regarding the multifactorial nature of AS in youth, and (3) discuss potential directions for continued research in this area. Method In a PsycInfo search, peer-reviewed studies published between 1991 and 2018 were identified for inclusion if they examined the factor structure of the CASI or reported data on the CASI subscales as administered to child participants. Results Findings from the 50 studies reviewed suggested that (1) the 18-item CASI does not consistently yield internally reliable assessments of specific AS facets, (2) significant discrepancies exist regarding the CASI subscales identified, the items comprising these scales, and their predictive validity in terms of anxiety, and (3) alternatives to assess the multifactorial construct of AS in youth do exist, but they have not been systematically examined in the literature. Conclusions Directions for future study include further examining expanded scales for AS in youth, continued study of shorter scales assessing more consistently reliable AS content, and evaluating the utility of an expanded response scale for the CASI.

Change and Predictability of Children’s Behavioral Adjustment in Tanzanian Pre-primary Schools Abstract Background Research in Western countries has shown the contribution of early teacher–child relationships and classroom emotional support on children’s behavioral adjustment in pre-schools. Results with regard to the direction and strengths of the relationships seem inconclusive, moreover, such research is lacking in African countries. Objective To examine the change and predictability of children’s behavioral adjustment in Tanzanian pre-primary schools. Method Longitudinal data were collected twice over a 1-year interval. Twenty teachers and their 310 children from 20 schools in the Ilala district, Dar es Salaam region, participated in the study. Methods used for data collection were teacher questionnaires and classroom observation. Results Results showed that over time, children’s aggressive behavior and teacher–child conflict decreased, whereas teacher–child closeness increased. Prosocial and anxious behavior remained stable. Multilevel and longitudinal analyses indicated that teacher–child closeness and conflict predicted children’s aggressive behavior. Children’s prosocial and anxious behavior predicted teacher–child closeness, while their prosocial, aggressive and anxious behavior at the individual level and anxious behavior at the aggregated class level predicted teacher–child conflict. Conclusions Teacher–child relationships and children’s behavior relate in a bidirectional way. If the relationship between a teacher and a child is characterized by conflict, children are more likely to develop difficult behavior and teachers find it more difficult to manage the children. These results imply that pre-primary teachers need to be trained on how to identify signs of behavioral problems in children and to establish an emotional supportive classroom environment and teacher–child closeness for a positive school trajectory in children.

Investigating Attachment Status Effects on Preschoolers’ Empathic Perspective-Taking Abstract Background Attachment theory emphasizes that parents’ responses to children’s emotional distress might shape their ability to empathize with others. Previous research showed that securely attached preschoolers are prone to exhibiting more empathy towards others’ distress compared to insecurely attached children, but less is known about the way attachment influences a particular empathy-related skill, namely perspective-taking. Objective The current study’s aim was to evaluate attachment status effects on preschool children’s empathic perspective-taking employing a multi-component conceptualization including affective, cognitive and behavioral perspective-taking. Method The sample included 212 children aged between 3 and 5. The attachment story completion task was employed to assess children’s internal working models concerning the quality of the parent–child attachment relationship. Additionally, a modified version of the Kid’s Empathic Development Scale was administered to evaluate children’s self-reported affective, cognitive and behavioral empathic perspective-taking. Results The results consistently revealed that the insecure avoidant group, but not the insecure ambivalent group, scored significantly lower on all dimensions of empathic perspective-taking compared to the secure category. Conclusions These findings suggest that in typically developing preschoolers, insecure avoidant attachment patterns might be associated with overall difficulties in perspective-taking abilities, whereas insecure ambivalent attachment patterns could be responsible for more specific perspective-taking difficulties related to eliciting prosocial behaviors (i.e., behavioral perspective-taking). These findings could have implications for designing interventions aimed at enhancing parents’ ability to support the development of their children’s empathic perspective-taking skills.

Parent–Educator Communication Linked to More Frequent Home Learning Activities for Preschoolers Abstract Background Parent involvement in children’s education has been linked to positive academic and behavioral outcomes. Home-based involvement is especially important for those who may face barriers to being involved at school. Teachers and school directors can encourage home learning activities, but research examining parent–educator communication for preschoolers is not as robust relative to school-aged children. Objective We address whether parent perceptions of parent–educator communication regarding preschoolers’ learning and development is related to the home literacy environment (HLE) and the home numeracy environment (HNE). Method Participants (n = 262) were drawn from a statewide pre-kindergarten evaluation project aimed at providing early education programming to families with low incomes. The majority of the sample was employed full- or part-time (72.3%), had less than a Bachelor’s degree (88.3%), and children were racially/ethnically diverse (i.e., 39.5% Black, 14.7% Hispanic, 34.9% White, 10.9% other). Multiple regressions were used to examine the relation between parent perceptions of parent–educator communication and children’s home learning environments. Results Findings indicated that perceptions of parent–educator communication were positively related to the HLE, HNE, and specific learning activities (i.e., naming written letters, identifying letter sounds, reading number books, completing number activity books, learning simple sums, naming written numbers). Conclusion Findings suggest that efforts to improve parent–educator communication in this domain may yield benefits for children’s learning, although additional research is necessary to determine whether greater parent–educator communication regarding children’s learning and development results in more frequent home learning activities during preschool.

Adolescents as Coaches during Service-Learning: Teaching Children Social and Emotional Skills Abstract Background Service-learning provides opportunities for adolescents to foster leadership skills, learn about those in different social circumstances, and enhance civic engagement. Objectives This pilot study described the implementation and evaluation of a service-learning project to train adolescents as coaches to teach social and emotional learning to elementary children. Reflection journals were used to document adolescent perceptions of the experience. Method Twenty-nine female and 16 male high school students participated. Adolescents delivered lessons focusing on emotional expression, learning emotions, and interpersonal problem solving. Adolescents used journals to reflect on their experiences. Coders used qualitative methods to analyze themes in adolescents’ answers to journal questions. Results Study findings indicated that several of the adolescents gained leadership and teaching skills, learned about children’s lives, and reported personal growth. Relatively more males described being in a teaching role as difficult, and they may require more support during teaching experiences. Keeping children focused and on-task was difficult for some students. However, adolescents reported feeling inspired by participating in the program and their positive influence as mentors for children. Conclusions Adolescents understood the impact of poverty on children’s lives and some felt inspired and more willing to engage in future service. Adolescents were a valuable workforce as teachers for social and emotional skills for children. This was a summer program, and leaders need to continue to search for ways to incorporate similar character education programming during the school year. Future research should focus on assessment of change in children’s behaviors and future civic engagement of adolescents.

Young People’s Preparedness for Adult Life and Coping After Foster Care: A Systematic Review of Perceptions and Experiences in the Transition Period Abstract Background The transition to adult life for those leaving foster care is a multidimensional phase of their personal development. Care leavers’ life outcomes are poorer in education, employment, income, housing and parenthood compared with their peers from the general population. They suffer more than other youngsters from mental health and behavioral problems, substance abuse and involvement with criminality. Objective This study aims to gather, assess and synthesize the current empirical evidence about subjective perceptions and experiences of former youth in foster care regarding their independent living during the transition to adulthood. Method A systematic review was conducted of studies drawn from six databases and included quantitative studies from 2010 to 2017. Of the 37 eligible studies identified, 13 were selected for final review. Data was analyzed using a narrative method. Results Foster care leavers identified themselves as adult and were quite confident about their future and potential for independent living. They had different coping strategies and profiles, but often faced the same challenges in finding employment, education and having a person whom they could rely on. Among the factors that supported the transition to independent living were care leavers’ personal characteristics, certain care-specific features, good education, sufficient prerequisites for a safe life and social support. Conclusions This review looked at various descriptive studies based on different conceptual perspectives, cultural contexts and methodologies. The evidence, however, still remains relatively insubstantial. Further studies are needed to provide more reliable evidence-based recommendations to inform service development, staff education and additional research activities.

Cross-National Examination of Work-Family in Parents of Children with Disabilities Using a Bioecological Model Abstract Background Although work-family balance (WFB) has received much attention from researchers, there are relatively few studies exploring WFB in parents of children with disabilities. Such research is necessary because caregiving demands are greater among these parents than those caring for typically developing children. Objective The objective was to examine the impact of person and context elements of Bronfenbrenner’s bioecological model (BM) on WFB among employed parents of children with disabilities. Hypotheses stated that personal resources, personal demands, and microsystem, exosystem, and macrosystem variables would impact work interference with family (WIF) and family interference with work (FIW). Method Parents (N = 145) from several English-speaking countries responded to an internet survey. They were recruited through advocacy groups for children with disabilities. They were employed at least part-time with a child under 18 years of age and diagnosed with a disability living with them. Results Regression analyses indicated that some personal resources (e.g. work-family enrichment) and some personal demands (e.g. rated severity of child disability) predicted both WIF and FIW in the expected direction. Microsystem (i.e. supervisory support) and exosystem (i.e. organizational culture) variables predicted lower levels of WIF and FIW. However, macrosystem variables (i.e. national family supportive policies) did not. Conclusions The BM is useful for understanding WFB among employed parents of children with disabilities. Future research should include incorporating more aspects of the BM when exploring parents’ experiences. For example, examination of the chronosystem may be particularly important as the demands of parenting children with disabilities shift as children age.

Identifying Opportunities to Promote Physical Activity in a Diverse Low-Income Population: A Mixed-Method Study at a Boys & Girls Club Site Abstract Background Prevalence and consequences of obesity and sedentary lifestyle are well-documented public health concerns for youth in the United State of America (USA) that disproportionally affect children from low income and minority families. Objective This mixed-method study focused on estimating levels of physical activity and sedentary behavior and prevalence of overweight and obesity among the child members served in one Boys & Girls Club in the Midwest USA. We aimed to better understand opportunities for improving children’s engagement in physical activity through focus groups with members, staff, and parents/caregivers of members. Method Social cognitive learning theory, the ecological model of health behavior, and community based participatory research principles provided the study framework. Members completed assessments of physical activity, sedentary activity, height, and weight. Focus groups with members, staff, and parents/caregivers identified barriers, facilitators, and opportunities for promoting physical activity. Results Nearly 50% of members were overweight or obese. Most (87%) participants reported at least 60 min physical activity every day across the 3-day recall. Fewer than half (41%) reported 2 h or less of sedentary screen time every day across the 3 day recall. Focus group themes identified opportunities for addressing needs associated with health disparities in physical activity and pediatric obesity. Conclusions Findings suggest stakeholder interest in physical activity promotion through afterschool programs. We discuss study implications regarding needs specific to individuals from diverse, low-income households that may not be adequately addressed with existing empirically-supported treatments and opportunities to address health disparities in physical activity and pediatric obesity through afterschool programs.

Toward a Measure for Assessing Features of Effective Youth Development Programs: Contextual Safety and the “Big Three” Components of Positive Youth Development Programs in Rwanda Abstract Background When delivered in a safe space, programs effective in promoting positive youth development (PYD) involve key features termed the Big Three: (1) Positive and sustained adult–youth relationships; (2) Life-skill-building activities; and (3) Opportunities for youth contribution and leadership. However, no measures exist in the literature for assessing the Big Three. Objective The present study sought to develop a quantitative measure of program quality. Method Using data collected from Rwandese participants from the Compassion International (CI) Study of PYD, we developed a youth-report measure with two groups: 603 youth enrolled in CI-supported programs, and 320 youth not enrolled in CI but involved in other youth development programs (total N = 923, Mage = 11.81 years, SD = 1.68). We used exploratory and confirmatory factor analyses to refine the item pool. Using a propensity-score matched subsample, we added a measure of youth contribution to assess predictive validity of the measure, and tested for between-group measurement invariance across age, gender, and CI-enrollment status. We then compared CI-supported and non-CI-supported youth as an initial assessment using the measure. Results We established a parsimonious and robust measure of the Big Three demonstrating strong psychometric properties. CI-supported-youth reported higher levels of each of the Big Three features. Conclusions These results provide information about the usefulness of a measure assessing the Big Three attributes of effective PYD programs. We discuss how future research using this approach to understanding the content of youth development programs may provide evidence of how PYD may be promoted.