HDE 110 Final Exam

PDI: use BE DIRECT

- Be specific with commands - Every command positively stated - Developmentally appropriate - Individual commands - Respectful and polite - Essential commands only - Carefully timed explanations - Tone of voice neutral

PC-CARE Course of treatment:

- Intake: Collect information: clinical interview, standardized measures; Define treatment goals, describe treatment; 12‐minute observation; Trauma Didactic - Session 1: PRIDE Skills; Transitions; Creating a compliance‐friendly environment - Session 2: Selective Attention; Redirect; Modeling; Calming - - Session 3: Rules; Choices; When‐then & If‐then - Session 4: Direct Commands; Two‐choice removal of privileges - Session 5: Recovery; Redo; Hand‐over‐hand (for very young children) - Session 6: Review all skills; Discuss what works and what doesn't; 12‐minute observation; Collect standardized measures

4 tenets of PC-CARE:

- Live, in‐the‐moment coaching of parenting skills - Daily homework: special play time + practicing skills to manage behavior - Encourage proper use of skills that work best for each dyad (no mastery + learn new skills weekly) - Active involvement of children

Individuals with ASD exhibit:

- Persistent challenges in social communication - Repetitive behaviors or circumscribed interests

CDI: use PRIDE Skills

- Praise - Reflection - Imitation - Description - Enjoy

Death of a spouse:

1. Death of a spouse one of the most stressful life experiences and is associated with increased risks for depression and substance abuse in the surviving partner • Challenges include: handling final arrangements, end of life medical decisions, losing a sense of identity or purpose, learning new domestic skills, loneliness 2. Men are more likely to remarry after the death of a spouse than women 3. For older adults, the death of a spouse increases the probability of entering nursing homes 4. The recently bereaved have been shown to have a higher risk of death than the currently married • Particularly at risk for alcohol-related diseases, suicides, and other accidents and violence

Native American/American Indian families:

1. 1% of families (70% do not live on Reservations) • Population have been increasing at every census count since 1940 • Variation among tribal groups (Apache, Navajo, Cherokee, Sioux) • High level of family cohesion (65% are married) • Emphasis on extended family - Extended family is centrally involved in childcare - Children and grandparents typically have very close relationships 2. Public policies towards Native Americans have historically prevented individuals from relying on their communities and families - Use of boarding schools 3. 70 % of Native Americans live off of reservations and in increasingly live in urban environments • These families do best when they can find ways of remaining connected to their cultural identities and communities

When children become caregivers:

1. An estimated 66% of caregivers are female • Caregiving for older family members can have drastic effects on wages, retirement benefits, and health on the caregiver • Most common profile of a caregiver is a working mother who is caring for a parent 2. Caregiving for parents can create conflicts between siblings • Some perceive their siblings as contributing less than themselves and feeling freer to alter their caregiving • Some perceive their siblings as resistant to increasing their relative contributions due to concerns about equity among siblings

Cross-cultural findings in sibling research:

1. Anthropology researchers find that across cultures: • Siblings are common companions growing up and share a family history; • In childhood, siblings are ubiquitous across all primate species • Cultures imbue sibling roles and relationships with meaning because "siblings always matter" 2. Cross-cultural research emphasizes the caregiving responsibilities of older siblings and the hierarchical structure of sibling roles in non-Western societies

Cycle of abuse:

1. Argument/ accusations (physical/ verbal) 2. Abusive act 3. Regret/ flowers/ forgiveness 4. Makeup period 5. New stress/ tension 6. Alcohol/ drugs

Ideal response to abuse:

1. Avoid forceful physical resistance 2. Employ verbal or nonforceful physical resistance 3. End the relationship

PCIT: Structure of 50-minute coaching session:

1. Check in (discuss homework) 2. DPICS coding 3. Coaching (50% of time) 4. Review of session 5. Document session

Operational definitions of behavior:

1. Describe the behavior in terms of what you see. •Specific / Observable / Measureable 2. Why we do we need Operational Definitions? • It is an objective and explicit definition that allows anyone observing the behavior to record the same behavior (data) • Helps to ensure that appropriate intervention and consequence strategies are utilized by all members of a client's team (how we react to the behavior) 3. Examples: • Objective: Johnny leaves his assigned seat by standing up or falling to the ground during instruction without permission • Not objective: Johnny wanders around the classroom

Differential treatment of siblings:

1. Differential treatment, such as differences in privileges, discipline, and parent-child conflict and affection, are linked to less positive sibling relationships poorer adjustment, and adjustment differences between siblings • Disfavored children generally showing poorer adjustment • Moderated by children's understanding of parents' reasons for differential treatment, their perceptions of its fairness, and their family values 2. Incongruence between mothers' and fathers' differential treatment, such that one parent shows preferential treatment toward one sibling and the other does not, may mark a parent -child coalition or breakdown in coparenting • Associated with negative sibling and marital dynamics and poorer adjustment in both siblings

Autism in adulthood:

1. Education: - 36% attended any postsecondary education - 30% attended any college 2. Employment: - 58% has a job for pay - 32% had a job soon after high school 3. Living arrangements: - 19% lived independently - 31% lived apart from parents 4. Social & community participation: - 76% any socialization - 68% any community participation 5. Access to services: - 74% received any services - 37% received vocational services 6. Health & safety: - 60% co-occurring conditions - 47% bullying victimization

3 main functions of behavior:

1. Escape/Avoidance 2. Attention Seeking/Access 3. Sensory (Automatic Reinforcement)

Birth order:

1. Firstborn children, who are often surrogates for their parents as caregivers, teachers, and models, enjoy a greater status/power position in relationship to their younger siblings. • This difference becomes more pronounced as the age gap increases for at least up to four years. • Status/power is conferred most heavily on the eldest son • Older girls are more often good teachers and nurturers for younger children 2. Because firstborn children mirror their parents in searching for their identity, middle children turn to peers, often adopting some of their values • In contrast to the first-born the middle child may be more friendly, cheerful, placid, and less studious with lower self-esteem 3. At a very early age, the youngest are more outgoing, exploring toys, making responses to people, and initiating more play with strangers. Youngest children are significantly more successful socially than other birth orders

Death of a parent:

1. For children and adolescents, the death of a parent has profound effects on socioemotional development and mental health • Children and adolescents who experience the death of a parent are at greater risk for social impairment, depression, and anxiety • These effects can be attenuated by having a surviving parent who is attentive and skilled at communicating 2. The death of a parent is the most common bereavement experience for adults • Affects psychological well-being, drinking behaviors, and physical health • Also affects an individual's close relationships with siblings, surviving parents, and spouse 3. After a partner experiences a death of a parent, there can be declines in marital harmony and support as well as increases in marital strain, conflict, and negative behaviors • Emotional need may be particularly high after the death of a close parent, putting pressure on a spouse to provide compensatory empathic support

Ethnicity

1. Group of people who are distinct from other groups because of cultural characteristics such as language, religion, and customs 2. Racial and ethnic categories are social and political categories. • They are chosen by government officials who are responding not to biological realities, but to immigration, war, prejudice, and social movements. • Despite being socially constructed, these categories have real world consequences for policy

PCIT findings:

1. Improved parenting skill • More parent reflective listening, physical proximity, and prosocial verbalizations • Less sarcasm and criticism • Positive attitudes towards children 2. Improved parent functioning • Less parental stress • Fewer psychological symptoms • Greater sense of control • High satisfaction with treatment 3. Improved child functioning • Fewer child behavior problems, reduced to normal limits • Improved child responsiveness to parent 4. Generalization of effects • Long-lasting effects-demonstrated up to 6 years • Generalized to untreated siblings, home, and school

Some avenues to a PCIT referral:

1. Inattentive, permissive parents with children who are hyperactive 2. Very busy parents who have little time to spend with children, and children are disruptive 3. Children experiencing grief or loss, who are emotionally dysregulated, with disruptive behaviors 4. Children exposed to violence, fearful, or frightening caregivers who are emotionally dysregulated and disruptive

Reasons for violence & abuse in relationships:

1. Individual factors • Alcohol and other drug use • Criminal/psychiatric background • Impulsive • Victim of abuse 2. Relationship factor • On-and-off pattern is associated with physical and emotional violence 3. Family factors • Child abuse in family of origin • Family conflict • Parents who abuse each other 4. Cultural factors • Violence in the media • Acceptance of corporal punishment - Corporal punishment: Use of physical force on a child to correct or control his/her behavior • Gender inequality - Less violence in same-sex relationships, but hard to find supports when there is 5. Community factors • Social isolation and poverty • Inaccessible or unaffordable community services • Community violence

Socioemotional Selectivity Theory:

1. Individuals seek social partners consistent with their broader goals, and the goals of older adults are focused on optimizing emotional well-being 2. People of all ages, how people perceive time left in their life determines motivational goals for all aspects of behavior, including social partner selection • Individuals who perceive a vast temporal horizon: goals are focused on gaining information and knowledge for the future • When perceived time grows shorter: individuals place a greater priority on present-oriented goals, such as regulating social experiences to maximize relationship satisfaction 3. For older adults, family members are especially important for life satisfaction, due to the emotional support derived from these relationships 4. Social network size decreases with age, but the interactions older adults have with people in their remaining network are rated as more satisfying with age • Older adults recall experiencing a greater intensity of positive emotions and less intense negative emotions with their close social partners than do younger adults • Older adults report better quality ties with their children, more positive marriages, closer friendships, and an overall greater proportion of positive versus problem-ridden relationships than do middle-aged or young adults • Even when potential conflicts arise, older adults tend to view their own and their partner's emotions and behaviors favorably - During negative exchanges with marital partners, older adults are more likely to express positive emotions and affection than are middle-aged adults 5. Older adults engage in strategies that optimize positive social experiences and minimize negative ones by avoiding conflicts • Social partners often reciprocate by treating older adults more positively and with greater forgiveness than they do younger adults.

PCIT: Course of treatment

1. Intake: • Collect information: clinical interview, standardized measures • Define treatment 2. CDI: • Teaching session • Coaching 7 to 10 sessions • Parents master CDI skills 3. Mid: • Identify remaining behavior problems 4. PDI: • Teaching session • Coaching 7 to 10 sessions • Parents master PDI skills

Social Convoy Findings:

1. Less "close relationships" as you age 2. Maxing as ages 20-59 3. Convoy composition for age 20-39 in US: - Inner: daughter, son, spouse, mother - Middle: female friend, brother, sister - Outer: sister/female friend/brother 4. Convoy composition for age 40-59 in US: - Inner: daughter, son, spouse, mother - Middle: female friend, sister, brother - Outer: female friend 5. Convoy composition for age 60-69 in US: - Inner: daughter, son, spouse, sister - Middle: female friend/daughter/sister, son - Outer: female friend 6. Convoy composition for age 70-79 in US: - Inner: daughter, son, spouse, sister - Middle: female friend, son, daughter - Outer: female friend 7. Convoy composition for age 80-93 in US: - Inner: daughter, son, spouse - Middle: female friend, daughter/son - Outer: granddaughter

Leaving an abusive relationship:

1. Make a plan and act on it • Pack clothes/belongings, move in with parents or friends, or go to a homeless shelter 2. Call the police • Have the man arrested for violence and abuse 3. Take out a protective order • Accused is prohibited from being within close proximity of the victim partner

Spacing of siblings:

1. Most children are born within two or three years of the last sibling's birth 2. Research from the 1980's suggested spacing of less than two years or five or more years is beneficial for the child's adjustment to a new sibling • A child under age two cannot realize all the implications of another sibling to their special position • Young children closely spaced spend more time together than with their parents during these years and learn to understand each other intimately • However, close spacing can be detrimental for mothers and children's neonatal development, and can have detrimental effects on family resources • After age two, resentment and rivalry increase until children reach age five or six. By this time their world outside the family has expanded and they are better able to cope with and/ or avoid some of these feelings 3. The optimal spacing of siblings instead is dependent upon family environments

Multigenerational households:

1. Nearly 1 in 5 Americans lives in a multigenerational household (19% or 60.6M in 2014) 2. Whites less likely than other racial and ethnic groups to live in multigenerational households (highest for Asians) 3. Three-generation households -for example, grandparents, parents and grandchildren -housed 26.9 million people in 2014 4. Another 3.2 million Americans lived in households consisting of grandparents and grandchildren 5. Majority of parents and adult children (and grandchildren) would rather live independently than together for reasons concerning autonomy and privacy 6. Beneficial arrangement: • Grandparents and older family members can provide child care • Younger adults can care for elderly relatives • May cause strife if family does not communicate how to share costs/household duties

Abuse in romantic relationships: emotional

1. Nonphysical behavior designed to: • Denigrate the partner • Reduce the partner's status • Make the partner feel vulnerable to being controlled by the partner 2. Known as psychological abuse, verbal abuse, or symbolic aggression 3. Emotionally abusive behaviors • Making personal decisions for the partner • Criticizing/belittling 4. Often a precursor to physical abuse 5. Women are more likely to engage in emotional abuse 6. Refusing to talk to the partner as a way of punishing the partner 7. Throwing a temper tantrum and breaking things 8. Acting jealous when the partner was observed talking or texting a potential romantic partner 9. Revenge porn: Posting nude photos of ex-partner - Legislation action is being considered by some states

A few explanations for SST:

1. Older adults may report fewer interpersonal stressors because they have a reduction of social roles that generate stress • With retirement, older adults report greater freedom to select their social partners and their leisure activities 2. American older adults may report fewer interpersonal stressors because they are less likely to live with family members who evoke stress. In early midlife, many adults have children or adolescents living in the household, and the presence of such children is a source of stress as well as reward 3. A growing body of literature has documented that social partners treat older adults more kindly than younger adults • For example, one study demonstrated that people respond differently to younger and older social partners when they commit a social transgression or faux pas 4. Shortened time perspective in relationships with older adults also may lead to older adults having greater forgiveness for social grievances

Effects of abuse:

1. On victims • Violence is associated with symptoms of PTSD • Loss of interest in activities/life • Feeling detached from others • Inability to sleep • Irritability 2. Intimate partner violence increases: • Risk for unintended pregnancy/multiple abortions • Levels of anxiety and drug abuse 3. On children • Increased risk of miscarriage • Birth defects • Low birth weight • Preterm delivery • Neonatal death • Depression • Household instability/foster care

Autism Clinical Criteria

1. Persistent deficits in social communication and interactions - verbal & nonverbal - lack of social reciprocity - failure to develop & maintain appropriate peer relationships 2. Restricted, repetitive patterns of behavior, interests, etc. (at least 2) - stereotyped motor or verbal behaviors, or unusual sensory behaviors - excessive adherence to routines - restricted, fixated interests 3. Symptoms must be present in early childhood

Abuse in romantic relationships: physical

1. Physical aggression • Purpose is to control, intimidate, and subjugate another human being 2. Intimate partner violence: Crimes committed against current or former spouses, boyfriends, or girlfriends • Situational couple violence: Conflict escalates over an issue (Common couple violence) • One or both partners lose control • Intimate terrorism: Behavior designed to control the partner

Why are children in the same family so different from one another?

1. Research on siblings has revealed, however, that two individuals from the same family are often as different as unrelated individuals 2. Researchers use different explanations for this phenomena including: • Behavioral genetics • Birth order & De-Identification • Sibship size or constellation

Siblings into adulthood:

1. Sibling contact and relationships becomes more voluntary in adulthood 2. Older siblings serve as role models for younger siblings during the transition to adulthood • Sibling social support typically declines in early adulthood as individuals gain more independence in varying adult roles (get married, have children, go to university) • Feelings of equity or equality may emerge as siblings reach similar milestones 3. Perceived closeness to an adult sister for both men and women is related to less depression 4. Highly supportive sibling relationships can help individuals cope with poor peer relationships more than supportive parent relationships in adulthood

Siblings as positive influencers:

1. Sibling interactions as unique opportunities for social - cognitive development. Through their conflicts, for example, siblings can develop skills in perspective taking, emotion understanding, negotiation, persuasion, and problem solving • These competencies extend beyond the sibling relationship and are linked to later social competence, emotion understanding, and peer relationships 2. In adolescence, siblings also contribute to positive developmental outcomes, including prosocial behavior empathy and academic engagement • In rural, African American, single-parent families, older siblings' social and cognitive competence explained changes in younger siblings' competencies via their self-regulation

Siblings as negative influencers:

1. Sibling relationships can serve as a training ground for aggression when siblings become involved in coercive cycles: escalation of negative behavior is rewarded by one partner giving in to the other's demanding relationship • Sibling conflicts in childhood, for example, are associated with concurrent and later deviance, school problems, bullying, substance use, and internalizing symptoms • Coercive interaction styles learned in the context of sibling conflict extend to aggression with peers and antisocial behaviors 2. Siblings (especially older ones) provide each other with models of deviant behavior and serve as gatekeepers to delinquent peers and risky activities by providing a setting for practicing coercive behaviors, reinforcing antisocial behaviors such as deviant talk, and colluding to undermine parental authority • Concordance between siblings' externalizing and antisocial behaviors during adolescence has been interpreted as evidence of sibling influences, although these sibling influence processes are rarely measured directly 3. Siblings also are similar in their risky sexual behaviors, including age at first intercourse and attitudes about sex and teenage pregnancy • Longitudinal data showed that the risk of teenage pregnancy increased fourfold for the younger sisters of Latina and African American adolescent mothers • Having an older sister who became a parent before age 20 posed a substantially greater risk than having a mother who became pregnant during adolescence 4. Sibling similarities in risky sexual behaviors are greatest for same-sex siblings and those with warm relationships 5. Older siblings also help to create family norms and expectancies regarding substance use which influence later use 6. Siblings may expose each other to settings and peer groups in which substance use is accepted. • Siblings' patterns of use are more strongly correlated when they share friends 7. Substance abuse is one sibling may also lead to reduced likelihood of substance abuse in another due to processed of de-identification

Sibling influences on parenting:

1. Siblings can provide learning opportunities for their parents that have implications for how parents carry out their parental roles 2. Research that takes sibling dynamics into account has revealed that children also can influence parents' expectations, knowledge, and parenting behavior in ways that have implications for their siblings • Parents who had experienced an earlier-born child's transition to adolescence were less likely to expect later-born offspring to exhibit emotional and behavioral problems during this transition • Comparisons of siblings' relationships with parents at the same chronological ages, for example, have shown that parents exhibit more effective parenting behaviors, including lower conflict and higher levels of warmth and parental knowledge, with secondborn than with firstborn adolescents

Growing up with siblings vs. without:

1. Some studies reported that only children were more sociable in terms of being more outgoing, engaging more in extracurricular activities, and enjoying higher levels of peer acceptance than those with siblings • Other research suggested only children were noticeably disadvantaged in terms of social and interpersonal skills, less able to negotiate peer relationships, and more likely to be both victims and aggressors 2. Only children have unique social networks (compared to first-borns), having smaller networks with fewer friends 3. Only children do not differ from others in terms of overall social participation, but are more likely to engage in extracurricular activities, music, painting, cultural activities, radio listening, reading newspapers, reading books, and solitary play 4. Compared to adults who grew up with siblings, adults who grew up without siblings have less frequent social activities with relatives

Caregiving for a spouse:

1. Spouses often become caregivers when their partner has a serious illness • Caregiving for a spouse is associated with increased distress and a decline in intimacy • Coping mechanisms, social support, and the quality of pre-illness relation between spouses are important predictors of distress during caregiving 2. Caregiving for a spouse can often be accompanied with declines in health and cognitive functioning 3. Ambiguous loss framework

Empty nesting:

1. Studies have found marital satisfaction to be higher in the empty nest phase compared to the launching phase, when children are preparing to leave the home • Increase in marital satisfaction was driven by an increased enjoyment of time with partners 2. Since the Great Recession, the proportion of young adults living with their parents has risen steadily in the United States • Recent census data show that from 2007 to 2012, the percent of young adults aged 18-31 living in their parents' home rose from 32% to 36%, the highest share in more than forty years 3. Adult children living at home can have financial and emotional consequences: • In a longitudinal study coresidence with a child was associated with lower parental marital quality in 2008, but not in 2013

Kin Keepers

1. The kinkeeper maintains communication links with and among family members • Most commonly women in late middle age are kinkeepers 2. Women have greater contact with relatives than men throughout the lifespan 3. Women provide the majority of informal care to spouses, parents, parents-in-law, friends and neighbors • Play many roles while caregiving—hands-on health provider, care manager, friend, companion, surrogate decision-maker and advocate

Resource Dilution Theory:

1. The resource dilution model posits that parental resources are finite and that as the number of children in the family increases, the resources available for any one child declines 2. Siblings are competitors for parents' time, energy, and financial resources and so the fewer the better 3. There is a consistent negative relation between the number of siblings in a group and academic success, but may be explained by other factors • Lower achieving parents have more children • National comparisons show that family size effects are not evident in countries with strong family supportive policies • These effects that are correlated with changes in social policies and economic conditions • Sibship size effects on achievement are not evident in Mormon families, which emphasize the importance of family

Grandparenting:

1. There has been a rise in grandparent-headed households over the past three decades • Partly explained by changes in child welfare practices that encouraged placing children with kin rather than strangers in the foster care system • Welfare reform legislation has also instituted rules requiring that teenage mothers live with a parent or guardian to receive benefits, which has also furthered the creation of three-generation households 2. Grandparent caregivers are more likely to experience economic hardship than grandparents who do not live with their grandchildren • However, the presence of grandparents in the household and their economic contributions to the family reduces grandchildren's economic hardship

Why do victims stay in abusive relationships?

1. Victims may feel emotionally attached to their partners 2. Abuse is only one part of the relationship - Victims are hooked to the positive behaviors of the partner 3. Violence was normalized in childhood • Periodic reinforcement - Occurs every now and then - Abused victim never knows when the abuser will be polite and kind again 4. Victims may be entrapped • Factors of entrapment - Love, fear of loneliness - Emotional and economic dependency - Commitment to the relationship and hope - Guilt, view violence as legitimate - Fear for one's life - Isolation 5. Victims may not have escape routes related to educational or employment opportunities

Black/African American families:

13% of families • Extended family households - Child focused family system - 1 in 5 African American families consist of extended family networks • Strong family bonds and strong religious orientation • Egalitarian gender roles and activities • In 20th century - Increase in single parent households (marriage rates ↓, divorce rates ↑)

1st & 2nd-generation share of population:

1900: 34.5% 2nd gen ~1975: 17% 2nd gen ~2010: 24.5% 2nd gen 2050: 36.9% 2nd gen 2nd generation seems to be 2+ times the population of 1st generation

Maltreatment victims by Age, 2010:

<1 year: 12.7% 1 year: 7.4% 2 years: 7.2% 3 years: 6.7% 4-7 years: 23.4% 8-11 years: 18.7% 12-15 years: 17.3% 16-17 years: 6.2% unknown: 0.4%

Child fatalities by age, 2010:

<1 year: 47.7% 1 year: 14.0% 2 years: 11.6% 3 years: 6.1% 4-7 years: 11.1% 8-11 years: 3.6% 12-15 years: 3.8% 16-17 years: 1.8% unknown & age 18-21: 0.2%

Attention seeking/Access:

Attention seeking: • An individual engages in behavior to gain attention (either positive or negative) of another individual(s) - Can include physical attention, eye contact, or verbal exchange Access: • An individual engages in behavior to gain access to an item/activity/or situation

ABA methods:

ABA methods are used to support persons with developmental disabilities in the following ways: • to increase behaviors (e.g. reinforcement procedures increase on-task behavior, or social interactions). • to teach new skills (e.g., systematic instruction and reinforcement procedures teach functional life skills, communication skills, or social skills). • to maintain behaviors (e.g., teaching self control and self-monitoring procedures to maintain and generalize job-related social skills). • to generalize or to transfer behavior from one situation or response to another (e.g., from completing assignments in the resource room to performing as well in the mainstream classroom). • to restrict or narrow conditions under which interfering behaviors occur (e.g., modifying the learning environment). • to reduce interfering behaviors (e.g., self injury or stereotypy).

Placement stability:

An essential part of young children's mental health • Young children in Sacramento County appear to change placements more frequently

Emotional abuse:

Behaviors that harm a child's self-worth or emotional well-being Examples: rejection, name calling, shaming withholding love terrorizing, berating, ignoring, or isolation

Black families and social change:

Black families are considered barometers of social change • Patterns observed in black families can often become larger, evident trends in the US - Increase in single parent families and cohabitation - Motherhood by choice - Working mothers - Extended family residences

Autism in adolescence:

• Increased social demands can exacerbate existing limitations • Difficulties establishing and maintaining peer relationships • Adolescents with ASD experience more frequent victimization from peers

PCIT outcomes:

Decreases in: 1. internalizing 2. externalizing 3. parent distress 4. parent-child dysfunction 5. difficult child 6. anxiety 7. depression 8. dissociation 9. sexual concerns

Sexual abuse:

Engaging a child in sexual acts. Examples: fondling, rape, and exposing a child to other sexual activities

Replacement behaviors:

Escape/Avoidance Maintained: If the function of the unwanted behavior is for escape or avoidance then the replacement behavior must also allow them to escape or avoid activities. • Breaks • More time Attention Seeking/Access Maintained: If the function of the unwanted behavior is for attention or access, then the replacement behavior must also allow them to gain attention or access. • Functional Communication Training • PECS • Appropriate Attention Seeking Behaviors • Differential Reinforcement

Escape/Avoidance:

Escape: • An individual displays behavior in an effort to terminate (end or leave) a seemingly aversive situation/activity • Behaving in such a way as to remove oneself from a task, demand, or routine that the child is already involved in Avoidance: • An individual displays behavior in an effort to delay or avoid completely a seemingly aversive situation/activity • Behaving in such a way as to prevent the occurrence of a task, demand, or routine

% of children in immigrant families

Europe: 87% (1910), 12% (2000) North America: 10% (1910), 2% (2000) Latin America: 2% (1910), 62% (2000) Asia: 1% (1910), 22% 2000) Africa: 2% (2000) Oceania: 1% (2000) - About 2/5ths of children in immigrant families were born in Mexico or had a parent who was born in Mexico

European American families:

European American Families: 72% of population • More similarities than differences among different European ancestries • Married with few children and focus on nuclear family • Individual focused • 1st and 2nd generation European Americans navigate acculturation process similar to Asian Americans and Latinos

Immigration & fictive kin:

Extended family networks and fictive kin are extremely important relationships for recent immigrants • Help families to find housing and employment • Help to build immigrant communities • Provides buffers against risk behavior for immigrant youth

Neglect:

Failure of parents or caretakers to provide needed, age appropriate care including food, clothing, shelter, protection from harm, and supervision appropriate to the child's development, hygiene, and medical care

What makes PCIT work?

In a CDC meta-analysis of parenting programs (Kaminski et al., 2008), what helps families: • Increasing positive parent-child interactions • Increasing emotional communication skills • Teaching parents to use time-out • Encouraging consistency in parenting

Example of replacement behavior:

• Jason is nine and cries when asked to do difficult tasks. The crying is maintained by avoiding or escaping the tasks • Possible replacement behavior: - Asking for a break from tasks - Asking to do something other than the tasks

Child maltreatment: federal definition

Keeping Children and Families Safe Act (2003) • Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or • An act or failure to act which presents an imminent risk of serious harm

Machismo & Marianismo:

More common to have traditional gender role ideology: • Machismo: Male dominance in the family. Given honor, respect, dignity, and freedom • Marianismo: Veneration of feminine virtue for girls and women. Emphasizes purity and morality and care for others • Values are changing as women gaining power and leadership positions through work

Physical abuse:

Non-accidental injury to a child as a result of hitting, kicking, shaking, burning or other show of force

What is PCIT?

PCIT is a dyadic Intervention treating children 2 to 7 years old with disruptive behaviors and caregivers who have (at least) regular contact with children. 1. Therapists coach the parents while playing with their children, using an FM receiver (2 way mirror/ video feed) • Adaptations in home settings • Adaptations in low-tech settings 2. Course of treatment- 14 - 20 weeks • CDI - Enhance the parent-child relationship, teaching parents to attend to appropriate child behavior • PDI - Teach parent effective behavior management techniques 3. Assessment driven • Assessment informs didactic, coaching strategies 4. Process of treatment- from "hear" to "do" • Intake assessment -> didactic teaching -> coaching -> skills mastery

Compadrazgos:

Refers to compadres or comadres • Fictive kin who become godparents of children and who assist with childcare and social, emotional and monetary support if needed • Have bonds to parents of godchildren similar to siblings • Usually in close proximity to family

Historical context of ASD:

• Kanner 1943 -innate biological processes likely to be the cause of early infantile autism • Bruno Bettelheim and the refrigerator mother • Early empirical work demonstrated minor differences between families of children with autism and families of children with dysphasia

Roles of siblings:

Siblings are lifetime: • Companions • Confidantes • Combatants • Social partners • Role models • Scapegoats • Sources of social comparisons

Why mini-didactics?

• Keep treatment brief • Provide basic concepts then immediately coach - Continue teaching during coaching • Include child

Ambiguous loss of ASD:

• Loss of expectations and thoughts about the future • Negatively impacts parent stress • Considerations of lifelong caregiving responsibilities can lead to identity ambiguity

Entrapped:

Stuck in an abusive relationship and unable to extricate oneself from the abusive partner

Identified prevalence of ASD:

Surveillance year: - 2000: 1 in 150 w/ ASD - 2010: 1 in 68 w/ ASD

Finding the function of a behavior:

Taking data on the settings, antecedents, and consequences of behaviors helps to isolate the function of the behavior

PC-CARE is only 6 weeks because:

• Low PCIT retention rates • Brief intervention requires less parent commitment • Often, the largest PCIT gains occur within the first 6 weeks • Some funding sources allow only a certain number of sessions

Care for older adults with autism:

• Many families report many positive aspects of raising their adult children with ASD • Parents have a hard time balancing their needs with providing ample opportunities for their children to grow • Thinking about the future is a major stressor for families who retain caregiving responsibilities

Stigma of ASD:

• Families can feel stigma, scrutiny and blame for their child's behavior by community members and by extended family members • Parents can blame themselves for their child's autism, although this is becoming less common over time

ASD: Family environment & behaviour

• Five-Minute Speech Sample • Expressed emotion is predictive of increased internalizing, externalizing, and social problems • Warmth and praise are related to reductions in autism symptoms

Acculturation:

Transfer of values from one group to another

Disengagement strategies:

When social partners do something offensive, older adults engage disengagement strategies to a greater extent than do younger adults • Older adults prefer disengagement strategies that regulate their own emotions, such as ignoring the situation or avoiding the topic of conflict rather than confronting their social partners • Older adults often recommend passive disengagement strategies to others and believe these are the best strategies to use in various situations, especially difficult interpersonal situations

Current Etiology & Parent Activism:

• Genetic and prenatal environmental factors affect the development of the brain at different stages • Differential timing and sources of environmental exposures can lead to the heterogeneous behavioral phenotypes of individuals with autism • Parents challenged the medical establishments view of autism, and began fundraising for more rigorous research into causes

PDI goal:

improve compliance

CDI goal:

relationship enhancement

Biculturism:

situations in which children and adults adopt new cultural values while retaining values of origin is associated with most positive development

Immigrant paradox:

when immigrants adopt the values and customs of the host country and give up their cultural values, there are costs to mental health and deviant adolescent behavior

Resolved vs. unresolved trauma:

• "During the interviews, it appeared that the abused mothers who were not abusing their children had an awareness of their own past history of abuse that was integrated into each mother's view of herself. They recognized the effects parental abuse had on them, as well as its potential effects on current child-rearing patterns." • "This is in contrast to mothers abused as children who reenacted their maltreatment in the next generation. These women seemed to dissociate affect (their feelings) from cognitions (their memories) from this period, an example of what Sullivan (1953) refers to as "splitting." They spoke in generalities about their history of care and seemed to lack an understanding of the relation between their own childhood experiences and current childcare practices. They also lacked an understanding of the psychological complexities of their child and of their relationship with their child. As a result, these mothers tended to view their children in an entirely negative or positive light and failed to recognize the ambivalence, which, of necessity, accompanies child care (Cohler, Weiss, & Grunebaum, 1970). In many instances, their description of their child, or for that matter of their parents and mates, appeared to be idealized." -Egeland et al., 1988, p. 1087

Latino families:

• 16% of US families • Of diverse descent, but most research is on Mexican families • La Familia: network of caregivers that includes older siblings, cousins, grandparents, aunts, uncles and godparents - Provides economic, emotional, and social support • High rates of relationship stabilities - 75% of Mexican children of US immigrants live with married or cohabitating parents - Less likely to divorce than other ethnic groups in US • Higher rates of female headed households than white families

Early intensive behavior therapy:

• 1:1 therapy for children with Autism Spectrum and related disorders. • Early intervention (starting at 48 months or younger) • Intensity (25-40 hours per week of direct instruction depending on age) • Breadth of focus (language skills, self help skills, academic skills and social skills are taught across multiple environments) • Parent participation is a vital portion to skill acquisition, maintenance, and generalization to natural environments

Hispanic or Latino ethnicity:

• 2000: "Hispanic or Latino" as "a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race." • 2010: more clearly distinguish Hispanic ethnicity as not being a race. That included adding the sentence: "For this census, Hispanic origins are not races." - "Hispanic, Latino or Spanish origin". • Part of the reason we have the "Hispanic" ethnicity question is because Mexican Americans advocated for it - They considered it advantageous to be categorized as "white" and, so, they fought for an ethnicity category instead of a racial one

Asian American Families:

• 5% of US families • Diverse in their heritage (Chinese, Filipino, Japanese, Vietnamese, Cambodian) - Diverse in family structure and roles • 62% of Asian American children live in married households • Strong sense of family over individual importance • Encourage independence and achievement in children • Highest income and education level among families

PC-CARE:

• 6 weeks • Weekly mini‐ didactics • Many strategies taught • No mastery • Child involved in teaching

Distinctions within Autism:

• Heterogeneity of behavioral profiles -Parental attributions of behavior • Differences in quality of research - Quasi-experimental vs. Within-subjects designs • Changes in the diagnosis of ASD

Sibling Demographics

• 82.22% of youth age 18 and under lived with at least one sibling • In 2010, the number of siblings in the household for youth age 18 and under averaged 1.51 - Almost 40% of youth live with one sibling, about 25% live with two siblings, and over 15% live with 3 or more siblings. • Variability in sibship size across racial/ethnic groups, - Asian (M= 1.41) and White (M= 1.49) youth have fewer siblings - African American (M= 1.64) and Hispanic youth (M= 1.68) grow up with more siblings. • In 2010, more than 10% of households with children included step-or adoptive siblings

Race:

• A group of people that share physical characteristics • Differences between races are social constructions, not biological

Careers in ABA:

• ABA Therapist: High school degree; Implements programs on 1 to 1 basis in homes, schools, or centers; ~10-15$/ hour starting wage • ABA Consultant (some companies): BA/BS Psychology or related field; manages programs, staff, and coordinates between parents and staff • Board Certified Behavior Analyst (BCBA): MS or PhD; performs assessments, designs programs; trains staff and parents; ~40-60K Salary Range for new hires

Fluidity of race & ethnicity:

• About 10 million Americans switched their race or ethnicity on the 2010 census (as changed from their response on the 2000 census) - Most of this change can be accounted for changes in the rules for checking multiple boxes and people being unsure of which category best described them • Hispanic Americans accounted for 18.5 of the 19 million people who chose "Some other race" to describe themselves in 2010

Advanced care directives:

• Advanced care directives are formal preferences for future medical treatment, and also designate a surrogate who has power of attorney to make medical decisions. • Only 28% of couples have completed an advanced care directive, and about 50 % of couples have had informal discussions - The most common reason why couples don't discuss this was "I do not want to think about death."

Extended family networks:

• African American families rely on extended family networks for the care of children - A variety of figures help to deliver care and resources that aid in the well being of families • Many African American grandparents provide child care and child rearing assistance - Grandparents can be a source of discipline and monitoring

Long term consequences of abuse:

• Aggression • Early sexual activity • Drug and alcohol problems • Mental health issues • Depression (5x more likely) • Unemployment • Unhealthy intimate relationships • Incarceration

Structure of black families:

• Andrew Billingsley: Structure of black families is not the cause of social problems, but an adaptation to racism - Resilience in the face of economic and social difficulties • Shirley Hill: Strength and stability, not weakness and instability, are characteristics of black families - Civil rights movement diversified the black community created new class, race, and gender divisions • Some argue Black women are encouraged to be independent as a result of feminist movement and media exposure

ASD: Sources of stress

• Attaining a diagnosis and interventions • Economic Stress • Marital Stress • Parenting Stress

Autism Spectrum Disorder

• Autism is a developmental disability that can cause behavioral, communication, and social challenges • Affects your ability to establish and maintain (non-familial) relationships • Individuals with ASD are widely different from one another, also known as heterogeneity • Diagnosis of ASD can happen at 18 months or earlier, but isn't considered reliable until 2 years of age • Seems to affect more boys than girls, about 1:4/1:5 ratio • First described in medical literature by Kanner in 1943 and Apserger in 1944

Who is treated in PC-CARE?

• Children aged 1‐5 years old • Entered a new foster placement in the previous 60‐90 days • Children in resource homes: County foster homes, FFA foster homes, kin caregivers • Assessment, preventive intervention

Is abuse generational:

• Children who are abused are more likely to commit abuse as adults - Social learning perspective - Attachment perspective • Getting abused in childhood does not inevitably lead to carrying out abuse in adulthood, but is considered a risk factor

ASD: Parent-child interactions

• Children with autism can focus more on objects than their play partners • Parents of children with ASD often use more physical control during interactions • These strategies can be detrimental to social development, such as use of joint attention • Parent comments during their child's ongoing activities is related to later gains in language skills • Overall, parents of children with any disability display more negativity and intrusiveness than parents of typically developing children • Positivity emerges more in unstructured play than during structured activities • Interventions that utilize child-directed approaches may be extremely beneficial for the development of social communicative behavior

Applied Behavior Analysis (ABA):

• Developmental Science in Action! • Applied Behavior Analysis is the scientific study of behavior and the application of techniques to the solution of problems of social significance. • Many decades of research have validated treatments based on ABA. Evidence is so robust for ABA that random assignment and controls are no longer ethical or practical • ABA analyzes the way that the environment affects behavior!

Different programs provided by ABA companies:

• Early Intensive Behavior Therapy • Functional Adaptive Therapy Trainer-to-Trainer • Social Behavior Intervention Groups • Instructional Aide Support in Schools

Maltreatment statistics:

• Every year more than 3.6 million referrals are made to child protection agencies involving more than 6.6 million children (a referral can include multiple children) • The United States has one of the worst records among industrialized nations- losing on average between four and seven children every day to child abuse and neglect

Social Convoy Model:

• Extension of Attachment theory • Describe people who are emotionally close to an individual • People who travel with you through life providing support and challenge

Spillover from marital relationships to sibling relationship:

• Marital and family processes, such as spousal conflict, coparenting, and parenting behaviors, are better predictors of sibling relationship qualities than is family income • Findings have generally been consistent with a spillover process, such that hostility and conflict in the marital subsystem and negativity in parent -child relationships are linked to sibling conflict and violence. • Some youth may compensate for family negativity (e.g., in their parents' marriage), however, by forming close sibling relationships, which in turn protect youth from adjustment problems

ASD: Changes in relationships during the transition to adulthood

• Maternal positive affect increases with time throughout high school • After high school, these trajectories plateau

ASD: Attachment

• Most children with ASD develop secure attachments with their parents using the Strange Situation paradigm • Children with ASD that initiate and respond more frequently to joint attention are more likely to develop secure relationships • Maternal sensitivity and insightfulness are important predictors of secure attachments in families of children with ASD

Identifying alternative replacement behaviors:

• Must serve the same function as the inappropriate behavior • Must produce the same natural reinforcement of the inappropriate behavior (so they don't depend on outside reinforcement strategies to be effective).

Types of child abuse:

• Neglect: 78.3% • Physical abuse: 17.6% • Sexual abuse: 9.2% • Psychological maltreatment: 8.1% • Medical neglect: 2.4% • Other: 10.3%

Interdependence & family obligations:

• Obedience and loyalty to parents and grandparents is often emphasized in Asian American families - Children will often assist in care and teaching of their younger siblings • Multigenerational households are common • In Asian American families, older siblings are slower to acculturate than younger siblings

Social Convey Theory:

• Overall, as adults age their social networks appear to decline • The networks of older adults often contain family members in their convoys

Cons of PCIT:

• PCIT is 14 - 20 weeks on average? ... but actually it can take 6 - 9 months • PCIT is highly intensive for both provider and caregiver • Often high-risk families (child welfare involved, high stress, etc.) • Attrition rates are typically 50-70% • What about kids that don't meet medical necessity? • The majority of positive changes made in relationship enhancement and parent skill acquisition occurs in the first 6 sessions • What about newly placed foster children? They have trauma symptoms and if behaviors are too much, they could lose their placement

ASD: Parenting stress & mental health

• Parents of children with ASD have more parenting stress than parents of children with other developmental delays or with typical development • Broader Autism Phenotype • Parents of children with ASD have increased rates of depression, anxiety, and physical health problems

Why include the child?

• Parent‐child relationships are dyadic - Children can also work to improve the relationship • Encourage open communication • Teach children skills for successful relationships with siblings, peers, etc.

Social Motivation Theory:

• People are innately motivated by social information • Individuals with ASD appear to have less approach towards social information • Parents may have difficulties establishing positive interaction patterns

Social Learning Perspective:

• People learn from one another using observation, imitation and modeling • Siblings' extensive contact and companionship during childhood and adolescence— increasingly outside the direct supervision of parents or other adults—provides ample opportunity for them to shape one another's behavior and socioemotional development and adjustment • Siblings can end up being both positive and negative influences on each other

Environmental influences associated with increased risk of ASD:

• Pesticide exposure • Maternal infections during pregnancy • Maternal and paternal age at conception • Fetal exposure to contaminants in amniotic sac • Certain prescription drugs

Why no mastery?

• Purpose is to help caregivers become knowledgeable about many strategies • Maintain treatment brevity • Reduce demands on caregivers - Keep treatment child‐focused - Keep treatment positive and strengths‐based

De-identification:

• Siblings treat one another as sources of social comparison but also treat one another as foils, de-identifying from one another by selecting different niches in the family and developing distinct personal qualities • Some work suggests that differentiation dynamics help protect siblings from rivalry and jealousy • Early work on sibling differentiation focused on personality and temperament • More recent studies have shown that differentiation dynamics are prevalent in domains ranging from adjustment to social competence and risky behaviors and attitudes - Furthermore, when not measured directly, the strength of sibling influence processes may be underestimated, because some serve to make siblings alike and others serve to make siblings different.

Why many strategies?

• Strengths‐based approach - Provide many options and determine which works best for that family • Less severe behaviors, so different strategies may be most effective • Strategies will continue to be effective as child gets older

Racism:

• Systemic racism disproportionately places low income minority children into unsafe neighborhoods and housing, and under resourced schools • Racist and discriminatory interactions leave a child prone to depression, anxiety, and low self-esteem • Racism and poverty reduce minority parents' mental and physical well-being - Less supportive, and more punitive, parenting practices - Family Stress Model

ASD: Common problem behaviors

• Tantrums: May include a combination of behaviors (e.g., screaming, crying, collapsing, aggression) • Self Stimulatory Behavior: Hand Flapping, rocking, etc. • Aggression: Hitting, kicking, biting, pinching, pulling hair • Response Refusal/Protest: Crying/ Whining/ Screeching/ Shrieking

Measuring race:

• The U.S. Census Bureau must adhere to the 1997 Office of Management and Budget (OMB) standards on race and ethnicity which guide the Census Bureau in classifying written responses to the race question • The 1997 OMB standards permit the reporting of more than one race. An individual's response to the race question is based upon self-identification • Based on socially constructed categories to which people self-identify • For the first time in Census 2000, individuals were presented with the option to self-identify with more than one race and this continued with the 2010 Census - People who identify with more than one race may choose to provide multiple races in response to the race question.

Multiethnic:

• The U.S. population is becoming increasingly multiethnic • Non-Latino whites are numerical minorities in CA, NM, TX, and HI • Asian families outnumber black families in CA • MD, GA, NV, FL, AZ, NY, NJ, MS, and LA are close, and already have under-18 non-white majorities • A majority of babies born in the U.S. since 2011 were non-white • The under-5 population is majority-minority today • The under-18 population will be majority non-white by 2019 • Among non-Latino whites, # deaths > # births

Familism:

• The needs of the family often take precedent over individual needs • Self-identity is firmly placed in the context of the family • Family obligation linked with lower rates of anxiety and depression, and the development of vocational skills • Can lead to problems with academic achievement and stress if too much time is devoted to the fulfillment of family obligations

Social Convoy Circle members:

• Three levels of support/closeness • Inner circle -classic attachment relationships (family, SO, BFF's) • Middle Circle -not as close, but important relationships (extended family, close friends) • Outer circle -less close, still significant to individual (friends, mentors, coworkers)

Latino demographic change:

• US population undergone rapid racial change • Diversification most pronounced among children • US population undergone rapid racial change • Diversification most pronounced among children • Most rapid change outside of traditional gateway areas

Physical indicators of physical abuse:

• Unexplained bruising • Human bites • Broken bones • Missing hair • Scratches

Behavioral genetics:

• Using twin studies, behavioral genetic research examines the concordance between siblings • This one approach to argue how much of a certain trait is genetic (heritable) or environmental • Classic approach was to compare identical twins to fraternal twins • Identical twins are considered to be genetically identical, fraternal twins share 50% of their genes (according to Mendelian rules) - Both sets share environmental influences - All behavioral differences due to genetics • Best case scenario for study design: comparing adopted identical twins reared in different families vs reared together • What are some of the problems associated with these study designs? - 3:00~13:40

Behavioral indicators of physical abuse:

• Wary of physical contact • Behavioral extremes (aggression/ withdrawal) • Frightened of parents/ afraid to go home • Layered clothing

Races on U.S. Census:

• White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. • Black or African American: A person having origins in any of the Black racial groups of Africa. • American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. • Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. • Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Behavioral indicators of neglect:

• begging or stealing food • frequent sleepiness • lack of appropriate supervision • unattended physical problem or medical needs • abandonment • inappropriate clothing for weather conditions

Physical indicators of neglect:

• constant hunger • poor hygiene • excessive sleepiness • lack of appropriate supervision • unattended physical problems or medical needs • abandonment • inappropriate clothing for weather conditions

Physical indicators of sexual abuse:

• difficulty in walking or sitting • torn, stained, or bloody underclothing • pain or itching in genital area • bruises or bleeding in rectal/genital area • venereal disease

Behavioral indicators of emotional abuse:

• habit disorders (sucking, biting, rocking) • conduct disorders (withdrawal, destructiveness, cruelty) • sleep disorders • inhibition of play • behavior extremes (aggression or withdrawal)

Common ASD behavioral symptoms:

• not look at objects when another person points at them • have trouble relating to others or not have an interest in other people at all • avoid eye contact and want to be alone • have trouble understanding other people's feelings or talking about their own feelings • appear to be unaware when people talk to them, but respond to other sounds • be very interested in people, but not know how to talk, play, or relate to them • repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language • repeat actions over and over again • have trouble adapting when a routine changes

Behavioral indicators of sexual abuse:

• sexual touching • abrupt change in personality • withdrawn • poor peer relationships • unwilling to change for gym or participate in physical activities • promiscuous behavior/seductive behavior • drop in school performance/decline in school interest • sleep disturbances, regressive behavior (i.e., bed wetting)

Physical indicators of emotional abuse:

• speech disorders • lags in physical development • failure to thrive