Psychology (Functional Area: Clinical-Developmental)

Permanent URI for this collectionhttps://hdl.handle.net/10315/27657

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Access status: Open Access ,
Childhood Maltreatment And Caregiver Sensitivity: Exploring The Mediating Role Of Emotion Regulation
(2025-07-23) Abdelmaseh, Marette; Bohr, Yvonne M.
Childhood maltreatment is believed to have intergenerational effects through its impact on caregiving behaviour, however the mechanisms underlying this relationship are still unclear. The current study aimed to investigate how emotion dysregulation and postpartum depressive symptomology may mediate the relationship between a caregiver’s experiences of maltreatment in childhood and their sensitivity towards their own children in infancy. One hundred and twelve caregivers completed questionnaires related to their subjective experiences of maltreatment in childhood, their difficulties with emotion regulation, and their symptoms of postpartum depression. Caregivers also attended a virtual session during which a sample of dyadic interaction with their infants was obtained and coded for maternal sensitivity using the mini–Maternal Behaviour Q-sort. The Emotional Stroop Task was employed as a measure of implicit emotion regulation, however data from this task were excluded from analyses as an interference effect was not successfully demonstrated. No study variables were found to significantly predict caregiver sensitivity in this study, calling into question the validity of collecting samples of dyadic interaction virtually. Self-reported difficulties with emotion regulation were found to partially mediate the relationship between self-reported experiences of maltreatment in childhood and symptoms of postpartum depression. These findings lend support to the development and implementation of interventions focused on fostering adaptive emotion regulation among caregivers and caregivers-to-be, especially those who have experienced childhood maltreatment. Additional research is needed to further understand these relationships, including studies with different measures employed within more controlled settings, as well as diverse participant samples that are more representative.
Access status: Open Access ,
Parents With Adverse Childhood Experiences: Exploring Buffering Effects Of A Brief Couple Intervention
(2025-07-23) De Luca, Paul; Prime, Heather
Adults with Adverse childhood experiences (ACEs) report greater relational distress and lower relationship satisfaction. Enhanced risk amongst those with ACEs may be due to increased stress sensitization. The transition to parenthood (and years thereafter) is therefore an important window for intervention. The ‘Love Together, Parent Together’ (L2P2) program was designed to support couples by teaching conflict reappraisal strategies. The current study used piecewise growth curve modelling to assess whether participation in L2P2 buffers against the risk of ACEs in the prediction of parent mental health and relationship quality, respectively. One hundred forty couples (N = 280) were recruited to participate. ACEs did not predict weekly changes in relational or psychological outcomes in our sample, nor did the effectiveness of L2P2 differ as a function of ACEs. This study furthers our understanding of the complex relationship between ACEs, parents’ mental health, and relationship quality.
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Engaging Caregivers In The Service Of Their Child?s Mental Health: An Examination Of Emotion Focused Family Therapy In Relation To Parental Reflective Functioning
(2025-07-23) Radosavljevic, Dorde; Muller, Robert Tom
This study examined parental reflective functioning (PRF - a genuine interest in understanding a child’s mental states and ability to recognize the inherent complexity, and separation of these states from that of the parents) withing the context of a brief, 2-day intensive Emotion- Focused Family Therapy (EFFT) intervention. We also examined how PRF impacts therapeutic outcomes for caregivers and their children. PRF has been noted to be a key factor in parent-child dyad functioning and subsequent child development, however, there have been no studies to date examining its role as a potential mechanism of therapeutic change in EFFT. Method: Symptom change was assessed among 243 participants undergoing a brief 2-day intensive EFFT caregiver workshop. The average age of participants was 44.93 years (SD = 7.59), approximately 68.8% identified as female, and 87.6% identified as Caucasian. Data were collected at six timepoints: registration, pre-treatment, post-treatment, 4 months, 8 months, and 12 months following treatment. Participants completed questionnaires about child psychological symptoms and emotion regulation, as well as parental self-efficacy, parental blocks, and parental reflective functioning. Results: Significant improvements in levels of parent mentalization (a component of PRF) were found, confirming that EFFT is effective in improving parental mentalizing capacity. Additionally, moderate interactions were found between various components of PRF (mentalizing capacity, and parents’ interest & curiosity) and level of fears surrounding parenting in reducing child symptomatology. However, the findings are variable and warrant further investigation.
Access status: Open Access ,
Maternal Substance Use Treatment During a Time Of Crisis: The Effect Of COVID-19 Restrictions on Programming, Family Functioning, and Community Service Engagement
(2025-07-23) Janus, Monika Kamila; Pepler, Debra
Substance use among pregnant and parenting women is a problem in Canada which was exacerbated by the COVID-19 pandemic. Stressors that drive and sustain maternal substance use can be understood through a domain-specific conceptualization of risk and protection. Although integrated treatment promotes positive outcomes in substance-involved families, there is limited understanding of how the pandemic affected clients referred to treatment. Methods: This study used qualitative and quantitative data to evaluate the influence of the pandemic and its related health restrictions on families referred to Breaking the Cycle (BTC), an integrated treatment program for maternal substance use. In Study 1, interviews from three BTC staff members were analysed using thematic analysis to investigate changes to BTC programming, client engagement and psychosocial functioning, and access to partnering agencies, from pre-pandemic to during the pandemic. Subsequently, quantitative analyses were completed to compare clients referred to BTC pre-pandemic vs. during the pandemic using the profiles of 68 families (Study 2) and to evaluate cumulative risk and protection profiles of 30 families (Study 3). Results: Thematic analyses in Study 1 yielded 2 primary themes, 5 secondary themes, and 12 tertiary themes. Marginalized, substance-involved families referred during the pandemic, compared to pre-pandemic, were found to have increased rates of displacement, interpersonal violence, substance use, and reduced access to family supports, among others. In turn, protective intervention factors, including the relational and predictable nature of programming, emerged as critical to service engagement. Study 2 indicated that women referred during the pandemic, compared to pre-pandemic, reported less engagement with services, more depressive symptoms, lower self-efficacy around their substance use and a trend suggesting increased use during pregnancy. Study 3 revealed that 7% of pre-pandemic families vs. 50% of pandemic families were characterized by more domains of risk relative to protection. A mixed-methods investigation revealed specific factors of risk and protection that characterized moderate-to-high-risk vs. low-risk families. Conclusions: The findings revealed exacerbated levels of adversity experienced by these families during the pandemic. This research contributes to an evolving understanding of the interplay of cumulative risk and protective factors, with clinical and policy implications for early intervention work.
Access status: Open Access ,
The Acculturation of Maternal Sensitivity: A Comparison of South Korean, Korean American, European American Mother-Infant Dyads and Variation in Korean American Mothers' Traditional South Korean Parenting Values
(2025-07-23) Lee, Yookyung; Bohr, Yvonne
This study explored the relations between acculturation and the maternal sensitivity of Korean American mothers and examined how Confucian-derived values of hyo might be associated with maternal sensitivity. Mean-levels of maternal sensitivity in native South Korean, South Korean immigrants in the United States (Korean American), and U.S.-born European American mothers and their 5.5-month-old infants were compared. In addition, this study examined the associations between maternal sensitivity and acculturation in Korean American mothers, specifically the extents to which Korean American mother maintain South Korean cultural values and/or adapt the dominant cultural values in the United States (U.S.). Maternal sensitivity was assessed using three popular Western observational maternal sensitivity measures, namely the Ainsworth Maternal Sensitivity Scales (AMSS; Ainsworth, 1969), Mini Maternal Behaviour Q-Sort-VR (Mini MBQS-VR; Moran et al., 2009), and the Nursing Child Assessment Feeding Scale (NCAFS; Oxford & Findlay, 2015). Altogether 181 mother-infant dyads participated: 57 South Korean, 74 Korean American, and 50 European American. South Korean mothers showed statistically greater (< 2-point), but perhaps not meaningful, mean-level AMSS Acceptance subscale score than European American mothers. Additionally, South Korean mothers showed meaningfully greater (.20), but not statistically significant, difference in Mini MBQS-VR scores than European American mothers. No associations were found between maternal sensitivity, as measured by AMSS, MBQS, and NCAFS, and acculturation level in Korean American mothers. This study suggests that, depending on the measure used to assess maternal sensitivity, there may be some differences observed in the scores of mothers from different cultures. However, overall, there appear to be few differences in observed maternal sensitivity across South Korean, Korean American, and European American mothers. Furthermore, this study suggests that there may be no relations between acculturation and maternal sensitivity in Korean American mothers. This study provides insight into maternal sensitivity behaviours in South Korean, Korean American, and European American mothers in different cultural contexts.
Access status: Open Access ,
Screening for Sex Trafficking Within Child Welfare: Addressing the Challenges by Constructing a Child Welfare Specific Screening Tool
(2025-07-23) Asghari, Melody; Connolly, Jennifer A.
Strong evidence suggests that children and youth in care of the child welfare system have a particularly high risk of being trafficked for sex. Accordingly, child welfare workers are likely to encounter individuals at a greater risk of sex trafficking and therefore have a greater responsibility in identifying and supporting these victims. While the literature suggests challenges and barriers to the identification of sex trafficking, little is known about the experience of child welfare workers when assessing youth in their care, especially compared to frontline workers in other human service sectors. Furthermore, few validated screening tools comprehensively assess risk, and none are specifically targeted for youth in the child welfare system. The present dissertation sought to address challenges related to the screening of sex trafficking in partnership with child welfare experts. Chapter 1 introduces the issue of sex trafficking amongst youth in child welfare through a brief review of the relevant literature. Chapter 2 draws on interviews with child welfare experts to uncover challenges experienced during their assessment of sex trafficking risk and involvement. Findings revealed challenges unique to the child welfare context highlighting the transactional nature of the Social Ecological Model. Chapter 3 focuses on the construction of a sex trafficking screening tool in partnership with child welfare experts. This study also explores preliminary validation of the items included using interviews with survivors of sex trafficking as minors. Based on feedback obtained from child welfare experts, items were deleted, added, and modified. Child welfare experts were supportive of the screener. Survivors endorsed 40 of the items included in the screening tool when describing their experience of being trafficked. The interim version of the York Sex Trafficking Screening Tool used for this study includes 52 indicators of sex trafficking that are relevant to the child welfare context. Chapter 4 concludes the dissertation through a review of the study findings, integrative summary, review of the theoretical models, and clinical implications. In summary, this dissertation contributes to clinical research and current practice by investigating ways to support child welfare workers, and youth involved in the system, when screening for sex trafficking.
Access status: Open Access ,
Randomized Controlled Trial of the Arson Prevention Program for Children (TAPP-C)
(2025-07-23) Ruttle, Erin Mary; Desrocher, Mary
Despite the serious consequences that can derive from youth fire involvement, and the extensive use of fire intervention programs, efficacy data for existing treatments is limited and includes only one randomized controlled trial (RCT). The current RCT examined the relative benefits of a multimodal, collaborative firesetting intervention by comparing a modified protocol of The Arson Prevention Program for Children (TAPP-C), which included fire service and mental health components, to the standard treatment, which is fire safety education only (FSE). The study examined change in fire-specific safety knowledge, attitudes and behaviors, and is the first to examine change across broader indices of behavioural and emotional well-being, and parenting constructs. The study sample comprised 27 fire-involved youth, aged 6-16, referred to the TAPP-C program at a large teaching hospital, and their caregiver. Caregiver-youth dyads were randomly assigned to a modified TAPP-C or FSE intervention with data collected at pre- and post-intervention, and 3-month follow-up. Results showed both interventions were effective in reducing firesetting, fire interest, and behavioural and emotional difficulties. No recidivism was reported for either group post-intervention or at 3-month follow up. Results for the parenting constructs revealed negative perceptions of the caregiver-child relationship. Preliminary results suggest fire-involvement may be associated with externalized parental locus of control (PLOC) orientation, and significant relationships were found among parental cognitions, PLOC, and perceived parental competence. Novel findings showed youth deficit in executive function (EF), and that greater EF deficit was significantly related to greater youth-reported fire-interest and behavioural difficulties. Youth participants performed poorly on an impulsivity task, suggesting great impairment in this area. Only youth who received the modified TAPP-C intervention showed significant improvement on the impulsivity task, highlighting a unique benefit for interventions including a mental health component. Finally, results showed readiness to change significantly improved post-treatment for caregivers and youth in both groups. As only the second RCT of a firesetting intervention, the results represent a significant contribution to the existing literature and establishment of best practice intervention by providing preliminary data on the relative efficacy of FSE and combined, collaborative approaches.
Access status: Open Access ,
The Indirect Effect of a Brief Couple Intervention on Child Mental Health via the Interparental Relationship
(2025-07-23) Koven, Maya Rachel; Prime, Heather
Child mental health challenges (CMHC) have long-term implications for social and emotional functioning. The quality of the interparental relationship (IPR) is an important contributor to children’s mental health challenges. Evidence supports the use of brief couple interventions (BCI) to enhance couple functioning, though secondary benefits to child outcomes are unknown. The current study examines whether changes to IPR following participation in a BCI, in turn, lead to changes in CMHC. Participants come from a secondary dataset from a randomized controlled trial of Love Together, Parent Together, a BCI, and included 267 parents (140 couples) with at least one child under 6 years old. Parents reported on ten indicators of the IPR and their CMHC at baseline, 1-week post-intervention, and 1- and 3-month follow-up. Based on an exploratory factor analysis, a two-factor model emerged, which included interparental conflict and relationship quality. Structural equation modelling was used to test indirect effects with interparental conflict and relationship quality, respectively, as mediators, and CMHC at 1- and 3-month follow-ups, respectively, as outcomes. The intervention did not significantly predict couple’s T2 conflict, nor did T2 conflict predict follow-up CMHC. The intervention significantly improved the couple’s T2 relationship quality, though there were no reliable effects found on CMHC. In sum, though findings are consistent with the idea that conflict and relationship quality are unique factors of the IRP, there is no evidence for benefits of a BCI to CMHC. Future studies should carefully consider measurement selection and assessment schedules to detect developmental cascades following couple interventions.
Access status: Open Access ,
Left in the Waiting Room: A Virtual Intervention for Siblings of Youth with Disabilities
(2025-07-23) Hooper, Marie Diane; Desrocher, Mary E.
Evidence-based, psychosocial interventions for siblings of youth with disabilities are rare, but those that do exist typically occur in-person. Research is lacking on the impact of virtual support groups for siblings. This dissertation comprises two studies that describe the adaptation of an in-person intervention- SibWorks- into a virtual format (iSibWorks) and the psychosocial functioning of siblings before and after participating in the six-week iSibWorks intervention. The objectives of Study One included: (1) Adapt the in-person SibWorks group intervention for use on a virtual healthcare platform; and (2) Assess the acceptability of the adapted intervention, iSibWorks. Siblings were youth aged 8 to 12 years who had a sibling with a disability, and their caregivers. One week after the final session, siblings and their caregivers participated in separate semi-structured interviews, which were analysed using qualitative content analysis to examine intervention acceptability. The adaptation was successful, and iSibWorks was deemed acceptable and beneficial. Suggestions were provided to enhance the intervention’s future delivery, content, and engagement. The objective of Study Two was to evaluate the impact of participating in iSibWorks on psychosocial functioning at three time-points: before the intervention, one-week post-intervention and three-months post-intervention. Symptom severity at baseline was examined in relation to changes in psychosocial functioning over time. Validated measures were employed: Youth Self-Report (YSR; siblings) or Child Behavior Checklist (CBCL; caregivers) and Strengths and Difficulties Questionnaire (SDQ; siblings and caregivers). Participants (12 siblings and 13 caregivers) reported significant improvements in psychosocial functioning from baseline to post-intervention and these gains were maintained at three-month post-intervention. Participants reporting a high level of psychosocial difficulties at baseline demonstrated greater gains at follow-up. Overall, iSibWorks is a promising intervention to support the psychosocial functioning of siblings. Further research using control groups and comparing delivery models directly is recommended.
Access status: Open Access ,
Exploring Thriving of Inuit Youth Through an Engagement Lens: A Strengths-Based Focus on Factors Related to Nunavummiut Youth's Participation in a Psycho-Educational Mental Health Project
(2025-07-23) Thomas, Alaina Frances MacInnis; Bohr, Yvonne
Few studies have investigated strategies to support Inuit youth engagement in mental wellness using a strengths-based, culturally grounded approach. Existing literature primarily focuses on environmental science and addresses solely physical and educational barriers. The current study aimed to identify multi-systemic factors that may directly or indirectly support Inuit youth leaders and participants engagement in two mental wellness research initiatives: the Making I-SPARX Fly in Nunavut [I-SPARX] and the Virtual Qaggiq projects. For Inuit youth leaders/ research assistants, this was explored through semi-structured interviews. For Inuit youth testers in the I-SPARX game evaluation trial, demographics and response patterns on a pre/post intervention wellness questionnaires were analyzed. Thematic analysis identified common themes in the qualitative data, while multiple linear regression and an adaptive lasso analysis extracted key factors from the quantitative data. The findings revealed multiple interrelated individual, contextual, relational, and cultural influences on youth’s engagement. Clinical and research implications are discussed.
Access status: Open Access ,
Autism Spectrum Disorder In Girls: Sex Differences, Subtypes, And Symptom Structure
(2025-04-10) Rourke, Melissa Laurie-Anne; Perry, Adrienne
The present study investigated how autism spectrum disorder manifests in female children through three separate studies. Two separate datasets were used. The Surrey Place (SP) dataset (N=1725) was composed of children screened to participate in an intensive treatment program. The SFARI dataset (N=2757), is a collection of data representing autistic children who participated in the Simons Simplex Collection (SSC; Fischbach & Lord 2010). Each study boasts a large sample of autistic females (n=301, and n=375, respectively). The datasets differed from one another in many important ways, such as the characteristics of the sample, method of data collection, and the measures used. Study 1 comprised an investigation of sex differences between female and male autistic children across a wide range of developmental and diagnostic characteristics. Groups of male and female children were compared using frequency data, correlations, and Multivariate Analysis of Covariance. Results of this study showed significant differences based on sex. That is, boys tended to have higher FSIQ, Non-Verbal IQ and adaptive abilities than girls. No differences were found in terms of total autism symptom scores. Boys were found to have higher levels of RRBIs and Self Injurious Behaviour. Study 2 used Latent Profile Analysis to explore subtypes within the sample of girls; that is, autistic girls with specific characteristics that cluster together, and likewise within the samples of boys. Results indicated three distinct profiles (or classes) for the SP dataset and these were similar in boys and girls. Class 1 consisted of children who were slightly younger than the sample mean, with adaptive scores close to the sample mean, and autism scores that showed mild to moderate symptoms of autism. Class 2 again consisted of younger children with better adaptive skills, and mild to no autism symptoms. Class 3 consisted of older children, with lower adaptive skills, and more severe autism symptoms. The SFARI sample included more developmental variables and allowed for a more nuanced analysis. As a result, many possible combinations of profiles emerged. Using LPA fit statistics and clinical judgement, a five-profile solution was deemed to best fit the data. Visual comparison across the profiles for girls and boys found that four of the five profiles were largely similar across boys and girls. One of the five profiles showed unique and distinct profiles for girls and boys. Study 3 used confirmatory factor analysis to investigate the symptom structure of autism between females and males, based on factor structures reported in previous research. Overall, the factor structure was found to be largely consistent for males and females. These results suggest that sex differences in the current study were minimal, although some subtle differences were noted. More research is needed to better understand the unique qualities of autistic females. Neuro-affirming diagnostic measures and more representative research samples may allow for the discovery of more sex differences.
Access status: Open Access ,
Cognitive Correlates Of Fatigue In Pediatric-Onset Multiple Sclerosis
(2025-04-10) Fabri, Tracy Lauren; Till, Christine
Fatigue is common in pediatric-onset multiple sclerosis (POMS), yet causal factors and correlates of fatigue are poorly understood in this population. A systematic review of fatigue and cognition was conducted in Chapter 2. The available evidence confirms that fatigue is a common symptom in POMS with rates in samples varying from 9-76% and symptoms typically severe and functionally impairing for POMS patients. The relationship between parent- and self-reported fatigue and cognitive performance is not consistently found in the literature, though higher levels of fatigue tend to associate with performance on measures of sustained visual attention and task switching. In Chapter 3, we investigated associations between cognitive and clinical features of POMS, namely objective fatigability, and subjective fatigue. Fatigability was operationalized as response time variability on a brief version of the Continuous Performance Test (CPT). We found that there is a significantly greater probability of parents and participants endorsing severe fatigue in POMS relative to age- and sex-matched healthy controls (HCs). We also identified that POMS were less accurate and more variable in their performance on the CPT relative to HCs. We did not however observe the expected associations between performance-related fatigability on the CPT and severe levels of parent- and self-reported fatigue. Finally, diffusion tensor imaging was used to explore neural correlates of fatigability. POMS participants demonstrated lower whole brain white matter integrity relative to HCs and while generally in the expected direction, white matter integrity was not significantly associated with fatigability on the CPT. Until there is a cure for MS, it is essential that we continue to understand fatigue and its correlates in this population in order to develop targeted interventions, increase quality of life, and minimize the secondary impacts of fatigue.
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PECSPERTS: Evaluating Telehealth and Hybrid Caregiver Training Models for Teaching Caregivers How to Implement the Communication System
(2025-04-10) Esteves, Jeffrey Brent; Perry, Adrienne
Roughly 30% of children diagnosed with autism do not develop functional speech. For these children, augmentative and alternative communication systems (AAC) may be used to help develop functional communication systems. One such system is the Picture Exchange Communication System (PECS). Prior research has established professional-delivered PECS as an evidence-based AAC. However, few studies have assessed the efficacy of parent training on caregiver PECS use and there is limited research on the use of telehealth technology when implementing PECS caregiver training. This dissertation reports on two studies designed to expand our understanding of PECS caregiver training using both telehealth and in-person applications of behavioural skills training (BST) and generalized case training (GCT). Study one evaluated the feasibility as well as caregiver outcomes of the PECSperts Caregiver Training package. Six caregivers participated in a two-week telehealth training in which they were taught how to implement the first four phases of PECS (phases 1-3b) using BST and GCT. Caregivers were taught to implement PECS with the use of structured scenarios and demonstrated their skill through roleplay with a trained mediator. Following the conclusion of the 2-week training, all caregivers had met the mastery criteria for all four phases. Caregivers maintained these treatment gains at 1- and 2-month follow-up. Study two evaluated a second iteration of the PECSperts Caregiver Training package and included an evaluation of child outcomes and child characteristics (e.g., cognitive level) and their relations to child PECS outcomes. Nine caregivers participated in a 4-week hybrid (online and in-person) training. Participants were evaluated on their ability to implement the first four phases of PECS (phases 1-3b) with their children and their children were evaluated on their independent PECS use across five timepoints. Overall, there was a significant improvement in both caregiver PECS teaching accuracy and child PECS use accuracy between baseline and the end of intervention. Caregivers and children maintained their treatment gains at both 1- and 3-month follow-up. Baseline child characteristics were not significantly associated with PECS outcomes at the end of the intervention; however, parents reported a significant decline in autism symptom severity over the course of the intervention.
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An Evaluation of Acceptance and Commitment Therapy Workshops for Parents of Autistic Children
(2025-04-10) Maughan, Andrea Louise; Weiss, Jonathan
Emerging research shows that Acceptance and Commitment Therapy (ACT) may improve mental health for caregivers. This dissertation sought to understand outcomes and experiences for parents of autistic individuals following participating in a 3-day ACT group workshop. Workshops were co-led by other trained parents of autistic people and professional clinicians. In Study 1, parents (N=54) were randomly assigned to either complete a brief group- based ACT intervention or remain on the waitlist. Participants completed surveys immediately prior to randomization, and 3-, 7-, and 17-weeks post-randomization. Mixed effects linear models testing group x time interaction indicated the Treatment group demonstrated greater post- intervention improvements than the Waitlist group in parent depression and family distress. Treatment group parents also reported greater short-term gains in positive affect and personal goal attainment, compared to the Waitlist group. Although there was no significant group x time interaction for other outcomes, stress, defusion, and experiential avoidance showed improvement for the Treatment group, but not the Waitlist group, at post-intervention. All Treatment group improvements were maintained at follow-up. Results suggested that a brief ACT group intervention is efficacious for improving some aspects of mental health for parents of autistic children. In Study 2, 15 parents who had previously attended the ACT workshop participated in individual interviews, focusing on parents’ experiences in a group with a co-facilitation model, and their perspectives about who should facilitate interventions for parents of autistic people. Using a qualitative thematic analysis approach, overall themes identified included the importance of a group environment in which trust is created through establishing credibility of the program and ensuring emotional safety. This environment allowed for parents to be able to fully participate in the workshop by sharing experiences, feeling open minded and hopeful, and focusing on what is important to them. Participants discussed behaviours, knowledge, and skills that they value in facilitators, that both parent leaders and professional clinicians can contribute, as well as emphasizing the unique value that the parent leader brought to the group. Findings lend themselves to developing best practices around creating effective and supportive interventions for parents of autistic people.
Access status: Open Access ,
A Pilot Study Using Machine Learning for Classification of Pain-Related Versus Non-Pain-Related Electroencephalographic Activity in Preterm Infants
(2025-04-10) Hamwi, Lojain; Pillai Riddell, Rebecca
Effective pain assessment and management are crucial to mitigate both immediate and long-term consequences of prolonged NICU stays. Accurately assessing pain in premature infants is challenging due to their inability to verbally communicate their pain, the potential judgement bias by caregivers, the lack of specificity in current pain assessment tools and time constraints in a busy hospital environment. This pilot study explores a machine learning approach to support pain assessment in neonatal care using cortical activity. The current study aims to test machine learning models that autonomously distinguishes non-pain related from pain-related cortical activity. The present dataset includes 72 preterm infants (27 females), born between 24- and 36-weeks gestational age, from two NICUs: Mount Sinai Hospital (Toronto, Canada) and University College London Hospital (London, UK). The primary outcome was to assess the accuracy of various machine learning models (XGBoost, Support Vector Machines, Random Forest, Logistic Regression, Convolutional Neural Networks) in distinguishing EEG features within a one-second pre-lance epoch (non-pain related) from a one-second post-lance epoch (pain-related). Performance metrics varied across post-menstrual age groups, reflecting developmental differences in EEG patterns. Machine learning algorithms can autonomously distinguish the one-second epoch immediately following a heel lance from the one-second epoch immediately preceding the procedure in preterm infants. Moreover, the performance of these algorithms improves with increasing postmenstrual age, demonstrating greater accuracy and reliability in older infants. This study provides a foundation for developing an autonomous and accurate tool for pain assessment in neonatal patients that can improve pain management practices in NICUs.
Access status: Open Access ,
Who Benefits from a Brief Online Couples Intervention? Examining Baseline Moderators of the Effectiveness of the Love Together, Parent Together Program
(2025-04-10) Markwell, Alexandra; Prime, Heather
Brief relationship interventions are needed to support the relationship quality of couples parenting young children who face a heightened risk of relationship deterioration. Accordingly, the Love Together, Parent Together (L2P2) program was created as a brief online writing program for parents. The present study addresses secondary objectives of a two-arm pilot randomized control trial (RCT) of the L2P2 program, examining whether multilevel risk factors across the family system moderate the program’s effectiveness. Participants included 140 couples with children (under six years), randomized to the L2P2 intervention or control condition. They completed baseline, post-intervention, and 1- and 3-month follow-up surveys. The intervention involved three writing sessions teaching couples conflict reappraisal strategies. The current study examined couples’ baseline dyadic adjustment, COVID-19 family stress, children’s effortful control, and composite risk as multilevel risk factors. Piecewise latent growth curve modelling (LGCM), using data from four timepoints, was conducted in MPlus 8.5 to examine rates of weekly change in couples’ relationship quality scores as a function of condition (L2P2 vs. control), baseline risk, and the interaction between the two. Results revealed that none of the moderators predicted weekly change in relationship quality, nor did the interaction between each respective moderator and condition. Findings do not support the differential effectiveness of L2P2 as a function of multilevel household risk. Results contribute to a growing literature that addresses for whom and/ or in what circumstances couples’ prevention programs are most effective.
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Understanding Problematic Media Use in Children and Youth with ADHD, Early Neurological Risk and a Community Sample: Exploring Parental Cognitions and Perspectives
(2025-04-10) Lyon, Rachael Elizabeth MacLean; Toplak, Maggie
While children at risk of attention difficulties, such as those with ADHD or early neurological risk, are recognized as more susceptible to problematic media use (PMU), less emphasis has been placed on understanding these vulnerable groups. Current theories of PMU draw from a psychopathology framework, aiming to distinguish normal variation from pathological behaviour. Measures like the Problematic Media Use Measure (PMUM) predict children's challenges over and above the amount of screen time. In light of the current literature, parent perspectives, grounded in a theoretical framework of developmental psychopathology, were used to explore the following interrelated research questions: (1) How do attention difficulties interface with PMU and how do these interactions manifest across various developmental stages? (2) How do parents understand PMU when asked to consider their child's perspective? Two studies were conducted. In Study 1, three samples of parents with children aged 6-18 were collected: community (N=386), ADHD (N=66) and early neurological risk (N=65) samples. The purpose of Study 1a was to evaluate PMUM factor structure across ages and compare PMU across samples. Parents also completed an adapted version of the PMUM with questions from their child’s perspective to explore discrepancies between parents’ own perspective and what they thought their child would report (Study 1b). In Study 2, interviews were conducted with a subset of parents in the ADHD sample. The ADHD sample showed higher levels of PMU and experienced more negative outcomes related to screens than the other samples. Parents fell into four groups based on 1) whether a discrepancy in perspective was reported and 2) the level of parent-reported problems (high or low PMU), with most parents reporting no discrepancy. Similar patterns were observed in the early neurological risk sample, while parents in the ADHD sample mainly fell into groups with high PMU, without or without discrepancy. In Study Two, thematic analysis revealed that children with ADHD face unique challenges with screen use and parents may not fully consider their child’s perspective with respect to PMU. Clinical implications and future research directions are discussed with respect to the utility of understanding parent cognitions about their child’s screen use.
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“It Fostered a Greater Appreciation for my Little Corner of the World": A Feasibility Study of a Therapeutic Photography Intervention for the Well-Being of Autistic Young People.
(2024-11-07) Charalampopoulou, Marina; Weiss, Jonathan
The multifaceted nature of well-being has been overshadowed by an overwhelming focus on negative mental health in the autism literature. This has created a shortage of interventions addressing the promotion of positive emotional (hedonic) and psychological (eudaimonic) states. Therapeutic photography (TP), referring to self-initiated photo-taking activities paired with mindful reflections of the photographs, has the potential to provide an accessible and cost-effective approach to the development of positive mental health interventions for autistic emerging adults. The current study employed a mixed-methods methodology to explore the development, feasibility, and future adaptations of a novel TP intervention aimed at promoting hedonic and eudaimonic well-being among autistic emerging adults. Forty-one autistic young people between the ages of 16 and 25 were recruited. Participant reports indicated that TP is a largely feasible intervention with reference to the domains of demand, implementation, acceptability, practicality, and limited efficacy. Suggestions for future adaptations of the intervention are provided to best address the needs of the community based on study results. Our findings suggest that TP is a promising new direction in the application of positive psychology interventions to promote the well-being of autistic young people.
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Collateral Benefits Of A Brief, Couple-Focused Intervention On Coparenting: Indirect Effects Through Couple Relationship Quality And Conflict
(2024-11-07) Demy, Jazzmin Stephanie; Prime, Heather
In two-parent households, the interparental relationship is central to the wellbeing of family relationships and individual members. The current study examines whether participation in a brief, online, couple-focused relationship intervention has collateral benefits to coparenting (i.e., how two parents coordinate in their parenting roles), indirectly through improvements in couple relationship quality and conflict frequency, respectively. A community sample of couples with young children (N = 140 couples; 280 participants; 91.4% heterosexual) participated in a longitudinal randomized controlled trial. Both members of the couple (49.3% women) reported on perceived relationship quality and conflict frequency (at baseline and post-intervention; T1, T2), and coparenting (at baseline, 1-month, and 3-month follow-up; T1, T3, T4). Controlling for initial levels (T1), longitudinal path modelling indicated that random assignment to the intervention directly predicted relative increases in relationship quality at T2. In turn, increased relationship quality at post-intervention predicted relative increases in coparenting at T3 and T4, respectively. Consistent with longitudinal mediation, the indirect effect of random assignment to the intervention on later coparenting via relationship quality was also significant. Random assignment to the intervention was not associated with changes in conflict frequency; thus, there was not a significant indirect effect through conflict frequency to coparenting. Similarly, sensitivity analyses testing conflict-related distress as a mediator demonstrated no collateral benefits to coparenting. Finally, a parallel mediation analysis including both mediators indicated that the indirect effect of the intervention to coparenting via relationship quality was significant when controlling for the pathway through conflict frequency. There are positive cascading effects of a couple-focused intervention onto how parents work together to parent their child.
Access status: Open Access ,
Coping, Context And Family Mental Health Within CBT For Autistic Children
(2024-11-07) Black, Karen Rebecca; Weiss, Jonathan
Autistic children experience elevated emotional-behavioural difficulties; links have been identified between these struggles and parent distress. Although parent-involved cognitive behavioural therapy (CBT) helps many autistic children improve overall emotional distress, there is a critical lack of understanding as to the role of children’s coping ability within this process, and the systemic factors that may impact change. To address this gap, this dissertation investigated the impact of family and child moderators of coping skill change within CBT for autistic, school-age children. Data was pooled from three related CBT interventions administered to 186 autistic children ages 8 – 13 years and their families, from 2013 – 2021. In Study 1, Exploratory Item Factor Analysis was conducted with pre-treatment data to investigate the dimensionality of the ERSSQ-P. A multidimensional structure with three factors was identified as the most appropriate fit, comprised of a 10-item subscale within the emotion regulation domain (Coping: a child’s ability to modulate distressing feelings in stressful contexts), and two subscales within the social communication domain (Initiating and Interacting). Validity for the subscales was confirmed based on associations with measures of emotion regulation, depression and social communication. Study 2 used the Coping subscale and multilevel modeling to investigate how pre-treatment child and family factors impact coping skill change for autistic children across three timepoints, and whether these relationships varied according to treatment type (individual vs. small group). Results indicated that on average, all children experienced the same, small level of improvement in coping ability, regardless of treatment type. However, pre-treatment systemic factors (child depression, restricted interests and repetitive behaviours, parent distress, family stress related to child behaviour) were related to lower initial coping ability, suggesting that children experiencing higher levels of difficulties at the beginning of treatment were also likely to finish the program at a relatively lower skill level. Although these relationships do not appear to be a barrier to statistical improvement, meaningful change may require longer than 10 weeks. Greater support for parents may also be warranted. Overall, findings present preliminary, yet practical considerations for clinicians and community agencies that can assist with targeted, strength-based treatment planning.

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