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The interprofessional, interagency model PLUSS offers education for preschool teachers on how to detect and support preschool children with neurodevelopmental symptoms. A total of 119 preschool teachers used the Strengths and Difficulties Questionnaire (SDQ) to assess behavioural problems and the Children's Engagement Questionnaire (CEQ) to evaluate engagement and social interaction in 119 preschool children, before and after their PLUSS education. After education, the preschool teachers rated fewer behavioural problems (total SDQ p <.001) and increased engagement and social interactions (CEQ p <.001). In conclusion, the PLUSS preschool teachers' education and screening with the SDQ and the CEQ facilitate assessment of behavioural problems, engagement and social interaction in preschool children. Increased understanding of neurodevelopmental symptoms seems to influence how preschool teachers manage a child's behaviour, which indirectly changes the child's engagement and social interactions for the better. The preschool teachers expressed perceived needs, especially to learn how to deal with a child's emotions and behavioural regulation, and their interactions with other children. [ABSTRACT FROM AUTHOR]

Background: Childhood trauma adversely impacts adolescents, and consequently, they develop behavioural problems. Understanding the distribution of childhood traumas and their association with behavioural problems among adolescents is paramount for the preventive efforts. Aim/Objective: The present research aimed to investigate this association among adolescents. Methods: This association was investigated among adolescents (N = 200) between 12 and 18 years. Childhood Trauma Questionnaire and Strength and Difficulty Questionnaire was used to assess the distribution of trauma and internalizing and externalizing behavioural problems among adolescents through purposive and convenience sampling technique. Results: The findings across trauma distribution indicated higher distribution of childhood abuse and neglect across males as compared to females. Males further significantly scored higher on sexual abuse and emotional neglect. Apparently, a large number of adolescents experienced all five sub types of childhood traumas (sexual abuse, emotional abuse, physical abuse, emotional and physical neglect). Additionally, across the severity continuum of childhood traumas, male scored higher on the severe to extreme continuum for all subtypes except physical abuse, where females scored higher. Lastly, logistic regression analysis indicated higher peer problems among those adolescents who have experienced all types of childhood traumas. Conclusion: These findings could be beneficial for intervention-based programs and policies to help trauma-exposed adolescents cope with their lives. [ABSTRACT FROM AUTHOR]

ABSTRACT In Sweden, both maltreatment and behavioural problems are indicative of needs that motivate interventions from child welfare services (CWS). However, the likelihood of being referred to CWS can be influenced by other than indicative factors on individual, peer and school‐area levels. Studies disentangling such other factors (possible bias) from indicative factors are still lacking in Sweden. Using a subsample of 1286 children across 14 schools from a longitudinal research programme and linking survey data to child welfare records, this article examines the relationship between maltreatment, behavioural problems, individual socio‐economic factors, peer affiliation, disadvantaged school areas and the likelihood of being referred. After controlling for maltreatment and behavioural problems, findings demonstrate that other factors on all three levels (individual, peer and school‐area) increase the likelihood of being referred, for example, living with low socio‐economic status, living in a single‐parent household, being affiliated with peers who smoke and attending school with a large proportion of children from socioeconomically disadvantaged areas. The findings highlight that individual‐level socio‐economic factors are pivotal in understanding why some children are referred, while others with similar needs are not. Implications for outreach social work with children at risk of maltreatment and behavioural problems are discussed. [ABSTRACT FROM AUTHOR]

This research aims to investigate the potential emotional stress and behavioural issues that may arise in children in the early aftermath of the Kahramanmaraş earthquake in Turkey. This cross-sectional study was conducted with 447 parents of children aged 4–10 living in 11 provinces in Turkey affected by the Kahramanmaraş earthquake. The data were collected using the "Demographic Information Form," the "Preschool Age Post-Traumatic Emotional Stress Scale," and the "Strengths and Difficulties Questionnaire-Parent Version" between March and July 2023. Multiple regression analysis was used to determine predictors of emotional stress and strengths and difficulties based on children's earthquake-related experiences. Among the children, 51.5% were male, and the mean age was 6.52 ± 1.58. The results indicated a positive correlation between emotional stress and behavioral problems (r = 0.461, p < 0.001). Losing a family member, being injured in the earthquake, having injured family members, hospitalisation, family members hospitalisation, and home damage were identified as significant determinants of emotional stress and behavioural problems. This research provides valuable insights for tailoring interventions to children directly exposed to earthquakes. The full extent of the psychological damage caused by the earthquake that resulted in significant damage in Turkey has yet to be fully revealed. Similar studies conducted in the future will contribute to our understanding of the psychological consequences of the 2023 earthquake and aid in planning and implementing appropriate interventions for children. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition in children and adolescents is a global issue particularly in low‐ and middle‐income countries, while behavioural problems are becoming a growing public health concern in the area of child and adolescent mental health, with very few studies examining their association in preadolescence. This study aimed to assess the epidemiological relationship between malnutrition and behavioural problems in preadolescence. Methods: A school based, cross‐sectional survey was conducted in Karachi, Pakistan. Total 660, 11‐ to 12‐year‐old preadolescents were selected from a middle‐class, coeducational school chain. Sociodemographic questionnaires and an officially adapted version of Youth Self‐Report Form (YSR), which is the child and adolescent reported version of the Child Behavior Checklist (CBCL), were used to collect data, along with anthropometric assessments following the WHO protocol. Results: Thin and stunted preadolescents had significantly higher odds of internalizing problems (AOR = 2.05, p = 0.003 and AOR = 2.09, p = 0.039, respectively) than normal ones. Overnutrition was not associated with any behavioural issues. According to the Composite Index of Anthropometric Failure, 40% of preadolescents had at least one type of malnutrition and among them about 3% had co‐occurring malnutrition (stunted and thin or overweight). They significantly had higher risk of being associated with the internalizing problems (AOR 2.92, p = 0.027). The effect was considerably higher than that associated with stunted or thin only, highlighting the cumulative impact of the co‐occurring malnutrition on the internalizing problems. Conclusion: Our study concludes that overnutrition and undernutrition are prevalent in preadolescents, with significant association of undernutrition with internalizing problems. Moreover, our study is the first that reports that the co‐occurrence of malnutrition is significantly associated with increased risk of internalizing problems. This study highlights the importance of the link between physical and mental health and emphasizes the need for holistic interventions and programmes for addressing preadolescents' issues. [ABSTRACT FROM AUTHOR]

Background: Neurodevelopmental conditions frequently co‐occur. The aim of this paper was to determine whether there is a cumulative association between (1) the number of neurodevelopmental conditions, specifically hyperkinetic disorder (hereafter referred to as attention deficit hyperactivity disorder), autism spectrum disorder (hereafter referred to as autism) and intellectual disability, and (2) behavioural and socio‐emotional problems and the level of clinician‐rated functioning for young males and females. Methods: In this cross‐sectional study, diagnostic information, caregiver‐rated behavioural and socio‐emotional data (as conceptualised by the Strengths and Difficulties Questionnaire) and clinician‐rated functioning scores (as conceptualised by the Children's Global Assessment Scale) were extracted from electronic patient records for 2768 young people aged 3–17 years (mean = 11.55, SD = 3.46). All data were extracted at baseline, that is, at the time the young person was diagnosed with attention deficit hyperactivity disorder, autism and/or an intellectual disability. Ordinal regression analyses tested associations between the number of neurodevelopmental conditions met (i.e. 1, 2 or 3) and behavioural and socio‐emotional outcomes and functioning. Results: After controlling for age and biological sex, the number of neurodevelopmental conditions was associated with higher levels of inattention/hyperactivity and peer problems, lower levels of prosocial behaviour and poorer clinician‐rated functioning. Although these findings were consistent for males, a cumulative association was not identified for females, except for clinician‐rated functioning. Conclusions: For young people, the presence of multiple neurodevelopmental conditions may have a cumulative impact across domains, but this may differ between males and females. [ABSTRACT FROM AUTHOR]

Background: Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.Objective: This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children’s behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.Participants and setting: Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.Methods: Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children’s behavioural problems. This study used a moderated mediation model.Results: The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children’s behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children’s behaviour problems via psychological distress.Conclusion: Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.

Trauma refers to an overwhelming experience that can leave lingering and negative memories in individuals. Although it is a precursor to challenging behaviours among students with disabilities, the ability of teachers to manage and support them in overcoming their post-trauma experiences is rarely discussed in the literature. This study aims to understand the perceived competence of teachers in adopting trauma-informed practices (TIP) for students with disabilities in regular classrooms in the United Arab Emirates (UAE). The trauma model of the Substance Abuse and Mental Health Services Administration (SAMHSA) guided the development of the Teacher Trauma Management Scale (TTMS) as well as the Balanced Inventory of Desirable Responding (BIDR-16), which was used for data collection. A total of 244 in-service teachers were recruited from 22 schools in one of the seven Emirates in the UAE. The data were subjected to a t-test, an analysis of variance, Pearson moment-production correlation, hierarchical regression and moderation analyses. The results show an interrelationship between most of the domains of the SAMHSA model, the ambivalence of participants towards the implementation of TIP, a small influence of social desirability and the effect of background variables on TIP in the UAE. The study findings showed neutrality of participants on trauma management and thus, highlighting the need for TIP policy formulation, curriculum reform and other implications, which are discussed in detail in the paper. [ABSTRACT FROM AUTHOR]

• Growing evidence associates inflammation during pregnancy with behavioural and cognitive outcomes of the offspring. • Asthma during pregnancy may trigger maternal immune activation (MIA). • Maternal asthma symptoms during pregnancy were associated with internalising behaviours and executive functioning at age 7. • Paternal asthma symptoms in the perinatal period was not linked to child outcomes. Maternal history of inflammatory conditions has been linked to offspring developmental and behavioural outcomes. This phenomenon may be explained by the maternal immune activation (MIA) hypothesis, which posits that dysregulation of the gestational immune environment affects foetal neurodevelopment. The timing of inflammation is critical. We aimed to understand maternal asthma symptoms during pregnancy, in contrast with paternal asthma symptoms during the same period, on child behaviour problems and executive function in a population-based cohort. Data were obtained from 844 families from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort. Parent asthma symptoms during the prenatal period were reported. Asthma symptoms in children were reported longitudinally from two to five years old, while behavioural problems and executive functioning were obtained at seven years old. Parent and child measures were compared between mothers with and without prenatal asthma symptoms. Generalized linear and Bayesian phenomics models were used to determine the relation between parent or child asthma symptoms and child outcomes. Children of mothers with prenatal asthma symptoms had greater behavioural and executive problems than controls (Cohen's d : 0.43 – 0.75 ; all p < 0.05). This association remained after adjustments for emerging asthma symptoms during the preschool years and fathers' asthma symptoms during the prenatal period. After adjusting for dependence between child outcomes, the Bayesian phenomics model showed that maternal prenatal asthma symptoms were associated with child internalising symptoms and higher-order executive function, while child asthma symptoms were associated with executive function skills. Paternal asthma symptoms during the prenatal period were not associated with child outcomes. Associations between child outcomes and maternal but not paternal asthma symptoms during the prenatal period suggests a role for MIA. These findings need to be validated in larger samples, and further research may identify behavioural and cognitive profiles of children with exposure to MIA. [ABSTRACT FROM AUTHOR]

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Background: In this study we compare results obtained when applying the monozygotic twin difference cross‐lagged panel model (MZD‐CLPM) and a random intercept cross‐lagged panel model (RI‐CLPM) to the same data. Each of these models is designed to strengthen researchers' ability to draw causal inference from cross‐lagged associations. We explore differences and similarities in how each model does this, and in the results each model produces. Specifically, we examine associations between maladaptive parenting and child emotional and behavioural problems in identical twins aged 9, 12 and 16. Method: Child reports of 5698 identical twins from the Twins Early Development Study (TEDS) were analysed. We ran a regular CLPM to anchor our findings within the current literature, then applied the MZD‐CLPM and the RI‐CLPM. Results: The RI‐CLPM and MZD‐CLPM each enable researchers to evaluate the direction of effects between correlated variables, after accounting for unmeasured sources of potential confounding. Our interpretation of these models therefore focusses primarily on the magnitude and significance of cross‐lagged associations. In both the MZD‐CLPM and the RI‐CLPM behavioural problems at age 9 resulted in higher levels of maladaptive parenting at age 12. Other effects were not consistently significant across the two models, although the majority of estimates pointed in the same direction. Conclusion: In light of the triangulated methods, differences in the results obtained using the MZD‐CLPM and the RI‐CLPM underline the importance of careful consideration of what sources of unmeasured confounding different models control for and that nuance is required when interpreting findings using such models. We provide an overview of what the CLPM, RI‐CLPM and MZD‐CLPM can and cannot control for in this respect and the conclusions that can be drawn from each model. [ABSTRACT FROM AUTHOR]

Background: Low socioeconomic status (SES) is associated with increased risk for emotional and behavioural problems among children. Evidence from twin studies has shown that family SES moderates genetic and environmental influences on child mental health. However, it is also known that SES is itself under genetic influence and previous gene–environment interaction (G×E) studies have not incorporated the potential genetic overlap between child mental health and family SES into G×E analyses. We applied a novel approach using extended family data to investigate the moderation of aetiological influences on child emotional and behavioural problems by parental socioeconomic status in the presence of modelled gene–environment correlation. Methods: The sample comprised >28,100 children in extended‐family units drawn from the Norwegian Mother, Father and Child Cohort Study (MoBa). Mothers reported children's emotional and behavioural symptoms. Parents' income and educational attainment were obtained through linkage to administrative register data. Bivariate moderation Multiple‐Children‐of‐Twins‐and‐Siblings (MCoTS) models were used to analyse relationships between offspring outcomes (emotional and behavioural symptom scores) and parental socioeconomic moderators (income rank and educational attainment). Results: The aetiology of child emotional symptoms was moderated by maternal and paternal educational attainment. Shared environmental influences on child emotional symptoms were greater at lower levels of parents' education. The aetiology of child behavioural symptoms was moderated by maternal, but not paternal, socioeconomic factors. Genetic factors shared between maternal income and child behavioural symptoms were greater in families with lower levels maternal income. Nonshared environmental influences on child behavioural symptoms were greater in families with higher maternal income and education. Conclusions: Parental socioeconomic indicators moderated familial influences and nonshared environmental influences on child emotional and behavioural outcomes. Maternal SES and child mental health share aetiological overlap such that shared genetic influence was greater at the lower end of the socioeconomic distribution. Our findings collectively highlight the role that family socioeconomic factors play in shaping the origins of child emotional and behavioural problems. [ABSTRACT FROM AUTHOR]

Reported associations of pre-pregnancy weight and/or gestational weight gain with offspring behavioural outcomes are inconsistent. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), this study aimed to examine these associations at five developmental stages between the ages of 3 and 16. Over 6800 mother–offspring pairs at age 3 and 3925 pairs at age 16 were included. Pre-pregnancy underweight was associated with a 22% increased risk of total behavioural difficulties (OR = 1.22, 95% CI 1.02–1.45). In separate analyses using the SDQ subscales, pre-pregnancy underweight was linked to a 37% (OR = 1.37, 95% CI 1.14–1.65) and 33% (OR = 1.33, 95% CI 1.01–1.76) increased risk of emotional symptoms and prosocial behaviour problems over time, respectively. While pre-pregnancy overweight was associated with an 11% (OR = 1.11, 95% CI 1.03–1.20) and 18% (OR = 1.18, 95% CI 1.03–1.36) increased risk of conduct and peer relationship problems, respectively, pregnancy obesity was associated with a 43% increased risk of emotional problems (OR = 1.43, 95% CI 1.16–1.77). We found no evidence of associations between gestational weight gain and child behaviour except for a reduced risk in prosocial behaviour problems (OR = 0.82, 95% CI 0.70–0.96). Our findings provide insights into the link between preconception BMI and child behaviour, underscoring the necessity for further research to validate these associations and elucidate underlying mechanisms. [ABSTRACT FROM AUTHOR]

Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4‐year follow‐up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110–130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15–65 µg/L), and normal‐high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5–5 years and the Behaviour Rating Inventory of Executive Function‐Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5–5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal–high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4‐year‐old children. Key messages: Prenatal iron supplementation succeeds in improving maternal haematological outcomes and cognitive performance of children, but few studies have focused on behavioural development.Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4‐year‐old children.Maternal iron stores early in pregnancy should be measured in addition to haemoglobin concentration.These findings contribute greatly to the advancement of public health by giving physicians the tools to prescribe the most appropriate dose of iron supplementation to contribute to better child development. [ABSTRACT FROM AUTHOR]

Introduction: The present study build on previous research that found a bidirectional relation of parenting stress and negative behavioural outcomes in children with Autism Spectrum Disorders. Aim: To investigate the mediating role of parenting self-efficacy in the relationship of parenting stress and children's behavioural and emotional problems. Materials and methods: The sample included 32 young children and their families. Sociodemographic and clinical data were collected. Hierarchical regression analysis revealed direct and indirect mediating effects. Results: Parenting self-efficacy mediated the relationship between parenting stress and children's behavioural and emotional problems in fathers only. Conclusions: We discuss potential ways targeted parenting self-efficacy intervention can support fathers. Results contribute to gain father-informed knowledge in, a research branch generally focused on mothers. [ABSTRACT FROM AUTHOR]

Problems related to social, emotional and psychological well-being in children at an early age may cause behavioural problems. Previous studies show that the development of emotion regulation strengthens social-emotional well-being, and psychological resilience and reduces behavioural problems in children. This study aims to test the possible mediating role of emotion regulation and to gain a better perspective on the association between social and emotional well-being, resilience, and behavioural problems. 250 children aged 4-6 years (122 boys, 48.8%; 128 girls, 51.2%; mean age = 4.93) studying in kindergartens in Turkey were included in the study. Data on children's behavioural problems and emotion regulation skills were obtained from mothers, and data on social-emotional wellbeing, and psychological resilience levels were obtained from teachers. Social and emotional wellbeing, and psychological resilience indirectly significantly predicted behavioural problems through emotion regulation. Emotion regulation has a partial mediator role in the relationship between social and emotional well-being, psychological resilience and behavioural problems. In line with the results, the importance of supporting the development of emotion regulation skills in the preschool period was emphasized. [ABSTRACT FROM AUTHOR]

Background: Previous cross-sectional studies have found a beneficial relationship between greenspace and children's behaviour. Nevertheless, evidence on the mechanisms underlying this association remains scant. We examined whether the availability of greenspace was related to fewer behavioural problems in Polish children and investigated potential mechanisms. Methods: Data were obtained from the case-control NeuroSmog study, in which children with and without attention deficit hyperactivity disorder (ADHD) were tested from October 2020 to September 2022. The analytic sample comprised 679 children aged 10–13 years. Parents reported internalizing, externalizing, and total behavioural problems using the Child Behaviour Check List (CBCL), as well as information about the presence of a domestic garden and potential mediators: greenspace perception, neighbourhood social cohesion, and physical activity. Tree and grass covers were extracted in 500 m and 1 km buffers around lifelong residences. Structural equation modelling (SEM) was used to examine the psychosocial pathways linking the greenspace metrics to behavioural problems. Results: Greenspace was only indirectly related to fewer behavioural problems. Specifically, tree cover was related to greater levels of physical activity which, in turn, was related to fewer internalizing and total behavioural problems. Tree cover and presence of garden were related to greenspace perception which, in turn, was associated with higher neighbourhood social cohesion which, in turn, was linked to fewer behavioural problems. The patterns of associations in children without ADHD were very similar to those in the full sample except that the associations from garden to greenspace perception and from physical activity to total behavioural problems were no longer significant. The only association persisted among girls was from neighbourhood social cohesion to behavioural problems and among boys were from tree cover to physical activity and tree cover and garden to greenspace perception. Conclusion: Trees and garden, but not grass, are linked to fewer behavioural problems through greenspace perception, neighbourhood social cohesion, and physical activity in Polish children.

Abstract Background The prevalence of mental health problems in childhood and adolescence has increased significantly, not least due to the COVID-19 pandemic in Germany and other countries worldwide. Although holistic school interventions to promote mental health and prevent mental health problems are considered promising, there is currently uncertainty about their effectiveness due to evaluation studies with heterogeneous methodological quality. This paper presents the study protocol for the evaluation of the primary school module of MindMatters. Methods As part of a universal mental health intervention, the MindMatters primary school module ‘Learning Together with Emotions’ aims to promote social-emotional learning (SEL) in the classroom across five skill areas. In addition to classroom activities, the intervention includes a school development module to help primary schools create structures and processes to maintain and promote mental health. To evaluate the effectiveness of the intervention, a two-arm cluster-randomised controlled trial will be conducted, including schools implementing MindMatters over a 12-month period and a control group with no access to the intervention. Data will be collected before and 18 months after initiation of the intervention. Controlled for baseline conditions, multilevel regression analysis will be used to examine primary intervention outcomes at the pupil level (i.e. reductions in mental and behavioural problems). Further mediation and moderation analyses will examine whether proximal outcomes predict changes in mental health outcomes and whether school-level factors influence the effectiveness of the intervention. Discussion This study will contribute to strengthen the evidence base for holistic school (mental) health promotion interventions using a study design with high internal validity. Based on an intervention model, the results will not only provide insights into the relationship between proximal and distal outcomes, but will also allow conclusions to be drawn about how the implementation of the intervention affects its effectiveness. Finally, the findings also address the question of whether improved mental health has a positive effect on primary school pupils’ academic performance. Trial registration German Clinical Trials Register DRKS00023762. Registered on 5 January 2021.

Background: The Inventory of Parental-Peer Attachment (IPPA) is an internationally recognized measure to assess the attachment of adolescents to their parents and peers. The objective of this study was to examine the psychometric properties of the IPPA in a sample of Spanish adolescents with behavioural problems. Method: The sample was composed of 294 Spanish adolescents (53% girls) with behavioural problems. The IPPA mother, father, and peer versions, along with other related measures, were administered. Results: The 25-item scale, distributed into three factors, was confirmed for both the mother and father versions but not for the peer version. The IPPA showed adequate values of reliability ranging from .79 to .86. Validity was demonstrated through correlations with emotional intelligence, antisocial behaviour, and aggressiveness. Conclusion: The three-factor version of the IPPA is a useful, reliable, and valid scale to assess the attachment of adolescents with problematic behaviours and their parents.

Introduction Behaviour problems like hyperactivity, lack of focus, temper tantrums, aggression, disobedience, conflicts with peers, nail-biting, thumb-sucking, and insomnia can happen during childhood or during the formative years of human development. The behavioural problem might not yet be categorised as a mental disorder, but it could develop into one. Although it could be challenging to spot these problems in young children. Schools are places where kids spend a lot of time and are active. Therefore, schools are the finest setting for young children’s mental and physical growth. Objective The study objective is to assess the prevalence of the behavioural problems among school-going children. Methods This cross-sectional observational study will be conducted on school going children in government school using a questionnaire, (which include questions based on socio-demographic and child behaviour characteristics). Sample population involved 172 school-going children aged 15-18 years old. Data will be collected by Google Form (using as a data collection tool) and Microsoft Excel (MS Excel 2010) will be used for the analysis. Study implication Study interest will be identifying the factors influencing behavioural change in school-going children and to develop an intervention program to address these issues and development of effective interventions targeting behaviour-related problems in school-going children.

Abstract Background In this study we compare results obtained when applying the monozygotic twin difference cross‐lagged panel model (MZD‐CLPM) and a random intercept cross‐lagged panel model (RI‐CLPM) to the same data. Each of these models is designed to strengthen researchers' ability to draw causal inference from cross‐lagged associations. We explore differences and similarities in how each model does this, and in the results each model produces. Specifically, we examine associations between maladaptive parenting and child emotional and behavioural problems in identical twins aged 9, 12 and 16. Method Child reports of 5698 identical twins from the Twins Early Development Study (TEDS) were analysed. We ran a regular CLPM to anchor our findings within the current literature, then applied the MZD‐CLPM and the RI‐CLPM. Results The RI‐CLPM and MZD‐CLPM each enable researchers to evaluate the direction of effects between correlated variables, after accounting for unmeasured sources of potential confounding. Our interpretation of these models therefore focusses primarily on the magnitude and significance of cross‐lagged associations. In both the MZD‐CLPM and the RI‐CLPM behavioural problems at age 9 resulted in higher levels of maladaptive parenting at age 12. Other effects were not consistently significant across the two models, although the majority of estimates pointed in the same direction. Conclusion In light of the triangulated methods, differences in the results obtained using the MZD‐CLPM and the RI‐CLPM underline the importance of careful consideration of what sources of unmeasured confounding different models control for and that nuance is required when interpreting findings using such models. We provide an overview of what the CLPM, RI‐CLPM and MZD‐CLPM can and cannot control for in this respect and the conclusions that can be drawn from each model.

Context: Behavioural problems are common after brain injury and can cause feelings of distress in the nursing staff, which can in turn have a negative influence on the behaviour of the patient. Nurses often do not feel they have the necessary skills to apply behavioural interventions in daily practise. They may benefit from the ABC (Antecedent-Behaviour-Consequence) method. Objective(s): This study examined nurses’ impressions of the effects after implementation of the ABC method on a brain-injury ward. Method(s): This study is part of the long-term follow-up (LT-FU) of our longitudinal group intervention study. Nurses were asked to complete a questionnaire once at the time of the LT-FU. Outcome measures were based on the theory of planned behaviour (Ajzen, 1991). Descriptive statistics were used. Findings: After implementation of the ABC method, most nurses reported they perceived behavioural control, received social support, had few feelings of fear, and had confidence in the way they deal with behavioural problems. Moreover, nurses reported positive changes in all these topics since working with the method. Limitations: Although first findings are interesting, we must also underline that the absence of a baseline measurement is a shortcoming of the study. Implications: Training nursing staff in managing behavioural problems with the ABC method might give them more perceived control and decrease feelings of distress and fear. Further longitudinal research is needed to investigate these experiences of the nursing staff to examine whether this has a positive effect on their well-being, job-satisfaction, and the behavioural problems of patients.

Abstract Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4‐year follow‐up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110–130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5–5 years and the Behaviour Rating Inventory of Executive Function‐Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5–5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal–high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF

Background: An individual's overall burden of behavioural and emotional problems across childhood is associated with increased likelihood of later mental health conditions. However, the relative extent of behavioural versus emotional problems ‐ that is, the extent to which the domains are differentiated from one another ‐ may provide additional information about who is at risk of developing a mental health condition. Here, we seek to validate differentiation as an independent predictor of later mental health conditions, and to explore its aetiology. Methods: We analysed data from ~79,000 children in the population‐based Norwegian Mother, Father, and Child Cohort Study, and linked health‐care registries. In preregistered analyses, we modelled the extent and rate of differentiation of behavioural and emotional problems between ages 1.5–5 years, and estimated associations with later symptoms (age 8) and diagnoses (after age 8). We also explored the aetiology of differentiation by estimating associations with early life exposures and, in a subset of 23,945 full siblings, assessing the impact of accounting for unobserved familial confounding. Results: Differentiation of behavioural and emotional problems was associated with later symptoms and diagnoses of mental health conditions, independent of total problems. Maternal at‐risk drinking (β = 0.04 [0.02, 0.06]) and parental relationship problems (β = 0.04 [0.02, 0.05]) were associated with higher behavioural relative to emotional problems at age 5. Maternal prenatal distress (|β| = 0.04 [0.03, 0.06]), concurrent distress (|β| = 0.04 [0.02, 0.06]) and parental education (|β| = 0.05 [0.04, 0.07]) predicted higher emotional relative to behavioural problems at age 5. Estimates for maternal prenatal distress and at‐risk drinking were consistent across both unadjusted and adjusted analyses accounting for unobserved familial risk. Conclusions: Differentiation of behavioural and emotional problems in early childhood represents a valid source of inter‐individual variability linked to the later emergence of psychopathology and may be relevant for early detection and prevention strategies for mental health. [ABSTRACT FROM AUTHOR]

Children with neurodevelopmental disorders often have social-emotional and behavioural difficulties. The present study explored these difficulties in children (n = 50, aged 6–10 years) with autism spectrum disorder, attention-deficit/hyperactivity disorder and developmental language disorder. Parents, teachers and therapists evaluated children's social-emotional and behavioural difficulties through a self-devised questionnaire and the Strengths and Difficulties Questionnaire. Additionally, the children, along with their typically developing age peers (n = 106), completed six emotion discrimination tasks. Analysis revealed some impaired emotion discrimination skills that were predictive for behavioural challenges in daily life and associated with the parent-reported existence of friends. Timely intervention in these children is needed, and it should also include emotion perception training. [ABSTRACT FROM AUTHOR]

Background: The prevalence of mental health problems in childhood and adolescence has increased significantly, not least due to the COVID-19 pandemic in Germany and other countries worldwide. Although holistic school interventions to promote mental health and prevent mental health problems are considered promising, there is currently uncertainty about their effectiveness due to evaluation studies with heterogeneous methodological quality. This paper presents the study protocol for the evaluation of the primary school module of MindMatters. Methods: As part of a universal mental health intervention, the MindMatters primary school module 'Learning Together with Emotions' aims to promote social-emotional learning (SEL) in the classroom across five skill areas. In addition to classroom activities, the intervention includes a school development module to help primary schools create structures and processes to maintain and promote mental health. To evaluate the effectiveness of the intervention, a two-arm cluster-randomised controlled trial will be conducted, including schools implementing MindMatters over a 12-month period and a control group with no access to the intervention. Data will be collected before and 18 months after initiation of the intervention. Controlled for baseline conditions, multilevel regression analysis will be used to examine primary intervention outcomes at the pupil level (i.e. reductions in mental and behavioural problems). Further mediation and moderation analyses will examine whether proximal outcomes predict changes in mental health outcomes and whether school-level factors influence the effectiveness of the intervention. Discussion: This study will contribute to strengthen the evidence base for holistic school (mental) health promotion interventions using a study design with high internal validity. Based on an intervention model, the results will not only provide insights into the relationship between proximal and distal outcomes, but will also allow conclusions to be drawn about how the implementation of the intervention affects its effectiveness. Finally, the findings also address the question of whether improved mental health has a positive effect on primary school pupils' academic performance. Trial registration: German Clinical Trials Register DRKS00023762. Registered on 5 January 2021. [ABSTRACT FROM AUTHOR]

Background: The Inventory of Parental-Peer Attachment (IPPA) is an internationally recognized measure to assess the attachment of adolescents to their parents and peers. The objective of this study was to examine the psychometric properties of the IPPA in a sample of Spanish adolescents with behavioural problems. Method: The sample was composed of 294 Spanish adolescents (53% girls) with behavioural problems. The IPPA mother, father, and peer versions, along with other related measures, were administered. Results: The 25-item scale, distributed into three factors, was confirmed for both the mother and father versions but not for the peer version. The IPPA showed adequate values of reliability ranging from .79 to .86. Validity was demonstrated through correlations with emotional intelligence, antisocial behaviour, and aggressiveness. Conclusion: The three-factor version of the IPPA is a useful, reliable, and valid scale to assess the attachment of adolescents with problematic behaviours and their parents. [ABSTRACT FROM AUTHOR]

There is growing concern about the relationship between screen use by young children and negative effects on their development, as children with developmental and socioemotional impairments tend to have difficulties in their relationships and increased academic problems. The aim of our study was to analyse the relationship between the use of multimedia devices and paediatric symptoms in children below 5 years old. Data from 534 Portuguese parents of children aged from 18 to 57 months were collected via a self-report questionnaire. Children's daily exposure to multimedia devices was nearly 2 h per day. Paediatric symptoms were positively associated with watching television and screen time and negatively associated with parents' working hours. Touchscreen use was more frequent among girls and older children. Parents' working hours comprised the most significant predictor of paediatric symptoms. Our findings reinforce past findings on the adverse links between the use of multimedia devices and paediatric symptoms and also highlight the influence of other variables like the child's age and gender, as well as parental factors. The need to both create a more comprehensive framework regarding the long-term effects of multimedia device use and delineate effective strategies for prevention and intervention with parents and children is discussed. [ABSTRACT FROM AUTHOR]

Abstract Background Around 10% of school-aged children experience mental health difficulties. Many more are ‘vulnerable’: experiencing emotional and/or behavioural problems reaching clinical levels, and thus at greatest risk of future mental illness. The trial aim is to evaluate the effectiveness of the CUES for schools programme in reducing emotional and behavioural problems in vulnerable children. Methods The “CUES for Schools” study is a multicentre cluster randomised controlled trial in primary schools in south east England. Schools will be randomised to receive the usual school curriculum, or the CUES programme (1:1). We aim to enrol 74 schools (5550 children including 2220 vulnerable children). CUES is a whole-class teacher-facilitated interactive digital cognitive-behavioural intervention, delivered as 24 short (20-min) modules over 12 weeks, targeting emotional/behavioural regulation skills. Children self-report emotional/behavioural problems at baseline, 8, and 16 weeks, and wellbeing and cognitive vulnerability at 0 and 16 weeks. Adverse events are assessed at 8 and 16 weeks. Teachers rate classroom behaviour at baseline and 16 weeks. School senior leadership teams and individual teachers consent to involvement in the study; parents can opt their child out of CUES sessions, assessments, or research. Children can similarly opt out and assent to research participation. The primary objective of this trial is to evaluate the effectiveness of CUES for schools compared to the usual school curriculum in improving emotional/behavioural problems for vulnerable Year 4 (8–9 years old) children at 16 weeks post-randomisation, as measured using a standardised questionnaire designed for primary schools. The secondary objective is to investigate the impact of the CUES for schools programme on both vulnerable and non-vulnerable children on wellbeing and teacher-rated classroom behaviour. Discussion The study will show whether CUES for schools is more effective than the usual curriculum in reducing emotional and behavioural problems in vulnerable Year 4 children, and thus reducing the risk of mental health difficulties in later adolescent and adult life. As a digital, teacher-facilitated intervention, CUES for schools can be readily implemented, at minimal cost. If effective, CUES for schools therefore has the potential to reduce the impact of emotional/behavioural difficulties on children’s learning, behaviour, and relationships and the burden of future mental health morbidity. Trial registration Trial Registration ISRCTN11445338. Registered on September 12, 2022.

Abstract Background An individual's overall burden of behavioural and emotional problems across childhood is associated with increased likelihood of later mental health conditions. However, the relative extent of behavioural versus emotional problems ‐ that is, the extent to which the domains are differentiated from one another ‐ may provide additional information about who is at risk of developing a mental health condition. Here, we seek to validate differentiation as an independent predictor of later mental health conditions, and to explore its aetiology. Methods We analysed data from ~79,000 children in the population‐based Norwegian Mother, Father, and Child Cohort Study, and linked health‐care registries. In preregistered analyses, we modelled the extent and rate of differentiation of behavioural and emotional problems between ages 1.5–5 years, and estimated associations with later symptoms (age 8) and diagnoses (after age 8). We also explored the aetiology of differentiation by estimating associations with early life exposures and, in a subset of 23,945 full siblings, assessing the impact of accounting for unobserved familial confounding. Results Differentiation of behavioural and emotional problems was associated with later symptoms and diagnoses of mental health conditions, independent of total problems. Maternal at‐risk drinking (β = 0.04 [0.02, 0.06]) and parental relationship problems (β = 0.04 [0.02, 0.05]) were associated with higher behavioural relative to emotional problems at age 5. Maternal prenatal distress (|β| = 0.04 [0.03, 0.06]), concurrent distress (|β| = 0.04 [0.02, 0.06]) and parental education (|β| = 0.05 [0.04, 0.07]) predicted higher emotional relative to behavioural problems at age 5. Estimates for maternal prenatal distress and at‐risk drinking were consistent across both unadjusted and adjusted analyses accounting for unobserved familial risk. Conclusions Differentiation of behavioural and emotional problems in early childhood represents a valid source of inter‐individual variability linked to the later emergence of psychopathology and may be relevant for early detection and prevention strategies for mental health.

Specific Learning Disabilities (SLD) have gained increasing attention from the scientific community due to their diverse characteristics and significant impact on academic outcomes. Children with SLD often experience emotional consequences, leading to vulnerabilities in mental health. This study explores the potential of adjunct yoga training, a holistic wellness approach, with multisensory teaching, an educational method that engages multiple senses during learning activities, in enhancing self-esteem and addressing behavioural challenges faced by children with learning disorders. The research sample consists of thirty children with learning disorders attending primary school in Ranchi, India, who were randomly assigned to three groups: a multisensory teaching intervention group, a combined multisensory teaching and yoga training group, and a waitlist control group. The participants were obtained through purposive sampling after diagnosis of specific learning disorders with the aid of Malin's Intelligence Scale for Indian Children (MISIC) and NIMHANS Index for Specific Learning Disabilities (NISLD). Coppersmith's Self-Esteem Inventory (CSEI) and Strength and Difficulties Questionnaire (SDQ) were used to assess the self-esteem and behavioural challenges of the participants before and after the intervention. All the thirty patients recruited completed the intervention and assessments at baseline and post-intervention. Statistical Package for Social Sciences (SPSS) software - version 21.0 (SPSS, Chicago, IL, USA) was employed to analyse the data obtained from baseline and post-intervention assessment of the study participants. Descriptive statistics were used to describe the demographic, clinical and other psychosocial variables. Kruskal Wallis test was used to compare the participants of the study groups across the scores obtained in the and post-intervention. The results show that both multisensory and combined multisensory teaching with yoga training interventions effectively enhanced general and social self-esteem in children with learning disorders. Furthermore, adding yoga training to multisensory teaching led to significantly higher self-esteem scores in the school-academic domain. Regarding behavioural outcomes, both interventions significantly reduced emotional problems, conduct problems, and peer relationship issues compared to the waitlist control group. The study highlights the positive effects of multisensory teaching on self-esteem and behavioural parameters in children with learning disorders. Including yoga training as an adjunct to multisensory teaching greatly enhances school academic self-esteem and prosocial behaviour. The findings advocate for integrating yoga training alongside traditional remedial educational approaches to improve the selfesteem and behaviour of children with learning disorders. [ABSTRACT FROM AUTHOR]

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The rising prevalence of mental health disorders among children is a serious concern. Young children who exhibit early warning signs of mental health issues are more likely to develop symptoms in the same or overlapping regions years later. The research aimed to identify emotional and behavioural problems and associated factors in Malaysian preschools. A sample of young children aged 4–6 years from public and private preschools was chosen using a multistage random sampling method. Data were collected from 18 preschools via a parent survey using the Strengths and Difficulties Questionnaire (SDQ). The sample involved 557 children in the SDQ assessment (92%). The overall estimated prevalence of emotional and behavioural problems was 8.4%. Peer problems were the most prevalent attribute, with a percentage of 19.7%. Conduct problems were found in 5.2%, hyperactivity problems in 5.6%, prosocial behaviours in 13.5%, and emotional problems in 6.8%. Girls showed a significant increase in behavioural and emotional problems compared to boys. Having one parent working, having more than two siblings, and having a single-parent family were associated with emotional and behavioural problems. The prevalence of emotional and behavioural problems in Malaysian children was relatively low compared to data from previous studies and other Asian countries but consistent with European studies. Measuring mental health disparities in young children helps stakeholders launch local early intervention programmes. [ABSTRACT FROM AUTHOR]

Purpose: Existing evidence on the relationship between mode of delivery and offspring emotional and behavioural problems, especially in older age groups, is limited and inconsistent. This study aimed to examine the association between obstetric mode of delivery and emotional and behavioural problems in offspring aged 3–16 years. Methods: The sample for this study comprised participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) in the United Kingdom. The study cohort ranged from 7074 (at 3 years of age) to 4071 (at 16 years of age) mother–offspring pairs. Data on obstetric mode of delivery were abstracted from obstetric records by trained research midwives and classified as spontaneous vaginal delivery, assisted vaginal delivery and caesarean delivery (elective and emergency). Offspring emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ) when the child was 3, 7, 9, 11, and 16 years. Logistic regression analyses were used to examine associations. Results: Assisted vaginal delivery was associated with an increased risk of emotional problems at age 11 years (OR = 1.42; 95% CI 1.11–1.81). No significant associations were observed at ages 3, 7, 9 and 16. We found no evidence of associations between caesarean delivery (elective or emergency) and emotional and behavioural measures in offspring across all age groups. Conclusion: Mode of delivery does not appear to be associated with emotional and behavioural problems in children and adolescents. Further research is needed to understand the potential longer-term effects of assisted vaginal deliveries on offspring emotional development. [ABSTRACT FROM AUTHOR]

This comparative study aimed to investigate the association between religious orientation, prosocial behaviour and behavioural problems in adolescent girls studying in traditional and modern madrassas systems. Following APA-mandated ethical guidelines, 172 (n = 86 traditional madrassa, n = 86 modern madrassa) adolescent girls of 11-17 years of age (M = 13.69, SD = 1.80) were recruited through purposive sampling technique in this cross-sectional correlational research. Apart from providing sociodemographic information, all participants responded to the Religious Orientation Scale-Revised (Gorsuch & McPherson, 1989) and The Strength and Difficulty Questionnaire (used both for prosocial behaviour and behavioural problems; Goodman et al., 1998). The findings indicated that intrinsic religious orientation had a negative association with behavioural problems including conduct problems, peer relationship problems, emotional problems and hyperactivity/inattention, while a positive relationship with prosocial behaviours. Also, intrinsic religious orientation positively predicted prosocial behaviour whereas extrinsic religious orientation positively predicted behavioural problems. Moreover, adolescents from traditional madrassas showed more extrinsic religious orientation and behavioural problems than those studying at modern madrassas who demonstrated more intrinsic religious orientation and prosocial behaviour. These outcomes have important implications for mental health professionals, policymakers and researchers focused on educational settings and adolescent development. [ABSTRACT FROM AUTHOR]

Background: Studies using symptom‐based screeners have suggested that mental ill‐health has increased in adolescents in recent decades, however, few studies have tested the equivalence of their instruments, which is critical for inferring changes in prevalence. In addition, little research has explored whether socioeconomic position (SEP) and sex inequalities in adolescent mental health have changed over time. Methods: Using structural equation modelling, we explored SEP and sex differences in harmonised parent reports of emotional and behavioural problems, using data from four UK birth cohorts: the 1958 National Child Development Study (NCDS'58; n = 10,868), the 1970 British Cohort Study (BCS'70; n = 8,242), the 1991–92 Avon Longitudinal Study of Parents and Children (ALSPAC'91; n = 5,389), and the 2000–01 Millennium Cohort Study (MCS'01; n = 9,338). Results: Compared with the two earliest cohorts, members of MCS'01 had higher latent mean scores on emotional problems (both sexes), and lower scores on behavioural problems (females only). The associations between four indicators of SEP and emotional problems were strongest in MCS'01, with housing tenure having the strongest association. All four SEP indicators were associated with behavioural problems in each cohort, with housing tenure again more strongly associated with problems in the MCS'01. Mediation analyses suggested that the increase in emotional problems occurred despite broadly improving socioeconomic conditions. Conclusions: Our findings suggest that parent reports of adolescent emotional problems, but not behavioural problems, have risen in recent generations and this trend is not solely due to reporting styles. A failure to address widening social inequalities may result in further increases in mental ill‐health amongst disadvantaged young people. [ABSTRACT FROM AUTHOR]

The current study explored similarities and differences in parenting stress (PSI) and behaviours in parent reports of autism spectrum disorder (ASD) and attachment disorder (AD). 155 parents whose children had developmental delays and disorders completed the social communication questionnaire, Randolph attachment questionnaire, strengths and difficulties questionnaire, PSI, and parent–child relationship inventory. Parents of children with AD reported greater levels of PSI than parents of children with ASD. Parents of children reaching criteria for both disorders reported the greatest levels of PSI. Limit setting was poorest in parents of children with both classifications, followed by parents of children with AD, and then ASD. Limit setting mediated the relationship between PSI and child behaviour problems for parents of children with ASD < but not for parents of children with AD. These findings suggest different areas of difficulty for parents of children with these conditions, which may be of help in designing interventions. [ABSTRACT FROM AUTHOR]

Adolescents in secure residential care mostly suffer from serious behavioural problems, often accompanied by trauma and adverse family circumstances. This paper presents findings of a comparison of behavioural problems and risk factors of 255 boys and girls (aged 12 to 18 years) in secure residential care in the Netherlands and their association with behavioural problems. A cross‐sectional design and standardized questionnaires were used to measure behavioural problems and individual and familial risk factors. By using independent‐sample t tests, the severity of these factors in boys and girls was compared, and by using structural equation modelling (SEM), associations between these factors and behavioural problems were investigated. The findings of the study show that post‐traumatic stress disorder (PTSD) symptoms, maladaptive emotion regulation, impaired perceived competence and internalizing behavioural problems were more severe in girls than in boys. Boys experienced more severe externalizing behavioural problems and more family problems than girls. Maladaptive emotion regulation, PTSD symptoms, perceived competence and parenting problems were related to behavioural problems. The results indicate that treatment for girls should address PTSD symptoms, perceived competence and maladaptive emotion regulation and that extra attention for family problems in the treatment of boys is warranted. [ABSTRACT FROM AUTHOR]

Background : Around 10% of school-aged children experience mental health difficulties. Many more are 'vulnerable': experiencing emotional and/or behavioural problems reaching clinical levels, and thus at greatest risk of future mental illness. The trial aim is to evaluate the effectiveness of the CUES for schools programme in reducing emotional and behavioural problems in vulnerable children. Methods: The "CUES for Schools" study is a multicentre cluster randomised controlled trial in primary schools in south east England. Schools will be randomised to receive the usual school curriculum, or the CUES programme (1:1). We aim to enrol 74 schools (5550 children including 2220 vulnerable children). CUES is a whole-class teacher-facilitated interactive digital cognitive-behavioural intervention, delivered as 24 short (20-min) modules over 12 weeks, targeting emotional/behavioural regulation skills. Children self-report emotional/behavioural problems at baseline, 8, and 16 weeks, and wellbeing and cognitive vulnerability at 0 and 16 weeks. Adverse events are assessed at 8 and 16 weeks. Teachers rate classroom behaviour at baseline and 16 weeks. School senior leadership teams and individual teachers consent to involvement in the study; parents can opt their child out of CUES sessions, assessments, or research. Children can similarly opt out and assent to research participation. The primary objective of this trial is to evaluate the effectiveness of CUES for schools compared to the usual school curriculum in improving emotional/behavioural problems for vulnerable Year 4 (8–9 years old) children at 16 weeks post-randomisation, as measured using a standardised questionnaire designed for primary schools. The secondary objective is to investigate the impact of the CUES for schools programme on both vulnerable and non-vulnerable children on wellbeing and teacher-rated classroom behaviour. Discussion: The study will show whether CUES for schools is more effective than the usual curriculum in reducing emotional and behavioural problems in vulnerable Year 4 children, and thus reducing the risk of mental health difficulties in later adolescent and adult life. As a digital, teacher-facilitated intervention, CUES for schools can be readily implemented, at minimal cost. If effective, CUES for schools therefore has the potential to reduce the impact of emotional/behavioural difficulties on children's learning, behaviour, and relationships and the burden of future mental health morbidity. Trial registration: Trial Registration ISRCTN11445338. Registered on September 12, 2022. [ABSTRACT FROM AUTHOR]

Reported associations of pre-pregnancy weight and/or gestational weight gain with offspring behavioural outcomes are inconsistent. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), this study aimed to examine these associations at five developmental stages between the ages of 3 and 16. Over 6800 mother–offspring pairs at age 3 and 3925 pairs at age 16 were included. Pre-pregnancy underweight was associated with a 22% increased risk of total behavioural difficulties (OR = 1.22, 95% CI 1.02–1.45). In separate analyses using the SDQ subscales, pre-pregnancy underweight was linked to a 37% (OR = 1.37, 95% CI 1.14–1.65) and 33% (OR = 1.33, 95% CI 1.01–1.76) increased risk of emotional symptoms and prosocial behaviour problems over time, respectively. While pre-pregnancy overweight was associated with an 11% (OR = 1.11, 95% CI 1.03–1.20) and 18% (OR = 1.18, 95% CI 1.03–1.36) increased risk of conduct and peer relationship problems, respectively, pregnancy obesity was associated with a 43% increased risk of emotional problems (OR = 1.43, 95% CI 1.16–1.77). We found no evidence of associations between gestational weight gain and child behaviour except for a reduced risk in prosocial behaviour problems (OR = 0.82, 95% CI 0.70–0.96). Our findings provide insights into the link between preconception BMI and child behaviour, underscoring the necessity for further research to validate these associations and elucidate underlying mechanisms.