This paper presents information pertaining to attachment processes as risk factors in the development of disruptive behavior in young children. In recognition of the fact that attachment is not the only or necessarily most important risk factor in the prediction of behavior problems, attachment is considered in the context of other domains of variables, including child biologic factors, family ecology, and parental management and socialization practices. Within the attachment domain, we describe three complementary processes that may lead to disruptive behavior: the information-processing aspects of affective-cognitive structures, the function of observable attachment patterns, and the motivational consequences of attachment security. The indirect effects of maternal representations of attachment on child disruptive behavior are also considered. Examples of protypical risk factor combinations involving attachment and other domains are provided. The implications of the attachment perspective for research and clinical work with young disruptive children are discussed.

Available literature on neurocognitive development of children with SSC is suggestive of mild but persistent neuropsychological deficits, which become more significant as cognitive demands increase at school age. Anatomical studies of children without SSC are beginning to identify particular groups of brain structures that if disrupted or malformed, may be associated with specific cognitive deficits. Controlled research investigating the relationship between persistent anatomical changes and neurocognitive functioning of school-aged children with SSC is needed.

This study attempted to replicate previous findings that indicated that preschool-aged children with significant externalizing problems are more likely to have insecure attachment relations than nonproblem peers (Speltz, Greenberg, & DeKlyen, 1990). Fifty children (ages 3–6) and their mothers participated; 25 referred to a child psychiatry clinic for one of the DSM-IIIR Disruptive Behavior Disorders, and 25 matched comparisons without externalizing behavior problems. Attachment was measured at the time of referral using two separation and reunion sequences in a clinic context. We found that 80% of the clinic-referred children were classified as insecure, whereas only 28% of the comparisons were so classified (p <.001). Further, a high percentage of clinic insecure children showed a controlling pattern of attachment. Thus, the present study, with improved methodological rigor, provided an almost exact replication to previous results. The discussion focuses on what contribution attachment research can provide to a developmental psychopathology perspective on early externalizing disorders.

WHAT'S KNOWN ON THIS SUBJECT: Previous studies that reported learning deficits among children with oral clefts mostly used small, clinic-based samples prone to ascertainment bias. No previous studies in the United States have used a populationbased sample and direct testing of academic achievement. WHAT THIS STUDY ADDS:Using a large population-based sample from the United States and standardized school tests for achievement, we found that children with oral clefts scored significantly lower than their classmates on all evaluated domains of achievement and had higher rates of learning disability. abstract BACKGROUND AND OBJECTIVE: Previous studies of academic achievement of children with oral clefts have mostly relied on small, clinicbased samples prone to ascertainment bias. In the first study in the United States to use a population-based sample with direct assessment, we evaluated the academic achievement of children with oral clefts relative to their classmates. METHODS:Children born with isolated oral clefts in Iowa from 1983 to 2003 were identified from the Iowa Registry for Congenital and Inherited Disorders and matched to unaffected classmates by gender, school/school district, and month and year of birth. Academic achievement was assessed by using standardized tests of academic progress developed by the Iowa Testing Programs. Iowa Testing Programs data were linked to birth certificates for all children. Regression models controlled for household demographic and socioeconomic factors. The analytical sample included 588 children with clefts contributing 3735 child-grade observations and 1874 classmates contributing 13 159 child-grade observations. RESULTS: Children with oral clefts had lower scores than their classmates across all domains and school levels, with a 5-percentile difference in the overall composite score. Children with clefts were approximately one-half grade level behind their classmates and had higher rates of academic underachievement and use of special education services by 8 percentage points. Group differences were slightly lower but remained large and significant after adjusting for many background characteristics.CONCLUSIONS: Children with oral clefts underperformed across all academic areas and grade levels compared with their classmates. The results support a model of early testing and intervention among affected children to identify and reduce academic deficits. Pediatrics 2014;133:785-792

Future studies would benefit from larger samples and larger control groups; measures of specific neuropsychological functions (in addition to global cognition); analyses of neuropsychological status in relation to the severity and cortical impact of synostosis; and an examination of interactions between synostosis and social/family risk factors on neurodevelopment. Routine neurodevelopmental screening of young children with isolated craniosynostosis is recommended.

The current study utilized both variable- and person-oriented analyses to examine correlates of early disruptive behavior problems. Participants included 80 preschool boys referred to a child psychiatry clinic and diagnosed with oppositional defiant disorder (with or without attention-deficit hyperactivity disorder) and 80 case-matched normal comparison boys. The study examined four domains of correlates: vulnerable child characteristics, poor parenting practices, insecure attachment, and adverse family ecology. Results indicated that the combination of these factors provided relatively high sensitivity (81%) and specificity (85%), clearly differentiating referred from comparison boys. A dramatic increase in clinic status occurred when three or more factors were present, and specific combinations of factors were differentially predictive of conduct problems. However, no correlates were found to be either necessary or sufficient for clinic status. By maintaining the integrity of individual cases, person-oriented analyses were able to answer different questions than more traditional variable-oriented analyses. Discussion focuses on the value of person-oriented analyses for understanding heterogeneous clinical groups.

This is one of the first studies of reading in children with orofacial clefts to include a control sample. The findings suggest that children with clefts are less adept readers than demographically matched peers without clefts, supporting the need to monitor academic achievement in this population.

Background-The hypothesized association between single-suture craniosynostosis and neurodevelopment remains unclear, given the methodologic limitations of previous studies, most notably the absence of control groups.