Predicting developmental outcomes at school entry using a multiple-risk model: four American communities. The Conduct Problems Prevention Research Group.
The contributions of different risk factors in predicting children's psychological and academic outcomes at the end of 1st grade were examined. Using a regression model, levels of ecobehavioral risk were assessed in the following order: specific demographics, broad demographics, family psychosocial status, mother's depressive symptoms, and neighborhood quality. Participants were 337 families from 4 American communities. Predictor variables were assessed in kindergarten, and teacher, parent, and child outcomes (behavioral and academic) were assessed at the end of 1st grade. Results indicated that (a) each level of analysis contributed to prediction of most outcomes, (b) 18%-29% of the variance was predicted in outcomes, (c) a common set of predictors predicted numerous outcomes, (d) ethnicity showed little unique prediction, and (e) the quality of the neighborhood showed small but unique prediction to externalizing problems. (+info
Darryl, a cartoon-based measure of cardinal posttraumatic stress symptoms in school-age children.
OBJECTIVES: This report examines the reliability and validity of Darryl, a cartoon-based measure of the cardinal symptoms of posttraumatic stress disorder (PTSD). METHODS: We measured exposure to community violence through the reports of children and their parents and then administered Darryl to a sample of 110 children aged 7 to 9 residing in urban neighborhoods with high crime rates. RESULTS: Darryl's reliability is excellent overall and is acceptable for the reexperiencing, avoidance, and arousal subscales, considered separately. Child reports of exposure to community violence were significantly associated with child reports of PTSD symptoms. CONCLUSIONS: Darryl possesses acceptable psychometric properties in a sample of children with frequent exposure to community violence. (+info
Telling the story: parents' scripts for donor offspring.
This study documents experiences of parents who chose to disclose, and intended to disclose to their children, information about the donor involvement, and children's responses when they received this information. Of the 181 parents who responded, 30% (n = 54) gave their children information about their conception (34 families). Couples chose to tell when 'it just seemed right' or when they believed their children could understand their stories. The stories shared concerned the parents' inability to have children together, and the need for spermatozoa and specialist attention, and the families reading a book about donor insemination. There appeared to be an advantage in giving children this information at a young age, at which the information was processed in a factual, non-emotional way. Any questions asked by the children related to practical issues. These parents reported that it gave them opportunities gradually to introduce information as the children's understanding progressed. Of the parents who had not told (n = 127), 77% (n = 98) intended to disclose information in the future. This group gave their child's age and inability to understand as their main reasons for choosing to wait. Some 17% (n = 22) of parents who had not told chose not to disclose. There were no significant differences between the responses of mothers and fathers. (+info
Empirically supported treatments in pediatric psychology: pediatric obesity.
OBJECTIVE: To review the efficacy of existing interventions for pediatric obesity with reference to the Chambless criteria. METHODS: Chambless criteria for determining treatment efficacy were applied to 42 randomized studies involving nonschool-based programs targeting childhood and adolescent weight loss. RESULTS: We summarize the following dimensions of the pediatric obesity treatment literature: description of participants, diagnostic criteria for study participation, experimental design, treatment protocol, treatment outcome, and follow-up. CONCLUSIONS: There is strong evidence for the short- and long-term efficacy of multicomponential behavioral treatment for decreasing weight among children relative to both placebo and education-only treatments. Conclusions about adolescent obesity treatment programs are more tentative as they have been less frequently examined, less rigorously controlled, and usually have not conducted long-term follow-up. Current research appears to be working to identify more efficacious treatments for pediatric obesity by exploring the specific behavioral strategies that will be most effective in modifying children's eating and physical activity habits. (+info
The psychological status at school age of children conceived by in-vitro fertilization.
This study assessed the behavioural and psychological profiles of children conceived by in-vitro fertilization (IVF) who are now at school age. A total of 743 IVF children born at one institution and now of school age, over 4 years old, were surveyed with Achenbach questionnaires. Follow-up telephone interviews were conducted with non-responders. The results from the study group were compared to the questionnaire control group using one-tailed t-test with statistical significance set less than 0.05. There was an 84% overall response rate. Sixty-seven per cent returned questionnaires. An additional 17% completed a telephone interview. The study group had no statistically significant increase in the rate of behavioural or psychological problems compared with the control group. There were no statistically significant differences within the study group related to sex or to multiple gestation IVF births. This large group of school-age IVF children has normal psychological development with no identified adverse effect of their status as IVF children. Determining the role, if any, of IVF in the very small number of children with behavioural and psychological problems will require additional study. (+info
Origins of theory of mind, cognition and communication.
There has been a revolution in our understanding of infant and toddler cognition that promises to have far-reaching implications for our understanding of communicative and linguistic development. Four empirical findings that helped to prompt this change in theory are analyzed: (a) Intermodal coordination--newborns operate with multimodal information, recognizing equivalences in information across sensory-modalities; (b) Imitation--newborns imitate the lip and tongue movements they see others perform; (c) Memory--young infants form long-lasting representations of perceived events and use these memories to generate motor productions after lengthy delays in novel contexts; (d) Theory of mind--by 18 months of age toddlers have adopted a theory of mind, reading below surface behavior to the goals and intentions in people's actions. This paper examines three views currently being offered in the literature to replace the classical framework of early cognitive development: modularity-nativism, connectionism, and theory-theory. Arguments are marshaled to support the "theory-theory" view. This view emphasizes a combination of innate structure and qualitative reorganization in children's thought based on input from the people and things in their culture. It is suggested that preverbal cognition forms a substrate for language acquisition and that analyzing cognition may enhance our understanding of certain disorders of communication. (+info
Psychosocial impact of pediatric BMT on siblings.
Although bone marrow transplantation (BMT) has become standard therapy for many life-threatening disorders of childhood, there is little research on the psychosocial impact of BMT on siblings of children undergoing BMT. Such siblings face issues common to any family with a chronic illness. However, the psychological impact on the family is intensified because two family members, usually children, are subjected to intrusive medical procedures. Investigators had earlier noted that sibling donors may be at risk for behavioral problems and anxiety, while nondonors may experience ambivalent feelings of disappointment and relief. It was suggested that psychosocial stages of BMT may parallel the medical transplant process, with high levels of stress experienced pre-BMT, during hospitalization, and post-discharge. Our own group has recently conducted more systematic investigations on the psychosocial effects of BMT on donor vs nondonor siblings of surviving pediatric BMT patients. We found that sibling donors showed significantly more anxiety, lower self-esteem, and more adaptive skills in school than nondonors. Nondonors, on the other hand, showed significantly more school problems. One third of the siblings in each group reported a moderate level of post-traumatic stress. Taken together, our research indicates that BMT affects the life of the child at home and at school and that post-traumatic stress symptomatology is a component of the psychological reaction in siblings. The psychosocial adjustment of siblings is a critical area of investigation in BMT populations. Parents need to know that the BMT process affects every member of the family system, and both parents and professionals need to direct more emotional support and attention to siblings. Studies are needed that focus on interventions designed to reduce levels of sibling psychosocial maladjustment. The psychosocial developmental model of post- traumatic stress disorder is a viable theoretical model that may be used to guide future research. (+info
The diagnostic and statistical manual for primary care (DSM-PC), child and adolescent version: what pediatric psychologists need to know.
OBJECTIVE: To address the need for a comprehensive, developmentally appropriate method to facilitate primary care pediatricians' recognition, management, and referral of a wide spectrum of childrens' behavioral and developmental problems, as well as stressful situations. METHODS: Use of the Diagnostic and Statistical Manual for Primary Care (DSM-PC), Child and Adolescent Version can facilitate psychologists' abilities to conduct research concerning the prevalence of behavioral and developmental problems, describe collaborative practice in primary care, and train pediatricians to recognize and manage common behavioral and developmental problems. CONCLUSIONS: Strategies to enhance utilization of the DSM-PC include more widespread dissemination of information concerning the manual and its practical utility, promotion of reimbursement for its use, and documenting applications of the DSM-PC in teaching, practice, and research. (+info