Tensions and contradictions in family court innovation with high risk parents: The place of family drug treatment courts in contemporary family justice

Parental substance misuse is a leading factor in child abuse and neglect and frequently results in court-mandated permanent child removal. Family drug treatment courts, which originated in the USA and are only found in adversarial family justice systems, are a radical innovation to tackle this problem. Unlike ordinary court, they treat parents within the court arena as well as adjudicating, and in this way they seek to draw a new balance between parental needs and the child’s right to timely permanency. Family drug treatment courts have spread to England, Australia and Northern Ireland and international research has found they have higher rates of parental substance misuse cessation and family reunification and lower foster care costs than ordinary courts. Yet their growth has been far from straightforward. In the USA they have not kept pace with the rise of criminal drug treatment courts and in England and Australia their numbers remain small. The central purpose of this article is to explore why the family drug treatment movement has not achieved wider impact and to consider opportunities and challenges for its future development. To address these questions we draw on evidence and experience from the USA, England and Australia. We discuss the operational challenges, tensions between children’s needs for stability and parental timescales for recovery, the impact of wider economic and political change, and issues in data evaluation. We conclude that despite the promise of family drug treatment courts as a new paradigm to address risky parenting, effecting systemic change in the courts is extremely difficult.     

Increased attentional load moves the left to the right

Introduction: Unilateral brain damage can heterogeneously alter spatial processing. Very often brain-lesioned patients fail to report (neglect) items appearing within the contralesional space. Much less often patients mislocalize items’ spatial position. We investigated whether a top-down attentional load manipulation (dual-tasking), known to result in contralesional omissions even in apparently unimpaired cases, might also induce spatial mislocalizations. Method: Nine right-hemisphere-damaged patients performed three computer-based tasks encompassing different levels of attentional load. The side of appearance of visual targets had to be reported either in isolation or while processing additional information (visual or auditory dual task). Spatial mislocalizations (from the contralesional hemispace towards the ipsilesional unaffected one) were then contrasted with omissions both within and across tasks, at individual as well as at group level. Results: The representation of ipsilesional targets was accurate and not affected by dual-tasking requirements. Contralesional targets were instead often omitted and, under dual-task conditions, also mislocalized by four patients. Three cases reported a significant number of left targets as appearing on the right (alloesthesia). Two of these patients perceived more targets (albeit to a wrong spatial location) under dual- than under single-task load. In a fourth patient, increased visual load resulted in synchiria, the (mis)perception of single, contralesional targets as being two (one on each side). Conclusions: When the neural circuitry subtending spatial processing is damaged, an increase in task load can lead to either a disregard or a bias in the processing of contralesional hemispace. The spatial bias subtending mislocalizations seems to index a more severe deficit than neglect, as if contralesional space would be completely erased rather than merely ignored.     

397名高中生的儿童期心理虐待与忽视问卷调查

目的调查高中生儿童期心理虐待和忽视情况。方法采用整群随机抽样的方法,以南昌市某中学397名高中生作为研究对象,完成一般资料问卷、儿童期心理虐待与忽视量表。结果在被调查的397名高中生中,心理虐待阳性率为19.6%,忽视阳性率为26.20%,儿童期经历过心理虐待或忽视的高中生占被调查人数的45.84%,且在心理虐待分量表、忽视分量表及总量表得分上,两性之间存在显著性差异。结论在本研究样本中,儿童期心理虐待与忽视是一种较为普遍的现象。     

Dissociable effects in reaction time performance after unilateral cerebral infarction: a comparison between the left and right frontal cortices in rats

Reaction time performance reflects the speed of information processing, both in humans and lower vertebrates like the rat. The present study compared reaction time performance in rats following unilateral infarction to the frontal cortex. The objective was to model cognitive impairment as it is seen in humans after stroke. Rats were trained in a reaction time paradigm, after which unilateral cortical infarction was induced photochemically. Reaction time performance was differentially affected after unilateral infarction to either the left or right frontal cortex, whereas sham operation did not result in a significant alteration in reactivity. An overall increase in reaction time of about 10% was present at 4 weeks after frontal infarction. In addition, a lateralized reaction time deficit occurred very early after right frontal infarction as an increase of 10-15% in trials directed towards the contralesional side. Additional analyses showed that these reaction time deficits can be explained differently: the former as a gradual and general decrease in the speed of information processing, whereas the latter shows specific impairment to initiate a contralateral motor response. The former matches well with the mental slowing observed in stroke patients, whereas the latter resembles a neglect phenomenon. We conclude that measuring reaction time performance after frontal cortical infarction in rats could offer a useful tool to model particular human cognitive impairments following cerebral infarction.     

Is susceptibility to perceptual migration and fusion modality-specific or multimodal?

A previous paper reported high susceptibility to spatial migration (allochiria) of tactile stimuli in about 25% of healthy individuals (High Error subjects). When synchronous stimuli touched the two hands, if the unattended stimulus was temporally modulated when the attended one was not (and was thus more salient than the latter), it "migrated" to and fused with or replaced the stimulus on the attended hand. When subjects rated similarity of the attended stimulus accompanied by a distractor to each stimulus alone, scaling distributions tested against a sampling model showed most High Error subjects experienced fused stimuli, others experienced replacement and Low Error subjects experienced neither. We argued that these migrations are equivalent to allochiria and that this underlies neglect and extinction. This study assessed whether the individual difference is modality-specific or not. In auditory and visual equivalents of the tactile rating experiment, the difference between High and Low Error subjects was replicated in audition, but no migration occurred in vision. However, when two words were briefly presented visually before a mask with cued report of one, letter migrations to equivalent locations did occur and the individual difference was reproduced. This constitutes the first report of individual differences in auditory fusion and visual letter migration. Migration occurred in egocentric coordinates but apparently preserved structural homology. Different migration rates between the modalities paralleled relative salience of the unattended to the attended stimulus. The multimodality of the individual difference suggests that its source is supramodal, in deficient binding of perceptual content to location.     

Eye-blink rate predicts individual differences in pseudoneglect

Most healthy individuals display a subtle spatial attentional bias, exhibiting relative inattention for stimuli on one side of the visual field, a phenomenon known as pseudoneglect. Prior work in animals and patients has implicated dopamine in spatial attention asymmetries. The current study therefore examined - in healthy individuals - the relationship between the attentional bias and spontaneous eye-blink rate (EBR), a putative measure of central dopaminergic function. We found that those individuals, who blinked more often under resting conditions, displayed greater preference for the right side of the visual display in a subsequent attention task. This finding may support the idea that the observed attentional bias in healthy individuals reflects asymmetries in dopaminergic circuits, and corroborates previous findings implicating dopamine in spatial attention.     

Non-accidental injury in children--an update

The abuse of children is a universal problem. It affects children from all social classes, racial and religious groups. Child abuse involves acts of commission or omission which directly or indirectly result in harm to the child and prevent a normal development into healthy adulthood. Those responsible may be members of a family, a community or an institution. The prevalence of child abuse and neglect is difficult to measure since events tend to be unreported because they happen behind closed doors. The majority of children who have been physically abused present with soft tissue injuries, thermal injuries and fractures. This article is focused on the physical abuse of children with particular emphasis on fractures.