Special Educators’ Conceptualizations of Emotional Disturbance and Educational Placement Decision Making for Middle and High School Students

The purposes of this study were to examine secondary school special educators’ perspectives on (1) the relative importance of the academic, mental health, and behavioral elements of the emotional disturbance (ED) special education classification in relation to determining eligibility for students with suspected ED, and (2) factors that are relevant both to education placement decision making for students classified with ED and to decision making regarding the degree of restrictiveness of education placements, including highly restrictive, alternative placements. A national survey was conducted with 1,025 middle and high school special educators. Results indicated that aggression was the most important factor for considering ED eligibility, followed by psychiatric diagnoses and, lastly, academic factors such as grades and achievement scores. Effectiveness was rated as very important in determining a student’s education placement, whereas financial cost and logistical issues were rated as less important. Some differences emerged between middle school and high school participants on items related to determining education placement. Compared to middle school educators, high school educators indicated that students themselves play a more active role in determining education placement. High school educators also indicated that they are more likely to consider homebound instruction and computer/web-based programs and that they better meet the vocational needs of students classified with ED. Middle school special educators indicated that they better meet the behavioral and emotional needs of students classified with ED.     

Do Psychological Interventions Work for Psychosis in Adolescents?

BackgroundThere is emerging evidence to show that psychological interventions such as cognitive remediation therapy (CRT), psychoeducation, family therapy, and group psychotherapies may be useful for adolescents with psychosis. The current review is on the effects of various psychological interventions for adolescents with psychosis compared with treatment as usual (TAU) or other psychological interventions.MethodsWe undertook a comprehensive search for all randomized controlled trials on the topic as per predefined criteria. For binary data, a standard estimation of risk ratio, and, for continuous data, the mean difference between groups were estimated. GRADE approach was used to assess studies. “Risk of Bias” was calculated, and finally random-effects model was used for analyses. ResultsThe review included 7 studies (n = 317). Two studies compared CRT and TAU with TAU alone. CRT showed improvement in short-term memory compared with those in the TAU group (relative risk 0.58, 95% CI 0.37 to 0.89, participants = 31, very low-certainty evidence). When comparing group psychosocial therapy with TAU, global state scores measured using Children’s Global Assessment Scale (CGAS) were clearly higher in the intervention arm (mean difference 5.10, 95% CI 1.35 to 8.85, participants = 56, very low-certainty evidence) as compared with the TAU group. None of the other interventions were found to be significantly effective for the treatment of psychosis in adolescents.ConclusionsEvidence suggests that psychological interventions may have beneficial effects in the treatment of adolescents with psychosis, but the evidence is of low or very low certainty.     

Systematic Review and Meta-analysis of Parent Group Interventions for Primary School Children Aged 4–12 Years with Externalizing and/or Internalizing Problems

This systematic review and meta-analysis evaluates the efficacy of parent training group interventions to treat child externalizing and/or internalizing problems. A search identified 21 randomized controlled trials of parent group interventions aimed at ameliorating child externalizing and/or internalizing problems in children aged 4–12 years. Random effects meta-analyses yielded significant pooled treatment effect size (g) estimates for child externalizing (g?=??0.38) and internalizing problems (g?=??0.18). Child anxiety symptoms or internalizing problems evident in children with externalizing behavior problems did not change significantly following intervention. Study quality was a statistically significant moderator of treatment response for child externalizing problems, however hours of planned parent group treatment and treatment recipient were not. Findings support the use of parent group interventions as an effective treatment for reducing externalizing problems in children aged 4–12 years. Whilst statistically significant, programs had a limited impact on internalizing symptoms, indicating a need for further investigation.     

Parent–child interaction of mothers with depression and their children with ADHD

Attention deficit/hyperactivity disorder (ADHD) is a developmental disorder that may have a chronic and pervasive impact on the child's function and cause long-term stress to parents. A higher rate of depression is associated with mothers of children with ADHD. This observational study aimed to investigate the effect of maternal depression and the child's ADHD on the quality of the parent–child interaction in children with ADHD and their mothers with depression. The study participants comprised 39 mother–son dyads including children with ADHD and mothers with depression, children with ADHD and mothers without depression, and children without ADHD and mothers without depression. The Specific Affect Coding System, 20-code version was used to code interactional affect, including positive engagement, negative engagement, negative disengagement, and neural affect. There were no statistically significant group-by-context interaction effects or group effects on all affective variables between the group of children with ADHD and mothers without depression and the group of children without ADHD and mothers without depression. Stimulant medication may account for these nonsignificant findings. No significant difference of positive affect between neutral and conflict-solving contexts was observed in depressed mothers whose children were diagnosed as ADHD. Children with ADHD whose mothers were depressed were less positive in their parent–child interaction compared with children in the other groups. Maternal depression may play an important role in the affective presentation of dyads of children with ADHD and mothers with depression. Implications for clinical practice and future research are provided.     

Additive Effects of Parent Adherence on Social and Behavioral Outcomes of a Collaborative School–Home Behavioral Intervention for ADHD

The present study evaluated the impact of the Collaborative Life Skills Program (CLS), a novel school–home psychosocial intervention, on social and behavioral impairments among children with attention and behavior problems. Fifty-seven ethnically/racially diverse children (70 % boys) with attention and/or behavior problems in the second through fifth grades participated in a pilot study. Ten school-based mental health professionals were trained and then implemented the intervention at their respective schools. Children significantly improved from pre- to post-treatment on parent, teacher, and report card ratings of children’s social and behavioral functioning. Treatment improvements were consistent for children with and without co-occurring disruptive behavior problems. The impact of the intervention was enhanced when parents used the intervention strategies more regularly, according to both clinicians’ and parents’ reports. Findings support the emphasis of CLS on coordinating intervention strategies across contexts to facilitate the generalization of treatment-related improvements in social and behavioral functioning.     

Do Children and Adolescents With ADHD Respond Differently to Atomoxetine?

OBJECTIVE: Controversy exists over changes in tolerability and response to medications across the life span. Here the authors report data contrasting the efficacy and tolerability of atomoxetine between children and adolescents with attention-deficit/hyperactivity disorder (ADHD). METHOD: Data were analyzed for children ages 6-11 (510 atomoxetine, 341 placebo) and adolescents ages 12-17 (107 atomoxetine, 69 placebo) with DSM-IV-defined ADHD enrolled in similarly designed, double-blind, placebo-controlled trials. Efficacy measures included response rates, times to response, and mean changes from baseline to endpoint in the ADHD Rating Scale, Conners' Parent Rating Scale, and Clinical Global Impressions. RESULTS: Adolescents had lower baseline ADHD scores compared with children. There were no statistically significant differences in the overall effects on ADHD symptoms, response rates, or time to response between age groups. Children, but not adolescents, had higher rates of somnolence and headache relative to placebo. No other clinically meaningful treatment differences were seen in adverse event rates, vital signs, weight, height, laboratory values, or ECG between children and adolescents. CONCLUSIONS: Acute atomoxetine treatment appears to be equally effective and tolerated in children and adolescents. These findings suggest that pharmacological differences in tolerability or ADHD symptom response are negligible between children and adolescents.     

Getting to First Base: Promoting Engagement in Family–School Intervention for Children with ADHD in Urban,Primary Care Practice

The optimal model of intervention for children with ADHD is typically a multimodal approach involving a partnership across the family, school, and primary care health systems. Unfortunately, even when multimodal interventions are available, mental health services generally are underutilized, particularly by children and families of racial and ethnic minority background who often reside in under-resourced, urban settings. Partnering to Achieve School Success (PASS) was developed as a service based in urban primary care settings to foster partnerships among the family, school, and primary care practice and promote engagement in intervention. This study was designed to examine the pre-treatment telephone history of contacts between clinicians and families to determine early indicators of engagement and potential strategies to improve treatment initiation. The data were derived from a retrospective analysis of 80 cases referred by primary care providers to PASS. Findings indicated that success rates of clinician-initiated contact and number of parent-initiated attempts were independent predictors of treatment initiation. Also number of minutes of actual phone contact predicted treatment initiation. Follow-up analyses suggested that amount of phone contact may serve as a mediator in the relationship between phone contact (clinician-initiated and parent-initiated) and treatment initiation. The predictive value of telephone contact was affirmed, and strategies for using phone contact to improve treatment initiation were discussed.     

Are Stimulants Overprescribed for Youths with ADHD?

Critics of stimulant treatment for youths with attention deficit hyperactivity disorder (ADHD) have increased their rhetoric of late, contending that the leading medication for it, Ritalin^®, is vastly overprescribed. Additionally, they claim that Ritalin (methylphenidate) is inherently dangerous and that the entire system of the diagnosis and treatment of ADHD is seriously flawed. The critics view the underlying reason for the epidemic as societal, due to our modern pace of living, our competitive society, and our consumer emphasis. Rejoinders to and clarifications of the more tangible points of the critics are presented, followed by a discussion of some more practical and legitimate concerns for researchers in this area. These concerns include changes within the ADHD category, the clinical need for multiple sources of diagnostic data, infrequent teacher–physician communication, problematic ADHD/conduct disorder comorbidity in adolescence, and the limited amount of community-based research.     

Improving Social Knowledge and Skills among Adolescents with Autism: Systematic Review and Meta-Analysis of UCLA PEERS® for Adolescents

UCLA PEERS® for Adolescents is a widely applied program among a number of social skills training programs developed over the years. We synthesized current research evidence on the PEERS program to evaluate the treatment effect on four commonly used outcome measures. 12 studies met inclusion criteria for the review and nine met the criteria for meta-analysis. Results showed moderate to large pooled effects across measures and informants in favor of the PEERS program, with the largest effect seen in social knowledge improvement and the smallest effect in the frequency of get-togethers. The heterogeneity of effects across studies were examined and the limitations of the current evidence were discussed.

     

A Comparative Study of Psychosocial Interventions for Internet Gaming Disorder Among Adolescents Aged 13–17 Years

International Journal of Mental Health and Addiction - The present study is a quasi-experimental, prospective study of interventions for internet gaming disorder (IGD). One hundred four parents and...     

Attentional functioning in children with ADHD – predominantly hyperactive-impulsive type and children with ADHD – combined type

Summary. Although particular importance has been attributed to attention deficits in attention deficit hyperactivity disorder (ADHD), there is no consensus as to the exact nature of inattention in ADHD or which components of attention are affected. The present study was based on a neuropsychological model of attention and assessed various components of attention in 23 children with ADHD/predominantly hyperactive-impulsive type (ADHD-H), 32 children with ADHD/combined type (ADHD-C) and healthy children (N₁ = 23 and N₂ = 32). A computerized test battery consisting of reaction time tasks of low complexity was used for the assessment of attention (alertness task, vigilance task, divided attention task, visual scanning task, incompatibility task, test of crossmodal integration, flexibility task). In comparison to healthy participants, patient groups were impaired in measures of vigilance, divided attention, selective attention and flexibility but not in measures of alertness. Analysis of the test performance of patient groups revealed no differences between children with ADHD-H and children with ADHD-C. The results of the present study suggest that both children with ADHD-H and children with ADHD-C are seriously impaired in attentional functioning. Children with ADHD-H and children with ADHD-C produced comparable results in measures of attention.     

Interference control in 6–11 year-old children with and without ADHD: behavioral and ERP study

Event-related potentials (ERPs) were recorded during a hybrid Simon–spatial Stroop task. We compared interference control and conflict monitoring in children with and without attention-deficit/hyperactivity disorder (ADHD), to examine developmental functional patterns. We found that children with ADHD exhibited lower accuracy rates and longer and more variable reaction time (RT) in both tasks, especially in the incongruent condition. In both controls and ADHD children, the accuracy rate increased and RT decreased with age. Major development in interference control occurred from 6–7 to 8 years in ADHD children and controls, yet only occurred from 9 to 10–11 years in normal children. The ERP results revealed that the N2 potentials were not significantly different from age-matched controls in the two tasks and that the development pattern of conflict monitoring was not different in school age children with and without ADHD. Children with ADHD had normal conflict monitoring ability.     

Associated Health Risks of Adolescents with Disordered Eating: How Different Are They from Their Peers? Results from a High School Survey

In this study, we compare health risks of adolescents with disordered eating to those of their peers without disordered eating. A self-report health survey from a community sample of 1769 high school students was used to compare emotional, medical, and social behaviors of these two groups. Risk data for disordered eating students was compared within and across genders. Adolescents with disordered eating are at increased risk for emotional and physical health problems compared to their peers. Overall health risks for boys and girls with disordered eating are quite similar. However, boys with disordered eating develop associated health risk profiles that differentiate them from male peers by having increased mental health, sexual and physical abuse, and general health problems. Girls with disordered eating have associated health risks for substance use and sexual risk-taking that distinguished them from their female peers.     

Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

Some evidence suggests that the HPA axis may be dysfunctional in children with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to investigate whether a different pattern of HPA axis activity is found between the inattentive (I) and combined (C) subtypes of ADHD, in comparison with healthy control children. A total of 100 prepubertal subjects [52 children with ADHD combined type (ADHD-C), 23 children with ADHD predominantly inattentive type (ADHD-I), and 25 healthy control subjects] were studied. The effects of stress were studied by comparing cortisol responses to a psychosocial stressor, consisting of a public speaking task. Children with ADHD-I showed an elevated cortisol response to the psychosocial stressor, in contrast to children with ADHD-C who showed a blunted cortisol response to the psychosocial stressor. When a distinction was made between responders and non-responders (a subject was classified as a responder when there was an increase in cortisol reactivity), hyperactivity symptoms were clearly related to a lower cortisol reactivity to stress. The results indicate that a low-cortisol responsivity to stress may be a neurobiological marker for children with ADHD-C, but not for those with ADHD-I. Directions for future research and clinical implications are discussed.     

Peer-Victimization and Mental Health Problems in Adolescents: Are Parental and School Support Protective?

The aim of this study was to investigate the frequency and effects of peer-victimization on mental health problems among adolescents. Parental and school support were assumed as protective factors that might interact with one another in acting as buffers for adolescents against the risk of peer-victimization. Besides these protective factors, age and gender were additionally considered as moderating factors. The Social and Health Assessment survey was conducted among 986 students aged 11–18 years in order to assess peer-victimization, risk and protective factors and mental health problems. For mental health problems, the Strengths and Difficulties Questionnaire (SDQ) was used. Effects of peer-victimization on mental health problems were additionally compared with normative SDQ data in order to obtain information about clinically relevant psychopathology in our study sample. Results of this study show that peer-victimization carries a serious risk for mental health problems in adolescents. School support is effective in both male and female adolescents by acting as a buffer against the effect of victimization, and school support gains increasing importance in more senior students. Parental support seems to be protective against maladjustment, especially in peer-victimized girls entering secondary school. Since the effect of peer-victimization can be reduced by parental and school support, educational interventions are of great importance in cases of peer-victimization.     

Relationships Between School Climate Dimensions and Adolescents’ School Life Satisfaction,Academic Satisfaction and Perceived Popularity Within a Chinese Context

The first part of this study explored the association between school climate and students’ well-being (i.e., school life satisfaction, academic satisfaction and perceived popularity) within the Chinese school context. Two hundred and twenty-one secondary school students in Hong Kong participated in this exploratory study. Due to the lack of culturally relevant instruments, school climate was measured with an adapted instrument that was evaluated by factor analyses. Findings revealed six dimensions of school climate, including positive student–teacher relationships, school order and environment, perceived academic competence, perceived privileges, learning interests and academic support. Preliminary results obtained from multiple regression analyses indicated that the dimension of school order and environment significantly predicted school life satisfaction. Perceived academic competence predicted not only academic satisfaction, but also perceived popularity. However, perceived privilege, learning interests and academic support were negatively related to school life satisfaction and perceived popularity. Interestingly, positive student–teacher relationships did not significantly predict overall well-being. The second part of this study adopted a qualitative approach to explore school climate in relation to well-being from students’ perspectives. The findings showed that learning-related issues, such as learning difficulties, were major contributors to students’ well-being. The findings are discussed from a cultural standpoint to inform educational practices and directions for future research.