Family systems practice in pediatric psychology

OBJECTIVE: To present a pediatric psychology consultation treatment framework based on family systems and developmental theories. METHODS: After reviewing background relevant to family systems interventions, a five-step protocol (referral, assessment, collaboration, outcome) for consultation is presented, using case examples from our pediatric oncology service, to illustrate joining, focusing, promoting competence and collaboration with patients, families, and staff. RESULTS: Using protocols based on family systems frameworks, pediatric psychologists can offer systems-oriented consultation to patients, families, and healthcare teams. CONCLUSIONS: Further development and evaluation of family systems protocols are necessary to understand the efficacy of these approaches and their role in training and practice.     

Internship and postdoctoral training in pediatric and clinical child psychology: a survey

A survey was designed to obtain data from pediatric psychology,clinical child psychology, and combined training centers. Sixtyprogram directors provided identifying characteristics aboutthe facility, application information for internship and postdoctoraltraining, information on clientele and case load of trainees,and specific training information. In addition, respondentsprovided definitions of the two areas and suggested differentiatingfeatures. It was concluded that the similarities are more numerousthan are the differences in training. Definitions suggest that(a) clinical child psychology has broader application than pediatricpsychology despite the latter's broader principles of application,and (b) pediatric psychologists rely heavily on the traditionalskills and techniques of clinical child psychology. The onlydifferentiating features identified were in terms of medicallyrelated populations of children served, collaboration with healthcare disciplines, and a specialized focus of viewing psychologicaldifficulties within the medical culture by pediatric psychologists.     

Training in pediatric psychology: a survey of predoctoral internship programs

OBJECTIVE: To describe internship training in pediatric psychology and to determine its correspondence with the recommendations of the Society of Pediatric Psychology (SPP) Task Force on Training. METHODS: A survey based on the Task Force recommendations was sent to all internship programs that reported offering a major rotation in pediatrics. RESULTS: Opportunities in a wide range of assessment and intervention strategies were available. Training in disease process, medical management, and consultation/liaison with a variety of disciplines was also offered. Interns interacted with individuals from a range of developmental stages and ethnicities. Many professional issues were addressed. Experiences in research methods and prevention were less well represented. CONCLUSIONS: Despite some variability, experiences in a wide range of areas were offered by many programs in several of the training domains recommended by the SPP Task Force. However, there is room for improvement in training in research and prevention and health promotion.     

Psychological adjustment to pediatric physical disorders: a meta-analytic review.

Reviewed 87 studies of children's adjustment to physical disorders in a meta-analysis. Results indicate (a) children with such disorders show increased risk for overall adjustment problems, internalizing and externalizing symptoms; (b) risk was greatest in studies making comparisons to norms rather than to study controls; (c) risk varied by informant (teacher, mental health professional, parent), and by degree of matching with controls; (d) the self-concept of children with physical disorders across all studies appears significant for studies with careful matching or comparisons with norms; (e) there are interdisease differences, but the number of studies within individual disorders, with a few exceptions, are quite small. The need for improved methodology is discussed.     

Benchmarks for work performance of pediatric psychologists

Objective To establish benchmarks for work performance of pediatricpsychologists. Methods All full members of the Society of PediatricPsychology, Division 54 of the American Psychological Association(N = 1043), were recruited for participation in a mail survey.Four hundred and seventy surveys were returned (45%); 356 usablesurveys (34%) were included in the analyses. Surveys assessedwork-settings, academic appointments, salary, performance expectationsand evaluations, and satisfaction. Results Most of the surveyrespondents, 63%, worked in a hospital setting. On average,survey respondents were directly accountable for generatinghalf, 52%, of their salary. Salary covered by institutions wasmost frequently provided for nonrevenue generating activitiessuch as administration and teaching. Most of the sample (78%)indicated clear performance expectations and criteria. ConclusionsFindings update and expand previously established benchmarksfor work performance and have implications for the practiceof pediatric psychology in an ever-changing health care environment.     

Cognitive remediation in pediatric head injury: a case study.

Little work has been done in delineating cognitive remediation approaches for pediatric survivors of head injury. The use of a cognitive remediation approach is described in a case study of a 16-year-old male, who was 1 1/2 years post severe traumatic brain injury. Specific techniques and treatment course are outlined to demonstrate the model offered as one meeting the unique needs of the pediatric survivor. This model emphasizes a behavioral, individually tailored approach with clear delineation of a functional academic skill goal of competence in mathematical computation. Results indicate accomplishment of goals and some generalization of skills obtained to a math domain that was not the major focus of the remediation attempts.     

Training graduate-level pediatric psychology researchers at Case Western Reserve University: meeting the challenges of the new millennium

OBJECTIVE: To describe the challenges in training graduate-level pediatric psychology researchers for successful careers and to discuss solutions. METHODS: We reviewed experiences in training graduate students at Case Western Reserve University to identify key challenges in research training and potential strategies to meet them. RESULTS: We identified the following key challenges: stimulating graduate students' career interest in pediatric psychology research; teaching students about the pragmatic challenges of conducting research in pediatric settings, specialized research design, and data analytic issues; helping students to develop essential research skills; developing opportunities for student research-related collaborations; helping students develop professional identities as researchers; and developing and supporting their research careers beyond graduate school. CONCLUSIONS: Useful strategies for meeting these challenges include involving an interdisciplinary faculty in research training; developing specialized training methods that focus on critical research skills such as writing and data analysis; peer support; and involvement with multiple mentors who are successful researchers. Pediatric psychologists should also develop opportunities for the next generation of researchers by facilitating research job options and leadership opportunities.     

Theory-driven research in pediatric psychology: a little bit on why and how.

Introduces a Special Issue, covering two published issues (5 and 6) of this journal, on theory-driven research in pediatric psychology. A rationale for conducting research from a conceptual basis is presented. It is emphasized that science is primarily an intellectual activity, demonstrated in the form of theory building, testing, and reformulation. Furthermore, it is argued theory serves as a planning and communication aide for scientific pursuit. The process and components of theory-driven research are then highlighted. Theoretical constructs, theoretical and empirical definitions of constructs, and the use of variables are discussed. A definition of scientific theory is offered. Theory testing is distinguished from post hoc theorizing. Differences in the scope of theories are noted. Connections between theory and hypothesis testing and research design are addressed, especially for nonexperimental or correlational research.     

Sociocultural issues in pediatric transplantation: a conceptual model

OBJECTIVE: To demonstrate the value of viewing the pediatric transplant experience through a sociocultural lens and to offer an organized framework for identifying influential sociocultural variables in pediatric transplantation. METHODS: A conceptual model is presented which organizes sociocultural factors that may influence the transplant process. A review of the pediatric and adult transplant literature is conducted. RESULTS: The need for a model addressing sociocultural issues and benefits of using the proposed model is evident. Guided by the proposed model, pediatric psychologists will be prepared to more readily attend to sociocultural influences associated with the transplant experience when conducting research or providing clinical services to patients and families. CONCLUSIONS: Further development and evaluation of the proposed model are necessary to investigate its practical utility and validate the influence of the identified variables on assessment and treatment of pediatric transplant patients as well as patient health outcomes.     

Use of magnetophoresis of glutamic acid and magnesium sulfate in the rehabilitation of children with cerebral palsy

We report here our studies on the clinical efficacy of courses of magnetophoresis of glutamic acid and magnesium sulfate in the complex rehabilitation treatment of preschool children with spastic types of cerebral palsy. Clinical-neurophysiological investigations were performed in 40 children aged 1–7 years. Treatment was significantly more effective when use of running pulsed magnetic fields was combined with medicinal agents as compared with magnetotherapy using the same regime. __________ Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 107, No. 12, pp. 45–49, December, 2007     

Inpatient pediatric consultation-liaison: a case-controlled study

OBJECTIVE: To conduct a prospective case-controlled study of pediatric inpatients referred for consultation in a tertiary care children's medical center. METHOD: Referrals (n = 104) were matched with nonreferrals (n = 104) for age (4 to 18 years), gender, and illness type/severity and completed parent- and self-report (dependent on age) behavioral rating scales to assess for adjustment/functioning. Nurses completed in-hospital ratings of behavioral/adjustment difficulties. Goal attainment and satisfaction ratings were obtained from the referring physicians, parents/guardians, and the consultant. RESULTS: Referrals exhibited more behavior/adjustment/coping difficulties than nonreferrals by parent, nurse, and self report. Frequently employed interventions included coping-strategies intervention, cognitive and behavioral therapies, and case management. Referring physician and consultant ratings of goal attainment were high, as were physician ratings of satisfaction and parent/guardian ratings of overall helpfulness. CONCLUSIONS: Pediatric inpatients referred by their physicians had significantly more internalizing and externalizing disturbances than their nonreferred hospitalized peers. Many of the behavioral and adjustment problems that lead to in-hospital consultation referral were evident in global behavior difficulties prior to hospitalization. Referring pediatricians, parents/guardians, and consultants rate the outcome as benefiting the patients via assisting in the overall management of their health concerns, coping, and adjustment.     

Family influences on pediatric asthma

OBJECTIVE: To describe pathways by which families may influence the onset and course of a child's asthma. METHODS: We critically reviewed published articles and book chapters to identify research findings and integrated conceptualizations that demonstrate how families affect pediatric asthma. RESULTS: Family emotional characteristics, asthma management behaviors, and physiological factors account for key influences on pediatric asthma onset and outcomes. CONCLUSIONS: Multiple family characteristics are associated with pediatric asthma onset and outcomes. Behavioral and physiological mechanisms may act independently or may interact to affect asthma manifestations. Families with specific emotional characteristics may be at an elevated risk for poorer asthma outcomes.     

Cardiac rehabilitation: applying exercise physiology in clinical practice

In this paper new insights into the beneficial effects of physical training for patients with coronary artery disease are reviewed. Endurance training as part of a comprehensive cardiac rehabilitation programme in combination with strength training, smoking cessation and lipid management may slow down and in some cases reverse the progress of coronary atherosclerosis. Thus, exercise training remains an invaluable tool in the hands of the clinical cardiologist dealing with chronic coronary care. Accepted: 12 June 2000     

Frequency and characteristics of birth defects admissions to a pediatric hospital in Venezuela

A survey of the 6,161 admissions to a pediatric hospital of Caracas during 1976 was conducted to determine the frequency and some characteristics of those admissions due to birth defects. The charts of all patients in whom a birth defect had been suspected or diagnosed during admission were reviewed and analyzed. These admissions numbered 629, that is 10.2% of the total, and were categorized as follows: 1) Birth defects of genetic origin: a) single gene – 3.2%; b) polygenic – multifactorial – 3.3%; c) chromosomal – 0.7%. 2) Birth defects due to an intrauterine insult – 0.1%. 3) Birth defects of unknown or heterogenous causes – 2.9%. The mean length of hospitalization was higher for birth defects patients than for all admissions: 15.6 and 11.6 days, respectively. There was no difference in mortality during admission between birth defects patients and all admissions, both being rather high, 8.2 and 8.3%, respectively. The lower prevalence of birth defects observed in this study as compared with North American surveys is due to several factors, among which the most relevant is the persistent burden of environmental infectious and nutritional diseases in the pediatric age population in Venezuela. Nevertheless, it is thought that the foreseeable improvement in medical care organization and socioeconomic conditions of the population will lead to a relative rise in the morbidity and mortality due to birth defects in the near future, as was the case in developed nations. Thus it is necessary to develop medical genetics services in major hospital centers in order to provide present and future demands of genetic care.     

精神疾病院外综合康复治疗

目的介绍精神疾病院外综合康复治疗手段,为改善和加强院外综合康复治疗提供一些有用的信息。方法对近年来有关精神疾病院外综合康复治疗的研究和文献进行整理、回顾、归纳总结。结果精神疾病院外综合康复治疗对恢复患者社会功能、预防复发有明显的作用,但存在一些问题。结论精神疾病院外综合康复治疗有待于进一步改善。     

Society of pediatric psychology task force report: recommendations for the training of pediatric psychologists

OBJECTIVE: To provide an overview of the types of training experiences considered most important to the development of competency in pediatric psychology. METHODS: This is the work of a task force commissioned by the Society of Pediatric Psychology, Division 54 of the American Psychological Association. RESULTS: Twelve topic areas, adapted from Roberts et al. (1998), deemed important for obtaining knowledge and expertise in pediatric psychology, were identified. These topics include life span developmental psychology; life span developmental psychopathology; child, adolescent, and family assessment; intervention strategies; research methods and systems evaluation; professional, ethical, and legal issues pertaining to children, adolescents, and families; issues of diversity; the role of multiple disciplines in service-delivering systems; prevention, family support, and health promotion; social issues affecting children, adolescents, and families; consultant and liaison roles; and disease process and medical management. Each area is briefly described and recommendations for obtaining training in these areas are offered. CONCLUSIONS: The Society of Pediatric Psychology offers this document as a comprehensive review of the ideal types of training experiences most important to developing competencies in pediatric psychology. These recommendations can be used by graduate students and graduate programs in shaping a training plan for students interested in pediatric psychology training.