Measuring staff perceptions of challenging behaviour: the Challenging Behaviour Attributions Scale (CHABA)

Causal attributions may interact with other variables to determine staff responses to challenging behaviour. Furthermore, staff perceptions of the causes of challenging behaviour are likely to change as a result of theoretical and practical training. However, there is no established simple method for measuring staff attributions that could facilitate research in these areas. The present paper describes the development and preliminary psychometric analysis of the Challenging Behaviour Attributions Scale (CHABA).     

Verbal and nonverbal emotional behaviour of staff: a first attempt in the development of an observation instrument

It is common to use questionnaires and interviews to assess the emotions of staff who serve clients with intellectual disabilities. Remarkably, observations of actual staff behaviour and assessments of nonverbal expressions are usually not involved. In the present study, we have made a first start in the development of an observation instrument that registers both verbal and nonverbal expressions of emotion. Following extensive literature reviews, interviews with clinical experts and pilot observations, we have created an observation system and observed a team of staff members during a period of three months. Results revealed sufficient to good interrater reliabilities regarding the observation of the three forms of emotional expression: body movement, facial expression, and verbal utterances. Low levels of explained variances between the different forms of expression showed that predictive values were weak. This means that there is a surplue value of the observation of nonverbal emotional expressions as compared to existing instruments that base their assessment on verbal and/or written responses only.     

Measuring anxiety in late life: A psychometric examination of the Geriatric Anxiety Inventory and Geriatric Anxiety Scale

We examined the psychometric properties, internal scale reliability and validity, of two geriatric anxiety measures: the Geriatric Anxiety Inventory (GAI) and Geriatric Anxiety Scale (GAS). We also determined the extent to which memory ability influenced the psychometric properties of these measures. Older adult participants (N = 110; M age = 75 years) completed self-report, clinician-rated and diagnostic psychiatric measures and a neuropsychiatric battery. GAI and GAS scores had good internal consistency, adequate reliability, and strong convergent validity. GAI scores had better discriminant validity than GAS scores relative to a health rating. Both measures had strong associations with depression scores. Psychometric properties were decreased in participants with average delayed memory recall compared with those with superior recall. Both measures had good psychometric support, particularly in those with strong memory abilities. Psychometric performance characteristics indicate that the GAI and GAS may be good alternatives to anxiety measures not designed specifically for older adults.     

Morphine and specific changes in the sensitivity of noradrenergic receptors within the “limbic” part of the feline caudate nucleus: A behaviour study

The present study describes the behaviour effects of intracerebral injections of the noradrenergic (NE) agonist oxymetazoline and the NE antagonist phentolamine into the "limbic" part of the caudate nucleus of cats primed 24 hr earlier and/or treated acutely with morphine (5 mg/kg, IP). Drug-induced changes in the morphine-specific behaviour served as dependent variables. Experiments were performed during two different periods of the year, each of them marked by a characteristic sensitivity of alpha-like NE receptors to NE agents, viz. the so-called NE "antagonist" period during which the NE receptors were sensitive to the NE antagonist phentolamine and the so-called NE "agonist" period during which the NE receptors were sensitive to NE and the NE agonist oxymetazoline. The present study demonstrates that morphine reversed the initial sensitivity to oxymetazoline respectively insensitivity to phentolamine in animals tested in the NE "agonist" period. In animals tested in the NE "antagonist" period morphine did not reverse the initial insensitivity to oxymetazoline resp. sensitivity to phentolamine. Furthermore, evidence is provided that the initial sensitivity to NE agents did not conspicuously determine the animal's response to the acute administration of morphine. The data are discussed in view of the concept that the firing rate of NE fibres determines the actual sensitivity of presynaptic and postsynaptic NE receptors to NE agonists and antagonists.     

Play, behaviour, language and social skills: the comparison of a play and a non-play intervention within a specialist school setting

The aim of the present study was to investigate the play, behaviour, language and social skills of children aged 5-8 years participating in a play intervention (based on the ‘Learn to Play’ program) compared to a group of children participating in traditional classroom activities within a specialist school over a six month period. Thirty-five children participated in the study, 19 participated in the play intervention group and 16 participated in the comparison group. Fourteen staff members at the special school were involved. A quasi-experimental design was used with pre and post data collection. Children in the play intervention and the comparison group were assessed using the Child-Initiated Pretend Play Assessment (play), Goal Attainment Scaling (behaviour), the Preschool Language Scale (language) and the Penn Interactive Peer Play Scale (social skills) at baseline and at follow up. Findings revealed that children participating in the play intervention showed a significant decrease in play deficits, became less socially disruptive and more socially connected with their peers. Both groups improved in their overall language skills and significantly improved in their goal attainment. This study supports the use of a play intervention in improving a child's play, behaviour, language and social skills.     

Computerized cognitive examination of the elderly (ECO): The development of a neuropsychological examination for clinic and population use

The development of a computerized neuropsychological examination (ECO), designed to evaluate intellectual functioning in elderly populations, is described. The examination is based on clinical and laboratory observations of cognitive functioning in normal and pathological ageing. ECO provides extensive information on attention, memory, and visuospatial and linguistic functioning, and the use of a touch screen permits the recording of reaction time and response delays. Information regarding qualitative aspects of responses is also recorded. The examination takes relatively little time given the extent of the information obtained (approximately 40 min), is highly acceptable to the elderly, and provides qualitative neuropsychological data although administered by lay interviewers. The results obtained by a normaal group of 335 elderly persons aged between 60 and 100 years are discussed in relation to age and education level.     

The measurement of coping responses: validity of the Billings and Moos Coping Checklist

OBJECTIVE: The primary aim of the study was to investigate the factor structure and psychometric properties of the modified Coping Checklist. METHODS: Self-report questionnaires asking about coping responses and mental health were administered to 515 undergraduate university students and to 119 patients awaiting elective coronary artery bypass graft surgery. Confirmatory (CFA) and exploratory factor analyses (PCA) were used to summarize and describe coping responses. RESULTS: CFA indicated that the subscale structure originally proposed for the Coping Checklist did not adequately fit the data. Subsequent PCA resulted in four factors: (1) Positive reappraisal; (2) Seeking support; (3) Avoidance; and (4) Information seeking. Internal consistencies ranged between .41 and .62 and 12-week test-retest reliability ranged between .59 and .71. Evidence for the concurrent validity of the solution generated by PCA was demonstrated by low to moderate correlations between the four factors identified and demographic and psychosocial measures. CONCLUSION: Even with modifications to the Coping Checklist, it is recommended that researchers investigate alternative methods of assessing coping responses in health psychology settings.     

Spinal cord injury by clip-compression induces anxiety and depression-like behaviours in female rats: The role of the inflammatory response

Traumatic spinal cord injury (SCI) promotes long-term disability that affects mobility and functional independence. The spinal cord inflammatory response after the initial mechanical insult substantially impacts locomotor impairment and development of neuropsychiatric disorders, including anxiety and depression. However, these psychiatric events are scarcely investigated in females. This study investigated the anxiety/depression-like behaviours and inflammatory responses related to the production/release of pro- and anti-inflammatory cytokines in female adult Wistar rats submitted to severe clip-compression SCI. Data showed that SCI impaired the locomotor performance assessment by the BBB scale, but did not alter exploratory activity in open-field test. Animals’ locomotor impairment was associated with anxious and depressive-like behaviours characterised by a decreased amount of time in the open arms of the elevated plus-maze test, and the motivational reduction of social interaction and anhedonia assessed by social exploration and sucrose preference tests. By contrast, SCI decreased the immobility time in the forced swimming test. Moreover, SCI caused a significant increase in local and systemic proinflammatory cytokines (TNF-α, INF-γ, IL-1β, and IL-6) and a reduction in the anti-inflammatory cytokine IL-10. Finally, there were significant negative correlations between depression-like behaviour, but not anxiety, and increased plasma concentrations of TNF-α, IL-1β, IL-6, and INF-γ. Additionally, the laminectomy procedure provoked the inflammatory response associated with reduced sucrose intake in Sham animals, although less expressively than in the SCI group. Collectively, these results indicate that SCI by clip-compression in female rats promotes a neuropsychiatric-like profile associated with an imbalance in the production/release of pro- and anti-inflammatory cytokines.     

The Dutch version of the behavioral activation for depression scale (BADS): Psychometric properties and factor structure

In a community sample of 402 respondents, the authors examined the psychometric properties of the Dutch version of the Behavioral Activation for Depression Scale (BADS; Kanter, Mulick, Busch, Berlin, & Martell, 2006). Results of confirmatory factor analysis supported the original 4-factor structure, providing the following subscales: Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment. All subscales showed adequate internal consistency, evidence of convergent validity with concurrent measures of depressive symptoms, rumination, psychological flexibility, and avoidance behavior, and evidence of differential validity between currently, formerly, and never depressed respondents.     

The first 83 and the next 83: Perspectives on neurotoxicology

This commentary depicts the author's history, and how it became interwoven with neurotoxicology. Born in 1925, most of his life spanned a century burdened with calamitous wars as well as revolutionary developments in science. Aviation played a large role in the century's wars and in the author's outlook on the world. He moved from a literary perspective, after his war experiences, to one governed by science, his earliest bent. During his career, which embodied the early development of both behavioral pharmacology and behavioral toxicology, he emphasized the critical need for precise measures, a point of view illustrated by his adoption of digital computer technology in 1962 as a means to secure such measures. The commentary also describes the author's views of some of the new directions open to neurotoxicology, such as the pursuit of questions about endocrine disruptors, countermeasures for brain aging, and epigenetics.     

The Social Communication Assessment for Toddlers with Autism (SCATA): An Instrument to Measure the Frequency,Form and Function of Communication in Toddlers with Autism Spectrum Disorder

The Social Communication Assessment for Toddlers with Autism (SCATA) was designed to measure non-verbal communication, including early and atypical communication, in young children with autism spectrum disorder. Each communicative act is scored according to its form, function, role and complexity. The SCATA was used to measure communicative ability longitudinally in two samples of toddlers with autism spectrum disorder. Overall frequency of non-verbal communicative acts did not change between the two assessments. However, the form and complexity, the function and the role the child took in the interaction did change with time. Both frequency and function of communicative acts in toddlerhood were positively associated with later language ability: social acts, comments and initiations showed greater predictive association than requests and responses.     

The relation between intrapersonal and interpersonal staff behaviour towards clients with ID and challenging behaviour: a validation study of the Staff–Client Interactive Behaviour Inventory

Background   Interpersonal staff behaviour is one of the instigating factors associated with challenging behaviour in clients with intellectual disabilities (ID). There are several studies focusing on the influence of intrapersonal staff characteristics – such as beliefs, attributions and emotional reactions – on staff behaviour. Little is known, however, about interpersonal staff behaviour itself. This study describes the development and validation of the Staff–Client Interactive Behaviour Inventory (SCIBI), measuring both intrapersonal and interpersonal staff behaviour in response to challenging behaviour in clients with ID.
Method   A total of 292 staff members, employed in residential and community services, completed the SCIBI for 34 clients with ID and challenging behaviour.
Results   Confirmatory factor analysis of a seven-factor model – with assertive control, hostile, friendly and support-seeking interpersonal behaviour; proactive thinking; self-reflection; and critical expressed emotion as reliable factors – showed an exact fit to the data, indicating construct validity and reliability of the SCIBI. A series of multilevel regression analyses showed higher age of the client to be negatively associated with assertive control. Job experience, level of education, type and sex of staff predicted interpersonal behaviour. Also, intrapersonal staff behaviour, including critical expressed emotion, proactive thinking and self-reflection, predicted interpersonal behaviour.
Conclusions   The SCIBI can be used to identify staff intrapersonal and interpersonal behaviour towards clients with ID and challenging behaviour. Results obtained with the SCIBI can provide new directions for individual client treatment plans and staff training programmes.     

The effects of unilateral frontal eye field lesions in the monkey: Visual-motor guidance and avoidance behaviour

Macaque monkeys were tested on a visual-motor guidance task and observations of avoidance behaviour were made following unilateral frontal eye field lesions. Visual-motor guidance was assessed by speed and accuracy of reaching to press recessed, illuminated buttons arrayed in a 90° arc in front of the monkey.Unilateral frontal eye field lesions produced a marked neglect of stimulus lights contralateral to the side of the lesions, as shown in greatly increased errors and response latencies. Responses to the most peripheral of the ipsilateral stimulus lights were also affected, although not to the same degree. Partial to complete recovery occurred, usually within a month. A unilateral lesion of the principal sulcus did not cause symptoms of neglect in the visual-motor guidance task.Section of the cerebral commissures partially restored the visual-motor guidance deficit in the frontal eye field-lesioned monkeys, with recovery again occurring. Commissurotomy and the unilateral frontal eye field lesion performed in a single-stage operation produced an initially more severe neglect than the two-stage operation, but recovery was no less rapid.The unilateral frontal eye field lesions resulted in a severe neglect of contralateral threat objects when the monkeys were threatened from both sides (avoidance-avoidance tests). Avoidance was normal when the threat was presented to one side. Commissurotomy fully restored the avoidance-avoidance deficit and made it permanent.These and other recent findings suggest that the contralateral visual field defect and the other symptoms resulting from frontal eye field lesions represent an impairment in directing and sustaining attention in regions of the visual field arising from disruption of a corticothalamotectal sensorimotor integration system.     

The development of intonation in young children with cochlear implants: a preliminary study of the influence of age at implantation and length of implant experience

This study describes the development of emerging intonation in six children who had received a cochlear implant (CI) before the age of 3 years. At the time their implant was activated, the children ranged in age from 11–37 months. Spontaneous longitudinal speech samples were recorded from 30‐minute sessions in which the child interacted with his or her mother. Data were collected 2 months before activation of each child's CI and at monthly intervals after activation for 6 months. The findings were compared to the typical pattern of early intonation development in children with normal hearing (NH). The results suggested that young CI recipients progress through stages similar to those observed in children with NH. However, the intonation development of children with a CI reflects a marked interaction between chronological age at implantation and amount of CI experience. That is, after 2 months of CI‐assisted hearing experience, the older children demonstrated a later stage of intonation development than younger children. These preliminary results support the idea that children acquire some foundations or prerequisites of intonation production through maturation, as measured by chronological age, even without robust auditory experience.     

Measuring the social interactions of people with traumatic brain injury and their communication partners: The adapted Kagan scales

Background: Considerable attention has been given to the nature of communication impairments of individuals with TBI (Coelho, 2007 Coelho, C. A. 2007. Management of discourse deficits following traumatic brain injury: Progress, caveats, and needs. Seminars in Speech & Language, 28(2): 122–135.  [Google Scholar]; Ylvisaker, Turkstra, & Coelho, 2005 Ylvisaker, M., Turkstra, L. S. and Coelho, C. 2005. Behavioral and social interventions for individuals with traumatic brain injury: A summary of the research with clinical implications. Seminars in Speech & Language, 26: 256–267. [Crossref], [PubMed] , [Google Scholar]). However, there have been few data focusing on the way communication partners deal with the often distressing sequelae of TBI.

Aims: This study reports inter- and intra-rater reliability of the Adapted Measure of Support in Conversation (MSC) and Measure of Participation in Conversation (MPC) for TBI interactions.

Method & Procedures: The MSC and MPC were adapted to reflect theoretical models of cognitive-communication support for people with TBI. A total of 10 casual and 10 purposeful TBI interactions were independently rated by two raters to establish inter-rater reliability and by one rater on two separate occasions to determine intra-rater reliability.

Outcomes & Results: Excellent inter-rater agreement was established on the MSC (ICC?=?0.85–0.97) and the MPC (ICC?=?0.84–0.89). Intra-rater agreement was also strong (MSC: ICC?=?0.80–0.90; MPC: ICC?=?0.81–0.92). Over 90% of all ratings scored within 0.5 on a 9-point scale.

Conclusions: This is the first scale to measure the communication partner during TBI interactions. It shows promise in evaluating communication partner training programmes.     

Measuring positive and negative aspects of youth behavior: Development and validation of the Adolescent Functioning Scale

This paper outlines the development and validation of the Adolescent Functioning Scale (AFS) in an Australian sample of parents of young people aged 11–18 years (N = 278). The AFS, a parent self-report measure, was designed to assess problem behavior and positive development in adolescents. Principal components analysis produced a 33-item measure comprising four subscales: Positive Development, Oppositional Defiant Behavior, Antisocial Behavior and Emotional Difficulties. Convergent validity was established via correlations between the AFS and established measures of adolescent functioning and parenting, and discriminant validity was shown through no association between the AFS and a measure of technology use. Internal consistency for the subscales was high (H = .82–.92 for different age groups), as was test-retest reliability (r = .77–.86). The study indicated that the AFS is a potentially valuable tool for assessing levels of problem behaviors and positive development in adolescents.     

The bed nucleus of the stria terminalis and immobilization-stress: Unit activity,escape behaviour,and gastric pathology in rats

Multiple unit-activity in the bed nucleus of the stria terminalis was increased or decreased, relative to baselines, during physical restraint in rats. Changes in unit-activity were also obtained by presenting an auditory stimulus that had been paired with the immobilization treatment. The animals escaped from that stimulus in behavioural tests, and bilateral lesions in the bed nucleus reduced the latencies of escape responses. The lesion also increased the severity of restraint-induced mucosal erosions. The latter effect was most pronounced when the damage was in the lateral portion of the bed nucleus. It was concluded that the bed nucleus of the stria terminalis is part of a coping system which responds when the organism is placed in a stressful situation.     

The assessment of the quality of life of adults with intellectual disability: The use of self-report and report of others assessment strategies

Assessment strategies that reliably and validly assess the indicators of quality of life (QOL) of individuals with intellectual disability (ID) are necessary for planning interventions and evaluating outcomes. In the present study, inter-rater reliability and concordance of the two assessment strategies report of others and self-report were evaluated in a group of 176 Italian adults with ID using the Personal Outcomes Scale, which employs the same QOL indicators in the self-report and report of others versions. Report of others resulted a reliable assessment strategy. Clients’ point of view was compared with both the estimation of their point of view and third-party-point-of-view obtained by two independent caregivers for each client. Results indicated that both self-report and report of others assessment strategies are necessary and that estimation of the client's point of view may be a valid and reliable substitute of self-report when clients are not able to answer.     

The epilepsy treatment gap in developing countries: a systematic review of the magnitude, causes, and intervention strategies

SUMMARY: In many developing countries, people with epilepsy do not receive appropriate treatment for their condition, a phenomenon called the treatment gap (TG). We carried out a systematic review to investigate the magnitude, causes, and intervention strategies to improve outcomes in developing countries. We systematically searched MEDLINE, EMBASE, and PsycINFO databases, supplemented by a hand search of references in the key papers. The degree of heterogeneity and a pooled TG estimate were determined using metaanalysis techniques. The estimates were further stratified by continent and location of study (urban, rural). Twenty-seven studies met the inclusion criteria: twelve from Africa, nine from Asia and six from Latin America. We observed a high degree of heterogeneity and inconsistency between studies. The overall estimate of the TG was 56/100 [95% confidence interval (CI) 31.1-100.0]. The variation in estimates could possibly be explained by nonuniform TG estimation methods and the diverse study populations, among other factors. The TG was mainly attributed to inadequate skilled manpower, cost of treatment, cultural beliefs, and unavailability of antiepileptic drugs (AEDs). These factors have been addressed using different intervention strategies, such as education and supply of AEDs. Future research should estimate the TG coherently and develop sustainable interventions that will address the causes.