Examining clinical judgment in an adaptive intervention design: The fast track program

Although clinical judgment is often used in assessment and treatment planning, rarely has research examined its reliability, validity, or impact in practice settings. This study tailored the frequency of home visits in a prevention program for aggressive- disruptive children (n = 410; 56% minority) on the basis of 2 kinds of clinical judgment: ratings of parental functioning using a standardized multi-item scale and global assessments of family need for services. Stronger reliability and better concurrent and predictive validity emerged for the 1st kind of clinical judgment than for the 2nd. Exploratory analyses suggested that using ratings of parental functioning to tailor treatment recommendations improved the impact of the intervention by the end of 3rd grade but using more global assessments of family need did not.     

Executive functions and school readiness intervention: impact, moderation, and mediation in the Head Start REDI program

Despite their potentially central role in fostering school readiness, executive function (EF) skills have received little explicit attention in the design and evaluation of school readiness interventions for socioeconomically disadvantaged children. The present study examined a set of five EF measures in the context of a randomized-controlled trial of a research-based intervention integrated into Head Start programs (Head Start REDI). Three hundred fifty-six 4-year-old children (17% Hispanic, 25% African American; 54% girls) were followed over the course of the prekindergarten year. Initial EF predicted gains in cognitive and social-emotional skills and moderated the impact of the Head Start REDI intervention on some outcomes. The REDI intervention promoted gains on two EF measures, which partially mediated intervention effects on school readiness. We discuss the importance of further study of the neurobiological bases of school readiness, the implications for intervention design, and the value of incorporating markers of neurobiological processes into school readiness interventions.