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PubMed1999

[When and how to research anxiety disorders in children?].

From the epidemiological evidence, anxiety disorders appear frequent in childhood and adolescence. Because anxiety has normal adaptative forms through development, the identification of pathology may sometimes pose difficulty. Child and adolescent anxiety disorders are defined in modern classifications with diagnostic criteria nearby of those used for adulthood. Behavioural symptoms of anxiety often alert relatives or teachers of the children. This paper reviews the main behavioural signs found in anxiety disorders (shyness, school refusal, sleep disorders, somatic distress, slowness, domestic tyranny).

Adaptation, Psychological↗
PubMed2003

Juvenile bipolar disorder in Brazil: clinical and treatment findings.

BACKGROUND: Because few studies were conducted to evaluate bipolar disorder in children and adolescents outside North America, this investigation aims to describe clinical features, pattern of comorbidities, and response to pharmacologic treatment in a sample of youths with bipolar disorder (BD) from a pediatric psychopharmacology outpatient clinic in Brazil. METHODS: We performed a retrospective chart review of all patients under age 15 with BD diagnoses who were evaluated and treated in our clinic from 1998-2001. A comparison sample of subjects with attention-deficit/hyperactivity disorder (ADHD) without BD (n = 362) was also evaluated. RESULTS: The prevalence of juvenile BD in our sample was 7.2% (36/500) (95% confidence interval = 5.2-9.9). Irritable mood was detected in 91.7% of the bipolar patients. The main comorbidity found was ADHD (58.3%). Children with BD had significantly higher rates of abnormally elevated CBCL scores in the externalizing dimension, anxiety and depression, delinquent behavior, and aggressive behavior scales than ADHD subjects (p <.05). Most BD patients (78%) needed combination drug therapy to achieve symptomatic control. CONCLUSIONS: Our results replicate clinical and treatment findings from U.S. investigations in a different culture demonstrating that juvenile BD is not a rare disorder in clinical samples.

Adolescent↗
PubMed2006

Using social stories and comic strip conversations to promote socially valid outcomes for children with autism.

Very little is documented regarding the efficacy of social stories and comic strip conversations for promoting an understanding of social situations and the appropriate social behaviors of individuals with autism spectrum disorder (ASD). In addition, few studies on the efficacy of social stories have examined whether outcomes are socially valid. The purpose of this article is to respond to some of the gaps in the literature on the efficacy of a frequently used intervention for children with ASD and to describe a family-centered collaborative approach to developing social stories and comic strip conversations. The results of intervention employing an A-B design are reported for two case vignettes. Clinical implications, limitations of the available data, and potential factors contributing to outcome variability are discussed.

Autistic Disorder↗
PubMed1990

Effects of choice making on the serious problem behaviors of students with severe handicaps.

This study assessed the impact of choice making on the serious problem behaviors of 3 students with severe autism and/or mental retardation. In the context of within-subject reversal designs, the results showed consistently reduced levels of problem behaviors (e.g., aggression) when the students were given opportunities to make choices among instructional tasks and reinforcers. Additional data showed no systematic differences in the rate of correct responding between the two conditions. The results are discussed in relation to the continuing search for effective, nonintrusive solutions to the occurrence of serious problem behavior.

Autistic Disorder↗
PubMed2005

On the effectiveness of and preference for punishment and extinction components of function-based interventions.

The current study describes an assessment sequence that may be used to identify individualized, effective, and preferred interventions for severe problem behavior in lieu of relying on a restricted set of treatment options that are assumed to be in the best interest of consumers. The relative effectiveness of functional communication training (FCT) with and without a punishment component was evaluated with 2 children for whom functional analyses demonstrated behavioral maintenance via social positive reinforcement. The results showed that FCT plus punishment was more effective than FCT in reducing problem behavior. Subsequently, participants' relative preference for each treatment was evaluated in a concurrent-chains arrangement, and both participants demonstrated a dear preference for FCT with punishment. These findings suggest that the treatment-selection process may be guided by person-centered and evidence-based values.

Attention Deficit and Disruptive Behavior Disorder↗