[EARLY DIAGNOSIS OF BEHAVIOR DISORDERS].
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Adolescent↗
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School problems in Tourette's syndrome.
BACKGROUND: A retrospective study of 138 children with Tourette's syndrome for associated school problems revealed that at the time of initial evaluation, 64 subjects (46%) experienced a school-related problem. OBJECTIVE: To survey a childhood population with Tourette's syndrome to explore the contributions of neurobehavioral concomitants to academic difficulties. RESULTS: A diagnosis of a specific learning disorder had previously been made in 30 (22%) of 138 children. Among the 108 without a diagnosis of learning disorder, 36 (33%) experienced school difficulties defined as grade retention (16 [15%]) and/or special education placement (41 [38%]). Regression analysis of subjects without a diagnosis of learning disability revealed that the presence of attention-deficit hyperactivity disorder served as a significant predictor of school problems. CONCLUSIONS: Tics represented the primary reason for referral, but did not emerge as a significant predictor of academic problems. Rather, school-related difficulties appeared to be strongly associated with comorbid attention-deficit hyperactivity disorder.
Adolescent↗
Hyperactive boys almost grown up. V. Replication of psychiatric status.
We previously reported a prospective follow-up study of 101 young adult males whose conditions had been diagnosed as hyperactivity in childhood. Compared with controls, probands had significantly higher rates of attention-deficit, antisocial, and drug use disorders at follow-up (mean age, 18 years). The present study was an attempt to replicate these findings on an independent sample of 94 hyperactive boys who were seen at the same clinic, compared with 78 normal controls. Assessments were made by clinicians who were blind to group membership. Information was obtained for 90% of the original cohort. As in the previous study, significantly more probands than controls were given ongoing diagnoses of attention-deficit disorder (43% vs 4%), antisocial disorders (32% vs 8%), and drug use disorders (10% vs 1%). Furthermore, the absolute rates of these disorders were comparable for corresponding groups across studies, and the adjusted odds ratios did not differ significantly. As previously, there was no increased risk for affective disorders in the grown hyperactive children. The present study provides a powerful replication of the nature of the young adult outcome of childhood hyperactivity.
Adolescent↗
Parents' locus of control and perception of cause of children's problems.
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Adolescent↗
Factor structure of the WPPSI in mental health clinic settings.
Factor analyzed the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) scores of children (N = 181) seen at several outpatient mental health clinics. A two-factor solution that approximated Wechsler's grouping into Verbal and Performance sections was extracted. The Arithmetic subtest, however, loaded strongly onto both factors. The results suggest that the structure of intelligence for emotionally disturbed children is similar to that for normal children. The results also suggest that WPPSI profile analysis that uses subtest scores may be invalid in clinical settings because the specific variance of most subtests was low and because error variance exceeded specific subtest variance for half of the subtests. Further research is needed to clarify the utility of the WPPSI in outpatient clinical settings.
Aggression↗
Children's satisfaction with out-of-home care in South Australia.
Two studies were undertaken to assess children's satisfaction with their current placement experiences in South Australian alternative care. A total of 99 children with a mean age of 11 years were interviewed while still in care. Over 80 per cent of children reported being satisfied with both their case-worker and their placement, although children in residential (group) care reported being less satisfied than their counterparts in foster care. Foster homes were generally considered secure, happy and supportive, and case-workers were considered helpful, caring and willing to listen. Comparisons of background characteristics, measures of adjustment and demographic characteristics suggested that the samples interviewed were highly representative of the population of children referred for placements during the study period.
Adaptation, Psychological↗
Anti-epileptic therapy and behaviour disturbances in children.
In order to evaluate the effects on behaviour of some anti-epileptic drugs, we studied 300 children treated with phenobarbital and other drugs; their age ranged from 3.1 months to 15.9 years. The children were divided into two groups: group A: 197 (116 male and 81 female) children, mean age +/- SD 5.3 +/- 2.8 years, treated with phenobarbital; group B: 103 (66 male and 37 female) children, mean age 6.4 +/- 3.1 years, treated with anti-epileptic drugs other than phenobarbital. In all patients hyperactivity, irritability, disturbances of sleep, and drowsiness were investigated. The parents of patients completed a questionnaire with seven items. In group A, 150 (76.1%) children showed one or more behaviour disturbances, while in Group B a smaller number of patients 32 (31%) had such disorders. There was a significant difference between the two groups (P < 0.0001). The most frequent disorder was hyperactivity. The results of this study suggest that anti-epileptic drugs, in particular phenobarbital, can cause behaviour disturbances.
Anticonvulsants↗
Psychoactive drugs in the immature organism.
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Amphetamine↗
The validity of the hyperkinetic syndrome. A study in child psychiatric clinic attenders.
The total group of hyperkinetic children drawn from the pool of consecutive admissions to a child and adolescent out-patient department were compared with further groups admitted consecutively to the same institution in 1979 and 1980. These other groups consisted of normal controls, conduct disorders, emotional disorders or mixed disorders. The question of validity was studied in terms of several comparisons including sex, age, SES, family history, development characteristics, neurological findings and questionnaire scores. It was found that some data support the concept of concurrent validity of the hyperkinetic syndrome, namely the extremely asymmetric sex distribution in favour of boys, some indicators of developmental delay, the early onset of the symptoms and the higher rates of coordination deficits detected by neurological examination.
Adolescent↗
Cognitive therapy with young children.
This paper discusses the common cognitive features characterizing children's most frequently referred problems, with an emphasis on the difficulties' prevalence, gender ratio, and family incidence. The efficacy of cognitive treatments is examined in terms of dropping-out, regression, and generalization. In view of Piaget's notion on the concrete thinking of children, it is suggested that cognitive therapy be adopted for children by translating abstract, holistic concepts into concrete examples and by relating to day-to-day events which children can use, relate to and understand. Two cases studies are presented to illustrate the cognitive therapeutic process with young children.
Child↗
Responsive parenting: an approach to training parents of problem children.
Two behavior modification groups for parents of problem children between the ages of two and ten were conducted along the lines of the Responsive Teaching Model. The two groups met for 10 and 8 weeks, respectively, with six families represented in each group. In Responsive Parenting (RP), parents are taught to observe and measure their children's problematic behavior. Subsequently, each parent develops a home project designed to modify this behavior; 11 of the 12 parents developed a successful home project. In addition, the attendance was approximately 90% and the completion of weekly assignments was close to 100%. Paper-and-pencil measures revealed that the parents were very satisfied with the parent-training group and rated their children as improved on a bipolar adjective checklist. These results are discussed with regard to implications for the delivery of mental health services for children. Future research directions are delineated.
Adult↗
The differential validity of hyperactivity/attention deficits and conduct problems among mentally retarded children.
The independence of hyperactivity, attention deficits, and conduct problems among mentally retarded children was addressed using factors of the Conners' Teacher Rating Scale-39 (CTRS-39) and the more recently developed IOWA Conners' inattention/overactivity (IO) and aggression (A) subscales. CTRS-39 ratings were obtained for children of normal intelligence and for mentally retarded children. Differences between the groups were examined as were intercorrelations of the Conners' factors and IOWA subscales. Conduct problems proved to be less strongly associated with hyperactivity and attention deficits among mentally retarded children compared to children of normal intelligence. However, attention problems and conduct problems may be associated with mental retardation in general. Implications of these data and CTRS scoring system recommendations for mentally retarded children are discussed.
Aggression↗
An examination of predictor variables for child compliance and noncompliance.
The purpose of this study was to examine the antecedents of child compliance and noncompliance. Both maternal and child behaviors served as predictors. Fifty-six clinic-referred children and their mothers served as subjects. Data were collected in the home setting by independent observers. Four multiple regression analyses were performed. The results indicated that the behavior immediately preceding child compliance or noncompliance typically was the best predictor. Furthermore, the antecedents for child compliance and noncompliance differed. For maternal antecedents, the type of command that served as the best predictor for child compliance and noncompliance differed; however, the final predictor equation was similar for the two types of child behaviors. For child antecedents, compliance was best predicted by compliance and noncompliance was best predicted by noncompliance. The results were discussed in terms of Patterson's coercion hypothesis.
Child↗
Enhancing the effectiveness of self-administered videotape parent training for families with conduct-problem children.
Parents of 43 conduct-problem children, aged 3-8 years, were randomly assigned to one of two treatments: an individually self-administered video-tape modeling treatment (IVM) and IVM treatment plus therapist consultation (IVMC). Randomization also included a waiting-list control group (CON). Compared with the control group, both treatment groups of mothers reported significantly fewer child behavior problems, reduced stress levels, and less use of spanking. Home visit data indicated that both treatment groups exhibited significant behavioral changes. There were relatively few differences between the two treatment conditions. However, the IVMC children were significantly less deviant than the IVM children, suggesting that the IVMC (with therapist consultation) treatment was superior to self-administered treatment with no therapist involvement. The added benefits of therapist involvement are discussed.
Adult↗
Contextual factors in vigilance testing of children with ADHD.
The effect of contextual factors on continuous performance testing was examined by administering a vigilance task to 51 children with ADHD under conditions of examiner presence and absence at different times (i.e., beginning and middle) of an assessment battery. The results showed that the ability to differentiate target stimuli from distractors (d-prime) was related to examiner presence vs. absence, and that response bias (beta), a measure of the subject's carefulness in responding to stimuli, was associated with the time of task administration. The decline in d-prime under conditions of examiner absence was shown to be related more to level of aggression as opposed to level of inattention. Children with ADHD having relatively high levels of aggression demonstrated a significant decline in d-prime scores under conditions of examiner absence, but those with relatively low levels of aggression did not. The results demonstrated the importance of contextual factors on vigilance task performance and suggested a differential impact of contextual variables on children who are inattentive vs. aggressive.
Aggression↗
Overanxious disorder: an examination of developmental differences.
Differences between a clinical sample of younger (ages 5 to 11) and older (ages 12 to 19) children meeting DSM-III criteria for overanxious disorder (OAD) were examined. Younger and older children were compared in terms of (1) the rates of OAD diagnoses occurring in the two age groups, (2) sociodemographic characteristics, (3) symptom expression, (4) association with other forms of maladjustment, and (5) self-reported anxiety and depression. The prevalence of OAD diagnoses and sociodemographic characteristics did not differ. Although younger and older OAD children showed similar rates of most specific DSM-III OAD symptoms, older children presented with a higher total number of overanxious symptoms than younger children. Older children more frequently exhibited a concurrent major depression or simple phobia, whereas younger OAD children more commonly had coexisting separation anxiety or attention deficit disorders. Older OAD children reported significantly higher levels of anxiety and depression on self-report measures. Findings indicated that the expression of OAD varies by developmental level.
Adolescent↗
Incidental learning, distraction, and sustained attention in hyperactive and control subjects.
Thirty-two children designated as hyperactive (ADD) were compared with an equal number of control subjects who were matched for age, sex, and verbal IQ. The subjects were tested on a component selection task, measuring serial memory and incidental learning and a cancellation task, assessing attentional variables and distractibility. No straightforward group differences were found on the component selection task, whereas hyperactive subjects made more omission and commission errors than controls on the cancellation task. It was concluded that a deficit in sustained attention and impulsivity best described the group differences. Age was also found to influence performance on a number of variables, including incidental learning on the component selection task and response rate and omission errors on the cancellation task. Because subjects in the hyperactive group were rated as extreme on a number of subscales not necessarily related to hyperactivity, the data were reexamined by multiple regression analyses. Subscales considered to be related both to hyperactivity and to conduct disorder were associated with different performance variables, indicating that each of these subscales provided some unique information.
Age Factors↗
Minor physical anomalies in exceptional children: a review and critique of research.
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Anthropometry↗