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Treatment efficacy: hearing loss in children.

This article provides a review of the topic of treatment efficacy for children with hearing loss. Efficacy is related to a wide range of treatment goals in the areas of sensory and perceptual skill development, language development (regardless of communication modality), speech-production skill development, academic performance, and social-emotional growth. Topics addressed in this article include (a) the definition of hearing loss in children; (b) incidence and prevalence data; (c) the effects of childhood hearing loss on daily life, including language and literacy, speech perception and production, socialization and family dynamics; (d) the role of audiologists and speech-language pathologists in managing children with hearing loss; and (e) a summary of pertinent efficacy research for children with hearing loss. The analysis of the available research suggests that (a) early intervention for children who are deaf or hard of hearing has long-term positive effects on overall development; (b) a variety of communication modalities exist for this population, and research to date has been more descriptive than prognostic on the choice of modality; (c) sensory aids (hearing aids, tactile aids, and cochlear implants) provide different degrees of benefit for children in the areas of speech perception, production, and language development, depending upon the extent of their hearing loss; (d) few studies have addressed rates of learning and long-term outcomes, but existing data suggest that enriched programs provide some children with hearing loss with the ability to overcome developmental lags in language and academic skills.

Child Language↗

Using cooperative learning in clinical laboratory science education.

OBJECTIVE: To compare performance of students instructed by cooperative learning (CL) activities with those taught by lecture. A secondary objective was to assess students' perceptions about their ability to work in teams before and after their exposure to these instructional approaches. DESIGN/SETTING/PARTICIPANTS: CL was incorporated into the immunology/serology course of a university-based clinical laboratory science (CLS) program. Twenty-two students participated in a 4-week study and were randomly assigned to one of two study groups. INTERVENTION: One group received the course material by CL activities, and the other group was exposed to the material through lecture. MAIN OUTCOMES MEASURE: Mean examination scores for CL and lecture groups were compared using an independent samples t-test. Teamwork knowledge, skills, and attitude (KSA) assessment rated students' perceptions of their ability to work in a team environment pre and post tests were compared using a 2 x 2 repeated measures ANOVA. RESULTS: No significant difference was found between mean examination scores of students who acquired their knowledge by CL activities (85.09%) and those taught by lecture (82.18%). Teamwork KSA means scores pre and post tests (22.5, 22.6 CL; 22.7, 21.6 lecture) were not significantly different. CONCLUSION: Results suggest that the incorporation of CL activities did not reduce the students' academic performance or self-perceptions of their ability to work in teams. The use of CL in the classroom, student laboratory, or clinical setting may help prepare students for the role they will be expected to perform as laboratory professionals.

Adult↗

[Failure effects and gender differences in perfectionism].

Perfectionism is a dimension which has been studied very little as a separate entity. It is not even considered as a nosological factor. No classification of the medical sciences underlines its importance other than to speak of a personality trait, of an aspect, or of a parameter. Nevertheless, perfectionism is related to multiple disorders such as depression (18, 20, 36), suicide (8, 16, 55), nutritional problems (11, 28), anxiety (3), obsessive-compulsive personality disorder (53), social phobia (2), as well as insomnia (46). Certain authors stress the possible role of perfectionism in the development or the persistence of a substantial number of these disorders (7, 22, 38). Given these facts, it is all the easier to understand the interest shown by clinicians and researchers in the subject. Better detection and evaluation of its impact on behaviour is important in putting therapies in place (6, 53). Relationships between perfectionism and fear of failure have been approached (21, 51, 54). Correlations between perfectionism and high levels of state and trait anxiety have been demonstrated (23). The evaluation of perfectionism has been dealt with very little. Some questionnaires devote a sub-category to it, such as the Eating Disorder Inventory and the Irrational Beliefs Test. However, recently, it has been recognized that perfectionism is a multidimensional construct. Two Multidimensional Perfectionism Scales have been developed and investigated in relative isolation. Frost, Marten, Lahart and Rosenblate defined perfectionism as the setting of excessively high standards for performance associated with critical self-evaluation. Six dimensions are described: concern over making mistakes, high personal standards, parental expectations, parental criticism, doubt about quality of performance and organization. Internal consistency and validity have been established (25, 26). Hewitt and Flett (30, 31, 33, 35) have developed another approach where three dimensions of perfectionism are described: SOP (Self Oriented Perfectionism) related to high standards and self criticism, SPP (Socially Prescribed Perfectionism) related to the need of approval from others and fear of negative evaluation, OOP (Other-Oriented Perfectionism) reflecting a tendency to set high expectations for others and to evaluate them in a demanding way; this component is related, especially for males, to self-esteem, hostility and authoritarianism. Validity and internal consistency have been established too (30, 31, 35). The Frost and al's Multidimensional Perfectionism Scale and the Hewitt and Flett's scales are closely associated, except concerning the OOP. Because this component could provide new information, we have chosen the second scale, referring to the French translation and validation of Labrecque (45). EMP is the French name of MPS; it is a self-report questionnaire of 45 questions, in fact three subscales of 15 items rated on a 7-point Likert-type scale. MPS was administered to 617 first year students at the university of Liège (table II). Differences are considered according to gender and experience of failure i.e. the fact of repeating an academic year. We realized a component analysis with promax rotation. Among the different possibilities offered by the scree-test the choice of a 4 factor solution stresses the original structure: SOP (14 items), SPP (12 items), OOP (9 items) and anti OOP (10 items); the last one is additional but allows for respecting semantics and saturation of the items. The first aim of confirming validity and internal consistency is satisfactory. In other respects the multidimensional structure of the concept leads to consideration of a positive, adaptive perfectionism and a more negative perfectionism, facilitating psychopathology (59, 60, 61). So it seems interesting to compare the different components of MPS in order to find an eventual sex-failure effect. The evaluation of perfectionism is obvious, considering it as a personality trait, but it can be used also in taking into account stress and its impact, for instance that of academic performance (29, 37, 39, 58). Conferring on MPS more pertinence in gender differentiation and failure evaluation is an other goal of this research. Through the particular choice of statistical results, sex and sex-failure effects can be demonstrated: a MANOVA underlines sex effect (lambda de Wilks = 0.96, p = 0.001) and sex-failure effect (lambda de Wilks = 0.98, p = 0.05). Structure of MPS is different in four groups (FE: women with failure, FnE: women without failure, ME: men with failure, MnE: men without failure). ANOVA show differences of MPS3, MPS1 and MPS2. Far more promising is the use of LISREL method allowing for the construction of a coherent model of relationships between some dimensions of MPS and Test-Anxiety, approached here with THEE (test d'habileté aux études et à leur évaluation) French abbreviated version (49) of TASTE (Test for Ability to Study and Evaluation). In fact according to the literature of fear of failure, girls score higher on anxiety and procrastination but less on self-confidence. The structural model shows different pathways, more especially between SPP (socially prescribed perfectionism), T2 (sense of incompetence) and T1 (anxiety). SOP (self oriented perfectionism) and SPP (socially prescribed perfectionism) by girls are very much correlated; it seems that they are more subjected to society and its exigencies of studying but consequently they are more at risk of anxiety and a sense of incompetence. SOP (self oriented perfectionism) by boys functions more indiscriminately of SPP (socially prescribed perfectionism) and is negatively correlated with self-incompetence; boys are more self-confident but they usually procrastinate more probably because failure expectancies would be particularly harmful for their self-esteem; consequently, failure should be related to something else than their own capacity; this may be an explanation of the high rate of male dropouts and failure in the first year at the university of Liège; also a factor explaining the female domination at the university. In the same way the first choice of studies is moving towards shorter and less difficult orientation (46). In case of failure the model is very similar according to gender: SOP (self oriented perfectionism) and T1 (anxiety) are directly connected; SOP and SPP are in this case better correlated by boys but the path between SPP, sense of incompetence and anxiety is less significant than in girls. In conclusion, providing some modifications according to semantics, the choice of a four factor solution allows for confirmation of the original structure of MPS and for internal consistency. The different components of MPS vary according to gender: SOP and more OOP discriminate men and women; SPP allows for differentiating women with failure. A structural model enhances the role of perfectionism in the cognitive and behavioural contexts; for instance it clarifies its action on fear of failure and success rates according to gender.

Adult↗

Therapy for attention-deficit hyperactivity disorder.

Attention-deficit hyperactivity disorder (ADHD) is a common, chronic neurological and behavioral syndrome in children, adolescents, and adults. Research studies carried out with subjects referred to specialists for treatment of ADHD have shown that methylphenidate hydrochloride improves behavior and academic performance in both children and adolescents, at least in the short term. Dextroamphetamine sulfate, pemoline, and desipramine hydrochloride are reasonable second choices for those patients who cannot tolerate or do not respond to methylphenidate. Cognitive-behavioral and family therapies, while intuitively appealing, appear to have weak effects and little empirical validation. The long-term outcome of ADHD as seen in primary care settings is not predictable.

Adolescent↗

Children's use of CROS hearing aids.

Ten children with unilateral hearing loss, aged 7 to 17 years, who were fit with contralateral routing of signal (CROS) hearing aids were followed up for three years to assess the suitability of this type of hearing aid fitting on children. The determination of the success of the fitting was based on follow-up visits, chart review, and response to a questionnaire sent to the parents. The fitting was considered to be successful if the child accepted the aid and if parents and teachers observed substantial improvement in academic performance and/or social behavior. Seven children were considered to be successful users of their CROS aids; one was unavailable for follow-up; one did better with a BICROS aid; and one did not do well with amplification. Our experience suggests that children with unilateral hearing loss can benefit from CROS amplification.

Adolescent↗

The resident selection process in otolaryngology-head and neck surgery.

This study was undertaken to characterize the objective information available about applicants to otolaryngology-head and neck surgery residency positions, and to determine the influence of these factors on obtaining a residency position. Applicants to the otolaryngology-head and neck surgery programs at University of Utah, Salt Lake City, University of Texas Medical Branch, Galveston, and University of Louisville (Ky) were studied. Thirty-one variables were examined, representing demographic and academic factors. Excellent academic performance in medical school (as represented by medical school grade-point average greater than 3.4, National Board part I score greater than 650, class percentile rank greater than 85th percentile, honors grades in both junior medicine and surgery clinical clerkships, or [5] election to Alpha Omega Alpha) was significantly correlated with success in obtaining an otolaryngology-head and neck surgery residency position.

Adult↗

The effect of Kawasaki disease on cognition and behavior.

OBJECTIVE: To determine whether there are associated long-term deficits in the cognitive, academic, or behavioral outcomes of children with a previous episode of Kawasaki disease. DESIGN: Cohort analytic study. SETTING: A tertiary care pediatric hospital in Ottawa, Ontario. PARTICIPANTS: Thirty-two patients with a past diagnosis of Kawasaki disease. Siblings of the patients with Kawasaki disease were eligible to be controls. MEASURES: A blinded psychometrist (Y.K.) assessed cognition by the appropriate Wechsler Intelligence scale, academic achievement by the Wechsler Individual Achievement Test, and behavior by the Achenbach Child Behavior Checklist. RESULTS: No differences were found in cognitive or academic measures and the mean scores corresponded closely to national norms. Parents rated their children who had Kawasaki disease as having significantly more internalizing (P<.03) and attentional (P<.02) behavior problems than controls; the risk of a clinically significant behavioral score was 3.3 times greater (P<.03; 95% confidence interval, 1.1-9.9) than for sibling controls. CONCLUSIONS: While no effect on cognitive development or academic performance was demonstrated, these results provide preliminary indication of a post-Kawasaki disease deficit in internalizing and attentional behavior.

Adolescent↗

Role models, ethnic identity, and health-risk behaviors in urban adolescents.

BACKGROUND: The assumption that role models or mentors constructively influence adolescent psychological functioning has prompted societal investment in mentoring programs. However, there has been little empirical evaluation of the relationship between role model or mentor characteristics and health behaviors. OBJECTIVES: To describe role model selection in urban adolescents and examine the relationships between role model characteristics, psychosocial functioning, and health-risk behaviors. DESIGN: Cross-sectional survey. PARTICIPANTS: A population-based, multiethnic sample of Los Angeles County adolescents aged 12 to 17 years was generated from a 3-stage, area-probability sampling frame. Of 877 adolescents identified, 749 are included in this analysis. METHODS: In-person, in-home interviews were conducted. MAIN OUTCOME MEASURES: Substance use, academic performance, and self-perception (measures of ethnic identify and self-esteem). Ethnic identity was measured by an adaptation of a scale developed by Phinney (J Adolesc Res. 1992;7:156-176) to assess commonalities across ethnic groups. RESULTS: Fifty-six percent of adolescents identified a role model. Higher levels of ethnic identity were associated with moving from identifying no role model to identifying a figure primarily available through the media to identifying a known individual, familial or nonfamilial (P<.001). Having a role model, particularly an individual known to the adolescent, was also associated with higher self-esteem (P<.001) and higher grades (P<.05). For white males without custodial fathers, having a role model was associated with decreased substance use (P<.05). CONCLUSION: Role model selection is associated with protective psychosocial characteristics.

Adolescent↗

Parental decision making and the choice of communication modality for the child who is deaf.

BACKGROUND: Early intervention decisions for a deaf or hard of hearing child are difficult to make, partly because of the lack of definitive proof of the superiority of any particular communication approach. OBJECTIVE: To compare the relative importance of the child's hearing loss and parental attitudes, beliefs, values, and aspirations in the decision process. METHODS: Eighty-three parents were surveyed about decision factors that may have affected their choice of communication modality, including resource availability, attitudes and beliefs about hearing loss, values, trade-offs, and goals. Parental preference ratings on hypothetical outcomes were also collected in 4 domains: communication, academic performance, social functioning, and emotional well-being. RESULTS: The child's extent of hearing loss was the most influential decision factor (P<.001). Beyond the extent of hearing loss, logistic regression further showed that parental cognitive-attitudinal factors were important in the inclination to favor an oral approach-if they believed that deafness can and should be corrected and if they desired the child to be able to speak (P =.03 and.04, respectively). Technology that aims at improving the child's ability to speak (eg, cochlear implants) had no significant impact on the decision to choose oral only training. CONCLUSIONS: Professionals who work with deaf children and their parents should recognize the presence of many relevant issues beyond the extent of the child's hearing loss. Interventions may be most effective if aimed at balancing parental beliefs and aspirations and audiologic considerations.

Adolescent↗

Correlations between family meals and psychosocial well-being among adolescents.

OBJECTIVE: To determine the association between frequency of family meals and multiple indicators of adolescent health and well-being (tobacco, alcohol, and marijuana use; academic performance; self-esteem; depressive symptoms; and suicide involvement) after controlling for family connectedness. METHODS: Data come from a 1998-1999 school-based survey of 4746 adolescents from ethnically and socioeconomically diverse communities in the Minneapolis/St Paul, Minn, metropolitan area. Logistic regression, controlling for family connectedness and sociodemographic variables, was used to identify relationships between family meals and adolescent health behaviors. RESULTS: Approximately one quarter (26.8%) of respondents ate 7 or more family meals in the past week, and approximately one quarter (23.1%) ate family meals 2 times or less. Frequency of family meals was inversely associated with tobacco, alcohol, and marijuana use; low grade point average; depressive symptoms; and suicide involvement after controlling for family connectedness (odds ratios, 0.76-0.93). CONCLUSIONS: Findings suggest that eating family meals may enhance the health and well-being of adolescents. Public education on the benefits of family mealtime is recommended.

Adolescent↗

Multimodality treatment. A one-year follow-up of 84 hyperactive boys.

This study reports findings at the end of the first year of a three-year prospective study of 84 hyperactive boys. A multidimensional approach to evaluation and an individualized multimodality treatment plan commensurate with each child's disabilities was used. Treatment plans were implemented by members of the research staff working together as a coordinated therapeutic team. Measures of the child's behavior at home and at school, academic performance, delinquent behavior, and emotional adjustment were obtained initially and at one year. Results suggest that the combination of a clinically useful medication with appropriate psychological treatments simultaneously directed to each of the child's many disabilities is associated with an unexpectedly good outcome. Whether this will continue to be true when these children are followed up over a longer period of time awaits further investigation.

Achievement↗

Multimodality treatment. A two-year evaluation of 61 hyperactive boys.

This study reports findings at the end of the second year of a three-year prospective study of 61 hyperactive boys. Individualized multimodality treatment plans commensurate with each child's disabilities were implemented by the research staff. Measures of the child's behavior at home and at school, academic performance, delinquent behavior, and emotional adjustment were obtained initially and at the end of each treatment year. The combination of a clinically useful medication in appropriate dosage schedules with relevant psychological treatments simultaneously directed to each of the child's many disabilities were associated with an unexpectedly good outcome at the end of one and two years. Whether this improvement will be maintained over a longer period of time and whether young adult outcome will be affected await further investigation.

Achievement↗

Construct validity of the Rorschach Oral Dependency (ROD) Scale: relationship of ROD scores to WAIS-R scores in a psychiatric inpatient sample.

Three-hundred and two psychiatric inpatients (166 women and 136 men) completed Masling, Rabie, and Blondheim's Rorschach Oral Dependency (ROD) Scale and the Weschler Adult Intelligence Scale Revised (WAIS-R). As predicted, ROD scale scores were unrelated to WAIS-R scores in subjects of either sex. These findings support the discriminant validity of the ROD scale as a measure of interpersonal dependency, and suggest that deficits in intellectual ability do not underlie the dependency-related behaviors (e.g., suggestibility, conformity, interpersonal yielding) that are associated with high scores on the ROD scale. Implications of these findings for research on the dependency-academic performance relationship are discussed, and suggestions for future studies assessing the convergent and discriminant validity of the ROD scale are offered.

Adolescent↗

The relationship between marijuana initiation and dropping out of high school.

The prevalence of marijuana use among young people has risen rapidly in recent years, causing concern over the potential impact on academic performance of such use. While recent studies have examined the effect of alcohol use on educational attainment, they have largely ignored the potential negative effects of other substances, such as marijuana. This paper examines whether the relationship between the initiation of marijuana use and the decision to drop out of high school varies with the age of dropout or with multiple substance use. Data are from a longitudinal survey of 1392 adolescents aged 16-18 years. The results suggest that marijuana initiation is positively related to dropping out of high school. Although the magnitude and significance of this relationship varies with age of dropout and with other substances used, it is concluded that the effect of marijuana initiation on the probability of subsequent high school dropout is relatively stable, with marijuana users' odds of dropping out being about 2.3 times that of non-users. Implications of these conclusions are considered for both policy makers and researchers.

Adolescent↗

The uses of hypnotherapy with learning disabled children.

Explored the impact of group hypnotic and self-hypnotic training on the academic performance and self-esteem of learning disabled (LD) children. Three hypnotic training sessions and instructions for 6 weeks of daily self-hypnotic practice that contained suggestions for imagery related to improvement in these areas were given to 15 children (12 males and 3 females, ages from 7 to 13), their reading teacher, and both their parents, and their responses were compared to a similar but untreated control group of 18. No overall differences were observed between groups. A multiple regression analysis revealed important predictors of self-esteem improvement for the experimental group. The child's hypnotic susceptibility score and self-hypnotic practice by children and parents were the most relevant. These LD children were at least as hypnotically susceptible as a normative sample. Hypnotherapy is seen as feasible in group administration by persons only moderately trained in hypnosis and of potential benefit to self-esteem improvement in LD children, depending on individual difference factors.

Adolescent↗

Suicidal ideation in high school students: depression and other correlates.

English-Canadian high school students (129 boys, 117 girls) participated in a study of the relationship between suicidal ideation and selected personal variables, stress, and social support. Associations were found between suicidal ideation and the variables of gender, self-esteem, locus of control, depression, drug use, stress, perception of health, family status, academic performance, social support, and anomie. Multiple regression analysis identified depression and alcohol use as best individual predictors among these variables. Semi-partial correlation analyses showed that removal of the effect of depression resulted in a loss of initially significant relationships between suicidal ideation and the other variables except for alcohol use, drug use, and health satisfaction.

Adolescent↗

Psychological and/or educational interventions for the prevention of depression in children and adolescents.

BACKGROUND: Depression is the fourth most important disease in the estimation of the burden of disease Murray 1996 and is a common problem with prevalence rates estimated to be as high as 8% in young people. Depression in young people is associated with poor academic performance, social dysfunction, substance abuse, suicide attempts, and completed suicide (NHMRC 1997). This has precipitated the development of programmes aimed at preventing the onset of depression. This review evaluates evidence for the effectiveness of these prevention programmes. OBJECTIVES: To determine whether psychological and/or educational interventions (both universal and targeted) are effective in reducing risk of depressive disorder by reducing depressive symptoms immediately after intervention or by preventing the onset of depressive disorder in children and adolescents over the next one to three years. SEARCH STRATEGY: The Cochrane Depression, Anxiety and Neurosis Group trials register (August 2002), MEDLINE (1966 to December Week 3 2002), EMBASE (1980 to January Week 2 2003), PsychInfo (1886 to January Week 2 2003) and ERIC (1985 to December 2002) were searched. In addition, conference abstracts, the reference lists of included studies, and other reviews were searched and experts in the field were contacted. SELECTION CRITERIA: Each identified study was assessed for possible inclusion by two independent reviewers based on the methods sections. The determinants for inclusion were that the trial include a psychological and/or educational prevention programme for young people aged 5 to 19 years-old, who did not meet DSM or ICD criteria for depression and/or did not fall into the clinical range on standardised, validated, and reliable rating scales of depression. DATA COLLECTION AND ANALYSIS: The methodological quality of the included trials was assessed by two independent reviewers according to a list of pre-determined criteria, which were based on quality ratings devised by Moncrieff and colleagues (Moncrieff 2001). Outcome data was extracted and entered into Revman 4.2. Means and standard deviations for continuous outcomes and number of events for dichotomous outcomes were extracted where available. For trials where the required data were not reported or could not be calculated, further details were requested from first authors. If no further details were provided, the trial was included in the review and described, but not included in the meta-analysis. Results were presented for each type of intervention: targeted or universal interventions; and educational or psychological interventions and if data were provided, by gender. Where possible data were combined in meta-analyses to give a treatment effect across all trials. Sensitivity analysis were conducted on studies rated as "adequate" or "high" quality, that is with a score over 22, based on the scale by Moncrieff et al (Moncrieff 2001). The presence of publication bias was assessed using funnel plots. MAIN RESULTS: Studies were divided into those that compared intervention with an active comparison or placebo (i.e. a control condition that resembles the intervention being investigated but which lacks the elements thought to be active in preventing depression) and those that used a "wait-list" or no intervention comparison group. Only two studies fell into the former category and neither showed effectiveness although one study was inadequately powered to show a difference and in the other the "placebo" contained active therapeutic elements, reducing the ability to demonstrate a difference from intervention. Psychological interventions were effective compared with non-intervention immediately after the programmes were delivered with a significant reduction in scores on depression rating scales for targeted (standardised mean difference (SMD) of -0.26 and a 95% confidence interval (CI) of -0.40 to -0.13 ) but not universal interventions (SMD -0.21, 95% CI -0.48, 0.06), with a significant effect maintained on pooling data (SMD -0.26, 95% CI -0.36, -0.15). While small effect sizes were reported, these were associated with a significant reduction in depressive episodes. The overall risk difference after intervention translates to "numbers needed to treat" (NNT) of 10. The most effective study is the targeted programme by Clarke (Clarke 2001) where the initial effect size of -0.46 is associated with an initial risk difference of -0.22 and NNT 5. There was no evidence of effectiveness for educational interventions. Reports of effectiveness for boys and girls were contradictory. The quality of many studies was poor, and only two studies made allocation concealment explicit. Sensitivity analysis of only high quality studies did not alter the results significantly. The only analysis in which there was significant statistical heterogeneity was the sub-group analysis by gender where there was variability in the response to different programmes for both girls and boys. For the most part funnel plots indicate findings are robust for short term effects with no publication bias evident. There are too few studies to comment on whether there is publication bias for studies reporting long-term (12-36 month) follow-up. REVIEWER'S CONCLUSIONS: Although there is insufficient evidence to warrant the introduction of depression prevention programmes currently, results to date indicate that further study would be worthwhile. There is a need to compare interventions with a placebo or some sort of active comparison so that study participants do not know whether they are in the intervention group or not, to investigate the impact of booster sessions to see if effectiveness immediately after intervention can be prolonged, ideally for a year or longer, and to consider practical implementation of prevention programmes when choosing target populations. Until now most studies have focussed on psychological interventions. The potential effectiveness of educational interventions has not been fully investigated. Given the gender differences in prevalence, and the change in these that occurs in adolescence with a disproportionate increase in prevalence rates for girls, it is likely that girls and boys will respond differently to interventions. Although differences have been reported in studies in this review the findings are contradictory and a more definitive delineation of gender specific responses to interventions would be helpful.

Adolescent↗

Children's temperament and teachers' decisions.

Findings from a series of studies of the educational implications of children's temperament patterns are summarized. This research has been guided by three hypotheses: (1) that there are real individual differences among children in behavioural styles or temperament; (2) that individual variations in children's patterns of temperament influence the nature of their interpersonal interactions; and (3) that perceived variations in temperament become especially powerful influences on adults' decisions when children are handicapped or at risk. Based on these assumptions, the study of temperament has followed two primary lines of research. in the first we have attempted to delineate the hypothesized link between perceived temperament variations and teachers' educational decisions. In the second we have attempted to determine the influence of perceived temperament variations on children's personal-social competence within intervention settings. Findings support a relationship between children's temperament and their achievement and adjustment in school. Temperament was related to measures of children's academic performance and to teachers' perceptions of other aspects of children's school adjustment. Further, teachers' ratings of children's temperament were related to their classroom management decisions. The results suggest that teachers' responses to children in the classroom are mediated by their perceptions of the children's temperament.

Child↗