Time Perception in Boys With Attention-Deficit/Hyperactivity Disorder According to Time Duration,Distraction and Mode of Presentation

The present study describes the incidence of test refusal at neuropsychological assessment, investigates its correlates, and its stability. The participants were 124 children aged 3.5 years whose development has been followed from birth in the Jyväskylä Longitudinal Study of Dyslexia (JLD). The frequency of test refusal on the Finnish version of the NEPSY was analyzed with respect to the children's concurrent and earlier cognitive and language skills, assessed using tests and parental ratings. Refusal during test-taking was found to be relatively common at this age, and high frequency of refusal at an earlier age was associated with similar tendency at a later age. High test refusal was associated with compromised neuropsychological and linguistic test scores. Missing data due to refusal were more common in neuropsychological tasks requiring verbal production. It is concluded that test refusals reflect a child's poor underlying skills and an attempt to avoid failure, rather than noncompliant or oppositional behavior.     

Lateralized brain injury and behavior problems in children

This study investigated the types of behavior problems found in children with lateralized brain lesions. Children referred for neuropsychological assessment were assigned to dominant (DH) or nondominant (NDH) groups on the basis of history of neurological disease or injury, findings on neurological examination, functional and structural laboratory findings, and neuropsychological assessment. Over two-thirds fell into the clinical range of behavior problems by parental report on the Achenbach Child Behavior Checklist. Degrees of pathology were nearly equal. DH children showed more externalizing than internalizing symptomatology. NDH children showed more internalizing than externalizing behavior problems. Results are discussed in terms of symptom formation based on lateralization of lesion.     

Neuropsychological complications of insulin dependent diabetes in children

Previous research suggests that children with insulin dependent diabetes (IDDM) show selective impairments on neuropsychological tests, with those developing IDDM before 5 years of age appearing to be the most affected. The effect of hypoglycaemia on the developing brain has been suggested as a possible risk factor as has the disruptive effect of chronic hyperglycaemia on myelinisation. A cohort of children (n = 124) with newly diagnosed IDDM, managed at The Royal Children's Hospital, Melbourne has been assembled and evaluated 3 months post diagnosis on standardised tests of general intelligence, attention, memory, new learning, executive functions, and educational achievement. The performance of the children with IDDM has been compared with that of a demographically representative control group (n = 129) of healthy children. At this baseline assessment, the findings strongly support the hypothesis that the neuropsychological and educational profiles of newly diagnosed children are not different from that of controls early in the course of the illness. Both groups will be reassessed 2 and 5 years after the initial evaluation when it is hypothesised that children with diabetes will perform more poorly. Parameters of the illness, such as age of onset, major metabolic crises, and history of glycaemic control will be related to the test performance of the children with IDDM to identify specific risk factors for neuropsychological and educational sequelae in that population.     

Münchhausen by Proxy Syndrome in Clinical Child Neuropsychology: A Case Presenting With Neuropsychological Symptoms

Münchhausen by proxy syndrome (MBPS) is a rare but dramatic variant of child abuse. In MBPS adults, mostly the mother, invent, manipulate, or produce the child's illness, and as a consequence the child has to undergo numerous diagnostic or treatment procedures. Typically, valid information about the etiology of the child's illness is withheld by the parents, and reversible symptoms vanish, when the child and the responsible adults are separated. Although valid statistical data about the epidemiology of MBPS are not available, MBPS should be considered more often than normally recognized. Neurological and neuropsychological presentations including developmental delays and learning problems appear to be common among MBPS cases so that clinical child neuropsychologists should be aware of this problem and consider MBPS at least in some of the mysterious cases that come to their attention. The present study describes a case of MBPS in which neurological and neuropsychological symptoms predominate. It presents a MBPS variant that is characterized by developmental delays and learning problems induced by unnecessary isolation at home, hospitalization, and treatment procedures. In the present case MBPS was at first suspected following neuropsychological assessment, since some of the main features of non-authenticity of symptom presentation gave cause for suspecting deceptive behavior on the mother's (and possibly also on the maternal grandmother's) side.     

Long-Term Executive Function Deficits in Children With Traumatic Brain Injuries: Assessment Using the Behavior Rating Inventory of Executive Function (BRIEF)

Long-term deficits in executive functions following childhood traumatic brain injuries (TBI) were examined using the Behavior Rating Inventory of Executive Function (BRIEF). Parents completed the BRIEF approximately 5 years postinjury as part of a prospective study of children injured between the ages of 6 and 12. The children were between 10 and 19 years of age at the time of the assessment, and included 33 with severe TBI, 31 with moderate TBI, and 34 with orthopedic injuries. Parents also rated children's adaptive functioning and completed several other measures of parent and family functioning. Children were administered a neuropsychological test battery that included several measures of executive functions. The groups displayed a significant linear trend in BRIEF scores, with the largest deficits in executive functions reported in children with severe TBI. BRIEF scores were related consistently across groups to a test of working memory, but not to other neuropsychological measures. BRIEF scores also predicted children's adaptive functioning and behavioral adjustment, as well as parent psychological distress, perceived family burden, and general family functioning. The findings indicate that TBI results in long-term deficits in executive functions that are related to children's psychosocial outcomes, as well as to parent and family functioning.     

A model for the behavioral assessment of behavior disorders in children: Measurement considerations and practical application

School psychologists have traditionally experienced difficulty in assessing children referred to them for behavior disorders. Given this reported difficulty, a behavioral assessment model is proposed which specifies three types of assessment information: direct observations, rating scale data, and interview data. Characteristics of these three types of assessment information are discussed, along with recommendations for their use. Two psychological models are suggested to guide school psychologists through the assessment process. Bergan's behavioral consultation model is recommended for securing valid and reliable interview and observational data, and Campbell and Fiske's multitrait-multimethod model is proposed as a means of logically integrating behavioral assessment information. The notion of convergence or agreement between dissimilar assessment methods is discussed.     

留守儿童情绪和行为问题特征的潜在类别分析：基于个体为中心的研究视角

对2288个留守儿童样本用儿童长处与困难问卷（SDQ）进行施测,并对他们的情绪和行为问题特征进行探索性的潜在类别分析,发现留守儿童的情绪和行为问题存在明显的分组特征。统计指标支持了3个潜类别的模型,根据3个潜在类别在问卷各条目上的条件概率特征分别定义为：“适应困难组”,“行为冲动组”和“良好适应组”,3个潜在类别所占全体样本的比例分别为32%、41%和27%。进一步的分析发现：相比较良好适应组而言,适应困难组和行为冲动组有着显著的性别和年级水平效应,适应困难组和行为冲动组的男生所占比例更大;同时,这两个组的小学生所占的比例也更大。     

Assessment of Attention in Children with Attention Deficit Hyperactivity Problems in Primary Care Settings

Clinical child psychologists in primary care settings are often asked to evaluate children with suspected attention and learning problems. This paper will review some of the methods and assessments available to child psychologists to enable them to perform this task. Some problems with current practice will be described and some of the newer techniques will be introduced. A research-based understanding of areas of chronic impairment of children with Attention Deficit Hyperactivity Disorder (ADHD) will be discussed, and a new approach to the assessment of both executive functions and attention will be explored. This paper will primarily explore assessment in the primary care setting.     

Screening for Medical and Neurodevelopmental Disorders for the Professional Counselor

This article reviews several assessment factors useful identifying the presence of a possible medical illness or neurodevelopmental disorder contributing to a client's adjustment problems. Use of behavioral observations, record reviews, brief neuro-behavioral screening tests, and the taking of a history are outlined that can assist in raising the index of suspicion for organic influence. Also addressed are issues pertaining to referral for medical and specialty assessments, including neuropsychological evaluation.     

Suicide assessment and evaluation strategies: a primer for counselling psychologists

Suicide is a recognized national health risk in many countries. In order to effectively intervene in suicidal crises, it is important for mental health professionals to understand facts about suicidal behaviour, procedures for assessing an individual's risk of self-harm, and the evaluation of the lethality of a client's suicidal gestures. With updated knowledge and proper training, counselling psychologists can play a vital role in suicide prevention. This paper summarizes for counselling psychologists current statistics about suicide, general and specific risk factors for suicidality, and assessment tools used to evaluate suicidal risk.     

PSYCHOEDUCATIONAL SERVICES FOR CHILDREN AND YOUTH IN THE ORIENT: CURRENT STATUS,PROBLEMS, AND SOME REMEDIES*

Utilizing information obtained through an international survey and existing literature, patterns in the practices, research, and preparation of professionals who deliver psychoeducational services to children and youth in six Oriental countries (i.e., China, Hong Kong ¹, Japan, the Philippines, Taiwan, and Thailand) are described. Services are provided by many professional groups. While few formal programs exist for the preparation of psychologists to work in schools, those providing such services have at least a bachelor's degree. Services commonly provided include assessment, vocational and educational guidance, counseling, parent education, and teaching. School psychological services generally are not governed by legislation or professional standards. Research tends to be applied and directed toward the construction and translations of tests and toward the needs of the mentally retarded, learning disabled, and behaviorally disordered. Ten major problems creating barriers for the delivery of psychoeducational services are identified. Three suggestions to help resolve these problems are offered.     

A supposedly objective thing I'll never use again: Word association and the quest for validity and reliability in emotional adjustment research from Carl Jung to Carl Rogers (1898–1927)

As the first two decades of the 20th century unfolded, clinical psychologists, who had until then been mainly associated with intelligence testing, attempted to implement a specific psychological method—Carl Gustav Jung's (1875–1961) word-association “test”—in individual personality assessments. As one of the early clinical psychologists who attempted to use the method, Carl Ransom Rogers (1902–1987) is conspicuously absent from the historiography of clinical psychological testing. In fact, historians have recently suggested that we are lacking narratives about Rogers' early ideas and techniques in the context of both the development of clinical psychology and the emergence of psychological testing as clinicians' foremost scholarly activity. In light of the above, this paper pursues two main goals. First, it attempts to reconstruct Rogers' first original research project on emotional adjustment testing in young children in the broader context of the development of word-association tests as carried out by Jung and Whately Smith (1892–1947). Second, it aims to reconstruct Rogers' earliest theoretical ideas as well as his epistemological assumptions regarding test objectivity, validity and reliability. By drawing on unpublished documents and heretofore overlooked primary sources I show that although Rogers initially drew from Jung and Smith's complex and refined tradition, he ultimately rejected it as well as the tests themselves. At first drawn to Smith's quantitative, empiricist and experimental philosophy of psychology, Rogers was deterred when the data gathered through his own research in 1927 suggested that word association tests had no real, effective clinical value when used in children. By showcasing the complex process of test construction and validation undertaken by 1920s clinical psychologists, Rogers' case illustrates the research practices, the methodological problems and the epistemological dilemmas faced by most if not all of his contemporaries.     

Young handicapped children and their families: Patterns of interaction with human service institutions

The experiences of nine young handicapped children and their families with a variety of human service institutions are discussed. A retrospective account is presented from the parents' perspective of those aspects of their and their children's experience that have had a significant impact on their quality of life. Central among these experiences has been the interpersonal interaction with professionals. The parents' reported experiences regarding identification, the search for assistance, assessment, and their children's receipt of services suggest that there are problems in the areas of locating and acquiring an appropriate combination of services to meet family needs and in the quality of interpersonal relationships between parents and professionals. Recommendations are made to alleviate these and other problems.     

State of Multicultural Neuropsychological Assessment in Children: Current Research Issues

Scientific attention to cultural considerations in child neuropsychological assessment has not developed parallel to the focus these issues have received in adult and elderly neuropsychological assessment. There are limited data on the presence, magnitude, etiology, and implications of culture-related differences in cognitive test performance among children. This preliminary report reviews the available empirical literature on the current state of multicultural neuropsychological assessment in children. The review identified articles by searching PubMed and PsycINFO databases, and the tables of contents of Developmental Neuropsychology and Child Neuropsychology from 2003-2008. Of the 1,834 abstracts reviewed, ten papers met inclusion criteria for the review. Five studies were completed in America; four of these compared performance between ethnic groups while the fifth examined neighborhood level poverty indicators exclusively within African-American children. Of the five international studies, all established local normative data and/or were exploratory investigations of neuropsychological functions in specific cultural groups, including Taiwanese infants, South African youth, and bilingual British children. Taken together, the results yield important clinical and research data that begin to inform many of the complex and fascinating mechanisms by which ethnic identity and culture impact cognitive development and the neuropsychological assessment of children. A critique of the existing literature and directions for future research are provided.     

Subtypes of Psychopathology in Children Referred for Neuropsychological Assessment

The validity of a Personality Inventory for Children-Revised edition (PIC-R) typology was examined in a sample of 323 children aged 6–16 years. These children had been referred to a children's mental health centre for neuropsychological assessment. In study 1, K-means cluster analysis (k = 12) was applied to the PIC clinical scales in an attempt to replicate the 12 clusters identified by Gdowski, Lachar, and Kline (1985). Partial cluster replication was achieved. Examination of the obtained clusters revealed significant overlap, suggesting that fewer clusters would represent an optimal solution. In study 2, a two-stage cluster analysis yielded a seven-cluster solution consistent with several key forms of psychopathology previously reported in the literature using specific neuropsychological populations. Identified subtypes included profiles characterized as: normal, cognitive deficit, cognitive deficit with internalized psychopathology, cognitive deficit with social impairment, cognitive deficit with hyperactivity, cognitive deficit with both internalized and externalized psychopathology, and combined internalized and externalized psychopathology without a cognitive deficit component.     

Neuropsychological sequelae following pediatric stroke: A nonlinear model of age at lesion effects

Aim: The distribution and quality of brain recovery following pediatric arterial ischemic stroke remains controversial. The literature suggests that age at stroke may be an important modulator of neuropsychological outcome, with reports inferring either greater vulnerability or plasticity in the nascent brain. Our aim was to investigate neuropsychological outcomes following pediatric stroke in a clinical sample with reference to age at lesion, lesion laterality, elapsed time from stroke to assessment, and persistent neurological sequelae.

Methods: Using comprehensive neuropsychological assessment batteries, we investigated retrospectively a large (n?=?44) and evenly distributed group of children who had ischemic stroke during “infancy” (1 month to 1 year), “early childhood” (1 to 6 years), and “late childhood” (6 to 16 years).

Results: Children who suffered a stroke performed significantly worse on a range of neuropsychological measures when compared to a normative sample. However, children who suffered a stroke between 1 and 6 years old demonstrated better preserved neuropsychological profiles than either the earlier (before age 1) or later (after age 6) age groups. In addition, those children suffering a left hemisphere lesion performed more poorly on a range of neuropsychological measures than did children with right hemisphere lesions.

Interpretation: Age at stroke is an important determinant of recovery following insult and may modulate neuropsychological and cognitive outcome.     

Repeated assessment of cognition in children and the measurement of performance change.

There is limited understanding of the problems associated with repeated neuropsychological assessment in children, including the statistics used to guide decisions about cognitive change. This study investigated the utility of a computerized assessment battery that was specifically designed for the repeated assessment of cognitive function in children. Eighty-seven participants aged 8 to 12 years completed the battery four times within a 2-hour testing session. The results support the application of this assessment battery for measuring cognitive change in children. A novel method for calculating measurement error is employed, and its use in the detection of cognitive change in individual children is discussed. An estimate of the measurement error within each of the tests is provided, and recommendations are made regarding the application of this assessment battery for measuring cognitive change in children.     

A case of developmental exposure to inorganic mercury

This case report describes behavioral and neuropsychological function in a young man who experienced chronic exposure to elemental mercury at home from age 4 through 9 years. Data are presented on school history, behavior, and performance on standardized tests during the developmental period, and from a full neuropsychological evaluation at age 19 years, several years after environmental exposure had ended. These data specify the course of a decline in function as development proceeds. The patient's progress appeared normal in the preschool period but pronounced academic difficulties and persistent emotional irritability emerged during the elementary school years. At age 19 years, neuropsychological testing revealed diminished executive function, difficulties with language, problems with visuospatial orientation, deficiencies in tine motor control, and manual tremor. Tension, irritability, and depressive affect were evident as well as marked problems with academic performance. These findings suggest widespread cerebral dysfunction, both cortical and subcortical, and are consistent with the diffuse pattern of brain damage seen in children with exposure to heavy metals.     

Legal and psychological implications in the assessment of sexual consent in the cognitively impaired population

The question of competency to consent to sexual activity in the cognitively impaired population continues to be a difficult assessment issue. Problems center on inconsistent legal and clinical criteria, current inadequate methods of psychological assessment, and the need to promote basic human rights, while protecting people from harm. The purpose of this study was twofold. First, the problems inherent in the psychological assessment of competency to consent to sexual activity are discussed with an emphasis on problems defining consent competency. Second, the utility of a neuropsychological test battery in assisting with the assessment of the ability to consent to sexual activity was examined. Findings indicated that executive measures of neuropsychological assessment were primarily associated with competency to consent to sexual activity. It is important that these neuropsychological measures were more accurate in categorizing competent and noncompetent individuals than methods currently in use. This suggests that sexual consent assessments in the forensic arena should include neuropsychological testing and that current methods are insufficient.