Collateral effects of behavioral parent training on families of children with developmental disabilities and behavior disorders

We evaluated collateral effects of behavioral parent training (BPT) on families with children who have developmental disabilities and behavior disorders. We compared 18 BPT graduates to 18 similar families waiting for service. The BPT graduates reported significantly less (i) child behavior problems, (ii) disruption to child and family quality of life due to child problem behavior, and (iii) stress related to limits on family opportunities and child physical limitations, up to 5 years after discharge. On a self‐efficacy scale, the graduates reported being more effective child behavior change agents in not only stopping child problem behavior, but also in preventing new occurrences and teaching the child appropriate behavior. These results suggest that BPT has persistent beneficial effects on children and parents. The findings reflect the program's focus on teaching parents how to use functional assessment derived positive teaching strategies to replace child problem behavior. Copyright © 2002 John Wiley & Sons, Ltd.     

Social competence as a developmental construct

The concept of social competence presents problems for conceptualization and assessment. At times researchers have tried to circumvent these problems by defining competence in terms of specific capacities or skills, with the consequence that the integrative potential of the concept is lost. On the other hand, more molar definitions (e.g., “effectiveness”), while being true to the integrative nature of the construct, provide little guidance for assessment. In this paper a developmental perspective on competence is presented which is congruent with a molar definition of competence while still guiding assessment efforts. In addition to this developmental viewpoint, certain practical guidelines are presented for assessment of competence across ages. These include the use of broadband assessments, which are tied to real-life adaptational problems, call for the coordination of affect, cognition, and behavior, and tax the integrative capacities of the child. Initial validation of the developmental competence construct and this approach to assessment is presented.     

A methodology for assessing the functions of emerging speech in children with developmental disabilities

An approach based on Skinner's (1957) theory of verbal behavior has been developed to understand and teach elementary communication skills to children with autism and developmental disabilities (Sundberg & Partington, 1998). However, few studies have directly examined the characteristics of emerging language in children with developmental disabilities. The purpose of this study was to develop and evaluate an assessment for identifying the elementary functions of vocal speech in children. Participants were 4 children with developmental disabilities, aged 6 years to 12 years, who exhibited at least one distinguishable vocal response (word or phrase) frequently in the natural environment. The assessment focused on three verbal operants delineated by Skinner (mand, tact, and intraverbal). One or more functions were identified for at least one vocal response of each child. Results suggested that this assessment would be useful for (a) evaluating Skinner's theory, (b) guiding decisions about language training for individual children, and (c) studying the nature of expressive language development in children with developmental disabilities.     

Developmental theory and the practice of clinical child psychology

Examined developmental theory and its relevance for the practice of clinical child psychology. Following a brief review of basic principles of developmental psychology and developmental psychopathology, implications of a developmental perspective are explored for the diagnosis, assessment, and treatment of childhood disorders. Although it is obvious that many developmental issues confront the clinical child psychologist and that we have learned much about translating developmental theory into clinical practice, we conclude we have a long way to go before we can assert that a true developmental-clinical child interface has been realized.     

Ethics in Case Conceptualization and Diagnosis: Incorporating a Medical Model Into the Developmental Counseling Tradition

In this literature review, the author focuses on several ethical considerations in case conceptualization and diagnosis, including diagnostic training and competence. Meeting the American Counseling Association's (1995) ethical standard for diagnostic training has several ethical implications for counselors, counselor educators, and supervisors. For counselors who might struggle with how to meet their ethical responsibilities in diagnosis but who want to remain true to their developmental counseling emphases, the author discusses some of their concerns, the implications of and possible approaches to this aspect of their work. Conclusion Yalom (2002) asked a poignant question of counselors in his book, The Gift of Therapy: “If you were in personal psychotherapy or are considering it, what DSM‐IV diagnosis do you think your therapist could justifiably use to describe someone as complicated as you?” (p. 5). This question and continued dialogue about the ethics and implications of diagnosis are essential aspects of diagnostic training. Yalom's poignant and deeply personal question seems especially appropriate for increasing a counselor's empathy toward the client's sensitivity and vulnerability during the diagnostic process. Counselor educators might ask how one remains true to a developmental model of counseling while adhering to the ethical and accreditation standards of teaching the DSM's medical model of diagnosis. Counselors may also question how to use diagnosis ethically and empathically. Seligman (1999) recommended that clinicians view the DSM as one of many important sources of information about a person. Furthermore, counselors should seek to incorporate diagnostic information into a holistic context, recognizing that a diagnosis does not reflect the totality of the client. Some counselor educators have advised students to integrate the DSM model into their work with clients rather than abandoning their developmental roots (Waldo et al., 1993). Some counselors may not actually put their diagnoses in writing; Seligman believed, however, that thinking diagnostically may assist counselors in determining the best approaches to help clients and to help clients help themselves. This clinical and ethical debate about how, and in fact, whether, to integrate the medical model of the DSM and the developmental origins and distinctiveness of counseling continues. However, the CACREP (2001) standards, managed care systems, and other forces have pushed counseling professionals toward a medical model by mandating counselor knowledge and use of the DSM. Whatever a counselor's stance and behavior on client assessment and diagnosis may be, the literature presented in this review and discussion seems to suggest a need for heightened sensitivity to, preparation for, and accuracy in all facets of client assessment, especially diagnosis.     

Understanding teachers' perceptions of the motor difficulties of children with developmental coordination disorder (DCD)

Background. Children with developmental coordination disorder (DCD) are often identified by classroom teachers and the identification process relies heavily on teachers' perceptions. The literature would suggest that teachers' perceptions may be influenced by a child's gender, behaviour and the type of motor problem they demonstrate. To date, the influence of these factors on teachers' perceptions of children with DCD has not been empirically tested. Aim. This study investigated whether child gender, behaviour and type of motor problem influenced teachers' ratings of concern and importance of intervening for children with motor difficulties. Sample. One hundred and forty‐seven teachers of children from 6 to 9 years of age participated in this study. Method. Hypothetical case scenarios were developed that experimentally manipulated the factors of child gender (male/female), behaviour (disruptive/non‐disruptive) and type of motor problem (fine motor/gross motor). Teachers were given two case scenarios of the same gender (that varied by behaviour) and rated: (a) their degree of concern about children's motor problems and (b) how important they thought it was for the child to receive intervention for that problem. Results. The effect of child gender on teachers' perceptions depends upon the type of motor problem. While child behaviour had a marginal influence on teachers' perceptions, interestingly, teachers appeared to recognize motor problems only in the absence of disruptive behaviour. The type of motor problem demonstrated also influenced teachers' perceptions. Conclusion. This study provides preliminary insight into factors that influence teachers' perceptions of children with DCD with clear implications for the classroom identification of children with DCD.     

Assessment as Intervention: A Pilot Study of Short-Term Dyadic Treatment

Assessment, as an intervention, is a hallmark of infant mental health that has not been evaluated for treatment effectiveness. A comprehensive assessment framework was standardized as a short-term intervention model and evaluated for treatment effects based on dynamic systems theory of change. The transdisciplinary interaction-based assessment model embeds nondidactic developmental guidance interpretations in the context of eliciting child functional capacities while engaging the caregiver in direct co-observation and reflection to challenge inflexibility in parents’ representations. The findings of this pilot project, with a community sample of Spanish- and English-speaking families, suggest this assessment as intervention model has the potential to promote an active process of change in parents’ representations toward a “disorderly,” or unstable state, possibly both in perceptions of self as caregiver and in representations of the child. Clinically, this disorderly state would be seen as an opportunity that could perpetuate the change process, recognizing disorderliness of representation as an opening, as emerging permeability of representations. Results indicate that this caregiver-clinician collaborative process is associated with caregiver reports of decreased distress, increased empathy for child’s difficulties, and changes in caregiver representations. A subset of families, caregivers who hold immutable views of their children, are less responsive to the developmental guidance approach and may require different or more long-term treatment.     

Executive function and developmental disorders: the flip side of the coin

Several common developmental disorders emerge during early to middle childhood (e.g. autism, attention deficit and hyperactivity disorder) and are associated with impairments in executive function (EF). Contrary to the prevailing view, I suggest that, within populations at-risk, the association with EF is found because individuals with strong EF skills are better able to compensate for atypicalities in other brain systems early in life, and are therefore less likely to receive a diagnosis later in life. I discuss evidence consistent with this view from considerations of individual variability, neuroimaging, and genetics. To the extent that this view is correct, it offers hope for remediation of some later emerging symptoms, as evidence from typical groups indicates that training programs for EF in preschoolers may be effective in improving skills.     

Review of a Parent’s Influence on Pediatric Procedural Distress and Recovery

Understanding how parents influence their child’s medical procedures can inform future work to reduce pediatric procedural distress and improve recovery outcomes. Following a pediatric injury or illness diagnosis, the associated medical procedures can be potentially traumatic events that are often painful and distressing and can lead to the child experiencing long-term physical and psychological problems. Children under 6 years old are particularly at risk of illness or injury, yet their pain-related distress during medical procedures is often difficult to manage because of their young developmental level. Parents can also experience ongoing psychological distress following a child’s injury or illness diagnosis. The parent and parenting behavior is one of many risk factors for increased pediatric procedural distress. The impact of parents on pediatric procedural distress is an important yet not well-understood phenomenon. There is some evidence to indicate parents influence their child through their own psychological distress and through parenting behavior. This paper has three purposes: (1) review current empirical research on parent-related risk factors for distressing pediatric medical procedures, and longer-term recovery outcomes; (2) consider and develop existing theories to present a new model for understanding the parent–child distress relationship during medical procedures; and (3) review and make recommendations regarding current assessment tools and developing parenting behavior interventions for reducing pediatric procedural distress.     

Distributed learning: Educating and assessing extended cognitive systems

Extended and distributed cognition theories argue that human cognitive systems sometimes include non-biological objects. On these views, the physical supervenience base of cognitive systems is thus not the biological brain or even the embodied organism, but an organism-plus-artifacts. In this paper, we provide a novel account of the implications of these views for learning, education, and assessment. We start by conceptualizing how we learn to assemble extended cognitive systems by internalizing cultural norms and practices. Having a better grip on how extended cognitive systems are assembled, we focus on the question: If our cognition extends, how should we educate and assess such extended cognitive systems? We suggest various ways to minimize possible negative effects of extending one’s cognition and to efficiently find and organize (online) information by adopting a virtue epistemology approach. Educational and assessment implications are foregrounded, particularly in the case of Danish students’ use of the internet during exams.     

SIDDS: Simulations in developmental disabilities

SIDDS, or simulations in developmental disabilities, is a computer system that provides students with the opportunity to acquire and practice skills in behavioral psychology. During the simulation, the student assumes the role of a psychologist whose professional duties involve the assessment and treatment of the severe problem behavior displayed by a child with a developmental handicap. Following an introduction to the use of the program, SIDDS guides the student/clinician through a series of steps involved in reducing a behavior problem. With the goal of eliminating the client’s behavior problem, the student/clinician proceeds through referral, problem identification, assessment, functional hypothesis, and treatment stages. This article describes the content and structure of SIDDS and provides a glimpse of what future developments of this system will entail.     

Counterfactually mediated emotions: a developmental study of regret and relief in a probabilistic gambling task

Regret and relief are related to counterfactual thinking and rely on comparison processes between what has been and what might have been. In this article, we study the development of regret and relief from late childhood to adulthood (11.2-20.2 years), and we examine how these two emotions affect individuals' willingness to retrospectively reconsider their choice in a computerized monetary gambling task. We asked participants to choose between two "wheels of fortune" that differed in the amount of gain and loss expected and the probability of winning. We manipulated the outcome of the wheel of fortune that was not selected by participants to induce regret or relief. For each trial, participants rated how they felt about the outcome and their willingness to modify their choice. Participants' ratings suggest that regret and relief are stronger in adults than in children and adolescents. Regret affects participants' willingness to modify their initial choice, but this desire is stronger for adults than for children. In children, the experience of regret seems to be dissociated from the willingness to reconsider a choice. This study provides the first evidence that the ability to experience counterfactually mediated emotions, such as regret and relief, and the ability to take them into consideration continue to develop during late childhood and adolescence.     

The dynamic lift of developmental process

What are the essential properties of human intelligence, currently unparalleled in its power relative to other biological forms and relative to artificial forms of intelligence? We suggest that answering this question depends critically on understanding developmental process. This paper considers three principles potentially essential to building human‐like intelligence: the heterogeneity of the component processes, the embedding of development in a social world, and developmental processes that change the cognitive system as a function of the history of soft‐assemblies of these heterogeneous processes in specific tasks. The paper uses examples from human development and from developmental robotics to show how these processes also may underlie biological intelligence and enable us to generate more advanced forms of artificial intelligence.     

Why specific developmental disorders are not specific: On-line and developmental effects in autism and dyslexia

In this paper we will suggest that impairments in domain-specific functions may have wide-ranging developmental effects which mimic domain-general impairments. This may explain why ‘pure’ cases of developmental disorders are rare. The understanding of autism and dyslexia has been advanced by theories postulating failure of a specific mechanism against a background of unimpaired general processing. Impairment in the mechanisms underlying ‘theory of mind’ in autism, and ‘phonology’ in dyslexia, predict and explain the pattern of poor and good performance on a range of experimental and real-life tasks. However, existing accounts deal largely with the on-line effects of modular deficits, and can be criticised as not truly developmental. Here we attempt to trace developmental or down-stream effects of specific impairments in mentalising and phonological processing. We argue that these modules act as vital gatekeepers in development. Important in this process is the interaction of cognition with socio-cultural environment, an effect well-illustrated by cross-language differences in dyslexia. We claim that consideration of these developmental effects makes clear why postulating specific impairments may be sufficient for explaining more general deficits.     

Functional magnetic resonance imaging: basic principles of and application to developmental science

Functional magnetic resonance imaging (fMRI) has quickly become the preferred technique for imaging normal brain activity, especially in the typically developing child. This technique takes advantage of specific magnetic properties and physiological processes to generate images of brain activity. These images can be interpreted as a function of group or individual based differences to explore developmental patterns and/or cognitive abilities. In this paper we present an overview of the basic principles of fMRI and a discussion of what is currently known about the physiological bases of the resulting signal. We also report findings from developmental fMRI studies that examine the development of cognitive and neural systems underlying attention and memory. Behavioral performance and age‐related neural changes are examined independently in an attempt to disentangle developmental differences from individual variability in performance.     

Incorporating a developmental perspective in doctoral training: survey of clinical child psychology training programs and introduction to the special section

Examined the degree to which clinical child programs incorporate and integrate developmental theory into their training, and introduced the contributions of 6 leaders in the field to this special section. Fifty-one clinical child doctoral programs responded to the survey. Results indicate that 3 types of training programs are operating: (a) child emphasis (n = 7), which do not have a formal clinical child training program but do have a faculty member who has child research interests; (b) clinical child (n = 37), which have a group of faculty members with specific child research and clinical interests and a formalized program of study; and (c) developmental-clinical programs (n = 7), which are similar to clinical child programs but require a substantive amount of developmental psychology course work and endorse a developmental psychopathology perspective. Findings reveal that clinical child programs have become increasingly differentiated and specialized over the past 20 years, but, with the exception of developmental-clinical programs, most programs are still neglecting to incorporate developmental theory into training. This issue, as well as concerns about the future direction of clinical child doctoral training is addressed in this special section on the Importance of Incorporating Developmental Theory Into Clinical Child Training.     

Women's mental health during pregnancy influences fetal and infant developmental and health outcomes

Women's mental health during pregnancy has important implications not only for the well-being of the mother, but also for the development, health, and well-being of her unborn child. A growing body of empirical evidence from population-based studies suggests that two indicators of women's mental health during pregnancy--psychosocial stress and social support--may exert a significant influence on fetal development and infant birth outcomes, such as birth weight and length of gestation, even after controlling for the effects of established sociodemographic, obstetric, and behavioral risk factors. This paper describes the role of three major biological systems involved in the physiology of pregnancy and stress physiology: neuroendocrine, immune/inflammatory, and cardiovascular systems. These systems have been hypothesized to mediate the effects of maternal mental health on fetal developmental and health outcomes, and a central role has been proposed for placental corticotropin-releasing hormone in this process. However, not all women reporting high prenatal stress and/or low social support proceed to develop adverse birth outcomes, raising the question of the determinants of susceptibility/vulnerability in the context of high stress and/or low social support. In this context, the role of race/ethnicity and genetic predisposition are discussed as two promising avenues of further investigation.     

Psychodynamic counselling with parents of children with developmental disabilities

A joint treatment of parents and child can be the treatment of choice when dealing with developmental disabilities. In our clinical experience, we have observed that psychoanalytically oriented support (developmental guidance), which involves the child and the parents together, answers the needs and addresses the difficult dynamics that are characteristic of developmental disabilities.     

The psychoanalytic process: the developmental and the integrative

Psychoanalysis is a treatment that focuses on intrapsychic events and activates integrative tendencies to promote-insights. Almost from the time it originated, however, it was also promoted as a therapy informed by the interpersonal, inducing change through experiences generated within the psychoanalytic situation. In recent years the interpersonal or object relations approach has come to be categorized as "developmental," a term that fosters no end of ambiguities. The resulting confusion compromises the study of the actual developmental process on the one hand and the structure-enhancing features of transactions on the other. This encumbers research on the psychoanalytic process. The author distinguishes the intrapsychic from the interpersonal, the integrative from the developmental, and the two very different realms of psychological activities currently advanced as "developmental."