Phenotypic profiles of language-impaired children based on genetic/family history

Although etiological influences in developmental language impairment (dysphasia) are not well defined, a significant increase of family aggregation for the disorder has been reported. We report data from a large cohort of language-impaired (LI) children participating in the San Diego longitudinal study in which we examined whether children with or without positive family histories show different phenotypic profiles. Due to the longitudinal design of the study, questions pertaining to change over time are also addressed. Second, a subgroup of the most impaired children were reevaluated to obtain additional information pertaining to family history and phenotypic outcome. Approximately 70% of the LI children met criteria for inclusion as family history positive, with fathers reporting a history of language or learning problems one and a half to two times as frequently as mothers. LI children with or without a positive family history were not significantly different on language skills or IQ. However, subjects having a positive family history for developmental language/learning problems were significantly lower in socioeconomic status and were rated by parents and teachers as having more attention-related behavior problems than their family history negative counterparts. Similarly, family history positive LI children performed more poorly on standardized academic tests as well as on tests of auditory processing and attention.     

Cognitive outcomes of pediatric stroke

A limited number of longitudinal studies have investigated long-term neuropsychological development in the pediatric stroke population. This study retrospectively examines cognitive outcomes in 41 children with a history of stroke, with reference to age at stroke, laterality, region and mechanism of stroke. In the course of recovery, neuropsychological measures of intellectual functioning and memory were administered at two time points, whilst executive functioning, attention and academic skills were administered at one time point. As predicted, children with stroke performed significantly worse compared to normative expectations on all neuropsychological measures. Up to two thirds of children scored in the borderline impaired and impaired ranges on at least one domain of cognition. Performance on intellectual and memory assessment remained relatively stable over time. Younger age at stroke was found to be associated with poorer intellectual functioning. No effects of laterality of stroke on neuropsychological performance over time were found. Children with subcortical stroke demonstrated a greater improvement in immediate memory over time than children with cortical stroke. These findings reveal that children with stroke display long-term cognitive difficulties that typically remain stable over time. Attention and academic skills are particularly vulnerable to impairment. Further evidence that age at stroke is a significant factor in terms of cognitive outcome is provided, in support of the “early vulnerability” position.     

Three-year Trajectories of Emotional Expressiveness among Maltreating Mothers: The Role of Life Changes

Parents are perhaps the most direct and profound influences on children’s development of emotional competence. For example, how and what emotions parents express in the family has implications for children’s ability to understand and regulate their emotions. What is less well understood is what potential environmental or contextual factors impact parents’ emotional expressiveness, particularly in high-risk samples prone to atypical emotional expressiveness (e.g., deficits in the production and recognition of emotional expressions). The present longitudinal study examined the association between life changes and parents’ expression of positive and negative emotions, as well as, how these associations changed over time in a sample of maltreating mothers. Eighty-eight mothers with a substantiated history of physical abuse completed measures of emotional expressiveness and life changes experienced over the past 6 months when their children were in preschool, kindergarten, and first grade. Results indicated that life changes decreased over time, while parental emotional expressiveness remained stable. Moreover, life changes were associated across time with the expression of negative emotions, but were unrelated to expressions of positive emotions. Findings have important implications for understanding emotional expressiveness in high-risk samples.     

Identifying unreliable informants: do children excuse past inaccuracy?

In three experiments (N = 123; 148; 28), children observed a video in which two speakers offered alternative labels for unfamiliar objects. In Experiment 1, 3‐ to 5‐year‐olds endorsed the label given by a speaker who had previously labeled familiar objects accurately, rather than that given by a speaker with a history of inaccurate labeling, even when the inaccurate speaker erred only while blindfolded. In Experiments 2 and 3, 3‐ to 7‐year‐olds showed no preference for the label given by a previously inaccurate but blindfolded speaker, over that given by a second inaccurate speaker with no obvious excuse for erring. Children based their endorsements on speakers’ history of accuracy or inaccuracy irrespective of the speakers’ information access at the time, raising doubts that children made mentalistic interpretations of speakers’ inaccuracy.     

Task experience and children's working memory performance: a perspective from recall timing

Working memory is an important theoretical construct among children, and measures of its capacity predict a range of cognitive skills and abilities. Data from 9- and 11-year-old children illustrate how a chronometric analysis of recall can complement and elaborate recall accuracy in advancing our understanding of working memory. A reading span task was completed by 130 children, 75 of whom were tested on 2 occasions, with sequence length either increasing or decreasing during test administration. Substantial pauses occur during participants' recall sequences, and they represent consistent performance traits over time, while also varying with recall circumstances and task history. Recall pauses help to predict reading and number skills, alongside as well as separate from levels of recall accuracy. The task demands of working memory change as a function of task experience, with a combination of accuracy and response timing in novel task situations being the strongest predictor of cognitive attainment.     

The Relation of Exposure to Traumatic Events and Longitudinal Mental Health Outcomes for Children Enrolled in Systems of Care: Results from a National System of Care Evaluation

This study examined the relation between children's history of exposure to potentially traumatic events (PTEs) and clinical and functional mental health trajectories over a 18‐month period among a national sample of youth referred for services in children's behavioral health systems of care (SOCs). Using data from the national evaluation of the Comprehensive Community Mental Health Services program for communities funded from 1997 to 2000, the study sample included 9556 children and their families. Latent growth modeling was used to assess the effect of history of exposure to PTEs on trajectories in a number of behavioral health outcomes during the 3‐year period following referral to services, controlling for child demographic characteristics (gender, race, and age). Results revealed that, on average, children in SOCs exhibited significant improvements over time on all four outcome measures. Children with a history of exposure to PTEs had higher rates of internalizing and externalizing problem behaviors and functional impairments and fewer behavioral and emotional strengths at baseline, but experienced improvements in these outcomes at the same rates as children without exposure to a traumatic event. Finally, child race, gender, and age also were associated with differences in behavioral health trajectories among service recipients. Implications for SOCs, including approaches to make them more trauma‐informed, are discussed.     

The Effects of Capitation on Outpatient Mental Health Episodes of Children

We analyzed the effects of the Colorado Medicaid Capitation Program on the duration and services of over 21,000 outpatient mental health episodes for young children. The study spanned a three year period before and after capitation was implemented, and compared episodes of outpatient care for children from 14 capitated Community Mental Health Centers (CMHCs) with those from three CMHCs that remained fee-for-service. Proportional hazards regressions revealed that capitation resulted in an increase in outpatient episode duration, over and above similar effects for the comparison fee-for-service episodes. The hypothesis that there were longer capitated episodes for children who were hospitalized was not supported. Children with behavioral and anxiety disorders had longer capitated episodes. Service intensity decreased over time in the managed care sites. Changes in case mix may have had an impact on changes in episode duration and service intensity. That outpatient episode duration increased over time while costs were lowered in the capitated agencies indicates some effects of capitation in changing patterns of care.     

Longitudinal Impact of a Family Critical Time Intervention on Children in High-Risk Families Experiencing Homelessness: A Randomized Trial

A randomized trial compared effects of a Family Critical Time Intervention (FCTI) to usual care for children in 200 newly homeless families in which mothers had diagnosable mental illness or substance problems. Adapted from an evidence‐based practice to prevent chronic homelessness for adults with mental illnesses, FCTI combines housing and structured, time‐limited case management to connect families leaving shelter with community services. Families were followed at five time points over 24 months. Data on 311 children—99 ages 1.5–5 years, 113 ages 6–10 years, and 99 ages 11–16 years—included mother‐, teacher‐, and child‐reports of mental health, school experiences, and psychosocial well‐being. Analyses used hierarchical linear modeling to investigate intervention effects and changes in child functioning over time. Referral to FCTI reduced internalizing and externalizing problems in preschool‐aged children and externalizing for adolescents 11–16. The intervention led to declines in self‐reported school troubles for children 6–10 and 11–16. Both experimental and control children in all age groups showed reductions in symptoms over time. Although experimental results were scattered, they suggest that FCTI has the potential to improve mental health and school outcomes for children experiencing homelessness.     

Pervasive traumatic loss from AIDS in the life of a 4-year-old African boy

It is estimated that, by the end of this century, over five million children under the age of 10 will have lost their mothers as a result of HIV infection. The psychological implications for the children who survive are extensive. These children suffer not only from bereavements and disruption to family life, they also suffer from prevailing anxieties about their own health and the health of their carers. It is the pervasive threat of death which constitutes chronic trauma for child survivors of HIV infection. Confusions abound in fact and in phantasy of where responsibility lies for the tragedies which surround them. Psychotherapeutic treatment for the survivors concentrates on both the cognitive and the emotional aspects of the traumas to enable the child to grieve and to feel appropriate anger for the tragedy in their life. This paper presents a detailed case history of a 4-year-old African boy of refugee parents who were victims of war as well as AIDS. Using a psychoanalytic framework, the child's distorted perceptions of his world are described and his attempts to make sense of his world and keep hope alive in spite of the continual threat of abandonment is demonstrated.     

Working memory outcomes following unilateral arterial ischemic stroke in childhood

There is a dearth of research examining working memory (WM) following pediatric arterial ischemic stroke (AIS). This study assesses the WM patterns of 32 children, aged 6 to 14 years, with a history of unilateral AIS and 32 controls using a paradigm based on Baddeley and Hitch’s multi-component WM model. The results indicate compromised WM in children with AIS relative to controls and parent reports confirm higher rates of dysfunction. Supplementary analyses of impairment confirm higher rates in children with AIS, ranging from 31.25% to 38.70% on performance-based measures and 50.00% on parent reports, compared to 0.00% to 21.88% on performance-based measures in controls and 15.63% on parent reports. Continual follow-up is recommended given that a subset of children with stroke appear to be at risk for WM impairment. Moreover, the subtle nature of WM challenges experienced by many children who have experienced a stroke increases the likelihood that WM impairment could go undetected. The long-term trajectories of WM in the pediatric stroke population remains unknown and future studies are needed to track changes in WM functioning over time.     

Overprotective Parenting: Helping Parents Provide Children the Right Amount of Risk and Responsibility

Overprotective parenting in low-risk environments may have negative consequences for the psychosocial development of children and youth. Though not well studied, a number of different bodies of literature can be used to speculate on the reasons for overprotective parenting and the impact it has on children. In this article, the social and familial dynamics leading to overprotection are discussed. It is shown that overprotection among middle-class families may result from poorly informed parents regarding the psychosocial developmental needs of their children for risk and responsibility and a lack of familiarity with population-wide data which shows that many of today's youth are safer that at any previous time in history. Focusing on the “risk-taker's advantage,” this article uses a case example to illustrate a three-part model of intervention to help challenge overprotective parenting while opening up safe opportunities for youth to experience manageable amounts of risk and responsibility.     

Developing spirituality through the use of literature in history education

This paper demonstrates the significant potential for history teachers to contribute to the development of children’s spirituality through the use of literature within the history curriculum. Using four case studies of history teaching in English comprehensive schools, the paper outlines a holistic approach to the subject – drawing upon art and music as well as literature – to foster children’s capacity for meaning‐making from historical interpretations. The paper argues that history education prepares children for the spiritual by virtue of three elements unique to the subject: First, the subject matter and conceptual content of history provide the context for students to engage with the complexity of questions at the essence of the human condition, establishing a cognitive conflict through which spiritual development is fostered. Second, the subjectivity of historical knowledge allows for the development of a community of ethical enquiry within the classroom through which individuals can explore their own ideas and beliefs as well as those of others. Such enquiry fosters the development of reflexive empathy – the capacity to reflect on one’s own life in the light of understanding the lives of others. Third, the subject provides children with a language through which they can articulate their thoughts, beliefs and feelings. The paper argues that these unique elements are significantly strengthened through the complementary use of literature within history lessons, providing a powerful methodology which fosters children’s spirituality.     

The Family Throughout the Therapeutic Wilderness Process: Our Stories

This article explores the experiences of families that have sent struggling adolescents to therapeutic wilderness programs. We employ a modified case study approach, in which we, the participants, are also observers of the experiences of our entire families. The article begins by explaining what wilderness therapy is and offering an overview of research that has examined the effectiveness of therapeutic wilderness programs. We delineate the process of seeking, selecting and participating in wilderness therapy as well as the role of an educational consultant in facilitating this. We describe our experiences from (1) the time we realized and accepted that our children were struggling and suffering to (2) considering sending our children to wilderness therapy to (3) the stresses of the decision making process to (4) what the experience was like for us including participating in a parent workshop to (5) planning the next steps and discharge, and finally to (6) seeing and living the results over the next few years. Areas of growth and struggle are noted. Our children’s perspectives on our families’ development over time and the interactions among us are also discussed.     

Children’s Affect Expression and Frontal EEG Asymmetry: Transactional Associations with Mothers’ Depressive Symptoms

Although parents and children are thought to influence one another's affect and behavior, few studies have examined the direction of effects from children to parents, particularly with respect to parental psychopathology. We tested the hypothesis that children's affective characteristics are associated with the course of mothers' depressive symptoms. Children's affect expression was observed during a series of mother-child interaction tasks, and children's resting frontal electroencephalogram (EEG) asymmetry was assessed in a psychophysiology laboratory. Mothers' depressive symptoms were assessed at two time points, approximately one year apart, at the mother-child interaction visits. Depressive symptoms increased over time for mothers with a history of childhood-onset depression whose children exhibited right frontal EEG asymmetry. Depressive symptoms were associated with high child negative affect at both time points for mothers whose children exhibited right frontal EEG asymmetry. Cross-lagged models with a subset of participants provided some evidence of both parent-to-child and child-to-parent directions of effects. Findings suggest that akin to other interpersonal stressors, children's affective characteristics may contribute to maternal depressive symptoms.     

Brooding Rumination and Risk for Depressive Disorders in Children of Depressed Mothers

The goal of the current study was to examine the role of brooding rumination in children at risk for depression. We found that children of mothers with a history of major depression exhibited higher levels of brooding rumination than did children of mothers with no depression history. Examining potential mechanisms of this risk, we found no evidence for shared genetic influences (BDNF or 5-HTTLPR) or modeling of mothers’ rumination. However, we did find that children with a history of prior depressive disorders exhibited higher current levels of brooding rumination than children with no depression history. Importantly, children’s brooding predicted prospective onsets of new depressive episodes over a 20-month follow-up even when we statistically controlled for depressive symptom levels at the initial assessment, suggesting that the predictive effect of brooding rumination in children was not due simply to co-occurring depressive symptoms.     

Is knowledge of family history related to psychosocial functioning? Comparison of adolescents living in institutional care and adolescents living with their biological families

We tested adolescents growing up in institutional care and adolescents living with their birth families using the ‘Do you know?’ scale and other measures of psychosocial functioning. We found that children living in group homes knew significantly less of their family history, exhibited more behavioural problems and had a more external locus of control. Moreover, the correlations between self-esteem and knowledge of family history were significantly different between the groups. This may suggest that the contribution of the knowledge of family history to self-esteem is different depending on the quality of family history. We also found a significant correlation between locus of control and behavioural problems for the children in institutional care, but not children living with their birth families, which may indicate that their behavioural problems may partially stem from the sense of lack of control over their lives.     

Behavior modification of aggressive behavior on a nursery school bus: A case study

A case study is presented in which aggressive behavior of two preschool boys on a nursery school bus was modified by the introduction of a negative punishment contingency in which the Ss were told they would be detained on the bus until the second time the bus passed their house (delay of reinforcement) if abusive behavior occurred. The practical implications of the study and the relative merits of choosing negative punishment over positive punishment as therapy with children are discussed.     

Rrepresentations of trauma in infancy: Clinical and theoretical implications for the understanding of early memory

Understanding the nature of the infant's internal experience is a crucial prerequisite for delineating the developmental effects of an early trauma. In addition, to the extent that internal representations of a trauma can be traced over time, traumatic experiences present unique opportunities for the study of early memory. This article will describe case vignettes of children who experienced a trauma in the preverbal period and who evidenced forms of memory of their trauma at subsequent points in time. In conjunction with the clinical material, developmental research bearing on the types of early memories described will be discussed. The clinical data, reinforced by research findings, indicate that preverbal children, even in the first year of life, can establish and retain some form of internal representation of a traumatic event over significant periods of time. The specificity and enduring nature of the internal representations suggest that specific therapeutic interventions over and above general comforting will be required if an infant is to maximally recover from a trauma. The clinical findings have relevance for a number of issues currently under debate in the area of infant memory, including the role of reminders in memory retention, the nature of early memory systems, and the development of autobiographical memory. ©2002 Michigan Association for Infant Mental Health.     

Carrot-Eaters and Creature-Believers: The Effects of Lexicalization on Children's Inferences About SocialCategories

This article examines how language affects children's inferences about novel social categories. We hypothesized that lexicalization (using a noun label to refer to someone who possesses a certain property) would influence children's inferences about other people. Specifically, we hypothesized that when a property is lexicalized, it is thought to be more stable over time and over contexts. One hundred fifteen children (5- and 7-year-olds) learned about a characteristic of a hypothetical person (e.g., "Rose eats a lot of carrots"). Half the children were told a noun label for each character (e.g., "She is a carrot-eater"), whereas half heard a verbal predicate (e.g., "She eats carrots whenever she can"). The children judged characteristics as significantly more stable over time and over contexts when the characteristics were referred to by a noun than when they were referred to by a verbal predicate. Lexicalization (in the form of a noun) provides important information to children regarding the stability of personal characteristics.     

The Familial Context of Creativity: Patterns of Nurturance in Families of Creative Children

This article presents the results of a longitudinal research study undertaken to understand the familial context of creative children. The objective was to identify commonalities and specifics in patterns of nurturance present in the home environments of creative children. The participants, identified using intensity sampling, comprised four children in the age group three to 16 years at the time of selection, who had received public recognition for their creative pursuits; their families, and each child’s guru/coach. Qualitative semi-structured interviews and naturalistic observations were used to understand the dynamic nature of the relationships within the family setting that led to the discovery of the child’s creativity and its subsequent nurturance. Detailed case profiles were developed over a three year period. The case profiles reflected commonalities in the basic processes of nurturance. All the families were cohesive, with the members sharing a commonality of purposes. Parents actively fostered their children’s creativity by allocating resources—money, time and effort; introducing the child to the domain and the field; being closely involved in the learning process; and expressing praise. The uniqueness of the cases lay in the specifics – in the quality of cultural capital available to the families, in the parents’ experiences as children which were the motivational source for parenting. The key feature in nurturance was the synchronicity of purpose created by strong parental motivation to nurture their child’s creativity and the strong internal motivation of the child to persevere in the creative domain.