Neurodevelopmental Disorders Across the Lifespan: A Neuroconstructivist Approach.

Objectives. To investigate neuropsychological and neurobehavioral outcome in children with arterial ischemic stroke (AIS).

Background. Childhood stroke can have consequences on motor, cognitive, and behavioral development. We present a cross-sectional study of neuropsychological and neurobehavioral outcome at least one year poststroke in a uniquely homogeneous sample of children who had experienced AIS.

Method. Forty-nine children with AIS aged 6 to 18 years were recruited from a specialist clinic. Neuropsychological measures of intelligence, reading comprehension, attention, and executive function were administered. A triangulation of data collection included questionnaires completed by the children, their parents, and teachers, rating behavior, executive functions, and emotions.

Key Findings. Focal neuropsychological vulnerabilities in attention (response inhibition and dual attention) and executive function were found, beyond general intellectual functioning, irrespective of hemispheric side of stroke. Difficulties with emotional and behavioral regulation were also found. Consistent with an “early plasticity” hypothesis, earlier age of stroke was associated with better performance on measures of executive function.

Conclusions. A significant proportion of children poststroke are at long-term risk of difficulties with emotional regulation, executive function, and attention. Data also suggest that executive functions are represented in widespread networks in the developing brain and are vulnerable to unilateral injury.     

Repetitive Behavior in Neurodevelopmental Disorders: Clinical and Translational Findings

Repetitive behavior refers to a highly heterogeneous set of responses associated with a wide range of conditions, including normative development. Treatment studies for aberrant repetitive behavior are limited although one promising approach involves conceptualizing such behavior as a generalized inflexibility or lack of variability in responding. Relatively little is known about the neurobiological mechanisms that mediate the development and expression of repetitive behavior, information critical to the design of effective pharmacotherapies, early interventions, and prevention strategies. We will review clinical findings in repetitive behavior as well as findings from animal models highlighting environmental factors and the role of cortical-basal ganglia circuitry in mediating the development and expression of these behaviors. Findings from animal models have included identification of a specific neural pathway important in mediating repetitive behavior. Moreover, pharmacological studies that support the importance of this pathway have led to the identification of novel potential therapeutic targets. Expanding the evidence base for environmental enrichment-derived interventions and focusing on generalized variability in responding will aid in addressing the broader problem of rigidity or inflexibility.     

Employment Counselor Training and Professional Issues in the United States

Employment counseling as practiced during the past 30 years in the United States Employment Service (now Job Service) is discussed, including (a) the historical forces that affected employment counseling, (b) their consequences over this period of time, and (c) employment counseling training initiatives. The Competency-Based Employment Counselor Training Model is described, and more recent training initiatives are identified. The counselor credentialing process (particularly certification and licensure) is examined.     

A Review of Occupation-Based Life Skills Interventions for Adults with Neurodevelopmental Disorders

Adults with neurodevelopmental disorders are at a higher risk for poverty, unemployment, and difficulties in relationships. Instrumental activities of daily living deficits often go unaddressed and minimal research has explored interventions to address them. The purpose of this study was to synthesize findings about occupation-based life skills interventions for adults with neurodevelopmental disorders. Ten articles met inclusion criteria and the American Occupational Therapy Association level of evidence and quality ratings were identified. Results indicate that occupation-based life skills interventions effectively address limitations experienced by adults with neurodevelopmental disorders but the overall quantity and quality of evidence-based interventions are lacking.     

Developmental Instability and Individual Variation in Brain Development: Implications for the Origin of Neurodevelopmental Disorders

ABSTRACT— Research on the origin of neurodevelopmental disorders has traditionally been pursued within a constrained, disorder-specific perspective. The developmental instability (DI) model described here offers a broader approach based on the evolutionary genetics of normal variation, reflecting our understanding that the processes generating genetic diversity are not unique to any specific disorder. The DI model helps account for shared features, including atypical functional and anatomic asymmetries, reduced general intellectual functioning, and complex patterns of heritability, across different types of neural variation. The model suggests research strategies that may help illuminate the specific and unique causal factors characterizing different types of neural variation.     

Counselor Professional Identity: Findings and Implications for Counseling and Interprofessional Collaboration

This exploratory, qualitative study examined the professional identity of 238 practicing counselors and how they perceived counseling as distinct from psychology and social work. Participants' professional identities seemed to be grounded in a developmental, prevention, and wellness orientation toward helping. Participants also seemed to embrace a unified professional identity. Psychology was perceived as emphasizing testing and social work as focusing on systemic issues. Findings and implications for the counseling profession and interprofessional collaboration are discussed.     

Screening HIV-Infected Patients with Chronic Pain for Anxiety and Mood Disorders with the Beck Anxiety and Depression Inventory-Fast Screens for Medical Settings

The Beck Anxiety (BAI-FS) and Depression (BDI-FS) Inventory-Fast Screens for Medical Settings were administered to 63 HIV-infected outpatients seeking treatment at a chronic pain clinic to evaluate how effectively these 7-item instruments would, respectively, differentiate those who were and were not diagnosed with DSM-IV anxiety, mood, or both disorders. The Anxiety and Mood Modules from the Primary Care Evaluation of Mental Disorders (PRIME-MD) were employed to establish the diagnoses. The coefficient 's for the BAI- and BDI-FS were, respectively, .80 and .84. A BAI-FS cut-off score of 4 and above yielded 82% sensitivity and 59% specificity rates for identifying patients with and without anxiety disorders, whereas a BDI-FS cut-off score of 4 and above had 90% sensitivity and 74% specificity rates for detecting patients with and without mood disorders. It was concluded that the BDI-FS was a useful instrument for screening HIV-infected patients with chronic pain for mood disorders.     

Intrinsic And Extrinsic Motivation and Attitudes Toward Professional Continuing Education: Implications for the Counselor

The purpose of this study was to investigate intrinsic and extrinsic motivation of individuals enrolled in a continuing education program. The types of couseling strategies and programs to help workers increase their self-confidence are discussed.     

A Discriminant Analysis of Gender and Counselor Professional Identity Development

This quantitative study examined professional identity development and orientation for 489 counseling practitioners, educators, and trainees as predicted by participant‐identified sex and engagement in professional activities. Differences between male and female participants regarding aspects of professional identity were evaluated. Discriminant analysis results indicate sex differences in professional identity development. Additional regression analysis revealed a significant predictive relationship between professional engagement and professional identity orientation and development.     

An Abbreviated Screening Instrument for Autism Spectrum Disorders

The reliability and validity of the Parent's Observations of Social Interactions (POSI), a new, seven‐item screening instrument for autism spectrum disorders (ASD), is examined in two substudies. In Study 1, parents of 217 children (18–48 months) evaluated at a developmental clinic completed intake questionnaires that included the POSI and the Modified Checklist for Autism in Toddlers (M‐CHAT) checklist. POSI and M‐CHAT scores were compared to clinical evaluation results to assess reliability and validity. In Study 2, parents of 232 children (16–36 months) from both primary care and subspecialty settings completed the POSI, the M‐CHAT, and a report of their child's diagnoses. POSI and M‐CHAT scores were compared to reported diagnoses to assess reliability and validity. In both studies, the POSI demonstrated adequate internal reliability (Cronbach α = 0.83 and 0.86, respectively). In Study 1, POSI sensitivity (89%) was higher than that for the M‐CHAT (71%; p < .05); specificities were not significantly different (POSI: 54%, M‐CHAT: 62%). In Study 2, sensitivity (83%) compared favorably to that for the M‐CHAT (50%), although specificity was lower (75 vs. 84%). Despite its brevity, the POSI demonstrated good internal reliability and comparable sensitivity/specificity to the M‐CHAT checklist in two independent populations. If results are reproduced in larger, more diverse samples, the POSI may provide an efficient method for ASD screening in young children.     

Perceived Impact of Professional Counselor Identity: An Exploratory Study

Counselor educators (N= 378) provided their viewpoints regarding the impact of counselor identity on professional advancement and recognition. Respondents indicated that counselors, the American Counseling Association, and other counseling organizations are responsible for advocacy of the counseling profession. Collaboration among counselors for the development of a single coherent message is necessary for advocacy efforts aimed at congressional Medicare leaders, managed care organizations, state licensing boards, and allied professions.     

Assessment and Diagnosis of Eating Disorders: A Guide for Professional Counselors

Despite the prevalence of and risk associated with disordered eating, there are few guidelines for counselors on how to conduct an eating disorder assessment. Given the importance of the clinical interview, the purpose of this article is to provide recommendations for the assessment and diagnosis of eating disorders that (a) specifically focus on assessment in the context of a clinical interview and (b) can be used by counselors whether or not they specialize in eating disorder treatment.     

Addiction Topics in Counselor Educator Professional Development: A Content Analysis

Counselor educators prepare master's‐level counselors‐in‐training on addiction topics. This content analysis examined the frequency and types of addiction topics for counselor educator continuing education. The results revealed limited attention to addiction topics within professional literature and conference presentations.