A Playroom Observation Procedure to Assess Children with Mental Retardation and ADHD

Forty-two children (ages 6 to 12 years old) with moderate mental retardation to borderline intellectual functioning were studied in a laboratory playroom setting to determine whether children identified as ADHD (attention deficit hyperactivity disorder) or controls differed on activity and attentional measures. Children with ADHD were further divided into ADHD + conduct problems (ADHD + CD) and ADHD-only subgroups (with an ADHD-combined group comprising children of both subgroups). An interval recording system was used to code observations of independent play and a restricted academic task. Results indicated that the ADHD-combined group was significantly more vocal and engaged in a significantly greater number of toy changes than controls during independent play. Significant group differences were also noted during the restricted academic task, with the ADHD-combined and ADHD + CD groups more off-task and engaging in a greater number of toy touches than controls. Discriminant analyses found independent play measures to predict group membership in 70 percent of cases (ADHD-combined vs. controls), but in only 64 percent of cases using measures from the restricted academic task. No significant findings resulted when the ADHD subjects were further divided into two subgroups. Despite some inconsistent findings, such laboratory-based observations may be of value in the diagnosis of ADHD in children with moderate mental retardation to borderline intellectual functioning.     

轻度智力落后学生心理健康问题的研究

本研究使用心理健康诊断测验(MHT)手册对10-16岁(四至九年级)的轻度智力落后学生与智力正常学生间的心理健康水平进行比较研究,结果发现：轻度智力落后学生有不同程度的心理健康问题,随班就读轻度智力落后学生的心理健康问题尤为突出．有待相应有效的教育支持。     

Impulsive Responses In Children with Conduct Disorder and Borderline Intellectual Functioning

The study is designed to investigate response inhibition in children with conduct disorder and borderline intellectual functioning. To this end, children are compared to a normal peer control group using the Alertness test. The test has two conditions. In one condition, children are instructed to push a response button after a visual “go” signal is presented on the screen. In a second condition the “go” signal is preceded by an auditory signal, telling the child that a target stimulus will occur soon. Compared to the control group, the group carrying the dual diagnosis made many preliminary responses (responses before the presentation of the “go” signal), especially in the condition with an auditory signal. This impulsive response style was controlled for attention deficit/hyperactivity disorder characteristics of the children.     

智力落后儿童适应行为发展特点的研究

本研究用儿童适应行为评定量表对4～12岁中、轻度智力落后儿童适应行为发展特点进行探讨,结果发现：他们的适应行为与智力有显著性相关;智力落后儿童适应行为发展落后,其中认知技能发展严重滞后是一个重要原因,但他们的适应行为仍有着相当的发展潜力。     

Behavioral Microanalysis of Helping Interactions Between Mothers and Adult Children with Mental Retardation

Although direct observation has provided much information regarding caregiver-care recipient interactions, our understanding of the applications of this technique remains incomplete. This study expands upon earlier observational work by examining adults with mental retardation (MR) and their family caregivers in the home setting. Specialized computer software was used to conduct real-time observation and recording of interactional styles of maternal caregivers of eight younger (M = 23 years old) and eight older (M = 49 years old) MR adults during two cognitive tasks: block design and card sorting. Differences in the amount and type of assistance provided by the caregiver were examined by coding the occurrence and duration of seven interactional behaviors. The results demonstrated that the caregivers of the younger adults used more positive statements and modeling/gestural prompts, whereas the caregivers of the older adults provided more physical assistance and performed more of the tasks themselves. More importantly, this project provided information regarding interactions between MR adults and their maternal caregivers and demonstrated the utility of computer-assisted data collection technology with a community-based, nondemented population.     

轻度弱智儿童工作记忆、加工速度的实验研究

选取轻度弱智、一般智力以及智力优秀三组共288名小学生作为被试,每个被试接受三种测验,即工作记忆测验、加工速度测验、韦氏儿童智力测验中国修订版,以考察轻度弱智儿童群体在与工作记忆和加工速度相关的认知任务上的反应特征,以及轻度弱智儿童与一般儿童在这些任务上的差异。通过方差分析、聚类分析等统计方法得到以下结果：1．轻度弱智儿童和智力一般儿童在工作记忆和加工速度上有显著差异。2．轻度弱智儿童群体在各基本认知能力中可能存在的缺陷并不平衡,工作记忆较稳定地反映了该群体在智力上的缺陷,但存在一部分在加工速度上体现为正常水平的亚类群体。     

轻度智障学生心理健康教育干预的形式与方法

轻度智障学生具有学习焦虑、孤独感、好责备自己、缺乏主动性和积极性等心理健康方面的问题。产生这些问题的原因有个体因素、父母教养因素和学校教育因素等。针对这些问题,教育者使用多种辅导形式和方法进行干预,使轻度智障学生的心理健康水平得以提高与改善。本文最后提出了在进行教育干预时需注意的一些问题,为学校开展该方面工作提供参考。     

Acculturation in Women with Mental Retardation and Its Impact on Genetic Counseling

The provision of genetic counseling to women with mild mental retardation poses many challenges, some directly related to their developmental and cognitive disabilities. Traditional genetic counseling models, in which decision-making is largely based on the understanding of factual information, are particularly affected by the intellectual limitations which characterize this population. Equally important, however, are these women's attitudes, perceptions, and behaviors related to their involuntary inclusion into a highly stigmatized social group. Common themes among these women which surface in the genetic counseling setting include the denial of mental retardation, a hierarchical perception of their own and others' disabilities, and a strong motivation to conceive and parent a child. Such attitudes and behaviors may be symptomatic of acculturation, as these women struggle to take on accepted social roles while rejecting the stigma of intellectual disability. In contrast to factual information, the counselee's ability to discuss emotions and perceptions is not necessarily hampered by her intellectual limitations. A focus on the recognition and discussion of psychosocial issues provides a more meaningful approach than traditional genetic counseling models for facilitating informed reproductive decisions among women with mental retardation.     

The Siblings of Individuals with Mental Retardation: A Quantitative Integration of the Literature

The sibling relationship has recently become the focus of much research in developmental psychology. The family system perspective implies the presence of a sibling with mental retardation will impact on the psychological development and functioning of their typically developing siblings. Past reviews of the literature have found this impact to be negative but there is the suggestion of positive consequences to having a sibling with mental retardation. The present meta-analysis sought to quantitatively integrate 25 studies and 79 effect sizes from the literature on the siblings of individuals with mental retardation. A small negative effect for having a sibling with mental retardation was discovered that could not be attributed to a publication bias or some other artifact. This negative effect was greatest for direct observation measures, measures of psychological functioning, especially depression, and for children. Limitations to this meta-analysis and directions for future research are discussed.     

The Effects of Two Taped-Words Interventions on Sight-Word Reading in Students with Mental Retardation

Multiple-baseline and alternating treatments design elements were combined to evaluate the effects of two taped-words (TW) interventions (rapid-paced and slow-paced) on sight-word reading accuracy levels in elementary students with mental retardation. During rapid TW, one word was presented every second via tape recorder and students were instructed to read aloud along with the tape. During slow TW, words were presented every 5s. Both TW interventions increased word reading accuracy but differences in learning rates between the two TW interventions were inconsistent across participants. Although no firm conclusions can be drawn regarding which pace is more effective, results show that regardless of pace, this efficient, self-managed intervention can be used to increase sight-word reading in students with mental retardation.     

Associations Between Family Environment, Parenting Practices, and Executive Functioning of Children with and Without ADHD

We examined the relationships between executive functioning, family environment, and parenting practices in children diagnosed with ADHD as compared to children without ADHD. Participants were parents (N = 134) of 6- to 12-year-old ADHD and non-ADHD-diagnosed children. Compared to the control group, parents of children diagnosed with ADHD reported their children as exhibiting greater problems with behavioral control and metacognitive abilities, and described their family environments as less organized and higher in family conflict. Family environment and parenting practices were not correlated with behavioral control or metacognitive abilities in children with ADHD. In children without ADHD, higher levels of family cohesion, organization, and expressiveness, and lower levels of family conflict, were significantly correlated with greater behavioral control. Higher levels of family cohesion and organization were significantly and positively associated with regulation of metacognitive abilities in children without ADHD. In general, aspects of the family environment and parental limit setting appear to be associated with the development of executive functions in children not diagnosed with ADHD; however, family environment and parenting practices were not associated with executive functions in children diagnosed with ADHD.     

Use of Logotherapy's Mountain Range Exercise with Male Adolescents with Mental Retardation/Developmental Disabilities and Sexual Behavior Problems

This article discusses the use of logotherapy's Mountain Range Exercise (MRE) with adolescent males with mild to moderate mental retardation/developmental disabilities and sexual behavior problems in a high-management group home setting. The activity was used in group therapy with nine patients to build rapport, clarify values, enhance attention and focus, and facilitate patient disclosure of sexual offense histories in subsequent sessions. The literature on youths with sexually aggressive behavior problems is reviewed, followed by the rationale for using the technique with this population. Future directions for research are offered.     

Memory Functioning in Children with Reading Disabilities and/or Attention Deficit/Hyperactivity Disorder: A Clinical Investigation of their Working Memory and Long-Term Memory Functioning

We examined memory functioning in children with reading disabilities (RD), Attention deficit/hyperactivity disorder (ADHD), and RD/ADHD using a clinic sample with a clinical instrument: the Children's Memory Scale, enhancing its generalizability. Participants included 23 children with RD, 30 with ADHD, 30 with RD/ADHD, and 30 controls. Children with RD presented with reduced verbal short-term memory (STM) but intact visual STM, central executive (CE), and long-term memory (LTM) functioning. Their deficit in STM appeared specific to tasks requiring phonetic coding of material. Children with ADHD displayed intact CE and LTM functioning but reduced visual-spatial STM, especially when off stimulant medication. Children with RD/ADHD had deficits consistent with both disorders.     

Story Comprehension in Children with ADHD

A wealth of research is available examining children's story comprehension. However, little attention has been directed toward understanding the story comprehension of children with attention deficit hyperactivity disorder (ADHD). The present paper attempts to integrate the developmental literature on children's story comprehension with the little that is known about the story comprehension processes of children with ADHD. This review is guided by a network model of story representation that emphasizes the structure of causal and enabling relations between story events. Examination of the available studies indicates that children with ADHD lag behind their peers in their understanding of causal relations, and that their attentional problems may contribute to difficulties in understanding factual information in the preschool years and causally related information in the elementary years. Some evidence also is presented suggesting that children with ADHD are less effective in taking advantage of story structure features in guiding their recall of story events. Suggestions for future research are offered that would elaborate our knowledge of the developmental progression in the processing of complex information by children with ADHD.     

Maintaining High Subject Retention in Follow-Up Studies of Children with Mental Illness

Measuring a program's success in enabling a child to improve functioning at home, school, and the community requires careful tracking of children's progress during the intervention and after it is completed. Attrition is often a major problem in carrying out longitudinal research. I present a number of strategies for maintaining high rates of response in follow-up studies, including how to choose a study design that enhances participation, how to locate study participants, how to engage study participants, and how to select and train high quality interviewers. The strategies presented have been used with success by a children's mental health agency and may be helpful to other researchers as they evaluate programs, measure outcomes, and study the life course of children with mental illness.     

An Investigation into the Relationship Among ADHD Symptomatology,Creativity, and Neuropsychological Functioning in Children

This paper examined the relationship between creativity and ADHD symptomatology. First, the presence of ADHD symptomatology within a creative sample was explored. Secondly, the relationship between cognitive functioning and ADHD symptomatology was examined by comparing four groups, aged 10–12 years: 1) 29 ADHD children without creativity, 2) 12 creative children with ADHD symptomatology, 3) 18 creative children without ADHD symptomatology, and 4) 30 controls. Creativity, intelligence, processing speed, reaction time, working memory, and inhibitory control were measured. Results showed that 40% of the creative children displayed clinically elevated levels of ADHD symptomatology, but none met full criteria for ADHD. With regard to cognitive functioning, both ADHD and creative children with ADHD symptoms had deficits in naming speed, processing speed, and reaction time. For all other cognitive measures the creative group with ADHD symptoms outperformed the ADHD group. These findings have implications for the development and management of creative children.     

Measuring Symptoms and Functioning of Youth with ADHD in Middle Schools

The identification of reliable and valid means for evaluating the effectiveness of school-based treatments and completing diagnostic evaluations of middle school aged students are needed. The present study examined the inter-rater agreement of teacher ratings and the relationship between ratings and observational data in a middle school setting. The data are interpreted in the context of differences between a secondary and elementary school setting. Teacher ratings and observational data were collected regularly over the course of two academic years for middle school students diagnosed with ADHD. The results indicate low rates of inter-rater agreement as well as low rates of agreement between teachers and observational data, and between observational data collected in different classrooms. Inter-rater agreement was lowest in late fall and gradually increased over the second half of the year. Implications for conducting treatment outcome evaluations of school-based treatment programs and diagnostic evaluations are discussed.     

The Relationship of Functional Variables and Psychopathology to Aggressive Behavior in Persons With Severe and Profound Mental Retardation

A number of hypotheses have emerged regarding the etiology of physical aggression in persons with mental retardation. Although a multicomponent model is appropriate, results of functional analysis-based studies have yielded promising results in identifying instigating and maintaining factors of aggression. However, the relationship between functional variables and conditions such as psychiatric diagnosis to aggressive behavior has yet to be investigated in persons with mental retardation. We conducted a study examining the prevalence of environmental or physical factors in aggressive behavior in mentally retarded persons with and without psychiatric disturbance. One hundred and thirty-five individuals with mental retardation who exhibited physical aggression were assessed with the Questions About Behavior Function Scale (QABF) to identify environmental or physical contribution to aggressive behavior. One or more behavioral functions were identified for 75% of the participants. Additionally, of 66 of the participants scoring above the clinical cutoff on an assessment for dual diagnosis, 75% met criteria for an environmental or physical function for aggression. No significant differences in number of participants with an identifiable function of aggression were found between the no dual diagnosis and dual diagnosis groups. Our findings underscore the importance of identifying functions underlying aggressive behavior in persons with mental retardation, and the need to consider functional variables regardless of psychiatric condition in treatment planning efforts for such individuals.     

7-10岁学龄儿童ADHD筛查研究

用SDQ（家长版）对上海10所小学二至四年级学生进行测查,以探求被试的ADHD症状表现,锁定ADHD高风险儿童。结果：（1）男生ADHD得分偏高（p<.01）,但女生在红橙两个级别内的百分数均高于男生;（2）9岁被试的ADHD得分分布最分散,占男生ADHD红色级别的比例最大,在女生ADHD得分中均值最大;（3）红橙两个级别为高风险级别。结论：（1）9岁是ADHD症状表现最严重的年龄;（2）女生具有更高的ADHD风险;（3）ADHD高风险被试晒出率：男生14.4%,女生17.4%。     

Parent Ratings of ADHD Symptoms: Differential Symptom Functioning Across Malaysian Malay and Chinese Children

This study examined differential symptom functioning (DSF) in ADHD symptoms across Malay and Chinese children in Malaysia. Malay (N=571) and Chinese (N=254) parents completed the Disruptive Behavior Rating Scale, which lists the DSM-IV ADHD symptoms. DSF was examined using the multiple indicators multiple causes (MIMIC) structural equation modeling procedure. Although DSF was found for a single inattention (IA) symptom and three hyperactivity-impulsivity (HI) symptoms, all these differences had low effect sizes. Controlling for these DSF, Chinese children had higher IA and HI latent factor scores. However the effect sizes were small. Together, these findings suggest adequate support for invariance of the ADHD symptoms across these ethno-cultural groups. The implications of the findings for cross-cultural invariance of the ADHD symptoms are discussed.