Helping the child with cancer: what school personnel want to know

As more children with cancer survive, the importance of facilitating school reintegration as a part of maximizing the quality of life has become evident. Workshops have been presented to school personnel to acquaint them with the issues facing cancer patients and their families, but there are gaps in our knowledge of what school personnel really need or want to know. In this study, 18 teachers of children with cancer and 15 teachers with no prior contact with students with cancer completed a questionnaire designed to assess needs, beliefs, and priorities with regard to working with cancer patients in the classroom. Significant findings included: (a) a consensus that a certain core of information about medical/psychological issues would be useful, and presentation of such information by psychologists and medical personnel working with such families would be optimal; (b) teachers having cancer patients as students were less likely to see the adaptation of siblings as an important issue; (c) teachers associated working with a student with cancer with less stress and demands on their time than predictable from previous studies; and (d) cancer patients as a whole were rated as having fewer behavioral, emotional, and learning problems than randomly selected students without a major illness, suggesting a "halo effect" or contradiction of some literature. Preliminary findings are detailed and implications are discussed for those attempting to help teachers facilitate students' adjustment to school following diagnosis and treatment of cancer.     

Perceptions of the therapist in family therapy

Thirty-five families completed ratings describing their perceptions of their therapists. These ratings were then correlated with measures of outcome to assess whether there was a relationship between experiences of the therapist and treatment outcome. Further, the study addresses whether some family members' perceptions are more influential in affecting the course of treatment. The results showed that family members' perception of the therapist does have an impact on treatment outcome, but not all members affect the outcome equally. Further results and their implications are discussed.     

Neurological soft signs and school achievement: The mediating effects of sustained attention

A group of 115 black male adolescents drawn from a clinically unselected birth cohort, half of whom were known to have had neurological soft signs at age 7, were examined at age 17 to determine the relation between soft signs and performance on standard tests of school achievement and sustained attention. Three signs measured at age 17-dysgraphesthesia, difficulties with rapid alternating movements (dysdiadochokinesis), and motor slowness—were related to lower concurrent and past IQ and to impaired performance on laboratory and paper-and-pencil measures of sustained attention. The relation between signs and the attentional measures remained significant after IQ was statistically controlled. The three age 17 soft signs as well as age 7 signs were related to impaired performance on standardized tests (age 17) of school achievement. Most of the relation between signs and school achievement could be accounted for by the variance signs shared with sustained attention. One sign, mirror movements, was unrelated to all other attentional and cognitive measures.The study was supported by center grant MH 306906 and research training grant 5 T32 MH 13043-13 from the National Institute of Mental Health, as well as by the City College and the City University Computing Centers. We thank Lillian Belmont and two reviewers for their critical comments on an earlier version of the paper. We dedicate this paper to the memory of Joseph Barmack.     

Child Behavior Profile types in a general population sample of boys 6 to 11 years old

Characteristics of Child Behavior Profile (CBP) types were studied in a general population sample of 202 boys aged 6 to 11 years. Parents completed the Child Behavior Checklist and teachers simultaneously rated the Teacher's Report Form. Overall, 39.7% of the boys were classified within a CBP type: 28.8% Internalizing and 10.9% Externalizing. The most common specific type was Somatic Complaints. Teachers rated the Externalizing CBP boys as showing robust externalizing behaviors in school. Also, boys with Externalizing profile types showed severe degrees of psychopathology in both home and school environments. An intraclass correlation of 35 or greater was found to identify boys with sufficiently severe psychopathology to warrant further clinical evaluation. Findings in this general population sample appear consistent with previous results in outpatient samples, and extend our understanding of the validity and clinical value for CBP types.     

A neuroscience model of stuttering

Using motor control systems analysis and a reductionist approach, we provide a unified model of stuttering. This model views stuttering as a momentary instability in a complex multiloop control system. The model predicts the temporal conditions under which this instability will occur. Furthermore, these temporal conditions account for the efficacy of fluency-evoking maneuvers, therapy, and the variability of speech output in stutterers.     

The Children's Firesetting Interview with psychiatrically referred and nonreferred children

This study evaluated the Children's Firesetting Interview (CFI). The measure was developed to operationalize multiple domains of functioning derived from a riskfactor model of firesetting. The model poses that child, parent, and family characteristics promote firesetting and continuation of a pattern of firesetting. Major factors include curiosity about fire, involvement in and exposure to firerelated activities, and knowledge about first safety The CFI, consisting of 46 questions reflecting six a prioridimensions, was administered to 519 children (ages 6–13) recruited from nonpatient, outpatient, and inpatient samples. Internal consistency and testretest reliability of the measure were satisfactory. Criterion validity was supported by the findings that firesetters showed greater curiosity about fire, involvement in firerelated activities, exposure to models/materials, and knowledge about things that burn than did nonfiresetters. These findings did not vary as a function of the child's patient status or level of antisocial behavior. Implications for the evaluation of firesetting risk are discussed.This study was supported by grant MH-39976 from the Antisocial and Violent Behavior Branch of the National Institute of Mental Health and by a Research Scientist Development Award (MH00353) from the National Institute of Mental Health. The authors acknowledge the constructive suggestions of two anonymous reviewers.     

Behavioral correlates of developmental expressive language disorder

The association of behavior problems with preschool language disorders has been documented extensively. However, researchers have typically failed to differentiate subgroups of language-impaired children, to use observational data in documenting the behavior disorders, or to study children at the youngest ages. Using a multimodal assessment, this study examined parent-child interaction and behavior problems in a clearly defined subgroup of language-impaired children, those with developmental expressive language disorder (ELD). These children exhibit a delay in expressive language compared with receptive language and nonverbal cognitive skills. Subjects were identified and studied at the youngest age at which the disorder can be assessed. A group of ELD children, averaging 27 months of age, was contrasted with a group of normally developing children, matched for age, sex, and receptive language ability. Groups were compared on observed parent-child interactions as well as maternal responses on the Parenting Stress Index, the Eyberg Child Behavior Inventory, and a behavior-related structured interview. ELD children, when compared with normally developing children, exhibited higher levels of negative behavior and were perceived as different by their parents.Portions of these data were presented at the biennial meeting of the Society for Research in Child Development, Baltimore, April 1987, and at the annual meeting of the Society for Pediatrie Research, Anaheim, California, April 1987. This work has been supported by NIMH grant no. 1 R03 MH41603 to author Fischel, and by NICHD grant no. 1 ROI HD19245 to authors Whitehurst and Fischel. It has also been supported by grants of equipment from Commodore Business Machines, Inc., Koala Corporation, and NEC Telephones. We thank the Department of Pediatrics at the Nassau County Medical Center for the use of their facilities.     

Identifying depression in children: A comparison of alternative selection criteria

This study evaluated commonly used methods of identifying depressed children and examined the extent to which the conclusions about correlates of dysfunction vary among different selection criteria. Child psychiatric patients (N=237,ages 7–12) and their parents participated and completed measures to permit identification of depressed children on the basis of three separate criteria, including selfreport scores on the Children's Depression Inventory, parent-reported scores for the same measure, and a DSM-III diagnosis of major depression. The study examined whether depressed and nondepressed children, defined separately by the different criteria, differed in a variety of depression-related symptoms, cognitive processes, and social activity. The results indicated little overlap in the persons identified as depressed on the basis of child-or parent-completed CDI scores or DSM-III diagnosis. Depressed and nondepressed children tended to differ across all domains (depression-related symptoms, cognitive processes, and social activity) for each selection criterion. However, significant differences were evident in these domains only when the selection criterion and other domains were assessed with the same informant (e.g., self-report) and hence shared a common method (rater) component. The findings underscore the potential influence that method factors may have in influencing the conclusions that are drawn regarding the correlates of childhood depression.Completion of this research was supported by a Research Scientist Development Award (MH00353) and by a grant (MH35408) from the National Institute of Mental Health. The author is grateful to Debra Bass, Antoinette Rodgers, and Todd Siegel for assistance with this project.     

The effects of right and left hemiparkinsonism on prosody

Recent studies show right hemisphere dominance in the mediation of emotional prosody and left hemisphere contribution to linguistic prosody in patients with cortical injury. The present study investigated emotional and linguistic functions of prosody as well as facial and musical processing in 21 patients with lateralized subcortical disease. Fourteen right hemiparkinsonians (RPD) and 7 left hemiparkinsonians (LPD) were compared to 17 normal controls (NC). Patients were impaired on receptive and expressive tests of emotional and linguistic prosody. Patients were also selectively impaired on emotional processing of facial stimuli and in the musical processing of pitch and tonal memory, though not timber. These findings suggest that monotone speech reported in PD is of multimodal origins and may involve dysfunction in neural centers involved in emotional and linguistic processing. There were no differences between RPD and LPD groups in the pattern of deficits, suggesting bilateral involvement in emotional processing at the subcortical level.