An investigation of intra-individual variability in children with fetal alcohol spectrum disorder (FASD)

Intra-individual variability (IIV) is defined as systematic within-person variation in performance either across test sessions (e.g., test/retest performance on the same task) or in one session (e.g., variations in performance on multiple trials of a single task). Higher levels of IIV have been noted as a characteristic of neurodevelopmental disorders such as attention deficit/hyperactivity disorder? (ADHD), but IIV is yet to be investigated in fetal alcohol spectrum disorder (FASD). FASD is a term used to describe a range of conditions resulting from prenatal exposure to alcohol. As part of a comprehensive neuropsychological battery, four study groups (1. fetal alcohol syndrome/partial fetal alcohol syndrome; 2. static encephalopathy/alcohol exposed; 3. neurobehavioral disorder/alcohol exposed as diagnosed using the University of Washington FASD 4-Digit Code; 4. typically-developing (TD) age-matched children with no prenatal alcohol exposure) were administered measures of motor response and inhibitory control, attention, and adaptive behavior. The results indicate increased levels of IIV in those with FASD compared to the TD controls. It was found that IIV uniquely contributes to predicting adaptive behavior above and beyond attention, while attention partially mediates the relationship between IIV and adaptive behavior. This is the first study to the authors’ knowledge to show the presence of increased IIV in children with FASD. It additionally provides evidence that IIV measures some inherent variability in performance independent of poor attention in children with FASD.     

Incorporating Social Media into your Support Tool Box: Points to Consider from Genetics-Based Communities

Patients with newly-described or rare genetic findings are turning to social media to find and connect with others. Blogs, Facebook groups, and Twitter have all been reported as tools for patients to connect with one another. However, the preferences for social media use and privacy among patients, their families, and these communities have not been well characterized. To explore preferences about privacy and membership guidelines, an online survey was administered to two web-based patient registries, Simons Variation in Individuals Project (www.simonsvipconnect.org) and GenomeConnect (www.genomeconnect.org). Over a three-month period, invitations were sent to 2524 individuals and 103 responses (4%) were received and analyzed. Responses indicate that Facebook is the most popular resource accessed within this sample population (99%). Participants used social media to look for information about their diagnosis or test results (83%), read posts from rare disease groups or organizations (73%), participate in conversations about their diagnosis (67%), and connect with others to find support (58%). Focusing on privacy issues in social media, respondents indicate that membership and access impact the level of comfort in sharing personal or medical information. Nearly 60% of respondents felt uncomfortable sharing photos or medical information within a public Facebook group, whereas only 12% of respondents felt uncomfortable sharing in private group targeted to families alone. Using this preliminary data concerning social media use and privacy, we developed points for genetic counselors to incorporate when discussing available support resources for patients with a new, or rare, genetic diagnosis or genetic test result. Genetic counselors are trained to provide anticipatory guidance to families adapting to new genetic information, and are well-equipped to help patients consider their preferences about using social media as a source of information and support.     

Strategies to Engage Underrepresented Parents in Child Intervention Services: A Review of Effectiveness and Co-occurring Use

The purpose of this review was to estimate the impact of parent engagement strategies tested with underrepresented families of young children with social, emotional, or behavioral disorders, and describe the combinations in which these strategies are commonly used together. We conducted a systematic review using the PracticeWise Engagement Coding System to identify which strategies had the strongest empirical support for engaging underrepresented (i.e., minority race or ethnicity, or low income) families receiving psychosocial services for their children. Social network analyses were used to identify the frequency of strategy use and how strategies were combined to engage underrepresented families. Linear regression was used to estimate the impact of each strategy on parent engagement, using attrition as a proxy for non-engagement. Thirty-five studies met inclusion criteria. Parent attrition was predicted by larger sample sizes, lower maternal education, interventions that were more community or home-based, less therapist monitoring, positive reinforcement from therapists, and more pairing families with peers. Social network analyses suggested that more effective strategies were more frequently implemented alone and less effective strategies were commonly combined with each other. Our findings suggest that researchers and practitioners require guidance in selecting engagement strategies to reduce attrition of underrepresented families in treatment. Although we identified promising strategies for improving parent engagement in treatment for underrepresented children with social, emotional, or behavioral disorders, the frequent combining of engagement strategies in research means that there is little data on the independent effects of interventions to increase parent engagement for this population.     

The Positive Plus Program: Affirmative classroom management to improve student behavior

This study describes the Positive Plus Program, a multicomponent intervention combining behavior‐specific praise with an interdependent group contingency and teacher feedback. An elementary school teacher wanting to improve her classroom management skills implemented the Positive Plus Program. Four second‐grade students participated in the study, and each of the students emitted disruptive behavior in class previously. This study, using an ABAB design, indicated that when the teacher reliably delivered high levels of behavior‐specific praise and awarded points, disruptive behavior was less likely. Student outcomes showed increased academic engagement and decreased off‐task motor and verbal behavior from pre‐ to post‐intervention. Teacher ratings indicated high levels of social validity. In light of these findings, implications for future research and implementation are discussed.     

Limited effects of pre‐existing maternal antisocial behaviours on infant neurodevelopment: A pilot study

Antisocial behaviour disorders (ABDs) are among the most costly and treatment resistant of all psychiatric syndromes. Select neurodevelopmental abnormalities have been labelled a risk factor for ABDs, but it is unknown if maternal ABDs are associated with early neurodevelopmental abnormalities. This study tested whether infants of ABD mothers had more neurodevelopmental abnormalities than mothers with no psychiatric disorder (ND). Thirty‐nine pregnant women (49% with ABDs; 51% no psychiatric disorder) were recruited from the community. Infant neurodevelopment was assessed at ≤1 and 8 weeks using the Neonatal Behavioural Assessment Scale and at 16 weeks of age using the Bayley Scales of Infant and Toddler Development‐III. There was no significant group difference at ≤8 weeks. At 16 weeks, ABD mothers rated their infants higher on the Adapted Behaviours subscale, specifically on the leisure and self‐directed scales, when corrected for substance use and socio‐economic status. This pilot study found higher maternal ratings of Adapted Behaviours at 16 weeks, which may be due to unrealistic expectations about infant development.

Highlights

• Maternal Antisocial behaviour disorders (ABDs) do not impact early infant neurodevelopment at ≤ 8 weeks old as measured by standardized assessment.
• Mothers with ABDs view their infants at 16 weeks as better adapted than women without any psychiatric disorder.
• Specifically, mothers with ABDs reported their infants as better adapted on the leisure and self‐direction subscales of the Bayley Scales of Infant and Toddler Development‐III. This finding may be due to less knowledge about normal infant adaptive behavior.

     

Maternal Parenting and Toddler Temperament: Predictors of Early School Age Attention-Deficit/Hyperactivity Disorder-Related Behaviors

Research on Child and Adolescent Psychopathology - Detection of early risk for developing childhood attention-deficit/hyperactive disorder (ADHD) symptoms, inattention and hyperactivity, may be...     

Responses to exclusion are moderated by its perceived fairness

Experimental exclusion manipulations may induce exclusion in a way that participants perceive as unfair. Groups often use exclusion punitively to correct inappropriate behavior, however, which may lead to perceptions that it is potentially justified or fair. The current studies examined if individuals' perceptions of fairness with respect to an exclusion experience moderated their reactions. Participants wrote about or imagined a time in which they were excluded after they did something wrong (fair exclusion) or excluded even though they did nothing wrong (unfair exclusion) or about a mundane experience unrelated to exclusion (control). Compared with fair exclusion, unfair exclusion resulted in significantly weaker efficacy needs satisfaction (Studies 1, 2, and 4), greater antisocial intent (Study 3), and greater sensitivity to signs of interpersonal acceptance and rejection in a visual search task (Study 4). These results suggest that it is important to consider the role of perceived fairness in shaping responses to exclusion.