Disability in the family: a life span perspective

This article provides an overview of disability in families. The goal of the article is to raise awareness of the status of people with disabilities and their families to develop culturally relevant psychological support. Families have widely varying perspectives on disability; those perspectives influence responses to disability from the preconception and prenatal developmental stages through old age. An international literature review is provided with consideration of cultural meanings of disability, preparation for dealing with disability, coping strategies, support, developmental dynamics, competing needs of family members, and ethics. Voices of people with disabilities and their families are included.     

Prevalence of Attention-Deficit/Hyperactivity Disorder Symptoms in 4- to 17-Year-Old Children in the General Population

The purposes of this study were (a) to estimate the prevalence of Attention-Deficit/Hyperactivity Disorder (AD/HD) symptoms in the general preschool and school population; and (b) to analyze the influence of gender, age, and socioeconomic status (SES) variables on AD/HD symptoms. Out of the 80,000 preschool and schoolchildren living in Manizales, Colombia, a random sample of 540 children was selected. Two gender, three age (4- to 5-year olds, 6- to 11 -year olds, and 12- to 17-year olds), and three SES (low, middle, and high) groups were used. The 18 DSM-IV symptoms corresponding to AD/HD Criterion A were assessed on a scale of 0 (never) to 3 (almost always). All three demographic variables established statistically significant differences: AD/HD symptoms were more frequent in 6-to 11-year-old, low-SES, male participants. DSM-IV Criterion A for AD/HD was fulfilled by 19.8% of the boys and 12.3% of the girls. However, this difference was marginally significant only in the AD/HD Subtype I: Combined. It was concluded that demographic variables are significant correlates of the AD/HD diagnosis. The prevalence found in this study was higher than usually reported, even though only the symptomatic DSM-IV AD/HD criterion was analyzed. We failed to confirm the assumed AD/HD gender ratio.     

Making the Parents as Partners Principle a Reality: The Role of the Alliance

We explore the dimensions of the Parents as Partners principle, the widely touted, but somewhat elusive construct in the literature on treating children with serious mental illness, whose poorly defined boundaries, lack of empirical grounding, and overemphasis on instrumental dimensions attenuates its usefulness as a guide for practice and research. Four major barriers to the realization of this principle are outlined, all of which may impede actualizing partnership in practice and may also inhibit the early formation of a positive clinician/parent alliance, a neglected, though key dimension of true partnership practice. The alliance, which has a long clinical and research history in psychotherapy and behavioral research, and more recently, in a variety of community-based interventions, is a precursor to active client partnership with helpers and to treatment participation, as well as therapeutic in its own right. After reviewing relevant alliance research, we close with a beginning research agenda to incorporate the alliance as an integral component of future conceptualization and research about the Parents as Partners principle.     

The Program Environment Scale: Assessing Client Perceptions of Community-Based Programs for the Severely Mentally Ill

The Program Environment Scale (PES) was developed for use with clients of community-based programs for the severely mentally ill. It is intended to fill the gap in available tools for assessing clients' perceptions of program functioning as it affects their quality of life in a program. Formal pretests were conducted with 121 clients at 12 randomly selected programs near Washington, DC. The final field test used a revised form (29 domains; 129 items) with 221 clients in 22 programs selected randomly throughout the U.S., including Clubhouse, day treatment, psychosocial rehabilitation, and social club programs. Twenty-three subscales met at least five of eight psychometric criteria for internal consistency and discriminant validity. A 24th subscale was retained because of its substantive importance. Successful subscales cover program atmosphere and interactions (program cares about me, energy level, friendliness, openness, staff-client and client-client respect, reasonable rules, availability of positive physical contact, protection from bad touch, staff investment in their jobs, and confidentiality), client empowerment/staff-client equality (program and treatment empowerment, egalitarian space use), and service components (support for paid work, work importance, emergency access, family activities, housing, public benefits, community activities, medications, substance abuse, and continuity). Subscale validity is indicated by associations of specific service offerings with scores on scales measuring client perceptions of those services, and by an ability to differentiate among program models (i.e., Clubhouses, day treatment programs, and psychosocial rehabilitation programs look different from each other). Subscale scores were not influenced by client characteristics (gender, race, age, diagnosis, number of hospitalizations, length of time in program). The final scale has 97 items and takes about 25 minutes to complete. The PES succeeds in measuring different aspects of programs as clients perceive them. In the programs we visited, directors felt the PES covers the important things they want to know about how clients perceive their program. The PES should become a useful tool both for researchers interested in how client responses to programs may influence their therapeutic outcomes, and for practitioners interested in improving their clients' program experiences and/or increasing convergence of staff and client views of their program.     

Effects of Self-Monitoring on On-Task Behaviors of At-Risk Middle School Students

The purposes of this study were to evaluate the effects of self-monitoring on increasing the on-task behaviors of four at-risk middle school students, and to examine its indirect effects on academic performance. Additionally, we attempted to develop and validate cost- and time-efficient procedures that typical classroom teachers could use. The data from a multiple baseline design across three academic settings, replicated with four students, revealed immediate increases in on-task behavior as each student began to self-monitor in each sequential setting. The data also revealed slightly higher levels of academic performance and, in most instances, gradually accelerating trends. These findings suggest that self-monitoring is a cost- and time-efficient procedure that classroom teachers can use to teach at-risk students to manage their own behaviors.     

Family-expressed emotion,childhood-onset depression,and childhood-onset schizophrenia spectrum disorders: Is expressed emotion a nonspecific correlate of child psychopathology or a specific risk factor for depression?

Expressed emotion (EE) was examined, using the brief Five Minute Speech Sample measure, in families of (1) children with depressive disorders, (2) children with schizophrenia spectrum disorders, and (3) normal controls screened for the absence of psychiatric disorder. Consistent with the hypothesis of some specificity in the association between EE and the form of child disorder, rates of EE were significantly higher among families of depressed children compared to families of normal controls and families of children with schizophrenia spectrum disorders. Within the depressed group, the presence of a comorbid disruptive behavior disorder was associated with high levels of critical EE, underscoring the need to attend to comorbid patterns and subtypes of EE in future research.This research was supported by a grant from the John D. and Catherine T. MacArthur Foundation as part of their Network on Risk and Protective Factors in the Major Mental Disorders. The authors wish to express their appreciation to Sybil Zaden and Ana Magana-Amato for their assistance coding the FMSS-EE data, to Gwen Gordon for her assistance with data analysis, and to the families participating in the project.     

Leadership Style and Leader Title

In a 2 by 4 design, leadership style (authoritarian versus democratic) was varied against form of address (Mr., Ms., Miss, Mrs.) in a simulated small group case study. Subjects (374 college and high school students) read the case study and then rated their reactions to the leaderson behavioral differential factors of "subordination" and "friendship." These ratings indicate significant effects due to leader style (i.e., greater subordination and stronger friendship attraction to democratic rather than authoritarian leaders). Leader title produced no significantmain effects although authoritarian leaders using the title Ms. evoked higher subordination (p <.001) than other authoritarian leaders.     

GENERALIZING ARTICULATION TRAINING WITH TRAINABLE MENTALLY RETARDED SUBJECTS1

A multiple-baseline technique was used to evaluate generalization effects during articulation training with trainable mentally retarded subjects. Four target words were selected for each subject on the basis of whether the subject could articulate the word correctly when it was modelled but could not articulate the word correctly in response to a picture of it. Five different settings were selected for generalization probing and training for each subject. In Setting 1, Experimenter 1 initiated training sequentially on all four target words for each subject. Other experimenters probed for correct articulation generalization in four other settings. Training was initiated in these four other settings sequentially only if correct responding failed to generalize to a setting. Results indicated that it was necessary to initiate training on at least three of the four selected target words in at least one additional setting with an additional trainer before correct responding generalized to untrained settings.