Multisensory Stimulation to Improve Low- and Higher-Level Sensory Deficits after Stroke: A Systematic Review

The aim of this systematic review was to integrate and assess evidence for the effectiveness of multisensory stimulation (i.e., stimulating at least two of the following sensory systems: visual, auditory, and somatosensory) as a possible rehabilitation method after stroke. Evidence was considered with a focus on low-level, perceptual (visual, auditory and somatosensory deficits), as well as higher-level, cognitive, sensory deficits. We referred to the electronic databases Scopus and PubMed to search for articles that were published before May 2015. Studies were included which evaluated the effects of multisensory stimulation on patients with low- or higher-level sensory deficits caused by stroke. Twenty-one studies were included in this review and the quality of these studies was assessed (based on eight elements: randomization, inclusion of control patient group, blinding of participants, blinding of researchers, follow-up, group size, reporting effect sizes, and reporting time post-stroke). Twenty of the twenty-one included studies demonstrate beneficial effects on low- and/or higher-level sensory deficits after stroke. Notwithstanding these beneficial effects, the quality of the studies is insufficient for valid conclusion that multisensory stimulation can be successfully applied as an effective intervention. A valuable and necessary next step would be to set up well-designed randomized controlled trials to examine the effectiveness of multisensory stimulation as an intervention for low- and/or higher-level sensory deficits after stroke. Finally, we consider the potential mechanisms of multisensory stimulation for rehabilitation to guide this future research.     

Evaluating the Effectiveness of a Teaching Package Utilizing Behavioral Skills Training and In Situ Training to Teach Gun Safety Skills in a Preschool Classroom

There are a number of different safety threats that children face in their lives. One infrequent, but highly dangerous situation a child can face is finding a firearm. Hundreds of children are injured or killed by firearms each year. Fortunately, behavioral skills training (BST) and in situ training (IST) are effective approaches for teaching a number of different skills, including safety skills. The purpose of this study was to evaluate a teaching package for preschool teachers to learn to conduct BST to teach safety skills. Following teacher-implemented BST, the experimenter completed in situ training and supplemental instructions. A multiple baseline across subjects design was used to evaluate the effectiveness of this teaching package implemented by the teacher and experimenter with five preschoolers. Five children demonstrated the skills following IST and additional reinforcement or time out. The use of additional reinforcement, as well as treatment fidelity are discussed.     

Comparison of the Effects of Telephone Suicide Prevention Help by Volunteers and Professional Paid Staff: Results from Studies in the USA and Quebec,Canada

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.     

The development of and interaction among alerting,orienting, and executive attention in children

A sex-balanced sample (N = 96) of children from age 6.5 to age 12.5 completed a modified Attention Network Test. Across these ages, we found evidence for developmental changes to alerting and executive control but stable orienting. Additionally, we found that the youngest members of our sample manifested an interaction between alerting and executive control that is opposite to that typically found in adults; a reversal that diminishes with age to achieve the adult pattern by the older end of the age range of our sample.     

The Relationship Between Parenting Style and Children's Adjustment: The Parents' Perspective

We examined the relationship between authoritative and authoritarian parenting styles and socio-emotional adjustment in elementary school children as reported from the parents' perspective. Mothers of first through fifth graders provided information about parenting style as well as children's competencies and problem behaviors. Teachers provided ratings of children's adjustment for a subset of the participants. Results indicated that authoritative parenting was associated negatively with parent- and teacher-rated maladaptive behavior, and positively with indicators of healthy adjustment. Correlations between authoritarian parenting and adjustment were either small or non-significant. Regression analyses indicated that authoritative parenting was more predictive of children's competence than maladaptation (22% versus 10% of variance). The effects of parenting style on adjustment were not moderated by demographic variables, such as the child's gender, grade level, ethnicity, and family income.     

Self‐restraint and self‐injury: a demonstration of separate functions and response classes

We evaluated the self‐injurious behavior (SIB) and self‐restraint (SR) of an 11‐year‐old boy with severe mental retardation that were suspected to be functionally unrelated. A functional analysis (consequences provided for SIB) resulted in near‐zero levels of SIB across experimental conditions and did not indicate a specific function of SIB. In contrast, high, undifferentiated levels of SR were observed during the attention, control, alone, and demand conditions. Further analysis of a possible tangible function of SIB using pairwise comparisons resulted in a high rate of SIB during the contingent tangible condition, no SIB in the noncontingent tangible condition, and comparable levels of SR in both conditions. A subsequent analysis using restraint blocking during play and no‐play contexts suggested that SR produced automatic reinforcement under conditions of low ambient stimulation. Thus, SIB and SR were shown to be functionally independent and maintained by distinct consequences. The results are briefly discussed and suggestions for future research are provided. Copyright © 2000 John Wiley & Sons, Ltd.     

Determining Normal Deviance: Adolescent Drug Use?

This research examines change in lifetime drug use frequency among three drugs, marijuana, alcohol and inhalants, and antisocial behaviors using a cohort longitudinal model. Findings indicate marijuana and alcohol use increases with grade level. Inhalants are the only drugs which use decline with grade level. Focus of the paper is whether the use of these three drugs is a normal part of adolescent development. Using three determinants: associations between drug use and grade and scores on an antisocial behavior scale; and percent of abstainers; the authors determined none of the three drugs represent normal deviance. Data are from 2008 thru the 2014 the Caring Communities Youth Survey (CCYS). The concept of normal deviance is discussed.     

Associations of transcranial doppler velocity,age, and gender with cognitive function in children with sickle cell anemia in Nigeria

Children with sickle cell anemia (SCA) have elevated cerebral blood velocity relative to healthy peers. The primary aim of this study was to evaluate the association between cerebral blood velocity, measured by transcranial Doppler (TCD) ultrasound, age, and gender with cognitive function in children with SCA in Nigeria. Eighty-three children (M_age = 9.10, SD = 1.90 years; 55% female) with SCA in Nigeria completed cognitive assessments and a TCD ultrasound. The association between TCD velocity and measures of perceptual reasoning (Raven’s Progressive Matrices), working memory (WISC-IV Digit Span), and executive planning (Tower of London, TOL) were assessed. Results showed that elevated TCD velocity significantly predicted lower scores on TOL Time Violations and Total Problem-Solving Time when controlling for BMI, hemoglobin level, and parent education, suggesting that TCD velocity is related to the efficiency of executive function. Further, age was negatively related to children’s performance on the Ravens Matrices and TOL Total Correct, and boys showed greater deficits on the TOL Total Correct relative to girls. Moderation analyses for gender showed that there was a conditional negative association between TCD velocity and Digit Span for boys, but not for girls. Findings suggest that children with SCA in Nigeria with elevated TCD velocity are at risk for deficits in efficiency of executive planning, and boys with elevated TCD velocity are particularly at increased risk for deficits in auditory working memory. Implications of this study are important for interventions to reduce cerebral blood velocity and the use of TCD in this population.