Developmental considerations for assessment of trauma symptoms in preschoolers: a review of measures and diagnoses

Child maltreatment can lead to a unique set of trauma stress among young children that can be challenging to measure. The purpose of this review was to review measures of maltreatment-related trauma outcomes (trauma-related symptoms and post-traumatic stress disorders) in very young children (ages 0–6) and to examine research trends in how and if child development is accounted for in this area of measurement. A systematic search strategy was used to identify articles in two databases, CINAHL and PsychInfo. Articles were eligible for inclusion in the review if they measured trauma symptoms in children ages 0–6, were quantitative research reports of studies conducted in North America, and were published in English. The search resulted in 74 articles meeting prespecified inclusion criteria. Results suggested that recognition of the ways maltreatment trauma affects child development and the importance of developmental sensitivity in assessing trauma symptoms has grown in recent years. However, many research studies did not use developmental frameworks and applied adult-oriented trauma symptom frameworks in measurement and treatment. Behavioral symptoms were the primary outcome of interest for this age group. There was also incongruity and lack of consensus about diagnostic tools for post-traumatic stress disorders in young children. Further research is needed to resolve theoretical and empirical controversies related to measurement and diagnosis of trauma symptomatology in young children.     

A Case of Premature Termination in a Treatment for Generalized Anxiety Disorder

In this paper we present a case of failure in an integrative treatment for generalized anxiety disorder (GAD) combining cognitive-behavioral therapy, an empirically supported treatment for GAD, and interpersonal-emotional processing therapy. The client of focus dropped out of treatment after the eighth session. Based on our analysis of this case, we discuss the participant, technical and relationship factors that were likely implicated in this case of premature termination in both of the cognitive-behavioral and interpersonal-emotional processing segments that comprised the treatment. Implications for practice, training and future research are also discussed.     

COUNSELING AND PSYCHOTHERAPY AS MORAL AND SPIRITUAL PRACTICE: FACING A MAJOR PARADIGM SHIFT

Blakeney and Blakeney offer a metatheoretical perspective for counseling and therapy that gives primacy to developmental issues and to understanding the worldview of the client. Their thinking adds to the growing paradigm shift currently occurring in the counseling field. This article further demonstrates the holistic and integrative nature and potential of the Blakeney framework, using Developmental Counseling and Therapy (DCT) as a method of translation. The authors offer a framework that challenges the notion of “higher” forms of knowledge, emphasizing instead multiperspctive thought and life-span cognitive-developmental processes.     

Teacher implementation of precorrection and praise statements in Head Start classrooms as a component of a program-wide system of positive behavior support

Although research has clearly supported the use of school-wide positive behavior support (PBS) in elementary school settings, data-based research has not been conducted to support program-wide PBS in early childhood settings. The purpose of this study was to specifically support teachers’ use of universal features of program-wide PBS and to determine whether increases in the use of positive teacher behaviors, including precorrection and praise, were functionally related to decreases in students’ problem behavior. Using a multiple baseline design, three teachers were introduced to an intervention to increase their use of precorrections and specific behavioral praise statements. A relationship was established between the three teachers’ use of key features of program-wide PBS and the reduction of students’ problem behavior in a small group setting. However, findings should be viewed as tentative and future research should explore the relative influence of each of the intervention components on preschool students’ behavior.     

Associations and dissociations of transitive and intransitive gestures in left and right hemisphere stroke patients

The study investigated performance on pantomime and imitation of transitive and intransitive gestures in 80 stroke patients, 42 with left (LHD) and 38 with right (RHD) hemisphere damage. Patients were also categorized in two groups based on the time that has elapsed between their stroke and the apraxia assessment: acute–subacute (n = 42) and chronic (n = 38). In addition, patterns of performance in apraxia were examined. We expected that acute–subacute patients would be more impaired than chronic patients and that LHD patients would be more impaired than RHD patients, relative to controls. The hemisphere prediction was confirmed, replicating previous findings. The frequency of apraxia was also higher in all LHD time post-stroke groups. The most common impairment after LHD was impairment in both pantomime and imitation in both transitive and intransitive gestures. Selective deficits in imitation were more frequent after RHD for transitive gestures but for intransitive gestures they were more frequent after LHD. Patients were more impaired on imitation than pantomime, relative to controls. In addition, after looking at both gesture types concurrently, we have described cases of patients who suffered deficits in pantomime of intransitive gestures with preserved performance on transitive gestures. Such cases show that the right hemisphere may be in some cases critical for the successful pantomime of intransitive gestures and the neural networks subserving them may be distinct. Chronic patients were also less impaired than acute–subacute patients, even though the difference did not reach significance. A longitudinal study is needed to examine the recovery patterns in both LHD and RHD patients.