Building capacity in neurodevelopment assessment of children in sub-Saharan Africa: A quality assurance model to implement standardized neurodevelopment testing

Compromised neurodevelopment (ND) among infants and children is prevalent in sub-Saharan Africa. Standardized testing of ND is frequently prohibitive in these contexts, as tests require skilled staff for their application. In this paper, we present a quality assurance (QA) model (QualiND) for standardized ND testing, discussing findings and implications from our experience applying the Kaufman Assessment Battery for Children second edition (KABC-II). The QualiND model was implemented within IMPAACT P1104s study, a multisite, prospective study including 615 children affected by HIV. From 2014 to 2016, the QualiND managed 18 testers across 6 sites located in 4 African countries applying the KABC-II in 9 local languages. The QualiND is a multilevel, video-assisted iterative model incorporating remote evaluation, feedback, and supervision roles. Using an ad hoc rubric, videos of test application were evaluated by experienced staff in a centralized QA center. At each study site, testers and supervisors reviewed feedback from videos received via email from the QA center and devised an action plan to address testing errors and deficiencies. There were few instances of invalid tests and few barriers to test completion. Over 97% of KABC-II tests across sites were considered to be valid by the QA center. Overall, the QualiND model was a useful platform for remote supervision to nonspecialist and minimally trained research staff. The QualiND model may be useful to researchers and organizations involved in measuring early child development using standardized tests in low and middle-income countries.     

The WISC-V in children and adolescents with epilepsy

Despite its popularity in the neuropsychological evaluation of children, the utility of the Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V) has not yet been investigated in children with epilepsy. Eighty clinically referred children and adolescents with epilepsy were administered the WISC-V as part of a comprehensive assessment and scores were compared to matched controls from the WISC-V standardization sample. T tests compared WISC-V indices and subtests between patients and controls and Chi-square analyses compared the rates of low scores. Correlational analyses assessed the relationships between epilepsy severity variables (e.g., age of onset, duration of epilepsy, number of antiepileptic drugs, seizure frequency). All WISC-V composites and subtests were significantly lower in patients versus controls and the rate of low scores was higher in patients than controls for all composites and subtests with the exception of Figure Weights. The Working Memory Index and Processing Speed Index were most sensitive to impairment, while the Verbal Comprehension Index and Fluid Reasoning Index were least sensitive. Of the epilepsy severity variables, age of seizure onset and number of antiepileptic drugs were strong predictors of deficits, whereas seizure frequency was the weakest predictor. Importantly, no significant differences were seen in children with right hemisphere epilepsy versus left on the five WISC-V composites, though a trend was seen towards a lower Visual-Spatial Index in those with right-sided focal seizures.     

The Meaning of Obesity in the Church: A Pastoral Leader’s Perspective

The purpose of this study is to highlight a unique case regarding obesity and weight loss in the Christian church that emerged when interviewing men who had experienced bariatric surgery. Thirty-four-year-old “Pastor Tom” was removed from his position in the church due to his obesity. Through critical reflection, utilizing an intrinsic case study methodology, the authors explore how this research participant constructed meaning around obesity and weight loss. In this study, two major themes emerged: (1) leading by example and (2) becoming a leader. The study includes a discussion of implications for the church as well as teaching, clinical, and research implications.     

Piecing together numerical language: children's use of default units in early counting and quantification

When asked to ‘find three forks’, adult speakers of English use the noun ‘fork’ to identify units for counting. However, when number words (e.g. three) and quantifiers (e.g. more, every) are used with unfamiliar words (‘Give me three blickets’) noun‐specific conceptual criteria are unavailable for picking out units. This poses a problem for young children learning language, who begin to use quantifiers and number words by age 2, despite knowing a relatively small number of nouns. Without knowing how individual nouns pick out units of quantification – e.g. what counts as a blicket– how could children decide whether there are three blickets or four? Three experiments suggest that children might solve this problem by assigning ‘default units’ of quantification to number words, quantifiers, and number morphology. When shown objects that are broken into arbitrary pieces, 4‐year‐olds in Experiment 1 treated pieces as units when counting, interpreting quantifiers, and when using singular–plural morphology. Experiment 2 found that although children treat object‐hood as sufficient for quantification, it is not necessary. Also sufficient for individuation are the criteria provided by known nouns. When two nameable things were glued together (e.g. two cups), children counted the glued things as two. However, when two arbitrary pieces of an object were put together (e.g. two parts of a ball), children counted them as one, even if they had previously counted the pieces as two. Experiment 3 found that when the pieces of broken things were nameable (e.g. wheels of a bicycle), 4‐year‐olds did not include them in counts of whole objects (e.g. bicycles). We discuss the role of default units in early language acquisition, their origin in acquisition, and how children eventually acquire an adult semantics identifying units of quantification.     

Impact of Remembering Childhood Sexual Abuse on Addiction Recovery for Young Adult Lesbians

This article examines the impact of childhood sexual abuse on young adult lesbians' sexual identity and their recovery from chemical dependency. The authors recommend that counselors assess for sexual orientation (past and present), sexual abuse, and possible dual diagnosis. Implications for counselors are discussed.     

Un-thought out metaphysics in analytical psychology: a critique of Jung's epistemological basis for psychic reality

The author investigates the relation of Kant, Schopenhauer and Heidegger to Jung's attempts to formulate theory regarding the epistemological conundrum of what can and what cannot be known and what must remain uncertain. Jung's ambivalent use and misuse of Kant's division of the world into phenomenal and noumenal realms is highlighted in discussion of concepts such as the psychoid archetype which he called 'esse in anima' and his use of Schopenhauer's concept of 'will' to justify a transcendence of the psyche/soma divide in a postulation of a 'psychoid' realm. Finally, the author describes Jung's reaction to Heidegger's theories via his assertion that Heidegger's 'pre-given world design' was an alternate formulation of his concept of the archetypes. An underlying theme of the paper is a critique of Jung's foundationalism which perpetuates the myth of an isolated mind. This model of understanding subjectivity is briefly contrasted with Heidegger's 'fundamental ontology' which focuses on a non-Cartesian 'understanding' of the 'presencing of being' in everyday social and historical contexts.     

“Brother Where Art Thou?” African American Male Instructors' Perceptions of the Counselor Education Profession

The purpose of this study was to investigate the perceptions of African American male counselor educators regarding the limited number of African American male faculty members in counselor education. Implications and suggestions on how universities can recruit and retain African American male faculty members are provided. El propósito de este estudio fue investigar las percepciones de educadores en consejería afroamericanos con respecto al limitado número de miembros afroamericanos entre el profesorado para la educación de consejeros. Se proporcionan implicaciones y sugerencias sobre cómo las universidades pueden contratar y retener profesores varones afroamericanos.     

Godly play: an intervention for improving physical, emotional, and spiritual responses of chronically ill hospitalized children

An experimental two-group comparison pilot study of forty chronically ill hospitalized children was carried out at Wolfson Children's Hospital in Jacksonville, Florida. Three Godly Play interventions were given to participants in the experimental group. Children in the control group did not participate but received a fairy tale book as a control. The sample was evenly distributed with twenty (20) males and twenty (20) females. Ages ranged from six (6) to fifteen (15) years and all participants were chronically ill. Five (5) variables were studied. Of the five (5), three (3) showed significant differences before and after Godly Play: the Staic-Trait Anxiety Scale (p = .049), the Children's Depression Inventory (p = .011), and the McBride Spirituality Assessment (p = .033). A marginal difference in parent satisfaction with hospital care of children in the experimental and control groups was also determined (p = .058). Findings suggest that Godly Play had a significant effect on anxiety, depression, and spirituality of children and support the idea that the parents of children who participated in Godly Play were more satisfied with hospital care than those parents whose children did not engage in Godly Play.     

Blood lead (Pb) levels: a potential environmental mechanism explaining the relation between socioeconomic status and cardiovascular reactivity in children.

OBJECTIVE: A number of studies have shown an association between socioeconomic status (SES) and cardiovascular reactivity to acute stress. In addition, the authors recently reported that higher early childhood blood lead (Pb) levels are associated with significantly greater total peripheral (vascular) resistance (TPR) responses to acute stress. It is not known whether the SES-TPR association is mediated by underlying differences in blood lead levels. DESIGN: Participants were 9.5-year-old children (N=122) with established early childhood blood lead levels. MAIN OUTCOME MEASURES: Family SES was measured using the Hollingshead Index, blood lead levels were abstracted from pediatrician and state records, and children's cardiovascular responses to acute stressors were measured in the laboratory with impedance cardiography and an automated blood pressure monitor. RESULTS: Lower family SES was shown to be associated with significantly higher blood lead levels as well as significantly heightened systolic blood pressure, diastolic blood pressure, and TPR responses to acute stress tasks. A mediational analysis confirmed that Pb was a significant mediator of the SES-TPR reactivity association; some evidence also suggested moderation. CONCLUSION: These results suggest the importance of considering the chemical environment as well as social and psychological environment when evaluating cardiovascular effects of low SES.