Occupational Therapy Interventions for Children with Attention Deficit Hyperactivity Disorder: A Systematic Review

This systematic review examined evidence published 2005–2015 for occupational therapy interventions for children with Attention Deficit Hyperactivity Disorder (ADHD). We identified 590 abstracts with 17 full-text articles eligible for review. Fourteen articles were included in the final analysis with two level I studies, two level II studies, eight level III studies, and two level IV studies. Occupational therapy interventions focused on play, sensory, motor, and cognitive skills. While the interventions yielded good results, there were limitations in study design, interventions, and outcome measures. Future research should include larger sample size, randomization, control groups, and interventions that can be replicated.     

创伤后应激障碍个体对威胁刺激的注意偏向：眼动研究的证据

对威胁刺激的注意偏向是创伤后应激障碍(PTSD)个体的一种表现。近年来, 研究者利用眼动技术探讨了注意偏向的加工特点及其内在机制。尽管针对是否存在注意定向加速、注意解除困难或注意回避的研究结果并不一致, 但都试图为验证如警戒-回避模型、注意保持模型等提供眼动证据。未来研究在记录PTSD个体注视模式时, 不仅需要从多个维度构建、整合PTSD个体的眼动模型, 也要结合多种技术从多模态角度共同考察PTSD个体的威胁信息注意偏向机制。     

Violence Exposure and the Development of School-Related Functioning: Mental Health, Neurocognition, and Learning

The relation between history of violence exposure and the development of academic and mental health problems is explored. Violence exposed children have an increased risk of developing school-related problems including: mental health problems, learning disabilities, language impairments, and other neurocognitive problems. These problems interact to create a complex web of deficits and disabilities where intervention access points are difficult to assess. Often mental health problems and academic problems develop in parallel. Timing of violence exposure and the developmental stage of the child during exposure complicate our understanding of the underlying mechanism. A model is presented that explores pathways linking violence exposure to aspects of school-related functioning, both academically and behaviorally. Early life stress, in the form of violence exposure, is related to neurocognitive deficits, including executive functioning and problems in self-regulation. Deficits in self-regulation at the level of behavior, and cognitive control and executive functioning, at the level of brain processing, are related to both academic and mental health problems, suggesting a possible psychological mechanism. Biological mechanisms are also included in the model to illustrate the contribution of the stress response, neuroendocrine system response, and neuroanatomical structural and functional impairments associated with violence exposure.     

7～10岁自闭症谱系障碍儿童对情绪面孔的觉察与加工

为了考察自闭症谱系障碍(autism spectrum disorder,ASD)儿童对不同情绪面孔的觉察和加工情况,设计两个眼动实验任务,要求14名7～10岁ASD儿童和20名同年龄正常儿童观看图片。实验一采用将情绪面孔嵌入风景图片中引起语义不一致的刺激;实验二采用含有情绪面孔的无意义背景乱序图片刺激。结果发现:(1)ASD儿童对不同情绪面孔的觉察时间都显著长于正常儿童;(2)与正常儿童一样,ASD儿童表现出对恐惧面孔的注意偏向;(3)实验二中,ASD儿童对不同情绪面孔内部特征区的注意分配与正常儿童不同;正常儿童能注意最能展示该类情绪特征信息的区域,如恐惧的眼睛、愉快的嘴巴,而ASD儿童对三类情绪面孔特征区的注意分配方式相似;(4)两个实验条件下,ASD者对不同情绪面孔的觉察、加工模式与正常儿童相似。     

The influence of task paradigm on motor imagery ability in children with Developmental Coordination Disorder

Children with Developmental Coordination Disorder (DCD) have difficulty imagining movements such that they conform to the customary temporal constraints of real performance. We examined whether this ability is influenced by the choice of task used to elicit motor imagery (MI). Performance of typically developing (TD) (n = 30) and children with DCD (n = 30) was compared on two tasks: the Visually Guided Pointing Task (VGPT) and the Computerized Virtual Radial Fitts Task (C-VRFT). Since the VGPT places higher demands on executive functions like working memory but requires less spatial planning, we reasoned that the C-VRFT would provide a purer measure of motor imagery (or simulation). Based on our earlier work, we predicted that imagery deficits in DCD would more likely manifest on the C-VRFT. Results showed high correlations between tasks in terms of executed and imagined movement time suggest that both tasks measure MI ability. However, group differences were more pronounced in the imagined condition of the radial Fitts’ task. Taken together, the more spatially complex C-VRFT appears to be a more sensitive measure of motor imagery, better discriminating between DCD and TD. Implications for theory and practice are discussed.     

Predicting Perceived Risk of Crime: a Multilevel Study

With a sample of Italians selected from 71 Italian counties (N = 1,868), we performed two multilevel analyses aimed at predicting the perceived risk of crime at local (i.e., in the participants' county of residence) and at societal (i.e., in the context of Italian society) levels. A significant proportion of the variation in local risk perception was at the county level. The following individual variables predicted higher levels of this variable: indirect victimization, the perception of social and physical disorder, being a woman, being poorly educated, and being an older person. Among the ecological predictors, the crime rate and unemployment rate predicted higher levels of local crime risk perception, while the immigrant rate did not. Perceived risk of crime at the societal level did not show significant variation at the county level. Education, being a man, trusting people, and adhesion to post‐materialistic values predicted lower levels of societal crime risk perception, while number of sons/daughters and exposure to television news increased it. The limitations and possible development of this study are discussed.     

Attention-Deficit/Hyperactivity Disorder symptoms in an adult sample: Associations with Cloninger’s temperament and character dimensions

Relationships between C.R. Cloninger’s temperament and character dimensions and the Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms of inattention (IA) and hyperactivity/impulsivity (HI) were examined in 231 adults from the general population. Regression analyses that predicated overall ADHD, IA and HI by the seven temperament/character dimensions revealed: IA was predicted positively by Harm Avoidance and negatively by Self-Directedness; HI was predicted positively by Persistence; and overall ADHD was predicted negatively by Self-Directedness. These findings are also interpreted in terms of current theories of ADHD, and the related original and revised versions of Gray’s reinforcement sensitivity theory (RST) of personality.     

Suppression of Chronic High Frequency Spitting in a Multiply Handicapped and Mentally Retarded Adolescent

Excessive drooling and spitting are maladaptive behaviors often encountered among severely developmentally delayed children. In the present study a blind, deaf and retarded adolescent exhibited an extremely high rate of spitting which had resisted numerous classroom intervention efforts by teachers using punishment techniques. His recalcitrant spitting was eliminated with a behavioral intervention consisting of positive reinforcement for not spitting and facial screening for spitting. Experimental control was demonstrated using a multiple baseline across situations and within subject reversal design. The treatment package successfully eliminated the child's chronic spitting. Teacher reports one year later indicated the results maintained across time and spitting was no longer a problem. Social and academic implications of modifying such behaviors are discussed.     

CBT for Children and Adolescents With High-Functioning Autism Spectrum Disorders,edited by A. Scarpa,S. Williams White, & T. Attwood

ABSTRACT

Parent-Child Interaction Therapy (PCIT) is a manualized behavioral intervention originally developed by Eyberg (1988 Eyberg, S. (1988). Parent-child interaction therapy: Integration of traditional and behavioral concerns. Child &; Family Behavior Therapy, 10(1), 33–46. doi:10.1300/j019v10n01_04[Taylor &; Francis Online] , [Google Scholar]) to address disruptive behaviors in young children. Although previous research findings support the contention that components of PCIT would positively impact communication, behavior, and adaptive skills (Howard, Sparkman, Cohen, Green, &; Stanislaw, 2005; Lovaas, 1987 Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9. doi:10.1037/0022-006x.55.1.3[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Remington et al., 2007 Remington, B., Hastings, R. P., Kovshoff, H., Degli Espinosa, F., Jahr, E., Brown, T., &; Ward, N. (2007). Early intensive behavioral intervention: Outcomes for children with autism and their parents after two years. American Journal on Mental Retardation, 112(6), 418–438. doi:10.1352/0895-8017(2007)112[418:eibiof]2.0.co;2[Crossref], [PubMed] , [Google Scholar]) in children with developmental disabilities, few studies are shown in the literature. In a modified version of PCIT, caregivers completed two phases of intervention with their child diagnosed with Autism Spectrum Disorder (ASD). During the Child-Directed Interaction (CDI) phase, caregivers were taught to conduct mand training, follow-their child’s lead, provide attention for their child’s positive behaviors, and ignore their child’s negative behaviors. During the Parent-Directed Interaction (PDI) phase, caregivers were taught to give effective commands and follow through with demands. The goal of the current study was to determine whether children’s production of vocalizations increased after participation in a modified PCIT program. Data from two participants diagnosed with autism were included in the study. Outcomes of these two case studies show that both children displayed an increase in the total number of vocalizations emitted in the posttreatment observation relative to baseline. Additionally, caregivers of both participants displayed an increased number of positive behaviors in the posttreatment observation relative to baseline.     

Improving FASD Children’s Self-Regulation: Piloting Phase 1 of the GoFAR Intervention

ABSTRACT

The initial parent training component of GoFAR, an intervention designed to improve the self-regulation and adaptive living skills of children with Fetal Alcohol Spectrum Disorders (FASDs), was piloted in a small, randomized clinical trial of 28 participants assigned to either a time-lapsed control group or one of two parent training groups who differed on whether the child’s computerized instruction was congruent or incongruent with the parent instruction. Parental compliance and achievement of therapy goals were indicators of improvement in the child’s self-regulation skills. Children who received computerized instruction consistent with the parent training demonstrated greater self-regulation improvements than those receiving incongruent computerized instruction.