Cognitive Functioning,Behavior, and Quality of Life After Stroke in Childhood

Rationale: To provide a better understanding of cognitive functioning, motor outcome, behavior and quality of life after childhood stroke and to study the relationship between variables expected to influence rehabilitation and outcome (age at stroke, time elapsed since stroke, lateralization, location and size of lesion).

Methods: Children who suffered from stroke between birth and their eighteenth year of life underwent an assessment consisting of cognitive tests (WISC-III, WAIS-R, K-ABC, TAP, Rey-Figure, German Version of the CVLT) and questionnaires (Conner's Scales, KIDSCREEN).

Results: Twenty-one patients after stroke in childhood (15 males, mean 11;11 years, SD 4;3, range 6;10–21;2) participated in the study. Mean Intelligence Quotients (IQ) were situated within the normal range (mean Full Scale IQ 96.5, range IQ 79–129). However, significantly more patients showed deficits in various cognitive domains than expected from a healthy population (Performance IQ p?=?.000; Digit Span p?=?.000, Arithmetic's p?=?.007, Divided Attention p?=?.028, Alertness p?=?.002). Verbal IQ was significantly better than Performance IQ in 13 of 17 patients, independent of the hemispheric side of lesion. Symptoms of ADHD occurred more often in the patients' sample than in a healthy population (learning difficulties/inattention p?=?.000; impulsivity/hyperactivity p?=?.006; psychosomatics p?=?.006). Certain aspects of quality of life were reduced (autonomy p?=?.003; parents' relation p?=?.003; social acceptance p?=?.037). Three patients had a right-sided hemiparesis, mean values of motor functions of the other patients were slightly impaired (sequential finger movements p?=?.000, hand alternation p?=?.001, foot tapping p?=?.043). In patients without hemiparesis, there was no relation between the lateralization of lesion and motor outcome. Lesion that occurred in the midst of childhood (5–10 years) led to better cognitive outcome than lesion in the very early (0–5 years) or late childhood (10–18 years). Other variables such as presence of seizure, elapsed time since stroke and size of lesion had a small to no impact on prognosis.

Conclusion: Moderate cognitive and motor deficits, behavioral problems, and impairment in some aspects of quality of life frequently remain after stroke in childhood. Visuospatial functions are more often reduced than verbal functions, independent of the hemispheric side of lesion. This indicates a functional superiority of verbal skills compared to visuospatial skills in the process of recovery after brain injury. Compared to the cognitive outcome following stroke in adults, cognitive sequelae after childhood stroke do indicate neither the lateralization nor the location of the lesion focus. Age at stroke seems to be the only determining factor influencing cognitive outcome.     

Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P): Test Review and Clinical Guidelines for Use

The Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) is a standardized questionnaire that measures executive functioning in preschoolers. This test review provides an overview of the BRIEF-P, including scale structure, administration, norms, score interpretation, current reliability and validity evidence, and provides general guidelines for clinical use.     

Complementary assessments of executive function in preterm and full-term preschoolers

Executive functions (EFs) are interrelated cognitive processes that have been studied in relation to behavior, attention, academic achievement, and developmental disorders. Studies of EF skills assessed through parent report and performance-based measures show correlations between them ranging from none to modest. Few studies have examined the relationship between EF skills measured through parent report and performance-based measures in relation to adaptive function. The present study included preschool children born preterm as a population at high risk for EF impairments. Preschool children (N = 149) completed a battery of EF tasks that assess working memory, response inhibition, idea generation, and attention shifting or cognitive flexibility. Parents reported on children’s EF and adaptive skills. Preterm children showed more parent-rated and performance-based EF impairments than did full-term children. The combined use of either parent report or performance-based measures resulted in the identification of a large number of children at risk for EF impairment, especially in the preterm group. Both parent report and performance-based EF measures were associated with children’s adaptive function. EF skills are measurable in young child'ren, and we suggest that EF skills may serve as targets for intervention to improve functional outcomes. We recommend the use of both parent report and performance-based measures to characterize children’s EF profiles and to customize treatment.     

Rethinking ‘Don't Blame the Victim’

SUMMARY

The psychology of victims and the dynamics of victimhood have been largely ignored by scholars and clinicians. While in past years the tendency has been to blame victims, more recently the tide has turned. It is now politically incorrect to explore the role of victims in violent systems, as exploring the psychology of victims has become synonymous with blaming the victim. While shying away from blame, this article will explore the familial and cultural origins of victimhood, victims' characteristics, their relationships with the perpetrators, and it will offer a victim typology. As we move from btame to a more complex understanding of violent systems, the perpetuation of these systems in our culture, and the role victims play in these systems, we provide ourselves with better tools to predict and prevent further victimization.     

Children with Attention Deficit Hyperactivity Disorder

ABSTRACT

It is estimated that there have been over 4,000 articles in the literature on the subject of attentional problems, addressing its etiology, epidemiology, assessment, diagnosis, and treatment. This article reviews recent and relevant literature with an eye toward functional conclusions and linkages between assessment and intervention. The article concludes by providing a problem-solving model that integrates parent or teachers' referral concerns, reasons for these concerns, assessment methods, and intervention strategies. In the end, four definitive conclusions are drawn, and the importance of multimodal strategies that collaboratively involve home, school, and community settings is emphasized.     

Judgments of Aggressive, Withdrawn and Prosocial Behavior: Perceived Control, Anger, Pity and Sympathy in Young Dutch Children

In two studies, we examined first- and second-grade children's judgments of aggressive, withdrawn, and prosocial behavior by means of fictional scenarios. In study I, we compared judgments of fictional aggressive children with those of fictional withdrawn children. Aggressive children were perceived as more responsible for their behavior and elicited more feelings of anger, while withdrawn children were more likely to be chosen as a friend and elicited more feelings of pity. In study II, we compared judgments of fictional aggressive, withdrawn, and prosocial children with each other. Again aggressive children elicited the strongest feelings of anger, while withdrawn children elicited the strongest feelings of pity. These withdrawn children were perceived as more similar to the prosocial children. In an attempt to test the ecological validity of our sympathy measure, we asked children to rate their peers on a three-point liking scale and checked the scores of those judged to be aggressive by their teachers. These aggressive children were found to receive the lowest liking scores. The results are discussed.     

Marital conflict: Correlates, structure, and context

Marital conflict has deleterious effects on mental, physical, and family health, and three decades of research have yielded a detailed picture of the behaviors that differentiate distressed from nondistressed couples. Review of this work shows that the singular emphasis on conflict in generating marital outcomes has yielded an incomplete picture of its role in marriage. Recently, researchers have tried to paint a more textured picture of marital conflict by studying spouses' backgrounds and characteristics, investigating conflict in the contexts of support giving and affectional expression, and considering the ecological niche of couples in their broader environment.     

The theory of learning styles applied to distance learning

Distance Education (DE) associated with the use of Virtual Learning Environments (VLE) as interaction tools between the student and the educator has become a large research niche spread around the world. Techniques to improve learning effectiveness in VLEs seek to find relation-ships connections between pedagogical advances and educational technological resources available in VLEs. In this context, this work sought to associate the theory of Learning Styles with the behavior of the student of Distance Education, observing their interaction with the Virtual Learning Environment and trying to associate them with their learning style identified by the CHAEA questionnaire. For this purpose, the CHAEA questionnaire was applied to a group of distance learning students and the correlation between their interactions with VLE and their learning styles was verified. The results show that there is no correlation between these elements, which may show, in fact, the lack of coherence between these theories. Seeking a model for data, a linear regression was applied and the results were, then, confirmed.     

Social learning under the labeling effect: Exploring travellers’ behavior in social dilemmas

This paper presents results of a laboratory experiment, in which subjects made choices between public and private transportation when managing Personal Carbon Allowances (PCAs). The objectives of this study were twofold. Firstly, it was aimed at investigating the labeling effect under the social dilemma context. Secondly, it showed insights into the decision-making process when feedback about others’ choices was provided. A combination of the labeling effect and feedback helped individuals change their commuting pattern and increase the number of trips by public transportation under the PCAs regime. Feedback on others’ choices resulted in social learning and incentivized choice of public transportation more frequently in social dilemma situations.     

Patch choice as a function of procurement cost and encounter rate.

The effects of patch encounter rate on patch choice and meal patterns were studied in rats foraging in a laboratory environment offering two patch types that were encountered sequentially and randomly. The cost of procuring access to one patch was greater than the other. Patches were either encountered equally often or the high-cost patch was encountered more frequently. As expected, rats exploited the low-cost patch on almost 100% of encounters and exploited the high-cost patch on a percentage of encounters that was inversely proportional to its cost. Meal size was the same at both patches. Surprisingly, when low-cost patches were rare, the rats did not increase their use of high-cost patches. This resulted in spending more time and energy searching for patches and a higher average cost per meal. The rats responded to this increased cost by reducing the frequency and increasing the size of meals at both patches and thereby limited total daily foraging cost and conserved total intake.