Resilience in developing systems: the promise of integrated approaches

Abstract

This article describes a contemporary systems approach to resilience in human development and its promise for integrating findings and applications across system levels. Resilience is defined as the capacity of a system for successful adaptation to disturbances that threaten system function, viability, or development. Advantages of this definition are delineated in regard to integrating sciences and disciplines across scales and levels of interaction in a bioecological systems framework. Central concepts of resilience, including pathways and cascades, are described in light of this approach, and advances that link system levels are highlighted. Given significant progress toward a more dynamic, integrated, multisystem approach, developmental resilience science stands at new frontier of possibilities that promises to inform science, practice, and policy focused on building human capacity for surviving and thriving in times of turbulence and change.     

Culture and the organization of infant sleep: A study in the Netherlands and the U.S.A.

This study investigates differences in the amount and structure of infant sleep in two cultural places with previously documented, divergent parental beliefs and practices. Eight-month-old infants (n = 24 per site) were recruited from towns in the Netherlands and the eastern U.S.A. To evaluate sleep, infants’ physical activity was recorded at home for 24 h using a miniature actigraph, while parents kept a diary of infant activities. Measures derived from actigraphy include total sleep, longest sleep episode, longest wake episode, number of sleep episodes, and percent of sleep during nighttime, as well as time in the stages of Quiet and Active Sleep. Measures based on the parental diaries include most of these aspects as well, except those related to sleep stages. Results based on the more precise actigraphy method indicate that (1) the Dutch infants averaged 13.65 h of sleep per 24 h, 1.67 h more than the U.S. infants; this difference was mostly due to daytime sleep; (2) The Dutch infants’ longest wake episode averaged less than that of the U.S. infants, while their longest sleep episode appeared slightly longer. (3) The Dutch infants, compared to the U.S. sample, spent more time in the Quiet, rather than the Active phase of sleep; (4) They began their Quiet sleep earlier in the evening than did their U.S. counterparts. Measures derived from parental diaries are largely in agreement with the actigraph findings. These results are consistent with reported and observed practices and beliefs in the two communities. The pattern of differences – less apparent maturity among the Dutch in the amount of sleep, but greater apparent maturity in the structure of sleep -- illustrates that behavioral and neurological maturity can be assessed only in the context of the developing child’s adaptation to the specific demands and affordances of the culturally structured developmental niche.     

Identifying developmental stuttering and associated comorbidities in electronic health records and creating a phenome risk classifier

PurposeThis study aimed to identify cases of developmental stuttering and associated comorbidities in de-identified electronic health records (EHRs) at Vanderbilt University Medical Center, and, in turn, build and test a stuttering prediction model.MethodsA multi-step process including a keyword search of medical notes, a text-mining algorithm, and manual review was employed to identify stuttering cases in the EHR. Confirmed cases were compared to matched controls in a phenotype code (phecode) enrichment analysis to reveal conditions associated with stuttering (i.e., comorbidities). These associated phenotypes were used as proxy variables to phenotypically predict stuttering in subjects within the EHR that were not otherwise identifiable using the multi-step identification process described above.ResultsThe multi-step process resulted in the manually reviewed identification of 1,143 stuttering cases in the EHR. Highly enriched phecodes included codes related to childhood onset fluency disorder, adult-onset fluency disorder, hearing loss, sleep disorders, atopy, a multitude of codes for infections, neurological deficits, and body weight. These phecodes were used as variables to create a phenome risk classifier (PheRC) prediction model to identify additional high likelihood stuttering cases. The PheRC prediction model resulted in a positive predictive value of 83 %.ConclusionsThis study demonstrates the feasibility of using EHRs in the study of stuttering and found phenotypic associations. The creation of the PheRC has the potential to enable future studies of stuttering using existing EHR data, including investigations into the genetic etiology.     

Situations de vulnérabilités familiales et pandémie COVID-19

ContextAware of the difficulties caused by the COVID-19 pandemic for many families with children aged 6 or under, this study focuses on three contexts of potential vulnerability: single parenthood, children with developmental disorders, poverty.MethodA questionnaire, consisting of 69 questions, was transmitted nationally during the first lockdown (from 17 March to 10 May 2020). Among the study sample (n = 490), 36 households were single-parent, and 93 families had a child with developmental impairments. From November 2020 to June 2021, a additional qualitative approach was used to reach the most vulnerable groups (n = 23).ResultsThe methodology adopted made it possible to identify modes of experience that converge across families in the three contexts (more strengthened intrafamily relationships and investment in protection measures, for example), and others that appear more specific: pressure felt and need for information for single-parent households and those with children with developmental disorders, the burden of home schooling for single-parent households and the poorest, social isolation for single-parent households and difficulties in maintaining the previous food budget for the most precarious.ConclusionThe various pressures felt, the housing (with or without outdoor spaces) and working conditions, the fear of being sick, the negative feelings, etc. must encourage public authorities to implement psychological support mechanisms, particularly for the most vulnerable parents, in order to avoid subsequent physical and/or psychological health problems or even post-traumatic symptoms for parents and their children.     

Profiles of Everyday Executive Function in Acquired and Developmental Disorders

The current study focused on the early development of inhibitory control in 5- to 7-year-old children attending kindergarten in two Eastern-European countries, Romania and Russia. These two countries share many aspects of child-rearing and educational practices, previously documented to influence the development of inhibitory control. Using the Lurian-based developmental approach offered by the Developmental Neuropsychological Assessment battery, the study aimed to contribute to cross-cultural developmental neuropsychology by exploring (a) early interrelationships between subcomponents of inhibitory control (response suppression and attention control) and generative fluency (verbal and figural) in these two cultures, as well as (b) the predictive value of external factors (culture and maternal education) and individual differences (age, gender, nonverbal intelligence, trait anxiety) on inhibitory control and fluency outcomes in children from both countries. First, findings in both culture samples suggest that even at this young age, the construct of inhibitory control cannot be considered a unitary entity. Second, differences in maternal education were not predictive of either inhibitory control or fluency scores. However, children’s attention control performance varied as a function of culture, and the direction of these cultural effects differed by whether the target outcome involved performance accuracy versus efficiency as an output. Findings also confirmed the previously documented intensive developmental improvement in preschoolers’ inhibitory control during this period, influencing measures of response suppression and particularly attention control. Finally, the results further stress the importance of individual differences effects in trait anxiety on attention control efficiency across cultures.     

Attention and social functioning in children with malformations of cortical development and stroke

Attention and social functioning and their interrelationships have not been routinely examined in children with early brain insult (EBI). This study aimed to describe attention and social functioning in children with two types of EBI: malformations of cortical development (MCD) and stroke. Children diagnosed with MCD (n?=?14, 6 males) or stroke (n?=?14, 8 males) aged 8 to 14 years (M?=?12 years 11 months) completed neuropsychological assessments to examine attention processes. Primary caregivers completed a questionnaire to assess executive components of children's attention and teachers completed a questionnaire to measure children's social functioning. Brain scans (MRI or CT) were coded by a pediatric neuroradiologist. Higher rates of impairments in attention and social function were found in children with EBI compared with normative expectations. Children with MCD experienced more global and clinically significant levels of impairment than children with stroke; though impairments were present in both groups. A strong association between executive components of attention and social function was observed. In addition, complex attention processes were associated with social function. The findings emphasize the reciprocity between attention, behavior and social outcomes, and the vulnerability of social function following EBI.     

A comparison of working memory profiles in children with ADHD and DCD

The main objective of present study was to investigate whether the patterns of working memory performance differ as a function of attention and motor difficulties, and whether children with ADHD and DCD could be reliably discriminated on the basis of their memory deficits. A related aim was to investigate the link between their working memory profiles and academic attainment. Fifty children with ADHD-Combined, 55 children with DCD, and an age-matched group of 50 typically developing children with average working memory were assessed on standardized measures of working memory, IQ, and academic attainment (reading, spelling, comprehension, and math). The normal controls performed significantly better than both clinical groups on all working memory tests. Specific patterns emerged in the memory profile of the clinical groups: The children with DCD had a depressed performance in all working memory tests, with particularly low scores in visuospatial memory tasks; children with ADHD performed within age-expected levels in short-term memory but had a pervasive working memory deficit that impacted both verbal and visuospatial domains. The clinical groups could reliably be discriminated on the basis of their short-term memory scores. Their learning profiles were similar. It is possible that the working memory profiles of the children with ADHD and DCD are influenced by distinct underlying cognitive mechanisms, rather than a general neurodevelopmental delay. Despite these distinctive patterns of memory performance, both clinical groups performed similarly on academic attainments, suggesting that memory may underlie learning difficulties, independent of related clinical disorders.     

Central executive involvement in children's spatial memory

Previous research with adults found that spatial short-term and working memory tasks impose similar demands on executive resources. We administered spatial short-term and working memory tasks to 8- and 11-year-olds in three separate experiments. In Experiments 1 and 2 an executive suppression task (random number generation) was found to impair performances on a short-term memory task (Corsi blocks), a working memory task (letter rotation), and a spatial visualisation task (paper folding). In Experiment 3 an articulatory suppression task only impaired performance on the working memory task. These results suggest that short-term and working memory performances are dependent on executive resources. The degree to which the short-term memory task was dependent on executive resources was expected to be related to the amount of experience children have had with such tasks. Yet we found no significant age-related suppression effects. This was attributed to differences in employment of cognitive strategies by the older children.     

Brief communications from the edge: psychotherapy with challenging adolescents

Issues of technique in work with adolescents who, if adult, would attract a forensic label, are discussed with especial focus on interpretation and countertransference in the light of primitive anxieties and body-based mechanisms of defence. The therapist as 'new object' and 'developmental object' is explored. The case study of Matthew - a mid-adolescent who has abused a younger child, is delinquent, seeks violent and dangerous situations and experiences outbursts of aggression - is used as illustration throughout.