When should clinicians switch treatments? An application of signal detection theory to two treatments for women with alcohol use disorders

Statistical application of signal detection theory has been used to study the clinical utility of early treatment response in a range of treatments and psychiatric disorders. The current study sought to examine the predictive value of weekly within-treatment drinking using receiver operator curves (ROCs) and zero-inflated Poisson (ZIP) regression in 102 women with alcohol use disorders (AUDs) randomized to either alcohol behavioral individual treatment (ABIT; n = 52) or alcohol behavioral couples treatment (ABCT; n = 50). ROC analyses indicated that failure to achieve or sustain abstinence by the end-of-treatment and one-year follow-up was predicted with reasonable accuracy by week 4 percent days abstinent (PDA) in ABIT. ZIP models yielded similar results with evidence for within-treatment PDA with week 6 PDA predicting both the abstinence as well as percent days drinking at the end-of-treatment and one-year follow-up. Within-treatment PDA was a significantly better predictor of outcomes for ABIT than ABCT, despite a better overall treatment response for ABCT. Implications for stepped care models of alcohol treatment are discussed and recommendations for future research made. When Should Clinicians Switch Treatments: An Application of Signal Detection Theory to Two Treatments for Women with Alcohol Use Disorders.     

Tier 1 and Tier 2 early intervention for handwriting and composing

Three studies evaluated Tier 1 early intervention for handwriting at a critical period for literacy development in first grade and one study evaluated Tier 2 early intervention in the critical period between third and fourth grades for composing on high stakes tests. The results contribute to knowledge of research-supported handwriting and composing instruction that informs practice as school psychologists are empowered to embrace the role of intervention specialist. The first study found that neurodevelopmental training (orthographic-free motor activities and motor-free orthographic activities) led to improved accuracy and legibility of letter formation, but that direct handwriting instruction with visual cues and verbal mediation led to improved automatic handwriting (rate of writing legible letters) and transfer to improved word reading. The second study found that neither motor training nor orthographic training alone added value to direct instruction in automatic letter writing and composing practice in developing handwriting skills, which transferred to improved word reading; but the added motor training did improve performance on a grapho-motor planning task for sequential finger movements that is relevant to composing. A related analysis showed that direct instruction with visual cues and memory delays may reduce reversals. A third study found that adding handwriting to reading instruction improved handwriting but did not add value to reading outcomes for at risk readers; reading instruction alone was beneficial for word reading, decoding, and comprehension. The fourth study showed that comprehensive, explicit instruction in the processes of composition led to more significant improvement, based on group and individual data, than did the regular fourth grade program, on high stakes writing assessment.     

A Cognitive-behavioral Approach to Reconstructing Intergenerational Family Schemas

This article suggests the use of cognitive-behavioral techniques, namely cognitive restructuring combined with family-of-origin sessions, for reconstructing intergenerational family schemas. A case example portrays the use of the techniques as an effective intervention for addressing ingrained schemas, such as in the case of spousal abuse.Portions of this article were drawn from a lecture provided to the University of London’s Institute of Psychiatry at the Maudsley Hospital, UK in August of 2005. The author wishes to acknowledge Mr. Eric Frey and Ms. Katherine Adams for their assistance with the literature search.     

Is the Role of the School Psychologist in Early Childhood Truly Expanding? A National Survey Examining School Psychologists' Practices and Training Experiences

Historically, the role of school psychologists in early childhood settings has been limited to the identification and evaluation of children who may be in need of special education services under Part B of the Individuals with Disabilities Education Act. It has been suggested that the role should reflect a more proactive model; specifically, it should continue to expand to include involvement in school readiness and early intervention for all students. The purpose of this study was to examine the present role of school psychologists in early childhood settings and investigate the graduate-level training provided to school psychology graduate students. Results of the survey found that a significant percentage of school psychologist practitioners continue to spend a substantial portion of their professional time completing special education evaluations. Furthermore, respondents reported minimal to moderate graduate training in the area of early childhood populations. Implications for school psychology practitioners and school psychology graduate training programs are discussed.     

Strengthening the Child‐ and Youth‐Serving Workforce: Surveying the Landscape,Overcoming Challenges

This special issue addresses a neglected but important topic in our field: strengthening the child‐ and youth‐serving workforce. Investing in this workforce should be a national priority because considerable evidence has shown that investments in early childhood education and development, particularly in low‐resource contexts, that are reinforced through skills‐based programs in adolescence and adulthood, have beneficial impacts throughout life. Investing in quality child‐ and youth‐serving programs also has the additional benefit of creating a productive and capable future workforce. The editors and authors of the special issue should be commended for producing the first special issue on this topic in our field or in related fields, one that is long overdue. Articles in this issue survey the landscape of an amorphous and complex area of practice and research and describe key challenges for the field. In this commentary, I offer organizing frameworks to characterize the child‐ and youth‐serving workforce, note emerging issues when addressing specific challenges, and identify areas for future research.     

The role of early care and education in addressing early childhood trauma

Young children's experience of trauma is associated with a wide range of adverse events and circumstances, including abuse and neglect, domestic violence, loss of a parent, and community violence. Policymakers and practitioners are increasingly aware that trauma during the first few years of life is especially widespread, and there is growing interest in new ways to support these young children and their families. Many young children who experience trauma attend early care and education (ECE) programs, and these settings offer important opportunities to promote their well‐being. This paper examines strategies currently being implemented in ECE to address early childhood trauma. The paper first examines research on how trauma affects young children's development, ECE environments, and society. We then describe the unique needs of young, traumatized children and features of trauma‐informed care that can address their needs, along with emerging interventions and supports that can be incorporated into or linked with ECE settings as part of a trauma‐informed approach. We conclude with a discussion of future directions for ECE and trauma research, policy, and practice, bearing in mind both the promise of new approaches and a limited evidence base to date.     

Early family adversity,stability and consistency of institutional care and infant cognitive,language and motor development across the first six months of institutionalization

This study extends research on the effects of institutionalization—by examining the trajectories of cognitive, language and motor development of 64 Portuguese infants and toddlers across the first six months of institutionalization, while determining whether pre-institutional adversities and the stability and consistency of institutional care predict children’s development. At time of enrollment, 23.4%, 32.8% and 31.3% of the children were moderately to severely delayed, respectively, in their cognitive, linguistic and motor functioning. Developmental problems persisted after six months of institutionalization. The accumulation of early pre-institutional adversities predicted cognitive and motor limitations at admission to the institutions, but not variation in subsequent development. The stability and consistency of institutional care also failed to predict developmental growth and change. Children who had never lived with their families of origin showed a better language development at enrollment than their counterparts who had lived with their families of origin before institutionalization. Such advantage was followed by a deceleration in language growth after six months of institutional placement. Results are discussed in terms of short- vs. longer-term effects of institutionalization.     

When autobiographical memory begins

The authors review competing theories concerning the emergence and early development of autobiographical memory. It is argued that the differences between these accounts, although important, may be more apparent than real. The crux of these disagreements lies not in what processes are important, but rather, the role these different processes play in the emergence of autobiographical memory and the temporal primacy of these controlling variables. These differences are explored theoretically and then extant as well as new data are brought to bear on these issues. What emerges is a new, more inclusive, multifactorial framework that integrates the controlling variables from diverse perspectives providing a more complete account of the beginnings of autobiographical memory.     

Relations Between Emotion Regulation, Parenting, and Psychopathology in Young Maltreated Children in Out of Home Care

Young maltreated children, birth to three years, represent the age group with the highest rates of maltreatment in the United States (ACYF 2007). There are few studies to date that have investigated early childhood maltreatment and its effects on emotion regulatory processes and psychopathology. In response, the current investigation uses a dyadic assessment procedure to examine the relationship between parenting, emotion regulation, and symptoms of psychopathology among maltreating and non-maltreating parent–child interactions. The participants in this study were 123 children (66 maltreated and 57 nonmaltreated) from ages 1–3. Child and parent affect and child effortful control were observed during a parent–child interaction task. Symptoms of psychopathology were measured using the Child Behavior Checklist. The maltreated children exhibited more anger, more internalizing symptomatology, and less positive affect compared to non-maltreated children. Among maltreated children, emotion dysregulation was associated with internalizing symptomatology. Moreover, these data reveal parental positive affect was associated with lower child internalizing symptomatology and parental anger was associated with higher child internalizing symptomatology in the entire sample. This investigation offers evidence that emotion dysregulation subsequent to poor dyadic interactions is associated with early child maltreatment. These data suggest that maltreated children experience difficulties in emotion regulation which may be related to their higher levels of behavioral symptomatology.