Integrated,Family‐based,Partial Hospital Treatment for Complex Pediatric Illness

This paper describes a unique treatment program for complex pediatric illness. The Hasbro Children's Partial Hospital Program uses a family systems orientation, integrated care, and a partial hospital setting to treat children with a wide range of pediatric illnesses that have failed outpatient and inpatient treatments. We have treated more than 2000 children with at least 80 different ICD‐9 diagnoses. The multidisciplinary treatment team functions as a meta‐family for children and their families who present with illness and family beliefs that impede successful outcomes with standard care. The three features: family systems orientation, integrated care, and partial hospital setting, hopefully interact to create an environment that helps families expand and modify their explanatory models regarding participating in effective medical care. The goal of treatment is for both children and their parents to feel empowered to take control of the illness. Parents completing standardized measures at intake describe their children and families as experiencing significant emotional distress, low levels of general family functioning, and poor quality of life. Although the children are described as having distinct behavioral differences, the families are described as responding to the experience of a seriously ill child in similar ways. A treatment program that addresses the noncategorical aspects of how families respond to illness while addressing the specific diseases of the children can allow children and their families to respond favorably to treatment.     

Beyond the Couple: A Qualitative Analysis of Successful In‐law Relationships in Iran

In‐laws can play a significant role in the success or failure of marriages around the world. In the Middle East, recent quantitative research indicates that having trouble with in‐laws is a major predictor of divorce in Iran. To explore this further, we undertook a qualitative (grounded theory) analysis of in‐depth interviews with 17 Iranian daughters‐in‐law, five sons‐in‐law, three mothers‐in‐law, three fathers‐in‐law, and three expert family clinicians. Emergent concepts, themes, and coding categories were consistent with a Family Triad Model (FTM) of successful marital and in‐law relationships, wherein each spouse must (a) form we‐ness with their partner, (b) establish flexible boundaries between themselves and their families of origin, and (c) join their in‐laws. A higher‐order core category suggested that optimal couple and family functioning depends on the coherence or balance of these functions across the triadic role components of spouse, child‐in‐law, and family‐in‐law (or family‐of‐origin). In the changing cultural context of Iran, where blood relations have traditionally held primacy over marital relations, such triadic coherence appears crucial to marital success, at least from the perspective of many women. Our FTM results also highlight the importance of taking in‐laws into account when planning educational, preventative, or clinical interventions.     

Neighbourhood,school and family determinants of children's aspirations in primary school

Aspirations can be important for young children as well as adolescents. However, there is little research on the determinants of aspirations in young children. We carried out this study to investigate the early contextual (neighbourhood, school and family) determinants of occupational aspirations in primary school children. Our sample comprised children from the Millennium Cohort Study who lived in England in the beginning of our study period (n = 10,086; 5,126 boys). Occupational aspirations were measured at age 7 years, while their contextual determinants were measured in the previous data sweeps, at ages 3 and 5 years. We fitted structural equation models to test the role of family and neighbourhood socio-economic status (SES) and child ethnicity in predicting aspirations both directly and via their associations with parental involvement, household chaos, school-level achievement and child cognitive ability. We found that the only significant determinants of aspirations at age 7 years were family SES and ethnicity, and only in boys. Family SES and ethnicity were also related to parental involvement, household chaos, cognitive ability and school-level achievement, but none of these factors predicted aspirations. Supplementary analysis showed that family SES was a particularly powerful determinant of the aspirations of white compared to non-white boys.     

The Integration of Family and Group Therapy as an Alternative to Juvenile Incarceration: A Quasi‐Experimental Evaluation Using Parenting with Love and Limits

The current study employed a quasi‐experimental design using both intent‐to‐treat and protocol adherence analysis of 155 moderate‐ to high‐risk juvenile offenders to evaluate the effectiveness of Parenting with Love and Limits® (PLL), an integrative group and family therapy approach. Youth completing PLL had significantly lower rates of recidivism than the comparison group. Parents also reported statistically significant improvements in youth behavior. Lengths of service were also significantly shorter for the treatment sample than the matched comparison group by an average of 4 months. This study contributes to the literature by suggesting that intensive community‐based combined family and group treatment is effective in curbing recidivism among high‐risk juveniles.     

The relationship between family support; pain and depression in elderly with arthritis

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0%) and 1567 females (65.0%) with arthritic conditions (n = 2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p < .05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.     

The structure of coordination in first language acquisition of Mandarin Chinese: evidence for a universal

This study exemplifies a type of cross-linguistic research which is based on the theory that certain parameters of natural language variation are central to the human competence for language. Sensitivity to these parameters allows the child to develop various specific language structures which follow from setting the parameters. Results of this study provide evidence that children are universally sensitive to one such parameter, namely, Principal Branching Direction.Data are based on results of a standardized elicited imitation test of 68 Chinese children in Taiwan between 2;0 and 4;5 with mean age of 3;3. The test is on a set of coordinate sentences. The results show that children acquiring Mandarin Chinese (a left-branching language) systematically prefer VO sentences with a backward reduction pattern ([V + V]O) over those with a forward reduction pattern (V[O + O]).Children's responses to SV coordinate sentences differ systematically from their VO responses. They very frequently reduce redundant subjects in a forward direction (in SV sentences) and do not prefer backward reduction ([S + S])V) over forward reduction (S[V + V]) in these SV sentences.This paper suggests an explanation of this apparent paradox in terms of an interaction in early language acquisition between children's sensitivity to a predominant Chinese topic-comment structure (in SV) and their sensitivity to the abstract, specifically grammatical concept of “Principal Branching Direction”.     

The family and the bonds of recognition

I draw upon the resources of the philosophy of recognition, as well as recent research associated with existentialist, psychoanalytic and family-therapy forms of psychotherapy, to develop an account of the family as a distinctive and relatively autonomous system of affective recognition. Those forms of recognition that are most essential in the broader social and political spheres—for instance, those found in law and in contractual relations—generally concern our recognition of each other as discrete, self-conscious, individual agents who are at bottom independent of each other. In contrast, it is argued that familial recognition is founded upon a rather different conception of selfhood, one that emphasizes our inherent porosity with respect to other selves, and so on our incapacity to set ourselves apart from others. Moreover, familial recognition is enacted primarily at the affective, preconscious level, such that members find themselves implicated in each other's self-identities prior to their being in a position to fully appreciate, in a more self-conscious and independent manner, the nature and extent of their involvement. I follow Hegel in arguing that, for these reasons, familial recognition is not only autonomous with respect to certain of the forms of recognition governing the wider social world, but that it is in certain respects at odds with them.     

Reading disability: A problem in rule learning and word decoding

Traditional explanations of reading disability (e.g., perceptual, memory, and phonetic receding deficits) have encountered logical difficulties and substantial empirical disconfirmation. An alternative conceptualization of the nature of reading disability is proposed. Disabled readers are hypothesized to suffer a fundamental problem in acquiring word knowledge and word processing skills. Poor decoding skills prevent them from developing sophisticated reading comprehension skills. From this perspective, the cognitive deficits of disabled readers result from failure to acquire and generalize complex processing skills originally mastered through reading experience. Recent research of the author and of others relating to these issues is discussed.