A Review of Occupation-Based Life Skills Interventions for Adults with Neurodevelopmental Disorders

Adults with neurodevelopmental disorders are at a higher risk for poverty, unemployment, and difficulties in relationships. Instrumental activities of daily living deficits often go unaddressed and minimal research has explored interventions to address them. The purpose of this study was to synthesize findings about occupation-based life skills interventions for adults with neurodevelopmental disorders. Ten articles met inclusion criteria and the American Occupational Therapy Association level of evidence and quality ratings were identified. Results indicate that occupation-based life skills interventions effectively address limitations experienced by adults with neurodevelopmental disorders but the overall quantity and quality of evidence-based interventions are lacking.     

Cognitive-Behavioral Constructs and Children's Behavioral and Emotional Problems

Each cognitive behavior therapy has produced research concerning the cognitive construct it posits to mediate psychopathology. This study attempted to compare the major cognitive behavioral constructs to determine how they are related to each other and how each is related to teachers' perception of externalized and internalized behavioral and emotional problems. Children between the ages of 9 to 13 were classified as internalized, externalized, mixed, or no behavior and emotional problems groups according to their scores on the Teacher's Report Form of the Child Behavior Checklist and teachers' ratings on the Walker Problem Identification Scale. Measures of Ellis' (1962) irrationality, Beek's (1976) negative automatic thoughts, Spivack's (Spivack, Platt, & Shure, 1976) social problem skills, and Meichenbaum's (1977) guiding self statements were administered to the children. The results indicated that the various cognitive constructs were only moderately correlated with each other. Irrational beliefs and cognitive distortions were correlated higher than other comparisons. The correlations between the measures of the constructs suggest they are slightly related but represent different constructs. The emotional and behavioral problems groups scored higher than the no problems group on some subtest of irrational beliefs and negative cognitive thoughts. Also, the measures of emotional and behavior problems correlated significantly with some subtest of irrational beliefs and negative automatic thoughts. Irrational beliefs appeared to be related to internalized and externalized emotional and behavioral problems, while negative automatic thoughts appeared to be best related to internalized emotional and behavioral problems. The measures of problem solving skills and guiding self statements appear to be best related to externalized problems.     

Cognitive Appraisal Therapy: A Treatment Plan for “Silvia”

The principles and procedures of Cognitive Appraisal Therapy (CAT) are applied to the case of Silvia. The assessment plan focuses on affective, behavioral, and cognitive aspects of personality. The patient evidences self-pity and anger, and rebellion and withdrawal in her interpersonal relations. Key interventions include encouraging positive methods for comforting her feelings, building self-respect by doing what she deems morally right, eliminating self-defined victim status by active pursuit of her goals, and correcting cognitive distortion of self-image and pessimistic forecasts. Other characteristic CAT interventions are also discussed and illustrated.     

Personality Dysfunction, Coping Styles, and Clinical Symptoms in Younger and Older Adults

This study examined age-related differences in personality disorders, dispositional coping strategies, and clinical symptoms between younger (n = 79; age range = 18–29; M age = 21.2 years) and older (n = 79; age range = 55–89; M age = 65.5 years) persons (matched on gender and ethnicity). Participants completed the Coolidge Axis II Inventory (CATI), Coping Orientations to Problems Experienced Scale (COPE), and Brief Symptom Inventory (BSI). Personality results (t tests) based on the CATI revealed that older persons were significantly more obsessive–compulsive and schizoid than younger adults but significantly lower on 7 scales, including antisocial, borderline, histrionic, and sadistic. As assessed by the COPE, older adults reported lower levels of dysfunctional coping strategies than younger adults. Specifically, older persons were less likely to use mental disengagement, venting of emotions, and alcohol/drugs to cope with problems. BSI results for clinical symptoms revealed that younger adults were significantly higher on 5 of 9 scales, including anxiety, depression, and hostility. Results suggest that younger adults experience higher levels of personality and clinical symptoms and use more dysfunctional coping strategies than older adults, dispelling the myth that old age is associated with inevitable psychological impairment. Theoretical considerations, clinical implications, and future research ideas are discussed.     

Factors Predicting Attrition Within a Community Initiated System of Care

We designed this study to elucidate child, family, and service level characteristics that may influence attrition from a continuum of care developed and maintained by a community initiated collaboration of local clinics and agencies. Subjects included 117 children and adolescents referred to the Middlesex County system of care from 1992–1999. Data were collected through a retrospective case review. The strongest predictors of attrition from the system of care both before and after the establishment of an individualized service plan included depressed/isolated symptoms, substance abuse, general risk for psychiatric problems, number of referral reasons and urgency status at program intake. Among youth exiting residential placement, those completing recommended services were more likely to be returned home earlier or within the expected time frame than were dropouts. Our study presents important preliminary findings regarding characteristics related to treatment adherence within a community initiated systems of care.     

Converting between word and syllable counts in children's conversational speech samples

Several authors have suggested that it is possible to convert between word and syllable counts for basic clinical measurements such as the frequency of speech disfluencies or speaking rate in conversational speech samples. Based primarily on results from adults' speech samples, proposed conversion factors have averaged approximately 1.5 syllables per word. Because children produce fewer multisyllabic words than adults, this conversion factor is probably not appropriate for children's speech samples. This study sought to develop a more accurate conversion factor for children's speech by comparing syllable and word counts in spontaneous speech samples produced by 50 children, age 3 to 5. Analyses revealed an average ratio of 1.15 syllables per word, which was consistent across different subjects, across subject groups (children who stutter and children who do not stutter) and also, somewhat surprisingly, across age groups (3-year olds, 4-year olds, and 5-year olds). Results suggest that this constant conversion factor of 1.15 can be used to convert between word and syllable with sufficient precision to allow clinicians to compare their data to published guidelines and benchmarks about childhood stuttering.     

Responsive Parenting and Child Socialization: Integrating Two Contexts of Family Life

Developmental and behavioral research traditions differ in their prioritization of certain interpersonal contexts. Developmentalists focus on what might be called the attunement context and investigate how parent responsiveness impacts child symbolic capacities and social behavior. Behaviorists, on the other hand, focus primarily on limit-setting encounters and how reinforcement impacts rates of coercive and cooperative child behavior. The present paper discusses parental attunement from a reinforcement perspective. It illustrates that child behavior is related not only to how parents respond to prior episodes of coercion and cooperation, but to a wide range of child social behaviors.     

Unconscious odour conditioning 25 years later: Revisiting and extending ‘Kirk-Smith, Van Toller and Dodd’

The pioneering work by Kirk-Smith, Van Toller, and Dodd [Kirk-Smith, M. D., Van Toller, C., & Dodd, G. H. (1983). Unconscious odour conditioning in human subjects. Biological Psychology, 17, 221–231], established that an unnoticed odorant paired with an emotionally meaningful task can influence mood and attitudes when the odorant alone is re-encountered subsequently. This study was particularly important in highlighting unconscious odour learning processes as they may happen in everyday life. However, it was severely criticized by Black and Smith [Black, S. L., & Smith, D. G. (1994). Has odor conditioning been demonstrated? A critique of “Unconscious odour conditioning in human subjects”. Biological Psychology, 37, 265–267] on methodological grounds. In the present paper, we replicated and extended Kirk-Smith et al.’s investigation taking into account Black and Smith’s criticisms and carrying out additional controls to improve the validity of the study. The results confirm the initial findings of Kirk-Smith and colleagues by demonstrating the effectiveness of olfactory stimuli in inducing conditioned hedonic reactions even when presented below the level of awareness.     

Brain activation on pre-reading tasks reveals at-risk status for dyslexia in 6-year-old children

In this fMRI-study, 6-year-old children considered at risk for dyslexia were compared with an age-/gender-matched control group for differences in brain activation when presented with visual stimuli differing in demands for literacy processing. Stimuli were nameable pictures, brand logos familiar to children, and written words - these were either regularly spelled using early-acquired rules ("alphabetic") or more complex ("orthographic"). Brain responses distinguished between the presentation conditions, as a function of group, within many cortical areas. Activation in the alphabetic and orthographic conditions in the left angular gyrus correlated with individual at-risk index scores, and activation in inferior occipito-temporal regions further indicated differential activation for the two groups related to orthographic processing, especially. Since similar patterns are reported in adult dyslexics when processing written words, it appears that sensitivity to the cortical differentiation of reading networks is established prior to formal literacy training.