TEACHING CHILD-CARE SKILLS TO MOTHERS WITH DEVELOPMENTAL DISABILITIES

The present study identified and remediated child-care skill deficits in parents with developmental disabilities to reduce their risk of child neglect. Eleven mothers with developmental disabilities who were considered by social service and child welfare agencies to be providing neglectful child care were found in baseline to have several important child-care skill deficits (e.g., bathing, diaper rash treatment, cleaning baby bottles) compared to nonhandicapped mothers. Parent training (consisting of verbal instructions, pictorial manuals, modeling, feedback, and reinforcement) resulted in rapid acquisition and maintenance of child-care skills in all mothers. Mean percentage correct scores increased from 58% in baseline to 90% in training and 91% in follow-up (M = 31 weeks). The latter two scores compare favorably to the mean score (87%) of 20 nonhandicapped mothers on the same skills. Where observable, parent training was associated with corresponding benefits to the children (e.g., elimination of diaper rash and cradle cap, increased weight gain, successful toilet training). These results indicate that parent training may be a viable option to the removal of the child from the home when parenting skill deficits place the child's well-being in jeopardy.     

远、近空间内注意加工的分离

临床证据发现空间忽视症病人对于近处和远处空间内的注意加工存在差异,表现为空间忽视只发生于近处空间或只发生于远处空间,提示近处空间与远处空间在脑内可能是分别表征的。对健康成人的研究也发现了与之类似的近处空间和远处空间注意的分离现象,即在近处空间表现出左偏的伪忽视现象,在远处空间表现出左偏减弱或者右偏的趋势。本文综述了远、近空间内注意加工分离的实验证据以及采用线段二分任务这一主要的研究范式相关的实验结果,并且着重指出了远、近空间的划分不是绝对的,而是动态可变的研究证据。最后,指出了将来的研究需要深入考察空间参照系统在远、近空间知觉中的作用,以及关注社会交互情境下的远、近空间距离认知的动态变化。     

A simple method to dissociate sensory-attentional and motor-intentional biases in unilateral visual neglect

A variant of a line bisection test was devised. Patients with unilateral visual neglect and control subjects were asked to perform the test, which consisted of two subtasks: a verbal and a manual task. The verbal task was newly designed and did not require manual responses from the subjects. The manual task was similar to conventional line bisection tasks. This paper reports and discusses the results obtained from each task and their correlations. This technique is compatible with bedside examinations, does not require a complex apparatus, and provides useful data for the assessment of unilateral visual neglect.     

The Effects of the <Emphasis Type="Italic">Nobody’s Perfect</Emphasis> Program on Parenting Resourcefulness and Competency

We conducted an evaluation of Nobody’s Perfect Program involving 71 participants from Peterborough County, Canada. Prior to the program, parents completed demographic information, along with self-report measures assessing the types of interactions with their children, parent resourcefulness, knowledge and use of resources, parent competency and self-efficacy, which were completed again after the program and at a two month follow-up testing. In comparison to parents not earning certificates, parents earning certificates were younger and more likely to have completed previous parenting programs. As well, parents earning certificates demonstrated and maintained an increase in parenting resourcefulness, warm/positive parent-child interactions, sense of parenting competency and satisfaction, and use of community resources. The more sessions parents attended, the better their parenting resourcefulness and warm/positive parent-child interactions on completion and at follow-up, and the less their angry and punitive parenting at follow-up. Parents who had attended parenting programs before had higher parenting resourcefulness scores at entry. They left the program with increased levels of parenting resourcefulness, better parent-child interactions, and more effective child management skills. A number of recommendations are suggested to help facilitators of the program enhance service delivery and improve parental outcomes.     

From affect to feelings and thoughts: from abuse to care and understanding

The capacity of the infant to bear affect relies on the capacity of the caregiver until it has achieved enough strength to perform this task itself. In the case of neglect the necessary strength to contain, metabolize and think about affect so that it may be converted into differentiated feelings cannot develop because of the absence of a caregiver capable of sustaining the infant in its emotional development. Instead a system of defence against affect arises in which the affect itself is perceived as intrusive and abusive. Because of neglect a confusion between abuse and affect is to be observed, with catastrophic consequences for the growing up child. Furthermore neglected children can be seduced by external abuse in the hope of being protected from affect that threatens to feel abusive from within. Paradoxically these children are drawn toward abusive situations in the hope of finding some ongoing shelter from unmanageable affect. A corollary of this is that actual containment comes to feel abusive to them: if they are made to feel affect, they perceive the other, who put them in touch with affect, as abusive: thus affect, abuse and containment are confused. Clinical material will support this thesis.     

The caregiving relationship under stress: foster carers’ experience of loss of the sense of self

This paper is an account of a piece of research which involved interviewing six foster carers who had ended a placement with a child under the age of five with an early experience of abuse and neglect. The paper describes one of the themes that emerged from the data analysis, the loss of the sense of self in the foster carers, and argues that the experience of attempting to provide care for these children led to internal shifts in the carers that reverberated throughout the network around the child. The paper suggests that knowing about the external reasons for placement breakdown is not enough without taking into account the impact on the internal world of the foster carers and the emotional impact of attempting to provide care for a child who has experienced abuse and neglect.     

Aggression in Children With Reactive Attachment Disorder: A Sign of Deficits in Emotional Regulatory Processes?

Children diagnosed with reactive attachment disorder (RAD) have been reported to exhibit a multitude of symptoms and behaviors that are not captured by the Diagnostic and Statistical Manual of Mental Disorders criteria. One behavior in particular that has been the source of much argument and controversy is aggression. Although limited research on this topic does support an association between aggression and RAD behaviors, the exact nature of this link remains unclear. This study aims to fill this gap by reporting data from a study that examined the behavioral processes that occur in adopted children with RAD. Guided by the principles of grounded theory, this study employed a multi-stage semi-structured interview design. The sample consisted of 5 adoptive families, and included both adult and child participants, including the adopted children with RAD. The findings revealed 5 prominent themes: The adopted children are reported to engage in extreme and prolonged tantrums, known as rages; children were often inconsolable during these rages; these rages are perceived as uncontrollable by children with RAD; these rages are directed toward a discriminate caregiver; and the impetus for these rages appears to be associated with difficulties in adapting to environmental demands. An in-depth discussion that draws a theoretical connection between these rages and possible deficits in brain-based processes responsible for emotional regulation is presented.