Family-centered intensive case management: A step toward understanding individualized care

New York State's initial attempt at individualizing services occurred within the context of an experiment. We randomly assigned children 5–12 years old who were referred for out-of-home placement in treatment foster care to either treatment foster care, Family-Based Treatment (n=15), or to Family-Centered Intensive Case Management (FCICM) (n=27). FCICM used teams of case managers and parent advocates to provide in-home services. Flexible service dollars, respite care, and behavior management skills training were available to assist teams in individualizing care. Preliminary outcomes indicate that children in FCICM are doing as well or better than children assigned to FBT in their functioning and symptom reduction. Parents of children in FCICM have made gains, although not at a statistically significant level, in behavior management skills and family strengths that allow them to provide care for their children at home.     

Matching adolescents with foster mothers and fathers: An evaluation of the role of temperament

We tested the notion that better foster care adjustment would be observed when the temperaments of mothers and fathers were matched with those of adolescent foster children. We hypothesized that families in which foster parents and foster children had high (easy) scores on subscales of the Revised Dimensions of Temperament Scale (DOTS-R) would also report higher family functioning and higher foster care adjustment than parents and children from families in which one or both family members had low (difficult) scores on these scales. The hypotheses were supported when the mothers and fathers family assessments were used but rejected when the observations of the case managers and adolescents were tested. Methodological and substantive explanations for the findings are discussed and recommendation for foster care practice and continuing research are provided.     

A biopsychosocial therapeutic approach in a private outpatient clinic in Portugal

Patients with chronic stress and ambiguous symptoms are likely to be more frequent in primary care. Somatizers represent 75.8% of the patients in this study and executives 56% of the sample. Job stressors were present in 78.3% of executive men. This scenario suggests that the primary care physician has to be academically better prepared to fully understand and deal with stress problems in daily clinical practice. The physician must have skills to deal with stress at a curative and preventive level, extending those skills to the workplace.     

TEACHING FOSTER GRANDPARENTS TO TRAIN SEVERELY HANDICAPPED PERSONS

Five foster grandparents were taught training skills for use in their daily interactions with severely handicapped persons in an institution. Following baseline, specific teaching procedures consisting of teacher instructions, prompts, modelling, and praise were implemented. The grandparents' frequency of training three skill areas increased as the specific teaching was implemented in multiple-baseline format. The total amount of training continued as teacher instructions, prompts, and modelling were terminated and praise continued, although the grandparents spent their training time emphasizing only two of the three skill areas. Teacher presence was gradually reduced over an 11-week period, with no decrease in grandparents' frequency of training. Four of the foster grandchildren, all profoundly retarded and multiply handicapped, demonstrated progress throughout the study. Results were discussed in light of the available contributions of foster grandparents in institutional settings and maintenance of staff training.     

THE FUNCTIONAL RELATIONSHIP BETWEEN ARTIFICIAL FOOD COLORS AND HYPERACTIVITY

The presence of a functional relationship between the ingestion of artificial food colors and an increase in the frequency and/or duration of selected behaviors that are representative of the hyperactive behavior syndrome was experimentally investigated. Two eight-year-old females, who had been on the Feingold K-P diet for a minimum of 11 months, were the subjects studied. The experimental design was a variation of the BAB design, with double-blind conditions. This design allowed an experimental analysis of the placebo phases as well as challenge phases. Data were obtained by trained observers on Out of Seat, On Task, and Physically Aggressive behaviors, as they occurred in the subjects' regular class setting. Results indicated (a) the existence of a functional relationship between the ingestion of artificial food colors and an increase in both the duration and frequency of hyperactive children.     

AN INDEX FOR ASSESSING WEIGHT CHANGE IN CHILDREN: WEIGHT/HEIGHT RATIOS1

Weight and height data from two studies were recomputed, and original data were computed using a Weight Index formula that accounts for the interaction of actual weight/height changes in growing children and compares this ratio with that of normed weight/height ratios for equal-aged children. Recomputing the data of one study showed that the Weight Index is a more sensitive procedure for assessing long-term behavioral treatment of obesity for girls than weight alone. Recomputing the data of a second study showed that the Weight Index formula is consistent for boys and girls and is a more sensitive procedure for assessing long-term effects of a variety of medical treatments for obesity than the Ponderal Index or weight alone. Computation of the data for 17 “normal” children in a preschool class showed a zero Weight Index score before and after a six-month interval elapsed without treatment. The procedure may be useful in assessing ponderosity or anorexia over intervals of six months or more with growing children or difference between actual and normed weight over shorter intervals.     

A new measure for determining children's subjective organization of speech

A new technique for determining children's subjective organization of speech is described. The technique consists of teaching a child a sentence and then repeatedly (1) reading the sentence up to a selected point, (2) sounding a tone, and (3) having the child supply the next word. The time from the tone to the onset of the child's voice is the dependent variable. In the first study 6- and 8-year-old children memorized the following sentence: “John likes to feed the little puppies in the barn.” Their response times suggested that the dominant segmentation pattern consisted of four phrases: a subject phrase, a verb phrase, an object phrase and a modifier phrase. Within each phrase differences between reaction times were on the order of 30 msec. Across phrases they were on the order of 120 msec. The same trend emerged for subsamples of the children with various short-term memory sizes, and for adults. It also appeared for subsamples of the total scores (e.g., first six trials and last six trials). In order to provide further evidence of the technique's validity, different sentences of the same general type were presented to children with short-term memory spans of either 3, 4, or 5. As predicted, it was found that when children's spans corresponded to the number of hypothesized chunks (i.e., 4), they could repeat the sentences verbatim on the first exposure. They could not do so, however, when their spans were lower than that value or when the number of phrases was increased. It was concluded that the new technique is a promising one for assessing young children's patterns of speech segmentation.     

Effects of neutral and positive stimuli on stuttering: “Calling attention to stuttering” revisited

This study investigated the effects of presumably positive and neutral response-contingent stimuli on the occurence of stuttering. Eight adult stutterers spoke spontaneously during a 60-min experimental session, which was divided into three 20-min periods. During Condition I no stimuli were delivered. During Condition II a digital counter and a pair of yellow lights were activated each time the subject stuttered. During Condition III these same response-contingent stimuli were delivered, but with the additional factor that the subject would earn 5¢ each time the counter moved forward and the lights were illuminated. Conditions II and III were counterbalanced across subjects. The experimenter was unaware of which of the two contingencies were operative during Conditions II and III. Results showed no significant changes in occurence of stuttering due to either response-contingent stimulus. A discussion of theoretical and experimental implications is given.     

The use of averaged electroencephalic response techniques in the study of auditory processing related to speech and language

This paper reviews a number of studies done by the authors and others, who have utilized various averaged electroencephalic response (AER) techniques to study speech and language processing. Pertinent studies are described in detail. A relatively new AER technique, auditory brainstem responses (ABR), is described and its usefulness in studying auditory processing activity related to speech and language is outlined. In addition, a series of ABR studies, that have demonstrated significant male—female differences in ABR auditory processing abilities, is presented and the relevance of these data to already established differences in male—female language, hearing, and cognitive abilities is discussed.