Factor structure of the CNS Vital Signs computerized cognitive battery in youth with neurological diagnoses

Computerized cognitive batteries, such as CNS Vital Signs (CNSVS), can provide valuable information in clinical and research settings. However, psychometric properties, especially in children and adolescents, remain relatively understudied. The aim of this study was to investigate the factor structure of CNSVS in children and adolescents with neurological diagnoses.

Participants with neurological diagnoses (N = 280) age 7–19 years were assessed as part of their clinical care at a tertiary hospital. All participants received the full CNSVS computerized cognitive battery, which contains seven subtests designed to measure attention, executive functioning, psychomotor speed, and memory. Principal components analyses were used to examine factor structure.

Scores from CNSVS subtests loaded onto a three-component solution and accounted for 46% of the variance. The three components were deemed to best represent (1) speed, (2) memory, and (3) inhibition, with subtest scores loading differently than the original 11 primary and secondary domain scores would have suggested.

Although the CNSVS program generates numerous primary and secondary domain scores, a three-component solution represents a more parsimonious approach to interpreting performance on the CNSVS in youth with neurological diagnoses. Confirmation of this factor solution in other samples is warranted.     

The Welch Emotional Connection Screen: Adapting observational methods to pediatric primary care via resident training

The Welch Emotional Connection Screen (WECS) is a novel instrument that is a brief, practicable, evidenced-based observational screening tool for assessing relationship health between parent and child. The WECS requires observing 2−3 min of face-to-face interactions between parent and child, without toys, prompts, paradigms or technology. Here, we describe a translational project from the coding lab to the primary care provider via a residency training program conducted with 50 residents during a 30-day developmental and behavioral pediatrics medical resident education rotation. The aims of this study were to evaluate the efficacy of WECS pediatric resident training: 1) to improve residents' accuracy in recognizing the dyadic behaviors of emotional connection (EC) via WECS training; and 2) to improve residents' attitudes, self-efficacy, and perceived professional norms (ASPPN) pertaining to Early Relational Health in Pediatrics. Results indicate that using a rapid prototyping approach to training, residents improved in their identification of dyads showing low to midrange levels of emotional connection. As well, resident attitudes about the importance of relationship health in pediatrics and their self-efficacy in identifying emotional connection improved significantly after this brief resident training.     

Experimental consideration of preference in decision making under certainty

This paper describes an experiment in decision making under certainty with multiple, conflicting objectives and continuous decision variables. Two techniques for analysing such problems are considered: one taken from the paradigm of multicriteria decision making (MCDM), a non-directed approach called the NAIVE technique, and one from the paradigm of multiattribute decision analysis (D/A), the SMART technique. While the two techniques seek and are throught to arrive at the same end—a solution which is in some sense optimal for the decision maker (DM)—the former approach implicitly incorporates DM preferences while the latter approach considers preferences explicitly. The setting is a laboratory study using a sample of university students on a three-criteria problem which is designed to study the extent to which value functions implied/assessed by the techniques are consistent with DMs' holistic ranking of alternatives. Results show that (1) the two techniques of interest show significantly better rank order correlation with holistic judgement compared with other techniques, (2) DMs prefer the non-directed MCDM approach and (3) subjects break down into two groups: those that use assessable value functions when ranking and those that do not. This implies that for small-dimensioned problems DMs may first need to be classified as to the assessability of their value functions before a solution method is chosen.