Mental health service utilization among Puerto Rican children ages 4 through 16

This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives.     

The detection and management of mental health disorders in pediatric primary care

We reviewed the literature on the detection and management of mental health disorders within the context of pediatric primary care. Pediatricians have displayed a low sensitivity and high specificity in research investigating the detection of mental health impairment in children. Active management efforts characterize approaches to identified cases with more recently trained primary care pediatricians displaying a wider range of skills in managing mental health disorders. Few efforts have been made by pediatric psychologists to develop strategies for enhancing detection rates and management or to empirically evaluate the integration of pediatric psychology services into the primary care context. A conceptual model of factors influencing detection rates and ongoing management of mental health disorders within pediatric primary care is presented. Recommendations are made for more direct involvement of pediatric psychologists within the primary care context.     

COSMOLOGY FROM ALPHA TO OMEGA

Abstract. This paper focuses on four passages in the journey of the universe from beginning to end: its origin in the Big Bang, the production of heavy elements in first generation stars, the buzzing symphony of life on earth, and the distant future of the cosmos. As a physicist and a Christian theologian, I will ask how each of these passages casts light on the deepest questions of existence and our relation to God, and in turn how these questions are being explored through ongoing research into the interaction between Christian theology and the natural sciences.     

句子先提述的参与者在可提取性上的优势现象

下述五个实验就汉语句子成分（包括句子的参与者及其动作）的提述次序对其可提取性的影响进行了研究,结果表明：（１）句子先提述的参与者比后提述的参与者容易被提取,提述的次序对参与者的可提取性有明显影响。（２）先提述参与者的这种优势与句子呈现的方式有一定的关系。（３）在系列呈现的条件下,先提述参与者的易提取性与探测词呈现的延迟间隔有关。（４）在系列呈现的条件下,参与者以名词形式出现时,被试的反应速度较快,而参与者以名字的形式出现时,反应则较慢;在同时呈现的条件下这种差异基本消失。（５）句子参与者的行动（即句子的动词）的提述次序对其可提取性也有明显的影响,说明提述次序对句子成分的可提取性的影响,不只限于句子参与者本身。     

The holocaust of first nation people: Residual effects on parenting and treatment implications

The residential school experience was devastating for many First Nation (Indian) people. The lingering effects of this era have been far reaching and remain painfully evident throughout Native communities. One of the more obvious areas directly affected has been parenting. This paper discusses current parenting difficulties of Native clients who were formerly in residential schools. A connection is made between the abuse experienced by these individuals and their parental struggles. Along with addressing various sociopolitical issues, a number of clinical interventions designed to promote the healing process of these victims and their families are provided and discussed.     

Teaching simple addition to children with mental retardation using a microcomputer

Computer assisted instruction (CAI) was used for improving the efficiency of simple addition (single-digit without carrying) computation in three children with mental retardation. The training program, conducted on a portable personal computer, consisted of demonstrations and repetitive practices on simple addition presented in a vertical format. A number of behavioral instruction techniques such as direct feedback, corrective demonstration, verbal association, and token reinforcement were also included. To evaluate the effects of the CAI package, a multiple-baseline across subjects design with followup was employed. Results showed that performances of children improved with training and were maintained at 1-week, 4-week, and 12-week followups. Generalization of the learned skills was evident when children were assessed on a paper-and-pencil addition test in a vertical format. The skills were also transferable, with initial prompting, to a computerized addition test in a horizontal format. These findings reaffirmed the applicability of CAI and behavioral techniques for teaching math skills to children with mental retardation.     

Reliability of self-reported service use: Test-retest consistency of children's responses to the Child and Adolescent Services Assessment (CASA)

This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA) — a self-report instrument for use with 8– to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use).     

Evaluating children's mental health service systems: An analysis of critical behaviors and events

A lack of studies which evaluate system change by tracking client outcomes is noted in the children's mental health area. This deficit may be a result of the inability of researchers to define outcomes and to draw conclusions about which measures reflect the efficacy of services and service delivery systems. This paper reviews five social validation surveys which examined children's mental health outcome measures. Based on the results of the five surveys, a model of critical behaviors and events is presented. This model will assist evaluators and researchers in understanding which critical events and behaviors should be measured to assess the impact of community-based mental health services for children.     

Effects of models and demonstrations of personal narratives on the use of lexical ties by writers with mental retardation

A single subject reversal design was used to investigate the effects of two methods for teaching writing to eight adolescents with mild or moderate mental retardation during a weekly process writing workshop. During each workshop, each student wrote a personal narrative while the teacher circulated among the group and provided positive verbal feedback and spelled words on request. Students' texts were later typed with corrected spelling and punctuation and returned to them with verbal praise before the next writing workshop. During the first experimental condition, the subjects listened to an exemplar text selected by the teacher. In the second phase, the teacher read a narrative she had written as the exemplar text. During the third experimental condition, the teacher orally self-instructed herself through steps in writing a narrative. The subjects' texts were analyzed for number of words written and number and type of lexical ties used to produce cohesion between sentences in a text. The model narrative produced the best gains in the number of words written by the poorer readers, while the demonstration improved the cohesiveness of their texts. The better readers and writers wrote more cohesively during the model narrative and produced longer text during the demonstration condition.