Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

The Roles of Ethnicity and School Context in Predicting Children's Victimization by Peers

This study examines the prevalence, stability, and contextual correlates of peer victimization in a sample of African-American, Hispanic, and non-Hispanic White urban elementary school-age children. A total of 1956 children (40% African-American, 42% Hispanic, and 18% White) attending any 1 of 14 public elementary schools located in one large and one mid-sized Midwestern city participated in this study. Peer ratings of victimization were obtained at two points in time, separated by a 2-year period. Findings revealed that risk for being victimized by peers varied by ethnicity and by school context. Hispanic children had lower victimization scores than did either African-American or White children. These findings, however, were moderated by school context, such that attending ethnically integrated schools was associated with a significantly higher risk of victimization for White children and a slightly lower risk of victimization for African-American children and did not affect the risk of victimization for Hispanic children. In addition, African-American children were less likely than Hispanic and White children to be repeatedly victimized by peers over time. The importance of considering ethnicity and context in explaining peer victimization is discussed and suggestions for preventive interventions and future research are provided.     

中小学生认知能力发展水平测验的研究

以皮亚杰的认知发展理论为基础,采用皮亚杰及其学生研究认知发展时的任务为测验题目,编制成测量中小学生认知能力发展水平的测验.通过对2240名中小学生施测,结果表明本测验不仅具有很好的信度和效度,而且也具有适中的难度.然后以一所中学特长班学生为被试,通过对他们进行测量,并将测验结果与同年级普通班学生的认知成绩进行比较,结果存在很明显的差异.最后对中小学生认知能力发展水平测量问题进行了探讨.     

John Dewey,The Other Face of the Brazilian New School

This paper intents to analyze the influence of John Dewey’s ideas in the movement that defended the educationl renovation in Brazil (named New School) at the end of the 1920s and in the 1930s. For this, it explains two trends of that movement: the first is described by the metaphor of industrial or mechanical efficiency, whose emphasis was in the power derived from the disciplinary idea of progress, which was embedded in the process of rationalization of the social relations submitted by a factory model; the second, developed by influence of Dewey, is characterized by a project of democratization of society and school that prevented the individual massification and the adoption of the rationalizing model inspired by the factory without any criticism. When Dewey was put in the center of the debate on political, pedagogical and social goals of the Brazilian New School, he was called to introduce a series of concepts that helped to find the balance between the respect for individuality and the observation of the social needs. This paper has some of the conclusions of a major research project, “Philosophy and Science in the New Educational Discourse (Brazil: l930–1960),” sponsored by CNPq.     

师生关系与中小学生学校适应性的关系

师生关系作为儿童人际关系的一部分,是儿童社会化的重要内容,对儿童的学校适应产生重要影响。本研究运用问卷法、访谈法等对6个年级867名中小学生进行测查,以了解中小学生师生关系对学生学校适应性的影响。结果表明:(1)中小学生学校适应性与师生关系之间存在显著正相关;(2)师生关系是影响学生学校适应性的重要因素。其影响程度从大到小依次为:亲密性、主动性、合作性;年龄也影响学生的学校适应性,但程度较小。     

A Review of Self-Management Interventions Targeting Academic Outcomes for Students with Emotional and Behavioral Disorders

The purpose of this review was to report on the effectiveness and focus of academic self-management interventions for children and adolescents with emotional and behavioral disorders. Twenty-two studies published in 20 articles and involving 78 participants met inclusionary criteria. The overall mean effect size (ES) across those studies was 1.80 (range –0.46 to 3.00), indicating effects were generally large in magnitude and educationally meaningful. Self-monitoring interventions were the predominant type of self-management technique used by researchers. The mean ES for intervention types were self-evaluation (1.13), self-monitoring (1.90), strategy instruction techniques (1.75), self-instruction techniques (2.71), and multiple-component interventions (2.11). Interventions targeted improvement in math calculation skills more than any other area. The mean ES by academic area were math interventions (1.97), writing (1.13), reading (2.28), and social studies (2.66). There was evidence to support a claim of the generalization and maintenance of findings. Implications, limitations, and areas for future research are discussed.     

Parent Perception of Elementary School Aged Children’s Sleep Problems

Wide discrepancies exist concerning the reported occurrence of sleep problems for elementary school children. We describe parental perception of sleep problem behavior in elementary school aged children 5–12 years. Approximately 4% of parents reported their children experienced significant global sleep problems serious enough to adversely affect family functioning. Significant specific sleep problems reported by parents occurred for approximately 9–14% of the children in the sample. These ranges were in the low end of the ranges of sleep problems reported in previous literature for this age group.     

School Mobility and Students with Emotional Disturbance

We examined the school mobility of a cross-sectional sample of 70 secondary-age youth with emotional disturbance (ED). Data were collected through an archival review of school records. Students’ school mobility histories were examined in terms of the overall number of schools attended in the elementary school years, as well as the timing of the moves that were made. Findings indicate that sample students experienced high rates of school mobility with 66% having changed schools at least once by the end of 2nd grade and 89% having changed schools at least once by the end of 5th grade. Strategies for minimizing school mobility and the impact of high rates of school mobility are reviewed.     

Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

The Association of American Medical Colleges and the Association of Medical School Psychologists: Finding Psychology’s Place in Academic Medicine

This paper highlights the role of the Association of Medical School Psychologists (AMSP) as a bridge between academic medicine and psychology. AMSP’s affiliation with Division 12 of the American Psychological Association is discussed, but the primary focus is AMSP’s affiliation with the Association of American Medical Colleges (AAMC) and the AAMC’s Council of Academic Societies (CAS). The history, structure, activities, and goals of AAMC and CAS are examined. AMSP’s affiliation with AAMC is important for psychologists in medical schools and academic medical centers, and for psychology in general, because AAMC is the major voice of academic medicine in the US. AAMC activities affect medical education at all levels, as well as research and health services at academic medical centers, and health care policy at the national level. AMSP’s dual affiliation with AAMC’s CAS and APA’s Society of Clinical Psychology will increase psychology’s visibility and influence in academic medical centers and enhance the two-way flow of ideas and information between academic medicine and psychology.