Digital Mental Health Interventions for Child and Adolescent Anxiety

Anxiety disorders are the most common mental health conditions in children, with approximately 13% of kids struggling with excessive anxiety. The vast majority do not have access to effective treatments and there continues to be a disjunction between treatments that are empirically supported and those that are available in the community. Digital mental health interventions (DMHI) can increase efficiency, reach, and standardization as well as reduce costs of providing of mental health care. Here we review the extant research on DMHI, including web- or cloud-based programs, mobile applications (apps), virtual reality (VR), and digital assessment methods such as ecological momentary assessment (EMA) for the delivery and/or support of evidence-based care in child anxiety. Preliminary research is promising for these tools to improve access and efficiency of evidence-based practice. However, ethics and practice guidelines are needed and questions remain regarding what level and quality of therapeutic involvement is needed to maximize treatment completion and outcomes in youth and whether DMHIs are contraindicated for certain populations or whether they are similarly effective with those with comorbid conditions is unclear.     

来自屏幕的纽带：视频聊天与儿童发展

随着近几年视频聊天的兴起, 越来越多的研究者开始探索视频聊天对儿童发展的影响。相较于传统通讯技术, 视频聊天具备了视听结合与即时互动的特征; 但同时, 作为数字媒体, 视频聊天仍然保持了传统屏幕媒体二维性的特征。汇总以往视频聊天与儿童学习的实证研究发现, 与录制视频教学比较, 视频聊天在婴幼儿词汇学习(d = 0.33)和动作学习(d = 0.90)上的教学效果更佳; 同时, 视频聊天也能够使婴幼儿在教学过程中保持较高的注意水平(d = 0.90)。视频聊天对儿童远距离亲子关系和同伴关系上均有一定的促进作用。视频聊天也可以作为一种辅助治疗手段应用于特殊儿童的干预中。未来研究仍需关注扩大视频聊天学习中儿童被试的年龄范围、共同观看者的不同支持行为对儿童视频聊天学习的效果产生的影响。     

Prosecutors' Perspectives on Clarifying Terms for Genitalia in Child Sexual Abuse Interviews

In investigative interviews with alleged victims of child sexual abuse, professionals must establish the nature of the alleged abuse by determining what body parts were involved in the offending. This can be difficult, however, because children often use colloquial (non‐anatomical) terms to describe genitalia, and there has been little direction for interviewers about clarifying these terms sufficiently to establish the charge. The aim of this study was to address the need for guidance from prosecutors about the level of clarity in terms required from a legal perspective, and how this clarity can be achieved. A focus group of nine prosecutors (representing all but one Australian State and Territory) were asked to consider what degree of clarity in terminology for genitalia was adequate and how such clarity could be achieved. Thematic analysis revealed that a reduction in specific questioning around genitalia would improve the usefulness of investigative interviews with children from a legal perspective. Recommendations for improving interviews about abuse with child witnesses are discussed.     

A Probabilistic and Individualized Approach for Predicting Treatment Gains: An Extension and Application to Anxiety Disordered Youth

The objective of this study was to extend the probability of treatment benefit method by adding treatment condition as a stratifying variable, and illustrate this extension of the methodology using the Child and Adolescent Anxiety Multimodal Study data. The probability of treatment benefit method produces a simple and practical way to predict individualized treatment benefit based on pretreatment patient characteristics. Two pretreatment patient characteristics were selected in the production of the probability of treatment benefit charts: baseline anxiety severity, measured by the Pediatric Anxiety Rating Scale, and treatment condition (cognitive-behavioral therapy, sertraline, their combination, and placebo). We produced two charts as exemplars which provide individualized and probabilistic information for treatment response and outcome to treatments for child anxiety. We discuss the implications of the use of the probability of treatment benefit method, particularly with regard to patient-centered outcomes and individualized decision-making in psychology and psychiatry.     

First symbols in a girl with Down syndrome: A longitudinal study from 12 to 18 months

Symbolic uses of objects originate in communicative and triadic contexts (adult–child-object). In this longitudinal study we explore the emergence and development of the first symbolic uses in triadic interaction contexts in a girl with Down syndrome between 12 and 18-months of age. We conducted five sessions of video recording, at 12, 13½, 15, 16½, and 18 months chronological age. At each session we videotaped the girl and her mother interacting with different objects. Data were coded in semiotic categories used in previous studies (Rodríguez & Moro, 1999) and a microgenetic analysis was conducted for each session. The first symbolic uses by the girl appeared at 13½ months. Symbols were of different types and levels of complexity, and the adult had an important role in facilitating the production of these symbols.     

Collaborative mother–toddler communication and theory of mind development at age 4

Focusing on social pragmatics, this longitudinal study investigated the contribution of mother–toddler collaborative communication to theory of mind (ToM) development at age 4. At age 2½, 78 toddlers (42 boys) and their mothers were observed during pretend play. At age 4, children were tested using 4 false belief understanding tasks. Both mothers and toddlers engaged in more collaborative (inform, guide/request, and support/confirm) than non-collaborative communication acts. Other-focused collaborative acts of support/confirm by mothers and toddlers predicted children's false belief understanding, even after controlling for 5 covariates. In addition, as active agents in their own ToM development, the contribution of toddlers' collaborative acts to false belief understanding was independent of their mother's. Finally, the way toddlers and their mothers co-constructed their communication mattered. Only when toddlers engaged in high levels of collaborative acts, the mothers' high levels of collaborative acts demonstrated a positive effect on children's ToM development. The applied implications of these findings are discussed.     

Personalization in Mother–Child Emotion Talk Across Three Contexts

An unexplored aspect of contextual variation in emotion talk is the extent to which the emotions mothers and children discuss relate to the child, mother, or another self. To establish the extent to which mothers and children personalize the emotions they discuss, we examined the emotion talk of 40 American mother–child dyads in three conversational contexts: reminiscing, book reading, and play. We found that both mothers and children talked about emotions directly relevant to the child mostly in the reminiscing context and about emotions relating to another self mostly in the book context. Interestingly, the discussion of personalized emotions did not significantly differ between the book and play contexts, but did for the independent emotions. The discussion of mothers' own emotions occurred with almost the same frequency in all three contexts. In addition, within‐context analyses revealed that while mothers discussed the child's and their own emotions in the book and play contexts at about the same rate, children focused on their own emotions significantly more than on mothers' emotions in all three contexts. We contextualize the significance of the results in light of intervention programmes and future research. Copyright © 2013 John Wiley & Sons, Ltd.     

Children's Coping in the Context of Disasters and Terrorism

Disasters and terrorism present significant and often overwhelming challenges for children and families worldwide. Individual, family, and social factors influence disaster reactions and the diverse ways in which children cope. This article links conceptualizations of stress and coping to empirical knowledge of children's disaster reactions, identifies limitations in our current understanding, and suggests areas for future study of disaster coping. Coping strategies, developmental trajectories influencing coping, and the interplay between parent and child coping represent critical areas for advancing the field and for informing programs and services that benefit children's preparedness and foster resilience in the face of mass trauma.     

Adapting Parent–Child Interaction Therapy for Deaf Families That Communicate via American Sign Language: A Formal Adaptation Approach

While our field has made positive strides in adapting psychotherapeutic interventions for diverse groups of people, considerable work is still needed in this area. We present our formal adaptation procedure for parent–child interaction therapy (PCIT) with Deaf persons. This includes a review of the cultural adaptation process for psychological interventions, including PCIT, as well as an introduction to Deaf culture. Details regarding the specific adaptation of PCIT for Deaf persons are outlined. We found that the utilization of a clear framework to guide the cultural adaptation process facilitated careful consideration of the numerous linguistic and cultural variables involved, while maintaining integrity of the treatment model. While the current focus was on adapting PCIT for Deaf families who communicate via American Sign Language, this framework can also be applied to other populations and/or interventions.