Developmental sequences in the age of onset of disruptive child behaviors

Retrospective and prospective reports of the onset of disruptive child behaviors were analyzed in a sample of clinic-referred boys. The younger boys (ages 7–9 years), compared with the older boys (ages 10–12 years), showed the highest level of disruptive behavior and, judging from mothers' reports, had the fastest progression of onsets from less serious to more serious problem behaviors. Despite some overlap, developmental sequences in problem behavior within the domains of hyperactivity/inattention, oppositional behavior, and conduct problems were similar across the two age groups. This was also the case for developmental sequences of overt or confrontive problem behaviors and covert or concealing conduct problems. Sequences of the onset of oppositional behavior and conduct problems were validated through prospective data, based on the information from mothers, teachers, and boys themselves. The implications of the findings are discussed for the formulation of developmental pathways of behavior and the analysis of causal factors.     

EFFECTS OF MEMORY AIDS ON THE DYADIC CONVERSATIONS OF INDIVIDUALS WITH DEMENTIA

The effects of a prosthetic memory aid on the conversational content and social skills of dyads with dementia were evaluated. Six individuals with moderate to severe dementia served as either subject or partner in dyads during 5-min conversational probes conducted three times per week in daycare and nursing-home settings. During phases when a memory aid, consisting of personally relevant picture and sentence stimuli, was available, most subjects used their own aid to improve the quality of conversations by increasing the frequency of on-topic statements, diminishing nonproductive utterances, lengthening their conversational turn, and/or increasing the frequency of turns taken. Most partners demonstrated awareness of social discourse conventions by appropriately relinquishing conversational dominance, decreasing both content and nonproductive utterances, and increasing acknowledging or affirmative comments when subjects used memory aids. Naive judges' ratings of aided and unaided conversational samples on seven conversational dimensions reflected differences in perceptions of significant improvement as a function of the conversational discourse style of each dyad.     

Disrupted memory inhibition in dementia of Alzheimer’s type

Cognitive inhibition has been suggested to deteriorate in Alzheimer’s disease. While numerous studies with different experimental paradigms found evidence on impaired inhibition in attention and memory, evidence in favour of intact memory inhibition has been reported with regard to the phenomenon of retrieval-induced forgetting (Moulin et al., 2002). Here, we adapted the previously used paradigm in order to reduce the contribution of non-inhibitory processes and examined whether retrieval-induced forgetting could still be observed in a sample of participants with diagnosed Alzheimer’s disease. In contrast to the previous finding, we found that retrieval-induced forgetting only occurred in an age-matched control group. These results suggest that inhibitory deficits in Alzheimer’s disease also generalize to memory inhibition that resolves interference occurring during retrieval, whereas effects of retrieval-induced forgetting may still occur when non-inhibitory causes, such as, blocking by previously retrieved content, are not precluded.     

Stability of developmental status and risk of impairment at 24 and 36 months in late preterm infants

BackgroundFew studies investigated whether late preterm infants might have developmental delays in several domains in early life and how stable the lag in developmental status might be.AimWe aimed to examine the stability of potential delays across developmental domains at 24 and 36 months of age in late preterm (34°-36⁶ weeks) and term (≥37 weeks) children and whether the risk of delays remained high at 36 months.Study design, subjects, and outcome measureWe conducted a prospective cohort analysis of the children of pregnant women participating in the Vitamin Antenatal Asthma Reduction Trial (VDAART). 652 children who were prospectively followed up and had parent-completed Ages Stages Questionnaires (ASQ-3) questionnaires at both 24 and 36 months were analyzed to assess their domain-specific developmental status.Results6.61 % (42/635) of children had a late preterm birth. Developmental delays were stable between 24 and 36 months on all 5 domains for the children born preterm and on 4/5 domains for those born at term. The developmental domains with the status stability at 24 and 36 months in both late preterm and term children were the gross motor, communication, personal-social skills, and problem-solving. Late preterm children compared with term children remained at higher risk of delays at 36 months for gross motor, communication, and problem-solving skills (aOR = 4.54, 95 %CI: 1.81−10.79; aOR = 8.60, 95 %CI: 3.10−23.28 and aOR = 3.80, 95 %CI: 1.58−8.73, respectively).ConclusionLate preterm birth is associated with suboptimal development and stability in several domains at both 24 and 36 months and compared with term birth, requiring early monitoring and assessment of the developmental lag to avoid potential long-term implications.     

Dormio: A targeted dream incubation device

Information processing during sleep is active, ongoing and accessible to engineering. Protocols such as targeted memory reactivation use sensory stimuli during sleep to reactivate memories and demonstrate subsequent, specific enhancement of their consolidation. These protocols rely on physiological, as opposed to phenomenological, evidence of their reactivation. While dream content can predict post-sleep memory enhancement, dreaming itself remains a black box. Here, we present a novel protocol using a new wearable electronic device, Dormio, to automatically generate serial auditory dream incubations at sleep onset, wherein targeted information is repeatedly presented during the hypnagogic period, enabling direct incorporation of this information into dream content, a process we call targeted dream incubation (TDI). Along with validation data, we discuss how Dormio and TDI protocols can serve as tools for controlled experimentation on dream content, shedding light on the role of dreams in the overnight transformation of experiences into memories.     

Brief training to promote the use of less intrusive prompts by nursing assistants in a dementia care unit

We evaluated the efficacy of a brief staff-training procedure to increase the use of graduated prompting by 2 certified nursing assistants (CNAs) while they helped to dress 3 persons with dementia in a seven-bed dementia care unit. The multiple baseline design across participants showed that CNAs dressed residents with minimal resident involvement during baseline observations. Following brief in-service training, CNAs provided graduated prompts and praise appropriately, suggesting that CNAs can promote active involvement in personal care routines by older adults with dementia.     

The Feeling-Tone Questionnaire: Reliability and Validity of a Direct Patient Assessment Screening Instrument for the Detection of Depressive Symptoms in Cases of Dementia

The purpose of this study was to develop a reliable and valid measure of affective disorder in elderly demented patients. The field lacks instruments which are sensitive to detecting depressive signs in severely as well as mildly and moderately demented subjects. Two samples of subjects were chosen for study. The first sample consisted of subjects from six institutions, which were chosen for study from a probability sample of 25 long-term care institutions in New York City. This sample was part of the Cross-National Institutional Study conducted in New York and London (Gurland et al., 1979; Mann et al., 1984). Thirty patients were selected at random within each institution. The second sample consisted of 52 inpatients at Willard Psychiatric Center, a traditional state psychiatric hospital in upstate New York. All subjects had a chart diagnosis of dementia and were 60 years old or older. The mean age of the sample was 82 years and 56% of the subjects were female. The Feeling-Tone Questionnaire, which was developed for these analyses, consists of 16 dichotomous items and 16 5-point Likert ratings of affect. The reliability of this scale using Cronbach's alpha is .91 for the long-term care institutional sample and .90 for the psychiatric hospital sample. Interrater reliability for two raters on ten cases is .99. Test–retest reliability on ten cases with a 1-day to 2-day interval between trials is .81. A short mood scale was developed from the observational data as a validity measure for the Feeling-Tone Questionnaire. Evidence for the validity of the Feeling-Tone Questionnaire is provided.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.