Childhood abuse and later parenting outcomes in two American Indian tribes

OBJECTIVES: To examine the relationship of childhood physical and sexual abuse with reported parenting satisfaction and parenting role impairment later in life among American Indians (AIs). METHODS: AIs from Southwest and Northern Plains tribes who participated in a large-scale community-based study (n=3,084) were asked about traumatic events and family history; those with children were asked questions about their parenting experiences. Regression models estimated the relationships between childhood abuse and parenting satisfaction or parenting role impairment, and tested for mediation by depression or substance use disorders. RESULTS: Lifetime substance use disorder fully mediated the relationship between childhood physical abuse and both parenting satisfaction and parenting role impairment in the Northern Plains tribe. There was only partial mediation between childhood sexual abuse and parenting role impairment in the Southwest. In both tribes, lifetime depression did not meet the criteria for mediation of the relationship between childhood abuse and the two parenting outcomes. Instrumental and perceived social support significantly enhanced parenting satisfaction; negative social support reduced satisfaction and increased the likelihood of parenting role impairment. Exposure to parental violence while growing up had deleterious effects on parenting outcomes. Mothers and fathers did not differ significantly in the relation of childhood abuse experience and later parenting outcomes. CONCLUSIONS: Strong effects of social support and mediation of substance abuse disorders in the Northern Plains offer direct ways in which childhood victims of abuse could be helped to avoid negative attributes of parenting that could put their own children at risk. PRACTICE IMPLICATIONS: Mothers were not significantly different from fathers in the relation of abusive childhood experiences and later parenting outcomes, indicating both are candidates for interventions. Strong effects of social support offer avenues for interventions to parents. The prevalence of substance use disorders and their role as a mediator of two parenting outcomes in the Northern Plains should focus special attention on substance use treatment, especially among those who experienced childhood victimization. These factors offer direct ways in which childhood victims of abuse can be helped to avoid negative attributes of parenting that could put their own children at risk of violence.     

Neurobiological Processes of Risk and Resilience in Adolescence: Implications for Policy and Prevention Science

This article focuses on the concepts of risk and resilience and their potential to inform clinical interventions, school‐based prevention programs, and social policies. Research suggests that childhood adversity can trigger a cascade of psychological and neurobiological events that can lead to mental disorders in later life. Yet little is known about how these processes manifest in adolescence, a developmental window that is typically associated with an elevated risk for psychopathology and represents a period of neurological growth and reorganization that is second only to early childhood. A better understanding of adolescent brain development may provide an empirical grounding to improve the focus and timing of interventions, particularly those that target self‐regulation, meta‐cognition, and social supports. Finally, opportunities and challenges that emerge when bridging neuroscience and prevention science are discussed.     

儿童注意缺陷多动障碍研究现状与动向

儿童注意缺陷多动障碍是一种发展性的异常,是儿童期最为常见的最复杂的情绪与行为障碍之一。本文对儿童ADHD研究的热点即成因研究和干预研究的已有成果进行了归纳和总结,并分析了目前研究的趋势,以期为今后的研究提供一些科学的参考。     

Early indicators of pathological dissociation in sexually abused children.

Although reported cases of adult multiple personality disorder (MPD) are increasing, confirmation of MPD and related dissociative disorders in children remains rare. Since MPD can cause severe impairment and psychological distress, and is thought to originate in childhood, early recognition of pathological dissociation and predictors of MPD is critical. Sexual abuse in childhood has similarly been under-reported until recently, and is highly associated with the development of dissociative disorders. This paper reviews factors in the professional neglect of these syndromes as well as recent diagnostic developments in childhood dissociative disorders. The identification of subtle dissociative symptomatology in children is illustrated and two case examples are presented.     

Understanding and treating psychopathology in schools: Introduction to the special issue

Investigating psychopathology in school‐aged children is a topical discussion given the recent increased focus of the U.S. government and professional psychology on this issue. In the last 5 years, the Surgeon General of the United States (Satcher, 2000) and the President's New Freedom Commission on Mental Health (2003) both addressed the need for schools to actively participate in the treatment of children's mental health disorders. Further, psychologists were charged with transforming mental health care for children and families by promoting collaboration between schools, families, and communities; identifying empirically supported interventions; and enhancing culturally competent care for children and teens (P. Tolan & K. Dodge, 2005). To achieve these goals, mental health professionals in the schools need to be able to understand and effectively treat psychopathology in the school setting. School‐based treatment of psychopathology should be based on effective collaboration and grounded within the cultural context of the student population. A comprehensive understanding takes into account the biological basis of these disorders and factors influencing risk and resiliency. Treatment needs for these students often combine traditional therapies and psychopharmacology. Within a comprehensive system of care, specific disorders such as Reactive Attachment Disorder, Early Onset Bipolar Spectrum Disorder, Posttraumatic Stress Disorder, depression, and anxiety can and should be treated in schools. © 2006 Wiley Periodicals, Inc. Psychol Schs 43: 413–417, 2006.     

Neurological impairment in maltreated children

The neurological competency of maltreated children was assessed by comparing physically abused children not known to have sustained serious head trauma, neglected children, and normally raised children from the same socioeconomic milieu. Each child underwent physical and neurological examinations including EEGs, supplemented by perceptual-motor tests devised to detect subtle evidence of neurological dysfunction. Obstetrical and developmental histories, as well as intelligence test protocols, were available. Blind ratings by a pediatric neurologist using all available information revealed significantly more impairment in the maltreated groups with more than 50% of the abused children in the moderate or severely impaired category. The complex relationship between the maltreating environment and neurological disorders in these populations is discussed including the need to routinely search for evidence of subtle neurological impairment when maltreatment is known or suspected.     

The Co-occurrence of Reading Disorder and ADHD: Epidemiology, Treatment, Psychosocial Impact, and Economic Burden

The co-occurrence of reading disorder (RD) and attention-deficit/hyperactivity disorder (ADHD) has received increasing attention. This review summarizes the epidemiology, treatment strategies, psychosocial impact, and economic burden associated with the co-occurrence of these conditions. Common genetic and neuropsychological deficits may partially explain the high degree of overlap between RD and ADHD. Children who face the additive problems of both disorders are at greater risk for academic failure, psychosocial consequences, and poor long-term outcomes that persist into adulthood. However, few studies have evaluated interventions targeted to this patient population, underscoring the importance of identifying effective multimodal treatments that address the neuropsychological deficits of RD and ADHD through carefully planned clinical research.     

Children's attitudes towards ADHD,depression and learning disabilities

Attention deficit hyperactivity disorder (ADHD), depression and general learning disabilities (LD) are common difficulties for British primary school children. It has been found that characteristics associated with these difficulties can result in negative attitudes and stigma from other children, causing problems with peer relationships. Furthermore, problematic peer relations can intensify the difficulties associated with these disorders. Packages such as ‘Tackling Stigma: A Practical Toolkit’ aim to combat stigma in schools. However, these packages have not been based on evidence regarding children's attitudes towards different disorders. This study aims to explore children's attitudes towards ADHD, depression and LD from a conative (measure of social distance) and cognitive (measure of positive or negative attributes ascribed to a person) perspective. Participants were 273 children (M= 9.2 years). Vignettes were used to describe a child with ADHD, depression, or LD or a ‘normal’ child. The Shared Activities Questionnaire was utilised to assess conative attitudes, and the Adjective Checklist was utilised to assess cognitive attitudes. Results showed that children generally displayed more negative attitudes to vignettes describing mental health difficulties (MHD) (ADHD and depression) than LD. Children had more negative attitudes towards the ADHD (externalising disorder) vignette than the depression vignette (internalising disorder). Younger children had more positive conative attitudes than older children. Those who had previous contact with children with ADHD, depression and LD had more positive attitudes. These findings can enhance current stigma reduction interventions through contributing a deeper understanding of children's attitudes towards the most common MHD and LD in childhood.     

Interventions and Adaptations for Children with Autism Spectrum Disorder in Inclusive Early Childhood Settings

The inclusive education of children with disabilities is considered best practice, yet many early childhood educators feel unprepared to deliver appropriate instruction for children with disabilities and often require supports to successfully meet the children’s unique needs. Young children experiencing autism spectrum disorder are being diagnosed at a young age and they are commonly receiving their education within inclusive early childhood settings. This article presents two methods to meet the needs of children with autism spectrum disorder. First, early childhood educators can provide interventions tailored to the children’s learning needs. Second, educators can adapt the environment, materials, activity, instruction, and assistance they provide so that each child is appropriately supported, while still being encouraged to succeed as independently as possible. This article summarizes research-based interventions and adaptations that early childhood educators can implement within inclusive settings to meet the diverse needs of young children with autism spectrum disorder and presents a case study to describe how these practices can support young children with autism spectrum disorder within inclusive settings.     

Processing speed in children with clinical disorders

The Processing Speed Index (PSI) was first introduced on the Wechsler Intelligence Scale, Third Edition (WISC‐III; D. Wechsler, 1991), and little is known about its clinical significance. In a referred sample (N = 980), children with neurological disorders (ADHD, autism, bipolar disorder, and LD) had mean PSI and Freedom from Distractibility Index (FDI) scores that were below the group mean IQ and lower than Verbal Comprehension (VCI) and Perceptual Organization (POI). For these groups, Coding was lower than Symbol Search. The majority of these children had learning, attention, writing, and processing speed weaknesses. This pattern was not found in the other clinical groups. For children with depression, only PSI was low. Children with anxiety disorders, oppositional‐defiant disorder, and mental retardation had no PSI weakness. PSI and POI were both low in children with traumatic brain injury and spina bifida. Implications for a revision of the WISC‐III (WISC‐IV; D. Wechsler, 2003) are discussed. © 2005 Wiley Periodicals, Inc. Psychol Schs 42: 333–343, 2005.     

A Tale of Two Cases: Lessons for Education From the Study of Two Boys Living With Half Their Brains

ABSTRACT— In recent years, educators have been looking increasingly to neuroscience to inform their understanding of how children’s brain and cognitive development are shaped by their learning experiences. However, while this new interdisciplinary approach presents an unprecedented opportunity to explore and debate the educational implications of neuropsychological research, a good model for this dialogue is lacking. This is in part because relatively little is known about the relationships between cognitive, emotional, and neurological development, in part because of a dearth of research methods designed to rigorously connect issues of learning and development to neuropsychological strengths and weaknesses, and in part because neuropsychological studies are rarely presented in a format that is conducive to meaningful cross‐disciplinary dialogue with educators. To begin to address these issues, in this article, I present the complementary cases of Nico and Brooke, two high‐functioning adolescents, who have suffered the removal of an entire brain hemisphere (Nico his right and Brooke his left) to control severe epilepsy. Through presenting a neuropsychological study of these rare boys’ emotion and affective prosody (vocal intonation) through the developmental lens of an educator, I reinterpret the neuropsychological findings for what they reveal about how the boys leveraged their emotional and cognitive strengths to learn important skills for which they were each missing half of the normally recruited neural hardware. While Nico’s and Brooke’s results seem on the surface to contradict expectations based on neuropsychological findings with adults, they combine to reveal a compensatory logic that begins to elucidate the active role of the learner as well as the organizing role of emotion in brain development, providing a jumping‐off point for discussion between educators and neuroscientists and a model for connecting neuropsychological strengths and weaknesses to learning.     

Neuropsychological screening with school-age children: Rationale and conceptualization

School psychologists have become increasingly interested in neuropsychological assessment of children with learning and behavioral problems. In large part, this interest can be traced to the recognition that many learning disorders found in school-age children are directly attributable to neurological factors. Recently endorsed definitions of learning disabilities presume that the disability is due to central nervous system dysfunction. To identify those children who should receive a comprehensive neuropsychological evaluation, an effective and flexible approach to neuropsychological screening is needed. This article provides a rationale and conceptual framework necessary for the development of neuropsychological screening procedures with school-age children.     

Longitudinal Study of Reading Disability and Attention-Deficit/Hyperactivity Disorder: Implications for Education

ABSTRACT— The majority of children who receive special education services meet criteria for reading disability (RD) or attention-deficit/hyperactivity disorder (ADHD), but additional research is needed to understand the long-term academic outcome of children in these groups. Individuals with RD only ( N = 71), ADHD only ( N = 66), both RD and ADHD ( N = 51), or neither disorder ( N = 118) were identified through the ongoing Colorado Learning Disabilities Research Center twin study and retested 5 years later. Results of the follow-up testing indicated that, in addition to ongoing reading difficulties, individuals with RD exhibited higher rates of academic difficulties, depression, and adolescent-onset conduct disorder. Initial ADHD status was associated with academic and social difficulties and elevated rates of nearly all comorbid disorders 5 years later. The group with comorbid RD and ADHD had more stable reading deficits than the group with RD without ADHD and exhibited greater impairment than groups with either disorder alone on outcome measures of academic functioning and social difficulties. These results suggest that individuals with both RD and ADHD are at increased risk for negative outcomes as adolescents and young adults and that when RD and ADHD co-occur, interventions should be provided for both disorders.     

Studies of visual information processing in schizophrenic children

11 children meeting DSM III criteria for schizophrenia (mean age approximately 12 years), a group of normal children matched in mean mental age to the schizophrenic children, and a group of younger normal children (mean age 6.6 years) were administered a series of visual information-processing tasks in order to isolate core information-processing impairments in childhood onset schizophrenia. In Experiment 1, the schizophrenic children showed impairment relative to the MA-matched normals and performed at the level of the younger normal children on a forced-choice partial-report version of the span-of-apprehension task. Previous research has shown that this task is sensitive to dysfunction in both actively and partially recovered schizophrenic adults as well as a subset of foster children at risk for schizophrenia. Experiment 2 delimited the source of the information-processing impairment in schizophrenic children by ruling out a number of possible causes of impairment and suggesting that schizophrenic children use the same information-acquisition strategies as MA-matched children but less efficiently. Experiment 3 revealed that, consistent with the previous research, the schizophrenic children were comparable with the MA-matched controls on a full-report span-of-apprehension task that placed heavy demands on iconic and short-term memory. Both the schizophrenic and MA-matched normals performed significantly better than the younger normal children. Taken collectively, the results of the three experiments suggest that all groups of children engaged in a serial information-processing strategy while performing on the partial-report version of the span-of-apprehension task. The differential impairment of the schizophrenic children on the partial-report versions but not the full-report version of the span-of-apprehension task seems to reflect inefficiencies in controlled attentional processes that normally develop during middle childhood.     

Epilepsy in school‐aged children: more than just seizures?

Epilepsy is the most common neurological disorder in childhood and can have a significant impact on a child's schooling. Children with epilepsy may have special educational needs due to having learning disability, specific learning difficulties, specific cognitive deficits or having symptoms associated with ASD, ADHD, depression or anxiety. These difficulties are often under‐recognised due to the emphasis placed on the management of seizures. The effects of seizures and side‐effects of anti‐epileptic medications (AEDs) can also influence classroom learning. The significant stigma associated with epilepsy can influence attitudes towards affected children and impact on self‐esteem. Interventions to support children with epilepsy should focus on epilepsy management, learning and behavioural interventions and whole‐school psychosocial interventions. Epilepsy is a spectrum condition and for some children the effects on schooling will be minimal but for others significant supports will be needed. Therefore, an individualised approach within the school environment and close collaboration between teachers, parents and medical professionals are essential in order to meet the children's needs.     

Organic vs. functional neurological disorders: The role of childhood psychological trauma

Although the relationship between psychological trauma and medically unexplained symptoms (MUS) is well established, this relationship is less well understood in people with medically unexplained neurological symptoms. In the present study, we set out to compare people with functional neurological disorders, and organic neurological disorders, in terms of childhood and adulthood traumatic events, traumatic stress, emotional dysregulation and symptoms of depression and anxiety. We have hypothesised that those with functional neurological disorders would be more likely to report childhood and adulthood traumatic life events, traumatic symptomatology, emotional dysregulation and symptoms of anxiety and depression, compared to those with organic neurological disorders. Sample consisted of a consecutive series of people with functional neurological disorders and with organic neurological disorders (n = 82) recruited from a hospital in Scotland. Participants completed measures of life events, traumatic stress, emotional regulation, anxiety and depression. The two groups were found to significantly differ in relation to all measures, with the MUS group being more likely to report childhood and adulthood life events, more severe emotional dysregulation, traumatic stress and symptoms of anxiety and stress. Logistic regression analysis revealed that exposure to childhood traumatic life events, specifically childhood sexual abuse, and childhood physical neglect, were the only factors which were significantly associated with membership of the medically unexplained neurological symptoms group. Although further research is required to confirm our findings, our results suggest that identifying and addressing the impact of childhood trauma, may alleviate distress and aid recovery from functional neurological disorders.     

Exposure to childhood sexual and physical abuse and adjustment in early adulthood

OBJECTIVE: This research examined linkages between exposure to childhood sexual abuse (CSA) and childhood physical punishment/abuse (CPA) and mental health issues in early adulthood. METHOD: The investigation analyzed data from a birth cohort of over 1,000 New Zealand young adults studied to the age of 25. RESULTS: Exposure to CSA and CPA was associated with increased risks of later mental disorders including depression, anxiety disorder, conduct/anti-social personality disorder, substance dependence, suicidal ideation, and suicide attempts at ages 16-25. Control for social, family, and individual factors reduced the associations between CPA and mental health outcomes to the point of statistical non-significance. However, there was a consistent finding for CSA to remain associated with increased risks of later mental health problems. After adjustment, those exposed to CSA including attempted or completed sexual penetration had rates of disorder that were 2.4 times higher than those not exposed to CSA. Those exposed to harsh or abusive physical punishment had rates of disorder that were 1.5 times higher than those exposed to no or occasional physical punishment. It was estimated that exposure to CSA accounted for approximately 13% of the mental health problems experienced by the cohort. Findings showed that exposure to CPA had only weak effects on later mental health. It was estimated that exposure to CPA accounted for approximately 5% of the mental health problems experienced by the cohort. CONCLUSIONS: Exposure to CSA was associated with consistent increases in risks of later mental health problems. Exposure to CPA had weaker and less consistent effects on later mental health. These findings suggest that much of the association between CPA and later mental health reflects the general family context in which CPA occurs, whereas this is less the case for CSA.     

CONVERGENCE OF TWO INDEPENDENT ROADS LEADS TO COLLABORATION BETWEEN EDUCATION AND NEUROSCIENCE

Collaboration is the foundation for innovative discoveries, as individuals with different backgrounds come together and combine their unique expertise. In the current article, an educational researcher and two neuroscientists relate their experiences in establishing a successful collaborative effort. The marriage of neuroscientific findings with educational research has begun to further advance educational approaches. Initial functional magnetic resonance imaging (fMRI) findings indicate that direct interplay between educational interventions and brain‐based measures of sensory, motor, and cognitive processes provides an important link among cognitive processing and psychometric measures. If neuroimaging results support existing theoretical constructs of brain organization, then testable hypotheses may be designed to determine which educational interventions will be effective. The neuropsychological approach may provide school psychologists and teachers with an extensive array of fMRI‐based, developmentally appropriate instructional strategies for enhancing the functional organization of the developing brain of children. Promising suggestions and strategies for educational researchers, school psychologists, and neuroscientists are included.     

A study of clerics who commit sexual offenses: are they different from other sex offenders?

OBJECTIVE: The goal of this study was to determine if cleric-sex offenders differed significantly from other sex offenders when compared to a control group and assessed with standard instruments that examine the major factors important in sexual offenses. METHOD: Twenty-four male clerics accused of sexual offenses were compared to 24 male sex offender controls, matched on offense type, age, education, and marital status. Both groups were compared to a general sample of sex offenders (n = 2125) matched only for offense type. The three groups were compared on sexual history and preference, substance abuse, mental illness and personality, history of crime and violence, neuropsychological impairment, and endocrine abnormalities, using reliable and valid measures. RESULTS: The clerics in this study formed a statistically significant highly educated, older, and predominantly single subgroup of sex offenders. The majority of cleric-sex offenders suffered from a sexual disorder (70.8%), predominantly homosexual pedophilia, as measured by phallometric testing, but did not differ from the control groups in this respect. The clerics were comparable to the other two groups in most respects, but tended to show less antisocial personality disorders and somewhat more endocrine disorders. The most noteworthy features differentiating the clerics from highly educated matched controls were that clerics had a longer delay before criminal charges were laid, or lacked criminal charges altogether, and they tended to use force more often in their offenses. CONCLUSIONS: In spite of differences in age, education, and occupation between cleric-sex offenders and sex offenders in general, the same procedures should be used in the assessment of this group as for the sex offender population in general. Hypotheses about reduced sexual outlet and increased sexual abuse of clerics in childhood were not supported. Assessment and treatment of cleric-sex offenders should focus especially on sexual deviance, substance abuse, and endocrine disorders.     

Sensorial experiences and childhood: nineteenth-century care for children with idiocy

Following Foucault’s analysis of expanding psychiatric power, this article addresses the shift from psychiatry into pedagogy in interventions concerning children with mental problems in the nineteenth century. The aims of this article are twofold. First, to answer the question of how the notion of “idiocy” developed in the context of an increasing interest in sensorial experiences in childhood, in relation to both psychopathology and “normalcy”. New research into the early nineteenth-century case of the “wild boy of Aveyron” reveals the importance of care in the first observations of the boy and the connection that was subsequently made with sensorial experiences in childhood and child development. In the wake of the work of Enlightenment alienists such as Pinel and Itard, Edouard Séguin constructed an educational trajectory for children with mental impairments in which, through strict pedagogical guidance, the lack of “will” would be restored by stimulating the senses. The second aim is to examine the case of the first autonomous school for “idiotic” children in The Netherlands. Following the “praxeography” approach, I focus on the interventions by the Reverend Cornelis van Koetsveld, who shaped his “cure by education” through training the senses in children with problems.