A Comparison of Responsive Interventions on Kindergarteners’ Early Reading Achievement

This study compared the effects of Tier 2 reading interventions that operated in response‐to‐intervention contexts. Kindergarten children (N = 90) who were identified as at risk for reading difficulties were stratified by school and randomly assigned to receive (a) Early Reading Intervention (ERI; Pearson/Scott Foresman, 2004) modified in response to student performance or (b) their schools’ typical supplemental reading intervention (regrouping and curriculum pacing adjustments). In both conditions, intervention was provided 30 minutes per day in small groups for approximately 100 sessions. Results indicated no statistically significant group differences on any outcome measures. Between‐group effect sizes revealed substantively important differences (Valentine & Cooper, 2003) favoring the ERI responsive condition on multiple measures with effect sizes ranging from .35 to .59. Overall, findings indicated that the majority of students in both Tier 2 intervention conditions performed above the 30th percentile on posttest measures of word reading measures.     

How Can Genetically Informed Research Help Inform the Next Generation of Interparental and Parenting Interventions?

There is robust evidence that the interparental relationship and parenting behaviors each have a significant influence on children's risk for emotional (internalizing) and behavioral (externalizing) problems. Indeed, interventions targeting the interparental relationship and parenting processes show significant intervention‐related reductions in child internalizing and externalizing problems. However, most evidence‐based parenting‐ and couple‐focused interventions result in small to medium effects on children's emotional and behavior problems. It is proposed that there is opportunity to improve upon these interventions through incorporation of knowledge from quantitative genetic research. Three core recommendations are provided for practitioners engaging in intervention work with children and families. These recommendations are contextualized relative to what quantitative genetic studies can tell us about the role of the interparental relationship and parenting behaviors on child outcomes.     

Trajectories of parenting and child negative emotionality during infancy and toddlerhood: a longitudinal analysis

The current longitudinal study examined trajectories of child negative emotionality, parenting efficacy, and overreactive parenting among 382 adoptive families during infancy and toddlerhood. Data were collected from adoptive parents when the children were 9-, 18-, and 27-month-old. Latent growth curve modeling indicated age-related increases in child negative emotionality and overreactive parenting for adoptive fathers and adoptive mothers (AM), and decreases in parent efficacy among AM. Increases in child negative emotionality were also associated with increases in parent overreactivity and decreases in maternal efficacy. Mothers' and fathers' developmental patterns were linked within but not across parenting domains. Limitations and directions for future research are discussed.     

Investigating geographic variation in use of psychotropic medications among youth in child welfare

Objectives

Public Law (P.L.) 110-351, the “Fostering Connections to Success Act,” calls for state child welfare agencies to partner with Medicaid and pediatric experts to provide planning and oversight regarding the provision of health and mental health services, including medication, to children in state custody. Recent reports, media cases, and class action lawsuits suggest over-use of psychotropic medications to address the behavioral needs of children in the child welfare system. We examined geographic variability in psychotropic medication use across US child welfare agency catchment areas to determine how rates of psychotropic medication use vary in relation to child, community, child welfare, and health system-level factors.

Methods

Cross-sectional analysis of Wave 1 data for the 92 child welfare catchment areas participating in the National Survey of Child and Adolescent Well-being, a random probability sample of 2,504 children ages 2-15 years undergoing investigation for abuse and neglect. We employed multilevel regression modeling to examine the impact of catchment-level variables on medication use, controlling for child-level variables.

Results

Fifteen percent of children reported taking psychotropic medications. Rates of medication use across catchment areas ranged widely from 0 to 40%, a 40-fold difference. On multi-level logistic regression modeling, older age (p < .001), male gender (p < .001), emotional and behavioral problems (p < .001), and insurance (p = .05) were associated with psychotropic medication use at the child-level. At the catchment-level, stressful environment within the child welfare system was negatively associated with medication use. No other catchment-level variables examined were found to explain use.

Conclusions

Striking disparities in medication use exist across catchment areas in this national sample. Of the catchment variables examined, only stressful environment was related to medication use.

Practice implications

These findings highlight significant geographic variation in medication use that most likely reflect both under-use and over-reliance on psychotropic medication. The link between child welfare environment and medication use suggests the influence of systemic, as opposed to clinical, causes of variation in medication use. This requires greater implementation of organizational processes governing quality of care for this highly vulnerable population.     

Step 6: does not routinely employ practices, procedures unsupported by scientific evidence: the coalition for improving maternity services:

Step 6 of the Ten Steps of Mother-Friendly Care addresses two issues: 1) the routine use of interventions (shaving, enemas, intravenous drips, withholding food and fluids, early rupture of membranes, and continuous electronic fetal monitoring; and 2) the optimal rates of induction, episiotomy, cesareans, and vaginal births after cesarean. Rationales for compliance and systematic reviews are presented.