Stimulant medication and reading performance: follow-up on sustained dose in ADHD boys with and without conduct disorders.

The study examined the sustained effects of methylphenidate on reading performance in a sample of 42 boys, aged 8 to 11, with attention deficit-hyperactivity disorder (ADHD). Two subgroups were formed based on the presence or absence of co-occurring conduct disorders. Subjects were selected on the basis of their positive response to methylphenidate as determined in a series of original medication trials (Forness, Cantwell, Swanson, Hanna, & Youpa, 1991). For the purpose of this study, subjects were placed on their optimal dose of medication for a 6-week period and then tested on measures of oral reading and reading comprehension equivalent to those used in the original trials, retested after a week without medication (placebo), then tested again the following week after return to medication. Only the subgroup with conduct disorders responded, and this response was limited to reading comprehension improvement in only those subjects who also demonstrated improvement in oral reading on original trials. No response differences were found between subjects with or without learning disabilities.     

Early Identification and Intervention: Head Start's Response to Mental Health Challenges

Serving low-income children from birth to age five and their families, Head Start is a primary venue for identification and intervention in the area of child mental health. However, recent research has demonstrated that the knowledge base regarding prevalence, developmental course, and predictive power of child mental health problems is lacking for young children in general and low-income, diverse populations in particular. Head Start's agency-level data is often discrepant from both national estimates and small, intensive studies of similar populations, perhaps for reasons related to availability of community services and professional staff, as well as concerns about stigmatization. Following on recent expert recommendations, new collaborative Federal initiatives are underway to increase our understanding of the types, trajectories, and treatments of mental health problems affecting the vulnerable children served by Head Start. The paper concludes with a call to action for the field in the area of young children's mental health.     

Clinical criteria for mainstreaming mildly handicapped children

Although integrating handicapped children into regular classrooms has become well established educational practice, the clinical decision to mainstream a given child should be based on systematic consideration of several factors. Among these are age, pervasiveness and degree of handicap, curriculum, social skills, class size, teacher competency, and family resources. These criteria are discussed, along with various approaches to, and the pertinent evidence for and against, mainstreaming.     

Stability of pupil behavior in short-term classroom observations

In order to determine the point at which successive days of classroom observation results in a reliable sample of behavior, a classroom of 30 kindergarten children was observed over a period of 18 days in four behavior categories. High correlations between running and total averages were obtained around the fourth day, including low base rate behaviors. Implications for subsequent classroom observation studies were discussed.     

Eventual school placement of kindergartners observed as high risk in the classroom

To determine whether children's observable kindergarten behavior might predict eventual educational risk, 40 of 94 children originally observed in their classrooms at the beginning of kindergarten were followed at completion of second grade. The 40 subjects appeared to be representative in that they did not differ significantly from the total sample in terms of original kindergarten classroom behavior, sex, or race. Using four clusters of kindergarten behavior, significant differences were found in eventual special placement and in ratings of teacher anecdotal material. Attending behavior correlated highly with eventual risk, leading to speculation about early identification procedures.     

Follow-up of high-risk children identified in kindergarten through direct classroom observation

Sixty-one children, originally identified at the beginning of kindergarten on the basis of 4 distinct clusters of observable classroom behavior, were evaluated at completion of first grade. Teacher ratings and individual achievement test scores partially confirmed the predictive validity of the original clusters. Children in the nonrisk cluster continued to do well, while children in the high-risk cluster were still doing poorly in some areas. An unexpected finding was that children in another cluster, originally seen as nonrisk, also seemed to be in some difficulty. Concerns about specific aspects of observable behavior were discussed.     

Clusters of observable behavior in high-risk kindergarten children

Children in four kindergarten classes were observed directly in their classrooms over a 10-day period early in the chool year. Cluster analysis revealed four distinct groups of children as determined by observable classroom behavior. One group with a particular pattern of observable behavior emerged as high-risk. This group appeared to receive more observable response from teachers and peers and also scored lower on concurrent teacher evaluations.