Strength In Children Research Articles

An Examination of the Measurement Properties of the Pediatric Volitional Questionnaire

The Pediatric Volitional Questionnaire (PVQ) is a 15-item play-based assessment of a child's motivational strengths and weaknesses in various settings based on the Model of Human Occupation. A previous study examined the PVQ's ability to provide a valid measure of volition in ten non-disabled children. This study combined data from the previous study with data on eight children with disabilities to further test the instrument's psychometric properties. Data on 36 observations of the 18 participants were observed by a total of 20 raters. Each rater was randomly assigned to rate videotapes. Data were analyzed using the Rasch Measurement Model. Results indicate that the 15 items of the scale work well together to measure volition and were well matched to the volitional levels of the sample group. Nineteen of the twenty raters used the scale in a valid manner, though scores were affected by the extent of severity/leniency of the rater. All eighteen participants were validly rated and the scale items effectively differentiated levels of volition among the eighteen children. These findings supported the conclusion that the PVQ provides a valid and sensitive measure of volition. The study also found that the 4-point rating scale operated as a 3-point scale in this study and that raters differentiated in their severity/leniency. These latter findings indicate the need to further clarify the rating scale.

The FTF (Five to Fifteen): the development of a parent questionnaire for the assessment of ADHD and comorbid conditions

This paper describes the development of a new parent questionnaire ("Five to Fifteen", or the FTF) for elicitation of symptoms and problems typical of ADHD and its comorbidities. The FTF comprises 181 statements related to behavioural or developmental problems that can be endorsed as either "does not apply" (0), applies sometimes or to some extent" (1), "definitely applies" (2), plus a number of open-ended questions including some about the child's strengths. The items are arranged into eight different domains (memory, learning, language, executive functions, motor skills, perception, social skills, and emotional/behavioural problems), most of which can be subdivided into subdomains. For each domain, a mean score ranging from 0-2 can be calculated. A representative sample (n=1350) of the total population of 6-15-year-old children was targeted. Parents of 63% of these completed a questionnaire and returned it to the researchers. Boys showed significantly more problems than did girls across domains and age. Younger children had more problems than pre-adolescents and adolescents (except in the domains of social skills and emotional/behavioural problems). Executive dysfunction was common, and 5.3% of all children in the population had clear problems suggesting a diagnosis of ADHD according to parent report. The paper provides means, medians, and 90(th) and 95(th) centiles for individual items as well as for the eight domains. The Discussion centres on whether or not the FTF can (or should) be used in school-aged children for the identification of children at risk for ADHD or other early childhood onset neuropsychiatric disorder.

Nonverbal learning disability: a tutorial for speech-language pathologists.

Nonverbal learning disability (NLD) is a diagnostic category that is unfamiliar to most speech-language pathologists. This brief tutorial describes NLD's characteristics, a theoretical model proposed to explain its source, and areas of overlap between NLD and similar diagnostic categories. The communicative profile, made up of difficulties in pragmatic and semantic language in the presence of relatively preserved syntactic skill, is also discussed. Empirical evidence relevant to NLD is also evaluated. Many questions remain unresolved, but until systematic research provides definitive answers, speech-language pathologists are encouraged to rely on careful description of the individual child's communicative strengths and weaknesses to identify appropriate targets and to focus intervention on improving the child's ability to communicate effectively in everyday contexts.

Efficacy of modular cognitive behavior therapy for childhood anxiety disorders

The present investigation evaluated the initial efficacy of a modular approach to cognitive behavior therapy (CBT) for anxiety disorders in youth. Modular CBT consists of the guided combination of individually scripted techniques that are explicitly matched to the child's individual strengths and needs. Eleven youth primarily of Asian and Pacific Island ethnicity ranging in age from 7 to 13 were referred for treatment. Comparisons in a multiple baseline across children provided preliminary support for the efficacy of the intervention. Among the 7 completers, all principal diagnoses were absent at posttreatment and 6-month follow-up assessments, and measures of anxiety symptoms and life functioning almost uniformly evidenced clinically significant improvements.

Activity-Focused Motor Interventions for Children with Neurological Conditions

SUMMARYThis article presents a model to guide activity-focused physical therapy and occupational therapy interventions for children with neurological conditions. Activity-focused interventions involve structured practice and repetition of functional actions and are directed toward the learning of motor tasks that will increase independence and participation in daily routines.According to this model, the pediatric therapist: (1) develops activity-related goals in collaboration with the child and the family; (2) plans activity-focused interventions by adapting knowledge of motor learning to the child's individual learning strengths and needs; and (3) integrates impairment-focused intervention with activity-focused intervention.

Wellness promotion as a life‐long endeavor: Promoting and developing life competencies from childhood

AbstractPresented here are arguments for reframing school psychologists as agents‐of‐change for children's entire life spans through creating positive patterns that promote healthy living. Such a focus on children's strengths and the enhancement of wellness, in contrast to the current pathology‐driven model of school psychology, may even develop a cadre of healthier professionals. Wellness begins at home, and the brightest prospect for engaging children in positive activities is a “mental‐health enhancer” role model who has personally addressed the goals of wellness, health improvement, and affiliation with constructive communities of friends, colleagues, and family. We offer some justification for a reformulation to the positive, data why this might be beneficial, and some speculative means for how a school psychologist can “take the high road.” © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 131–141, 2004.

Behavioral and Emotional Rating Scale: Two Studies of Convergent Validity

As the field of mental health services shifts its focus to early intervention, the need to develop valid and reliable measures of young children's behavioral functioning is clear. Traditional assessment instruments have focused on deficits, problems, and pathologies to the exclusion of strengths and competencies. However, assessing child strengths provides parents, direct service providers, and educators with a more holistic view of the child's functioning and an understanding of skills from which individualized treatment and education plans may be written. The Behavioral and Emotional Rating Scale (BERS; Epstein & Sharma, 1998) is a strength-based instrument designed to identify children's behavioral and emotional strengths. The psychometrics of the BERS has been demonstrated through several studies; however, the focus has mainly been on older age students. We sought to assess the convergent validity of the BERS with kindergarten children. The results of these two studies provide further support of the psychometric characteristics of the BERS and indicate its appropriateness with young children.

Reliability of isokinetic concentric and eccentric knee and elbow extension and flexion in 9/10 year old boys

The aim of this study was to determine the reliability of measures of concentric and eccentric extension and flexion peak moment of the knee and elbow of prepubertal boys. Twenty boys volunteered for the study. Ten performed the knee test and ten performed the elbow test. All subjects were permitted a separate day familiarisation session and were later tested on two separate occasions, exactly 1 week apart, at the same time of day and with the same test administrators. Peak moment was measured with an adapted Biodex System-3 using continuous concentric-concentric and eccentric-eccentric cycles at 30°/s and 180°/s. The reliability measures were intraclass correlation coefficient (ICC), repeatability coefficient (RC), limits of agreement (LOA) and coefficient of variation (CV). ICCs ranged from 0.55 to 0.97 and CV ranged from 4% to 15%. There was no systematic difference in peak moment between test and retest. The various indices demonstrated moderate to high reliability of peak moment measurements in this age group which compared favourably with the existing literature. The results of the study support the reliability of measures of concentric and eccentric peak moment in studies of children's strength.

The Quest for an Instructional Delivery Framework for Children with Gerstmann's Syndrome

Gerstmann's syndrome, a disorder of cognition, is characterized by the tetrad of finger agnosia, dysgraphia, dyscalculia, and right-left disorientation. A review of areas in the brain affected by the syndrome is discussed in order to determine cognitive weaknesses and strengths of affected children. Because of the tetrad of symptoms associated with Gerstmann's syndrome, providing educational assistance to children with this syndrome is a challenging task for the educator. One of the most challenging problems presented to educators is to plan an education program based on the child's information-processing strengths, taking into account his or her disabilities. No systematic cataloguing of an instructional delivery framework concerning children with Gerstmann's syndrome is available. To provide such a framework, the following two research questions were asked: How can the medical, neuropsychological and educational elements of Gerstmann's syndrome be'converged so that an instructional delivery framework for children with Gerstmann's syndrome be formulated? How can the information-processing strengths of the child with Gerstmann's syndrome be translated into an asset-based instructional approach? The goal of instruction is to move from the child's strengths to those areas with which the child is less comfortable or had less experience. Furthermore, educational implications as well as specific recommendations for children with Gerstmann's syndrome are discussed.

Operation Positive Change

Children who have problem behavior need not only the support of school personnel but also the support of their parents to be successful in both educational and community/home settings. However, too often research-based best practices in positive behavior support (PBS) do not reach families, particularly culturally and linguistically diverse families living in underserved urban communities. This article describes Operation Positive Change—a training curriculum and train-the-trainer model developed by Pyramid Parent Training Community Parent Resource Center that brings PBS best practices identified by leading PBS researchers to parents in New Orleans, Louisiana. After participating in Operation Positive Change work-shops, parents who are dealing with the problem behavior of their children, as well as a myriad of other challenges related to poverty, race, and language barriers, are gathering data about their child's strengths and needs and likes and dislikes, developing a functional assessment for their child, and participating as full partners in the development of a PBS plan

Speech and language skills and cognitive functioning in children with Apert syndrome: a pilot study.

There are few studies that report findings on the speech and language characteristics of Apert syndrome and little is known about the cognitive profile of the syndrome. The current study addresses this gap and explores speech, language, resonance/voice, attention oro-motor and cognitive skills in a group of 10 children (4;1-5;11) with Apert syndrome. The speech and language battery included: the CELF-Pre-school, the PLS-3, the Vocal Profile Analysis, GOS.SP.ASS, PACS; and the Brodsky Drooling Scale. Subscales of the BAS II-Early Years Version were used to assess cognition. Data were also collected on other factors that could influence developmental outcome such as audiological history and management; occlusion/dentition; respiratory problems and management; neuroanatomical abnormalities; the number and nature of cranial surgeries; and the occurrence of raised intracranial pressure. All children for whom a Performance IQ was obtained (n = 8) had abilities within the average range and IQ scores were considerably higher than those reported in previous studies. Eight children had moderate or severe language difficulties and expressive language difficulties were the most frequent. These language difficulties were not associated with a general cognitive deficit. All the children had problems with attention, speech and oro-motor skills. Nine had abnormal voice. In addition, a range of other associated factors that could affect functioning were identified. The discrepancies between the current study and previous investigations are outlined. Parameters for assessment are considered. The implications of these findings for valid assessments of children with Apert syndrome are discussed. Multidisciplinary assessment of children with Apert syndrome across a broad range of dimensions is recommended to obtain a profile of each child's strengths and weaknesses to ensure that appropriate educational placements and early interventions are implemented. Considering patterns of development over time at key ages is also argued to be of central importance.

Current trends in the community treatment of seriously emotionally disturbed youths.

It is a pleasure to initiate this column on child and adolescent psychiatry. Psychiatrists and other mental health care professionals who work with children and adolescents have needed a forum for discussing issues related to community practice—in particular, for bringing innovations in community programs for youths into our professional dialogue. Through federal and private grants, programs have emerged that have realized the ideals of the original initiatives of the Child and Adolescent Service System Program (CASSP) for the community treatment of youths (1). These initiatives promote CASSP values and principles—that is, that care should be family centered, child focused, culturally competent, community based, and integrated. This system-of-care reform movement has been greatly advanced by The Children’s Mental Health Initiatives Grants from the Center for Mental Health Services. These grants have created laboratories for experimenting with ever more effective ways of addressing the needs of our most challenging young people. Many of these programs address the fragmentation of services in poorly conceived systems of care. I hope this column will be a forum for those who have experience in in

Children with Feeding Tube Dependency

We describe an innovative program that weans young children from their feeding tube. Our program focuses on making the children competent, normal-for-age eaters, promoting the child's strengths. All of the children were treated for 2 to 3 weeks by an interdisciplinary team in a family-centered care

Using Curriculum-Based Measures to Promote a Linked System Approach

Early childhood intervention teams face many challenges in providing high-quality services. Challenges include accurately assessing children's current strengths and needs, developing transdisciplinary goals and objectives, individualizing intervention within the context of developmentally appropriate activities, and monitoring children's performance across time. To address the complexities and challenges of providing services to young children with special needs and their families, a linked system to intervention has been recommended. Within a linked system approach, assessment information guides the development of goals and objectives, which in turn guides individualization of intervention efforts and evaluation activities. Specifically, recommended practice suggests the use of curriculum-based measures in promoting a linked system approach. This article outlines a five-step process for use in selecting and adopting curriculum-based measures designed to facilitate a linked system approach and promote family-centered, collaborative early childhood intervention practices.

The early education of socioeconomically disadvantaged children.

This chapter reviews selected research on the education of low-socioeconomic status (SES) children from birth through the first years of elementary school. Themes include the importance of early academic skills and interest to later achievement; the benefits of integrating knowledge from research on mental health and other areas; the need to utilize and build children's strengths as well as address their weaknesses; and a call to connect research to practice and policy. Relevant research on race and culture is reviewed because ethnic minority low-SES children are at great risk of poverty. Gender is discussed because low-SES boys have poorer general achievement than girls, while very few low-SES girls pursue careers in math- and science-related fields.

Do children of long-lived parents age more successfully?

Long-lived individuals are rare and may be selected in part for the genetic factors that promote successful aging. The children of long-lived parents may therefore age more successfully than the children of short-lived parents. We used three major cross-sectional population-based surveys to study the association of parental longevity with successful aging in offspring. The measures of aging were hand-grip strength, cognitive performance (Mini Mental State Examination and a cognitive composite score), self-reported diseases, and self-rated health. For every additional 10 years the parents lived, their children's grip strength increased by 0.32 kg (95% CI = 0.00-0.63), Mini Mental State Examination score by 0.20 points (95% CI = 0.03-0.37), and cognitive composite score by 0.24 points (95% CI = 0.07-0.40). A 10-year increment of parental life was associated with a reduction by approximately 0.20 in the adjusted odds ratio for their children having each of the following conditions: diabetes; hypertension; ischemic heart disease; heart failure; stroke; or fair, poor, or very poor self-rated health. Almost all the effects were seen solely in the cohort of 70+-year-olds, but not among middle-aged or nonagenarian subjects. Parental life span is positively associated with the children's physical and cognitive functioning and avoidance of some of the common chronic diseases. However, the effects are small and are seen among offspring who are elderly, but not among the middle-aged or the oldest old.

Assessing and teaching diverse learners

A major challenge for teacher preparation programs and future teachers is learning to work skillfully with the diversity of children in American classrooms. This paper describes a tool developed to address this challenge: the Learning and Teaching Assessment System (LTAS). The LTAS is a performance‐based, curriculum‐embedded assessment tool designed to uncover young children's strengths in different curricular areas as well as their approaches to learning. Developed for use with children 3–8 years of age, the LTAS helps teachers understand what children know in relation to key concepts in the different disciplines as well as how they learn in order to further their learning in subsequent days and weeks of teaching. The development of the LTAS is based primarily on two theoretical frameworks: Leont'ev's activity theory and Gardner's theory of multiple intelligences. To examine the efficacy of the LTAS in its proposed objectives, a pilot study was conducted; results point to the potential of the LTAS for helping student teachers uncover new information about children to guide future instruction.

Measuring functional outcomes after prematurity: developmental impact of very low birth weight and extremely low birth weight status on childhood disability.

Our purpose was to describe functional outcomes in essential activities in preschool, school-age, and adolescent children who were born very (<32 weeks gestation) and extremely (<28 weeks gestation) prematurely. Very low birth weight (VLBW; 1000-1499 g), or extremely low birth weight (ELBW;<1000 g) populations are the focus of our analysis. We describe models of disablement and enablement for specifying the complexity of childhood outcomes using a framework of pathophysiology, impairment, functional limitation and functional strengths, disability in social roles and social participation, societal limitations and environmental facilitators. Representative early childhood, preschool, school-age, and adolescent studies were examined in terms of describing children's functional strengths and challenges after VLBW and ELBW survival. In early childhood, disability was assessed by diagnosing neurosensory impairments and delays on developmental testing. Instruments for measuring functional status in essential activities of self-care, mobility, communication and learning are described. Rates of neurosensory disability in the first three years among recent ELBW survivors ranged from 9-26% for cerebral palsy, 1-15% for blindness, 0-9% for deafness, and 6-42% for evolving cognitive disability (MDI <70). Rates of preschool functional limitation were 5-27% motor, 5-30% self-care, and 5-22% communicative. Rates of school-age functional educational disabilities exceeded 50%. Rates of adolescent activity limitation were 13-32% and vocational limitations were 27-71%. By examining the functional strengths and challenges of children with major neurodevelopmental impairments after very or extremely preterm birth, we can examine causal pathways that lessen the risk of severe functional disability. Among children with mild to moderate disability, we can enhance functional outcomes, optimize community participation, and provide quality family supports. In order to assess the changing outcomes of this vulnerable population of survivors, combinations of clinical and survey based methodologies are required.

Longitudinal Assessment of Oxygen Cost and Velocity in Children With Myelomeningocele: Comparison of the Hip-Knee-Ankle-Foot Orthosis and the Reciprocating Gait Orthosis

Oxygen consumption and cost and velocity were evaluated over time in 23 children with myelomeningocele to determine whether differences exist when children walk with hip-knee-ankle-foot orthoses (HKAFOs) versus reciprocating gait orthoses (RGOs). Children using HKAFOs had similar oxygen cost as children using RGOs while achieving a faster velocity. Children walking with HKAFOs into adolescence had a faster velocity and lower oxygen cost than children who discontinued use of their HKAFOs. No significant differences in velocity or oxygen cost were found between children who continued to walk with RGOs and those who discontinued use of their RGOs. Upright ambulation may progress from ambulation with an RGO, when the child's upper extremity strength to mass ratio is low, to an HKAFO when upper extremity strength improves and velocity or keeping up with peers is of concern. Wheelchair mobility should be offered when speed and an energy-efficient method of community mobility are desired.

Grip Strength in Children

Grip Strength in Children