Typically Developing Youth Research Articles

Interventions for Improving Affective Abilities in Adolescents: An Integrative Review Across Community and Clinical Samples of Adolescents

A large body of literature suggests that adolescents with callous-unemotional traits have significant affective impairments, yet few evidence-based interventions exist for this population. The current article reviews the literature on interventions that target emotion recognition and/or perspective-taking abilities among adolescents to identify common processes and features that might help inform further development of treatment strategies for youth with callous-unemotional traits. Thirty-two articles were included and involved samples of typically-developing youth, youth with autism spectrum disorder, youth with antisocial behavior/conduct problems, and youth with disabilities. Overall, interventions for emotion recognition and perspective-taking for adolescents appear promising. Integrating across populations, commonalities among interventions associated with positive outcomes were identified. Recommendations for informing treatment for youth with callous-unemotional traits are discussed.

Friendship in school-age boys with autism spectrum disorders: A meta-analytic summary and developmental, process-based model.

Friendship-making is considered a well-established domain of deficit for children with autism spectrum disorders (ASD; American Psychiatric Association, 2013), with this population sometimes described as incapable of making friends. However, the majority of children with ASD indicate a desire for friends, and many report having friends. To what degree, then, do youth with ASD succeed in achieving friendships with peers? If and when they do succeed, by what means do these friendships emerge relative to models of typically developing (TD) youths' friendships? To address these questions, we first meta-analyzed the descriptive friendship literature (peer-reported sociometrics, self-report, parent-report) among school-age boys with ASD. Using random effects models, we found that youth with ASD do make friends according to peers and parents (Hedges's g > 2.84). However, self-reported friendship quality (Hedges's g = -1.09) and parent- and peer-reported quantity (Hedges's g < -0.63) were poorer than TD peers. We consider these findings in light of 2 conceptual frameworks for understanding social deficits in ASD (social cognition and social motivation theory) and in view of a leading model of friendship in TD youth (Hartup & Stevens, 1997). We then present a model that synthesizes these domains through the construct of social information processing speed, and thereby present the first developmental, process-based model of friendship development among youth with ASD. (PsycINFO Database Record

Developmental Course and Determinants of Sleep Disturbances in Adolescents With Spina Bifida.

To examine (1) trajectories of sleep disturbances in adolescents with spina bifida (SB) compared with a typically developing (TD) group over a 10-year period and (2) individual, family, and socioeconomic determinants of changes in sleep disturbances. Participants were 68 families of youth with SB and 68 families of TD youth. Parent-report of adolescent sleep was collected every 2 years at 6 time points (T1: ages 8-9; T6: ages 18-19). Multiple informants and measures were used to examine internalizing, externalizing, and inattention symptoms, dyadic/family conflict, socioeconomic status (SES), and family income. Sleep disturbances increased over the 10-year period. Youth with SB had greater sleep disturbances during early adolescence. Greater preadolescent externalizing symptoms, greater parent-child and marital conflict, and lower SES predicted increased sleep disturbances. Sleep disturbances are common and persistent in adolescents with SB. Sleep assessment and management are important clinical and research priorities in this population.

Anxiety and Gender Influence Reward-Related Processes in Children and Adolescents.

This study examined the effects of pediatric anxiety and its interaction with gender on reward processes. Based on the purported greater sensitivity to risk in females than males and the propensity for risk aversion in anxiety, clinical anxiety and female gender were hypothesized to act synergistically in reducing reward sensitivity and increasing risk aversion in a pediatric population. This hypothesis was tested in two separate experiments using two independent samples. Both experiments compared clinically anxious with typically developing (TD) youth, 8-18 years. Experiment 1 used a decision-making task, the Wheel of Fortune task (WOF), to examine risk taking as a function of varying levels of risk and reward in 36 anxious and 61 TD youths. Experiment 2 used an incentive delay task, the Piñata task, to examine sensitivity to reward and motivation to work for a reward in 38 anxious and 30 TD youth. Percent bet, reaction time, and accuracy were analyzed as a function of gender and diagnostic group. As hypothesized, anxiety was associated with reduced risk taking and sensitivity to reward. However, contrary to prediction, this effect was seen in males and not in females. These findings are consistent across both experiments. In experiment 1 (WOF), betting rate (i.e., risk taking) was significantly lower in anxious than in TD males (F[1;53] = 7.07, p = 0.01), whereas anxious females did not differ from TD females (F[1,42] = 1.2, p = 0.28). In experiment 2 (Piñata), anxiety impaired performance accuracy in males (F[1;36] = 8.39; p < 0.01) but not females (F[1;28] = 0.6; p = 0.445). Anxiety affected reward function differently in males and females. Contrary to hypothesis, anxious females behaved similarly to TD females on both tasks. However, anxious males were significantly more risk averse and less accurate than TD males. These findings suggest that therapeutic interventions for anxiety, which use manipulations of reward processes, should consider gender for optimal outcome.

Resilience and Disruption in Observed Family Interactions in Youth With and Without Spina Bifida: An Eight-Year, Five-Wave Longitudinal Study.

To examine differences between families of youth with spina bifida (SB) and families of typically developing (TD) youth on family-, parent-, and youth-level variables across preadolescence and adolescence. Participants were 68 families of youth with SB and 68 families of TD youth. Ratings of observed family interactions were collected every 2 years at 5 time points (Time 1: ages 8-9 years; Time 5: ages 16-17 years). For families of youth with SB: families displayed less cohesion and more maternal psychological control during preadolescence (ages 8-9 years); parents presented as more united and displayed less dyadic conflict, and youth displayed less conflict behavior during the transition to adolescence (ages 10-13 years); mothers displayed more behavioral control during middle (ages 14-15 years) and late (ages 16-17 years) adolescence; youth displayed less engagement and more dependent behavior at every time point. Findings highlight areas of resilience and disruption in families of youth with SB across adolescence.

Social Function and Communication in Optimal Outcome Children and Adolescents with an Autism History on Structured Test Measures.

Youth who lose their ASD diagnosis may have subtle social and communication difficulties. We examined social and communication functioning in 44 high-functioning autism (HFA), 34 optimal outcome (OO) and 34 typically developing (TD) youth. Results indicated that OO participants had no autism communication symptoms, no pragmatic language deficits, and were judged as likable as TD peers. Some group differences were found: OO youth had less insight into social relationships and poorer friendship descriptions than TD youth. OO participants had attention, self-control, and immaturity difficulties that may impact social abilities. However, OO participants were most engaged, friendliest, warmest, and most approachable. Overall, OO participants had no social and communicative impairments, although some exhibited mild social difficulties that often accompany attentional problems.

Neural systems for cognitive reappraisal in children and adolescents with autism spectrum disorder

Despite substantial clinical and anecdotal evidence for emotion dysregulation in individuals with autism spectrum disorder (ASD), little is known about the neural substrates underlying this phenomenon. We sought to explore neural mechanisms for cognitive reappraisal in children and adolescents with ASD using functional magnetic resonance imaging (fMRI). We studied 16 youth with ASD and 15 age- and IQ-matched typically developing (TD) comparison youth. Participants were instructed in the use of cognitive reappraisal strategies to increase and decrease their emotional responses to disgusting images. Participants in both groups displayed distinct patterns of brain activity for increasing versus decreasing their emotions. TD participants showed downregulation of bilateral insula and left amygdala on decrease trials, whereas ASD participants showed no modulation of insula and upregulation of left amygdala. Furthermore, TD youth exhibited increased functional connectivity between amygdala and ventrolateral prefrontal cortex compared to ASD participants when downregulating disgust, as well as decreased functional connectivity between amygdala and orbitofrontal cortex. These findings have important implications for our understanding of emotion dysregulation and its treatment in ASD. In particular, the relative lack of prefrontal-amygdala connectivity provides a potential target for treatment-related outcome measurements.

Who are those “risk-taking adolescents”? Individual differences in developmental neuroimaging research

Functional magnetic resonance imaging (fMRI) has illuminated the development of human brain function. Some of this work in typically-developing youth has ostensibly captured neural underpinnings of adolescent behavior which is characterized by risk-seeking propensity, according to psychometric questionnaires and a wealth of anecdote. Notably, cross-sectional comparisons have revealed age-dependent differences between adolescents and other age groups in regional brain responsiveness to prospective or experienced rewards (usually greater in adolescents) or penalties (usually diminished in adolescents). These differences have been interpreted as reflecting an imbalance between motivational drive and behavioral control mechanisms, especially in mid-adolescence, thus promoting greater risk-taking. While intriguing, we caution here that researchers should be more circumspect in attributing clinically significant adolescent risky behavior to age-group differences in task-elicited fMRI responses from neurotypical subjects. This is because actual mortality and morbidity from behavioral causes (e.g. substance abuse, violence) by mid-adolescence is heavily concentrated in individuals who are not neurotypical, who rather have shown a lifelong history of behavioral disinhibition that frequently meets criteria for a disruptive behavior disorder, such as conduct disorder, oppositional-defiant disorder, or attention-deficit hyperactivity disorder. These young people are at extreme risk of poor psychosocial outcomes, and should be a focus of future neurodevelopmental research.

Walking activity patterns in youth with cerebral palsy and youth developing typically

Purpose: To describe daily walking stride rate patterns of young children with cerebral palsy (CP) as compared to a typically developing youth (TDY) cohort relative to age and functional level. Method: A cross-sectional comparison cohort study compared 209 youth with CP with 368 TDY aged 2–13 years. Youth with CP had Gross Motor Function Classification System (GMFCS) levels I–III with 60% bilateral involvement and 79% spastic. Five days of StepWatch data were averaged and classified into low, moderate and high stride rates. Group differences were examined by t-test and analysis of variance. Results: Children with CP walk significantly less each day than TDY (F = 245, p ≤ 0.001) and differ by GMFCS (F = 1.51, p < 0.001). TDY walk a similar number of strides in low and moderate stride rates each day while youth with CP do not. TDY attained high stride rates (>60 strides/min) for 8 min/d with levels I–III at 4.0, 3.2 and 0.53 min/d, respectively. Conclusions: The relative relationship of walking intensity levels within total daily stride activity differs for youth with CP as compared to TDY. The influence of functional walking ability on walking stride activity levels and intensity does not appear to differ significantly across age groups.Implications for RehabilitationLimitation in the ability to attain moderate stride-rate intensity, regardless of total number of strides taken each day for ambulatory youth with CP, is a potential area of focus for intervention.Understanding of stride activity levels and intensity in youth with CP may be employed to focus rehabilitation strategies to enhance habitual walking activity.Community-based stride rate data has potential as an effectiveness outcome for rehabilitation strategies focused on walking (i.e. orthopedic surgery, orthoses and injections therapies).

Moral reasoning and empathy in adolescents with autism spectrum disorder: implications for moral education

A mixed methods approach was used to understand moral reasoning and empathy in 12- to 18-year-old adolescents with high-functioning autism spectrum disorder (HF-ASD) compared to same age typically developing (TD) youth. Adolescents completed measures assessing empathy (perspective-taking, personal distress, and empathic concern), and moral reasoning, as well as a qualitative interview asking them to discuss a challenging sociomoral situation and recount their moral competencies and strengths in difficult situations. For quantitative results, both groups demonstrated similar empathic concern, but adolescents with HF-ASD had significantly higher personal distress and lower moral reasoning than TD youth. Qualitative results suggest that adolescents with HF-ASD perceived themselves as having empathic concern but struggled to use these feelings to support their actions in spontaneous challenging sociomoral situations. Results suggest that teachers should be educated in providing specific guidance to adolescents with HF-ASD about how to express empathic concern in ways that promote mutually rewarding relationships.

Physical Activity Assessment in Adolescents with Limb Salvage

To evaluate ambulatory activity differences between youth with limb salvage procedures and typically developing youth (TDY) and assess differences in self-reported activity levels in the 2 groups, to provide a basis for physical activity assessment in patients who had undergone limb salvage surgery and treatment planning that incorporates regaining normal physical and daily living activities. In this cohort comparison study, we compared ambulatory and self-reported activity levels in 20 youth (aged 11.7-20.8 years) who had undergone limb salvage surgery and a sex- and age-matched comparison cohort of 20 TDY. StepWatch activity monitor and Activity Scale for Kids data were used to answer these questions. Significant differences were found between the youth who had undergone limb salvage surgery and the TDY in total time active each day (43% vs 48%; P = .03), median total strides per day (4487 vs 7671; P = .001), and amount of time per day at high activity levels (20 minutes vs 47 minutes; P = .001). Self-reported overall physical activity, locomotion, and standing Activity Scale for Kids subscale scores were significantly lower in the youth undergoing limb salvage surgery compared with the TDY (summary score, 88.3 vs 97.7; P = .001). Patients undergoing limb salvage surgery exhibit reduced physical activity compared with normal age-matched controls.

StepWatch stride counting: Accuracy, precision, and prediction of energy expenditure in children

Accuracy and precision of the StepWatch (SW) was tested in typically developing youth (TDY) with the prediction of oxygen consumption derived from stride counts. Ten TDY (5 boys, 5 girls) with an average age 14.1 years (SD=2.2) enrolled. Participants underwent treadmill cardiopulmonary exercise testing (CPET) wearing two SW devices at 1, 2, 3, and 4 miles per hour (mph). Average sign-corrected disagreement for strides counted between the 2 monitors was 0.4 (0.52), 0.2 (0.42), 0.1 (0.32), and 0.1 (0.32) for 1, 2, 3, and 4 mph, respectively. The ratio of SW counts to observed manual counts averaged 100.03% with ICC=0.995. Oxygen consumption equations were derived from resting and walking VO(2), age, gender, and stride counts. Excellent accuracy and precision was documented for treadmill walking speeds up to 4 mph while VO(2) per number of strides taken appears to decrease with age and is lower in girls.

Influence of Age on Step Activity Patterns in Children With Cerebral Palsy and Typically Developing Children

Stevens SL, Holbrook EA, Fuller DK, Morgan DW. Influence of age on step activity patterns in children with cerebral palsy and typically developing children. Objective To document the influence of age on step activity patterns in children with cerebral palsy (CP) and typically developing (TD) children. Design Cross-sectional. Setting All step activity data were collected in free-living environments. Participants Children with CP (n=27; age, 4–18y; 22 boys, 5 girls; Gross Motor Function Classification System levels I and II) and 27 age- and sex-matched TD children were recruited through public advertisements and contacts with local clinicians. CP and TD participants were stratified into younger (<10y; n=14) and older (10–18y; n=13) age groups. Intervention Daily step activity was monitored using a step activity monitor that was individually programmed to account for the gait characteristics of each participant. Step activity data were collected in 1-minute epochs during waking hours on 3 weekdays and 1 weekend day. Stored data were analyzed to yield average values of daily step activity, percentage of inactive time (0 steps) over the entire day, and percentage of total daily active time spent in low step activity (1–15 steps/min), medium step activity (16–40 steps/min), and high step activity (>40 steps/min). Main Outcome Measures Daily step activity, percentage of inactive time, and percentage of active time spent in low-, moderate-, and high-intensity step activity. Results A significant ( P<.05) interaction was observed between age (younger, older) and condition (CP, TD) for daily step activity, percentage of inactive time, and percentage of active time spent in low- and high-intensity step activity. The main effect of age was significant for each physical activity measure except for relative high-intensity step activity, and the main effect of condition was significant for all physical activity measures. Follow-up analyses ( P<.025) revealed that older children with CP took fewer daily steps and displayed higher relative levels of inactivity and low-intensity activity and lower relative levels of high-intensity activity compared with older TD children. Older children with CP also exhibited lower daily step activity, demonstrated higher relative levels of inactivity and low-intensity activity, and displayed lower relative levels of moderate-intensity activity compared with younger children with CP. Conclusions Compared with younger children with CP and age- and sex-matched TD youth, older youth with CP generally displayed step activity patterns typified by lower levels of physical activity and a greater degree of inactivity. These findings highlight the need to provide multiple opportunities for adolescents with CP to engage in a variety of physical activities that are appropriate to their needs, abilities, and preferences and that can aid in maintaining functional mobility, health, and quality of life.

Rights Conceptions of Maltreated Children Living in State Care

AbstractAlthough research on children's thinking about children's rights has increased over the past few decades, there has been virtually no study of children with maltreatment histories who live in state care. This group is particularly vulnerable, having suffered profound violations of their right to security at the hands of their caregivers and often residing in non-kinship settings. We examined conceptions and attitudes about nurturance and self-determination rights in 100 10-18-year-old maltreated children living in state care in Toronto, Canada. Participants demonstrated a more accurate definition of a right than typically-developing youth in previous studies. Rights that were salient related predominantly to participants' current – rather than historical – circumstances. However, compared to nonmaltreated children in previous research, there was a greater focus on rights related to protection and access to basic needs, which suggests that basic issues of protection and provision are still quite relevant in their lives. While type of maltreatment did not relate to participants' thinking about rights, differences emerged between youth living in foster care and group homes. In general, rights that appeared salient to participants had an aspirational quality in that they related to opportunities or benefits that they deemed important but may not have experienced. Theoretical and practical implications of the results are discussed.

Self-Reported Health Status and Quality of Life in Youth With Cerebral Palsy and Typically Developing Youth

Bjornson KF, Belza B, Kartin D, Logsdon RG, McLaughlin J. Self-reported health status and quality of life in youth with cerebral palsy and typically developing youth. ObjectiveTo describe self-reported health status and quality of life (QOL) of ambulatory youths with cerebral palsy (CP) compared with sex- and age-matched typically developing youth (TDY). DesignProspective cross-sectional cohort comparison. SettingCommunity-based. ParticipantsA convenience sample of 81 youth with CP (age range, 10−13y) with Gross Motor Function Classification System (GMFCS) levels I through III and 30 TDY participated. They were recruited from 2 regional children’s hospitals and 1 regional military medical center. InterventionsNot applicable. Main Outcome MeasuresParticipants completed the Child Health Questionnaire−Child Form (CHQ-CF87) for health status and the Youth Quality of Life for QOL. ResultsYouth with CP reported significantly lower health status than age- and sex-matched TDY in the following CHQ-CF87 subscales: role/social behavioral physical, bodily pain, physical function, and general health (CP mean rank, 46.8−55.2; TDY mean rank, 62.2−80.9). There were significant differences across GMFCS levels. There were no significant differences in self-reported QOL. ConclusionsSelf-reported health status, but not QOL, appears sensitive to the functional health issues experienced by ambulatory youth with CP. Pain management and psychosocial support may be indicated for them.