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Biomedical subjects

A W Atkinson

Publications and source records attributed to A W Atkinson.

6 recordsLinked to original sources

Psychosocial screening in pediatric practice: identifying high-risk children.

The purpose of this study was to evaluate the effectiveness of the Pediatric Symptom Checklist (PSC) as a psychosocial screening instrument. Using the PSC, the researchers screened 212 patients, ages 6-12 years, at a military outpatient pediatric clinic. Twenty-one children with scores in the "high-risk" range were randomly selected and matched with children scoring in the normal, "not-high-risk" range. Two trained interviewers, blind to individual PSC scores, independently interviewed and rated each subject's level of psychosocial functioning on the Children's Global Assessment Scale (CGAS). The Child Behavior Checklist (CBCL), a standardized psychosocial measure, was also completed by each subject's mother. PSC scores were compared to the CGAS and CBCL scores in terms of sensitivity and specificity. Additional analyses compared data from the study sample with that of previous studies. Results suggest that the PSC is a valid pediatric psychosocial screening instrument for multiethnic patient populations.

Child

Parent, teacher, child. A trilateral approach to attention deficit disorder.

We compared the effectiveness of three instruments in initially diagnosing and monitoring children with attention-deficit disorder with and without hyperactivity (ADD/H). Twenty-one children clinically assessed as having ADD/H and meeting criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, were examined initially and after treatment with methylphenidate hydrochloride and placebo. The following instruments were used: the ADD-H Comprehensive Teacher Rating Scale, the Connors' Parent Rating Scale-Revised, and the Gordon Diagnostic System. The ADD-H Comprehensive Teacher Rating Scale initially classified 67% of the children as having ADD/H and 14% as borderline. The Connors' Parent Rating Scale-Revised identified 71% as having ADD/H, while the Gordon Diagnostic System assessed 52% as having ADD/H and 29% as borderline. With methylphenidate treatment, the mean scores on the ADD-H Comprehensive Teacher Rating Scale displayed an increase in attention span and a decrease in hyperactivity, the Connors' Parent Rating Scale-Revised showed a significant decrease in ADD/H behavior, and the Gordon Diagnostic System mean scores indicated no significant change.

Attention Deficit Disorder with Hyperactivity

Self-esteem in children medically managed for attention deficit disorder.

Self-esteem was measured initially in a group of 21 eight- to 12-year-old children with newly diagnosed attention deficit disorder/hyperactivity and remeasured after 1-month courses of treatment with methylphenidate and placebo given in double-blind crossover fashion. Multimodal management of all patients included diagnosis, demystification, medication, close follow-up with supportive counseling, and referral as indicated for psychosocial and educational assistance. Long-term follow-up of 12 children who continued to receive methylphenidate was done for an average of 16 months. Initial total self-esteem was low in 30% of all subjects, intermediate in 55%, and high in 15%. No statistically significant changes occurred in self-esteem during the short-term phase of the study despite clinically significant behavioral responses to medication as assessed by serial questionnaires. At long-term follow-up, total, general, and academic self-esteem scores were improved significantly, however. These findings indicate that many preadolescents with attention deficit disorder/hyperactivity exhibit low self-esteem. Despite clinical response to medication, short-term improvement in self-esteem may not occur; however, long-term, multimodal management that includes medication does appear to improve self-esteem.

Attention Deficit Disorder with Hyperactivity

"Latchkey". Three voices with one message.

Two to five million children, 6 through 13 years old, are unsupervised at home after school. This practice, called "latchkey," involves issues of children without adult supervision for periods of time and questions of safety and social isolation. There are no published age guidelines for "latchkey" or data on actual practice. To investigate age guideline opinions and the factors that influence them, a survey of pediatricians (the professional voice), military police (the legal voice), and parents (the popular voice) was undertaken. Solicited opinions concerned ages at which children can be left alone for brief or extended periods and can be allowed to babysit younger children. The three "voices" expressed similar mean ages and distributions for each of the "latchkey" questions. For less than 15 minutes without supervision, the means approximated 9 years; for periods of 1 hour or longer, 12 years; and for babysitting, 14 years. The data presented do not address actual or appropriate practice, but instead provide a basis to begin investigation.

Adolescent