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Biomedical subjects

C E Cunningham

Publications and source records attributed to C E Cunningham.

At least 19 recordsLinked to original sources
PubMed1995

Large group community-based parenting programs for families of preschoolers at risk for disruptive behaviour disorders: utilization, cost effectiveness, and outcome.

A significant percentage of children with disruptive behavior disorders do not receive mental health assistance. Utilization is lowest among groups whose children are at greatest risk. To increase the availability, accessibility, and cost efficacy of parent training programs, this prospective randomized trial compared a large group community-based parent training program to a clinic-based individual parent training (PT) programs. All families of junior kindergartners in the Hamilton public and separate school boards were sent a checklist regarding problems at home. Those returning questionnaires above the 90th percentile were block randomly assigned to: (1) a 12-week clinic-based individual parent training (Clinic/Individual), (2) a 12-week community-based large group parent training (Community/Group), or (3) a waiting list control condition. Immigrant families, those using English as a second language, and parents of children with severe behaviour problems were significantly more likely to enroll in Community/Groups than Clinic/Individual PT. Parents in Community/Groups reported greater improvements in behaviour problems at home and better maintenance of these gains at 6-month follow-up. A cost analysis showed that, with groups of 18 families, Community/Groups are more than six times as cost effective as Clinic/Individual programs.

Child Behavior Disorders↗
PubMed1993

Coping modeling problem solving versus mastery modeling: effects on adherence, in-session process, and skill acquisition in a residential parent-training program.

This trial compared two approaches used to introduce parenting skills in a residential staff training program. Fifty staff were randomly assigned to: mastery modelling in which videotaped models demonstrated new skills, coping modelling problem solving (CMPS) in which participants formulated their own solutions to the errors depicted by videotaped models, or a waiting-list control group. In both, leaders used modelling, role playing, and homework projects to promote mastery and transfer of new skills. The skills of all groups improved, but CMPS participants attended more sessions, were late to fewer sessions, completed more homework, engaged in more cooperative in-session interaction, rated the program more positively, and reported higher job accomplishment scores. These data suggest that CMPS allowing participants to formulate their own solutions may enhance adherence and reduce the resistance observed in more didactic programs.

Adaptation, Psychological↗
PubMed1991

The influence of parenting stress and child behavior problems on parental estimates of expressive and receptive language development.

This study examined the relative contributions of parental reports of child-related and parent-related stress to their estimates of expressive and receptive language skills on the Minnesota Child Development Inventory in 152 children referred to a communicative disorders clinic. Correlational analysis showed moderately high agreement between parental estimates and objective measures of expressive and receptive language ability. Multiple-regression analyses revealed that independent measures of language acquisition accounted for the greatest amount of variance in parental estimates of expressive and receptive language skills. Stressful child behavior accounted for a small but statistically significant proportion of the variance in estimates of expressive and receptive language skills. Parental stress, in contrast, did not contribute significantly to language estimates. These findings suggest that parents are able to formulate estimates of language development which are relatively independent of personal or child-related stressors.

Child↗
PubMed1991

A dose-response analysis of the effects of methylphenidate on the peer interactions and simulated classroom performance of ADD children with and without conduct problems.

To examine the social effects of methylphenidate, groups of 15 attention-deficit disordered boys with (ADD) and 15 ADD boys without conduct problems (ADD/CP) were paired with normal peers. ADD and ADD/CP children showed a different pattern of responses to methylphenidate. While on task behavior in ADD/CP dyads increased at 0.15 mg/kg doses, increases in ADD dyads were not observed until doses reached 0.50 mg/kg. Although controlling interaction in ADD children decreased at 0.15 mg/kg, the controlling behavior of ADD/CP children did not decline at either dose. Peers of both ADD and ADD/CP children showed reciprocal declines in controlling behavior. In both free play and cooperative task situations, 0.15 mg/kg increased social interaction in ADD boys and decreased social interaction in ADD/CP boys.

Achievement↗
PubMed1989

Parents' attributions for achieving compliance from attention-deficit-disordered children.

Ninety-one parents provided reasons for the compliance and noncompliance of either their attention-deficit-disordered, hyperactive (ADDH) or non-ADDH child in six different situations. These attributions were rated on Weiner's (1979) dimensions of locus, stability, and controllability. While parents used the same categories to explain the reasons for their children's compliance behavior, they used different dimensional ratings for these explanations. Mothers rated attributions for noncompliance as more external than did fathers. Mothers of ADDH children viewed the causes of their children's behavior to be more unstable than did mothers of control children. Also, ADDH parents had lower expectations of achieving future compliance from their child than did non-ADDH parents. Results were discussed in terms of parental experiences, the need to consider an idiosyncratic approach to attributional meaning, and treatment implications.

Adult↗
PubMed1988

Dyadic peer interaction and task orientation in attention-deficit-disordered children.

A sequential observational approach was used to compare peer interactions in 10 mixed dyads of ADD-H and non-Add-H boys and 10 dyads of non-ADD-H boys in laboratory cooperative and school classroom task analogue activities. Mixed dyads were found to have a greater frequency of aggression and less joint activity than control dyads in specific situations. No differences were found for measures of functional attention as measured by frequency, duration, and mean duration of task-oriented behavior. Lag sequential analyses revealed two major sequences that differentiated mixed from normal dyads. These were Verbal Reciprocity (a measure of reciprocal verbal interaction) and Retreat (a measure of social withdrawal following aggression).

Aggression↗
PubMed1987

Peer interactions of normal and attention-deficit-disordered boys during free-play, cooperative task, and simulated classroom situations.

Groups of 30 ADD-H boys and 90 normal boys were divided into 30 mixed dyads composed of a normal and an ADD-H boy, and 30 normal dyads composed of 2 normal boys. Dyads were videotaped interacting in 15-minute free-play, 15-minute cooperative task, and 15-minute simulated classroom settings. Mixed dyads engaged in more controlling interaction than normal dyads in both free-play and simulated classroom settings. In the simulated classroom, mixed dyads completed fewer math problems and were less compliant with the commands of peers. ADD-H children spent less simulated classroom time on task and scored lower on drawing tasks than normal peers. Older dyads proved less controlling, more compliant with peer commands, more inclined to play and work independently, less active, and more likely to remain on task during the cooperative task and simulated classroom settings. Results suggest that the ADD-H child prompts a more controlling, less cooperative pattern of responses from normal peers.

Attention Deficit Disorder with Hyperactivity↗
PubMed1987

Self-control and reinforcement in the management of a cerebral-palsied adolescent's drooling.

Self-control of swallowing and positive reinforcement were used to eliminate drooling of a non-vocal 16-year-old with severe spastic quadriplegia. Prompts for self-controlled swallowing appeared to be more effective than positive reinforcement. The effects of treatment were maintained at three-month follow-up, but not at six months. Drooling was eliminated again by prompts for self-controlled swallowing, and had not recurred one year after treatment had ended.

Adolescent↗
PubMed1986

Early home intervention with low-birth-weight infants and their parents.

We investigated the effects of a year-long home intervention with a sample of preterm infants randomly assigned to 1 of 3 groups: a developmental intervention, a parent-infant intervention, and a no-treatment control group. A full-term no-treatment control was also used. Both intervention approaches focused on the parent-child unit, providing training for parents to improve observational skills, emotional support, and information about community resources. However, whereas specific tasks to facilitate the child's development were provided in the developmental intervention group, the quality of the parent-infant interaction was the target for treatment in the other group. All infants were assessed at 4, 8, 12, and 16 months of age corrected for prematurity. The results suggest that although both intervention approaches were effective in modifying some aspects of the home environment and, to a lesser degree, in improving infants' cognitive development, the parent-infant interaction approach seemed to have the greater impact. These findings confirm previous observations regarding the cognitive development of preterm and full-term infants during the first 18 months of life and demonstrate changes in behavior and behavior styles in both pre- and full-term infants as they become older.

Child Development↗
PubMed1986

Low birth weight and home intervention strategies: preterm infants.

We investigated the effects of a 1-year home intervention on premature infants with low (less than 1500 g) and higher (1500-2000 g) birth weights. Infants from each weight condition were block randomly assigned to a control or to one of two treatment groups. One treatment group focused on the development of the infant; the other treatment group focused on the parent-infant interaction. The low birth weight infants obtained significantly lower Bayley mental and motor scores, and were more passive and less intense than the higher birth weight infants. However, the low birth weight infants and their parents were more responsive to the home intervention than were the higher birth weight infants, as demonstrated by changes in the Bayley mental scores and the Home Observation for Measurement of the Environment (HOME) inventory. These findings exemplify the reciprocal relationship between the child's characteristics and parental responding. The importance of selecting the most high-risk premature infants for early home intervention is outlined.

Clinical Trials as Topic↗
PubMed1985

A developmental dose-response analysis of the effects of methylphenidate on the peer interactions of attention deficit disordered boys.

Mixed dyads of 42 normal and 42 ADD boys were videotaped in free play, co-operative task, and simulated classrooms. ADD boys received placebo, 0.15 mg/kg, and 0.50 mg/kg of methylphenidate. ADD boys were more active and off task, watched peers less, and scored lower on mathematics and visual-motor tasks. Older boys interacted less, ignored peer interactions and play more frequently, were less controlling, and more compliant. In class, methylphenidate improved visual motor scores, and reduced the controlling behaviour, activity level, and off task behaviour of ADD boys. Normal peers displayed reciprocal reductions in controlling behaviour, activity level, and off task behaviour.

Age Factors↗
PubMed1985

Interactions of language-delayed and normal preschool boys with their peers.

This study examined the impact of specific language delay (LD) on peer interactions in preschool children. Three groups of dyads were studied: normal children interacting with normal children, normals interacting with LD children and LD children with each other. The normal children were more likely to initiate interaction when the partner was non-responsive and to attempt to dominate the interaction. The results of this study illustrate reciprocity in the social interactions of young children, the significant role of dominance and control in interaction and the sensitivity of preschool children to the characteristics of their peers.

Child, Preschool↗
PubMed1985

The behavioral and linguistic interactions of specifically language-delayed and normal boys with their mothers.

3 studies were based on subgroups selected from larger pools of either normal children or children with delays in the expression and/or comprehension of language but normal nonverbal abilities. In Study 1, younger (28-50 months) and older (51-68 months) normal (N = 27) and language-delayed (N = 33) boys were observed interacting with their mothers in free play and structured task situations. Although language-delayed children initiated fewer interactions, their responsiveness to maternal interactions, questions, and commands did not differ from that of normal children. Mothers questioned language-delayed children less frequently during tasks but did not differ from mothers of normal children on other measures of interaction, responsiveness, control, or reward strategies. In Study 2, the complexity of maternal speech directed to normal (N = 11) and expressively delayed (N = 11) boys who were matched on the basis of comprehensive skills did not differ. Maternal speech to boys with delays in both language expression and comprehension (N = 11) was significantly less complex. In Study 3, the discrepancy between the speech complexity of mothers and that of their language-delayed children (N = 47) was greatest in younger children with greater expression and comprehension delays, who initiated fewer interactions and proved less responsive to maternal interactions and questions.

Child↗
PubMed1982

In vivo desensitization in the management of self-injurious behavior.

In vivo desensitization procedures were used successfully to manage self-injurious face slapping in a 10 yr old retarded boy. Face slapping had increased and persisted at self-injurious intensity following a surgical dental evaluation and had initially been prevented by the use of a hockey helmet. Parent's efforts to remove the helmet resulted in increased agitation, severe self-injurious behavior, and repeated efforts by the child to replace the helmet to restrain himself, or prompt adult restraint. An in vivo desensitization procedure involving increasingly extended periods without the helmet was introduced by the parents into a hierarchy of situations at home. Progress was monitored across four situations using a multiple baseline design with 6, 9, 12 and 15 month follow-up on each baseline. During treatment, self-injurious behavior was eliminated and the child developed a self-control response of wearing the helmet when agitated and spontaneously removing it when relaxed. Continued improvement was noted at 6, 9 and 12 month follow-ups. At the 15 month follow-up, no self-injurious behavior was observed and the use of the helmet was discontinued.

Behavior Therapy↗
PubMed1979

The effects of methylphenidate on the mother-child interactions of hyperactive children.

Twenty hyperactive boys were observed while interacting with their mothers during a free play and task period on each of three occasions (no drug, drug, placebo). A triple-blind, drug-placebo crossover design was used to study the effects of methylphenidate on these interactions. A complex objective coding system was used to score the children's responses to various maternal behaviors as well as the mother's responses to a variety of children's behaviors. Results indicated that these children were more compliant with maternal commands during drug treatment. In response, mothers displayed increased attention to compliance while reducing their directiveness toward the boys. However, the hyperactive boys receiving methylphenidate initiated fewer social interactions and tended to show greater nonresponding. Thus, methylphenidate may improve the compliance of hyperactive children but tends to decrease their sociability.

Child↗