Biomedical subjects

K J Tarnowski

Publications and source records attributed to K J Tarnowski.

At least 19 recordsLinked to original sources

PubMed2001

Utility of the Pediatric Symptom Checklist for behavioral screening of disadvantaged children.

Investigated the utility of a parent report measure designed specifically for behavior screening in the pediatric primary care setting for use with disadvantaged children and families. Results indicated that the Pediatric Symptom Checklist was significantly related to scores derived from the Child Behavior Checklist. Receiver Operator Characteristic analysis indicated the need for modification of the cutting score previously established with middle-class children. A model for screening children for psychopathology within the structural-organizational constraints of the pediatric primary care setting is presented.

Adult↗

PubMed1993

Acceptability of behavioral treatments: influence of knowledge of behavioral principles.

The relation of staff knowledge of behavioral principles to ratings of treatment acceptability for interventions used in the management of self-injurious behavior (SIB) was examined with 57 direct-care staff members from an ICF/MR. Case descriptions of an adult with severe mental retardation who exhibited SIB were presented, followed by descriptions of six behavioral interventions rated on acceptability. Subjects also completed a 25-item measure of general knowledge of behavioral principles. Results indicated that staff age and educational attainment but not treatment acceptability ratings were significantly related to knowledge scores. Implications of the findings were discussed.

Adult↗

PubMed1993

Child, parent, and physician perceived satisfaction with pediatric outpatient visits.

Patient satisfaction has been linked empirically to a variety of health care outcomes (e.g., treatment adherence). Unfortunately, there is a paucity of data regarding the assessment of children's satisfaction with pediatric care. This lack of instrumentation was the impetus for the development and preliminary validation of the Metro Assessment of Child Satisfaction (MACS). Findings indicated the MACS is internally consistent and easily administered and understood by children as young as 6 years of age. Factor analysis yielded four distinct factors that appear to be statistically valid and clinically meaningful. Findings are discussed in relation to maternal ratings of satisfaction and physician perceptions of patient and parent satisfaction.

Adolescent↗

PubMed1992

Assessing treatment acceptance: the Abbreviated Acceptability Rating Profile.

As part of a broad focus on service accountability, increased attention has been devoted to the assessment of consumer judgments of treatment acceptability. Current treatment acceptability measures are limited by item complexity and time-intensiveness. These limitations were addressed with the modification of an existing instrument (Intervention Rating Profile; Witt & Elliott, Journal of Abnormal Child Psychology, 13, 59-67, 1985). Psychometric support was found for the revised measure (Abbreviated Acceptability Rating Profile; AARP) in an initial sample of parents (N = 60) who rated child treatments. Results were replicated in a cross-validation study of a second independent sample of parents (N = 80). A third sample of subjects was used to assess the time-intensiveness and readability of the AARP. The usefulness of the modified instrument is discussed.

Adolescent↗

PubMed1992

Acceptability of interventions for childhood depression.

Using a case description methodology, this study examined the effects of behavior problem severity, intervention type, and subject race on mothers' acceptability ratings of five interventions used to treat childhood depression. Results indicated that (a) all psychological (behavioral or cognitive-behavioral) interventions were rated more acceptable than pharmacological treatment; (b) among the psychological interventions, the social skills intervention was the least preferred; (c) acceptability of treatments varied as a function of subject race; and (d) severity of depressive symptoms failed to influence acceptability ratings significantly. Psychometric support was found for a revised measure of acceptability (Abbreviated Acceptability Rating Profile; AARP) developed in the context of the present study. Implications of the findings for consultation are discussed.

Adolescent↗

PubMed1991

Social skills and antisocial conduct of delinquents.

A revised and abbreviated version of the Adolescent Problems Inventory (API) was used to examine the relationship between social skills deficits and antisocial behavior. A factor analysis of the revised API yielded three factors (Immediate Response Demand, Deferred Response Demand, and Antisocial Peer Influence) which were differentially related to specific measures of antisocial responding. Results are discussed in the context of a multifactorial model of juvenile delinquency.

Adolescent↗

PubMed1991

Psychosocial adjustment and physical growth in children with imperforate anus or abdominal wall defects.

Pediatric surgeons have the unique responsibility of performing surgical procedures that will enable their patients to function normally throughout a lifetime. Good anatomic results may not ensure that this goal will be achieved. Using a battery of psychological testing instruments, we evaluated the academic achievement and psychosocial status of 56 children (mean age, 10.6 years) with imperforate anus (IA) and abdominal wall defects (AWDs). Physical growth was assessed by measurement of standard anthropometric parameters, and a parent questionnaire was used to define clinical status. As a group, the children presented with average intellectual ability. Achievement in both reading and math was in the normal range. In 12.5% of the children a reading learning disability was noted and 10.7% had a disability in math. On the basis of parental assessments, 25% of the children demonstrated externalizing behavior disorders (eg, conduct problems) and 29% displayed internalizing symptomatology (eg. withdrawal, anxiety). Social competency deficits were described in 23% of the children. Data obtained from the teachers were consistent with the parental assessments. No major differences between the IA and AWD patients in academic achievement, psychosocial status, or physical growth were discovered. Routine screening of these children for learning disabilities and behavior problems is recommended.

Abdominal Muscles↗

PubMed1991

Congenital gastrointestinal anomalies: psychosocial functioning of children with imperforate anus, gastroschisis, and omphalocele.

This study assessed the psychosocial status of 56 children aged 6-16 years with imperforate anus, gastroschisis, or omphalocele. Results indicate that (a) children were of average intellectual ability; (b) approximately 9% of the sample had learning disabilities; (c) although the mean maternal ratings of behavioral adjustment did not differ from those reported for children without anomalies, approximately 18% of the children had deviant adjustment scores; (d) a multivariate risk and resistance model accounted for a significant amount of the variance in children's adjustment; and (e) child, maternal, and family utilitarian and psychological risk and resistance resources contributed independently to children's overall behavioral adjustment.

Abdominal Muscles↗

PubMed1990

Depressive characteristics of sexually abused children.

Allen and Tarnowski (1988) identified a pattern of depressive characteristics that distinguished physically abused from nonabused children. The present study attempted to extend the generality of these findings to sexually abused children. Sexually abused and nonabused children were compared on measures of depression, hopelessness, and self-esteem. Results indicated that while sexually abused children self-reported more depressive symptoms in comparison to nonabused controls, that these differences were not statistically significant and failed to replicate the findings noted for physically abused children.

Child↗

PubMed1990

Disproportionate referrals for child academic/behavior problems: replication and extension.

Drabman, Tarnowski, and Kelly (1987) investigated children's month of birth in relation to mental health referrals and found that the younger children in a class were disproportionately referred for services. We conducted a replication and extension of the Drabman et al. investigation. Data were collected on children's (N = 222) cognitive and academic competencies. Results indicated that (a) younger children in a class were disproportionately referred, (b) the referral pattern remained constant across all grades examined, (c) the referral pattern could not be explained by differences in children's competencies, and (d) although the youngest children in the class were referred most frequently, they had the lowest rate of qualification for special services.

Achievement↗

PubMed1990

Maternal characteristics and perceptions of pervasive and situational hyperactives and normal controls.

Thirty 6- to 9-year-old boys were rated by their mothers and teachers as being pervasively hyperactive, situationally hyperactive, or not hyperactive at home or school. Maternal characteristics and perceptions of their children's behavior problems were collected. Children's global and molecular social skills were also assessed in a role-play format. Mothers of pervasive hyperactive boys reported significantly more overall stress in their relationship with their child and perceived their sons as displaying more behavioral problems compared to mothers of situational hyperactive and nonhyperactive children. Mothers of pervasive hyperactive boys also rated themselves as more depressed, less competent, more restricted, and frustrated compared to control mothers. Mothers of situational hyperactive children indicated that their sons displayed more behavior problems and reported more maternal stress compared to mothers of normal controls. Normal controls were rated as overall more socially skilled than situational hyperactive boys. The utility of the pervasive and situational hyperactivity distinction is discussed.

Attention Deficit Disorder with Hyperactivity↗

PubMed1990

Acceptability of behavioral interventions for self-injurious behavior: replication and interinstitutional comparison.

Using a case description methodology, Tarnowski, Rasnake, Mulick, and Kelly (1989) examined the effects of behavior problem severity and intervention type on staff ratings of six behavioral interventions used to treat self-injurious behavior (SIB). Results indicated that accelerative interventions were judged more acceptable than reductive treatments, and acceptability of treatments varied as a function of SIB severity. We hypothesized that judgments of treatment acceptability might vary as a function of specific institutional characteristics and conducted a replication of the previous study in a setting where the institutional treatment philosophy was explicitly behavioral. Results indicated that (a) accelerative interventions were preferred to reductive treatments, (b) acceptability ratings were not significantly influenced by SIB severity, and (c) interventions were generally found to be more acceptable by staff working in a behavioral treatment milieu.

Adult↗

PubMed1990

The school breakfast program and cognition in adolescents.

We studied cognitive function and metabolic status in a group of healthy adolescents fed the government supplied breakfast (n = 18) versus a control group (n = 16) fed a very low calorie meal. Serum glucose and beta-hydroxybutyrate levels were repeatedly measured at predetermined intervals throughout the testing period. Acute cognitive and mood effect were evaluated in all subjects on a pre-post basis. No significant group differences emerged on a battery of psychological measures that assessed short-term auditory memory, vigilance, impulsivity, and mood. Neither serum glucose or beta-hydroxybutyrate levels correlated significantly with any behavioral measure. Results are discussed in the context of previous studies of nutrition and cognition.

3-Hydroxybutyric Acid↗

PubMed1990

Readability of pediatric biomedical research informed consent forms.

Informed consent forms are used in biomedical research as a mechanism to convey study information to potential subjects so that they may arrive at a decision concerning their willingness to participate. Although the Department of Health and Human Services Regulations for the Protection of Human Subjects require the presentation of specific study information at a level that is easily understood, according to research concerning adult biomedical consent forms, the typical form is not readily comprehensible. Unfortunately, no data exist concerning the readability of informed consent forms that are used in the context of pediatric biomedical research. In the present study, readability analyses were conducted on a large sample (N = 238) of pediatric biomedical informed consent forms obtained during a 10-year period from a large midwestern children's hospital. For the entire sample, results derived from two readability estimates (Fry grade equivalent and Flesch Reading Ease methods) indicated that the consent forms were written at the college graduate level. Although there was a linear increase in the length of the consent document during the 10-year period evaluated, expanded length was not associated with improved readability. According to analyses, a differential pattern of reading difficulty was associated with specific sections of the informed consent document. Findings are highly consistent with those from studies of adult biomedical consent form and document that the purpose of the informed consent form is being compromised, in part, by a readability factor. Suggestions for solving this critical problem are advanced.

Comprehension↗

PubMed1989

Depressive characteristics of physically abused children.

Physically abused and nonabused children were compared on child-completed measures of depression, hopelessness, self-esteem, and locus of control. Results indicated that, in comparison with nonabused controls, abused children evidenced more depressive symptoms, heightened externality, lower self-esteem, and greater hopelessness about the future. Group differences in depressive symptomatology were not accounted for on the basis of differences in age, sex, race, gender, IQ, or socioeconomic status. Results replicate the results of Kazdin, Moser, Colbus, and Bell (1985) derived from a sample of physically abused psychiatric inpatients and extend the generality of these findings to abused children of nonpatient status. Implications of the findings for clinical interventions, theoretical models of child depression, and future research are discussed.

Adaptation, Psychological↗

PubMed1989

Self-regulation treatment to reduce the aversiveness of cancer chemotherapy.

In an A-B design, the effectiveness of a multicomponent intervention for reducing chemotherapy-associated nausea and emesis in an 11-year-old cancer patient was evaluated. A highly structured, time-limited, self-regulation treatment was implemented that consisted of patient and parent instruction in self-hypnotic methods, cue-controlled relaxation, and guided imagery. Practice of the self-regulation methods at home and in vivo (clinic setting) in the absence of chemotherapy infusion were emphasized to promote skill acquisition and cross-setting generalization. Dependent variables included self-reported nausea intensity and parental report of duration of the patient's sleep and vomiting frequency. Data were obtained before, during, and following chemotherapy for baseline and self-regulation treatment phases across five cycles of chemotherapy that occurred over a 5-month period. During the intervention phase, a marked and clinically significant reduction in self-reported nausea and parent-observed vomiting were noted as well as a concurrent increase in sleep duration. The integrity of patient self-report and parental observations were supported by clinic staff anecdotal data. Treatment limitations and cost-effectiveness are discussed as well as the use of this intervention with adolescent patients.

Antineoplastic Agents↗

PubMed1989

Acceptability of interventions for pediatric pain management.

Examined the effects of pain symptom severity and patient diagnostic status on pediatric staffs' acceptability ratings of 6 interventions used to treat pediatric pain. Results indicated that (a) extinction was significantly less acceptable than all other behavioral and pharmacologic interventions, (b) self-management was more acceptable than all other interventions with the exception of contingency management, (c) accelerative procedures and self-management interventions were preferred to pharmacologic treatment, (d) patient diagnostic status and pain symptom severity failed to significantly influence treatment ratings, (e) self-management was the only intervention differentially rated as a function of pain symptom severity, and (f) pharmacologic treatment was differentially rated as a function of patient diagnostic status.

Adult↗

PubMed1989

Behavioral adjustment of pediatric burn victims.

Investigated the relationship of a variety of biopsychosocial variables to maternal ratings of children's psychosocial adjustment in a sample of 68 child burn survivors. Results indicated that (a) the mean maternal ratings of behavioral adjustment for pediatric burn patients did not differ from those reported for nonburned, nonclinic children, (b) a relatively small but statistically significant percentage of children had overall adjustment scores in the deviant range, and (c) little variance in the behavioral outcome measures was accounted for on the basis of three sets of predictor variables (demographic, burn severity, injury visibility) hypothesized to influence children's adjustment. Results suggest that the prevalence of behavioral disturbance in long-term pediatric burn survivors may be lower than previous reports have indicated. Implications of the results for consultation and future research are discussed.

Adolescent↗