Biomedical subjects

Philip A Fisher

Publications and source records attributed to Philip A Fisher.

11 recordsLinked to original sources

PubMed2006

Bringing basic research on early experience and stress neurobiology to bear on preventive interventions for neglected and maltreated children.

A major focus in developmental psychopathology is on understanding developmental mechanisms and, armed with this information, intervening to improve children's outcomes. Translational research attempts to bridge the distance between understanding and intervention. In the collaborations that have formed the core of our research network on early experience, stress, and prevention science, we have focused on translating basic research on early experiences and stress neurobiology into preventive interventions for neglected and abused children. Our experiences in attempting to move from bench to bedside have led us to recognize the many challenges that face translational researchers. This review provides a brief synopsis of the animal model literature on early experience and stress neurobiology from which we glean several key bridging issues. We then review what is currently known about the impact of childhood neglect and abuse on stress neurobiology in human adults and children. Next, we describe how this work has informed the evaluation of our preventive interventions with maltreated children. Finally, we discuss several considerations that should facilitate a more complete integration of basic research on early experience and stress neurobiology into preventive intervention strategies.

Adrenal Glands↗

PubMed2005

Emotion understanding and theory of mind among maltreated children in foster care: evidence of deficits.

Children in foster care are at heightened risk for poor psychosocial outcomes. This study examined differences in two areas that may be associated with many of these outcomes, emotion understanding and theory of mind, using a sample of 3- to 5-year-old maltreated foster children (n = 60) and a comparison group of same-aged, low-income, nonmaltreated children living with their biological families (n = 31). Being in foster care was significantly associated with worse emotion understanding and theory of mind capabilities, even when accounting for age, intelligence, and executive function. There were no significant associations between length of time in foster care, number of transitions, and emotion understanding and theory of mind. Results help to expand knowledge about the cognitive and affective deficits of children in foster care and suggest that interventions targeted at these deficits include an emphasis on emotion understanding and theory of mind.

Child↗

PubMed2005

Balancing empiricism and local cultural knowledge in the design of prevention research.

Prevention research aims to address health and social problems via systematic strategies for affecting and documenting change. To produce meaningful and lasting results at the level of the community, prevention research frequently requires investigators to reevaluate the boundaries that have traditionally separated them from the subjects of their investigations. New tools and techniques are required to facilitate collaboration between researchers and communities while maintaining scientific rigor. This article describes the tribal participatory research approach, which was developed to facilitate culturally centered prevention research in American Indian and Alaska Native communities. This approach is discussed within the broader context of community-based participatory research, an increasingly prevalent paradigm in the prevention field. Strengths and limitations of the approach used in the study are presented.

Advisory Committees↗

PubMed2005

Developmental, cognitive, and neuropsychological functioning in preschool-aged foster children: associations with prior maltreatment and placement history.

Although young children in foster care are at high risk for developmental delays and subsequent academic, social, and behavioral difficulties, many do not receive services for delays. We sought to explicate the types of developmental delays observed in young children (ages 3-6 years) in foster care and how placement and maltreatment experiences for these children were associated with such delays. Physical growth, neuropsychological functioning, executive functioning, language, and general cognitive functioning were compared for a sample of 99 foster children and 54 nonmaltreated, same-aged children from comparable socioeconomic status backgrounds. The foster children showed developmental lags on measures of height, head circumference, visuospatial functioning, language, and general cognitive functioning. A history of neglect was negatively associated with functioning in a number of domains; surprisingly, the number of maltreatment types experienced was positively associated with functioning. Placement history was generally not associated with scores in the various developmental domains. We discuss the need to screen and evaluate preschoolers and possible methods for doing so.

Child↗

PubMed2005

The early intervention foster care program: permanent placement outcomes from a randomized trial.

Preschool-aged foster children face multiple risks for poor long-term outcomes. These risks appear to increase with the number of placement changes experienced. The Early Intervention Foster Care Program (EIFC) targets the spectrum of challenges that preschool-aged foster children face via a team approach delivered in home and community settings. In this article, we report on permanent placement outcomes from the EIFC randomized clinical trial. Children in EIFC had significantly fewer failed permanent placements than children in the regular foster care comparison condition. The number of prior placements was positively associated with the risk of failed permanent placements for children in the comparison condition but not for children in EIFC. Type of prior maltreatment did not predict permanent placement outcomes. These results provide the foundation of an evidence base for the EIFC program as a preventive intervention to improve permanent placement outcomes for preschool-aged foster children.

Child↗

PubMed2004

Predictors of disruptive behavior, developmental delays, anxiety, and affective symptomatology among institutionally reared romanian children.

OBJECTIVE: To examine the associations between duration of institutionalization, age at abandonment, and mental and physical health outcomes of young institutionalized children in Romania and to examine patterns of associations between placement history, physical growth variables, and psychiatric symptoms. METHOD: Institutionalized children (ages 2-6 years) in a Romanian orphanage were studied through caregiver reports. Orphanage staff completed questionnaires on the children's psychiatric symptoms and physical growth measurements and placement histories on the children. RESULTS: Children showed high rates of developmental delays, anxiety/affective symptoms, and physical growth delays. Patterns of associations between history and growth variables (duration of institutionalization, age at abandonment, and physical stature) and psychiatric symptom clusters were examined using three sequential multiple regressions. Longer duration of institutionalization and shorter physical stature were significantly associated with anxiety/affective symptoms (F3,47=6.49, p <.01). Physical stature was significantly associated with developmental delays (F3,47=5.603, p <.01) and disruptive behaviors (F3,47=2.832, p <.05), with smaller stature being associated with greater developmental delays and fewer disruptive behavior problems. CONCLUSIONS: Institutionalized children demonstrate high rates of psychiatric symptoms. Duration of institutionalization, physical stature, and age at abandonment differentially relate to psychiatric symptoms. Findings are interpreted in light of implications for intervention and social policy.

Affect↗

PubMed2003

Tribal participatory research: mechanisms of a collaborative model.

Although much social science research has been conducted within American Indian and Alaska Native (AIAN) communities, relatively little research has been conducted by or for those communities. We describe an approach that facilitates the active involvement of AIAN communities in the research process, from conceptualizing the issues to be investigated to developing a research design, and from collecting, analyzing, and interpreting the data to disseminating the results. The Tribal Participatory Research (TPR) approach is consistent with recent developments in psychology that emphasize the inclusion of community members and the social construction of knowledge. We describe the foundations of the approach and present specific mechanisms that can be employed in collaborations between researchers and AIAN communities. We conclude with a discussion of the implications of the use of TPR regarding project timelines and budgets, interpretation of the data, and ultimately the relationships between tribes and researchers.

Community Participation↗

PubMed2002

Interventions for foster parents: implications for developmental theory.

All children who enter foster care have experienced disruptions in their relationships with caregivers, and many have experienced maltreatment. Studying the effects of these adverse early experiences can inform developmental theory. In particular, insight can be provided regarding sensitive periods in the development of attachment and self-regulatory capabilities. The quality of surrogate caregivers varies as a function of both the intervention services provided and foster parent characteristics. Studying the effects of foster parent quality can suggest which aspects of child functioning are more or less canalized at various developmental periods. This paper considers salient developmental issues of infancy, preschool years, middle childhood, and adolescence and examines ways in which these issues may present special difficulties for foster children. Across development, foster care is associated with difficulties regulating behaviors, emotions, and physiology. Thus, conditions associated with foster care placement (e.g., disruptions in care, maltreatment) appear to affect very basic and fundamental regulatory processes. Interventions have been designed that target developmentally specific manifestations of regulatory difficulties. Although the literature regarding evidence-based interventions for foster parents is quite limited, preliminary findings provide some evidence that nurturing, responsive care can serve to partially remediate early deficits. These findings suggest that stable and nonfrightening care is essential for normal development. Nonetheless, even in the case of quite adverse early experience that results in problematic child outcomes, there is some evidence that the development of many systems remains relatively plastic.

Adolescent↗

PubMed2002

The Indian Family Wellness project: an application of the tribal participatory research model.

This paper describes a family-centered prevention intervention for preschool-aged children-the Indian Family Wellness (IFW) project. The development, implementation, and evaluation of IFW has been based upon a tribal participatory research model, an approach that emphasizes full participation of tribes and tribal members in all phases of the research process and incorporates cultural and historical factors vital to strengthening American Indian and Alaska Native families. We present four mechanisms of tribal participatory research, describe how they have been applied in the IFW project, and consider the implications of this work for the field of family-centered prevention research.

Child, Preschool↗

PubMed1999

Neuropsychological characteristics and test behaviors of boys with early onset conduct problems.

School-age children and adolescents with conduct problems typically exhibit deficits in verbal IQ, language abilities, and executive functions. This study examined the extent to which this pattern was evident in a clinic group of preschool boys with early onset conduct problems who met criteria for oppositional defiant disorder (ODD) with and without attention deficit hyperactivity disorder (ADHD). A 2nd question focused on the strength of relation between clinic boys' uncooperative or inattentive test behaviors and their test performance. As expected, the clinic boys showed a neuropsychological profile highly similar to the one found in older conduct problem populations. Verbal tests distinguished clinic from matched comparison boys even after controlling for observers' ratings of disruptive behavior during testing. Clinic boys with ODD and ADHD had lower verbal and executive function scores than clinic boys with ODD alone. After general vocabulary knowledge and test behavior were controlled, clinic boys were found to have poorer vocabularies for describing affective states than comparison group boys.

Age of Onset↗

PubMedDate not supplied

Language delays among foster children: implications for policy and practice.

This article highlights the centrality of language in early childhood development and the potential for language delays to negatively affect long-term outcomes in educational and social domains. Given the high rate of language delays in the foster care population, an emphasis should be placed on assessing language skills among children ages 6 and younger entering foster care. The authors describe several existing approaches to assessing language skills and discuss obstacles to the widespread implementation of systematic evaluation among foster children. Finally, the authors discuss the need for research and programming to establish evidence-based practices that encourage the remediation of language delays in this highly vulnerable population.

California↗