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PubMed1991

Changes in cognitive and language functioning of preschool children with autism.

Preschool children with autism and their normally developing peers were compared on the Stanford-Binet IV and Preschool Language Scale before and after 1 school year. Both measures showed that although the children with autism functioned at a lower level than their normally developing peers, the children with autism had narrowed this gap after treatment, making a nearly 19-point increase in IQ and an 8-point gain in language quotient. The IQ measure remained stable for the normally developing peers while their language showed a 7.73-point increase. The data support the notion that young children with autism can make very significant developmental gains.

Autistic Disorder↗

PubMed2003

Peer and teacher ratings of third- and fourth-grade children's social behavior as a function of early maternal employment.

BACKGROUND: One of the more controversial issues related to maternal employment in the United States concerns the timing of entry into the workforce and its effect on children, particularly during the first year of the child's life. Some studies show deleterious effects on children, such as increases in aggression and noncompliance, while others document few negative and even positive effects of early employment. METHODS: This study examined the long-term effects of maternal employment during the child's first year of life on the social behavior of 171 third- and fourth-grade children in two-parent families. The moderating effects of child gender and social class were investigated. The extent to which stability in alternative care arrangements statistically explained links between early maternal employment and child outcomes was tested. RESULTS: After controlling for child gender, and maternal ethnicity, social class, and current employment status, third- and fourth-grade children whose mothers were employed during their first year of life evinced more acting out and less frustration tolerance and were nominated more often by peers for 'hitting' and 'being mean' than children whose mothers were not employed. There was some evidence that these associations were moderated by child gender and social class: boys, but not girls, whose mothers were employed during the first year were subsequently rated by teachers as acting out more than other children, and were also more likely to be nominated by peers for hitting. Higher nominations for hitting were only found in the working class. Finally, there was partial evidence that the number of alternative child-care arrangements during the first year accounted for the links between early maternal employment and subsequent child outcomes. CONCLUSIONS: These results are congruent with extant research that posits a risk of early employment on socioemotional development, but show that this risk is partially attributable to child-care instability.

Affect↗

PubMed1994

Factors influencing the outcome and duration of removable appliance treatment.

The study models and records of 150 consecutively completed removable appliance cases were analysed and the influence of various factors assessed on both the change in Peer Assessment Rating (PAR) score produced by treatment and the duration of treatment. For the purpose of analysis the material was divided into two groups; a functional appliance/headgear group (n = 43) and an upper removable appliance group (n = 103). The initial PAR score accounted for 71 per cent of the variation in PAR change in the functional/headgear group when combined with the sex of the patient; females on average showing a further improvement of 3 PAR points over equivalent males. The initial PAR score alone accounted for 68 per cent of the variation in PAR change in the upper removable appliance group. Sixty per cent of the variability in treatment duration could be explained in the functional/headgear group by the initial PAR score and a binary variable indicating whether three or more appliances had been required. Fifty-six per cent of the variability in duration in the upper removable appliance group was explained by the number of appliances used alone. Regression equations for prediction of outcome and duration of removable appliance treatment are given.

Adolescent↗

PubMed1984

The assessment of intention-cue detection skills in children: implications for developmental psychopathology.

A reliable measure of children's skills in discriminating intention cues in others was developed for this investigation in order to test the hypothesis that intention-cue detection skill is related to social competence in children. Videotapes were prepared in which one child provoked another child. The intention of the first child varied across videotapes. The subject's task was to discriminate among types of intentions. Care was taken to ensure that scores on this measure were not confounded by a child's verbal capacity or general discrimination skill. This instrument was administered to 176 children in kindergarten, second grade, and fourth grade, who were identified by sociometric measures as having a peer status as popular, average, socially rejected, or socially neglected. Scores on this measure were found to increase as a function of increasing age, and normal children (popular and average) were found to score more highly than deviant children (neglected and rejected). The errors by deviant children tended to consist of erroneous labels of prosocial intentions as hostile. Also, children's statements about their probable behavioral responses to provocations by peers were found to vary as a function of subjects' perceptions of the intention of the peer causing the provocation, not as a function of the actual intention portrayed by the peer. Sociometric status differences in these responses were also found. These findings were consistent with a hypothesis of a developmental lag among socially deviant children in the acquisition of intention-cue detection skills.

Child↗

PubMed1999

A critical review of the studies of the effects of simulated or real gastroesophageal reflux on pulmonary function in asthmatic adults.

OBJECTIVE: To identify and critically review the published peer-reviewed, English-language studies of the effects of both spontaneous and simulated gastroesophageal reflux (GER) on pulmonary function in asthmatic adults. DESIGN: Using the 1966 to 1997 MEDLINE database, the terms asthma and lung disease were combined with GER to identify studies of the effects of GER and acid perfusion (AP) of the esophagus on pulmonary function. The bibliographies were also reviewed. Studies of asthmatics with and without symptomatic GER were analyzed both together and separately. RESULTS: A total of 254 citations, including 180 published in English, were identified. Among these were 18 studies of GER and AP in asthmatic adults. These reports, which contain data on 312 asthmatics, found that the FEV1 and the midexpiratory rate did not change during AP and GER in the studies containing 97% and 94% of the asthmatics, respectively. Flow volume loop indexes, including the flow at 50% of the vital capacity (V50), flow at 25% of the vital capacity, and the peak expiratory flow rate, did not change during AP or GER in the studies with 77%, 60%, and 65% of the asthmatics, respectively. Small changes in the resistance were reported in the studies containing 42% of the asthmatics. Among asthmatics without symptomatic GER, no changes in spirometry, resistance, and flow volume indexes were found, except for a 10% decline in V50 in one study with seven subjects. CONCLUSIONS: In asthmatics with GER, the effects of AP on pulmonary function are minimal, and only a minority are affected. The literature does not support the conclusion that asymptomatic reflux contributes to worsening lung function.

Adult↗

PubMed2002

Increasing drug users' adherence to HIV treatment: results of a peer-driven intervention feasibility study.

Active drug users with HIV infection suffer from both low utilization of, and adherence to, primary care. Combining drug treatment and primary care on-site reduces these problems significantly because it creates a social support structure; treatment program staffs can monitor patients' adherence and provide ongoing encouragement. But in the United States, only a very small minority of HIV + drug users receive this demonstrably effective form of care. We report the results from a feasibility study of an alternative support structure, termed a "peer-driven intervention", that serves as a functional equivalent to drug treatment for increasing drug users' adherence to HIV therapeutics. The six-month study included 14 adult active drug users receiving medical care for HIV disease in New Haven, Connecticut. As a health advocate, each subject was assigned and asked to meet with another subject once a week at the project's storefront to provide peer support and counseling. As a peer, each subject was assigned and asked to meet with another health advocate once a week to receive support in keeping up his or her medical care. No two subjects played both roles for one another. Advocates earned nominal monetary rewards for eliciting positive responses from their peers in keeping clinical appointments, responding to physicians' referrals, picking up prescriptions on time and attending weekly meetings with the advocate. The results of the study suggest that an alternative social support structure to drug treatment is feasible for increasing active drug users' adherence to medical care. Innovative mechanisms that harness drug users' peer pressure to promote positive behavioral changes deserve greater study.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Perinatal predictors of respiratory symptoms and lung function at a young adult age.

A longitudinal cohort of 2,957 babies, born in 1975-1978, was used to investigate whether perinatal factors predict respiratory morbidity at a young adult age. In 1997, the presence of asthmatic (wheeze, nocturnal dyspnoea) and bronchitic (cough, phlegm, dyspnoea grade 3) symptoms and the level of lung function was determined in this cohort. The independent association between smoking during pregnancy, being first-born, birth weight and respiratory symptoms and lung function at young adult age was investigated using multiple regression models, taking other potential risk factors into account. Of 1,568 responders, 608 (39%, aged 18-22 yrs) had at least one respiratory symptom. The young adults who had a mother that smoked during pregnancy had a significantly lower level of lung function than their nonintra-uterine exposed peers (regression coefficient (B) (standard error): peak expiratory flow (PEF) -0.257 (0.131) L x s(-1); forced expiratory flow when 25% of the forced vital capacity has been exhaled (FEF25) -0.290 (0.129) L x s(-1)), although they were not at increased risk of having respiratory symptoms. Young adults who were first-born had better levels of lung function (B (SE): forced expiratory volume in one second (FEV1) 0.090 (0.042) L) and were less likely to have asthmatic symptoms (odds ratio (95%, confidence interval): 0.58 (0.35-0.95)) than those not first-born. Low birth weight (FEV1 -0.013 (0.004) L for a reduction of 100 g) was also predictive of reduced achieved levels of lung function at young adult age, independent of other potential risk factors, e.g. current smoking habits or familial predisposition. This study adds to the knowledge of the role of perinatal factors, such as smoking during pregnancy, as important predictors of respiratory morbidity.

Adolescent↗

PubMed1981

Parents' and peers' communication to toddlers.

The speech which parents and peers direct to toddlers was examined for differences as a function of sex of parent, parent/peer status, sex of child, and age of child. Mothers, fathers, and peers of 18 parent dyads were individually audio- and videotaped in a natural play setting with their children (nine boys and nine girls) when the children were 2 years (parents only) and 2 1/2 years (both parents and peers). Ten language measures were coded from the transcribed speech samples: mean length of utterance, type-token ratio, number of utterances, number of turns, rate of questioning, rate of answering, rate of directives, rate of attentionals, rate of polite directives, and rate of repetitions. Analyses of variance on these dependent measures produced significant main effects for parents/peer status for number of utterances, number of turns, mean length of utterance, questions, answers, and polite directives; however, no main effects for sex of child, age of child, and sex of parent were produced.

Age Factors↗

PubMed1992

Self-perceived social function among disabled children in regular classrooms.

Disabled children represent an important "at-risk" group for emotional and behavioral problems. This study determined how they assess their own social function in regular classrooms and compared them with their able-bodied peers. School principals identified 60 visibly disabled children who were integrated into regular classes for at least 50% of the time. A comparison group of 56 randomly selected, same-gender classmates was identified. Children completed the Perceived Competence Scale and a classroom sociometric scale. Parents and teachers were asked to rate each child's social function. Disabled children rated themselves lower on physical competence (mean = 2.53 vs 2.92, p = .002) but not on social or cognitive competence. However, disabled children had fewer friends and scored lower on the classroom sociometric measure than did their able-bodied classmates (mean = 2.06 vs 2.39, p = .01). There was no difference between disabled and control children when social function was assessed by parents or teachers. For all children two variables were significantly associated with the child's self-perceived social competence: the child's self-perceived physical competence (R2 = .27) and the peer sociometric rating (R2 = .13). Teacher perception (R2 = .35) and self-perception (R2 = .10) of social function were most strongly associated with the perception of peers. In both cases whether the child was disabled contributed little to the observed association. These findings support the importance of peers in the successful social function of children and suggest that teachers can have an impact on how children are perceived by other children.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

PubMed1999

Clozapine reduces severe self-mutilation and aggression in psychotic patients with borderline personality disorder.

BACKGROUND: Clozapine has been reported to be effective in diminishing violence toward others in psychotic patients. This article describes the impact of clozapine on severe self-mutilation among patients with the dual diagnoses of borderline personality disorder and persistent psychoses. METHOD: Seven subjects known to the authors were selected for careful chart audits. These subjects had been admitted to 2 state psychiatric hospitals owing to severe self-mutilation and/or violence and subsequently treated with clozapine. A mirror-image design anchored to the start date of clozapine treatment and extending in either direction to a maximum of 1 year was used to extract data. Data extracted included incidents of self-mutilation (restraint), seclusion, the as and when needed (p.r.n.) use of medications, injuries to staff and peers, hospital privileges, and Global Assessment of Functioning (GAF) scores. RESULTS: The subjects were all white women with a mean age of 37 years. All subjects carried DSM-III-R or DSM-IV borderline personality disorder diagnoses and an Axis I disorder diagnosis. They had received trials of several psychotropic agents, often in combination and mostly without benefit. After clozapine treatment, there were statistically significant reductions in incidents of self-mutilation (restraint), seclusion, the use of p.r.n. antianxiety medications, and injuries to staff and peers. These subjects received higher levels of hospital privileges, and their GAF scores nearly doubled following clozapine treatment. Four subjects were subsequently discharged from hospital. CONCLUSION: These preliminary but nonetheless favorable results suggest that clozapine deserves careful consideration for a controlled study in patients with borderline personality disorder and psychoses, especially if the clinical issues include severe self-mutilation, aggression, and violence. Until such studies are done, the risk-to-benefit ratio of clozapine treatment needs to be carefully evaluated on an individualized basis in such subjects.

Adult↗

PubMed2001

A six-year prospective study of pathways toward drug use in adolescent boys with and without a family history of a substance use disorder.

OBJECTIVE: The purpose of this study was to test a developmental model of drug use in male adolescents. The model postulates that low executive functioning and a difficult temperament are related to aggression and affiliations with delinquent peers which, in turn, are related to elevated drug use. METHOD: Boys (N = 187) with and without a family history of a substance use disorder (SUD) were followed over a 6-year period. Executive functioning and temperament were measured at age 10-12, aggression and affiliations with delinquent peers were assessed at age 12-14 and drug use was measured at age 16. RESULTS: Low executive functioning and a difficult temperament were related to increased aggression and affiliations with delinquent peers. These latter variables were related to increased drug use. Furthermore, the relation between difficult temperament and drug use was fully mediated by aggression and affiliations with delinquent peers. CONCLUSIONS: Drug abuse prevention efforts may benefit from clinical interventions aimed at strengthening executive functioning, regulating temperament and improving socialization strategies in antisocial children.

Adolescent↗

PubMed1989

Communicative performance of adolescents with severe speech impairment: influence of context.

The communicative performance of 4 preoperational-level adolescents, using limited speech, gestures, and communication board techniques, was examined in a two-part investigation. In Part 1, each subject participated in an academic interaction with a teacher in a therapy room. Data were transcribed and coded for communication mode, function, and role. Two subjects were found to predominantly use the speech mode, while the remaining 2 predominantly used board and one other mode. The majority of productions consisted of responses to requests, and the initiator role was infrequently occupied. These findings were similar to those reported in previous investigations conducted in classroom settings. In Part 2, another examination of the communicative performance of these subjects was conducted in spontaneous interactions involving speaking and nonspeaking peers in a therapy room. Using the same data analysis procedures, gesture and speech modes predominated for 3 of the subjects in the nonspeaking peer interactions. The remaining subject exhibited minimal interaction. No consistent pattern of mode usage was exhibited across the speaking peer interactions. In the nonspeaking peer interactions, request predominated. In contrast, a variety of communication functions was exhibited in the speaking peer interactions. Both the initiator and the maintainer roles were occupied in the majority of interactions. Pertinent variables and clinical implications are discussed.

Adolescent↗

PubMed1989

Social competence and behavioral adjustment of children who are long-term survivors of cancer.

Relatively little is known about the special needs of long-term survivors of childhood cancer or the factors that make this growing population vulnerable to chronic psychologic disorders. We therefore surveyed 183 children who had been treated for cancer at St Jude Children's Research Hospital and were free of the disease for greater than or equal to 2 years after completing therapy. Parental responses to the Child Behavior Checklist, a standardized inventory of social competence and behavioral problems, were analyzed in relation to demographic and medical variables, as well as the children's appearance and functional status. School-related problems and somatic complaints of undetermined origin were increased fourfold relative to age- and gender-adjusted rates for peer groups in the general population. The presence of functional but not cosmetic impairments increased the risk of academic and adjustment problems. An older age at evaluation, treatment with cranial irradiation, and residence in a single-parent household were also associated with an increased risk of psychologic problems. General pediatricians must eventually assume responsibility for the extended follow-up care of children who have survived a malignancy. Their awareness of the high-risk groups described in this report should facilitate more timely identification of problems and referral of the children to appropriate services.

Achievement↗

PubMed1995

[Light therapy can restore a disturbed sleep/wake rhythm in dementia: but what is the basis of its efficacy?].

In dementia short nocturnal sleep length, agitation and naps in the day-time suggest a chronobiological disturbance. Bright light therapy seems indicated because of its chronobiological activity. However, dementia is accompanied by a decrease in volume and number of active cells of the suprachiasmatical nuclei, the internal clock. Is the circadian system still functioning then or is it irrevocably damaged? The findings concerning the circadian rhythm of several physiological functions are not consistent but do not show a weakened rhythm. Rest/activity and sleep/wake rhythms, however, are weaker in demented elderly than in their peers. All things considered the internal clock is still functioning and the Zeitgeber maintain their chronobiological activity. Research shows that bright light therapy can restore the sleep/wake rhythm in dementia but research does not uncover the working mechanism. Further studies can give clues for alternative treatments. If the effect of light therapy is based on its Zeitgeber function, other Zeitgeber may be considered as treatments. There is some evidence that an increase in social contacts is effective. The efficiency of light therapy can also be caused by stimulation in a situation of sensory deprivation. There are only anecdotical indications that this stimulus role can also be fulfilled by music.

Aged↗

PubMed1995

Effects of paternal absence on male adolescents' peer relations and self-image.

This study explores the extent to which adolescent males experience different peer adjustment and masculine self-image as a function of father deprivation. A sample of 40 middle school boys (20 father-present and 20 father-absent) rated each other on peer adjustment and masculine self-image. Results indicate that father-absent boys evidence a poorer sense of masculinity as well as poorer interpersonal relationships than do father-present boys.

Absenteeism↗

PubMed1977

Peer sex education training and evaluation.

Human sexuality has been recognized as an important developmental, emotional, and medical concern on the college campus. The Peer Sex Education Program at the University of Massachusetts/Amherst has been developed as a model for the use of trained students in an educational, referral, and counseling role. This paper describes the program and outlines the methodology used in the documentation and evaluation of various program aspects. Aspects described include the program's rationale and background, the recruiting process, roles and responsibilities, training and supervision models, community development, and delivery of service. Categories of documentation and evaluation considered include effort, performance, adequacy of performance, efficiency, and process. These are related to consumer acceptance and satisfaction, outcome measures of knowledge, attitude, and behavior, effectiveness of referral and other functions, and effect of program on the peer educators' growth and development. The allocation of energy and resources between program development, service delivery and evaluation needs is highlighted.

Humans↗

PubMed2002

Parental management of adolescent peer relationships in context: the role of parenting style.

Three hundred 9th-graders and their best friends participated in this short-term longitudinal study. Confirmatory factor analysis of the Parental Management of Peers Inventory (N. Mounts, 2000) suggested that the 4-factor structure provided a good fit to the data. Significant differences in adolescents' perceptions of parental management of peers occurred across 4 parenting style groups. Structural equation modeling was used to examine the relation among 5 aspects of parental management of peers and adolescents' Time 1 drug use, friends' Time 1 drug use, and adolescents' Time 2 drug use. The parental management styles of monitoring, guiding, prohibiting, and supporting all had significant paths in the model, whereas neutrality was not significant. Multiple group comparisons were used to examine whether parenting style moderates the relation between parental management of peers and the drug use outcomes. Parenting style functioned as a moderator for 7 of the paths in the model.

Adolescent↗

PubMed1992

The relationship between attitude to disabled siblings and ratings of behavioural competency.

The impact of maturation factors and functioning level on the relationship between disabled and non-disabled siblings was examined. Two groups of adults, distinguished by level of functioning of their mentally retarded sibling, completed a Schaefer Sibling Behavior Inventory (SBI) and participated in a semi-structured interview. The latter explored a number of dimensions of the relationship including degree of warmth, contact and involvement. Judgements about involvement and comfort as remembered from the past and judgements about the present were obtained to derive hypotheses about possible changes with time. Data from the SBI indicated that significantly more competent siblings tended to be involved in relationships with a higher degree of reciprocity. In contrast, measures of attitude derived from interview data did not appear to relate to the functioning level of the sibling in any systematic manner. The results suggest that level of discomfort with peers may decrease significantly over the years with neither level of functioning nor gender being important variables. The extent to which non-disabled individuals expressed a preparedness to participate in the life of their disabled sibling may relate to the life-stage of the two. Males in particular anticipated increased future involvement. Although higher-functioning siblings were described as more active in the relationship, this did not appear to influence perceived positiveness of regard. The implications of these results are discussed briefly.

Activities of Daily Living↗