The Affect in Play Scale-Preschool (APS-P) and Affect in Play Scale-Preschool-Brief Rating (APS-P-BR) versions assess cognitive and affective play processes during a 5-min standardized play task. In this study, construct validity, external validity, and factor analyses for each scale were examined in 107 preschoolers. Reliability and validity were supported. Unlike results found with school-aged samples, positive affect loaded with the cognitive variables on factor analyses of the APS-P and APS-P-BR, suggesting that negative and undefined affect might represent a separate factor in preschool-aged children. Developmental significance and implications for use of the 2 scoring versions are discussed.

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Cognitive and affective processes in play have related to measures of creativity in school-age children. In a previous examination of these play processes in preschool-age children with the Affect in Play Scale-Preschool version, cognitive and affective play processes related to divergent thinking. One goal of the current study was to replicate this finding and examine the relationship between pretend play and storytelling creativity in preschoolers. A second goal was to test the effectiveness of a brief play intervention. Adult-led play interventions have effectively improved play skills and related developmental skills for children with documented play deficits. However, there is a need for an empirically based, brief play intervention for typically developing preschool-age children. A pilot study found medium to large effect sizes for increased play skills for an intervention with preschool-age children and their parents. The current study aimed to examine the effectiveness of the intervention without parent involvement. Forty-one typically developing children (ages 4 -6 years) participated. Pretend play, divergent thinking, and creative storytelling were assessed at baseline and outcome. Children were randomly assigned to the play skills intervention, which received three 20 -30 min individual play sessions, or the active control. At baseline, results were that cognitive and affective play processes related to divergent thinking and creative storytelling. The play intervention did not significantly improve pretend play skills or creativity in the intervention group compared to the control group. Reasons for the nonsignfiicant findings for the intervention, suggestions for future refinement of the intervention, and implications for childhood development are discussed.

aim: To examine the relationship of sleep disturbance with adherence and glycemic control in adolescents with Type 1 diabetes mellitus. materials & methods: Participants included 72 adolescents in poor metabolic control. Parents reported on the frequency of the following sleep disturbances: sleeping too much, not sleeping enough, trouble sleeping and being overtired. Adherence was assessed via self-report and frequency of blood glucose monitoring. Glycemic control was assessed via hemoglobin A1c and continuous glucose monitoring data. results: Sleeping more was associated with lower adherence and higher HbA1c. Sleeping more and trouble sleeping were associated with hyperglycemia as measured by continuous glucose monitoring. Conclusion: Sleep disturbance may negatively impact adherence and glycemic control. Additional research is needed to determine directionality of relationships. Practice points• Adherence to diabetes care is particularly problematic during adolescence for young people with Type 1 diabetes mellitus (T1D).• Difficulties with sleep have a known impact on cognitive and executive functioning, which is important for adherence. However, research has not yet examined relationships between sleep disturbance and adherence for adolescents with T1D.• The current study aimed to examine relationships of sleep disturbance with adherence and glycemic control in adolescents with T1D.• Participants included 72 adolescents between the ages of 10 and 18 years, who had poor diabetes control.• Parents reported on adolescent sleep disturbance, self-report and frequency of blood glucose monitoring were used to assess adherence, and HbA1c and results of continuous glucose monitoring were used to assess glycemic control.• Sleeping too much and trouble sleeping were associated with hyperglycemia. Sleeping too much was also associated with lower adherence and higher HbA1c.• Sleep variables collectively explained 16% of the variance in adherence and 15% of the variance in average CGM glucose levels.• Associations of sleep disturbance with adherence suggests the importance of assessing sleep and also highlights the need for future research on methods to improve sleep for adolescents with T1D.For reprint orders, please contact: reprints@futuremedicine.com

The opportunity for psychology trainees to provide services on multidisciplinary teams in the pediatric medical setting offers unique opportunities and ethical challenges (e.g., deciding which information to disclose to medical team). The developmental process of integrating ethical principles learned from general ethics training in the classroom with ethical decision making for issues that present in the pediatric medical setting can be challenging for trainees. In this article the authors will highlight ethical issues related to working in a pediatric medical setting. In particular, ethical issues unique to the pediatric setting are highlighted, including (a) working with children with medical conditions and potentially life-threatening illnesses and (b) working on multidisciplinary teams. Case examples illustrate potential ethical concerns, and suggestions for both trainees and supervisors are discussed.

Objective The goal of this study was to examine modifiable factors related to health disparities by exploring the role of predisposing, need, and enabling characteristics on mental/behavioral health treatment-seeking behaviors in a rural sample. Parental treatment preferences and knowledge about treatment options were also examined. Methods One hundred eighteen parents completed questionnaires assessing demographics, child prior psychological treatment, child psychological symptoms, barriers to care, mental health stigma, and willingness to seek services across settings. Questions also assessed preferences for treatment, awareness of behavioral/mental health services, and knowledge of community treatment options. Results Prior treatment use and stigma significantly predicted willingness to seek services in a doctor’s office after controlling for predisposing (demographic) and need characteristics (psychological symptoms). Symptom severity and barriers significantly differentiated between parents who previously sought treatment or reported an unmet treatment need from those who reported no prior treatment and no treatment need. Families overwhelmingly (94%) reported a preference for individual versus group treatment, and up to 10 sessions were most commonly reported (38%) as the ideal number of sessions. Forty percent of respondents reported no knowledge of treatment options in their community. Conclusions These results highlight the role of enabling characteristics (i.e., stigma, barriers to care, psychological symptoms) and prior service use in understanding parental treatment seeking in a rural sample. Overall, these results support integrated behavioral health in rural settings. Understanding modifiable factors and parent treatment preferences and knowledge may be important to increase access to services and reduce health disparities in rural areas. Future research directions are discussed.

Sleep problems and bedtime resistance are common in young children. Treatment is critical because sleep problems typically persist, and insufficient sleep is related to worse outcomes. Current behavioral treatments do not work directly with the child to reduce anxiety and distress at bedtime. Cognitive–behavioral play therapy is a treatment approach designed to teach coping skills to young children by combining cognitive–behavioral therapy with pretend play, a developmentally appropriate intervention mode. The current case series examined the effectiveness of adding a brief cognitive–behavioral play intervention (CBPI) to parent behavior management for young children with sleep difficulties. Four children (4–6 years of age) received 3 20- to 30-min individual sessions during which the child played out stories with an advanced graduate student therapist (first author, K. F.) about a child coping with sleep problems. Each child’s parent also received a 30-min sleep information session. Three parents returned questionnaires posttreatment. As expected, all 3 parents reported improvements in their child’s sleep habits, sleep anxiety, and general fears. All 3 parents also reported a high level of satisfaction with the treatment. These preliminary results suggest that the CBPI may be effective for decreasing anxiety and child distress when added to behavioral treatment, thus increasing the breadth of treatment approaches available for young children with sleep problems. These results are promising, although a randomized study is needed to further refine the intervention and establish the efficacy of a CBPI for treatment of sleep problems in young children.

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