This study aims to evaluate the efficacy of a brief cognitive behavioral intervention program for children and adolescents experiencing persistent post-concussion symptoms. A total of 31 patients aged 10 to 18 years participated in the intervention. The median time since injury at treatment onset was 95 days though the range was large (23-720 days). Treatment was on average four sessions in duration. Sessions included concussion education, activity scheduling, sleep hygiene relaxation training, and cognitive restructuring. Outcomes were measured using symptom reports on the Sports Concussion Assessment Tool - Third Edition (SCAT-3) and parent-reported quality of life on the Pediatric Quality of Life Inventory (PedsQL). Mixed-effects models revealed that symptom reports did not decrease prior to the initiation of this treatment, though significant symptom improvement occurred following treatment. Quality of life scores significantly improved across domains, with the largest gains made in the emotional and school domains. Participant characteristics including age, sex, maternal education, and previous mental health problems were not found to be significantly related to treatment outcomes. Contrary to predictions, length of time since injury was not related to symptom changes. The primary limitation of this study is that it lacks randomization and an experimental control group. The results suggest that brief cognitive behavioral intervention may be a promising treatment for children and adolescents experiencing persistent post-concussive symptoms and warrants further investigation.
This pilot study investigated driving history and driving behaviors between adults diagnosed with autism spectrum disorders (ASD) as compared to non-ASD adult drivers. Seventy-eight licensed drivers with ASD and 94 non-ASD comparison participants completed the Driver Behavior Questionnaire. Drivers with ASD endorsed significantly lower ratings of their ability to drive, and higher numbers of traffic accidents and citations relative to non-ASD drivers. Drivers with ASD also endorsed significantly greater numbers of difficulties on the following subscales: intentional violations, F(1, 162) = 6.15, p = .01, η p (2) = .04; mistakes, F(1, 162) = 10.15, p = .002, η p (2) = .06; and slips/lapses, F(1, 162) = 11.33, p = .001, η p (2) = .07. These findings suggest that individuals with ASD who are current drivers may experience more difficulties in driving behaviors and engage in more problematic driving behaviors relative to non-ASD drivers.
Sleep differences between Black and White preschool children were primarily mediated by parent behaviors rather than socioeconomic variables. Results may reflect differences in cultural practices and provide important information for treatment and parent-directed intervention regarding improving sleep in young children.
WHAT'S KNOWN ON THIS SUBJECT: Caregiver behavioral symptom ratings are frequently used to assist in diagnosing childhood behavioral disorders. Although behavioral disorders are highly comorbid with learning disabilities (LDs), little work has examined the utility of caregiver ratings of learning concerns for screening of comorbid LD. WHAT THIS STUDY ADDS:The validity of a time-and cost-efficient caregiver rating of academic concerns (Colorado Learning Difficulties Questionnaire) was examined. The screening measure accurately predicted children without LD, suggesting that the absence of parentreported difficulties may be adequate to rule out overt LD. abstract BACKGROUND AND OBJECTIVE: Behavioral disorders are highly comorbid with childhood learning disabilities (LDs), and accurate identification of LDs is vital for guiding appropriate interventions. However, it is difficult to conduct comprehensive assessment of academic skills within the context of primary care visits, lending utility to screening of academic skills via informant reports. The current study evaluated the clinical utility of a parentreported screening measure in identifying children with learning difficulties. METHODS:Participants included 440 children (66.7% male), ages 5.25 to 17.83 years (mean = 10.32 years, SD = 3.06 years), referred for neuropsychological assessment. Academic difficulties were screened by parent report using the Colorado Learning Difficulties Questionnaire (CLDQ). Reading and math skills were assessed via individually administered academic achievement measures. Sensitivity, specificity, classification accuracy, and conditional probabilities were calculated to evaluate the efficacy of the CLDQ in predicting academic impairment. RESULTS:Correlations between the CLDQ reading scale and reading achievement measures ranged from 20.35 to 20.65 and from 20.24 to 20.46 between the CLDQ math scale and math achievement measures (all P , .01). Sensitivity was good for both reading and math scales, whereas specificity was low. Taking into account the high base rate of reading and math LDs within our sample, the conditional probability of true negatives (96.2% reading, 85.1% math) was higher than for true positives (40.5% reading, 37.9% math). CONCLUSIONS:Overall, the CLDQ may more accurately predict children without LDs than children with LDs. As such, the absence of parentreported difficulties may be adequate to rule out an overt LD, whereas elevated scores likely indicate the need for more comprehensive assessment. Pediatrics 2013;132:e1257-e1264 Although community-based clinicians have been increasingly successful at acquiring parent and teacher behavior ratings 17 to assist in diagnosis of behavioral disorders such as ADHD, current diagnostic approaches to LDs are not as easily transferred to the community provider setting. 18 Specifically, a formal diagnosis of LD requires comprehensive assessment of cognitive and academic skills and/or careful assessment of the student' s response to targeted and empirically based intervention. 19 ...
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