College students with attention deficit hyperactivity disorder (ADHD) often request and receive extended time to complete high-stakes exams and classroom tests. This study examined the performances and behaviors of college students on computerized simulations of high-stakes exams. Thirty-five college students with ADHD were compared to 185 typical peers on measures of reading decoding, speed, vocabulary, comprehension, test strategies, time management, and test anxiety. Results indicated no differences between students with and without ADHD on various reading (decoding, speed, vocabulary, and comprehension) and test-taking variables (time utilization, navigation style, or strategy use), yet significant differences were present regarding their perceptions of, and anxiety during, test taking. It appears that students with ADHD perform similarly to peers on timed reading tests, although they think they perform less well and worry more about their performance.
As expected, more post-concussion symptoms were initially reported by children and adolescents with mTBI vs orthopaedic injury, but there was no difference at 3 months. The BRIEF and ImPACT cognitive measures did not differentiate concussed subjects from controls, with the exception of concussed subjects' lower performance on a visual memory test at both initial assessment and at 3 months.
Although there is a large literature examining head trauma in general, several areas remain understudied. Notably, little is known about symptom expression over the course of a day for adolescents recovering from concussion. Furthermore, intra-individual symptom variability has not been well characterized. This pilot study examined the feasibility of a momentary data-gathering method, as well as the sensitivity of the assessment to the subtle and dynamic changes in symptoms of concussion. Six adolescents, three of whom suffered a concussion and three non-injured controls, provided symptom ratings five times per day for 5 days. This ecological momentary assessment (EMA) was conducted on a personal digital assistant to capture variability in symptom reports while in the natural environment. Preliminary results indicated that the EMA method showed great promise as a research tool in natural settings (e.g., school and home). Adolescents were able to comply with all tasks with little interference in their daily activities. Students with concussion showed generally higher symptom ratings across physical, cognitive, and affective domains, and temporal and diurnal patterns for symptoms emerged. Implications for future research and patient care are discussed.
Objective: It is critical to address the behavioral health (BH) needs of youth given the high prevalence of diagnosable BH concerns prior to age 18 and the barriers for accessing BH services. To improve access, integration of BH services with primary care is increasing. The colocated model is one proposed method for increasing access to BH services for children. The current study sought to provide demonstration data for colocated BH services within the pediatric medical home. Method: A retrospective review of 694 new BH patient charts ranging from 1–18 years from 9 primary care clinics across three states participated. Data on number of sessions attended with a BH provider, report of homework completion (where relevant), clinician rating of adherence, and improvement ratings were collected. Results: Across all sites, 85% of referred patients attended their first appointment, and 84% of patients showed improvement over a 6-month period. Conclusions: This study is among the first to provide outcome data demonstrating the effectiveness of the colocated model for delivering BH services in primary care. Data provide information on the relationship between patient outcomes and adherence to recommendations delivered during colocated BH treatment. High attendance rates at initial appointment and overall improvement ratings were observed, suggesting the colocated BH model is a feasible model to improve access and outcomes in pediatric BH services.
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