A feasibility randomised controlled trial of the New Orleans intervention for infant mental health: a study protocol.

Child maltreatment is associated with life-long social, physical, and mental health problems. Intervening early to provide maltreated children with safe, nurturing care can improve outcomes. The need for prompt decisions about permanent placement (i.e., regarding adoption or return home) is internationally recognised. However, a recent Glasgow audit showed that many maltreated children "revolve" between birth families and foster carers. This paper describes the protocol of the first exploratory randomised controlled trial of a mental health intervention aimed at improving placement permanency decisions for maltreated children. This trial compares an infant's mental health intervention with the new enhanced service as usual for maltreated children entering care in Glasgow. As both are new services, the trial is being conducted from a position of equipoise. The outcome assessment covers various fields of a child's neurodevelopment to identify problems in any ESSENCE domain. The feasibility, reliability, and developmental appropriateness of all outcome measures are examined. Additionally, the potential for linkage with routinely collected data on health and social care and, in the future, education is explored. The results will inform a definitive randomised controlled trial that could potentially lead to long lasting benefits for the Scottish population and which may be applicable to other areas of the world. This trial is registered with ClinicalTrials.gov (NC01485510).

The effects of mild and severe traumatic brain injury on the auditory and visual versions of the Adjusting-Paced Serial Addition Test (Adjusting-PSAT).

Auditory and visual versions of the Adjusting-PSAT [Tombaugh, T. N. (1999). Administrative manual for the adjusting-paced serial addition test (Adjusting-PSAT). Ottawa, Ontario: Carleton University] were used to examine the effects of mild and severe traumatic brain injury (TBI) on information processing. The Adjusting-PSAT, a computerized modification of the original PASAT [Gronwall, D., & Sampson, H. (1974). The psychological effects of concussion. Auckland, New Zealand: Auckland University Press], systematically varied the inter-stimulus interval (ISI) by making the duration of the ISI contingent on the correctness of the response. This procedure permitted calculation of a temporal threshold measure that represented the fastest speed of digit presentation at which a person was able to process the information and provide the correct answer. Threshold values progressively declined as a function of the severity of TBI with visual thresholds significantly lower than auditory thresholds. The major importance of the current study is that the threshold measure offers a potentially more precise way of evaluating how TBI affects cognitive functioning than is achieved using the traditional PASAT and the number of correct responses. The Adjusting-PSAT offers the additional clinical advantages of eliminating the need to make a priori decisions about what ISI should be used in different clinical applications, and avoiding spuriously high levels of performance that occur when an "alternate answer" or chunking strategy is used. Unfortunately, the Adjusting-PSAT did not reduce the high level of frustration previously associated with the traditional PASAT.