Parent-Child Interaction Therapy for Children with Disruptive Behaviors and Autism: A Randomized Clinical Trial.

A relatively large number of children with autism spectrum disorder (ASD) exhibit disruptive behavioral problems. While accumulating data have shown behavioral parent training programs to be efficacious in reducing disruptive behaviors for this population, there is a dearth of literature examining the impact of such programs across the range of ASD severity. To evaluate the effectiveness of Parent-Child Interaction Therapy (PCIT), an evidence-based treatment for children with problem behaviors and their families, in reducing disruptive behaviors among children (4-10 years) with ASD (without intellectual disabilities). Fifty-five children (85.5% male, 7.15 years; SD 1.72) were enrolled from pediatric offices and educational settings into a randomized clinical trial (PCIT: N = 30; Control: N = 25). PCIT families demonstrated a significant reduction in child disruptive behaviors, increase in positive parent-child communication, improvement in child compliance, and reduction in parental stress compared to the control group. Exploratory analyses revealed no differential treatment response based on ASD severity, receptive language, and age. Results are promising for the use of PCIT with children demonstrating disruptive behaviors across the autism spectrum.

Experiences of Nurses Who Care for Women After Fetal Loss.

OBJECTIVE: To examine the experiences of, meaning for, and personal consequences for obstetric, emergency, and surgical nurses caring for women after fetal death and to determine how these nurses use Swanson's caring processes in providing such care. DESIGN: Four focus groups. SETTING: Two hospitals within the same health care system. PARTICIPANTS: Registered nurses (N = 24) working in the obstetric, surgery, or emergency departments. METHODS: Swanson's Theory of Caring guided focus group questions that were audiotaped and transcribed verbatim. Data were analyzed using a continuously emergent process of data collection, data reduction, data display, and interpretation. RESULTS: All participants demonstrated all of Swanson's caring processes but used them preferentially according to situational exigencies and level of rapport with each woman. Nurses had positive and negative feelings associated with caring for women after fetal loss. CONCLUSIONS: Obstetric nurses provided relatively equal focus on all processes in the Theory of Caring except Maintaining Belief. Surgical and emergency department nurses focused primarily on the caring processes of Knowing and Doing For. The negative feelings reported by nurses mirror some emotions commonly associated with compassion fatigue. More research is needed to determine whether nurses caring for mothers experiencing fetal loss are at risk for compassion fatigue. Research is also needed to identify strategies and interventions to help nurses so they may continue to give the best care possible to these very vulnerable families without detriment to themselves.

Mother-daughter and father-daughter attachment of college student ACOAs.

This 2005 study compared parent-child attachment in 89 American female Adult Children of Alcoholics (ACOAs) as compared to 201 non-ACOAs. Women attended a large university in the southeastern United States. Participants categorized as ACOA on the Children of Alcoholics Screen Test (CAST; Jones, 1983) reported significantly more negative affect and less support from their fathers as indicated on the Parental Attachment Questionnaire (Kenney, 1987). When results were examined by the gender of the alcohol-abusing(1) parent, participants who suspected their fathers were problem drinkers did not differ from non-ACOAs in their attachment to either parent. As compared to non-ACOAs, women who self-identified as daughters of problem-drinking mothers reported poorer attachment both to mothers and fathers.

A comparison of the psychosocial functioning of children with drug-versus alcohol-dependent fathers.

The present study compared the psychosocial functioning of children whose fathers primarily abused illicit drugs other than alcohol (n = 51 ) to children from a demographically matched sample of families whose fathers abused alcohol (n = 51). Children with drug-abusing (DA) fathers exhibited significantly more negative child behaviors on a standardized child-rating scale than did children from homes with alcohol-abusing fathers. In addition, a significantly greater proportion of children with DA fathers met clinical cutoffs indicative of psychosocial impairment (n = 23: 45%) than did children whose fathers abused alcohol (n = 5; 10%). Mediation analyses indicated that severity of drug, legal, medical, employment, and family problems partially mediated the relationship between type of family (i.e., families with fathers who had an alcohol problem versus families with fathers who had a drug problem) and children's psychosocial adjustment.

Pilot of a workbook for children visiting a loved one in a hospice.

A palliative care counsellor developed a workbook for use by children aged 5 to 14 years visiting a loved one in a hospice. This article reports the findings of a small qualitative pilot study exploring how children used the workbook, their views on it and the views of their families and hospice staff. The seven children in the study all enjoyed having the workbook. It provided opportunities for them to interact and build relationships with the staff and to become more involved in their visits to the hospice. Nurses and staff thought the workbook had the potential to help nurses and parents respond to questions or to stimulate discussion. Children used the workbook in different ways, highlighting the need for a flexible approach. It is essential when using such a tool that individual and family needs are respected. The study also raised issues regarding the need for training and emotional support for staff.

Predictors of the psychosocial adjustment of children living in households of parents in which fathers abuse drugs: the effects of postnatal parental exposure.

The purpose of this study was to examine the relationship between the psychosocial adjustment of children living in households of parents (N=112) in which fathers were entering treatment for substance abuse and the following sets of variables: (a) parents' sociodemographic characteristics, (b) parents' dyadic adjustment, (c) fathers' substance use severity, and (d) parents' psychological adjustment. Mothers did not meet current criteria for a psychoactive substance use disorder on alcohol or other drugs; moreover, based on reports by parents, none of the children was not exposed prenatally to illicit drugs. Results of hierarchical-by-blocks regression analyses revealed that each of the variable sets made a significant unique contribution to the prediction of children's psychosocial adjustment. Furthermore, the following variables within the sets were also found to be significant: (a) parents' age, (b) weekly family income, (c) frequency of male-to-female physical aggression between the parents, (d) frequency of fathers' substance use during the previous year, (e) diagnosis of antisocial personality disorder of fathers, and (f) mothers' level of psychological distress.