Effects of interventions to reduce adolescent depression in low- and middle-income countries: A systematic review and meta-analysis.

BACKGROUND: International comparisons found that depression prevalence ranged from 18.3% (China) to 51.5% (Zambia) among school students in some low- and middle-income countries (LMICs). The evidence base for treatment of adolescent depression in LMICs is limited and inadequate. Moreover, most treatment interventions are developed in high income countries and the effectiveness of these treatments in LMICs is largely unknown. METHOD: Randomized controlled trials, including cluster-randomized trials that have been implemented in LMICs to reduce adolescent depression, were examined in this systematic review and meta-analysis. Only one-time point (3 months or close to 3 months) of the outcome measures was chosen to evaluate effectiveness of interventions. RESULTS: Studies that used cognitive-behavioral therapy reduced depressive symptoms more effectively than other treatments with standardized mean difference (SMD) = -1.27, (95% CI -2.19 to -0.35). Microfinance/economic interventions also reduced depression in adolescents with SMD = - 0.35, (95% CI -0.71 to 0.01) and Interpersonal therapy was used in three studies and depressive symptoms reduced by SMD = -0.23, (95% IC -0.60 to 0.13). Moreover, complex psychotherapeutic interventions that used integrated techniques showed a reduction in depression with SMD = -0.23, (95% IC -0.33 to -0.14) as well. CONCLUSIONS: Across twenty-eight studies, the evidence showed that cognitive behavioral therapy that delivered by nurses, social workers and counselors at community-based settings were more effective treatments in decreasing adolescent depression in LMICs. Future studies should implement these universal treatment approaches to identify accessible, feasible, affordable and sustainable depression treatments in the countries with less available resources.

Pragmatic Language Performance of Children Adopted Internationally.

Purpose Pragmatic language is important for social communication across all settings. Children adopted internationally (CAI) may be at risk of poorer pragmatic language because of adverse early care, delayed adopted language development, and less ability to inhibit. The purpose of this study was to compare pragmatic language performance of CAI from Asian and Eastern European countries with a nonadopted group of children who were of the same age and from similar socioeconomic backgrounds as well as explore the relationship among emotion identification, false belief understanding, and inhibition variables with pragmatic language performance. Method Using a quasi-experimental design, 35 four-year-old CAI (20 Asian, 15 Eastern European) and 33 children who were not adopted were included in this study. The children's pragmatic language, general language, and social communication (emotion identification of facial expressions, false belief understanding, inhibition) were measured. Comparisons by region of origin and adoption experience were completed. We conducted split-half correlation analyses and entered significant correlation variables into simple and backward regression models. Results Pragmatic language performance differed by adoption experience. The adopted and nonadopted groups demonstrated different correlation patterns. Language performance explained most of the pragmatic language variance. Discussion Because CAI perform less well than their nonadopted peers on pragmatic communication measures and different variables are related to their pragmatic performance, speech-language pathologists may need to adapt assessment and intervention practices for this population.

False Belief Performance of Children Adopted Internationally.

PURPOSE: The purpose of this study was to explore relationships among adoption, individual, and family variables on false belief performance of children adopted internationally (CAI). METHOD: Using a quasiexperimental design, thirty-five 4-year-old children adopted from Asian and Eastern European countries before age 2 years were compared with a U.S. group of 33 nonadopted 4-year-old children on a standardized English-language measure, 3 false belief tasks, and a go/no-go inhibition measure. RESULTS: The adopted group differed significantly from the U.S. nonadopted group in expressive language and false belief performance. For the adopted group, inhibition measures were significantly correlated with core language scores. Core language scores and number of older siblings predicted false belief performance. CONCLUSIONS: Similar to children who are not adopted, language competence and living with older siblings positively influenced social understanding in CAI. Because CAI experience interrupted language acquisition and live with fewer older siblings, they are at risk of having weaker language competence and social understanding in their adopted language. When working with CAI, practitioners should assess social communication, language competence, and inhibition skills. They should assist adoptive families in providing socially mentored opportunities for their children to observe and interact with older children.

Emotion identification from facial expressions in children adopted internationally.

PURPOSE: Children adopted internationally who are exposed to institutional care receive less social interaction than children reared in families. These children spend their preadoptive life with individuals from their birth country and are adopted into families who may look and interact differently. The presumed patterns of limited social stimulation and transition from ethnically similar to ethnically and culturally different social interactions may affect these children's ability to accurately identify emotions from facial expressions. METHOD: Thirty-five 4-year-old children adopted from Asia and Eastern Europe by U.S. families were compared with 33 nonadopted peers on the Diagnostic Analysis of Nonverbal Accuracy, Version 2 (DANVA2) Faces subtests. Correlation and regression analyses were completed with preadoption (adoption age, foster care exposure), postadoption environment (postadoption care duration, number of siblings, socioeconomic status), and individual (chronological age, gender, language competence) variables to determine related and predictive variables. RESULTS: The nonadopted group demonstrated better emotion identification than children internationally adopted, but no region-of-origin differences were found. English language performance was correlated with and predicted 20% of the variance in emotion identification of facial expressions on the DANVA2. CONCLUSION: Children adopted internationally who have stronger language ability tend to be more accurate in identifying emotions from facial expressions.

Psychoeducational characteristics of children with hypohidrotic ectodermal dysplasia.

OBJECTIVE: Hypohidrotic ectodermal dysplasia (HED) is an X-linked hereditary disorder characterized by hypohidrosis, hypotrichosis, and anomalous dentition. Estimates of up to 50% of affected children having intellectual disability are controversial. METHOD: In a cross-sectional study, 45 youth with HED (77% males, mean age 9.75 years) and 59 matched unaffected controls (70% males, mean age 9.79 years) were administered the Kaufman Brief Intelligence Test and the Kaufman Test of Educational Achievement, and their parents completed standardized neurodevelopmental and behavioral measures, educational, and health-related information regarding their child, as well as standardized and nonstandardized data regarding socioeconomic information for their family. RESULTS: There were no statistically significant differences between the two groups in intelligence quotient composite and educational achievement scores, suggesting absence of learning disability in either group. No gender differences within or between groups were found on any performance measures. Among affected youth, parental education level correlated positively with (1) cognitive vocabulary scores and cognitive composite scores; (2) educational achievement for mathematics, reading, and composite scores. CONCLUSION: Youth affected with HED and unaffected matched peers have similar profiles on standardized measures of cognition, educational achievement, and adaptive functioning although children with HED may be at increased risk for ADHD.

Communication development and differences in children adopted from China and Eastern Europe.

PURPOSE: The communication development of children adopted from China and Eastern Europe was compared by region of origin at 6 and 12 months after adoption. METHOD: Twenty children, recruited before or immediately following their adoption, participated in the study. Measures were collected between 2 and 6 months after adoption (Time 1) and between 12 and 14 months after adoption (Time 2). The children's ages ranged between 11-22 months and 22-34 months, respectively. Parent-reported vocabulary comprehension and expression and behavioral communication assessments were administered. RESULTS: No significant differences between region of origin were found at Time 1. At Time 2, significant group differences in expressive language performance were found, with children adopted from China and Eastern Europe demonstrating different patterns of English language development. CONCLUSION: Early prelinguistic measures may provide prognostic indicators for later English language development. Children adopted from different countries where they are initially exposed to different birth languages may acquire English differently.

Payments to children and adolescents enrolled in research: a pilot study.

OBJECTIVES: The goal was to identify current payment practices in research involving children. METHODS: A 4-page survey was mailed to the first author or corresponding author of pediatric research studies. Questions concerned whether children enrolled in research and/or their parents received any form of payment, values and types of remuneration, federal categories of pediatric research under which studies were approved, institutional policies regarding payments to children and/or their parents, institutional review board review of payment plans, factors that influenced payment decisions, prorating of payments, purposes of payments, perceived effects of payments on recruitment, and investigators' attitudes toward payments and the perceived risks and discomforts of studies. RESULTS: Payment practices varied, and the reasons for which investigators adopted particular payment practices varied. Approximately one half offered payment. The most popular form of payment was cash. The number of institutions with policies addressing directly payments for children enrolled in research has increased, but still only approximately one half of institutions studied had such policies in place. CONCLUSIONS: Awareness of the variations in payment practices and policies and additional study of the ethical issues surrounding payments for research participation are essential for building consensus and developing the guidelines the Institute of Medicine has said are necessary. Additional research also is needed to understand why parents enroll their children in research, how payments affect research participation decisions, and what the relationship between a study's risks and discomforts and payment should be.

Vietnamese children and language-based processing tasks.

PURPOSE: Vietnamese children's performance on language-based processing tasks of fast-mapping (FM) word-learning and dynamic assessment (DA) word- and rule-learning tasks were investigated. METHOD: Twenty-one first- and second-generation Vietnamese preschool children participated in this study. All children were enrolled in 2 Head Start programs in a large city in the Midwest. All children had passed a developmental assessment and routine speech, language, and hearing screenings. All participants were taught 4 invented monosyllabic words in an FM word task, an invented monosyllabic suffix rule (-po) meaning "a part of" in a DA rule task, and 4 invented bisyllabic words in a DA word task. Potential relationships among task performances were investigated. Receptive task performances, expressive task performances, and task totals were added to create receptive total, expressive total, and accumulated performance total (APT) scores. Relationships among receptive total, expressive total, and APT scores were also investigated. RESULTS: Significant correlations were found between FM word, DA rule, and the receptive total. The expressive total correlated with all task total scores, APT, age, and modifiability scores. Modifiability scores correlated with the two DA tasks, expressive total, and the APT. Findings indicate that FM word and the expressive total were positively correlated with most of the other tasks, composite totals, and age. CLINICAL IMPLICATIONS: Performance on language-based processing tasks may provide valuable information for separating typically developing Vietnamese preschool children from their peers with language disorders. Practitioners should consider linguistic characteristics of target stimuli. Comparisons should include task, receptive, expressive, and APT.

Attitudes toward victims of rape: effects of gender, race, religion, and social class.

Although previous literature focusing on perceptions of victims of rape has examined how gender, race, and culture influence the attitudes one holds toward victims, these studies have yielded mixed results. This study compared perceptions of victims of rape across a wide range of ages, educational backgrounds, religions, and income levels, while focusing on gender and racial differences. Results indicate (N = 220) that victims of rape are generally viewed more sympathetically by females than by males and by Whites than by African Americans. However, the effect of race disappears when socioeconomic variables are controlled, suggesting a more complex relationship. Also, a hierarchical regression indicates that age, sex, education, and income are significant predictors of attitudes toward victims. This study builds on existing research that examines such attitudes from a cultural perspective and extends this literature by examining the interactive effects of several demographic variables within a community sample.