Brief report: cautions against using the Stanford-Binet-IV to classify high-risk preschoolers.

OBJECTIVE: To explore concurrent and predictive validity of the Stanford-Binet: Fourth Edition (SB-IV) by comparing scores on the SB-IV with scores from the Battelle Developmental Inventory (BDI) and later achievement scores in preschoolers at risk due to very low birthweight, and/or intraventricular hemorrhage (IVH) and other medical complications. METHODS: At ages 3,4, and 5, 92 preschoolers were tested with the SB-IV and BDI as part of an 8-year early intervention follow-up. RESULTS: The SB-IV and BDI concurrent correlations at ages 3, 4, and 5 were statistically significant (r = .73-.78, p < .0001), as were predictive correlations (r = .58-.85, p < .0001). However, the BDI and SB-IV failed to place the children in the same categories for intervention services. With the BDI as the comparison measure, SB-IV failed to detect 87% of the children who were "delayed" (by BDI) at age 3 and 50% of the "delayed" children at age 5. CONCLUSIONS: Caution is recommended when using the SB-IV to assess high risk for early intervention eligibility.

Use of the child development inventory to screen high-risk populations.

This study examined the validity of a parent-report inventory, the Child Development Inventory (CDI), as a developmental screening instrument in high-risk toddlers and preschoolers. Seventy-six children, aged 15-70 months, were assessed in a neonatal high-risk developmental follow-up clinic. The data included the completion of CDIs by parents/caregivers and developmental evaluations by a physician using either the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) (15-35 months) or Slosson Intelligence Test (36-70 months). Analysis revealed a good level of sensitivity (true "abnormals"--73%) and specificity (true "normals"--87%) for the CDI General Development score. The findings suggested that the CDI is a valid and useful screening instrument for high-risk infants.

The Child Development Inventory: A developmental outcome measure for follow-up of the high-risk infant.

OBJECTIVE: To examine the validity of the Child Development Inventory (CDI) compared with other commonly used measures of developmental outcomes in high-risk infants. STUDY DESIGN: Primary caregivers of 63 toddlers and preschoolers enrolled at a routine neonatal high-risk follow-up clinic completed a CDI describing their children. Only those with successfully completed CDIs were included in the analysis (n = 43). The CDI General Development Developmental Quotient was compared with the Clinical Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) and the Bayley Scales of Infant Development, 2nd Edition (BSID-II). RESULTS: Significant correlations were found between the CDI, the CAT/CLAMS (r =.87, P <.001), and the BSID-II (r =.86, P <.001). There were no significant correlations between the CDI and parent education and income. Findings revealed high sensitivity (80% to 100%) and specificity (94% to 96%) for the CDI. CONCLUSION: The CDI appears to be a useful and cost-effective screening measure for determining developmental outcomes among high-risk infants.

The pediatric emotional distress scale: a brief screening measure for young children exposed to traumatic events.

Introduced the Pediatric Emotional Distress Scale (PEDS), which was developed to quickly assess behaviors identified in empirical and theoretical literature as significantly elevated in children after experiencing traumatic events. The 21-item parent-report rating scale includes 17 general behavior items and 4 trauma-specific items. Factor analyses on the 17 items, with 475 two- to ten-year-olds (traumatic event exposure and nontraumatic event exposure), yielded 3 reliable factors labeled Anxious/Withdrawn, Fearful, and Acting Out. Factor and total scores were shown to have good internal consistency, and both test-retest and interrater reliability were at acceptable levels. Discriminant analyses demonstrated the PEDS could distinguish traumatic event exposure and nonexposure groups, although maternal education should be a significant consideration in interpretation. Future research with diverse populations who have documented trauma is needed to enhance the utility of the full PEDS scale.

Infant screening: the usefulness of the Bayley Infant Neurodevelopmental Screener and the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale.

We assessed the usefulness of the Bayley Infant Neurodevelopmental Screener (BINS) and the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) for screening high-risk infant populations in a sample of 78 infants followed after premature birth and/or perinatal insults. Both measures were highly correlated with the Bayley Scales of Infant Development-II, but sensitivity and specificity analyses revealed disparities related to the tests administered and the cutoffs used. The BINS had optimal sensitivity (true positives) of 90% when referral was made for a BINS score of high or moderate. The CAT/CLAMS had excellent specificity (true negatives) of 95% to 98% but poor sensitivity (5%-36%). Until the cutoff issue can be clarified, clinicians should be cautious in using the CAT/CLAMS as the primary screening instrument in settings in which early identification of infants with developmental problems is the main goal.

Predictors of developmental outcomes for medically fragile early intervention participants.

Little is documented about the determinants of developmental outcomes for medically fragile infants who receive early intervention. In this controlled longitudinal study 65 premature infants with intraventricular hemorrhage (IVH) were randomly assigned to intervention groups beginning at 3 months adjusted age (Early) or 12 months adjusted age (Delayed). The sample was 65% African American and 35% Caucasian, and over half the youngsters were being raised by single mothers. Although cost analyses revealed that it was almost twice as expensive to begin sensorimotor intervention at the earlier age, annual comprehensive assessments revealed no significant differences in developmental outcomes based on age at start. Stepwise multiple regression analyses revealed that Maternal Education and Neonatal Medical Problems were significant predictors of outcomes at years 1, 3, 5, and 7 regardless of age at start. Related findings from other studies are discussed along with implications for policy and future research.

Impact of a natural disaster on preschool children: adjustment 14 months after a hurricane.

Fourteen months after a hurricane, young children who had experienced the storm showed significantly higher anxiety and withdrawal and more behavior problems than did children who had not. Behavioral problems decreased steadily over the six months following the storm. Mothers' distress in the hurricane's aftermath was associated with the longevity of their children's emotional and behavioral difficulties.

Determinants of responsiveness in mothers of children with intraventricular hemorrhage.

Explored relationships between maternal responsiveness and parenting stress, family, medical, and demographic factors in mothers of children born prematurely at very low birth weights with intraventricular hemorrhage. Mothers of 82 2-year-olds completed self-report questionnaires and were observed interacting with their children in free play during a yearly assessment. Path analysis (LISREL) revealed that lower maternal responsiveness, measured by the Parent/Caregiver Involvement Scale, was associated with greater demographic disadvantage and with high parent-related stress on selected subscales of the Parenting Stress Index. Child-related parenting stress was not associated with responsiveness, and severity of the child's medical condition at birth was weakly related. Results are discussed in the context of this unique population, and relevant research and measurement issues.

A comparison of children's behaviors following three types of stressors.

One purpose of this study was to examine the differences in behavior of children exposed to trauma versus no trauma. Another goal was to compare different types of traumatic events in terms of their effects on behaviors. Our analysis indicated significant differences between trauma and no trauma groups. Additional analyses indicated that those children who were allegedly sexually abused were rated as exhibiting higher levels of symptomatology on all three factors of the Pediatric Emotional Distress Scale (PEDS) as well as the Total PEDS score than the other three groups.

Concurrent validity of the Minnesota Child Development Inventory with high-risk infants.

Investigated the validity and clinical utility of the Minnesota Child Development Inventory (MCDI) as a developmental screening instrument with a sample of 280 premature infants identified as medically and socioeconomically high risk for developmental delays. Correlational analyses demonstrated significant correlations between the MCDI scales and the criterion Bayley Mental Age Equivalent score. Results of a moderator multiple regression analysis indicated that parent and child characteristics have a statistically significant "moderating" influence on the validity of the MCDI although the clinical significance of this finding may be minimal. A prediction-performance matrix analysis revealed a high degree of classification specificity (92%) but a relatively low sensitivity rating (56%). Findings suggest that the MCDI is a valid and useful screening instrument for high-risk infants but should be used diagnostically only in conjunction with other measures.

Responses of fish populations and communities to pulp mill effluents: a holistic assessment.

Fish populations residing in a river receiving bleached kraft mill effluents (BKME) and in an uncontaminated river were investigated to evaluate causal relationships between exposure to BKME and various indicators of fish health. The Index of Biotic Integrity demonstrated that species richness and composition were much lower in the contaminated river with an obvious imbalance in the trophic structure of the fish community. Biomolecular and biochemical responses such as DNA damage and elevated activity of detoxification enzymes indicated that fish in the contaminated river had been exposed to toxicants. The status of various condition indices such as the liver and visceral somatic indices suggested metabolic and nutritional imbalances in sunfish as a result of exposure to pulp mill effluents. Fish populations in the contaminated river also demonstrated an abnormal size distribution and age structure. Female redbreast sunfish from the BKME-impacted river contained a large number of atretic oocytes and had lower serum levels of estradiol than fish from the reference site. These observations plus data from previous developmental toxicity studies suggest that the primary mechanism by which BKME may affect fish populations in this river is through reproductive dysfunction and recruitment failure. Decreased recruitment may have caused a reduction in population size and resulted in decreased competition and increased resource availability. With increased food and habitat availability, more energy may have been available for growth and lipid storage of survivors in the contaminated river.

Hurricane Hugo blows down the broccoli: preschoolers' post-disaster play and adjustment.

This article reports highlights from over 200 parents' observations of their preschoolers' play and verbalizations in the year following Hurricane Hugo. Commonly reported activities included reenactment and discussion of the event in multiple mediums, personification of "Hugo", and expression of fears related to storms. Precocious concern for others, insight, and vocabulary were also noted. In these intact, relatively high functioning families, parents seemed able to facilitate their youngsters' adjustment without outside intervention.

Depends on who you ask: what maximizes participation of families in early intervention programs.

This two-part study was a preliminary investigation of the types of procedures that could be useful in maximizing the participation of families in early intervention programs for their special-needs infants, toddlers, and pre-schoolers. In Study 1, 64 professionals in the early intervention field completed a survey that described 29 potential techniques for maximizing participation of families. For each technique, the respondents endorsed whether they employed the procedure, or would if they could. In addition, they rated the expected effectiveness of each procedure. Verbal praise and encouragement were highly rated and almost universally in use, as were various types of written and resource materials. Tangible reinforcement was seldom employed and professional respondents tended to indicate that they did not expect that such techniques would be useful. In Study 2, 29 mothers of high-risk infants and toddlers currently in early intervention rated the same 29 procedures, but were significantly more likely to endorse the use of tangible reinforcers and logistical support. Comparisons among respondents from professional and parent samples were discussed, along with implications of the findings and necessary directions for future research in this area.

Personality factors, family structure, and sex of drawn figure on the Draw-A-Person Test.

One hundred seventy-four youthful psychiatric inpatients were given the Draw-A-Person Test (DAP) as part of an assessment battery. Sex of person drawn was compared to subject's sex, Achenbach aggression and delinquency scores, and scores on Children's Inventory of Anger and Nowicki-Strickland Locus of Control Scale. The sex of the person drawn was also compared to family composition, specifically whether or not the child came from an intact family with both a male and female parent or role model. Results support drawing of a same-sexed individual as normative, regardless of age or sex. Adolescent girls and young boys were the only groups that differed significantly from this norm. Personality measures and family composition were not significantly related to the tendency to draw same versus opposite sex.

Helping the child with cancer: what school personnel want to know.

As more children with cancer survive, the importance of facilitating school reintegration as a part of maximizing the quality of life has become evident. Workshops have been presented to school personnel to acquaint them with the issues facing cancer patients and their families, but there are gaps in our knowledge of what school personnel really need or want to know. In this study, 18 teachers of children with cancer and 15 teachers with no prior contact with students with cancer completed a questionnaire designed to assess needs, beliefs, and priorities with regard to working with cancer patients in the classroom. Significant findings included: (a) a consensus that a certain core of information about medical/psychological issues would be useful, and presentation of such information by psychologists and medical personnel working with such families would be optimal; (b) teachers having cancer patients as students were less likely to see the adaptation of siblings as an important issue; (c) teachers associated working with a student with cancer with less stress and demands on their time than predictable from previous studies; and (d) cancer patients as a whole were rated as having fewer behavioral, emotional, and learning problems than randomly selected students without a major illness, suggesting a "halo effect" or contradiction of some literature. Preliminary findings are detailed and implications are discussed for those attempting to help teachers facilitate students' adjustment to school following diagnosis and treatment of cancer.

The Bender-Gestalt with adolescents: comparison of two scoring systems.

The present study was designed to evaluate the relative efficacy of two different scoring systems (Koppitz, 1975; Lacks, 1984) for use in evaluating Bender-Gestalt performance by adolescents. Normative data are presented for the two scoring systems with a sample of "normal" controls (N = 150), emotionally disturbed (N = 140), and mentally retarded/neurologically impaired adolescents (N = 47), aged 12-17. Results suggested that age and psychopathology were not related to the quality of the Bender-Gestalt reproductions of these subjects. An inverse relationship was found between cognitive ability and visual motor skills. Data obtained from these samples of adolescents showed a high degree of consistency between the scoring systems, which suggests that either scoring procedure is suitable for evaluating the Bender-Gestalt performance of adolescents.

Locus of control and achievement in child psychiatric inpatients.

The relationship between the Nowicki-Strickland Locus of Control Scale for Children (Nowicki & Strickland, 1973) and academic achievement was examined in a sample of 66 child psychiatric inpatients. Previous studies had suggested that this measure correlated with achievement in normal samples (Nowicki & Strickland, 1973) but not in populations of male juvenile offenders (Little & Kendall, 1978). The product-moment correlation between the Nowicki-Strickland Scale and the Peabody Individual Achievement Test was significant. However, when the effect of IQ was controlled for in a partial correlation, there was no significant correlation. Discussion focuses on the relationship between these results and other findings in the area of locus of control, intelligence, and achievement.