The cost incurred by victims of bullying from a societal perspective: estimates based on a German online survey of adolescents.

Being a victim of bullying is linked to various social, emotional and behavioral problems potentially leading to a reduced quality of life. Furthermore, victims of bullying may cause extensive costs for society, for example by an above-average need for healthcare services. The present study was designed to quantify the costs and the loss of quality of life attributable to bullying by comparing victims with a control group of non-bullied students. A cross-sectional sample of 1293 adolescents (mean age 14.07, SD = 1.36) and their parents reported on bullying victimization, quality of life (adolescents' self-report), and annual direct (medical and non-medical) as well as indirect costs (parents' self-report) from a societal perspective (all expressed in €, year 2014 and 2015). For frequent (20.6% of our sample; costs: €8461.80 p.a.) but not occasional (13.3%; costs: €2850.06) bullying, victimization was associated with significantly higher costs compared to non-bullied adolescents (costs: €3138.00; annual difference between frequently bullied students and controls: €5323.01 p.a.; p = 0.008). Cost drivers included increased direct medical costs, but mostly indirect costs caused by productivity losses of the parents. Self-reported quality of life of frequent victims was considerably reduced (T = - 10.96; p < 0.001); also occasional bullying showed significantly reduced values in global quality of life (T = - 5.73; p < 0.001). The present findings demonstrate that frequent bullying is associated with substantial cost to society and reduced quality of life of victims. This observation underscores the need for effective school-based bullying prevention and suggests a high potential of effective programs to be cost effective as well.

[Cluster-randomized, controlled evaluation of stress management training for high school students]. / Clusterrandomisierte kontrollierte Untersuchung eines Stressbewältigungs-Trainings in der gymnasialen Oberstufe.

Cluster-randomized, controlled evaluation of stress management training for high school students Abstract. OBJECTIVE: One fifth of German adolescents show elevated levels of mental health problems. The development of mental health problems is often closely related to experiences of stress. Hence, fostering competences in coping with stress offers an approach for counteracting the development of psychological problems. The aim of the present study is to test a stress management training of 3 x 90 minutes in a German high school, 11th grade. METHOD: A cluster-randomized, controlled design was used. The primary outcome was stress. Secondary outcome criteria were knowledge about stress, coping behaviour, emotional and behavioural problems as well as health-related quality of life. Students from twenty-one courses from four schools participated in the study. RESULTS: The sample comprised 286 students (58.25 % girls; mean age 16.58 ± 0.65). Changes in stress levels from pre- to post-evaluation did not differ significantly between intervention and control group. With regard to secondary criteria, apart from a significant increase in knowledge no further effects were observed. An exploratory moderation analysis hints at a positive association between baseline levels of stress and effectiveness of the training. CONCLUSIONS: The results question whether the universal application of a brief cognitive behavioural intervention is appropriate to prevent stress in this population. Future research should, inter alia, investigate the potential of indicated prevention regarding stress.

[Parental Monitoring and its Relation to Behaviour Problems and Risk Behaviour in an Adolescent School Sample]. / Der Zusammenhang von elterlichem Monitoring mit Verhaltensauffälligkeiten sowie Risikoverhalten in einer adoleszenten schulischen Stichprobe.

Parental Monitoring and its Relation to Behaviour Problems and Risk Behaviour in an Adolescent School Sample Numerous research studies emphasize parental monitoring as a protective factor for adolescent problem behaviour. The purpose of the study presented was to use Stattin and Kerr's (2000) monitoring subscales for the first time in a German-speaking area and to explore the relations to behaviour problems in an adolescent school sample. The two active monitoring strategies "parental control" and "parental solicitation" as well as "parental knowledge" and "child disclosure" relating to behaviour problems and risk behaviour were examined. A sample of 494 pupils, grades 5, 7 and 9, of German secondary schools and their parents answered questions on "parental knowledge", "control", "solicitation" and "child disclosure". Adolescents also answered the German version of the Strengths and Difficulties Questionnaire (SDQ) and items about risk behaviour like frequency of violence, delinquency, substance abuse, self-injuring behaviour and school absenteeism. Behaviour problems in terms of the SDQ could be predicted sufficiently by "parental knowledge", but for the prediction of risk behaviour, the active parental monitoring strategies were of importance, too. More "parental knowledge", more "control" and less "solicitation" could predict less risk behaviour. Results confirm "parental knowledge" as a general protective factor for problem behaviour. However, they show the importance of "parental control" for adolescent risk behaviour.

Does parental monitoring moderate the relationship between bullying and adolescent nonsuicidal self-injury and suicidal behavior? A community-based self-report study of adolescents in Germany.

BACKGROUND: Being a victim of bullying in school is clearly linked to various social, emotional, and behavioral problems including self-harm behavior. However, it is not known whether even occasional victimization has similar negative consequences and whether protective factors such as social support may prevent those harmful developments. The present study therefore focuses on the nonsuicidal self-injury (NSSI) and suicidal behavior (SB) in victims of bullying and the potentially moderating effect of parental monitoring. METHODS: In all, a cross-sectional sample of 647 adolescents (mean age 12.8 years) were surveyed concerning bullying experiences, NSSI and SB, and parental monitoring. RESULTS: A total of 14.4% of respondents reported being a victim of frequent bullying in the past few months (with verbal and social bullying playing the most important role), which increased the risks of both NSSI (OR = 11.75) and SB (OR = 6.08). This relationship could also be shown for occasional victims of bullying (35.6%), although to a lesser extent. Parental monitoring had a significant protective effect on SB in victims of occasional bullying. However, parental monitoring did not show any protective effect in victims of repetitive bullying. CONCLUSIONS: Victims of bullying show a substantial risk for engaging in self-harm behavior. Therefore, the dissemination of anti-bullying programs in schools would probably also prevent such disorders. Parental participation in school-based prevention may increase its effect; this also matches the results of the present study, showing that parental monitoring may be able to buffer the negative effects of bullying victimization, at least to a certain degree.

[The relationship between ADHD, problem behaviour and academic achievement at the end of primary school]. / Der Zusammenhang von ADHS, Verhaltensproblemen und Schulerfolg am Beispiel der Grundschulempfehlung.

So far there are contradictory findings concerning the degree of negative influence of attention deficit disorders, external or socio-emotional disorders on academic development of a child. Therefore the present epidemiologic study analyses the relationship between clinically relevant problems and academic achievement of fourth graders (measured by recommendation for secondary school: A-level, B-level or C-level). Children (N = 3910) were rated by their parents by anonymised questionnaires (Child Behavior Checklist CBCL) at the end of primary school. Especially in the field of attention deficit, somatic and anxiety/depression disorders, many children were in a clinically relevant range compared to German norm data. It became obvious that future C-level pupils are particularly strong, multiply problem troubled, with constantly higher problems at all subscales. Mainly attention deficit disorders proved to be relevant for academic achievement, but also delinquent behaviour and social problems, which enhance the relative risk of recommendation for B- or C-level considerably. Early applied preventive interventions supporting social and cognitive development seem therefore of central importance for the school career of primary school children.

Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population-based study.

BACKGROUND: While suicide is the second leading cause of death among young people in most industrial countries, non-fatal suicidal behaviour is also a very important public health concern among adolescents. The aim of this study was to investigate gender differences in prevalence and emotional and behavioural correlates of suicidal behaviour in a representative school-based sample of adolescents. METHODS: A cross-sectional design was used to assess suicidal behaviour and various areas of emotional and behavioural problems by using a self-report booklet including the Youth Self-Report. One hundred sixteen schools in a region of Southern Germany agreed to participate. A representative sample of 5,512 ninth-grade students was studied. Mean age was 14.8 years (SD 0.73); 49.8% were female. RESULTS: Serious suicidal thoughts were reported by 19.8% of the female students and 10.8% of the females had ever attempted suicide. In the male group, 9.3% had a history of suicidal thoughts and 4.9% had previously attempted suicide. Internalizing emotional and behavioural problems were shown to be higher in the female group (difference of the group means 4.41) while externalizing emotional and behavioural problems slightly predominated in male students (difference of the group means -0.65). However, the total rate of emotional and behavioural problems was significantly higher in the adolescent female group (difference of the group means 4.98). Using logistic regression models with suicidal thoughts or attempted suicide as dependent variables, the pseudo-R2 of gender alone was only 2.7% or 2.3%, while it was 30% or 23.2% for emotional and behavioural problems measured by the YSR syndrome scales. By adding gender to the emotional and behavioural problems only an additional 0.3% of information could be explained. CONCLUSIONS: The findings suggest that gender differences in non-fatal suicidal behaviour among adolescents can to a large extent be explained by the gender differences in emotional and behavioural problems during this age.

Prevalence and psychological correlates of occasional and repetitive deliberate self-harm in adolescents.

OBJECTIVE: To determine the prevalence and the associated psychological and social factors of occasional and repetitive deliberate self-harming behavior in adolescents. DESIGN: Cross-sectional self-report survey. SETTING: One hundred twenty-one schools in Germany. PARTICIPANTS: A representative sample of 5759 ninth-grade students was studied between 2004 and 2005. OUTCOME MEASURES: Deliberate self-harm (DSH) and suicidal behaviors, emotional and behavioral problems (Youth Self-Report), living standard, family composition, parental conflict and illness, school type and performance, relationship to peers, bullying, body satisfaction and dieting, media consumption, smoking, and alcohol and drug use. RESULTS: Occasional forms of DSH within the previous year were reported by 10.9% of the ninth-grade students. Four percent of the students reported repetitive forms of DSH. Suicidal behavior was strongly associated with repetitive DSH, an association that held for both subtypes of DSH. The findings also indicated that social background factors were important concomitants of occasional DSH but were not related to an increased likelihood of repetitive DSH. Symptoms of depression/anxiety and delinquent/aggressive behavior were associated with self-harming behavior in both adolescent girls and boys. CONCLUSIONS: The data suggest that there is a link between social factors and occasional DSH and, especially in repetitive DSH, that there is a strong association between DSH and suicidal behavior as well as DSH and emotional and behavioral problems. These findings indicate a different pathway in the development of DSH in adolescents. The results support a need to investigate the possible neurobiological underpinnings of DSH within a longitudinal model to enhance the knowledge of this poorly understood behavior.

[Temperament and character profiles of female adolescent patients with anorexia and bulimia nervosa]. / Temperaments- und Charaktermerkmale jugendlicher Patientinnen mit Anorexia und Bulimia Nervosa.

OBJECTIVE: Based on the personality model outlined by Robert C. Cloninger, studies in adult patient samples demonstrated that according to distinct personality profiles patients with anorexia nervosa could be differentiated from those with bulimia nervosa, as well as from healthy controls. The current study examines whether these personality-related differences also exist in adolescent patients with eating disorders and a short duration of illness. METHOD: The sample studied consists of 73 consecutively admitted female patients aged 12 to 18 years, with eating disorders. The German version of the Junior Temperament and Character Inventory (JTCI) was administered to 29 patients with anorexia nervosa, restricting type (AN-R), to 16 patients with anorexia nervosa, binge-eating/purging type (AN-B), and to 28 patients with bulimia nervosa (BN). RESULTS: Different temperamental factors were most pronounced between AN-R and BN patients, whereas AN-B patients exhibited a personality profile between those of AN-R and BN. BN patients scored higher on Novelty Seeking but lower on Persistence than AN-R patients. In contrast to AN-R patients, both BN and AN-B patients scored lower on Self-Directedness. CONCLUSIONS: The current results of differential temperamental dimensions in adolescent patients with eating disorders tended to be similar to findings for adult patients, which strengthens the assumption that distinct personality factors underlie the different subtypes of eating disorders.

[The effectiveness of body-oriented methods of therapy in the treatment of attention-deficit hyperactivity disorder (ADHD): results of a controlled pilot study]. / Zur Wirksamkeit körperorientierter Therapieverfahren bei der Behandlung hyperaktiver Störungen: Ergebnisse einer kontrollierten Pilotstudie.

OBJECTIVES: Randomized controlled studies on the effectiveness of body-oriented methods of treatment for children with attention-deficit hyperactivity disorder (ADHD) are lacking. Our aim was to compare the effectiveness of two methods of treatment (yoga for children vs. conventional motor exercises) in a randomized controlled pilot study. METHODS: Nineteen children with a clinical diagnosis of ADHD (according to ICD-10 criteria) were included and randomly assigned to treatment conditions according to a 2x2 cross-over design. Effects of treatment were analyzed by means of an analysis of variance for repeated measurements. RESULTS: For all outcome measures (test scores on an attention task, and parent ratings of ADHD symptoms) the yoga training was superior to the conventional motor training, with effect sizes in the medium-to-high range (0.60-0.97). All children showed sizable reductions in symptoms over time, and at the end of the study, the group means for the ADHD scales did not differ significantly from those for a representative control group. Furthermore, the training was particularly effective for children undergoing pharmacotherapy (MPH). CONCLUSIONS: The findings from this pilot study demonstrate that yoga can be an effective complementary or concomitant treatment for attention-deficit hyperactivity disorder. The study advocates further research into the impact of yoga or body-oriented therapies on the prevention and treatment of ADHD.

[Parent- and teacher-reported behavior problems of first graders]. / Verhaltensauffälligkeiten bei Erstklässlern aus Sicht der Eltern und der Lehrerinnen.

Parents information about behavior, problems and life situation of children before and after first year of school were analysed and compared with data from teacher reports. At the end of first grade 131 parents were asked about behavior problems of their children using the child behavior checklist (CBCL) and additional items about living condition of the familiy and child. Findings were compared with those of a large epidemiological study conducted one year before in the same area using the same instruments. Additional teacher-reported data about behavior problems and school achievement were included. Comparing data before and after first year of school, no significant change in average CBCL total score could be observed. From parents view oppositional behavior was the most prevalent problem. There was a decrease of social problems. Children became more independent having more contact with peers. More children have their own television and computer at the end of first grade. Prevalence of headache and perfectionism as well as symptoms of tension and irritation increased. The most important problems from teachers' view are lack of attention and concentration affecting 32% of the first graders. Compared to the parents, teachers report only few oppositional and aggressive behavior. Achievement at school and behavior problems are highly correlated. Especially attention problems go along with low achievement at school. Parents' and teachers' ratings show an average correlation of r = .28 with the highest accord for attention problems and school achievement. The results of the study contribute to the question how children deal and cope with the new situation coming to school. The findings of a high rate of attention problems at school and the close relationship between behavior problems and achievement lead to the conclusion that an early prevention of behavior problems is essential to promote school performance.

The association of self-injurious behaviour and suicide attempts with recurrent idiopathic pain in adolescents: evidence from a population-based study.

BACKGROUND: While several population-based studies report that pain is independently associated with higher rates of self-destructive behaviour (suicidal ideation, suicide attempts, and self-injurious behaviour) in adults, studies in adolescents are rare and limited to specific chronic pain conditions. The aim of this study was to investigate the link between self-reported idiopathic pain and the prevalence and frequency of self-injury (SI) and suicide attempts in adolescents. METHODS: Data from a cross-sectional, school-based sample was derived to assess SI, suicide attempts, recurrent pain symptoms and various areas of emotional and behavioural problems via a self-report booklet including the Youth Self-Report (YSR). Adolescents were assigned to two groups (presence of pain vs. no pain) for analysis. Data from 5,504 students of 116 schools in a region of South Western Germany was available. A series of unadjusted and adjusted multinomial logistic regression models were performed to address the association of pain, SI, and suicide attempts. RESULTS: 929 (16.88%) respondents reported recurrent pain in one of three areas of pain symptoms assessed (general pain, headache, and abdominal pain). Adolescents who reported pain also reported greater psychopathological distress on all sub-scales of the YSR. The presence of pain was significantly associated with an increased risk ratio (RR) for SI (1-3 incidences in the past year: RR: 2.96; >3 incidences: RR: 6.04) and suicide attempts (one attempt: RR: 3.63; multiple attempts: RR: 5.4) in unadjusted analysis. Similarly, increased RR was observed when adjusting for sociodemographic variables. While controlling for psychopathology attenuated this association, it remained significant (RRs: 1.4-1.8). Sub-sequent sensitivity analysis revealed different RR by location and frequency of pain symptoms. CONCLUSIONS: Adolescents with recurrent idiopathic pain are more likely to report previous incidents of SI and suicide attempts. This association is likely mediated by the presence of psychopathological distress as consequence of recurrent idiopathic pain. However, the observed variance in dependent variables is only partially explained by emotional and behavioural problems. Clinicians should be aware of these associations and interview adolescents with recurrent symptoms of pain for the presence of self-harm, past suicide attempts and current suicidal thoughts. Future studies addressing the neurobiology underpinnings of an increased likelihood for self-injurious behaviour and suicide attempts in adolescents with recurrent idiopathic pain are necessary.

Reduced cortical thickness and its association with social reactivity in children with autism spectrum disorder.

Symptomatology and behavioral characteristics in autism spectrum disorders (ASD) have increasingly been linked to abnormalities in early brain growth patterns of affected children. Studies investigating specific components of gray matter structure, such as cortical thickness (CT), have produced conflicting results, and have rarely included additional measures of social impairment. In the present study, we applied a surface-based whole brain analysis to investigate CT in a sample of 36 pre-adolescent children [18 subjects with ASD (IQ mean: 111) and 18 healthy controls (IQ mean: 112.8), age range 6-12 years]. The CT analysis revealed widespread, but mostly left-hemispheric thinning in frontal, temporal, parietal and occipital brain areas related to the theory-of-mind network and the heteromodal association cortex. In an exploratory analysis, CT was observed to be differently associated with social impairment in children with ASD compared with typically developing children. The affected neuroanatomical regions are related to characteristic deficits in language, cognition and behavior that are often observed in the disorder. The relationship between social impairment and CT in children with ASD and controls seems to indicate aberrant developmental trajectories in ASD emerging early in life.

[Success of treatment, experience of treatment, and satisfaction with treatment from the perspective of patients, parents, and therapists--results of an evaluative study on inpatient treatment in child and adolescent psychiatry]. / Behandlungserfolg, Behandlungserleben und Behandlungszufriedenheit aus der Sicht von Patienten, Eltern und Therapeuten--Ergebnisse einer evaluativen Studie aus der stationären Kinder- und Jugendpsychiatrie.

In spite of the high importance of subjective opinions as essential evaluation criteria there are hardly any studies available, dealing with the research of subjective judgements made by children and adolescent patients in relation to their inpatient treatment, and comparison with the evaluation of their parents. The evaluative study on an age-group random sample survey (n=95) of patients and parents at the Department of Child and Adolescent Psychiatry at the University of Heidelberg includes success of treatment, experience of treatment and satisfaction with treatment by means of specially constructed and parallelized questionnaires for patients, parents and therapists. Apart from the extent of subjectively experienced changes in precisely defined success variables, not only agreements and differences were studied, but also connections between success of treatment, experience of treatment and satisfaction with treatment as well as influences of success variables and experience variables on treatment satisfaction. Parents', patients' and therapists' evaluations of the treatment in regard of most success variables were all positive. At the end of treatment a perspective convergence was noticeable in some variables. The pressure on the parents requires special therapeutic attention. In the sense of therapy evaluation the change in the way the problem was viewed proved to be a worthwile success criterium. From the patients' and parents' point of view the change in the problem "as a whole" is mainly characterized by a positive change in emotional disposition. The therapeutic atmosphere and organisation of therapeutic relationships were highly appreciated by patients and parents. All in all patients, parents and therapists were highly satisfied with inpatient treatment. The correlations found between the grade of success, experience of treatment and satisfaction with treatment were clearly positive. On the patients' side treatment satisfaction was dictated more by their experiences during the treatment, whereas on the parents' side the success of treatment proved to be the stronger factor.

[Behavioral symptoms in preschool children at the time of school entrance from the perspective of parents--data regarding prevalence and risk factors in an epidemiological study]. / Verhaltensauffälligkeiten im Einschulungsalter aus elterlicher Perspektive--Ergebnisse zu Prävalenz und Risikofaktoren in einer epidemiologischen Studie.

Behavioral and emotional problems based on parents information from the Child Behavior Checklist (CBCL) were investigated in a large epidemiological sample of 4363 six year old pre-school children from the area of Heidelberg and Rhein-Neckar county. An overview about symptom frequencies of boys and girls is given, taking age specific evaluations into account. Considering symptoms and syndromes, externalizing and attention problems show high prevalence, especially for boys. Family problems are the most important predictors of child global symptomatology, explaining about 10% of variance of the CBCL total score. Other factors like gender, chronical illness, adverse living conditions, family constellation or amount of TV consumption prove as additional independent predictors. An overall model explains about 20% of variance of child symptomatology. Results are discussed from the view of normal child development, developmental psychopathology, changing norms and altered socio-cultural conditions.

[Changes in test norms of spelling achievement and nonverbal intelligence]. / Normverschiebungen bei Rechtschreibleistung und sprachfreier Intelligenz.

The norms of the spelling test R-T Form C "Moselfahrt" (Althoff et al. 1974) from the year 1968 and of the nonverbal intelligence test CFT 20 (form A/part 1) from the year 1977 (Weiss 1987) are evaluated for their actual validity. In 1995, both original tests were being administered to an epidemiological sample (N = 592) of adolescents and young adults in the age of 16 to 30 years having passed at least their obligatory amount of school years. These results are being compared to those of the original norm samples. Using the norms for the CFT 20 from 1977 adolescents and young adults achieve in the year 1995 a mean IQ of 110.8 points, equaling a yearly IQ-gain of 0.6 IQ-points. This exceeds the expected gain of 0.33 IQ-points annually according to the literature and indicates a distinct change of norms. There were no significant gender differences found. The distribution of mistakes in the spelling test R-T "Moselfahrt" compared to the original norm sample from 1968 changes considerably as well and requires revised test norms. With an increase from 9-11 mistakes (depending on the age norm) to 19.8 mistakes the mean amount of mistakes is almost being doubled. Extremely high numbers of mistakes occurred more frequent and could not be differentiated according to the old norms. Using the original norms from 1968 in the year of 1995 12.4% of the sample achieve with a T-score of 20 the lower limit of the measured value scale and the overall mean has decreased by 1.2 standard deviations to T-score = 38.48% of the sample reach a result that equates percentage 10 or less which is interpreted as insufficient school mark. Women's mean spelling achievement is significantly better than men's. Causes and implications of this scissors-like development of deteriorated spelling achievement and increased nonverbal intelligence are being discussed. Tables containing the new standardization scores are included in the appendix.

Fronto-temporal disconnectivity and symptom severity in children with autism spectrum disorder.

OBJECTIVES: There is increasing evidence that many of the core behavioural impairments in autism spectrum disorders (ASD) emerge from disconnectivity of networks that are important for social communication. The present study aimed at investigating which specific fibre tracts are impaired in ASD and if possible alterations of white matter are associated with clinical symptomatology. METHODS: Eighteen children with ASD and 18 carefully matched typically developing controls aged 6-12 years were examined using diffusion tensor imaging (DTI) and voxel-based morphometry (VBM). Fractional anisotropy (FA) values were correlated with symptom severity as indexed by the children's scores on the Autisms Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). RESULTS: Decreased FA values were identified for the fornix (FO), the superior longitudinal fasciculus (SLF) the corpus callosum and the uncinate fasciculus (UF) in the ASD group compared to controls, with most prominent differences in the UF bilaterally and the right SLF. FA values of affected fibre tracts were negatively associated with clinical measures of autistic symptomatology. We did not observe significantly altered grey or white matter concentration after correction for multiple comparisons. CONCLUSION: Our findings support the hypothesis of abnormal white matter microstructure of fronto-temporal cortical networks in ASD, which are associated with core symptoms of the disorder.

Does successful training of temporal processing of sound and phoneme stimuli improve reading and spelling?

OBJECTIVE: The aim of this study was to measure and train auditory temporal processing in children with dyslexia and to examine whether there was a transfer of improved auditory temporal processing to reading and spelling skills. METHODS: Computer-based procedures to measure and train temporal processing of sound and phoneme stimuli were developed. Test-scores for a normal control group consisting of 8-year-olds were established. Second graders with dyslexia were included in the training condition and divided into three groups: a control group, a group specifically trained in sound processing, and a third group specifically trained in phoneme processing. After an initial diagnostic procedure, both training groups received specific training every day for 4 weeks. All children, regardless of the group, received the same standard reading training programme designed for children with dyslexia at school. Outcome measures were assessed immediately after training as well as 6 and 12 months later. RESULTS: Tests for temporal processing of sound and phoneme stimuli proved to be highly reliable. Children with dyslexia (N = 44) showed impaired auditory processing of sound and phoneme stimuli compared to normal controls (N = 51). There was a specific significant improvement in sound, respectively phoneme, processing for the training groups immediately after the end of training. The improvement of phoneme processing remained stable after 6 months and as a trend after 12 months. After 6 and 12 months of training, children of all three groups improved significantly in reading no matter what group. In spelling, the sound training group had a slight advantage after 6 months, which was not stable after 12 months. CONCLUSIONS: Auditory temporal processing could be trained effectively at the sound and phoneme levels. However, no significant stable transfer of these improved abilities on reading and spelling exceeding the effect of the school-based standard training was demonstrated.