Amanda M. Pearl

Effects of Monetary Incentives on Engagement in the PACE Parenting Program

This study evaluated parental engagement in an 8-week parenting program offered through daycare centers that were randomly assigned to a monetary incentive or nonincentive condition. Of an initial sample of 1,050 parents who rated their intent to enroll in the program, 610 went on to enroll—319 in the incentive and 291 in the nonincentive condition. Results showed that intent to enroll predicted enrollment irrespective of condition. Further, parents did not enroll in greater numbers, attend more sessions, or participate more actively in the incentive condition. Incentives encouraged some parents, often younger and socioeconomically disadvantaged, to enroll but had no effect on their attendance. Of importance, these results could not be accounted for by between-condition differences in child and family or in daycare characteristics.

A Profile on Emergency Department Utilization in Adolescents and Young Adults with Autism Spectrum Disorders

There has been an increase in utilization of the Emergency Department (ED) in individuals with autism spectrum disorder (ASD) which may reflect a deficit of services (Green et al., Journal of the American Academy of Child and Adolescent Psychiatry 40(3):325–332, 2001; Gurney et al., Archives of Pediatric and Adolescent Medicine 160:825–830, 2006; Leichtman et al., American Journal of Orthopsyhciatry 72(2):227–235, 2001). The current study examined the rates of ED utilization between 2005 and 2013 in ASD youth 12- to 21-years-old. Adolescents with ASD accessed ED services four times as often as adolescents without ASD. Older adolescents and those living in rural areas showed a significant increase in ED visits over time. Post hoc analysis revealed increased ED utilization for females and behavioral health ED services over time. Better access to and greater understanding of services for adolescents with ASD is a critical need.

Assessing adolescent social competence using the Social Responsiveness Scale: Should we ask both parents or will just one do?:

There is a paucity of instruments designed to measure social competence of adolescents with autism spectrum disorders. The Social Responsiveness Scale is one of a few that can be used. This study compared differences between mother and father reports of social competence of adolescents. Data were collected from parents of 50 adolescents with and without an autism spectrum disorder diagnosis between the ages of 12 and 17 years. The Social Responsiveness Scale demonstrated high interrater reliability between parents. These results suggest that the Social Responsiveness Scale is an efficient and valuable tool for researchers and clinicians to obtain a more comprehensive understanding of an individual’s social skills deficits. Additionally, given the extremely high agreement between mothers and fathers on the ratings of their children’s social competence, obtaining data from either parent is sufficient to provide an accurate reflection of social competence at home.

Supervising Child Psychiatry Fellows in Cognitive Behavioral Therapy: Crucibles and Choices

Child psychiatric fellows enter cognitive behavioral therapy (CBT) training experiences with a wide variety of backgrounds and experiences in this area of treatment. Although some child fellows have fundamental knowledge of cognitive-behavioral theory, most struggle with the CBT model and even more so, subsequently using this model to guide treatment. Unlike supervising early career mental health professionals, child residents often possess a skill set apt for CBT including using a problem-oriented focus, a tendency to use structured methods in treatment, the use of psychoeducation, and basic clinical skills including genuineness, understanding, and empathy. On the other hand, child psychiatric fellows find several areas of CBT challenging because it is often vastly different from previous experience, including more frequent and longer sessions, the use of collaborative empiricism, developing case conceptualizations, and tolerating negative affective arousal. Moreover, training climates in psychiatry departments may shape the supervision experiences. Various specific recommendations are offered to manage these crucibles. Overall, although there are significant challenges when supervising child residents in CBT rotations, having knowledge of these crucibles and access to choices for addressing these supervisory tests enhances both supervisor and supervisee competence.

Cognitive-behavioral treatment of a second-generation child of Pakistani descent: Ethnocultural and clinical considerations

Ethnocultural variables in cognitive behavioral therapy (CBT) are gaining an increasing amount of attention. This is a welcome development since cultural responsiveness is a core element in ethical and effective CBT practice. However, the literature is sparse and generally silent regarding CBT with children of Pakistani descent. Accordingly, this case based article attempts to close the knowledge gap by reviewing the extant literature pertaining to the role of religion, help seeking behavior, and emotional expression in Pakistani families. The literature review is followed by a case discussion of an 11 year old second generation Pakistani male living in the United Kingdom who is struggling with posttraumatic stress disorder (PTSD). The case presentation highlights the importance of culturally informed case conceptualization and individually tailored interventions. The case illustrates the way cognitive behavioral psychotherapy balanced empirically based procedures with a sensitive appreciation of cultural context.

Comparison of self-and other-report of symptoms of autism and comorbid psychopathology in adults with autism spectrum disorder

While the presentation of autism-related symptoms is variable across individuals with ASD, there is growing evidence that many of these symptoms may be further complicated or exacerbated by comorbid symptoms of psychopathology. Some individuals with ASD may also have difficulty reflecting and reporting on their own behavioral and emotional symptoms, which can interfere with diagnosis and treatment. The current study compared selfand other-ratings of the behavior of 47 young adults with ASD in the home environment, to identify areas of rater agreement and discrepancy across symptoms of both ASD and general pathology. For ASD symptoms, nominated reporters rated the participant’s behavior as significantly more impaired regarding social communication symptoms, but no significant difference was found for restricted and repetitive behavior. For symptoms of psychopathology, only attention problems, depression problems, avoidant personality problems, and total problems were reported by others as significantly higher when compared to self-report. While this provides increased confidence for assessing most comorbid symptoms of psychopathology via one reporter, results suggest obtaining collateral reports for ASD symptoms may be important for comprehensive assessment. The results from this study may inform the future of the clinical field regarding the use of a more efficient assessment of individuals with ASD’s behavior and comorbid psychopathology. Correspondence to: Amanda M. Pearl, PhD, Assistant Professor of Psychiatry, Division of Autism Services, Penn State Hershey, 500 University Drive Hershey, PA 17033, USA, E-mail: apearl@pennstatehealth.psu.edu

Methods and Procedures for Measuring Comorbid Disorders: Psychological

It is critical to identify the frequency and severity of various comorbid psychological problems if they are to be effectively treated. Among the autism spectrum disorder (ASD) population challenging behaviors, attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, and depression are among the most common of these problems. The purpose of this chapter is to review methods that have been designed to measure these problems and related psychological problems.

Intelligence Testing and Treatment Planning with Children

The role of intelligence testing as a central part of treatment planning is reviewed. The specific components identified components of intelligence (such as fluid and crystallized intelligence; simultaneous and sequential intelligence) and how these are used in treatment planning is discussed. Several major intelligence tests are described, and how these are utilized in developing treatment plans for childhood anxiety is discussed.