Amy C. Tishelman

Parental problem-solving skills and child behavior problems: A comparison of physically abusive, neglectful, clinic, and community families

Failure to solve problems related to parenting and other aspects of daily living is hypothesized to result in frustration or inability to cope, and lead to deviant parental behavior such as aggression or neglect. The present investigation provided support for a procedure for measuring parental problem-solving skill and compared the problem-solving abilities and child behavior problems of maltreating and nonmaltreating parents. Subjects were 40 parents with at least one child between the ages of three and twelve. Subjects were assigned to one of four groups: (a) physically abusive parents (n = 9); (b) neglectful parents (n = 9); (c) nonmaltreating clinic parents seeking help for child behavior problems (n = 11); and (d) nonmaltreating, non-help-seeking community parents (n = 11). Abusive and neglectful parents were deficient in problem-solving skill as compared to clinic and community parents, yet there were many similarities in parental reports of child behavior problems for maltreating and nonmaltreating parents. Parental problem-solving skill did not correlate significantly with parental ratings of child behavior problems.

The gender affirmative model: What we know and what we aim to learn

in which he stated: ‘‘Cur-rently experts can’t tell apart kids who outgrow gender dysphoria (desisters) from those who do not (persisters), and how to treat them is controversial’’ [Drescher, 2013, p. 1]. As members of a four-site child gender clinic group, we concur with Dr. Drescher regarding the controversy, but take issue with his assessment of experts and their inability to differentially assess ‘‘persisters’’ and ‘‘desisters’’ in childhood. We would like to take this opportunity to outline the gender affirmative model from which we practice, dispel myths about this model, and briefly outline the state of knowledge in our field regarding facilitators of healthy psychosocial development in gender-nonconforming children. The major premises informing our modes of prac-tice include: (a) gender variations are not disorders; (b) gender presentations are di-verse and varied across cultures, therefore requiring our cultural sensitivity; (c) to the best of our knowledge at present, gender involves an interweaving of biology, devel-opment and socialization, and culture and context, with all three bearing on any in-dividual’s gender self; (d) gender may be fluid, and is not binary, both at a particular time and if and when it changes within an individual across time; (e) if there is pathol-ogy, it more often stems from cultural reactions (e.g., transphobia, homophobia, sex-ism) rather than from within the child.Our goals within this model are to listen to the child and decipher with the help of parents or caregivers what the child is communicating about both gender identity and gender expressions. We define gender identity as the gender the child articulates

An investigation of the test-retest reliability of the stroop colorword test across two intervals

The Stroop Color- Word Test is frequently used in neuropsychological settings. However, there has been no rigorous evaluation of the test-retest reliability of the commercially available version of the Stroop. The present study investigated the test-retest reliability of the Stroop across two different time intervals. In addition, the standard error of prediction and the standard error of differences were computed, and applications of the results to the use of the Stroop to document change in cognitive rehabilitation are discussed.

Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents

Evidence indicates an overrepresentation of youth with co-occurring autism spectrum disorders (ASD) and gender dysphoria (GD). The clinical assessment and treatment of adolescents with this co-occurrence is often complex, related to the developmental aspects of ASD. There are no guidelines for clinical care when ASD and GD co-occur; however, there are clinicians and researchers experienced in this co-occurrence. This study develops initial clinical consensus guidelines for the assessment and care of adolescents with co-occurring ASD and GD, from the best clinical practices of current experts in the field. Expert participants were identified through a comprehensive international search process and invited to participate in a two-stage Delphi procedure to form clinical consensus statements. The Delphi Method is a well-studied research methodology for obtaining consensus among experts to define appropriate clinical care. Of 30 potential experts identified, 22 met criteria as expert in co-occurring ASD and GD youth and participated. Textual data divided into the following data nodes: guidelines for assessment; guidelines for treatment; six primary clinical/psychosocial challenges: social functioning, medical treatments and medical safety, risk of victimization/safety, school, and transition to adulthood issues (i.e., employment and romantic relationships). With a cutoff of 75% consensus for inclusion, identified experts produced a set of initial guidelines for clinical care. Primary themes include the importance of assessment for GD in ASD, and vice versa, as well as an extended diagnostic period, often with overlap/blurring of treatment and assessment.

Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic

PURPOSE There is evolving evidence that children and adolescents with gender dysphoria have higher-than-expected rates of autism spectrum disorder (ASD), yet clinical data on ASD among youth with gender dysphoria remain limited, particularly in North America. This report aims to fill this gap. METHODS We conducted a retrospective review of patient chart data from 39 consecutive youth ages 8 to 20 years (mean age 15.8 years, natal male: n = 22, natal female: n = 17) presenting for evaluation at a multidisciplinary gender clinic in a large U.S. pediatric hospital from 2007 to 2011 to evaluate the prevalence of ASD in this patient population. RESULTS Overall, 23.1% of patients (9/39) presenting with gender dysphoria had possible, likely, or very likely Asperger syndrome as measured by the Asperger Syndrome Diagnostic Scale (ASDS). CONCLUSION These findings are consistent with growing evidence supporting increased prevalence of ASD in gender dysphoric children. To guide provision of optimal clinical care and therapeutic intervention, routine assessment of ASD is recommended in youth presenting for gender dysphoria.

A Framework for School-Based Psychological Evaluations: Utilizing a ‘Trauma Lens’

Despite an increased recognition of the prevalence of exposure to traumatic stress in the lives of children, relatively little attention has been devoted to their socioemotional functioning and learning experiences at school. This article identifies a framework for trauma-informed psychological evaluation practices adapted to a school setting to facilitate the development of intervention strategies to account for trauma-related obstacles to learning. Specifically, the goals of the current article include the following: (a) to provide a discussion of critical considerations or roadblocks that create challenges for the assessment of traumatized children at school, (b) to identify several primary functional domains in which children manifest trauma-related difficulties at school, (c) to identify core issues that characterize each functional domain, and (d) to propose a general framework for evaluating these issues.

The Clinical–Forensic Dichotomy in Sexual Abuse Evaluations: Moving Toward an Integrative Model

We propose the use of an approach to evaluation that can be undertaken in a clinical setting when concerns regarding child sexual abuse are unclear or ambiguous and other systems are not involved, thus providing an option for the nondisclosing child often discussed in the “delayed disclosure” literature. This approach can also be appropriate for a child with a questionable prior disclosure not being served by other intervention systems. We have labeled this an “integrative” model, incorporating forensically sound practices into evaluations conducted in a clinical setting. The goals of this manuscript are to (a) provide a rationale for conducting child sexual abuse extended evaluations in a clinical setting, (b) delineate the purposes of such evaluations, (c) differentiate this “integrative” model from the forensic–clinical dichotomy framework discussed by Kuehnle (1996), and (d) briefly describe the format, which can be refined by future practice and research.

Forensic, Cultural, and Systems Issues in Child Sexual Abuse Cases—Part 1: An Introduction

This article introduces the first in a two-part special issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. The five articles contained in this issue include a diversity of perspectives on approaches to extended interviews and evaluations of child sexual abuse suspicions, an exploration of the ways culture affects child sexual abuse disclosure and reporting, considerations relevant to the management of a childs mental health needs while forensic process are ongoing, and the use of anatomical dolls in forensic interviews. We call for attention to several practice areas, including (a) prioritizing a childs mental health needs while minimizing disruption of forensic processes, (b) developing best practices and models of child sexual abuse assessment and evaluation when a one-session forensic interview is insufficient, (c) appropriately evaluating child sexual abuse concerns when they occur without a disclosure and/or in children with communication limitations, and (d) the integration of cultural sensitivity into interviews and evaluations.

Influence of information related to child physical abuse on professional ratings of adjustment and prognosis

The study investigates the influence of access to information of a history of physical maltreatment on the evaluative responding of social service and clinical psychology professionals. Written vignettes were used in a 2 x 2 x 2 factorial design to manipulate the: (a) presence/absence of abuse history; (b) presence/absence of behavior problems; and (c) gender of the child. Professionals rated children presented in 12 case vignettes along five treatment-related dimensions: (a) overall adjustment; (b) predicted 6 months temporal stability of behavior; (c) likelihood of treatment referral; (d) expected home intervention success; and (e) expected school intervention success. Four dimensions related to social functioning were also rated, including likelihood of the child being: (a) recommended to serve as assistant to teacher; (b) elected as a school activity team leader; (c) elected as a class officer; and (d) nominated as a candidate for successful completion of a summer camp program. The findings verified the influence of information related to a history of maltreatment of professional judgments, despite matched vignette content for all factors other than maltreatment status. The results suggests a possible failure to recognize that some children have been buffered from the negative effects of abuse and point to the risk of erroneous judgments that may be directed toward maltreated children.

Preliminary data concerning the test-retest and parallel-forms reliability of the randt memory test

Abstract The Randt Memory Test was designed to measure a fairly broad range of memory functions, including immediate recall and retrieval from long-term memory storage. Five alternate forms of the Randt are available to minimize the possibility of practice effects. However, its test-retest and parallel-form reliability have not been sufficiently investigated. In Study 1, the test-retest reliability of Form A of the Randt across 1 - and 2-week intervals was investigated with 56 undergraduate university students. Results indicated significant increases in the mean scores obtained on the retest occasion for both 1- and 2-week retest intervals. The effect of the length of retest interval was not significant. In Study 2, the parallel-form reliability of Forms A and B of the Randt was investigated. Results of the analyses indicated no significant differences between scores obtained from Form A and Form B. Overall, the results of the two studies indicated the presence of significant practice effects for Form A o...