Astrida S. Kaugars

Emotion in Children's Play and Creative Problem Solving

Theoretically, pretend play facilitates cognitive and affective processes important in creativity. Expression of affect states and affect-laden fantasy are affective processes common to both play and creativity. This study investigated the effect of instructing children to engage in happy or angry play on affect in play and on divergent thinking. Eighty 1st- and 2nd-grade children were randomly assigned to 1 of 4 groups. It was hypothesized that children in the happy and angry puppet play groups would have more affect in their play and that their mood would be congruent with the play instruction. It was also hypothesized that children in the happy and angry groups would have higher divergent thinking scores than children in the free-play and puzzle conditions. One major finding was that children in the angry play group had more expression of negative affect in their play and more self-reported negative mood than children in the other groups. There were no differences among the experimental groups in divergent thinking. However, self-reported mood during the play and puzzle tasks was significantly associated with originality of the divergent thinking responses. Children who experienced more affect as opposed to feeling neutral gave more original responses. The major conclusion of the study is that the play paradigm can be used to study affective processes in children.

Child and family functioning 6 and 12 months after a serious pediatric fracture.

BACKGROUND Previous findings indicate that pediatric fractures can have adverse consequences for child adjustment and family functioning immediately after injury. However, longer term effects of the fractures are unknown. The purposes of the present prospective study were to examine the child and family outcomes of pediatric traumatic fractures at 6 months and 1 year after injury, and to identify injury and treatment factors associated with these outcomes. METHODS We evaluated 57 children 6 to 12 years of age with traumatic fractures requiring hospitalization. Using standardized measures and parent interview, we obtained measures of pre- and postinjury child and family functioning. RESULTS Although outcomes were primarily positive at 1 year after injury, child functional limitations and family stress were observed up to 6 months after injury. Lower extremity fractures had a more negative impact on families across all three assessment points. Children with fracture interventions that involved prolonged immobilization had more functional limitations at 6 months than children who were ambulatory. Family burden was higher at 1 month for the immobilized children, but not at later follow-up. CONCLUSION Some children and families experience adverse effects during the year after a serious pediatric fracture, especially if sustained in a lower extremity. Fracture stabilization that allows for greater ambulation may offer some benefits related to functional outcomes and family impact.

Assessing Preschool Children's Pretend Play: Preliminary Validation of the Affect in Play Scale-Preschool Version

Research Findings: A description of the development and preliminary validation of the Affect in Play Scale-Preschool version (APS-P) is presented by demonstrating associations among preschool childrens play, creativity, and daily behavior using multiple methodologies. Thirty-three preschool-age children completed a standardized 5-minute play task and a measure of creativity. Teachers answered questions about childrens daily play behavior, affective expression, social competence, and adjustment. Good interrater reliability and internal consistency were demonstrated for the APS-P. Affect expression and fantasy in 5 minutes of play were related to theoretically and empirically relevant constructs such as daily play behavior, creativity, and social competence. Practice or Policy: Results support the use of the APS-P as a potentially valuable tool for assessing developments and changes in both affective and cognitive dimensions of preschool childrens play.

Use of the Family Interaction Macro-coding System with Families of Adolescents: Psychometric Properties Among Pediatric and Healthy Populations

OBJECTIVE To examine reliability and validity data for the Family Interaction Macro-coding System (FIMS) with adolescents with spina bifida (SB), adolescents with type 1 diabetes mellitus (T1DM), and healthy adolescents and their families. METHODS Sixty-eight families of children with SB, 58 families of adolescents with T1DM, and 68 families in a healthy comparison group completed family interaction tasks and self-report questionnaires. Trained coders rated family interactions using the FIMS. RESULTS Acceptable interrater and scale reliabilities were obtained for FIMS items and subscales. Observed FIMS parental acceptance, parental behavioral control, parental psychological control, family cohesion, and family conflict scores demonstrated convergent validity with conceptually similar self-report measures. CONCLUSIONS Preliminary evidence supports the use of the FIMS with families of youths with SB and T1DM and healthy youths. Future research on overall family functioning may be enhanced by use of the FIMS.

Exploratory analysis of the relationships among different methods of assessing adherence and glycemic control in youth with type 1 diabetes mellitus.

OBJECTIVES The present study examined four methods of assessing diabetes adherence (self-report, diary measure, electronic monitoring, and provider rating) within a population of youth with Type I Diabetes Mellitus (T1DM). METHODS Comparisons were conducted among the four methods of assessing diabetes adherence. Associations among the seven different measures of blood glucose monitoring (BGM) and HbA1c were examined. An exploratory stepwise regression analysis was conducted to determine the best predictors of glycemic control (i.e., Hemoglobin A1c; HbA1c) while controlling for relevant demographic variables. RESULTS The adherence measures appeared to be interrelated. The relationships between many of the BGM measures and HbA1c demonstrated a medium effect size. The Self Care Inventory (SCI) adjusted global score was the strongest predictor of HbA1c, even after taking the demographic variables into account. CONCLUSIONS The SCI is a robust, easy-to-use, and cost-efficient measure of adherence that has a strong relationship to HbA1c. Demographic variables are important to examine within the context of different methods of assessing adherence. The research methodology utilized to assess both general diabetes adherence and more specific behavioral measurements of BGM should be clearly documented in future studies to ensure accurate interpretation of results.

Sibling relationships and behavior after pediatric traumatic brain injury.

ABSTRACT. To evaluate long-term outcomes for siblings of children with traumatic brain injury (TBI), measures of sibling relationships and sibling behavior were collected an average of 4 years postinjury. The study sample included participants in a larger longitudinal study who had school-aged siblings, including 34 with severe TBI, 30 with moderate TBI, and 39 with orthopedic injuries not involving brain insult (ORTHO group). Group comparisons revealed more negative sibling relationships in families of children with TBI than in families of children in the ORTHO group, but only for mixed-gender sibling pairings. Behavior problems in children with TBI predicted both sibling relationships and sibling behavior problems. The findings indicate a need to monitor the adjustment of siblings and sibling relationships after TBI and to include siblings in family interventions.

Assessing readiness to change the balance of responsibility for managing type 1 diabetes mellitus: Adolescent, mother, and father perspectives

Kaugars AS, Kichler JC, Alemzadeh R. Assessing readiness to change the balance of responsibility for managing type 1 diabetes mellitus: adolescent, mother, and father perspectives.

Exploring self-management characteristics in youths with type 1 diabetes mellitus: does membership in a glycemic control category matter?

Kichler JC, Kaugars AS, Ellis J, Alemzadeh R. Exploring self‐management characteristics in youths with type 1 diabetes mellitus: does membership in a glycemic control category matter?

Associations Among Parent-Child Relationships and Cognitive and Language Outcomes in A Clinical Sample of Preschool Children

Abstract Objective: To examine associations among parent–child relationship characteristics and child cognitive and language outcomes. Methods: Preschool children (n = 72) with early neurological insult completed assessments of cognitive and language functioning and participated in a parent–child semi-structured interaction. Results: Quality of the parent–child relationship accounted for a significant amount of unique variance (12%) in predicting children’s overall cognitive and language functioning. Impact of neurological insult was a significant predictor. Conclusions: Caregiver–child interactions that are harmonious and reciprocal as evidenced by affective and/or verbal exchanges support children’s cognitive and language development. Observations of interactions can guide providers in facilitating child- and family-centered interventions.

Behavioral Factors Influencing Health Outcomes in Youth with Type 1 Diabetes

The Pediatric Self-Management Model provides an overview of how behavioral factors influence children’s chronic medical illnesses. This general framework is used to organize the present review of how self-management behaviors, contextual factors, and processes impact health outcomes for adolescent youth with type 1 diabetes. Adherence has been widely studied in the diabetes literature, and there are consistent findings demonstrating associations between aspects of self-management, adherence, and metabolic control, yet there are still equivocal approaches to adherence assessment methodology (e.g. global versus specific measures). Metabolic control is a hallmark health outcome for youth with type 1 diabetes, but additional outcomes need to be further explored. Future research should utilize the Pediatric Self-Management Model’s operational definitions to guide empirically-supported interventions for youth with type 1 diabetes.