Donald J. Carek

Controlling Childhood Rumination through Differential Reinforcement of other Behavior

Rumination is a rare behavior disorder of childhood involving regurgitation of food which is then ejected or reswallowed. The present study investigated the control of rumination through use of a positive reinforcer (a mixture of honey and water) delivered on a differential reinforcement of other behavior (DRO) schedule. The subject was a 26-month-old girl who had lost 50% of body weight through rumination. DRO was used as part of a multifaceted treatment program which also included, at different phases, punishment and time out from positive reinforcement. Evaluation of treatment components via a single-subject experimental design with withdrawals indicated the DRO procedure exerted powerful controlling effects over rumination. Transfer of control to social consequences was attempted through use of time out with punishment. The subjects weight increased over her 69-day hospitalization from 7.1 kg. to 11 kg. A 10-month followup revealed continued weight gain and suppression of rumination. Possible limitations to generalizability of findings, particularly previous experience with punishment, are discussed as are advantages of DRO in the management of this behavior problem.

Mothers' Reactions to Their Newborn Infants

Abstract A detailed examination of videotapes taken at the time of the newborns presentation to his or her mother and a follow-up of these mothers and their infants at 6 months was undertaken. The correlations between the delivery room behaviors and later maternal and child behaviors were examined. Emphasis is on the need for clinical attentiveness to those delivery room variables that may impede the process of mother-infant bonding. A mothers mixed feelings about the sex of her child and the pain she experiences at the time of presentation are proposed as possible factors that may impede this process.

Intelligence and Emotional/Behavioral Factors as Correlates of Achievement in Child Psychiatric Inpatients

This study investigated the extent to which IQ and emotional/behavioral factors were related to tested academic achievement in 56 child psychiatric inpatients. The first part of the study replicated and extended previous research; WISC—R IQs were highly correlated with tested achievement, Verbal IQs being more highly correlated with achievement than were Performance or Full Scale IQs. In the second part of the study which examined the relationship between the emotional/behavioral indices and achievement, only Trait Anxiety correlated significantly with achievement. However, after the relationship between Trait Anxiety and Verbal IQ was partialed out, the correlation between anxiety and achievement was no longer significant. These findings raise questions regarding the magnitude of the relationship between measures of emotional/behavioral status and tested academic achievement within a single sample of emotionally disturbed children and 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.

A study of a child psychiatrist's interventions.

Psychiatric assessment and interventions with 73 child and adolescent patients, and follow-up 1 year after the last clinical visit, are reported. The interventions were based on individual psychodynamic principles with the focus on the experience and expression of affect. It is proposed that many child psychiatric patients are likely to require very limited interventions over a brief period of time and that relatively few may be in need of, or candidates for, long-term individual psychodynamic psychotherapy.

Focus on affect. The pediatrician and empathic confrontation.

* Professor of Psychiatry and Pediatrics, Chief, Youth Division, Department of Psychiatry, Medical University of South Carolina, 80 Barre Street, Charleston, SC 29401. THE PEDIATRICIAN is now expected to provide comprehensive care to meet a child’s total needs in the psychologic as well as the physiologic realm. As Lourie anticipated in 1962, &dquo;the future c>f’ child psychiatry is in pediatrics and the future of pediatrics is in child psychiatry,&dquo; with the lirles of demarcation less and less marked.’ Yet the rotes of the