Ineke Pit-Ten Cate

Disability and quality of life in spina bifida and hydrocephalus

This study examined the impact of severity and type of condition and family resources on quality of life in children with spina bifida and hydrocephalus. A national UK sample of children aged between 6 and 13 years with spina bifida (n=62), hydrocephalus (n=354), and spina bifida plus hydrocephalus (n=128) were identified via the register of the Association for Spina Bifida and Hydrocephalus (ASBAH). Parents completed standardized measures of Child Health Related Quality Of Life (CQOL), family needs survey (FNS), and caregiving self-efficacy scale (CSES) as well as questions on childrens health and physical ability. Results showed there were no significant differences in the overall quality of life for the three disability conditions. The overall CQOL was over 1 SD lower for those with spina bifida and hydrocephalus than for children with other physical conditions. Sex and age were not related to overall CQOL. Specific aspects of CQOL differentiated the three groups. Children with spina bifida had poorer CQOL scores on self-care, continence, and mobility/activities whilst those with hydrocephalus had poorer scores on school activities, worries, sight, and communication. Severity of condition and family resources, i.e. CSES and FNS, predicted 32% of the variance in CQOL. Associations were also found between overall CQOL and problems discernible at birth as well as epilepsy. Other factors, including those related to shunts, were not significantly related to CQOL. It was concluded that hydrocephalus is just as great a threat to CQOL as spina bifida. Beyond the general effect of condition severity on CQOL, family resources (as measured by the CSES and FNS) represent an additional influence on CQOL.

Behaviour difficulties and cognitive function in children born very prematurely

Children born very prematurely are at risk of low average IQ and behaviour difficulties throughout childhood and adolescence. Associations among preterm birth, IQ and behaviour have been reported; however, the nature of the relationship among these outcomes is not fully understood. Some studies have proposed that the consequences of preterm birth, such as low average IQ, mediate the association between preterm birth and later behaviour difficulties. The aim of this study was to investigate the relationship among preterm birth, IQ and childhood behaviour problems, by testing mediation and moderation models. We assessed a UK sample of 69 very preterm (< 32 weeks gestational age) and 70 term born children aged between 6 and 12 years on an abbreviated IQ test. Parental behaviour ratings were obtained using the Strengths and Difficulties Questionnaire. Mediation and moderation models were tested using hierarchical regression analyses. The findings indicate that IQ mediates the relationship between birth status and emotional behaviour problems. Furthermore, the results indicate that birth status moderates the relationship between IQ and behavioural difficulties, i.e., that the relationship between low IQ and behaviour problems is most pronounced for the preterm children. The findings highlight the importance of considering indirect effects in the study of outcome after very preterm birth.

Team approaches to treating children with disabilities: A comparison

OBJECTIVE To investigate differences in team functioning between the multidisciplinary and transdisciplinary models when treating children with disabilities. DESIGN A crossover trial. SETTING An outpatient educational and rehabilitation program in a rehabilitation institute based at a university medical center. PARTICIPANTS A population-based sample of 19 rehabilitation specialists and educators. INTERVENTION Participants attended four team meetings using the multidisciplinary approach and then attended four team meetings using the transdisciplinary approach. OUTCOME MEASURES Behavioral ratings of team participation (Transdisciplinary Team Rating Scale) and self-report instruments of team development (Team Assessment Questionnaire) and treatment planning and goal development (Staff Perception Questionnaire). RESULTS Results of t tests confirmed the hypothesis that there was more team member participation during transdisciplinary meetings than during multidisciplinary meetings (p=.027). There were no differences in levels of team development (p=.329); however, staff members favored the transdisciplinary model for treatment planning and goal development (p < .001). CONCLUSION This study provides evidence of the effectiveness of the transdisciplinary model. Further research is now needed to investigate outcome variables such as rate of success in attaining treatment goals when using this model.

Grandparent support for mothers of children with and without physical disabilities

Grandparents’ support to families of children with disabilities is generally associated with improved parental well-being. Little research addresses the question of quantitative differences in grandparent support to families of children with and without disabilities. This article examines such differences. Data was collected on 50 mothers of children with spina bifida and 43 mothers of children without disabilities and results showed how mothers rated perceived maternal and paternal grandparent support. No differences were found between mothers of children with and without disabilities. These results confirm previous findings that grandparent support appears to be no more frequent in families of children with disabilities than in other families. These findings are discussed with reference to sampling limitations and implications for further research.

Empathy in Preschool Children: The Development of the Southampton Test of Empathy for Preschoolers (STEP).

In this study, we investigated a new instrument: the Southampton Test of Empathy for Preschoolers (STEP). The test incorporated 8 video vignettes of children in emotional scenarios, assessing a childs ability to understand (STEP-UND) and share (STEP-SHA) in the emotional experience of a story protagonist. Each vignette included 4 emotions (angry, happy, fearful, sad) that reflected emotion judgments based on the protagonists facial expression, situation, verbal cues, and desire. The STEP was administered to 39 preschool children, and internal reliability, concurrent validity, and construct validity were addressed. The results showed good internal consistency. They also highlighted moderate concurrent validity with parent-rated empathy, a measure of facial indices, and construct validity with teacher-rated prosocial behavior.

When chronic disability meets acute stress: psychological and functional changes

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The Nature of Hyperactivity in Children and Adolescents With Hydrocephalus: A Test of the Dual Pathway Model

To determine the strength and nature of the association between hydrocephalus and hyperactivity and to test the dual pathway model (DPM) of AD/HD, we compared a group of 51 children and adolescents with hydrocephalus with 57 normally developing controls from the general population on a battery of neuropsychological assessments. The mean hyperactivity scores were significantly greater in the group with hydrocephalus (effect size =0.94). This association was not just part of a general elevated rate of behavior problems and was not affected by sex or age. Variation in the clinical features of hydrocephalus was not related to the severity of hyperactivity. Path analysis was used to examine the relation between IQ, delay aversion, and executive function. In accordance with the DPM, the effect of hydrocephalus on hyperactivity was completely mediated via delay aversion and executive functions.

Improving Teachers’ Judgments

A central aspect of teachers’ professional competence is the ability to judge students’ achievements adequately. Giving grades and marks is the prototypical task in this context. Besides giving grades, assessments for school placements or tracking decisions belong to these tasks. Other judgments are more implicit in that no specific judgment is required, but students’ achievements are estimated intuitively. Examples are decisions made during class such as “calling on a particular student”.

Reliability and Validity of the Southern California Ordinal Scales of Development for a Sample of Young Children with Disabilities

The primary purpose of this study was to investigate the reliability and validity of the Southern California Ordinal Scales of Development (SCOSD). The SCOSD is a criterion-referenced test that assesses six domains of development and was designed for use with children with disabilities. Results found that the SCOSD alpha internal consistency coefficients ranged from .94 to .98; percent agreement between raters ranged from 85% to 100%; and interrater correlations ranged from .96 to .99. Strong intercorrelations were found between the SCOSD and standardized domain-specific instruments (.65 to .92), providing evidence of concurrent validity. The secondary purpose was to investigate patterns of development across domains of the childrens functioning. As expected, results revealed a hierarchy of skill development, with the children showing relatively less development in gross-motor skills and practical abilities.

Teachers’ Judgments and Decision-Making: Studies Concerning the Transition from Primary to Secondary Education and Their Implications for Teacher Education

Accuracy in assessing academic achievement and potential is a core component of teachers’ diagnostic competence. Large-scale studies in the Luxembourgish and German educational systems show that teachers’ secondary school track decisions are biased by a student’s social background. Therefore, biased assessment of students may contribute to the social inequalities observed in secondary schools in both countries. Within a social cognitive framework of dual-process theories, bias is explained by heuristic information processing, which, in contrast to information-integrating processing, relies on stereotype-based expectations to form judgments about students. A series of experimental studies investigated the information processing strategies of teachers, identifying a low accountability of the decision setting and a high consistency of student information as key moderators that promote stereotype-based information processing strategies in teachers’ school track decisions. Results on intervention modules gave insights how to increase diagnostic competence in teacher education programs.