Kimberly A. Driscoll

Phonological Sensitivity: A Quasi-Parallel Progression of Word Structure Units and Cognitive Operations.

This study investigated the order of acquisition of phonological sensitivity skills among preschool and kindergarten children. Phonological sensitivity was examined in terms of four levels of linguistic complexity (words, syllables, onsets and rimes, phonemes) across four levels of task complexity (blending detection, elision detection, blending, and elision). Participants were 947 two- to five-year-old children from diverse backgrounds. Hierarchical loglinear analyses evidenced a quasi-parallel pattern of development that corresponded to a hierarchical model of word structure and a working memory model of task complexity. Findings support a developmental conceptualization of phonological sensitivity. Findings are discussed in relation to their implications for improving assessment, early literacy instruction, and prevention of reading difficulties.

Health-Related Quality of Life across Pediatric Chronic Conditions

OBJECTIVE To compare health-related quality of life (HRQOL) across 8 pediatric chronic conditions, including 5 understudied populations, and examine convergence between youth self-report and parent-proxy report. STUDY DESIGN Secondary data from 589 patients and their caregivers were collected across the following conditions: obesity, eosinophilic gastrointestinal disorder, inflammatory bowel disease, epilepsy, type 1 diabetes, sickle cell disease, post-renal transplantation, and cystic fibrosis. Youth and caregivers completed age-appropriate self-report and/or parent-proxy report generic HRQOL measures. RESULTS Youth diagnosed with eosinophilic gastrointestinal disorder and obesity had lower HRQOL than other pediatric conditions by parent report. Caregivers reported lower HRQOL by proxy report than youth self-reported across most subscales. CONCLUSIONS Use of brief, easily administered, and reliable assessments of psychosocial functioning, such as HRQOL, may provide clinicians additional opportunities for intervention or services targeting improved HRQOL relative to the needs of each population.

Family Functioning in the Context of Pediatric Chronic Conditions

Objective: The aims were to describe and compare generic family functioning in children with five different chronic conditions and healthy comparisons, and to examine the relations between family functioning and sociodemographic variables. Methods: A secondary data analysis from six independent studies including 301 children (cystic fibrosis: n = 59; obesity: n = 28; sickle cell disease: n = 44; inflammatory bowel disease: n = 43; epilepsy: n = 70; healthy comparison group: n = 57) was conducted. In each study, parents completed the Family Assessment Device. Results: Across all five chronic conditions, between 13% and 36% of families endorsed levels of functioning in the “unhealthy” range, with the greatest proportions in the following domains: communication, roles, and affective involvement. No significant group (i.e., between all six groups, namely five chronic conditions as well as healthy comparisons) differences were observed on Family Assessment Device scales (model F [35, 1335] = 0.81, p = .79). Older child age, fewer children living in the home, and lower household income were significantly related to poorer family functioning in the areas of communication, roles, affective involvement, and general functioning. Conclusions: Families of children with and without chronic conditions do not differ significantly from each other on generic family functioning. However, risk factors for poor family functioning include older child age, less children in the home, and lower household income. These risk factors combined with data suggesting that a subset of families exhibit “unhealthy functioning” warrants the need for close monitoring of how families function in the context of a pediatric condition.

Positive and Negative Affectivity in Children: A Multitrait-Multimethod Investigation

Examined the validity of the tripartite model of anxiety and depression and its internal structure in children. Measures of positive affect/surgency (PA/S) and negative affect/neuroticism (NA/N) and self-report and peer nominations of symptoms of depression and anxiety were completed by 104 children (mean age = 14.9 years, SD = 1.9). Parents completed measures of temperament and anxious and depressive symptoms. Multitrait-multimethod and confirmatory factor analyses (CFA) supported a 3-factor model that included separate Child and Parent NA/N factors and a joint PA/S factor. Child and Parent NA/N were related to symptoms of both depression and anxiety, but neither parent nor peer symptom ratings related to Child NA/N. PA/S was primarily related to symptoms of depression. These results support aspects of the tripartite model in children and suggest caution in the use of multimethod assessment of childrens temperament and internalizing symptoms.

A Computer-Assisted Instruction Phonological Sensitivity Program for Preschool Children At-Risk for Reading Problems:

Previous research has demonstrated that phonological sensitivity is an important causal skill for decoding. This study evaluated the use of computer-assisted instruction (CAI) to provide training in phonological sensitivity skills to preschoolers at-risk for reading problems. Forty-five children ranging in age from 44 to 64 months (M = 55.1, SD = 6.07) were randomly assigned to a CAI group or a control group. Children exposed to CAI made significantly greater gains on rhyming and elision skills compared to the control group. Expressive vocabulary scores were predictive of pre- to posttest growth. Children in the CAI condition positively rated participation in the training program. Results provide preliminary support for CAI to improve the phonological sensitivity skills of preschoolers who are at-risk.

Reliability, validity, and responsiveness of the pediatric quality of life inventory (PedsQL) generic core scales and asthma symptoms scale in vulnerable children with asthma.

Background. Patient-reported outcomes such as health-related quality of life (HRQOL) are increasingly used as primary endpoints in clinical trials. The Pediatric Quality of Life Inventory™ (PedsQL™) is widely used as a measure of HRQOL and may be a particularly suitable primary outcome in pediatric asthma clinical trials. Objectives. To examine the reliability, validity, and responsiveness to clinical change of the PedsQL™ 4.0 Generic Core Scales and PedsQL™ Asthma Module Asthma Symptoms Scale in a sample of vulnerable children with persistent asthma recruited from Federally Qualified Health Centers. Methods. Children (N = 252; ages 3 to 14 years) with persistent asthma (27% mild, 40.9% moderate, 32.1% severe) and their parents (93.7% mother, 83.3% Hispanic, 76.9% Spanish-speaking, 72.6% less than a high school diploma) enrolled in a clinical trial completed the PedsQL™ 4.0 Generic Core Scales, the PedsQL™ 3.0 Asthma Module Asthma Symptoms Scale, and a measure of asthma symptom frequency (used as an indicator of clinical change) at baseline and 3-month follow-up. Results. The PedsQL™ demonstrated adequate internal consistency reliability and convergent and discriminative validity. Based on intra- and intersubject change, effect sizes, and standard errors of measurement, the PedsQL™ demonstrated responsiveness to clinical change. Conclusions. For both child self-report and parent proxy-report, the PedsQL™ Generic Core Scales Total Scale score and the PedsQL™ Asthma Symptoms Scale are suitable for use as primary asthma clinical trial outcomes.

Sex Differences and Response Styles: Subtypes of Rumination and Associations with Depressive Symptoms

In view of recent findings regarding the multifaceted nature of rumination in adults and older adolescents, the purpose of this study was to evaluate the construct of rumination as a 2-factor model (brooding and reflection) in a child and early adolescent sample as well as examine sex differences and associations between depressive symptoms and these ruminative subtypes. Participants were children in 2nd through 7th grades (N = 303). Results of a confirmatory factor analysis supported the hypothesis that subtypes of rumination (2-factor model) are present in children and provided a better fit than a unitary construct of rumination (1-factor model). As predicted, girls endorsed higher levels of brooding than boys, and brooding (not reflection) was uniquely related to depressive symptoms. Results revealed that a distinction between brooding and reflection subtypes is warranted as it can help lead to better assessment and identification of risk factors of depression.

Improved Treatment Outcome Associated With the Shift to Empirically Supported Treatments in a Graduate Training Clinic

There has been an increase in recent years in the use of empirically supported treatments (ESTs) for a variety of mental disorders. This study was an investigation of the impact of standardized use of ESTs in an outpatient community clinic. Clients treated prior to and those treated after the implementation of this policy were compared. The results indicate significant group differences, with the improvement ratings of the group receiving ESTs surpassing those of the group receiving unsupported treatment. Support for the use of ESTs indicates that patients may be best served if therapists rely primarily on these treatments.

Risk Factors Associated with Depressive Symptoms in Caregivers of Children with Type 1 Diabetes or Cystic Fibrosis

OBJECTIVE Evaluate depressive symptoms in caregivers of children with type 1 diabetes (T1D) or cystic fibrosis (CF) and identify associated risk factors. METHODS A total of 195 caregivers completed demographic, stress, and depressive symptoms questionnaires. Childrens health status was obtained from medical records. RESULTS Approximately 33% of caregivers reported elevated symptoms of depression (i.e., exceeded clinical cutoff of 16 on the Center for Epidemiological Studies-Depression Scale). For caregivers of children with T1D, elevations were associated with less caregiver education, more family stress, older child age, and worse glycemic control. For caregivers of children with CF, more family stress and lack of employment outside of the home were associated with elevated depressive symptoms. CONCLUSIONS Many caregivers of children with T1D or CF experience depressive symptoms, although risk factors may differ in these two populations. Screening of caregiver depressive symptoms as part of routine clinic visits may provide opportunities for needed intervention.

Relations between depressive and anxious symptoms and quality of life in caregivers of children with cystic fibrosis

Little is known about depressive and anxious symptoms and quality of life (QOL) in caregivers of children with cystic fibrosis (CF). The aims of this study were to: (1) assess rates of female and male caregiver depressive and anxious symptoms, and (2) evaluate relations between depressive and anxious symptoms, caregiver QOL, and health outcomes.