Maurice Place

The diagnostic utility of behavioral checklists in identifying children with ADHD and children with working memory deficits

The present study investigated whether children with ADHD and those with working memory impairments have a common behavioral profile in the classroom. Three teacher checklists were used: the Conners’ teacher rating scale (CTRS), the behavior rating inventory of executive function (BRIEF), and the working memory rating scale. The Conners’ continuous performance test (CPT) was also included to determine whether there is a correspondence between performance on this widely used cognitive measure of attention deficits and teacher ratings of classroom behavior. All three behavior scales, but not the CPT, were able to successfully discriminate children with ADHD and those with working memory deficits from typically-developing children. Both the CTRS and the BRIEF discriminated a significant proportion of the children with ADHD from those with working memory deficits, indicating that while both groups exhibit behavioral problems in the classroom, they are characterized by differential attention profiles. The children with ADHD were identified on the basis of oppositional and hyperactive behavior, while those with working memory deficits were more inattentive.

Developing a Resilience Package for Vulnerable Children

In recent years great efforts have been made to clarify what factors make it more likely that a child will develop mental health problems, and what elements increase the resilience of vulnerable children, and hence protect them from becoming disturbed. With the increase in understanding about the nature of such resilience comes the possibility of developing preventative packages for at-risk groups. METHOD Children whose parents have significant depressive illness have been offered a supportive package that seeks to increase their resilience. This focuses on the childs resources, family education and interaction, and community resources and supports for the family to access. RESULTS Initial results show the package increases social activity, reduces emotionality and helps families become more flexible. CONCLUSION Helping children reduce their risk of developing mental health problems is rightly an area of growing importance. This package is a potentially successful way of achieving this by promoting their resilience.

Children with low working memory and children with ADHD: same or different?

The purpose of this study was to compare working memory (WM), executive function, academic ability, and problem classroom behaviors in children aged 8–11 years who were either identified via routine screening as having low WM, or had been diagnosed with ADHD. Standardized assessments of WM, executive function and reading and mathematics were administered to 83 children with ADHD, 50 children with low WM and 50 typically developing children. Teachers rated problem behaviors on checklists measuring attention, hyperactivity/impulsivity, oppositional behavior, and difficulties associated with executive function in the classroom. The ADHD and low WM groups had highly similar WM and executive function profiles, but were distinguished in two key respects: children with ADHD had higher levels of rated and observed impulsive behavior, and children with low WM had slower response times. Possible mechanisms for these common and distinct deficits are discussed.

The Frequency of Emotional and Behavioural Disturbance in an EBD School

The education of children with behavioural difficulties is under scrutiny from various quarters. The provision of specialised school environments is being questioned, at the same time as there is pressure to minimise the exclusion of disruptive pupils. This study looked at the rate of psychiatric disorder that was prevalent in a school for emotionally and behaviourally disordered (EBD) pupils, and found, using DSM III-R criteria, that 24% of the sample had depression, 11% had overanxiousness, and 70% had a diagnosis of Attention Deficit Disorder with Hyperactivity (ADHD). Educational attainment assessment showed that 75% had a reading age that was at least 2 years below their chronological age. These results suggest that such settings are dealing with a very disturbed group of youngsters.

School Refusal: A Changing Problem Which Requires a Change of Approach?

School refusal is a condition which was delineated by a large quantity of empirical work carried out in the 1960s and 1970s. The current study reveals a pattern at variance with the traditional picture of the child and their family, with the children generally coming from socially deprived backgrounds, having significant difficulties relating to peers, and a family life containing conflict and stress. The pattern described suggests that elements of therapeutic intervention may need to be altered to give the greatest opportunity for the youngsters to overcome their school attendance difficulties and minimize the likelihood of future psychiatric problems.

Investigating the Relationship Between Attention and Working Memory in Clinical and Community Samples

The first aim of the present study was to investigate whether differences in core deficits in ADHD subtypes lead to dissociable working memory profiles. The second aim was to compare the working memory profiles of inattentive students with those identified as having poor working memory, as they exhibit very similar behavioral profiles. Finally, the relationship between working memory and academic attainment in these groups were also of interest. Four groups of 9-year-olds were recruited: a community sample of children with inattentive symptoms, a clinically diagnosed group of children with ADHD-Combined, children with low working memory, and a healthy comparison group. They were assessed on measures of working memory, IQ, academic attainment, and sustained attention. The findings indicated that the combined and inattentive subtypes could not be distinguished on the basis of their working memory profile. In contrast, those with inattentive symptoms did better on the short-term memory tasks than the low working memory group. The majority of all three atypical groups performed very poorly in reading and math. This pattern can be interpreted as reflecting the link between working memory and academic attainment, even in those with attention problems.

Cutting to cope - a modern adolescent phenomenon

BACKGROUND The frequency of young people cutting themselves appears to be increasing, with one review estimating the current prevalence across the UK to be between 1 in 12 and 1 in 15. AIM To identify factors that are associated with self-harm by cutting, and more especially coping strategies that if encouraged might reduce such behaviour. METHOD Multivariate and exploratory factor analysis were used to analyse the results from a survey of the pupils attending four large comprehensive schools in the North of England where the frequency of cutting behaviour was causing concern. RESULTS Three factors were identified from the analysis - Social & Active Coping, Seeking External Solutions and Non-Productive Coping. The Social & Active Coping was the only factor that significantly correlated with non-cutting behaviour. CONCLUSIONS The fostering of the elements that make up Social & Active Coping - namely working successfully and feeling a sense of achievement, together with positive friendship networks and positive diversions, including physical recreation, will help to minimize young peoples sense of needing to cope by cutting themselves.

Self-Harm through Cutting: Evidence from a Sample of Schools in the North of England.

This project explored the prevalence of self‐harm by cutting in a geographically circumscribed area of the North of England, using a school‐based survey. Twenty‐three per cent of the young people reported they had cut themselves at least once, with no major changes evident at different age groups or with gender. There were clear differences in rates between schools, and statistically significant differences when comparing the coping mechanisms used by young people who cut themselves with those of their peers.

Brief report: Development of the family perceptions scale; a novel instrument for evaluating subjective functioning in the families of adolescents

A pool of 75 items relating to family functioning was created and piloted in a sample of 12-18 year olds (N = 673). The responses were subjected to an exploratory factor analysis which indicated the presence of three significant latent traits. The results were then used to inform the development of a rating instrument with five subscales labelled Nurture, Problem Solving, Expressed Emotion, Behavioural Boundaries and Responsibility. These demonstrated high levels of internal consistency (Cronbachs alphas .70-.81), high test-retest reliability (rho = .70-.82), varying degrees of intercorrelation (rho = .18-.75) and significant associations with family functioning as defined by the McMaster Family Assessment Device (p < 0.0001 in all cases). This novel instrument is a promising tool for use in both clinical practice and research.

Attention Deficit Disorder as a Factor in the Origin of Behavioural Disturbance in Schools.

The education of children with behavioural difficulties is under scrutiny from various quarters. The provision of specialised school environments isbeing questioned and, at the same time, there is pressure to minimise the exclusion of disruptive pupils. The study reported in this article lookedat a group of children whose behaviour had prompted placement in a school for emotionally and behaviourally disordered (EBD) pupils. The results showed the overall rate of psychiatric disturbance in the group was 86% and, in particular, that the rate of Attention Deficit Hyperactivity Disorder (ADHD) was 70%. These findings suggest that a significant minority of disruptive pupils may have their difficulties compounded by the presence of ADHD, and raises the question of whether specific screening processes should be established for such pupils.