Search

Examined posttraumatic stress (PTS) symptoms in children following pediatric traumatic brain injury (TBI). Children (ages 6-12) with TBI (n = 81) and orthopedic injury (OI; n = 59) were assessed 6 and 12 months postinjury. Parents of children with severe TBI reported higher levels of child PTS symptoms than did parents of children with moderate TBI or OI at the 6- and 12-month follow-ups. Group differences in child-reported PTS symptoms emerged at the 12-month follow-up with higher symptom levels reported by children with severe TBI than by those with moderate TBI or OI. At both follow-ups, rates of clinically significant symptom levels were higher in the severe TBI group than in the moderate TBI or OI groups. The group differences in parent and child reports were significant even after taking ethnicity, social disadvantage, and age at injury into account. Parent and child reports of child PTS symptoms were related to family socioeconomic status. Implications for clinical intervention with children and families following pediatric TBI are discussed. Language: en

Our clinical experiences in a pediatric setting indicate that selective use of home observational assessment can facilitate psychological evaluation of such problems as failure to thrive, behavioral and developmental deficits, and dysfunctional adaptation to childhood chronic illness. Home observations provide a valuable source o fin formation about parent-child and family interaction patterns, which enhances clinical understanding and family acceptance of intervention plans. We discuss the considerable technical difficulties involved in the conduct and interpretation of information from home visits. Home observational assessment is especially useful in planning intervention for families that are difficult to reach and in sensitizing clinicians to the role o f family interaction and culture in children's behavioral problems.

We describe the role of psychological testimony in a legally contested adoption concerning a 13-month-old infant whose foster parents had cared for him since early infancy. Using the concept of attachment, psychological testimony emphasized the duration and quality of his relationship to his foster parents in order to suggest that a separation from them would pose a significant psychological stress. This report has implications for psychological testimony and placement decisions in similar situations.

Children diagnosed with environmentally based failure to thrive (FTT) early during their first year of life were seen at 12 and 18 months for assessment of psychological development (i.e., cognition, language, symbolic play, and behavior during testing) following hospitalization and intervention. Based on an interactional model of outcome, factors reflecting biologic vulnerability (i.e., wasting and stunting) and family ecology (i.e., income level, family size, and ratio of adults to children) were assessed. Predictions that outcomes would reflect a combination of biological vulnerability and family ecology were upheld for Bayley Mental Development Index (MDI) and Symbolic Play scores at 18 months but not at different ages or for other measures. Instead, wasting alone predicted the 12- and 18-month behavioral ratings and ratio of adults to children predicted the 12-month Bayley MDI and 18-month language measures. These findings underscore the utility o fan interactional model in predicting psychological o...

Studies of the intellectual development of failure to thrive children are critically reviewed. On long term follow up, failure to thrive children have a high incidence of mental retardation and a below average distribution of abilities. However, the conclusions based on prior research have been obscured by significant methodological problems. Future research should include suitable comparison groups, more careful subject selection, and specify the conditions of assessment. Treatment approaches should plan remediation of developmental deficits by helping parents improve their interactions with their children.

Patterns of psychosocial assessment and care of 30 infants hospitalized for non‐organic failure to thrive (NOFT) were studied by means of an indepth chart review. The following findings emerged: underutilization of psychosocial services, an emphasis on diagnostic assessment rather than treatment planning, and inconsistent charting of information concerning follow up and treatment following hospitalization. Findings suggest a need for a comprehensive intergration of psychosocial assessment with physical diagnosis in the hospital based care of NOFT infants. A high level of psychologist visibility and availability to the staff and active involvement with families is seen as a means of facilitating more effective assessment and treatment planning for these infants at risk. Greater attention to treatment planning and involvement of community resources for ongoing clinical intervention following the hospitalization is needed to lessen the long‐term developmental, emotional and family problems associate...

Experiences with training clinical psychologists to consult with pediatricians are reviewed. Disparate training backgrounds and problematic models of collaboration are seen as barriers to learning effective consultation. To meet these potential obstacles, training approaches should stress observation of staff interaction, participation in viable consultation structures and intensive clinical training. With optimal supervision, psychologists at a variety of levels can be trained to consult successfully to pediatricians.