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Purpose: Speech-language pathologists are influential in shaping identity development for individuals who stutter, particularly as it relates to communication. This study investigated the experiences of lesbian, gay, and bisexual individuals who stutter to learn more about how multiple marginalized identities affect their psychosocial experiences. Method: Semi-structured interviews were conducted with seven individuals who stutter with lesbian, gay, and bisexual identities. Participants ranged in age from 22 to 60 years. Data were analyzed for themes and categories by using interpretive phenomenological analysis. Results: Four primary themes were identified: (a) the importance of visibility and shared social identity connections for affirmation; (b) effects of oppressive social expectations on identity; (c) intersectionality of stuttering, gay, lesbian, and bisexual identities; and (d) effects of not being affirmed for identity. Discussion: Results are discussed in the context of identity affirmation and intersectionality. Through an understanding of identity formation and psychosocial experiences of lesbian, gay, and bisexual individuals who stutter, speechlanguage pathologists can use identity-affirmative practices to support individuals who stutter and mitigate stigmatizing experiences. Implications focus on suggestions for the provision of identity-affirming speech-language pathology practices for students who stutter. [ABSTRACT FROM AUTHOR]

The latent class structure of autism symptoms from the time of diagnosis to age 6 years was examined in a sample of 280 children with autism spectrum disorder. Factor mixture modeling was performed on 26 algorithm items from the Autism Diagnostic Interview - Revised at diagnosis (Time 1) and again at age 6 (Time 2). At Time 1, a '2-factor/3-class' model provided the best fit to the data. At Time 2, a '2-factor/2-class' model provided the best fit to the data. Longitudinal (repeated measures) analysis of variance showed that the '2-factor/3-class' model derived at the time of diagnosis allows for the identification of a subgroup of children (9 % of sample) who exhibit notable reduction in symptom severity. [ABSTRACT FROM AUTHOR]

Background: Maximizing measurement accuracy is an important aim in child development assessment and research. Parents are essential informants in the diagnostic process, and past research suggests that certain parental characteristics may influence how they report information about their children. This has not been studied in autism spectrum disorders (ASD) to date. We aimed, therefore, to investigate the possible effect that maternal depression might have on a mother's reports of her child's ASD behaviors. Using structural equation modeling, we disaggregated shared from unique variation in the association between latent variable measures of maternal depression and ASD behaviors. Methods: Data were obtained from a study of preschoolers aged 2-4 newly diagnosed with ASD ( n = 214). Information from a parent questionnaire, a semi-structured parent interview, and a semi-structured observational assessment was used to develop a latent variable measure of child ASD behaviors. Mothers reported on their own depression symptoms. We first modeled the covariance between maternal depression and child ASD behavior. Then, to quantify unique variation, we added covariance terms between maternal depression and the residual variation associated with the individual measures of child ASD behaviors. Results: The model demonstrated excellent fit to the underlying data. Maternal self-report of depression symptoms exhibited a significant association with the unique variance of the questionnaire report but not with the latent variable measure of child ASD behavior. A gradient pattern of association was demonstrated between maternal depression and the unique variance of the ASD measures: most strongly for the maternal questionnaire report, more weakly for the maternal semi-structured interview, and to a trivial extent for the observational interview. Conclusions: Parental depression may influence reporting of ASD behaviors in preschoolers. Shared method effects may also contribute to bias. This finding highlights the importance of obtaining multimethod reports of child ASD symptoms. [ABSTRACT FROM AUTHOR]

Background: Although structured interviews are assumed to be scientifically superior to checklists for measuring youth psychopathology, few studies have tested this hypothesis. Interviews place a much greater burden on respondents, making it critical to determine their added value when quantifying psychiatric symptoms. Methods: Confirmatory factor analysis was used to compare interviews and checklists in community ( N = 251) and clinically referred ( N = 406) samples of youth aged 5 to 17 years. We examined the associations between mother-reported externalizing symptoms assessed by interview versus checklist against (a) teacher-reported externalizing symptoms, and (b) child’s gender, academic performance, single- versus two-parent family, and family income. Models in which associations were estimated freely were contrasted to models in which the interview and the checklist were constrained to have equal associations with the variables. Finding these models fit comparably would suggest no difference between interviews and checklists. Results: In the community sample, both the constrained and unconstrained models provided comparable fit to the data, suggesting no marked differences between interviews and checklists. In the clinical sample, associations with the interview were generally stronger. Reducing the number of items on the interview to match those on the 6-item checklist eliminated these differences, suggesting that the increased reliability of the interview scales, afforded by additional items, enhanced their quantification of psychopathology. Conclusions: Consistent with previous studies, interviews were not notably superior to checklists for the measurement of externalizing symptoms. When only a few items are used, small performance differences between checklists and interviews may be due to scale length. [ABSTRACT FROM AUTHOR]

Background: This study describes the development of the Brief Child and Family Phone Interview (BCFPI) – a computer-assisted telephone interview which adapts the revised Ontario Child Health Study’s (OCHS-R) parent, teacher, and youth self-report scales for administration as intake screening and treatment outcome measures in children’s mental health services. It focuses on the factor structure of the BCFPI’s hypothesized parent-reported child mental health scales describing attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety disorder (SAD), generalized anxiety disorder (GAD), and major depression (MDD). Methods: Data for the analysis come from an OCHS-R measurement study that included two groups of children and adolescents selected from the same urban area: a general population sample ( n = 1,712) and a clinic-referred sample ( n = 1,512); and a third sample that was enlisted in a province-wide implementation study of clinic-referred 6- to 18-year-olds ( n = 56,825). We used confirmatory factor analysis to assess the factor structure of the BCFPI scales in different populations and to test measurement equivalence across selected groups. Results: Despite the strong constraints imposed on the measurement models, estimates of model fit across the three samples were comparable in magnitude and approached the cut-offs suggested for the GFI and CFI (>.9) and RMSEA (<.05). Measurement equivalence was demonstrated between the OCHS-R clinic and provincial implementation samples. Within the implementation sample, the factor structure of the BCFPI scales was equivalent for boys versus girls and for 6- to 12- versus 13- to 18-year-olds. A companion paper examines the test–retest reliability, sensitivity, specificity, and validity of these BCFPI scales when used for screening. Conclusion: This project supports the feasibility and acceptability of a computer-assisted telephone interview for assessing emotional-behavioral problems of children and adolescents referred to children’s mental health services. [ABSTRACT FROM AUTHOR]

Background: This study examines the use of the Brief Child and Family Phone Interview (BCFPI) to screen for childhood psychiatric disorder based on Diagnostic Interview Schedule for Children Version IV (DISC-IV) classifications of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), separation anxiety (SAD), generalized anxiety (GAD) and major depression (MDD). Methods: Data for analysis come from a sample of 399 children and adolescents aged 5–17 years old referred to child mental health outpatient services in three Ontario cities. Mothers were administered the BCFPI on three occasions: baseline, 2 and 13 months; and the DISC-IV on two occasions: 1 and 12 months. Results: Based on kappa, test–retest reliability for disorders classified by the BCFPI exceeded .50 for all conditions except MDD (.45). In receiver operating characteristic (ROC) analysis, area-under-the-curve (AUC) estimates for BCFPI scale score associations with DISC-IV classifications of disorder exceeded .80 for CD, ODD, ADHD and SAD; and were lower for GAD (.76) and MDD (.75). In stratified analyses, there were no statistically significant differences in AUC estimates for boys versus girls and 5 to 11 versus 12 to 17-year-olds. Conclusions: Classifications of childhood disorder derived from the BCFPI provided a reasonable approximation to disorders classified by the DISC-IV administered by lay interviewers. [ABSTRACT FROM AUTHOR]

Background: We investigated the effectiveness of Nurse‐Family Partnership (NFP), a prenatal‐to‐age‐two‐years home‐visiting programme, in British Columbia (BC), Canada. Methods: For this randomised controlled trial, we recruited participants from 26 public health settings who were: <25 years, nulliparous, <28 weeks gestation and experiencing socioeconomic disadvantage. We randomly allocated participants (one‐to‐one; computer‐generated) to intervention (NFP plus existing services) or comparison (existing services) groups. Prespecified outcomes were prenatal substance exposure (reported previously); child injuries (primary), language, cognition and mental health (problem behaviour) by age two years; and subsequent pregnancies by 24 months postpartum. Research interviewers were masked. We used intention‐to‐treat analyses. (ClinicalTrials.gov, NCT01672060.) Results: From 2013 to 2016 we enrolled 739 participants (368 NFP, 371 comparison) who had 737 children. Counts for child injury healthcare encounters [rate per 1,000 person‐years or RPY] were similar for NFP (223 [RPY 316.17]) and comparison (223 [RPY 305.43]; rate difference 10.74, 95% CI ‐46.96, 68.44; rate ratio 1.03, 95% CI 0.78, 1.38). Maternal‐reported language scores (mean, M [SD]) were statistically significantly higher for NFP (313.46 [195.96]) than comparison (282.77 [188.15]; mean difference [MD] 31.33, 95% CI 0.96, 61.71). Maternal‐reported problem‐behaviour scores (M [SD]) were statistically significantly lower for NFP (52.18 [9.19]) than comparison (54.42 [9.02]; MD ‐2.19, 95% CI −3.62, −0.75). Subsequent pregnancy counts were similar (NFP 115 [RPY 230.69] and comparison 117 [RPY 227.29]; rate difference 3.40, 95% CI ‐55.54, 62.34; hazard ratio 1.01, 95% CI 0.79, 1.29). We observed no unanticipated adverse events. Conclusions: NFP did not reduce child injuries or subsequent maternal pregnancies but did improve maternal‐reported child language and mental health (problem behaviour) at age two years. Follow‐up of long‐term outcomes is warranted given that further benefits may emerge across childhood and adolescence. [ABSTRACT FROM AUTHOR]

• The experience of the transition from concealment to openness was investigated. • A phenomenological approach was used to understand experiences of those who stutter. • Participants reported a general progression from more concealment to more openness. • The process was not entirely linear over time and regression was reported. • Openness is a continuum of behavior dependent on environment and personal factors. The purpose of this study was to gain a deeper understanding of the experience of people who stutter as they navigate through the growth process from concealment to openness. Twelve adults who stutter who are active in self-help/support groups for stuttering described their experiences of concealment and openness in a semi-structured interview. Purposeful selection was utilized to recruit participants who could comment thoughtfully on previous concealing, but became more open about their stuttering. A phenomenological approach was utilized to gain a deeper understanding of how people who stutter experience the transition from concealment to openness regarding their stuttering and identity. Thematic analysis contributed to identification of themes and subthemes describing participants' experiences. Participants described precursors to concealment that led to hiding and avoidance, which grew in strength until they reached a turning point. They then changed how they related to their stuttering by changing their behaviors and perceptions of stuttering, which led to increased openness about their identity. This process of continued adaptation to stuttering was ongoing and non-linear, but suggested general trends from concealment to more openness over time. Level of openness was impacted by situational context and individual differences. The findings extend our understanding of how people who stutter navigate transitions from concealment to openness. This deeper understanding could be helpful in explaining the complexities involved in managing the identity of a person who stutters, and the process of adapting to living with stuttering over time. [ABSTRACT FROM AUTHOR]

• Disclosure events are comprised of antecedents, the event itself, and outcomes. • It is hypothesized that the aspects of disclosure impact one another. • The findings provide a more nuanced understanding of disclose. • Results can potentially improve disclosure outcomes for people who stutter. The purpose of this study was to identify components of disclosure events among people who stutter, and identify possible relations between these components in order to understand how disclosure events unfold. Twelve adults who stutter participated in semi-structured interviews focused on disclosure of stuttering. Participants were purposefully selected due to their self-reported history of disclosing stuttering. Qualitative content analysis using a grounded theory approach helped to identify relevant themes and subthemes related to the process of disclosure of stuttering. The findings describe the complex process of disclosure as being comprised of antecedents (including considerations about when and why to disclose), the disclosure event itself (including the content and form of the disclosure, most and least helpful methods of disclosure, as well as immediate listener reactions), and the perceived outcomes of the disclosure at individual, dyadic, and societal/contextual levels. These components of the process are linked and affect one another, resulting in a feedback loop. Disclosure methods are context-dependent and not mutually exclusive within individuals who stutter. Professionals and advocates gaining a more nuanced understanding of the process of disclosure events can increase their ability to help people who stutter make optimal decisions about disclosure. Making good disclosure decisions can help PWS improve their quality of life and reduce a variety of environmental communicative barriers. [ABSTRACT FROM AUTHOR]

A qualitative study was undertaken to explain findings of a cross-sectional study of Canadian Community Health Survey (CCHS) 4.1 data showing older persons who attend religious services more than once a week, compared to persons who do not attend at all, have lower prevalences of coronary heart disease (CHD), diabetes and high blood pressure. Twelve semi-structured interviews with ordained pastors and three focus groups with older parishioners from Canadian churches were conducted. Interviews were transcribed and analyzed for emergent themes through a process of direct content analysis. All participants claimed that religious service attendance (RSA): (1) enhances mental health; (2) provides social support and activities; and (3) promotes health and lifestyle behaviours that lower CHD risk. These three themes appear to be underlying mechanisms that help to explain the inverse association between RSA and the prevalence of adverse health outcomes found in the CCHS 4.1 data. [ABSTRACT FROM AUTHOR]

Background: A better understanding of factors contributing to the observed variability in estimates of test–retest reliability in published studies on standardized diagnostic interviews (SDI) is needed. The objectives of this systematic review and meta‐analysis were to estimate the pooled test–retest reliability for parent and youth assessments of seven common disorders, and to examine sources of between‐study heterogeneity in reliability. Methods: Following a systematic review of the literature, multilevel random effects meta‐analyses were used to analyse 202 reliability estimates (Cohen's kappa = ҡ) from 31 eligible studies and 5,369 assessments of 3,344 children and youth. Results: Pooled reliability was moderate at ҡ = .58 (CI 95% 0.53–0.63) and between‐study heterogeneity was substantial (Q = 2,063 (df = 201), p < .001 and I2 = 79%). In subgroup analysis, reliability varied across informants for specific types of psychiatric disorder (ҡ = .53–.69 for parent vs. ҡ = .39–.68 for youth) with estimates significantly higher for parents on attention deficit hyperactivity disorder, oppositional defiant disorder and the broad groupings of externalizing and any disorder. Reliability was also significantly higher in studies with indicators of poor or fair study methodology quality (sample size <50, retest interval <7 days). Conclusions: Our findings raise important questions about the meaningfulness of published evidence on the test–retest reliability of SDIs and the usefulness of these tools in both clinical and research contexts. Potential remedies include the introduction of standardized study and reporting requirements for reliability studies, and exploration of other approaches to assessing and classifying child and adolescent psychiatric disorder. [ABSTRACT FROM AUTHOR]

The goals of the study were to examine test-retest reliability, informant agreement and convergent and discriminant validity of nine DSM-IV-TR psychiatric disorders classified by parent and youth versions of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Using samples drawn from the general population and child mental health outpatient clinics, 283 youth aged 9 to 18 years and their parents separately completed the MINI-KID with trained lay interviewers on two occasions 7 to 14 days apart. Test-retest reliability estimates based on kappa (κ) went from 0.33 to 0.79 across disorders, samples and informants. Parent-youth agreement on disorders was low (average κ = 0.20). Confirmatory factor analysis provided evidence supporting convergent and discriminant validity. The MINI-KID disorder classifications yielded estimates of test-retest reliability and validity comparable to other standardized diagnostic interviews in both general population and clinic samples. These findings, in addition to the brevity and low administration cost, make the MINI-KID a good candidate for use in epidemiological research and clinical practice. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]