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This article synthesized evidence for the validity and reliability of the Strengths and Difficulties Questionnaire in children aged 3-5 years. A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines was carried out. Study quality was rated using the Consensus-based Standards for the Selection of Health Measurement Instruments. In total, 41 studies were included (56 manuscripts). Two studies examined content and cultural validity, revealing issues with some questions. Six studies discussed language validations with changes to some wording recommended. There was good evidence for discriminative validity (Area Under the Curve = 0.80), convergent validity (weighted average correlation coefficients = 0.50, except for the Prosocial scale), and the 5-factor structural validity. There was limited support for discriminant validity. Sensitivity was below 70% and specificity above 70% in most studies that examined this. Internal consistency of the total difficulty scale was good (weighted average Cronbach's alpha parents' and teachers' version 0.79 and 0.82) but weaker for other subscales (weighted average parents' and teachers' range 0.49-0.69 and 0.69-0.83). Inter-rater reliability between parents was moderate (correlation coefficients range 0.42-0.64) and between teachers strong (range 0.59-0.81). Cross-informant consistency was weak to moderate (weighted average correlation coefficients range 0.25-0.45). Test-retest reliability was mostly inadequate. In conclusion, the lack of evidence for cultural validity, criterion validity and test-retest reliability should be addressed given wide-spread implementation of the tool in routine clinical practice. The moderate level of consistency between different informants indicate that an assessment of a pre-schooler should not rely on a single informant.

This study examined whether scores on the Test of Premorbid Functioning (TOPF) accurately predicted current performance on the Wechsler Adult Intelligence Scale (Fourth Edition; WAIS-IV) in a sample of 284 neurologically normal Maori (age range 16-90yrs). Participants were recruited from seven areas of New Zealand's (NZ) North and South Islands, as well as from different iwi (tribes) to ensure a representative sample. The hypothesis that the TOPF would not accurately predict current WAIS-IV performance was supported. TOPF scores only accounted for between 32-36% of the variance in WAIS-IV Full Scale Intelligence Quotient (FSIQ) scores as compared to the over 50% typically reported in overseas studies. The TOPF accurately predicted FSIQ categorisation for just over half the sample. These findings suggest that the TOPF is not a valid measure of premorbid functioning for Maori in New Zealand., There is an abundance of research indicating culture influences performance on neuropsychological tests (Brickman Cabo, & Manly, 2006), with disparities in test scores between majority and minority cultures (Brickman et [...]

Aim: The aim of this study is to investigate Māori (Indigenous peoples of Aotearoa New Zealand) understandings of dementia (mate wareware) and develop a framework to inform assessment of cognitive impairment. Method: Qualitative, kaupapa Māori (M ā ori approach) research with 241 older Māori (kaumātua) involving 17 focus groups across Aotearoa New Zealand (NZ) and eight families (whānau) from one region. We thematically analyzed transcribed data from audio-recorded interviews. Results: Two overarching themes, namely, connection (Tūhononga) and self (Whaiaro), and eight subthemes in particular mind (hinengaro), spirit (wairua), body (tinana), family (whānau), social connection (whanaungatanga), identity and role (tuakiri), place (wāhi), and ancestors (tūpuna) emerged. Māori language (Te Reo Māori) was important for cognitive health. Conclusion: The findings embedded in cultural values improve understanding of dementia (mate wareware) in Māori. These themes can inform the assessment of older Māori with cognitive impairment. For those without cognitive impairment, the Tūhononga Whaiaro framework suggests factors potentially crucial for healthy aging in Māori. [ABSTRACT FROM AUTHOR]

This qualitative study gives voice to rangatahi (young people) and their whānau (families) (n = 10) who have experienced communication assistance in the New Zealand youth justice system. Communication assistance is a form of specialist support for witnesses and defendants who have been identified as having communication difficulties; and is modelled on the role of the intermediary in England and Wales. The findings overall suggest that communication assistance has a valuable and ongoing role to play in the NZ youth justice system, and may be one means of addressing the rights and needs of those with communication difficulties who offend. [ABSTRACT FROM AUTHOR]

Communication assistance is a form of specialist support for witnesses and defendants in justice settings who have been identified as having communication difficulties. This relatively new role in New Zealand is modelled on the role of the intermediary in England and Wales. This research provides a qualitative analysis of professionals' perspectives (n = 28 participants) on the challenges of communication assistance for young people facing criminal charges in the New Zealand youth justice system. The findings of this study do not question whether or not communication assistance should exist, but rather how it might best function in practice. The overall implications are that more education and guidance for youth justice professionals is needed. [ABSTRACT FROM AUTHOR]

Objective: To explore feasibility and potential efficacy of on-line interventions for sleep quality following a traumatic brain injury (TBI). Design: A two parallel-group, randomized controlled pilot study. Setting: Community-based. Subjects: In all, 24 participants (mean age: 35.9 ± 11.8 years) who reported experiencing sleep difficulties between 3 and 36 months after a mild or moderate TBI. Interventions: Participants were randomized to receive either a cognitive behaviour therapy or an education intervention on-line. Both interventions were self-completed for 20-30 minutes per week over a six-week period. Main measures: The Pittsburgh Sleep Quality Index assessed self-reported sleep quality with actigraphy used as an objective measure of sleep quality. The CNS Vital Signs on-line neuropsychological test assessed cognitive functioning and the Rivermead Post-concussion Symptoms and Quality of Life after Brain Injury questionnaires were completed pre and post intervention. Results: Both programmes demonstrated feasibility for use post TBI, with 83.3% of participants completing the interventions. The cognitive behaviour therapy group experienced significant reductions (F = 5.47, p = 0.04) in sleep disturbance (mean individual change = -4.00) in comparison to controls post intervention (mean individual change = -1.50) with a moderate effect size of 1.17. There were no significant group differences on objective sleep quality, cognitive functioning, post-concussion symptoms or quality of life. Conclusion: On-line programmes designed to improve sleep are feasible for use for adults following mild-to-moderate TBI. Based on the effect size identified in this pilot study, 128 people (64 per group) would be needed to determine clinical effectiveness. [ABSTRACT FROM AUTHOR]

Objective: The relationship between moderate/severe traumatic brain injury (TBI) and cognitive deficits is well known. The nature, duration and predictors of cognitive difficulties post-mild TBI remain unclear. This study examined cognitive, mood and post-concussion outcomes of mild TBI over 1-year post-injury. Method: Adults (>15 years) with mild TBI (n = 260) completed neuropsychological (CNS-Vital Signs, Behavioural Dyscontrol Scale), mood (Hospital Anxiety Depression Scale) and behavioural assessments (Cognitive Failures Questionnaire, Rivermead Post-Concussion Questionnaire) at baseline, 1-, 6- and 12-months post-injury. Results: Over the 12-months post-injury self-reported cognition (p = 0.027), post-concussion symptoms (p < 0.001), depression (p < 0.001), anxiety (p < 0.001) and dyscontrol (p = 0.025) improved significantly. Assessments of memory, processing speed, executive function, psychomotor speed/reaction time, complex attention and flexibility also improved significantly. At baseline >20% of individuals produced very low scores on executive ability, complex attention and cognitive flexibility. At 1- and 6-month follow-ups >20% of participants were very low for complex attention, with 16.3% remaining so at 12-months. Executive abilities and speed were related to post-concussion symptoms, mood and self-reported cognition at 12-months. Conclusions: Whilst significant improvements were noted across measures over time, a significant proportion of individuals still perform poorly on neuropsychological measures 12-months after mild TBI; and these were linked to post-concussion symptoms, mood and self-reported cognitive outcomes. This implies a longer trajectory for recovery than has previously been suggested, which has implications for provision of assessment and rehabilitation services for more extended periods. [ABSTRACT FROM PUBLISHER]