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Investigated the utility of a parent report measure designed specifically for behavior screening in the pediatric primary care setting for use with disadvantaged children and families. Results indicated that the Pediatric Symptom Checklist was significantly related to scores derived from the Child Behavior Checklist. Receiver Operator Characteristic analysis indicated the need for modification of the cutting score previously established with middle-class children. A model for screening children for psychopathology within the structural-organizational constraints of the pediatric primary care setting is presented.

The relation of staff knowledge of behavioral principles to ratings of treatment acceptability for interventions used in the management of self-injurious behavior (SIB) was examined with 57 direct-care staff members from an ICF/MR. Case descriptions of an adult with severe mental retardation who exhibited SIB were presented, followed by descriptions of six behavioral interventions rated on acceptability. Subjects also completed a 25-item measure of general knowledge of behavioral principles. Results indicated that staff age and educational attainment but not treatment acceptability ratings were significantly related to knowledge scores. Implications of the findings were discussed.

Patient satisfaction has been linked empirically to a variety of health care outcomes (e.g., treatment adherence). Unfortunately, there is a paucity of data regarding the assessment of children's satisfaction with pediatric care. This lack of instrumentation was the impetus for the development and preliminary validation of the Metro Assessment of Child Satisfaction (MACS). Findings indicated the MACS is internally consistent and easily administered and understood by children as young as 6 years of age. Factor analysis yielded four distinct factors that appear to be statistically valid and clinically meaningful. Findings are discussed in relation to maternal ratings of satisfaction and physician perceptions of patient and parent satisfaction.

This study assessed the psychosocial status of 56 children aged 6-16 years with imperforate anus, gastroschisis, or omphalocele. Results indicate that (a) children were of average intellectual ability; (b) approximately 9% of the sample had learning disabilities; (c) although the mean maternal ratings of behavioral adjustment did not differ from those reported for children without anomalies, approximately 18% of the children had deviant adjustment scores; (d) a multivariate risk and resistance model accounted for a significant amount of the variance in children's adjustment; and (e) child, maternal, and family utilitarian and psychological risk and resistance resources contributed independently to children's overall behavioral adjustment.

Numerous studies have documented the cariogenic effects of prolonged or nocturnal bottle feeding in children. Guidelines prepared by the American Academy of Pediatrics (AAP) suggest that pediatricians advise parents to begin bottle weaning when their child is approximately nine months of age and accomplish weaning soon after the first birthday. However, little information exists concerning the advice pediatricians give to parents about nursing bottle weaning. Information about bottle weaning advice was obtained from 127 pediatricians selected from the American Academy of Pediatrics (AAP) Fellowship listing (1985-86). The majority of respondents discussed bottle weaning with parents and recommended a specific age for accomplishment of bottle weaning. Bedtime bottle feeding was discouraged actively, mainly due to the increased risk of dental caries. Implications of the findings are discussed.

We studied cognitive function and metabolic status in a group of healthy adolescents fed the government supplied breakfast (n = 18) versus a control group (n = 16) fed a very low calorie meal. Serum glucose and beta-hydroxybutyrate levels were repeatedly measured at predetermined intervals throughout the testing period. Acute cognitive and mood effect were evaluated in all subjects on a pre-post basis. No significant group differences emerged on a battery of psychological measures that assessed short-term auditory memory, vigilance, impulsivity, and mood. Neither serum glucose or beta-hydroxybutyrate levels correlated significantly with any behavioral measure. Results are discussed in the context of previous studies of nutrition and cognition.

Using a case description methodology, Tarnowski, Rasnake, Mulick, and Kelly (1989) examined the effects of behavior problem severity and intervention type on staff ratings of six behavioral interventions used to treat self-injurious behavior (SIB). Results indicated that accelerative interventions were judged more acceptable than reductive treatments, and acceptability of treatments varied as a function of SIB severity. We hypothesized that judgments of treatment acceptability might vary as a function of specific institutional characteristics and conducted a replication of the previous study in a setting where the institutional treatment philosophy was explicitly behavioral. Results indicated that (a) accelerative interventions were preferred to reductive treatments, (b) acceptability ratings were not significantly influenced by SIB severity, and (c) interventions were generally found to be more acceptable by staff working in a behavioral treatment milieu.

Drabman, Tarnowski, and Kelly (1987) investigated children's month of birth in relation to mental health referrals and found that the younger children in a class were disproportionately referred for services. We conducted a replication and extension of the Drabman et al. investigation. Data were collected on children's (N = 222) cognitive and academic competencies. Results indicated that (a) younger children in a class were disproportionately referred, (b) the referral pattern remained constant across all grades examined, (c) the referral pattern could not be explained by differences in children's competencies, and (d) although the youngest children in the class were referred most frequently, they had the lowest rate of qualification for special services.

Informed consent forms are used in biomedical research as a mechanism to convey study information to potential subjects so that they may arrive at a decision concerning their willingness to participate. Although the Department of Health and Human Services Regulations for the Protection of Human Subjects require the presentation of specific study information at a level that is easily understood, according to research concerning adult biomedical consent forms, the typical form is not readily comprehensible. Unfortunately, no data exist concerning the readability of informed consent forms that are used in the context of pediatric biomedical research. In the present study, readability analyses were conducted on a large sample (N = 238) of pediatric biomedical informed consent forms obtained during a 10-year period from a large midwestern children's hospital. For the entire sample, results derived from two readability estimates (Fry grade equivalent and Flesch Reading Ease methods) indicated that the consent forms were written at the college graduate level. Although there was a linear increase in the length of the consent document during the 10-year period evaluated, expanded length was not associated with improved readability. According to analyses, a differential pattern of reading difficulty was associated with specific sections of the informed consent document. Findings are highly consistent with those from studies of adult biomedical consent form and document that the purpose of the informed consent form is being compromised, in part, by a readability factor. Suggestions for solving this critical problem are advanced.

The role of social desirability response sets on self-reported marital satisfaction in 143 male alcoholics and their wives was assessed in a factor analytic study of the combined Locke-Wallace Marital Adjustment Scale (MAS) and Edmonds Marital Conventionalization Scale (MCS). Overall, results indicated that alcoholics rated their marriage as significantly more satisfying than did their wives. There was, however, a large amount of covariation between the MAS and MCS for husbands, and factor analyses revealed considerable redundancy between the two measures as evidenced in one dominant factor on which both MAS and MCS items loaded. Although there was also high covariation between the two scales for wives, there was still enough differential responding to MAS and MCS items to identify both a dominant factor and a second factor, the latter loaded on only by MCS items. Results suggest that the self-reported marital satisfaction of male alcoholics may be highly contaminated by social desirability response sets. The results are discussed with respect to the two-component model of socially desirable responding and caution is urged in the evaluation of self-report marital adjustment measures with this population.

Using a case description methodology, we examined the effects of behavior problem severity, intervention type (accelerative vs. reductive), client status (child vs. adult), and type of work setting (child vs. adult unit) on staff members' acceptability ratings of six behavioral interventions used to treat self-injurious behavior (SIB). Results indicated that (a) accelerative interventions were rated more acceptable than reductive treatments, (b) acceptability of treatments varied as a function of SIB severity, and (c) client status and type of work setting failed to significantly influence acceptability ratings. Findings were discussed in the context of the current controversy surrounding the use of aversive treatments. The implications of the results for the design of institutionally based behavioral intervention programs were examined.