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Now, more than ever, transgender and gender diverse youth need allyship and support in educational settings. Advocating for those most vulnerable to recent legal restrictions must be a priority for practitioners. Navigating barriers while upholding ethical codes and best practices can be difficult to implement in many school systems. The aim of this article is to highlight the need to support these students, given the trajectory of a public mental health crisis and the recent and historical treatment of marginalized groups by state and local school systems. Without supportive systems in place, youth are vulnerable to victimization and harassment, which directly impacts their mental health, emotional well-being, and academic success. Although this article is addressing the need for activism in schools and local communities, there is a dire need for advocacy at the national level. Gender diverse youth are at risk of negative outcomes at the hands of their school and community-based experiences, and this article calls for the action of school-based professionals.

Identity development is a critical process common to the human experience across all demographics. While everyone engages in identity development, the range of nuances in identity that need to be navigated makes the process more complicated. As children progress through adolescence, developing their unique identity becomes a vital task in which they need ongoing support. As universal as identity development is for children, one particular group has a great deal to navigate in this process--Black students. The focus of this article will center on Black students developing their racial identities and how school psychologists can support them. Since the overwhelming majority of school psychologists identify as White (86%; NASP, 2021), there is a gap between their own identity and that of the Black students they work with. This article aims to equip school psychologists to bridge that gap, beginning with a description of what is known as typical identity development as studied by Erikson (1964) and many psychologists thereafter. The typical identity development section will be followed by a survey of the identity development of Black students, the ways it is influenced, and why it is crucial for school psychologists to be cognizant of the aforementioned gaps. Finally, this article will conclude with recommendations on how best to support Black students in the process of developing their racial identities.

Background: In minimally displaced Weber B ankle fractures, the distal fibular fracture fragment can be externally rotated. This malrotation is difficult to detect on radiographs and, when left malreduced through nonoperative treatment, may contribute to altered joint mechanics, predisposing to posttraumatic osteoarthritis. This study evaluates the effects of fibular malrotation on tibiotalar joint contact mechanics. Methods: Six cadaveric ankles were tested using a materials testing system (MTS) machine. A tibiotalar joint sensor recorded contact area and pressure. Samples were tested in the intact, neutrally rotated, and malrotated state. Each trial applied a 686N axial load and a 147N Achilles tendon load in neutral position, 15° dorsiflexion, and 15° plantarflexion. Results: In the comparison of malrotated to intact ankles, peak contact pressure was found to be significantly greater at neutral flexion (intact 5.56 MPa ± 1.39, malrotated 7.21 MPa ± 1.07, P =.03), not significantly different in dorsiflexion, and significantly decreased in plantarflexion (intact 11.2 MPa ± 3.04, malrotated 9.01 MPa ± 1.84, P =.01). Significant differences in contact area were not found between conditions. Conclusion: The findings suggest that fibular malrotation contributes to significant alterations in tibiotalar joint contact pressures, which may contribute to the development of posttraumatic osteoarthritis. When malrotation of the fibula is suspected on plain radiographs, a computer tomography (CT) scan should be obtained to evaluate its extent and further consideration should be given to surgical treatment. Levels of Evidence: Level V: Bench testing [ABSTRACT FROM AUTHOR]

Many prominent intelligence tests (e.g., Wechsler Intelligence Scale for Children, Fifth Edition [WISC-V] and Reynolds Intellectual Abilities Scale, Second Edition [RIAS-2]) offer methods for computing subtest- and composite-level difference scores. This study uses data provided in the technical manual of the WISC-V and RIAS-2 to calculate reliability coefficients for difference scores. Subtest-level difference score reliabilities range from 0.59 to 0.99 for the RIAS-2 and from 0.53 to 0.87 for the WISC-V. Composite-level difference score reliabilities generally range from 0.23 to 0.95 for the RIAS-2 and from 0.36 to 0.87 for the WISC-V. Emphasis is placed on comparisons recommended by test publishers and a discussion of minimum requirements for interpretation of differences scores is provided.

Recently, an increasing number of researchers and school psychologists have advocated for the use of School-Based Motivational Interviewing (SBMI) for working directly with students and for consulting with teachers and parents. However, little attention has been given to the possible ethical implications of school psychologists' use of SBMI with various stakeholders in school settings. In this paper, unique ethical challenges are highlighted and recommendations for implementing SBMI techniques in relation to both MI ethical guidelines and the National Association of School Psychologists (NASP) Principles for Professional Ethics are provided.

The current study examined (1) if the Strengths and Difficulties Questionnaire (SDQ) would yield alternative factor structures related to either symptoms or strengths with early adolescent students when an exploratory factor analysis (EFA) is used; (2) which scales best predicted suspensions of typically developing early adolescents; and (3) what cutoff scores were useful for identifying youth at risk for suspensions. The current study included 321 parent-student dyads, who were followed from the middle of eighth grade until the end of tenth grade. A symptoms-based EFA yielded three factors: Misbehavior, Isolation, and Agitation. A strength-based EFA yielded three factors, as well: Emotional, Social, and Moral competence. Logistic regression path analyses were used to predict risk of any suspension at the end of eighth, ninth, and tenth grades. The predictor variables were the original SDQ Conduct Problems and Hyperactivity scales in one model, the Misbehavior and Agitation scales in a second model, and the Emotional and Moral competence scales in the third model. Only the Misbehavior scale consistently predicted suspensions across each grade (b = 0.27, OR = 1.32, p < 0.001; b = 0.15, OR = 1.18, p = 0.029; b = 0.17, OR = 1.18, p = 0.029, respectively). For the Misbehavior scale, cutoff scores were established that reflected the 75th and 90th percentile; however, each cutoff demonstrated strengths and weaknesses for identifying at-risk students. The expectation of screening to identify youth at risk for suspensions, a complex school discipline decision, is discussed.

School bullying is associated with a host of unfavorable psychosocial outcomes, even as victims enter college. Thus, the identification of modifiable protective factors remains an important goal of psychological research in the context of resilience theory. The purpose of this study was to examine the moderating effect of natural mentoring relationships (NMRs) on the association between peer victimization and college adjustment. Participants were 239 undergraduate students from a rural Midwestern university. Results indicated that higher levels of past peer victimization were associated with higher levels of depression and interpersonal problems. The presence of NMRs moderated the relationship between past peer victimization and interpersonal problems. Though further study is necessary, NMRs among school-aged students who experience bullying may be beneficial.

Background: We investigated the experience of siblings of children with CHARGE syndrome (n = 29). Siblings of children with a disability are an understudied population, and, to our knowledge, this is the first investigation of the sibling relationship in CHARGE. Method: Participants were asked to complete 5 measures: (a) Sibling Evaluation Questionnaire, (b) UCLA Loneliness Scale, (c) Network Orientation Scale, (d) Family Hardiness Index, and (e) Family Member Well-Being Index. Results: Participants accepted their sibling with CHARGE, with the relationship being neither highly negative nor positive. Although siblings reported to be somewhat less lonely, they were no less likely to access social support than college-aged peers. Participants did not indicate adjustment issues; however, more than half of the siblings reported avoiding adding to their parents' stress. Further, they rated their own personal wellbeing very positively. Conclusion: In spite of acknowledging stress within the family, these siblings represent themselves as well adjusted with a somewhat typical sibling relationship.

Objective: To assess whether training provided to an inexperienced clinician just before performing a high stakes procedure can improve procedural care quality, measuring the first attempt success rate of trainees performing infant orotracheal intubation., Design: Randomized clinical trial., Setting: Single center, quaternary children's hospital in Boston, MA, USA., Participants: A non-crossover, prospective, parallel group, non-blinded, trial design was used. Volunteer trainees comprised pediatric anesthesia fellows, residents, and student registered nurse anesthetists from 10 regional training programs during their pediatric anesthesiology rotation. Trainees were block randomized by training roles. Inclusion criteria were trainees intubating infants aged ≤12 months with an American Society of Anesthesiology physical status classification of I-III. Exclusion criteria were trainees intubating infants with cyanotic congenital heart disease, known or suspected difficult or critical airways, pre-existing abnormal baseline oxygen saturation <96% on room air, endotracheal or tracheostomy tubes in situ, emergency cases, or covid-19 infection., Interventions: Trainee treatment group received preoperative just-in-time expert intubation coaching on a manikin within one hour of infant intubation; control group carried out standard practice (receiving unstructured intraoperative instruction by attending pediatric anesthesiologists)., Main Outcome Measures: Primary outcome was the first attempt success rate of intraoperative infant intubation. Modified intention-to-treat analysis used generalized estimating equations to account for multiple intubations per trainee participant. Secondary outcomes were complication rates, cognitive load of intubation, and competency metrics., Results: 250 trainees were assessed for eligibility; 78 were excluded, 172 were randomized, and 153 were subsequently analyzed. Between 1 August 2020 and 30 April 2022, 153 trainees (83 control, 70 treatment) did 515 intubations (283 control, 232 treatment). In modified intention-to-treat analysis, first attempt success was 91.4% (212/232) in the trainee treatment group and 81.6% (231/283) in the control group (odds ratio 2.42 (95% confidence interval 1.45 to 4.04), P=0.001). Secondary outcomes favored the intervention, showing significance for decreased cognitive load and improved competency. Complications were lower for the intervention than for the control group but the difference was not significant., Conclusions: Just-in-time training among inexperienced clinicians led to increased first attempt success of infant intubation. Integration of a just-in-time approach into airway management could improve patient safety, and these findings could help to improve high stakes procedures more broadly. Randomized evaluation in other settings is warranted., Trial Registration: ClinicalTrials.gov NCT04472195., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: support from the Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work; PGK was a medical advisor for Verathon Medical until December 2020, outside of the submitted work; ABJ reports receiving (in the past 36 months) consulting fees unrelated to this work from Bioverativ, Merck/Sharp/Dohme, Janssen, Edwards Life Sciences, Novartis, Amgen, Eisai, Otsuka Pharmaceuticals, Vertex Pharmaceuticals, Celgene, Sanofi Aventis, Precision Health Economics, and Analysis Group; ABJ also reports receiving (in the past 36 months) income unrelated to the submitted work from hosting the podcast Freakonomics MD, and from book rights to Doubleday Books., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)