LDs' expressions of anxiety in terms of minor somatic complaints

Adverse childhood experiences (ACEs) and child behaviour problems in KwaZulu-Natal, South Africa

BACKGROUND

Adverse childhood events (ACEs) are associated with negative health effects in adulthood. Despite knowledge of these later impacts, little is known about the earlier effect of ACEs on later child behaviour in low- and middle-income countries (LMIC).

METHODS

The population-based Asenze cohort study was implemented in a peri-rural area of KwaZulu-Natal, South Africa, comprising five Zulu tribal areas. Two waves of data were examined: family information and ACEs exposure when children were on average 5 years old and child behaviour problems (Strengths and Difficulties Questionnaire [SDQ]) approximately 2 years later (average age 7 years). Logistic regression analysis was used to examine unadjusted and adjusted relationships between cumulative ACEs experienced and the SDQ total scores (dichotomized as top 10% vs. the rest) as well as selected SDQ subscales.

RESULTS

A significant relationship between increased ACE exposure and SDQ total score was observed. The same relationship was also seen for the SDQ emotional symptoms and conduct problem subscales, but not for hyperactivity. The results of a sensitivity analysis excluding intimate partner violence from the ACEs measure demonstrated similar results.

CONCLUSIONS

There is an association between exposure to ACEs and later child behaviour problems within this LMIC population demonstrating an early negative impact for ACEs. While previous research has focused on the effects of ACEs on adult health, this study provided evidence for an earlier relationship between ACEs and child behaviour problems that may be a part of the mechanism through which later health effects arise.

From Deficit Remediation to Capacity Building: Learning to Enable Rather Than Disable Students With Dyslexia

Purpose

In this article, we explore the deficit view of dyslexia and consider how it may narrow research so as to hamper the progress of scientific discovery and constrain best practices to the detriment of the overall well-being and growth of students with dyslexia. We consider the neurodiversity view of dyslexia as an alternative to the deficit view and explore how strengths-based approaches such as Universal Design for Learning can be used to support the overall well-being and development of students with dyslexia. Practical strategies are provided for applying a strengths-based approach in the speech-language pathologist setting to support students with dyslexia.

Method

We completed a focused literature review of the history of the deficit view of dyslexia, the alternate neurodiversity view, exceptional abilities related to dyslexia, and strategies for Universal Design for Learning.

Results

Although the research literature that deals with visual-spatial affordances associated with dyslexia is limited, there is significant evidence that a strengths-based approach to learning experience design can be leveraged by practitioners to improve student self-development, motivation, and academic outcomes.

Conclusion

We find that further research is needed to explore strengths associated with dyslexia and argue that a shift in mindset from the deficit view toward the neurodiversity view is required to build the capacity of students with dyslexia to thrive in learning and life.

Insights into the Feelings, Thoughts, and Behaviors of Children with Visual Impairments: A Focus Group Study Prior to Adapting a Cognitive Behavior Therapy–Based Anxiety Intervention

Introduction

Anxiety is the most common psychological problem reported among children with visual impairments. Although cognitive behavior therapy interventions have proven successful in treating childhood anxiety, it is unclear whether they are suitable and accessible for children who have visual impairments. This study aimed to determine if and how traditional cognitive behavior therapy–based interventions could be adapted for use with this specific population by interviewing children with visual impairments themselves.

Methods

A qualitative research design was used. Sixteen children with visual impairments (aged 9 to 13 years) participated in two focus group interviews. Participants attended two special schools in the Western Cape, South Africa. Interviews were audio-recorded and transcribed verbatim, and content analysis was undertaken.

Results

Three primary themes emerged from the focus group data: (1) difficulties encountered by children with visual impairments; (2) existing coping strategies; and (3) insight into the concepts of feelings, thoughts and behaviors (central to cognitive behavior therapy).

Discussion

The emergent themes and their implications for the adaptation of a cognitive behavior therapy–based anxiety intervention are discussed.

Implications for practitioners

Results provide practitioners with guidelines to consider when using or adapting therapeutic techniques such as cognitive behavior therapy for children with visual impairments.

The impact of adverse childhood experiences on an urban pediatric population

OBJECTIVE

The goal of this study was to investigate the adverse childhood experiences (ACEs) in youth in a low-income, urban community.

STUDY DESIGN

Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. Medical chart documentation of ACEs as defined in previous studies were coded and each ACE criterion endorsed by a traumatic event received a score of 1 (range=0-9). This study reports on the prevalence of various ACE categories in this population, as well as the association between ACE score and two pediatric problems: learning/behavior problems and body mass index (BMI)≥85% (i.e., overweight or obese).

RESULTS

The majority of subjects (67.2%, N=471) had experienced 1 or more categories of adverse childhood experiences (ACE≥1) and 12.0% (N=84) had experienced 4 or more ACEs (ACE≥4). Increased ACE scores correlated with increased risk of learning/behavior problems and obesity.

CONCLUSIONS

There was a significant prevalence of endorsed ACE categories in this urban population. Exposure to 4 or greater ACE categories was associated with increased risk for learning/behavior problems, as well as obesity.

PRACTICE IMPLICATIONS

Results from this study demonstrate the need both for screening of ACEs among youth in urban areas and for developing effective primary prevention and intervention models.

Assessing fears and related anxieties in children and adolescents with learning disabilities or mild mental retardation

The purpose of the present study was to examine self-reported fears and related anxieties in children and adolescents (7-18 years of age) having learning disabilities (LD) or mild mental retardation (MIMR), and whether these fears and related anxieties differ based on gender and age. Students responded to two well validated instruments, The Fear Survey Schedule for Children-Revised and Revised Children's Manifest Anxiety Scale. The results revealed age, gender, and disability interaction effects. Adolescent boys having mild mental retardation reported highest levels of fear related to failure and criticism, a finding that was different from those reported in previous studies. In addition, girls reported higher levels than boys of total fear, fears related to minor injury and small animals, and worry/oversensitivity. Age main effects were also observed where younger students from both the LD and the MIMR groups reported higher levels of non-specific general anxiety. Implications and directions for future research were presented.

Severity of emotional and behavioral problems among poor and typical readers

The purpose of this study was to examine the severity of behavioral and emotional problems among adolescents with poor and typical single word reading ability (N = 188) recruited from public schools and followed for a median of 2.4 years. Youth and parents were repeatedly assessed to obtain information regarding the severity and course of symptoms (depression, anxiety, somatic complaints. aggression, delinquent behaviors, inattention), controlling for demographic variables and diagnosis or ADHD. After adjustment for demographic variables and ADHD, poor readers reported higher levels of depression, trait anxiety, and somatic complaints than typical readers, but there were no difference, in reported self-reported delinquent or aggressive behaviors. Parent reports indicated no difference, in depression, anxiety or aggression between the two groups but indicated more inattention, somatic complaints, and delinquent behaviors for the poor readers. School and health professionals should carefully assess youth with poor reading for behavioral and emotional symptoms and provide services when indicated.

The influence of affect on the achievement and behavior of students with learning disabilities

Research indicates that students with learning disabilities are likely to be at greater risk for experiencing negative affect than their higher achieving counterparts. The purpose of this article is to review recent research on the effects of affect on thoughts, cognition, and behavior. This research finds that induced positive affects leads to more accurate performance on math, greater learning of new vocabulary, and better performance on a new learning task. Implications of and suggestions for follow-up studies of negative and positive affect in students with learning disabilities are presented.

Adolescents with learning disabilities at risk? Emotional well-being, depression, suicide

As recently as 5 years ago, very little information on the emotional well-being of adolescents with learning disabilities (LD) was available. However, a great deal of research has been conducted recently and some of the implications are unnerving. Research on self-concept, attributions, anxiety, depression, and suicide among adolescents with LD is examined for the purpose of detecting consistency of indicators concerning these emotional and developmental variables. The research indicates that the emotional development of many adolescents with LD is not notably positive, and these students appear to be at increased risk for severe depression and suicide. The discussion highlights methodological pitfalls and developmental issues. Practical implications are suggested.

The Boston Teacher Questionnaire. 1. Definition of syndromes

To obtain information about the academic function of 9-year-old children from their school teachers, we created a short, forced-choice questionnaire that asked about the child's knowledge and use of arithmetic tables, reading, spelling, persistence at tasks, flexibility of approach, ability to function independently, distractibility, daydreaming, impulsivity and overexcitability, hyperactivity, and ability to follow simple and sequential directions. Questionnaires were collected from the teachers of 3451 white children whose mothers had enrolled in the National Collaborative Perinatal Project. Six syndromes in girls and five in boys were identified by both cluster and factor analyses of these data. Common to both sexes were five syndromes we labeled arithmetic, tasks (ie, impersistent/dependent/inflexible), reading, attention, and hyperactive. A syndrome characterized by difficulty following directions was seen in girls only. The prevalence of these syndromes ranged from a low for hyperactivity of 2.3 per 100 girls to a high for the attention syndrome of 27.6 per 100 boys. The congruent results obtained with clustering and factor analysis, and the agreement between the observed prevalence of syndromes and prior expectations suggests that the Boston Teacher Questionnaire, as this instrument is called, identifies learning problems in 9-year-old children.

Depression and learning disabilities in children

Occurrence of learning disabilities was determined in 30 inpatient children aged 6-12 with major depressive disorder (MDD). Learning disabilities (LD) occurred seven times more often compared to community base rates (33% v 4.7%). While rates of comorbid diagnoses, severity of depression, and children's and parents' reports (DICA-C, DICA-P) did not differ between groups, teachers' reports (TRS, TRF) indicated increased classroom problems and poorer adaptive functioning in MDD/LD subjects (P < 0.0001).