Transcript Chapter 1

RECENT DEVELOPMENTS IN
BEHAVIORAL, SOCIAL, AND
CLINICAL ASSESSMENT OF
CHILDREN
JEROME M. SATTLER
Copyright © 2014 Jerome M. Sattler, Publisher, Inc.
Snapshots of Our World in
Headlines
Panda Mating Fails;
Veterinarian Takes Over
Snapshots of Our World in
Headlines
Police Begin Campaign to
Run Down Jaywalkers
Snapshots of Our World in
Headlines
Local High School Dropouts Cut in Half
Snapshots of Our World in
Headlines
Drunk Gets Nine Months in Violin Case
Snapshots of Our World in
Headlines
New Study of Obesity Looks
for Larger Test Group
Revised, New, or Additional
Assessment Measures [1]




Behavior Dimensions Scale, Second
Edition: School Version and Behavior
Dimensions Scale, Second Edition: Home
Version, p. 347
Conners 3rd Edition, p. 351
Conners Comprehensive Behavior Rating
Scales, p. 352
Social Skills Improvement System, p. 359
Revised, New, or Additional
Assessment Measures [2]




Parenting Relationship Questionnaire, p.
366
Parenting Stress Index, Fourth Edition and
Parenting Stress Index, Fourth Edition–
Short Form, p. 368
Koppitz Developmental Scoring System
for the Bender Gestalt Test, Second
Edition, p. 406
Beery VMI, p. 407
Revised, New, or Additional
Assessment Measures [3]





Bruininks-Oseretsky Test of Motor
Proficiency, Second Edition, p. 409
Multidimensional Anxiety Scale for
Children, Second Edition, p. 439
Revised Children’s Manifest Anxiety
Scale, Second Edition, p. 439
Children’s Depression Inventory, Second
Edition, p. 442
Reynolds Child Depression Scale, Second
Edition, p. 443
Revised, New, or Additional
Assessment Measures [4]




Strengths and Difficulties Questionnaire,
p. 463
ADHD Questionnaire, p. 463
Attention Deficit Disorder Evaluation
Scale, Fourth Edition–Home Version,
p. 463
Attention Deficit Disorder Evaluation
Scale, Fourth Edition–School Version,
p. 463
Revised, New, or Additional
Assessment Measures [5]






BASC–2 Progress Monitor, p. 463
Comprehensive Executive Function
Inventory, p. 463
See Table 17-1 for examples of
standardized achievement tests
Autism Diagnostic Observation Schedule,
Second Edition, p. 608
Autism Observation Scale for Infants,
p. 608
Autism Spectrum Rating Scale, p. 608
Revised, New, or Additional
Assessment Measures [6]





Checklist for Autism Spectrum Disorder,
p. 608
Childhood Autism Rating Scale, Second
Edition, p. 608
PDD Behavior Inventory, p. 608
Psychoeducational Profile–Third Edition,
p. 608
Scale of Pervasive Developmental
Disorder in Mentally Retarded Persons,
Revised, New, or Additional
Assessment Measures [7]





Screening Tool for Autism in Toddlers and
Young Children, p. 608
Social Responsiveness Scale, p. 608
SCAT3 (Sport Concussion Assessment
Tool 3), p. 635
NEPSY–II, p. 665
NIH Toolbox, p. 669
Revised, New, or Additional
Assessment Measures [8]

Also see the Resource Guide for revised
questionnaires, semistructured interviews,
observation forms, self-monitoring forms,
FBA forms, ADHD forms, SLD forms, ASD
forms, Instructional handouts,
miscellaneous tables, and formal and
informal measures of executive functions
(p. 251 and p. 258 in Resource Guide)
Video Link

Fetal Alcohol Spectrum Disorders
Prevention PSA
 http://www.youtube.com/watch?v=mRf2
Kjz0hAg&feature=share&list=UU7PjTluf
hDCfET974TcMWmA&index=18
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [1]
Abbreviations Used in the Table
NA = National Average
EA = European American
AA = African American
As = Asian American
HA = Hispanic American
AI = American Indian
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [2]
Indicator
NA
EA
AA
As HA AI
Children in poverty
23
14
40
15
34 24
Teens not in school 8
and not working
Children not
54
attending preschool
Fourth graders not 66
proficient in reading
6
12
4
10
51
51
48
63 53
55
83
49
81 61
8
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [3]
Indicator
NA
EA
AA
As HA AI
Eight graders not
proficient in math
High school
students not
graduating on time
Low-birthweight
babies
66
56
86
40
79 63
19
15
32
7
24 NA
8
7
12.8 8.2
7
NA
10 Indicators of Child Well-Being
by Ethnicity (%), 2012-2013 [4]
Indicator
Child and teen
death per
100,000a, b
Children in singleparent families
Teen birth per
1,000a
a Not in percent.
b 2010.
NA
EA
AA
As HA AI
26
25
36
14
21 NA
35
25
67
17
42 43
29
20
44
10
46 NA
10 Indicators of Child Well-Being
by Ethnicity (%), 2004-2005 [5]


Source:
Annie E. Casey Foundation. (2014). 2014
data book: State trends in child well-being
(25th Ed.). Retrieved from
http://www.aecf.org/m/resourcedoc/aecf2014kidscountdatabook-2014.pdf
Paternal Age at Childbearing [1]
Sample
All individuals born in Sweden in 1973–
2001 (N = 2,615,081)
Results
Offspring of fathers 45 years and older,
compared with offspring born to fathers 20–
24 years old, were at heightened risk of
 ADHD (13.13 times greater)
 Autism (3.45 times greater)
Paternal Age at Childbearing [2]
Results (Cont.)
Bipolar disorder (24.70 times greater)
Psychosis (2.07 times greater)
Suicide attempts (2.72 times greater)
Substance use problems (2.44 times
greater)
Failing a grade (1.59 times greater)
Low educational attainment (1.70 times
greater)
Paternal Age at Childbearing [3]
Conclusions
Advancing paternal age is associated with
increased risk of psychiatric and academic
morbidity in children
In older fathers
 Sperm may not develop fully
 Sperm may have some form of genetic
mutation
Paternal Age at Childbearing [4]
Conclusions (Cont.)
Older fathers also may have been exposed
to
 Environmental toxins longer than
younger fathers and
 Long exposure to toxins may affect the
DNA in the father’s sperm
Paternal Age at Childbearing [5]
Source
D’Onofrio, B. M., Rickert, M. E., Frans, E.,
Kuja-Halkola, R., Almqvist, C., Sjölander, A.,
Larsson, H., & Lichtenstein, P. (2014).
Paternal age at childbearing and offspring
psychiatric and academic morbidity. JAMA
Psychiatry. Advanced online publication.
doi:10.1001/jamapsychiatry.2013.4525
Adverse Childhood Experiences
(ACEs) California Study [1]




Year 2008
Representative sample of 9,500 adults
Aim of study: Effects of childhood trauma
on later health problems
Childhood trauma defined as experiencing
 Physical abuse
 Sexual abuse
 Emotional abuse
Adverse Childhood Experiences
(ACEs) California Study [2]


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Living in a household with
 Mental illness
 Substance abuse
 Domestic violence
Having separated or divorced parents
Having an incarcerated parent
Findings of ACE Study [1]


61% suffered at least one ACE
25% experienced three or more ACEs
(referred to as polyvictimization)
Findings of ACE Study [2]

Adults who suffered from childhood
trauma (compared to those who did not)
were
 500% more likely to suffer from
depression
 350% more likely to smoke tobacco
 90% more likely to engage in binge
drinking
 63% more likely to have a heart attack
 60% more likely to be obese
Findings of ACE Study [3]

Income level also associated with negative
effects of ACEs
 52% of low-income adults exposed to
four or more ACEs had serious
psychological distress
 Fewer than 25% of high-income adults
with same exposure levels had similar
levels of psychological distress
Findings of ACE Study [4]

Source:
http://tcenews.calendow.org/releases/state
-assembly-hearing:-childhood-trauma-iscommon-and-can-be-devastatingbutdamage-can-be-overcome
Life Expectancy Tied To Education
[1]


Life expectancy is 82 for individuals with
more than 12 years of education
Life expectancy is 75 for individuals with
12 or fewer years of education
Life Expectancy Tied To Education
[2]

Possible Reasons
Those with less education:
Are likely to have more smoking-related
diseases, such as lung cancer and
emphysema—35% of Americans with an
9th to 11th grade education smoke, while
only 7% with a graduate degree smoke
 Are likely to have lower incomes

Life Expectancy Tied To Education
[3]

Possible Reasons (Continued)
Are likely to live in areas that have their
own health threats, either through crime or
poor housing conditions
Are likely to have limited health insurance
and limited access to health services
 Are more likely to agree with the
statement: “It doesn't matter if I wear a
seat belt, because if it’s my time to die, I'll
die.”

Life Expectancy Tied To Education
[4]



Summary and Recommendations
The less affluent and less educated are
also, invariably, less healthy
Disparities in health are a major challenge
in the United States
Health is not a product of health care per
se, but of one's life course and
opportunities
Life Expectancy Tied To Education
[5]
Summary and Recommendations (Cont.)


The less educated must learn the
following: “It does matter. Life is uncertain,
but that's no reason to surrender to fate”
Fighting poverty and improving education
are keys to increasing life expectancy
among less-advantaged Americans
Life Expectancy Tied To Education
[6]
Summary and Recommendations (Cont.)

Source: Meara, E. R., Richards, S., &
Cutler, D. M. (2008). The gap gets bigger:
Changes in mortality and life expectancy,
by education, 1981–2000. Health Affairs,
27, 350–360.
Equity and Educational
Opportunities In US Schools [1]




Office for Civil Rights, Civil Rights Data
Collection
Sample Statistics
Year of study: 2009–2010
Representative sample
Covering approximately 85% of nation’s
students
Equity and Educational
Opportunities US Schools [2]
Key Findings
African-American students represent 18% of
students in sample and
35% of students suspended once
46% of students suspended more than
once
39% of students expelled
Equity and Educational
Opportunities In US Schools [3]
Key Findings (Cont.)
Hispanic-American students represent 24%
of students in sample and
25% of students suspended once
25% of students suspended more than
once
24% of students expelled
Equity and Educational
Opportunities In US Schools [4]
Key Findings (Cont.)
Asian-American students represent 6% of
students in sample and
3% of students suspended once
1% of students suspended more than once
2% of students expelled
Equity and Educational
Opportunities In US Schools [5]
Key Findings (Cont.)
American-Indian-American students
represent 1% of students in sample and
1% of students suspended once
1% of students suspended more than once
1% of students expelled
Equity and Educational
Opportunities In US Schools [6]
Key Findings (Cont.)
European-American students represent 51%
of students in sample and
36% of students suspended once
29% of students suspended more than
once
33% of students expelled
Equity and Educational
Opportunities In US Schools [7]
Key Findings (Cont.)
Referred to Law Enforcement
25% of European American students
(51% in sample)
42% of African American students
(18% in sample)
29% of Hispanic American students
(24% in sample)
Equity and Educational
Opportunities In US Schools [8]
Key Findings (Cont.)
School Related Arrests
21% of European American students
(51% in sample)
37% of African American students
(18% in sample)
35% of Hispanic American students
(24% in sample)
Equity and Educational
Opportunities In US Schools [9]
Key Findings (Cont.)
Sex of Students Expelled
Males 74% (about 50% of sample)
Females 26% (about 50% of sample)
Equity and Educational
Opportunities In US Schools [10]
Key Findings (Cont.)
Disability Status of Students
Suspended
 13% of students with disabilities covered
by IDEA were suspended
 6% of Non-IDEA students were
suspended
Equity and Educational
Opportunities In US Schools [11]
Key Findings (Cont.)
Disability Status of Students (Cont.)
Referred to Law Enforcement
 Students with disabilities covered by
IDEA 25% (but 12% of student
population)
 Non-IDEA students 75% (but 88% of
student population)
Equity and Educational
Opportunities In US Schools [12]
Key Findings (Cont.)
English Language Learners Suspended
7% (but 10% of student population)
Equity and Educational
Opportunities In US Schools [13]
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

Sources:
http://www2.ed.gov/about/offices/list/ocr/d
ocs/crdc-2012-data-summary.pdf
http://www2.ed.gov/about/offices/list/ocr/d
ocs/crdc-disciplinesnapshot.pdf?utm_source=JFSF+Newslett
er&utm_campaign=0f6e101c7eNewsletter_July_2013&utm_medium=ema
il&utm_term=0_2ce9971b29-0f6e101c7e195307941
Reducing Suspensions
and Expulsions [1]


Education Development Center May 2011
Recommendations
Schools and mental health, juvenile
justice, and law enforcement agencies
 Must collaborate to improve outcomes
for youth, especially those at risk for
suspension or expulsion
Reducing Suspensions
and Expulsions [2]
Recommendations (Cont.)
Schools and mental health, juvenile justice,
and law enforcement agencies (Cont.)
 Must employ improved informationsharing and data collection systems to
identify, serve, and communicate about
at-risk students
Reducing Suspensions
and Expulsions [3]
Recommendations (Cont.)
State standards are needed to guide
schools’ practices related to
 Promoting students’ mental health
 Identifying students who need mental
health services
 Assisting students to access services
Reducing Suspensions
and Expulsions [4]
Recommendations (Cont.)
School districts should
 Focus on implementing, adapting, and
evaluating evidence-based interventions
 Have policies that require programs and
services for at-risk youth
 Consistently apply suspension and
expulsion policies so that existing racial
and ethnic disparities are not
perpetuated
Reducing Suspensions
and Expulsions [5]
Recommendations (Cont.)
School districts should (Cont.)
 Identify effective strategies to engage
and collaborate with parents
 Provide support to enable expelled
students to rejoin the school community
(and community partners)
Reducing Suspensions
and Expulsions [6]

Source:
http://www.promoteprevent.org/sites/www.
promoteprevent.org/files/resources/Califor
nia_Action_Steps_May_2011.pdf
Outcomes in Serious
Youthful Offenders [1]





Why do some serious adolescent
offenders stop offending while others
continue to commit crimes?
Investigators interviewed 1,354 young
offenders in the US
Mean age = 16.2 years
Years of offense: 2000 to 2003
Year of data collection: 2010
Outcomes in Serious
Youthful Offenders [2]
FINDINGS
Other than those with substance abuse
problems, those with behavioral health
problems were at no greater risk than those
without behavioral health problems for
 Rearrest
or
 Engaging in antisocial activities
Outcomes in Serious
Youthful Offenders [3]
FINDINGS (Cont.)
More frequent aftercare services (e.g.,
frequent supervision and involvement in
community activities) significantly reduced
the odds of
 An arrest
or
 Return to an institution during the 6month aftercare period
Outcomes in Serious
Youthful Offenders [4]

FINDINGS (Cont.)
Those with substance use disorders, in
comparison with those without substance
abuse, disorders had more negative
outcomes
Outcomes in Serious
Youthful Offenders [5]

Source
Schubert, C. A. & Mulvey, E. P. (2014).
Behavioral health problems, treatment,
and outcomes in serious youthful
offenders. Retrieved from
http://ojjdp.gov/pubs/242440.pdf
Executive Functions
(EF; Appendix M,
pp. 246–262 in RG)
Executive Functions [1]
Cognitive abilities responsible for
Complex goal-directed behavior
Adaptation to environmental changes and
demands
Development of social and cognitive
competence
Development of self-regulation of behavior
Executive Functions [2]
EF enable individuals to modulate, control,
organize, and direct
Cognitive activities
Emotional activities
Behavioral activities
Executive Functions [3]
EF help individuals
Make personal and social decisions
Distinguish relevant from irrelevant material
Follow general rules
Make use of existing knowledge in new
situations
Executive Functions [4]
EF important for
Daily living
Academic performance
Work-related activities
Social relationships
Primary Executive Functions
(RG, p. 247)[1]
1.
2.
3.
4.
Planning and goal setting: ability to plan
and reason conceptually, monitor one’s
actions, and set goals
Organizing: ability to organize ideas and
information
Prioritizing: ability to focus on relevant
themes and details
Working memory: ability to temporarily
hold and manipulate information in
memory
Primary Executive Functions
(RG, p. 247) [2]
5.
6.
7.
Shifting: ability to alternate between
different thoughts and actions, to devise
alternative problem-solving strategies,
and to be cognitively flexible
Inhibition: ability to inhibit thoughts and
actions that are inappropriate for a
situation
Self-regulation: ability to regulate one’s
behavior and monitor one’s thoughts and
actions
Developmental Aspects of
Executive Functions [1]


EF most closely associated with the frontal
lobes of the brain
Maturational changes in brain structure
and function and in social experiences
govern the development of EF (see Table
M-1 on p. 249 in RG)
Developmental Aspects of
Executive Functions [1]


Begin to develop as early as 2 months of
age
 Self-exploration
 Emerging understanding of volitional
actions
At 1 year of age
 Working memory
 Ability to detect another’s attentional
and intentional states
Developmental Aspects of
Executive Functions [2]

EF improves throughout development;
gains noted in
 Working memory
 Strategic thinking and fluency
 Goal-directed behavior
 Monitoring of behavior
 Flexibility
Developmental Aspects of
Executive Functions [3]

EF improve throughout development gains
in (Cont.)
 Understanding of emotions, intentions,
beliefs, and desires
 Deciphering of metaphors and
understanding of faux pas
 Processing speed
 Problem solving
Developmental Aspects of
Executive Functions [4]

Overall EF has elements
 Of uniformity—common evolution
across EF
 Of individuality and variation—unique
evolution across EF
Intelligence and EF [1]
Tests of intelligence correlate moderately—
about .40 to .60—with tests of EF
Working memory more closely related to
fluid and crystallized intelligence
Inhibition and flexibility less closely related
to fluid and crystallized intelligence
Intelligence and EF [2]
Correlations moderate because IQ tests do
not require
Shifting between different tasks
Shifting between competing demands
Using self-regulation strategies to
maximize long-term objectives
Inhibiting less favorable responses
Achievement and EF [1]
Writing Essays
Planning and defining the first step
Rephrasing and paraphrasing one’s own
work and the work of others (cognitive
flexibility)
Organizing and prioritizing
Using accurate syntax
Achievement and EF [2]
Reading Comprehension
Planning what to read first and which
sections to focus on most
Organizing the material mentally by its
most important points
Monitoring one’s comprehension by
summarizing material
Achievement and EF [3]
Independent Studying, Completing
Homework, and Long-Term Projects
Planning ahead (time management)
Acquiring materials and information
(information processing)
Setting long-term goals (completing tasks)
Self-regulation (balancing needs)
Achievement and EF [4]
Independent Studying, Completing
Homework, and Long-Term Projects
(Cont.)
Self-monitoring (remembering to submit
completed assignments by a specific time)
Cognitive flexibility (ability to modify how
one goes about doing projects)
Achievement and EF [4]
Test-Taking
Prioritizing and focusing on relevant
themes
Managing time to study and answer
questions
How EF Are Compromised?
By
 Mental disorder
 Brain injury
 Learning disability
 Attention difficulties
 Fatigue
Anxiety
Stress
Depression
Motivational
deficits
Examples of Disabilities Where
EF are Compromised








Planning: ASD, TBI, SLD
Goal setting: ASD, TBI, SLD
Inhibition: ASD, ADHD, TBI
Self-regulation: ASD, ADHD, TBI, SLD
Shifting: ADHD, TBI, SLD
Prioritizing: SLD
Working memory: TBI
Organizing: ADHD, SLD
Assessment of EF [1]


Neuropsychological tests (see Table M-2 on
pp. 251–257 in RG)
Psychological tests (see Table M-2 on pp.
251–257 in RG)
Assessment of EF [2]

Interviews with
 Child (see Table M-3 on pp. 258–259 in
RG)
 Parents (see Tables M-3 on pp. 258–
259 in RG and B-9 on pp. 40–43 in RG)
 Teachers (see Table B-15 on pp. 67–70
in RG)
Assessment of EF [3]



General Assessment Considerations
Measures of information processing and
academic skills are indirect measures of
EF
Amount and nature of EF involved in each
task varies
No single measure provides an accurate
estimate of all types of EF
Assessment of EF [4]



Observing child at school, home, and
during the assessment (see Table M-3 on
pp. 258–259 in RG)
Analyzing samples of the child’s
schoolwork and written homework
assignments (see Table H-8 on p. 137 in
RG)
See Table L-18 (p. 242 in RG) for a
checklist for rating EF
Assessment of EF [5]

Conclusion
A multifaceted, comprehensive
assessment is required for the
assessment of EF
Improving Deficits in EF


See pp. 259 and 260 in RG
See Handout K-1 (for parents, begins on
p. 162) and Handout K-3 (for teachers,
begins on p. 185) in RG