Background: Migraine headache is a chronic pain condition that affects 20% of women of reproductive age, and is often treated with triptans. Triptans are serotonin 1B, 1D, and 1F receptor agonists that act as vasoconstrictors and inhibitors of the trigeminal cervical complex as well as peripheral neurons; they cross the blood brain barrier and placenta, and as such are plausible neurodevelopmental teratogens. No studies have examined risk of neurodevelopmental problems in children with prenatal triptan exposure. This dissertation had three aims: (1) to examine risk of behavioral problems in children using in the presence of time-varying confounding by concomitant medication use; (2) to examine risk of temperamental, motor, and communication disturbances associated with prenatal triptans exposure, adjusting for unmeasured confounding by migraine type and severity; and (3) to examine changes in neurodevelopment over time associated with prenatal triptan exposure. Methods: This dissertation used data from the Norwegian Mother and Child Cohort Study, a prospective birth cohort including more than 100,000 women recruited during their first prenatal ultrasound visit. Aims 1 and 3 used marginal structural models to assess the risk of (1) neurodevelopmental problems at age 36 months (Aim 1), or (2) change in risk of neurodevelopmental problems from 18 to 36 months (Aim 3) associated with prenatal triptan exposure. Aim 2 used propensity matching and calibration to adjust for unmeasured confounding by migraine type, severity, and attitudes towards medication use in pregnancy. Neurodevelopmental outcome measures included the Child Behavior Checklist (CBCL), the Emotionality, Activity, and Temperament Scale (EAS), and the Ages and Stages Questionnaire (ASQ). Exposure to triptans was ascertained by self-report. Results: Prenatal triptan exposure was associated with greater externalizing behavior problems at 18 and 36 months, as well as greater increases in emotionality and activity from 18 to 36 months. We observed no association between triptan exposure and motor skills or communication problems; triptan use during pregnancy was associated with migraine severity but not migraine type, and adjustment for unmeasured migraine characteristics moved effect estimates towards the null. Conclusions: Prenatal triptan exposure is associated with externalizing-type behaviors and temperament in children, while migraine itself is associated with internalizing-type behaviors and temperament. The use of concomitant medications and the severity of the underlying condition both exerted substantial influence on observed effect estimates, and should be considered in any future studies of triptan medication use in pregnancy.

Indiana University-Purdue University Indianapolis (IUPUI) / Serious emotional disturbance, including disruptive disorders (i.e., attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder), affects large numbers of adolescents, with costly and tragic consequences. Adolescents with disruptive disorders are likely to be arrested, drop out of school, and have poor treatment outcomes. There is an urgent need to identify strengths-based factors associated with improvement in adolescents’ behavioral and social functioning to help them achieve their full potential. The purpose of this study was to determine whether change in adolescent personal strengths and change in family functioning over 12 months predicted changes in behavioral and social functioning for adolescents with disruptive disorders who participated in a System of Care (SOC) program and if findings varied by race. De-identified data from 179 adolescents, aged 12-17 years, with disruptive disorders and their caregivers were included in this secondary analysis. Data were analyzed using Pearson correlations, t-tests, chi-square tests, and multivariate multiple regressions. Upon admission to the program, caregiver ratings indicated that African American adolescents had greater personal strengths (p = .001), fewer behavior problems (p < .001), and less functional impairment (p < .001) compared to their Caucasian counterparts. Girls had more behavior problems (p = .05) and fewer personal strengths than boys (p < .001). Increase in caregiver-rated adolescent personal strengths was significantly associated with improvement in caregiver-rated adolescent behavioral and social functioning (p < .001). Change in caregiver-rated family functioning was not significantly associated with change in caregiver-rated adolescent behavioral and social functioning (p = .171). The strength and direction of predictors did not vary by race. The adolescents in the study participated in a SOC program that emphasized their strengths versus, primarily, focusing on their deficits. Change in caregiver ratings of adolescent personal strengths was a significant predictor of change in adolescent behavioral and social functioning over a 12 months period. Findings provide evidence for psychiatric mental health professionals to focus on enhancing adolescent personal strengths to improve behavioral and social functioning in adolescents with disruptive disorders. Future research is needed to understand the impact of family variables on adolescents’ treatment outcomes.

Background. Adolescent antisocial behaviors are versatile in terms of their onset, severity, pervasiveness, continuity, and developmental outcomes. A substantial body of literature on developmental pathway of antisocial behaviors indicates that meaningful subtypes exist within these heterogeneous antisocial behaviors, rendering important implications to their etiology, causal mechanism and intervention. This study tests a taxonomy of antisocial behavior by examining whether different offending groups can be distinguished by their different group features including background risks and external correlates. First, two broad offending groups, i.e., the early-onset group and the adolescent-onset group were identified in a clinical sample of 118 adjudicated male adolescents based on age of onset of symptoms of Conduct Disorder. Further, two distinct subtypes, i.e. antisocial behavior associated with symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and antisocial behavior associated with callous-unemotional traits ii (CD traits), a defining feature of psychopathy, were hypothesized to coexist within the broad early-onset offending group, based on two lines of recent studies indicating ADHD and CD traits as important correlates of antisocial behaviors. These two subgroups were identified within the sample in this current study. / Conclusion. Different offending groups could be discerned by their distinctive associated group risks and deficits, giving evidence to different developmental pathways to antisocial behaviors. Implications to understanding and intervention of antisocial behaviors were discussed. / Method. Data were collected from 118 adjudicated male adolescents from a centralized probation facility in Hong Kong and 63 non-delinquent male control subjects from mainstream secondary schools, all aged between 12 and 17. Group comparisons and multinominal logistic regression were performed to test whether these offending groups could be distinguished by different background risks and deficits including variables pertaining to cognitive processes, family, parenting, and deviant peers, etc. / Results. The early-onset offending group could be differentiated from the adolescent-onset offending group by their association with adolescent adjustment iii difficulties, more background risks, ADHD diagnosis, and callous unemotional traits. The two early-onset subgroups, early-onset ADHD and early-onset CU traits group, shared similarities of having severer delinquency and poorer adolescent adjustment, but demonstrated differences in terms of disinhibitory processes. / Law, Yuen Wah Sonya. / Adviser: Patrick Wing-leung Leung. / Source: Dissertation Abstracts International, Volume: 73-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 265-289). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendix in Chinese.

Movement in Gestalt therapeutic intervention, using structured activities and free improvisations, is a successful alternative to punishing adolescents with disruptive behavioural tendencies in the classroom. An overview of the existing literature regarding the therapeutic value of movement in Gestalt therapeutic intervention for adolescents with disruptive behavioural tendencies is firstly presented. Various techniques supporting the adolescent in his quest to achieve equilibrium, ultimately improving his relationships with others and his environment, are described. A case study, involving eight adolescents with disruptive behavioural tendencies in group therapy follows, which indicates that movement in Gestalt therapy is an alternative to punishment. In the light hereof it is suggested that movement in Gestalt therapy could be implemented successfully in the formal school environment. This form of intervention can contribute to the adolescent's growth, his ability to communicate and his relationships with self, others and the environment, culminating in improved behavioural tendencies. / Social Work / M. Diac. (Play Therapy)

The aim of this study was to explore and describe the psychosocial problems perceived (their phenomenological field) by children in middle childhood, living in shelters in the Cape Metropolitan Area. The psychosocial problems included poor self regulation as a result of disturbances in the contact cycle, restrictions in shelters negatively impacting the holistic sense of self, barriers hindering relationships with significant others and the continuation of violence into the participants‟ broader field. The experience of multiple losses and persistence of violent behavior within and without the shelter context was a thread that ran through this study. Current literature provided an overview of the theoretical underpinnings of this study which included the key tenets of Gestalt therapy theory, core Gestalt principles, the child living in a shelter and development in middle childhood. A qualitative research approach with a case study of ten children from three shelters was implemented. / Social Work / M. Diac. (Play Therapy)

The study investigated adolescent boys who experienced behavioural problems at school and the possible causes for these phenomena. It was evident that the adolescent boys who experienced behavioural problems were found to lack emotional connections with others due to their fathers’ absence and lack of positive attachment. A total of 403 adolescent boys from various schools in the Tshwane districts were used in the sample group. This quantitative study employed the use of a quantitative questionnaire as a means of data collection that included qualitative open-ended question as a method to enrich the quantitative data and obtain insight into the life world functioning and experience of the participants. The primary aim of the research study was to determine the emotional relationship between fathers and sons within the sample group. Secondly, the study sought to investigate how this emotional relationship affects the adolescent boy’s self-concept, resilience and motivational aspects in his daily functioning. The approach to quantitative data analysis was by means of descriptive statistical analysis. The findings revealed that emotionally absent fathers indeed impact negatively on the adolescent boys’ resilience and motivational aspects of their functioning and that a father’s absence has a significant influence on the behaviours of adolescent boys in relation to motivation and resilience. However, the research results also revealed that an emotionally absent father does not significantly affect the self–concept of an adolescent boy. Finally, an intervention programme was developed to assist and guide fathers and adolescent boys to improve their relationship with one another. / Psychology of Education / D. Ed. (Psychology of Education)

As a result of the reauthorization of the Individuals with Disabilities Education Act of 1997, schools must now consider positive behavioral interventions and strategies to address problem behavior of students with Emotional/Behavioral Disorders (E/BD). Given the poor behavioral, academic, and social outcomes for these students, there is a compelling need to identify effective, proactive interventions. Current literature has well established the ineffectiveness of traditional, punitive, and consequence-laden strategies to deal with behaviors. Research has shown the manipulation of antecedent stimuli, in the form of curricular adaptations, can provide a positive, proactive means of managing behavior. Specifically, curriculum modifications, based on student interest, are proposed as a positive, proactive strategy used to manipulate antecedent stimuli to improve the behavior of students with E/BD. The purpose of this study was to investigate the manipulation of antecedent stimuli through the implementation of individualized, curricular adaptations, based on student interest, to reduce the problem behavior of students exhibiting disruptive behaviors. A second purpose was to explore the effect of those adaptations on the behavior motivation of students with E/BD. In this study, curriculum modifications based on student interest were used to reduce disruptive behavior, increase desirable behavior, and effect change in the motivation for problem behavior among four elementary school boys with E/BD. Use of an ABAB reversal design, including interval data collection, and the use of a behavior rating scale and a motivation assessment scale were used to establish baseline data and determine effectiveness of the intervention. Results indicate that each student demonstrated a reduction in disruptive behavior, an increase in desirable behavior, and changes in motivation for behavior.

Historical documentation of the impact of PL 88-164 on the field of emotional and behavioral disorders (E/BD) and the development and implementation of teacher-training programs for children and youth identified as E/BD is limited. This study was designed to document the historical significance and professional contributions of Dr. Richard J. Whelan, Professor Emeritus, University of Kansas and his work in the development of teacher preparation training programs in the field of E/BD in institutions of higher education (IHE). The second purpose of this study was to document the legislative and program initiatives that have impacted the services, education, teaching, and research initiatives in the field of E/BD as interpreted by Dr. Whelan. The final purpose of this study was to examine the views of Dr. Whelan regarding the need for future developments in the field of E/BD. Legislative and policy efforts continue to change the climate in which children are educated. The field of special education relies on the efficacy of the training programs in IHE to provide appropriate teaching and research efforts in a manner that is consistent with the current needs of students with E/BD, their families, and the schools in which they seek to be educated. As this study revealed, understanding the history of the field, the foundational framework from which research and evidence-based practices have emerged, is paramount to forward movement in the field and necessary to the measurement of effective interventions and strategies in support of the students, their families, and those who choose this field as their lifework. It is the foundation from which educational theory is developed, researched, revised, and reflected.

<p>Увод: Процена минималних неуролошких дисфункција (МНД) пружа информације о неуролошком стању детета, помаже у идентификовању вулнерабилности детета ка развоју моторних слабости, тешкоћа у учењу или поремећаја понашања. Деформитети кичменог стуба код деце предшколског узраста су у сталном порасту. Циљ истраживања: Утврђивање преваленце МНД-а у узорку предшколске деце тестирањем по Touwen-у, евалуација постуралног статуса код деце предшколског узраста, као и утврђивање повезаности јављања минималних неуролошких дисфункција и постуралних поремећаја код деце предшколског узраста. Материјал и методе: Истраживање је урађено у предшколској установи &bdquo;Радосно детињство&ldquo; из Новог Сада. Укупан узорак је обухватио 120-оро деце која су подељена у две групе у односу на узраст, 60-оро деце старости од 6 до 7 година (група А) и 60-оро деце старости од 5 до 6 година (група Б). Методом случајног избора су изабрана три вртића из различитих делова града, а деца су насумично одабрана са приближно једнаком заступљеношћу пола. Тестирање је урађено са Touwen-овим тестом модификованим од стране Hadders-Algre. Резултати су груписани у три групе: одсуство, присуство једноставних (присуство једне или две области дисфункције) и присуство комплексних МНД (присуство најмање три области дисфункције). Код све деце урађена је евалуација постуралног статуса, као и антропометријска мерења. Резултати: Постоји статистички значајна разлика у учесталости јављања МНД-а у односу на узраст, одступања су чешће присутна у млађем узрасту. МНД се чешће јављају код дечака у односу на девојчице, али није показана статистички значајна разлика. Код 68,3% деце уочени су елементи лошег држања тела. Најчешћа одступања од нормалног постуралног положаја била су у виду спуштених стопала (45,8%), асиметрије висине рамена (35%), искривљења ахилових тетива ван (30%), повећања слабинске кривине (29,2%) и асиметрије троуглова стаса (20%). Утврђена је статистички значајна позитивна повезаност између јављања минималних неуролошких дисфункција и лошег држања тела код деце предшколског узраста. Закључак: Деца старијих (узраст од 5 до 6 година) група предшколског узраста знатно чешће испољавају знаке минималне неуролошке дисфункције у односу на децу најстаријих (узраст од 6 до 7 година) група. Више од половине деце предшколског узраста показује одступање од нормалног постуралног статуса. Постоји статистички значајна позитивна повезаност између јављања минималних неуролошких дисфункција и лошег држања тела код деце предшколског узраста.</p> / <p>Uvod: Procena minimalnih neuroloških disfunkcija (MND) pruža informacije o neurološkom stanju deteta, pomaže u identifikovanju vulnerabilnosti deteta ka razvoju motornih slabosti, teškoća u učenju ili poremećaja ponašanja. Deformiteti kičmenog stuba kod dece predškolskog uzrasta su u stalnom porastu. Cilj istraživanja: Utvrđivanje prevalence MND-a u uzorku predškolske dece testiranjem po Touwen-u, evaluacija posturalnog statusa kod dece predškolskog uzrasta, kao i utvrđivanje povezanosti javljanja minimalnih neuroloških disfunkcija i posturalnih poremećaja kod dece predškolskog uzrasta. Materijal i metode: Istraživanje je urađeno u predškolskoj ustanovi &bdquo;Radosno detinjstvo&ldquo; iz Novog Sada. Ukupan uzorak je obuhvatio 120-oro dece koja su podeljena u dve grupe u odnosu na uzrast, 60-oro dece starosti od 6 do 7 godina (grupa A) i 60-oro dece starosti od 5 do 6 godina (grupa B). Metodom slučajnog izbora su izabrana tri vrtića iz različitih delova grada, a deca su nasumično odabrana sa približno jednakom zastupljenošću pola. Testiranje je urađeno sa Touwen-ovim testom modifikovanim od strane Hadders-Algre. Rezultati su grupisani u tri grupe: odsustvo, prisustvo jednostavnih (prisustvo jedne ili dve oblasti disfunkcije) i prisustvo kompleksnih MND (prisustvo najmanje tri oblasti disfunkcije). Kod sve dece urađena je evaluacija posturalnog statusa, kao i antropometrijska merenja. Rezultati: Postoji statistički značajna razlika u učestalosti javljanja MND-a u odnosu na uzrast, odstupanja su češće prisutna u mlađem uzrastu. MND se češće javljaju kod dečaka u odnosu na devojčice, ali nije pokazana statistički značajna razlika. Kod 68,3% dece uočeni su elementi lošeg držanja tela. Najčešća odstupanja od normalnog posturalnog položaja bila su u vidu spuštenih stopala (45,8%), asimetrije visine ramena (35%), iskrivljenja ahilovih tetiva van (30%), povećanja slabinske krivine (29,2%) i asimetrije trouglova stasa (20%). Utvrđena je statistički značajna pozitivna povezanost između javljanja minimalnih neuroloških disfunkcija i lošeg držanja tela kod dece predškolskog uzrasta. Zaključak: Deca starijih (uzrast od 5 do 6 godina) grupa predškolskog uzrasta znatno češće ispoljavaju znake minimalne neurološke disfunkcije u odnosu na decu najstarijih (uzrast od 6 do 7 godina) grupa. Više od polovine dece predškolskog uzrasta pokazuje odstupanje od normalnog posturalnog statusa. Postoji statistički značajna pozitivna povezanost između javljanja minimalnih neuroloških disfunkcija i lošeg držanja tela kod dece predškolskog uzrasta.</p> / <p>Introduction: Assessment of minor neurological dysfunction (MND) provides information about a child&#39;s neurological condition, which helps to identify the vulnerability of the child to the development of motor impairment, difficulties in learning or behavioral disorders. Spinal deformities in preschool children are constantly increasing. Aim: Determining the prevalence of MND in a sample of preschool children using Touwen&rsquo;s test, the evaluation of postural status in preschool children, as well as determining the relation between the occurrence of minor neurological dysfunction and postural disorders in preschool children. Material and methods: The examination was carried out in the preschool institution &ldquo;Radosno detinjstvo&rdquo; in the city of Novi Sad. The total sample included 120 children who were divided into two groups according to their age, 60 children aged 6 to 7 years (group A) and 60 children aged 5 to 6 years (group B). The children were recruited at three randomly selected kindergartens, and the children were randomly selected with approximately equal gender representation. The testing was done with Touwen&#39;s test modified by Hadders-Algra. The results were classified into three groups: the absence of MND, the presence of simple MND (presence of one or two domains of dysfunction) and the presence of complex MND (presence of at least three domains of dysfunction). Evaluation of postural status and anthropometric measurements were carried out for all the children. Results: There is a statistically significant difference in the prevalence of MND in relation to age, variations were more likely at a younger age. MND is more frequent in boys than in girls, but this difference is not statistically significant. In 68.3% of the children there are elements of bad posture. The most common deviations from the normal postural position are flat feet (45.8%), shoulder height asymmetry (35%), distortion of Achilles tendons to the outside (30%), excessive curvature of lower back (29.2%) and asymmetry of stature triangles (20%). There is a statistically significant positive correlation between the occurrence of minor neurological dysfunction and poor posture in children of preschool age. Conclusion: Children in older preschool groups (5 to 6 years old) more often show signs of minor neurological dysfunction in comparison to the children in the oldest groups (6 to 7 years old). More than half of the preschool children show deviation from normal postural status. There is a statistically significant correlation between the occurrence of minor neurological dysfunction and poor posture in children of preschool age.</p>

Introdução: A psicoterapia infantil mediada com o computador pode tornar os pacientes mais colaborativos e motivados, diminuir o estigma de ir à terapia, aproximar e melhorar a relação com o terapeuta, facilitar a compreensão de conceitos terapêuticos fundamentais dentro da abordagem cognitivo-comportamental, melhorando suas habilidades de resolução de problemas além de estruturar as sessões de terapia. Objetivo: Criar um protocolo computadorizado para tratamento psicoterápico de crianças denominado Projeto Transformador. Avaliar o projeto para saber de sua viabilidade e utilidade como instrumento terapêutico. Método: Foram realizados dois estudos, um com as crianças e outro com os terapeutas. Os dois estudos foram abertos e utilizaram métodos quantitativos e qualitativos. O primeiro ensaio (A), foi realizado com 10 crianças com transtornos de ansiedade, que responderam a escalas de avaliação e a questionários. No segundo estudo (B), 12 terapeutas usaram o Projeto Transformador em sua prática clínica e sua experiência foi ouvida e analisada. Resultados: Os dados coletados mostraram que as crianças e os terapeutas ficaram satisfeitos com o programa computadorizado Projeto Transformador e este mostrou-se útil motivando a execução de um ensaio clínico randomizado / Introduction: Computer-mediated child psychotherapy can make patients more collaborative and motivated, decrease the stigma of going to therapy, closen and improve the relationship with the therapist, facilitate the understanding of fundamental therapeutic concepts within the cognitive-behavioral approach, improving their problem solving skills, as well as structure therapy sessions. Objective: To create a computerized protocol for psychotherapeutic treatment of children called Projeto Transformador. To assess the project\'s feasibility and usefulness as a therapeutic instrument. Method: Two studies were performed, one with children and one with therapists. Both studies were open and used quantitative and qualitative methods. The first study (A) was conducted with ten children with anxiety disorders who responded to evaluation scales and questionnaires. In the second study (B), twelve therapists used Projeto Transformador in their clinical practice and their experiences were heard and analyzed. Results: The data collected showed that both children and therapists were satisfied with the computerized program Projeto Transformador and that the program proved to be useful, motivating the implementation of randomized clinical tests