Our sample consisted of 116 adults aged 18 and older, recruited from college and community settings. Participants were currently in a romantic relationship and endorsed the sudden and/or violent death of a family member, close friend, or romantic partner. We hypothesized that: 1) prolonged grief is associated with poor dyadic functioning; 2) social support moderates the relationship between prolonged grief and dyadic functioning; 3) religious coping moderates the association between prolonged grief and dyadic functioning. Results indicated that prolonged grief was not significantly related to dyadic functioning, and neither social support nor religious coping moderated this association.

This dissertation explores the functioning and participation of children with autism spectrum disorder (ASD) in their natural environments, with a focus on the preschool years. Chapter 1 provides the context for this dissertation through introducing the theoretical frameworks that were used, exploring function-based measures, and social communication functioning. Chapter 2 is a qualitative evidence synthesis of the literature to identify the cultural factors that are associated with parents’ engagement in their children’s healthcare services. This chapter highlights the challenges that parents of children with ASD faced and the importance of health providers to be culturally competent in family-centered care. Chapter 3 is a descriptive study that aims to explore the participation patterns of preschool children with ASD at home and in the community. The association of environmental factors and social communication abilities on children’s participation are also explored. This chapter emphasizes that children with ASD participated in a variety of activities at home and in the community. It also highlights the importance of supporting parents to engage their children in activities and the need for community to support their participation. Chapter 4 examines the stability of a function-based categorization system – the Autism Classification System of Functioning: Social Communication (ACSF:SC). Children’s social communication abilities were rated using the ACSF:SC at baseline and six months. This chapter indicates that rating of social communication abilities can vary over time. Therefore, frequent assessment using the ACSF:SC is recommended for accurate identification of the child’s current social communication abilities. Chapter 5 discusses the clinical and research implications of this dissertation work. It also discusses knowledge translation opportunities and potential future work. / Thesis / Doctor of Philosophy (PhD) / This thesis consists of a series of studies examining factors associated with the abilities of children with autism spectrum disorder and their participation in daily activities. The first study provides a review of the literature examining the association between cultural backgrounds of parents and their engagement in autism child services. The second study explores the patterns of engagement in childhood activities for preschool children with autism using parent-reported measures. This study also examines the associations between environmental factors and the social communication abilities of a child and their participation in childhood activities. The third study examines the social communication abilities of children with autism using a new approach to describing levels of ability, rather than deficits. This study looks at the social communication abilities of preschool children with autism over six months. The importance of this work is that it adds to the literature by generating new knowledge on the abilities of children with autism, rather than their deficits. It also emphasizes the need for support in healthcare settings and in the community to improve these children’s participation.

No description available.

Adolescence is a period of social, physical, and neurobiological transitions that may leave individuals more vulnerable to the development of adjustment problems such as internalizing and externalizing symptomatology. Extant research demonstrates how self-regulation can predict adjustment outcomes in adolescence; however, it has yet to be examined how longitudinal growth in self-regulation may predict individual differences in symptomatology. That is, adolescents who develop self-regulatory capacities such as executive functioning (EF; including shifting, working memory, and inhibitory control) more slowly than their peers may be at increased risk for maladjustment. Data were collected from 167 adolescents and their primary caregiver over approximately three years. At each time point, adolescents completed three behavioral tasks that capture the underlying dimensions of EF, and both adolescents and their primary caregiver completed measures of adolescent symptomatology. Parallel process growth curve modeling was used to test the associations between initial levels and trajectories of both EF and adjustment. Results did not reveal any significant associations between initial levels of EF and adjustment or between growth in EF and growth in adjustment. Furthermore, there were no differential associations between the different EF dimensions. However, post-hoc analyses revealed that longitudinal increases in growth of EF predicted lower externalizing (but not internalizing) symptomatology at Time 3 (controlling for Time 1). Findings suggest that those with more rapid EF development may be better able to regulate behavioral and affective states and thus be less likely to develop externalizing symptoms, and that both early levels and growth in EF may be important predictors of adolescent outcomes. / Master of Science / Adolescence is a period of social, physical, and neurobiological transitions that may leave individuals more vulnerable to the development of symptoms such as anxiety, depression, aggression, and delinquency. Self-regulation affects these outcomes in adolescence; however, individuals demonstrate growth in self-regulation abilities at different rates. Thus, the current study sought to examine how differences in self-regulation (specifically, executive functioning (EF)) development over time may contribute to different behavioral and emotional symptoms in adolescence. Data were collected from 167 adolescents and their primary caregiver over approximately three years. At each time point, adolescents completed three behavioral tasks that capture EF, and both adolescents and their primary caregiver completed measures of adolescent symptoms. Results showed that there were no significant associations between initial levels of EF and symptoms, or between growth in EF and growth in symptoms. Furthermore, different aspects of EF (such as memory, attention, and inhibitory control) did not differentially predict symptomatology. However, additional analyses revealed that increases in growth of EF over time predicted lower symptoms of aggression and delinquency at Time 3. Findings suggest that those with more rapid EF development may be better able to regulate behavioral and emotional states and thus be less likely to develop these types of symptoms, and that both early levels and growth in EF may be important predictors of adolescent outcomes.

The study of measurement invariance in polytomous items that targets individual score levels is known as differential step functioning (DSF; Penfield, 2007, 2008). DSF methods provide specific information describing the manifestation of the invariance effect within particular score levels and therefore serve a diagnostic role in identifying the individual score levels involved in the item's invariance effect. The analysis of DSF requires the creation of a set of dichotomizations of the item response variable. There are two primary approaches for creating the set of dichotomizations to conduct a DSF analysis. The first approach, known as the adjacent categories approach, is consistent with the dichotomization scheme underlying the generalized partial credit model (GPCM; Muraki, 1992) and considers each pair of adjacent score levels while treating the other score levels as missing. The second approach, known as the cumulative approach, is consistent with the dichotomization scheme underlying the graded response model (GRM; Samejima, 1997) and includes data from every score level in each dichotomization. To date, there is limited research on how the cumulative and adjacent categories approaches compare within the context of DSF, particularly as applied to a real data set. The understanding of how the interpretation and practical outcomes may vary given these two approaches is also limited. The current study addressed these two issues. This study evaluated the results of a DSF analysis using both the adjacent categories and cumulative dichotomization schemes in order to determine if the two approaches yield similar results and interpretations of DSF. These approaches were applied to data from a polytomously scored alternate assessment administered to children with significant cognitive disabilities. The results of the DSF analyses revealed that the two approaches generally led to consistent results, particularly in the case where DSF effects were negligible. For steps where significant DSF was present, the two approaches generally guide analysts to the same location of the item. However, several aspects of the results rose questions about the use of the adjacent categories dichotomization scheme. First, there seemed to be a lack of independence of the adjacent categories method since large DSF effects at one step are often paired with large DSF effects in the opposite direction found in the previous step. Additionally, when a substantial DSF effect existed, it was more likely to be significant using the cumulative approach over the adjacent categories approach. This is likely due to the smaller standard errors that lead to greater stability of the cumulative approach. In sum, the results indicate that the cumulative approach is preferable over the adjacent categories approach when conducting a DSF analysis.

Epilepsy is one of the most common neurological disorders in children, with both seizures and their medical treatment associated with increased risk of neuropsychological impairments. Adaptive functioning in children with epilepsy is poorly understood. This study sought to identify the neuropsychological and medical predictors of optimal adaptive functioning in pediatric epilepsy. Forty-six children with epilepsy and 16 typically developing children and their parents participated in this study at two time points. Overall, adaptive functioning was found to be in the average to low average range in children with epilepsy. A composite measure assessing cumulative seizure history was able to significantly predict Adaptive Behavior Assessment System-II (ABAS-II) scores. Whether a child had experienced one or more seizures in the last year was the only individual seizure and treatment variable able to significantly predict adaptive functioning as measured by the ABAS-II. Verbal learning, executive functioning, and internalizing and externalizing behavior problems assessed at Time 1 predicted performance on the ABAS-II at Time 2. Verbal memory and attention, however, were not significant predictors of adaptive functioning. Consistent with what was hypothesized, executive functioning was found to mediate the relationship between seizure history and adaptive functioning when controlling for behavior problems at both Times 1 and 2. When behavior problems were the mediator and executive functioning was controlled for, mediation was not found. Executive functioning also mediated the relationship between group membership (monotherapy, polytherapy, and typically developing) and ABAS-II scores at Time 1, but not at Time 2 when a post-surgical group also was represented. Secondary analyses showed that the relationship between executive and adaptive functioning at Time 2 was moderated by whether or not a child had ever experienced seizures, such that children diagnosed with epilepsy evidenced greater correlations between these constructs than typically developing children. The results of this study suggest that a subset of children with epilepsy, those with active seizures and/or executive dysfunction, are at increased risk of adaptive deficits. These findings highlight the risk factors for suboptimal adaptive functioning in this population, and also suggest potential avenues for remediation.

<p>Many survivors of pediatric brain tumors and leukemia will experience cognitive, academic, and social difficulties that will significantly impact their quality of life. Of these, the least is known about the nature and range of survivors' social difficulties. Using a model developed for children with traumatic brain injury, the objective of the current study was to evaluate the neurocognitive and social-cognitive skills that may determine social outcomes in survivors of pediatric brain tumors and leukemia. A sample of survivors of childhood cancer aged 8 to 16 (n = 19) was compared to two control groups - children with ADHD (n = 10) and typically-developing children (n = 41) - on measures of neurocognitive skills, social-cognitive skills, and social experience. Results revealed that survivors demonstrated significant deficits in all domains as compared to typically-developing children. Evaluation of the model revealed that neurocognitive and social-cognitive skills were significant predictors of social experience. More specifically, attention problems and facial expression recognition were significant individual predictors. Survivors of pediatric cancer may experience deficits in social functioning that will impact their quality of life. Further assessment of the skills that influence social outcomes will be particularly important as a means for developing evidence-based interventions.</p> / Dissertation

ADHD is a well researched disorder in children and is associated with impairments in social functioning (Barkley, 2006). However, little is known about the etiology of social difficulties. An emerging body of literature is beginning to address the possible role social cognition may share in the social functioning outcomes in children with ADHD (Buitelaar et al., 1999; Corbett & Glidden, 2000; DaFonseca et al., 2009; Rapport et al., 2002; Sibley et al., 2010; Yuill & Lyon, 2007). Yet, research focusing on social cognition deficits in ADHD that accounts for subtype differences is limited. Some studies evaluated social cognition in CT children only (Corbett & Glidden, 2000; DaFonseca et al., 2009; Rapport et al., 2002) while other research utilized behavior ratings or sociometric studies (Matthys et al., 1999; Zentall et al., 2001). Another body of literature has examined the impact executive functioning deficits may have on social functioning (Barkley, 1997; Charman et al., 2001; Chhabildas et al., 2001). The purpose of the current study was to identify factors that predict social functioning impairments in children with ADHD as well as differentiate between ADHD subtypes. Participants included 89 youth with ages ranging from 6 to 16 years (M = 10.19, SD = 2.76). Forty-nine children met the diagnostic criteria for ADHD, Predominantly Inattentive Subtype (PI) and 40 for ADHD, Combined Type (CT). Results indicated CT youth demonstrated more aggressive and rule-breaking behavior than PI youth. Measures of social cognition did not predict ADHD subtype, and when compared to a normative sample, participants performed in the average range on affect recognition and theory of mind tasks. Performance-based measures of executive functioning largely associated with inattention (i.e., vigilance, processing speed, and working memory) best predicted subtype differences with CT youth being more impaired. Executive functioning, not social cognition, was predictive of social maladjustment in CT and PI youth. For CT youth, deficits in emotion control, shift, and initiate were related to anxiety, aggressive behavior, and depressed mood. Similarly, emotion control and shift were predictors of aggressive behavior, anxiety, and depressed mood in PI youth with deficits in self-monitoring, initiate, and inhibit as secondary predictors. / text

Sleep appears to play a critical role in regulating daytime functioning in children. However, few child-focused studies have used objective measures of sleep and examined its role in emotional functioning, memory, and attention. This dissertation consisted of 2 studies. Study 1 examined children’s typical sleep and how it correlates with daytime functioning in 32 typically developing children (14 boys, 18 girls), 8 to 12 years of age (M=9.8 y, SD=1.4). Participants wore actigraphs (recording devices that provide information about sleep and activity) for 1 week and then completed tasks to measure emotional functioning, memory, and attention. On average, children slept less than 9 h per night, which is approximately 1 h less than the recommended duration for this age. Older children had shorter sleep durations, higher sleep efficiency, and later sleep onset times. Correlational analyses revealed that within this group of typically developing children, small variations in sleep were associated with statistically significant effects on daytime functioning. Specifically, shorter sleep duration was associated with increased negative affective response, and lower sleep efficiency was associated with poorer performance on a divided attention task. Study 2 involved experimental manipulation of sleep duration in the same sample of children. Following a week of typical sleep, each child was randomly assigned to go to bed 1 h earlier for 4 nights (Extended condition) or 1 h hour later for 4 nights (Restricted condition) relative to their typical bedtime. Each child then completed the opposite condition. Following each condition, emotional functioning, memory, and attention were assessed using objective and subjective measures. The sleep manipulation was effective: the children slept significantly longer in the Extended (M=9.3 h, SD=0.6) versus Restricted (M=8.1 h, SD=0.7) condition, and children were significantly sleepier in the Restricted condition according to parent, child, and research assistant report. Positive affective response, emotion regulation, memory, and aspects of attention were worse in the Restricted, compared to Extended condition. These studies provide evidence that modest variations in sleep can have substantial effects on daytime functioning in children. Clinical implications are discussed, including the importance of identifying sleep problems and promoting healthy sleep habits in children.

abstract: ABSTRACT PHYSCIAL ACTIVITY AND EXECUTIVE FUNCTIONING IN COLLEGE STUDENTS INTRODUCTION: Regular physical activity may increase neurological development, which has been shown to increase cognitive functioning in older adults and those with dementia. Studies have also shown physical activity and exercise may positively affect executive functioning in children. Little is known about the influence of physical activity on executive functioning in college students between the ages of 18-21 years, a population that is traditionally thought of as healthy. Therefore, the purpose of this study is to explore the association between physical activity and executive functioning in college-aged students. We hypothesize that regular physical activity is positively associated with executive functioning scores and that this association is independent of adiposity. METHODS: Twenty males and 29 females (19.5 ± 0.1 yrs. old) participated in this study. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Executive function was assessed by Stroop Color and Word Association Test (Stroop) and Trail Making Test A & B. A verbal ability test (analogies, synonyms, antonyms) was given in order to control for intelligence. Body composition was determined by a Tanita TBF-300 Body Composition Analyzer. RESULTS: Partial correlations between physical activity/inactivity measures and measures of executive functioning were generally small (r-values &#8804; 0.2) and not significant. However, there was a significant inverse correlation between log moderate physical activity minutes per week and Stroop interference scores (r=0.50, p=0.01). Also, a trend towards significance was noted for the correlation between sitting minutes per week and Stroop interference scores (r=0.4 p=0.08) CONCLUSION: These results suggest that in college students, moderate physical activity is inversely associated with executive functioning while sitting time may be positively associated with executive functioning. These findings are in contrast to previous studies in children and older adults, and may indicate a unique relationship between physical activity/inactivity and executive functioning in college students. Future studies to further examine this population in greater depth are warranted. / Dissertation/Thesis / M.S. Exercise and Wellness 2012