This thesis used FIT Science (Fletcher & Stead, 2000) as a framework to study different aspects of family functioning. FIT variables measure the cognitive and behavioural characteristics of a person that mediate interpretations of events and attempts at coping with constraints. The research sought to examine whether scores on FIT variables explain differences in perceptions of family functioning and outcomes such as individual stress levels. In the first questionnaire study, members of the general population (N=235) completed The FIT Profiler (Fletcher, 1999), which measures scores on FIT variables, and the Family Assessment Device (Epstein, Baldwin & Bishop, 1983), which measures family functioning across six dimensions. The study found that higher scores on FIT variables were associated with more positive experiences of the family. A similar pattern of results was observed in study two involving participants (N=52) with Autistic Spectrum Conditions (ASCs). The results of the studies suggested that FIT Science is a useful framework to study family functioning in diverse contexts. Study three compared the stress and perceptions of family functioning of mothers of typically developing children (n=55), and children with ASCs (n=33). Mothers scoring high on FIT variables had better perceptions of family functioning, were less anxious and depressed, and also coped better with the demands of parenting. Studies four and five explored whether FIT Science also offers a useful framework for promoting changes in family functioning and individual well being. Study four reported a randomized control trial of a FIT-­‐Do Something Different (FIT-­‐DSD) intervention, which was administered to mothers (n=13) of children with ASCs. The FIT-­‐DSD intervention aimed at expanding behavioural flexibility and disrupting constraining habits. Study five reported a qualitative follow-­‐up of the intervention group in study four. 17 The results of studies four and five suggested that the FIT-­‐DSD intervention was a useful and novel tool to help mothers across a number of domains of family life. Relative to a wait-­‐list control group (n=11), the intervention group reported moderate to large improvements in their levels of parenting stress, depression, relationship satisfaction and scores on the cognitive FIT variable Self-­‐responsibility. Qualitative investigation also suggested that the intervention helped mothers develop feelings of control, self-­‐esteem and self-­‐efficacy. The thesis suggests that FIT Science offers a fruitful framework with which to study and intervene with family functioning. Further research seeking to explore the use of FIT Science as a vehicle for family change is recommended. This may help promote better physical and psychological health for individuals struggling with their environmental and self-­‐generated constraints.

Black South Africans account for a majority of HIV cases in South Africa, and there is thus a need for greater understanding of protective factors specific to this group. Within the HIV prevention and risk literature, little information exists regarding the familial and neuropsychological contributions to HIV prevention in youth. The current study addressed this gap. In a group of black South African parent-child dyads, we explored factors contributing to the development of pre-adolescents’ protective attitudes in the context of a family-based HIV prevention intervention, named Imbadu Ekhaya (IE), which translates to “communication in the home,” in Xhosa. As expected, the intervention increased communication practices among parents and children. However, child attitudes were not affected by the intervention through either of the two proposed mediators, parent-child communication or parent attitudes about child sexuality. Furthermore, child executive functioning did not play a role in the relationship between parent-child communication and child sexual attitudes measured 6 months post intervention. Results indicated that the intervention improved communication practices between parents and children, but the impact of such interventions on child outcomes should be explored further.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by dopamine dysregulation in several regions of the brain, including the striatum. Because of the intimate connections between the striatum and the frontal lobes, individuals with PD often demonstrate impairments on those tasks relying on the prefrontal cortex (e.g. tests of executive functioning). Source memory, or memory for context, is believed to rely on the prefrontal cortex and has been previously associated with executive functioning performance, although it has received little attention in the PD literature. Executive functioning and source memory were measured in a group of non-demented PD patients and healthy control participants. Within the PD group, an anti-Parkinson's medication withdrawal manipulation was used to examine whether source memory was affected by phasic changes in dopamine levels. Compared to healthy control participants, PD patients were impaired in source memory (both on and off medication) and on two composite measures of executive functioning. Within the PD group, medication administration improved motor performance but did not have a significant effect on source memory, suggesting that source memory may not rely on the dopamine system.

In DIF studies, a Type I error refers to the mistake of identifying non-DIF items as DIF items, and a Type I error rate refers to the proportion of Type I errors in a simulation study. The possibility of making a Type I error in DIF studies is always present and high possibility of making such an error can weaken the validity of the assessment. Therefore, the quality of a test assessment is related to a Type I error rate and to how to control such a rate. Current DIF studies regarding a Type I error rate have found that the latter rate can be affected by several factors, such as test length, sample size, test group size, group mean difference, group standard deviation difference, and an underlying model. This study focused on another undiscovered factor that may affect a Type I error rate; the effect of multiple testing. DIF analysis conducts multiple significance testing of items in a test, and such multiple testing may increase the possibility of making a Type I error at least once. The main goal of this dissertation was to investigate how to control a Type I error rate using adjustment procedures for multiple testing which have been widely used in applied statistics but rarely used in DIF studies. In the simulation study, four DIF methods were performed under a total of 36 testing conditions; the methods were the Mantel-Haenszel method, the logistic regression procedure, the Differential Functioning Item and Test framework, and the Lord’s chi-square test. Then the Bonferroni correction, the Holm’s procedure, and the BH method were applied as an adjustment of multiple significance testing. The results of this study showed the effectiveness of three adjustment procedures in controlling a Type I error rate.

No description available.

Phonological awareness is known to be associated with reading disorder. Intervention for specific reading disorder that focuses on training to improve phonological processing abilities has been found an effective means of addressing reading difficulties experienced by children. However, little is known as to what happens to other neurocognitive abilities associated with the process of reading but that are not causally linked to it. Some of these cognitions include attention, executive functions and verbal and visual memory. A series of three studies explored the relation between neuropsychological skills and phonological abilities in children with specific reading disorder. The first step in the studies involved establishing deficits in associated cognitive abilities in children with specific reading disorder. Children attending the Literacy Clinic, Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand, are screened for the presence of specific reading disorder. They are routinely assessed on reading and phonological processing measures before an intervention programme is initiated. Four such children who were assessed and identified as having specific reading disorder without speech language difficulties were chosen for the study. These children, who ranged in age from 7 to 15 years, referred to as the RD group, were assessed during the week before the onset of the intervention for the neuropsychological functions of attention, executive functions, verbal and visual learning, and memory. After the assessment (termed pre-intervention assessment), they were provided with phonological processing intervention. The intervention programme was carried out by trained speech-language therapists and lasted for 10 weeks. Two sessions a week were conducted, giving a total of 20 sessions. The week after completion of the intervention, the children were assessed once again on the same neuropsychological, reading and phonological awareness tests used before the intervention (termed post-intervention assessment). The results of the pre-intervention assessment were compared with the assessment of a group of typically developing group of children without reading disorder (N = 4; age range 8 to 10 years; referred to as the NRD group). Results indicated that, at pre-intervention assessment, the specific reading disorder (RD) group had deficits in verbal fluency and inhibitory control whereas the typically developing (NRD) group did not. The RD group also differed significantly from the NRD group in reading accuracy and comprehension. After the intervention, the RD group was assessed on reading, phonological processing, and neuropsychological tests. The group showed an improvement in reading accuracy and phonological processing. Of all the neuropsychological functions, only set shifting and visuo-spatial working memory scores showed a significant change in response to intervention. Deficits in executive functions and reading comprehension difficulties persisted. It was hypothesised that the RD group improved in reading accuracy in response to the phonological awareness intervention. However, the persistent reading comprehension difficulties were hypothesised as attributable to the presence of the executive function deficits noticed in the RD group. The exploratory study helped identify the presence of neuropsychological deficits in children with specific reading disorder in addition to their reading and phonological deficits. The study also established that phonological awareness intervention brought about a change in some neuropsychological function while other deficits persisted. The phonological awareness intervention used in the first study was developed for children in New Zealand. The second study hypothesised that, if effective, this intervention would help address reading deficits found in other populations. Children from a culture outside New Zealand accordingly the same intervention as the New Zealand children received in the first study. Children in Bangalore, India, 10 to 12 year of age and under-performing in their class, were screened for the presence of specific reading disorder. From this screening, 20 children with specific reading disorder (the RD group), with average to above average intelligence and without co-morbid psychiatric conditions were chosen to participate. Twenty children were randomly allotted to one of two treatment conditions. The first group of 10 children (the PA group) received phonological awareness intervention. The second group of 10 children (the NP group) received neuropsychological intervention. All 20 children were assessed on reading, phonological awareness tests and neuropsychological tests before and after intervention. Phonological measures included, Queensland University Inventory of Literacy (QUIL, ) Sthal and Murray, Phonological awareness probes of tracking speech sounds and non-word reading tests. Neuropsychological measures included Controlled Word Association test (COWA), Digit Span, Spatial Span, Stroop Colour-Word Test Coulor trails (A & B), Ray Auditory verbal learning test, Rey Osterriech Complex figure test and block design. The scores from the pre-intervention assessment were compared to the assessment data for 20 typically developing, non-reading-disabled children (referred to as the control group). The control group was assessed once on neuropsychological tests and reading and phonological awareness measures (QUIL only). The results indicated that the 20 children with reading disorder (the RD group) differed significantly from the control group on reading abilities. In addition, the two groups differed significantly on neuropsychological measures of attention (Colour Trail, Form A), set-shifting (Colour Trail, Form B), word reading and interference control (Stroop Colour-Word Test) and phonological awareness measures of non-word reading, syllable identification, visual rhyme, spoonerism, phoneme detection and phoneme deletion. After intervention, the RD group was again assessed on reading, phonological awareness and neuropsychological measures. Both the intervention groups (PA and NP) showed improvements on reading. Both groups also made significant gains on neuropsychological measures and phonological awareness measures. The PA group showed significant changes in verbal fluency, visual scanning and attention (Colour Trails, Form A), word reading (Stroop Colour-Word Test, verbal memory (Auditory Verbal Learning Test), immediate visual memory (Complex Figure Test) and visuo-construction abilities (Block Design Test). Phonological measures that showed significant increase in response to intervention in this group included non-word reading, phoneme detection, phoneme segmentation, phoneme deletion and tracking of syllable sound changes via use of coloured blocks and letter tiles. The NP group showed significant change in neuropsychological functions such as verbal fluency, word reading and interference control (Stroop Colour-Word Test), verbal learning (Auditory Verbal Learning Test), immediate visual memory (Complex Figure Test) and visuo-construction ability (Block Design Test). The NP group also improved significantly on phonological awareness measures such as syllable identification, spoken and visual rhyme, spoonerism, phoneme detection, phoneme deletion and tracking of syllable sound changes via use of coloured blocks. This second study established that the two interventions helped improve reading abilities equally. However, the interventions differentially affected neuropsychological and phonological awareness functioning in the participants. The third study explored the changes seen in the second study’s two treatment groups (Group PA and Group NP) three months after the conclusion of the intervention programme. During the three-month period between the post-intervention assessment and the follow-up assessment, all 20 children attended regular school. They received no special help or input for their reading and spelling difficulties during this period. The follow-up assessment consisted of the same tests of reading and neuropsychological measures used at the pre- and post-intervention assessments. The results showed that the groups had maintained the gains evident at the time of the post-intervention assessment on reading measures. The PA group’s performance on the neuropsychological measures and phonological measures showed significant changes in digit span and interference control. In addition, a significant increase from the pre-intervention measures, not observed at the post-treatment assessment, was observed for set-shifting, verbal learning and memory and now-word reading. Visuo-spatial working memory showed a trend towards significance for the NP group on the follow-up assessment. Most other neuropsychological functions did not differ significantly from those evident at the time of the post-intervention assessment. The NP group, like the PA group, showed a significant increase between pre-assessment and follow-up assessment on non-word reading, visual scanning, verbal learning and visual perception. The increase noticed in these measures at the time of the post-treatment assessment, however, was not significant. Comparisons between the PA and NP group at follow-up revealed that the PA group’s performance was significantly better than the NP group’s on digit backward and interference control, while the NP group performance was significantly better than the PA group’s on verbal fluency. The two groups were comparable on all other neuropsychological, phonological awareness and reading measures. The improvements noticed in both groups immediately after the intervention and then three months after intervention were hypothesised to have occurred because the interventions addressed reading along with other cognitive abilities (e.g., executive functions, attention, verbal learning and memory, visual learning and memory) addressed in the study. The improvements noticed in both groups after three months after intervention was hypothesised to be the outcome of improvements in the neuropsychological functions. The series of three studies conducted as part of this research work has helped identify neuropsychological deficits in children with reading disorder that persisted after phonological awareness intervention. The provision of two different interventions to children with reading difficulties showed that these had positive outcomes not only for reading and phonological awareness but also for neuropsychological functioning. The most important conclusion drawn from the findings of the three studies that form this doctoral research is that intervention for reading disorder is most likely to be effective when it addresses the reading and other associated cognitive skills that underlie the reading process. The two interventions used in the study had a similar effect on reading. Both helped the participating children improve their reading scores and both helped maintain those improvements over time. It is hypothesised that the improvement observed was probably sustained over time because both interventions could have addressed the associated deficits (in addition to reading difficulties) known to occur in children with reading disorder. The efficacy of the phonological awareness intervention documented in the studies is strengthened by the finding that it was effective in treating reading disorders in children from different cultural and educational settings (New Zealand and India).

The present investigation determined how different component-processes of executive functioning (EF) acted as risk factors for intoxicated aggression. Participants were 512 (246 men and 266 women) healthy social drinkers between 21 and 35 years of age. EF was measured using the Behavior Rating Inventory of Executive Functioning – Adult Version (BRIEF-A; Roth, Isquith, & Gioia, 2005) that assesses nine EF components. Following the consumption of either an alcohol or a placebo beverage, participants were tested on a modified version of the Taylor Aggression Paradigm (Taylor, 1967) in which mild electric shocks were received from, and administered to, a fictitious opponent. Aggressive behavior was operationalized as the shock intensities and durations administered to the fictitious opponent.

The purpose of this study was to examine the relationships between several aspects of family environment and adolescent substance use. Participants included 372 (M = 15.45 years, range = 15-17) adolescent males with and without a paternal history of Substance Use Disorder (SUD). Participants completed measures of family functioning, family communication, parentadolescent communication, living arrangement, temperament, and substance use. Results indicated that family functioning and communication predicted a significant reduction in the number of drugs used, frequency of drug use, and problems associated with drug use beyond the effects of demographic covariates. Additionally, temperament and family history of SUD were examined as moderators of the associations between family environment and adolescent substance use. Neither temperament nor family history of SUD significantly altered these relationships. The results of this study highlight the importance of elucidating family environment and the role it may play in prevention and interventions efforts for adolescent substance use.

The purpose of this investigation was twofold. First, to test the hypothesis that irritability and executive functioning (EF), two previously established risk factors for alcohol-related aggression, would interact to conjointly confer multiplicative risk for intoxicated violence that is not observed when testing either variable alone. Second, to test the hypothesis that irritability would mediate the relation between EF and alcohol-related aggression. EF was measured using seven well-established neuropsychological tests. Irritability was measured using the Caprara Irritability Scale-CIS. Participants were 310 male and female social drinkers between the ages of 21 – 35 years old. After consuming an alcohol or placebo beverage, participants were tested on a laboratory aggression task in which electric shock are given to and received from a fictitious opponent under the guise of a competitive reaction time task. Aggression was operationalized as shock intensities administered to the fictitious opponent. Results indicated that irritability successfully mediated the relation between EF and intoxicated aggression for men only. No support was found to suggest that EF and irritability together confer multiplicative risk for intoxicated aggression. Results are discussed within a cognitive neoassociationistic framework for aggressive behavior.

The young child’s experiences of living with cancer are crucial to providing evidence based care. The overall aim of this thesis was to explore and describe experiences of health and functioning in the everyday life of young children with cancer, over a three year period from diagnosis, to provide insights and suggestions to improve evidence based care. The first and second papers in the series of four for this thesis used a qualitative content analysis to describe the child’s experiences shortly after diagnosis and six and 12 months later. The third paper used mixed methods to identify a comprehensive set of ICF-CY codes describing everyday health and functioning in the life of the young child with cancer. The fourth paper used the identified comprehensive set of ICF-CY codes to follow changes in everyday health and functioning over the study’s entire three year period from diagnosis. Entry into the health-illness transition was characterised by trauma and isolation. Health and functioning in everyday life was utterly changed and physical difficulties were at their peak. The passage through transition was characterised by an active striving on the part of the child to make a normal everyday life of the cancer experience. Difficulties affecting health and functioning in everyday life decreased and changed during the trajectory, though feelings of loneliness prevailed. A new period of stability in the child’s post treatment life was seen from two years after diagnosis and onwards, with (re)-entry to preschool/school and other social activities. However, an increase in difficulties with personal interactions with others and access to, and support from healthcare professionals was seen. Variances were seen within individual children’s’ trajectories. In summary it can be stated that the everyday life of young children with cancer changes over time and health care services are not always in phase with these changes. Young children living with cancer want to be participatory in their care and to have access to their parents as protectors. They need access to and ongoing contact with peers and preschool. Although physical difficulties in living an everyday life with cancer reduce over time, new difficulties emerge as the child post cancer treatment re-enters society. A structured follow-up throughout the cancer trajectory and not just during active treatment is necessary. A child-centered philosophy of care would guide the child towards attainment of health and well-being. Both the child’s own perspective and a child’s perspective as described by adults caring for them should be seen on a continuum, rather than as opposites. This view could help ensure that young children become visible and are listened to as valuable contributors to care planning. Knowledge of health-illness transition can be useful in illustrating everyday health and functioning through long term illness trajectories.