Children are incredible variable

One of the main issues with testing children is they’re incredibly variable.

A zero-month-old child or a one-day-old child is incredibly different from a two-month-old child, who is incredibly different from a nine-month-old child who is incredibly different from a two-year-old, who is incredibly different from a four-year-old who is so very different from a ten-year-old and so on, and so on.

And all of these different populations require different techniques to study them.
So what we try to do is develop methods that are appropriate for children of particular ages, and that can
be generalized to as many different ages possible.

Really this depends on a couple of sort of key capabilities that change over the development of the child. Probably the most important is the development of language.
Before children know language, you can’t really ask them to do particular tasks.

The Clinical Psychology of Children and Young People
The University of Edinburgh


Childhood Disability: changing trends

What’s Behind The Stark Rise In Children’s Disabilities
August 19, 2014

A recent study finds that the rate of children diagnosed with a disability is rising — particularly among kids who come from a more affluent background. Dr. Amy Houtrow was one of the lead authors on the study, and she speaks with Audie Cornish.

Six million – that’s how many children are considered disabled in the U.S. today, a nearly 16 percent increase from a decade ago. And what accounts for that rise is explained in a new study out this week in the journal Pediatrics. The research shows that while physical disabilities are down, neurodevelopmental or mental health conditions are up, especially among children from more affluent families.

undetected bias. In what way and what’s your basis for that assessment?

HOUTROW: There’s quite a bit of literature that supports the idea that the way physicians and health care providers approach families differs in terms of what the family brings to the table and the encounter. So a family from a more affluent background is able to articulate their concerns and their needs in a different way. That might raise the suspicion of the doctor to look for the condition, to make a diagnosis and recommend treatment. On the flipside, a family who is less affluent might not bring to the attention of the provider in the same way, nor may the provider ask the questions that would lead them down the path of making a diagnosis of a developmental problem or mental health problem.

original paper:
Changing Trends of Childhood Disability, 2001–2011
Pediatrics. 2014 Aug 18. pii: peds.2014-0594.
Amy J. Houtrow, MD, PhD, MPH, et al.
CONCLUSIONS: Over the past decade, parent-reported childhood disability steadily increased. As childhood disability due to physical conditions declined, there was a large increase in disabilities due to neurodevelopmental or mental health problems. For the first time since the NHIS began tracking childhood disability in 1957, the rise in reported prevalence is disproportionately occurring among socially advantaged families. This unexpected finding highlights the need to better understand the social, medical, and environmental factors influencing parent reports of childhood disability.

Key Words: disability
activity limitations

Predictors of adolescent alcohol misuse

Neuropsychosocial profiles of current and future adolescent alcohol misusers
Robert Whelan, et al.
Nature (02 July 2014)

A comprehensive account of the causes of alcohol misuse must accommodate individual differences in biology, psychology and environment, and must disentangle cause and effect.
Animal models can demonstrate the effects of neurotoxic substances; however, they provide limited insight into the psycho-social and higher cognitive factors involved in the initiation of substance use and progression to misuse.

One can search for pre-existing risk factors by testing for endophenotypic biomarkers in non-using relatives; however, these relatives may have personality or neural resilience factors that protect them from developing dependence.
A longitudinal study has potential to identify predictors of adolescent substance misuse, particularly if it can incorporate a wide range of potential causal factors, both proximal and distal, and their influence on numerous social, psychological and biological mechanisms.

Here we apply machine learning to a wide range of data from a large sample of adolescents (n = 692) to generate models of current and future adolescent alcohol misuse that incorporate brain structure and function, individual personality and cognitive differences, environmental factors (including gestational cigarette and alcohol exposure), life experiences, and candidate genes.

These models were accurate and generalized to novel data, and point to life experiences, neurobiological differences and personality as important antecedents of binge drinking.
By identifying the vulnerability factors underlying individual differences in alcohol misuse, these models shed light on the aetiology of alcohol misuse and suggest targets for prevention.

The “Cool” Kids & Pseudomature Behavior

What Ever Happened to the “Cool” Kids? Long-Term Sequelae of Early Adolescent Pseudomature Behavior
Child Development. 11 JUN 2014
Joseph P. Allen, et al.

Pseudomature behavior—ranging from minor delinquency to precocious romantic involvement—is widely viewed as a nearly normative feature of adolescence.
When such behavior occurs early in adolescence, however, it was hypothesized to reflect a misguided overemphasis upon impressing peers and was considered likely to predict long-term adjustment problems.
In a multimethod, multireporter study following a community sample of 184 adolescents from ages 13 to 23, early adolescent pseudomature behavior was linked cross-sectionally to a heightened desire for peer popularity and to short-term success with peers.
Longitudinal results, however, supported the study’s central hypothesis: Early adolescent pseudomature behavior predicted long-term difficulties in close relationships, as well as significant problems with alcohol and substance use, and elevated levels of criminal behavior.

more on peer pressure:

Brain changes precede schizophrenia and autism

In children with certain gene variants, symptoms similar to common learning disabilities could be omens of serious psychiatric conditions.

Brain changes precede schizophrenia and autism
Carriers of high-risk genes show cognitive impairments and could benefit from early intervention.
18 December 2013

People who carry high-risk genetic variants for schizophrenia and autism have impairments reminiscent of disorders such as dyslexia, even when they do not yet have a mental illness, a new study has found.
The findings offer a window into the brain changes that precede severe mental illness and hold promise for early intervention and even prevention.

Rare genetic alterations called copy number variants (CNVs), in which certain segments of the genome have an abnormal number of copies, play an important part in psychiatric disorders: Individuals who carry certain CNVs have a several-fold increased risk of developing schizophrenia or autism.
But previous studies were based on individuals who already have a psychiatric disorder, and until now, no one had looked at what effects these CNVs have in the general population.
people with these variants but no diagnosis of autism or a mental illness still show subtle brain changes and impairments in cognitive function.

People carrying the variants performed worse than controls from the general population on cognitive tests and measures of general day-to-day functioning, and they were more likely to show a history of various learning disabilities.
For instance, carriers of one particular CNV, a deletion in a specific region of chromosome 15, tend to have a history of dyslexia and a difficulty in understanding numbers.
MRI showed that the same deletion alters brain structure in a way also seen in individuals with early stages of psychosis, and in individuals with dyslexia.

“It’s not as if [the variants] are just one incremental factor in your risk for psychosis … “They actually are impacting cognition in a significant way.”

DSM-5 Autism Spectrum Disorder (ASD)

DSM-5 Autism Spectrum Disorder (ASD)
American Academy of Child Adolescent Psychiatry

The new guidebook, DSM-5, contains significant changes to the criteria currently used to diagnose autism, including incorporating several diagnoses into the single diagnosis of autism spectrum disorder (ASD). AACAP crafted a list of Frequently Asked Questions to help families who have a child with autism understand the impact of these changes.
In addition, we updated the Fact for Families on Asperger’s. For more information, visit AACAP’s Autism Resource Center.

AACAP also created a new Facts for Families on the new diagnosis Disruptive Mood Dysregulation Disorder (DMDD).

AACAP > Living with Mental Illness: Books

Living with Mental Illness: Books
American Academy of Child Adolescent Psychiatry
Some families and children who have experience with mental illness choose to share their stories. These first-hand accounts can be rich educational tools and therapeutic resources.

Psychodynamic Readings
American Academy of Child Adolescent Psychiatry
an annotated bibliography created by members of the Psychotherapy Committee that contains some of the best papers and books to help you learn about psychotherapy with children and adolescents.