Quantitative analysis of long-term child-centered play therapy.

This exploratory study measured the impact of long-term Child- Centered Play Therapy (CCPT) with 23 children identified by teachers as exhibiting behavioral and emotional difficulties. Through the use of a repeated measures design, researchers examined the use of CCPT from pre-intervention to mid-intervention (16 sessions) to post intervention (32 sessions). Results indicated that children who participated in 32 sessions of CCPT demonstrated statistically significant improvement on the Total Problems Scale as measured on the Teacher Report Form, Total Stress Scale of the Index of Teaching Stress (ITS), ADHD Domain of the ITS, and Student Characteristics of the ITS. Researchers reported improvement to be statistically steady over the full duration of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential impact of play therapy on developmental levels of children.

The purpose of this preliminary study was to explore the impact of child-centered play therapy (CCPT) on children identified within J. Piaget's (1962) preoperational and concrete operations developmental stages. Using archival data, this study used a 3-wave repeated measures analysis of variance design to analyze the impact of CCPT on 24 children between the ages of 3 and 8 who received 19-23 individual CCPT sessions. On the basis of the child's age, children were evenly divided into 2 treatment groups of preoperational or operational developmental stage. A pretest, approximate midpoint, and posttest administration of the Parenting Stress Index (R. Abidin, 1995) was collected for use in the analysis. Preliminary results of this study revealed statistically significant differences in the impact of CCPT for children of different developmental stages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An exploratory study of child-centered play therapy with aggressive children.

Children exhibiting aggressive problem behaviors typically reach a peak of aggressive acts at an early age, providing evidence that early intervention for aggression is needed. Child-centered play therapy (CCPT) is 1 intervention that offers the child an environment in which aggression can be expressed and empathically responded to by a play therapist. Forty-one elementary school age children were assigned to a CCPT condition or a wait-list control group condition. Children who participated in 14 sessions of CCPT showed a moderate decrease in aggressive behaviors over children in the control group, according to effect sizes as reported by parents (N = 32). Teachers reported that both groups significantly improved over time (N = 41). Post hoc analysis revealed that children assigned to CCPT decreased aggressive behaviors statistically significantly and children assigned to control group demonstrated no statistically significant difference. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child-centered play therapy with a seven-year-old boy diagnosed with intermittent explosive disorder.

Child-centered play therapy (CCPT) has been supported as an effective method for working with children. A case study is presented that describes treatment using CCPT with a 7-year-old boy diagnosed with intermittent explosive disorder (IED). This case study delineates 16 sessions of play therapy with a registered play therapist. The behavioral problems the child exhibited at the onset of therapy were greatly improved at the conclusion of the sessions. The outcome of this case study supported the use of play therapy for children with IED. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child-Centered Kinder Training for Teachers of Pre-School Children Deemed At-Risk.

The purpose of this study was to examine the impact of child-centered kinder training on both at-risk children and their teachers using Landreth's 10-week filial training model. In this project, the teachers received 30 minutes of immediate feedback following their play sessions with individual children. Following the 10-week training, teachers participated in 13 group sessions to help them generalize the use of the skills into their classrooms. The findings indicate that changes occurred in both the children and the teachers. The children who participated in play sessions with their teachers improved in three of the four composite scales of the Behavior Assessment Scale for Children (Internalizing Problems, Behavioral Symptoms Index, and Adaptive Skills), when compared to a control group of children who did not have the play sessions. The teachers demonstrated better play therapy skills and higher levels of empathic responding with children in the playroom. In addition, teachers were able to generalize the skills into their classrooms when compared to teachers who had not received kinder training. The findings of this study indicate that child-centered kinder training is an effective strategy for both at-risk pre-school children and their teachers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School-Based Child-Centered Play Therapy with Hispanic Children: Outcomes and Cultural Consideration.

Hispanic children are the fastest growing segment of the population. Numerous factors place them at-risk for school success. This study examined the effects of Child-Centered Play Therapy (CCPT) compared to a curriculum-based small group intervention with 29 Hispanic children referred for school counseling due to behavior problems. Children were assigned to treatment groups by random drawing within grade levels. Treatment was provided by Hispanic bilingual counselors. Statistical analysis revealed that, according to parent report, children receiving CCPT showed statistically significant decreases in externalizing behavior problems, compared to the curriculum-based treatment group. Effect size calculations revealed that CCPT demonstrated a large treatment effect on externalizing behavior problems and a moderate treatment effect on internalizing behavior problems. Cultural considerations and recommendations for practice and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two case studies of child-centered play therapy for children referred with highly disruptive behavior.

This article presents two cases with strong evidence measures in which child-centered play therapy (CCPT) was provided for children referred for highly disruptive behavior, including attention problems and aggression. Apparent progress was evidenced on the Teacher Report Form (TRF) of the Child Behavior Checklist (Achenbach & Rescorla, 2001). One client had a waiting period equal to his treatment period in which ratings were stable before change across his treatment period. The cases provide opportunities to consider how CCPT may work differently for similar behavioral difficulties in individual children. Researchers conceptualized each client's areas of difficulty and apparent treatment effects as an expert panel, aided by indications from the TRF. Individual discussions are provided regarding rationales for apparent progress and why CCPT seemed to have been effective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric properties of the Cognition Checklist with psychiatric outpatients and university students.

To provide further information about the psychometric characteristics of the Cognition Checklist (CCL), the CCL was administered to 1,907 outpatients who had various Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) disorders and 290 university students. Factor analyses supported the scoring of the CCL as 14-item Depression (CCL-D) and 12-item Anxiety (CCL-A) subscales in outpatients and partially supported such scoring in students. The convergent and discriminant validities of the subscales were high for the outpatient sample, but the CCL-A did not display discriminant validity in the student sample. Both subscales differentiated (1) students from outpatients and (2) the outpatients, by primary, secondary, and personality diagnostic groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inspection time and attention-deficit/hyperactivity disorder symptoms in children with cerebral palsy.

Objective: To examine between-groups differences in the associations between aspects of processing speed assessed with an inspection time task and attention-deficit/hyperactivity disorder (ADHD) symptoms. Research Design: Two groups comprising 34 children with cerebral palsy (CP) and 70 nonaffected peers (control), ages 8–16 years, participated in a prospective correlational study. Measures included a visual inspection time task and the Conners' Parent Rating Scale—Revised: Long Version. Results: Children with CP exhibited significantly slower processing speed and more symptoms of inattention and hyperactivity than controls. Significant associations between inspection time and ADHD symptoms were found only in the control group. Conclusions: Findings have implications for clinical assessment and understanding of attentional risks associated with CP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive functioning in children with attention-deficit/hyperactivity disorder: Combined type with and without a stimulant medication history.

Behavioral and neuropsychological functioning in unmedicated children with attention-deficit/hyperactivity disorder (ADHD) who have a history of medication treatment (Rx) versus those who are treatment na?ve (TN) has, to our knowledge, not been previously studied. Ninety-four children in four groups (ADHD/Rx, ADHD/TN, learning disabilities [LD], and controls) were evaluated, while unmedicated, on measures of achievement, neuropsychological functioning, and behavior. The ADHD/Rx group performed significantly better than the TN group on writing, Stroop interference, and measures of attention, and performed as well as the control group on executive functioning, verbal working memory, and academics. Behaviorally, the ADHD groups showed more difficulty with mood and externalizing behaviors compared with the LD and control groups, with the ADHD/TN performing the most poorly. Findings suggest that the ADHD/Rx group shows better executive and academic functioning even when unmedicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Delay and reward choice in ADHD: An experimental test of the role of delay aversion.

Children with attention deficit/hyperactivity disorder (ADHD) choose smaller sooner (SS) over larger later (LL) rewards more than controls. Here we assess the contributions of impulsive drive for immediate rewards (IDIR) and delay aversion (DAv) to this pattern. We also explore the characteristics of, and the degree of familiality in, ADHD SS responders. We had 360 ADHD probands; 349 siblings and 112 controls (aged between 6 to 17 years) chose between SS (1 point after 2 s) and LL reward (2 points after 30 s) outcomes on the Maudsley Index of Delay Aversion (Kuntsi, Oosterlaan, & Stevenson, 2001): Under one condition SS choice led to less overall trial delay under another it did not. ADHD participants chose SS more than controls under both conditions. This effect was larger when SS choice reduced trial delay. ADHD SS responders were younger, had lower IQ, more conduct disorder and had siblings who were more likely to be SS responders themselves. The results support a dual component model in which both IDIR and DAv contribute to SS choice in ADHD. SS choice may be a marker of an ADHD motivational subtype. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of student ethnicity on judgments of ADHD symptoms among Hispanic and White teachers.

The present study examined whether teacher ratings of student disruptive, impulsive, and inattentive behaviors vary according to teacher-student ethnic differences. A total of 129 Hispanic and 89 White teachers observed standardized videotapes of a Hispanic and a White child and assessed each child for hyperactive-inattentive behaviors, using a rating scale. Based on analyses of subscales, this study revealed significant differences in ratings of attention-deficit/hyperactivity disorder (ADHD) behaviors among Hispanic and White teachers with Hispanic teachers reporting higher mean scores on the Hyperactivity-Impulsivity Scale. This was true on the ratings of the Hispanic student but not on the White student. Further analyses suggested that when acculturation was covaried, no significant group differences remained, suggesting that teacher perception of deviance may be partially mediated by cultural values more than ethnicity. The need to consider the rater's ethnicity and ethno-cultural variables is discussed, and findings are explained in terms of the adult distress threshold model. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

What Aspects of Peer Relationships Are Impaired in Children With Attention-Deficit/Hyperactivity Disorder?

Participants included 165 children with attention-deficit/hyperactivity disorder (ADHD; 130 boys, 35 girls) and their 1,298 same-sex classmates (1,026 boys, 272 girls) who served as raters. For each child with ADHD, a child of the same sex was randomly selected from the same classroom to serve as a comparison child, which yielded 165 dyads. Consistent with predictions, contrasted with the comparison children, those with ADHD were lower on social preference, higher on social impact, less well liked, and more often in the rejected social status category; they also had fewer dyadic friends. When liking ratings that children made versus received were examined, children with ADHD had less positive imbalance and greater negative imbalance relative to comparison children. Analyses that considered the types of peers who chose children with ADHD as friends or nonfriends demonstrated that children with ADHD were nominated as nonfriends by children of higher social preference and who were better liked by others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of an organization skills intervention to improve the academic functioning of students with attention-deficit/hyperactivity disorder.

Children with attention-deficit/hyperactivity disorder (ADHD) exhibit significant academic impairments, as evidenced by poor academic achievement, grade retention, and school dropout. Deficits in organization skills may contribute to these academic impairments, as children with ADHD frequently lose assignments, misplace their completed work, and have difficulty planning for tests. The present study examined the pilot efficacy of an 8-week organization skills intervention for children with ADHD. Thirty-seven children were randomly assigned to receive the intervention immediately or to a wait-list control. Participants made significant improvements in organization and homework management skills during the intervention and these gains were maintained at 8-week follow-up. Parents of children in the intervention group reported decreased homework problems. Children in the intervention group also demonstrated pre-post gains on teacher ratings of academic impairment and GPA. This study suggests that targeted academic skills interventions have the potential to improve overall academic performance among children with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-Perceptions of Competence in Children With ADHD and Comparison Children.

The self-perceptions of children with attention-deficit/hyperactivity disorder (ADHD; n=487) were compared with those of children in a local normative comparison group (n=287), relative to teacher- and parent-rated perceptions of their competence. Children were participants in the ongoing follow-up portion of the Multimodal Treatment Study of Children with ADHD. Children with ADHD were much more likely than comparison children to overestimate their competence relative to adult report, regardless of who was used as the criterion rater (teacher, mother, or father). Examination by comorbidity subgroups revealed that children with ADHD inflated their self-perceptions the most in domains of greatest deficit. Gender effects also are reported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of Executive Function Deficits and Attention-Deficit/Hyperactivity Disorder (ADHD) on Academic Outcomes in Children.

The association between executive function deficits (EFDs) and functional outcomes were examined among children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Participants were children and adolescents with (n = 259) and without (n = 222) ADHD, as ascertained from pediatric and psychiatric clinics. The authors defined EFD as at least 2 executive function measures impaired. Significantly more children and adolescents with ADHD had EFDs than did control participants. ADHD with EFDs was associated with an increased risk for grade retention and a decrease in academic achievement relative to (a) ADHD alone, (b) controlled socioeconomic status, (c) learning disabilities, and (d) IQ. No differences were noted in social functioning or psychiatric comorbidity. Children and adolescents with ADHD and EFDs were found to be at high risk for significant impairments in academic functioning. These results support screening children with ADHD for EFDs to prevent academic failure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of relaxation training with cognitive or nondirective therapy and the role of relaxation-induced anxiety in the treatment of generalized anxiety.

Thirty volunteers who met criteria for generalized anxiety disorder received 12 sessions of training in progressive muscular relaxation. Sixteen of the clients also were given cognitive therapy during 10 of those sessions, and the remaining 14 received nondirective therapy. Therapy was provided by 16 graduate student clinicians. The group as a whole showed substantial reductions in anxiety as measured by psychiatric assessor ratings, questionnaires, and daily self-monitoring, although relaxation plus cognitive therapy produced significantly greater improvement than relaxation plus nondirective therapy on several pretherapy-posttherapy questionnaires. Relaxation-induced anxiety, as measured by a questionnaire after each relaxation session, was significantly related to improvement in the total group: Clients who became anxious during relaxation training showed the least improvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlations of male college students' verbal response mode use in psychotherapy with measures of psychological disturbance and psychotherapy outcome.

Compared verbal response mode use by 31 male college student clients in 3 sessions of time-limited psychotherapy (selected from an average of 17.2 sessions) with measures of clients' psychological distress, disturbance, and change, which were gathered at intake, termination, and 1-yr follow-up as part of the Vanderbilt Psychotherapy Project. Results show that (a) clients who were more distressed tended to use a higher percentage of Disclosures (revealing subjective information) and a lower percentage of Edifications (conveying objective information), perhaps reflecting greater preoccupation with inner troubles; and (b) clients who improved more were those who participated more, as measured by their estimated total number of utterances, a product of talking more in each session and remaining in therapy for more sessions; but (c) there was no relationship between clients' percentage of Disclosures and their improvement in psychotherapy, as hypothesized, even though percentage of Disclosures was correlated with process ratings of intrapsychic exploration. (58 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fifth-grade students as emotional helpers with kindergartners: Using play therapy procedures and skills.

This research study investigated the effectiveness of a filial therapy training model as a method to train 5th-grade students in child-centered play therapy skills and procedures. The 5th-grade students were trained to be therapeutic change agents in weekly play sessions with kindergarten children identified as having adjustment difficulties. Skill acquisition was assessed by videotaping 5th-grade student participants playing with a kindergarten child identified as having adjustment difficulties in 20-min play sessions before and after the training. Analysis of covariance on adjusted posttest means revealed that 5th-grade children in the experimental group demonstrated statistically significant increases in empathic responses, behavioral willingness to follow the kindergarten children's lead, and involvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Wechsler Intelligence Scale for Children-Third and -Fourth Edition predictors of academic achievement in children with attention-deficit/hyperactivity disorder.

IQ and achievement scores were analyzed for 678 children with attention-deficit/ hyperactivity disorder (ADHD; 6-16 years of age, IQ≥80) administered the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; n=586) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV, n=92). Approximately 76% of children in both samples were identified with a learning disability (LD). LD in written expression was more common than in reading or math. For both the WISC-III and the WISC-IV, full-scale IQ was the strongest single predictor of achievement in all areas. The verbal subtests comprising the Freedom from Distractibility/Working Memory Index (FDI/WMI) and Verbal Comprehension Index were more highly correlated with achievement scores than the nonverbal subtests on both the WISC-III and WISC-IV. The most powerful predictors of LD, however, were the FDI/WMI and Processing Speed Index (PSI) subtests. These findings suggest that verbal intelligence is more influential in determining level of academic achievement, whereas cognitive abilities assessed by FDI/WMI and PSI are more important in determining LD in children with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)