Objective The purpose of this study was 2-fold: (1) to explore the transfer of responsibility of medical tasks from parent to child during the transition to adolescence, and (2) to examine the associations between family functioning and medical adherence in youth with spina bifida. Methods Seventy families of children with spina bifida participated in this study. Data were collected during family interaction sessions by using questionnaires completed by mothers, fathers, youth, teachers and health professionals. Results Findings suggest that responsibility for medical regimens transfers gradually from parent to child over time. Additionally, family conflict and cohesion were correlated with medical adherence. Finally, family conflict over medical issues was related to a decrease in medical adherence over time. Conclusions Results suggest that as youth take more responsibility over their medical regimens, family conflict regarding medical issues becomes a contributor to their adherence behaviors. Interventions that target family conflict may facilitate adherence behaviors.

Objective To assess whether family involvement and acculturation were related to adherence and glycemic control among Hispanic youth with type 1 diabetes (T1D). Methods Hispanic youth with T1D (n = 111; M age = 13.33; 53% female) and parents completed questionnaires that assessed diabetes-related family involvement (distribution of responsibility for diabetes, family support for diabetes), acculturation (linguistic acculturation, generational status), and adherence. HbA1c levels indexed glycemic control. Results Better adherence was associated with less adolescent independent responsibility, more family support for diabetes, and more recent immigration (fewer generations of the family living in US). Family support mediated the relationship between responsibility and adherence. Better glycemic control was associated with higher levels of parental education and adherence. Conclusions Family support for diabetes is important for adherence among Hispanic youth with T1D. Research should examine aspects of recent immigration that contribute to better adherence and the impact of supportive interventions on diabetes care.

Objective This study provides normative data, divided by age and gender, for the Diabetes Self-Management Profile (DSMP), an empirically supported structured interview that assesses adherence with the type 1 diabetes treatment regimen. Despite wide use, normative data on the DSMP have yet to be reported. Methods The sample included 444 parents and 275 youth with type 1 diabetes. The DSMP was administered by a trained clinician. Results For both child and parent ratings of adherence, means and standard deviations for the overall sample and subdivision by gender and three age groups are presented for normative comparisons. Subscale data (e.g., glucose monitoring, diet, exercise) are similarly presented. Lower adherence scores were reported among older adolescents relative to preadolescents. Conclusions The literature has lacked normative data on pediatric diabetes adherence. These data present means and standard deviations for parent and child ratings of regimen adherence from a relatively large sample of youth with diabetes that can be utilized for normative comparisons for clinical and research purposes.

Objective To present psychometric data on youth and parent versions of the Inflammatory Bowel Disease-Family Responsibility Questionnaire (IBD-FRQ), a measure of family involvement in IBD management. Methods Fifty-eight adolescents with inflammatory bowel disease (IBD), along with 55 mothers and 26 fathers completed the IBD-FRQ, a demographics questionnaire, and a measure of family involvement in decision making in non-IBD domains. Medical information was obtained via chart review. Results Support for the internal consistency of the IBD-FRQ was obtained. Evidence of validity was documented via moderate to high intercorrelations among reporters. Youth involvement increased with youth age, while maternal and paternal involvement decreased with youth age. Across all reporters, maternal involvement was higher than paternal involvement. Conclusions Preliminary analyses offer support for the measure's reliability and validity. The measure shows promise as a means of assessing family involvement in IBD condition management; however, further validation studies are needed.

Objective The study examined social-cognitive correlates of physical activity in a multi-ethnic cohort of girls from six regions of the United States who participated in the Trial of Activity for Adolescent Girls during their 6th and 8th grade school years. Methods Girls completed validated questionnaires and wore accelerometers that measured weekly physical activity in the spring of 2002 and 2005. Results In 8th grade, self-efficacy and perceived social support had indirect relations with physical activity mediated through perceived barriers, which was inversely related to physical activity. Self-efficacy also had a direct relation with physical activity. Conclusions Correlations were smaller than those obtained in studies that measured physical activity by self-reports, suggesting that previous estimates were inflated by common method artifact. Nonetheless, physical activity trials among girls during early adolescence might focus on increasing self-efficacy for overcoming barriers to physical activity and on ways by which perceived barriers can otherwise be reduced.

Objective To investigate the methylphenidate (MPH) response rate among childhood survivors of acute lymphoblastic leukemia (ALL) and brain tumors (BTs) and to identify predictors of positive MPH response. Methods Cancer survivors (N = 106; BT = 51 and ALL = 55) identified as having attention deficits and learning problems participated in a 3-week, double-blind, crossover trial consisting of placebo, low-dose MPH (0.3 mg/kg), and moderate-dose MPH (0.6 mg/kg). Weekly teacher and parent reports on the Conners’ Rating Scales were gathered. Results Following moderate MPH dose, 45.28% of the sample was classified as responders. Findings revealed that more problems endorsed prior to the medication trial on parent and teacher ratings were predictive of positive medication response (p < .05). Conclusions MPH significantly reduces attention problems in a subset of childhood cancer survivors. Parent and teacher ratings may assist in identifying children most likely to respond to MPH so prescribing may be optimally targeted.

Objective We examined longitudinal associations among neonatal and socioeconomic risks, maternal scaffolding behaviors, and 24-month visual-spatial processing and working memory in a sample of 73 toddlers born preterm or low birthweight (PT LBW). Methods Risk data were collected at hospital discharge and dyadic play interactions were observed at 16-months postterm. Abbreviated IQ scores, verbal/nonverbal working memory, and verbal/nonverbal visual-spatial processing data were collected at 24-months postterm. Results Higher attention scaffolding and lower emotion scaffolding during 16-month play were associated with 24-month verbal working memory scores. A joint significance test revealed that maternal attention and emotion scaffolding during 16-month play mediated the relationship between socioeconomic risk and 24-month verbal working memory. Conclusions These findings suggest areas for future research and intervention with children born PT LBW who also experience high socioeconomic risk.

Objective A biopsychosocial model was used to treat pain-associated disability in children and adolescents. We assessed the clinical outcomes of children and adolescents (8–21 years of age) with pain-associated disability who were treated in an interdisciplinary inpatient rehabilitation program which included physical, occupational, and recreational therapy, medicine, nursing, pediatric psychology, neuropsychology, psychiatry, social work, and education. Psychological treatment emphasized cognitive-behavioral intervention for pain and anxiety management, and behavioral shaping to increase functioning. Methods We conducted a retrospective chart review of 41consecutive patients. School attendance, sleep, and medication usage were assessed at admission and discharge; functional disability and physical mobility were assessed at admission, discharge, and 3-month follow-up. Results As a group, significant improvements were observed in school status, sleep, functional ability, physical mobility, and medication usage. Conclusion Findings support the efficacy of an inpatient interdisciplinary behavioral rehabilitation approach to the treatment of pain-associated disability in pediatric patients.

Objective To examine reading and related skills in children with and without orofacial clefts. Methods Forty-two children with orofacial clefts were recruited from an urban craniofacial center. A demographically similar sample of 43 children without clefts was recruited using community advertisements and a research registry. Participants completed assessments of basic reading, phonological awareness, phonological memory, reading fluency, and rapid naming. Parents completed a semi-structured interview regarding educational and medical history. Results Children with clefts scored significantly lower than controls on measures of basic reading, phonological memory, and reading fluency. Conclusions This is one of the first studies of reading in children with orofacial clefts to include a control sample. The findings suggest that children with clefts are less adept readers than demographically matched peers without clefts, supporting the need to monitor academic achievement in this population.

Objective To present a case study using multisystemic therapy (MST), an intensive family focused psychotherapy. For the clinical trial from which this case was drawn, MST was adapted to address multiple human immunodeficiency virus (HIV) transmission risk behaviors in HIV-infected youth. Targeted behaviors included medication nonadherence, risky sexual behaviors, and substance use. Method One young woman's transmission risk behaviors are described, followed by a description of the MST procedures used to identify and treat the primary drivers of these risk behaviors. Outcome measures were self-report, urine screens, and blood draws. Results At discharge, the young woman showed significant improvements in medication adherence and related health status (e.g., reduced HIV viral load), healthier sexual behaviors, and reduced substance use. Importantly, neither her boyfriend nor her newborn tested positive for HIV. Conclusions Findings from this case study suggest that MST has the potential to reduce transmission risk behaviors among teens with HIV.

Objectives To describe the development and validation of a measure of negative attitudes toward physical activity and examine the association between these attitudes and self-reported physical activity among preadolescents. Method A school-based sample of 382 fifth and sixth graders (mean age = 10.8) completed measures of attitudes toward physical activity and self-reported physical activity. Body mass index data for the participants was collected as a part of a standard school health assessment. Exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were utilized to test the factor structure and predictive value of attitudes toward physical activity. Results Results supported the reliability and concurrent validity of the negative attitudes measure and found a significant association between negative attitudes and physical activity. Negative attitudes was found to be a stronger predictor of physical activity than positive attitudes, which have been the focus of previous research in this area. Conclusions The results suggest that negative attitudes toward physical activity can be reliably measured and may be an important target for intervention efforts to increase physical activity among children and adolescents.