ABSTRACT
OBJECTIVE: Colocation of mental health screening, assessment, and treatment in primary care reduces stigma, improves access, and increases coordination of care between mental health and primary care providers. However, little information exists regarding older adults' attitudes about screening for mental health problems in primary care. The objective of this study was to evaluate older primary care patients' acceptance of and satisfaction with screening for depression and anxiety. METHODS: The study was conducted at an urban, academically affiliated primary care practice serving older adults. Study patients (N = 107) were screened for depression/anxiety and underwent a post-screening survey/interview to assess their reactions to the screening experience. RESULTS: Most patients (88.6%) found the length of the screening to be "just right." A majority found the screening questions somewhat or very acceptable (73.4%) and not at all difficult (81.9%). Most participants did not find the questions stressful (84.9%) or intrusive (91.5%); and a majority were not at all embarrassed (93.4%), upset (93.4%), or uncomfortable (88.8%) during the screening process. When asked about frequency of screening, most patients (72.4%) desired screening for depression/anxiety yearly or more. Of the 79 patients who had spoken with their physicians about mental health during the visit, 89.8% reported that it was easy or very easy to talk with their physicians about depression/anxiety. Multivariate results showed that patients with higher anxiety had a lower positive reaction to the screen when controlling for gender, age, and patient-physician communication. CONCLUSIONS: These results demonstrate strong patient support for depression and anxiety screening in primary care.
Subject(s)
Anxiety Disorders/diagnosis , Delivery of Health Care, Integrated/standards , Depressive Disorder/diagnosis , Health Services for the Aged/organization & administration , Mass Screening/organization & administration , Mental Health Services/organization & administration , Patient Satisfaction , Primary Health Care/organization & administration , Adult , Aged , Female , Geriatric Assessment/methods , Health Services for the Aged/standards , Humans , Male , Mass Screening/standardsABSTRACT
A corpus of nearly 150,000 maternal word-tokens used by 53 low-income mothers in 263 mother-child conversations in 5 settings (e.g., play, mealtime, and book readings) was studied. Ninety-nine percent of maternal lexical input consisted of the 3,000 most frequent words. Children's vocabulary performance in kindergarten and later in 2nd grade related more to the occurrence of sophisticated lexical items than to quantity of lexical input overall. Density of sophisticated words heard and the density with which such words were embedded in helpful or instructive interactions, at age 5 at home, independently predicted over a third of the variance in children's vocabulary performance in both kindergarten and 2nd grade. These two variables, with controls for maternal education, child nonverbal IQ, and amount of child's talk produced during the interactive settings, at age 5, predicted 50% of the variance in children's 2nd-grade vocabulary.
Subject(s)
Language Development , Mother-Child Relations , Vocabulary , Adult , Child, Preschool , Female , Follow-Up Studies , Forecasting , Humans , Male , PovertyABSTRACT
The two studies presented here explore the relationship between children's pragmatic skills and their growth in grammar. In study 1, thirty normally developing children were videotaped interacting with their parents at 1;2 and again at 2;7. Using correlational and regression techniques, we found that pragmatic accomplishments of MUTUAL ATTENTION, as well as mother's conversational style, explained 45% of the variance in grammar at 2;7. The second study investigated pragmatic-grammatical relationships with data from 6 high-functioning children with autism. To control for individual variation in skill level at the start of the study, within-individual growth rates for grammar were estimated as our outcome. The results substantiated those of study 1, in that pragmatic accomplishments within mutual attention predicted the per month growth rate in grammar. We interpret these findings as consistent with the position that the infant's social-pragmatic skills contribute to the acquisition of grammar.
Subject(s)
Attention , Autistic Disorder/psychology , Child Development/physiology , Child Language , Interpersonal Relations , Language Development , Linguistics , Parent-Child Relations , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
This study examines individual growth rates in definitional skill over a period of three to six years, for 68 low-income children. Children were asked to define words once a year at school, from kindergarten (youngest administration at 5:3) through fourth grade (oldest administration at 10:10). A plateau was observed between age nine and ten both for percent formal definitions (characterized by presence of a superordinate) and for the quality of formal definitions. The plateau was lower than the theoretical ceiling for these measures. However, the children appear to have attained 'adult levels' of definitional skill: forty-seven fourth-graders (aged 9:1 to 10:10) performed higher, on average, than their own mothers when giving definitions. These results support the notion that definitional skill is related to being part of an academic culture: low-income mothers, whose formal schooling is complete, generally do not give oral definitions to simple nouns as well as do their nine- to ten-year-old children.
Subject(s)
Child Language , Language Development , Language Tests , Age Factors , Child , Child, Preschool , Female , Humans , Longitudinal Studies , MaleABSTRACT
The purpose of this study was to compare the pragmatic skills of five children with Specific Language Impairments (SLI) and their Mean Length of Utterance-matched younger siblings, thus in part controlling for home language environment and expressive language level. Data were videotaped as mother-child free play in the home. Children's communicative acts were coded on three levels (social interchange, speech act, and conversational). Analysis of each level separately indicated generally comparable performance within sibling pairs. However, when the three levels were integrated into a measure of pragmatic flexibility, the children with SLI were found to demonstrate a more varied repertoire than their younger, normally developing siblings.
Subject(s)
Child Language , Language Disorders/psychology , Child , Child, Preschool , Female , Humans , Male , Mother-Child Relations , Play and Playthings , Videotape RecordingABSTRACT
Describing speakers' repertoires of communicative intents and rules for expressing those intents is crucial to any complete description of the language capacity. Many different systems for classifying speakers' communicative intents have been developed and used in research analyzing both the acquisition of speech acts and the nature of the communicative deficits shown by various language-impaired populations. We argue, though, that these systems have typically been limited in scope, in applicability across the full developmental range, or in their theoretical foundations. The criteria for an adequate system for analyzing communicative intents are discussed, and a system proposed which meets those criteria.
Subject(s)
Child Language , Language Tests , Verbal Behavior , Child , Child, Preschool , Humans , Language Disorders/diagnosis , Semantics , Verbal LearningABSTRACT
Giving good definitions requires controlling both word meaning and definitional form. Definitions from 137 second to fifth graders (i.e. aged seven to eleven) were scored to reflect conformity to the classic Aristotelian form and quality of information provided. Comparisons among children with different backgrounds indicated that school exposure to English was strongly related to per cent formal definitions given and their quality. 63 children were also tested in French, their foreign language. Performance in French was lower than in English; exposure to French at home related to the amount of information the children provided in informal definitions, not to quality of formal definitions. The results suggest that performance on definitions is most strongly affected by opportunities to practise the required form.
