Psychological adjustment of adolescents with sickle cell disease: relations with demographic, medical, and family competence variables.

OBJECTIVE: Investigate the hypothesis that family competence in addressing challenges associated with sickle cell disease (SCD) contributes to adolescents' adjustment. METHOD: During routine clinic appointments, 80 adolescents (M age = 14.4 years) and their parents independently completed the Self-Report Family Inventory (SFI), which assesses family competence, and measures of adolescent adjustment problems. Information related to disease severity was obtained from clinic files. RESULTS: Regression analyses controlling for demographic and medical variables revealed that higher family competence was associated with fewer internalizing and externalizing behaviors by the adolescent; these relations were particularly true for younger adolescents and for girls. Parental reports of somatic complaints in girls were predicted by parental ratings of family competence. DISCUSSION: Interventions for adolescents with SCD should be family-centered and should focus on strengthening the family's ability to manage stressors associated with parenting an adolescent with a chronic illness.

Case study: audio feedforward treatment of selective mutism.

Selective mutism is a relatively rare and difficult-to-treat disorder. Audio feedforward is a potential intervention that involves having the individual with selective mutism listen to audiotapes edited to depict him or her speaking in situations in which he or she is not currently speaking. The successful use of this intervention for three children with selective mutism is reported. The intervention was used in both school and community settings. This intervention has not always proved successful, sometimes because children refused to make the audiotapes.