Parent-directed intervention for children with cancer-related neurobehavioral late effects: a randomized pilot study.

OBJECTIVE : To evaluate feasibility and preliminary efficacy of an intervention directed at parents of childhood cancer survivors (CCSs) with neurobehavioral late effects to improve targeted parenting skills, and thus to indirectly benefit the child's educational functioning. METHODS : 44 CCSs and their parents were randomized. Intervention-arm parents participated in eight individual training sessions augmented by a 3-month telephone support period. Pre- and postparent measures and child performance on Wechsler Individual Achievement Test-II and School Motivation and Learning Strategies Inventory assessed intervention effects. RESULTS : 90% of intervention parents completed the program with high adherence/perceived benefit. Between-group effect sizes ranged from d = 0.77 to d = 1.45 for parent knowledge, efficacy, frequency of pro-learning behaviors, and d = 0.21 to d = 0.76 for child academic scores. Parental time spent in intervention activities was associated with academic change. CONCLUSIONS : A parent-directed intervention to indirectly promote academic functioning in CCSs appears feasible and effective in improving targeted parenting outcomes and for selected child academic outcomes.

Distress screening, rater agreement, and services in pediatric oncology.

OBJECTIVE: Empirically based data support the validity of the distress thermometer recommended by the National Comprehensive Cancer Network as a standard screen for patient distress. However, the feasibility and utility of the distress thermometer has not been studied in the pediatric oncology setting. We conducted a study to: (1) investigate the validity of an adapted distress thermometer with pediatric oncology patients, (2) assess the degree of agreement among different respondents, including physician and psychosocial staff, with respect to (a) the pediatric cancer patient's distress and (b) the caregiver/parent's distress, and (3) to evaluate the relationship between distress levels and the psychosocial services provided to patients and families. METHODS: Ninety-one patients and their English and Spanish-speaking caregivers were prospectively assessed at 3-month intervals for 1 year. The quantity of psychosocial services provided to each family was logged for a 12-month period. RESULTS: Convergent validity was demonstrated by reasonable agreement between the pediatric distress rating tool and standardized measures. Additionally, the demographic and medical predictors of distress were consistent with previously reported findings using more extensive assessment. There was reasonable agreement among multiple raters of the child's distress; however, there was discrepancy between self-ratings of caregiver distress and psychosocial staff ratings of caregiver distress. This difference in perception impacted the quantity of psychosocial services provided following the baseline assessment. CONCLUSION: The single-item distress thermometer is a viable option as a rapid screening tool of patient and caregiver distress to help efficiently identify those who should be evaluated further.

Social narratives in agenesis of the corpus callosum: linguistic analysis of the Thematic Apperception Test.

In a previous study, individuals with agenesis of the corpus callosum (ACC) with normal intelligence provided narratives to pictures from the Thematic Apperception Test (TAT) that were limited in logical coherence and social awareness. The current study examined the linguistic content of TAT stories from 22 persons with isolated complete ACC compared to 30 IQ- and age-matched controls using the Linguistic Inquiry and Word Count (Pennebaker et al., 2001). Compared to controls, individuals with ACC used fewer words pertaining to emotionality, cognitive processes, and social processes. They also used relatively more present tense verbs and first person pronouns. These findings suggest that callosal agenesis results in deficiencies in imagining and inferring the mental, emotional, and social functioning of others as implied by TAT pictures, and in translating this content into a narrative. In addition, ACC affects the grammatical structure of verbally produced narratives, with greater emphasis on the present tense and the first person.

Psychosocial factors in chronic fatigue syndrome among Chinese Americans: a longitudinal community-based study.

Chronic fatigue syndrome (CFS) is a relatively new condition of unknown etiology. Research suggests that psychosocial factors such as perceived social support, life stress, and acculturation may significantly influence individuals who are prone to CFS. For 57 Chinese American individuals initially diagnosed with CFS, those who recovered after one year reported lower levels of life stress than those who did not recover. Effects of changes in perceived social support also appeared to be mediated by life stress.