Kimberley Lakes | University of California, Irvine (original) (raw)

Papers by Kimberley Lakes

Research paper thumbnail of The Relative Utility of Concurrent Sources of Information for Diagnosis of Autism Spectrum Disorder in Early Childhood

Research paper thumbnail of Psychological Determinants of Physical Activity and Development in Early Childhood Among Children With Developmental Delays: The Role of Parent Beliefs Regarding the Benefits of Physical Activity

Frontiers in Sports and Active Living

Research paper thumbnail of Girls From Socioeconomically Disadvantaged Schools Exhibit Greater Object Control Skills Than Girls From Schools on the Upper Levels of Socioeconomic Development

Journal of Motor Learning and Development

This study compared fundamental movement skills (FMS) in children from schools on the lower and u... more This study compared fundamental movement skills (FMS) in children from schools on the lower and upper levels of socioeconomic status. Data were collected from 228 schoolchildren across five schools in Ireland. There were 147 children from schools of social disadvantage (Mage = 7.67 [SD = 0.62] years; 55% boys) and 81 children from schools considered in the normal range for socioeconomic development (Mage = 7.34 [SD = 0.26] years; 56% boys). FMS were assessed using the Test of Gross Motor Development–2. Mixed models were used to estimate differences in FMS, while controlling for the nested structure of the data and for sex, age, body mass index, and class size. There was a substantial sex×school interaction, with girls from schools of social disadvantage exhibiting greater object-control skills proficiency than their counterparts in schools on the upper tertiles of socioeconomic development (standardized effect size = 0.66 [±95% confidence limits, ±0.50]; p = .02). The suggestion tha...

Research paper thumbnail of A Six Week Therapeutic Ballet Intervention Improved Gait and Inhibitory Control in Children With Cerebral Palsy—A Pilot Study

Frontiers in Public Health

Children with cerebral palsy (CP) have motor impairments that make it challenging for them to par... more Children with cerebral palsy (CP) have motor impairments that make it challenging for them to participate in standard physical activity (PA) interventions. There is a need to evaluate adapted PA interventions for this population. Dance can promote coordination, posture, muscle strength, motor learning, and executive functioning. This pilot study evaluated the feasibility and the effects of a new therapeutic ballet intervention specifically designed for children with CP. Methods: Eight children with CP (9-14 y/o; 75% female) participated in a 6-week therapeutic ballet intervention. Outcomes were measured in multiple domains, including body composition (DXA), muscle strength (hand-grip dynamometer), habitual physical activity, gait and selective motor control functions, and executive functioning. Follow-up assessments of habitual physical activity, gait, and executive functioning were completed 4 to 5 weeks post-intervention. Results: Five of the eight participants were overfat or obese based on DXA percentage of body fat. All participants were below the 50th percentile for their age and gender for bone density. Four participants showed a trend to improve hand-grip strength in one hand only, while one improved in both hands. There were significant improvements in gait across time points (pre, post, and follow-up), specifically in time of ambulation (X pre = 4.36, X post = 4.22, X follow−up = 3.72, d = 0.056, p = 0.02), and in step length (cm) on the right: X pre = 48.29, X post = 50.77, X follow−up = 52.11, d = 0.22, p = 0.027, and left stride: X pre = 96.29, X post =102.20, X follow−up =104.20, d = 0.30, p = 0.027, indicating gait changes in bilateral lower extremities. There was improvement in inhibitory control (d = 0.78; 95% Confidence Limit = ±0.71, p < 0.05) with large individual responses primarily among those above the mean at baseline. Lakes et al. Ballet Intervention for Cerebral Palsy Conclusions: Therapeutic ballet may prove to be a useful intervention to promote physiological and cognitive functions in children with CP. Results demonstrated feasibility of the physical, physiological, and cognitive assessments and suggested improvements in participants' gait and inhibitory control with large individual responses. Modifications to personalize the intervention may be needed to optimize positive outcomes.

Research paper thumbnail of Beyond Broadway: Analysis of Qualitative Characteristics of and Individual Responses to Creatively Able, a Music and Movement Intervention for Children with Autism

International Journal of Environmental Research and Public Health

Movement in response to music represents one of the natural social environments in which physical... more Movement in response to music represents one of the natural social environments in which physical activity occurs. The study of music and movement, including dance, requires a careful, holistic consideration of many features, which may include music, physical activity, motor learning, social engagement, emotion, and creativity. The overarching goal of this manuscript is to examine qualitative characteristics of and individual responses to a music and movement intervention (Creatively Able) for children with Autism Spectrum Disorder (ASD). We provide a description of Creatively Able, illustrating how the program design and physical and social environment were informed by children’s needs and preferences in order to provide an enriched environment in which to promote multiple systems in children with ASD. Using data from two pilot studies with 20 children with ASD, we illustrate how researchers can use observational research methods to measure important aspects of the social environme...

Research paper thumbnail of The Role of Animal Assisted Intervention on Improving Self-Esteem in Children With Attention Deficit/Hyperactivity Disorder

Frontiers in Pediatrics

Attention Deficit/Hyperactivity Disorder (ADHD), the most ubiquitous mental health problem in chi... more Attention Deficit/Hyperactivity Disorder (ADHD), the most ubiquitous mental health problem in children, has been associated with poor self-esteem. Psychosocial interventions have aimed to improve self-esteem among this group, with the aim of reducing the development of comorbid depression and anxiety. The present study implemented a randomized control design to examine the possibility of Animal Assisted Interventions (AAI) as a viable approach to improving self-esteem among children with ADHD. Children's self-esteem across multiple domains as measured by the Self-Perception Profile for Children was evaluated (n = 80, ages 7-9, 71% male). To test the hypothesis that AAI improves self-esteem, stratified Wilcoxon Signed-Rank Tests (SAS NPAR1WAY procedure) were used to compare pre-to post-treatment ratings. Analyses indicated that scores of children's self-perceptions in the domains of behavioral conduct, social, and scholastic competence, were significantly increased from baseline to post-treatment in the AAI group (z = 2.320, p = .021, z = 2.631, p = .008, and z = 2.541, p = .011, respectively), whereas pre-post-treatment differences in self-perceptions were not found for the children in the control group without AAI. Findings suggest that AAI is a viable strategy for improving ratings of self-perceived self-esteem in children with ADHD.

Research paper thumbnail of An 8 Week Aerobic Exercise Training Intervention Improved Executive Functions in Adolescents

Medicine & Science in Sports & Exercise

Research paper thumbnail of Measuring Maternal Behaviors in the Neonatal Intensive Care Unit

Infants & Young Children

One of the most important considerations in designing clinical infant research studies is the sel... more One of the most important considerations in designing clinical infant research studies is the selection of reliable and valid measurement procedures. Few measures of caregiver-child interactions have been studied with newborns, particularly premature infants. The main objective of this study was to examine psychometric properties of the National Institute of Child Health and Human Development (NICHD) Mother-Child Interaction Qualitative Ratings in a sample of premature infants and their mothers to evaluate its use in the neonatal intensive care unit. Mother-baby dyads (N 24) were videotaped in a 10-min interaction in the NICU. Nine raters independently assessed dyadic interactions using the NICHD Mother-Child Interaction Qualitative Ratings in a fully crossed research design. Rater reliability was strong for mother and infant ratings (.76-.94). Scores yielded normal distributions for maternal sensitivity, positive regard, and flatness of affect and skewed distributions for maternal intrusiveness, detachment, negative regard, and all child ratings. Positive maternal behaviors correlated positively with one another and negatively with negative maternal behaviors. Thus, preliminary analyses suggest that scores obtained using the NICHD Mother-Child Interaction Qualitative Ratings with premature babies and their mothers in the neonatal intensive care unit demonstrate adequate interrater reliability, and distributional properties provide preliminary evidence of face validity.

Research paper thumbnail of More than one road leads to Rome: A narrative review and meta-analysis of physical activity intervention effects on cognition in youth

International Journal of Sport and Exercise Psychology

Research paper thumbnail of Assessing Parent Perceptions of Physical Activity in Families of Toddlers with Neurodevelopmental Disorders: The Parent Perceptions of Physical Activity Scale (PPPAS)

Pediatric exercise science, Aug 9, 2017

The purpose of this study was to examine a new tool (PPPAS: Parent Perceptions of Physical Activi... more The purpose of this study was to examine a new tool (PPPAS: Parent Perceptions of Physical Activity Scale-Preschool) developed to study parental perceptions of physical activity (PA) among parents of toddler and preschool age children. 143 children (mean age 31.65 months; 75% male) and their parents were recruited from a neurodevelopmental clinic. Parents completed questionnaires, and both a psychologist and a physician evaluated the children. 83% of the children received a diagnosis of Autism Spectrum Disorder; 20% of the children had a BMI > 85(th) percentile. Analyses were conducted to evaluate the reliability, concurrent validity, discriminant validity, and predictive validity of PPPAS scores. Results supported a two-factor structure: Perceptions of the Benefits of PA and the Barriers to PA. The internal consistency of scores was good for both PPPAS subscales, derived from the two factors. Parent perceptions of barriers to PA were significantly correlated with delays in overa...

Research paper thumbnail of Designing an iPad App to Monitor and Improve Classroom Behavior for Children with ADHD: iSelfControl Feasibility and Pilot Studies

PloS one, 2016

Children with Attention Deficit/Hyperactivity Disorder (ADHD) receive approximately 80% of instru... more Children with Attention Deficit/Hyperactivity Disorder (ADHD) receive approximately 80% of instruction in the general education classroom, where individualized behavioral management strategies may be difficult for teachers to consistently deliver. Mobile device apps provide promising platforms to manage behavior. This pilot study evaluated the utility of a web-based application (iSelfControl) designed to support classroom behavior management. iSelfControl prompted students every 'Center' (30-minutes) to self-evaluate using a universal token-economy classroom management system focused on compliance, productivity, and positive relationships. Simultaneously, the teacher evaluated each student on a separate iPad. Using Multi Level Modeling, we examined 13 days of data gathered from implementation with 5th grade students (N = 12) at a school for children with ADHD and related executive function difficulties. First, an unconditional growth model evaluated the overall amount of cha...

Research paper thumbnail of Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results

Journal of the American Academy of Child & Adolescent Psychiatry, 2016

To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavi... more To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison group (LNCG) in the Multimodal Treatment Study of Children with ADHD (MTA). Data were collected 12, 14, and 16 years postbaseline (mean age 24.7 years at 16 years postbaseline) from 476 participants with ADHD diagnosed at age 7 to 9 years, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence versus desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD versus LNCG and symptom-persistent (50%) versus symptom-desistent (50%) subgroups. Functional outcomes were measured with standardized and demographic instruments. Three patterns of functional outcomes emerged. Post-secondary education, times fired/quit a job, current income, receiving public assistance, and risky sexual behavior showed the most common pattern: the LNCG group fared best, symptom-persistent ADHD group worst, and symptom-desistent ADHD group between, with the largest effect sizes between LNCG and symptom-persistent ADHD. In the second pattern, seen with emotional outcomes (emotional lability, neuroticism, anxiety disorder, mood disorder) and substance use outcomes, the LNCG and symptom-desistent ADHD group did not differ, but both fared better than the symptom-persistent ADHD group. In the third pattern, noted with jail time (rare), alcohol use disorder (common), and number of jobs held, group differences were not significant. The ADHD group had 10 deaths compared to one death in the LNCG. Adult functioning after childhood ADHD varies by domain and is generally worse when ADHD symptoms persist. It is important to identify factors and interventions that promote better functional outcomes.

Research paper thumbnail of Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity

Journal of child psychology and psychiatry, and allied disciplines, Jan 19, 2016

Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates... more Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5-75%). This study documents how information source (parent vs. self-report), method (rating scale vs. interview), and symptom threshold (DSM vs. norm-based) influence reported ADHD persistence rates in adulthood. Five hundred seventy-nine children were diagnosed with DSM-IV ADHD-Combined Type at baseline (ages 7.0-9.9 years) 289 classmates served as a local normative comparison group (LNCG), 476 and 241 of whom respectively were evaluated in adulthood (Mean Age = 24.7). Parent and self-reports of symptoms and impairment on rating scales and structured interviews were used to investigate ADHD persistence in adulthood. Persistence rates were higher when using parent rather than self-reports, structured interviews rather than rating scales (for self-report but not parent report), and a norm-based (NB) threshold of 4 symptoms rather than DSM criteria. Receiver-Operating Chara...

Research paper thumbnail of Cultural Competence and Psychotherapy: Applying Anthropologically Informed Conceptions of Culture

Psychotherapy Theory Research Practice, Dec 1, 2006

The authors apply two contemporary notions of culture to advance the conceptual basis of cultural... more The authors apply two contemporary notions of culture to advance the conceptual basis of cultural competence in psychotherapy: Kleinman's (1995) definition of culture as what is at stake in local, social worlds, and Mattingly and Lawlor's (2001) concept of shared narratives between practitioners and patients. The authors examine these cultural constructs within a clinical case of an immigrant family caring for a young boy with an autism-spectrum disorder. Their analysis suggests that the socially based model of culture and the concept of shared narratives have the potential to broaden and enrich the definition of cultural competence beyond its current emphasis on the presumed cultural differences of specific racial and ethnic minority groups.

Research paper thumbnail of Innovations in Practice: A pilot randomized controlled trial comparing computer-assisted cognitive rehabilitation, stimulant medication, and an active control in the treatment of ADHD

Child and Adolescent Mental Health, 2016

Research paper thumbnail of Enhancing the Construct and Content Validity of Rating Scales for Clinical Research: Using Qualitative Methods to Develop a Rating Scale to Assess Parental Perceptions of Their Role in Promoting Infant Exercise

The International Journal of Educational and Psychological Assessment, Apr 1, 2012

With a focus on the early stages of developing new assessment tools, we present an example of how... more With a focus on the early stages of developing new assessment tools, we present an example of how researchers can apply qualitative data to the development of conceptual domains and specific items representing those domains for quantitative instruments. Specifically, our previous research examining mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions and experiences of engaging in assisted exercise with their infants provided the foundation for the development of the Perceptions of Pediatric Activity Scale (PPAS). We describe the process we used to develop the PPAS as an exemplar for the process of incorporating qualitative data in instrument development. In addition, we address instrument development for diverse populations, and we provide examples illustrating how we extracted concepts using a concept-indicator model to construct the items in the PPAS. We conclude by noting that we are currently in the process of pilot-testing the PPAS to evaluate its utility and reliability.

Research paper thumbnail of Categorical and Dimensional Definitions and Evaluations of Symptoms of ADHD: History of the SNAP and the SWAN Rating Scales

The International journal of educational and psychological assessment, 2012

An earlier version of this article was originally submitted for publication in early 2000 to intr... more An earlier version of this article was originally submitted for publication in early 2000 to introduce a new dimensional of concept of Attention Deficit Hyperactivity Disorder (ADHD) provided by the Strengths and Weaknesses of ADHD-symptoms and Normal-behavior (SWAN) rating scale. The SWAN was developed to correct some obvious deficiencies of the Swanson, Nolan and Pelham (SNAP) rating scale that was based on the categorical concept of ADHD. The first submission was not accepted for publication, so a draft of the article was posted on a website (www.ADHD.net). The SWAN scale was published as a table in a review article (Swanson et al, 2001) to make it available to those interested in this dimensional approach to assessment of ADHD. Despite its relative inaccessibility, the SWAN has been used in several genetic studies of ADHD (e.g., Hay, Bennett, Levy, Sergeant, & Swanson, 2005; Cornish et al, 2005) and has been translated into several languages for European studies of ADHD (e.g., L...

Research paper thumbnail of A Pilot Evaluation of An Early Intervention Home Exercise Program for Premature Infants: Caregiver Adherence, Proficiency, and Perceptions

Purpose: Approximately 12% of infants are born preterm. Evidence is mounting that low birth weigh... more Purpose: Approximately 12% of infants are born preterm. Evidence is mounting that low birth weight and prematurity are related to higher body fat, lower lean mass, increased blood pressure and decreased fitness in adulthood. It is also becoming clear that the effectiveness of interventions in premature babies may depend on how early they are begun. To date, efforts to augment physical activity early in life in premature babies are deficient. The Objective of this study was to evaluate the feasibility of a home-based program of assisted infant exercise in which the caregiver was taught a set of exercise tasks and asked to implement the exercise program at home following discharge. Methods: 10 caregivers of preterm infants were trained in the techniques of assisted infant exercise. The caregivers, the majority of whom were the mothers, were instructed to perform the exercises daily for approximately 3 weeks, starting on the day of discharge from the NICU. Caregivers completed a daily ...

Research paper thumbnail of Generalizability Study of an Observer-Rated Measure of Self-Regulation in Children

Research paper thumbnail of The Response to Challenge Scale (RCS): The Development and Construct Validity of an Observer-Rated Measure of Children's Self-Regulation

The International journal of educational and psychological assessment, 2012

In this manuscript, I present an observer-rated measure of child self-regulation, the Response to... more In this manuscript, I present an observer-rated measure of child self-regulation, the Response to Challenge Scale (RCS). The RCS was designed to measure children's cognitive, affective, and motor regulation in response to a physical challenge course. 198 children (Kindergarten through fifth grade) were evaluated using the RCS. All children individually completed a challenge course on two separate occasions four months apart. During their completion of the tasks, research-trained observers rated the degree to which children exhibited cognitive, affective, and motor regulation. In a fully-crossed research design, five raters on Occasion 1 and six raters on Occasion 2 rated all children. I examined the RCS within the Generalizability Theory (GT) framework to analyze construct validity (PRS). Results demonstrated that raters are able to distinguish between children's self-regulation in various domains, providing some validity evidence for the RCS, and supporting the theory that ...

Research paper thumbnail of The Relative Utility of Concurrent Sources of Information for Diagnosis of Autism Spectrum Disorder in Early Childhood

Research paper thumbnail of Psychological Determinants of Physical Activity and Development in Early Childhood Among Children With Developmental Delays: The Role of Parent Beliefs Regarding the Benefits of Physical Activity

Frontiers in Sports and Active Living

Research paper thumbnail of Girls From Socioeconomically Disadvantaged Schools Exhibit Greater Object Control Skills Than Girls From Schools on the Upper Levels of Socioeconomic Development

Journal of Motor Learning and Development

This study compared fundamental movement skills (FMS) in children from schools on the lower and u... more This study compared fundamental movement skills (FMS) in children from schools on the lower and upper levels of socioeconomic status. Data were collected from 228 schoolchildren across five schools in Ireland. There were 147 children from schools of social disadvantage (Mage = 7.67 [SD = 0.62] years; 55% boys) and 81 children from schools considered in the normal range for socioeconomic development (Mage = 7.34 [SD = 0.26] years; 56% boys). FMS were assessed using the Test of Gross Motor Development–2. Mixed models were used to estimate differences in FMS, while controlling for the nested structure of the data and for sex, age, body mass index, and class size. There was a substantial sex×school interaction, with girls from schools of social disadvantage exhibiting greater object-control skills proficiency than their counterparts in schools on the upper tertiles of socioeconomic development (standardized effect size = 0.66 [±95% confidence limits, ±0.50]; p = .02). The suggestion tha...

Research paper thumbnail of A Six Week Therapeutic Ballet Intervention Improved Gait and Inhibitory Control in Children With Cerebral Palsy—A Pilot Study

Frontiers in Public Health

Children with cerebral palsy (CP) have motor impairments that make it challenging for them to par... more Children with cerebral palsy (CP) have motor impairments that make it challenging for them to participate in standard physical activity (PA) interventions. There is a need to evaluate adapted PA interventions for this population. Dance can promote coordination, posture, muscle strength, motor learning, and executive functioning. This pilot study evaluated the feasibility and the effects of a new therapeutic ballet intervention specifically designed for children with CP. Methods: Eight children with CP (9-14 y/o; 75% female) participated in a 6-week therapeutic ballet intervention. Outcomes were measured in multiple domains, including body composition (DXA), muscle strength (hand-grip dynamometer), habitual physical activity, gait and selective motor control functions, and executive functioning. Follow-up assessments of habitual physical activity, gait, and executive functioning were completed 4 to 5 weeks post-intervention. Results: Five of the eight participants were overfat or obese based on DXA percentage of body fat. All participants were below the 50th percentile for their age and gender for bone density. Four participants showed a trend to improve hand-grip strength in one hand only, while one improved in both hands. There were significant improvements in gait across time points (pre, post, and follow-up), specifically in time of ambulation (X pre = 4.36, X post = 4.22, X follow−up = 3.72, d = 0.056, p = 0.02), and in step length (cm) on the right: X pre = 48.29, X post = 50.77, X follow−up = 52.11, d = 0.22, p = 0.027, and left stride: X pre = 96.29, X post =102.20, X follow−up =104.20, d = 0.30, p = 0.027, indicating gait changes in bilateral lower extremities. There was improvement in inhibitory control (d = 0.78; 95% Confidence Limit = ±0.71, p < 0.05) with large individual responses primarily among those above the mean at baseline. Lakes et al. Ballet Intervention for Cerebral Palsy Conclusions: Therapeutic ballet may prove to be a useful intervention to promote physiological and cognitive functions in children with CP. Results demonstrated feasibility of the physical, physiological, and cognitive assessments and suggested improvements in participants' gait and inhibitory control with large individual responses. Modifications to personalize the intervention may be needed to optimize positive outcomes.

Research paper thumbnail of Beyond Broadway: Analysis of Qualitative Characteristics of and Individual Responses to Creatively Able, a Music and Movement Intervention for Children with Autism

International Journal of Environmental Research and Public Health

Movement in response to music represents one of the natural social environments in which physical... more Movement in response to music represents one of the natural social environments in which physical activity occurs. The study of music and movement, including dance, requires a careful, holistic consideration of many features, which may include music, physical activity, motor learning, social engagement, emotion, and creativity. The overarching goal of this manuscript is to examine qualitative characteristics of and individual responses to a music and movement intervention (Creatively Able) for children with Autism Spectrum Disorder (ASD). We provide a description of Creatively Able, illustrating how the program design and physical and social environment were informed by children’s needs and preferences in order to provide an enriched environment in which to promote multiple systems in children with ASD. Using data from two pilot studies with 20 children with ASD, we illustrate how researchers can use observational research methods to measure important aspects of the social environme...

Research paper thumbnail of The Role of Animal Assisted Intervention on Improving Self-Esteem in Children With Attention Deficit/Hyperactivity Disorder

Frontiers in Pediatrics

Attention Deficit/Hyperactivity Disorder (ADHD), the most ubiquitous mental health problem in chi... more Attention Deficit/Hyperactivity Disorder (ADHD), the most ubiquitous mental health problem in children, has been associated with poor self-esteem. Psychosocial interventions have aimed to improve self-esteem among this group, with the aim of reducing the development of comorbid depression and anxiety. The present study implemented a randomized control design to examine the possibility of Animal Assisted Interventions (AAI) as a viable approach to improving self-esteem among children with ADHD. Children's self-esteem across multiple domains as measured by the Self-Perception Profile for Children was evaluated (n = 80, ages 7-9, 71% male). To test the hypothesis that AAI improves self-esteem, stratified Wilcoxon Signed-Rank Tests (SAS NPAR1WAY procedure) were used to compare pre-to post-treatment ratings. Analyses indicated that scores of children's self-perceptions in the domains of behavioral conduct, social, and scholastic competence, were significantly increased from baseline to post-treatment in the AAI group (z = 2.320, p = .021, z = 2.631, p = .008, and z = 2.541, p = .011, respectively), whereas pre-post-treatment differences in self-perceptions were not found for the children in the control group without AAI. Findings suggest that AAI is a viable strategy for improving ratings of self-perceived self-esteem in children with ADHD.

Research paper thumbnail of An 8 Week Aerobic Exercise Training Intervention Improved Executive Functions in Adolescents

Medicine & Science in Sports & Exercise

Research paper thumbnail of Measuring Maternal Behaviors in the Neonatal Intensive Care Unit

Infants & Young Children

One of the most important considerations in designing clinical infant research studies is the sel... more One of the most important considerations in designing clinical infant research studies is the selection of reliable and valid measurement procedures. Few measures of caregiver-child interactions have been studied with newborns, particularly premature infants. The main objective of this study was to examine psychometric properties of the National Institute of Child Health and Human Development (NICHD) Mother-Child Interaction Qualitative Ratings in a sample of premature infants and their mothers to evaluate its use in the neonatal intensive care unit. Mother-baby dyads (N 24) were videotaped in a 10-min interaction in the NICU. Nine raters independently assessed dyadic interactions using the NICHD Mother-Child Interaction Qualitative Ratings in a fully crossed research design. Rater reliability was strong for mother and infant ratings (.76-.94). Scores yielded normal distributions for maternal sensitivity, positive regard, and flatness of affect and skewed distributions for maternal intrusiveness, detachment, negative regard, and all child ratings. Positive maternal behaviors correlated positively with one another and negatively with negative maternal behaviors. Thus, preliminary analyses suggest that scores obtained using the NICHD Mother-Child Interaction Qualitative Ratings with premature babies and their mothers in the neonatal intensive care unit demonstrate adequate interrater reliability, and distributional properties provide preliminary evidence of face validity.

Research paper thumbnail of More than one road leads to Rome: A narrative review and meta-analysis of physical activity intervention effects on cognition in youth

International Journal of Sport and Exercise Psychology

Research paper thumbnail of Assessing Parent Perceptions of Physical Activity in Families of Toddlers with Neurodevelopmental Disorders: The Parent Perceptions of Physical Activity Scale (PPPAS)

Pediatric exercise science, Aug 9, 2017

The purpose of this study was to examine a new tool (PPPAS: Parent Perceptions of Physical Activi... more The purpose of this study was to examine a new tool (PPPAS: Parent Perceptions of Physical Activity Scale-Preschool) developed to study parental perceptions of physical activity (PA) among parents of toddler and preschool age children. 143 children (mean age 31.65 months; 75% male) and their parents were recruited from a neurodevelopmental clinic. Parents completed questionnaires, and both a psychologist and a physician evaluated the children. 83% of the children received a diagnosis of Autism Spectrum Disorder; 20% of the children had a BMI > 85(th) percentile. Analyses were conducted to evaluate the reliability, concurrent validity, discriminant validity, and predictive validity of PPPAS scores. Results supported a two-factor structure: Perceptions of the Benefits of PA and the Barriers to PA. The internal consistency of scores was good for both PPPAS subscales, derived from the two factors. Parent perceptions of barriers to PA were significantly correlated with delays in overa...

Research paper thumbnail of Designing an iPad App to Monitor and Improve Classroom Behavior for Children with ADHD: iSelfControl Feasibility and Pilot Studies

PloS one, 2016

Children with Attention Deficit/Hyperactivity Disorder (ADHD) receive approximately 80% of instru... more Children with Attention Deficit/Hyperactivity Disorder (ADHD) receive approximately 80% of instruction in the general education classroom, where individualized behavioral management strategies may be difficult for teachers to consistently deliver. Mobile device apps provide promising platforms to manage behavior. This pilot study evaluated the utility of a web-based application (iSelfControl) designed to support classroom behavior management. iSelfControl prompted students every 'Center' (30-minutes) to self-evaluate using a universal token-economy classroom management system focused on compliance, productivity, and positive relationships. Simultaneously, the teacher evaluated each student on a separate iPad. Using Multi Level Modeling, we examined 13 days of data gathered from implementation with 5th grade students (N = 12) at a school for children with ADHD and related executive function difficulties. First, an unconditional growth model evaluated the overall amount of cha...

Research paper thumbnail of Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results

Journal of the American Academy of Child & Adolescent Psychiatry, 2016

To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavi... more To compare educational, occupational, legal, emotional, substance use disorder, and sexual behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison group (LNCG) in the Multimodal Treatment Study of Children with ADHD (MTA). Data were collected 12, 14, and 16 years postbaseline (mean age 24.7 years at 16 years postbaseline) from 476 participants with ADHD diagnosed at age 7 to 9 years, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence versus desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD versus LNCG and symptom-persistent (50%) versus symptom-desistent (50%) subgroups. Functional outcomes were measured with standardized and demographic instruments. Three patterns of functional outcomes emerged. Post-secondary education, times fired/quit a job, current income, receiving public assistance, and risky sexual behavior showed the most common pattern: the LNCG group fared best, symptom-persistent ADHD group worst, and symptom-desistent ADHD group between, with the largest effect sizes between LNCG and symptom-persistent ADHD. In the second pattern, seen with emotional outcomes (emotional lability, neuroticism, anxiety disorder, mood disorder) and substance use outcomes, the LNCG and symptom-desistent ADHD group did not differ, but both fared better than the symptom-persistent ADHD group. In the third pattern, noted with jail time (rare), alcohol use disorder (common), and number of jobs held, group differences were not significant. The ADHD group had 10 deaths compared to one death in the LNCG. Adult functioning after childhood ADHD varies by domain and is generally worse when ADHD symptoms persist. It is important to identify factors and interventions that promote better functional outcomes.

Research paper thumbnail of Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity

Journal of child psychology and psychiatry, and allied disciplines, Jan 19, 2016

Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates... more Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5-75%). This study documents how information source (parent vs. self-report), method (rating scale vs. interview), and symptom threshold (DSM vs. norm-based) influence reported ADHD persistence rates in adulthood. Five hundred seventy-nine children were diagnosed with DSM-IV ADHD-Combined Type at baseline (ages 7.0-9.9 years) 289 classmates served as a local normative comparison group (LNCG), 476 and 241 of whom respectively were evaluated in adulthood (Mean Age = 24.7). Parent and self-reports of symptoms and impairment on rating scales and structured interviews were used to investigate ADHD persistence in adulthood. Persistence rates were higher when using parent rather than self-reports, structured interviews rather than rating scales (for self-report but not parent report), and a norm-based (NB) threshold of 4 symptoms rather than DSM criteria. Receiver-Operating Chara...

Research paper thumbnail of Cultural Competence and Psychotherapy: Applying Anthropologically Informed Conceptions of Culture

Psychotherapy Theory Research Practice, Dec 1, 2006

The authors apply two contemporary notions of culture to advance the conceptual basis of cultural... more The authors apply two contemporary notions of culture to advance the conceptual basis of cultural competence in psychotherapy: Kleinman's (1995) definition of culture as what is at stake in local, social worlds, and Mattingly and Lawlor's (2001) concept of shared narratives between practitioners and patients. The authors examine these cultural constructs within a clinical case of an immigrant family caring for a young boy with an autism-spectrum disorder. Their analysis suggests that the socially based model of culture and the concept of shared narratives have the potential to broaden and enrich the definition of cultural competence beyond its current emphasis on the presumed cultural differences of specific racial and ethnic minority groups.

Research paper thumbnail of Innovations in Practice: A pilot randomized controlled trial comparing computer-assisted cognitive rehabilitation, stimulant medication, and an active control in the treatment of ADHD

Child and Adolescent Mental Health, 2016

Research paper thumbnail of Enhancing the Construct and Content Validity of Rating Scales for Clinical Research: Using Qualitative Methods to Develop a Rating Scale to Assess Parental Perceptions of Their Role in Promoting Infant Exercise

The International Journal of Educational and Psychological Assessment, Apr 1, 2012

With a focus on the early stages of developing new assessment tools, we present an example of how... more With a focus on the early stages of developing new assessment tools, we present an example of how researchers can apply qualitative data to the development of conceptual domains and specific items representing those domains for quantitative instruments. Specifically, our previous research examining mothers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions and experiences of engaging in assisted exercise with their infants provided the foundation for the development of the Perceptions of Pediatric Activity Scale (PPAS). We describe the process we used to develop the PPAS as an exemplar for the process of incorporating qualitative data in instrument development. In addition, we address instrument development for diverse populations, and we provide examples illustrating how we extracted concepts using a concept-indicator model to construct the items in the PPAS. We conclude by noting that we are currently in the process of pilot-testing the PPAS to evaluate its utility and reliability.

Research paper thumbnail of Categorical and Dimensional Definitions and Evaluations of Symptoms of ADHD: History of the SNAP and the SWAN Rating Scales

The International journal of educational and psychological assessment, 2012

An earlier version of this article was originally submitted for publication in early 2000 to intr... more An earlier version of this article was originally submitted for publication in early 2000 to introduce a new dimensional of concept of Attention Deficit Hyperactivity Disorder (ADHD) provided by the Strengths and Weaknesses of ADHD-symptoms and Normal-behavior (SWAN) rating scale. The SWAN was developed to correct some obvious deficiencies of the Swanson, Nolan and Pelham (SNAP) rating scale that was based on the categorical concept of ADHD. The first submission was not accepted for publication, so a draft of the article was posted on a website (www.ADHD.net). The SWAN scale was published as a table in a review article (Swanson et al, 2001) to make it available to those interested in this dimensional approach to assessment of ADHD. Despite its relative inaccessibility, the SWAN has been used in several genetic studies of ADHD (e.g., Hay, Bennett, Levy, Sergeant, & Swanson, 2005; Cornish et al, 2005) and has been translated into several languages for European studies of ADHD (e.g., L...

Research paper thumbnail of A Pilot Evaluation of An Early Intervention Home Exercise Program for Premature Infants: Caregiver Adherence, Proficiency, and Perceptions

Purpose: Approximately 12% of infants are born preterm. Evidence is mounting that low birth weigh... more Purpose: Approximately 12% of infants are born preterm. Evidence is mounting that low birth weight and prematurity are related to higher body fat, lower lean mass, increased blood pressure and decreased fitness in adulthood. It is also becoming clear that the effectiveness of interventions in premature babies may depend on how early they are begun. To date, efforts to augment physical activity early in life in premature babies are deficient. The Objective of this study was to evaluate the feasibility of a home-based program of assisted infant exercise in which the caregiver was taught a set of exercise tasks and asked to implement the exercise program at home following discharge. Methods: 10 caregivers of preterm infants were trained in the techniques of assisted infant exercise. The caregivers, the majority of whom were the mothers, were instructed to perform the exercises daily for approximately 3 weeks, starting on the day of discharge from the NICU. Caregivers completed a daily ...

Research paper thumbnail of Generalizability Study of an Observer-Rated Measure of Self-Regulation in Children

Research paper thumbnail of The Response to Challenge Scale (RCS): The Development and Construct Validity of an Observer-Rated Measure of Children's Self-Regulation

The International journal of educational and psychological assessment, 2012

In this manuscript, I present an observer-rated measure of child self-regulation, the Response to... more In this manuscript, I present an observer-rated measure of child self-regulation, the Response to Challenge Scale (RCS). The RCS was designed to measure children's cognitive, affective, and motor regulation in response to a physical challenge course. 198 children (Kindergarten through fifth grade) were evaluated using the RCS. All children individually completed a challenge course on two separate occasions four months apart. During their completion of the tasks, research-trained observers rated the degree to which children exhibited cognitive, affective, and motor regulation. In a fully-crossed research design, five raters on Occasion 1 and six raters on Occasion 2 rated all children. I examined the RCS within the Generalizability Theory (GT) framework to analyze construct validity (PRS). Results demonstrated that raters are able to distinguish between children's self-regulation in various domains, providing some validity evidence for the RCS, and supporting the theory that ...