Bad Boys and Mean Girls: Callous-Unemotional Traits, Management of Disruptive Behavior in School, the Teacher-Student Relationship and Academic Motivation

Callous-unemotional (CU) traits comprise a temperament dimension characterized by low empathy, interpersonal callousness, restricted affect and a lack of concern for performance. CU traits are the hallmark feature of psychopathy in youth and are associated with more varied, severe and stable antisocial behavior. However, little is known about the presentation, impact and correlates of CU traits in schools. We conducted a mixed methods study investigating the relationships between CU traits, student disruptive behavior, responses to classroom management strategies, teacher-student relationship quality and academic motivation. Participants comprised 437 children aged 11–14 years (M = 12.5 years, 51% female) and 12 teachers recruited from a state school in England. Teacher participants consisted of 8 women and 4 men aged 23–51 (M = 35.27 years, SD = 10.43). Children completed the Inventory of Callous-Unemotional Traits (ICU; Frick, 2004). Teachers then completed an interview and questionnaires for a randomly selected subsample of students who (i) scored in the top 25% on student report of CU traits (n = 24), and (ii) scored below the median (n = 23). Thematic analysis of teacher interviews revealed that high CU children display more frequent, severe antisocial behavior in school. Teachers reported that high CU students were resistant to teacher discipline strategies, often showing intense displays of anger in response to their attempts to set limits. High CU students appeared to be less responsive to social rewards (e.g., praise). Encouragingly, some teachers reported a good relationship with a child identified as high in CU traits, despite recognizing that this student's behavior made it difficult for other teachers to maintain a harmonious classroom environment. Teachers attributed the poor academic performance of children high in CU traits to a lack of motivation, reporting the need for intense monitoring and feedback to ensure that these students completed schoolwork. Findings suggest that risk pathways for poor school outcomes may differ for antisocial children high and low in CU traits, and emphasize the need to modify existing school-based interventions to promote academic engagement and prosocial behavior in this high-risk subgroup of antisocial children

Clinicans' views and experiences of two alternative consent pathways for participation in a preterm intrapartum trial: a qualitative study

BackgroundThe Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. Preterm birth can be rapid and unexpected, allowing little time for the usual consent process. Therefore, in addition to the usual procedure for written consent, a two-stage pathway for consent for use when birth was imminent was developed. The aims of this study were to explore clinicians’ views and experiences of offering two consent pathways for recruitment to a randomised trial of timing of cord clamping at very preterm birth.MethodsThis was a qualitative study using semi-structured interviews. Clinicians from eight hospitals in the UK who had been involved in offering consent to the Cord Pilot Trial were invited to take part in an interview. Clinicians were interviewed in person or by telephone. Interviews were analysed using inductive systematic thematic analysis.ResultsSeventeen clinicians who had either offered usual written consent only (n = 6) or both the two-stage pathway (with oral assent before the birth and written consent after the birth) and usual written consent (n = 11) were interviewed. Six themes were identified: (1) team approach to offering participation; (2) consent form as a record; (3) consent and participation as a continual process; (4) different consent pathways for different trials; (5) balance between time, information, and understanding; and (6) validity of consent. Overall, clinicians were supportive of the two-stage consent pathway. Some clinicians felt that in time-critical situations oral assent presented an advantage over the usual written consent as they provided information on a “need to know” basis. However, there was some concern about how much information should be given for oral assent, and how this is understood by women when birth is imminent.ConclusionsThe two-stage pathway for consent developed for use in the Cord Pilot Trial when birth was imminent was acceptable to clinicians for comparable low-risk studies, although some concerns were raised about the practicalities of obtaining oral assent

Women's views and experiences of two alternative consent pathways for participation in a preterm intrapartum trial: a qualitative study

BACKGROUND: The Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. In addition to standard written consent, an oral assent pathway was developed for use when birth was imminent. The aim of this study was to explore women's views and experiences of two alternative consent pathways to participate in the Cord Pilot Trial. METHODS: We conducted a qualitative study using semi-structured interviews. A total of 179 participants in the Cord Pilot Trial were sent a postal invitation to take part in interviews. Women who agreed were interviewed in person or by telephone to explore their experiences of two consent pathways for a preterm intrapartum trial. Data were analysed using inductive systematic thematic analysis. RESULTS: Twenty-three women who gave either written consent (n = 18) or oral assent followed by written consent (n = 5) to participate in the trial were interviewed. Five themes were identified: (1) understanding of the implications of randomisation, (2) importance of staff offering participation, (3) information about the trial and time to consider participation, (4) trial secondary in women's minds and (5) reasons for agreeing to take part in the trial. Experiences were similar for the two consent pathways. Women recruited by the oral assent pathway reported being given less information about the trial but felt it was sufficient to make a decision regarding participation. There were gaps in women's understanding of the trial and intervention, regardless of the consent pathway. CONCLUSIONS: Overall, women were positive about their experiences of being invited to participate in the trial. The oral assent pathway seems an acceptable option for women if the intervention is low-risk and time is limited. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN21456601 . Registered on 28 February 2013