Adolescent Predictors of Emerging Adulthood Milestones in Youth with Spina Bifida*

Objective To examine the predictive utility of demographic (illness status and SES), individual (neurocognitive functioning and intrinsic motivation), and family-based (parental intrusiveness) factors during adolescence on the achievement of emerging adulthood milestones in youth with and without spina bifida (SB). Methods Questionnaire and observational data were collected from 14/15-year-old adolescents with SB, typically developing peers, mothers, and teachers. Emerging adulthood milestones (i.e., leaving home, attending college, employment, romantic relationship experience, and number of friendships) were assessed at ages 18/19 years in the full sample and subset of youth who graduated from high school. Results Typically, developing youth were more likely to achieve milestones compared to youth with SB in the full sample but not when only high school graduates were compared. Executive function, SES, intrinsic motivation, and parental intrusiveness emerged as significant predictors for particular milestones. Conclusions Interventions targeting executive function, intrinsic motivation, and parenting behavior may facilitate achievement of emerging adulthood milestones

Direct Observation of Mother–Child Communication in Pediatric Cancer: Assessment of Verbal and Non-verbal Behavior and Emotion

Objective To examine the acceptability and feasibility of coding observed verbal and nonverbal behavioral and emotional components of mother–child communication among families of children with cancer. Methods Mother–child dyads (N = 33, children ages 5–17 years) were asked to engage in a videotaped 15-min conversation about the child’s cancer. Coding was done using the Iowa Family Interaction Rating Scale (IFIRS). Results Acceptability and feasibility of direct observation in this population were partially supported: 58% consented and 81% of those (47% of all eligible dyads) completed the task; trained raters achieved 78% agreement in ratings across codes. The construct validity of the IFIRS was demonstrated by expected associations within and between positive and negative behavioral/emotional code ratings and between mothers’ and children’s corresponding code ratings. Conclusions Direct observation of mother–child communication about childhood cancer has the potential to be an acceptable and feasible method of assessing verbal and nonverbal behavior and emotion in this population

Evidence-based Assessment of Adherence to Medical Treatments in Pediatric Psychology

Objectives Adherence to medical regimens for children and adolescents with chronic conditions is generally below 50% and is considered the single, greatest cause of treatment failure. As the prevalence of chronic illnesses in pediatric populations increases and awareness of the negative consequences of poor adherence become clearer, the need for reliable and valid measures of adherence has grown. Methods This review evaluated empirical evidence for 18 measures utilizing three assessment methods: (a) self-report or structured interviews, (b) daily diary methods, and (c) electronic monitors. Results Ten measures met the “well-established” evidence-based (EBA) criteria. Conclusions Several recommendations for improving adherence assessment were made. In particular, consideration should be given to the use of innovative technologies that provide a window into the “real time” behaviors of patients and families. Providing written treatment plans, identifying barriers to good adherence, and examining racial and ethnic differences in attitudes, beliefs and behaviors affecting adherence were strongly recommended