Examining the Efficacy of a Family Peer Advocate Model for Black and Hispanic Caregivers of Children with Autism Spectrum Disorder

Autism spectrum disorder (ASD) affects individuals across all racial and ethnic groups, yet rates of diagnosis are disproportionately higher for Black and Hispanic children. Caregivers of children with ASD experience significant stressors, which have been associated with parental strain, inadequate utilization of mental health services and lower quality of life. The family peer advocate (FPA) model has been utilized across service delivery systems to provide family-to-family support, facilitate engagement, and increase access to care. This study used a randomized controlled design to examine the efficacy of FPAs in a racially and ethnically diverse sample. Results demonstrate significantly increased knowledge of ASD and reduced levels of stress for caregivers who received the FPA intervention as compared to treatment as usual.

Integrating signals from RTKs to ERK/MAPK

Signals received at the cell surface must be properly transmitted to critical targets within the cell to achieve the appropriate biological response. This process of signal transduction is often initiated by receptor tyrosine kinases (RTKs), which function as entry points for many extracellular cues and play a critical role in recruiting the intracellular signaling cascades that orchestrate a particular response. Essential for most RTK-mediated signaling is the engagement and activation of the mitogen-activated protein kinase (MAPK) cascade comprised of the Raf, MEK and extracellular signal-regulated kinase (ERK) kinases. For many years, it was thought that signaling from RTKs to ERK occurred only at the plasma membrane and was mediated by a simple, linear Ras-dependent pathway. However, the limitation of this model became apparent with the discovery that Ras and ERK can be activated at various intracellular compartments, and that RTKs can modulate Ras/ERK signaling from these sites. Moreover, ERK scaffolding proteins and signaling modulators have been identified that play critical roles in determining the strength, duration and location of RTK-mediated ERK signaling. Together, these factors contribute to the diversity of biological responses generated by RTK signaling.

Understanding urban child mental health l service use: two studies of child, family, and environmental correlates

The results of two studies identifying child, family, and environmental correlates of initial and ongoing mental health service use by urban minority children and their families are presented. In the first study, data from a sample of 405 adult caregivers of children revealed no predictive power of child demographic characteristics in relation to initial or ongoing service usage. Only parental ratings of child impulsive-hyperactive behavior were significantly related to ongoing involvement in services. In the second study, a new sample of 100 urban caregivers of children was interviewed. Parental discipline efficacy and attitudes about mental health services were found to relate significantly to initial attendance. Relative to ongoing service use, level of family stress, presence of another adult in the home, and parental discipline efficacy were significant. Implications for research and child mental health service organizations are highlighted.

Involving families in an urban HIV preventive intervention: how community collaboration addresses barriers to participation

This article addresses the increasing need within urban communities for effective, culturally relevant HIV prevention programs. The recruitment efforts of a family-based prevention program aimed at promoting health and preventing HIV risk exposure in urban, African American fourth and fifth grade children living in a community with high rates of HIV infection is detailed. The program, referred to as the CHAMP (Chicago HIV Prevention and Adolescent Mental Health Project) Family Program, is overseen by a collaborative partnership of community parents, school staff, and university-based researchers (Paikoff & McKay, 1995). The recruitment strategies developed as a result of this community-research collaboration are described. Preliminary results of the project's efforts to reach out to families within the targeted, inner-city community are presented.

Basic research and community collaboration: necessary ingredients for the development of a family-based HIV prevention program

This article describes the development of a family-based, longitudinal HIV prevention program targeting urban, African American fourth- and fifth-grade children and their families living in areas with high rates of HIV infection. The intervention is based on the research findings of the Chicago HIV Prevention and Adolescent Mental Health Family Study, a longitudinal study of 315 urban, African American families with preadolescent children (Paikoff, 1997). Results from this study informed the development of a 12-week, family-based preventive intervention-the Chicago HIV-Prevention and Adolescent Mental Health Project (CHAMP) Family Program. The development and implementation of the program also was guided by a collaborative partnership between university researchers and community members (parents and school staff). A description of the process by which collaboration influenced the development of the intervention is provided. This article is meant to serve as a model for the integration of empirical findings and community collaboration into the development of HIV prevention programs.

Adopted children's behavior problems: a review of five explanatory models

Although the majority of adopted children are well-adjusted, adopted children evidence proportionately more behavior problems when compared to nonadopted children in both clinic and nonclinic populations. An extensive literature examining behavioral, diagnostic, and demographic characteristics of adopted children has provided several plausible explanations for the high rate of behavior problems among adopted children. In this review, the existing literature is organized into five explanatory models: (a) genetic or "biosocial" factors, (b) pathogenesis of the adoption process, (c) long-term effects of impaired preadoption childrearing, (d) referral bias in adoptive parents, and (e) impaired adoptive parent-adoptee relations. We conclude that evidence for each model is mixed at best. Especially noteworthy is the mixed results for genetic or biosocial studies and the relative absence of studies focused on identifying factors associated with disruptions in the adoptive parent-adoptee relationship. We propose that a psychosocial model to explain the high rate of behavior problems among adopted children is highly plausible and further suggest that it may be time for a new awareness and appreciation for the normative aspects of adoption. An overview of parenting and family characteristics associated with risk factors for antisocial behavior is provided as a guide for future research.

An ecological model for school-based mental health services for urban low-income aggressive children

An ecological model for school-based mental health services that targets urban low-income aggressive children--a highly vulnerable and underserved population--is presented. The goals of the model are to increase children's and teachers' involvement in the delivery of services and to increase the integration of these services into existing school resources and activities. The model proposes that mental health service providers work in collaboration with teachers to deliver services that (1) can be managed by existing school resources and personnel, (2) are related to empirically based factors associated with reduced aggression and increased social functioning, and (3) are group administered to increase the number of children served and to reduce stigmatization associated with mental health services. The model is individualized and flexible by acknowledging that contexts for aggression differ across classrooms and children and by providing services specific to those contexts. Two studies are presented illustrating the application of this model to decrease aggression and increase academic engagement in low-income urban public schools.

Increasing access to child mental health services for urban children and their caregivers

This article presents the results of a study that evaluated the effects of two engagement interventions on the initial attendance and ongoing retention in child mental health services of 109 primarily children of color and their families. Both the combined intervention (telephone and first interview) and the telephone-alone intervention were associated with significant increases in attendance at initial intake appointments over the usual intake procedure, but only the combined intervention was related to the greater ongoing use of services. Implications for future research and recommendations for modifying procedures in outpatient child mental health centers are also presented.

Addressing the barriers to mental health services for inner city children and their caretakers

This paper will outline a series of three research studies meant to identify factors related to child mental health service usage and barriers to help seeking for urban minority children and their caretakers. In addition, this paper will describe the systematic development and evaluation of a telephone intervention strategy aimed towards increasing overall attendance at initial intake appointments at an urban child serving agency. The first study explores differences in demographic variables, for two groups of children (n = 450), those that came to an initial intake interview and those that requested child mental health services, but failed to come to any scheduled appointments. The second study evaluates a telephone engagement intervention meant to increase initial attendance (n = 54). Finally, the third study, more rigorously evaluates the impact of an intensive telephone intervention on initial attendance rates by randomly assigning families to the more focused telephone intervention or a "business as usual" telephone screening (n = 108).

Causal attributions for criminal offending and sexual arousal: comparison of child sex offenders with other offenders

Causal attributions for their offending, and for sexual arousal and sexual behaviour, were investigated for 50 males convicted of child sex offences. These attributions were compared with those obtained from 150 males convicted of one of three other criminal offences: rape, property offences and violent offences against persons. In semi-structured interviews, the Offence and Sexual Arousal and Behaviour Attribution Questionnaires were administered. Offenders offered causal attributions for their offending and for their sexual arousal, and they rated these causes on attribution dimensions. Results showed that child sex offenders attributed both their offending and their sexual arousal to internal, stable and uncontrollable causes. Rapists and property offenders attributed their offending behaviour to external, stable and uncontrollable causes; and violent offenders to internal, stable and uncontrollable causes. In contrast to child sex offenders, the other three groups all attributed their sexual arousal and sexual behaviour to external, unstable and controllable causes. The findings are discussed in terms of their implications for intervention programmes.

The link between domestic violence and child abuse: assessment and treatment considerations

This article discusses the existence of both spouse abuse and child abuse within families. Recent research suggests that practitioners have often missed the coexistence of these problems within their caseloads. Practice implications for both domestic violence service providers and child welfare professionals are outlined. Recommendations for changes in assessment procedures, treatment planning, and implementation are made.