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J Can Acad Child Adolesc Psychiatry. 2006 May; 15(2): 92–93.
PMCID: PMC2277293

Awarded at the Joint Annual Meeting of CACAP and AACAP, Toronto, Ontario: October 18–23, 2005

J Can Acad Child Adolesc Psychiatry. 2006 May; 15(2): 92–93.

Improving the Assessment of Adolescent Anorexia Nervosa

Objective: Given that adolescents with Anorexia Nervosa (AN) typically have lower scores on the Eating Disorder Examination (EDE) than expected, this study examined whether the inclusion of eight supplementary items developed by the authors of the EDE better captured the symptoms of adolescent AN. Methods: A dataset consisting of EDEs from 86 adolescents was examined by three primary methods: 1) baseline subscale scores were compared before and after the addition of the supplementary items; 2) the internal consistency of the EDE with the addition of these items was examined; and 3) each of these items was compared before and after treatment. Results: After the addition of the supplementary items, the eating concern, and weight concerns subscales were significantly increased, while the restraint subscale was significantly decreased, and the shape concern subscale was unchanged. Internal consistency was improved on the eating concern, weight concern, and shape concern subscales, and was decreased on the restraint subscale. Three of eight items showed a significant decrease with treatment. Conclusion: Although the addition of some of these eight supplementary items better captured the psychopathology of adolescent AN, scores were still substantially below expected, indicating that the exploration of other methods of assessment is needed.

J Can Acad Child Adolesc Psychiatry. 2006 May; 15(2): 92–93.

Social Skills Groups For Verbal Adolescents With Autism Spectrum Disorders

Objective: The effectiveness of a social skills training group for adolescents with Asperger Syndrome and high-functioning autism (AS/HFA) was evaluated. Methods: Parents of six groups of adolescents (N=46, 61%) male, mean age 14.6) completed three questionnaires immediately before and after the 12-week group: The Social Responsiveness Scale (SRS), the Aberrant Behavior Checklist (ABC), and the Nisonger Child Behavior Rating Form (N-CBRF). Parents and adolescents were surveyed regarding their experience with the group. Results: Complete data was available for 29 adolescents. Mean age and baseline scores did not differ between adolescents with complete or incomplete data. On Wilcoxon tests, significant gains were found on total scores of the SRS (mean change −12.4, SD 27.7, p=.002), the ABC (mean change −13.6, SD 22.5, p=.002), and the N-CBRF (Positive Social: mean change +2.2, SD 4.5, p=.023; Problem Behavior: mean change −12.8, SD 25.2, p=.006), suggesting that the social skills group yielded effects not only for social competence but also for problem behaviors associated with AS/HFA. Effect sizes ranged from .43 to .69. Adolescents reported more perceived skill improvement than did parents. Conclusion: Parent-reported improvements suggests that social skills learned in group sessions generalize to settings outside the treatment group. Larger, controlled studies of social skills training groups would be valuable.

J Can Acad Child Adolesc Psychiatry. 2006 May; 15(2): 92–93.

The Challenge of Assessing Attachment in Children From Developing Countries

Objective: Concordance between attachment categories in mothers and their infants in the Western world is 85%. This is remarkable since attachment classifications in children are based on mother-child interactions while adults are evaluated by a semi-structured interview. Based on experiences with recent immigrants, the present study examines the relevance non-Western cultural traditions have on attachment patterns. Methods: 46 children aged 18–40 months and their Northern Sotho speaking mothers in a township of Johannesburg had 4 home visits by local research assistants. Mothers were assessed using a semi-structured demographic interview and the SCL-90-R. Visit 3 consisted of a two-hour observation of mother-child interaction, analyzed using the Attachment-Q-Sort (AQS) criteria of Waters (1995). During visit 4, mothers were given the Working Model of the Child Interview (WMCI) (Zeanah & Benoit, 1995). Results: Agreement between home observations and WMCI ratings was 29% on secure and 65% insecure attachment when US developed scoring criteria of the WMCI were used. Agreement increased to 81% for secure and 79% for insecure attachment when the WMCI protocols were re-scored, using a modified scoring system developed by local cultural experts. Conclusion: Interview based representations of attachment patterns are more profoundly influenced by cultural traditions than are actual parent-child interactions.

J Can Acad Child Adolesc Psychiatry. 2006 May; 15(2): 92–93.

Structural Language Impairment As Predictor Outcome in Pervasive Developmental Disorder

Objective: There has been much debate as to the relationship between Asperger Syndrome and high-functioning autism. The objective of this study was to see whether a more powerful predictor of outcome could be based on the presence or absence of structural language impairment (SLI) rather than DSM-IV criteria. Methods: At inception, 68 PDD children between the ages of four and six were identified. Children with a diagnosis of either autism (N=47) or Asperger Syndrome (N=21) were included in the final cohort. During the inception, children were also given tests of language abilities to determine SLI. The children were seen approximately four, six, and eight years respectively after the date of inception and assessed for measures of adaptive behavior functioning and autism symptoms. Separate regression analyses were run for each method of classifying the children. Results: In general, the presence or absence of specific language impairment at age six-eight years-old emerged as the most robust predictor of variance on all outcome measures. Conclusions: Differentiating ASD children on the basis of structural language impairment was a more robust predictor of functional and symptom outcomes than the DSM-IV criteria and may be a better diagnostic feature of Asperger Syndrome than any other clinical characteristics.


Articles from Journal of the Canadian Academy of Child and Adolescent Psychiatry are provided here courtesy of Canadian Academy of Child and Adolescent Psychiatry