Christy Mangione Walcott

The chapter “Managing Chronic Health Concerns,” in School Mental Health Services for Adolescents, reviews biopsychosocial influences on learning and behavior and presents service models targeted for youth with chronic medical conditions. Systemic issues (e.g., racial disparities, disjointed delivery of care, poor communication) are reviewed, with the conclusion that school-based services for chronically ill adolescents are essential to a high-quality continuum of care. This chapter provides strategies for identifying students and reviews common school-based support mechanisms for chronically ill youth. Three common health conditions—asthma, diabetes, and obesity—are highlighted. Finally, this chapter proposes a service delivery model that embraces a behavioral and developmental-ecological framework and focuses on school as a central context, with integration of services across home, school, and medical settings.

Sickle cell trait (SCT) places individuals at risk of passing an abnormal hemoglobin gene to biological children and is associated with rare but serious complications. The present study sought to examine knowledge of SCT and awareness of personal trait status among 258 young African American adults. Participants were surveyed regarding demographics, medical history, and sources of sickle cell information before completing a trait knowledge questionnaire. Overall, participants possessed significant misinformation about the condition. Women and those who had learned about sickle cell from families displayed higher levels of knowledge. Most participants were uncertain of personal trait status, and many did not wish to be informed of it. Health care providers should be alert that individuals with SCT may be unaware of their condition and potential reproductive and health implications. Screening and reporting procedures should be examined to ensure individuals have access to and control of this vital health information.

Methods for measuring homework performance have been limited primarily to parent reports of homework deficits. The Homework Performance Questionnaire (HPQ) was developed to assess the homework functioning of students in Grades 1 to 8 from the perspective of both teachers and parents. The purpose of this study was to examine the factorial validity of teacher and parent versions of this scale, and to evaluate gender and grade-level differences in factor scores. The HPQ was administered in 4 states from varying regions of the United States. The validation sample consisted of students (n = 511) for whom both parent and teacher ratings were obtained (52% female, mean of 9.5 years of age, 79% non-Hispanic, and 78% White). The cross-validation sample included 1,450 parent ratings and 166 teacher ratings with similar demographic characteristics. The results of confirmatory factor analyses demonstrated that the best-fitting model for teachers was a bifactor solution including a general factor and 2 orthogonal factors, referring to student self-regulation and competence. The best-fitting model for parents was also a bifactor solution, including a general factor and 3 orthogonal factors, referring to student self-regulation, student competence, and teacher support of homework. Gender differences were identified for the general and self-regulation factors of both versions. Overall, the findings provide strong support for the HPQ as a multi-informant, multidimensional measure of homework performance that has utility for the assessment of elementary and middle school students.

Background: The aims of this study were to describe guardian perceptions of the experiences of a sample of youth with sickle cell disease (SCD) in rural emergency departments (EDs) with a focus on overall patient satisfaction and characteristics of care. Procedure: Guardians of 139 children with SCD (0 to 17 y) seen at a rural pediatric SCD clinic completed a survey concerning their children’s ED experiences in the past 6 months, including information about ED wait times, quality of communications and interactions with the ED health care providers, pain management, perceptions of speed of care, and overall satisfaction. Results: About 41% of guardians reported that their child visited the ED in the past 6 months. Guardians reported moderate satisfaction with ED care. About 25% of those who visited the ED indicated that health care providers did not spend enough time with them and their children did not receive speedy care. Shorter ED wait times and higher ratings of speed of care predicted higher satisfaction. Conclusions: Families of youth with SCD are experiencing longer wait times in rural EDs which contribute to dissatisfaction with care. Efforts are needed to develop strategies to reduce ED wait times and improve speed of care which may improve outcomes following ED care.

Background: Youth with sickle cell disease (SCD) are at higher risk for grade retention than healthy peers. This is salient because research suggests grade retention is ineffective and places youth at additional risk for negative outcomes. The aims of the present study were to identify possible risk factors for grade retention in youth with SCD and to examine positive family functioning as a possible resilience factor.Procedure: Data were extracted from phase 3 of the Cooperative Study of Sickle Cell Disease, a multisite, longitudinal study of individuals with SCD. Participants were 370 youth, aged 6–16 years, with complete data on history of grade retention. Collected data included demographics, history of grade retention, disease severity factors, evidence of stroke, family functioning, and academic achievement. A logistic regression model predicting grade retention was calculated.Results: Increasing age, lower reading achievement, and lower family cohesion were predictive of higher likelihood of grade retention. Also, high family achievement‐orientation moderated the negative effects of increasing age on likelihood of grade retention, such that at increasing levels of family achievement‐orientation, the relationship between age and grade retention decreased.Conclusions: These findings suggest the need for interventions that promote connectedness and achievement‐orientation in families of youth with SCD. Research is also needed to further explore other possible risk or resilience factors for grade retention in this population, such as school absenteeism. Pediatr Blood Cancer 2014;61:1252–1256.

This is a commentary on the article by E. L. Sportsman, J. S. Carlson, and K. M. Guthrie (2010/this issue) on the application and evaluation of a specific anger management group intervention called “Seeing Red.” The author discusses issues of implementation and use, how practitioners choose and judge evidence-based interventions, and methods for documenting intervention effectiveness. This reflection on the companion article is presented to allow readers to contemplate the potential use and challenges of using the Seeing Red intervention within a school setting.