Classroom composition - Students with behavioural problems, across ISCED levels

2020 ◽  
Vol 112 (8) ◽  
pp. 1677-1691 ◽  
Author(s):  
J. Ashwin Rambaran ◽  
Marijtje A. J. van Duijn ◽  
Jan Kornelis Dijkstra ◽  
René Veenstra

Author(s):  
Jinsong Zhang ◽  
Wei Li ◽  
Huifeng Zhang ◽  
Amanda Wilson ◽  
Lan Shuai ◽  
...  

Abstract Background Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD. Methods A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4–5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child’s sex, conduct problems, and oppositional defiant symptoms. Results The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = − 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24–0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable. Conclusions The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.


Author(s):  
Ngoc Huong Lien Ha ◽  
Philip Yap Lin Kiat ◽  
Sean Olivia Nicholas ◽  
Ivana Chan ◽  
Shiou Liang Wee

<b><i>Introduction:</i></b> Living with dementia is challenging for persons with dementia (PWDs) and their families. Although multi-component intervention, underscored by the ethos of person-centred care, has been shown to maintain quality of life (QOL) in PWDs and caregivers, a lack of service integration can hinder effectiveness. <b><i>Methods:</i></b> CARITAS, an integrated care initiative provided through a hospital-community care partnership, endeavours to provide person-centred dementia care through ambulatory clinic consults, case management, patient and caregiver engagement, and support. We evaluated CARITAS’ clinical outcomes and cost-effectiveness with a naturalistic cross-sectional within-subject design. We assessed patients’ function, QOL, and behavioural problems post-intervention. We estimated CARITAS’ cost-effectiveness from a patient’s perspective, benchmarking it against other dementia treatments and Singapore’s Gross Domestic Product (GDP) per capita. <b><i>Results:</i></b> CARITAS care significantly improved health utility (<i>p</i> &#x3c; 0.001), reduced caregiver burden (<i>p</i> &#x3c; 0.001), and improved PWDs’ behavioural problems (<i>p</i> &#x3c; 0.001) related to “memory” (<i>p</i> &#x3c; 0.001), “disruption” (<i>p</i> = 0.017), and “depression” (<i>p</i> &#x3c; 0.001). CARITAS’ benefits (<i>d</i><sub>RMBPC</sub> = 0.357, <i>d</i><sub>EQ5D index</sub> = 0.328, <i>d</i><sub>ZBI</sub> = 0.361) were comparable to those of other pharmacological and non-pharmacological interventions for dementia. CARITAS costs SG$133,056.69 per quality-adjusted life years gain, yielding an incremental cost-effectiveness ratio of 1.31 and 1.49 against the cost of donepezil in patients with mild Alz­heimer’s disease and Singapore’s GDP per capita in 2019, respectively, falling within the cost-effectiveness threshold of 1.0–3.0. <b><i>Discussion:</i></b> CARITAS integrated dementia care is a cost-effective intervention that showed promising outcomes for PWDs and their caregivers.


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