Objective: To present a synthesis of program improvement evaluations of two approaches to bereavement support for families: (a) weekend family camps providing developmentally targeted grief education and social support for children and parents, and (b) a wait-list control randomized trial of a parent bereavement group intervention. Method: Families eligible for camp experienced a child's death (from any cause) and have surviving children at home. No-cost twice-yearly weekend camps include support sessions and family activities like fishing. After each retreat, parents and children complete an anonymous evaluation. We analyzed forms from 2009-2014 using the constant comparative method to devise a code structure and identify themes to understand camp impact. The second intervention, the bereavement group, included English and Spanish speaking parents of children who died from cancer. They were initially randomized to intervention and wait-list control groups. Intervention included six-weekly sessions of a bereavement program. Participants were invited to a postintervention focus group to better understand reasons for participation, the value of the group, and their support needs. Results: Qualitative findings from both groups strongly indicate that bereaved parents have specific ongoing needs that can be addressed through family-or parent-focused interventions. Families identified benefits including being able to openly express feelings with peers who truly understand, gaining an understanding of individual and developmental differences in the grief Julie N.

Objective: To demonstrate the clinical feasibility and utility of referring young children (ages 2 to 5 years old) presenting to an interdisciplinary pediatric sleep clinic for objective sleep assessment using actigraphy. Method: A retrospective chart review was conducted to identify young children referred for actigraphy from the sleep clinic. Each referred child wore an actigraph for approximately 1 week; caregivers completed daily sleep diaries to report on children's estimated bedtime and wake time. Treatment recommendations provided after actigraphy and treatment responses were abstracted via chart review. Results: Of the 88 young children presenting to the sleep clinic during the study period, 11 were referred for and completed actigraphy monitoring. All referred children, including those with neurodevelopmental disabilities, tolerated wearing the actigraph on their wrist. All children were shown to have sleep disturbances via actigraphy results. The most common disturbances were the frequency and duration of night wakings, which reduced total sleep time compared to published norms from a healthy, same-aged sample. All children received behavioral treatment recommendations and the majority were prescribed medication for sleep concerns. The majority of children were considered treatment responders (73%). Conclusions: Actigraphy may be a feasible and informative assessment tool for clinicians to integrate into regular practice with young children to obtain objective sleep data that may not have otherwise been available. Clinical recommendations and practical concerns (e.g., billing) of using actigraphy in an interdisciplinary pediatric setting are discussed. Implications for Impact StatementPediatric psychologists may implement objective sleep assessments using actigraphy with young children during clinical practice and use the data generated to communicate details about problematic sleep patterns to caregivers, which may inform intervention recommendations.

Chronic tic disorders (CTDs), including Tourette's disorder and persistent motor or vocal tic disorder, are neurobiological conditions affecting an estimated 3 to 4 percent of children and adolescents. These disorders include the presence of motor and/or phonic tics, which can range in number, frequency, and severity. Although CTDs are typically treated through medications, the available medications have the potential of adverse side effects, do not result in long-term coping strategies, and may not be effective or preferable for all individuals. Habit reversal training (HRT), a behavioral intervention for tics, has been identified as a well-established treatment. The purpose of habit reversal is to build an individual's awareness of his or her tics and disrupt tics through developing a competing behavioral response. One avenue or service delivery that has not yet been explored for individuals with CTDs is use of a parent-mediated approach to habit reversal. Parent-mediated interventions have been used successfully with children with challenging behavior and autism. They are based on a triadic model, in which a therapist works directly with a parent to teach the therapeutic techniques. Parents, in turn, work directly with their children while receiving feedback from the therapist. The current study investigated a parent-mediated habit reversal intervention for the treatment of chronic tic disorders in two children. A delayed multiple baseline design was used. Baseline data were collected for three sessions. Intervention was delivered over six sessions, during which time coaching was faded. Follow up data collection occurred one month after the end of treatment. Based on changes in parental fidelity of implementation from baseline to intervention, this study provides preliminary evidence for parents being trained as therapists and providing habit reversal training strategies to their children. This treatment was reported as vi acceptable by both parent participants and by one of the child participants. Treatment motivation remained high and stable throughout baseline, intervention, and follow up. Child motivation was more variable during baseline, intervention, and follow up. Tic severity was also variable and more research would be needed to determine the impact of treatment for tics. Limitations and implications for future research are provided. vii