Background: Children and adolescents with callous unemotional (CU) traits are at risk

The WISC-R profiles of 456 Grade 3 students with full scale IQs of 120 and above were analyzed. Large subtest scatter, verbal-performance discrepancy, and idiographic variability appear to be normal for the test profiles of bright students. They excelled in complex reasoning but were often not different from average students in their attention span, memory, sequential reasoning, visualspatial perception, or visual-motor coordination. Differences were identified in subgroups according to verbal or nonverbal strengths and gender. Boys showed strengths for simultaneous and visual-spatial reasoning, and girls showed strengths for sequential and social reasoning. Academic achievement varied as a function of full scale IQ and verbal or nonverbal strengths. Implications for educational programming are discussed.The WISC-R is one of the most widely used tests for identifying gifted children. However, there is a limited body of literature regarding its use for assessing children of high intellectual ability, particularlv normal functioning bright children. Many of the studies were based on small samples (Brown & Yal~imo~vski, & Saphire, 1990). Moreover. different criteria were used in defining giftedness, ranging from verbal (VIQ), performance (PIQ), or full scale IQ (FIQ) above 119 to FIQ of 130. Small sample sizes and inconsistent definitions of giftedness limit the comparability and generalizahility of their findings.The scarcity of research data provides scanty empirical support for the interpretation of WISC R profiles. There is considerable controversy in the literature regarding the cognitive profile characteristics of bright children. Several studies found significant variability within their WISC-R profiles, but the interpretations differed. Mueller. Dash. Matheson. and Short (1984) suggested thai WISGR pmfile patterns differ as a function of FIQ in normal (non LD) subjecis. They examined profile configurations of different ability groups constructed from a metaanalysis of published data and found that there was greater variation in the hrofile of the &dquo;above average group than that of the &dquo;average group. Comparisons within the above average group revealed that thev performed better on verbal subtests and less well on performance subtests. Arithmetic and coding were the lowest ranking subtests. Intergroup comparisons indicated that after adjusting for the difference in overall profile elevation, above average children were superior to average children on verbal subtests. Kaufman (1979) suggested that the reason bright children perform better on verbal subtests is that it is more difficult to obtain extremely high scores on performance subtests which involve bonus speed points at the upper end of the score range.Hollinger and Kosek (1986) also discovered considerable variability within the profiles of children with FIQ of 130 and above. Using Kaufman's (1979) method of determining intrascale differences, they found that 84.6% of their sample demonstrated significant idiographic strength(s) or weakness...

BackgroundChildren undergoing surgery and their parents are at risk of developing post-traumatic stress reactions. We systematically reviewed the literature to understand the prevalence of this issue, as well as potential risk factors.MethodsWe conducted a systematic review and meta-analysis, using PubMed, PsycInfo, Web of Science and Google Scholar, with searches conducted in February 2021. Papers were included if they measured post-traumatic stress in children and/or parents following paediatric surgery and were excluded if they did not use a validated measure of post-traumatic stress. Data were extracted from published reports.FindingsOur search yielded a total of 1672 papers, of which 16 met our inclusion criteria. In meta-analysis, pooled studies of children estimated an overall prevalence of 16% meeting criteria for post-traumatic stress disorder post surgery (N=187, 95% CI 5% to 31%, I2=80%). After pooling studies of parents, overall prevalence was estimated at 23% (N=1444, 95% CI 16% to 31%, I2=91%). Prevalence rates were higher than those reported in the general population. Risk factors reported within studies included length of stay, level of social support and parental mental health.InterpretationThere is consistent evidence of traumatic stress following surgery in childhood which warrants further investigation. Those delivering surgical care to children would benefit from a raised awareness of the potential for post-traumatic stress in their patients and their families, including offering screening and support.

Complex post-traumatic stress disorder (CPTSD) is a new diagnosis which has been developed for the forthcoming International Classification of Diseases 11th Revision criteria. This is in recognition of the impact of repeated, interpersonal trauma and an emerging evidence base supporting a distinction between PTSD and CPTSD, with its disturbances in self-organization in addition to the core features of reexperiencing, avoidance, and hypervigilance. The new diagnosis is discussed in the context of assessing children who have experienced maltreatment, many of whom will have affect dysregulation, interpersonal difficulties, and negative thoughts about themselves. However, not all maltreated children will have the core features of PTSD, and they may be affected in various other ways, which are discussed in the experience of a specialist clinic taking referrals for children who have been abused or neglected. The assessments recognize that maltreated children are typically exposed to multiple genetic and environmental risk factors. Traumatic symptoms are seen an adaptation to chronic threat, and close attention is also paid to systemic factors such as family relationships. Young children with PTSD will require developmentally sensitive assessment. Maltreated children are at high risk of mental health and neurodevelopmental problems but may present with symptoms in various domains which cumulatively are very impairing without always meeting diagnostic thresholds. Children may frequently be referred with possible autistic traits or symptoms of attention-deficit hyperactivity disorder, which need to be assessed in the light of their traumatic backgrounds. Assessing the role attachment in the development of children who have been abused or neglected is also considered.

There may be some similarities in the presentation of children who have autism spectrum disorder (ASD) and those exposed to maltreatment affecting assessment and diagnosis. Overlapping characteristics include difficulties understanding and maintaining relationships, sensitivity to routine and hyper-reactivity to sensory inputs. Children who have been maltreated are at increased risk of various developmental vulnerabilities with both environmental and genetic factors being relevant. The existing epidemiological evidence has found that looked-after children are more likely to screen positively for neurodevelopmental disorders and there are smaller scale studies in adoptive children finding higher rates of ASD than would be expected in the general population. Other research suggests a predominantly genetic basis for this increased risk in keeping with what is generally understood about the aetiology of autism. Children exposed to profound deprivation in Romanian orphanages were found to be at higher risk of a pattern of traits termed ‘quasi autistic’ which tended to reduce following adoption, but these findings have not been replicated in children experiencing maltreatment in birth families. Reactive attachment disorder (RAD) has some overlapping criteria with ASD, but its prevalence is unknown and children with RAD should be more socially reciprocal and not have the same repetitive and restricted behaviours and interests. We recommend experienced multidisciplinary assessment that considers both the possibility of maltreatment in children with ASD and neurodevelopmental vulnerabilities in children who have been maltreated and advise on assessment and management strategies.