C M C m S RESEARCH DIGESJ ' Morch 2008/4
Classroom Observations
Are Important When
Making an ADHD Diagnosis
Kofler, M. J., Rapport, M. D., [Dept. of Psychology, Univ.
of Central Florida, 4000 Central Florida Blvd., Orlando,
FL 38217; mrapport@mail.ucf.edu] & Alderson, R. M.
(2008). Quantifying ADHD classroom inatrentiveness,
its moderators, and variability: A meta-analytic review.
Journal of Child Psychology and Psychiatry, 49, 59-69.
Treatment for Female
Victims of Human Trafficking
Gajic-Veljonoski, O. [University Health Network,
Women's Health Program, 200 Elizabeth St., EN7-228A,
Toronto, O N M5G 2C4, Canada; ogve!jan@uhnres
.utornonto.ca] & Stewart, D. E. (2007). Women trafficked
into prostitution: Determinants, human rights, and health
needs. Transcullural Psychiatry, 44, 338-358.
O b t a i n i n g direct classroom observations when conducting eval-
uations of children referred for attention-deficit/hyperactivity
disorder (ADHD) is invaluable. In fact, to make an ADHD
diagnosis using criteria of the International Statistical Clas-
sification of Diseases and Related Health Problems-lOth Revision, one
is required to observe on-task behavior directly. Although several stan-
dardized observation coding schemes are available, little is known about
how factors (e.g., sample and situational variables, diagnostic practices,
and observational methods) influence whether a child is determined to be
engaging in on-task behavior. These authors conducted a meta-analysis
of 23 classroom observation studies to determine the magnitude of these
factors on deficiencies in classroom attention of children with and with-
out ADHD. Results revealed that children with ADHD were significantly
deficient in their ability to maintain visual attention in the classroom
setting compared with their peers. In addition, several variables affected
differences in visual attention that clinicians should take into account
when completing standardized observations.
How This Helps Practitioners: Variables that can affect interpreta-
tions of children's attentional abilities in the classroom include age and
sex of the child, classroom type (i.e., simulated or regular), diagnostic
method (e.g., multiple informants, rating scales and who completed
them, semistructured interview), observational interval and method (i.e.,
alternating or continuous), number of codes, and days of observation.
When conducting child evaluations of all kinds (e.g., behavior, learning,
ADHD), it would be easy to rely on well-established standardized assess-
ment tools, without taking into account the context in which information
was obtained. This meta-analysis highlights the importance of incorpo-
rating contextual variables when interpreting information about chil-
dren's classroom behavior. Those unfamiliar with existing standardized
observation coding schemes are directed to the article by Volpe, DiPerna,
Hintze, and Shapiro (2005) in School Psychology Review.
T h e U.S. government estimates that approximately 600,000-
800,000 individuals are trafficked annually worldwide, with
3% being trafficked into the United States. Approximately 80%
of individuals trafficked are girls and women used for sexual
exploitation. Victims of sex trafficking often present with a complicated
host of symptoms including self-harm, suicide attempts, somatic stress-
related symptoms, chronic depression, impulsivity, dissociative disorders,
difficulty forming relationships, anxiety, posttraumatic stress disorder,
guilt, self-blame, low self-esteem, hopelessness and helplessness, and
sexual aversion. In 2004, Zimmerman and Watts writing in The Lancet
provided interview and initial assessment guidelines for professionals
conducting a first session with victims of sex trafficking; the guidelines
cover most psychological, physical, and behavioral symptoms victims
have been found to exhibit. In addition, the U.S. Department of Health
and Human Services has an online toolkit for health and mental health
providers of educational, legal, and health information and services for
sex trafficking victims (www.acf.hhs.gov/trafficking/). This recent review
by Gajic-Veljanoski and Stewart identified cultural and psychosocial
determinants of women involved in sex trafficking, internal and external
barriers to escaping from sex trafficking, physical and mental health
outcomes, and types of protection and assistance available for victims.
Although sex trafficking victims have limited access to health care, 28%
after rescue report having visited a health provider for services during
their captivity (most were chaperoned), highlighting the importance of
health providers knowing the indicators of victims of sex trafficking.
How This Helps Practitioners: Human trafficking occurs yearly in the
United States; California, Texas, Florida, New York, and Washington, DC,
have reported regular occurrences of sex trafficking. The information noted
provides health professionals with online information, interview guide-
lines, and general background information on victims of sex trafficking.