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ADHD is a common neurodevelopmental disorder with a pediatric prevalence of 5.2%.While medication treatment for ADHD is effective, it does not address all symptoms and a small but notable subgroup does not respond to medications. Adverse effects limit its use and some parents and participants resist use of medication. Thus, limitations of medication treatment for ADHD motivate searching for other therapeutic options. Transcranial Direct Current Stimulation (tDCS) has been suggested as a treatment for children with ADHD, with mixed results to date. Protocol variables employed, including combined use of cognitive training (CT) and scheduling of sessions, may explain diverse findings to date. The aim of this study was to examine safety, feasibility and efficacy of tDCS combined with CT provided three-times-per week for one-month to treat children with ADHD.In a double blind, randomized, sham-controlled pilot study, 25 children with ADHD were randomized to receive 12 sessions of either anodal tDCS or sham-tDCS for 20 min combined with CT three-times-per-week for four weeks. The tDCS anode was over left dorsolateral prefrontal cortex (DLPFC) and cathode over vertex. Assessments were obtained prior to, after 6 sessions, 12 sessions and one-month after intervention.No significant post-intervention differences were found between those receiving tDCS or sham-tDCS. Both groups demonstrated significant improvement on questionnaire measures of ADHD and executive function with mixed results seen on computerized performance measures. Overall, adverse effects were mild with no significant difference between groups. However, three children, all from the tDCS group, experienced headaches with two requiring temporary cessation and one requiring removal from the study.Anodal tDCS to the DLPFC using the above protocol in children with ADHD did not demonstrate additional treatment benefits beyond that of CT.

Peer reviewed: True, Funder: Jacobs Foundation; FundRef: https://doi.org/10.13039/501100003986, Funder: Nuffield Foundation; FundRef: https://doi.org/10.13039/501100000279, Statements by alleged victims are important when child abuse is prosecuted; triers-of-fact often attend to nonverbal emotional expressions when evaluating those statements. This study examined the associations among interviewer supportiveness, children's nonverbal emotions, and informativeness during 100 forensic interviews with alleged victims of child abuse. Raters coded the silent videotapes for children's nonverbal emotional expressions while other raters coded the transcripts for interviewer support, children's verbal emotions, and informativeness. Results showed that children's nonverbal signals were more common than and preceded the verbal signs. Interviewer support was associated with children's expressivity. When children expressed more nonverbal emotions, they were more responsive during the pre-substantive phases and more informative about the abuse. Nonverbal emotions partially mediated the association between support and informativeness. The findings underline the value of nonverbal emotional expression during forensic interviews and demonstrate how the interviewers' supportive demeanor can facilitate children's emotional displays and increase informativeness.

BACKGROUND: Emotions can powerfully affect memory retrieval although this effect has seldom been studied in everyday contexts. OBJECTIVE: This study aimed to explore the association between children's verbal emotional expressions and the type of information reported during forensic interviews. PARTICIPANTS AND SETTING: The sample included 198 interviews with 4- to 14-year-old (M = 9.36, SD = 2.37) alleged victims of repeated physical abuse perpetrated by family members conducted using the Revised NICHD Protocol which emphasizes a supportive interviewing style. METHODS: Interview videos were transcribed and each conversational turn was coded to reflect the amount and type of children's verbal emotional expressions, forensic information provided, interviewers' demeanor, and type of question asked. RESULTS: The verbal expression of negative emotions was positively associated with the production of more central details (β = 0.29, SE = 0.05, p < 0.001) and peripheral details (β = 0.66, SE = 0.07, p < 0.001), while the verbal expression of positive emotions was correlated with peripheral details (β = 0.29, SE = 0.15, p = 0.047). The verbal expression of negative emotions was associated with the production of more specific details (β = 0.73, SE = 0.06, p < 0.001]) and less generic information (β = -0.39, SE = 0.18, p = 0.029) whereas positive emotions were associated only with increased specific information (β = 0.28, SE = 0.12, p = 0.025). CONCLUSIONS: These findings highlight how emotional expression, especially of negative emotions, enhances the quantity and quality of children's reports in forensic contexts.

Because intensely reluctant children often fail to report being abused even when they are supportively interviewed, the Revised NICHD (National Institute of Child Health and Human Development) Protocol (RP) guides interviewers to delay discussion of sensitive topics and build rapport before scheduling a follow-up interview in which children might feel more comfortable. We sought to determine whether adherence to these recommendations was associated with the children’s propensity to make allegations. Repeated forensic interviews were conducted with 202 Israeli children aged 3-14 who did not make allegations in the first interview, but of whom 104 made allegations during the second interview. The interviews were coded to identify interviewers’ provision of support and types of substantive questions (invitations vs. closed-ended), as well as children’s signs of reluctance, responsiveness, and informativeness. Interviewer behavior was represented with a latent variable reflecting the interviewers’ expression of support, use of invitations, and the avoidance of closed-ended questions. Structural Equation Modeling (SEM) showed that adherence to the suggested interviewing model was positively associated with children being more likely to allege abuse (total effect: β = .29). This association was mediated by children’s enhanced cooperativeness in the second interview (indirect effect: β = .16). These findings suggest that repeated interviews can be useful despite the additional financial costs.

Supportive forensic interviews conducted in accordance with the National Institute of Child Health and Human Development Revised Protocol (RP) help many alleged victims describe abusive experiences. When children remain reluctant to make allegations, the RP guides interviewers to (a) focus on rapport building and nonsuggestive support in a first interview, and (b) plan a second interview to allow continued rapport building before exploring for possible abuse. We explored the dynamics of such two-session RP interviews. Of 204 children who remained reluctant in an initial interview, we focused on 104 who made allegations when re-interviewed a few days later. A structural equation model revealed that interviewer support during the first session predicted children's cooperation during the rapport-building phase of the second session, which, in turn, predicted more spontaneous allegations, which were associated with the interviewers’ enhanced use of open-ended questions. Together, these factors mediated the effects of support on children's free recall of forensically important information. This highlighted the importance of emphasizing rapport with reluctant children, confirming that some children may need more time to build rapport even with supportive interviewers.

Background Child Maltreatment (CM) is a worldwide phenomenon. Literature suggests that children with disabilities are at increased risk for CM. However, limited information exists regarding if such increased risk is noted in community primary care clinics. Aim To report on the incidence of CM in children with and without disabilities attending community primary care clinics. Method This was a cohort study of children belonging to a Health Maintenance Organization (HMO) in Israel. The study group consisted of children with disabilities and the control group consisted of children without disabilities. Formal reports to child protection services, medical and sociodemographic data were extracted from designated documentation and medical records. Results The odds to be identified as suspected CM, after adjusting for sociodemographic variables, was 6.2 times higher among children with disabilities compared to children without disabilities and 5.0 times higher among children with severe vs. mild disability. Conclusions Developmental disability is a risk factor for CM, and is noted even more seriously in community primary care clinics. CM positively correlated with the severity of disability. The presented data marks higher figures than previously reported, enhancing understanding of the scope of the problem and its relation to the type of organization being examined.

Summary: Although many children are reluctant to disclose abuse due to embarrassment, fear, and the anticipation of negative consequences, researchers have only recently begun to examine whether forensic interviewers can be trained to manage children's reluctance. In this study, the supportiveness of 53 experienced interviewers was assessed in their interviews with 321 3- to 14-year-old alleged victims, each conducted during the course of training to use the Revised Protocol (RP). The use of support increased, especially between levels evident at baseline and in the last two interviews assessed. Over time, instances of inadequate support and insensitivity to children's reluctance became less common. Younger children received proportionally more support, including inadequate support, than older children. The RP training did not affect the extensive use of free recall-based questions. Findings highlight the benefits of continued supervision and training.Copyright © 2017 John Wiley & Sons, Ltd.

Children’s testimony is often critical to the initiation of legal proceedings in abuse cases. In forensic interviews, the expression of emotions can powerfully enhance both the quality of children’s statements and perceptions that their statements are coherent and credible. However, children rarely express their emotions when reporting abusive events. The Revised The National Institute of Child Health and Human Development (NICHD) Protocol (RP) was designed to emphasize socioemotional communication during forensic interviews and thus should be associated with more extensive and diverse expressions of emotions by alleged victims of abuse. The present study focused on forensic interviews (178 using the Revised and 100 using the Standard NICHD Protocol) with victims of physical child abuse whose allegations were corroborated using independent evidence. Detailed content coding showed that the RP was associated with the expression of more different emotions, more expression of abuse-related emotions, and more expression of emotions related to the interview context. Emotional expressiveness was associated with increased informativeness, and the association between the type of protocol and informativeness was fully mediated by emotional expressiveness. These results suggest that the Revised Protocol facilitates the expression of emotions by alleged victims of abuse in a way that enhances the value of children’s testimony in multiple ways.

Child maltreatment victims are often reluctant to report abuse when formally interviewed. Evidence-based guidelines like the National Institute of Child Health and Human Development (NICHD) Standard Investigative Interview Protocol do not adequately address such reluctance because they are focused on cognitive rather than socio-emotional strategies. The present study was designed to determine whether the Revised NICHD Protocol, which emphasizes supportive interviewing more than the Standard Protocol does, might predict increases in the overall informativeness and reductions in the reluctance of alleged victims. A total of 254 interviews, 166 using the Revised Protocol and 88 using the Standard Protocol, were conducted with 4.06- to 13.98-year-old children (M = 9.20, SD = 2.49) who disclosed multiple incidents of physical abuse by their parents and were thus expected to be more reluctant than victims of extrafamilial abuse. We coded indices of interviewer support and question types, children’s reluctance, and informativeness in each utterance during the substantive phases of the interviews. The Revised Protocol was associated with better interviewer support and questioning as well as reduced reluctance and increased informativeness on the part of the children. These findings document the value of training interviewers to attend to the socio-emotional needs of suspected abuse victims during investigative interviews., Nuffield and Jacobs Foundations, Haruv Institute

Socio-emotional dynamics were examined in 230 forensic interviews of 3- to -13-year-old Israeli children who disclosed chronic physical abuse that could be substantiated. Half of the children were ...

We aimed to examine family quality of life (FQOL) of Northern Israeli families having a child with a severe neurodevelopmental disability and its relation to socio-demographics. The cohort included caregivers of 70 children ages (mean ± standard deviation) 5.36 ± 3.53 years. Families were two-parent (85.7%), lived in the periphery (67.1%) and included Jews (60%), Muslims (18.6%), Druze (14.3%) and Christians (7.1%). Religiosity included: secular (38.6%), traditional (31.4%), religious (30%). Children's diagnosis included autistic spectrum disorder (41.4%), intellectual disability (21.4%), cerebral palsy (17.1%), genetic syndromes (17.1%) and sensorineural hearing loss (2.9%). Degree of support (1-minimal,5-greatest) required by the child was 3.67 ± 1.28 for physical and 3.49 ± 1.36 for communication. Primary caregivers completed the FQOL Survey. Domain scores were highest for family relations and lowest for financial well-being. Dimension scores were highest for importance and lowest for opportunities. Overall FQOL approximated average. Jewish families and residents of a major urban area reported higher and more religious families reported lower overall FQOL. Regression analysis found ethnicity contributing to overall FQOL and domain scores with residence contributing to support from services. Ethnicity and child dependence contributed to dimension scores. Northern Israeli families having a child with a severe neurodevelopmental disability report average FQOL scores. However, family and child dependence characteristics affect FQOL scores. Professionals working with these families should consider FQOL information when making recommendations.