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This article addresses the essential role of sleep in the medical, emotional, behavioral, and cognitive health of children. Sleep disorders common among children are defined along with the most common sleep concerns reported by caregivers. Prevention and intervention strategies are described.

Objective To derive and test a series of brief diagnosis-specific scales to identify subjects who are at high probability of meeting diagnostic criteria and those who may safely be spared more extensive diagnostic inquiry. Method Secondary data analysis of a large epidemiological data set ( n = 1,286) produced a series of gate and contingent items for each diagnosis. Findings were replicated in a second retrospective analysis from a residential care sample ( n = 884). The DISC Predictive Scales (DPS) were then used prospectively as a self-report questionnaire in two studies, in which parents ( n = 128) and/or adolescents ( n = 208) had subsequent diagnostic interviewing with the Diagnostic Interview Schedule for Children or the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Results All analyses showed that gate item selection was valid and that any missed cases were due solely to inconsistent reports on the same questions. Screening performance of the full scales was shown to be good, and substantial reductions in scale length were not associated with significant changes in discriminatory power. Conclusions The DPS can accurately determine subjects who can safely be spared further diagnostic inquiry in any diagnostic area. This has the potential to speed up structured diagnostic interviewing considerably. The full DPS can be used to screen accurately for cases of specific DSM-III-R disorders.

Using recently refined diagnostic criteria, the authors hypothesized that the frequent touching of others by a 16-year-old male adolescent with Tourette's syndrome was a compulsion and not a tic. Consistent with the study's hypothesis, the authors applied exposure and response prevention, a procedure empirically supported for treatment of compulsions but not for tics, to the touching. Results showed a significant decrease in touching attempts, overt anxiety, and subjective anxiety across time.

This brief comment presents my clinical interpretation of the problems presented by Mike, a 13-year-old Caucasian male living at Boys Town, as described in his case description. My perspective on the case is behavior analytic, and my interpretation is that it involves profound social-skills deficits. To begin, I recommend a comprehensive functional assessment including an interview with Mike. Cautiously, in lieu of information from that assessment, I recommend a 6-point treatment plan including a carefully selected therapist, two types of positive peer reporting, a group approach to social-skills training, and staged and unstaged practice of target social skills.

School performance and attitudes of a group of children placed in residential care were assessed during placement and for an average of four years after discharge. A comparison group of children who were not placed in the program was also followed. The residential program emphasized both behavioral and educational treatment. Group differences were tested using Hierarchical Linear Modeling (HLM). Results indicated that the treatment group had significantly greater improvements in both school performance and attitudes during placement. These differences were also maintained after discharge. It is suggested that long-term educational effects with troubled children may require an intensive intervention over an extended period of time.

We evaluated parent use of DRI to treat high rate disruptive behavior in their severely handicapped four-year old son. We used a withdrawal experimental design for the analysis. Both parents used DRI with equivalent accuracy and effectiveness resulting in substantial direct and collateral treatment effects.

Trichotillomania, chronic hairpulling resulting in alopecia, is predominantly a disorder exhibited by children and young adults. This paper presents a brief review of prevalence, assessment methods, and etiological considerations combined with a more complete review of behavioral treatment approaches for trichotillomania. Behavioral approaches appear to be effective for persons with chronic hairpulling but further experimental evaluation of treatment methods is needed. Recommendations for future research on the treatment of trichotillomania are made.

Thumb sucking in childhood frequently accompanies such other behaviors as holding or manipulating favored objects. This study evaluated the effects on thumb sucking of preventing doll holding in a five-year-old girk who chronically sucked her thumb while holding a doll. A withdrawal (ABAB) experimental design revealed that preventing doll holding eliminated thumb sucking. The results of the study show that preventing a covariant can be an effective, efficient method of controlling thumb sucking.

This experiment evaluated parent and teacher use of reinforcement-based, reductive procedures to treat aggressive pinching in a severely retarded child. A withdrawal and a multiple baseline design were used for the analysis. Substantial and lasting treatment effects were obtained at home and school. The benefits and problems associated with parent use of reinforcement-based, behavioral procedures with severely handicapped children, as well as the comparative effects of DRO and DRI are discussed.

Consulting psychologists evaluated the application of several aversive treatment methods for a self-stimulatory behavior exhibited by a severely retarded 11-year-old male. Three punishment procedures—the contingent applications of watermist, lemon juice, and vinegar—were evaluated using a reversal design. Substantial reductions occurred for self-stimulatory hand-touching following the application of each procedure; low rates were maintained using watermist during sessions conducted by group home staff members across a 6-month follow-up. The watermist procedure was as effective as lemon juice or vinegar, presented less physical threat to the client, and was preferred by the staff.