OKUL ÇAĞI ÇOCUKLARINDA BİLİŞSEL KOPMA SENDROMU BULGULARI AÇISINDAN EBEVEYN-ÖĞRETMEN UYUMU

Abstract

Giriş ve Amaç: Bu çalışmanın amacı, okul çağındaki çocuklarda Bilişsel Kopma Sendromu (BKS) semptomlarının değerlendirilmesinde ebeveyn ve öğretmen bildirimlerinin ne kadar uyumlu olduğunun incelenmesidir. Gereç ve Yöntemler: Örneklem Türkiye'nin dört büyük şehrinden 7 ila 11 yaş aralığında rastgele seçilen 268 çocuktan oluşan epidemiyolojik bir örneklemdir. Hem ebeveynler hem de öğretmenler, Barkley Yavaş Bilişsel Tempo Ölçeği-Çocuklar ve Ergenler (BYBTÖ-ÇE) ve BKS-Çocuk ve Ergenlerde Davranış Değerlendirme Ölçeği'ni (BKS-ÇDDÖ) doldurmuşlardır. BKS ile ilgili ebeveyn ve öğretmen puanlamaları arasındaki uyum ve korelasyonlar, Cohen’in Kappa (k) ve Spearman Rho (r) katsayıları aracılığıyla değerlendirilmiştir. Bulgular: Olgularda BKS’nin varlığına veya yokluğuna yönelik olarak ebeveynler öğretmenlerle uyum içinde saptanmamıştır (BYBTÖ-ÇE değerlendirmesine göre k=0,143, p=0,042; BKS-ÇDDÖ değerlendirmesine göre k=0,039, p=0,366). Ancak, ebeveyn ve öğretmenlerin BYBTÖ-ÇE'nin BKS-gündüz düşleri ve BKS-yavaşlık puanlamaları orta düzeyde korelasyon (sırasıyla r=0,375, r=0,305; tüm p<0,001), BKS-ÇDDÖ toplam puanlamaları ise düşük düzeyde korelasyon göstermiştir (r=0,290, p<0,001). Ebeveyn ve öğretmen değerlendirmeleri arasında 12 BYBTÖ-ÇE maddesinin 9'unda (tüm r<0,26, tüm p<0,05) ve 4 BKS-ÇDDÖ maddesinin 3'ünde (tüm r<0,16, tüm p<0,05) düşük düzeyde korelasyon saptanmıştır. Sonuç: Bulgular, ebeveynler ve öğretmenlerin okul çağındaki çocuklarda BKS'yi değerlendirmede düşük düzeyde fikir birliği ve uyum içinde olduğunu göstermektedir. Her iki BKS semptom boyutunda orta düzeyde korelasyon saptanmasına rağmen, neredeyse tüm BKS semptomlarındaki uyum ebeveynler ve öğretmenler arasında düşük düzeyde kalmaktadır. Sonuçlar farklı kültürlerde değişebilse de klinisyenler okul çağındaki çocukları BKS açısından değerlendirirken BKS semptomları açısından değerlendiriciler arasındaki uyumun düşük düzeyde olmasını dikkate almalıdırlar.

Keywords

• bilişsel kopma sendromu
• ebeveyn-öğretmen uyumu
• değerlendirme
• konkordans
• BKS
• yavaş bilişsel tempo

Parent-Teacher Agreement On Cognitive Disengagement Syndrome Symptoms In School-Age Children

Abstract

Aim: This study examined how well parent and teacher reports are concordant in evaluating Cognitive Disengagement Syndrome (CDS) symptoms in school-age children. Method: The epidemiological sample consisted of 268 randomly chosen children aged 7 to 11 from four metropolitan cities in Turkey. Both parents and teachers evaluated the children by completing the Barkley Sluggish Cognitive Tempo Scale- Children and Adolescents (BSCTS-CA) and the CDS-Child Behavior Checklist (CDS-CBCL). Agreement and correlations between parent and teacher reports regarding CDS were assessed via coefficients of Cohen’s Kappa (k) and Spearman’s Rho (r). Results: Parents were not in agreement with teachers concerning the presence/absence of CDS (k=0,143, p=0,042 according to BSCTS-CA evaluation; k=0,039, p=0,366 according to CDS-CBCL evaluation). However, parent and teacher ratings on CDS-daydreaming and CDS-sluggish scores of BSCTS-CA showed medium correlation (r=0,375, r=0,305; respectively; all p<0,001); whereas showed low correlation on CDS-CBCL total scores (r=0,290, p<0,001). Parent and teacher ratings showed low correlations on 9 out of 12 BSCTS-CA items (all r<0,26, all p<0,05) and on 3 out of 4 CDS-CBCL items (all r<0,16, all p<0,05). Conclusion: The findings demonstrate that parents and teachers are in low agreement and concordance in evaluating CDS in school-age children. Despite medium-level correlations on both CDS symptom dimensions, the concordance between parents and teachers on almost all CDS symptoms remains at low levels. Although the outcomes may vary across different cultures, clinicians should pay regard to low inter-rater agreement on CDS symptoms in school-age children while evaluating them for CDS.

Keywords

• cognitive disengagement syndrome
• parent-teacher agreement
• assessment
• concordance
• CDS
• sluggish cognitive tempo

Supporting Institution

Yoktur.

Ethical Statement

Ethical approval was obtained from the Ege University Ethical Committee of Clinical Research (decision no: 15-11/3).

Thanks

The authors acknowledge all the participating children and adolescents and their parents who were involved in the study.

References

1. 1. Becker, S. P., Marshall, S. A. et al. (2014). Sluggish cognitive tempo in abnormal child psychology: an historical overview and introduction to the special section. Journal of abnormal child psychology, 42(1), 1–6. https://doi.org/10.1007/s10802-013-9825-x
2. 2. Barkley, R. A. (2018). A review of research on SCT. In R. Barkley (Ed.), Barkley sluggish cognitive tempo scale—children and adolescents (BSCTS-CA) (pp. 4–66). Guilford Press.
3. 3. Becker, S. P., Leopold, D. R. et al. (2016). The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review. Journal of the American Academy of Child and Adolescent Psychiatry, 55(3), 163–178. https://doi.org/10.1016/j.jaac.2015.12.006
4. 4. Becker, S. P., Willcutt, E. G. et al. (2023). Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 62(6), 629–645. https://doi.org/10.1016/j.jaac.2022.07.821
5. 5. Barkley R. A. (2013). Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 42(2), 161–173. https://doi.org/10.1080/15374416.2012.734259
6. 6. Burns, G. L., & Becker, S. P. (2021). Sluggish Cognitive Tempo and ADHD Symptoms in a Nationally Representative Sample of U.S. Children: Differentiation Using Categorical and Dimensional Approaches. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 50(2), 267–280. https://doi.org/10.1080/15374416.2019.1678165
7. 7. Rondon, A. T., Hilton, D. C. et al. (2020). Sleep, Internalizing Problems, and Social Withdrawal: Unique Associations in Clinic-Referred Youth With Elevated Sluggish Cognitive Tempo Symptoms. Journal of attention disorders, 24(4), 524–534. https://doi.org/10.1177/1087054718756197
8. 8. Tahıllıoğlu, A., Bilaç, Ö. et al. (2024). The association between cognitive disengagement syndrome and specific learning disorder in children and adolescents with ADHD. Applied neuropsychology. Child, 1–9. Advance online publication. https://doi.org/10.1080/21622965.2024.2323647

9. 9. Ergül, B., & Ersöz Alan, B. (2024). The role of cognitive disengagement syndrome in non-suicidal self-injury among adolescents with attention deficit hyperactivity disorder. Early intervention in psychiatry, 10.1111/eip.13535. Advance online publication. https://doi.org/10.1111/eip.13535
10. 10. Cáceres, J., & Herrero, D. (2011). Cuantificación y analisis de la concordancia entre padres y tutores en el diagnostico del trastorno por deficit de atención/hiperactividad [Quantification and concordance assessment among parents and teachers in attention deficit hyperactivity disorder diagnosis]. Revista de neurologia, 52(9), 527–535.
11. 11. Malhi, P., Singhi, P., & Sidhu, M. (2008). Impact of parent and teacher concordance on diagnosing attention deficit hyperactivity disorder and its sub-types. Indian journal of pediatrics, 75(3), 223–228. https://doi.org/10.1007/s12098-008-0049-y
12. 12. Willard, V. W., Conklin, H. M., Huang, L., Zhang, H., & Kahalley, L. S. (2016). Concordance of parent-, teacher- and self-report ratings on the Conners 3 in adolescent survivors of cancer. Psychological assessment, 28(9), 1110–1118. https://doi.org/10.1037/pas0000265
13. 13. Gomez R. (2007). Australian parent and teacher ratings of the DSM-IV ADHD symptoms: differential symptom functioning and parent-teacher agreement and differences. Journal of attention disorders, 11(1), 17–27. https://doi.org/10.1177/1087054706295665
14. 14. Kaner, S. (2011). ADHD symptoms in national samples of Turkish adolescents: parent, and teacher reports. Procedia-Social and Behavioral Sciences, 15, 3342-3348.
15. 15. Mayes, S. D., Calhoun, S. L. et al. (2023). Agreement between mother, father, and teacher ratings of cognitive disengagement syndrome (sluggish cognitive tempo) in children with autism and children with ADHD. Psychological assessment, 35(7), 582–588. https://doi.org/10.1037/pas0001234
16. 16. Sáez, B., Servera, M. et al. (2019). Optimal Items for Assessing Sluggish Cognitive Tempo in Children Across Mother, Father, and Teacher Ratings. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 48(6), 825–839. https://doi.org/10.1080/15374416.2017.1416619
17. 17. Tahıllıoğlu A., Bilaç Ö., et al. (2024). The prevalence, sociodemographic, and comorbidity characteristics of turkish children with cognitive disengagement syndrome. Neuropsychiatric Investigation. 2024;62(1):22-31. B
18. 18. Achenbach T. Manual for the Child Behavior Checklist/4-18 and 1991 Pro- file. Burlington, VT: University of Vermont; 1991.
19. 19. Erol N, Arslan BL et al. (1995). The Adaption and Standardization of the Child Behavior Checklist among 6-18 Year Old Turkish Children. Eunethydis: European Approaches to Hyperkinetic Disorder (Sergeant J, ed.). Zurich: Fotoratar; 1995, 97-113.
20. 20. Ünsel-Bolat, G., Ercan, E. S. et al. (2019). Comparisons between sluggish cognitive tempo and ADHD-restrictive inattentive presentation phenotypes in a clinical ADHD sample. Attention deficit and hyperactivity disorders, 11(4), 363–372. https://doi.org/10.1007/s12402-019-00301-y
21. 21. Camprodon-Rosanas, E., Ribas-Fitó, N. et al. (2017). Sluggish Cognitive Tempo: Sociodemographic, Behavioral, and Clinical Characteristics in a Population of Catalan School Children. Journal of attention disorders, 21(8), 632–641. https://doi.org/10.1177/1087054716652477
22. 22. Firat, S., Bolat, G. U. et al. (2018). Barkley child attention scale validity and reliability study. Dusunen Adam Journal of Psychiatry and Neurological Sciences, 31(3), 284.
23. 23. Baytunca, M. B., Inci, S. B., Ipci, M., Kardas, B., Bolat, G. U., & Ercan, E. S. (2018). The neurocognitive nature of children with ADHD comorbid sluggish cognitive tempo: Might SCT be a disorder of vigilance?. Psychiatry research, 270, 967–973. https://doi.org/10.1016/j.psychres.2018.03.038
24. 24. McHugh M. L. (2012). Interrater reliability: the kappa statistic. Biochemia medica, 22(3), 276–282.
25. 25. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.
26. 26. Cohen J. (1988). Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale (MI): Lawrence Erlbaum Associates.
27. 27. Tahıllıoğlu, A., Bilaç, Ö. et al. (2021). Who predict ADHD with better diagnostic accuracy?: Parents or teachers?. Nordic journal of psychiatry, 75(3), 214–223. https://doi.org/10.1080/08039488.2020.1867634
28. 28. Korsch, F., & Petermann, F. (2014). Agreement between parents and teachers on preschool children's behavior in a clinical sample with externalizing behavioral problems. Child psychiatry and human development, 45(5), 617–627. https://doi.org/10.1007/s10578-013-0430-6
29. 29. Cheng, S., Keyes, K. M. et al. (2018). Understanding parent-teacher agreement of the Strengths and Difficulties Questionnaire (SDQ): Comparison across seven European countries. International journal of methods in psychiatric research, 27(1), e1589. https://doi.org/10.1002/mpr.1589