Sexual orientation is considered from Savin-Williams’ continuum perspective, and gender and sexual orientation are both conceptualized from a fluid, rather than a categorical viewpoint. A Minority Stress Model is applied to the experience of LGBTQ+ communities, whereby stress reactions relate to concerns about one’s safety, discrimination, oppression, and internalized oppression, among many other negative mental and physical health outcomes. Proximal and distal stressors are presented in conjunction with the Minority Stress Model and applied to several domains illustrating community gaps and interventions in academic, legislative, religious, economic, medical, social, and social-environmental realms. Key policies are presented supporting greater rights for LGBTQ+ communities. Despite these advances, significant gaps remain with regard to responsiveness to the needs of LGBTQ+ communities. A case study highlights adverse effects and policy regarding conversion therapy.

This chapter discusses the state of current community-based interventions to support adolescents and young adults (AYAs) with neurodevelopmental disabilities (with a specific focus on spina bifida, autism spectrum disorder, and intellectual disability) as they navigate the transition to adulthood. Taking a social-ecological, developmentally grounded perspective, we provide an overview of the transition to adulthood and key elements related to this process for AYAs with disabilities. Examples of evidence-based community interventions and programs across different countries are discussed. Case studies elucidate how individual, familial, cultural, and community factors can facilitate or complicate the transition process. The implications of culture around disability are also highlighted. Lastly, future directions and ways that community psychologists can incorporate these interventions to support and empower AYAs with disabilities are provided.

This chapter addresses how mental health needs and challenges experienced during adolescence can be understood within a framework of clinical neuroscience and its implications regarding development and risk. Through a discussion of current findings regarding adolescent brain development and its organization of the skills required for managing the increased demands for problem-solving and self-reliance that come with adulthood, a biopsychosocial consideration is presented to support how pediatric neuropsychological consultation can facilitate more effective guidance regarding developmental demands and how they can be supported within the family and community. Utilizing the author’s experience consulting in China as a model for critically considering how current assessment practices play out cross-culturally, a model for a more informed, multidisciplinary, and collaborative approach to neuropsychological consultation is proposed that seeks to foster greater attention to the intersectional and contextual demands adolescent development presents.

This chapter is premised on the belief that ethical medical and mental healthcare require a social justice framework, one that takes as its principal stance that healthcare is a human right. Utilizing Ruger’s health capability paradigm, we consider how, both within the United States itself and globally, the engagement of a perspective of positive rights regarding health and healthcare is required when approaching how to best address social disparities and access to medical and mental health treatment. We first consider the health capability paradigm and how it conceptually frames, within a social justice perspective, the right to health and the provision of healthcare for children and youth. We next explore how this model can be considered within a discussion of how dual medical and mental healthcare is currently practiced in a context where patients referred and treated are from lower- to lower-middle-class socioeconomic status communities, and who utilize Medicaid as their primary source of insurance for healthcare. We focus specifically on the provision of forms of medical and mental healthcare that are often the least considered and subsequently unreimbursed by Medicaid, neuropsychological assessment and consultation/liaison for mental health. We next present a case that addresses the application of the health capability paradigm within a child and adolescent psychiatric care setting, and then end with a discussion of how communities, both locally and within the United States, can better engage this model as a means for justifying more equitable and conscientious care for children and adolescents.

Preface

Executive functioning (EF) is a complex construct with many facets, served by an intricate neurobiologic network that develops over the course of childhood, adolescence, and early adulthood. The behavioral manifestations of EF and executive dysfunction (EdF) go through periods of rapid growth during this same time. This book reviews the research literature on the development and neurobiology of EF. Conceptual assessment issues are discussed, with a focus on key elements of identifying EF/EdF in specific clinical conditions such as Disruptive Behavior Disorders (DBD), autism spectrum disorders (ASDs), learning disorders (LD), mood and anxiety disorders, seizure disorders, and human immunodeficiency virus (HIV), among others, including test performance, neuro-imaging, and clinical presentation. Several chapters are devoted to practical aspects of EdF, including research-based treatment strategies, educational implications, forensic cautions, and intervention resources.

The text is divided into three sections. Section I provides a foundation by reviewing models of EF, neuropsychological and neurobiological development, and key assessment considerations. Section II presents critical information on how EF deficits present in pediatric neurodevelopmental and acquired disorders. The book closes with a section addressing applications of the research, including remediation and educational implications of EF deficits, cautions for forensic neuropsychologists, and reflections on the volume as a whole.

This book is essential reading for medical, psychological, and educational professionals who work with children and adolescents in clinical and educational settings.

Executive functions are a set of interdependent, progressively acquired, higher-order cognitive skills that emerge in tandem with the expansion and integration of cerebellar, subcortical, corticocortical, and prefrontal neural networks across early childhood, through adolescence, and into early adulthood. Because the development of neural systems that support EF is so protracted, it is vulnerable across time to alterations in its unfolding trajectory, resulting in multiple possible routes to EdF. This chapter provides a summary of the underlying neuroanatomical and neurochemical substrates of EF development that support the behavioral and cognitive capacities discussed in Chapter 2. Although a primary emphasis of this chapter is typical EF development, discussion of abnormalities in and insults to the developing circuits that support EF are also considered.

Neurodevelopment

In contrast to models that describe the neural underpinnings of EF in adults, which emphasize modularity and take a reductionist approach to characterizing the “how and where” of executive capabilities, given their focus on the frontal lobes, models of early brain development and its role in the establishment of EF are much less “tidy” and “bounded”. Instead, the boundaries of what constitutes EF in childhood and the description of specific structures supporting its elicitation are less distinct and are more broadly situated anatomically. As a result, the classical emphasis on frontal cortical networks that characterizes adult neuropsychology is inadequate when thinking about EF developmentally. Instead, when considering the developmental neurobiology of EF, it is important to think about how the whole brain organizes and establishes its connections over time and across neural space, in order to best understand and make sense of the increasingly automatic and controlled responses that emerge neuropsychologically.

Mood and anxiety disorders in children and adolescents have been widely examined empirically, yet relatively few studies have focused on the effects of these disorders on developing EF skills. This lack of knowledge regarding a core cognitive capacity has hampered efforts at understanding and addressing potential disruptions in problem solving, memory, and engagement that often co-occur with mood and anxiety disorders.

Mood disorders

Mood disorders include diagnoses for which the primary symptoms are a change in emotional state. This category of psychopathology includes significantly elevated or depressed mood, inappropriate affect, or a limited range of feelings, and is diagnostically composed of major depressive disorder (MDD), bipolar disorder (BD), cyclothymic disorder, and dysthymic disorder in the DSM-IV-TR. In the upcoming DSM-5, this group of disorders will likely be divided further into two categories, bipolar and related disorders and depressive disorders. While few changes to the diagnosis of MDD are anticipated, the criteria for BD will likely be developmentally based, and include increased specificity in order to capture the presentation of manic symptoms observed in children. The DSM-5 may include a new disorder, temper dysregulation disorder with dysphoria (TDD), characterized by temper outbursts that begin before 10 years of age, although its inclusion remains both controversial and uncertain.