Colorado V. Connelly479 U.S 157 (1986)Facts· Co.docx

Colorado V. Connelly
479 U.S 157 (1986)
Facts:
· Connelly approached a police officer and showed interest on
confessing about a murder that he committed.
· Connelly had a history of mental illness and had been of his
medication for at least 6 months.
· Before Connelly made a confession, the officer gave Connelly
his Miranda warnings and called a detective that before
interrogating him, read him again his Miranda warnings.
· Connelly acknowledge the understanding of his Miranda rights
and confessed that he murder a young girl.
· The next morning Connelly was disoriented and claimed that
voices made him confess to the murder.
· Connelly then was diagnosed by a psychiatrist with
schizophrenia and wanted to suppress the use of his statements
in court because his psychotic condition made him confess but
he was able to understand his Miranda rights.
Procedural History:
· Supreme court of Colorado suppressed the evidence
· U.S Supreme Court
Law:
· “No person shall be held to answer for a capital, or otherwise
infamous crime, unless on a presentment or indictment of a
Grand Jury, except in cases arising in the land or naval forces,
or in the Militia, when in actual service in time of War or public

danger; nor shall any person be subject for the same offense to
be twice put in jeopardy of life or limb; nor shall be compelled
in any criminal case to be a witness against himself, nor be
deprived of life, liberty, or property, without due process of
law; nor shall private property be taken for public use, without
just compensation.”
-5th amendment
· All persons born or naturalized in the United States, and
subject to the jurisdiction thereof, are citizens of the United
States and of the state wherein they reside. No state shall make
or enforce any law which shall abridge the privileges or
immunities of citizens of the United States; nor shall any state
deprive any person of life, liberty, or property, without due
process of law; nor deny to any person within its jurisdiction
the equal protection of the laws.
-14th amendment
Legal Question:
· Can Connelly’s statement be suppressed, since he made it in a
state of mind in which he was not aware of the situation and the
consequences?
Holding and vote: No (7-2)
Reasoning: (Rehnquist, majority) joined by White, Blackmun,
Powell, Stevens, O’Connor and scalia.
1. The admissibility of statements is governed by state rules of
evidence, rather than previous supreme court decisions
regarding coerced confessions and Miranda waivers.
2. The officers did not use any questionable methods to get a
confession from Connelly, in fact they told him that he had the
right to remain silent, yet he proceeded to confess.
3. Similar cases in which statements were suppressed due to the
defendant’s mental state is because the officers exploited their
mental health to get a confession. I.e Blackburn v. Alabama,
361 U. S. 199 (1960), and Townsend v. Sain, 372 U. S. 293

(1963)
4. The due process clause of the 5th and 14th amendment was
not violated because the defendant did everything voluntarily
and somewhat knowingly because schizophrenia does not
impairs comprehension.
5. Voluntary in the eyes of the law means, not being influenced
by an external force, in this case the defendant was not
influenced by any police officer.
Concurring Opinion: (Blackmun and Stevens)
· Justice Blackmun agrees with everything, except with part III
A, where it was talked about the defendant waived his Miranda
rights. He believes that it was unnecessary.
· Justice Stevens believes that Connelly’s statement were
involuntary. However the fifth amendment was not violated,
therefore, it is not required to suppress the evidence gathered by
the officers.
Dissenting opinion: (Justice Brennan joined by Marshall)
· Justice Brennan believe that the defendant did not made this
confessions in the right state of mind because of his condition
and his withdrawal from medication for a prolonged period of
time. He also believe that his hallucination had some effect in
his ability to comprehend his Miranda rights. The absence of
police misconduct does not necessarily means that the
confessions was made on free will. The court has reversed
similar cases in which a person confessed to a crime due to
medication (Townsend v. Sain,372 U. S. 293, 1963). Allowing
to include mentally ill individual to voluntary confession is an
error because more often than not this confessions are going to
be unreliable
Volume 4 1 /Number 3/July 2019/Pages 242-259/https: 11
ioi.org! IO.I7744/mehc.4l .3.04

NEUROCOUNSELING
Fostering Intrinsic Resilience: A
Neuroscience-Informed Model of
Conceptualizing and Treating Adverse
Childhood Experiences
Eraina Schauss
Greg Horn
Frances Ellmo
Tegan Reeves
Haley Z e ttle r
Debra Bartelli
Pam Cogdal
Steven West
An increasingly common dialogue among mental health
professionals revolves around adverse
childhood experiences (ACEs) and developmental trauma. ACEs
can occur in a number of ways
with a myriad of potential outcomes, often making treatment
choices difficult. During critical
stages of neurodevelopmental growth, trauma makes a mark on
the brain and body at a physi-
ological level. Although the National Institute of Mental
Health’s Research Domain Criteria
have been used to address this brain-body impact, the far-
reaching scope of implications needs
grounding in a theoretical framework. The current paper
discusses developmental trauma and
proposes a new reciprocally determinant model that advocates
for neuroscience-informed coun-

seling interventions such as neurofeedhack therapy. Clinical
implications and considerations
for counselors are discussed.
Eraina Schauss, Department o f Counseling, Educational
Psychology and Research, The University o f
Memphis: Greg Horn, Department o f Counseling, Educational
Psychology and Research, The University o f
Memphis: Frances Ellmo, Department o f Counseling,
Educational Psychology and Research, The University
o f Memphis: Tegan R e e ve s, Department o f Counseling.
Educational Psychology and Research, The
University o f Memphis: Haley Zettler, Department o f
Criminology and Criminal Justice, The University o f
Memphis: Debra Bartelli, School o f Public Health, The
University o f Memphis: Pam Cogdal, Department o f
Counseling. Educational Psychology and Research, The
University o f Memphis: Steven West, Department
o f Counseling, Educational Psychology and Research. The
University o f Memphis.
This research is supported by a Memphis Research Consortium
Grant (Grant #2 3 2 0 0 0 ) to the University
o f Memphis in partnership with the University o f Tennessee H
ealth Science Center. This article also
acknowledges Kristi Nobbman in the conceptual development o
f the reciprocally determinant b ra in -
body model.
Correspondence concerning this article should be addressed to
Eraina Schauss, Department o f
Counseling, Educational Psychology and Research, Patterson H
all Room 123, The University o f Memphis,
Memphis, TN 38152. E-mail: [email protected]
242 0 Journal o f Mental Health Counseling
mailto:[email protected]

F o s t e r in g I n t r i n s i c R e s ilie n c e
Mental health professionals increasingly seek information on
approaches
to childhood maltreatment in terms of the prevention and
treatment of trau-
matic response. Counselors seeking applicable information
often find theories
and approaches siloed within specialties and fields of practice.
For instance,
social, interpersonal, and biological theories each provide
useful explanations,
yet are limited in explaining how such variables interact. The
model we present
provides insight into the concept of developmental trauma by
examining the
reciprocal interaction of clients’ environment, behavior, and
personal factors
and a regulatory self-system (Bandura, 1978) that includes
biological and neu-
rological processes. This theoretical framework aims to bridge
important fields
of research including developmental psychology and
neuroscience.
ADVERSE CHILDHOOD EXPERIENCES
AND DEVELOPMENTAL TRAUMA
Adverse childhood experiences (ACEs) include abuse
(emotional, phys-
ical, and sexual), household challenges (e.g., witnessing parent-
to-parent
violence, household substance abuse, mental illness in
household, parental
separation or divorce, incarcerated household member), and

emotional and
physical neglect (Felitti et ah, 1998). Since Felitti et al. (1998)
found in their
seminal study that ACEs were linked to chronic illness in
adulthood and early
morbidity, research examining the profound impact of ACEs has
become a
priority for the Centers for Disease Control and Prevention
(2018) and other
research organizations. In the past two decades, this extensive
field of research
has established early childhood maltreatment as a significant
etiological factor
for a wide range of health and psychological conditions. A
comprehensive
review of this literature is beyond the scope of this article;
however, to summa-
rize, children and adolescents who experience a high number of
ACEs tend to
manifest an increased num ber of psychiatric conditions
(Giaconia et al., 1995)
and a multitude of behavioral and health-related complications
throughout
their life span (Schilling, Aseltine, & Gore, 2007). Research
also indicates
that ACEs are more common among youth with juvenile justice
involvement
(Zettler, Wolff, Baglivio, Craig, & Epps, 2017). The long-term
physiological
response to trauma appears to link ACEs and chronic health
problems (van der
Kolk, 1994). Specifically, a dose effect was found linking
greater ACE exposure
in children and adolescents with greater instances of obesity,
diabetes, heart
disease, maladaptive sleep patterns, autoimmune disorders, and

inflammation,
ultimately leading to a lifetime of chronic physical and mental
illness (Felitti
et al., 1998).
Felitti et al. (1998) further theorized a causal link between
ACEs and early
death mediated by three categories of factors in a linear fashion.
According to
0 Journal o f Mental Health Counseling 243
their model, ACEs lead to social, emotional, and cognitive
impairment, which,
in turn, leads to the adoption of health-risk behaviors, often
resulting in dis-
ease, disability, and ultimately early death. This explanation,
which admirably
accounts for social and psychological factors, represents the
medical model,
which tends to identify (and treat) the root cause of pathology
in a linear
fashion. The medical model is the long-standing dominant
model in health
care (Engel, 1977), has many strengths, and is clearly an
appropriate model for
understanding the factors that lead to early death.
However, the medical model also has significant limitations,
especially
when applied to dynamic social and interpersonal processes. For
instance, due
to the assumption of cause and effect, when applied to ACEs,
the medical

model can imply that “what is done is done” and suggest a sense
of hopeless-
ness to clients and a subsequently defeatist and challenging
position for coun-
selors. In addition, the scale used to measure ACEs assigns the
same weight
to each type of adverse experience (Felitti et ah, 1998).
However, research
shows that not all childhood maltreatment has an equal effect;
some adverse
experiences are more traumatizing than others (Schwartz &
Perry, 1994), and
the degree of long-term traumatic effects can depend on
subjective mediating
factors such as loneliness (Shelvin, McElroy, & Murphy, 2015)
or social sup-
port (Allbaugh et ah, 2018). The medical model does little to
acknowledge the
subjective experience of an individual. In addition, the ACE
scale is additive,
as researchers have argued that they are interested in the
cumulative effect of
ACEs (Thompson, Richards, & Gaysina, 2017). However, an
additive measure
of adverse experience does not acknowledge possible
interaction effects. In
such instances, 1 + 1 does not necessarily equal 2 when adverse
experiences
compound one another and have an exponentially greater
negative effect for
the child. For example, consider a child whose father is
incarcerated and who
is physically abused by his overly stressed single mother, with
no other adult
support to help cope with the physical abuse. Clearly, adverse
experiences can

have an effect on each other, with the resulting impact being
greater than the
sum of its parts. Finally, the medical model does not address
how previous
adverse experiences can make individuals vulnerable to future
adverse expe-
riences. For instance, failure to identify traumatic response
behaviors as such
can exacerbate intense emotions and lead to application of
stigmatizing labels
such as oppositional, rebellious, unmotivated, or antisocial (van
der Kolk, 2005,
p. 404), which can have long-term effects on self-concept
(Rockett, Murrie, &
Boccaccini, 2007).
244 0 Journal o f Mental H ealth Counseling
Fostering In trin s ic Resilience
VIEWING ADVERSE CHILDHOOD EXPERIENCES
THROUGH A
RECIPROCAL DETERMINANT LENS
Social, interpersonal, and attachm ent theories have offered
explanations
for the sequelae of childhood maltreatment and have addressed
many of the
issues the medical model could not (Siegel, 2012; van der Kolk,
2015). The
concept of reciprocal determinism from Bandura’s social
learning theory, in
our view, provides a particularly useful means by which to
address the complex-

ity of issues that arise from ACEs. Bandura (1978) postulated
the self system
within his reciprocal determinism model to describe cognitive
mechanisms
by which the individual uses perception and assessment of past
or potential
future experience to regulate behavior. This process was
theorized to involve
bidirectional relationships among behavior, person, and
environment. Thus,
the self system is used as an analytical self-regulatory process
and describes the
psychosocial interactions within the individual (Bandura, 1978).
Whereas the medical model is limited in that it does not account
for
reciprocal influences, Bandura’s model is limited in that it does
little to address
physical and neurological processes in the body. In this paper
we propose
an expansion of a theoretical model that incorporates an
understanding of
neurological process in the context of developmental trauma and
ACEs. O ur
model will be discussed in detail, and implications for clinical
practice will be
presented.
RESEARCH DOMAIN CRITERIA
An impetus for change in understanding and conceptualizing
develop-
mental trauma is the rise of the Research Domain Criteria
(RDoC) project, a
National Institute of Mental Health (NIMH) movement to
develop research

frameworks incorporating neurobiological, genetic, behavioral,
and cognitive
influences on the classification of mental disorders. The RDoC
initiative
emphasizes neural circuitry, levels of arousal, regulatory
systems, social pro-
cesses, cognitions, developmental trajectories, and the dynamic
interaction
between an individual and their environment. The rise of the
RDoC move-
m ent emphasizes the desire for a precision medicine approach,
“an emerging
approach for disease treatment and prevention that takes into
account individ-
ual variability in genes, environment and lifestyle for each
person” (National
Institutes of Health, as cited in Adams & Petersen, 2016, p.
787), to mental
health treatment.
The RDoC paradigm shift comes at a critical time in mental
health
care. RDoC seeks to foster a more precise way of
conceptualizing and treating
m ental disorders that will transform treatment and public health
outcomes
through four main objectives. The first strategic objective of
RDoC is to define
the mechanisms of complex behavior. The second objective is to
identify and
characterize sensitive periods of brain development across the

life span with a
goal of determining “the points in time during which the brain
is most sensitive
to intervention and the underlying molecular and system-level
mechanisms
responsible for this sensitivity” (NIMH, 2015, p. 32). The third
strategic
objective of RDoC concerns the areas of treatment, prevention,
and cures.
The objective seeks to integrate neuroscience, genomics, and
evidence-based
behavioral science methodologies into more precise treatments.
Additionally, a
need exists to develop new interventions and tailor current
treatments to indi-
vidualized symptoms. The fourth and final RDoC objective is to
strengthen the
public health impact of NIMH-supported research (NIMH,
2015).
The current ideological shift is to understand and integrate basic
neuro-
science findings into evidence-based clinical practice and
interventions with
the ultimate goal of delivering the most accurate diagnosis at
the earliest point,
followed by precise and individualized treatments. To pave the
way for a pre-
cision medicine approach in mental health counseling,
additional diagnostic
evaluations must be incorporated into treatment, which examine
symptoms,
behaviors, cognition, genotype, physiology, environmental
exposures, cultural
background, and family dynamics (NIMH, 2015). As such, the
task of answer-

ing the call of the RDoC must include counselors and not solely
medical
professionals and scientists.
Our unique counseling perspective brings a much-needed focus
on holis-
tic wellness, individualized treatment, and social justice
considerations and
provides the opportunity to change the way other helping
professions concep-
tualize mental health.
INTEGRATING NEUROSCIENCE AND COUNSELING
Given the RDoC emphasis on precision medicine, neuroscience
is a
logical field for mental health counselors to embrace in order to
understand
the complex mechanisms underlying mental health disorders.
The field of
neurocounseling, the “integration of neuroscience into the
practice of coun-
seling” (Russell-Chapin, 2016, p. 93), although in its infancy,
has already shed
new light on how counselors conceptualize and treat clients.
Neuroscience
findings have profound implications for the field of counseling
and provide a
heuristic for counselors to use evidence-based treatments with
clients with a
history of ACEs (Navalta, McGee, & Underwood, 2018).
Neuroscientists have
identified forms of psychosocial engagement, such as nurturing
and caring,
healthy behaviors, and environmental enrichment, that promote
neuroplasti-

246 ^ Journal o f Mental Health Counseling
Fostering Intrinsic Resilience
city (Gonqalves & Perrone-McGovern, 2014), the brain’s ability
to reorganize
structural neural connections.
One way the brain does this is through a process called memory
recon-
solidation. According to Tronson and Taylor (2007), memories
that have been
learned, or achieve neuronal consolidation, can become labile
when activated.
During this labile phase, a memory can become either
reconsolidated or
transformed if contradictory information is presented within a
window of time.
Tronson and Taylor (2007) argued that this process is distinct
from the extinc-
tion process in classical conditioning. This finding has clear
implications for
emotionally learned processes such as phobias, trauma-related
disorders, and
some aspects of other anxiety disorders.
In addition, neurons are understood to fire when people feel,
think, and
behave. Interestingly, neuroscientists have found that mirror
neurons fire in a
similar pattern when we observe others feeling, thinking, and
behaving (Ivey
& Zalaquett, 2011). Mirror neurons have implications for

counselors’ use of
empathy and for work with clients who have difficulty
empathizing with oth-
ers. The study of brain networks in neuroscience has
strengthened the theory
that the brain does not work in isolated sections, but in
functionally connected
regions. This paradigm has led neuroscientists to hypothesize
“pathways” that
communicate among the brain’s structures. Some of the brain
networks that
have been proposed are the default mode network (resting
state), attention
network, social cognition network, motivational network, and
emotional regu-
lation network (Gongalves & Perrone-McGovern, 2014). As
implied by these
names, these networks facilitate (or do not facilitate) many of
the functions
addressed in counseling.
Though these neuroscience concepts have clear implications for
coun-
seling, counselors may still be at a loss for what to do with
them. One concern
is that integrating neuroscience into counseling would be
reductionist. For
instance, neural bases have been used to explain mental health
disorders such
as posttraumatic stress disorder (PTSD), depression, and anxiety
disorders
(Grawe, 1997). Some may be tempted to localize a disorder to a
specific cere-
bral region and neglect social, cultural, and interpersonal
factors. However,
neuroscientists have long viewed the brain as a dynamic system

with complex
networks (Cole, 1978), and more recently as a system that
informs and is
shaped by the social and interpersonal environment (Siegel,
2012). Though
it may be tempting to reduce mental health conditions to a
specific region of
the brain, research supports a reciprocal view of the interaction
between the
brain and the environment. Therefore, a comprehensive and
pragmatic model
is needed, one that integrates social and regulatory factors that
counselors can
use to inform assessments, hypotheses, and treatment decisions.
^ Journal of Mental Health Counseling 247
Linear counseling models have been offered to consider the
complex
neural processes that occur during the counseling process and
how these
processes affect or are affected by the environment. Decety &
Jackson (2004)
outlined the parallel neural processes that occur during key
components of
empathy, such as self-awareness, mental flexibility, and
emotion regulation.
Gonsalves and Perrone-McGovern (2014) presented a linear
model that posits
the interpersonal and environmental factors that influence the
psychological
process, which in turn affect brain networks, which impact
developmental
tasks. Though these models effectively integrate neuroscience

and counseling,
they fail to address the reciprocal interaction between the brain
and the envi-
ronment.
THE RECIPROCALLY DETERMINANT BRAIN-BODY
MODEL
Our approach extends the reach of current counseling
interventions
that address the aftermath of ACE exposure and acknowledges
the interactive
influence of environment and behavioral patterning within the
brain and
body. This addition to current family and social systems
approaches assumes a
reciprocal relationship among environment, behavior, person,
and physiology
(brain-body).
Regarding research on neurobiophysiological factors of
development
(Siegel, 2012; van der Kolk, 2015), we extend the model of
reciprocal deter-
minism to include physiology, or the brain-body connection.
This extended
neurobiophysiological model of reciprocal determinism
provides a theoretical
framework for research examining how integrated therapies,
such as neuro-
feedback (NEB), facilitate the regulation of brainwave activity,
emotional and
behavioral self-regulation, and physiology. Further, the model
provides a con-
text for diagnosing maladaptive stress responses that may
present as a myriad of

symptom clusters and/or co-occurring disorders.
In our model, neurobiophysiological functioning such as the
vagal
response (i.e., fight, flight, or freeze; Porges, 2011) and neuro-
maladaptation
(Siegel, 2012) influences the interaction of the person,
environment, and
behavior. When the self-regulatory system does not adequately
develop or
is interrupted by environmental demands, hyperarousal becomes
chronic
(Levine, 1997), which in turn affects perception and behavior
toward the
current environment. Responses during developmental
experiences involve
neurological and physiological changes in the central and
peripheral nervous
systems (Porges, 2011). Based on an understanding of research
addressing the
brain-body connection, the use of cognitive and behavioral
therapies appears
insufficient to address maladaptive responses, as these therapies
only focus on
change in one aspect of the self system and not the entire
system.
F o s te rin g In tr in s ic R e s ilie n c e
Person
An individual’s personality and temperament have a
bidirectional rela-

tionship to behavior and environment. An individual who has
been exposed
to trauma during a developmentally sensitive period may have
maladaptive
patterns of coping and dissociation that can lead to poor health.
For example,
stressors early in life can cause dysfunction in the brain-gut
microbiota axis
and therefore increase the likelihood of disease and alter
cognitions, moods,
and emotions (Cryan & Dinan, 2012; Rhee, Pothoulakis, &
Mayer, 2009).
Behavior
An individual’s behavior can influence and be influenced by
their person
and environment. An individual who has been exposed to
trauma in a devel-
opmentally sensitive period may present with a myriad of
bidirectional mal-
adaptive behavioral responses, from aggression to juvenile
delinquency. For an
individual exposed to trauma, the reciprocally deterministic
nature of behavior
with environment and person can be better understood and
influenced through
an integrated lens. Maladaptive behaviors in adolescence, such
as aggression
and poor regulation, are mechanisms in reaction to a stimulus.
Responding to
stress involves internal systems such as the autonomic nervous
system (Porges,
2009) and is often a learned behavior (Bandura, 1978).
Autonomic dysregula-

tion, or hypersensitivity, may explain higher rates of conduct
problems such as
aggression and delinquency (Beauchaine, Gatzke-Kopp, &
Mead, 2007).
Environment
An individual’s environment from prenatal inception to death
includes
physical environment, attachment, and genetic expression. An
individual
who has been exposed to environmental trauma in a
developmentally sen-
sitive period may present a number of social and physiological
maladaptive
responses. Long-standing research on bonding and attachment
underlines the
importance of environment for healthy, adaptive development.
Insufficient
early childhood attunement (Bowlby, 1980) and connection can
lead to physio-
logical developmental delays as well as social maladaptation
later in life. Siegel
(2012) argued that attachment problems in adulthood may be
due to the lack
of secure attachment or bonding in developmentally sensitive
periods, leading
to problems in neurological integration.
Environmental context does not manifest solely in neurological
expres-
sion but also in genetic expression. Epidemiologists estimate
that genes can
explain approximately 10% to 20% of adverse health conditions.
The vast
majority of diseases are caused by a combination of, or

interaction between,
genes and the environment. Epigenetics, or “the study of
changes in gene func-
tion that are ... heritable and that do not entail a change in DNA
sequence”
(Wu & Morris, 2001), is a growing consideration for mental
health providers
(Simon-Dack & Marmarosh, 2014).
Brain-Body
Neural oscillations, or brainwaves, are one prominent way to
understand
the communication pattern between brain and body. Brainwaves
are theorized
to have a self-regulatory function based on behavior and
demands from the
environment. Looking at the function of each type of brainwave
shows us the
opportunities for regulation within those patterns. For example,
slow delta
waves are prominent during sleep; theta waves have high
amplitude during
light sleep and meditation; alpha waves are associated with
relaxed, detached
awareness; and beta waves are linked to a heightened state of
alertness and
critical thinking (Swingle, 2008).
However, when brainwaves become dysregulated, they can
become

unhelpful (Hamlin, 2011). For instance, Clark, Barry,
McCarthy, & Selikowitz
(1998) found that excess delta and theta bandwidths were
associated with
hyperactivity and inattention. Individuals with more magnitude
of beta waves
are more likely to develop alcoholism (Rangaswamy et ah,
2002). Hamlin
(2011) explained that these individuals seek alcohol, an external
source of per-
ceived relaxation, because they are unable to internally diminish
the amplitude
of beta waves, which have an arousing effect. Likewise, adverse
experiences
may require high beta waves, which are adaptive for being alert;
however, when
these patterns persist, they can lead to behaviors that are
maladaptive in other
environments (Hamlin, 2011).
CLINICAL IMPLICATIONS
The model provides counselors a framework to take a
reciprocally deter-
minant perspective of their clients’ presenting problems while
being sensitive
to the impact of ACEs (Felitti et ah, 1998) and aware of the role
of neurobio-
physiological processes as a response to interaction with the
environment and
underlying mechanisms for behavior (Siegel, 2012). Awareness
of ACEs has
grown in the counseling profession, and many counselors
include an assess-
ment of ACEs upon intake and through the conceptualization
process. The

model then facilitates client conceptualizations with
consideration for interac-
tions among ACEs, the person, their brain, and their
environment. Counselors
may use the model to make hypotheses about how these
interactions impact
development, mental health, behavior, physical health, and
physiology.
Underpinning the counseling profession are the principles of
wellness,
of a strengths-based focus, of the belief that intrinsic features of
resilience are
250 0 Journal o f Mental H ealth Counseling
F o s t e r i n g I n t r i n s i c R e s i l i e n c e
inherent in an individual, and of the internal capacity for change
and self-
healing (Rogers, 1951). Given these beliefs, many professional
counselors have
embraced the integration of mind-body work in clinical
practice. Examples of
mind-body-based interventions include mindfulness meditation
(Kabat-Zinn,
1982), dance/movement therapy (Payne, 2003), and somatic
experiential
therapy (Levine, 1997), to name a few. More and more
therapeutic modalities
have been developed that incorporate mind-body interventions
alongside
traditional talk-therapy methods such as acceptance and
commitment therapy

(Hayes, Luoma, Bond, Masuda, & Lillis, 2006), coherence
therapy (Ecker &
Toomey, 2008), dialectical behavior therapy (Linehan, 1993),
and eye move-
ment desensitization and reprocessing (Shapiro, 2001).
Counselors practicing
integrative therapeutic techniques are often looking for new
evidence-based
and neuroscience-informed interventions to support brain-body
healing. As
more counselors begin to understand the importance of
including biological
considerations in their assessment and treatment of clients, a
model from
which to conceptualize and treat clients is needed. Our model
illustrates how
biological considerations, such as brain activity, can
complement the counsel-
ing perspective. Our model suggests a need for greater
measurement of neuro-
biophysiological concerns as a part of the presenting problems
of our clients.
Neuro feedback
A readily accessible and safe technology, NFB is an ideal
methodology
integrating the current findings of neuroscience with the body’s
ability for
self-healing. A type of biofeedback, NFB uses
electroencephalogram (EEG)
and operant conditioning to guide clients toward optimal
cognitive flexibility
based on cortical electrical activity, also referred to as
brainwaves (Swingle,
2008). In an NFB session, a clinician applies sensors on the

client’s scalp. The
sensors detect brainwaves and feed the signal to computer
software, which
quantifies and transforms the data into auditory and/or visual
stimuli for the
client to observe, completing one of many reciprocal loops of
ongoing informa-
tion (Angelakis, Hatzis, Panourias, & Sakas, 2007).
The nature of NFB, however, has presented a unique challenge
for
researchers. Studies have found improved outcomes for a wide
range of prob-
lems in research spanning more than four decades. However,
few of these
studies have convincingly attributed the results to the specific
mechanism of
feedback of a particular brainwave (Thibault & Raz, 2017). The
double-blind
randomized clinical trial design is the gold standard for
minimizing most
threats to internal validity, but the reciprocal nature of NFB
presents numerous
challenges for this design. Recent innovations are thought to
have improved
the science of NFB. For instance, live Z-Score NFB training
allows the cli-
nician to contrast the clients’ brain activity to a normative
database, nesting
an individual’s performance within a social and statistical
context (Collura,

2017). However, a new model is needed for researchers to better
understand
the process of NFB. Although this article is practitioner
oriented, a model that
can be used by researchers and practitioners alike will improve
the ability for
these two professional activities to inform one another. In
addition, research is
needed to test and/or modify the reciprocally determinant brain-
body model.
Random control trial research is specifically needed to
contextualize the model
in order to further address current concerns about the efficacy
and scope of the
impact of NFB.
The reciprocal interaction among brainwaves, the computer
software’s
quantified analysis of the electroencephalogram data, the
perception of the
visual and auditory stimuli of NFB by the individual, and the
normative data-
base is inherently consistent with the reciprocally determinant
brain-body
model. This model may provide a framework for counselors to
integrate NFB
into their practice and easily apply research guided by the same
model.
Applying IS euro feedback
If inclined, counselors may integrate NFB into their evidence-
based prac-
tice. Extensive literature showing the effectiveness of NFB for a
wide range of
conditions dates back to the 1960s (Hammond, 2011). NFB has

been success-
fully integrated into treatment for individuals who have been
exposed to long-
term traumatic experiences during early development (Fisher,
2014). Recent
studies have shown long-term benefits for individuals with
attention-deficit/
hyperactivity disorder (ADHD) after treatment and at 6-month
follow-up (Van
Doren et ah, 2018) and with intractable epilepsy 10 years
following treatment
(Strehl, Birkle, Worz, & Kotchoubey, 2014). Recent meta-
analyses and reviews
have described NFB’s efficaciousness for PTSD (Panisch &
Hai, 2018) and
for criminal behavior associated with ADHD, schizophrenia,
substance use,
and psychopathy (Fielenbach, Donkers, Spreen, Visser, &
Bogaerts, 2018). In
addition, NFB can enhance performance for athletes (Xiang et
ah, 2018) and
visual artists (Shourie, Firoozabadi, & Badie, 2018) and can
improve cognitive
functioning (Reiner, Gruzelier, Bamidis, & Auer, 2018) and
creativity (Agnoli,
Zanon, Mastria, Avenanti, & Corazza, 2018) among healthy
adults.
Using the reciprocally determinant brain-body model, NFB can
be con-
ceptualized as a microcosm of the reciprocal flow of
information that occurs in
clients’ environments. Brainwaves, or cortical electrical
activity, are measured
with quantitative EEG (Niedermeyer & Da Silva, 2004), which
influences the

visual or auditory stimuli, functioning as the environment,
presented to the
client. The client then perceives the stimuli and allows the self
system, includ-
ing beliefs and brain activity, to adapt to the ongoing
environment. This cycle
occurs in real time and is ongoing throughout an NFB session
(Hammond,
2011).
CONSIDERATIONS FOR COUNSELORS
Adopting NFB into clinical practice requires careful
consideration of a
variety of questions, as Chapin (2016) comprehensively
described. Counselors
practicing in settings that focus on acute or short-term solution-
focused
interventions would not be ideal candidates for NFB.
Counselors working in
settings that provide longer-term therapy (20+ sessions) would
be excellent
candidates to integrate NFB into their practice. NFB therapy
requires multiple
and continuous sessions to activate sustained change in the
brain.
Counselors must consider ethical and legal issues applicable to
NFB.

Counselors are obligated to “practice only within the boundaries
of their com-
petence” (American Counseling Association [ACA], 2014, p. 8).
In keeping
with the ACA code of ethics, we recommend that interested
counselors receive
comprehensive training such as that designed by certification
agencies like the
Biofeedback Certification International Alliance or the
International Society
for Neurofeedback and Research. Certification involves didactic
coursework,
hours of hands-on practice, and supervision by a certified
clinician. No laws
currently require practitioners to be certified in NFB to provide
the service;
however, ACA (2014) ethical standards ask counselors to
practice “in specialty
areas new to them only after appropriate education, training,
and supervised
experience” (p. 8).
The American Mental Health Counselors Association (AMHCA,
2015)
code of ethics states that counselors in practice should maintain
confidential-
ity. Adequate NFB training involves case consultation after the
basic training.
Given that few experts in the field provide such consultation,
this service is
often done via videoconferencing. Therefore, counselors must
take precautions
to ensure they are in line with the AMHCA (2015) code of
ethics when dis-
cussing their clients’ NFB data electronically. Clients should
also be informed

during the consent process if their personal identifying
information will be
shared for case consultation purposes. Mental health counselors
must take
precautions to protect, store, transfer, and dispose of client
records including
NFB session and assessment data in a confidential manner
consistent with
applicable laws and regulations (AMHCA, 2015).
During the informed consent process, mental health counselors
must
provide information to clients that describes any potential risks
that could
occur with NFB. NFB is a Class II device approved by the US
Food and
Drug Administration for relaxation. However, clients should be
informed that
0 Journal of Mental Health Counseling 253
relaxation does not always mean feeling better immediately. For
instance, NFB
could increase self-awareness of anxiety the client had
previously denied. O ther
possible side effects of NFB include headaches, changes in
sleep patterns, or
irritability, but these are usually temporary and reversible
(Hammond, 2011).
T he importance of informing clients of these risks is reinforced
by the ACA
(2014), which states “counselors explicitly explain to clients the
nature of all
sendees provided ... such as ... techniques, procedures,

limitations, potential
risks, and benefits of services” (p. 4). This is especially
important given the lack
of regulations on NFB and the am ount of information that is
still unknown
about brain activity.
Counselors must also consider the age and typical symptom
presentation
of the clients with whom they work. Although NFB has shown
promising find-
ings with children with ADHD, few clinical studies have
included children
younger than 7 in their sample (Van Doren et al., 2018). This is
due in large
part to rapid cortical maturation in gray matter volume during
the critical early
years of child development (Sowell, Thompson, & Toga, 2004),
and NFB may
not be an effective treatment during this time period. Given
this, counselors
who work primarily with small children may choose to forgo
incorporating
NFB into their practice. Additionally, although NFB may be an
effective treat-
m ent for some individuals presenting psychotic symptoms
(McCarthy-Jones,
2012), counselors must be careful to assess the severity of the
symptoms and the
individual’s capacity to understand the treatment so as not to
become triggered
by the treatment procedure itself. Severely acute individuals
suffering from
active phase psychosis would not be appropriate candidates for
NFB treatment.
Counselors must also be mindful of a client’s mental health

history so as not to
trigger a psychotic episode in an individual prone to psychosis.
Another consideration for counselors contemplating NFB is cost
(Chapin,
2016). NFB devices can cost anywhere from $3,000 to $50,000
or more,
depending on the type of technology used. Counselors would
also need NFB
software and a subscription to training packages in addition to
supplies such as
sensors, ear clips, alcohol swabs, and syringes. In an effort to
make NFB devices
more accessible for practitioners, many NFB device distributors
offer monthly
rental or financing plans. Despite these options, the cost can be
a barrier of
entry for many practicing counselors.
DISCUSSION
Counselors have the capacity to utilize theory and research from
other
fields to affect positive change. The clinical application of
counselor training
with a focus on wellness opens the door for the counseling
profession to inte-
grate theory and knowledge from the fields of cognitive
psychology, neurology,
F o s te rin g In trin s ic R es ilie n ce

and psychiatry. Our model draws from these professions and
provides a deeper
understanding of the part mental health plays in overall
functioning and
well-being. This new conceptualization offers a map to guide
counselors to aim
fora variety of possible treatment outcomes. These potential
outcomes include
improved sleep patterns; adaptive interpersonal relationships;
increased emo-
tional regulation, resilience, self-control, attention, and
executive functioning;
and decreased digestive problems, substance dependence,
anxiety, depression,
and delinquent or aggressive behaviors. Moreover, the model
highlights the
need to incorporate more mind-body theories and interventions
in counseling.
Mind-body interventions can have positive effects in the
domains of physio-
logical response, physical health, social and emotional health,
mental health,
and behavior (Jayawardene, Bebe, Lorhmann, & Torrabi, 2017).
With the
raised awareness of the impact of trauma (van der Kolk, 2015)
and the need
for evidence-based mind-body interventions, counselors have
the opportunity
to advocate for trauma-exposed individuals on an individual and
societal level.
Integrative therapies, such as NFB, when used from a
counseling perspective,
offer an accessible mind-body modality that works within a
whole-person
model of conceptualizing exposure to childhood trauma and
ways to treat it

(Fisher, 2014). Flowever, ethical issues, such as competence
(ACA, 2014),
must be considered before incorporating new specialty areas
like NFB into
counseling practice.
0 Journal of Mental Health Counseling 255
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The Journal of Educational Research
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The association among literacy proficiency,
effortful control, and frustration
Su-Ying Huang & Li-Li Yeh
To cite this article: Su-Ying Huang & Li-Li Yeh (2019) The
association among literacy proficiency,
effortful control, and frustration, The Journal of Educational
Research, 112:2, 168-178, DOI:
10.1080/00220671.2018.1461599
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The association among literacy proficiency, effortful control,
and frustration
Su-Ying Huanga and Li-Li Yehb
aDepartment of Clinical Psychology, Fu Jen Catholic
University, New Taipei City, Taiwan; bDepartment of
Audiology and Speech-Language Pathology,
Mackay Medical College, New Taipei City, Taiwan
ARTICLE HISTORY
Received 12 December 2017
Revised 28 March 2018
Accepted 31 March 2018
ABSTRACT

The authors investigated the relationships among effortful
control and frustration and literacy proficiency
of preadolescence to determine which subcomponent of effortful
control and/or emotion might be critical
in achieving academic success. The participants included 72
children recruited from a larger longitudinal
study. Children’s frustration, effortful control, and literacy
skills were assessed at Grade 5, and their
nonverbal IQ levels were assessed at Grade 1. Effortful control
and frustration were measured by a self-
report questionnaire. Literacy proficiency was measured with
tests of reading comprehension, written
language, and the semestral grades in the subject of Chinese
literacy. Results showed that children with
higher effortful control perception had better literacy abilities,
particularly writing and language academic
achievement. The dispositional frustration moderated the
predictive effect of attention control on
children’s reading comprehension. The findings support the
importance of self-regulation and emotions
on literacy proficiency.
KEYWORDS
Effortful control; frustration;
literacy proficiency; self-
regulation; temperament
Preadolescence is a transitional stage between childhood and
adolescence, during which self-regulation skills—often associ-
ated with children’s ability to adjust—continue to develop
(King, Lengua, & Monahan, 2013). Preadolescents may seek
recognition from their families and among their peers by
achieving academic success, which is based on good literacy
skills. Literacy is a new mode of communication that children
need to learn as they begin formal schooling. Reading and writ-
ing are the receptive and expressive aspects of literacy, respec-

tively, and serve as the foundation of one’s learning of other
subjects. A previous study has shown that children with better
effortful control are more likely to perform better academically,
such as in the area of literacy acquisition (Blair & Razza, 2007).
In addition, emotions are functionally important in ensuring
good academic performance (Pekrun, 2009). However, the key
effects of effortful control and negative moods on the literacy
performance of preadolescents have yet to be systematically
investigated.
Effortful control is a dispositional, higher-order self-regula-
tion of one’s temperament. It refers to one’s ability to perform
effectively in a conflict situation, which requires one to demon-
strate attention control, inhibit a dominant response, or acti-
vate a goal-directed response (Posner & Rothbart, 1998;
Rothbart, Derryberry, & Posner, 1994). Effortful control sup-
ports individual attainment of competence-related goals
(Rothbart & Hwang, 2005) and is related to school adaptation
(Blair, 2002). For adolescents, effortful control is constantly
developing and becoming more crucial, particularly for those
who display more intense negative emotions when it comes to
facing challenging situations (Oldehinkel, Hartman, Ferdinand,
Verhulst, & Ormel, 2007).
Effortful control emerges from the end stage of infancy,
markedly increases during preschool, and continues its devel-
opment into adolescence (Rueda, Posner, & Rothbart, 2011). It
is a broad construct consisting of specific components, namely,
attention control, inhibitory control, and activation control
after middle childhood (i.e., around 8 years old; Putnam, Ellis,
& Rothbart, 2001). Effortful control not only is influenced by
biological factors, but also can be shaped by environmental fac-
tors, such as family context and parental practices (Rothbart &
Bates, 2006). Given that literacy acquisition requires complex
processing (e.g., encoding and decoding signals, comprehend-
ing and composing passages) and also emerges from the pre-

school period, there is a growing interest in the regulation
processes involved in children’s literacy acquisition (e.g., Blair
& Razza, 2007; McClelland et al., 2007).
Emotions are crucial contributors to students’ motivation,
interpersonal resources, memory, and learning (Valiente,
Swanson, & Eisenberg, 2012). Specific emotions relate to child-
ren’s development for different reasons, thus requiring an
assessment of specific types of emotions, instead of using broad
composites, such as emotionality (Rothbart & Bate, 2006;
Valiente et al., 2012). Anger or frustration, as negative emo-
tions, involves a tendency to experience an unpleasant affect,
which can be led by goal blocking. The kind of emotion may
increase when children enter school because this is where they
face more academic expectations from themselves or others
(Eisenberg et al., 2005).
Thus far, the direct association between negative emotions
and academic achievement has not been fully examined
(Valiente et al., 2012), particularly for the critical period of
liter-
acy and effortful control acquisition (i.e., at the preadolescence
CONTACT Dr. Li-Li Yeh [email protected] Department of
Audiology and Speech-Language Pathology, Mackay Medical
College, No.46, Sec. 3, Zhongzheng
Rd., Sanzhi Dist., New Taipei City, Taiwan.
© 2018 Taylor & Francis Group, LLC
https://doi.org/10.1080/00220671.2018.1461599
THE JOURNAL OF EDUCATIONAL RESEARCH
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stage). In addition, given that the direct associations between
specific measures of negative emotion and achievement are at a
modest level (Valient et al., 2012), the potential indirect effects
of emotion must also be investigated (Blair, 2002).
Role of effortful control on literacy acquisition
Effortful control is significantly associated with preschoolers’
prerequisite literacy skills, such as phonemic awareness and let-
ter knowledge, and must be strengthened for children from low
socioeconomic status families to avoid possible school failures
(Blair & Razza, 2007). For 7- to 12-year-old children, the
global
effortful control score as reported by parents, is positively
related to children’s grade point average in language, vocabu-
lary, and mathematics (Valiente, Lemery-Chalfant, Swanson, &
Reiser, 2008). Furthermore, global effortful control at Grade 1
significantly predicted academic performance in mathematics
and Chinese four years later among Chinese children (Zhou,
Main, & Wang, 2010). McClelland et al. (2007) indicated that
the specific components of effortful control (e.g., attention con-
trol, inhibitory control) are positively related to letter-word
identification and the vocabulary ability of preschool children.
Attention control, including attention focusing and shifting,
is a more cognitively oriented component of effortful control.
Past studies have reported the direct link between academic
competence and attention control, which serves as a key factor
in promoting academic achievement and learning (Liew, 2012;
Valiente et al., 2008). Children who have difficulty directing
their attention are more likely to experience significant chal-

lenges when trying to learn educational materials (Valiente
et al., 2008). Empirical data have shown that children who have
difficulty focusing their attention often have poor reading and
language skills (McGee, Partridge, Williams, & Silva, 1991;
Tamis-LeMonda & Bornstein, 1989). Attention control can
also regulate emotions and limit the impact of (anxiety) emo-
tion on information processing (Derrybery & Reed, 2002).
Inhibitory control and activation control are two behavioral
regulation components of effortful control. First, inhibitory
control is the ability to appropriately inhibit a dominant
response or desirable behavior (Putnam & Rothbart, 2006).
Associated with emotional adaptation, inhibitory control rap-
idly develops with marked improvement during childhood
(Lengua, 2003; Williams, Ponesse, Schachar, Logan, &
Tannock, 1999). However, its contribution on academic success
are inconsistent. For example, Blair and Razza (2007) indicated
that the inhibitory control by direct measurement is positively
associated with the letter knowledge of preschoolers. Neverthe-
less, the inhibitory control of parents’ rating does not have a
significant association with children’s literacy abilities. The
inconsistency among past studies may be attributed to different
test environments or the design of tasks conducted among vari-
ous studies.
Meanwhile, activation control is the ability to plan new
actions; it also refers to the ability to perform the appropriate
action when there is a tendency to give up, when people are
experiencing challenges or failures, or when individuals are
facing detestable learning tasks (Posner & Rothbart, 1998;
Rothbart et al., 1994). In stressful situations, such as when
people are facing challenges or failures, they may also need to
force themselves to take action to ameliorate the situation.
Activation control is the key that enables an individual to per-
form unpleasant activities, which can be helpful in achieving

one’s long-term goals (Ellis, 2002). Literacy acquisition
requires complicated processing. For example, when writing
an assignment, children need to actively engage and initiate
behaviors to work on tasks that they may otherwise want to
avoid. However, to our knowledge, no study has yet to directly
examine the role of activation control on the literacy abilities
of school-age children.
In summary, although evidence has proven that effortful
control has a direct link with children’s literacy in early child-
hood, few studies have focused on school-age children, particu-
larly preadolescents. Aside from analyzing effortful control in
general, studying both the direct and indirect predictive effects
by examining various components of effortful control can also
improve our understanding of whether any specific component
of effortful control is uniquely predictive of academic achieve-
ment (Valiente et al., 2008), and whether specific components
are associated with literacy performance.
Association between frustration and literacy acquisition
Different negative moods may have varying associations with
academic performance (Schwarz, 2001), and an increasing
number of studies have focused on the association between
anxiety-related emotions and academic performance (e.g.,
Duchesne, Vitaro, Larose, & Tremblay, 2008; Zeidner, 2007),
particularly in how different negative moods may have varying
predictive effects on academic performance (Schwarz, Chang,
& Farver, 2001). Clarifying the relationship between emotions
and achievement by specific types of emotions—instead of
using broad composites, such as negative emotionality—is
helpful in understanding the role of emotions in developing
academic competence (Valiente et al., 2012).
Anger or frustration, as negative moods, may reduce
achievement, because they disrupt cognitive resources, motiva-

tion, and the use of flexible strategies (Blair, 2002; Rice,
Levine,
& Pizarro, 2007). According to previous studies, children’s
frus-
tration at school is correlated negatively with their academic
self-efficacy, self-regulation of learning, and academic perfor-
mance (Boekaerts, 1993; Pekrun, Goetz, Per, Kramer, &
Hochstadt, 2004). Zhou et al. (2010) found that, based on
teachers’ reports, Chinese children who had higher levels of
dis-
positional anger or frustration from 6 to 9 years old also had
lower levels of academic performance (i.e., grade point aver-
age). Furthermore, Blair (2002) proposed that emotions have
an important contribution on the self-regulation of children, as
they have not fully developed their cognitive and higher-order
regulative abilities. Rothbart and Hwang (2005) also claimed
that the efficiency of effortful control depends on the strength
of the dominant response, such as emotional reactivity.
Effortful control demand and frustration reaction during
reading and writing
Reading is an activity that is significantly correlated with both
decoding skills and language comprehension. The correlations
between word recognition and reading tend to decline with
THE JOURNAL OF EDUCATIONAL RESEARCH 169
grade level, and the correlations between comprehension and
reading tend to increase with grade level (Gough, Hoover, &
Peterson, 1996). If frustration is more likely to arise when
ongoing tasks are interrupted or when goal blocking occurs
(e.g., Zhou et al., 2010), factors associated with reading
fluency,

such as word recognition skills or higher-level language com-
prehension skills, may relate to experience of frustration. In
other words, before school-aged children develop mature read-
ing skills, particularly for early adolescents, frustration may
eas-
ily occur, especially when their goal for reading is mismatched
to their academic assignments and texts (Graesser & D’Mello,
2012).
Writing consists of several processes, such as text construc-
tion, handwriting, spelling, executive function, and working
memory for accessing or selecting appropriate vocabulary
(Owens, 2011). Therefore, compared with reading, writing as
actively generating text may demand more self-regulatory skills
to select and sustain attention, organize ideas, and control
social and affective behavior (Ylvisaker & DeBonis, 2000).
Unless it is under time pressure, writing itself emphasizes less
on nonstop or fluent processing than reading. For early adoles-
cents, compared with early writing skills, such as spelling or
orthography knowledge, text generation is more critical to their
writing performance (Owens, 2011).
Aims and research questions for this study
The aim of this study was to investigate whether children’s own
perceptions of their effortful control and frustration had a rela-
tive contribution to their literacy proficiency after their gender,
age, and nonverbal IQ were controlled. The research questions
are as follows:
Research Question 1: Does global effortful control predict
the concurrent literacy proficiency? Is there any signifi-
cant prediction effect between global effortful control
and various indicators of literacy proficiency, such as
reading comprehension, written expression, and semes-
tral literacy test grade, while controlling for gender,

nonverbal IQ, and age?
Research Question 2: How do the specific components of
effortful control relate to different indicators of literacy
proficiency?
Research Question 3: Does children’s dispositional frustra-
tion have not only a direct predictive effect on children’s
literacy proficiency, but also an indirect predictive effect
on the influence of effortful control toward literacy
proficiency?
Methods
Participants
Seventy-two Mandarin-speaking children (33 boys and 39 girls)
in Taiwan, who were earlier recruited for a larger longitudinal
study, were involved in the current longitudinal first- and sec-
ond wave studies. At Wave 1, the children were in Grade 1;
Wave 2 occurred four years later when the children were in
Grade 5, with an average age of 10.77 years (SD D 0.27 years,
age range D 10.17–11.17 years).
Measures
Nonverbal IQ
The children’s nonverbal IQ scores at Grade 1 were assessed
using Tonic Test of Nonverbal Intelligence (TONI-3; Brown,
Sherhenou, & Johnsen, 1996).
Effortful control
The short form of the Chinese version of the self-report ver-
sions of the Early Adolescence Temperament Questionnaire-
Revised (EATQ-R; Putnam et al., 2001) were employed to
assess 9- to 15-year-old children’s effortful control (Ellis &

Rothbart, 2001). The three subtasks of effort control include
attention control (6 items, e.g., “It is easy for me to really con-
centrate on homework problems”), inhibitory control (5 items;
e.g., “When someone tells me to stop doing something, it is
easy for me to stop”), and activation control (5 items; e.g., “If I
have a hard assignment to do, I get started right away”). Items
were rated on a 5-point Likert-type scale ranging from 1
(almost never true or almost always untrue) to 5 (almost always
true). The EATQ-R is a valid and consistent scale employed to
assess children and adolescents’ temperament, including effort-
ful control. The Cronbach’s alpha values ranged from .67–.76
(Muris & Meesters, 2009).
Frustration
The anger-frustration subscale of the negative emotionality in
EATQ-R was used to measure the negative effects related to the
interruption of ongoing tasks or goal blocking in children. The
Cronbach’s alpha value of the 7-item test used in the current
study was .72.
Reading comprehension
Reading comprehension was measured using a paper-and-pen-
cil task from a published Test of Reading Comprehension (Lin
& Chi, 2000), which was designed for pupils in Grades 2–6. It
is a standardized test that was published by the Minister of
Education in Taiwan. In addition, it is a popular test employed
by elementary teachers in Taiwan to assess pupils’ reading
comprehension competence. This was a group test that took
around 45 min to complete. The reading comprehension test
contained six narrative passages and six expositive passages
fol-
lowed by multiple questions. The test assessed the children’s
skills of phonological recoding, syntactic parsing, semantics,
comprehending facts explicitly as stated in the text, deriving
main ideas from the text, making inferences, and comparing or
analyzing the facts stated in the text. The total raw score of the

test is 100. The test manual reports internal consistencies rang-
ing from .88 to .98 and test–retest reliability of .89.
Written expression
Written language skills were assessed by a paper-and-pencil
task from a published Test of Written Language (Lin & Chi,
2002) designed for pupils in Grades 3–6. This was a group test
that took around 1 hr to complete. It is a standardized test that
was published by the Minister of Education in Taiwan. It is one
of the popular tests used by elementary teachers in Taiwan to
assess pupils’ written expression competence. The written lan-
guage test consisted of five subtasks, including listening-
S.-Y. HUANG AND L.-L. YEH170
writing, sentence combination, correction of characters, and
clause and sentence construction. The total raw score of the
test is 100. The test manual reports internal consistencies rang-
ing from .76 to .97 and test–retest reliabilities of .79–.94.
Language academic achievement in terms of semestral
grades
Individual children’s grades were used to obtain measures of
children’s academic competence in the domain of Chinese liter-
acy. At the conclusion of the semester in January boundary
2014, we obtained the mid- and final-term grades, and the aver-
age of the two examinations served as a composite of each stu-
dent’s academic achievement. The semestral grades of Chinese
literacy test consisted of word recognition, semantic discrimi-
nation of a variety of words, reading comprehension of text-
book or passages, the structure and format of articles, and
sentence construction.
Procedure

All participants were recruited from Mandarin-speaking ele-
mentary schools in North Taiwan during the 2009 and 2013
fall semester. At Grade 1, the nonverbal IQ of each child was
individually assessed using the TONI-3 in school settings. At
Grade 5, the children were assessed for Chinese comprehension
and written ability. Self-report versions of the EATQ-R for
children’s frustration and effortful control were also used. Only
the test of nonverbal intelligence and reading comprehension
was administered to groups. The average scores of academic
achievement of language at Grade 5 were also collected.
Analysis
Before the hypothesis testing of the research topic, gender dif-
ference analysis for all the variables was computed by separate
multivariate analyses of variance. Next, the zero-order correla-
tions among study variables were examined. Finally, hierarchi-
cal regressions were conducted to test whether children’s
frustration, overall effortful control, and the three components
of effortful control predicted their reading comprehension,
written expression, and semestral Chinese literacy test grades
after controlling for children’s gender, age, and nonverbal IQ.
Preliminary analysis
Data were combined before analysis because no significant gen-
der difference was found in all variables. Table 1 presents the
means, standard deviations, and the Pearson correlation coeffi-
cients for all study variables. The IQ score of all the children
ranged from 82 to 134, with an average of 102.29 (SD D 10.77),
and all the participants’ scores were above ¡1.5 SD, that is,
within the normal range. The cohort’s performance of reading
comprehension test ranged from 30 to 95, with an average of
76.42 (SD D 11.66). Only one participant had a score lower
than the 15th percentile of the norm. However, the score was

still above ¡1.5 SD according to the norms for 9-year-olds.
Given that EATQ-R is suitable for 9- to 15-year-old preadoles-
cents, it was thought that the participants’ reading comprehen-
sion would allow them to finish the questionnaire and its
results had validity.
Correlation analyses
The analysis of zero-order correlations showed that children’s
age positively correlated with reading comprehension and writ-
ten expression, rs(70) D .27 and .31, ps D .022 and .009, respec-
tively. In addition, nonverbal IQ positively correlated with
written expression and semestral literacy test grades, rs(70) D
.23 and .37, ps D .056 and .001, respectively. There was no sig-
nificant correlation between frustration and children’s reading
comprehension, written expression, and semestral literacy test
grades.
Effortful control was positively associated with attention as
well as inhibitory and activation control, rs(70) D .75, .62, and
.76, respectively, ps < .001. Reading comprehension and writ-
ten expression were positively related with semestral literacy
test grades, rs(70) D .49 and .60, respectively, ps < .001. Effort-
ful control was positively correlated with children’s written
expression and semestral literacy test grades, rs(70) D .27 and
.26, ps D .024 and .03, respectively. Attention control of
Table 1. Descriptive statistics and correlations for all variables
in this study (N D 72).
Variable 1 2 3 4 5 6 7 8 9 10 11
1. Gender —
2. Age .04 —
3. Nonverbal IQ .21 ¡.15 —
4. Frustration .02 .10 .06 —
5. Effortful control .00 ¡.07 .08 ¡.18 —
6. Attention control ¡.03 ¡.06 .10 ¡.22y .76*** —

7. Inhibitory control .05 ¡.06 .06 ¡.16 .62*** .45*** —
8. Activation control .04 ¡.10 .03 ¡.20 .76*** .68*** .38** —
9. Reading comprehension ¡.17 .27* .20 .00 .21 .17 ¡.01 .17 —
10. Written expression ¡.14 .31** .23y ¡.03 .27* .32** .12 .23y
.48*** —
11. Semestral score of literacy ¡.08 .21 .37** ¡.06 .26* .22y .13
.23* .49*** .60*** —
Descriptive Statistics
M — 10.77 102.29 3.11 3.46 3.49 3.43 3.46 76.42 65.58 88.1
SD — 0.27 10.77 0.77 0.58 0.66 0.67 0.81 11.66 12.38 7.75
yp < .08.
�p < .05.
��p < .01.
��p < .001.
effortful control was positively and marginally associated with
written expression, r(70) D .32, p < .01, and semestral literacy
test grades; r(70) D .22, p D .065. Activation control was mar-
ginally and significantly associated positively with written
expression and semestral literacy test grades, rs(70) D .23 and
.23, ps D .054 and .047, respectively.
Regression analyses
Three hierarchical regression equations were created to predict
each of the three indicators of literacy proficiency, including
reading comprehension, written expression, and semestral liter-
acy test grades. Given that gender and IQ were previously cor-
related with children’s literacy ability, and the children’s ages
were correlated with literacy ability, all three variables were
entered as control variables at Step 1 in each of the regressions.
In Step 2, frustration, overall effortful control, the three compo-

nents of effortful control (attention control, inhibitory control,
and activation control) were entered. Then, the interaction var-
iables of frustration and global effortful control, along with the
three components of effortful control, were respectively entered
in Step 3.
Results
Predicting the contribution of frustration and effortful
control on reading comprehension
Table 2 presents the contribution of frustration, global effortful
control, and the three components of effortful control on read-
ing comprehension. As can be seen, the control variables of
gender, age, and nonverbal IQ made unique contributions to
reading ability in any of the four regressions at Step 1. These
variables respectively accounted for 19% of the variance, F(3,
68) D 5.24, p D .003. Gender (b D –.24), t(71) D –2.13, p D
.037; age (b D .33), t(71) D 2.94, p D .001; and nonverbal IQ (b
D .31), t(71) D 2.66, p D .01; significantly positively predicted
children’s reading comprehension in the four models.
After considering the effects of the three variables, we found
that effortful control, attention control, inhibitory control, and
activation control had no significant contributions (bs D .19,
.15, .01, and .20, respectively; ps > .09), and that frustration
had no significant association with reading comprehension.
Further results for the reading comprehension model indi-
cated that there was a marginally significant two-way interac-
tion between frustration and effortful control (b D –.20), t(71)
D ¡1.91; DR2 D .04; F(1, 65) D 3.63, p D .061. As depicted in
Figure 1, the relation between effortful control and reading
comprehension was positive and stronger for lower frustration
children (b D .42), t(71) D 2.62, p D .011. However, among
children with high levels of frustration, effortful control was

not significantly predictive of reading comprehension (b D
.14), t(71) D 0.89, p D ns. The results indicated that a low-
level,
frustration with high effortful control ameliorated children’s
reading comprehension.
Further results for the reading comprehension model indi-
cated that there was a two-way interaction between frustration
and attention control (b D –.36), t(71) D –3.48; DR2 D .12, F(1,
65) D 12.10, p < .01. The interaction variable significantly
added to the regression model (12%). As depicted in Figure 2,
attention control was positively predictive of reading compre-
hension among children with low frustration. However, the
simple slope analysis showed that such a difference was not sig-
nificant (bs D .11 and .15), ts(71) D 0.28 and 1.37, p D ns.
Prediction of frustration and effortful control on written
expression
Written expression was regressed against the variables that
were entered in blocks, similar to the reading comprehension
variable. Table 3 shows the results of the hierarchical
regression
analysis for predicting written expression. Similar to the results
of reading comprehension, the control variables of gender, age,
and nonverbal IQ made unique contributions to written
expression in any of the four regressions at Step 1. These mod-
els accounted for 22%, F(3, 68) D 6.23, p < .01, of the variance.
Gender (b D –.22), t(71) D –2.01, p D .049; age (b D .36), t(71)
D 3.35, p D .001; and nonverbal IQ at Grade 1 (b D .32), t(71)
D 2.93, p D .005; significantly positively predicted children’s
written expression in the four models.
After considering the above variables, frustration and global
effortful control, attention control, and activation control of

effortful control all added a significant amount of variance to
these three models (7%, 9%, and 7%; bs D .25, .32, and .26), ts
(71) D 2.34, 2.82, and 2.39, ps D .022, .006, and .02, respec-
tively. Children who had higher levels of effortful control,
attention control, and activation control also had better written
expression skills. However, the frustration and inhibitory con-
trol did not have a significant effect. Further results from Step 3
for the written expression model indicated that there was no
significant two-way interaction between frustration and global
effortful control and the three components of effortful control.
Prediction of frustration and effortful control on the
semestral literacy test grades
Table 4 shows the contribution of frustration and effortful con-
trol in predicting the semestral literacy test grades. Results
showed that children’s age and nonverbal IQ were two major
contributors to the children’s semester literacy test grades.
However, the children’s gender did not have a significant asso-
ciation with their grades. Frustration, inhibitory control, and
attention control did not have a significant predictive effect on
children’s semestral literacy test grades; in comparison, global
effortful control and activation control had significant associa-
tion with semestral literacy test grades (bs D .22 and .24), ts
(71) D 2.09 and 2.28, ps D .04 and .026, respectively. The two-
way interaction effect between frustration and effortful control
or any component was not proven.
Discussion
The goal of this study was to investigate whether children’s per-
ceptions of their effortful control and frustration may predict
their literacy proficiency. The key findings revealed that
children
with higher effortful control perception had better literacy abili-
ties, particularly writing and language academic achievement.

The association of effortful control components with children’s
literacy proficiency also proved to be dependent on literacy
Ta
b
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2.
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s
of
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indicators. Attention control positively predicted children’s
writ-
ing ability. Activation control also had a direct association with
writing ability and semestral language academic performance
after controlling the basic variables. Meanwhile, no significant
association of inhibitory control and any indicator of literacy
pro-
ficiency was found. In addition, dispositional frustration had no
direct predictive effect on preadolescents’ literacy proficiency;
however, frustration moderated the predictive effect of attention
control on children’s reading comprehension.
Role of effortful control in the development of literacy
proficiency
In terms of the first research question, the results showed that
preadolescents’ overall perceptions about their behaviors and
attention regulation did account for the unique variance in
writing- and literacy-related academic achievements in task-
directed performance, even when children’s gender, age, and
IQ were controlled. In line with previous studies (e.g., Valiente
et al., 2008; Zhou et al., 2010), the results implied that effortful
control perception was closely associated with children’s ability
to perform effectively in school. In addition, consistent with
previous studies (e.g., Ylvisaker & DeBonis, 2000), the results
indicated that written expression and semestral literacy test
seemed more closely associated with intentional control than
receptive reading tasks for preadolescents, given that the per-
formance on writing and semestral grading both significantly
related to global effortful control. In other words, the results

suggested that different underlying mechanisms of reading,
writing, or taking a literacy exam may require different compo-
nents or levels of effortful control to perform well.
Association between effortful control components
and indicators of literacy proficiency
Regarding the second research question, our results showed
that the specific component of effortful control was associated
with the different indicators of literacy proficiency. However,
only attention control and activation control were closely tied
to literacy ability for early adolescents. The results implied that
during expressive written tasks, if a preadolescent pays enough
attention and repeatedly activates his or her focus on the tasks
at hand, he or she may have a greater chance of achieving a bet-
ter performance in the writing assignment or literacy exam. In
addition, a possible reason for the absence of a significant rela-
tionship between any literacy indicators and inhibitory control
may be the matureness of inhibitory control for high-grade
pupils who had already adapted to task-conducting situations
(Eisenberg et al., 2005; Williams, Ponesse, Schacha, Logan, &
Tannock, 1999); thus, more inhibitory control would not be
linked to their performance on either the literacy assessment or
literacy exam. It was also possible that inhibitory control had
an indirect predictive effect on academic performance through
social and motivation processes (Valiente et al., 2008).
Relative contribution of dispositional frustration
on literacy proficiency
Finally, in terms of the third research question, the significant
linkage between frustration and attention control, and a mar-
ginal moderator of global effortful control on reading compre-
hension, were found in the study. Given that inhibitory control
and activation control relates to the regulation of impulsive
behaviors and those involved in stressful situations, and less

related to the adjustment of the emotion itself; therefore, no
direct association of frustration was expected. The results sug-
gest that anger-frustration related to the disfluency of reading
(e.g., Zhou et al., 2010) or children’s goal for reading is mis-
matched to their academic assignments and texts (Graesser &
D’Mello, 2012), which is more likely to impede the positive
association between attention regulation and reading compre-
hension. The results support the notion that the indirect model
(Blair, 2002) is valuable in understanding the mechanism of
which emotion correlates with children’s literacy ability and
academic achievement. In addition, the finding also supports
the assumptions that the efficiency of effortful control depends
on the strength of the dominant response or the strength of
emotion reactivity (Rothbart & Hwang, 2005), and that nega-
tive emotion may be associated with lower academic achieve-
ment by disrupting subject’s cognitive resources (Blair, 2002;
Rice et al., 2007).
Clinical implications
The findings of this study have implications on the importance
of facilitating children’s development of effortful control, par-
ticularly attention control and activation control so that their
84.38 83.57
80.04
89.69
70
75
80

85
90
95
Low High
R
ea
di
ng
C
om
pr
eh
en
si
on
Effortful Control
Frustration: High Frustration: Low
Figure 1. Effortful control and reading comprehension for high
and low levels of
frustration.
86.62
81.41

76.80
91.12
70
75
80
85
90
95
Low High
R
ea
di
ng
C
om
pr
eh
en
si
on

Attention control
Frustration: High Frustration: Low
Figure 2. Attention control and reading comprehension for high
and low levels of
frustration.
Ta
b
le
3.
Pr
ed
ic
ti
ng
w
ri
tt
en
ex
p
re
ss
io
n
fr
om

ch
ild
re
n’
s
fr
us
tr
at
io
n
an
d
th
e
th
re
e
co
m
po
ne
nt
s
of
EC
.
W
ri
ti
ng
ex

p
re
ss
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n
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ri
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p
re
ss
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n
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ri
ti
ng
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p
re
ss
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n
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ri
ti
ng
ex

p
re
ss
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n
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ic
to
rs
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SE
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rs
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Colorado V. Connelly479 U.S 157 (1986)Facts· Co.docx

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