Characteristics of auditory agnosia in a child with severe traumatic brain injury: a case report

We present a case that is unusual in many respects from other documented incidences of auditory agnosia, including the mechanism of injury, age of the individual, and location of neurological insult. The clinical presentation is one of disturbance in the perception of spoken language, music, pitch, emotional prosody, and temporal auditory processing in the absence of significant deficits in the comprehension of written language, expressive language production, or peripheral auditory function. Furthermore, the patient demonstrates relatively preserved function in other aspects of audition such as sound localization, voice recognition, and perception of animal noises and environmental sounds. This case study demonstrates that auditory agnosia is possible following traumatic brain injury in a child, and illustrates the necessity of assessment with a wide variety of auditory stimuli to fully characterize auditory agnosia in a single individual.     

Implementation of a comprehensive schoolwide behavioral intervention: The ABC program

The Academic and Behavioral Competencies (ABC) Program, a schoolwide program to reduce classroom disruption and encourage rule following, academic task completion, and homework completion, is described. The program was initially developed and implemented in an elementary school with a high-risk population. Data from teachers, parents, and children indicate high levels of satisfaction with the program. In addition, unobtrusive measures of program impact, reported as reductions in referrals to the principal's office, suspensions, and increases in homework completion rates relative to the year prior to implementation of the program, suggest a preliminary positive impact of the program. A replication is reported for another school district, with teacher evaluations of satisfaction and effectiveness reported, supporting the flexibility and adaptability of the program. Although the present article does not constitute a systematic evaluation of the ABC Program, it presents preliminary data on the process of implementation and stakeholder satisfaction.     

Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone

Cambodian refugees with posttraumatic stress disorder (PTSD) represent a cohort in severe need of treatment, but little information is available to guide treatment choices. We selected a sample of pharmacotherapy-refractory individuals to test the efficacy of combination treatment with sertraline and cognitive-behavior therapy (CBT) for treating PTSD. Participants in this pilot study were ten Khmer-speaking women who had been at a mean age of 22-26 years during the Pol Pot period (1975-1979). These patients were randomly assigned to either sertraline alone or combined treatment. We found that combined treatment offered additional benefit in the range of medium to large effect sizes for PTSD and associated symptoms. Our findings indicate that substantial gains can be achieved by adding CBT to pharmacotherapy for PTSD, and that a program of CBT emphasizing information, exposure, and cognitive-restructuring can be successfully modified for Khmer-speaking refugees.     

Promoting responsible conduct in research through “survival skills” workshops: Some mentoring is best done in a crowd

For graduate students to succeed as professionals, they must develop a set of general "survival skills". These include writing research articles, making oral presentations, obtaining employment and funding, supervising, and teaching. Traditionally, graduate programs have offered little training in many of these skills. Our educational model provides individuals with formal instruction in each area, including their ethical dimensions. Infusion of research ethics throughout a professional skills curriculum helps to emphasize that responsible conduct is integral to succeeding as a researcher. It also leads to the consideration of ethical dimensions of professional life not covered in traditional ethics courses.     

Self as verb and the metaphor of dance: An explanation of the self discovery experience within a constructivist framework

The concept of self discovery within a constructivist framework is difficult to explain given the central assumption of constructivism that self is a created construct rather than an entity to be discovered. Two problems are identified as impediments to constructivist accounts of the self discovery experience: first, their failure to adequately account for the embodied experience of self, and second, the difficulties inherent in using self as a noun to express a process.
It is proposed that if self is considered as a verb, as the action of a body-subject, the verbal contortionism of referring to self as a process in a language that places self as an entity may be overcome. The notion of self as verb places the individual firmly in the role of active embodied participant in the experience of self. The metaphor of "self'" as "dance" is explored to emphasize the materiality of the human animal that is argued to be central to the experience of self discovery.     

Healing and Harming

As part of a volunteering program, a medical student learns the story of a sick infant whose survival was wholly dependent on modern medicine. The family was pacified by believing, during pregnancy, that the fetus would be healthy. Poor counseling and unethical physician behavior led to the trauma of the family's struggle to keep its baby alive, happy, and as healthy as possible. The need for adequate, thorough, and individualized counseling is a critical and still unfulfilled need in patient care.     

Learning new vocabulary in German: the effects of inferring word meanings,type of feedback,and time of test

In the present study, introductory-level German students read a simplified story and learned the meanings of new German words by reading English translations in marginal glosses versus trying to infer (i.e., guess) their translations. Students who inferred translations were given feedback in English or in German, or no feedback at all. Although immediate retention of new vocabulary was better for students who used marginal glosses, students who inferred word meanings and then received English feedback forgot fewer translations over time. Plausible but inaccurate inferences (i.e., those that made sense in the context) were more likely to be corrected by students who received English feedback as compared with German feedback, providing support for the beneficial effects of mediating information. Implausible inaccurate inferences, however, were more likely to be corrected on the delayed vocabulary test by students who received German feedback as compared with English feedback, possibly because of the additional contextual support provided by German feedback.     

Impact of Location and Availability of Behavioral Health Services for Children

Literature suggests advantages for co-locating behavioral health care in primary care. We compared the impact of location of services on attendance at behavioral health appointments when access to care was assured for externalizing behavior problems with referral as usual. Two primary care pediatric practices had an evidence-based parenting program co-located in the practice for parents of children aged 2?C12 years and two practices had the program available using an enhanced-referral procedure for locations external to the practices. The program was available at the regional children??s hospital (referral as usual). During an 8-month period, the rate of attendance at first appointments was significantly higher in the co-located than the enhanced referral condition (.38 and .12 % of patient visits, respectively; ??² = 13.32; p < .0003; OR = 3.10; 95 % CI: 1.63, 5.89). These outcomes, while low, were better than the near 0 rate of attendance to referral as usual. Availability of behavioral health services in both conditions increased rates of attended appointments. However, the low rates of attendance indicate increasing availability of services, alone, is not sufficient to decrease the unmet need of children with behavioral problems. Factors other than availability must be addressed in order to improve outcomes for children.