Neuropsychological Functioning in Children with Medium Chain Acyl Coenzyme A Dehydrogenase Deficiency (MCADD): The Impact of Early Diagnosis and Screening on Outcome

Children with medium chain acyl coenzyme A dehydrogenase deficiency (MCADD) have been reported to be at high risk for neurocognitive deficits. However this has not been systematically studied and little is known about the exact nature of neuropsychological sequelae or of the impact of early diagnosis and screening on outcome. We examined cognitive and adaptive outcome in children with MCADD (N?=?38, age range: 2 years, 2 months – 10 years, 3 months) diagnosed either through a newborn screening program (tandem mass spectrometry/MSMS) or upon clinical presentation. There was no evidence of overall intellectual impairment in either groups but there was some suggestion of poorer verbal and specific executive functioning (i.e., planning) abilities in the unscreened cohorts. Adaptive functioning was relatively intact with the exception of reduced Daily Living Skills in both our screened and unscreened groups. Early diagnosis and greater number of hospitalizations were related to higher verbal, communication, and socialization skills. Overall, our results highlight the importance of early diagnosis and management for children with MCADD.     

Factors Facilitating and Inhibiting the Use of Research to Inform Interpretation Practice: A Case Study of Australian Protected Area Management Agencies

ABSTRACT

Interpretation research can be and is used to inform and improve interpretation policymaking and planning undertaken by practitioners such as those who work for Australian protected area management (PAM) agencies. This study explores perceptions of the extent to which interpretation research is undertaken and used by these agencies, and the facilitators and constraints to doing so. In-depth telephone interviews were conducted with senior interpretation planners and managers in all Australian PAM agencies. The findings indicate that interpretation research is usually prompted by a crisis or a short-term need such as a specific project and that most research is site-specific and content-focused, while respondents see a need for more longitudinal and evaluation-focused research. Two-thirds of the respondents reported that their agency made poor or no use of research findings for improving interpretation practice. Stated barriers to undertaking and using research included lack of funding, lack of time and that research was not considered an agency priority. Underpinning these were perceptions consistent with diffusion of innovation theory (e.g., that doing or using research is perceived as being too complex, not compatible with agency goals or not offering relative advantage). Strategies for removing these perceptual barriers to undertaking and using interpretation research and research findings are presented.     

Delayed sidetone in relation to the reading of different materials

Several studies were conducted with speakers reading short phrases aloud while experiencing one amount or another of delayed sidetone (0.0–0.30 sec). The phrases represented different numbers of syllables, different types of syllables, different numbers of phonemes, and first and second languages. Additional syllables and unfamiliar material consistently increased the reading time of the speakers disproportionately. The reading of syllables of two and four sounds was apparently more retarded by delayed sidetone than ones of three sounds. Two-sound syllables comprised of vowel-consonants required more time to read than ones comprised of consonant-vowels. The effect of additional phonemes, with the type of syllables held constant, added linearly in the reading time of the phrases. The syllabic characteristics, the length, and probably the familiarity of the material affected the reading time nonlinearly.     

Are reporting errors due to encoding limitations or retrieval failure? Surveys of child vaccination as a case study

Surveys of childhood vaccinations are often highly inaccurate, due to parental misreporting. We conducted three experiments to examine the source of the inaccuracies. In Experiment 1, we provided parents with memory aids; these aids did little to improve reporting accuracy. Two further experiments asked whether parents forgot what they knew about their children's vaccinations, or whether they never knew the information. In Experiment 2 we surveyed parents both immediately and ten weeks after their child's medical visit. Accuracy was only slightly better than chance immediately afterwards; ten weeks later performance had not changed significantly. Experiment 3 compared reports in both recall and recognition conditions. Although the recognition condition lowered the response burden on parents it did not produce more accurate reports. We conclude that low levels of accuracy in parental reports on vaccinations appear to reflect poor initial encoding rather than retrieval failure. Copyright © 1999 John Wiley & Sons, Ltd.     

An Integral Approach to Counseling Ethics

The authors offer an integral approach to counseling ethics using K. Wilber's (2000a, 2000b) integral metatheory. The article examines traditional counseling ethics through the lens of K. Wilber's (2000a, 2000b) “all‐quadrants, all‐levels” model, consisting of quadrants, levels, lines, states, and types. The authors begin with the 4 quadrants and how they can inform understanding of traditional counseling ethics. Vertical development in relation to counseling ethics is addressed, followed by a case study of an ethical dilemma in counseling. The authors offer an integrally informed process of ethical decision making that can be seen to complement less comprehensive ethical decision‐making models.