Pragmatic Assessment and Therapy for Persons with Brain Damage: What Have Clinicians Gleaned in Two Decades?

Pragmatic competence comprises a number of interrelated skills which manifest in real-time in a range of adaptive behaviors and which are driven by underlying cognitive processes that appear to be variably compromised in brain damage. Differential neurological profiles reflect different pragmatic outcomes. The essence of pragmatic assessment and therapy for clinicians is therefore to capture accurately, measure, and, where possible, enhance the ability of the individual to adapt to a changing communicative environment. Assessment measures differ along a number of dimensions. A distinction is drawn between testing and assessment and the argument proposed that for clinical purposes, it is helpful to keep the notions of functional and pragmatic distinct.     

Hallucinations in schizophrenia, sensory impairment, and brain disease: a unifying model

Based on recent insight into the thalamocortical system and its role in perception and conscious experience, a unified pathophysiological framework for hallucinations in neurological and psychiatric conditions is proposed, which integrates previously unrelated neurobiological and psychological findings. Gamma-frequency rhythms of discharge activity from thalamic and cortical neurons are facilitated by cholinergic arousal and resonate in networks of thalamocortical circuits, thereby transiently forming assemblies of coherent gamma oscillations under constraints of afferent sensory input and prefrontal attentional mechanisms. If perception is based on synchronisation of intrinsic gamma activity in the thalamocortical system, then sensory input to specific thalamic nuclei may merely play a constraining role. Hallucinations can be regarded as underconstrained perceptions that arise when the impact of sensory input on activation of thalamocortical circuits and synchronisation of thalamocortical gamma activity is reduced. In conditions that are accompanied by hallucinations, factors such as cortical hyperexcitability, cortical attentional mechanisms, hyperarousal, increased noise in specific thalamic nuclei, and random sensory input to specific thalamic nuclei may, to a varying degree, contribute to underconstrained activation of thalamocortical circuits. The reticular thalamic nucleus plays an important role in suppressing random activity of relay cells in specific thalamic nuclei, and its dysfunction may be implicated in the biological vulnerability to hallucinations in schizophrenia. Combined with general activation during cholinergic arousal, this leads to excessive disinhibition in specific thalamic nuclei, which may allow cortical attentional mechanisms to recruit thalamic relay cells into resonant assemblies of gamma oscillations, regardless of their actual sensory input, thereby producing an underconstrained perceptual experience.     

EVALUATING COMPETENCE OF WOMEN AND MEN

College students (78 females, 79 males) were placed in all-female, all-male, or mixed-gender groups. In the presence of a male or female experimenter, subjects evaluated an article written by a female or male job applicant. Subjects in mixed-gender groups generally evaluated the female applicant more favorably in the presence of the female experimenter than the male experimenter. Subjects in mixed-gender groups also rated the female applicant more favorably than the male applicant in the presence of the female experimenter. Male subjects generally were more influenced than were females by the experimenter's gender, tending to give higher ratings to the applicant of the same gender as the experimenter.     

Understanding of Genetic Inheritance among Xhosa-Speaking Caretakers of Children with Hemophilia

Hemophilia A and B are X-linked recessive inherited bleeding disorders that have a profound impact on the family of affected individuals. Education is vital to enable women to appreciate the implications of being a carrier and the implications for a prospective child. Prior research has shown that cultural, socio-economic and linguistic issues in South Africa are major barriers to communication for first-language Xhosa-speakers. This exploratory study aimed to investigate the basic knowledge of genetic inheritance among this cultural group in order to promote culturally-sensitive, effective genetic counseling. Ten in-depth interviews were conducted with Xhosa-speaking mothers or caregivers of boys with hemophilia. Results suggest that the participants had a very limited understanding of the clinical management, genetic consequences and cause of hemophilia. While treatment and care by health care service providers was fully accepted, several participants believed that traditional methods would provide them with more satisfactory explanations. These findings suggest that there is a critical need for socio-culturally tailored, language-specific education for families with hemophilia.     

The end of analysis for the analyst (Translated by Ann Kutek)

This paper is an account of an analyst's personal exploration to make conceptual sense of the delicate closing stages of an analysis. Jung's theory of complexes provides a model of the functioning of the analytic relationship as an integral whole which itself is the locus of the process that brings an analysis to completion. Clinical vignettes are used to illustrate this.     

EARLY RESPONSE DISTRIBUTION AND OUTCOMES OF RESPONSE-RESTRICTION ANALYSES

We examined whether the results of a response‐restriction analysis (RRA) could be predicted on the basis of response distribution in early sessions, when these sessions indicated interaction with multiple items. Four preschool‐aged children participated. For 3 of the 4 participants, the results from sessions conducted prior to restriction of the first item corresponded closely with results of the full RRA.     

The learning of visually guided action: An information-space analysis of pole balancing

In cart-pole balancing, one moves a cart in 1 dimension so as to balance an attached inverted pendulum. We approached perception-action and learning in this task from an ecological perspective. This entailed identifying a space of informational variables that balancers use as they perform the task and demonstrating that they improve by traversing the space to the loci of more useful variables. We presented a novel information space-including fractional derivatives of pendulum angle (e.g., halfway between angle and angular velocity)-as possible information for balancing. Fourteen college students tried to meet a criterion of balancing the pole for 30 s on 3 of 5 successive trials, up to a maximum of 150 attempts. Loci in the fractional derivative space predicted the time series of force production well. Systematic differences were seen in loci as a function of success, and systematic changes in locus were seen with learning. The fractional derivatives were shown to predict pole angles a short time interval into the future, allowing balancers to prospectively control the action and thereby nullify visuomotor delay. In addition to loci in the information space, we analyzed loci in a calibration space, reflecting the gain relating force to information. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

The Gender Marketing of Toys: An Analysis of Color and Type of Toy on the Disney Store Website

The purpose of this study was to examine 1) the extent to which the gender marketing of toys on the Internet replicates findings of previous studies of the gendering of toys, and 2) the extent to which toys for “both boys and girls”, a previously overlooked category of toys, share characteristics, such as color and type of toy, with toys marketed for “boys only” or for “girls only”. The sample consisted of the 410 toys listed for boys and the 208 toys listed for girls, including 91 toys that appeared on both lists, on the English language U.S. Disney Store website. The marketing of toys on the Disney Store website is important not only because of the growth in e-commerce, but also because of this company’s global domination of the children’s entertainment industry. Tabular analysis and chi-square revealed that bold colored toys, predominantly red, black, brown, or gray toys, and those that were action figures, building toys, weapons, or small vehicles typified toys for “boys only” on this U.S. website. Pastel colored toys, predominantly pink or purple toys, and those that were dolls, beauty, cosmetics, jewelry, or domestic-oriented typified toys for “girls only”. A majority of toys for “both boys and girls” were mostly “gender-neutral” in type, but they resembled toys for “boys only” in terms of their color palette, presumably to appeal to boys, who are less likely to cross gender lines than girls. The potential impact of the gendering of toys on individuals as well as limitations of this research and suggestions for future research are discussed.     

Teacher Acquisition of Functional Analysis Methods Using Pyramidal Training

Pyramidal training involves an experienced professional training a subset of individuals who, in turn, train additional individuals. Pyramidal training is effective for training a variety of behavior-analytic skills with direct-care staff, parents, and teachers. As teachers’ roles in behavioral assessment increase, pyramidal training may be useful to improve the procedural fidelity with which teachers conduct functional analyses. In the current study, previously trained teachers taught six other teachers (trainees) to conduct standard functional analysis conditions in a pyramidal training model. All trainees quickly acquired the skills necessary to conduct attention, escape, play, and tangible conditions during analog role-plays. Trainees also implemented functional analysis conditions with fidelity in their classrooms with students. Using a pyramidal training model may help to disseminate behavior-analytic procedures.