Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

Dual processes in recognition: Does a focus on measurement operations provide a sufficient foundation?

Current theoretical thinking about dual processes in recognition relies heavily on the measurement operations embodied within the process dissociation procedure. We critically evaluate the ability of this procedure to support this theoretical enterprise. We show that there are alternative processes that would produce a rough invariance in familiarity (a key prediction of the dual-processing approach) and that the process dissociation procedure does not have the power to differentiate between these alternative possibilities. We also show that attempts to relate parameters estimated by the process dissociation procedure to subjective reports (remember-know judgments) cannot differentiate between alternative dual-processing models and that there are problems with some of the historical evidence and with obtaining converging evidence. Our conclusion is that more specific theories incorporating ideas about representation and process are required.     

Toward a more pragmatic approach to morality: a critical evaluation of Kohlberg's model

In this article, the authors evaluate L. Kohlberg's (1984) cognitive- developmental approach to morality, find it wanting, and introduce a more pragmatic approach. They review research designed to evaluate Kohlberg's model, describe how they revised the model to accommodate discrepant findings, and explain why they concluded that it is poorly equipped to account for the ways in which people make moral decisions in their everyday lives. The authors outline in 11 propositions a framework for a new approach that is more attentive to the purposes that people use morality to achieve. People make moral judgments and engage in moral behaviors to induce themselves and others to uphold systems of cooperative exchange that help them achieve their goals and advance their interests.     

A Contextual Approach to Scientific Understanding

Achieving understanding of nature is one of the aims of science. In this paper we offer an analysis of the nature of scientific understanding that accords with actual scientific practice and accommodates the historical diversity of conceptions of understanding. Its core idea is a general criterion for the intelligibility of scientific theories that is essentially contextual: which theories conform to this criterion depends on contextual factors, and can change in the course of time. Our analysis provides a general account of how understanding is provided by scientific explanations of diverse types. In this way, it reconciles conflicting views of explanatory understanding, such as the causal-mechanical and the unificationist conceptions.     

Idiom comprehension deficits in relation to corpus callosum agenesis and hypoplasia in children with spina bifida meningomyelocele

Idioms are phrases with figurative meanings that are not directly derived from the literal meanings of the words in the phrase. Idiom comprehension varies with: literality, whether the idiom is literally plausible; compositionality, whether individual words contribute to a figurative meaning; and contextual bias. We studied idiom comprehension in children with spina bifida meningomyelocele (SBM), a neurodevelopmental disorder associated with problems in discourse comprehension and agenesis and hypoplasia of the corpus callosum. Compared to age peers, children with SBM understood decomposable idioms (which are processed more like literal language) but not non-decomposable idioms (which require contextual analyses for acquisition). The impairment in non-decomposable idioms was related to congenital agenesis of the corpus callosum, which suggests that the consequences of impaired interhemispheric communication, whether congenital or acquired in adulthood, are borne more by configurational than by compositional language.     

Auditory saltation in the vertical midsagittal plane

Auditory saltation is an illusion in which a train of clicks, the first half of which is presented at one location and the other half of which is presented from a second location, is perceived as originating not only from the anchor points, but also from locations between them. That is, intermediate members of the series of clicks have their spatial locations systematically misperceived. In the present study, auditory saltation was examined for the first time in the vertical midsagittal plane. Subjects rated the perceived continuity of motion for 8-click trains systematically varied in inter-click interval (ICI), direction of motion (up, down), and trial type ('saltation' versus 'real' motion). In all listeners, saltation stimuli supported robust saltation, but only for trials with ICIs less than about 120 ms. Real motion was rated as continuous for all ICIs. These data indicate that the auditory-saltation illusion can exploit monaural stimulus cues for source location in the generation of the illusory motion percept.     

How Should a Speech Recognizer Work?

Although researchers studying human speech recognition (HSR) and automatic speech recognition (ASR) share a common interest in how information processing systems (human or machine) recognize spoken language, there is little communication between the two disciplines. We suggest that this lack of communication follows largely from the fact that research in these related fields has focused on the mechanics of how speech can be recognized. In Marr's (1982) terms, emphasis has been on the algorithmic and implementational levels rather than on the computational level. In this article, we provide a computational-level analysis of the task of speech recognition, which reveals the close parallels between research concerned with HSR and ASR. We illustrate this relation by presenting a new computational model of human spoken-word recognition, built using techniques from the field of ASR that, in contrast to current existing models of HSR, recognizes words from real speech input.     

How dogs navigate to catch frisbees

Using micro-video cameras attached to the heads of 2 dogs, we examined their optical behavior while catching Frisbees. Our findings reveal that dogs use the same viewer-based navigational heuristics previously found with baseball players (i.e., maintaining the target along a linear optical trajectory, LOT, with optical speed constancy). On trials in which the Frisbee dramatically changed direction, the dog maintained an LOT with speed constancy until it apparently could no longer do so and then simply established a new LOT and optical speed until interception. This work demonstrates the use of simple control mechanisms that utilize invariant geometric properties to accomplish interceptive tasks. It confirms a common interception strategy that extends both across species and to complex target trajectories.     

Children's competence for assent and consent: a review of empirical findings

This narrative review summarizes the empirical literature on children's competence for consent and assent in research and treatment settings. Studies varied widely regarding methodology, particularly in the areas of participant sampling, situational context studied (e.g., psychological versus medical settings), procedures used (e.g., lab-based vs. real-world approaches), and measurement of competence. This review also identifies several fundamental dilemmas underlying approaches to children's informed consent. These dilemmas, including autonomy versus best interest approaches, legal versus psychological or ethical approaches, child- versus family-based approaches, and approaches that emphasize consent versus those that emphasize assent, have implications for the measurement of children's competence and interpretation of findings. Recommendations for future research in the area of children's informed consent include the use of diverse samples and control groups, development of multidimensional and standardized measures of competence, utilization of multidimensional and standardized measures of competence, utilization of observational methods and longitudinal designs, examination of noncognitive aspects of children's competence and comparison of children's competence for treatment and research decisions.