The Integration of Noninvasive Prenatal Screening into the Existing Prenatal Paradigm: a Survey of Current Genetic Counseling Practice

Since its introduction four years ago, noninvasive prenatal screening for fetal aneuploidy (NIPS) has been widely adopted as a screening tool for women at a high risk for fetal aneuploidy. As use expands into the general population, questions arise concerning the integration of NIPS into preexisting screening paradigms. This study aims to examine the use of NIPS in current practice among prenatal counselors, predominantly in the United States, in order to inform strategies for the optimal use of both new and existing screening techniques. We electronically surveyed 208 members of the National Society of Genetic Counselors to ascertain how NIPS is currently being used. Genetic counselors were also queried as to the advantages and disadvantages of offering NIPS to all patients regardless of a priori risk. Results indicate substantial variation in practice regarding which patients are offered NIPS and how counselors have incorporated this technology into existing screening routines. The majority of participants report offering NIPS in conjunction with another method of screening for fetal aneuploidy, indicating that NIPS is being used as an addition rather than as a replacement. These screening methods primarily include nuchal translucency (NT) (45.1 %, n = 78) and first trimester serum screening, with or without an NT (19.7 %, n = 34). Furthermore, the majority report that they would be concerned about losing the clinical value of an NT in a complete transition to NIPS (85.4 %, n = 164). Counselors are evenly split on the merits of expanding the use of NIPS to the general population (con: 55.3 %, n = 105; pro: 44.7 %, n = 85). The lack of consensus suggests that updated practice guidelines might benefit counselors. In addition, respondents emphasized the need to better educate patients and providers about the risks, benefits, and limitations of the test.     

An Evaluation of a Brief Multiple-Stimulus Without Replacement Preference Assessment Conducted in an Electronic Pictorial Format

We compared the results of a brief electronic pictorial multiple-stimulus without replacement (EP-MSWO) preference assessment to a brief tangible MSWO preference assessment in five children with autism. Results of both assessments yielded a match between high preferred (HP) toys for four participants and low preferred toys for three participants. The overall correlation between assessments across participants was strong and statistically significant (ρ = .67, p < .01). A reinforcer assessment conducted with three participants confirmed HP toys identified in the EP-MSWO functioned as reinforcers.     

Forum: Crafting the Introductory Course in Religious Studies

This series of short essays considers the complex choices and decision‐making processes of instructors preparing to teach, and continuing to teach, introductory courses in religious studies. In a paper originally presented in the University of Chicago's “The Craft of Teaching in the Academic Study of Religion” series, Russell McCutcheon explores a “baker's dozen” of such choices and the larger pedagogical problems with which they are entwined, ranging from classic questions of skill development and content coverage to philosophical concerns around students' identification with their topics of study and institutional concerns around governance and assessment. Aaron Hollander provides a brief introduction and four doctoral students at the University of Chicago Divinity School respond to McCutcheon's essay, widening its scope, testing its applicability, and interrogating its undergirding suppositions from the perspective of early‐career educators in the field.     

The Influence of Relational Knowledge and Executive Function on Preschoolers’ Repeating Pattern Knowledge

Children’s knowledge of repeating patterns (e.g., ABBABB) is a central component of early mathematics, but the developmental mechanisms underlying this knowledge are currently unknown. We sought clarity on the importance of relational knowledge and executive function (EF) to preschoolers’ understanding of repeating patterns. One hundred twenty-four children aged 4 to 5 years old were administered a relational knowledge task, 3 EF tasks (working memory, inhibition, set shifting), and a repeating pattern assessment before and after a brief pattern intervention. Relational knowledge, working memory, and set shifting predicted preschoolers’ initial pattern knowledge. Working memory also predicted improvements in pattern knowledge after instruction. The findings indicated that greater EF ability was beneficial to preschoolers’ repeating pattern knowledge and that working-memory capacity played a particularly important role in learning about patterns. Implications are discussed in terms of the benefits of relational knowledge and EF for preschoolers’ development of patterning and mathematics skills.     

Profiles of Resilience and Psychosocial Outcomes among Young Black Gay and Bisexual Men

Young Black gay/bisexual men (YBGBM) are affected by contextual stressors—namely syndemic conditions and minority stress—that threaten their health and well‐being. Resilience is a process through which YBGBM achieve positive psychosocial outcomes in the face of adverse conditions. Self‐efficacy, hardiness and adaptive coping, and social support may be important resilience factors for YBGBM. This study explores different profiles of these resilience factors in 228 YBGBM in New York City and compares profiles on psychological distress, mental health, and other psychosocial factors. Four profiles of resilience were identified: (a) Low self‐efficacy and hardiness/adaptive coping (23.5%); (b) Low peer and parental support (21.2%); (c) High peer support, low father support (34.5%); and (d) High father and mother support, self‐efficacy, and hardiness/adaptive coping (20.8%). YBGBM in profile 1 scored markedly higher on distress (d = .74) and lower on mental health functioning (d = .93) compared to men in the other profiles. Results suggest that self‐efficacy and hardiness/adaptive coping may play a more important role in protecting YBGBM from risks compared to social support and should be targeted in interventions. The findings show that resilience is a multidimensional construct and support the notion that there are different patterns of resilience among YBGBM.     

Applying Theories of Communal Motivation to Sexuality

One important but challenging aspect of maintaining a satisfying romantic relationship is keeping the sexual spark alive. Research suggests the importance of a couple's sexual connection in the maintenance of their relationship, but sustaining high levels of desire for a partner over the course of time can be difficult. In the current review, we argue that one novel approach to understanding how couples might maintain desire and satisfaction over the course of time in their relationships is applying theories of communal motivation to the domain of sexuality. In this line of research, we have demonstrated that people high in sexual communal strength – those who are motivated to be non‐contingently responsive to their partners' sexual needs – are able to sustain higher sexual desire over the course of time and navigate sexual disagreements in a way that maintains both partners' relationship quality. Future research directions include broadening the view of sexual needs to include the need to decline or reject a partner's sexual advances and investigating how partners manage unmet sexual needs.     

Spilling thoughts: configuring attentional resources in infants’ goal-directed actions

The focus and organization of attention in perception-action coupling is systematically examined in two studies involving 9 and 10 -month-old infants engaged in learning goal-directed behaviors. Experiment 1 (discrimination study) observed the influence of an attentionally demanding motor task on learning and cognition, while Experiment 2 (means-ends study) observed the influence of an attentionally demanding goal on motor planning and reaching performance. Taken together the results of these two experiments revealed that when mental processing resources were directed to thinking about movement, discrimination performance became compromised; conversely, when processing resources were directed to thinking about the goal-state, the motor planning and execution became compromised. These results suggest a “spilling forward” of thoughts onto actions and goal-states and thus an attention-driven cognition/action trade-off for infants’ goal-directed actions. Findings highlight the ultimate importance of emerging motor skills on cognition and are contextualized within the on-going dialogues and developmental debates surrounding perceptual-motor skill development and problem-solving strategies during the first year.