An Assessment of Genetic Counseling Services for Individuals with Multiple Sclerosis

Multiple sclerosis (MS) affects up to 1/500 Canadians. The University of British Columbia MS Clinic (UBC Clinic) is the only MS clinic in Canada (and likely internationally) that routinely offers genetic counseling to patients and their families. A typical session includes the collection of family history and demographic data, discussion of the inheritance of MS, interpretation of family-specific recurrence risks and psychosocial counseling. The aims of this study were to explore patients’: 1) expectations of the genetic counseling session; 2) understanding of the etiology of MS (both pre and post-session); and 3) post-session perceptions of genetic counseling. A two-part questionnaire to assess genetic counseling services was distributed before and after sessions to all consenting patients seen during the period October 1, 2008 to February 28, 2009 inclusive. Sixty-two completed questionnaires were analysed. Genetic counseling was found to significantly increase the number of individuals who were able to correctly identify the etiology of MS (p?<?0.001). Patient satisfaction with genetic counseling was high, with an average satisfaction score of 32.4/35 (92.6 %). Of those who provided comments (n?=?42/60) regarding the usefulness of the genetic counseling session, 95.2 % reported it useful (n?=?40/42). Findings suggest that genetic counseling is effective in increasing patients’ knowledge of the etiology of MS and is viewed by patients as a useful service. Based on the high level of positive feedback regarding genetic counseling by the study sample, this study suggests that the services provided by genetic counselors may be beneficial for patients with MS seen in other centers.     

Some task demands induce collapsing bounds: Evidence from a behavioral analysis

Traditional models of choice-response time assume that sensory evidence accumulates for choice alternatives until a threshold amount of evidence has been obtained. Although some researchers have characterized the threshold as varying randomly from trial to trial, these investigations have all assumed that the threshold remains fixed across time within a trial. Despite decades of successful applications of these models to a variety of experimental manipulations, the time-invariance assumption has recently been called into question, and a time-variant alternative implementing collapsing decision thresholds has been proposed instead. Here, we investigated the fidelity of the collapsing threshold assumption by assessing relative model fit to data from a highly constrained experimental design that coupled a within-subject mixture of two classic response time paradigms—interrogation and free response—within a random dot motion (RDM) task. Overall, we identified strong evidence in favor of collapsing decision thresholds, suggesting that subjects may adopt a dynamic decision policy due to task characteristics, specifically to account for the mixture of response time paradigms and motion strengths across trials in the mixed response signal task. We conclude that time-variant mechanisms may serve as a viable explanation for the strategy used by human subjects in our task.     

Development,Feasibility, and Refinement of a Toxic Stress Prevention Research Program

Innovative interventions accessible to at-risk populations to prevent the intergenerational cycle of toxic stress are needed. This paper describes the iterative development of a community-based intervention, 2Gen Thrive, which was designed to prevent toxic stress and promote resilience by improving caregiver capacity to respond to children’s emotional, behavioral, and developmental needs. 2Gen Thrive leverages the collaboration between a Children’s Hospital and an Early Head Start/Head Start education center to help low-income, minority families thrive in the context of risk factors for toxic stress. In this paper, we focus on the process of developing, piloting, and refining our 2Gen Thrive preventive intervention research program, which has been developed following a community-based participatory research (CBPR) approach. The primary objective was to pilot test two prevention interventions we adapted for use in this target population: Classroom Theraplay, a classroom-wide intervention designed to prevent toxic stress among children exposed to adversity by fostering nurturing relationships with their teachers; and Dialectical Behavior Therapy Skills Training for Parents (DBT4P), a group intervention developed to bolster parental responsiveness by teaching Dialectical Behavioral Therapy (DBT) mindfulness and emotion regulation skills. We evaluated qualitative and process data as well as quantitative data from standardized instruments, including The Classroom Assessment Scoring System (CLASS), Patient Health Questionnaire (PHQ-9), Difficulties in Emotion Regulation Scale (DERS), and Parenting Stress Index (PSI/SF). Results demonstrate the feasibility, acceptability, and appropriateness of these preventive interventions delivered in the early education setting, and of conducting intervention research using a CBPR approach.     

Using backward chaining and a physical guidance delay to teach self‐feeding

Many children with feeding disorders lack age‐appropriate self‐feeding without intervention, irrespective of whether refusal is a motivational or skill deficit. When a target behavior is infrequent or absent, multistep tasks can be shaped using chaining by targeting a preexisting step within an individual's behavioral repertoire. Studies suggest when the preexisting response is in the final step of the chain, backward chaining may increase mastery. In this study, we investigated the use of backward chaining to increase self‐feeding of solids of a 4‐year‐old male.     

Feedback influences children's reasoning about math equivalence: A meta-analytic review

ABSTRACT

Decades of research have focused on children's reasoning about math equivalence problems for both practical and theoretical insights. Not only are math equivalence problems foundational in arithmetic and algebra, they also represent a class of problems on which children's thinking is resistant to change. Feedback is one instructional tool that can serve as a key trigger of cognitive change. In this paper, we review all experimental studies (N = 8) on the effects of feedback on children's (ages 6–11) understanding of math equivalence. Meta-analytic results indicate that feedback has positive effects for low-knowledge learners and negative effects for high-knowledge learners, and these effects are stronger for procedural outcomes than conceptual outcomes. Findings highlight the variable influences of feedback on math equivalence understanding and suggest that models of thinking and reasoning need to consider learner characteristics, learning outcomes, and learning materials, as well as the dynamic interactions among them.