Is Speech Arrest during Wada Testing a Valid Method for Determining Hemispheric Representation of Language?

Background and objective: The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, but others base language lateralization solely on speech arrest. This study sought to determine whether speech arrest alone during Wada testing provides valid data regarding language lateralization. Methods: The subjects (previously reported) were 21 patients evaluated for intractable epilepsy, who underwent language lateralization by Wada testing and functional MRI (FMRI). For each patient, language representation was determined by calculating: (1) a Wada laterality index based exclusively on speech arrest; (2) a Wada laterality index based on comprehensive language assessment; and (3) an FMRI laterality quotient. Correlation coefficients and categorical classifications were analyzed. Results: There was no significant correlation between the Wada laterality quotient derived from duration of speech arrest and either the comprehensive Wada language laterality score (r= .35,p= .12) or FMRI language laterality score (r= .32,p= .16). Categorical classification as left, right or bilateral language also showed marked discordance between speech arrest and the other two methods. Conclusion: Duration of speech arrest during Wada testing is not a valid measure of language dominance.     

Treatment of traumagenic beliefs among sexually abused girls and their mothers: An evaluation study

The objective of this study was to evaluate and compare the efficacy of two short-term individual therapy interventions for sexually abused girls and their nonoffending female caretakers. Thirty-two girls, ages 8 to 13, and their caretakers from primarily low-income, African-American families were randomly assigned to a theoretically based, structured experimental treatment program or to a relatively unstructured comparison intervention. Measures of child outcome were completed before and after the treatment program by each parent and child, and by a clinician blind to treatment condition. Pre- and postmeasures of maternal outcome were completed by the caretaker and a clinician not involved in the treatment. Both treatment programs yielded decreases in children's posttraumatic stress disorder symptoms and traumagenic beliefs reflecting self-blame and powerlessness, and increases in children's overall psychosocial functioning. The experimental intervention was more effective than the comparison program in increasing abuse-related caretaker support of the child and in decreasing caretaker self-blame and expectations of undue negative impact of the abuse on the child. Clinical impfications of these findings include the development of interventions targeting sexually abused children's traumagenic beliefs and nonoffending parents' support of their victimized children.This research was supported by the Emory Medical Care Foundation and the Children's Trust Fund of Georgia. Preliminary findings were presented at the Society for Research in Child Development, New Orleans, March 1993.The authors thank the clinic families, volunteer therapists, and project staff members whose work together made this research possible. Core project staff members other than the authors include Milonne Ambroise, Mary Lynn Dell, Sherry Dey, Beth Dreelin, Jenny Gould, Katherine January, Suzann Lawry, Marie Simmons, and Lisseth Rojas.     

Media use and political commitment: The 1992 U.S. presidential election

This study explores the relationship between media use and political commitment. Undergraduate participants answered an extensive political background questionnaire, which included measures of media use, perceived importance of information sources regarding the 1992 presidential election, and various political behaviors as an index of political commitment. Correlational analyses revealed that those who are more politically committed tend to select a variety of media sources regarding a presidential candidate. This study also investigated how informational and commitment variables were related to attitudes towards the major presidential candidates. Results observed for people expressing positive attitudes toward Perot are discussed in terms of the modern day “third party voter.”     

Cognitive processing therapy for chronic PTSD from childhood sexual abuse: A case study

This paper describes a case of chronic Post-traumatic Stress Disorder (PTSD), as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 4th edn; American Psychiatric Association, 1994). The client has a long history of childhood sexual abuse (CSA), as well as repeated sexual victimization as an adult and addiction issues. She presented with significant avoidance symptoms, including a highly restricted range of affect and distinct feelings of detachment from others. These symptoms had been greatly reduced by the end of the 17-week therapy including both individual and group modalities. The paper elaborates on theoretical issues, the Cognitive Processing Therapy model (Resick & Schnicke, 1993) as it was adapted for use with survivors of childhood sexual abuse, the various phases of the therapeutic process, and specific examples of therapeutic change with this particularly complicated case.     

Evaluations of Tests Used for Making Selection and Promotion Decisions

Participants (N= 212) rated the fairness, job relevance, appropriateness, and invasiveness of 16 tests that could be used to select or promote people into production or management positions. Fairness, job relevance and appropriateness were highly correlated, and were combined to form a composite evaluation scale. Evaluations and invasiveness ratings varied among the 16 tests, with the most positive ratings given to interviews and work samples and the most negative ratings given to astrology, graphology and polygraphs. Evaluations of four tests were affected by the position (manager vs. production worker). Evaluations of 11 tests and invasiveness ratings of two tests were affected by respondent experience with the test. Respondents who had experienced the tests evaluated them more positively and considered them to entail a smaller invasion of privacy. Responses were not affected by whether the test was to be used for selection versus promotion decisions.     

Disputing clients' irrational beliefs

This paper describes and illustrates a conceptual framework developed to assist novice REBT therapists with enlarging their disputational repertoire. First, four disputational strategies are described and illustrated. Then four disputational styles of presenting the strategies to the client are also described and illustrated. Then the disputational strategies and the disputational styles are combined within a conceptual framework to assist the developing REBT therapist in generating a variety of disputes for a single IB. Finally, the conceptual framework is applied to the IB of the case of Karen from Dryden and Digiuseppe'sPrimer on Rational Emotive Therapy to yield thirty-two separate disputes (sixteen disputes for the premise of the IB, and sixteen disputes for the derivative) of the IB.     

Teaching peer reinforcement and grocery words: An investigation of observational learning and instructive feedback

A multiple probe across behaviors design, replicated across participants, assessed the effectiveness of constant time delay in teaching appropriate peer reinforcement and grocery words to 3 elementary students with moderate intellectual disabilities. Additionally, pretests and posttests assessed the acquisition of the participants' observational learning (acquisition of peers' grocery words) and instructive feedback (related information supplied by the teacher in the consequent event). Results indicate that the participants learned (a) how to appropriately reinforce peers, (b) to read their grocery words, (c) some of the targeted stimuli of their peers, and (d) much of the instructive feedback that was associated with each of the grocery words. Maintenance data indicate that the participants maintained their target grocery words at high levels of accuracy.     

Practice-based competencies for accreditation of and training in graduate programs in genetic counseling

In January 1996, the American Board of Genetic Counseling (ABGC) adopted 27 practice-based competencies as a standard for assessing the training of graduate students in genetic counseling. These competencies were identified and refined through a collective, narrative process that took place from January through November 1994, and included directors of graduate programs in genetic counseling, ABGC board members and expert consultants. These competencies now form the basis of the document Requirements for Graduate Programs in Genetic Counseling Seeking Accreditation by the American Board of Genetic Counseling (American Board of Genetic Counseling, 1996). The competencies are organized into four domains and are presented and discussed in this article.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January, 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

A case-based approach to the development of practice-based competencies for accreditation of and training in graduate programs in genetic counseling

The American Board of Genetic Counseling (ABGC) sponsored a consensus development conference with participation from directors of graduate programs in genetic counseling, board members, and expert consultants. Using a collective, narrative, and case-based approach, 27 competencies were identified as embedded in the practice of genetic counseling. These competencies were organized into four domains of skills: Communication; Critical Thinking; Interpersonal, Counseling, and Psychosocial Assessment; and Professional Ethics and Values. The adoption of a competency framework for accreditation has a variety of implications for curriculum design and implementation. We report here the process by which a set of practice-based genetic counseling competencies have been derived; and in an accompanying article, the competencies themselves are provided. We also discuss the application of the competencies to graduate program accreditation as well as some of the implications competency-based standards may have for education and the genetic counseling profession. These guidelines may also serve as a basis for the continuing education of practicing genetic counselors and a performance evaluation tool in the workplace.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).