Labeling: A study of an “autistic” child

Abstract

In this issue we are able to present reports from two very different meetings which, nevertheless, have particular significance for the developing field of family therapy, particularly as it relates to theory and practice. The first is a report by Professors Jeanne L. Thomas and Cecil J. Simons of West Virginia University on the eighth biennial conference on Life-Span Developmental Psychology, held in May 1982, in Mor-gantown, West Virginia. This conference was one of a series sponsored by West Virginia University since 1970 dealing with theoretical and empirical issues in the study of life-span human development. This particular conference highlighted two themes involving the impact of specific historical context on family development as well as the influence of the family on the individual's own experience of these historical events. This kind of broad and in-depth exploration of the multiple factors involved in the historical as well as the personal context of an individual's development promises to provide exciting new opportunities for clinicians and teachers in our field.

The second report from James E. Durkin, Ph.D., of Lincoln University deals with a recent conference on Epistemology, Psychotherapy, and Psychopathology in Houston, September 1982, sponsored by the Houston Galveston Family Institute. Outstanding theoreticans and clinicans in the field of family therapy and systems theory were present, and their exciting discussions have been put into an interesting framework by Dr. Durkin, who has his own way of integrating these issues based on his long work in the application of general systems theory to the field of group psychotherapy. —I. A.     

Reliability of Ratings of Children’s Expressive Reading

This study examined ratings of fourth graders’ oral reading expression. Randomly assigned participants (n = 36) practiced repeated readings using narrative or informational passages for 7 weeks. After this period raters used the Multidimensional Fluency Scale (MFS) on two separate occasions to rate students’ expressive reading of four equivalent passages. Results of this generalizability study showed that a minimum of two and preferably three equivalent passages, two raters, and one rating occasion are recommended to obtain reliable ratings. This research substantiates the reliability of the MFS and demonstrates the importance of raters collaborating and finding texts at students’ independent reading levels.     

EPISTEMOLOGICAL ORIGINS–EPISTEMOLOGICAL AIMS: RETHINKING POSTMODERN THERAPY IN RESPONSE TO HELD

There has been a great deal of controversy over Barbara Held's use of the term "antirealism" in her now popular critique of postmodern therapy. Many of her respondents have rejected this label, claiming that it restricts the debate and oversimplifies their position. Recognizing that this is so, I nevertheless accept Held's term as a useful signifier of the epistemological framework of postmodern therapy, and, thus, challenge her critique on its own grounds. I argue that Held's critique of this epistemological approach, in fact, misses the epistemological point, targeting ontological issues where there are none, and misinterpreting the original aim behind the shift to epistemological antirealism. It is Held's contention that the antirealist turn aimed at "maximizing individuality" in therapy - a goal which can and should be achieved through realism. Her justification for the latter is a supposed "oscillation" between realism and antirealism in the theory of this movement. To the contrary, l suggest that the aim of this epistemological shift was the resolution of strictly epistemological problems, and that the oscillation that Held identifies is the product of her own conflation of epistemological and ontological issues.     

Does body satisfaction differ between gay men and lesbian women and heterosexual men and women? A meta-analytic review

Studies investigating body image satisfaction among groups of different sexual orientations (i.e., gay men, lesbian women, and heterosexual men and women) have produced equivocal findings. To synthesise the available research, 27 studies (20 published and 7 unpublished) were meta-analysed (N=5220). Comparisons between heterosexual (n=1397) and gay men (n=984) produced a small effect size, with the former being slightly more satisfied with their bodies. An even smaller difference was observed for studies comparing heterosexual (n=1391) and lesbian women (n=1448), with greater levels of body satisfaction being evidenced by the latter group. Tests of homogeneity for each effect size were found to be highly significant. In an attempt to identify variables that may be responsible for the observed heterogeneity, the following categorical factors were assessed: the measures used to evaluate body satisfaction, date of study (1980s versus 1990s+), publication status (published or unpublished), and body weight. The results of this exploratory search for potential moderator variables as well as limitations of the current meta-analysis are discussed.     

Keeping adolescents safe from harm: management strategies of African-American families in a high-risk community

In this study, we investigated changes in parents' use of restrictive and promotive management strategies from early to middle adolescence. We also examined the antecedents of these changes and their effects on adolescents' achievement and mental health. Longitudinal data included 50 African American adolescents and their parents living in a low-income school district. There were three major findings. First, parents, on average, used less restrictive and promotive management strategies from early to middle adolescence. Second, parents who experienced increased depressive symptoms reported using more restrictive management strategies from early to middle adolescence. Third, adolescents whose parents increased their use of restrictive management strategies experienced more anger and lower grade point averages, whereas adolescents whose parents increased their use of promotive management strategies experienced less anger, higher grade point averages, and less absences from early to middle adolescence. These findings suggest that increasing parents' use of promotive rather than restrictive management strategies may be more beneficial in supporting the academic achievement and mental health of adolescents living in high-risk neighborhoods.     

GENDER-RELATED DISCOURSES AS MEDIATORS IN THE ASSOCIATION BETWEEN INTERNALIZATION OF THE THIN-BODY IDEAL AND INDICANTS OF BODY DISSATISFACTION AND DISORDERED EATING

This study examined whether the gender-related discourses of self-objectification, self-silencing, and anger suppression mediated the association between internalization of the thin-body ideal and body dissatisfaction and eating pathology. We employed a cross-sectional design to study both university ( n  = 140) and community ( n  = 76) samples of women from Ireland ranging from 17 to 30 years of age ( M  = 21.48,  SD  = 3.05). Structural equation modeling was used to test for mediation, with the final model suggesting that gender-related discourses (silencing the self/anger suppression and body surveillance) mediated the association between thin-body ideal internalization and attitudes and behaviors characteristic of disordered eating. Limitations of the current study and directions for future research are highlighted.     

Effects of receptive language training on receptive and expressive language development

The effects of a six-month training program in receptive language on receptive and expressive language development were investigated. Developmentally retarded preschoolers were pretested and posttested on one standardized test of receptive language and two tests of expressive language. Both the training and control groups participated in a preschool program. In addition, the training group received a two-sequence training program: (1) reinforcement for matching responses to modeling cues and accompanying verbal requests, and (2) reinforcement for appropriate responses to verbal requests alone. The training group demonstrated a significant increase in appropriate responses to verbal request over base-rate performance after the training and also demonstrated a significantly improved posttest performance on one test of expressive language as compared to the control group.The authors wish to thank Mrs. Helen Huggins and the staff of the Aid to Retarded Children's Preschool Training Center, San Francisco, California, for their assistance in this study. A modified version of this paper was presented at the Gatlinburg Conference on Mental Retardation, March, 1974, Gatlinburg, Tennessee.     

Advocacy processes in mental health: a qualitative study

Advocates perform an important role in representing the rights of mental health consumers, especially since mental health consumers are often marginalized. Little is known about the processes advocates use to assist mental health consumers in navigating the health care system. This study details the manner in which advocates work together with mental health consumers and health professionals through presenting a qualitative synthesis of 60 case records. Four main themes emerged: negotiating on behalf of consumers during meetings with health professionals; liaising between consumers and health professionals outside of meetings; supporting consumer decision making without the involvement of health professionals; and involvement in legal processes. The findings of this study demonstrated that advocates were primarily oriented toward the protection of negative rights, but they also promoted positive rights.     

Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care

Facial gender confirmation surgery (FGCS), also popularly known and referred to in the scientific literature as facial feminization surgery (FFS), was previously treated as a collection of aesthetic procedures complementing other aspects of gender-confirming surgery. Recent literature on quality-of-life outcomes following FGCS has supported the substantial impact these procedures have on overall well-being and reduction of psychosocial sequelae in patients. The World Professional Association for Transgender Health Standards of Care, Version 7 (WPATH SOC 7), did not deem FGCS a medical necessity. Based on these new studies, increasing evidence points to the need to include FGCS among medically necessary gender-confirming surgeries, though more-prospective studies are needed. Updates to the WPATH SOC 8 are proposed based on available quality of life studies.