Certification in neurodevelopmental disabilities: the development of a new subspecialty and results of the initial examinations

The American Board of Psychiatry and Neurology, in collaboration with the American Board of Pediatrics, administered the first Subspecialty Certification Examination in Neurodevelopmental Disabilities to 190 candidates on April 3, 2001, and the second to 80 candidates on April 9, 2002. This report describes the history of the certifying examination including the process of its development and the results of the first and second examination administrations. The purpose of the Certification Examination in Neurodevelopmental Disabilities is to assess knowledge of qualified candidates in the subspecialty. A committee comprised of child neurologists and pediatricians developed this examination. Of the 190 pediatricians (n = 169) and child neurologists (n = 21) who completed the examination in 2001, 157 (83%) passed the examination. The second group of examinees included 68 pediatricians and 12 child neurologists, and the pass rate was 70%. The 213 candidates certified to date have received ten-year time-limited certificates that may be renewed by recertification process beginning in 2010. After the "grandfathering period," candidates for the examination must complete ACGME-approved training programs in the subspecialty.     

Advances in prevention and treatment of cerebral palsy

In recent years there have been a number of advances in understanding of predisposing and protective factors in the development of cerebral palsy in infants. Multiple gestation births, maternal infection, and maternal and fetal thrombophilic conditions all predispose to the development of CP in the infant. Opportunities for prevention of CP may develop from an improved understanding of these factors and their mechanisms of operation. Similar progress has been made in the evaluation of treatments for CP and the effects of these treatments on the individual's impairment, function, and disability. Selective posterior rhizotomy and Botulinum toxin A are now widely used in the treatment of spasticity. The challenge remains to determine how effectively these promising interventions can alter long-term function and quality of life outcomes in children and adults with CP.     

Expansion of Sidman's theory: The inclusion of prompt stimuli in equivalence classes

Stimulus equivalence is defined as the ability to relate stimuli in novel ways after training in which not all of the stimuli had been directly linked to one another. Sidman (2000) suggested all elements of conditional discrimination training contingencies that result in equivalence potentially become class members. Research has demonstrated the inclusion of samples, comparisons, responses, and reinforcers in equivalence classes. Given the evidence that all elements of a conditional discrimination become part of the class, the purpose of this study was to determine if class-specific prompts would also enter into their relevant equivalence classes. Experiment 1 investigated the inclusion of prompts in an equivalence class using abstract stimuli with neurotypical students enrolled in higher education courses. Experiment 2 systematically replicated Experiment 1 using meaningful stimuli and individuals diagnosed with autism spectrum disorder. The results of both experiments demonstrated that class-specific prompts became part of equivalence classes with the other positive elements of the contingency. The results are discussed in terms of class expansion and the potential impact on equivalence-based instruction.     

Adults’ self-reported attachment influences their savoring ability

Positive affect is important for well-being, yet little is known about individual differences in the ability to up-regulate (savor) positive emotions. In a sample of 120 adults (ages 18–94; 62.5% female), this study extends correlational work by examining how attachment relates to self-reported savoring and to an experimentally-induced behavioral savoring task where participants were randomly assigned to reflect on a positive event (or complete a control task). Avoidance was related to lower trait savoring, and the effects of attachment on experimentally-induced savoring differed by the type of event participants savored. Avoidance was related to poorer affective outcomes after savoring interpersonal events but was unrelated to affective outcomes for non-interpersonal events. Anxiety was related to better outcomes after savoring non-interpersonal events but was unrelated to savoring interpersonal events. Overall, effects suggest that more insecurely attached adults may not savor as often, and may have difficulty savoring interpersonal events but not non-interpersonal events.     

Exploring the Relationships Between Maternal Mental Health Symptoms and Young Children’s Functioning in a Low-Income,Minority Sample

Poor maternal mental health, including depression and high stress levels, can negatively impact many domains of child development, particularly among low-income, ethnic minority families experiencing multiple stressors. Low-income minority mothers, particularly Hispanic mothers, are also at increased risk of experiencing exposure to community violence and other types of trauma. However, studies exploring the additional impact of maternal trauma symptoms on children’s functioning are rare. This study aims to address this gap by examining the impact of maternal trauma symptoms on young children’s functioning in a low-income, predominantly Hispanic sample through the mechanisms of maternal depressive symptoms, and mother’s experiences of parenting stress and strain. The sample consisted of 158 biological mothers (58% Hispanic, 13% African American, 5.7% White American) who were participating in community-based mental health treatment for their children (M_AGE?=?3.7, SD?=?1.2). Mothers completed questionnaires providing information on their children’s behaviors and their own mental health and stress levels at intake. Path analysis indicated that there was a significant indirect effect of maternal trauma symptoms on children’s behavior problems through maternal depressive symptoms and maternal stress in the parent-child relationship (β?=?0.09, p?<?0.01). In addition, there was a direct effect of maternal trauma symptoms on children’s behavior problems (β?=?0.32, p?<?0.001). The results suggest that maternal trauma symptoms, in addition to maternal depressive symptoms, contribute to poor maternal and child functioning.     

Distrusting the present

We use the hierarchical nature of Bayesian perceptual inference to explain a fundamental aspect of the temporality of experience, namely the phenomenology of temporal flow. The explanation says that the sense of temporal flow in conscious perception stems from probabilistic inference that the present cannot be trusted. The account begins by describing hierarchical inference under the notion of prediction error minimization, and exemplifies distrust of the present within bistable visual perception and action initiation. Distrust of the present is then discussed in relation to previous research on temporal phenomenology. Finally, we discuss how there may be individual differences in the experience of temporal flow, in particular along the autism spectrum. The resulting view is that the sense of temporal flow in conscious perception results from an internal, inferential process.     

Sociomoral reasoning,perceptions of parenting and self‐reported delinquency in adolescents

This study considers the relationships between perceived parenting, sociomoral reasoning, and self‐reported delinquency in a sample of high school adolescents. Correlational analysis revealed that moral reasoning was associated with a consistent disciplinary style. Self‐reported delinquency was positively related to a number of the parenting variables but negatively correlated with moral reasoning. Separate analysis for males and females showed similar patterns for self‐reported delinquency, with the exception that moral reasoning was negatively correlated with attachment and supervision among females. The most significant predictors of delinquency scores were parenting variables, with moral reasoning also playing a role for males. A factor analysis of the perceived parenting measure revealed two factors. The first factor reflected a warm, inductive and involved style of parenting with the second reflecting a parenting style characterized by physical punishment. Self‐reported delinquency was negatively significantly associated with Factor 1, and positively related to Factor 2. There were also differences in the self‐reported delinquency scores of the top and bottom quartiles of Factor 1 scores. These support the conclusion that a parental style that is perceived to be warm, involved and inductive is associated with lower levels of delinquency in adolescence. Copyright © 2001 John Wiley & Sons, Ltd.     

Social competence and sociomoral reasoning in young offenders

This study considers the relationship between social competence, sociomoral reasoning, and self‐reported delinquency in a sample of convicted young offenders. Correlations across these factors showed that social competence was significantly related to delinquency. This finding was corroborated by multiple regression, which showed that social competence was the most significant predictor of self‐reported delinquency. Copyright © 1999 John Wiley & Sons, Ltd.     

Sharing <Emphasis Type="Italic">GJB2</Emphasis>/<Emphasis Type="Italic">GJB6</Emphasis> Genetic Test Information with Family Members

Although GJB2/GJB6 genetic testing for non-syndromic hearing loss is available, there is no information regarding sharing of test results with family members. A qualitative study was conducted to elucidate if, how, and why parents of a child with hearing loss share GJB2/GJB6 test results with relatives. Parents whose child had testing (n = 7 positive, n = 4 negative, n = 1 inconclusive results) participated in a semi-structured interview and responses were analyzed using qualitative methods. All participants shared the test result with at least one relative, but selective non-disclosure also was observed. Reasons for, and reactions to, sharing were diverse and differed as a function of test result. In comparing the results from this study to published literature, similarities and differences were identified with regards to disclosure of genetic test results for hearing loss versus other conditions. Differences suggest that hearing loss may have unique attributes that influence responses to genetic test information. Further research is needed to replicate these findings.     

Examination and Measurement of Halo Via Curvilinear Regression: A New Approach to Halo1

Much disagreement and confusion has surrounded the nature of the relationship between halo and performance rating accuracy. Traditionally, the relationship has been assumed to be linear ( Cooper, 1981 ), but Fisicaro (1988 ) proposed that the relationship between halo and performance rating accuracy is, instead, curvilinear. Using the halo index suggested by Balzer & Sulsky (1992 ), the results of the present study provided empirical evidence to support Fisicaro's proposal. Future research examining the relationship between halo and accuracy should consider the use of quadratic models, instead of linear ones. For the practitioner, this result implies that low rating dimension intercorrelations (negative halo) may lead to inaccuracy in ratings in much the same way as do high rating dimension intercorrelations (positive halo).