A Tailored Approach to Family-Centered Genetic Counseling for Cystic Fibrosis Newborn Screening: The Wisconsin Model

This article describes the development of a tailored family-centered approach to genetic counseling following abnormal newborn screening (NBS) for cystic fibrosis (CF). A genetic counseling consortium reviewed research literature, selected theoretical frameworks, and incorporated counseling psychology micro skills. This innovative intervention integrated theories and empirically validated techniques. Pilot testing and parent feedback confirmed satisfaction with and feasibility of the approach designed to (a) minimize parents’ distress, (b) facilitate parents’ understanding, (c) increase parents’ capacities to use genetic information, and (d) enhance parents’ experiences with genetic counseling. Counselors engage in a highly interactive process of evaluating parents’ needs and tailoring assessments and interventions that include a therapeutic environment, the family’s emotional needs, parents’ informational needs, and a follow-up plan. This promising new model is the first to establish a theory-driven, evidence-based standard for genetic counseling in the context of NBS for CF. Additional research will evaluate the model’s efficacy in clinical practice.     

Evaluation of sex-typed tasks by black men and women

Two studies examined the relationship of sex of subject, sex-typing of tasks, and prior task experience on self-confidence ratings of Black men and women. In both investigations, women's self-confidence tended to vary as a function of task type, while men's self-confidence remained relatively stable across all tasks. Prior experience with the task was highly correlated with self-confidence ratings for men and women and moderated the effects. The variations in the findings of Studies I and II and implications for future research are discussed.Portions of this study were reported at the Eastern Psychological Association Convention, 1983.     

The frequency and significance of additional self-reported psychiatric diagnoses in children with attention deficit disorder

The frequency of additional self-reported diagnoses in a large, heterogeneous sample of attention defiict disorder (ADD) children (N=182)was determined using the Diagnostic Interview for Children and Adolescents (DICA). Over half the children had additional DICA diagnoses, with oppositional disorder and anxiety/mood disorders the most frequent. ADD boys with internalizing-type diagnoses had lower verbal IQs and arithmetic scores and performed more poorly on attention tasks than those without; parents also rated them more adversely. Those with externalizing- type diagnoses were rated as more aggressive by teachers and had sociopathic, thrill- seeking profiles on paper-pencil self-ratings. Over 40% of the children were dyslexic or slow learners but they had no higher rate of DICA diagnoses than those who read adequately.This research was supported by NIMH grant R01-MH39189 and by the Marie Wilson Howells Fund. The authors are grateful to the Chid Study Center staff who assisted in recruiting and evaluating subjects and to the Behavioral Laboratory team members who collected and analyzed the data.     

A methodological approach to manipulation of hunger and thirst drive stimuli in the rat

The hunger and thirst drives of rats were equated using a titration procedure in a modified T-maze with food as the reinforcer on the left and water on the right. The conditions (amount) rather than schedules (hours) of maintenance were varied from day to day during a 9-day cycle which was then replicated. The results showed that condition manipulations produce reliable and approximately linear functions for individual Ss on the following response measures: percent water choices, median latencies, and body weight. Results were discussed in terms of the animals responding to the drive stimuli and also in terms of some of the methodological problems that this procedure solved. Finally, it was suggested that the construct drive as defined by conditions of maintenance might possess more utility as an experimental variable.     

TRAINING FUNCTIONAL EXPRESSIVE LANGUAGE: THE ACQUISITION AND GENERALIZATION OF FIVE-ELEMENT SYNTACTIC RESPONSES1

A single-subject multiple-baseline design using within- and across-subject replication was employed to study the acquisition of expanded “agent-action-object” sentences and the spontaneous generation of this form in the natural environment. Three young language-delayed subjects were trained to describe various agent-action-object relationships with a five-element syntactical form. The language training strategy was a synthesis of the developmental-psycholinguistic and behavioral models. Dynamic interactions between familiar persons and objects were the stimulus events that the children mapped. A five-element syntactical form, previously absent from the children's language repertoires, was trained during individual sessions. Concurrent with baseline, training, and followup, each subject's language was monitored in another setting, the classroom during free play. After onset of training, the core elements of the complex syntactic form were spontaneously emitted by the child in its natural environment. The free-play data reflect individual differences in the emergence and frequency of each child's spontaneous use of the agent-action-object form. The acquisition and maintenance of the specific lexicon and syntax trained were tested by posttraining probes and responses to videotape presentations. These probes revealed generalization and maintenance of both the lexical and syntactical forms acquired in treatment. The main purpose of any language-training procedure should be to provide language that is functional for the child in the natural environment. This study, which documented the spontaneous usage of the core agent-action-object syntactical form in the natural environment, effectively trained a functional syntactical rule.     

LONG-TERM EFFECTS OF OPPOSITIONAL CHILD TREATMENT WITH MOTHERS AS THERAPISTS AND THERAPIST TRAINERS

The follow-up data reported represent a long-term (3 to 9 years out of treatment) evaluation of 40 children who were clients of the Regional Intervention Program (RIP) from 1969 to 1978. As 3-, 4-, and 5-year olds, these youngsters exhibited severe and prolonged tantrums, continual opposition to adults' requests and commands, and physical aggression toward parents. Each child and mother participated in a standardized intervention package modeled after Wahler's Opposition Child Treatment. Results from school and home-based follow-up showed that: (a) commands, demands, or requests made by parents were likely to be followed by former clients' compliance; (b) former clients' social interactions in the home were overwhelmingly positive and their nonsocial behavior was by and large appropriate; (c) parent behavior in the home was consistent with the child management skills taught many years ago; (d) there were no differences between the compliant, on-task, social interaction and appropriate/inappropriate nonsocial behaviors of former clients and randomly selected class peers; (e) there were no differences in teachers' commands, negative feedback, positive social reinforcement, and repeated commands that were directed toward either former clients or randomly selected class peers; (f) both teachers' and parents' rating of former clients on the modified Walker Problem Behavior Checklist were highly correlated; (g) there were no differences in teachers' rating of former clients and class peers; and (h) of all the studied demographic variables, only age that treatment began and family intactness were related to current levels of behavior.