Neonatal Intensive-Care Unit Graduates Show Persistent Difficulties in an Intradimensional Shift Card Sort

Neonatal intensive-care unit (NICU) graduates, a group at risk for attention problems and attention-deficit hyperactivity disorder, performed an intradimensional shift card sort at 34, 42, 51, and 60 months to assess executive function and to examine effects of individual risk factors. In the “silly” game, children sorted cards (airplanes and dogs) so they were not the same as targets. In the “same” game, they did the opposite. Performance on the “silly” game was poor, especially when it was presented first. Success in following “silly” game rules improved with age and was significantly linked to maternal education and birth weight for gestational age, a measure of intrauterine stress. Degree of central nervous system injury differentiated children who completed the task from children who did not, and it also affected the need to repeat instructions in the “same” game. These results confirm an increased likelihood of impairments in executive function during preschool years in NICU graduates.     

NEW LOSS FROM AN OLD PROBLEM: HOW COUNSELORS CAN ASSIST PERSONS WITH POSTPOLIO SYNDROME

For many persons who were diagnosed with polio years ago, late effect symptoms were not anticipated. They believed they had gone through the more severe ramifications of the illness and were unaware that additional problems could occur. Currently, there are hundreds of thousands of persons in the United States who are experiencing significant difficulties with old symptoms and are also developing new physical and emotional difficulties. Unfortunately, little research has looked at the ways counselors can assist this population.Therefore, the purposes of this study were to identify the physical and emotional problems confronting persons with postpolio and to help counselors gain an understanding of issues they feel might be most appropriate to address in therapy sessions.     

A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: Results of the Pleasant Events Program (PEP)

Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51). Assessments were completed pre- and post-intervention and at 1-year follow-up. Biological assessments included CVD risk markers Interleukin-6 (IL-6) and D-dimer. Psychosocial outcomes included depressive symptoms, positive affect, and negative affect. Participants receiving the PEP intervention had significantly greater reductions in IL-6 (p = .040), depressive symptoms (p = .039), and negative affect (p = .021) from pre- to post-treatment. For IL-6, clinically significant improvement was observed in 20.0% of PEP participants and 6.5% of IS participants. For depressive symptoms, clinically significant improvement was found for 32.7% of PEP vs 11.8% of IS participants. Group differences in change from baseline to 1-year follow-up were non-significant for all outcomes. The PEP program decreased depression and improved a measure of physiological health in older dementia caregivers. Future research should examine the efficacy of PEP for improving other CVD biomarkers and seek to sustain the intervention's effects.     

Parents' Perceptions of Children's Worries in a Changing World

The nature and intensity of worries that preadolescent children experience and the extent to which parents are aware of their children's concerns were examined. Questionnaires with three subscales (Physical Harm, Daily Life Matters, and Global Issues) were filled out by 89 6th graders and their parents. Parents underestimated the overall degree to which children worry, and they tended to believe that their children worried most about daily life matters, such as grades and popularity; children were in fact least worried about daily life matters and most worried about global issues, such as pollution and starvation. Both child and parent gender differences were found.     

Normal and Exceptional Children's Attitudes Toward Themselves and one Another

In this study 65 junior high school boys and girls (54 normal and 11 exceptional children) evaluated themselves most favorably, normal children as a group less favorably, and exceptional children as a group least favorably of all on the Personal Attribute Inventory for Children. This was so regardless of whether the respondents were normal or exceptional children. Since data were collected from mainstreamed classrooms, it appears that mainstreaming may not be directly deleterious to exceptional children's self-concepts, but has associated with it a negative stigma for exceptional children as a group for both exceptional and normal children. These findings, plus others reported previously, fail to demonstrate that mainstreaming in its present form may be an elixir for exceptional children's social-emotional difficulties.     

Syllable frequency and syllable structure in apraxia of speech

Recent accounts of the pathomechanism underlying apraxia of speech (AOS) were based on the speech production model of Levelt, Roelofs, and Meyer, and Meyer (1999)1999. The apraxic impairment was localized to the phonetic encoding level where the model postulates a mental store of motor programs for high-frequency syllables. Varley and Whiteside (2001a) assumed that in patients with AOS syllabic motor programs are no longer accessible and that these patients are required to use a subsyllabic encoding route. In this study, we tested this hypothesis by exploring the influence of syllable frequency and syllable structure on word repetition in 10 patients with AOS. A significant effect of syllable frequency on error rates was found. Moreover, apraxic errors on consonant clusters were influenced by their position relative to syllable boundaries. These results demonstrate that apraxic patients have access to the syllabary, but that they fail to retrieve the syllabic motor patterns correctly. Our findings are incompatible with a subsyllabic route model of apraxia of speech.     

Applying evidence to support ethical decisions: Is the placebo really powerless?

Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the effects of knowledge framing and its impact on ethical, medical, economical and legal decisions. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

Do differences in brain activation challenge universal theories of dyslexia?

It has been commonly agreed that developmental dyslexia in different languages has a common biological origin: a dysfunction of left posterior temporal brain regions dealing with phonological processes. Siok, Perfetti, Jin, and Tan (2004, Nature, 431, 71-76) challenge this biological unity theory of dyslexia: Chinese dyslexics show no deficits in posterior temporal brain regions but a functional disruption of the left middle frontal gyrus. Here, I will argue that these data do not challenge universal cognitive theories of dyslexia according to which weaknesses in the ability to process the phonological features of language are at the origin of dyslexia.     

Better the Devil You Know? High-Risk Individuals’ Anticipated Psychological Responses to Genetic Testing for Melanoma Susceptibility

Purpose: The psychological consequences of genetic testing for mutations among individuals at increased risk of developing melanoma remain unexamined. The present study aimed to explore anticipated emotional, behavioral, cognitive, and familial responses to hypothetical genetic testing for melanoma susceptibility. Methods: Forty semi-structured interviews were undertaken with affected (n=20) and unaffected (n=20) individuals at either high or average risk of developing melanoma due to family history. Results: In-depth thematic analysis revealed that, in response to being identified as a mutation carrier, most participants with a family history anticipated calmly accepting their increased risk; either increasing precaution adoption or maintaining already vigilant behavioral practices; perceiving such information as important and valuable; and communicating genetic test results to family members, despite the acknowledgement of potential difficulties. In response to being identified as a non-carrier, the majority of participants expected to feel relieved; to maintain current precautionary health practices; to still perceive themselves at some risk of developing melanoma; and to be wary of the potential negative behavioral consequences of disclosing such information to family members. Women appeared more likely than men to acknowledge the potential for depression and worry following genetic testing. In contrast, more males than females expected to carry a gene mutation, and viewed their current preventive practices as optimum. Conclusion: Genetic testing for melanoma risk is likely to elicit a complex array of emotional, behavioral, cognitive, and familial responses for both testees and their family members, and these responses are likely to bear subtle differences for males and females.     

Becoming literate in different languages: similar problems, different solutions

The teaching of reading in different languages should be informed by an effective evidence base. Although most children will eventually become competent, indeed skilled, readers of their languages, the pre-reading (e.g. phonological awareness) and language skills that they bring to school may differ in systematic ways for different language environments. A thorough understanding of potential differences is required if literacy teaching is to be optimized in different languages. Here we propose a theoretical framework based on a psycholinguistic grain size approach to guide the collection of evidence in different countries. We argue that the development of reading depends on children's phonological awareness in all languages studied to date. However, we propose that because languages vary in the consistency with which phonology is represented in orthography, there are developmental differences in the grain size of lexical representations, and accompanying differences in developmental reading strategies across orthographies.