Training Methods for Delivering Difficult News in Genetic Counseling and Genetics Residency Training Programs

Genetic counselors and clinical geneticists are often in the position of delivering difficult news (DDN) to patients and families. Many studies show that healthcare providers require major improvement in the skills needed in DDN in a manner that is satisfactory to their patients. The purpose of this study was to assess the amount and methodology of DDN training received by genetic counselors and medical genetics residents in their training programs, such as observations of DDN or attending didactic lectures. To our knowledge, there is no previous assessment or study of DDN training in genetic counselor and medical genetics residency programs; therefore, we aim to both assess and compare the training in DDN received by genetic counselors and by genetics residents and determine whether there is a desire for recommendations on DDN training. We invited genetic counseling (GC) and genetics residency program directors to participate in an online survey designed to assess coursework, clinical experiences, and directors’ attitudes toward teaching DDN. Response rate was 85% (28/33) for GC program directors and 26% (14/53) for genetics residency program directors. One hundred percent of GC and genetics residency directors who responded to the survey agreed that it is important for genetic counselors and medical geneticists to be able to deliver difficult news effectively and that training programs should formally teach students how to deliver difficult news. Six of the eight common teaching methods are used by at least 75% of GC programs while two of eight are used by at least 75% of genetics residency programs. Seventy-nine percent of GC and 93% of genetics residency program directors agree that there should be recommendations on how to teach students to deliver this news. Our results show that techniques for DDN are integrated more fully into GC program curricula than genetics residency curricula. Directors of both types of programs desire recommendations and more standardized education for training students to deliver difficult news.     

Caregiver‐mediated joint attention intervention

Joint attention is a pivotal social communication skill often absent or impaired in young children with autism spectrum disorder. Joint attention is the shared and alternating attention of two individuals on an object or event, and has implications for later communication and social communication skills. This study used a concurrent multiple‐baseline design across 3 caregiver–child dyads to train caregivers to teach response to joint attention behaviors to their 3–6 years old children with moderate to severe autism spectrum disorder. Caregivers were trained on strategies including prompting, time delay, and elements of naturalistic teaching and implemented the intervention in brief 10‐min sessions 2–3 times per week. Results indicate parent mastery of intervention and substantial increase in child response to joint attention behaviors both prompted and independent. Implications for practice and areas for future research are discussed.     

Disclosure on Campus: Students’ Decisions to Tell Others About Unwanted Sexual Experiences,Intimate Partner Violence,and Stalking

The scope of student victimization occurring on college campuses is problematic, drawing the attention of researchers and campus officials. While most researchers of the disclosure of these unwanted experiences tend to examine just 1 form of victimization, a direct comparison of the disclosure of different types of campus victimization within a singular study is missing in the literature. The current study aimed to address this issue by examining 4 types of victimization experiences (unwanted sexual contact, unwanted sexual intercourse, intimate partner violence, and stalking) in a college population. A common set of possible predictors of disclosure were examined, including both demographic (e.g., gender, race, age) and situational factors (e.g., alcohol use, level of fear, relationship with perpetrator). While patterns of similarity across all victimization experiences emerged, the impact of gender, race, age, and alcohol use on disclosure decisions varied substantially by victimization type. The findings of this study address the gap in the current literature by providing a comparison and contrast of the influence of predictors across different types of victimization. Furthermore, the findings provide needed information that could help colleges and universities develop ways to encourage support-seeking and reporting among students.     

Teachers’ Knowledge of Evidence-Based Interventions and Available School Resources for Children with Emotional and Behavioral Problems

School professionals need to be prepared to support children with emotional and behavioral problems. Teachers in particular should be aware of the resources provided by their school as well as the evidence-based practices available to support children with behavioral problems. This study explored general education teachers’ knowledge of 10 evidence-based interventions as well as resources and data collected at their schools to support children with mental health problems. Participants included 239 general educators from 5 school districts. Overall, most teachers had not heard of 9 out of 10 of the evidence-based programs presented. Teachers were also not sure whether their schools provided specific assessments and interventions to support children. One particularly noteworthy finding was that 57% of teachers were not sure whether their schools provided functional behavioral assessment and intervention planning. Findings illuminate a need for continued work in this area.     

Anxiety Symptoms in African American Children: Relations with Ethnic Pride,Anxiety Sensitivity,and Parenting

This cross-sectional study examined the relations among children’s ethnic pride, perceived parenting behavior (i.e., parental control, parental acceptance), anxiety sensitivity, and child anxiety symptoms (i.e., physical symptoms, social anxiety symptoms, separation anxiety symptoms, and harm avoidance symptoms) in 266 African American school children (M = 9.98 years old; 55% girls). Structural equation modeling results indicated that high ethnic pride was associated with high parental acceptance. High perceived parental acceptance, in turn, was related to children reporting low levels of social anxiety symptoms and high levels of harm avoidance. In addition, high parental control was related to high anxiety sensitivity. Anxiety sensitivity partially mediated the relation between parental control and separation anxiety symptoms, such that parental control was both directly and indirectly related to separation anxiety symptoms. Parental control was indirectly related to physical symptoms, social anxiety symptoms, and harm avoidance symptoms through its direct link to anxiety sensitivity. The study’s results increment knowledge about factors influencing specific dimensions of anxiety in African American children.     

Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE)

The successful adoption of technology is becoming increasingly important to functional independence. The present article reports findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE) on the use of technology among community-dwelling adults. The sample included 1,204 individuals ranging in age from 18-91 years. All participants completed a battery that included measures of demographic characteristics, self-rated health, experience with technology, attitudes toward computers, and component cognitive abilities. Findings indicate that the older adults were less likely than younger adults to use technology in general, computers, and the World Wide Web. The results also indicate that computer anxiety, fluid intelligence, and crystallized intelligence were important predictors of the use of technology. The relationship between age and adoption of technology was mediated by cognitive abilities, computer self-efficacy, and computer anxiety. These findings are discussed in terms of training strategies to promote technology adoption.     

Promoting response variability and stimulus generalization in martial arts training

The effects of reinforcement and extinction on response variability and stimulus generalization in the punching and kicking techniques of 2 martial arts students were evaluated across drill and sparring conditions. During both conditions, the students were asked to demonstrate different techniques in response to an instructor's punching attack. During baseline, the students received no feedback on their responses in either condition. During the intervention phase, the students received differential reinforcement in the form of instructor feedback for each different punching or kicking technique they performed during a session of the drill condition, but no reinforcement was provided for techniques in the sparring condition. Results showed that both students increased the number of different techniques they performed when reinforcement and extinction procedures were conducted during the drill condition, and that this increase in response variability generalized to the sparring condition.     

A posteriori information effects on culpability judgments from a cross-cultural perspective

A posteriori information about the moral attributes of the victim of a crime can affect an observer's judgment on the culpability of the actor of the crime so that negative moral attributes of the victim will lead to a lower judgment of culpability. The authors found this effect of a posteriori information among 118 American and 123 Chinese participants, but the underlying mechanisms were different between the two cultural groups. The Americans considered the psychological state of the actor during the crime, whereas the Chinese considered the morality of the actor during the crime. The authors discussed these results in light of the respondents' implicit theories of morality.