Pre-screening education in multiple marker screening programs: The effect on patient anxiety and knowledge

Previous studies have shown that unexplained deviations in maternal serum multiple marker screening (MMS) generate considerable anxiety during the remainder of pregnancy. While the role of education in decreasing anxiety is documented, to date there has been no prospective evaluation of which educational practices might minimize this emotional stress. In a pilot study, we prospectively examined the effects on anxiety and knowledge by providing information about MMS (1) by genetic counselor, (2) by pamphlet, and (3) by primary physician. Women randomized to one of these three modalities were administered the Spielberger State- Trait Anxiety Inventory [STAI] and knowledge questionnaires at their initial obstetrics visit, at their second visit after educational intervention and 1–2 weeks after MMS results were provided to patients. Education resulted in an increase in knowledge and post-education knowledge was different between educational modalities. Anxiety declined in patients educated through genetic counseling or a pamphlet.     

The psychologist's role in assessing and facilitating patients' knowledge of advance directives in medical settings: A preliminary investigation

In a time of budgetary shortfalls in the medical industry, an aging population, and an increased emphasis on health care choices, psychologists are being called upon to administer advance medical directive programs to patients. This study reports preliminary findings from a program to assess and facilitate patients' knowledge of advance directives (ADs) by the Psychology Service at the Ann Arbor VA Medical Center. The participant pool included 243 male veteran patients admitted to medical and surgical wards at the hospital. The intervention included the use of a computer-generated prompt for consultation, which was sent to the psychology staff in response to a patient inquiry regarding ADs. It also involved an increased emphasis on the delivery of written material on ADs by the admissions clerks. The intervention appeared to result in a modest increase in patients' knowledge of advance directives. Suggestions are offered for areas that should be emphasized in future attempts to increase patients' knowledge and utilization of advance directives.     

Behavioral coaching in the development of skills in football, gymnastics, and tennis

A review of the literature indicates that methods of skill acquisition based on the operant paradigm have been scientifically validated with many motor behaviors. However, these procedures have been limited to the use of positive reinforcement for correct performance when applied to the acquisition of complex sports skills in natural settings. To find complementary procedures to enhance skill acquisition, a coaching method involving several behavioral techniques was developed that focused on remediation of errors. This coaching method combined the following components: (1) systematic use of verbal instructions and feedback, (2) positive and negative reinforcement, (3) positive practice, and (4) time out. Three sports, football, gymnastics, and tennis, were selected to determine the effectiveness and generality of this behavioral coaching method. A total of 23 male and female subjects, ranging in age from 11 to 35, was included in this study. Baseline data were first collected for each sport under standard coaching conditions. Next, the behavioral coaching method was evaluated depending on the sport in either a multiple baseline or a reversal design. The behavioral dimensions selected were blocking in football; backward walkovers, front hand springs, and reverse kips in gymnastics; and the forehand, backhand, and serve in tennis. Behavioral coaching was immediately effective in increasing the correct execution of complex skills in all three sports. Gains of up to 10 times the baseline performance were achieved in each sport. In football, behavioral coaching resulted in an increase in correct blocking performance from a baseline average of 5% to 51.3%. Gymnasts' performances increased from baseline averages of 2.7% to 52.6% across the three skills. In tennis, standard coaching produced an average of 6% correct performance which increased dramatically under behavioral coaching to 57% across the three strokes. The success of the behavioral coaching package used here suggests that a technology of behavior may offer additional and complementary strategies to the acquisition of motor skills in the natural environment.     

Consequence analysis: Its effects on verbal statements about an environmental project

Typically, citizens lack relevant information concerning possible consequences of proposed environmental projects. Despite federal requirements for citizen participation in decisions about proposed roadway projects, no systematic procedures exist for educating citizens as to the possible consequences of such projects. The effects of a consequence analysis procedure on community residents' verbal statements about the favorability of a proposed roadway project were assessed. The consequence analysis procedure involved asking residents to rate the desirability and magnitude of each of 48 possible consequences of the proposed roadway project. Following the intervention, overall ratings of favorability of the project changed for nine of ten residents. Community residents' ratings of the quality of participants' justifications of their position on the roadway issue provided evidence of generalization to this collateral behavior.     

A new measure for determining children's subjective organization of speech

A new technique for determining children's subjective organization of speech is described. The technique consists of teaching a child a sentence and then repeatedly (1) reading the sentence up to a selected point, (2) sounding a tone, and (3) having the child supply the next word. The time from the tone to the onset of the child's voice is the dependent variable. In the first study 6- and 8-year-old children memorized the following sentence: “John likes to feed the little puppies in the barn.” Their response times suggested that the dominant segmentation pattern consisted of four phrases: a subject phrase, a verb phrase, an object phrase and a modifier phrase. Within each phrase differences between reaction times were on the order of 30 msec. Across phrases they were on the order of 120 msec. The same trend emerged for subsamples of the children with various short-term memory sizes, and for adults. It also appeared for subsamples of the total scores (e.g., first six trials and last six trials). In order to provide further evidence of the technique's validity, different sentences of the same general type were presented to children with short-term memory spans of either 3, 4, or 5. As predicted, it was found that when children's spans corresponded to the number of hypothesized chunks (i.e., 4), they could repeat the sentences verbatim on the first exposure. They could not do so, however, when their spans were lower than that value or when the number of phrases was increased. It was concluded that the new technique is a promising one for assessing young children's patterns of speech segmentation.     

Effects of neutral and positive stimuli on stuttering: “Calling attention to stuttering” revisited

This study investigated the effects of presumably positive and neutral response-contingent stimuli on the occurence of stuttering. Eight adult stutterers spoke spontaneously during a 60-min experimental session, which was divided into three 20-min periods. During Condition I no stimuli were delivered. During Condition II a digital counter and a pair of yellow lights were activated each time the subject stuttered. During Condition III these same response-contingent stimuli were delivered, but with the additional factor that the subject would earn 5¢ each time the counter moved forward and the lights were illuminated. Conditions II and III were counterbalanced across subjects. The experimenter was unaware of which of the two contingencies were operative during Conditions II and III. Results showed no significant changes in occurence of stuttering due to either response-contingent stimulus. A discussion of theoretical and experimental implications is given.     

Self-esteem and cognitive consistency effects on self-other evaluation

Reactions to bogus evaluations of one's self, either positively or negatively discrepant from one's own self-evaluation, were investigated among subjects differing in self-ideal discrepancy. All subjects exhibited greater acceptance of the source of favorable information than the source of unfavorable information, and changed their self-evaluation more toward the favorable than unfavorable position. However, among low self-ideal discrepancy subjects, the change in self-evaluation was accompanied by a similar change in friend evaluation, thereby maintaining their standing in relation to this friend after receiving either positive or negative evaluations. In contrast, high discrepancy subjects downgraded the friend more and upgraded the friend less than themselves, thereby enhancing their relative standing as a result of the feedback. These findings indicated that defensive or self-enhancing effects on self-evaluation processes are determined by self-ideal discrepancy.     

Shift of visual field preference for Hebrew words in native speakers learning to read

Lateralization for Hebrew words was tested in both the visual and auditory modalities in Israeli children learning to read their native language, Hebrew. A left visual field preference for tachistoscopically presented words was found in the second graders in contrast to a right visual field preference for the same words in the third graders. Children in both grades showed a right ear dominance for similar words presented dichotically. These data suggest right hemisphere involvement in acquiring reading skills of a native language.     

The communication disorder in dialysis dementia: A case report

The communication disorder in dialysis dementia is an integral feature of the syndrome. This report describes the communication disorder in a 67-year-old man over a period of 4 months from his admission to the hospital to his death. In the early stage of the syndrome, the most prominent feature was a speech problem, the characteristics of which may vary among cases. In the middle stage, it was difficult to distinguish among aphemia, aphasia, or a combination of dysarthria and confusional state. The severity of the problems in these stages was temporally related to the dialysis treatments. The final stage was characterized by constant mutism and was unrelated to the dialysis treatments. Death occurred 10 months after the communication problems emerged. Communication studies of dialysis dementia patients may offer a systematic method to monitor the course of the syndrome, its response to therapeutic trials, and a clinical model for the study of communication disorders in general.     

The use of averaged electroencephalic response techniques in the study of auditory processing related to speech and language

This paper reviews a number of studies done by the authors and others, who have utilized various averaged electroencephalic response (AER) techniques to study speech and language processing. Pertinent studies are described in detail. A relatively new AER technique, auditory brainstem responses (ABR), is described and its usefulness in studying auditory processing activity related to speech and language is outlined. In addition, a series of ABR studies, that have demonstrated significant male—female differences in ABR auditory processing abilities, is presented and the relevance of these data to already established differences in male—female language, hearing, and cognitive abilities is discussed.