New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.     

Involuntary memory and the development of retrieval skills in young children

An incidental memory paradigm was used to study involuntary encoding processes and voluntary retrieval strategies in children's memory. Preschool (mean age: 4 years, 4 months) and kindergarten (mean age: 5 years, 10 months) children sorted pictures according to their color or category membership, and then received either a recall test (Experiment 1) or a recognition test (Experiment 2). Better retention of category- than color-sorted items was observed for kindergarten children in free recall, preschool and kindergarten children in cued recall, and neither group in recognition. These results were interpreted in terms of the retrieval strategies used by children in each of the memory tasks. The importance of distinguishing between voluntary and involuntary memory processes, and between acquisition and retrieval, in studies of depth-of-processing was emphasized. Developmental differences in performance appear to derive primarily from the role of voluntary search strategies in retrieval, rather than from age differences in involuntary encoding processes.     

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.     

Performance of dyslexic children on speech perception tests

Several researchers who have compared the performance of dyslexic and normal-reading children on a variety of different tasks have suggested that dyslexic children may have subtle deficits in the phonemic analysis of spoken as well as written language. Thus it is of interest to know how children who have extraordinary difficulty learning to read can perform explicity auditory-phonetic tasks. Seventeen dyslexic children (10 years of age) and a group of 17 controls were administered tests of identification and discrimination of synthesized voiced stop consonants differing in place of articulation. These were tests of the type used to study categorical perception in adults, adapted for use with young children. Significant differences between dyslexics and controls were found in both kinds of tasks; the pattern of identification and discrimination differences suggests an inconsistency in the dyslexics' phonetic classification of auditory cues. A significant relationship was found between reading level and speech discrimination.     

Syntactic influences on stuttering in young child stutterers

This study examined the location and rate of stuttering in the spontaneous speech of nine young stutterers (4.0–6.6 yr) in relation to certain aspects of syntax. It was designed to answer the following questions: Is there more stuttering at clause onset (boundary) than at other points in the clause? Does the type of clause influence rate of stuttering? Is there more stuttering on complex than on simple sentences? The syntactic analysis defined 10 clause types (seven pertaining to complex sentences and three pertaining to simple sentences); clause boundaries (taking into account “filler” words occuring in such positions); and hierarchical constituent structure within sentences. Stuttering was found with significantly greater frequency at clause boundaries than at internal (nonboundary) positions of clauses. This was apparent for nine of the 10 clause types, the exception being complement clauses. The word “and” at the beginning of simple and complex sentences provoked a high rate of stuttering. The hierarchical structure within the clause did not influence the location of stuttering, and sentence complexity was not a factor in the rate of stuttering.     

Are there constraints on childhood disfluency?

Analysis of the spontaneous speech of eight stuttering and eight normally fluent children reveals that (a) the location of both stuttering and normal disfluent moments is constrained by sentential constituent structure, and (b) stuttering children experience fluency breakdown with a particular type of constituent (verb phrase) not usually disfluently produced by normals. A view of early stuttering as a sentence planning and integration disorder is present.     

Stuttering and fluency: Exclusive events or points on a continuum?

In recent years, several studies have been conducted in which the fluency of stutterers was compared with that of normal speakers. These investigations have been of two basic types, some involving objective measures of physiologic, aerodynamic, or acoustic features of the subjects' fluent speech signal, and others involving experiments performed in which listeners attempted to distinguish the fluency produced by stutterers from that generated by normal speakers. The body of literature pertaining to each of these two types of investigations is reviewed and interpreted. The interpretations offered are then developed in an effort to shed further light on both fluency and stuttering. Implications for further research, as well as for the evaluation, treatment, and post-therapy assessment of stutterers are drawn.     

Concurrent validity of the WISC-R factor scores

This study investigated the efficacy of predicting academic achievement as measured by the Wide Range Achievement Test using the factor scores of the Wechsler Intelligence Scale for Children-Revised as potential predictors. Both instruments were administered to 200 school children referred for psychological evaluations. Factor scores for the WISC-R were computed according to equations provided by Gutkin (1978). These factor scores then were regressed in a stepwise manner on the Reading, Spelling, and Arithmetic standard scores from the Wide Range Achievement Test. Stepwise regressions also were performed using the traditional Verbal and Performance IQs as the potential predictors. A comparison was made between the results obtained by use of the factors or the more common scores. The results indicated that the Freedom From Distractibility factor score significantly aided in the prediction of Reading and Spelling achievement and was of primary importance in predicting Arithmetic achievement. When the stepwise results using the different scores were contrasted, the factor scores accounted for appreaciably more variance in Arithmetic than did the traditional Verbal and Performance IQs. Derived regression equations are reported along with a discussion of the interpretability of the Freedom From Distractibility factor.