Cultural competency in genetic counseling

Incorporating a cross-cultural curriculum into genetic counseling training programs demonstrates a professional conviction of genetic counselors that cultural issues are important in genetic counseling. Funded by the Special Projects Fund in 1993 from the National Society of Genetic Counselors and the Kitson Fund from the Department of Social, Organizational, and Counseling Psychology, Teachers College, Columbia University, theHandbook of Cross-Cultural Genetic Counseling was developed to provide genetic counseling programs a curriculum to teach cross-cultural genetic counseling. The theoretical rationale for the development of a cultural curriculum is presented. By expanding cultural knowledge, developing an awareness of oneself and others, and increasing the repertoire of culturally relevant counseling skills within a socio-political context, genetic counselors will be able to better serve all clients seeking genetic counseling.     

Teaching spontaneous requests to children with autism using a time delay procedure with multi-component toys

Children with autism were taught spontaneous requests through a time delay procedure. Unlike previous research, which usually employed food as the target stimuli to be requested, the present study used toy pieces from multi-component toys. The procedure involved presenting a child with the target stimulus, with the trainer prompting the child by immediately modeling the request response. When the response was imitated without error, prompting was delayed with the time interval gradually being increased over trials. A spontaneous or imitated response was reinforced by giving the child the requested object. As the stimulus/model interval increased, children with autism were expected to initiate the request by themselves prior to the prompt. The efficacy of the time delay procedure was assessed using a multiple baseline across subject design with three Chinese boys with autism. Results showed that the three children acquired a 100% performance within five to nine sessions of training and the skill was maintained at the one-month and three-month followups. Furthermore, the learned response transferred to various conditions when tested across setting, person, toy, and food items. These results suggest that toys, the multi-component ones in particular, served well as reinforcers for language training. Furthermore these findings confirmed the practical utility of the time delay procedure for promoting spontaneous communication skills in children with autism.     

An integrated mindfulness and acceptance-based program for young elite female basketball players: Exploratory study of how it works and for whom it works best

In order to better understand how an integrated mindfulness and acceptance-based intervention works and for whom it works best, study objectives were to examine (i) the trajectories of mindfulness skills and performance-related outcomes during the intervention, and athletes’ perceptions of the impact of the intervention; and (ii) the potential moderating effects of personality characteristics on changes in targeted variables associated with the intervention. The sample consisted of 40 young elite female basketball players (M = 16.33, SD = 0.75 years) from three incoming groups at the French Federal Basketball Center over a 3-year period. All players participated in a 15-week Mindfulness BasketBall Integrated program. They completed online questionnaires measuring personality traits 10 months before the intervention, as well as pre-, mid- and post-intervention measurements of mindfulness skills, intensity and directional interpretation of stress, and performance satisfaction. They also participated in semi-structured social validation interviews conducted one month after the intervention. The results of the multilevel growth curve (MGCA) and thematic analyses revealed how the mindfulness skills and performance-related outcomes evolved over the course of the intervention and how these changes were perceived by the athletes. Specifically, the MGCA showed significant linear increases in acceptance, positive stress direction, and performance satisfaction. The complementary social validation data indicated perceived improvements in mindfulness skills and performance. The MGCA also showed that baseline personality traits moderated the effects of the program on acceptance and experience of stress. These findings may be used to inform the design of more effective integrated mindfulness and acceptance-based interventions.     

COMPARISON OF PROTOTYPE AND ROTE INSTRUCTION OF ENGLISH NAMES FOR CHINESE VISUAL CHARACTERS

This study compared prototype and rote instruction of English names for Chinese visual characters. In the prototype condition, participants were taught the meaning of the prototype that served as the distinctive feature of multicomponent characters. In the rote condition, participants traced the character and wrote its translation. Participants learned more rapidly and maintained more words in the prototype condition.     

SEQUENTIAL APPLICATION OF MAJOR HABIT-REVERSAL COMPONENTS TO TREAT MOTOR TICS IN CHILDREN

In this study, we sequentially administered up to four components of the habit-reversal treatment to 4 children with motor tics within a multiple baseline design. The habit-reversal components included (a) awareness training; (b) awareness training and self-monitoring; (c) awareness training, self-monitoring, and social support; and (d) awareness training, social support, and the use of a competing response. Results demonstrated that the combined use of awareness training, social support, and competing response training was effective in eliminating motor tics in 2 of 4 children, that awareness training alone was effective for 1 child, and that a combination of awareness training and self-monitoring was effective for the 4th child. The treatment and ensuing improvement were found to be socially valid. We discuss possible explanations for these results and recommend directions for future research.     

CHOICE-MAKING TREATMENT OF YOUNG CHILDREN'S SEVERE BEHAVIOR PROBLEMS

The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an alternative neutral response) to obtain different durations and qualities of reinforcement, was conducted. Finally, treatment packages involving choice making via manding were implemented to decrease inappropriate behavior and to increase mands. The results extended previous applications of choice making to severe behavior disorders and across behaviors maintained by positive and negative reinforcement.     

Token reinforcement, choice, and self-control in pigeons.

Pigeons were exposed to self-control procedures that involved illumination of light-emitting diodes (LEDs) as a form of token reinforcement. In a discrete-trials arrangement, subjects chose between one and three LEDs; each LED was exchangeable for 2-s access to food during distinct posttrial exchange periods. In Experiment 1, subjects generally preferred the immediate presentation of a single LED over the delayed presentation of three LEDs, but differences in the delay to the exchange period between the two options prevented a clear assessment of the relative influence of LED delay and exchange-period delay as determinants of choice. In Experiment 2, in which delays to the exchange period from either alternative were equal in most conditions, all subjects preferred the delayed three LEDs more often than in Experiment-1. In Experiment 3, subjects preferred the option that resulted in a greater amount of food more often if the choices also produced LEDs than if they did not. In Experiment 4, preference for the delayed three LEDs was obtained when delays to the exchange period were equal, but reversed in favor of an immediate single LED when the latter choice also resulted in quicker access to exchange periods. The overall pattern of results suggests that (a) delay to the exchange period is a more critical determinant of choice than is delay to token presentation; (b) tokens may function as conditioned reinforcers, although their discriminative properties may be responsible for the self-control that occurs under token reinforcer arrangements; and (c) previously reported differences in the self-control choices of humans and pigeons may have resulted at least in part from the procedural conventions of using token reinforcers with human subjects and food reinforcers with pigeon subjects.     

Effects of cocaine on briefly signaled versus completely signaled delays to reinforcement.

Key pecking by 4 pigeons was maintained by a multiple schedule consisting of two variable-interval 60-s schedules wherein each food presentation followed a nonresetting 27-s delay that was either briefly signaled at its outset or completely signaled. Brief-signal duration was adjusted so that response rates maintained by the briefly and completely signaled delays of reinforcement were similar. In general, acute administration of small to intermediate doses (0.3 to 3.0 mg/kg) of cocaine produced either small increases in response rates in both components or no change, and larger doses (5.6 to 13.0 mg/kg) decreased response rates. Chronic (i.e., daily) cocaine administration (10.0 mg/kg) resulted in tolerance to the rate-decreasing effects in both components. Cocaine's effects were generally similar whether delays were completely or briefly signaled. Discontinuation of cocaine administration and subsequent removal of the delay signals also had similar effects in both components of the multiple schedule. Taken together, these results are consistent with the view that the two types of delay signals were equally effective in maintaining responding during the variable-interval schedules.     

Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

An Ecological Approach to Enhancing Parenting Skills in Family Therapy

To increase the effectiveness of parent education interventions, family therapists can address those factors that shape the way in which parents interact with their children. This article presents ecological theory as a framework that can help clinicians expand the range of their parent training efforts. In order to assess the utility of ecological theory for clinical practice, the present study empirically explored the ways in which selected characteristics of parents, children, and the family context related to mothers' parenting behavior. Specific recommendations for family therapists who employ parent training techniques are offered.