Persistence during and resurgence following noncontingent reinforcement implemented with and without extinction

Noncontingent reinforcement (NCR) is typically implemented with extinction (EXT) for destructive behavior reinforced by social consequences and without EXT for destructive behavior reinforced by sensory consequences. Behavioral momentum theory (BMT) predicts that responding will be more persistent, and treatment relapse in the form of response resurgence more likely, when NCR is implemented without EXT due to the greater overall rate of reinforcement associated with this intervention. We used an analogue arrangement to test these predictions of BMT by comparing NCR implemented with and without EXT. For two of three participants, we observed more immediate reductions in responding during NCR without EXT. However, for all participants, NCR without EXT produced greater resurgence than NCR with EXT when we discontinued all reinforcers during an EXT Only phase, although there was variability in response patterns across and within participants. Implications for treatment of destructive behavior using NCR are discussed.     

Attention and Communication Following TBI: Making the Connection through a Meta-Narrative Systematic Review

Neuropsychology Review - Background and aim: Communication difficulties are one of the hallmark characteristics of adults following traumatic brain injury (TBI), a difficulty that incorporates...     

Screening for Muir-Torre Syndrome Using Mismatch Repair Protein Immunohistochemistry of Sebaceous Neoplasms

Screening for the Muir-Torre variant of Lynch Syndrome (LS) using Mismatch Repair (MMR) gene immunohistochemistry (IHC) on sebaceous neoplasms (SNs) is technically feasible. To date, research into the clinical utility of MMR IHC for this indication is limited. We conducted a retrospective chart review of 90 patients with MMR IHC completed on at least one SN from January 2005 to May 2010. SNs included were adenomas, epitheliomas, carcinomas and basal and squamous cell carcinomas with sebaceous differentiation. Of the 90 patients, 13 (14 %) had genetically confirmed or fulfilled clinical criteria for a diagnosis of MTS and 51 patients (57 %) presented with an abnormal MMR IHC result (loss of one or more MMR proteins) on at least one SN. Abnormal IHC had a sensitivity of 85 %, specificity of 48 %, positive predictive value (PPV) of 22 % and negative predictive value (NPV) of 95 % when evaluating for MTS. When personal or family history of colorectal cancer (≥2 family members with a history of colorectal cancer) was taken into consideration, ignoring IHC results, sensitivity was 92 %, specificity was 99 %, PPV was 92 % and NPV was 99 %. MMR IHC on SNs when used to screen for MTS has poor diagnostic utility. We recommend that MMR IHC not be performed routinely on SNs when the patient does not have either personal or family history of colorectal cancer.     

“Who Cares for the Children?” Lessons from a Global Perspective of Child Care Policy

We present the argument that the meaning of child care and the policies that address it are explicitly linked with national ideologies, work force participation, economic success, and child outcomes. The relationship between family and child care policies is cyclical in nature, with a nation’s ideology and vision of family often driving child care policies, while child care policies in turn drive and support a nation’s ideology. We examine the interrelatedness of child care policy and national ideologies of family in selected industrialized countries. Specifically, this paper first defines child care policy and discusses the national ideological frameworks that provide the impetus for child care policy formation and implementation. Second, the paper explores current child care policies and their connection to the historical and political context of several countries within, including France, Germany, Japan, South Korea, Belgium, the Nordic countries, and the United States. Lastly, recommendations are offered for the future of child care policy development with specific recommendations for child care policy development in the United States.     

Caregivers can implement play-based instruction without disrupting child preference

Young children diagnosed with autism spectrum disorder often require systematic teaching to learn new skills, and caregivers can teach their children by embedding learning opportunities in a play-based context. However, researchers have not evaluated procedures to train caregivers how to implement a combination of strategies designed to establish rapport and early language skills while maintaining play as a preferred context. Caregiver–child dyads composed of 2 mothers and their sons were recruited to participate. A multiple-probe design across strategies was used to demonstrate the efficacy of behavioral skills training on the mothers' integration of parallel play, child-directed interaction, teaching requests (mands), and teaching labels (tacts). Both children acquired the target requests and labels as a function of their mothers' teaching. By assessing the children's preferences, we confirmed the teaching strategies did not decrease toy engagement or the value of playing with their mother. We obtained stimulus generalization of the mothers' implementation of the strategies from a clinic to their home and maintenance of mother and child performance across a month.     

Self Diagnosis of Lynch Syndrome Using Direct to Consumer Genetic Testing: A Case Study

We are reporting what we believe to be the first published case of patient initiated direct to consumer (DTC) genetic testing to test for the presence of a known familial mutation. Our client in this case is from a known MSH2 family; both his/her parent and associated grandparent have previously tested positive for the known familial MSH2 mutation. Using 23andme’s “family inheritance genome-wide comparison” option we were able to determine that our client most likely inherited the known familial MSH2 mutation without pursuing single site genetic testing. Our client pursued DTC genetic testing instead of single site genetic testing due to the fear of genetic discrimination. This case shows that patients are still fearful of genetic discrimination, despite the passage of the Genetic Information Nondiscrimination Act (GINA), and that DTC genetic testing may be useful despite the overall negative feeling towards this type of testing in the genetic counseling community.