Teaching reading to disabled readers with language disorders: A controlled evaluation of synthetic speech feedback

In a long-term study two groups of language and reading impaired students ( N = 15 + 15) were reading with the aid of segmented speech-feedback in a computerized program. One group received feedback that was simultaneously segmented visually and auditorily into syllables, the other received feedback by letter names. In both groups subjects were expected to synthesize segments into words and to compare their synthesis to whole word feed-back subsequently provided by the computer. They worked for half a lesson (approximately 20 minutes) a day for a total of 40 days. During this period, the experiment groups progressed more in reading than a control group of age and reading-level-matched students ( N = 35) who received traditional remedial instruction. The group in the syllable condition gained slightly more in non-word reading and in syllable segmentation than did the letter group. Differences in gains in reading abilities were not explained by differences in age, but to some extent by initial level of phoneme and syllable awareness. Future applications of the speech-feedback system are discussed.     

A comparison of self-instructional checking procedures for remediating mathematical deficits

We examined the relative effectiveness of three procedures for teaching long multiplication/division to seven adolescents with learning disabilities: no-checking, end-checking, and multi-checking. During training, each subject was taught by modelling and imitation to verbalize self-instructions in the form of a strategy while solving the problems. The relative effects of the checking and no-checking procedures on accuracy and rate of problems completed were examined in an alternating treatments design. The best treatment was then given alone and a reversal was implemented six weeks later, followed by a return to the best treatment during a final phase. Irrespective of the procedure used, the subjects' accuracy improved while the rate of problems completed decreased. These effects were greatest with the multi-checking procedure for six of the seven subjects. Generalization to untaught problems of various levels of complexity occurred under all procedures. Though maintenance effects were seen during the follow-up, accuracy was generally higher and more reliable when the subject's best checking procedure was reinstated. It is suggested that error detection and correction were important for maintaining high levels of accuracy and that these operated differentially in the three procedures to produce the differing levels of accuracy. The role of other factors such as pre-skill knowledge, complexity of the problem and prior reinforcement history are also considered.     

Approaches to Cognitive Remediation of Neuropsychological Deficits in Schizophrenia: A Review and Meta-Analysis

A review and critique of the literature pertaining to the use of cognitive remediation techniques in patients with schizophrenia is presented. The review is organized into three sections, according to the neuropsychological deficit targeted for remediation: 1) executive-function, 2) attention, and 3) memory. With regards to executive-function, despite an initial report suggesting that Wisconsin Card Sorting Test performance cannot be remediated, subsequent studies suggest that performance can be improved on a variety of dependent measures including perseverative errors, categories achieved, and conceptual level responses. These observations were confirmed by a meta-analytic investigation that revealed large mean effects sizes (d ₊ = 0.96) for these studies. Effect sizes were homogenous across discrepant remediation strategies and dependent measures. With regards to attention, serial scanning can be improved with instruction and reinforcement, whereas there is mixed evidence suggesting that practice-based attention drills can improve performance on measures of sustained attention in schizophrenia. With regards to memory, relatively simple semantic and affective elaborate encoding strategies elevates verbal list-learning memory in patients with schizophrenia to levels consistent with controls. A similar encoding procedure, combined with vigilance training, produces substantial improvement in social cue recognition. Avenues for future research are discussed.     

Ethics Remediation,Rehabilitation, and Recommitment to Medical Professionalism: A Programmatic Approach

This article recounts the development of the Professional/Problem-Based Ethics (ProBE) Program, the original physicians’ professional ethics remediation course. Since 1992, more than 1,200 healthcare professionals of many disciplines have been mandated to attend ProBE by licensing boards and other oversight entities. Using a small-group, interprofessional setting, the ProBE Program assists participants to discover and articulate ethical underpinnings violated by their misconduct; appreciate professional responsibilities that are societal, regulatory, and ethical; and recommit to professional ideals. The authors describe the rationale for developing ProBE, its curriculum, participant demographics, and infractions and reconsider medical professionalism in light of two decades of ProBE.     

Spaced Retrieval Enhances Memory for a Name–Face–Occupation Association in Older Adults With Probable Alzheimer's Disease

The authors trained 4 older adults with probable Alzheimer's disease to recall a name–face–occupation association using the spaced retrieval technique. Six training sessions were administered over a 2-week period. On each trial, participants selected a target photograph and stated the target name and occupation at increasingly longer retention intervals, contingent upon successful recall. Two transfer tasks were included to determine whether the trained association transferred to the person whose picture served as the training stimulus. Results yielded a positive effect of spaced retrieval on memory for the trained association. Analyses of errors revealed that participants remembered the target person's occupation more often than his or her name. There was modest evidence of transfer of the name–face–occupation association to the actual person. Implications of these data for memory remediation and quality of life in cognitively impaired older adults are considered.     

Regaining access to marginal knowledge in a classroom setting

Students learn large amounts of information, but not all of it is remembered after courses end – meaning that valuable class time is often spent reviewing background material. Crucially, laboratory research suggests different strategies will be effective when reactivating previously learned information (i.e. marginal knowledge), as opposed to learning new information. In two experiments, we evaluated whether these laboratory results translated to the classroom. Topics from prior courses were tested to document which information students could no longer retrieve. Half were assigned to a not-tested control and half to the intervention; for these topics, students answered multiple-choice questions (without feedback) that gave them the chance to recognize the information they had failed to retrieve. Weeks later, students completed a final assessment on all topics. Crucially, multiple-choice testing increased the retrieval of previously forgotten information, providing the first classroom demonstration of the reactivation of marginal knowledge.     

Trainees with Competence Problems in the Professionalism Domain

Increasingly, professionalism has been recognized as a core competency for health service professionals and is the domain in which vexing competence problems are observed in trainees. We begin by describing manifestations of problems of professionalism in accord with the values that fall within the rubric of this multifaceted construct. We provide an approach for evaluating problems of professionalism and discuss intervention for trainees with mild, moderate, or severe problems in this domain. We propose implications for training focused on enhancing the culture of programs; bolstering the education, guidance, and mentoring provided related to professionalism; and encouraging best practices for addressing trainees with problems of professionalism. We conclude by sharing ideas about defining professionalism, identifying problems of professionalism, strengthening our approach to assessing professionalism and intervening when problems are evident, developing strategies for preventing professionalism problems, and ensuring that psychologists take seriously their responsibility to address professionalism concerns with colleagues.     

A pilot investigation on the effects of combination transcranial direct current stimulation and speed of processing cognitive remediation therapy on simulated driving behavior in older adults with HIV

Cognitive impairments seen in people living with HIV (PLWH) are associated with difficulties in everyday functioning, specifically driving. This study utilized speed of processing cognitive remediation therapy (SOP-CRT) with transcranial direct current stimulation (tDCS) to gauge the feasibility and impact on simulated driving. Thirty PLWH (M_age = 54.53, SD = 3.33) were randomly assigned to either: sham tDCS SOP-CRT or active tDCS SOP-CRT. Seven indicators of simulated driving performance and safety were obtained. Repeated measures ANOVAs controlling for driver’s license status (valid and current license or expired/no license) revealed a large training effect on average driving speed. Participants who received active tDCS SOP-CRT showed a slower average driving speed (p = 0.020, d = 0.972) than those who received sham tDCS SOP-CRT. Non-significant small-to-medium effects were seen for driving violations, collisions, variability in lane positioning, and lane deviations. Combination tDCS SOP-CRT was found to increase indices of cautionary simulated driving behavior. Findings reveal a potential avenue of intervention and rehabilitation for improving driving safety among vulnerable at-risk populations, such as those aging with chronic disease.