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The use of standardized tests for individuals with cognitive-communication disorders.

The assessment of individuals with cognitive-communication disorders after traumatic brain injury can present a major challenge to speech-language pathologists. For this reason, the Academy of Neurologic Communication Disorders and Sciences Practice Guidelines Group dedicated a specific writing committee to this topic. This article summarizes the writing committee's efforts related to the use of standardized, norm-referenced tests. The article begins with the key questions speech-language pathologists might ask in choosing a standardized test. We then provide a summary of the results of the writing committee's data-gathering activities and a brief description of the tests that appeared to meet most established criteria for validity and reliability for use with this clinical population. The article concludes with the identification of areas in which instruments and additional normative data are needed.

Brain Injuries↗

Macrophage proteomic fingerprinting predicts HIV-1-associated cognitive impairment.

BACKGROUND: Specific proteins produced from monocytes may be linked to the pathogenesis and aid in the diagnosis of HIV-1-associated dementia (HAD). OBJECTIVE: The authors assessed whether a diagnostic phenomic protein profile could be obtained from monocyte-derived macrophages (MDM) from HIV-1-infected patients with cognitive impairment. METHODS: Twenty-one HIV-1-infected Hispanic women and 10 seronegative controls matched by age and sex were followed at the University of Puerto Rico Medical Sciences Campus, where neuropsychological, immune, and viral parameters were tested. Monocytes were recovered by Percoll gradient centrifugation from peripheral blood mononuclear cells. MDM lysates were prepared after 7 days of cultivation and protein profiles analyzed by surface enhanced laser desorption/ionization (SELDI)-time of flight (TOF) ProteinChip tests. Classification trees were prepared for statistical analyses. RESULTS: A total of 177 protein peaks from 2 to 80 kDa were evaluated in 31 patient MDM lysates by SELDI-TOF ProteinChip assays. Select protein peaks, at 5028 and 4320 Da, separated HIV-1-infected from HIV-1-seronegative subjects with a sensitivity of 100% and a specificity of 80%. Thirty-eight peaks were used to differentiate HIV-1-infected subjects with and without cognitive impairment. A 4348 Da protein separated the two groups with a sensitivity of 100% and a specificity of 75%. CONCLUSIONS: The identification of unique phenomic MDM profiles from cognitively impaired HIV-1-infected patients supports the hypothesis that changes in monocyte function parallel the development of HAD.

AIDS Dementia Complex↗

iSTART: interactive strategy training for active reading and thinking.

Interactive Strategy Training for Active Reading and Thinking (iSTART) is a Web-based application that provides young adolescent to college-age students with high-level reading strategy training to improve comprehension of science texts. iSTART is modeled after an effective, human-delivered intervention called self-explanation reading training (SERT), which trains readers to use active reading strategies to self-explain difficult texts more effectively. To make the training more widely available, the Web-based trainer has been developed. Transforming the training from a human-delivered application to a computer-based one has resulted in a highly interactive trainer that adapts its methods to the performance of the students. The iSTART trainer introduces the strategies in a simulated classroom setting with interaction between three animated characters-an instructor character and two student characters-and the human trainee. Thereafter, the trainee identifies the strategies in the explanations of a student character who is guided by an instructor character. Finally, the trainee practices self-explanation under the guidance of an instructor character. We describe this system and discuss how appropriate feedback is generated.

Adolescent↗

Cognitive neuroscience of human social behaviour.

We are an intensely social species--it has been argued that our social nature defines what makes us human, what makes us conscious or what gave us our large brains. As a new field, the social brain sciences are probing the neural underpinnings of social behaviour and have produced a banquet of data that are both tantalizing and deeply puzzling. We are finding new links between emotion and reason, between action and perception, and between representations of other people and ourselves. No less important are the links that are also being established across disciplines to understand social behaviour, as neuroscientists, social psychologists, anthropologists, ethologists and philosophers forge new collaborations.

Cognition↗

Nutritional interventions for individuals with bulimia nervosa.

Many physical and psychological effects of bulimia nervosa are caused by the patient's partial starvation and chaotic nutritional cycle. Attention should thus be initially directed to correcting nutritional deficiencies and abnormal eating patterns, and providing dietary counselling. Nevertheless, very little has been written about the nutritional management of this eating disorder. Nutritional counselling for bulimia patients is reviewed in this paper. Current knowledge about nutritional therapy and its efficacy, goals and objectives is presented, along with recommendations used in treatment programmes. Lastly, the key steps of nutritional management are summarised.

Bulimia↗

Beyond determinism and materialism, or isn't it time we took consciousness seriously?

This essay argues: (1) that the fundamental conflict between the behaviorist and cognitive approaches to psychology are philosophical, not scientific; (2) that the philosophical premises underlying behaviorism (materialism, epiphenomenalism, functional model of causality, and the rejection of concepts referring to conscious states and processes) are false; and (3) that an objective, scientific approach to psychology must take consciousness and volition as axiomatic starting points.

Cognition↗

The effect of anxiety and hostility in silent mentation on localized cerebral glucose metabolism.

Ten normal, wakeful, young (average age, 25.3 +/- 6.6 years) male subjects received positron emission tomographic (PET) scans 45 to 120 minutes after an infusion of D-[18 F]deoxyglucose in order to assess localized cerebral glucose metabolic rates during silent visual and other sensory imagery and cognitive mentation. The typescripts of the verbal reports, limited to 5 minutes, of this type of mentation (including free-associations to all the silent mental events), were blindly content-analyzed to provide objective measures of various kinds of anxiety and hostility. Many significant positive and negative correlations were found in medial cortical, lateral cortical, and subcortical gray matter, and white matter areas between the magnitude of the anxiety and hostility aroused in the silent mental processes and localized cerebral glucose metabolic rates. Clearly, energy consumption in the brain, as judged from localized glucose metabolic rates, is highly influenced by the quality and quantity of emotionally tinged private reveries and mental events occurring spontaneously within human subjects. Brain areas involved with the processing of language, sensation, cognition, memory, and emotional reactions appear to be involved especially in these significant correlations. The implications of such findings in the neurosciences and behavioral sciences are discussed.

Adult↗

Phonological dyslexia and phonological impairment: an exception to the rule?

The condition known as phonological dyslexia involves very poor reading of non-words, with otherwise good word reading performance [e.g. Derouesné & Beauvois, 1979; Sartori, G., Barry, C., & Job, R. (1984). Phonological dyslexia: A review. In R. N. Malatesha & H. A. Whitaker (Eds.), Dyslexia: A global issue. The Hague: Martinus Nijhoff Publishers]. Theoretical accounts of this non-word reading impairment suggest disruption to either a component of a non-lexical orthographic-phonological reading route [that is specifically involved in reading non-words; Coltheart, M., Rastle, K., Perry, C., Langdon, R., & Zeigler, J. (2001). A dual route cascaded model of visual word recognition and reading aloud. Psychological Review, 108, 204-256] or to generalised phonological processes on which novel reading is heavily dependent [Farah, M., Stowe, R. M., & Levinson, K. L. (1996). Phonological dyslexia: Loss of a reading-specific component of cognitive architecture? Cognitive Neuropsychology, 13, 849-868; Harm, M. W., & Seidenberg, M. S. (1999). Phonology, reading acquisition, and dyslexia: Insights from connectionist models. Psychological Review, 106, 491-528]. The present paper questions the latter hypothesis: that phonological dyslexia always occurs in connection with some other form of phonologically based disruption (i.e. in a 'cluster' of impairments that are not necessarily reading-specific). Contrary to this view, several recent studies have reported that phonological dyslexia can occur without corresponding generalised phonological impairment [e.g. Caccappolo-van Vliet, E., Miozzo, M., & Stern, Y. (2004a). Phonological dyslexia without phonological impairment? Cognitive Neuropsychology, 21, 820-839; Caccappollo-van Vliet, E., Miozzo, M., & Stern, Y. (2004b). Phonological dyslexia: A test case for reading models. Psychological Science, 15, 583-590]. However, the work is subject to a number of criticisms. The following study examines performance of a phonological dyslexic case (JH) on a variety of phonological based tasks and, unlike many other studies, components of phonological short-term memory. Despite clear impairments in reading non-words, good performance on a variety of phonological tasks makes the possibility of generalised phonologically based disruption unlikely. The view that JH's good phonological skill was dependent on the use of spelling based strategies was also excluded. As a result, JH's pattern of performance provides clear evidence that phonological dyslexia can occur without any generalised phonological impairment.

Articulation Disorders↗

The debt of neuropsychology to the epilepsies.

Both neuropsychology and psychology in general have been enhanced markedly by brain-behavior models derived from the study of the epilepsies. A significant body of neuropsychological concepts originated or were confirmed through epilepsy-based treatment and research. These concepts include the peri-Rolandic homunculus, the role of the hippocampal-temporal lobe complex in cognitive memory, hemisphere plasticity for speech in childhood, the intracarotid amytal procedure for determining hemisphere memory patency, and hemisphere-based models of cognition confirmed through human commissurotomy. Personality and social-emotional research in epilepsy are additional areas in which new conceptual models grounded in psychological science can both repay our debt to the epilepsies and provide much needed psychological research and treatment.

Brain↗

Evolutionary psychology from a developmental systems perspective: comment on Lickliter and Honeycutt (2003).

Although agreeing with R. Lickliter and H. Honeycutt (2003) that evolutionary psychology lacks and should adopt a coherent developmental model to explain how evolved mechanisms become expressed in phenotypes, it is argued that adhering to the principles of developmental systems theory, despite enhancing evolutionary psychology, would not change appreciably its basic focus. The concepts of innateness and modularity, what is inherited and what evolves, as well as the possible role of developmental plasticity in the evolution of human cognition are discussed. It is proposed that evolutionary psychology can incorporate the developmental systems perspective into its theorizing, with the end result being a science that more closely reflects human nature.

Biological Evolution↗

A neurobehavioral approach for treatment of complex partial epilepsy: efficacy.

This is a retrospective study of the efficacy of a short-term comprehensive multidisciplinary neurobehavioral treatment approach for complex partial epilepsy. Eleven patients were treated intensively for five consecutive days followed by 6 months of weekly telephone contact and an additional 6 months of monitoring of seizure logs and journals. Data was analysed at least 24 months after initiation of treatment. Pre-treatment seizure frequency ranged from 1 to 15 per month. Post-treatment seizure frequency was zero per month for the nine patients who experienced less than four seizures per month prior to treatment and less than two per month for the other two patients. Additional benefits of the treatment program were improved levels of professional achievement in the arts and computer sciences and reduction of medication dosages.

Adolescent↗

An emotional mediation theory of differential age effects in episodic and semantic memories.

Although there is a large decrement in central episodic memory processes as adults age, there is no appreciable decrement in central semantic memory processes (Allen et al., Journal of Gerontology: Psychological Sciences, 57B, P173-P186, 2002; Allen et al., Experimental Aging Research, 28, 111-142, 2002; Mitchell, Journal of Experimental Psychology: Learning, Memory, and Cognition, 15, 31-49, 1989). The authors develop a theory of episodic memory's connections to cognitive, emotional, and motivational systems to explain these differential age effects. The theory is discussed within the context of the cognitive neuroscience research regarding limbic system connectivity in conjunction with Damasio's notion of somatic markers (Descartes' error: Emotion, reason, and the human brain, New York: Grosset/Putnam, 1994). The central hypothesis is that elements of limbic system circuitry, including portions of the medial temporal lobes and frontal cortex, are associated with both working and long-term episodic memory performance, and by extension, with the capacity to engage in emotion-guided, self-regulatory processes that depend heavily on episodic memory. In contrast, the semantic memory system may have less shared interface with episodic and affective networks (i.e., the limbic-related system), and therefore remain independent of neurocognitive changes impacting emotional states and episodic-type memory processes. Accordingly, this framework may account for the pattern of age-related declines in episodic relative to semantic memory, particularly if older adults experience less emotional activation, and therefore fewer somatic markers, than younger adults. An initial empirical examination of this emotional mediation theory is presented, using preexisting data that include indicators of age, chronic tendency to focus on negative emotional stimuli (neuroticism), and working memory performance.

Adolescent↗

Are tailored health education materials always more effective than non-tailored materials?

While promising, the evidence in support of tailored health communication has not been overwhelming. One explanation is that tailored materials may be far superior to non-tailored materials in some cases, but only slightly better, no different or less effective in others. In this study, 198 overweight adults were randomly assigned to receive either tailored or non-tailored weight loss materials. Participants' cognitive, affective and behavioral responses to the materials were measured at an immediate and 1 month follow-up. Analyses compared those who received tailored materials to those who received non-tailored materials that were--by chance alone--either a good fit, moderate fit or poor fit, based on the match between behavioral characteristics of the participant and content of the non-tailored materials. Findings showed that good-fitting non-tailored materials performed as well or better than tailored materials for several cognitive, affective and behavioral outcomes. However, moderate- and poor-fitting non-tailored materials were consistently inferior to both approaches. The art and science of creating tailored health communication programs is still evolving. Data from this study suggest present approaches to tailoring are more effective than non-tailored materials in most, but not all cases. Specific recommendations are made describing ways to refine tailoring methods to maximize the effectiveness of this approach.

Adult↗

Extending the testimony problem: evaluating the truth, scope, and source of cultural information.

Children's learning--in the domains of science and religion specifically, but in many other cultural domains as well--relies extensively on testimony and other forms of culturally transmitted information. The cognitive processes that enable such learning must also administrate the evaluation, qualification, and storage of that information, while guarding against the dangers of false or misleading input. Currently, the development of these appraisal processes is not clearly understood. Recent work, reviewed here, has begun to address three important dimensions of the problem: how children and adults evaluate truth in communication, how they gauge the inferential potential of information, and how they encode and evaluate its source.

Adult↗

Connections between experience, beliefs, scientific knowledge, and self-evaluated expertise among investigators of child sexual abuse in Finland.

The purpose of this study was to investigate whether clinicians investigating child sexual abuse (CSA) rely more on scientific knowledge or on clinical experience when evaluating their own expertise. Another goal was to check what kind of pre-trial beliefs the clinicians had. The connections between these different factors were investigated. A questionnaire covering items concerning demographic data, experience, knowledge about CSA, self-evaluated expertise and beliefs about CSA was given to 126 social workers, 60 child psychiatrists and 134 psychologists. The results showed that the clinicians relied more on their clinical experience than on scientific knowledge when evaluating their expertise as investigators of CSA. Furthermore, social workers possessed stronger attitudes in favor of children than the other groups, while child psychiatrists had more negative attitudes towards the criminal justice system. Male participants had less strong beliefs than did the female participants. The findings indicate that the education of CSA investigators should focus more on theoretical knowledge and decision-making processes as well as the role of pre-trial beliefs.

Adult↗

Sun Protection is Fun! A skin cancer prevention program for preschools.

Children and their caregivers are prime candidates for intervention to curb the rising incidence of skin cancer in the United States. Preschools provide a unique opportunity to influence the sun protection practices of parents and teachers on behalf of young children. Sun Protection is Fun!, a comprehensive skin cancer prevention program developed by The University of Texas M. D. Anderson Cancer Center in collaboration with The University of Texas-Houston Health Science Center School of Public Health, was introduced to preschools in the greater Houston area. The program's intervention methods are grounded in Social Cognitive Theory and emphasize symbolic modeling, vicarious learning, enactive mastery experiences, and persuasion. Program components include a curriculum and teacher's guide, videos, newsletters, handbooks, staff development, group meetings designed to encourage schoolwide changes to support the program, and sunscreen. The intervention map, including objectives for program development, implementation, and evaluation, is discussed.

Child, Preschool↗

Modulation of motor function and cortical plasticity in health and disease.

Basic science studies demonstrated mechanisms of plasticity and metaplasticity. More recent human studies identified some of these mechanisms as operating in multiple areas of human cognition, such as learning and memory, and in functional recovery from lesions in the CNS, as in stroke. One of the goals of neurorehabilitation is the translation of these principles into rational strategies to promote recovery of function. Understanding the mechanisms and functional role of human plasticity could lead to the development of therapeutic options in situations in which there is virtually no treatment alternative, as in chronic stroke. We review some of the work performed to better understand the substrates and mechanisms underlying cortical plasticity and discuss some experimental approaches to enhance cortical plasticity and recovery of function, like cortical stimulation.

Health↗