Bruce Quarrington

Child outcome following mid‐trimester amniocentesis: development, behaviour, and physical status at age 4 years

Summary. Four‐year‐old children whose mothers had mid‐trimester amniocentesis (n = 88) were compared with children whose mothers chose not to have the procedure (n = 46). Intelligence, visual‐motor‐perccptual skills, language, behaviour, social competence, temperament, physical growth, hearing, and middle‐ear function were measured using standardized procedures. Health histories were obtained by maternal report. The results suggest that the wide range of developmental and behavioural variables studied is not influcnced by removal of amniotic fluid in the mid‐trimester. However, mothers who had amniocentesis were more likely to report a history of ear infections in their child (P = 0.04). In support of this finding were the results of audiological assessment which demonstrated a trend toward a higher rate of bilateral middle‐ear impedance abnormalities in children whose mothers had amniocentesis (P = 0.06). Further study of the upper respiratory system is recommended to explore potential long‐term sequelae of mid‐trimester amniocentesis.

Infant outcome following mid-trimester amniocentesis: development and physical status at age six months.

Summary. Ninety‐one infants whose mothers had had amniocentesis, because age increased their risk for a fetal chromosome abnormality, were compared with 53 infants whose mothers chose not to have the test. Mental and motor development and temperament were studied to assess potential influence of amniocentesis on the brain. Physical growth was assessed and the infants were examined for orthopaedic abnormalities and needle injury. The results indicated that amniocentesis does not appear to influence infant mental and motor development, temperament, physical growth or the risk of orthopaedic abnormalities. However, amniocentesis is not entirely free of risk because several of the infants had needle marks. Reassessment of the cohort at age 4 and 7 years and will provide information on the potential longer term consequences of mid‐trimester amniocentesis.

Midtrimester amniocentesis: Obstetric outcome and neonatal neurobehavioral status

The possible effects of midtrimester genetic amniocentesis on neurobehavioral status were studied in newborn infants of women who had had the procedure (N = 100) and in newborn infants of women who had declined the test (N = 56). Brazeltons Neonatal Behavioral Assessment Scale was administered to newborn infants born at term and did not reveal consequences of amniocentesis on neonatal orientation, range of state, motor ability, autonomic regulation, regulation of state, response decrement, or reflexes. Information on obstetric complications also was obtained. The findings raised questions regarding the temporal relationship between amniocentesis and fetal loss and focused attention on preterm birth as a potential risk that warrants further investigation. This study provides the foundation for our prospective longitudinal follow-up in which the cohort will be reassessed later in infancy and in childhood.

How do the various theories of stuttering facilatate our therapeutic approach

Considering the current ascendency of learning theories in the treatment of behavior disorders, I believe that the question posed might be rephrased by many as “Are theories of stuttering really necessary?” More specifically, the question might be framed as “What evidence exists that stuttering behaviors differ from other behaviors that have been demonstrated to be under operant control?” To suit those favoring a two-factor theory of learning, the last question could be extended to include control by classical conditioning or desensitization. In these forms the question at issue is not whether theory plays a guiding role in therapy, but what sort of theory is appropriate in the treatment of stuttering. The latter is an interesting question while the former is a trivial one. Almost certainly theory of some sort, however unsystematic or to whatever extent implicit, guides therapeutic practice. Pure empiricism is a myth in treatment and research. The issue of current interest is whether the guiding theory should be one of the general theories of learning or should be some special theory that distinguishes stuttering behaviors from other behaviors and gives specific therapeutic guidance beyond that issuing from general theories of learning. The answer that I propose to offer is that, at the present time, the treatment of stuttering cannot be approached adequately without resort to special theory. This answer should not be construed to imply that stuttering will never be embraced by general learning theory, but is simply a recognition that the facts of stuttering cannot be accounted for by present learning theories. Studies of normal speakers have shown that speech disfluencies come under operant control with the attachment of rewarding and aversive contingencies (Hill, 1954; Savoye, 1959; Flanagan et al., 1959; Stassi, 1961; Stevens, 1963; Siegel and Martin, 1965a, b, 1966, 1967, 1968; Brookshire and Martin, 1967; Martin and Siegel, 1969; Siegel et al., 1969). When one turns to stuttering behaviors, however, several studies have failed to demonstrate a reduction in stuttering in the presence of negative contingent stimulation (Frick, 1951; Stevens, 1963; Daly, 1967, 1968; Timmons, 1966). Other studies have shown that when stuttering behaviors are differentiated, some behaviors will increase while others will decrease with negative contingent reinforcement (Martin et al., 1964; Quist, 1966; Webster, 1968; Starkweather, 1970). Such findings suggest that

The effects of reward on types of stuttering

Abstract The effect of rewarding types of stuttering behaviors was studied by observing 21 young stuttering adults, divided into three groups. Payment of a nickel per stutter was signalled contingently to group one, non-contingently to group two, and a control light signalled the occurrence of stuttering in group three. All subjects were examined in baseline, experimental, and extinction periods, and recorded on videotape. Statistical comparisons were made both between groups and between conditions within groups. Results showed a significant decrease in the frequency of struggle in both reward groups and a significant increase in the frequency of struggle in the control signal group. Repetitions, prolongations, intrusions, and speech rate did not change. The discussion evaluated predictions drawn from Operant, Two-factor, and Approach-avoidance conflict learning theories. It was concluded that chief among the clinical implications is that if stuttering is composed of many types of behavior which react differently to similar stimulation, then each will require different therapeutic interventions.

Infant development following midtrimester amniocentesis

Abstract The present study examined potential developmental and behavioral effects of midtrimester genetic amniocentesis. Comparisons between infants whose mothers had this diagnostic test and control infants yielded no differences in the neonatal period or at age 6 months. The continued need for longitudinal studies is discussed.

The mathematical analysis of glucose tolerance curves obtained by in vivo autoanalysis

Abstract Intravenous glucose tolerance curves were obtained by in vivo autoanalysis in six healthy subjects on low- and high-carbohydrate diets. The resultant curves were analyzed with methods of increasing mathematical complexity including fitting to the model Gt = G0 + Ae−αtcos(ωt). The low carbohydrate intake resulted in significant lowering of the fasting glucose level, prolongation of time of initial return to fasting level (TR) and decrease in ω. It was found that the peak blood glucose value is not significantly different for the ditferent diets. Although diminution rate did not differ with diet, TR and the ω component of the model did differ. It is suggested that these factors may be of some importance for experimental use.

The parents of stuttering children. The literature re-examined.

Reappraisal of the literature dealing with the personality, attitudes, and behaviour of the parents of stuttering children suggests they are characterized by low social dominance, and points to the mothers of beginning stutterers as particularly permissive and/or passive regarding the shaping and control of the developing childs behaviour. While instructional passivity appears to persist in the mothers of chronic stutterers, the emergence of specific punitive attitudes is also noted. The possible roles of instructional passivity and punitive parental reactivity in the precipitation and maintenance of stuttering behaviours are considered briefly.