The Social Construction of Asperger Syndrome: The pathologising of difference?

This article poses the question 'Is Asperger Syndrome (AS) a disorder or a neurological difference that has been socially constructed as a disorder?' AS is currently defined within the medical paradigm as a developmental disorder. Alternative conceptualisations of Asperger Syndrome have largely been absent within the academic discourse on AS. Drawing on the emerging field of disability studies we examine how the diagnostic category of AS has been socially constructed. Our contention is that Asperger Syndrome has been readily adopted as a category because of its value as a category of special education. In other words, the school is a pivotal institution in the dissemination of AS as a category. Within the framework of special needs AS is viewed as a social disability and the aim of professional interventions is to help to rehabilitate or 'normalise' the child. In attempting to re-frame this conceptualisation of AS it is important to shift the emphasis from issues of diagnosis and evaluation to examining the social implications of representing children as having AS.     

Achieving the indeterminate: Accomplishing degrees of certainty in life and death situations

This paper explores technology's pivotal position at the intersection of control and uncertainty. It examines two areas: Intensive Care and a Labour Ward. Building on the work of Davis (1960), it argues that certainty and uncertainty are socially constructable and reconstructable. This is actively achieved by the deployment of strategies involving particular paradigms (the biomedical model) and artefacts (medical technology). Power lies in control over knowledge and the structures and practices which sustain it, including those embedded in advanced technology. The contribution of medical technology to the achievement of certainty in Intensive Care and end-game Obstetrics (the Labour Ward) is considered. Achieved certainty in medical situations is seen as: the structured masking of uncertainty by the application of medical iconography, artefacts and techniques to create the illusion of certainty. The accomplishment of uncertainty in Obstetrics (as a precursor to technological intervention) is also explored. The accomplishment of uncertainty in medical situations is seen as associated with the structured projection of uncertainty, involving using medical discourse rooted in the medical paradigm to exaggerate the generality of risk and the probability of pathology. It is argued that the highly structured and routinised settings of ICU and the labour Ward, not only aid control by the medical profession but diminish perceptions of uncertainty.     

Net worth and the economic diversity of the elderly

Using data from the 1984 panel of the Survey of Income and Program Participation (SIPP), this article examines characteristics of the older population disaggregated by net-worth quintiles. The authors argue that income is not a sufficient measure of economic status for current policy discussions on issues such as changing Medicare co-payments, increasing the taxation of social security benefits, or means-testing under Medicaid. Net worth is a better measure of economic status, particularly for the elderly, because it represents the net value of assets accumulated over the life course. Their results indicate that there is considerable diversity in the economic status of the older population, which is masked by aggregate statistics (such as means and medians) typically used to summarize the economic status of population groups. Stereotypical views of the elderly based on such aggregates result in misdirected policy formulation. In the future, policymakers will need to formulate policies and programs using information on the distributions of income and assets among the older populations rather than relying on statistical aggregates.     

Quantitative Estimates of Risk for Noncancer Endpoints

While quantitative estimates of risk have been a standard practice in cancer risk assessment for many years, no similar practice is evident in noncancer risk assessment. We use two recent examples involving methylmercury and arsenic to illustrate the negative impact of this discrepancy on risk communication and cost-benefit analysis. We argue for a more balanced treatment of cancer and noncancer risks and suggest an approach for reaching this goal.     

Reflective Supervision for Child Protection Practice – Reaching Beneath the Surface

This paper describes a model of reflective supervision for child protection practice that is informed by psychoanalytic theory. Eileen Munro promotes the idea of depth in practice, referring to the skills and knowledge required to undertake the work. Her reports highlight the importance of supervision to provide a thinking space for practitioners where reflection can take place. This paper will explore the importance of supervision in more depth and describe how psychoanalytic ideas can help us understand the complexities of our work with families, anchoring us to a solid theoretical base and helping to make sense of the maelstrom of feelings that are stirred in us as well as in our colleagues and clients.     

Impact of an Overt Response System on Staff Performance and Maintenance of Computer-Based Instruction

Interactive Computer Based Instruction (CBI) systems involve teaching strategies to facilitate greater response opportunities during training in an effort to improve learner performance. The current study investigated the effect of online staff training videos with and without overt response requirements on posttest and maintenance test scores across six block-randomized instructional modules for four employees of a university located in the southeastern region of the United States. The overt response consisted of multiple-choice questions administered throughout select teaching modules using an alternating treatment design. Findings suggest that learning occurred as a result of the CBI training; however, the effectiveness of the overt response system varied across individuals, with no discernible differentiation between learning gains associated with response requirements. Other areas of research for expanding the efficacy of CBI and overt response systems are highlighted.