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.     

Self-management of Initiations by Students Diagnosed with Autism

During prebaseline observations, three students diagnosed with autism were unable to make social initiations to another individual. The ability to make initiations would be considered a “pivotal response” in that it would allow an individual to come into contact with a wide variety of social reinforcement. A multiple-baseline design was implemented to measure the effects of a using a self-management package to teach the students to make social initiations. Two interventionists worked with each student to prompt and reinforce initiations. All students acquired social initiations during externally-determined reinforcement. The initiations were maintained when reinforcement changed from externally determined to a self-management system. The prompts to initiate and self-reinforce were faded over the course of the sessions. The use of self-management by the student led to less need for staff intervention. Implications from the literature are discussed.     

A simultaneous-equations model of the relationship between public sector bargaining legislation and unionization

This paper estimates a simultaneous-equations model with public sector bargaining laws and union membership treated as jointly-determined variables. The extent of public sector unionization has a significant positive influence on the passage of prolabor bargaining legislation and bargaining legislation has strong, independent effects on the extent of public sector unionization. We gratefully acknowledge the research support provided by Minbo Kim and Parisun Chantonahom.     

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.     

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-community. Results of the first study indicated that the school-as-community component--which involved weekly meetings and periodic events at seven schools--was implemented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self-reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.     

Program analysis using the client oriented cost outcome system.

The client oriented cost outcome system has been under development in Pennsylvania community and hospital programs since 1972. The system builds upon the behavioral and decision data generated with or on behalf of consumers. Flexibility for local program system design is permitted if the procedures of consumer intake, review, and termination document each consumer's (a) problems, resources, and goals, (b) overall functioning level in their ordinary community, and (c) services intended and rendered as related to (a), above. While the system's primary application is in providing feedback for local program quality assurance and evaluation procedures, aggregation of data permits program planning and evaluation at county, state, and federal levels in terms of (a) client demographic or diagnostic characteristics, and (b) program service characteristics and objectives.     

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.