Multiple Schedules Facilitate Rapid Noncontingent Reinforcement Schedule Thinning

We evaluated a noncontingent reinforcement treatment that included initial brief exposures to signaled alternation of availability and nonavailability of reinforcement, followed by rapid schedule thinning. Results confirmed findings from previous research (typically with differential reinforcement schedules) that establishing stimulus control across multiple treatment components facilitated schedule thinning. We discuss both the clinical utility of this procedure and the utility of stimulus control for making interventions more practical for clinicians.

A comparison of RIRD within chained and multiple schedules in the treatment of vocal stereotypy

Slaton and Hanley (2016) compared the effects of multiple and chained schedules on stereotypy and item engagement for 2 individuals who exhibited automatically maintained motor stereotypy. Contingent access to motor stereotypy (i.e., chained schedules) was more effective than time-based access (i.e., multiple schedules) at reducing motor stereotypy, increasing item engagement, and establishing stimulus control for both participants. We systematically replicated Slaton and Hanley with 2 participants by a) targeting vocal stereotypy, b) including response interruption and redirection as a treatment component across conditions, c) conducting sessions in the natural environment with teaching assistants as change agents, and d) conducting an analysis of the effective treatment component(s). Chained schedules were more effective for 1 participant, whereas both treatments were effective for the other participant. The component analysis showed that different components were necessary for effective treatment for each participant.

Two-dimensional echocardiographic detection of left pulmonary artery aneurysm following Potts' anastomosis

The two-dimensional echocardiographic detection of left pulmonary artery aneurysm following a Pott's anastomosis in a patient with tetralogy of Fallot is described. The diagnosis was confirmed at angiography and surgery.

The modern diagnosis of cardiac myxoma: role of two-dimensional echocardiography

We reviewed our experience with the diagnosis of cardiac myxoma in 10 patients seen between 1960 and 1981. At surgery, large myxomas (greater than 5 cm) were found in the left atrium in 6 patients, right atrium in 3, and right ventricle in 1. The correct preoperative diagnosis was made in 9 patients: clinically in 3 and at catheterization and angiocardiography in 6. Diagnoses were falsely negative in 3/13 (23%) catheterizations and 2/10 (20%) angiocardiograms. Echocardiography (echo) was positive in 5/5 (100%). Gated blood-pool scans confirmed a right atrial myxoma in 1 patient. The interval between onset of symptoms and surgery was 30.5 months, (range, 2-120) and was not significantly different in the eras before and after echo. The age at diagnosis exceeded 40 years in 9 patients and was not significantly less in the echo era. The size and site of the tumor at surgery agreed with findings on M-mode echo (n=5) or two-dimensional (2-D) echo (n=2), but the size (85 vs. 88 cm3) and mass (81 vs. 88 g) of the tumors were similar in the 2 eras. Although 2-D echo facilitates the preoperative diagnosis of cardiac myxoma, earlier patient referral of suspicious cases for 2-D echo is still necessary.

Congenital fistula between left ventricle and coronary sinus

The occurrence of a congenital fistula between the left ventricle and the coronary sinus has not previously been reported. A patient with this rare anomaly is described in whom the diagnosis was established during life and confirmed at operation and necropsy.

Aortic atresia occurring with complete transposition of great arteries

Aortic atresia occurring with complete transposition of the great arteries (ventriculoarterial discordance) has not previously been reported. A patient with this condition is described, who is alive and relatively well at the age of 6 years. This survival contrasts conspicuously with that of patients with the far commoner situation of aortic atresia with normally connected great arteries. It is suggested that this difference in longevity is a result of the greater ability of the left ventricle to supply both the systemic and pulmonary circulations.