Literacy Assessment Via Telepractice Is Comparable to Face-to-Face Assessment in Children with Reading Difficulties Living in Rural Australia.

Background/Introduction: Literacy difficulties have significant long-term impacts on individuals, and therefore early identification and intervention are critical. Access to experienced professionals who conduct standardized literacy assessments with children is limited in rural and remote areas. The emerging literature supports the feasibility of using telepractice to overcome barriers to accessing specialist literacy assessment. The current study sought to determine the feasibility and reliability of telepractice assessments, using consumer-grade technology, in children with reading difficulties. MATERIALS AND METHODS: Thirty-seven children, aged 8 to 12 years, with reading difficulties, attended a multidisciplinary reading clinic. Children completed literacy assessments delivered via a web-based application by a remotely located research assistant. A teacher was stationed with the child and coscored the assessments. Scores and qualitative observations of the two assessors were compared. RESULTS: Spearman's correlation analyses revealed strong agreement between telepractice- and face-to-face-rated scores (r = 0.79-0.99). Bland-Altman plots indicated excellent agreement between derived scores. Parents reported a high degree of comfort with the telepractice assessments. Clinicians reported the audio and video quality was sound in most cases. DISCUSSION/CONCLUSIONS: Web-based technology can enable remote delivery of literacy assessments. The technology has the potential to increase the availability of assessments to meet the needs of children who live remotely, in a timely manner and at their family's convenience.

Agreement between telehealth and face-to-face assessment of intellectual ability in children with specific learning disorder.

INTRODUCTION: Access to cognitive assessments for children living remotely is limited. Telehealth represents a potential cost- and time-effective solution. A pilot study was conducted to determine the feasibility of telehealth to assess cognitive function in children with learning difficulties. METHODS: Thirty-three children (median age = 9 years 11 months), recruited from the New South Wales (NSW) Centre for Effective Reading, underwent assessment of intellectual ability. Comparisons were made between the intellectual ability index scores obtained by a psychologist sitting face-to-face with the children and another psychologist via telehealth using a web-based platform, Coviu. RESULTS: The telehealth administration method yielded comparable results to the face-to-face method. Correlation analyses showed high associations between the testing methodologies on the intellectual ability indices (correlation coefficient range = 0.981-0.997). DISCUSSION: Findings indicate that telehealth may be an alternative to face-to-face cognitive assessment. Future work in a broader range of cognitive tests and wider range of clinical populations is warranted.

The social life of genes: privacy, property and the new genetics.

With the advent of the Human Genome Project and widespread fears over human cloning and medical privacy, a number of states have moved to protect genetic privacy. Oregon's unique Genetic Privacy Act of 1995, which declared that an individual had property rights to their DNA, has provoked national and international interest and controversy. This paper critically reviews the literature on genetic privacy and gene patenting from law, philosophy, science and anthropology. The debate in Oregon, from 1995 to 2001, illustrates many of the key issues in this emerging area. Both sides of the debate invoke the property metaphor, reinforcing deterministic assumptions and avoiding more fundamental questions about the integrity of the body and self-identity. The anthropological critique of the commodification of the body, and the concept of 'embodiment' are useful in analyzing the debate over DNA as property.

They say it runs in the family: diabetes and inheritance in Oaxaca, Mexico.

The globalization of genetic discourses, especially where ethnicity is treated as a "risk factor" for disease, deserves special attention and concern. In countries such as Mexico, with large indigenous populations, the consequences of the Thrifty Genotype hypothesis and/or the attribution of type 2 diabetes to "family history" may be especially detrimental to poor rural communities, playing as they do into existing racial hierarchies. Based on semi-structured interviews with doctors and patients in a public clinic in a community near Oaxaca, Mexico, the study examines etiologies for type 2 diabetes. While notions of genetic inheritance and family history figure prominently in government and public health discourse, the "explanatory model" of patients places most emphasis on strong emotions, traumatic events, and dietary factors. Clinic doctors emphasize diet and lifestyle factors. The diffusion of "genetic risk" has had little impact on doctor-patient interactions in this community, but can be clearly seen in academic research, government policy, and medical specialties in the region, raising concerns about whether or not interventions will be directed at the social determinants of this growing health concern.

Can you keep a (genetic) secret? The genetic privacy movement.

This paper reviews the literature on genetic privacy, especially since 1995 and the first proposal for national genetic privacy legislation. Since that time, a majority of states have passed some form of genetic privacy legislation, and efforts to pass federal legislation are ongoing. Such new laws, however, remain untested in the courts and their effects are unclear. If they fail to provide additional protections against discrimination for most people, their most significant impact may be in their ability to either diminish or enhance the power of genetic information and to influence the way individuals view themselves and others. How does "genetic exceptionalism"--the idea that genetic information is different from other types of medical information--relate to "genetic essentialism"--the idea that we are to a large extent shaped by our genes? Anthropological views on genetics and personhood bring a new perspective to this ongoing debate. Implications for counseling practices are also explored.