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Many of the same interventions used in other disorders may be appropriate for children with tuberous sclerosis. Speci c interventions that have been studied with samples of children with tuberous sclerosis are identi ed in Table 16.5. For example, vigabatrin (Sabril) has proved to be effective against infantile spasms due to tuberous sclerosis (Curatolo, Bombardieri, & Cerminara, 2006). Surgical treatment may be an option for those children with tuberous sclerosis who have refractory epilepsy (Curatolo et al., 2008; Madhavan et al., 2007). Other methods of intervention for epilepsy (see 10) also have been considered in conjunction with tuberous sclerosis related epilepsy (Connelly et al., 2006). In addition, citalopram (Celexa) demonstrated ef cacy in treating anxiety and depression while risperidone (Risperdal) demonstrated ef cacy in treating problematic behaviors (Muzykewicz et al., 2007). With the high co-occurrence of autism, the evidence-based practices discussed in 5 also may be appropriate.

Biological factors may be divided into two kinds: those known to directly affect the development of the organism and those that often accompany the appearance of a syndrome but with an uncertain developmental role. The former include temperament and some genetic conditions; the latter include congenital factors, physical constitution, hormonal patterns, brain structure, and neurotransmitter patterns. The most definitive and interesting line of research that links biology with the violation of shared standards of social living is associated with the construct of psychopathy. The following findings might, or might not, generalize across psychopathic, antisocial, and sociopathic individuals. Casual observers have often remarked that antisocials and psychopaths appear to have inborn temperaments that make them seem tough, aggressive, fearless, impulsive, hotheaded, and sensation seeking. Naturally, such traits tend to send the individual down certain life trajectories rather than others, namely, toward the development of delinquent and antisocial behaviors and away from the development of prosocial or altruistic attitudes. In an interesting chapter, one of the leaders of the field, David Lykken (1995) discusses his pet bull terrier, a breed that crosses the strength and temperament of a bulldog with the agility of a terrier, thus providing, according to Lykken, something of an animal model of psychopathy. Pups easily and playfully destroy household items with their powerful jaws, he states, and are almost indifferent to punishment. Consequently, raising a bull terrier requires patience and fortitude. Drawing on four parenting styles described by Baumrind (1971, 1980), Lykken suggests that the authoritarian style produces an adult who is obedient when faced with strength, but surly and dangerous to the weak. Permissive parents fail to set limits, thus producing an animal that is ultimately uncontrollable. Neglectful or rejecting parenting produces a bully outlaw. Only a firm but loving authoritative style, Lykken

27 at output of 28 29 30 31 32 33 34 35 36 37 Module 1 Cable 1 Module 2 Cable 2 mixer from in mixer at out Cable 3 (diplexer) Module 4 Cable 4 Module 5

In 1979, Maritime Engines and Motors (MEM), a medium-sized British rm manufacturing outboard engines and motors for pleasure craft, was considering the introduction of a new product based on modi cations to one of its best-selling models Recently, this model had been banned in the USA because it did not meet federal emission standards Fortunately this was not an important market for MEM, but the managing director was concerned that similar emission controls might be introduced in Britain Consequently, MEM was considering introducing a new motor with a redesigned carburation system using conventional but up-to-date technology However, the existing model was so well established that any change to its design might cause a loss of market share, and in any event the new product might soon be overtaken by motors using microchip technology produced by a German competitor.

FACTORS AFFECTING PROJECTS The three major factors indicating a project will succeed are (1) timely user involvement, (2) executive management support, and (3) a clear user requirement statement. There are other success criteria, but with these three elements in place, the chances of success are much greater. Without them, organizations run a high risk of failure. Organizations should carefully consider whether projects are too excessive to undertake in one go, as this approach may impact the success or failure of a project. This is particularly important if a project is influenced by many business dependencies. The number of project failures could be dramatically reduced by dividing the entire project into relatively smaller projects or phases, with each successive one being reviewed and approved before the next one is started. The advantage of such a structured approach is that it helps to reduce the complexity of planning, monitoring, and control. Table 3.4 portrays negative factors and solutions that have been used to overcome them, thus aiding the successful delivery of projects. Table 3.4: Factors affecting project management Factors effecting IT Projects Incomplete requirements Lack of user involvement Lack of resources Unrealistic expectations Lack of executive support Changing requirements & specifications Lack of planning Client no longer needs project Lack of IT management 10. Technological illiteracy Recommended Solutions Obtain all requirements Involve all stakeholders Develop resource planning Negotiate with the client Communicate with and involve executives Adopt change control