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Background: Sudden gains, defined as large and stable improvements of psychopathological symptoms, are a ubiquitous phenomenon in psychotherapy. They have been shown to occur across several clinical contexts and to be associated with better short-term and long-term treatment outcome. However, the approach of sudden gains has been criticized for its tautological character: sudden gains are included in the computation of treatment outcomes, ultimately resulting in a circular conclusion. Furthermore, some authors criticize sudden gains as merely being random fluctuations. Objective: Use of efficient methods to evaluate whether the amount of sudden gains in a given sample lies above chance level. Method: We used permutation tests in a sample of 85 patients with posttraumatic stress disorder (PTSD) treated with trauma-focused cognitive behaviour therapy in routine clinical care. Scores of self-reported PTSD symptom severity were permuted 10.000 times within sessions and between participants to receive a random distribution. Results: Altogether, 18 participants showed a total of 24 sudden gains within the first 20 sessions. The permutation test yielded that the frequency of sudden gains was not beyond chance level. No significant predictors of sudden gains were identified and sudden gains in general were not predictive of treatment outcome. However, subjects with early sudden gains had a significantly lower symptom severity after treatment. Conclusions: Our data suggest that a significant proportion of sudden gains are due to chance. Further research is needed on the differential effects of early and late sudden gains.

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Language is learned through social interactions, in which gaze has a special role because it can be used to guide the attention and reference objects easily. Children, starting from very early ages, are also very good at utilizing gaze to map labels to referenced objects. To achieve language teaching robots, we need to understand how these functions of gaze can be implemented most efficiently. To this aim, we allowed children to interact with a social robot to learn the labels of several objects in a naturalistic setting. In some trials the child guided the gaze and chose the object to be learned while the robot was following and in the others they changed the roles and robot guided the gaze and decided on the object to be learned. We measured how much children actually followed the robot’s gaze and how many words they learned in these two conditions, referred to as active and passive learning conditions, respectively. The results indicate that although children followed the robot’s gaze and learned words successfully, there were no meaningful differences inword learning between the two conditions. The rate of gaze following and time spent looking at the robot did not influence word learning, either. The implications of these results for use of robots in educational settings are further discussed.