Using guided credible history interviews to establish special education eligibility for students with traumatic brain injury

BACKGROUND

In Oregon in 2019, only 261 students were eligible for special education under the traumatic brain injury (TBI) category. Many students with TBIs are not treated by a medical provider, so the requirement for a medical statement could prevent eligible youth from receiving special education services.

OBJECTIVE

This study investigated barriers to using a medical statement to establish special education eligibility for TBI, support for using a guided credible history interview (GCHI), and training needs around GCHI.

RESULTS

Among participants, 84% reported difficulty obtaining a medical statement for TBI eligibility determination, and 87% favored the GCHI as an alternative, though they reported a need for training in TBI and GCHI.

CONCLUSION

The results support the use of GCHI to establish special education eligibility for TBI and informed Oregon's addition of GCHI to TBI special education eligibility determination.

Data Mountain: Self-Monitoring, Goal Setting, and Positive Attributions to Enhance the Oral Reading Fluency of Elementary Students With or at Risk for Reading Disabilities

Data Mountain is a self-determination program that has shown early promise in enhancing the oral reading fluency (ORF) of students with or at risk for reading disabilities (RD). This program supports self-determined learning behaviors through explicit teaching of self-monitoring, goal setting, and positive attributions. The present study tested the effects of Data Mountain on the ORF of 81 students with or at risk for RD in second through fifth grades, randomly assigned to one of three conditions: Data Mountain delivered in small groups, Data Mountain delivered individually, or a comparison condition. Results from hierarchical linear modeling indicated that treatment students read an average of 31 more words per minute with a growth rate twice that of comparison students (p < .01). The transferable possibilities of Data Mountain to provide students with an opportunity to learn self-determination skills and support ORF is significant to the field of special education.

DEVELOPMENT OF INCLUSIVE EDUCATION IN UKRAINE IN THE CONTEXT OF WORLD TRENDS

The aim of the research is to analyze the problem of inclusive education in Ukraine in the context of world trends. According to its philosophy, each school should be inclusive, which implies the readiness of the school to accept every child with SEN at any time, the desire to create the most favorable educational environment that will serve the development of its potential. According to the results of the analysis, we also conclude that Ukrainian scientists pay more attention to issues of inclusion related to higher education (foreign experience, features of teaching students with inclusion, training future teachers to work with children with disabilities, etc.). Meanwhile, in our opinion, the theoretical and methodological principles, pedagogical conditions, practical methods of organizing inclusive education of children with various types of developmental disabilities are insufficiently studied. This, among other things, highlights the scientific problem raised in our study. Thus, the attention of the Ukrainian state to people with SEN, European-oriented social educational policy is evidenced not only by the reduction of the number of boarding schools, orphans and children deprived of parental care there, but also the dynamics of growing enrollment of children with SEN in inclusive special classes of secondary schools (in 2020/2021 academic year compared to 2015/2016 academic year this amount increased by 7% (from 5.3 thousand to 5.7 thousand). As a result of the development of inclusive education over the past five years, the number of students with SEN covered by inclusive education has increased more than 6 times, and the number of inclusive classes in secondary schools has increased 7 times. Similar changes have taken place in the staffing of inclusive education. Inclusive education and upbringing of children with SEN is a long-term strategy that is considered not as a local area of work, but as a systematic approach to organizing the activities of the general education system in all areas in general.

The Effects of Data-based Instruction (DBI) for Students with Learning Difficulties in Korea: A Single-subject Meta-analysis

Data-based instruction (DBI) is an ongoing process to utilize students' data for determining when and how to intensify intervention. It is an educational approach that is suggested as effective to enhance achievements of struggling learners, particularly for those who did not respond to intensive intervention in usual ways. In Korea, DBI was introduced and applied for students with learning difficulties especially since 2000 when the first Korea curriculum-based measurement (CBM) was developed as the name of Basic Academic Skills Assessment. Despite a number of studies accumulated since then, there has been a lack of research that examined the level of evidence-based practice (EBP) of DBI research. Thus, the present study sought to synthesize the DBI research so far in Korea by analyzing the effectiveness of DBI for school-aged students with learning difficulties via meta-analysis and evaluating the quality of the research. In this study, a total of 32 single-subject design studies were used. Multilevel meta-analysis revealed that the mean effect size of DBI was statistically significant (B = 1.34) and there was significant variance across participants in effect sizes. The results from the conditional model showed that exceptionality type, the number of sessions, and the length of each session were significantly accountable for the variability of effect sizes. In addition, the results of the qualitative analysis revealed the acceptable quality of the overall DBI research with some limitations. Based on these findings, implications and study limitations were discussed.

Gestational age at birth and child special educational needs: a UK representative birth cohort study

OBJECTIVE

To examine the association between gestational age at birth across the entire gestational age spectrum and special educational needs (SENs) in UK children at 11 years of age.

METHODS

The Millennium Cohort Study is a nationally representative longitudinal sample of children born in the UK during 2000-2002. Information about the child's birth, health and sociodemographic factors was collected when children were 9 months old. Information about presence and reasons for SEN was collected from parents at age 11. Adjusted relative risks (aRRs) were estimated using modified Poisson regression, accounting for confounders.

RESULTS

The sample included 12 081 children with data at both time points. The overall prevalence of SEN was 11.2%, and it was inversely associated with gestational age. Among children born <32 weeks of gestation, the prevalence of SEN was 27.4%, three times higher than among those born at 40 weeks (aRR=2.89; 95% CI 2.02 to 4.13). Children born early term (37-38 weeks) were also at increased risk for SEN (aRR=1.33; 95% CI 1.11 to 1.59); this was the same when the analysis was restricted to births after labour with spontaneous onset. Birth before full term was more strongly associated with having a formal statement of SEN or SEN for multiple reasons.

CONCLUSION

Children born at earlier gestational ages are more likely to experience SEN, have more complex SEN and require support in multiple facets of learning. This association was observed even among children born early-term and when labour began spontaneously.

The effect of training intensity on implicit learning rates in schizophrenia

Cognitive impairments in learning and memory are core symptoms of schizophrenia, associated with reduced self-reported quality of life. The most effective treatment of cognitive impairments is drill and practice cognitive training. Still, to date no study has investigated the effect of varying the frequency of training on cognitive outcomes. Here we utilized a verbal memory based language learning task, tapping into implicit cognitive processes, to investigate the role of training intensity on learning rates in individuals with schizophrenia. Data from 47 participants across two studies was utilized, one with a daily training regimen over 5 days and the other with a more intensive schedule of 5 sessions delivered over 2 days. The primary outcome measure was the change in implicit learning performance across five sessions, quantified with the Matthews Correlation Coefficient (MCC). Participants in the daily training group showed improved performance compared to the intensive group only at session 4. This is the first study to show that implicit learning rates are influenced by training intensity, with daily sessions outperforming a more intensive regimen; a period of consolidation overnight may be necessary to optimize cognitive training for individuals with schizophrenia.

Examining academic confidence and study support needs for university students with dyslexia and/or developmental coordination disorder

Higher education providers are seeing a shift from externally funded support for students with specific learning difficulties (SpLD), to a need to develop more inclusive practices generally. However, the precise needs of students with different SpLD diagnoses is unknown. A total of 367 students in England and Wales (163 students with dyslexia, 50 students with developmental coordination disorder [DCD/"dyspraxia"], 62 students with dyslexia and DCD, and 92 non-SpLD students) completed an online questionnaire to determine: (a) how confident they are with their study-related capabilities, (b) the types of support they access, and (c) their views on current inclusive practices. Students with dyslexia and students with dyslexia/DCD reported lower confidence in their grades and studying than non-SpLD students, and accessed more technology-related support than students with DCD only. Examination accommodations supporting writing were common for all SpLD students. Inclusive practices were perceived positively, although different priorities were seen across groups. The findings demonstrate the complexities inherent in providing effective support for all students at university, with the varied profiles across and within SpLD groups suggesting that an individualized approach is necessary. Practical implications are discussed.

Is part-time special education beneficial for children at risk for reading difficulties? An example from Estonia

This longitudinal quasi-experimental study examined the general efficiency of part-time special education for students at risk for reading difficulties in Estonian primary schools. Participants were selected from 464 students whose pre-reading and reading skills were assessed for the study at the beginning of school. Eighty-four of these children received part-time special education support throughout the first grade (treatment group). Statistical matching was used to find a control group similar to the treatment group on pre-reading skills and parental educational level but who did not receive extra help (control group; 84 children). Students' reading fluency and task persistence were assessed at the end of Grade 1 and Grade 2. Neither group differed in reading fluency nor task persistence at the end of either grade. Developmental trajectories of those treatment group children who received additional support only for reading and spelling difficulties did not differ from those who received this support for concurrent developmental disorders in addition to reading and spelling difficulties. Our findings indicate that a full-year of special education support in the form of extra lessons without a prior diagnostic assessment, frequent progress monitoring, or focused interventions might not be an effective way to support children with reading difficulties.

General health status in young people with intellectual disabilities with and without Down syndrome in, and transitioning from, special education: findings from the National Longitudinal Transitions Study-2

BACKGROUND

There has been little prior investigation of the general health of young people with intellectual disabilities across transition, nor separately for youth with intellectual disabilities with or without Down syndrome, despite general health being a strong predictor of subsequent health service use, hospital admissions and mortality in the general population. We aimed to investigate general health status in youth with intellectual disabilities with and without Down syndrome over the transitional period and quantify the extent to which personal characteristics, parental relationship and household income are associated with general health status.

METHODS

The National Longitudinal Transitions Study-2 includes a nationally representative sample of youth receiving special education services aged 13-17 years at wave 1, followed up over 10 years in five waves of data collection. Data on general health status of youth with intellectual disabilities with and without Down syndrome were obtained from parent reports. We summarised overall demographics and general health status and plotted general health status for those who had health data available for all five waves. We then used random-effects ordered logistic regression to investigate whether wave of data collection, age, sex, Down syndrome, ethnicity, parental relationship status and household income are associated with general health status.

RESULTS

At wave 1, data on intellectual disabilities were available on 9008/9576 (94.1%) young people, and 871/9008 (9.7%) of them had intellectual disabilities, of whom 125/871 (14.4%) had Down syndrome. Youth with intellectual disabilities with or without Down syndrome had low rates of excellent or very good health. Across waves 1-5, there was a shallow gradient in the proportion of youth with intellectual disabilities reporting excellent/very good health, from 57.7% at 13-17 years to 52.6% at 21-25 years, being more marked for those without Down syndrome (57.8% at 13-17 years to 51.8% at 21-25 years). However, contrary to our expectations, an ordinal measure of general health status did not decline over this transitional period and did not differ between youth with and without Down syndrome. There was a gradient with higher income associated with better health, significantly so over $50 001 (odds ratio = 0.559, 95% confidence interval 0.366-0.854). Poorer health was experienced by youth with Hispanic, Latino or Spanish ethnicity (odds ratio = 1.790, 95% confidence interval 1.051-3.048). Female sex and parental relationship status were not associated with health status.

CONCLUSIONS

Young people with intellectual disabilities have bad health, and require support across all ages, including transition. Schools, teachers and staff in transitional services should consider health, and health care and support during transitional planning due to change in service provision and be aware of ethnicity and the stressful effects of low household income. This is important as interventions based on provision of greater support can prevent adverse consequences.

"It's Not Just About a Paycheck": Perspectives on Employment Preparation of Students With Intellectual Disability in Federally Funded Higher Education Programs

Students with intellectual disability (ID) are increasingly attending postsecondary education institutions and acquiring work experiences while completing their studies. One of the main motivations for students with ID to seek higher education is to broaden and increase their chance for finding fulfilling, paid employment in their communities. Findings from a qualitative study on staff perspectives regarding career development and employment supports and services provided to students attending Transition and Postsecondary Education Programs for Students With Intellectual Disability (TPSID) model demonstration programs in the United States are presented. Results reflect consensus across program staff regarding the goals and expectations for employment of TPSID students. Programs vary considerably in their institutional context, their partnership with other entities, and the structure of employment services, as well as the emphasis placed on paid versus unpaid employment. Some of the key strategies shared by staff regarding successful student employment practices involved outreach and engagement, visibility on campus, improving access to career services, and cultivating partnerships. As higher education continues to expand its offerings to students with ID, postsecondary education programs need to continue to emphasize and honor the importance of paid employment, and continue to seek the best methods to achieve this outcome for students with ID.

The Effect of Business Internships Model and Employment on Enhancing the Independence of Young Adults With Significant Impact From Autism

This article presents findings from a multisite randomized clinical trial measuring the impact of employment on independence in 18 to 22 year old youth with significant impact from autism spectrum disorder (ASD). The treatment condition was Project SEARCH plus ASD Supports (PS+ASD) where 73.4% of participants gained competitive integrated employment (CIE) within 1 year of graduation compared to control participants who acquired CIE at 17%. Within group analysis revealed that PS+ASD participants demonstrated improvement in all domains whereas control group participants demonstrated improvement in one domain only. Between groups analysis indicated that participants in PS+ASD demonstrated nominally better rates of improvement than control group participants at graduation and 1-year follow-up. Results provide evidence that employment provides therapeutic benefits to individuals with ASD.

Reading Comprehension Instruction for Young Students with Autism: Forming Contextual Connections

Central coherence is the ability to perceive and connect salient information in a context such as a narrative text. Individuals with autism exhibit a detail-focused cognitive style of processing information that overlooks connections and shows weak central coherence. A six-session instructional intervention to foster coherence processing was administered to first and second graders (N = 10) while a control group (N = 10) received an irrelevant treatment, mean age 7.06 years, 18 males and 2 females. Results showed that the instruction benefited children's comprehension of narrative text. The intervention improved children's ability to retell a narrative text and improved first graders' use of sequence words to retell a story compared to control students. Findings carry implications for designing reading instruction for this special population.

Exploring neuropsychological effects of a self-monitoring intervention for ADHD-symptoms in school

Children who have symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) often experience disruptive and off-task behavior and lower school performance than would be expected based on their cognitive abilities. These behavior and achievement difficulties are a challenge to teachers, who often provide inclusive education for children with ADHD. This study explored whether a self-monitoring intervention can help children with ADHD-symptoms to reduce off-task behavior as well as improve their cognition. The participating children were seven boys in special needs education with an age between nine and twelve. The students used an interval timer to remind themselves to monitor whether they were still on task. During math classes, observations, teacher ratings and neuropsychological tests were assessed. The results showed that off-task behavior was significantly reduced during the period the interval timer was used compared to baseline (reduction from 46.8 to 27.3%), as measured by observations (effect size: η²_p = .83) and this was confirmed by teacher ratings (effect size: η²_p = .69). With respect to cognition, children only showed significant improvements in inhibition (effect sizes: Cohen's d = 2.62 and 1.24). The teachers as well as students evaluated the intervention mainly as positive. In line with previous studies, we found that that a self-monitoring intervention can be beneficial for children with ADHD-symptoms. Larger studies including a control group and blind observers are necessary to establish these results and to investigate the underlying mechanisms.

Teaching students with ASD to solve fraction computations using a video modeling instructional package

BACKGROUND

With the surge of intervention research examining ways of supporting students with autism spectrum disorder (ASD) in inclusive settings, there remains a need to examine how technology supports could enhance students' learning by offering one size fits one instruction. Furthermore, intervention studies focused on teaching students with ASD how to solve fractions are scarce.

AIMS

The purpose of this research study was to examine the effects of providing instruction via video modeling (VM), concrete manipulatives, a self-monitoring checklist, and practice for comprehension check on the accuracy of fraction problem solving of three middle school students with ASD.

METHODS AND PROCEDURES

Through the use of single-case multiple probe across students experimental design, we examined whether a functional relation existed between the intervention and students' improved accuracy of solving simple proper fraction problems.

OUTCOMES AND RESULTS

All three students improved the accuracy of solving simple proper fraction problems from baseline to intervention sessions and two students generalized the skill to solving whole proper fraction problems.

CONCLUSIONS AND IMPLICATIONS

The intervention consisting of VM and concrete manipulatives along with additional behavioral strategies offers an option for teachers to accommodate diverse learning needs of students with ASD in a variety of settings.

Supplementing teacher knowledge using web-based Intelligent Tutoring System for the Text Structure Strategy to improve content area reading comprehension with fourth- and fifth-grade struggling readers

The effects of teaching the text structure strategy using a web-based Intelligent Tutoring System for the Text Structure Strategy (ITSS) were examined with fourth- and fifth-grade children scoring below the 25th percentile on comprehension measures using the Gray Silent Reading Test (GSRT) and researcher designed assessment from 130 fourth-grade and 130 fifth-grade classrooms. The ITSS was designed to teach students how to select and encode strategic memory from expository texts. The system provides modelling, practice, assessment, scaffolding, and feedback to learners on identifying signalling words, summarizing, making inferences, generating elaborations, and monitoring comprehension. A large scale randomized controlled trial was conducted with 130 fourth-grade and 130 fifth-grade classrooms. Students completed GSRT- and researcher-designed measures of reading comprehension at pretest and posttests. An analysis of fourth-grade students using ITSS who scores less than the 25th percentile on the GSRT pretest showed small but meaningful effect sized on the posttests. The fifth-grade students in ITSS, who scored less than the 25% percentile on the GSRT pretest, showed the highest effect sizes (moderate to large effects) on the standardized test scores on the posttests.

Examining the Impact of the SDLMI and Whose Future Is It? Over a Two-Year Period With Students With Intellectual Disability

The purpose of this study was to examine self-determination outcome data in the year following a one-year cluster randomized controlled trial (C-RCT) comparing the impacts of a Self-Determined Learning Model of Instruction (SDLMI) only condition to a SDLMI + Whose Future Is It? (SDLMI + WF) condition. Using multilevel B-spline model analysis with Bayesian estimation, we examined ongoing patterns of growth after the trial ended and all students were exposed to SDLMI + WF. The findings suggest that the inclusion of an additional year of outcome data provided additional insight into the impact of more intensive intervention conditions over time. Specifically, after the initial year of implementation, the SDLMI + WF condition predicted greater annual gains than the SDLMI only condition, unlike findings in the first year which reflected the opposite pattern. This evidence suggests a nonlinear growth pattern over multiple years of intervention with more intensive interventions. Implications for future research and practice are discussed.

Exploring the Relation Between Teacher Factors and Student Growth in Early Writing

Data from a small randomized control trial of teachers' use of Data-Based Instruction (DBI) for early writing were analyzed to determine the influence of teacher knowledge, skills, and treatment fidelity on student Curriculum-Based Measurement (CBM) slope. Participants included 11 elementary grade teachers who delivered intensive intervention in early writing and their students (n = 31), all identified as either at risk for or with disabilities that affect their writing. Teachers received professional development and ongoing coaching to support the implementation of DBI for improving their students' early writing skills. Results from a multiple regression analysis suggest that teacher knowledge and skills in DBI was strongly related to student CBM slope in early writing (p < .01) and a small but significant relation between fidelity of writing instruction and student CBM slope (p < .01). Implications for instructional coaching and improving student writing progress are discussed.

Gathering Diverse Perspectives to Tackle "Wicked Problems": Racial/Ethnic Disproportionality in Educational Placement

Among students receiving behavioral health and special education services, racial/ethnic minority students are consistently overrepresented in settings separate from general classrooms. Once separated, many young people struggle to improve academically and face significant difficulty upon trying to return to a general education setting. Given the complex, ongoing, and multifaceted nature of this challenge, racial/ethnic disproportionality can be identified as a "wicked problem," for which solutions are not easily identified. Here, we describe our community-engaged research efforts, eliciting perspectives from relevant partners in an ongoing dialogue, to better integrate diverse stakeholders' perspectives when attempting to address such disparities. We conducted focus groups and qualitative interviews with members of three stakeholder groups: community-serving organizations, individuals with lived experience of behavioral health conditions, and state-level policymakers, with a shared interest in addressing racial and ethnic disparities. Participant responses illustrated the "wickedness" of this problem and highlighted the need for additional supports for students, families, and school personnel, increased collaboration across relevant systems and agencies, and reduced barriers related to funding. Overall, this methodology bridged differing perspectives to develop, in concert with our partners, a shared language of the problem and a core set of issues to consider when seeking to effect change.

Using Video-Based Instruction via Augmented Reality to Teach Mathematics to Middle School Students With Learning Disabilities

The purpose of this study was to examine the effectiveness of video-based mathematics instruction for seven middle school students with specific learning disability (SLD), using an augmented reality-based training package. The dependent variable was the percentage of steps students performed correctly to solve each type of mathematics problem. The independent variable was the augmented reality video-based intervention, which used video to model the individual steps for solving four types of multistep mathematics problems: (a) addition and subtraction of integers, (b) multiplication and division of integers, (c) using ratio reasoning to convert measurement units, and (d) using multiplication and division to calculate rate of change. Results indicated a functional relation between the video-based mathematics intervention and the percentage of steps completed correctly for each type of problem. All seven participants showed significant gains immediately after receiving the intervention and maintained improved problem-solving skills in at least three out of the four problem categories.

Teaching Grapheme-Phoneme Correspondences Using a Direct Mapping Approach for At-Risk Second Language Learners: A Randomized Controlled Trial

Reading interventions developed to teach grapheme-phoneme correspondences (GPCs) were evaluated among L2 at-risk readers. In the direct mapping of grapheme (DMG) condition, children's attention was explicitly drawn to the application of a graphemes taught on that day to shared reading of words in authentic text. In the control condition there was no such systematic daily linkage of the GPCs and texts. The two reading interventions were otherwise identical. Two hundred fifty-three Chinese Grade 1 and Grade 2 students were screened, and those who scored in the bottom 30% of an English word-reading test were identified as L2 at-risk readers. Seventy-one L2 at-risk readers were thus randomly assigned to two conditions, both of which were small-group reading interventions: (a) DMG or (b) taught control. We hypothesized a significant main effect of Intervention condition and significant interaction of Intervention by Phonological Awareness (PA) effects on word reading, word attack, spelling, and sentence comprehension favoring the DMG intervention. Results showed that predicted interaction effects were significant for word reading, spelling, and sentence comprehension. No other effects were significant. Results suggest that the daily Direct Mapping of taught GPCs to shared book reading promotes reading development in at-risk English L2 readers with stronger phonological skills.

Brief, computerized inhibitory control training to leverage adolescent neural plasticity: A pilot effectiveness trial

Adolescence is a time of heightened neural plasticity. Many brain networks show protracted development through this period, such as those underlying inhibitory control (IC), a neurocognitive skill implicated in risk-taking and therefore relevant to public health. Although IC appears to be trainable in adults and young children, whether and how IC may be malleable during adolescence is not fully understood. In this pilot RCT, we tested the effects of a school-based IC training paradigm (versus active control) on IC performance and neural function in adolescents (N = 19) aged 15 to 17 recruited from a low-income school district. We also examined the extent to which training effects transferred to a nontrained IC task and real-world risk behavior, as well as potential moderation effects by early adversity exposure. Training altered brain function related to attention during IC preparation and implementation, though it did not alter IC performance in the training group compared to the control group. There was limited evidence of training transfer. Results have implications for translational neuroscience research in adolescents.

Supported Education and Employment Services for Young People with Early Psychosis in OnTrackNY

BACKGROUND

Psychosis onset commonly occurs at ages 16-30 when individuals are typically developing their education, employment and career trajectories. Coordinated specialty care (CSC) programs provide access to team-based early invention services for psychosis, including supported education and employment (SEE) services.

AIMS OF STUDY

We examine factors associated with the use of SEE services and whether use of SEE services (for supported education, supported employment, or both) is associated with education and employment participation within New York's CSC program, OnTrackNY.

METHODS

Participants (n=779) enrolled in OnTrackNY from October 2013-September 2017. Assessments were collected by clinical staff at admission, quarterly, and at discharge. Logistic regression models were specified to identify factors associated with the probability of use of SEE specialist services during the first year of program participation, using generalized estimating equations with an autoregressive covariance structure to account for within-subject correlations over time. Logistic models were also used to predict whether use of SEE services in the prior quarter predict the probability of work and school participation in the subsequent quarter, respectively; these were analyzed cross-sectionally for each time period. Models controlled for other factors associated with work/school outcomes for young people with early psychosis.

RESULTS

Participants who were younger, and who had lower rates of work/school participation had greater odds of SEE service use. Use of SEE services for education support in the first quarter among clients under age 23 is significantly associated with school enrollment in the second quarter and this continued through the first year. Use of SEE services for employment support in the first quarter is significantly associated with employment in the second quarter, but significant associations for employment were not found at later periods of participation. Use of SEE services for both education and employment support was inconsistently associated with subsequent school enrollment or employment in the subsequent quarter. Results were upheld when limiting the sample to those not receiving other SEE services.

DISCUSSION

Rates of school and work participation increased over the duration of OnTrackNY participation. Clients with lower work/school participation were more likely to use SEE services. Supported education services are associated with greater school participation during the first year for clients under age 23. However, this association is only significant in the first quarter for supported employment services, and is inconsistent when examining those who used both simultaneously. It is possible that we may find significant associations for employment as the program continues. It is also possible that clients may end supported employment services after obtaining employment, while those in school may require ongoing services (e.g. to renew educational accommodations). Additionally, it is possible that OnTrackNY's supported education model, designed to adhere to Individual Placenment and Support (IPS) principles, may be helping clients stay in school. However, as this is an observational study with no control condition, we cannot say that OnTrackNY, or SEE services participation, caused the observed outcomes.

IMPLICATIONS FOR FURTHER RESEARCH

Future research should continue to develop the evidence base for supported education services.

Improving developmental and educational support for children born preterm: evaluation of an e-learning resource for education professionals

OBJECTIVES

Children born preterm are at higher risk for special educational needs and poor academic attainment compared with term-born peers, yet education professionals receive limited training and have poor knowledge of preterm birth. We have developed an interactive e-learning resource and evaluated its efficacy in improving teachers' knowledge of preterm birth and their confidence in supporting the learning of children born preterm.

SETTING

Eight primary, infant or junior schools in England.

PARTICIPANTS

61 teachers of children aged 4-11 years, of which 55 (90%) were female.

INTERVENTION

Interactive e-learning resource designed to improve education professionals' knowledge of long-term outcomes following preterm birth and strategies that can be used to support children's learning (www.pretermbirth.info). In a repeated measures design, participants were given up to 30 days access to the e-learning resource, before and after which they completed the Preterm Birth Knowledge Scale (PB-KS; scores 0-33; higher scores indicate greater knowledge) to assess knowledge of outcomes of prematurity. Four Likert scale items were used to assess confidence in supporting children's learning and 10 items were used to evaluate the utility of the resource. PB-KS scores and responses on confidence item were compared pre-resource and post-resource use.

RESULTS

PB-KS scores significantly increased after accessing the e-learning resource (median (95% CI): pre-resource 13 (11 to 14); post-resource 29 (28 to 30)), equating to a 2.6 SD increase in PB-KS scores. Teachers' confidence in supporting children born preterm was also significantly improved after using the resource. The utility of the resource was evaluated positively by participants with 97% reporting that they would recommend its use to others.

CONCLUSIONS

The e-learning resource substantially improved teachers' knowledge of preterm birth and their confidence in supporting preterm children in the classroom. Use of this resource may represent a key advance in improving educational outcomes for children born preterm.

Student-teacher relationships of children with autism spectrum disorder: Distinct contributions of language domains

BACKGROUND AND AIMS

High quality student-teacher relationships (STR) are important for children's academic and social development. We explore how individual child language domains (semantics, syntax, pragmatics), teacher years of experience, and classroom placement (general or special education) relate to STR quality for children with autism spectrum disorder (ASD) across the school year.

METHODS AND PROCEDURES

191 children with ASD (Mage = 5.6 years) completed a standardized language assessment and their teachers reported on STR quality twice during the school year.

OUTCOME AND RESULTS

Pragmatics, but not semantics or syntax, had a direct effect on student-teacher closeness. The association between semantics and closeness was moderated by classroom type; for students with low semantics, teacher-reported closeness was lower in general versus special education. Teachers in special versus general education classrooms reported closer relationships. More experienced teachers reported closer and less conflictual relationships. None of the three language domains were associated with student-teacher conflict.

CONCLUSIONS AND IMPLICATIONS

Pragmatic and semantic language skills were associated with closer relationships. Language-focused therapies may be effective in carrying over to impact STR quality. Given the stability in relationship quality, targeted interventions should be delivered to teachers at the beginning of the school year to support positive relationship development.

Can I teach students with Autism Spectrum Disorder?: Investigating teacher self-efficacy with an emerging population of students

Currently, 1 in 68 children in the U.S. is diagnosed with Autism Spectrum Disorder (ASD; Centers for Disease Control & Prevention, 2015) and this growing population of learners has been noted as one of the most challenging groups to teach. Teacher self-efficacy, the belief teachers hold about their instructional capabilities, has been shown to differ according to contextual factors, such as the type of students teachers face. The purpose of this investigation was to develop an instrument that can used to measure teachers' self-efficacy for effectively working with students with ASD. Study 1 involved the development and evaluation of a new instrument, the Teacher Self-Efficacy for Students with Autism Scale (TSEAS) with a sample of general and special education teachers in the U.S. (N = 120). Study 2 involved a cross-validation of the measure with teachers in Australia (N = 85). Results indicated that the scale represented a unidimensional construct in both studies. Self-efficacy for teaching students with ASD was distinct from, though positively related to, general teaching self-efficacy, job satisfaction, and self-regulation. Using a student-specific teaching self-efficacy measure might provide more useful information for supporting teachers' beliefs for teaching students with ASD.

Teachers' perceptions of Restricted and Repetitive Behaviours (RRBs) in children with ASD: Attributions, confidence and emotional response

BACKGROUND

Restricted and Repetitive Behaviours (RRBs) are some of the most difficult behaviours to manage in children with Autism Spectrum Disorders (ASD). Although RRBs frequently occur in educational settings, we know little about the way in which teachers understand these behaviours.

AIMS

The study aimed to explore the attributions, emotional response and feelings of confidence held by teachers working in different educational settings when faced with RRBs.

METHODS AND PROCEDURES

A single group survey design using behavioural vignettes was adopted in order to elicit teacher beliefs and ratings.

OUTCOMES AND RESULTS

Analysis indicated that there were differences in the attributions and confidence ratings held for different types of RRBs. Significant differences were also observed between teachers working in mainstream and specialist educational settings. Emotional response and confidence scores were often predictive of one another alongside factors related to teaching experience.

CONCLUSION AND IMPLICATIONS

The findings indicate that teachers from mainstream schools potentially hold less helpful beliefs in response to RRBs and therefore are a professional group who may benefit the most from additional support and training. Further research could consider conducting a qualitative exploration of why teachers hold certain beliefs about RRBs and/or sampling those who are less experienced in working with children with ASD.

The Effects of a Shared Reading Intervention on Narrative Story Comprehension and Task Engagement of Students with Autism Spectrum Disorder

The purpose of this study was to investigate the effects of a shared reading intervention on narrative story comprehension and task engagement of students with autism spectrum disorder (ASD). A single-case multiple baseline design was used, and three elementary-aged students with ASD participated in this study. The shared reading intervention included before, during, and after reading strategies (i.e., topic anticipation, dynamic reading, story retelling). Results of this study indicated that all participants demonstrated noticeable improvements in reading comprehension. Despite the longer duration of intervention sessions as compared to baseline sessions, participants showed similar or better task engagement with intervention. Improved reading outcomes were maintained at follow up for all participants. Implications for practical implementation and future research were discussed.

How Mixed-Effects Modeling Can Advance Our Understanding of Learning and Memory and Improve Clinical and Educational Practice

Purpose A key goal of researchers, clinicians, and educators within the fields of speech, language, and hearing sciences is to support the learning and memory of others. To do so, they consider factors relevant to the individual, the material to be learned, and the training strategy that can maximize learning and retention. Statistical methods typically used within these fields are inadequate for identifying the complex relationships between these factors and are ill equipped to account for variability across individuals when identifying these relationships. Specifically, traditional statistical methods are often inadequate for answering questions about special populations because samples drawn from these populations are usually small, highly variable, and skewed in distribution. Mixed-effects modeling provides advantages over traditional statistical techniques to answer complex questions while taking into account these common characteristics of special populations. Method and Results Through 2 examples, I illustrate advantages of mixed-effects modeling in answering questions about learning and memory and in supporting better translation of research to practice. I also demonstrate key similarities and differences between analysis of variance, regression analyses, and mixed-effects modeling. Finally, I explain 3 additional advantages of using mixed-effects modeling to understand the processes of learning and memory: the means to account for missing data, assess the contribution of variations in delay intervals, and model nonlinear relationships between factors. Conclusions Through mixed-effects modeling, researchers can disseminate accurate information about learning and memory to clinicians and educators. In turn, through enhanced statistical literacy, clinicians and educators can apply research findings to practice with confidence. Overall, mixed-effects modeling is a powerful tool to improve the outcomes of the individuals that researchers and practitioners serve within the fields of speech, language, and hearing sciences.

Health-related quality of life, educational and family outcomes in survivors of congenital diaphragmatic hernia

PURPOSE

Congenital diaphragmatic hernia (CDH) survivors experience increased risk of medical and neurodevelopmental challenges. This study describes the health-related quality of life (HRQOL), special education utilization and the family impact among neonatal CDH survivors.

METHODS

A single-center prospective cohort of CDH survivors born between 1995 and 2006 was followed. Parents completed the PedsQL HRQOL index and a Family Impact survey to assess the need for medical equipment, home health services, and special education and quantify the burden placed on the family by their child's medical needs.

RESULTS

Parents of 32 survivors participated at a mean survivor age of 8 ± 4 years. Many survivors utilized medical equipment (62%), home health services (18%) and special education (28%). CDH survivor HRQOL (79 ± 17) did not differ significantly from that of healthy children (83 ± 15, p = 0.12). HRQOL was diminished among survivors who required special education (67 ± 8 vs 82 ± 3; p = 0.04) and those reporting increased Family Impact score (p = 0.001).

CONCLUSION

Many CDH survivors continue to require home medical equipment and home health services at school age. Most survivors have normal parent-reported HRQOL; however, the need for special education and higher family impact of neonatal CDH correlates with decreased HRQOL.

[FEATURES OF SOCIAL AND PEDAGOGICAL WORK WITH CHILDREN WITH PSYCHOLOGICAL IMMATURITY]

The essence of the organization of social and pedagogical work with children with psychological immaturity in the system of training of future social educators is revealed and its outcome is determined. The structural components of the criteria, indicators of the psychological condition of children with developmental delay were revealed. It is revealed that an adequate educational process is important, its functions should be as a correction of already existing disadvantages of psychological development, as well as preventing the formation of new ones in the conditions of this institution; the formation of a comfortable and appropriate psychological needs of the child environment around it; formation of attitude towards life in general: adequate motivation, models of communication with others. The program of organization of social pedagogical work with children with psychological immaturity in the preparation of future social educators was developed and implemented, which was aimed at developing students' knowledge and skills in the field of activity and providing methodological recommendations and advisory assistance in the process of social and pedagogical practices through the use of modern effective forms and methods. The results of research of mental states of children with psychological immaturity are presented.

Effectiveness of leisure and play activities for socialization skills of a child with intellectual disability - A case study

OBJECTIVE

To investigate effectiveness of leisure and play social group activities for enhancing socialisation skills in a child with intellectual disability..

METHODS

The experimental study was done at a special education school for disadvantaged children Lahore from 28th November, 2016 to 3rd February, 2017. The subject was a boy aged 17 years who was part of a leisure and play group comprising peers. Pre-rating of socialisation domain of the subject was carried out through Portage Guide to Early Education (PGEE). Atotal of 20 groups were conducted in which two sessions per week were carried out. One session of group activity lasted 25-30 minutes. Postrating was carried out after the completion of group activities..

RESULTS

There were 6 children in the play group, but the focus remained on 1(17%) subject. From pre and post rating it was evident that significant reduction in symptoms occurred in the subject, indicating effectiveness of leisure and play social groups approach..

CONCLUSIONS

Leisure and play social group activities were found to be effective in enhancing overall social skills of a child having intellectual disability.

SRSD Fractions: Helping Students at Risk for Disabilities Add/Subtract Fractions With Unlike Denominators

Many students fall below benchmarks in the area of fractions computation, particularly students with disabilities. Self-regulated strategy development (SRSD) is one strategy with proven effectiveness for improving outcomes for students with disabilities, although very few studies have applied SRSD to the area of mathematics. In this study, we used SRSD Fractions to teach adding and subtracting fractions with unlike denominators, simplifying fractions, and converting fractions to mixed numbers using the mnemonics FILMS, CUT, and EDIT. A researcher provided instruction in small groups to fifth-grade students at risk for disabilities. The results from use of a multiple-baseline-across-groups design suggest a functional relationship between SRSD Fractions and 8 fifth-grade students' digits correct on timed fraction probes. Results from treatment fidelity, social validity, and academic engagement during the intervention are also reported. We also discuss limitations and directions for future researchers.

Do learners with special education needs really feel included? Evidence from the Perception of Inclusion Questionnaire and Strengths and Difficulties Questionnaire

BACKGROUND

School inclusion is an important right of students in school systems around the world. However, many students with special education needs (SEN) have lower perceptions of inclusion despite attending inclusive schools.

AIMS

This study examined perceived levels of inclusion, academic self-concept and developmental problems in inclusive schools.

METHODS AND PROCEDURES

The Strengths and Difficulties Questionnaire and the Perception of Inclusion Questionnaire were administered at two measurement points (6th and 7th grade; n = 407, including 48 with SEN) at multiple inclusive schools. Responses were compared based on gender, grade level, and SEN. Factor structure and measurement invariance were evaluated.

OUTCOMES AND RESULTS

Factor structures of both questionnaires were confirmed. Academic self-concept and emotional inclusion were lower for learners with SEN. However, these effects shrank in grade 7. Similarly, academic self-concept increased between grade 6 and 7. Lastly, learners with SEN had a higher level of conduct problems.

CONCLUSIONS AND IMPLICATIONS

Both instruments remain suitable for use in comparisons in inclusive schools. Significant differences exist for learners with SEN in inclusive classrooms, although these differences may shrink over time. We recommend the continued use of the Perception of Inclusion Questionnaire for information about school inclusion and for learners with SEN.

Should Heritage Languages be Incorporated into Interventions for Bilingual Individuals with Neurodevelopmental Disorders? A Systematic Review

Special education policies recognize the need for developing and preserving the heritage languages of individuals with disabilities. Yet there seems to be a disconnect between policy and practice. Should the heritage languages of bilingual individuals with neurodevelopmental disorders be incorporated into interventions? This review evaluated 18 studies that examined the effects of heritage language instruction on treatment outcomes for individuals with neurodevelopmental disorders. Overall, results suggest a small effect favoring interventions delivered in the heritage language versus interventions delivered solely in the majority language. In general, studies were also found to be of high-quality according to What Works Clearinghouse Standards. Findings are discussed in terms of recommendations for future research and practice.

Self-rated health and wellbeing among school-aged children with and without special educational needs: Differences between mainstream and special schools

BACKGROUND

Studies among students with special educational needs (SEN) in separate special schools (SSS) and mainstream schools (MS) are particularly applicable to educational attainment and social participation. However, indicators of health and wellbeing have rarely been considered.

AIMS

This study investigates two related topics: first, health and wellbeing differences between students with SEN in special schools (SSS) and students without SEN in regular schools, and second, the rarely considered question whether health and wellbeing among students with SEN differ between school settings (i.e. MS vs. SSS).

METHODS AND PROCEDURES

Bivariate and multilevel analyses are applied with data from the German National Educational Panel Study (NEPS) with 5267 students (grade 7).

OUTCOMES AND RESULTS

After having controlled for background characteristics, students in SSS report higher likelihoods of poor self-rated health compared to students in higher track schools. Self-rated health of students with SEN does not significantly differ between MS vs. SSS. For life satisfaction, students with SEN show higher likelihoods of low life satisfaction when attending MS.

CONCLUSIONS AND IMPLICATIONS

Teachers in inclusive settings are encouraged to establish class work and teaching that support a real change from class placement to inclusive culture in order to suitably support students with SEN.

Pre-Service Teachers' Intervention in School Bullying Episodes with Special Education Needs Students: A Research in Italian and Greek Samples

Background: The aim of the study was to compare the level of self-confidence in dealing with problems at school, the attitude towards bullying situations and the recommended strategies to cope with bullying in two samples of pre-service teachers (PSTs). The PSTs were in training to become teachers with special education needs students (SEN) and came from two different countries (Italy and Greece). Methods: A questionnaire survey was made involving 110 Italian and 84 Greek PSTs. Results: The results about self-confidence showed that Greek PSTs had lower outcome expectations and a higher external locus of causality than Italian PSTs. Teachers' training programs and school preventive intervention were also discussed. Conclusions: Because the participants in this investigation will be teachers in the near future, they require specific training on bullying in general and in students with SEN in particular.

The Effects of a Text-Centered Literacy Curriculum for Students With Intellectual Disability

The purpose of this study was to examine the promise and feasibility of a newly developed curriculum to teach early literacy skills to students with intellectual disability (ID) and students with low IQs. The curriculum texts were written to include familiar settings, high frequency words, natural syntax, and cumulative practice. A single-case design was used with multiple baseline across levels of instruction and included eight participants who had IQs spanning from 40 to 63. The study was conducted across one academic year in two private schools for students with special needs. Results showed that all eight students demonstrated significant growth on proximal measures of taught words, as well as growth on at least some curriculum-based distal measures. Additionally, the program was demonstrated to be feasible; the teachers implemented the intervention with high degrees of fidelity and expressed satisfaction with the effectiveness and practicality of the program.

Incorporating a Peer-Mediated Approach Into Speech-Generating Device Intervention: Effects on Communication of Preschoolers With Autism Spectrum Disorder

Purpose

This study examined the effects of incorporating a peer-mediated approach into a speech-generating device (SGD) intervention on communication of 45 nonverbal and minimally verbal preschoolers with autism spectrum disorder (ASD) and 95 peers without disabilities. The SGD was an iPad 2 (Apple) with voice output app.

Method

Effects were evaluated using a multivariate randomized control trial design with repeated measures for 4 cohorts across baseline, intervention, generalization, and maintenance phases. Children were randomly assigned to an experimental treatment that trained peers on use of the SGD or a business-as-usual comparison condition with untrained peers. Communication outcomes were measured for both children with ASD and peers.

Results

Children receiving the treatment demonstrated significant increases in rates of communication and more balanced responses and initiations (a measure of reciprocity) than children in the comparison group. They were able to generalize improvements and maintain communication gains. Treatment fidelity was high for school staff and peer implementation.

Conclusions

Results support positive effects on communication of teaching young children with ASD and peers without disabilities to use the same SGD system in typical preschool activities. SGD interventions that utilize peer-mediated approaches may improve core deficits in communication and reciprocity and allow for greater classroom social participation and interactions with peers.

Appraisal of comparative single-case experimental designs for instructional interventions with non-reversible target behaviors: Introducing the CSCEDARS ("Cedars")

Evidence-based practice as a process requires the appraisal of research as a critical step. In the field of developmental disabilities, single-case experimental designs (SCEDs) figure prominently as a means for evaluating the effectiveness of non-reversible instructional interventions. Comparative SCEDs contrast two or more instructional interventions to document their relative effectiveness and efficiency. As such, these designs have great potential to inform evidence-based decision-making. To harness this potential, however, interventionists and authors of systematic reviews need tools to appraise the evidence generated by these designs. Our literature review revealed that existing tools do not adequately address the specific methodological considerations of comparative SCEDs that aim to compare instructional interventions of non-reversible target behaviors. The purpose of this paper is to introduce the Comparative Single-Case Experimental Design Rating System (CSCEDARS, "cedars") as a tool for appraising the internal validity of comparative SCEDs of two or more non-reversible instructional interventions. Pertinent literature will be reviewed to establish the need for this tool and to underpin the rationales for individual rating items. Initial reliability information will be provided as well. Finally, directions for instrument validation will be proposed.

Generalization and maintenance of functional communication training for individuals with developmental disabilities: A systematic and quality review

BACKGROUND

Functional communication training (FCT) is considered an evidence-based practice for treating problem behavior in individuals with developmental disabilities (e.g. autism, intellectual disabilities, down syndrome, etc.). However, there is little known on how to sustain behavioral change following FCT interventions. This systematic and quality review synthesizes the current literature base evaluating the maintenance and generalization of behavioral effects following FCT.

METHOD

A systematic review identified 37 studies that met the pre-set inclusion criteria. Those studies were summarized in terms of: (a) generalization dimension, (b) generalization assessment design, (c) maintenance assessment design, (d) maintenance and generalization teaching strategy, and (e) latency to maintenance probes. All studies employed single-case research designs and were evaluated using the What Works Clearinghouse pilot single-case research standards (Kratochwill et al., 2013) as adapted by Maggin, Briesch, and Chafouleas (2013). Maintenance and generalization data were evaluated using a researcher-developed rubric based on the WWC standards.

RESULTS AND DISCUSSION

Results indicate that 30 studies met standards or met standards with reservations while only six studies also met all of the maintenance and generalization standards. Of the six studies, five did not implement any additional strategies beyond the contacting natural contingencies that is inherent in the FCT intervention. Implications for future research and practice are discussed.

Tablet-based interventions for individuals with ASD: Evidence of generalization and maintenance effects

BACKGROUND

Despite positive effects of and established empirical evidence for tablet-based interventions for individuals with autism spectrum disorder (ASD), it is not known whether such findings can be applicable to maintenance and generalization effects of those interventions.

AIMS

This systematic review evaluated peer-reviewed single-case experimental design (SCED) studies concerning evidence of generalization and maintenance effects of tablet-based interventions for individuals with ASD.

METHODS

To evaluate the methodological rigor of the literature in terms of generalization and maintenance effects, the authors adopted four of the basic design standards developed by What Works Clearinghouse (WWC; Kratochwill et al., 2010/2014). In addition, the authors used Tau-U effect size measure and attempted to calculate effect sizes differentiated by the type of generalization and maintenance teaching strategies.

RESULTS

A total of 21 studies assessed generalization and/or maintenance effects. In the first evaluation of evidence of generalization and maintenance effects, it was found that more than half of the studies included in this review collected interobserver agreement (IOA) on at least 20% of sessions across all generalization and maintenance conditions and met the minimum quality thresholds of IOA. Meanwhile, less than one third of the studies included more than three data points in each generalization and maintenance condition. With regard to maintenance of effects, about half of the reviewed studies did not report the latency to the maintenance measure, which may hamper the assessment of the clinical and practical significance of the effect of the tablet-based intervention. In the second evaluation, the omnibus Tau-U effect size for baseline to generalization comparisons resulted in a moderate effect. For the contrasts between intervention and generalization comparisons resulted in a small effect. The omnibus Tau-U effect size for baseline and maintenance comparisons resulted in a strong effect. For the contrasts between intervention to maintenance comparisons, the omnibus Tau-U effect size resulted in a small effect.

CONCLUSIONS AND IMPLICATION

Findings in this review suggest that efforts should be made to establish a system for appraising generalization and maintenance procedures in SCED studies. In addition, future studies should investigate if tablet-based interventions are truly effective in creating sustainable behavioral change in individuals with ASD.

Differences in teachers verbal responsiveness to groups of children with ASD who vary in cognitive and language abilities

BACKGROUND

This study aimed to examine whether verbal responsiveness in special education teachers varied among subgroups of children with autism spectrum disorder (n = 112) who differed in cognitive and language abilities.

METHODS

Participants were divided into clusters using cluster analysis based on standardised cognitive and language tests using k-mean clustering. For each child, a 15-min video of free play in school setting was collected. Three types of responsive utterances were coded: follow-in directives for behaviour, follow-in directives for language and follow-in comments.

RESULTS

Results showed that the three groups did not differ in overall verbal responsiveness after controlling for engagement, classroom type, age and gender. However, groups differ in follow-in directives for language, but not in follow-in directives for behaviours or follow-in comments. Compared with children with autism spectrum disorder who had higher cognitive and language ability, children with more severe impairments received fewer follow-in directives for language. Moreover, children with more cognitive and language impairments produced fewer amount of vocal/verbal acts, which results in receiving fewer verbal responses from their teachers. Additionally, teachers from the three groups did not differ in their responses to the child's verbal/vocal acts when the number of the child's verbal/vocal acts were controlled for.

CONCLUSION

Findings suggest child characteristics are related to the type of teachers' verbal responses in preschools. This difference in follow-in directives for questions may be related to language or other outcomes that warrant further investigations.

Social validity in single-case research: A systematic literature review of prevalence and application

BACKGROUND

Single-case research (SCR) has been a valuable methodology in special education research. Montrose Wolf (1978), an early pioneer in single-case methodology, coined the term "social validity" to refer to the social importance of the goals selected, the acceptability of procedures employed, and the effectiveness of the outcomes produced in applied investigations. Since 1978, many contributors to SCR have included social validity as a feature of their articles and several authors have examined the prevalence and role of social validity in SCR.

AIM AND METHODS

We systematically reviewed all SCR published in six highly-ranked special education journals from 2005 to 2016 to establish the prevalence of social validity assessments and to evaluate their scientific rigor.

RESULTS

We found relatively low, but stable prevalence with only 28 publications addressing all three factors of the social validity construct (i.e., goals, procedures, outcomes). We conducted an in-depth analysis of the scientific rigor of these 28 publications.

CONCLUSIONS

Social validity remains an understudied construct in SCR, and the scientific rigor of social validity assessments is often lacking. Implications and future directions are discussed.

Use of key word signing by staff in special schools and in day centres for adults with intellectual disabilities

BACKGROUND

Staff may encourage individuals with intellectual disabilities to use manual signs by modelling its use, but implementing key word signing during daily activities can be demanding.

METHOD

Staff's use of manual signs was observed in four special schools and four day centres for adults with intellectual disabilities during communicative group activities, non-communicative group activities and mealtimes. Using in situ partial interval coding, we measured staff's communication rate, semantic diversity of manual signs, sign reinforcement and sign imitation. With Chi-squared tests, associations were measured between these variables, the two settings and the three activity types.

RESULTS

During communicative activities, staff used manual signs significantly more in adult services than special schools. During non-communicative activities and mealtimes, staff seldom used or reinforced signs.

CONCLUSIONS

Staff communicated frequently but did not often model sign use during daily activities. To investigate influence from training background, further detailed measurements are warranted.

Predictors of General Functioning and Correlates of Quality of Life: A Cross-Sectional Study among Psychiatric Outpatients

INTRODUCTION

Functioning and quality of life (QOL) are negatively impacted as a result of mental illness. This study aimed to determine the: i) socio-demographic and clinical correlates of functioning and; ii) associations between functioning and QOL in a multiethnic sample of psychiatric outpatients.

MATERIALS AND METHODS

This was a cross-sectional study of outpatients receiving treatment from a tertiary psychiatric hospital. Functioning was assessed using the Global Assessment of Functioning (GAF) scale, while QOL was measured using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) which comprises 4 domains: physical health, psychological health, social relationships and environment.

RESULTS

Various socio-demographic and clinical correlates were associated with functioning including employment and marital status, education and diagnosis. Depression was the only clinical characteristic which negatively correlated with functioning (P = 0.035). Amongst the whole sample, multiple linear regressions revealed that functioning was positively associated with all 4 QOL domains (physical health [P <0.001], psychological health [P <0.001], social relationships [P <0.001] and environment [P <0.001]). Further analysis of each diagnostic group revealed that functioning was positively associated with all 4 QOL domains in the anxiety, depression and obsessive compulsive disorder subsamples, while in the schizophrenia subsample, functioning was only significantly associated with all environment domain.

CONCLUSION

Functional impairments were associated with different socio-demographic and clinical characteristics, which should be addressed when planning tailored treatment and interventions. Given that functioning is significantly associated with QOL, it is crucial to regularly assess and monitor them (in addition to symptomatic outcomes and adopting a more holistic and biopsychosocial approach).

Comprehension of "Narrow Focus" by Adolescents in the Autism Spectrum

OBJECTIVE

The study compared the performance of adolescents with autistic spectrum disorder (ASD) to that of age-matched peers with typical development (TD) and cognitive language-matched peers with TD on measures of identification and comprehension of "narrow focus."

PARTICIPANTS

Forty-nine participants, 17 autistic, 17 TD peers matched for age and sex, and 15 TD children matched for expressive vocabulary participated in the study.

METHOD

The Hebrew Narrow Focus Test (HNFT) was used. The HNFT includes 3 subtests. The first subtest (A) required identification of the stressed word in the sentence based on psychoacoustic abilities alone. The second (B) and third (C) subtests required understanding the meaning of focused stress in different contexts. In subtest B, the meaning of "narrow focus" was to contrast other possibilities related to the lexical-grammatical role of the stressed word in the sentence, whereas in subtest C, the meaning was to indicate a mistake.

RESULTS

ASD participants showed reduced performance compared to peers across all the subtests of the HNFT, but similar performance compared to TD children in subtests A and B and better performance on subtest C. A significant correlation was found between the Raven test for assessing nonverbal intelligence and subtests B and C of the HNFT in the group of adolescents with ASD.

CONCLUSIONS

Comprehension of narrow focus in adolescents with ASD who study in a special educational system is related to their cognitive-linguistic abilities and not to the autistic condition by itself or to its severity.

Evaluation of an interview skills training package for adolescents with speech, language and communication needs

BACKGROUND & AIMS

We evaluated a structured intervention programme aimed at preparing adolescents with developmental language disorders for job interviews. Our primary outcome measures included change in ratings of verbal and non-verbal social communication behaviours evident during mock interviews.

METHODS & PROCEDURES

In study 1, 12 participants, aged 17-19 years, from a specialist sixth-form college completed the intervention and two mock interviews, one pre- and one post-intervention. In study 2, 34 participants, aged 17-19 years, completed a modified intervention programme and three mock interviews, one at baseline (included to control for possible practise effects), one pre- and one post-intervention. In both studies, interviews were video recorded and social communication behaviours were coded by independent assessors blind to interview time, participant diagnosis and therapy content. A repeated-measures design was employed to measure change in communication behaviours.

OUTCOMES & RESULTS

In study 1, a significant increase in the number of 'positive' verbal and non-verbal social communication behaviours was observed from pre- to post-intervention. However, there was no significant change in the number of 'negative' behaviours (i.e., fidgeting, irrelevant remarks). In study 2, there were no significant changes in verbal behaviours, but significant group differences (though wide individual variation) in both positive and negative non-verbal social communication behaviours.

CONCLUSIONS & IMPLICATIONS

Our findings suggest that training specific social communication skills that are important for interview success, and consistently reinforcing those behaviours during therapy practice, can increase the use of those skills in an interview setting, though in this heterogeneous population there was considerable variation in therapy outcome. The skills of the interviewer were identified as a potential source of variation in outcome, and a target for future research and practice.

Education of children with disabilities in New Delhi: When does exclusion occur?

BACKGROUND

In the new Sustainable Development Goal 4, quality of education defined as equity and inclusion alongside traditional learning outcomes, has replaced the narrow goal of access to primary education stipulated in the Millennium Development Goal 2. Since 2000, considerable progress has been made towards improving access to school for children in India, yet questions remain regarding not just children with disabilities' access and acquisition of basic learning skills, but also completion of learning cycles.

METHODS AND FINDINGS

Between November, 2, 2011 and June 20th 2012, we interviewed 1294 households about activity limitations and functioning difficulties associated with a health problem among all family members using a validated screening instruments, as well as questions about access, retention and barriers to education. We found that vulnerable children, particularly children with disabilities are less likely to start school and more likely to drop out of school earlier and before completing their high school education than non-disabled children, showing that the learning process is not inclusive in practice. The gap is wider for girls, economically deprived children, or children from households where the head is uneducated.

CONCLUSIONS

Firstly, in order to fill the existing knowledge gap on education of children with disabilities in line with SDG4, not only is there a necessity for relevant data with regards to learning outcomes, but also an urgent requirement for more innovative information pertaining to relational aspects of learning that reflect inclusion. Secondly, a stronger understanding of the implications of early assessment would further promote equity in education. Finally, research should tackle learning as a complex and dynamic phenomenon. Education needs to fulfil its instrumental value, but must also re-claim its intrinsic value that often gets watered down in the journey from policies to implementation.

Effectiveness of 1:1 speech and language therapy for older children with (developmental) language disorder

BACKGROUND

Evidence of the effectiveness of therapy for older children with (developmental) language disorder (DLD), and particularly those with receptive language impairments, is very limited. The few existing studies have focused on particular target areas, but none has looked at a whole area of a service.

AIMS

To establish whether for students with (developmental) language disorder attending a specialist school, 1:1 intervention with an SLT during one school term improves performance on targeted areas, compared with untreated control areas. Also, to investigate whether gender, receptive language status, autism spectrum disorder (ASD) status, or educational Key Stage affected their response to this intervention.

METHODS & PROCEDURES

Seventy-two students (aged 9-17 years, 88% of whom had receptive language impairments) and all speech and language therapists (SLTs) in our specialist school for children with Language Disorder, most of whom have DLD participated in this study over one school term. During this term, the SLTs devised pre- and post-therapy measures for every student for each target they planned to treat 1:1. In addition, for each target area, a control measure was devised. The targets covered a wide range of speech, language and communication areas, both receptive and expressive. Post-therapy tests were administered 'blind'.

OUTCOMES & RESULTS

During the term, SLTs and students worked 1:1 on 120 targets, the majority in the areas of expressive and receptive language. Targets and controls did not differ pre-therapy. Significant progress was seen both on targets (d = 1.33) and controls (d = 0.36), but the targeted areas improved significantly more than the controls with a large and clinically significant effect size (d = 1.06). There was no effect of language area targeted (targets improved more than their controls for all areas). Participants with versus those without receptive language difficulties, co-occurring ASD diagnosis or participants in different educational Key Stages did not differ significantly in terms of the progress they made on target areas.

CONCLUSIONS & IMPLICATIONS

Direct 1:1 intervention with an SLT can be effective for all areas of language for older children with (D)LD, regardless of their gender, receptive language or ASD status, or age. This adds to the relatively limited evidence base regarding the effectiveness of direct SLT intervention for school-aged children with (D)LD and for children with receptive language impairments. If direct 1:1 intervention can be effective with this hard-to-treat group, it may well also be effective with younger children with (D)LD. Thus, direct SLT services should be available for school-aged children with (D)LD, including older children and adolescents with pervasive difficulties.