Development of infants with disabilities and their families: implications for theory and service delivery.

This Monograph presents the results of a nonexperimental, longitudinal investigation of developmental change in 190 infants and their families after 1 year of early intervention services. The Early Intervention Collaborative Study (EICS), conducted in association with 29 community-based programs in Massachusetts and New Hampshire, was designed to assess correlates of adaptation in young children with disabilities and their families over time, to inform social policy by analyzing the influences of family ecology and formal services on child and family outcomes, and to generate conceptual models to guide further investigation. The study sample (mean age at entry = 10.6 months) includes 54 children with Down syndrome, 77 with motor impairment, and 59 with developmental delays of uncertain etiology. Data were collected during two home visits (within 6 weeks of program entry and 12 months later) and included formal child assessments, observations of mother-child interaction, maternal interviews, and questionnaires completed independently by both parents as well as monthly service data collected from service providers. Child and family functioning varied considerably. Developmental change in the children (psychomotor abilities, adaptive behavior, spontaneous play, and child-mother interaction skills) was influenced to some extent by gestational age and health characteristics, but the strongest predictor of change was the relative severity of the child's psychomotor impairment at study entry. Families demonstrated generally positive and stable adaptation (in terms of the effect of rearing a child with disabilities on the family, parenting stress, and social support), despite persistent challenges with respect to mother-child interaction and differences in reported stress between mothers and fathers. Documentation of services revealed that early intervention is a complex and multidimensional experience that spans multiple public and private systems. Vulnerable and resilient subgroups within the sample were identified, and different correlates of adaptive change were demonstrated. Results of data analyses suggest new perspectives on the study of early childhood disability. The implications of the findings for developmental theory and social policy are discussed.     

Assessment of health-care professionals’ knowledge and attitudes on sexuality and aging: an integrative review

ABSTRACT

This study aims to establish an understanding of (a) health-care professionals’ knowledge and attitudes; and (b) tools used to assess sexuality in older people living with/(out) dementia and those identified as lesbian, gay, bisexual, trans, or intersex (LGBTI) individuals. An integrative review of the literature, as registered on the PROSPERO international Prospective Register of Systematic Reviews (CRD42019129589), was conducted. A comprehensive and systematic literature search was performed for the period between 2009 to 2019 across eight electronic databases: CINAHL, PubMed, MEDLINE, Web of Science, Cochrane library, Embase, PsycINFO, and Scopus, together with a manual search of reference lists. Screening of titles, abstracts, and full texts of eligible studies plus quality appraisal (using the Mixed Methods Appraisal Tool) were independently conducted by two reviewers with disagreements resolved via discussion with a third reviewer. Nineteen articles were reviewed with three themes identified from the synthesis: 1) varying knowledge and attitudes amongst health-care professionals; 2) needs for professional development opportunities and support from workplace and 3) lack of recent validated tools to assess knowledge and attitudes. Health-care professionals’ knowledge and attitudes toward sexuality in older people living with/(out) dementia and those identified as LGBTI individuals are varying. Sexuality education and professional development training are needed to enhance their knowledge and attitudes and build skills in order to manage sexuality concerns. Current assessment tools are inadequate, highlighting the need for an appropriate assessment tool to be developed.     

Systemic cognitive-developmental therapy: A counselling model and an integrative classification schema for working with partners and families

Systemic Cognitive-Developmental Therapy (SCDT) represents a holistic, non-pathological, and integrative approach to partner and family counselling. The model directly links developmental constructs to the counselling process and offers specific assessment and treatment strategies that can be easily learned and applied in the immediacy of the counselling encounter. Additionally, it offers a classification schema that clinicians can use to organize familiar counselling and therapy approaches into a developmental framework. This article introduces the theory and practice of SCDT, illustrates the techniques and strategies specific to the model, and provides illustrative partner, family, and client examples for clarification.Paper presented in April, 1994 at the International Conference on Counselling in the Family in München, Germany, sponsored by the International Round Table for the Advancement of Counselling.     

Working with adolescent mothers of babies and toddlers: an approach to parent education

Adolescent mothers and their very young children are a high‐risk group, physically, emotionally and socially. These very young parents present special challenges to the early childhood educator, who must often deal with the simultaneous demands created by an immature adolescent and the needs of her child for responsible parenting. Social isolation, lack of education, inexperience, and un‐met needs to play further complicate the lives of teen parents, and of educators who attempt to teach them parenting skills.

Recognising the adolescent needs of very young parents and building a parent education program based on concrete, playful experiences with plentiful opportunities to interact with peers seem to be keys to successful intervention. In this presentation we will look at the special characteristics of adolescent parents and review a series of field‐tested hands‐on parent education workshops for them.     

Chicken Club: schools and their relationship with families

Over time, schools have developed systems that include the families of children. Families often sign a home school agreement and attend parent forums or more formal meetings designed to plan provision for children with special educational needs. These endeavours, however, are arguably inadequate when the full influence of the family is properly acknowledged. Research makes clear that the main influencer on the child’s self-efficacy and therefore learning behaviours, is the family. This article reports findings from literature and a case study looking at making the most of the partnership between families and schools in order to meet the learning needs of individual children. It also addresses many barriers that families face in approaching schools and three ways schools in Cornwall, a rural county in South West England, are 'opening out’ their practice. The case study provides evidence of the progress children made in learning as a response to the new school and family partnership.     

Bones,boys, bombs and booze: an exploratory study of the reliability of marking dissertations across disciplines

The primary aim of this study was to evaluate the reliability of the University’s Masters’ level (M‐level) generic assessment criteria when used by lecturers from different disciplines. A further aim was to evaluate if subject‐specific knowledge was essential to marking these dissertations. Four senior lecturers from diverse disciplines participated in this study. The University of Teesside’s generic M‐level assessment criteria were used and formatted into a grid. The assessment criteria related to the learning outcomes, the depth of understanding, the complexity of analysis and synthesis and the structure and academic presentation of the work. As well as a quantitative mark, a qualitative statement for the reason behind the judgement was required. Each lecturer provided a dissertation that had previously been marked. All participants then marked each of the four projects using the M‐level grid and comments sheet. The study found very good inter‐rater reliability. For any one project, the variation in marks from the original mark was no more than 6% on average. This study also found that subject‐specific knowledge was not essential to marking when using generic assessment criteria in terms of the reliability of marks. The authors acknowledge the exploratory nature of these results and hope other lecturers will join in the exploration to test the robustness of generic assessment criteria across disciplines.     

Peripheral nerve injury in patients exposed to n-hexane: an analysis of eight cases

Poisoning is often characterized by the acute onset,rapid progress,or specific manifestations of pathological symptoms,such as pulmonary fibrosis due to paraquat poisoning or high mortality arising from dinitrophenol intoxication (Jiang et al.,2016;Wang et al.,2017;Feng et al.,2018;Lu,2018;Xu and Lu,2019).Unlike general poisoning,however,the manifestation of n-hexane intoxication is subacute,and its clinical symptoms are dormant,and thus the provision of a timely and correct diagnosis is often difficult.     

Advancing the construct validity of the Early Communication Indicator (ECI) for infants and toddlers: Equivalence of growth trajectories across two early head start samples

The Early Communication Indicator (ECI) is a measure for universal screening, intervention decision-making, progress monitoring for infants and toddlers needing higher levels of support, and program accountability. In the context of the ECI's long-term wide-scale use for these purposes, we examined the invariance of ECI measurement in two samples of the same Early Head Start (EHS) population differing in the years data were collected. Invariance or equivalence across samples is an important step in measurement validation because making inferences assumes that the measurements are factorially invariant. A number of time-covarying factors (e.g., assessors, children, etc.) can be hypothesized as threats to measurement invariance. Results of latent growth curve analyses indicated similarity in the functional forms (velocity and shape) of the ECIs four key skill trajectories between groups of children and ECI vocalizations, single, and multiple words trajectories met strong factorial and structural invariance. Gestures met only weak factorial invariance. ECI total communications, a weighted composite of the four scales, also met both strong factorial and structural invariance. With one exception, results indicated that the ECI produced comparable growth estimates over different conditions of programs, assessors, and children over time, strengthening the construct validity of the ECI. Implications are discussed.     

Proposals for improving the transition process of young people with intellectual disabilities in Spain: insights from focus groups of professionals,young people and their families

This research aims to present proposals that can improve the transition to adulthood of young people with intellectual disabilities (ID). Four focus groups were set up in three different cities in Spain, each comprising education and social work professionals, people with ID and family members. In total, 32 participants were included in the study. The discussions were recorded, transcribed and analysed using thematic content analysis. Improvements proposed by participants were organised into six themes: coordination between services and professionals; curricular approaches; participation by young people with ID; peer-relationship networks; family and administration. Participants highlighted the need to make the curriculum more flexible and foster curricular experiences related to social and workplace inclusion, as well as establish more continuity in guidance processes throughout the different stages of education and especially at the end of secondary education. Participants also suggested the need for young people with ID to have a more prominent role in their educational process, and strengthening their social networks by promoting their participation in community activities.     

Gender matters in transition to adulthood: A survey study of adolescents with disabilities and their families

This survey study explored gender differences in transition imperatives and opportunities for youth with disabilities (N = 521). Results indicated that males and females differ in terms of the adult outcomes they hope to achieve, transition training opportunities they have received, and their access to teachers and other nonfamilial adults to assist them. Youth and parents who responded to the survey indicated that gender stereotypes continue to exist and that these stereotypes result in lowered expectations for girls. Gender stereotypes were found to vary by ethnicity. Access to health insurance and a good doctor were rated as top priorities for all youth transitioning to adulthood. Implications for educators, psychologists, and counselors are discussed. © 2008 Wiley Periodicals, Inc.     

The assessment of at-risk infants and toddlers with the Bayley Mental Scale and the Battelle Developmental Inventory: Beyond the data

The purpose of this study was to compare the usefulness of the Bayley Scales of Infant Development (BSID)-Mental Scales and the Battelle Developmental Inventory (BDI) in assessing the abilities of infants and toddlers from teen-parent families. The 34 children lived with their mothers, who ranged in age from 15 to 21. The results of the study indicate that these two developmental instruments cannot be used interchangeably and that one needs to look beyond the psychometric data in order to understand the results of infant and toddler assessment. The correlation between the BSID-Mental Development Index (MDI) and BDI Total score was −.03.     

Reframing our approach to doctoral programs: an integrative framework for action and research

A serious problem exists in the academic world, namely doctoral education attrition rates that approach 50% in some disciplines. Yet, calls for action have generally been ad hoc rather than theory driven. Further, research has not been conceived and implemented with sufficient breadth to integrate factors influencing the outcomes across the societal/supra‐societal, institutional and departmental/disciplinary contexts. Concurrently, epistemological questions are being directed at the appropriateness of both the content and the process of doctoral programs. In this paper, we propose as a heuristic, an integrative framework of nested contexts to guide both research and action. The framework integrates the range of factors influencing doctoral student experience, so that we can envision responding to this issue in a coherent and effective fashion.     

An analysis of the different patterns of 1:1 interactions between educational professionals and their students with varying abilities in inclusive classrooms

The purpose of this study was to examine the different types and patterns of 1:1 interactions provided by general educators, special educators and paraprofessionals to children with mild disabilities (n?=?13), severe disabilities (n?=?13), and children without disabilities (n?=?13) in inclusive classrooms. General educators, special educators, and paraprofessionals' 1:1 interactions with students in three comparison groups were recorded in 17 elementary and middle school classrooms using a partial interval observation system. We found significant differences with respect to interaction frequency and content. Teachers and paraprofessionals had consistently more 1:1 interactions with students with severe disabilities, followed by children with mild disabilities, and then students without disabilities. In comparison to special education teachers and paraprofessionals, general educators interacted significantly more frequently with children without disabilities and children with mild disabilities. In contrast, paraprofessionals interacted significantly more often with students with severe disabilities and less frequently with children with mild disabilities and students without disabilities. Instructional interactions in social, behavioural, and functional domains were infrequent in these classrooms. We conclude with a brief discussion of the implications of these findings for future research and practice.     

Changes and challenges in the transition to adulthood: views and experiences of young people with learning disabilities and their families

The transition to adulthood poses one of the most complex challenges for young people with intellectual disabilities. In order to conduct a wide-reaching and in-depth study of this process, we need to know the views of these young people themselves and their families. This article presents research designed to collect the experiences and perceptions of young people with disabilities and their families regarding perceived problems and support in their transition to adulthood in Spain. A qualitative case study method was used to achieve this. Data were collected in three stages on the following topics: educational pathway (primary and secondary school), social support networks and free time, and construction of a personal plan for the future (labour market inclusion and independent living). Various different instruments were used, including interviews, focus groups and visual methods. As for the results, the young people who participated in the study experienced difficulties with both successfully completing secondary education and continuing their education. The families in our study were not very satisfied with the guidance received from professionals upon finishing secondary school. They also complained about the lack of training options available to young people with disabilities. The participants expressed certain fears regarding social inclusion and labour market integration. They are aware that they will need help, and have doubts about whether they will receive the necessary support to progress with their plans for labour market integration and independent living. As a result of the study, we propose several recommendations to improve opportunities for the social inclusion of young people with disabilities in their transition to adulthood.     

Perspectives on the transition from preschool to kindergarten for children with disabilities and their families.

This article addresses the transition of young children from preschool programs that provide special education services to kindergarten or alternative elementary school placements. The roles of the child, family, and service providers in transition preparation, planning, implementation, and evaluation are described. Successful transitions include assessments of children's skills in meeting the demands of kindergarten programs, teaching these skills to children, and actively encouraging parent participation in plans and programs. Barriers to successful transitions include lack of time and funding to coordinate both parent activities and between-school arrangements. A critical area for future research is the long-term evaluation of the procedures described as "best practice," as well as the definition of what constitutes a successful transition.     

Adolescents' perceptions of attachments to their mothers and fathers in families with histories of domestic violence: a longitudinal perspective

OBJECTIVE: The effects of both childhood and teenage experiences of domestic violence on adolescent-parent attachments were examined. METHOD: Israeli adolescents (M = 15.9 years) who were either victims of physical abuse, witnesses of physical spouse abuse, victims and witnesses of abuse, or neither victims nor witnesses of abuse were questioned about attachments to their parents using the Inventory of Parent and Peer Attachment [IPPA; Armsden, G. C., & Greenberg, M. T. (1987). The inventory of parent and peer attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16, 427-454]. FINDINGS: Abuse status 5 years earlier was unrelated to the adolescents' current perceptions of their attachments whereas current abuse status predicted the adolescents' perceptions of attachment to their mothers. Adolescents who were victims of physical abuse reported weaker attachments to their parents than adolescents who were not abused or who had solely witnessed interparental physical abuse. Attachments to mothers were weaker whether or not mothers were the perpetrators of abuse. CONCLUSIONS: These findings suggest that victimization adversely affects children's perceptions of relationships with their parents, but that changes in the exposure to family violence are associated with changes in relationships with parents. These findings suggest that intervention can have positive effects on parent-child relationships despite violent histories.