Language development, delay and intervention-the views of parents from communities that speech and language therapy managers in England consider to be under-served

Evidence-based practice includes research evidence, clinical expertise and stakeholder perspectives. Stakeholder perspectives are important and include parental ethno-theories, which embrace views about many aspects of speech, language and communication, language development, and interventions. The Developmental Niche Framework provides a useful theory to understand parental beliefs. Ethnotheories, including those about language development, delay and interventions, may vary cross culturally and are less well understood in relation to families who may be considered ‘under-served’ or ‘hard-to-reach’ by speech and language therapy services. Who is considered to be under-served and the reasons why some families are under-served are complex

Meeting the educational and social needs of children with language impairment or autism spectrum disorder:the parents’ perspectives

Background There is increasing interest in examining the perspectives of parents of children with special educational needs (SEN). Exploring the view of parents of a child with language impairment (LI) or autism spectrum disorder (ASD) is particularly important because of their high prevalence, at over 30% of children with SEN in England, and the increasing evidence of overlapping profiles of their needs. Aims To examine the similarities and differences between the perspectives of parents of children with LI or ASD on three issues: i) their child’s educational progress, and their behavioural, emotional and social development, ii) the provision made to support their child’s education and meet their SEN; and iii) their own involvement in decision making about provision for their child. Method and procedure The parents of 129 children with LI (n = 76) or ASD (n = 53) were interviewed using a semi-structured protocol that gathered both quantitative data (parent ratings) and qualitative, in depth explorations of their perspectives. Outcomes and results There were no significant differences between the perspectives of parents of children with LI and parents of children with ASD with respect to their child’s educational progress; the provision made to meet their child’s educational needs; or their involvement in decision making during the statutory assessment procedure, including the determination of a statement of SEN, and the current provision made by their child’s school. Both parent groups were generally positive about these but parents of children with ASD were more concerned about their child’s peer relationships. Parents whose child attended a mainstream school with a specialist resource tended to be more positive about the provision made than parents whose child was included individually into a mainstream school. Conclusions and implications Although previous research indicates that parents of children with ASD are overrepresented among those that express dissatisfaction with provision made to meet their child’s needs, our study indicates high levels of satisfaction and overlap between the perspectives of parents of children with LI or ASD regarding their child’s educational progress and their own involvement in decision making about the child’s provision. Our findings indicate the importance for policy and practice of focusing on identified needs rather than diagnostic category; and the importance of practitioners and administrators engaging meaningfully with parents in collaborative decision making.

Systematic review of tools to measure outcomes for young children with autism spectrum disorder

Background: The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children's progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness, skills such as social functioning and play, participation outcomes such as social inclusion, and parent and family impact. Objectives: To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents. Methods: The MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013, systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD, and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers. Results: The conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains 'Impairments', 'Activity Level Indicators', 'Participation', and 'Family Measures'. In review 1, 10,154 papers were sifted - 3091 by full text - and data extracted from 184, in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed tools was combined with information about their accessibility and presentation. Twelve tools were identified as having the strongest supporting evidence, the majority measuring autism characteristics and problem behaviour. The patchy evidence and limited scope of outcomes measured mean these tools do not constitute a 'recommended battery' for use. In particular,there is little evidence that the identified tools would be good at detecting change in intervention studies. The obvious gaps in available outcome measurement include well-being and participation outcomes for children, and family quality-of-life outcomes, domains particularly valued by our informants (young people with ASD and parents). Conclusions: This is the first systematic review of the quality and appropriateness of tools designed to monitor progress and outcomes of young children with ASD. Although it was not possible to recommend fully robust tools at this stage, the review consolidates what is known about the field and will act as a benchmark for future developments. With input from parents and other stakeholders, recommendations are made about priority targets for research. Future work: Priorities include development of a tool to measure child quality of life in ASD, and validation of a potential primary outcome tool for trials of early social communication intervention. Study registration: This study is registered as PROSPERO CRD42012002223. Funding: The National Institute for Health Research Health Technology Assessment programme

FREE CONVECTION AND RADIATION HEAT TRANSFER FROM FIN-ON-TUBE HEAT EXCHANGES

Abstract not availabl

La fièvre hémorragique de Marburg, une zoonose issue d'un réservoir important, la chauve-souris

STRASBOURG ILLKIRCH-Pharmacie (672182101) / SudocSudocFranceF