Improving the Speech and Communication Abilities of Children with Down's Syndrome: A New Model of Service Delivery using Electropalatography

Down's syndrome (DS) is the most common genetic cause of mild to moderate learning difficulties (LD), affecting 1 in every 1000 live births in the UK (Down's Syndrome Association, 2015). The speech skills of individuals with DS are poorer than would be anticipated in relation to both their general cognitive ability and their skills in expressive language (Roberts et al., 2007). These specific difficulties in speech production can lead to significantly reduced intelligibility (Kumin, 2006) which in turn affects the ability to communicate effectively. This often places considerable constraints on educational progress, affects friendship formation and impedes integration into the wider community. The specific speech production difficulties encountered by individuals with DS are often considered to be intractable as they have proved to be resistant to conventional methods of intervention delivered by speech and language therapists (Kumin, 2006). These difficulties persist into adulthood which can negatively impact life outcomes, affect employability and contribute to social exclusion (Shriberg & Widder, 1990). Our previous research funded by the Medical Research Council investigated the speech difficulties experienced by 27 children and young people, aged 9 to 18 years, with DS. As well as increasing our understanding of the types of speech errors made by this population, it experimented with the use of an intervention technique called electropalatography (EPG), not currently routinely available within the NHS, as a method of correcting speech errors in children with DS with a view to improving their intelligibility. The results from this previous research led to the grant funded by the Nuffield Foundation.caslpub4279pu

Visual supports at home and in the community for individuals with autism spectrum disorders: A scoping review

Marion Rutherford - ORCID 0000-0002-2283-6736 https://orcid.org/0000-0002-2283-6736Published in Association with The National Autistic SocietyVisual supports are recommended in autism spectrum disorder clinical guidelines. They can reduce anxiety, increase predictability, support communication and improve participation. They are implemented regularly in schools but evidence about home visual supports is limited. This paper reports results of a scoping literature review, alongside qualitative evaluation with parents and professionals. We report findings from 34 studies, identifying 4 categories of visual support and heterogeneity in participant characteristics, intervention methods, environments and outcome measures. Qualitative data from questionnaires (n=101) and focus groups generated key themes about home visual supports, through thematic analysis: 1) Access 2) Participation focussed 3) Individualisation 4) Teaching methods 5) Consistency 6) Information and Training. We propose consensus with terminology and implications for practice and research.https://doi.org/10.1177/136236131987175624pubpub

Development and implementation of the CIRCLE Framework

Donald Mciver - ORCID: 0000-0002-6173-429X https://orcid.org/0000-0002-6173-429XAcknowledgements: Thanks are due to the Head Teachers and staff from the participating schools. Thanks to the City of Edinburgh Council’s Additional Support for Learning Service and to Martin Vallely, Professional Services Manager.This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Disability, Development and Education on 12 Jul 2019, available online: https://www.tandfonline.com/doi/full/10.1080/1034912X.2019.1628185We report the implementation of a new framework supporting teacher practice for inclusion of children with disabilities in mainstream classrooms. Eight schools in one Scottish authority took part. Questionnaire, focus group and interview data were gathered. Results indicated that the framework was well-received and provided a useful resource for class teachers. The framework was perceived as a feasible method for supporting teachers and related personnel to think systematically about key issues relating to children with disabilities in the classroom. It was suggested that provision of a common language was supportive of collaborative working. Areas for revision included a system of navigation and simplification in the framework manual.67pubpub

Supporting successful inclusive practices for learners with disabilities in high schools: A multisite, mixed method collective case study

Purpose: The increase in the number of individuals with disabilities in general education has led to an increased interest in how to best provide support. Despite an emphasis on inclusion and participation in policy and practice, defining and describing the support provided for these learners is still an important task. Method: This multisite, mixed method collective case study reports on 125 education and other staff from seven schools who took part in interviews and focus groups to reflect on a range of topics related to learners with disabilities in high schools. We focused on what the participants did, what they considered to be successful and what their best- practices were. Results: Descriptions of practices were rich, nuanced and complex. The analysis identified over 200 strategies- which were synthesized into two meta-themes and eight subthemes. We discuss the results in the context of an ecological perspective, and the importance of focusing on the full range of influences and outcomes for young people in designing supports. Conclusions: We have drawn on evidence from this study as a basis for professional development activities and identified that focusing on the environment and the role of practitioners has a potential to improve the inclusion outcomes for older learners with disabilities.sch_occ40pub4706pub1

A clinical and cost-effectiveness trial of a parent group intervention to manage challenging restricted and repetitive behaviours in young children with autism spectrum disorder: study protocol for a randomised controlled trial

Background Restricted and repetitive behaviours vary greatly across the autism spectrum, and although not all are problematic some can cause distress and interfere with learning and social opportunities. We have, alongside parents, developed a parent group based intervention for families of young children with autism, which aims to offer support to parents and carers; helping them to recognise, understand and learn how to respond to their child’s challenging restricted repetitive behaviours. Methods The study is a clinical and cost-effectiveness, multi-site randomised controlled trial of the Managing Repetitive Behaviours (MRB) parent group intervention versus a psychoeducation parent group Learning About Autism (LAA) (n = 250; 125 intervention/125 psychoeducation; ~ 83/site) for parents of young children aged 3–9 years 11 months with a diagnosis of autism. All analyses will be done under intention-to-treat principle. The primary outcome at 24 weeks will use generalised estimating equation (GEE) to compare proportion of children with improved RRB between the MRB group and the LAA group. The GEE model will account for the clustering of children by parent groups using exchangeable working correlation. All secondary outcomes will be analysed in a similar way using appropriate distribution and link function. The economic evaluation will be conducted from the perspective of both NHS costs and family access to local community services. A ‘within trial’ cost-effectiveness analysis with results reported as the incremental cost per additional child achieving at least the target improvement in CGI-I scale at 24 weeks. Discussion This is an efficacy trial to investigate the clinical and cost-effectiveness of a parent group based intervention designed to help parents understand and manage their child’s challenging RRB. If found to be effective, this intervention has the potential to improve the well-being of children and their families, reduce parental stress, greatly enhance community participation and potential for learning, and improve longer-term outcomes

Australia\u27s health 2002 : the eighth biennial report of the Australian Institute of Health and Welfare

Australia\u27s Health 2002 is the eighth biennial health report of the Australian Institute of Health and Welfare. It is the nation\u27s authoritative source of information on patterns of health and illness, determinants of health, the supply and use of health services, and health service costs and performance. Australia\u27s Health 2002 is an essential reference and information resource for all Australians with an interest in health

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació