Pre- and In-Service Teachers’ Attitudes Toward Students With Learning Difficulties and Challenging Behavior

The implementation of inclusive policies is largely dependent on teachers’ willingness to accommodate students with special educational needs (SEN) in mainstream classrooms, which is affected by their perceived competence and attitudes. This study investigated attitudes of pre- and in-service teachers toward students with two types of SEN: challenging behavior and learning difficulties. The three components of attitudes (affective, cognitive, and behavioral) were assessed using indirect and direct measures. Results revealed that teachers held negative implicit attitudes toward challenging behavior and learning difficulties, however, implicit attitudes did not vary as a function of the type of SEN. Ratings of the stereotypical dimensions warmth and competence and overall ratings of scholastic achievement were affected by professional status and type of SEN. Professional status, implicit attitudes, and stereotypical knowledge together explained 52 and 43% of the variance in teachers’ ratings of academic proficiency for students with challenging behavior and learning difficulties, respectively. Results are interpreted within the theoretical framework and implications for teacher training are discussed

Measurement invariance of the Positive Gains Scale in families of children with and without disabilities

Aims The present study sought to establish measurement invariance for the Positive Gains Scale (PGS) across 1219 mothers of children with developmental disabilities, 234 mothers of children with spina bifida/hydrocephalus, and 157 mothers of children without disabilities. Methods and procedures A three-step test for measurement invariance across the three groups was conducted using Multigroup Confirmatory Factor Analysis. Outcomes and results Loadings between the three groups were invariant, suggesting the criteria to assume metric invariance was met. However, the assumption of scalar invariance was not met, suggesting that item intercepts differed between the three groups. Conclusions and implications Our findings suggest that the PGS cannot be meaningfully used to compare outcomes between mothers of children with developmental disabilities and other mothers. These findings may have wider implications for research utilising well-being measures to make comparisons with carers of children with developmental disabilities

Lower plasma insulin levels during overnight closed-loop in school children with type 1 diabetes: Potential advantage? A randomized cross-over trial.

BACKGROUND: Studies have shown that overnight closed-loop insulin delivery can improve glucose control and reduce the risk of hypoglycemia and hence may improve metabolic outcomes and reduce burden for children with type 1 diabetes and their families. However, research so far has not reported insulin levels while comparing closed-loop to open-loop insulin delivery in children. Therefore, in this study we obtained glucose levels as well as plasma insulin levels in children with type 1 diabetes to evaluate the efficacy of a model-based closed-loop algorithm compared to an open-loop administration. METHODS: Fifteen children with type 1 diabetes, 6-12 years, participated in this open-label single center study. We used a randomized cross over design in which we compared overnight closed-loop insulin delivery with sensor augmented pump therapy for two nights in both the hospital and at home (i.e., 1 night in-patient stay and at home per treatment condition). Only during the in-patient stay, hourly plasma insulin and blood glucose levels were assessed and are reported in this paper. RESULTS: Results of paired sample t-tests revealed that although plasma insulin levels were significantly lower during the closed-loop than in the open-loop (Mean difference 36.51 pmol/l; t(13) = 2.13, p = .03, effect size d = 0.57), blood glucose levels did not vary between conditions (mean difference 0.76 mmol/l; t(13) = 1.24, p = .12, d = 0.37). The administered dose of insulin was significantly lower during the closed-loop compared with the open-loop (mean difference 0.10 UI; t(12) = 2.45, p = .02, d = 0.68). CONCLUSIONS: Lower insulin doses were delivered in the closed-loop, resulting in lower plasma insulin levels, whereby glucose levels were not affected negatively. This suggests that the closed-loop administration is better targeted and hence could be more effective

Cambridge hybrid closed-loop system in very young children with type 1 diabetes reduces caregivers’ fear of hypoglycemia and improves their well-being

Objective To evaluate the impact of CamAPS FX hybrid closed-loop automated insulin delivery (HCL) in very young children with type 1 diabetes (T1D) on caregivers’ well-being, fear of hypoglycemia and sleepiness. Research Design Multinational, open label, randomized crossover study. Children (1-7years) with T1D received treatment for two 4-month periods in random order, comparing HCL with sensor augmented pump (SAP) (control). At baseline and after each treatment period, caregivers were invited to complete WHO-5, Hypoglycemia Fear Survey (HFS) and Epworth Sleepiness Scale (ESS). Results Caregivers of 74 children (mean±SD: age 5±2 years; 42% female, baseline HbA1c 7.3±0.7%) participated. Results revealed significantly lower scores for hypoglycemia fear (p<.001) and higher for well-being (p<.001) after HCL treatment. A trend towards a reduction in sleepiness score was observed (p=0.09). Conclusion Our results suggest a better well-being and less hypoglycemia fear in caregivers of very young children with T1D on CamAPS FX HCL

Psychological Well-Being of Parents of Very Young Children With Type 1 Diabetes – Baseline Assessment

Background: Type 1 diabetes in young children is a heavy parental burden. As part of pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to study the association between hypoglycemia fear, parental well-being and child behavior. Methods: All parents were invited to fill in baseline questionnaires: hypoglycemia fear survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties Questionnaire (SDQ). Results: 24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two parents. Median daytime sleepiness score was high in five parents (>10). For six children a high total behavioral difficulty score (>16) was reported. Pro social behavior score was lower than normal in six children (<6). Parental well-being was negatively associated with HFS total (r = - 0.50, p <.05) and subscale scores (r = - 0.44, p <.05 for HFS-Worry and HFS-Behavior), child behavior (r = - 0.45, p = .05) and positively with child age and diabetes duration (r = 0.58, p <.01, r = 0.6, p <.01). HFS, parental well-being nor daytime sleepiness are associated with the HbA1c. Conclusion: Regular screening of parental well-being, hypoglycemia fear and child behavior should be part of routine care to target early intervention

Psychological Well-Being of Parents of Very Young Children With Type 1 Diabetes – Baseline Assessment

Background: Type 1 diabetes in young children is a heavy parental burden. As part of pilot phase of the KIDSAP01 study, we conducted a baseline assessment in parents to study the association between hypoglycemia fear, parental well-being and child behavior. Methods: All parents were invited to fill in baseline questionnaires: hypoglycemia fear survey (HFS), WHO-5, Epworth Sleepiness Scale and Strength and Difficulties Questionnaire (SDQ). Results: 24 children (median age: 5-year, range 1-7 years, 63% male, mean diabetes duration: 3 ± 1.7 years) participated. 23/24 parents filled out the questionnaires. We found a higher score for the hypoglycemia fear behavior 33.9 ± 5.6 compared to hypoglycemia worry 34.6 ± 12.2. Median WHO-5 score was 16 (8 - 22) with poor well-being in two parents. Median daytime sleepiness score was high in five parents (>10). For six children a high total behavioral difficulty score (>16) was reported. Pro social behavior score was lower than normal in six children (<6). Parental well-being was negatively associated with HFS total (r = - 0.50, p <.05) and subscale scores (r = - 0.44, p <.05 for HFS-Worry and HFS-Behavior), child behavior (r = - 0.45, p = .05) and positively with child age and diabetes duration (r = 0.58, p <.01, r = 0.6, p <.01). HFS, parental well-being nor daytime sleepiness are associated with the HbA1c. Conclusion: Regular screening of parental well-being, hypoglycemia fear and child behavior should be part of routine care to target early intervention

Experiences of Siblings of Children with Physical Disabilities: An Empirical Investigation

peer reviewedPURPOSE: This study aimed to investigate the experiences of Dutch siblings of children with physical disabilities (n=43). METHOD: Interviews were conducted to investigate experiences of siblings in 3 areas: the sibling relationship, the relationship with parents, and the relationship with others. The siblings also completed a coping response inventory. RESULTS: The siblings reported difficulties in undertaking activities and in communicating with their brother/sister with a disability. Most siblings worried about the future and the health of their brother/sister with a disability. The siblings reported open communication and trust as the main characteristics of the relationship with their parents. They acknowledged their parents' attempts to treat all children equally, although parents were not always successful in doing so. Having a sibling with a disability did not cause problems in the relationship with friends. The awkward reactions of strangers caused the siblings much annoyance and distress. Siblings in this sample used more approach coping strategies than avoidance strategies, t(34) = 2.37, p < 0.05. CONCLUSION: The brothers and sisters generally did not experience many significant problems, however, a minority of the children did experience problems for which they would like help. In addition, they reported joys as well as problems

Pain, anxiety, and cooperativeness in children with cerebral palsy after rhizotomy: changes throughout rehabilitation

Assessed pain, anxiety, physical functioning, and cooperativeness in 32 children with spastic cerebral palsy. This is the first study to assess children throughout rehabilitation following selective posterior rhizotomy. Results of the Observational Scale of Behavioral Distress and observer Likert ratings confirmed the hypothesis that children's pain and anxiety decrease over time. Children's physical functioning and cooperativeness improve over time. No significant correlation was found between pain and changes in physical functioning. Cognitive impairment, parental involvement, and children's pain behaviors explained 77% and 56% of the variance in two forms of cooperativeness. Research and clinical implications are discussed, and special considerations regarding pain assessment and management in this population are addressed

Disability and quality of life in spina bifida and hydrocephalus

This study examined the impact of severity and type of condition and family resources on quality of life in children with spina bifida and hydrocephalus. A national UK sample of children aged between 6 and 13 years with spina bifida (n=62), hydrocephalus (n=354), and spina bifida plus hydrocephalus (n=128) were identified via the register of the Association for Spina Bifida and Hydrocephalus (ASBAH). Parents completed standardized measures of Child Health Related Quality Of Life (CQOL), family needs survey (FNS), and caregiving self-efficacy scale (CSES) as well as questions on children's health and physical ability. Results showed there were no significant differences in the overall quality of life for the three disability conditions. The overall CQOL was over 1 SD lower for those with spina bifida and hydrocephalus than for children with other physical conditions. Sex and age were not related to overall CQOL. Specific aspects of CQOL differentiated the three groups. Children with spina bifida had poorer CQOL scores on self-care, continence, and mobility/activities whilst those with hydrocephalus had poorer scores on school activities, worries, sight, and communication. Severity of condition and family resources, i.e. CSES and FNS, predicted 32% of the variance in CQOL. Associations were also found between overall CQOL and problems discernible at birth as well as epilepsy. Other factors, including those related to shunts, were not significantly related to CQOL. It was concluded that hydrocephalus is just as great a threat to CQOL as spina bifida. Beyond the general effect of condition severity on CQOL, family resources (as measured by the CSES and FNS) represent an additional influence on CQOL