Using Telehealth to Adapt Service Delivery for Children during the COVID-19 Pandemic

Staff from the Institute for Human Development (IHD) at Northern Arizona University have provided evaluations for children with developmental disabilities (DD) in Arizona communities for over 20 years. These evaluations include Developmental Evaluations, Augmentative and Alternative Communication (AAC) evaluations, and evaluations for eligibility for Part C of IDEA (Individuals with Disabilities in Education Act) early intervention services. Following the evaluations, IHD staff may provide interventions that consist of training, coaching, and direct services. Evaluations and follow-up interventions have historically been provided in homes, the community, or a clinic setting by interdisciplinary teams that consist of two or more of the following: Occupational Therapists, Speech-Language Pathologists, Physical Therapists, Educational Psychologists, or Developmental Specialists. During the COVID-19 pandemic and subsequent need for physical distancing, three IHD programs modified the standard in-person evaluation process. Staff from the Growing in Beauty Partnership Program (GIBPP, the Navajo Part C program), the Interdisciplinary Training Clinic, and the Augmentative Communication Evaluation and Training Program conducted evaluations through televisits that consisted of parent interviews and observations of the child performing specific tasks. GIBPP staff modified intervention methods for children birth to three years old already on caseload at the time of the pandemic outbreak, providing coaching to families through telepractice. For AAC evaluations, AAC equipment was delivered to the family before the evaluation. In reporting the adaptation of our processes due to the COVID-19 pandemic, we used the expanded Framework for Modifications and Adaptations (FRAME) developed by Stirman et al. (2019). Using the eight components of the FRAME, we described the processes developed and undertaken to implement telepractice in these three programs at IHD during COVID-19. The article includes a summary of the decision-making processes used to determine which clients to include or exclude. The decision- making process included such criteria as the child’s characteristics and capabilities, technology access of the parents, and equipment needs. The outbreak of COVID-19 provided opportunities for practical experiences in the utilization of telepractice in a variety of settings and with a diverse clientele with developmental disabilities. These experiences informed diagnostic and intervention telepractice efforts that are potentially efficient, beneficial, and sustainable over the long-term. Steps to guide the criteria for inclusion of families in telepractice, the operational procedures for evaluation and intervention, and the contextual factors that influence quality and fidelity are further explained. The role of telepractice in reducing and accentuating health disparities are discussed based on our experiences in rural and tribal communities. This information will help to guide other practitioners working in similar settings with similar populations

Underestimating Capable Readers

Capable and gifted readers are often held back in grade level basal reading texts, regardless of their reading ability, for fear that essential skills may be missed (Allen and Swearingen, 1987; Carr, 1984). The abilities of these students are often underestimated (Bennett and Desforges, 1988)

Searching for Inclusion: Campus Conversations with People of Color in Predominantly White Institutions

“The purpose of this study is to share perceptions of students of color regarding their perceived acceptance and inclusion in Nebraska’s public schools and universities.

Coming Together during COVID-19: A Mixed Methods Exploratory Study on Collective Efficacy in a State Developmental Disabilities Network

Background: Collective efficacy (CE) is a group’s shared belief that through their united efforts they can overcome challenges to achieve common goals (Bandura, 1993; 1997). CE has been shown to be related to professional growth, stress reduction, and overall collaborative impact in studies of groups responding to ongoing challenges as well as unforeseen circumstances (i.e. teachers, first-responders, and community responses to natural disasters) (Benight, 2004; Donohoo, 2016; Prati et al., 2011). COVID-19 has forced organizations serving individuals with disabilities to come together to adapt and change the ways in which they serve the disability community. Objective: This study examines reported attributes of CE as experienced by Arizona Developmental Disability Network (ADDN) members and their partners. This study respectively examines CE prior to COVID-19, currently, and predicted likelihood of CE attributes continuing in the future. Method: This mixed-method study involves data collected through a questionnaire and qualitative data collected through interviews with ADDN members and their partners. Results: The questionnaire results describe and compare the attributes of CE using sub-domains of social cohesion and trust, group competence, and enabling structures in three-time frames: prior to COVID-19, currently, and prediction of six months from now. The interviews provide narrative description of specific ADDN activities, roles, and perceptions; thus, adding a valuable dimension to interpreting the results. Conclusion: ADDN members and their partners have persisted and quickly adapted to COVID-19. These connections made during this time are likely to remain and help better serve Arizona’s disability community

Is There a Role for Benefit-Cost Analysis in Environmental, Health, and Safety Regulation?

Benefit-cost analysis has a potentially important role to play in helping inform regulatory decision-making, although it should not be the sole basis for such decision-making. This paper offers eight principles on the appropriate use of benefit-cost analysis.Environment, Health and Safety, Regulatory Reform

Modelling the Interruption on HCI Using BDI Agents with the Fuzzy Perceptions Approach: An Interactive Museum Case Study in Mexico

Technological advancements have revolutionized the proliferation and availability of information to users, which has created more complex and intensive interactions between users and systems. The learning process of users is essential in the construction of new knowledge when pursuing improvements in user experience. In this paper, the interruption factor is considered in relation to interaction quality due to human–computer interaction (HCI) being seen to affect the learning process. We present the results obtained from 500 users in an interactive museum in Tijuana, Mexico as a case study. We model the HCI of an interactive exhibition using belief–desire–intention (BDI) agents; we adapted the BDI architecture using the Type-2 fuzzy inference system to add perceptual human-like capabilities to agents, in order to describe the interaction and interruption factor on user experience. The resulting model allows us to describe content adaptation through the creation of a personalized interaction environment. We conclude that managing interruptions can enhance the HCI, producing a positive learning process that influences user experience. A better interaction may be achieved if we offer the right kind of content, taking the interruptions experienced into consideration

The BCN Challenge to Compatibilist Free Will and Personal Responsibility

Many philosophers ignore developments in the behavioral, cognitive, and neurosciences that purport to challenge our ideas of free will and responsibility. The reason for this is that the challenge is often framed as a denial of the idea that we are able to act differently than we do. However, most philosophers think that the ability to do otherwise is irrelevant to responsibility and free will. Rather it is our ability to act for reasons that is crucial. We argue that the scientific findings indicate that it is not so obvious that our views of free will and responsibility can be grounded in the ability to act for reasons without introducing metaphysical obscurities. This poses a challenge to philosophers. We draw the conclusion that philosophers are wrong not to address the recent scientific developments and that scientists are mistaken in formulating their challenge in terms of the freedom to do otherwise