Challenging behavior exhibited by young children is becoming recognized as a serious impediment to social–emotional development and a harbinger of severe maladjustment in school and adult life. Consequently, professionals and advocates from many disciplines have been seeking to define, elaborate, and improve on existing knowledge related to the prevention and resolution of young children's challenging behaviors. Of particular concern for the field of behavioral disorders is the lack of correspondence between what is known about effective practices and what practices young children with challenging behavior typically receive. To increase the likelihood that children receive the best of evidence-based practices, the current analysis was conducted to provide a concise synthesis and summary of the principal evidence pertaining to the presence and impact, prevention, and intervention of challenging behaviors in young children. A consensus building process involving review and synthesis was used to produce brief summary statements encapsulating core conclusions from the existing evidence. This article presents these statements along with descriptions of the strength of the supporting evidence. The discussion addresses directions and priorities for practice and future research.
The quality of nursing documentation is an important issue for nurses both nationally and internationally. Nursing documentation should, but often does not show the rational and critical thinking behind clinical decisions and interventions, while providing written evidence of the progress of the patient. A number of frameworks are currently available to assist with nursing documentation including narrative charting, problem orientated approaches, clinical pathways, and focus notes. However many nurses still experience barriers to maintaining accurate and legally prudent documentation. A review of nursing documentation of patient care and progress towards achieving outcome goals in our organisation identified a lack of clear and easy to follow information about the patient's progress. In order to address with this issue a project group was established to look at different frameworks for nursing documentation. The aim of the project was to identify and implement a documentation framework that would encourage critical thinking and provide evidence of the rationale for nursing actions utilising a problem based approach in order to provide accurate evidence of patient progress. This paper provides a synopsis of available literature related to the frameworks mentioned above, highlights barriers to safe, timely and accurate documentation for nurses, and concludes with an explanation of the framework chosen as a result of this review.
The serious consequences of challenging behaviors in young children have become an increasing concern of caregivers. Without intervention, the presence of challenging behaviors in young children is associated with unfavorable outcomes in school and later life. This paper describes a synthesis of the existing knowledge related to the processes of identification and access to services for children with challenging behaviors and their families. A variety of data sources were examined to extract findings relevant to national initiatives. Findings are presented as a description of the existing federal programs and funding streams that provide pathways to services and associated mandates relating to cross-system convergence, along with the limited empirical data related to their implementation, utilization, and effectiveness. Service pathways for identification and referral were found to be fragmented with less than complete implementation of many mandates, largely unaccompanied by utilization and evaluation data. These gaps are described and recommendations are offered to guide research for addressing the paucity of systems information for this important group of children.
Although considerable progress has been achieved regarding the research and laws supporting preschool inclusion, access to inclusive preschool environments remains intangible for many children with disabilities in the United States. The purpose of this article is to discuss current challenges and solutions to high-quality preschool inclusion. We use the conceptual framework identified in the Division for Early Childhood (DEC)/National Association for the Education of Young Children (NAEYC) inclusion position statement to promote solutions to support high-quality inclusion and the success of all children. We provide conceptual and empirical support for preschool inclusion and outline recommendations to the field.
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