Two analyses investigated the effects of choice making on the responding of elementary school students with emotional and behavioral challenges. In the first analysis, 2 participants were given choices from menus of academic tasks, all of which were pertinent to their educational objectives in English and spelling, respectively. Reversal designs showed that the choice-making conditions increased task engagement and reduced disruptive behavior for both students. An additional analysis was performed with a 3rd student in an effort to further distinguish the effects of choice making from preference. In this study, one of the no-choice phases was yoked to a previous choice-making condition. This analysis demonstrated that the choice-making condition was superior to baseline and yoked control phases as determined by levels of task engagement and disruptive behavior. The findings ofthe two analyses contribute information relevant to students with emotional and behavioral disorders, and to a growing literature on the desirable effects of choice making for students with disabilities and challenging behaviors. DESCRIPTORS: choice, problem behavior, emotional and behavior disorders, classroom behavior Students with emotional and behavioral challenges frequently display behaviors that are incompatible with the routines and requirements of their dassrooms. As a result, behavior management programs are typically a salient feature of these students' educational experiences. The most common programs have been based on the manipulation of consequences and have included token and point systems as well as punishment procedures (e.g., time-out). Recently, concern has been expressed

Objective-To test hypothesized relationships between multiple health parameters and mortality among persons with spinal cord injury (SCI) while controlling for variations in biographical and injury characteristics.Design-Prospective cohort study with health data collected in late 1997 and early 1998 and mortality status ascertained in December 2005. Setting-A large rehabilitation hospital in the Southeastern United States.Participants-A total of 1389 adults with traumatic SCI, at least 1 year postinjury. Interventions-Not applicable.Main Outcome Measures-The primary outcome was time from survey to mortality (or time of censoring). Mortality status was determined using the National Death Index and the Social Security Death Index. There were 225 deaths (16.2%) by December 31, 2005.Results-Cox proportional hazards modeling identified several significant health predictors of mortality status, while controlling for biographic and injury factors. Two sets of analyses were conducted-the first identifying the significance of a single variable of interest and the second analysis building a comprehensive model based on an optimal group of variables. Multiple types of health conditions were associated with mortality. The best set of health predictors included probable major depression, surgeries to repair pressure ulcers, fractures and/or amputations, symptoms of infections, and days hospitalized. Inclusion of these variables, along with a general health rating, improved prediction of survival compared with biographic and injury variables alone, as the pseudo R 2 increased from .12 to .18 and the concordance from .730 to .776. Conclusions-In addition to secondary conditions that have been the traditional focus of prevention efforts (eg, pressure ulcers, urinary tract infections), amputations, fractures, andCorrespondence to James S. Krause, Ph.D., Department of Rehabilitation Science, College of Health Professions, Medical University of South Carolina, 77 President St, Suite 117, PO Box 250700, Charleston, SC 29425, Phone: 843-792-1337, Fax: 843-792-5649, Email: krause@musc.edu. Reprints are not available from this author. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.I certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on me or on any organization with which I am associated AND, if applicable, I certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in the title page of the manuscript. NIH Public Access Author ManuscriptArch P...

Functional assessment and functional analysis are processes that have been applied successfully in work with people who have developmental disabilities, but they have been used rarely with students who experience emotional or behavioral disorders. In the present study, five students in elementary school programs for severe emotional disturbance participated in a comprehensive functional assessment process designed to yield a useful understanding of their desirable and undesirable behaviors. Interviews, record reviews, and direct classroom observations led to the development of individualized hypotheses regarding relationships between classroom events and the occurrence of target behaviors. Subsequently, direct manipulations (i.e., functional analyses) were conducted to test each of the hypotheses in the context of regularly-occurring classroom activities. These analyses demonstrate important influences that certain classroom variables can exert over individual student's behavior. The process and results are discussed with regard to the need for improved methods for understanding student responding, and the benefits that functional assessment can offer programs of educational and behavioral support.

Purpose Few studies of sport-related traumatic brain injury (TBI) are population-based or rely on directly observed data on cause, demographic characteristics, and severity. This study addresses the epidemiology of sport-related TBI in a large population. Methods Data on all South Carolina hospital and emergency department encounters for TBI, 1998–2011, were analyzed. Annual incidence rate of sport-related TBI was calculated, and rates were compared across demographic groups. Sport-related TBI severity was modeled as a function of demographic and TBI characteristics using logistic regression. Results A total of 16,642 individuals with sport-related TBI yielded an average annual incidence rate of 31.5/100,000 population with a steady increase from 19.7 in 1998 to 45.6 in 2011. The most common mechanisms of sport-related TBI were kicked in football (38.1%), followed by fall injuries in sports (20.3%). Incidence rate was greatest in adolescents ages 12–18 (120.6/100,000/persons). Severe sport-related TBI was strongly associated with off-road vehicular sport (odds ratio [OR], 4.73; 95% confidence interval [95% CI], 2.92–7.67); repeated head trauma (OR, 4.36; 95% CI, 3.69–5.15); equestrian sport (OR, 2.73; 95% CI, 1.64–4.51); and falls during sport activities (OR, 2.72; 95% CI, 1.67–4.46). Conclusions The high incidence of sport-related TBI in youth, potential for repetitive mild TBI, and its long-term consequences on learning warrants coordinated surveillance activities and population-based outcome studies.

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Eating disorder patients appear to have high degrees of alexithymia, a diminished capability to verbally describe feelings, although little data exist. We administered the Toronto Alexithymia Scale (TAS) to 114 females with DSM‐III‐R defined eating disorders. Patients, regardless of subtype, scored significantly higher than 370 college‐aged females. TAS scores were significantly correlated to self‐ratings of affective symptoms, but not weight or binge‐purge frequency. © 1993 by John Wiley & Sons, Inc.

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