Key words: autistic spectrum disorders, intervention research, methodology.Developing, implementing and evaluating programmes of intervention for children and young people on the autistic spectrum are challenging endeavours. In this paper, we adopt a critical approach to research in this area, and attempt to offer an alternative perspective for understanding and interpreting empirical evaluations. We outline and discuss theoretical, methodological and practical issues and limitations associated with the current research body, and provide illustrative examples of gaps in the current literature. Aromatherapy, art therapy, behaviour modification (for teaching skills or managing behaviour), computer-assisted learning, Daily Life Therapy, drama therapy, Early Bird, early intensive behavioural intervention (e.g., Applied Behaviour Analysis), facilitated communication, floor time (the Greenspan approach), Geoffrey Walden approach, Hanen programme, holding therapy, Makaton signing and symbols, massage, the Miller method, music therapy, musical interaction therapy, Option method, picture exchange communication system (PECS), sensory integration, Sherborne movement, social stories, speech and language therapy, treatment and education of autistic and communication handicapped children (TEACCH). Research on specific approachesAlongside the 'comprehensive' approaches to autism, there exists a huge research base for strategies that seek to facilitate specific behaviours, skills or areas of development. Examples
To investigate the relationship between the presence of language disorder, type of epilepsy, and epileptic seizures in childhood, language levels, types of language impairment, and aetiologies were examined in 109 children, aged between 5 and 17 years, attending a national children's epilepsy assessment unit over a 4-year period. There were 70 males and 39 females. Median age was 11 years 4 months (range 5 to 18 years 9 months). In addition to neurological assessment, simultaneous video and EEG monitoring and prolonged ambulatory EEG, each child underwent a comprehensive series of multidisciplinary tests, including intelligence, language, and communication assessments. Classification of seizures and epilepsy syndromes was agreed in conference by a physician specializing in childhood epilepsies, a paediatric neurologist, and a neuropsychiatrist. Other test procedures were administered by a speech and language pathologist with assistance from a neuropsychologist when relevant. Level of language disability in these children was associated with a range of aetiological factors. Evidence was found of a significant number of associations between focal epilepsies, certain seizure types, and language disorder. Of the 46 (42.2%) children with language disorders in the research sample, 30 had localization-related epilepsies and a further three had epilepsies which were undetermined as to whether focal or generalized. Children with focal epilepsies were 30% more likely to have language disorder than other language disability subtypes. The research demonstrated a clear though often subtle association between focal (localization-related) epilepsy and language disorder, indicating an increased risk in this patient group. Children with simple or complex partial seizures were more likely to have language disorder than other language disability subtypes; they also tended to have the lowest number of seizure types per case. This is of importance to clinicians managing children with epilepsy and has implications for their educational and social welfare.
Many countries have established systems for identifying, and providing for, the range of students with disabilities during their formal educational assessments. Most systems include the provision of variously termed ‘special access arrangements’ (SAAs), such as the provision of extra time or practical assistance with some aspect of an examination. There is, however, a paucity of outcome monitoring data relating to such systems, particularly that relating to the student and parent perspective. Using a combination of focus group, questionnaire and interview methods, the present study reports the views of 86 students with disabilities, their parents and teachers, upon the students’ educational assessment experiences. Findings indicate four specific areas for development of current practice: individualization of assessment of needs; utilization of student and parent voice; consideration of test anxiety factors; improved communication between schools, parents and students. From this, the researchers propose a revised system for needs identification and provision for students with disabilities during their formal educational assessments, highlighting a proactive role for school psychologists.
Embarking upon a programme of distance study can be bewildering for students and the experience compounded by apprehension and uncertainties. Induction is a way of easing the transition and helping students to become effective distance learners so that they can progress successfully through their studies. The purpose of this research was to enable tutors to gain a more comprehensive understanding of the induction experiences of their distance students in order to improve and make more appropriate the levels of support provided to students commencing distance study. The research investigated the induction provision of five distance programmes offered by a traditional UK university and identified specific areas where developments could be made. The research also identified generic components of induction, represented in 'START-OUT', and which can be utilized as a comprehensive checklist for induction.
Background: e-Bug is an international health education resource which support World Health Organization (WHO) public health recommendations by educating young people about microbes, hygiene and antibiotics use. The e-Bug team collaborated with Kingfisher Treasure Seekers to develop a six-session course for community groups called Beat the Bugs covering: microbes; hygiene; antibiotic use; and selfcare. A pilot was used to inform further development and evaluation. Methods: Pilot courses with 9-12 adults with learning difficulties and young parents were delivered by community leaders and observed by researchers. Participants completed before and after knowledge questionnaires. Two participant focus groups and two course leader interviews explored views on the course and retention of knowledge. Results: Completed questionnaires and qualitative results showed an improvement in participant knowledge in each session; microbes and antibiotics sessions showed the greatest knowledge improvement. Self-care showed the greatest knowledge retention and participants reported behaviour change including an increase in appropriate hand-washing and tooth-brushing. Conclusion: The Beat the Bugs course is a useful intervention for communities to give individuals the knowledge and confidence to manage their own infection and change behaviour around hygiene, self-care and antibiotics. Beat the Bugs is freely available to download.
To investigate the relationship between the presence of language disorder, type of epilepsy, and epileptic seizures in childhood, language levels, types of language impairment, and aetiologies were examined in 109 children, aged between 5 and 17 years, attending a national children's epilepsy assessment unit over a 4‐year period. There were 70 males and 39 females. Median age was 11 years 4 months (range 5 to 18 years 9 months). In addition to neurological assessment, simultaneous video and EEG monitoring and prolonged ambulatory EEG, each child underwent a comprehensive series of multidisciplinary tests, including intelligence, language, and communication assessments. Classification of seizures and epilepsy syndromes was agreed in conference by a physician specializing in childhood epilepsies, a paediatric neurologist, and a neuropsychiatrist. Other test procedures were administered by a speech and language pathologist with assistance from a neuropsychologist when relevant. Level of language disability in these children was associated with a range of aetiological factors. Evidence was found of a significant number of associations between focal epilepsies, certain seizure types, and language disorder. Of the 46 (42.2%) children with language disorders in the research sample, 30 had localization‐related epilepsies and a further three had epilepsies which were undetermined as to whether focal or generalized. Children with focal epilepsies were 30% more likely to have language disorder than other language disability subtypes. The research demonstrated a clear though often subtle association between focal (localization‐related) epilepsy and language disorder, indicating an increased risk in this patient group. Children with simple or complex partial seizures were more likely to have language disorder than other language disability subtypes; they also tended to have the lowest number of seizure types per case. This is of importance to clinicians managing children with epilepsy and has implications for their educational and social welfare.
Findings demonstrate a strong association between early onset epilepsy with autism or autistic regression and additional pragmatic impairment. A number of children exhibited weak or abnormal prosody in association with temporal lobe EEG abnormalities, particularly in the non-dominant hemisphere. Consideration is given to recent studies of the converse--the presence of a reducing prevalence of epilepsy in the autism population and acknowledgment of implications for learning within the autistic population.
Over the past 30 years successive governments in the UK have endeavoured to make the statutory framework suitable for children with special educational needs (SEN). More recently, efforts have been made to personalise children's learning, making educational experience more innovative and responsive to the diversity of needs in schools. A drive is emerging in health and education to develop and evaluate intervention strategies for children with language impairments (LIs), which is both methodologically challenging and rewarding. The current review demonstrates difficulties encountered with using evidence-based (evidence-related) outcome research involving children with LIs. Many studies have inherent methodological problems such as small sample sizes, ill-matched groups and designs that are difficult to replicate or compare. Such approaches are unlikely to yield significant results, or if they do, it is difficult to devise clear guidance regarding choice of intervention strategies. In the light of these difficulties, theoretical, methodological and practical issues are discussed herein and a model is proposed to assist in enabling interventions to be identified, evaluated in a robust manner, and the results shared with educators. We suggest that the use of a process-driven model ensures a more rigorous approach when undertaking large-scale systematic, evidence-based research into the effective approaches to teaching children not only with LIs but across the field of special needs education. 'Provision for children with speech and language (SL) needs in England and Wales: facilitating communication between education and health services: the parent perspective.
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