BackgroundShared decision-making in rheumatoid arthritis (RA) care is a priority among policy makers, clinicians and patients both nationally and internationally. Demands on patients to have basic knowledge of RA, treatment options, and details of risk and benefit when making medication decisions with clinicians can be overwhelming, especially for those with limited literacy or limited English language proficiency. The objective of this study is to describe the development of a medication choice decision aid for patients with rheumatoid arthritis (RA) in three languages using low literacy principles.MethodsBased on the development of a diabetes decision aid, the RA decision aid (RA Choice) was developed through a collaborative process involving patients, clinicians, designers, decision-aid and health literacy experts. A combination of evidence synthesis and direct observation of clinician-patient interactions generated content and guided an iterative process of prototype development.ResultsThree iterations of RA Choice were developed and field-tested before completion. The final tool organized data using icons and plain language for 12 RA medications across 5 issues: frequency of administration, time to onset, cost, side effects, and special considerations. The tool successfully created a conversation between clinician and patient, and garnered high acceptability from clinicians.ConclusionsThe process of collaboratively developing an RA decision aid designed to promote shared decision making resulted in a graphically-enhanced, low literacy tool. The use of RA Choice in the clinical encounter has the potential to enhance communication for RA patients, including those with limited health literacy and limited English language proficiency.

A multiple probe across participants design assessed the effectiveness of an instructional strategy to teach 10 elementary-aged students with moderate intellectual disabilities how to shop for grocery items. Following the intervention, which consisted of in vivo training using constant time delay and simulation training using a pictorial storyboard, 6 students achieved criterion. Two other students' shopping performances improved considerably during training, but the students did not achieve criterion as training was discontinued due to the end of the school year. Maintenance data indicate that the students who achieved criterion retained their skills for 6 weeks, and generalization data indicate that they could shop for the same items in a novel store.

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As the quintessential right-to-education case, Brown v. Board of Education, Topeka, (1954) addressed equality of educational opportunity for all students regardless of race. Recently, the term digital divide has been used primarily to highlight inequities between various social groups with respect to acquiring computers and accessing the Internet. Given how use of these technologies has permeated our society, including our nation's schools, all relevant aspects of the digital divide must be addressed if the spirit of Brown is to be realized. Hence, in this article, the multidimensional meaning of the term digital divide is discussed, as are (a) the effect of this phenomenon as it relates to equality of educational opportunity for all students and (b) ways to address it.

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Four years following the decimation of the New Orleans Public Schools by Hurricane Katrina the city has been described as the center of a unique urban public school reform effort. This effort is a combination of events that transpired just before the storm and those that have occurred as a result of it. In particular some claim that the emerging public school configuration seeks to be one that is comprised entirely of charter schools, thereby allowing public schools in New Orleans to become a “system of schools” as opposed to a traditional school system. While a fundamental operating principle of charter schools is increased student academic achievement in exchange for school autonomy and innovative practices, an additional responsibility of the charter schools in New Orleans is identical to that of their counterpart traditional public schools: the provision of special education services in accordance with the Individuals with Disabilities Education Improvement Act. Accordingly, this article presents an overview of the seminal reform events that have occurred to date and discusses the potential implications of this reform effort with respect to the provision of special education services.

This investigation reports about the development and formative evaluation of an assistive technology instructional module that was developed in an integrated hypermedia format according to principles of anchored instruction. The module was field-tested with undergraduate students, graduate students, and professionals. Revisions were made in the module on the basis of feedback from the field tests. It was concluded that people respond positively to anchored instruction on the topic of assistive technology and that anchored instruction appears to have utility for both preservice and inservice training. A number of implications are described for those who are involved in the development and delivery of instruction about assistive technology.