The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability

The relationship between the quality of parent-child interactions and positive child developmental trajectories is well established (Guralnick, 2006; Shonkoff & Meissels, 2000; Zubrick et al., 2008). However, a range of parental, family, and socio-economic factors can pose risks to parents’ capacity to participate in quality interactions with their children. In particular, families with a child with a disability have been found to have higher levels of parenting stress, and are more likely to experience economic disadvantage, as well as social isolation. The importance of early interventions to promote positive parenting and child development for these families is widely recognised (Shonkoff & Meissels, 2000). However, to date, there is a lack of evidence about the effectiveness of early parenting programs for families who have a young child with a disability. This thesis investigates the impact of a music therapy parenting program, Sing & Grow, on 201 parent-child dyads who attended programs specifically targeted to parents who had a young child with a disability. Sing & Grow is an Australian national early parenting intervention funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs and delivered by Playgroup Queensland. It is designed and delivered by Registered Music Therapists for families with children aged from birth to three years. It aims to improve parenting skills and confidence, improve family functioning (positive parent-child interactions), enhance child development, and provide social networking opportunities to socially isolated families. The intervention targets a range of families in circumstances that have the potential to impact negatively on family functioning. This thesis uses data from the National Evaluation Study of Sing & Grow from programs which were targeted at families who had a young child with a disability. Three studies were conducted to address the objectives of this thesis. Study 1 examines the effects of the Sing & Grow intervention on parent reported pre and post parent mental health, parenting confidence, parenting skills, and child development, and other parent reported outcomes including social support, use of intervention resources, satisfaction with the intervention and perceived benefits of and barriers to participation. Significant improvements from pre to post were found for parent mental health and parent reported child communication and social skills, along with evidence that parents were very satisfied with the program and that it brought social benefits to families. Study 2 explored the pre to post effects of the intervention on children’s developmental skills and parent-child interactions using observational ratings made by clinicians. Significant pre to post improvements were found for parenting sensitivity, parental engagement with child and acceptance of child as well as for child responsiveness to parent, interest, and participation in the intervention, and social skills. Study 3 examined the nature of child and family characteristics that predicted better outcomes for families while taking account of the level of participation in the program. An overall outcome index was calculated and served as the dependent variable in a logistic regression analysis. Families who attended six or more sessions and mothers who had not completed high school were more likely to have higher outcome scores at post intervention than those who attended fewer sessions and those with more educated mothers respectively. The findings of this research indicate that the intervention had a positive impact on participants’ mental health, parenting behaviours and child development and that level of attendance was associated with better outcomes. There was also evidence that the program reached its target of high risk families (i.e., families in which mothers had lower educational levels) and that for these families better outcomes were achieved. There were also indications that the program was accessible and highly regarded by families and that it promoted social connections for participants. A theoretical model of how the intervention is currently working for families is proposed to explain the connections between early parenting, child development and maternal wellbeing. However, more research is required to further elucidate the mechanisms by which the intervention creates change for families. This research presents promising evidence that a short term group music therapy program can elicit important therapeutic benefits for families who have a child with a disability.

What do IPAQ questions mean to older adults? Lessons from cognitive interviews

Background Most questionnaires used for physical activity (PA) surveillance have been developed for adults aged ≤65 years. Given the health benefits of PA for older adults and the aging of the population, it is important to include adults aged 65+ years in PA surveillance. However, few studies have examined how well older adults understand PA surveillance questionnaires. This study aimed to document older adults’ understanding of questions from the International PA Questionnaire (IPAQ), which is used worldwide for PA surveillance. Methods Participants were 41 community-dwelling adults aged 65-89 years. They each completed IPAQ in a face-to-face semi-structured interview, using the “think-aloud” method, in which they expressed their thoughts out loud as they answered IPAQ questions. Interviews were transcribed and coded according to a three-stage model: understanding the intent of the question; performing the primary task (conducting the mental operations required to formulate a response); and response formatting (mapping the response into pre-specified response options). Results Most difficulties occurred during the understanding and performing the primary task stages. Errors included recalling PA in an “average” week, not in the previous 7 days; including PA lasting ≤10 minutes/session; reporting the same PA twice or thrice; and including the total time of an activity for which only a part of that time was at the intensity specified in the question. Participants were unclear what activities fitted within a question’s scope and used a variety of strategies for determining the frequency and duration of their activities. Participants experienced more difficulties with the moderate-intensity PA and walking questions than with the vigorous-intensity PA questions. The sitting time question, particularly difficult for many participants, required the use of an answer strategy different from that used to answer questions about PA. Conclusions These findings indicate a need for caution in administering IPAQ to adults aged ≥65 years. Most errors resulted in over-reporting, although errors resulting in under-reporting were also noted. Given the nature of the errors made by participants, it is possible that similar errors occur when IPAQ is used in younger populations and that the errors identified could be minimized with small modifications to IPAQ.

The impact of users’ cognitive style on their navigational behaviors in web searching

User-Web interactions have emerged as an important area of research in the field of information science. In this study, we investigate the effects of users’ cognitive styles on their Web navigational styles and information processing strategies. We report results from the analyses of 594 minutes recorded Web search sessions of 18 participants engaged in 54 scenario-based search tasks. We use questionnaires, cognitive style test, Web session logs and think-aloud as the data collection instruments. We classify users’ cognitive styles as verbalisers and imagers based on Riding’s (1991) Cognitive Style Analysis test. Two classifications of navigational styles and three categories of information processing strategies are identified. Our study findings show that there exist relationships between users’ cognitive style, and their navigational styles and information processing strategies. Verbal users seem to display sporadic navigational styles, and adopt a scanning strategy to understand the content of the search result page, while imagery users follow a structured navigational style and reading approach. We develop a matrix and a model that depicts the relationships between users’ cognitive styles, and their navigational style and information processing strategies. We discuss how the findings from this study could help search engine designers to provide an adaptive navigation support to users.

The effects of cognitive ageing on the use of complex interfaces

This paper discusses an experiment investigating the effects of cognitive ageing and prior-experience with technology on using complex interfaces intuitively. Overall 37 participants, between the ages of 18 to 83, participated in this study. All participants were assessed for their cognitive abilities and prior-experience with technology. It was anticipated that the Central Executive function (a component of Working Memory) would emerge as one of the important cognitive functions in using complex interfaces. This was found to be the case with the strongest negative correlation occurring between sustained attention (one of the functions of the Central Executive), the time to complete the task and number of errors made by the participants.

Older adults, interface experience and cognitive decline

This paper describes an experiment undertaken to investigate intuitive interaction, particularly in older adults. Previous work has shown that intuitive interaction relies on past experience, and has also suggested that older people demonstrate less intuitive uses and slower times when completing set tasks with various devices. Similarly, this experiment showed that past experience with relevant products allowed people to use the interfaces of two different microwaves more quickly and intuitively. It also revealed that certain aspects of cognitive decline related to aging, such as central executive function, have more impact on time, correct uses and intuitive uses than chronological age. Implications of these results are discussed.

Web searching interaction model based on user cognitive styles

As more and more information is available on the Web finding quality and reliable information is becoming harder. To help solve this problem, Web search models need to incorporate users’ cognitive styles. This paper reports the preliminary results from a user study exploring the relationships between Web users’ searching behavior and their cognitive style. The data was collected using a questionnaire, Web search logs and think-aloud strategy. The preliminary findings reveal a number of cognitive factors, such as information searching processes, results evaluations and cognitive style, having an influence on users’ Web searching behavior. Among these factors, the cognitive style of the user was observed to have a greater impact. Based on the key findings, a conceptual model of Web searching and cognitive styles is presented.

Cognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use : current evidence and directions for future research

Issues and Approach: The high rates of co-occurring depression and substance use, and the negative impact of this on illness course and outcomes have been well established. Despite this, few clinical trials have examined the efficacy of cognitive behaviour therapy (CBT). This paper systematically reviews these clinical trials, with an aim of providing recommendations for how future research can develop a more robust evidence base for the treatment of these common comorbidities. Leading electronic databases, including PubMed (ISI) and PsychINFO (CSA), were searched for peer-reviewed journal articles using CBT for the treatment of co-occurring depression and substance use. Of the 55 articles identified, 12 met inclusion criteria and were included in the review. ---------- Key Findings: There is only a limited evidence for the effectiveness of CBT either alone or in combination with antidepressant medication for the treatment of co-occurring depression and substance use. While there is support for the efficacy of CBT over no treatment control conditions, there is little evidence that CBT is more efficacious than other psychotherapies. There is, however, consistent evidence of improvements in both depression and substance use outcomes, regardless of the type of treatment provided and there is growing evidence that that the effects of CBT are durable and increase over time during follow up. ---------- Conclusions. Rather than declaring the ‘dodo bird verdict’ that CBT and all other psychotherapies are equally efficacious, it would be more beneficial to develop more potent forms of CBT by identifying variables that mediate treatment outcomes.

Modelling web search behaviour : a user’s cognitive style perspective [Unpublished]

Many researchers have investigated and modelled aspects of Web searching. A number of studies have explored the relationships between individual differences and Web searching. However, limited studies have explored the role of users’ cognitive styles in determining Web searching behaviour. Current models of Web searching have limited consideration of users’ cognitive styles. The impact of users’ cognitive style on Web searching and their relationships are little understood or represented. Individuals differ in their information processing approaches and the way they represent information, thus affecting their performance. To create better models of Web searching we need to understand more about user’s cognitive style and their Web search behaviour, and the relationship between them. More rigorous research is needed in using more complex and meaningful measures of relevance; across a range of different types of search tasks and different populations of Internet users. The project further explores the relationships between the users’ cognitive style and their Web searching. The project will develop a model depicting the relationships between a user’s cognitive style and their Web searching. The related literature, aims and objectives and research design are discussed.

Simulated cataract and low contrast stimuli impair cognitive performance in older adults : implications for neuropsychological assessment and everyday function

Objective: To investigate how age-related declines in vision (particularly contrast sensitivity), simulated using cataract-goggles and low-contrast stimuli, influence the accuracy and speed of cognitive test performance in older adults. An additional aim was to investigate whether declines in vision differentially affect secondary more than primary memory. Method: Using a fully within-subjects design, 50 older drivers aged 66-87 years completed two tests of cognitive performance - letter matching (perceptual speed) and symbol recall (short-term memory) - under different viewing conditions that degraded visual input (low-contrast stimuli, cataract-goggles, and low-contrast stimuli combined with cataract-goggles, compared with normal viewing). However, presentation time was also manipulated for letter matching. Visual function, as measured using standard charts, was taken into account in statistical analyses. Results: Accuracy and speed for cognitive tasks were significantly impaired when visual input was degraded. Furthermore, cognitive performance was positively associated with contrast sensitivity. Presentation time did not influence cognitive performance, and visual gradation did not differentially influence primary and secondary memory. Conclusion: Age-related declines in visual function can impact on the accuracy and speed of cognitive performance, and therefore the cognitive abilities of older adults may be underestimated in neuropsychological testing. It is thus critical that visual function be assessed prior to testing, and that stimuli be adapted to older adults' sensory capabilities (e.g., by maximising stimuli contrast).

Simulated visual impairment leads to cognitive slowing in older adults

PURPOSE: To investigate the impact of different levels of simulated visual impairment on the cognitive test performance of older adults and to compare this with previous findings in younger adults. METHODS.: Cognitive performance was assessed in 30 visually normal, community-dwelling older adults (mean = 70.2 ± 3.9 years). Four standard cognitive tests were used including the Digit Symbol Substitution Test, Trail Making Tests A and B, and the Stroop Color Word Test under three visual conditions: normal baseline vision and two levels of cataract simulating filters (Vistech), which were administered in a random order. Distance high-contrast visual acuity and Pelli-Robson letter contrast sensitivity were also assessed for all three visual conditions. RESULTS.: Simulated cataract significantly impaired performance across all cognitive test performance measures. In addition, the impact of simulated cataract was significantly greater in this older cohort than in a younger cohort previously investigated. Individual differences in contrast sensitivity better predicted cognitive test performance than did visual acuity. CONCLUSIONS.: Visual impairment can lead to slowing of cognitive performance in older adults; these effects are greater than those observed in younger participants. This has important implications for neuropsychological testing of older populations who have a high prevalence of cataract.

(Dia)logics of difference : disability, performance & spectatorship

In this paper I examine the way artists with disabilities use performances in public spaces to encourage people to reflect on their own contribution to the construction of publics, or counter-publics, during and after the moment of encounter. I focus on Liz Crow’s Resistance on the Plinth. This is the title Crow gave her performance on the Forth Plinth in Trafalgar Square as part of Antony Gormley’s One and Other project in 2009. Described as a public art project presenting a portrait of the U.K., Gormley’s One and Other gave 2400 people selected at random via a lottery the chance to do whatever they chose for an hour on the vacant Forth Plinth in Trafalgar Square. In her hour, Crow chose to present herself in a Nazi uniform, in her wheelchair. In this paper, I discuss how Crow’s performance used a counterposition of images – the Nazi uniform, associated with eugenics and a desire to eliminate people who do not accord with the Arayan ‘norm’, counterposed with her wheelchair – to encourage passersby to “stop, look, think.” I examine how Crow used this counterposition to prevent passersby from attributing a single, stable, monologic meaning to the image – forestalling the risk that passersby would read the image as a Nazi on the Plinth – and instead draw passersby into a dialogue in which the impossibility of reconciling the contradictory images, ideologies and cultural logics Crow embodied encouraged people to continue thinking and talking about these cultural logics during and after the encounter.

The role of informal networks in providing effective work opportunities for people with an intellectual disability

Being in paid employment is socially valued, and is linked to health, financial security and time use. Issues arising from a lack of occupational choice and control, and from diminished role partnerships are particularly problematic in the lives of people with an intellectual disability. Informal support networks are shown to influence work opportunities for people without disabilities, but their impact on the work experiences of people with disability has not been thoroughly explored. The experience of 'work' and preparation for work was explored with a group of four people with an intellectual disability (the participants) and the key members of their informal support networks (network members) in New South Wales, Australia. Network members and participants were interviewed and participant observations of work and other activities were undertaken. Data analysis included open, conceptual and thematic coding. Data analysis software assisted in managing the large datasets across multiple team members. The insight and actions of network members created and sustained the employment and support opportunities that effectively matched the needs and interests of the participants. Recommendations for future research are outlined.

Nonverbal Learning Disability explained : the link to shunted hydrocephalus

A Nonverbal Learning Disability is believed to be caused by damage, disorder or destruction of neuronal white matter in the brain’s right hemisphere and may be seen in persons experiencing a wide range of neurological diseases such as hydrocephalus and other types of brain injury (Harnadek & Rourke 1994). This article probes the relationship between shunted hydrocephalus and Nonverbal Learning Disability. Description of hydrocephalus and intelligence associated with hydrocephalus concludes with explication of the ‘final common pathway’ that links residual damage caused by the hydrocephalic condition to a Nonverbal Learning Disability (Rourke & Del Dotto 1994, p. 37). The paper seeks to assist teachers, teacher aides, psychologists, guidance officers, support workers, parents and disability service providers whose role is to understand and advocate for individuals with shunted hydrocephalus and spina bifida.

Assessing cognitive development in early childhood : a comparison of the Bayley-III and the Stanford-Binet fifth edition

The Bayley Scales of Infant Development, Third Edition (Bayley-III) and Stanford-Binet Intelligence Scale, Fifth Edition (SB5) were administered in a sample of 26 typically developing children (12 males and 14 females) aged 24 – 42 months. Children completed the assessments in two separate sessions, counterbalanced for order of administration. Scores on the two instruments were not significantly related, with the exception of the SB5 Knowledge score, which was moderately correlated with the Language score on the Bayley-III (r = .41, p = 0.04). Despite no other significant correlations, for 22 of the 26 children, scores were very consistent across the two instruments. Implications for test selection are discussed.