A Comunicação Alternativa favorecendo a aprendizagem de crianças com autismo, Asperger e Angelman: formação continuada de profissionais de Educação e Saúde

A formação continuada de profissionais de Educação e Saúde se constitui como objeto desta dissertação. Na presente pesquisa pretendi planejar, implementar e avaliar os efeitos de um programa de formação continuada de profissionais de Educação e Saúde, oferecendo instruções e orientações de uso dos recursos da Comunicação Alternativa e Ampliada (CAA), para favorecer a comunicação e aprendizagem de crianças com autismo, Asperger e Angelman. Os estudos foram realizados em uma escola regular e em uma instituição especializada, com abordagem clínica-terapêutica-educacional. O universo da pesquisa abrangeu oito profissionais: duas professoras de classes regulares de ensino, uma professora especialista (Atendimento Educacional Especializado), duas estagiárias (estudantes de Pedagogia), exercendo a função de mediadora do aluno com autismo incluído, uma professora da instituição especializada, um auxiliar da professora e uma psicóloga. Também nove crianças fizeram parte desse universo: uma criança com autismo, incluída em classe regular e oito crianças que frequentavam a instituição especializada, sendo duas com Asperger, quatro com autismo e duas com Angelman. Para responder à pergunta principal do estudo: A Comunicação Alternativa e Ampliada pode favorecer a comunicação e a aprendizagem de crianças com autismo, Asperger e Angelman?, foi necessário conhecer os profissionais, as instituições e as respectivas gestoras, bem como o corpo docente, a equipe técnica e as crianças assistidas pelos profissionais, para verificar as suas necessidades, potencialidades, interesses e limitações. Outro elemento fundamental na proposta de formação dos profissionais foram os procedimentos do ensino e da consultoria colaborativa. A pesquisa foi desenvolvida em três estudos, durante o período de julho de 2010 a abril de 2012. Foi utilizado o delineamento intrasujeitos do tipo A-B (estudo I) e A-B-C (estudos II e III) e análise qualitativa dos resultados. Os procedimentos iniciais adotados foram: aplicação de questionários para os profissionais e os responsáveis pelas crianças, entrevistas semiestruturadas com as gestoras das instituições, observações in loco, filmagens das atividades pedagógicas e anotações de campo. Com base nos questionários, entrevistas, observações e anotações foram levantadas as principais dificuldades e necessidades dos profissionais e das crianças e construídos protocolos de observação dos comportamentos destes sujeitos. Durante o desenvolvimento dos estudos foram realizadas filmagens das atividades pedagógicas e anotações de campo, bem como reuniões com os profissionais, para orientações e planejamento das atividades pedagógicas adaptadas a serem desenvolvidas com as crianças, bem como materiais e recursos da CAA. Os resultados apontaram à presença de algumas modificações nos comportamentos dos profissionais e nos comportamentos das crianças. Revelaram ainda, que este trabalho proporcionou aos profissionais a oportunidade de reverem as suas atuações e as suas crenças, com relação à inclusão de crianças com autismo, Asperger e Angelman em ambientes não protegidos. Foi possível verificar as contribuições dos procedimentos e dos recursos da CAA, para favorecer a comunicação, a autorregulação e a aprendizagem dessas crianças e o quanto os procedimentos do ensino e da consultoria colaborativa se apresentam como promissores para o desenvolvimento dos profissionais.

学习困难儿童智力结构及其与心理语言、视动能力关系的研究

IQ Structure, Psycholinguistic and Visual-motor Abilities Study on Children Learning Disability TONG Fang Directed by professor Zhu Liqi (Developmental and educational psychology) ABSTRACT Objective To comprehensive analyze the IQ structures, and relationships among IQ, psychometric characteristics and visual-motor integration on children disability. At same time, to probe into the family factors that influenced IQ, psycholinguistic abilities and behavior of LD children. Method (1) Downloading the papers on children learning disability from www.cqvip.com and www.wanfangdata.com, in which, the articles were collected by key words from 1985 to 2005. To conduct meta-analysis on IQ construction, compare the case group and the control group, including full IQ, verbal and practice IQ. (2) Designed with model compared and self-compared, 59 diagnosed learning disability children, tested themes with WISC, ITPA and Berry’s VMI. WISC included 10 items, 5 of which subtotal to verbal and practice IQ respectively. IPTA included 10 items, too, 5 process of which subtotal to auditory and visual perception. The first 3 items shared representation level, the other 2 of that shared automatic level.VMI had one score. Analyzed factors and levels with description and Pearson Correlation. To probe to linguistic internal alternately functions of LD children, and compare the scores of groups in different IQ. (3) Analyzed the perspective questionnaire filled by parents. Early development facts compared with model groups. Factors relationships analyzed with Kendall correlation, KOM and Bartlett’s test of sphericity, Promax Rotation. Results: (1) There have been 319 papers related with LD, in which 36 with IQ and 14 valid reports have been analyzed by Meta. FIQ’s 95%CI (confidence interval) is 2.418 ~ 0.172, VIQ between the difficulty and non- difficulty group. C-WISC-R reports were 10 papers, of which, 95%CI of FIQ is 2.424 ~ 0.676, of VIQ is 2.314 ~ 1.196, of PIQ is 2.176 ~ 0.176. The VIQ comparing the PIQ, 95%CI is 1.1 ~ -0.07 in difficulty group and 0.5 ~ -0.0046 in non-difficult group. Nevertheless, in the other 4 tests, FIQ’s 95%CI is 2.00 ~ -0.818 between LD and NLD. (2) Children psycholinguistic abilities had strong relation with Berry’s VMI test excluding auditory reception, and with perceptive factor of intelligence excluding verbal expression. Auditory reception and visual closure had strong relation with FIQ and PIQ. Grammatic closure, visual association and manual expression had strong relation with concept factor. The representational and automatic levels are depended on integration of auditory and visual procession. Lower verbal expression (VE) let to lower expression process and low scores on representational level. Lower visual sequential memory (VSM) let to lower memory process and influenced automatic level. Groups compared by IQ 90 show that LD children with under IQ 90 had lower scores on items of IPTA than with up IQ 90 excluded verbal expression. It was proved that IQ administrated the linguistic ability. Nevertheless, general abilities deficiency didn’t show influencing on the types of the perceptive delay. There was mutual function among linguistic ability on LD children. Auditory and visual level are overlapped each other. Not only show higher Decoding and lower Encoding on Auditory perception, lower Decoding and higher Encoding on Visual perception, in representation, but also higher Sequential remember, lower Closure on Audition, and lower Sequential member, higher Closure on Vision, in Automation. Nevertheless, there was no different between Representational and Automatic level, which may be the relationship of parallel or evolution. (3) Major family factors were father’s education, occupation. Lower auditory perception related to unconcerned, lower visual perception related to premature delivery and written slowly. Threatened–abortion, childbirth-suffocated were known as influencing children’s IQ and later linguistic abilities. It wasn’t shown that dosage relationship with the types of perceptive delay. Conclusion: (1) The FIQ, VIQ and PIQ of Children with LD is lower than that of NLD group. There is no significantly different between VIQ and PIQ in LD and NLD groups. (2) The objectives of ITPA and WISC tests are differently. The psycholinguistic abilities had strong relation with perceptive factor and VMI. Some facts of IPTA related with FIQ. IQ had strong administration on linguistic abilities. There was mutual function among linguistic internal abilities. (3) Family facts on IQ and psycholinguistic abilities were Father’s education, abnormal pregnant and abortion. It would be pre-show development delay in early period.

A Quantitative Evaluation of the AVITEWRITE Model of Handwriting Learning

Much sensory-motor behavior develops through imitation, as during the learning of handwriting by children. Such complex sequential acts are broken down into distinct motor control synergies, or muscle groups, whose activities overlap in time to generate continuous, curved movements that obey an intense relation between curvature and speed. The Adaptive Vector Integration to Endpoint (AVITEWRITE) model of Grossberg and Paine (2000) proposed how such complex movements may be learned through attentive imitation. The model suggest how frontal, parietal, and motor cortical mechanisms, such as difference vector encoding, under volitional control from the basal ganglia, interact with adaptively-timed, predictive cerebellar learning during movement imitation and predictive performance. Key psycophysical and neural data about learning to make curved movements were simulated, including a decrease in writing time as learning progresses; generation of unimodal, bell-shaped velocity profiles for each movement synergy; size scaling with isochrony, and speed scaling with preservation of the letter shape and the shapes of the velocity profiles; an inverse relation between curvature and tangential velocity; and a Two-Thirds Power Law relation between angular velocity and curvature. However, the model learned from letter trajectories of only one subject, and only qualitative kinematic comparisons were made with previously published human data. The present work describes a quantitative test of AVITEWRITE through direct comparison of a corpus of human handwriting data with the model's performance when it learns by tracing human trajectories. The results show that model performance was variable across subjects, with an average correlation between the model and human data of 89+/-10%. The present data from simulations using the AVITEWRITE model highlight some of its strengths while focusing attention on areas, such as novel shape learning in children, where all models of handwriting and learning of other complex sensory-motor skills would benefit from further research.

Issues in the prescribing of psychotropic and psychoactive medication for persons with learning disability: quantitative and qualitative perspectives

The administration of psychotropic and psychoactive medication for persons with learning disability and accompanying mental illness and/or challenging behaviour has undergone much critical review over the past two decades. Assessment and diagnosis of mental illness in this population continues to be psychopharmacological treatment include polypharmacy, irrational prescription procedures and frequent over-prescription. It is clear that all forms of treatment including non-pharmacological interventions need to be driven by accurate and appropriate diagnoses. Where a psychiatric diagnosis has been identified, it greatly aides the selection of appropriate medication, although a specific medication for each diagnosis, as was once hoped, is simply no longer a reality in practice. Part one of the present thesis seeks to address many of the current issues in mental health problems and pharmacological treatment to date. The author undertook a drug prevalence study within both residential and community facilities for persons with learning disability within the Mid-West region of Ireland in order to ascertain the current level of prescribing of psychotropic and psychoactive medications for this population. While many attempts have been made to account for the variation in prescribing, little systematic and empirical research has been undertaken to investigate the factors thought to influence such prescribing. While studies investigating the prescribing behaviours of General Practitioners (GP's) have illustrated the complex nature of the decision making process in the context of general practice, no similar efforts have yet been directed at examining the prescribing behaviours of Consultant Psychiatrists. Using The Critical Incident Technique, the author interviewed Consultant Psychiatrists in the Republic of Ireland to gather information relating not only to their patterns of prescribing for learning disabled populations, but also to examine reasons influencing their prescribing in addition to several related factors. Part two of this thesis presents the findings from this study and a number of issues are raised, not only in relation to attempting to account for the findings from part one of the thesis, but also with respect to implications for improved management and clinical practice.

Cheats offer lesson in learning

Plagiarism and the internet should make us rethink the purpose of assessment, says Tony Mann.

Web-based course support systems: an essential tool for supporting flexible learning environment

In Higher Education web-based course support systems are essential for supporting flexible learning environments. They provide tools to enable the interaction between student and tutor to reinforce transfer of theory to understanding particularly in an academic environment, therefore this paper will examine issues associated with the use of curriculum and learning resources within Web-based course support systems and the effectiveness of the resulting flexible learning environments This paper is a general discussion about flexible learning and in this case how it was applied to one of the courses at undergraduate level one. The first section will introduce what is flexible learning and the importance of flexible learning in Higher Education followed by the description of the course and why the flexible learning concepts is important in such a course and finally, how the flexibility was useful for this particular instance.

What Education Studies is and what it might be

Education Studies at the University of Greenwich is presented as an example of what Education Studies is – at least at one Higher Education Institution. As a field of practice to which a body of knowledge can be applied, Education Studies shares common features with other disciplinary fields of study. It is also unique in that its field – learning, is also what its students do – learn. What Education Studies isn’t is then discussed in relation to studies of schooling, the psychology of learning, sociology of education, traditional education degrees and teacher training. Lastly, what Education Studies could become is presented with reference to Ranson’s (1993) argument for the centrality of education as the common focus of all HE study. It is suggested that the subject could then contribute to expanding critical space in (higher) education through making research/ scholarship and creation an integral part of the Independent Study of all students at all levels of learning. This would be a necessary complement to the wider democratic transformation now demanded for human survival. It would also accord with what Marx called humanity’s “species being” as a “learning animal” (Morris). Such a social theory of learning can discriminate between information and competence at one level of learning and (corresponding terms) knowledge and skill at another more generalised level in relation to new divisions of knowledge and labour. Potentially these levels can be combined to create a new form of polytechnic learning, relating theory to practice, education to training and further to higher education.

Assessment of data quality in a multi-centre cross-sectional study of participation and quality of life of children with cerebral palsy

Background: SPARCLE is a cross-sectional survey in nine European regions, examining the relationship of the environment of children with cerebral palsy to their participation and quality of life. The objective of this report is to assess data quality, in particular heterogeneity between regions, family and item non-response and potential for bias. Methods: 1,174 children aged 8–12 years were selected from eight population-based registers of children with cerebral palsy; one further centre recruited 75 children from multiple sources. Families were visited by trained researchers who administered psychometric questionnaires. Logistic regression was used to assess factors related to family non-response and self-completion of questionnaires by children. Results: 431/1,174 (37%) families identified from registers did not respond: 146 (12%) were not traced; of the 1,028 traced families, 250 (24%) declined to participate and 35 (3%) were not approached. Families whose disabled children could walk unaided were more likely to decline to participate. 818 children entered the study of which 500 (61%) self-reported their quality of life; children with low IQ, seizures or inability to walk were less likely to self-report. There was substantial heterogeneity between regions in response rates and socio-demographic characteristics of families but not in age or gender of children. Item non-response was 2% for children and ranged from 0.4% to 5% for questionnaires completed by parents. Conclusion: While the proportion of untraced families was higher than in similar surveys, the refusal rate was comparable. To reduce bias, all analyses should allow for region, walking ability, age and socio-demographic characteristics. The 75 children in the region without a population based register are unlikely to introduce bias

Self-reported quality of life of 8-12 year old children with cerebral palsy: a cross-sectional European Study

Background

Little is known about the quality of life (QoL) of disabled children. We describe self-reported QoL of children with cerebral palsy, factors that influence it, and how it compares with QoL of the general population.

Methods

1174 children aged 8–12 years were randomly selected from eight population-based registers of children with cerebral palsy in six European countries and 743 (63%) agreed to participate; one further region recruited 75 children from multiple sources. Researchers visited these 818 children. 318 (39%) with severe intellectual impairment could not self-report; 500 (61%) reported their QoL using KIDSCREEN, an instrument with scores in ten domains, each with SD=10. Multivariable regression was used to relate QoL to impairments, pain, and sociodemographic characteristics. Comparisons were made with QoL data from the general population.

Findings

Impairments were not significantly associated with six KIDSCREEN domains. Comparison of least and most able groups showed that severely limited self-mobility was significantly associated with reduced mean score for physical wellbeing (7·6, 95% CI 2·7–12·4); intellectual impairment with reduced mean for moods and emotions (3·7, 1·5–5·9) and autonomy (3·3, 0·9–5·7); and speech difficulties with reduced mean for relationships with parents (4·5, 1·9–7·1). Pain was common and associated with lower QoL on all domains. Impairments and pain explained up to 3% and 7%, respectively, of variation in QoL. Children with cerebral palsy had similar QoL to children in the general population in all domains except schooling, in which evidence was equivocal, and physical wellbeing, in which comparison was not possible.

Interpretation

Parents can be reassured that most children aged 8–12 years with cerebral palsy will have similar QoL to other children. This finding should guide social and educational policy to ensure that disabled children participate fully in society. Because of its association with QoL, children's pain should be carefully assessed.

Frequency of participation of 8-12 year old children with cerebral palsy: a multi-centre cross sectional European study

Participation in home, school and community is important for all children; and little is known about the frequency of participation of disabled children. Frequency of participation is a valuable outcome measure for evaluating habilitation programmes for disabled children and for planning social and health services.

We investigated how frequency of participation varied between children with cerebral palsy and the general population; and examined variation across countries to understand better how the environmental factors such as legislation, public attitudes and regulation in different countries might influence participation.

We undertook a multi-centre, population-based study in children with and without cerebral palsy. Working from the Life-H instrument, we developed a questionnaire to capture frequency of participation in 8–12-year-old children. In nine regions of seven European countries, parents of 813 children with cerebral palsy and 2939 children from the general populations completed the questionnaire.

Frequency of participation for each question was dichotomised about the median; multivariable logistic regressions were carried out.

In the general population, frequency of participation varied between countries. Children with cerebral palsy participated less frequently in many but not all areas of everyday life, compared with children from the general population. There was regional variation in the domains with reduced participation and in the magnitude of the differences. We discuss how this regional variation might be explained by the different environments in which children live. Attending a special school or class was not associated with further reduction in participation in most areas of everyday life.

Association between participation in life situations of children with cerebral palsy and their physical, social, and attitudinal environment:A cross-sectional multicenter European study

Objective:
To evaluate how participation of children with cerebral palsy (CP) varied with their environment.

Design:
Home visits to children. Administration of Assessment of Life Habits and European Child Environment Questionnaires. Structural equation modeling of putative associations between specific domains of participation and environment, while allowing for severity of child's impairments and pain.

Setting:
European regions with population-based registries of children with CP.

Participants:
Children (n=1174) aged 8 to 12 years were randomly selected from 8 population-based registries of children with CP in 6 European countries. Of these, 743 (63%) agreed to participate; 1 further region recruited 75 children from multiple sources. Thus, there were 818 children in the study.

Interventions:
Not applicable.

Main Outcome Measure:
Participation in life situations.

Results:
For the hypothesized associations, the models confirmed that higher participation was associated with better availability of environmental items. Higher participation in daily activities—mealtimes, health hygiene, personal care, and home life—was significantly associated with a better physical environment at home (P<.01). Mobility was associated with transport and physical environment in the community. Participation in social roles (responsibilities, relationships, recreation) was associated with attitudes of classmates and social support at home. School participation was associated with attitudes of teachers and therapists. Environment explained between 14% and 52% of the variation in participation.

Conclusions:
The findings confirmed the social model of disability. The physical, social, and attitudinal environment of disabled children influences their participation in everyday activities and social roles.

A leadership framework to support the use of e-learning resources

Aim
This inquiry aims to apply the NHS leadership framework to nurse education for the implementation of e-learning.
Background
Recognition needs to be given to the emerging postgraduate nursing students new status of consumer and the challenge now for nurse education is how to remain relevant and competitive in this consumer led market. The move towards an e-learning paradigm has been suggested as a competitive and contemporary way forward for the student consumer. The successful introduction of e-learning in nurse education will require leadership and a strong organisational management system.
Discussion
Each element of the NHS leadership framework is described and interpreted for application in a higher education setting for the implementation of e-learning.
Conclusions
Change in the delivery of post graduate nurse education is necessary to ensure it remains current and reflective of consumer need in a competitive marketplace. By applying a leadership framework that acknowledges the skills and abilities of staff and encourages the formation of collaborative partnerships from within the wider university community, educators can begin to develop skills and confidence in teaching using e-learning resources.