Evaluation of a treatment program for individuals with an intellectual disability who have high risk behaviours

In the past two decades numerous programs have emerged to treat individuals with developmental disabilities who have sexual offending behaviours. There has, however been very few studies that systematically examine the effectiveness of long term treatment with this population. The present research examines the therapeutic outcomes of a multi-modal behaviour approach with six individuals with intellectual disabilities previously charged with sexual assault. The participants also exhibited severe behavioural challenges that included verbal aggression, physical aggression, destruction and self-injury. These six participants (5 males, 1 female) were admitted to a Long Term Residential Treatment Program (LTRTP), due to the severity of their behaviours and due to their lack of treatment success in other programs. Individualized treatment plans focused on the reduction of maladaptive behaviours and the enhancing of skills such as positive coping strategies, socio-sexual knowledge, life skills, recreation and leisure skills. The treatment program also included psychiatric, psychological, medical, behavioural and educational interventions. The participants remained in the Long Term Residential Treatment Program (LTRTP) program from 181 to 932 days (average of 1.5 years). Pre and post treatment evaluations were conducted using the following tools: frequency of target behaviours, Psychopathology Inventory for Mentally Retarded Adults (PIMRA), Emotional Problems Scale (EPS), Socio-Sexual Knowledge and Attitudes Assessment Tool (SSKAAT-R) and Quality of Life Questionnaire (QOL-Q). Recidivism rates and the need for re-hospitalization were also noted for each participant. By offering high levels of individualized interventions, all six participants showed a 37 % rate of reduction in maladaptive behaviours with zero to low rates of inappropriate sexualbehaviour, there were no psychiatric hospitalizations, and there was no recidivism for 5 of 6 participants. In addition, medication was reduced. Mental health scores on the PIMRA were reduced across all participants by 25 % and scores on the Quality of Life Questionnaire increased for all participants by an average of 72 %. These findings add to and build upon the existing literature on long term treatment benefits for individuals with a intellectual disability who sexually offend. By utilizing an individualized and multimodal treatment approach to reduce severe behavioural challenges, not only can the maladaptive behaviours be reduced, but adaptive behaviours can be increased, mental health concerns can be managed, and overall quality of life can be improved.

Central Park, Sterling, Illinois

Written on front: "Central Park, Sterling, Illinois, 24729." Written on back: "My playground 1911-13 and 1916-19."

An assessment of autism knowledge in the medical field

Once thought to be rare, pervasive developmental disorders (PDDs) are now recognized as the most common neurological disorders affecting children and one of the most common developmental disabilities (DD) in Canada (Autism Society of Canada, 2006). Recent reports indicate that PDDs currently affect 1 in 150 children (Centre for Disease Control and Prevention, 2007). The purpose of this research was to provide an understanding of medical resident and practicing physicians' basic knowledge regarding PDDs. With a population of children with PDDs who present with varying symptoms, the ability for medical professionals to provide general information, diagnosis, appropriate referrals, and medical care can be quite complex. A basic knowledge of the disorder is only a first step in providing adequate medical care to individuals with autism and their families. An updated version of Stone's (1987) Autism survey was administered to medical residents at four medical schools in Canada and currently practicing physicians at three medical schools and one community health network. As well, a group of professionals specializing in the field ofPDDs, participating in research and clinical practice, were surveyed as an 'expert' group to act as a control measure. Expert responses were consistent with current research in the field. General findings indicated few differences in overall knowledge between residents and physicians, with misconceptions evident in areas such as the nature of the disorder, qualitative characteristics of autism, and effective interventions. Results were also examined by specialty and, while pediatricians demonstrated additional accurate 11 knowledge regarding the nature of the disorder and select qualitative impairments, both residents and practicing physicians demonstrated misconceptions about PDDs. This preliminary study replicated the findings of Stone (1987) and Heidgerken (2005) concerning several misconceptions of PDDs held by residents and practicing physicians. Future research should focus on additional replications with validated measures as well as the gathering of qualitative information, in order to inform the medical profession of the need for education in PDDs at training and professional levels.

Predictors of primary health care utilization by former residents of institutions in Ontario

For years institutionalization has been the primary method of service delivery for persons with developmental disabilities (DD). However, in Ontario the last institution was closed on March 31, 2009 with former residents now residing in small, communitybased homes. This study investigated potential predictors of primary health care utilization by former residents. Several indirect measures were employed to gather information from 60 participants on their age, health status, adaptive functioning level, problem behaviour, mental health status and, total psychotropic medication use. A direct measure was used to gather primary health care utilization information, which served as the dependent variable. A stepwise linear regression failed to reveal significant predictors of health care utilization. The data were subsequently dichotomized and the outcomes of a logistic regression analysis indicated that mental health status, psychotropic medication use and, an interaction between mental health status and health status significantly predicted higher primary health care usage.

Closing the summer learning gap for vulnerable junior kindergarten students

Under current academic calendars across North America, summer vacation creates a significant gap in the learning cycle. I t has been argued that this gap actually decreases student achievement levels over the course of the summer. In a synthesis of 39 studies Cooper, Nye, Charlton, Lindsay, & Greathouse (1996) indicated that summer learning loss equaled at least one month of instruction as measured by grade level equivalents on standardized test scores whereby children's test scores were at least one month lower when they returned to school in the fall than scores were when students left in the summer. Specifically, Cooper et aI., (1996) found that the summer learning loss phenomena may be particularly troublesome for less advantaged children including those with speech and language delays, children at-risk for reading disabilities, children from lower socio-economic backgrounds, and children learning English as a second language. In general, research illustrated clearly that the summer learning gap can be particularly problematic for vulnerable children and furthermore, that literacy skills may be the area of achievement that is most affected. A foundational pillar to this research project is including primary caregivers as authentic partners in a summer literacy program designed to support their children's literacy needs. This pillar led the research team to use the Learning Begins at Home: A Research-Based Family Literacy Program Curriculum designed by Antoinette Doyle, Kathleen Hipfner-Boucher, and Janette Pelletier from the Ontario Institute for the Studies of Education. The LBH program is designed to be flexibly adapted to suit the needs of each individual participating family. As indicated by Timmons (2008) literacy interventions are most powerful when they include authentic family involvement. Based on this research, a requirement for participating in the summer literacy program was involvement of a child and one of their primary caregivers. The participating caregiver was integrally involved in the program, participating in workshop activities prior to and following hands-on literacy work with their child. By including primary caregivers as authentic partners, the research team encouraged a paradigmatic shift in the family whereby literacy activities become routine within their household. 5 Participants in this study were 14 children from junior kindergarten classrooms within the Niagara Catholic District School Board. As children were referred to the program, they were assessed by a trained emergent literacy specialist (from Speech Services Niagara) to identify whether they met the eligibility requirements for participation in the summer program. To be eligible to participate, children demonstrated significant literacy needs (i.e. below 25%ile on the Test of Preschool Early Literacy described below). Children with low incidence disabilities (i.e. profound sensory impairments, severe intellectual impairments, developmental disabilities, etc) were excluded as participants. The research team used a standard pre- and posttest design whereby all participating children were assessed with the Test of Preschool Early Literacy (Lonigan et aI., 2007), and a standard measure of letter names and sounds. Pretests were administered two weeks prior to the commencement of the program and the first set of posttests was administered immediately following the program. A second set of posttests was administered in December 2009 to measure the sustainability of the program. As a result of the program, all children scored statistically significantly higher on their literacy scores at the post-program assessment point immediately following the program and also at the Dec-post-program assessment point. These results in general indicated that the summer family literacy program made an immediate impact on the emergent literacy skills of participating children. All participating children demonstrated significant increases in print and phonological awareness as well as their letter sound understanding.

Youth with intellectual disabilities and the right to make choices : investigating the family context to inform a training program

People with intellectual disabilities (ID) are more likely to be victims of abuse and human rights violations than people without ID. The 3Rs: Rights, Respect, and Responsibility project has developed and is testing a human rights training program for adults with ID. The current project was conducted to make recommendations to adapt the 3Rs rights training program to be used with youth with ID and their families. An interpretive phenomenological framework was employed to investigate youth with ID, parents', and siblings' perceptions of the i r experiences with choice making, an enactment of rights, in the family context. Thematic analysis of interviews revealed that, consistent with previous research, family members consider family values, conventions, and family members' well being when making decisions. A training program should promote a consideration of expanded opportunities for youth with ID to make choices and should be flexible to address individual families' cultures, needs, and desires.

Clinician-Perceived Bridges and Barriers to Parental Implementation of Picture Exchange Communication System (PECS): An evaluation.

Picture Exchange Communication System (PECS) is an augmentative and alternative communicative system that improves communication and decreases problem behaviors in children with Developmental Disabilities and Autism. The mediator model is a validated approach that clinicians use to train parents to perform evidence-based interventions. Parental non-adherence to treatment recommendations is a documented problem. This qualitative study investigated clinician-perceived factors that influence parental adherence to PECS recommendations. Three focus groups (n=8) were conducted with Speech Language Pathologists and Behavior Therapists experienced in providing parents with PECS recommendations. Constant comparison analysis was used. In general, clinicians believed that PECS was complex to implement. Thirty-one bridges were identified to overcome complexity. Twenty-two barriers and 6 other factors also impacted parental adherence. Strategies to address these factors were proposed based on a review of the literature. Future research will be performed to validate these findings using parents and a larger sample size.

Actitudes hacia la discapacidad : la influencia de variables individuales y contextuales

Este trabajo constituye una revisión de la influencia de las variables individuales y contextuales sobre las actitudes hacia la discapacidad. Para alcanzar este objetivo, se describió el concepto de discapacidad desde una perspectiva social, en donde se concibió la discapacidad como un aspecto relacional en vez de una característica individual. Por otra parte se describieron las actitudes hacia la discapacidad, los tipos y sus consecuencias, teniendo en cuenta las percepciones, creencias, emociones, información sobre discapacidad y variables sociodemográficas las cuales tienen un papel significativo en la formación y mantenimiento de las actitudes hacia la discapacidad. Adicionalmente se presentaron algunas de las estrategias de intervención que tiene como propósito mejorar las actitudes, aspecto que puede ayudar o contribuir a la aceptación de las personas con discapacidad. Finalmente, el presente trabajo muestra la necesidad de continuar el estudio de las actitudes hacia la discapacidad, y el mejorar las intervenciones basadas en los hallazgos presentados.

Uso de la Hibridación Genómica Comparativa-Array (HGC-a) en pacientes con retraso global del desarrollo y fenotipo particular. Revisión sistemática de la literatura

Introducción: la hibridación genómica comparativa en una técnica que permite la exploración de las anormalidades cromosómicas. Su utilidad en la aproximación de los pacientes con retraso global del desarrollo o fenotipo dismórfico, sin embargo, no ha sido explorada mediante una revisión sistemática de la literatura. Metodología: realizó una revisión sistemática de la literatura. Se incluyeron estudios controlados, cuasi-experimentales, de cohortes, de casos y controles, transversales y descriptivos publicados en idiomas inglés y español entre los años 2000 y 2013. Se realizó un análisis de la evidencia con un enfoque cualitativo y cuantitativo. Se realizó un análisis del riesgo de sesgo de los estudios incluidos. Resultados: se incluyeron 4 estudios que cumplieron con los criterios de inclusión. La prevalencia de alteraciones cromosómicas en los niños con retraso global del desarrollo fue de entre el 6 y 13%. El uso de la técnica permitió identificar alteraciones que no fueron detectadas mediante el cariotipo. Conclusiones: la hibridación genómica comparativa es una técnica útil en la aproximación diagnóstica de los niños con retraso global del desarrollo y del fenotipo dismórfico y permite una mayor detección de alteraciones comparada con el cariotipo.

La proyección de imagen a partir de Soft Power, mediante Nation Branding y Diplomacia Pública en el caso de Japón, durante el periodo 2002 – 2010

En el actual contexto de globalización y con el comienzo de la era de la información, cada vez más Estados han buscado proyectar una imagen favorable con el objetivo de atraer atención y crear una reputación que permitan cumplir objetivos de política exterior y fomentar el desarrollo económico, logrando de esta manera un posicionamiento en el sistema internacional mediante estrategias novedosas, que incluyen elementos tanto diplomáticos, políticos, económicos, como comerciales y culturales. Para Japón, Nation Branding y la diplomacia pública han sido dos de las principales herramientas para lograr este reposicionamiento internacional, resaltando atractivos como las tradiciones culturales, el turismo, los incentivos para negocios, y trabajando en conjunto entre el gobierno nacional, el sector privado y la sociedad civil para crear relaciones entre el país y gobiernos y sociedades a nivel internacional.

Análisis de la política exterior rusa frente a Abjasia en el período 2000-2008

El objetivo de la presente monografía de grado es analizar la relación entre la identidad dentro de Rusia y la política exterior de dicho Estado hacia la región de Abjasia. Se analiza y explica la manera en que los referentes identitarios dentro de Rusia en el periodo 2000-2008 influyen en las decisiones de política exterior que Rusia tomó hacia Abjasia en el campo militar y político. Se efectúa una revisión de textos (transcripciones de intervenciones y textos escritos) del Presidente y Primer Ministro de la Federación Rusa entre 2000 y 2008 para encontrar los referentes identitarios que determinan el comportamiento de Rusia hacia otros Estados y la forma en que influenciaron sus acciones con respecto a Abjasia.

Incremento de la salud financiera mediante la utilización de la relación estratégica comunitaria y marketing.

Debido a las crisis mundiales, la perdurabilidad empresarial se ha convertido en la primera preocupación de las organizaciones, puesto que los problemas económicos en otros países pueden generar un efecto negativo en las condiciones del mercado doméstico, que junto con el entorno empresarial complejo y dinámico en el que se deben desempeñar las empresas hoy en día gracias a la globalización, sumado al aumento en la competitividad nacional e internacional, la perdurabilidad de las empresas se está viendo seriamente comprometida. Lo anterior, ha llevado a las empresas a buscar nuevas formas de mejorar su salud financiera. Para medir la salud financiera empresarial, se pueden usar distintos indicadores como lo es el flujo de caja que está asociado con la rentabilidad, el patrimonio que está asociado a las dificultades financieras, entre otros, o a través de varios modelos de bancarrota, los cuales, por medio de un conjunto de ratios financieros, reflejan el estado actual de la organización y su probabilidad de fracaso en el futuro. Las estrategias comunitarias y el marketing permiten incrementar la salud financiera de las empresas a través de la orientación al cliente y el establecimiento de relaciones gana-gana a largo plazo con las diferentes comunidades con las que se relaciona la organización.

Validity evidence based on internal structure

Resumen tomado de la publicación

Aprendizagem de aluno com deficiência intelectual e desenvolvimental em contexto de sala de aula

O presente estudo propôs-se estudar a temática da aprendizagem de um aluno com deficiência intelectual e desenvolvimental em contexto de sala de aula e as implicações no desenvolvimento de processo educativo. Foi realizado com um jovem que atingiu este ano a maioridade e que esteve a frequentar o 9º ano de escolaridade. Este jovem apresenta características que o definem como portador de Deficiência Intelectual e Desenvolvimental (DID). Realizou-se a análise documental através das informações que constam do processo educativo do jovem, das entrevistas efectuadas aos professores que o acompanharam no seu percurso escolar e dos registos de observação de aulas. Procedeu-se à discussão dos resultados, onde se aferiu que as escolas regulares apresentam, actualmente condições para responder às necessidades académicas, pessoais e sociais destes jovens, contudo o processo de aprendizagem destes alunos deveria passar por uma preparação para a vida ativa através do estabelecimento de protocolos com Entidades formadoras, que visam formação a nível técnico e que proporcionam a inclusão em mercado laboral. É imperioso compreender que o processo de aprendizagem destes jovens com Necessidades Edicativas Especiais (NEE) implica uma multiplicidade de aspetos, sendo o direito à igualdade de oportunidades primordial, considerando que todos têm direito a ser diferentes quando a igualdade os descaracteriza.