Develop Treatment Goals Research Articles

Using Computerized Language Analysis to Evaluate Grammatical Skills.

Purpose Conducting in-depth grammatical analyses based on language samples can be time consuming. Developmental Sentence Scoring (DSS) and the Index of Productive Syntax (IPSyn) analyses provide detailed information regarding the grammatical profiles of children and can be conducted using free computer-based software. Here, we provide a tutorial to support clinicians' use of computer-based analyses to aid diagnosis and develop and monitor treatment goals. Method We analyzed language samples of a 5-year-old with developmental language disorder and an adolescent with Down syndrome using computer-based software, Computerized Language Analysis. We focused on DSS and IPSyn analyses. The tutorial includes step-by-step procedures for conducting the analyses. We also illustrate how the analyses may be used to assist in diagnosis, develop treatment goals focused on grammatical targets, and monitor progress on these treatment goals. Conclusion Clinicians should consider using Computerized Language Analysis's IPSyn and DSS analyses to support grammatical language assessments used to aid diagnosis, develop treatment goals, and monitor progress on these treatment goals. Supplemental Material https://doi.org/10.23641/asha.12021141.

Theoretical Foundations: Delinquency Risk Factors and Services Aimed at Reducing Ongoing Offending

Utilizing theory to understand youth in the context of their larger environment is of vital importance when assessing youth delinquency risk, and subsequent adjudication service assignment. Using a person-in-environment approach, theories that posit risk factors for delinquency are explored based on individual attributes associated with delinquency, then expand to theories that describe family, peer, and community risk factors, connecting the interrelatedness between the individual and their environment. Theories for services aimed at reducing ongoing delinquency are guided by Carpiano and Daley and begin with the broad ecological framework, then narrow the scope to address mediators between thoughts and actions. A theoretical framework for delinquency risk factors gives us context as to why youth may offend and offers a road map to service providers, while a theoretical framework for services extends the interconnectedness between youth and their environment, and the significance of social learning. Social workers in practice settings are tasked with assessing clients to determine risk factors, develop treatment goals, and link with specialized services. Social workers and agencies should develop assessments and services that are theory driven, and incorporate youth, family, peer, and community components.

Using ultrahigh-resolution mass spectrometry and toxicity identification techniques to characterize the toxicity of oil sands process-affected water: The case for classical naphthenic acids.

Previous assessments of oil sands process-affected water (OSPW) toxicity were hampered by lack of high-resolution analytical analysis, use of nonstandard toxicity methods, and variability between OSPW samples. We integrated ultrahigh-resolution mass spectrometry with a toxicity identification evaluation (TIE) approach to quantitatively identify the primary cause of acute toxicity of OSPW to rainbow trout (Oncorhynchus mykiss). The initial characterization of OSPW toxicity indicated that toxicity was associated with nonpolar organic compounds, and toxicant(s) were further isolated within a range of discrete methanol fractions that were then subjected to Orbitrap mass spectrometry to evaluate the contribution of naphthenic acid fraction compounds to toxicity. The results showed that toxicity was attributable to classical naphthenic acids, with the potency of individual compounds increasing as a function of carbon number. Notably, the mass of classical naphthenic acids present in OSPW was dominated by carbon numbers ≤16; however, toxicity was largely a function of classical naphthenic acids with ≥17 carbons. Additional experiments found that acute toxicity of the organic fraction was similar when tested at conductivities of 400 and 1800 μmhos/cm and that rainbow trout fry were more sensitive to the organic fraction than larval fathead minnows (Pimephales promelas). Collectively, the results will aid in developing treatment goals and targets for removal of OSPW toxicity in water return scenarios both during operations and on mine closure. Environ Toxicol Chem 2017;36:3148-3157. © 2017 SETAC.

Clinical indices for orthodontic mini-implants

Orthodontic mini-implants were recently developed and have been widely used in clinics. However, loosening of mini-implants, as well as infection and swelling of mucosal tissue at the placement site, are often observed during orthodontic treatment. Thus, clinical indices are greatly needed for the safe use of orthodontic mini-implants. This article presents information on mini-implants and offers suggestions on indications, placement technique, optimum design, and evaluation of the placement site for mini-implants. The author concludes that 1) mini-implants should be left in the placement site for 3 months before loading to allow for a healing period, which increases the success rate in adolescent patients, 2) placement torque should be considered when tightening mini-implants into bone, as excessively high or low torque results in low stability, 3) mini-implants with optimal screws should be placed in the correct position, and 4) a prepared site should be established in an area with a cortical bone thickness of greater than 1.0 mm, to improve the success rate. Finally, the vector of orthodontic forces in the arrangement with the center of resistance of the entire dental arch should be considered when developing treatment goals.

A Person-Centered, Strength-Based Treatment of Aggression and Sexually Inappropriate Behavior in Mental Health

A major strength of behavior analysis is the link between the assessment and treatment of problem behavior. However, the individual is rarely consulted about their definition of the problem behavior or regarding what, if any, behavior should be the target of treatment. A case study of a hospital-based treatment for an adult with serious and persistent mental illness who engaged in aggressive and sexually inappropriate behaviors is presented. Treatment involved a positive behavior supports approach based on the person's strengths. During treatment, incidents of sexually inappropriate behavior and acts of physical aggression decreased and reached near-zero levels within the first 6 months. Results of this person-centered approach suggest the value of withholding judgment prior to a complete assessment and enlisting help of the individual to develop treatment goals and strategies. This approach is recovery focused in terms of symptom and functional recovery as perceived and driven by the individual.

Primary intracerebral haemorrhage?-?clinical and radiologic predictors of survival and functional outcome

Purpose: Primary intracerebral haemorrhage (ICH) is a common and devastating disorder that often results in long-term disability. This review examines the literature on predictors of survival and long-term functional outcome after ICH. Method: Medical literature review. Results: Numerous clinical and radiologic variables have been shown to be associated with survival and functional recovery following ICH. These include patient age and gender, lesion size and location, initial level of consciousness, presence of intraventricular haemorrhage, hydrocephalus, and mass effect. Studies have employed a variety of outcome measures including survival and functional recovery. Conclusions: Clinical and radiologic findings following ICH may assist rehabilitation specialists as they develop treatment goals, anticipate long-term patient care needs, and educate and train caregivers.

Decision-making in children with asthma and their parents.

To learn how children with asthma and their parents make treatment-related decisions. Verbatim transcripts of focus group interviews of 28 school age children with asthma and their parents. Children had attended an educationally based asthma camp program. Questions related to choices parents and children made regarding implementation of their asthma treatment plans both, at home and at school. Parents and children made many non-adherence decisions especially with respect to preventive aspects of the treatment plan. Symptoms were the driving force for children's decisions. Parents and children had concerns about implementing the management plan at school. Parents and children may not perceive asthma treatment options as true choices, thus affecting motivation for adherence. Practitioners need to form partnerships with parents and children in developing treatment goals. Goals should focus on achievement of normal daily activities. Asthma education needs to be concrete and include school personnel. Practitioners need to give families positive, informational feedback.

Challenges to treatment goals and outcomes in pediatric asthma

To achieve long-term control in pediatric asthma, it is essential to establish treatment goals acceptable to both the patient and care giver and to choose appropriate outcome measures that will show the benefits of the treatment. Differences between the perceptions of patients and care givers of what constitutes a desirable treatment goal, and poor perception of asthma control by both patient and physician, hinder optimal treatment of asthma. The use of objective outcome measures in pediatric asthma generally can provide a good evaluation of asthma severity as well as a basis for setting treatment goals that are acceptable to patients and care givers alike. Objective measurements that assess airway inflammation, which is the fundamental pathophysiology in asthma and the underlying mechanism for chronic airway remodeling, may be the most useful means for gauging pediatric asthma control and evaluating response to treatment. Techniques such as exhaled nitric oxide analysis, bronchoalveolar lavage, and sputum analysis, although used primarily in research, have successfully identified the level of airway inflammation in children. Furthermore, the association of meaningful outcome measures with education about the long-term effects of uncontrolled asthma and the need for anti-inflammatory treatment should help in developing treatment goals and strategies that will be acceptable to both patient and care giver.