Direct Observation Measures Research Articles

What do we know about physical activity in infants and toddlers: A review of the literature and future research directions

Summary Objectives To search the literature for studies evaluating physical activity levels and sedentary behaviours in infants and toddlers, thus in children under the age of three. News Only two studies could be located, evaluating physical activity levels in this young age group and only four studies could be identified looking into sedentary behaviours in infants and toddlers. The limited evidence shows that TV viewing is already common and that the time spent in moderate to vigorous physical activity is limited in infants and toddlers. Prospects and projects To gain a comprehensive understanding of physical activity and sedentary behaviour during the toddler and infant years, more research is needed. Due to the short intermittent bursts of activities of young children, only direct observation or objective measures, like accelerometers, should be used to define activity levels in infants and toddlers. However, studies on the validity and feasibility of accelerometers in toddlers and infants are lacking. Conclusion More research is needed to improve understanding of basic aspects and valid measurement of physical activity and sedentary behaviours in infants and toddlers. Efforts to promote physical activity and to minimize sedentary behaviour (e.g., media use) in infants and toddlers are advocated.

A Comparison of the Instructional Context for Students with Behavioral Issues Enrolled in Self-Contained and General Education Classrooms

Students with emotional and behavioral disorders (EBD) are often placed into self-contained settings to provide more focused academic and behavioral supports. Little is known, however, about differences in the instructional contexts of self-contained and general education classrooms. Using direct observation and self-report measures, the present study investigated disparities in the practices used to support the academic and social achievement of students with and at risk for developing EBD across settings. Results indicated that teachers in self-contained settings were able to provide a greater amount of instruction in small-group settings. However, there were no differences found in the use of effective instructional strategies or practices. Findings are discussed within the context of the academic and behavioral needs of students within the sample.

Assessment of Feeding Problems in Children with Autism Spectrum Disorders

Feeding problems are common among children with autism spectrum disorders (ASD), but the assessment of feeding behavior in this population has received little attention. Currently, two of the most promising psychometric assessments of feeding problems in children and adolescents with ASD are the Brief Autism Mealtime Behavior Inventory (BAMBI) (Lukens and Linscheid Journal of Autism and Developmental Disorders 38:342–352, 2008) and the Parent Mealtime Action Scale (PMAS) (Hendy et al. Appetite 52:328–339, 2009). The BAMBI addresses common feeding problems exhibited by children and adolescents with ASD and the PMAS addresses parent behavior associated with child mealtime problem behavior. Additionally, there are direct observation measures that assess feeding problems. The current definition for pediatric feeding problems in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revisions [DSM-IV-TR]; American Psychiatric Association [APA] 2000) is limited and incomplete when assessing feeding problems in children with ASD; however, proposed changes to diagnostic criteria may lead to more accurate assessment of feeding problems in this population.

The Census of Social Institutions (CSI): A Public Health Direct Observation Measure of Local Land Use

This manuscript describes the development of the Census of Social Institutions (CSI), a reliable direct observation parcel-level built environment measure. The CSI was used to measure all non-residential parcels (n = 10,842) in 21 one-mile-radius neighborhoods centered around census block groups of varying income and ethnicity in a large metropolitan area. One year test-retest and inter-rater intra-class correlations showed high reliability for major use type and detail code observations. The CSI accurately captured the presence of about 9,500 uses, including 828 multiple major use and 431 mixed major use parcels that would have been missed in standard commercial databases. CSI data can be utilized to determine the health impacts of environmental settings.

A Comparison of Students With Behavior Challenges Educated in Suburban and Rural Settings: Academic, Social, and Behavioral Outcomes

The authors compared the characteristics of early elementary age students educated in either rural or suburban schools who were identified as showing soft signs of emotional or behavioral disorders according to systematic screening procedures. The authors followed 134 kindergarten, first grade, and second grade students identified by these screening tools over a 3-year period to determine (a) the academic, social, and behavioral characteristics of students served in each of these locales and (b) how they progressed over time. The results indicated very few differences in performance patterns for students educated in rural and suburban communities. In general, students were within average performance levels, mostly declining or remaining stable over time on the majority of student-completed and direct observation measures. Teacher-completed measures indicated progress in some areas. Limitations, future directions, and educational implications are offered.

Video analysis of dogs with separation-related behaviors

Separation-related behaviors are described as problematic behaviors that occur exclusively in the owner's absence or virtual absence. Diagnosis is generally based on indirect evidence such as elimination or destruction that occurs during owner absence. Questionnaire studies are based on owner perception and might therefore underestimate the actual proportion of dogs with separation problems. The aim of this study was to film dogs with separation-related problems when left home alone and compile objective information on behaviors exhibited. Twenty-three dogs, ranging in age from 5 months to 13 years (2.9 ± 22.7 years), were filmed home alone for 20–60 min (49.87 ± 12.9 min) after owner departure. Analysis of behaviors on tape showed that dogs spent most of their time vocalizing (22.95 ± 12.3% of total observed time) and being oriented to the environment (21 ± 20%). Dogs also exhibited panting (14 ± 18%), were passive (12 ± 27%) and were destroying (6 ± 6%) during owner absence. Most dogs displayed signs within less than 10 min after owner departure, such as vocalizing (mean latency 3.25 min) and/or destroying (mean latency 7.13 min). Barking and oriented to the environment tended to decrease (respectively p = 0.08 and p = 0.07) and conversely panting tended to increase over time ( p = 0.07). Diagnosis of separation-related problems is traditionally dependant on owner reports. Although owner observation may be informative, direct observation and standardized behavioral measurement of dogs with separation-related problems, before and after treatment, would be the best way to diagnose and to measure behavioral improvement.

Classroom Observations and Effects of Reading Interventions for Students at Risk for Emotional and Behavioral Disorders

This study investigated the effects of small-group reading interventions, implemented within a schoolwide positive behavior support model, on elementary students with and without risk for emotional and behavior disorders. Participating schools and students were part of a larger randomized controlled group study. A subset of the larger study, four experimental and four comparison schools, participated in this current study. Participants included 117 first- through third-grade students who were identified through a systematic screening process as having reading or behavior/reading risk. Direct observation and reading performance measures yielded several important outcomes. Students receiving small-group interventions within the experimental group spent more time in small-group instruction and during that instruction were more actively engaged in reading aloud and academic responding. These differences translated into differential gains between groups on the Dynamic Indicators of Early Literacy Skills—DIBELS nonsense word fluency and oral reading fluency measures. In addition, with intensive small-group reading interventions, students with the combined behavior/reading risk were as responsive to the intervention as students with reading risk alone. No differences were recognized for student conduct or for reading outcomes on the Woodcock Reading Mastery Test. Implications for future research and practice are discussed.

Visualizing the Lower Critical Solution Temperature Phase Transition of Individual Poly(Nipam)-Based Hydrogel Particles Using Near-Infrared Multispectral Imaging Microscopy

This manuscript reports the use of near-infrared multispectral imaging (NIR-MSI) microscopy to provide the first direct observation and spectral measurement of individual poly(n-isopropylacrylamide-co-acrylic acid) (NIPAM-co-AAc) hydrogel particles. The high sensitivity and high spatial resolution (approximately 0.9 microm/pixel) of the NIR-MSI microscope, coupled with its ability to measure images and spectra directly and simultaneously, allows the unprecedented in situ monitoring of the size, morphology, and spectroscopic properties of individual hydrogel particles, which respond strongly to external stimuli (e.g., changes in temperature and/or pH). Importantly, this novel technique allows, for the first time, the direct measurement of the lower critical solution temperature (LCST) phase transition of individual hydrogel particles rather than that of a collection of hydrogel particles. Furthermore, NIR-MSI measurements reveal that the LCST value is unique for each individual hydrogel particle, depending strongly on particle size, with larger particles exhibiting higher LCST values.

Randomized trial of hyperbaric oxygen therapy for children with autism

Autism Spectrum Disorders (ASDs) are characterized by the presence of impaired development in social interaction and communication and the presence of a restricted repertoire of activity and interests. While numerous treatments for ASDs have been proposed, very few have been subjected to rigorous scientific investigation. Hyperbaric oxygen therapy (HBOT) has been recently popularized as a treatment for the symptoms of ASDs. The purpose of this study was to test the hypothesis that HBOT would have a beneficial effect on ASD symptoms in the context of a double-blind placebo-controlled trial. This randomized double-blind placebo-controlled trial compared HBOT used to deliver 24% oxygen at 1.3 atmospheric pressure ( n = 18) to placebo ( n = 16) in children with Autistic Disorder. Both direct observational measures of behaviors symptomatic of autism and standardized psychological assessments were used to evaluate the effects of the treatment. No differences were detected between HBOT and placebo groups across any of the outcome measures. The present study demonstrates that HBOT delivered at 24% oxygen at 1.3 atmospheric pressure does not result in a clinically significant improvement of the symptoms of Autistic Disorder.

Physical activity and inactivity in Girl Scouts Juniors troop meetings

Purpose: To describe the environmental context, physical activity, and inactivity levels in Girl Scout Junior troop meetings. Methods: Forty-two girls (mean age 10.8 ± 1.2) from four troops wore accelerometers during 28 meetings. Physical activity (PA) and sedentary behavior (SED) were assessed during a six-month period. Minutes spent in sedentary, light, moderate, and vigorous PA were summed and averaged. Direct observation measures assessed the environmental context of activity/inactivity. Results: In an average troop meeting, girls spent 94.4 min of time in SED, 26.3 min in light physical activity (LPA), and 2.0 min in moderate-to-vigorous physical activity (MVPA). There was no significant difference for time spent in PA at various levels among girls of different socio-economic status, racial/ethnic background, or weight status (F [3,238] .05). Troop leaders were more likely to discourage PA (0.6% of time) than to promote PA (0.0%), and no PA related educational content was observed. Conclusion: Girls accumulated two min MVPA, and >90 min SED per meeting. Based on our observations, these troop meetings currently are missing opportunities to contribute positively to the health and fitness of attending girls. Interventions providing opportunities for enjoyable PA specifically catering to needs and interests of girls are warranted.

Effect of Behavioral Intervention on Comorbid General Anxiety Disorder and Parkinson's Disease

A multiple-baseline, across-behaviors experimental design was used to evaluate the effects of a multicomponent behavioral intervention for anxiety secondary to Parkinson's disease (PD). A 67-year-old man with an 18-year history of PD, a 13-year history of anxiety, and meeting DSM-IV-TR criteria for general anxiety disorder (GAD) took part in the study. Dependent variables were the Clinical Anxiety Scale (CAS), Subjective Unit of Discomfort (SUD) ratings, and the Behavioral Relaxation Scale, a direct observation measure of relaxed behavior. Systematic increases in relaxed behavior with corresponding reductions in SUD ratings and CAS scores were obtained following Behavioral Relaxation Training (BRT). Further decreases in SUD ratings occurred following BRT + Imagery and BRT + Coping. Generalization assessment of relaxed behavior in the home environment indicated 78% relaxed. Social validity ratings, obtained by a “blinded” rater during neuropsychological assessment, indicated the patient was as “calm as other individuals.” Behavioral intervention was rated as highly acceptable. Behavioral intervention was beneficial in reducing anxiety beyond that obtained by medication alone. Further research replicating these findings is needed.

Measurement of problem behaviour during medication evaluations

The focus of this review is on methods that are currently being used to evaluate the behavioural effects of medication for individuals with intellectual disabilities. First we describe what has been identified as the ideal criteria for conducting clinical trials and how these criteria may be adapted to do less controlled evaluations. The central theme is a review of the biological measures (e.g. labs, drug levels), behavioural rating scales and direct observation measures that are often used to evaluate medication effects. Issues related to how the side effects of medication can affect behaviour will also be discussed. The importance of encouraging communication and collaboration across all systems of care and the use of socially valid measures are discussed.

The Paradox of Prader Willi Syndrome: A genetic model of starvation

Aims: To review the mechanisms that may explain the excessive eating behaviour observed in people with Prader Willi Syndrome (PWS) and the change in the ‘behavioural phenotype’ noted in infancy. Methods: The findings from different studies will be reviewed including those using direct observation and behavioural measures, those involving brain scanning technologies, and studies investigating the peripheral and hypothalamic feeding pathways. Results: Abnormalities of eating behaviour are universally found in people with PWS. The change from a failure to thrive in infancy to the later phenotype (characterized by excessive eating behaviour), occurs gradually from as early as one year of age. Underpinning the over‐eating behaviour is an abnormal satiety response to food intake with limited changes in feelings of hunger and fullness after normal or excessive food intake, and an absence of changes in patterns of brain activation, measured using PET and MRI scanning technologies, which are observed in people without PWS. Whilst abnormalities have been observed in the peripheral feeding pathway (increased levels of the appetite stimulating hormone ghrelin) at present the cause of the abnormal satiety response in PWS remains unclear. Discussion: In an hypothesis paper published in 2003 we proposed that these various observations, when taken together with the observed relative insufficiency of sex and growth hormones, could be explained by people with PWS responding as if in a state of chronic starvation. The difference for people with PWS was that they lived in a food rich, rather than a food poor environment. We hypothesized that this model of starvation could also explain the early phenotype and the intellectual disabilities observed.

Direct observation measurement of drowning risk exposure for surf beach bathers

Because not all persons bathe at surf beaches, drowning rates based on resident population are likely to be underreported. To facilitate more precise drowning risk exposure data, this study aimed to develop a reliable direct observation measure of frequency and duration for surf beach bather exposure to water, by gender and age group. Bathers were defined as persons entering the water to wade, swim or surf with equipment. Observed bathers were systematically selected entering the water in daylight hours at six patrolled or unpatrolled beaches over 10 days. Variables measured were: weather and water conditions, water entries, duration of water exposure, water exposure location and person factors. The dataset comprised 204 (69.6%) males and 89 (30.4%) females, with males more likely to be in an older age group ( p < 0.05). Compared to females, males spent longer in the water, were more likely to use surfing equipment, and mainly used a surf zone located farther from the shore in deeper water ( p < 0.05). Two factors were significant predictors of bathing duration (adjusted R 2 = 0.45): main surf zone occupied (based on water depth and distance from shore); and surf equipment used. The study provides new information about water exposure for bathers at surf beaches and new methods for measuring exposure to drowning risk. The findings suggest that overrepresentation of adolescent and adult males in surf beach drowning statistics is in part a product of greater total exposure to the water plus more frequent exposure to deeper water and bathing farther from shore.

The family check-up with high-risk indigent families: preventing problem behavior by increasing parents' positive behavior support in early childhood.

Seven hundred thirty-one income-eligible families in 3 geographical regions who were enrolled in a national food supplement program were screened and randomized to a brief family intervention. At child ages 2 and 3, the intervention group caregivers were offered the Family Check-Up and linked parenting support services. Latent growth models on caregiver reports at child ages 2, 3, and 4 revealed decreased behavior problems when compared with the control group. Intervention effects occurred predominantly among families reporting high levels of problem behavior at child age 2. Families in the intervention condition improved on direct observation measures of caregivers' positive behavior support at child ages 2 and 3; improvements in positive behavior support mediated improvements in children's early problem behavior.

Directly Observed Physical Activity Levels in Preschool Children

Millions of young children attend preschools and other structured child development programs, but little is known about their physical activity levels while in those settings. The purpose of this study was to describe the physical activity levels and demographic and school-related correlates of physical activity in children attending preschools, using a direct observation measurement system. The Observational System for Recording Physical Activity in Children-Preschool Version was used to measure physical activity levels and related factors in four hundred ninety-three 3- to 5-year-old children in 24 preschools. A minimum of six hundred 30-second observation intervals were recorded for each child. Physical (height/weight) and demographic data also were collected. Children engaged in moderate-to-vigorous physical activity (MVPA) during less than 3% of the observation intervals and were sedentary during more than 80% of the observation intervals. Boys were more likely than girls to engage in MVPA (p = .01), and 3-year-old boys were more active than 4- and 5-year-old boys (p = .01). The preschool that a child attended explained 27% of the variance in activity levels. The study indicates that young children are physically inactive during most of their time in preschool. The preschool that a child attended was a stronger predictor of physical activity level than any other factor examined. Additional research is needed to identify the characteristics of preschools in which children are more active.

Characterization of Everyday Functioning in Mild Cognitive Impairment: A Direct Assessment Approach

Aims: To evaluate the degree and pattern of functional difficulties in mild cognitive impairment (MCI) via direct observation of everyday task performance. Methods: MCI (n = 25), mild Alzheimer’s disease (AD; n = 25), and control (n = 18) participants performed three everyday tasks of increasing complexity. Results: Although caregivers reported no functional difficulties in MCI, direct observation measures of overall impairment and total errors showed MCI participants performed worse than controls, but better than AD participants, even on simple tasks. MCI and control participants exhibited significantly more difficulty performing steps accurately (i.e. commission errors) than completing task steps (i.e. omission errors), but AD participants showed an even distribution of commissions and omissions. Conclusions: Diagnostic criteria for MCI should specify mild functional deficits due to the inefficient and imprecise execution of task steps. Functional deficits characterized by omission of major task segments may indicate a diagnosis of dementia.

The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve staff interactions with children at two group foster care homes. Method: Staff at both homes were trained, and direct observation measures were obtained on positive and negative interactions and lack of interactions. A multiple-baseline design across homes was used to assess staff interaction behavior. Results: Increases in both positive interactions and tool use were observed in the treatment phase, as were decreases in negative interactions for both group homes. Conclusions: The results suggest that training direct care staff, including social workers, to use behavioral strategies change patterns of interaction, resulting in a greater likelihood of improved relationships between staff and children.

Direct Observation of Behavior: A Review of Current Measures for Use with Older Adults with Dementia

This review article reports on methods of direct observation of behaviors for use in long-term care settings, particularly with older adults who have dementia. This article provides information on the theoretical roots, administration methods, and psychometric properties of measures of direct observation of individual behavior. It is hoped that this review will help gerontological nurses make informed choices about the direct observation measures that suit their specific needs, highlight the role of direct observation in quality improvement for dementia care, and facilitate a balance between identifying a gold standard and allowing flexibility to assess project-specific behaviors.

A PRACTICAL AND LOW COST MICROBIOTEST TO ASSESS THE PHYTOTOXIC POTENTIAL OF GROWING MEDIA AND SOIL

For routine toxicity testing of composts and growing media, two different types of assays are usually applied. One approach is the use of growing trials in pots with various mixtures of the material. In extract-based tests, seeds are germinated in petri dishes and exposed to an exudate from the material to be tested. In this study, one of these methods, the Phytotoxkit microbiotest, was compared to the standard phytotoxicity test with Lactuca sativa as used by the RHP foundation. The Phytotoxkit test was performed in transparent test containers which allow for direct observation and length measurements of the seedlings by means of image analysis. Two dicotyles (Lepidium sativum and Sinapis alba) and one monocotyle (Sorghum saccharatum) were used. When measuring a presumably phytotoxic bark, in comparison with a reference bark, the Phytotoxkit showed a seedling length inhibition of 60?80% for the dicotyles and less than 20% for the monocotyle after three days. The RHP growing trial showed 30% weight inhibition of the lettuce after two weeks of plant growth when comparing the same barks in mixtures. This preliminary comparison showed that the Phytotoxkit microbiotest is a quick and practical bioassay with a high resolution which has a potential to become an international standard.