Personal Care Routines Research Articles

Comparing specialist early years provision for speech and language impaired children with mainstream nursery provision in the UK – an application of the Early Childhood Environment Rating Scale (ECERS)

This study examines the application of the Early Childhood Environment Rating Scale (ECERS) to specialist early years provision for children with developmental speech and language impairment. The scale, which has been used in the national Effective Provision of Pre-school Education (EPPE) study in the UK comprises seven subscales describing the quality of provision along a continuum centred on the following areas: 'space and furnishings', 'personal care routines', 'language reasoning', 'activities', 'interaction', 'program structure', and 'parents and staff'. The ECERS was applied to two nurseries funded by the UK charity I CAN by two researchers with inter-rater-reliability coefficients ranging from 0.91 to 0.96. There were notable differences between the specialist early years provision and 'average' nursery provision in the UK. On 7/8 measures the early years centre scores are markedly higher than average pre-school provisions. The standard of education and care for the pre-school provisions included in the EPPE project ranged from below minimal (for the diversity subscale, ECERS-E) to approaching good (for the space and furnishings subscale). In contrast, the early years centres were rated as between minimal to good on areas such as space and furnishings and good to excellent on all other areas. Clearly specialist services such as those described offer something different from the average. Given results which suggest the positive effects on the children's language abilities of such services it is quite possible that the distinctive characteristics of the nursery environment are responsible for the positive impact. There is a good case for extending the application of the ECERS as a way of helping those providing specialist services start to detect the active ingredients of the provision.

Brief training to promote the use of less intrusive prompts by nursing assistants in a dementia care unit.

We evaluated the efficacy of a brief staff-training procedure to increase the use of graduated prompting by 2 certified nursing assistants (CNAs) while they helped to dress 3 persons with dementia in a seven-bed dementia care unit. The multiple baseline design across participants showed that CNAs dressed residents with minimal resident involvement during baseline observations. Following brief in-service training, CNAs provided graduated prompts and praise appropriately, suggesting that CNAs can promote active involvement in personal care routines by older adults with dementia.

Timed-event sequential analysis of agitation in nursing home residents during personal care interactions with nursing assistants.

Computer-assisted behavioral observation data were collected from 66 nursing home residents while they received assistance during personal care routines from a certified nursing assistant (CNA). Data were collected both before and after a comprehensive behavior-management and communication-skills training program was delivered to the nursing staff. A total of 30 residents showed 6 or more episodes of disruptive vocalization or other forms of agitation during baseline observations, and timed-event sequential analysis methods were used to test whether certain CNA behaviors either elicited or prevented onsets of agitation in these 30 residents. Simple verbal prompts used by CNAs during personal care routines before staff training were found to elicit agitation onset ( p =.03), whereas positive statements to the resident were found to reduce the likelihood of agitation onset (p =.02). In a previous analysis of the effects of staff training, we found that rates of resident agitation were significantly lower after training compared with baseline and that CNAs increased their rates of positive statements to residents. In the present study, timed-event sequential analyses indicated that the verbal prompts used by CNAs during personal care routines were no longer associated with an increased rate of resident agitation after staff training among the 20 residents who showed 6 or more episodes of agitation both before and after staff training. These findings suggest that the staff training program improved the quality of CNA verbal prompts. The sequential analysis of observational data provides an important method for studying interpersonal interactions, including those of nursing home residents and the nursing staff who care for them.

Early childhood environment rating scale

The ECERS -- R has been expanded to 43 items and includes many improvements that will make this widely used resource even more valuable to early educators. Examples of new items include: Interaction items, such as staff-child interactions, interactions among children, and discipline -- Curriculum items, such as nature/science and math/number -- Health and Safety items -- More inclusive and culturally sensitive indicators for many items -- More items focusing on staff needs -- and much more. The scale is conveniently organized under seven categories: Space and Furnishings, Personal Care Routines, Language-Reasoning, Activities, Interactions, Program Structure, Parents and Staff.