Provision Of Related Services Research Articles

Exploring the Impact of School-Based Interprofessional Parent Education

ABSTRACT This study evaluated an educational program designed to enhance parents’ understanding of related services provided within a school-based setting. The program sought to empower parents of children receiving special education services by fostering an understanding of interprofessional team roles of school-based related service providers. This one-time, two-hour program was developed using the comprehensive and client-centered Person-Environment-Occupation-Performance model to ensure that relevant topics were covered. A pretest-posttest design, utilizing Parent Knowledge and Parent Confidence Assessments, was employed to evaluate the program. Additionally, three open-ended questions collected qualitative information on the program’s impact. Quantitative analysis showed a statistically significant improvement in parent knowledge (p < .001). Additionally, after the program, parents reported an average confidence rating of 4.62 out of 5 on a 5-point Likert scale. Analysis of the qualitative data supported an increase in caregiver’s advocacy capacity. Based on preliminary results, the educational program significantly improved caregiver understanding and confidence. This enhancement is expected to positively impact future interactions with the interprofessional team during Individualized Education Program meetings.

Pilot educational intervention for the care of adolescents with autism spectrum disorder during puberty

ABSTRACT Puberty is a particularly vulnerable time for individuals with autism spectrum disorder (ASD) during which baseline challenges are exacerbated, functioning often deteriorates, and additional barriers emerge. Specific concerns include increased vulnerability, decreased safety, and increased mood and behavioral disturbances. Youth with ASD need guidance and explicit instruction/skill development on topics such as hygiene/self-care, appropriate sexual activity, and menstruation management. Lack of provider preparation, knowledge, and confidence, along with stigma about the needs and capabilities of individuals with ASD, are major barriers to care. Initiatives to expand the preparation of health care personnel, including nurse practitioners, to provide quality care to individuals with ASD are essential. This article describes the results of a pilot project using a brief, self-guided educational intervention for developing and practicing family nurse practitioners. Before and after viewing the educational module, participants completed author-created surveys assessing their self-perceived knowledge, attitudes, and intent to change practice. Expert analysis of survey items provided face validity. Comparison of mean presurvey and postsurvey responses showed significant increases in self-perceived knowledge, attitudes, and intent to implement practice changes. Lack of confidence was endorsed as the most common remaining barrier to change. Findings indicate that the brief module improved participants' self-reported knowledge, attitudes, and intent to implement practice recommendations. Such interventions can be easily incorporated into nursing education and professional development and are appropriate for dissemination to including nurse practitioners working within and outside primary care settings, as well as to related service providers.

Understanding Early Intervention and Early Childhood Special Education Professional Access to and Utilization of Evidence-Based Practices

ABSTRACT Federal legislation and regulations addressing educational practices have provided clear mandates that educators when designing educational intervention use systematic decision-making processes to identify instructional strategies and methods that are evidence based. This study employed a survey to examine how familiar early interventionist/early childhood educators, who serve young children aged birth to eight, seek information on evidenced -based practices (EBP) prior to implementing a practice. This study also explored methods that educators use and prefer to access information about EBPs. A total of 223 educators completed the survey that included four identified subgroups (teachers, related service providers, administrators, and faculty/researchers/trainers). We found that most respondents, across the groups, reported being familiar or somewhat familiar with research evidence for their practices and chose discussion with colleagues as the most frequently used strategy to learn and make decisions about a new practice. Implications for future research and professional development are discussed.

“Experiences of Occupational Therapists with the Every Student Succeeds Act”

ABSTRACT In the United States, school occupational therapists serve as related service providers under the Individuals with Disabilities Education Act and specialized instructional support personnel (SISP) for all students under the Every Student Succeeds Act (ESSA). Since ESSA was enacted in 2015, there has been limited research on school occupational therapists’ understanding and application of their professional expertise to support all students. Given the gap in research, this study focused on facilitators and barriers to school occupational therapy practitioners’ participation in Connecticut public school settings. A convenience sample identified five school occupational therapists. Participation involved engagement in a 6-week program, including 10-minute asynchronous learning activities and 30-minute synchronous virtual meetings. Methods included a pre/post-intervention survey, a weekly questionnaire, and a thematic analysis of recordings. Findings indicated that program course content and activities led to improved insight on ESSA. The program revealed the following themes: there are benefits in ESSA involvement, further education on ESSA is warranted, engagement in ESSA occurs more than realized, and barriers may not be as significant as initially perceived. Qualitative findings identified themes for school occupational therapists to increase their participation in ESSA.

Assessing Health Equity in Partnership with Children's Mental Health Organizations: Considerations Before the Implementation of Parenting Programs.

Understanding and addressing how an individual's social, political, economic, and cultural context affects their ability to achieve optimal health is essential to designing and implementing interventions. Before evaluating two parenting programs, in partnership with four children's mental health organizations, we used the Health Equity Impact Assessment tool (HEIA) to identify groups that may experience unintended health impacts, as well as generated mitigation strategies to address these impacts. HEIA activities included a review of the published literature, a review of organizational documents, key informant interviews with staff (n = 12) and other related community service providers (n = 7), and a geographic information systems analysis. All sources of evidence were considered and analyzed using reflective thematic analysis. Summary reports were shared with all partners. A range of groups were identified as at risk of experiencing unintended health impacts, including caregivers who are racialized, immigrants, Indigenous, living with mental health issues or addictions, dealing with intellectual challenges and/or low literacy levels, survivors of childhood trauma, single parent families, or families experiencing financial difficulties. Unintended health impacts were sorted into 6 main themes which fell under the overarching themes of accessibility of the programs and cultural appropriateness. Mitigation strategies as well as innovative strategies already being applied by participating organizations are discussed. Although this HEIA focused on parenting programs, the findings address equity issues applicable to the provision of a wide spectrum of children's mental health services.

“. . .We’re Not Doing Enough:”: Trauma-Informed Care in an Early Childhood Special Education Center

Young children with disabilities experience trauma at high rates. To mitigate and address the negative effects of trauma on young children’s development, systematic implementation of trauma-informed care is needed. In schools, it is important that all staff members at every level are trained to implement trauma-informed care. In this qualitative study, we explored the experiences of ECSE professionals in one center, including administrators, teachers, paraprofessionals, and related service providers, as they planned and implemented trauma-informed care. We used Bronfenbrenner’s ecological systems theory to guide the design of the study. Our findings suggest that ECSE professionals are impacted by factors at the micro-, meso-, exo-, and macrosystem level of the environment, which influenced the extent to which they were able to successfully implement trauma-informed care.

Preliminary Investigation of the Relationship of Ivymount Social Cognition Instructional Package (IvySCIP) to Similar Assessment Tools and Impact on Students with High Functioning Autism

Abstract Ivymount Social Cognition Instructional Project (IvySCIP) supports teachers and related service providers to implement data-driven social and emotional learning (SEL) instruction for their kindergarten through 5th grade students with social cognition challenges, especially those with high functioning autism spectrum disorders (HF-ASD). Based on comprehensive assessment of students’ SEL strengths and needs, IvySCIP identifies instructional priority areas, generates individualized education plan (IEP) goal recommendations, and enables SEL progress monitoring. In order to begin establishing the psychometric properties of the IvySCIP strengths and needs assessment, we examined correlations between participants’ scores on IvySCIP and their scores on similar tools. As predicted, strong correlations emerged between IvySCIP and other tools. We also examined the impact of using IvySCIP over a 20 week period to facilitate SEL in students with HF-ASD. IvySCIP was piloted with 53 instructor/student pairs broken into two groups. The first group received 20 weeks of access to IvySCIP and the latter received 10 weeks of access. While pilot study outcomes suggested that there were no significant differences between the groups, all students made significant SEL progress over the course of the 20 week study as measured by IvySCIP and similar tools. Social validation surveys indicated that instructors perceived IvySCIP to be innovative, valuable, and an effective means of improving SEL instruction for students.

The Need for Occupational Therapist Eligibility for Formal Administrative Roles in Public School Systems.

In 45 of 50 states, occupational therapists are not eligible to pursue formal administrative positions in public school systems (e.g., director of transition services, special education director) on the basis of state-level legislation and credentialing. Most state boards of education, however, recognize other related service providers (e.g., speech-language pathologists, social workers) as credentialed educators. Most states require education credentials to pursue further administrative credentials and, thus, administrative positions. Occupational therapists and other stakeholders lack awareness of this issue. In this column, I summarize the issue; identify occupational therapists' qualifications for eligibility to pursue these positions; and provide solutions, primarily at the state level, to effect change so occupational therapists can be recognized as equals to their related service provider peers and use their unique skill set to influence public school communities as administrators.

Digital Zero-Price Market – VAT Consequences

In Italy, criminal proceedings and large VAT assessments have been initiated against IT service providers in relation to the free access to their apps/platforms aimed at collecting users’ data. However, in the view of the authors, there is currently no legal ground to consider this a supply of services relevant for VAT given the lack of a legal relationship pursuant to which there is a reciprocal performance (exchange of a consideration versus an economically valuable supply).

Provision of drug and alcohol services amidst COVID-19 pandemic: a qualitative evaluation on the experiences of service providers

BackgroundThe impact of COVID-19 pandemic on the provision of drug and alcohol (D&A) services and associated outcomes have been under-researched.AimThis study aimed to understand the experiences of service providers in relation to how drug and alcohol (D&A) services were affected during COVID-19 pandemic, including the adaptations made and lessons learnt for the future.MethodFocus groups and semi-structured interviews were conducted with participants from various D&A service organisations across the UK. Data were audio recorded, followed by transcription and thematic analysis.ResultsA total of 46 participants representing various service providers were recruited between October and January 2022. The thematic analysis identified ten themes. COVID-19 required significant changes to how the treatment was provided and prioritised. Expansion of telehealth and digital services were described, which reduced service wait times and increased opportunities for peer network. However, they described missed opportunities for disease screening, and some users risked facing digital exclusion. Participants who provided opiate substitution therapy service spoke of improving service provider/user trust following the shift from daily supervised treatment consumption to weekly dispensing. At the same time, they feared fatal overdoses and non-adherence to treatment.ConclusionThis study demonstrates the multifaceted impact of the COVID-19 pandemic on UK-based D&A service provisions. The long-term impact of reduced supervision on Substance Use Disorder treatment and outcomes and any effect of virtual communications on service efficiency, patient-provider relationships and treatment retention and successes are unknown, suggesting the need for further study to assess their utility.

There’s No Place Like Us: Beyond Fidelity of Implementation in Rural Contexts

Rural schools experience difficulty in filling teaching positions at higher rates than non-rural schools. Recruiting and retaining teachers are critical in these districts; however, because the term “rural” is variable, a one-size-fits-all response is not possible. Rural communities tend to be geographically remote, have a low critical mass of students with distinct disabilities, and have relatively few resources to provide differential support for students. In this context, special educators may find themselves in circumstances where they operate as general specialists who are responsible for addressing a broad range of student needs without the support of other related service providers (e.g., school psychologists, curriculum specialists, school counselors, speech and language pathologists). Garwood’s article provides a catalyst to consider ecological system factors that affect burnout, attrition, and, as a consequence, instruction, particularly for students with disabilities. In this response, we view this issue from a perspective of rural schools, where the system contexts are varied and directly impact teacher-level variables, such as the ability to implement evidence-based practices (EBPs) with fidelity. Taking a developmental systems approach, we describe what makes rural settings unique and how these characteristics interact with the critical features of EBPs, as well as suggest how preparation and induction programs might better prepare and sustain teachers to adapt instruction to these rural contexts. We conclude with implications for practice and policy.

Performance of the Severely Challenged High School Students Using Modified Curriculum and Vocational Life-Skills Curriculum

This study was focused on the most effective means of educating severely challenged students. The study compares the effectiveness of the Modified Curriculum or a Vocational Life-Skills Curriculum in helping the student attain independence and success after educational or training services. This is conducted in Central Maryland, USA, High School classrooms. This endeavor helps guide parents and other stakeholders, educators, related service providers, and policymakers in determining the most effective way to educate or train students with severe cognitive and physical limitations. This study is important because it addresses the different curricula that may be used for a successful and meaningful classroom experience for severely challenged students. This study helps teachers to implement a curriculum that best serves this population. The study shows that Modified Curriculum and Vocational Life Skills Training are effective for students with Severely Challenged Students if implemented with ample time, resources, planning, and collaboration between Special Educators, Instructional Supports, Other Health Providers, and Parents/Guardians. There’s no significant difference in the performance of the respondents before and after using the Modified Curriculum and Vocational Life Skills Training curriculum.

“It’s a Touchy Subject”: Service Providers’ Perspectives of Eating Disorders in Men and Boys

This study explores the perceptions and experiences of providers of eating disorder services towards men to understand the challenges and barriers experienced by both professionals and patients in addressing the gender bias within this field. A total of 21 professionals took part in the study. Using interviews and focus groups, the study explored service providers’ experience, understanding and knowledge in working with men with eating disorders using thematic analysis. Findings suggest that the growing issue of eating disorders affecting men, while a serious concern for practitioners, remains a ‘touchy subject’, a difficult and sometimes even uncomfortable topic for service providers to tackle. These findings provide insight into the challenges and barriers faced by professionals and men seeking help or treatment for an eating disorder and highlights the need for targeted training and resources to improve the eating disorders health literacy of service providers in relation to men’s experiences.

Implementation readiness for evidence-based autism practices in school systems.

The increase in the number of autistic children being identified has led to increased demand on public schools to provide high-quality services. Effectively scaling up evidence-based practice (EBP) use for autistic students is challenging, given the complicated organization of special education. Teachers have significant challenges implementing autism EBP with fidelity. Factors such as implementation leadership and climate and attitudes toward EBP are linked to successful EBP use and may vary at different levels of the education system. Examining mechanisms of successful implementation is a critical step to support scale-up. In this observational study, conducted from September 2018 to March 2020, California school personnel (n = 2273) at multiple levels of the system completed surveys related to implementation climate, leadership, and attitudes toward EBP. Data were collected throughout California at the Special Education Local Plan Areas, County Office of Education, and district and school levels from educators and administrators working in public schools supporting autistic students. Multi-level modeling was conducted to characterize implementation readiness. Overall, implementation climate and leadership scores are low across levels with regional levels rated more positively than districts or schools. Attitudes toward EBP were moderate, with those working in schools having the poorest ratings and specialists/trainers and related service providers (e.g., speech-language pathologists) having the highest ratings. Outcomes provide a unique opportunity to compare implementation factors across organizational levels with a large, statewide sample. These data provide guidance for developing implementation interventions at multiple levels of the education system to increase readiness for effective scale-up of autism EBP in schools. Personnel and leaders at different organizational levels may need differentiated training targeting improved implementation climate and leadership. Personnel within districts and schools may experience a particular benefit from leadership support for EBP implementation.

A Survey of Perceptions of Consulting in Inclusive Preschool Classrooms

This study examined consultants' and consultees' perspectives of itinerant service delivery for students with disabilities in inclusive preschool classrooms. Consultants (i.e., early childhood special education teachers and related service providers) and consultees (lead and assistant preschool teachers) working in inclusive preschool classrooms in a large Mountain West school district completed a survey eliciting their perceptions on consulting, including their definitions of the consulting role and factors they believed to be most important in building successful consulting relationships. Participants' answers to survey questions were analyzed and grouped into themes. There were similarities across both groups when describing the role of consultants, including assumptions that consultants should work directly with students in the classroom. Consultants and consultees also agreed that they have positive relationships with one another and that consultants are effective; however, consultant and consultee survey responses emphasized a need for respect within the consulting relationship. Understanding perceptions of consultative approaches may lead to practices and policies that improve consultative services and potentially lead to improved outcomes for preschool children with disabilities in inclusive settings.

Winning customers' hearts and minds using DFSS in the insurance industry

PurposeThis study aims to simultaneously examine customer complaints through the proposed novel Design for Six Sigma (DFSS) model which incorporates of creating the new insurance services to win customers' hearts and mind for the insurance industry.Design/methodology/approachA novel DFSS research methodology which includes the theory of inventive problem solving (TRIZ), Pugh concept selection, creative product analysis matrix and importance–satisfaction model (I–S Model) was proposed. In addition, a real insurance company case was studied to illustrate the effectiveness of the proposed DFSS model.FindingsThe results of a novel DFSS model not only can establish new services, but also can dramatically reduce the cost of resolving customer complaints.Practical implicationsThe findings of this study are useful for insurance companies and other related service providers in devising tailored strategies to offer quality and suitable services to their customers.Originality/valueThis study addresses the paucity of research and marketing gaps through the proposed novel DFSS model for the first time in the insurance industry. These study findings would enable researchers and practitioners to formulate strategies for solving customer complaints effectively and develop new services from time to time.

Progress Monitoring Data for Learners With Disabilities: Professional Perceptions and Visual Analysis of Effects

This study serves as an initial attempt to establish content validity for graphs likely to be included in trainings targeting progress monitoring for professionals serving learners with or at risk for disabilities. We created a survey containing 32 graphic displays of hypothetical learner data. These surveys were administered to a sample of special education teachers, behavior analysts, higher education faculty, and related service providers. Survey respondents rated each graph on its likelihood of being encountered in practice and whether a graph depicted a therapeutic effect. Results indicated that graphs displaying a therapeutic effect were most likely to be encountered and that graphs with variable data in either a baseline or intervention condition were associated with incorrect visual analysis determinations. Implications of our findings are discussed with respect to personnel who develop and provide trainings on analyzing learners’ progress monitoring data.

Exploring the contextual factors, behaviour change techniques, barriers and facilitators of interventions to improve oral health in people with severe mental illness: A qualitative study.

People with severe mental illness (SMI) have significantly poorer oral health compared to people without SMI and interventions targetted to improve oral health in this population failed to show any long-term improvement. Interventions are influenced by many contextual factors ranging from individual to systems level. This study aimed to understand the contextual factors, behaviour change techniques of the available oral health interventions and explore the barriers to and facilitators for engagement with these interventions from the perspectives of people with SMI (service users) and related service providers. Intervention details were extracted from 12 intervention studies identified from a previous systematic review using the template for intervention description and replication checklist (TIDieR) and behaviour change techniques (BCTs) were coded using the behaviour change technique taxonomy v1. Sixteen individual BCTs were identified and out of which “4.1 instructions on how to perform the behaviour” (n = 9) and “6.1 demonstration of behaviour” (n = 6) were most frequently used BCTs. Video vignettes prepared from the different intervention components identified from existing studies were shown to service users and service providers in dyadic or one-to-one interview format to elicit their views on barriers and facilitators for engagement with the intervention components. Interviews were analysed using Framework analysis and were guided by theoretical domains framework (TDF); and capability, opportunity and motivation (COM-B) model of behaviour change. Main facilitators identified to increase capability, opportunity and motivation of service users were the involvement of carers/care coordinators and integration of dental and mental health care, provision of oral health/hygiene information/products at an appropriate level and provision of tailored support according to individual needs and preferences. Barriers identified were related to lack of communication skills of the service providers, provision of coordinated care, lack of support in visiting a dentist and navigating the payment system and long follow up times. Appropriate training was considered as a facilitator, and staff turnovers and workload were considered as main barriers by the service providers. The findings suggest that comprehensive interventions that target barriers and enhance facilitators from individual to systems level are needed to improve oral health outcomes of people with SMI.

Circular economy digital market solutions for reuse in the European construction sector

Focusing on the cross-matching supply and demand for reused building components and related services, the paper analyses existing Digital Reuse Market Solutions (DRMS) in the European construction sector. A collection of 746 DRMS is built from major online circular economy platforms and custom online search queries. A taxonomy of 9 categories and 28 types is then extracted based on the activities of collected DRMS. Nearly half (46%) of collected DRMS are proper dealers of reused building components. Traditional building component dealers and demolition companies account for another third (32.8%). The rest is made of marketplaces, craftmanship, and providers of related services and knowledge. Only 13.4% of all collected DRMS allow online payment for goods or services.

Strengthening Professional Networks to Serve Students With Autism Who Have Communication Needs

Many students with autism have complex communication needs and benefit from the use of aided augmentative and alternative communication (AAC), which can include picture symbols, communication boards or books, or speech-generating devices. However, many of the challenges to high-quality AAC intervention are amplified by inadequate collaboration. Effective collaboration is critical, including between teachers and speech-language pathologists (SLPs), with students’ parents and other family members, and with other related service providers or specialists. This article draws from social network theory and special education research to offer practical guidelines for special education teachers and SLPs to develop and strengthen their own professional networks and more effectively serve students with autism who have communication needs. Guidance is also offered for school and district leaders. Strong professional networks can improve communication outcomes for students with complex communication needs by fostering educators’ knowledge, skills, confidence, and collective action toward effective and integrated AAC intervention.