School-based Settings Research Articles

The Efficacy of Brainspotting and Sand Therapy to Reduce Anxiety Symptoms in Children Aged 8-9

This study explored the use of Brainspotting (BSP) in combination with Sand Therapy (ST) for use with 8–to 9-year-old children with anxiety symptoms in a school-based setting. Using the Spence Children's Anxiety Scales (SCAS), The Behavior and Feelings Survey (BFS), and the Top Problems Assessment (TPA), the research project measured anxiety as reported by parents/caregivers and students, internalizing, externalizing, and total concerns as reported by parents/caregivers, teachers, and students, and finally individually identified unique concerns as reported by parents/caregivers, teachers, and students. The researcher collected data from student participants (11) who experienced six sessions of BSP and ST. The quantitative data collected identified project signifiers for future researchers. Outcomes reflected statistical significance of a reduction in anxiety scores for parents in the subscale of generalized anxiety and a significant reduction of scores in children in the subscales of generalized anxiety and separation anxiety. Parents and teachers indicated significantly lower scores in internalizing and total concerns identified across time intervals. All three groups of reporters indicated a significant reduction of top problems identified across time intervals. Outcomes demonstrate the promise of the integrated practice of BSP and ST while laying a framework for future research of this method.

Consolidating the evidence on the effectiveness of strategies to promote vegetable intake in priority settings: An overview of systematic reviews.

Effective interventions to increase vegetable intake are urgently needed. This systematic rapid review aimed to summarise the effectiveness of interventions targeting increased vegetable intakes across diverse settings. The review was guided by the conduct of rapid reviews from the Cochrane Handbook. The literature was searched in February 2024 across PubMed, Web of Science and Cochrane Central for systematic review articles published since 2014. The Risk of Bias In Systematic Reviews tool was used and characteristics of reviews synthesised narratively with intervention effectiveness results were summarised. A total of 20 systematic reviews met the eligibility criteria. Most targeted school-based settings (n = 7) or community/home-based settings (n = 4). Early childhood education and workplaces had one review each, with none in retail, secondary or tertiary education, food service, food relief or aged care. The mean change in vegetable consumption was +0.12 serves per day, with increases of up to +0.42 serves reported (range -0.09 to +0.42). By setting, the largest increases were reported for interventions in school settings (+0.42 serves/day), followed by home (+0.38 serves/day). Almost half the studies reporting effect sizes suggested no effect on intake (46%), 41% suggested a small effect and 13% suggested a medium effect. Greater effect sizes were achieved in interventions implemented across multiple settings. Review findings indicate that the average increase in vegetable intake following interventions is about one-eighth of a serve but up to almost half a serve in some settings. An increase of this magnitude could have a substantial population impact, particularly in population groups with persistently low intakes.

Evaluating the Acceptability and Impact of an Online, Lifestyle-Based Mental Well-Being Initiative Targeting School Communities in New York State - Lifting the School Community Project.

To determine the acceptability and impact of an online, lifestyle-based mental well-being initiative in a school-based setting. A post-program evaluation survey was administered after the intervention. Fifty-seven New York State school districts. Participating school districts invited all employees and community members to register for the intervention. A total of 4083 individuals participated, with 1060 (26%) responding to the post-program survey. The 7-week intervention (The Lift Project) incorporated strategies from lifestyle medicine, positive psychology and neuroscience literature. The ten lessons included online, video-based content and related experiential learning exercises. The post-program survey included Likert items that evaluated the participants' perceived program acceptability, mental health enhancement, self-efficacy, and skill acquisition. Inductive thematic qualitative analysis assessed the participants' likes and dislikes concerning the initiative. A high percentage of respondents indicated that the program improved their well-being (85%), enhanced their well-being-related self-efficacy (92%), and provided them with skills for supporting their long-term mental well-being (82%). Respondents liked the evidence-based, engaging content and design elements and the focus on personal well-being, community connection, and practical applicability. Some respondents desired more social connection, disliked certain design elements, lacked time and experienced technical issues. The initiative was acceptable and impactful, indicating that school districts may serve as an effective network for addressing the mental health epidemic.

Tri-Ponderal Mass Index (TMI)- A Reliable Anthropometric Indices for Early Screening of Adolescent Obesity in a School-Based Setting: A Cross-Sectional Study

ObjectiveThis study aimed to examine the reliability of Tri-Ponderal Mass Index (TMI) for early screening of adolescent obesity in comparison to anthropometric measures such as hip-circumference, neck-circumference, waist-circumference, waist-height-ratio, waist-hip-ratio, and body mass index. MethodsA school-based, cross-sectional study was conducted between July-December 2019 among 1101 school-going adolescents (both genders), aged 12 to 17 years in Rudrapur city of Uttarakhand. Data on anthropometric measurements was collected by using well calibrated equipment's, and age- and gender-specific BMI percentile cut-off values recommended by the Indian Academy of Pediatrics (IAP) were used to define the overweight and obesity. Statistical analysis was done using SPSS software version 16.0. Receiver operating characteristic (ROC) curve analysis was conducted, and optimal cut-off values for anthropometric measurements were determined using the Youden Index (sensitivity + specificity -1). ResultsOut of 1101 study participants 71.5% (n=787) and 28.5% (n=314) were boys and girls, respectively. The prevalence of overweight and obesity amongst adolescents was 10.4% and 4.1%, respectively. ROC curve analysis was conducted and TMI exhibited the highest Youden index both in terms of overweight (0.835) and obesity (0.869) among adolescents. The optimal TMI cut-off values for overweight and obese boys and girls were determined to be >12 kg/m³ and >14 kg/m³; >13 kg/m³ and >16 kg/m³, respectively. TMI demonstrated superior predictive capacity for early screening of adolescent obesity, as indicated by high discriminative power, sensitivity, and specificity. ConclusionsTMI can be used as the simple reliable screening tool for early screening of overweight and obesity among adolescents.

Overcoming barriers in implementing healthy school nutrition policies: insights from Ukraine

Abstract The general mortality rate from NCDs in Ukraine exceeds that in European Union countries, (Yurochko et al., 2023) exacerbated by the ongoing war. Healthy nutrition plays a pivotal role in enhancing the overall quality of life and curbing the prevalence of non-communicable diseases (NCDs). Despite its significance, ensuring healthy eating habits, particularly during the early stages of life at the period of setting lifelong habits (Jackson et al., 2020; Riley et al., 2018), remains a challenge. Besides, school-based settings represent an ideal environment for effective intervention because they offer a shared common physical, academic, and social space (Tapia-Fonllem et al., 2020). Through a series of semi-structured interviews with key stakeholders, this study identifies barriers and facilitators to policy implementation, with a focus on educational institutions. Qualitative analysis reveals barriers such as inadequate human resources, funding constraints, resistance from the food industry, and ineffective communication strategies at the family level. Moreover, there exists a disjointed understanding of nutrition standards. However, collaborative efforts with civil society, empowerment of nursing roles, strategic utilization of grants and fundraising, engagement with the food industry, and the adoption of a family-oriented approach emerge as crucial enablers for successful policy implementation. These findings offer theoretical foundations for fostering healthier nutrition environments within schools. This research serves as a roadmap for policymakers and educators striving to create sustainable and effective strategies for promoting healthy eating among early school-age children in Ukraine and beyond. Study finds human resource shortages, funding constraints, and food industry resistance as major barriers to school nutrition policy. Recommendations include collaborative approaches, nurse involvement, and aligned standards for effective school nutrition policy. Key messages • Healthy nutrition plays a pivotal role in enhancing the overall quality of life and curbing the prevalence of non-communicable diseases. • Through a series of semi-structured interviews with key stakeholders, this study identifies barriers and facilitators to policy implementation, with a focus on educational institutions.

Supporting emotion regulation in children on the autism spectrum: co-developing a digital mental health application for school-based settings with community partners.

KeepCalm is a digital mental health application, co-designed with community partners, that incorporates wearable biosensing with support for teams to address challenging behaviors and emotion dysregulation in children on the autism spectrum. We followed a user-centered design framework. Before app development, we conducted design workshops, needs assessment interviews, a systematic review, and created an Expert Advisory Board. Once we had a working prototype, we recruited 73 participants to test and help improve the app across five testing cycles. Participants rated the app across testing cycles as highly acceptable, appropriate, feasible, and with good usability. Qualitative data indicated that KeepCalm helped teachers (a) be aware of students' previously unrealized triggers, especially for nonspeaking students; (b) prevent behavioral episodes; (c) communicate with parents about behaviors/strategies; and (d) equipped parents with knowledge of strategies to use at home. We learned that in order to make the app acceptable and appropriate we needed to make the app enjoyable/easy to use and to focus development on novel features that augment teachers' skills (e.g., behavioral pattern and stress detection). We also learned about the importance of maximizing feasibility, through in-person app training/support especially regarding the wearable devices, and the importance of having aides involved. Our findings have informed plans for wider-scale feasibility testing so that we may examine the determinants of implementation to inform adaptations and refinement, and gather preliminary efficacy data on KeepCalm's impact on reducing challenging behaviors and supporting emotion regulation in students on the autism spectrum.

Early intervention speech-language pathologists’ beliefs and practices related to assessing dual language learners

IntroductionEarly intervention (EI) speech-language pathologists (SLPs) are required to provide culturally and linguistically responsive assessments for dual language learners (DLLs). However, SLPs consistently report feeling underprepared to assess DLLs and research demonstrates gaps in implementation of best practices in pediatric outpatient and school-based settings. This study was designed to understand EI SLPs’ beliefs and practices related to assessing DLLs referred to early intervention programs. MethodsA total of 132 EI SLPs completed a survey in which they were asked to describe their assessment procedures for a DLL case scenario and were further asked to identify the degree to which they agreed with a variety of assessment practices for assessing DLLs. ResultsResults revealed that EI SLPs’ beliefs aligned with best practices for assessing DLLs. However, substantial gaps exist between EI SLPs’ beliefs and their self-reported practices for assessing DLLs. ConclusionsThese results suggest DLLs may not be receiving evidence-based EI assessments, leading to the potential perpetuation of both over- and under-diagnosis of speech and language delays within this population. Implications include the need to increase the quality of EI SLPs assessment practices through additional training, the removal of systems-level barriers, and the continued need for increased training within preprofessional training programs.

The After-School Treatment Program: A School-Based Adaptation of the Summer Treatment Program

ABSTRACT Background Intensive treatments, such as the Summer Treatment Program (STP), were developed to target functional impairments of children with ADHD; however, the STP is limited in that it occurs only in the summer, and families often wish to extend the gains made into the academic year. Implementing treatment in the afterschool setting may reduce logistical barriers for families, as the treatment is embedded within the school which the child attends precluding the need to find time and funds to travel. These programs may be especially important for Latino/Hispanic youth, where both practical and cultural barriers may interfere with obtaining treatment. Objective The goals of the current study were to highlight the components of the STP that were translated to an afterschool treatment program, present the demographics of children served by the program, and include preliminary data based on child- and parent-report. Method The After-school Treatment Program (ATP) was developed in consultation with community stakeholders (e.g. school administrators, teachers) to translate components of the STP to a school-based after-school setting to help ameliorate the mental health gap of children in an elementary school in South Florida. Various components of the ATP were translated from the STP. Many components (e.g., parent training, monitoring treatment progress) were modified in consultation with community stakeholders. Feedback from both children and parents was obtained on how they liked the various components of the program. Results Overall, parents found the program to be helpful in teaching them how to set rules, and children enjoyed the various components and felt welcome at the program. Conclusions Lessons learned include working with community stakeholders to adjust programs, and using a tiered intervention system in school to identify students that have more intensive needs and may require additional assistance in the after-school setting.

Peer-to-peer leadership of physical activity in the New Zealand school-based setting: an exploration of student leader perspectives

ABSTRACT This study explored the perceptions of peer leaders participating in a peer-led physical activity (PA) initiative where student leaders conduct fitness classes for their peers. Thirty-eight participants aged 9–13 from four New Zealand elementary and middle schools were surveyed using an online questionnaire gathering both qualitative and quantitative data. Student leaders viewed the experience positively, despite the physical challenges involved, and many reported increased fitness or PA levels. Provision of regular school practice time, teacher input, and resources from the outside provider were key. The task of leading their peers placed the leaders in a supportive yet anxiety-provoking environment, which presented valuable opportunities to teach them resilience-building skills. To fully leverage the programme’s potential impact, connections to a range of curriculum learning objectives could offer more meaningful learning experiences, including resilience building, generating understanding of the benefits of PA, and developing the skills involved in group work and leadership.

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.

Conducting research on teacher professional development in partnership with educators: promises, tensions and opportunities

ABSTRACT This study aims to document how a research-practice partnership designed and carried out joint work between researchers and educators to support teacher instructional improvement. A district-wide research-based teacher professional program, grounded in research on student development of mathematical ideas, was adapted to the assets and needs of one elementary school. The primary source of data were field notes of meetings of the school instructional improvement team, involving researchers, the principal, and teacher leaders, and focused on the co-design of school-based settings for instructional support. A framework outlining key conditions of research-practice partnership success was used as an analytical tool to examine partnership design elements that support joint work towards both practice and research goals, partner practices, processes, and activities as they unfolded, and methodological tensions and opportunities. Findings highlight how centring relationships, shared goals, and relevance to practice supported researchers in gaining deep understanding of the local context and of the complexity involved in creating settings that facilitate instructional improvement within school systems. They also underscore the need for vulnerability and flexibility in researcher involvement. Future directions include supplementing data sources to examine co-design sessions discourse and through multiple perspectives and extending analyses to subsequent years of the partnership.

‘Bridge-builders’ and ‘boundary spanners’: a qualitative study of youth workers’ perceptions of their roles and practices with vulnerable young people in school-based settings

ABSTRACT This paper presents a qualitative study of 22 youth workers’ perceptions of their roles and practices in seven school-based settings in a large post-industrial city in regional Australia. Youth workers are often engaged in school-based settings working with vulnerable young people, yet knowledge of how workers perceive and conceptualize their role and practice in these settings remains limited. Through focus group interviews, youth workers were asked how they engage, and work with vulnerable students, how they conceptualize their roles and the bodies of knowledge to which those practices and roles pertain. We find that youth work in school-based settings requires the dynamic and non-linear application of the practices of youth accompaniment, family support and youth-centred advocacy, underpinned by respect for the dignity, autonomy and agency of the young person. We argue that the complex application of these practices positions youth workers as ‘bridge-builders’ and ‘boundary-spanners’. Bridge-builders assist young people to connect and engage with support services. Boundary-spanners build relationships across service providers to network different organizations and professionals for better collaboration and support of young people. These findings have implications for youth policy and practice in the area of youth work with vulnerable young people in school-based settings.

A transdiagnostic examination of cognitive heterogeneity in children and adolescents with neurodevelopmental disorders

ABSTRACT Children and adolescents with neurodevelopmental disorders demonstrate extensive cognitive heterogeneity that is not adequately captured by traditional diagnostic systems, emphasizing the need for alternative assessment and classification techniques. Using a transdiagnostic approach, a retrospective cohort study of cognitive functioning was conducted using a large heterogenous sample (n = 1529) of children and adolescents 7 to 18 years of age with neurodevelopmental disorders. Measures of short-term memory, verbal ability, and reasoning were administered to participants with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), comorbid ADHD/ASD, and participants without neurodevelopmental disorders (non-NDD) using a 12-task, web-based neurocognitive testing battery. Unsupervised machine learning techniques were used to create a self-organizing map, an artificial neural network, in conjunction with k-means clustering to identify data-driven subgroups. The study aims were to: 1) identify cognitive profiles in the sample using a data-driven approach, and 2) determine their correspondence with traditional diagnostic statuses. Six clusters representing different cognitive profiles were identified, including participants with varying forms of cognitive impairment. Diagnostic status did not correspond with cluster-membership, providing evidence for the application of transdiagnostic approaches to understanding cognitive heterogeneity in children and adolescents with neurodevelopmental disorders. Additionally, the findings suggest that many typically developing participants may have undiagnosed learning difficulties, emphasizing the need for accessible cognitive assessment tools in school-based settings.

Facilitating Inclusion for Neurodiverse Students Using Evidence-Based Practices: A Strengths-Based Approach to Sensory Regulation

ABSTRACT Educational inclusion aims to support all students through instructional and contextual designs that promote learning. Educators are assigned the task of teaching an increasingly neurodiverse population with varying neurological processes and perceptions. Traditional school-based settings are designed for individuals with less neurodivergence, and, therefore, may not adequately facilitate an environment supportive of learning for all students. Additionally, neurodiverse learners, including those with autism, may have sensory processing differences that impact occupational participation and performance. Understanding the processing differences of neurodivergent students and interventions that support those needs may facilitate successful inclusion programs. Research and data analysis confirmed the Ready to Learn and Play (RtLP) as an evidence-based framework to facilitate participation and performance for individuals with neurodiversity and sensory processing challenges, both for in-person (statistical significance p = .001) and virtual presentation of the RtLP content (statistical significance p = .00000607). Through a neuroaffirming approach to teaching, coaching, and training, RtLP may assist in supporting individuals with sensory regulation challenges to participate to the greatest extent possible in inclusive education.

Locating Australian school students in sites of curriculum making: a literature review

Young people and children are central to conceptualisations of curriculum as a social process, especially in school-based settings. However, students have tended to be on the periphery of education policy development more broadly and curriculum reform more specifically. As a more inclusive approach to engaging students in curriculum consultation processes is beginning to be taken in Australia, it is timely to gauge the extent to which students are being actively engaged as curriculum actors and research participants across the Australian curricular landscape. This article draws on Priestley et al.’s (2021) sites of curriculum making model to frame a systematised literature review of a decade of Australian academic and grey literature for the purpose of identifying the sites and activities in which students are active and/or the focus of research. The review suggests there is a small body of research on curriculum negotiation within school-based nano and micro sites of curriculum making. However, an absence of academic research related to meso and macro curriculum making means we have a limited understanding of the dynamics of the activities, interactions, contestations and power relations that constitute curriculum making in these spaces in relation to students. This article considers some of the reasons for and implications of these trends, including how existing curriculum and student voice scholarship might inform future research. It argues that a better understanding of the possibilities and challenges of student-centred curriculum making activities could assist in moving beyond superficial “consultation” methods, especially during periods of significant curriculum renewal.

Teachers’ Perspectives on Best Occupational Therapy Service Provision in School-Based Practice: A Qualitative Study

ABSTRACT There is currently limited evidence regarding teachers’ perspectives of push-in and pull-out occupational therapy services in the school-based setting. Occupational therapy services can be delivered in different combinations and often vary based on the needs of the student, needs of the teacher and classroom, need for academic time, and need for social interactions. To examine teachers’ perspectives of push-in and pull-out services, a qualitative approach was used. Thirty-nine participants were recruited using a combination of convenience, snowball, purposive, and voluntary response sampling. Data was collected via a multiple choice and open response online survey. Thematic analysis was completed with the identification of six themes. Pros and cons of both push-in and pull-out service delivery, carryover, and modifications were discussed. Conclusively, most teachers preferred a combination of push-in and pull-out services, highlighting the importance of communication, collaboration, carryover, and finding the just-right fit for each student to best support their needs and learning styles. The findings of this study will better provide school-based occupational therapy practitioners with context for selecting the most appropriate service delivery model for each student.

Examining Teacher Concerns and Anxiety on the Implementation of a Universal Body Image Program.

In the past 30 years, there have been numerous positive body image and eating disorder prevention programs targeting youth developed for school-based settings. Frequently, teachers are used as interventionists to increase dissemination, decrease costs relative to researchers, and increase scalability. However, little is known about teacher concerns and barriers that may hinder successful uptake and implementation. The current study recruited a total of 269 teachers who consented to implement a universal body image and appearance-related bullying and teasing prevention program in their classrooms as part of a randomized controlled trial. Teachers expressed some worry that they may say the wrong thing, and concern about feeling uncomfortable teaching the program due to their own body dissatisfaction. Teacher's ethnicity, gender, years teaching, dieting behaviors and other weight control behaviors, and self-efficacy were not associated with concerns related to teaching the curriculum. Teachers with lower body esteem reported higher concerns and anxiety related to teaching a body image curriculum. In free response items, teachers worried about handling student comments that were beyond the scope of the curriculum. Teacher self-efficacy was the only variable associated with the number of program sessions implemented. Findings suggest avenues to increase implementation.

Implementation of a minimally invasive cell culture system to measure the regulation of inflammation in a school-based sample of adolescents.

Dysregulated inflammation underlies many human diseases, and measures of responsiveness to activation, and sensitivity to inhibition, provide important information beyond baseline assessments of chronic inflammation. This study implements a simplified cell culture protocol in a school-based setting, using finger stick capillary blood collected from 333 adolescents (age 11.4-15.6 years) incubated with lipopolysaccharide (LPS). Median cytokine responses for IL6, IL1β, and TNFα were 61.9, 26.2, and 11.2 pg/mL, respectively. Samples were also incubated with LPS and glucocorticoid (GC) to measure GC sensitivity. Median responses were reduced in the presence of GC inhibition for IL6 (20.3 pg/mL), IL1β (10.5 pg/mL), and TNFα (3.3 pg/mL). Minimally invasive cell culture protocols provide novel opportunities for measuring inflammatory phenotypes in a wide range of non-clinical settings.

Perspectives and Attitudes of Newer New Jersey High School Teachers towards Cleaning, Sanitizing, and Disinfecting Consumer Products Used in School Classrooms.

During the COVID-19 pandemic, there was an increased reported use of chemical cleaning, sanitizing, and disinfecting products (CSDPs), which created public concerns about negative health consequences for both children and adults in public schools. A subset of newer teachers shared experiences regarding safety and health (S&H) while working in school-based settings through a series of online surveys. Surveys were provided to teachers who completed work-based learning supervisory trainings provided by the New Jersey Safe Schools Program between October 2021 and June 2023. The participants answered questions focusing on CSDPs purchased for school use, their attitudes towards CSDPs, their use of personal protective equipment, and symptoms employees may have had due to CSDPs. A total of 205 teacher participants successfully completed the surveys. Over 25% of the teachers did not know where their CSDPs originated from, as they were provided by the school. Most participants "sometimes", "not often", or "never" read labels for CSDP ingredients or looked them up on healthy product apps. The participants (60%) tended to wear gloves while cleaning/disinfecting but did not wear masks. A third of the participants experienced respiratory health problems after working at school. Overall, the data suggest that more education on S&H regarding CSDPs needs to be provided to New Jersey teachers.

"She Couldn't Say the Word Penis": Experiences of 2SLGBTQ+ People with Developmental and Intellectual Disabilities with Sex Education in Alberta, Canada.

This exploratory qualitative study sought to better understand the experiences of Two-Spirit, lesbian, gay, bisexual, transgender, queer (2SLGBTQ+) disabled people when learning about sexuality, sexual orientation, and gender identity. We conducted 31 semi-structured, in-depth interviews with adults labeled/with developmental and intellectual disabilities in Alberta, Canada. Findings showed a significant lack of comprehensive sex education available to 2SLGBTQ+ disabled people. Sexual and gender identities were rarely discussed in formal school-based education settings and most parents and caregivers did not feel comfortable addressing these topics either. As a result, many participants had to do their own research and use other sources for information and advice. Participants then provided recommendations in terms of what they wish they had learned in sex education as well as potentially effective ways of delivering that content to disabled people.