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Teachers' perceptions play a critical role in defining and giving meaning to new initiatives and policies in schools. However, very little is known about the perceptions of self-contained special educators responsible for students with significant cognitive disabilities (SCD) pertaining to the inclusion of students with SCD in general education classes and how those perceptions impact educational programming. In this qualitative study, the authors conducted semi-structured interviews with 21 special educators responsible for students with SCD who taught in self-contained classes within traditional public schools. The interview was designed to explore special educators' perceptions pertaining to including students with SCD in general education classes and possible personal and environmental factors that may influence their perceptions. The findings suggest that self-contained special educators responsible for students with SCD are tentatively supportive of including their students in general education classes. However, several factors (e.g., lack of support, student abilities and skills, general educator attitudes) and reservations appeared to impact special educators' decision-making pertaining to including their students with SCD in general education classes.

The Individuals with Disabilities Education Improvement Act (IDEA) of 2004 requires that all students with disabilities participate and progress in the general education curriculum. Although IDEA requires individualized education program (IEP) teams to include academic and life skills goals in a students' as necessary to meet their individual needs, many researchers have raised concerns that the emphasis on the general education curriculum could lead IEP teams to deemphasize goals focused on instruction on life skills which are consistently predictive of improved post-school outcomes for students with a significant cognitive disability (SCD). This study used a direct content analysis to examine the IEPs of 1,103 students with a SCD from four school districts to determine the proportion of goals included in their IEPs that were drawn from the state's general education curriculum and life skills domains. The authors coded the goals found in student IEPs and used descriptive (i.e., measures of central tendency and variability) and inferential (i.e., Wilcoxon matched-pairs signed-rank test) statistics to analyze the data. We found that students from this sample have a larger proportion of IEP goals related to the academic core standards than IEP goals related to life skills. These findings will be discussed in terms of the implications for future research and practice.

Educational programs for students with moderate and severe disabilities (MSD) have undergone drastic changes since the mandate for access to the general curriculum was provided by Individuals With Disabilities Education Act. Since then, educators have struggled to find methods to use to promote optimal learning, including in the area of mathematics. The purpose of this systematic literature review was to provide an update on research related to teaching mathematics to students with MSD published from 2005 to 2017. Results from the included studies indicated that mathematics research has started to diversify in the skills that are being taught to this population. In addition to skills taught, current research has continued to inform the field on some promising methods that can be used to teach a broader range of mathematics skills. Emerging strategies that were identified included the use of concrete representations, anchored instruction, and instructional technology. Suggestions for future research are discussed.

Numerous studies have demonstrated the positive effects of the Good Behavior Game (GBG); however, limited information exists on the impact of the GBG on students with severe disabilities. This study investigated the impact of the GBG on students with severe disabilities and their off-task behaviors. Three students in three self-contained elementary classrooms and three special education teachers participated in this study. Special Education teachers implemented the GBG during whole group instruction, and researchers used a momentary time sample to measure the percentage of student off-task behavior. A multiple-probe baseline design organized the data to analyze the overall effects of the intervention. All participants showed a decrease in off-task behavior during the GBG. Implementing teachers found the intervention to be socially valid.

Current research on teaching mathematics to students with intellectual disability (ID) has demonstrated that, given evidence-based instruction, these students can acquire a wide range of skills. However, very little research has been conducted in inclusive general education (GE) classrooms and no studies have utilized the GE teacher as the intervention agent (Spooner, Root, Saunders, & Browder, 2018). This study utilized a multiple baseline design to evaluate the effects of GE teacher-delivered embedded instruction on two main variables: (1) students' ability to solve word problems, and (2) generalization across people and materials and to untaught word problems. The data indicate that the embedded mathematics instructional package was effective in teaching students to (1) solve additive word problems with sums less than five, and (2) to generalize to untaught word problems and across people and materials. Limitations and suggestions for future research are also discussed.

One concern raised about teaching content from the general education curriculum to students with intellectual and developmental disabilities is whether they generalize the skills learned to typical performance settings. We conducted a literature review of research studies that taught content from the general education curriculum and assessed generalization of the target skill to determine (a) whether the studies demonstrated a causal relationship between the intervention and the generalization-dependent variable(s), (b) what forms of generalization were assessed, and (c) what strategies were incorporated into the interventions to promote generalized responding by study participants. We identified 31 studies that met the initial selection criteria. However, only 22 demonstrated a causal relationship between the intervention and the acquisition-dependent variable(s), and only four of these studies demonstrated a causal relationship between the intervention and the generalization-dependent variable(s). The implications of the findings for future research are discussed.

A high-quality education in the social studies is recommended by the National Council for the Social Studies to promote civic competence and democratic participation for school system graduates. Currently, limited empirical information exists to inform social studies instruction for students with significant intellectual disability (SID), especially within inclusive academic settings. Effective content instruction in social studies areas, aligned to the general academic curriculum and presented in the general setting, may help to improve post-school outcomes for students with SID. A multiple probe across participants single case design was used to determine the effectiveness of paraprofessional-implemented inquiry-based social studies instruction, presented within an embedded trial distribution schedule in general education classrooms. Study results suggest that this method of instruction had a positive effect on recall of information presented during history lessons for three junior high school students with intellectual disability. After repeated practice, students showed improvements in recall of information when using the structured inquiry-based instructional framework without direct instruction. Paraprofessionals and general education teachers generally found the intervention to be effective and acceptable. Implications for classroom practice and for future research are discussed.

This article describes rural and remote teacher training in low incidence (LI) disabilities through an alternative teaching pathway (ATP) and the efforts of one university's ATP program to address the ongoing critical special education teacher shortage in rural and remote school districts. The impact of the federal investment in recruiting/training teacher candidates in LI disabilities in rural and remote areas is described, and critical features of a distance education ATP programs in LI are discussed. Lessons learned over two decades of distance ATP delivery in LI are shared.

In this convergent mixed methods design study, single-subject and qualitative data were collected concurrently to provide an in-depth picture of the impact of a modified schema-based instructional intervention. The intervention was delivered using instructional trials embedded across general education math lessons and a modified concrete-semi-concrete-abstract instructional sequence. This study investigated the impact of the intervention on the word-problem-solving, strategy use, and concept acquisition of three students with extensive support needs. The paraprofessional-delivered intervention was implemented in elementary general education mathematics classrooms using embedded instruction and focused on teaching students to solve addition and subtraction word-problems. Single-subject data indicated that all three students learned to solve word-problems given concrete materials but needed more time to master the use of semi concrete supports. Qualitative data indicated that students used taught and untaught strategies to solve word-problems, and mastered addition word-problems before subtraction when they were taught simultaneously. Data were integrated in narrative format to explore how strategy use and concept acquisition related to student word-problem-solving performance. Limitations and implications for research are discussed. [ABSTRACT FROM AUTHOR]

Despite the rapid and ongoing increase in the use and availability of computers and technology in and outside of public school classrooms, there is relatively little literature that has examined preservice special education teachers' perceptions of their own computer use and self-efficacy with new technologies or how these perceptions may impact their educational and professional practice. This study used a Computer Use and Self-Efficacy (CUSE) survey to examine current rural and special education teacher candidates' computer use, their perceptions of computer self-efficacy, and the impact on performance in a teacher preparation program for teachers working with students with low-incidence disabilities. Data indicate a difference in perceptions of self-efficacy for rural and urban teacher candidates. Implications for practice and future research are discussed.

Minimization of intra-operative opioid use is an area of ongoing research interest with several potential benefits to the patient. Pre-emptive analgesia, defined as the administration of an analgesic before surgery to prevent establishment of central sensitization of pain, is one avenue that has been explored to achieve this. A retrospective observational study was undertaken to examine the effect of pre-emptive paracetamol on intra-operative opioid requirements. The medical and operative data of 156 patients who underwent day-case wide local excision and sentinel lymph node biopsy with and without regional block surgery at our center between October 2019 and May 2022 was carried out. Data were collected on demographics, total intra-operative and immediate post-operative opioid consumption. 57 patients did not receive pre-emptive paracetamol while 90 did. Baseline characteristics were similar. Our results showed a statistically significant reduction in morphine (p <0.029) and remifentanil (p <0.007) consumption in patients who received a regional block and pre-emptive paracetamol. Those who did not receive a regional block and were given pre-emptive paracetamol had a decrease in OxyNorm (p <0.022) requirements. A combination of general anesthesia (GA), regional block and pre-emptive paracetamol reduced intraoperative consumption of Fentanyl, OxyNorm, diclofenac, dexketoprofen, and clonidine (P <0.001) when compared to just GA alone. Use of pre-emptive paracetamol in reduction of intra-operative opioid requirements showed promising results but larger studies may strengthen the evidence for this association. A multimodal analgesic approach that utilizes pre-emptive paracetamol can be a viable method to decrease intra-operative of analgesic requirements. [ABSTRACT FROM AUTHOR]

The emergence of the standards-based reform movement has raised a number of issues related to the design of educational programs for students with severe disabilities, and a debate has arisen that presents an "either/or" choice between the general education curriculum and an ecological curricular framework that has traditionally guided curriculum development. In this paper, the authors propose that, to adequately meet the needs of students with moderate to severe disabilities, an ecological approach focusing on quality of life outcomes must be reconciled with the development and implementation of standards-based academic curricula. To accomplish this reconciliation, the authors recommend that individualized education plan teams engage in a process that allows them to work within an ecological curricular framework to develop standards-based goals that reflect meaningful knowledge and skills that are tailored to students' individual needs and applicable to their everyday lives. They propose that quality of life goals expand beyond home, friendships, community participation, and work to include academic goals that are life enriching and promote lifelong learning that can be linked to a broader range of subject area domains in the core curriculum. In addition, they suggest instructional approaches that promote effective instruction and generalized outcomes for both academic and functional skills. Finally, they outline a number of issues that require additional reflection, discussion, and research. (Contains 1 table.)

Distance teacher education programs employing videoconferencing technology and other online teaching tools are increasingly being used to prepare teachers of students with disabilities in rural and remote communities. This evaluation study compared the effectiveness of a distance and an on-campus teacher education program for teachers of students with severe disabilities. Teacher candidates in the distance cohort received the same program of study as candidates in the on-campus program except that the coursework was delivered through videoconferencing technology instead of traditional, face-to-face instruction. Instructional activities for candidates in both cohorts were supported through online instructional tools (i.e., Web CT) and on-site field supervision from university clinical faculty members and cooperating professionals from the local school districts. A variety of measures were used to assess candidates' acquisition of content and their ability to apply the knowledge and skills acquired through the program of study. The results indicate that there were no significant differences between students in the distance and on-campus teacher education cohorts on the measures of learning. The implications of the findings for further research are discussed. (Contains 2 tables.)

The neurocognitive processing of environmental sounds and linguistic stimuli shares common semantic resources and can lead to the activation of motor programs for the generation of the passively heard sound or speech. We investigated the extent to which the cognition of environmental sounds, like that of language, relies on symbolic mental representations independent of the acoustic input. In a hierarchical sorting task, we found that evaluation of nonliving sounds is consistently biased toward a focus on acoustical information. However, the evaluation of living sounds focuses spontaneously on sound-independent semantic information, but can rely on acoustical information after exposure to a context consisting of nonliving sounds. We interpret these results as support for a robust iconic processing strategy for nonliving sounds and a flexible symbolic processing strategy for living sounds. (Contains 3 tables and 1 figure.)

This study investigated the effects of a training package (written manual, individual training session, and ongoing verbal feedback) on middle school peer tutors' use of embedded, constant time delay procedures and on the learning outcomes for students with significant cognitive disabilities in general education settings. The study data showed that peer tutors could be trained quickly and efficiently to accurately use constant time delay and embedded instructional techniques in general education settings. The data also showed that peer tutors delivering embedded, constant time delay instruction in general education settings resulted in skill acquisition for students with significant cognitive disabilities. In addition, teacher and peer tutor measures were positive about the social validity of the procedures and outcomes of the peer-delivered embedded instructional package.

Self-determination continues to be a focus for secondary students who have intellectual disabilities. This study examined the relationship between recreation and self-determination for adolescents and young adults with intellectual disabilities. Students from secondary and post-high school special education programs tracked their involvement in recreation for a 2-week period. Then students were given the "Arc's Self-Determination Scale." The results establish a predictive relationship between recreation and self-determination indicating that increased amounts of time adolescents and young adults spend actively involved in recreation were found to be predictive of higher levels of self-determination. The findings support that recreation may be a useful strategy for enhancing self-determination skills and that self-determination can be increased through experiences, not just through teaching explicit skills. (Contains 3 tables.)

This study investigated (a) variables that predict amount of time students with severe disabilities spend in leisure and physical activity education and (b) teacher beliefs about provision of these services. Participants included 35 secondary special education teachers and 170 students with severe disabilities. Findings suggest that special education teachers provided recommended duration, but valued other curriculum domains over leisure and physical activity education. Hierarchical linear modeling (HLM) indicated individual teacher differences are a significant predictor of students' participation in leisure and physical activity. Further, HLM analysis indicated that teachers' beliefs about their role in providing leisure education explained a significant portion of the variance among teachers. Recommendations for policy development and teacher education are provided. (Contains 6 tables.)

A single subject alternating treatment design was used to compare the effectiveness of embedded and small-group instruction to teach vocabulary word definitions to four middle school students with developmental disabilities. Embedded instruction was implemented in the students' general education classes. Students were taught to verbally define five vocabulary words drawn from the general curriculum. Instructional trials were distributed within and across the ongoing activities of the general education class. Instructional procedures included constant time-delay, differential reinforcement, and systematic error correction procedures. Small-group instruction was implemented in the students' self-contained special education class. Students were taught to verbally define five vocabulary words drawn from the curriculum in their general education classes. Instructional procedures for small-group instruction were identical to those used during embedded instruction. The small-groups included the target student and two peers who were randomly selected from his or her special education class. Small-group instruction employed an intrasequential format with spaced-trials (Collins et al., 1991; Reid & Favell, 1984). Results suggest that embedded and small-group instruction were equally effective in promoting the acquisition and generalization of the target skill. Results are discussed in terms of future research and implications for supporting the inclusion of students with developmental disabilities in general education classes. (Contains 1 table and 4 figures.)

COVID-19 vaccines are highly effective in immunocompetent recipients; however, individuals with inborn errors of immunity (IEI) may not mount an adequate response to the COVID-19 vaccine [[2]]. To the Editor, Introduction Individuals with inborn errors of immunity are at increased risk of developing severe disease and mortality from SARS-CoV-2 infections compared to the general population [[1]]. This study was conducted when the Omicron variants were most prevalent, and two patients had symptomatic SARS-CoV-2 prior to receiving the second dose while three patients had symptomatic SARS-CoV-2 despite the higher dose. [Extracted from the article]

We compared the effectiveness of two trial distribution schedules implemented in an embedded instruction package to teach academic skills to students with developmental disabilities in general education classes. In the first package, instructional trials were distributed across a 30-min time period that reflected the typical length of a lesson in the content area (e. g., math or reading). In the second package, instructional trials were distributed across a 120-min time period that cut across at least two lessons (e.g., math and reading). General education teachers provided instruction to students under both trial distribution conditions. The results indicated that both schedules lead to the acquisition of the target skills. In addition, students were able to generalize their performance to natural stimuli found in general education classes. However, the 30-min trial distribution schedule resulted in faster acquisition of the skills for two of the students. There were no substantial differences in the rates of acquisition under the two schedules for the other two students. Results are discussed in terms of future research and implications for supporting the inclusion of students with developmental disabilities in general education classes.

A multiple probe across subjects design was used to evaluate the effectiveness of embedded instruction with three students with developmental disabilities who were enrolled in general education classrooms. Two general education teachers delivered embedded instruction to students during regularly schedule instructional activities. The skills taught to students included matching functional sight-words, signing "help" to request assistance on difficult tasks, and identifying the two-digit number that was "greater than." Student data showed that embedded instruction was effective with two of the three students. The third student appeared to show some initial skill gains but did not maintain performance across time despite modifications in reinforcement and the instructional procedures. The results also indicate that both general education teachers were able to implement the procedure with a high degree of fidelity. Teacher ratings of the acceptability and perceived effectiveness of the procedures suggested that teachers viewed embedded instruction as a practical, effective, and efficient strategy for teaching students with disabilities in general education settings.

A multiple baseline across behaviors design was used to evaluate the efficacy of embedded instruction with 3 students with developmental disabilities who were enrolled in general education classes. Two general education teachers and 1 paraprofessional delivered embedded instruction to students during regularly scheduled instructional activities. The skills taught to students included answering probe questions drawn from the general science curriculum, identifying functional sight-words drawn from the general reading curriculum, and making requests using an electronic communication device. Student data showed that embedded instruction was effective with all 3 students. The results also indicate that both general education teachers and paraprofessionals were able to implement the procedure with a high degree of fidelity without disrupting the ongoing instructional activities of the general education classes. Teacher ratings of the acceptability and perceived effectiveness of the procedures suggested that teachers viewed embedded instruction as a practical, effective, and efficient strategy for teaching students with developmental disabilities in general education settings. (Contains 4 tables and 3 figures.)

This article discusses concerns with the No Child Left Behind definition of scientifically based research and its preference for random-assignment experiments from a single/within subject research perspective. A comprehensive program of research that can focus on the bridging the gap between research and practice is proposed. (CR)

This study involved 14 students (ages 6-12) with developmental disabilities in inclusive classrooms, their 324 typical classmates, and 221 typical students in noninclusive classes. Students with developmental disabilities made gains in adaptive behavior. The academic performance of the typical students in reading/language arts and mathematics did not differ by placement. (Contains references.) (Author/CR)

Four students with moderate mental retardation were taught to read or define words on vocabulary lists of general education classes using embedded instruction. Results indicate that embedded instruction led to the acquisition and maintenance of the target skills. Paraprofessionals successfully implemented the embedded instruction in general education classes. (Contains references.) (Author/PB)