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The importance of reducing restraint and restrictive interventions in special schools has been recognised across the four nations of the UK. Government guidance for England and Wales, and recommendations produced by Restraint Reduction Scotland, both reference Positive behavioural support (PBS) as an evidence-based approach that can be used to proactively support pupils with, or at risk of, behaviours that challenge. The Department of Education of Northern Ireland recommends the development of behaviour support plans to support children with special education needs and disabilities. Special schools, however, also have a responsibility to set high expectations for every pupil, to provide access to the respective national curricula and to meet individual needs. School-wide positive behavioural support (SW-PBS), originated in the USA in the 1990s in response to a body of evidence that showed improved social and academic outcomes when behavioural interventions were implemented across whole school settings. It is increasingly being adopted in the UK. Drawing upon examples from schools in England and Wales with which the authors are familiar, this paper outlines the rationale for a special schools' model of SW-PBS and illustrates the ways in which this can be adjusted to meet the specific needs of each setting.

Emotional and behavioural problems occur more commonly in children with Autism Spectrum Disorder (ASD) compared to other children. Few studies have focused on these problems in children with ASD attending mainstream schools. We assessed via parent report the emotional and behavioural problems in 160 children aged 4-17 years with ASD attending mainstream schools and investigated differences between the primary and secondary aged children. Children with ASD had higher levels of problems across all domains of the Strengths and Difficulties Questionnaire (SDQ) compared to UK norms. Within the ASD sample, SDQ scores were associated with male sex, living in a household with more children, more severe autism symptoms and fewer adaptive skills, and higher levels of family socio-economic risk. No robust primary-secondary school differences were found. Implications for future research and the support of children with ASD in mainstream school settings are discussed.

Statistics relating to special schools indicate very low rates of basic literacy. However, there is very little information available regarding typical instruction in these settings and, therefore, no clear picture of the potential barriers precluding the improvement of reading skills in special schools. The current paper investigated current practices in conventional early reading instruction (i.e., instruction involving the development of reading abilities using traditional orthography) with children in special schools and, in particular, children with intellectual disabilities. One hundred and ninety teachers participated in the survey, which aimed to: collate information on current practices related to conventional early reading instruction for children with intellectual disabilities in special schools across the United Kingdom (UK); investigate the putative effects of age and severity of intellectual disabilities on teachers' choice of instructional approaches; and examine teachers' perceptions of barriers to improving reading skills in this population. Age and severity of intellectual disability were associated with different responses relating to the choice of approaches and expectations. Access to training and suitable curricula were seen as greater barriers to improving reading skills than time or staffing.

Background: Research suggests that parents who perceive themselves as more effective and satisfied report less stress when raising a child with autism. We examined associations between parenting sense of competence, reported family support needs, and parental future expectations, with a sample of mothers of children with autism. Method: Mothers completed a cross-sectional online survey, which included a measure of expectations: Hopes for the Future, the Parenting Sense of Competence Scale and the Family Needs Survey. Results: Analysis revealed that mothers with lower support needs had greater parenting satisfaction; and mothers with more positive expectations perceived themselves to be more effective. Ethnicity, expectations, and lower levels of perceived family support needs, were predictors of greater satisfaction. Higher positive expectations predicted a greater sense of efficacy. Conclusions: The findings highlight the need for further research into the factors that underlie parental efficacy and expectations when parenting a child with autism.

Research into factors underlying the dissemination of evidence-based practice is limited within the field of Applied Behaviour Analysis (ABA). This is pertinent, particularly in the UK where national policies and guidelines do not reflect the emerging ABA evidence base, or policies and practices elsewhere. Theories of evidence-based practice in education and policy suggest that decision makers' "perceptions" of evidence are significant factors in dissemination. For professionals, scientific evidence is often critical. For others, including parents, experiential and anecdotal evidence can be as important. Within autism education, parents are often, and not necessarily by choice, key decision makers. This study is the first to try to identify and quantify UK parents' beliefs about ABA in the education and support of children with autism. We developed and tested, using an internet survey method, the Parental Beliefs about ABA and Autism scale (P-BAA). Current and/or past use by parents of any behaviorally based approach including ABA was a significant predictor of P-BAA scores as were parent education, household income and child diagnosis: experience of a behaviorally based approach, higher levels of education and income and children at the more "severe" end of the autism spectrum were associated with more positive beliefs about ABA.

Objectives: Tick‐borne encephalitis virus and louping ill virus are neurotropic flaviviruses transmitted by ticks. Epidemiologically, tick‐borne encephalitis is endemic in Europe whereas louping ill's predominant geographical distribution is the UK. Rarely, these flaviviruses affect dogs causing neurological signs. This case series aimed to describe the clinical, clinicopathological, and imaging findings, as well as the outcomes in six dogs with meningoencephalitis and/or meningomyelitis caused by a flavivirus in the UK in 2021. Materials and Methods: Observational retrospective case‐series study. Clinical data were retrieved from medical records of dogs with positive serological or immunohistochemical results from three different institutions from spring to winter 2021. Results: Six dogs were included in the study. All dogs presented an initial phase of pyrexia and/or lethargy followed by progressive signs of spinal cord and/or intracranial disease. Magnetic resonance imaging showed bilateral and symmetrical lesions affecting the grey matter of the thalamus, pons, medulla oblongata, and thoracic or lumbar intumescences with none or mild parenchymal and meningeal contrast enhancement. Serology for tick‐borne encephalitis virus was positive in five dogs with the presence of seroconversion in two dogs. The viral distinction between flaviviruses was not achieved. One dog with negative serology presented positive immunohistochemistry at post‐mortem examination. Three dogs survived but presented neurological sequelae. Three dogs were euthanased due to the rapid progression of the clinical signs or static neurological signs. Clinical Significance: These cases raise awareness of the presence of tick‐borne encephalitis as an emergent disease or the increased prevalence of louping ill virus affecting dogs in the UK. [ABSTRACT FROM AUTHOR]

Purpose: With a historic lack of attention to synthesis methods such as systematic review and meta-analysis and a lack of randomised controlled trials, the evidence base for behavioural interventions for children and adults who are autistic or are diagnosed with developmental disabilities is patchy. The Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network (SF-DDARIN), a network of like-minded researchers and practitioners across the UK, aims to address this. The purpose of this paper is to describe the network's work and provide the context for the remaining articles in the special issue that exemplify network projects. Design/methodology/approach: In this case study paper, the authors describe how the SF-DDARIN works and is resourced, detailing the process used to maximise research opportunities by facilitating network members working together. The authors outline the progressive research steps that the SF-DDARIN has identified are needed to develop and improve the evidence base for behavioural interventions systematically and, with examples, describe how the network delivers these steps. Findings: Since its establishment in 2016, the SF-DDARIN network members have collectively worked on more than 53 projects involving over 50 researchers, had over 120 special schools contribute to projects and have recruited over 500 participants. This has been achieved through funding from the Sharland Foundation, primarily to cover the staffing costs of a small support team and internship partnerships with external organisations. Some projects have attracted external funding. Originality/value: SF-DDARIN may provide an innovative, effective and resource-efficient model for other groups seeking to develop and extend their evidence base in developmental disability research. [ABSTRACT FROM AUTHOR]

This article describes how applied behaviour analysis can be implemented effectively and affordably in a maintained special needs school in the UK. Behaviour analysts collaborate with classroom teachers to provide early intensive behaviour education for young children with autism spectrum disorders (ASD), and function based behavioural interventions for children between the ages of three and 18 years. Data are presented that show how the model is effective. Children with ASD under the age of seven made significant gains on intelligence quotient and on a range of skills including language, social and play, and academic skills following three academic terms of intervention. Case study data for two children reveal a marked decrease in challenging behaviour following a function based behavioural intervention. These interventions have led to greater independence, integration and access to curricular activities. These data show that children are making significant gains within this cost-effective model.

Gwynedd Local Education Authority (LEA) in North West Wales, UK, is funding a small-scale autism-specific specialist education service using ABA methodology. The program is available through the medium of Welsh, English or bilingually, depending on the individual needs of the child (Jones and Hoerger in Eur J Behav Anal 10:249-253, "2009"). Delivering an ABA curriculum within a Welsh context raises issues regarding how ABA interventions work in a non-Anglo-American cultural and linguistic context. We describe one part of the program, as well as the mechanics of translation and interpretation: How ABA fits conceptually in a different language, how Skinner's original ideas about developing a scientific terminology to describe behavior can be applied to a different cultural and linguistic tradition, and cultural variation in reinforcement practices.

Following pretraining with everyday objects, 14 children aged from 1 to 4 years were trained, for each of three pairs of different arbitrary wooden shapes (Set 1), to select one stimulus in response to the spoken word /zog/, and the other to /vek/. When given a test for the corresponding tacts ("zog" and "vek"), 10 children passed, showing that they had learned common names for the stimuli, and 4 failed. All children were trained to clap to one stimulus of Pair 1 and wave to the other. All those who named showed either transfer of the novel functions to the remaining two pairs of stimuli in Test 1, or novel function comprehension for all three pairs in Test 2, or both. Three of these children next participated in, and passed, category match-to-sample tests. In contrast, all 4 children who had learned only listener behavior failed both the category transfer and category match-to-sample tests. When 3 of them were next trained to name the stimuli, they passed the category transfer and (for the 2 subjects tested) category match-to-sample tests. Three children were next trained on the common listener relations with another set of arbitrary stimuli (Set 2); all succeeded on the tact and category tests with the Set 2 stimuli. Taken together with the findings from the other studies in the series, the present experiment shows that (a) common listener training also establishes the corresponding names in some but not all children, and (b) only children who learn common names categorize; all those who learn only listener behavior fail. This is good evidence in support of the naming account of categorization. (Contains 3 tables and 4 figures.)

Following pretraining with everyday objects, 10 children aged from 1 to 4 years were given common vocal tact training with a set of three pairs of arbitrary stimuli of differing shapes; Set 1. Nine children learned to tact one stimulus as "zog" and the other as "vek" in each pair, and all passed subsequent pairwise tests for the corresponding listener behavior to each listener stimulus (i.e., /zog/ and /vek/, respectively). The children were next trained to clap to one stimulus of Pair 1 and wave to the other, and all then showed name-consistent transfer of these behaviors to the stimuli of Pair 2 and Pair 3. Seven children also were given a test of listener responding to experimenter-modeled clap and wave gestures, respectively, which they all passed. Four of the children next participated in a category match-to-sample test for the Set 1 stimuli; all 4 passed. For each pair of two additional six-stimuli sets, Set 2 and Set 3, 3 children were trained to wave to one stimulus and to clap to the other. For each set, all 3 children showed perfect transfer of the vocal tacts trained to Set 1, and of listener behavior both to the auditory stimuli /zog/ and /vek/ and to experimenter-modeled clap and wave gestures. They also sorted the stimuli perfectly in category match-to-sample tests for Set 2, Sets 1 and 2 combined, Set 3, and Sets 1, 2, and 3 combined. The results show that even in very young children, naming is a powerful means of generating new category relations among as many as 18 arbitrary stimuli. (Contains 2 tables and 3 figures.)

Purpose: There is an apparent disconnect between the understanding of best practice and service delivery in the support of people with learning disabilities at risk of behaviours that challenge. We suggest, is a problem of implementation. The purpose of this paper is to explore reasons why this might be the case: a failure to recognise the collective works of successive generations of research and practice; and a failure to address the macro-systems involved and systems changes needed to support implementation. Design/methodology/approach: This paper reviews the consensus that exists in respect of best practice. Drawing upon ideas from implementation science the paper highlights the complexities involved in the implementation of all evidence-based practices and uses this as a framework to propose ways in which an infrastructure that facilitates the delivery of services in the learning disabilities field might be built. Findings: This paper highlights core recommended practices that have been consistent over time and across sources and identifies the systems involved in the implementation process. This paper demonstrates that many of the necessary building blocks of implementation already exist and suggests areas that are yet to be addressed. Critically, the paper highlights the importance of, and the part that all systems need to play in the process. Originality/value: In the absence of any generalised implementation frameworks of evidence-based practice in the learning disabilities field, the paper suggests that the findings may provide the basis for understanding how the gap that exists between best practice and service delivery in the support of people with a learning disability at risk of behaviours that challenge might be closed. [ABSTRACT FROM AUTHOR]

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Objectives: The National Institute for Health and Care Excellence referral guidelines prompting urgent two-week referrals were updated in 2015. Additional symptoms with a lower threshold of 3 per cent positive predictive values were integrated. This study aimed to examine whether current pan-London urgent referral guidelines for suspected head and neck cancer lead to efficient and accurate referrals by assessing frequency of presenting symptoms and risk factors, and examining their correlation with positive cancer diagnoses. Methods: The risk factors and symptoms of 984 consecutive patients (over a six-month period in 2016) were collected retrospectively from urgent referral letters to University College London Hospital for suspected head and neck cancer. Results: Only 37 referrals (3.76 per cent) resulted in a head and neck cancer diagnosis. Four of the 23 recommended symptoms demonstrated statistically significant results. Nine of the 23 symptoms had a positive predictive value of over 3 per cent. Conclusion: The findings indicate that the current referral guidelines are not effective at detecting patients with cancer. Detection rates have decreased from 10–15 per cent to 3.76 per cent. A review of the current head and neck cancer referral guidelines is recommended, along with further data collection for comparison. [ABSTRACT FROM AUTHOR]

Aim Around one-third of patients with Crohn's disease are affected by Crohn's fistula-in-ano (p CD). It typically follows a chronic course and patients undergo long-term medical and surgical therapy. We set out to describe current surgical practice in the management of p CD in the UK. Method A survey of surgical management of pCD was designed by an expert group of colorectal surgeons and gastroenterologists. This assessed acute, elective, multidisciplinary and definitive surgical management. A pilot of the questionnaire was undertaken at the 2015 meeting of the Digestive Disease Federation. The survey was refined and distributed nationally through the trainee collaborative networks. Results National rollout obtained responses from 133 of 179 surgeons approached (response rate 74.3%). At first operation, 32% of surgeons would always consider drainage of sepsis and 31.1% would place a draining seton. At first elective operation, 66.6% would routinely insert of draining seton, and 84.4% would avoid cutting seton. An IBD multidisciplinary team was available to 87.6% of respondents, although only 25.1% routinely discussed pCD patients. Anti-tumour necrosis factor-alpha therapy was routinely considered by 64.2%, although 44.2% left medical management to gastroenterologists. Common definitive procedures were removal of the seton only (70.7%), fistulotomy (57.1%), advancement flap (38.9%), fistula plug (36.4%) and ligation of intersphincteric track ( LIFT) procedure (31.8%). Indications for diverting stoma or proctectomy were intractable sepsis, incontinence and poor quality of life. Conclusion This survey has demonstrated areas of common practice, but has also highlighted divergent practice including choices of definitive surgery and multimodal management. Practical guidelines are required to support colorectal surgeons in the UK. [ABSTRACT FROM AUTHOR]

Unlabelled: The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described.Method: Cross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results.Results: Of 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65).Conclusions: Most HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known. [ABSTRACT FROM AUTHOR]

The authors report 1-year outcomes for 11 children (3-7 years) with autism who attended an “Applied Behavior Analysis (ABA) classroom” educational intervention in a mainstream school setting. The children learned new skills by the end of 1 year and learned additional skills during a 2nd year. Group analysis of standardized test outcomes (IQ and adaptive behavior) showed moderate to large effect size changes over 1 year, with further changes during a 2nd year. Standardized test outcomes for nine children after 2 years were also analyzed against a comparison group (n = 18) of children with autism receiving “education as usual.” These controlled comparisons were associated with statistically significant large effects in favor of the ABA group for adaptive skills. Exploratory analysis also showed that increases in language and learning skills in the ABA class group were generally associated with positive changes in standardized test scores. A comprehensive behavioral intervention model can be successfully implemented in a mainstream school setting. [ABSTRACT FROM AUTHOR]

The article presents a study which explores the use of the HadGEM2-ES Earth System Model (ESM) by the Met Office Hadley Center for the Phase Five of the Coupled Model Intercomparison Project (CMIP5) centennial experiments in Great Britain. CMIP5 is a standard experimental protocol which provides estimates on the future of climate change. Greenhouse gas concentrations, atmospheric ozone assumptions and aerosol precursors are documented in the study.