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There is a need to provide evidence-based social, emotional, and behavioral interventions for learners at risk for emotional and behavioral problems. Evidence-based interventions for social and emotional success are especially necessary for Black learners with emotional or behavioral problems. In the current study, we used a multiple-baseline design time-lagged across groups (i.e., classrooms) to examine the effects of a culturally adapted version of the Strong Start curriculum plus Check-In/Check-Out on externalizing problem behaviors of 18 first-grade and second-grade Black learners. Results indicate a functional relation between the intervention package and externalizing problem behaviors. Additionally, post-intervention social validity assessment indicates that participating teachers viewed the intervention package as feasible and participating learners reported a positive experience.

ObjectiveThe objective of this quality improvement project was to evaluate the effectiveness of a succinct health literacy training for providers at a demanding federally qualified health center.MethodsOne group, pretest-posttest design was used to measure for a change in knowledge regarding the effects of limited health literacy, a change in self-reported measure of routine screening for limited health literacy and a change in self-reported utilization of patient-centered communication techniques.ResultsThe average percentage of correct responses on the Health Literacy Knowledge Check showed significant improvement from 23.6% (SD = 18.1%) to 63.9% (SD = 25.3%), p < .001. There were no significant changes in median responses at pre- and post-intervention for self-reported use of screening and communication techniques (all p > .05).ConclusionThis brief training was effective at improving participants' knowledge of health literacy but did not improve use of recommended communication techniques or screening for health literacy. The results suggest that emphasizing a universal precautions approach to health literacy may be more effective with participants who work in high-volume clinics.Practice implicationsFor high-volume clinics, a brief training may improve participants' knowledge but does not increase use of actual communication techniques based on self-report.

Black learners, like all other learners, bring their cultural values into the classroom, how they express themselves, and how they problem-solve. In addition, their life experiences influence their social and emotional behaviors. This study examined the effects of a multicomponent intervention approach--including a culturally adapted social and emotional learning curriculum, check-in/check-out, and self-monitoring--on the externalizing behaviors of Black male learners in an urban elementary school. A multiple-baseline-across-classes, single-case, experimental design evaluated the effects of the intervention package. Results from the study show a consistent decrease in externalizing problem behaviors, increases in social and emotional competencies, and high levels of social validity for the intervention package based on the input of relevant stakeholders. An embedded alternating-treatment, single-case design explored the relative impact of self-monitoring. The authors also include a discussion of the limitations of this work and the implications for future research.

We previously conducted a series of conceptual replications to parse out which--and to what degree--adaptations and individualized supports were needed for children to access and learn early reading skills using Headsprout®. Here we developed a systematic decision-making process for providing levels of support to individuals with autism who require additional instruction in order to access and/or advance through Headsprout®. Using a series of single-case AB, ABC, and multiple-baseline designs we examined strategies from our previous research and additional strategies iteratively developed during the study on six students with autism, all of whom demonstrated progression through Headsprout® and increased reading skills. We provide practical implications for teachers and suggestions to research these supports with other computer-based programs.

The purpose of this study was to investigate the associations between elementary students' reading skills and their online reading (i.e., real-time reading) behaviors during silent sentence processing. Thirty-five students participated in this study and their eye movements were recorded during sentence reading tasks. The effects of students' reading skills measured by traditional standardized measures were investigated for widely-used eye tracking measures such as first fixation duration, gaze duration, regression path duration, total duration, word skipping, fixation count, and regression frequency. The eye tracking measures were chosen to represent early/late cognitive processes and temporal/spatial gaze behaviors. Linear mixed-effects regression analyses revealed that children's performances in reading skills predict most of the eye tracking measures.

We previously conducted a series of conceptual replications to parse out which-and to what degree-adaptations and individualized supports were needed for children to access and learn early reading skills using Headsprout®. Here we developed a systematic decision-making process for providing levels of support to individuals with autism who require additional instruction in order to access and/or advance through Headsprout®. Using a series of single-case AB, ABC, and multiple-baseline designs we examined strategies from our previous research and additional strategies iteratively developed during the study on six students with autism, all of whom demonstrated progression through Headsprout® and increased reading skills. We provide practical implications for teachers and suggestions to research these supports with other computer-based programs., Author(s): Julie L. Thompson [sup.1] , Joshua B. Plavnick [sup.2] , Lori E. Skibbe [sup.3] , M. Y. Savana Bak [sup.4] , Paul Doher [sup.2] Author Affiliations: (1) grid.264756.4, 0000 [...]

Background: Nursing interventions in the care of pediatric patients with severe traumatic brain injury (TBI) can have a direct effect on intracranial pressure (ICP), yet they have been largely underexplored. Early evidence is therefore needed to describe these relationships and to determine intervention that promotes neuroprotection and recovery. Objectives: The aim of this study was to examine nursing interventions within the first 72 hours of pediatric severe TBI and their effects on ICP. Method: This is a retrospective review of pediatric patients admitted for severe TBI using a quasiexperimental approach to assess nursing interventions and their association with the patients' ICP values prior to and after each intervention. Results: Of the 56 patients who met the inclusion criteria, 3392 intervention events (range, 31-138 events per patient) were reported. Paired t tests conducted for each intervention type found a statistically significant relationship with suctioning and percent change in ICP values (P = .045). All other interventions showed no significant differences. Discussion: Standard nursing interventions, specifically suctioning, in pediatric severe TBI may affect ICP and therefore neuroprotection. Further work is needed to better understand the role and timing of nursing interventions and their influence on cerebral hemodynamics so that future TBI guidelines consider nursing care and their impact on brain injury recovery. [ABSTRACT FROM AUTHOR]

Objectives: Parturients are at increased risk for difficult airway management with subsequent fetal complications. Videolaryngoscopy was opined to be the new standard of airway care to facilitate orotracheal intubation under urgent care conditions. We examined in parturients requiring general anesthesia for urgent cesarean delivery the association of the type of laryngoscopy technique and time required to facilitate orotracheal intubation with the incidence of subsequent neonatal intensive care unit (NICU) admission. Methods: Following institutional review board approval, 431 parturients aged 18 years and older who underwent urgent cesarean section requiring general anesthesia were entered into this study. Patient characteristics, maternal comorbidities, and indications for urgent cesarean delivery were collected from the electronic medical records from January 2013 to November 2018. Orotracheal intubation times by type of laryngoscopy (video or direct) and NICU admission rates also were collected. A measure of effect size, risk differences with 95% confidence intervals (CIs),were calculated for the likelihood of NICU admission by difficult orotracheal intubation and by type of laryngoscopy used to secure the airway. Results: Videolaryngoscopy as the primary type of laryngoscopy was used in 24.1% (95% CI 20.3%-28.3%) of general anesthetics. The incidence of difficult orotracheal intubation was 4.4% (95% CI 2.8%-6.7%), with a higher incidence observed with videolaryngoscopy (8.7%) than with direct laryngoscopy (3.1%) and a risk difference of 5.6% (95% CI 0.001%-11.3%). The incidence of NICU admission was 38.4% (95% CI 34.0%-43.1%). Times for successful orotracheal intubation were longer with videolaryngoscopy. Videolaryngoscopy had a higher association for NICU admission (47%) than for direct laryngoscopy (36%), with a risk difference of 11.4%(95% CI 0.01%-22.3%). Conclusions: Videolaryngoscopy did not decrease the incidence of difficult orotracheal intubation, and it did not decrease the time associated with orotracheal intubation. Videolaryngoscopy was associated with a higher association of NICU admission. These results suggest that videolaryngoscopy does not supplant direct laryngoscopy as the standard of care for orotracheal intubation under urgent care conditions of general anesthesia for cesarean section. [ABSTRACT FROM AUTHOR]

Aim(s): To assess the effectiveness of sub‐epidermal moisture (SEM) assessment technology in the detection of early‐stage pressure damage in a critical care unit (CCU) and dark skin tone patients and its impact on hospital‐acquired pressure injury (HAPI) incidence. Design: Quality improvement study employing Kurt Lewin's change model emphasizing planning, implementation, evaluation and sustainable change. Methods: The study evaluated 140 adult patients admitted to the CCU over a 24‐week period, from July to December 2022. Retrospective analysis of standard PI care pathways was performed in 90 patients admitted during a 12‐week pre‐implementation period. Fifty patients were admitted through the subsequent 12‐week implementation period. SEM assessments were performed daily at the sacrum and heels and interventions were applied based on SEM assessments; SEM delta ≥0.6 indicating localized oedema or persistent focal oedema. Statistical analyses were performed on anonymized data. Results: Pre‐implementation HAPI incidence was 8.9% (N = 8/90). All eight patients were African American with varying skin tones. A 100% reduction in HAPI incidence was achieved in the implementation period which included 35 African American patients. The relative risk of HAPI incidence was 1.6 times higher in the pre‐implementation group. Conclusion: Implementing SEM assessment technology enabled equitable PI care for all population types and resulted in a 100% reduction of PIs in our CCU. Objective SEM assessments detected early‐stage PIs, regardless of skin tone and enabled providing interventions to specific anatomies developing tissue damage as opposed to universal preventive interventions. Implications: PI care pathways relying on visual and tactile skin assessments are inherently biased in providing equitable care for dark skin tone patients. Implementing SEM assessments empowers healthcare practitioners in driving objective clinical interventions, eliminates bias and enables positive PI health outcomes. Impact: Implementing SEM assessment technology had three main effects: it detected early tissue damage regardless of skin tone (detection effect), enabled anatomy‐specific interventions (treatment effect) and prevented PIs across all population types (prevention effect). The authors have adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines. Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community? Addressing health inequities in pressure injury prevention; Demonstrated effectiveness across patient populations; Resource optimization and enhanced patient safety. [ABSTRACT FROM AUTHOR]

The use of technology in intervention and instruction for adolescents with autism spectrum disorder (ASD) is increasing at a striking rate. The purpose of this paper is to examine the research literature underlying the use of technology in interventions and instruction for high school students with ASD. In this paper, authors propose a theoretical and conceptual framework for examining the use of technology by and for adolescents with ASD in school, home, and community settings. This framework is then used to describe the research literature on efficacy of intervention and instruction that utilizes technology. A review of the literature from 1990 to the end of 2013 identified 30 studies that documented efficacy of different forms of technology and their impact on academics,adaptive behavior, challenging behavior, communication, independence, social competence, and vocational skills. [This paper was published in "Journal of Autism and Developmental Disorders," (EJ1082511).]

Children with autism spectrum disorder (ASD) are at greater risk for experiencing high levels of anxiety symptoms. Recent evidence suggests Cognitive behavioral therapy (CBT) may also be effective for anxiety reduction in some presentations of ASD. This meta-analysis evaluated twenty-three studies. Results yielded a moderate effect size (g = -0.66) for the reduction of anxiety symptoms. Moderators indicated larger effects for studies were achieved with parental involvement (g = -0.85, p < 0.05) than with child-only treatments (g = -0.34, p < 0.05). Short-term interventions generated a smaller effect (g = -0.37 p < 0.05) than either standard-term (g = -1.02, p < 0.05) or long-term interventions (g = -0.69, p < 0.05). Implications for children with ASD are discussed.

In-service and coaching can increase teachers' use of research-based practices. This study examined the effects of in-service training plus coaching that included preconference, side-by-side coaching, and feedback on kindergarten teachers' use of research-based strategies during beginning reading instruction. Teachers were trained to enhance beginning reading instruction using research-based strategies including model-lead-test, unison responding (i.e., choral responding, response cards), and systematic error correction. Results indicated that for some teachers, a half-day in-service improved delivery of the research-based strategies, while others required side-by-side coaching to demonstrate improved use of the strategies. Teachers reported the in-service and coaching support were helpful and provided information on research-based strategies that increased student engagement. Implications for future research and practice are discussed.

Schools need cost and resource-efficient strategies to improve the academic performance of students with autism spectrum disorder (ASD). High-quality research demonstrates peer-mediated interventions effects on improved social skills for students with ASD. However, effects of peer-mediated interventions on academic outcomes are less understood concerning quality in ASD populations. This paper provides an updated systematic and quality review of the literature for Peer-Mediated Academic Instruction (PMAI) using peers of students with ASD. Authors identified eight new studies. Evaluation criteria included Council for Exceptional Children's Single Case Design Standards and the What Works Clearinghouse Standards. Results indicate PMAI can be considered and evidence-based practice to improve academic performance in the ASD population. Limitations and future directions are discussed.

Research indicates that employers rate personal hygiene as the number one barrier to employment among individuals with developmental disabilities. However, there is limited literature on improving personal hygiene in preparation for employment among individuals with developmental disabilities. Using a multiple-baseline across-participants design, this study examined the effect of self-monitoring on personal hygiene among five individuals with developmental disabilities, ages 19 to 22 years, attending a postsecondary education program. A functional relation was demonstrated between self-monitoring and reduced distracting body odor. Limitations, suggestions for future research, and practical applications are provided.