Iterative redesign of a caregiver-mediated intervention for use in educational settings

Teachers endorse disruptive behavior as a considerable concern for autistic students, which is compounded by the lack of adequate resources for behavioral intervention planning in the classroom. The RUBI program is an evidence-based, low-intensity manualized intervention, initially developed for parents of autistic children ages 3–14 and co-occurring disruptive behavior. Utilizing the Discover, Design/Build, Test (DDBT) framework, which combines user-centered design and implementation science, RUBI intervention content was collaboratively and iteratively redesigned with elementary school stakeholders (40 school staff from 28 schools) to ensure the feasibility, acceptability, and appropriateness of the redesigned intervention, RUBI in Educational Settings (RUBIES). Iterative quantitative and qualitative methods were conducted with stakeholders to identify targets for RUBI redesign. Conventional content analysis was used to code qualitative data and identify usability issues. Recommendations were provided for modifications to RUBI sessions to address the needs of the school context and end-users to develop RUBIES. Feasibility scores improved following the redesign. The use of the DDBT framework to redesign the RUBI intervention may promote greater usefulness and usability in school contexts. Lay abstract Teachers often report concerns about behavior challenges in their students with autism spectrum disorder (ASD) in the school setting. Furthermore, teachers often report that they do not have adequate training in how to manage these challenging behaviors effectively. The RUBI program is an intervention initially developed for parents of children with ASD and co-occurring challenging behavior in clinic settings. The present project used school staff input to systematically redesign RUBI to be used with educators in schools. School staff gave input at multiple stages of development to ensure the adapted intervention was appropriate to use in a school setting. Responses were coded and analyzed to identify strengths and weaknesses of the RUBI manual in schools and adaptations were made accordingly. Scores of how appropriate, possible, likable, and usable RUBI would be in schools rose after the intervention was redesigned. The redesigned RUBIES manual may give school staff the tools they need to manage disruptive behaviors. In addition, collaborating with providers over multiple stages to redesign established interventions for new contexts may be a promising way to help bring research tools to practice in the future.

Assessment and Management of ID in Childhood

Intellectual disability is a neurodevelopment disorder that affects the intellectual and adaptive functioning. The individual fails to meet standards of personal independence and social responsibility in one or more aspects of daily life, including communication, social participation, academic or occupational functioning, and personal independence at home or in community settings. There is an immense need to understand and be aware of the signs and symptoms of the disorder. This chapter focuses on the process of the assessment which is necessary to identify intellectual deficiency and also the issues that should be taken care of during the process. The various principles and tools of assessment, which can be used to measure IQ, are mentioned. It also focuses on the various challenging behaviors and functional analysis. It also focuses on recent and efficient management strategies that can be used to help the affected person cope and acquire new skills.

Technology-Aided Interventions to Reduce Challenging Behaviors for Individuals With Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) display a variety of challenging behaviors, such as tantrums, aggression, stereotypy, and disruption. Challenging behaviors can have a serious negative impact on the development of social relations, in the learning process, and education. To this aim, there is a need for appropriate interventions in order to improve the quality of life of individuals with ASD. This chapter aims to provide data with regard to different types of interventions and technological tools used for the reduction of challenging behaviors of students with ASD. Functional communication training with the use of speech-generating devices, video self-modeling, self-monitoring with the use of technological devices, and social stories presented in electronic form reflect types of interventions used for challenging behavior reduction. Research data indicate that technology-aided interventions are generally effective in reducing challenging behaviors of students with ASD.

A functional communication training for developing verbal behavior and treatment of challenging behavior in individuals with autism spectrum disorders

Communication problems are one of the symptoms of autism spectrum disorders. Challenging behaviors may be a form of communication with the environment, and when other forms of communication are not available, they may be the only way to meet their needs. The purpose of this article is to demonstrate the potential use of functional communication training in reducing problem behaviors of individuals with ASD, as well as developing acceptable ways of communication. In a research process based on behavior analysis, the method of single-subject experiment with multiple-baseline design was used. The results of the study show that the research participants developed communication skills on the basic level, and the frequency of their challenging behaviors has significantly decreased.

Double Casing Exit for Side-Track to Commingle Two Borehole Sizes Based Sections in One Slim Shot to Well TD

This project began when a 9-5/8" in 43.5 ppf production casing became inaccessible due to the existing cemented pipe inside, preventing further reservoir section exposure and necessitating a mechanical side-track meanwhile introducing the challenge of loosing one section and imposimg slim hole challenges. The size and weight of the double-casing made for challenging drilling, as did the eight very different formations, which were drilled. The side-track was accomplished in two steps, an 8½ in hole followed by a single long 6⅛ in section, rather than the three steps (16 in, 12¼ in, 8½ in) that are typically required. The optimal kick off point carfully located across the dual casing by running electromagnetic diagnostics, the casing collar locator, and the cement bond log. The double casing mill was carefully tailored to successfully accomplish the exit in one run. Moreover, an extra 26 ft. MD rathole was drilled, which helped to eliminate the mud motor elongation run. A rotary steerable system was utilized directly in a directional BHA to drill an 8½ in open hole building section from vertical to a 30⁰ inclination. A 7.0 in liner was then set to isolate weak zones at the equivalent depth of the outer casing (13-3/8"). Subsequently, a single 6⅛ in section was drilled to the well TD through the lower eight formations. Drilling a 6⅛ in section through eight formations came with a variety of challenges. These formations have different challenging behaviors relative to the wellbore pressure that typically leads to the drilling being done in two sections. Modeling the geo-mechanical characteristics of each formation allowed the determination of a mud weight range and rheology that would stabilize the wellbore through all eight formations. The slim, 6⅛ in, hole was stabilized with higher equivalent circulating density (ECD) values than is typically used in larger boreholes. Optimizing mud weight and drilling parameters, while managing differential sticking with close monitoring of real-time ECD, helped to stabilize the high-pressurized zones to deliver the well to the desired TD with a single borehole. This project represents the first time in Kuwait that double casings in such large sizes have been cut and sidetracked. It is also the first time these eight formations have been cut across such a smaller hole size, slim hole (6⅛ in) in a single shot. Geo-mechanical modeling allowed us to stabilize the pressurized formations and to control the ECD. The well also deployed the longest production liner in the field commingling multiple reservoirs with differnt pore pressure ramps, with excellent cement quality providing optimal zonal isolation.

Determining the Impacts of Educational Intervention based on PLST Extended Care on Caregiving Methods and Improved Exposure to Challenging Behaviors of People with Dementia (PWD): A mixed-methods study

BackgroundPsychological events in people with dementia (PWD) lead to behavioral disorders that require targeted planning for caregivers on how to adapt to these behaviors. A progressively lowered stress threshold (PLST) model provides effective interventions for caregivers to adapt to the behaviors of people with dementia (PWD). Therefore, this study aims to determine the impacts of educational intervention based on the progressively lowered stress threshold extended (PLSTE) model on the caregiving of people with dementia (PWD) in Isfahan, Iran.MethodsThis exploratory mixed methods study was initially conducted with a qualitative approach to content analysis type from May 2016 to June 2018. Data were collected in a qualitative stage through in-depth nonstructured interviews with 29 People with Dementia (PWD)'s caregivers using the "new comment" command and then analyzed. The researcher designed a multisectional questionnaire, including demographic characteristics, knowledge measurement, and monitoring the practice of caregivers. The validity of the questionnaire was verified by a panel of experts, and its reliability was confirmed using the Cronbach alpha coefficient (knowledge section 0.838 and practice section 0.802). To adjust the intervention program, the educational content based on the PLSTE model was used for 38 caregivers available at two elderly nursing centers in Isfahan. This educational intervention was designed and managed for the first time in our community. None of the caregivers agreed to refuse to receive the educational content, So the evaluation of the program lacks a randomized controlled group. The data were collected immediately and one month after the educational intervention using a questionnaire.ResultsAccording to the results of the qualitative section of this study, the researcher was able to add a cultural and belief class and then the related intervention method to the PLST model. In the quantitative part, paired t-test indicated that the mean scores of knowledge, caregiving practice, and exposure to Challenging Behaviors (CB) in all dimensions of practice immediately and one a month after intervention were significantly higher than the mean scores before intervention (P < 0.05).ConclusionConsidering the impacts of this intervention, educating caregivers with PLST extended the care model is recommended, with a specific focus on cultural and traditional issues of society, to improve the knowledge and practice of caregivers in caregiving skills and appropriate exposure to challenging behaviors people with dementia (CBPWD).Trial registration No. IRCT20180421039370N1 -2019-01-11-http://www.irct.ir

Environmental Strategies to Promote Appropriate Behaviors and Social Interaction in Young Children

Research suggests an increase in challenging behaviors among young children in early care and education settings (Granja et al., 2018). Challenging behaviors in early years are among the strongest predictors of more serious problem behaviors later in life (Brennan et al., 2015). High-quality, safe, responsive, and nurturing early care and education environments are critical to support development, engagement, and learning of young children with and without disabilities. Well-organized and engaging classroom environments help to prevent or decrease rates of challenging behaviors of young children by promoting appropriate behaviors and social interactions (Powell et al., 2006). Unfortunately, many practitioners working in early care and education settings are unsure how to create environments that support children’s engagement and prevent challenging behaviors they exhibit (Steed and Roach, 2017). This practice brief offers recommendations and strategies for practitioner to design more engaging and developmentally appropriate classroom environments to support appropriate behaviors and prevent challenging behaviors of young children.

Unbreakable Resolutions as an Effective Tactic for Self-Control: Lessons From Mahatma Gandhi and a 19th-Century Prussian Prince

Despite the relative consensus in the self-management literature that personal resolutions are not an effective stand-alone tactic for self-control, some individuals seem capable of using them to exert a remarkable level of control over their behavior. One such individual was Mahatma Gandhi, the famous Indian statesman. Gandhi often used personal resolutions—or “vows”—to commit himself to a range of challenging behaviors, such as extreme diets, sexual abstinence, and fasting. Similarly, Prince Pückler-Muskau, a celebrated 19th-Century adventurer, landscape designer and travel author, described using personal resolutions to unfailingly accomplish numerous tasks in his everyday life. In this article, we examine the historical writings of Gandhi and Pückler-Muskau concerning their use of resolutions. We describe three defining characteristics of their resolutions, which we will refer to as unbreakable resolutions, and outline Gandhi’s advice for making and keeping such resolutions. Our analysis suggests that the effectiveness of unbreakable resolutions may be primarily due to the temporally extended contingencies of reinforcement associated with their use, and can be usefully interpreted from the perspective of delay-discounting and say-do correspondence models of self-control. The implications of this examination for understanding the concept of willpower and for enhancing modern research into self-control training are also discussed. Based on this analysis, we additionally offer a tentative set of guidelines on how to make and keep unbreakable resolutions.

Enhancement of Social Communication Behaviors in Young Children With Autism Affects Maternal Stress

Children with autism spectrum disorder (ASD) show difficulties in social communication behaviors, emotion regulation and daily living skills, and they frequently present with challenging behaviors. In parents of children with ASD, higher rates of stress and mental health problems have been reported than in parents of either typically developing children or children with other conditions. In this study, we tested whether maternal well-being changes with improved social communicative behaviors of children with ASD receiving early intervention. We examined developmental changes in 72 pre-schoolers and stress levels in their mothers (measured by the Parental Stress Inventory) before and after a 12-month community-based intervention program based on the Early Start Denver Model, a naturalistic developmental behavioral intervention targeting social communication. Multiple regression analyses showed that maternal child-related stress was predicted by changes in children's social communication behaviors (measured with the Pervasive Developmental Disorder Behavior Inventory). Gains in the early social communication behavior domain were the strongest predictor of post-intervention child-related maternal stress, surpassing adaptive behavior, language and non-verbal cognitive gains, and reduction in challenging behavior. These findings support the hypothesis that, in children with ASD, the acquisition of social communication behaviors contribute to improvements in maternal well-being.

Enhancing Classroom Management Skills: Efficacy of a Supplemental Multi-Platform Intervention for Preservice Teachers

Many teachers are ill-prepared to apply practices that can both preempt and address challenging behaviors that interfere with academic instruction. We evaluated the efficacy of a supplemental multi-platform (direct instruction, guided practice, and mixed reality simulations) intervention designed for preservice teachers who do not have opportunities to participate in formal classroom management courses. Efficacy of the intervention was assessed through the quality of classroom management plans, the presentation and implementation of the plan in the virtual classroom, and classroom management self-efficacy. Results indicated that preservice teachers successfully developed quality proactive classroom management plans but struggled to present and implement their plans. However, self-efficacy increased indicating that participants believed they were better able to manage classroom behavior than they did prior to the intervention. Implications of these outcomes are discussed with an emphasis on how adequate opportunities to practice acquired classroom management skills are included in budget-challenged teacher preparation programs.