The feasibility of a strategy for the remote recruitment, consenting and assessment of recent referrals: a protocol for phase 1 of the On-Line Parent Training for the Initial Management of ADHD referrals (OPTIMA)

Background In the UK, children with high levels of hyperactivity, impulsivity and inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially regarding the management of challenging and disruptive behaviours that often accompany ADHD. However, traditional face-to-face PT is costly and difficult to organise in a timely way. We have created a low-cost, easily accessible PT programme delivered via a phone app, Structured E-Parenting Support (STEPS), to address this problem. The overall OPTIMA programme will evaluate the efficacy and cost-effectiveness of STEPS as a way of helping parents manage their children behaviour while on the waitlist. To ensure the timely and efficient evaluation of STEPS in OPTIMA, we have worked with children’s health services to implement a remote strategy for recruitment, screening and assessment of recently referred families. Part of this strategy is incorporated into routine clinical practice and part is OPTIMA specific. Here, we present the protocol for Phase 1 of OPTIMA—a study of the feasibility of this remote strategy, as a basis for a large-scale STEPS randomised controlled trial (RCT). Methods This is a single arm observational feasibility study. Participants will be parents of up to 100 children aged 5-11 years with high levels of hyperactivity/impulsivity, inattention and challenging behaviour who are waiting for assessment in one of five UK child and adolescent mental health or behavioural services. Recruitment, consenting and data collection will occur remotely. The primary outcome will be the rate at which the families, who meet inclusion criteria, agree in principle to take part in a full STEPS RCT. Secondary outcomes include acceptability of remote consenting and online data collection procedures; the feasibility of collecting teacher data remotely within the required timeframe, and technical difficulties with completing online questionnaires. All parents in the study will receive access to STEPS. Discussion Establishing the feasibility of our remote recruitment, consenting and assessment strategy is a pre-requisite for the full trial of OPTIMA. It can also provide a model for future trials conducted remotely.

Development and validation of the professional sense of competence scale (ProSOCS) for practitioners who treat disruptive behaviours in children

PurposeThe purpose of this paper is to develop a measure of practitioner sense of competence when treating children with disruptive behaviours.Design/methodology/approachTwo online surveys were conducted with health, social work and psychology practitioners (n = 113 and n = 239, respectively) working within varied Australian clinical settings. Study 1 developed scale items and conducted an exploratory factor analysis of the initial Professional Sense of Competence Scale (ProSOCS). Study 2 conducted confirmatory factor analysis and tested the construct validity of the scale.FindingsStudy 1 established a three-factor model, which accounted for 56.9% of variance in the ProSOCS items. Study 2 confirmed the three-factor model and considered an alternative unidimensional model. Study 2 demonstrated good convergent validity with measures of knowledge and general sense of competence.Originality/valueThe ProSOCS is a valid and reliable way to measure three subscales of a more global composite score of practitioner sense of competence when treating children with disruptive behaviours. Disruptive behaviour represents one of the most common reasons for child presentation in mental health care settings. Understanding how sense of competence among professionals who treat disruptive behaviours in children relates to their level of training, treatment decisions and outcomes could help to enhance use of evidence-based treatment strategies and complement strategies for measuring competence-based training in post-graduate settings.

Enhancing Interprofessional Collaboration in Perioperative Setting from the Qualitative Perspectives of Physicians and Nurses

Communication failures were a leading cause of sentinel events in the operation room due to frequently the communication breakdown occurs between physicians and nurses. This study explored the perspectives of surgical teams (nurses, physicians, and anaesthesiologists) on interprofessional collaboration and improvement strategies. A surgical team comprising eight perioperative nurses, four surgeons, and four anaesthesiologists from a university-affiliated hospital participated in this qualitative and phenomenological research from December 2018 to April 2019. Data were collected in in-depth interviews and were used in a thematic analysis according to Colaizzi to extract themes and categorised codes with the ATLAS.ti software. The result is presented in three generic categories: Barrier-like disruptive behaviours and lack of coordination of care; consequences by safety threats to the patient; overcoming barriers by shared decision making among professionals, flattened hierarchies, and teamwork/communication training. The conclusion is that different teams’ perspectives can facilitate genuine reflection, discussion, and implementation of targeted interventions to improve operating room interprofessional collaboration and overcome barriers and their consequences. Currently, there is a need to change towards interprofessional collaboration for optimal patient outcomes and to ensure all professionals’ expectations are met.

The Role of Physical Environmental Characteristics and Intellectual Disability in Conduct Problem Trajectories Across Childhood: A Population-Based Cohort Study

Background: The paucity of research investigating the role of the physical environment in the developmental progression of conduct problems and the potential moderating effects of intellectual disability (ID) is surprising, given the clinical relevance of elucidating environmental determinants of disruptive behaviours. Aims: To use data from a large UK cohort study to assess associations between physical environmental exposures, ID, and conduct problem trajectories. Method: The sample included 8,168 Millennium Cohort Study children (1.9% with ID). Multilevel growth curve modelling was used to examine the role of physical environment characteristics in the developmental trajectories of conduct problems after adjustments for ID status. Results: Exposure to external environmental domains was not associated with differences in child conduct problems across development. Alternatively, internal aspects of the household environment: spatial density (b = 0.40, p<.001) and damp problems (b = 0.14, p<.001) were both significantly associated with increased trajectories. Various individual and familial covariates were positively associated with conduct problems over time, including: presence of ID (b = 0.96, p<.001), autism spectrum disorder (b = 1.18, p<.001), male sex (b = 0.26, p<.001), poverty (b = 0.19, p<.001), maternal depression (b = 0.65, p<.001), and non-nuclear family structure (b = 0.35, p<.001). Positive ID status appeared to moderate the effects of internal household spatial density, reporting a non-linear negative association with spatial density and conduct problems across development (b = -1.08, p<.01). Conclusions: Our findings highlight the potential harmful consequences of poor internal residential conditions on child development of disruptive behaviours.

The Feasibility of a Strategy for the Remote Recruitment, Consenting and Assessment of Recent Referrals: A Protocol for Phase 1 of the on-line Parent Training for the Initial Management of ADHD Referrals (OPTIMA).

Background: In the UK, children with high levels of hyperactivity, impulsivity and inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially regarding the management of challenging and disruptive behaviours that often accompany ADHD. However, traditional face-to-face PT is costly and difficult to organise in a timely way. We have created a low-cost, easily accessible PT programme delivered via a phone app, Structured E-Parenting Support (STEPS), to address this problem. The overall OPTIMA programme will evaluate the efficacy and cost-effectiveness of STEPS as a way of helping parents manage their children behaviour while on the waiting list. To ensure the timely and efficient evaluation of STEPS in OPTIMA, we have worked with children’s health services to implement a remote strategy for recruitment, screening, and assessment of recently referred families. Part of this strategy is incorporated into routine clinical practice and part is OPTIMA specific. Here we present the protocol for Phase 1 of OPTIMA – a study of the feasibility of this remote strategy, as a basis for a large-scale STEPS randomised controlled trial (RCT). Methods: This is a single arm observational feasibility study. Parents of up to 100 children aged 5-11 years with high levels of hyperactivity/impulsivity, inattention and challenging behaviour who are waiting for assessment in one of five UK child and adolescent mental health or behavioural services. Recruitment, consenting and data collection will occur remotely. The primary outcome will be the rate at which the families, who meet inclusion criteria, agree in principle to take part in a full STEPS RCT. Secondary outcomes include acceptability of remote consenting and online data collection procedures; the feasibility of collecting teacher data remotely within the required timeframe, and technical difficulties with completing online questionnaires. All parents in the study will receive access to STEPS. Discussion: Establishing the feasibility of our remote recruitment, consenting and assessment strategy is a pre-requisite for the full trial of OPTIMA. It can also provide a model for future trials conducted remotely. Trial registration: N/A

Capturing the emotional experiences of English as a foreign language university teachers: A critical perspective

Although emotions constitute an integral aspect of teachers’ lives, emotions experienced by teachers of English as a foreign language (EFL) in higher education, settings are relatively under-researched. Through in-depth interviews, this study aims to capture a small cohort of nine EFL female teachers’ emotional experiences when teaching English-major students in a large public university in Saudi Arabia. Methods of inductive thematic analysis helped capture the participants’ emotional experiences during teaching. The analysis of their emotional experiences is informed by Benesch’s (2017) critical approach to teachers’ emotions. The study revealed that relationships in the classroom and the institutional system greatly influence how teachers construct, express, and communicate their emotions. Teachers’ passion for teaching, students’ classroom engagement, and students’ appreciation of teachers’ efforts triggered the teachers’ sense of happiness and pride and contributed to their occasional positive valence. However, teachers often experienced anger, frustration, demoralization, anxiety, and sadness as a result of feeling disempowered when dealing with students’ disruptive behaviours and constraining institutional policies. The study suggests that teachers’ emotions influenced their pedagogical practices and physical and psychological wellbeing. Therefore, to support teachers’ emotional competence, mitigate teachers’ emotional difficulties experienced during teaching, and enhance classroom teaching and learning, educational institutions, program leaders, and policymakers need to acknowledge the centrality of teachers’ emotions in the EFL classroom.

DISCIPLINE STRATEGIES PRACTISED IN EARLY CHILDHOOD SETTINGS IN MAURITIUS

<p>This research was conducted to identify and examine the discipline strategies that early childhood teachers may adopt to deal with disruptive behaviours of toddlers. The research was a qualitative research design and a case study. Five early childhood teachers were selected using purposive sampling and 30 toddlers in a private early childhood centre. The data about the practice of discipline strategies by the teachers were gathered by a semi-structured interview schedule and non-participant observation was used to collect data from the toddlers. According to the results of the study, it was found that early childhood education teachers were adopting positive discipline to prevent behaviour problems. The strategies adopted are guidance, autonomy, creating positive relationships, effective planning of the learning environment, and emotion coaching. This research shed light on the shift in the discipline paradigm in the early childhood setting in Mauritius. Instead of adopting reactive and punitive strategies, the practitioners are adopting proactive and discipline which is more humanistic and egalitarian, particularly when the child should be given the best learning opportunities for their holistic development. The findings may serve as an eye-opener especially for the policy and decision-makers like the Ministry of Education, to rethink the current practices in the public early childhood settings. For further research, a comparative study may be done to examine the extent to which positive discipline may be implemented in the public early childhood centres of the country.</p><p> </p><p>Cette recherche a été menée pour identifier et examiner les stratégies disciplinaires que les enseignants de la petite enfance peuvent adopter pour faire face aux comportements perturbateurs des tout-petits. La recherche était une conception de recherche qualitative et une étude de cas. Cinq enseignants de la petite enfance ont été sélectionnés à l'aide d'un échantillonnage raisonné et 30 enfants en bas âge dans un centre privé de la petite enfance. Les données sur la pratique des stratégies disciplinaires par les enseignants ont été recueillies par un calendrier d'entretien semi-structuré et l'observation non participante a été utilisée pour recueillir des données auprès des tout-petits. D'après les résultats de l'étude, il a été constaté que les enseignants en éducation de la petite enfance adoptaient une discipline positive pour prévenir les problèmes de comportement. Les stratégies adoptées sont l'accompagnement, l'autonomie, la création de relations positives, la planification efficace de l'environnement d'apprentissage et le coaching émotionnel. Cette recherche met en lumière le changement de paradigme de la discipline dans le cadre de la petite enfance à Maurice. Au lieu d'adopter des stratégies réactives et punitives, les praticiens adoptent une discipline proactive et plus humaniste et égalitaire, en particulier lorsque l'enfant doit bénéficier des meilleures opportunités d'apprentissage pour son développement holistique. Les résultats peuvent ouvrir les yeux, en particulier pour les responsables politiques et les décideurs comme le ministère de l'Éducation, pour repenser les pratiques actuelles dans les milieux publics de la petite enfance. Pour des recherches plus poussées, une étude comparative peut être menée pour examiner dans quelle mesure une discipline positive peut être mise en œuvre dans les centres publics de la petite enfance du pays.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0743/a.php" alt="Hit counter" /></p>

COMPASSION FATIGUE OF TEACHERS HANDLING STUDENTS WITH DISRUPTIVE BEHAVIOURS IN INCLUSIVE CLASSROOM

The present study, the investigator aims to compassion fatigue of teachers while handling students with disruptive behaviours in inclusive classroom. One Hundred and Fifty teachers handling students with disruptive behaviours in inclusive setup from Sivaganga District in Tamil Nadu were chosen as sample, by using purposive sampling technique and administered with a compassion fatigue Rating Scale. The results of the research questions tested revealed that teachers were signicantly more likely to have high and moderate risk of compassion fatigue, while teachers handling students with disruptive behaviours. Male teachers experience higher level of compassion fatigue than the female teachers. This result shows that the female teachers are experiencing less compassion fatigue than male teachers and it may be due to their nature of patience, tolerance and societal & cultural background. This study revealed the need for compassion fatigue reduction training programme for the teachers handling students with disruptive behaviour. Educational Bodies like NCERT, SCERT, DIET should design in service and pre service training programme for teachers to overcome their depression and compassion fatigue while handling disruptive behaviours. Training to male counterparts to strength their emotional stability is also to be designed to combat the compassion fatigue arising out of their nature.

Are the Most Effective Approaches towards Helping Students with Emotional Behavioural Disorders (EBDs) Predisposed and Trait Based?

Trait emotional intelligence (EI) may prove to be most valuable as an approach for dealing with others’ behaviours/emotions via its related psychological processes. Personality trait theory posits that an individual’s level of EI affects their cognitive-affective-behavioural reaction towards students with emotional behavioural disorders (EBDs) and influences the level of difficult behaviour. EI would be an essential element in fostering supportive interactions with students as a way of preventing and/or managing disruptive behaviours. The author explores which individuals are more predisposed to discriminate against EBD students using an attribution model framework and identifies the most effective and supportive EI traits. Two hundred and sixty-one teachers from 51 Victorian schools completed self-report questionnaires, including the Trait Emotional Intelligence Questionnaire. A quantitative survey methodology used vignettes (depicting a student with either mild or severe EBD symptoms), with 50/50 surveys randomly distributed. Teacher EI predicted the behaviour towards students with EBDs, whilst bypassing or biasing conscious thought processing. Combinations of EI traits were identified that produced the most desirable outcomes, demonstrating EI’s propensity to direct reactions towards a more effective or dysfunctional helping approach. The findings suggest that the most effective approaches towards helping EBD students are the innate dispositional reactions that establish the necessary psychological foundations for any successful interaction or outcome. The development of an assessment tool (Assessment Screen for Emotionally Intelligent Teachers (ASET)) lays a sound foundation for profiling teachers with these ideal qualities.