Thesis (Ph. D.)--University of Sydney, 1999. / Title from title screen (viewed Apr. 21, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Faculty of Nursing. Degree awarded 1999; thesis submitted 1998. Includes bibliography. Also available in print form.

Thesis (Ph. D.)--UCLA, 2005. / Vita. Includes bibliographical references (leaves 59-67).

Thesis (PhD. (Nursing Science, Faculty of Health Sciences))--University of Pretoria, 2005. / Includes bibliographical references

Thesis (Ph. D.)--Florida State University, 2006. / Advisor: Amy Wetherby, Florida State University, College of Communications, Dept. of Communication Disorders. Title and description from dissertation home page (viewed June 13, 2006). Document formatted into pages; contains vi, 93 pages. Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 90-101).

OBJECTIVE: Within the U.S. population approximately 20 percent of individuals are diagnosed with some type of disability and another 12 percent are considered severely disabled. Many times special health care needs (SHCN) patients with one condition are burdened by more than one disability. A variety of conditions such as behavioral issues, developmental disorders, and cognitive, congenital or systemic diseases have been proven to increase the risk of oral heath disease in individuals with SHCN. These conditions may affect the ability to communicate and limit dexterity for proper oral health maintenance, which is why caregivers must become advocates for these patients to insure their oral health needs are met. By communicating effectively with caretakers, dentists will be able to establish a positive impact on patients to make dental visits easier and less traumatizing. Unfortunately studies have found that dental and hygiene students graduate without feeling adequately prepared to treat patients with SHCN. With the proper education and training, more dental students and future dentists will take on the challenges that are brought by these individuals to provide the best care possible. Establishing a strong support system could potentially decrease oral health disparity in SHCN patients and improve overall care. The goal of this study was to assess whether or not there was a positive impact on the oral health of SHCN individuals when caregivers and oral health professionals worked together in a team treatment effort to fight against oral disease. METHODS: Study used a systematic review approach of literature where a PICO question was formed and the article selection process included a review of title, abstract, and application of inclusions and exclusion criteria. Printed-text and online databases such as Pubmed/MEDLINE, Google Scholar, and Web of Science were used to conduct a review of literature where a total of 210 papers were collected. After selection process, only four papers were eligible for systematic review. Pre-determined questions were used to determine the how involved caregivers and oral health professionals were during each study followed by an assessment using a point system, which scored caregiver and oral health professionals involvement during intervention. RESULTS: Selected studies showed heterogeneity in study design and sample size but all used multidisciplinary approach, which included some degree of caregiver and oral hygiene provider (OHP) collaboration. Two out of the four studies totaled nearly perfect scores in both caregiver and oral health professional involvement, which resulted in a positive effect on oral health care of SHCN patients. Case reports that included an interdisciplinary team approach to oral care procedures on patients, showed the benefits of teamwork and how collaborative practice between dental and medical professionals increased successful patient outcomes. Results illustrated the significant role that caregiver’s play in the dental team and how their absence during intervention treatment significantly lowered study scores for the overall success of patient care. CONCLUSIONS: Results demonstrated that studies with a well-rounded dental team, which included caregivers, OHP, health care professionals accompanied by social support systems, saw the greatest success and improvements in oral health care of SHCN patients. Nevertheless, a dedicated dental team where most members were present did not guarantee intervention success if caregivers did not show a significant involvement. Caregivers alone could positively impact oral health care of a patient more than if OHP worked alone. In conclusion, we found that each member of a dental team had the ability to impact change to an almost equal degree. For this reason, it is important for caregivers, OHP, dental staff and health care professionals to work together, support one another and communicate effectively to decrease oral health disparities in SHCN patients.

The present study utilized Microsoft Visual Basic 2008 to investigate the role of comparing high and low preferred education-based stimulus equivalence protocols for adults with developmental disabilities outside the educational system. First, participants were exposed to all educational categories and completed a paired choice preference assessment to identify high and low preferred protocols. Next, participants completed high and low preferred protocols following an alternating treatments design, with an initial pretest, training, posttest, and a test for an emergent topography (typing skills). Results showed evidence of higher preference through duration and errors per min measures for two of three participants, with results unclear for a third participant. Furthermore, one participant displayed all equivalence classes expected of the training protocol, while another demonstrated all emergent relations for the high preferred protocol but only one of six for the low preferred protocol, and the last participant exceeded criterion for four of six posttests for the high preferred protocol, and two of six for the low preferred protocol. The results are discussed in terms of measures for preferences, habilitation, modifications to training protocols, the study's limitations, and directions for future research.

Basic laboratory research has shown that variability is an operant dimension of behavior (Page & Neuringer, 1985). Applied research on behavioral variability has been conducted with a variety of populations and response topographies; however, no research has been conducted with adults with developmental disabilities, and only one study has targeted activity selection (Cammilleri & Hanley, 2005). In the present study, varied activity selection was reinforced according to a Lag 1 schedule of reinforcement. The present study also evaluated whether selection of novel activities occurred in the absence of differential reinforcement and assessed generalization of varied activity selection. Varied activity selection increased for all participants although prompts to select activities were required for 2 of 3 participants. Few novel selections occurred throughout the study and varied activity selection did not generalize to participants' natural environments. These results suggest that a lag schedule of reinforcement can be used to increase varied activity selection by adults with developmental disabilities but should be implemented in the natural environment.

The goal of community placement for people with developmental disabilities is to enable them to live productively and independently. However, the very routines followed at programs and facilities that serve them often thwart that goal. The present study was designed to increase the extent to which individuals with developmental disabilities engaged in tasks pursuant to preparing for, consuming, and cleaning up after lunch. During the pre-served condition, staff prepared and served the lunches to the clientele without involving them in any substantial way. The self-served condition involved staff training and environmental changes in order to set the occasion for greater independence among the clientele. The changes included involving the clientele in the preparation, consumption, and clean-up of the meal by least-to-most prompting of the clients through the tasks. Data was collected on 61 participants. A subset of 12 participants' verbal behavior was examined in order to determine the intervention's impact on positive and negative verbal behavior. A multiple baseline analysis across lunch groups indicated an increase in participation in activities associated with the lunch routine, but had varying effects on verbal behavior.

Positive staff interactions with clients can be difficult to maintain when working with adults with developmental disabilities who display challenging behavior. Research findings have demonstrated a common display of challenging behaviors within this population and some of the staff that work with these individuals display less than positive interactions which has led researchers to investigate the use of several behavioral approaches to improve staff interactions. One intervention that has been explored is Acceptance and Commitment Therapy (ACT); however, there is limited research in applying ACT to this problem. Therefore, the purpose of this study was to evaluate the effectiveness of ACT, specifically the use of mindfulness techniques in improving staff interactions towards developmentally disabled clients. Results of this study revealed that mindfulness techniques were effective at improving staff interactions towards clients, as indicated by an increased number of positive staff interactions, with continued practice of these behaviors during maintenance probes.