Early intervention services are important in obtaining better outcomes for infants with a developmental delay or a condition that may result in a delay. In Florida, a primary resource for providing these services is the Early Steps Program. This study analyzed the Early Steps referral process to identify barriers to prompt access. The guiding hypothesis was if differences exist in key outcomes of the referral process, then these differences may reveal where improvements can be made. Improving access to early intervention should produce better outcomes and reduce the costs of services required later by addressing developmental concerns earlier. The dataset included records for 10,688 infants referred to the Hillsborough County Early Steps Program between 2006 and 2009. Two measures (age at referral and time to IFSP) represented points within the referral process where delays could be quantified. Age at referral is a measure of how long it takes for a delay to be identified and the infant referred for evaluation. The time from the referral to the date an IFSP is created provides a measure of the delay in beginning services. Delays in obtaining a referral were associated with being referred by a family member, the referral code Developmental Delay At Risk and barrier codes Child/Family Issues and No Show/Unsuccessful Contact. Delays in completing the IFSP were related to being younger at referral, being referred by one of the sources that made less frequent referrals to Early Steps, an eligibility determination related to behavior concerns, maternal education that stopped at grade 8 or below and being Black.

Made available in DSpace on 2014-06-11T19:22:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-09-25Bitstream added on 2014-06-13T20:49:31Z : No. of bitstreams: 1 schlittler_dxc_me_rcla.pdf: 775914 bytes, checksum: 22d8e55318f13c46c957c86e637fc1f3 (MD5) / Dois estudos foram realizados para investigar o efeito de esteira motorizada nas passadas de bebês com desenvolvimento típico e de risco de atraso desenvolvimental e no desenvolvimento motor global de bebês de risco de atraso desenvolvimental. O primeiro estudo teve como objetivo examinar o efeito da velocidade da esteira em passadas desencadeadas em bebês com desenvolvimento típico. Seis bebês, com idade entre 11 e 13 meses e iniciando o andar independente, foram filmados andando na esteira, nas velocidades de 0,1, 0,16, 0,22 e 0,28 m/s, com marcas passivas afixadas no centro articular do ombro, quadril, joelho e tornozelo e no 5o metatarso. As imagens foram digitalizadas com o software Ariel Performance Analysis System, obtendo variáveis espaço-temporais e angulares das passadas dos bebês. Nas velocidades de 0,22 e 0,28 m/s, foi observado aumento da velocidade e duração da passada, além de uma menor duração da fase de suporte na velocidade de 0,22 m/s. Ainda, nas velocidades de 0,22 e 0,28 da esteira, observou-se aumento da amplitude articular de quadril e joelho. Estes resultados sugerem que as velocidades de 0,22 e 0,28 m/s são as mais indicadas para desencadear passadas em bebês que estão iniciando o andar independente. O objetivo do segundo estudo foi examinar o efeito de intervenção em esteira motorizada na idade de aquisição do andar independente e de outros marcos motores em bebês de risco de atraso desenvolvimental. Para tanto, foram constituídos três grupos de bebês: bebês de risco de atraso desenvolvimental que foram submetidos a tratamento fisioterápico e programa de intervenção... / Two studies were proposed in order to investigate the treadmill effects on walking strides in typical developing infants and in infants at risk for developmental delay and on global motor development of infants at risk for developmental delay. The purpose of the first study was to investigate the effects of treadmill belt speed on induced walking strides of typical developing infants. Six infants aging between 11 and 13 months and acquiring independent walking were videotaped walking on a treadmill, belt speeds of 0.1, 0.16, 0.22, and 0.28 m/s, with passive reflective markers on shoulder, hip, knee, and ankle joint centers and on fifth metatarso. The walking images were digitized using the Ariel Performance Analysis System software, obtaining spatio-temporal and angular variables of the walking strides. In the speeds of 0.22 and 0.28 m/s, it was observed stride velocity and duration increasing besides a decreased of supportive phase at velocity of 0.22 m/s. Moreover, in the speeds of 0.22 and 0.28 m/s, it was observed increased hip and knee range of motion. These results indicate that 0.22 and 0.28 m/s velocities are the most indicated ones to induce walking strides in infants who are acquiring independent walking. The purpose of second study was to examine the effects of a motorized treadmill intervention in the age of independent walking acquisition and global motor development in infants at risk for developmental delay. Three groups were constitute: infants at risk for developmental delay submitted to a physical therapy and motorized treadmill intervention (Experimental Group – EG); infants at risk... (Complete abstract click electronic access below)

This dissertation is a qualitative study of the relationship between a mother and a toddler with a disability. This study was conducted with both a mother and toddler at the Baby Therapy Centre in Pretoria, a facility that caters for babies and toddlers between the ages of birth to three years with special needs and developmental delays. The purpose of this research was to explore how the medium of music throughout a process of eight music therapy sessions might afford a mother and toddler with a disability opportunities for relating. Throughout the course of the music therapy process, moments of play, communication and meaningful interaction occurred between the mother and toddler, indicating a shift in the mother-toddler relationship, thereby advocating for the inclusion of mothers in music therapy sessions. The research approach adopted in this dissertation includes an in-depth case study of one mother-toddler pair, using interviews and thick descriptions of video excerpts as the main data sources. The findings from this research indicate that music therapy affords a mother and toddler with a disability opportunities to relate within sessions through play, musical interaction, instrumental play, vocal use and improvisation. The inclusion of the mother in music therapy sessions appeared to enhance the mother-toddler relationship, in addition to the learned transference of skills that the toddler acquired during the process. Copyright / Dissertation (MMus)--University of Pretoria, 2012. / Music / unrestricted

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In comparison to school age special education practices, preschool special education practices have received far less attention in the research community. Each year in the United States, over 250,000 preschool age children are determined to exhibit developmental delay. It is unknown how many of them exhibit developmental delay in the area of social emotional functioning and what is the educational placement in which they received special education services. In this study, a national sample of school psychologists (n=119) who practice in early childhood settings was surveyed with regard to their assessment and educational placement practices. Results indicated that more school psychologists chose the regular education setting as opposed to separate classroom for placement of children with social and developmental delays. However, when placement options were grouped by settings it became evident that overall more preschoolers with social and emotional delays receive services in non-inclusive settings. Assessment factors as opposed to program factors were most influential on placement decisions. Observation in the educational setting was found to be the primary assessment tool in both assessment of social emotional competencies and in contributing to placement decisions. School psychologists reported annual monitoring of placement decisions and no correlation between the frequency of monitoring and the psychologists' perceived quality and efficacy of programming was found. Possible explanations and the associated implications of the study's findings are discussed. / School Psychology

Neuropsychological developmental screening (NES) is a German tool (published in 2005) for assessing eight fields of development of children aged 3 to 24 months. It is designed for pediatritians, early intervention specialists and psychologists. This thesis builds on A. Klapetek's thesis and aims to verify and check accurancy of Czech translation of the tool by administring the test to a group of Czech children. A. Klapetek conducted a pilot study of the tool. 50 children (10 for every age group) were administred the translation which was being refined during the field research. She also planned further steps to applying NES. Literature review of the thesis deals with developmental characteristics of infants and toddlers. Psychological assessment of young children and its uses and risks are described. The thesis also persues developmental scales, their history and present state. Theoretical concept of the Neuropsychological developmental screening (NES) is introduced. During the field research a group of 50 children was assessed by Czech translation of the tool, and the same group was tested by Developmental screening (Kovařík). Results of the testing were used to discuss existing norms of the tool, to identify problematic exercises (both too difficult and too easy) and to statistically analyse...

Obesidade sindrômica é definida como a obesidade ocorrendo em conjunto com várias características clínicas distintas, associadas a retardo mental. A forma sindrômica mais freqüente é a síndrome de Prader-Willi (PWS) caracterizada por hipotonia, dificuldade de sucção no período neonatal, atraso do desenvolvimento neuropsicomotor (DNPM), hiperfagia, obesidade, baixa estatura na adolescência, mãos e pés pequenos, hipogonadismo, dificuldade de aprendizado e distúrbios de comportamento. Estudamos 141 pacientes com obesidade e/ou hiperfagia, atraso no desenvolvimento neuropsicomotor e/ou dificuldades de aprendizado e distúrbios de comportamento, pela técnica de MLPA (multiplex ligation-dependent probe amplification) assim como 19 pacientes que apresentavam além de atraso do DNPM e/ou dificuldade de aprendizado, distúrbios de comportamento, obesidade e/ou hiperfagia, outro sinal ao exame físico que sugerisse alteração cromossômica, pela técnica de SNP-array (The GeneChip 174; Mapping 100K Set, Affymetrix), com o objetivo de identificar genes e/ou segmentos cromossômicos envolvidos com obesidade sindrômica. Essas técnicas detectam deleções e/ ou duplicações do genoma, seja analisando regiões específicas, como a de MLPA, seja cobrindo praticamente o genoma inteiro (SNP-array). Dez pacientes apresentaram alterações cromossômicas: duas deleções 1p36, uma deleção 2p25.3, uma deleção 3p26.3 e duplicação 11q22.3, uma deleção 6(q16.1-q21), duas deleções 12(q15q21.1) (irmãs gêmeas), uma deleção X(p22.13p22.12), uma duplicação 14q11.2 e uma duplicação X(q26.3). Dentre as alterações encontradas estão duas síndromes relacionadas com obesidade já descritas, a monossomia 1p36 e a monossomia 6q16, que são diagnósticos diferencias da PWS. Nos segmentos alterados foram localizados vários genes relacionados a obesidade: DRD2, MCHR2, PLCH2, PRKCZ, RAB21, RAB2B, RAB39, TPO e SIM1. Onze genitores foram analisados por MLPA, SNP-Array e/ou cariótipo e rearranjos cromossômicos não foram identificados. Na presença dos cromossomos parentais normais o risco de recorrência é considerado desprezível. O diagnóstico de pacientes com obesidade sindrômica é um desafio, pois há sobreposição de fenótipos impossibilitando até agora o diagnóstico diferencial, a não ser o da síndrome de Prader-Willi clinicamente reconhecível, pelo menos, em sua segunda fase. O emprego de técnicas que detectam variações no número de cópias do genoma humano amplia a possibilidade de reconhecimento de novas síndromes e a descrição do espectro da variabilidade fenotípica de síndromes conhecidas. Estas síndromes são uma potencial fonte de esclarecimento das causas das formas comuns de obesidade. / Syndromic obesity is defined as obesity occurring in association with several distinct clinical features and mental retardation (MR). Prader-Willi syndrome (PWS) is the most frequent syndromic form of obesity and is characterized by hypotonia, poor sucking in the neonatal period, developmental delay, hyperphagia, obesity, short stature in adolescence, small hands and feet, hypogonadism, learning disabilities and behavior disturbances. Herein, we studied 141 patients with obesity and/or hyperphagia, psychomotor developmental delay and/or learning disabilities and behavior disturbances with the technique of MLPA (multiplex ligation-dependent probe amplification), and 19 patients by SNP-array technique (\"The GeneChip 174; Mapping 100K Set, Affymetrix) to identify copy number variations. By using both techniques we detected deletions or duplications of the genome in ten patients: two deletions at 1p36, two deletions at 12q15q21.1 (twins), a deletion of chromosomes 2p25.3, 6q16.1-q21, and Xp22.13p22.12, a duplication of chromosomes 14q11.2 and Xq26.3, and an unbalanced translocation between chromosomes 3p26.3 and 11q22.3. Monosomy 1p36 and monosomy 6q16 are well-known syndromes and had already been related with obesity. Both syndromes are considered as differential diagnosis of PWS. Several genes related to obesity are mapped in the altered chromosome segments: DRD2, MCHR2, PLCH2, PRKCZ, RAB21, RAB2B, RAB39, TPO and SIM1. Eleven parents were studied by MLPA, SNP array, and / or karyotype analyses, and chromosomal rearrangements were not identified. Therefore, we consider these rearrangements to be causative of the patients´ phenotype. The diagnosis of patients with syndromic obesity is a challenge due to the overlapping of the phenotypes, except for Prader-Willi syndrome that is a clinically recognizable syndrome, mainly in its second phase. The use of techniques that detect copy number variations of the human genome will increase the recognition of new syndromes and also the description of the spectrum of phenotypic variability of known syndromes. These syndromes are a potential source for the understanding of the etiology of the common forms of obesity.

An increasing number of infants are diagnosed with neonatal abstinence syndrome (NAS) as a result of prenatal opioid exposure. Early intervention services are recommended for this population of children and families to mitigate developmental delays associated with NAS. The effectiveness of early intervention is dependent on the ability of interventionists who deliver these services. The purpose of this qualitative case study was to explore early interventionists' perspectives of self-efficacy when working with infants diagnosed with NAS and their families. Bandura's self-efficacy theory and Rotter's concept of locus of control provided the conceptual framework for this study. The study's guiding research questions focused on early interventionists' self-efficacy beliefs and factors that may affect those beliefs in their work with infants diagnosed with NAS and their families. Data were collected via semistructured interviews with 8 interventionists. Themes emerged from both in vivo and a priori coding pertaining to interventionists' self-efficacy beliefs working with the NAS population. Most interventionists in this study reported feeling highly efficacious in their work with infants with NAS and their families despite a lack of applicable educational and professional preparation. Interventionists attributed their professional efficacy to their own self-study, experience, and motivation to learn. Interventionists agreed that training specific to their work with NAS may improve their ability and self-efficacy in their work with infants with NAS and their families. Targeted training to increase interventionists' self-efficacy in their work with infants diagnosed with NAS and their families may result in increased effectiveness of intervention services and lead to lifelong positive outcomes for these vulnerable children.

Made available in DSpace on 2016-06-02T20:30:50Z (GMT). No. of bitstreams: 1 3579.pdf: 743261 bytes, checksum: b02e2d46e571c13a05a8e9358e8d7250 (MD5) Previous issue date: 2011-03-04 / Financiadora de Estudos e Projetos / Obesity and pre-obesity have been considered as one of the major health problems in modern society, both in developed and in developing countries is the increase in rates of overweight or obese individuals. Although much is known about the types of foods that contribute to it, few results have been observed in the control of impulsivity commonly involved in food intake behavior. This study investigated whether the caloric component of food and its magnitude have control over choice behavior and preference in subjects ranging from seven to thirteen years old, with overweight and intellectual developmental delay. The research was conducted in a charity institution specialized in serving individuals with intellectual developmental delay. Two identical gums were prepared for this study, in relation to the organoleptic characteristics, differing only for the calories they contain. For data collection, we used an experimental apparatus that operated in concurrent chain schedule of reinforcement. The first link was operating on values of fixed ratio (FR- 1), followed by another scheme, also operating in FR-1. The schedules were controlled by a computer program. Choice responses in Button 1 were followed by one caloric gum in its terminal link, and choice responses in Button 2 were followed by a non-caloric gum in its terminal link. The session consisted of four presentations of the schedules. The data of interest were the responses in the initial links of concurrent chain schedules. A single subject design was applied, with the participant as his own control. The results, first, illustrated that there was no preference for calorie-rich foods, and will be considered as baseline for continuing the study, in which each of the possible variables controlling food choice could be introduced (eg, delay of reinforcing contingency , cost of response). Studies on the nature of choice and preference for non-caloric and caloric foods are important to identify and describe appropriate procedures for understanding and controlling food intake in overweight or obese children with intellectual developmental delay. / Um dos principais problemas de saúde na sociedade moderna, tanto em países desenvolvidos como naqueles em desenvolvimento, é o aumento nos índices de indivíduos sobrepesos ou obesos. Embora se conheça muito a respeito dos tipos de alimentos que contribuem para isso, poucos resultados têm sido observados no controle da impulsividade comumente envolvida no comportamento de se alimentar. Este estudo investigou se o componente calórico do alimento e sua magnitude exercem controle sobre o comportamento de escolha e preferência, em indivíduos com idade variando entre sete e treze anos de idade, com sobrepeso e deficiência intelectual. A pesquisa foi realizada em uma instituição filantrópica especializada no atendimento a indivíduos com deficiência intelectual. Foram elaboradas, para tal estudo, duas gomas idênticas em relação às características organolépticas, diferindo apenas quanto às calorias contidas nelas. Para coleta, utilizou-se um aparato experimental que operava em esquema de reforçamento concorrente com encadeamento. O primeiro elo operava em valores de razão fixa (FR 1), seguidos por outro esquema, também operando em FR 1. Os esquemas foram controlados por um programa de computador. Durante a Fase 1, respostas de escolha no Botão 1 eram seguidas por uma goma calórica no respectivo elo terminal e, respostas no Botão 2 eram seguidas de uma goma não calórica no respectivo elo terminal. Nesta Fase,analisou-se a influência da caloria no comportamento de escolha. Nas fases 2 e 3, analisou-se a influência da magnitude no comportamento de escolha, aumentando primeiramente a magnitude referente ao botão situado no lado esquerdo do aparato experimental (Fase 2), sendo posteriormente aumentado a magnitude referente ao outro botão. A sessão foi constituída de quatro apresentações dos esquemas. Os dados de interesse foram as respostas nos elos iniciais dos esquemas concorrentes com encadeamento. Foi aplicado um delineamento de sujeito único, com o participante como seu próprio controle. Os resultados, primeiramente, ilustraram que não houve preferência por alimentos calóricos e que o aumento da magnitude exerceu pouco controle sobre a resposta de escolha dos participantes, e serão considerados como linha-de-base para a continuidade do estudo, em que cada uma das possíveis variáveis controladoras de escolha alimentar poderão ser introduzidas (e.g., atraso da contingência reforçadora, custo da resposta). Estudos sobre a natureza da escolha e preferência por alimentos calóricos e não calóricos são importantes para identificar e descrever os procedimentos adequados para compreender e controlar a ingestão de alimentos em crianças sobrepesas ou obesas e com deficiência intelectual.