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PREFACE: The purpose of this Master’s thesis was to determine which attributes of an early intervention (EI) mental health service would encourage treatment initiation and sustained engagement. This research was motivated by the bourgeoning interest in patient-centered care, particularly the incorporation of patient preferences into service design and implementation. Additionally, the research was inspired by the use of marketing research methodology in healthcare. Two conjoint surveys were formulated with the purpose of asking two questions: what EI service attributes will increase the likelihood of someone (1) initiating contact with an EI service and attending their first appointment, and (2) remaining engaged in treatment. A literature search determined which attributes would be the most relevant and important for conceptualizing an EI service. These attributes were narrowed down with the help of focus groups, key informant interviews, the expertise of the authors, and in the case of the second survey, was also informed by the first survey’s results. Each attribute was assigned four levels and these multi-level attributes were formulated into the two aforementioned surveys that were completed by mental health patients, their families, and mental health professionals. Chapter 1 of this thesis contains a short overview of the research literature investigating the benefits of EI services, some of the reasons why many patients may not receive such services, and some potential strategies to enhance patients’ initial contact and ongoing engagement with such services. In particular, the central tenet of this thesis is that patient engagement with EI services will be enhanced if service design considers and incorporates the preferences of patients and their families with regard to the attributes that characterize the service and its delivery. This hypothesis is explored using discrete choice conjoint experimental (DCE) methods to identify important service attributes regarding patient initiation and engagement. Given that DCEs are the central methodology of this thesis, Chapter 1 also includes an introduction to these methods and their unique benefits. Each of these service attribute questions posed above is addressed in a separate survey and experiment. Therefore, the rationale, methods, results and conclusions of each experiment are described in separate chapters (Chapters 2 & 3). It should be noted that these two chapters are written in the form of stand-alone scientific reports, each of which is about to be submitted for publication to peer-reviewed journals. Finally, the thesis concludes with a General Discussion (Chapter 4), which attempts to frame the two studies, and this line of inquiry more generally, in the broader research literature and highlight their clinical and policy implications. It should also be noted that, given that there exists substantial conceptual overlap between the two experiments and the main issues described in both the General Introduction and General Discussion, the reader may encounter some repetition throughout the thesis. / Mental illness places a large burden on individuals and society-at-large, a problem that becomes much worse the longer it is left untreated. Early intervention (EI) can mitigate this burden; however, those experiencing emerging mental illnesses often do not seek help promptly. Patient-centered care, such as shared-decision making models of mental healthcare, may reduce barriers to treatment. A central tenet of patient-centered care is that patient engagement and service utilization increases when patient preferences are incorporated into clinical services. In the current thesis, discrete choice conjoint experiments (DCE) were used to elicit the preferences of patients and their families, as well as the hypothesized preferences of patients according to mental health professionals, in two surveys. The first survey aimed to identify the attributes of an EI service that would encourage people experiencing psychiatric symptoms to initiate contact with a service and attend their first appointment (Chapter 2). The second survey sought to determine which service attributes would encourage someone to remain engaged with mental health treatment (Chapter 3). Both surveys used Latent Class Analysis to segment the study populations into identifiable subgroups based on shared preferences, and Randomized First Choice simulations to predict which service delivery model each of these identified groups would most likely use. The results of these studies have several implications for current and future mental health services. Effective EI mental health services should include rapid access to services, a range of treatment options, and effective crisis response. Moreover, future DCE studies should focus on replicating these results using more heterogeneous samples and improving DCE methods. / Thesis / Master of Science (MSc)

A qualitative study was undertaken to develop an understanding of the social welfare services rendered to street children and to ascertain how these social welfare services can be enhanced from the perspective of service providers employed by NGOs in Pretoria. An explorative, descriptive and contextual research design was utilised. The researcher used purposive and non-probability sampling methods to draw the sample. Semi-structured interviews were used to collect information from nine service providers working with street children. Data were analysed according to the framework provided by Tesch (in Creswell, 2009). Data was verified using Guba‘s model (in Krefting, 1991).The study highlights challenges faced by NGOs in providing social welfare services to street children. The study provides a critical analysis of some of the key social welfare service challenges that need to be addressed to ensure effective and sustainable delivery of social welfare services. how these social welfare services can be enhanced from the perspective of service providers employed by NGOs in Pretoria. An explorative, descriptive and contextual research design was utilised. The researcher used purposive and non-probability sampling methods to draw the sample. Semi-structured interviews were used to collect information from nine service providers working with street children. Data were analysed according to the framework provided by Tesch (in Creswell, 2009). Data was verified using Guba‘s model (in Krefting, 1991).The study highlights challenges faced by NGOs in providing social welfare services to street children. The study provides a critical analysis of some of the key social welfare service challenges that need to be addressed to ensure effective and sustainable delivery of social welfare services. the social welfare services rendered to street children and to ascertain how these social welfare services can be enhanced from the perspective of service providers employed by NGOs in Pretoria. An explorative, descriptive and contextual research design was utilised. The researcher used purposive and non-probability sampling methods to draw the sample. Semi-structured interviews were used to collect information from nine service providers working with street children. Data were analysed according to the framework provided by Tesch (in Creswell, 2009). Data was verified using Guba‘s model (in Krefting, 1991).The study highlights challenges faced by NGOs in providing social welfare services to street children. The study provides a critical analysis of some of the key social welfare service challenges that need to be addressed to ensure effective and sustainable delivery of social welfare services. / Social Work / MA (Social Work)

Les enfants atteints d’un trouble du spectre de l’autisme (TSA) présentent souvent des difficultés à généraliser leurs apprentissages à des nouveaux stimuli, contextes et individus (Brown & Bebko, 2012; Happé & Frith, 2006; Lovaas, Koegel, Simmons, & Long, 1973; Plaisted, O'Riordan, & Baron-Cohen, 1998). Pour cette raison, il est important d’utiliser des techniques promouvant la généralisation au sein des programmes d’intervention leur étant destinés. Cette recherche visait à évaluer l’efficacité de deux des techniques les plus fréquemment utilisées dans les programmes d’intervention comportementale intensive (ICI), soit l’enseignement séquentiel et l’enseignement simultané, afin de déterminer si l’une d’elles était systématiquement plus efficace que l’autre pour promouvoir la généralisation des concepts chez les enfants ayant un TSA. Des devis expérimentaux à cas unique ont été utilisés pour évaluer les effets des deux techniques sur la généralisation de quatre enfants ayant un diagnostic de TSA et recevant des services d’ICI en clinique privée. Pour deux participants, la méthode enseignement simultané a démontré une plus grande efficacité quant à la généralisation des concepts enseignés. Pour les deux autres, les deux techniques se sont avérées aussi efficaces. Bien que préliminaires, les résultats suggèrent qu’il serait préférable d’appliquer la méthode enseignement simultané lors de l’enseignement de concepts chez les enfants ayant un TSA en contexte d’ICI. / Children with autism spectrum disorder (ASD) often show difficulties in generalizing what they have learned to new stimuli, contexts or persons (Brown & Bebko, 2012; Happé & Frith, 2006; Lovaas, Koegel, Simmons, & Long, 1973; Plaisted, O'Riordan, & Baron-Cohen, 1998). For this reason, it is important to implement strategies to promote generalization within programs intended for this population. This study aimed to compare the effectiveness of two of the most commonly used strategies in intensive behavioral intervention (IBI), serial training and concurrent teaching, to determine whether one was systematically more effective than the other at promoting generalization in children with ASD? Single-case experimental designs were used to assess the effects of the two strategies with four children with an ASD diagnosis receiving services in a private clinic. For two participants, concurrent teaching was more effective to promote generalisation of the learned concepts. For the remaining two participants, the two strategies were equally effective. Albeit preliminary, the results suggest that it may be preferable to introduce exemplars concurrently when teaching concepts to children with ASD within IBI programs.

This survey-based, quantitative research investigated Early Intervention teachers' perception about Early Intervention services in Mecca Region in The Kingdom of Saudi Arabia. This research focused on three dimensions of Early Intervention including attitude toward Early Intervention services, the cultural influences in the provision of services, and the recommended practices that were used by professionals. Two options were offered to subjects to complete the survey: 1) an online survey and 2) a hard copy of the survey which was distributed to teachers in Early Intervention Centers. The majority of the participants completed the online survey. Data was collected and analyzed. The results showed that the teachers in Mecca Region in Saudi Arabia did not follow recommended practices. However, they had positive attitudes about Early Intervention services and indicated that they considered the culture of the children and families when determining curriculum and services in their programs.

The first part of the thesis summarizes theoretical knowledge of the areas that relate to the characteristics of pervasive developmental disorders, as well as chapter focused on family and compensatory mechanisms with the diagnosis and the adoption of a child. Next chapter describe helping professions and it is a brief introduction of specific professions with who I have the opportunity to meet and get to know that their work and the methods used with a target group of preschool children with ASD. I consider the importance of an early intervention in terms of working with the family and the child to be important, therefore, I focus on diagnostic methods and organization APLA Prague and Central Bohemia. I had the opportunity to attend several practices in this organization and I got to know methods of working with clients with autism. Overall, this practice must be assessed as very beneficial. System and work of the organization is actually a good example for practice. I will try to describe this organization in the form of case studies and interviews with families. I then will focus on the social support of families and the financial opportunities that are offered to these families. The next chapter is about social services which are services of social prevention, care and counseling. These...

This thesis focuses on functional assessments, visual stimulation and on offers of Centres for Early Intervention that provide services in the area of visual perception for children in early and preschool age. The goal of the thesis is to analyze interviews with workers in these centres on options and services in the area of visual aid that these centres provide for families and their children with disabilities. The first four chapters deal with theoretical background in the area of functional assessments of vision, visual stimulation and description of the group of children in early and preschool age with visual and multiple disabilities. Last but not least, these chapters also deal with organizations that provide early intervention services, their structure, composition of personnel and range of offered services. The content of the fifth chapter is a qualitative research investigation. The data were collected through interviews with instructors of visual stimulation and with an early intervention assistant. Analysis of these interviews then became basis for the subsequent definition of commendable suggestions for good practise.