The purpose of this qualitative research study was to identify the perceptions of general and special education teachers currently participating in collaborative co-teaching team models regarding the leadership practices of principals in support of co-teaching as a service delivery model in high schools. The literature review findings indicated the importance of administrative leadership and support being essential for the implementation of co-teaching. Therefore, the two research questions for this qualitative study focused on administrative practices that support co-teaching. The two research questions for this qualitative research study were a) What are the leadership practices of principals, as perceived by general education teachers, in support of co-teaching as a service delivery model in high schools? and b) What are the leadership practices of principals, as perceived by special education teachers, in support of co-teaching as a service delivery model in high schools? This research study utilized a qualitative phenomenological research approach which was an interview protocol used to collect data from high school general and special education teachers participating in the study. The criteria for participation included: a) high school general and special education teachers currently participating or had participated in a collaborative co-teaching team model servicing students with disabilities, and b) high school general and special education teachers participating or had previously participated in a collaborative co-teaching team model servicing students with disabilities in core-content areas. The findings for school divisions and high school principals are common vision, expectations for co-teaching, ongoing, job-embedded professional development, and amenities that support co-teaching. The findings in this study resulted in five implications for school divisions and high school principals. Implications for practice were provided at the conclusion of the study and focused on identifying the practices of principal leadership, as perceived by general and special education teachers, in support of co-teaching in high schools. Also, suggestions for future research were addressed in this study. / Doctor of Education / The purpose of this basic qualitative study was to identify perceptions of high school general and special education teachers regarding principal leadership practices in support of co-teaching as a service delivery model in high schools. During this basic qualitative study, the researcher investigated the perceptions of eight high school general and special education teachers by conducting one-on-one interviews to collect data on the participants' perceptions of principal leadership practices in support of co-teaching in high schools. This basic qualitative study resulted in five findings. The high school general and special education teachers indicated a) principals conveyed a common vision for co-teaching with all staff members, b) professional development was provided by the principal to support implementing a co-teaching model, c) principal collaboration and communication with co-teaching teams was provided for the co-teaching model, d) co-teaching expectations were communicated by the principal to all staff members to foster a collaborative environment, and e) administrative support is fundamental for effective co-teaching. The five findings resulted in five implications for high school general and special education teachers perceptions of principal leadership practices in support of co-teaching a) school divisions should provide school leaders with support to develop and articulate a common vision for co-teaching based on research and best practices, b) the school division can allocate funds to provide job embedded co-teaching (for both the general and special educator) professional development, training, and conferences for full co-teaching implementation, c) principals should provide scheduled collaborative opportunities with general and special education teachers working in co-teaching teams, d) principals should convey co-teaching expectations with all staff members in an effort to strengthen collaborative environments, and e) principals should provide general and special education teachers continuous support in co-teaching collaborations.

Lack of trust between nonprofit organizations and the communities in which they are located is a well-documented problem in the academic literature. The nature of this mistrust is far less understood, and little is known how community-nonprofit collaborations can overcome these gaps in trust. Guided by Simmel's theory of trust, this study examined the role of collaborative trust between public and non-profit organizations with a focus on better understanding how trust evolves. The research questions focused on how trust was defined and the factors that enhanced and inhibited trust evolution within the context of collaborations between nonprofit organizations and communities. Data were gathered through structured, in-depth interviews with 14 staff and stakeholders, a focus group of 4 management committee members, and the examination of partnership documents.Data from the interviews and documents were inductively coded and then organized around key themes. The themes from the content analysis indicated that the 3 chief executive officers in the partnership embraced the concept of collaboration, invested time at trust building activities, and obtained stakeholder support. This study contributes to positive social change by providing information for policy makers and administrators of public and nonprofit organizations facing similar contexts about how the development of trust can remove the barriers and sustain collaboration to deliver social program services efficiently and equitably.

We compare the health needs between children and young adults with CL/P. Patient-reported experiences about the impact of a cleft are described. A service delivery model integrating quality of life into the ICF framework is presented. Lastly, transition of care for the young adult with CL/P is highlighted.

As a child approaches adulthood, many transitions take place; physically and psychosocially. There are new roles and responsibilities. For the young adult with cleft lip and palate (CLP), one of the most significant transitions is moving from the pediatric interdisciplinary team to the adult-centered health care system. There is a shift in focus from the cleft itself and clinician-reported outcomes to patient self-report about the perceived impact of the cleft on quality of life. Transition also befalls the parents and team providers who, through the course of some 18 years, were active participants in the young person's care. Their roles, too, have changed. The International Classification of Functioning, Disability, and Health (ICF; World Health Organization, 2001, 2004) is a conceptual framework for considering the totality of the cleft by addressing the interaction between the person and their personal and social environment. This model is suitably applicable to the transition of care of the young adult with CLP. In this paper, we propose an evidence-based person-centered delivery model of care using the concepts of the ICF to facilitate the transition of care for this population. A case example is presented highlighting the use of these concepts for the speech-language pathologist.

The educational rights of students with disabilities are supported through federal mandates, as the Individuals with Disabilities Education Act (IDEA) safeguards a free and appropriate public education (FAPE) in the least restrictive environment (LRE). Special education students encompass a wide range of individual and unique learning needs, thus the creation of educational environments that utilize fluid and flexible service delivery models is warranted. Furthermore, students with moderate to severe disabilities (MSD) require specialized academic instruction that promotes advancements across several developmental areas, which includes cognition, adaptive skills, communication, and emotional awareness. Exploring educational service delivery models that proficiently address the unique needs of students with MSD is essential, as limited research exists in this specific area. Utilizing a qualitative phenomenological research methodology, this study sought to explore an informal class reassignment program that provides educational instruction to students with MSD. Additionally, the intent behind this study was to explore how the informal class reassignment program influenced the special education teachers’ perspectives regarding learning outcomes for students with MSD, if at all. Moreover, this study sought to explore how moderate to severe special education teachers experience, define and describe an informal class reassignment program specifically designed to target the individual earning needs of students with MSD. This inquiry incorporated semi-structured interviews combined with reflective field notes to gain a deeper understanding of the participants’ lived experiences. Consequently, the findings shed light on factors that relate to optimal service delivery models for students with MSD.

In South Africa, the current movement towards the inclusion of children with disabilities, including children with hearing loss, is likely to have far-reaching consequences for both teachers and learners. Undoubtedly, needs will arise from teachers during the transition, especially in the areas pertaining to the audiological and educational management of children with hearing loss. A hearing loss often negatively impacts on the development of the child’s auditory, language, speech, communication, literacy, academic, and psychosocial skills. The educational audiologist is uniquely skilled in managing the effects of hearing loss on the child’s educational development, and is a crucial member on the educational team. The educational audiologist as specialist in the management of children with hearing loss, is able to offer a wide range of support and assistance to teachers as well as children with hearing loss in the inclusive educational system. When teachers receive appropriate educational audiology services, they are enabled to provide quality education that strives to reach the full potential of every child with hearing loss. Therefore, an urgent need existed to determine the needs of teachers of children with hearing loss regarding an educational audiology service delivery model for use within the inclusive educational system. In order to comply with this need, a descriptive research design was developed comprising of a questionnaire survey followed by focus group interviews. The questionnaire survey explored the needs of 664 teachers of children with hearing loss. Focus group interviews were conducted with 19 teachers of children with hearing loss and these results were used to substantiate findings from the questionnaire survey. The results of the study indicated that the needs of teachers differ according to the sub-groups found among teachers, namely those teachers who mainly promote the use of spoken language and those who mainly promote Sign Language. Findings revealed that, although participants realised the importance of various aspects of development of the child with hearing loss, they generally did not realise the importance of receiving support from an educational audiologist. With respect to specifics in term of support, participants strongly recommended that teachers receive support in the acquisition of knowledge re the trouble-shooting of hearing aids, advocacy for the implementation of FM systems in inclusive classrooms and the development of speech production skills of the child with hearing loss in the inclusive environment. In addition, various suggestions were made regarding the structure of services rendered within the educational context. These findings were utilised in order to propose an educational audiology service delivery model for South Africa in the current timeframe. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2005. / Speech-Language Pathology and Audiology / unrestricted

Multilingualism in classrooms is currently prompting debate and has significantly impacted on schooling in South Africa over the last decade. At present South African educators face the challenge of coping with and finding solutions to culturally and linguistically diverse urban school contexts that did not exist before. In many South African communities young learners, without any prior knowledge of English, are placed in English preschools. Preschool teachers have the demanding task of preparing these multilingual preschoolers for formal schooling in English, and, in addition, are pressurised by parents or caregivers who expect their children to be fluent in English by the time they enter primary school. A group of preschool teachers in a specific urban, multilingual preschool context expressed concern about multilingual preschool learners’ academic performances and their future, and requested advice and support. Consequently a need was identified for speech-language therapists to make their expertise available to multilingual preschool learners, as well as to their preschool teachers. To address this need, an exploratory, descriptive, contextual research design, incorporating the quantitative perspective, was selected to describe the specific educational context of multilingual preschools in the Pretoria Central Business District (CBD) and Sunnyside area. A descriptive survey was conducted and two survey techniques were employed to collect the data, namely a questionnaire and a test battery. The questionnaire was used to collect information from 32 teacher participants to investigate the needs and strengths of preschool teachers and multilingual preschool learners. The test battery was utilised to collect data on the language and communication proficiency in English of 30 learner participants. Results indicated that the teacher participants perceived certain personal challenges while supporting the preschool learners acquiring English as Language of Learning and Teaching (ELoLT). These teachers expressed a need for knowledge and support. They also reported that the multilingual preschool learners in the research context had to communicate in ELoLT despite it being an unfamiliar language. Some of the multilingual preschool learners displayed behaviours that could be indicative of negative influences on their self-esteem. The language and communication assessment revealed that many learner participants’ comprehension and expression in ELoLT were insufficient for learning and that they required support for academic success. In addition, the results support the claim that an integrated view of the multilingual learners’ communication abilities need to be established across contexts, by combining assessment strategies, such as naturalistic and structured assessment, as well as interdisciplinary perspectives. The results of the empirical research was used to propose a service delivery model for the acquisition of ELoLT in the research context. This proposed model may be an effective approach to provide supportive intervention to multilingual preschool learners with linguistic barriers to learning. In addition, initial stage intervention guidelines for the basic level ELoLT learner were offered in response to the needs of the specific community. These guidelines may provide a basis for the planning of intervention strategies to preschool teachers who were concerned about the education and future of multilingual preschool learners. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / Unrestricted

South African welfare policies and social problems dictate social service rendering in South Africa. Social workers are involved in various service delivery interventions of which community development (macro focus) and statutory services (micro focus) are two separate specialised interventions. In social work practice there is a need for both interventions, however, there is no clear guidelines for social workers how to integrate these interventions in practice. The aim of this study was to determine how community development and statutory services as two distinctive social work interventions could be integrated in order to render effective, integrated social services within a developmental approach. A qualitative research approach was utilised for the study and data was gathered by means of four focus group interviews. Respondents for the study included social workers and clients who were involved in both statutory and community development interventions. Research findings indicated that statutory and community development interventions are guided by different processes, time frames, and models of implementation, such as the legislative framework in the case of statutory work as opposed to participatory models in community development. The study concluded that there is not only confusion with regard to the role of social workers, but also a high risk of clients loosing trust in the helping relationship when one social worker simultaneously does community work and render statutory services in the same community. The distinctive nature of statutory services and community development calls for other options for the integration of these two intervention levels. This study proposed three options for social workers and NGOs to integrate statutory services and community development. Based on the research findings and conclusions of the study, the researcher proposed guidelines for (1) the development of an integrated model and (2) a policy framework for the integration of statutory services and community development within a developmental approach and finally recommended that such a designed model and policy framework be implemented and the impact thereof on social service delivery be researched. / Dissertation (MSD (Social Development and Policy))--University of Pretoria, 2006. / Social Work / unrestricted

Cette thèse a pour but de documenter la réorganisation des services effectuée au programme Enfants et adolescents (PEA) du Centre de réadaptation Estrie, Sherbrooke. Une démarche de recherche-action participative (RAP) est utilisée afin de collaborer au développement, à l’implantation et à l’évaluation d’un nouveau modèle de services visant à accroître l’accessibilité et la qualité des services de réadaptation offerts aux enfants ayant une déficience physique. Spécifiquement, les objectifs sont : 1) de documenter les retombées de la réorganisation des services; 2) de réaliser une analyse critique du processus de changement. Des méthodes quantitatives et qualitatives sont utilisées afin d’atteindre ces objectifs. Tout d’abord, la Mesure des processus de soins (MPOC) documente la perception de la qualité avant (2007), pendant (2008) et après (2009) l’implantation du nouveau modèle de services. Au total, cet outil est employé auprès de 222 familles et 129 intervenants. À quatre reprises, les intervenants et les gestionnaires répondent également à un questionnaire sur leurs perceptions des forces, des faiblesses, des opportunités et des menaces au PEA. En 2008 et en 2009, des focus groups et des entrevues téléphoniques sont réalisées auprès des familles (n=5), des intervenants (n=19) et des gestionnaires (n=13) afin de documenter leurs perceptions sur le processus de changement et sur les retombées de la réorganisation des services. Quant à l’observation participante, elle permet de recueillir de l’information sur le processus de réorganisation des services tout au long de ces trois années. Enfin, les informations recueillies sont analysées à l’aide de différentes approches, dont des tests statistiques et des analyses de contenu utilisant une grille de codification inspirée de la théorie des systèmes d’actions organisées. Les résultats indiquent que davantage d’enfants reçoivent des services en 2009 en comparaison à 2007. De plus, la qualité des services s’est maintenue selon les perceptions évaluées par la MPOC (article 1). L’utilisation d’interventions de groupe contribue fort probablement à augmenter le nombre d’enfants qui reçoivent des services, mais plusieurs défis doivent être adressés afin que cette modalité d’intervention soit réellement efficiente (article 2). Les résultats font ressortir que le processus de réorganisation des services est complexe. L’évaluation des forces, des faiblesses, des opportunités et des menaces d’un programme, de même que l’implication des acteurs dans le processus de développement d’un nouveau modèle de services, favorisent l’amélioration continue de la qualité (article 3). Or, les facilitateurs et les obstacles à l’implantation du nouveau modèle de services évoluent durant la réorganisation des services. Considérant cela, il est important de poser les actions nécessaires afin de soutenir le changement tout au long du processus (article 4). En résumé, cette thèse contribue à l’avancement des connaissances en réadaptation en comblant une lacune dans les écrits scientifiques. En effet, peu de projets visant le développement et l’implantation de nouveaux modèles de services sont évalués et documentés. Pourtant, des modèles tels que celui développé par le PEA semblent prometteurs afin d’améliorer l’accessibilité, et éventuellement, la qualité des services de réadaptation chez l’enfant. / This thesis aims at documenting the reorganization of services that took place within the programme Enfants et adolescents (PEA) of the Centre de réadaptation Estrie, Sherbrooke. Participatory action research (PAR) is used to collaborate in the development, implementation and evaluation of a new model of service delivery aimed at increasing the accessibility and quality of rehabilitation services offered to children with physical disabilities. Specifically, the objectives are to : 1) evaluate outcomes of the service reorganization, and 2) critically analyze the change process. Quantitative and qualitative methodologies are used. First, the Measures of processes of care (MPOC) are utilized to document quality-related perceptions before (2007), during (2008) and after (2009) the implementation of the new service delivery model. In total, these tools are utilized with 222 families and 129 clinicians. On four occasions, clinicians and administrators also responded to a questionnaire on the program’s strengths, weaknesses, opportunities and threats. In 2008 and 2009, focus groups and phone interviews are conducted with families (n=5), clinicians (n=19) and administrators (n=13) to document their perceptions of the change process and the service reorganization outcomes. Participatory observation allowed collecting data during the whole process of service reorganization. Finally, all the data collected are analyzed using different approaches, such as statistical tests and content analysis using an emerging coding grid inspired from the organized action systems theory. Results indicated that the program served more children in 2009 compared to 2007. Moreover, service quality was maintained according to perceptions evaluated with the MPOC (article 1). The utilization of intervention groups probably contributed to the increased number of children receiving services, but many challenges have to be overcome to ensure effective use of this service delivery method (article 2). Results highlight that reorganizing services is a complex process. Evaluating strengths, weaknesses, opportunities and threats of a new program, as well as the involvement of stakeholders to develop a new model of service delivery, contribute to quality improvement efforts (article 3). However, the facilitators and barriers to the implementation of a new model of service delivery evolved during the reorganization process, and it is essential to take the required actions to sustain changes through the transformation process (article 4). In summary, this thesis contributes to increasing the knowledge in rehabilitation by providing information in an area of the literature where little has been published. Indeed, few projects aiming at developing and implementing new models of service delivery are evaluated and documented. Models, such as the one developed by the PEA, seem interesting to increase accessibility, and eventually, the quality of rehabilitation services for children.

Cette thèse a pour but de documenter la réorganisation des services effectuée au programme Enfants et adolescents (PEA) du Centre de réadaptation Estrie, Sherbrooke. Une démarche de recherche-action participative (RAP) est utilisée afin de collaborer au développement, à l’implantation et à l’évaluation d’un nouveau modèle de services visant à accroître l’accessibilité et la qualité des services de réadaptation offerts aux enfants ayant une déficience physique. Spécifiquement, les objectifs sont : 1) de documenter les retombées de la réorganisation des services; 2) de réaliser une analyse critique du processus de changement. Des méthodes quantitatives et qualitatives sont utilisées afin d’atteindre ces objectifs. Tout d’abord, la Mesure des processus de soins (MPOC) documente la perception de la qualité avant (2007), pendant (2008) et après (2009) l’implantation du nouveau modèle de services. Au total, cet outil est employé auprès de 222 familles et 129 intervenants. À quatre reprises, les intervenants et les gestionnaires répondent également à un questionnaire sur leurs perceptions des forces, des faiblesses, des opportunités et des menaces au PEA. En 2008 et en 2009, des focus groups et des entrevues téléphoniques sont réalisées auprès des familles (n=5), des intervenants (n=19) et des gestionnaires (n=13) afin de documenter leurs perceptions sur le processus de changement et sur les retombées de la réorganisation des services. Quant à l’observation participante, elle permet de recueillir de l’information sur le processus de réorganisation des services tout au long de ces trois années. Enfin, les informations recueillies sont analysées à l’aide de différentes approches, dont des tests statistiques et des analyses de contenu utilisant une grille de codification inspirée de la théorie des systèmes d’actions organisées. Les résultats indiquent que davantage d’enfants reçoivent des services en 2009 en comparaison à 2007. De plus, la qualité des services s’est maintenue selon les perceptions évaluées par la MPOC (article 1). L’utilisation d’interventions de groupe contribue fort probablement à augmenter le nombre d’enfants qui reçoivent des services, mais plusieurs défis doivent être adressés afin que cette modalité d’intervention soit réellement efficiente (article 2). Les résultats font ressortir que le processus de réorganisation des services est complexe. L’évaluation des forces, des faiblesses, des opportunités et des menaces d’un programme, de même que l’implication des acteurs dans le processus de développement d’un nouveau modèle de services, favorisent l’amélioration continue de la qualité (article 3). Or, les facilitateurs et les obstacles à l’implantation du nouveau modèle de services évoluent durant la réorganisation des services. Considérant cela, il est important de poser les actions nécessaires afin de soutenir le changement tout au long du processus (article 4). En résumé, cette thèse contribue à l’avancement des connaissances en réadaptation en comblant une lacune dans les écrits scientifiques. En effet, peu de projets visant le développement et l’implantation de nouveaux modèles de services sont évalués et documentés. Pourtant, des modèles tels que celui développé par le PEA semblent prometteurs afin d’améliorer l’accessibilité, et éventuellement, la qualité des services de réadaptation chez l’enfant. / This thesis aims at documenting the reorganization of services that took place within the programme Enfants et adolescents (PEA) of the Centre de réadaptation Estrie, Sherbrooke. Participatory action research (PAR) is used to collaborate in the development, implementation and evaluation of a new model of service delivery aimed at increasing the accessibility and quality of rehabilitation services offered to children with physical disabilities. Specifically, the objectives are to : 1) evaluate outcomes of the service reorganization, and 2) critically analyze the change process. Quantitative and qualitative methodologies are used. First, the Measures of processes of care (MPOC) are utilized to document quality-related perceptions before (2007), during (2008) and after (2009) the implementation of the new service delivery model. In total, these tools are utilized with 222 families and 129 clinicians. On four occasions, clinicians and administrators also responded to a questionnaire on the program’s strengths, weaknesses, opportunities and threats. In 2008 and 2009, focus groups and phone interviews are conducted with families (n=5), clinicians (n=19) and administrators (n=13) to document their perceptions of the change process and the service reorganization outcomes. Participatory observation allowed collecting data during the whole process of service reorganization. Finally, all the data collected are analyzed using different approaches, such as statistical tests and content analysis using an emerging coding grid inspired from the organized action systems theory. Results indicated that the program served more children in 2009 compared to 2007. Moreover, service quality was maintained according to perceptions evaluated with the MPOC (article 1). The utilization of intervention groups probably contributed to the increased number of children receiving services, but many challenges have to be overcome to ensure effective use of this service delivery method (article 2). Results highlight that reorganizing services is a complex process. Evaluating strengths, weaknesses, opportunities and threats of a new program, as well as the involvement of stakeholders to develop a new model of service delivery, contribute to quality improvement efforts (article 3). However, the facilitators and barriers to the implementation of a new model of service delivery evolved during the reorganization process, and it is essential to take the required actions to sustain changes through the transformation process (article 4). In summary, this thesis contributes to increasing the knowledge in rehabilitation by providing information in an area of the literature where little has been published. Indeed, few projects aiming at developing and implementing new models of service delivery are evaluated and documented. Models, such as the one developed by the PEA, seem interesting to increase accessibility, and eventually, the quality of rehabilitation services for children.