AN ABSTRACT OF THE THESIS OF Anna Kallal, for the Masters of Science degree in Communication Disorders and Sciences presented on March 28, 2016, at Southern Illinois University Carbondale. TITLE: AUTISM AND OUR COMMUNITY: FEEDBACK FROM EARLY INTERVENTION PROVIDERS MAJOR PROFESSOR: Dr. Valerie Boyer Early Intervention (EI) providers often work closely with children who are diagnosed with autism spectrum disorder (ASD) or children who have signs and symptoms of ASD. An understanding of the characteristics in children at early ages can lead to an earlier diagnosis of ASD. The current study investigated specific characteristics that EI providers identify prior to making a referral for an ASD evaluation as well as what treatment strategies EI providers report utilizing when working with children who have ASD. Information was gathered for this study by use of a survey. The survey contained two vignettes of children with varying degrees of ASD characteristics. Speech-Language Pathologists (SLP) who work as EI providers responded to a survey. Results showed that respondents were more willing to make referrals for ASD evaluations when a child displayed more severe characteristics. Respondents listed treatment strategies they were likely to employ with children who display similar characteristics of the children in the vignettes. The researcher identified from survey responses that EI providers are more likely to identify social communication characteristics when describing features critical to referral. This study identifies the characteristics important to making earlier referrals for ASD evaluations, as well as what treatment strategies work best when working with children with ASD.

The purpose of this study is to ascertain the essential elements of Response to Intervention programs among 150 high performing Title I schools with high rates of poverty as measured by free/reduced lunch participation rates. Response to Intervention (RTI) is a nationally-known instructional model used to assist students who are struggling to obtain or maintain grade-level equivalency in reading and math. This study focused on reading, as this subject is the one most targeted in schools for full intervention supports. This study utilized a quantitative research approach, which included examining and rank ordering data supplied by the Missouri Department of Elementary and Secondary Education. The study used a survey instrument to determine how frequently instructional coaches in fifty selected districts used program elements. The research revealed that the most effective RTI model is a fully implemented one. The goal of this study is to inform districts of the most powerful elements of the RTI model in order to meet the learning needs of struggling students in reading.

Class of 2015 Abstract / Objectives: The specific aim of the study was to examine the effects of a 30-minute educational intervention, developed and delivered by student pharmacists, on knowledge of hypertension and its management among community-dwelling older adults and their caregivers. The study also aimed to examine the helpfulness of the program and readiness of the participants to adopt healthier lifestyle practices afterward. Methods: This was a pre- and post-interventional study. At senior centers around the Phoenix metropolitan area, community-dwelling older adults (ages 60 or older) and family members or caregivers (ages 18 or older) were recruited to participate. Participants completed knowledge-based questionnaires prior to and after the educational program. The mean number of correct responses was calculated for pre- and post-program questionnaires, then compared using paired t-test. Results: A total of 77 individuals participated in the program with mean age of 72 and 67% female. The mean number of correct responses calculated for survey before the educational program was 3.03 and 5.46 for survey after the program, which was significantly different (p <0.01). 85% of participants reported the program to be helpful, and 84% participants were willing to adopt healthier lifestyle after attending the program. Conclusions: An intervention tailored to community-dwelling older adults, developed and delivered by student pharmacists, was found to improve awareness of hypertension and generated willingness to adopt healthier lifestyle among the participants.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Physiotherapists are part of the medical team involved in prevention and management of football injuries in Malawi. However, in Malawi no physiotherapist is currently involved in prevention and management of football injuries in the Malawi Super League. Aim: The aim of the study was to determine the need for physiotherapy intervention in prevention and management of football injuries. Methodology: A concurrent mixed method study design was used to collect data. A self-administered questionnaire was used to collect quantitative data from football players. Qualitative data was collected through in-depth interviews from team doctors and coaches respectively. Quantitative data was analysed using the SPSS version 20.0. Descriptive data was presented in the form of percentages, means, ranges, standard deviations, and frequencies using tables, figures and graphs. A chisquare test of association and Fischer’s exact test were used to study the factors associated with football injuries against prevalence of injury. Audiotaped interviews were transcribed verbatim and expressed ideas were read several times, coded and reduced into categories and themes. Ethical clearance was granted by the University of the Western Cape and relevant authorities in Malawi. Results: A response rate of 67.5% was obtained. The mean age of football players was 21.73 (SD=3.295) years. The injury prevalence was 68.9% with 64% of injuries occurring during matches and 37% during training. The majority (84%) of the injuries were sustained in the lower limbs and 52.7% of the players who reported to have incurred an injury had recurring injuries with the ankle joint (33.3%) being the most affected part. Ligament sprain was the most common type of injury (36%) and most of the injuries (36.5%) reported were severe. No medical professional is available to manage injuries during training while team doctors are always available during matches. Recurrent injury was significantly associated injury prevalence (P=0.000). Use of protective gear was also significantly associated with injury prevalence both at training (P<0.01) and matches (P<0.05). Both coaches and team doctors reported that recurrent injury, psychological, player fitness, and lack of equipment were factors contributing to injury prevalence. Regarding injury management, coaches and team doctors reported sprains and strains as the most common injuries seen in the league. Furthermore, their views regarding injury prevention were sought. Team doctors perceived use of protective equipment as the main strategy of injury prevention while coaches regarded warm up as the main injury preventative strategy. Conclusion: There is need for physiotherapy intervention in prevention and management of football injuries in Malawi.

Stuttering is a problem that touches the lives of many people. The goal of this research is to come to a better understanding of a complex process of psychotherapy with a person who stutters. This is a qualitative study: sixteen sessions of interpersonal psychotherapy were conducted over a period of six months with a twenty-year-old male who was diagnosed with a severe stutter. Process notes were analysed based on the principle of self-reflexivity, which entails personally and systematically examining the reciprocal influences in a process. This study provides traditional conceptualisations of stuttering and comes to the conclusion that stuttering is a multifaceted phenomenon that may require a complexity of interventions. It is suggested that stuttering can be approached from an interpersonal perspective. This means that stuttering is a less effective means of dealing with other probable interpersonal problems. It is also s problem that is maintained by less effective attempts at alleviating it and by a limited scope of interactional manoeuvres. Stuttering can be addressed through interpersonal psychotherapy. The study suggests that the therapeutic approach should consider warmth, empathy, congruence, patience, therapeutic decision-making and timing. It is important to note that each client should be treated uniquely and valued as a person. Self-reflexivity is proposed as an effective way of facilitating the psychotherapeutic process, the scientific basis of this process and the development of the therapist. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

A number of studies have reported that many children with Autism Spectrum Condition (ASC) experience unusual responses to sensory stimuli, however it is argued that there is a lack of conceptual understanding regarding this phenomenon and an underdeveloped evidence base regarding appropriate support for these responses within an educational context. Despite this, practitioners from a range of professions are called upon to offer consultation, advice and intervention. Therefore, the present study sought to qualitatively explore the experiences of these professionals with regards to the sensory needs of children with ASC within an educational setting. An exploratory single-embedded case study design was adopted. Two Specialist Teachers, two Educational Psychologists (specialists in ASC) and two Occupational Therapists were recruited opportunistically and individual semi-structured interviews were conducted with each participant, resulting in six interviews. Each interview was audio recorded and transcribed verbatim. Interview data were analysed using thematic analysis and the findings presented as three thematic maps according to research question. Six organising themes were identified for Research Question 1: conceptualisations, assessment, defining unusual sensory responses, pragmatism, impact at school and professionals’ roles. Three organising themes arose from the data for Research Question 2: interventions, differences between special and mainstream, and efficacy. The data from the interviews yielded two organising themes for Research Question 3: barriers and facilitators. The study extends conceptual understanding by presenting a proposed Interactive Factors Framework (IFF) for unusual sensory responses in children with ASC. A number of recommendations for supporting children with ASC and unusual sensory responses within educational settings are also proposed. Implications for professionals supporting the sensory needs of children with ASC are discussed with reference to the pragmatic issues involved in translating a developing evidence base into practice.

Obesity is a growing concern in North America and current research suggests that for addressing childhood obesity, family-based behavioural interventions targeting children are the treatment of choice. Due to the lack of clinics that offer face to face treatment, the Internet may serve as a viable method for the delivery of such interventions. Three studies are presented in order to explore the viability of the internet as a treatment modality for delivering family-based interventions for children who are overweight. The first study attempted to deliver a family-based behavioural intervention via the internet - the Healthy Eating and Active Living Throughout Youth (HEALTHY) - for children aged 8 to 14 (M = 10.5). The initial goal was to evaluate the effectiveness of the internet as a treatment modality for childhood obesity. A total of 20 families consisting of 25 child-parent dyads consented to the intervention. However, adherence and attrition were significant issues throughout the 3-month intervention and only two child-parent dyads (8%) completed the 3-month intervention. Therefore the goals of this study changed to become primarily exploratory, with the aims of identifying factors related to treatment adherence and attrition. For the second study, the parents of the 20 families who consented to the HEALTHY intervention were invited to participate in a telephone interview around their impressions of the study, barriers to participation, and their needs in seeking services for their children. Sixteen families (80%) provided consent and thematic analyses were conducted. Four categories of themes emerged from the data and included: 'Knowledge and Education', 'Social Supports', 'Tools for Success', and 'Program Goals'. These categories, and the themes embedded within each category are presented and discussed. For the third study a systematic review of exclusively web-based studies for paediatric obesity was conducted. Five health and social sciences databases were search between 1995 and March 2012 (including an initial and updated search). A total of 2432 bibliographic records were identified (following de-duplication) and were subjected to title and abstract screening, and a further 120 records were subject to full-text screening. Two reviewers independently assessed the eligibility of each bibliographic record at these multiple levels and conflicts were resolved by third party. Three records were included in the review, and a further three records were identified as noteworthy in that they reported on one larger web-based study with a minimal face-to-face component (i.e., 4 sessions over 2 years). Data regarding attrition, adherence, and body composition changes were extracted by two independent reviewers. Attrition rates from the included studies ranged from 43% to 85%. The noteworthy study reported 18% overall attrition at six months (following randomization: 18% from the intervention group) and 34% overall attrition at two years (following randomization: 36% from the intervention group). Adherence measures were varied, but suggested low adherence to study components. Body composition changes were marginal in the short-term, but then lost in the longer-term. Implications for research and practice will be discussed. The contributions of this thesis include examining whether family-based interventions for pediatric obesity delivered over the internet are feasible. This question will be answered by exploring baseline characteristics that are related to treatment adherence and attrition, investigating barriers that interfere with adherence and contribute to attrition, and reviewing other research conducted in the field. Following from this thesis, and other relevant research, implications and recommendations for future research and clinical practice will be discussed

Objective: To explore interventions that support children and parents making health decisions. Systematic Review: A systematic review was conducted to synthesize evidence on interventions that support children’s health decision making. Five studies of variable quality were included. Interventions that improved decision making were decision coaching with or without an educational resource, or education alone. Pre-/post-test pilot: A pre-/post-test study evaluated the feasibility and acceptability of decision coaching guided by the Ottawa Family Decision Guide for children with type 1 diabetes and their parents. Of 16 families invited, 7 participated. Compared to children/parents who preferred one option at baseline, participants who were unsure of the best option rated decision coaching as more acceptable and had larger decreases in decisional conflict. Conclusions: Few studies have evaluated interventions supporting children’s decision making. The piloted decision support intervention was feasible and acceptable, particularly with children and parents who were unsure of the best option.

Class of 2008 Abstract / Objectives: To evaluate changes in parental knowledge regarding antibiotic use and antibiotic resistance with an educational intervention given at elementary school parent-teacher association (PTA) meetings. Methods: This was an analytical pre-test/post-test study of an educational intervention given at two elementary schools in the Phoenix metro area. The primary dependent variable was a knowledge measure, calculated as a total score. The changes between the pre- and post-test total score means were compared using a dependent t-test. The a-priori alpha level used was 0.05. Results: The study sample consisted of 25 participants. Study data were collected between September 2007 and December 2007. The mean (SD) pre- and post-test scores were 33.7 (4.4) and 40.7 (2.7), respectively (p < 0.05). Conclusions: The educational intervention presented at elementary school PTA meetings resulted in a significant knowledge increase regarding the appropriate use of antibiotics when pre- and post-test scores were compared.

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