Questions remain about the range of abilities autistic children possess and what constitutes effective treatment. Strength-based intervention contrasts with traditional autistic intervention approaches that focus on children's deficits. Studies on strength-based intervention approaches have not revealed how children's strengths are identified and have not used the insights of parents for this purpose. Neurodiversity serves as the conceptual framework because the tenets of neurodiversity align with those of strength-based approaches and hold that autism is a variation of the human condition rather than a disability. The purpose of this qualitative interpretive phenomenological study was to explore how the parent-identified strengths of autistic children may act as the basis for the advancement of strength-based intervention. The research questions focused on identifying the strengths of autistic children through semistructured interviews with 15 parents of high-functioning autistic children, who were recruited using purposive sampling. Data were analyzed using a three-level method, and six themes emerged: Routine, Caring for Others, Relationship with Parent, Intervention in School, Therapy, and Outlook for the Future. Practical implications for community psychology include development of strength-based approaches based on altruism, parent-child relationships, and positive outlooks for the future. Further research is recommended on caring for others and displaying affection in relation to strength-related constructs, such as resiliency and growth. Effective strength-based interventions may help autistic children develop based on their strengths, leading to positive social change.

Thèse d'exercice : Médecine. Médecine générale : Paris 12 : 2007. / Titre provenant de l'écran-titre. 89 f. : ill. Bibliogr. f. 63-71.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

xiv, 183 p. : ill. (some col.) / Educators are responsible for helping students develop academic and behavior skills and for creating safe environments that promote these outcomes. Achieving these outcomes has become increasingly difficult due to disruptive, anti-social student behavior. Researchers identified Positive Behavioral Interventions and Supports (PBIS) as an evidence-based approach, integrating primary, secondary, and tertiary interventions that provide benefit for students, schools, and educational communities. However, an extensive PBIS literature and research review identified a limited application of PBIS in secondary school settings. The purpose of this dissertation was to broaden the scope of research by examining the impact of PBIS on school-wide discipline outcomes and student academic performance in a secondary school setting using case study methodology. The case study was conducted in a large, urban Pacific Northwest high school that expressed interest in improving the general school expectations and positive interactions between students and staff members. Study participants were members of a student cohort from grade 9 to grade 12. The case study provided a descriptive analysis of students’ social behavior outcomes (as measured by Office Discipline Referrals, Suspensions/ Expulsions, and Attendance Rate) and their academic performance (as measured by students’ Grade Point Averages and Course Credits). An ordered time-series display was applied to analyze behavior and achievement outcome trends. Results showed an increase in students’ Grade Point Average, Course Credits, and Attendance Rate and a decrease in students’ Office Discipline Referrals and Suspensions/ Expulsions. This study’s findings are discussed in the context of its impact on students’ social engagement and academic achievement. Evidence of students’ academic and behavior outcomes has the potential to assist in the development of material and approaches to guide, replicate, and extend current PBIS practices to secondary school settings. / Committee in charge: Dr. Gerald Tindal, Chairperson; Dr. Keith Hollenbeck, Member; Dr. Scott Baker, Member; Dr. K. Brigid Flannery, Member; Dr. Nathaniel Teich, Outside Member

Bakgrund: Forskning tyder på att preoperativ ångest utgör ett vanligt förekommande problem hos patienter som skall genomgå kirurgi. Flera studier visade att den kan leda till olika postoperativa komplikationer. Det är sjuksköterskans ansvar att både identifiera och åtgärda ångest inför ett kirurgiskt ingrepp. Syfte: Att beskriva vilka icke-farmakologiska interventioner finns för att minska preoperativ ångest hos vuxna patienter. Metod: Studiens design var en litteraturöversikt som genomfördes enligt Fribergs metodbeskrivning. Litteraturöversikten bygger på tolv kvantitativa studier publicerade mellan 01/2007 och 09/2017. Sökningar utfördes i databaserna CINAHL Complete och PubMed. Resultat: Denna litteraturöversikt tyder på att det finns flera, olika interventioner som kan användas som komplement till farmakologisk behandling för att effektivt minska preoperativ ångest hos vuxna patienter. Ångest i den preoperativa fasen kan lindras om patienten får en utökad, individuell anpassad information. Ångest kan också minskas om patienten får ett känslomässigt stöd eller hjälp med att finna tröst i andlighet/religion. Litteraturöversiktens resultat tyder dessutom på att ångestnivå kan sänkas med hjälp av en lugn musik, naturljud eller vägledd dagdröm. Det framkom även att den preoperativa ångesten kan minskas genom avslappningsövningar, aromaterapi, akupunktur och zonterapi. Endast en fotografisk utställning har inte visats vara effektiv för att minska ångest i det preoperativa skedet. Diskussion: Resultatet av litteraturöversikten har diskuterats i relation till sjuksköterskans ansvarsområde. Resultatdiskussionen koncentreras kring praktiska frågor gällande implementering av de icke-farmakologiska metoderna i vården. Jean Watsons teori om mänsklig omsorg utgjorde översiktens teoretiska referensram som hjälpte författaren i resultatdiskussionen. / Background: Research indicates that preoperative anxiety is a widespread problem among patients undergoing surgery. It has been shown in several studies that preoperative anxiety may lead to different postoperative complications. It is the nurse's responsibility to identify and to reduce patients' anxiety. Aim: To describe which non-pharmacological interventions are available to reduce preoperative anxiety in adult patients. Method: The study was designed as a literature review performed according to the Fribergs method. This literature review is based on twelve quantitative articles published between 01/2007 and 09/2017. The search for the articles was conducted in CINAHL Complete database and PubMed database. Results: The result of this review indicates that there are several, different interventions that may be used in addition to pharmacological treatment in order to effectively reduce preoperative anxiety in adult patients. Anxiety in the preoperative phase can be alleviated by providing the patient with information tailored to the individual's needs. Anxiety can also be reduced by providing emotional support or by helping the patient to find comfort in spirituality/religion. The result of this review indicates moreover that the level of anxious can be minimized by listening to soothing music, nature sounds or guided imagery. Relaxation exercises, aromatherapy, acupuncture and reflexology were also found to reduce preoperative anxiety. Only the photographic display was not found to be effective in reducing anxiety in the preoperative phase. Discussion: The result of this review was discussed in relation to the nurse's responsibilities. The discussion of the results was focused on the practical issues about implementation of the non-pharmacological methods in the clinical practice. Jean Watson's Theory of Human Caring was used as a theoretical framework that helped the author in results analysis.

Although interventions that take an individualized, holistic approach to service delivery have been recommended for homeless youth, few such interventions have been described in the literature. This study sought to examine a unique, multi-faceted, community-based intervention developed in 2009 in Tampa, FL to provide services to homeless adolescents who are no longer living in the custody of a parent or guardian (i.e. unaccompanied youth). The intervention, titled Starting Right, Now (SRN), has served over 100 youth to date. The program provides residential, educational, recreational, and professional development services, as well as mental and physical health care. Each youth also receives a trained mentor who is in frequent contact with the youth. Other individualized services are provided as needed. Although SRN has been in existence for six years, the program has only been evaluated using measures such as changes in GPA, absentee rates, etc. In the current study, individual interviews with nine program participants who had been in SRN for at least one year were analyzed to explore how the youth themselves perceived that their lives had been impacted. Thematic analysis of interviews provided an opportunity to examine common themes among participants. Results showed that despite encountering some challenges, participants perceived that they had been lifted to higher educational and personal levels through obtainment of resources; adult and peer support systems; renewed trust in adults; increased hope; improved mental health; and a heightened sense of community. Practical implications for practice and research are discussed.

This dissertation presents an analysis of the models of psychosocial processes structuring UNICEF’s psychosocial intervention after the emergency caused by the floods in Venezuela during 1999, and some of their political and ethical implications. I discuss how UNICEF’s intervention in the shelter of Fuerte Tiuna, in Caracas, provides a context in which discourses and practices construct the disaster as an event of a particular type, affording particular positions to those affected by it, and presenting the intervention as a reparative response that engages in different ways with these constructions. Specific issues explored by this dissertation include how practices and discourses construct the disaster and its impact on persons and communities; the nature of the psychosocial intervention; the subject; and the different forms of expertise involved in the intervention. Further, it examines how the intervention-as-designed is implemented and how the actual contact with the beneficiary population generates changes not only in the implementation itself, but also in the conceptual frameworks displayed by UNICEF. The analysis presents UNICEF’s psychosocial intervention as a practice that is simultaneously material and discursive. The participation of experts, the use of specific resources, the deployment of techniques and their devices, the organisation of time and space within the intervention, can all be considered as supporting certain notions of the disaster, its impact and its solution, which organise the models of the psychosocial. The main issues that appear as relevant for the analysis are related to the way in which the intervention constructs the disaster as a psychosocial problem; the appeal to the notion of trauma to explain the impact on those affected; the disciplinary, ethical and political implications of the different forms of understanding suffering in the Venezuelan contemporary context and how the notions put forward by UNICEF’s intervention engage with the social dynamics in Venezuela, in particular with the processes associated with the social and political polarisation.

Training siblings as change agents for children diagnosed with autism spectrum disorders (ASD) has been shown to be beneficial in teaching a sibling to teach their brother or sister. There are very few interventions, however, that explore the range of effects that targeting particular skills has on sibling interactions. The purpose of this study was to assess the direct and collateral effects of training behavioral teaching techniques to a typically developing sibling. Four experimental conditions were assessed: baseline, sibling teaching toy play, baseline, and sibling teaching social play. Across all conditions, measures of teaching components and siblings' interactions were assessed. Results of the assessment showed that the sibling was an effective change agent and that more favorable interaction and engagement occurred when social play skills were taught. The results of this sibling intervention and guidelines for condition changes are discussed in terms of sibling relationships.

Plusieurs enfants ayant un trouble du spectre de l’autisme (TSA) manifestent des comportements d’autostimulation. Ces comportements peuvent interférer avec l’apprentissage, la socialisation et les comportements adaptatifs. Même si les interventions comportementales sont reconnues efficaces pour réduire les comportements d’autostimulation, ces types d’intervention ne sont pas accessibles à toutes les familles. En réponse à ce problème, ce mémoire vise à évaluer les effets d’iSTIM, une application mobile conçue pour accompagner les parents dans la réduction des comportements d’autostimulation de leur enfant ayant un TSA. Une série de protocoles de recherche AB pour évaluer l’efficacité d’iSTIM sur les comportements d’autostimulation et les comportements appropriés auprès de sept familles. L’utilisation d’iSTIM par les parents a mené à une réduction des comportements d’autostimulation chez six des sept participants et une augmentation des comportements appropriés chez trois des participants. Les résultats indiquent que l’utilisation de la technologie peut être une méthode efficace, peu coûteuse et facilement accessible pour les parents dans le but de réduire les comportements d’autostimulation chez les enfants ayant un TSA. / Many children with ASD engage in stereotypy, which may interfere with learning, socialization as well as adaptive functioning. Although behavioral interventions have been known to effectively reduce stereotypy in children with ASD, these types of interventions are not accessible to all families. In response to this issue, the purpose of our study was to evaluate the effects of the iSTIM, an iOS application designed to support parents in the reduction of stereotypy in their child with ASD. We used a series of AB designs to determine the effectiveness of iSTIM on stereotypy and appropriate behavior in seven families. The use of iSTIM by the parents led to a reduction in stereotypy for six of our seven participants as well as an increase in an alternative appropriate behavior in their three children. Our results indicate that the use of technology may be a cost effective and easily accessible method for parents to reduce stereotypy in children with ASD.

Background: Asthma Link is a program that aims to increase adherence to inhaled corticosteroids among children with persistent asthma by delivering evidence-based school-supervised therapy. This program, which leverages existing infrastructure, improves asthma outcomes in children from low-income, minority families. Our aim was to elicit the perspectives of school nurses who supervise preventive medication administration. Methods: Semi-structured qualitative interviews were conducted with 12 school nurses participating in Asthma Link. Thematic analysis was used to identify themes related to barriers and facilitators to preventive medication delivery. Results: Barriers described by school nurses included communication challenges with families and providers, inconsistent supplies of the preventive medicine at school, and the perception by some families and nurses that preventive therapy should be provided at home. Facilitators included the ease of incorporating preventive medication delivery into morning routines, recognizing the positive impacts on children from families with limited resources, feeling part of the preventive health care team, and being well-positioned to engage families in preventive asthma care. Conclusions: To facilitate Asthma Link adoption, it is critical to incorporate school nurse feedback in the program’s protocol refinement. School-supervised asthma therapy programs are advised to engage school nurses in the opportunity to provide preventive care, streamline communication, and address social and logistical challenges which may impede families from bringing medication to school.