High prevalence of individuals with autism spectrum disorder (ASD) and the legislation movement impacted the placement of students with ASD in general education settings. Hence, the increase raised the need to conduct research for ASD populations, and to examine the effectiveness of these interventions. With the increase of single case-design (SCD) studies, there is a demand to include SCD in the evaluation of evidence- based practices (EBPs), to analyze and interpret SCD results in meaningful ways beside visual analysis, and to generate effect size estimates. This dissertation contains four systematic literature reviews which examine single-case intervention research targeting academic, social communication, play, and functional life skills for children with ASD in school settings. 132 studies with 924 AB phase contrasts were analyzed using visual analysis and three non-overlap measures. Sensitivity and specificity of Tau-U, IRD, and Baseline Corrected Tau were tested on detecting intervention effects. Also, the three methods were examined in their agreement with interpretations based on the visual analysis and the effect of confounding factor on their scores. The analysis demonstrated that the three methods performed fairly well in distinguishing effective from non-effective interventions. The three non-overlap methods had a moderate to substantial level of agreement with visual analysis. The author recommended further research on the impact of confounding factors especially baseline trend and autocorrelation as well as the use of effect size methods with high sensitivity and visual aids to improve the reliability and accuracy of visual analysis.

Sluggish cognitive tempo (SCT) is a construct that includes symptoms of slowness, mental confusion, excessive daydreaming, low motivation, and drowsiness/sleepiness. SCT is often co-morbid with attention-deficit/hyperactivity disorder (ADHD), and SCT symptoms are associated with significant academic and interpersonal impairment above and beyond the influence of ADHD symptoms. Despite the overlap between ADHD and SCT and associated impairments, no studies have evaluated how evidence-based psychosocial interventions for adolescents with ADHD impact symptoms of SCT. This study examined whether SCT symptoms improved in a sample of 274 young adolescents with ADHD who received either an organizational skills or a homework completion intervention. SCT intervention response was evaluated broadly in all participants, and specifically, for participants in the clinical range for SCT symptom severity at baseline. Change in ADHD symptoms of inattention, executive functioning, and motivation was examined as potential predictors of improvement in SCT. Multilevel modeling analyses indicated that SCT symptoms decreased at the same rate for adolescents in both the organizational skills and homework completion interventions when compared to the waitlist group (d = .410). For adolescents with parent-reported clinical levels of SCT, the decrease in symptoms was more pronounced (d = .517), with the interventions decreasing the total score of SCT by 2.91 (one symptom). Additionally, in the high SCT group, behavior regulation executive functioning, metacognitive executive functioning, and inattention predicted change. Clinical implications and future directions are discussed, including development of interventions for adolescents with high levels of SCT.

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.

This study examined the effectiveness of training low income Black American parents in child parent relationship therapy (CPRT). In response to the cultural values and challenges faced by low income Black American parents, the CPRT manual was adapted slightly for use with parents for this study. In this quasi-experimental design, 14 parents were assigned to the experimental group and 13 parents were assigned to the no treatment control group. Six hypotheses were analyzed. Different analyses were conducted based on the hypotheses. A two-factor repeated measures analysis of variance and analysis of covariance were conducted to determine if the CPRT treatment and the no treatment control group performed differently across time according to pretest and posttest results of the Child Behavior Checklist - Parent Version (CBCL) and the Parenting Stress Index (PSI). Additionally, partial η2 was calculated to determine practical significance. Five hypotheses were retained at the .025 level of significance. Findings indicated that parents who participated in the CPRT training reported a statistically significant decrease in parent-child relationship stress. Specifically, parents assigned to the experimental group demonstrated a statistically significant decrease in Child Domain (p < .001), Parent Domain (p < .001), and Total Stress (p < .001) of the PSI when compared to parents assigned to the no treatment control group. Similarly, results indicated that parents assigned to the experimental group reported statistically significant improvements in Total Problems (p < .01) and Externalizing Problems (p = .001) of the CBCL, when compared to parents assigned to the no treatment control group. No statistical significant results were found on Internalizing Problems.

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Introduction Substance use in adolescents with disabilities is rising, containing the prevalence of substance-related disorders (SRD) such as addiction, mental or health disorders, cancer, accidents and mortality. Yet little is known about the existing substance use prevention programs among adolescents with dosabilities or physical impairments. The aim of this systematic review was to investigate the effects of school-based interventions or prevention programs directed at the reduction of alcohol, tobacco and drug use in young adolescents with disabilities or physical impairments. Method Five scientific databases were explored mainly for school-based randomized controlled trials (RCTs) and prevention programs examining the effects of substance use interventions and prevention programs on adolescents with disabilities or physical impairments. Guided by the NICE guidelines, eligible articles were detected from which data were collected. A systematic literature review was performed for many diverse outcomes such as, substance use knowledge, substance use, modelling social environment, intention to quit smoking, peer pressure, etc. Results The primary literature search resulted in 821 articles. Five studies were incuded in the systematic literature review. Most of the collected studies were about adolescents with intellectual disabilities (MBID or MMID). The review's sample group ranged from 12-to 18-year-old adolescents. Included studies had a total sample of 981 out of which 13 were teachers. Studies measured both primary and secondary outcomes like modelling smoking, substance use and frequency of alcohol use. Conclusion This review summarized evidence about interventions and prevention programs aimed at decreasing or preventing substance use in adolescents with various types of disabilities or physical impairments. Substance use education increases knowledge about alcohol, tobacco and drug use and the health-related harms in teenagers with disabilities. Additional research is required especially among teenagers with intellectual disabilities and other types of disabilities.

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