1) The study examined the effects of positive distractions on the attention, behavior, and activities of pediatric patients waiting in dental and cardiac clinics.
2) It found that multi-sensory distractions like ambient art with sound were most effective at focusing patients' attention, and resulted in patients being calmer with less movement.
3) The type of distraction that worked best varied between the two clinics, suggesting that factors like a patient's illness or disability can influence their response to different distractions. Overall, positive distractions helped improve the waiting experience for pediatric patients.
060915 current research that you should incorporate into yourDominick Maino
Current Research that You Should Incorporate into Your Mode of Practice Now!
Dominick Maino, OD, MEd, FAAO, FCOVD‐A
Moderator
Featuring the Best of AOA's 2015 Poster Presentations
Jun‐27‐2015 8:00AM ‐ 10:00AM
Optic Nerve Head Drusen: A Myriad of Presentations
Jennifer L. Jones, Sylvia E. Sparrow, Christina Grosshans
Validation Study of New LCD‐Based Contrast Sensitivity Testing Method
Sarah Henderson, Jeung H Kim, Paul Harris
Bilateral Cystoid Macular Edema in Retinitis Pigmentosa and its Management
Lindsay T. Gibney
An ODE to Optic Disc Edema
Kelli Theisen
Is Binocular Balancing with Subjective Refraction a thing of the Past?
David Geffen
Optometry's Meeting 2015
Seattle, Washington
Can a Virtual tour reduce anxiety in young optometry patients with ASD?Dr Greg Carey
This study looks at the effect of an online preview of visiting the optometrist on the levels of anxiety in children and adolescence with Autism Spectrum Disorder (ASD). It is hypothesised that those who use the online preview will experience less anxiety before and during the visit resulting in more reliable assessments and improved service for this group.
The level of anxiety of those using the online preview is compared to those who had no intervention before the appointment. Before the visit half of those given appointments were given access to an online interactive walkthrough of the examination environment. Others received no contact before the visit. On arrival both groups used a simple visual method to describe their level of anxiety and the self-reporting used to determine any effect of the online preview on the reported level of anxiety.
A reduction in the level of anxiety during the visit will bring more accurate and confident results in the testing. This research will have extensive implications for future testing and assessment of health issues for children and adolescents with ASD.
Evidence Based Practice: Pediatrics, Binocular Vision and Patients with Speci...Dominick Maino
This document discusses evidence-based clinical practice in pediatrics and optometry, specifically for patients with special needs. It covers different perspectives of clinicians and researchers, as well as patients' views. It questions whether evidence is needed for everything, given limitations of randomized controlled trials and systematic reviews. The document also discusses levels of scientific evidence and grades of evidence in evaluating research studies and forming clinical recommendations.
Maino D. Agenda Driven Research. Vis Dev Rehab 2015; 1(1):7-11.
Read the editorial.....
Conclusion
It is time for all to put aside our agendas,
our biases, our preconceived notions. It is time
to work together to determine best practices
even if it is contrary to prevailing opinion. The
world is not flat. Amblyopia can be treated at
any age. And optometric vision therapy is an
appropriate treatment modality for disorders of
he binocular vision system.
Orkun Oguz (CyVision): Critical Factors for the Mass Adaption of XRAugmentedWorldExpo
CY Vision is developing computational holographic display technology for AR, VR, and HUD applications. They have $10M+ in funding from investors like Intel Capital and a team of 17+ engineers and scientists. Computational holography can provide the best "visual comfort" by enabling continuous depth, natural focus blur without vergence-accommodation conflict, which are issues that cause visual discomfort in current stereoscopic displays. CY Vision believes visual comfort will be a key factor for the mass adoption of extended reality and their technology has the potential to achieve this by more closely matching natural human vision compared to alternatives.
This document discusses potential pitfalls in scientific inquiry such as sampling error and bias. It uses the example of Natalie randomly selecting jelly beans from a jar to illustrate how sampling error can occur when a sample size is small, but larger sample sizes provide results that more closely approximate the actual population ratios. It also notes that scientists are susceptible to bias in interpreting results and emphasizes using quantitative, objective data collection methods to minimize bias. The document outlines some limits of science as well, such as its inability to address subjective questions or make claims about the supernatural.
This document discusses the development of an attention-deficit hyperactivity disorder (ADHD) awareness game called "Attention Grabber" and its testing on public screens. The game aimed to educate the public about ADHD through gamification of a continuous performance test used clinically to assess ADHD symptoms. Initial results found over 500 plays across 4 locations, with varying levels of ADHD awareness and knowledge gained depending on the demographic of each location. While engagement with the game and educational film was good, ethical concerns remain around balancing increased awareness and potential health anxiety. Further evaluation is needed on gamifying clinical ADHD assessments for public education.
Monitoring Outcomes of Children Who Wear Hearing Aids Phonak
This document discusses outcome measures for evaluating the auditory performance of pediatric hearing aid users. It describes the development and validation of several tools, including the LittlEARS Auditory Questionnaire, PEACH scale, Ling 6 sounds detection test, and UWO Plurals test. A study found that typically developing children with hearing aids performed well on these measures when fitted according to evidence-based protocols, while children with comorbidities or complex factors had more variable results. Outcome evaluation is important for tracking individual progress, improving service delivery, and assessing early hearing detection and intervention programs.
060915 current research that you should incorporate into yourDominick Maino
Current Research that You Should Incorporate into Your Mode of Practice Now!
Dominick Maino, OD, MEd, FAAO, FCOVD‐A
Moderator
Featuring the Best of AOA's 2015 Poster Presentations
Jun‐27‐2015 8:00AM ‐ 10:00AM
Optic Nerve Head Drusen: A Myriad of Presentations
Jennifer L. Jones, Sylvia E. Sparrow, Christina Grosshans
Validation Study of New LCD‐Based Contrast Sensitivity Testing Method
Sarah Henderson, Jeung H Kim, Paul Harris
Bilateral Cystoid Macular Edema in Retinitis Pigmentosa and its Management
Lindsay T. Gibney
An ODE to Optic Disc Edema
Kelli Theisen
Is Binocular Balancing with Subjective Refraction a thing of the Past?
David Geffen
Optometry's Meeting 2015
Seattle, Washington
Can a Virtual tour reduce anxiety in young optometry patients with ASD?Dr Greg Carey
This study looks at the effect of an online preview of visiting the optometrist on the levels of anxiety in children and adolescence with Autism Spectrum Disorder (ASD). It is hypothesised that those who use the online preview will experience less anxiety before and during the visit resulting in more reliable assessments and improved service for this group.
The level of anxiety of those using the online preview is compared to those who had no intervention before the appointment. Before the visit half of those given appointments were given access to an online interactive walkthrough of the examination environment. Others received no contact before the visit. On arrival both groups used a simple visual method to describe their level of anxiety and the self-reporting used to determine any effect of the online preview on the reported level of anxiety.
A reduction in the level of anxiety during the visit will bring more accurate and confident results in the testing. This research will have extensive implications for future testing and assessment of health issues for children and adolescents with ASD.
Evidence Based Practice: Pediatrics, Binocular Vision and Patients with Speci...Dominick Maino
This document discusses evidence-based clinical practice in pediatrics and optometry, specifically for patients with special needs. It covers different perspectives of clinicians and researchers, as well as patients' views. It questions whether evidence is needed for everything, given limitations of randomized controlled trials and systematic reviews. The document also discusses levels of scientific evidence and grades of evidence in evaluating research studies and forming clinical recommendations.
Maino D. Agenda Driven Research. Vis Dev Rehab 2015; 1(1):7-11.
Read the editorial.....
Conclusion
It is time for all to put aside our agendas,
our biases, our preconceived notions. It is time
to work together to determine best practices
even if it is contrary to prevailing opinion. The
world is not flat. Amblyopia can be treated at
any age. And optometric vision therapy is an
appropriate treatment modality for disorders of
he binocular vision system.
Orkun Oguz (CyVision): Critical Factors for the Mass Adaption of XRAugmentedWorldExpo
CY Vision is developing computational holographic display technology for AR, VR, and HUD applications. They have $10M+ in funding from investors like Intel Capital and a team of 17+ engineers and scientists. Computational holography can provide the best "visual comfort" by enabling continuous depth, natural focus blur without vergence-accommodation conflict, which are issues that cause visual discomfort in current stereoscopic displays. CY Vision believes visual comfort will be a key factor for the mass adoption of extended reality and their technology has the potential to achieve this by more closely matching natural human vision compared to alternatives.
This document discusses potential pitfalls in scientific inquiry such as sampling error and bias. It uses the example of Natalie randomly selecting jelly beans from a jar to illustrate how sampling error can occur when a sample size is small, but larger sample sizes provide results that more closely approximate the actual population ratios. It also notes that scientists are susceptible to bias in interpreting results and emphasizes using quantitative, objective data collection methods to minimize bias. The document outlines some limits of science as well, such as its inability to address subjective questions or make claims about the supernatural.
This document discusses the development of an attention-deficit hyperactivity disorder (ADHD) awareness game called "Attention Grabber" and its testing on public screens. The game aimed to educate the public about ADHD through gamification of a continuous performance test used clinically to assess ADHD symptoms. Initial results found over 500 plays across 4 locations, with varying levels of ADHD awareness and knowledge gained depending on the demographic of each location. While engagement with the game and educational film was good, ethical concerns remain around balancing increased awareness and potential health anxiety. Further evaluation is needed on gamifying clinical ADHD assessments for public education.
Monitoring Outcomes of Children Who Wear Hearing Aids Phonak
This document discusses outcome measures for evaluating the auditory performance of pediatric hearing aid users. It describes the development and validation of several tools, including the LittlEARS Auditory Questionnaire, PEACH scale, Ling 6 sounds detection test, and UWO Plurals test. A study found that typically developing children with hearing aids performed well on these measures when fitted according to evidence-based protocols, while children with comorbidities or complex factors had more variable results. Outcome evaluation is important for tracking individual progress, improving service delivery, and assessing early hearing detection and intervention programs.
The document summarizes key findings from the 2011 Public Attitudes to Science study in the UK. It found that while most of the public values science and sees its benefits, some remain concerned about regulation of scientists and potential negative consequences. Segmentation analysis identified groups with different levels of engagement, from "Confident Engagers" who are already highly engaged to "Indifferent" who are least engaged. Effective communication requires understanding these groups and their preferences to build understanding and trust in science.
Public Understanding of Science Seminar (26 October 2011)Marilyn Booth
The document summarizes the findings of a large study on public attitudes toward science in the UK. It identifies six audience segments based on levels of engagement and views of science: Confident Engagers, Distrustful Engagers, Late Adopters, The Concerned, Disengaged Sceptics, and The Indifferent. While public interest in science is rising, many still lack understanding of processes like peer review and have concerns about regulation and scientists' intentions. Effective engagement requires tailoring approaches to different audience needs.
BIS/Ipsos MORI: Learning From Public Attitudes to Science 2011Marilyn Booth
- The document summarizes findings from a 2011 UK study on public attitudes toward science. It identified six main audience segments with differing levels of engagement and concerns about science.
- While most value science, concerns often stem from lack of understanding of the scientific process. Public engagement is challenging as more information does not always reduce anxiety or increase feelings of being informed.
- Targeting communication to different audience segments identified in the research could help ensure more diverse participation in public discussions about science issues.
This document outlines a presentation on emotional and behavioral difficulties (EBD). It begins with an introduction and outline, then defines EBD and challenges in defining it. Specific conditions are mentioned like obsessive compulsive disorder (OCD). Statistics on prevalence of mental health issues are provided. The document discusses identifying and diagnosing EBD. It provides information on OCD, including signs and symptoms. Support available from the government and where to seek help is outlined. Suggested teaching strategies for students with EBD are presented, along with a proposed group activity and conclusion.
- 83% of parents of children with autism reported their child had difficulties with emotional symptoms, conduct, hyperactivity and peer relationships. Autism affects twice as many boys than girls.
- Autism may be caused by connectivity issues in the brain and involve gene-environment interactions. It may also impact the gastrointestinal tract, immune system, and sensory systems.
- While some early studies claimed links between autism and vaccines/mercury, large subsequent studies found no scientific evidence supporting these connections.
1) The document discusses HopeLab's work using video games to improve health outcomes for chronic illnesses like cancer.
2) It describes HopeLab's cancer-fighting video game Re-Mission, which improved patients' cancer knowledge, self-efficacy, and medication adherence through gameplay.
3) HopeLab is conducting further research on Re-Mission to understand how gameplay impacts emotions, motivation, and real-life behaviors through studies analyzing player brain activity and game mechanics.
The document summarizes current research on autism, including:
- Autism was first identified in 1943, though early theories wrongly blamed mothers
- Prevalence has increased and is now 1 in 150, possibly due to improved diagnosis and definitions
- Diagnosis has shifted from a social disorder to recognizing global brain processing differences
- Genetic research finds higher concordance rates in identical twins and links to specific genes
- Brain research shows differences in size, connectivity, and activity in face and emotion regions
Experts roundtable presentations june 6 2012 european parliamentBilly Cometti
This document summarizes presentations given at an experts roundtable on ending the institutionalization of children. It discusses the impact of institutionalization on child development, noting that children raised in institutions have compromised development across cognitive, physical, emotional, social, and behavioral domains. Placement in family environments can help mitigate some of these negative effects, with earlier placement leading to better outcomes. It also discusses the economic case against institutionalization, citing both the direct costs of residential care and various indirect costs to society from the poor outcomes of children in institutions. Finally, it discusses practical implications and the need to invest in family support services, foster care, adoption and other alternatives to replace institutional care.
The optometric examination involves 4 main parts: obtaining a patient history, performing a preliminary examination, conducting a refractive examination, and assessing binocular vision. The patient history is the most important first step, as it guides the exam and allows the optometrist to make a tentative diagnosis. A thorough history involves learning about the chief complaint, history of present illness, review of systems, ocular history, medical history, family history, social history, and medications.
This document discusses using telemedicine in schools for children with developmental disabilities. It describes how telemedicine can be used for psychotherapy, assessments, training teachers, and more. While telemedicine improves access to care and support, there are also challenges like difficulty establishing rapport and scheduling emergencies remotely. The Marcus Autism Center has collaborated with other organizations to provide telemedicine services for 1,459 patient appointments across 34 sites in Georgia.
This document summarizes a study on the effects of electronic gadgets on children's health. It includes an introduction discussing previous research finding negative cognitive and health effects. The objectives are to examine consequences of gadget use and how demographics affect views of consequences. Hypotheses are that gadgets negatively impact health and demographics influence views of consequences. The methodology describes the sample, data collection/analysis. Results found gadgets used for entertainment and games. Most agreed children face headaches and eye/sleep issues from use. Demographics did not affect views of consequences. Practical implications encourage exercise and limiting screen time. Future research could study other age groups, increase sample size, and examine role of parents in mitigating sensitivity. The conclusion
The document provides an overview of data analysis, interpretation, and presentation for research. It discusses quantitative and qualitative data analysis methods. Quantitative methods include descriptive statistics like measures of central tendency and spread to summarize numeric data. Qualitative methods include coding of open-ended responses to identify themes. Both types of data can be presented visually in tables, graphs, and word clouds. Proper interpretation relates results back to the research question and previous studies and draws conclusions about the meaning and implications of the findings.
AAAS Presentation on Scientists' Views about EngagmentJohn C. Besley
This presentation is to be delivered on Feb. 14 at the annual meeting of the AAAS. It reports research supported by the NSF's Advancing Informal Science Learning group (see disclaimer in presentation).
This document provides practical tips for evaluating research as a communicator. It discusses common problems that can occur in research such as bias, flawed methodology, and overstating conclusions. Specific red flags are highlighted, such as undisclosed conflicts of interest from funding sources. The importance of considering alternative viewpoints, statistical versus practical significance, and whether findings have been replicated are also covered. The document aims to help readers critically analyze research and be savvy consumers of science.
Spreadsheets And Stories: STP & A presentation, Oct 26, 2013Snow Dowd
The document provides information on how data can be used to support arts organizations and projects. It includes examples of arts organizations that have used data to improve strategies, give people choices, understand places, share information, provide proof of impact, improve care, make connections, and measure social progress. Overall, the document demonstrates how data collection and analysis can help arts organizations achieve their goals and better serve their communities.
Developing a Virtual Environment for Discharge Planning after Stroke :A Preliminary Study
Interactive Technologies and Games (ITAG) Conference 2014
Health, Disability and Education
Dates: Thursday 16 October 2014 - Friday 17 October 2014
Location: The Council House, NG1 2DT, Nottingham, UK
Behavioral disorders screening and prediction1Sonu Kumar
Behavioral disorders are common in children and adults and can negatively impact one's life if left untreated. Some common behavioral disorders include anxiety disorders, disruptive behavioral disorders, and ADHD. Emotional symptoms of behavioral disorders may include anger, blaming others, and difficulty handling frustration. Physical symptoms are generally absent aside from potential issues from substance abuse. Autism is a type of behavioral disorder characterized by challenges with social skills and communication. Artificial intelligence can help predict autism and other behavioral disorders through analysis of behavioral screening data to enable early diagnosis and improved outcomes.
- The document discusses different types of evidence that can be used to support arguments and claims, including statistical evidence, testimonial evidence, anecdotal evidence, and research studies.
- Statistical evidence uses numbers and data, testimonial evidence relies on individual accounts and endorsements, anecdotal evidence cites specific observations or examples, and research studies can provide stronger evidence through systematic reviews and meta-analyses of multiple studies.
- Each type of evidence has strengths and limitations depending on the claim. Statistical and research evidence may be stronger, but anecdotes and testimonials can still have value when used carefully and supplemented with other evidence.
This document summarizes a presentation on how emergency department design impacts safety and efficiency. It discusses 14 domains of physical design that were studied, including entry/public waiting, patient intake, configuration, care-giver work areas, and physician work areas. Certain design elements like visibility, queuing, and security provisions in the entry area significantly affect both safety and efficiency. The study's findings can help hospitals optimize their emergency department design.
This document summarizes a study examining the impact of decentralizing nursing units at MD Anderson Cancer Center. Data was collected before and after the transition to new units with decentralized nurse stations, medication rooms, and supplies. Findings included an increase in time spent walking and documenting for nurses, though collaboration was mixed with some improvements but staff also feeling more isolated at times. Overall, the study found that simply changing the physical design did not automatically achieve the desired outcomes and that operational processes and culture change are also needed to fully realize benefits from decentralization.
The document summarizes key findings from the 2011 Public Attitudes to Science study in the UK. It found that while most of the public values science and sees its benefits, some remain concerned about regulation of scientists and potential negative consequences. Segmentation analysis identified groups with different levels of engagement, from "Confident Engagers" who are already highly engaged to "Indifferent" who are least engaged. Effective communication requires understanding these groups and their preferences to build understanding and trust in science.
Public Understanding of Science Seminar (26 October 2011)Marilyn Booth
The document summarizes the findings of a large study on public attitudes toward science in the UK. It identifies six audience segments based on levels of engagement and views of science: Confident Engagers, Distrustful Engagers, Late Adopters, The Concerned, Disengaged Sceptics, and The Indifferent. While public interest in science is rising, many still lack understanding of processes like peer review and have concerns about regulation and scientists' intentions. Effective engagement requires tailoring approaches to different audience needs.
BIS/Ipsos MORI: Learning From Public Attitudes to Science 2011Marilyn Booth
- The document summarizes findings from a 2011 UK study on public attitudes toward science. It identified six main audience segments with differing levels of engagement and concerns about science.
- While most value science, concerns often stem from lack of understanding of the scientific process. Public engagement is challenging as more information does not always reduce anxiety or increase feelings of being informed.
- Targeting communication to different audience segments identified in the research could help ensure more diverse participation in public discussions about science issues.
This document outlines a presentation on emotional and behavioral difficulties (EBD). It begins with an introduction and outline, then defines EBD and challenges in defining it. Specific conditions are mentioned like obsessive compulsive disorder (OCD). Statistics on prevalence of mental health issues are provided. The document discusses identifying and diagnosing EBD. It provides information on OCD, including signs and symptoms. Support available from the government and where to seek help is outlined. Suggested teaching strategies for students with EBD are presented, along with a proposed group activity and conclusion.
- 83% of parents of children with autism reported their child had difficulties with emotional symptoms, conduct, hyperactivity and peer relationships. Autism affects twice as many boys than girls.
- Autism may be caused by connectivity issues in the brain and involve gene-environment interactions. It may also impact the gastrointestinal tract, immune system, and sensory systems.
- While some early studies claimed links between autism and vaccines/mercury, large subsequent studies found no scientific evidence supporting these connections.
1) The document discusses HopeLab's work using video games to improve health outcomes for chronic illnesses like cancer.
2) It describes HopeLab's cancer-fighting video game Re-Mission, which improved patients' cancer knowledge, self-efficacy, and medication adherence through gameplay.
3) HopeLab is conducting further research on Re-Mission to understand how gameplay impacts emotions, motivation, and real-life behaviors through studies analyzing player brain activity and game mechanics.
The document summarizes current research on autism, including:
- Autism was first identified in 1943, though early theories wrongly blamed mothers
- Prevalence has increased and is now 1 in 150, possibly due to improved diagnosis and definitions
- Diagnosis has shifted from a social disorder to recognizing global brain processing differences
- Genetic research finds higher concordance rates in identical twins and links to specific genes
- Brain research shows differences in size, connectivity, and activity in face and emotion regions
Experts roundtable presentations june 6 2012 european parliamentBilly Cometti
This document summarizes presentations given at an experts roundtable on ending the institutionalization of children. It discusses the impact of institutionalization on child development, noting that children raised in institutions have compromised development across cognitive, physical, emotional, social, and behavioral domains. Placement in family environments can help mitigate some of these negative effects, with earlier placement leading to better outcomes. It also discusses the economic case against institutionalization, citing both the direct costs of residential care and various indirect costs to society from the poor outcomes of children in institutions. Finally, it discusses practical implications and the need to invest in family support services, foster care, adoption and other alternatives to replace institutional care.
The optometric examination involves 4 main parts: obtaining a patient history, performing a preliminary examination, conducting a refractive examination, and assessing binocular vision. The patient history is the most important first step, as it guides the exam and allows the optometrist to make a tentative diagnosis. A thorough history involves learning about the chief complaint, history of present illness, review of systems, ocular history, medical history, family history, social history, and medications.
This document discusses using telemedicine in schools for children with developmental disabilities. It describes how telemedicine can be used for psychotherapy, assessments, training teachers, and more. While telemedicine improves access to care and support, there are also challenges like difficulty establishing rapport and scheduling emergencies remotely. The Marcus Autism Center has collaborated with other organizations to provide telemedicine services for 1,459 patient appointments across 34 sites in Georgia.
This document summarizes a study on the effects of electronic gadgets on children's health. It includes an introduction discussing previous research finding negative cognitive and health effects. The objectives are to examine consequences of gadget use and how demographics affect views of consequences. Hypotheses are that gadgets negatively impact health and demographics influence views of consequences. The methodology describes the sample, data collection/analysis. Results found gadgets used for entertainment and games. Most agreed children face headaches and eye/sleep issues from use. Demographics did not affect views of consequences. Practical implications encourage exercise and limiting screen time. Future research could study other age groups, increase sample size, and examine role of parents in mitigating sensitivity. The conclusion
The document provides an overview of data analysis, interpretation, and presentation for research. It discusses quantitative and qualitative data analysis methods. Quantitative methods include descriptive statistics like measures of central tendency and spread to summarize numeric data. Qualitative methods include coding of open-ended responses to identify themes. Both types of data can be presented visually in tables, graphs, and word clouds. Proper interpretation relates results back to the research question and previous studies and draws conclusions about the meaning and implications of the findings.
AAAS Presentation on Scientists' Views about EngagmentJohn C. Besley
This presentation is to be delivered on Feb. 14 at the annual meeting of the AAAS. It reports research supported by the NSF's Advancing Informal Science Learning group (see disclaimer in presentation).
This document provides practical tips for evaluating research as a communicator. It discusses common problems that can occur in research such as bias, flawed methodology, and overstating conclusions. Specific red flags are highlighted, such as undisclosed conflicts of interest from funding sources. The importance of considering alternative viewpoints, statistical versus practical significance, and whether findings have been replicated are also covered. The document aims to help readers critically analyze research and be savvy consumers of science.
Spreadsheets And Stories: STP & A presentation, Oct 26, 2013Snow Dowd
The document provides information on how data can be used to support arts organizations and projects. It includes examples of arts organizations that have used data to improve strategies, give people choices, understand places, share information, provide proof of impact, improve care, make connections, and measure social progress. Overall, the document demonstrates how data collection and analysis can help arts organizations achieve their goals and better serve their communities.
Developing a Virtual Environment for Discharge Planning after Stroke :A Preliminary Study
Interactive Technologies and Games (ITAG) Conference 2014
Health, Disability and Education
Dates: Thursday 16 October 2014 - Friday 17 October 2014
Location: The Council House, NG1 2DT, Nottingham, UK
Behavioral disorders screening and prediction1Sonu Kumar
Behavioral disorders are common in children and adults and can negatively impact one's life if left untreated. Some common behavioral disorders include anxiety disorders, disruptive behavioral disorders, and ADHD. Emotional symptoms of behavioral disorders may include anger, blaming others, and difficulty handling frustration. Physical symptoms are generally absent aside from potential issues from substance abuse. Autism is a type of behavioral disorder characterized by challenges with social skills and communication. Artificial intelligence can help predict autism and other behavioral disorders through analysis of behavioral screening data to enable early diagnosis and improved outcomes.
- The document discusses different types of evidence that can be used to support arguments and claims, including statistical evidence, testimonial evidence, anecdotal evidence, and research studies.
- Statistical evidence uses numbers and data, testimonial evidence relies on individual accounts and endorsements, anecdotal evidence cites specific observations or examples, and research studies can provide stronger evidence through systematic reviews and meta-analyses of multiple studies.
- Each type of evidence has strengths and limitations depending on the claim. Statistical and research evidence may be stronger, but anecdotes and testimonials can still have value when used carefully and supplemented with other evidence.
Similar to NACHRI_2009_Positive Distraction Study (20)
This document summarizes a presentation on how emergency department design impacts safety and efficiency. It discusses 14 domains of physical design that were studied, including entry/public waiting, patient intake, configuration, care-giver work areas, and physician work areas. Certain design elements like visibility, queuing, and security provisions in the entry area significantly affect both safety and efficiency. The study's findings can help hospitals optimize their emergency department design.
This document summarizes a study examining the impact of decentralizing nursing units at MD Anderson Cancer Center. Data was collected before and after the transition to new units with decentralized nurse stations, medication rooms, and supplies. Findings included an increase in time spent walking and documenting for nurses, though collaboration was mixed with some improvements but staff also feeling more isolated at times. Overall, the study found that simply changing the physical design did not automatically achieve the desired outcomes and that operational processes and culture change are also needed to fully realize benefits from decentralization.
1. The document summarizes a study on wayfinding in hospitals that sought to understand what environmental cues people use to navigate.
2. Interviews and tracking of patients, visitors, and employees at a large hospital campus found that people primarily rely on maps, signs, and developing familiarity with landmarks.
3. Other design elements like architectural features, artworks, and furniture arrangements can also serve as landmarks to help orient people and develop familiarity with an unfamiliar environment.
This document discusses the importance of perception in resolving human factors and change management issues during design projects. It provides an overview of a project to design a new patient care tower at Akron Children's Hospital that used an integrated project delivery approach involving clinical staff. The project employed various tools and techniques to manage staff perceptions and expectations during the design process, including value stream mapping, mockups, and pulse surveys. The presentation emphasizes that perception is reality, and change starts with addressing initial perceptions. It also discusses how involving staff voices, managing expectations, and closing gaps between perception and reality are key to leading successful transitions during change.
This document discusses research on defining the design characteristics of a successful adaptable inpatient unit. The research studied six hospitals to understand what flexibility means to different stakeholders and how physical design influences flexibility. Key findings include that flexibility was found to mean adaptability, convertability, and expandability. Design characteristics like proximity of support spaces, lines of sight, and adjustable core spaces promoted flexibility by accommodating operational changes.
1. The study examined the influence of view duration and content on nurse stress and arousal levels. It found that arousal levels significantly decreased over the course of a shift while acute stress levels significantly increased, supporting the hypotheses.
2. Exposure to an external view, particularly a nature view, was associated with higher arousal levels and lower acute stress levels at the end of the shift. Those without a view or with a non-nature view saw greater deterioration in arousal and acute stress.
3. View duration and content had a small but statistically significant influence on arousal and acute stress levels, after controlling for other stressors. A nature view was most beneficial in maintaining arousal levels over the course of a shift.
TRADELINE_2007_Academic Medical Center ConferenceUpali Nanda
This document summarizes a conference presentation on designing workplaces to enhance collaboration in academic medical centers. It discusses how knowledge workers in these environments generate new ideas through both planned and spontaneous interactions. The presentation explores different dimensions of interaction and how physical workplace strategies like proximity and visibility can encourage both conservative sharing of knowledge as well as more generative collaboration. Examples are given of design features that support informal meetings and serendipitous connections between colleagues in medical centers.
The document discusses findings from observations of critical care units at a hospital. Key findings include:
- Medical staff spent most of their time at the patient bedside or gathering information at the nurses' station. Nurses spent most of their time on patient care or documentation tasks at the bedside.
- Ideal room designs were proposed with equipment and supplies organized around the patient bed to minimize staff walking distances and improve ergonomics.
- Future trends may include larger, flexible critical care rooms designed around patient needs and staff workflows.
The document discusses a study examining the association between view duration and content on staff stress and alertness levels. The study was conducted at a children's hospital and measured the chronic stress, acute stress, and alertness of 32 medical personnel over 12-hour shifts. Results showed no statistically significant difference in chronic stress levels before and after shifts. However, alertness levels were significantly lower after shifts, indicating that view may influence staff stress and alertness.
The document summarizes a study that assessed how different room configurations in adult medical-surgical units impact patient care activities. Participants ranked 23 criteria and evaluated 6 room layouts. Non-designers and designers had some differences in criteria rankings. Layouts B and F received the highest suitability scores while layouts with inboard toilets received negative ratings. The findings could help programming and design but questions remain about reliability and validity. Performance-based evaluation frameworks may improve traditional decision-making.
This document summarizes a study comparing medical gas booms to traditional headwalls in ICU patient rooms. Clinicians participated in simulations of various patient care scenarios using both systems. Physicians and respiratory therapists generally preferred booms for flexibility and ergonomics. Nurses preferred booms to reduce clutter and improve access to the patient's head. Family access and visibility were not significantly impacted by either system in most situations. The document outlines factors to consider when deciding between booms or headwalls, such as anticipated acuity level and procedures. Further research is suggested to enhance understanding of impacts on patient safety and day-to-day care delivery.
The document summarizes key findings from a study examining the impacts of patient room handedness on nursing care delivery. The study involved observing 20 left-handed and 20 right-handed nurses performing common nursing tasks like taking vitals and suctioning in different room configurations. The study found:
- There were predictable patterns of behavior among both left-handed and right-handed nurses within each group.
- There were statistically significant differences between left-handed and right-handed nurse behaviors.
- For the vitals task, the location of the IV and overhead table determined what side nurses positioned themselves on relative to the patient. For suctioning, nurse handedness and equipment locations influenced positioning.
BIM Forum_2010_Beyond a Reasonable DoubtUpali Nanda
1) Evidence-based design (EBD) emerged in healthcare to improve safety and outcomes using research-informed design decisions.
2) Studies found EBD strategies like decentralized nursing units reduced patient falls by 75% and transfers by 90%.
3) Other research linked factors like patient visibility and private rooms to lower mortality and infection risk.
4) For BIM to be truly evidence-based, it needs an empirical evidence base from built project performance and linkage to organizational goals, not just cost savings.
HCD_2010_Inflexibility in Flexible DesignUpali Nanda
The document summarizes research into nine domains of design decision-making that impact operational flexibility in acute care medical-surgical units: peer lines-of-sight, patient visibility, multiple division/zoning options, proximity of support, resilience to move services, inter-unit movements, service expansion options, adjustable support core, and expandable support core. The research identified several factors that can impede designing for optimal operational flexibility, including systemic, cultural, human, financial, and physical factors. Examples of impediments discussed include unanticipated consequences of information technology, lack of standardized communication platforms, and assumptions about IT implementation timelines not being realized.
Decentralizing nursing units at MD Anderson Cancer Center was intended to improve efficiency, teamwork, and the patient and caregiver experience. A study collected data before and after decentralizing three nursing units to evaluate the impact. Key findings included a decrease in time spent on documentation and at the centralized nurse station, and an increase in time spent at decentralized medication and supply areas and on the unit. Walking distance for nurses also increased with the decentralized design. The consistency of these changes across the three units provides evidence that decentralization can impact how nurses spend their time and perform tasks.
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Research based practice: Field Research + Parametric Analysis in Medical Planning and Design
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2. Presenters
2009 NACHRI F iliti D i2009 NACHRI Facilities Design
Conference, Austin, TX
Debajyoti Pati, PhD, FIIA, HKS Architects
Jeff Stouffer, FAIA, HKS Architects
3. The Ongoing Debate
In a time of rising health… In a time of rising health
costs, it doesn’t make a ton
of sense for facilities to be
spending lavishly on perks.
Jacob Goldstein, in Behind Hospitals’ Pretty
Facades, Dingy Rooms for Patients, Wall
Street Journal, August 20, 2008
5. Learning Objectives
Understand the influence of positive
distractions on pediatric patients while
waiting
Understand the role of positive distractions in
the parents’ waiting experience
Distinguish the difference between uni-g
sensory and multi-sensory distractions
10. Waiting Experience
The Cornell
University Studyy y
Location: Weill Cornell
Medical College, New York
Six clinical outpatient servicesSix clinical outpatient services
Key findings:
Physical environment
attractiveness correlated with
perceived care quality and
anxietyanxiety
Physical environment
attractiveness correlated with
perceived waiting timeperceived waiting time
14. Study Objective # 1
Can positive distractions produce positiveCan positive distractions produce positive
behavioral outcomes in children (with and
without neurological disorders)?without neurological disorders)?
15. Study Objective # 2
Do positive distractions in an environment actDo positive distractions in an environment act
as points of focus that can improve the
overall waiting experience?overall waiting experience?
16. Study Objective # 3
Are multisensory distractions more effective
than purely visual distractions?
18. Study Site # 1
Children’s Medical Center Dallas - Dental Clinic
19. Study Site # 2
Children’s Medical Center Dallas – Cardiac Clinic
20. Distraction Conditions
5 positive distraction conditions
Still nature photo slide show Naturep
Ambient Art
Ambient Art with Sound
Nature
Slides
Aquarium
Aquarium with sound
Ambient Art
All nature themes
No-Distraction condition
as control
Aquarium
21. Subjects and Data Collection
Subjects:
Pediatric patients visiting the
Process:
10 min randomized distraction
clinic
>= 5 years old
With and without
10 min no-distraction
Trained observers
O b hild
With and without
developmental/neurological
problems
One observer per child
Parent questionnaire
Data Collection
Dental Clinic: 6 days in
Sample size
Children data: 81 (Dental) + 77
December 2008
Cardiac Clinic: 6 days in
January 2009
(Cardiac)
Parents: 51 (Dental) + 24
(Cardiac)
22. Subject Attributes
Dental Clinic
Age = 10.95 (mean); 5 – 17 years
Cardiac Clinic
Age = 11.57 (mean); 5 – 17 yearsg ( ) y
Ethnicity
White = 25.3%
Bl k 13 9%
g ( ) y
Ethnicity
White = 40.8%
Bl k 22 4%Black = 13.9%
Hispanic = 58.2%
Asian = 2.5%
Black = 22.4%
Hispanic = 35.5%
Asian = 1.3%
Gender
Male = 59.3%
Female = 40 7%
Gender
Male = 53.9%
Female = 46 1%Female = 40.7%
Developmental/ Neurological
deficiencies
P t 47 8%
Female = 46.1%
Developmental/ Neurological
deficiencies
P t 12 5%Present = 47.8% Present = 12.5%
28. Analytical Procedures
Paired sample t-tests for identifying significant
differences between distraction and no-distraction
diticonditions
Covariance models to compare the five distraction
conditionsconditions
Factorial Design to identify main effects
C l ti A l i t l l ti hi b tCorrelation Analysis to explore relationships between
children’s behavior and parent’s perception
Mediation analysis to explore the true pattern ofMediation analysis to explore the true pattern of
relationship between waiting experience and perceived
care quality
30. Distraction vs No-Distraction
What differences in attention, behavior andat d e e ces atte t o , be a o a d
activities were observed during the presence
of positive distraction conditions?
33. Attention :: Key Inferences
Substantial diversion of attention to the TV monitor
during distraction conditions
Presence of distraction conditions diverted attention
from two or more of the following to the TV monitor:
people, book, toy, themselves
Positive Distraction do help focus attention
“People” drew most attention even in the presence of
distraction conditionsdistraction conditions
34. Physical Behavior: Dental Clinic
Behavior
Type
Distraction No-
Distraction
Difference Significance
Type Distraction
Calm 64.92 58.3 6.62 0.080
Fidgety 20.99 19.41 1.58 0.570
Fine 10 79 15 36 4 57 0 051Fine
Movement
10.79 15.36 -4.57 0.051
Gross
Movement
2.63 5.18 -2.55 0.079
Intense
Movement
0.67 1.75 -1.08 0.153
35. Physical Behavior :: Cardiac Clinic
Behavior
Type
Distraction No-
Distraction
Difference Significance
Type Distraction
Calm 68.88 59.92 8.96 0.029
Fidgety 11.50 13.08 -1.58 0.473
Fine Movement 18 33 23 32 4 99 0 183Fine Movement 18.33 23.32 -4.99 0.183
Gross
Movement
1.28 3.49 -2.21 0.049
Intense 0 00 0 19 -0 19 0 176Intense
Movement
0.00 0.19 0.19 0.176
36. Distraction vs No-Distraction Inferrences
Dental Clinic Cardiac Clinic
Most children were observed to
be ‘calm’, ‘solitary behavior’, ‘in
seat’, ‘not playing’, and ‘watching
Most children were observed to
be ‘calm’, ‘solitary behavior’, ‘in
seat’, ‘not playing’, and ‘watching
other people’.
Distraction condition results in:
other people’.
Distraction condition results in:Distraction condition results in:
More attention on TV Monitor
More calm; less fine and
t
Distraction condition results in:
More attention on TV Monitor
More calm; less gross
tgross movement movement
38. Distribution of Attention
Dental Clinic %
Attention
Cardiac Clinic %
Attention
Ambient Art with Sound 42.35 Ambient Art 37.18
Aquarium 28.87 Ambient Art with Sound 23.67
Still Art 28.00 Aquarium with Sound 23.00
A i ith S d 23 49 A i 14 53Aquarium with Sound 23.49 Aquarium 14.53
Ambient Art 4.66 Still Art 9.11
Both Clinics %Distribution by Clinic Both Clinics %
Attention
Ambient Art with Sound 66.02
Distribution by Clinic
Aquarium with Sound 46.48
Aquarium 43.40
Ambient Art 41.84
Still Art 37.11Combined Mean Distribution
39. Distribution of Attention :: Key Inferences
Overall, multi-sensory (visual + auditory) stimuli attract
greater attention
Still nature slide show demonstrate least preference
HOWEVERHOWEVER
Substantial differences between the two clinics
A pattern observable for cardiac population
Ambient art conditions, Aquarium conditions, Still, q ,
Nature
No meaningful pattern identifiable for dental population
40. Interaction Effects?
Did bj t tt ib t ( th i itDid subject attribute (ethnicity,
developmental disability, illness type)
interact with attention and behavior?interact with attention and behavior?
41. Physical Behavior :: CALM
CALM
(Most to Least)
Dental Clinic Cardiac Clinic
Aquarium Ambient Art
Ambient Art with Sound Aquarium with Sound
Still Art Ambient Art with Sound
Aquarium with Sound Still ArtAquarium with Sound Still Art
Ambient Art Aquarium
Pole ReversalPole Reversal
42. Physical Behavior :: FIDGETY
FIDGETY
(Least to Most)
Dental Clinic Cardiac Clinic
Ambient Art with Sound Aquarium
Still Art Aquarium with Sound
Aquarium Ambient Art
Aquarium with Sound Ambient Art with SoundAquarium with Sound Ambient Art with Sound
Ambient Art Still Art
Block ShiftBlock Shift
43. Physical Behavior :: FINE MOVEMENT
FINE MOVEMENT
(Least to Most)
Dental Clinic Cardiac Clinic
Ambient Art with Sound Ambient Art
Aquarium Still Art
Aquarium with Sound Ambient Art with Sound
Still Art Aquarium with SoundStill Art Aquarium with Sound
Ambient Art Aquarium
Pole ReversalPole Reversal
44. Physical Behavior :: GROSS MOVEMENT
GROSS MOVEMENT
(Least to Most)
Dental Clinic Cardiac Clinic
Aquarium Ambient Art
Aquarium with Sound Still Art
Ambient Art with Sound Ambient Art with Sound
Still Art Aquarium with SoundStill Art Aquarium with Sound
Ambient Art Aquarium
Total ReversalTotal Reversal
45. Activity :: PLAY TOY
PLAY TOY
(Most to Least)
Dental Clinic Cardiac Clinic
Aquarium Aquarium with Sound
Ambient Art with Sound Aquarium
Still Art Still Art
Aquarium with Sound Ambient Art with SoundAquarium with Sound Ambient Art with Sound
Ambient Art Ambient Art
Partial ReversalPartial Reversal
46. Activity :: PLAY NON-TOY
PLAY NON-TOY
(Most to Least)
Dental Clinic Cardiac Clinic
Aquarium with Sound Still Art
Ambient Art Ambient Art with Sound
Still Art Aquarium
Ambient Art with Sound Aquarium with SoundAmbient Art with Sound Aquarium with Sound
Aquarium Ambient Art
Block ShiftBlock Shift
47. Location :: OUT OF SEAT
OUT OF SEAT
(Least to Most)
Dental Clinic Cardiac Clinic
Aquarium Still Art
Still Art Ambient Art with Sound
Aquarium with Sound Aquarium
Ambient Art Aquarium with SoundAmbient Art Aquarium with Sound
Ambient Art with Sound Ambient Art
Partial ReversalPartial Reversal
48. Location :: IN SEAT
IN SEAT
(Most to Least)
Dental Clinic Cardiac Clinic
Aquarium Still Art
Still Art Ambient Art with Sound
Ambient Art with Sound Aquarium with Sound
Ambient Art Ambient ArtAmbient Art Ambient Art
Aquarium with Sound Aquarium
Pole ReversalPole Reversal
49. Social Behavior :: POSITIVE INTERACTION
POSITIVE
INTERACTION
(Most to Least)
Dental Clinic Cardiac Clinic
Aquarium with Sound Still Art
( ost to east)
Ambient Art with Sound Ambient Art
Aquarium Aquarium with Sound
Ambient Art Ambient Art with SoundAmbient Art Ambient Art with Sound
Still Art Aquarium
Pole ReversalPole Reversal
50. Social Behavior :: SOLITARY BEHAVIOR
SOLITARY BEHAVIOR
(Least to Most)
Dental Clinic Cardiac Clinic
Aquarium with Sound Still Art
Ambient Art with Sound Ambient Art
Aquarium Aquarium with Sound
Ambient Art Ambient Art with SoundAmbient Art Ambient Art with Sound
Still Art Aquarium
Block ShiftBlock Shift
51. Key Behavioral Inferences
Population attribute (ethnicity, developmental
disability, illness type) may constitute ay, yp ) y
factor determining physical and social behavior
Most frequent top and bottom conditions:
Dental Clinic Cardiac Clinic
Most frequently at the
top
Aquarium Ambient Art + Still Art
Most frequently at the
bottom
Ambient Art Aquarium
52. Question
Is patient attribute (as defined by clinic) a
major predictor of behavior?
Method: 2 x 5 Factorial Designg
Still Art Ambient
Art
Ambient
Art +
Aquarium Aquarium
+ Sound
Sound
Dental
Cardiac
53. Factorial Analysis: Attention
Attention WITHOUT Covariate
Clinic Distraction Interaction
WITH Covariate
Clinic Distraction Interaction
TV Monitor Yes
Other Art
Toy Yes
Yes
Yes
Book Yes
Wall Yes Yes
Ceiling Yes
Yes Yes
Ceiling Yes
Floor
Door Yes Yes
Window
Furniture Yes
People
Yes
Themselves
54. Factorial Analysis: Behavior and Activity
Attention WITHOUT Covariate
Clinic Distraction Interaction
Calm
WITH Covariate
Clinic Distraction Interaction
Calm
Fidgety Yes
Fine Movement Yes
Gross Movement Yes
Yes
Yes
Gross Movement Yes
Intense
Play Toy Yes
Play Non-ToyPlay Non Toy
None/Other Play Yes Yes
Out of Seat
In Seat
On Lap Yes
Positive Int Yes
Negative Int
Yes
Yes
YesNegative Int
Solitary Yes
Yes
Yes
55. Key Inferences
A number of behavior outcomes associated with patient attribute:
Culture and/or Neurological State and/or Illness Type
Difference reduces when controlled for no-distraction condition data
Multi-sensory distractions more effective in Dental Clinic
Behavior Dental Clinic Cardiac Clinic
Calm Ambient Art (S); Aquarium Ambient Art
Fidgety Ambient Art (S) Aquariumg y ( ) q
Fine Movement Ambient Art (S) Ambient Art
Gross Movement Aquarium Ambient Art
Intense Movement Aquarium (S) Aquariumq ( ) q
Positive Interaction Aquarium (S) Still Art
Negative Interaction Aquarium Still Art
Solitary Behavior Aquarium (S) Still ArtSolitary Behavior Aquarium (S) Still Art
57. Inferences
Presence of distraction conditions associated with change in
children’s attention, activities and behavior
P ’ i i i i d i h hild ’ iParents’ waiting experience associated with children’s attention,
activities and behavior
Elements of parents’ waiting experience associated with their
perceived waiting time
Parent’s waiting experience (including perceived waiting time)
associated with their:associated with their:
Exam room experience
Perception regarding staff
Overall visit
Overall experience
59. Items in Overall Visit and Experience
Felt cared
Child treated in timely mannerChild treated in timely manner
Felt welcome
Less anxiety feeling
Recommend this clinic to others
Quality of care child received
Quality of service parent’s receivedQuality of service parent s received
Quality of interaction with staff
Quality of interaction with doctor
61. The Ongoing Debate
… In a time of rising health
costs it doesn’t make a toncosts, it doesn t make a ton
of sense for facilities to be
spending lavishly on perks.p g y p
Jacob Goldstein, in Behind Hospitals’ Pretty
F d Di R f P ti t W llFacades, Dingy Rooms for Patients, Wall
Street Journal, August 20, 2008
64. Implications
All positive distractions
are not the same
Culture and/or
neurological state and/or
li i t i t d ithclinic type associated with
behavioral outcomes
Positive distractions are
attention grabbers
Locate distraction
conditions carefully
Positive distractions
associated with calm
behavior
Take advantage of
behavioral influence of
positive distractionbehavior positive distraction
65. Implications
Attention on People:
Do not ignore
physical placement,
dj i iWhether distraction
conditions were switched
on or not, most attention
was fixated on other
adjacencies, view
corridors, and
activities aroundwas fixated on other
people
activities around
hospital waiting areas
68. Definitions of Terms: Attention
Attention Eye-fixation on any object/person will be recorded as
attention. Objects can include art work, toys, furniture,
etc.
Positive distraction The flat screen TV in the waiting room on which
artwork/music will be displayed
Other artwork Any other artwork in the waiting area: painting,
sculpture, … at any location in the waiting lounge
Toy Any piece of toy/game in the waiting area or brought
in by the subjectin by the subject
Book Book or books in the waiting lounge or brought in by
the subject
Wall Blank portions of any of the wall in the waiting room
Ceiling Ceiling of the waiting room
Floor Floor of the waiting room
Door Any of the doors of the waiting room
Window Any window – external or internal – in the waiting
room, including the reception desk/windowg p
Furniture Any unoccupied furniture in the waiting lounge –
without any person or thing on the furniture
P l A i h i iPeople Any person in the waiting room
Themselves Any portion of the patient’s own body
69. Definition of Terms: Physical Behavior
Calm No visible major motor movement
Fidgety This will be coded whenever repetitive,
restless motor movements is observed which
appeared to be primarily purposeless (e.g.,
taping a pencil, kicking one's foot)p g pe c , c g o e s oo )
Fine Movement Defined as fine motor movement involving
very low intensity purposeful movements of
body parts.
Gross Movement Defined as gross motor movement involving
taking one or more steps or, if sitting, moving
the buttocks from one spot to another
Intense Defined as engaging in inappropriate or
excessively vigorous physical activities (e.g.,
throwing toys, running about, yelling or
singing loudly)
70. Definition of Terms: Activity and Location
Playing with toys Defined as playing with toys in the room (ifPlaying with toys Defined as playing with toys in the room (if
available)
Playing with non toys Defined as playing with non toy objects in the
room (e.g., doorknob, table)
Non-play activity/ Other Play Defined as neither playing with a toy or non-
toy item (e.g., standing and gazing at the door;
reading; eating; drinking)
OR
Other play activities (not involving toys or
non-toys)
Out of seat This will be coded if a child left the seat
entirely at the time of observation
In-seat This will be coded if a child is in his/her seat at
the time of observation
Parent’s lap This will be coded if a child is sitting on the
lap of another accompanying adult.
71. Definition of Terms: Social Behavior
Positive interaction All vocalizations directed to
sibling/parent/objects excluding screams,
shouts, cries, and whines; all cooperative
responses involved with sharing an object; andespo ses vo ved w s g objec ; d
hugs and holding hands
Negative interaction Screams, shouts, or other utterances that
indicate rejecting and oppositional behavior;
hit, pinch, kick, and “nonplaying” push or pull;
grabbing objects from sibling/parent; and
destroying possessions of sibling/parent
Solitary behavior All solitary activity (excluding parallel play
conducted between two children within two
feet of one another)