1
4
Discrete Trial Training (DTT) effect on children with ASD
Introduction
Autism Spectrum Disorder (ASD) is a condition that affects the development of an individual affecting their behaviour and the ability to communicate (Autism Spectrum Disorder, 2021). In most cases, this disorder exhibits its symptoms within the initial two years of an individual, despite its diagnosis being plausible for individuals of all ages. Persons diagnosed with this disorder often have repetitive behaviours and restricted interests, find it difficult to partake in social interactions and communication with others, and show other symptoms that may impede the individual's ability to perform well in school, work and several other aspects of life ("Autism Spectrum Disorder, 2021). The individuals diagnosed with the disorder will, in some cases, be reliant on their families and individuals close to them for help and support. Despite the disorder's potency as a life-long condition, some services and treatments are provided, helping an individual diagnosed with the condition improve the quality of their life. It is also important to note that the disorder has several different variations; hence, the spectrum of different characteristics, unique to every diagnosed individual.
According to studies conducted, one in fifty-four children is diagnosed with the disorder in the United States, occurring in children of all racial backgrounds and socioeconomic groups ("Data and Statistics on Autism Spectrum Disorder | CDC," 2021). According to the same report, the disease is four times more likely to occur in boys than in girls. Between 2009 to 2017, the number of children aged between 3-17 years diagnosed with development disorders, inclusive of ASD, increased from 16.2% to 17.8%. (Ünlü et al., 2018). In the use of discrete trial training (DTT), children are taught a plethora of skills, which include academic, language, and social skills, necessary to facilitate their development. In the treatment of ASD, options are limited. However, early diagnosis, coupled with behaviour interventions, is considered to have the best outcomes in managing the disorder's symptoms (Masi et al., 2017).
The prevalence of ASD in children has been noted to rise significantly in the population (Masi et al., 2017; "Data and Statistics on Autism Spectrum Disorder | CDC," 2021), affecting a larger portion of the population. This number of affected individuals is projected to rise even higher in the coming years, a problem in society that needs to be addressed. In the treatment of the disorder, drug interventions, while widely used, have failed to prove their efficiency in improving or managing symptoms in most cases (Masi et al., 2017). The treatment options for the disorder are also very limited. The use of drug interventions, early diagnosis, and early behavioural interventions is very expensive and inaccessible to many individuals affected by the condition. Identifying the disorder i ...
1
JOURNAL SUMMARY 2
Journal Summary
[Insert Name]
Lamar University
Journal Summary
Van der Donk, Hiernstra-Beernink, Tjeenk-Kalff, van der Leij and Lindaur (2013) conducted a study to determine the effects of executive functioning and working memory interventions on academic achievement and classroom behavior in students diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). This study consisted of two randomly selected groups of 175 students each between the ages of 8 and 12 that had a single, prior diagnosis of ADHD. The students were either assigned to a computer-based or a teacher instructed intervention. Students were selected from various elementary schools from two Dutch regions. The interventions were implemented by developmental psychologists that underwent a three-hour training course for their respective intervention. Group monitoring by a licensed clinical staff, recording observations of implementation, and reviewing student work samples were methods used to authenticate intervention fidelity. The computer-based intervention consisted of working memory tasks that adapted to the students’ skill level in a game format. The teacher instructed intervention consisted of several visual and verbal tasks that addressed five executive functions that are critical for success within a classroom setting. Both interventions were implemented 5 times a week for 45 minutes for a duration of 5 weeks. Various assessment methods including standardized tests and checklists were administered at baseline, at the conclusion of the intervention period, and six months after the intervention period to measure academic performance and classroom behavior. Results of the study showed a notable increase in academic performance and a statistically significant improvement in student behavior in the classroom.
Strengths and Weaknesses
This study had several strengths and limitations. One strength of the study was the randomization of the test groups. Randomly assigning subjects is the best practice to ensure efficacy. Each group was comprised of 175 students which is an adequate sample size to determine valid results. Measures were taken to verify the fidelity of intervention implementation. One limitation of this study was the content and applicability of the test groups differed greatly making it difficult to compare the efficacy of the interventions. Single tasks were used to assess the effects of working memory training which made results ambiguous as to whether academic and behavior improvement was due to the changes in ability or due to assessed tasks resembling practiced tasks.
Instructional Implications
The Centers for Disease Control and Prevention (CDC) reported that in 2016, 9.4% of children ages 4-17 were diagnosed with ADHD in the United States. 62% of children diagnosed with ADHD are taking some sort of medication. These medications help alleviate behavior sympt.
JOURNAL OF APPLIED BEHAVIOR ANALYSISREDUCING BEHAVIOR PROB.docxcroysierkathey
JOURNAL OF APPLIED BEHAVIOR ANALYSIS
REDUCING BEHAVIOR PROBLEMS THROUGH FUNCTIONAL
COMMUNICATION TRAINING
EDWARD G. CARR AND V. MARK DURAND
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, STATE UNIVERSITY OF
NEW YORK AT ALBANY, AND SUFFOLK CHILD DEVELOPMENT CENTER
It is generally agreed that serious misbehavior in children should be replaced with socially appro-
priate behaviors, but few guidelines exist with respect to choosing replacement behaviors. We
address this issue in two experiments. In Experiment 1, we developed an assessment method for
identifying situations in which behavior problems, induding aggression, tantrums, and self-injury,
were most likely to occur. Results demonstrated that both low level of adult attention and high
level of task difficulty were discriminative for misbehavior. In Experiment 2, the assessment data
were used to select replacements for misbehavior. Specifically, children were taught to solicit atten-
tion or assistance or both verbally from adults. This treatment, which involved the differential
reinforcement of functional communication, produced replicable suppression of behavior problems
across four developmentally disabled children. The results were consistent with an hypothesis stating
that some child behavior problems may be viewed as a nonverbal means of communication.
According to this hypothesis, behavior problems and verbal communicative acts, though differing
in form, may be equivalent in function. Therefore, strengthening the latter should weaken the
former.
DESCRIPTORS: disruptive behavior, assessment, classroom behavior, communication, devel-
opmentally disabled children
A major portion of child behavior therapy is
justifiably concerned with the treatment of behav-
ior problems, given that such problems can seri-
ously disrupt the educational process (O'Leary &
O'Leary, 1977; Sulzer-Azaroff & Mayer, 1977)
and in some cases may lead to institutionalization
This investigation was supported in part by U.S.P.H.S.
Biomedical Research Support Grant 2 S07 RR-07067-18
to the State University of New York at Stony Brook to the
first author and a Sigma Xi Grant-in-Aid of Research to the
second author. Portions of this paper were presented at the
annual meeting of the American Psychological Association,
Washington, D.C., August 1982, and Anaheim, California,
August 1983. This research was based on a master's thesis
conducted by the second author under the direction of the
first author.
We thank Martin Hamburg, Executive Director, Suffolk
Child Development Center, for his generous support, and
Roseann D'Evanzo, JoAnn Giles, Terry Leykis, Cathy Sher-
edos, and Doug Walters for assistance with data collection.
Finally, we thank Alan 0. Ross, Susan G. O'Leary, K. Dan-
iel O'Leary, Crighton Newsom, Paul A. Dores, and Daniel
B. Crimmins for their helpful comments.
Requests for reprints or individual data should be sent to
Edward Carr, Department of Psychology, State University
of New York, Stony Brook, New ...
1
4
Discrete Trial Training (DTT) effect on children with ASD
Introduction
Autism Spectrum Disorder (ASD) is a condition that affects the development of an individual affecting their behaviour and the ability to communicate (Autism Spectrum Disorder, 2021). In most cases, this disorder exhibits its symptoms within the initial two years of an individual, despite its diagnosis being plausible for individuals of all ages. Persons diagnosed with this disorder often have repetitive behaviours and restricted interests, find it difficult to partake in social interactions and communication with others, and show other symptoms that may impede the individual's ability to perform well in school, work and several other aspects of life ("Autism Spectrum Disorder, 2021). The individuals diagnosed with the disorder will, in some cases, be reliant on their families and individuals close to them for help and support. Despite the disorder's potency as a life-long condition, some services and treatments are provided, helping an individual diagnosed with the condition improve the quality of their life. It is also important to note that the disorder has several different variations; hence, the spectrum of different characteristics, unique to every diagnosed individual.
According to studies conducted, one in fifty-four children is diagnosed with the disorder in the United States, occurring in children of all racial backgrounds and socioeconomic groups ("Data and Statistics on Autism Spectrum Disorder | CDC," 2021). According to the same report, the disease is four times more likely to occur in boys than in girls. Between 2009 to 2017, the number of children aged between 3-17 years diagnosed with development disorders, inclusive of ASD, increased from 16.2% to 17.8%. (Ünlü et al., 2018). In the use of discrete trial training (DTT), children are taught a plethora of skills, which include academic, language, and social skills, necessary to facilitate their development. In the treatment of ASD, options are limited. However, early diagnosis, coupled with behaviour interventions, is considered to have the best outcomes in managing the disorder's symptoms (Masi et al., 2017).
The prevalence of ASD in children has been noted to rise significantly in the population (Masi et al., 2017; "Data and Statistics on Autism Spectrum Disorder | CDC," 2021), affecting a larger portion of the population. This number of affected individuals is projected to rise even higher in the coming years, a problem in society that needs to be addressed. In the treatment of the disorder, drug interventions, while widely used, have failed to prove their efficiency in improving or managing symptoms in most cases (Masi et al., 2017). The treatment options for the disorder are also very limited. The use of drug interventions, early diagnosis, and early behavioural interventions is very expensive and inaccessible to many individuals affected by the condition. Identifying the disorder i ...
1
JOURNAL SUMMARY 2
Journal Summary
[Insert Name]
Lamar University
Journal Summary
Van der Donk, Hiernstra-Beernink, Tjeenk-Kalff, van der Leij and Lindaur (2013) conducted a study to determine the effects of executive functioning and working memory interventions on academic achievement and classroom behavior in students diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). This study consisted of two randomly selected groups of 175 students each between the ages of 8 and 12 that had a single, prior diagnosis of ADHD. The students were either assigned to a computer-based or a teacher instructed intervention. Students were selected from various elementary schools from two Dutch regions. The interventions were implemented by developmental psychologists that underwent a three-hour training course for their respective intervention. Group monitoring by a licensed clinical staff, recording observations of implementation, and reviewing student work samples were methods used to authenticate intervention fidelity. The computer-based intervention consisted of working memory tasks that adapted to the students’ skill level in a game format. The teacher instructed intervention consisted of several visual and verbal tasks that addressed five executive functions that are critical for success within a classroom setting. Both interventions were implemented 5 times a week for 45 minutes for a duration of 5 weeks. Various assessment methods including standardized tests and checklists were administered at baseline, at the conclusion of the intervention period, and six months after the intervention period to measure academic performance and classroom behavior. Results of the study showed a notable increase in academic performance and a statistically significant improvement in student behavior in the classroom.
Strengths and Weaknesses
This study had several strengths and limitations. One strength of the study was the randomization of the test groups. Randomly assigning subjects is the best practice to ensure efficacy. Each group was comprised of 175 students which is an adequate sample size to determine valid results. Measures were taken to verify the fidelity of intervention implementation. One limitation of this study was the content and applicability of the test groups differed greatly making it difficult to compare the efficacy of the interventions. Single tasks were used to assess the effects of working memory training which made results ambiguous as to whether academic and behavior improvement was due to the changes in ability or due to assessed tasks resembling practiced tasks.
Instructional Implications
The Centers for Disease Control and Prevention (CDC) reported that in 2016, 9.4% of children ages 4-17 were diagnosed with ADHD in the United States. 62% of children diagnosed with ADHD are taking some sort of medication. These medications help alleviate behavior sympt.
JOURNAL OF APPLIED BEHAVIOR ANALYSISREDUCING BEHAVIOR PROB.docxcroysierkathey
JOURNAL OF APPLIED BEHAVIOR ANALYSIS
REDUCING BEHAVIOR PROBLEMS THROUGH FUNCTIONAL
COMMUNICATION TRAINING
EDWARD G. CARR AND V. MARK DURAND
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, STATE UNIVERSITY OF
NEW YORK AT ALBANY, AND SUFFOLK CHILD DEVELOPMENT CENTER
It is generally agreed that serious misbehavior in children should be replaced with socially appro-
priate behaviors, but few guidelines exist with respect to choosing replacement behaviors. We
address this issue in two experiments. In Experiment 1, we developed an assessment method for
identifying situations in which behavior problems, induding aggression, tantrums, and self-injury,
were most likely to occur. Results demonstrated that both low level of adult attention and high
level of task difficulty were discriminative for misbehavior. In Experiment 2, the assessment data
were used to select replacements for misbehavior. Specifically, children were taught to solicit atten-
tion or assistance or both verbally from adults. This treatment, which involved the differential
reinforcement of functional communication, produced replicable suppression of behavior problems
across four developmentally disabled children. The results were consistent with an hypothesis stating
that some child behavior problems may be viewed as a nonverbal means of communication.
According to this hypothesis, behavior problems and verbal communicative acts, though differing
in form, may be equivalent in function. Therefore, strengthening the latter should weaken the
former.
DESCRIPTORS: disruptive behavior, assessment, classroom behavior, communication, devel-
opmentally disabled children
A major portion of child behavior therapy is
justifiably concerned with the treatment of behav-
ior problems, given that such problems can seri-
ously disrupt the educational process (O'Leary &
O'Leary, 1977; Sulzer-Azaroff & Mayer, 1977)
and in some cases may lead to institutionalization
This investigation was supported in part by U.S.P.H.S.
Biomedical Research Support Grant 2 S07 RR-07067-18
to the State University of New York at Stony Brook to the
first author and a Sigma Xi Grant-in-Aid of Research to the
second author. Portions of this paper were presented at the
annual meeting of the American Psychological Association,
Washington, D.C., August 1982, and Anaheim, California,
August 1983. This research was based on a master's thesis
conducted by the second author under the direction of the
first author.
We thank Martin Hamburg, Executive Director, Suffolk
Child Development Center, for his generous support, and
Roseann D'Evanzo, JoAnn Giles, Terry Leykis, Cathy Sher-
edos, and Doug Walters for assistance with data collection.
Finally, we thank Alan 0. Ross, Susan G. O'Leary, K. Dan-
iel O'Leary, Crighton Newsom, Paul A. Dores, and Daniel
B. Crimmins for their helpful comments.
Requests for reprints or individual data should be sent to
Edward Carr, Department of Psychology, State University
of New York, Stony Brook, New ...
EFFICACY OF AND PREFERENCE FOR REINFORCEMENT ANDRESPONSE COSEvonCanales257
EFFICACY OF AND PREFERENCE FOR REINFORCEMENT AND
RESPONSE COST IN TOKEN ECONOMIES
ERICA S. JOWETT HIRST
SOUTHERN ILLINOIS UNIVERSITY
CLAUDIA L. DOZIER
UNIVERSITY OF KANSAS
AND
STEVEN W. PAYNE
STATE UNIVERSITY OF NEW YORK
Researchers have shown that both differential reinforcement and response cost within token
economies are similarly effective for changing the behavior of individuals in a group context
(e.g., Donaldson, DeLeon, Fisher, & Kahng, 2014; Iwata & Bailey, 1974). In addition, these
researchers have empirically evaluated preference for these procedures. However, few previous
studies have evaluated the individual effects of these procedures both in group contexts and in
the absence of peers. Therefore, we replicated and extended previous research by determining
the individual effects and preferences of differential reinforcement and response cost under both
group and individualized conditions. Results demonstrated that the procedures were equally
effective for increasing on-task behavior during group and individual instruction for most chil-
dren, and preference varied across participants. In addition, results were consistent across partici-
pants who experienced the procedures in group and individualized settings.
Key words: differential reinforcement, independent group contingency, preference, response
cost, token economy
The token economy is a common behavioral
intervention that has been demonstrated to be
effective for increasing appropriate behavior
and decreasing inappropriate behavior for many
populations across different settings (Doll,
McLaughlin, & Barretto, 2013; Hackenberg,
2009; Kazdin, 1977). Token economies involve
delivery, removal, or both delivery and removal
of conditioned reinforcers (e.g., tokens and
points) that can be exchanged for back-up rein-
forcers (e.g., prizes, treats, and leisure activ-
ities). When tokens are delivered contingent on
appropriate behavior or for the absence of inap-
propriate behavior, these procedures are termed
differential reinforcement of alternative behavior
(DRA) or differential reinforcement of other
behavior (DRO), respectively. When tokens are
removed contingent on inappropriate behavior
or for the absence of appropriate behavior, this
procedure is termed response cost (RC).
An advantage of token economies is that
they can be implemented with a group of indi-
viduals as a general behavior-management strat-
egy during small-group instruction or as a
classwide intervention. Classwide behavior-
management strategies such as token economies
should be considered to address minor disrup-
tive behavior, to increase motivation for learn-
ing, or as a complement to an individualized
intervention. However, general behavior-
management strategies may not be effective in
isolation for some individuals who engage in
severe problem behavior or have more intense
Correspondence concerning this article should be
addressed to Claudia L. Dozier, Department of Applied
Behavioral Science, U ...
Running head Advanced behavioral analysis and its successful use .docxjoellemurphey
Running head: Advanced behavioral analysis and its successful use in the treatment of autism 1
Advanced behavioral analysis and its successful use in the treatment of autism 2Advance Behavioral Analysis And Its Successful Use In The Treatment Of Autism
Darin Bullock
Columbia Southern University
Advance Behavioral Analysis and its Successful use in the Treatment of Autism
Fryling, M. J., Wallace, M. D., & Yassine, J. N. (2012). Impact of Treatment Integrity on Intervention Effectiveness. Journal of Applied Behavior Analysis , 449-53.
In this article, Fryling et al. proposes that by using Advanced Behavioral Analysis (ABA) in the proper way, the integrity will be maintained and will be more effective. They state “treatment integrity has cogent implications for intervention effectiveness.” They propose that by proper training and understanding of ABA, the integrity can be maintained. Proper use of reinforcements with appropriate behavior showed signs of improvement. They point out that DiGennaro et al. “demonstrated a relation between improved integrity and intervention effectiveness when they compared procedures aimed at improving special educators’ integrity in classrooms.” They proposed that by having effective intervention and integrity, problem behaviors decreased in a classroom setting.
Layne, C. M. (2007). Early Identification of Autism: Impications for Counselors. Journal of Counseling and Development , 110-114.
Layne discusses screening tools and diagnostic assessments used to identify autism in children around the age of 2. Layne also discusses the impact this diagnosis can have on families as well as counselors. She states autism “impairs language, social interactions, and play skills, as well as cognitive and adaptive functioning.” She proposes that 1 out of 166 children will be diagnosed with autism. She proposes and commends the diligence in early diagnosis stating it is more than likely due to the diligence of parents, clinicians, and teachers. Public awareness has helped as well and the fact that either autism is increasing, or clinicians are more apt to diagnose children with autism rather than another developmental disability.
Pulse International. (2012, Aug 14). Early Intervention has considerable impact on reducing symptoms and increasing child's ability to learn new skills.
An article by Pulse International quotes Prof. Mohamed Chetouani at a press conference on Monday, 23 July 2012. The article speaks of warning signs of autism characterized by social symptoms, communications deficits, and repetitive behaviors. The child should then be evaluated by specialized professionals so appropriate treatment can be initialized. The articles states, “Early intervention has considerable impact on reducing symptoms and increasing a child’s ability to learn new skills.” It was proposed that there are items in place to diagnose children with autism after the age of two, but “information on autism in the first two years of life i ...
Running Head MANAGEMENT OF AUTISM IN CHILDREN .docxcowinhelen
Running Head: MANAGEMENT OF AUTISM IN CHILDREN 1
MANAGEMENT OF AUTISM IN CHILDREN 2
Autism spectrum disorder in Toddlers
Name of student
Institution Affiliation
Literature review
After conducting an investigation on the connection of social skills, adaptability limitations, emotional and behavioural challenges among school children (Pack, C.J, et al., 2012) came to the conclusion that, kids diagnosed with autism had challenges related to daily social skills and behavioural complications. He proposed that physical conversation abilities are mostly related to practical and developmental effects rather than basic communication skills. However, according to a study by (Tager-Flusberg, et al., 2010) and (Ellawadi, A.B, et al., 2015), from their investigation on socialisation abilities of autistic toddlers and the variances in variables assumed to affect communication advancements at various ideal stages. They organised the toddler’s based on verbal communication standards to survey the variances on the chosen variables through the standardisation groupings. From the investigation they found that verbal communication standards are essential in describing premature communication outlines as well as determining factors that affect effective language development.
Besides, (Ellis Weimer, et al., 2010) described premature socialisation abilities among children suffering from Autism Spectrum Disorder (ASD, n=257) by use of multiple communication advancement measures, in comparison to children with non-spectrum Developmental Delay (DD, N=69. Results of ASD presented substantial variance in the outline of receptive-sensitive communication skills for autism children in comparison to the development delay (DD). Children with autism had moderately more serious receptive verbal delays than expressive. These results contradict those of (Ventola, P, et al., 2007) in their study. Ventola related the conduct of children suffering from autism spectrum disorder to general developmental delay. They came to the conclusion that the two categories of children shared a variety of related characteristics but still there were specific behavioural change that distinguished the two categories of children’s.
Another study by (Drew, A, et al 2007) through the means of Social Communication Assessment for Toddlers with Autism (SCATA) which measured communication skills on the two groups of children found to be suffering from the autism spectrum disorder came to the conclusion that the regularity and persistence of verbal acts of communications during childhood determined their communication abilities in the future. Socialisation acts provided a more prediction to association than replies and appeals.
Problem statement
Complains by parents about their growing children especially of age 4-12 years having a challenge on social skills with people have i ...
Importance of Physical Activities in Relation to Academic MalikPinckney86
Importance of Physical Activities in Relation to Academic Achievement
Southeastern Oklahoma State University
1
Importance of Physical Activities in Relation to Academic Achievement
Introduction
Schools have served many purposes throughout history. They serve to teach children to
become successful adults. Over time the idea of what it takes to make a student a successful adult has
changed. Schools have been forced to measure students with tests instead of the whole child. Students
are evaluated year after year on their academic achievement through standardized tests. Teachers are
now judged on how well their pupils do on tests whether it be on a nationally standardized test or
benchmark testing in the classroom. Since testing will not go away, teachers must find ways that
improve the way students retain information. Physical activity supports developmental, emotional, and
cognitive growth.
Physical activity helps students develop fine and gross motor skills. Typical recess activities such
as monkey bars, pumping legs on a swing, throwing balls all help develop motor skills that are needed in
the classroom. Hand eye coordination that is developed from these physical activities helps students
track when reading, take notes, and holding a pencil. When recess is cut, these activities either suffer or
the teacher must find time in their already hectic schedule to work these activities into the curriculum
(Franxman & Gilbert, 2018).
Many playground activities lead to social and emotional development. Students are put into
situations that are not guided by a teacher and are tested to make their own decisions. Peer
relationships are developed through physical activity (Murray & Ramstetter, 2018). This “free” time
helps develop a student’s ability to communicate, negotiate, and problem solve, all of which are needed
to contribute to society (Murray & Ramstetter, 2018).
School days are long. Students are expected to sit for long periods of time focusing on specific
content. When students are given breaks to move, different motions fire up neurons in their brains.
Students are more attentive to their lessons after a chance to engage in physical activity (Murray &
2
Ramstetter, 2018). The physical activity helps keep the brain active by giving one area a chance to rest
and recharge, while another area of the brain develops other skills.
Physical activity is important to the development of the whole child. Schools have drifted away
from making physical activity or play a priority in favor of structured academic time. This paper will look
at the role physical activity plays in academic achievement. It will show if physical activity is improving
test scores, curbing behavioral issues, and encouraging student learning by using physical activity in
unstructured activity, using set programs, and as motivation for cognitive improvement.
Literature Review
This ...
NT2580 Week 1 Understanding IT Infrastructure Security An.docxhenrymartin15260
NT2580: Week 1 Understanding IT Infrastructure Security
Analysis 1.1
Case Study
1
In March 2010, 28 year-old Albert Gonzalez was sentenced to 20 years in federal prison for breaching
security measures at several well-known retailers and stealing millions of credit card numbers, which he then
resold across a variety of shadow “carding” Web sites. Using a fairly simple packet sniffer, Gonzalez was able
to steal payment card transaction data in real time, which he then parked on blind servers in places such as
Latvia and Ukraine—countries formerly part of the Soviet Union. Gonzalez named his activities “Operation
Get Rich or Die Tryin'” and lived a lavish lifestyle by selling stolen credit card information. He was eventually
tracked down by the U.S. Secret Service, which was investigating the stolen card ring. Operation Get Rich or
Die Tryin' took place for more than two years and cost major retailers, such as TJX, OfficeMax, Barnes &
Noble, Heartland, and Hannaford, more than $200 million in losses and recovery costs. It is the largest
computer crime case ever prosecuted.
At first glance, Operation Get Rich or Die Tryin' seems to be an open-and-shut case. A hacker commits a
series of cybercrimes, is caught, and is successfully prosecuted. Fault and blame are assigned to the
cybercriminal, and justice is served for the corporations and the millions of people whose credit card
information was compromised.
Unless you ask the shareholders, banking partners, and some customers of TJX, who filed a series of class-
action lawsuits against the company claiming that the “high-level deficiencies” in its security practices make it
at least partially responsible for the damages caused by Albert Gonzalez and his accomplices. The lawsuits
point out, for example, that the packet sniffer Gonzalez attached to the TJX network went unnoticed for more
than seven months. Court documents also indicate that TJX failed to notice more than 80 GB of stored data
being transferred from its servers using TJX’s own high-speed network. Finally, an audit performed by TJX’s
payment-card processing partners found that it was noncompliant with 9 of the 12 requirements for secure
payment card transactions. TJX’s core information security policies were found to be so ineffective that the
judge presiding over sentencing hearing of Gonzalez reviewed them to determine whether TJX’s damages
claim against him of $171 million is valid.
Apart from lawsuits, TJX faced a serious backlash from customers and the media when the details of the
scope of the breaches trickled out. Customers reacted angrily when they learned that nearly six weeks had
passed between the discovery of the breach and its notification to the public. News organizations ran
headline stories that painted a picture of TJX as a clueless and uncaring company. Consumer organizations
openly warned people not to shop at TJX stores. TJX’s reputation and brand.
NTC/362 Week 3
OSI Model, Switching Systems, Network Channel Processors, and Media
1 Write a 200- to 300-word response to the following:
Supporting Activities: Introduction to Network Channels, Processors, and Media
•What are the advantages and disadvantages of network processors, such as hubs, switches, routers, and gateways?
•What are the three main types of network media?
•What is their performance in terms of reliability, speed capabilities, and nominal distance for reliable spans?
2 Write a 200- to 300-word response to the following
Supporting Activity: Introduction to Circuit Switching
• •What are the basic concepts of circuit switching?
•What are the advantages and disadvantages of circuit switching?
3 Write a 200- to 300-word response to the following:
Supporting Activity: Introduction to Packet Switching
•What is a packet? What is packet switching?
•How would you explain the concept of packet switching?
•What are the advantages and disadvantages of packet switching over circuit switching?
4Write a 200- to 300-word response to the following:
NTC/362
Week
3
OSI Model, Switching Systems, Network Channel Processors, and
Media
1
Write
a 200
-
to 300
-
word response to the following:
Supporting Activities:
Introduction to Network Channels, Processors, and Media
•
What are the advantages and disadvantages o
f network processors, such as hubs, switches,
routers, and gateways?
•What are the three main types of network media?
•What is their performance in terms of reliability, speed capabilities, and nominal distance for
reliable spans?
2
Write
a 200
-
to 300
-
word response to the following
Supporting Activity:
Introduction to Circuit Switching
•
•What are the basic concepts of circuit switching?
•What are the advantages and disadvantages of circuit switching?
3
Write
a 200
-
to 300
-
word response to the following:
Supporting Activity:
Introduction to Packet Switching
•What is a packet? What is packet switching?
•How would you explain the concept of pa
cket switching?
•What are the advantages and disadvantages of packet switching over circuit switching?
4
Write
a 200
-
to 300
-
word response to the f
ollowing:
NTC/362 Week 3
OSI Model, Switching Systems, Network Channel Processors, and
Media
1 Write a 200- to 300-word response to the following:
Supporting Activities: Introduction to Network Channels, Processors, and Media
•What are the advantages and disadvantages of network processors, such as hubs, switches,
routers, and gateways?
•What are the three main types of network media?
•What is their performance in terms of reliability, speed capabilities, and nominal distance for
reliable spans?
2 Write a 200- to 300-word response to the following
Supporting Activity: Introduction to Circuit Switching
• •What are the basic concepts of circuit switching?
•What are the advantages and disadvantages of circuit switching?
3 Write a 200- to 300-word response to the follo.
EFFICACY OF AND PREFERENCE FOR REINFORCEMENT ANDRESPONSE COSEvonCanales257
EFFICACY OF AND PREFERENCE FOR REINFORCEMENT AND
RESPONSE COST IN TOKEN ECONOMIES
ERICA S. JOWETT HIRST
SOUTHERN ILLINOIS UNIVERSITY
CLAUDIA L. DOZIER
UNIVERSITY OF KANSAS
AND
STEVEN W. PAYNE
STATE UNIVERSITY OF NEW YORK
Researchers have shown that both differential reinforcement and response cost within token
economies are similarly effective for changing the behavior of individuals in a group context
(e.g., Donaldson, DeLeon, Fisher, & Kahng, 2014; Iwata & Bailey, 1974). In addition, these
researchers have empirically evaluated preference for these procedures. However, few previous
studies have evaluated the individual effects of these procedures both in group contexts and in
the absence of peers. Therefore, we replicated and extended previous research by determining
the individual effects and preferences of differential reinforcement and response cost under both
group and individualized conditions. Results demonstrated that the procedures were equally
effective for increasing on-task behavior during group and individual instruction for most chil-
dren, and preference varied across participants. In addition, results were consistent across partici-
pants who experienced the procedures in group and individualized settings.
Key words: differential reinforcement, independent group contingency, preference, response
cost, token economy
The token economy is a common behavioral
intervention that has been demonstrated to be
effective for increasing appropriate behavior
and decreasing inappropriate behavior for many
populations across different settings (Doll,
McLaughlin, & Barretto, 2013; Hackenberg,
2009; Kazdin, 1977). Token economies involve
delivery, removal, or both delivery and removal
of conditioned reinforcers (e.g., tokens and
points) that can be exchanged for back-up rein-
forcers (e.g., prizes, treats, and leisure activ-
ities). When tokens are delivered contingent on
appropriate behavior or for the absence of inap-
propriate behavior, these procedures are termed
differential reinforcement of alternative behavior
(DRA) or differential reinforcement of other
behavior (DRO), respectively. When tokens are
removed contingent on inappropriate behavior
or for the absence of appropriate behavior, this
procedure is termed response cost (RC).
An advantage of token economies is that
they can be implemented with a group of indi-
viduals as a general behavior-management strat-
egy during small-group instruction or as a
classwide intervention. Classwide behavior-
management strategies such as token economies
should be considered to address minor disrup-
tive behavior, to increase motivation for learn-
ing, or as a complement to an individualized
intervention. However, general behavior-
management strategies may not be effective in
isolation for some individuals who engage in
severe problem behavior or have more intense
Correspondence concerning this article should be
addressed to Claudia L. Dozier, Department of Applied
Behavioral Science, U ...
Running head Advanced behavioral analysis and its successful use .docxjoellemurphey
Running head: Advanced behavioral analysis and its successful use in the treatment of autism 1
Advanced behavioral analysis and its successful use in the treatment of autism 2Advance Behavioral Analysis And Its Successful Use In The Treatment Of Autism
Darin Bullock
Columbia Southern University
Advance Behavioral Analysis and its Successful use in the Treatment of Autism
Fryling, M. J., Wallace, M. D., & Yassine, J. N. (2012). Impact of Treatment Integrity on Intervention Effectiveness. Journal of Applied Behavior Analysis , 449-53.
In this article, Fryling et al. proposes that by using Advanced Behavioral Analysis (ABA) in the proper way, the integrity will be maintained and will be more effective. They state “treatment integrity has cogent implications for intervention effectiveness.” They propose that by proper training and understanding of ABA, the integrity can be maintained. Proper use of reinforcements with appropriate behavior showed signs of improvement. They point out that DiGennaro et al. “demonstrated a relation between improved integrity and intervention effectiveness when they compared procedures aimed at improving special educators’ integrity in classrooms.” They proposed that by having effective intervention and integrity, problem behaviors decreased in a classroom setting.
Layne, C. M. (2007). Early Identification of Autism: Impications for Counselors. Journal of Counseling and Development , 110-114.
Layne discusses screening tools and diagnostic assessments used to identify autism in children around the age of 2. Layne also discusses the impact this diagnosis can have on families as well as counselors. She states autism “impairs language, social interactions, and play skills, as well as cognitive and adaptive functioning.” She proposes that 1 out of 166 children will be diagnosed with autism. She proposes and commends the diligence in early diagnosis stating it is more than likely due to the diligence of parents, clinicians, and teachers. Public awareness has helped as well and the fact that either autism is increasing, or clinicians are more apt to diagnose children with autism rather than another developmental disability.
Pulse International. (2012, Aug 14). Early Intervention has considerable impact on reducing symptoms and increasing child's ability to learn new skills.
An article by Pulse International quotes Prof. Mohamed Chetouani at a press conference on Monday, 23 July 2012. The article speaks of warning signs of autism characterized by social symptoms, communications deficits, and repetitive behaviors. The child should then be evaluated by specialized professionals so appropriate treatment can be initialized. The articles states, “Early intervention has considerable impact on reducing symptoms and increasing a child’s ability to learn new skills.” It was proposed that there are items in place to diagnose children with autism after the age of two, but “information on autism in the first two years of life i ...
Running Head MANAGEMENT OF AUTISM IN CHILDREN .docxcowinhelen
Running Head: MANAGEMENT OF AUTISM IN CHILDREN 1
MANAGEMENT OF AUTISM IN CHILDREN 2
Autism spectrum disorder in Toddlers
Name of student
Institution Affiliation
Literature review
After conducting an investigation on the connection of social skills, adaptability limitations, emotional and behavioural challenges among school children (Pack, C.J, et al., 2012) came to the conclusion that, kids diagnosed with autism had challenges related to daily social skills and behavioural complications. He proposed that physical conversation abilities are mostly related to practical and developmental effects rather than basic communication skills. However, according to a study by (Tager-Flusberg, et al., 2010) and (Ellawadi, A.B, et al., 2015), from their investigation on socialisation abilities of autistic toddlers and the variances in variables assumed to affect communication advancements at various ideal stages. They organised the toddler’s based on verbal communication standards to survey the variances on the chosen variables through the standardisation groupings. From the investigation they found that verbal communication standards are essential in describing premature communication outlines as well as determining factors that affect effective language development.
Besides, (Ellis Weimer, et al., 2010) described premature socialisation abilities among children suffering from Autism Spectrum Disorder (ASD, n=257) by use of multiple communication advancement measures, in comparison to children with non-spectrum Developmental Delay (DD, N=69. Results of ASD presented substantial variance in the outline of receptive-sensitive communication skills for autism children in comparison to the development delay (DD). Children with autism had moderately more serious receptive verbal delays than expressive. These results contradict those of (Ventola, P, et al., 2007) in their study. Ventola related the conduct of children suffering from autism spectrum disorder to general developmental delay. They came to the conclusion that the two categories of children shared a variety of related characteristics but still there were specific behavioural change that distinguished the two categories of children’s.
Another study by (Drew, A, et al 2007) through the means of Social Communication Assessment for Toddlers with Autism (SCATA) which measured communication skills on the two groups of children found to be suffering from the autism spectrum disorder came to the conclusion that the regularity and persistence of verbal acts of communications during childhood determined their communication abilities in the future. Socialisation acts provided a more prediction to association than replies and appeals.
Problem statement
Complains by parents about their growing children especially of age 4-12 years having a challenge on social skills with people have i ...
Importance of Physical Activities in Relation to Academic MalikPinckney86
Importance of Physical Activities in Relation to Academic Achievement
Southeastern Oklahoma State University
1
Importance of Physical Activities in Relation to Academic Achievement
Introduction
Schools have served many purposes throughout history. They serve to teach children to
become successful adults. Over time the idea of what it takes to make a student a successful adult has
changed. Schools have been forced to measure students with tests instead of the whole child. Students
are evaluated year after year on their academic achievement through standardized tests. Teachers are
now judged on how well their pupils do on tests whether it be on a nationally standardized test or
benchmark testing in the classroom. Since testing will not go away, teachers must find ways that
improve the way students retain information. Physical activity supports developmental, emotional, and
cognitive growth.
Physical activity helps students develop fine and gross motor skills. Typical recess activities such
as monkey bars, pumping legs on a swing, throwing balls all help develop motor skills that are needed in
the classroom. Hand eye coordination that is developed from these physical activities helps students
track when reading, take notes, and holding a pencil. When recess is cut, these activities either suffer or
the teacher must find time in their already hectic schedule to work these activities into the curriculum
(Franxman & Gilbert, 2018).
Many playground activities lead to social and emotional development. Students are put into
situations that are not guided by a teacher and are tested to make their own decisions. Peer
relationships are developed through physical activity (Murray & Ramstetter, 2018). This “free” time
helps develop a student’s ability to communicate, negotiate, and problem solve, all of which are needed
to contribute to society (Murray & Ramstetter, 2018).
School days are long. Students are expected to sit for long periods of time focusing on specific
content. When students are given breaks to move, different motions fire up neurons in their brains.
Students are more attentive to their lessons after a chance to engage in physical activity (Murray &
2
Ramstetter, 2018). The physical activity helps keep the brain active by giving one area a chance to rest
and recharge, while another area of the brain develops other skills.
Physical activity is important to the development of the whole child. Schools have drifted away
from making physical activity or play a priority in favor of structured academic time. This paper will look
at the role physical activity plays in academic achievement. It will show if physical activity is improving
test scores, curbing behavioral issues, and encouraging student learning by using physical activity in
unstructured activity, using set programs, and as motivation for cognitive improvement.
Literature Review
This ...
NT2580 Week 1 Understanding IT Infrastructure Security An.docxhenrymartin15260
NT2580: Week 1 Understanding IT Infrastructure Security
Analysis 1.1
Case Study
1
In March 2010, 28 year-old Albert Gonzalez was sentenced to 20 years in federal prison for breaching
security measures at several well-known retailers and stealing millions of credit card numbers, which he then
resold across a variety of shadow “carding” Web sites. Using a fairly simple packet sniffer, Gonzalez was able
to steal payment card transaction data in real time, which he then parked on blind servers in places such as
Latvia and Ukraine—countries formerly part of the Soviet Union. Gonzalez named his activities “Operation
Get Rich or Die Tryin'” and lived a lavish lifestyle by selling stolen credit card information. He was eventually
tracked down by the U.S. Secret Service, which was investigating the stolen card ring. Operation Get Rich or
Die Tryin' took place for more than two years and cost major retailers, such as TJX, OfficeMax, Barnes &
Noble, Heartland, and Hannaford, more than $200 million in losses and recovery costs. It is the largest
computer crime case ever prosecuted.
At first glance, Operation Get Rich or Die Tryin' seems to be an open-and-shut case. A hacker commits a
series of cybercrimes, is caught, and is successfully prosecuted. Fault and blame are assigned to the
cybercriminal, and justice is served for the corporations and the millions of people whose credit card
information was compromised.
Unless you ask the shareholders, banking partners, and some customers of TJX, who filed a series of class-
action lawsuits against the company claiming that the “high-level deficiencies” in its security practices make it
at least partially responsible for the damages caused by Albert Gonzalez and his accomplices. The lawsuits
point out, for example, that the packet sniffer Gonzalez attached to the TJX network went unnoticed for more
than seven months. Court documents also indicate that TJX failed to notice more than 80 GB of stored data
being transferred from its servers using TJX’s own high-speed network. Finally, an audit performed by TJX’s
payment-card processing partners found that it was noncompliant with 9 of the 12 requirements for secure
payment card transactions. TJX’s core information security policies were found to be so ineffective that the
judge presiding over sentencing hearing of Gonzalez reviewed them to determine whether TJX’s damages
claim against him of $171 million is valid.
Apart from lawsuits, TJX faced a serious backlash from customers and the media when the details of the
scope of the breaches trickled out. Customers reacted angrily when they learned that nearly six weeks had
passed between the discovery of the breach and its notification to the public. News organizations ran
headline stories that painted a picture of TJX as a clueless and uncaring company. Consumer organizations
openly warned people not to shop at TJX stores. TJX’s reputation and brand.
NTC/362 Week 3
OSI Model, Switching Systems, Network Channel Processors, and Media
1 Write a 200- to 300-word response to the following:
Supporting Activities: Introduction to Network Channels, Processors, and Media
•What are the advantages and disadvantages of network processors, such as hubs, switches, routers, and gateways?
•What are the three main types of network media?
•What is their performance in terms of reliability, speed capabilities, and nominal distance for reliable spans?
2 Write a 200- to 300-word response to the following
Supporting Activity: Introduction to Circuit Switching
• •What are the basic concepts of circuit switching?
•What are the advantages and disadvantages of circuit switching?
3 Write a 200- to 300-word response to the following:
Supporting Activity: Introduction to Packet Switching
•What is a packet? What is packet switching?
•How would you explain the concept of packet switching?
•What are the advantages and disadvantages of packet switching over circuit switching?
4Write a 200- to 300-word response to the following:
NTC/362
Week
3
OSI Model, Switching Systems, Network Channel Processors, and
Media
1
Write
a 200
-
to 300
-
word response to the following:
Supporting Activities:
Introduction to Network Channels, Processors, and Media
•
What are the advantages and disadvantages o
f network processors, such as hubs, switches,
routers, and gateways?
•What are the three main types of network media?
•What is their performance in terms of reliability, speed capabilities, and nominal distance for
reliable spans?
2
Write
a 200
-
to 300
-
word response to the following
Supporting Activity:
Introduction to Circuit Switching
•
•What are the basic concepts of circuit switching?
•What are the advantages and disadvantages of circuit switching?
3
Write
a 200
-
to 300
-
word response to the following:
Supporting Activity:
Introduction to Packet Switching
•What is a packet? What is packet switching?
•How would you explain the concept of pa
cket switching?
•What are the advantages and disadvantages of packet switching over circuit switching?
4
Write
a 200
-
to 300
-
word response to the f
ollowing:
NTC/362 Week 3
OSI Model, Switching Systems, Network Channel Processors, and
Media
1 Write a 200- to 300-word response to the following:
Supporting Activities: Introduction to Network Channels, Processors, and Media
•What are the advantages and disadvantages of network processors, such as hubs, switches,
routers, and gateways?
•What are the three main types of network media?
•What is their performance in terms of reliability, speed capabilities, and nominal distance for
reliable spans?
2 Write a 200- to 300-word response to the following
Supporting Activity: Introduction to Circuit Switching
• •What are the basic concepts of circuit switching?
•What are the advantages and disadvantages of circuit switching?
3 Write a 200- to 300-word response to the follo.
NT2580 Week 4 Hardening a NetworkAnalysis 4.2Availability, In.docxhenrymartin15260
NT2580: Week 4 Hardening a Network
Analysis 4.2
Availability, Integrity, or Confidentiality (A-I-C)
Instructions:
Given the network security applications and countermeasures in the first column of the table below, explore answers to the following questions:
· Where does the countermeasure belong in the seven domains of a typical IT infrastructure?
· What CIA functions does the countermeasure provide?
Provide your answers in the table below.
Network Security Applications and Countermeasures
Domains
CIA Function
Ethical hacker
Intrusion detection system/intrusion prevention system (IDS/IPS)
Access controls
Failover server
Automatic updates
Cryptography
Data backups
Logon rights
Computer cluster
Firewalls
Proxies
Antivirus scanners
As a reminder, the seven domains of a typical IT infrastructure include the following domains:
1. User Domain: Actual users
1. Workstation Domain: Workstations, laptops, and end-point devices, such as smartphones and printers
1. LAN Domain: Physical and logical LAN technologies—100 Mbps/1000 Mbps switched Ethernet, 802.11-family of wireless LAN technologies—used to support workstation connectivity to the organization’s network infrastructure
1. LAN-to-WAN Domain: Routers, firewalls, demilitarized zones (DMZs), and IDS/IPS
1. WAN Domain: Routers, circuits, switches, firewalls, gateways, and equivalent gear at remote locations, sometimes under a managed service offering by the service provider
1. Remote access Domain: Virtual private networks (VPNs), laptops with VPN software, and secured socket layer/VPN (SSL/VPN) tunnels
1. System/Application Domain: Hardware, operating system software, database software, client/server applications, and data that are typically housed in the organization’s data center and computer rooms
Representation of the Seven Domains of a Typical IT Infrastructure
1
.
NTNU, May 2009 ntnu.nocbm 1 LEARNING AND MEMORY .docxhenrymartin15260
NTNU, May 2009 ntnu.no/cb
m
1
LEARNING AND MEMORY
- Cellular and molecular mechanisms
Øyvind Høydal
NTNU, May 2009 ntnu.no/cb
m
2
What is learning and memory?
Learning can be defined as acquisition of new
knowledge or skills and/or changes in behaviour as
a result of experience.
Memory refers to the storage and retrieval of
learned knowledge, skills or behaviours.
NTNU, May 2009 ntnu.no/cb
m
3
NTNU, May 2009 ntnu.no/cb
m
4
Information and skills are stored within the networks
of neurons in the brain.
When we learn, changes take place that alters the way
neurons communicate with eachother.
Can you guess what changes take place?
NTNU, May 2009 ntnu.no/cb
m
5
Cellular plasticity in learning
and memory
The efficacy of signalling between neurons are altered.
New synapses form
New neurons?
NTNU, May 2009 ntnu.no/cb
m
6
Aplysia californica as a model system for
cellular learning and memory
Studying cellular mechanisms for learning and memory in the mammalian
brain is a formidable challenge due to the enormous number of neurons and
the complexity of synaptic connections.
Aplysia californica is an advantagous model organism because:
- Neurons are quite few (20 000) and can be identified in the circuit.
- Neurons are rather big, making them readily accessable
for in vivo intracellular recordings
NTNU, May 2009 ntnu.no/cb
m
7
The gill-siphon reflex in aplysia offers a great
opportunity to link changes in neurons and
synapses with a behavioral output.
When a mechanical stimulus
is applied to the siphon, the
slug responds by withdrawing
its gill.
NTNU, May 2009 ntnu.no/cb
m
8
Gill-siphon-withdrawal reflex
S
M
Tactile
NTNU, May 2009 ntnu.no/cb
m
9
The synapse and some common forms of short-
term synaptic plasticity
Synaptic facilitation: rapid increase in synaptic strength when two APs arrive at the axon terminal
within a short interval of time. Increased Ca+ -influx causes more transmitter substance to be
released.
Synaptic depression: neurotransmitter release decline with sustained stimulation. A possible
mechanism might be depletion of neurotransmitter-containing vesicles in the presynaptic neuron.
Augementation (acts over seconds) and potentation (post-tetanic, acts over minutes) are other forms
of short-term plasticity that enhance transmitter release due to prolonged and increased Ca+ levels.
NMDA
AMPA
AMPA
Na+
AP
Ca+ Ca+ Ca
+
Na+
Na+
NTNU, May 2009 ntnu.no/cb
m
10
Habituation in Aplysia
Habituation: reduced response to a stimulus that is neither harmful nor
beneficial.
In Aplysia: if the siphon is touched repeatedly, the snail will eventually stop
withdrawing its gill.
The response in the sensory neuron is mostly unchanged, so the habituating
effect on behaviour is likely to be mediated by a.
nowHow to be Army StrongI was 18 years old when I saw my fa.docxhenrymartin15260
now
How to be Army Strong
I was 18 years old when I saw my favorite uncle in his uniform. I could see how much respect he got and how strong of a man he was and I wanted that for myself. I asked him how could I become strong like he was. He said to me, it’s not going to be an easy job. I would have to leave my family, friends and everything behind to fight for my country Saudi Arabia.
The first thing I needed was talk with a recruiter. He tried to make me see how difficult this walk was going to be. I believed the hard work would make me strong just like my uncle. We started off with a whole lot of questions. I filled out many different types of paperwork. The paper work included: criminal background checks, medical history, family history, and job history. I had to take a test to see if I was smart enough for the army. I think it was similar to the test soldiers take in America. It asked questions from basic mechanics, computers, cooking, and all general studies. Its purpose was to find out what job I could choose. I passed the test and then I was able to pick a job. I had my pick of a lot of different jobs but I chose to be a machine gunner. Then, after I chose my job, I signed my contract. After that, I was told to come back in two weeks for a drug test and medical test to see if I was fit for the Army. I had to do psychological testing and the doctor checked everything on my body I received my stamp and it was on to basic training.
The second step in becoming Army strong is going to basic training. There are three phases to go through. I arrived to the training camp called Reception. At Reception I received all of my equipment and clothing. I was assigned to the company where I would learn all about being a soldier. The first day I received a haircut and was taught how to properly exercise and gain strength of my body by doing Physical Training. I started learning how to run long distances and how to breathe the right way so I would not get too tired. I did not enjoy ring but I had to do it. After that I issued a M16 Assault Rifle. I took training classes on how to clean, fix and shoot. The next step was learning about the history of the Army and all the things it takes to make up a true soldier. I went through many field exercises where I learned about teamwork. The men were like brothers; we helped each other like a family I participated in rappelling, nuclear biological defense and weapons training. The next step was learning drill, which is how I am supposed to present my self in parades, when we march and at funerals. After that we learned tactics and techniques to stay alive. Then I learned medical training. I had to learn CPR, Heimlich maneuver, wound care and many other forms of medical procedures. The next stage I learned was radio communication. Radio communication is how I can communicate with other soldiers on a mission in the field. Then I learned combat fighting. I used bayonets, padded sticks and hand and hand comba.
NR-351 Transitions in Professional NursingWebsite Evaluation T.docxhenrymartin15260
NR-351: Transitions in Professional Nursing
Website Evaluation Template
Student Name:Date:
Directions:
1. Carefully read the Website Evaluation Guidelines found in Doc Sharing. This provides specific details on how to complete this assignment.
2. Rename this document by clicking “Save As.” Change the file name so it reads Your Last Name Website Evaluation.docx. For example, if your last name is Smith, type “Smith Website Evaluation.docx”.
3. Save the document in a file format compatible with Microsoft Word 2010 or later.
4. Type your name and date at the top of this template.
5. Type your answers directly on the saved and renamed template. Follow all instructions. Save frequently to prevent loss of your work.
6. Submit to the Dropbox by the end of Week 6, Sunday at 11:59 p.m. MT.
7. Post questions about this assignment to the Q & A Forum so your classmates can read the advice, too. You may also e-mail questions to your instructor.
Item instructions:
Type your answers below:
General Information:
State the search engine used to locate the website and the URL of the homepage of the selected website.
URL must link to homepage when copied or clicked.
Authority:
Describe the reasons this website would be considered a reliable resource for information on the topic. Include contact information (group name, address, and phone number).
Information:
Describe information presented on the website including all of the main headings of the site. Describe accuracy and thoroughness of information and how you made this determination.
Objectivity:
Explain how content does or does not represent bias based on advertising and sponsorship.
Ease of Navigation:
Discuss the ease of use of this website for healthcare professionals and for lay persons. Differentiate the ease of navigation for each of these two groups.
Usefulness:
Describe how useful the information on this website is for healthcare professionals and for lay persons. Differentiate usefulness for each of these two groups.
Website Evaluation Template.docx Revised 2/9/2013 cjm
1
Website Evaluation GuidelinesPurpose
The purpose of this assignment is to allow the learner to demonstrate effective strategies for evaluation of credible scholarly websites. Course Outcomes
This assignment enables the student to meet the following course outcomes.
1. Demonstrate effective verbal, written, and technological communication using legal and ethical standards for transferring knowledge. (PO #3)
2. Use leadership strategies that promote quality nursing practice and increase collaboration with other disciplines when planning comprehensive care for individuals and groups. (PO #2)
4. Integrate critical thinking and judgment in professional decision-making in collaboration with faculty and peers. (PO #4)
6. Relate application of the legal and ethical requirements of nursing laws and standards to interactions with faculty, peers, and.
Ntc 362 Week 2, Integrative Network Design Project , Part 1By Alucard1990 | Studymode.com
Kudler Fine Foods Network Overview
Name
University of Phoenix
NTC 362
Date
Instructor
Upon reviewing Kudler Fine Food network, it has been determined that a major network overhaul will need to be conducted to make sure that Kudler is brought up to speed with the latest technology. This is very important because if Kudler is unable to keep up with the technological advances then the company will fall behind. Making sure that Kudler is not only able to keep up with the advances with network systems it is also important to install the proper systems so that no money is wasted. What is meant by this is that if the improper systems and storage units are installed to only handle data over the next year this is only going to force Kudler to spend more money in upgrades in the future. This is why it is vital to install the proper systems that will provide room for future network expansion without having to waste money on unnecessary upgrades. The following is a list of problem areas with the Kudler network: • 56K modems provide slow connections speeds
• Host systems at all site running Window 98 – over 10 years old • Windows NT servers are at the Delmar and Lajolla sites – over 10 years old. • The XLS servers at the Delmar and Lajolla sites are running Office 97 – over 15 years old. • The Novell Servers at the Delmar and Lajolla sites are running this was released in 1994. – over almost 20 years old. • All sites have a stand lone ups system that will need upgraded to provide a redundant power supply to support new systems.
One of the first things that were noticed was that fact that all of the sites are still running 56k modems. This is an old technology and is only hindering the speed between each site. Having the proper connection speed is vital to provide real time updates not only for the profits made each day, but providing the inventory updates on the products that are sold so that those items can be restocked without waiting. These modems will be removed to make the way for the new wide area network and within each site there will be a wireless local area network. The WAN will link all of the site networks together which will in turn boost the network speed and the way employees communicate. The communication aspect of the new network will incorporate a VoIP system and will be managed at one central location. “The great thing about VoIP is that it taps additional value from the already existing infrastructure without additional costs” This will provide the highest quality of phone network will saving on the cost of out phone services.
Another issue that issue that is hindering the speed and efficiency on the network is the fact that all the host systems being used within all the sites are Windows 98. These systems are well over ten years old and a.
NTHEMIND OF GREATCOMPANIESBy Scott BlanchardThe.docxhenrymartin15260
NTHE
MIND OF GREAT
COMPANIES?
By Scott Blanchard
T
he old saying, "money isn't
everything," rings hollow in
today's business world.
where rninute-by-minute
stock quotes scroll across
our computer monitors, and
careers are won or lost based
on Wall Street's analysis of a
company's perforniance. Throw in giob-
al competition, outdated products and
services, increased costs, corporate silos
and other business challenges, and it's
no wonder that tnatiy of today's compa-
nies focus solely on their bottom line,
ofteti at the expense of customer service
and employee satisfaction.
It need not be this way. Great compa
nies focus on more than one bottom
line when gauging their perforniance.
Ttiey choose to be not only the invest-
ment of choice, but also the provider of
choice for their products or services, as
well as the employer of choice for work-
ers in their industry. By looking beyond
immediate, short term results and focus-
ing on strategies to make their compa-
nies successful for the long-term, they
recognize challenges sooner, identify
solutions more quickly and deliver re-
sults ahead of their competitors. In short,
they learn to lead at a higher level.
A clear warning sign that your busi-
ness is trapped in a short-term mindset
is the presence of an "either/or" philoso-
phy. Managers either believe they can
achieve profitability or they can develop
a great workplace, but not both. These
leaders don't always take morale and job
satisfaction into consideration. Their
focus is only their financial bottom line.
From there, it's a short leap to the false
notion tlrat making money is the sole
reason to be in business.
A NEW APPROACH
Contrary to the either/or philosophy,
leading at a higher level requires man-
agers to embrace a "both/and" approach.
In great companies, the development of
people is of equal importance to finan-
cial performance. As a result, the focus
is on long-term results and human satis-
faction. Accordingly, great companies
begin by both creating and nurturing a
vision of the future, and then measuring
progress against that vision.
There are three questions to ask,
which represent the main components
of a corporate vision. By focusing on
these questions, companies are more
likely to ensure they don't lose sight of
their path to success. They are:
• What business are you in? This will
help you identify your company's signif-
icant purpose.
• What will the future look like if you
are successful?
• What guides your behavior and deci-
sions on a daily basis? This will help
you identify clear values.
Great companies keep al! three of
these ideas clearly in mind and make
necessary course corrections when they
realize they are off track.
The next step is to create a corporate
culture that both reflects and reinforces
the corporate vision. The culture con-
sists of the values, attitudes, beliefs,
behaviors and practices of the organiza-
tion's members. Culture is an organiza-
tion's personality, and it can help or hin-
.
nR E E 693 5T o c o m p l e t e th i s e x a m y o u n.docxhenrymartin15260
n
R E E 693 5
T o c o m p l e t e th i s e x a m y o u n e e d t o a n s w e r 8 q u e s t i o n l i s t e d b e lo w . T h e
f i r s t t w o q u e s t i o n s a r e t o b e a n s w e r e d i n E x c e l u s i n g th e a s s o c ia t e d t a b s
i n c l u d e d o n t h e e x a m R E E 6935 t h a t i s p r o v i d e d t o y o u q u e s t i o n 3
- 8 a r e
t o b e a n s w e r e d o n a Wo r d D o c u m e n t i n t h e o r d e r i n w h ic h t h e y a p p e a r .
D u e A p r i l 28 , 2015 .
1. ) (9 P o i n t s ) U s i n g t h e d a t a p r o v i d e d t o y o u i n t h e P r o b l e m 1 t a b ,
c a lc u la t e t h e r e q u e s t e d v a l u e s a n d i n c l u d e y o u r a n s w e r i n th e i r
r e s p e c t i v e c e l ls h i gh l ig h t e d i n y e l lo w .
2 . ) (10 P o i n t ) T h e t a b la b e l e d P r o b l e m 2 i n c l u d e s m o n t h ly p r i c e d a t a o n
th e SA P 500 (SPY ) a s w e l l a s o n K B H o m e (K B H , a r e a l e s t a t e
d e v e lo p m e n t c o m p a n y ) a n d o n H o m e P r o p e r t i e s I n c . (H M E , a n d e q u i t y
R E I T s p e c ia l i z e s i n a p a r tm e n t r e n t a ls ) . U s i n g r e g r e s s i o n c a l c u l a t e t h e
B e t a o f e a c h o f t h e s e 2 r e a l e s t a t e c o m p a n ie s f o r t h e f u l l t im e p e r i o d
p r o v id e d t o y o u .
a . D is p l a y y o u r c a l c u l a t e d B e t a s i n t h e c e ll s h i g h l igh t e d i n y e l l o w .
Y o u m a y i n c l u d e y o u r f u l l r e g r e s s i o n r e s u l t s i n t w o o th e r s e p a r a t e
t a b s
b . W h i c h c o m p a n y h a s a h i g h e r B e t a ? I n o n e t o tw o s e n t e n c e s
e x p l a i n w h y y o u d id o r d i d n
'
t e x p e c t t h a t c o m p a n y t o b e
a s s o c ia t e d w i t h a h ig h e r B e t a .
3 . (10 P o i n t s ) P l e a s e r e f e r t o t h e p a p e r t it l e d O n t h e R e la t i o n b e t w e e n
L o c a l A m e n i t ie s a n d H o u s i n g P r ic e C h a n g e s
"
p r o v i d e d t o y o u w i t h t h i s
e x a m a n d a n s w e r t h e f o l lo w i n g q u e s t io n s .
a . B r i e f ly e x p l a i n w h a t w e c a n l e a r n f r o m F ig u r e 2 ? A r e t h e s e
r e s u l t s e x p e c t e d ? Wh y ?
b . B r i e f ly e x p l a i n w h a t w e c a n l e a r n f r o m f i g u r e 4? A r e t h e s e r e s u l t s
e x p e c t e d ? W hy ?
c . B r i e f ly e x p l a i n w h a t w e c a n l e a r n f r o m t h e r e g r e s s i o n r e s u l t s
p r e s e n t e d i n c o l u m n (4) o f t a b l e 4 . H o w t h e s e r e s u lt s a r e d if f e r e n t
f r o m t h e r e s u l t s p r e s e n t e d i n c o l u m n (2) o f t a b le 4?
d . B r i e f l y e x p l a i n w h a t w e c a n l e a r n f r o m t a b l e 6 t h a t w e d o n
'
t
a l r e a d y k n o w f r o m t h e r e s u l t s p r e s e n t e d i n t h e p r e v i o u s t a b l e s .
NEATPAGEINFO:id=C46A481D-C837-496A-BF88-1036B1B658D9
NEATPAGEINFO:id=1C69E900-548F-4525.
NR360 We Can But Dare We.docx Revised 5 ‐ 9 .docxhenrymartin15260
NR360 We Can But Dare We.docx Revised 5 ‐ 9 ‐ 16 DA/LS/psb 07.14.16 1
NR360 INFORMATION SYSTEMS IN HEALTHCARE
Required Uniform Assignment: We Can, but Dare We?
PURPOSE
The purpose of this assignment is to investigate smartphone and social media use in healthcare and to
apply professional, ethical, and legal principles to their appropriate use in healthcare technology.
Course Outcomes
This assignment enables the student to meet the following course outcomes.
• CO #4: Investigate safeguards and decision‐making support tools embedded in patient
care technologies and information systems to support a safe practice environment for
both patients and healthcare workers. (PO 4)
• CO #6: Discuss the principles of data integrity, professional ethics, and legal
requirements related to data security, regulatory requirements, confidentiality, and
client’s right to privacy. (PO 6)
• CO #8: Discuss the value of best evidence as a driving force to institute change in the
delivery of nursing care (PO 8)
DUE DATE
See Course Schedule in Syllabus. The college’s Late Assignment Policy applies to this activity.
TOTAL POINTS POSSIBLE
This assignment is worth a total of 240 points.
Requirements
1. Research, compose, and type a scholarly paper based on the scenario described below, and
choose a conclusion scenario to discuss within the body of your paper. Reflect on lessons
learned in this class about technology, privacy concerns, and legal and ethical issues and
addressed each of these concepts in the paper, reflecting on the use of smartphones and social
media in healthcare. Consider the consequences of such a scenario. Do not limit your review of
the literature to the nursing discipline only because other health professionals are using the
technology, and you may need to apply critical thinking skills to its applications in this scenario.
2. Use Microsoft Word and APA formatting. Consult your copy of the Publication Manual of the
American Psychological Association, sixth edition, as well as the resources in Doc Sharing if you
have questions (e.g., margin size, font type and size (point), use of third person, etc.). Take
NR360 INFORMATION SYSTEMS IN HEALTHCARE
NR360 We Can But Dare We.docx Revised 5 ‐ 9 ‐ 16 DA/LS/psb 07.14.16 2
advantage of the writing service SmartThinking, which is accessed by clicking on the link called
the Tutor Source, found under the Course Home area.
3. The length of the paper should be four to five pages, excluding the title page and the reference
page. Limit the references to a few key sources (minimum of three required).
4. The paper will contain an introduction that catches the attention of the reader, states the
purpose of the paper, and provides a narrative outline of what will follow (i.e., the assignment
criteria).
5. In the body of the paper, discuss the scenario in relation to HIPAA, leg.
n
s;
,e
il
rl
t.
lnterviewing is one HR function that
almost all managers are involved
with at some point. Here are some
tips for conducting interviews that
identify the best candidates:
. Be prepared-Make sure the
place where you interview is
accessible and comfortable
for you and the candidate.
Read the candidate's r6sum6
and other paperwork ahead
of time, to avoid asking for
information that has already
been provided. Prepare a list
of questions, as well as infor-
mation about the company's
history, culture, and other
details the candidate might be
interested in knowing.
t Put the applicant at ease- A
nervous or cautious job candi-
eate !'!':ay not show his or her
es. qua\itres. Express your
appreciation tor the candr-
date's time, and let the person
know you're glad to meet him
'';
i- i lr'
or her. Briefly explain what to
expect during the interview.
. Ask about past behaviors-
Talking about specific events
makes it harder for a candidate
to focus on guessing what the
interviewer wants to hear, and
the answers give clues about
what the candidate will do in
new situations. For examPle,
depending on the type of job,
you might ask, "Ptease telt
me about a time when you
received a customer comPlaint
and how you handled it," or
"This job involves tight dead-
lines; could you tell me about
a time when you faced a dif-
ficult deadtine?"
. Listen-fhe interview infor-
mation is only as good as the
interviewer's ability to gather
it. Let the candidate do most
oi \he ta\krng, and par; atten-
tion to what is being said and
not said. lf a candidate sounds
vague or too good to be true,
ask follow-up questions to
gather details.
. Take nofes-As much as you
can without distracting Your-
self or the candidate, jot down
notes to remind you of keY
points. Also schedule 5 or 10
minutes after each interview for
writing down your impressions.
r At the end of the interview,
make sure the candidate
knows what to expect next-
for example, a phone call or
additional interviews within
the next week.
Sources: U.S. Department of Com-
merce, Minority Business Development
Agency, "Tips on How to SuccessfullY
tnterview Job Candidates," November 17.
2009, raruw.mbda.gov; University o{ South
Carolina Division of.Human Resources,
"Tips on lnterviewing University Job
Applicants, " http://hr.sc.eoi.r, accesseo'
March 23,2010; and Dun & Bradstreet,
"How to Conduct an E{iective Emp\oyee
lnterview," Small Business
Solution
s,
http:l/smallbusiness.dnb.com, accessed
March 23,2010.
t-I
rl
i.
i.
s
.S
k
S
t
t
5
t
S
{
Preparing to lnterview
Organizations can reap the greatest benefits from intervierving if they prepare care-
fully. A well-planned intervierv should be standardized, comfortable for the partici-
pants, and focused on the job and the organization. The interviewer should have a
cluiet place in rvhich to conduct interviervs r.vithout interruption. This person should
be trained in how to ask objective questions, u'hat subject matter to avoid, a.
NR443 Guidelines for Caring for PopulationsMilestone 2 As.docxhenrymartin15260
NR443 Guidelines for Caring for Populations
Milestone 2: Assessment and Diagnosis
Purpose
The purpose of this paper is to provide an opportunity to utilize community assessment strategies, uncover a community health problem, and identify the components of the problem related to the community dynamics.
Points
225 pointsDirections
This paper is expected to be no more than four pages in length (not including the title page and reference list). Typical papers are usually three pages. Below are the requirements for successful completion of this paper.
· Introduction: This should catch the reader’s attention with interesting facts and supporting sources and include the purpose statement of the paper. This should be no more than one or two paragraphs.
· Community: Identify the community by name that you will be using for this paper and provide a brief, general description of the community. Your community should be the area where you live or work. This should be one or two paragraphs.
· Demographic and epidemiological data: Compile a range of demographic (population description) and epidemiological (causes of health problems and death) data for your community by examining census reports, vital statistic reports, city records, morbidity and mortality reports, and other agency sources. Using these data, describe the community and the problem. Compare your community data to state or national data. This comparison will help to identify a community health problem specific to your community. A summary of these data should be no more than one page.
· Windshield survey: Provide a brief summary of the findings from your first assignment. Make sure to discuss elements that link your observations to your identified problem. This should be no more than one or two paragraphs.
· Problem: Using the assessment data, identify the problem that you consider to be a priority concern. Provide a rationale for your choice and relate your choice to one of the Healthy People 2020 specific numbered objectives. Healthy People objectives are located within a topic area under the Objectives page. Your rationale should also include why this is specifically a problem in your community. This should be no more than three paragraphs. Include support of your rationale with at least two scholarly sources such as professional journal articles related to your problem.
· Summary: The summary paragraph of your paper should include a statement about the problem, the population at risk for this problem, and the major direct or indirect factors that contribute to this problem. This information should be no more than one or two paragraphs.
· Reference page: All references cited within the paper should be included on a separate References page.Guidelines
· Application: Use Microsoft Word 2010™ to create this assignment.
· Use the categories above as APA headings for the sections of your paper.
· Length: This paper is expected to be no more than four pages in length (not including the title pa.
NRB Dec’99 1WHITHER THE EMERGENCY MANAGER 1Neil R Bri.docxhenrymartin15260
NRB Dec’99 1
WHITHER THE EMERGENCY MANAGER? 1
Neil R Britton, PhD
Ministry of Emergency Management & Civil Defence
Wellington, NEW ZEALAND2
Introduction
The invitation to comment on Thomas E Drabek’s Human System Responses to
Disaster: An Inventory of Sociological Findings provides an opportunity to reflect on
the practice of emergency management and the evolving role of the emergency manager.
This focus is timely. The past decade has brought disaster into sharp relief for many;
several large-scale impacts have occurred; and disaster costs (in lives and property
damage) have escalated. The links between community growth, land-use management
practices and vulnerability have become more apparent. These issues have taken place at a
time when the clarion call is for smaller government and more fiscal constraint. This
combination is prompting questions, particularly from central government, about the
function and value of emergency management arrangements.
It is also appropriate to re-think the emergency manager’s role in contemporary society.
Much has changed in 10 years, ranging from the burgeoning of relevant information to the
need to develop integrated management programs for responders. This is leading to a re-
definition of the task-set and a re-evaluation of the emergency manager’s job parameters.
College-level programs and other knowledge-based accreditation courses are rapidly
becoming a prerequisite. These developments are enhancing the image of emergency
management and helping it progress to being a distinctive professional sector.
This essay uses Drabek’s 1986 publication Human System Responses to Disasters as a
vehicle to reflect on major developments influencing emergency management practice. It
begins by locating Human System Responses to Disasters within the disaster sociology
literature, and argues that the book makes two major contributions to disaster study. From
here, the focus of the essay shifts from Drabek’s work to identifying elements that
characterized emergency management practice at the time when Drabek wrote his text.
The essay moves on to look at some current issues pertaining to emergency management,
and leads into a discussion of where the practice might be heading in the coming decade.
A brief return to Human System Responses to Disasters completes the discussion.
1 Paper requested by the Editor, The International Journal of Mass Emergencies and Disasters.
Statements in this paper were first presented at a session of the International Research
Committee on Disasters (ISA Research Committee 39), at the 14th World Congress of
Sociology, Montreal (Quebec), Canada. 26 July - 1 August 1998. The session explored the
contribution of Thomas E Drabek’s textbook Human System Responses to Disaster: An
Inventory of Sociological Findings.
2 Neil Britton manages the Sector Development and Education unit in the Ministry of Emergency
Management & Civil Defence. The commen.
Now, its time to create that treasure map to hide the treasur.docxhenrymartin15260
Now, it's time to create that treasure map to hide the treasure from Ol' Red Coat's family.
Decide on which quadrilateral you will create. For this activity you may use a kite, trapezoid or a parallelogram (that is not a square, rhombus, or rectangle).
Graph the quadrilateral on a coordinate plane. You may print and use graph paper a drawing program such as GeoGebra. The four vertices of the quadrilateral will serve as four destinations on your map. One can be the starting point, the others can be clues along the way, and the last one will be where X marks the spot!
Find the length and slope of each side to justify the classification of your quadrilateral. For example, if your map was a square, your calculations would prove that all four sides are congruent, slopes of opposite sides are congruent, and slopes of adjacent sides are opposite reciprocals.
You need to create a set of directions so you can come back and find the treasure later. Your directions need to explain how to get from each destination on the map to the next one. Use the properties of quadrilaterals in your directions. At least three different quadrilateral properties must be used.
What does it mean to use properties of quadrilaterals in your directions? Here is an example: If your map is in the shape of a parallelogram, your opposite sides will have equal slopes. You could say that to get from Point A to Point B you travel up 3 units and right 2 units to the Palm Tree. From there you might travel East 5 units to Point C. From Point C, you would travel down 3 and left 2 units, where X marks the spot. This proves that the slopes of opposite sides are equal. Include two more properties in your directions. Don’t forget to finish the directions to return to the starting point. See example below.
Get creative and think of clever ways to use the different properties!
Create a key for your map. Show proof that following the directions will get you to the treasure. If one of the directions is to make a 90 degree turn, show how you can prove the turn from one side to another is 90 degrees.
If one of the directions is to travel the same distance as a previous side, use the distance formula to show the two distances are the same.
Submit the following to your instructor:
1. The treasure map on a coordinate plane
2. The length and slope of each side to justify the classification of your quadrilateral
3. The directions to finding the treasure: Include the explanation for how each direction represents a quadrilateral property. Be sure to include at least three properties.
*Note: Please submit the written portion of this assignment using a word processing document or by copying and pasting into the assignment box.
1.1 Elements of Inquiry Used to Study the Workplace
1.2 Methodology Used to Study the Workplace
1.3 The Impact of Paradigms and Trends
1.4 The Major Sociological Perspectives
1.5 The Paradigm Shift to Capitalism
1.6 The Progressive Era
1.7 The Gr.
NR361 Information Systems in HealthcareInterview with a Nursing.docxhenrymartin15260
NR361 Information Systems in Healthcare
Interview with a Nursing Information Expert:
Guidelines and Grading RubricPurpose
The purpose of this assignment is to
· Communicate your understanding of the importance of quality information in everyday nursing practice;
· Discuss the roles and responsibilities of a Nursing Information Expert; and
· Articulate how the professional nurse uses information or data in everyday practice to improve outcomes.Course Outcomes
This assignment enables the student to meet the following course outcomes.
CO #1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO #1)
CO #4: Investigate safeguards and decision-making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers. (PO #4)
CO #8: Discuss the value of best evidence as a driving force to institute change in delivery of nursing care. (PO #8)
Points
This assignment is worth a total of 250 points.
Due Date
This assignment, Interview with a Nursing Information Expert, is due at the end of Week 6. Submit your completed Interview, using the Interview Form, to the basket in the Dropbox by Sunday, 11:59 p.m. mountain time. Post questions to the weekly Q & A Forum. Contact your instructor if you need additional assistance. See the Course Policies regarding late assignments. Failure to submit your paper to the Dropbox on time will result in a deduction of points.
Directions
1. Download the NR361 Interview Form from Doc Sharing. It is found under the Week 6 Interview link.
2. Select your interviewee and schedule an interview. This individual must be a registered nurse. Job titles of RNs who may be considered include but, are not limited to, Nursing Clinical Information Manager; Super User, Director/Manger Clinical Education; Chief Information Officer; Quality Assurance or Performance Improvement Nurse; Nurse Informaticist; Telenursing Specialist; Nurse Abstractor; Case Manager; Compliance Nurse. If you have any concerns about whether the RN is suitable for this assignment, contact your instructor BEFORE you schedule the interview.
3. Review all questions (areas of inquiry) on the Interview Form located in Doc Sharing PRIOR to conducting the interview. You may print the form and take it with you to the interview.
4. Note that there are five (5) Required Questions to ask the RN.
5. Note that there are four (4) Optional Questions. You need to select only ONE of them to ask the RN.
6. Note that there are two (2) Follow-Up Questions that must be answered by YOU.
Prior to conducting your interview, review two scholarly resources. These resources should guide your understanding of the RN’s role and responsibilities or make you more knowledgeable about GIGO, interprofessional communication, or other key concepts in the questions that you may not fully understand. For example, if your interviewee is a Telenurse, you would want.
NR360 Information Systems in Healthcare Team Technology Pr.docxhenrymartin15260
NR360 Information Systems in Healthcare
Team Technology Presentation Guidelines and Grading Rubric
Revised: 01/26/2014, 07/09/2014 09/12/2014 DA
Objective
The purpose of this Team Technology Presentation is to provide students the opportunity to explore a technology used in the healthcare
system. The project requires students to work in a small team together in order to describe how this technology supports the patient care
experience through the use of information technology and information structures. Additionally, the student will explore the experience of
clear and concise communication skills, when interacting with peers, who may or may not be from the same geographical area, or campus as
they are. The final product and discussion/critique of this project is to be completed online with the class in Unit 8.
Course Outcomes
This assignment enables the student to meet the following Course Outcomes:
CO 1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO 1)
CO 5: Identify patient care technologies, information systems, and communication devices that support safe nursing practice. (PO 5)
CO 6: Discuss the principles of data integrity, professional ethics, and legal requirements related to data security, regulatory requirements,
confidentiality, and client’s right to privacy. (PO 6)
CO 8: Discuss the value of best evidence as a driving force to institute change in delivery of nursing care. (PO 8)
Guidelines
• This is a Team or Group project. You will be assigned to groups, and given a topic (According to class size—typically 3-5 students
will be in a group).
Please do not ask to change groups, etc. as the group will not be changed. As nurses, we need to be able to participate as a part of a
multidisciplinary team, no matter where we are located, and regardless of whether or not we are familiar with a particular individual!
All group members will receive the same grade for each deliverable, UNLESS it is determined that a group member has not been
participating in assigned portions of the project. This is why documentation and communication in the assigned Team discussion
threads is essential. EVERYONE must complete/sign the Team Charter Form and place it in your designated Group discussion
thread under “Team Collaboration” in Course Home.
1. Communicate with your team members in the “Team Collaboration” Area of your Course Home, located under Week 8.
NR360 Information Systems in Healthcare
Team Technology Presentation Guidelines and Grading Rubric
Revised: 01/26/2014, 07/09/2014 09/12/2014 DA
***You will use the Group Project Team Collaboration Threads in the Course home as a “meeting” or communication venue. Be
sure you are documenting in YOUR Team’s discussion area, identified by a color assigned to your team! This will also serve as
documentation/verification for group members should there be ins.
NR443 Guidelines for Caring for PopulationsMilestone 2 Assess.docxhenrymartin15260
NR443 Guidelines for Caring for Populations
Milestone 2: Assessment and Diagnosis
Purpose
The purpose of this paper is to provide an opportunity to utilize community assessment strategies, uncover a community health problem, and identify the components of the problem related to the community dynamics.
Course Outcomes
This assignment enables the student to meet the following Course Outcomes.
CO 1. Evaluate the planning of delivery of care to individuals, families, aggregates, and communities in a variety of healthcare settings based on theories and principles of nursing and related disciplines. (PO 1)
CO 2. Integrate clinical judgment in professional decision-making and implementation of the nursing process through analysis of community health nursing practice. (PO 4)
CO 7. Accept accountability for personal and professional development as part of the life-long learning process. (PO 5)
Due Date
Submit to the appropriate basket in the Dropbox by 11:59 p.m. MT Sunday of Week 4.
Points
225 pointsDirections
This paper is expected to be no more than four pages in length (not including the title page and reference list). Typical papers are usually three pages. Below are the requirements for successful completion of this paper.
· Introduction: This should catch the reader’s attention with interesting facts and supporting sources and include the purpose statement of the paper. This should be no more than one or two paragraphs.
· Community: Identify the community by name that you will be using for this paper and provide a brief, general description of the community. Your community should be the area where you live or work. This should be one or two paragraphs.
· Demographic and epidemiological data: Compile a range of demographic (population description) and epidemiological (causes of health problems and death) data for your community by examining census reports, vital statistic reports, city records, morbidity and mortality reports, and other agency sources. Using these data, describe the community and the problem. Compare your community data to state or national data. This comparison will help to identify a community health problem specific to your community. A summary of these data should be no more than one page.
· Windshield survey: Provide a brief summary of the findings from your first assignment. Make sure to discuss elements that link your observations to your identified problem. This should be no more than one or two paragraphs.
· Problem: Using the assessment data, identify the problem that you consider to be a priority concern. Provide a rationale for your choice and relate your choice to one of the Healthy People 2020 specific numbered objectives. Healthy People objectives are located within a topic area under the Objectives page. Your rationale should also include why this is specifically a problem in your community. This should be no more than three paragraphs. Include support of your rationale with at least two scholarly sources such.
Nowak Aesthetics, was founded by Dr. Eugene Nowak in 1999, in Ch.docxhenrymartin15260
Nowak Aesthetics, was founded by Dr. Eugene Nowak in 1999, in Chula Vista, California; since then Nowak Aesthetic mission has been to serve residents throughout San Diego County for dermatological, cosmetic surgery and skin rejuvenation procedures.
Dr. Nowak it is a Board Certified Dermatologist; with one mission, to help their patients regain confidence in themselves and achieve desired look, not being an issue if is a dermatology or cosmetic procedure. To accomplish this, he has created his own formula in skin care products for patients with acne, and melisma conditions, also treats patients with eczema, birthmarks, psoriasis, sun spots caused by sun damage, which may cause cancer, rosacea, vitiligo or any other skin condition.
Dr. Nowak is conservative, and innovative on his cosmetics procedure. His mission it is to help patients to look better, and achieve their goals.
Overall he promotes, an exceptional customer service to each of his patients, assuring every patient gets an extraordinary experience at Nowak Aesthetics.
Nowak Aesthetics has 4 consecutive years, being in the top 5 in all San Diego County dermatologists
In Aesthetics Nowak received daily about 80 patients of whom 20% are medical consultations, the other 80% is basically cosmetic consultations or procedures. Each patient is offered a free skin analysis, regardless of the reason why we visit. Provides medical consultations for skin problems at very reasonable and affordable cost to patients who do not have medical insurance, I think these plans with the purpose of benefiting patients who do not have the resources to treat their skin problems; Nowak Aesthetics has a special program for the community, which donates baskets with products from Dr.Nowak’s skin care products, for schools in San Diego County, for the auctioned in their events and raise funds.
In addition to patients, visiting Nowak Aesthetics, for cosmetic consultations, first consultation is at no cost, given the opportunity to meet patients Nowak Aesthetics facilities, meet the staff, which always gets a smile every patient regardless of their financial status, and furthermore every cosmetic consultation, gives each patient a free evaluation with no obligation, concerning the service for which the patient visited Nowak Aesthetics.
Nowak Aesthetics has a protocol To receive each of our patients, in a personalized way. Every time you register a new patient was taking a photo, which is on file, on the other hand there is also a section in the patient's file where is written to any specification of the patient, what he likes, or do not like, as he prefers to be called, among other concerns. As patients continue to attend Nowak Aesthetics, certain patients are considered VIP patients. The reasons why a patient becomes VIP, may be, because they are people with positive attitude when they reach Aesthetics Nowak sees them as family, others may become VIP, because they are consistent in their cosmetic procedures, an.
NR305 Health Assessment Course Project Milestone #2 Nursing Di.docxhenrymartin15260
NR305 Health Assessment
Course Project Milestone #2: Nursing Diagnosis and Care Plan Form
Your Name: Date:
Your Instructor’s Name:
Directions: Refer to the Milestone 2: Nursing Diagnosis and Care plan guidelines and grading rubric found in Doc Sharing to complete the information below. This assignment is worth 250 points, with 10 points awarded for clarity of writing, which means the use of proper grammar, spelling and medical language.
Type your answers on this form. Click “Save as” and save the file with the assignment name and your last name, e.g., “NR305_Milestone2_Form_Smith” When you are finished, submit the form to the Milestone 2 Dropbox by the deadline indicated in your guidelines. Post questions in the Q&A Forum or contact your instructor if you have questions about this assignment.
1: Analyze Assessment Data:
Based on the health history information, identify the following:
A. Areas for focused assessment (30 points)
Provide a brief overview of those areas of strength and weakness noted from Milestone 1: Health History.
B. Client’s strengths (30 points)
Expand on areas identified as strengths related to the person's overall health. Support your conclusions with data from the textbook.
C. Areas of concern (30 points)
Expand on areas previously identified as abnormal and those that place the person at a health risk. Support your observations with data from the textbook.
D. Health teaching topics (30 points)
Identify health education needs. Support your statements with facts from the Health History and information from your textbook.
2: Nursing Care Plan
Next, plan your care based on your analysis of your assessment data:
A. Diagnosis (30 points)
Write one nursing diagnosis that reflects a priority need for this person. Remember a wellness diagnosis is a possibility.
B. Plan (30 points)
Write one goal and one measurable expected outcome related to your nursing diagnosis. Explain why this goal and outcome is a priority. Include cultural considerations for this client.
C. Intervention (30 points)
Write as many nursing orders or nursing interventions that you need in order to achieve the outcome. Provide the rationale for each intervention listed.
D. Evaluation (30 points)
You will not carry out your care plan so you cannot evaluate the effectiveness of your nursing interventions. Instead, comment on what you would look for in order to evaluate your effectiveness.
Milestone #2: Nursing Diagnosis and Care Plan Form 8-6-13 jm
2
NR 305 Health Assessment
Guidelines for Course Project Milestone 2:
Nursing Diagnosis and Care Plan AssignmentPurpose
This activity will be a continuation of the Milestone 1: Health History that you submitted in Week 4. In this part of the assignment you will take the information you gathered, analyze the data, and develop a nursing care plan.Course Outcomes
This assignment enables the student to meet the following course outcomes:
CO #3: Utilize effective communication when performing a .
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
Delivering Micro-Credentials in Technical and Vocational Education and TrainingAG2 Design
Explore how micro-credentials are transforming Technical and Vocational Education and Training (TVET) with this comprehensive slide deck. Discover what micro-credentials are, their importance in TVET, the advantages they offer, and the insights from industry experts. Additionally, learn about the top software applications available for creating and managing micro-credentials. This presentation also includes valuable resources and a discussion on the future of these specialised certifications.
For more detailed information on delivering micro-credentials in TVET, visit this https://tvettrainer.com/delivering-micro-credentials-in-tvet/
12. cessing” (Parham & Mailloux, 1996, p. 307). These “func-
tional disorders” are believed to be manifested in overt
behavioral challenges, such as problems with sensory dis-
crimination, perception, proprioception, tactile discrimina-
tion, visual perception, and vestibular processing (Parham
& Mailloux, 1996). An unregulated sensory system may
also inhibit the acquisition of positive skills, such as aca-
demics and socialization competencies (e.g., O’Brien &
Pearson, 2004).
Grandin (1992) posited that “deep pressure,” part of SIT,
can provide a “calming effect” for persons with PDD, since
some believe that persons with autism display high levels of
arousal (e.g., Hardy, 1990). Other methods of providing
“sensory input” include adding weight to vests and back-
packs (e.g., VandenBerg, 2001) and brushing parts of the
body (e.g., Stagnitti, Raison, & Ryan, 1999).
Many researchers have attempted to experimentally
examine the effect of sensory integration procedures (see
reviews of this literature by Arendt, MacLean, & Baumeister,
1988; Baranek, 2002; Daems, 1994; Hoehn & Baumeister,
1994; Miller, 2003; Parham et al., 2007). The general opin-
ion of these reviewers is that there is no consistent evidence
demonstrating a causal relationship between SIT and posi-
tive changes across numerous dependent variables (e.g.,
Parham et al. 2007; Shaw, 2002). For example, VandenBerg
(2001) examined the effect of a weighted vest to increase
on-task behavior of children diagnosed with attention-defi-
cit/hyperactivity disorder (ADHD). Four children between
the ages of 5 and 10 years participated in the study. All had
a diagnosis of ADHD and were receiving school-based
occupational therapy services due to a “sensory modulation
problem” (p. 623), described as “excessive movement”
13. 525663 FOAXXX10.1177/1088357614525663Focus on Autism
and Other Developmental DisabilitiesSniezyk and Zane
research-article2014
1Crossroads Center for Children, Schenectady, NY, USA
2Endicott College, Beverly, MA, USA
Corresponding Author:
Carolyn J. Sniezyk, Crossroads Center for Children, 1136 North
Westcott Road, Suite 100, Schenectady, NY 12306, USA.
Email: [email protected]
Investigating the Effects of Sensory
Integration Therapy in Decreasing
Stereotypy
Carolyn J. Sniezyk, MS, BCBA1 and Thomas L. Zane, PhD,
BCBA-D2
Abstract
Sensory Integration Therapy (SIT) is a popular treatment for
Pervasive Developmental Disorders that involves therapists
using various strategies and manipulanda to provide sensory
stimulation to improve behavioral dysfunctions. Although SIT
is popular, the research literature demonstrates little
experimental proof of effectiveness. Many published studies
find little
to no causal relationship between SIT and improvements in
target behaviors. There are numerous internal and external
validity threats that preclude confidence in a functional
relationship for those studies that report positive changes. The
current study attempted to evaluate the impact of different SIT
techniques on the behavioral excesses of children diagnosed
with autism, while using research designs that adhered to
commonly accepted standards for internal and external validity
controls. The results showed that there was no causal
relationship between the sensory procedures and improvements
14. in
the targeted dependent variables. Thus, SIT remains an
unproven treatment for autism.
Keywords
autism spectrum disorders, sensory integration, stereotypy
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
mailto:[email protected]
http://foa.sagepub.com/
14 Focus on Autism and Other Developmental Disabilities 30(1)
characterized by constantly moving, touching body parts,
being out of seat without authorization, laying and rolling
on the floor, and demonstrating extreme difficulty in sus-
tained attention and task completion. Experimenters mea-
sured the total time on-task during fine motor activities in
their classrooms. The intervention consisted of the children
wearing a denim vest to which were added weights of up to
5% of the child’s body weight.
VandenBerg used a single-subject “AB” sequence of
phases (Cooper, Heron, & Heward, 2007), with data first
being taken without, and then with, the children wearing the
vests. There were six sessions each of baseline and inter-
vention. Results seemed to show an increase of on-task
behavior for each child, based on comparisons of child per-
formance to a celeration line indicating statistical signifi-
cance, as determined by a standard deviation of two or
greater. VandenBerg thus concluded that the weighted vest
was an effective intervention to decrease sensory-based
problem behaviors in children with ADHD.
15. However, there were several potential limitations of this
study. First, the use of an AB sequence limits confidence in
any claim of a functional relationship between the interven-
tion and changes in subject behavior (e.g., Cooper et al.,
2007). Second, although observers were trained to take the
on-task data, this training took place prior to the beginning
of the study, and there were no inter-observer reliability
checks done during the baseline and intervention condi-
tions. Thus, there is no confirmation of the accuracy of
observations during the actual implementation of the
weighted vest procedures. In addition, the observers were
not blind to when the experimental condition was used,
raising the possibility of “expectancy bias” as a threat to
interval validity. Finally, the determination of significant
results was based on statistical analysis, rather than a visual
inspection of data for which there is a requirement of stabil-
ity over time.
Fertel-Daly, Bedell, and Hinojosa (2001) examined the
effect of a weighted vest on five young children ages 2 to 4
years, diagnosed with PDD. The researchers measured
attention to task, duration of different stereotypic behaviors,
and the number of distractions exhibited by the children
during a brief activity. Using a reversal design (Cooper et
al., 2007), the experimenters had the children alternate
between wearing and not wearing the vest. Each of the five
participants showed lower rates of attention in baseline,
higher rates during intervention, and reduced rates in the
second baseline phase. Only one subject showed the same
reversal pattern for the duration of stereotypic behaviors;
that is, there was a failure to replicate the higher baseline
phase with four of the five subjects.
Although this study seemed to support the hypothesis
that the weighted vest was functionally related to improve-
16. ments in these particular behaviors, the possibility of con-
founding variables influencing the results cannot be ruled
out. For example, Fertel-Daly et al. (2001) noted that
increased attention after a weekend could have been due to
the children being in a more calm and structured context
(i.e., school) than over the weekend. Most disconcerting,
however, is the fact that reliability data on the dependent
variables, and procedural fidelity data were not reported,
and the raters were not blind to the conditions being
implemented.
Van Rie and Heflin (2009) conducted a study empirically
investigating the causal relationship between sensory pro-
cedures and positive changes in learning. The rationale for
this study was the possible relationship between sensory
dysfunction and learning. An individual engaging in stereo-
typy and other repetitive behaviors may do so because of
difficulty in processing sensory input as is typically done.
An “optimal level of arousal” is needed for learning, and
stereotypy may interfere with this. Thus, Van Rie and Heflin
focused on using sensory procedures in an attempt to pro-
duce this optimal state of arousal and assess whether the
students then learned better. Four young children (aged 6–7
years) diagnosed with autism participated in the study. All
these children exhibited behaviors that could be interpreted
as being sensory based, such as bounding, looking away
from ongoing tasks, jumping up from the floor or chairs and
running away from instructional activities, walking on tip-
toes, and engaging in verbal stereotypy. Using an alternat-
ing treatments design, Van Rie and Heflin counterbalanced
implementing a control condition of a teacher reading a
story to the child, with sensory activities, of swinging or
bouncing on a ball, during 5-min sessions. The authors
measured the percentage of correct responses the children
made on selected academic tasks (receptive or expressive
17. identification of community helper and safety signs flash-
cards) during instructional sessions immediately following
the implementation of the independent variables.
The authors reported mixed results. A functional rela-
tionship between a sensory procedure and positive learning
was demonstrated for two of the four children. One student
showed better learning after the swinging intervention, and
the other student improved after bouncing on the ball. For
the other two children, no clear functional relationship
could be shown. In addition to showing some positive
results, Van Rie and Heflin provided an excellent model of
state-of-the-art experimental methodology by building into
their design commonly accepted research standards, such as
the measurement of both dependent measure and proce-
dural fidelity reliability, social validity assessments, a
strong experimental design, random assignment of partici-
pants to conditions, and rigorous data collection and
interpretation.
Schaaf et al. (2013) conducted a recent test of sensory
integration procedures with 32 children diagnosed with
autism spectrum disorder ranging in ages between 4 and 8
years. Using a manualized sensory integration intervention,
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
Sniezyk and Zane 15
the researchers implemented the treatment 3 times per week
during hour-long sessions, for 10 weeks. Dependent mea-
sures included standardized assessments in the sensory and
18. cognitive areas, and a general goal attainment assessment.
The researchers reported significantly higher scores on the
outcome variables after treatment, providing support for the
sensory procedures used. A strength of this study involved
the measurement of fidelity of implementation of the proce-
dures. A potential limitation involved assessing progress
through the use of standardized assessments instead of
direct measurement of target behaviors hypothesized to be
affected by the sensory procedures.
In summary, although sensory procedures are widely
used clinically (e.g., Olson & Moulton, 2004), there is a
lack of experimental literature using well-designed research
protocols supporting the effectiveness of sensory integra-
tion procedures on challenging behaviors exhibited by chil-
dren with autism (see Smith, Mruzek, & Mozingo, 2005, for
a review of this field). Dubouloz, Egan, Vallerand, and von
Zweck (1999) noted that, in the past, some members of the
occupational therapy field felt threatened by a focus on
making treatment decisions based on sound research.
Currently, there seems to be a clear trend in occupational
therapy, at least in the number of articles published about
“evidenced-based practice” (EBP), that this conceptual
framework is becoming the guiding principle in practice
(Ottenbacher, Tickle-Degnen, & Hasselkus, 2002).
Professionals must demonstrate a cause-and-effect relation-
ship between their techniques and improvements in their
clientele (Goldstein, 2000). Ottenbacher et al. (2002) advo-
cated for occupational therapists to pursue EBP more vigor-
ously in an attempt to empirically verify the effectiveness of
procedures in this field. They called occupational therapists
to “develop and use the skills necessary to plan treatment
strategies for individual clients based on what is supported
by evidence” (p. 247).
The purpose of the current study was to experimentally
19. evaluate the effect of various sensory techniques on the ste-
reotypy of three children diagnosed with autism. Several
specific questions were to be addressed. Will students
engage in less stereotypy after being exposed to slow ves-
tibular movements via the swing? Will students engage in
less stereotypy after being provided deep pressure? Will the
use of a sensory diet decrease rates of stereotypic
behavior?
Method
Participants
Three children (two males and one female) attending a pre-
school program for children with developmental disabilities
served as participants. All students participated in speech
and language testing using the Preschool Language
Scale–Fourth Edition (Zimmerman, Steiner, & Pond, 2002)
and cognitive testing using the Battelle Developmental
Inventory–Second Edition (Newborg, 2005). Tristan was 3
years, 5 months of age with receptive and expressive lan-
guage standard scores (SS) of 59 and 58, respectively, and
received an SS of 60 on measures of cognitive ability. He
was non-verbal, used a Picture Exchange Communication
System (PECS) to communicate, and engaged in stereo-
typic behaviors and active non-compliance to the extent
that performance of academic and social tasks were
interrupted.
CJ was also non-verbal and was learning to utilize PECS
for communication. He was 2 years, 10 months of age and
earned SS of 50 and 58 for receptive and expressive lan-
guage skills, respectively, and functioned in the Mild
Developmental Delay range (SS of 71) of cognitive ability.
CJ engaged in self-injury, active non-compliance, and ste-
20. reotypic behaviors that interfered with attention to task and
disrupted group activities.
Rosie was 2 years, 9 months of age at the onset of the
study. Testing revealed that her cognitive ability fell within
the Mild Developmental Delay range (SS of 73) with recep-
tive and expressive language scores being 3 standard devia-
tions below the mean (SS of 50 on both measures). She
engaged in stereotypy and tantrums that disrupted perfor-
mance on tasks and interrupted social exchanges, had no
functional language, and was working on verbal imitation
skills at the onset of the project. All children were diag-
nosed with autistic disorder by a developmental pediatri-
cian prior to participating in the study.
Program Description
All participants attended a preschool program that utilized a
treatment philosophy based on applied behavior analysis.
The program operated 5 days per week for 5½ hr each day.
The classrooms were organized by level of student func-
tioning rather than age range. Children placed in this pro-
gram received from 0 to 2½ hr of discrete trial training per
day depending on their level of cognitive functioning,
speech and language skills, socialization skills, and behav-
ioral excesses. They also received speech therapy, occupa-
tional therapy, and physical therapy as needed based on
their initial evaluation.
Target Behavior and Response Measurement
Stereotypy was chosen as the target behavior for measure-
ment for all three participants. Staff believed that this
response class negatively affected classroom performance
and learning, and was an important intervention target.
Stereotypy was defined as a rhythmic, repetitive, exagger-
21. ated or unusual tightening of the muscles of either a particu-
lar body part or entire body, in the absence of an appropriate
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
16 Focus on Autism and Other Developmental Disabilities 30(1)
environmental context. Functional assessments of behavior
were conducted for all three participants. In each case sen-
sory/automatic reinforcement was identified as the primary
function. The data collection system chosen for the study
was 10-s partial interval recording.
Research Design
A within-subjects reversal design (Cooper et al., 2007) was
chosen. First steady state responding during an initial base-
line period was established, and then SIT (in whatever form
it was prescribed by the occupational therapist for each
child) was implemented. A return to baseline phase would
have been conducted if, during the treatment phase, there
was a visually clear pattern of the target behaviors changing
in a positive way from the trend in the initial baseline phase.
If, during the second baseline phase, it was determined that
the behavioral trend matched the trend in the initial baseline
phase, the treatment would have been implemented again.
Settings and Procedures
The investigators met with the occupational and physical
therapy (OT/PT) staff to discuss the target behaviors and
possible interventions. In all cases, the OT/PT staff hypoth-
22. esized that the participants were over-stimulated and
engaged in the behavior as a means to “calm their sensory
systems.” Three different treatment plans were proposed by
the OT/PT department to reduce stereotypy. All plans were
chosen based on their hypothesized calming effects.
Tristan. Snack time was chosen as the target setting for
Tristan. A net swing was used to treat his stereotypy. This
technique was chosen based on the observation by the OT/
PT staff that the net swing seemed to produce a calming
effect for Tristan. During baseline, on a daily basis, a staff
member brought Tristan to the OT/PT room prior to partici-
pating in snack time; however, he was not placed on the net
swing. The staff simply sat on the floor with him and sang
to him.
During treatment, a staff member brought him to the OT/
PT room at which time he was placed in the net swing and
gently pushed back and forth by the staff. The staff placed
him in the net swing on a pillow and slowly and rhythmi-
cally swung him from side to side for 3 to 5 min while sing-
ing to him. He was then removed from the swing and
brought back to the classroom to participate in snack. This
procedure was conducted once per day.
CJ. Circle time was chosen as the target setting for CJ. He
was provided with “deep pressure” in an effort to reduce ste-
reotypy during the activity immediately following the sen-
sory technique. The baseline condition involved observing
CJ during circle using a 10-s partial interval recording sys-
tem. For the intervention, prior to the daily onset of circle
time, a staff member provided CJ with “deep pressure” by
prompting CJ to sit down in a chair, sitting behind CJ, placing
her hands on CJ’s shoulders (left hand on his left shoulder
and right hand on his right shoulder), pushing down for 2 s
23. and releasing for 2 s. The staff member repeated this 5 times
before moving to the next body part (e.g., bicep). The staff
member applied pressure to each bicep for 2 s and released
for 2 s, moving down the arm 2 to 3 in. at a time. The staff
member repeated the same procedure starting at CJ’s thighs
and moving down to his ankles (left hand on left thigh and
right hand on right thigh). Finally, the staff member provided
“deep pressure” to CJ’s trunk (left hand on left side of trunk
and right hand on right side of trunk) and moved down to his
waist. This procedure took approximately 2 min to complete
and was conducted once per day.
Rosie. Circle time was the target setting chosen for mea-
surement; however, Rosie was exposed to the sensory diet
throughout the entire day. To establish baseline levels of the
target behavior, Rosie was observed during circle time
using a 10-s partial interval recording system. Four activi-
ties comprised the sensory diet and staff exposed her to one
of the four activities on a half-hour rotating schedule. The
four activities were “deep pressure” via heavy work activi-
ties, “deep compression” via the therapy ball, joint com-
pressions, and the “meatball squeeze.” It was hypothesized
that this type of schedule would reduce stereotypy during
the entire day.
“Deep pressure” via heavy work activities involved the
therapist placing three gallon-sized laundry detergent bot-
tles filled with water on small utility cart/stroller. The thera-
pist prompted Rosie to push the cart with both hands up and
back the entire length of the hall in the school. This proce-
dure took approximately 3 to 5 min to complete.
Staff provided Rosie with “deep compression” via the
therapy ball by prompting Rosie to lie down on her stom-
ach, placing the therapy ball on Rosie’s back and applying
gentle pressure down onto the ball. The therapist rolled the
24. ball from Rosie’s shoulders, down her back, over her but-
tocks, and down to her calves. They then reversed the
motion of the ball to return back to her shoulders. This pro-
cedure was repeated 15 times and took approximately 2 min
to complete.
The therapist provided Rosie with joint compressions on
the following joints: elbow, wrist, fingers, hip, knee, and
ankle (both left and right sides of the body). The therapist
placed one hand just below the joint and one hand above the
joint on Rosie, gently compressed the joint together, and
then released compression. The compression was repeated
at all joints 10 times at a rate of 1 compression per second.
Joint compressions could be applied to all the above men-
tioned joints in approximately 2 min.
To implement the “meatball squeeze,” the therapist sat
Rosie in front of her (therapist and Rosie facing the same
direction), bent Rosie’s knees up and crossed her arms in
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
Sniezyk and Zane 17
front of her chest and knees (fetal position). The therapist
wrapped her arms around Rosie with the therapist’s hands at
Rosie’s shins while she was in this position and gently
squeezed Rosie for 10 s and then released. The therapist
repeated the squeeze 10 times. The “meatball squeeze” took
approximately 3 min to complete.
Inter-Observer Agreement (IOA) and
25. Procedural Fidelity
We obtained dependent measure and procedural reliability
checks on a minimum of 25% of all sessions across the par-
ticipants. A second independent observer viewed the ses-
sion and collected data on the occurrence of the target
behaviors. IOA was calculated by dividing the number of
10-s intervals with agreements by the number of 10-s inter-
vals with agreements plus disagreements and multiplying
by 100. The mean IOA was 97.3% (range, 96.5%–97.8%).
To determine procedural fidelity, the OT who designed
the intervention trained all staff to implement the proce-
dures and signed off on their competence. She then viewed
a minimum of 25% sessions for Tristan and CJ via video-
tape and observed 98.8% (range, 97.5%–100%) accuracy in
implementing the procedures, using the attached procedural
fidelity checklist (see appendix). Due to the high frequency
with which techniques were implemented with Rosie (rotat-
ing through 11 opportunities throughout each day for sev-
eral months), it was not feasible for the OT to observe 25%
of sessions. However, she viewed each intervention twice.
The fidelity of implementing the sensory procedures ranged
from 83% to 100% (M = 92.5%).
Results
Tristan engaged in the target behavior during an average of
29% (range, 26%–31%) of intervals during baseline (see
Figure 1). The average number of intervals during which he
engaged in the target behavior during intervention was 40%
(range, 31%–62%). A return to baseline condition was not
conducted because the levels of the behavior increased
rather than decreased.
Data for CJ are displayed in Figure 2. CJ engaged in the
26. target behavior during an average of 36% of intervals dur-
ing baseline (range, 22%–58%). The average number of
intervals during which he engaged in the target behavior
during intervention reduced to 28% (range, 24%–25%). We
then returned to baseline conditions and the occurrence of
the target behavior continued to trend downward (M = 9%;
range, 4%–10%).
Figure 3 depicts the percentage of intervals in which
Rosie engaged in the target behavior over four phases.
Phase 1 was the baseline condition during which Rosie
engaged in the target behavior on an average of 23.9% of
intervals (range, 8%–54%). Phase 2 was the intervention
condition consisting of 3 data points, these being the last 3
days of school prior to summer recess. She engaged in the
target behavior during an average of 15.3% of intervals
(range, 9%–23%). After the summer recess, Rosie began
program in a new classroom with new staff members. All
staff members were trained as described previously. Phase 3
depicts data collected during circle time with the interven-
tion in place in the new classroom. Rosie engaged in stereo-
typy between 8% and 14% of intervals (M = 13.3%) during
this condition. We returned to baseline in Phase 4. There
0
20
40
60
80
100
27. 1 5 10
%
o
f i
nt
er
va
ls
Sessions
Baseline Swing Intervention
Figure 1. Percentage of intervals of stereotypy for Tristan.
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
18 Focus on Autism and Other Developmental Disabilities 30(1)
was a further reduction in the percentage of intervals with
which Rosie engaged in the target behavior (M = 3.7%,
range 0%–8%).
Discussion
The purpose of this investigation was to use well-designed
experimental procedures to investigate several questions
pertaining to the effectiveness of different sensory proce-
28. dures on reducing various self-stimulatory behaviors of
children diagnosed with autism. We wanted to explore
whether students engaged in less stereotypy after being
exposed to slow vestibular movements via the swing. In
addition, would students engage in less stereotypy after
being provided with “deep pressure,” and would the use of
a “sensory diet” decrease rates of stereotypic behavior?
Based on recommendations by the participants’ occupa-
tional therapists, sensory procedures were implemented
according to the protocols established by the OTs.
Dependent measure and procedural fidelity were assessed
and found to be at acceptable levels. The results showed
that with no participant was there a clear functional rela-
tionship between positive changes in dependent measures
and the implementation of sensory procedures. In the cases
where there was reduced behavior during the SIT phase, the
behavior continued to decrease when SIT was removed,
suggesting that the initial reduction was not causally related
to the SIT procedures.
These results correspond with much of the literature
about the effectiveness of sensory integration procedures on
problem behaviors of persons with autism spectrum
disorders (e.g., Parham et al., 2007; Smith et al., 2005).
Reviewers of the literature report inconsistent results at
best. Often, when results seem promising, there are obvious
research design flaws, such as no reliability of measurement
or uncontrolled threats to internal validity. However, Van
Rie and Heflin (2009) conducted a study that met rigorous
research standards, and found some positive results, as did
Schaaf et al. (2013). More research, with the same level of
care when designing methodological controls approximat-
ing Van Rie and Heflin, is sorely needed. Strengths of the
current study include the use of a tightly designed investiga-
tion of sensory integration procedures and utilization of
29. common research methodologies to enhance both the inter-
nal and external validity of the outcomes.
With Tristan, the swing had no decelerative effect;
indeed, the target behavior actually increased slightly in
rate during intervention. Prior to the study, Tristan’s OT
noted that based on observation, Tristan seemed to be calm
during swinging. Post results, the OT could not explain why
the intervention had an excitatory effect; she noted that lin-
ear movement is typically calming and organizing; a rotary
movement would be considered to produce an excitatory
reaction, and could not speculate why swinging had such an
opposite effect on Tristan. In this case, there are at least two
possible explanations. First, perhaps the OT’s initial obser-
vations of Tristan—that he seemed to calm during swing-
ing—were simply in error or biased. Without objective
assessment based on data, the true nature of what transpires
may be lost. Second, it is highly likely that there are signifi-
cant differences across individuals with regard to respon-
siveness to sensory stimulation. That is, individuals are
0
20
40
60
80
100
1 5 10 15
%
30. o
f i
nt
er
va
ls
Sessions
Baseline Deep Pressure Baseline
Figure 2. Percentage of intervals of stereotypy for CJ.
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
Sniezyk and Zane 19
likely to respond to sensory stimuli as differently as they do
to other environmental stimuli. A sensory theory predicting
similar outcomes across different individuals seems
unlikely.
The data collected for CJ do not reveal a functional rela-
tionship between “deep pressure” and stereotypy. While the
target behavior did decrease in occurrence, it is important to
note that the intervention data were within the same range
as baseline; however, levels were more stable. The contin-
ued decrease in the occurrence of the target behavior during
the return to baseline condition does not allow a confident
31. assumption of a functional relationship between the inter-
vention and the target behavior. Some potential explana-
tions for this post-intervention reduction include maturation
or a cumulative effect of the intervention. A cumulative
effect is unlikely based on the large lapse in time in between
intervention and return to baseline. Any residual effects of
the treatment would most likely have worn off during this
time. It should be noted that the intervention phase was ter-
minated on the completion of the extended school year pro-
gram in August. CJ changed classrooms when school
commenced in September. Although the change in class-
rooms may be a confounding variable, it was considered to
be a natural opportunity to terminate the intervention phase.
Moreover, it is unlikely that the change in environment pro-
duced a decrease in the target behavior because CJ’s alleged
internal sensory issues would still be present in the new
classroom. CJ did experience some difficulty with the tran-
sition to the new classroom. He frequently engaged in tan-
trum behavior that resulted in staff prompting. Data were
not collected on days that CJ engaged in tantrum behavior
because his tantrum behavior was incompatible and inter-
fered with the observation of the target behavior.
Rosie is another child for whom a functional relationship
between improved behavior and the implementation of sen-
sory procedures cannot be established. Possible explana-
tions for the observed decreased occurrence of the target
included are the same as for CJ. In terms of maturation, it
should be noted that Rosie began imitating words and inde-
pendently initiating verbalizations after the break in
November. In addition, one would not expect the level of
behavior to continue to decrease after the intervention was
removed. The argument is the same for whether or not a
cumulative effect was observed. One would not expect con-
tinued improvements over intervention levels. It would seem
32. that this would be an adequate amount of time for any effects
of the treatment to “wear off” and therefore, one would
observe an increase in the occurrence of the target behavior.
In addition, there could be some unidentified confounding
variable, since Rosie developed a new behavior involving
manipulation of the seams in her clothes. This behavior was
not noted during baseline and the beginning stages of inter-
vention but became more prevalent as time went on. This
behavior is topographically incompatible with the target
behavior and may have interfered with its occurrence.
Several potential limitations should be addressed. There
was no placebo control condition, which could have served
as a test of the potential reactivity to having more attention
by an adult. We chose not to perform such a placebo condi-
tion because we were primarily interested in noting whether
0
20
40
60
80
100
%
o
f i
nt
er
33. va
ls
Sessions
Baseline Sensory Diet -New Classroom BaselineSensory Diet
1 5 10 15 20 25 30 35 40
Figure 3. Percentage of intervals of stereotypy for Rosie.
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
20 Focus on Autism and Other Developmental Disabilities 30(1)
or not there was any positive effect of sensory integration
procedures. A second potential limitation is that all aspects
of a reversal design were not implemented with Tristan.
With him, because the behavior did not change in a positive
way from the baseline to intervention phase, it was assumed
that going back to baseline would have again shown no sig-
nificant change and thus the intervention ended. If a return
to baseline had been implemented, there would have been
one of three outcomes—a decrease in rate, an increase in
rate, or no change in trend. None of these possibilities
would have changed the conclusion that the sensory proce-
dures had no positive impact. However, failure to return to
baseline is a potential limitation to the study’s design and
thus could affect the interpretation of the results.
Another potential limitation was the lack of blinded data
34. collection. We established the validity of the data through
frequent and carefully arranged reliability observations by
observers naïve to the purpose of the study. An additional
design issue concerns the break of the sessions between the
end of the school year and the beginning of the summer ses-
sion for Rosie. There was approximately a 2-week vacation
between the end of phase 2 and the beginning of phase 3. It
is doubtful that this recess influenced the effect of the sen-
sory procedures, since the behavior seemed to be minimally
affected prior to the vacation period. A final limitation con-
cerns the fact that different sensory procedures were used
across the three participants. The variability and implemen-
tation duration of these procedures could have had a con-
founding effect on the results. Although the sensory
procedures differed across the three participants, we believe
that this is not a weakness in our design. The procedures
varied across the participants because the occupational ther-
apist planned the procedures based on the unique needs and
characteristics of each child. We believe this treatment
validity overrides any methodological or experimental con-
cerns. It was important that each child received the therapy
best suited for that child, in the professional opinion of the
Occupational Therapist. To artificially implement treat-
ments for a child that were not identified to be best suited
for his or her unique needs, for the sake of experimental
rigor, may have detracted from the clinical significance of
the study. In addition, we used within-subject designs, using
each participant as his or her own control. Regardless of the
independent variable, the behavior measured during the
independent variable phase was compared with the same
behavior of the same participant during the baseline phases.
Thus, we did not need to worry about similarity of indepen-
dent variable across the three participants. We believe that
for sensory integration, we need to first determine if the
procedures—whatever they are—have any positive effect.
35. In our study, we provided three tests of three different
procedures.
This study contributes to the investigation of sensory
integration in several ways. First, the OTs—the profession-
als most often using sensory procedures—were given free
rein to determine what they thought were the behaviors to
be influenced by sensory procedures, and exactly what
those procedures would entail, including the exact steps of
the procedure, the duration of each application, the fre-
quency of applications daily, and how long-term the proce-
dures were used. Second, we implemented well-crafted
experimental designs that would allow an investigation of a
causal relationship, should the behavior seem to be sensi-
tive to the independent variables. Third, we rigorously
applied IOA procedures for all dependent variables, and
similarly checked procedural fidelity.
The clinical implication of this study is that service
providers must use sensory procedures with caution. The
current study adds more data from three participants to the
emerging conclusion that we cannot assume sensory pro-
cedures are evidenced-based. That is, the research that
exists on testing the effectiveness of SIT is at best incon-
clusive, at worst showing thus far that it is not an effective
treatment strategy. There does exist proven treatments that
can affect behaviors typically addressed by sensory proce-
dures, such as noncontingent reinforcement (e.g., Cox,
Gast, Luscre, & Ayres, 2009) and response interruption
and redirection (e.g., Ahrens, Lerman, Kodak, Worsdell,
& Keegan, 2011).
Future researchers should focus on developing clear pro-
tocols for testing sensory procedures. The sensory integration
professionals should drive these protocols; but the research-
ers need to develop research design methodologies to control
36. for threats to internal and external validity, and both depen-
dent measure and procedural reliability. The structure of the
experimental design is important to enhance, since if positive
results were ever discovered, there would be some confi-
dence that positive changes were due to the independent
variable(s) used. Only through a tightening of the experimen-
tal protocols to test sensory integration procedures could we
build a research foundation that provided any empirical sup-
port for this unsubstantiated treatment.
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
Sniezyk and Zane 21
Appendix
Treatment Fidelity Checklist
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect
to the research, authorship, and/or publication of this article.
“Deep pressure” via
heavy work activities Date Date Date
Holds cart with both
hands
Pushes cart to end
37. of hall
Pushes cart back to
class
Note. X = step implemented correctly; O = step implemented
incorrectly.
“Meatball squeeze” Date Date Date
Staff and Rosie sit on floor facing
the same direction
Rosie sits on staff’s lap
Bends Rosie’s knees to her chest
Wraps her arms around her
knees
Staff wraps arms around Rosie
Staff squeezes for 10 s and
releases
Repeats 10 s squeeze a total of
10 times
Note. X = step implemented correctly; O = step implemented
incorrectly.
38. Joint compressions Date Date Date
Staff grasps one hand above Rosie’s joint
and one hand below the same joint
Squeezes joint and release
Ten squeezes per joint
Left elbow
Left wrist
Left five fingers
Right elbow
Right wrist
Right five fingers
Left hip
Left knee
Left ankle
Right hip
Right knee
Right ankle
Note. X = step implemented correctly; O = step implemented
incorrectly.
Swing Date Date Date
Student sits on pillow in net swing
Staff moves slowly move swing from
side to side
Student is in moving swing for 3 to
5 min
39. Staff sings to student
Note. X = step implemented correctly; O = step implemented
incorrectly.
Joint compressions Date Date Date
Student sits in a chair
Staff sits in chair either in front or
behind student
Staff places left and right hand on
student’s left and right shoulder
Staff applies pressure by squeezing for
2 s and releasing
Staff moves hands down student’s arms
to the wrist, applying 2 s of pressure
every 2 to 3 in.
Staff place left and right hand on
student’s left and right thighs
Staff applies pressure by squeezing for
2 s and releasing
Staff moves hands down student’s legs
to the ankle, applying 2 s of pressure
40. every 2 to 3 in.
Staff places left and right hand on
student’s trunk under his or her left
and right arm
Staff applies pressure by squeezing for
2 s and releasing
Staff moves hands down student’s
trunk to his or her waist applying 2 s
of pressure every 2 to 3 in.
Note. X = step implemented correctly; O = step implemented
incorrectly.
CJ “Deep Pressure.”
Rosie Sensory Diet.
“Deep compression” via therapy ball Date Date Date
Rosie on stomach
Staff places ball on her back
Rolls to her ankles and back
Repeats 15 times
Note. X = step implemented correctly; O = step implemented
incorrectly.
Tristan Swing.
41. at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://foa.sagepub.com/
22 Focus on Autism and Other Developmental Disabilities 30(1)
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
References
Ahrens, E. N., Lerman, D. C., Kodak, T., Worsdell, A. S., &
Keegan, C. (2011). Further evaluation of response interrup-
tion and redirection as treatment for stereotypy. Journal of
Applied Behavior Analysis, 44, 95–108.
American Psychiatric Association. (2013). Diagnostic and
statis-
tical manual of mental disorders (5th ed.). Washington, DC:
Author.
Arendt, R., MacLean, W. E. Jr., & Baumeister, A. (1988).
Critique
of sensory integration therapy and its application in mental
retardation. American Journal of Mental Deficiency, 92,
401–411.
Ayres, A. J. (1979). Sensory integration and the child. Los
Angeles, CA: Western Psychological Services.
Baranek, G. T. (2002). Efficacy of sensory and motor inter-
ventions for children with autism. Journal of Autism and
42. Developmental Disorders, 32, 397–422.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied
behavior analysis (2nd ed.). Englewood Cliffs, NJ: Prentice-
Hall.
Cox, A. L., Gast, D. L., Luscre, D., & Ayres, K. M. (2009). The
effects of weighted vests on appropriate in-seat behaviors of
elementary-aged students with autism and severe to profound
intellectual disabilities. Focus on Autism and Developmental
Disabilities, 24, 17–26.
Daems, J. (Ed.). (1994). Reviews of research in sensory integra-
tion. Torrance, CA: Sensory Integration International.
Dubouloz, C. J., Egan, M., Vallerand, J., & Von Zweck, C.
(1999).
Occupational therapists’ perceptions of evidence-based
practice. American Journal of Occupational Therapy, 53,
445–453.
Fertel-Daly, D., Bedell, G., & Hinojosa, J. (2001). Effects of a
weighted vest on attention to task and self-stimulatory behav-
iors in preschoolers with pervasive developmental disorders.
American Journal of Occupational Therapy, 55, 629–640.
Goldstein, H. (2000). Commentary: Interventions to facili-
tate auditory, visual, and motor integration: “Show me the
data.” Journal of Autism and Developmental Disorders, 30,
423–425.
Grandin, T. (1992). Calming effects of deep pressure in patients
with autistic disorder, college students and animals. Journal
of Child & Adolescent Pharmacology, 2, 63–72.
Hardy, P. M. (1990, July). Anxiety and related disorders. Paper
43. presented at the Annual Conference of the Autism Society of
America, Los Angeles, CA.
Hoehn, T. P., & Baumeister, A. A. (1994). A critique of the
appli-
cation of sensory integration therapy to children with learning
disabilities. Journal of Learning Disabilities, 27, 338–350.
Lalli, J. S., Casey, S. D., & Kates, K. (1997). Noncontingent
rein-
forcement as treatment for problem behavior: Some proce-
dural variations. Journal of Applied Behavior Analysis, 30,
127–137.
McKerchar, T. L., Kahng, S., Casioppo, E., & Wilson, D.
(2001).
Functional analysis of self-injury maintained by automatic
reinforcement: Exposing masked social functions. Behavioral
Interventions, 16, 59–63.
Miller, L. J. (2003). Empirical evidence related to therapies for
sensory processing impairments. Communique, 31, 34–37.
Newborg, J. (2005). Battelle Developmental Inventory—Second
edition. Itasca, IL: Riverside.
O’Brien, G., & Pearson, J. (2004). Autism and learning
disability.
Autism, 8, 125–140.
Olson, L., & Moulton, H. J. (2004). Occupational therapists’
reported experiences using weighted vets with children with
specific developmental disorders. Occupational Therapy
International, 11, 52–66.
Ottenbacher, K. J., Tickle-Degnen, L., & Hasselkus, B. R.
44. (2002).
From the desk of the editor—Therapists awake! The chal-
lenge of evidence-based occupational therapy. American
Journal of Occupational Therapy, 56, 247–249.
Parham, L. D., Cohn, E. S., Spitzer, S., Koomar, J. A., Miller,
L.
J., Burke, J. P., . . .Summers, C. A. (2007). Fidelity in sensory
integration intervention research. The American Journal of
Occupational Therapy, 61, 216–226.
Parham, L. D., & Mailloux, Z. (1996). Sensory integration. In
J. Case-Smith, A. Allen, & P. Pratt (Eds.), Occupational
therapy for children (3rd ed., pp. 307–356). New York, NY:
Mosby.
Schaaf, R. C., Benevides, T., Mailloux, Z., Faller, P., Hunt, J.,
van
Hooydonk, E., . . .Kelly, D. (2013). An intervention for sen-
sory difficulties in children with autism: A randomized trial
(Department of Occupational Therapy Faculty Papers, Paper
15). Retrieved from http://jdc.jefferson.edu/otfp/15
Shaw, S. R. (2002). A school psychologist investigates sensory
integration therapies: Promise, possibility, and the art of pla-
cebo. Communique, 31, 5–6.
Smith, T., Mruzek, D. W., & Mozingo, D. (2005). Sensory inte-
grative therapy. In J. Jacobson, R. Foxx, & J. Mulik (Eds.),
Controversial therapies for developmental disabilities: Fad,
fashion, and science in professional practice (pp. 331-350).
Mahwah, NJ: Pergamon Press.
Stagnitti, K., Raison, P., & Ryan, P. (1999). Sensory
defensiveness
syndrome: A pediatric perspective and case study. Australian
45. Occupational Therapy Journal, 46, 175–187.
VandenBerg, N. L. (2001). The use of a weighted vest to
increase
on-task behavior in children with attention difficulties.
American Journal of Occupational Therapy, 55, 621–628.
Van Rie, G. L., & Heflin, L. J. (2009). The effect of sensory
activities on correct responding for children with autism spec-
trum disorders. Research in Autism Spectrum Disorders, 3,
783–796.
Vollmer, T. R., Iwata, B. A., Zarcone, J. R., Smith, R. G., &
Mazaleski, J. L. (1993). The role of attention in the treat-
ment of attention-maintained self-injurious behavior:
Noncontingent reinforcement and differential reinforcement
of other behavior. Journal of Applied Behavior Analysis, 26,
9–21.
Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (2002).
Preschool
Language Scales—Fourth edition. Bloomington, MN:
Pearson.
at UNIV OF NORTHERN COLORADO on March 19,
2015foa.sagepub.comDownloaded from
http://jdc.jefferson.edu/otfp/15
http://foa.sagepub.com/
Running head: PARENT GUIDE COMMUNITY INCLUSION
1
46. Guide to Including Children with Disabilities in
Community Settings in the Arab Gulf Region
Effat Shugdar
University of Northern Colorado
PARENT GUIDE COMMUNITY INCLUSION
2
Abstract
47. Many parents in the Arab Gulf Region avoid integrating their
children with disabilities into their
local community due to negative cultural beliefs about
disabilities and general unfamiliarity with
disabilities. Using information from research conducted in the
United States, successful
strategies for inclusion in community settings have been
identified that may be useful to parents
of children with disabilities in this region of the world.
Strategies which can be successful
include locating accessible activities when they exist,
increasing familiarity with specific
community settings and activities, finding opportunities for
children to communicate, managing
child behavior in public, and creating parent-to-parent
networks. The goal of the application of
successful strategies for community inclusion is to enable Arab
Gulf parents to understand, plan,
and develop ways to include their children with disabilities in
real activities taking place in their
own communities.
Keywords: inclusion, children with disabilities, community
settings, Arab Gulf Region
48. PARENT GUIDE COMMUNITY INCLUSION
3
Guide to Including Children with Disabilities in
Community Settings in the Arab Gulf Region
Families who have children with disabilities face numerous
obstacles for successful
inclusion of their children into different community settings.
Some of the consequences of
not participating in society include children with disabilities
being denied the right to live
their lives as others do, such as segregation of these children
from others and prohibitions
or limitations for these children to go outside and see different
places and people. This
exclusion from normal community life can lead to increased
behavioral and emotional
problems for these children. Such unfairness seriously hinders
49. children with disabilities’
awareness and experience to engage with others and to explore
the environment around
them.
The social and emotional development of children with
disabilities is affected by the
number of different settings and various kinds of interactions,
such as with peers without
disabilities, and people outside of school settings. Including
these students with significant
needs in the community will help the child engage in
interactions with other people more easily
(Bronfenbrenner, 1979). Children with disabilities feel more
comfortable when they are familiar
with a variety of community settings (Souza & Kennedy, 2003).
Families within societies where disability awareness and
disability rights are still
emerging as publicized and discussed issues are often hesitant
about including their children with
severe disabilities in the social milieu and activities of their
culture. Their hesitation may involve
fear of disapproval or embarrassment. Yet, this hesitation may
also have origins in uncertainty as
50. to how to make such an experience successful for themselves
and their children. As professionals
in the field of special education, we have a responsibility to
guide families in finding ways to
PARENT GUIDE COMMUNITY INCLUSION
4
include their children with severe disabilities in the larger
community around them. This
involves identifying and communicating to them strategies for
successful community inclusion.
This paper will explore first the experience of being a parent of
a child with a severe disability in
the Arab Gulf Region. Next, it will describe what is meant by
an effective strategy for
community inclusion. Lastly, it will examine specific strategies
that can help parents provide
opportunities for their children with severe disabilities to
experience life in the community.
An Arab Gulf Region Perspective on Having a Child with a
Disability
From previous experiences working with parents who have
children with severe
51. disabilities in the Arab Gulf Region, I have found that there is
only a small minority of parents
who are willing to include their children with disabilities in
community settings. On the one
hand, Arab Gulf society is more understanding and accepting of
children with hearing or vision
disabilities. The parents of these children often do not feel
devalued by including their children
in the community. On the other hand, parents of children
having disabilities with very evident
effects on their intellectual, physical, communication, or
emotional expression often avoid
engaging their child in different community settings, such as
going to restaurants, shopping,
traveling, or parties because the stigma and lack of knowledge
about these disabilities creates
more discrimination, guilt, and rejection.
There are three major reasons that reinforce Arab Gulf parents’
decisions to avoid
including their children with disabilities in a variety of
community settings. The first reason is
that parents who have children with disabilities may feel
ashamed to be accompanied by their
children with disabilities in the community or public areas
52. because of negative cultural
judgments about what can be expressed in public versus what is
private; i.e., what should be
permitted versus what should not be disclosed in the
relationship between family and the wider
PARENT GUIDE COMMUNITY INCLUSION
5
society. Further complicating the picture are feelings that some
Arab parents may have that they
are being viewed by their neighbors and others as having done
something corrupt, and are
therefore being punished by having a child with disabilities.
These parents then feel even more
ashamed and guilty to walk with their children with disabilities
in public view (Arab Gulf
Network for People with Disabilities, 2009). Yet, at the same
time, many of these parents are
also attempting to cope with perceptions that their children
should have the right to live life as
other individuals in Arab society. This mixture of emotions
regarding keeping what is in the
family in the family, shame over how others may view them,
53. and yet knowing that their children
deserve more than the sheltered life that they are providing
impacts not just the opportunities
their child with a severe disability will have over his/her
lifetime but also the interactions of
these parents with each other and with other members of the
community.
In Arab Gulf society, it is the mother who is primarily involved
with her child and who
plans and carries out activities for her children. This puts
increased pressure on mothers who
have a child with a disability, particularly when the child has
severe disabilities. Even in
countries where disability is more widely understood and
accepted, a mother’s anxiety of stigma
regarding her child may have a negative effect on her
relationship with her child, which further
encourages the mother to isolate her child from the community
(Groce, 1985). Mothers of
children with disabilities often feel devalued and discriminated
against from others who do not
have children with disabilities in the community. Since
communities tend to respond to these
mothers differently when contrasted with their responses to
54. children who have typically
developing children; this encourages the mother of child with a
disability to sometime feel
jealousy and anger toward the mother of a child without
disability (Geenen, Powers, & Lopez-
Vasquez, 2001). Because of longstanding cultural patterns,
these effects are even more
PARENT GUIDE COMMUNITY INCLUSION
6
pronounced in the Arab Gulf Region than in the United States
and other countries where
disability issues are more out in the open.
A second reason Arab Gulf parents may avoid including their
children with disabilities in
community settings is because of limitations in community
activities that are actually accessible
to children with disabilities in the Arab Gulf Region. There is a
lack of available and
accommodated facilities for these children to go to and enjoy,
such as public libraries, family
clubs, restaurants, and commercial shops. Al-Turaiki and
Joseph (2004) recommended that more
55. physical adaptations be constructed in public places to enhance
their accessibility for people with
disabilities, thereby helping encourage them to go places more
easily and spend enjoyable times
with their families.
The third and final reason for limited participation in
community settings, and the one to
be examined in detail here, is that parents are not educated
about how they can include their
children with disabilities in community settings. Ehrmann,
Aeschleman, and Svanum (1995)
reported that parents who have children with disabilities need
support in including their children
in community settings. Thus, parents who have children with
disabilities need instruction and
coaching which is vital to improve their knowledge about how
to integrate their children with
disabilities in different community settings (Day, 2000).
Strategies for Successful Community Inclusion
Strategies for successful community inclusion are steps and
procedures that can help
Arab parents with children who have severe disabilities provide
opportunities for these children
56. to do as their peers do and to engage in community life. Such
strategies should give direction
and guidance to these parents by providing explicit steps for
them that can result in more
inclusion of their children in community life and with fewer
cultural barriers. As a result,
PARENT GUIDE COMMUNITY INCLUSION
7
parents’ inclusion of their children with disabilities in the
community can become both more
successful for the children and enjoyable for all family
members. Five specific strategies will be
examined here: (a) locating accessible activities, (b) increasing
familiarity with specific
community settings and activities; (c) providing opportunities
for children to communicate; (d)
managing children’s behavior in public; and (e) creating parent-
to-parent networks.
Locating Accessible Activities
Especially when children have disabilities that impact their
movement and awareness of
57. space, universal design in buildings can help them experience
full inclusion in their communities
(Turnbull, Turnbull, & Wehmeyer, 2007). The concept of
universal design was created to make
buildings accessible to all people. Examples of universal
design include buildings provided with
curb cuts, electronic and wide doors, and clear aisles. All of
these accessibilities allow children
with disabilities to move more easily and safely in the physical
environment.
Parents who have children with physical disabilities need to
consider locating and
selecting places that are designed to be accessible for their
children so that all can fully enjoy the
opportunities offered by particular community settings. In the
Arab Gulf Region, new
constructions are more likely to include features of universal
design, such as some contemporary
shopping malls, large grocery store chains, modern restaurants
located in malls, and newly-
designed mosques. Special education professionals can help
parents be aware that such places
exist, and assist them in locating such settings that are near
their home.
58. Increasing Familiarity With Specific Community Settings And
Activities
Many community settings in Arab society are not presently
accessible through universal
design applications. Nor is universal design accessibility always
a concern when a family has a
child with a severe disability. Sometimes, fear may be
associated with simply how best to
PARENT GUIDE COMMUNITY INCLUSION
8
navigate an area of the community most efficiently, concerns
for pedestrian safety, or concerns
with how to ensure partial participation of a child in an activity.
A family can overcome some of
their concerns by analyzing the environment to determine its
expectations, the skills that could be
useful, the assistance that the family members will need to give
the child to make the experience
enjoyable and successful, and what parts of an activity a child
can do with and without
assistance.
Referred to in the United States as ecological analysis (Falvey,
59. 1989), this process offers
a way to begin being in the community safely and enjoyably.
For example, the parents may want
to take the family, including the child with a severe intellectual
disability, to a local shopping
mall for a day excursion. An advance trip to the mall by the
parents can identify best entrances;
family-friendly restaurants; places for resting and watching; and
a specific store or stores that can
offer particular activities that the child may enjoy for short
times. The trip is then planned by the
family from start to finish, including the roles played by the
various family members in different
locations and activities.
During an activity, the parents can also bring along a familiar
item that the child enjoys,
such as a toy or candy. A familiar item can help the child feel
comfortable in new situations.
Also, parents can do a “trial run” by going to the location of a
special event with the child at a
time when it is less crowded. The next time they all go to this
place, it will be a familiar to the
child. Such strategies can help children with disabilities to be
more familiar with people and
60. places and to interact positively in the larger community.
Providing Opportunities For Children To Communicate
Communication is a natural skill that all children need to
develop and learn from their
daily activities (Turnbull et al., 2007). Children with
communication difficulties are often unable
PARENT GUIDE COMMUNITY INCLUSION
9
to let others know their physical needs, to interact with others
in a sustained and satisfactory
ways; or let others know what they are feeling and thinking. To
help, parents can structure
opportunities for their children to interact and communicate
with others by encouraging their
children to introduce themselves, talk about incidents that
happened, and discuss achievements at
their school or events with their family members. Many children
who have difficulty expressing
themselves with words are responsive to questions, which can
be strategically asked to offer
opportunities for children to construct a story or describe an
61. incident that happened at some point
in the day or week. Parents can model these strategies when
they are in social events at home,
visiting with neighbors, or in community settings, so that other
people can become more
comfortable interacting with the child who has difficulty
communicating.
Children in the United States are often provided with
sophisticated communication
devices that allow them to construct with pictures, words, or
symbols messages that others can
see or hear. These devices often may not be available to
families in the Arab Gulf Region, but
simple graphic representations can be provided the child to
identify important tools, activities, or
people in a child’s life. Note cards, for example, may include
words and pictures to present the
most commonly used expressions in communication (Downing,
2000; Turnbull et al., 2007).
When children have pictorial or written word representations
that they can use to communicate,
it is important that parents keep these accessible, encourage
their use when appropriate, and to
use the pictures and words themselves when they are
62. communicating with the child.
Simply because a child does not speak does not mean that he or
she has nothing to say
(Fisher & Fisher, 1996). It is important to honor all of a child’s
efforts to let others know what
he/she wants and needs and to include them in ongoing
discussions and activities among family
members whether or not they add to a discussion with spoken
words. We can, of course explain
PARENT GUIDE COMMUNITY INCLUSION
10
something, or say something in a different way, when a child
needs help understanding what is
being said. However, it is best to believe that a child can
comprehend much that occurs and is
said in his/her environment rather than to assume that little or
nothing is comprehended by the
child. Often, when we assume understanding, we learn that more
is actually comprehended than
we might have at first guessed, and greater understanding will
emerge when the child feels that
the adults believe in him or her.
63. Managing Children’s Behavior in Public
For better or for worse, people form impressions of others based
on what they see them
do in public places. If they see a child behave in a manner that
matches expectations of a setting,
than onlookers either don’t notice at all or they notice the child
in a favorable way. If a child’s
behavior is unexpected or disorderly, then disapproval may be
felt or expressed, and the
impression formed may be long lasting.
Parents of children who have behavior problems can encourage
their children to do tasks
in the community. For example, they can ask the children to
select their food from the menu in
the restaurant, let them push the grocery cart, give them the
opportunity to pay the money to the
cashier, or think through and make alternative choices when
what is wanted is not available, such
as a restaurant not having a desired menu item.
Another approach to addressing discipline concerns is to
develop a system of nonverbal
signals to be used by the parent with the child, which mean
when they are delivered that the child
64. is to observe what certain others are doing (parent, particular
sibling) and to do the same. Such
signals could be gestures or facial expressions. The parent can
then focus on the way home on
what the child did that was right, reviewing the positive
accomplishments and the moments when
the child was paying attention to the parent’s signals.
PARENT GUIDE COMMUNITY INCLUSION
11
Sometimes it is helpful to review in advance with the child two
or three things for the
child to remember. For example, one might include: (a) stay
with the family; (b) keep your voice
down; and (c) keep your hands by your side unless given
permission to touch something. The
reminders could be reviewed at home or in the car, right before
entering a community context.
Other more complicated systems for assisting with discipline
include preparing and
reading a social story (Sutton, 2011); using pictures to prepare a
child in advance for an
65. upcoming event; or providing a visual schedule to indicate the
structure of the day and event, and
to identify the place and activities (Souza & Kennedy, 2003).
Special educators need to develop
the skills to do these more advanced procedures, and to be ready
to assist families in
implementing these strategies so that their children can access
community environments safely
and without worrisome incidences.
Creating Parent-To-Parent Networks
As a Saudi Arabian writer and citizen, and from my experience,
people in our region
develop their beliefs regarding disabilities from their cultures,
traditional background, and also
from misinterpretation of religious beliefs. They may believe
having children with disabilities
means God is punishing them for something evil they did in
their lives. Or they may believe that
children with disabilities are something caused by mysticism or
demons. They may not see that
disability might be the result of health or medical outcomes, or
an event of birth that should be
treated as a possible and natural outcome of life. Therefore,
they avoid including their children
66. with disabilities in the community because of the stigma.
Arab Gulf parents can include their children with disabilities in
spite of cultural belief
barriers and can face society with a greater sense of their own
personal power. However,
initially, parents may want to begin by working together,
creating networks within communities
PARENT GUIDE COMMUNITY INCLUSION
12
for parents of children with disabilities to meet and talk with
each other. In this network, the
parents can work collaboratively together in taking their
children with disabilities out in the
community. The parents can discuss their concerns regarding
their children; for example, the
places they can go with their children, activities they can do
with their children, and appropriate
strategies that works with each child of each family. Most
importantly, they can provide each
other with increased support for initiating more inclusion.
These parents may want to have weekly meetings or plan parties
67. that have activities and
exercises for their children in their homes. When these parents
become familiar with each other,
they can go into the community as a group, and thereby, be
stronger and more confident in
facing society.
Conclusion
I have presented a number of strategies for successful
community inclusion that I believe
can be useful for Arab Gulf Region parents to include their
children with disabilities in a variety
of community settings. These strategies are based on research
and practices I have observed or
have read about in the United States, and they are adapted here
to be a guide to Arab Gulf
parents. The strategies for successful community inclusion are
particularly discussed in
conjunction with the impact of cultural issues on including the
children with disabilities in the
community, such as stigma, guilt, discrimination and fear.
Special educators, including myself, have an obligation to assist
families in becoming
part of our culture and the communities of our region. It is not
68. enough just to train children with
severe disabilities in schools to perform the adaptive skills
required to survive and be functional
in the community. If we are to make a difference, we must
directly work with families, assisting
them to open doors for their children, so that community life
becomes a real possibility for them.
PARENT GUIDE COMMUNITY INCLUSION
13
References
Al-Turaiki, M. & Joseph, G. (2004). Ambalavavanan:
Environmental and vehicle adaptations
for handicapped- JCRPO experience. Proceedings from the 32nd
Annual National
Conference of Indian Association of Physical Medicine and
Rehabilitation, Calcutta,
India.
Arab Gulf Network for People with Disabilities. (2009). Our
disabled children. Retrieved from
http://m3aq.net/inf/articles-action-show-id-37.htm.
Bronfenbrenner, U. (1979). The ecology of human development:
69. Experiments by nature and
human design. Cambridge, MA: Harvard University Press.
Day, M. (2000). Supporting inclusion of young children with
disabilities in community settings.
(Order No. 9967889, University of Maryland College Park).
ProQuest Dissertations and
Theses, 237. Retrieved from http://0-
search.proquest.com.source.unco.edu/docview/
304605427?accountid=12832. (304605427).
Downing, J. (2000). Augmentative communication devices: A
critical aspect of assistive
technology. Journal of Special Education Technology. 15, 3-11.
Ehrmann, L., Aeschleman, S., & Svanum, S. (1995). Parental
reports of community activity
patterns: A comparison between young children with disabilities
and their nondisabled
peers. Research in Developmental Disabilities. 16(4), 331-343.
Falvey, M. A. (1989). Community-based curriculum:
Instructional strategies for students with
severe handicaps (2nd ed.). Baltimore: Brookes.
Fisher, D. (Producer), & Fisher, J. (Director) (1996).
Unforgotten: Twenty-five years after
70. Willowbrook. United States of America: City Lights
Productions
Geenen, S., Powers, L. E., & Lopez-Vasquez, A. (2001).
Multicultural aspects of parent
PARENT GUIDE COMMUNITY INCLUSION
14
involvement in transition planning. Exceptional Children. 67,
265-282.
Groce, N. E. (1985). Everyone here spoke sign language:
Hereditary deafness on Martha’s
Vineyard. Cambridge (MA): Harvard University Press.
Souza, G., & Kennedy, C. H. (2003). Facilitating social
interactions in the community for a
transition-age student with severe disabilities. Journal of
Positive Behavior Interventions,
5(3), 179-179. Retrieved from http://0-
search.proquest.com.source.unco.edu /docview
/218792784?accountid=12832.
Sutton, B. (2011). Social stories. Educating young children:
Learning & teaching in the early
childhood years, 17(1), 35-36.
71. Turnbull, A., Turnbull, R., & Wehmeyer, M. L. (2007).
Exceptional lives: Special education
in today’s schools (5th ed.). Columbus, OH: Pearson Merrill
Prentice Hall.
http://rps.sagepub.com/
Severe Disabilities
Research and Practice for Persons with
http://rps.sagepub.com/content/39/2/156
The online version of this article can be found at:
DOI: 10.1177/1540796914545960
2014 39: 156Research and Practice for Persons with Severe
Disabilities
Lewis Jackson
Ryndak et al
What Legitimizes Segregation? The Context of Special
Education Discourse: A Response to
Published by:
http://www.sagepublications.com
72. On behalf of:
TASH
can be found at:Research and Practice for Persons with Severe
DisabilitiesAdditional services and information for
http://rps.sagepub.com/cgi/alertsEmail Alerts:
http://rps.sagepub.com/subscriptionsSubscriptions:
http://www.sagepub.com/journalsReprints.navReprints:
http://www.sagepub.com/journalsPermissions.navPermissions:
http://rps.sagepub.com/content/39/2/156.refs.htmlCitations:
What is This?
- Jun 1, 2014Version of Record >>
at UNIV OF NORTHERN COLORADO on October 4,
2014rps.sagepub.comDownloaded from at UNIV OF
NORTHERN COLORADO on October 4,
2014rps.sagepub.comDownloaded from
74. Abstract
Ryndak and colleagues provide a strong case that progress
toward more and better access to general
education is not occurring for students with intellectual
disabilities. This response to their paper begins by
agreeing with their assessment of our current situation, then it
offers one possible reason for this state of
affairs: the discourse that occurs when special education teams
are planning outcomes and instruction for
these students discourages the use of grade-level curriculum and
general education classrooms. Part of the
problem is that the discourse preserves segregation through a
planning terminology that is inconsistent
with how all other students in a school are assessed and
described. However, it is also argued that a
major property of this discourse is a misguided emphasis on
“functional skills,” and that this emphasis
contributes to our lack of progress in achieving access to
general education curriculum and settings.
A related argument is also made that the educational goal
development process that typically occurs
within special education discourse derives student outcomes
from varied skill sources that, collectively,
do not offer the structure and coherency of a real curriculum.
This process, justified at least in part
by interpretations of individualization, may also be impeding
our movement toward greater alignment
with general education for these students. A case is made for
school districts establishing policies that
require the use of grade-level general education curriculum with
these students. Potential issues and
concerns related to individualization, content standards,
curriculum adaptation, and progress monitoring
are discussed.
Keywords
75. special education discourse, inclusive education, accessing
general curriculum, individualualized educational
programming, functional skills
In “Policy and the Impact on Placement, Involvement, and
Progress in General Education: Critical Issues
That Require Rectification,” Ryndak and her colleagues (2014)
argue that progress has largely come to a
halt for students with intellectual disabilities in their movement
toward increasingly less restrictive place-
ments and practices. They assert that despite legal and research
imperatives that could have significantly
reduced self-contained placements if their implications had been
enacted over the past decade, school sys-
tems have not changed with respect to how these students are
educated either in terms of placement or in
terms of curriculum. Their article scrutinizes and examines the
policy landscape associated with schools,
districts, and governmental entities in relation to least
restrictive environment, progress in general
curriculum, and assessment. Ryndak et al. conclude that policies
governing educational placement and
1University of Northern Colorado, Greeley, USA
Corresponding Author:
Dr. Lewis Jackson, School of Special Education, University of
Northern Colorado, Greeley, CO, 80639 USA.
545960RPSXXX10.1177/1540796914545960Research and
Practice for Persons with Severe DisabilitiesJackson
research-article2014
at UNIV OF NORTHERN COLORADO on October 4,
2014rps.sagepub.comDownloaded from
76. http://rps.sagepub.com/
Jackson 157
practice should be revised or strengthened if we are to achieve
the kinds of access to general education that
can make a difference for these students.
I will start my discussion with a single caveat: There are
individual teachers who practice educational
inclusion everyday of their lives, often against incredible odds;
and there are some schools and districts
within our country that are making integrated education their
standard, sometimes even given pressure from
higher up to use more pullout and self-contained placements.
Having said this, my assessment of our overall
progress toward educating students with intellectual disabilities
in more inclusive situations yields the same
conclusion reached by these authors. I consider the situation to
be quite bleak, and I assert, based on my
observations in schools, that what students with intellectual
disabilities typically receive does not constitute
an “appropriate education” in any sense of the word.
Most likely, there are multiple and varied moderating and
mediating factors determining what is happening
today with these students. Nevertheless, we must first question
our own practices: Is what we advocate and
implement in our practices today, as evidenced in the planning
and instruction of teachers, administrators, and
related service providers, contributing to our lack of progress
toward inclusion with students who have intel-
lectual disabilities? As a way of responding to this question, I
will consider in this article the content and
implications of special education discourse in schools. More
77. specifically, I will consider aspects of discourse
that reflect and potentially influence how special educators
make decisions about children’s educational ser-
vices and programs. I will then suggest that a “false logic”
permeates this discourse, and this false logic relates
to our widespread emphasis on functional skills. Finally, I will
recommend that concerns raised by Ryndak et
al. can be partially ameliorated by implementing policies in
school districts that mandate grade-level general
education curriculum, with adaptations when needed, as the
only curriculum source to be used by Individualized
Education Program (IEP) teams developing goals and objectives
for students with intellectual disabilities.
Special Education Discourse in Schools
Conversations and interactions across time in which teachers,
administrators, parents, and related service
providers collaborate, plan, and enact a program of activities
(i.e., IEPs, placement, curriculum, and instruc-
tion) for students with intellectual disabilities can be described
as purposeful discourse. In common with
other forms of interpersonal discourse, it expresses the
following properties: (a) an underlying “common
ground” within the exchange that assures a shared
understanding of the content, (b) an “accumulation pro-
cess” in which participants construct knowledge during their
interactions in ways that match the function of
the exchange, and (c) “unilateral action” in which participants
are encouraged to contribute to the exchange
only in acceptable or “right” ways (Schaefer, 1992, p. 145).
Purposeful discourse also reflects what has been
called the narrative of rhetoric; that is, the use of language
within discourse to “inform and persuade” others
toward common ends and consensual understandings (McGuire,
1990, p. 222).
78. Special education service providers engaged in purposeful
discourse may sometimes express the stance
that it is all about the child, determining his or her real needs,
and configuring a program that is fully indi-
vidualized, independent of location of services. In my
experience, this is often said in IEP meetings when
parents express a desire for “more inclusion” for their child.
However, the discourse eventually, and inevita-
bly, assumes a character that reflects the true culture and
attitudes of the school with regard to disability, and
it mirrors the patterns of service provision that have a history of
use with all other students with intellectual
disabilities. If we were to examine the language of this
discourse, expressions that we would hear when
adults are referencing any and all individuals within this group
of students include the following: (a) catego-
ries of disability that define special education eligibility (e.g.,
autism, severe disabilities), (b) the terminology
of IEP planning (IEP team, educational program, annual
meeting), (c) identified developmental and func-
tional individualized, educational needs (e.g., communication
goals, self-care goals, “speech”), (d) specific
program placement recommendations (e.g., autism class, life
skills), (e) recommended specialized instruc-
tion (Applied Behavior Analysis or ABA, one-to-one
instruction, a list of adaptations and modifications), and
last (f) general education options that are permissible (lunch,
PE, hallways, Science), accompanied by words
such as “appropriate” or “meaningful” inclusion. When
contrasted with the language used to describe all
other students who are not in special education (e.g., first
grader; reader; in Ms. Smith’s class), it can be seen
that “separateness” and “differentness” are mirrored in this
discourse. Purposeful discourse of this type will,
of course, follow students with intellectual disabilities across
79. their educational careers.
at UNIV OF NORTHERN COLORADO on October 4,
2014rps.sagepub.comDownloaded from
http://rps.sagepub.com/
158 Research and Practice for Persons with Severe Disabilities
39(2)
I would propose that social exchanges associated with
purposeful discourse do not just reflect but actu-
ally promote and sustain the program options that are provided
to these students, by maintaining the team’s
focus on educational options that are familiar and acceptable as
defined by this discourse. The implication
is that the educational decision-making processes used by
schools with these students are neither truly indi-
vidualized nor do they focus on providing these students with
the educational opportunities offered to other
students. Instead, these processes operate in a self-preserving
manner, narrowing educational opportunities
to those in keeping with what has been legitimized by the
discourse; that is, those opportunities that are
consistent with the already established social and ecological
boundaries of the program.
A concept that is operative within the purposeful discourse of
special educators in many of these programs
is the notion of functional skills, typically defined as those self-
care and independent living skills that are
needed for a student to be successful in the home and in the
community, and within adult life in general. When
selected as goals and objectives, these skills are drawn from
outside the offerings of general education curricu-
80. lum. It has been argued that appropriately and effectively
teaching functional skills requires curriculum and
instruction that run contrary to the academic emphasis of the
general education classroom (Bouck, 2009).
The problem with the foregoing is that general education is, of
itself, a functional educational process, in
which students have both broad and particular opportunities for
socialization, acculturation, and information
acquisition related to their culture and society (Jackson,
Ryndak, & Wehmeyer, 2008-2009). Equally impor-
tant, the maturation and growth associated with these
opportunities cannot be realized using the “intense,”
one-to-one instruction typically favored in special education
classrooms. Rather, authentic maturation and
growth is an evolving process, becoming more complex and
more like the norms of adulthood as a product
of a dynamic relationship between long-term exposure to a
shared curriculum and the context of instruction
represented by elementary, middle, and high school classrooms
at grade level (Jackson et al., 2008-2009).
Hence, the logic behind emphasizing functional skills as the
proper and best outcomes for students with
intellectual disability is a “false logic,” embedded within the
persuasive appeals of special education dis-
course to maintain the dominance of this type of instruction and
to bring others into agreement with it. It, in
fact, projects a false picture of both the outcomes of the general
education academic orientation and the
benefits of the special education functional skills orientation.
The foregoing presents a troubling concern for those of us who
are special educators: We have asserted to
parents for many decades now a rationale that something better
and more appropriate is achieved for students
81. with intellectual disabilities by focusing on a particular and
delimiting definition of “functional skills,” and
our actions are contributing to the large-scale denial for these
students of the normalizing and functional
experiences provided in general education. To make matters
worse, there is no evidence that a better educa-
tion is realized for these students when the emphasis is on
isolated functional skills as opposed to what could
be realized using general curriculum within K-12 classrooms
(Ryndak, Jackson, & White, 2013).
Where Do We Go From Here?
In my work with special education teachers who educate
students who have intellectual disabilities, I have
noted an odd dilemma that they experience when writing IEP
goals. Unlike, say, a first-grade or high school
teacher, special education teachers must come up with goals and
objectives for students not from a unified
curriculum but rather from multiple curriculum and non-
curriculum sources. These may include specialized
curriculum for basic skills (e.g., reading); special education
“expanded” state standards that sometimes bear
little resemblance to grade-level curriculum; their own
experiences as teachers; parents’ wishes for their
children; social, behavioral, and academic initiatives in their
schools; observed gaps in adaptive skills;
developmental assessments from other professionals (e.g.,
occupational therapy); and even, simply, what
they like teaching as part of their program.
The foregoing can be viewed positively as what makes
“individualization” possible, because it opens up a
wide range of outcome possibilities to choose from. However,
the other side of the coin is that it involves picking
and choosing from something that approaches the character of
82. an ill-defined list and not from a skill set that has
a defined scope and sequence. The question that can be raised
here is whether individualization, as accomplished
by this process, is any better of a way to define outcomes than
using the unified school curriculum, the latter at
least bearing an apparent relationship with the educational
standards of the area. When one considers how the
at UNIV OF NORTHERN COLORADO on October 4,
2014rps.sagepub.comDownloaded from
http://rps.sagepub.com/
Jackson 159
purposeful discourse of the special education team plays out
when choosing educational outcomes, the prediction
would be that individualization is no better served, because
goals and objectives would tend to regress toward the
mean of the program. Moreover, the discourse processes of the
service providers would tend to discourage con-
sideration of goals related to age-level general education
curriculum, because these require language and con-
cepts that are at odds with the language and conceptual
boundaries of the discourse.
The issue of establishing and setting expectations based on a
single curriculum versus multiple curricu-
lum and non-curriculum sources can be framed as a policy
issue. In my opinion, districts need to move
quickly toward viewing grade-level general curriculum as the
curriculum source for all students, and dis-
tricts should begin mandating that other instructional outcomes
(e.g., using a communication device, fol-
lowing an activity schedule, independent mobility) be framed
83. not as IEP goals but instead as supports and
adaptations that assist students in accessing general education
curriculum. When general education curricu-
lum is the established curriculum for all students, the
fundamental question that must be asked by IEP teams
would change in ways that could enhance inclusive placements:
“How can we better teach and test general
education curriculum knowledge,” instead of, “How do we make
a determination whether grade-level gen-
eral education curriculum is appropriate or not.”
A concern that can be raised with the foregoing is that such a
policy elevates the influence of a single
curriculum and lowers that of IEP teams in the task of choosing
learning expectations for students. However,
one should ask, has giving this kind of authority and power to
IEP teams benefitted students with intellec-
tual disabilities in today’s climate of standards-based testing? I
think not. If anything, the team’s power to
override grade-level curriculum has likely contributed to the
decline of inclusion in schools that is described
by Ryndak et al. (2014). Of course, a related concern is whether
the courts, given what is expected of IEP
teams by the Individuals With Disabilities Act (IDEA), would
overturn a single curriculum policy if legally
challenged. I can only respond to this by noting that IDEA also
favors general education curriculum and
classes, and that a unified curriculum does not prevent
individualization or interdisciplinary teaming. It only
gives direction to both.
A final concern about district policy mandating the use of K-12
curriculum for all children is, “How does
this impact standards-based assessment results, especially
alternate assessment results?” I note first that if
alternate assessments are really assessing the same standards as
84. the regular tests, then results could improve
for these students because of the increased focus on general
education curriculum and because there could
be a greater reliance on qualified instruction from general
education teachers. At the same time, issues in
the alignment between instruction and alternate testing might
need to be further examined. This concern, of
course, exists for all children who participate in standards-based
testing; that is, concern for the alignment
between what is taught and what is tested. However, in my
view, this research should not simply examine
whether what is taught aligns with what is tested. Rather, it
should examine instead how the results of two
assessments, standards-based/alternate testing and adapted
(modified or accommodated) measurement of
what is being taught, align with each other, and a third source
of information. This third source could
include post-school success indicators (McDonnell, Hunt,
Jackson, & Ryndak, 2013) and self-determina-
tion measures (Hughes, Cosgriff, Agran, & Washington, 2013).
Conclusion
Ryndak and her colleagues have raised valid concerns about
backsliding with respect to less restrictive
placements, access to general curriculum, and alternate
assessment testing. There is obviously no simple
solution, but one approach is for those of us in special
education to reflect more thoughtfully about our
discourse processes when engaged in educational planning with
these students, and consider whether what
we have advocated in the past regarding functional skills
actually benefits students with intellectual dis-
abilities. I have argued that our advocacy on this account is not
only part of the problem but is actually a
questionable practice in and of itself. I note in closing that
85. evidence-based practice research showing that
functional skills can be effectively taught (Alwell & Cobb,
2009) does not validate these skills as outcomes
for students in the K-12 period of life; it only shows that these
students can learn them.
Ryndak and her colleagues argue that district and state policies
need to be more assertive in assuring access
to general curriculum. I suggest that one way we might achieve
this, and realize more inclusive placements as
at UNIV OF NORTHERN COLORADO on October 4,
2014rps.sagepub.comDownloaded from
http://rps.sagepub.com/
160 Research and Practice for Persons with Severe Disabilities
39(2)
well, is through encouraging districts to implement policies that
mandate general education grade-level cur-
riculum as the curriculum to be used with all students. I
emphasize that “grade-level” does not mean that one
cannot use the principles of universal design for learning (UDL)
to creatively adapt content and response
expectations to achieve curriculum access, or to provide
alternative means to measure progress. However, it
does mean avoiding derivatives of standards (“expanded
standards”) that alter both what is taught and what is
expected to the point where neither resemble the content
standards presumably represented.
To accomplish the foregoing, it is evident that we in special
education must relinquish a belief structure
and a set of practices that are cherished by many of us, the
86. delineation of “functional skills” as primary IEP
goals and objectives for students with intellectual disabilities
during the K-12 period. We must then gener-
ate a very different special education discourse that will be
heard throughout our schools, one that commu-
nicates grade-level general education curriculum as the basis for
educating these and all students. In my
view, this would represent an important, positive step toward
encouraging districts to move away from the
routine segregation of these children and youth for educational
purposes.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of
this article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
References
Alwell, M., & Cobb, B. (2009). Functional life skills curricular
interventions for youth with disabilities: A systematic
review. Career Development and Transition for Exceptional
Individuals, 32, 82-93.
Bouck, E. C. (2009). No Child Left Behind, the Individuals
With Disabilities Act and functional curricula: A conflict
of interest? Education and Training in Developmental
Disabilities, 44(1), 3-13.
Hughes, C., Cosgriff, J. C., Agran, M., & Washington, B. H.
87. (2013). Student self-determination: A preliminary inves-
tigation of the role of participation in inclusive settings.
Education and Training in Autism and Developmental
Disabilities, 48(1), 3-17.
Jackson, L. B., Ryndak, D. L., & Wehmeyer, M. L. (2008-
2009). The dynamic relationship between context, curricu-
lum, and student learning: A case for inclusive education as a
research-based practice. Research and Practice for
Persons With Severe Disabilities, 33-34, 175-195.
McDonnell, J., Hunt, P., Jackson, L., & Ryndak, D. (2013).
Educational standards for students with significant intel-
lectual disabilities: A response to Lou Brown. Connections,
38(4), 30-34.
McGuire, M. (1990). The rhetoric of narrative: A hermeneutic,
critical theory. In B. K. Britton & A. D. Pellegrini
(Eds.), Narrative thought and narrative language (pp. 219-236).
Hillsdale, NJ: Lawrence Erlbaum.
Ryndak, D. L., Jackson, L. B., & White, J. M. (2013).
Involvement and progress in the general curriculum for students
with extensive support needs: K-12 inclusive education research
and implications for the future. Inclusion, 1, 28-49.
Ryndak, D. L., Taub, D., Jorgensen, C. M., Gonsier-Gerdin, J.,
Arndt, K., Sauer, J., Ruppar, A. L., Morningstar, M. E.
& Allcock, H. (2014). Policy and the impact on placement,
involvement, and progress in general education: Critical
issues that require rectification. Research and Practice for
Persons With Severe Disabilities, 39, 65-74
Schaefer, E. F. (1992). Contributing to discourse. In H. H. Clark
(Ed.), Arenas of language use (pp. 144-175). Chicago,
IL: University of Chicago Press.
88. Author Biography
Lewis Jackson is a professor of special education at the
University of Northern Colorado. He coordinates the Master
degree program for preparing special education teachers to work
with a wide range of students in today’s schools. Over
his forty years in special education, he has worked in both self-
contained and “inclusive” settings, with the result being
that he has become a strong proponent for inclusive educational
practices. He consults, publishes, and provides advo-
cacy supports at the state, national, and international level.
Received: March 17, 2014
Final Acceptance: May 22, 2014
Editor in Charge: Martin Agran
at UNIV OF NORTHERN COLORADO on October 4,
2014rps.sagepub.comDownloaded from
http://rps.sagepub.com/
Including Learners with Low-Incidence Disabilities
Facilitating Supports and Services for Learners with Low-
Incidence Disabilities
Jody Marie Bartz Jennifer Kurth Matthew Wangeman
Article information:
To cite this document: Jody Marie Bartz Jennifer Kurth
Matthew Wangeman .
"Facilitating Supports and Services for Learners with Low-
Incidence Disabilities" In
Including Learners with Low-Incidence Disabilities. Published