Search results

Healthcare-associated infections (HAIs) are a major cause of concern because of the high levels of associated morbidity, mortality, and cost. In addition, children and intensive care unit (ICU) patients are more vulnerable to these infections due to low levels of immunity. Various medical interventions and statistical process control techniques have been suggested to counter the spread of these infections and aid early detection of an infection outbreak. Methods such as hand hygiene help in the prevention of HAIs and are well-documented in the literature. This chapter demonstrates the utilization of a systems methodology to model and validate factors that contribute to the risk of HAIs in a pediatric ICU. It proposes an approach that has three unique aspects: it studies the problem of HAIs as a whole by focusing on several HAIs instead of a single type, it projects the effects of interventions onto the general patient population using the system-level model, and it studies both medical and behavioral interventions and compares their effectiveness. This methodology uses a systems modeling framework that includes simulation, risk analysis, and statistical techniques for studying interventions to reduce the transmission likelihood of HAIs.

Youth and young adults with emotional and/or behavioral difficulties (EBD) face particularly difficult challenges in their efforts to fit into adult roles and functions. The purpose of this chapter is to assist providers, educators, and administrators from the mental health, education, child welfare, justice/corrections, and adult service system sectors understand (a) a practice for improving the progress and outcomes for young people in transition, and (b) how this practice model is implemented in communities to impact the lives of youth in transition to adulthood. This is accomplished in two major parts in this chapter. The first part provides an overview of the Transition to Independence Process (TIP) model, a description of its status as an evidence-supported practice, and tools and strategies that support its implementation in communities and regions across North America. The TIP model is further illustrated through a description of how it is applied with a young person. The second part of the chapter provides an overview of implementation science, a description of how its strategies and tools can guide the implementation of an intervention or model; and an illustration of a large-scale TIP implementation initiative with collaboratives of agencies and schools. This chapter concludes with implications regarding the importance of having effective transition-to-adulthood models; and ensuring the implementation and sustainability of these to improve the progress and outcomes of youth and young adults with EBD.

Purpose – This chapter explores claims of social problem workers in criminal justice and mental health with regard to how to manage males who are identified as or self-identify as both victims and perpetrators (V/Ps) of sexual abuse. We also examine the claims of V/Ps with regard to how they manage their dual status.

Methodology – This chapter is based on an action research project on intervention services for V/Ps in Ontario, Canada. Our data include literature reviews, interviews with intervention professionals, V/P narratives, and a transcription of a stake-holder's workshop.

Findings – Intervention workers whose mandate is offender risk management state they give little attention to victimization-related issues of V/Ps, whereas workers in victims’ services often state that adult V/Ps are not covered under their mandate. This suggests that the status of offender is the master status for adult V/Ps. Our V/P narratives recount efforts at self-management and some V/Ps and intervention professionals have expressed interest in the possibility of developing programs specially designed for V/Ps.

Practical Implications – An examination of issues related to the dual status of sexual abuse V/Ps suggests that V/Ps may require special services that cannot be provided by existing programs for perpetrators and victims.

Originality/Value of Paper – Studies of social problem work might benefit from considering not only professionals’ viewpoints but also those of their clients. This chapter explores new intervention models (GLM and RJ) that incorporate ethical concerns based on a rights perspective (“moral repair”) and the experiential concerns of V/Ps.

The contemporary focus on high fidelity implementation of research-based practices often creates tensions for educators who seek to balance fidelity with needed flexibility as they strive to improve learner outcomes. In an effort to improve how decisions are made such that flexibility is achieved while fidelity to core components is maintained, this chapter begins with a discussion of the role of fidelity in research and practice. Particular attention is given to current conceptualizations of fidelity that may help inform theoretically and empirically driven adaptations to research-based practices. Specifically, we describe adaptations based on the instructional context for implementation and the characteristics of the individual learners. A framework for adapting research-based practices is then presented with relevant examples from research designed to optimize learner responsiveness without sacrificing fidelity to core components. The chapter ends with implications and future directions for research and practice.

The primary purpose of this chapter is to describe a synergistic “hybrid” model of Response to Intervention (RtI) that combines individualized effective Tier 1 classroom instruction with powerful early intervening services. First, we provide an overview and explain how RtI traditionally has been conceptualized. Next, we illustrate how to implement a hybrid model that focuses on beginning reading instruction and also incorporates additional school-level resources. Finally, we will discuss implementation issues related to identifying children who need additional intervention and propose directions for future research.

Functional assessment-based interventions are a tertiary support that have been incorporated in many three-tiered models of prevention to support students who do not respond to more global prevention efforts. Although endorsed by host of reputable organizations (e.g., National Association of School Psychologists) and mandated in Individuals with Disabilities Education Act (IDEA, 1997, 2004), concerns have been raised that this mandate may not be warranted if functional assessment-based interventions do not meet minimum criteria to establish this as an evidence-based practice. One issue contributing to this concern is variability in the functional assessment process. John Umbreit and colleagues (2007) have attempted to address this concern by introducing a systematic approach that includes (a) a Function Matrix to analyze functional assessment data and identify the hypothesized function(s) of the target behavior and (b) a Function-Based Intervention Decision Model to guide intervention planning. In this chapter, we applied the core quality indicators for single-case research developed by Horner, Carr, Halle, McGee, Odom, and Wolery (2005) to studies conducted using this practice to determine the extent to which this systematic approach to functional assessment-based interventions met the standards for evidence-based practices for use in educational settings across the K-12 continuum for students with or at-risk for high incidence disabilities. If this practice is deemed to meet criteria, then this systematic approach may be particularly useful in meeting the mandate established in IDEA. Results suggest that it may be appropriate to establish this systematic method as a promising practice.

The paper examines two race-based intervention programs, focusing on the distinction between models of intervention based on targeted and indiscriminate (i.e., normative) college-going cultures. We unpack the concept of the “college-going culture” – defined as a set of expectations and norms that socialize students to view themselves as college-bound – and add nuance to it by illustrating how racial/cultural community and school environments, respectively, act as spheres of influence. Findings are based on semi-structured interviews with 46 alums of two effective, race-based intervention programs. Within one program, participants experienced culturally relevant programming but felt excluded from the college-going culture of the wider school environment. In the other program, students were included in the larger college-going culture of the school, but often felt culturally isolated. Participants’ narratives provide insight into the strengths and pitfalls of both intervention programs, and the paper concludes with a diagram outlining elements essential in optimal college-going cultures.

Identification, implementation, and ongoing evaluation of scientifically supported and effective-practice methods are fundamental and crucial elements of an effective educational program for all children and youth, including learners with Autism Spectrum Disorders (ASD). To be sure, there is an unambiguous link between use of interventions and supports that have empirically supported merit and positive school and post-school outcomes. This chapter examines progress in the wide-scale adoption of evidence-based methods with learners with ASD. We also offer recommendations for advancing effective-practice initiatives and discuss trends and themes connected to effective-practice use with students with ASD.

Assessment and identification of children with emotional and behavioral disorders (EBD) is complex and involves multiple techniques, levels, and participants. While federal law sets the general parameters for identification in school settings, these criteria are vague and may lead to inconsistencies in selection and interpretation of assessment measures. Assessment practice across school settings is greatly influenced by clinical guidelines such as the DSM-IV, which more specifically defines emotional and behavioral disorders and highlights the issue of co-morbidity. Before a student is assessed for special education eligibility under the IDEIA category of emotional disturbance, screening techniques and pre-referral interventions are needed. Positive Behavioral Supports and Response to Intervention models provide empirically supported frameworks for establishing the need for formal psychological assessment. Collaboration among members of the multidisciplinary team, including parents, helps to ensure that identification and intervention efforts have ecological validity. Tests and techniques vary considerably, but developmental histories, interviews, observations across settings, and behavioral checklists and rating scales are recommended, along with cognitive and achievement testing. While problems exist in the reliability and validity of projective techniques, they continue to be used in school-based assessment for EBD. Multitrait, multisetting, and multimethod approaches are essential for culturally fair assessment and reduction of bias in identification and placement.

The purpose of this chapter is to highlight issues related to the current policy, practice, and research in the area of functional behavioral assessment (FBA) for students with (or at risk for) emotional/behavioral disorders (EBD). Although a substantial research base exists validating the effectiveness of FBA and function-based interventions for students with developmental disabilities, we believe that these same FBA practices are less valid when employed for students with EBD in classroom settings. Following a review of the current research and a discussion of the practical issues that are encountered when implementing FBA in classroom settings serving students with EB, we outline a more responsive FBA model for students with EBD with an emphasis on future policy, research, and practice applications for the field to consider.