Relegated to the Sidelines: A Qualitative Inquiry of Gatekeepers' Perspectives and Values of Physical Education for Disabled Children.

Several institutional aspects within the U.S. public school system impede the delivery of adapted physical education (APE) services to disabled children, including a lack of understanding and prioritization of these services by the special education team and a lack of qualified APE professionals to deliver these services. Thus, we conducted a qualitative inquiry grounded in a critical-ableism perspective to explore special education gatekeepers' experiences and perspectives of APE. Gatekeepers included parents, physical educators, and school administrators. Using a reflexive thematic analysis, we developed four interrelated themes: (a) disregard, negative, and charity mindsets toward disability; (b) systemic challenges in valuing and prioritizing APE; (c) presence as inclusion: (un)intentional marginalization in physical education; and (d) physical education for my child was a nightmare. These findings illustrate the complexities around the provision of physical education and APE to disabled children.

Trajectories of Symptoms in Digital Interventions for Depression and Anxiety Using Routine Outcome Monitoring Data: Secondary Analysis Study.

BACKGROUND: Research suggests there is heterogeneity in treatment response for internet-delivered cognitive behavioral therapy (iCBT) users, but few studies have investigated the trajectory of individual symptom change across iCBT treatment. Large patient data sets using routine outcome measures allows the investigation of treatment effects over time as well as the relationship between outcomes and platform use. Understanding trajectories of symptom change, as well as associated characteristics, may prove important for tailoring interventions or identifying patients who may not benefit from the intervention. OBJECTIVE: We aimed to identify latent trajectories of symptom change during the iCBT treatment course for depression and anxiety and to investigate the patients' characteristics and platform use for each of these classes. METHODS: This is a secondary analysis of data from a randomized controlled trial designed to examine the effectiveness of guided iCBT for anxiety and depression in the UK Improving Access to Psychological Therapies (IAPT) program. This study included patients from the intervention group (N=256) and followed a longitudinal retrospective design. As part of the IAPT's routine outcome monitoring system, patients were prompted to complete the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) after each supporter review during the treatment period. Latent class growth analysis was used to identify the underlying trajectories of symptom change across the treatment period for both depression and anxiety. Differences in patient characteristics were then evaluated between these trajectory classes, and the presence of a time-varying relationship between platform use and trajectory classes was investigated. RESULTS: Five-class models were identified as optimal for both PHQ-9 and GAD-7. Around two-thirds (PHQ-9: 155/221, 70.1%; GAD-7: 156/221, 70.6%) of the sample formed various trajectories of improvement classes that differed in baseline score, the pace of symptom change, and final clinical outcome score. The remaining patients were in 2 smaller groups: one that saw minimal to no gains and another with consistently high scores across the treatment journey. Baseline severity, medication status, and program assigned were significantly associated (P<.001) with different trajectories. Although we did not find a time-varying relationship between use and trajectory classes, we found an overall effect of time on platform use, suggesting that all participants used the intervention significantly more in the first 4 weeks (P<.001). CONCLUSIONS: Most patients benefit from treatment, and the various patterns of improvement have implications for how the iCBT intervention is delivered. Identifying predictors of nonresponse or early response might inform the level of support and monitoring required for different types of patients. Further work is necessary to explore the differences between these trajectories to understand what works best for whom and to identify early on those patients who are less likely to benefit from treatment.

Adapted Physical Educators Navigating Relationships With School Administrators.

School administrators represent key agents of socialization for teachers within their schools, including adapted physical educators who design and implement instruction for youth with disabilities, often across multiple school sites. The purpose of this study was to understand how adapted physical educators navigate and build relationships with administrators in the schools where they teach. Data were collected through semistructured interviews with 24 adapted physical educators from the U.S. state of California and analyzed using a multiphase approach. Analysis suggested both the importance of and challenges with building effective relationships with administrators. Themes included the following: (a) Administrators do not understand adapted physical education, which impacts programs and students; (b) the importance of relationship building in cultivating principal support; and (c) relationship development requires intentionality, but results in trust and motivation. Results are discussed using role socialization theory, and recommendations for the preparation of both adapted physical educators and school principals are discussed.

The Absence of Vision Impacts Attentional Focus Effects During a Balancing Task.

Purpose: Recent work involving reaching and aiming tasks provides evidence that an internal focus results in less error than an external focus when visual information is removed. The purpose of this study was to extend these findings by determining how an internal and external focus impact motor performance during a balancing task for adults with and without visual occlusion. Method: Thirty-two undergraduate students were randomly assigned to perform the task with or without visual occlusion. Participants balanced on a stability platform during four familiarization trials, three internal focus trials, and three external focus trials. Results: A significant Focus x Vision interaction indicated the group without visual occlusion had significantly lower root mean square error (RMSE) with an external focus, whereas the group with visual occlusion had lower RMSE with an internal focus. Conclusions: These findings indicate that for tasks that rely on online sensory feedback, such as balancing, the optimal attentional focus may be dependent on the dominant type of sensory feedback that is available.

The impact of educational rewards on the diagnosis of autism spectrum disorder.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects social interactions and communication. The prevalence of ASD has risen dramatically in recent years, but the underlying factors leading to this rise are not clear. In this paper, we test whether changes in state-level educational policy that impact school-level resources are associated with the rise in ASD diagnostic prevalence. Early identification of ASD can improve an array of outcomes for children, and school systems play an important role with identification of the condition. It is plausible that children attending schools with better resources from state governments are more likely to receive an ASD diagnosis and presumably appropriate services. We focus on one educational policy in particular, state-level rewards, which consist of a monetary transfer from state governments to school districts. To test the impact of educational rewards on ASD diagnosis, we rely on policy variation across states and time and estimate both two-way fixed effects (TWFE) models alongside recently advanced methods in the difference-in-differences (DiD) literature. Under a baseline TWFE specification we estimate that rewards policies are associated with a 18.46% increase in ASD diagnosis. Further, using DiD methods that account for bias in settings of differential policy timing, we find that the magnitude of the effect increases to 24.8%. We believe these findings to be suggestive evidence that educational rewards policies improved the likelihood of detection and diagnosis of ASD.

School Administrators' Experiences in a 6-Month Health and Wellness Community of Practice.

BACKGROUND: A statewide 6-month school administrator health and wellness program encouraged participants to use a fitness tracker to self-monitor their physical activity and sleep patterns. The purpose of this study was to examine participants' experience in a school administrator health and wellness program and their perceptions of the impact on health-related behaviors, including activity/movement, nutrition, and sleep. METHODS: Each of the 45 participants completed a semi-structured interview at three points in the program. Questions were designed to discern school administrators' perceptions of their ideal health and wellness balance at home and work. RESULTS: School administrators reported new insights into their own well-being, benefits of social supports in their personal wellness journey, an expanded understanding of their ideal health and wellness balance at home and work, and a stronger sense of serving as a role model who needs to take care of him/herself. CONCLUSIONS: Although the program was helpful in establishing an ideal health and wellness balance at home and work for some school administrators, future programs should better emphasize nutrition and scaffold opportunities to maintain new habits following program completion.

The Relationship between Psychological Stress and Healthy Lifestyle Behaviors during COVID-19 among Students in a US Midwest University.

The gripping coronavirus disease (COVID-19) has imposed dramatic changes to many areas of daily living in all sectors of society across the world. We examined the relationship between perceived stress and health behaviors among college students during the COVID-19 pandemic. An online survey with measures of psychological stress, physical activity and exercise, and sleep and social connectedness was distributed in June and July of 2020. The survey was completed by 550 college students (mean age: 21.3 ± 3.8 years, 74.2% female, 94.4% Caucasian). Being female and unemployed and having a lower annual income were significantly associated with higher levels of stress. In addition, regression analysis found that reduced exercise and sleep during the COVID-19 pandemic significantly predicted the levels of stress of participants after controlling for gender, employment status, and annual income. University officials should aim to implement health-promotion strategies directed at preventing reductions in exercise and sleep duration, especially in those at greater risk of increased perceived stress such as females and economically disadvantaged students.

Adapted Physical Educators' Perspectives of Educational Research.

Purpose: Educational research often provides insight into the potential best practices to use within the classroom setting. Yet, limited information is available on teachers' perspectives toward research in the field of adapted physical education (APE). The current study examined adapted physical educators' perceptions toward research. Method: Sixty general physical education and APE associations within the United State of America were emailed a survey adapted from the National Center for Research Policy and Practice. Results: One hundred twenty-four adapted physical educators were included within the study. Spearmen correlations and frequency counts of open-ended responses were used to analyze the data. Overall, findings indicated that a majority of participants had conducted research, with most participants mentioning it helped them learn more about a particular issue they were facing. Adapted physical educators reported a high rate of engagement with research and that research has a positive impact on important issues, such as behavior management and advocating for students with disabilities. Although positive overall perceptions toward educational research were reported, several items that related to the usefulness and accessibility of research were ranked quite low. In addition, it was found that higher levels of education and years of experience were correlated with lower perceptions toward the validity and usefulness of research. Conclusion: This study highlights the important role research plays in the practice of adapted physical educators; however, researchers need to present their research findings in a more practical way for teachers to translate to their own situations.

Author Correction: High-throughput single-cell activity-based screening and sequencing of antibodies using droplet microfluidics.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

High-throughput single-cell activity-based screening and sequencing of antibodies using droplet microfluidics.

Mining the antibody repertoire of plasma cells and plasmablasts could enable the discovery of useful antibodies for therapeutic or research purposes1. We present a method for high-throughput, single-cell screening of IgG-secreting primary cells to characterize antibody binding to soluble and membrane-bound antigens. CelliGO is a droplet microfluidics system that combines high-throughput screening for IgG activity, using fluorescence-based in-droplet single-cell bioassays2, with sequencing of paired antibody V genes, using in-droplet single-cell barcoded reverse transcription. We analyzed IgG repertoire diversity, clonal expansion and somatic hypermutation in cells from mice immunized with a vaccine target, a multifunctional enzyme or a membrane-bound cancer target. Immunization with these antigens yielded 100-1,000 IgG sequences per mouse. We generated 77 recombinant antibodies from the identified sequences and found that 93% recognized the soluble antigen and 14% the membrane antigen. The platform also allowed recovery of ~450-900 IgG sequences from ~2,200 IgG-secreting activated human memory B cells, activated ex vivo, demonstrating its versatility.

Influence of Attentional Focus Instructions on Motor Performance Among Adolescents With Severe Visual Impairment.

Substantial research has demonstrated that an external (vs. internal) attentional focus enhances motor performance among various populations. Interest has recently grown in examining the effects of attentional focus among individuals with visual impairments (VI), and, to date, research results have been conflicting with some studies supporting a potential benefit to an external focus among adults with VI, while a study of children with severe VI was inconclusive regarding this benefit. The present investigation compared the effects of an internal versus an external attentional focus on a discrete throwing task among adolescents with severe VI. We recruited 13 participants with a visual acuity score of less than 6/60 and had them throw a Goalball (25 cm ball with bells often used in competitive sports designed for people with VI) as fast as possible for three familiarization trials, three internal focus trials, and three external focus trials. These participants threw the ball with significantly higher velocity when using an external focus than in other conditions, indicating a benefit from an external focus for this population when performing this discrete task.

The Differential Effects of Attentional Focus in Children with Moderate and Profound Visual Impairments.

It has been consistently reported that an external focus of attention leads to better motor performance than an internal focus, but no research to date has explored this effect in a population with visual impairments (VI). External focus statements typically reference something in the environment (e.g., target) that may be difficult to conceptualize for people with VI since they cannot generate a visual representation of the object of focus. Internal focus statements could be more closely identifiable with proprioception that is not impaired in this population. Recent studies have reported that sighted adults with temporarily obstructed vision are able to receive an external focus benefit when performing discrete tasks (i.e., golf putt and vertical jump), however, it is unclear if those with VI would experience the same benefit. The purpose of this investigation was to compare how an internal focus and external focus impact the balance of children with VI. Eighteen children with VI were grouped into a moderate (n = 11) and a profound VI group (n = 7). Participants completed a familiarization trial, an internal focus trial (i.e., focusing on feet) and an external focus trial (i.e., focusing on markers) in a counterbalanced order. The moderate VI group had a lower root mean square error while using an external focus (p = 0.04), while the profound VI group did not differ between conditions (p > 0.05). These results suggest that while performing a task reliant on sensory feedback, an external focus benefit may be dependent on the severity of VI. Further research is needed to examine whether external focus statements can be presented in a way that may be more intuitive to those with profound VI. These findings may help to influence how professionals in health-related fields (e.g., physical therapist and physical educators) give instructions on motor performance to populations with VI.

Evaluating Exercise as Evidence-Based Practice for Individuals with Autism Spectrum Disorder.

BACKGROUND: The purpose of this study was to conduct a systematic review of the literature to evaluate empirical support for the use of exercise as an evidence-based practice (EBP) for individuals with autism spectrum disorder (ASD), aged 1-21 years, using the Adapted Physical Activity Taxonomy (APAT) (1). METHOD: A systematic review of research, published within the past 10 years and accessible in SPORTDiscus, ProQuest Nursing, Science Direct, ERIC, Ovid MEDLINE, and PsychINFO databases, was conducted following seven inclusion criteria. An initial 169 articles were identified of which 23 articles were found that met the inclusion criteria including implementation of an exercise intervention for participants diagnosed with ASD and utilization of an experimental/quasi experimental, correlational, single-subject, or qualitative research design. These 23 articles were evaluated using the APAT to determine the quality of the research and the strength of the recommendation in establishing exercise as an EBP. RESULTS: Of the 23 articles evaluated, 17 employed an experimental/quasi experimental design, 1 article employed a correlational design, and 5 articles employed a single-subject design. Only one article (2) was found to meet the minimum overall quality indicator of moderate (i.e., Level 2) when evaluated on the APAT. In total, 13 of the 23 articles (57%) had method sections evaluated as weak, and 17 of the 23 articles (74%) had results sections evaluated as weak. CONCLUSION: From the findings of this systematic review, and in accordance with the Every Student Succeeds Act of 2015 (3) definition of an EBP, it appears that exercise can be considered an EBP for school-aged children with ASD. However, this recommendation is based solely on moderate evidence from one well-designed and well-implemented experimental study; therefore, generalization is still pending further similar findings. Recommendations for future research are offered.