RESUMEN
BACKGROUND: Ten percent of the school-aged population have speech, language, and communication needs (SLCN) that impact access to the curriculum. Successful implementation of classroom-based SLCN interventions can reduce barriers to learning, thereby improving educational outcomes for this vulnerable population. The challenges of implementing innovations in educational settings are well-documented, yet limited studies have addressed such considerations when developing, and piloting universal level SLCN interventions for use in Irish schools. METHODS: A qualitative exploratory study was undertaken to establish the acceptability, feasibility, and appropriateness of a universal level SLCN intervention. An advisory panel of teachers (n = 8) and children with SLCN (n = 2) were engaged as co-researchers in the study. The Communication Supporting Classrooms Observation Tool, developed as part of the Better Communication Project in the UK, was trialled across a diverse sample of school settings (n = 5). Semi-structured interviews were conducted with school practitioners and school leaders, and a deductive content analysis was undertaken using the domains of the Consolidation Framework for Implementation Research. DISCUSSION: The observation tool was viewed as acceptable with suggested additions. Integrating use of the tool within existing data-informed, school self-evaluation processes aimed at supporting school improvement was noted as a potential means of supporting implementation. A knowledge gap in relation to school-based models of support for SLCN was identified which may negatively impact implementation. An implementation strategy targeting coherence, cognitive engagement and contextual integration is indicated if the tool is to be normalised into routine practice in Irish classrooms. Implementation needs appeared to vary at the school level. CONCLUSIONS: The importance of early-stage exploration to guide implementation planning with regards to developing and testing universal level interventions for SLCN in schools is highlighted. Engaging an advisory panel provides important insights to guide implementation decisions. Findings suggest an adaptive design is required when planning implementation studies targeting classroom setting.
Asunto(s)
Comunicación , Instituciones Académicas , Niño , Humanos , Estudios de Factibilidad , Investigación Cualitativa , HablaRESUMEN
BACKGROUND: Population-based studies provide important data to inform policy and service planning for vulnerable children in society. The aim of this study was to characterise social and educational circumstances and self-concept among a nationally representative sample of 13 year olds with developmental disabilities in Ireland. METHODS: A cross-sectional, secondary analysis of data collected from the Growing Up in Ireland (GUI) study was conducted. Descriptive statistics were used to calculate the reported prevalence of disabilities as reported by parents. Differences across the groups (those with and without disabilities) were analysed in relation to gender, socio-economic and school factors. Special education support received in school was described. The association between low self-concept scores (as measured by the Piers Harris Self-Concept Scales 2) and disability type was examined by use of multi-level logistic regression. RESULTS: Seventeen percent (17.36%) of the sample was reported to have a diagnosis of one or more developmental disabilities. Those with a disability were more likely to live in poorer households, have poorer health status, to experience more episodes of bullying at school, and to have more negative views of school (p<0.05) than their typically-developing peers. Forty nine percent of children with developmental disabilities were not receiving support in school as reported by parents. Discrepancies in the nature of support received were identified across disability types. Adjusting for individual and school level factors, a disability diagnosis was associated with increased odds of low self-concept scores on three of five self-concept domains. Further associations were identified which differed across disability type. CONCLUSIONS: The findings show that 13 year olds with a disability in Ireland have complex social and educational needs. Findings also suggest significant levels of unmet educational need across this age group. Apparent inequities in access to support in school require further investigation. Reliable measures to provide robust prevalence figures about childhood disabilities in Ireland are needed.
Asunto(s)
Discapacidades del Desarrollo/epidemiología , Discapacidades del Desarrollo/psicología , Autoimagen , Adolescente , Desarrollo del Adolescente , Acoso Escolar , Estudios Transversales , Educación Especial , Escolaridad , Femenino , Estado de Salud , Humanos , Irlanda/epidemiología , Modelos Logísticos , Masculino , Padres , Pobreza , Prevalencia , Instituciones Académicas , Clase SocialRESUMEN
BACKGROUND: Clinical services in the UK are increasingly delivering 'consultative' methods of intervention rather than 'direct' intensive input for children with receptive and expressive language difficulties, yet there has been little systematic evaluation of these different intervention models. AIMS: To investigate the effectiveness of different models of therapy provision for children with specific language impairment between the ages of 4;00 and 4;06 years. METHODS & PROCEDURES: Twenty-four children were selected from a specialist waiting list in the London Borough of Lambeth. They were assessed on a range of verbal and non-verbal skills, and randomly assigned to three different intervention groups. Group 1 received direct intensive speech and language therapy weekly over an 8-month period at a child development centre; Group 2 received a nursery-based model of intervention; and Group 3 received review sessions at their local clinic. OUTCOME & RESULTS: Statistical analysis before the intervention phase revealed no significant differences in scores between the three groups on a range of clinical and parental measures of language, non-verbal skills, play and behaviour. At the end of the intervention period the Intensive group showed significantly greater improvement than the No Intervention group on all clinical and parental measures, and significantly greater improvement than the Nursery-based group on all clinical and parental measures except for expressive grammar. CONCLUSIONS & IMPLICATIONS: The results of this small-scale study demonstrate that intensive direct speech and language therapy delivered by speech and language therapists was a more effective model of intervention for this clinical group with severe speech and language impairment.