Entering Kindergarten After Years of Play: A Cross-Case Analysis of School Readiness Following Play-Based Education.

Cross-case study research was used to explore the school readiness of four 5-year-old children entering kindergarten during the 2020-2021 school year after three or more years of play-based early childhood education at a Reggio Emilia-inspired early childhood education center. Data included a series of three 1-h individual interviews with four mothers and three kindergarten teachers, field visits during remote learning, and artifact collection over the course of the school year. Themes describing the children's school readiness were developed through cross-case analysis. Participants described the children as learners, explorers, communicators, and empathizers. The learner theme centers on the children's responsiveness to instruction; the explorer theme describes how the children approached learning; the communicator theme illustrates the children's prowess with social connection and self-advocacy, and the empathizer theme shows the thoughtfulness and emotional sensitivity these children displayed. Findings suggest that play-based learning prepared these children for successful kindergarten experiences and was a viable early childhood education pedagogy fostering school readiness.

Exploring features of integrative teaching through a microanalysis of connection-making processes in a health sciences curriculum.

The interconnected nature of knowledge in the health sciences is not always reflected in how curricula, courses, and learning activities are designed. Thus have scholars advocated for more explicit attention to connection-making, or integration, in teaching and learning. However, conceptual and empirical work to guide such efforts is limited. This study analyzed classroom processes to determine what connections educators promoted in their classrooms and how those connections were made. A qualitative, focused ethnography design explored connection-making in a health science curriculum. Eight instructors were observed during ten class sessions resulting in 35 h of video data. Video data were entered into the observational software, Noldus Observer, and coded using continuous sampling. Frequency and duration of connections made were calculated in Noldus. Connection-making involved four interactive elements: The topic under direct consideration, other domains of professional knowledge (practice, student experience, research, theory, other content, core construct of the profession, external influences, metacognition), the integrative processes instructors used to connect a topic to other knowledge domains (informal example, stories, questioning, linking statements, formal cases, and program descriptions), and the learning and instructor context (type and purpose of course, instructor personal and professional experience). These elements are presented as an initial integrative learning taxonomy that can be used to guide explicit attention to connection-making in education and research.

Life-bombing-injury-life: a qualitative follow-up study of Oklahoma City bombing survivors with TBI.

PRIMARY OBJECTIVE: To learn about and come to an understanding of the recovery process and outcomes experienced by the survivors of the 1995 Oklahoma City bombing, who sustained a traumatic brain injury (TBI) along with other injuries in the blast. RESEARCH DESIGN: A phenomenological study was conducted using in-person interviews, document and video-tape review, internet communication and researcher journals as the primary data set. METHODS AND PROCEDURES: A total of 20 of the 46 bombing survivors with TBI (44%) agreed to be a part of the study. The data collection process focused on stories about service needs, services accessed and long-term outcomes of the participants. MAIN OUTCOME AND RESULTS: The researchers' data analysis yielded four themes (Trauma-Healing-Support; What TBI?; How I went back to work and life; Now I really need assistance!) that represented the content and meanings of the interviews and supplemental data. CONCLUSIONS: A common thread running through the interviews of survivors with TBI was their portrayal of life-long medical, emotional, vocational and residential needs since the bombing. What they experienced in the months--extending into years--after the bombing was beyond their own anticipation and that of their families and healthcare professionals.

Impact of pediatric epilepsy: voices from a focus group and implications for public policy change.

Epilepsy affects approximately 0.5-1% of youth, and challenges for them and their families reach far beyond seizures. Quantitative studies have shown that in addition to increased risk for psychosocial difficulties, many experience stigma and barriers to services and resources. As a complement to quantitative analyses, qualitative research further provides unique insight into understanding the impact of epilepsy on youth and families. In the present study, focus groups were held to discuss families' experiences with epilepsy and access to related services. Qualitative analysis revealed three themes highlighting medical, educational, and social challenges of youth with epilepsy. Implications include recommendations for improvements in public awareness and public policy change.

Readiness to recognize: A qualitative case study of educational identification of TBI.

BACKGROUND: The educational identification (ED-ID) of students with traumatic brain injury (TBI) has been legislated in numerous states, and TBI has become its own special education category. Questions abound as to whether these changes will lead to more readily identifying these students to provide appropriate special education supports. OBJECTIVE: Elucidate one state's response to legislative changes around ED-ID of TBI. METHODS: This is a phenomenological case study of nine school districts in one state. Researchers conducted focus groups as well as individual interviews with various special education staff. On-going analysis of the focus group and interview data occurred, until themes were finalized. RESULTS: Reactions of staff comprised two opposing viewpoints: those supporting and carrying out ED-ID ("Toward ED-ID") and those describing processes and attitudes that stand in the way ("Barriers"). Themes that were supportive of ED-ID include Credible History, Personnel, Targeted Intervention, Effective Communication, and Education. Themes aligned with the barrier viewpoint include Concussion Protocols, Medical Nature, Misidentification, Stigma, and Communication Breakdown. CONCLUSION: While many districts reported success with ED-ID for TBI, responses to the ED-ID legislation and TBI category were mixed, with enough barriers identified to cause concern over whether the legislative and policy changes have been overall beneficial.

The Daily Experiences of Pleasure, Productivity, and Restoration Profile: A case study: Étude de cas sur l'utilité du Daily Experiences of Pleasure, Productivity, and Restoration Profile.

BACKGROUND: Occupational therapy enables clients to self-manage their health through the use of occupation; however, additional occupation-focused assessments are needed to capture people's subjective experiences associated with everyday activities as awareness of one's experiences can help promote change. PURPOSE: This qualitative case study explored the utility of one such assessment, the Daily Experiences of Pleasure, Productivity, and Restoration Profile (PPR Profile). METHOD: Five spousal caregivers completed and discussed the PPR Profile with an occupational therapist. Interviews with the caregivers and therapist occurred during and following use. Content analysis revealed several themes. FINDINGS: Both caregivers and the occupational therapist reported that use of the PPR Profile provided benefits but not without challenges. IMPLICATIONS: The findings support preliminary utility of the PPR Profile; however, additional research is needed and occupational therapists need to be aware of the challenges when deciding to use the tool.

"The left hand does not know what the right hand is doing": rural and urban cultures of care for persons with traumatic brain injuries.

This qualitative study examined systems of care for individuals with brain injury, from the providers' perspective, in two Colorado communities, one rural and one small urban, from 1998 to 2001. Using a guided interview format the researchers interviewed 53 medical, rehabilitation, community, and school service providers in the two sites. Of the 53 providers, ethnicity was reported as 100% Caucasian. Client ethnicity in the rural area was 87.9% Caucasian and 6.2% Hispanic, and the urban reported 67.3% Caucasian and 29% Hispanic. Both communities noted problems with care coordination, information about other available services, housing and transportation, and large underserved groups (persons with mild brain injury, non-English speakers, and persons without or with insufficient health insurance). The two communities noted strengths in having peer support networks and options for supported recreation. The rural community demonstrated strengths in dealing with trauma care but had few resources available for long-term rehabilitation and community-integrated services for its residents with brain injuries. The urban community uniquely had an array of alternative treatment approaches available.

Putting brain injury on the radar: exploratory reliability and validity analyses of the Screening Tool for Identification of Acquired Brain Injury in School-Aged Children.

PURPOSE: This study explored the reliability and validity of the Screening Tool for the Identification of Acquired Brain Injury in School-Aged Children (STI). METHODS: Parents and teachers of students (K-12) from 3 different groups (students with known acquired brain injuries, students with special education needs, and typical students) rated their students' behaviors, symptoms, and injuries using the STI. RESULTS: Test-retest and internal consistency analyses indicated acceptable reliability. Additionally, the 3 activities used to determine test validity all yielded positive results. DISCUSSION: The STI indicates sensitivity to learning challenges; however, further research is needed to develop instrument specificity. We also introduce the idea of using tools, such as the STI for the purpose of an "educational identification" for students who are in need of immediate support, and for whom no formal medical diagnosis yet exists.

Violence, abuse, and neglect among people with traumatic brain injuries.

BACKGROUND: Violence, abuse, and neglect (VAN) among people with physical and other disabilities has been reported; however, little is known about VAN experiences among people with traumatic brain injuries (TBI). METHODS: Nine people who reported experiencing VAN post-TBI were interviewed for this phenomenological study. The data were analyzed to understand VAN as experienced by those with TBI. RESULTS: Participants detailed many VAN experiences along with contributing factors, barriers in obtaining help, and recommendations for improving preventive and assistance services. CONCLUSIONS: Greater efforts are needed to identify and prevent VAN among people with TBI. Services following VAN must be improved.

Unmet service needs of persons with traumatic brain injury.

OBJECTIVES: Assess unmet needs of persons with traumatic brain injury (TBI) 1 year after hospital discharge; compare perceived need with needs based on deficits (unrecognized need); determine major barriers to services; evaluate association of needs with satisfaction with life. PARTICIPANTS: Representative sample of 1830 community-dwelling persons with TBI aged 15 years and older. MEASURES: Perceived and unrecognized unmet needs, barriers to receiving services, and satisfaction with life as a function of met service needs. RESULTS: 35.2% of participants reported at least 1 unmet need, 51.5% had unrecognized needs, 47% reported at least 1 barrier to receiving help. Receipt of services significantly increased satisfaction with life. CONCLUSIONS: Many persons experiencing TBI report having unmet service needs 1 year after hospital discharge.

Experiences of persons with epilepsy and their families as they look for medical and community care: a focus group study from South Carolina.

Epilepsy affects a larger number of individuals than previously thought-up to 2% of the population-and its effects reach further. Yet epilepsy, with its associated lingering stigma and fear, has remained in the background in terms of services and research. Traditional quantitative research often falls short when trying to describe the impact of epilepsy on the lives of individuals and their families. In the present study, focus groups were held throughout South Carolina to discuss individuals' experiences with accessing epilepsy-related services and health care, and what life with epilepsy is like. Following qualitative data analysis, findings included two themes. One theme focuses on the ongoing search for services and help. The second theme concerns the experiences of living life with epilepsy. Also highlighted are recommendations for potential improvements in public awareness and professional training, and helpful interventions.

Linking people with traumatic brain injury to services: successes and challenges in Colorado.

People with traumatic brain injury (TBI)-related disability often need services and other types of support to return to productive lives; thus, improving access to available TBI services is a priority for a variety of states' agencies, such as Human Services and Public Health. Although infrastructure and resources vary from state to state, each can benefit by learning about how other states link people with TBI to services. In this report, we summarize Colorado's experience in exploring and developing better ways to link state residents with TBI to services. Recommendations for improving the system of linking people to services in Colorado included the following: (1) expanding the population targeted for linkage to services beyond those who are hospitalized; (2) improving access to information about available services; and (3) increasing the availability of services.

Can traumatic brain injury surveillance systems be used to link individuals with TBI to services?

PRIMARY OBJECTIVE: This study was conducted to determine the feasibility of using Colorado Traumatic Brain Injury (TBI) Surveillance System data to link individuals to information and services in their communities. METHODS AND PROCEDURES: Using a qualitative exploratory approach, the investigators conducted focus groups of individuals with TBI and family members (n = 29) and individual interviews with state agency, medical and community services representatives (n = 15). MAIN OUTCOMES: The results showed that the participants saw many current problems with linking persons to services and with accessing care. The participants supported using TBI surveillance data to link persons to information and services, offered suggestions, discussed confidentiality and consent issues, described possible cultural competence issues and addressed cost feasibility. CONCLUSIONS: Overall persons with TBI and their family members overwhelmingly supported using the Colorado TBI Surveillance System to link persons to services. One major concern, however, was how to link persons who were not included in the surveillance data because their TBI happened before the surveillance system was implemented or because their injury did not result in hospitalization. This concern is addressed in a Linkage Model.

Exploring the service needs and experiences of persons with TBI and their families: the South Carolina experience.

PRIMARY OBJECTIVE: This article presents the results of four focus groups with persons with traumatic brain injury (TBI) and their families living in South Carolina. The objective was to learn what participants perceive their service needs to be and where they experience service gaps in the existing system of TBI services. METHODS AND PROCEDURES: Four focus groups were conducted. In each group, a convenience sample of persons < 5 years post-injury and family members responded to 10 semi-structured questions. MAIN OUTCOMES: Qualitative content analysis revealed overwhelming consensus regarding the need for (1) early, continuous, comprehensive service delivery; (2) information/education; (3) formal/informal advocacy; (4) empowerment of persons with TBI/families; and (5) human connectedness/social belonging. CONCLUSIONS: Persons with TBI and families in South Carolina experience the service system as unorganized, uneducated, unresponsive and uncaring. Effective strategies are needed that link services into an ongoing continuum of TBI care, increase TBI-specific education and awareness and foster social re-integration.