Effects of stimulus presentation order during auditory-visual conditional discrimination training for children with autism spectrum disorder.

Children with autism spectrum disorder are typically taught conditional discriminations using a match-to-sample arrangement. Consideration should be given to the temporal order in which antecedent stimuli (the sample and comparison stimuli) are presented during match-to-sample trials, as various arrangements have been used in the extant literature. The purpose of the current study was to compare the effects of four stimulus presentation orders on the acquisition of auditory-visual conditional discriminations. The study included participants from a clinically relevant population (three children with autism spectrum disorder), employed clinically relevant teaching procedures, and included two presentation formats not included in previous comparison evaluations (simultaneous and sample-first with re-presentation conditions). Results were found to be learner-specific; that is, a different stimulus presentation format was most efficient for each participant. We provide suggestions to evaluate stimulus control topographies and enhance experimental control in match-to-sample arrangements.

A preliminary investigation of a school-based musical theater intervention program for children with intellectual disabilities.

The presence of an intellectual disability may cause a child to have significant deficits in social skills and emotion regulation abilities across development. A vital next step is to find interventions that can be delivered in the school environment and across disability categories that target socioemotional factors. The current study investigated the feasibility of delivering a school-based musical theater program to students with intellectual disability across a range of school settings. A within-group repeated-measures design was used to analyze pre- and post-video recordings of the intervention program, which were coded for six domains of socioemotional ability across all participants ( n = 47). Results showed that significant gains across all domains were observed. However, these gains related to school- and individual-level student factors, such as grade level, severity of disability, and baseline social skill ability.

The effectiveness of the computerized visual perceptual training program on individuals with Down syndrome: An fMRI study.

This study investigated the effectiveness of the Computerized Visual Perception Training (CVPT) program on individuals with Down syndrome (DS, mean age=13.17±4.35years, age range: 6.54-20.75 years). All participants have mild intellectual disability classified by the standard IQ measures (mean=61.2, ranges from 55 to 68). Both the Test of Visual Perceptual Skill- Third Edition (TVPS-3) and functional magnetic resonance imaging (fMRI) were used to evaluate the training outcomes. Results of TVPS-3 and fMRI showed that DS group had visual perceptual deficits and abnormal neural networks related to visual organization. The results showed that DS intervention group had significant improvements on TVPS-3 after intervention. The fMRI results indicated more activation in superior and inferior parietal lobes (spatial manipulation), as well as precentral gyrus and dorsal premotor cortex (motor imagery) in DS intervention group. The CVPT program was effective in improving visual perceptual functions and enhancing associated cortical activations in DS.

InSPAL: A Novel Immersive Virtual Learning Programme.

In this paper we introduce The Interactive Sensory Program for Affective Learning (InSPAL) a pioneering virtual learning programme designed for the severely intellectually disabled (SID) students, who are having cognitive deficiencies and other sensory-motor handicaps, and thus need more help and attention in overcoming their learning difficulties. Through combining and integrating interactive media and virtual reality technology with the principles of art therapy and relevant pedagogical techniques, InSPAL aims to strengthen SID students' pre-learning abilities, promote their self-awareness, decrease behavioral interferences with learning as well as social interaction, enhance their communication and thus promote their quality of life. Results of our study show that students who went through our programme were more focused, and the ability to do things more independently increased by 15%. Moreover, 50% of the students showed a marked improvement in the ability to raise their hands in response, thus increasing their communication skills. The use of therapeutic interventions enabled a better control to the body, mind and emotions, resulting a greater performance and better participation.

Aportes desde la bioética para la incluision de niños y niñas con necesidades educativas especiales en la escuela común a través de musicoterapia / Contributions from bioethics for the inclusion of children with special educational needs in mainstream schools through music therapy

La tesis reflexiona sobre los aportes de la musicoterapia en la inclusión de niños y niñas con necesidades educativas especiales (NEE) en la escolaridad común. Tomando como punto de partida su reconocimiento como sujetos éticos, históricos, políticos, culturales e integrantes de una comunidad - y no solo como personas a la que hay que rehabilitar - este estudio documental y exploratorio integra fuentes bibliográficas y categorías pertenecientes a los campos de la bioética, la educación y la musicoterapia. La exploración de las potencialidades de la musicoterapia dentro del sistema educativo formal promueve reflexiones éticas y nuevos interrogantes sobre los límites y posibilidades de la acción escolar vinculando los principios bioéticos con el pleno ejercicio de los derechos consagrados en la Ley Nacional de Educación. Dentro de un marco de justicia distributiva, se presenta la musicoterapia como un recurso que puede optimizar los procesos de inclusión de personas con NEE pasando del cumplimiento del principio de la no maleficencia al de la beneficencia. A la luz de categorías provenientes del campo educativo, como la noción de educabilidad vinculada a la atención de la diversidad y el uso pleno de los derechos, se revisan los paradigmas que subyacen en los procesos de inclusión/exclusión de NEE. Luego de ofrecer un esquema conceptual referencial y operativo para incorporar la musicoterapia al ámbito educativo, se presenta el Caso Matías, un relato sistemático que permite integrar las particularidades y propiedades de la Musicoterapia y sus aspectos convergentes con la Bioética, en sentido inductivo y deductivo

ABSTRACT: This thesis shows how music therapy helps in the inclusion of boys and girls with special needs in the educational area, we have to recognize them as ethic, historical, political and cultural human been which integrates a community and not just see them as people who we need to rehabilitate. This documental study integrates the bioethics, education and music therapy resources. The exploration of how the music therapy has the potential to get into the formal educational system, and propose new question about limits and possibilities to get into the school vinculating the bioethics principles knowing the existence of the rights which are in the National Education Law. The musical therapy is a resource inside the distributive justice, can be used as an inclusive process for people with special educational needs, using the fulfillment of the non maleficence to the beneficence. With the categories of the educational area like educability notion, bonding to the attention of diversity and the use of rights, we check the paradigms that are in the process of inclusion/exclusion. After offering a conceptual, referential and operative scheme to incorporate the musical therapy to the educational system we present Matia’s case, a systematic report which help us to integrate the properties and particularities of the musical therapy convergent with the bioethics, in a sense of induction and deduction

The Beech Brook Group Therapy Assessment tool: a pilot study.

BACKGROUND: Assessment is a critical component of therapeutic intervention as it serves as the basis from which clinical goals and objectives are derived. Unfortunately, there is a dearth of reliable group therapy assessment instruments, especially for children and preadolescents who have severe emotional disturbances. OBJECTIVE: The purpose of this study was to test reliability of a newly developed group therapy assessment instrument for use with children who have serious emotional disturbances that require placement in a residential or partial hospitalization treatment program. METHODS: After conducting an extensive literature review, the authors developed, refined, and tested a group therapy assessment tool for use in both music therapy and traditional therapy, measuring nine items: attention to task (physical and verbal), eye contact, pro-social skills (physical and verbal), empathy (physical and verbal), and managing negative affect (physical and verbal). Six participants with a mean age of 9.5 (SD = 1.85) years were randomly selected to test the group therapy assessment tool from a pool of 60 eligible children receiving group partial hospitalization therapy. Participants were scored by three raters across two partial hospitalization therapy groups for inter-rater reliability. Content and construct validity were also examined. RESULTS: Intraclass Coefficients (ICC) averaged 0.994 across all nine items indicating excellent inter-rater reliability. Content and construct validity was established and the instrument demonstrated good external validity potential. CONCLUSIONS: The Beech Brook Therapy Assessment Instrument has demonstrated excellent inter-rater reliability in measuring important behaviors of functioning central in the treatment of youth with severe and emotional disturbances. The measure has potential for wide utility and application in practice and research; however, future studies are needed to establish external validity.

The effect of a music therapy social skills training program on improving social competence in children and adolescents with social skills deficits.

Three separate studies were conducted in school, residential and after-school care settings to test the effectiveness of a music therapy-based social skills intervention program on improving social competence in children and adolescents. A total of 45 children (n = 12; n = 13; n = 20) aged 6-17 years with social skills deficits participated in a group-based five session intervention program. The same curriculum, adapted to be age appropriate, was used at all 3 sites. Specific deficits within the social skills areas of peer relations and self-management skills were targeted. Active interventions like music performance, movement to music and improvisation were used. Cognitive-behavioral techniques like modeling, feedback, transfer training and problem solving were also incorporated. Data on social functioning were collected before, during, and after the music therapy intervention from participants, appropriate adult personnel and via behavioral observations. Results indicated that significant improvements in social functioning were found in (a) school participant pre and post self-ratings, (b) researcher pre and post ratings of school participants, (c) case manager's pre and post treatment ratings for the residential participants, (d) after-school care participants' pre and post self-ratings, and (e) behavioral observations at all three settings. Additional changes, although not significant, were noted in teacher ratings, residential participant self- and peer ratings, and after-school case manager ratings. Results from these studies suggest that the music therapy intervention was effective in improving social competence in children and adolescents with social deficits. More research is warranted to provide additional guidance about the use of music therapy interventions to improve social functioning.

Intervención centrada en el reconocimiento de pródromos: problemática observada desde un CRPS / No disponible

El objetivo del presente artículo es, en un primer lugar, llevar a cabo una revisión acerca de la evolución que han tenido hasta nuestros días tanto los programas de psicoeducación como los métodos de abordaje centrados en el reconocimiento y manejo de pródromos en personas con un diagnóstico de psicosis y trastorno bipolar. Posteriormente se ponen de manifiesto algunas dificultades encontradas durante la puesta en práctica de un programa psicoeducativo centrado en el reconocimiento y manejo de pródromos en el centro de rehabilitación psicosocial de Aranjuez, así como las estrategias usadas para tratar de solventar éstas. Por último se detallan y tratan de responder algunas cuestiones que surgen durante la aplicación del programa psicoeducativo y la elaboración de este trabajo (AU)

The aim of the present article is in a first place carry out a review about the evolution that have had until our days so much the psychoeducative programs and the methods of intervention centered in the recognition and handle of prodromes in people with a diagnose of psychosis and bipolar disorder. Subsequently we put of manifest some difficulties found during the put in practice of a psychoeducative program centered in the recognition and handle of prodromes in the CRPS of Aranjuez and the strategies used to treat to solve these. Finally we detail and treat to answer some questions that arise during the application of the psychoeducative program and the elaboration of this work (AU)

Outcomes of anti-bullying intervention for adults with intellectual disabilities.

Although existing research is scarce, evidence suggests that children and adults with intellectual disabilities may be at increased risk of being bullied (as they are for maltreatment generally) and possibly more likely than those without disabilities to also engage in bullying behavior. Despite significant clinical interest in bullying, we could find no published research on the outcomes of bullying intervention for individuals with intellectual disabilities. Adults with intellectual disabilities in three work center settings participated in one of two interventions for perpetrators and/or victims of bullying: (a) psychoeducational intervention with a cognitive behavioral orientation (n=20), or (b) the same intervention but with additional involvement of community stakeholders such as parents, the police, and local schools (n=22). A third work center (n=18) acted as a waiting list control comparison. Pre-intervention, 43% of participants reported that they had been bullied within the preceding three months and 28% identified themselves as having bullied others. Reports of being bullied decreased significantly within the two intervention groups over time but not in the control group. There were no differences between the two intervention groups, and no statistically significant reduction in self-reported bullying behavior. Initial data on this intervention suggest that its effects might be clinically meaningful with an associated Numbers Needed to Treat for reduction in exposure to bullying of 5.55.

Psicofamilia: experiencia terapéutica en la atención de jóvenes y adultos con diagnóstico de retraso mental y sus familiares / Psycho family: an experience on the care of young and adults with Mental Retard and their relatives

Este trabajo expone una estrategia psicoterapéutica para atender a familiares de jóvenes con discapacidad, los cuales fueron capaces de asumir a partir de su nacimiento una atención diferenciada hacia sus hijos o familiar inmediato, desde sus raíces y costumbres heredadas, con un predominio de conductas disfuncionales que obstaculizan la evolución de los mismos. De ahí la importancia de este trabajo que tiene como intensión fundamental la de transformar estas conductas y obtener una mayor rehabilitación física - mental, así como medir sus resultados. Se determinaron variables estructurales, evolutivas y funcionales cuya evaluación reveló cambios sustanciales expresados en el crecimiento psicológico de la familia en función de la aceptación y adecuado manejo de la discapacidad posibilitando la integración activa como seres sociales con las mismas oportunidades y derechos que cualquier ciudadano(AU)

This work is about a psychotherapeutic strategy to help those relatives (of young people suffering mental retard) that assumed a differentiated care including dysfunctional behaviors that hinder the development of these young people. This fact is the importance of this paper with the objectives of transforming these behaviors, to obtain a greater physical and mental rehabilitation and to value the results. Functional, progressive and structural variables were determined and they revealed significant psychological changes in the family respect to how to manage the disability of mental retardation of their relatives allowing them to participate actively as social citizens(AU)

Increasing independent decision-making skills of women with mental retardation in simulated interpersonal situations of abuse.

The effectiveness of two decision-making training approaches in increasing independent decision-making skills of 36 women with mild mental retardation in response to hypothetical social interpersonal situations involving abuse was evaluated. Participants were randomly assigned to a control or one of two training conditions (a decision-making training approach that either addressed both cognitive and motivational aspects of decision-making or included only instruction on the cognitive aspect of decision-making). Although both approaches were effective relative to a control condition, the combined cognitive and motivational training approach was superior to the cognitive only training approach. The superiority of this approach was also reflected on a verbally presented generalization task requiring participants to respond to a decision-making situation involving abuse from their own perspective and on a locus of control scale that measured perceptions of control.

Teaching preschool children with disabilities to respond to the lures of strangers.

An investigation was conducted to determine the effectiveness of a constant-time-delay procedure used in combination with multiple exemplars of strangers, lures, and sites to teach a generalized response to the lures of strangers to four preschool children with disabilities. Although the correct response was quickly acquired in the training site, the response failed to generalize to the probe sites until training was conducted in vivo. Instruction in vivo resulted in acquisition, maintenance, and generalization of the response to strangers' lures. Generalization occurred across probes with novel exemplars of lures, strangers, and sites.

Teaching children with autism to initiate to peers: effects of a script-fading procedure.

A script that was systematically faded from end to beginning was used to teach peer initiations about recently completed, current, and future activities. The effectiveness of the script-fading procedure was assessed via a multiple baseline design across 4 children with autism. During baseline, the children seldom initiated to peers, although all had previously acquired some functional expressive language and sometimes spontaneously addressed adults. When the script was introduced, peer initiations increased, and as the script was faded, unscripted initiations increased. With the minimal written prompts available in the final fading steps, initiations generalized to a different setting, time, teacher, and activity; and for 3 of the 4 children, peer initiations were maintained at a 2-month follow-up. After the script was faded, the participants' levels of peer initiations were within the same range as a normative sample of 3 nondisabled youngsters. The script-fading procedure enabled children with severe social and verbal deficits to practice context-specific, peer-directed generative language that was not prompted by adults or peer confederates.

Social validation of component behaviors of following instructions, accepting criticism, and negotiating.

This study evaluated whether behaviors often taught as part of social skills training are judged favorably by others. Community judges evaluated the performances of people in various situations requiring one of three social skills: following instructions, accepting criticism, and negotiating to resolve conflicts. These skills were displayed in videotaped scenes by actors with and without mental retardation who acted out roles that had different types of authority relationships, and when different components or clusters of behavior (nonverbal, specific verbal, or general verbal behaviors) were performed well or poorly. The highest ratings by judges were of videotaped scenes that depicted correct use of all behaviors, regardless of which skill was being examined, whether or not the actor had mental retardation, or what the relationship was between the two actors. The lowest ratings were of videotaped scenes that depicted poor performance of all behaviors, and intermediate ratings were obtained when only some of the behaviors were performed poorly. These results, as well as the verbal responses of judges to questions, indicated that the different behaviors commonly used in teaching the skills of following instructions, accepting criticism, and negotiating are relevant to judgment of social performance, and are likely to be reinforced and maintained by social contingencies.

Comparison of two methods of improving dynamic balance of mentally retarded children.

To compare the effectiveness of a creative dance and a movement exploration program in relation to balance performance 26 mildly and moderately mentally retarded boys and girls (ages 8 to 13 years) were randomly assigned to one of the programs. Mean ages of the subjects in the dance and movement exploration groups were 10.5 yr. and 11.1 yr., respectively. Each group received 24 lessons of 30 min. each, in the 8-wk. program. Pre- and posttest distance on six balance-beam tasks and stabilometer performance subjected to multivariate analysis of covariance indicated no significant differences.

Teaching refusal skills to sexually active adolescents.

Refusal skills training was extended to sexually active handicapped female adolescents who lacked an effective refusal strategy. Role-plays for assessment and training were developed using the who, what, when and where of situations which resulted in unwanted intercourse. Refusal skills were trained following the format of rationale, modeling, rehearsal, feedback, and reinforcement. Baseline rates of most target behaviors were quite low. High frequencies of target behaviors were observed as each behavior became the focus of training. Generalization across staff and time was also observed. The skillfulness and effectiveness of the subjects' refusal skills were judged to be improved as a function of training. One-year follow-up showed decreased sexual activity for each girl.

PIP: In an attempt to curtail adolescent pregnancy, refusal skills were taught to 2 sexually active and handicapped female adolescents. The goal was to surpass the just say no philosophy by 1) socially validating each girl's effectiveness and skill, and 2) extending refusal skills training to special populations, where skill deficits may be more prevalent and the need the greatest. One child Amy, 16 years) was dead and was being treated for sexual disorders, and the other (Karen, 14 years) was developmentally delayed and sexually precocious. Both desired refusal skills. Training was designed to teach skills to effectively refuse sexual advances when they deemed it necessary and desirable to do so. An assessment was made for each girl. A role play vignette was developed for each girl which relied on her past experiences. The performance of the role play was videotaped in order to identify the particular deficits in refusal assertion. Refusal, specification, leaving the situation, and eye contact were situations that were categorized as either an occurrence or nonoccurrence for the pre- and postassessments. Skills were taught based on rationale, feedback, modeling, behavioral rehearsal, and reinforcement. 8 randomly ordered play roles were analyzed by 2 observers to evaluate social perception of client refusal skills and effectiveness. Reliability was evaluated using Cohen's Kappa (K). The K for eye contact was .84; refusal , .85; leaving the situation, 1.0; and specifying objectionable behavior, .90. The deaf child, Amy, initially showed only eye contact skills, while Karen used only verbal refusal before skills training. The intervention created long and shortterm effects, i.e., use of target behaviors posttraining, at a 2-week follow up with nonintervention staff, and a 1-year telephone follow up which indicated decreased sexual activity for each girl. Significant differences were found in the baseline and posttreatment performance ratings for both refusal and effectiveness (F=103.02, df=27.3, p=.001; and F=243.7, df=27.3, p.001). For Karen only refusal skill rating was significantly changed (F=22.06, df=27.3, p=.001). There is a need to provide additional research to verify the actual effectiveness of refusal skills packages and their impact on the occurrences of unwanted sexual behavior. Refusal components, developmental factors, societal norms, familial and peer pressure that are most critical need to be determined. Generalizability is limited.

The effects of music therapy on a group of profoundly mentally handicapped adults.

An investigation of the effects of music therapy on profoundly mentally handicapped adults is reported. The therapy was directed at achieving specific objectives for individuals and the study compared the efficacy of music therapy and play activities in achieving these objectives. Four subjects out of the 12 included in the therapy groups were studied intensively. All subjects received both treatments in a reversal design with 20 weekly sessions of each treatment. Videotapes of the treatment sessions were analysed using a time-sampling method to record the occurrence of behaviour indicating the achievement of the individual treatment objectives. Staff behaviour in the treatment sessions was also observed to investigate the role of staff attention in mediating the treatment effects. The observations of staff behaviour showed that, overall, there was less individual attention given during music therapy than in play sessions, that there was a much greater role differentiation among the staff present in the music therapy groups and that individual clients in the groups received markedly unequal amounts of staff attention. For all four subjects studied in detail, some differences in behaviour were shown between the treatments and most, but not all, of these differences indicated greater effectiveness of music therapy. For one subject showing higher performance in play sessions than in music therapy, this could be attributed to a higher level of staff attention for this subject. The differences in favour of music therapy could not be accounted for in this way. It is concluded that music therapy is a useful treatment approach with profoundly handicapped people.