Care management in a French cohort with Down syndrome from the AnDDI-Rares/CNSA study.

Down syndrome (DS) is a genetic neurodevelopmental disorder. In individuals with DS, a multidisciplinary approach to care is required to prevent multiple medical complications. The aim of this study was to describe the rehabilitation, medical care, and educational and social support provided to school-aged French DS patients with varying neuropsychological profiles. A mixed study was conducted. Quantitative data were obtained from a French multicentre study that included patients aged 4-20 years with diverse genetic syndromes. Qualitative data were collected by semi-structured face-to-face interviews and focus groups. Ninety-five DS subjects with a mean age of 10.9 years were included. Sixty-six per cent had a moderate intellectual disability (ID) and 18.9% had a severe ID. Medical supervision was generally multidisciplinary but access to medical specialists was often difficult. In terms of education, 94% of children under the age of six were in typical classes. After the age of 15, 75% were in medico-social institutions. Analysis of multidisciplinary rehabilitation conducted in the public and private sectors revealed failure to access physiotherapy, psychomotor therapy and occupational therapy, but not speech therapy. The main barrier encountered by patients was the difficulty accessing appropriate facilities due to a lack of space and long waiting lists. In conclusion, children and adolescents with DS generally received appropriate care. Though the management of children with DS has been improved considerably, access to health facilities remains inadequate.

Impact of an Inclusive Postsecondary Education Program on Implicit and Explicit Attitudes Toward Intellectual Disability.

People with intellectual disability (ID) experience negative consequences as a result of stigmas held by the public. Students with ID involved in inclusive postsecondary education (IPSE) programs demonstrate positive outcomes. This study examines the impact of an IPSE program on typically matriculating student attitudes toward ID. Explicit and implicit attitudes were measured at the start and end of a semester among IPSE volunteer peer mentors (n = 17) and an uninvolved student group (n = 14). Findings indicate that volunteers demonstrated lower discomfort after their volunteer experience, as measured by the Attitudes Toward Intellectual Disability Questionnaire (ATTID). Volunteers also demonstrated higher knowledge of causes and preference for interaction with people with ID than nonvolunteers. This demonstrates that volunteer involvement in IPSE positively impacts attitudes toward people with ID among typically matriculating college students.

Quantifying differences between conditions in single-case designs: Possible analysis and meta-analysis.

The current paper is a call for and illustration of a way of closing the gap between basic research and professional practice in the field of neurorehabilitation. Methodologically, single-case experimental designs and the guidelines created regarding their conduct are highlighted. Statistically, we review two data analytical options, namely (a) indices quantifying the difference between pairs of conditions in the same metric as the target behavior and (b) a formal statistical procedure offering a standardized overall quantification. The paper provides guidance in the analysis and suggests free software in order to illustrate, in the context of data from behavioral interventions with children with developmental disorders, that informative analyses are feasible. We also show how the results of individual studies can be made eligible for meta-analyses, which are useful for establishing the evidence basis of interventions. Nevertheless, we also point at decisions that need to be made during the process of data analysis.

Pictorial mnemonic-strategy interventions for children with special needs: Illustration of a multiply randomized single-case crossover design.

An innovative single-case crossover design containing multiple forms of randomization was implemented with eight participants in seven weekly sessions, during which instruction was given in the use of two different pictorial mnemonic (memory-enhancing) strategies: one designed to improve the children's learning of the dates of various inventions and the other designed to improve the children's acquisition of unfamiliar vocabulary items. A composite randomization statistical test revealed that when compared with the children's own preferred learning methods, the mnemonic-strategy approach produced the predicted facilitation effects. At the same time, it was evident that mnemonic instruction enhanced children's performance to a greater extent on the vocabulary task than on the inventions task. In-depth examination of both individual student performance profiles and the tasks/procedures were conducted, yielding recommendations and challenges for follow-up single-case intervention research on the topic.

A Closer Look: Examining Teachers' Language Around UDL, Inclusive Classrooms, and Intellectual Disability.

The purpose of this study was to examine the language teachers used to discuss inclusion, Universal Design for Learning (UDL), and learners with intellectual disability (ID) in an effort to better understand how teachers describe the relationship between those three. Utilizing a secondary analysis procedure, interview transcripts from seven general education teachers were reanalyzed to identify language used by teachers to refer to inclusive educational settings, the implementation of UDL, and learners with intellectual disability. The identified themes were then juxtaposed against the UDL framework (principles, guidelines, and checkpoints) and the current literature related to UDL and inclusive education. We end with recommendations for future practice and research involving inclusive classrooms, UDL, and learners with ID.

Fiabilidad y estabilidad en el diagnóstico de la alta capacidad intelectual / Reliability and stability in the diagnosis of high intellectual capacity

Introducción. Desde una perspectiva diferencial, es esencial identificar la alta capacidad intelectual (ACI) como recurso de valor personal y social. Es necesaria una aproximacion metrica valida, estable y fiable que evite tanto los falsos positivos como su no deteccion, facilitando la planificacion e implementacion de programas de intervencion educativa que permitan la expresion del potencial y bienestar personal. Objetivo. Explorar la fiabilidad y estabilidad de la aproximacion metrica a la ACI en distintos momentos de medida. Sujetos y métodos. Se estudian 58 ninos con ACI, de 8-14 años, asistentes a un programa de enriquecimiento extracurricular. Se administra una medida intelectual multidimensional, en dos puntos temporales con un intervalo de un ano (T1 y T2), mediante la bateria de aptitudes diferenciales y generales o el test de aptitudes diferenciales (segun la edad), y el test de pensamiento creativo de Torrance. Se calcula si hay diferencias estadisticamente significativas entre las puntuaciones obtenidas por cada participante en T1 y T2, y se realiza un analisis de regresion intraindividual para conocer el significado de las diferencias significativas obtenidas. Resultados. Hay diferencias significativas en 25 de los perfiles estudiados entre las medidas T1-T2, de los cuales el analisis de regresion indica que hay cinco con inestabilidad entre las medidas T1 y T2, lo que implica un cambio de perfil intelectual. Conclusión. Se reflexiona sobre la importancia de asegurar la estabilidad y fiabilidad de la medida psicologica y el papel del cociente de inteligencia para aumentar la eficacia del diagnóstico de la ACI, dada su repercusion en el ajuste educativo, la expresion de la potencialidad y el bienestar personal (AU)

Introduction. From a differential perspective it is essential to identify high intellectual capacity (HIC) as a valuable personal and social resource. A valid, stable and reliable metric approach is needed that prevents both false positives and nondetection, thus facilitating the planning and implementation of educational intervention programmes that enable the individual to express his or her personal well-being and potential. Aim. To explore the reliability and stability of the metric approach to HIC at different times of measurement. Subjects and methods. The study examined a sample of 58 children with HIC, aged 8-14 years, who attended an extracurricular enrichment programme. A multidimensional intellectual measure was administered at two points in time with an interval of one year (T1 and T2), by means of the differential and general aptitudes battery or the differential aptitudes test (according to the age), and the Torrance test of creative thinking. Calculations were performed to determine whether there were any statistically significant differences between the scores obtained by each participant at T1 and T2. An intraindividual regression analysis was also performed to establish the meaning of the significant differences obtained. Results. There were significant differences between the T1-T2 measurements in 25 of the profiles studied. Of these, the regression analysis indicated that there were five with instability between the T1 and T2 measures, which implies a change in intellectual profile. Conclusion. We discuss the importance of ensuring the stability and reliability of the psychological measure, and the role of the intelligence quotient to increase the efficacy of the diagnosis of HIC, given its repercussion in educational adaptation, the expression of potentiality and the patient’s personal well-being (AU)

El educador en el aula, un valor añadido a la inclusión educativa: el aula itinerante / No disponible

La inclusión educativa se ve cuestionada, por la dificultad que los maestros encuentran al tener que gestionar diferentes niveles, capacidades y objetivos educativos dentro del aula ordinaria. Se va a exponer una experiencia que se lleva a cabo en Cataluña en el marco de la educación inclusiva. El objetivo es potenciar las capacidades del alumno con NEE, poniendo énfasis en superar «las barreras para la participación y el aprendizaje» con el fin de favorecer la participación en un entorno ecológico, favoreciendo que sean los recursos los que se aproximen al alumno y los que capaciten al conjunto de agentes educativos implicados. Se desarrolla con la intervención de un profesional especializado como mediador del proceso inclusivo trabajando dentro del aula, el «Aula Itinerante». Los principios sobre los que se sustenta el trabajo del especialista tienen que ver con capacitar al sistema trabajando a tres niveles: los docentes, el grupo clase y el alumno con NEE, facilitando que la institución educativa se enriquezca de la experiencia. La intervención en el aula facilita ofrecer estrategias a los docentes; la vivencia de diversidad a los compañeros; y la posibilidad, al alumno con NEE, de facilitar su desarrollo global y su calidad de vida

Inclusive education is challenged, because of the difficulty that teachers have to manage different levels, abilities and educational goals within the regular classroom. In this communication, it is presented an experience carried out in Catalonia in the context of inclusive education. The aim is to enhance the capabilities of students with SEN, emphasizing overcome «barriers to participation and learning» in order to promote participation in an ecological environment favoring the resources that are approaching students and to train the group of educators involved. It is developed with the intervention of a specialized professional as mediator in the inclusive process working in the classroom, the «Itinerant Classroom». The principles that underpin the specialist’s work have to do with training the system working at three levels: teachers, the group class and the student with SEN, providing that the school is enriched by this experience. Classroom intervention also offers strategies to teachers; the experience of diversity peers, and the possibility to facilitate the overall development and quality of life of students with SEN

Students with intellectual disability in higher education: adult service provider perspectives.

Postsecondary education (PSE) is increasingly becoming an option for students with intellectual disability (ID; Grigal & Hart, 2012 ). Postsecondary education offers the promise of pursuing a valued social role (that of college student), enhanced social networks, and, most significantly, increased employment options. To date, research and practice in the area of transition to PSE for students with ID has focused primarily upon the sending (public school systems) and receiving (colleges or universities) agencies ( Oertle & Bragg, 2014 ; Thoma et al., 2011 ). Yet adults with ID often require ongoing supports through state and federally funded developmental disability waivers, and agency providers of waiver services have, for the most part, not been part of this vital conversation. This study represents an exploratory study of directors of developmental disability provider agencies in one midwestern state to assess their knowledge of PSE for individuals with ID. A total of 87 directors responded; quantitative results are presented and, based on these findings, we provide implications for the future.

La habilidad visuo-espacial en el síndrome de Down: ¿es realmente un punto fuerte? Resumen de un meta-análisis / No disponible

El síndrome de Down muestra serios problemas en las habilidades verbales y relativamente mejores habilidades visuo-espaciales. A menudo se considera a la habilidad visuo-espacial como un punto fuerte o fortaleza en el síndrome de Down. Sin embargo, no está claro si se trata de una fortaleza sólo en comparación con sus habilidades verbales, o, lo que sería más impactante, en relación con su capacidad cognitiva en general. Para responder a esta cuestión, hemos realizado una extensa revisión de los estudios sobre habilidades visuoespaciales en las personas con síndrome de Down, desde enero de 1987 a marzo de 2013. Basándonos en la taxonomía general de las habilidades espaciales y en los estudios existentes sobre el síndrome de Down, hemos incluido cinco dominios diferentes de habilidades espaciales: la memoria visuo-espacial, la construcción visuoespacial, la rotación mental, el cierre gestáltico y la selección de un camino o senda. Hemos evaluado un total de 49 trabajos que han incluido 127 estudios diferentes comparaciones. La mayoría de ellas utilizaban un grupo con síndrome de Down vs. un grupo con desarrollo normal pero de la misma edad mental, enfrentados los dos a una misma tarea que medía una de las cinco habilidades visuo-espaciales. Aunque se necesita realizar más estudios para llegar a conclusiones firmes sobre algunas de estas habilidades, no se apreció evidencia alguna de que la habilidad visuo-espacial constituya un punto fuerte en el síndrome de Down cuando se la compara con la habilidad cognitiva general. Más bien, la revisión sugiere un perfil variable de habilidades visuo-espaciales en el síndrome de Down, en la que algunas de ellas guardan correspondencia con a las del nivel cognitivo, mientras que otras se Encuentra por debajo de dicho nivel

Down syndrome (DS) is associated with extreme difficulty in verbal skills and relatively better visuo-spatial skills. Indeed, visuospatial ability is often considered strength in DS. However, it is not clear whether this strength is only relative to the poor verbal skills, or, more impressively, relative to cognitive ability in general. To answer this question, we conducted an extensive literature review of studies on visuo-spatial Abilities in people with Down syndrome from January 1987 to May 2013. Based on a general taxonomy of spatial abilities and existing studies of DS, we included five different domains of spatial abilities - visuo-spatial memory, visuo-spatial construction, mental rotation, closure, and wayfinding. We evaluated a total of 49 studies including 127 different comparisons. Most comparisons involved a group with DS vs. a group with typical development matched on mental age and compared on a task measuring one of the five visuo-spatial abilities. Although further research is needed for firm conclusions on some visuo-spatial abilities, there was no evidence that visuo-spatial ability is a strength in DS relative to general cognitive ability. Rather, the review suggests an uneven profile of visuo-spatial abilities in DS in which some abilities are commensurate with general cognitive ability level, and others are below

Effects of computer-based graphic organizers to solve one-step word problems for middle school students with mild intellectual disability: A preliminary study.

The purpose of this study was to examine the effects of computer-based graphic organizers, using Kidspiration 3© software, to solve one-step word problems. Participants included three students with mild intellectual disability enrolled in a functional academic skills curriculum in a self-contained classroom. A multiple probe single-subject research design (Horner & Baer, 1978) was used to evaluate the effectiveness of computer-based graphic organizers to solving mathematical one-step word problems. During the baseline phase, the students completed a teacher-generated worksheet that consisted of nine functional word problems in a traditional format using a pencil, paper, and a calculator. In the intervention and maintenance phases, the students were instructed to complete the word problems using a computer-based graphic organizer. Results indicated that all three of the students improved in their ability to solve the one-step word problems using computer-based graphic organizers compared to traditional instructional practices. Limitations of the study and recommendations for future research directions are discussed.

Easy-to-read texts for students with intellectual disability: linguistic factors affecting comprehension.

BACKGROUND: The use of 'easy-to-read' materials for people with intellectual disabilities has become very widespread but their effectiveness has scarcely been evaluated. In this study, the framework provided by Kintsch's Construction-Integration Model (1988) is used to examine (i) the reading comprehension levels of different passages of the Spanish text that have been designed following easy-to-read guidelines and (ii) the relationships between reading comprehension (literal and inferential) and various linguistic features of these texts. METHOD: Sixteen students with mild intellectual disability and low levels of reading skills were asked to read easy-to-read texts and then complete a reading comprehension test. The corpus of texts was composed of a set of forty-eight pieces of news selected from www.noticiasfacil.es, a Spanish digital newspaper that publishes daily journalistic texts following international guidelines for the design of easy-to-read documents (IFLA, Tronbacke B. (1997) Guidelines for Easy-to-read Materials. IFLA, The Hague). RESULTS: Participants correctly answered 80% of the comprehension questions, showing significantly higher scores for literal questions than for inferential questions. The analyses of the texts' linguistic features revealed that the number of coreferences was the variable that best predicted literal comprehension, but contrary to what the previous literature seemed to indicate, the relationship between the two variables was inverse. In the case of inferential comprehension, the number of sentences was a significant negative predictor; that is, the higher the sentence density, the lower the ability of these students to find relationships between them. The effects of the rest of linguistic variables, such as word frequency and word length, on comprehension were null. CONCLUSIONS: These results provide preliminary empirical support for the use of easy-to-read texts but bring into question the validity of some popular design guidelines (e.g. augmenting word frequency) to optimally match texts and reading levels of students with intellectual disability. Two factors are suggested as contributing to the effect of sentence density on inferential comprehension: (i) long texts present higher conceptual density, so there are more ideas to store, retrieve and integrate, which increases the demand on inferential reasoning and (ii) long texts are perceived as difficult, which affects reading motivation and, consequently, induces passive reading strategies. The need for further research to elucidate the origin of our main findings with a larger and more heterogeneous sample of students with intellectual disability is highlighted.

Exploring the development of existing sex education programmes for people with intellectual disabilities: an intervention mapping approach.

BACKGROUND: People with intellectual disabilities face barriers that affect their sexual health. Sex education programmes have been developed by professionals working in the field of intellectual disabilities with the aim to overcome these barriers. The aim of this study was to explore the development of these programmes. METHODS: Sex education programmes geared to people with intellectual disabilities were examined in the context of the Intervention Mapping protocol. Data were obtained via interviews with the programme developers. RESULTS: All programmes lack specific programme outcomes, do not have a theoretical basis, did not involve members of relevant groups in the development process and lack systematic evaluation. CONCLUSIONS: Based on our findings and the literature, we conclude that these programmes are unlikely to be effective. Future programmes should be developed using a more systematic and theory- and evidence-based approach.

Validation of a questionnaire on behaviour academic competence among Chinese preschool children.

The aim of this study was to validate a questionnaire on academic competence behaviour for use with Chinese preschool children in Hong Kong. A parent version and a teacher version were developed and evaluated. The participants included 457 children (230 boys and 227 girls) aged four and five years old, their preschool teachers and their parents. Besides, 44 children (39 boys and 5 girls) with developmental disabilities were recruited. The children were assessed on the cognitive domain of the Preschool Development Assessment Scale (PDAS). Their parents completed a questionnaire on academic competence behaviour, as well as the Strength and Difficulty Scale (SDQ). Their teachers completed the questionnaire on academic competence behaviour. Rasch analysis results provided support for the unidimensionality of the parent and teacher versions of the scale, with one item deleted. The parent and teacher versions of the revised scale correlated positively with the cognitive domain of the PDAS and the prosocial scale of the SDQ and negatively with SDQ total problem behaviour score. Children with developmental delay were assigned lower scores by their parents and teachers, compared with preschool children, on the revised versions of the academic competence behaviour scale. Reliability estimates (Cronbach's alpha) of the parent and teacher versions of this revised scale were above .80. The results suggested that the two versions of academic competence behaviour scales were promising instruments for the assessment of academic competence behaviour among Chinese preschool children.

Managing the student with severe food allergies.

School nurses play a key role in managing students with food allergies. It is becoming more common to encounter students with severe allergies to multiple foods, putting them at risk for anaphylaxis. It is essential that the school nurse have a clear understanding of food allergies and how to effectively manage students in the school setting. Effective communication between families, health care providers, faculty, staff, and students, is of utmost importance when developing a plan of care to ensure the safety of the student with food allergies. Using an interdisciplinary approach to case management, the school nurse can develop comprehensive individualized health care plans for all students with food allergies.

Teaching individuals with profound multiple disabilities to access preferred stimuli with multiple microswitches.

We replicated and extended previous research on microswitch facilitated choice making by individuals with profound multiple disabilities. Following an assessment of stimulus preferences, we taught 6 adults with profound multiple disabilities to emit 2 different responses to activate highly preferred stimuli. All participants learnt to activate both microswitches. Five participants showed a higher overall level of responding when both switches activating preferred stimuli were available concurrently. After completion of microswitch training, a choice assessment was conducted in which participants had access to 2 microswitches concurrently, with 1 connected to the most highly preferred stimulus and the other to a least preferred stimulus. Choice making behavior was shown in 3 participants and provided support for the preference assessment results. The results of the 3 remaining participants showed that both the most highly preferred and the least preferred stimuli may serve as reinforcers for microswitch activation responses.

Community learning disability teams: developments, composition and good practice: a review of the literature.

This article presents the findings from a literature review related to community learning disability teams (CLDTs). Much of the existing literature on CLDTs is inspirational, theoretical or opinion based rather than evidence based. It was considered that current knowledge is insufficient to allow a systematic review; therefore a structured review of factors that impact on CLDTs was undertaken following some of the principles of a systematic review. The review covers historical and philosophical influences on the development of CLDTs; the structure and common composition of CLDTs; the main challenges facing CLDTs; and the barriers that impact on their effective working. Based on the available evidence a number of good practice suggestions are forwarded that have the potential to enhance the work undertaken by CLDTs, but it is acknowledged that there is a need for more research into the effectiveness of these teams.

Reflexiones sobre el diagnóstico de la discapacidad por retraso mental ligero-límite / Discussions on assessment of borderline mental retardation handicap

Este estudio trata de analizar la problemática que surge en nuestra comunidadautónoma, Andalucía, en torno a la necesidad de dotar a los centros educativos de losrecursos necesarios que den respuesta a la diversidad y necesidades educativas especialesdel alumnado. En concreto, se estudia la demanda del profesorado y la respuesta técnicade los Equipos de Orientación Educativa en la determinación del grado de discapacidadmental

This research addresses the problem faced in the Andalusian education system whengiving support to special needs children. Teachers’ expectations and the EducationalOrientation Team’s responses are both taken into account when stablishing the level ofmental disability, ie. either borderline or light disability

[Cooperation between medicine and education].

In cooperation between medicine and education, a reciprocal understanding is important. For this reason, we researched the needs of medical and educational professionals by questionnaires. Many child neurology specialists agreed that their medical profiled are unveiled in public about attending developmental disabilities. Some educational professionals felt it necessary to be given to offer medical informations of students such as treatments and/or diagnosis of their disease, to attend to seminars and lectures on developmental disabilities, and to obtain consultations of doctor more easily. From the above results, we propose an ideal cooperation between medicine and education.

An intervention package to support high school students with mental retardation in general education classrooms.

The effects of using a multicomponent intervention package to support the classroom performance of 4 high school students with mental retardation enrolled in general education classes were investigated. Intervention components were (a) modification of teacher-assigned worksheets, (b) instruction in assignment completion, (c) instruction in self-monitoring of classroom performance skills, (d) including students in setting performance goals, and (e) instruction in goal-evaluation. Implementation of the intervention package was associated with improved performance on modified assignments for all participants and higher report card grades for 3 participants. Three of 4 participants also correctly and independently evaluated their performance in relation to their performance goals. Findings are discussed and recommendations made for future research and practice.