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In 1965 and 1966, the United States and Canada adopted single-payer models of government insurance for physician and hospital services – universal in Canada, but restricted to certain population groups in the US. At the time, the American and Canadian political economies of health care and landscapes of public opinion were remarkably similar, and the different policy designs must be understood as products of the distinctive macro-level politics of the day. Subsequently, however, the different scopes of single-payer coverage would drive the two systems in different directions. In Canada, the single-payer system became entrenched in popular support and in the nexus of interest it created between the medical profession and the state. In the US, Medicare became similarly entrenched in popular support, but did so as part of the larger multi-payer private insurance system. In the process universal single-payer coverage became politically iconic in Canada and taboo in the US.

Policy decisions about healthcare coverage in Canada and the United States in the 1960s placed two virtually identical systems on different evolutionary paths in the physician and hospital sectors. However, prescription drug coverage remained outside Canada’s single-payer model, and employer-based coverage continued to be the norm for the workforce population, as is the case across the broad healthcare system in the United States. As a result the current debate about pharmacare in Canada mirrors in political microcosm the larger debate on universal health insurance among American Democrats. In each case the near-term prospects for a single-payer plan appear slim.

Given the growing importance of support needs assessment in the field of intellectual disability, it is imperative to develop assessments of support needs whose scores and inferences demonstrate reliability and validity. The purpose of this study was to examine the criterion validity of scores on the Supports Intensity Scale–Children’s Version (SIS-C) by identifying the relation of SIS-C scores to those on the Supports Intensity Scale–Adult Version (SIS-A) for youth on the boundary of appropriateness of the two assessments (ages 16–21). Using data from 142 youth who both completed the SIS-A and SIS-C, we found that parallel support need constructs on the two versions of the SIS have strong associations. In addition, there were similar relations between personal competency (i.e., intelligence and adaptive behavior) and support needs measured by the SIS-A and SIS-C. Implications for future research and practice are discussed.

This study examined similarities and differences in measurement properties and score comparability of the Supports Intensity Scale–Adult Version (16–64 years) and the Supports Intensity Scale–Children’s Version (5–16 years). Data were collected from 142 adolescents with intellectual disability with both versions of the Supports Intensity Scale. Data analyses indicated clear alignment of the specific set of items across parallel activity domains, as well as support for score comparability across two assessments. This suggests the two versions of Supports Intensity Scale can be used with confidence with transition-aged students to assess their support needs and inform supports planning, depending on the purpose of assessment. Implications and future directions for research and practice are discussed.

IntroductionDiagnosing psoriasis in children can be challenging. Early and accurate diagnosis is important to ensure patients receive psoriasis specific treatment and monitoring. It is recognised that the physical, psychological, quality of life, financial and comorbid burden of psoriasis are significant. The aim of this study is to develop clinical examination and history-based diagnostic criteria for psoriasis in children to help differentiate psoriasis from other scaly inflammatory rashes. The criteria tested in this study were developed through a consensus study with a group of international psoriasis experts (International Psoriasis Council).Methods and analysisChildren and young people (Ethics and disseminationHealth Regulatory Authority and National Health Service Research Ethics Committee approvals were granted in February 2017 (REC Ref: 17/EM/0035). Dissemination will be guided by stakeholders; patients, children and young people, dermatologists, primary care and paediatric rheumatologists. The aim is to publish the study results in a high-quality peer-reviewed journal, present the findings at international academic meetings and disseminate more widely through social media and working with patient associations.Trial registration numberISRCTN98851260.

The Supports Intensity Scale–Children's Version (SIS-C) was developed to assess the support needs of children and youth aged 5 to 16 years with intellectual and developmental disabilities. Data from the standardization sample of the SIS-C were analyzed to evaluate the impact of the age cohorts (5–6, 7–8, 9–10, 11–12, 13–14, and 15–16 years) used to stratify the sample on the measurement model, as well as the latent means, standard deviations, and correlations. The findings confirmed measurement invariance across age cohorts, but suggested that at the latent level, younger children, generally, have more intensive support needs and that as students with intellectual disability age, their support needs decrease. In addition, the 15- to 16-year-old cohort displayed differences in terms of the strength of correlations between support need domains, with stronger correlations than the other age groups. Implications for future research and practice are described.

Although social skills have long been recognized as essential in promoting employees’ employability (e.g., maintaining employment), there has been little research about work-related social skills for the last two decades. A systematic replication of Salzberg, Agran, and Lignugaris/Kraft’s investigation of critical social skills was conducted. Specifically, a national sample of secondary teachers was asked to rate the importance of social skills in employment settings and the extent to which instruction was provided to teach these skills. Among the skills rated as most important were seeking clarification for unclear instructions, arriving at work on time, refraining from inappropriate touching of others, carrying out instructions needing immediate attention, notifying a supervisor when assistance is needed, responding appropriately to critical feedback, and interacting well with customers/clients. Interestingly, the skills perceived to be the most important were not the skills that were most frequently taught. The implications of these findings are discussed.

Living in poverty increases the likelihood that students with disabilities will experience poor postschool outcomes, including unemployment, underemployment, and limited postsecondary education. The effects of the intersection of poverty and disability persist into adulthood where the employment rate for adults with disabilities is only one fourth that of individuals without disabilities. For close to 50 years, federal legislation has attempted to address the educational and economic disparities faced by students with disabilities and those growing up in poverty. In keeping with the focus of the civil rights movement and the Occupy Wall Street protests on the social and economic inequalities prevalent in the United States, policy directly addressing educational inequities is recommended to improve the daily lives and postschool outcomes of students with disabilities and those who are living in poverty.

Limited social interaction typically occurs between high school students with autism and their general education peers unless programming is introduced to promote interaction. However, few published social interaction interventions have been conducted among high school students with autism and their general education classmates. Such studies typically have involved considerable researcher assistance in arranging and supporting opportunities for interaction. This study represents a departure from previous interventions by teaching general education students a strategy to prompt themselves to increase their interactions with classmates with autism. Three general education high school students were taught to set interaction goals and monitor their interactions with a peer with autism in their classes. The goal-setting package was associated with increased social interaction among participating students. Based on findings, recommendations are provided for future research and practice.

We reviewed studies to identify strategies effective at increasing social interaction skills across a range of secondary school students with autism and/or intellectual disability who experienced limited peer interaction. We were particularly interested in identifying strategies that involved peers and were effective at increasing peer interaction beyond the instructional setting. We identified 13 intervention studies that we analyzed by (a) participant characteristics, settings, and outcomes measured; (b) effective instructional strategies, including role of peers and programming for generalization, related to generalized effects of social interaction interventions; (c) the relation of participant characteristics, type of intervention, and generalization effects; (d) social validation and treatment fidelity measures; and (e) methodological limitations. Findings allowed us to provide recommendations for future research and practice.

We investigated whether participation in a university-based, service learning mentoring program could affect college students’ learning about social inequities and the effects of poverty. The program we examined combined four critical components: (a) Mentor training, (b) mentoring youth on-site in their high-poverty environments, (c) mentors’ ongoing reflecting, and (d) class discussion of issues related to poverty and social inequities. By analyzing students’ ongoing reflective journals in relation to Kolb’s learning cycle, we sought to determine (a) experiences students reported to engage in while mentoring and (b) the relation between students’ experiences and learning about poverty. Mentees’ input was obtained via interviews to corroborate mentors’ perspectives. Based on findings, recommendations for the field are proposed. Social justice, as defined in Rawls’s (1971) theory of justice, is the ideal that everyone is treated fairly and that all receive a just share of

The authors compared involvement in educational planning and use of self-determination strategies reported by two groups of students attending a high-poverty, predominately Black high school: 19 students with severe intellectual disabilities and 20 general education seniors who were identified as successful. Findings revealed that special education students participated in few activities (e.g., general or career education classes, transition activities, or employment) on a daily basis outside their self-contained special education classes. Special education students were significantly less likely than their general education peers to report involvement in educational planning activities or use of self-determination strategies. Although successful general education peers did take an active and self-determined role in their high school education, they represented only 20 of 114 members of their graduating senior class. Findings are discussed in relation to increasing efforts to promote self-determination and resilience among students with severe intellectual disabilities and their general education peers who are attending high-poverty high schools.

Incorporating general education peers into social skills instructional programs has been effective at increasing social interaction of high school students with intellectual disabilities and autism with their classmates. In this study, communication book use (Hughes et al., 2000), combined with providing the opportunity to interact, was associated with increases in conversational initiations and responses of five high school students identified with intellectual disabilities and autism and their general education peers. We also addressed a limitation of Hughes et al. (2000) by expanding the role of peers during generalization to (a) engage in conversational interactions that were more reciprocal and typical of high school student dyads and (b) provide support to participants while interacting. This study adds to the few published social skills interventions involving high school students with intellectual disabilities and autism in inclusive settings and extends findings to a population of students with more varied communication characteristics.

For almost three decades, the inand post-school outcomes of youth with disabilities have provided an important gauge of the quality and relevance of special education and transition services. Despite many noteworthy gains over this time period, virtually every available indicator still suggests that young people with disabilities are not flourishing as they should during this transition to adulthood. Aspirations for a satisfying career, a college degree, a safe place to live, life in a community, and a strong network of friends do not materialize for far too many youth with disabilities, especially those young people with disabilities living in poverty [5]. As a result, numerous transition-age young and young adults leave high school without the constellation of skills and supports they need to realize their dreams for adulthood.

Researchers in the educational field have investigated how a caring adult can best provide mentoring support to youth placed at risk and what functions a mentoring program should serve to promote healthy mentoring relationships. However, the perspective of mentors rarely has been sought to elicit their evaluation of a mentoring program or recommendations for programmatic change. The purpose of this article was to investigate the views of university students serving as mentors in high‐need high schools or community centers. We asked 49 students, primarily undergraduates across a range of liberal arts disciplines, who were participating in a university‐based service‐learning mentoring program for youth attending high‐poverty high schools: (a) what activities they engaged in with mentees, (b) how they benefited from the mentoring program, and (c) how they perceived the program and what recommendations they had for change. Findings revealed specific suggestions that mentoring program coordinators can adopt to...

A person-environment fit conceptualization of intellectual disability (ID) requires educators to focus on the gap between a student's competencies and the demands of activities and settings in schools. In this article the implications of the person-environment fit conceptual model are considered in regard to instructional benefits, special education service delivery, assessment and planning processes (including developing Individualized Education Programs), and the roles and responsibilities of special and general education teachers.

Students without disabilities traditionally either enter postsecondary education or seek employment after high school graduation. These outcomes are not routinely experienced by youth with disabilities, however. Instead, they often face an uncertain future—one that may include unemployment or underemployment, social isolation, or dependence, despite federal legislation designed to pave the way toward successful and fulfilling adult lives. To address these inequalities, the authors propose constructing new transition bridges, including (a) teaching students to become self-directed learners before they enter high school, (b) assisting students in identifying where they would like to continue their education or work and placing these students in these student-identified destinations before they exit high school, and (c) coordinating post-placement support services with either postsecondary educational institutions or local agencies that provide employment support.

The authors applied an adaptation of prior models of acculturation to all 16 Hispanic students attending a predominately Black, high-poverty, urban high school ( n = 1,267 students) identified by No Child Left Behind standards as failing. No published study to date has investigated Hispanic acculturation within such a setting. Findings reveal that students were identified across all four acculturation modes of the model and that only half ( n = 8) of students demonstrated substantial affiliation with a dominant U.S. culture. Of these, five students identified more strongly with the dominant Black culture of the school versus the prevailing White U.S. culture. Findings are discussed with respect to future research and practice designed to improve educational experiences for Hispanic youth.

Despite national interest in promoting self-determination and active involvement in individualized education program (IEP) planning, available data suggest that many students have little involvement in these activities. Findings on the extent to which students are provided opportunities to be involved in IEP development and to receive self-determination instruction have been based on parent and teacher input, with little input provided by students. In this study, researchers piloted a tool that asked students with intellectual and other disabilities to provide input on their involvement in IEP development and their opportunities to learn self-determination strategies. Findings reveal that although the majority of students reported receiving some instruction on one or more self-determination strategies, few students were provided instruction in having an active role in the IEP process.

Background Psoriasis is a chronic skin disease that affects approximately two per cent of the general population. Plaque psoriasis is the most common form: it usually appears as raised, red patches of inflamed skin, covered with silvery white scales. The patches often occur in a symmetrical pattern. Guttate psoriasis is a particular form of psoriasis with widespread, small erythematosquamous lesions. Streptococcal infection is suspected to be a triggering factor for the onset of guttate psoriasis, and flare-up of chronic plaque psoriasis. The previous Cochrane Review on this topic was published in 2000; it required an update because antistreptococcal treatment continues to be used to treat psoriasis, especially for the acute form of guttate psoriasis. Objectives To assess the effects of antistreptococcal interventions for guttate and chronic plaque psoriasis. Search methods We searched Cochrane Skin Specialised Register, Cochrane Register of Studies Online, CENTRAL, MEDLINE, Embase, LILACS, and five trials registers (January 2019). We checked the reference lists of included and excluded studies and searched conference proceedings from the American Academy of Dermatology, Society for Investigative Dermatology, and European Academy of Dermatology and Venereology. Selection criteria We considered randomised controlled trials (RCTs) assessing antistreptococcal interventions (tonsillectomy or systemic antibiotic treatment) in people with clinically diagnosed acute guttate and chronic plaque psoriasis compared with placebo, no intervention, or each other. Data collection and analysis We used standard methodological procedures expected by Cochrane. Primary outcome measures were: 1) time-to-resolution; achieving clear or almost clear skin (Physician Global Assessment (PGA) 0 or 1 or Psoriasis Area and Severity Index (PASI) 90 or 100); 2) proportion of participants with adverse effects and severe adverse effects. Secondary outcomes were: 1) proportion of participants achieving clear or almost clear skin; 2) proportion of participants achieving PASI 75 or PGA 1 to 2; 3) risk of having at least one relapse at long-term follow-up. Short-term assessment was defined as within eight weeks of the start of treatment; long-term was at least one year after the start of treatment. Main results We included five trials (162 randomised participants); three were conducted in a hospital dermatology department. One study declared funding by a pharmaceutical company. Participants' ages ranged from 12 to 77 years; only two participants were younger than 15 years. Mean PASI score at baseline varied from 5.7 (i.e. mild) to 23 (i.e. severe) in four studies. Twenty-three of 162 participants had streptococcus-positive throat swab culture. We did not perform a meta-analysis due to heterogeneity of participants' characteristics and interventions.None of the trials measured our efficacy primary outcome, time-to-resolution, or the secondary outcome, risk of having at least one relapse at long-term follow-up.We rated the quality of the results as very low-quality evidence, due to high risk of bias (absence of blinding of participants and caregivers, and high risk of outcome reporting bias) and imprecision (single study data with a low number of events). Hence, we are very uncertain about the results presented.Guttate psoriasisOne three-armed trial (N = 43) assessed penicillin (50,000 international units (IU)/kg/day in three doses) versus erythromycin (250 mg four times per day) versus no treatment (treatment for 14 days, with six-week follow-up from start of treatment). Adverse events and the proportion of participants achieving clear or almost clear skin were not measured.One trial (N = 20) assessed penicillin (1.6 MU (million units) intramuscularly once a day) versus no treatment (six weeks of treatment, with eight-week follow-up from start of treatment). At six-week (short-term) follow-up, no adverse events were observed in either group, and there was no statistically significant difference between the two groups in the proportion of participants with clear or almost clear skin (risk ratio (RR) 2.00, 95% confidence interval (CI) 0.68 to 5.85).One trial (N = 20) assessed rifampicin (300 mg twice daily) versus placebo (14-day treatment duration; six-week follow-up from start of treatment); none of the review outcomes were measured.These trials did not measure the proportion of participants achieving PASI 75 or PGA 1 to 2.Chronic plaque psoriasisOne trial (N = 50) assessed long-term azithromycin treatment (500 mg daily dose) versus vitamin C. Adverse events were reported in the azithromycin group (10 out of 30 had nausea and mild abdominal upset), but not in the vitamin C group. The proportion of participants who achieved clear or almost clear skin was not measured. In the azithromycin group, 18/30 versus 0/20 participants in the vitamin C group reached PASI 75 at the end of 48 weeks of treatment (RR 25.06, 95% CI 1.60 to 393.59).One trial (N = 29) assessed tonsillectomy versus no treatment, with 24-month follow-up after surgery. One participant in the tonsillectomy group had minor bleeding. At eight-week follow-up, 1/15 in the tonsillectomy group, and 0/14 in the no treatment group achieved PASI 90; and 3/15 participants in the tonsillectomy group, and 0/14 in the no treatment group achieved PASI 75 (RR 6.56, 95% CI 0.37 to 116.7). Authors' conclusions We found only five trials (N = 162), which assessed the effects of five comparisons (systemic antibiotic treatment (penicillin, azithromycin) or tonsillectomy). Two comparisons (erythromycin compared to no treatment, and rifampicin compared to placebo) did not measure any of the outcomes of interest. There was very low-quality evidence for the outcomes that were measured, Therefore, we are uncertain of both the efficacy and safety of antistreptococcal interventions for guttate and chronic plaque psoriasis.The included trials were at unclear or high risk of bias and involved only a small number of unrepresentative participants, with limited measurement of our outcomes of interest. The studies did not allow investigation into the influence of Streptococcal infection, and a key intervention (amoxicillin) was not assessed.Further trials assessing the efficacy and tolerance of penicillin V or amoxicillin are needed in children and young adults with guttate psoriasis.

Increasing the participation of youth with severe disabilities in general education has remained a consistent and prominent focus of legislative, policy, and research initiatives. We examined the perceptions of high school staff regarding the goals, barriers, benefits, outcomes, and supports associated with including adolescents with severe disabilities in general education classes. We found that general and special educators, paraprofessionals, and administrators both converged and diverged in their evaluations of different aspects of general education participation. Despite broad agreement regarding the benefits of and instructional priorities in general education classrooms, stakeholders differed significantly in their perceptions of barriers associated with including students with disabilities in general education classes at their high schools.

Research indicates that peer interaction can have a substantial impact on the lives of adolescents with disabilities. However, social interaction among adolescents with intellectual disabilities and their general education peers typically occurs infrequently in secondary schools. This paper provides a critical analysis of twenty-six empirical interventions aimed at promoting social interaction among adolescents with intellectual disabilities and their general education peers in middle and high school settings. Findings are analyzed with regard to intervention components; student characteristics; interaction settings; measures of interaction; observation procedures; experimental designs; intervention components; and measures of generalization, social validity, and treatment integrity. Based upon findings from this literature, we present recommendations to guide future research and the development of effective social interaction interventions for adolescents with intellectual disabilities in middle and high schools.

Recent policy initiatives promoting high-stakes testing for graduation present a significant challenge to practitioners charged with educating students with high-incidence disabilities. The purpose of this study was to examine the effects of test-taking strategy instruction on the test performance of secondary students with high-incidence disabilities. Students demonstrated small but significant increases in test performance and decreases in ratings of test anxiety following intervention. Recommended strategies are presented to practitioners for preparing high school students with disabilities for high-stakes assessment tests.

We obtained perspectives on increasing access to general education from high school students who provided ongoing support to their peers with moderate or severe disabilities. Focus groups were conducted with 32 high school students without disabilities representative of students who participated in a structured service-learning peer support program. Analysis of their comments resulted in four categories of student responses: (a) perceived challenges to general education participation; (b) action taken by peer supports to increase access to general education by students with disabilities; (c) recommendations for improving a peer support program; and (d) perceived benefits to participating students and teachers. Findings are discussed and recommendations are provided for (a) refining a model of peer support to promote peer interaction and access to general education and (b) informing practice.

We conducted a review of the literature to investigate interventions designed to increase students' involvement in their individualized education program (IEP) process. Sixteen studies were identified and analyzed in terms of six variables: purpose, participants/setting, design, dependent variables, independent variable, and results. Our findings suggest that students with widely varying disabilities can be actively involved in the IEP process. Our results also indicate that both published curricula designed to teach students skills to enhance their participation prior to IEP meetings and person-centered planning strategies are effective in increasing students' involvement in their IEP meetings, as substantiated through direct observation; scores on measures of self-determination; and/or feedback from participants, parents, and teachers. We discuss the results in terms of implications for practice and research, the need for future studies to assess the impact of student participation on students' daily lives, and the need for institutions of higher education to prepare teachers to include students in the IEP process.

Secondary-level practitioners face mounting challenges in providing effective transition services to youth with disabilities living in high-poverty neighborhoods. We examined the summer activities of youth with high-incidence disabilities from high-poverty backgrounds who had taken vocational classes and participated in a self-determination curriculum during the previous school year. Few of the students were employed by the midpoint of summer, with the majority reporting difficulties related to finding a job. Students who were not employed were involved in a variety of activities (e.g., "hanging out" with friends or family, doing occasional odd jobs, caring for a child), but few reported satisfaction with these activities. Findings are discussed and recommendations are suggested for improving the effectiveness of secondary-level educational programming.

Student‐directed learning strategies involve teaching students to modify and regulate their own behaviour. Teaching students to self‐regulate behaviour has been identified as one means of promoting self‐determination, and promoting and enhancing self‐determination has become a valued outcome internationally. In addition, however, student‐directed learning strategies could prove important for including students with disabilities in general education classrooms by reducing the student's dependency upon others in the classroom setting. Four students with intellectual disability were supported to select an educational goal on which they wanted to work and were taught to self‐monitor their progress toward that goal in general education classrooms. Their progress toward the goal was evaluated through data collection activities and by using the Goal Attainment Scaling process. In general, students achieved their self‐selected goals. The potential contribution of student‐directed learning strategies to inclusion ...

Self-regulation and other student-directed learning strategies have the potential to benefit students with developmental disabilities and mental retardation in general education classrooms. However, to date, there is little information about use of such strategies in general education classrooms, particularly at the secondary education level. This study examined the effect of a self-regulation multicomponent process (antecedent cue regulation or self-monitoring with self-evaluation and self-reinforcement) with 3 students with developmental disabilities in typical classrooms. Use of the self-regulation strategies improved adaptive behaviors related to class participation or decreased problem behaviors for all students. Also, teachers working with students indicated that they had exceeded their expectations for achieving goals related to the target behaviors. The potential for use of self-regulation strategies to promote successful inclusion is discussed.

A systematic approach for addressing the support needs of persons with mental retardation and related developmental disabilities is presented and a new scale to measure individual differences in support needs described. The process employed in developing the scale is explained, including the establishment of a typology of support areas that was drawn from a review of the professional literature, a validation process using Q-sort methodology, and a pilot field test. Critical issues and practical challenges associated with efforts to measure and address the support needs of individuals are discussed.

Although skill in problem solving is critical to success in school and the community, as well as to promoting student self-determination, problem solving remains a neglected curriculum area for students with developmental disabilities. Using the self-determined learning model, 4 students with mental retardation or developmental disabilities were taught problem-solving skills to achieve self-set goals. A multiple-baseline-across-participants design was used, and the instruction was provided in general education content classes. Target behaviors included increasing appropriate touching, increasing contributions to class discussion, and increasing direction following. Data revealed immediate and dramatic changes for all participants, with performance levels maintained at 100%. Anecdotal social validation data supported the findings. The implications of these findings in respect to promoting self-determination and inclusive practice are discussed.

We used a multiple-baseline design across participants to assess the effects of a verbal directive on the social interactions of general education high school students enrolled in a peer buddy program and their peers with mental retardation. General education students were asked to interact “as friends” with their peers while they engaged in leisure activities. Delivery of the directive was associated with increases in occurrence of social interaction, improvement in quality and reciprocity of interaction, and increases in range of communication behaviors performed by students with mental retardation. In addition, students discussed a greater variety of conversational topics. Findings are discussed with respect to strategies for increasing social interaction among high school students.

We examined the differences between two groups of general education high school students: Those who volunteered to participate in a peer buddy program designed to increase their social interactions with their peers with severe disabilities ( n = 30), and those who chose not to volunteer ( n = 30). Differences were examined using the Social Distance Questionnaire for Attitudes of High School Students Toward Handicapped Persons. Analyses indicated that, at pre-test, peer buddies reported significantly greater willingness to interact with people with severe disabilities and more previous contact with these individuals than did nonvolunteers. There were no differences between the scores of the groups on knowledge of disability or affect toward persons with disabilities. After one semester of enrollment in the program, social willingness, knowledge, and contact scores of peer buddies increased significantly, whereas the scores of nonvolunteers remained the same as at the pre-test. In addition, students' self-reported previous contact with individuals with disabilities positively correlated with their scores indicating their social willingness to interact with their peers with disabilities. Implications of the study are discussed with respect to benefits of and recommendations for peer interaction programs.

This study investigated the effects of self-monitoring instruction delivered by peer tutors on the occurrence of academic survival skills displayed by five middle school students with severe disabilities. We employed a multiple baseline across subjects design. Instruction was provided in general education content classes. The students were taught to indicate on a self-recording sheet if they performed each of 11 skills. Data revealed an increase in the percentages of occurrence of survival skills across all students. Also, their general education teachers indicated that they observed a positive change for four of the five students. All students indicated that they believed that they were part of the class and reported an increase in their classroom participation. The implications of these findings are discussed.

This investigation examined the effects of self-prompted communication book training provided by peers on the conversational initiations of four high school students with extensive support needs. The intervention was associated with increases in participants' appropriate initiations and general education conversational partners' corresponding responses. The self-prompting strategy also was associated with increases in conversational topics discussed and decreases in inappropriate initiations by participants. In addition, interviews conducted postintervention generally indicated that participants believed they had (a) met their social goals to increase their interactions with their general education peers and (b) made more friends at school. Implications of findings are discussed and suggestions made for future programmatic efforts.

This article describes the findings of a national survey of teachers' opinions regarding the value of self-determination and issues relating to teaching skills leading to this outcome. Respondents were secondary-level educators serving students with varying types and severity of disabling conditions. Findings indicated that a majority of respondents believed that instruction in self-determination was important, but teachers differed in their responses regarding the strategies taught and the extent and type of instruction provided based on the severity of the student's disability. Implications for educational practice are discussed.

We evaluated the effects of a social interactive training program on early social-communicative skills (i.e., eye contact, joint attention, motor imitation) of three preverbal preschool children with autism. Training was conducted in the children's classroom during naturally occurring daily activities. Findings indicated that implementation of social interactive training components (i.e., contingent imitation, use of naturally occurring reinforcement, expectant look, environmental arrangement) was associated with increases in target behaviors across participants. In addition, generalization of eye contact and motor imitation behavior were found across an additional setting and different interactive partners, although joint attention rarely generalized. Social validation measures provided by 30 raters indicated that perceived positive changes in performance had occurred in child behaviors and that training procedures were considered acceptable. Results are discussed in terms of implications for research and practice.

We investigated the use of a peer-delivered social skills instructional package to teach four high school students with behavioral disorders to express anger appropriately. In contrast to previous studies, instruction was presented individually to the students by their general education peers. The instructional package, which combined peer instruction, self-instruction, and a traditional anger control program, was effective in improving the way these adolescents expressed anger in role-play situations with general education peers. In addition, generalization data indicated that some of the students decreased the rate at which they responded inappropriately to naturally occurring anger-provoking situations at school outside the instructional setting. Implications for future research and practice are discussed.

The purpose of this study was to examine school-to-work system development from local education agency perspectives in order to inform state and local implementation activities. One hundred-seven district administrators responded to a statewide survey regarding school-to-work activities in regular and special education. Descriptive statistics and qualitative analyses were used to characterize participants' responses. Local education agencies identified the most pressing system needs as (a) enhanced partnerships with local businesses, (b) staff development, and (c) guidelines for implementation. The need for more substantive dialogue between state and local education agencies' business representatives, and the community regarding the goals of a comprehensive school-to-work system was discussed.

The purpose of this study was to extend the empirical literature by identifying and socially validating strategies that support the transition from school to adult life. A three-step process was conducted: (a) reviewing 113 empirical articles that addressed secondary transition, (b) developing a candidate list of all support strategies that were empirically supported in the literature, and (c) conducting a national survey of 54 researchers who had published studies in the area of secondary transition (response rate = 92%) to establish the social validity of the proposed list of support strategies. Results of the survey corroborated multiple strategies that support students in the transition to adult life (e.g., family and peer support, student choice and preference, student self-determination). Findings are compared to those derived from the literature review and implications for research and practice are discussed.

As a behavior analyst, I assumed that I had the prerogative to set my own research agenda. After all, I had been to graduate school and read Skinner along with a host of empirical studies in nondescript, gray-covered issues of JABA, which demonstrated that a technology of behavior change existed and there was a set of principles that could be applied to change environments and behaviors in a systematic fashion. Why, I even had replicated a series of studies in which I used demonstrated behavioral principles, such as training sufficient exemplars (Stokes & Baer, 1977) and self-instruction (Meichenbaum & Goodman, 1971), to teach persons with severe mental retardation and extremely limited language skills to solve problems likely to occur in their everyday lives (e.g., plugging in a lamp to turn it on) (e.g., Hughes, 1992). Because I believed I had control of some of the independent variables used to change behavior (e.g., modeling, reinforcement, fading), I also thought I had control when it came to determining what the dependent variable of an intervention should be. As you can see, although I had read Wolfs (1978) exposition on social validation, I really hadn't taken it to "heart". I hadn't realized yet that having a potential solution didn't mean I could always identify the most relevant problem. Becoming a behavior analyst in a high school setting taught me who should be included in determining a research agenda. Contemporary writers (e.g., Malouf & Schiller, 1995; Schwartz & Baer, 1991) have challenged us to incorporate social validation into the research process by involving practitioners interactively in developing program goals and procedures, and in evaluating the acceptability of program outcomes. Rather than adopting a

We discuss topics related to a theoretical analysis of self-management, including theories of self-management, self-reinforcement and self-management, antecedent stimuli for self-management, teaching of self-management behaviors, and applications of self-management. Our analysis indicates that self-management's roots in behavioral explanations of phenomena are solid, but that there are important issues yet to be examined in developing a thorough understanding of self-management. We argue that self-management behaviors almost certainly must be examined in relation to the contexts in which they occur and the consequences that they produce.

Recent legislative, policy, and research initiatives affirm the importance of improving social outcomes for adolescents with moderate to severe intellectual disabilities. Using observational methodology, we examined the influence of level of integration and Peer Buddy proximity on social interaction between students with intellectual disabilities and their general education peers in high school settings. Similarities and differences were found between more and less integrated settings with respect to contextual variables and measures of social interaction. Across settings, the proximity of a Peer Buddy was associated with higher frequency interactions and more positive student affect. Implications regarding increasing social interaction among high school students are discussed.

The authors investigated the effects of an intervention package to support five high school students with extensive support-needs to initiate and engage in recreational activities with general-education peers in their physical education classes. The intervention components were (a) assessing participants’ recreational activity goals, (b) teaching self-prompting using a picture book, (c) programming common stimuli, and (d) asking participants to assess daily performance and evaluate daily goal achievement. The intervention was associated with increases in participants’ initiation of and engagement in recreational activities with general-education peers, as well as increases in ratings of quality of interaction. In addition, participants typically assessed with accuracy their performance of recreational activities and whether they had achieved their recreational goals. Findings are discussed with respect to future research and practice.

The effects of selected student-directed learning strategies on the classroom behavior of six students with varying disabilities in general education were examined using a multiple baseline design across groups. Target behaviors included academic, study, and social skills. Results indicated increases in student target performance for all participants, however, differential effects were observed across groups and reinforcement conditions (student-vs. teacher-delivered). Additionally, anecdotal reports obtained from the cooperating teacher and students supported the study's findings. The implications of these findings are discussed.

In this study, we used a four-step social validation process to identify and validate critical skill components that constitute high school students’ conversational behavior. The four steps were nominating target behaviors, establishing a normative range of performance, manipulating simulations of behavioral dimensions, and comparing ratings of judges to levels of performance on those behavioral dimensions. Multiple measures, both quantitative and qualitative, suggested that the rate and percentage of time initiating and responding verbally, the percentage of time attending, and the percentage of time not engaging in distracting motor behavior related to favorable ratings by a wide variety of 60 judges. Findings are discussed in relation to the utility of the multistep social validation process and the identification of critical social skill components as targets of interventions. DESCRIPTORS: social validation, high school students, mental retardation, conversational social skills