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Background and Context: In order to fully include learners with visual impairments in early programming education, it is necessary to gain insight into specificities regarding their experience of and approach to abstract computational concepts. Objective: In this study, we use the model of the layers of abstraction to explore how learners with visual impairments approach the computational concept of abstraction, working with the Bee-bot and Blue-bot. Method: Six blind and three low vision learners from the elementary school level were observed while completing programming assignments. Findings: The model of the layers of abstraction, can overall be generalized to learners with visual impairments, who engage in patterns that reflect iterative actions of redesigning and debugging. Especially our blind learners use specific tactile and physical behaviors to engage in these actions. Implications: Ultimately, understanding such specificities can contribute to inclusive tailored educational instruction and support.

University-based living labs serve as open innovation platforms that foster collaborative research and experimentation across various disciplines. These labs bring together academics, citizens, community organisations, companies, and other entities to collectively address complex contemporary issues. The labs' managers are expected to adopt flexible, agile management approaches to support the openness of their lab to stakeholders. Flexible management approaches create various challenges, as the labs are often expected also to comply with traditional project management principles of deadlines, project deliverables, budget restrictions, and quality conditions as set by their project sponsors and host organisation. The combination of prescriptive and agile project management approaches in such open innovation settings has been relatively underexplored in higher education research. Drawing on the theoretical literature on boundary work and project management, we analyse how the managers of a Dutch university-based living lab execute flexible project management styles in a setting that is dominated by prescriptive project management traditions. Based on information from 20 interviews and document analysis we identify five areas of tension between agile and prescriptive project management. Living lab managers, supported by researchers, buffer these tensions through boundary work that shapes the openness of the projects in rather unexpected ways.

Sex and gender are important determinants of healthcare that need to be taken into account for medical teaching. Education is more effective if tailored to students' subjectively-perceived needs and connected to their prior knowledge and opinions. This study explored first-year medical students thoughts about sex and gender differences in general and in specifically in healthcare, and what their educational preferences are in learning about these concepts during their medical training. Therefore six focus groups were conducted with 26 first-year medical students, 7 male and 19 female students, within one Dutch medical faculty. The discussions were audio-recorded and transcribed verbatim. After that a thematic analysis was performed which included descriptive coding, interpretative coding, and definition of overarching themes. Three major themes were identified. (1) Students' self-perception of concepts sex and gender, including three major domains: (a) The unavoidable allocation of individuals to groups, (b) The role of stereotypes, and (c) The effect of sex/gender on career choice options. (2) Students' goal orientedness in learning about sex/gender. (3) Students' struggles between the binary system of medicine and the complexity of reality. Continuous reflection during medical school might help medical students to acquire sex- and gender-sensitive competencies that can be applied in their future work. To increase awareness about the influence of sex and gender differences in healthcare and on career choices, we recommend addressing these themes explicitly early on in the medical curriculum.

Programming education is strongly emerging in elementary and high school. Diversity and inclusion are important topics, however, insights on suited programming materials for younger learners with visual impairments are lacking. A wide range of programming materials for children exists, diverse in both what is being programmed (output) and how this is done (input), yet often relying on visual features. An understanding of the usability and accessibility aspects of these different materials is important to inform educational practice and to increase understanding of what makes programming materials suited for low vision and blind children. The aim of this study is to explore the usability and accessibility of programming materials currently used in education to low vision and blind children in the Netherlands. A focus group was conducted with six teachers or IT experts, all working with the target group in special education. The thematic analysis of the discussion of 25 materials (including unplugged lessons, robots and robotic kits, block-based and text-based languages) showed the potential of several materials, especially unplugged lessons, and the continuing search for suited materials and workforms specifically for the blind children. Furthermore, prioritizing "fun" and close connections to children's daily life as well as careful explorations of usability at the cognitive level came forward as important factors for future research and development in programming materials for low vision and blind children. These insights can contribute to obtaining an inclusive approach to programming for young learners.

The application of restrictions plays a great part in daily support of people with moderate intellectual disability (ID). In this study we examine the evaluation of relatives of restrictions applied to their family members with moderate ID. Relatives are key and permanent figures in the lives of people with moderate intellectual disability. Moreover, relatives in their role as representatives are authorized to make decisions in case people with moderate ID are not able to oversee the consequences of their actions. To explore relatives' evaluation of restrictions, we conducted semi-structured interviews with 10 relatives. Qualitative analysis was carried out using a thematic approach. We found that respondents consider restrictions necessary when they promote physical well-being, safety and indistinctive, 'normal', appearance of their family members with ID. In applying these restrictions a 'rules are rules' and a 'tailor-made rules' approach can be discerned. The 'tailor-made approach' provides space for dialogue with people with moderate ID. In this dialogue the criteria of proportionality, effectiveness, and subsidiarity are helpful. In using these criteria, the application of a restriction has to be in proportion, has to lead to the desired effect, and, finally, should be as unintrusive as possible for the person concerned. As such, it is recommended that, in dialogue, support staff, people with moderate ID themselves, and their relatives seek ways to examine what kinds of restrictions are justified for people with moderate ID.

Adapting learning to the level and preferences of learners and game-based learning have increasingly received much attention. The current study examined whether learning styles based on the Felder-Silverman classification (perception, input, processing and organization of information) influence learning in GBL. Only the input and processing scales were found to be reliable. 109 students from prevocational-secondary education played a math game (proportional reasoning) after which learning gain and motivation were measured. Gameplay yielded no learning, but a median-split breakdown (prior knowledge) indicated that students with little prior knowledge did learn from the game, while those with much prior knowledge deteriorated. Subsequent multiple regression analyses revealed no predictive effect for motivation. The processing preference was predictive for learning: Students with an active processing preference performed better than students with a reflective processing preference. The discussion discusses consequences and a number of directions for follow-up research.

Objectives: One of the general articles of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) focuses on the right of freedom to make one's own choices and being aware of the importance for persons with disabilities to obtain independence. People with intellectual disability (ID) are, to a greater or lesser degree, dependent on significant others, such as support staff with respect to decision making. For that reason, the UNCRPD also stresses the relevance of supportive decision making, which should be stimulated by service policies. However, support staff may find it necessary to restrict people with ID to make their own choices, for example to prevent them from harm. Since restrictions should be applied in the interest of people with ID, it is essential to examine their own perception. In this study, we have examined how people with moderate ID themselves perceive and evaluate restrictions in daily care, using a qualitative methodology. Method: Based on an extensive pilot study, we conducted interviews being close in time and place in which possible restrictions might occur. Additionally, we applied triangulation of sources. After conducting interviews with eight persons with a moderate ID, we examined their clinical files and interviewed their key workers. Qualitative analysis was carried out by two researchers, using an inductive, thematic approach. Results: Results demonstrate communality between the participating people with ID and their key workers in perception and evaluation of restrictions, in people with ID tending to comply with the applied restrictions. When the participants with ID and their key workers differ in their evaluation of applied restrictions, this appears a value based dissensus. Conclusion: To ensure that restrictions are applied in the best interest of people with ID, it is essential that staff are attentive to the wishes of people with ID, which might be based on different values. By asking people with ID about their experiences and views of the restrictions imposed on them, we hope to contribute to an ongoing and open dialogue to inform the planning and delivery of services for people with ID based on 'best interest' principles.

Although several projects have addressed the importance of gender health issues in medical education, the sustainability of change efforts in medical education has rarely been addressed. Understanding the possible facilitators or barriers to sustainability may help to develop future interventions that are effective in maintaining gender health issues as a topic in medical curricula. The aim of this study is to provide a longitudinal evaluation of changes regarding gender health issues that occurred in the past decade and the factors that influenced this process. The coursebooks of eight theoretical courses of the Nijmegen medical curriculum were screened on the basis of criteria for an integrated gender perspective in medical education. To assess the sustainability of gender health issues, the screening results from 2014 were compared with those of a similar project in 2005. In addition, open interviews were conducted with eight coordinators to identify facilitators and barriers influencing the sustainability of gender health issues. Analysis showed that, over the past decade, the implementation of gender health issues was mainly sustained and additional changes were made, resulting in an ongoing gender perspective in the Nijmegen medical curriculum. The coordinators mentioned several factors that influenced the sustainability of implementation in medical education: coordinators' and teachers' gender-sensitive attitude, competing demands, the presence of sex and gender in learning objectives, examinations and evaluation, organizational support and curriculum revisions. Our findings suggest that, in implementing sex and gender in medical education, medical faculties need to focus on top-down support in incorporating sex and gender into core objectives and time spent on incorporating sex and gender into medicine, and on the continuous training of teaching staff.

Employing a large sample of children from Dutch regular elementary schools, this study assessed the contributing and discriminating values of reading disability (RD) and attention-deficit/hyperactivity disorder (ADHD) to two types of phonological processing skills, phonemic awareness (PA) and rapid automatized naming (RAN). A second objective was to investigate whether comorbidity of RD and ADHD should be considered as an additive phenomenon as to RAN and PA. A total of 1,262 children, aged 8 to 13 years, were classified as RD (n = 121), ADHD (n = 17), comorbid (RD+ADHD; n = 16), or control (n = 1,108). Phonological processing was assessed by standardized tests of PA and RAN. Disability groups were compared to each other and contrasted to the control group. Although results indicate substantial effects for all three disability groups on both types of phonological processing, and the RAN/PA compound measure in particular, effect sizes were considerably larger for the RD groups, as compared to the ADHD-only group. Theoretical and practical implications are discussed.

Purpose: The objective of this study was to assess and compare the predictive values of group membership for rapid automatized naming (RAN) and phonemic awareness (PA) in Dutch school children with and without reading disabilities (RD) or specific language impairment (SLI). Method: A composite word reading index and a formal SLI diagnosis were used to classify a total of 1,267 children aged 8 to 13 years old either as RD-only (n = 126), SLI-only (n = 21), comorbid (RD+SLI; n = 30), or typically developing (n = 1,090). RAN and PA were assessed with 4 standardized subtests. The clinical subgroups were compared to each other and contrasted with the control group. Results: For each subgroup, results indicate substantial effect sizes of RAN and PA. However, the RD-only group seems to be more affected by poor RAN than the SLI-only group, whereas the 2 groups perform equally poorly on PA. The comorbid group was revealed as most severely impaired on all measurements. Conclusions: In studying RD and SLI, this research indicates that it is important to distinguish between RD-only, SLI-only, and comorbid groups. The comorbid group shows additive effects of both disorders.

In this study word reading (WR) fluency was used to dichotomously classify 1,598 Dutch children at different cutoffs, indicating (very) poor or (very) good reading performance. Analysis of variance and receiver operating characteristics were used to investigate the effects of rapid automatized naming (RAN) and phonemic awareness (PA) in predicting group membership. The highest predictive values were found for the combination of RAN and PA, particularly for the poorest readers. Furthermore, results indicate that with the severity of impairment, WR is more dominated by deficient PA, which is interpreted as an enduring problem with sublexical processing. Another main result is that with the increase of reading skill, the contribution of PA diminishes, whereas the contribution of RAN remains fairly constant for the whole reading fluency continuum. These results warrant the conclusion that whereas PA hallmarks reading disability, RAN appears to be the default predictor for above-average or excellent reading proficiency.

Background: Gifted children learn differently compared to their peers in several ways. However, their educational needs are often not met in regular schools, which may result in underachievement and social-emotional and behavioral problems. A pullout program, the "Day a Week School" (DWS), was offered to gifted children in 25 elementary schools from neighborhoods of higher and lower SES in Amsterdam. Objective: To investigate whether DWS decreases children's social-emotional and behavior problems and parents' stress, and improves children's self-concept, enjoyment at school, and academic achievement. Methods: Gifted children (grades 3-5) were selected through a standardized identification procedure assessing "out-of-the box", logical, and creative thinking and motivation (n = 89). Children, as well as both their parents and teachers, completed questionnaires before the start of DWS and after 2,5 months. Results were analyzed for all children and for at-risk children with higher levels of psychopathology before starting DWS. Results: Analyses on the total group showed small positive effects on children's self-reported self-concept dimensions, scholastic competence and behavioral conduct, as well as on fathers' reported child prosocial behavior. In the at-risk group, children reported medium positive effects on scholastic competence and behavioral conduct, and on sleep problems and worry, and small improvements on enjoyment at school. Parents of at-risk children reported decreased child's somatic complaints and decreased social-emotional and behavioral problems. Finally, teachers reported higher academic achievement and medium positive effects on inattention-hyperactivity in the at-risk group. Conclusions: Day a Week School appears to be a promising pullout program for gifted children, particularly for children at-risk for psychopathology.

Researchers typically employ either peer or self-reports to assess involvement in bullying. In this study, we examined the merits of each method for the identification of child characteristics related to victimization and bullying others. Accordingly, we investigated the difference between these two methods with regard to their relationship with social adjustment (i.e., perceived popularity, likeability, and self-perceived social acceptance) and internalizing problems (i.e., anxiety, depression, and self-worth) in 1192 Dutch school children, aged 9 to 12 years. Perceived popularity and likeability were more strongly correlated with peer reports than self-reports, for both victimization and for bullying others. Self-perceived social acceptance correlated equally strong with peer and self-reports of victimization. Furthermore, peer reports of bullying were also correlated with self-perceived social acceptance, whereas self-reports of bullying were not. All internalizing problems showed stronger relations with self-reports than peer reports; although only the relation between self-reported victimization and internalizing problems was of practical significance. Despite our findings indicating that using only one type of report could be efficient for examining the relation between bullying behaviors and separate child characteristics, both types of report are necessary for a complete understanding of the personal and social well-being of the children involved. (Contains 3 tables.)

To examine whether bullying is strategic behavior aimed at obtaining or maintaining social dominance, 1129 9- to 12-year-old Dutch children were classified in terms of their role in bullying and in terms of their use of dominance oriented coercive and prosocial social strategies. Multi-informant measures of participants' acquired and desired social dominance were also included. Unlike non-bullying children, children contributing to bullying often were "bistrategics" in that they used both coercive and prosocial strategies and they also were socially dominant. Ringleader bullies also expressed a higher desire to be dominant. Among non-bullying children, those who tended to help victims were relatively socially dominant but victims and outsiders were not. Generally, the data supported the claim that bullying is dominance-oriented strategic behavior, which suggests that intervention strategies are more likely to be successful when they take the functional aspects of bullying behavior into account. (Contains 3 tables.)

The aim of this study was to assess the effect of adaptations for children with low vision of the Bayley Scales, a standardized developmental instrument widely used to assess development in young children. Low vision adaptations were made to the procedures, item instructions and play material of the Dutch version of the Bayley Scales of Infant Development--Second Edition (BSID-II), and the Original and Low Vision versions were administered to children with visual impairment over an interval of two weeks. Although quantitative analysis revealed no significant differences between the Original and Low Vision versions of the test in children's scores, feedback from test administrators indicates that the Low Vision materials make the test easier to administer and more engaging for children. (Contains 1 note, 3 tables, and 2 figures.)

Background: This study explores the psychometric qualities of the Scenario Test, a new test to assess daily-life communication in severe aphasia. The test is innovative in that it: (1) examines the effectiveness of verbal and non-verbal communication; and (2) assesses patients' communication in an interactive setting, with a supportive communication partner. Aims: To determine the reliability, validity, and sensitivity to change of the Scenario Test and discuss its clinical value. Methods & Procedures: The Scenario Test was administered to 122 persons with aphasia after stroke and to 25 non-aphasic controls. Analyses were performed for the entire group of persons with aphasia, as well as for a subgroup of persons unable to communicate verbally (n=43). Reliability (internal consistency, test-retest reliability, inter-judge, and intra-judge reliability) and validity (internal validity, convergent validity, known-groups validity) and sensitivity to change were examined using standard psychometric methods. Outcomes & Results: The Scenario Test showed high levels of reliability. Internal consistency (Cronbach's [alpha] = 0.96; item-rest correlations = 0.58-0.82) and test-retest reliability (ICC = 0.98) were high. Agreement between judges in total scores was good, as indicated by the high inter- and intra-judge reliability (ICC = 0.86-1.00). Agreement in scores on the individual items was also good (square-weighted [kappa] values 0.61-0.92). The test demonstrated good levels of validity. A principal component analysis for categorical data identified two dimensions, interpreted as general communication and communicative creativity. Correlations with three other instruments measuring communication in aphasia, that is, Spontaneous Speech interview from the Aachen Aphasia Test (AAT), Amsterdam-Nijmegen Everyday Language Test (ANELT), and Communicative Effectiveness Index (CETI), were moderate to strong (0.50-0.85) suggesting good convergent validity. Group differences were observed between persons with aphasia and non-aphasic controls, as well as between persons with aphasia unable to use speech to convey information and those able to communicate verbally; this indicates good known-groups validity. The test was sensitive to changes in performance, measured over a period of 6 months. Conclusions & Implications: The data support the reliability and validity of the Scenario Test as an instrument for examining daily-life communication in aphasia. The test focuses on multimodal communication; its psychometric qualities enable future studies on the effect of Alternative and Augmentative Communication (AAC) training in aphasia. (Contains 1 figure and 7 tables.)

Children with intellectual disabilities have an increased risk of visual impairment, caused by both ocular and cerebral abnormalities, but this risk has not been quantified. The same applies to preterm children and children with cerebral palsy with a normal intelligence. Many cases probably go unidentified, because participation of these children in preschool vision screening programs is not guaranteed, or because no screening program is available. Although there may be a case for specific screening, there is insufficient scientific evidence supporting such a claim. A "safety net" construction for vision screening is proposed by a Dutch expert working party, based on scientific information and joint professional expertise, to improve identification of both ocular and cerebral visual impairment in at-risk groups. Costs and gains of the model should be scientifically evaluated in a test region.

Background: A minority of patients with attention-deficit hyperactivity disorder (ADHD) do not respond favorably to methylphenidate. This has been partially associated with homozygosity for the Dopamine transporter (DAT1) 10-repeat allele and the presence of one or two Dopamine D4 receptor (DRD4) 7-repeat alleles. This study examined the sibling correlation of methylphenidate response rate and the possible association between response rate and these risk alleles. Methods: A sample of 82 Dutch children with ADHD, from 54 families, (including 30 singletons and 28 sib pairs), who used methylphenidate, was phenotyped according to DSM-IV criteria. Patients were members of affected sib pairs and were genotyped for DAT1 and DRD4. The sibling Intraclass Correlation Coefficient for methylphenidate response rate was calculated. The association between individual response rates and the risk alleles was examined using linear regression techniques. Results: The Intraclass Correlation Coefficient was significant (r = 0.563, p = 0.001). No evidence was found establishing an association between methylphenidate response and DAT1-homozygosity. There was a positive trend towards association with the presence of one or two DRD4-7R alleles. Conclusions: The sibling correlation may indicate a familial clustering of methylphenidate response. This response is possibly associated with the presence of one or two alleles at the DRD4-7R locus, but not with DAT1-10R homozygosity in the Dutch population.

Used the Child Behavior Checklists to develop a classification system to categorize behavior problems of foster children and initiated its validation with 91 foster children in The Netherlands. Identified four groups: normal, aggressive- delinquent-social problems, attention-social problems, and withdrawn-social problems. Found that these taxa corresponded well with Achenbach's general taxomony, but that both taxonomies lack predictive validity for foster care. (Author/KB)

Studied children's perceptions of their social networks, including the differentiations young children make between persons in their social networks and the functions they fulfill, the level of agreement between children and their parents, and the stability of the children's responses. Describes the use of a new instrument called the Support, Control and Maintenance Pictures Interview (SCAMPI). (Author)

Summary: Objects: The first aim of this study was to determine the incidence of craniosynostosis, metopic synostosis and sagittal synostosis in the Netherlands from 1997 to 2007. The second aim was to study whether a shift in the proportion of different subtypes of craniosynostosis had taken place in the Netherlands during the study period. Methods: Patients of all six units performing craniofacial procedures in the Netherlands that met the inclusion criteria participated in the study (n =927). A logistic regression in a weight sample was used to assess the differences in both the proportion and the incidence of different subtypes of craniosynostosis each year. The angle of the metopic ridge was compared using a regression analysis. Results: The incidence of craniosynostosis increased from 2.6 per 10 000 live births in 1997 to 6.4 in 2007. The incidence of metopic synostosis showed a significant increase of 6% each year (p =0.029). We observed a significant change in the proportion of metopic synostosis, with a mean percentage of 20% during 1997–2000 and 27% during 2001–2007 (p =0.046). The incidence of sagittal synostosis annually increased by 3% (p =0.89). We did not find a significant change regarding the proportion of sagittal synostosis during 2000–2001. No significant difference in the severity of metopic synostosis was found between 1997–2000 and 2001–2004. Conclusion: The incidence of craniosynostosis, metopic synostosis and sagittal synostosis is 6.4; 1.9; and 2.8 per 10,000 live births, respectively. Both the incidence and the proportion of metopic synostosis have significantly increased over the study period, concluding that metopic synostosis is on the rise. [ABSTRACT FROM AUTHOR]

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The article reports on research which was conducted to evaluate the scalability and item order of the revised checklist of the Dutch version of the home intervention program the Portage Program using Item Response Theory Modeling. Researchers administered the items of the checklist to a sample of 736 families by using an incomplete data collection design. They found that that it was possible to find a marginally or reasonably fitting scale for all areas of the checklist and that reordering of the items was necessary to get a correct overview of skills that the child masters. They concluded that their results have implications for future research into the use of the original checklist in other countries.

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The article presents a study on indices to describe interethnic memberships in sports clubs in the Netherlands at the twentieth century using survey and administrative data. According to the author, sports clubs are venues for affiliation with people of similar backgrounds. Results have shown that 50 percent of all sports club members belong to at least one club for a mixed sports group and that 34 percent of ethnic majority members belong to an ethnically mixed sports team. Furthermore, it was found out that majority of interethnic ties are built by soccer clubs.