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Gender disparity persists in the personal caregiving of children and older adults, and in professional caregiving duties, with many workplace policies and cultures favoring the "ideal worker" and presenting significant and continuing barriers to female caregivers' professional success and well-being. The recent pandemic both highlighted and augmented this disparity as schools, daycares, and adult care facilities closed or implemented restrictions. This study interprets results from the July 2021 Canadian Natural Sciences & Engineering (NSE) Faculty Workplace Climate Survey by empirically assessing the impact on emotional exhaustion of the increased caregiving burden during the COVID-19 pandemic on female academics in the highly masculinized NSE fields. Results indicate that women were more likely to experience emotional exhaustion even when other factors were considered. Collegiality and inclusion were found to be protective factors, illustrating important implications for, and the retention and support of, success and well-being of female NSE academics.

Concerned with the ongoing youth mental crisis in the United States, researchers intentionally planned for positive youth development (PYD) practices in nature. Educators, appreciating the critical importance of youth developing relationships and a sense of belonging, may regard this model as a powerful tool to enhance existing programs. Both youth and parents report this as ahigh quality PYD program, resulting in thriving youth. Youth participants feel welcome, supportively challenged, and passionate about the topic; resulting in a growth mindset, hopeful purpose, and openness to challenge and discovery. The program inspired an affinity for nature in both youth participants and associated adults. 97% of youth and 95% of adult caregivers report being inspired to spend more time in nature as a result of the program. The program also inspired increased youth interest in science college and career opportunities.

Context: Research on emotional intelligence (EI) shows this concept's decades-long positive influence on well-being, self-efficacy, employability, and academic and professional achievement. Indeed, several studies have demonstrated that students with high EI have better grades and quality of life, as well as are more employable than students with low EI. By considering the two conceptualizations of EI as either an ability or personality trait, the present study investigates EI's influence on training achievement in initial vocational education and training (IVET). We posited that the two types of EI positively influence training achievement in a complementary way: Ability EI relates to achievement in theoretical training, while trait EI relates to achievement in practical training. Furthermore, these links are mediated by apprentices' engagement at school and in learning. Method: To test our hypotheses, 92 dual IVET health and social care apprentices in their last year of vocational school completed an online survey composed of validated scales measuring EI as an ability, EI as a personality trait, personality traits, and school engagement. The apprentices' grades were also obtained with their permission. Results: The findings confirmed our hypotheses and reflected EI's positive influence on training achievement. We observed that participants with high EI (as an ability and personality trait) obtained better grades than participants with lower EI. Moreover, our results showed that ability EI has a direct influence on achievement in theoretical health and social care training, while the link between trait EI and practical training is indirect and mediated by engagement in learning. Conclusion: The present study confirms EI's positive influence on school achievement in the VET context and further corroborates the important role that EI can play in dual IVET apprentices' achievement, particularly in the health and social sectors. This original study contributes to research on the VET system by placing EI among the skills necessary to ensure professional success.

Little is known about OCD in people with learning disabilities (LD) in general and in terms of current and professional support. In this study, we examined caregivers' perceived challenges and strategies practiced in institutionalized settings in managing OCD in people with LD and derived implications for research and practice. We studied individual cases of people with LD (n = 7). Each case included group discussions (n = 28) and semistructured interviews with caregivers (n = 20). We used qualitative content analysis to analyze the data. Our findings reveal the following challenges for caregivers: recognizing and classifying ambiguous behaviors, recognizing emotional well-being and needs through nonverbal signals, finding and applying effective strategies, being unqualified regarding additional needs, managing inappropriate institutionalized conditions, and lacking external specialization. We identified five strategies for dealing with compulsive behavior: tolerating and allowing, accepting and supporting, involving, limiting the compulsive act, and stopping the act. Collaboration among psychiatric, therapeutic, and caregivers in institutionalized settings is critical for early identification and support of OCD. Challenges arise from caregivers' lack of training on the additional needs of people with LD and OCD, highlighting the urgent need for disorder-specific guidelines for identification and support.

This reflective essay addresses the nexus of two recent events in the United States: (1) the public scrutiny of the relationship between land grant universities and the expropriation of Indigenous lands and (2) the often uncritical and rapid uptake of settler land acknowledgments at public college and university events. We argue that written land acknowledgment statements need to accompany actions that align with declarations of respect and honor. Specifically, we offer readers three concrete ideas through which institutions may further land acknowledgments: challenging their historical legacies, fostering meaningful partnerships with Native Nations and Indigenous Peoples, and materializing resources for this highly underserved, long-neglected, often ignored community.

This article casts light on informal caregiving, an essential aspect of the international postgraduate researcher (PGR) experience, but which is often invisible in literature and discourses on international education. Drawing from qualitative semi-structured interviews with international PGRs in a British university, it highlights their dual role as care recipients and lesser known caregivers across transnational and local spaces. It gives insights into the forms and dynamics of care that they give to and receive from family, friends and others, uncovering the emotional and affective aspects of undertaking a postgraduate research degree overseas which impact on their mental wellbeing. The findings have implications for the improvement of university support for international PGRs which has relevance for the wider international student community.

In 2012, the southern African country of Eswatini ratified the United Nation's Convention on the Rights of Persons with Disabilities (CRPD), and in 2013 developed the national disability policy reform documents to implement the CRPD across different domains, including health care. The current study aimed to analyze these policy reform documents for the actors, context, and processes involved in the development and implementation of the national disability policy reform documents. It also examined the provisions made for access to health care for persons with disabilities by utilizing a novel disability policy analysis framework. In-depth interviews with key informants were conducted to substantiate the findings obtained from document reviews. Focus group discussions were then conducted with persons with disabilities, caregivers of persons with disabilities, and health care professionals as the end users of the policy documents. The goal was to establish their knowledge of these documents and to ascertain how effective they perceived these documents to be. Findings indicated that while the content of the policy documents mirror most of the CRPD's principles, certain aspects related to geographical and financial accessibility should be reconsidered. There is evidence to suggest a gap in policy implementation, owing to the lack of disability conscientization in general and among policymakers in particular, and manifested through political, financial, and attitudinal factors. This implies a need for disability sensitivity programs, as well as clearer implementation guidelines and government's commitment to disability rights and the process of implementing the national disability policy reform documents.

Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their child's adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the "service cliff" experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.

Autistic youth are more likely to experience depression than their non-autistic peers, yet research on risk and protective factors to depression in this population is limited. Behavioral activation (i.e., prioritizing and engaging in meaningful activities), including social activities, is an important mechanism in the pathway to depression in non-autistic youth that is understudied in autism. Ratings of youth depressive symptoms and behavioral and social activation at one timepoint from 100 autistic youth without intellectual disability and 100 of their caregivers were analyzed. The study aims were to examine caregiver and youth ratings of youth internalizing symptoms and behavioral and social activation, inter-rater reliability on study variables, and associations between depressive symptoms and behavioral and social activation in autistic youth by rater. Results revealed significant differences in youth and caregiver ratings on all variables and inter-rater reliability ranged from poor to moderate. Across both raters, more severe anxiety symptoms and lower behavioral activation were associated with more severe depressive symptoms; social activation, specifically the number of friends youth have, was significant in caregiver ratings only. Findings can be leveraged to enhance risk stratification and intervention efforts for autistic youth experiencing depression.

Background: Long-term care services are funded primarily by Medicaid long-term services and support in the United States, where eligibility is based on care needs of the individual with intellectual and developmental disability alone. Impact of Medicaid waiver services on self-reported caregiver needs is not well understood. Method: Caregivers (n = 405) of individuals with intellectual and developmental disabilities across four states (NY, OH, TX, and PA) completed an online survey. Results: Caregivers reported a moderate degree of burden and susceptibility of stress-induced health breakdown. Despite controlling for the activities of daily living of the care recipient, caregivers of individuals with Medicaid Waiver services reported greater difficulty managing medications (p = 0.013) and finding paid help (p < 0.001) than caregivers of individuals without services.

Background: The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. Method: Twenty-eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single-group non-randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. Results: The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5-week enrolment delay. Conclusion: The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial.

Background: Research suggests that a better awareness of how staff who directly support people with intellectual disabilities experience their working relationships, will contribute to understanding staff wellbeing and the quality of care they offer. This study aimed to gain insights into the lived experiences of support workers in supported living services in England. Method: Six support workers participated in semi-structured interviews, about their working relationships with service-users and colleagues. Data was analysed using interpretative phenomenological analysis. Results: Six interconnected themes emerged: The essence of good relationships; a trusting relationship as the vehicle for meeting service-users' needs; belonging to the support team; the organisational context of relationships; the social context of relationships; 'a fine balancing act'. Conclusions: The findings provide insights into staff wellbeing, indicating that developing supportive, trusting relationships with both service-users and colleagues, plays an important role in delivering effective care. Potential implications for service providers are discussed.

Background: India has a significant prevalence of people with intellectual disabilities. Despite their higher prevalence, they receive poor support. Therefore, this review aims to explore the experiences of family carers in providing care for children with intellectual disabilities in India. Methods: A qualitative evidence synthesis was undertaken, searching databases such as MEDLINE, CINAHL, Web of Science, and PsycInfo up to October 2023. Grey literature was also searched for unpublished studies, with two reviewers assessing methodological quality. Eleven eligible studies, mostly qualitative in design, were included in the review. The data synthesis followed a thematic approach. Results: The synthesis found five themes representing family carers' experiences and perspectives. These were 'resilience and acceptance', 'parental response', 'care dynamic', 'preparing for transition to adulthood' and 'parental advocacy'. Conclusion: Family carers hold diverse views, while almost all consider providing care complex and challenging, with few positive experiences.

Investigations into teacher dissatisfaction often limit concerns to the school setting; however, this ethnographic study investigated how Cuban women's employment as primary school teachers forced them to make strategic negotiations related to childbirth and eldercare. Interviews and participant observation conducted with five Black primary teachers revealed tensions between economic production and biological reproduction. Attention to teachers' lives outside of the classroom and the complications they experience are useful for Cuba and other counties experiencing shortages.

Background: Despite historical and contemporary trauma, American Indian and Alaska Native (AIAN; Indigenous) communities responded with resilience to the COVID-19 pandemic. However, AIANs experienced disproportionate rates of infection, hospitalization, death, and reduced life expectancy. School closures exacerbated disparities, leading to learning loss, economic instability, and mental health challenges among AIAN youth. Methods: The Project SafeSchools cohort study employed a comprehensive longitudinal convergent mixed-methods approach, integrating community-based participatory research principles. The study enrolled Navajo Nation caregivers whose children were eligible to attend local reservation-based schools. We conducted an analysis of caregiver self-report baseline data collected between August 2021 and May 2022. Results: A total of 242 caregivers completed at least part of the baseline assessment and were included in data analysis. Caregivers were primarily female (88.7%), non-Hispanic (97%), and Indigenous (97%). Most caregivers were in their late 30s (mean age 38), with varying educational backgrounds and employment statuses. Children were evenly split between males and females and distributed across different age groups. Most children attended school at baseline in various formats, including in-person, hybrid, and online-only settings. Caregivers reported a range of psychosocial and behavioral risks, including general mental distress, depressive symptoms, and anxiety for themselves and their children. Furthermore, caregivers and children exhibited various protective factors, such as strong cultural identity, resilience, and academic self-efficacy. Conclusions: This study highlights the higher rates of mental health distress among participating caregivers and children compared to national averages. Despite these challenges, cultural protective factors remained strong and should guide future crisis response efforts.

Background: The COVID-19 pandemic has brought about disruptions in healthcare for adults with intellectual and developmental disabilities. There is a need to explore ways to promote proactive healthcare and better prepare individuals for healthcare encounters. Methods: A co-designed tool, the COVID Check-in Tool, was introduced as part of a virtual health education programme to encourage proactive healthcare. Implementation of this Health Check-in was evaluated with 36 adults with intellectual and developmental disabilities and 96 family caregivers who completed the programme using surveys, structured interviews and focus groups. Findings: Forty-four percent of participants engaged in the Health Check-in process, resulting in many reported benefits for those who participated. However, there were also barriers to initiating the Check-in, along with challenges using the COVID Check-in Tool, according to both the adults with disabilities who were interviewed and the family caregivers. Conclusions: The study underscores the importance of considering ways to integrate tools into routine healthcare practices, to facilitate improved healthcare delivery for people with intellectual and developmental disabilities during pandemic recovery efforts. As well, involving people with lived experience in the development and implementation of healthcare resources is critical.

The Caregiver Strain Questionnaire assesses the three dimensions of caregiver strain, namely the objective, subjective externalized and subjective internalized strain. It was validated among caregivers of children with Autism Spectrum Disorder (ASD) in the United States and Mainland China with promising psychometric properties. This study aimed to develop and validate the Chinese (traditional script) version of the Caregiver Strain Questionnaire (C-CGSQ) among 198 caregivers of children with ASD in Hong Kong. The C-CGSQ showed excellent internal consistency ([alpha] = 0.958) and test-retest reliability (Spearman's r = 0.966). Concurrent, convergent, divergent validity and a three-factor structure (consistent with previous studies) were established. The C-CGSQ demonstrated promising psychometric properties in measuring caregiver strain among caregivers of Chinese ASD children in Hong Kong.

Purpose: The present study investigated school absence among 1,076 5-15 year-old children with neurodevelopmental conditions (intellectual disability and/or autism) approximately one year following the start of COVID-19 in the UK. Methods: Parents completed an online survey indicating whether their child was absent from school during May 2021 and the reason for each absence. Multi-variable regression models investigated child, family and school variables associated with absenteeism and types of absenteeism. Qualitative data were collected on barriers and facilitators of school attendance. Results: During May 2021, 32% of children presented with persistent absence (missing = 10% of school). School refusal and absence due to ill-health were the most frequent types of absence, accounting for 37% and 22% of days missed, respectively. COVID-19 related absence accounted for just 11% of days missed. Child anxiety was associated with overall absenteeism and with days missed because of school refusal. Parent pandemic anxiety and child conduct problems were not associated with school absenteeism. Hyperactivity was associated with lower levels of absenteeism and school refusal but higher levels of school exclusion. A positive parent-teacher relationship was associated with lower levels of absenteeism, school refusal and exclusion. Child unmet need in school was the most frequently reported barrier to attendance while COVID-19 was one of the least frequently reported barriers. Conclusion: COVID-19 had a limited impact on school attendance problems during this period. Findings highlighted the role of child mental health in different types of absence and the likely protective role of a positive parent-teacher relationship.

It is known that infant-directed speech (IDS) plays a key role in language development. Previous research, however, has also identified significant variability across societies in terms of how often IDS occurs. For example, some studies report very little IDS in non-western, small-scale societies -- including children growing up in small-scale societies in Tanna, Vanuatu. This is surprising given that IDS is widely assumed as a common feature of human caregiving based on research conducted in urbanised populations which are more well-studied. Here, we propose that IDS is only one of a suite of important caregiving behaviours that are produced during interactions with infants, which may vary by culture, perhaps being replaced by other, non-verbal infant-directed behaviours (IDB). We will examine previously collected data consisting of 94 semi-structured 10-min video observations of caregivers and their 18--24 month-old children in rural Tanna, Vanuatu and urban Vancouver, Canada to identify and compare the proportion of time caregivers spend engaging in IDS and IDB during these interactions, both within and between societies. We define IDS as caregiver speech or vocalisations during the interaction with the infant, and we define IDB as non-verbal behaviours that are produced with the infant during the interaction. This study aims to take a step towards a more generalised understanding of language development in children, moving beyond the urban and western societies in which our understanding of development is currently based, and the predicted results will aid in recognising different developmental pathways within multi-cultural communities.

This study explored the nature, prevalence, and developmental profiles of sensory processing disorders among children with autism spectrum disorder (ASD). The participants comprised 119 children with ASD and 30 typically developing children and their parents. The Child Sensory Profile-2 was used to assess the children's sensory processing characteristics. The children with ASD exhibited elevated sensory processing difficulties. Deficits were observed in all the sensory modalities among the children with ASD, except the visual processing modality. Age-related improvements were observed in most sensory processing domains, although non-significant differences were noted in three domains. These findings should enhance understanding of the sensory challenges faced by children with ASD and contribute to the development of individually tailored, targeted, and age-specific therapeutic interventions.

Objective: The purpose of this paper was to examine variables associated with food insecurity among community college caregivers during the COVID-19 pandemic. Methods: We used data from a multi-institutional survey of 15,051 caregivers enrolled at 130 community colleges in 42 states in fall 2020. We used a logistic regression to examine whether demographic, academic, caregiving-related, financial, or COVID-19-related variables were associated with caregivers' food insecurity. Results: Over half (52%) of community college caregivers experienced food insecurity. Transgender caregivers, first-generation caregivers, and caregivers who were divorced or single, had multiple disabilities, were previously in foster care, and had a family that experienced trouble making ends meet growing up had significantly (p < 0.05) higher probabilities of experiencing food insecurity. Community college caregivers who used childcare and those with at least one child up to 12 years old also had increased probabilities of experiencing food insecurity. Moreover, caregivers who felt childcare was not affordable and believed that they did not earn enough money to make employment worthwhile after paying for childcare expenses had higher probabilities of experiencing food insecurity, as did those who experienced housing insecurity and used Pell grants, student loans, and support from friends or family to pay for college. Losing a job, experiencing cuts to work hours or wages, employment as a frontline worker, and contracting COVID were associated with higher probabilities of food insecurity. Contributions: Community college caregivers experienced high rates of food insecurity during the pandemic and some caregivers were at greater risk of exacerbated probabilities of food insecurity. We advocate for targeted interventions, wraparound services, and increased advocacy for legislation to support student caregivers.

This study used a longitudinal probability sample survey, "Understanding Society: COVID-19," to examine trajectories in adolescents' mental health, via the Strengths and Difficulties Questionnaire, at three timepoints during COVID-19 with a particular emphasis on vulnerable groups (i.e., young carers, adolescent girls, BAME--Black, Asian and minority ethnic, and adolescents in financially strained households). Generally, self-reports of emotional and total difficulties remained stable during the pandemic, although adolescents who had limited social support were far more likely to report severe emotional and total difficulties. Young people with pre-existing mental and physical health conditions appeared more resilient, whereas vulnerable young people were hit the hardest during the pandemic. Compared to their less vulnerable peers, young carers, adolescent girls, Black or mixed-race young people and adolescents in financially strained households were more likely to report reduced mental health during the pandemic. It is hoped that the findings will contribute to debates about the pandemic unveiling existing mental health inequalities in society, and to public policy in an era of perma-crises as we currently face a cost of living crisis where public services are under enormous strain to reach those who need them most.

Background: We explored the experiences of staff working in Norwegian community-based living facilities, caring for people with intellectual disabilities during the Covid-19 pandemic, and what self-regulatory strategies staff used to maintain health and care service delivery and contribute to organisational resilience. Methods: A qualitative design was utilized. Data were collected from September 2021 to April 2022 with individual and focus group interviews. In this study, 25 staff members participated. Thematic analysis was conducted. Findings: Five main themes were identified regarding the experiences of staff during the pandemic: Lockdown of facilities, social isolation of residents, lack of health follow-up, high sick leave rates and communication challenges. Only some of the strategies to mitigate pandemic-related challenges were based on current Norwegian infection control guidelines. Some strategies were successful while others were not and some were negligent and challenged the delivery of health and care services for the residents. Conclusions: Our study shows that people with intellectual disabilities living in the community-based living facilities were subjected to human rights violations and violations of the Norwegian infection control law. This was caused by a lack of several important organisational qualities in the facilities.

Background: Despite humanistic declarations regarding the rights of people with intellectual disability to live a full, meaningful life, in practice, resulting from dilemmas experienced by direct support provides, support is often limited to a focus on functional independence. The aim of this research was to define the theoretical principles by which the gap between humanistic declarations and practice can be overcome. Method: The research focused on the role perception of 30 direct support providers who participated in semistructured interviews. A case study methodology was used applying an interpretative phenomenological analysis (IPA). Findings: The interviews revealed that a humanistic perspective has been partially incorporated into the general attitudes of direct support providers. In practice, however, they indicated that they face dilemmas that challenge them in their daily work. Conclusion: To assist direct support providers in resolving their dilemmas, by adhering to humanistic principles, a 'humanization' model is offered. The theoretical principles underlying the model focus on meaningful life as the aim of support, enhancing recipients' autonomy, adhering to a holistic perspective and conducting dialogues acknowledging the abilities of people with intellectual disability to understand, choose and face challenges. Further examination of the model and its application in practice is recommended.

During the COVID-19 pandemic, drastic measures to interrupt SARS-CoV-2 infection chains were implemented. In our study we investigated the consequences of pandemic related restrictions on the social, psychological, and physical well-being of institutionalized adults with intellectual and developmental disabilities. Methods: Online survey among professional caregivers in 71 residential groups, caring for 848 residents. Findings: (i.) A lack of participation concerning infection protection measures of the residents, their relatives, and their caregivers; (ii.) A 20% increase in doctor contacts during the pandemic; (iii.) A considerable deterioration in at least one item of the subdomains mood (49%), everyday skills (51%), social interaction (29%), exercise and coordination skills (12%), behavior (11%) and cognition and communication (7%); (iv.) A deterioration of the overall condition in 41%; Summary: Intensive attempts should be made to find individual and less categorical contra-infectious measures without questioning the basic everyday needs of people with intellectual and developmental disabilities.

Life skills development among youth in foster care is critical in helping them overcome the barriers they face when leaving care. While foster care agencies, child welfare professionals, and caregivers play important roles in life skills development, little research has examined the topic from their perspectives. This study examined the barriers and supports Florida foster care agencies, child welfare professionals, and caregivers face related to life skills development of youth in foster care. Foster care agency representatives (n = 11) completed interviews or questionnaires and identified agency-level challenges, agency-level supports, and caregiver-focused supports for life skills development. In surveys, child welfare professionals (n = 24) and caregivers (n = 23) identified the challenges and supports they experience, as well as additional supports they needed. Semi-structured interviews with three child welfare professionals and seven caregivers gathered in-depth information on the topics covered in the survey. Thematic analysis was employed to identify themes within the data. While a number of challenges (i.e., lack of youth-focused resources, staff turnover) emerged across all three groups, supports were more varied across and within groups. Notably, caregivers received minimal support from the foster care system in helping youth develop life skills. Despite this, caregivers and child welfare professionals mainly identified youth-focused resources and services as needed additional supports. More training, support, and funding are required to address the challenges identified in this study. Broader child welfare issues, such as staff retention and turnover, must also be addressed to support the youths' development of independent living skills.

The sharp rise over the past decade in young children's access to various forms of screen media (e.g., smartphones, tablets, TVs) has posed new and significant challenges to caregivers in managing children's use of this type of media. For caregivers of young children with externalizing behavior problems, managing children's time with screen media is especially important and challenging. In this article, we summarize evidence of bidirectional links between early externalizing behavior problems and unhealthy screen media use in young children and discuss the extent to which prior interventions have responded to the needs of caregivers of children with these problems. We propose a conceptual model for an intervention to promote healthy screen media use for children with externalizing behavior problems that leverages current behavioral parenting interventions.

The supervision of field experiences is an indispensable component of Board-Certified Behavior Analyst (BCBA®) training. During the supervised field experience, supervisors regularly provide performance feedback to trainees for the purpose of improving fidelity of implementation of various assessments and interventions. Emerging evidence supports the efficacy of using telehealth to train teachers and parents to implement interventions, but no study has evaluated the effectiveness of the remote delayed performance feedback among individuals completing BCBA® training. We used videoconference equipment and software to deliver remote delayed performance feedback to seven participants enrolled in a graduate program and completing supervised field experience. Remote delayed performance feedback was provided regarding participants' implementation of caregiver coaching. The results indicate that delayed performance feedback provided remotely increased the correct implementation of caregiver coaching. These preliminary results indicate the efficacy of remote supervision and delayed performance feedback.

The telehealth model can allow for cost-effective supports in areas where limited applied behavior analysis (ABA) services are available. As a result, e-learning programs for parents of children with autism have become part of the telehealth paradigm. In the Czech Republic, one of the many places where there are limited ABA supports and no available ABA e-learning courses for families, the development of an e-learning course that is freely available, and linguistically and culturally appropriate, is needed. It was anticipated that this course could mirror some of the free e-learning materials available to English-speaking caregivers and provide foundational knowledge to later support more intensive ABA services. Therefore, a pilot study was developed to assess an ABA e-learning course for caregivers in the Czech Republic with the aim of validating its efficacy and assessing whether a synchronous component was needed for the best outcomes. The materials were not meant to replace best practices in more intensive caregiver training but provide foundational skills for later more successful local services. Results demonstrated that a total of 33 caregivers completed the course, making statistically significant gains in their ABA knowledge and rating the course highly. Interestingly, the addition of the synchronous component only impacted the knowledge gain outcome. Suggestions for supporting caregivers in e-learning course completion and directions for future research are additionally explored.

Caregivers of children with neurodiverse needs are known to experience challenges and hardship due to the increased needs of the child and the lack of support available. This study aimed to explore the support needs and well-being of caregivers of children with neurodiverse needs in Australia. Sixty-six caregivers participated in an online survey asking questions about support needs. The results highlighted five main themes that caregivers commonly experienced including: barriers to community engagement, impact on close relationships, negative impact on mental health and identity, financial hardship, and identified support needs. Findings identified multiple unmet needs existing amongst caregivers and further emphasises the importance of addressing these needs to improve the quality of life of caregivers of children with neurodiverse needs.

Background: Person-centred services are inherently related to patients/caregivers' needs. However, the extent to which dysphagia services within Singapore meet consumer needs is largely unknown. Involving patients/caregivers in service evaluation/redesign deepens the understanding of consumer needs. This process also increases the success of implementing service enhancements through relevant and meaningful change. Aim: This study aimed to identify aspects of dysphagia services, within acute and subacute settings in Singapore, perceived as highly important and easy to change by patients/caregivers. Methods & Procedures: Using concept mapping methodology, 5 patients and 11 caregivers reflected on their experiences of receiving dysphagia care and proposed 59 unique suggestions to improve dysphagia services within Singapore. Then, each individual sorted the suggestions into groups based on similarity and rated each statement for its perceived importance and changeability for service enhancement. Data were analysed using multidimensional scaling, hierarchical cluster analysis, and bivariate analysis to generate clusters of conceptually similar suggestions and a prioritised list of suggestions for service enhancement. Results: Twelve clusters were identified, with most rated as more important than changeable for service improvement. Participants prioritised 23 (39%) of the suggestions as highly important and easy to change, and these focused on ensuring effective communication among consumers and healthcare team, enhancing patients and carers' access to support at home, increasing patients and carers' access to educational resources, and improving service quality and access through technology. Conclusion: These findings provide future directions on how to develop and implement dysphagia services in Singapore to better meet the needs of patients/caregivers.

This article outlines a stakeholder-created research agenda to guide future early intervention research for autistic children. We collaborated with 10 autism service providers, 10 parents of individuals with autism, and 10 autistic people across a total of 18 small group and 2 inter-group meetings occurring over 2 years. Together, we synthesized results from (1) these stakeholder workshops and (2) a survey completed by 237 autistic adults, autism providers, caregivers, and autism researchers in the United States. The finalized research agenda includes (1) Guiding Principles, (2) Research Priorities, and (3) Systems Implications. The full version of the early intervention autism research agenda is available in Supplemental Material. In this article, we summarize the main points of the research agenda and discuss unique themes highlighted by stakeholders in considering early autism intervention research. Finally, we highlight the need to include stakeholders in decision-making and consultant positions throughout the research process to align future work most directly and optimally with the goals and needs of the autism community. We have gathered guidance directly from our stakeholders and experiences with Project Stakeholders Engaging in Early Intervention Research (STEER) into a researcher workbook which we hope may facilitate these efforts. This workbook is available in Supplemental Material.

Autistic individuals with intellectual disability are at greater risk of experiencing anxiety than their non-autistic peers without intellectual disability. Anxiety in this group may present as behaviour that challenges, often leading families to reach out to healthcare or support services. However, many families experience difficulties accessing services and, due to the lack of research into evidence-based anxiety interventions for people with intellectual disability, may not receive individualised support once in a service. This study explored caregivers' experiences of accessing services for autistic individuals with intellectual disability, and their considerations when developing new interventions for this population. Interviews and focus groups were completed with 16 caregivers of autistic people with intellectual disability. Reflexive thematic analysis was used to develop five themes about service access experiences, and three themes about caregiver considerations for anxiety interventions. Caregivers reported that their experiences of accessing services did not meet their expectations, and considerations for future anxiety interventions were often reflective of this. Interventions being flexible to family circumstances to aid accessibility, the embedding of peer support in services, and skills that can be generalised across the lifespan could be applied when aiming to improve outcomes and develop interventions for this under-served population.

Background: The Reducing Disability in Alzheimer's Disease in Kansas City (RDAD-KC) intervention has been shown to improve the health of individuals with dementia and caregiver dyads. This manuscript reports the results of implementing the RDAD among individuals with intellectual disabilities and caregiver dyads. Methods: Nine community agencies deployed the 12-week intervention. We assessed changes in individuals with intellectual disabilities' behavioural symptom related severity and physical activity, and caregivers' behavioural symptom-related distress, unmet needs, and caregiver strain. Results: Forty-four dyads enrolled, and 23 (~60 years, 48% female) completed [greater than or equal to] 75% of the intervention. We observed decreases in behavioural symptom related severity (p = 0.07) and increases in physical activity (p = 0.20) among individuals with intellectual disabilities. We also observed decreases in behavioural symptom related distress (p = 0.14), unmet needs (p = 0.50), and caregiver strain (p = 0.50) among caregivers. Conclusions: The RDAD-KC intervention showed promising, although statistically non-significant, benefits among individuals with intellectual disabilities and their caregivers.

Background: Virtual mindfulness may be helpful for individuals with intellectual disabilities in the context of COVID-related disruptions of in-person programming, such as Special Olympics (SO). This study examined the feasibility of a virtual mindfulness intervention for SO athletes and their caregivers. Method: SO athletes (n = 44) and their caregivers (n = 29) participated in a 6-week adapted virtual mindfulness intervention. Athletes completed mindfulness and well-being questionnaires prior to, immediately following, and 3-months post-intervention. Caregivers completed questionnaires assessing their own stress, mindfulness, and well-being, as well as athlete mental health. Exit interviews were conducted immediately following the intervention. Results: The intervention was feasible in terms of demand, implementation, acceptability, and limited testing efficacy. There were significant improvements in athlete well-being and mental health, and caregiver stress and mindfulness post-intervention. Conclusions: Adapted virtual mindfulness groups may be an effective intervention in improving the well-being of adults with intellectual disabilities and their caregivers.

Background: Despite the enactment of disability laws/policies in India, research shows that caregivers of adults with intellectual and/or developmental disabilities experience inadequate formal supports/services due to dissemination barriers and lack of awareness about them. To address discrepancy between caregivers' support needs and the professionals' understanding of their needs, the study proposed to conduct a caregiver needs assessment so that culturally-tailored programs are developed. Method: A strengths-based mixed methods needs assessment was conducted with a convenience sample of 100 caregivers in Hyderabad, India. One hundred caregivers completed the survey and 15 caregivers participated in semi-structured interviews. Results: Caregivers needed more and improved formal supports/services, particularly from the government. Caregivers faced systemic and attitudinal barriers, and personal impediments to accessing them. Needs differed by care recipients' intellectual disability level, gender, and intellectual disability related conditions. Conclusions: Researchers, service providers and policymakers need to adopt innovative strategies to improve formal supports/services access.

Caregiver coaching is a mutually beneficial practice used by early interventionists (EIs) to build caregivers' confidence and capacities to support their children, which, in turn, leads to EIs gaining knowledge from families and developing new skills (e.g., Douglas et al., 2020; Meadan et al., 2020). Coaches (i.e., EIs) help others (i.e., caregivers) learn to (a) reflect on their actions and (b) create plans to improve their actions (Rush & Shelden, 2020b). EIs who use a coaching framework primarily interact with caregivers, while the caregivers' role is to work directly with their children. This service delivery model differs from traditional services, in which the primary interactions are between EIs and children, with caregivers mainly assuming the role of observer (Campbell & Sawyer, 2007). In this article, we provide guidance for adopting a coaching framework and cover the following topics: (a) rationale for using a caregiver coaching framework; (b) what coaching frameworks exist; (c) considerations when choosing a framework; and (d) how to individualize coaching for families.

Although individuals are exposed to a variety of pro-environmental influences in childhood, it is unclear which has the biggest impact on adult beliefs and behaviour. The aim of the current study therefore examined how formal sustainability education and childhood caregiver pro-environmental motivations, beliefs and behaviour, influence motivations and behaviours in adulthood. An Australian adult sample (n = 230) completed a survey measuring pro-environmental motivation, anthropogenic climate change beliefs and pro-environmental behaviour. Recollections of childhood caregivers' anthropogenic climate change beliefs and pro-environmental behaviours, and formal completion of sustainability education were obtained. Hierarchical multiple regression analysis found childhood caregiver pro-environmental behaviour significantly and uniquely predicted pro-environmental behaviour. Moderation analysis found no influence from formal sustainability education on this relationship. Caregiver and individual climate change belief were associated, but caregiver belief was not associated with pro-environmental motivation. No differences in adult pro-environmental behaviour were noted when considering childhood sustainability education. Results suggest transmission of anthropogenic climate change belief and pro-environmental behaviour occurs from childhood caregivers. Comparatively, formal childhood sustainability education was not significant in establishing ongoing pro-environmental behaviour patterns. This research adds to limited existing literature demonstrating caregiver impact on sustained pro-environmental behaviour and provides possible future direction for promoting sustainable behaviour.

This study explored the daily routines of caregivers and the coping behaviors of both children and caregivers during the novel coronavirus (COVID-19) global pandemic. We collected data from ten caregivers and their children through caregiver and child interviews, and a caregiver survey in the Summer of 2020. We used descriptive statistics, and open, axial, and selective coding processes to analyze research data. Findings indicated that caregivers experienced difficulties in balancing home, work, and personal responsibilities. Both caregivers and children experienced social and emotional challenges, and their technology and digital media use differed. To cope with challenges, caregivers and children used various coping strategies. Our study deepened our understanding of the daily routines and coping behaviors of caregivers and children during the global pandemic.

Informal Student Carers (ISC) are students across the UK who provide unpaid care to a friend or family member needing support. We explored the lived experiences of ISCs and the challenges they faced throughout the COVID-19 pandemic. A scoping review, questionnaire-based survey and volunteer interviews were undertaken to identify the themes which predicate ISC's experience during the COVID-19 pandemic. Our research showed that a combination of financial concerns, time constraints, and the lack of visibility of student caregivers all contributed to this student group's poor mental health during the COVID-19 pandemic. Educational institutions have an obligation to be informed and support the unique and varied needs of ISCs.

This partnership-based study identified how many middle and high school students take care of parents, siblings, and grandparents at home, via student surveys across Rhode Island public schools (N = 48,508; 46% White non-Latinx; 21% Latinx; 47% girls). Further, we investigated how students' caregiving for family related to their school engagement, belonging, and emotional well-being. A sizable proportion of students reported caring for family for part (29%) or most of the day (7%). Girls and Black, Asian, Latinx, Native, and multiracial youth were more likely to care for family, compared to boys and White non-Latinx youth. Caregiving students from all demographics were more likely to experience intense sadness compared to noncaregivers, revealing a need to support caregiving youth in schools. In addition, caregiving girls reported lower levels of school engagement and school belonging. However, caregiving for part of the day was related to greater belonging among Black and Native youth.

Background: College is a critical life stage for alcohol-related harms to others (AHTOs), gender, and sexual identity. We tested associations between inclusively-defined gender and sexual identities (separately) and AHTOs among college students. Methods: The Healthy Minds Study (n = 8,308) provided data about three AHTOs: (1) babysitting a drunk student, (2) alcohol-related unwanted sexual advance, and (3) alcohol-related sexual assault. Independent variables included gender and sexual identity. Results: One in four students (25.5%) reported babysitting, 6.2% reported unwanted advances, and 1.2% reported sexual assaults. Compared to cisgender males, cisgender females had higher odds of reporting babysitting (aOR = 1.36, p < 0.001) and unwanted advances (aOR = 2.59, p < 0.001); trans masculine students had higher odds of reporting sexual assaults (aOR = 4.49, p = 0.04). Conclusions: AHTOs are prevalent on college campuses, and cisgender female and trans masculine students have higher odds of experiencing them. Alcohol interventions may protect cisgender female and gender minority students from the drinkers around them.