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The effective management of chronic asthma requires long-term adherence to both pharmacotherapy and optimal self-management practices. The use of mobile applications (apps) offer a promising and co...

Soft skills are a collection of abilities instrumental to one being a successful professional. Soft skills are knowing why, what, when, and where to perform specific technical, hard skills. Traditionally, universities and other professional training providers have focused on teaching hard skills, relying on graduates to learn necessary soft skills on the job or through personal experiences. With more professional training requiring tertiary education and less work experience, a skills gap has developed between labour markets and professional training providers. A scoping review was conducted to answer two research questions: How are soft skills conceptualised and taught to health and education professionals? How are soft skills assessed for health and education professionals? The PAGER framework was utilised to present and synthesise the scoping review results. Eight themes emerged from the patterning analysis and data synthesis: Lack of definitions of soft skills; What soft skills are taught; Methods of teaching soft skills; Curriculum: Embedded vs. stand-alone courses; Use of digital tools; Assessment of soft skills; Variation of assessment tools; Limited regard for cultural competency, diversity, equality, and inclusion. These themes are discussed in relation to advances, gaps, evidence for practice, and research recommendations.

Objective To evaluate a home-based behavioral treatment model for children with tube dependency. Methods Nine children (aged 4-14 years) dependent on nasogastric and gastrostomy tubes were consecutively admitted into a home-based behavioral treatment program. A psychologist specializing in applied behavior analysis led the assessment and treatment phases with the support of caregivers and a multidisciplinary team. Caregivers participated in a caregiver training program and continued the intervention once the service was discontinued. We conducted follow-up visits up to 12 months after treatment. The program was evaluated with a multiple-baseline across participants design. We computed on-treatment and intention-to-treat effects according to the Hedges-Pustejovsky-Shadish model. We monitored behavioral (food acceptance and swallowing) and nutritional outcomes (body weight, oral intake, and tube intake), treatment acceptability and satisfaction, caregiver stress, and estimated treatment cost savings. Results Food acceptance, swallowing, oral intake, and tube intake demonstrated large treatment gains relative to pretreatment levels (effect size range of the intention-to-treat analysis = 0.74-2.1). All participants maintained or increased their body weight. Follow-up effect sizes indicated further improvements. By the final follow-up assessment, six out of the nine children had ceased tube feeding, and one had tube feeds reduced. Caregivers and health professionals provided strong ratings of treatment satisfaction. The cost-savings analysis suggested that a home-based treatment may be a cost-effective alternative to prolonged tube feeding as well as to other treatment approaches. Conclusions This study provides evidence supporting home-based multicomponent behavioral interventions in the treatment of pediatric feeding disorders. Clinical trial identifier ACTRN12614001127695, https://goo.gl/XSQ4ZH.

Often it is assumed that electronic recording by observers necessarily provides better quality data than pen-and-paper methods. Fifteen novice observers recorded rates of responding from 10 role-played video samples using one of three continuous recording input formats: keyboard (laptop), touchscreen (personal digital assistants), or pen-and-paper. We evaluated the quality of the observers' data compared with criterion records using calibration and interobserver agreement algorithms. Results of the calibration analysis revealed that observers in the touchscreen group produced the most consistently accurate and precise data, the keyboard group observers showed wide variation in precision and accuracy, and the pen-and-paper group observers were significantly less precise than the touchscreen group. We conclude that although electronic recording has the potential to be as accurate as, and more precise than, pen-and-paper methods, this is far from guaranteed. Analyses of observers' errors advise recommendations for improving data accuracy and precision when using each method. Copyright © 2014 John Wiley & Sons, Ltd.

This chapter provides an overview of the treatment and education of autistic-related communication-handicapped children (TEACCH). We provide a summary of the historical development of the program, its underlying philosophy, and the defining features of structured teaching. We provide a commentary on the eclectic nature of some of the program’s components. Subsequently, we summarize the evidence supporting the program according to the treatment outcome studies available. The literature suggests that TEACCH has a marginal or small impact on cognitive and verbal performance, developmental status, communication, motor, daily living, and social adaptive skills. The effects on maladaptive behavior are of larger magnitude but require further replication. We close the chapter by comparing the TEACCH program with other comprehensive educational programs for people with autism. The outcome research currently available suggests that, while TEACCH may be as acceptable to consumers as other competing models, it does not compare favorably to alternative models including early intensive behavioral intervention.

The effectiveness of four antecedent treatments for rumination was compared for two individuals with autism, severe intellectual disabilities and long histories (at least 20 years) of rumination. Comparisons of increased meal size, supplemental feedings, fixed-time provision of peanut butter, and liquid rescheduling found liquid rescheduling to be the most effective intervention for both clients. However, within-session analyses, both during intervention and for 30 min after the meal, showed individualized schedules of fluid provision were needed to increase the effectiveness of the treatment.

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

Obtaining paid employment is beneficial for youth during and following treatment for substance abuse. A training program for acquiring employment was implemented at a residential drug and alcohol rehabilitation facility for nine residents who were near to completing the program. Data are presented from three residents with the most complete data sets. Skills training was provided for completing biographic information on job application forms, job searching by telephone and in person, and job interviews. The training process included behavioral procedures of providing instructions, modeling, role-play, and feedback. Improvements were demonstrated across all behaviors and participants after the training and generalized to real community materials and settings. All participants who remained in treatment also gained real work experience opportunities or regular paid employment. Copyright © 2011 John Wiley & Sons, Ltd.

Functional assessments identified that the grabbing behavior of a 24-year-old man with intellectual disability was maintained by social positive reinforcement, that is, attention. Aggression was more likely to occur when his social environment changed from high to low attention. An intervention that combined extinction with activity choice and noncontingent reinforcement was most effective at reducing grabbing. The intervention and beneficial effects were maintained over 17 months, although staff retraining was required at 6 and 16 months. Retraining was implemented successfully when aggression increased and procedural integrity had declined. Copyright © 2011 John Wiley & Sons, Ltd.

Functional analysis is the most effective assessment for identifying the maintaining contingencies of aberrant behavior. However, it is suggested that functional analyses are not conducted regularly due to the level of skill required. A multiple baseline design across participants was used to assess if four residential caregivers, with limited experience with applied behavior analysis, could be trained to implement the standard analog functional analysis conditions. The training consisted of a lecture, written information, modeling, rehearsal, and feedback. Results showed that all participants attained percentage correct responding scores above 95% on three consecutive trials following training. One caregiver showed positive generalization of skills to the assessment of another behavioral topography. The result of this study provides further evidence that lay individuals can be trained to assist in conducting functional analyses. Copyright © 2008 John Wiley & Sons, Ltd.

We start with a review of the history and methods of determining evidence for practice in medicine as the evidence-based practice movement started in that discipline, and has led the way for other human services. Psychologists, especially those working for children and young people, tend to work collaboratively with other professionals. We sample those professionals' views on evidence-based practice. The generalizability to psychology of methods for evidence-based decision making in medicine is questioned. Next we examine criteria for determining the strength of evidence for interventions in clinical applications of psychology. These criteria are notably different to those employed in medicine, particularly concerning the relative value to the evidence base of research in psychology that has employed methods distinct from medicine (e.g., small-N experimental design research). The controversies concerning treatment guidelines derived from empirically supported treatments are outlined briefly. The extent to which special considerations exist regarding treatment selection for children and adolescents is then discussed. Finally, we highlight some of the aspects of evidence-based practice in psychology that require further work by researchers and clinicians. Keywords: applied behavior analysis; children; clinical psychology; evidence-based practice; small-N designs

It is often reported that children with ASD do not readily generalize and maintain skills. As such it is of particular importance that practitioners specifically address these issues when developing interventions. This chapter will review and discuss generalization and maintenance within the current ABA research.

Publisher Summary Any behavior performed to excess in frequency or intensity, and beyond the immediate resources available for effective treatment, can be called challenging behavior. The most frequently cited examples of challenging behaviors are aggressive, self-injurious, antisocial, offensive, disruptive, and destructive behaviors. Challenging behavior has a range of negative effects for the individual performing the behaviors and for those around them. Physical injuries, increased risk of isolation, neglect, and abuse from others are some of the consequences for the individual. Challenging behavior not only interferes with adaptive behavior instruction for the person and others around them, but it also decreases the range of options in living, educational, and working environments. This chapter samples the recent research literature regarding challenging behaviors in which the participants were identified by the researchers as being diagnosed with an ASD, i.e., autism, pervasive developmental disorders (PDD), or PDD-NOS (Not Otherwise Specified). Recent research using a variety of methods shows that people with ASDs are more vulnerable than others with similar levels of intellectual disability to developing challenging behaviors. People with ASD and more severe deficits in communication skills are more likely than others to develop self-injurious behavior. Also, challenging behaviors most often associated with ASDs did not change significantly over 12 years from ages 9 to 21 years.