Current and preferred services of specialized professionals in childcare settings in Quebec, Canada: A descriptive survey of childcare administrators' perspectives.

BACKGROUND: Many challenges exist in promoting inclusion in childcare settings. Adequate support from specialized professionals is necessary to create inclusive childcare settings. Understanding which services are being delivered by specialized professionals in childcare contexts is an important first step. The aim of this study was to (1) describe the services currently being delivered by specialized professionals in childcare settings in Quebec (Canada) and (2) seek childcare administrators' perspectives on their preferred services. METHODS: An online province-wide descriptive survey was conducted with childcare administrators (n = 344). Questions focused on 11 service delivery dimensions (e.g. professionals involved, children served). Descriptive statistics were calculated. RESULTS: Childcare settings received services from a median of two specialized professionals (IQR [1-4]). Most services were delivered by early childhood special educators (61.3%), speech-language pathologists (57.6%), psycho-educators (43.6%) and occupational therapists (43.3%). Childcare administrators identified these four services as being particularly supportive. Professionals delivered a median of 0.4 h of service per week in each childcare setting (IQR [0.1-3.0]). A high percentage (91.2%) of administrators reported unmet needs for professional support in at least one developmental domain, with a high percentage (57.3%) of administrators identifying needs in the socio-emotional domain. Most (63.3%) expressed a desire to prioritize services for children without an established diagnosis but identified by early childhood educators as having needs for professional support. Most administrators (71.4%) also preferred in-context services. CONCLUSIONS: Childcare administrators perceive an important role for specialized professionals in supporting inclusion in their settings. Recommendations emerging are based on the four main professional service needs identified: (1) increasing the intensity and stability of services; (2) providing services for undiagnosed children identified by early childhood educators as having unmet needs; (3) ensuring that services encompassing all developmental domains with a focus on the socio-emotional domain; and (4) prioritizing of in-context services.

Information and Communication Technology in Schools: Its Contribution to Equitable Speech-Language Therapy Services in an Underserved Small Island Developing State.

Purpose Access to speech-language therapy services for children with communication difficulties is limited in vulnerable countries within the Majority world, such as Small Island Developing States. The use of information and communication technology (ICT) has been identified as a possible solution to provide equitable access to services in Minority world countries. This study explored ICT-related conditions in remote schools of the Maldives, a Small Island Developing State, in order to identify potential service delivery approaches. Method A mixed methods approach was used, involving (a) an online survey of 107 teachers, (b) observational data from four schools, (c) interviews with 31 teachers and the four principals of participating schools, and (d) 13 relevant online documents. Content analysis was used to analyze and integrate data from all sources. Results Teachers' access to ICT devices and fixed broadband Internet varied across schools. The government had limited funds to provide adequate fixed broadband Internet for them. However, favorable prospects were also discovered, including high access to 4G mobile broadband Internet in islands, high levels of confidence among teachers to use ICT, a variety of ICT uses currently employed by teachers, and the presence of financial aid for students with special education needs. Conclusions The findings of the study support the potential for using mobile broadband Internet, available ICT devices, and teachers as agents of service delivery in remote schools to enhance speech-language therapy service delivery in the Maldives. The creation of relevant digital educational content for teachers could further support children with communication difficulties in the country. Supplemental Material https://doi.org/10.23641/asha.14143910.

Speech-Language Pathologist Involvement in Multi-Tiered System of Supports Questionnaire: Advances in Interprofessional Practice.

Purpose This article describes the development and initial validation of the Speech-Language Pathologist (SLP) Involvement in Multi-Tiered System of Supports (MTSS) Questionnaire. It was developed to measure the extent to which SLPs are involved in MTSS at their school site(s). Method A total of 567 SLPs practicing in the United States responded to up to 39 Likert-type items meant to reflect six domains: scope of practice, professional development, leadership, consulting/collaborating, assessment and analysis, and intervention. Measurement quality was evaluated in terms of score reliability and validity. An exploratory factor analysis was conducted to evaluate the internal structure of the questionnaire responses. A three-factor model with the following dimensions of Carrying out Roles and Responsibilities, Leading, and Planning and Providing Interventions was supported. Loadings for retained factors ranged from .35 to .87. Internal consistency estimates ranged from .87 to .92. Descriptive statistics summarized the overall involvement of SLPs in MTSS, and responses to questions to assess the feasibility and acceptability of this questionnaire were analyzed. Results Questionnaire responses indicated that SLPs infrequently engage in MTSS activities. The item with the highest mean was related to SLPs collaborating with teachers to help them address students' speech and language disorders in their classrooms. Most of the SLPs who took the questionnaire found it easy to complete, but only some found the information to be useful. Conclusions The infrequent involvement of SLPs in MTSS indicates a need to disseminate information on the potentially valuable roles SLPs can play in MTSS implementation. This tool may be used by SLPs to better understand contributions they can make within an MTSS framework and self-reflect on their current levels of involvement. Supplemental Material https://doi.org/10.23641/asha.13874516.

Improving Facilitation of Student Communication Through Observational Feedback Within a Partner Instruction Model.

Purpose The purpose of this study was to further evaluate an eight-step partner instructional model developed by Kent-Walsh and McNaughton that has been demonstrated to improve implementation quality and fidelity among adults in clinical and educational settings who support the use of augmentative and alternative communication (AAC) for individuals with complex communication needs. Method This study examined the effectiveness of the eight-step model in a K-12 special education setting. Participants included 26 staff and 19 students. Effects on both communication partner modeling and student AAC system use were assessed. The study expanded upon prior research by employing a group design, including largely adolescent participants, and utilizing multiple AAC hardware and software types. Results Staff receiving training and coaching via the full eight-step model demonstrated gains in the percentage of utterances modeled, and their student partners increased mean length of utterance. The study failed to find statistically significant differences between the experimental group and a comparison group receiving only Stages 1-5 of the model. Conclusion Findings provide additional evidence for the viability of the eight-step instructional model as a methodology to promote the communication skills of students who utilize AAC, and also point to the advanced practice and feedback element of the model as a potential mediator of intervention outcomes.

A Questionnaire Survey About Support Requests From School-Age Children and Adolescents Who Stutter.

Purpose Children who stutter (CWS) face communication difficulties in school activities and at home. Although the importance of receiving support from their surroundings has been documented, few studies have investigated potential requests of CWS from their surroundings. This study aimed to elucidate such requests. Method A total of 43 school-age children and 25 adolescents who stutter completed a free-description questionnaire, including questions such as "what you want your classmates/your classroom teacher/your family to do about your stuttering?" Their descriptions were summarized and categorized based on similarity. Results The results indicate that 90.6% of the participants had more than one request for their classmates, classroom teacher, or family. A total of 197 items were extracted and categorized into seven themes. In particular, the responses included "listen attentively," "treat us naturally," and "make arrangements." While participants tended to hope for classmates or family to "listen attentively" and "treat us naturally," the request to "make arrangements" was higher for their teacher. Their potential requests varied by age: While school-age CWS wanted people around them to "listen carefully," the hope of adolescents who stutter was "treat us naturally." Conclusions The various potential requests of CWS were categorized, and the responses shed light on the importance of increasing knowledge of stuttering. The difference between the requests could reflect psychosocial differences between school-age children and adolescents who stutter. In addition, social interaction among peers is more developed in adolescents, and they could harbor fear of being excluded within their community.

School reopening during COVID-19 pandemic: Considering students with disabilities.

Over 80% of the children in the world have had their education impacted by COVID-19. For children with disabilities who receive special education services, access to in-person education and other resources at school is particularly important. The American Academy of Pediatrics advocates for students to attend school in person, without specifics for how children with disabilities can safely return to school. To appropriately plan and accommodate children with disabilities we must prioritize safety, allow for adherence to the Individuals with Disabilities Education Act, and preserve essential school staff. The less cumbersome default of confining students with disabilities to home is not acceptable. We provide an outline describing why Individual Education Plans and 504 plans are important, how they are related to the COVID-19 pandemic, and recommendations for measures to help with safe return to school for children with disabilities.

A Snapshot of RTI Implementation a Decade Later: New Picture, Same Story.

Response to intervention (RTI) has evolved from its first decade of implementation. Because states guide and regulate policy and practice at the state and local education agency levels, it is important to understand their critical role in RTI implementation. A systematic review of all 50 state education agency websites was conducted to provide an updated "snapshot" of states' interpretation of RTI a decade after IDEA regulations were finalized. Findings revealed substantive progress towards developing approaches to systematic supports to students, with a major trend in adoption of multi-tiered system of support (MTSS) models. Findings also documented continued variation in how states are communicating about tiered systems on such matters as the roles of tiered systems in schoolwide prevention frameworks, meeting special education requirements, and aligning multiple systems within schools. Implications for special education services for students with learning disabilities are discussed.

Autism and Education.

Determining the most effective strategies to educate children and youth with autism spectrum disorder (ASD) can be daunting. Dr Stephen Shore, an autism advocate who is on the spectrum, said, "If you've met one person with autism, you've met one person with autism." Individuals diagnosed with ASD present with unique strengths and difficulties and experience characteristics of their disability in different ways. General and special educators must be prepared with a variety of evidence-based practices and instructional strategies to engage and educate students diagnosed with autism. This article discusses current methods, techniques, evidence, and controversies for educating individuals diagnosed with autism.

School-Clinic Care Coordination for Youth with ASD: A National Survey of School Psychologists.

Many youth with autism spectrum disorder (ASD) may benefit from interdisciplinary care coordination. Communication and collaboration between the school and clinic settings is particularly important when youth with ASD are receiving both special education and clinic-based services. The responsibility of initiating coordinated care has historically been with the medical home (e.g., primary care clinicians), however, educational professionals (e.g., school psychologists) are also well positioned to assume a leadership role in care coordination. Little is known about the current state, feasibility, or effectiveness of school psychologists leading care coordination efforts. The current study utilizes a mixed-method approach to understand school psychologists' engagement in interdisciplinary collaboration across settings, a central tenet to coordinated care, in providing services to youth with ASD.

The Effects of Enrolling in Oversubscribed Prekindergarten Programs Through Third Grade.

This study leverages naturally occurring lotteries for oversubscribed Boston Public Schools prekindergarten program sites between 2007 and 2011, for 3,182 children (M = 4.5 years old) to estimate the impacts of winning a first choice lottery and enrolling in Boston prekindergarten versus losing a first choice lottery and not enrolling on children's enrollment and persistence in district schools, grade retention, special education placement, and third-grade test scores. There are large effects on enrollment and persistence, but no effects on other examined outcomes for this subsample. Importantly, children who competed for oversubscribed seats were not representative of all appliers and almost all control-group children attended center-based preschool. Findings contribute to the larger evidence base and raise important considerations for future prekindergarten lottery-based studies.

A Description of Parent Input in IEP Development Through Analysis IEP Documents.

Parent input in individualized education program (IEP) development is the clear expectation in U.S. education law. Every IEP team must include parents, and their input must be equally considered when developing IEPs. The present study used content analysis of 88 IEPs of students with intellectual and developmental disabilities to explore team membership, concerns parents raised during IEP meetings, and evidence that parent concerns and priorities are reflected in IEP goals and supplementary aids and services. Findings reveal that although parents express a range of concerns and priorities, these are translated into goals or services only two thirds of the time. We provide implications of these findings for research and practice.

A National Survey of Speech-Language Pathologists' Engagement in Interprofessional Collaborative Practice in Schools: Identifying Predictive Factors and Barriers to Implementation.

Purpose This study examined the models of collaboration used by school-based speech-language pathologists (SLPs) during the provision of special education services including factors predicting use of the interprofessional collaborative practice (IPP) model and barriers to collaboration. Method School-based SLPs responded to a survey on models of collaboration within their work setting. Anchored vignettes were created to determine their engagement in 3 different models (i.e., multidisciplinary, interdisciplinary, and interprofessional) used in the provision of special education services during evaluation and intervention. Predictive factors supporting and/or hindering the use of IPP were identified. Results Results demonstrated low percentages of school-based SLPs engaging in IPP during initial evaluations (8%), eligibility meetings (43%), and intervention sessions (14%). Three factors predicted use of IPP in schools: prior training in collaboration, years of experience, and educational setting. The most frequently cited barriers to SLPs' engagement in collaboration included time constraints/scheduling (48%), resistance from other professionals (23%), and lack of support from employers/administration (11%). Conclusions The results of the current study indicated that systemic change is needed at both the university and public school levels. At the university level, preprofessional students need collaborative learning opportunities that are integrated across programs and colleges. School-based SLPs and other education professionals could benefit from job-embedded learning focused on IPP to increase their knowledge and engagement in IPP and improve student outcomes. Supplemental Material https://doi.org/10.23641/asha.9340760.

Implementation and Perceptions of Classroom-Based Service Delivery: A Survey of Public School Clinicians.

Purpose The choice of service delivery model is important for public school clinicians. Despite a theoretical emphasis on inclusive classroom-based services, data from a recent American Speech-Language-Hearing Association Schools Survey indicated that the pullout model is still the more frequently used approach (American Speech-Language-Hearing Association, 2016). In the current study, public school clinicians' use and perceptions of inclusion were examined to better understand potential influences on its implementation. Method Three hundred forty-four school-based clinicians completed an online survey about their training in and implementation of inclusion services, along with their perceptions of positive and potentially challenging aspects of this model. Descriptive data were examined, and the relationships of use and perceptions to issues such as caseload size, training, school setting, teacher factors, and administrative support were analyzed. Additionally, qualitative analysis was used to examine responses to 3 open-ended questions. Results Over half of the respondents served 1%-25% of their caseload through an inclusion model, and it was most frequently utilized to address language and social skills. Teacher collaboration and planning time were the 2 most frequently reported keys to inclusion success and were also 2 of the most frequently reported challenges to implementation. Conclusions The majority of the respondents reported many positive aspects of inclusion, yet they also reported many of the same challenging perceptions and roadblocks that existed when speech-language pathologists were surveyed over 20 years ago. Based on the results of this study, training in the inclusion model, teacher "buy-in," planning time, and administrative support are relevant to successful use of classroom-based intervention.

Promoting a Collective Voice from Parents, Educators and Allied Health Professionals on the Educational Needs of Students on the Autism Spectrum.

Providing support for the educational needs of students on the autism spectrum continues to be challenging. Findings from this survey of parents, teachers and specialist staff highlight the need for collaboration between stakeholders who support the education of these students. The main themes to emerge were for school staff to be equipped with the knowledge and expertise to support each student in their learning, and for support with social/emotional needs. Findings highlighted the need for a transparent process for building school capacity to translate research and knowledge into practice by all stakeholders. This collective voice is important to ensure the needs of these students are identified and that appropriate support is implemented to maximise the educational success of these students.

Bridging gaps in care for children with acquired brain injury: Perceptions of medical and educational service providers.

PURPOSE: Significant gaps in service delivery for children with acquired brain injury exist between healthcare and educational systems, such as the lack of coordinated efforts to transfer rehabilitation strategies to school settings. This paper attempts to address these issues and offer recommendations to bridge these gaps in care. METHODS: The American Congress of Rehabilitation Medicine (ACRM), Brain Injury-Interdisciplinary Special Interest Group (BI-ISIG), Pediatric-Adolescent Task Force constructed and disseminated a survey to medical rehabilitation (N= 44) and education professionals (N= 40). Responses were analyzed quantitatively and qualitatively, achieving > 85% inter-coder reliability. RESULTS: Results highlighted differences between groups in methods for seeking new information, opinions on advocacy needs, and differing priorities given to various resources. CONCLUSIONS: These discrepancies have important implications for improved collaboration needed for assuring an appropriate continuum of service for this population. Recommendations include: 1) providing education and training regarding brain injury in the most cost-effective ways utilizing technology that crosses the barriers identified and reaches people in multiple settings; 2) direct and active communication between medical and educational professionals; and 3) developing an interdisciplinary Community of Practice to help bridge medical rehabilitation and school systems.

Education Policy for Migrant Children in Thailand and How It Really Happens; A Case Study of Ranong Province, Thailand.

Health and education are interrelated, and it is for this reason that we studied the education of migrant children. The Thai Government has ratified 'rights' to education for all children in Thailand since 2005. However, there are gaps in knowledge concerning the implementation of education policy for migrants, such as whether and to what extent migrant children receive education services according to policy intentions. The objective of this study is to explore the implementation of education policy for migrants and the factors that determine education choices among them. A cross-sectional qualitative design was applied. The main data collection technique was in-depth interviews with 34 key informants. Thematic analysis with an intersectionality approach was used. Ranong province was selected as the main study site. Results found that Migrant Learning Centers (MLCs) were the preferable choice for most migrant children instead of Thai Public Schools (TPSs), even though MLCs were not recognized as formal education sites. The main reason for choosing MLCs was because MLCs provided a more culturally sensitive service. Teaching in MLCs was done in Myanmar's language and the MLCs offer a better chance to pursue higher education in Myanmar if migrants migrate back to their homeland. However, MLCs still face budget and human resources inadequacies. School health promotion was underserviced in MLCs compared to TPSs. Dental service was underserviced in most MLCs and TPSs. Implicit discrimination against migrant children was noted. The Thai Government should view MLCs as allies in expanding education coverage to all children in the Thai territory. A participatory public policy process that engages all stakeholders, including education officials, health care providers, Non-Governmental Organizations (NGOs), MLCs' representatives, and migrants themselves is needed to improve the education standards of MLCs, keeping their culturally-sensitive strengths.

Childhood Disability and Educational Outcomes: A Systematic Review.

PROBLEM: Graduation from high school is an important milestone for all adolescents and affects future health in adulthood. Children with chronic illnesses have additional challenges that affect school attendance, grade retention and graduation. If children with chronic conditions are not able to participate fully in education, this may limit their opportunities for future health. The aim of this study was to integrate the evidence in the past 28 years about educational outcomes of children and adolescents with chronic conditions causing disability. ELIGIBILITY CRITERIA: Quantitative studies reporting on a chronic condition and attendance, grade retention, or high school graduation, from a peer-reviewed journal in the English language, data collection since 1990, and research conducted with a population in the United States were eligible for review. SAMPLE: Forty-three studies from a literature search of CINAHL, MEDLINE, ERIC, Teacher Reference Center, Psychology & Behavioral Science Collection, and Academic Search Elite databases, followed by ancestry searches, were included in this review. RESULTS: In general, chronic conditions are significantly associated with increased absenteeism, grade repetition and not completing high school within four years, although hemophilia does not follow this pattern. Additionally, increased severity of the condition is associated with poorer educational outcomes. CONCLUSIONS: Nurses and other healthcare providers should include an educational assessment as part of psychosocial assessment of children and adolescents to identify risk, intervene early and limit risk.

Evaluating the quality of outcomes defined for children with Education Health and Care plans in England: A local picture with global implications.

Recently, the Children and Families Act 2014 was introduced in England to regulate provision for children with disabilities. According to this policy, statements of special educational needs were replaced with education, health and care plans, which should include high-quality, holistic and participation-focused outcomes to regulate provision; this change aligns with international recommendations regarding provision for children with disabilities. This study aimed to evaluate the outcomes defined for children with education, health and care plans in England. 236 Education Health and Care plans were included in the analysis, providing 2813 outcomes to be examined, which came from 11 local authorities and 42 schools and belong to 69 girls and 167 boys from 4 to 21 years of age. The outcomes were independently rated by two experienced researchers using a Goal Functionality Scale. Inter-rater agreement was calculated for 10% of the outcomes. Most outcomes were considered not to be functional or high-quality; differences in quality were found between local authorities, types of school, type of outcome, and the children's main need. There are important quality concerns regarding the outcomes that have been designed for children with disabilities in England, which should be addressed through standardised training and guidelines on procedures.

Class Time Physical Activity Programs for Primary School Aged Children at Specialist Schools: A Systematic Mapping Review.

Children with disabilities tend to be less active than typically developing peers and may therefore miss important developmental benefits. Class time physical activity (PA) programs can provide additional PA to children and have shown to contribute to numerous benefits in mainstream classrooms. However, it is unclear whether class time PA opportunities are provided in specialist education settings. This review aimed to identify and map class time PA programs that have been implemented in specialist schools and classes. Nine electronic databases were searched. Grey literature searches were also conducted. Programs were included if they were implemented in a primary/elementary specialist school or class, involved a PA component, were conducted during class time and involved more than one child from the class participating. Included programs were mapped and narratively synthesised according to activity type. Of the 2068 records screened, 34 programs were included. Programs involving dance/drama activities (k = 11) were most common and programs involving stretching activities (k = 2) were least frequently implemented. Twenty-three programs had been evaluated, of which only two were randomised controlled trials. More class time PA opportunities are warranted in specialist education settings. Further research is required to build the evidence base for these programs.