Arranging skill acquisition programs for individuals who engage in challenging behavior presents unique clinical and ethical challenges. These learners often require instructional procedures that are highly individualized and sensitive to the variables that evoke challenging behavior. While previous research indicates that the success of prompting procedures varies across learners, few studies have systematically compared the efficiency of various prompts to teach new skills to individuals who engage in severe challenging behavior. The current study compared the efficiency of three response-prompt hierarchies (gesture, model, and partial physical) to a no-prompt control condition to teach auditory-visual conditional discrimination skills to children and adolescents enrolled in specialized severe behavior clinical programs. A concurrent-chains procedure was then conducted to evaluate the participants’ preferences for the prompt hierarchies. Results demonstrate that the efficiency of and preference for different prompt hierarchies varies across learners. The findings highlight the importance of balancing efficiency and preference when selecting prompting procedures, emphasizing the need for individualized, responsive programming in intensive treatment settings.
Genetic testing is recommended for children with neurodevelopmental disorders (NDDs), yet referral and testing rates remain lower than expected. Provider attitudes and confidence are likely key determinants of whether eligible patients access genetic services. We conducted a cross-sectional survey of physicians and advanced practice providers in Developmental and Behavioral Pediatrics, Neurology, and Psychiatry at a large academic pediatric medical center. An 18-item survey, distributed electronically, assessed provider knowledge, attitudes, and experiences related to genetic testing and referral for patients with NDDs. Responses were rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) and analyzed using descriptive statistics, Kruskal–Wallis tests, and Mann–Whitney U tests (significance set at p < 0.05, with Bonferroni-adjusted results also reported), with ordinal logistic regression as a sensitivity analysis adjusting for provider type. Thirty-one providers completed the survey (12 Developmental and Behavioral Pediatrics, 11 Psychiatry, 8 Neurology); response rate 20
This study evaluated the feasibility of a 12-week, caregiver-mediated PECS intervention, PECSperts Caregiver Training Package, when implemented by community clinicians across community settings, using Bowen et al.’s feasibility framework. A prospective mixed-methods pre-, post-, maintenance, and follow-up feasibility study was conducted with 13 facilitators and 15 caregiver-child dyads. Feasibility was examined across Bowen’s domains of acceptability, demand, implementation, practicality, adaptation, expansion, integration, and preliminary efficacy. Quantitative measures included attendance, attrition, facilitator and caregiver treatment integrity, caregiver self-efficacy, social validity, and child PECS accuracy. Qualitative data from facilitator feedback and a key informant interview were analyzed using rapid qualitative analysis. Findings supported the feasibility of the intervention. Caregivers and facilitators reported high acceptability, and caregivers who completed the program attended all intervention sessions. Facilitators implemented the program with high treatment integrity. Hybrid delivery was associated with higher caregiver satisfaction than fully virtual delivery. Preliminary efficacy findings indicated significant improvements in child PECS accuracy and caregiver treatment integrity across timepoints, with gains remaining above pre-intervention levels at follow-up. The PECSperts Caregiver Training Package appears feasible, acceptable, and promising for community-based implementation. Findings support further evaluation with larger, more diverse samples and more rigorous experimental designs to assess effectiveness, generalization, and long-term sustainability.
Beliefs about the causes of autism and attitudes toward autistic individuals remain understudied in Sub-Saharan African contexts but have important implications for health and quality of life. This study examined causal beliefs about autism and attitudes toward autistic individuals among 188 parents and teachers in Uasin Gishu County, Kenya using a cross-sectional survey design. Results reflect a layered explanatory model in which respondents accept scientifically based causes of autism while also attributing autism to upstream social or environmental factors. Respondents who reported prior training in autism were more likely to reject non-scientific causes and to endorse evidence-based etiology, though the relationship between training and endorsement of scientific causes was modest. Causal beliefs were significantly associated with attitudes toward autistic children, specifically with endorsement of scientific causes associated with more positive attitudes towards autistic individuals and endorsement of non-scientific causes associated with more negative attitudes. These findings highlight the need for culturally responsive awareness programming and targeted educational initiatives to address autism misconceptions and promote positive attitudes toward autistic individuals in Kenya and similar low- and middle-income country contexts.
In the German school system, recess in schoolyards constitutes a central space for informal learning and social interaction among children and adolescents. Yet, empirical insights into their usage and accessibility particularly for children and adolescents with disabilities remain scarce. This study addresses the research question: “How do children and adolescents who use wheelchairs experience and interpret their recess in the schoolyard?” Nine students (4 female, 5 male; aged 8–15 years, M = 11.0 years; 4 powered wheelchairs, 5 manual wheelchairs) from special needs schools for physical and motor development in Hamburg, Germany, participated in guided interviews conducted on-site. Data analysis employed a pragmatic application of Grounded Theory Methodology strategies and coding procedures. The identified categories and areas of tension include – with a focus on the activities of the target group in question: (a) Finally chatting, letting off steam, resting, and playing extensively; and with a focus on the physical and spatial conditions and their accessibility: (b) Between no-go areas and favorite places; (c) Consciously limited vs. above all doubts; (d) With a careful eye on their schoolmates; and (e) Realistic ideas for improvement vs. fantasies. The research contribution expands existing research on inclusion in playgrounds, highlights activities and potential material and spatial barriers in schoolyards, and, taking into account the expertise of the respondents, generates knowledge on how to create greater accessibility.
