ADHD is one of the most prevalent neurodevelopmental disorders, and the numbers only continue to rise. Ontario has implemented play-based FDK in the last decade, thus it is imperative that the perceived effectiveness of the program for children with ADHD is studied. In conducting this study, the researchers present and interprets educators’ perceptions of the FDK program and the perceived effectiveness of FDK for children with ADHD. Using an Ecological Systems Theory lens, semi-structured interviews were conducted with kindergarten teachers and early childhood educators from multiple cities throughout Southwestern Ontario to obtain their perceptions of Play-Based FDK and ADHD. The data were analyzed using Thematic Analysis (TA) and three themes emerged: (1) Knowledge and Understanding, (2) Benefits and Challenges of Play-Based FDK for Children with ADHD, and (3) Strategies Used to Promote Success. These themes encompassed the general lived experiences and knowledge that educators have on the effectiveness of the FDK program for children with ADHD. Limitations of the study and future areas of research are discussed.

This study investigated whether a brief parent-mediated intervention would increase the frequency of question asking in children with ASD. Mothers participated in a 3-week training consisting of 2-h sessions twice weekly. Data were collected in the context of concurrent multiple baseline design. Results demonstrate all three children increased frequency of question asking with two children maintaining gains. All three children demonstrated generalization of question asking to novel items, family members, and/or settings. Affect improved for two of the three children. Overall, mothers were able to reach Fidelity of Implementation during most sessions and rated the intervention as highly acceptable. Results are discussed in regard to the feasibility of providing a short-term parent-implemented intervention to increase social initiations through question asking.

Despite the stated importance of a successful kindergarten transition (TTK) for future school success, no research has addressed this transition for culturally/ethnically diverse families having children with autism spectrum disorders (ASD). To address this gap, six focus groups (three with ethnically diverse parents, one with kindergarten teachers, and one each with early childhood resource teachers and early intervention providers) were conducted to elicit the experiences of these stakeholders regarding TTK for children with ASD generally, and the TTK experience for ethnically diverse families specifically. Four major themes relating to TTK emerged from the focus groups: Relationship Building, Communication, Knowledge, and Support. While these themes were relevant for all groups, parents who were relatively recent immigrants and for whom English was not a first language identified unique difficulties. Results are discussed within the context of Bronfenbrenner's Ecological Systems Theory. Recommendations to improve the experience for ethnically diverse families are explored.

Early and intensive intervention (EI) for children with autism spectrum disorder (ASD) is considered to be “best practice” to reduce the symptoms of autism and maximize the outcome for children’s functioning. Many studies have established the effectiveness of, particularly, early intensive behavioral intervention, and in some cases improvements have been impressive, with children moving off the autism spectrum. However, very few long-term follow-up studies have been conducted to determine if the progress seen as a result of EI has been maintained as children with ASD continue through school. Eight long-term follow-up studies published between 1993 and 2014 are reviewed. The researchers reported that although most children had made progress in many areas as measured by standardized assessments, children in some studies had regressed. Significant difficulties in autism symptomatology, behavior, and social skills remained at follow-up for many children across studies. It appears that ongoing, uninterrupted intervention after the conclusion of early intervention is necessary to ensure gains made in EI are maintained. However, because of numerous methodological issues in the studies, these conclusions cannot be definitive, and additional longitudinal research is called for.

ABSTRACT Using results of the US National Health Interview Survey (US-NHIS) for the years 1998–2013 we investigated the impact of having a child with autism spectrum disorder (ASD) on parents’ work behavior. After controlling for numerous background characteristics, we found that having a child with ASD lowered the number of hours of market work per week and the number of months of market work in the previous year for mothers. For fathers, having a child with ASD also reduced the number of hours of market work per week and the number of months of market work in the previous year. However, the magnitude of the effects were smaller for fathers than for mothers, and more sensitive depending on whether the estimates were derived from a linear regression model or propensity score models. Some evidence was also found that the impact of having a child with ASD on parents’ market work depended on whether or not the child with ASD also had an intellectual disability, the parent’s education level, immigration status, and parent race/ethnicity.

Parents of 144 children with autism spectrum disorders were surveyed regarding their perceptions of and satisfaction with the education their children were receiving. This article focuses on an analysis of the parents’ responses to the open-ended questions of this survey. Overall themes that emerged repeatedly across all questions concerned the ability of school personnel to effectively manage children’s behavior, teacher education and understanding of the disability, and effective communication and collaboration between parents and school. The implications for future research and practice emerging from these findings are discussed.

This study sought to determine the effects of using music and non-music interventions on the social responsive and avoidant behaviours of a preschool child with autism. A single-subject alternating treatment design was used in which two interventions were presented in a similar fashion except for the addition of music during the music condition. Four phases took place: baseline (Phase A), alternating treatments (Phase B), a second treatment phase (Phase C) using the condition that proved to be more effective in Phase B, and follow-up (Phase D). Data were collected over a total of 12 treatment sessions for various social responsive and avoidant behaviours. Results indicated that the music intervention was more effective than the non-music intervention in increasing all three social responsive behaviours in both Phases B and C. Furthermore, no avoidant behaviours were observed during the music condition. It is suggested that the music condition was more motivating for the participant than the non-music condition, resulting in more social responsive behaviours.

Manufacturing Novels:Charles Dickens on the Hearth in Coketown Elizabeth Starr In an unsigned 1855 Blackwood's Edinburgh Magazine essay celebrating the "great and well-deserved reputation" of Charles Dickens, Margaret Oliphant pauses to consider the famous author's latest offering. Compared to his otherwise organic, "full and many-toned conception of human life, its motives and its practices," Hard Times hits a metallic note: "The book is more palpably a made book than any of the many manufactured articles we have lately seen."1 Using the royal "we" of the weary critic who has become all too familiar with such products, Oliphant's statement evokes Thomas Carlyle's objections to an increasingly commercial literary marketplace in "Signs of the Times" (1829): "Literature, too, has its Paternoster-row mechanism, its Trade-dinners, its Editorial conclaves, and huge subterranean, puffing bellows; so that books are not only printed, but, in a great measure, written and sold, by machinery."2 Acting as a component of that literary machine, our reviewer shapes perceptions of "Charles Dickens" by setting his industrial novel apart from the rest of his work. Oliphant also perceptively hits on one of the novel's most provocative and abiding concerns as, in the midst of its efforts to protest the statistical abuses and inhumanity of industrial modernity, Hard Times explores the compatibility of literary work and manufacturing. In panning Hard Times, Oliphant was joining the critical chorus in response to a novel which excited many pronouncements. Attempting to define genres and fields of expertise in the mid-nineteenth century, reviewers repeatedly lament, as The Rambler does, that "It is a thousand pities that Mr. Dickens does not confine himself to amusing his readers, instead of wandering out of his depth in trying to instruct them."3 Oliphant's distaste for the clunky mechanics of Dickens's novel to some extent resides in her similar assertion that "fiction breaks down when it is bound within these certain limits, and compelled to prove and to substantiate a theory," one of many critical assessments that have become part of a familiar story about this novel's rocky reception and eventual reevaluation.4 [End Page 317] By introducing the language of manufacturing, however, Oliphant's review usefully foregrounds Hard Times's own apprehensions about purpose and the exercise of influence in a reading, working metropolis. Surprisingly, given her concerns, the critic does not have much to say about the character in Hard Times whose wedding wears "a manufacturing aspect";5 yet Oliphant's review can also, I will argue, help us make sense of Louisa Gradgrind Bounderby, the figure who embodies Hard Times's own worst fears and most deeply cherished hopes about urban readers and literary products. Hard Times's representation of the legitimate role of fiction in an urban setting challenges nineteenth-century critics like Oliphant who assume that the novel as a genre should be defined against industry. Efram Sicher says as much when he asserts that "Hard Times is a novel about writing a novel in a utilitarian urban society where the novel plays a diminishing role and may soon have no more right to existence than in Plato's Republic."6 Yet lest we read Dickens's work as a heroic attempt to revamp a literary institution, Oliphant's review reminds us that Hard Times was asserting the use-value of a genre that was still establishing its cultural credentials and could be accused of being already too immersed in commerce. Like Jennifer Ruth, I am suggesting that we should acknowledge Dickens's willingness to represent writing as continuous with industrial forms of labor, though in the case of Hard Times, the novel reflects Dickens's working through of the effects of literary labor rather than a representation of the work of writing itself.7 Robert Colby takes a similar approach as he argues that during the Victorian period, "the epoch of the novel's struggle for prestige," writers embraced "fiction with a purpose" as a way to establish the value of their work.8 As the critical response illustrates, however, rather than taking the novel's purpose and usefulness as a given, Hard Times immediately excited concerns about...

Parents of 209 children (162 mates and 46 females) with autism spectrum disorders, Down syndrome or learning disabilities ranging in age from 4 to 21 years were surveyed about their perceptions of the education of their children. Items on the survey were categorized into 7 areas: school personnel's knowledge about the disability, best practices, behavioural concerns, parent/school collaboration, education team, individual education plan, and miscellaneous other items. Group differences were observed on a number of items and in almost every case parents in the learning disabilities group rated the items significantly lower than one or more of the other groups. In addition, numerous items were paired such that parents were asked to rate if a certain educational "best practice" was being utilized with their child and if they felt their child required it. Examination of the paired items indicated many significant differences between what parents felt was being offered their child, and what their child needed to achieve their maximum potential across diagnostic groups. The implications of these and other results are discussed.

As an off-shoot of a study examining the reliability and validity of an adapted version of the Pre-Linguistic Autism Diagnostic Observation Schedule (A-PL-ADOS), 13 individuals with Down syndrome with IQs ranging between 24 and 48 were administered the Autism Diagnostic Interview-Revised (ADI-R) and the A-PL-ADOS, which are well-validated interview and observational diagnostic measures. Three out of 13 met lifetime criteria on the ADI-R, but none of these three showed behavior that met the criterion for autism on the A-PL-ADOS (although two nearly did so). However, two individuals did meet the A-PL-ADOS criterion and showed behavior that fell only just short of meeting lifetime criteria on the ADI-R. Altogether, 5 individuals with Down syndrome may be considered to show an autism spectrum disorder. Of the remaining 8, some showed a few autistic features, and some showed none. The findings raise both methodological and conceptual issues.

The Autism Diagnostic Observational Schedule (ADOS) is a semi-structured observational scale developed to assess social interaction, communication and play in individuals who are suspected to have autism. Since the ADOS is not suitable to be used with severely or profoundly mentally retarded adolescents and adults with very limited language skills, materials and some of the tasks of the PL-ADOS and the original ADOS (the former versions of the current ADOS) were adapted. Results indicated that almost all of the overall ratings showed good reliability and discriminative diagnostic validity. Furthermore, the combination of codings into an overall algorithm score on social/communicative behavior resulted in a sensitivity of .82 and a specificity of .85 when using a cut-off score of 15.

OBJECTIVE:Although gestational diabetes is among the most common diseases arising during pregnancy, glucose stix is the only screening test to date in Germany. Our goal was to evaluate the sensitivity of the glucose-stix for diabetes screening and the possible influence of other parameters. METHODS:1001 patients who underwent the 50 g glucose screening test between June 1, 1997 and January 5, 2000 as part of prenatal care were asked to participate. In accordance with the guidelines of the American Diabetes Association, patients with a screening test result >/= 140 mg/dl underwent a oral glucose tolerance test (Carpenter/Coustan criteria). A urine sample was collected prior to the test. The glucose content of the urine was semiquantitatively analyzed using a test strip (Multistix 10 SG Bayer), Munich, Germany). Blood pressure was measured in 349 consecutive cases according to the criteria of the National Institute of Health. RESULTS:The overall frequency of gestational diabetes was 4.1% (37/912). 8.2% of the women presented with glycosuria (82/1001, 36 before screening, 46 based on the pregnancy medical records booklet). 30/82 (37%) of these patients had a pathological screening test (P = 0.029). 7.1% (52/729) of the healthy patients and 10.8% (4/37) of the gestational diabetics had glycosuria at least once. Therefore, the sensitivity of glycosuria is 10.8%, the positive predictive value is 6.6%. The systolic blood pressure was 116+/- 12 mmHg and the diastolic blood pressure 72 +/- 9 mmHg. Three of 349 (0.9%) patients were documented with preexisting hypertension, 14/349 (4.0%) patients with "pregnancy induced hypertension". Patients with glycosuria were both significantly more advanced in gestational age (34.4 +/- 2.8 versus 33.7 +/- 2.9, P = 0.673) and had higher diastolic blood pressure (79 +/- 9 versus 71 +/- 9, P = 0.005). The 50 g glucose screening test results showed only a tendency to differ (131 +/- 23 versus 127 +/- 24, P = 0.073). A multivariate analysis of these factors showed a significant influence of the diastolic blood pressure (P = 0.016) and the 50 g glucose screening test (P = 0.032), whereas the gestational week had no influence (P = 0.673). CONCLUSIONS:Urine glucose dip stick analysis is not useful in the detection of gestational diabetes because of its low sensitivity and negative predictive value. Our study suggests that glycosuria is not only dependent on the blood glucose level, but highly influenced by diastolic blood pressure. The results clearly underscore the need for standardized, routine testing of every pregnant woman.

Objectives: Although glucose meters are well-established instruments for self-monitoring blood glucose levels, diagnostic and screening procedures should be performed using standard laboratory methods. In addition to standard laboratory methods, HemoCue(R) is authorized for screening and diagnostic purposes in Germany. The rapid development of other glucose meters makes it necessary to re-evaluate this recommendation. Our objective was to test the usefulness of glucose meters in screening pregnant patients for gestational diabetes.Methods: The 50-g glucose challenge test was administered to one hundred and ninety-three pregnant patients whose blood glucose levels were then simultaneously measured with five portable meters and the HemoCue(R). The results were compared to our standard method (Hexokinase). A cut-off of 7.8 mmol/L was used and sensitivity, specificity, accuracy, the Youden index, and the Kappa index were calculated. The tests were performed by well-trained personnel (C.D. and U.S.).Results: 1212 measurements were performed on 193 patients. All glucose meters showed a very good correlation (r > 0.90). None of the measurements showed an extreme deviation necessitating the error grid analysis. The GlucoTouch(R) (5.93% +/- 7.4) and the HemoCue(R) (-9.04% +/- 5.9) showed a mean deviation greater than 5%. None of the meters had a mean deviation greater than 10%. The accuracy fluctuated between 0.85 and 0.94. The Kappa index was between 66 to 85. In our clinical trial, the Accu-Chek(R) , Glucotoucho(R) OneTouch(R), and Precision(R) demonstrated greater accuracy and a higher Kappa index than the HemoCue(R).Conclusions: Our data showed good concordance in statistical and clinical parameters for most of the six glucose meters. The HemoCue(R), recommended as a standard method in several countries, did not show better concordance than most of the tested glucose meters. When used by well-trained personnel, the accuracy of the Accu-Chek(R), Glucotouch(R), One-Touch(R), and Precision(R) was acceptable for use in gestational diabetes screening. (C) 2003 The Canadian Society of Clinical Chemists. All rights reserved.

This study prospectively compared the 2-year outcome of children diagnosed with autism or Asperger syndrome at age 6–8 years in terms of symptoms from the Autism Diagnostic Interview. Significant differences were seen in the three-domain summary scores of social interaction, communication, and repetitive activities, with the Asperger syndrome group demonstrating fewer and/or less severe symptoms at both times. There was a trend for the trajectories to come together over time on the socialization and communication domains, but not the repetitive activities domain. Differences were not attributable to IQ. Analysis of individual items indicated that the autism group improved over time on seven items and showed increased symptom severity on three items. On the other hand, the Asperger syndrome group improved on only two items and showed increased symptom severity on six items. Results suggest that the two PDD subtypes represent similar developmental trajectories, although the Asperger syndrome group maintains its advantage. Educational and clinical implications of the results are discussed.

Written in an age that evaded mundane representations of both women's and literary work, Elizabeth Gaskell's social-problem novels express discomfort with commercial and competitive enterprises. By the end of Mary Barton, the novel's most public and commercial woman--the prostitute Esther--lies buried in an unmarked grave with the hapless John Barton; in the middle-class home of the Hales in North and South, work and payment for services rendered often go unmentioned. Yet Gaskell's fiction also embraces commerce and conflict. As factory workers confront their employers and would-be lovers argue and debate, Mary Barton (1848) and North and South (1855) place narrators, heroines, and authors firmly at the center of urban industry and social struggle. (1) Despite the novels' frequent maneuvers and omissions--and in some respects through them--Mary Barton and North and South insistently write fiction onto the industrial landscape. Most notably, by refusing to contain fiction-writing within the figure of the fallen woman or the (albeit unconventional) middle-class ingenue, Gaskell's novels demonstrate an effort to present authorship as a legitimate part of the often aggressive, contentious world of public streets and factories. Recognizing Gaskell's efforts to find a place for her fictional work in the midst of urban commerce and industry is one way in which contemporary readers can make sense of this writer's struggle to negotiate her public persona and her private integrity. As her novels embody fiction in the social world, they enable Gaskell to make sense of her own incorporation within a literary profession. The significance of reading Gaskell's social-problem novels in this light, then, is two-fold: while the novels suggest that fiction can materially intervene in the conflicts they represent, changing public life and commercial relations because they figure themselves as part of this world, they also require readers and critics to reconsider popular conceptions of a reassuringly domestic, self-effacing, and properly maternal Elizabeth Gaskell. As her correspondence attests, for Gaskell, authorship was both rewarding and discomfiting work. Relishing her first major literary accomplishment after the publication of Mary Barton, Gaskell issues an authorial missive to her publisher: I find every one here has most convincing proofs that the authorship of Mary Barton should be attributed to a Mrs Wheeler, nee Miss Stone, and authoress of some book called the `Cotton Lord'. I am only afraid lest you also should be convinced and transact that part of the which yet remains unaccomplished with her. I do assure you that I am the author, and so remain Yours very truly, E. C. Gaskell (2) In this letter, Gaskell enthusiastically engages in the business of literature. Teasing out the relationship between authorship and commerce, Gaskell assures John Chapman of her willingness to transact. Yet as Gaskell was emphatically aware, at the time she was putting her name into print, publicity was largely incommensurate with Victorian womanhood. Gaskell recoiled from the threat such publicity posed to her privacy and integrity as speculation over the initially anonymous Mary Barton increased: Hitherto the whole affair of publication has been one of extreme Annoyance to me, from the impertinent and unjustifiable curiosity of people, who have tried to force me either into an absolute denial, or an acknowledgment of what they must have seen the writer wished to keep concealed. (Elizabeth Gaskell to Edward Chapman, 5 December 1848, letter 33, 64) While these two excerpts can hardly do justice to the complex range of Gaskell's response to authorship as expressed in letters to friends, publishers, admirers and detractors, they distinctly illustrate the conflicted feelings that accompanied her ascension to public notice. …

We sought to determine if the family loading for either the broader autism phenotype or for cognitive impairment differed according to whether or not autism was accompanied by severe mental retardation. The sample comprised 47 probands with autism meeting ICD-10 criteria, as assessed by the Autism Diagnostic Interview and the Autism Diagnostic Observation Schedule. Family history interview and findings were compared with those for the higher IQ autism and Down syndrome samples in the Bolton et al. (1994) study. The familial loading for autism and for the broader phenotype was closely comparable to that in the study of higher IQ autism, and different from that for Down syndrome. The family loading for scholastic achievement difficulties was slightly, but significantly, higher when autism was accompanied by severe retardation.

Factors influencing the rate, form, and severity of phenotypic expression among relatives of autistic probands are examined. Family history data on 3095 first- and second-degree relatives and cousins from 149 families with a child with autism and 36 families with a child with Down syndrome are studied. The results provide further evidence of an increased risk among autism relatives for the broadly defined autism phenotype. Of proband characteristics, severity of autism and obstetric optimality were confirmed as being related to familial loading for probands with speech. There was little variation in loading among probands lacking speech. The type of phenotypic profile reported in relatives appeared little influenced by characteristics of the relative or the proband, except for variation by degree of relative, parental status of relative, and perhaps proband's birth optimality score. Phenotypic rates among parents suggested reduced fitness for the severest and more communication-related forms of expression but not for the more mild and social forms of expression. Patterns of expression within the families did not support a simple X-linked nor an imprinted X-linked mode of inheritance. The basis for sex differences in rates of expression is discussed.