Training respite care providers for families with handicapped children: Experimental analysis and validation of an instructional package

We conducted four experiments to evaluate a respite care training package. In Experiment 1, we assessed the effectiveness of an instructional manual on the acquisition of respite care skills and compared the relative effects of three different manual on the acquisition of respite care skills and compared the relative effects of three different manual presentation formats. Results showed that performance during simulated (role-played) respite care situations improved substantially for all six trainees following presentation of the instructional manual (with no significant differences between presentation formats) although some remedial training was necessary to achieve mastery criterion. In Experiment 2, we evaluated the effects of the manual presented as a whole with a larger group of trainees and compared it to a workshop training approach. Results showed that both the instructional manual and workshop training approaches were effective, but that the former appeared to be more cost-effective. In both experiments, correct responding generalized to a respite care situation with a multiply handicapped child. In addition, several measures of social validity were obtained. In Experiment 3, we evaluated a simplified training and assessment package that could be conducted using the resources typically available to respite care agencies, and in Experiment 4, we demonstrated that respite care agency personnel could successfully implement this program.     

COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.     

Avoir recours à du répit : regards sur la prise de décision des parents d’un enfant gravement malade

To address important medical, psychological and social issues, the concept of respite recently developed in Belgium. The service offered by the Villa Indigo in Brussels allows parents to recover from stressful situations while promoting the well-being of their seriously ill children. Noting the parents’ high level of exhaustion when they first contact us, we decided to study the factors that influence their decision to access respite services. The results of ten exploratory interviews conducted with parents of children who have already stayed at Villa Indigo highlight the complexity of their decision, which is influenced by a variety of factors, such as familial support, tiredness and information about respite care, as well as dynamic representations of themselves, their seriously ill children and the concept of respite care. Once they have overcome their initial reluctance to ask for respite care, the benefits are tangible for both the parents and their children, and future stays are rapidly organized.     

Interactive computer training to teach discrete‐trial instruction to undergraduates and special educators in Brazil: A replication and extension

Discrete‐trial instruction (DTI) is a behavioral method of teaching young children with autism spectrum disorders (ASD) that has received a significant amount of research support. Because of a lack of qualified trainers in many areas of the world, researchers have recently begun to investigate alternative methods of training professionals to implement behavioral teaching procedures. One promising training method is interactive computer training, in which slides with recorded narration, video modeling, and embedded evaluation of content knowledge are used to teach a skill. In the present study, the effectiveness of interactive computer training developed by Pollard, Higbee, Akers, and Brodhead (2014), translated into Brazilian Portuguese, was evaluated with 4 university students (Study 1) and 4 special education teachers (Study 2). We evaluated the effectiveness of training on DTI skills during role‐plays with research assistants (Study 1) and during DTI sessions with young children with ASD (Studies 1 and 2) using a multiple baseline design. All participants acquired DTI skills after interactive computer training, although 5 of 8 participants required some form of feedback to reach proficiency. Responding generalized to untaught teaching programs for all participants. We evaluated maintenance with the teachers in Study 2, and DTI skills were maintained with 3 of 4 participants.     

Carers of adults with mental illness: Comparison of respite care users and non‐users

The aim of this study was to investigate the rate, type and duration of respite care use in carers of an adult with mental illness, and the differences between respite care users and non‐users on demographic, caregiving context and adjustment variables. A total of 106 carers completed a postal survey questionnaire. The majority (76%) of carers who accessed care used it weekly, fortnightly or monthly. The most common types of respite services were in‐home, day programs, and residential respite. The mean duration of respite care periods was 58.18 hr each time respite was used. Compared to respite care non‐users, carers who accessed respite care were more likely to live with their care‐recipient and provide more caregiving. They also reported more benefits associated with their caregiving. Findings suggest that respite care services need to be varied, available for carers on a weekly to monthly basis with a range in duration, but catering for higher use of 2‐day respite periods. Carers who are highly engaged in a range of caregiving tasks and who live with their care recipient are more likely to have a greater need for respite care. Future research should examine the effects of a range of respite care factors on carer adjustment outcomes.     

TEACHING CHOICE MAKING DURING SOCIAL INTERACTIONS TO STUDENTS WITH PROFOUND MULTIPLE DISABILITIES

We taught 4 students with profound multiple disabilities to use a microswitch communication system to request a change in recreational stimuli during social interactions with nondisabled peers. In Study 1, we conducted a preference assessment across a range of stimuli for each student. The most and least preferred stimuli were incorporated into microswitch communication system training in Study 2. During the second study, 3 of the 4 students (a) learned to use the microswitch communication system to control stimulus presentation, (b) more clearly differentiated their time among stimuli, and (c) increased their level of general alertness. Study 3 extended the use of the microswitch communication system to social interactions with nondisabled peers. Two students were more engaged in interactions when they chose when to change stimuli; 1 student was more alert when a peer chose when to change activities; a 4th student showed an undifferentiated pattern. The outcomes of the investigation are discussed in terms of the effects of controlling stimulus presentation on the behavior of students with profound multiple disabilities and the stability of preference hierarchies over time.     

Understanding Respite Care Use by Families of Children Receiving Short-Term, In-Home Psychiatric Emergency Services

Respite care is widely believed to be an important support service for families raising a child with a disability. We report the findings of a respite care utilization study conducted within the context of a larger research and demonstration project examining three models of intensive, in-home services for children experiencing psychiatric crises. Respite care, both in-home and out-of-home, was a support service available to families in two of the three study conditions. Overall, 34% of 146 eligible families used in-home and or out-of-home respite care. Utilization was lower than the estimates developed prior to implementation, prompting an inquiry at the end of the first project year designed to maximize use and to gather more information on caregiver and service provider attitudes toward respite care. The inquiry included caregiver and provider focus groups, surveys, and enhanced data collection and analysis. Caregiver interviews indicated that many families did not fully understand what it meant to receive respite care or even that it was available to them. A comparative analysis of respite care users and non-users revealed that respite care users were more likely to have younger children, children who had a greater number of assessed functional impairments, and fewer social supports. Respite care users also reported greater difficulty managing their children's difficult behaviors.     

Group Creativity Training for Children: Lessons Learned from Two Award‐Winning Teams

The development of group creativity can be challenging for both young students and their teachers. This study examined the processes and learning outcomes of group creativity training from the perspectives of elementary school students and teachers while identifying critical factors that contributed to the success of the training. Data were collected from two Korean elementary school teams that won the gold (1st) and a special medal at the 2011 Destination Imagination global competition. Both individual and group interviews were carried out with 13 students and two teachers to investigate their perspectives of group creativity training. The analysis of the interview data revealed three major factors and subthemes: group dynamics (conflict and play), individual characteristics of the students (personality and motivation), and teachers’ roles (training strategies, training style, and commitment). In addition, a semi‐longitudinal survey conducted a year after the interviews examined nine skill or competency domains (self‐management, creativity, leadership, interpersonal relationship, patience, cooperation, information processing, communication, and presentation) to evaluate effects of the group creativity training on student learning. Synthesizing the analyses, we addressed the following three topics that arose from the discussions: the Safe Nest Effect, teachers’ training style, and multiple learning experiences derived from group creativity training.     

Factors associated with respite care use by families with a child with disabilities

This paper reviews the literature on respite care utilization, describes a respite care program in Arkansas, and reports on a study of utilization initiated by the Arkansas Division of Mental Health Services (DMHS). Among the 89 families qualifying for respite services, 70 consented to participate, and 66 were surveyed in a phone interview. Users (n=54) and non-users (n=12) were compared relative to a variety of staff, child, geographic, and budget differences. Also, respite use was examined relative, to the aforementioned variables based on level of use, (i.e., none, low, moderate, high). There were no differences in use according to age, the number of family members, family income, or needs of the child. A larger percentage of non-use and low use of respite care was evident among those families receiving Tax Equity Fiscal Responsibility Act (TEFRA) benefits. There were no significant differences between races related to perceived barriers to care. Differences in expectations/experiences with respite care among rural and urban groups were limited with rural respondents expressing, concern about travel/distance issues. Overall, the program as a whole received positive ratings by parents, and no clear factors were found to be related to non-use in the small sample (n=12) who did not take advantage of respite services.     

CO-WORKER IMPLEMENTED JOB TRAINING: THE USE OF COINCIDENTAL TRAINING AND QUALITY-CONTROL CHECKING ON THE FOOD PREPARATION SKILLS OF TRAINEES WITH MENTAL RETARDATION

In two studies, co-workers of persons with disabilities were taught to use coincidental training procedures while completing their own jobs. In Study 1, the effects of coincidental training on the salad-making skills of 3 trainees with mild and moderate mental retardation were evaluated. Coincidental training by co-workers resulted in improved accuracy of the salad-making skills of the trainees. In Study 2, trainees were also coincidentally taught to make quality-control checks of their salads. An alternating treatments and multiple baseline design indicated that the trainees more readily acquired the skills when taught to check the correctness of their work.     

材料呈现方式对不同音乐训练经验的汉语儿童英语言语记忆的影响

选取受过音乐训练和未受过音乐训练的汉语儿童为被试,在同一呈现速率条件下以歌曲、韵律和朗读三种方式呈现一段英文材料,从单词、句子和篇章三个层面探讨音乐训练经验和材料呈现方式对第二语言言语记忆的影响。结果发现：1）音乐组的记忆成绩高于非音乐组;2）相比于朗读材料,儿童对于歌曲和韵律材料的记忆效果更好;3）在单词和句子层面,音乐组和非音乐组的差异主要体现在歌曲材料上,而篇章层面没有类似发现。该结果表明音乐训练和材料呈现方式均能影响儿童的第二语言言语记忆,并且音乐训练效应对材料呈现方式表现出选择性     

The Psychology of Respite Care for People with Dementia in Australia

Australian health professional bodies promote the use of respite to ease carer burden, following well‐established findings that carers often face physical, mental, social, and financial strain while providing informal care. This narrative review examined the use and impacts of respite for older clients, with a particular focus on Australian research and on dementia respite. It was found that despite reports of high satisfaction from caregivers with respite use, barriers, such as caregiver concerns for the well‐being and safety of the care recipient during respite, limited flexibility for short‐notice respite booking, and low provision of support and education post respite, impacted on the accessibility and efficacy of respite care. It was concluded that respite care needs to move away from a custodial model to a more psychological model of care, and that more natural and flexible models (e.g., host family respite), integrated with increased post‐respite support and psychosocial education, are likely to be beneficial and need further evaluation.     

Effect of respite care on dementia and nondementia patients and their caregivers

The impact of a respite program on the cognitive and physical functioning of dementia and nondementia patients, and on the burden perceived by their caregivers, was assessed in a pretest-posttest design. A total of 55 caregivers were interviewed twice, 5 weeks apart. In the respite group, the caregiver's patient experienced a 2-week respite stay in a nursing home during the 5-week interval, whereas in the waiting-list comparison group, the patient experienced ongoing in-home care during the interval. We hypothesized that patient diagnosis (dementia vs. nondementia) would interact with respite exposure, with nondementia patients showing more improvement from respite than dementia patients. Regardless of diagnosis, however, positive effects from respite exposure were found for caregiver reports of the patient's memory and behavior.     

PARENT EDUCATION PROJECT II. INCREASING STIMULATING INTERACTIONS OF DEVELOP MENTALLY HANDICAPPED MOTHERS

Two studies are reported on the assessment and training of parent-child interactional skills in developmentally handicapped mothers. Study 1 compared the interactions of eight developmentally handicapped versus eight nonhandicapped mothers during play with their young (6–25 months) children. Results showed that the former group generally interacted much less with their children and that they were less likely to praise appropriate child behavior and imitate child vocalizations. Study 2 attempted to remediate these deficits, using a training package consisting of discussion, modeling, feedback, social reinforcement, and self-recording. Results showed, first, that the training did increase the targeted skills to well within the range found for the nonhandicapped mothers. Second, training effects generalized from the group instructional setting to the mothers' own homes. Third, newly acquired skills were generally maintained at or above levels found for the nonhandicapped mothers over a 5- to 10-month follow-up period. Finally, all seven children showed increases in vocalizations concomitant with parent training. The results suggest that developmentally handicapped mothers can be taught to provide more effective and stimulating interactions to their young children.     

GENERALIZATION OF NAMING RESPONSES TO OBJECTS IN THE NATURAL ENVIRONMENT AS A FUNCTION OF TRAINING STIMULUS MODALITY WITH RETARDED CHILDREN

Picture-cards, photographs, and real objects were compared as training stimuli in order to determine which best facilitated the generalization of naming responses learned in a special training room to real objects in the natural environments of four retarded children. The amount of transfer of naming behavior between the three stimulus modes and the average amount of training time required per stimulus mode were also assessed. Three of the four children displayed considerably more generalization to the real objects in the natural environment when they were trained with real objects. The fourth child displayed substantial generalization regardless of the training stimulus mode. No particular training stimulus mode clearly facilitated the transfer of naming responses to other modes or greatly reduced training time. The results of two supplementary procedures conducted with one child showed that: (1) training in several environments facilitated generalization to real objects in the natural environment when real objects were used as training stimuli but not when picture-cards were used, and (2) transfer from picture-cards to real objects was facilitated by training other picture-cards and the real objects portrayed by them at the same time.     

Effects of Training Reflective Listening in a Corporate Setting

A communication skills training of insurance company employees was devised and evaluated. Study 1 compared trained and untrained employees on their Reflective listening (RL; Rogers, 1951) skills before and after a 16-hr training, as they conversed with a confederate who rated them, and their responses were categorized. In a follow-up Study 2, some of the employees audiotaped conversations with customers, and their responses were categorized as well. In a validation Study 3, students rated conversations by employees who used more or less RL. Results showed that training increased RL, and that the skills were subsequently transferred to an authentic setting. Results did not show that trained employees were evaluated differently than untrained. Implications of the results are discussed.     

"Broken covenant": healthcare aides' "experience of the ethical" in caring for dying seniors in a personal care home

Canada's population is aging, and seniors constitute the fastest growing demographic in the nation. The chronic health conditions, limited social support, functional decline, and cognitive impairment experienced by seniors may necessitate admission to a personal care home (PCH) setting up until the time of their death. The ethical problems that arise in the care of dying patients are numerous and complicated. The care of dying seniors in PCHs, however, is largely provided by frontline workers such as healthcare aides (HCAs), who usually have little training in palliative care or ethics. Research examining the identification and resolution of ethical problems in care of the dying has been conducted from the perspectives of nurses and physicians in various clinical settings, but the voice of HCAs in PCHs is virtually absent from clinical ethics. Given that the inability to satisfactorily resolve ethical issues in clinical practice is associated with feelings of guilt, powerlessness, avoiding contact with patients, failing to provide good physical care, and increased staff turnover, an empirical examination of HCAs' experiences of ethically challenging situations is warranted. We conducted a phenomenological study to access the lived experience of HCAs (N = 12) working in proprietary and nonproprietary care homes as they encountered situations they deemed ethically challenging in providing end-of-life care to dying seniors. The findings reported here explicate: (1) the types of situations that are ethically problematic for HCAs; (2) the meanings they assign to these situations, and (3) the impact such situations have on the provision of end-of-life care.     

EVALUATION OF A COMMERCIALLY AVAILABLE PROGRAM AND IN SITU TRAINING BY PARENTS TO TEACH ABDUCTION‐PREVENTION SKILLS TO CHILDREN

Child abduction is a serious problem; therefore, it is essential that researchers evaluate the efficacy of commercially available abduction‐prevention programs. A multiple baseline design across participants (ages 6 to 8 years) was used to evaluate the effects of a training program, The Safe Side. Experimenters assessed safety responses in situ in two different situations (knock on the door and interaction by a stranger in public). Results revealed that participants did not demonstrate the safety skills following Safe Side training. All participants subsequently received in situ training (IST) implemented by the parent. Additional assessments and IST were conducted until each participant performed the skills to criterion. All participants demonstrated criterion performance following IST and maintained the skills over time.