bluuebunny/crossref_metadata_2025 huggingface dataset:
Upper Extremity Injuries in the National Football League
Authors: Carlisle John C. , Goldfarb Charles A. , Mall Nathan , Powell John W. , Matava Matthew J.
Published: June 2008

Background

Very little information is available regarding the incidence, causative mechanisms, and expected duration of time lost following upper extremity injuries in professional American football players.

Hypotheses

(1) Upper extremity injuries in professional American football players are a common cause of missed time from practice and game participation. (2) The effect of upper extremity injuries differs as a function of the site involved and the athlete's position.

Study Design

Descriptive epidemiologic study.

Methods

A retrospective review of all documented injuries to the elbow, forearm, and wrist sustained by all players in the National Football League over a 10-year period (1996–2005) was performed using the League's injury surveillance database. An injury was considered significant if it resulted in premature cessation of (or absence from) at least 1 practice, game, or training event. The data were analyzed from multiple perspectives, with emphasis on the type of injury, athlete position, and activity at the time of injury.

Results

There were 859 total injuries over the 10-year period: 58% involved the elbow, 30% involved the wrist, and 12% involved the forearm. Ligamentous injuries were the most common diagnosis in the elbow and wrist, with wrist sprains the most common of all diagnoses. Fractures were the most common injury occurring in the forearm. For all 3 anatomic locations, game injuries were much more common than practice injuries by a factor of 2.8 to 1. Forearm injuries led to a mean of 42 days lost, wrist injuries led to a mean of 27 days lost, and elbow injuries led to an average of 22 days lost. Fractures and dislocations led to the greatest amount of time lost (47 days and 53 days, respectively). Tackling was the activity most often (24%) implicated as causing injuries to the elbow, forearm, and wrist. Offensive and defensive linemen were most commonly injured. Elbow injuries were the most common at these positions, constituting approximately 75% of all injuries. Defensive backs sustained the greatest number of forearm injuries, approximately double the total number at any other position.

Conclusion

Upper extremity trauma is a significant issue for professional football players. In particular, the high incidence rates of elbow injuries in linemen and forearm injuries in defensive backs warrant further scrutiny.
Long-Term Shoulder Function after Type I and II Acromioclavicular Joint Disruption
Authors: Mikek Martin
Published: June 2008

Background

Acromioclavicular joint separations are very common lesions, with the majority falling into Rockwood classification type I and II. It is generally agreed that conservative treatment of these injuries leads to good functional results, although there are some studies that suggest these injuries are associated with a high incidence of persistent symptoms.

Hypothesis

Type I and II acromioclavicular joint disruption significantly impairs long-term shoulder function.

Study Design

Case series; Level of evidence, 4.

Methods

The shoulder function of 23 patients who were treated for type I or II acromioclavicular joint disruption was evaluated at a mean of 10.2 years after injury. The objective and subjective measures of the injured shoulder were assessed using Constant, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores and were compared with results of the uninjured shoulder.

Results

At an average follow-up of 10.2 years, 12 of 23 patients (52%) reported at least occasional acromioclavicular joint symptoms. The average Constant score for the injured shoulder was 70.5 and 86.8 for the uninjured shoulder ( P < .001). The average University of California-Los Angeles Shoulder Scale score for the injured shoulder was 24.1 and 29.2 for the uninjured shoulder ( P < .001). The average Simple Shoulder Test value for the injured shoulder was 9.7 and 10.9 for the uninjured shoulder ( P < .002). The extent of acromioclavicular joint disruption and acromioclavicular joint width did not have any statistically significant influence on the shoulder functional scores.

Conclusion

Type I and II acromioclavicular joint disruptions impair long-term shoulder function in about half of patients 10 years after injury.
Intercohort Trends in the Relationship Between Education and Health
Authors: Kim Jinyoung
Published: June 2008

Objective: This study examines whether educational differentials in functional and mental health are greater in more recent cohorts in the United States. Method: This study utilizes latent growth-curve modeling to examine intercohort trends in physical impairment and depressive symptomatology for three educational subgroups, using panel data (1986-1994) based on a national probability sample of 3,617 U.S. adults. Results: Among those with less than a high school diploma, the 8-year newer cohort demonstrated higher physical impairment at the same age, implying an unfavorable trend. College graduates and high school graduates enjoyed favorable trends in mental health, and the trends were different across age groups within certain educational groups. Discussion: This study provides evidence that the education-based disparity in health is increasing, but there are variations in the trend depending on health outcomes. These results argue for the necessity of examining trends in education and health using diverse health outcomes.
Social Care Interface in Early-Stage Dementia
Authors: Carpentier Normand , Pomey Marie-Pascal , Contreras Ricardo , Olazabal Ignace
Published: June 2008

Objective: Although issues of complementarity and coordination between health care institutions have recently generated great interest, few scholars have studied the thorny interface between formal and informal service networks. This exploratory study investigates the interface between health care practitioners and caregivers of people with Alzheimer's disease living in the community. Method: Using Pescosolido's multilevel network model and Martuccelli's sociology of the individual, the authors interviewed 20 practitioners drawn from seven urban groups and analyzed contacts between practitioners and caregivers at the beginning of the care trajectory. Results: The quality of the practitioner—caregiver interface was determined by the players' profiles, internal structures, and external links. Heterogeneous professional groups and the establishment of contacts in the early stages of dementia seemed beneficial. Discussion: The problematic interface between formal and informal service networks could be improved by a greater understanding of microsocial- and organizational-level interactions and implementing a social model of care.
Do Poverty Attitudes of Social Service Agency Directors Influence Organizational Behavior?
Authors: Reingold David A. , Liu Helen K.
Published: June 2008

This article explores why people are poor and on welfare, according to social service agency directors who administer programs that serve current and former welfare recipients. Based on data from 295 local social service agency directors in Indiana, 75% of respondents believe educational and labor market barriers are important causes of long-term poverty and welfare, 44% believe cultural transmission or learned lifestyles are causes, 23% believe poor attitudes and work ethics as well as laziness or lack of motivation among the poor are causes, and 8% believe government assistance causes dependency among recipients and makes them poor. Evidence suggests that agency directors who believe that poor attitudes and behavior of the poor primarily cause poverty and welfare are more likely to be in organizations that did not ration services since welfare reform or engage in political activities designed to support these changes. In contrast, agency directors who maintain educational and labor market barriers as primary causes of poverty and welfare are more likely to be in organizations that have adopted new programs and developed collaborative strategies with other organizations since welfare reform.
Faith-Based Assumptions About Performance
Authors: Amirkhanyan Anna A. , Hyun Joon Kim  , Lambright Kristina T.
Published: June 2008

To date, the common rhetoric and assumptions on the performance of faith-based organizations (FBOs), ironically, appear to be faith based rather than empirically supported: There is a paucity of research evaluating the effectiveness of FBOs that uses sufficiently rigorous methods and multiple measures of organizational performance. This study seeks to inform the debate on the relative effectiveness of FBOs by comparing religiously affiliated and secular nonprofit nursing homes using two distinct but complementary measures of organizational performance: service quality and access for impoverished clients. Using nationally representative panel data on 11,877 church-affiliated and secular nonprofit nursing homes, this study examines the effect of ownership with several regression models. Overall, the findings fail to confirm the assumption that FBOs perform better than secular nonprofit organizations in the context of the nursing home industry. Isomorphic pressures and commercialization trends within the nursing home industry are discussed to help explain these findings.
Essai Conceptualisation de l'intervention éducative en santé publique
Authors: Descarpentries Jacqueline
Published: June 2008

La fonction sociale de l'éducation pour la santé génère un questionnement propre qui est par nature différent de ceux soulevés par les interventions de protection telles que la vaccination obligatoire et les dépistages de masses. L'éducation pour la santé ne se présente plus uniquement sous la forme d'une intervention éducative justifiée par les évidences épidémiologiques pour la gestion des risques-au nom du principe de précaution-; mais elle se veut aussi participer à la hiérarchie implicite des valeurs de la société contemporaine. A la fois lieu de la normalisation et de la rationalisation de la vie, mais aussi lieu de la responsabilité citoyenne véhiculant des valeurs telles l'autonomie, la liberté individuelle, le libre arbitre, elle participe aujourd'hui à la laïcisation des corps, et aux compétences psychosociales et demain au développement durable de la santé publique. L'éducation pour la santé implique une connaissance des enjeux propres à la fonction sociale de l'éducation contingente à la santé publique qui sont insensiblement mais profondément liés à une archéologie des savoirs et des pouvoirs: des épistémologies des sciences de la vie et du vivant, des concepts et des méthodes qui ont naturalisé l'objet santé. Cette archéologie assigne à l'éducation une fonction sociale à la fois de biologisation de la vie, mais aussi de durabilité du développement humain en hésitant entre nature et culture.

Par une approche réflexive et critique, nos travaux de recherches participent à une élucidation des modes d'intervention éducatifs en santé publique, où le travail éducatif est entendu comme une modalité d'intervention dans les mandats de la santé publique. Il permet d'identifier une réalité sociale et historique étroitement liée aux traditions, aux conditions nationales, mondiales, économiques, politiques et culturelles des Etats dans lesquelles il s'est développé pour penser les conditions d'une éducation pour la santé tout au long de la vie. Nous élaborons une posture de recherche autour de la conceptualisation de l'intervention éducative en santé publique à partir de l'étude de différentes dimensions psychopédagogique, didactique, organisationnelle et sociale. (Promot Educ 2008; Supp(1): 14-16)
Trois défis pour l'évaluation en promotion de la santé
Authors: Potvin Louise , Bilodeau Angèle , Gendron Sylvie
Published: June 2008

L'évaluation des interventions en promotion de la santé est de plus en plus répandue, répondant ainsi à deux besoins cruciaux dans le domaine, soit: 1) justifier les ressources investies en démontrant ses effets et 2) soutenir les processus innovants nécessaires pour aligner les interventions avec les principes, valeurs et engagements de la Charte d'Ottawa pour la promotion de la santé, document fondateur du champ. Dans cet article, nous proposons que dans un cas comme dans l'autre, cet alignement que nous défendons comme inhérent à la promotion de la santé, pose des problèmes cruciaux pour l'évaluation. Ces problèmes se traduisent en trois défis de pertinence auxquels l'évaluateur en promotion de la santé doit confronter sa pratique: 1) définir l'intervention à évaluer de façon à élaborer des questions d'évaluation pertinentes; 2) mettre en œuvre des méthodologies de recherche adéquates et rigoureuses; et 3) produire des connaissances pertinentes pour l'action. (Promot Educ 2008; Supp(1): 17-21)
Promotion de la santé au Luxembourg
Authors: Wagener Yolande
Published: June 2008

La mise en œuvre de la promotion de la santé et de l'éducation pour la santé ne sont pas identiques d'un pays à l'autre. Les problèmes identifiés, les priorités d'intervention, les dispositifs en place, les « coutumes » de démarches et de stratégie, les possibilités infra-structurelles, organisationnelles, matérielles et professionnelles, l'organisation des services de santé, l'histoire et le développement de la santé publique, les systèmes de santé et de sécurité sociale, la culture de communication et de partenariat, la volonté politique, la demande publique… figurent parmi les facteurs qui influencent les initiatives établies dans les pays. Certains pays ont commencé le processus par des actions au niveau national, (législation, organe national de coordination), d'autres à des niveaux régionaux ou même locaux, certains ont développé des programmes globaux, d'autres ont favorisé de promouvoir la santé dans certains « settings » précis ( p.ex: écoles, hôpitaux)

Dans cet exposé, nous essayons de rendre compte de la promotion de la santé et de l'éducation pour la santé au Luxembourg: développement, aspects positifs et négatifs, domaines d'intervention, facilités et limites, domaines de réflexion et de recherche, états des lieux et futur. (Promot Educ 2008; Supp(1): 22-25)
Un programme politique de promotion de la santé: l'exemple de la Communauté française de Belgique
Authors: Bantuelle Martine , Lonfils Roger
Published: June 2008

Conduire un programme politique en promotion de santé nécessite des outils qui guident les décideurs et les promoteurs de programmes. Il s'agit de textes qui tracent les orientations prioritaires, des repères qui permettent d'observer l'implantation du national au local, des critères qui fixent la qualité des programmes. Au-delà, comment apprécier l'intégration des stratégies de promotion de la santé dans les pratiques de terrain? C'est à cette question que sont confrontés les acteurs de la promotion de la santé de la Communauté française de Belgique. C'est dans une dynamique d'évaluation-action-recherche que les réponses sont cherchées. (Promot Educ 2008; Supp(1): 26-28)
La place de la promotion de la santé et de l'éducation pour la santé dans le système de santé français
Authors: Fayard Annick , Marchand Annie-Claude
Published: June 2008

Le système de santé français reste très centré sur le curatif. La santé publique y occupe désormais une place plus importante mais son développement s'effectue prioritairement dans le champ des urgences sanitaires.

Cependant, la prévention et l'éducation pour la santé prennent progressivement place dans le système depuis les années 1990. Le Conseil des Ministres entérine en 2001 un programme national d'éducation pour la santé (PNEPS) et, dans son sillage une circulaire ministérielle préconise l'élaboration de schémas régionaux d'éducation pour la santé (SREPS). Le législateur crée en 2002 l'Institut National de Prévention et d'Education pour la Santé (INPES). Enfin, la nouvelle loi de santé publique prévoit en 2004 la mise en place dans chaque région d'un plan régional de santé publique (PRSP). Ce plan doit comporter, outre les programmes et actions pluriannuels thématiques, un programme de santé scolaire et d'éducation pour la santé.

Conformément à ses missions, l'INPES soutient le renforcement de la recherche et le développement des pôles de compétences en éducation pour la santé, ces plates formes de ressources et de services en éducation et promotion de la santé prévues par les SREPS. Mais ces initiatives restent modestes et isolées au regard des besoins de ce champ d'intervention.

L'articulation de la recherche avec la formation et les pratiques des intervenants reste un défi. Jusqu'alors, les recherches ont porté essentiellement sur les facteurs explicatifs et rarement sur les modalités d'intervention ou sur l'efficacité des actions. De plus, la formation initiale dans ce domaine reste insuffisamment développée et les contenus des programmes de formation sont très disparates et faiblement articulés à la recherche. L'absence d'une politique globale sur ces questions constitue un frein au développement de ce secteur d'intervention. (Promot Educ 2008; Supp(1): 31-34)
Savoirs endogènes, savoirs exogènes, impact sanitaire et formation en promotion de la santé au Benin. Aspects descriptifs et leçons à tirer
Authors: Gnansounou Elisabeth Fourn , Hounsa Assomption
Published: June 2008

La promotion de la santé est une approche efficace et efficiente pour améliorer de façon durable les indicateurs de santé. La plupart des pays africains au sud du Sahara sont en train de faire des efforts pour son appropriation. Ces pays connaissent dans leur secteur de la santé le phénomène de la pluralité des savoirs. On distingue d'un côté les savoirs endogènes ancrés dans les us et coutumes, de l'autre les savoirs exogènes introduits par la colonisation et enfin les savoirs professionnels acquis lors de sessions de formation continue de personnel. Les auteurs de cet article ont étudié le phénomène en utilisant la technique de l'analyse de contenu documentaire. Cela a consisté essentiellement à examiner les résultats d'études socio-anthropologiques relatifs à la gestion (représentation causale, prise en charge) de trois maladies prioritaires (paludisme, rougeole et choléra) d'une part, et le contenu de documents (modules et rapports) produits lors d'une récente formation organisée sur la promotion de la santé au Bénin d'autre part. Les résultats obtenus confirment le faible niveau de développement des pratiques de la PS dans le secteur de la santé. A cela s'ajoute une faible complémentarité entre les différents types de savoirs disponibles. Ils ont conclu que la mise en commun des savoirs sanitaires est un préalable au développement de la PS. Un effort supplémentaire est néanmoins requis lorsque le pays a une longue tradition de croyances et de pratiques sanitaires entretenus par des tradithérapeutes peu favorables à la synergie des savoirs. La conclusion majeure ici est que la généralisation de la PS passe par la complémentarité des savoirs sanitaires et la prise en compte des défis potentiels spécifiques aux pays africains au sud du Sahara. (Promot Educ 2008; Supp(1): 39-42)
La promotion de la santé en Afrique subsaharienne : état actuel des connaissances et besoins d'actions
Authors: Houéto David
Published: June 2008

La promotion de la santé (PS) en Afrique subsaharienne reste encore peu développée. L'auteur part de la situation actuelle préoccupante des indicateurs de santé et de développement du continent, comparés au reste de la planète, pour montrer l'intérêt et la place du concept de la PS dans la région africaine. Les efforts déployés dans la région pour le développement des systèmes de santé sont examinés. Un regard est jeté dans l'histoire, à travers l'analyse des facteurs pouvant expliquer « l'absence » actuelle de la PS en Afrique subsaharienne, dans le cadre de ces différents efforts d'amélioration des systèmes de santé. La place et le rôle des formes actuelles de partenariat, au niveau international entre les organisations internationales et les pays de la région, dans cette situation actuelle de la PS ont été également analysés. L'auteur explore enfin plusieurs pistes de solutions possibles pouvant aider, dans les meilleurs délais, à une valorisation de la PS dans le cadre des efforts de relance des systèmes de santé et du développement du continent en général. (Promot Educ 2008; Supp(1): 49-53)
Les problèmes psychosociaux — un défi en promotion de la santé
Authors: Steffgen Georges , Recchia Sophie
Published: June 2008

Le terme «psychosocial» connaît un grand succès sans qu'il soit clairement conceptualisé. Il peut caractériser le déclencheur autant que le médiateur ou le résultat d'une interaction ou d'un développement, être cause ou effet d'un trouble. La psychologie écologique de Bronfenbrenner (1977) définie les relations existantes entre l'individu et la société par quatre sphères relationnelles emboîtées du centre vers la périphérie, parmi lesquelles il est possible de localiser le « psychosocial » et de la même façon d'en comprendre son développement. L'événement social devient « psychosocial » une fois perçu au niveau psychologique, et dans le cas où les ressources ne sont pas suffisantes pour y faire face, l'événement est susceptible de devenir un trouble psychosocial. Ainsi par exemple, sur le lieu de travail une confrontation régulière à des tensions non surmontables peut engendrer l'épuisement professionnel, encore appelé « burnout ». Une étude sur le burnout a été réalisée auprès d'un échantillon représentatif de 399 enseignants de l'enseignement secondaire au Luxembourg. Ils ont répondu à un questionnaire auto administré évaluant l'épuisement et les contraintes professionnelles, ainsi que les stratégies d'ajustement à la colère et les symptômes les accompagnant. Les résultats montrent que 3,3% des enseignants du secondaire souffrent d'un burnout élevé ayant un impact indéniable sur la santé. Un modèle d'équation structurale indique que les facteurs à risque pour la profession enseignante se retrouvent tant au niveau individuel (âge, fatigue, stratégies de gestion de la colère) qu'au niveau organisationnel (contraintes professionnelles) et qu'il est possible de tamponner l'effet de l'épuisement professionnel par la mise à distance face à la colère. Les résultats de cette recherche appellent à aller plus loin dans l'analyse, à améliorer la méthodologie et à mettre à l'épreuve l'efficacité des programmes de prévention existants ou à développer. (Promot Educ 2008; Supp(1): 60-63)
Le développement de la recherche-action européenne en promotion de la santé mentale : Pourquoi ? Comment ?
Authors: Fond-Harmant Laurence
Published: June 2008

En matière de recherche en promotion de la santé mentale, les chercheurs et experts européens expriment le manque d'outils spécifiques d'analyse, évalués, validés et les limites des actions d'intervention au regard des priorités. Ils proposent le développement de recherches sans exclusive disciplinaire (neurologie, sciences sociales, psychiatrie…). L'article présente 4 axes prioritaires pour contribuer à produire des hypothèses, des modèles, des méthodes de mesures et d'évaluation et des connaissances nouvelles.

1- Créer les fondements d'une discipline de recherche à part entière, « Promotion de la santé mentale » faisant cruellement défaut dans le paysage scientifique. Les travaux porteront sur la définition de la santé mentale et sur son articulation à la psychiatrie. Ils auront pour objectif de définir des problématiques adaptés au contexte social et politique européen en proposant des outils conceptuels et des méthodes.

2- Analyser les problèmes de santé mentale en s'appuyant sur les meilleures connaissances disponibles notamment par:

• la définition précise des pathologies, l'estimation de leur fréquence et leur retentissement (en terme de mortalité, d'incapacité, de prise en charge, de traitement…) dans la population générale,

• l'identification des principaux déterminants associés à leur survenue ou à l'importance de leur impact et en particulier ceux dont la survenance peut être modifiée par des politiques de santé publique,

• l'identification des stratégies « efficaces » en promotion de la santé mentale.

3- Développer un regard international sur la question de la santé mentale et des inégalités sociales en Europe. Cet angle d'attaque ouvre le champs à des approches comparatives entre pays. Ces travaux analyseront les implications politiques et devront faire ressortir les changements et les évolutions possibles.

4- Articuler la formation à la recherche. Des travaux de recherche-action expérimentale doivent soutenir les professionnels non psychiatres qui doivent s'adapter à des conditions pour lesquelles ils ne sont pas préparés dans leur cursus initiaux de formation. (Promot Educ 2008; Supp(1): 64-70)
Le réseau francophone international pour la promotion de la santé (REFIPS): reconnaître la pertinence de la promotion de la santé en francophonie pour le 3e millénaire
Authors: Houéto David , Valentini Hélène
Published: June 2008

Le français, une des langues les plus parlées au monde, semble ne pas s'afficher, parlant de la promotion de la santé (PS). Le REFIPS s'est donné comme objectif la valorisation de la PS à travers l'utilisation de la langue française. Sa méthode de travail qui repose sur une démocratie à la base, contribue à asseoir le concept de PS dans les différentes parties du monde où le français est utilisé. L'exemple de la section Afrique subsaharienne est donné avant de tourner le regard vers l'avenir du réseau et de la PS dans le monde francophone. (Promot Educ 2008; Supp(1): 73-75)
L'Union internationale de promotion de la santé et d'éducation pour la santé : un réseau professionnel mondial
Authors: Lamarre Marie-Claude
Published: June 2008

Cet article présente brièvement l'Union internationale de Promotion de la Santé et d'Education pour la Santé et le travail qu'elle réalise dans le cadre du développement de la promotion de la santé. Après une description de sa mission et de ses valeurs, principalement la justice sociale et l'équité, la diversité, l'empowerment et le travail en partenariat, l'article expose l'articulation de ses stratégies et actions dans des projets et programmes concrets; en particulier le Programme mondial de recherche sur l'efficacité de la promotion de la santé, la production d'un ensemble de revues, rapports scientifiques et autres publications, l'organisation régulière de conférences mondiales et régionales, la mise en place de groupes de travail spécialisés et le développement à des niveaux élevés des capacités des personnes, des organisations et des pays pour entreprendre des actions de promotion de la santé à quelque niveau que ce soit. Contribuer au développement professionnel des acteurs de la promotion de la santé à travers le monde est une des principales stratégies d'action de l'UIPES. Le soutien qu'elle apporte à la création en Afrique d'un espace francophone d'échange en promotion de la santé en participant à la mise en place d'une première Université francophone de promotion de la santé à Dakar au Sénégal, en octobre 2008, qui va unir des équipes universitaires et des professionnels de santé publique engagés dans une pratique de terrain, en y associant des intervenants venant d'organismes de différents pays francophones en est un exemple. (Promot Educ 2008; Supp(1): 76-79)
Workplace Supports in Practice
Authors: Rogan Pat , Banks Becky , Howard Michelle
Published: June 2008

This study investigated the ways in which workplace supports are conceptualized and implemented by four organizations that provide supported employment services. Data were collected during 2-day site visits at each organization. Site visits included observations at a total of 39 work sites, semistructured interviews with a total of 126 primary stakeholders (supported employees, coworkers, employers/supervisors, and agency employment staff), document analysis (e.g., program descriptions, training and marketing materials), and a brief written survey about supported employment beliefs and practices. The findings indicate that each agency was driven by strong leadership and a cohesive vision and values. Each organization had a history of innovation and change. Staff were generally well trained, committed, and professional, and worked collaboratively with each other and with businesses. The involvement of workplace (or natural) supports was promoted in each organization, but there were a wide variety of interpretations and practices among staff. This article highlights areas with which these organizations struggle, including serving people with high support needs, developing a strong emphasis on person-centered approaches to planning and service delivery, assisting staff to facilitate workplace supports and social relationships, actively involving job seekers in the job search process, and increasing work hours and responsibilities of supported employees.
The Social, Behavioral, and Academic Experiences of Children with Asperger Syndrome
Authors: Church Catharine , Alisanski Susan , Amanullah Siraj
Published: June 2008

Very little information is available that describes the social, academic, and behavioral experiences of children with Asperger syndrome. This article describes those experiences in 40 children with Asperger syndrome between the ages of 3 and 15 years. The study illustrates both the variability and the consistency of the characteristics of this disorder over time and during specific developmental stages. The results indicate that social skill deficits were variable but remained the greatest challenge for these intellectually bright and verbal children. Critical areas for intervention are highlighted.
The Americans with Disabilities Act and Information Technology Access
Authors: Mondak Phyllis
Published: June 2008

Advances in information technology have created new employment opportunities for individuals with disabilities. The Americans with Disabilities Act of 1990 and other pieces of federal legislation have mandated the provision of reasonable accommodations, including assistive technology, to all individuals who might benefit from them. This article reviews the requirements of relevant legislation, describes various ways in which assistive technology can be used as a reasonable accommodation in employment settings, provides a case study from the Microsoft corporation, and discusses guidelines for the design, implementation, and evaluation of reasonable accommodations.
Educating Students with Mild Mental Retardation
Authors: Patton James R. , Polloway Edward A. , Smith Tom E. C.
Published: June 2008

The history of educating students with mild mental retardation has, in essence, been one focused heavily on social competence. This article examines the history of educating students with mild mental retardation and includes discussion of general demographic trends, contextual factors that influenced this process, assessment and instructional practices, and teacher roles and preparation. The article then examines these same features currently and provides recommendations for addressing these areas in the future.
Positive Behavior Supports
Authors: Horner Robert H.
Published: June 2008

The field of positive behavior supports has grown rapidly in the last decade as a practice to address the very real and difficult challenges posed by problem behaviors. The present article defines the current status of positive behavior support and provides a vision for where this technology will lead. The article identifies four central messages that will shape the vision for the future and discusses where we are now in relation to those central themes and where we need to go as we head into the 21st century.
Three Decades of Quality of Life
Authors: Schalock Robert L.
Published: June 2008

Over the last few decades, the field of mental retardation has embraced the concept of quality of life as both a sensitizing notion and an overarching principle for service delivery. This article summarizes the current understanding of the quality of life construct by examining previous efforts at defining and clarifying the concept, and examines issues that will affect the utility of the construct well into the new century.
The Drama and Trauma of Creating Policies on Autism
Authors: Feinberg Edward , Vacca John
Published: June 2008

There is considerable controversy regarding the provision of appropriate services for young children with autism and their families. A plethora of therapies have become available, most of which have uncertain efficacy. There is debate regarding which public agencies and private third-party payers have responsibility for the financing of services. There is particular controversy as to whether these therapies should be considered part of the scope of the entitlement under the Individuals with Disabilities Education Act (IDEA). This article identifies the factors that make autism a vexing public policy issue. These include an increase in the incidence and prevalence of children with autism; a lack of consensus on the etiology of the disorder; a lack of consensus on the most successful methodology for clinical intervention; coincidence of the age of diagnosis with the upper age limit of Part C of IDEA; a shift to a family-centered decision-making paradigm; and an increase in due process hearings and litigation. The authors identify concerns regarding the gradual shift to an expectation that early intervention and special education systems should include a full array of services for this population. They argue that the service delivery system should include a range of public and private agencies with a shared obligation for services to children with autism. They also propose the creation of a community-based mechanism for pooled funding of high-cost services. Autism is viewed as a metaphor for the dilemma that policymakers encounter when they attempt to fashion policies for children with special needs at a time when there is insufficient data to determine which services should be made available by public and private agencies.
Children with Autism Spectrum Disorder
Authors: Tsai Luke
Published: June 2008

This article examines the role and future of medicine and medically oriented interventions for children and youth with autism spectrum disorder. Included in the discussion are the diagnostic issues and medication treatments available currently and those that will become available in the new millennium.
A Response to Wehmeyer (1999) and a Challenge to the Field Regarding Self-Determination
Authors: Baker Daniel J. , Horner Robert H. , Sappington Gary , Ard William R.
Published: June 2008

This article provides a response to an article by Wehmeyer that appeared in the Spring 1999 issue of this journal. Self-determination presents a tremendous opportunity for all persons, and this promise enhances the challenge to prevent self-determination from becoming an empty cliché. To ensure a durable and substantive role for self-determination, the following critical components are needed: (a) a description of self-determination that is conceptually compelling and operational; (b) a sensitive, valid, and reliable method of assessing or measuring the self-determination experienced by an individual; and (c) documentation that efforts to improve self-determination are associated with improvements in the quality of life experienced by persons with disabilities and their families. Wehmeyer and colleagues have contributed greatly to the first of these components. The remaining two components must be the focus of further inquiry, research, and policy analysis.
Program Evaluation in Classrooms for Students with Autism
Authors: Oren Thomas , Ogletree Billy T.
Published: June 2008

This article reviews goal attainment scaling as an alternative method for evaluating treatments and programs for children with autism. Traditional evaluation methods such as compliance monitoring and efficacy studies may be unable to account for the elaborate set of components mandated by the Individuals with Disabilities Education Act and the number and variety of treatment/program options available to students with autism. Assessing the quality of program services delivered to children (i.e., process goals) and the progress of children in meeting those goals (i.e., outcome goals) should be the fundamental concern of programs for students with autism. The use of goal attainment scaling as an alternative evaluation method may provide a convergent link between student outcome goals and program goals within a framework of family-centered practices. A case study is provided to illustrate the use of goal attainment scaling.
A Participatory Action Research Approach to Evaluating Inclusive School Programs
Authors: Dymond Stacy K.
Published: June 2008

Efforts to evaluate inclusion have frequently focused on the efficacy of inclusive education as a service delivery model. Although this information has greatly enhanced the field's understanding of inclusion, a need exists for a comprehensive process to assist schools that embrace inclusion to evaluate their programs. This article reviews the literature on inclusive school program evaluations and proposes a model for evaluating inclusive schools. Key elements of the model are that it (1) includes stakeholders in the evaluation process through a participatory action research approach, (2) analyzes both program processes and outcomes, (3) uses multiple methods and measures, and (4) obtains perceptions from diverse stakeholder groups. Results from piloting the model are shared along with implications for the future role of program evaluation.
Application of ABA Principles to General Communication Instruction
Authors: Ogletree Billy T. , Oren Thomas
Published: June 2008

Effective communication instruction has drawn heavily from applied behavior analysis (ABA). Although intervention practices have evolved over time, technologies developed through the adherence to ABA principles and techniques continue to flourish. This article examines ABA-based communication instruction for persons with autism by providing a historical context for ABA as an instructional methodology and by reviewing ABA-related treatment options.
Functional Communication Training
Authors: Durand V. Mark , Merges Eileen
Published: June 2008

Problem behaviors such as aggression, self-injury, and tantrums can serve as major obstacles to even the most sophisticated intervention programs. Fortunately, there have been recent advances in our understanding of the nature of these behaviors, and as a result, new treatments for these behaviors have been developed. This article describes one such innovation—functional communication training, which involves teaching alternative communication to replace problem behavior. A great deal of research exists on the efficacy of this approach. This article reviews the literature outlining the conditions under which this intervention is successful and provides a comparison with other behavioral approaches to intervention. Functional communication training is an empirically validated approach to positive behavioral support for challenging behavior.
Autism, Augmentative Communication, and Assistive Technology
Authors: Mirenda Pat
Published: June 2008

This article provides a review of the empirical literature on a number of topics related to augmentative and alternative communication (AAC) and assistive technology as they have been used to support communication and learning in individuals with autism/PDD-NOS. The review is presented in six main topic areas: Assessment, Staff/ Family Training, Supports for Augmented Input, Supports for Augmented Input + Output, Supports for Augmented Output, and Assistive Technology for Communication and Learning. Finally, recommendations for future research are provided.
Effects of Symbol, Referent, and Instructional Variables on the Acquisition of Aided and Unaided Symbols by Individuals with Autism Spectrum Disorders
Authors: Koul Rajinder K. , Schlosser Ralf W. , Sancibrian Sherry
Published: June 2008

Individuals with little or no functional speech as a result of autism spectrum disorders frequently rely on aided and unaided augmentative and alternative communication (AAC) symbols and signs to augment or replace natural speech. This has led investigators to identify the variables that are responsible for the acquisition and communicative use of graphic symbols and manual signs. The overall aim of this article is to evaluate the role of symbol, referent, and instructional variables on the acquisition of AAC symbols by individuals with autism and severe speech and language impairments.
The Effect of an Augmentative Communication Intervention on the Communication, Behavior, and Academic Program of an Adolescent with Autism
Authors: Cafiero Joanne M.
Published: June 2008

This classroom intervention describes a nonverbal and behaviorally and cognitively challenged adolescent with autism who participates in a data-based, total immersion, augmentative communication intervention. Using a natural aided language approach and picture communication boards, the student was provided with intense visual-paired-with-verbal-language input in each activity and environment of his school day. Without training or prompting, the young man's picture language receptive and expressive vocabulary increased during the intervention. In addition, his positive behaviors increased. The increases in communication and positive behaviors dramatically altered the classroom staff's perception of the student, and as a result, his curriculum and IEP were made more complex, academic, and challenging.
Searching for Effectiveness and Efficiency in Conducting Functional Assessments
Authors: Johnston Susan S. , O'Neill Robert E.
Published: June 2008

There has been a tremendous increase in interest in and information about functional assessment and analysis strategies. However, teachers and other practitioners continue to struggle with choices about the most effective and efficient strategies for use in school and community settings. This article provides a review of current literature on the comparative validity of different assessment and analysis approaches. Based in part on this information, a process that can be followed by persons responsible for conducting assessments and developing and implementing behavior support plans is proposed.
Family Involvement in Functional Assessment and Positive Behavior Support
Authors: Dunlap Glen , Newton J. Stephen , Fox Lise , Benito Nila , Vaughn Bobbie
Published: June 2008

Recent developments in the field of autism and related disabilities have included two prominent themes: (a) the emergence of functional assessment (FA) as a requisite step in behavioral support and (b) a growing acknowledgment that families represent the most essential resource for the social, intellectual, emotional, and behavioral development of their children. In the vast majority of cases, families are the most committed, enduring, and knowledgeable source of personal support available for their children. Therefore, families are considered vital contributors in the educational process and, increasingly, in the application of FA and assessment-based behavioral interventions. This article provides a discussion of family involvement in the process of FA and offers some key considerations pertinent to the appropriate and optimal incorporation of families in the FA and intervention process.
Functional Assessment Strategies for Young Children with Autism
Authors: Schwartz Ilene S. , Boulware Gusty-Lee , McBride Bonnie J. , Sandall Susan R.
Published: June 2008

Functional assessments (FAs) are becoming more commonplace in early childhood special education. In this article we describe the FA procedures used in Project DATA, a school-based program to serve young children with autism and their families. These procedures consist of five interrelated steps: (a) gathering information, (b) brainstorming, (c) making a plan, (d) implementing the plan, and (e) evaluating the outcomes.
Application of Choice-Making Intervention for a Student with Multiply Maintained Problem Behavior
Authors: Peck Peterson Stephanie M. , Caniglia Cyndi , Royster Amy Jo
Published: June 2008

A functional behavioral assessment was completed for a 10-year-old boy with autism and problem behavior. The assessment indicated that both teacher attention and escape from task demands maintained his problem behavior. A choice-making intervention that involved allowing the participant to choose between completing work alone and subsequently receiving a break with teacher attention versus working with teacher assistance was implemented. Initial data collected on the intervention suggested that choice making decreased problem behavior. Thus, the intervention was adapted for many different applications across the school day. Anecdotal teacher records indicated that this reduced problem behavior across activities during the school day.
Employers' Attitudes Toward Persons with Disabilities in the Workforce
Authors: Unger Darlene D.
Published: June 2008

A review of literature on employers' attitudes toward workers with disabilities was completed. Factors that may affect employers' attitudes toward persons with disabilities in the workforce are provided, as well as a description of the methodologies used in the investigations. Although several key themes emerge, decades of employer attitudinal research has generally produced inconsistent findings due to variations in research design.
Peer Relationships as Support for Children with Disabilities
Authors: Overton Sheri , Rausch John L.
Published: June 2008

This article reports the results of a study to determine what mothers of children with disabilities considered important social goals and valid measures of success for their children concerning friendship development. Three focus groups were convened, consisting of 11 mothers of elementary-age students with various disabilities. A thematic analysis suggested 9 peer-specific friendship goals for children with disabilities and 3 broader goals to which friendship was perceived to contribute. Assessment of outcomes would be expected to include indicators of both types of goals, and specific indicators were suggested along the dimensions of (a) quantity and breadth of contacts, (b) affect or quality of relationships, (c) duration and stability of relationships, (d) level of independence of action, (e) consistency with parental expectations, and (f) contribution to overall adjustment. Implications of this research are discussed for teachers, administrators, program and curriculum developers, and researchers. The authors conclude that efforts to affect the peer relationships of children with disabilities in meaningful ways should consider the impact relative to these parental goals and should be based upon indicators that parents consider relevant and credible.
Analysis of Reading Skills in Individuals with Asperger Syndrome
Authors: Smith Myles Brenda , Hilgenfeld Tracy D. , Barnhill Gena P. , Griswold Deborah E. , Hagiwara Taku , Simpson Richard L.
Published: June 2008

The purpose of this study was to examine the reading performance of 16 individuals with Asperger syndrome. The students were administered the Classroom Reading Inventory (Silvaroli, 1993), and the results were analyzed to determine if individuals with Asperger syndrome present similar reading deficits, as posited by researcher and practitioners in special education. Findings of the study were discussed to better understand how the reading characteristics of students with Asperger syndrome affect classroom performance.