Special Education Theses and Dissertations

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Open Access
Investigating Early Childhood Trajectories of Parenting Feelings and Behavior on Outcomes for Children with Developmental Delays and Disabilities
(University of Oregon, 2024-12-19) Pompan, Emily; McIntyre, Laura Lee
Social-emotional development is foundational to learning and has been linked to long-term academic, behavioral and mental health outcomes for children (i.e., Jones et al., 2015). In early childhood, social-emotional development is encouraged primarily through familial relationships. Children with developmental delays and disabilities (DD) are more likely to experience social-emotional delays which can impact participation in these everyday interactions and opportunities for learning. Families with children with DD may face additional stressors which compete with resources and opportunities for relationship-enhancing interactions, further impacting child social-emotional development (Chan & Neece, 2018). Parent-mediated interventions have been linked to gains in child social-communication and behavior (Stahmer & Pellecchia, 2015; Webster-Stratton & Reid, 2010; Wetherby et al., 2014), which may facilitate positive parent-child interactions. Such interventions may also support parent and family well-being. Less is known about the mechanism through which parent-mediated interventions impact child social-emotional outcomes for children with DD. The present study of 180 caregivers enrolled in a primary prevention RCT examined (1) how positive feelings and attitudes (PFA) about their parenting role relate to parenting behaviors during parent-child play, (2) change in the context of parent-mediated early intervention, and (3) predict social-emotional outcomes at school-age for toddlers with DD. Analyses included confirmatory factor analyses and latent growth models within a structural equation modeling framework. Results identified parent-mediated intervention as a mechanism for change in parenting play behavior and showed positive PFA as a predictor for school-age social interaction outcome. The significance of findings, study limitations, and suggestions for future research are discussed.
Open Access
Remote Delivery of Culturally Adapted Prevent-Teach-Reinforce for Families (PRT-F) Program with Chinese American Families of Young Children with Intellectual and Developmental Disability
(University of Oregon, 2024-12-19) Zhu, Jinlan; Machalicek, Wendy
The prevalence of challenging behavior, such as aggression, self-injurious behavior, tantrums, and noncompliance with everyday expectations among young children with intellectual and developmental disability (IDD), is higher than the prevalence of challenging behavior for children without disabilities. Without appropriate intervention, challenging behavior tends to persist in individuals with IDD, contributing to subsequent problems in school, home, and community life, as well as negatively impacting future independence. Parent education and training programs focused on supporting parents of children with IDD to learn and use evidence-based behavioral interventions with their child contribute to improved parent strategy use and increased confidence in supporting their child’s behavior and ultimately support decreased child challenging behavior and increased appropriate adaptive behavior. Prevent, Teach, and Reinforce for Families (PTR-F) is a manualized and evidence-based positive behavior support program, including parent education and training to assist families in resolving their children’s mild to moderate severity challenging behavior in home and community settings. Few studies have empirically examined the effectiveness of PTR-F or other positive behavior support parenting programs for culturally diverse families of children with disabilities. The current study examined the efficacy and social validity of a culturally adapted and telepractice version of the PTR-F for Chinese American families of young children with IDD in the United States. The PTR-F intervention program was culturally adapted for enhanced cultural responsivity to Chinese American families using Bernal’s Ecological Validity Model as a guiding framework and delivered remotely for improved feasibility in recruitment for the planned single-case research design study and enhanced scalability in future research. Six mothers and their children with autism spectrum disorder (ASD) participated. Two independent randomized concurrent multiple baseline designs across six parent-child dyads were used to examine the effects of the culturally adapted PTR-F intervention program when delivered by mothers on the decreased rate of target child challenging behavior. Two randomization strategies, case randomization and intervention start-point randomization, were used in this study. Each dyad was randomly to different baseline lengths ,and range-bound start point randomization was used to a priori determine the length of the baseline phase for each participant while retaining the logic of the staggered introduction of the intervention over time across parent-child dyads. Visual analysis combined with the non-parametric Tau-U and parametric magnitude of treatment effect size standardized mean difference analysis, revealed mixed results with a medium effect found for child challenging behavior in the first concurrent multiple baseline design group and small effects found in the second group. Parent perceptions of the acceptability, feasibility and effectiveness of the culturally adapted PTR-F intervention program’s goals, procedures, and outcomes were collected using standardized social validity questionnaires with the addition of open-ended responses and reported using descriptive statistics and parent responses to open-ended questions. Chinese American families of children with developmental disabilities including ASD are absent in the intervention literature. This novel examination of the effects of a culturally adapted family centered intervention on child challenging behavior suggests the promise of a culturally adapted PTR-F for Chinese American families to address their child’s challenging behavior. Implications for future research and practice are discussed.
Open Access
Narrative Language Production: Examining How Young Spanish-English Learners Use the English Language
(University of Oregon, 2024-12-19) Le, Trinh; Durán, Lillian
The study was conducted by examining 37 language samples of 37 Spanish-English kindergartners and first graders from a larger sample of the Multitudes Project in California. The focus was on investigating how these young English language learners produced narratives in English, what language elements they included, and whether these elements were correlated or had a relationship with the learner’s English proficiency. The language elements examined were divided into three different levels: macro-structure including the identification of narrative problems and solutions, micro-structure such as the use of nouns, pronouns, and verbs, and language complexity including sentence markers and tier-two vocabulary. The results showed that, at the macro-structural level, students identified more correct problems and solutions than incorrect ones. There was no significant difference between the identification of problems versus solutions and between kindergartners and first graders. At the micro-structural level, a large number of children did not use plural forms of nouns and no students used possessive case "‘s", which were explained respectively by the requirement of such use according to the narrative topic and language transfer structures. The use of pronouns was also Spanish-influenced with gender mixing and redundancy. Results of the use of past-tense verbs showed that most students provided more incorrect forms than correct ones. Only one-fifth of these students provided all correct verbs, suggesting an emerging skill of conjugating verbs in past tenses. Lastly, language complexity was reported to be starting to develop at this age. As these Spanish-speaking students started to learn English, they did not use complex vocabulary and structures in their narrative production, providing evidence to advocate for the use of emerging English vocabulary and translanguaging in language assessment for young English language learners. Weak and moderate correlations were found between grade and the use of pronouns, and between verbs and language proficiency. However, regression analyses indicated no significant relationship between language proficiency and these elements. Study limitations such as a small language sample size and the report of socio-economic status are discussed. Keywords: Language assessment, narrative assessment, narrative production, narrative language elements, multilingual learners, dual language learners, bilingual education, and bilingual development
Open Access
A Modified "Talk Aloud Problem Solving" Intervention to Improve IEP Decision Making in Pre-Service Special Education Teachers
(University of Oregon, 2024-08-07) Quinn, Sarah; Machalicek, Wendy
In this randomized multiple baseline across participants single-case design study, pre-service special education teachers received a modified Talk Aloud Problem Solving (TAPS) intervention to improve their use of problem-solving verbal behavior and reasoning skills when making instructional decisions. Special education teacher candidates may have limited opportunities for meaningful practice with the problem-solving required to synthesize various information about student strengths, needs, and current performance into high-quality instructional decisions. This is evidenced in the field by IEP analyses that consistently demonstrate poor quality documents that lack evidence of strong instructional decisions. In this study, instructional decisions include a goal, an evidence-based instructional practice that will be used to reach that goal, and modifications or accommodations based on the student’s needs that ensure access to the general curriculum. Dyads were trained using the TAPS curriculum to use effective problem solving and active listening language when presented with a student vignette. Visual analysis, Tau-U overlap analysis, and a between-case standardized mean difference effect size were calculated. Overall, the TAPS intervention improved the use of problem-solving language but an effect on decision-making quality could not be established. Implications and future research are discussed.
Open Access
Development and Initial Validation of a Measure to Assess Accessibility and Inclusion Factors Related to Tier 1 in Schoolwide Positive Behavioral Interventions and Supports
(University of Oregon, 2024-08-07) Mowery, Aaron; McIntosh, Kent
Background: Schoolwide positive behavioral interventions and supports (PBIS) is an evidence-based framework for implementing a continuum of behavior support practices in schools to improve student outcomes. Research suggests that students with extensive support needs (ESN) may not have access to the complete continuum of behavioral supports within their schools or be included in the implementation of PBIS. Research also suggests that some special education teachers and other educators who work with students with ESN may be uninformed about PBIS initiatives or excluded from implementation and evaluation processes in their schools. Investigators have examined PBIS evaluation tools and found the measures contained exceptions to providing support and instruction to all students and staff, such that students with ESN and educators associated with these learners could be omitted when the tools were administered to evaluate implementation fidelity. Purpose: The purpose of this study was to develop and initially validate a new add-on scale for the Tiered Fidelity Inventory (TFI; version 3.0). The new add-on scale, titled the Tiered Fidelity Inventory-Accessibility & Inclusion Rating (TFI-AIR), was designed to measure the extent to which implementation of Tier 1 in PBIS is accessible for and inclusive of students with ESN. Method: This study was conducted in two phases. In Phase 1 we assessed the content validity of the TFI-AIR. In Phase 2 we pretested the TFI-AIR in schools and assessed the measure’s usability according to Tier 1 team members. Results: Results from Phase 1 indicated that the content of the TFI-AIR was valid for assessing fidelity related to students with ESN. Results from Phase 2 showed that all Tier 1 team members rated the TFI-AIR as an efficient and effective measure that teams should administer at least once or annually as part of their regular practice. Conclusion: Although future research is needed before disseminating the TFI-AIR, this study provides initial evidence that the content of the TFI-AIR is valid for assessing accessibility and inclusion factors related to Tier 1 implementation for students with ESN, and there may be demand for such a measure from implementation teams interested in developing their PBIS systems to be more equitable and inclusive for students who have been historically marginalized or underserved in schools.
Open Access
Empathic Education: Perceptions of Self-Determination by Rightful Presence
(University of Oregon, 2024-08-07) Galaxy, Annie; Linan-Thompson, Sylvia
Grounded in empathic education and the concept of rightful presence, this study moved beyond dominant inclusion paradigms, such as the inequitable host-guest ‘hospitality’ relationship; crucially, the study design prioritized equitable communication access, ensuring that all participants’ stories were treated with equal reverence. This qualitative study investigated the impact of an expansively designed Unified Robotics program on perceptions of three self-determination needs – competence (effective performance), relatedness (belonging and social engagement), and autonomy (equitable decision-making access) – among Autistic students, students with intellectual dis/abilities, and general education students. The study was enriched by an examination of parent perceptions of those same values in their children. Pre- and post-season interviews probed students’ perceptions, while field observations provided additional data on students’ self-determination expressions. The study also appraised perceptions of benefits and costs associated with participation in the intervention across all participants. Qualitative analysis involved interpretive examination of extracts from interview responses to closed questions, where the interviews had been coded for the three self-determination needs. The Unified Robotics intervention yielded substantial perceived benefits for students’ self-determination at negligible cost. Findings consistently demonstrated improved student perceptions of self-determination after program participation, as corroborated by parent and teacher reports. Students described enhanced perceptions across all three self-determination needs, which was further supported by parent data and field reports. The program’s expansive design also promoted reflection, attitude changes, and rightful presence.This research highlights the transformative potential of empathic, expansively designed programs in fostering self-determination and rightful presence for all learners. It challenges traditional, dominant inclusion paradigms and emphasizes the importance of equitable, supportive educational environments for all students.
Open Access
Double Burnout: Exploring the Experiences of Autistic and Educator Burnout Among Autistic Educators in the United States
(University of Oregon, 2024-08-07) Newson, Alexandra; Nese, Rhonda
This study explored the intersection of Autistic burnout and educator burnout and it’s the impact on mental health and wellbeing for Autistic educators in the United States. Through collaboration with five Autistic Community Partners (ACPs), the research team interviewed five Autistic Educators (AEs) who had left the field of education about their experiences with burnout, flourishing, mental health, and quality of life. Reflexive and template thematic analysis were used to understand the differences between Autistic and educator burnout, barriers and facilitators to Autistic mental health and flourishing, and recommendations to support Autistic mental health. Six themes were co-constructed by the research team and then sent back to the AEs for review and member checks. Results indicated that Autistic and educator burnout are separate but intertwined phenomena that deeply affect the mental health and wellbeing of Autistic educators, even after leaving the teaching profession. Recommendations provided by AEs included rejecting neuronormative and heteronormative standards in education, creating neuroinclusive spaces that allow all educators to feel psychologically safe, and fostering spaces for Autistic flourishing within school environments. Limitations of the study and future research is discussed, as well as recommendations for promoting Autistic flourishing and mitigating barriers to educator mental health.
Open Access
Examining Relationships between Components of Implementation Fidelity and Student Response within the Context of an Early Numeracy Intervention
(University of Oregon, 2024-08-07) Lussier, Cayla; Clarke, Benjamin
Evidence-based mathematics interventions are critical for supporting students with mathematics difficulties. In research and practice, collecting implementation fidelity is important for ensuring that all the core components of the intervention are implemented as designed. Historically, implementation fidelity has been defined as multi-faceted including examinations of adherence, instructional quality, and student engagement, though mathematics intervention studies rarely report on fidelity components outside of adherence. The current study examined relationships between these different components of fidelity and whether they are associated with student mathematics outcomes, intervention group size, and interventionist characteristics within the context of a first-grade mathematics intervention. Findings revealed relationships between components of fidelity with student initial mathematics skill, however no relationship was observed between fidelity components and student mathematics growth. Findings for group size and interventionist characteristics were mixed. Limitations, implications for research and practice, and future directions are discussed.
Open Access
MODELING CAREGIVER-CHILD EMOTION REGULATION AND SOCIALIZATION PROFILES IN DAILY LIFE: A LATENT CLASS ANALYSIS EXPLORING ASSOCIATIONS WITH REGULATION SUCCESS AND EMOTIONAL LABILITY IN PRESCHOOL
(University of Oregon, 2024-08-07) Cox , Maggie; Giuliani, Nicole
The influence of caregiver responses to child emotions (ERSBs) on child emotion regulation development in preschool is well established. However, less is known about how caregivers regulate their own emotions (emotion regulation; ER) during daily parent-child interactions, or the relationship between caregiver ER and ERSB patterns. There is also a need to identify contextual and environmental variables which moderate the association between daily ER and ERSBs on regulation success, to inform targeted interventions which are responsive to differences in the presentations and needs of caregiver-child dyads. This dissertation used Ecological Momentary Assessment methods (N = 197, 3 surveys per day over 7 days) and Latent Class Analysis (LCA) to model daily ER and ERSB strategy profiles that the caregivers of preschool children use in daily life. Logistic regressions were run at the caregiver level to determine how caregiver ER is associated with caregiver responses to child emotions (ERSBs; also referred to as emotion socialization). Linear regressions modelled the relationships between caregiver ER and ERSB profiles and perceived success of regulating their own and their child’s emotions. Across all measurement occasions, results indicated regulation success was highest for caregivers in ER and ERSB profiles characterized by frequent endorsement of “no regulation.” However, ERSB and ER profiles characterized by high diversity (e.g., flexibility) in strategy were most successful for regulating the emotions of children with high emotional lability, and for regulating caregiver emotions at timepoints when caregivers endorsed experiencing a negative emotion, respectively. Thus, results of this study suggest that competence with diverse ER and ERSB strategies, and flexible application of strategies across situations, may be particularly beneficial for caregivers managing difficult or variable emotions in themselves and their child.
Open Access
Student Perception of School Climate Before and During the COVID-19 Pandemic
(University of Oregon, 2024-08-07) Gallo, John; Rodriguez, Geovanna
School climate is comprised of experiences of school life that reflect norms, values, relationships, teaching practices and systemic structures. A student’s perception of school climate can be impacted by individual-level (race and gender), school-level (school socioeconomic status, school size, and schoolwide practices), and district-level (institutional policies) factors. There is extensive evidence on the impacts of schoolwide supports such as Positive Behavioral Interventions and Supports (PBIS) on school climate. Specifically, there is a robust body of literature suggesting that fidelity of PBIS implementation is associated with positive school climate outcomes. In March 2020, schoolwide practices were disrupted as a result of the COVID-19 pandemic, where educational practices changed drastically for millions of students. The present study investigates how school-level student perception of school climate changed throughout the COVID-19 pandemic in 195 elementary schools who maintained school climate data through PBISApps (dataset #D0130). All schools were implementing PBIS and assessed school climate data once before and once after the onset of the pandemic. Multilevel modeling with piecewise time covariates was conducted to examine changes in school climate from the 2018-2019 (Time 1) to the 2021-2022 (Time 4) school year. Results suggested a statistically significant increase during the 2020 – 2021 school year, followed by a statistically significant decrease during the 2021 – 2022 school year. Results also showed a negative association between the percent of students receiving free and reduced lunch and a school’s overall student perception of school climate. Limitations of this study include the sample composition, possible inaccuracies of demographic data, and school modality of instruction. Findings from this study outline the importance of school climate assessment data and indicators that promote fidelity in implementation. Recommendations to support school assessment procedures are discussed.
Open Access
School Suicide Prevention: A Breadth and Depth Perspective
(University of Oregon, 2024-01-09) Rochelle, Jonathan; Seeley, John
The present study provides a breadth and depth perspective of the current landscape for school suicide prevention (SSP). Despite an increase in SSP programming, practices, and policy, there remains a gap in understanding of how widely these activities are disseminated and implemented. Additionally, there is a lack of knowledge around the adoption of recommended programs and practices once disseminated to school practitioners, along with what SSP-related barriers, successes, and goals that were identified and prioritized by schools. To address these gaps, a sequential mixed-methodology design comprised of two studies was conducted with a breadth-focused statewide needs assessment survey (i.e., Study 1), and a depth-focused multi-method pilot (i.e., Study 2). Findings from Study 1 indicate that SSP activity (i.e., evidence-based programs [EBPs] and recommended practices implementation) increases slightly from elementary, to middle, and up through high school; with statistically significant differences in implementation occurring for three EBPs (i.e., Mental Health First Aid [MHFA], RESPONSE, and Connect Postvention) and two recommended practices (i.e., SSP Curriculum and Guest Speakers) at the school level (i.e., elementary, middle, and high school). Additional Study 1 findings are discussed in regard to SSP activity differences across region classification and the association between SSP activity and school staff comfort level on the topic of suicide prevention. Findings from Study 2 identified clear categories and themes for SSP challenges and barriers, current successes, and prioritized goals. Study 2 also explored what key features of SSP were already being implemented within an MTSS structure. Interpretation of Study 1 and 2 findings, along with limitations, implications for practice and policy, and future research directions are discussed.
Open Access
The Impact of Caregiving on Caregiver's Identity in Dementia
(University of Oregon, 2024-01-09) Campbell, Savanah; Shune, Samantha
The purpose of this research was to explore how caring responsibilities impact caregivers’ identity over time in first-time caregivers of parents with dementia. Further aims were to gain a deeper understanding of the “invisible second patient” perspective. This was a phenomenological study utilizing semi-structured interviews to capture longitudinal change in caregiver identity over a five-month interview period. Questions arose regarding caregiver identity such as how familial care relationships shape one’s caregiver identity. Participation in this study appears to be therapeutic to participants and appeared to engender greater reflection of self overall. This study promotes further research into the impact of caregiving on caregivers’ identity as well as the continued need for support services that are culturally responsive to improve the health and well-being of the caregiver and their recipients.
Open Access
Examining Patterns and Predictors of Response to Mathematics Intervention
(University of Oregon, 2024-01-09) Lesner, Taylor; Clarke, Ben
Concerns about low mathematics achievement have created a push to increase national mathematics proficiency levels through research and policy. Efforts have largely focused on early mathematics interventions for students with or at risk for mathematics learning difficulties implemented within multi-tiered response to intervention (RTI) frameworks. Within these models, important educational decisions are based upon instructional response, making meaningful categorization of student responsiveness to intervention paramount. Across research and practice, intervention outcomes are typically thought of as a binary, with students considered either responsive or non-responsive to intervention. However, defining and categorizing responsiveness in more complex ways may reveal important differences between subgroups of students who exhibit distinct patterns of responsiveness over time. The present study explored patterns of response to an early mathematics intervention using data from the ROOTS Efficacy Project. Participants included kindergarten students at risk for mathematics difficulties who were randomly assigned to the ROOTS intervention condition (n = 880). Results of a latent profile analysis indicated that variability in response to a generally effective intervention was best captured by a more complex categorization framework encompassing four distinct response profiles: a moderate-risk, mildly responsive group; a moderate-risk, delayed response group, a high-risk, strongly responsive group; and a lower-risk, non-responsive group. Membership in each response profile group was predicted by pre-intervention performance on measures of both early mathematics and cognitive skills (visual-spatial, fluid reasoning, and working memory). On average, students with lower initial math skill and cognitive performance demonstrated stronger intervention response. Implications for future research and practice are discussed.
Open Access
Adverse Childhood Experiences and Parental Warmth: A Mixed Methods Analysis of Adversity and Parenting Behavior With a Community Sample of Mothers
(University of Oregon, 2024-01-09) Fisher, Stephanie; Giuliani, Nicole
Parenting is an important and complex experience that drives a child’s healthy development and well-being as an adult. Parenting has strong implications for child outcomes, and the link between a history of adversity and unsupportive parenting practices as an adult has been well-established in research. The effects of childhood adversity on supportive parenting, however, are still unclear. Parental warmth is a key component of supportive practices, but little is known about how exposure to adverse childhood experiences can impact warmth-related parenting behaviors. In order to investigate this relationship further, 84 mothers and their 3 to 5 year-old children participated in parent-child interactions and self-report measures. Data from the Adverse Childhood Experiences (ACE) Questionnaire (ACE-Q; Felitti et al., 1998) and related variables of importance were analyzed using a mixed methods approach with quantitative statistical analyses and qualitative analysis of non-participant observations. This study aimed to closely understand the relationship between ACEs and parental warmth by operationalizing ACEs in three distinct ways, assessing related parenting behaviors, discovering differences among mothers with high ACE scores, and exploring data synergistically guided by qualitative analysis. Findings from this study indicate that more exposure to adverse childhood events is related to fewer warm behaviors as a parent, and that socio-emotional factors may play an influential role in this association.
Open Access
Associations Between Caregiver Depression and Social Support Among Diverse Caregivers of Children with Developmental Delay and Autism
(University of Oregon, 2024-01-09) Taiwo, Abiola; McIntyre, Laura Lee
Caregivers of children with developmental delay (DD) or disabilities are at a higher risk of developing mental health problems like depression when compared to caregivers of children who are typically developing. Several factors, including child diagnosis and child challenging behavior, have been known to exacerbate caregiver risk for mental health problems. Social support has been investigated as a way to cope with caregiver depression, but limited research has examined these associations in the DD population, particularly among diverse caregivers. This exploratory study sought to provide information about the association between types of social support and caregiver depression in a sample of 175 ethnically and linguistically diverse caregivers who have children with DD or autism spectrum disorder (ASD). The following research questions were addressed: (1) Which types of social support (family, informal, formal) are viewed as helpful to caregivers of young children with DD/ASD? (2) Does utilization of social support vary by ethnicity (Latinx, non-Latinx)? (3) Which types of social support (family, informal, formal) are associated with caregiver depression? (4) Is the association between social support and caregiver depression moderated by child challenging behavior, child diagnosis (ASD vs DD), or ethnicity (Latinx vs. non-Latinx)? (5) After accounting for family sociodemographic variables (i.e., income, caregiver education, and ethnicity) is social support associated with caregiver depression? Study results for the first research question demonstrated that caregivers rated formal support as most helpful, and informal support as less helpful. The second research question indicated that caregivers’ ratings of the utilization of support did not vary by ethnicity. Results for research question 3 revealed that 1) total and family based supports were associated with caregiver depression and 2) neither formal nor informal supports were associated with caregiver depression. The fourth research question showed that the relation between social support and caregiver depression was not moderated by child challenging behavior, child diagnosis, or caregiver ethnicity. The fifth research question indicated that after controlling for caregiver income, education, and ethnicity, social support explained unique variance in caregiver depression scores. The results of this study have implications for professionals and clinicians, particularly when working with Latinx families during the early childhood period, as well as implications for effectively and efficiently accessing interventions aimed at improving access to support, and caregiver depression when parenting children with developmental delays and disabilities.
Open Access
Pathways to Parenting Stress and Challenging Behaviors for Preschoolers with Developmental Delays: The role of emotion regulation
(University of Oregon, 2024-01-09) Glenn, Elizabeth; McIntyre, Laura Lee
Background: Parents play a significant role in shaping children’s behaviors and their responses to emotions. Research has established a strong, bi-directional effect between parenting stress and children’s challenging behaviors. Research also suggests the ways in which parents respond to their own emotions to accomplish goals, termed emotion regulation (ER), may affect the same process in their children. This role is especially pronounced during the preschool period, and among children identified with developmental delay (DD). However, research has yet to clarify how both parent and child ER shape the relationship between parenting stress and children’s challenging behavior. This study aimed to explore the extent to which parent and child ER explain the pathway between parenting stress and children’s challenging behavior, among culturally diverse families of children with DD. Methods: Baseline data from 265 families enrolled in a larger intervention study were used for this project. Multi-modal measurement methods (parent-report and observation) were used to measure ER for parents and children. Confirmatory Factor Analysis indicated distinct constructs for different measurement modalities of ER, and thus, were tested separately in models. Structural Equation Modeling was utilized to test parenting stress as a moderator of the relationship between parent and child ER, and child ER and parenting stress as mediators of the relationship between parent ER and child behaviors. Results: Partial support was given to initial hypotheses, such that parenting stress moderated the relationship between parent and child ER only for observational data. The original mediation hypotheses were unsupported, however, exploratory models indicated child ER as a partial mediator to the relationship between parenting stress and children’s challenging behaviors. Confirmatory Factor Analyses supported a two-factor structure of parent emotion dysregulation for observational data. Conclusions: The results of this study entail implications for both intervention and future research. Interventions which focus on either parenting stress or child ER may prevent the development of behavioral challenges in children with DD. Future research must work to clarify the interaction between parent ER and parenting stress, as well as from a developmental perspective, investigate how child ER mediates the relationship between parenting stress and children’s challenging behaviors.
Open Access
Part C Early Intervention Referral and Eligibility for Children with Diagnosed Medical Conditions: An Exploratory Study in Two States
(University of Oregon, 2024-01-09) Yadav, Asha; Squires, Jane
Insufficient referral and participation in Part C Early Intervention (EI) services are common among children aged birth to 3 years, including those automatically eligible due to diagnosed medical conditions. States have established lists of diagnosed medical conditions to streamline eligibility determination for these children. However, there is limited understanding regarding the knowledge and utilization of the state-approved lists as well as the associated policies and referral practices, among pediatricians and Part C EI personnel. To address this gap and gather recommendations for improvement, a concurrent embedded mixed-method study was conducted in Michigan and Washington. The study involved survey questionnaire completed by 193 Part C EI personnel and 69 pediatricians, and semi-structured interviews with 45 Part C EI personnel and 22 pediatricians from both states. The findings revealed that pediatricians have significantly (p < 0.05) less knowledge of the state-approved lists, associated policies and referral practices compared to Part C EI personnel. There is considerable variability in how referral practices are implemented by pediatricians and Part C EI personnel, indicating a lack of common understanding. Based on these findings, recommendations are proposed. Some of the short-term recommendations include improving the state-approved lists, development of a state-wide universal web-based referral form for pediatricians and establishing a centralized fax number for efficient information transmission. In the long term, implementing an integrated electronic health record (EHR) system and providing comprehensive training on referral and eligibility determination processes for both Part C EI personnel and pediatricians are emphasized to enhance collaboration and improve EI services.
Open Access
Enhancing Health and Quality of Life for Persons with Dementia and Their Caregivers Through a Biopsychosocial Approach to Mealtime Management
(University of Oregon, 2024-01-09) Bayne, David; Shune, Samantha
Dementia is a progressive neurodegenerative disease characterized by sensorimotor, psychosocial, and physiological deficits. As a result of this neurological damage, persons with dementia (PWD) often experience difficulty with memory, attention, cognition, sensation, and motor functioning (Gordon et al., 2018; Heßmann et al., 2016; Jack et al., 2009). As neurological damage progresses, PWD require greater reliance on caregivers for completion of activities of daily living (ADLs) like showering, clothing, and eating (Isik et al., 2019; Petersen et al., 2018).One major contributor to the deaths associated with dementia progression is the development of swallowing disorders (dysphagia), with nearly all PWD developing some form of eating or swallowing impairment (Affoo et al., 2013; Ranier Wirth et al., 2017). Associated with these mealtime deficits, individuals with cognitive impairment are at increased risk for malnutrition, dehydration, and the development of pneumonia (Namasivayam & Steele, 2015; Rainer Wirth et al., 2016). The following study utilized a person-centered, holistic model of patient care to identify areas for caregivers to support PWD during mealtimes. Person-centered care, as opposed to disease-centered care, shifts the perspective away from disease management to treat the PWD as a whole person. A person-centered, holistic model of mealtime management addresses the cognitive, social, psychological, and physiological domains that effect mealtime performance. Utilizing a person-centered model of patient care for mealtime management leads to improved patient outcomes, increased quality of life, and increased satisfaction with care (Bangerter et al., 2017; Cartwright et al., 2022; Gallant, 2019; Han et al., 2016; Reimer & Keller, 2009). The following study utilized the Biopsychosocial Model of Mealtime Management in Persons with Dementia (Bayne & Shune, 2022), as a framework to create individualized caregiver training sessions that address the multifactorial issues leading to deficits in mealtime performance for PWD. Individualized caregiver training was provided with the goal of increasing mealtime performance in PWD, decreasing caregiver burden, and optimizing the dyadic relationship of caregiver/care recipient surrounding mealtime management. Participants with dementia in this study demonstrated increased intake, better quality of life, and mealtime related impairment and their caregivers demonstrated increase quality of life, increased confidence, and decreased difficulty with provision of mealtime assistance. The findings of this study provide further support for multicomponent intervention to best support mealtimes for persons with dementia and their caregivers.
Open Access
Part C Procedural Safeguards - Assessing the Understandability, Readability, and Availability to All Caregivers in Early Intervention
(University of Oregon, 2024-01-09) Griffin, Madeleine; Cycyk, Lauren
Historically, many caregivers are dissatisfied with their inclusion in their child’s EI services. As a potential solution to this problem, federal law mandates all states to provide parents with a procedural safeguard document. The purpose of this document is to outline the rights of the parent and the child within the EI system. The procedural safeguard notices from all 50 states in the United States, retrieved from states’ EI websites, will be analyzed for this study. The notices were examined for their use of plain language, their readability, and their availability in languages other than English. Additionally, the webpages on which the notices were found were examined for accessibility. Findings indicated that notices were of moderate understandability, availability in other languages and exceedingly low readability. The webpages on which the notices were found varied widely in accessibility. Implications for EI are discussed at the federal, state, and practitioner level.
Open Access
Title: Diversity, Equity, Justice, and Inclusion Competencies for Preservice Behavior Analysts: A Modified Delphi Study
(University of Oregon, 2024-01-09) Cohen Lissman, Dana; Machalicek, Wendy
Applied Behavior Analysis (ABA) is a systematic approach that utilizes human learning and behavioral principles to assist individuals and groups in achieving their objectives. Despite the increasing diversity of the US population, the ABA field is predominantly represented by White cisgender women. Existing literature stresses the importance of addressing diversity, equity, justice, and inclusion (DEJI) for marginalized individuals, yet most of it remains at a conceptual level. In a recently modified Delphi study, 90% of the suggested DEJI competencies reached consensus among ABA experts, being deemed important for incorporation into preservice behavior analytic training. The study highlights the necessity to raise awareness among preservice behavior analysts about the impact of oppression on marginalized clients and provides explicit training to challenge inequitable systems. The findings underscore the need for DEJI-focused curricula in preservice ABA programs, paving the way for future research and measurement tools in this vital area.