• Acquisition of Joint Attention Skills in Children with Cortical Visual Impairment

      Keith, Avery; Center for Applied Disability Studies
      Joint attention (JA) is a skill that is essential to children’s later social and language development. Previous studies have demonstrated the efficacy of various behavioural teaching strategies in increasing children’s responses and initiations of bids for joint attention. However, research has predominantly relied on gaze alternation to evaluate the attainment of joint attention. This is problematic as gaze alternation is not the only method of demonstrating the skill; other sensory modalities can also serve the same function. Accordingly, research on the ability to engage in bids for joint attention is scarce among the child population with cortical visual impairment (CVI). Despite the scarcity, theories suggest children with visual impairment can learn joint attention skills through enriching social experiences. Furthermore, competent caregivers could facilitate these positive experiences by means of body contact, verbalizations, and activities involving singing and rhythm. In the current study, we examined the effectiveness of caregiver-implemented behavioural teaching strategies to teach children with CVI to engage in joint attention related skills. A multiple baseline design across subjects was used with three children between 3-4 years with CVI. In addition, pre to post changes in children’s engagement in joint attention were monitored. The caregiver-implemented behavioural teaching strategies were highly effective in increasing two target JA-related behaviours for one of three participants. Further, the study offers preliminary evidence that JA performance can generalize to a novel caregiver. Potential implications of the study involve allowing for children with CVI to experience more positive social experiences and improving parent-child socialization and play.
    • An Analysis of Behavioural Interventions for Transition Difficulties of Children and Youth with Developmental Disabilities

      Jichici, Brynn; Center for Applied Disability Studies
      Successfully transitioning from one activity, task, or location to another is an important adaptive skill. For children and youth with developmental disabilities, these transitions can be especially problematic. The purpose of the current study was to systematically examine behavioural studies aimed at improving activity, task, and location transitions for children and youth with developmental disabilities. Four electronic databases (Education Source, Eric, PubMed, and PsycINFO) were searched resulting in 1,439 studies for initial data analyses. Of these studies, 19 met full inclusion criteria and were subjected to additional analyses. Key characteristics of the final sample were described. Existing behavioural treatments incorporated intervention strategies such as visuals, prompting using assisted technology, and video modelling across various settings. Rigour assessments of the final 19 studies resulted in a majority of “weak” quality studies (n =15). Overall, it appears that behavioural interventions may be effective in treating transition difficulties among this population; however, additional research is required.
    • An analysis of the systemic aspects of rights training for people with intellectual disabilities

      Mullins, Laura.; Centre for Applied Disability Studies (Brock University, 2009-02-16)
      Individuals with intellectual disabilities (ID) as a group have been subject to abuse. Individuals with ID need to be made aware of their rights. The 3Rs: Rights, Respect and Responsibility Human Rights Project is promoting rights awareness in individuals with ID, their caregivers and family members. To be effeCtive, abuse prevention must include support from the whole organization and its processes. This research evaluated the impact of the 3Rs initiative on the organization. It focused particularly on descriptions of organizational change perceived by full-time staff and managers in response to the initiation of the 3Rs Project. Behavioural interviews were conducted and a thematic analysis was used to describe changes in the organizational culture and behavioural mechanisms maintaining these changes. Systemic barriers to change were also explored. The results indicate that the Association is effectively implementing and supporting the rights-based philosophy.
    • Assessing a Modified TAGteach Procedure to Increase Accurate and Fluent Performance of Gymnastics Skills in Children via Synchronous Videoconferencing

      Bajcar, Nicole; Center for Applied Disability Studies
      Sports offer children and youth opportunities to experience the physiological, physical, and psychological benefits of physical activity; however, in sports like gymnastics, injuries are quite common (Caine, 2003). Therefore, it is essential for coaches to teach athletes proper technique to prevent injury. TAGteach is an intervention package that uses an audible stimulus to provide immediate feedback following the correct performance of a skill (Fogel et al., 2010). To date, no study has (a) evaluated the effectiveness of TAGteach to enhance the fluency of dynamic sports skills or (b) conducted TAGteach remotely via a synchronous videoconferencing platform. We used a concurrent multiple baseline across skills design to evaluate the effectiveness of a modified TAGteach procedure to improve the accuracy and fluent performance of three dynamic gymnastics skills through synchronous videoconferencing with four participants between the ages of 6–11 years. For all participants, the modified TAGteach intervention package increased the accurate and fluent performance of all gymnastics skills, and these gymnastics skills maintained for a minimum of 4 weeks. Results are discussed within the context of intervention implications and suggestions for future research.
    • Assessing the Utility of a Video-Based Motion Capture Alternative in the Assessment of Lumbar Spine Planar Angular Joint Kinematics

      Goncharow, Paul; Applied Health Sciences Program
      Markerless motion capture is a novel technique to measure human movement kinematics. The purpose of this research is to evaluate the markerless algorithm, DeepLabCut (DLC) against a 3D motion capture system (Vicon Motion Systems Ltd., Oxford, UK) in the analysis of planar spine and elbow flexion-extension movement. Data were acquired concurrently from DLC and Vicon for all movements. A novel DLC model was trained using data derived from a subset of participants (training group). Accuracy and precision were assessed from data derived from the training group as well as in a new set of participants (testing group). Two-way SPM ANOVAs were used to detect significant differences between the training vs. testing sets, capture methods (Vicon vs. DLC), as well as potential higher order interaction effect between these independent variables in the estimation of flexion extension angles and variability. No significant differences were observed in any planar angles, nor were any higher order interactions observed between each motion capture modality and the training vs. testing datasets. Bland Altman plots were also generated to depict the mean bias and level of agreement between DLC and Vicon for both training, and testing datasets. Supplemental analyses, suggest that these results are partially affected by the alignment of each participant’s body segments with respect to each planar reference frame. This research suggests that DLC-derived planar kinematics of both the elbow and lumbar spine are of acceptable accuracy and precision when compared to conventional laboratory gold-standards (Vicon).
    • Assessment of the Inter-Rater Reliability of the Behavioural Assessment and Treatment Taxonomy (BATT)

      Awan, Ateeq; Center for Applied Disability Studies
      Applied Behaviour Analysis (ABA) is an evidence-based approach for treating a range of behavioural challenges and skill deficits commonly associated with developmental disabilities such as Autism Spectrum Disorder (ASD). ABA-based interventions are typically tailored to the socially significant needs of the individual receiving treatment. This individualized nature of treatment delivery can make it challenging for wide-scale program evaluation within and across different ABA service providers. The Behavioural Assessment and Treatment Taxonomy (BATT) is a tool designed specifically for the purpose of standardizing the documentation of assessment and treatment strategies and enabling systematic evaluation of treatment outcomes. The purpose of this study was to assess the inter-rater reliability of the BATT using a retrospective study design (N = 112). The results demonstrated acceptable level of inter-rater reliability (κ > .80) across a number of target variables, although additional refinement of the BATT coding scheme is still required.
    • Back to Basics: Exploring gestural habits as cues for anticipating self-injurious episodes in a child with Autism and Deafness

      Fleishman, Melissa Helen; Center for Applied Disability Studies (2013-04-02)
      This research project is a longitudinal qualitative case study. It contributes to an understanding of self-injurious behaviour (SIB) by inviting the reader through the narrative of the lived experience of a fifteen year old child-informant and the network of individuals in his life. The value and importance of a case-study is that it focuses on the authenticity of the experience of living with disability. Through the use of detailed field observations, interviews and photo documents, the study thoroughly explores three main areas: quality of movements, potential cues as pre-cursors to episodes of self-injury, and purposeful communication. The research begins with a review of literature on Autism, Deafness and Self-injury, formulates the research design and orientation of Physical Education, Phenomenology and Semiotics, and then systematically explores four distinct phases in the analytical process. The aim was to explore self-injurious episodes in the child informant in hopes to translate the meaning of the behaviour and potentially utilize this to provide more opportunities for adapted physical activity. The findings reveal distinct patterns of movement cues utilized for different purposes. The implications of the findings are self-injurious episodes in the child informant are preceded by distinct patterns of movement that are potentially communicative. Suggested future direction of the research is expanding the scope to other disabilities for which verbal communication is challenging, and standardizing the translating tools to assist in understanding the communication of movement.
    • Beyond Displacement: Understanding the Intersection of Cultural Variables on Mental Health Service Utilization among Newcomers

      Davy, Brittany; Center for Applied Disability Studies
      Existing literature regarding mental health and mental health service access reveals disparities between the experiences of newcomers and their native-born counterparts. Previous studies have mainly focused on how the immigration process and displacement from one’s country of origin influence mental health. Comparatively, few researchers have explored the association between these contributing factors and culture in how immigrants and refugees understand their mental health and approach available services. The goal of this study was to understand newcomers’ perspectives on mental health service access and utilization in order to ultimately meet their mental health needs using a phenomenological approach to inquiry. Interviews and a focus group were conducted with 10 newcomers and 5 support staff at a newcomer community organization in the Greater Toronto Area. A thematic analysis of the narratives was used to identify themes among the data. Findings from interviews with newcomers revealed the following themes: (1) perceptions of mental health challenges are influenced by internal and external pressures, (2) cultural beliefs influence if and when newcomers seek medical intervention, and (3) expectations and experiences of accessing services within the Canadian healthcare system. Additionally, findings from the support staff focus group revealed the following themes: (1) the influence of undocumented status and financial difficulties on newcomers’ mental health challenges, (2) tension between newcomers’ openness with mental health challenges and stigmatization from others in their cultural communities, and (3) barriers and facilitators associated with help-seeking and mental health service utilization. The dissemination of these findings for restructuring current mental health services and providing efficient and effective support for this vulnerable population is discussed.
    • Burnout of Direct Support Workers of Adults with Intellectual and Developmental Disabilities: A Systematic Review

      Soucie-Vukmanich, Katelyn; Center for Applied Disability Studies
      Several work-related, client-related, and personal stressors have shown to increase burnout levels of developmental support workers (DSWs) who support adults with intellectual and developmental disabilities (IDD). These stressors have included work overload, control, client challenging behaviour, job satisfaction, and much more. However, a previous systematic review by Skirrow and Hatton (2007) reported that there remain no conclusive results about which variables trigger the development of burnout in this population and they reported that burnout levels of this population is average and comparable to other human service professions. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the methods of Skirrow and Hatton (2007), a systematic review of the literature was completed which reports the consistencies and magnitudes of correlations and predictors of burnout in the population of DSWs supporting adults with IDDs. Classical meta-regression analyses and forest plots were also completed and analyzed to compare the difference in burnout levels in the review completed by Skirrow and Hatton (2007) compared to the sample of burnout levels in this review. The results show that there are several variables which were consistently significantly associated with burnout of this population across studies while other variables were inconsistent in their association with burnout across the studies. For burnout levels, it was found that both emotional exhaustion and personal accomplishment scores have significantly worsened since Skirrow and Hatton’s (2007) review while depersonalization scores have improved. Overall, this research shows the vast array of variables which can impact the development of burnout, where client and work-related variables appear to have a more significant impact on burnout development than personal characteristics of DSWs.
    • Changes in Employment Skills and Quality of Life for Adults with Intellectual and Developmental Disabilities During Transition from Pre-Employment to Cooperative Employment

      Whittingham, Lisa; Center for Applied Disability Studies
      Persons with intellectual and developmental disabilities are usually excluded from vocational training and education, and employment opportunities. While a variety of postsecondary opportunities do exist for persons with intellectual and developmental disabilities to receive vocational training and education and to be employed, there is no guarantee that these opportunities will lead to an increase in quality of life and benefits to the individual. This study builds on the findings of previous studies (Bishop, 2013; Owen, Li, et al., 2015; Owen, Readhead, et al., 2015; Readhead, 2012) and explored the impact on job skill development and quality of life for individuals participating in the training program for a social enterprise. Six students with a developmental disability from the training program were interviewed three times across the course of their training and entry to the partnership. They were divided into two cohorts based on when they started the program. The Quality of Life Instrumentation Package (Renwick & Myerscough, 2012), the Job Observation and Behavior Scale (Rosenberg & Brady, 2000), the JOBS: Opportunities for Self Determination (Brady, Rosenberg, & Frain, 2006), and a semi-structured interview were administered to the participants. The scores and the narratives provided as part of the interview were analyzed for changes. Scores on both measures did not reveal a trend indicating a change in quality of life or job skill development; however, analysis of the narratives indicated changes in both quality of life and job skills. Furthermore, participants described changes in self-determination and the limitations of participating in work. These findings are discussed in terms of previous research completed with Common Ground Co- operative, the limitations of the selected instruments and procedures; and considerations for future research regarding the impact of social enterprises on quality of life.
    • Children with Neurodevelopmental and Behavioural Challenges: A Descriptive Case Study Examining the Integration of Dance and Behaviour Therapy Within Day Treatment

      Kalil, Dana; Center for Applied Disability Studies
      Dance is a form of physical activity that may improve motor skills and coordination while simultaneously providing opportunities for social interaction and promote development of socio-emotional skills. A manualized program, Dance with a B-E-A-T! (behaviour analysis and therapy), combines recreational dance with components of behaviour analysis and therapy to help facilitate improvements in motor skills, social skills, emotional regulation, and self-coping. Building on a pilot study completed by Davis et al. (in progress), the present study evaluated a similar program incorporating behavioural components such as antecedent strategies, positive reinforcement, a token economy, relaxation strategies and positive self-talk. In collaboration with day treatment staff of a mental health centre, the dance program was integrated within children’s day treatment. The intensive dance program was offered for five consecutive days to five participants with behavioural challenges (7-9 years) from the same day treatment cohort. The aim of this project was to use a blended behaviour therapy and dance program to teach three dance combinations and examine collateral benefits. Observational probes at pre and post-test measured percent of dance skills completed correctly, and in-person semi-structured interviews with the counsellor and elementary school teacher evaluated satisfaction of the program within day treatment. Results suggested a positive impact on the physical and social skills of participants; increased physical activity and bidirectional use of socio-emotional skills.
    • Clinician-Perceived Bridges and Barriers to Parental Implementation of Picture Exchange Communication System (PECS): An evaluation.

      Pessah, Danielle; Center for Applied Disability Studies (Brock University, 2013-01-14)
      Picture Exchange Communication System (PECS) is an augmentative and alternative communicative system that improves communication and decreases problem behaviors in children with Developmental Disabilities and Autism. The mediator model is a validated approach that clinicians use to train parents to perform evidence-based interventions. Parental non-adherence to treatment recommendations is a documented problem. This qualitative study investigated clinician-perceived factors that influence parental adherence to PECS recommendations. Three focus groups (n=8) were conducted with Speech Language Pathologists and Behavior Therapists experienced in providing parents with PECS recommendations. Constant comparison analysis was used. In general, clinicians believed that PECS was complex to implement. Thirty-one bridges were identified to overcome complexity. Twenty-two barriers and 6 other factors also impacted parental adherence. Strategies to address these factors were proposed based on a review of the literature. Future research will be performed to validate these findings using parents and a larger sample size.
    • Cognitive Behavior Therapy for Obsessive-Compulsive Behavior in Children with Autism Spectrum Disorder: A Comparison of Hierarchical Linear Modelling and Visual Analysis

      Yates, Heather; Center for Applied Disability Studies (Brock University, 2014-03-24)
      Behavioral researchers commonly use single subject designs to evaluate the effects of a given treatment. Several different methods of data analysis are used, each with their own set of methodological strengths and limitations. Visual inspection is commonly used as a method of analyzing data which assesses the variability, level, and trend both within and between conditions (Cooper, Heron, & Heward, 2007). In an attempt to quantify treatment outcomes, researchers developed two methods for analysing data called Percentage of Non-overlapping Data Points (PND) and Percentage of Data Points Exceeding the Median (PEM). The purpose of the present study is to compare and contrast the use of Hierarchical Linear Modelling (HLM), PND and PEM in single subject research. The present study used 39 behaviours, across 17 participants to compare treatment outcomes of a group cognitive behavioural therapy program, using PND, PEM, and HLM on three response classes of Obsessive Compulsive Behaviour in children with Autism Spectrum Disorder. Findings suggest that PEM and HLM complement each other and both add invaluable information to the overall treatment results. Future research should consider using both PEM and HLM when analysing single subject designs, specifically grouped data with variability.
    • Community Recreation and Leisure Activities in Adults with Developmental Disabilities who have Recently Relocated to Community-based Residences in Ontario

      White, Keeley; Center for Applied Disability Studies (2013-04-19)
      In 2009, the Ontario Government closed the last three remaining large-scale institutions for people with Developmental Disabilities (DD). The purpose of this study is to examine the community-based recreation and leisure activities of 87 adults with DD who have recently moved into the community. Study 1 provided a descriptive insight into the community recreation and leisure activities, and revealed that people with DD engage in low levels of community activities, however are reported to have the desire to engage more often. Staff reported that people with DD do not have the opportunities to engage in their preferable activities. Study 2 investigated the prbspective predictors of the number and frequency of community, recreation and leisure activities and found that a higher level of functioning predicted a greater number of community activities ([beta] = .26, P < .05), while both a higher level of functioning ([beta] = .38,p < .001) and greater preference ([beta] = .23. p < .05) predicted more frequent access to community activities. Future research and the implications of the findings for clinical practice and policy development were discussed.
    • A Comparative Analysis of Community-Based Service Providers for "Extreme" Case ASD: Exploring Activity Program Options

      Brown, Laurie-Beth; Center for Applied Disability Studies (Brock University, 2014-05-01)
      The purpose of my research was to examine how community-based organizations in the Niagara region provide programs for children with Autism Spectrum Disorder (ASD), who are considered to represent “extreme” or “severe” cases. A qualitative, comparative case study was conducted that focused on three organizations who provide summer recreation and activity programs, in order to examine the issues these organizations face when determining program structure and staff training; and to understand what the threshold for physical activity is in this type of setting, and how the unique needs surrounding these “severe” cases are met while attending the program. Purposeful sampling was employed to select a supervisor and senior staff member from each organization to discuss the training process, program development and implementation, and the resources and strategies used within their organization’s community-based program. A confirming comparative analysis was comparative analysis of a parents survey with six mothers whose children are considered “severe” indicated that camp staffs’ expectations are unrealistic where as the parents and supervisors have more realistic expectations within the “real world” of camp. There is no definition of “severe” or “extreme” and therefore severity is dependent upon the context.
    • Comparing an Interdependent and Dependent Group Contingency to Increase Physical Activity in Students During Recess

      Asaro, Madeline; Center for Applied Disability Studies
      Physical activity is defined as any body movement that requires energy expenditure. It has important physiological, mental health, academic, and cognitive benefits for children and youth. Despite these advantages, a large proportion of this population does not meet the minimum recommended amount of physical activity. Recent studies have shown that the interdependent group contingency (IGC) and dependent group contingency (DGC) improve physical activity; however, no comparison of the effects of these group contingencies on physical activity has been conducted. We used a multielement within a concurrent multiple baseline across classes design to compare the effectiveness of these group contingencies to increase physical activity in two classes of grade 5 students. Both group contingencies increased physical activity in both classes, with the IGC producing slightly higher levels of physical activity than the DGC at the class-wide and individual levels of analyses. Conversely, side effect data suggest that participants in both classes preferred the DGC. Results are discussed within the context of treatment decisions and suggestions for future research.
    • Comparing High-Probability Demands With and Without Food to Increase the Consumption of Healthy Food in Picky Eaters

      Tardi, Laura; Center for Applied Disability Studies
      The high-probability (high-p) instructional sequence is a nonintrusive antecedent-based intervention that involves the presentation of a series of high-p demands followed by one low- probability demand. To date, only nine studies have examined the effectiveness of the high-p sequence to treat food selectivity in children, and the findings have been mixed. In the current study, we used a multielement within a multiple baseline across food sets design to compare the effectiveness of two iterations of the high-p sequence to increase the consumption of healthy food in one picky eater. One iteration consisted of presenting three bites of a preferred food followed by a bite of the nonpreferred food and the other iteration consisted of presenting three bites of an empty spoon followed by a bite of the nonpreferred food. We found the high-p preferred food condition was more effective than the high-p empty spoon condition during one of two comparisons; however, we were unable to replicate the effectiveness of the high-p preferred food condition in the second comparison. Results are discussed within the context of the limitations and implications for future research.
    • Comparing the High-Probability Instructional Sequence with and without Food to Increase Consumption of Nonpreferred Foods in Children with Food Selectivity

      Leathen, Nancy; Center for Applied Disability Studies
      The high-probability (high-p) instructional sequence is a non-intrusive procedure involving the presentation of a series of high-p instructions followed by 1 low-probability instruction. To date, 9 studies – with mixed findings – examined its effectiveness to treat food selectivity in children. We used a multielement within a reversal design to compare the effectiveness and efficiency of 2 iterations of the high-p sequence to increase food consumption in 2 food-selective children: high- p with preferred food on a spoon and high-p with an empty spoon. For both participants, neither high-p sequence alone increased consumption. For one participant, consumption increased in the high-p empty spoon condition with the introduction of non-removal of the spoon (NRS). For the other participant, consumption initially increased in the high-p with food condition with the introduction of NRS plus re-presentation but subsequently decreased. Results are discussed within the context of treatment implications and suggestions for future research.
    • A comparison of functional behaviour assessment rating scales in a sample of children and youth with autism spectrum disorders

      Maire, Lisa K.; Center for Applied Disability Studies (Brock University, 2010-10-27)
      This study sought to compare the results of the Motivation Assessment Scale (MAS; Durand & Crimmins, 1988), Questions About Behavior Function Scale (QABF; Matson & Vollmer, 1996) and Functional Analysis Screening Tool (FAST; Iwata & Deleon, 1996), when completed by parent informants in a sample of children and youth with autism spectrum disorders (ASD) who display challenging behaviour. Results indicated that there was low agreement between the functional hypotheses derived from each of three measures. In addition, correlations between functionally analogous scales were substantially lower than expected, while correlations between non-analogous subscales were stronger than anticipated. As indicated by this study, clinicians choosing to use FBA questionnaires to assess behavioural function, may not obtain accurate functional hypotheses, potentially resulting in ineffective intervention plans. The current study underscores the caution that must be taken when asking parents to complete these questionnaires to determine the function(s) of challenging behaviour for children/youth with ASD.
    • A Comparison of Modified Food Chaining and Simultaneous Presentation Plus Nonremoval of the Spoon to Treat Food Selectivity in Children with Autism Spectrum Disorder

      McHugh, Catherine L.; Applied Health Sciences Program
      Feeding disorders can range from mild (e.g., food selectivity by taste or texture) to severe (e.g., total food refusal; Bachmeyer, 2009). If left untreated, feeding disorders can result in serious health ramifications, including malnutrition, growth delays, and developmental delays (Kern & Marder, 1996). Recent studies comparing commonly used occupational therapy (OT) treatments and empirically supported applied behavior analysis (ABA) treatments found that the ABA treatments were effective for all children while the OT treatments were ineffective for all children exposed to the OT treatment (Addison et al., 2012; Peterson, Piazza, & Volkert, 2016). We used a multielement design to compare a modified version of a commonly used treatment, food chaining, and an empirically validated ABA treatment to treat the food selectivity of 2 children with autism spectrum disorder (ASD). For both children, consumption of the target foods only increased during the ABA-treatment condition. We subsequently faded the size of the preferred food within the simultaneous-presentation arrangement, moved to a sequential-presentation arrangement, and then thinned the schedule of reinforcement. We will discuss the results within the context of treatment implications, limitations, and suggestions for future research.