Bruce Oddson

Development of the FOCUS (Focus on the Outcomes of Communication Under Six), a communication outcome measure for preschool children

Aim  Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real‐world changes in preschool children’s communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived from observations of change provided by parents and clinicians after speech–language therapy.

Baseline Depressive Symptoms Are Not Associated With Clinically Important Levels of Incident Hypertension During Two Years of Follow-Up. The Multi-Ethnic Study of Atherosclerosis

Previous longitudinal cohort studies have suggested an association between baseline depressive symptoms and incident hypertension. We assessed this possible association using data from the Multi-ethnic Study of Atherosclerosis, a population-based prospective cohort study of 6814 US adults from 4 different racial/ethnic groups. Baseline users of antihypertensive medications and participants lost to follow-up were excluded leaving 3914 participants. Patients with baseline depressive symptoms (n=622) were defined using a high score on the Center for Epidemiological Studies Depression Scale (≥16) or the use of an antidepressant medication. Hypertension was defined as systolic blood pressure of ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg or new use of antihypertensive medications plus physician diagnosis. Estimates were adjusted for known risk factors, including age, sex, baseline blood pressure, diabetes, and body mass index. Untreated blood pressure was estimated using an imputation approach. A total of 477 participants developed hypertension. Using relative risk regression, patients with baseline depressive symptoms did not have an increased risk of incident hypertension (relative risk: 1.02; 95% confidence interval [CI]: 0.99 to 1.05), although an association between tricyclic antidepressants and hypertension (relative risk: 1.20; 95% CI: 1.05 to 1.37) was observed in subgroup analysis. Depression, even after adjustment for covariates, was associated with small changes in systolic (+2.4 mm Hg; 95% CI: 0.2 to 4.7) and diastolic (+0.8 mm Hg; 95% CI: −0.6 to 2.3) blood pressures. Depressive symptoms may be associated with slight increases in blood pressure in this multiethnic cohort, but it is premature to conclude much without longer studies in other populations.

Measuring communicative participation using the FOCUS©: Focus on the Outcomes of Communication Under Six.

Background The FOCUS© is a new outcome tool for use by both parents and clinicians that measures changes in the communicative participation skills of preschool children. Changes in communicative participation skills as measured by the FOCUS were compared across three groups of children: those with speech impairments only (SI), those with language impairments only (LI) and those with both speech and language impairments (S/LI). Methods Participating families (n = 112, 75 male children) were recruited through 13 Canadian organizations. Children ranged from 10 months to 6 years 0 months (mean = 2.11 years; SD = 1.18 years) and attended speech-language intervention. Parents completed the FOCUS at the start and end of treatment. There were 23 children in the SI group, 62 children in the LI group and 27 children in the S/LI group. The average amount of the childrens therapy varied from 7 to 10 h. Results The FOCUS captures changes in communicative participation for children with a range of communication disorder types and severities. All three groups of children made clinically important improvements according to their FOCUS scores (MCID ≥ 16 points). The FOCUS captured improvements in intelligibility, independent communication, play and socialization. Conclusions The FOCUS measured positive changes in communicative participation skills for all three groups of children after 7–10 h of speech-language therapy. An outcome measure that targets only specific speech and language skills would miss many of the important social function changes associated with speech-language treatment.

Validation of the Focus on the Outcomes of Communication under Six outcome measure

The aim of this study was to establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS©),a tool designed to measure changes in communication skills in preschool children.

Clinical use of the Mayo-Portland Adaptability Inventory in rehabilitation after paediatric acquired brain injury

The Mayo-Portland Adaptability Inventory (MPAI; designed to be administered by clinicians) is a popular measure of disability following head injury in adults. Its acceptability, validity, and reliability were assessed for use with children. There were 335 children and adolescents (215 males, 120 females) aged between 1 and 19 years at injury (median age 9y 8mo [SD 5y]) in our sample. The test was acceptable to respondents, rapidly and easily administered, and required only small modifications. It demonstrated validity against client and parent reports of major symptoms. It demonstrated test-retest reliability within the limitations of our data and excellent interrater accord. Consequently, the MPAI is recommended for paediatric use for evaluating rehabilitation needs and therapy outcome.

Estimating ethnic differences in self-reported new use of antidepressant medications: results from the Multi-Ethnic Study of Atherosclerosis.

There is evidence that the utilization of antidepressant medications (ADM) may vary between different ethnic groups in the United States population.

Validity of the Communication Function Classification System for use with preschool children with communication disorders

To evaluate construct and predictive validity of the Communication Function Classification System (CFCS) for use with preschool children with a range of speech and language disorders.

Behavioural Assessment of Wilderness Therapy Participants: Exploring the Consistency of Observational Data:

Wilderness therapy (WT) provides an alternative treatment modality for a number of mental health issues. It holds particular appeal for at-risk youth, a population that is often less responsive to traditional psychotherapeutic interventions. Anecdotal accounts on the effectiveness of WT often show positive outcomes. Still, some researchers have questioned the value of WT outcome studies on the basis of dubious methodology. The current study sought to address this issue through its use of well-validated observational scales drawn from the Child Behaviour Checklist (CBCL). While on a canoe expedition, three trained raters assessed the conduct of a group of at-risk youth aged 15 to 18 years. Results showed very little inter-observer agreement (Cronbachs alpha = .12). The findings underline the challenges of measuring WT outcomes. Even when equipped with validated and behaviourally anchored instruments, there appears to be little consistency among observers in terms of the degree to which WT influences participant change. The study demonstrates that when structured observation of WT participants is undertaken, outcomes are less definitive. This supports the criticisms offered by previous researchers who have expressed that in the absence of improvements to WT research methods, outcome findings are likely to be of questionable validity.

Leadership Status Congruency and Cohesion in Outdoor Expedition Groups

The purpose of the present study was to examine the relationship between status congruency and group cohesion in outdoor expedition groups in an educational setting. Specifically, three aspects of status congruency were assessed in relation to group cohesion in four adventure canoe groups. The groups participated in 2-week expeditions in the northern areas of the Canadian provinces of Ontario and Quebec. The participants were 32 upper-year undergraduate students enrolled in a central Canadian university (Mage = 22.41, SD = 2.43 years). Results indicated that (a) individuals who ranked themselves higher in the groups status hierarchy compared to where their peers ranked them had lower perceptions of their attraction to their groups social pursuits; (b) perceptions of group cohesion were greater when individuals occupying formal leadership positions were higher in the groups status ranking (i.e., greater congruency between formal and informal status hierarchies); and (c) individuals who were members of groups that had some level of consensus regarding status rankings perceived their groups to be more cohesive than those who were members of the group that had no consensus.

An Environmental Scan of Adventure Therapy in Canada

We report on an environmental scan (ES) of adventure therapy (AT) literature, organizations, and activities in Canada. The ES methodology involved (a) an examination of final reports related to a series of national symposiums on AT in Canada, (b) a review of academic literature related to AT in Canada, and (c) a summary of AT programs and courses offered at post-secondary institutions across Canada. Analysis of the reports from five AT symposiums revealed broad variability in terms of delegates and organizations represented and suggested that AT is practiced or endorsed by a diverse array of individuals and organizations across Canada. The literature review uncovered 113 relevant articles, book chapters, and papers with a substantial Canadian contribution. Canadian academic literature on the topic is sparse, and AT training and education opportunities at Canadian institutions are very limited. Implications for the future development of AT in Canada are shared.