John C. Begeny

Running Out of Time: Physician Management of Behavioral Health Concerns in Rural Pediatric Primary Care

OBJECTIVE. The purpose of this work was to examine pediatricians’ responses to behavioral health concerns raised in the context of rural primary care visits with particular focus on time spent. METHODS. Research assistants directly observed 302 patient visits in 2 rural pediatric primary care offices. The length of the visit, concerns raised, and physicians’ responses were recorded. Interrater reliability, scored for 25% of observed visits, was strong. RESULTS. Behavioral, emotional, or developmental concerns were raised by either the parent or physician in 23.6% of all primary care visits observed. Approximately 9% of all visits were identified as a psychological consultation before the visit and lasted ∼7 minutes longer than visits for other reasons. Behavioral concerns were raised during ∼18% of visits not originally identified as a psychological consultation. In these cases, visit length increased by >5 minutes on average, a statistically significant difference. In addition, during these visits, discussion of behavioral concerns often consumed more than half of the visit. Data suggested that physicians were responsive to behavioral, developmental, or emotional concerns, engaging in further assessment, supportive statements, treatment, or referral in ∼97% of the visits when such concerns were raised. CONCLUSIONS. Findings converge with previous research, showing that approximately one quarter of all primary care visits involve a discussion of behavioral, developmental, or emotional concerns. Moreover, this study is the first to document the specific impact of such concerns on pediatricians’ time, often sited as a key reason why they struggle to effectively identify and treat behavioral concerns presenting in primary care. These data provide a starting point for controlled studies, including comparisons of rural versus urban samples and the impact of various collaborative models of care.

Teachers' perceptions of students' reading abilities: An examination of the relationship between teachers' judgments and students' performance across a continuum of rating methods.

Teacher perceptions about students’ academic abilities are important for several reasons (e.g., instructional decision making, special education entitlement decisions). Not surprisingly, researchers have investigated the accuracy of teachers’ decisions. Although some data reveal that teachers are relatively good judges of academic performance, other findings have suggested otherwise. A likely explanation for conflicting findings is the varying assessment methods (e.g., direct vs. indirect, norm-referenced vs. peer-independent) and different data analysis procedures that have been used across studies. The purpose of this study was to investigate a continuum of teacher-perception assessment methods as they corresponded to students’ oral reading fluency performance. Participants included 10 teachers and 87 first, second, and third grade students from a suburban school in the northeast. Overall results suggested that teachers were generally accurate when estimating students’ performance when students had strong oral reading fluency skills, but teachers had more difficulty judging students with average to low oral reading fluency. Further, data interpretation of teachers’ judgment accuracy differed somewhat depending upon the statistical method employed. Implications, limitations, and suggestions for future research related to this study are discussed.

A Model for Predicting the Presence of School Psychology: An International Examination of Sociocultural, Sociopolitical and Socioeconomic Influences.

School psychology exists in many countries around the world; however, it is far from ubiquitous. The extant literature offers limited empirical information addressing why school psychology may be present in some countries but not in others. The purpose of this study was to conduct a comparative investigation examining four sociocultural and sociopolitical theories that may help to explain the presence of school psychology within countries around the globe. The results from this study examining 108 different countries revealed that although the socioeconomic development of a country is an important explanatory factor of the presence of school psychology, it does not fully explain the presence of school psychology. Specifically, variables measuring a country’s modern mass cultural values and legacy of expenditures on social programs were independently predictive of the presence of school psychology. The implications and limitations of this study are discussed.

Inclusionary Education in Italy A Literature Review and Call for More Empirical Research

Since the 1970s, Italy has had a national policy of integrating nearly all students with disabilities into the general education classroom. As a result, many advocates of inclusion in the United States have identified Italy as an excellent example of how wide-range inclusion can be accomplished. However, some U.S. and Italian educators have expressed concern that very little research has directly examined Italys inclusion practices and outcomes. In this article, all of the available literature in English in a 20-year period that pertained to Italys inclusion outcomes and classroom practices was reviewed. Of the studies directly addressing Italys inclusion practices, survey studies were the most common, and very few studies used experimental methodology. Furthermore, survey studies generally found outcomes considered to be favorable toward inclusion practices, whereas the results from experimental studies called the benefits of full inclusion into question. Of the studies that described interventions for students with disabilities, only a small percentage was conducted in a general education setting. Implications, limitations, and future research directions are discussed.

Single-case effect size calculation: Comparing regression and non-parametric approaches across previously published reading intervention data sets

Growing from demands for accountability and research-based practice in the field of education, there is recent focus on developing standards for the implementation and analysis of single-case designs. Effect size methods for single-case designs provide a useful way to discuss treatment magnitude in the context of individual intervention. Although a standard effect size methodology does not yet exist within single-case research, panel experts recently recommended pairing regression and non-parametric approaches when analyzing effect size data. This study compared two single-case effect size methods: the regression-based, Allison-MT method and the newer, non-parametric, Tau-U method. Using previously published research that measured the Words read Correct per Minute (WCPM) variable, these two methods were examined by comparing differences in overall effect size scores and rankings of intervention effect. Results indicated that the regression method produced significantly larger effect sizes than the non-parametric method, but the rankings of the effect size scores had a strong, positive relation. Implications of these findings for research and practice are discussed.

Validity Estimates and Functionality of Materials and Procedures Used to Monitor the Implementation Integrity of a Reading Intervention.

Observing for, documenting, and improving implementation integrity are critical components of effective intervention services in schools. Without them, students may not receive effective intervention, and systems-level models of intervention service-delivery may never be properly evaluated or realize its potential. The purpose of this study was to develop and evaluate a comprehensive set of materials and procedures for observing interventionists’ use of a structured reading program. We examined the following research questions: (a) do direct observations of an interventionist using the program correspond with his or her self-report of implementation integrity; (b) do direct observations of an interventionist correspond with permanent products that are generated from the intervention; and (c) did the observation and feedback procedures result in interventionists using the program more successfully? Primary findings showed that the observation and feedback procedures were effective in producing strong implementation integrity among the interventionists, self-report of implementation integrity was highly accurate, and permanent products (though used properly) do not seem to correspond well with overall measures of implementation integrity.

Development of Conceptually Focused Early Numeracy Skill Indicators

This research was conducted to evaluate the technical properties of a set of early numeracy CBM tests that were designed to operationalize early numeric concepts. Data were collected over the course of a school year from 113 kindergarten and first-grade children using nine separate tests with three alternative forms. In addition, test–retest reliability was examined. Correlational design methods were used to examine the consistency of the tests as well as their relation to criterion measures. Receiver operating characteristic (ROC) curves were also generated and inspected to examine diagnostic accuracy. Results indicated that two tests demonstrated strong technical properties across all three analyses, and an additional two demonstrated promise. Methodological improvements to test procedures should be addressed in future research, and linking assessment to intervention can be facilitated using tests developed in the current study.

Using Small-Group Instruction to Improve Students' Reading Fluency: An Evaluation of the Existing Research

ABSTRACT Reading fluency is necessary for reading comprehension, but approximately 40% of U.S. fourth-grade students have inadequate reading fluency skills. Because small-group (SG) instruction is often used as a first line of intervention for struggling readers, SG instruction targeting deficiencies in text reading fluency ought to be part of every schools intervention toolbox. The authors summarize the existing research on instruction and interventions that specifically targets reading fluency and is implemented by an adult with 3 or more students at once. Key findings revealed that most studies used a single-case design, nearly all studies were rated positively in terms of methodological quality, and the majority of participants significantly improved as a result of receiving SG intervention. Furthermore, of the five studies examining comparable SG and 1-on-1 interventions, 79% of the students performed equally well from both interventions. Implications and several recommendations for future research are discussed.

Evaluating contextually adapted reading interventions with third-grade, Costa Rican students experiencing significant reading difficulties

Scholarship in school psychology has continued to document the need and importance of contextually relevant intervention and prevention research, but this type of research remains relatively scarce. Also problematic, this type of research is even more limited in low- and middle-income countries (LMIC) compared to high-income countries. This situation within school psychology scholarship not only has negative implications for research and practice, it also limits internationalization within the discipline. The geographical context for the present study was in Costa Rica, currently a Latin American LMIC. Given the global importance of literacy, this article describes an experimental evaluation comparing two time- and resource-efficient reading interventions that differed only by instructional grouping: A one-on-one intervention, and an even more resource-efficient small-group intervention. Participants included third-graders experiencing significant reading difficulties. Analyses showed that all students benefitted from intervention, but some students responded somewhat more favorably to one intervention versus the other. Limitations, implications, and future research directions are discussed, particularly within the context of international school psychology and how professionals in the discipline can benefit from more intervention research in otherwise underrepresented global regions.

Tier 2 Reading Fluency Interventions With Middle School Students: A Comparison of the HELPS-SG Program and a Teacher-Directed Evidence-Based Intervention

ABSTRACT This randomized study evaluated two evidence-based reading interventions with 121 middle school students who presented with reading fluency deficits. One intervention was teacher-directed and utilized numerous evidence-based strategies; the other intervention, the Helping Early Literacy with Practice Strategies for Small Groups Program, provided a structured implementation protocol of evidence-based strategies and specific intervention materials. Students in both groups demonstrated statistically significant growth on standardized measures of reading fluency and comprehension, but there were no differences between intervention conditions for any of the dependent measures. Practical implications for using oral reading fluency interventions at the middle school level are discussed.