Lori Synhorst

Bulbar and speech motor assessment in ALS: Challenges and future directions

Abstract Bulbar motor deterioration due to amyotrophic lateral sclerosis (ALS) leads to the eventual impairment of speech and swallowing functions. Despite these devastating consequences, no standardized diagnostic procedure for assessing bulbar dysfunction in ALS exists and adequate objective markers of bulbar deterioration have not been identified. In this paper, we consider objective measures of speech motor function, which show promise for forming the basis of a comprehensive, quantitative bulbar motor assessment in ALS. These measures are based on the assessment of four speech subsystems: respiratory, phonatory, articulatory, and resonatory. The goal of this research is to design a non-invasive, comprehensive bulbar motor assessment instrument intended for early detection, monitoring of disease progression, and clinical trial application. Preliminary data from an ongoing study of bulbar motor decline are presented, which demonstrate the potential clinical efficacy of the speech subsystem approach.

Risk Factors Predictive of the Problem Behavior of Children at Risk for Emotional and Behavioral Disorders

Logistic regression analyses were used to establish the most robust set of risk factors that would best predict borderline/clinical levels of problem behavior (i.e., a t score at or above 60 on the Child Behavior Checklist Total Problem scale) of kindergarten and first-grade children at risk for emotional and behavioral disorders. Results showed that among the 11 risk factor domains considered, 5 were most predictive of borderline/clinical levels of problem behavior: externalizing behavior pattern, internalizing behavior pattern, early childhood child maladjustment, family functioning, and maternal depression. Within these 5 domains, the most robust set of individual risk factors were difficult child (i.e., temperament, parent management skills, interaction between temperament and parent management skills), destroys own toys, and maternal depression. Results, limitations, future research, and implications are discussed.

The Child Outcomes of a Behavior Model

Within 3-tier behavioral models, universal interventions are expected to prevent the onset of problem behavior in a majority of children altogether and to sustain improvements in child outcomes by the selected and indicated interventions. A cohort longitudinal design was used to assess the extent to which a 3-tier model achieves these expected outcomes. The respective universal, selected, and indicated interventions included Behavior and Academic Support and Enhancement, First Step to Success, and MultiSystemic Therapy. A total of 407 children in Grades K-3 from 1 of 4 longitudinal cohorts participated. The results of 2-level linear growth analyses indicate that the 3-tier behavior model achieved the anticipated outcomes with respect to social behavior. The results, limitations, and implications are discussed.

Development and Standardization of a Test to Measure the Emotional and Behavioral Strengths of Preschool Children

The purpose of the present study was to document the development and standardization of the Preschool Behavioral and Emotional Rating Scale and to examine its factor structure, internal consistency, and criterion validity. Data from a nationally representative sample (N = 1,471) of preschool children with and without disabilities were collected. An exploratory factor analysis identified four factors: Emotional Regulation, School Readiness, Social Confidence, and Family Involvement. The subscales and total instrument appear remarkably stable and consistent (.838 to .983). Age differences across 3-, 4-, and 5-year olds were small in magnitude, although girls were rated as possessing significantly more strengths than boys. Preschool children with disabilities were seen as having less emotional and behavioral strength than their peers without disabilities. The limitations and future research needs are discussed.

Profiles of Children Served in Early Intervention Programs for Behavioral Disorders Early Literacy and Behavioral Characteristics

Special education legislation has placed an increased emphasis on early intervention programs for children at risk for early literacy delays and behavioral disorders. Given this trend, it is important to understand the characteristics of students identified and served in at-risk programs. This study presents the findings from a cluster analysis on the early literacy and behavioral characteristics of 195 children screened at risk for behavioral disorders served in an early intervention program. Clustered variables included behavioral measures from the Early Screening Project (ESP; Walker, Severson, & Feil, 1995), Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992), and measures of early reading development from the Woodcock Reading Mastery Tests—Revised (WRMT-R; Woodcock, 1998). Split-half procedures and external criteria were used to validate results. Five distinct subgroups were revealed: Broad Risks, Academic Achievers, Primarily Behavior, Primarily Academic, and Extreme Behaviors. Results indicate heterogeneous characteristics and clear areas of behavioral and early reading risk between subgroups within the greater sample. Implications, limitations, and future research are discussed.

Assessing the Strengths of Young Children at Risk: Examining Use of the Preschool Behavioral and Emotional Rating Scale With a Head Start Population

Over the past decade, there has been an increased need for the development and use of psychometrically acceptable measures to assess the behavioral and emotional strengths of young children served in statewide preschool and Head Start programs. One measure developed to address this need is the Preschool Behavioral and Emotional Rating Scale (PreBERS), which is a strength-based instrument designed to evaluate the behavioral and emotional strengths of preschool children aged 3 to 5 years old. In a previous study with a nationally representative sample, researchers found that (a) the items of the PreBERS can best be described by a four-factor structure model (Emotional Regulation, School Readiness, Social Confidence, and Family Involvement), (b) the subscales and total measure have highly acceptable levels of internal consistency, and (c) differences were obtained for levels of strength for preschool children with and without disabilities. The findings of this investigation replicate these previous results with a national sample of children (N = 962) enrolled in Head Start programs. Confirmatory factor analysis and analyses of internal consistency and criterion validity provide support for the use of the PreBERS with children served in Head Start programs. Study limitations and implications are addressed.

Preschool Behavioral and Emotional Rating Scale (PreBERS): Test-Retest and Inter-Rater Reliability for Children with Disabilities

This article reports three studies that evaluated the test-retest and inter-rater reliability of the Preschool Behavioral and Emotional Rating Scale (PreBERS) (Epstein & Synhorst, 2009). First, teachers rated 63 children receiving school services for disability on the PreBERS, with two ratings one month apart. Second, paraprofessionals rated the same children on the PreBERS, with two ratings one month apart. Third, teacher and paraprofessional ratings were compared for inter-rater reliability between these observers. Correlations were large to very large in each of these studies, indicating that the PreBERS is a stable measure across time and raters. Recommendations for use of the PreBERS with preschool children with disabilities as well as directions for future research are discussed.

Confirmatory Factor Analysis of the Preschool Behavioral and Emotional Rating Scale (PreBERS) With Preschool Children With Disabilities

The Preschool Behavioral and Emotional Rating Scale (PreBERS) is a standardized, norm-referenced instrument that assesses emotional and behavioral strengths of preschool children. This study investigated whether the PreBERS four-factor structure (i.e., emotional regulation, school readiness, social confidence, and family involvement) could be replicated with an early childhood special education (ECSE) sample of children. Teachers who participated in the study rated a total of 1,103 preschool children with disabilities. Confirmatory factor analysis determined the extent to which the ECSE data fit the original four-factor PreBERS structure identified with the national normative sample. Results indicated that the four-factor structure demonstrated an acceptable fit with the ECSE sample.

Availability of Aftercare for Youth Departing Group Homes

ABSTRACT Aftercare has been suggested to improve the outcomes of youth who depart group homes. This project used a survey method to collect data from 38 agency leaders from across the United States on the aftercare supports they believed were available for youth departing group homes and returning to their homes/schools prior to high school graduation. The results revealed that 34% of agencies provided an aftercare service with a model, and 29% of agencies received external funding for aftercare. The findings are summarized and limitations and implications for future research are discussed.