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Thus, baseline communication level is likely one child characteristic that influences treatment outcomes. Likewise, another reason for differences in intervention outcomes may be related to the fit of treatment strategies to the pre-intervention characteristics, needs and strengths of participating parents and families.
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For instance, in a recent randomized controlled trial, Wetherby et al. Findings showed greater improvements on child outcome measures of social communication, adaptive behaviors, and developmental level for individualized home-based parent coaching versus parent training delivered in a group setting. Thus, tailoring intervention to fit the needs of individual families may be more effective in improving child communication outcomes than a one-size-fits-all approach.
Although an emerging body of evidence supports the inclusion of pre-treatment child characteristics e. The Siller et al. One potentially influential variable in parent uptake of a parent-mediated intervention is parent gender. Moreover, specifically examining the contributions of fathers is important given that fathers of both children who are typically developing and at risk use language models that are distinct from mothers and thus may influence child language in unique ways. Paternal communication styles may be facilitative in supporting child social communication development.
For children with ASD, who have impaired awareness of the impact of their communicative signals on others, the directive, didactic communication style of many fathers may help them to clarify their message, and increase their awareness of the impact of their communication on others. For instance, research with low-income families has shown that fathers who read, tell stories, and sign songs, have preschool aged children with better pre-literacy and attention skills Baker, Thus, parent gender is one important, although often overlooked, variable that could impact the effectiveness of parent-mediated communication intervention for children with ASD.
Another potentially relevant parent variable is the broad autism phenotype.
Specifically, researchers have defined three primary components of the BAP: a aloofness; b rigid personality; and c pragmatic language deficits Hurley et. Aloofness is characterized by diminished interest in or enjoyment of social interaction. Rigid personality is defined as difficulty adjusting to change. Finally, pragmatic language problems refer to deficits in the social use of language, resulting in reduced effectiveness of communicative exchanges.
Emerging evidence suggests that BAP characteristics can impact the communicative effectiveness of parents during exchanges with other adults. For example, compared to parents of children with Down syndrome, parents of children with ASD were found to use less frequent eye contact in interactions with adult examiners, and fathers of children with ASD used significantly less eye contact than mothers Ruser et al. Specifically, parental BAP was related to a higher overall rating of negative affect in couple interactions.
Moreover, parental BAP levels moderated the impact of parents reporting a high level of child ASD symptoms and co-occurring behavior problems on same and next-day ratings of negative couple problem-solving interactions. Taken together, results of these studies suggest that the BAP may impact parent couple interactions and adult-adult communication. Likewise, the BAP may also influence parent-child communication.
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Given the strong link between the quality of early parent-child communication and later language outcomes for children with ASD, understanding any potential relationships between parental BAP and child communication skills may have important clinical implications for parent-mediated interventions.
Finally, appropriately interpreting associations among parent characteristics, parent-child interaction variables, and child outcomes requires mindfulness that parents and children have bidirectional impacts on one another. The effects that children are having on the nature of parent-child interactions have received less explicit attention. This study represents an initial effort to examine some of these interrelationships among parental BAP characteristics, parental verbal responsiveness, and child behaviors in the context of parent-child interactions involving mothers versus fathers.
The long-term goal of this program of research is to develop an individualized, parent-implemented, social communication intervention for young children with ASD that effectively involves both fathers and mothers. The aims of the current study were to investigate several unanswered questions regarding relationships between parent responsiveness and BAP characteristics and the language skills of children with ASD.
Specifically, this investigation sought to identify any concurrent associations between parental BAP characteristics and child engagement and language skills, and to examine whether associations between parental BAP characteristics and child language remain significant after accounting for parental verbal responsiveness. We predicted that child engagement and language skills would be concurrently negatively associated with scores on the Broad Autism Phenotype Questionnaire BAPQ , a measure of parental BAP characteristics. In addition, we predicted that concurrent negative relationships between parental scores on BAPQ subscale and child language skills would decrease with increased parent use of responsive verbal behaviors.
Sixteen children with ASD 12 boys and 4 girls and their mothers and fathers participated in this study. Child participants met the following inclusion criteria: a chronologic age between 36 and 69 months; b existing clinical diagnosis of ASD, confirmed by the cutoff scores on the Autism Diagnostic Observation Schedule ADOS; Lord, Rutter, DiLavore and Risi ; c no severe sensory or motor impairments; and d no identified metabolic, genetic, or progressive neurological disorders.
In addition, each participating child was required to have two biological parents, or married caregivers, residing with the child continuously since birth. Table 1 provides demographic information for parents and children. Although each children in study had a previous community diagnosis of autism, the ADOS was administered by research-reliable project staff in order to confirm diagnosis of ASD and obtain severity scores for fifteen of the sixteen participating children.
For one child, ADOS had recently been completed by the local agency determining Part C eligibility and scores were shared with study, however the ADOS was not administered by project staff. Calibrated severity scores range from 1 to 10, with scores from 6 to 10 corresponding to approximate fifths of individuals included in Gotham et al.
Severity scores are reported for children in our sample for descriptive purposes see Table 2. The MSEL Mullen, is a comprehensive measure of cognitive function for children from birth to 68 months of age. The test is comprised of five subscales: gross motor, visual reception, fine motor, receptive language, and expressive language. The MSEL is recommended for evaluating verbal and non-verbal development quotients for young children with autism Akshoomoff, The Visual Reception VR subscale measures visual processing skills, spatial organization, and visual memory.
For participating children, scores obtained within 3 months were shared from larger projects, or the VR subtest was administered concurrent with their participation in this study for three children. The PLS-4 is a standardized measure of receptive and expressive language skills for children birth to 6 years, 11 months of age. The test is composed of two subscales: Auditory Comprehension and Expressive Communication. The PLS-4 yields norm-referenced scores for each subscale, as a well as a total score computed from the two subscales.
PLS-4 standard scores have a mean of and a standard deviation of For analytic purposes, total language raw scores were used as the metric of child language skills, as 5 of 16 children in this study obtained the lowest possible total language standard score i. Table 3 describes BAPQ scores for participating parents.
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Sensitivity and specificity of composite scores are Although the current study included only 16 mother-father dyads, a wide range of BAP characteristics were represented within the parent sample. Among individual parents, three mothers and five fathers did not meet criterion on any of the BAPQ subscales Aloof, Rigid, Pragmatic Language ; whereas, two mothers and three fathers met criterion on all 3 subscales. In addition to the wide range of BAPQ scores for individual mothers and fathers, there was also a wide range of combinations of BAP characteristics within and across parent couples.
For example, at one extreme, two mother-father dyads did not meet criterion for any of the three BAPQ subscales. At the other extreme, for one parent dyad, the mother met criteria for all three BAPQ subscales whereas the father met for none. Table 4 describes the various BAP characteristics of the 16 parent couples. Upper case letters identify married mother-father dyads.
Best estimate cutoff scores are as follows: Male : Aloof, Pragmatic Language: 2. Participating parents completed a demographic questionnaire to indicate ethnicity Hispanic or non-Hispanic and race i. Mother-child and father-child fifteen-minute naturalistic play observations were conducted in the lab. The order of mother-child and father-child sessions was counterbalanced across parents to control for order effects.
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Two different standard, parallel sets of age-appropriate toys were assembled so that toys would be equally novel to each child in play sessions with mothers and with fathers. Each toy set included masculine male figures, trucks, cars , feminine female figures, baby dolls and gender-neutral blocks, twirlers categories. Feel free to use some or all of the toys. We ask that if you are going to sit, parents sit in the larger blue chair so that it is easier to see the child on video.
Observational measures in this study were adapted from a coding schema developed by Yoder, Fey, Thompson, McDuffie, and Lieberman Using Procoder software Tapp, , fifteen minutes of each parent-child play session were coded at 5-second intervals intervals. Coding was conducted in three passes. On the first pass, coders determined whether each 5-second interval was either a codeable or b uncodeable.
Codeable intervals required the child to be visible on screen for the entire 5-second interval period. For all codeable intervals, child engagement was then coded on the second pass through the media files. On the second pass, child-initiated engagement was coded for all intervals in which the child either looked at or physically touched an object or person. Child-initiated engagement in this study did not require that the child initiate an intentional communication bid to the parent.
Touch engagement was not coded if a child was engaged in perseverative or self-stimulatory use of an object. For intervals in which a child both actively touched one toy, but looked at another, the child was credited with visual engagement. If a child was not engaged with either looking at or touching a person or object e. On the third pass through the media files, parent responses were coded for each 5-second interval for which a child was coded with visual or tactile engagement on the previous pass.
Parent utterances i. In addition, parent use of affirmatives e. Coding of parent-child observations videos was completed by two coders, with backgrounds in public health, and communication sciences and disorders, respectively. The second coder independently coded the full parent-child play sample and then codes were compared. ICC values were uniformly above. ICCs were as follows: codeable,. Table 2 describes child assessment data.
Sessions were scheduled on weeknights and Saturdays, as needed, to allow both fathers and mothers to participate. Prior to answering the research questions, distributions of variables were examined to determine whether they met assumptions of normality. Next, associations between levels of household income and parent education and measures of child language skills and parent verbal responsiveness were examined.
To answer the three research questions, correlations were run between: 1 parent BAPQ subscale scores and parent responsiveness; 2 parent BAPQ subscale scores and child language raw scores; and 3 parent BAPQ scores and child language raw scores, controlling for parent responsiveness. For all correlations, non-parametric Spearman rho was utilized.
The Spearman correlation coefficient is based on the ranked values for each variable rather than the raw data and is appropriate for examining monotonic relationships between two variables, in which the variables tend to change together, but not necessarily at a constant rate. Statistical analyses were conducted using SPSS Results of data analysis procedures are described relative to each of the research questions below. Therefore, as the frequency of child-initiated engagement increased, mothers tended to show less aloof and rigid characteristics, as indicted by lower BAPQ subscale scores.
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The directions of these nonsignificant associations also varied Table 5. Several findings emerged. This finding is consistent with findings from other recent studies documenting associations between maternal BAP traits and child social communication skills Hasegawa et al.
www.gbrmag.com/wp-includes/sisym-clorochina-miglior-prezzo.php In considering these findings however, it is important to remember that the operational definition of a child-initiated engagement in this study does not require that the child initiate an intentional communication bid to the parent.