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Intensive Intervention (intensive + intervention)
Selected AbstractsIssues related to the diagnosis and treatment of autism spectrum disorders,DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2007Paul T. Shattuck Abstract This paper explores issues and implications for diagnosis and treatment, stemming from the growing number of children identified with autism spectrum disorders (ASDs). Recent developments and innovations in special education and Medicaid programs are emphasized. Eligibility determination policies, innovations in diagnostic practices, the cost and financing of assessment, variability among programs in diagnostic criteria, and racial/ethnic disparities in the timing of diagnosis all influence the capacity of service systems to provide diagnoses in a timely, coordinated, accurate, economical, and equitable manner. There are several barriers to the more widespread provision of intensive intervention for children with ASDs, including lack of strong evidence of effectiveness in scaled-up public programs, uncertainty about the extent of obligations to provide services under the Individuals with Disabilities Education Act, high cost of intervention, and variability among states in their willingness to fund intensive intervention via Medicaid. Innovative policy experiments with respect to financing intensive intervention through schools and Medicaid are being conducted in a number of states. © 2007 Wiley-Liss, Inc. MRDD Research Reviews 2007;13:129,135. [source] Reflecting on Type 2 Diabetes Prevention: More Questions than Answers!DIABETES OBESITY & METABOLISM, Issue 2007J. Rosenstock Given the enormous public health and economic burden posed by the global epidemic of type 2 diabetes mellitus (T2DM), intervention in the prediabetes stage of disease to prevent progression to T2DM and its vascular complications seems the most sensible approach. Precisely how best to intervene remains the subject of much debate. Prudent lifestyle changes have been shown to significantly reduce the risk of progression in individuals with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Although lifestyle modifications are notoriously difficult to maintain, there is evidence that intensive intervention results in continued preventive benefit after the stopping of structured counselling. A number of drug therapies, including metformin, acarbose, orlistat and rosiglitazone, have also been proven effective in preventing progression from IFG/IGT, but unresolved issues still remain. Specifically, whether large numbers of individuals with glucose dysregulation who may never progress to T2DM should be exposed to the risk of pharmacological adverse effects is a topic of discussion and debate. Furthermore, there are limited data on the effectiveness of implementing interventions during the prediabetic state to prevent cardiovascular complications that may be hyperglycaemia related. A recent American Diabetes Association (ADA) consensus statement on IFG/IGT recommends lifestyle modification for individuals with IFG or IGT. Of note, the ADA consensus statement introduces the option of adding metformin treatment to lifestyle changes in those individuals who have combined IFG/IGT plus an additional risk factor for progression and who also have some features that increase the likelihood of benefiting from metformin treatment. The dipeptidyl peptidase-4 inhibitors are a new class of oral antidiabetic agents that, in addition to being effective in improving glycaemic control, may exert beneficial effects in preserving ,-cell function. These characteristics, combined with a low risk of hypoglycaemia, weight neutrality and what appears , so far , to be a relatively benign tolerability profile, make these agents intriguing candidates for preventive treatment. [source] Lipid-lowering therapy in patients with type 2 diabetes: the case for early interventionDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 4 2008Armin Steinmetz Abstract Chronic complications of type 2 diabetes, in particular, macrovascular complications, confer substantial morbidity and mortality and adversely affect a patient's quality of life. Early intensive intervention to control cardiovascular risk factors is essential in clinical management. Atherogenic dyslipidaemia characterized by elevated triglycerides, a low level of high-density lipoprotein cholesterol (HDL-C), and an increase in the preponderance of small, dense low-density lipoprotein (LDL) particles, is a key modifiable risk factor for macrovascular diabetic complications. Lowering low-density lipoprotein cholesterol (LDL-C) with a statin (or the combination of statin and ezetimibe) is the main focus for reducing cardiovascular risk in patients with diabetes. However, statins fail to address the residual cardiovascular risk associated with low HDL-C. Fibrates are effective against all components of the atherogenic dyslipidaemia associated with type 2 diabetes. Secondary analyses of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study suggest a role for early treatment with fenofibrate in improving cardiovascular risk reduction in type 2 diabetes and provide safety data supporting the use of fenofibrate in combination with a statin. Data from the FIELD study suggest that fenofibrate may also have potential to impact on microvascular diabetic complications associated with type 2 diabetes. Data are awaited from the ongoing Action to Control Cardiovascular Risk in Diabetes (ACCORD) study to evaluate the outcome benefits of combining fenofibrate with a statin in patients with type 2 diabetes. Finally, in view of divergent study results and outstanding data, assessment of the risk of the individual with type 2 diabetes is mandatory to assist clinical decision-making when initiating lipid therapy. Copyright © 2008 John Wiley & Sons, Ltd. [source] Jump start exit criterion: Exploring a new model of service delivery for the treatment of childhood feeding problemsBEHAVIORAL INTERVENTIONS, Issue 3 2009Bianca Pizzo While the literature on the assessment and treatment of childhood feeding disorders continues to grow, little research has focused on developing new forms of service delivery. This study demonstrates the effectiveness of a brief, intensive intervention for the treatment of food selectivity in three boys who had failed to progress in traditional outpatient treatment. The implications of this model of service delivery are discussed. Copyright © 2009 John Wiley & Sons, Ltd. [source] Computer-delivered interventions to reduce college student drinking: a meta-analysisADDICTION, Issue 11 2009Kate B. Carey ABSTRACT Aims This meta-analysis evaluates the efficacy of computer-delivered interventions (CDIs) to reduce alcohol use among college students. Methods We included 35 manuscripts with 43 separate interventions, and calculated both between-group and within-group effect sizes for alcohol consumption and alcohol-related problems. Effects sizes were calculated for short-term (,5 weeks) and long-term (,6 weeks) intervals. All studies were coded for study descriptors, participant characteristics and intervention components. Results The effects of CDIs depended on the nature of the comparison condition: CDIs reduced quantity and frequency measures relative to assessment-only controls, but rarely differed from comparison conditions that included alcohol-relevant content. Small-to-medium within-group effect sizes can be expected for CDIs at short- and long-term follow-ups; these changes are less than or equivalent to the within-group effect sizes observed for more intensive interventions. Conclusions CDIs reduce the quantity and frequency of drinking among college students. CDIs are generally equivalent to alternative alcohol-related comparison interventions. [source] The Efficacy of Repeated Reading and Wide Reading Practice for High School Students with Severe Reading DisabilitiesLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 1 2010Jade Wexler This experimental study was conducted to examine the efficacy of repeated reading and wide reading practice interventions for high school students with severe reading disabilities. Effects on comprehension, fluency, and word reading were evaluated. Participants were 96 students with reading disabilities in grades 9,12. Students were paired within classes and pairs were randomly assigned to one of three groups: repeated reading (N,= 33), wide reading (N,= 34), or typical instruction (N,= 29). Intervention was provided daily for approximately 15,20 minutes for 10 weeks. Results indicated no overall statistically significant differences for any condition, with effect sizes ranging from ,.31 to .27. Findings do not support either approach for severely impaired readers at the high school level. We hypothesize that these students require more intensive interventions that include direct and explicit instruction in word- and text-level skills as well as engaged reading practice with effective feedback. [source] Responsiveness to General Education Instruction as the First Gate to Learning Disabilities IdentificationLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 3 2003Deborah L. Speece Most definitions of learning disabilities (LD) include a qualification that adequate general education instruction was received and the child with LD did not benefit. Rarely is this tenet assessed in either practice or research before a diagnosis is made. We review three studies that investigated children's responsiveness to general education reading instruction as an indicator of need for more intensive interventions. Adequacy of instruction was quantified by children's level and rate of progress, compared to classmates, as measured by curriculum-based measures of oral reading fluency. We found that the response-to-instruction model tested was valid in that (1) children who differ from their peers on level and slope of performance (dual discrepancy) have more severe academic and behavioral problems than children who have IQ-achievement discrepancies or low achievement; (2) children who demonstrate persistent nonresponsiveness over three years differ from other at-risk children on reading, reading-related, and behavioral measures; and (3) at-risk children who participated in specially designed general education interventions had better outcomes than at-risk children who did not participate. We conducted additional analyses to assess low achievement definitional variations and found that they lack sensitivity and coverage compared to a dual discrepancy definition. [source] Why intensive interventions are necessary for students with severe reading difficultiesPSYCHOLOGY IN THE SCHOOLS, Issue 5 2010Sharon Vaughn This article reviews research related to intensive interventions within a Response to Intervention framework. We review the research from studies that provided different levels of intensity of intervention with the goal of establishing a case that movement through less intensive tiers of intervention may not be an effective and responsible approach to addressing the reading difficulties of some students, particularly those with significant reading difficulties or disabilities. © 2010 Wiley Periodicals, Inc. [source] | |||||||||||||