Early Intervention

This article presents an qualitative case study of a recent educational development project 1,2 Fellaskóli in Breiðholt, which took place during the 2012-2013 academic year. Fellaskóli is in many ways unique as nearly half of the student population speaks a language other than Icelandic at home. One of the main purposes of the project, 1, 2 and Fellaskóli, is to intertwine school and after-school programs in an effort to improve reading, language and social skills for six and seven year old students. The opportunity for greater exposure to an Icelandic speaking environment through the lengthening and combining of the school and after-school program is part of a broader project in the neighborhood to support and improve resident experiences. In the spring of 2012, the school received funding and subsequently lengthened the school day and hired classroom aides who were placed in the classrooms during the school day and who then took charge of the children during the after-school program times.
This article begins with a discussion of the theoretical underpinnings of the evaluation project, where the authors explore recent research on school and after-school care, its melding, the importance of socialization for children, as well as a discussion of education in a multicultural context and active bilingualism as it informs the discussion of the results of the research. The researchers interviewed employees, children and parents to better understand their school and after-school experiences as well as conducting a number of site visits which included tours of the school grounds lead by students and extensive document reviews. Student and parent interviews were audio recorded for further analysis and parent focus groups included interpreters in order to facilitate discussion. 
The findings indicate high parental satisfaction with the new program as parents noted the improved opportunity students had to build social contacts both with adults and other children. However, parent involvement was low and cultural and language barriers seemed to hinder active parent-teacher cooperation. Many parents noted they valued the multicultural learning environment the school offered although a few noted there had been small racial incidents between students. Both teachers and support staff found that the work day often did not allow for enough time to collaboratively work on development of curriculum and activities. Furthermore, support staff indicated that they would have liked more input in the development of the project. Classroom support staff indicated they often could not find enough time in the day to plan activities for the afterschool programs and were often left out of meetings relevant to the project. Over all, the children reported satisfaction with the changes in the program, and neither the parents nor the children reported significant tiredness due to the length of the school day. Children made a clear distiction between the role of the teacher and the support staff, and noted that they apprieciated that some of the staff was with them through out the day into the after school time. However, the children also pointed out areas for improvement, as they noted how loud and disorganized the transition between school and the after-school area was. Overall the researchers concluded that a signficiant effort was being made in regard to improving children´s language and readings skills as well as addressing the varied social and cultural needs of the students. The authors also noted various areas that the school administrators and teachers can focus on for improvement. The article concludes with a discussion of the practical and academic lessons to be drawn from this project.

With the advent of “Response to Intervention” there has been emphasis on preventing reading disabilities. This study examined the effectiveness of a classroom teacher Tier II intervention for struggling readers in kindergarten and first grade called the Targeted Reading Intervention. Three rural schools were randomly assigned to experimental and control conditions, with 8 experimental and 12 control classrooms. Five struggling and five non-struggling readers were randomly selected from each classroom. With the support of biweekly coaching, experimental teachers instructed struggling readers in one-on-one sessions in the classroom. Intent-to-treat analyses revealed significant kindergarten gains for initial word identification but no significant gains in first grade. Discussion focuses on the use of classroom teachers to prevent reading disabilities.

Sleep-related breathing disorders encompass a range of disorders in which abnormal ventilation occurs during sleep as a result of partial or complete obstruction of the upper airway, altered respiratory drive, abnormal chest wall movement, or respiratory muscle function. The most common of these is obstructive sleep apnea (OSA), occurring in both adults and children, and causing significant cognitive and daytime dysfunction and reduced quality of life. OSA patients experience repetitive brief cessation of breathing throughout the night, which causes intermittent hypoxemia (reductions in hemoglobin oxygen levels) and fragmented sleep patterns. These nocturnal events result in excessive daytime sleepiness, and changes in mood and cognition. Chronic excessive sleepiness during the day is a common symptom of sleep-related breathing disorders, which is assessed in sleep clinics both subjectively (questionnaire) and objectively (sleep latency tests). Mood changes are often reported by pat...

Background: We aimed to investigate a key element of the early intervention approach; whether treatment at an earlier stage of bipolar disorder is more effective than later in its course. Methods: A comprehensive literature review using Medline, Embase, Psychinfo, PsycArticle, and Web of Science, as data sources, with a subsequent narrative synthesis. Study quality was assessed using the Cochrane risk of bias method. Results: Our search strategy yielded eight primary papers and two meta-analyses (of psychological therapies and Olanzapine) in total representing 8942 patients. Five studies focused on comparisons between first and multiple episodes, and the others on fewer vs more episode categories. There was a consistent finding, suggesting treatment in earlier illness stage resulted in better outcomes in terms of response, relapse rate, time to recurrence, symptomatic recovery, remission, psychosocial functioning, and employment. This effect was found for pharmacological (Lithium, Olanzapine, Divalproex) and psychological treatments. Limitations: There was high risk of selection, performance, and attrition bias in most studies. First admission or presentation is unlikely to equate to first episode, because of the duration of untreated illness. Some patients having experienced multiple episodes could be " treatment resistant ". Study heterogeneity precluded meta-analysis. Conclusions: Psychological and pharmacological treatments in the early stages of illness are more effective than in the later stages of bipolar disorder across multiple domains. There is a first episode and the early phase effect. Consistent with the staging model of illness, findings provide evidence for the clinical utility of an early intervention approach in bipolar disorder to improve patient outcomes.

Academic ED SBIRT Research Collaborative* Study objective: We determine the impact of a screening, brief intervention, and referral for treatment (SBIRT) program in reducing alcohol consumption among emergency department (ED) patients. Methods: Patients drinking above National Institute of Alcohol Abuse and Alcoholism low-risk guidelines were recruited from 14 sites nationwide from April to August 2004. A quasiexperimental comparison group design was used in which control and intervention patients were recruited sequentially at each site. Control patients received a written handout. The intervention group received the handout and a brief intervention, the Brief Negotiated Interview, to reduce unhealthy alcohol use. Follow-up surveys were conducted at 3 months by telephone using an interactive voice response system. Results: Of 7,751 patients screened, 2,051 (26%) exceeded the low-risk limits set by National Institute of Alcohol Abuse and Alcoholism; 1,132 (55%) of eligible patients consented and were enrolled (581 control, 551 intervention). Six hundred ninety-nine (62%) completed a 3-month follow-up survey, using the interactive voice response system. At follow-up, patients receiving a Brief Negotiated Interview reported consuming 3.25 fewer drinks per week than controls (coefficient [B] 3.25; 95% confidence interval [CI] 5.76 to 0.75), and the maximum number of drinks per occasion among those receiving Brief Negotiated Interview was almost three quarters of a drink less than controls (B 0.72; 95% CI 1.42 to 0.02). At-risk drinkers (CAGE 2) appeared to benefit more from a Brief Negotiated Interview than dependent drinkers (CAGE 2). At 3-month follow-up, 37.2% of patients with CAGE less than 2 in the intervention group no longer exceeded National Institute of Alcohol Abuse and Alcoholism low-risk limits compared with 18.6% in the control group (18.6%; 95% CI 11.5% to 25.6%). Conclusion: SBIRT appears effective in the ED setting for reducing unhealthy drinking at 3 months.