Action Picture Test (The Renfrew Language Scales)

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Is the intervention protocol sufficiently detailed to be replicated? In this context, protocol refers to an operations manual or implementation guide, not the Institutional Review Board submission. To be ready for a PCT, an intervention should have a well-documented protocol. Ideally, an intervention’s outcomes should be measurable and captured using existing data sources or systems, so that the intervention – if proven effective – can be readily adopted on a broad scale. Although it may be possible to make minor revisions to existing systems, such as electronic health records, major revisions and any data collection that would burden staff will affect widespread adoption. Evidence

l Vocabulary at age 5 is the best predictor of whether children who experience social deprivation in childhood escape poverty in later adult life U.S. Department of Health & Human Services, ASPE, Office of the Assistant Secretary for Planning and Evaluation. State of the science for pragmatic trials of non-drug interventions to improve outcomes among persons with dementia and their caregivers [Online]. https://aspe.hhs.gov/pdf-report/state-science-pragmatic-trials-non-pharmacological-interventions-improve-outcomes-among-persons-dementia-and-their-caregivers. Accessed 26 Mar 2018. Department Of Health and Human Services, National Institute on Aging (NIA). NIA AD/ADRD health care systems research collaboratory (U54 clinical trial required). https://grants.nih.gov/grants/guide/rfa-files/RFA-AG-19-009.html. Accessed 1 Aug 2018. To what extent does the evidence base support the intervention’s efficacy? Ideally, there should be an evidence base establishing efficacy using rigorous methods, such as randomized, controlled trials (RCTs). Efficacy studies may also have demonstrated which intervention components, alone or in combination, are associated with improvement. An intervention with mixed findings or less robust evidence may not be sufficiently efficacious for a PCT. Furthermore, overwhelming evidence for efficacy doesn’t necessarily translate to overwhelming evidence for effectiveness. While an intervention may work in a controlled setting, it is vital to test the intervention in a real-world context (such as a PCT). RiskSpirals is designed to be universal. Elements of Spirals could easily be incorporated into group times. Some settings are already doing this and seeing the advantages.

Therefore, it is impressive that so many children are making good amounts of progress (between 1 and 8 months) and even more impressive that a large number are making more progress than expected (over 8 months). Each weekly session lasts between 20 – 30 minutes and consists of approximately six activities. Ideally, each session should involve six children and be run by two adults in a quiet room with few distractions. The sessions are similar each week, creating a familiar structure for children to feel comfortable within. The Assessment of Comprehension and Expression assesses children’s understanding of verbal language, their ability to express their thoughts effectively, grammar, semantic skills and pragmatics. These skills are assessed through the 5 main subtests:Participation in Spirals may not have enabled every child to have done well enough to fall within normal limits for their age on the post-intervention assessment, but this does not mean that they haven’t made progress. The figures below are for children who managed to make some headway into reducing their language delay.

I got to know his Mum through Stay and Play and she talked to me about how the Children’s Centre had supported her at the time of Tom’s diagnosis and after. She had taken Tom to the Sparklers group for children with disabilities and was a regular attender at Stay and Play. When she received reports about Tom, we looked through them together and I explained any jargon or terms she was unsure about. Tom’s Speech Therapist came to see him in Spirals and made recommendations.U.S. Department of Health & Human Services, ASPE., Office of the Assistant Secretary for Planning and Evaluation. National research summit on care, services, and supports for persons with dementia and their caregivers: report to the national advisory council on alzheimer’s research, care, and services. https://aspe.hhs.gov/pdf-report/national-research-summit-care-services-and-supports-persons-dementia-and-their-caregivers-final-summit-report. Accessed 1 Aug 2018. Assesses children’s understanding of spoken sentences of various lengths and complexities through pointing to the picture that best matches the sentence spoken. A full oral examination was not considered appropriate at this time, but there does not appear to be any weakness of the oral musculature. There is no reported drooling or choking. Tongue movement is appropriate Every Teacher was given a form to rate each child in the 5 areas of thinking, language, listening, social and confidence. These were handed out in September 2010 and June 2011. Forms were returned for 9 out of 13 groups. Teachers were asked to give the child a score from 1-5 in each area, with 5 indicating no difficulties at all and 1 indicating that the child’s skills are extremely poor in that area. Scores from September were compared to June to find out how much the child had improved. Every child made progress in at least one area. Exactly as the results from this analysis showed last year, the two areas in which children made the greatest improvement were language and confidence.