Browsing by Author "Sample, Pat, committee member"
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Item Open Access Adverse childhood experiences, executive function, and maladaptive behaviors in children involved with child protective services(Colorado State University. Libraries, 2024) Carvalho, Isidro, author; Daunhauer, Lisa, advisor; Aichele, Stephen, committee member; Sample, Pat, committee member; Barrett, Karen, committee member; Riggs, Nathaniel, committee memberChildhood traumatic events are common and frequently associated with maladaptive coping mechanisms which contribute to long-term harm. Yet few targeted treatment options exist to prevent maladaptive coping in children exposed to trauma. The purpose of this thesis is to identify if executive function may serve as a potential target for such interventions. This thesis used a sample of 244 children – aged 6 to 18 years old – who were referred by the Larimer County Department of Human Services for trauma assessments. Participant trauma events, executive function, and maladaptive behavior data were used to determine if executive function moderated the established association between trauma events and maladaptive behavior development. Results showed no significant interaction between trauma events and executive function when assessing for either maladaptive internalization or externalization. However, results indicated that executive function had a main effect on both internalization and externalization. This study emphasizes the need for further research on the associations between childhood trauma, executive function, and maladaptive behaviors. It is imperative that moderators of the association between childhood trauma and maladaptive behaviors are found so that new treatment options can be developed.Item Open Access Cultural adaptation of the young children's participation and environment measure (YC-PEM) for use by Hispanic families of young children with special health care needs (CSHCN)(Colorado State University. Libraries, 2016) Arestad, Kristen Elizabeth, author; Khetani, Mary, advisor; Sample, Pat, committee member; MacPhee, David, committee memberCulture informs the occupations in which children engage as well as how they are enacted. Hence, occupational therapists need assessments that are culturally relevant in order to deliver culturally competent practice. Current approaches to cultural adaptation of assessments present with three major limitations: (a) use of inconsistent translation process; (b) current processes assess for some, but not all, elements of cultural equivalence; and (c) limited evidence to guide decision making about whether to undertake cultural adaptation with and without language translation. To our knowledge, this is the first study to systematically develop and compare multiple versions of a culturally adapted questionnaire for potential use by a Hispanic population of young children with special health care needs (CSHCN). The purpose of this study is two-fold: (a) to examine similarities and differences of culturally adapting an occupation-centered pediatric assessment with and without translation; and (b) to examine the feasibility of developing a culturally adapted assessment with and without translation. The Young Children’s Participation and Environment Measure (YC-PEM) underwent cultural adaptation processes (i.e., language translation and cognitive testing) to establish Spanish and English pilot versions for potential use by caregivers of young CSHCN of Mexican descent. Following language translation to develop a Spanish YC-PEM pilot version, 7 caregivers (4 with Spanish as their primary language; 3 with English as their primary language) completed cognitive testing to inform decisions regarding content revisions to the YC-PEM Spanish and English pilot versions. Participant responses were content coded to established cultural equivalencies (i.e., semantic/idiomatic, item, conceptual). Coded data were then summed to draw comparisons on the number of revisions needed to achieve cultural equivalence between the two pilot versions. Feasibility was assessed according to resources required, data collection procedures, and data quality. Results suggest that a greater number of revisions are required to achieve cultural equivalence for the translated (Spanish) version of the YC-PEM. However, issues concerning conceptual equivalence were identified in both the Spanish and English versions. Feasibility results indicate that language translation processes require high resource investment, but may increase translation quality. However, use of questionnaire (i.e., paper, PDF) cognitive testing versus interview methods (e.g., phone, face-to-face) may have limited data saturation. Study results lend preliminary support to the need for and feasibility of pursuing cultural adaptation of the YC-PEM with and without language translation. Larger and more diverse samples are needed to examine the effects of acculturation status on revisions needed to achieve cultural equivalence. Also, interview methods may help improve data quality and confirm study findings.Item Open Access Developmental trajectories of adaptive behavior in Autism Spectrum Disorder and Down syndrome(Colorado State University. Libraries, 2017) Gerlach-McDonald, Brianne, author; Hepburn, Susan, advisor; Fidler, Deborah, advisor; Daunhauer, Lisa, committee member; Riggs, Nathaniel, committee member; Sample, Pat, committee memberThe increasing prevalence of developmental disabilities indicates a need for research and interventions for these populations. One growing area of interest is adaptive behavior or the functional skills individuals perform in their everyday lives, such as communication and daily living skills. Individuals with developmental disabilities with greater adaptive behavior skills experience a better quality of life in childhood and achieve better functional outcomes in adulthood (e.g., living independently). However, more research is needed to understand how adaptive behavior develops in childhood to identify critical time points for targeted interventions. The current study examined developmental trajectories of adaptive behavior across childhood in two developmental disabilities: Autism Spectrum Disorder(ASD) and Down syndrome (DS). This study examined secondary data obtained from a longitudinal study conducted at the University of Colorado Health Sciences Center between 1997 and 2007. The aim of this dissertation was to examine the extent to which individual differences in diagnostic status, maternal education, intellectual functioning, executive function, and autism symptoms predicted developmental trajectories of adaptive behavior. Examination of the predictors of developmental trajectories of adaptive behavior provided information regarding potential intervention targets to promote optimal adaptive behavior. This study used growth modeling techniques to compare two developmental disabilities. Participants included 77 children with ASD and 24 children with DS who were assessed in toddlerhood (ages 1-3 years), preschool (ages 4-6), and during the school years (ages 7-10). Parents completed a demographic questionnaire and interviews of adaptive behavior (Vineland Adaptive Behavior Scales; Sparrow, Balla, & Cicchetti, 1984), and autism symptoms (Autism Diagnostic Interview-Revised; Lord, Rutter, & LeCouteur, 1994). Child participants completed standardized developmental testing (Mullens Scales of Early Learning; Mullen, 1995), an executive function task measuring cognitive flexibility and working memory (Spatial Reversal; Kaufmann, Leckman, & Ort, 1989), and a semi-structured play-based assessment of autism symptoms (Autism Diagnostic Observation Schedule; Lord, Rutter, DiLavore, & Risi, 1999). Growth models were specified for developmental trajectories of communication, daily living skills, and socialization as measured by the Vineland Adaptive Behavior Scales. Diagnostic status, maternal education, intellectual functioning, executive function, and autism symptoms were added as predictors. Children with ASD and DS made gains in their adaptive behavior skills from toddlerhood to middle childhood but had significantly delayed scores compared to children in the standardization sample. The best fitting models of communication and socialization indicated significant linear and quadratic growth, and the best fitting model of daily living skills indicated significant linear growth. Diagnostic status was a significant predictor of initial starting states of communication and socialization in toddlerhood, but not daily living skills. Diagnostic status was a significant predictor of linear and quadratic slopes of communication. Maternal education was a significant predictor of initial starting states of socialization in toddlerhood in both groups. Mental age in toddlerhood was a significant predictor of initial starting states in toddlerhood for communication, daily living skills, and socialization in both groups. Mental age was a significant predictor of linear slopes of communication, daily living skills, and socialization, and quadratic slopes for communication and socialization in both groups. These findings provide implications for intervention; many existing manualized early intervention treatments do not explicitly target adaptive behavior. Implications for available programs are discussed, followed by recommendations for targeting adaptive behavior and expanding research efforts to promote these skills in children with ASD and DS.Item Open Access Increasing BCI usability in the home: assessing the user and caregiver perspectives(Colorado State University. Libraries, 2017) Bruegger, Katie, author; Davies, Patti, advisor; Roll, Marla, advisor; Sample, Pat, committee member; Anderson, Chuck, committee memberObjective. Despite research indicating that brain-computer interface (BCI) technology can be an effective option for persons with motor disabilities, BCI is currently not being used by this population on a regular basis. The purpose of this research is to determine the current usability of the BCI system in the user's home from the perspective of BCI users with motor disabilities and their caregivers in order to influence the future direction of BCI advancement to improve the usability of BCI technology for this population. Method. Within this study, there were four separate phases. In Phase 1, using feedback from five participants with motor disabilities and three caregivers for persons with motor disabilities, a questionnaire was developed for both BCI users and caregivers to assess the experience of setting up and using the BCI system. In Phase 2, these questionnaires were administered to five participants with motor disabilities and their caregivers a total of three times after experiencing the set-up and use of a P300 BCI system in the user's home on three separate occasions. In Phase 3, the responses of the questionnaires were analyzed and common themes and patterns were used to develop a list of questions to guide a focus group discussion. Finally, in Phase 4 a focus group consisting of three BCI users and two caregivers was held to gather more in depth information about the experience of using and setting up the BCI system. Throughout these phases, both quantitative and qualitative methods were used to analyze data. Results: Quantitative data analysis of questionnaire responses yielded no significant results; however, a variety of patterns were identified and within these patterns multiple patterns were found to approach significance. Relationships that approached significance included the difference between user and caregiver ratings for ease of use over time (z= -1.730, p= 0.084) and the difference between user and caregiver ratings for the likelihood of using or advocating for the use of BCI in the home on a regular basis (z= -1.792, p=0.073). These findings showed that ease of use decreased across the course of the three visits for both caregivers and users and that caregivers were more likely to advocate for the use of BCI on a regular basis than BCI users. When asked what area of life participants wanted this version and future versions of BCI to help increase users' current participation, the most common response chosen by users was environmental aids to daily living (EADL) while the most common response for caregivers was verbal and written communication. Qualitative analysis of the focus group provided answers to the three research questions (What are current barriers preventing BCI from being used by persons with disabilities on a regular basis in the home?; What are the aspects of BCI that BCI user's and caregivers enjoy?; And what are BCI users' and their caregivers' desires for the future of BCI) and yielded three emergent themes: the cost benefit analysis of BCI use, comparison of BCI to existing technology, and BCI and its relationship to independence. Conclusions. Although at its current state, none of the participants believed that the P300 BCI system would be a valuable addition to their life, users and caregivers agreed that in cases where the need was great enough, the challenges of using the system would be outweighed by its benefits. With the implementation of developments that decrease the challenges involved in setting up and using the system or the implementation of developments that increase the utility of real life applications, future BCI systems will become more practical options for a larger population.Item Open Access Parent-mediated interventions for infants with Down syndrome(Colorado State University. Libraries, 2020) Swanson, Molly, author; Fidler, Deborah, advisor; Daunhauer, Lisa, committee member; Sample, Pat, committee memberParent-mediated interventions (PMIs) are becoming increasingly popular but the parents' role as the administrator of the intervention, specifically the parental fidelity to an intervention protocol (PF) has yet to be standardized. Early syndrome specific PMIs can influence many domains of development for infants with Down syndrome (DS); however, the impact of PMIs on object exploration for infants with DS has yet to be tested. The current study examined the impact of parental fidelity to a PMI protocol on object exploration skills in infants with DS. The sample for this study consisted of 37 infants (M=7.04, SD=2.44) infants from 4 to 18 months with a confirmed case of trisomy 21. Infants in the intervention group (n=19) received the Sticky Mittens intervention and infants in the alternative group (n=18) received the 'object dance' activity. Parents were asked to fill out a parent logs to track their PF. Multiple regressions revealed that increased parental fidelity resulted in more infant swats and reach attempts from pre to post-intervention for the intervention condition, but not the control condition. The findings from this study indicate the unique role that parental fidelity plays in explaining intervention effects or a lack of intervention effects in PMIs. The implications for parental fidelity in PMIs are discussed.Item Open Access Parenting behavior and executive function in children with Down syndrome(Colorado State University. Libraries, 2017) Schworer, Emily, author; Fidler, Deborah, advisor; Daunhauer, Lisa, committee member; Sample, Pat, committee memberParenting behaviors have an important influence on child development, and recent work has demonstrated the specific effects of parenting on the development of executive function (EF) abilities. Although these associations have been examined in typically developing children, the relationship between parent-child interaction and EF abilities has yet to be examined in dyads where the child has a diagnosis of Down syndrome (DS). The current study examined the differences in parenting behaviors between DS dyads and dyads with TD children matched on non-verbal mental age. DS dyads (n= 44) and TD dyads (n=29) participated in the Parent-Child Challenge Task to assess behaviors of both the parent and child during a challenging problem-solving task. Parent directive and teaching behaviors were coded, along with child compliance and noncompliance. Child participants completed the pony/gator task, a laboratory measure of inhibition and working memory. Parents also completed the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P), a proxy-report measure of EF. Results showed a difference in parenting behavior between DS dyads and TD dyads. Frequencies of parenting behaviors in DS were also related to both the pony/gator laboratory measure and the Inhibitory Self-Control index raw scores on the BRIEF-P. The findings indicate a unique pattern of association between parent behaviors and EF in DS. The implications for parent training and intervention are discussed.Item Open Access Parenting strategies and child behavior in children with Down syndrome(Colorado State University. Libraries, 2014) Lopez, Amber, author; Fidler, Deborah, advisor; Daunhauer, Lisa, committee member; Lunkenheimer, Erika, committee member; Sample, Pat, committee memberThis study examined parent-child interactions in Down syndrome in the context of a collaborative puzzle task. Variables of interest included the parent dimensions of teaching and directives, and the child behaviors of compliance, persistence, and social engagement during a five-minute interaction. Based on previous research in the field of parenting and developmental disabilities, it was hypothesized that parents of children with Down syndrome would exhibit significantly more directive behavior than parents of typically developing children, and that the use of directives would be associated with higher levels of compliance and task persistence in children with Down syndrome. It was also hypothesized that children with Down syndrome would engage in higher levels of off-task behavior, such as social engagement with a parent, based on evidence of the over-use of social behaviors during challenging tasks in this population. Children with Down syndrome (N = 20) and mental-age matched typically developing children (N = 13), and their parents, were recorded during a five-minute problem-solving task. Parent and child behaviors were captured utilizing a modified version of Lunkenheimer's (2009) Dyadic Interaction Coding System. Results indicated that parents of children with Down syndrome demonstrated both significantly higher levels of directive behaviors and teaching behaviors in comparison to parents with typically developing children. Contrary to previous research, children with Down syndrome in this study were found to be significantly more compliant than their typically developing peers, and no significant differences emerged between the groups in terms of off-task, socially-related behavior. Additionally, this study examined the reciprocal nature of parent-child interactions using state lag sequential analyses. Results from these analyses demonstrated a higher probability of directive parenting behavior following child social engagement in the Down syndrome group as compared to the typically-developing group. Conversely, the lag sequential analyses demonstrated a higher probability of teaching parent behavior following social engagement in the typically-developing group as compared to the Down syndrome group. The likelihood for both teaching and directive parenting behavior following child noncompliance was also higher in the Down syndrome group as compared to the typically-developing group. The findings from this study demonstrate consistency with previous work that parents of children with Down syndrome are more directive than parents of typically developing children, and highlights the differing patterns of parenting behavior in both typically and atypically developing populations. The use of analyses to examine dyadic contingencies also provides new information regarding the strategies that parents employ with their children to promote on-task behavior, specifically in children with an intellectual disability. Lastly, this study contributes to the body of research on the behavioral phenotype of children with Down syndrome.Item Open Access Staff satisfaction in a long term care facility undergoing culture change(Colorado State University. Libraries, 2012) Knight, Kerri Lyn, author; Wood, Wendy, advisor; Sample, Pat, committee member; Vacha-Haase, Tammi, committee memberAn instrumental case-study look at perceptions of staff satisfaction at a long-term care facility undergoing the process of implementing culture change reforms was presented. Participants included CNAs, RNs and LPNs, managers, and therapists and therapy aides who participated in homogeneous and heterogeneous forum group discussions. Dissatisfaction was found in the work environment, breakdown of communication, and perceptions of leadership; satisfaction was found in enforcement of accountability, successful communication, suggestions for improvement and meaningful work experiences. The main conclusion was that the opportunities for empowerment are vital to staff members' experience of satisfaction; specifically, supporting staff authority and acknowledging effort, implementing systematic communication, cultivating positive relationships, and implementing staff suggestions to optimizing psychological benefits of the work experience.Item Open Access The lived experiences of directors providing leadership to part-time faculty at study abroad centers in Italy: a phenomenological analysis(Colorado State University. Libraries, 2021) Earhart, Alan, author; Gloeckner, Gene, advisor; Kuk, Linda, advisor; Lynham, Susan, committee member; Sample, Pat, committee memberIn the 2017-2018 academic year, 332,727 U.S. university students participated in a study abroad program in a foreign country (Institute of International Education, 2018). Many of these students attend courses taught by part-time faculty, hired locally by study abroad centers with affiliations to U.S. universities. The directors of these centers have responsibility for all aspects of the study abroad programs, including academics and the faculty. The purpose of this interpretative phenomenological analysis (IPA) study was to investigate how directors of study abroad centers in Italy understand and experience their leadership of part-time faculty. The main research question asked how directors of study abroad centers in Italy understand and experience their leadership of the part-time faculty they supervise? Eight individuals shared their experiences through semi-structured interviews and a follow-up focus group. The participants' essential experience in providing leadership to part-time faculty at study abroad centers in Italy was bridging the gap between different realities. The unique research setting produced results showing that participants employed some practices supporting part-time faculty not found in past research on leading part-time faculty. These included: paying for travel to academic conferences, hosting academic conferences organized by PT faculty, and paying to publish PT faculty scholarship.Item Open Access Universal design for learning: perceptions of faculty and students at a northeastern community college(Colorado State University. Libraries, 2014) Gawronski, Michael E., author; Kuk, Linda, advisor; Anderson, Sharon, committee member; Sample, Pat, committee member; Lombardi, Allison, committee memberTo examine community college faculty and student attitudes toward and actions associated with inclusive instruction based on Universal Design for Learning (UDL) principles and practices, two online surveys, the Inclusive Teaching Strategies Inventory (ITSI) and the Inclusive Teaching Strategies Inventory-Student (ITSI-S), were administered at a medium-sized Northeastern public Community College (n=449). The ITSI and ITSI-S contain six subscales representing the following constructs: (a) accommodations, (b) accessible course materials, (c) course modifications, (d) inclusive lecture strategies, (e) inclusive classroom, and (f) inclusive assessment. A series of Multivariate Analyses of Variances (MANOVA's) were performed to identify predictors of these attitudes and actions among faculty and students. Results found significant differences among faculty (N=179) in overall action scale scores based on age and ethnicity. However, similar analyses conducted on students were not significant. Results of the current study respond to the gap in the literature by examining inclusive instruction based on universal design for learning in the community college environment. Discussion, implications of these findings and recommendations for future research were discussed.Item Open Access Users' perspectives of clinical utility of the Daily Experiences of Pleasure, Productivity and Restoration Profile in a caregiver support group(Colorado State University. Libraries, 2015) Stephans, Lindsey E., author; Atler, Karen, advisor; Fruhauf, Christine, committee member; Sample, Pat, committee memberOccupationally-focused assessments that consider the client’s occupational experience in context are crucial to providing interventions that are meaningful and ecologically valid for our clients. Yet, few assessments go beyond an evaluation of typical occupational performance to recognize the contextual elements that provide depth to an individual’s occupational experience. The purpose of this paper is to report on a utility study of one such assessment, The Daily Experiences of Pleasure, Productivity and Restoration Profile (PPR Profile), used by an occupational therapist with a group of spousal caregivers. This pragmatic, single case study design sought to capture caregivers’ perceptions of utility in completing the PPR Profile and discussing it with an occupational therapist. Four major themes emerged: initial perspectives of using the PPR Profile, using the PPR Profile was helpful, but difficult, using the PPR Profile provided opportunities for change, and recommendations for using the PPR Profile. The results support the use of the PPR Profile to capture and discuss contextual occupational experiences as a client-centered and ecologically valid occupational therapy assessment to guide interventions for caregivers to self-manage their health. Discussion focused on issues that occupational therapists need to consider in using the PPR Profile. While these results are promising in one setting, further research is warranted.