Goal Attainment Scaling: An Idiographic Measure Sensitive to Parent and Teacher Report of IEP Goal Outcome Assessment for Students with ASD

Young students with ASD have instructional needs in social, communication, and learning skills that should be reflected in their Individualized Education Program (IEP). Research suggests that many of these goal areas present a challenge for special educators because of problems with measurability. The current study utilized an idiographic approach called Goal attainment scaling (GAS) for measuring IEP progress of individualized skills. Cross-sectional analysis of the associations between GAS ratings from an independent observer were correlated against teacher and parent ratings of IEP progress at the end of the school year and with standardized measures of the Behavior Assessment System for Children and Vineland Adaptive Behavior Scales (VABS). GAS scores were associated with parent and teacher ratings, including the VABS.

Improving Outcomes for Children With Developmental Disabilities Through Enhanced Communication and Collaboration Between School Psychologists and Physicians

A renewed call for enhanced communication and collaboration between school psychology and medicine is envisioned, in light of a transdisciplinary model, where school psychologists, family physicians, and other health professionals transcend disciplinary boundaries. Recommendations for optimal communication and collaboration are described, as well as challenges inherent in such an endeavor. School psychologist–physician collaboration has the potential to result in significant improvements in outcomes for families and children with developmental disabilities. A case illustration highlights the major points mirrored in the discussion, and conclusions are drawn regarding necessary components for meaningful change to occur.

Goal attainment scaling as an outcome measure in randomized controlled trials of psychosocial interventions in autism

Goal attainment scaling (GAS) holds promise as an idiographic approach for measuring outcomes of psychosocial interventions in community settings. GAS has been criticized for untested assumptions of scaling level (i.e., interval or ordinal), inter-individual equivalence and comparability, and reliability of coding across different behavioral observation methods. We tested assumptions of equality between GAS descriptions for outcome measurement in a randomized trial (i.e., measurability, equidistance, level of difficulty, comparability of behavior samples collected from teachers vs. researchers and live vs. videotape). Results suggest GAS descriptions can be evaluated for equivalency, that teacher collected behavior samples are representative, and that varied sources of behavior samples can be reliably coded. GAS is a promising measurement approach. Recommendations are provided to ensure methodological quality.

Analysis of Parent, Teacher, and Consultant Speech Exchanges and Educational Outcomes of Students With Autism During COMPASS Consultation

The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate that an autism-specific consultation planning framework known as the collaborative model for promoting competence and success (COMPASS) is effective in increasing child Individual Education Programs (IEP) outcomes (Ruble, Dal-rymple, & McGrew, 2010; Ruble, McGrew, & Toland, 2011). In this study, we describe the verbal interactions, defined as speech acts and speech act exchanges that take place during COMPASS consultation, and examine the associations between speech exchanges and child outcomes. We applied the Psychosocial Processes Coding Scheme (Leaper, 1991) to code speech acts. Speech act exchanges were overwhelmingly affiliative, failed to show statistically significant relationships with child IEP outcomes and teacher adherence, but did correlate positively with IEP quality.

What does minimal important change mean to patients? Associations between individualized goal attainment scores and disability, general health status and global change in condition

RATIONALE, AIMS AND OBJECTIVES

In previous work we described a modified version of goal scaling, which enabled patients to identify a meaningful change in their condition within important areas of their lives affected by low back pain. The aim of this study was to explore the associations between goal attainment scores and disability, general health and global change in condition, with particular reference to minimal important change.

METHODS

This was an observational cohort study. Patients attending a multidisciplinary clinic to manage unresolving acute low back pain were interviewed using the modified goal scaling schedule, completed the Roland-Morris Disability Questionnaire and rated their general health status. They were reassessed at 3 and 6 months.

RESULTS

Thirty-five patients were recruited. Minimal important change was identified on 67% of the goals. At follow-up, goal attainment scores were able to distinguish between 'improvers' and 'non-improvers', and these categories showed significant agreement with change in disability (Kappa = 0.865). Goal attainment was highly correlated with satisfaction (Spearman's rho = 0.88) and moderately associated with general health status (Spearman's rho = 0.40).

CONCLUSIONS

The modified version of Goal Attainment Scaling used here may provide useful additional information about both the problems associated with, and the progress of patients who consult with low back pain in Primary Care.

Goal scaling for low back pain in primary care: development of a semi-structured interview incorporating minimal important change

RATIONALE, AIMS AND OBJECTIVES

Goal attainment scaling was an individualized assessment technique developed to evaluate the provision of complex public services. However, this produced a measure which was driven more by the need to demonstrate clinical efficacy rather than reflecting a patient's own aspirations. People with low back pain have problems ranging from functional daily activities to areas which impinge upon their wider role in society and quality of life. Commonly used scales to measure back pain-related disability may not capture domains of relevance to patients. The aim of this project was to develop a goal-based individualized assessment tool capable of defining meaningful change in condition from the patient perspective for use in longitudinal clinical studies.

METHODS

We developed a semi-structured interview to elicit patient important goals. We refined our initial framework by conducting consecutive rounds of interviews with patients and reviewing the feedback. Within this approach, we included a point identified as the minimum level of change needed within each goal that would be considered a meaningful improvement in condition by the patient.

RESULTS

Fifteen patients with low back pain took part in the study. Three rounds of interviews were held to refine the questions used to develop the goal scales. Overall, the participants identified a total of 59 problem areas, reducing these to the 45 most important goals (three for each patient). The minimal significant improvement was identified on 31 (69%) of these, with all except one patient able to identify this marker on two or more of their goal scales.

CONCLUSIONS

The formation of individualized goal scales was successful in all of the participants in this study. Patients were able to understand the concept of 'minimal important change', and identify a specific target to reflect this for two-thirds of their chosen goals.

The Effects of Consultation on Individualized Education Program Outcomes for Young Children With Autism: The Collaborative Model for Promoting Competence and Success

The effects of a teacher consultation intervention were examined-namely, the collaborative model for promoting competence and success (COMPASS), which was designed to improve objectives of individualized education programs for children with autism. The intervention consists of an initial parent-teacher consultation, followed by four teacher consultations across the school year. Thirty-five teachers and a randomly selected child with autism (M age = 6.1 years) from each classroom participated. Compared to the nonintervention teacher-child dyads, the intervention teacher-child dyads showed improvements in individualized education program objectives, with a large effect size (d = 1.51).

Effective Consultation in Educational and Child Psychology Practice

How should applied psychology practitioners be prepared to meet an increasingly challenging and unpredictable working context? This article explores some of the key current issues for educational and child psychology practitioners and their professional trainers in the UK with regard to the topic of effective consultation. The article argues that Educational and Child Psychologists can make a distinctive and essential contribution to improving outcomes for children, young people and their families (a contribution that is firmly grounded in psychological theory, research and applied practice) and that effective professional consultation is an appropriate medium for applying psychology with a range of consultees and clients in diverse contexts. How ECPs are trained in consultation approaches is therefore a significant issue for all members of the profession. The objectives of this article are to examine specific practice and training problems and possibilities relating to consultation in educational and child psychology, to recommend improvements for the professional training for applied psychologists in this area and to make a plea for a renewed emphasis on practitioner research that is aimed at making a difference to applied problem solving.