Objective: Examine the effects of indicated interventions on attendance with chronic truant students. Method: Systematic review and meta-analytic methods, following Campbell Collaboration guidelines, were utilized. A comprehensive search identified 5 randomized and 11 quasi-experimental studies. Results: The mean effect on attendance outcomes was moderate, positive, and significant, g ¼ .46, 95% confidence interval [.30, .62], p < .05, translating into an improvement in attendance by an average of 4.69 days; however, significant heterogeneity was observed. Moderator analyses found no significant differences in mean effects between studies on variables tested. Discussion: Chronic truant students benefit from interventions targeting attendance behaviors; however, no program stood out as being more effective than others. Mean rates of absenteeism at posttest in most studies remained above acceptable levels, indicating a need for more effective interventions. The paucity of research, gaps, and deficiencies affirm the need for strengthening the evidence base. Recommendations for practice, policy, and research are discussed.
| PLAIN LANGUAGE SUMMARY | The review in briefDespite growing support and increased rate of which traumainformed approaches are being promoted and implemented in schools, evidence to support this approach is lacking. | What is this review about?Exposure to different types of trauma have been associated with varying types and complexity of adverse outcomes, including adverse effects on cognitive functioning, attention, memory, academic performance, and school-related behaviors. Given the growing research on trauma and increased knowledge about the prevalence, consequences and costs associated with trauma, there have been increased efforts at the local, state and federal levels to make systems "trauma-informed" (Lang, Campbell, & Vanerploeg, 2015). While the intent of creating trauma-informed approaches in schools is a noble one, relatively little is known about the benefits, costs, and how trauma-informed approaches are being defined and evaluated (Berliner & Kolko, 2016).Adopting a trauma-informed approach in a complex system such as a school building or district is a time consuming and potentially costly endeavor and thus it is important to assess the effects of this approach to inform policy and practice.This aim of this review was to assess trauma-informed approaches in schools on trauma symptoms/mental health, academic performance, behavior, and socioemotional functioning.Trauma-informed approaches include programs, organizations, or systems that realize the impact of trauma, recognize the symptoms of trauma, respond by integrating knowledge about trauma policies and practices, and seeks to reduce retraumatization. At least two of the three key elements of a trauma-informed approach must have been present: Workforce development, trauma-focused services, and organizational environment and practices, which differ from trauma-specific interventions designed to treat or otherwise address the impact/symptoms of trauma and facilitate healing. What is the aim of this review?This Campbell systematic review sought to examine the effects trauma-informed schools on trauma symptoms/ mental health, academic performance, behavior, and socioemotional functioning. Although we conducted a comprehensive search to find studies testing traumainformed approaches in schools, no studies met the inclusion criteria.
This Campbell systematic review examines the effect of interventions on school attendance to inform policy, practice and research. The review summarise findings from 28 studies conducted in the US, Canada, UK and Australia. Overall, truancy intervention programs are effective. There is a significant overall positive and moderate mean effect of intervention on attendance, which increases attendance by 4.7 days per student by the end of the intervention. Studies did not measure longer‐term outcomes, so we do not know if these gains in attendance continue after the intervention ends. There was no significant difference in the effectiveness of different delivery channels (e.g. school, court or community‐based), different modalities (e.g., individual, family, group, or multimodal), or different lengths of time (e.g., one day versus a school year). Contrary to popular belief and recommendations for best practices in truancy reduction found in the existing literature, collaborative programs and multimodal interventions do not produce greater effects on attendance than other types of programs. However, small sample sizes and substantial variation between studies suggest caution is needed in interpreting and applying these findings. There are shortcomings in the literature, notably the lack of inclusion of minority students. Executive summary/Abstract BACKGROUNDTruancy is a significant problem in the U.S. and in other countries around the world. Truancy has been linked to serious immediate and far‐reaching consequences for youth, families, and schools and communities, leading researchers, practitioners, and policy makers to try to understand and to address the problem. Although numerous and significant steps have been taken at the local, state, and national levels to reduce truancy, the rates of truancy have at best remained stable or at worst been on the rise, depending on the indicator utilized to assess truancy rates.The costs and impact of chronic truancy are significant, with both short‐ and long‐term implications for the truant youth as well as for the family, school, and community. Although several narrative reviews and one meta‐analysis of attendance and truancy interventions have attempted to summarize the extant research, there are a number of limitations to these reviews. It is imperative that we systematically synthesize and examine the evidence base to provide a comprehensive picture of interventions that are being utilized to intervene with chronic truants, to identify interventions that are effective and ineffective, and to identify gaps and areas in which more research needs to be conducted to better inform practice and policy. OBJECTIVESThe main objective of this systematic review was to examine the effects of interventions on school attendance to inform policy, practice, and research. The questions guiding this study were: 1) Do truancy programs with a goal of increasing student attendance for truant youth affect school attendance behaviors of elementary and secondary students with chronic attendance pr...
Noninvasive brain stimulation refers to a set of technologies and techniques with which to modulate the excitability of the brain via transcranial stimulation. Two major modalities of noninvasive brain stimulation are transcranial magnetic stimulation (TMS) and transcranial current stimulation. Six TMS devices now have approved uses by the U.S. Food and Drug Administration and are used in clinical practice: five for treating medication refractory depression and the sixth for presurgical mapping of motor and speech areas. Several large, multisite clinical trials are currently underway that aim to expand the number of clinical applications of noninvasive brain stimulation in a way that could affect multiple clinical specialties in the coming years, including psychiatry, neurology, pediatrics, neurosurgery, physical therapy, and physical medicine and rehabilitation. In this article, the authors review some of the anticipated challenges facing the incorporation of noninvasive brain stimulation into clinical practice. Specific topics include establishing efficacy, safety, economics, and education. In discussing these topics, the authors focus on the use of TMS in the treatment of medication refractory depression when possible, because this is the most widely accepted clinical indication for TMS to date. These challenges must be thoughtfully considered to realize the potential of noninvasive brain stimulation as an emerging specialty that aims to enhance the current ability to diagnose and treat disorders of the brain.
ObjectiveDetermining the quality of narrative evaluations to assess medical student neurology clerkship performance remains a challenge. This study sought to develop a tool to comprehensively and systematically assess quality of student narrative evaluations.MethodsThe Narrative Evaluation Quality Instrument (NEQI) was created to assess several components within clerkship narrative evaluations: performance domains, specificity, and usefulness to learner. In this retrospective study, 5 investigators scored 123 narrative evaluations using the NEQI. Inter-rater reliability was estimated by calculating interclass correlation coefficients (ICC) across 615 NEQI scores.ResultsThe average overall NEQI score was 6.4 (SD 2.9), with mean component arm scores of 2.6 for performance domains (SD 0.9), 1.8 for specificity (SD 1.1), and 2.0 for usefulness (SD 1.4). Each component arm exhibited moderate reliability: performance domains ICC 0.65 (95% confidence interval [CI] 0.58–0.72), specificity ICC 0.69 (95% CI 0.61–0.77), and usefulness ICC 0.73 (95% CI 0.66–0.80). Overall NEQI score exhibited good reliability (0.81; 95% CI 0.77–0.86).ConclusionThe NEQI is a novel, reliable tool to comprehensively assess the quality of narrative evaluation of neurology clerks and will enhance the study of interventions seeking to improve clerkship evaluation.
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