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This study used a modified multiple-baseline design to determine the effects on the writing performance of seven students with special needs when a talking word processor with spell checker software was used independent of and in conjunction with word prediction software as accommodations in daily writing exercises. Results indicated that, in general, the impact of using writing software was positive. The group mean for number of misspellings decreased, accuracy percentage increased, number of words increased, and overall district writing rubric scores increased. Further, the software had different benefits for different students and students expressed preferences for particular software functions. Implications for practice and research are presented.

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We report a case series of buprenorphine-related respiratory and neurological depression in opioid-naïve elderly hospitalised patients who received buprenorphine for acute pain management at our institution over a 24-month period. All six patients had risk factors for respiratory depression such as advanced age, concurrent comorbidities, or the ingestion of other potential central nervous system depressants. All patients required escalation of management with additional monitoring, with some transferred to a high dependency or intensive care unit. Five patients had attempted naloxone reversal with varying results. Our cases highlight the fact that while buprenorphine has been demonstrated to have a ceiling effect in relation to respiratory depression in healthy volunteers, it remains an important side-effect and may result in significant respiratory depression in patients with reduced respiratory or neurological reserve. Difficulties with buprenorphine's reversal using naloxone are described. We recommend additional caution when considering buprenorphine for acute pain management in elderly opioid-naïve patients, especially if they have comorbidities or are taking other central nervous system depressants. When buprenorphine is used in patients with risk factors, we recommend additional monitoring and education about potential adverse respiratory effects and their management.

The accuracy of interpretation of single subject data was evaluated by comparing raters' visual analysis of behavior change with statistical determination of behavior change using the split‐middle methods of trend estimation. In addition, the effects of rater background (undergraduate, graduate student) and characteristics of the fictitious student (gender, label) on the ratings were determined. Results indicated that the accuracy of visual analysis was less than chance (47%). Rater and student characteristics, for the most part, did not affect the ratings. Implications of these results are discussed. © 1997 John Wiley & Sons, Inc.