Referral

About: Referral is a research topic. Over the lifetime, 27614 publications have been published within this topic receiving 479918 citations.

The Special Education Referral and Decision-Making Process for English Language Learners: Child Study Team Meetings and Placement Conferences

Abstract: The purpose of this study was to examine the special education referral and decisionmaking process for English language learners (ELLs), with a focus on Child Study Team (CST) meetings and placement conferences/multidisciplinary team meetings. We wished to learn how school personnel determined if ELLs who were struggling had disabilities, to what extent those involved in the process understood second language acquisition, and whether language issues were considered when determining special education eligibility. We observed CST meetings and placement conferences for 19 students who were considered ELLs when they were referred. Findings revealed that in practice, only cursory attention was given to prereferral strategies. Most students were pushed toward testing, based on an assumption that poor academic performance or behavioral difficulties had their origin within the child and indicated a need for special education. Although some school personnel were quite knowledgeable about language issues, many were not. There was tremendous variation in the quality of what transpired during meetings. These differences were influenced by the intentions, knowledge, skills, and commitment of CSTor multidisciplinary team members. All the factors we describe point to aspects of the process that should be improved.

Pediatrician Interview Style and Mothers' Disclosure of Psychosocial Issues

Abstract: Objective. Primary care pediatricians play an important role in the detection, diagnosis, treatment, and referral of children with mental health problems. Some parents, however, are reluctant to discuss behavioral and emotional symptoms with their child9s pediatrician. Studies of patient-physician communication suggest that specific aspects of pediatrician interview style (asking questions about psychosocial issues, making supportive statements, and listening attentively) increase disclosure of sensitive information. We hypothesized that disclosures of parent and child psychosocial problems would be more likely to occur during visits when pediatricians used these techniques. Design. Cross-sectional analysis of a systematic sample of pediatric primary care visits. Population. Two hundred thirty-four children ages 6 months to 14 years and their mothers or female guardians attending an inner-city hospital-based pediatric primary care clinic; 52 physicians in their second or third year of pediatric residency training. Methods. Visits audiotaped and dialogue coded using the Roter Interactional Analysis System. Independent variables included counts of pediatrician utterances in the following categories: (a) questions about psychosocial issues, (b) statements of support and reassurance, and (c) statements indicating sympathetic and attentive listening. Dependent variables were the disclosure of information about: (a) parental medical or emotional impairment, (b) family disruption, (c) use of physical punishment, and (d) aggressive or overactive child behavior. Results. Use of psychosocially oriented interviewing techniques was associated with a greater likelihood of disclosure for all four of the topic areas studied. Odds ratios for disclosure, adjusted for parental concerns and child age, ranged from 1.09 to 1.22 depending on the interview technique and outcome involved. Positive associations were observed both for topics raised primarily in response to pediatrician questions (family and parent problems) and for topics raised primarily by mothers (behavior and punishment). Conclusions. Three simple communication skills were associated with disclosure of specific concerns relevant to child mental health. Training pediatricians to use these skills would help to better detect and diagnose children9s mental health problems.

Can health visitors prevent fractures in elderly people

Abstract: OBJECTIVES--To assess whether intervention by a health visitor could reduce the number of fractures, over a four year period, in those aged 70 and over DESIGN--Randomised, controlled trial; randomisation by household SETTING--General practice in a market town SUBJECTS--Of 863 patients aged 70 and over on the practice records, 674 were traced and successfully interviewed; 350 were assigned to the intervention group, 324 as controls INTERVENTION--The people in the intervention group were allocated to the care of a health visitor The approach was four pronged: assessment and correction of nutritional deficiencies, including reducing smoking and alcohol intake; assessment and referral of medical conditions such as heart block or inappropriate medication; assessment and correction of environmental hazards in the home such as poor lighting; assessment and improvement of fitness--for example, exercise classes for the moderately fit The intervention continued for four years MAIN OUTCOME MEASURE--Fracture rate over four years RESULTS--The incidence of fractures was 5% (16/350) in the intervention group and 4% (14/324) in the control group (difference not significant) CONCLUSIONS--A health visitor visiting a group of people aged 70 and over and using simple preventive measures had no effect on the incidence of fractures