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  • 51.
    Axelsson, Anna Karin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Wilder, Jenny
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Engagement in family activities: a quantitative, comparative study of children with profound intellectual and multiple disabilities and children with typical development2013In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 39, no 4, p. 523-534Article in journal (Refereed)
    Abstract [en]

    Background

    Participation is known to be of great importance for children's development and emotional well-being as well as for their families. In the International Classification of Functioning, Disability and Health – Children and Youth version participation is defined as a person's ‘involvement in a life situation’. Engagement is closely related to involvement and can be seen as expressions of involvement or degree of involvement within a situation. This study focuses on children's engagement in family activities; one group of families with a child with profound intellectual and multiple disabilities (PIMD) and one group of families with children with typical development (TD) were compared.

    Methods

    A descriptive study using questionnaires. Analyses were mainly performed by using Mann–Whitney U-test and Spearman's rank correlation test.

    Results

    Engagement in family activities differed in the two groups of children. The children with PIMD had a lower level of engagement in most family activities even though the activities that engaged the children to a higher or lesser extent were the same in both groups. Child engagement was found to correlate with family characteristics mostly in the children with TD and in the children with PIMD only negative correlations occurred. In the children with PIMD child engagement correlated with cognition in a high number of listed family activities and the children had a low engagement in routines in spite of these being frequently occurring activities.

    Conclusions

    Level of engagement in family activities in the group of children with PIMD was lower compared with that in the group of children with TD. Families with a child with PIMD spend much time and effort to adapt family living patterns to the child's functioning.

  • 52.
    Axelsson, Anna Karin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Imms, Christine
    Australian Catholic University, Melbourne.
    Wilder, Jenny
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Strategies that facilitate participation in family activities of children and adolescents with profound intellectual and multiple disabilities: parents’ and personal assistants’ experiences2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 25, p. 2169-2177Article in journal (Refereed)
    Abstract [en]

    Purpose: Participation throughout one's life plays a significant role for development and emotional well-being. For this reason, there is a need to identify ways to facilitate participation in family activities for children and adolescents with profound intellectual and multiple disabilities (PIMD).

    Methods: The study design was qualitative and explorative, based on semi structured interviews with 11 parents and 9 personal assistants of children with PIMD.

    Results: The interviews revealed participation-facilitating strategies relating to the children's/adolescent's proximal environment, such as "Availability and acceptability of the activity", "Good knowledge about the child" and a "A positive attitude of people close to the child", as well as strategies related to the children/adolescents themselves: "Sense of belonging", "Possible for the child/adolescent to understand", "Opportunities to influence" and "Feeling of being needed".

    Conclusions: Children and adolescents with PIMD are dependent on support obtained through their environment. The identified strategies, individually adapted through awareness and knowledge by the parents and the personal assistants, provide important evidence to assist our understanding in gaining understanding about how to improve participation in family activities of children and adolescents with PIMD.

    Implications for Rehabilitation Participation-facilitating strategies related to the child/adolescent and his or her proximal environments are identified to improve participation in children and adolescents with profound intellectual and multiple disabilities (PIMD). Examples of strategies for the child's/adolescents' proximal environment include "good knowledge about the child/adolescent", and, for the child/adolescent, include creating "sense of belonging" and "opportunities to influence". Identifying and making these strategies explicit may assist in enhancing the participation of children and adolescents with PIMD in family activities. People in the child's/adolescent's proximal environment need to set the scene for participation.

  • 53.
    Axelsson, Anna Karin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Wilder, Jenny
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Mälardalens Högskola.
    Frequency of Occurrence and Child Presence in Family Activities: A Quantitative, Comparative Study of Children with Profound Intellectual and Multiple Disabilities and Children with Typical Development2014In: International Journal of Developmental Disabilities, ISSN 2047-3869, Vol. 60, no 1, p. 13-25Article in journal (Refereed)
    Abstract [en]

    Objectives: The objective was to investigate the performance aspect of participation, operationalized as the frequency of occurrence of family activities and child presence in these activities for children with profound intellectual and multiple disabilities (PIMD) and children with typical development (TD). The focus was also on how family and child characteristics are related to the frequency of occurrence of family activities. This is part of a larger research project investigating facilitating factors for participation in children with PIMD.

    Methods: A descriptive, comparative study was performed using a questionnaire developed for the purpose.

    Results: In the families with a child with PIMD, the majority of activities occurred less often than in families with children with TD. In both groups, relationships were found between the frequency of occurrence of family activities and total family income, as well as the educational level of the parents. For children with PIMD, motor ability, cognition, health, and behaviour, were related to frequency of occurrence. Moreover, the presence of the children in the activities differed in the two groups; the children with PIMD were present in the activities less often.

    Discussion: Considering a long-term perspective, low occurrence of family activities and child presence may affect child development and everyday functioning. Knowledge about factors related to the occurrence of family activities and child presence in them, as well as an understanding of its causes, can promote the provision of everyday natural learning opportunities for children with PIMD.

  • 54.
    Backman, Ellen
    et al.
    School of Health and Welfare, Halmstad University, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Karlsson, Ann-Kristin
    Department of Research and Development, Region Halland, Halmstad, Sweden.
    Documentation of everyday life and health care following gastrostomy tube placement in children: a content analysis of medical records2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, p. 1-11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Everyday routines play a vital role in child functioning and development. This study explored health professionals' documentation of everyday life and health care during the first year following gastrostomy tube placement in children and the content of intervention goals.

    METHODS: The medical records of 39 children (median age 38 months, min-max: 15-192) in one region of Sweden were analysed. A content analysis approach was used with an inductive qualitative analysis supplemented by a deductive, quantitative analysis of documented intervention goals following the ICF-CY.

    RESULTS: One overall theme, "Seeking a balance", captured the view of life with a gastrostomy and the health care provided. Two categories, "Striving for physical health" and "Depicting everyday life" with seven sub-categories, captured the key aspects of the documentation. Twenty-one children (54%) had intervention goals related to the gastrostomy, and these goals primarily focused on the ICF-CY component "Body functions".

    CONCLUSIONS: To some extent the medical records reflected different dimensions of everyday life, but the intervention goals clearly focused on bodily aspects. Understanding how health care for children using a gastrostomy is documented and planned by applying an ecocultural framework adds a valuable perspective and can contribute to family-centred interventions for children using a gastrostomy. Implications for Rehabilitation There is a need for increased awareness in healthcare professionals for a more consistent and holistic healthcare approach in the management of children with gastrostomy tube feeding. This study suggests that an expanded focus on children's participation in everyday mealtimes and in the healthcare follow-up of gastrostomy tube feeding is important in enhancing the intervention outcome. Multidisciplinary teams with a shared bio-psycho-social understanding of health would contribute to a situation in which the everyday lives of households adapt to living with gastrostomy. Routine care for children with gastrostomy should follow a checklist combining crucial physiological aspects of gastrostomy tube feeding with seemingly mundane family functions in order to achieve a successful gastrostomy tube feeding intervention.

  • 55. Barnett, A.
    et al.
    Green, Dido
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Blank, R.
    New international clinical recommendations on Developmental Coordination Disorders (DCD): focus on adolescents and adults2018Conference paper (Refereed)
  • 56. Bedrosian, J
    et al.
    Calculator, S
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Light, J
    Mirenda, P
    Schlosser, R
    Issues in AAC efficacy research1998In: Proceedings from the eight biennal ISAAC conference, 1998Conference paper (Other academic)
  • 57. Bekiaris, E.
    et al.
    Panou, M.
    Gemou, M.
    Nalbantis, D.
    Arno, P.
    Tavares, G.
    Falkmer, Torbjörn
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. CHILD.
    Foerst, K.
    Ruspa, C.
    New driver training curricula, best practice, design guidelines and recommendations to authorities.2003Report (Other academic)
  • 58.
    Bengtsson, Staffan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Building a community: Disability and identity in the Qur’an2018In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 20, no 1, p. 210-218Article in journal (Refereed)
    Abstract [en]

    This article elaborates on disability and the Qur’an and accentuates how a grand narrative of moral codes held the community together and enforced a collective identity of the ummah, in which disability was interlaced with the shaping of an in-group grounded in a common set of values. This process of identity making in turn had implications for people with disabilities, since they could have trouble fulfilling religious requirements, something that was met with counter mechanisms of solidarity within the community of Muslim believers.

  • 59.
    Bengtsson, Staffan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Out of the frame: disability and the body in the writings of Karl Marx2017In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 19, no 2, p. 151-160Article in journal (Refereed)
    Abstract [en]

    How disability as a phenomenon is to be understood has been widely discussed within the field of disability research. Influenced by a Marxist perspective, the social model has reinforced the view that disability results from the organization of society rather than from individual premises. This article elaborates on these issues by exploring the writings of Karl Marx and his views concerning disability. The analysis pinpoints bodily normality in Marx’s reasoning and how the economic system shapes the premises for participation and roles, but also how people with disabilities were left out of the progressive call for social change. 

  • 60.
    Bengtsson, Staffan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The nation’s body: disability and deviance in the writings of Adolf Hitler2018In: Disability & Society, ISSN 0968-7599, E-ISSN 1360-0508, Vol. 33, no 3, p. 416-432Article in journal (Refereed)
    Abstract [en]

    This article takes its starting point in the Nazi ideology as it appears in the writings of Adolf Hitler, and discusses how disability and the body can be understood in the context of Mein Kampf. The article underlines how disability and bodily infirmities, alongside race, featured significantly in Hitler’s demagogic message. Although the overall image of disability was related to a sense of threat–and a culture gone wrong–Mein Kampf also contains a mixed interpretation of disability as a phenomenon, in which different and opposing disability narratives took part in the construction and the image of the body as a national property. 

  • 61.
    Bergendal, Birgitta
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Norderyd, Johanna
    Jönköping University, School of Health and Welfare, HHJ. CHILD. National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Zhou, Xiaolei
    Uppsala University, Department of Immunology, Genetics and Pathology, Uppsala, Sweden.
    Klar, Joakim
    Uppsala University, Department of Immunology, Genetics and Pathology, Uppsala, Sweden.
    Dahl, Niklas
    Uppsala University, Department of Immunology, Genetics and Pathology, Uppsala, Sweden.
    Abnormal primary and permanent dentitions with ectodermal symptoms predict WNT10A deficiency2016In: BMC Medical Genetics, ISSN 1471-2350, E-ISSN 1471-2350, Vol. 17, no 1, article id 88Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The WNT10A protein is critical for the development of ectodermal appendages. Variants in the WNT10A gene may be associated with a spectrum of ectodermal abnormalities including extensive tooth agenesis.

    METHODS: In seven patients with severe tooth agenesis we identified anomalies in primary dentition and additional ectodermal symptoms, and assessed WNT10A mutations by genetic analysis.

    RESULTS: Investigation of primary dentition revealed peg-shaped crowns of primary mandibular incisors and three individuals had agenesis of at least two primary teeth. The permanent dentition was severely affected in all individuals with a mean of 21 missing teeth. Primary teeth were most often present in positions were succedaneous teeth were missing. Furthermore, most existing molars had taurodontism. Light, brittle or coarse hair was reported in all seven individuals, hyperhidrosis of palms and soles in six individuals and nail anomalies in two individuals. The anomalies in primary dentition preceded most of the additional ectodermal symptoms. Genetic analysis revealed that all seven individuals were homozygous or compound heterozygous for WNT10A mutations resulting in C107X, E222X and F228I.

    CONCLUSIONS: We conclude that tooth agenesis and/or peg-shaped crowns of primary mandibular incisors, severe oligodontia of permanent dentition as well as ectodermal symptoms of varying severity may be predictors of bi-allelic WNT10A mutations of importance for diagnosis, counselling and follow-up.

  • 62.
    Bergström, Maria
    et al.
    Department of Social and Welfare Studies, Linköping University, Sweden.
    Ahlstrand, Inger
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Thyberg, Ingrid
    Department of Rheumatology, Linköping University, Sweden.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Börsbo, Björn
    Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Björk, Mathilda
    Department of Social and Welfare Studies, Linköping University, Sweden.
    ‘Like the worst toothache you’ve had’ – How people with rheumatoid arthritis describe and manage pain2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 6, p. 468-476Article in journal (Refereed)
    Abstract [en]

    Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease often associated with disability. Despite new treatments, pain and activity limitations are still present.

    Objectives: To describe how persons with RA experience and manage pain in their daily life.

    Methods: Seven semi-structured focus groups (FGs) were conducted and analyzed using content analysis.

    Results: The analysis revealed four categories: 1) Pain expresses itself in different ways referred to pain as overwhelming, aching or as a feeling of stiffness. 2) Mitigating pain referred to the use of heat, cold, medications and activities as distractions from the pain. 3) Adapting to pain referred to strategies employed as coping mechanisms for the pain, e.g. planning and adjustment of daily activities, and use of assistive devices. 4) Pain in a social context referred to the participants’ social environment as being both supportive and uncomprehending, the latter causing patients to hide their pain.

    Conclusions: Pain in RA is experienced in different ways. This emphasizes the multi-professional team to address this spectrum of experiences and to find pain management directed to the individual experience that also include the person’s social environment.

  • 63.
    Bertills, Karin
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Augustine, Lilly
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Inclusive teaching skills and student engagement in physical education2019In: Frontiers in Education, ISSN 2504-284X, Vol. 4, no 74Article in journal (Refereed)
    Abstract [en]

    Including students with disabilities in school-based Physical Education (PE) is common practice. However, little is known about students’ engagement and interaction in this environment and how it is related to PE teaching skills. Student engagement and interaction patterns were therefore observed. A multiple time-sampling method was used to perform observations of individual, contextual and environmental aspects of student engagement in school-based PE lessons. Three groups of students, aged 14 (n = 94), with: (1) Disabilities (n = 23), (2) Low grades (n = 27), and (3) High grades (n = 44) were compared. Students, independent of group, showed relatively high engagement in PE. The observed frequency of linking lesson content to PE syllabus in combination with using a vibrant affective tone when instructing was used as an indicator of high-/low-level teaching skills. Higher student engagement was observed in environments with high-level PE teaching skills, which included more whole group teaching, a higher frequency of student-teacher communicative proximity and more instructions. Students with disabilities and with low grades were more often observed in whole group activities, students with high grades in small group activities. The primary type of support provided to students with disabilities in PE seemed to consist of communicative proximity to the teacher. They were more often observed to be close to the teacher. Our results suggest that proximity to the teacher may serve as an indicator of inclusive teaching. In high-level teaching environments, teachers were more frequently in communicative proximity to all students, which facilitates learning. Lessons were also more focused (physically and academically) and technical devices and music were used for teaching purposes. More complex lesson content requires more instructions and our results show that, despite more instructions, all student groups were more on-task. Implied from our observations is that lesson complexity, the structuring of whole/small group formats, teacher proximity, and student engagement are aspects to consider when studying school-based PE. More instructions, closer communicative proximity and higher student engagement in high-level teaching provide students with more learning opportunities and facilitate feed-back and feed-forward, and individual support to students with disabilities.

  • 64.
    Bertills, Karin
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Education and Communication, HLK, Praktiknära utbildningsforskning (PUF), Didactics in Social Sciences.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Augustine, Lilly
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Education and Communication, HLK, CHILD. School of Education and Environment, Kristianstad University, Kristianstad, Sweden.
    Student engagement and high quality teaching in PE2018Conference paper (Refereed)
  • 65.
    Bertills, Karin
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work.
    Dahlström, Örjan
    Linköping University, Linköping, Sweden.
    Augustine, Lilly
    Jönköping University, School of Education and Communication, HLK, CHILD. Kristianstad University, Kristianstad, Sweden.
    Relationships between physical education (PE) teaching and student self-efficacy, aptitude to participate in PE and functional skills: with a special focus on students with disabilities2018In: Physical Education and Sport Pedagogy, ISSN 1740-8989, E-ISSN 1742-5786, Vol. 23, no 4, p. 387-401Article in journal (Refereed)
    Abstract [en]

    Background: Students with disability show an increasing incidence of school failure. Quality teaching and appropriate support may foster high self-efficacy, a predictive factor for successful school outcomes. Physical Education (PE) can provide students with a context in which self-efficacy and participation are promoted leading to improved academic achievement. The transition into secondary school can be challenging for many students with increased educational demands, developmental changes and individual social identification coinciding. A disability may add to the challenge of success.

    Methods: Three groups of students, aged 13 years and enrolled in Swedish mainstream schools were targeted (n = 439). Groups included students with 1. A diagnosed disability, 2. Low grades in PE (D–F) and 3. High grades (A–C) in PE. Questionnaires were collected and analyzed from 30/439 students with a diagnosed disability (physical, neuro-developmental and intellectual) from 26 classes, their classmates and their PE-teachers (n = 25). Relationships between student self-reports and PE-teachers’ self-ratings were investigated. Also examined was the potential to which students’ functional skills could predict elevated general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. Results were compared with the total sample and between the three target groups (n = 121).

    Results: For students with disabilities, better self-rated teaching skills were related to lower student perceived general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. The impact of classroom climate in PE was more obvious among students with disabilities. Perceived functional skills were associated with elevated general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. Better socio-cognitive functional skills had an overall positive effect on all outcomes. Students with disabilities reported results similar to the total sample, the D–F group scored lower and the A–C group higher than the total sample and the disability group. Elevated self-efficacy in PE is six times less probable in students with disabilities, compared to the A–C group.

    Conclusions: Our findings that better teacher planning and grading skills, are detrimental to students disadvantaged by disability is contradictive. Improving the establishment and communication of adapted learning standards at the transition to secondary school is a crucial and a predictive factor for promoting positive school experiences for students with disability. Students with disabilities need to be assured that the intended learning outcomes can be reached by doing activities differently than their typically functioning peers. Consideration of class composition is suggested as a means of promoting a positive learning climate, which would particularly benefit students with disabilities. Allocation of resources to support student socio-cognitive skills would improve experiences for the D–F group and likely promote a positive learning environment.

  • 66.
    Bertills, Karin
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Education and Communication, HLK, Praktiknära utbildningsforskning (PUF), Didactics in Social Sciences.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Augustine, Lilly
    School of Education and Environment, Kristianstad university, Kristianstad, Sweden.
    Measuring self-efficacy, aptitude to participate and functioning in students with and without impairments2018In: European Journal of Special Needs Education, ISSN 0885-6257, E-ISSN 1469-591X, Vol. 33, no 4, p. 572-583Article in journal (Refereed)
    Abstract [en]

    Including vulnerable groups of students such as students with learning disabilities in mainstream school research, require ethical considerations and questionnaire adaptation. These students are often excluded, due to low understanding or methodologies generating inadequate data. Students with disability need be studied as a separate group and provided accessible questionnaires. This pilot study aims at developing and evaluating student self-reported measures, rating aspects of student experiences of school-based Physical Education (PE). Instrument design, reliability and validity were examined in Swedish secondary school students (n = 47) including students, aged 13, with intellectual disability (n = 5) and without impairment and test–retested on 28 of these students. Psychometric results from the small pilot-study sample were confirmed in analyses based on replies from the first wave of data collection in the main study (n = 450). Results show adequate internal consistency, factor structure and relations between measures. In conclusion, reliability and validity were satisfactory in scales to measure self-efficacy in general, in PE, and aptitude to participate. Adapting proxy ratings for functioning into self-reports indicated problems. Adequacy of adjustments made were confirmed and a dichotomous scale for typical/atypical function is suggested for further analyses.

  • 67.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Carlhed, C
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    The impact of early intervention on the family system: perspectives on process and outcome1999In: Proceedings of the 4th European Symposium of EURYLAID: Equal opportunities and quality of life for families with a young disabled child. October 14th - 17th, 1998, Butgenbach, Belgium, 1999Conference paper (Other academic)
  • 68.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Changing perspectives in early intervention for children with disabilities in Sweden1997In: Infants and young children, ISSN 0896-3746, E-ISSN 1550-5081, Vol. 9, no 3, p. 56-68Article in journal (Refereed)
  • 69.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Creating a Team Around the Child Through Professionals' Continuing Education2003In: Early intervention practices around the world, Baltimore: Paul H. Brookes , 2003, p. 171-190Chapter in book (Other academic)
  • 70.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Early Intervention in Sweden: A Developmental Systems Perspective2004In: The Developmental Systems Approach to Early Intervention, Baltimore: Paul H. Brookes Publishing Company , 2004, p. 571-592Chapter in book (Other academic)
  • 71.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Family involvement in assessment and intervention: Preceptions of professionals and parents in Sweden1995In: Exceptional children, ISSN 0014-4029, E-ISSN 2163-5560, Vol. 61, no 6, p. 520-535Article in journal (Refereed)
    Abstract [en]

    Describes perceptions of professionals and parents of the current and ideal state of family involvement in the habilitation process for children with disabilities in early intervention in Sweden. Significant discrepancies between current and ideal practices in four dimensions; Professionals' preferences for a higher degree of family involvement.

  • 72.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Reagera och reglera: Beteendestilar hos barn med grava funktionsnedsättningar1997In: Forskare om utvecklingsstörning: perspektiv - kunskaper - utmaningar: en vänbok till Lars Kebbon, Uppsala: Uppsala Universitet , 1997, p. 52-76Chapter in book (Other (popular science, discussion, etc.))
  • 73.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Små barns hälsa och välbefinnande2015In: Att bli förskollärare: Mångfacetterad komplexitet / [ed] Ingrid Engdahl, Eva Ärlemalm-Hagsér, Stockholm: Liber, 2015, 1, p. 73-78Chapter in book (Other academic)
  • 74.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Transatlantic Consortium on Early Childhood Intervention2003In: Mental Health and Mental Retardation: A lifespan Multidisciplinary Approach: Abstract Book from the 4th European Congress,  17 – 20th September 2003. Italy, Rome., 2003Conference paper (Other academic)
  • 75.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Adolfsson, Margareta
    Jönköping University, School of Education and Communication, HLK, CHILD.
    ICF-CY as a common language in early childhood intervention : Work shop2012Conference paper (Other academic)
    Abstract [en]

    The workshop covers ICF-CY as a framework in collaborative problem solving together with families and in preschool. A short introduction to ICF-CY will be presented. The workshop will be based on case studies where the participants will use ICF-CY as a tool in assessment and intervention. The model for collaborative problem solving developed by the CHILD group includes problem formulations, problem explanations, goal setting, design of methods, implementation and follow-up. The tool uses checklists based on ICF-CY for formulation of difficulties and problems in terms of activity and participation, problem explanations in terms of body structures and functions and environmental factors. An individual intervention plan for a child with disability based on functioning in everyday life is developed based on the assessment. The utility and feasibility of ICF-CY as a tool and a common language in early childhood intervention will be discussed.

  • 76.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Ibragimova, N
    Svensk fältprövning av WHO:s Internationell klassifikation av funktionstillstånd och funktionshinder, version för barn och ungdom (ICF-CY)2006Report (Other academic)
  • 77.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Light, J
    McNaughton, D
    Goal setting and problem solving with AAC users and families2000In: Proceedings from the Ninth Biennial Conference of the International Society for Augmentative and Alternative Communication, August 2nd-6th, 2000, Washington DC, USA., 2000Conference paper (Other academic)
  • 78.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Simeonsson, Rune
    Assessment philosophies and practices in Sweden2000In: Interdisciplinary clinical assessment of young children with developmental disabilities, Baltimore: Paul H. Brookes , 2000, p. 391-412Chapter in book (Other academic)
  • 79.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Simeonsson, Rune
    Jönköping University, School of Education and Communication, HLK, CHILD.
    ICF och ICF-CY - Historik och utveckling2011In: Handbok i att använda ICF och ICF-CY / [ed] Mia Pless & Mats Granlund, Lund: Studentlitteratur , 2011, 1:1, p. 71-90Chapter in book (Other academic)
  • 80.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Simeonsson, Rune
    Special education: a systems theory perspective2005In: Mångsidigt samspel: en vänbok till Siv Fischbein, Stockholm: Hls Förlag , 2005, p. 41-55Chapter in book (Other academic)
  • 81.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Simeonsson, Rune J.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Early Childhood Intervention2006In: Encyclopedia of Disability, London: Sage Publications , 2006Chapter in book (Other academic)
  • 82.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Granlund, Mats
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. CHILD.
    Åman, K
    Early Intervention and the Family System: Process and Outcome2000In: Journal of Intellectual Disability Research Volume 44 Issue 3-4: New millennium research to practice : congress abstracts. 11th World Congress of the International Association for the Scientific Study of Intellectual Disabilities (IASSID): August 1-6 2000, Seattle, Washington, USA., Oxford: Blackwell Science , 2000, p. 209-Conference paper (Other academic)
  • 83.
    Björck-Åkesson, Eva
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Wilder, Jenny
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Pless, Mia
    Simeonsson, Rune
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Adolfsson, Margareta
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Almqvist, Lena
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Augustine, Lilly
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Klang, Nina
    Lillvist, Anne
    The international classification of functioning, disability and health and the version for children and youth as a tool in child habilitation/early childhood intervention: feasibility and usefulness as a common language and frame of reference for practice2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no S1, p. 125-138Article in journal (Refereed)
    Abstract [en]

    Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

  • 84.
    Björk, Maria
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Division of Nursing, Department of Health and Learning, University of Skövde, Sweden.
    Sundler, Annelie J.
    Division of Nursing, Department of Health and Learning, University of Skövde, Sweden.
    Hallström, Inger
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Hammarlund, Kina
    Division of Nursing, Department of Health and Learning, University of Skövde, Sweden.
    Like being covered in a wet and dark blanket – Parents' lived experiences of losing a child to cancer2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 25, p. 40-45Article in journal (Refereed)
    Abstract [en]

    Purpose The aim of this study was to illuminate parents' lived experiences of losing a child to cancer.

    Method Interviews and a narrative about parents' experiences of losing a child to cancer were gathered from six parents of children whom had participated in a longitudinal study across the child's illness trajectory. The analysis of the data was inspired by van Manen's hermeneutic phenomenological approach.

    Results One essential theme emerged: Like being covered in a wet and dark blanket, as well as six related themes: Feeling conflicting emotions, Preparing for the moment of death, Continuing parenting after death, Recollecting and sharing memories, Working through the sorrow and New perspectives in life.

    Conclusion There is a need for good palliative care. If not, there is a risk that the parent will perseverate and blame themselves for not being a good parent during the suffering child's last time in life. Meetings with the parents six months and two years after the child's death might facilitate healing through the grief process.

  • 85.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. CHILD.
    Berättelsen om "den obente" soldaten.1998In: Arbetsterapeuten, ISSN 0345-0988, no 13, p. 14-18Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Ett försök att reda ut begreppen med anknytning till ett arbetsterapeutiskt perspektiv.

  • 86.
    Björklund, Anita
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. CHILD.
    Fokus på hälsa, engagemang och stolthet: En diskussion av teoretiska perspektiv på rehabilitering av sjukskrivna.2006In: Vågor på HaVet: tio texter om arbete och funktionshinder, Jönköping: Hälsohögskolan , 2006, p. 22-Chapter in book (Other (popular science, discussion, etc.))
  • 87.
    Björkman, Berit
    Jönköping University, School of Health Science, HHJ. CHILD.
    Children in the Radiology Department: a study of anxiety, pain, distress and verbal interaction2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This dissertation focuses on children’s experiences of going through an acute radiographic examination due to a suspected fracture. The findings from interviews with children aged 3-15 years showed anxiety, pain and distress to be a concern in conjunction with an examination (Paper I). These initial findings entailed empirical studies being undertaken in order to further study children’s pain and distress in conjunction with an examination (Paper II) as well as children’s anxiety, pain and distress related to the perception of care in the periradiographic process (Paper III). Finally, the verbal interaction between the child and radiographer during the examination was studied (Paper IV).

    The research was conducted through qualitative, quantitative and mixed method studies. The data collection methods comprised interviews (Paper I), children’s self-reports (Papers II and III), drawings (Paper III), questionnaire (Paper III) and video recordings (Papers I, II and IV). Altogether, 142 children (3-15 years) and 20 female radiographers participated in the studies.

    Children aged 5-15 years were observed and they completed selfreports on pain and distress. The children were also provided with an opportunity to express their perceptions of the peri-radiographic process and to make a drawing that was analysed with regard to their level of anxiety. Finally, the verbal interaction between the child and radiographer during the examination was analysed.

    Qualitative content analysis was used to analyse the interviews and the written comments in the questionnaire (Papers I and III). The Child Drawing: Hospital Manual (CD:H) was used when analysing the children’s drawings (Paper III), and the Roter Interaction Analysis System (RIAS) was used when analysing the verbal interaction derived from the video recordings (Paper IV). Non-parametric statistics were applied when analysing the quantitative data (Papers II, III and IV). The findings showed that children aged 5-15 years reported pain on the Coloured Analogue Scale (CAS) and distress on the Facial Affective Scale (FAS) above levels at which treatment or further intervention is recommended. These findings corresponded to the observed pain behaviour measured on the Face, Legs, Activity, Cry and Consolability Scale (FLACC) and anxiety expressed through drawings (CD:H). The children’s perception of the care being provided in the peri-radiographic process, was not related to the experience of anxiety, pain and distress however. The children were confident in the radiographers, who they perceived to be skilled in the task and sensitive to their needs. These findings are supported by the analysis of the verbal interaction (RIAS), which showed that the radiographer adjusted the communication when balancing the task-focused and socio-emotional interaction according to the child’s age.

    The findings point to the conclusion that children going through an acute radiographic examination should be assessed regarding the anxiety, pain and distress they experience. This is a prerequisite for the radiographer to provide care according to the child’s ability and preferences when interacting with children in the peri-radiographic process.

  • 88.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Almqvist, Lena
    Jönköping University, School of Education and Communication, HLK, CHILD. Mälardalens Universitet.
    Sigstedt, Bo
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Children's experience of going through an acute radiographic examination.2012In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 18, no 2, p. 84-89Article in journal (Refereed)
    Abstract [en]

    Children’s experience of radiographic examinations remains largely unexplored, although most radiog- raphers examine children on a daily basis. In order to provide the high quality care that meets the needs of patients it was considered important to undertake research focused upon the patients’ experience of radiographic practice.

    The aim of the study was to investigate children’s experiences undergoing a radiographic examination for a suspected fracture.

    Inclusion criteria were Swedish-speaking children between 3 and 15 years of age who were submitted for a radiographic examination with an acute condition of the upper or lower extremity. Patients were informed of the study and together with the escorting parent or relative asked for consent to participate.

    During the examination the child was videotaped and immediately after, the child was interviewed in a nearby facility. The interview contained open-ended questions and was conducted while watching the videotape together with the child and their parent or relative and the researcher.

    Qualitative content analysis was used in analyzing the collected data. The analysis resulted in two categories e “feeling uncomfortable” and “feeling confident”. The subcategories contained in these categories were “pain in relation to injury and examination”, “the waiting time is strenuous”, “worries for the future and consequences of the injury”, “confidence in parental presence”, “confidence in radio- graphic staff and examination procedure”, and finally “recognition entails familiarity”.

    The results revealed that for the younger children, the experience of undergoing an acute radiographic examination was associated with pain and anxiety, but for the older children, the anxiety was more connected to whether the injury had caused a fracture and any anticipated future consequences or complications.

  • 89.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Bendroth, R.
    Lund University, Lund, Sweden.
    Andersson, B. T.
    Dep Health Sciences, Lund, Sweden.
    Swedish radiographer’s experiences of their work-performance when possessing increased knowledge in reporting2017In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 58, no 1 Suppl., p. 24-24Article in journal (Refereed)
    Abstract [en]

    Introduction: Radiographers are today facing various challenges as the technical equipment is getting more advanced and the examinations encounter patients with complex medical records. Furthermore, in the Swedish context, radiology departments are struggling with shortage of both radiologists and radiographers. Following, this has led to a work-situation where radiologists are not always in place during emergency duty, and radiographers’are taking on additional responsibility. Hence, there is a need for further and deeper knowledge within areas that previously was undertaken solely by radiologists. One such area is reporting; and a 7.5 ECTS course was designed and offered to registered radiographers. The aim was to investigate radiographer’s experience of their work-performance and contribution to the clinic after attending this particular course in reporting.

    Methods: The study had a qualitative design based on individual and semi-structured interviews with 34 radiographers who attended the course in reporting the fall of 2013, 2014 and 2015. The interviews were transcribed verbatim and analysed using qualitative content analysis.

    Results: The analysis resulted in a comprehensive theme: Width and depth in the professional practice. This theme embraced three categories: Increased knowledge, Professional recognition, Work satisfaction.

    Conclusions: Increased knowledge in reporting is necessary to meet the demands from the diagnostic departments. A course in reporting on advanced level is a tool for deeper understanding of the medical image. However, there will still be challenges and constraints during the path to be a fully specialized radiographer in reporting. There is a need for more courses in this area on the second and third level.

  • 90.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Nilsson, Stefan
    Jönköping University, School of Health and Welfare, HHJ. CHILD. The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg.
    Children's and parents' perceptions of care during the peri-radiographic process when the child is seen for a suspected fracture2016In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 22, no 1, p. 71-76Article in journal (Refereed)
    Abstract [en]

    Background

    Visiting a Radiology department may elicit both positive and negative feelings for children and parents alike. This study investigated children's and parents' perceptions of care during the peri-radiographic process and whether these perceptions correlated with the child's perceptions of pain and distress.

    Methods

    This study utilized a quantitative descriptive design. Its data was collected in five Radiology departments, two where examinations are performed exclusively on children and three that treat both children and adults. Data collection contained questionnaires from children (n = 110) and their parent (n = 110) as well as children's self-reports of pain and distress.

    Results

    The findings illustrated that the children and their parent were satisfied with the care provided throughout the peri-radiographic process, unrelated to the child's self-reported levels of pain and distress or examination setting (i.e. children's department or general department). The highest scores of satisfaction were ascribed to “the radiographer's kindness and ability to help in a sufficient way,” whereas “available time to ask questions and to meet the child's emotional needs” received the lowest scores.

    Conclusions

    Parents and children alike perceived the radiographers as skilled and sensitive throughout the examination, while radiographers' time allocated to interacting with the child was not perceived be sufficiently covered.

  • 91.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Fridell, Kent
    Karolinska Institutet, Clinical Science, Intervention and Technology, Stockholm, Sweden.
    Tavakol Olofsson, Parvin
    Vårdförbundet, Stockholm, Sweden.
    Plausible scenarios for the radiography profession in Sweden in 20252017In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 23, no 4, p. 314-320Article in journal (Refereed)
    Abstract [en]

    Introduction: Radiography is a healthcare speciality with many technical challenges. Advances in engineering and information technology applications may continue to drive and be driven by radiographers. The world of diagnostic imaging is changing rapidly and radiographers must be proactive in order to survive. To ensure sustainable development, organisations have to identify future opportunities and threats in a timely manner and incorporate them into their strategic planning. Hence, the aim of this study was to analyse and describe plausible scenarios for the radiography profession in 2025.

    Method: The study has a qualitative design with an inductive approach based on focus group interviews. The interviews were inspired by the Scenario-Planning method.

    Results: Of the seven trends identified in a previous study, the radiographers considered two as the most uncertain scenarios that would have the greatest impact on the profession should they occur. These trends, labelled "Access to career advancement" and "A sufficient number of radiographers", were inserted into the scenario cross. The resulting four plausible future scenarios were: The happy radiographer, the specialist radiographer, the dying profession and the assembly line.

    Conclusion: It is suggested that "The dying profession" scenario could probably be turned in the opposite direction by facilitating career development opportunities for radiographers within the profession. Changing the direction would probably lead to a profession composed of "happy radiographers" who are specialists, proud of their profession and competent to carry out advanced tasks, in contrast to being solely occupied by "the assembly line".

  • 92.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gimbler Berglund, Ingalill
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform. Division of Medical Diagnostics, Region Jönköping County, Jönköping, Sweden.
    Huus, Karina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Peri-radiographic guidelines for children with autism spectrum disorder: a nationwide survey in Sweden2017In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 43, no 1, p. 31-36Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aimed to investigate the prevalence of guidelines and routines used nationwide when children with autism spectrum disorder (ASD) are taken care of and examined in a radiology department during a peri-radiographic process.

    METHOD: A nationwide survey was compiled and distributed to 94 radiology departments throughout Sweden, i.e. those performing more than 100 000 radiographic examinations annually. The survey was designed as a web questionnaire with seven questions on possible guidelines and/or routines for the departments when preparing and taking care of children with ASD in conjunction with a radiographic procedure. The data were scrutinized, using descriptive statistics.

    RESULTS: In total, 86 radiology departments responded to the survey (response rate 92%). Of those departments, 40 did not examine children with ASD. None of the departments included in the study had existing guidelines underpinning the routines when preparing and performing radiographic examinations for children diagnosed with ASD. A few departments (n = 8) would set aside more time for the procedure if it were known in advance that the child to be examined had been diagnosed with ASD. Also, some departments (n = 7) had radiographers who were more experienced in the care of children who would be appointed to perform examinations for children with ASD.

    CONCLUSION: It is suggested that guidelines should be developed in order to increase interaction in a supportive way and decrease anxiety during the peri-radiographic process with children with ASD.

  • 93.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gimbler Berglund, Ingalill
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Huus, Karina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Are radiographers prepared to meet children with special needs, when seen for an examination?2017In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 58, no 1 Suppl., p. 16-16Article in journal (Refereed)
    Abstract [en]

    Introduction: Anxiety is often experienced by children undergoing health care procedures, and children with autism spectrum disorders (ADS) experience more anxiety than typically developed children. A prerequisite for obtaining an optimum procedure is firstly based on the health care provider’s knowledge about children with ASD, but may also depend on the use of guidelines. Two previous national surveys showed, that none radiology or paediatric departments and a minority of anaesthesiology departments throughout Sweden use specific guidelines when seeing children with ASD. Following, the purpose was to develop guidelines to use when caring for and preparing children with ASD in those settings.

    Methods: A modified Delphi method was used, including19 experts identified from the two afore mentioned surveys. The questions considered in the process, proceeded from previous research and the results from the surveys. The experts’ responses regarding the importance of each item, were analysed and scrutinized between each round.

    Results: The Delphi process resulted in guidelines consisting of 15 items and a checklist with 16 aspects. The items cover the areas: planning and involving parents, features in the environment, use of time, communication, thehealth care professionals. The checklist covers the child’spattern of communication, anxiety, sensory stimuli, special interests and likes/dislikes.

    Conclusions: To obtain an optimum caring encounter when a child with ASD is seen in the preoperative and radiology setting, a meticulous planning is important and the environment should be adjusted for the needs of the child. To accomplish this, guidelines need to be in place and be followed.

  • 94.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Children's Anxiety, Pain, and Distress Related to the Perception of Care While Undergoing an Acute Radiographic Examination2014In: Journal of Radiology Nursing, ISSN 1546-0843, Vol. 33, no 2, p. 69-78Article in journal (Refereed)
    Abstract [en]

    Visiting the hospital is likely a frightening experience for a child, and going through a radiographic examination has been reported as both distressing and painful. More knowledge from the children's perspective is needed on this subject, however, and thus, the aim of this study was to investigate children's anxiety, pain, and distress in conjunction with an acute radiographic procedure and whether these factors can be related to the perception of care. A mixed method design was used to analyze data from 110 participants between 5 and 15 years of age, who were examined in a Swedish radiology department. The quantitative findings showed anxiety, pain, and distress to be a concern during a radiographic examination. Significant correlations were obtained between anxiety and pain as well as between anxiety and distress. In addition, also the qualitative findings showed pain and the waiting time to be concerns. Regardless of the quantitative findings, however, children of all ages were satisfied with the care performed in the periradiographic process, perceiving the examination as supportive and geared to their needs. Robust assessment of anxiety, pain, and distress is imperative when interacting with children in acute examination situations to avoid both negative short-term and long-term consequences.

  • 95.
    Björkman, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Simeonson, Rune J.
    Jönköping University, School of Education and Communication, HLK, CHILD. University of North Carolina at Chapel Hill.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Will it Hurt? Verbal Interaction between Child and Radiographer during Radiographic Examination2013In: Journal of Pediatric Nursing, ISSN 0882-5963, Vol. 28, no 6, p. e10-e18Article in journal (Refereed)
    Abstract [en]

    This study investigated the nature of verbal interactions between child, parent and radiographer and theextent to which it varied as a function of the child's age. The participants were 20 female radiographersand 32 children (3–15 years) examined for acute injuries. The verbal interactions during theexamination were video recorded and analyzed using the Roter Interaction Analysis System (RIAS).Results indicated that 80% of the verbal interaction was accounted for by the radiographer, 17% by thechild and 3% by the parent. The distribution of utterances varied with regard to children's age.

  • 96.
    Björkman, Berit
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Nilsson, Stefan
    Jönköping University, School of Health Science, HHJ. CHILD.
    Sigstedt, Bo
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ. CHILD.
    Children’s pain and distress while undergoing an acute radiographic examination2012In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 18, no 3, p. 191-196Article in journal (Refereed)
    Abstract [en]

    Pain has been highlighted as a main concern for children in conjunction with an acute radiographic examination. The aim of this study was to further investigate children’s pain and distress while undergoing an acute radiographic examination.

    The study comprised 29 participants with an age range of 5–15 years who were injured and submitted to an acute radiographic examination of the upper or lower extremity when the question at issue was fracture. The Coloured Analogue Scale (CAS) and the Facial Affective Scale (FAS) were used as self-reporting scales to measure the children’s pain and distress. The Face, Legs, Activity, Cry and Consolability Behavioural scale (FLACC) was used as an observation tool to assess behaviours associated with pain in children.

    Descriptive statistics were used when analysing the scores, and the results showed that children experience pain and distress in conjunction with a radiographic examination after an injury. Spearman’s correlation was used to compare variables, and significant correlations were obtained between the self-reported pain and the observed pain behaviour. Fischer’s Exact test was used to compare groups, and when using the cut-off 3.0 on the self-reporting scale no significant correlation was found concerning the pain reported by children diagnosed with and without a fracture. No significant correlations were found concerning the self-reported distress and pain either, regardless of whether it was a first-time visit and whether a parent was near during the examination.

  • 97.
    Black, Melissa H.
    et al.
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia. Curtin Autism Research Group, Curtin University, Perth, Western Australia .
    Mahdi, Soheil
    Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden .
    Milbourn, Benjamin
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia; Curtin Autism Research Group, Curtin University, Perth, Western Australia .
    Thompson, Craig
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia; Curtin Autism Research Group, Curtin University, Perth, Western Australia .
    D'Angelo, Axel
    Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden .
    Ström, Eva
    Swedish Public Employment Service, Unit for Rehabilitation and Work, Hallunda-Norsborg, Stockholm, Sweden..
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia; Curtin Autism Research Group, Curtin University, Perth, Western Australia .
    Falkmer, Torbjörn
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia; Curtin Autism Research Group, Curtin University, Perth, Western Australia; Pain and Rehabilitation Centre. Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden .
    Lerner, Matthew
    Stony Brook University, Stony Brook, New York, USA..
    Halladay, Alycia
    Autism Science Foundation, New York, USA.
    Gerber, Alan
    Stony Brook University, Stony Brook, New York, USA..
    Esposito, Christopher
    Stony Brook University, Stony Brook, New York, USA..
    Girdler, Sonya
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia; Curtin Autism Research Group, Curtin University, Perth, Western Australia .
    Bölte, Sven
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia; Curtin Autism Research Group, Curtin University, Perth, Western Australia; Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden .
    Perspectives of Key Stakeholders on Employment of Autistic Adults across the United States, Australia and Sweden2019In: Autism Research, ISSN 1939-3792, E-ISSN 1939-3806, p. 1-15Article in journal (Refereed)
    Abstract [en]

    Despite efforts to improve employment outcomes for autistic individuals, internationally their employment rates remain low. There is a need to better understand the factors influencing successful employment for autistic adults in the labor market from the perspectives of multiple keystakeholders. This study represents the second in a series of papers conducted as part of an International Society for Autism Research policy brief aimed at improving employment outcomes for autistic individuals. A community consultation methodology using focus groups, forums, and interviews was applied with autistic individuals (n = 19), family members (n = 18), service providers (n = 21), employers (n = 11), researchers (n = 5), and advocacy group representatives (n = 5) in Australia, Sweden, and the United States, aiming to identify the factors perceived to determine gaining and maintaining employment for autistic individuals. Directed content analysis, guided by the International Classification of Functioning, Disability and Health (ICF), was conducted to investigate the key factors influencing employment outcomes for autistic individuals. Meaningful verbal concepts, or units of text with common themes, were also derived from the qualitative data and then linked and compared to the ICF Autism Spectrum Disorder (ASD) Core-sets. Across countries, activity and participation and environmental factor categories of the ICF were the most associated with employment outcomes. Results suggest that removal of environmental barriers and enhancing environmental facilitators may assist to remediate ASD-related difficulties in the workplace.

    LAY SUMMARY: This study sought to understand the perspectives of autistic individuals and key stakeholders on factors influencing if autistic adults get and keep jobs. Across Australia, Sweden, and the UnitedStates, focus groups and interviews were conducted to understand international perspectives on what helps and hinders getting and keeping a job for autistic individuals. The environment, including supports, relationships, attitudes, and services, were perceived to be the most important for workplace success. Intervention targeting barriers and facilitators in the workplace environment may support autistic adults to be successful in the labor market.

  • 98.
    Black, Melissa H.
    et al.
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
    Vaz, Sharmila
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
    Parsons, Richard
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
    Tang, Julia S. Y.
    School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
    Morris, Susan
    School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
    Lee, Hoe
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
    Disembedding performance and eye gaze behavior of adolescents with Autism Spectrum Disorder2019In: Research in Autism Spectrum Disorders, ISSN 1750-9467, E-ISSN 1878-0237, Vol. 66, article id 101417Article in journal (Refereed)
    Abstract [en]

    Background: Atypical visual perception in individuals with Autism Spectrum Disorders (ASD) may contribute to superiority in disembedding tasks. Gaze behavior has provided some insights in to mechanisms underlying this purported superiority in children, however evidence is limited and requires additional investigation.

    Method: The performance and gaze behavior of 27 adolescents with ASD and 27 matched typically developing (TD) peers were examined during the Figure Ground Subtest of the Test of Visual Perception Skills-third edition (TVPS-3).

    Results: Compared to their TD counterparts, adolescents with ASD were no different in accuracy, however, had a longer response time. Differences in gaze behavior were also observed, characterized by adolescents with ASD spending less time viewing the incorrect and target figures, and spending a greater proportion of time viewing irrelevant areas of the stimuli compared to TD adolescents.

    Conclusions: Results suggest that while altered visual perception was observed, this did not contribute to superiority in disembedding tasks in adolescents with ASD. Future research is required to elucidate conditions under which altered visual perception may contribute to behavioral superiority. 

  • 99.
    Blane, A.
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, H. C.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, M.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Parsons, R.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    The cognitive and socio-demographic influences on driving performance and driving cessation in post-stroke drivers2016In: Advances in Transportation Studies, ISSN 1824-5463, no 38, p. 75-90Article in journal (Refereed)
    Abstract [en]

    Background: Driving is a complex activity requiring highly integrated cognitive and perceptual functions that can be negatively affected following a stroke. The decision to continue or cease with driving after a stroke may not be exclusively dependent on deficits in cognitive and motor abilities. Instead, it is possible that social supports, alternative means of transportation, education level, income, self-regulation ability and the awareness of personal health problems may also influence the decision.

    Aim: The aim of this research was to explore the influence of personal and socioeconomic factors, in addition to existing cognitive impairment, on the decision of post-stroke adults to return to driving.

    Method: A case control design was employed to compare driving performance of 48 individuals who had experienced a stroke and 22 volunteer healthy control participants. Half of the post-stroke cohort (N=24) had continued driving and the other half had ceased driving. Socio-demographic and driving-related cognitive performance data were collected to characterise the comparison groups before driving performance was assessed in a driving simulator.

    Results: Overall, the post-stroke groups did not perform as well as the control participants in the cognitive and driving assessments. The perceived ability to drive after a stroke was not significantly correlated with participants'€™ actual driving ability. Post-stroke adults were more likely to continue driving if they reported having a tertiary level education and a greater income.

    Conclusion: The decision to return to driving after a stroke is a complicated, multifactorial process. This study confirms previous research, which found that cognition and driving performance are impaired poststroke. The findings also suggest that post-stroke drivers'€™ decision to return to driving was not linked to their ability to drive, but more to socio-demographic and environmental factors. Further screening tools and assessments to identify those at risk when returning to the road post-stroke are required. 

  • 100.
    Blane, Alison
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, Hoe C.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Willstrand, Tania D.
    Human Factors, Swedish National Road and Transport Research Institute (VTI), Göteborg, Sweden.
    Investigating cognitive ability and self-reported driving performance of post-stroke adults in a driving simulator2018In: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 25, no 1, p. 44-53Article in journal (Refereed)
    Abstract [en]

    Background

    Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers.

    Objectives

    The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls.

    Methods

    A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration.

    Results

    There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability.

    Conclusion

    This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery.

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