Zabel, T. A., Gray, R. M., Gardner, J., & Ackerman, J. (2005). Use of school-based one-to-one aides for children following traumatic brain injury: A proposed practice model. Physical Disabilities: Education and Related Services 24(1), 5-22.
The authors proposed that students with traumatic brain injuries (TBI) may have greater success when transitioning back to school if they are supported by one-to-one aides. To support this, the authors noted that similar interventions have been shown to be successful with students with other disabilities (Pervasive Developmental Disorders and Attention-Deficit/Hyperactivity Disorder) who struggle with executive functioning difficulties (i.e., problems maintaining attention, concentration, and behavioral regulation).
Despite the hope of one-to-one aides providing positive and supportive contexts while student functioning and independence improves, several potential problems were outlined: (a) conflict b/w teachers and aides, (b) over-reliance on aides for instruction, (c) over-dependence on aides for behavior management, (d) and high costs. For these reasons, the authors emphasized that such an intervention should be individualized to meet the unique needs of each student and time-limited to promote independence.
The authors outlined a model to provide a foundation for developing and assessing interventions utlizing one-to-one aides for students with TBI. The authors' model includes two dimensions: (1) independence vs. dependence and (2) inhibition vs. goal direction. For the first dimension, the authors emphasized that one-to-one aides should avoid fostering student dependence (e.g., by providing cues or behavior management) while facilitating independence (e.g., reinforce self-regulatory strategies). Students with TBI can experience difficulties with executive functioning, impairing their abilities to stop or inhibit impulsive behaviors as well as initiate goal-directed behaviors. Thus, for the second dimension, the authors proposed that both ends of the continuum (inhibition and goal direction) were essential goals for students with TBI.
The authors also provided several guidelines to facilitate process: (1) child-generated input for designing interventions, (2) frequent changing of rewards, (3) adequate training for aides in TBI and effective interventions, (4) regular supervision of aide by behavior specialist, (5) opportunities for student to make mistakes to learn independence, (6) one-to-one aide should collect data to evaluate progress, and (7) data should be collected in contexts with and without the aide to inform decisions about when to end one-to-one services.
Summarized by: Jesse Suter, July 2006
Last modified February 14 2008 11:24 AM
