The TROG assesses understanding of grammatical structures, e.g. “The boy is running” as opposed to walking/not running. On the 7 th July 2011, various people connected to Spirals and the Children’s Centre were invited to come and see a presentation of the data and to join in with some discussion around the results. This session included Early Years Advisory Teachers, Foundation Stage Coordinators, Children’s Centre Teachers, Head Teachers, the Head of the Leys Children’s Centre and the Area Service Manager for Children’s Centres in Central Oxford. ResultsA total of 27 references were retrieved, and 8 studies were selected. All analyzed studies demonstrated that RAPT could reduce LOS and accurately predict discharge disposition especially for high- and low-risk patients. In the intermediate risk category, a targeted intensive postoperative rehabilitation program has demonstrated good results in reducing the uncertain outcome. The Advance Care Planning (ACP) Specialist Program (B) is a nursing home intervention that involves providing standardized staff education and strengthening facilities’ procedures, to enable systematic advance care planning facilitation by existing staff [ 11, 12]. The interventionists are currently implementing a PCT applying the intervention to nursing home residents with ADRD [ 13]. Because it aims to strengthen a process that is already occurring as part of standard practice, the ACP Specialist Program is low risk and scores high on that domain. It also scores high for alignment, because nursing home staff widely recognize advance care planning as valuable, but challenging, and welcome assistance improving the process. In contrast, medium scores for several domains, such as feasibility and measurement, reflect the fact that the intervention requires nursing home leaders to review and revise existing policies, explicitly commit staff time (which may require shifting commitments), and modify electronic documentation to capture advance care planning.

children who are learning English as an additional language managed to score within normal limits for their age on either comprehension or expressive language post-Spirals without taking into account the EAL factor. Spirals seems to be particularly useful for children learning English as an additional language. This Summer (August 2011) there will be four sessions for parents and children to attend. The principles of the sessions will be based on Spirals and other general Speech and Language Therapy advice. Children who have attended Spirals throughout the year will be invited to attend with their parents. The idea of these sessions is to build on parent’s skills in facilitating their child’s language and communication development and for children to continue to practice their skills during the six week break so that do not regress while they are away from their setting.Another child made 33 months progress in expressive language. He started off with just over a 7 month delay and finished scoring what would be expected for a child just under 18 months older than him. Only 7 children made no statistically significant progress. This means that they made less than 6 months progress in expressive language and less than 2 months progress in comprehension. 86% of these children are those who are known to Speech and Language Therapy. 4 of them have Special Educational Needs. 2 of the children are under Speech and Language Therapy Services and are learning English as an additional language. Baier RR, Mitchell SL, Jutkowitz E, Mor V. Identifying and supporting nonpharmacological dementia interventions ready for pragmatic trials: results from an expert workshop. J Am Med Dir Assoc. 2018;19:560–2. A theme that came out of the parent workshop evaluation and figures was that parents like to be involved and included as much as possible in their child’s learning. The parents who attended the workshops generally either had a good relationship with Laura, or with the child’s Teacher or both. Only those really confident or really well-supported parents came to the workshop having not met Laura before. One parent wrote on the evaluation that she would have liked homework sheets; another said that she would have liked a workshop earlier in the year.

Assess children’s expressive vocabulary skills through presenting a series of pictures that children have to name. One child made 26 months progress in comprehension. He started Spirals 14 months delayed and, 8 months later, was scoring more highly than expected for his age. A case study of this child is included as appendix 1. Although these procedures are safe treatments for OA, the costs associated with them are substantial. Is the intervention protocol sufficiently detailed to be replicated? In this context, protocol refers to an operations manual or implementation guide, not the Institutional Review Board submission. To be ready for a PCT, an intervention should have a well-documented protocol. Ideally, an intervention’s outcomes should be measurable and captured using existing data sources or systems, so that the intervention – if proven effective – can be readily adopted on a broad scale. Although it may be possible to make minor revisions to existing systems, such as electronic health records, major revisions and any data collection that would burden staff will affect widespread adoption. Evidenceof all children assessed were more than 12 months delayed for expressive language (information and grammar scores combined). (21% post) A full oral examination was not considered appropriate at this time, but there does not appear to be any weakness of the oral musculature. There is no reported drooling or choking. Tongue movement is appropriate The Children’s Centre is hoping to become involved with the pilot of Marion Nash’s ‘Baby Spirals’, which is suitable for younger children and/or children with greater difficulties than those accessing Spirals presently. This is very exciting. Is it known how safe the intervention is? PCTs often involve providers implementing interventions as a new standard of care with all patients. An intervention should therefore be of minimal risk, with careful consideration given to potential adverse events and unintended consequences. This is particularly true when an intervention targets people who are vulnerable, such as those with ADRD or residing in nursing homes and other residential care settings. Feasibility