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Essay Instructions: The purpose of this assignment is for you to examine definitions and theories of health and health promotion and find one that works for you and your practice of nursing.

The World Health Organization defines health in the Preamble to the Constitution of the World Health organization as "a state of complete physical, mental, and social well being, not merely absence of disease and infirmity" (World Health Organization. (2006). WHO definition of Health. Retrieved May 20, 2010, from http://www.searo.who.int/EN/Section898/Section1441.htm).

A definition for health promotion presented by O’Donnell (2009) is "Health promotion is the science and art of helping people change their lifestyle to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior and create environments that support good health practices" (Am. J. (2009, September-October). A national health promotion is within our grasp. American Journal of Health Promotion, 24(1). Retrieved May 20, 2010, from http://www.healthpromotionjournal.com/).

There are also other definitions and theories of both health and health promotion available in the literature. In writing this paper, research health behavior and health promotion theories and discuss how the concepts can be applied in your nursing practice. This paper should be five (5) content pages in length, not including the title and reference page.

In addition to the two (2) websites mentioned above, information on health behavior theory and health promotion theory can be found at the following links:
http://www3.doh.wa.gov/HERE/howto/images/Behavior.html
http://chcr.umich.edu/how_we_do_it/health_theories/healththeories4/chcr_document_view
http://www.nursing.umich.edu/faculty/pender/HPM.pdf
When examining the literature and writing your paper:

• Review the literature on definitions and theories of health and health promotion.
• Begin your paper with a brief introduction to health and health promotion and discuss the definition of health and health promotion
• Identify two theories of health behavior useful in health promotion.
• Discuss how you could integrate health promotion theory into your nursing practice with two examples
• Discuss the barriers to patient adoption of health promotion activities and how you would evaluate the effectiveness of the health promotion theory you chose for your area of practice
• Include introductory and concluding statements for your paper
• Use subheadings for each section of your paper (Introduction, Health, etc.)

Essay Instructions: customer not sending fax!

(do not fax)

I have study called The Knowledge, Attitude and Practice of Ministry of health physicians toward surveillance system in Saudi Arabia. I well send the proposal of the study. I need the Introduction chapter for this study (Example of the references style well be sent at the end of the proposal also you can use these references)

Proposal:
(The Knowledge, Attitude and Practice of Ministry of health physicians toward surveillance system in Saudi Arabia.)

Introduction:

Surveillance is the ongoing systematic collection, analysis and interpretation of health data in the process of describing and monitoring a health event. This information is used for planning, implementing and evaluating public health intervention programs.
An epidemiological surveillance system is a set of interrelated elements and activities which contributes to the achievement of surveillance objectives. It is usually well-known as a central part of a health care system in order to monitor priority health events which are known to be taking place in the population.
Once an infectious disease has been detected or suspected it should be notified to the local authorities by whom an operational control measures will be operated. Through reporting, the public health officials are allowed to describe new diseases and the mode of transmission, so the preventive measures can be developed and implemented. As well, it is essential in the planning and evaluation of disease prevention and control.
The first step in the control of a communicable disease is identification; this involves the use of the reporting system.
Epidemiological surveillance is disease for action. For disease control and preventive action to be timely and effective:
1-Epidemiological surveillance should be an essential component of any control program.
2- The surveillance activities should be carried out at all levels of the health service (local, regional, central).
Over the past few years, fears from disease outbreaks have increased in both numbers and complexity. New diseases such as Severe Acute Respiratory Syndrome (SARS) have emerged and other diseases such as Tuberculosis (T.B) have reemerged.
The remarkable increase in international travel and trade in recent years has provided chances for diseases to spread across geopolitical and international boundaries.
GIS has emerged as powerful evidence based practice technology for early detection and timely, but considered, response to disease outbreak. It is an information technology that can educate health professionals and public of the threat of emerging infectious diseases and the agent that cause them. It can enhance decision making at all levels-local, regional, and national. Also the analytical capability of GIS helps in planning disease surveillance activities that reduce the cost and improve efficiency.
The evaluation of surveillance system should endorse the best use of public health resources by ensuring that only important health events are under surveillance and that surveillance systems operate efficiently.
In Saudi Arabia as in most countries notifiable disease surveillance system relies on mandatory reporting of cases by physicians.
All hospitals and health centers in K.S.A (Kingdom of Saudi Arabia). routinely send their reports to the Communicable Disease Control Department (CDC) in the Primary Health Care (PHC) directorate of each region. Some diseases must be notified to the department as soon as they are suspected; this is for class 1 diseases that need immediate action they are immediately reported within 24 hours by fax or telephone. Other diseases are reported weekly and this is for class 2 diseases, or monthly which takes place from the regions to the preventive directorate in the MOH. Figure (2) the weekly reports are based on international weeks recommended by (WHO) for all the year.
Although the reporting physicians are the first and most qualified entry post into such an information system, little research is available on the knowledge, attitude, and practices of these physicians regarding surveillance of reportable diseases.
MOH is looking for improving the surveillance system and applying the GIS to it.
Objective:
1- To assess the knowledge, attitude, and practices of MOH physicians toward the surveillance system.
2- To identify the needs of physicians in order to improve the public health surveillance.
Materials and methods:
Study design: It is a cross sectional, descriptive study that will be conducted at a national level involving all the 20 health regions of K.S.A.
Study population:
The study population is defined as all the MOH physicians working in PHC and in the hospitals (OPD, ER) all over the kingdom.
Data collection:
Regional coordinators were selected from the 20 health regions for distributing and collecting the self administered questionnaire.
Data analysis:
Data entry and analysis will be done using spss software, starting with measuring the frequencies of all the studied variables. The effect of different explanatory variables on different outcomes will be estimated by using appropriate tests of significance.



Example of references style:
References:
1) Waife S, Davenhall B. ESRI Health and Human Services Solutions: Extending Disease Surveillance with GIS. ArcUser [serial on the Internet]. April - June 2005 [cited 2006 Jul 26];[about 2 p.]. Available at:
http://www.esri.com/news/arcuser/0405/disease_surveil1of2.html. Accessed on June 25, 2006.
2) Bakarman MA, Al-Raddadi RM. Assessment of reporting and recording system of communicable diseases in Jeddah Region. Saudi Medical Journal 2000; Vol.21(8):751-754
3) World Health Organization Regional Office for the Eastern Mediterranean. Surveillance of communicable diseases a training manual. Alexandria: 1998 WHO-EM/CDS/52/E/L/06.98/2000.
4) Krause G, Ropers G, Strak K. Notifiable Disease Surveillance and Practicing Physicians. Emerging Infectious Diseases. 2005 March;11(3):442-5.
5) Wuhib T, Chorba TL, Davidiants V, Kenzie WR, McNabb S. Assessment of the infectious diseases surveillance system of the Republic of Armenia: an example of surveillance in the Republics of the former Soviet Union. BMC Public Health; vol.2;2002.
6) Center for Disease Control and Prevention U.S Department of Health and Human services. Principles of Epidemiology.Atlanta Georgia 30333.
7) Guidelines for evaluating surveillance systems. MMWR 1988, 37(S-5);1-18.
8) Ministry of Health. Surveillance in Saudi Arabia. Saudi Epidemiology Bulletin. 1993;1(2)
9) Ministry of Health. Surveillance: Information for action. Saudi Epidemiology Bulletin. 1993;1(1)
10) Seneviratne SL, Gunatilake SB, de Silva HJ. Reporting notifiable diseases: methods for improvement, attitudes and community outcome. Trans R Soc Trop Med Hyg. 1997 Mar-Apr;91(2):135-7.
11) Doyle T, Samuel KG. Completeness of notifiable infectious disease reporting in the United States: An analytical literature review. American Journal of Epidemiology.155(9):866-74.
12) Jajosky RA, Groseclose S. Evaluation of reporting timeliness of public health surveillance systems for infectious diseases. BMC Public Health 2004 July, 4:29
13) Ofili AN, Ugwu EN, Ziregbe A, Richars R, Salami S. Knowledge of disease notification among doctors in government hospitals in Benin City, Edo State, Nigeria. Public Health 2003 May, 117(3):214-7.
14) Assessment of Infectious Disease Surveillance – Uganda,2000. MMWR 2000 Aug, 49(30);687-91.
15) Nsubuga P, Eseko N, Wuhib T, Ndayimirije N, Chungong S, McNabb S. Structure and performance of infectious disease surveillance and response, United Republic of Tanzania, 1998. Bull World Health Org 2002;80(3):196-202.


References style:
Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Sample References

1. Standard journal article
List the first six authors followed by et al. (Note: NLM now lists all authors.)
Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002 Jul 25;347(4):284-7.
As an option, if a journal carries continuous pagination throughout a volume (as many medical journals do) the month and issue number may be omitted.
Halpern SD, Ubel PA, Caplan AL. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
More than six authors:
Rose ME, Huerbin MB, Melick J, Marion DW, Palmer AM, Schiding JK, et al. Regulation of interstitial excitatory amino acid concentrations after cortical contusion injury. Brain Res. 2002;935(1-2):40-6.
2. Organization as author
Diabetes Prevention Program Research Group. Hypertension, insulin, and proinsulin in participants with impaired glucose tolerance. Hypertension. 2002;40(5):679-86.
3. Both personal authors and an organization as author (This example does not conform to NISO standards.)
Vallancien G, Emberton M, Harving N, van Moorselaar RJ; Alf-One Study Group. Sexual dysfunction in 1,274 European men suffering from lower urinary tract symptoms. J Urol. 2003;169(6):2257-61.
4. No author given
21st century heart solution may have a sting in the tail. BMJ. 2002;325(7357):184.

5. Article not in English
(Note: NLM translates the title into English, encloses the translation in square brackets, and adds an abbreviated language designator.)
Ellingsen AE, Wilhelmsen I. Sykdomsangst blant medisin- og jusstudenter. Tidsskr Nor Laegeforen. 2002;122(8):785-7.
6. Volume with supplement
Geraud G, Spierings EL, Keywood C. Tolerability and safety of frovatriptan with short- and long-term use for treatment of migraine and in comparison with sumatriptan. Headache. 2002;42 Suppl 2:S93-9.
7. Issue with supplement
Glauser TA. Integrating clinical trial data into clinical practice. Neurology. 2002;58(12 Suppl 7):S6-12.
8. Volume with part
Abend SM, Kulish N. The psychoanalytic method from an epistemological viewpoint. Int J Psychoanal. 2002;83(Pt 2):491-5.
9. Issue with part
Ahrar K, Madoff DC, Gupta S, Wallace MJ, Price RE, Wright KC. Development of a large animal model for lung tumors. J Vasc Interv Radiol. 2002;13(9 Pt 1):923-8.
10. Issue with no volume
Banit DM, Kaufer H, Hartford JM. Intraoperative frozen section analysis in revision total joint arthroplasty. Clin Orthop. 2002;(401):230-8.
11. No volume or issue
Outreach: bringing HIV-positive individuals into care. HRSA Careaction. 2002 Jun:1-6.
12. Pagination in roman numerals
Chadwick R, Schuklenk U. The politics of ethical consensus finding. Bioethics. 2002;16(2):iii-v.

13. Type of article indicated as needed
Tor M, Turker H. International approaches to the prescription of long-term oxygen therapy [letter]. Eur Respir J. 2002;20(1):242.
Lofwall MR, Strain EC, Brooner RK, Kindbom KA, Bigelow GE. Characteristics of older methadone maintenance (MM) patients [abstract]. Drug Alcohol Depend. 2002;66 Suppl 1:S105.
14. Article containing retraction
Feifel D, Moutier CY, Perry W. Safety and tolerability of a rapidly escalating dose-loading regimen for risperidone. J Clin Psychiatry. 2002;63(2):169. Retraction of: Feifel D, Moutier CY, Perry W. J Clin Psychiatry. 2000;61(12):909-11.
15. Article retracted
Feifel D, Moutier CY, Perry W. Safety and tolerability of a rapidly escalating dose-loading regimen for risperidone. J Clin Psychiatry. 2000;61(12):909-11. Retraction in: Feifel D, Moutier CY, Perry W. J Clin Psychiatry. 2002;63(2):169.
16. Article republished with corrections
Mansharamani M, Chilton BS. The reproductive importance of P-type ATPases. Mol Cell Endocrinol. 2002;188(1-2):22-5. Corrected and republished from: Mol Cell Endocrinol. 2001;183(1-2):123-6.
17. Article with published erratum
Malinowski JM, Bolesta S. Rosiglitazone in the treatment of type 2 diabetes mellitus: a critical review. Clin Ther. 2000;22(10):1151-68; discussion 1149-50. Erratum in: Clin Ther 2001;23(2):309.
18. Article published electronically ahead of the print version
Yu WM, Hawley TS, Hawley RG, Qu CK. Immortalization of yolk sac-derived precursor cells. Blood. 2002 Nov 15;100(10):3828-31. Epub 2002 Jul 5.
Books and Other Monographs
19. Personal author(s)
Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA. Medical microbiology. 4th ed. St. Louis: Mosby; 2002.
20. Editor(s), compiler(s) as author
Gilstrap LC 3rd, Cunningham FG, VanDorsten JP, editors. Operative obstetrics. 2nd ed. New York: McGraw-Hill; 2002.
21. Author(s) and editor(s)
Breedlove GK, Schorfheide AM. Adolescent pregnancy. 2nd ed. Wieczorek RR, editor. White Plains (NY): March of Dimes Education Services; 2001.
22. Organization(s) as author
Royal Adelaide Hospital; University of Adelaide, Department of Clinical Nursing. Compendium of nursing research and practice development, 1999-2000. Adelaide (Australia): Adelaide University; 2001.
23. Chapter in a book
Meltzer PS, Kallioniemi A, Trent JM. Chromosome alterations in human solid tumors. In: Vogelstein B, Kinzler KW, editors. The genetic basis of human cancer. New York: McGraw-Hill; 2002. p. 93-113.
24. Conference proceedings
Harnden P, Joffe JK, Jones WG, editors. Germ cell tumours V. Proceedings of the 5th Germ Cell Tumour Conference; 2001 Sep 13-15; Leeds, UK. New York: Springer; 2002.
25. Conference paper
Christensen S, Oppacher F. An analysis of Koza's computational effort statistic for genetic programming. In: Foster JA, Lutton E, Miller J, Ryan C, Tettamanzi AG, editors. Genetic programming. EuroGP 2002: Proceedings of the 5th European Conference on Genetic Programming; 2002 Apr 3-5; Kinsdale, Ireland. Berlin: Springer; 2002. p. 182-91.
26. Scientific or technical report
Issued by funding/sponsoring agency:
Yen GG (Oklahoma State University, School of Electrical and Computer Engineering, Stillwater, OK). Health monitoring on vibration signatures. Final report. Arlington (VA): Air Force Office of Scientific Research (US), Air Force Research Laboratory; 2002 Feb. Report No.: AFRLSRBLTR020123. Contract No.: F049.

Issued by performing agency:
Russell ML, Goth-Goldstein R, Apte MG, Fisk WJ. Method for measuring the size distribution of airborne Rhinovirus. Berkeley (CA): Lawrence Berkeley National Laboratory, Environmental Energy Technologies Division; 2002 Jan. Report No.: LBNL49574. Contract No.: DEAC0376SF00098. Sponsored by the Department of Energy.
27. Dissertation
Borkowski MM. Infant sleep and feeding: a telephone survey of Hispanic Americans [dissertation]. Mount Pleasant (MI): Central Michigan University; 2002.
28. Patent
Pagedas AC, inventor; Ancel Surgical R&D Inc., assignee. Flexible endoscopic grasping and cutting device and positioning tool assembly. United States patent US 98. 2002 Aug 1.
Other Published Material
29. Newspaper article
Tynan T. Medical improvements lower homicide rate: study sees drop in assault rate. The Washington Post. 2002 Aug 12;Sect. A:2 (col. 4).
30. Audiovisual material
Chason KW, Sallustio S. Hospital preparedness for bioterrorism [videocassette]. Secaucus (NJ): Network for Continuing Medical Education; 2002.
31. Legal Material
Public law:
Veterans Hearing Loss Compensation Act of 2002, Pub. L. No. 107-9, 115 Stat. 11 (May 24, 2001).
Unenacted bill:
Healthy Children Learn Act, S. 1012, 107th Cong., 1st Sess. (2001).
Code of Federal Regulations:
Cardiopulmonary Bypass Intracardiac Suction Control, 21 C.F.R. Sect. 870.4430 (2002).

Hearing:
Arsenic in Drinking Water: An Update on the Science, Benefits and Cost: Hearing Before the Subcomm. on Environment, Technology and Standards of the House Comm. on Science, 107th Cong., 1st Sess. (Oct. 4, 2001).
32. Map
Pratt B, Flick P, Vynne C, cartographers. Biodiversity hotspots [map]. Washington: Conservation International; 2000.
33. Dictionary and similar references
Dorland's illustrated medical dictionary. 29th ed. Philadelphia: W.B. Saunders; 2000. Filamin; p. 675.
Unpublished Material
34. In press
(Note: NLM prefers "forthcoming" because not all items will be printed.)
Tian D, Araki H, Stahl E, Bergelson J, Kreitman M. Signature of balancing selection in Arabidopsis. Proc Natl Acad Sci U S A. In press 2002.
Electronic Material
35. CD-ROM
Anderson SC, Poulsen KB. Anderson's electronic atlas of hematology [CD-ROM]. Philadelphia: Lippincott Williams & Wilkins; 2002.
36. Journal article on the Internet
Abood S. Quality improvement initiative in nursing homes: the ANA acts in an advisory role. Am J Nurs [serial on the Internet]. 2002 Jun [cited 2002 Aug 12];102(6):[about 3 p.]. Available from: http://www.nursingworld.org/AJN/2002/june/Wawatch.htm
37. Monograph on the Internet
Foley KM, Gelband H, editors. Improving palliative care for cancer [monograph on the Internet]. Washington: National Academy Press; 2001 [cited 2002 Jul 9]. Available from: http://www.nap.edu/books/9/html/.

38. Homepage/Web site
Cancer-Pain.org [homepage on the Internet]. New York: Association of Cancer Online Resources, Inc.; c2000-01 [updated 2002 May 16; cited 2002 Jul 9]. Available from: http://www.cancer-pain.org/.
39. Part of a homepage/Web site
American Medical Association [homepage on the Internet]. Chicago: The Association; c1995-2002 [updated 2001 Aug 23; cited 2002 Aug 12]. AMA Office of Group Practice Liaison; [about 2 screens]. Available from: http://www.ama-assn.org/ama/pub/category/1736.html
40. Database on the Internet
Open database:
Who's Certified [database on the Internet]. Evanston (IL): The American Board of Medical Specialists. c2000 - [cited 2001 Mar 8]. Available from: http://www.abms.org/newsearch.asp
Closed database:
Jablonski S. Online Multiple Congential Anomaly/Mental Retardation (MCA/MR) Syndromes [database on the Internet]. Bethesda (MD): National Library of Medicine (US). c1999 [updated 2001 Nov 20; cited 2002 Aug 12]. Available from: http://www.nlm.nih.gov/mesh/jablonski/syndrome_title.html
41. Part of a database on the Internet
MeSH Browser [database on the Internet]. Bethesda (MD): National Library of Medicine (US); 2002 - [cited 2003 Jun 10]. Meta-analysis; unique ID: D015201; [about 3 p.]. Available from: http://www.nlm.nih.gov/mesh/MBrowser.html Files updated weekly.
MeSH Browser [database on the Internet]. Bethesda (MD): National Library of Medicine (US); 2002 - [cited 2003 Jun 10]. Meta-analysis; unique ID: D015201; [about 3 p.]. Available from: http://www.nlm.nih.gov/mesh/MBrowser.html Files updated weekly.

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Essay Instructions: This is a literature review for a dissertation. It should include a historical perspective of autism as well as address current current programs and treatment. There should be no more then two/three direct quotes per page.

Below is the perspectus.

Historically, documented disruptive behaviors displayed by residential students diagnosed with Autism and other developmental disabilities include noncompliance, physical and verbal aggression, inappropriate verbalizations not characterized as aggression, poor social skills, as well as deficits in attention to task (Green, 1996; Luce, 1981; Maurice, 1996). These behaviors require residential treatment and preclude participation in community based activities, (Luce, 2004). Educators generally agree that deficits in academic skills result from a decrease in on-task behaviors because of disruptive off-task behaviors (Skinn, Ramsey, Walker, Stieber, & O?Neill, 1987).

Frequently used techniques to decrease these disruptive behaviors include reinforces such as verbal praise, token economies, time out, and self-contained classrooms. Autism affects one in 1,000 individuals in the United States (World Health Organization, 2001) and warrants further investigation to examine the use of daily activities to decrease these inappropriate behaviors. This quantitative dissertation study will examine the effectiveness of an everyday activities-based protocol (Holm, Santangelo, Fromuth, Brown & Walter, 2000) for managing challenging and disruptive behaviors of 13-23 year old residential students (male and female) with Autism and other developmental disabilities to reduce two out of three inappropriate behaviors as identified by residential staff.

Purpose
The purpose of this quantitative dissertation study is to test the effectiveness of an everyday activities-based protocol (Holm, Santangelo, Fromuth, Brown & Walter, 2000) for managing challenging and disruptive behaviors of 13-23 year old residential students (male and female) (dependent variable) with Autism and other developmental disabilities who live at Melmark Homes, Inc., of southeastern Pennsylvania, and attend school or adult day programs. Applied behavior analysis and a focus on everyday occupations (activities) (independent variable) will be combined during the intervention phase. Reinforcement will be for subtask completion and duration of participation, not for absence of target maladaptive or disruptive behaviors. A single-subject, multiple-baseline, across-subjects design with 50 subjects will be used to evaluate change in behaviors under alternating conditions. Data will be analyzed using graphical, semi-statistical, and statistical techniques, including celeration lines, slopes, 2 standard deviation bands, and the C-statistic.

Research Question
Will participation in Activities of Daily Living (ADL?s) reduce or extinguish inappropriate behaviors displayed by individuals with Autism or other developmental disorders who currently reside in residential facilities?

Significance
Clinically significant behavioral changes in this area have the potential to lead to the expansion of residential programs, implementation of new programs, and the identification of, and access to, additional community funding resources for curriculum improvement and development; in addition to the development of more comprehensive community-based programs. The proposed dissertation study replicates the results found by Holm et al. (2000), which successfully combined behavioral and occupational therapy interventions with dually diagnosed subjects in Community Living Arrangements (CLA)/School environments. Should a study such as this be successful, a full protocol can be developed for residential staff so that they too can be taught how to break down everyday tasks into manageable units so that residents with Autism are able to increase their participation in everyday activities at school and in their communities-be they residential or non-residential (home-based) living communities (WHO, 2001).

When evaluating community based programming for individuals with Autism and other developmental disabilities, community, school, and healthcare leaders, must utilize data that is not only clinically significant but data that will drive cost effective programming to ensure the appropriate utilization of private and governmental financial resources (McConnell, 2004). The study will have significance to the consumer community because of the intervention's potential to enable greater participation of individuals with Autism in lived in environments. The study will have significance to the care-giving community because it promotes a novel approach to care-giving, using an intervention that combines a behavioral approach with enabling of everyday activities. To community healthcare leaders, this reduces the financial resources needed for community based programming (WHO, 2001).

Here is additional information that may be incorporated, but should only serve to provide a basis.

Abstract
The purpose of this dissertation study is to test the effectiveness of an everyday activities-based protocol (Holm, Santangelo, Fromuth, Brown & Walter, 2000) for managing challenging and disruptive behaviors of 13-23 year old residential students (male and female) with Autism who live at Melmark Homes, Inc., of southeastern Pennsylvania, and attend school or adult day programs. Applied behavior analysis and a focus on everyday occupations (activities) will be combined during the intervention phase.

Reinforcement will be for subtask completion and duration of participation, NOT for absence of target maladaptive or disruptive behaviors. Behavior analysts, however, will document the frequency/duration of the target behaviors during each condition. Interventions will occur daily, Monday through Friday. A single-subject, multiple-baseline, across-subjects design with 9 subjects will be used to evaluate change in behaviors under alternating conditions. Data will be analyzed using graphical, semi-statistical, and statistical techniques, including celeration lines, slopes, 2 standard deviation bands, and the C-statistic. The projected outcome of the study is the validation of an activities-based protocol to enable greater participation of individuals with Autism in everyday activities (WHO, 2001), and in their communities, be they residential or non-residential (home-based) communities.

Background
The World Health Organization?s International Classification of Functioning, Disability and Health (ICF) (World Health Organization, 2001, see Figure 1) provides a model for describing and studying functioning (positive state) and disability (negative state) of individuals and populations, including residential students diagnosed with Autism and other conditions. ICF performance qualifiers differentiate between performance in the actual or ?lived in? home environment, and the student?s ability to execute tasks or actions in a standard or uniform environment such as the classroom (WHO, 2001). Thus, the ICF provides a guide for examining and documenting a student?s functioning and disability and the impact of the environment and participation on the functional outcomes of everyday activities-based behavioral interventions.

Because Autism creates a disabling impact on functioning and full participation, in February 2002 the National Institutes of Health (NIH) and the Department of Health and Human Services prepared a report to Congress addressing Autism and Pervasive Developmental Disorders (PDD); the report authorized both money and research to ?conduct activities relevant to Autism and Pervasive Developmental Disorders". It indicates, "Families coping with this devastating illness are searching for answers about these causes, diagnoses, prevention, and treatment? (NIH, 2002; Strock, 2004).

Historically documented disruptive behaviors displayed by residential students diagnosed with Autism and other developmental disabilities include noncompliance, physical and verbal aggression, inappropriate verbalizations not characterized as aggression, poor social skills, as well as deficits in attention to task. Educators generally agree that deficits in academic skills result from a decrease in on-task behaviors because of disruptive off-task behaviors (Skinn, Ramsey, Walker, Stieber, & O?Neill, 1987). These behaviors continue to be seen today in educational and residential programs. Frequently used techniques to decrease these disruptive behaviors include reinforcers such as verbal praise, token economies, time out, and self-contained classrooms (Luce, 2004).

In order to increase the frequency of an individual?s appropriate behavior, it is most often recommended that such behaviors be praised or otherwise rewarded when they occur (e.g., with a natural consequence). Attempts to increase the frequency of positive behaviors are based on the belief that, by doing so, behaviors that are more appropriate will gradually replace less desirable (e.g., disruptive) behaviors. The literature suggests that teacher or caregiver consideration should provide attention to the individual when he/she is engaged in positive rather than negative behaviors (Green, 1996). Token economy systems involve awarding tokens, stickers, points, or other items to individuals who demonstrate targeted behaviors. Students usually exchange tokens for rewards, which may consist of preferred food or other activities. Token economies can be effective for those individuals who are resistant to other types of behavior management techniques. The benefits to using this system are ease of administration, immediate reinforcement (tokens) while teaching delayed gratification (holding tokens until trade in time), satiation for the student due to the availability of a variety of back-up reinforcers, as well as lack of competition between students as they compete only against themselves (Society of Treatment for Children, 1998).

Over the last several years, Applied Behavioral Analysis (ABA) has become the most preferred and utilized behavioral intervention. ABA, in brief, "involves a breakdown of all skills into small, discrete tasks, taught in a highly structured and hierarchical manner." This is accompanied by differential reinforcement, and data are recorded systematically and regularly so that interventions can be adjusted as needed based on the student's progress or lack thereof. ABA is designed to help those with Autism learn how to learn (Luce & Christian, 1981; Maurice, 1996, p. 8).

Consistent with the ICF (WHO, 2001) view of the impact of the environment on functioning and disability, another perspective is that ?the origin of challenging, disruptive behaviors is not within the person with the disability, but rather the interaction of the person, environment, and task? (Holm, Santangelo, Fromuth, Brown & Walter 2000, p. 362). In fact, one profession, namely occupational therapy, ?was founded on the belief that engaging in occupation (everyday activities) brought about mental and physical health? (Trombly, 1995, p. 970). One of the tenets of occupational therapy related to disruptive behaviors displayed by individuals diagnosed with Autism and other developmental disabilities is that engagement in everyday functional activities has the potential to decrease incidents of inappropriate disruptive behaviors. However, to date there is limited documented research supporting such a statement. In 2000, Holm, Santangelo, et al., conducted a seminal study that used everyday activities- (or occupation-) based interventions with two dually diagnosed students who attended school and lived in a CLA. The everyday activities-based intervention focused on enabling the students? participation in everyday AM and PM activities such as bed making, selecting clothes for school, helping prepare the food for dinner, setting the table, and selecting the games and crafts for after-dinner activities. Overall, the disruptive and challenging behaviors of the two students were significantly reduced when they participated in the everyday activities based tasks, even though the focus of the intervention was NOT on their behavior as in the school environment, but rather on their active participation in everyday activities.

The references below are provided to help provide a focus and can be used as references but should not be counted as part of the 50-75. 80% of the references used should be within the last 5 years.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, IV-TR. (4th ed.). Washington, DC.
Bianchi, S. M. & Robinson, J. P. (1997). What did you do today? Chiltern Jews of time, family composition, and the acquisition of social capital. Journal of Marriage and Family, 59, 332- 344.
Christiansen, C. H. (1999). Defining lives: occupation as identity: and as they own competence, coherence, and the creation of meaning. American Journal of Occupational Therapy, 53, 547-558.
Christiansen, C. H. (2000). Identity, personal projects and happiness: self construction in every day, action. Journal of Occupational Science, 7(3), 98-107.
Christiansen, C. H. (2004). Occupation and identity: becoming who we are through what we do. In C. H. Christiansen, and E. A. Townsend (Eds.) Introduction to occupation: The art and science of living. Upper Saddle River, New Jersey: Prentice hall.
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Essay Instructions: The World Health Organization (WHO) utilizes the WHO Family of International Classifications in an effort to have a universal method for classifying diseases. There are 3 main components of this system that include the following:

?International Classification of Diseases (ICD)
?International Classification of Functioning, Disability, and Health (ICF)
?International Classification of Health Interventions (ICHI)
Define and explain the purpose of each type of classification, and give 2 examples from each classification category.

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