1. family and parenting
2. children

Social Skills Training in LD
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Funderburk, Schwartz, Nye
Title: Social Skills Training for Children with Learning Disabilities
Lead Reviwer: Lucy Funderburk
Co-Reviewers: Jamie Schwartz
Chad Nye
Contact Reviewer:
Chad Nye
UCF CARD
12001 Science Dr
Suite 145
Orlando, FL 32826
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Social Skills Training in LD
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Funderburk, Nye, Schwartz
According to the 2006 Annual Report by the National Center for Learning Disabilities
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(NCLD), there are over 15 million children, adolescents and adults with learning disabilities in
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the United States (US) alone. Over the past 35 years, the term learning disability (LD) has been
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used to identify and subsequently inform instruction for children struggling in the classroom. The
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characteristics typically defining children with LD include recognition of a neurological
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processing disorder impacting oral or written language as exhibited in tasks involving speaking,
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listening, reading, writing, spelling, or mathematic calculations. (IDEA, 34 Code of Federal
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Regulations §300.8 (c)(10); NJCLD, 1997, ). The term learning disability does not include
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individuals with sensory impairment (e.g., deaf, blind), mental retardation, emotional disturbance,
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or environmental, cultural, or economic disadvantage; although individuals with these
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handicapping conditions frequently have difficulty learning [IDEA, 34 Code of Federal
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Regulations §300.8 (c)(10); NJCLD, 1997]. Unfortunately, the definition of LD is not universal
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and does not necessarily cross international boundaries. In other countries (e.g., United Kingdom,
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Belgium), the term learning disability refers to individuals with mental retardation. In these
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countries terms such as ‘dyslexia,’ ‘dyscalculia,’ and ‘dysgraphia’ are used to identify those
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children who have specific difficulties learning and may not necessarily be identified as LD based
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on the US definition.
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Although the definition of learning disability centers on the difficulties in academic
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achievement, difficulties in self-regulation, social perception, and social interaction also may exist
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in children with LD. Social skill deficits in children with LD have the potential to affect
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adversely not only their social interactions but academic achievement as well. Researchers
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(Kavale & Forness, 1996; Kavale & Mostert, 2004; Swanson & Malone, 1992) have
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Social Skills Training in LD
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demonstrated the importance of social competence on the overall development and well-being of
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children with learning disabilities.
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Implications of Social Skills Deficits
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Social skills can refer to a wide range of behaviors and abilities, which can be categorized
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as behaviors associated with social interactions (Kavale & Forness, 1996), and social competence
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(McFall, 1982). These dimensions of social interactions and competence can include friendliness,
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helpfulness, self-control, the ability to cooperate, and the ability to share (LaGreca, 1987). The
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positive attributes of these social behaviors result in successful social interactions for the child
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while the negative attributes are viewed as deficits that can lead to problems such as aggression,
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impulsiveness, acting out, and an overall inability to get along with peers in social situations
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(LaGreca, 1987).
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Social interaction and competence deficits prove to be a defining characteristic of most
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individuals with LD, especially in children and adolescents. Kavale and Forness (1995)
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suggested that social skills deficits are a prominent feature in 75% of children with LD. The
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implication of such a high rate of social deficit is that children and adolescents with LD are faced
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with compound deficits that impact both the quality of life and academic performance in school.
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Few would argue that development of social skills does not play an important role in how all
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children adapt to both societal and academic pressures, thus the presence of social skill and
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competence difficulties can only exacerbate the lack of school success for children with LD.
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Social skill and competency deficits are readily identified at the pre- and early adolescence
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age. Social skill deficits have been shown to increase chances of involvement with juvenile
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authorities, legal problems, or both (Parker & Asher, 1987; Bender & Wall, 1994; Winters, 1997).
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Social Skills Training in LD
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In addition, Seidel and Vaughn (1991), Bear, Kortering and Braziel (2006), and Reschly and
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Christenson (2006) have all found that youth with LD are at a higher risk of dropping out of
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school. An understanding of difficulties that these students face (Sabornie, 1994) and the impact
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that these deficits have on factors such as peer status and acceptance (Bruininks, 1978; Dudley-
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Marling & Edmiaston, 1985; Wiener, 1987), the student-teacher relationship (Brophy, 1979;
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Garrett & Crump, 1980; Siperstein & Goding, 1985; Northcutt,1986; Seidel & Vaughn, 1991),
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self-concept and perceptions of others (Gresham & Reschly, 1986, Bryan, 1991), and adjustment
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later on in life (Parker & Asher, 1987; Gerber et al, 1990; Kavale & Forness, 1996; Winters,
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1997; Moisan, 1998) may be important to academic success. Thus, attention to interventions that
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will remediate these deficits may be an important component of an individual’s educational
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program.
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Social Skills Training (SST)
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SST has been approached from several different cognitive and behavioral intervention
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models such as direct instruction, coaching, modeling, rehearsal, shaping, prompting, and
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reinforcement. Though these models have distinctly unique dimensions they all share the same
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core goal of developing more normalized social behaviors in children and adolescents with
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learning disabilities. The interventions for the various social skills and competencies target
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behaviors such as learning how to listen, ask questions, and ask for assistance; anger control;
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disappointment management; or, demonstrating appropriate emotions and expression of feelings.
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Evidence regarding SST can be drawn from at least three different types of research information
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including primary studies, narrative reviews, and meta-analyses.
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Findings from Primary Studies
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Social Skills Training in LD
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SST has been advocated by many in the research community as an effective means to treat
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social skills deficits in children and adolescents with LD. For instance, Amerikaner & Summerlin
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(1982) found that group counseling and relaxation techniques were effective in promoting social
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self-esteem and reducing the probability of acting out and distracting others. Likewise, Omizo &
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Omizo (1988) incorporated similar techniques into a treatment program and found that the
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individuals who participated scored significantly higher on the Piers-Harris Children’s Self-
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Concept Scale (Piers, 1969). Trapani and Gettinger (1989) studied the effects of SST and tutoring
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on school-aged boys with LD and found that a combination of a direct instruction method for SST
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and cross-aged tutoring had a positive effect on both the child’s overall communication ability
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and academic test scores.
SST interventions that focus on role-playing, modeling, and feedback have also reported
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mixed or inconclusive findings. Berler, Gross, and & Drabman (1982) found that a five-week
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intervention implemented in group sessions was effective in improving appropriate verbalizations
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and speech duration. However, there was no noted improvement in observed sociometric ratings
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by peers. Hart (1996), who applied a cross-age tutoring and social skills training program similar
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to Trapani but applied to school-aged girls with LD, reported inconclusive results suggesting that
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any social intervention must take into account gender differences.
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Not all research has produced positive intervention effects. Some studies have reported an
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absence of compelling results to support SST (Berler, Gross, & Drabman, 1982; Straub &
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Roberts, 1983; Wanat, 1983; Blackbourn, 1989; Fox, 1989; Utay & Lampe, 1995; Wiener &
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Harris, 1997; Conway, 2001). Other studies have reported little to no improvement in outcomes
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measured, including sociometric scores, teacher ratings, self-perception, starting and maintaining
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conversations, and responding to failure (LaGreca & Mesibov, 1981; Byham, 1983; Merz, 1985).
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Discrepancies across these studies can be attributed to sampling, measurement, and
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methodological differences; but it is clear that there is a substantial body of research on the topic
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that warrants attention in order to summarize and synthesize the available research regarding the
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efficacy of SST in children and adolescents with LD.
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Findings from Narrative Reviews
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The need for SST for children and adolescents with LD has been a focus of the
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research community for over 30 years (La Greca & Mesibov, 1979; Schumaker & Hazel, 1984;
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Vaughn, 1985) . The awareness of this need has prompted several seminal narrative reviews on
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the topic. In 1980, Zigmond and Brownlee pointed out the need for children with LD to have
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training in social skills. They argued that adolescents with LD need some form of SST and that
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instruction in social skills is as important to the education process as instruction in academic and
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vocational skills. The focus of this summary addressed a series of recommendations as to on
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what an SST program should entail, including aspects of social perception and social behavior;
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how to implement adequately a program through careful assessment and instruction of targeted
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skills; and what kind of student would benefit from SST such as individuals with inappropriate,
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passive, or aggressive behaviors.
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Other researchers have provided similar narrative reviews that have highlighted the need
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for SST in children and adolescents with LD due to low social acceptance ratings among their
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peers. LaGreca (1987) summarized the social skills research in terms of four primary categories
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of issues related to social skill research for children with LD. The first issues was that of
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‘heterogeneity’ of the definition of LD which is reflected in the presence of children in the
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research that present with learning deficits who do not meet the formal definition of a learning
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disabled child (e.g., attention deficit disorder, hyperactive).
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even among the identified LD population, the heterogeneity of cognitive, behavioral, and social
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skills is remarkable. For example, in some studies, the participatning LD children were drawn
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from children identified as ADDH making the interpretation of the appropriateness of any
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intervention difficult to extrapolate for those identified specifically as LD.
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Further, LaGreca points out that
A second area of concern regarding social skill training for LD children centers on ‘social
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status’. LaGreca (1987) concluded that several studies reported that most children with LD are
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perceived as socially unappealing and that they are generally rejected by their peers. Several
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sociometric issues emerged that would warrant a more indepth investigation of social skill
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intervention for LD children. For example, several studies reported that girls were at a
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disadvantage in social acceptance in spite of the fact that the prevalence of LD is considerably
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higher in males. Other studies reported not all identified LD children have social skill problems
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and concluded that non-academic characteristics may be critical to school success.
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The third area of interest for LaGreca (1987) was ‘social cognitive skills’ in which a case
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is made for confusion in understanding the research in the area of social skills. LaGreca points
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out that LD children have difficultly in the areas of social perception, social motication, and
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social knowledge and that the research in these areas is inconsistent in terms of the nature of the
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deficits as well as the efficacy of remediation. The conclusions drawn from this summary
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suggested that while social processing may social processing poses potential difficulties for LD
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children, the evidence for the impact of remediation is questionable.
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Social Skills Training in LD
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Funderburk, Nye, Schwartz
Lastly, LaGreca (1987) suggested that the area of ‘social skill training’ is noticeably
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absent a rich research literature. She points out that while a few studies suggest that intervention
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studies suggest a measure of improvement, the generalization of the trained skills and the impact
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on social status are unknown.
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In a more recent summary, Olmeda & Trent (2003) explored the need for including
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minority individuals with LD in research investigating SST. The authors stressed that the social
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behaviors resulting from sociocultural contexts need to be taken into consideration when
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assessing an individual’s social skills abilities. Olmeda and Trent argued that there is a need for
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incorporation of perspectives reflecting multicultural aspects when designing and implementing
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SST interventions.
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These summaries indicated that cognitive, behavioral, and social interaction contribute to
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the low social acceptance of children and adolescents with LD. The primary shortcoming of the
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all of these reviews was the absence of a critical assessment of the existing research that would
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provide guidance in the implementation of a social skill intervention program for learning
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disabled children. That is, they did provide a narrative description of the conclusions that might
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have been gleaned from the primary research, but little attention was paid to either the critical
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analysis of the reported research or the efficacy of that research base.
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The conclusions drawn from these narrative reviews offer a consistent picture of the
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nature, need, and importance of SST for individuals with LD. However, they provide little insight
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into the practices or social skills interventions that might be effective in providing LD children
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with an improved social skill set. A quantitative summary of SST programs would provide an
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independent and objective assessment of the magnitude of effect for SST programs. Several such
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meta analyses have been reported and are summarized next.
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Findings from Meta-analyses
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Kavale and colleagues (Forness and Kavale (1996); Kavale and Forness, 1996; Kavale &
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Forness, 1995; Kavale and Mostert, 2004) reported results from one (reported in four different
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publications) meta-analysis assessing the effectiveness of SST training for children and
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adolescents with LD. The meta-analysis included 53 empirical studies of varying research design
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representing 2113 participants, 74% of whom were male, with a mean age of 11.5 years and a
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mean IQ of 96. The included studies spanned the years 1976 to 1991. The focus of the review
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was SST programs for children and adolescents with LD that targeted specific behaviors
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associated with social interactions and competence. Summaries of SST effect were presented for
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peer, self, and teacher report. Results suggested that overall, SST programs produced minimal
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results, with about two-tenths of a standard deviation improvement reported by peer and self
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report studies and teachers reporting an SST effect size of about .16. In order for a social skills
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training program to be more effective, Kavale and colleagues have suggested that research on
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STT programs should provide more attention to a higher level of research rigor in the areas of (1)
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design quality, (2) fidelity of program implementation, (3) outcome measurement, and (4)
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implementation of reliable and valid SST programs.
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The Need for a Systematic Review
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Several primary and summary studies have been reported regarding the nature of the
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social skills and competencies of children and adolescents with LD and the effects of programs
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designed to improve those skills and competencies. However, only Kavale and colleagues
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(Forness and Kavale (1996); Kavale and Forness, 1996; Kavale & Forness, 1995; Kavale and
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Mostert, 2004) have attempted to summarize statistically the nature and magnitude of the effect of
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SST for LD children and adolescents. Unfortunately, the authors did not provide a sufficiently
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transparent and systematic approach to their study in order to replicate the findings. In addition,
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the review did not include studies reported since 1991. Further, their analyses did not provide an
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assessment of the differential effects of SST based on the quality of research design related
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characteristics (e.g., design type, allocation procedure, and fidelity of implementation). Thus, the
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purpose of this review will be to conduct a comprehensive up-to-date systematic review of SST
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programs to provide an assessment of the magnitude of SST effects based on a more extensive,
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transparent, and explicit presentation of the information retrieval, data extraction, analysis, and
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synthesis processes.
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OBJECTIVE
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The purpose of this review is to assess the effectiveness of school based social skills
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training programs on learning disabled school-aged children (grades K - 12) as measured by
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observational, criterion, or formal measures of social skill outcomes.
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Operational Definitions of learning disability and social skills training
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Learning Disability
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For this review the term ‘ learning disability’ (LD) will be defined as ". . . a disorder in
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one or more of the basic psychological processes involved in understanding or in using language,
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spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read,
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write, spell, or do mathematical calculations, including conditions such as perceptual disabilities,
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Social Skills Training in LD
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brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia." Learning
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disabilities do not include, "…learning problems that are primarily the result of visual, hearing, or
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motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural,
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or economic disadvantage." [IDEA, 34 Code of Federal Regulations §300.8(c)(10)]. It is
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recognized that this definition is not universal and indeed most countries do not use the term LD
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to identify individuals who have difficulty learning. In other countries individuals that may be
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identified LD in the US may be identified as having learning difficulties (e.g., United Kingdom,
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Australia, Zimbabwe) or instrumental disabilities (Belgium). In addition, many countries do not
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provide services in the schools for these individuals. According to the Organization for Economic
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Co-operation and Development (OECD), for the 22 countries most likely to provide services to
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children with special needs only 54% provide LD services (OECD, 2004). The following are
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common qualities of individuals with LD regardless of the terminology used to describe them:
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--reading, mathematics, and/or written language achievement substantially below that of peers
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despite normal intelligence,
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--visual and/or auditory perceptual problems,
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--adequate academic instruction,
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--LD first identified in elementary grades,
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--may demonstrate social or emotional difficulties,
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--generally life long
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Social skills training are those cognitive or behavioral interventions used to develop more
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normalized social behaviors in children and adolescents with learning disabilities. The
Social Skill Training
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Social Skills Training in LD
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intervention may include any of the following strategies: direct instruction, coaching, modeling,
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rehearsal, shaping, prompting, and/or reinforcement.
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METHOD
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Inclusion Criteria and Procedure
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Inclusion of studies will be achieved through a process of screening for (a) titles and
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abstracts and (b) full texts. At the first stage of screening (title/abstract), citations will be
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reviewed for the following inclusion criteria:
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1. social skills training intervention targeted towards participants identified as learning
disabled; AND
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2. participants in grades K – 12 (or international equivalent) AND
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3. two group comparison designs.
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Information Retrieval
Database thesauri will be consulted, if available, to ensure that appropriate terms and
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synonyms have been included in the participant, intervention and outcome search term categories.
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Search terms and retrieval techniques will be modified to meet the requirements of each
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individual database. No restriction will be used for publication source, language, or date.
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Electronic Databases
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At a minimum, the following electronic databases/sources will be searched:
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1. PSYCINFO
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2. ERIC
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3. DISSERTATION ABSTRACTS
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4. MEDLINE
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5. GOOGLE SEARCH
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6. SAGE FULL TEXT EDUCATION
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7. BRITISH EDUCATION INDEX
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8. AUSTRIALIAN EDUCATION INDEX
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9. FRANCIS
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10. CBCA EDUCATION
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11. EDUCATION ABSTRACTS
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12. ACADEMIC SEARCH PREMIER
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All databases, including grey literature, will be submitted to the same information retrieval
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criteria described below. Reference lists from a variety of sources such as reviews, retrieved
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studies, anthologies, and conference papers, will be searched for potential inclusion
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characteristics. The following information will be reported for the electronic search:
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a. Databases searched
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b. Time frame searched
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c. Search terms used
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d. Number of citations retrieved
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Grey literature search will be limited to the databases cited above. No attempt will be
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made to search non-professional databases such as Google, AltaVisa, or Web Crawler in order to
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focus time and resources on the professional database sources.
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Search Strategy
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All electronic searches will be comprehensive without restriction to date, language, or
source. Additional grey literature citations will be sought through contact with experts and
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organizations (e.g., CED) representing individuals with learning disabilities in the US and
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abroad(e.g., LDUK). Because the primary print sources for research in learning disabilities are
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cataloged in the major databases (e.g., ERIC, PsycInfo) a comprehensive and extensive hand-
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search on individual journals would not be an appropriate use of resources. However, if five (5)
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or more included studies are retrieved from any single journal publication source, a hand-search
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of that journal will be conducted.
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For each database, we will use the following terms to locate relevant studies for this
review:
a. Domain Terms: learning disabil*, social skill*,
b. Intervention Terms: interven*, Treat*, Therap*, training method*, program evaluation,
behavior-modification, counseling
c. Target Population Terms: , elementary*, secondary or high school, Sschool-age,
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adolescen*
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Title and Abstract Screening Procedure
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All citations at the title/abstract and full-text retrieval stages will be assessed for inclusion
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criteria by two authors independently. In the event of a disagreement between the two reviewers
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regarding inclusion of a study at the title/abstract stage, the full text of the article will be retrieved
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and read by both reviewers for a decision. Should the reviewers still disagree, the full-text article
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will be reviewed by a third author and a final decision made whether to accept the study for
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inclusion. Reviewers will not be blinded at any level of the review to the name(s) of the author(s),
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institution(s), or publication source.
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Full-Text Screening Procedure
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All citations at the full-text retrieval stage will be assessed for inclusion criteria by two
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authors independently. In the event of a disagreement between the two reviewers regarding
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inclusion of a study at the full text retrieval stage, the full-text article will be reviewed by a third
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author and a final decision made whether to accept the study for inclusion. Reviewers will not be
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blinded at any level of the review to the name(s) of the author(s), institution(s), or publication
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source.
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Coding Procedure and Categories for Included Studies
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Coding of included studies will be conducted independently by two authors. Any
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discrepancies in coding of an article will be resolved through discussion between the two authors.
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If the reviewers cannot come to a consensus regarding a particular study, a third author will be
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consulted for final judgment. Interrater reliability will be reported in the final review. All coding
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will address design, participant, intervention, and outcome characteristics.
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Coding for Included Non-English Studies
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Studies meeting the inclusion criteria but published in a language other than English will
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be coded using the same form as the English language publications. The coding will be
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conducted by an individual proficient in the written form of the non-English language and guided
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by one of the trained coders of the included English language studies. While we recognize that
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there is not a reliability of coding in the non-English language, a limitation on resources and
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access to multi-lingual coders make this a reasonable approach to obtaining a coding for non-
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English studies.
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Research Design Characteristics
All included studies will be either randomized controlled trials or quasi-experimental
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designed studies in which the control and/or comparison group is either matched or statistically
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controlled for at the pre-treatment level. Studies assigning participants at the group level (class,
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school, or district) or individually will be included for review and analysis. No study will be
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included that utilizes a pre-experimental group design (pre- post treatment only), single subject
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design, or qualitative approaches to data collection or analysis.
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Participant Characteristics
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Participants of the included studies for this review will be Kindergarten through High
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School (or the international equivalent). Each study will be coded for participant characteristics
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such as age, gender, SES, grade in school, severity level, and the number of participants in
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experimental and control or comparison groups. Any study performed outside the United States
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will be examined for the international equivalents of US grades. Excluded populations include
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individuals who were not identified as learning disabled or individuals in whom a learning
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disability was not the primary diagnosis (e.g., deaf, blind, mental retardation, emotional
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disturbance).
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Intervention Characteristics
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Intervention characteristics will include dimensions such as type of intervention
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(e.g., cross-age tutoring, direct instruction, counseling), length of intervention program (e.g.,
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number of days/weeks of program implementation), length of intervention session (number of
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minutes, hours per session) , number of sessions, structure of intervention (e.g., group, individual,
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both). Studies will be excluded from this review if they include only pharmacological
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interventions. In the event that a study treats participants with both behavioral and
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pharmacological interventions, ONLY the behavioral intervention outcomes will be included
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AND only if there is an accompanying non-experimental control (comparison) group for
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comparison.
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Follow-up assessments will be identified for maintanence and generalization where
provided and coded for the length of time immediately post intervention.
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Outcome Characteristics
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Outcomes for this review will include:
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a.
Behavioral (e.g., anger, aggression)
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b.
Cognitive (e.g., social problem solving, self image)
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c.
Social (e.g., peer interactions, cooperation)
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Measurement of the outcome characteristics can include observational report, criterion referenced
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assessments, rating scales, or standardized tests
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Assessment of Methodological Quality
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The quality of the methodological rigor of a study may have an important impact on the
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magnitude of the treatment effect size. Individual study methodological quality will be coded and
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assessed for characteristics such as design type, unit of assignment/analysis, attrition, and fidelity
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of treatment implementation. The results of this assessment will be analyzed for their impact on
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the treatment effects. The analysis of this study’s methodological quality will be used as
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moderating variables in the data synthesis and interpretation.
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Calculating Effect Size
Since outcome data may be reported in a variety of formats within individual studies,
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Comprehensive Meta-Analysis (CMA; Borenstein 2001) will be used to calculate the treatment
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effect sizes. This software has the ability to accept data in more than 100 different formats in
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order to transform it to a common effect size and variance. This information is then used in the
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meta-analysis.
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The following are the primary metrics anticipated for the calculation of the effect size:
Standardized Mean Difference Statistic (d-index)
For studies reporting outcomes on a continuous scale, the post-treatment mean of the control
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group will be subtracted from the post-treatment mean of the experimental group and the
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difference will be divided by the pooled standard deviation of both groups.
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For studies reporting statistics such as t, F, or p value statistics only, conversion formulae
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will be used to calculate the d-index for the effect size estimate. All study calculations will be
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weighted by the inverse mean variance to allow larger n studies to contribute proportionately in
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any effect size synthesis. All effect sizes will be calculated using a 95% confidence interval.
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Effect Size Adjustments
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Adjustments to the calculated effect sizes will be made for both sample size and
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assignment/analysis mismatch. In order to maximize the interpretation of the calculated effect
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size, we will calculate all effect sizes using Hedge’s g. Hedge’s g is a standardized mean
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difference with a small sample size bias correction factor.
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Missing Data
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For any included study presenting missing or inadequate data for analysis, the senior author
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will be contacted in an effort to obtain the needed data. Should that data not be available, the
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study will be excluded from analysis.
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Synthesis of Effect Sizes
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When estimating the overall effect size of an intervention, the study is represented by the
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mean value of all outcomes in the study. For those studies presenting multiple outcomes, we will
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employ a shifting unit of analysis approach. However, when examining potential moderators of
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the overall outcomes, a study’s results will be aggregated only within the separated categories of
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the moderator variable(s). For example, if a study on the effect of social skill training on social
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behavior measured two outcomes, acting-out and distractibility, those two effects would be
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averaged for purposes of estimating the intervention’s effect on social behavior. However, when
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examining the type of outcome measure as a moderator variable, the study would contribute an
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effect size to the “acting-out” variable category, and an effect size to the “distractibility” variable
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category.
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Heterogeneity Analysis
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The heterogeneity analysis allows for an assessment of the amount of variation in the
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calculated effect beyond what is expected due to sampling error. Two basic models of analysis
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are available: fixed effects and random effects. Since the results derived from a random effects
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model will allow us to apply inferences of effect to a population of studies involving individuals
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who have been engaged in a social skill-training program we will use only a random effects
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model for our data analysis.
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Sensitivity Analysis
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A sensitivity analysis allows for the assessment of potential bias that may be part of the
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calculated effect size. This bias may be present in a variety of characteristics including attrition,
2
type of treatment, missing data, sample size, and study design. At a minimum and, where
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appropriate, we will assess potential bias for extreme study effect size, bias using the one study
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removed analysis and funnel plots depictions.
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Post Hoc Subgroup and Moderator Analyses
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It may be important to analyze the impact of specific subsets or study moderators such as
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design, participant, or treatment characteristics. We will examine a limited number of these
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subgroup comparisons or study moderator variables. These analyses may include:
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1. Types of Treatment
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2. Severity Level
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3. Attrition
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4. Intention to Treat vs. Active Treatment only
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5. Age of Participant
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6. Length of Treatment
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REVIEW MAINTENANCE
Maintenance of the review will be the responsibility of the lead author Lucy Funderburk.
TIME FRAME FOR REVIEW COMPLETION: October 2009
AUTHOR INFORMATION
Lucy Funderburk [email protected]
Jamie Schwartz [email protected]
Chad Nye [email protected]
Sources of Support
Nordic Campbell Center, Copenhagen, Denmark
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