Age of Entry into Early Intervention: Influence of the COVID-19 Pandemic, Telehealth, and Other Factors.

<abstract> <p>The COVID-19 outbreak affected the world badly in this 21<sup>st</sup> century leading to the closure of all types of anthropogenic activities. It is declared that there was an environmental betterment in names of water quality and air quality during the COVID-19 period. In this study, we analyzed the improvement in water quality by evaluating the suspended particulate matter (SPM) using the remote sensing technique in a tropical South Sumatra wetland i.e., Musi River in Southern Sumatra, Indonesia. The SPM values were estimated from Landsat 8 images Level-2 product. A quantitative and spatial analyses of before (20<sup>th</sup> May 2019), during (22<sup>nd</sup> May 2020), and after COVID-19 (28<sup>th</sup> May 2022) periods were also calculated. Results revealed that the mean SPM values during COVID-19 period (4.56 mg/L) were lower than that before COVID-19 period (8.33 mg/L). Surprisingly, SPM showed an increase of 54% in SPM values after COVID-19 period, compared with during COVID-19 period. The role of human activities including industrial and domestic wastes during the restriction period was the main reason for alteration of pollution loads in the river. Outputs of this study can be used to arrange policies for the sustainable management of aquatic environments and water resources.</p> </abstract>

To summarize current evidence for early identification and motor-based intervention for children aged 5 years and younger of age with/at risk of developmental coordination disorder (DCD). Using scoping review methodology, we independently screened over 11 000 articles and selected those that met inclusion criteria. Of the 103 included articles, 78 articles were related to early identification and are summarized in a companion article. Twenty-two articles focused on early intervention, with an additional three articles covering both early identification and intervention. Most intervention studies were at a low level of evidence, but provide encouraging evidence that early intervention is beneficial for young children with/at risk of DCD. Direct intervention can be provided to whole classes, small groups, or individuals according to a tiers of service delivery model. Educating and building the capacity of parents and early childhood educators are also key elements of early intervention. Evidence for early intervention for children with/at risk of DCD is emerging with promising results. Further studies are needed to determine best practice for early intervention and whether intervening early can prevent the negative developmental trajectory and secondary psychosocial consequences associated with DCD.

Part C Early Intervention (EI) systems are an entry point to services for autistic toddlers and can be leveraged to facilitate access to autism evidence-based practices (EBPs). However, EI systems are complex and limited research has examined how an EI system's infrastructure (i.e. system-level factors) impacts the adoption and implementation of EBPs. To address this gap, 36 EI providers and 9 EI administrators completed a semi-structured interview or focus group about factors impacting the implementation of autism EBPs. Qualitative analysis included a combination of grounded theory and causative coding. Analyses were refined by input from providers, administrators, and family stakeholders in the form of round tables and presentations at the state's interagency coordinating council. Primary themes centered on: (1) the costs associated with independent contracting structures; (2) operational demands; (3) workforce stability; (4) communication consistency; and (5) implementation supports for EBP implementation. Causative coding helped to demonstrate the perceived relationships between these factors and underscored the important role of incentivization structures, collaboration opportunities, and championing in supporting the use of EBPs within a system that primarily uses independent contracting structures. The current study extends previous research by demonstrating how several system-level factors are perceived to play a role in the adoption and implementation of EBPs by independently contracted EI providers. These findings underscore the need for implementation strategies, such as incentivization strategies and social network building, to increase providers' implementation of autism EBPs within EI systems.

Objective: To investigate the impact of the COVID-19 pandemic on the diagnosis and treatment processes of ectopic pregnancies (EP) at a tertiary hospital in Turkey. Methods: This retrospective study compared 221 cases of tubal EP diagnosed after March 15, 2020, with 217 cases diagnosed before this date. Patient demographics, clinical characteristics, and treatment modalities were analyzed. Statistical analyses, including independent t-tests, Chi-square tests, and multinomial logistic regression, were conducted to assess differences between the COVID and pre-COVID periods. Results: The study found no significant differences in maternal age, gravidity, parity, or gestational weeks between the COVID and pre-COVID periods. However, there was a notable increase in patients presenting with abdominal pain (52.5% vs. 37.8%) and intraperitoneal hemorrhage (26.7% vs. 7.4%) during the COVID period. Despite the higher frequency of abdominal pain, vaginal bleeding was less common during the pandemic. Treatment approaches also shifted, with a significant increase in medical management (41.2% vs. 29.0%) and a slight decrease in surgical interventions during the COVID period. Multinomial logistic regression revealed that parity, gestational week, presence of Douglas fluid, and the period of diagnosis (COVID vs. pre-COVID) were significant predictors of treatment modality. Conclusion: The COVID-19 pandemic influenced the clinical presentation and management of ectopic pregnancies in our hospital. While there were no significant differences in key demographic or laboratory parameters, the increased presence of abdominal fluid and a shift towards medical management during the pandemic period suggest changes in patient presentation and treatment preferences. This study underscores the importance of maintaining vigilant diagnostic and therapeutic approaches for EP, even during global health crises.

BackgroundParticipation in Naturalistic Developmental Behavioral Interventions (NDBI) is associated with significant improvements in functioning for toddlers with, and showing early signs of, autism spectrum disorder. The Part C Early Intervention (EI) system, which is publicly funded and available in all U.S. states, offers an optimal infrastructure through which toddlers can receive NDBIs. This study seeks to assess the effectiveness and fit of one NDBI, Caregiver Implemented Reciprocal Imitation Teaching (CI-RIT), within the Part C EI system.MethodsThis hybrid type 1 effectiveness/implementation trial uses a multi-site randomized control design to simultaneously test effectiveness and collect implementation data on CI-RIT in the Part C EI system across four states: Illinois, Massachusetts, Michigan and Washington. Participants include EI providers (target n = 160) who are randomized to either CI-RIT or treatment as usual (TAU), and child/caregiver dyads on their caseloads (target n = 440). Primary effectiveness outcomes focus on (1) child social communication, joint attention, motor imitation; and (2) caregiver responsivity, implementation fidelity of RIT, and self-efficacy, which are all measured at baseline and then 4-months and 9-months after baseline. Implementation outcomes include CI-RIT modifications, treatment acceptability, fidelity of CI-RIT coaching, and RIT session completion.DiscussionThis study represents a critical effort to transport an evidence-based NDBI, CI-RIT, into a national service delivery setting, the Part C EI system. The large, multi-site nature of the trial provides the opportunity to address critical questions about training and intervention effectiveness, which will, in turn, optimize and support CI-RIT implementation at scale.Trial registrationThe trial protocol is registered at ClinicalTrials.gov (NCT05114538; Registration date: 10/28/2021).

ObjectiveWe aimed to ascertain the trends of injury mortality during the COVID-19 period in southern China.MethodsWe conducted a population-based retrospective analysis to compare the mortality changes of all-cause injury and...

The National Early Intervention Longitudinal Study (NEILS) is the first study of Part C of the Individuals With Disabilities Education Act (IDEA) early intervention system with a nationally representative sample of infants and toddlers with disabilities. This article presents national estimates of characteristics of infants and toddlers and their families at the time they entered the early intervention (EI) system. The variability in children in EI is marked by high proportions of children from low-income families, ethnic minorities, those in foster care, and males. Nearly one third (32%) are low birth weight, four times the rate in the general population. Infants and toddlers in EI are eight times more likely to be rated as having fair or poor general health. Children enter at all ages across the first 3 years of life, but those eligible because of developmental delays enter as toddlers, in comparison with those eligible because of diagnosed conditions or subject to biological or environmental risk factors, who tend to enter in the first year of life. The variability of the infants and toddlers in EI indicates that there is no typical child in EI.

The Early Intervention Parenting Partnerships (EIPP) program is a home visiting program that provides home visits, group services, assessments and screenings, and referrals delivered by a multidisciplinary team to expectant parents and families with infants who experience socioeconomic barriers, emotional and behavioral health challenges, or other stressors. The present study examines whether EIPP successfully meets its aims of screening families for social and environmental factors that may increase the risk of children’s developmental delays and connect them to the larger statewide early intervention (EI) system relative to families with similar background characteristics who do not receive EIPP. Coarsened exact matching was used to match EIPP participants who enrolled between 2013 and 2017 to a comparison group of families identified from birth certificates. Primary study outcomes including EI referrals, evaluations, and service receipt for children from 3 months to 3 years were measured using EI program data. Secondary outcomes included EI referral source, EI eligibility criteria (e.g., presence of biological, social, or environmental factors that may increase later risk for developmental delay), and information on service use. Impacts were assessed by fitting weighted regression models adjusted for preterm birth and maternal depression and substance use. EIPP participants were more likely than the comparison group to be referred to, evaluated for, and receive EI services. EIPP facilitated the identification of EI-eligible children who are at risk for developmental delays due to social or environmental factors, such as violence and substance use in the home, child protective services involvement, high levels of parenting stress, and parent chronic illness or disability. EIPP serves as an entry point into the EI system, helping families attain the comprehensive supports they may need to optimize their well-being and enhance children’s development.

IntroductionThe translation and use of evidence-based practices (EBPs) within early intervention (EI) systems presents challenges. The Office of Special Education (OSEP) has emphasized results-driven accountability to expand state accountability from compliance to also include quality services that align with EBPs. OSEP’s results-driven accountability provided states the opportunity to design State Systemic Improvement Plans (SSIP) to strengthen the quality of EI services by increasing the capacity of EI systems to implement, scale-up, and sustain use of EBPs. Caregiver coaching is widely accepted as an EBP within EI settings, yet uptake and fidelity to coaching practices remains limited. Such widespread implementation of caregiver coaching is partially limited by a lack of measurement tools that operationalize behaviors consistent with coaching. In this study, we describe the development of the Kentucky Coaching Adherence Rubric-Revised (KCAR-R) and psychometric testing of the instrument.MethodsWe developed and tested the KCAR-R to measure fidelity of coaching practices within a state-wide professional development program, the Coaching in Early Intervention Training and Mentorship Program. We define operational elements of the KCAR-R and rubric design elements related to: creators; users and uses; specificity, judgment complexity; evaluative criteria; quality levels; quality definitions; scoring strategies; presentation; explanation; quality processes; accompanying feedback information; secrecy; and exemplars. With regard to psychometric validation of the KCAR-R, interrater reliability was analyzed using intraclass correlation coefficients across eight raters and 301 randomly selected video submissions. Internal consistency was evaluated using Cronbach’s alpha across 429 video submissions.ResultsResults showed 0.987 agreement, indicating excellent interrater reliability; item level internal consistency values ranged from 0.860 to 0.882. for scale if item deleted and 0.834 for the total scale.DiscussionFindings from this study showed that the KCAR-R operationalized behaviors that exemplify caregiver coaching and may serve as a resource for other states or programs to document the quality and fidelity of evidence-based EI services. To influence EI provider practices at a systems level, we used implementation science to guide our work and provide examples of how EI systems seeking ways to create sustainable quality services may build upon our approach.

New federal legislation requires states to develop policies to refer children younger than age 3 with substantiated cases of abuse or neglect to state Early Intervention (EI) systems. This article presents state-by-state estimates of potential referral and enrollment increases for EI. Many states could experience a significant increase in referrals (average 44%) and enrollment (average 22%). For effective implementation, states' EI systems will need to (a) increase EI system capacity, (b) identify additional funding, (c) find ways to successfully engage potentially resistant families, and (d) forge new interagency linkages. The state-by-state estimates provide both an indication of the potential impact in each state as well as goals that would reflect effective implementation of the referral mandate.

The current crisis caused by the COVID-19 pandemic has hit the global economy hard, causing significant damage to every aspect of the global banking system, and Bangladesh is no exception. For that reason, its performance and profitability have been affected. In this study, we investigate the impact of COVID-19 on the financial performance and profitability of the listed private commercial banks in Bangladesh. We initially compute each bank’s financial performance index (FPI) to determine the position according to their financial performance individually before and the current period of COVID-19 by the standardized CAMELS rating system. After assessing the position, the fixed-effect regression model is used to explore the impact of the bank’s specific variables and macroeconomic variables along with the banks’ variables on the banks’ profitability. The banks that performed better during the pre-pandemic period of COVID-19 also performed better during the pandemic period of COVID-19. The performance of AIBL, EBL, and BBL was almost autonomously higher during both periods. In the case of bank profitability, our paper discovered that during the pandemic period of COVID-19, high non-performing loan rates, holding more liquid assets, a high amount of hedging capital, and inappropriate bank size lessened the banks’ profitability. In contrast, a low leverage position and inflation rate enhanced the bank’s profitability during this period. The outcome of this study will help bank authorities detect the loopholes and take preventive measures that can improve their profitability during a crisis period like COVID-19. The investors and depositors who invest money in banks can precisely decide their portfolios.

This article is devoted to the development of early intervention in the Perm region as a measure for the prevention of child disability in the system of complex rehabilitation and habilitation of disabled people (disabled children). The article presents the level of disability among the child population in modern Russia; the theoretical and methodological foundations of the provision of early comprehensive intervention to children with special needs and their families are considered; the relevance of the development of early intervention at the federal and regional levels as a strategically significant area of modern social policy in the country, the creation of a unified system of early intervention, taking into account the characteristics of the regions of the country. The authors presented results of the study reflect the experience of organizing an early intervention service in the system of comprehensive rehabilitation and habilitation of disabled people (disabled children) in the Perm region over the past few years. The early intervention system in the Perm region is constructed at three levels. At the macro level, the activity of the region is analyzed within the framework of the implementation of the Pilot Project to develop approaches to the formation of a system of comprehensive rehabilitation and habilitation of disabled people; the specifics and content of the created mechanisms of interdepartmental interaction are disclosed; the problems and prospects of their implementation are identified, the experience of organizing early intervention as a public service is studied. At the meso-level, the structure of early intervention services created at institutions of various departmental affiliations is presented; disclosed the activities of the early intervention service, created at the departments of social service institutions of the Perm region; describes the procedure for providing early intervention services to children and their families. The provision of early intervention services to a child and his family is presented as a micro level; disclosed the content of early intervention technology in the early intervention service; describes the stages of providing early intervention services, forms and methods of work used. The prospects for the development of early assistance in social service institutions, new forms of providing early intervention services in modern conditions are determined.

Early Intervention (EI) systems are police accountability tools widely used to identify and address at-risk officers. Studies have yet to incorporate supervisory review practices into EI evaluations. The current study helps fill this gap by examining the operation and effectiveness of an EI system through the integration of policy and supervisory review practices using a mixed methods design. EI alert data, supervisor response memos, and semi-structured supervisor interviews were collected from a large, metropolitan police agency in the southwestern United States. Results indicated that several officer, supervisor, and EI case characteristics were associated with both supervisors’ EI policy adherence and the likelihood of subsequent EI alerts occurring. These results were supplemented with supervisors’ perceptions of EI processes and reasons for EI system effectiveness and ineffectiveness. Collectively, EI system design and implementation, supervisory review processes, and appropriate oversight of these processes were perceived to be key to an EI system’s success.

Objective The COVID-19 pandemic disrupted the healthcare system and disproportionally affected individuals with substance use. This study aimed to evaluate the prehospital emergency medical service (EMS) use for substance-related health issues during the COVID-19 pandemic period and compare the changes with the pre-COVID-19 period. Methods The prehospital EMS calls due to substance-related problems in overall Turkiye were analyzed retrospectively. The applications were categorized into the pre-COVID-19 period (May 11, 2019, to March 11, 2020) and the COVID-19 period (March 11, 2020, to January 4, 2021). These two periods were compared to if there were any changes in sociodemographic features of the applicants, the reason for EMS calls, and the dispatch results of the calls. Results There were 6,191 calls in the pre-COVID-19 period and 4,758 calls in the COVID-19 period. According to the age groups, the number of applications of 18 years and under decreased, while the application of people 65 years and over increased during the COVID-19 period (p < 0.001). Considering the reasons for the EMS application, there was an increase in the calls due to suicide and transfers during the COVID-19 period. Besides, the EMS applications for court-ordered treatment decreased in the COVID-19 period (p < 0.001). There was no statistically significant difference in terms of dispatch results (p = 0.081). Conclusions This study shows that the elderly group is at higher risk for substance-related medical problems. Suicide is an important risk among individuals with substance use. The increase in demand for ambulance transfer services can place a significant burden on prehospital emergency care. There is a need for measures to provide emergency and transport services, especially for the elderly and suicide attempts during any future case of emergency.

Police reform, including transparency and officer and agency accountability, is a top priority. In response to patterns of excessive force and misconduct, reform agreements have been instituted, and consistently require early intervention (EI) systems, a supervision and accountability tool to address at-risk officers. Yet little is known about the likelihood and timing of recurring EI alerts. This study examines EI data from a large, metropolitan police agency in the southwestern USA. Results indicate officer race, division, time to initial alert, type of performance indicator, and year of the alert were significant for the likelihood and timing of subsequent EI alerts. Supervisor tenure was also significant for timing to a subsequent EI alert. For officers with a subsequent EI alert, half recurred within 6 months of their initial EI alert and intervention, and 90 per cent did so within 2 years. Implications for police reform include enhanced supervision and accountability with EI systems.