Behavioral Intervention For Young Children Research Articles

Home-based early behavioral interventions for young children with autism spectrum disorder.

Home-based early behavioral interventions for young children with autism spectrum disorder.

Identifying and measuring the common elements of naturalistic developmental behavioral interventions for autism spectrum disorder: Development of the NDBI-Fi.

Naturalistic developmental behavioral interventions for young children with autism spectrum disorder share key elements. However, the extent of similarity between programs within this class of evidence-based interventions is unknown. There is also currently no tool that can be used to measure the implementation of their common elements. This article presents a multi-stage process which began with defining all intervention elements of naturalistic developmental behavioral interventions. Next, intervention experts identified the common elements of naturalistic developmental behavioral interventions using a survey. An observational rating scheme of those common elements, the eight-item NDBI-Fi, was developed. We evaluated the quality of the NDBI-Fi using videos from completed trials of caregiver-implemented naturalistic developmental behavioral interventions. Results showed that the NDBI-Fi measure has promise; it was sensitive to change, related to other similar measures, and demonstrated adequate agreement between raters. This unique measure has the potential to advance intervention science in autism spectrum disorder by providing a tool to measure the implementation of common elements across naturalistic developmental behavioral intervention models. Given that naturalistic developmental behavioral interventions have numerous shared strategies, this may ease clinicians' uncertainty about choosing the "right" intervention package. It also suggests that there may not be a need for extensive training in more than one naturalistic developmental behavioral intervention. Future research should determine whether these common elements are part of other treatment approaches to better understand the quality of services children and families receive as part of usual care.

Behavioral insomnia in infants and young children.

In infants and young children, bedtime problems and night waking are common and the main presentations of insomnia. Poor sleep may critically impact the daytime functioning and mood of the child and their caregivers. A comprehensive sleep history, a sleep diary/log, and the BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing) sleep screen are useful for diagnosing sleep problems in young children. Behavioral therapies for this type of insomnia include extinction, bedtime fading with positive routines, and scheduled awakening. Previous studies of behavioral interventions for young children showed significant improvements in sleep-onset latency, night waking frequency, and night waking duration. Parent education about their child’s sleep, bedtime routines, and sleep hygiene is essential for treatment.

Early Behavioral Intervention for Young Children with Intellectual and Developmental Disabilities

Early intervention can enhance the development of young children with IDD by altering the developmental trajectory and preventing further delay. This review summarizes the approach and findings of studies on early behavioral interventions specific to young children (< 5) with intellectual and developmental disabilities (IDD) excluding autism spectrum disorders (ASD). There is support for the efficacy of focused and comprehensive behavioral interventions as well as milieu communication training and behavioral parent training for addressing the needs of young children with IDD. New research explores interventions tailored to the needs of specific subgroups of children with IDD and how learner characteristics and intensity moderate outcomes. Most research does not consider the needs of subgroups of IDD aside from ASD. Future work needs to include high-quality evaluation studies and to further evaluate tailored intervention approaches that address the specific needs of subgroups of children with IDD.

Preliminary clinical outcomes of a short-term low-intensity Early Start Denver Model implemented in the Taiwanese public health system.

The Early Start Denver Model is a comprehensive naturalistic developmental behavioral intervention for young children with autism spectrum disorder. Rigorous studies indicate that long-term, high-intensity Early Start Denver Model in home-based settings can help young children with autism spectrum disorder have great progress in language, cognitive development, and adaptive skills and reduce overall symptom severity. In accordance with the current limitations in resourcing for early intervention in Taiwan, this study evaluated the effects of implementing the Early Start Denver Model in the Taiwanese public health system with some adaptations, including lower intensity, shorter duration, and delivery in general hospitals. A total of 16 children with autism spectrum disorder, aged between 25 and 46 months, received approximately 8 h per week one-on-one Early Start Denver Model intervention. After 6 months of intervention, the children showed great improvements in language and overall cognitive functioning and reduced symptom severity in communication and play. This study suggests that directly delivering the Early Start Denver Model in community-based hospitals may be an effective intervention, which can make more young children with autism spectrum disorder in Taiwan access the Early Start Denver Model service.

Meta-analysis of naturalistic developmental behavioral interventions for young children with autism spectrum disorder.

Naturalistic developmental behavioral intervention is an emerging class of interventions for young children with autism spectrum disorder. The present article is a meta-analysis of outcomes of group-design studies (n = 27) testing interventions using naturalistic developmental behavioral intervention strategies. Small, significant positive effects of naturalistic developmental behavioral intervention were found for expressive language (g = 0.32), reduction in symptoms of autism spectrum disorder (g = -0.38), and play skills (g = 0.23). Larger effects were found for social engagement (g = 0.65) and overall cognitive development (g = 0.48). A marginal effect was found for joint attention (g = 0.14) and receptive language (g = 0.28). For joint attention, improvement was moderated by hours of professional involvement. Evidence of publication and reporting bias was present for language outcomes. This meta-analysis grows the evidence base for naturalistic developmental behavioral interventions, particularly in the key areas of social engagement and cognition.

장애위험유아 대상 행동중재의 효과성 연구 : 단일대상연구를 중심으로

장애위험유아 대상 행동중재의 효과성 연구 : 단일대상연구를 중심으로

Aassessing progress and outcome of early intensive behavioral intervention for young children with autism

Introduction: There is an increase in incidence of autism among children. The development of comprehensive therapeutic approaches and techniques for the recovery of those affected becomes a necessity. Moreover, evaluating the progress and the results of the therapeutic interventions, as well as identifying the clinical variables that can influence the quality of the response to therapy are just as important. Objectives: This paper aims to analyze the progress and results of an early intensive behavioral intervention. Methods: The current study was conducted in 116 children aged between 2 and 5 years old with an autism diagnosis. The developmental domains are evaluated with the ADOSG test. We analyzed the variation of ADOS score consequently to applied therapy, as well as the influence of comorbidities such as ADHD or intellectual disability on the patient's progress. Results: Our results show that after 2 years of EIBI, the ADOS-G total score decreased on average with 2,98 points, and for 14 children this score was below the diagnostic threshold. Comorbidities did not have an influence on the progress. These results certify the efficiency of EIBI therapies and encourages the start of a therapeutic program independent of the severity of the symptoms or associated pathologies.

Promoting Parent Engagement in Behavioral Intervention for Young Children With ADHD: Iterative Treatment Development

The most efficacious psychosocial intervention for reducing attention-deficit/hyperactivity disorder (ADHD) symptoms in young children is behavioral parent training (BPT). Potential benefits are hindered by limited accessibility, low session attendance, and poor implementation of prescribed strategies. As a result, only approximately half of families with young children with ADHD receive BPT. We describe an innovative approach for reducing barriers to BPT access. Specifically, we invoked an iterative, 5-step process of intervention development and revision to modify an existing face-to-face BPT program and develop an online version. Results indicated that the revised program and online versions (a) increased parent engagement with BPT, (b) enhanced accessibility, (c) produced favorable parent acceptability and feasibility ratings, and (d) resulted in improved child outcomes.

Interventions for Young Children With and at Risk for Emotional and Behavioral Disorders

Social-emotional and behavioral skills are essential to school and life success. Some young children, though, demonstrate significant delays in these areas. While there is a current hierarchical model of behavioral interventions for young children, it is lacking explicit interventions to be implemented in the early childhood classroom. This column suggests an intervention continuum to be used that extends beyond the current model, providing a matrix that aligns social-emotional or behavioral skills with specific interventions shown to be effective for students who fall under other disability labels.

Improving Early Identification and Intervention for Children at Risk for Autism Spectrum Disorder.

To provide an example of a successful, novel statewide effort to increase early identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination. The South Carolina Act Early Team (SCAET) provided focused collaboration among leaders representing state agencies, universities, health care systems, private organizations, and families to improve quality of life for children with ASD. Specific focus was on implementing policy changes and training to result in earlier identification and home-based behavioral intervention for young children at risk for ASD. Policy changes, training, and modified state agency practices were accomplished. Presumptive eligibility, on the basis of a 2-tiered screening process was implemented by BabyNet (South Carolina's Early Intervention Program) in collaboration with the lead agency for developmental disability services. There was a fivefold increase in children eligible for early intensive behavioral intervention without waiting for a diagnosis of ASD, avoiding long waits for diagnostic evaluations. Only 16 children (2.5%) were later found not to have ASD from a comprehensive evaluation. Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with ASD.

Identifying Common Practice Elements to Improve Social, Emotional, and Behavioral Outcomes of Young Children in Early Childhood Classrooms.

Educators are increasingly being encouraged to implement evidence-based interventions and practices to address the social, emotional, and behavioral needs of young children who exhibit problem behavior in early childhood settings. Given the nature of social-emotional learning during the early childhood years and the lack of a common set of core evidence-based practices within the early childhood literature, selection of instructional practices that foster positive social, emotional, and behavioral outcomes for children in early childhood settings can be difficult. The purpose of this paper is to report findings from a study designed to identify common practice elements found in comprehensive intervention models (i.e., manualized interventions that include a number of components) or discrete practices (i.e., a specific behavior or action) designed to target social, emotional, and behavioral learning of young children who exhibit problem behavior. We conducted a systematic review of early childhood classroom interventions that had been evaluated in randomized group designs, quasi-experimental designs, and single-case experimental designs. A total of 49 published articles were identified, and an iterative process was used to identify common practice elements. The practice elements were subsequently reviewed by experts in social-emotional and behavioral interventions for young children. Twenty-four practice elements were identified and classified into content (the goal or general principle that guides a practice element) and delivery (the way in which a teacher provides instruction to the child) categories. We discuss implications that the identification of these practice elements found in the early childhood literature has for efforts to implement models and practices.

Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism.

Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing overall functioning level rather than via repeated observational measures of autism-specific deficits (i.e., social behavior). In the current study, 83 children with autism (CWA), aged 1, 2 and 3 years, and 58 same-aged typically developing children (TDC) were directly observed in the areas of cognitive skills, joint attention (JA), play, and stereotypic behavior using a measure called the Early Skills Assessment Tool (ESAT; MacDonald et al., 2006). CWA were assessed at entry into an EIBI program and again after 1 year of treatment. Changes in performance were compared pre- and post-treatment as well as to the normative data by age. Results indicate significant gains on the ESAT across all age groups with the greatest gains seen in the children who entered treatment prior to their second birthday. Increases were seen on direct measures of JA, play, imitation and language while decreases were seen in stereotypy regardless of level of performance at entry into EIBI. The ESAT, a direct measurement tool, served as a sensitive tool to measure changes in autism symptomatology following EIBI treatment.

Efficacy of Behavioral Interventions for Young Children with Autism Spectrum Disorders: Public Policy, the Evidence Base, and Implementation Parameters

The complex and extensive deficits associated with Autism Spectrum Disorders, in concert with the substantial increase in prevalence over the last three decades, combine to present a challenge to individuals, families, communities, and government that has few parallels. This challenge is complicated by debate among service providers concerning appropriate treatment approaches and the evidence for efficacy. Within this backdrop, numerous healthcare reform initiatives have included coverage for Autism Spectrum Disorders, both enhancing and complicating the role of public education in the mix of provision of appropriate services. Basic principles of limited resources and expenditure accountability require that standards of care and evidence-based procedures be established and agreed upon. While this approach is common in health insurance policies and procedures, it is less so in public education. The purpose of this review is to provide impetus toward guidelines for comprehensive treatment services, as well as individual skill/behavior interventions, with respect to required service provider characteristics, setting, and “dosage” (number of hours per week for a designated time period). Quantitative analysis will permit progress in review panel deliberation for both insurance reimbursement and public services allocation by having appropriate comparisons with which to evaluate progress reported versus progress expected given the specific intervention program being provided.

Parent inclusion in early intensive behavior interventions for young children with ASD: A synthesis of meta-analyses from 2009 to 2011

This paper presents a comprehensive synthesis of six meta-analyses of early intensive behavioral interventions (EIBI) for young children with autism spectrum disorders published from 2009 to 2011. Analysis was conducted in three steps to account for different formats of treatment delivery and the extent to which parents took part in treatment. The three components of the synthesis were (a) descriptive analysis, (b) effect size analysis, and (c) mediator analysis via partial correlation and linear regressions. We completed the analysis by obtaining standardized mean difference effect sizes for 13 comparative studies ordered by comparison study type and 22 mean change effect sizes ordered by treatment delivery type. Results suggest that EIBI leads generally to positive medium-to-large effects for three available outcome measures: intellectual functioning, language skills and adaptive behaviors. Although favorable effects were apparent across comparative studies, analysis by type of delivery format revealed that EIBI programs that include parents in treatment provision are more effective. Mediator analyses suggest that treatment variables and child characteristics impact program effectiveness when accounting for the extent of parent inclusion. Clinical implications toward individualized treatment tailoring are discussed.

Right from the Start: Behavioral Intervention for Young Children with Autism, 2nd ed.

Right from the Start: Behavioral Intervention for Young Children with Autism, 2nd ed.

Overview of Meta-Analyses on Early Intensive Behavioral Intervention for Young Children with Autism Spectrum Disorders

This paper presents an overview of 5 meta-analyses of early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASDs) published in 2009 and 2010. There were many differences between meta-analyses, leading to different estimates of effect and overall conclusions. The weighted mean effect sizes across meta-analyses for IQ and adaptive behavior ranged from g=.38-1.19 and g=.30-1.09, respectively. Four of five meta-analyses concluded EIBI was an effective intervention strategy for many children with ASDs. A discussion highlighting potential confounds and limitations of the meta-analyses leading to these discrepancies and conclusions about the efficacy of EIBI as an intervention for young children with ASDs are provided.

The effectiveness of a cross-setting complementary staff- and parent-mediated early intensive behavioral intervention for young children with ASD

We compared the effects of Early Intensive Behavioral Intervention (EIBI) and eclectic intervention in children with ASD on autism severity, developmental performance, adaptive behavior, language skills and challenging behaviors. Twelve children received cross-setting staff- and parent-mediated EIBI of centre-based one-to-one and play sessions as well as home-based sessions, including continuous parent training and supervision. A comparison group of 10 children received eclectic intervention. Standardized tests were carried out independent examiners at intake and after 6 months. The groups were equivalent on key variables at intake. The intervention group outperformed the eclectic group in measures of autism severity, developmental and language skills. Scores on adaptive behaviors revealed comparable changes in both treatment groups. Furthermore, the intervention group reduced challenging behaviors, a progress facilitated by parents that achieved treatment fidelity and gained competence to manage challenging behavior functions. Descriptive data of treatment progress showed that parental treatment provision and treatment fidelity gains indicated differential child progress in outcomes and skill mastery in learning environments. Our results show the effectiveness of a staff- and parent-mediated EIBI program for children with ASD. These findings highlight the importance of generalization across settings and persons for improving functional behavior in various learning environments that result in reduced problem behaviors and increased language and communication skills.

Cross-setting complementary staff- and parent-mediated Early Intensive Behavioral Intervention for young children with autism: A research-based comprehensive approach

Although, recent reviews and outcome research support empirical evidence for Early Intensive Behavior Intervention in University and community settings, research has also indicated that not all intensive behavioral service provisions are equally effective. Therefore, it was necessary to comprehend key variables that are common to empirically validated programs. This paper provides a research-based comprehensive EIBI model which has been recently implemented in Italy. Important components include post-diagnostic provision, complementary treatment in clinical setting by professionals and parent-mediated in the child's natural environment, treatment based on applied behavior analysis–verbal behavior, staff and parent training, as well as evaluation of progress.

Cognitive and Adaptive Behavior Outcomes of Behavioral Intervention for Young Children With Intellectual Disability

Data from Norway were analyzed to evaluate early behavioral intervention for children with intellectual disabilities. The intervention group (n = 11) received approximately 10 hours per week of behavioral intervention; the eclectic comparison group (n = 14) received treatment as usual. After 1 year, changes in intelligence and adaptive behavior scores were statistically significant in favor of the behavioral intervention group (effect sizes of 1.13 for Intelligence quotient (IQ) change and .95 for change in adaptive behavior composite). Approximately 64% of the children in the behavioral intervention group met objective criteria for reliable change in IQ, whereas 14% in the eclectic comparison group did so. These results suggest that children with intellectual disability may profit from behavioral intervention typically provided for children with autism.