Early Intervention Services For Children Research Articles

Identification of psychosocially stressed families by practice pediatricians : Results on the effectiveness of the PATH (Pediatric Attention To Help) intervention

In Germany, about afifth of families with young children live under psychosocially stressful conditions that can threaten the healthy development of the child. In order to improve the referral of these families from pediatric practices to early childhood intervention services ("Frühe Hilfen"), the PATH intervention was developed and implemented in Baden-Württemberg. The first step in the referral process is to identify psychosocially stressed families. This study investigated whether the PATH intervention increases the proportion of identified families with psychosocial stress by pediatricians. In aquasi-experimental study, atotal of 293 psychosocially stressed families who were cared for by 29pediatricians from established pediatric practices were examined. The intervention group (IG) consisted of families with pediatricians from Baden-Württemberg who took part in the PATH intervention. The control group (CG) consisted of families with pediatricians from Bavaria who did not take part in the PATH intervention. Additional qualitative telephone interviews were conducted with 10pediatricians from the IG and 20families from the IG with psychosocial stress. Asignificantly higher proportion of psychosocially stressed families was identified in the IG than in the CG. The difference was about 20percentage points and was similar regardless of the family's level of stress. The results show that the PATH intervention improves the identification of psychosocially stressed families by pediatricians. This improved identification of psychosocially stressed families is an important prerequisite for referring families to tailored early childhood intervention services such as those provided by the "Frühe Hilfen".

Early Childhood Intervention under the Australian National Disability Insurance Scheme: Characteristics and Recruitment Practices of Service Providers

AbstractThe National Disability Insurance Scheme (NDIS) constitutes a major policy reform for Australian people with disabilities. Despite its ten-year implementation, little is known about the characteristics of the workforce delivering Australia’s NDIS early childhood intervention services (ECI). The present study sought to identify the range of skills, knowledge, and experience of ECI professionals as listed in recruitment advertisements, and their alignment with best practice guidelines. Provider data were extracted from 246 advertisements for ECI roles over a 5-month period and assigned into various categories. Interrater reliability was determined by randomly selecting 65 of the 246 of the advertisements, which were coded independently by two researchers and assigned to service provider categories. Significant changes have occurred in the qualities of professionals providing ECI services under the NDIS, and their adherence to best practice guidelines. The limited emphasis on best practice in the recruitment process may result in an ECI workforce that is not well equipped to deliver specialised and inclusive support to young children with disabilities and their families.

Early childhood intervention and children's health development : Exemplary findings and methodological challenges in the use of the school entry examination

Early childhood intervention is intended to systematically network and customise support services, particularly for socio-economically disadvantaged families. The programmes are universal or selective, but the evidence on their effectiveness is limited. The aims of this study were to exemplary analyse whether participants in early childhood intervention services had better development than non-participants using the school entry examination (SEE) as well as to discuss to what extent the SEE can be used to assess the impact of early childhood intervention services. We analysed three typical offers of early childhood intervention services (family education; Zukunft für Kinder (ZfK); Kita-U) in relation to full vaccination coverage and age-appropriate development at U9. Data from 4579 Düsseldorf first graders were included. Propensity score matching was used to calculate percentage differences (average treatment effect on the treated; ATT) in terms of immunisation coverage and development between comparable intervention and control groups. All programmes are associated with aslightly increased probability of full vaccination protection (ATT2.1 for family education; 2.5 for ZfK; 5.3 for Kita-U). Family education is also associated with aslightly higher probability of age-appropriate development (ATT 1.6), while the probability of age-appropriate development is lower for participants in ZfK (-10.1) and Kita‑U (-4.5). The evaluation of early childhood intervention, especially selective services, is amethodological challenge due to confounding and suitable comparison groups. However, the SEE could be aframework for impact analyses under specific conditions.

"I was very scared when I found out my son had sickle cell": Caregiver knowledge and attitudes toward early intervention for young children with sickle cell disease: Implications for policy and practice from a multi-site study.

This study characterized caregivers' beliefs related to early intervention services for children with sickle cell disease (SCD) to gain an indepth understanding of caregivers' experiences and desires for early intervention services. Both qualitative and quantitative data were collected from caregivers of children aged 0-4years with SCD across two sites in the United States. Caregivers completed the Knowledge of Infant Development Inventory, a custom survey about their experiences with early intervention, and a qualitative interview. A total of 127 caregivers were approached, 47 participated in surveys, and 20 completed interviews. Caregivers expressed varying levels of confidence and understanding of developmental milestones across sites. Interviews highlighted three main themes: fear of SCD-related complications, variable buy-in to early intervention, and the importance of provider-caregiver relationships. While some caregivers appreciated early intervention, others questioned its necessity. Caregivers communicated interest in connecting with other families facing similar challenges, emphasizing the need for increased awareness of available resources. Fear about their child's well-being was expressed by many caregivers, emphasizing the need for a supportive healthcare team that can help families connect with preventive interventions. While about a quarter of children had been referred to rehabilitation services, caregivers were unaware of the elevated risk for developmental delay, which diminished caregiver interest in participating in programs like early intervention. This study underscores the importance of addressing knowledge gaps and overcoming barriers to enhance care for families affected by SCD.

Responses to the needs of families with children with disabilities in Spain: The voices of families and professionals

Children with disabilities and their families have the right to access Early Childhood Intervention (ECI). Family members should act as active agents of the intervention. In this sense, service professionals should offer support and intervention to improve family well-being and child development. We analyzed the experiences of parents of children with disabilities users of ECI services and the professional coordinators in the Balearic Islands (Spain) from a phenomenological-hermeneutic approach. Data collection was through semi-structured interviews and focus groups. A total of 5 coordinators and 30 family members participated in the study. The results indicate five categories: making ECI visible, reception phase, family well-being, intervention, and current barriers. The findings project the need to make ECI visible in policies and administrations, as well as plans to raise social awareness of child disability. Protocols must be found to facilitate access to services for children and families. Implications for the improvement of ECI are proposed.

Measuring Home Activities and Participation of Children Receiving Early Childhood Intervention Services in Spain

Measuring Home Activities and Participation of Children Receiving Early Childhood Intervention Services in Spain

Awareness, access, and communication: provider perspectives on early intervention services for children with sickle cell disease.

This study aimed to identify determinants influencing the utilization of early intervention services among young children with sickle cell disease (SCD) based on perspectives from medical and early intervention providers. Early intervention and medical providers from the catchment area surrounding St. Jude Children's Research Hospital and Washington University were recruited (20 total providers). Interviews were completed over the phone and audio recorded. All interviews were transcribed verbatim, coded, and analyzed using inductive thematic analysis. Three overarching themes were identified from both groups: Awareness (e.g., lack of awareness about the EI system and SCD), Access (e.g., difficulties accessing services), and Communication (e.g., limited communication between medical and early intervention providers, and between providers and families). Although these three themes were shared by medical and early intervention providers, the differing perspectives of each produced subthemes unique to the two professional fields. Early intervention services can limit the neurodevelopmental deficits experienced by young children with SCD; however, most children with SCD do not receive these services. The perspectives of early intervention and medical providers highlight several potential solutions to increase early intervention utilization among young children with SCD.

Sociological analysis of the functioning of early assistance services for children under 3 years in the Krasnoyarsk Krai

The purpose of the study is a comprehensive sociological analysis of the functioning of early intervention services for children under 3 years of age in the Krasnoyarsk Territory. The tasks of the analysis include: 1) studying the structure of the early intervention service as a social organization, the functions of its elements, systemic connections and relationships between them; 2) studying the satisfaction of representatives of client families with the work of early intervention services; 3) studying the subjective perceptions of employees of early intervention services and representative’s client families about the content and meaning of the services. The authors used the methods of a sociological survey, in-depth interviews, participant observation. Based on a number of indicators, the authors concluded that early intervention services were predominantly highly effective. The article shows the problem area of the functioning of early intervention services, which lies in the difference in understanding the goals and results of working with children on the part of client families and early intervention service specialists. Specialists see as the main goal the development of functional skills by children that contribute to socialization and independence, and then the improvement, the acquisition of educational, cognitive skills. Parents often prioritize learning skills when setting class goals. This difference may reduce parental satisfaction with the results of early intervention and the effectiveness of classes. The authors revealed the dependence of the level of involvement of parents in work with children together with specialists from early intervention services on the length of service and the age of the child. The more experience and the older the child, the less parents are involved in working with children. The authors proposed a social typology of representatives of client families on the grounds of their involvement in work with children and their attitude to the results of work with a child.

Home-based early intervention services for children with disabilities in Saudi Arabia: opportunities and challenges from a specialists perspective

ABSTRACT This study seeks an understanding of the opportunities and challenges involved in providing home based early intervention services for children with disabilities in Saudi Arabia (SA), from the perspective of early intervention specialists. A qualitative approach was implemented involving semi-structured interviews with eight (8) participants who were specialists in early intervention with experience of the provision of home based services. The thematic approach was applied for data analysis. The results identify several opportunities, including flexibility, family participation, financial return, developmental advancement, family wishes, use of surrounding environment and daily routines, and use of reliable programmes. The study also indicated certain challenges present relating to high expectations from families, the preparation and professional training of specialists, ministry input, lack of cooperation from families, and transportation issues. The findings of this study have several important implications for future practice.

Access to Part C, Early Intervention for children younger than 4 years evaluated for autism spectrum disorder.

Health disparities are defined as preventable differences in the opportunities to achieve optimal health outcomes experienced by marginalized and underrepresented communities. For families with autistic children, health disparities limit accessing early intervention services-which have been found to improve quality of life and other outcomes. One specific early intervention service in the United States is Individuals with Disabilities Education Act, Part C Early Intervention programs, which are federally funded interventions for children birth-to-three with developmental delays. This study adds to this topic by examining which factors impact accessing Part C, Early Intervention services for children who were evaluated for autism. Results showed that only half of the sample received these services despite there being concerns about development for all children. In addition, results showed that those who identified as Black had decreased odds of having accessed Part C, Early Intervention compared to those who identified as White. These results suggest that there are disparities when it comes to accessing important early intervention services that may be negatively impacting the Black autistic community.

Evidence-Based Implementation of the Family-Centered Model and the Use of Tele-Intervention in Early Childhood Services: A Systematic Review.

The purpose of this review is to explore the evidence and efficacy of two trends in early childhood intervention services: the family-centered model and the use of tele-intervention. A systematic review was carried out following the PRISMA methodology and using three databases: Web of Science, PubMed and Scopus. The studies included were those aimed at children from 0 to 6 years of age, focused on early intervention, and which alluded to the family-centered model and/or tele-intervention. a total of 33 studies were included. Five main themes were identified: (1) The participation of children and family is facilitated and improved by the family-centered model of care; (2) the feeling of competence, self-efficacy, satisfaction and empowerment in professionals and families have a positive impact on quality of life; (3) the use of tele-intervention as a tool for prevention and intervention; (4) preparation for telepractice can improve the development of commitment; (5) tele-intervention as a possible solution to contextual barriers. Tele-intervention in pediatrics is presented as a tool inherent to the family-centered model since its implementation involves several common strategies. Future lines of research should explore the use of this tool as a possible solution to contextual barriers.

Familiar Perception: Opportunities for Typical and Ideal Experiences in Early Intervention

The present study delves into the crucial domain of early childhood intervention services, with a specific focus on the familiar perspective and its impact on intervention outcomes. Family-centered practices approach emphasizes the importance of a collaborative relationship between professionals and families, to empower family strengths and their utilization in promoting optimal child development. Thus, the study aims to validate the Families in Natural Environments Scale of Service Evaluation (Family FINESSE), which assess the fidelity of intervention practices (identified as typical practices) and identify areas for improvement (identified as ideal practices) based on 432 Spanish families´ perceptions, with children aged 0 to 6 years old experiencing neurodevelopmental challenges or risks, engaged in early intervention services for a minimum of six months. We conducted Structural Equation Modeling (SEM) as the primary analytical technique for scale validation and found the Exploratory Factor Analysis and Confirmatory Factor Analysis showed optimal adjustment indices and good internal consistency in both ideal-practices (α=.84).and typical-practices (α=.93) scales. The findings validate the relevance and applicability of the Family Finesse Scale in evaluating and enhancing early childhood intervention services, particularly in aligning practices with family needs and aspirations.

Psychosocial Stressors and Resources in Parents Using Home-Visiting Programs in Early Childhood: A Study Protocol.

Psychosocial stressors and resources present in the early life of a child play a crucial part in determining outcomes later in life. Preventive early childhood intervention services aim to reduce negative and increase positive outcomes. Home-visiting programs are an example for preventive services that are common in many countries.The present study focusses on a wide spread home-visiting program in Germany and has three main objectives: First, to characterize the professionals that conduct and the families who participate in the program. Second, to study relations between a broad range of resources and stressors. Third, to analyse potential outcome variables for future efficacy studies on early childhood intervention services. The goal is to recruit 130 professionals and 500 families from 20 cities and municipalities in Germany. For families with two caregivers, both are invited to participate. Questionnaire topics for professionals and families include a range of stressors and resources, need for support, and the work focus of the professionals. Statistical analyses will mainly be descriptive, exploring the complex interplay of stressors and resources in vulnerable families.These results will not only provide insights into how the program is currently conducted and whom it serves, but might also help to further accelerate the program and the training of professionals.

Functional measures on PEDI are associated with BSID-3 scales at 2 years, following neonatal surgery

BackgroundNeonates requiring early surgical intervention for major non-cardiac congenital anomalies are at high risk of adverse neurodevelopmental outcomes. Early recognition of potential neuro-developmental delay is critical to facilitate access to early childhood intervention services and therefore maximise the functional capabilities of these children. AimsThis study aims to compare Bayley's Scales of Infant and Toddler Development (BSID-3) and the Paediatric Evaluation of Disability Inventory (PEDI) as early screening tools in predicting neuro-developmental disability across multiple domains. In addition, it looks at determining which pre, peri and post-operative risk factors lend themselves to more adverse outcomes. Study designRetrospective cohort study. SubjectsNeonates requiring surgical intervention at the Royal Children's Hospital from 2012 to 2018 who subsequently underwent neurodevelopmental assessment at 2 years of age. Outcome measuresThe main outcome was the relationship between performance on the PEDI compared with the BSID-3, in 2-year-olds following neonatal surgery. ResultsParent -reported functional measures across all domains on PEDI strongly related to the more formal measures of cognition, language, and motor development assessed on BSID-3 (p < 0.05). ConclusionsThe questionnaire-based PEDI tool could be considered a reliable replacement to the formal Bayley (BSID-3) scale in low-risk infants and provide a more accessible means of assessment where there are deficiencies in availability of suitably trained clinicians or limited resource centres.

Evidence-Based Practices Via Remote Service Delivery for Early Intervention in Rural Communities

The COVID-19 pandemic increased the use of remote service delivery in early childhood intervention (EI), and this increased use is promising for young children with disabilities living in rural communities. However, the increase in remote service delivery requires a greater understanding of using evidence-based practices (EBP) delivered by EI providers via this mode. Remote service delivery adds a new context to EI services requiring study to identify (a) what works for whom and under what conditions, (b) how an evidence-based practice delivered remotely results in positive outcomes for young children and caregivers, and (c) the independent variables that influence those outcomes. This position paper explains the importance of remote service delivery for improving access to EBP for young children with disabilities and their families in rural communities using a conceptual framework. The conceptual framework includes three essential factors described in depth in this article. First, the conceptual framework can support researchers in designing rigorous studies to deliver evidence-based practices remotely. Second, the conceptual framework can support EI programs and providers in identifying EBP for service delivery for young children and families in rural communities.

Telepractice in Early Childhood Intervention: A Parent-Reported Social Validity Scale.

In recent years, telepractice has become widespread as an intervention strategy in Early Childhood Intervention (ECI) services. However, studies supporting its use in this field remain scarce. Because reliable instruments are needed to evaluate the perceived quality, satisfaction and the acceptability of telepractice from the families' perspective, the present study aims to report the psychometric properties of an ECI-specific instrument that includes a variety of social validity indicators that are also important and consistent with a family-centered approach. This study, with a sample of 738 families, introduces an instrument aimed at evaluating the social validity of telepractice. The scale includes the main indicators of social validity: Usability, Effectiveness; Feasibility, Utility, intervention with natural caregivers, and Future Intentions. The study aims to report its psychometric properties through a split-sample method, conducting both exploratory and confirmatory factor analysis with randomly assigned sub-samples. We found that all seven items fit into one factor measuring social validity of telepractice, with acceptable internal consistency and sensitive enough to capture differences between the type of service delivery families received. In addition, the proposed instrument provides relevant information for professionals to improve the quality of service-delivery in ECI.

Annual Research Review: Early intervention viewed through the lens of developmental neuroscience.

The overarching goal of this paper is to examine the efficacy of early intervention when viewed through the lens of developmental neuroscience. We begin by briefly summarizing neural development from conception through the first few postnatal years. We emphasize the role of experience during the postnatal period, and consistent with decades of research on critical periods, we argue that experience can represent both a period of opportunity and a period of vulnerability. Because plasticity is at the heart of early intervention, we next turn our attention to the efficacy of early intervention drawing from two distinct literatures: early intervention services for children growing up in disadvantaged environments, and children at elevated likelihood of developing a neurodevelopmental delay or disorder. In the case of the former, we single out interventions that target caregiving and in the case of the latter, we highlight recent work on autism. A consistent theme throughout our review is a discussion of how early intervention is embedded in the developing brain. We conclude our article by discussing the implications our review has for policy, and we then offer recommendations for future research.

'All Aboriginal and Torres Strait Islander children should have access to the ASQ-TRAK': Shared vision of an implementation support model for the ASQ-TRAK developmental screener.

The ASQ-TRAK, a strengths-based approach to developmental screening, has high acceptability and utility across varied Aboriginal and Torres Strait Islander contexts. While substantive knowledge translation has seen many services utilise ASQ-TRAK, we now need to move beyond distribution and support evidence-based scale-up to ensure access. Through a co-design approach, we aimed to (1) understand community partners' perspectives of barriers and enablers to ASQ-TRAK implementation and (2) develop an ASQ-TRAK implementation support model to inform scale-up. The co-design process had four phases: (i) partnership development with five community partners (two Aboriginal Community Controlled Organisations); (ii) workshop planning and recruitment; (iii) co-design workshops; and (iv) analysis, draft model and feedback workshops. Seven co-design meetings and two feedback workshops with 41 stakeholders (17 were Aboriginal and Torres Strait Islander), identified seven key barriers and enablers, and a shared vision - all Aboriginal and Torres Strait Islander children and their families have access to the ASQ-TRAK. Implementation support model components agreed on were: (i) ASQ-TRAK training, (ii) ASQ-TRAK support, (iii) local implementation support, (iv) engagement and communications, (v) continuous quality improvement and (vi) coordination and partnerships. This implementation support model can inform ongoing processes necessary for sustainable ASQ-TRAK implementation nationally. This will transform the way services provide developmental care to Aboriginal and Torres Strait Islander children, ensuring access to high quality, culturally safe developmental care. SO WHAT?: Well-implemented developmental screening leads to more Aboriginal and Torres Strait Islander children receiving timely early childhood intervention services, improving developmental trajectories and optimising long-term health and wellbeing.

The impact of family characteristics on the level of empowerment and the level of Family Quality of Life of parents using Early Childhood Intervention services

Early Childhood Intervention (ECI) may be defined as the set of interventions for children from 0 to 6 years of age with disabilities or developmental disorders, their families, and the environment. Understanding the family as an active agent during the intervention, the aim of this study was to analyse the relationship between Family Quality of Life (FQoL) and family empowerment of parents with children with disabilities or developmental disorders who are users of ECI services. It also aimed to clarify the impact of family characteristics on FQoL and parental empowerment. The sample consisted of 322 parents or legal guardians from the Balearic Islands (Spain) users of ECI services, who responded to sociodemographic questions, the Family Quality of Life Scale for families with children with Intellectual and/or Developmental Disabilities under 18 years of age (CdVF-ER) and Family Empowerment Scale (FES). Descriptive, differential, and correlational analyses were performed. The results obtained show medium-high levels of empowerment and FQoL, as well as differences in FQoL and family empowerment depending on family characteristics. Highlighting the scarcity of previous research, this study shows a positive and significant link between the level of family empowerment and FQoL.

Strengthening Equitable Access to Care and Support for Children with Cerebral Palsy and Their Caregivers.

Cerebral palsy is one of the most prevalent groups of motor disorders affecting children and adults across the world. As increasingly more children with cerebral palsy are living longer into adulthood, it is ever more crucial to ensure access to timely and needed early intervention from the onset of diagnosis, on a continuum, to optimize medical, developmental, socio-emotional, and academic outcomes for these children over time. The American Academy of Pediatrics (AAP), in collaboration with the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM), substantially revised the clinical practice guidelines for cerebral palsy in 2022, after their prior publication of the guidelines in 2006. The revised guidelines account for a range of considerations that are in line with the biopsychosocial, risk and resilience, and family-centered care models as well as promote a more strengths-based approach to care. Furthermore, there is increased emphasis in the guidelines on promoting equitable access to care as part of contributing towards health equity for all children with cerebral palsy. In addition, the 2022 guidelines clearly present recommendations for earlier diagnosis of cerebral palsy, potentially as early as infancy, as the basis for activating access to early intervention services for children that can bolster their neuroplasticity and global development from an earlier age onward. We consolidate the existing literature on caregiver perceptions, beliefs and concerns surrounding earlier diagnosis of cerebral palsy and connect them to the recommendations in the revised guidelines. We also delineate several considerations surrounding education for healthcare providers and caregivers of children in navigating the chronicity of cerebral palsy in both community and healthcare contexts. There is a scant amount of literature on cerebral palsy across traditional and nontraditional sources of media in published studies, which we also review. Lastly, we present a wealth of recommendations for further research and practice that account for the revised 2022 guidelines, caregiver preferences and acceptability of care, and health equity as the bases for strengthening equitable access to care for children with cerebral palsy on a continuum as they transition into adulthood.