Early Childhood Intervention Research Articles

Feasibility and Acceptability of a Synchronous Online Parent-Mediated Early Intervention for Children with Autism in a Low Resource Setting During COVID-19 Pandemic

ABSTRACT Very few studies exist on tele-health models of parent-mediated interventions delivered in low resource developing countries. The global COVID-19 pandemic catalysed a pilot of an online delivery of an evidence-based parent-mediated intervention (Project ImPACT) for children with Autism Spectrum Disorder in Mumbai, India. Context and culture-specific adaptations were made in program structure and a mixed-methods approach was adopted to evaluate acceptability, feasibility and preliminary efficacy of this model. Quantitative results (n = 12) showed excellent completion rates, with significant improvement in parent fidelity to intervention and child social-communication skills. Analysis of qualitative data from focus groups with parents on completion revealed that parents found the online mode convenient and acceptable, found the synchronous model of sessions especially beneficial and perceived improvements in their own parenting skills and children’s developmental profiles. Though piloted in pandemic times, the results from the study have implications for future service delivery models across similar settings in other developing countries.

Basic principles of early intervention for children with hearing loss

Hearing loss is a common birth problem that can affect a babys ability to develop speech, language and social skills in lack of comprehensive early intervention. Early intervention occurring within the first 6 months has higher effectiveness for hearing impaired children. The introduction of universal newborn hearing screening programs allowed to identify hearing loss in the first months of life. That determines the need of immediate comprehensive early intervention for children identified with hearing loss. The main approaches of such intervention have been described in detail in the literature. However there are not well-developed, evidence-based, well-documented recommendations for family-centred early intervention for children who are deaf or hard of hearing. Similar problems are noted in many countries, that is why in 2012, within the framework of an international conference, specialists and parents of deaf and hard of hearing children developed a document (international consensus statement). The experts arrived at consensus on 10 principles guiding family-centred early intervention. These principles are presented in the article as well as a brief description of their implementation in various countries. The consensus statement has become an important document which is intended to provide a framework for professionals over the world. Knowledge of these principles allows specialists to apply evidence-based approaches working with children who are deaf of hard of hearing.

Maternal knowledge explains screen time differences 2 and 3.5 years post-intervention in INFANT

Very few early childhood interventions have observed sustained effects regarding television viewing and none have examined the mechanisms behind sustained intervention effects at long-term follow-ups. Thus, the aim of this study was to investigate potential mechanisms relating to the maintained intervention effect on television viewing at two long-term follow-ups in the Melbourne Infant Feeding Activity and Nutrition Trial (INFANT). INFANT was a cluster-randomised controlled trial. At the 2- and 3.5-year follow-ups, a total of 262 infant/mother pairs had complete information. Television viewing was assessed via a questionnaire at both follow-ups and six potential mediators were measured post-intervention (i.e. 15 months after baseline). Causal mediation analysis was conducted. At the 2- and 3.5-year follow-ups, the positive impacts of INFANT on maternal television viewing knowledge were maintained (B = 0.34 units; 95% confidence interval (CI95): 0.21, 0.48). An indirect effect of the intervention on reducing children’s television viewing time was observed at the 2- and 3.5-year follow-ups (B = −11.73 min/day; CI95: −22.26, −3.28 and B = −4.78 min/day; CI95: −9.48, −0.99, respectively) via improved maternal television viewing knowledge.Conclusion: The positive impacts of INFANT on maternal television viewing knowledge were maintained at both follow-ups, with better maternal knowledge associated with less television viewing time in their children. These results have implications for paediatricians and healthcare professionals as educating new parents early on regarding screen time may lead to the development of healthier screen time habits that are sustained through to the pre-school years.What is Known: • Lifestyle behaviours inclusive of screen time have been found to be established before the pre-school years and track. • Few trials have evaluated the long-term mechanisms related to maintained intervention effectiveness.What is New: • This study shows the positive impacts of a low-dose intervention on maternal television viewing knowledge at two long-term follow-ups. • Better maternal television viewing knowledge was associated with less television viewing time in their children.

Prevalence and correlates of common mental health problems and recent suicidal behaviour among female sex workers in Nairobi, Kenya: findings from the Maisha Fiti study

AimsAdverse childhood experiences (ACEs), poverty, violence and harmful alcohol/substance are associated with poor mental health outcomes in the general population. These risks are likely to be exacerbated among Female Sex Workers (FSWs), however there are few studies examining risks factors for mental health problems among FSWs. We examine the prevalence and correlates of common mental health problems including suicidal behaviour among FSWs in Kenya.MethodMaisha Fiti is a longitudinal study among FSWs randomly selected from Sex Worker Outreach Programme (SWOP) clinics across Nairobi. Baseline data were collected from June-December 2019. Mental health problems were assessed using the Patient Health Questionnaire (PHQ-9) for depression, the Generalised Anxiety Disorder tool (GAD-7) for anxiety, and the Harvard Trauma Questionnaire (HTQ-17) for Post-Traumatic Stress Disorder (PTSD). Recent suicidal behaviour was defined as reported suicide attempt or suicidal ideation in the past 30 days. Other measurement tools included the WHO Adverse Childhood Experiences (ACE) score, WHO Violence Against Women questionnaire, and the WHO ASSIST tool (to measure harmful alcohol/substance use in the past 3 months). Descriptive statistics and multivariable logistic regression were conducted in Stata 16.1.ResultOf 1039 eligible FSWs, 1003 FSWs took part in the study (response rate: 96%) with a mean age of 33.7 years. The prevalence of moderate/severe depression was 23.2% (95%CI: 20.7–25.9%), moderate/severe anxiety 11.0% (95%CI: 9.3–13.1%), PTSD 14.0% (95% CI: 12.2–16.5%) and recent suicidal behaviour 10.2% (95%CI: 8.5–12.2%) (2.6% suicide attempt; 10.0% suicidal ideation). Among women with any mental health problem 63.0% also had a harmful alcohol/substance use problem. One in four women (25%; 95%CI: 22.5–27.8%) had depression and/or anxiety and this was independently associated with higher ACE scores, hunger (skipped a meal in last week due to financial difficulties), death of a child, perceived sex work stigma and recent sexual/physical violence. PTSD was associated with higher ACE scores, hunger, increased STI prevalence (chlamydia trachomatis) and recent violence. Recent suicidal behaviour was associated with higher ACE scores, low literacy, hunger, and recent violence. Mental health problems and suicidal behaviour were less prevalent among women reporting social support.ConclusionThe high burden of mental problems among FSWs indicates a need for accessible services tailored for FSWs alongside broader structural interventions addressing poverty, harmful alcohol/substance use and violence. High rates of ACEs among this population indicates the need to consider early childhood and family interventions to prevent poor mental health outcomes.Funding: Medical Research Council and the UK Department of International Development

Kindergarten Teachers' Perspective on Early Intervention in Autism Spectrum Disorders

In Portugal, children with developmental disorders are supported by the National Early Childhood Intervention System (NECIS). This network aims to promote child development from a family-centered perspective, based on community support and carried out in everyday natural contexts by a transdisciplinary team.
 This study aims to verify how the NECIS responds to the needs identified by educators who receive children with Autism Spectrum Disorder (ASD) in pre-school. This is a qualitative, multiple case study using the content analysis of 6 semi-structured interviews. The results show that these educators feel ill-prepared to work with children with ASD. They expect NECIS professionals will perform more targeted and rehabilitative work with the child and point out the limited time that they have to spend with children as one of the main constraints.

PROFESSIONALS’ OPINIONS ON MULTIDIMENSIONAL APPROACH TO EARLY INTERVENTION FOR CHILDREN WITH ASD

Early intervention methods for children with Autism Spectrum Disorders, increasingly turn to multidimensional approaches with a parallel focus on interprofessional collaboration in order the interventions to be effective. Multidimensional approaches efficiently support the complex system of family interaction and function affecting positively the child’s development. Early and efficient interventions are widely recognized to lead to long-term positive socio-cognitive results for children with Autism Spectrum Disorders and their families. The purpose of this research is to delve into professionals’, special educators ’and therapists’, opinions on their collaboration with parents and other professionals as they apply early intervention programs to children with ASD. Semi-structured interviews of 15 professionals, experts on early intervention in children with ASD, from different regions of Greece, were analyzed using qualitative research methods. Part of the data analysis that presented in this paper demonstrates clearly that the professionals’ and special educators’ opinions emphasize the need for multidimensional approaches. The analysis also highlights the obstacles that restrict collaboration with parents and other professionals. The material resources of state support have also been suggested as factors that interact with family resources that affect the child’s developmental characteristics.

Characterizing Family Contextual Factors and Relationships with Child Behavior and Sleep Across the Buffering Toxic Stress Consortium.

The Buffering Toxic Stress (BTS) consortium included six sites in locations that varied widely in racial/ethnic composition and population density. Each site tested a promising parent-child intervention designed to supplement Early Head Start (EHS) services and prevent "toxic stress." To better understand family risk in a large and diverse EHS sample, studies gathered extensive data on family risk exposure, including demographic risk factors (single mother, unemployed, less than high school education or its equivalent, and neighborhood safety), income-to-needs ratio, household resource constraints, perceptions of economic hardship and pressure, caregiver mental health, and caregiver-reported dysfunctional parent-child interactions. Results presented here for all six sites offer context for the more targeted studies in this special issue. Average levels of family characteristics and child behavior varied by site. We also characterized associations between family characteristics, observer-rated child temperament, and child outcomes (i.e., caregiver-reported child behavior problems and behavioral sleep quality), controlling for child age; these relationships were similar across sites. Demographic risk and caregiver mental health problems were positively associated with child behavior problems, with low income-to-needs ratio and increased financial strain relating to behavioral problems in infancy and toddlerhood. Caregiver mental health problems, financial strain, and social and affect temperament dimensions were related to increased behavioral sleep problems. Dysfunctional parent-child interactions and household resource constraints did not demonstrate statistically significant associations. Findings suggest helpful targets to increase effectiveness of parent-child interventions in early childhood on behavior and sleep outcomes.

The impact of early childhood interventions on mothers

Failure to measure the impacts on women's time and other maternal outcomes implicitly sets their value at zero

Nutritional risk in early childhood and parent-reported school concerns.

To determine if nutritional risk in early childhood is associated with parent-reported school concerns. A prospective cohort study conducted through the TARGet Kids! primary care research network (2011-2018). Nutritional risk was measured between 18 months and 5 years of age using validated parent-completed NutriSTEP® questionnaires with eating behaviour and dietary intake subscores (0 = lowest and 68 = highest total nutritional risk score). Parent-reported school concerns were measured at school age (4-10 years of age) and included: speech and language; learning; attention; behaviour; social relationships; physical coordination; fine motor coordination and self-help skills and independence. The primary outcome was any parent-reported school concerns, and individual school concerns were used as secondary outcomes. Multiple logistic regression models were conducted adjusting for clinically relevant confounders to assess the relationship between nutritional risk and school concerns. Toronto, Canada. Children aged 18 months to 10 years. The study included 3655 children, 52 % were male, mean NutriSTEP® score was 14·4 (sd 6·4). Each 1 sd increase in NutriSTEP® total score was associated with a 1·18 times increased odds of school concerns (adj OR: 1·18, 95 % CI 1·07, 1·28, P = 0·0004), and high nutritional risk was associated with a 1·42 times increased odds of school concerns (adj OR: 1·42, 95 % CI 1·13, 1·78, P = 0·002). Nutritional risk in early childhood was associated with school concerns. Nutritional interventions in early childhood may reveal opportunities to enhance school outcomes.

Interventions to improve neurodevelopmental outcomes of children born moderate to late preterm: a systematic review protocol.

Introduction:Prematurity (birth before 37 +0 weeks' gestation) is associated with wide-ranging neurodevelopmental impairment. Prognosis among moderate to late (32 +0 to <37 +0 weeks' gestation) preterm infants (MLPT) is better compared to their counterparts born very preterm (<32 +0 weeks' gestation). However the risk of developmental impairment among MLPT, who make up about 84% of all preterm infants, is 2-3 times higher when compared to infants born at term. Early interventions have aimed to improve outcomes in preterm infants generally, but there are limited data on their need and effect in MLPT specifically. Prioritising research, long-term follow-up and early interventions targeted at ameliorating the impact of preterm birth among MLPT is required. Objectives:To conduct a systematic review of the type of early childhood interventions (from birth until 4 years of age) offered to MLPT children and to evaluate their impact on neurodevelopmental outcomes (cognitive, neurobehavioural and motor) as assessed in these children during childhood (until 18 years of age). Methods and analysis:A systematic literature search in Web of Science, Medline Ovid, PsycINFO, CINAHL and EMBASE will be conducted. Data on MLPT children receiving developmental interventions until the age of 4 years will be evaluated. Interventions may involve parents or primary caregivers. Primary outcomes are cognitive, neurobehavioural and motor development as measured from birth until the age of 18 years. The Cochrane Risk of Bias Assessment Tool will be used to evaluate the methodological quality of randomised controlled trials (RCTs) included in the review and will be graded as low, high or unclear risk of bias. The quality of non-RCTs will be evaluated with the Newcastle-Ottawa Scale. The quality of evidence for each outcome will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation Approach. Publication and reporting bias will be assessed using Egger's test and funnel plots respectively.

Reading-impaired children improve through text-fading training: analyses of comprehension, orthographic knowledge, and RAN

Early intervention for children with reading impairments is crucial in order to achieve reading improvements and avoid school failure. One line of reading intervention research focuses on the experimental manipulation of reading rate through a text-fading training approach. Considering relevant reading-related predictors (i.e., orthographic knowledge and rapid automatized naming; RAN), we aim at evaluating the text-fading training’s efficiency for a sample of German reading-impaired third graders (n = 120). The purpose of the present study was to examine (1) the predictive value of orthographic knowledge and RAN and their contribution of explained variance in comprehension performance during training, (2) text-fading training effects on reading rate and comprehension in a pre-post comparison, and (3) (lasting) text-fading training effects at word and sentence level in a pre-post-follow-up design. Results of structural models indicated RAN to be significantly related to comprehension performance for the experimental group, whereas no sufficient regression weight was found for orthographic knowledge. A reverse pattern was found for the self-paced group. No significant improvements regarding reading rate and comprehension were revealed for the experimental group after training. However, significant positive effects on word and sentence level at post-test time point indicate stronger reading improvements for the experimental compared to the control group. The retention of training gains was indicated at sentence-level reading 6 months after the training. Possible explanations for the presented positive training effects as well as the mixed results for reading rate, comprehension, and follow-up preservation are discussed.

An Ounce of Prevention

I look at prevention through an economic lens and make three main points. First, those advocating preventive measures are often asked how much money a given measure saves. This question is misguided. Rather, preventive measures can be thought of as insurance, with a certain cost in the present that may or may not pay off in the future. In fact, although most medical preventive measures improve expected health, they do not save money. Various lifestyle and early childhood interventions, however, may both save money and improve health. Second, preventive measures, including medical and life style measures, are heterogeneous in their value, both across measures and within measure, across individuals. As a result, generalizations in everyday discourse about the value of prevention can be overly broad. Third, health insurance coverage for medical preventive measures should generally be more extensive than coverage for the treatment of a medical condition, though full coverage of preventive services is not necessarily optimal.

Repetitive Behavior Scale for Early Childhood (RBS-EC): Psychometrics and Developmental Effects with a Community Sample.

Restricted, repetitive behaviors and interests (RRBIs) occur commonly in young children in the course of typical development, but too frequent or persistent RRBIs have been linked to a variety of psychosocial and neurodevelopmental disorders. Unfortunately, a lack of psychometrically sound, feasible instruments stymies RRBI study and intervention in early childhood. Therefore, this study validated an extant RRBI measure (i.e., Repetitive Behavior Scale for Early Childhood; RBS-EC) for predominately neurotypical community children ages 2-7years via an MTurk survey of 300 caregivers. Confirmatory factor analyses best supported a 4-factor model for the RBS-EC (i.e., repetitive motor, rituals and routines, restricted interests, self-directed behaviors). RBS-EC scores varied significantly with age and gender; namely, RRBIs were typically (1) less frequent but more problematic with older versus younger children and (2) more frequent and problematic with boys versus girls. Findings extend the RBS-EC's utility in RRBI assessment and treatment during early childhood.

Effect of sleep-disturbed breathing on maxillofacial growth and development in school-aged children

ABSTRACT Purpose : In children, snoring and apnoea cause impairments in growth, cognitive function, attention, and school performance. In this study, we aimed to identify the association between craniofacial disharmony and paediatric sleep-disordered breathing. Materials and Methods : Forty-one patients with malocclusion (19 boys; 22 girls; mean age, 10.0 ± 2.1 years) were selected from our hospital. The relationship between maxillofacial morphology, pharyngeal airway form, and nasal respiratory function was examined using cephalometric analysis and skeletal patterns. All patients underwent portable monitoring with an overnight out-of-centre sleep testing protocol that could be performed at home using a portable computerized monitoring system. Results : The respiratory disturbance index was significantly greater in patients with mandibular retrusion than those with malocclusion. Arterial oxygen saturation and nasopharyngeal area were significantly smaller in participants with Class II malocclusion than in those with other types of malocclusion. Moreover, dental cast model analyses confirmed that patients with reduced transverse maxillary dimensions had a higher obstructive sleep apnoea syndrome (OSAS) risk than those with malocclusion. Therefore, patients with mandibular retrusion have a higher OSAS risk than those with other types of malocclusion. Conclusion : Childhood maxillofacial morphology may influence adult OSAS, and early treatment for children with OSAS may help prevent adult OSAS.

The Early Childhood Personnel Center

There are concerns about the quantity and quality of personnel in early childhood intervention (ECI) as the numbers of infants and young children with delays and disabilities grow in number, needs, and diversity. The Early Childhood Personnel Center (ECPC) was funded to provide technical assistance (TA) to state systems of ECI and institutions of higher education (IHE) through the development of comprehensive systems of personnel development (CSPD). A CSPD is comprised of 6 interrelated subcomponents and each provides the infrastructure necessary to meet the current and future needs of a competent workforce. The subcomponents include recruitment and retention, personnel standards, preservice programs, in-service training, leadership and sustainability, and evaluation. TA audiences have included ECI administrators, IHE faculty, doctoral students, professional development providers, and families that jointly develop, implement, and evaluate effective personnel practices, policies, and systems. The purpose of this article is to provide an overview of the TA provided by the ECPC over the past 8 years.

Scale Evaluation and Eligibility Determination of a Field-Test Version of the Assessment, Evaluation, and Programming System–Third Edition

Rasch and classification analyses on a field-test version of the third edition of the Assessment, Evaluation, and Programming System (AEPS-3), a curriculum-based assessment used to assess young children birth to age 6 years, were conducted. First, an evaluation of the psychometric properties of data from each developmental area of an AEPS-3 field-test version was conducted. Next, cutoff scores at 6-month age intervals were created and then the validity of the cutoff scores was evaluated. Results using Rasch modeling indicated acceptable model fit statistics with reasonable reliability estimates within each developmental area. Classification results showed cutoff scores accurately classified a high percentage of eligible children. Findings suggest that scores from a field-test version of the AEPS-3 are reliable within developmental areas. To the extent allowed by state criteria, early childhood interventionists could possibly use a new field-test version of the AEPS-3 to determine or corroborate eligibility for special education services.

Understanding key worker experiences at an Australian Early Childhood Intervention Service.

The delivery of family-centred practice (FCP) within Early Childhood Intervention Services (ECISs) for young children with a disability or development delay conceptualises that children's learning environments, parenting, family and community supports intersect to have the greatest impact on the developing child. The transdisciplinary key worker model is considered a best-practice approach within ECISs whereby staff work collaboratively across disciplinary boundaries to plan and implement services for children and their families. Research suggests families who have a key worker have better relationships with services, fewer unmet needs, better morale, more information about services, higher parental satisfaction and more parental involvement than those not receiving this service. Using a phenomenological qualitative design this study sought to understand transdisciplinary key workers' perspectives regarding the strengths and challenges to undertaking their role in providing services to children and families accessing an ECIS at a major disability service organisation, in light of the changing policy reform during the roll out of the National Disability Insurance Scheme in Australia. Purposive sampling was used to recruit key workers (n=13) to participate in semi-structured interviews during 2015. Data were analysed using an inductive, thematic approach. Results revealed four main themes that impact on the effectiveness of key workers' service provision. These are broadly categorised as (a) Engagement with the workplace, (b) Engagement with clients, (c) Professional capacity and (d) Staff Wellbeing. The findings aligned with previous studies identifying sources of support and stress for disability services staff. They also provided new insights into key workers' lack of confidence in addressing parental mental health issues, despite operating under a family-centred approach. These findings informed the development of an intervention trial and evaluation to improve support for parent and staff wellbeing within a Victorian Disability Service with the aim of building their capacity to support children with a disability.

Child development as social action: Reflections on four underrated contributions of Edward Zigler to science and society.

In a career spanning six decades, Edward Zigler redefined developmental psychology as the equal integration of scientific inquiry and evidence with social policy formulation and analysis to improve child well-being. The theme of his accumulated work was advancing child development as social action for children and families. Besides early childhood intervention and policy, for which he devoted most of his time, Dr. Zigler did pioneering work in education and school reform, social policy, prevention, child maltreatment, family support, developmental disabilities, and in service to government. In this article, I reflect on four of Dr. Zigler's major contributions to science and society that are underrated and, in many respects, under-appreciated in the larger context of the field. These are (a) historical analysis of Head Start, (b) conceptualization and analysis of motivation as a key component of early childhood program impacts, (c) development of preschool-to-third-grade programs and school reforms, and (d) critical analysis of theory, research, policy, and practice. Together, these and other contributions by Dr. Zigler provide a strong foundation to build a better society for all.

Child Abuse Potential in Young German Parents: Predictors, Associations with Self-reported Maltreatment and Intervention Use

Since child maltreatment has highly negative effects on child adjustment, early identification of at-risk families is important. This study focuses on longitudinal risk factors for child maltreatment and associations between abuse risk and occurrence. It also examines whether abuse risk and involvement in early childhood intervention are associated. The sample comprises 197 German caregivers with children under 3 years of age. Data was collected in two waves. The Brief Child Abuse Potential Inventory assessed abuse risk. Socio-demographic, parent, child and family-related risk factors were measured using screening tools. The analysis revealed that parental characteristics (psychopathology, own maltreatment experiences etc.) were associated with concurrent abuse risk. Longitudinal changes in abuse risk were linked to caregiver education and child-related factors. Cumulative risk did not explain more variance than specific risk factors. Significant associations with caregiver-reported abuse were found, and data suggest that some burdened families cannot be reached by early childhood intervention.

Determination of preservice special education teachers’ views on early childhood intervention

Experiences in early childhood have a great influence on a child's physical and mental development. Early childhood interventions are widely accepted as an effective way to prevent learning difficulties and to promote healthy development for children with special needs. For this reason, it is important for teachers who will work with children with special needs or children who are at risk to have sufficient knowledge about early childhood intervention and be competent in this area. Therefore, the present study aims to determine the views of preservice special education teachers about early childhood intervention. This study used quantitative research method and a questionnaire form was used to collect the data. The results are discussed in detail with reference to relevant literature. Implications and recommendations for further research are also provided in order to improve the quality of education policies, programs and practices related with early childhood intervention and increase awareness and knowledge related with early childhood interventions among teacher candidates. &#x0D; &#x0D; Keywords: Early childhood, early intervention, preservice special education teachers, views.&#x0D;