Early Family Intervention Research Articles

Specialist early parenting intervention: Effectiveness of a novel nurse-led approach for rural families

BackgroundRural Australian families report lower access to specialist early parenting services than urban families. To address the early parenting needs of rural families with children aged 0–3, a novel specialist-nursing early parenting service, Tresillian To You, was implemented for five rural communities in New South Wales, Australia. This study aimed to investigate the initial impact and reach of the service. MethodsConvenience sampling was used to recruit 36 parents who attended the service. Of these, 34 completed structured pre-and-post intervention phone interviews. Additional data were collected from the parent and child health record. Data were imported into SPSS for descriptive and inferential data analysis. FindingsAll parent participants were mothers, with a mean age of 31.5 (SD 4.582). Sleep and settling was the primary reason for referral (78%, n = 28). Following service engagement, statistically significant improvements were seen in parent adjustment (95% CI = −1.71, −0.52, p < .001), parent comprehensibility (95% CI = −1.81, −0.42, p = .003), and parent perception of child sleep (95% CI = 16.3, 34.9, p < .001). Families from non-target communities (n = 15) reported a higher level of need at baseline, compared with families from target rural communities (n = 21). Following service engagement, a similar level of benefit was reported between both groups. DiscussionPreliminary evidence suggests that this new service may be an effective method of providing specialist early parenting intervention for families in rural communities. Practice implicationsThe provision of effective nurse-led specialist early child and family interventions may help to alleviate early parenting difficulty for rural families, leading to improvements in child and family outcomes.

Parents’ experiences of participating in the Small Step early intervention program for infants at high risk of cerebral palsy: essential components and potential dilemmas

Purpose: To explore parents’ perceptions of essential components and potential dilemmas within the family-centred and goal-directed Small Step program, an interprofessional early intervention for families of infants at high risk of cerebral palsy (CP). Materials and methods Thirteen parents (eight mothers and five fathers) of ten children participated in this qualitative study through individual in-depth interviews. Transcripts were analysed using reflexive thematic analysis. Results The parents emphasized the advantage of having the intervention provided at home with coaching and flexible support from the interprofessional team of therapists. This assured the families and enhanced their capacity to provide the child with playful and enriched learning opportunities integrated in everyday life. However, identification of achievable goals and intervention delivery could be emotionally taxing for parents, especially in the early stages and if treatment effects were below hopes and expectations. Conclusions Our findings provide insights into what kind of support parents prefer and dilemmas professionals should be aware of when providing early intervention to families of infants at high risk of CP. Parents appreciated being involved as equal partners and receiving home-based guidance. Acknowledging grief and sorrow as natural reactions and fostering open discussions about expectations seem essential in addressing families’ individual needs.

Prenatal Experiences and Desires With Early Intervention for Families of Children With Down Syndrome

Part C early intervention (EI) starts no earlier than birth, even with a prenatal diagnosis resulting in automatic eligibility. Despite other early home visiting programs beginning prenatally and the increasing likelihood of uncovering certain diagnoses prenatally, pregnant families cannot access EI. This study sought to understand families’ perspectives on their desire for prenatal EI and how EI could support them. Seventeen primarily White non-Hispanic mothers with a prenatal diagnosis of Down syndrome shared their prenatal experiences through retrospective, qualitative interviews. Three themes emerged: (1) prenatal period as a time to connect to EI, (2) different families, different prenatal desires, and (3) postnatal EI experiences, prenatal EI hopes. Families saw benefits to starting prenatally to enroll in and understand EI, and prepare for their baby’s arrival through individualized outcomes. Families appreciated their postnatal EI and envisioned similar supports prenatally. Participants’ shared experiences are discussed in relation to pre- and postnatal EI.

Neighbourhood deprivation and access to early intervention and support for families of children with intellectual and developmental disabilities

AbstractEnsuring families of children with intellectual and/or developmental disabilities (e.g., developmental delay, intellectual disability, autism) can access early intervention and support is important. Current research indicates there are family‐level socioeconomic disparities of access to early intervention and support, however, there is limited evidence on the relationship between neighbourhood‐level socioeconomic deprivation and access to support. Therefore, the aim of this study was to examine the relationship between neighbourhood deprivation and families' access to and unmet need for early intervention and support. We collected cross‐sectional data using a survey of 673 parental caregivers of young children with suspected or diagnosed intellectual and/or developmental disabilities in the UK. Multiple regression models were fitted for three early intervention and support outcome variables: access to early intervention; access to services across education, health, social care, and other sectors; and unmet need for services. Each regression model included a neighbourhood deprivation variable based on the index of multiple deprivation and five control variables: family‐level economic deprivation, country, caregivers' educational level, developmental disability diagnosis, and informal support sources. Neighbourhood deprivation was a significant independent predictor of access to services, but neighbourhood deprivation was not a significant predictor of access to early intervention or unmet need for services. Families living in the most deprived neighbourhoods accessed fewer services than other families. Socioeconomic disparities of access to early intervention and support, at both a neighbourhood and family level, exist for families of young children with suspected or diagnosed intellectual and/or developmental disabilities in the UK. Future research should focus on policy and other interventions aimed at addressing socioeconomic disparities at the neighbourhood and family level, to ensure equitable access to early intervention and support.

LEGAL PROTECTION AND RESTORATIVE APPROACH IN HANDLING CHILDREN INVOLVED IN TERRORISM CRIMES IN INDONESIA

This study examines the implementation of restorative justice in handling children involved in terrorism crimes in Indonesia. Restorative justice, which focuses on rehabilitating and reintegrating individuals into society, is a relevant approach to rehabilitating children involved in criminal acts of terrorism. The concept also allows community and victim participation in the settlement process. The study uses normative legal and analytic philosophical approaches. Although restorative justice has the potential to handle terrorism cases involving children, its implementation still faces challenges and requires cooperation from various parties. The research emphasizes that restorative justice should be part of a broader strategy in protecting children from involvement in terrorism, involving effective education, early intervention, and support for families and communities vulnerable to extremist influences. This study also emphasizes that implementing restorative justice in the context of criminal acts of terrorism involving children poses significant challenges and requires cooperation between various parties, including the legal system, educational institutions, families, and communities. The research argues that restorative justice should be an integral part of a broader strategy that involves effective education about the values of peace and tolerance, early intervention to detect and prevent radicalization, and support for families and communities vulnerable to extremist influences.

Early childhood predictors of early school‐age academic skills and resilience among children living in poverty

AbstractThis longitudinal study of low‐income families tested neighborhood‐, family‐, and child‐centered promotive factors in early childhood, responses to an early family intervention, and their interactions as predictors of school‐entry levels of and early school‐age gains in academic skills. Using a racially‐diverse, low‐income sample (n = 527) from a randomized controlled trial of the Family Check‐Up (FCU) intervention and Bayesian multilevel regression modeling, we tested whether neighborhood cohesion, positive mother–child engagement, and child self‐regulation in early childhood (ages 2–5 years) and their interactions with FCU group assignment predicted the intercept and slope of academic skills across child age 5, 7.5, and 8.5 years. Higher positive mother–child engagement and child self‐regulation predicted higher academic skills at school entry. An interaction between the FCU intervention and positive mother–child engagement predicted gains in academic skills compared to national norms. The findings suggest the FCU intervention leveraged positive mother–child engagement in early childhood to promote academic skills, offering a potential avenue from which to prevent income achievement gaps before school entry.

The Insight of Patients and Their Parents Differ in the Early Phase of Psychosis

The aim of this cross-sectional study was to investigate whether the insight of patients and their parents differ in the early phase of psychosis. Target population were the patients hospitalized with the diagnosis of the psychotic spectrum (F20- F29; ICD- 10th; disease duration ≤ 5 years), both sexes, with average age M = 25.4 (SD = 3.56, C = 25, min = 18, max = 32) and their parents. Insight into illness in patients was assessed using the Scale to assess Unawareness of mental Disorder (SUMD) abbreviated version. Parents’ insight into illness was assessed with a modified version of the SUMD with question rephrased to probe parents’ understanding of patients’ illness. The expression, structure and severity of psychotic symptoms was assessed by The Positive and Negative Syndrome Scale of Schizophrenia (PANSS- Five factor models) and Clinical global impression scale (CGI- s). The results indicated a statistically significant (Z = 2.99; p &lt; 0.01) higher mean value on General Awareness of patients (M = 6.1, SD = 3.26) compared to parents (M = 5.0, SD = 2.99. A significant difference was obtained by the sex of parents too (z = -2.07, p &lt; 0.05): fathers had better insight (M = 2.0, SD = 1.15) than mothers (M = 1.5, SD = 0.89). The results call for necessity to develop innovative and comprehensive program for early family interventions.

Early Family Intervention for Youth at Risk for Bipolar Disorder: Psychosocial and Neural Mediators of Outcome.

The impairing neurodevelopmental course of bipolar disorder (BD) suggests the importance of early intervention for youth in the beginning phases of the illness. We report the results of a 3-site randomized trial of family-focused therapy for youth at high-risk (FFT-HR) for BD, and explore psychosocial and neuroimaging variables as mediators of treatment effects. High-risk youth (<18 years) with major depressive disorder or other specified BD, active mood symptoms, and a family history of BD were randomly assigned to 4 months of FFT-HR (psychoeducation, communication and problem-solving skills training) or 4 months of enhanced care psychoeducation. Adjunctive pharmacotherapy was provided by study psychiatrists. Neuroimaging scans were conducted before and after psychosocial treatments in eligible participants. Independent evaluators interviewed participants every 4-6 months over 1-4 years regarding symptomatic outcomes. Among 127 youth (mean 13.2 ± 2.6 years) over a median of 98 weeks, FFT-HR was associated with longer intervals prior to new mood episodes and lower levels of suicidal ideation than enhanced care. Reductions in perceived family conflict mediated the effects of psychosocial interventions on the course of mood symptoms. Among 34 participants with pre-/post-treatment fMRI scans, youth in FFT-HR had (a) stronger resting state connectivity between ventrolateral PFC and anterior default mode network, and (b) increased activity of dorsolateral and medial PFC in emotion processing and problem-solving tasks, compared to youth in enhanced care. FFT-HR may delay new mood episodes in symptomatic youth with familial liability to BD. Putative treatment mechanisms include neural adaptations suggestive of improved emotion regulation.

Retracted: Early Family Intervention in Children with Language Delay: The Effect of Language Level and Communication Ability.

[This retracts the article DOI: 10.1155/2022/3549912.].

Economic analysis of early intervention for autistic children: findings from four case studies in England, Ireland, Italy and Spain.

Many autistic children experience difficulties in their communication and language skills development, with consequences for social development into adulthood, often resulting in challenges over the life-course and high economic impacts for individuals, families, and society. The Preschool Autism Communication Trial (PACT) intervention is effective in terms of improved social communication and some secondary outcomes. A previously published within-trial economic analysis found that results at 13months did not support its cost-effectiveness. We modeled cost-effectiveness over 6years and across four European countries. Using simulation modeling, we built on economic analyses in the original trial, exploring longer-term cost-effectiveness at 6years (in England). We adapted our model to undertake an economic analysis of PACT in Ireland, Italy, and Spain. Data on resource use were taken from the original trial and a more recent Irish observational study. PACT is cost-saving over time from a societal perspective, even though we confirmed that, at 13months post-delivery, PACT is more expensive than usual treatment (across all countries) when given to preschool autistic children. After 6years, we found that PACT has lower costs than usual treatment in terms of unpaid care provided by parents (in all countries). Also, if we consider only out-of-pocket expenses from an Irish study, PACT costs less than usual treatment. PACT may be recommended as a cost-saving early intervention for families with an autistic child.

Telehealth Training in Principles of Applied Behavior Analysis for Caregivers of Young Children with Autism Spectrum Disorders during the COVID-19 Pandemic.

Following the outbreak of the COVID-19 pandemic, the U.S. government declared a state of emergency and many applied behavior analysis clinics temporarily closed. The current study described a pilot of an existing manualized caregiver behavior skills training, the Online and Applied System of Intervention Skills (OASIS), to promote telehealth caregiver training during the pandemic and facilitate the start of early intervention for families on waitlists. The OASIS telehealth curriculum trains caregivers to use applied behavior analysis with their children with autism spectrum disorder. Pre/post measures suggest that OASIS modestly improved parent knowledge, improved perceived quality of life, decreased stress, improved caregiver self-efficacy, and was viewed positively by participating families.

Minding the Baby versus usual care: study protocol for a quasi-cluster-randomized controlled study in Denmark of an early interdisciplinary home-visiting intervention for families at increased risk for adversity

BackgroundInequality in health can have profound effects on a child’s opportunities later in life. To prevent these downstream effects in families at increased risk of adversity, programs are needed to provide support and improve well-being across several domains. The present trial is aimed at assessing the effectiveness of the Minding the Baby® (MTB) home visiting intervention in improving the mother-child relationship, parental reflective functioning, well-being, and mental health, as well as child development and well-being in families at known risk of adverse health, relational, and developmental outcomes.MethodsThe study is a pragmatic, prospective, quasi-cluster-randomized controlled trial in which seven Danish municipalities were randomized to MTB training in either 2018 or 2019. A total of 250 pregnant women at increased risk of adversity will be recruited (75 care as usual families and 175 intervention families). Care as usual families will be recruited before and after the MTB training. The MTB intervention is an attachment-based, interdisciplinary home visiting intervention offered from the third trimester of pregnancy until the child is 2 years old. The participants are assessed at baseline, and when the infant is 3, 12, and 24 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior scale applied to video recordings of mother-infant interactions. Secondary outcomes include parent-child interaction, parental reflective functioning, parental mental health, maternal satisfaction, parental stress, and child development and well-being. The treatment effect is estimated as a fixed effect using a binary indicator of MTB treatment, and cluster-robust standard errors based on wild bootstrap are used for inference.DiscussionThis is the first trial of MTB in a Scandinavian context and will include the largest sample yet in a trial of MTB. The trial is expected to contribute to knowledge about the effect of early support for pregnant women, their infants, and their families at increased risk of adversity.Trial registrationClinicalTrials.gov NCT03495895. The study was registered on April 12, 2018.

The COVID-19 pandemic and Australian parents with young children at risk of interparental conflict

ABSTRACT Background: The COVID-19 pandemic has created many challenges for families across the world, with those who have recently had a baby particularly vulnerable to increased stress Study Aim: The current study aimed to explore the experiences of the COVID-19 pandemic of families who have recently had a baby in Melbourne, Australia. Methods: Interviews were conducted with sixteen parents participating in a family-based intervention during early parenthood and seven clinicians who delivered the program. Results: Parents and clinicians described impacts of the pandemic on parent and family functioning included mental health concerns, stress and irritability, feelings of isolation, and increased relationship tension. Parents discussed coping strategies used during the crisis, including activities with their family, connecting with others, trying to stay positive, and self-care activities such as spending time outdoors. Both parents and clinicians acknowledged the importance of mental health and parenting support during and following the pandemic, and for these services to be promoted and easily accessible. Discussion: The study highlights the mental health and parenting support needs of families during times of crisis and emphasises the importance of early intervention for families exhibiting poor communication and relationship tension.

Early Family Intervention in Children with Language Delay: The Effect of Language Level and Communication Ability.

Language development delay refers to the children's oral expression ability or language understanding ability obviously lagging behind the normal development level of children of the same age. The efficacy of early family intervention in children with language delays is promising. The observational study was conducted involving 120 children aged 0∼3 years treated in the pediatric health department of the Third Affiliated Hospital of Zunyi Medical University for language delay. They were assessed for eligibility and recruited. The eligible children were grouped by 1 year, 2 years, and 3 years and were assessed on the Gesell Developmental Schedules and Normal Development of Social Skills from Infant to Junior High School Children (S-M) at the time of initial diagnosis and after the family language intervention. The family language intervention was performed by the parents and lasted for 6 months. All eligible children had a development quotient (DQ) > 86 in motor ability before and after the intervention. All eligible children had a DQ < 86 before the family language intervention in adaptive ability, social ability, and language ability and a DQ > 86 after the intervention. Family language intervention was associated with significant improvement in social life skills in all children, with higher independent living, exercise, operation, interaction, and participation in group activities and self-management after the intervention. Early family intervention yields significant efficacy in children with language delays in Zunyi City by improving the language ability and communication ability of young children, which provides a reference for clinical treatment.

Central American Parents' Preferences for Content and Modality for a Family-Centered Intervention to Promote Healthful Energy Balance-Related Behaviors of Their Preschool-Age Children.

This formative research used a cross-sectional survey to assess interest in informational content and intervention modalities for the design of an early childhood obesity prevention intervention for Central American families from the Northern Triangle countries (El Salvador, Guatemala, and Honduras) living in the United States. A total of 74 parents (36 mothers, 38 fathers) with a mean age of 31.6 years (SD = 5.6) completed the survey; 59.5% of whom were born outside of the United States. Although most parents reported being very interested in receiving information related to the seven assessed energy balance-related behaviors, there were significant differences by parents’ gender and nativity. Most parents endorsed remote modalities for content delivery via text/SMS, WhatsApp, and e-mail. However, respondents were also receptive to in-person delivery provided by community health workers. There were also significant differences in parents’ preferences for intervention modalities by parents’ gender and nativity. Future steps should include investigating different intervention modalities and their integration into a linguistic and culturally sensitive family-based intervention to promote healthful energy balance-related behaviors of preschool-age children in Central American families originating from the Northern Triangle countries.

Early screening and diagnosis of autism spectrum disorders in Vietnam: A population-based cross-sectional survey.

Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam.Design and methods: During 2017-2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria.Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence.Conclusions: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children. Significance for public health This first nationally representative and population-based survey adds empirical data about autism spectrum disorder (ASD) amongst children aged 18 to 30 months in Vietnam. Using M-CHAT as screening tool and DSM-IV criteria for confirmation, ASD amongst children aged 18 and 30 months shows an increasing trend with the prevalence as high as 0.758% in 2018. Early detection and intervention should be conducted to provide affected child with the potential for a better life.

Identification of models, theoretical design and formal evaluation of integrated specialist community health service provision for the first 2000 days: a protocol for a scoping review

IntroductionThe first 2000 days of a child’s life (during pregnancy up to age 5 years) represent a critical period, in which early interventions reduce risk associated with developmental delay, disability...

Inexpensive Detection of Substance Abuse Based on Social Media Data using Machine Learning

Over the past few years, substance abuse has become one of the most severe public health problems in the United States. The annual cost of substance abuse aftereffects in the United States alone is approximately $3.73 Trillion. The societal costs of substance abuse include premature deaths, lost productivity, and increased crime rates. Unfortunately, many victims, especial¬ly in lower-income families, don't have access to early detection and early family intervention tools due to limited access to traditional diagnostic tools and rehab specialists. Currently, there is no complete diagnostic pipeline to inexpensively detect substance abuse and automatically inform family members or trusted contacts. To combat this, the experimenter developed the SOS 280 system, which utilizes machine learning techniques in a smartphone application. SOS 280 works through social media monitorin¬g and automatic notification using SMS and GPS location. The SOS280 algorithm primarily uses social media data, namely publicly available Twitter, and Instagram posts, to identify substance abuse-related activity. The experimenter collected and classified data by applying for the Twitter and Instagram Developer API Platforms, mining tweets and posts with specific drug keywords present. The investigator trained a Natural Language Processing (NLP) text classification model to analyze the sentiments on the tweets, then classifying them as positives (containing substance abuse-related keywords) and negatives. The master model is a Bidirectional Encoder Representations (BERT) derivative that uses a transformer-based architecture to detect emotions in sentences and conversations to classify substance abuse instances. In total, the researchers looked at 55,551 tweets and Instagram posts indicative of potentially alarming substance usage. Finally, the experimenter developed a smartphone application to capture trusted contact information and GPS location, send data to a remote server housing the neural network, output the network's detection, and send automated alerts to trusted contacts via SMS and GPS location. The experimenter further validated the system's effectiveness through a partnership with national nonprofit Faces and Voices of Recovery, which works with 23 million addiction recovery victims. SOS280 is an inexpensive, reliable, easy to use, and timely tool for families of young adults in predicting substance abuse.

The sociodemographic and clinical profile of children with an autism spectrum disorder in the oriental region of Morocco

BackgroundThe objective of our study is to assess the clinical profile of autistic children in Morocco and the cultural perception of their parents. We collect data with a standard questionnaire on 130 children with autism spectrum disorder (ASD). They were recruited from child psychiatry consultation in the hospital for mental health from 2017 to 2019. This questionnaire assesses the socio-demographic characteristics of children and parents, personal and family medical history, the progress of pregnancy and childbirth. For each child, we determined the developmental age, signs of autism, the comorbidities, the nature of the treatment, the evolution. We complete the examination with parents' perception and attitude towards autism.ResultsThe age of diagnosis was 3.4 years. The sex ratio in our study was 4.6. A low rate of children screened by general practitioners (4.6%). Language impairment was the main reason for the consultation, followed by social withdrawal and stereotypies. 75% of the children benefited from multidisciplinary care. The autism age of screening was significantly lower among families belonging to medium and high socioeconomic status (F = 11.233; p = 0.001).Acceptance of diagnosis was present in 83% of cases, while 73.6% were involved in the care. Only 24% of parents thought that autism etiology is genetic, 75.4% notice improvement with age, and 80.2% consider it a source of family suffering.ConclusionsThese findings underscore the sociodemographic and clinical profile of children with ASD in the oriental region in Morocco. It could be relevant for early screening, intervention, and guidance for families with children having these conditions.

Barriers in Education of Children from Socially Disadvantaged Environment

The paper discusses and summarizes the knowledge in the field of education of socially disadvantaged children with an em- phasis on the Roma ethnic group in Slovakia. It focuses on the issue of pre-primary education of these children and points to the specifics that have a negative impact on the adaptation to the school educational process. The paper addresses the risk aspects of poverty, social exclusion, child development and the need for early intervention for families with children. Further- more, in the article we focus on the support of children at the community level and on possible forms of aid that can help to achieve a more favorable development of the overall Roma family within specific projects. We also deal with early care, which is very important for the bio-psycho-social development of children and youth.