Early Intervention For Young Children Research Articles

Fidelity of family centered care model to early disability diagnosis and rehabilitation in the United Arab Emirates.

The role of parents in supporting early intervention for young children with disabilities is critical. Indeed, models of family centered care (FCC), which emphasis strong partnerships between health professionals and families in disability health services delivery are now widely associated with best practice. While FCC is consistently argued to be an appropriate model for disability service delivery, its utilization is limited primarily to Western countries such as Australia and the United States. Countries such as the United Arab Emirates (UAE) have prioritized early childhood development and are thus in search of best practices for delivery of early intervention for children and their families. The aim of this study was to explore the appropriateness of the FCC model in disability service delivery in the UAE. This study was conducted from the perspectives of health professionals who are involved in disability diagnosis, referral and ongoing support for families and children with disabilities. A total of 150 health professionals were recruited from health facilities, rehabilitation centers and schools in the Emirates of Abu Dhabi. The 27-item Measure of Process of Care for Service Providers (MPOC-SP) was used for data collection. The data were subjected to confirmatory factor analysis to confirm applicability of the model to this context. Multivariate analysis of variance and moderation analysis were also conducted, to ascertain the relationship between participants' satisfaction levels with their ability to diagnose, refer and provide on-going support and their likelihood of practicing key components of FCC. Computation of confirmatory factor analysis provided support for applicability of the MPOC-SP in the UAE context. Further inspection showed moderate to large correlations between the four components of FCC measured by MPOC-SP, providing further support for utilization of FCC in disability health service delivery in the UAE. The study concludes with a call to policymakers in the UAE to consider developing disability health policy based on key components of FCC. This could be supplemented by development of training modules on FCC to upskill health professionals involved in disability diagnosis and rehabilitation.

Younger age is associated with better outcomes in autism severity, language, and adaptive skills after one school year in autism special education classes

A well-accepted hypothesis in the field of autism spectrum disorder (ASD) is that early intervention is crucial for better outcomes. However, research has noted significant variability in early intervention outcomes. This study examined the role of age in relation to outcomes in comprehensive developmental domains following one year of school in community special education classes for ASD. We compared two groups: a younger group (n = 35) aged 34–59 months and an older group (n = 38) aged 60–91 months. The groups did not differ in cognitive ability, autism severity or adaptive behavioral skills at the start of the school year. After one year, the entire study population showed significant progress in all developmental domains. However, changes in effect size were much more robust in the younger ASD group. Only younger children showed a significant decrease in the severity of communication, awareness and restricted interests and repetitive behavior subdomains and a significant increase in motor adaptive skills. Younger children also showed more remarkable improvement in the naming and expressive subdomains. Respectively, older age predicted more severe ASD symptoms at the end of the educational year.Corresponding to brain plasticity theories, our findings point to an association between age and outcomes. The findings should serve as a benchmark for policymakers regarding early intervention in young children with autism.

Feasible Adaptation of ESDM for Statewide Implementation: A Look at Potential Effects, Implementation Conditions, and Cost

This article describes the development and use of a first of its kind statewide implementation of an adapted Early Start Denver Model (ESDM). Supported by a collaborative partnership between stakeholders that included families, state agencies, and a state university, the intervention was implemented within the existing framework of a northeastern state’s relationship-based Individuals with Disabilities Education Act (IDEA) Part C early intervention program. Participants were 194 families. The study examined the effectiveness and implementation costs of an adaptation of the ESDM using a coaching model to inform statewide implementation to improve outcomes for young children with autism spectrum disorder (ASD) in rural and low-resource states. Results indicated 194 children who received a monthly average of 10.90 hr of adapted ESDM for an average of 12 months demonstrated an improvement in the frequency of ASD symptomology for a total cost of US$2,511/child. Intervention intensity and child factors demonstrated varying influence on outcomes. This study contributes to the literature by demonstrating the potential for positive impact of an evidence-based practice scaled to a statewide model of early intervention for young children with ASD.

Mediation of meaningful outcomes in early intervention: a commentary on Carruthers etal. (2023).

Across the spectrum of behavioral, naturalistic developmental behavioral, and developmental/relational interventions for young children with autism, there has been limited empirical testing of the mechanism of these early intervention approaches. Testing mediation provides insights to the how or why the intervention condition may be preferred in comparison to a control in the population sample (Kraemer, American Journal of Psychiatry, 2016, 173, 672). Combined with an understanding of moderation (for whom or under what conditions), we move toward a better understanding of how to personalize interventions to build on strengths and maximize skill gains for autistic children. Yet, to date there are very few published texts of mechanism in early intervention for young children with autism. This commentary explores a recently published article by Carruthers etal (2023) and examines themes and considerations for measurement of intervention outcomes and mediators.

Étude exploratoire de la mise en place de l’Early Start Denver Model en France

BackgroundThe Early Start Denver model is one of the interventions recommended by the French High Authority on Health since 2012 for the very early care of children with Autism Spectrum Disorders. This program, developed in the United States, has shown the best evidence of effectiveness in an intensive form of delivery that is difficult to generalize to other culturally different contexts. Consequently, its implementation in the French health care system has required some adaptations that have not yet been evaluated. After a summary of the method's features and the results of studies of its effectiveness, this first retrospective descriptive observational study aims to characterize the implementation and practice of this intervention in France. In doing so, it also aims to better understand the potential obstacles to the implementation of early intervention and thus propose avenues for improvement. Material and methodA census of French units offering the Denver model was conducted from June to October 2020. A questionnaire sent to the participating units made it possible to explore different dimensions: first, the characteristics of these units, including their composition. Secondly, their integration into the care network and the children's care pathway. Practice and delivery modalities were also assessed. Finally, the objective was to highlight the difficulties that the teams may have faced when implementing the model. The data were collected in Microsoft Excel® software in order to perform a descriptive statistical analysis. ResultsIn total, 92% of the units surveyed participated in the study and returned the questionnaire. Our results highlight a significant heterogeneity in the deployment of the Denver method at the national level and underline the limit of resources available in the territory, particularly in its intensive delivery form. ConclusionFurther research is still needed to study the feasibility and effectiveness of ESDM interventions deployed in the specific context of the French healthcare system. In addition, significant work remains to be done to establish rapid and identifiable pathways for early intervention in young children with ASD.

Parenting young children with developmental disabilities: Experiences during the COVID-19 pandemic in the U.S.

High-stress events (e.g., natural disasters, political unrest, disease) significantly impact the lives of children and families. The Coronavirus Disease 2019 (COVID-19) is one event that has brought numerous hardships to families and children with developmental disabilities (DD), likely exacerbating already heightened levels of stress. For this study, we interviewed mothers living in the U.S. (N = 14) of 2- to 8-year-old children with DD about how COVID-19 has affected their family life. The interviews examined how the pandemic impacted (a) their child’s educational, therapeutic, and medical services, (b) their stress and resiliency, and (c) their parenting role as an advocate, educator, and interventionist. The results of our thematic analysis of the qualitative data highlight four domains with themes that describe families’ experiences as indicated by the mothers interviewed. Voices of families are essential in the delivery of effective and ethical early intervention for young children with disabilities. Based on the data from these interviews with mothers, suggestions for family-focused intervention to support families during high-stress events are discussed. As the long-term effects of the pandemic remain unknown, suggestions for future research to continue to examine the impact of high-stress experiences on young children with DD and their families are also presented.

Parental Self-Efficacy and Involvement in Early Intervention for Young Children with Hearing Loss

Objectives: The purposes of this study were (1) to determine the reliability of the Korean version of the Scale of Parental Involvement and Self-efficacy-Revised (SPISE-R-K), (2) to examine whether rehabilitation experience and residual hearing level have an impact on parental self-efficacy and their involvement in rehabilitation processes, and (3) to describe the early intervention for young children with hearing loss (CHL) and their caregivers in Korea by analyzing the items in the SPISE-R-K. Methods: We collected 61 SPISE-R-K questionnaires from the caregivers of CHL (mean age = 20.85 months, SD = 7.85; male = 33, female = 28). All children used hearing devices (hearing aid (s) users = 36; cochlear implant (s) users = 25). The reliability of the questionnaire was assessed, and the effects of rehabilitation experience, and children’s residual hearing were examined for the sub-sections of ‘Knowledge’, ‘Confidence’ and ‘Action’. Moreover, the item scores from each section were compared. Results: Cronbach’s α analyses indicated that the SPISE-R-K was reliable in measuring the self-efficacy and involvement of caregivers of CHL. We found that the rehabilitation experience did not show a significant effect on each section’s score whereas residual hearing level had a significant effect on the ‘Knowledge’ section scores. Overall, parents showed higher self-efficacy in items related to auditory access than in items related to language development. Conclusion: The SPISE-R-K is a reliable tool for measuring the self-efficacy and involvement of Korean caregivers of young CHL. We hope that professionals utilize SPISE-R-K to identify the information that needs to be provided to caregivers of young Korean children with hearing loss, making it a valuable tool for early intervention.

Neuroinflammation, Energy and Sphingolipid Metabolism Biomarkers Are Revealed by Metabolic Modeling of Autistic Brains

Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disorders generally characterized by repetitive behaviors and difficulties in communication and social behavior. Despite its heterogeneous nature, several metabolic dysregulations are prevalent in individuals with ASD. This work aims to understand ASD brain metabolism by constructing an ASD-specific prefrontal cortex genome-scale metabolic model (GEM) using transcriptomics data to decipher novel neuroinflammatory biomarkers. The healthy and ASD-specific models are compared via uniform sampling to identify ASD-exclusive metabolic features. Noticeably, the results of our simulations and those found in the literature are comparable, supporting the accuracy of our reconstructed ASD model. We identified that several oxidative stress, mitochondrial dysfunction, and inflammatory markers are elevated in ASD. While oxidative phosphorylation fluxes were similar for healthy and ASD-specific models, and the fluxes through the pathway were nearly undisturbed, the tricarboxylic acid (TCA) fluxes indicated disruptions in the pathway. Similarly, the secretions of mitochondrial dysfunction markers such as pyruvate are found to be higher, as well as the activities of oxidative stress marker enzymes like alanine and aspartate aminotransferases (ALT and AST) and glutathione-disulfide reductase (GSR). We also detected abnormalities in the sphingolipid metabolism, which has been implicated in many inflammatory and immune processes, but its relationship with ASD has not been thoroughly explored in the existing literature. We suggest that important sphingolipid metabolites, such as sphingosine-1-phosphate (S1P), ceramide, and glucosylceramide, may be promising biomarkers for the diagnosis of ASD and provide an opportunity for the adoption of early intervention for young children.

Perinatal Cerebral Ischemic Lesion and SARS-CoV-2 Infection during Pregnancy: A Case Report and a Review of the Literature.

Perinatal stroke is related to possible differences in predisposing factors and outcomes between acutely and retrospectively diagnosed cases. In most cases, there are different risk factors and infections that could play an important role. Thus far, different clinical manifestations have been reported in children presenting with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), ranging from asymptomatic status to severe disease sustained by an immune-mediated inflammatory response. SARS-CoV-2 has been associated with severe neurological diseases including seizures and encephalitis in both adults and children. However, there are still few reports regarding the possible relation between SARS-CoV-2 infection of mothers during pregnancy and the neurologic outcome of the newborns. We described the case of a newborn diagnosed with a perinatal stroke, born at 35 weeks of gestation from a mother presenting with SARS- CoV-2 infection during the last months of pregnancy. We also added a brief review of the literature with similar cases. Close monitoring and early intervention in young children born to infected mothers would be highly recommended for the potential neurodevelopmental risk.

Families’ and professionals’ perspectives of building and maintaining engagement in telepractice early intervention for young children with communication disability

Purpose To explore and describe families’ and professionals’ perspectives about building and maintaining engagement in telepractice early intervention (EI). Methods Individual semi-structured reflexive interviews were conducted with Australian families of young children with communication disability receiving telepractice EI and their treating professionals. These interviews were conducted within one day of a telepractice EI session and analysed using thematic analysis. Results Thematic analysis of 72 interviews resulted in five themes that emphasised collaboration as an overarching enabler of engagement. The themes were: (1) the delivery of family-centred telepractice was essential for engaging children and families; (2) engagement in telepractice was variable and was affected by child, parent and professional factors; (3) engagement was an investment that required time, consistency and technology; (4) maximising communication interactions during telepractice sessions encouraged children and families to engage with professionals; and (5) joint planning and preparation facilitated child and family engagement in telepractice. Conclusions In the midst of the current COVID-19 pandemic, the present study shed light that in many ways, engagement in in-person and telepractice intervention is similar. However, the findings revealed the importance of families having an active role in telepractice EI sessions that occur in the family’s social and communication environment. Implications for Rehabilitation Family engagement and high levels of parent participation are recommended in family-centred early intervention (EI). In EI delivered via telepractice, families and professionals invest in engagement-building and collaboration in a similar manner to in-person EI and in line with the principles of family-centred practice. The distinctiveness of telepractice engagement includes professionals being conscious of their communication style, taking advantage of the home environment, communicating inside and outside appointments, and jointly planning with parents/primary carers. EI professionals and students who work with young children with communication disability via telepractice can benefit by considering the engagement-building strategies described in the present study.

CORRIGENDUM to “A Pilot Study of a Culturally Adapted Early Intervention for Young Children With Autism Spectrum Disorders in China”

CORRIGENDUM to “A Pilot Study of a Culturally Adapted Early Intervention for Young Children With Autism Spectrum Disorders in China”

Early intervention for young children with autism spectrum disorder: protocol for a scoping review of economic evaluations

BackgroundIn many countries, children who are diagnosed with autism during the first 5 years of life are offered a range of early intervention options. These options vary considerably in the theoretical approaches and techniques applied, their intensity and duration, settings, the person/s delivering supports and the training they require. Early interventions are a significant contributor to total autism-related costs in Western countries, but only in the last 10–20 years has there been adequate outcome data to enable the comparison of different interventions’ cost-effectiveness. This protocol describes a scoping review to better understand what economic evaluations have been completed in this field, and the methods used to date.MethodsWe will systematically search the following databases from their inception to 2021 for eligible studies: MEDLINE, EMBASE, PsycINFO, Econlit, PEDE, NHS EED and HTA. Full economic evaluations of any types of early intervention for children with autism prior to school entry will be included. Two reviewers will screen the studies, extract the data and assess the study quality using established checklists. The risk of bias will be assessed using the extended CHEC-list for all studies and, additionally, the Philips checklist for modelled studies. Quality of reporting will be assessed using the CHEERS checklist. A narrative synthesis will be completed to collate the findings, describe the methods used and identify which interventions have been researched from an economic perspective.DiscussionThis review will provide researchers, policymakers and service providers with current information about the economic evidence for early interventions for young children with autism and point to priorities for further research. It will inform future economic evaluations by highlighting the gaps or inconsistencies in the methods used to date. Limitations of the review will be acknowledged and discussed.Systematic review registrationOpen Science Framework: https://osf.io/sj7kt

Parental Adherence to Home Activities in Early Intervention for Young Children With Delayed Motor Development.

The purpose of this study was to investigate the relationship between characteristics of home activities and coaching practices with the adherence of parents of children with motor delays to home activities provided by physical therapists and occupational therapists in early intervention. An online survey study was developed and distributed to physical therapists and occupational therapists across the United States. A survey flier was posted online in parent support groups, physical and occupational therapy groups, newsletters, and organizations supporting parents of children with disabilities. A total of 720 respondents participated in the survey, and 446 participants from 49 states met the inclusion criteria and were included in the analysis. Parents indicated that physical therapists and occupational therapists applied the 5 coaching practices (joint planning, observation, practice, reflection, and feedback). However, parents (63%) reported more time was needed on coaching. Parents stated that therapists' modeling the activities was the most helpful teaching technique that enhanced their adherence to home activities. Coaching practices, appropriateness of the home activities to daily routines and home environment, provision of home activities enjoyed by the child, and parent self-efficacy were all significantly associated with adherence to home activities. Parents' adherence to home activities is affected not only by the type of coaching used by the therapists but also by the characteristics of the home activities provided for young children with delayed motor development. The results of this study provide additional evidence supporting individualization of home activities to promote parents' continuous provision of learning opportunities to promote their children's development. There was also support of the therapists' use of the 5 coaching practices in early intervention to support the parent's application of home activities when the therapists are not present. This study explored the use of home activities from the parents' perspective and provided valuable recommendations to therapists to improve parents' adherence to the recommended home activities in early intervention.

T-STAT for detecting autism spectrum disorder in toddlers aged 18-24 months.

The benefits of early intervention for young children with autism spectrum disorder highlight the importance of early diagnosis. Reliable diagnoses of autism spectrum disorder can be made before 24 months of age. However, many children are diagnosed with autism spectrum disorder at a later age. Delayed diagnosis can occur for children with less severe symptoms and lead to missed opportunities for early intervention. This current study was executed to examine the Taiwanese version of the Screening Tool for Autism in Two-Year-Olds in detecting autism spectrum disorder in toddlers between 18 and 24 months of age. One strength of this study was the inclusion of toddlers with autism spectrum disorder or mild-autism spectrum disorder using the strict and relaxed Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for autism spectrum disorder simultaneously. The results of this study supported that diagnosis of toddlers with autism spectrum disorder could be made reliable before 24 months of age. And the Taiwanese version of the Screening Tool for Autism in Two-Year-Olds was a Level 2 autism-specific screening tool for toddlers aged from 18 to 24 months in Taiwan.

Using social and emotional learning paradigms to inform a therapeutic intervention for preschool-aged children and their parents

ABSTRACT Early intervention for young children who struggle with emotional dysregulation can prevent future social, emotional, and behavioural problems and promote healthier trajectories. Although existing interventions address these areas, there are few that focus explicitly on the acquisition of targeted social and emotional skills within a developmentally appropriate framework. To address this gap, a novel social and emotional learning intervention (SEL-I) for children identified with mental health concerns and their parents is introduced. An overview of the intervention theory, structure, and initial pilot implementation with five children, aged four to six, is provided. Participants in this phase had high rates of session attendance, treatment satisfaction, and SEL-I skill use. Initial results indicate good adherence and behavioural outcomes and improved social and emotional skill attainment. This suggests the need for the additional study and development of SEL-informed therapy interventions to prevent and reduce impairing social and emotional development, especially for young children with additional risk factors.

Maternage et politiques d’intervention précoce au Royaume-Uni. Biologisation et reproduction des inégalités de genre, de classe et de race

This article shows how the use of neurosciences in the concepts and practices of early intervention in young children reproduces inequalities through two main processes : conferring a protective role on disadvantaged mothers (buffer effect), presumed to overcome the effects of an environment that is generally detrimental to their children, and expunging social divisions, while at the same time integrating a set of inequalities. A certain conception of attachment theory supported by that developed by John Bowlby in the years 1930– 1940 perpetuates gender inequalities by introducing a culture of ‘ intensive parenting’, associated with a discourse on brain development. Class distinctions are also strengthened by early intervention and the concepts derived from the neurosciences that present poor mothers and children as biologically and culturally different people. In parallel, early intervention tends to transmit inequalities linked to ethnicity through Eurocentric conceptions of ideal educational roles and practices.

Trauma-Informed Elementary Schools: Evaluation of School-Based Early Intervention for Young Children

Abstract Trauma-Informed Elementary Schools (TIES) is a program designed to bring trauma-informed services to early elementary classrooms. Built on a foundation of adverse childhood experiences research and the Attachment, Self-Regulation, and Competency framework, TIES provides early intervention to children who exhibit symptoms of chronic stress or trauma in the classroom. Designed as an innovative school-based approach, TIES provides classrooms with a resource liaison to support teachers in recognizing and responding to trauma indicators. This article describes a study that examined the effectiveness of the TIES intervention across multiple domains, measuring the quality of classroom interaction by comparing TIES classrooms with comparison classrooms in 11 schools in a rural Appalachian state. CLASS (Classroom Assessment Scoring System) was used to measure classroom outcomes at the beginning (baseline) and end (follow-up) of the school year. Results indicate that TIES classrooms demonstrated significant improvement from baseline to follow-up in multiple domains, whereas comparison classrooms showed decline. The article concludes with a discussion of the study’s implications.

Börn sem eru sein til máls: Áhrif þjálfunar á orðaforða barns á þriðja ári

Tilgangur rannsóknarinnar var að skoða áhrif þjálfunar á orðaforða barns á þriðja ári, sem seint var til máls. Einn þátttakandi var í rannsókninni. Við upphaf rannsóknarinnar var hann 30 mánaða, notaði rúmlega 160 orð og var ekki farinn að tengja saman orð í setningar. Þátttakandinn var valinn af hentugleika. Þjálfunin var byggð á fyrirlögn fyrir fram ákveðinna markorða sem þjálfuð voru bæði á fjölbreyttan hátt og með ákefð. Einnig voru valin samanburðarorð sem ekki voru þjálfuð. Þjálfunin fór fram tvisvar í viku í leikskóla barnsins og voru þjálfunartímar 14 talsins. Niðurstöður leiddu í ljós að almennur orðaforði barnsins, sem mældur var með staðlaða málþroskaprófinu Orðaskil, jókst yfir þjálfunartímabilið umfram það sem vænta mátti vegna almenns þroska. Mælingar sýndu að barnið notaði markorðin meira en samanburðarorðin, bæði heima og í þjálfunartímum, og að notkun á orðunum jókst eftir því sem leið á þjálfunina. Sú aukning sem varð á orðaforða barnsins hélst mánuði eftir að íhlutun lauk. Mikilvægt er að bera kennsl á seinkun í málþroska eins snemma og kostur er. Þegar búið er að bera kennsl á barn sem seint er til máls þarf í framhaldi að veita því viðeigandi örvun eða íhlutun, en þessi rannsókn bendir til að slík þjálfun geti haft góð áhrif. Sambærileg rannsókn hefur ekki verið gerð áður á Íslandi.

Progress and challenges in early intervention of autism spectrum disorder in China

Autism spectrum disorder (ASD) is a neurodevelopmental disorder whose prevalence has increased rapidly in recent decades. Advances in the fields of intervention for ASD have contributed to a more optimistic outcome for children with ASD. Furthermore, the development of early detection, screening, and diagnosis has highlighted the importance of early intervention for young children with ASD. The present article reviews commonly used intervention approaches for children with ASD in China, including recently introduced approaches and originally developed Chinese models for early intervention, and then briefly summarizes the progress and challenges of intervention in combination with associated services and supports.

Increasing global access to early intervention for young children with ASD

In their recent paper, “Caregiver descriptions of joint activity routines with young children with autism spectrum disorder in South Africa”, Ramseur and colleagues examined the applicability of an early intervention model for children with autism spectrum disorder (ASD), which was developed and validated in more highly resourced settings, to the diverse cultural context of South Africa (1). They highlighted the importance of this work by noting the dearth of ASD research on the African continent; for example, Africa is yet to see an ASD prevalence study, and as of 2017, a scoping review identified only 53 peer-reviewed publications on ASD published in sub-Saharan Africa (2). Moreover, none of the publications focused on early intervention in Africa. Thus, Ramseur et al .’s study represents an important step forward in addressing the needs of children with ASD in South Africa.