Early Intervention Services For Children Research Articles

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Professional Development and Use of Evidence-Based Practice in Autism Early Intervention

We investigated the experiences of Australian autism early intervention service providers, including the professional development they receive on the job and how they translate research evidence into their practice. Semi-structured interviews were conducted with 15 providers drawn from three locations. Participants described the crucial role of paraprofessionals in early intervention services, and indicated that, within multidisciplinary teams, allied health professionals, and teachers are the ones who select intervention practices and upskill paraprofessionals. Furthermore, participants reported using practices supported by research evidence, but also some emerging and unsupported practices. The use of unsupported practices is examined in light of the daily challenges faced by centers. Results may inform further professional development in early intervention services for children on the autism spectrum, to support the best possible outcomes for this population. The findings highlight the potential need for job-embedded hands-on professional development conducted in real time.

Social validity of telepractice in early intervention: Effectiveness of family‐centered practices

AbstractObjectiveThe present study evaluates the impact of family‐centered practices on families' ratings of social validity of telepractice in 659 Spanish families in early childhood intervention (ECI) services.BackgroundThe integration of telepractice in ECI services has been accelerated by the social and health situation caused by the COVID‐19 pandemic. Until then, telepractice was a well‐known but scarcely used resource in early intervention. Social validity assessments are critical for telepractice because services are focused on supporting primary caregivers. Social validity, therefore, refers to whether the intervention approach and outcomes match the needs of children and families, allowing for improved planning, implementation, and evaluation of early intervention programs.MethodA survey‐based cross‐sectional study on families' ratings of social validity was carried out. A structural equations model was performed in order to assess the influence of families' ratings of the social validity of telepractice. The model analyzed a mediation through latent variables: family‐centered practices (X), fit of services to family needs (M), and social validity of telepractice (Y).ResultsOur study shows an overall good perception of social validity of telepractice by families. Focusing on family needs and priorities and professionals encouraging families to have an active role completely mediates the relationship between family‐centered practices and family social validity scores. No differences in telepractice modalities were found.Conclusions and ImplicationsA family‐centered approach to telepractice in ECI is needed, not only for greater social validity, but also for improved child and family outcomes, especially when services support real family needs and priorities.

An Examination of Early Intervention Services for Children With Visual Impairments During the COVID-19 Pandemic.

Introduction: In the early spring of 2020, governments were beginning to react to the news of a global pandemic being caused by COVID-19. The purpose of this study was to examine the effect of COVID-19 on early intervention services for young children with visual impairments and their families. Methods: Parents of children with visual impairments aged birth to 3 years were asked a series of questions contained in a larger Access and Engagement survey that investigated the experiences of families of children and young adults with visual impairments aged birth to 21 years and professionals that provided educational services. Results: Three overall themes emerged from the data: (1) many changes occurred in the home, (2) early intervention services changed, and (3) planning for the transition to preschool was affected. Discussion: Overall, the changes in education due to the pandemic and initial shutdown resulted in much parental stress. Parents reported that they were stressed and sometimes overwhelmed by the sudden and dramatic changes in their daily lives and how best to help their children in continuing to learn and develop their skills while simultaneously working from home, being caregivers to the other children in the family, and serving as educators and sometimes informal therapists to their children. Many services moved to an online format and were provided remotely. Implications for Practitioners: Service providers should continue to provide services to families and children who have been affected by the COVID-19 pandemic and resulting shutdown while continuing to provide ways to support the social and emotional well-being of their families. Service providers and families should monitor their children's development and learning both now and in the future.

An intervention to improve the self-efficacy of key workers to support parental wellbeing at an early childhood intervention service in Australia: a stepped wedged randomized cluster trial

Purpose It is well documented parents of children who have a disability are at an increased risk of poor mental health and wellbeing. A capacity building program designed to build key worker self-efficacy to support the mental health of parents accessing early childhood intervention services (ECIS) for their child was trialled. Materials and Methods A stepped-wedge cluster randomised trial design was utilised to deliver and evaluate a 12-month intervention program, comprising tailored professional development, resource development and sustainability measures. The repeated measurements on individuals in six clusters over three follow-up periods were analysed using linear mixed models. Comparison of the control and new program statistical means (adjusted for period effects) were assessed with an F test. Results Key workers reported increased confidence to talk to parents about their own wellbeing (d = 0.51, F(1, 51.8) = 4.28, p = 0.044) and knowledge of parental mental wellbeing improved (p = 0.006). A reduction in staff sick leave partially offset the cost of the intervention. Conclusions A multi-pronged intervention targeted at key workers was found to be an effective way to ensure parental wellbeing is supported at an ECIS in Australia. Trial Registration ACTRN12617001530314 Implications for Rehabilitation There are implications for the development of children whose parents are experiencing high stress and poor mental health, whereby parents of children with disability or developmental delays are at increased risk. Findings from this study support the recommendation that a key worker is provided to holistically support families who access Early Childhood Intervention Services to aid in reducing poor parental wellbeing and child outcomes. Improved confidence to support and initiate conversations regarding parental wellbeing by key workers, in combination with support from management and the organisation to undertake this as part of their role, is a positive finding from this intervention study.

Does family quality of life get better as the years go by? A comparative mixed‐methods study between early years and school‐aged children with disability in Australia

AbstractThis Australian study compared perspectives of family quality of life (FQOL) of parents of preschool children attending early childhood intervention services (ECIS) with parents of school‐aged children with disability. It examined the relationships between disability‐related services, parent occupations, and FQOL. Two mixed‐methods studies with 122 participants and 24 in‐depth interviews were conducted. The first study included 72 parents attending ECIS. The second study included 50 parents of school‐aged children with disability. The quantitative aspect (N = 122) used the Beach Center FQOL survey and a demographic questionnaire. Twelve semistructured interviews were conducted for each study. Spearmann's Rho correlations for quantitative data analysis and thematic analysis for qualitative data were used for each study. A two‐way analysis of variance along with a qualitative comparative analysis were conducted to compare the findings from both studies. Results indicated lower scores on FQOL in parents with school‐aged children when compared with the ECIS group. Loss of work, lack of time for caregiver health, lack of respite, and interim residential care had detrimental impacts on parents' long‐term well‐being. Based on the results, it can be concluded that the hardships and challenges of caregiving increase as the child gets older; however, positive adaptations, beliefs, and positive transformations help FQOL. Family‐centered care and supportive practitioners assist FQOL and are highly recommended.

Pediatric Feeding Disorder in Early Intervention: Expanding Access, Improving Outcomes, and Prioritizing Responsive Feeding

Purpose: Pediatric feeding disorder (PFD), like many childhood medical conditions, is likely to negatively impact a child's growth and development, daily learning opportunities, and family functioning. Parents who have children with a diagnosis of PFD may not yet know the most effective way to feed their children and often experience negative emotions surrounding mealtimes. These families may receive therapy services through early intervention (EI) programs. In many states, there are barriers that limit access to programs and provision of high-quality care for this population. These barriers include the lack of an approved single feeding-related diagnosis that renders a child automatically eligible, lack of approved stand-alone feeding-specific testing tools with which to determine eligibility, lack of educational and clinical experience requirements for providers, and considerable variation in service provision. Method: This clinical focus article reviews the definition of PFD, the multifaceted needs of families and children in EI, support for use of responsive feeding in treatment of PFD, alignment of responsive feeding strategies with EI principles, and barriers limiting access to consistent, high-quality EI services for children with PFD. Several changes to EI programs are proposed to address these barriers. Conclusions: Use of PFD as an automatically qualifying diagnosis for EI programs and use of approved stand-alone feeding-specific assessment tools could establish more consistent and specific eligibility standards for this population, likely expanding early access to support and improving outcomes. EI provider clinical experience and training requirements would likely lead to more consistent and high-quality, evidence-based service provision. Required training should include the use of methods such as routines-based intervention, parent coaching, and anticipatory guidance to support implementation of responsive feeding practices during mealtime routines.