Effectiveness Of Early Intervention Services Research Articles

Effectiveness of the early intervention service for first-episode psychosis in Navarra (PEPsNa): Broadening the scope of outcome measures.

This study compares the effectiveness of a new early intervention service for firstepisode psychosis (FEP) in patients under conventional treatment. Six primary and 10 secondary outcome measures are used to better characterize the comparative effectiveness between two FEP groups. This study plans to enroll 250 patients aged 15-55 years with FEP from all inpatient and outpatient mental health services and primary health care from January 2020 until December 2022. The control group will be composed of 130 FEP patients treated in mental health centers in the 2 years prior to the start of PEPsNa (Programa de Primeros Episodios de Psicosis de Navarra). The primary outcome measures are symptomatic remission, functional recovery, personal recovery, cognitive performance, functional capacity in real-world settings, and costs. The secondary outcome measures are duration of untreated psychosis, substance abuse rate, antipsychotic monotherapy, minimal effective dose of antipsychotic drugs, therapeutic alliance, drop-out rate, number of relapses, global mortality and suicidality, resource use, and general satisfaction in the program. This study arises from the growing need to broaden the scope of outcome measures in FEP patients and to account for unmet needs of recovery for FEPs. It aims to contribute in the dissemination of the NAVIGATE model in Europe and to provide new evidence of the effectiveness of early intervention services for stakeholders of the National Health Service.

Outcomes During and After Early Intervention Services for First-Episode Psychosis: Results Over 5 Years From the RAISE-ETP Site-Randomized Trial.

To examine long-term effects of early intervention services (EIS) for first-episode psychosis, we compared Heinrichs-Carpenter Quality of Life (QLS) and Positive and Negative Syndrome Scale (PANSS) scores and inpatient hospitalization days over 5 years with data from the site-randomized RAISE-ETP trial that compared the EIS NAVIGATE (17 sites; 223 participants) and community care (CC) (17 sites; 181 participants). Inclusion criteria were: age 15-40 years; DSM-IV diagnoses of schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, or psychotic disorder not otherwise specified; first psychotic episode; antipsychotic medication taken for ≤6 months. NAVIGATE-randomized participants could receive NAVIGATE from their study entry date until NAVIGATE ended when the last-enrolled NAVIGATE participant completed 2 years of treatment. Assessments occurred every 6 months. 61% of participants had assessments conducted ≥2 years; 31% at 5 years. Median follow-up length was CC 30 months and NAVIGATE 38 months. Primary analyses assumed data were not-missing-at-random (NMAR); sensitivity analyses assumed data were missing-at-random (MAR). MAR analyses found no significant treatment-by-time interactions for QLS or PANSS. NMAR analyses revealed that NAVIGATE was associated with a 13.14 (95%CI:6.92,19.37) unit QLS and 7.73 (95%CI:2.98,12.47) unit PANSS better improvement and 2.53 (95%CI:0.59,4.47) fewer inpatient days than CC (all comparisons significant). QLS and PANSS effect sizes were 0.856 and 0.70. NAVIGATE opportunity length (mean 33.8 (SD = 5.1) months) was not associated (P = .72) with QLS outcome; duration of untreated psychosis did not moderate (P = .32) differential QLS outcome. While conclusions are limited by the low rate of five-year follow-up, the data support long-term benefit of NAVIGATE compared to community care.

From Knowledge Transfer to Action: An Example of a Community of Practice for First-Episode Psychosis in Lyon, France.

Despite the proven effectiveness of early intervention services for first-episode psychosis (FEP), these services are poorly implemented in France. This column describes the establishment in 2018 of a community of practice dedicated to the implementation of early intervention services for FEP at the Vinatier Hospital in Lyon, France, in 2019. To evaluate the implementation process, the authors analyzed materials produced during the process of conceiving and developing the community of practice, reviewed participant observation notes, and examined responses to a satisfaction survey completed by community of practice members. Creation of the community of practice network has led to substantial changes in care pathways for FEP patients in Greater Lyon.

Early intervention services for special needs children: An exploration of the effectiveness of early special education in Malaysia

Early intervention programme (EIP) are a range of different programmes included different types of therapy and education that aimed to help and support children with developmental delays or other specific health conditions. The programmes are helpful to improve children development and adaptability, enhance family capability in handling the special needs children and increase family and children participation in society. This research aims to discover the effectiveness and importance of the early special education in Malaysia. To meet the objectives of this study, a qualitative research using phenomenological approach has conducted on five special needs teachers who work in a Non-Governmental Organization (NGO) early intervention centre in Johor, Malaysia by using purposive sampling. Thematic analysis was used to analyse the collected data. This research found that improvement in attention and behaviours, self-care skills, social interaction skills of special needs children are the effectiveness of early intervention services. Besides that, providing knowledge and happiness to the parents and preparing for integration into kindergarten and future schooling are also some of the effectiveness. The implications of this study consist of contributing significantly to the community by making people understand the effectiveness and importance of sending special needs children to the EIP. It is important for the parents to realise the importance of sending their special needs children to the EIP as earlier as possible as learning occur effective before six years old and behavior more likely to be trained. Keywords: early intervention services, early special education, special needs children

Youth services: meeting the mental health needs of adolescents.

Youth mental health services are poised for a paradigm shift. Recent epidemiological evidence confirms the seriousness of adolescence as a risk period for mental ill-health - 50% of all adult mental disorders begin before the age of 16% and 75% before the age of 25. Here, we identify issues with transition of care between CAMHS-AMHS service, and effectiveness of early intervention services. We provide a selective review providing evidence of adolescence as a risk period, discuss CAMHS-AMHS service transition problems, and discuss avenues for change to implement the early intervention model across youth mental health. Traditional service structures,with paediatric -adult split at 16-18 years increasingly appear not fit for purpose. A radical redesign of youth mental health services is not only necessary, it is also feasible and achievable, as illustrated by a pilot Birmingham youth service - Youthspace. Pilot youth mental projects currently underway can help radically redesign the existing child and adolescent services. This will in turn lead to an improvement in the young people's experience of engagement with the services so that they too have a positive future.

Die psychische Gesundheit von Kindern, Jugendlichen und jungen Erwachsenen – Teil 2: Krankheitslast, Defizite des deutschen Versorgungssystems, Effektivität und Effizienz von „Early Intervention Services“

Numerous birth-control studies, epidemiological studies, and observational studies investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use of children, adolescents and young adults is low, even lower than in adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the border of child and adolescent and adult psychiatry. Emerging studies show that these health care structures are effective and efficient. Part 2 of the present review focuses on illness burden including disability and costs, deficits of the present health care system in Germany, and efficacy and efficiency of early intervention services.

Die psychische Gesundheit von Kindern, Jugendlichen und jungen Erwachsenen – Teil 1: Häufigkeit, Störungspersistenz, Belastungsfaktoren, Service-Inanspruchnahme und Behandlungsverzögerung mit Konsequenzen

Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.

Early intervention services, cognitive–behavioural therapy and family intervention in early psychosis: systematic review

BackgroundEarly intervention services for psychosis aim to detect emergent symptoms, reduce the duration of untreated psychosis, and improve access to effective treatments.AimsTo evaluate the effectiveness of early intervention services, cognitive–behavioural therapy (CBT) and family intervention in early psychosis.MethodSystematic review and meta-analysis of randomised controlled trials of early intervention services, CBT and family intervention for people with early psychosis.ResultsEarly intervention services reduced hospital admission, relapse rates and symptom severity, and improved access to and engagement with treatment. Used alone, family intervention reduced relapse and hospital admission rates, whereas CBT reduced the severity of symptoms with little impact on relapse or hospital admission.ConclusionsFor people with early psychosis, early intervention services appear to have clinically important benefits over standard care. Including CBT and family intervention within the service may contribute to improved outcomes in this critical period. The longer-term benefits of this approach and its component treatments for people with early and established psychosis need further research.

The Implementation of Families First NSW: Process lessons from the first four years

Families First is a NSW Government strategy that aims to improve the effectiveness of early intervention services supporting families and communities to care for children. Its implementation is the joint responsibility of the five NSW Human Services agencies: the NSW departments of Community Services (DoCS); Ageing Disability and Home Care (DADHC); Education and Training (DET); Housing; and NSW Health through Area Health Services. Area Reviews are one element of the Families First evaluation process. The reviews focus on the experiences of individual areas during the implementation of the strategy. They were not designed to evaluate individual services but to garner generalisable lessons for future implementation. This article sets out four categories of implementation lessons from the Area Reviews, relating to managing systems change, a systems approach to early intervention and prevention, family services system capacity, and Indigenous participation. These lessons reflect the challenges faced and achievements made in each of the three Families First Areas to improve the coordination of the service network and increase the provision of services for early intervention and prevention.

Behavioral Problems and the Effects of Early Intervention on Eight-Year-Old Children with Learning Disabilities

1) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children. 2) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities (LD). This is a secondary data analysis of the Infant Health and Development Program (IHDP), a randomized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature. The findings are based on a prospective follow-up of these children at 8 years of age. Compared to children without verbal LD (VLD), those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89% more likely to exhibit externalizing behavior problems. Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors, as well as an increased likelihood of attention problems among children with VLD. No significant association was found between nonverbal LD (NVLD) and any type of behavior problem. Furthermore, there was a significant interaction between VLD and the intervention, in which the odds of internalizing behavior problems were greater among children with VLD. No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD. These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children.

Medical Complications of the Critically III Newborn

Sophisticated technology in neonatal intensive care units (NICU) has resulted in remarkable improvements in the survival of the sickest and most premature newborn infants. Although fortunately the prevalence of disability among NICU graduates has not increased with such advances, the total number of these infants in the community has grown as a result of the improved survival. Many of these babies manifest complex residual health problems and are at risk for developmental difficulties. An understanding of the complications of prematurity and other neonatal illnesses as well as of their treatments can enhance the effectiveness of early intervention services, both in devising creative approaches aimed at promoting the optimal development of medically vulnerable infants and in supporting their families during prolonged periods of intense stress.

The Relationship of Parent-Child Interaction to the Effectiveness of Early Intervention Services for at-Risk Children and Children with Disabilities

The results from four early intervention evaluation studies are described in relationship to their impact on parent-child interaction as measured by the Maternal Behavior Rating Scale. Intervention studies included the Infant Health and Development Program, the Longitudinal Studies of the Effects and Costs of Alternative Types of Early Intervention, the Play and Learning Strategies Program, and the Family-Centered Outcome study. Results from these analyses indicated that intervention effects on child development were unlikely to occur unless mothers modified their style of interacting with their children. Although these studies indicated that mothers of children who participated in intervention modified several different parameters of interactional style, only their level of responsiveness was positively associated with their children's developmental outcomes. These results are discussed in relationship to child-focused and relationship-focused models of early intervention.

Early Intervention for Disabled Infants and Their Families: A Quantitative Analysis

In an evaluation of 31 selected studies, statistical procedures for synthesizing data (meta-analysis) were used to assess the effects of early intervention services on disabled children younger than 3 years of age and on their families. Results indicate that early intervention is effective in promoting developmental progress in infants and toddlers with biologically based disabilities. Programs that served a heterogeneous group of children, provided a structured curriculum, and targeted their efforts on parents and children together appeared to be the most effective. Definitive evaluation of the efficacy of early intervention programs is tempered by the restricted range of outcomes measured and by a paucity of information about the children and families enrolled in such programs, as well as about the specific nature of the services received. Despite their limitations, available data provide the basis for a rational pediatric approach to early intervention programs, while highlighting specific directions for further investigation.

An Analysis of the Effects of Early Intervention Services for Infants and Toddlers with Moderate and Severe Handicaps

The effectiveness of an early intervention program which featured combination home and center based, transdisciplinary team services for children with moderate to severe disabilities and their parents is discussed. Program evaluation was conducted utilizing multiple methods including pre-posttest comparisons of child change as measured by the Bayley Scales of Infant Development, the Uniform Performance Assessment System, a project curriculum objectives checklist, and pre-posttest comparisons of parent behavior change as measured on the Parent Behavior Progression Scale. Comparisons indicated statistically significant positive behavioral changes for both children and their parents. No relationship was found, however, between amount of child developmental progress and parenting behavior.