Home-based Early Intervention Program Research Articles

Psychological Impact of Caregiving for Children With Eye Diseases: A Systematic Review and Meta-analysis.

To identify and characterize the psychological impact of caregiving for children with eye disease. Awareness of the caregiving experience and insight into the factors related to caregiver burden is necessary to support high-quality ophthalmic care and develop supportive interventions. The databases MEDLINE (Ovid), CINAHL, EMBASE, Cochrane Library, PsychINFO, PubMed, and Google Scholar were queried up to June 25, 2021. Studies included assessed the psychological impact of providing care to children with eye diseases. A risk of bias assessment was performed according to the Modified Downs and Black Checklist. Demographic data and measures of burden were extracted and tabulated. A total of 2,823 articles were screened, 28 underwent data extraction, and 7 were included in the meta-analysis. The meta-analysis indicated significant levels of burden (40% mild, 95% CI: [0.28 to 0.53]; 59% moderate, 95% CI: [0.36 to 0.82]; 7% severe, 95% CI: [0.02 to 0.11]) and depression (26% mild, 95% CI: [0.17 to 0.35]; 8% moderate, 95% CI: [0.03 to 0.14]); 11% severe, 95% CI:[0.03 to 0.10]). Interventions such as educational programs, life skills training programs, and other home-based early intervention programs were shown to improve psychological well-being of families. Caregivers experience significant levels of burden and depression, which may, in turn, affect the level of ophthalmic care they can provide for their children. Further studies investigating educational or psychological interventions for parents are needed, because the small number of studies that investigated these types of interventions have reported reduced parental stress and improved well-being. [J Pediatr Ophthalmol Strabismus. 2023;60(4):238-247.].

Suicide Gatekeeping: An Important Potential Role for Early Childhood Home Visitors

Parents of young children with disabilities may experience high levels of stress and psychological distress that may put them at higher risk for experiencing suicidality. Thus, early childhood home visitors (e.g., professionals who work for home-based early intervention programs) may serve as important gatekeepers for identifying and referring parents who are experiencing psychological distress, including suicidal thoughts. However, most early childhood home visitors do not receive training on identifying or intervening with distressed and potentially suicidal caregivers. Therefore, early childhood home visitors would benefit from acquiring evidence-based, accessible strategies for identifying and responding to caregivers who they know or suspect are experiencing suicidal thoughts—a class of knowledge and skills that can be obtained through “suicide gatekeeper” training. In this article, we provide evidence-based information about suicide risk among parents of young children with disabilities, the intervention of suicide gatekeeping, and how suicide gatekeeping can be incorporated into the early childhood home visitor role.

Use of the portage curriculum to impact child and parent outcome in an early intervention program in Lebanon

ABSTRACT The purpose of this study, that took place in Lebanon, is to investigate the effectiveness of Portage, a home-based early intervention program for children with special needs. The sample consisted of 16 children (eight male and eight female) whose ages ranged between 1 and 3 years. Participants were provided with home-based services by a Portage home-visitor for a period of six months. Data were collected before and after the intervention. Participants’ progress was evaluated in five developmental areas: communication, social-emotional, exploration, purposeful-motor activity, and sensory organization. Parents’ satisfaction with the program’s provisions was also examined. The results revealed significant differences in the participants’ pre and post ratings, indicating improvement in the children’s functional skills in all developmental areas. Also, parents’ interviews revealed satisfaction with the program’s services. In sum, Portage seems to be a promising home-based intervention, but further research is needed before making any claims about its wider potential.

Developing a Home-Based Early Intervention Personnel Training Program in Southeast China

China is expected to have a rapid growth in specialized early intervention (EI) services for young children ages birth to 6 and their families. A major barrier in the provision of EI services in China is the shortage of well-trained EI personnel. In 2013, a Home-Based Early Intervention Program (HBEIP) was started at South China Normal University (SCNU) in Guangzhou, China to prepare future professionals to use family-centered EI practices adapted from similar programs in the United States. During the first year of implementation, HBEIP collected data from a self-efficacy survey and a needs assessment. Results from the evaluation showed that Chinese trainees perceived the family-centered approach to EI as relevant and valuable, and indicated needs for improving supervision and coaching supports in future implementation of HBEIP. The research team discussed implications for cross-cultural adaptation and implementation of personnel training practices.

Developing the Home-based Early Intervention Program: A Case Study

The current study was aimed to develop a home-based early intervention program based from activity-based approach and to prove the effectiveness of the program on 18 month old child with developmental delay/risk of delay. Developmental delay was assessed with DENVER II Developmental Screening Test (DENVER II DST) at first. The child was also assessed in detail within the current study and it was determined that the child had developmental delay. After receiving family’s approval, procedures were conducted according to the steps of early intervention. After detailed evaluations, filling the Individualized Family Service Plan and determining the goals for the child, researcher implemented the early intervention program. All of the family members were incorporated with the program and 36 developmental support programs were implemented in home environment. Results show that the early intervention program has a positive effect on the child’s development and mothers’ opinion is positive about the program.

Development of a 12 month screener based on items from the Bayley II Scales of Infant Development for use in Low Middle Income countries

ObjectivesThe purpose of the current study was to adapt the Bayley Scales of Infant Development II for use as a screening measure that could be used by health care professionals in Low Middle Income (LMI) countries with 12month old infants to determine if they needed further assessment and early intervention. MethodsThe adaptations were made as part of a larger study of children participating in a home-based early intervention program in India, Pakistan, and Zambia. Using Item Response Theory, a brief 12month screener, with excellent sensitivity and specificity was identified. ResultsThe proposed 12month screener contains 7 mental/cognitive items and 5 motor items. Children who cannot perform more than 3 items on the mental scale (sensitivity 79%, specificity 85%) and/or 3 items on the motor scale (sensitivity 96%, specificity 95%) should be referred for further assessment. ConclusionThis screener can reliably be used to determine if a child needs further developmental assessment.

Participant characteristics and process variables predict attrition from a home-based early intervention program

Although advocates of home visits claim that they improve access to preventive interventions for socially disadvantaged families, home visiting programs often report high dropout rates. This study investigated factors predicting attrition in a sample of 434 low-income, first-time mothers in a German program modeled on the Nurse–Family Partnership program. Both participant characteristics and process variables associated with attrition were examined. The results indicated that 38.5% of the mothers left the program before completing 75% of the enrollment time; 62% of those left for addressable reasons (e.g., losing interest in program participation). Arguably, these participants might be retained through program modifications. Almost half of the dropouts left the program before completing 25% of the enrollment time. Program dropouts were younger and did not experience pregnancy-related risks. With regard to process variables, a high frequency of unsuccessful visit attempts and low maternal engagement during the home visits increased the risk for attrition. Self-referral, a high percentage of time spent on parenting issues as well as a high percentage of grandmother participation during visits contributed to participant retention. Among mothers with a high number of risk factors for child abuse and neglect, partner (husband or boyfriend) participation during visits positively influenced the retention rate. Since process variables explained a larger amount of variance in attrition compared to participant characteristics, it is reasonable to focus on the intervention processes when trying to reduce attrition.

EVALUTING THE EFFECTS OF EARLY INTERVENTION PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES IN COMMUNITY

Objectives: To evualate the effects of early intervention program after one year for 33 disabled children in Hue city in 2010. Objects and Methods: Conduct with practical work and assessment on developing levels at different skills of the children with developmental delay under 6 years old who are the objects of the program. Results: With the Portage checklist used as a tool for implementing the intervention at the community and assessing developing skills on Social, Cognition, Motor, Self-help and Language skills for children with developmental delay, there still exists significant difference (p ≤ 0.05) at developing level of all areas in the first assessment (January, 2010) and the second assessment (December, 2010) after 12 months. In comparison among skills of different types of disabilities, there is significant difference of p ≤ 0.05 of social, cognition and language skills in the first assessment and of social, cognition, motor and language skills in the second assessment. Conclusion: Home-based Early Intervention Program for children with developmental delay has achieved lots of progress in improving development skills of the children and enhancing the parents’ abilities in supporting their children at home.

Commentary on Classic Articles from Issue Two of RSEQ's 30-Year Retrospective

I honestly cannot remember when I first understood the concept of disability or special education. I grew up a rural East Tennessee Appalachian community. This community included individuals with disabilities that I just viewed as different. Across the hollow was my next door neighbor Flo, a young adult female with cognitive impairments with whom I played dolls and whom I later tried to teach to read when I went to school. I had a church friend whose older brother, Brian, went to a special school because he had undiagnosed autism (he was identified as having mental retardation) and was our preschool Sunday school class. In the nearest small town was a wandering teenage male, Fredthe, who had cognitive impairments and did odd jobs for small business owners and who might sit down with your family to eat at the local Dairy Queen. For me, and the community which I grew up, that was just life. Later, when given the opportunity to be a graduate assistant a home-based early intervention program even though my background was English literature, I knew I had found a career about which I could be passionate. I never will forget the interview process for an assistantship that included a 2-hour car ride to a rural home where an 8 month-old with significant health impairments lived. Sitting on the floor of that home talking to the mother and holding the baby felt very natural. Later still, I was presented with a whole new set of challenges as a rural special educator of preschoolers and elementary students with severe disabilities. Though being rural most of my life and special education for much of my adult life, I am a relative newcomer to the American Council on Rural Special Education, attending my first ACRES conference Tulsa, OK, 2005. Finding ACRES was like finding a friend, or rather a group of friends, who also had a passion for rural areas, including warts, beauty marks, and all. It was a pleasure to see a group so dedicated to the rural issues that I had experienced when I was growing up and had come to understand even better as a home-visiting early interventionist and a special education teacher. The ACRES journal, Rural Special Education Quarterly (RSEQ), has become a favorite journal that gives me glimpses into issues and what others have found to work their rural areas. It was interesting to read the classic articles published this issue and to find that multiculturalism, family-centered approaches, and school violence were topics of importance the late 90s and are still of concern to our field. Multiculturalism and how to identify and serve children with disabilities who are culturally different than the dominant culture is still a concern today, especially rural areas that are changing culturally more than ever before. One theory for overrepresentation of individuals who are culturally different is that many live poverty, and poverty is known to increase special education rates (Coutinho & Oswald, 2000). The Federal government reported that, in 2002, 14.2 percent of the [rural] population, or 7.5 million people, were poor, compared with 11.6 percent of the metro population (Rural Poverty at a Glance, n.d. p. 2). Another theory is that special education referral and assessment is still biased (Coutinho & Oswald, 2000). With the 1997 and 2004 IDEA reauthorizations, research this area has increased since the Gritzmacher and Gritzmacher (1995) article and the Carter and Paez ( 1997) article. In 1995, the Mailory article discussed the need for a family-centered approach to early intervention rural areas. In the Fall 2009 RSEQ issue, Cathy Kea also presented the need for a family- centered approach, highlighting the value of practitioners understanding the culture of African American families they serve rural areas. This article highlighted that rural is not as homogeneous as it once was. …

Evaluation of a feasibility study addressing risk factors for childhood obesity through home visits

This pilot study aimed to explore the feasibility of addressing risk factors for childhood obesity through a home-based early intervention program. A pilot study was conducted with 56 first-time mothers, recruited through the antenatal and delivery units of an inner western Sydney hospital. The study offered five home visits by a community early childhood health nurse during the child's first year of life. At each visit, the intervention was tailored to the appropriate developmental stage of the child. One-to-one consultation was provided with a focus on sustained breastfeeding, appropriate introduction of solids, avoiding food rewards and promoting the drinking of water and the use of a cup. Both quantitative and qualitative methods were applied to assess the feasibility and acceptability of the program. The results indicate that the program was very well received by the participating mothers, with a retention rate of 95%. Compared with the state population average, the rate of breastfeeding at 12 months was significantly higher (36% vs. 18%, chi(2)= 8.21, P < 0.01), there was a lower rate of the introduction of solids before 4 months (2% vs. 13%, chi(2)= 8.73, P < 0.01), and there was a high rate of cup usage at 12 months (98%). The early onset of childhood overweight and obesity requires health promotion intervention programs to commence as early as possible. A home-based intervention through multiple home visits is feasible in addressing the risk factors for childhood obesity.

Early Intervention for Children with Autism: Parental Priorities

This paper describes a process of assisting parents of young children with Autistic Spectrum Disorder (ASD) to identify and prioritise their goals for their children's early intervention. A modified version of the Canadian Occupational Performance Measure (M-COPM) was used to facilitate this process. Twenty-two child–parent dyads involved in a home-based early intervention program participated in this study. Parents were able to identify and prioritise three to six early intervention goals for their children. Consistent with the core impairments of ASD, identified goals related to the domains of communication, behaviour, play and social interaction. The M-COPM was found to be a useful tool for enabling parents to identify goals for their children, when used and understood from a strong client and family-centred philosophical perspective. Pre- and post-intervention parent ratings of goal performance and satisfaction are presented to demonstrate the use of the M-COPM as an outcome measure. Implications for practitioners in early childhood and special education settings, and areas for further research, are also discussed.

Effects of Three Levels of Early Intervention Services on Children Prenatally Exposed to Cocaine

Cocaine use during pregnancy is a high-risk indicator for adverse developmental outcomes. Three levels of intervention (center, home, and primary care) were compared in a full service, birth to age 3, early intervention program serving children exposed to cocaine prenatally. Data were collected on 130 children from urban, predominantly poor, primarily minority families. At 36 months, statistically significant, moderate to large intervention effects were found for cognition, receptive and expressive language, and gross motor development. Small effects were observed for behavior problems, and no statistically significant effects were found for fine motor or prosocial skills. Center-based care was most effective for improving language. These findings provide support that the center- and home-based early intervention programs examined in this study had positive effects on children at risk due to prenatal cocaine exposure.

Congenital Cytomegalovirus Infection.

Intrauterine infection with cytomegalovirus (CMV), a betaherpesvirus, remains the most frequent congenital virus infection in many regions of the world. Although most CMV-infected newborns lack signs of CMV infection, approximately 10% have signs that can consist of low birth weight, jaundice, hepatosplenomegaly, skin rash, microcephaly, and chorioretinitis. Neonates with signs of CMV infection at birth have high rates of audiologic and neurodevelopmental sequelae. Although postnatal therapy with ganciclovir transiently reduces virus shedding and may lessen the audiologic consequences of CMV in some infected infants, additional strategies are needed to prevent congenital CMV disease and to improve the neurodevelopmental prognosis of infants infected with CMV in utero. Some cases of intrauterine infections can be prevented in susceptible women by avoiding contact with the urine or saliva of young children who may be shedding CMV. Vaccines against CMV remain in the experimental stages of development. Termination of pregnancy can be offered to women whose infants have evidence of intrauterine CMV infection and sonographic signs of central nervous system damage. Infants who survive symptomatic intrauterine infections have high rates of neurodevelopmental sequelae and require comprehensive evaluation and therapy through center and home-based early intervention programs.

Implementation and effectiveness of a home-based early intervention program for blind infants and preschoolers

This article presents results from a comprehensive evaluation of a home-based early intervention project for congenitally blind young children. Five full-term and five preterm blind children, who had a mean age of 12 months at the beginning of the project, were visited at home with their families every 2 weeks over a 2-year period. Results showed that an individualized, handicap-specific early intervention using different types of parent involvement (cotherapist, parent counseling) could be implemented successfully. Compared with controls, developmental test data from the ages of 12 to 36 months showed an accelerating impact on the full-term children. However, no intervention effects could be found in the preterm children. This finding was mainly due to methodological limitations (e.g., selection bias). The best results among full-term children were found on blindness-specific scales (e.g., orientation and mobility). It is concluded that the outcomes in full-term children confirm the success of this type of early intervention.

The next step: Parent Perspectives of Transition to Preschool of Children with Disabilities

An innovative project was established to support the transition of young children from their home-based early intervention program to a neighbourhood preschool. The project, called Stepping Stones, provides specialist staff for a small group of severely disabled children with the aim of gradually introducing them to the on-site preschool. The participation of parents, consistent with a family-centred philosophy, was an important part of the transition process. Parents and staff were interviewed in the second week of the project to identify initial concerns and information needs. A follow-up interview was undertaken six weeks later. Results suggest that the parents were not really sure about the educational objectives for non-disabled children at the preschool and therefore were uncertain about what to expect in terms of developmental gains for their disabled children in spite of their strong commitment to the general principles of inclusive practice. In preparation for transition, more time needs to be given to familiarising parents with the implicit educational goals of preschool programs and making these more explicit where necessary.

A Study of Employee Stability and Turnover in Home-Based Early Intervention

Unusually high turnover rates in early intervention programs will contribute significantly to the documented shortage of qualified personnel needed for the successful implementation of PL 99-457, forcing policy makers to consider options for maximizing the retention of personnel presently in the field. This study was conducted to provide an initial indication of the extent of turnover among early childhood interventionists working in a statewide network of home-based early intervention programs. Results indicated that the mean length of service of staff was increasing (2.5 years in 1985; 3.5 years in 1988) whereas the mean length of service of related therapists and specialists employed as consultants was decreasing (2.9 years, 1985; 2.2 years, 1988). The findings also revealed that 49% of staff and 38% of consultants remained employed over a 2.7 year period, while 68% of directors of programs remained during the same period. The results of the study are compared to turnover rates and length of service for various related settings described in the literature, and implications for further research are discussed.

Training pediatric residents in early intervention with handicapped children.

Pediatric residents gained experience in the management of disabled children in a four-session training component that linked the residency program and a school- and home-based early intervention program. Each resident worked with a disabled child's parents, a special education teacher, therapists, and others. The training emphasized working with parents and special education professionals to solve problems in the management of handicapped children and working with appropriate community agencies. The residents completed a questionnaire before and after the training that measured their perceptions of their knowledge and skill in several areas. At the completion of the rotation, they also rated their satisfaction with the training program. The results of these evaluations suggest that such a program is an effective method for introducing pediatric residents to issues concerning interventions with handicapped infants.

Lack of effects for home-based early intervention? Some possible explanations.

A review of research on home-based early intervention programs suggests that statistical evidence in support of program effects is lacking. Methodological problems, inadequacies in causal modeling, and limitations inherent in the intervention approach are examined.

Early Intervention Program for Adolescent Mothers and Their Infants

ABSTRACT The effectiveness of a home-based early intervention program for children of adolescent mothers was examined in comparison to a control group who received no such intervention. Intellectual assessment at 2 1/2 years of age suggested that the early intervention program can promote developmental functioning and lessen the risk of cognitive delays. Behavioral analysis suggested that the patterns of adolescent mothers' interaction with their children varied as a function of both involvement in the intervention program and the child's risk status, as defined by IQ scores.