Provision Of Early Intervention Services Research Articles

발달지체 및 장애 영아 조기개입 서비스 제공에 대한 현장 전문가의 인식

This mixed methods analysis employed online surveys and semi-structured interviews to explore the perspectives of 60 early intervention service providers in South Korea regarding service delivery. This study aimed to comprehensively understand their perceptions of the barriers and facilitators in early intervention services. The online survey- consisting of 30 items related to participant characteristics, service information, and perspectives on barriers and facilitators- was conducted. Participants were intentionally categorized based on survey data, and six individuals were randomly selected for follow-up interviews to ensure a wide spectrum of perspectives. The results of the mixed-methods study indicated diverse experiences and perspectives among early intervention providers, with responses varying across each item. While there was relative consistency among respondents regarding facilitators, perspectives on barriers differed both among participants and across various variables. The significance of preservice educator preparation programs and in-service educators’ professional development opportunities in enhancing early intervention services was commonly emphasized. The study concludes with recommendations and implications aimed at enhancing the early intervention system in South Korea.

Infants entering out-of-home care: Health, developmental needs and service provision

BackgroundThere are rising numbers of infants entering out-of-home care due to child protection concerns. Research has found that infants entering care are at higher risk of developmental vulnerability and poor health problems. ObjectivesTo determine the prevalence of developmental vulnerability for children who entered care as infants, and the extent and likelihood of service provision in relation to their developmental vulnerability. Participants and settingThis study includes children who entered care before the age of 1 year for the first time between May 2010 and October 2011 in New South Wales, Australia, and who received final Children's Court care and protection orders by 30 April 2013. MethodsThis is a prospective cohort study using interview data from the Pathways of Care Longitudinal Study (POCLS) as well as linked administrative child protection and health data. This study used standardised assessments (Age and Stages Questionnaire and the Brief Infant Toddler Social Emotional Assessment) included in the POCLS. Simple and multiple logistic regression analysis was conducted to investigate the likelihood of infants receiving professional services for developmental delays since placement. FindingsA high proportion of children who entered care as infants were identified as developmentally vulnerable through health indicators (36 %) and standardised assessments (70 %). Only 17 % of infants in care received services for developmental delay, with 20 % and 15 % of those identified as developmentally vulnerable through standardised assessments and health-related variables receiving services, respectively. ConclusionsThe findings point to the importance of developmental assessment of infants in care and the identification of developmental vulnerability and delays. The provision of early intervention services is essential for this group of high-risk infants and will be important in optimising their health, as well as social and emotional outcomes.

Strengthening Early Intervention Home Visitation Quality: A Focus on Partnerships and Interactions

Early Intervention (EI) home visitation programs are central to delivering services that support infants and toddlers displaying developmental delays or disabilities and their families. Entities that oversee such programs continually seek to strengthen the quality of program practices. The Getting Ready approach is a professional development (PD) framework for partnering with families and delivering high quality routines-based home visits. Interviews were conducted with family members ( n = 22), EI service providers ( n = 12), and independent, dedicated EI service coordinators ( n = 7) and written home visit action plans from professionals’ home visits ( n = 11) were reviewed. Findings from qualitative analyses of these two data sources deepen understanding of effective family-professional partnerships, data-driven decision-making processes, and collaborative development of routines-based interventions focused on family-child interactions and the achievement of child/family IFSP outcomes.

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.

Military families with young children with disabilities: Families’ and providers’ perceptions

Active duty military families have unique life experiences that can affect individual members and also the family as a whole. While many benefits to the military lifestyle exist, previous research has described how children of active duty military families may also be more at-risk for emotional and academic difficulties as a result of parent absence, family stress or strain. For active duty military families who have children with disabilities, mobility and change can be especially stressful. However, limited research has been conducted to understand the experiences and perceptions of military families who have young children with disabilities. The purpose of this study was to explore (a) the experiences and needs of military families with young children with disabilities, and (b) the experiences and recommendations of early intervention professionals who work with young children with disabilities and their military families. Semi-structured individual interviews were conducted with six active duty military family members who have a children with disabilities, and focus groups were conducted with 12 early intervention service providers. Findings of the study include unique experiences and needs of military family members with young children with disabilities that have been highlighted in previous literature, as well as some unique findings specific to those receiving services under part of Part C of the Individuals with Disabilities Education Act.

Transitions Out of Early Intervention

This study was designed to describe the experience of families exiting the early intervention (EI) system and transitioning into early childhood special education (ECSE) programs. Eight mothers of children preparing to exit EI services completed semistructured interviews, which were transcribed and analyzed using interpretative phenomenological analysis. Four mothers answered additional post-transition interview questions. Interview participants experienced anxiety about the transition process but reported that they found EI personnel to be knowledgeable and supportive allies. Participants also described favorable outcomes related to a structured transition class. These findings indicate that the transition out of EI is associated with parental anxiety and uncertainty, which can be allayed through strong relationships with EI service providers.

The Impact of COVID-19 on Illinois Early Intervention Services.

We sought to understand the extent of the nationwide disruption to Part C Early Intervention services due to COVID-19 and the subsequent shift to telehealth, primarily through a focused examination of providers' perspectives on this disruption in a single state, which is Illinois. To examine the impact of coronavirus disease (COVID-19) on Early Intervention service provision and implementation, 385 Early Intervention Illinois providers completed a web-based survey. Archival data were used to determine changes in number of Illinois Early Intervention referrals following the pandemic onset and to compare Illinois' telehealth and stay-at-home policies to those of other states. The majority (85%) of Illinois Early Intervention providers reported a disruption in service provision during COVID-19. The number of sessions delivered and the number of children per caseload decreased significantly. Provider confidence also decreased significantly. Only 28% of providers reported high confidence with telehealth. Identified benefits of telehealth included increased accessibility and caregiver involvement, whereas limitations included perceived lack of caregiver buy-in. New Illinois Early Intervention referrals and cases were lower during COVID-19 than in the previous year. Prior to 2020, 33 states did not have a permanent reimbursement policy for providing telehealth Early Intervention services. For states with a suspension of in-person Early Intervention services due to COVID-19, time to approval for telehealth reimbursement varied (0-22 days). The shift to telehealth in Illinois resulted in decreases in service provision and provider confidence across disciplines. However, providers identified some benefits to telehealth. Telehealth may represent a means to increase Early Intervention accessibility following the pandemic. https://doi.org/10.23641/asha.19119539.

The COVID-19 Pandemic Impact on Households of Young Children With Special Healthcare Needs.

ObjectiveThis study examined how the COVID-19 pandemic differently affected households of children with versus without special healthcare needs. We compared caregivers’ and children’s emotional well-being (Aim 1), the utilization of preventive healthcare services for young children (Aim 2), and the promotive effects of social support on well-being outcomes (Aim 3) during the pandemic between the two groups.MethodsData were drawn from an ongoing, large, longitudinal, and national survey that assessed the pandemic impact on households of young children (0–5). Analyses for Aims 1 and 2 were based on 10,572 households, among which 10.96% had children with special healthcare needs. Analyses for Aim 3 were based on a subsample of 821 families, among which 12.54% had children with special healthcare needs.ResultsCaregivers of children with special healthcare needs exhibited more emotional distress and reported higher levels of household children’s behavioral problems during the pandemic. The percentages of missed preventive healthcare visits and vaccinations were also higher in families of children with special healthcare needs due to structural barriers. Lastly, emotional social support was indirectly related to children’s decreased behavioral problems through caregivers’ reduced emotional distress, only among households of children without special healthcare needs. In other words, social support alone was not sufficient in promoting caregivers’ and children’s better well-being outcomes among households of children with special healthcare needs.ConclusionsThe pandemic has caused extensive burdens on families of children with special healthcare needs. Actions from policymakers and early intervention service providers are urgently needed to mitigate these impacts.

Motor Development in Children With Autism Spectrum Disorder.

Objective: This study was conducted to determine the gross and fine motor profiles of children with autism spectrum disorder compared to typically developing children. Additionally, we also assessed if the motor delay was more pronounced with increasing age.Method: This was a retrospective study involving children aged 12–60 months of age comparing motor development in children with autism spectrum disorder with typically developing children. Their developmental profile was assessed using Schedule of Growing Skills II. Descriptive statistics was used to analyse the developmental profile between the groups.Results: ASD children had significant gross motor (6.7%) and fine motor delay (38.5%) compared to typically developing children, who did not show any delay. The motor delay in ASD children was more prominent in older children.Conclusion: It is important to assess motor development in ASD children as there is significant motor delay in these children compared to typically developing children, and the delay becomes more prominent with age. Early detection of motor delay could allow provision of early intervention services to optimize developmental outcomes.

Supporting Individuals With Autism Spectrum Disorder in Singapore

It has been reported that there is a rise in the number of individuals being diagnosed with autism spectrum disorder (ASD) in Singapore along with evolving changes in public awareness, attitudes, and levels of financial support occurring in the field in recent years. As such, this column presents the current status and issues related to the identification of individuals with ASD and the provision of early intervention services, education, and transition services for these people in Singapore. Additional needs and future recommendations are also included.

Technology of early intervention in a preventionof chilfren disability in perm region

This article is devoted to the development of early intervention in the Perm region as a measure for the prevention of child disability in the system of complex rehabilitation and habilitation of disabled people (disabled children). The article presents the level of disability among the child population in modern Russia; the theoretical and methodological foundations of the provision of early comprehensive intervention to children with special needs and their families are considered; the relevance of the development of early intervention at the federal and regional levels as a strategically significant area of modern social policy in the country, the creation of a unified system of early intervention, taking into account the characteristics of the regions of the country. The authors presented results of the study reflect the experience of organizing an early intervention service in the system of comprehensive rehabilitation and habilitation of disabled people (disabled children) in the Perm region over the past few years. The early intervention system in the Perm region is constructed at three levels. At the macro level, the activity of the region is analyzed within the framework of the implementation of the Pilot Project to develop approaches to the formation of a system of comprehensive rehabilitation and habilitation of disabled people; the specifics and content of the created mechanisms of interdepartmental interaction are disclosed; the problems and prospects of their implementation are identified, the experience of organizing early intervention as a public service is studied. At the meso-level, the structure of early intervention services created at institutions of various departmental affiliations is presented; disclosed the activities of the early intervention service, created at the departments of social service institutions of the Perm region; describes the procedure for providing early intervention services to children and their families. The provision of early intervention services to a child and his family is presented as a micro level; disclosed the content of early intervention technology in the early intervention service; describes the stages of providing early intervention services, forms and methods of work used. The prospects for the development of early assistance in social service institutions, new forms of providing early intervention services in modern conditions are determined.

Caregiver Involvement in Early Intervention Services: Service Providers' Perspectives

Abstract Communication skills are critical for young children with developmental disabilities or delays (DD) to increase their inclusion in school and community settings. Thus, many early intervention (EI) services focus on improving children's communication skills. The involvement of the caregivers, the natural change agents, in EI sessions could significantly impact the communication skills development of young children with DD. EI service providers' perspectives could be one of the factors that increase caregiver involvement. Their perspectives may work as a discernment variable through which they reject or accept the practices related to caregiver involvement, based on their beliefs (Campbell & Halbert, 2002). The purpose of this pilot study was to understand service providers' perspectives on caregiver involvement in EI services. Survey methodology was used, and 129 service providers' responses were analyzed. Overall, the service providers reported that they believed caregiver involvement in EI sessions, and, more specifically, in communication intervention, is critical. Also, service providers reported that they were trying to involve caregivers in their EI services, with some variation between subgroup characteristics. Findings from the survey data have implications related to professional development in the area of building strong partnerships between professionals and families to support children's communication and inclusion.

Technology-mediated professional development for early intervention service providers: connecting adult learning with caregiver support

ABSTRACT High quality, easily accessible professional development is needed to ensure that service providers are well-qualified to facilitate early intervention (EI) that targets caregiver learning during visits with children and families. This research evaluated a multi-component, technology-mediated inservice training course entitled, Using Adult Learning Strategies to Support Caregivers during Early Intervention Visits. This 6-week course included ongoing, embedded support and was provided for nine EI service providers. A mixed methods intervention evaluation was conducted using a within-subjects pre-post-test design to determine the effects of participation on: 1) service providers’ use of four EI adult learning strategies (e.g., reflective conversation, caregiver practice with feedback, collaborative problem-solving, and joint planning); 2) providers’ changes in knowledge about adult learning and how to apply learned strategies; and 3) providers’ perceptions of course effectiveness. Analysis of pre-post videos revealed increases in the use of caregiver practice with feedback and collaborative problem-solving strategies with participation in the course. Participants showed a statistically significant gain in knowledge, with very large effects, especially related to applying adult learning to EI service delivery. All participants rated the overall training as ‘excellent’ and strongly agreed the format was more effective than a single workshop.

Comment les services d’intervention précoce pour la psychose peuvent-ils mieux servir les migrants, les minorités ethniques et les populations autochtones ?

Objectives To synthesize the available epidemiological and clinical evidence relevant to the mental health care of migrant, ethnic minority and Indigenous populations in the context of early psychosis. Methods This study provides a narrative review of the literature on psychosis in these populations, including issues related to the provision of early intervention services for psychosis. Results Migrant status has long been reported as a significant risk factor for psychosis in many geographic contexts. This increased risk among migrants seems to persist beyond the first generation and has been found to be higher in all migrant populations, but especially for black ethnic minorities and individuals migrating from economically developing countries to developed ones. Recent evidence suggests that this higher risk is at least in part due to migrants' and minorities' cumulative exposure to social adversities, such as racial discrimination, marginalization and socio-economic disadvantage. Systemic racism affects migrant and minority populations by creating bias in diagnostic practices and aggravating treatment disparities in addition to contributing to causation of psychosis. Furthermore, migrant and ethnic minority groups are known to seek mental healthcare after longer delays, to be more frequently forcibly hospitalized, to disengage from treatment prematurely and to be less satisfied with their treatment. The consideration of social and cultural context and factors is essential to the provision of good healthcare, especially in a culturally diverse society. Furthermore, acknowledging power relationships that stem from the societal context and shape institutions and models of care is a key step towards structural competence and safety in mental healthcare. Several strategies have been proposed to make mental healthcare services and systems more culturally and structurally competent. These include the use of interpreters and cultural brokers, tailored assessments and specialised cultural interventions. However, these strategies have yet to be adopted broadly in early intervention for psychosis. Conclusion Given its emphasis on meaningful engagement and person-centered care, early intervention should integrate inclusive, structurally competent and context-informed interventions as a priority. Efforts must be made to apply knowledge from and adapt the tools of social and cultural psychiatry to the field of early intervention in psychosis. Sociocultural considerations, hitherto inconsistently applied in psychosis research and service design in Quebec, are especially relevant to the province given its distinct linguistic context, its increasing cultural diversity, and its ongoing effort to systematize and expand the delivery of early intervention services.

Collaborating across sectors to provide early intervention for Aboriginal and Torres Strait Islander children with disability and their families: a qualitative study of provider perspectives

ABSTRACTAboriginal and Torres Strait Islander children experience a higher prevalence of disability than other Australian children. Early intervention from across the health, education, and social service sectors is vital for improving outcomes, but families face lack of coordination between services. This study aimed to inform improvements in service access for families of urban-dwelling Aboriginal children with disability through exploring providers’ perceptions of factors that influenced working together across sectors. Semi-structured interviews were conducted. Data analysis was informed by the general inductive approach and the Collaborative Practice to Enhance Patient Care Outcomes framework. Twenty-four providers participated. Interprofessional collaborative practice was influenced by interdependent interactional and organizational factors. Interactional factors fit within one of two dimensions: the ability of providers to share common goals and vision within a complex cross-sector service landscape, and influence of interpersonal relationships on their sense of belonging working in a cross-cultural space. Organizational factors also fit within one of two dimensions: the influence of governance in relation to its role in coordination and unlocking the strength of schools as service settings, and the need to formalize processes for effective interprofessional communication. Interprofessional collaborative practice was managed within the context of systemic factors relating to policy and funding. These findings demonstrate the complex interplay of factors related to the cross-sector involvement of providers in early intervention service provision. Consideration of these factors is required to facilitate collaborative cross-sector responses to improve service access for Aboriginal families.Abbreviations: WHO: world health organization; ACCHS: aboriginal community controlled health service; GP: general practitioner; NDIS: national disability insurance scheme

The Cascading Coaching Model for Supporting Service Providers, Caregivers, and Children

Teaching caregivers to support their young children’s language development is recommended as an effective early language intervention, and caregiver-implemented interventions are recognized as evidence-based. However, as the natural change agents for training and coaching caregivers, early intervention (EI) service providers are in need of professional development to effectively coach caregivers to use interventions with their child. The purpose of this study was to examine the Coaching Caregivers Professional Development program (CoCare PD) in which researchers train and coach EI service providers via telepractice in caregiver coaching, a set of skills useful in nurturing partnerships with families to support caregivers’ use of evidence-based practices with their young children with disabilities. A single-case research study across four EI service providers was conducted and findings support a functional relation between training and coaching EI service providers via telepractice and providers’ use of coaching practices with families on their caseload.

Promoting Caregiver Coaching Practices Within Early Intervention: Reflection and Feedback

Family-centered practices are a hallmark of early intervention (EI). Early intervention service providers are expected to engage in practices that emphasize family strengths, promote family choice and control, and develop collaborative relationships between professionals and families. In 2014 the Division for Early Childhood of the Council for Exceptional Children released a series of revised recommended practices for the field of EI and early childhood special education. The seven topic strands include: assessment, environment, family, instruction, interaction, teaming and collaboration, and transition. This paper addresses practices under multiple topic strands including instruction and family. The purpose of this manuscript is to present strategies that: (a) encourage caregiver reflection—a critical, yet challenging, component of coaching, (b) guide service providers in providing feedback to the caregiver, and (c) enhance service providers use of self-reflection.

Parent-Provided Cognitive Opportunities and Infant Mobility During Play for Children With Motor Impairments

Abstract Date Presented 04/05/19 For infants with mild motor impairments, parent-provided cognitive opportunities during play continue to increase after mobility is achieved, in contrast to those with severe motor impairment, where cognitive opportunities decrease, as gross motor abilities remain stable. This analysis of two infants demonstrates this difference and will be confirmed in the analysis of 90 children with mild, moderate, and severe impairment. These findings have implications for early-intervention service providers. Primary Author and Speaker: Audrey Kane Additional Authors and Speakers: Stacey Dusing Contributing Authors: Emily Marcinowski, Lin-Ya Hsu

Early Intervention and Family-Centeredness in Spain: Description and Profile of Professional Practices

Despite an emphasis on family-centered practices in early intervention, the translation of this philosophy into practice is unclear. We, therefore, measured practices of 250 early intervention service providers in Spain, with the Families in Natural Environments Scale of Service Evaluation. We analyzed the “difficulty” of practices, through Rasch analysis, and reasons for the discrepancy between typical and ideal practices, through qualitative analysis. Results showed that the typical high-quality practices were working with families and demonstrating strategies, whereas the typical low-quality practices were identifying family supports and letting the family set the agenda for the home visit. Lack of training was the most frequently reported reason for the discrepancy. Rasch analyses showed that the items participants were most likely to score low were identifying family supports, addressing families’ satisfaction with routines, and letting families set the agenda for the visit.

From early intervention to elementary school: A survey of transition support practices for children with autism spectrum disorders

BackgroundEarly school transitions can be difficult for children, however, children with autism spectrum disorders (ASDs) often experience greater difficulty making the transition into school. Transition support practices, such as transition meetings, can facilitate successful school beginnings. AimsThe aim of the present study was to determine what type and amount of transition support practices early intervention (EI) service providers were implementing to support the transition to school of children with ASDs. Barriers and facilitators to transition planning were also evaluated. Methods and ProceduresSurveys were completed by program directors of 164 EI service providers across Canada. Program directors reported on transition support practices in use, as well as program level characteristics. Outcomes and ResultsOverall, Canadian EI providers reported using a high frequency of high-quality, individualized transition supports for children with ASD. Major barriers included a lack of government support and elementary school engagement. Specialized transition training and offering ASD-specific services were related to an increase in transition supports. Conclusions and ImplicationsThe present study highlights areas for improvement in transition support practice and policy. Namely, increased government support could lead to increased levels of elementary school engagement, which has important implications for children’s long- and short-term educational outcomes.