Supplemental Intervention Research Articles

Treatment Considerations for Adolescents Who Exhibit Cognitive/Communication Problems: A Neuroscience Perspective

Purpose Adolescence is a period of substantial neurophysiological and behavioral growth, representing a second sensitive period of brain development. It is a psychological and social transition period between childhood and adulthood with many beneficial changes occurring, especially with respect to potential responsiveness to clinical intervention. However, adolescent behavioral complexities introduce clinical challenges as well. The purpose of this review article is to review the current neuroimaging research on neurophysiological changes observed during adolescence and the cognitive and social behavioral counterparts, with specific attention to the clinical implications. The review article will then summarize currently available intervention tools that can be utilized by speech-language pathologists working with this population. It will conclude with available evidence-based social-communication approaches that may be applicable as well as available evidence-based supplemental technological cognitive interventions that may be useful in working with adolescents who exhibit language and communication issues. Conclusion As a transition period between childhood and adulthood, adolescence represents a second sensitive period during which there is opportunity for clinically derived beneficial cognitive and communication growth.

Rupture of a Previously Undiagnosed Anterior Communicating Artery Aneurysm following External Lumbar Drainage in a Patient with Normal Pressure Hydrocephalus: A Case Report

Background and importance: Both asymptomatic unruptured intracranial aneurysms (AUIA) and idiopathic normal pressure hydrocephalus (NPH) have been found in the elderly population to increase in incidence with advancing age. In NPH, external lumbar drainage (ELD) is a gold standard and widely accepted low-risk procedure for supplemental testing of CSF responsiveness and suitability for surgical intervention. Herein, we reported the first case of aneurysmal subarachnoid haemorrhage (SAH) as a cause of neurological decline following ELD for the testing of patients with NPH. Clinical Presentation: A 65-year-old gentleman with probable NPH was admitted for supplemental testing using ELD. He had demonstrated CSF responsiveness as evidenced by improving Tinetti score. Unfortunately, on the third day of post-insertion, his GCS deteriorated from 15 to 3 due to rupture of a previously undiagnosed anterior communicating artery (Acom) aneurysm. He underwent left frontal external ventricular drain in an emergency setting and his GCS improved to E1VtM4. After frank discussion with his family, we proceeded with craniotomy and clipping of the aneurysm. However, his neurological recovery remained poor post-operatively and he had eventually undergone tracheostomy and ventriculo-peritoneal shunt. Conclusion: As SAH is also a known trigger of secondary NPH, there may be a critical role for screening of AUIA prior to ELD for NPH. The characterization of this risk would then allow for a full discussion of surgical or endovascular treatment options for AUIA, as well as the risk-benefit ratio of proceeding with supplemental testing and intervention for NPH.

The Effects of Tier 2 Mathematics Interventions for Students With Mathematics Difficulties: A Meta-Analysis

This meta-analysis examined the effectiveness of supplemental Tier-2 mathematics interventions for students with mathematics difficulties (MD). We reviewed 39 experimental and quasi-experimental studies that included 40 independent samples, with 61 treatment groups. Utilizing robust variance estimation (RVE), results revealed a treatment effect of 0.41. Mixed-effects meta-regression analyses revealed that Tier-2 interventions were moderated by intervention model type, group size, and type of measure. We present recommendations for future research and implementation of mathematics practices.

Cross Linguistic Transfer of Literacy Skills between English and French among Grade 1 Students Attending French Immersion Programs

ABSTRACT This study explored the impact of a supplemental reading intervention delivered in English in Grade 1 on the performance of at-risk children educated in French Immersion schools. The intervention contrasted “Direct Mapping and Set-for-Variability” with a “Common and Best Practices” taught control condition in a matched quasi-experimental design. To test claims of cross-linguistic transfer, measures of English and French word reading were administered before and after intervention. Hierarchical linear modeling analyses confirmed that children in the intervention condition showed improved performance at posttest on measures of English and French regular, exception, and pseudoword reading compared to the control condition. Intervention-specific cross language effects on French word and pseudoword reading shown here provide partial support for causal models of transfer in bilingual reading development.

Design, Development, and Initial Testing of Asset-Based Intervention Grounded in Trajectories of Student Fraction Learning

One of the most persistent areas of difficulty in mathematics for children with learning disabilities (LDs) and difficulties is fractions. We report the development and initial testing of an intervention designed to increase access to and advancement in conceptual understanding. Our asset-based theory of change—a tested and confirmed learning trajectory of fraction concepts of students with LDs grounded in student-centered instruction—served as the basis for our multistage scientific design process. We report on foundational (i.e., a theory of change, establishment and refinement of learning trajectories, and core instructional components) and evaluative (pilot data on student outcomes) components of the intervention. The results of the study reveal positive effects of the program’s fidelity and potential to improve student outcomes in school settings. The positive outcomes support continued exploration and expansion of a new framework for supplemental intervention grounded in trajectories of student learning.

Physical Therapy Management of Children With Developmental Coordination Disorder: An Evidence-Based Clinical Practice Guideline From the Academy of Pediatric Physical Therapy of the American Physical Therapy Association.

Developmental coordination disorder (DCD), classified as a neurodevelopmental disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), affects approximately 5% to 6% of school-aged children. Characteristics of DCD include poor motor coordination and delayed development of motor skills, not explained by other conditions. Motor deficits negatively affect school productivity, performance in activities of daily living, and recreation participation. Children with coordination problems, at risk for or diagnosed with DCD, should be evaluated by a team of professionals, including a physical therapist (PT). This clinical practice guideline (CPG) provides management strategies for PTs and informs clinicians and families about DCD. It links 13 action statements with specific levels of evidence through critical appraisal of the literature and provides recommendations for implementation. The DCD CPG addresses examination, referral, first choice and supplemental interventions, discharge, compliance audits, implementation, and research recommendations. Supplemental tools are provided to support PT management.

Leveraging Interdisciplinary Teams to Develop and Implement Secure Websites for Behavioral Research: Applied Tutorial.

Behavioral researchers are increasingly using interactive digital platforms, either as standalone or supplementary intervention tools, to facilitate positive changes in research participants’ health habits. Research-oriented interactive websites optimally offer a variety of participatory mediums, such as blogs, user-driven content, or health activities. Owing to the multidirectional features of interactive websites, and a corresponding need to protect research participants’ identity and data, it is paramount that researchers design ethical platforms that ensure privacy and minimize loss of anonymity and confidentiality. Authentication (ie, digital verification of one’s identity) of interactive sites is one viable solution to these concerns. Although previous publications have addressed ethical requirements related to authenticated platforms, few applied guidelines in the literature facilitate adherence to ethical principles and legally compliant study protocols during all phases of research website creation (feasibility, design, implementation, and maintenance). Notably, to remain compliant with ethical standards and study protocols, behavioral researchers must collaborate with interdisciplinary teams to ensure that the authenticated site remains secure and usable in all stages of the project. In this tutorial, we present a case study conducted at a large research university. Through iterative and practical recommendations, we detail lessons learned from collaborations with the Institutional Review Board, legal experts, and information technology teams. Although the intricacies of our applied tutorial may require adaptations based on each institution’s technological capacity, we are confident that the core takeaways are universal and thus useful to behavioral researchers creating ethically responsible and compliant interactive websites.

Associations of early-life exposure to famine with abdominal fat accumulation are independent of family history of diabetes and physical activity.

The present study aimed to investigate the association of early-life exposure to famine with abdominal fat accumulation and function and further evaluate the influence of first-degree family history of diabetes and physical activity on this association. The present work analysed parts of the REACTION study. A total of 3033 women were enrolled. Central obesity was defined as waist circumferences (W) ≥ 85 cm. Chinese visceral adiposity index (CVAI) was used to evaluate visceral adipose distribution and function. Partial correlation analysis showed BMI, W, glycated Hb and CVAI were associated with early-life exposure to famine (both P < 0·05). Logistic regression showed that the risks of overall overweight/obesity and central obesity in fetal, early-childhood, mid-childhood and late-childhood exposed subgroups were increased significantly (all P < 0·05). Compared with the non-exposed group, the BMI, W and CVAI of fetal, early- to late-childhood exposed subgroups were significantly increased both in those with or without first-degree family history of diabetes and in those classified as physically active or inactive, respectively (all P < 0·05). The associations of BMI, W and CVAI with early-life exposure to famine were independent of their associations with first-degree family history of diabetes (all P < 0·01) or physical activity status (all P < 0·001). Early-life exposure to famine contributed to abdominal fat accumulation and dysfunction, which was independent of the influence of genetic background and exercise habits. Physical activity could serve as a supplementary intervention for women with high risk of central obesity.

Effects of a Supplemental Spanish Phonological Awareness Intervention on Latinx Preschoolers' Dual Language Emergent Literacy Skills.

Purpose Preschoolers' phonological awareness (PA) and alphabet knowledge (AK) skills are two of the strongest predictors of future reading. Despite evidence that providing at-risk preschoolers with timely emergent literacy interventions can prevent academic difficulties, there is a scarcity of research focusing on Latinx preschoolers who are dual language learners. Despite evidence of benefits of providing Latinxs with Spanish emergent literacy instruction, few studies include preschoolers. This study examined the effects of a supplemental Spanish PA and AK intervention on the dual emergent literacy skills of at-risk Latinx preschoolers. Method A multiple probe design across four units of instruction evaluated the effects of a Spanish supplemental emergent literacy intervention that explicitly facilitated generalizations to English. Four Latinx preschoolers with limited emergent literacy skills in Spanish and English participated in this study. Bilingual researchers delivered scripted lessons targeting PA and AK skills in individual or small groups for 12-17 weeks. Results Children made large gains as each PA skill was introduced into intervention and generalized the PA skills they learned from Spanish to English. They also improved their English initial sound identification skills, a phonemic awareness task, when instruction was delivered in Spanish but with English words. Children made small to moderate gains in their Spanish letter naming and letter-sound correspondence skills and in generalizing this knowledge to English. Conclusion These findings provide preliminary evidence Latinx preschoolers who are dual language learners benefit from emergent literacy instruction that promotes their bilingual and biliterate development.

SNAP-Ed Policy, Systems, and Environmental Interventions and Caregivers’ Dietary Behaviors

ObjectiveTo examine dietary behaviors and diet quality among caregivers of children regarding the number of policy, systems, and environmental (PSE) change interventions implemented in their neighborhoods. MethodsHouseholds with incomes ≤185% of the federal poverty level were randomly sampled throughout California. A validated 24-h dietary recall assessment tool was administered by telephone. The independent variable was the number of Supplemental Nutrition Assistance Program Education PSE change interventions per census tract where the caregivers lived. ResultsMost (69.1%) of the 2,222 caregivers were Latino. Policy, systems, and environmental reach predicted decreased intake of sugar-sweetened beverages (P = 0.022, Cohen d = −0.12) and added sugar (P = 0.014, Cohen d = −0.18), and increased Healthy Eating Index–2015 scores (P = 0.046, Cohen d = 0.18), regardless of race and/or ethnicity, age, or reach of Supplemental Nutrition Assistance Program Education direct education. Conclusions and ImplicationsReplication of these methods and findings, and comparisons of dietary outcomes in association with PSE change interventions with and without direct education activities aimed at the same population under study, are encouraged.

Supplemental reading interventions implemented by paraprofessionals: A meta‐analysis

AbstractPreventative and intensive reading intervention can be administered to at‐risk students in a systematic way to help facilitate gains on literacy outcomes. Despite this fact, there are clear barriers to implementation. One solution may be to use paraprofessionals to provide supplemental reading instruction. This study employed meta‐analytic procedures to address two questions: (a) what is the overall effectiveness of paraprofessionals as implementers of reading interventions? and (b) in which areas are paraprofessionals most effective? A literature search of research from 2001 to 2017 yielded 76 studies. Nine studies meeting a priori inclusion criteria were coded for demographic information and six common reading outcomes. The mean ES across outcomes was 0.55, and spelling and decoding emerged as areas to inform future research. Although these meta‐analytic findings must be interpreted with caution due to issues of sample size and heterogeneity of variance, involving paraprofessionals as reading interventionists appears to be a highly promising strategy.

A Comparison of the Armeo to Tabletop-assisted Therapy Exercises as Supplemental Interventions in Acute Stroke Rehabilitation: A Randomized Single Blind Study.

To evaluate the feasibility of an additional therapeutic upper limb exercise (ULE) intervention in early phase post-stroke rehabilitation and to assess outcomes of therapy using the Armeo Spring (ARMEO) versus Therapist-assisted Table Top (TAT) interventions. Randomized, single-blind trial. Stroke acute inpatient rehabilitation unit. Forty-five participants early after first stroke, Fugl-Meyer Assessment (FMA) score >8, Modified Ashworth score (MAS) of <3. Participants were randomized to TAT or ARMEO ULE in addition to the required 3 hours of 1:1 standard of care provided in an inpatient rehabilitation facility (IRF). Completed number of treatments; withdrawals; serious/adverse events; Functional Independence Measure (FIM) motor; FIM efficiency; FMA; MAS; elbow active (A) and passive (P) range of motion (ROM); and therapist effort measured by the Modified Borg Rating of Perceived Exertion Scale (RPE). Post-intervention FIM and FMA scores increased but did not demonstrate any statistically significant differences between the intervention groups (P = .585, .962, partial n2 = .001, .001, respectively). There were no statistically significant differences in post-intervention MAS elbow flexion and extension (P = .332, .252, partial n2 = .009, .007, respectively) and A/P ROM elbow extension between training groups (P = .841, .731, partial n2 = .001, .003, respectively). There was a statistically significant difference in post-intervention A/P ROM elbow flexion between groups (P = .031, .018, partial n2 = .123, .146). Post-intervention RPE did not show any statistically significant differences between the training groups (P = .128, partial n2 = .063). Total elbow range showed larger adjusted mean gains for the ARMEO. No serious adverse events were reported. This study demonstrates that additional therapeutic ULE in the early phase of post-stroke inpatient rehabilitation is feasible and that both interventions showed positive changes in selected outcomes.

Evidence supporting the enhanced efficacy of pentavalent antimonials with adjuvant therapy for cutaneous leishmaniasis: a systematic review and meta-analysis.

Cutaneous leishmaniasis (CL) is one of the major neglected disease worldwide. Although many drugs have been used, the pentavalent antimonials (PA) remain as the first-line choice despite their toxicity and limited efficacy. The combination of two drugs has risen as a potential alternative to increase the cure rate while lowering the side-effects caused by pentavalent antimonials (PA). The objective of this study was to critically review and appraise the potential synergism of the adjuvant therapies of PA with other drugs/interventions previously used in the literature. We carried out a search of literature from PubMed, MEDLINE, Embase, Cochrane and clinicaltrials.gov. Articles that described a two-arm or three-arm design in which one of the arms consisted in a combination of a drug/intervention with intralesional or systemic PA were selected. The primary outcome was proportion of complete clearance of the lesions defined as complete re-epithelization and/or negative direct smear. Our literature search identified 554 references. Thirty-one records with a total sample size of 2668 participants met the eligibility criteria. The studies investigated the association of PA with the following: cryotherapy (five studies), allopurinol, imiquimod, pentoxifylline (four studies each), trichloroacetic acid 50% (three studies) and other additional interventions (eleven studies). Overall, the combined therapy of PA with a supplementary intervention was superior to PA monotherapy (RR: 1.23 95% CI: 1.11-1.35, I2 =64%). In association with PA, the comparator-specific stratified analysis showed that cryotherapy (RR: 1.50 95% CI: 1.25-1.81, I2 =57%) and allopurinol (RR: 1.70 95% CI: 1.37-2.12, I2 =28%) were superior to PA in monotherapy. On the contrary, the combined therapy with imiquimod (RR: 1.08 95% CI: 0.88-1.32, I2 =40%) and pentoxifylline (RR: 1.14 95% CI: 0.94-1.40, I2 =41%) revealed a non-significant result. The application of TCA along with PA did not show significant differences in the clearance rate, although it was close to it (RR: 1.31 95% CI: 0.99-1.73, I2 =84%). The present work represents an attempt to find new and reliable treatment modalities to enhance the efficacy based on the adjuvant therapy of pre-existing drugs/interventions with PA. According to our results, the combination of allopurinol-PA is the most effective adjuvant therapy. The application of cryotherapy and TCA stand as useful and encouraging supplementary interventions. The combination of imiquimod-PA and pentoxifylline adds no additional benefit. The results of this work may be helpful in devising and modifying the current guidelines for CL which face major remaining evidence gaps. Triple therapies consisting in cryotherapy-PA-TCA or allopurinol-PA-cryotherapy or allopurinol-PA-TCA can represent promising treatments yet to be confirmed in future trials.

Patterns of human exposure to malaria vectors in Zanzibar and implications for malaria elimination efforts

BackgroundZanzibar provides a good case study for malaria elimination. The islands have experienced a dramatic reduction in malaria burden since the introduction of effective vector control interventions and case management. Malaria prevalence has now been maintained below 1% for the past decade and the islands can feasibly aim for elimination.MethodsTo better understand factors that may contribute to remaining low-level malaria transmission in Zanzibar, layered human behavioural and entomological research was conducted between December 2016 and December 2017 in 135 randomly selected households across six administrative wards. The study included: (1) household surveys, (2) structured household observations of nighttime activity and sleeping patterns, and (3) paired indoor and outdoor mosquito collections. Entomological and human behavioural data were integrated to provide weighted estimates of exposure to vector bites, accounting for proportions of people indoors or outdoors, and protected by insecticide-treated nets (ITNs) each hour of the night.ResultsOverall, 92% of female Anopheles mosquitoes were caught in the rainy season compared to 8% in the dry season and 72% were caught outdoors compared to 28% indoors. For individual ITN users, ITNs prevented an estimated two-thirds (66%) of exposure to vector bites and nearly three quarters (73%) of residual exposure was estimated to occur outdoors. Based on observed levels of ITN use in the study sites, the population-wide mean personal protection provided by ITNs was 42%.Discussion/conclusionsThis study identified gaps in malaria prevention in Zanzibar with results directly applicable for improving ongoing programme activities. While overall biting risk was low, the most notable finding was that current levels of ITN use are estimated to prevent less than half of exposure to malaria vector bites. Variation in ITN use across sites and seasons suggests that additional gains could be made through targeted social and behaviour change interventions. However, even for ITN users, gaps in protection remain, with a majority of exposure to vector bites occurring outdoors before going to sleep. Supplemental interventions targeting outdoor exposure to malaria vectors, and groups that may be at increased risk of exposure to malaria vectors, should be explored.

Making the Most of Tier 2 Intervention: What Decisions Are Made in Successful Studies?

Implementation of Tier 2 or supplemental reading intervention for students who struggle with reading in elementary schools is a nearly universal practice in the United States. Resources exist for assisting schools with selecting evidence-based interventions. However, there are many more explicit and implicit decisions that schools make when implementing evidence-based intervention that may or may not impact the effectiveness of the intervention. In this literature synthesis, we aggregate the decisions made in effective Tier 2 reading interventions to help students improve their reading skills. These decisions include identifying which students would most benefit from specific interventions, how long to schedule intervention time, how to schedule staffing, the types of professional learning supports needed, and decisions based on progress monitoring.

The Importance of Growth in Oral Reading Fluency to Predict Performance on High-Stakes Assessments among Students Receiving Supplemental Intervention

Educators and researchers measure student improvement in words read correct per minute (WRCM) to evaluate student response to reading interventions. The utility of evaluating improvement in WRCM via curriculum-based measures to make instructional decisions is based upon the assumption that growth in WRCM is predictive of performance on meaningful distal outcomes (e.g., state achievement tests). This study explored the relative value of measuring growth in WRCM to predict performance on an end of year state achievement test after controlling for baseline performance. We used quantile regression to analyze outcomes from 449 grade three students receiving tier II reading interventions to measure the relationship between growth in WRCM and performance on an end of year test across different levels of performance on that test. Results suggest that growth in WRCM is a meaningful predictor of performance on the end of year test after statistically controlling for baseline performance amongst students that perform better on that test (> 50th percentile). However, the amount of explained variance was consistently small (< 5%). Progress monitoring measures that more closely resemble the criterion of interest may be worth exploring for students that have made the transition from fluency to comprehension, while measures targeting lower order skills may be warranted for students with persistent fluency deficits.

Typical Rates of Regression After Exiting Supplemental Interventions in Reading

Once students meet exit criteria and Tier 2 reading supports are removed, many do not maintain their current progress and fail to meet future performance benchmarks. Although estimates of average growth during intervention exist, typical rates of growth after supports are removed are relatively unknown. In this research brief, we used segmented regression to quantify differences between students’ reading fluency progress during intervention and postintervention. Participants were second and third grade students, from 16 schools, who were receiving Tier 2 reading interventions targeting oral reading fluency. Once students met exit criteria, their progress was monitored weekly for the rest of the school year. The average rate of improvement was 3.50 words read correct in 1 minute (WRCM) per week (SD = 1.65) during the intervention and 0.09 WRCM (SD = 1.63) after exiting the intervention. Students who met exit criteria during the fall semester (i.e., fast responders) displayed significantly (p < .001) higher growth during the intervention (M = 4.32) compared to students who exited during the spring semester (i.e., slow responders; M = 2.69). Moreover, the average rate of postintervention growth was significantly (p < .001) higher for fast responders (M = 0.54) compared to slow responders (M = −0.35 WRCM improvement per week).

Impact of Different Mass Drug Administration Strategies for Gaining and Sustaining Control of Schistosoma mansoni and Schistosoma haematobium Infection in Africa.

.This report summarizes the design and outcomes of randomized controlled operational research trials performed by the Bill & Melinda Gates Foundation–funded Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) from 2009 to 2019. Their goal was to define the effectiveness and test the limitations of current WHO-recommended schistosomiasis control protocols by performing large-scale pragmatic trials to compare the impact of different schedules and coverage regimens of praziquantel mass drug administration (MDA). Although there were limitations to study designs and performance, analysis of their primary outcomes confirmed that all tested regimens of praziquantel MDA significantly reduced local Schistosoma infection prevalence and intensity among school-age children. Secondary analysis suggested that outcomes in locations receiving four annual rounds of MDA were better than those in communities that had treatment holiday years, in which no praziquantel MDA was given. Statistical significance of differences was obscured by a wider-than-expected variation in community-level responses to MDA, defining a persistent hot spot obstacle to MDA success. No MDA schedule led to elimination of infection, even in those communities that started at low prevalence of infection, and it is likely that programs aiming for elimination of transmission will need to add supplemental interventions (e.g., snail control, improvement in water, sanitation and hygiene, and behavior change interventions) to achieve that next stage of control. Recommendations for future implementation research, including exploration of the value of earlier program impact assessment combined with intensification of intervention in hot spot locations, are discussed.

Plasma and Nail Zinc Concentrations, But Not Hair Zinc, Respond Positively to Two Different Forms of Preventive Zinc Supplementation in Young Laotian Children: a Randomized Controlled Trial

Plasma zinc concentrations (PZC) have been shown to significantly increase during zinc supplementation. This study investigated the effects of daily preventive zinc supplementation on hair and nail zinc concentrations compared with a control group. In a randomized controlled trial, 6- to 23-month-old children (n = 3407) in Lao PDR were randomly assigned to one of four groups and followed for ~ 36 weeks: daily preventive zinc dispersible tablet (7 mg/d; PZ), daily micronutrient powder (10 mg zinc/d; MNP), therapeutic zinc supplements for diarrhea treatment (20 mg/d for 10 days; TZ), or daily placebo powder (Control). Plasma, hair, and nail zinc concentrations were assessed in a sub-sample of participants (n = 457) at baseline and endline. At baseline, 75% of children had low PZC (< 65 μg/dL). At endline, geometric mean (95% CI) PZC were greater in the PZ and MNP groups compared with the TZ and control groups (P < 0.01), but hair zinc concentrations did not differ among groups (P = 0.99). Nail zinc concentrations were marginally higher in the PZ (115.8 (111.6, 119.9) μg/g) and the MNP (117.8 (113.3, 122.3) μg/g) groups than in the TZ group (110.4 (106.0, 114.8) μg/g; P = 0.055) at endline. This study does not support the use of hair zinc as a biomarker of zinc exposure in young children. However, it provides some evidence that zinc concentrations in nails may respond to supplemental zinc interventions and supports the need for collecting additional data on this emerging biomarker.

Elimination of diurnally sub-periodic Wuchereria bancrofti in Andaman and Nicobar Islands, India, using mass DEC-fortified salt as a supplementary intervention to MDA.

Feasibility of implementing a DEC-fortified (DEC at 0.2% w/w and iodine) salt strategy to hasten elimination of diurnally sub-periodic Wuchereria bancrofti (DspWB) from the lone foci in Nancowry islands, Nicobar district, India, was assessed. This is a two-arm community-based study: one arm (12 villages, population 2936) received double fortified salt along with annual mass drug administration (MDA) of DEC plus albendazole (DEC-salt+MDA-arm), and another (14 villages; population 4840) received MDA under the National Filaria Elimination Programme. DEC salt was distributed on camp mode supplemented by door delivery. Monthly survey was carried out in fixed and random households to assess the coverage, usage of DEC salt and DEC content. The impact on prevalence of mf at community level and antigenaemia among children was assessed. A total of 21metric tonnes of free-flow DEC salt manufactured by Tamil Nadu Salt Corporation, India, was distributed for 1year. In the DEC-salt+MDA-arm, > 90% of the households received and used the DEC salt. DEC was within therapeutic range (0.2-0.32% w/w) in the samples collected from kitchens. Community mf prevalence reduced from 2.27 to 0.14% in the DEC-salt-arm (< 1% in all the villages) and 1.26 to 0.74% (> 1% in 4 out of 14 villages) in the MDA-arm. Ag prevalence reduced to zero from 1.0 (DEC-salt+MDA-arm) and 6.3% (MDA-arm) in 2-3years old, 1.2 and 3.6% from 2.9 in the DEC-salt-arm and 4.5% in the MDA-arm among 6-7years old. It was feasible to deliver DEC-fortified salt covering > 90% of the households with compliance reaching the elimination target in the islands.