Implementation of Early Intervention Protocol in Australia for ‘High Risk’ Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care

This review discusses early diagnostics and early intervention in developmental disorders in the light of brain development. The best instruments for early detection of cerebral palsy (CP) with or without intellectual disability are neonatal magnetic resonance imaging, general movements assessment at 2–4 months and from 2–4 months onwards, the Hammersmith Infant Neurological Examination and Standardized Infant NeuroDevelopmental Assessment. Early detection of autism spectrum disorders (ASD) is difficult; its first signs emerge at the end of the first year. Prediction with the Modified Checklist for Autism in Toddlers and Infant Toddler Checklist is possible to some extent and improves during the second year, especially in children at familial risk of ASD. Thus, prediction improves substantially when transient brain structures have been replaced by permanent circuitries. At around 3 months the cortical subplate has dissolved in primary motor and sensory cortices; around 12 months the cortical subplate in prefrontal and parieto-temporal cortices and cerebellar external granular layer have disappeared. This review stresses that families are pivotal in early intervention. It summarizes evidence on the effectiveness of early intervention in medically fragile neonates, infants at low to moderate risk, infants with or at high risk of CP and with or at high risk of ASD.

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Early intervention for infants at high risk for cerebral palsy: evidently important, but where’s the evidence?

Developmental Medicine & Child Neurology ◽

10.1111/dmcn.14875 ◽

2021 ◽

Author(s):

Anna Purna Basu

Keyword(s):

Cerebral Palsy ◽

Early Intervention ◽

High Risk

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What can we learn from offspring studies in bipolar disorder?

BJPsych Advances ◽

10.1192/apt.bp.114.013086 ◽

2016 ◽

Vol 22 (3) ◽

pp. 176-185 ◽

Cited By ~ 4

Author(s):

Josephine Loftus ◽

Bruno Etain ◽

Jan Scott

Keyword(s):

Risk Factors ◽

Bipolar Disorder ◽

Early Intervention ◽

High Risk ◽

Secondary Prevention ◽

Environmental Risk ◽

Clinical Characteristics ◽

Intervention Strategies ◽

Prevention Programmes ◽

Methodological Approaches

SummaryWe offer a contemporary review of studies of the offspring of parents with bipolar disorder and explore the clinical characteristics of these populations. We discuss how different methodological approaches may influence study findings and may explain some of the heterogeneity in the results reported. We also highlight some of the environmental risk factors that may increase the likelihood of transition from an ‘at-risk’ or high-risk state to bipolar disorder. Last, we briefly discuss the implications of study findings for early intervention strategies and comment on such issues as genetic counselling and primary and early secondary prevention programmes.

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Decision-Making in the Scheduling of Endovascular Treatment after Brain Arteriovenous Malformation Haemorrhage: A Retrospective Single Centre Study

The Neuroradiology Journal ◽

10.1177/197140091102400609 ◽

2011 ◽

Vol 24 (6) ◽

pp. 879-885 ◽

Cited By ~ 2

Author(s):

J.J. Downer ◽

M. Cellerini ◽

R.A. Corkill ◽

S. Lalloo ◽

W. Küker ◽

...

Keyword(s):

Early Intervention ◽

High Risk ◽

Arteriovenous Malformation ◽

Endovascular Treatment ◽

Complication Rate ◽

Injury Severity ◽

Endovascular Intervention ◽

Brain Arteriovenous Malformation ◽

Single Centre ◽

Significant Difference

The appropriate timing for endovascular intervention after brain arteriovenous malformation (bAVM) rupture is not known. This paper aims to determine factors that lead to early endovascular intervention and to investigate whether early intervention has the same complication rate as late intervention in a single centre. All patients who underwent endovascular treatment for a ruptured bAVM at our institution in the period January 2007 and July 2010 were included in this retrospective observational study. Of 50 patients, 33 had early endovascular intervention, defined as within 30 days of haemorrhage and the remaining 17 patients had endovascular treatment at day 30 or beyond. A greater proportion of patients treated within the first 30 days were in neurointensive care preoperatively (51.5% vs. 23.5%, p=0.07). A ‘high-risk’ angioarchitectural feature was identified in more patients who had acute intervention (78.8% vs. 11.8%, p<0.0001) and targeted embolization was also more frequent in this group (48.5% vs. 5.9%, p=0.004). Nidal aneurysms, venous varices and impaired venous outflow (venous stenosis) were the principal ‘high risk’ features. Clinically apparent complications occurred in 10.8% of procedures with permanent neurological deficit in 3.6%. There was no directly procedure-related mortality. There was no statistically significant difference in the complication rate of early procedures compared with delayed interventions (12.5% vs. 7.4%, p=0.71). Greater initial injury severity and the presence of high-risk lesion characteristics are the factors that lead to early endovascular intervention. Early intervention is associated with a higher complication rate, but this difference is not statistically significant.

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High-Risk Children Referred to an Early-Intervention Developmental Program

Clinical Pediatrics ◽

10.1177/000992289503401202 ◽

1995 ◽

Vol 34 (12) ◽

pp. 635-641 ◽

Cited By ~ 5

Author(s):

Lee Ann Britain ◽

Grace E. Holmes ◽

Ruth S. Hassanein

Keyword(s):

Early Intervention ◽

High Risk ◽

Developmental Program ◽

High Risk Children

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Programma 2000: Celebrating 10 Years of Activity of an Italian Pilot Programme on Early Intervention in Psychosis

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670802512032 ◽

2008 ◽

Vol 42 (12) ◽

pp. 1003-1012 ◽

Cited By ~ 39

Author(s):

Angelo Cocchi ◽

Anna Meneghelli ◽

Antonio Preti

Keyword(s):

Early Intervention ◽

High Risk ◽

Rating Scale ◽

Young Patients ◽

Skills Training ◽

First Episode ◽

Global Functioning ◽

Adult Intelligence Scale ◽

Cognitive Behavioural ◽

Early Intervention In Psychosis

Objective: This paper describes the structure and the organization of the single Italian programme specifically targeted at the early detection of and interventions for subjects at onset of or at high risk of psychosis, Programma 2000. Methods: Programma 2000 is a comprehensive multi-modal protocol of early intervention in psychosis, set up in Milan in 1999. The service has been very active since its opening, and at the time of writing (spring (April) 2008), more than 300 young patients have been evaluated through a detailed protocol that embraces Health of the Nation Outcome Scale (HoNOS), Brief Psychiatric Rating Scale (BPRS), Cognitive Behavioural Assessment 2.0, Disability Assessment Schedule, Camberwell Family Interview, Wechsler Adult Intelligence Scale and the Early Recognition Inventory Retrospective Assessment of Symptoms. The treatment includes psychoeducation, cognitive behavioural therapy (CBT), both structured and unstructured psychosocial interventions and pharmacotherapy, when necessary. Results: The programme focuses on young people aged 17–30 years: to date, a total of 132 subjects with definite psychosis or within the high-risk category have been enrolled in treatment after assessment. Patients with first-episode psychosis were, on average and expectedly, more severe than those in the at-risk group, and were more likely to be prescribed antipsychotic drugs. A large majority of patients in both groups received tailored CBT; individual sessions of skills training were provided to two-thirds of patients. In both groups, improvement was found in both the BPRS and HoNOS, and in the level of global functioning as assessed on Global Assessment of Functioning at 6 month and 1 year follow up. Global functioning was more sensitive to change than symptom severity, reflecting the intensive and personalized efforts to improve social and role functioning in patients. Conclusions: Programma 2000 is still in development but it has already gained the support of therapists and other relevant people involved in the life of subjects at onset, or at high risk of psychosis.

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