Provider perspectives and reach of an evidence-based intervention in community services for toddlers

Autism ◽  
2022 ◽  
pp. 136236132110655
Author(s):  
Sarah R Rieth ◽  
Kelsey S Dickson ◽  
Jordan Ko ◽  
Rachel Haine-Schlagel ◽  
Kim Gaines ◽  
...  
Keyword(s):  
Early Intervention ◽  
Young Children ◽  
Child Outcomes ◽  
Scale Up ◽  
Training Model ◽  
Evidence Based ◽  
Community Settings ◽  
Training Study ◽  
Project Impact ◽  
Daily Routines

Best-practice recommendations for young children at high likelihood of autism include active involvement of caregivers in intervention. However, the use of evidence-based parent-mediated interventions in community practice remains limited. Preliminary evidence suggests that Project ImPACT for Toddlers demonstrates positive parent and child outcomes in community settings. Project ImPACT for Toddlers was adapted specifically for toddlers and teaches parents of young children strategies to build their child’s social, communication, and play skills in daily routines. This study reports implementation outcomes from the initial community rollout of Project ImPACT for Toddlers and examines the system-wide intervention reach, with the goal of informing continued community sustainment and scale-up. Participants include 38 community providers who participated in a Project ImPACT for Toddlers’ training study who completed an implementation survey and semi-structured interviews after approximately 3 months of community implementation. Participants perceived the training model as acceptable and appropriate, and identified several strengths of the approach. Interview themes also supported the feasibility, acceptability, and utility of the intervention in community settings. Quantitative findings complemented the thematic results from interviews. Intervention reach data indicate an increasing number of agencies delivering and families receiving Project ImPACT for Toddlers. Efforts to scale-up evidence-based interventions in early intervention should continue to build upon the model of the Bond, Regulate, Interact, Develop, Guide, and Engage Collaborative. Lay abstract Expert recommendations for toddlers who are likely to develop autism include caregivers being actively involved in the services children receive. However, many services available in the community may not follow these recommendations. Evidence suggests that an intervention named Project ImPACT for Toddlers demonstrates positive parent and child outcomes for families in the community. Project ImPACT for Toddlers was designed specifically for toddlers by a group of parents, clinicians, researchers, and funders. It teaches parents of young children strategies to support their child’s development in daily routines. This study reports the perspectives of early intervention providers who learned to use Project ImPACT for Toddlers on whether the intervention was a good fit for their practice and easy to use. The study also examines how many agencies are using Project ImPACT for Toddlers and how many families have received the intervention in the community. The goal of the study is to inform the continued use of Project ImPACT for Toddlers in the community and support offering the intervention in other regions. Participants include 38 community providers who participated in a training study of Project ImPACT for Toddlers and completed a survey and semi-structured interview after approximately 3 months of using Project ImPACT for Toddlers with families. Participants perceived the training model as acceptable and appropriate, and identified the group-based model of training, comprehensive materials, and agency support as strengths of the approach. Survey findings complemented the results from the interviews. Data indicate an increasing number of agencies and families accessing Project ImPACT for Toddlers. Efforts to expand evidence-based intervention in early intervention should continue to build upon the model used for Project ImPACT for Toddlers.

Abstract A024: Planning for scale-up of an evidence-based intervention in community settings: Project HEAL insights from the SPRINT Initiative

2020 ◽  
Author(s):  
Laundette P. Jones ◽  
Jimmie L. Slade ◽  
Felicia Davenport ◽  
Sherie Lou Z. Santos ◽  
Cheryl L. Holt
Keyword(s):  
Scale Up ◽  
Evidence Based ◽  
Community Settings ◽  
Project Heal

scholarly journals Utilization of telemedicine to support caregivers of young children with ASD and their Part C service providers: a comparison of intervention outcomes across three models of service delivery

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Laura L. Corona ◽  
J. Alacia Stainbrook ◽  
Kathleen Simcoe ◽  
Liliana Wagner ◽  
Bethena Fowler ◽  
...  
Keyword(s):  
Early Intervention ◽  
Young Children ◽  
Service Delivery ◽  
Behavioral Intervention ◽  
Child Outcomes ◽  
Service Model ◽  
Part C ◽  
Part C Early Intervention ◽  
Models Of Service Delivery ◽  
Brief Behavioral Intervention

Abstract Background Families of young children with autism spectrum disorder (ASD) frequently experience barriers to accessing evidence-based early intervention services. Telemedicine presents an opportunity to increase access to these services, particularly for families in rural and under-resourced areas. The present article describes a brief behavioral intervention and support model for families of young children with concerns for ASD. In the context of the COVID-19 pandemic, this service model shifted to telemedicine-only service delivery, resulting in an opportunity to analyze intervention outcomes from services delivered either via traditional in-person visits, telemedicine-only sessions, or a hybrid model including both in-person and telemedicine sessions. Methods Data are presented for 115 families with toddlers 16-33 months of age who participated in a six-session behavioral intervention and support service model either in-person, through telemedicine, or through a hybrid service model. This intervention was available for families referred for ASD evaluation through the state Part C early intervention program. Intervention feasibility, fidelity of implementation, child outcomes, and stakeholder satisfaction are compared across service delivery models. Results Caregivers, behavioral consultants, and Part C early intervention providers reported satisfaction with services, regardless of service delivery model. Caregivers and consultants also reported positive child outcomes. Statistically significant differences emerged for caregiver- and consultant-reported child outcomes in some domains, with stakeholders in the telemedicine-only group reporting slightly less improvement, compared to stakeholders in the in-person-only group. Caregivers and consultants in the telemedicine-only group also provided qualitative feedback on benefits and challenges related to telemedicine services. Conclusions Both caregivers and behavioral consultants reported positive outcomes following a brief behavioral intervention and support model targeted at families of young children with concern for ASD. Stakeholders reported improvement in child behavior and satisfaction with services across in-person, telemedicine-only, and hybrid models of service delivery. These results suggest that telemedicine presents a promising opportunity for increasing service access. Additional research is needed to continue optimizing the experience of telemedicine-based service delivery for both families and intervention providers.

scholarly journals Assessing the effectiveness of training models for national scale-up of an evidence-based nutrition and physical activity intervention: a group randomized trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rebekka M. Lee ◽  
Jessica L. Barrett ◽  
James G. Daly ◽  
Rebecca S. Mozaffarian ◽  
Catherine M. Giles ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Trial ◽  
Primary Outcome ◽  
Scale Up ◽  
Implementation Strategies ◽  
Training Model ◽  
Evidence Based ◽  
Training Models ◽  
Group Randomized Trial ◽  
Nutrition And Physical Activity

Abstract Background There is a great need to identify implementation strategies to successfully scale-up public health interventions in order to achieve their intended population impact. The Out-of-school Nutrition and Physical Activity group-randomized trial previously demonstrated improvements in children’s vigorous physical activity and the healthfulness of foods and beverages consumed. This implementation study aimed to assess the effects and costs of two training models to scale-up this evidence-based intervention. Methods A 3-arm group-randomized trial was conducted to compare effectiveness of in-person and online training models for scaling up the intervention compared to controls. One-third of sites were randomized to the in-person train-the-trainer model: local YMCA facilitators attended a training session and then conducted three learning collaborative meetings and technical assistance. One-third were assigned to the online model, consisting of self-paced monthly learning modules, videos, quizzes, and facilitated discussion boards. Remaining sites served as controls. Fifty-three afterschool sites from three YMCA Associations in different regions of the country completed baseline and follow-up observations using a validated tool of afterschool nutrition and physical activity practices. We used multivariable regression models, accounting for clustering of observations, to assess intervention effects on an aggregate afterschool practice primary outcome, and conducted secondary analyses of nine intervention goals (e.g. serving water). Cost data were collected to determine the resources to implement each training model. Results Changes in the primary outcome indicate that, on average, sites in the in-person arm achieved 0.44 additional goals compared to controls (95%CI 0.02, 0.86, p = 0.04). Increases in the number of additional goals achieved in sites in the online arm were not significantly greater than control sites (+ 0.28, 95% CI -0.18, 0.73, p = 0.24). Goal-specific improvements were observed for increasing water offered in the in-person arm and fruits and vegetables offered in the online arm. The cost per person trained was $678 for the in-person training model and $336 for the on-line training model. Conclusions This pilot trial presents promising findings on implementation strategies for scale-up. It validated the in-person training model as an effective approach. The less expensive online training may be a useful option for geographically disbursed sites where in-person training is challenging. Trial registration Although this study does not report the results of a health care intervention on human subjects, it is a randomized trial and was therefore retrospectively registered in ClinicalTrials.gov on July 4, 2019 in accordance with the BMC guidelines to ensure the complete publication of all results (NCT04009304).

scholarly journals Evaluation of low-intensity therapy and parent training for young children with autism based on the early start Denver model

2021 ◽  
Author(s):  
◽  
Hannah Waddington
Keyword(s):  
Early Intervention ◽  
Young Children ◽  
Parent Training ◽  
Child Outcomes ◽  
Autism Spectrum ◽  
Behavioural Intervention ◽  
Early Start ◽  
Early Start Denver Model ◽  
Low Intensity ◽  
Children With Asd

<p>Autism spectrum disorder (ASD) is a pervasive developmental disorder that is characterised by deficits in social communication and restricted and repetitive behaviours, interests and activities. Recent developments in identification techniques mean that many children can be reliably diagnosed with ASD before the age of 2. Early identification creates the opportunity for early intervention. In fact, some research suggests that the earlier a child with ASD receives intervention, the greater the progress he or she is likely to make. Naturalistic developmental behavioural interventions are a relatively recent method of early intervention for children with ASD, which combine elements of previous intervention approaches (behavioural, naturalistic behavioural, and developmental/relationship-focused intervention). One such naturalistic developmental behavioural intervention is the early start Denver model (ESDM), which is designed for children with or at risk for ASD between the ages of 12 and 60 months (5 years). Research suggests that ESDM intervention may improve a range of child outcomes when delivered for at least 15 hours per week over at least 10 months. However, many families may not be able to access or afford such intensive intervention. Therefore, the two studies in this thesis evaluated the effectiveness of two ESDM delivery approaches that required relatively few hours of professional input per week. Specifically, low-intensity therapist delivered ESDM intervention, and ESDM parent training.  Study 1 used a multiple probe across participants design to evaluate the effectiveness of 3 hours per week of home-based ESDM therapy for 12 weeks for improving imitation, communication, and engagement for four young children with ASD. It also examined whether children showed increases in these outcomes with their mothers following the intervention. The results of this study suggest that, following the intervention, all four children increased their imitation skills and their engagement with the therapist. In addition three of the children had more functional utterances and one child increased his use of intentional vocalisations. These results were maintained four weeks after intervention and generalised to a lesser degree to each child’s mother. This suggests that low-intensity therapist delivered ESDM intervention may improve outcomes for children with ASD.  The results of Studies 1 and 2 suggest that both low-intensity therapist delivered ESDM intervention and ESDM parent training may be promising intervention approaches for young children with ASD. This is particularly encouraging as both approaches involved relatively few hours of professional input per week. In theory, this could increase the number of families who are able to access such intervention. More research is needed to identify the most effective low-intensity ESDM intervention method, or combination of methods.</p>

Update on Early Speech and Language Intervention for Children With Craniofacial Conditions

2016 ◽  
Vol 1 (5) ◽  
pp. 50-58
Author(s):  
Nancy J. Scherer
Keyword(s):  
Early Intervention ◽  
Young Children ◽  
Parent Training ◽  
Language Intervention ◽  
Current Evidence ◽  
Evidence Based ◽  
Speech And Language ◽  
Early Speech ◽  
Structure Parent

This article discusses the current evidence for early intervention for children with craniofacial conditions. The article describes the evidence-based intervention approaches, strategies, and parent training options to support language and speech outcomes in young children with clefts. Use of coaching to structure parent training is discussed.

scholarly journals Meta-Analysis of Studies Incorporating the Interests of Young Children with Autism Spectrum Disorders into Early Intervention Practices

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Carl J. Dunst ◽  
Carol M. Trivette ◽  
Deborah W. Hamby
Keyword(s):  
Autism Spectrum Disorders ◽  
Early Intervention ◽  
Young Children ◽  
Meta Analysis ◽  
Child Outcomes ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Young Children With Autism ◽  
Spectrum Disorders ◽  
Core Features

Incorporating the interests and preferences of young children with autism spectrum disorders into interventions to promote prosocial behavior and decrease behavior excesses has emerged as a promising practice for addressing the core features of autism. The efficacy of interest-based early intervention practices was examined in a meta-analysis of 24 studies including 78 children 2 to 6 years of age diagnosed with autism spectrum disorders. Effect size analyses of intervention versus nonintervention conditions and high-interest versus low-interest contrasts indicated that interest-based intervention practices were effective in terms of increasing prosocial and decreasing aberrant child behavior. Additionally, interest-based interventions that focused on two of the three core features of autism spectrum disorders (poor communication, poor interpersonal relationships) were found most effective in influencing child outcomes. Implications for very early intervention are discussed in terms addressing the behavior markers of autism spectrum disorders before they become firmly established.

scholarly journals Statewide policies to improve early intervention services: Promising practices and preliminary results

2020 ◽  
Vol 28 ◽  
pp. 148
Author(s):  
Miriam Kuhn ◽  
Courtney Boise ◽  
Sue Bainter ◽  
Cindy Hankey
Keyword(s):  
Professional Development ◽  
Early Intervention ◽  
Service Providers ◽  
Scale Up ◽  
Home Visits ◽  
Evidence Based ◽  
Promising Practices ◽  
Family Service ◽  
Early Intervention Services ◽  
Intervention Service

The State of Nebraska Co-Lead agencies, who are responsible for developing statewide early intervention policies, rolled out professional development for two evidence-based strategies across several pilot sites. Implications of these strategies for child/family assessment, Individualized Family Service Plan (IFSP) development, and Early Intervention service delivery were examined utilizing family (n=30) and professional interviews (n=50), and analyses of IFSPs (n=30). The results of this mixed method study indicate widespread strategy implementation with fidelity fosters early working relationships with families and enables teams to generate, using family members’ own words, a robust group of high-quality child and family IFSP outcomes. Family engagement in planning services such as identifying service providers and setting the frequency and length of home visits was limited. In addition, further professional development is needed to strengthen use of routines-based interventions during home visits and promote family-professional collaboration to monitor child/family progress. Implications for systematic scale-up of evidence-based practices as a function of state policy implementation are reported.

scholarly journals Evaluation of low-intensity therapy and parent training for young children with autism based on the early start Denver model

2021 ◽  
Author(s):  
◽  
Hannah Waddington
Keyword(s):  
Early Intervention ◽  
Young Children ◽  
Parent Training ◽  
Child Outcomes ◽  
Autism Spectrum ◽  
Behavioural Intervention ◽  
Early Start ◽  
Early Start Denver Model ◽  
Low Intensity ◽  
Children With Asd

<p>Autism spectrum disorder (ASD) is a pervasive developmental disorder that is characterised by deficits in social communication and restricted and repetitive behaviours, interests and activities. Recent developments in identification techniques mean that many children can be reliably diagnosed with ASD before the age of 2. Early identification creates the opportunity for early intervention. In fact, some research suggests that the earlier a child with ASD receives intervention, the greater the progress he or she is likely to make. Naturalistic developmental behavioural interventions are a relatively recent method of early intervention for children with ASD, which combine elements of previous intervention approaches (behavioural, naturalistic behavioural, and developmental/relationship-focused intervention). One such naturalistic developmental behavioural intervention is the early start Denver model (ESDM), which is designed for children with or at risk for ASD between the ages of 12 and 60 months (5 years). Research suggests that ESDM intervention may improve a range of child outcomes when delivered for at least 15 hours per week over at least 10 months. However, many families may not be able to access or afford such intensive intervention. Therefore, the two studies in this thesis evaluated the effectiveness of two ESDM delivery approaches that required relatively few hours of professional input per week. Specifically, low-intensity therapist delivered ESDM intervention, and ESDM parent training.  Study 1 used a multiple probe across participants design to evaluate the effectiveness of 3 hours per week of home-based ESDM therapy for 12 weeks for improving imitation, communication, and engagement for four young children with ASD. It also examined whether children showed increases in these outcomes with their mothers following the intervention. The results of this study suggest that, following the intervention, all four children increased their imitation skills and their engagement with the therapist. In addition three of the children had more functional utterances and one child increased his use of intentional vocalisations. These results were maintained four weeks after intervention and generalised to a lesser degree to each child’s mother. This suggests that low-intensity therapist delivered ESDM intervention may improve outcomes for children with ASD.  The results of Studies 1 and 2 suggest that both low-intensity therapist delivered ESDM intervention and ESDM parent training may be promising intervention approaches for young children with ASD. This is particularly encouraging as both approaches involved relatively few hours of professional input per week. In theory, this could increase the number of families who are able to access such intervention. More research is needed to identify the most effective low-intensity ESDM intervention method, or combination of methods.</p>

Caregiver Involvement in Early Intervention Services: Service Providers' Perspectives

Inclusion ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 31-45
Author(s):  
Moon Y. Chung ◽  
Hedda Meadan
Keyword(s):  
Early Intervention ◽  
Young Children ◽  
Communication Skills ◽  
Survey Methodology ◽  
Service Providers ◽  
Change Agents ◽  
Community Settings ◽  
Early Intervention Services ◽  
Natural Change ◽  
Caregiver Involvement

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.

From the President: Working Early-Intervention Magic in Community Settings

ASHA Leader ◽  
2013 ◽  
Vol 18 (2) ◽  
pp. 5-7 ◽  
Author(s):  
Patty Prelock
Keyword(s):  
Early Intervention ◽  
Children With Disabilities ◽  
Community Settings ◽  
The Way

Children with disabilities benefit most when professionals let families lead the way.

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