Evaluate and Intervene in Sensory Processing Disorders by Occupational Therapists in Early Intervention Teams of the North of Portugal

Background: The National Early Childhood Intervention System of Portugal is an organized set of services under the responsibility of the Ministries of Health, Labor, and Social Security and Education aimed to support children between 0 and 6 years old and their families, and its mission is to ensure Early Childhood Intervention. At present, there is no research to support the extent of the use of sensory interventions in early intervention teams of Portugal. Aims: This study aims to analyze and understand the role of occupational therapists who support children with Sensory Processing Dysfunction and their families in local Early Intervention Teams. Methods: A qualitative and descriptive research was developed using semi-structured interviews. The interviews were conducted with ten occupational therapists who have worked in Early Intervention Teams in the North of Portugal for at least one year. Results: Modulation and Praxis were the categories of Sensory Processing Dysfunction most identified. Families consider that Sensory Processing Dysfunctions interfere with children's performance in activities of daily living and playing. Early childhood educators report that Sensory Processing Dysfunctions influence the child's participation in food, playing, and in more structured and directed activities. To transfer skills, occupational therapists organize training for professionals, families, and early childhood educators. Conclusion: The importance of collaborative work between professionals and the child's family is evident, and the support they provide in the natural environment and daily routines.

Roadmaps for Reflection: Implementation Drivers to Bridge the Research-to-Practice Gap in Early Childhood Intervention

Training alone will not enable early childhood practitioners to operationalize evidence-based practices. When newly learned practices do not immediately work as intended, the temptation to return to old ways can be great. Moving an innovation from research to practice may require the use of implementation drivers. The field of implementation science informs us of the need for ongoing support during the implementation process. Implementation guides using a flow chart design may assist practitioners to implement evidence-based practices with fidelity immediately after training. This article provides a framework for developing implementation guides to move quickly from knowledge to utilization after a training occurs as well as a means to consider the usefulness of flowcharts for driving implementation efforts.

An Inclusive Early Childhood Intervention Program for Children With Disabilities: Possible Effects on Children and Nursery Teachers

Inclusive early childhood intervention provides opportunities for children with disabilities to receive education with typically developing children. The present study examined the effects of the AI-AI STEP Program, which is designed to help nursery teachers learn the methods of inclusive early childhood intervention for children with disabilities. This study involved 37 managers of 37 nursery schools in Japan, 48 nursery teachers, and 48 children with disabilities. The school managers, who had previously learned about the program through a seminar we offered, provided the nursery teachers with guidance on the program. The guidance provided to the nursery teachers consisted of combined structured explanations with a manual and on-the-job training. The program was performed for 6 months, and changes in the children's development and behavior and the school nursery teachers' self-efficacy and state-trait anxiety, were examined before and after using the program. Multivariate analysis was used to assess factors that had an effect on the children's developmental gains through the program. The developmental quotient of children significantly improved. In addition, “emotional symptoms” and “peer problems” on the Strengths and Difficulties Questionnaire subscale markedly improved. The self-efficacy of nursery teachers significantly improved, and state anxiety decreased. There was a significant relationship between the improvement of the children's development quotient and a lower development quotient at baseline. The provision of inclusive early childhood intervention using the program promoted the children's development, and improved their behavior. Furthermore, it had a positive effect on the nursery teachers.

ADHD, Self-Harm, and the Importance of Early Childhood Intervention - In Conversation with Dr. Melissa Mulraney

In this podcast, we talk to Dr. Melissa Mulraney, Senior Lecturer and co-leader of the Child Mental Health Research Centre at the Institute for Social Neuroscience in Melbourne, Australia, Honorary Research Fellow at the Murdoch Children's Research Institute in the Department of Paediatrics at the University of Melbourne, and Associate Editor of CAMH.

Prospective Randomized Observational Pilot Trial Evaluating the Effect of Information of Early Childhood Intervention on Stress Levels of Parents of Extremely Low Gestational Age Infants at the NICU

It is not known to what extent early information on early childhood intervention (ECI) by ECI professionals reduces or increases stress levels of parents having an extremely preterm infant at the neonatal intensive care unit (NICU). Using an observational pilot study, we gave information on ECI in a randomized matter to parents of an extremely low gestational age newborn (ELGAN) at the chronological age of 3–4 weeks (cases) or not (controls). After informed consent, parents judged the infants at the age of 5–7 weeks with the Parental Stressor Scales: Neonatal Intensive Care Unit [PSS: NICU test has three subscales = “Sights and Sounds” (five items), “Parental Role Alteration” (14 items), and “Look and Behave” (seven items)]. Total scales score and subscales scores were comparable between 13 cases and 13 controls over a study period of 1.5 years. Total scores were 9.32 ± 0.72 in the cases compared to 10.02 ± 0.76 in the controls, (95% CI −6.93 to 4.93). Overall, the cases scored lower in most of the items. Early information on ECI at the NICU was provided to parents with an ELGAN did not result in higher stress levels measured with the PSS: NICU. Whether early information on ECI is a strategy, which might be able to reduce parental stress levels, has to be proven in larger studies.

The Protocol for Child Monitoring Kenya - Infant/Toddler (PCM-IT) version: Construction and validation of a multiple-domain child assessment for use in Early Childhood intervention Programmes

Introduction: The integration of an informative and inclusive monitoring, evaluation and learning process which requires appropriate tools and methods is crucial to the effective implementation of early childhood interventions. Most of the child development assessment tools that have been constructed for use in sub-Saharan Africa consider the need to be affordable and feasibly administered by those with limited previous experience. These tools include the Kilifi Developmental Inventory (KDI), the A-not-B task, the Developmental Milestones Checklist, and the Profile for Socio-Emotional Development (PSED) which each use different approaches such as direct child assessment, observation, and parental reports. Whereas these tools have demonstrated good psychometric properties, each of them focusses either on only one or two child developmental domains, does not adequately measure all aspects of the different domains that are theoretically affected by a risk factor or intervention, or is not in sufficient depth. We therefore constructed a tool that combined these separate measures into one assessment schedule – the Protocol for Child Monitoring – Infant/Toddler version (PCM-IT). We subjected the combined tool to a process of pilot testing and validation to establish its psychometric properties, the feasibility of administration and acceptability.Method: The framework of five aspirations (inclusive, informative, people-centered, dynamic and interactive) that guide effective intervention delivery mechanisms was used to structure the evaluation of the PCM-IT. The piloting of the administration of the PCM-IT was based on a proof-of-concept study with a multi-arm pre-post design in Kibera and Kangemi, while the validation study was carried out in Mathare. The three areas are informal settlements in Nairobi. The results of the pilot study informed the selection of items that were included in the validation study.Results: The timed items were too difficult for the children included in the study and were therefore excluded. Overall, the PCM-IT had excellent reliability levels. Children’s raw sub-scale and overall developmental scores were normally distributed. There were weak to moderate correlations across the different domains. Speed and fluency of administration of items among the assessment team improved with practice and familiarity. The tool was perceived as providing holistic information about a child’s performance. Conclusion: The aspirations of Measurement for Change including the need for a tool development and administration process to be inclusive, informative, people-centered, and dynamic were met to a large extent. The aspiration of being interactive would be better met through an exploration of the use of the tool to engage with families to strengthen the quality of their nurturing care practices.

Psychosocial stress and the utilization of early childhood intervention services in German families with children aged 0-3 years during the COVID-19 pandemic: The CoronabaBY study (pre-print)

Objective: The CoronabaBY study investigates the perceived pandemic burden, parenting stress, child and parent mental health problems as well as the utilization of psychosocial support measures in families with children between 0-3 years.Methods: Participants were recruited and surveyed via smartphone app for this cross-sectional study. Standardized questionnaires on perceived pandemic burden, parenting stress, parental symptoms of depression and anxiety, children`s regulatory or emotional and behavioral problems and utilization of early childhood intervention services were applied. Results: N = 991 parents (Mage = 33.7 years, 94% mothers, 92% German nationals) with infants (n = 554, Mage = 5.9 months) or toddlers (n = 435, Mage = 25.9 months) participated in the first half-year of 2021. 65% of the parents perceived a high pandemic burden, approx. 40% experienced elevated parenting stress and 24% showed symptoms of depression/anxiety. Infants and toddlers did not show increased mental health problems. 71% (62%) of the stressed (strongly stressed) parents were aware of early childhood intervention services, 36% (55%) were using them in the past and 5% (13%) at the time being.Conclusions: Families with infants and toddlers experience the pandemic as highly stressful. The main challenges are increased parental affective symptoms and limited resources for childcare due to parenting stress. Staggered detrimental effects on children`s mental health might occur if the stressful conditions persist. Accessibility to early childhood intervention services should be a top priority for policy makers.