Evaluation of an Early Start Denver Model-based intervention for young children with autism in an inclusive preschool setting.

<p>Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by difficulties in social communication and the presence of restricted or repetitive behaviours or interests. There is evidence to suggest that early intervention (EI) can lead to improved outcomes for children with ASD. Inclusive preschool-based delivery of EI appears to satisfy current legal and best-practice recommendations around the delivery of EI for young children with ASD. It may also offer several potential benefits including cost-effectiveness, efficiency and opportunities for children with ASD to learn from their peers. The Early Start Denver Model (ESDM) is a promising naturalistic behavioural developmental intervention for young children with ASD aged between 12 and 60 months. The ESDM can be delivered to children in a group-based format and several studies have demonstrated its effectiveness when delivered for 15 to 25 hours per week in designated ESDM preschools with low child–teacher ratios. However, the preschools involved in these studies may not be representative of the typical preschool setting for many communities. Thus, more research is needed to determine the effectiveness of this intervention when delivered under conditions that more closely reflect the typical real-world preschool setting. In the present thesis, two studies with multiple probe across participants designs, each involving three preschool children with ASD, examined the feasibility and effectiveness of the use of the ESDM in an inclusive preschool setting. Specifically, Study 1 evaluated the effectiveness of a modified version of ESDM therapy delivered by a certified therapist and Study 2 evaluated (a) the effectiveness of a brief ESDM coaching programme, and (b) the effectiveness of a modified version of ESDM therapy delivered by preschool teachers. For both studies, the intervention was delivered in regular community preschools and no major changes were made to the typical preschool environments or routines. Effectiveness was assessed by measuring improvements in child active participation, vocal/verbal communication and imitation, and, for Study 2, teachers’ fidelity of implementation of ESDM techniques. Teachers’ perceptions of the acceptability and effectiveness of the intervention were also assessed via a questionnaire and in-depth interviews. In Study 1, an outside certified therapist delivered 3 hours per week of ESDM to three children with ASD over an 8- to 10-week period. Participants showed improvement in active participation, imitation and either intentional vocalisations or spontaneous functional utterances. These results were generally maintained at follow-up. For Study 2, a brief coaching programme was used to train three preschool teachers to use the ESDM with a child with ASD who attended the inclusive preschools where they worked. Teachers improved in their use of the ESDM strategies and children demonstrated improved levels of active participation but results for child imitation and communication were mixed. Teachers also found the intervention to be acceptable and effective. Together, the results from these studies provide preliminary support for the feasibility and effectiveness of the ESDM when delivered in real-world inclusive preschool settings. More research is needed to determine the most effective approach to delivering EI for ASD in an inclusive preschool setting. It may also be valuable to evaluate the extent to which gains made by children and teachers during intervention generalise to other people and/or settings.</p>

Evaluation of an Early Start Denver Model-based intervention for young children with autism in an inclusive preschool setting.

<p>Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by difficulties in social communication and the presence of restricted or repetitive behaviours or interests. There is evidence to suggest that early intervention (EI) can lead to improved outcomes for children with ASD. Inclusive preschool-based delivery of EI appears to satisfy current legal and best-practice recommendations around the delivery of EI for young children with ASD. It may also offer several potential benefits including cost-effectiveness, efficiency and opportunities for children with ASD to learn from their peers. The Early Start Denver Model (ESDM) is a promising naturalistic behavioural developmental intervention for young children with ASD aged between 12 and 60 months. The ESDM can be delivered to children in a group-based format and several studies have demonstrated its effectiveness when delivered for 15 to 25 hours per week in designated ESDM preschools with low child–teacher ratios. However, the preschools involved in these studies may not be representative of the typical preschool setting for many communities. Thus, more research is needed to determine the effectiveness of this intervention when delivered under conditions that more closely reflect the typical real-world preschool setting. In the present thesis, two studies with multiple probe across participants designs, each involving three preschool children with ASD, examined the feasibility and effectiveness of the use of the ESDM in an inclusive preschool setting. Specifically, Study 1 evaluated the effectiveness of a modified version of ESDM therapy delivered by a certified therapist and Study 2 evaluated (a) the effectiveness of a brief ESDM coaching programme, and (b) the effectiveness of a modified version of ESDM therapy delivered by preschool teachers. For both studies, the intervention was delivered in regular community preschools and no major changes were made to the typical preschool environments or routines. Effectiveness was assessed by measuring improvements in child active participation, vocal/verbal communication and imitation, and, for Study 2, teachers’ fidelity of implementation of ESDM techniques. Teachers’ perceptions of the acceptability and effectiveness of the intervention were also assessed via a questionnaire and in-depth interviews. In Study 1, an outside certified therapist delivered 3 hours per week of ESDM to three children with ASD over an 8- to 10-week period. Participants showed improvement in active participation, imitation and either intentional vocalisations or spontaneous functional utterances. These results were generally maintained at follow-up. For Study 2, a brief coaching programme was used to train three preschool teachers to use the ESDM with a child with ASD who attended the inclusive preschools where they worked. Teachers improved in their use of the ESDM strategies and children demonstrated improved levels of active participation but results for child imitation and communication were mixed. Teachers also found the intervention to be acceptable and effective. Together, the results from these studies provide preliminary support for the feasibility and effectiveness of the ESDM when delivered in real-world inclusive preschool settings. More research is needed to determine the most effective approach to delivering EI for ASD in an inclusive preschool setting. It may also be valuable to evaluate the extent to which gains made by children and teachers during intervention generalise to other people and/or settings.</p>

Moving Towards Greater Inclusion in Singapore’s Preschools: The Enablers, Possibilities and Barriers

Inclusive education is the next item on the agenda of policy makers in Singapore, in its striving to provide quality education for all children. The move to introducing more inclusive practices in preschools has not been easy. There are many structural obstacles in Singapore’s current preschool context. This review of existing literature on this topic reveals how policymakers, schools, teachers, and parents need to work together to create a successful inclusive education system. There is much that Singapore must work on to develop a successful inclusive preschool education model. The paper aims to provide an understanding of how inclusion in preschools can be more effectively practiced in Singapore by considering the current dual education system in Singapore and the recent measures introduced to improve inclusive preschool education. It examines how effective these measures and recommendations in existing literature will be when placed in Singapore’s current education system which prioritizes academic excellence. In doing so, this paper hopes to highlight the critical issues that policymakers and key stakeholders should consider when planning for inclusive practices in Singapore’s preschools.

Teacher-Implemented AAC Intervention to Support Peer Interaction in an Inclusive Preschool Classroom: A Pilot Study

Children with complex communication needs confront many barriers to peer interaction and, without intervention, are at risk for social isolation, even in inclusive classrooms. The aims of this pilot study were to determine the feasibility of training a preschool teacher to implement a peer interaction intervention and to measure the impact on the participating children. The teacher in this study was taught to program an augmentative and alternative communication (AAC) app and to implement a peer interaction intervention. The teacher's positive perception of the training and intervention, along with the social improvements seen in this pilot study are promising. More research is needed to increase confidence in the effectiveness of this training to support teacher-implemented intervention and peer interaction in inclusive classrooms.

The inclusive preschool classroom : perspectives of the early childhood teacher

This study explored through naturalistic inquiry three early childhood teacher's perceptions of inclusion and in-class practices in the inclusive preschool classroom. Interviews and in-class observations were used for the purpose of data collection. A social constructivist lens was used to analyze the data. Drawing from a social model of inclusion and theory of attribution framework, the results revealed that inclusion is multifaceted. An understanding and commitment to the ideology of inclusion must occur in conjunction with inclusive in-class strategies and techniques to create successful inclusive programs. This study suggests recommendations for change must be made at the government level, the post-secondary education level and at the community level. These reforms need to be made collaboratively to ensure that all stakeholders have a common understanding and vision for inclusion.

The inclusive preschool classroom : perspectives of the early childhood teacher

This study explored through naturalistic inquiry three early childhood teacher's perceptions of inclusion and in-class practices in the inclusive preschool classroom. Interviews and in-class observations were used for the purpose of data collection. A social constructivist lens was used to analyze the data. Drawing from a social model of inclusion and theory of attribution framework, the results revealed that inclusion is multifaceted. An understanding and commitment to the ideology of inclusion must occur in conjunction with inclusive in-class strategies and techniques to create successful inclusive programs. This study suggests recommendations for change must be made at the government level, the post-secondary education level and at the community level. These reforms need to be made collaboratively to ensure that all stakeholders have a common understanding and vision for inclusion.

Promoting Diversity and Belonging: Preschool Staff’s Perspective on Inclusive Factors in the Swedish Preschool

This article reports the Swedish results and experiences from the survey study “Educators’ perspectives of belonging in early years education,” which was part of the research project “Politics of belonging: Promoting children’s inclusion in educational settings across borders”. The purpose of the survey study was to gain knowledge about the preschool staff’s perspective on factors and pedagogical approaches that promote diversity and belonging. The research questions and study instruments were co-produced by researchers from Finland, Iceland, Norway, the Netherlands and Sweden. This Swedish part reports the answers from 180 respondents/staff from preschools. The experiences and the way the results are analysed and discussed are entirely from the investigation conducted in Sweden. The results show that the staff’s work environment, values and working methods are important for an inclusive programme. Preschool children are a source of strength for building a sense of belonging for all children, and increased confidence in their ability provides better conditions for creating an inclusive preschool; that is, giving children more influence and trust promotes the sense of belonging. In addition to these results, the survey has provided important methodological experience and initiated a discussion on how the contact between academia and preschool programmes can be improved.