Latinx Mothers' Experiences With Linkage to Early Intervention

National monitoring surveys indicate that developmental disabilities among US children constitute a substantial public health issue. While scientific literature documents the benefits of targeted, developmental interventions, there has been less study of formal early intervention (EI) services provided through Part C of the Individuals With Disabilities Education Act. To assess the population-level utilization of the New York City EI program and estimate the association between receipt of EI services before 3 years of age and academic achievement later in childhood. This retrospective cohort study was performed within an administrative data linkage of public health and educational data systems in New York City, with records from January 1, 1994, to December 31, 2007. Participants included children born in New York City between January 1, 1994, and December 31, 1998, who attended public elementary school for third grade. Analyses were conducted from January 1, 2023, to December 31, 2024. Any use of EI services from birth through 3 years of age. The primary outcomes were standardized test scores in math and English language arts (ELA) in third grade. After propensity score matching, linear and log-binomial regression were used to estimate differences in standardized test scores and incidence ratios of meeting test-based standards, comparing individuals who did and did not receive EI services. The study population consisted of 214 370 children with records through third grade. Of the 13 022 children who had received EI services (6.1%) before 3 years of age, 8516 (65.4%) were male (mean [SD] gestational age, 37.5 [3.8] weeks). When examining third grade standardized test scores, higher absolute test scores were observed among children who received EI in ELA (estimate, 0.045; 95% CI, 0.021-0.069) and greater incidence of meeting test-based standards in both math (incidence ratio, 1.08; 95% CI, 1.06-1.10) and ELA (incidence ratio, 1.09; 95% CI, 1.07-1.12) when comparing propensity score-matched samples. Evidence of heterogeneity was observed, as individuals who required special education, those from households with lower socioeconomic status, and those born to immigrant mothers had greater test score benefits associated with EI. The findings of this cohort study suggest that EI services for children younger than 3 years with moderate to severe developmental delays or disabilities had tangible academic benefits later in childhood. Future research should investigate the implementation of EI services among individuals with different diagnoses and developmental delays to determine the most beneficial service plans for children with differing needs.

The author reflects on the importance of early psychosis intervention services. She says health decision-makers are planning to include the results of health economic analyses within resource allocation decisions. She refers to a study which showed that early intervention services may save about 14,000 British pounds per patient to the mental health sector. She notes that economic evaluations of early intervention for other mental health problems are also found to be cost-effective.

Congenital hearing loss affects one to three of every 1,000 live born infants and negatively impacts children through delayed speech, language, social, and emotional development when undetected. To address this public health issue, jurisdiction-based Early Hearing Detection and Intervention (EHDI) programs are working to ensure all newborns are screened for hearing loss, receive follow-up diagnostic testing (DX) if they do not pass the screening, and are enrolled in early intervention (EI) services if diagnosed with a permanent hearing loss. Although substantial progress has been made in the provision and documentation of services, challenges remain because, unlike screening results, diagnostic test results and enrollment in EI are not consistently reported to the EHDI programs. Therefore, it is difficult for states and territories to know if infants received recommended follow-up services (diagnostic testing and/or EI services), often resulting in infants being classified at either stage as lost to follow-up (LFU)/lost to documentation (LTD). To assess progress toward identifying children with hearing loss and reducing LFU/LTD for DX (LFU/LTD-DX) and EI enrollment (LFU/LTD-EI), CDC analyzed EHDI surveillance data for 2006-2012. Results indicated that the number of jurisdictions reporting data increased from 49 to 57, rates of screening increased from 95.2% to 96.6%, rates of referral from screening decreased from 2.3% to 1.6%, rates of diagnosis among infants not passing their final screening increased from 4.8% to 10.3%, and enrollment in EI among children diagnosed with hearing loss increased from 55.4% to 61.7%, whereas rates for both LFU/LTD-DX and LFU/LTD-EI declined. These findings show sustained progress toward screening, identification, and enrollment in EI as well as highlighting the need for continued improvements in the provision and documentation of EHDI services.

<h3>Context</h3> New York City Health + Hospitals (NYC H+H), a large urban safety-net hospital system, launched an Early Childhood Community Health Worker (EC CHW) program in 2021 to facilitate referrals to Early Intervention (EI) and address other social needs impacting families of pediatric patients. <h3>Objective</h3> Evaluate the EC CHW program implementation and outcomes using mixed methods. <h3>Study Design and Analysis</h3> Qualitative data included interviews with program staff at 5 facilities, program leadership, and caregivers of pediatric patients. Interview transcripts were analyzed using rapid qualitative methods. Quantitative primary data collection and analysis included a pre/post survey (baseline, 3 months) with caregivers of pediatric patients. Secondary quantitative data included NYS Medicaid claims to analyze program effects on children. Matching methods based on child and maternal characteristics identified a comparison group of pediatric patients who received care at similar NYC safety-net providers (n=18,158) that was compared to families in the program (n=7,516). <h3>Setting or Dataset</h3> NYC H+H pediatric primary care facilities. <h3>Population Studied</h3> EC CHW program staff and leadership; pediatric patients and their caregivers. <h3>Intervention/Instrument</h3> An EC CHW program. <h3>Outcome Measures</h3> Pre/post caregiver surveys assessed self-reported health, parenting self-efficacy, engagement with child’s healthcare, social needs, and clinic/program satisfaction. Analysis of mother-child dyads assessed impact of the program on use of EI evaluation and services one year after enrollment. <h3>Results</h3> Qualitative interviews identified key facilitators and barriers to effective program implementation. We found significant increases in caregiver engagement with their child’s healthcare as well as parenting self-efficacy, and high satisfaction with pediatric clinics and the program. Medicaid claims analyses showed that children in the program were 15.7 percentage points (pp) more likely to have an EI evaluation and 9.7 pp more likely to receive EI services than children in the comparison group. <h3>Conclusions</h3> The EC CHW program was successfully implemented across NYC H+H pediatric primary care facilities, was well received by families, and resulted in families receiving EI evaluation and services at a higher rate compared to pediatric patients seen at similar NYC safety-net providers. Our findings can inform the development, implementation, and sustainability of similar programs.

The American Academy of Pediatrics (AAP) has called for a universal system of developmental screening and surveillance to enhance early detection and intervention for children. While the need and potential impact of universal screening is well documented, recent reports show that screening rates have not reached expected goals and gaps remain in terms of effective follow-up and referral to early intervention (EI) services. Few studies have explored parent and child experiences of developmental screening, which would aid researchers, practitioners and policymakers in improving early detection and referral to EI. The purpose of this qualitative study was to understand the experiences of caregivers and children who received developmental screening across different service sectors, including the type of screening received, location of screening, experiences during the screening process and the follow-up interventions received following screening. Individual interviews were conducted with 31 caregivers. A descriptive qualitative design allowed for the exploration of caregiver experiences with developmental screening. Thematic analysis was utilized to categorize caregiver reflections prior to, during and following developmental screening events. Analysis revealed five themes that described caregivers' experiences with screening and assessment for their child: (1) parent's goals of screening; (2) screening preparation and support; (3) parent/child response to screening; (4) result reporting and follow-up; (5) overall satisfaction with screening process. Each theme was composed of several subthemes. Caregivers see the importance of developmental screening, caregivers and children respond well to screening delivered by various providers in multiple settings and caregivers find the information gleaned from screening events important in planning for their child's developmental trajectory. Key places where improvements can be made to further bolster parental engagement and satisfaction include screening preparation and follow-up.

You have accessThe ASHA LeaderPolicy Analysis1 Jul 2009State Laws Improve Hearing Screening Follow-Up Rend Al-MondhiryJD Rend Al-Mondhiry Google Scholar More articles by this author , JD https://doi.org/10.1044/leader.PA2.14092009.9 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Recently enacted state legislation in Kentucky and Iowa will increase the number of infants who receive follow-up diagnostic assessments and early intervention services after failing a newborn hearing screening. The new laws reflect a growing nationwide trend to implement Phase II initiatives in early hearing detection and intervention (EHDI). The successful Phase I effort to mandate newborn hearing screening in all hospitals and birthing centers raised the number of newborns screened from 38% in 2000 to 96% in 2009. Phase II extends that effort with initiatives that improve tracking and surveillance to reduce the number of cases lost to follow-up; address privacy concerns associated with the exchange of health-related information; provide comprehensive coverage of early intervention and amplification devices; and promote an unbiased, family-centered approach to help parents make the best early intervention choice for their child. Nationally, 46% of the infants born in 2006 did not complete follow-up after a failed newborn hearing screening and are considered “lost to follow-up” or “lost to documentation.” The new laws will help ensure that newborns and infants with hearing loss receive needed audiological and early intervention services and will help reduce the number of infants lost to follow-up by strengthening the requirements for reporting hearing screening results and diagnostic assessments. Kentucky The Kentucky law requires the Kentucky Commission for Children with Special Health Care Needs to establish standards for infant audiological assessment and diagnostic centers based on national standards, including those established by ASHA and the Joint Committee on Infant Hearing (JCIH). The law includes new reporting requirements: Diagnostic centers must provide data to the commission within 48 hours regarding children ages birth to 3 who are newly identified with permanent hearing loss and also must refer those children to the state’s early intervention system. In addition, if a newborn fails a hearing screening, the hospital or birthing center must forward the screening report to the child’s primary care provider, the child’s parent(s), the commission, and an audiological assessment and diagnostic center, if follow-up is needed. (Previously the law did not require the report to be sent to a diagnostic center.) Finally, the law also expands the definition of “infant at risk for late-onset, progressive hearing loss, or both”; the expanded definition will help identify more infants who have a higher-than-normal risk of becoming deaf or hard of hearing, and who should therefore be monitored for hearing loss. Iowa In Iowa, the new law requires a hospital, birthing center, or person performing a hearing screening to report the results or screening status to the primary care provider of the infant upon discharge from a hospital or birthing facility, not to just the infant’s parents, as previously required. The information must now include, in addition to existing reporting requirements, information about the primary care provider, any known risk indicators for hearing loss, and other information specified by the Iowa Department of Public Health. An audiologist who conducts diagnostic audiological assessments of newborns and infants will now be required to do so in accordance with the department’s standards; the audiologist’s report to the department must now include the assessment results and any known risk indicators. Strengthened Requirements With mandates to report hearing screening and diagnostic assessment data, states are helping to ensure that all newborn infants are screened and that those with hearing loss—or at risk for later-onset hearing loss—are identified as early as possible and receive appropriate follow-up services. The new laws in Kentucky and Iowa reflect a growing trend to strengthen reporting and documentation requirements and improve all aspects of EHDI, such as enrollment in early intervention services and mandated coverage of hearing aids by insurance providers. Other aspects of EHDI, however, remain in need of improvement, such as the availability of culturally competent family resources, information for parents of children with hearing loss, and use of computerized data management systems to record, track, and monitor hearing health throughout childhood. ASHA is continuing to work with state associations and EHDI professionals nationwide to advance and implement Phase II objectives. ASHA plans to update the model bill in the near future to incorporate the next phase of its EHDI campaign: promoting lifetime screening. ASHA will focus on the importance of continued hearing screening at 12–18 months, pre-kindergarten, and elementary school. For more information on EHDI, including Phase II state model legislation and talking points, state laws, and federal information, go to ASHA’s Early Hearing Detection & Intervention Action Center. Author Notes Rend Al-Mondhiry, JD, director of state legislative and regulatory advocacy, can be reached at [email protected] or 800-498-2071, ext. 5665. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 14Issue 9July 2009 Get Permissions Add to your Mendeley library History Published in print: Jul 1, 2009 Metrics Downloaded 70 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2009 American Speech-Language-Hearing AssociationLoading ...

Any attempt to reconstruct early psychological intervention services after traumatic events must include a consideration of how hospitals might provide this essential service. Many of the injuries for which patients seek hospital care result from events (e.g., assault, motor vehicle collisions, other accidents) that may be experienced as life threatening and may elicit significant emotional distress. Other medical stressors (e.g. life-threatening illness, myocardial infarction, bums, inva sive procedures) may also exact a serious psychological toll. In short, hospitals are full of patients whose experiences can be conceptualized as psychological trauma, making this setting a vital ‘capture site’ for those at risk for a broad range of trauma-related psychosocial problems. In this chapter, we specifically focus on traumatic injury as an example of a traumatic medical stressor for which early intervention may be efficacious. We discuss the negative outcomes associated with traumatic injury, note limitations of psychosocial care in most emergency medical settings and propose a model of hospital-based early intervention services following traumatic events.

Objectives: Achieving optimal outcomes in deaf children’s communication skills depends on the availability of early specialized high-quality intervention services. Early intervention services through teletechnology could respond to this need. The development of teletechnology has led to the creation of new formats for family-centered services. Such measures could address the hearing, speech, and language needs of young deaf children. This study aimed to investigate the effects of teleintervention for providing early interventions to the families of newborns and deaf children. Methods: This was a quasi-experimental study with a pre-test/post-test and a control group design. In total, 30 deaf children aged 0-2 years, and their parents were selected by purposive sampling method. Then, they were randomly assigned to the experimental and control groups. The experimental group received the teleintervention program through the internet in 36 individual and group sessions (24 group sessions &amp; 12 individual sessions). The control group received the same intervention program directly at the rehabilitation centers for deaf children. To investigate the hearing and pre-verbal skills, the Preverbal Communication Skills Scale and the Listening Skills Scale were used. The obtained data were analyzed using Analysis of Covariance (ANCOVA). Results: The provided teleintervention program was effective in increasing the scores of hearing and pre-verbal skills in the studied samples. The intensity of the effect on hearing and pre-verbal skills were 0.57 and 0.28, respectively. Discussion: The present study demonstrated the effect of teleintervention program on hearing and pre-verbal skills in the explored subjects. It also indicated that the provided teleintervention was more effective than direct intervention. Therefore, implementing this program is recommended for therapists, the parents of deaf children, and rehabilitation centers for this population.

There is a significant risk of negative outcomes for families when a parent experiences serious mental illness. Family-focused practice (FFP) emphasises the "whole family" as the unit of care and has been found to improve outcomes for service users and their families. Despite its benefits, FFP is not routinely implemented in UK adult mental health services. This study explores adult mental health practitioners' experiences and views of FFP within Early Intervention Psychosis Services in the UK. Sixteen adult mental health practitioners employed in three Early Intervention Psychosis teams in the Northwest of England were interviewed. Interview data were analysed using thematic analysis. Five core themes were generated: (1) A limited understanding of FFP, (2) Our practitioners, (3) Our approach, (4) Our families and (5) Our services. Practitioners' understanding of FFP was limited and typically excluded dependent children. Practitioners' age, professional and personal experience, and preconceptions of families influenced delivery, and in turn, the engagement approach they adopted impacted families' responsiveness. The diversity and dynamics of service user families such as age, socioeconomic status, culture and stigma impacted FFP. An operational context characterised by insufficient resources reduced FFP; however, organisational structures such as leadership, clinical supervision and multi-disciplinary teams facilitated FFP. FFP is not yet embedded within Early Intervention Services. Practice recommendations include agreeing on a formal definition of FFP and its scope; the development of FFP policy; clarity in relation to staff responsibilities and identities; the adoption of a collaborative approach which encourages service user choice and for time to be ring-fenced to prioritise FFP. Future research should ascertain service user and family views on the facilitators and barriers to engaging with FFP in Early Intervention Services.

Social functioning in patients with first-episode psychosis

&#x0D; High quality early intervention is a crucial component of supportive and inclusive early childhood education and care (ECEC) and crucial for children with autism spectrum disorder (ASD). For children with ASD, there is limited access to ECEC services and there is little research or writing on the importance of bridging even conversations between the fields of ECEC and special education needs. This paper addresses the importance of starting a conversation by delineating current literature on ASD and early intervention services while making recommendations for how practitioners and policy-makers can consider the needs of young children with ASD in ECEC programming, bringing together clinicians and educators in ECEC settings into broader and closer collaborations. Through investigating current wide-scale reports on ASD in ECEC and inclusive settings, screening, early intervention, and evidence-based interventions, as well as the specific needs of parents of children with ASD, we seek to bring such essential discussions to the forefront. In turn, practitioners can provide supportive early-years environments for children with ASD, as well as early intervention and identification services that support inclusive practices.&#x0D;

In 2004, the American Academy of Pediatrics (AAP) Board of Directors formed the Task Force on Mental Health and charged it with developing strategies to improve the quality of child and adolescent mental health* services in primary care. The task force acknowledged early in its deliberations that enhancing the mental health care that pediatricians and other primary care clinicians† provide to children and adolescents will require systemic interventions at the national, state, and community levels to improve the financing of mental health care and access to mental health specialty resources. Systemic strategies toward achieving these improvements are the subject of other publications of the task force: “ Strategies for System Change in Children's Mental Health: A Chapter Action Kit ” (chapter action kit),1 “Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration,”2 and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community.”3 The task force also recognized that enhanced mental health practice will require competencies not currently achieved by many primary care clinicians; in the policy statement “The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care,”4 the task force collaborated with the AAP Committee on Psychosocial Aspects of Child and Family Health to outline these competencies and propose strategies for achieving them. This report offers strategies for preparing the primary care practice itself for provision of enhanced mental health care services. The task force proposes incrementally applying chronic care principles to the care of children with mental health and substance abuse problems as primary care clinicians apply them to the care of children with chronic medical conditions such as asthma. Most primary care clinicians will find that significant gaps exist between their current practice and the proposed ideal. The task force offers guidance in … Address correspondence to Jane Meschan Foy, MD, Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. E-mail: jmfoy{at}wfubmc.edu

To the Editor .— In their article regarding early-intervention services provided through Part C of the Individuals With Disabilities Education Act, Bailey et al1 express concern that the length of time is excessive between the identification of a child with a possible disability and referral for intervention services. However, whether this delay in referral for intervention is harmful totally depends on whether the interventions available are effective. The Part C program serves a large number of children with a variety of disabilities or risk factors, and the effectiveness of the interventions differs with the disability involved. For example, for children diagnosed early with hearing loss, the effectiveness of early intervention is well-supported by existing data, and a delay in referral for intervention may have a substantial negative impact on the future development of the child with hearing loss. Depending on how risk is defined, varying numbers of children, perhaps a majority, who might be referred for early-intervention services because they have been deemed at risk, will develop normally even if early-intervention services are not provided. For such children, it can be argued that immediate referral for intervention …

BACKGROUND: Neurodevelopmental disorders/disabilities are characterized by impairment in one or more of the classic developmental domains of motor functioning, speech language/communication, learning and cognition, and social-emotional relating. Children with NDD/D require a wide variety of supports and services over their lifetimes and diagnostic classification has traditionally been used to determine eligibility for these resources. However, diagnosis alone tends to under-describe the functional complexity of this population and functional difficulties within a given NDD/D diagnosis can vary and may change over time. The International Classification of Functioning, Disability and Health re-conceptualized the notion of disability focusing on how a given health condition interacts with factors intrinsic and extrinsic to the individual to impact their functioning. In Canada ongoing tension exists between limited services and a growing population of children with NDD/D. These factors have lead to an evolving discourse on the appropriate way to confer eligibility to supports and services in this population. OBJECTIVES: To summarize eligibility criteria for supports and services for Canadian youth with NDD/D in an effort to facilitate discussion and advocacy to help ensure that all children receive the supports and services they require regardless of diagnostic categorization. DESIGN/METHODS: A focused gray literature review was performed to obtain eligibility criteria for government funded supports and services (early intervention, speech therapy, occupational therapy, behavioral intervention, and special education services) for youth aged 0-18 in each Canadian Province. Information was included only if it was published in a government website or document and was available online. Eligibility criteria was coded according to whether it was based on diagnostic categorization, functional impairment, or both and descriptive statistical analysis was performed. RESULTS: Early intervention services and pre-school aged speech/occupational therapy relies on functional impairment in nearly every (90% and 100% respectively) Canadian province/territory for which the information was available. Conversely, access to behavioral intervention relies heavily on diagnostic classification (81%). Some diagnoses (e.g. ASD) confer eligibility to extra therapy or more funding compared to other children with NDD/D. When children enter school access to special education services and speech/occupational therapy is more likely to be tied to diagnosis (45%, 36%, and 43% respectively) than in their pre-school years. CONCLUSION: 1) Eligibility criterion for services and supports for children/youth with NDD/D in Canada vary depending on province/territory. 2) Eligibility criteria are more likely to be based on the presence of functional impairment in preschool than school aged children, with an increasing requirement for children to have a specific diagnostic classification to access services as they age. 3) Certain diagnostic classifications confer increased eligibility for supports and services, in some cases without regard for level of functional impairment. 4) Further research is needed to develop ways of accurately, meaningfully, and efficiently measuring the function of children with NDD/D both at the individual and population level in order to equitably deliver supports and services in a resource limited environment.

The second week of May&rsquo;s Better Hearing &amp; Speech Month focuses on early intervention (EI). COVID-19 caused some families and caregivers to delay seeking EI services and forced professionals to significantly alter how they provide services. Many families/caregivers with young children might now be thinking about seeking EI screenings and services as we begin to return to pre-pandemic routines.