Early Hearing Detection Intervention (EHDI) Program: What is the Data Telling Us?

Hearing impairments in infants can negatively impact speech and language development, academic achievement, and social and emotional development if left undetected. These negative impacts can be reduced through early intervention. There are three goals of the EHDI Program: All newborns will be screened for hearing loss before 1 month of age, preferably before hospital discharge. All infants who screen positive will have a diagnostic audiologic evaluation before three months of age. All infants diagnosed with a hearing loss will receive appropriate early intervention services before 6 months of age. The South Dakota Department of Health recently evaluated 2010-2015 EHDI data to identify weaknesses in the surveillance program in order to identify where to focus efforts for program improvemen

Quasi-experimental design and outcomes of a graduate clinician and caregiver-infant coaching intervention in a university speech-language pathology program

Infants are born ready to learn language as one of their most critical developmental tasks, yet infants subject to environmental risk factors related to poverty and low maternal education have been shown to lag behind their peers in language development as early as 8 months of age. Research also indicates the quality of an infant’s language environment can significantly diminish the effects of these risk factors. This quasi-experimental clinical research study explored the effects of a preventive caregiver-infant coaching intervention delivered by graduate student clinicians in a university speech-language pathology program. Developed based on a systematic review of preventive programs for caregivers-infants, the Facilitating Infant Responsiveness to Stimulate Talking (FIRST) Program provided 36 caregiver-infant dyads with education and experience in evidence-based practices known to support prelinguistic development and provided clinical experience for 70 graduate clinicians in preventive education, infant interaction, and caregiver coaching. Offered to parents of any socioeconomic status with infants ages 6- to 12- months-old, the intervention was hypothesized to be of particular benefit to the 14 participating caregiver-infant dyads from low-socioeconomic (low-SES) backgrounds. The intervention, which combined the individual attention of home visit coaching with peer-group instructive modeling, was offered as an 8-session program (2019), a 1-session program (2020), and a 4-session program (2021). A control group participated in all outcome measurements timepoints (pre-test, post-test, and a 3-month follow-up) prior to receiving a delayed session of intervention. Scores on measures of caregiver knowledge and beliefs about early language development significantly increased for the 8- and 4-session participants. Time spent in responsive, turn-taking communication patterns significantly increased for 8-session caregivers and infants. Infant standardized expressive communication scores increased significantly in all intervention conditions. Low-SES participant scores on multiple measures of language learning showed boosts not observed in mid-high SES scores. Graduate clinician confidence in both caregiver coaching and infant assessment showed higher gains for higher numbers of intervention sessions. Overall outcomes reveal a promising preventive model for clinical education in speech-language pathology that benefits caregivers, infants, and students and should be replicable in other university settings and communities

LEARN 2 MOVE 0-2 years:effects of a new intervention program in infants at very high risk for cerebral palsy; a randomized controlled trial

Background: It is widely accepted that infants at risk for cerebral palsy need paediatric physiotherapy. However, there is little evidence for the efficacy of physiotherapeutic intervention. Recently, a new intervention program, COPCA (Coping with and Caring for infants with special needs - a family centered program), was developed. COPCA has educational and motor goals. A previous study indicated that the COPCA-approach is associated with better developmental outcomes for infants at high risk for developmental disorders. LEARN 2 MOVE 0-2 years evaluates the efficacy and the working mechanisms of the COPCA program in infants at very high risk for cerebral palsy in comparison to the efficacy of traditional infant physiotherapy in a randomized controlled trial. The objective is to evaluate the effects of both intervention programs on motor, cognitive and daily functioning of the child and the family and to get insight in the working elements of early intervention methods.Methods/design: Infants are included at the corrected age of 1 to 9 months and randomized into a group receiving COPCA and a group receiving traditional infant physiotherapy. Both interventions are given once a week during one year. Measurements are performed at baseline, during and after the intervention period and at the corrected age of 21 months. Primary outcome of the study is the Infant Motor Profile, a qualitative evaluation instrument of motor behaviour in infancy. Secondary measurements focus on activities and participation, body functions and structures, family functioning, quality of life and working mechanisms. To cope with the heterogeneity in physiotherapy, physiotherapeutic sessions are video-recorded three times (baseline, after 6 months and at the end of the intervention period). Physiotherapeutic actions will be quantified and related to outcome.Discussion: LEARN 2 MOVE 0-2 years evaluates and explores the effects of COPCA and TIP. Whatever the outcome of the project, it will improve our understanding of early intervention in children with cerebral palsy. Such knowledge is a prerequisite for tailor-made guidance of children with CP and their families.Trial registration: The trial is registered under NTR1428.</p

The importance of caregiver-child interactions for the survival and healthy development of children : implications for intervention.

Thesis (M.A.)- University of Natal, Pietermaritzburg, 2002.The quality of early infant-caregiver interactions determines the path of an infant's social, cognitive and emotional development. Theoretical and empirical evidence supporting this claim is reviewed, and the implications for early relationship-focussed interventions are considered. The study focuses on infants from birth to three years of age. Developmental psychology research findings are presented, and the role of risk and protective factors in planning preventative interventions are discussed. Recommendations are made for developing a centre-based relationship-enhancing early intervention program for infants and their depressed caregivers. The program is intended for implementation in a rural or periurban South African Primary Health Care setting

The Effect of an Early Sensorimotor Intervention Program on the Development of Infants with Perinatal Intraventricular Hemorrhage

Our current ability to identify and appropriately treat infants who are at risk for developing various handicapping conditions is limited. Thus, research aimed at developing early diagnostic techniques and differential intervention programs for infants at risk for handicaps needs further attention. The purpose of this study was to determine if infants who suffered perinatal intraventricular hemorrhage and who received routine medical care plus sensorimotor intervention between 3 and 12 months of age, differed from similar infants who received only routine medical care. Twenty-four subjects (10 experimental and 14 control) who were patients in neonatal intensive care at University of Utah or Primary Children\u27s Medical Centers constituted the study sample. Descriptive data specific to the birth and perinatal period were obtained on the infant and its mother. All infants were evaluated with the Battelle Developmental Inventory at 3 and 12-months corrected age. In addition, the Carey Infant Temperament Questionnaire was completed by the parent when the infant was 6 to 9 months corrected age, and the Parenting Stress Index was completed when the infants was 12 months corrected age. Experimental subjects and their parent(s) participated in an individualized sensorimotor intervention program, directed by a licensed physical therapist, for 1 hour per week on a bi-monthly basis. Parents reported spending an average of 20 minutes per day, 5 days per week, working on exercises with their infant at home throughout the 9- month program. A statistically significant positive relationship was found between developmental outcome and participation in sensorimotor intervention , as measured by the posttest Battelle. No significant differences between groups were found on levels of parenting stress. On each of the measures, stress levels were moderate. Continued enrollment and annual follow-up of subjects in the current study will allow for longitudinal evaluation of the effects of early sensorimotor intervention on development

Why early intervention works A reply to Baumeister and Bacharach

In a wide-ranging critique of compensatory education, Baumeister and Bacharach [Intelligence 23 (1996) 28 (2000)] focus most specifically on the Infant Health and Development Program (IHDP), an intervention program lasting from birth through age 3 for low birth weight (LBW) preterm infants. In response, we identify logical, methodological, and analytical inconsistencies in their critique of early intervention research and offer a balanced assessment of IHDP findings to date. Specifically, we note that Baumeister and Bacharach overinterpret null findings, selectively review the early intervention literature, engage in an inappropriate analytical appeal to variance partitioning, and evidence limited understanding of the ways in which individual differences among program participants and controls may be related to early intervention outcomes. Careful examination of the IHDP study design and database provides a clear indication of what the study accomplished and why. Alternative explanations for the absence of long-term IHDP effects are proposed

A randomised clinical trial on the impact of early intervention on parental child-rearing attitudes and cognitive, motor and behavioral outcomes in preterm infants.

The papers of this thesis are not available in Munin: 1. Nordhov SM, Kaaresen PI, Rønning JA, Ulvund SE and Dahl LB.: 'A randomized study of the impact of a sensitizing intervention on the child-rearing attitudes of parents of low birth weight preterm infants', Scandinavian Journal of Psychology (2010), 51(5):385-391. Available at http://dx.doi.org/10.1111/j.1467-9450.2009.00805.x 2. Nordhov SM, Rønning JA, Dahl LB, Ulvund SE, Tunby J and Kaaresen PI.: 'Early intervention improves cognitive outcomes for preterm infants : Randomized controlled trial', Pediatrics (2010), 126:e1088-e1094. Available at http://dx.doi.org/10.1542/peds.2010-0778 3. Nordhov SM, Rønning JA, Ulvund SE, Dahl LB and Kaaresen PI.: 'Early intervention improves behavioural outcomes for preterm infants : Randomized controlled trial' (submitted for publication at Pediatrics)BACKGROUND: Preterm infants are at increased risk of cognitive problems/delay and behavioual problems in the long term. Studies have shown that their mothers are more overprotective, and find it hard to implement a nurturant child rearing practice compared to parents of term infants. To improve the parent-infant interaction and thereby influence infant development in a beneficial different early intervention (EI) strategies have been studied but the results are conflicting OBJECTIVE: To study the effect of an EI program in low birth weight (LBW) children on parental child-rearing attitudes, and cognitive, motor and behaviorual outcomes in pre-school age (2-5 years). METHODS: LBW babies (BW <2000g) were randomized to an intervention (IG) or a control group (CG). In addition a term group (TG) was recruited to provide reference data. The EI program was a modified version of the Mother Infant Transaction Program (MITP). The intervention was implemented by eight specially trained neonatal nurses and consisted of seven daily sessions during the week prior to discharge, followed by four home visits. The unit’s standard discharge procedure was followed in the CG and TG. RESULTS: A total of 146 LBW infants were randomized, and 134 and 131 were assessed at 3 and 5 y, respectively. BW in the IG (n=72) was 1396 (SD 429) g, 1381(436)g in CG (n=74) and 3619 (490) in the TG . Mean GA was 30.2 (3.1) w in IG, 29.9 ( 3.5) w in CG and 39.3 (1.3) in TG. The groups were well balanced in baseline characteristics. At 1 and 2 year, mothers in the intervention group reported significantly more nurturant child- rearing attitudes compared to the control group. Children in the intervention group had 4.5 higher IQ scores at 3 years and this difference increased to 6.4 points at 5 years. Furthermore, children in the intervention group had significantly less behaviour problems reported by parents at 5 years compared with the control group. CONCLUSION: This EI program leads to improved IQ scores and less behaviour problems in the pre-school age in preterm infants. In addition, mothers reveal more nurturant child-rearing attitudes at 1 and 2 years. There were no effect on motor outcome

Effects of Early Intervention Services on Adaptive Functioning

In 1986, Congress enacted Public Law 99-457, Part H of the Individuals with Disabilities Education Act (IDEA). This law, currently referred to as Part C, was established in response to the growing number of children born with developmental delays. Infants born prematurely, addicted to drugs, or with conditions such as Down Syndrome face challenging lives. Part C allows for eligible infants, ages birth to three years to receive free early intervention services to address their individual delays. Previous studies have shown that children who have participated in early intervention programs have benefited in various areas of their overall development. The purpose of this study is to examine parents’ perceptions of the effects of early intervention services on adaptive functioning in toddlers who are enrolled in a center-based early intervention program. The present study utilized archival data from a random sample of children (N=75) who were enrolled in a center-based program at the Infant and Child Learning Center located in Brooklyn, New York. The majority of participants in the sample were African-American (f=93.3%) and male (f=73.3%). The children ranged in age from four to twenty-eight months prior to beginning the program, with a mean age in months of M=19.24 (SD=5.02). At postintervention, the children ranged in age from twenty-one to thirty-seven months, mean age in months M=32.12 (SD=1.99). The mean duration of enrollment in the program in months was M=11.83 (SD=2.65) and ranged from seven to eighteen months. The results of this study showed that parents did, in fact, believe that their children made improvements after attending the program

South Dakota Early Hearing Detection and Intervention Program: Using Teleaudiology to Conduct Infant Diagnostic Assessments

Teleaudiology allows patients and providers to bypass several economic and geographic barriers that impede the delivery and accessibility of audiological services. The South Dakota Early Hearing Detection and Intervention (EHDI) program recognized this benefit and created a teleaudiology infrastructure for the diagnostic assessment of infants. Using a hub-and-spoke model, a certified pediatric audiologist at the hub site assesses infants located at two spoke sites in South Dakota. Remote control software applications are used to provide a synchronous method of service delivery. The audiologist’s test battery includes video otoscopy, tympanometry, and auditory brainstem response (ABR) testing. Since establishing the teleaudiology program, nine infant assessments have been completed. The South Dakota EHDI program will continue improving the teleaudiology project to ensure all infants in the state have access to pediatric audiological services

Promoting the Social-emotional Wellbeing of Infants and Toddlers in Early Intervention Programs: Promising Strategies in Four Communities

This brief presents promising approaches to support the social-emotional wellbeing of infants and toddlers through the Part C Program. The strategies discussed in this brief were identified through case studies carried out in four communities: Boston, Massachusetts; Los Angeles County, California; Doña Ana County, New Mexico; and Southeast Kansas. These case studies were part of a larger project designed to show different policy options that states use to support strategies that target social-emotional development as part of a comprehensive approach to early intervention services. The project included a 50-state survey of Part C Program coordinators, the individuals who are responsible for administering the Part C Program in compliance with federal and state requirements. Findings from this survey are reported in Promoting Social-Emotional Wellbeing in Early Intervention Services: A Fifty State View. As a companion to the survey report, this brief examines exemplary policies and practices that highlight the potential of the Part C Early Intervention Program to play a major role in reducing the risk of long-term social-emotional and behavioral difficulties of vulnerable children