Effects of a parent training using telehealth: Equity and access to early intervention for rural families

Children living in geographically rural areas may have limited access to early, intensive evidence-based interventions suggesting children residing in these areas are less likely to experience positive outcomes than their urban-dwelling peers.  Telehealth offers an option to rural families seeking early intervention by using communication technologies where providers are able to consult and deliver services in real-time over geographical distances. To our knowledge, no other study has examined the implementation of P-ESDM in rural natural environments within the framework of the state’s early intervention program. Using a multiple baseline design across participants, the current study investigated the effects of the parent-Early Start Denver Model implemented within a rural northeastern state’s existing IDEA Part C early intervention program.  Parents demonstrated increased fidelity to intervention strategies and reported satisfaction with the program’s ease of implementation and observed child gains.  Statistically significant pre-to post- change in children’s ASD symptomatology were reported for the domains of communication, social reciprocity and repetitive and restricted behaviors.  Support for parent-mediated interventions, the importance of fidelity of implementation for sustainability of intervention strategies, and the need to explore telehealth as a viable service delivery option to improve developmental trajectories for toddlers with autism are discussed

Parenting young children with developmental disabilities: Experiences during the COVID-19 pandemic in the U.S.

High-stress events (e.g., natural disasters, political unrest, disease) significantly impact the lives of children and families. The Coronavirus Disease 2019 (COVID-19) is one event that has brought numerous hardships to families and children with developmental disabilities (DD), likely exacerbating already heightened levels of stress. For this study, we interviewed mothers living in the U.S. (N = 14) of 2- to 8-year-old children with DD about how COVID-19 has affected their family life. The interviews examined how the pandemic impacted (a) their child’s educational, therapeutic, and medical services, (b) their stress and resiliency, and (c) their parenting role as an advocate, educator, and interventionist. The results of our thematic analysis of the qualitative data highlight four domains with themes that describe families’ experiences as indicated by the mothers interviewed. Voices of families are essential in the delivery of effective and ethical early intervention for young children with disabilities. Based on the data from these interviews with mothers, suggestions for family-focused intervention to support families during high-stress events are discussed. As the long-term effects of the pandemic remain unknown, suggestions for future research to continue to examine the impact of high-stress experiences on young children with DD and their families are also presented

Maternal Colonization With Group B Streptococcus and Serotype Distribution Worldwide: Systematic Review and Meta-analyses.

Background: Maternal rectovaginal colonization with group B Streptococcus (GBS) is the most common pathway for GBS disease in mother, fetus, and newborn. This article, the second in a series estimating the burden of GBS, aims to determine the prevalence and serotype distribution of GBS colonizing pregnant women worldwide. Methods: We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus), organized Chinese language searches, and sought unpublished data from investigator groups. We applied broad inclusion criteria to maximize data inputs, particularly from low- and middle-income contexts, and then applied new meta-analyses to adjust for studies with less-sensitive sampling and laboratory techniques. We undertook meta-analyses to derive pooled estimates of maternal GBS colonization prevalence at national and regional levels. Results: The dataset regarding colonization included 390 articles, 85 countries, and a total of 299924 pregnant women. Our adjusted estimate for maternal GBS colonization worldwide was 18% (95% confidence interval [CI], 17%-19%), with regional variation (11%-35%), and lower prevalence in Southern Asia (12.5% [95% CI, 10%-15%]) and Eastern Asia (11% [95% CI, 10%-12%]). Bacterial serotypes I-V account for 98% of identified colonizing GBS isolates worldwide. Serotype III, associated with invasive disease, accounts for 25% (95% CI, 23%-28%), but is less frequent in some South American and Asian countries. Serotypes VI-IX are more common in Asia. Conclusions: GBS colonizes pregnant women worldwide, but prevalence and serotype distribution vary, even after adjusting for laboratory methods. Lower GBS maternal colonization prevalence, with less serotype III, may help to explain lower GBS disease incidence in regions such as Asia. High prevalence worldwide, and more serotype data, are relevant to prevention efforts

Guidelines for the use of flow cytometry and cell sorting in immunological studies (third edition)

The third edition of Flow Cytometry Guidelines provides the key aspects to consider when performing flow cytometry experiments and includes comprehensive sections describing phenotypes and functional assays of all major human and murine immune cell subsets. Notably, the Guidelines contain helpful tables highlighting phenotypes and key differences between human and murine cells. Another useful feature of this edition is the flow cytometry analysis of clinical samples with examples of flow cytometry applications in the context of autoimmune diseases, cancers as well as acute and chronic infectious diseases. Furthermore, there are sections detailing tips, tricks and pitfalls to avoid. All sections are written and peer‐reviewed by leading flow cytometry experts and immunologists, making this edition an essential and state‐of‐the‐art handbook for basic and clinical researchers.DFG, 389687267, Kompartimentalisierung, Aufrechterhaltung und Reaktivierung humaner Gedächtnis-T-Lymphozyten aus Knochenmark und peripherem BlutDFG, 80750187, SFB 841: Leberentzündungen: Infektion, Immunregulation und KonsequenzenEC/H2020/800924/EU/International Cancer Research Fellowships - 2/iCARE-2DFG, 252623821, Die Rolle von follikulären T-Helferzellen in T-Helferzell-Differenzierung, Funktion und PlastizitätDFG, 390873048, EXC 2151: ImmunoSensation2 - the immune sensory syste

Coaching via Telehealth: Caregiver-mediated Interventions for Young Children on the Waitlist for an Autism Diagnosis

The average age for an autism diagnosis in the U.S. is 4-years-old (Hine et al., 2018), which is devastatingly late as caregivers often report initial concerns in their child’s development around 12-months-old and reliable autism diagnosis can be made by 18-months (Pierce et al., 2019). For children from under-resourced families in rural communities, the age of diagnosis is even later, around 5-years-old (Martinez et al., 2018). Early diagnosis of ASD provides toddlers access to medically necessary interventions beyond federally funded early intervention (Individuals with Disabilities Education Act, Part C, 2004) during a vital window of developmental opportunity (Warren et al., 2011). Late diagnosis often leads to under-served families despite economic status or geographic location. This study targeted ASD symptomology (i.e., higher-order restrictive and repetitive behaviors and interests; HO-RRBIs) in toddlers by pairing caregivers with an early interventionist via telehealth. Six mother-child dyads (four girls and two boys) whose child was (a) between 18 and 36-months-old, (b) demonstrated difficult levels of inflexible behaviors (i.e., HO- RRBIs), and (c) were on an ASD diagnostic waitlist were recruited from pediatrician offices and service districts throughout the Pacific Northwest and Texas. All families were considered under-served, under-resourced, or living in rural locations. In a concurrent multiple baseline design across participants, caregivers were coached to mediate early intervention to decrease inflexible and increase flexible child behaviors during play sessions through the use of four evidence-based applied behavior analytic strategies: modeling, prompting, differential reinforcement of appropriate behaviors, and response interruption and redirection. A visual analysis of the data combined with Tau-U revealed a strong basic effect between the intervention package and parent strategy use and child flexible and inflexible behavior. These findings were consistent except for one child participant whose results were a medium effect for flexible behaviors, yet a strong effect for inflexible behaviors. Standardized mean difference was beyond zero for all participants. All mothers rated their participation in the study as favorable. Results of distal and non-experimental outcomes are addressed. Implications for science and practice in early intervention for families whose children are at-risk for ASD are discussed

Behavioral Consultation in Inclusive Preschool Classrooms

The purpose of this report is to describe a behavior consultation model that has been successfully tested in early childhood classrooms. A behavior consultant can assist in a teachers’ use of behavior analytic techniques, which have proven successful in classroom settings when applied. Recommendations for choosing a behavior consultant and successful behavior strategies are presented

A Longitudinal Study of Behavioral Consultation in Inclusive Preschool Classrooms

Teachers in early childhood classrooms face a diverse child population, including children with developmental delays and differences (DD), requiring teachers to exhibit professional skills to address a broad spectrum of developmental needs. At times, early learners with and without DD exhibit challenging behaviors (e.g., aggression, tantrums). Nevertheless, teachers find themselves ill-prepared to manage such behavior and teach under these circumstances due to limited training in classroom behavior management. Applied Behavior Analysis (ABA) is an effective treatment for children with various developmental differences and has proven successful in classroom settings when applied. This report describes a behavior consultation model used in a four-year project in 44 early childhood classrooms with 196 teachers and 97 children identified as having developmental delays and challenging behavior. Recommendations for choosing a behavior consultant for similar settings and a discussion of recurring behavior strategies recommended are presented

Community Conversations: Finding solutions to increase employment for individuals with intellectual and developmental disabilities

This study describes the implementation and findings of a pilot community conversations event in the state of Oregon to identify innovative solutions to under- and unemployment experienced by individuals with intellectual and developmental disabilities (IDD). The event was facilitated in partnership with the University of Oregon UCEDD, local Arc chapter, and other relevant community stakeholders. A total of 36 diverse individuals (e.g., school personnel, business owners, individuals with IDD, and caregivers of individuals with IDD) participated in a two-hour community conversations event about how to improve employment opportunities for those experiencing IDD. Participants engaged in discussions about solutions to employment challenges and completed a pre-post event survey about their experience at the event. Results from the survey and future considerations for additional community conversations are discussed

Coaching via Telehealth: Caregiver-Mediated Interventions for Young Children on the Waitlist for an Autism Diagnosis Using Single-Case Design

Years can elapse between parental suspicion of a developmental delay and a diagnostic assessment, ultimately delaying access to medically necessary, autism-specific intervention. Using a single-case, concurrent multiple baseline design, autism spectrum disorder symptomology (i.e., higher-order restrictive and repetitive behaviors and interests; higher-order RRBIs) was targeted in toddlers (21–35 months) waiting for a diagnostic appointment. Caregivers were coached via telehealth to mediate early intervention to decrease interfering, inflexible higher-order RRBIs during play using four evidence-based applied behavior analytic strategies: modeling, prompting, differential reinforcement of appropriate behaviors, and response interruption and redirection. Six mother–child dyads were recruited from pediatrician offices and early intervention service districts in the United States. All families were considered under-served, under-resourced, or living in rural locations. A visual analysis of the data combined with Tau-U revealed a strong basic effect between the intervention package and parent strategy use and child flexible and inflexible behavior. Findings were consistent across participants with one exception demonstrating a moderate effect for flexible behaviors yet a strong effect for inflexible behaviors. Standardized mean difference was beyond zero for all participants. Implications for science and practice include support for early intervention of higher-order RRBIs for young children with and at risk for ASD

A Systematic Review of Asynchronous Online Learning Opportunities for Paraeducators.

Due to a variety of factors, many paraeducators receive little to no opportunities to advance their professional skills. Asynchronous online learning opportunities offer a flexible way for districts to provide paraeducators opportunities to advance their knowledge, although little is known about what online resources are available, their features, or their overall quality. A review was conducted of 19 freely available online learning opportunities to evaluate features, alignment with federal legislation and professional standards, active engagement features, and usability. Results indicated that features and quality indicators varied across resources and half of the resources required active user engagement. Limitations, suggestions for future development, and future research directions are discussed with an emphasis on factors related to online delivery