Developmental screening and early intervention in a childcare setting for young children at risk for autism and other developmental delays: A feasibility trial

Abstract

Efforts to decrease disparity in diagnosis and treatment for under-resourced children with developmental delays, such as autism spectrum disorder, have led to increased interest in developing programs in community settings. One potential setting that has already demonstrated feasibility in conducting universal screening is the childcare setting. The current study conducted developmental screening in a total of 116 children ages 16-80 months of age in an urban low-income community childcare center. Parents of 20 children who screened positive were enrolled in the intervention phase of the study, where children received a staff-delivered targeted early intervention or a waitlist control condition. Given the small and imbalanced sample sizes, confidence intervals from mixed effect models were used to measure changes across time for each group. Of the children who received treatment, there was an average increase in child initiated joint engagement, symbolic play, and language use. This study provides initial feasibility data for the implementation of a screening and early intervention program to service a predominantly low-resource and ethnically diverse population within the childcare system in a large metropolitan city.Lay Summary: Identifying and delivering treatment services for young children with developmental delays, such as autism spectrum disorder, may be most successful in community settings, especially for those children from underresourced areas. This study found preliminary evidence that the childcare setting is a good place to conduct screening and deliver early interventions for children at risk for autism and other developmental delays.

Monitoring children’s development in early childhood education settings to promote early detection of autism

“…Most participating educators (98.8%) agreed that systematically monitoring the development of children in their care is a key part of their role as ECEPs and expressed their understanding that early detection can improve long-term outcomes for children. These results add to a small but growing body of research suggesting that early childhood settings are an appropriate place to conduct development surveillance (Gulsrud et al, 2019;Marchbank, 2019; and that reliance on surveillance conducted only in health settings may miss many young children who would benefit from support (Miller et al, 2011;Mozolic-Staunton et al, 2020).…”

“…Building the capacity of front-line professionals to implement routine, evidence-based early detection processes effectively (Marks et al, 2008) as well as enhanced interagency cooperation between health, disability and education services (Eapen et al, 2014) is needed to effectively identify and support young children who are experiencing developmental delays. A growing body of evidence suggests ECEPs can make a valuable contribution to early detection and intervention for young children experiencing developmental vulnerability and to the support of their families (Branson et al, 2008; Daniels et al, 2014; Gulsrud et al, 2019; Janvier et al, 2016; Marchbank, 2019; Rybski & Wilder, 2008). It has been established that ECEPs who receive training in administering developmental surveillance using the SACS-R can reliably administer the tool (Mozolic-Staunton et al, 2017, 2020), lending support to the notion of education and training within the ECEC sector to implement routine developmental surveillance for autism.…”

The effects of JASPER intervention for children with autism spectrum disorder: A systematic review

“…Supplementary Table 1 describes the characteristics of the individuals who implemented the intervention in the original studies. Intervention was implemented by graduate students in two studies, by parents in three studies, by teachers in four studies, by teaching assistants in two studies and by childcare staff in the one remaining study (Gulsrud et al, 2019). The methods used to train implementers varied across studies.…”

“…Kasari et al (2014) was conducted in the home for the intervention group and in the community for the comparison group. The remaining studies occurred in educational settings or a childcare centre (Gulsrud et al, 2019). All studies were conducted in the United States except for Kaale et al (2012), which was conducted in Norway.…”

“…Although studies evaluating JASPER interventions have been included in systematic reviews or meta-analyses examining the effects of NDBIs (Sandbank et al, 2020; Tiede & Walton, 2019) or joint attention interventions more generally (Murza et al, 2016), to date, there are no reviews which examine the effects of JASPER specifically. Given the number of studies evaluating this approach and claims that JASPER is a promising or evidence-based intervention (Chang et al, 2016; Gulsrud et al, 2019; Shire et al, 2017), it is timely to review the available research evidence.…”