Dimensions of behavior of toddlers entering early intervention: Child and family correlates

State Variability in Diagnosed Conditions for IDEA Part C Eligibility

An infant or toddler can begin the process of receiving Part C early intervention services by having a diagnosed condition with a high probability of developmental delay (Individuals with Disabilities Education Improvement Act, 2004). How states define those diagnosed conditions that begin the initiation process varies widely. Lists of diagnosed conditions were collected from state Part C websites and Part C coordinators for a descriptive analysis. Across 49 states, the District of Columbia, and 4 territories, a final list of 620 unique conditions was compiled. No single condition was listed by all jurisdictions. Hearing impairment was the condition listed by the most states (n = 38), followed by fetal alcohol syndrome (n = 34). Of the 620 conditions, 168 (27%) were listed by only 1 state, 554 (89%) were listed by fewer than 10 states, and 66 (11%) were listed by 10 or more states. Of these 66 conditions, 47 (71%) were listed by fewer than 20 states. Most of these 66 conditions (n = 48; 72.7%) had a prevalence of "very rare or rare," 8 (12%) were "common," 6 (9%) were "very common," and 4 (6.1%) were "unknown." The wide heterogeneity in the number and type of diagnostic conditions listed across states should be further investigated as it may represent imbalances in children with diagnosed conditions gaining access to Part C evaluations and individualized family service plans and potentially the services themselves across states. In addition, providing ready access to lists of diagnosed conditions is a simple step that could help states and Part C programs facilitate access to services.

Improving kindergarten readiness in children with developmental disabilities: Changes in neural correlates of response monitoring

Among children diagnosed with developmental delays, difficulties in self-regulation are prominent and have been linked to school readiness problems. The current study sought to examine the impact of the Kids in Transition to School (KITS) school readiness intervention program on self-regulation, with a specific focus on response monitoring skills, among children with developmental delays. Children (n = 20 in the KITS group and n = 21 in a services as usual group) were administered a flanker task during which event-related potential data were collected to examine group differences in response monitoring. Findings indicated that children in the KITS group showed significant enhancement of a neural index of response monitoring post-intervention. Specifically, the KITS group showed a significant change in the magnitude of their feedback-related negativity in response to negative performance feedback from baseline to post-intervention, whereas children in the services as usual group did not. There were no significant differences between the groups for the error-related negativity or the error-related positivity on incorrect trials nor were there group differences in behavioral performance on the task at the post-intervention assessment. Overall, these findings provide support for the plasticity of response monitoring skills in young children and support the growing literature demonstrating improved self-regulation outcomes via intervention that enhances children's response monitoring.

Prevention of behavior problems in a selected population: Stepping stones triple P for parents of young children with disabilities

Because young children with disabilities are at elevated risk for development of challenging behaviors, and caregivers of these children typically lack access to evidence-based parenting interventions, two randomized trials were conducted to examine the impact of an evidence-based parenting intervention, Stepping Stones Triple P (SSTP), as a selective preventive intervention. Both studies targeted parents of children under two with a variety of disabilities who were enrolled in the IDEA Part C Early Intervention (EI) system in one state. SSTP was delivered in family homes. In Study One, 49 families were randomly assigned to EI services as usual, with or without SSTP; a 52% attrition rate from treatment was seen. No significant between-group differences were seen aside from a trend toward reduced symptoms of parental depression at follow-up. Intervention group children demonstrated significant decline in behavior problems from post treatment to follow-up, and there was a trend toward improved parenting style in the intervention group during this same time frame. Study Two incorporated a separate workforce intervention for EI service coordinators; 40 families on their caseloads were then randomly assigned to receive EI services as usual with or without SSTP. Attrition from treatment was limited to 20%. No differential impact was seen on child behavior; a trend was noted post-treatment on parent symptoms of depression and on the observed parent-child relationship. At 12-month follow-up, there was a trend favoring improvement in the intervention group in parenting style; statistically significant impact was also seen on the observed quality of the parent-child relationship. SSTP shows promise as a selective preventive intervention for an early intervention population. Reasons for the differential findings between the two studies are explored and suggestions for future research are provided.

Development and content validity of the Therapy Behavior Scale

The purpose of this study was to develop an assessment instrument that would allow clinicians to (1) evaluate behaviors of infants and toddlers during therapeutic intervention based on their own observations; (2) be applicable in a home-based or an outpatient therapeutic setting; and (3) be appropriate for use with infants and toddlers from birth to three years of age regardless of their developmental level or level of disability. Six pediatric therapists participated in the development and content evaluation of the instrument, Therapy Behavior Scale (TBS) with its subsequent revision into the TBS Version 1.0. Three raters pilot tested the scale with seven infants and toddlers. The results supported the content validity of the TBS Version 1.0 and led to the development of the TBS Version 1.1. Further research is needed to validate the newest version of the scale and to establish its intra-rater and interrater reliability.

Sleep problems and early developmental delay: implications for early intervention programs

Sleep disorders negatively impact behavior, cognition, and growth--the same areas targeted by early intervention. Conversely, developmental delays and disabilities may themselves precipitate sleep disorders. Young children with developmental delays experience sleep disorders at a higher rate than do typically developing children; the most common types are difficulties initiating or maintaining sleep and sleep disordered breathing. To date, attention has been focused on sleep problems in children with specific conditions (e.g., autism, genetic syndromes, prematurity, and seizure disorder). The authors review evidence of sleep problems' broader impact across the range of children screened for early intervention. Eligibility evaluations for early intervention address the five developmental domains: adaptive, motor, cognitive, communication, and socioemotional. Disordered sleep may be symptomatic of socioemotional and adaptive problems. Assessing sleep problems within the evaluation may help establish eligibility for early intervention services and would maximize developmental potential by ensuring timely identification, referral, and treatment.

Comparison of problem behaviours in atypically developing infants and toddlers as assessed with the baby and infant screen for children with aUtIsm traits (BISCUIT)

OBJECTIVE

Compares infants and toddlers with intellectual and developmental conditions in regard to the presence of challenging behaviour.

METHODS

Parents and caregivers to 140 children ranging from 17-35 months with five different conditions (Down syndrome (n = 23), developmental delay (n = 18), prematurity (n = 56), Cerebral Palsy (n = 15) and Seizure disorder (n = 28)) were administered the BISCUIT-Part 3. An ANOVA on overall scores and a MANOVA on the sub-scale scores were conducted to determine if groups differed significantly.

RESULTS

Results found no significant differences on total scores or differences on the sub-scales of the BISCUIT-Part 3: Aggressive/Destructive, Stereotypic and Self-Injurious. Some trends in individual item endorsement were found.

CONCLUSIONS

It is possible that differences among individuals with these disorders are not apparent until later in life. These results emphasize the importance of monitoring challenging behaviours in all at-risk infants and toddlers to ensure that early interventions to treat these challenging behaviours are possible.