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Stewart SL, Applequist KL, Seanez P. Promoting Coordination and Collaboration in Tribal Home Visiting Programs in the United States. Matern Child Health J 2024; 28:19-23. [PMID: 38010588 DOI: 10.1007/s10995-023-03847-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND A joint statement from two federal agencies in the United States calls for coordination and collaboration between programs serving families of infants and toddlers who are at risk or developmentally delayed or disabled U.S. Department of Education and U.S. Department of Health and Human Services. Policy guidance: Joint statement on collaboration and coordination of the MIECHV and IDEA Part C programs. (2017). Individuals with Disabilities Education Act. ED/HHS Joint Guidance Document: Collaboration and Coordination of the Maternal, Infant, and Early Childhood Home Visiting Program and the Individuals with Disabilities Education Act Part C Programs. Young Native American children living on tribal lands in this country are currently eligible for two federal programs associated with these agencies which overlap in mission and implementation. PURPOSE This paper outlines potential strategies for creating a more seamless system of services for tribal families involving more centralized intake processes and procedures, cross training of staff to work across programs, and adopting more unifying approaches to program implementation. CONCLUSION A streamlined system of services will result in interventions that better support family and child outcomes while reducing duplication of services, consolidating the limited number of qualified professionals available to provide services, and increasing convenience and cultural attunement of services to Native American families currently participating in both programs.
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Affiliation(s)
- Sandra L Stewart
- Department of Communication Sciences and Disorders, Northern Arizona University, 208 E. Pine Knoll Dr., PO Box 15045, Flagstaff, AZ, 86011, USA.
| | - Karen L Applequist
- Department of Educational Specialties, Northern Arizona University, Flagstaff, USA
| | - Paula Seanez
- Department of Diné Education, Office of Special Education & Rehabilitation Services, Arizona, USA
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Bravo A, Ibañez LV, Scott S, Dick C, Carpentier P, Stone WL. Telehealth Delivery in Part C Early Intervention: Provider and Caregiver Perspectives. J Autism Dev Disord 2023; 53:4545-4559. [PMID: 36153443 PMCID: PMC9510265 DOI: 10.1007/s10803-022-05734-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/29/2022]
Abstract
Telehealth is a promising modality for Part C early intervention (EI), services typically implemented face-to-face in home and community settings. Barriers to telehealth in EI reported prior to COVID-19 included lack of training and access to reliable internet. The abrupt telehealth shift at the onset of the pandemic did not permit a phased adoption approach. This mixed-methods study aimed to characterize perspectives of service changes resulting from the telehealth transition. Providers (n = 39) and caregivers (n = 11) completed surveys about perceptions towards the telehealth switch. All providers indicated at least one aspect of services had changed. Approximately half of caregivers reported satisfaction with services decreased and half that satisfaction remained the same. Implications for telehealth in EI beyond the pandemic are discussed.
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Affiliation(s)
- Alice Bravo
- College of Education, University of Washington, Seattle, WA, 98115, USA.
| | - Lisa V Ibañez
- Department of Psychology, University of Washington, Seattle, WA, 98115, USA
| | - Sabine Scott
- Department of Psychology, University of Washington, Seattle, WA, 98115, USA
| | - Catherine Dick
- Department of Psychology, University of Washington, Seattle, WA, 98115, USA
| | - Pascale Carpentier
- Department of Psychology, University of Washington, Seattle, WA, 98115, USA
| | - Wendy L Stone
- Department of Psychology, University of Washington, Seattle, WA, 98115, USA
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Kay HG, Lipscomb B, Zhao S, Shannon C, Phillips JD. Utilization of part C early intervention services for patients with cleft palate. Int J Pediatr Otorhinolaryngol 2021; 151:110961. [PMID: 34736013 DOI: 10.1016/j.ijporl.2021.110961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate the utilization of early intervention services under Part C of the 2004 Individuals with Disabilities Educational Act for children with cleft palate and to better understand barriers these patients encounter when receiving services. METHODS A retrospective chart review was performed on children under the age of 18 who were treated for cleft palate at a single tertiary care center and referred to Tennessee's Early Intervention System (TEIS) between January 2007 and December 2018. RESULTS For the 61 patients included, developmental therapy was the most common TEIS referral made (n = 408, 28%), followed by speech therapy (n = 371, 26%). Most of these services were delivered as scheduled (n = 513, 80%); some families missed appointments without notifying the provider (i.e., family no-show)(n = 101, 2%). Children referred at a younger age were more likely to receive developmental therapy (p = 0.012) and to attend their services (p = 0.027). Patients with Medicaid were more likely to have absences with prior notification (p = 0.05) and without prior notification (i.e., family no-show)(p = 0.009) than patients with other types of health insurance. CONCLUSIONS Patients with cleft palate often have complex needs; earlier referral to ancillary services may improve attendance at appointments and impact the services they receive. Socioeconomic factors may hinder patients from accessing these services even once they are referred.
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Affiliation(s)
- Hannah G Kay
- Vanderbilt University School of Medicine, Nashville, TN, USA; Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brittany Lipscomb
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilin Zhao
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University, USA
| | - Chevis Shannon
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James D Phillips
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
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Spence CM, Rooks-Ellis DL, Ruiz AB, Fish LA, Jones B, O’Grady CE, Sulinski E. The Language We Use: Providers' Perceptions About Families. Early Child Educ J 2021; 50:1291-1302. [PMID: 34493916 PMCID: PMC8412869 DOI: 10.1007/s10643-021-01258-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
Implicitly-held unconscious associations and attitudes may not align with the beliefs we hold outwardly or explicitly but can affect our professional perceptions, decisions, and actions. In a phenomenological study identifying strategies used to support families in vulnerable circumstances, we conducted nine focus groups to examine how early interventionists (EIs) described families and children, the language they used, and how they used it. Thematic qualitative analysis revealed three themes about families: perceptions of parenting, perceptions of capability, and perceptions of priorities. How EIs characterized families and their interactions with families were both reflective of and counter to family-centeredness and, at times, indicative of implicit bias. This study addresses a critical gap in the field, given the lack of empirical research available about implicit bias in early childhood intervention professionals. Implications for personnel preparation and practice change are discussed to begin the necessary work of moving the field toward more culturally sustaining practices.
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Affiliation(s)
- Christine M. Spence
- Department of Counseling and Special Education, Virginia Commonwealth University, 1015 West Main Street, Richmond, VA 23284-2020 USA
| | | | - Amber Brown Ruiz
- Department of Counseling and Special Education, Virginia Commonwealth University, 1015 West Main Street, Richmond, VA 23284-2020 USA
| | - Leigh Ann Fish
- Department of Elementary, Early Childhood, and Early Childhood Special Education, University of Maine – Farmington, Farmington, ME USA
| | | | - Courtney E. O’Grady
- Department of Special Education, University of Illinois at Urbana-Champaign, Champaign, IL USA
| | - Ella Sulinski
- School of Social Work, University of Maine, Orono, USA
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Cole B, Pickard K, Stredler-Brown A. Report on the Use of Telehealth in Early Intervention in Colorado: Strengths and Challenges with Telehealth as a Service Delivery Method. Int J Telerehabil 2019; 11:33-40. [PMID: 31341545 PMCID: PMC6597149 DOI: 10.5195/ijt.2019.6273] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The use of telehealth as a service delivery method for early intervention (EI) is in its infancy and few studies have examined its use within the context of a statewide program. The focus of this report was to determine the factors that influence providers' utilization of telehealth in Colorado's Part C Early Intervention program (EI Colorado). This report presents information that was gathered through surveys sent to Part C program administrators, service coordinators, providers, and caregivers. Surveys were used to understand perceptions of telehealth, actual experiences with telehealth, and perceived benefits and challenges using this service delivery method. Follow-up focus groups were conducted with program administrators and family members to gather more nuanced information. Participants identified several benefits associated with telehealth including its flexibility, access to providers, and more family engagement. The primary barriers included access to high speed internet and the opinion that telehealth was not as effective as in-person treatment. The results in the report served to identify next steps in the implementation of telehealth in Colorado's Part C EI program.
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Affiliation(s)
- Beth Cole
- EARLY INTERVENTION COLORADO, DENVER, CO, USA
| | - Katherine Pickard
- JFK PARTNERS, UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, AURORA, CO, USA
| | - Arlene Stredler-Brown
- DEPARTMENT OF SPEECH, LANGUAGE, AND HEARING SCIENCES, UNIVERSITY OF COLORADO, BOULDER, CO, USA
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Abstract
Authors conducted a systematic literature review on early identification steps leading at-risk young children to connect with Part C services. Authors classified data collection settings as primary (settings for general population) or specialized (settings for children at risk of developmental delay) and according to the phases of early identification in the study: (a) original population of children aged 0 to 6 years who had received Part C services, (b) screening and/or referral and/or developmental assessment from 0 through age 2 years, and (c) were deemed eligible and/or received Part C services. Authors identified 43 articles including at least two phases of the early identification process. The literature about connecting children to Part C early intervention (EI) is sparse and fragmented; few studies document the full process from community monitoring to service receipt. Results indicate opportunities for development of systems to better track and improve the identification of young children in need of EI.
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Affiliation(s)
| | | | | | - Rebecca Wolf
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Barger B, Rice C, Wolf R, Roach A. Better together: Developmental screening and monitoring best identify children who need early intervention. Disabil Health J 2018; 11:420-426. [PMID: 29459217 DOI: 10.1016/j.dhjo.2018.01.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 12/14/2017] [Accepted: 01/21/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Widely recommended developmental surveillance methods include developmental monitoring (DM) and development screening (DS). Much research has been done on DS, but very little research has compared the effectiveness of DM and DS together. OBJECTIVES To investigate the relationship between DM and DS in Part C early intervention (EI) service receipt. METHODS Authors used data from the 2007/2008 and 2011/2012 National Survey of Children's Health (NSCH). Authors report the prevalence of children aged 10 months to 3 years who received (a) DM only, (b) DS only, (c) both DM and DS, and (c) no DM or DS across survey years. Authors compare the odds of EI receipt across these groups. RESULTS During both periods, estimated EI receipt prevalence was higher for children receiving both DM and DS (8.38% in 2007/2008; 6.47% in 2011/2012) compared to children receiving no DM or DS (1.31% in 2007/2008; 1.92% in 2011/2012), DM alone (2.74% in 2007/2008; 2.70% in 2011/2012), or DS alone (3.59% in 2007/2008; 3.09% in 2011/2012) (for both time frames, p < .05). From 2007/2008 to 2011/2012, the proportion of children receiving DS only and both DM and DS increased, while children receiving DM only and no DM or DS decreased. CONCLUSIONS Children receiving DM and DS together were more likely to receive EI compared to children receiving DM alone, DS alone, or neither DM nor DS. These findings support the AAP recommendations indicating that DM and DS are complementary strategies for improving early identification and linkage to EI for young children.
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Affiliation(s)
- Brian Barger
- USC, DRDC Policy Research Fellow at National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA; Center for Leadership in Disability, Georgia State University, School of Public Health, Epidemiology and Biostatistics, Atlanta, GA, USA.
| | - Catherine Rice
- Learn the Signs. Act Early., National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA; Emory Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Rebecca Wolf
- Learn the Signs. Act Early., National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrew Roach
- Center for Leadership in Disability, Georgia State University, School of Public Health, Epidemiology and Biostatistics, Atlanta, GA, USA
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Abstract
The medical home and the Individuals With Disabilities Education Act Part C Early Intervention Program share many common purposes for infants and children ages 0 to 3 years, not the least of which is a family-centered focus. Professionals in pediatric medical home practices see substantial numbers of infants and toddlers with developmental delays and/or complex chronic conditions. Economic, health, and family-focused data each underscore the critical role of timely referral for relationship-based, individualized, accessible early intervention services and the need for collaborative partnerships in care. The medical home process and Individuals With Disabilities Education Act Part C policy both support nurturing relationships and family-centered care; both offer clear value in terms of economic and health outcomes. Best practice models for early intervention services incorporate learning in the natural environment and coaching models. Proactive medical homes provide strategies for effective developmental surveillance, family-centered resources, and tools to support high-risk groups, and comanagement of infants with special health care needs, including the monitoring of services provided and outcomes achieved.
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