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Results for “Early intervention”

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PubMed2006

The determinants of compliance with an early intervention programme for high-risk babies in India.

BACKGROUND: Early intervention is known to improve outcomes for babies at risk for growth and developmental problems. Such programmes usually have a prolonged course and require frequent contacts with the service providers. As a consequence of poverty, illiteracy and lack of communication facilities in developing countries, treatment adherence can suffer. METHODS: The present study is an analysis of a clinic-based early intervention programme for high-risk babies in a developing society in Goa, India. A sample of 152 neonates and their parents were offered an early intervention programme and followed up until their first birthday. The primary outcome under study was the uptake of the programme. Various socio-demographic, programmatic and infant-related variables that could affect compliance were examined. RESULTS: Compliance with the intervention programme was only moderate, with 59.2% of infants brought for three or more sessions. Higher maternal educational levels and proximity of the place of residence of the family to the early intervention clinic were significantly associated with better compliance. CONCLUSIONS: Early intervention programmes that go into homes have a greater chance of reaching high-risk infants, compared with those provided at a distant centre. Better-educated mothers are more likely to be convinced about the benefits of such inputs. The authors conclude with recommendations for future practice and research.

Adolescent↗

PubMedDate not supplied

Nurses in early intervention.

The number of children from ages birth to 3 in need of early intervention services has increased over the past decades. A family-centered approach to early intervention services is essential. The family-centered approach emerged from early intervention philosophy developed by professionals in response to the needs of children and families. The historical perspective of early intervention and family-centered care, the role of nurses in early intervention and suggested focus of future research are outlined.

Child, Preschool↗

PubMed1994

Early intervention: the professional views and referral practices of paediatricians in Victoria.

Early intervention services for young children with developmental disabilities have developed considerably in the past decade, yet little information is available about the referral practices and views of Australian paediatricians. During 1991, 100 paediatricians in Victoria completed a postal questionnaire designed to gain information regarding their attitudes to early intervention and referral practices. The results indicated that paediatricians had a positive view of early intervention, and perceived the standard and quality of the services in their region as comprehensive (16%) or adequate (54%). They were likely to make prompt referrals in the presence of an established disability (75%), but with suspected developmental delay, many (45%) were likely to wait until the delay was confirmed. Referrals were more often made for intervention for the child rather than for family support. However, paediatricians felt that early intervention had a beneficial effect on family functioning (81%). In general, the results indicate that there seem to be few barriers between paediatricians and the early intervention field.

Attitude of Health Personnel↗

PubMed1992

Brief and early intervention: experience from studies of harmful drinking.

Brief and early interventions represent an innovative strategy for the prevention of harm from alcohol and other drugs. The pioneering study of early intervention, undertaken by Kristenson et al. (1983) as part of a preventive medicine programme, demonstrated the efficacy of this approach for problem drinking. Subsequent studies have confirmed these findings. Brief and early interventions have been shown to be effective in a wide range of health care settings, including hospital wards and outpatient clinics, general practice, private health screening facilities and community-based health screening programmes. What is required now is the ascertainment of the most effective settings for brief and early interventions and the incentives needed for incorporation into routine practice.

Alcohol Drinking↗

PubMedDate not supplied

Early intervention in schizophrenia: a critique.

OBJECTIVE: Two forms of early intervention in psychosis are currently being proposed--intervention before the onset of illness with at-risk individuals and intervention after the onset of psychosis. METHOD: The risks and potential benefits associated with these two approaches were examined using published data and Bayes probability theorem. RESULTS: Claims for benefits from early intervention in established psychosis go back more than two hundred years to the nineteenth-century advocates for asylum construction. Theoretical support for early intervention in psychosis rests on data suggesting that a longer duration of untreated psychosis (DUP) is associated with poor outcome. The association of DUP with outcome, however, appears to be inseparable from the confounding influence of the good outcome expected in recent-onset psychosis. Although some researchers advocate treating people with premorbid features of psychosis or other high-risk indicators, adequate screening measures and effective interventions are not yet available. The most promising current screening measure, if applied to the general population, would be accurate only two percent of the time. The accuracy of these measures can be improved by screening only those patients who are referred to a clinic, but this strategy will result in many cases in the population-at-large being overlooked. DISCUSSION: The risks and potential benefits associated with the two early intervention approaches are very different. The provision of optimal treatment early in psychosis could produce benefits, but people with brief, good-prognosis psychotic episodes are likely to receive unnecessary treatment. Screening the general population or patients referred to a clinic will have little public health impact on the incidence of schizophrenia. There is likely to be considerable negative impact on those who are inaccurately labeled as being at imminent risk of psychosis and are treated accordingly.

Humans↗

PubMed2000

Social work early intervention for young children with developmental disabilities.

Social workers' awareness of and formal involvement in family-centered early intervention for infants and toddlers who are at risk of or who have developmental disabilities has increased considerably during the past 15 years. The functional role that social workers can play on early intervention teams and as coordinators of early intervention services is underscored by the formal recognition of the discipline in the Individuals with Disabilities Education Act. Despite the relevance of social work to early intervention, personnel often enter early intervention practice without the benefit of formal preparation related to very young children with developmental disabilities. This article provides an overview of the definition and identification of developmental disabilities, and discusses the role of and challenges to social work in early intervention.

Child, Preschool↗

PubMed1986

Early intervention care in the acute stroke patient.

Early intervention care has been identified as an important factor in the functional outcome of patients with completed stroke. Little has been published, however, on the efficacy of early intervention in the acute hospital setting. In a retrospective study of 30 patients in an acute care hospital, there was a statistically significant difference in length of stay and ambulatory status (p less than 0.05) for the group receiving rehabilitation treatment within the first 72 hours after admission. There was no significant difference between the two groups with regard to age, sex, site of lesion, or previous cardiovascular disease. The present study indicates that early intervention shortens hospital stay and improves outcome, considerations especially important with the adoption of Diagnosis-Related Groups (DRGs), as hospitals seek measures of cost-containment in the provision of quality cost-effective health care.

Activities of Daily Living↗

PubMed2005

Thirty-six-month outcomes for families of children who have disabilities and participated in early intervention.

OBJECTIVE: Infants and toddlers with disabilities in the United States and their families are eligible for early intervention services under Part C of the Individuals With Disabilities Education Act. The purpose of this study was to assess family outcomes at the end of early intervention (near the child's third birthday). METHODS: A nationally representative sample of 2586 parents in 20 states completed a 40-minute telephone interview on or near their child's third birthday. This article summarizes data related to perceived family outcomes at the end of early intervention. RESULTS: At the end of early intervention, most parents felt competent in caring for their children, advocating for services, and gaining access to formal and informal supports. They also were generally optimistic about the future. Most (82%) parents believed that their family was better off as a result of early intervention. Parents were somewhat less positive in their perceived ability to deal with their child's behavior problems or gain access to community resources, and lower family outcome scores were found for parents of minority children, children with health problems, and children who were living with a single adult. CONCLUSION: Results suggest that Part C early intervention provides important supports for families of young children with disabilities. The findings reinforce the need for experimental research to identify factors that are most likely to lead to successful outcomes for all families. In the meantime, early identification and expeditious referral are important so that maximum benefit can be realized for children with disabilities and their families.

Child, Preschool↗

PubMedDate not supplied

Knowledge of early intervention in three groups of nurses: implications for service and training.

The mandate for a multidisciplinary approach in early intervention for at-risk and developmentally disabled infants and their families is creating new roles and opportunities for professionals in a variety of disciplines. The extent to which such roles and opportunities will be realized, however, depends on awareness of the nature and scope of early intervention efforts. This study was designed to examine the awareness of early intervention among nurses as a function of professional level. A total group of 64 students, practicing registered nurses, and nurse practitioners completed questionnaires assessing (a) their awareness of early intervention; (b) their perception of characteristics important in early intervention; and (c) assessment of their skill and knowledge in this area. Nursing students were significantly less aware than the other two groups of nurses who did not differ from each other. Each group differed significantly from the other on perceived skills, whereas only the nursing students differed from the other two groups in terms of knowledge. The endorsement of family-centered intervention did not differ as a function of level of educational preparation. It was concluded that nursing education curricula should include information on early intervention.

Early Intervention, Educational↗

PubMed1989

Satisfied conclusion validity of early intervention research with handicapped children.

The statistical conclusion validity of early intervention research studies was examined by conducting a post hoc power analysis of 484 statistical tests from 49 early intervention articles. Statistical power determinations were made based on Cohen's (1977) criteria for small, medium, and large effect sizes. The analysis revealed that the median power to detect small, medium, and large effect sizes ranged from .08 to .46. Four percent of early intervention studies had adequate power (.80 or greater) to detect medium intervention effects and 18% to detect large intervention effects. The power values suggest poor statistical conclusion validity in the analyzed research and should alert investigators to the possibility of Type II experimental errors in the early intervention research literature. The argument is made that low statistical conclusion validity has practical consequences in relation to program evaluation and cost-effectiveness determinations.

Child, Preschool↗

PubMed2002

Early interventions following psychological trauma.

What is the best way to provide early interventions for psychiatric disorders after trauma? The terrorist attacks of September 11, 2001, have raised urgent concerns about the evidence for early treatments after trauma that can prevent psychiatric disorders. This review outlines the expected course of posttraumatic stress reactions and discusses the current means of identifying people who are at risk of developing disorders. A critique of psychological debriefing and an analysis of evidence for cognitive-behavioral therapy as an early intervention is provided. The major challenges for early intervention are discussed, including increasing treatment effectiveness, delivering therapy when it is required by thousands of people, and developing early interventions for a wide array of psychiatric disorders in addition to posttraumatic stress disorder that can develop following trauma.

Journal Article↗

PubMed1979

The learning-disabled juvenile delinquent: a case for early intervention of perceptually handicapped children.

The relationship between learning disabilities and juvenile delinquency is examined from an historical perspective as well as from the author's investigations. The majority of studies suggest that learning disabilities occur with significant frequency in delinquent populations. Perceptual disorders can be a significant cause of academic underachievement and poor social adaptation among youthful offenders. Preliminary results of an investigation of the learning-disabled delinquent confirm that the perceptually handicapped child is at high risk for developing these behavioral problems. As one of the first professionals who may be involved in the evaluation and treatment of the perceptually handicapped child, the occupational therapist is a key person in effecting early intervention. Early intervention is considered of prime importance as one preventive measure of juvenile delinquency.

Adolescent↗

PubMed1989

Clinical approaches to families in early intervention.

Clinical approaches to families with infants in early intervention programs require more sophisticated and individualized plans that have been traditionally available. Clinicians in early intervention programs, including those trained in child-oriented disciplines, will increasingly be expected to develop comprehensive family focused interventions. Empirical findings support the legislative mandate of PL99-457 in requiring that families have an active role in specifying the intervention services they require. In addition, the broader concept of risk that now includes multi-problem families also complicates the job of the early interventionist. As parents must learn to adapt to their infant's unique characteristics, early interventionists must adapt to the unique characteristics of each family with whom they are involved. To aid in this process, we apply the concept of a working alliance to the aspect of the parent-professional relationship that early interventionists must develop and maintain in providing empathic and individualized care to families in early intervention. Sensitivity to the families' unique characteristics, responsitivity to their concerns, positive connotation of parents' and infants' behavior, a nonjudgmental attitude, and a willingness to monitor one's feelings and responses elicited by the family are clinical principles essential for developing and maintaining the working alliance.

Child Guidance Clinics↗

PubMed2004

Essential elements of an early intervention service for psychosis: the opinions of expert clinicians.

BACKGROUND: Early intervention teams attempt to improve outcome in schizophrenia through earlier detection and the provision of phase-specific treatments. Whilst the number of early intervention teams is growing, there is a lack of clarity over their essential structural and functional elements. METHODS: A 'Delphi' exercise was carried out to identify how far there was consensus on the essential elements of early intervention teams in a group of 21 UK expert clinicians. Using published guidelines, an initial list was constructed containing 151 elements from ten categories of team structure and function. RESULTS: Overall there was expert consensus on the importance of 136 (90%) of these elements. Of the items on which there was consensus, 106 (70.2%) were rated essential, meaning that in their absence the functioning of the team would be severely impaired. CONCLUSION: This degree of consensus over essential elements suggests that it is reasonable to define a model for UK early intervention teams, from which a measure of fidelity could be derived.

Adult↗

PubMed1988

The changing environment of early intervention services: implications for practice.

A new plan for providing early intervention services for very young children and their families has been established with Part H of the Education of the Handicapped Act Amendments of 1986, Public Law 99-457. Each state is currently exploring how it can best develop one comprehensive system of care that combines health, education, social, and family services. Health practitioners have traditionally provided early intervention services in medical settings such as hospitals and local health departments since the early 1900s. Educators, prompted by federal legislation, have provided early intervention services in the public schools primarily since 1975. Occupational therapy practitioners work in both medical and educational settings and must now meet the numerous challenges and opportunities in developing comprehensive, family-centered, community-based care for very young children with special needs. This paper traces the historical development of early intervention services and discusses the major practice issues associated with implementing Part H of the Education of the Handicapped Act Amendments of 1986.

Child, Preschool↗

PubMed2000

The New York State universal newborn hearing screening demonstration project: ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention.

OBJECTIVE: To determine the ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention through a multi-center, state-wide universal newborn hearing screening project. DESIGN: Universal newborn hearing screening was conducted at eight hospitals across New York State. All infants who did not bilaterally pass hearing screening before discharge were recalled for outpatient retesting. Inpatient screening and outpatient rescreening were done with transient evoked otoacoustic emissions and/or auditory brain stem response testing. Diagnostic testing was performed with age appropriate tests, auditory brain stem response and/or visual reinforcement audiometry. Infants diagnosed with permanent hearing loss were considered for hearing aids and early intervention. Ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention were investigated regarding nursery type, risk status, unilateral versus bilateral hearing loss, loss type, loss severity, and state regions. RESULTS: The prevalence of infants diagnosed with permanent hearing loss was 2.0/1000 (85 of 43,311). Of the 85 infants with hearing loss, 61% were from neonatal intensive care units (NICUs) and 67% were at risk for hearing loss. Of the 36 infants fitted with hearing aids, 58% were from NICUs and 78% were at risk for hearing loss. The median age at identification and enrollment in early intervention was 3 mo. Median age at hearing aid fitting was 7.5 mo. Median ages at identification were less for infants from the well-baby nurseries (WBNs) than for the NICU infants and for infants with severe/profound than for infants with mild/moderate hearing loss, but were similar for not-at-risk and at-risk infants. Median ages at hearing aid fitting were less for well babies than for NICU infants, for not-at-risk infants than for at-risk infants, and for infants with severe/ profound hearing loss than for infants with mild/ moderate hearing loss. However, median ages at early intervention enrollment were similar for nursery types, risk status, and severity of hearing loss. CONCLUSIONS: Early ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention can be achieved for infants from NICUs and WBNs and for infants at risk and not at risk for hearing loss in a large multi-center universal newborn hearing screening program.

Age Factors↗

PubMedDate not supplied

The importance of sustainability in the design of culturally appropriate programmes of early intervention.

The need for early intervention with regard to children with developmental disabilities is of increasingly universal relevance. The means adopted in pursuit of this end will, however, vary appropriately across cultures. All intervention programmes will inevitably share many features in common, but to be truly effective, programmes need to take into account circumstances in the locality in which they operate. This notion is frequently paid 'lip-service', but many programmes across the globe still retain the essential character of services developed in the context of Europe or North America. What is required is a radical appreciation of the importance of service programmes reflecting the structure and functions of indigenous culture. A concept useful in this regard is that of sustainability, which is currently guiding much discussion concerning the nature of economic and agricultural programmes in the developing world. This term emphasizes the need to consider from the outset the mechanisms that will serve to support changes brought about on the formal introduction of intervention programmes. Using a behaviour analytic framework to examine the concept of sustainability, specific prerequisites of a 'sustainable service' within any particular setting are suggested. A resulting checklist of factors that should be considered in advance of service development may be a useful aid to service planners.

Behavior Therapy↗

PubMed1998

Early intervention, untreated psychosis and the course of early schizophrenia.

BACKGROUND: Studies have proved that early intervention can delay psychotic relapses, and prevent psychosocial deterioration in people with schizophrenia and related disorders. METHOD: Our study with young people with recent onset schizophrenia has shown that an intensive intervention programme had a beneficial effect on the occurrence of psychotic relapse and the course of psychotic syndromes. This effect lasted until the end of the 15-month intervention. No significant effect of the two different intervention conditions became apparent. RESULTS: The results of a follow-up study showed that this beneficial effect did not last. Fifteen per cent of the people had a psychotic relapse during the intervention, whereas 64% relapsed during follow-up. CONCLUSIONS: These results show that referral to other mental health agencies after intervention is not sufficient and that more support is required to continue disease management, medication compliance and stress management.

Adult↗