Developmental screening and early intervention in a childcare setting for young children at risk for autism and other developmental delays: A feasibility trial
Amanda Gulsrud1, Themba Carr2, Justin Williams1
1University of California, Los Angeles, California.
Insights
Childcare centers can effectively screen and provide early interventions for developmental delays, including autism spectrum disorder, in underserved communities. This approach shows promise for improving early detection and support for at-risk children.
Area of Science:
- Developmental Pediatrics
- Early Childhood Education
- Public Health
Background:
- Disparities in diagnosis and treatment for children with developmental delays persist, particularly in under-resourced populations.
- Community-based settings are increasingly recognized as feasible locations for universal developmental screening.
- Childcare centers offer a promising venue for early identification and intervention services.
Purpose of the Study:
- To assess the feasibility of implementing a developmental screening and early intervention program within an urban, low-income childcare center.
- To evaluate the impact of a staff-delivered intervention on developmental outcomes for children at risk for delays.
- To provide initial data on serving a diverse, low-resource population within the childcare system.
Main Methods:
- Developmental screening was conducted on 116 children (16-80 months) in a childcare center.
- Parents of 20 children who screened positive were enrolled in either a targeted early intervention or a waitlist control group.
- Mixed-effect models with confidence intervals were used to analyze changes over time, accounting for small and imbalanced sample sizes.
Main Results:
- Children receiving the targeted early intervention demonstrated average increases in child-initiated joint engagement, symbolic play, and language use.
- The study provides initial feasibility data for screening and intervention in a childcare setting.
- Positive outcomes were observed in a predominantly low-resource and ethnically diverse population.
Conclusions:
- The childcare setting is a viable location for implementing developmental screening and early intervention programs.
- This approach can help reduce disparities in accessing services for young children with developmental delays.
- Further research is warranted to confirm these findings in larger, more diverse populations.
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. Autism Res 2019, 12: 1423-1433. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. 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 under-resourced 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.
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