From Concerns to Care: Understanding Parental Priorities and Access to Early Intervention for Infants With Fragile X
Samantha Scott1, Katherine C Okoniewski1, Anne Edwards1
1RTI International, Durham, North Carolina, USA.
Insights
Infants with fragile X syndrome (FXS) face barriers to early intervention services despite early diagnosis. Caregiver concerns focus on motor and communication development, yet only half access services by age one.
Area of Science:
- Neurodevelopmental disorders
- Genetics and genomics
- Pediatric health
Background:
- Fragile X syndrome (FXS) is a genetic condition impacting development.
- Early diagnosis in newborns allows for proactive intervention.
- Caregiver experiences and service access for presymptomatic infants are not well understood.
Purpose of the Study:
- To examine the experiences of infants diagnosed with FXS at birth and their caregivers.
- To identify caregiver concerns during the first year of life.
- To assess access to early intervention services for these infants.
Main Methods:
- Pilot intervention program for newborns with FXS and caregivers.
- Mixed-methods approach utilizing caregiver questionnaires and intervention notes.
- Data collection focused on identifying concerns and service utilization.
Main Results:
- Caregivers reported motor development concerns early, shifting to communication concerns by 12 months.
- Only 50% of eligible infants were enrolled in Part C services by their first birthday.
- Occupational therapy was most utilized, followed by physical and feeding therapies.
Conclusions:
- Infants with FXS diagnosed presymptomatically encounter barriers to early intervention access.
- Despite eligibility for Part C services, access remains a challenge.
- Further research is needed on referral processes for infants with neurogenetic conditions.
Background:
This study examined the experiences of infants diagnosed with fragile X syndrome (FXS) in the newborn period and their caregivers during the infant's first year of life. The primary objective was to understand caregiver concerns and access to early intervention services for infants diagnosed with FXS presymptomatically.
Methods:
Participants for this study were part of a pilot intervention programme for newborns with FXS and their caregivers. A mixed-methods approach was taken combining data from caregiver questionnaires as well as intervention session notes to identify caregiver concerns and early intervention services.
Results:
Caregivers of infants with FXS consistently reported concerns in motor development in the first few months of life with increasing concern regarding communication development closer to 12 months of age. Despite all being eligible based on having an established condition and instruction for accessing early intervention services provided by the intervention team, only half of participants were enrolled in their state's Part C programme by the child's first birthday. Occupational therapy was the most accessed service (33% of infants), followed by physical therapy (27%), feeding therapy (20%), speech therapy (13%) and developmental play therapy (7%).
Conclusions:
Although one of the main benefits of earlier diagnosis is purported to be earlier access to interventions, we found infants diagnosed with FXS prior to emergence of symptoms experienced barriers to accessing early intervention services, despite FXS being an established condition for Part C services. These findings highlight the need for further exploration of the referral process for infants diagnosed with neurogenetic conditions in infancy.
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