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Background: This implementation feasibility study was conducted to determine whether an evidence-based parent-implemented distance-learning intervention model for young children at high likelihood of having ASD could be implemented at fidelity by Part C community providers and by parents in low-resource communities. Methods: The study used a community-academic partnership model to adapt an evidence-based intervention tested in the current pilot trial involving randomization by agency in four states and enrollment of 35 coaches and 34 parent-family dyads. After baseline data were gathered, providers in the experimental group received 12-15 h of training while control providers received six webinars on early development. Providers delivered 6 months of intervention with children-families, concluding with data collection. Regression analyses were used to model outcomes of the coach behaviors, the parent fidelity ratings, and child outcomes. Results: A block design model-building approach was used to test the null model followed by the inclusion of group as a predictor, and finally the inclusion of the planned covariates. Model fit was examined using changes in R[superscript 2] and "F"-statistic. As hypothesized, results demonstrated significant gains in (1) experimental provider fidelity of coaching implementation compared to the control group; and (2) experimental parent fidelity of implementation compared to the control group. There were no significant differences between groups on child developmental scores. Conclusions: Even though the experimental parent group averaged less than 30 min of intervention weekly with providers in the 6 months, both providers and parents demonstrated statistically significant gains on the fidelity of implementation scores with moderate effect sizes compared to control groups. Since child changes in parent-mediated models are dependent upon the parents' ability to deliver the intervention, and since parent delivery is dependent upon providers who are coaching the parents, these results demonstrated that two of these three links of the chain were positively affected by the experimental implementation model. However, a lack of significant differences in child group gains suggests that further work is needed on this model. Factors to consider include the amount of contact with the provider, the amount of practice children experience, the amount of contact both providers and parents spend on training materials, and motivational strategies for parents, among others.

BackgroundThis implementation feasibility study was conducted to determine whether an evidence-based parent-implemented distance-learning intervention model for young children at high likelihood of having ASD could be implemented at fidelity by Part C community providers and by parents in low-resource communities.MethodsThe study used a community-academic partnership model to adapt an evidence-based intervention tested in the current pilot trial involving randomization by agency in four states and enrollment of 35 coaches and 34 parent-family dyads. After baseline data were gathered, providers in the experimental group received 12-15 h of training while control providers received six webinars on early development. Providers delivered 6 months of intervention with children-families, concluding with data collection. Regression analyses were used to model outcomes of the coach behaviors, the parent fidelity ratings, and child outcomes.ResultsA block design model-building approach was used to test the null model followed by the inclusion of group as a predictor, and finally the inclusion of the planned covariates. Model fit was examined using changes in R2 and F-statistic. As hypothesized, results demonstrated significant gains in (1) experimental provider fidelity of coaching implementation compared to the control group; and (2) experimental parent fidelity of implementation compared to the control group. There were no significant differences between groups on child developmental scores.ConclusionsEven though the experimental parent group averaged less than 30 min of intervention weekly with providers in the 6 months, both providers and parents demonstrated statistically significant gains on the fidelity of implementation scores with moderate effect sizes compared to control groups. Since child changes in parent-mediated models are dependent upon the parents' ability to deliver the intervention, and since parent delivery is dependent upon providers who are coaching the parents, these results demonstrated that two of these three links of the chain were positively affected by the experimental implementation model. However, a lack of significant differences in child group gains suggests that further work is needed on this model. Factors to consider include the amount of contact with the provider, the amount of practice children experience, the amount of contact both providers and parents spend on training materials, and motivational strategies for parents, among others.Trial registrationRegistry of Efficacy and Effectiveness Studies: #4360, registered 1xx, October, 2020 - Retrospectively registered, https://sreereg.icpsr.umich.edu/sreereg/.

As the rates of Autism Spectrum Disorder (ASD) increase and early screening efforts intensify, more toddlers with high likelihood of ASD are entering the United States' (US') publicly funded early intervention system. Early intervention service delivery for toddlers with ASD varies greatly based on state resources and regulations. Research recommends beginning ASD-specific evidence-based practices (EBP), especially caregiver-implemented intervention, as early as possible to facilitate the development of social-communication skills and general learning. Translating EBP into practice has been challenging, especially in low-resourced areas. The main goal of this study was to obtain a more comprehensive understanding of public early intervention system structure, service delivery practices, and factors influencing EBP use for children with ASD in the US. Participants (N = 133) included 8 early intervention state coordinators in 7 states, 29 agency administrators in those states, 57 early intervention providers from those agencies, and 39 caregivers of children with ASD receiving services from those providers. Online surveys gathered stakeholder and caregiver perspectives on early intervention services as well as organizational factors related to EBP implementation climate and culture. Stakeholders identified key intervention needs for young children with ASD. In general, both agency administrators and direct providers reported feeling somewhat effective or very effective in addressing most needs of children with ASD. They reported the most difficulty addressing eating, sleeping, family stress, and stereotyped behaviors. Data indicate that children from families with higher income received significantly higher service intensity. While administrators and providers reported high rates of high-quality caregiver coaching (>60%), caregivers reported low rates (23%). Direct providers with more favorable attitudes toward EBP had greater EBP use. In turn, provider attitudes toward EBP were significantly associated with implementation leadership and culture at their agency. Results suggest that publicly funded early intervention programs in the US require additional resources and training for providers and leaders to support improved implementation climate and attitudes toward ASD EBPs. Results also suggest that more state system support is needed to increase use of ASD-specific EBP use, including high-quality caregiver coaching, to better serve toddlers with ASD. Recommendations for implementation strategies are addressed.

Children living in rural areas are diagnosed with Autism Spectrum Disorder later than their non-rural counterparts. In rural areas, caregivers have limited access to ASD information and services. Caregivers play a central role in early diagnosis and intervention, only when they have current knowledge about early ASD symptoms. The purpose of this paper was to understand caregivers' knowledge of ASD behaviours and its aetiology and to explore if there were differences between rural and urban caregivers' knowledge about ASD. One hundred and eighty-five Alabama caregivers answered two open-ended questions on the causes and behaviours of ASD as part of a larger survey. This report focuses on a qualitative textual analysis of the open-ended questions. Eight themes emerged regarding ASD behaviours including communication, emotion and behaviour, heterogeneity, unknown, learning and development, other, repetitive and sensory behaviours, and social impairments. Ten themes emerged regarding aetiology including born with it, cause unknown, combination, environmental, genetic/environmental interaction, genetics/chromosomal I do not know, neurological, other, and pregnancy. Both rural and urban caregiver groups reported behaviours associated with diagnostic criteria. However, urban caregivers reported behaviours more proximal to DSM-5 diagnostic criteria while rural caregivers reported behaviours less specific to ASD. Findings may help better understand why children in rural communities receive later diagnoses.

Background: This implementation feasibility study was conducted to determine whether an evidence-based parent -implemented distance-learning intervention model for young children at high likelihood of having ASD could be implemented at fidelity by Part C community providers and by parents in low resource communities. Methods: : The study used a community academic partnership model to adapt an evidence-based intervention tested in the current pilot trial involving randomization by agency in four states and enrollment of 35 coaches and 34 parent-family dyads. After baseline data were gathered, providers in the experimental group received up to 12 hours of training while control providers received six webinars on early development. Six months of intervention with children-families then followed, concluding with data collection. Regression analyses were used to model outcomes of the coach behaviors, the parent fidelity ratings, and child outcomes. Results: : A block design model-building approach was used to test the null model followed by the inclusion of group as a predictor, and finally the inclusion of the planned covariates. Model fit was examined using changes in R 2 and F-statistic. As hypothesized, results demonstrated significant gains in (1) experimental provider fidelity of implementation compared to the control group; and (2) experimental parent fidelity of implementation compared to the control group. There were no significant differences between groups in child developmental scores. Conclusions: : Even though the experimental parent group averaged less than 30 minutes weekly with providers in the 6 months, both providers and parents demonstrated statistically significant gains with moderate effect sizes compared to control groups. Since child changes in parent mediated models are dependent upon the parents’ ability to deliver the intervention, and since parent delivery is dependent upon providers who are coaching the parents, these results demonstrated that two of these three links of the chain were positively affected by the experimental implementation model. However, lack of significant differences in child group gains suggests that further work is needed on this model. Factors to consider include amount of contact with the provider, amount of practice children experience, amount of contact both providers and parents spend on training materials, and motivational strategies for parents, among others. Trial registration: Registry of Efficacy and Effectiveness Studies: #4360, registered 1xx, October, 2020 – Retrospectively registered, http://

Museum-based settings such as zoos provide a unique opportunity to engage educators in professional development opportunities. For instance, zoo settings can provide professional development opportunities focused on facilitating learning through a lens of conservation action to promote sustained action by teachers and their students. In this paper, we present an overview of a new zoo-based teacher professional development program designed to develop educators' connections with wildlife and experiences with conservation actions. The program specifically aligns to the CARE framework for conservation education that addresses limitations of prior models for moving individuals from caring about wildlife to taking action to protect wildlife. We present results from two implementations of this professional development program with 21 teachers. The implications of these findings are discussed with reference to the value of action-based frameworks for guiding zoo-based teacher professional development and empowering educators to facilitate learning through a conservation lens to promote conservation action. [ABSTRACT FROM AUTHOR]

Over the past decade, a newer class of interventions has emerged specifically designed for young children with or at high likelihood of autism, which are called Naturalistic Developmental Behavioral Interventions (NDBIs). NDBIs are particularly well-suited as a discipline agnostic, primary intervention for young children with autism and other social communication challenges; however, community providers from multiple disciplinary backgrounds who serve these children typically do not develop competencies in areas crucial for effectively implementing NDBI. The goal of this commentary is to: (a) describe the interdisciplinary competencies needed to deliver NDBIs effectively and (b) provide recommendations for moving the field of early intervention for autism and social communication delays forward. Resources for building these competencies for providers at the pre- and in-service level are also provided. [ABSTRACT FROM AUTHOR]

Background: Phonological memory (PM) plays a significant role in language development but is impaired in individuals with Down syndrome (DS). Without formal recommendations on how to address PM limitations in clients with DS, it is possible speech-language pathologists (SLPs) find ways to do so in their practices. Aims: This study asked if and how SLPs address PM in language therapy with clients who have DS. It also asked about SLPs' opinions of the importance, practicality and difficulty of addressing PM in clients with DS. Methods & Procedures: SLPs participated in an online survey that asked if they address PM in clients with DS and, if so, how often and with which techniques. The survey also asked SLPs to rate their opinions of addressing PM in clients with DS with Likert scales. To contrast clients with DS, SLPs were asked about their practices and opinions with clients who have specific language impairment (SLI) and autism spectrum disorders (ASD). SLPs were recruited through e-mails sent from state organizations and researchers. To compare SLPs' practices and opinions across client types, frequency analyses and analyses of variance (ANOVAs) were run. Outcomes & Results: In all, 290 SLPs from 28 states completed the survey. Nearly all SLPs were currently practising at the time data were collected, and all worked with at least one of the three client types. Findings indicated SLPs less often addressed PM and used less variety when addressing PM with clients who have DS compared with clients who have SLI or ASD. Further, SLPs considered it less important, less practical and more difficult to address PM in clients who have DS when compared with clients who have SLI, whereas a similar pattern was found with clients who have ASD. Conclusions & Implications: SLPs' opinions could be one reason they under-address PM with clients who have DS. Other reasons include there are no evidence-based practice (EBP) guidelines on this topic, and there is not enough familiarity with the DS phenotype among SLPs. Future research on ways to address PM in clients with DS successfully are essential so that EBP guidelines can be established and language therapy can be made more effective.

This study explored unique constructs of fantasy orientation and whether there are developmental benefits for fantasy-oriented children. By age 3, children begin developing executive functions, with some children exhibiting high fantasy orientation in their cognitions and behaviors. Preschoolers ("n" = 106) completed fantasy orientation measures and executive function tasks, including parent and teacher questionnaires. Principal Component Analysis revealed four specific constructs within fantasy orientation (FO). Relations were examined between children's FO constructs and executive functions to determine if developmental benefits exist with being fantasy-oriented. Hierarchical linear regressions suggested that certain FO constructs are uniquely related to specific executive functions, such that there are potentially specific developmental benefits to being a fantasy-oriented child (i.e., inhibition and attention shift positively related to fantastical cognitions).

The present study extended the findings of Watt et al. (J Autism Dev Disord 38:1518-1533, 2008) by investigating repetitive and stereotyped behaviors (RSB) demonstrated by children (n = 50) and typical development (TD; n = 50) matched on developmental age, gender, and parents' education level. RSB were coded from videotaped Communication and Symbolic Behavior Scales Behavior Samples (Wetherby and Prizant 2002) using the Noldus Pro Observer[C] video software. Children with ASD demonstrated significantly higher frequencies of RSB with body objects excluding categories involving banging or tapping objects or surfaces. Behaviors demonstrated by both groups indicated overlapping RSB profiles at this age. These findings highlight the significance of RSB in the early identification and support the need for future research to further determine ASD-specific RSB.

Appropriate play behaviors facilitate language skills, increase cognitive skills, and provide opportunity for social interaction. However, play skills often present differently in children with Autism Spectrum Disorders (ASD). Currently, there are several global standardized ASD measures used during diagnostic evaluations that include, but are not limited to, assessment of play. However, it is unclear whether these measures examine similar aspects of play. This uncertainty is important to explore to better understand the whole profile of children’s play competencies to implement developmentally appropriate interventions and create fitting goals. The current study explored the relations of children’s play measured by clinicians’ observations (Autism Diagnostic Observation Schedule [ADOS], Childhood Autism Rating Scale–Second Edition [CARS2-ST]) and parents’ reports (Adaptive Behavior Assessment System–Second Edition [ABAS-II], Communication and Symbolic Behavior Scales Developmental Profile–Infant/Toddler Checklist [CSBS DP-ITC]). Participants (n = 34) were toddlers and preschool-aged children with ASD. A play composite was created for each aforementioned measure, which included extracted items that specifically examined play skills. Initial results suggested minimal similarities in play composites across measures. Play composites were also compared with children’s developmental skills (Mullen Scales of Early Learning [MSEL]) to explore the reciprocal relationship between play/developmental skills. Results revealed that expressive and receptive language skills, fine motor skills, and visual reception skills (from MSEL) were significantly correlated with specific play composites. This study’s innovative identification of play composites from standardized ASD diagnostic measures highlights the importance of (a) using multiple methodologies to gain a whole profile of children’s play/developmental skills, and (b) selecting interventions matched on children’s current play/developmental skills. [ABSTRACT FROM PUBLISHER]

A prototype Digital Video Library was developed as part of a project to assist rural primary care clinics with diagnosis of autism, funded by the National Network of Libraries of Medicine. The Digital Video Library takes play sample videos generated by a rural clinic and makes it available to experts at the Autism Spectrum Disorders (ASD) Clinic at The University of Alabama. The experts are able to annotate segments of the video using an integrated version of the Childhood Autism Ratings Scale-Second Edition Standard Version (CARS2). The Digital Video Library then extracts the annotated segments, and provides a robust search and browse feature. The videos can then be accessed by the subject's primary care physician. This article summarizes the development and features of the Digital Video Library. [ABSTRACT FROM AUTHOR]