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Very few studies have examined how to culturally and linguistically (CL) adapt professional development (PD) programs in assistive technology (AT) for Latinx teachers serving young children with disabilities. The purposes of this article are (a) to present an iterative design of a CL-adapted PD program, (b) to examine the impact of this program on teachers' use of AT practices to support young children with disabilities in early childhood classrooms, and (c) to evaluate the usefulness of program adaptations through the lens of bilingual Latinx practitioners. The Ecological Validity Model (EVM) was used as a framework for both the development and assessment of the program's CL adaptations. Quantitative results indicated significant changes in teachers' AT use pre- to post-intervention, while qualitative findings revealed the program's alignment with the "language," "persons," "metaphors," and "context" dimensions of the EVM. In addition, three themes provided rich descriptions of the program's responsiveness to practitioners and classrooms. This study supports the CL adaptation of AT interventions as an equitable practice, supporting young children across a range of disabilities, cultures, and contexts while empowering the diverse practitioners who serve them.

Although there are documented benefits and legislative mandates for children from birth through age 22, assistive technology (AT) is highly underused, especially among young children (Dunst & Trivette, 2011). One of the main reasons for this underuse is that while teachers are legally required to provide AT for children with disabilities, many teachers do not have the knowledge, confidence, or skills needed to provide AT to support early literacy instruction (Dean, 2020; Hilaire & Gallagher, 2020; Temple, 2019). This article identifies the benefits of AT during early literacy instruction and describes how teachers can integrate practical AT tools and strategies into early literacy instruction using a widely utilized framework call the SETT (Student Environment Task Tool; Zabala, 1995) Framework. The authors aim to provide free professional development resources to improve teachers integration of AT in their classrooms to enhance opportunities for young children with disabilities to meaningfully participate in everyday literacy activities.

Despite the efficacy of assistive technology (AT), many children with disabilities do not have access to AT and are not fully benefiting from inclusive preschool education. The current mixed-methods study examined a multi-faceted professional development (PD) intervention aligned with the CEC's Early Intervention/Early Childhood Special Education (EI/ECSE) Standards to increase general early childhood education (ECE) teachers' use of AT to promote early literacy in young children with disabilities. The 24-week PD intervention included: (a) online modules, (b) coaching; and (c) a classroom kit of AT devices. Participants were six lead teachers, 10 teacher aides, and 34 children from six inclusive classrooms in two preschools. Quantitative methods included pre-and post- surveys, early literacy assessments, and classroom observations. Qualitative analysis explored data from focus groups and input from teacher adherence forms. Results revealed that (a) teachers' AT knowledge, positive beliefs, and use; and (b) children's use of AT and early literacy skills significantly increased pre- to post- intervention. Qualitative findings revealed themes relating to how teachers benefitted from the PD and the impact of AT on teacher instruction and child learning. Findings support innovative PD practices to build capacity of practitioners implementing AT as a responsive instructional strategy in inclusive classrooms.

The COVID-19 pandemic has had massive impacts across the globe. Children with developmental delays are an increasingly vulnerable population, highlighting the importance of ensuring they have access to high-quality virtual services during this time. The Early Discovery program currently provides therapeutic interventions for children with mild developmental delays. We sought to compare the outcomes of 2 cohorts within the Early Discovery program using different delivery approaches (n = 238 families): children who received services in person before the pandemic (n = 126) and children who received services via telehealth in the acute phase of the pandemic (n = 112). Both groups of children showed significant improvements in language skills posttreatment, and, with regard to auditory comprehension, both groups showed similar rates of improvement. However, children receiving in-person services before the pandemic showed greater improvements in expressive communication skills than children receiving telehealth services during the pandemic. Results indicate that the Early Discovery program was able to make adjustments during the pandemic that assisted families in maintaining progress in improving their child's language skills.

Teaching is a stressful profession given teachers' competing demands. Due to COVID-19, teachers struggle to balance maintaining a safe classroom environment and the traditional child-directed focus of early education. The purpose of this study was to examine the effectiveness of an adaptation of Infant/Early Childhood Mental Health Consultation (IECMHC) on reducing teachers' stress and examine associations between teacher stress and classroom practices. Measures were collected at baseline (T1) and 6-months post-intervention (T2) using the Childcare Worker Job Stress Inventory, an observational measure of classroom practices (Health Environment Rating Scale), and teacher-child interaction quality (Classroom Assessment Scoring System). Regression analyses revealed that teacher-reported Job Resources were associated with higher Classroom Organization at T2. Findings suggested that providing mental health consultation may be an important first step in improving quality classroom practices, particularly those practices that support children's social-emotional and behavioral development.

Introduction Community-academic partnerships (CAPs) aim to improve neighborhood population health. Though measuring the impact of partnership activities at a population level can be difficult, evaluating indicators of wellbeing may increase understanding of how communities benefit from CAPs. This study examined child health indicators over time in two low-income, predominantly Black/African American and Hispanic communities where partnerships between an academic child development center and community coalitions were formed with the intention of improving child well-being. Methods Trends in three child wellbeing indicators (graduation rates, kindergarten readiness, and proportion of youth in school and/or employed) were compared between two CAP communities and several neighboring comparison communities. Data between 2011 and 2017 were analyzed to calculate percent change from baseline and mapped using ArcGIS to visualize trends by zip code. Proportions of youth meeting benchmarks were also determined. Results Kindergarten readiness and high-school graduation rates improved in CAP communities but not in geographically proximal and socioeconomically similar comparison communities. No improvements were found in the proportion of youth in school or employed. Discussion This study revealed population-level indicators improved over time in CAP communities. Because community-level child health and wellbeing are influenced by many factors, this correlation is not proof of a causal relationship. Assessing population level indicators can nonetheless provide insight into the benefit of CAPs, and the commitment to monitoring such outcomes can itself advance how academic and community partners plan activities and set long-term goals., Author(s): Renae D. Schmidt [sup.1] , F. Daniel Armstrong [sup.2] , Viviana E. Horigian [sup.1] , Graylyn Swilley-Woods [sup.3] , Betty Alonso [sup.4] , Douglene Jackson [sup.2] , Ruby Natale [...]

Early Discovery is a program that supports mildly delayed young children who did not qualify for Part B/C services. Our goals were to: (1) provide high-quality services; (2) educate and empower parents/caregivers; (3) link families to community resources; and (4) reduce the need for special education. Services included speech-language, occupational, behavioral, or general developmental intervention. Significant improvement from pre- to post-intervention were seen. Eighty-six percent of children did not require special education 1-3 years post-intervention. Results suggested intensive interventions for children with mild delays prevented developmental decline. Discussion focuses on the need for continued research and programming in early intervention for children with mild delays.

Universal screening of social-emotional deficits in preschool children is a promising avenue for detecting children in need of early intervention. Due to the enormity of this task, it is vital that the instruments used in universal screening be brief, inexpensive, and capable of accurately measuring social-emotional development. The Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) fulfills these requirements, but has been established only as a parent-report instrument, which makes it difficult to assess preschool-based child behavior and reporter bias. The current study examined the reliability and validity of the ASQ:SE in a sample of 443 preschool children and their teachers. Overall, the teacher-report ASQ:SE produced promising findings, including adequate internal consistency reliability (a = 0.73-0.74) and strong concurrent validity. Further studies should include discriminant validity analyses, and more representative samples to allow for generalization of results.

Childcare centers (CCCs) can provide opportunities to implement physical activity (PA) via health promotion interventions to prevent obesity and associated chronic disease risk factors in young children. This study evaluated the impact of the Healthy Caregivers-Healthy Children (HC2) intervention on body mass index percentile (PBMI) and the PA environment in CCCs serving children with disabilities (CWD) over one school year. Ten CCCs were cluster-randomized to either (1) an intervention arm that received the HC2 curriculum adapted for CWD or (2) an attention control arm. Mixed-effect linear regression models analyzed the relationship between change in child PBMI and CCC childcare center PA environment by experimental condition and child disability status over one school year. Findings showed a significant decrease in PBMI among children in the HC2 centers (−6.74, p = 0.007) versus those in control centers (−1.35, p = 0.74) over one school year. Increased PA staff behaviors (mean change 3.66, p < 0.001) and PA policies (mean change 6.12, p < 0.001) were shown in intervention centers during the same period. Conversely, there was a significant increase in sedentary opportunities (mean change 4.45, p < 0.001) and a decrease in the portable play environment (mean change −3.16, p = 0.03) and fixed play environment (mean change −2.59, p = 0.04) in control centers. No significant differences were found in PBMI changes between CWD and children without disabilities (beta = 1.62, 95% CI [−7.52, 10.76], p = 0.73), suggesting the intervention's efficacy does not differ by disability status. These results underscore the importance of (1) including young CWD and (2) PA and the supporting environment in CCC health promotion and obesity prevention interventions. [ABSTRACT FROM AUTHOR]

Objectives Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children. Methods Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced. Results Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced. Conclusions Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development., Author(s): Sarah E. Messiah [sup.1] [sup.2] , Folefac Atem [sup.1] [sup.2] , Cynthia Lebron [sup.3] , Ashley Ofori [sup.1] [sup.2] , M. Sunil Mathew [sup.1] [sup.2] , Catherina Chang [sup.4] [...]

The purpose of this study was to explore the experiences of parents of children with mild language delays who were referred to an Individuals With Disabilities Education Act (IDEA) birth-to-3 or preschool program, were determined not eligible for services, and were referred on to a community-based program for short-term speech-language therapy. Interviews were conducted in the parents' preferred language (10 Spanish, 10 English). A grounded theory approach was applied to identify emergent themes. Results indicated that the process of recognizing a developmental delay, receiving assessment results, and enrolling in services presents challenges that require parents to demonstrate engagement and advocacy throughout. This study highlights parents' motivations for seeking out early intervention services and underscores the importance of understanding parents' experiences navigating developmental service systems. Program planners can partner with parents to address barriers and also capitalize on successes to facilitate timely response to developmental concerns, appropriate referrals, and effective interventions.

An extensive body of research demonstrates a higher prevalence of obesity among children with developmental delays (DD) versus children without delays. This analysis examined the effectiveness of a randomized controlled trial to promote healthy weight in a subsample of preschool-age children with DD (n = 71) on the adoption of quality nutrition and increased physical activity habits versus controls. Child care centers (N = 28) randomized to the intervention group received a multilevel (parent, teacher, child) role modeling program and curriculum on obesity prevention. Results showed that children in the intervention group slightly decreased their junk food consumption while the control group increased their junk food consumption. In addition, among preschool-age children with DD, change in parent fruit and vegetable consumption significantly influenced change in their child's consumption. Conversely, the greater the consumption of junk food by parents, the greater consumption by their children. Results imply that preschool-age children with DD may benefit from child care center-based healthy weight programs.

Background: One in four preschool-age children in the United States are currently overweight or obese. Previous studies have shown that caregivers of this age group often have difficulty accurately recognizing their child's weight status. The purpose of this study was to examine factors associated with accurate/inaccurate perception of child body mass index (BMI) among a multicultural sample of caregivers who were predominantly low-income and foreign-born. Methods: A total of 980 caregivers (72% Hispanic, 71% born outside of the United States) of preschool-age children (N = 1,105) were asked if their child was normal weight, overweight, or obese. Answers were compared to actual child BMI percentile category via chi-square analysis. Logistic regression analysis was performed to assess predictors of accurate perception of child BMI percentile category. Results: More than one third of preschoolers were either overweight (18.4%) or obese (16.5%). The majority (92%) of caregivers of an overweight/obese child inaccurately perceived that their child was in a normal BMI category. Overall, foreign-born caregivers were significantly less likely to accurately perceive their child's BMI percentile category versus U.S.-born caregivers (odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.48-0.88). Specifically, those born in South America (OR = 0.59, 95% CI = 0.36-0.98), Central America/Mexico (OR = 0.59, 95% CI = 0.41-0.85), and Caribbean Hispanic nations (OR = 0.54, 95% CI = 0.35-0.83) were significantly less likely to accurately perceive their child's BMI category versus U.S.-born caregivers. Conclusions: The results of this study suggest that foreign-born caregivers of U.S. preschool-age overweight/obese children in particular do not accurately perceive their child's BMI status. Health care professionals serving foreign-born caregivers may consider additional culturally appropriate healthy weight counseling for these families.

Obesity is a significant public health issue affecting even our youngest children. Given that a significant amount of young children are enrolled in child care, the goal of this project was to evaluate the effectiveness of a child care facility-based obesity prevention program. Over 1,000 facilities participated in the study. The intervention consisted of teacher trainings and technical assistance focused around the implementation of four policies: snack, beverage, physical activity, and screen time. Changes in teacher's attitudes and beliefs, as well as improvements in healthy lifestyle practices, were assessed. Results revealed significant improvements in child care center practices, such as: (1) the amount of health-related lessons provided to students increased t(664) = -6.09, P < 0.00; (2) the amount of outdoor physical activity increased t(702) = -3.83, P < 0.000; (3) the amount of screen time decreased t(686) = -2.52, P < 0.01; (4) the amount of juice served decreased t(577) = -7.38, P < 0.000; and (5) the amount of junk food decreased t(568) = -2.73, P < 0.006. The findings from this study can be easily disseminated and potentially serve as a model for improving the quality of nutrition and physical activity practices in child care facilities.

Obesity rates among preschool-aged children have doubled in the past 10 years, and 60% of these children spend the majority of their day in childcare facilities. Few studies have examined the quality of nutrition and physical activity practices in childcare centers as compared to family childcare homes. The purpose of this study is to determine if a pattern of differences exist in these two settings. As part of a CDC-funded study to reduce the obesity epidemic in young children, directors of 1,140 childcare facilities (842 out-of-home and 298 in-home) in one large county completed a survey that detailed their practices related to child nutrition and physical activity. Results showed that compared with out-of-home facilities, in-home facilities were more likely to report excellent indoor physical activity (87.2 vs. 85.5%, p = 0.059), less likely to report excellent outdoor physical activity (92.8 vs. 96.5%, p = 0.018), more likely to serve fruit (80.3 vs. 51.2%), and less likely to serve 1% milk (45.2 vs. 55%). This study's present findings revealed that ample opportunity exists to significantly improve the health of young children in both in-home and out-of-home facilities.

Objective: The prevalence of obesity among pre-school-aged children in the USA remains unacceptably high. Here, we examine the impact of Healthy Caregivers-Healthy Children (HC2) Phase 2, a childcare centre (CCC)-based obesity prevention intervention on changes in the CCC nutrition and physical activity environment over 2 school years. Design: This was a cluster-randomised trial with twelve CCC receiving the HC2 intervention arm and twelve in the control arm. The primary outcome was change in the Environment and Policy Assessment and Observation (EPAO) tool over 2 school years (Fall 2015, Spring 2016 and Spring 2017). Changes in EPAO physical activity and nutrition score were analysed via a: (1) random effects mixed models and (2) mixed models to determine the effect of HC2 v. control. Setting: The study was conducted in twenty-four CCC serving low-income, ethnically diverse families in Miami-Dade County. Participants: Intervention CCC received (1) teachers/parents/children curriculum, (2) snack, beverage, physical activity, and screen time policies, and (3) menu modifications. Results: Two-year EPAO nutrition score changes in intervention CCC were almost twice that of control CCC. The EPAO physical activity environment scores only slightly improved in intervention CCC v. control CCC. Intervention CCC showed higher combined EPAO physical activity and nutrition scores compared to control CCC over the 2-year study period (β = 0·09, P = 0·05). Conclusions: Obesity prevention programmes can have a positive impact on the CCC nutrition environment and can promote healthy weight in early childhood. CCC may need consistent support to improve the physical activity environment to ensure the policies remain intact. [ABSTRACT FROM AUTHOR]

Abstract Background Many unhealthy dietary and physical activity habits that foster the development of obesity are established by the age of five. Presently, approximately 70 percent of children in the United States are currently enrolled in early childcare facilities, making this an ideal setting to implement and evaluate childhood obesity prevention efforts. We describe here the methods for conducting an obesity prevention randomized trial in the child care setting. Methods/design A randomized, controlled obesity prevention trial is currently being conducted over a three year period (2010-present). The sample consists of 28 low-income, ethnically diverse child care centers with 1105 children (sample is 60% Hispanic, 15% Haitian, 12% Black, 2% non-Hispanic White and 71% of caregivers were born outside of the US). The purpose is to test the efficacy of a parent and teacher role-modeling intervention on children’s nutrition and physical activity behaviors. . The Healthy Caregivers-Healthy Children (HC2) intervention arm schools received a combination of (1) implementing a daily curricula for teachers/parents (the nutritional gatekeepers); (2) implementing a daily curricula for children; (3) technical assistance with meal and snack menu modifications such as including more fresh and less canned produce; and (4) creation of a center policy for dietary requirements for meals and snacks, physical activity and screen time. Control arm schools received an attention control safety curriculum. Major outcome measures include pre-post changes in child body mass index percentile and z score, fruit and vegetable and other nutritious food intake, amount of physical activity, and parental nutrition and physical activity knowledge, attitudes, and beliefs, defined by intentions and behaviors. All measures were administered at the beginning and end of the school year for year one and year two of the study for a total of 4 longitudinal time points for assessment. Discussion Although few attempts have been made to prevent obesity during the first years of life, this period may represent the best opportunity for obesity prevention. Findings from this investigation will inform both the fields of childhood obesity prevention and early childhood research about the effects of an obesity prevention program housed in the childcare setting. Trial registration Trial registration number: NCT01722032