Initial Evaluation Practices to Identify Young Children With Delays and Disabilities During the COVID-19 Pandemic
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ABSTRACT:
SUBMITTER: Steed E
PROVIDER: S-EPMC9637929 | biostudies-literature | 2022 Nov
REPOSITORIES: biostudies-literature
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Project description:The value of early intervention is well demonstrated; however, less is known about the processes that initial evaluation teams use to evaluate and determine young children's eligibility for early intervention (EI) and preschool special education. The present study surveyed multidisciplinary early childhood providers (N = 1445) who conduct initial evaluations for young children. Quantitative survey data were analyzed using descriptive analyses to describe the location of initial evaluations, tools used, team membership, and approaches to eligibility determination for children with possible delays and disabilities. Evaluation practices varied greatly, but evaluation teams most often included early childhood special educators and speech and language pathologists, school psychologists or other specialists were less frequently involved. Eligibility approaches were also wide-ranging with percentage delay and standard deviation below the mean most often used; several challenges when determining eligibility were also described. Evaluations for EI and preschool special education were compared to look at variations. Statistically significant differences were found when comparing evaluations focused on eligibility for EI or preschool special education. Implications and future directions are explored.Supplementary informationThe online version contains supplementary material available at 10.1007/s40688-023-00467-3.
| S-EPMC10072816 | biostudies-literature
Project description:This study examined whether children exposed to adversity would exhibit lower epigenetic age acceleration in the context of improved parenting. Children with developmental delays and externalizing behavior problems (N = 62; Mage = 36.26 months; 70.97% boys, 29.03% girls; 71% Latinx, 22.6% Black) were drawn from a larger randomized controlled trial (RCT), which randomized them to receive Internet-delivered parent-child interaction therapy (iPCIT; n = 30) or community referrals as usual (RAU; n = 32). Epigenetic age acceleration was estimated with the pediatric buccal epigenetic clock, using saliva. Adversity was assessed using parent, family, and neighborhood-level cumulative-risk indicators. Adversity interacted with Time 2 (T2) observations of positive and negative-parenting practices to predict epigenetic age acceleration 1.5 years later, regardless of treatment assignment. Children exposed to more adversity displayed lower epigenetic age acceleration when parents evidenced increased positive (b = -0.15, p = .001) and decreased negative (b = -0.12, p = .01) parenting practices.
| S-EPMC10626625 | biostudies-literature
Project description:ObjectiveThe coronavirus 2019 (COVID-19) pandemic has had widespread implications on clinical practice at U.S. hospitals. These changes are particularly relevant to otolaryngology-head and neck surgery (OHNS) residents because reports suggest an increased risk of contracting COVID-19 for otolaryngologists. The objectives of this study were to evaluate OHNS residency program practice changes and characterize resident perceptions during the initial phase of the pandemic.Study designA cross-sectional survey of U.S. OHNS residents at 81 programs was conducted between March 23, 2020, and March 29, 2020.ResultsEighty-two residents from 51 institutions (63% of invited programs) responded. At the time of survey, 98% of programs had enacted policy changes to minimize COVID-19 spread. These included filtered respirator use for aerosol-generating procedures even in COVID-19-negative patients (85%), decreased resident staffing of surgeries (70%), and reduced frequency of tracheotomy care (61%). The majority of residents (66%) perceived that residents were at higher risk of contracting COVID-19 compared to attendings. Residents were most concerned about protective equipment shortage (93%) and transmitting COVID-19 to patients (90%). The majority of residents (73%) were satisfied with their department's COVID-19 response. Resident satisfaction correlated with comfort level in discussing concerns with attendings (r = 0.72, P < .00001) and inversely correlated with perceptions of increased risk compared to attendings (r = -0.52, P < .00001).ConclusionU.S. OHNS residency programs implemented policy changes quickly in response to the COVID-19 pandemic. Sources of resident anxieties demonstrate the importance of open communication and an integrated team approach to facilitate optimal patient and provider care during this unprecedented crisis.Level of evidence4. Laryngoscope, 130:2550-2557, 2020.
| S-EPMC7267342 | biostudies-literature
Project description:This study includes the whole-genome screening of unbalanced chromosomal rearrangements (copy-number variants; CNV) in children with ID/DD, ASD and MCA. We identified a broad range of pathogenic/likely pathogenic CNVs as well as variants of unclear significance and likely benign variants. Our results confirm the benefit of array-CGH in the current clinical genetic diagnostics through the identification of genetic cause of ID/DD in the high proportion of affected children.
2019-08-31 | E-MTAB-7696 | biostudies-arrayexpress
Project description:This study includes the whole-genome screening of unbalanced chromosomal rearrangements (copy-number variants; CNV) in children with ID/DD, ASD and MCA. We identified a broad range of pathogenic/likely pathogenic CNVs as well as variants of unclear significance and likely benign variants. Our results confirm the benefit of array-CGH in the current clinical genetic diagnostics through the identification of genetic cause of ID/DD in the high proportion of affected children.
2019-08-31 | E-MTAB-8044 | biostudies-arrayexpress
Project description:BackgroundThe use of tele-rehabilitation in children was limited before the COVID-19 pandemic, due to culture, technology access, regulatory and reimbursement barriers.MethodsThe study was conducted according to the CHERRIES (Checklist for reporting results of internet E-surveys) guidelines in order to provide quantitative and qualitative data about experience of patients with disabilities and their caregivers during Phase 1 of the COVID-19 pandemic, and their level of satisfaction. An online survey was developed using Google Forms and sent via email. The outcome measures were rated using a 5-point Likert Scale. Two additional open-ended questions were used to collect qualitative data.ResultsOne hundred twenty-eight out of 261 families responded to the survey: 80.5% of the caregivers reported they were satisfied with the tele-rehabilitation. More than a half (53%) of the families reported a high level of satisfaction with the involvement they received in defining and sharing of rehabilitation goals.ConclusionsThe implementation of telehealth during the COVID-19 lockdown has allowed us to gain more information about the potential of tele-rehabilitation, and resulted in an excellent satisfaction of caregivers. With appropriate education and consistent models of care, an increased use of telehealth may provide advances in remote patient care.Trial registrationNot applicable.
| S-EPMC9170348 | biostudies-literature
Project description:ObjectivesThe study aimed to determine the impact of the pandemic on parents/caregivers and children with neurologic disabilities.Patients and methodsThis multi-center cross-sectional study was conducted with 309 parents/caregivers (57 males, 252 females) and their 309 children (198 males, 111 females) with disabilities between July 5, 2020, and August 30, 2020. The parents/caregivers were able to answer the questions and had internet access. The survey included questions on the utilization of educational and health care services (whether they could obtain medicine, orthosis, botulinum toxin injection, or rehabilitation) during the pandemic. A Likert scale was used to evaluate the effect of the specific health domains, including mobility, spasticity, contractures, speech, communication, eating, academic, and emotional status. The Fear of COVID-19 Scale was used to assess fear of COVID-19.ResultsAmong the children, 247 needed to visit their physician during the pandemic; however, 94% (n=233) of them could not attend their physician appointment or therapy sessions. The restricted life during the first wave of the pandemic in Türkiye had negatively affected 75% of the children with disabilities and 62% of their parents. From the perspective of the parents/caregivers, mobility, spasticity, and joint range of motion of the children were affected. Forty-four children required repeated injections of botulinum toxin; however, 91% could not be administered. The Fear of COVID-19 Scale scores were significantly higher in the parents who could not bring their children to the routine physician visit (p=0.041).ConclusionDuring the pandemic, access to physical therapy sessions was disrupted in children with neurological disabilities, and this may have harmful consequences on the functional status of children.
| S-EPMC10186024 | biostudies-literature
Project description:BackgroundThe impact of the COVID-19 pandemic on people with disabilities has been described as a 'triple jeopardy'. Not only have they experienced the negative social impacts of disease control measures, but access to required health services has been affected, and, not least, they are at increased risk of severe outcomes from COVID-19. This study aimed to determine how children with disabilities have experienced the pandemic in Sweden and its impact on their lives.MethodsSix children (5-13 years) were interviewed via video conferencing. An interview guide was adapted based on the children's communicative abilities and included augmentative and alternative communication support. Reflective field notes were included in the analysis. The data were analysed using qualitative content analysis.ResultsTwo themes were identified: The child's knowledge of Corona raises anxiety and fear; and Boring Corona makes the child even lonelier. The children had knowledge about and were worried about COVID-19, primarily about illness and death of their grandparents. The children longed for their grandparents and other social contacts at school, and life was described as boring and lonely. Many families lacked adequate tools to communicate with their children about the pandemic.ConclusionGiven adequate support, children with disabilities and communication difficulties can give insights to their unique life situations. The interviewed children reported significant impact on their life and school life. Children were worried about their grandparents based on their knowledge about the virus. The enthusiasm with which the children engaged in the interviews is testament to the need and right of all children, regardless of communicative competence, to voice their experiences.
| S-EPMC8983410 | biostudies-literature
Project description:The present study examines provider and caregiver satisfaction with telehealth evaluation of autism spectrum disorder (ASD) in young children during the coronavirus SARS-CoV-2 (COVID-19) pandemic. A telehealth model of ASD evaluation was implemented with 308 children ages 14 to 78 months between May 2020 to June 2021. Data were gathered from electronic health records, autism-specific telehealth diagnostic tools, and post-evaluation surveys. Overall, the majority of providers and caregivers were satisfied with telehealth ASD evaluation. Multiple variables were associated with ratings of satisfaction, differing by providers and caregivers. Findings have important implications for the feasibility and acceptability of telehealth ASD evaluations, in addition to key factors to consider in optimizing and sustaining telehealth evaluations beyond the COVID-19 pandemic.
| S-EPMC9112250 | biostudies-literature
Project description:This study explored whether young children with Down syndrome show praxis deficits that impact activities of daily living, and whether these deficits are specific to Down syndrome. We compared the performance of young children with Down syndrome, a mental age-matched group of children with developmental disabilities of mixed or unknown etiologies, and a group of typically developing infants and toddlers on praxis tasks and overall adaptive behavior (Vineland Adaptive Behavior Scales). Children with Down syndrome showed poorer overall motor functioning than the developmental disabilities comparison group as measured by the Vineland Adaptive Behavior Scales, F(2, 47) = 5.24, p < .01 (using one-way analysis of variance [ANOVA]). A one-way multivariate analysis of variance also showed that children with Down syndrome performed significantly worse overall than the developmental disabilities comparison group on a battery of praxis tasks, F(7, 18) = 2.95, p < .05, and a series of object retrieval tasks, F(7, 18) = 2.95, p < .05, suggesting a deficit in praxis that is specific to Down syndrome. Children with Down syndrome elicited significantly more help than both comparison groups during object retrieval trials, F(2, 48) = 4.94, p < .01 (using one-way ANOVA). When chronological age was partialled out, a strong relationship was observed between praxis and adaptive functioning in Down syndrome, r(8) = .69, p < .05. These findings suggest that young children with Down syndrome may need targeted interventions that focus on both praxis skills and motivational orientation.
| S-EPMC4512666 | biostudies-other