Modified Ride-on Car Intervention for Children With Profound Intellectual and Multiple Disabilities: A Case Series.

PURPOSE: To describe a pilot clinical case series of a modified ride-on car (MROC) intervention on mobility and alertness for young children with profound intellectual and multiple disabilities (PIMD). METHODS: Four young children with PIMD participated in 4 baseline observations and 5 intervention sessions (A-B design). Data collection occurred via video. Assessment of mobility and alertness duration used structured visual analysis. RESULTS: Three of the 4 children increased their independent mobility during the intervention sessions. One of the 4 children increased their active alertness during the intervention sessions. CONCLUSIONS: This pilot study demonstrates the initial feasibility of an MROC intervention in a clinical setting and outcome measures of mobility and alertness for children with PIMD. This provides support that this population should be considered for power mobility in early childhood. Further, this study used a novel, caregiver-implemented prompting protocol to teach children how to use the MROC.

Serving young children with communication disabilities from Latinx backgrounds and their families with equity: Provider perspectives.

INTRODUCTION: Latinx children with communication disorders from birth to age 5 and their families are increasingly served in United States (US) educational and medical settings where longstanding structural barriers threaten their access to equitable assessment and intervention. However, little is known about providers' perceptions serving this highly diverse population as they relate to reducing disparities in care for communication disorders. METHODS: This exploratory qualitative study interviewed 24 speech-language pathologists (SLPs) and early intervention (EI)/early childhood special education (ECSE) developmental specialists serving young Latinx children with communication disorders to offer targeted recommendations toward improving equity. The semi-structured interview included questions regarding communication assessment, diagnostics/eligibility, intervention, interpretation, translation, and solutions to enhance EI/ECSE. Interviews were coded with content analysis using elements of grounded theory, and responses from SLPs in medical versus education settings and from EI/ECSE developmental specialists were compared. Data triangulation was used to validate themes. RESULTS: Analysis revealed the following themes related to provider challenges and resources: family factors, provider factors, cultural and linguistic differences, assessment approaches, eligibility determinations, translation and interpretation, and institutional factors. Few variations in themes between provider types (SLPs vs. EI/ECSE developmental specialists) and settings (medical vs. educational) were found. Providers also offered several policy and practice solutions. CONCLUSIONS: Findings suggest minimal advances in improving equity for young Latinx children with communication disorders over prior decades. Results also indicate that providers may benefit from reflecting on their cultures and biases as well as systemic racism within EI/ECSE.

Modifying a general social-emotional measure for early autism screening.

Objective: Broadband social-emotional screening tools are designed to evaluate a child's social development and interactions. Such tools are expected to have reasonable sensitivity for identifying children at risk for autism spectrum disorder (ASD) but would also likely over-estimate risk for ASD since other conditions can also affect social development. In this study, a subset of ASD items from one general social-emotional screening measure, the Ages & Stages Questionnaires: Social Emotional, 2nd edition, was analyzed to determine if use of an ASD subscale might improve prediction of ASD risk for young children. Methods: The ASD subscale was used with 60 families who had a child referred for an ASD evaluation. Social-emotional screening and ASD screening results were compared with the subsequent results from gold-standard diagnostic testing for ASD at a regional autism center, using contingency matrices. Results: As expected, the social-emotional screening tool identified nearly all of the children in the high-risk clinical sample. Use of the ASD subscale increased specificity for ASD (from 4% to 52%) and demonstrated correct prediction of ASD diagnosis in 70% of ASD cases. Conclusions: These preliminary results suggest that using a subset of ASD-specific items on a social-emotional screening tool can increase the tool's specificity for ASD, by isolating ASD-specific concerns.