An initial trial of OPT-In-Early: An online training program for caregivers of autistic children.

LAY ABSTRACT: Early intervention can help children learn language and improve social communication. However, many barriers, including the expense of services and an insufficient number of providers, prohibit families from accessing services when their children are young. We developed a comprehensive online program for caregivers of autistic children. The program, Online Parent Training in Early Behavioral Intervention (OPT-In-Early), uses text and video demonstrations to teach caregivers effective methods for improving their children's language, social, and adaptive skills (e.g. using utensils, toilet training), and reducing their children's disruptive behavior. Sixty-three parents from three states participated in the study. Half of the parents received access to the OPT-In-Early program. After 4 months, parents who had access to the OPT-In-Early program learned more effective intervention strategies, and started using these strategies during interactions with their children, than parents who did not receive access to the program. Parent participation in OPT-In-Early did not significantly influence children's social communication compared to children whose parents did not have access to OPT-In-Early. A longer duration of parents using learned intervention skills with their children may be needed for children's social communication skills to improve.

Packaging and shipping capabilities of New York State hospital laboratories: a 3-year drill assessment.

In a previous publication, we discussed the results of the 2006-2007 New York State (NYS) Hospital Laboratory Drill Series which emphasized the need for ongoing testing and evaluation of laboratory preparedness capabilities, particularly those required to support hospital functions during a public health emergency. In this paper, we will discuss how a followup drill series in 2007-2008 was implemented in an effort to re-assess the ability of NYS acute care hospital facilities to recognize and respond to a suspected bioterrorism, chemical terrorism or pandemic flu emergency specimen submission event. We will explain how the results of the follow-up drill series, when compared to those of the original exercise, warranted a statewide hospital laboratory preparedness drill held in 2009, focused solely on addressing the overarching deficiency of chemical terrorism (CT) specimen submission capabilities. Although drill results conclude that NYS acute care hospital facilities are much better prepared than 3 years ago to support hospital functions during a CT public health emergency event, they also highlight the continued need to improve competency.

Development and Acceptability of a New Program for Caregivers of Children with Autism Spectrum Disorder: Online Parent Training in Early Behavioral Intervention.

Early intervention with parent participation is important for facilitating skill development in children with Autism Spectrum Disorder (ASD). However, many barriers delay or prohibit families from accessing care. We describe the development and acceptability of a novel, comprehensive, self-directed online program for caregivers of children with ASD. Program effectiveness will be presented in a subsequent manuscript. The program is based on behavioral, naturalistic, and developmental principles, and teaches caregivers to use evidence-based interventions to teach developmentally appropriate targets. Approximately two-thirds of enrolled parents completed all 14 modules; barriers to completion for the additional families are described. Parents reported that the program was clear, enjoyable, and useful in teaching them interventions and in improving their children's skills and behavior.

Functional assessment of hospital laboratory packaging and shipping preparedness in New York State.

The 2006-2007 New York State (NYS) Hospital Laboratory Drill Series was implemented in order to test notification, referral and packaging and shipping (P&S) procedures at acute care hospital facilities (statewide, excluding New York City) that submit suspect bioterrorism (BT), chemical terrorism (CT), and/or pandemic influenza (Pan Flu) clinical specimens to the NYS Department of Health (DOH) Wadsworth Center for confirmatory testing. Results showed that 97% and 84% of hospital facilities had the ability to directly access the notification network and retrieve drill guidance, respectively. Most hospital laboratories (92%) demonstrated the ability to refer specimens to the Wadsworth Center laboratory. Evaluation of specimen submissions found that 68% of BT packages, 27% of Pan Flu packages, and 20% of CT packages arrived to the laboratory with no P&S deficiencies. It can be concluded that acute care hospital facilities in NYS are more prepared to refer and submit clinical specimens during a BT public health emergency than during a Pan Flu or CT emergency event.

A Video Parent-Training Program for Families of Children with Autism Spectrum Disorder in Albania.

BACKGROUND: Behavioral intervention with parent participation is effective in reducing symptoms of Autism Spectrum Disorder (ASD), but access to intervention is limited. The current study explored whether a video-enriched parent-training program would (a) be comprehensible and acceptable to parents in the Republic of Albania, (b) increase parental knowledge of behavioral strategies and (c) increase parental self-efficacy. METHODS: Twenty-nine parents of children with ASD aged 18-70 months completed the Early Intervention Parenting Self-Efficacy Scale (EIPSES, Guimond, Wilcox, & Lamorey, 2008) and a quiz to assess their knowledge of behavioral strategies. Parents in the Treatment Group then received access to a parent-training (PT) program on evidence-based teaching and behavior management techniques. The program was based on empirical research, but considered Albanian cultural norms and included topics Albanian parents requested. Parents in the Treatment Group rated the program using the Treatment Evaluation Inventory Short Form (TEI-SF; Kelley, Heffer, Gresham, & Elliott, 1989). Change in parents' quiz scores and EIPSES ratings from baseline to post-treatment were compared by group. RESULTS: Parents rated this video training program as comprehensible and valuable. The program modestly increased aspects of self-efficacy as well as parents' knowledge of effective teaching strategies. CONCLUSION: Remote PT may be useful in low-resource settings to help parents develop techniques for teaching skills and forestalling problem behavior in children with ASD. Additional research, with a larger sample size, that observes the effect of the program on child behavior is warranted.

Intensive behavioral treatment for a toddler at high risk for autism.

Intensive, comprehensive treatment using a variety of applied behavior analysis methods was provided to a toddler who was determined to be at high risk for autism at the age of about 1 year. Initially, treatment was delivered in a one-to-one adult-child format in the child's home and other settings, with gradual transitions to group instruction in early intervention and preschool classrooms. Intensive treatment continued for 3 years; by the 4th year, the child was spending most of her time in a regular preschool classroom, with minimal ongoing one-to-one instruction. Direct observational data and results of norm-referenced tests documented large increases in language, social, cognitive, and daily living skills over the course of treatment. After 4 years, the child demonstrated no behavioral or developmental abnormalities, performed above her chronological age level on norm-referenced tests of cognitive and language skills, and was functioning as a typical child in a regular public school kindergarten classroom.

A global public health strategy for autism spectrum disorders.

In recent years, there has been increasing awareness about autism spectrum disorders (ASD) around the world, including in low and middle income countries. Unlike countries in Western Europe and North America where infrastructure and capacity are available to help meet some of the needs of individuals with ASD, little expertise or capacity exists in most of the developing world. In 2008 Autism Speaks launched the Global Autism Public Health (GAPH) Initiative to facilitate the development of systematic and sustainable solutions for enhancing global autism awareness, research, training and service delivery. In the last 3 years Autism Speaks has established collaboration with stakeholders from over 20 countries who are working alongside dedicated local and international stakeholders to effect change. In this article, the GAPH framework is described, along with a few brief case examples that illustrate how the framework for implementation of the model can occur. GAPH is still in its infancy but has the potential to have significant impact through inclusive collaboration with local and international stakeholders to develop effective and sustainable public health solutions for disseminating best practices and delivering tangible benefits to individuals with ASD and their families.