Child social-emotional and behavioral problems and competencies contribute to changes in developmental functioning during Early Intervention.

This study examined how social-emotional and behavioral (SEB) problems and competencies contribute to changes in developmental functioning among children enrolled in Part C Early Intervention (EI), a U.S. program supporting young children with developmental delays and disabilities. The sample included 1,055 children enrolled in EI from 2011-2019 (mean age at EI entry = 17 months; 64% male; 72% marginalized racial and ethnic backgrounds). Standardized developmental assessments, drawn from administrative records, characterized developmental functioning at EI entry and exit and parents reported SEB functioning. Hierarchical regression analyses revealed that SEB problems and competencies interacted in predicting change in developmental functioning from EI entry to exit. Monitoring, identifying, and addressing SEB problems and competencies may optimize developmental outcomes for young children with developmental delays and disabilities.

Reaching "The Other Half": Teacher Referral Increases Inclusivity in Intervention Research for Neurodivergent School-Age Children.

OBJECTIVE: Researchers employed two recruitment strategies in a school-based comparative effectiveness trial for students with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) or autism. This study assessed the: 1) effectiveness of school-based referrals for identifying students meeting diagnostic criteria and 2) impact of eliminating requirements for existing diagnoses on recruitment, sample characteristics, and intervention response. METHOD: Autistic students and students with ADHD in schools serving underresourced communities were recruited for an executive functioning (EF) intervention trial over 2 years. In Year 1, school staff nominated students with previous diagnoses. In Year 2, school staff nominated students demonstrating EF challenges associated with ADHD or autism; previous diagnosis was not required. Study staff then confirmed diagnoses. RESULTS: More students were included in Year 2 (N = 106) than Year 1 (N = 37). In Year 2, 96% of students referred by school staff met diagnostic criteria for ADHD or autism, 53% of whom were not previously diagnosed. Newly identified students were less likely than previously diagnosed students to be receiving services and, for those with ADHD, were more likely to speak primarily Spanish at home. Previously diagnosed and newly identified students did not differ on other demographic variables or intervention response. Caregivers of previously diagnosed students reported more symptoms than caregivers of newly identified students for both diagnostic groups. Previously diagnosed students with ADHD had more researcher-rated symptoms than newly identified students. CONCLUSIONS: Recruitment for an intervention study using behavior-based referrals from school staff enhanced enrollment without compromising the sample's diagnostic integrity and engaged children who otherwise would have been excluded.

Leveraging technology to make parent training more accessible: Randomized trial of in-person versus online executive function training for parents of autistic children.

LAY ABSTRACT: This study compared the first online parent training program for executive function intervention for autism to in-person parent training on the same content. Participants were parents of autistic children, who were between 8 and 12 years of age and did not have intellectual disability. Parents were randomized to the in-person (n = 51) or online (n = 46) training conditions. Both trainings were developed with stakeholder (parents and autistic people) guidance. In this trial, most parents reported that they liked both trainings and that they were able to implement what they learned with their children. Parents in both groups spent equivalent amounts of time (about 8 hours) with the training materials, but while 94% of parents in the in-person training attended both parent trainings, only 59% of parents in the online group completed all 10 online modules. Parents reported that it was difficult to stay motivated to complete the online trainings over the 10-week trial. Parent and child outcomes did not differ significantly between the groups. Overall, parents reported that the trainings resulted in a reduction in their own parenting strain and improvements in their child's flexibility, emotional control, and global executive function, but not planning and organization. These findings indicated brief in-person and online training can help parents learn to support and improve their autistic children's executive function abilities, reducing their own experience of parenting strain. The finding that the online training was equivalent to the in-person trainings is important because it is accessible to parents who encounter barriers to in-person care.

Mental health first aid USA implementation: Trainee reported quality and impact of training.

This study investigated the association of training implementation factors (Quality, Impact, Usefulness) with Mental Health First Aid (MHFA)-targeted outcomes (e.g., increased knowledge, confidence helping someone). Trainees who completed MHFA USA training in 2016 (N = 1003) were surveyed post training about its influence on their thoughts and behaviors, and about implementation factors. Some trainees completed 3- and 6-month follow-ups (N = 430, N = 276, respectively). Training Quality, Impact and Usefulness were rated highly. Differences in Quality and Impact across demographic groups were found; trainees from racially and ethnically marginalized backgrounds, and trainees with lower education levels, reported greater effect. Quality and Impact predicted positive changes in MHFA-targeted constructs such as self-efficacy, stigma and trainee perceived positive effect of MHFA strategies for those in crisis. Impact predicted positive change in mental health knowledge; this association strengthened over time. Results provide information about acceptability and perceived Impact of MHFA USA training and lead to recommendations for future evaluation and implementation.

Increasing autism acceptance: The impact of the Sesame Street "See Amazing in All Children" initiative.

To promote knowledge and acceptance of autism, Sesame Workshop created an online initiative: See Amazing in All Children. This nationwide evaluation of See Amazing assessed whether it increased knowledge and acceptance, promoted community inclusion, reduced parenting strain, and enhanced parenting competence. Survey responses were collected online from parents of children (age ⩽ 6) with and without autism before (N = 1010), 1 week after (N = 510), and, for parents of autistic children, 1 month after (N = 182) they viewed the See Amazing materials. Following exposure, parents of non-autistic children showed small but significant increases in knowledge of autism and, like parents of autistic children, greater acceptance of autistic children. Parents of autistic children reported less strain, increased parenting competence, and more hope about involving their child in their community. That the See Amazing materials invoked positive changes in the general parent community and in parents of autistic children suggests that See Amazing materials have the potential to be an effective resource to increase acceptance and community inclusion, although limitations of self-selection, dropout rate, and lack of control group constrain interpretation. Implications include support for targeting acceptance as a step beyond awareness campaigns, though actual behavior change is a subject for future research.

Evaluation of Mental Health First Aid USA Using the Mental Health Beliefs and Literacy Scale.

PURPOSE: This study assessed the impact of Mental Health First Aid (MHFA) in the United States with a theoretically based and psychometrically sound measure, the Mental Health Beliefs and Literacy Scale (MBLS). DESIGN: Online MBLS surveys were administered pre-MHFA training, 3-weeks post-training, and 6-months posttraining. SETTING: Mental Health First Aid trainings carried out across the United States. PARTICIPANTS: Six hundred sixty-two trainees were contacted, and 273 (41%) completed the presurvey. Of those, 63% filled out the postsurvey and 35% completed the 6-month survey. Seventy-six individuals completed all 3 surveys. INTERVENTION: Mental Health First Aid is an 8-hour education program to help the general public identify, understand, and respond to signs of mental illness and substance abuse; to date, almost 1 million people have been trained. MEASURE: The MLBS, based on the Unified Theory of Behavior Change framework, consists of attitudinal, social-, and skill-based constructs affecting the intention to perform and achievement of MHFA actions and reports of their actual completion. ANALYSIS: Change across time points was assessed using multivariate repeated measures analysis of variance. RESULTS: Significant short- and longer term changes were found in internally consistent constructs tapping positive beliefs about MHFA actions, the confidence and intention to perform them as well as mental health literacy. CONCLUSION: The MBLS documented strong positive effects of MHFA training that were greater in individuals without prior mental health training, the intended targets of MHFA efforts.

Tracking progress in peer-delivered family-to-family support.

Peer delivered, family-to-family (F2F) support-defined as the provision of outreach, engagement, knowledge, care coordination, and support to family members of children and youth with mental health challenges-is a rapidly growing and needed component of the service array. Progress is occurring toward greater specification of program models and core competencies for the parent support providers (PSPs) with lived experience providing these services; however, strategies to inform quality improvement and ensure accountability are lacking. The Family Journey Assessment (FJA), completed by PSPs and family members, fills this gap by tracking caregiver progress toward self-advocacy and self-efficacy. Analyses of 436 FJAs showed a reliable 3-component structure, reflecting progress in the recognition of needs, collaboration to access help from formal and natural supports, and activation of skills to cope with stress, enhance resilience, and develop and carry out plans of care. PSP feedback provided strong evidence for relevance and usability. Examination of FJAs at baseline and follow-up provides one of the first reports showing significant improvement in key indicators of benefit of F2F for participating families. The FJA holds promise as a measure of the impact of F2F services on key goals and as a way to identify benchmarks for focused and individualized peer-to-peer support depending on the family's level of need. (PsycINFO Database Record (c) 2019 APA, all rights reserved).