Parents’ sensemaking processes in the identification of developmental delays and engagement with early intervention services

Scherr, Courtney L.; Getachew-Smith, Hannah; Sudec, Laura; Brooks, John J.; Roberts, Megan Y.

doi:10.1016/j.socscimed.2020.112941

Cited by 5 publications

(6 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Behavior professionals may frequently interact with parents of children diagnosed on the autism spectrum and, therefore, may field questions about younger siblings with a high likelihood for autism. Parents who receive referrals to early intervention services during birth-age 3 may face multiple barriers to navigating the services available such as delayed scheduling, limited therapist availability, and interpersonal challenges (Scherr, Getachew-Smith, Sudec, Brooks, & Roberts, 2020). Parents may need more information about developmental delays and the early intervention process to fully benefit from early and preemptive interventions.…”

Section: Discussionmentioning

confidence: 99%

Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis

Hampton

Rodriguez

2021

Autism

View full text Add to dashboard Cite

Understanding the impact of preemptive interventions on development for those with a high likelihood for autism is a critical step in building a transdiagnostic model of optimized intervention. The purpose of this systematic review and meta-analysis is to examine the impact of preemptive autism interventions on parent outcomes and child developmental outcomes. A total of 345 unique records were assessed for eligibility yielding 13 unique studies with 715 total infant/toddlers with a high likelihood for autism. There was a significant association between the early interventions on parent implementation of intervention strategies immediately following the intervention. However, there was no significant association between the early interventions and child developmental outcomes. The studies reporting moderator and/or mediator analyses suggest a meaningful association between parent implementation and long-term child social communication outcomes. Taken together, these findings suggest that parent-mediated interventions are associated with improved parent use of strategies, and although these results do not translate into immediate or short-term child developmental outcomes, there is evidence that parents with the greatest implementation facilitate later improved communication outcomes for their children. There is an urgent need to develop a nuanced intervention approach during a time of ever-changing concern about child development. Lay abstract Interventions to address core symptoms for young children on the autism spectrum have a strong and growing evidence base. Adapting and delivering evidence-based interventions to infants and toddlers with a high likelihood for autism is a logical next step. This systematic review and meta-analysis summarize the association between infant and toddler interventions and developmental and family outcomes. Results indicate that these early interventions are effective for improving parent implementation of core strategies, yet the effects do not readily translate to child outcomes. However, key studies demonstrate conditional results that indicate that parent implementation is associated with child outcome. Implications for research and practice toward building adaptive interventions that respond to parent implementation and changing child characteristics are discussed.

show abstract

Section: Discussionmentioning

confidence: 99%

Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis

Hampton

Rodriguez

2021

Autism

View full text Add to dashboard Cite

show abstract

“…Although these results underscore pediatric clinicians’ abiding attentiveness to preserving the clinician–caregiver relationship, at times, this benevolent stance may undermine clinicians’ directness in raising social-emotional or developmental concerns with caregivers and unwittingly introduce bias. Other studies have found that a lack of directness has left parents feeling unsupported, falsely reassured, or that their concerns about their child’s development were invalid (Alegría et al, 2015; Gellasch, 2016; Scherr et al, 2020). Bottom-up and top-down training and systems engagement may be key to providing a sound and effective strategy that bolsters clinician confidence in having direct discussions about risk equitably across families with varied lived experiences.…”

Section: Discussionmentioning

confidence: 99%

“…Yet, clinician–caregiver communication is a frequently cited barrier to discussions about social-emotional risk and developmental delays (Aylward et al, 2021; Gellasch, 2016). Most studies have examined caregiver–clinician interactions from the perspective of young children’s caregivers (Gellasch, 2016; Scherr et al, 2020; Sices et al, 2009), but few have examined the practices or perspectives of pediatric clinicians (Sices et al, 2009; Tanner et al, 2009). Research is needed on how clinicians communicate with families about social-emotional risk, including processes associated with information gathering, processing, managing, and sharing, to develop clinician-focused strategies that enable discussions about social-emotional risk with families (Aylward et al, 2021).…”

mentioning

confidence: 99%

Possible unintended consequences of pediatric clinician strategies for communicating about social-emotional and developmental concerns in diverse young children.

Scherr,

Getachew-Smith,

Moe

et al. 2024

Families, Systems, & Health

View full text Add to dashboard Cite

“…Additionally, if a parent discloses concerns regarding their child's language development, waiting to act on this concern likely has significant consequences for parental well-being, parental efficacy, and the parent-clinician relationship. 10,11 Delaying referrals for evaluation is viewed by the speechlanguage pathology community as a harm that necessitates urgent action. 12 It is also the case that parents may delay disclosing their concerns to their health care professional.…”

mentioning

confidence: 99%

“…Underreferrals are especially concerning in minoritized communities because children with limited access to comprehensive health care and early childhood development services face a higher risk of academic difficulties. Additionally, if a parent discloses concerns regarding their child’s language development, waiting to act on this concern likely has significant consequences for parental well-being, parental efficacy, and the parent-clinician relationship . Delaying referrals for evaluation is viewed by the speech-language pathology community as a harm that necessitates urgent action …”

mentioning

confidence: 99%

Recommendations for Speech and Language Screenings

Speights,

Jones,

Roberts

2024

JAMA

View full text Add to dashboard Cite

A recent Evidence Report from the US Preventive Services Task Force (USPSTF) 1,2 highlights a persistent gap in research regarding preventive care services for children showing no obvious signs or symptoms of speech and language delay and disorder. In the accompanying Recommendation Statement, 3 the task force concludes that the "evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children 5 years or younger without signs or symptoms (I statement)." The USPSTF recommendation was determined based on the general lack of evidence for screening rather than the absence of sound findings on the topic of speech and language delays, which underscores the importance of prioritizing research in this area to fill the current knowledge gaps. Given the rigorous data-driven approach of the USPSTF to evaluate the current evidence base, we as speech-language pathologists agree with the conclusions.Contained within the USPSTF Recommendation Statement is the acknowledgment, shared by the American Speech-Language-Hearing Association (ASHA), that speech and language delays/disorders can have adverse effects on educational, social, and mental health outcomes. 4 As speech-language pathologists, we are concerned about the number of children and families that could benefit from speech and language interventions. Robust research is essential to endorsing universal screening, but resources and time are needed to establish this evidence base. Notably, in the 8 years since the previous recommendation in 2015, there has been no new evidence to evaluate the utility of universal screening. 5 Children and families cannot wait, and it is necessary to consider the potential harm caused by the misinterpretation of USPSTF findings and discuss the steps that pediatric primary care clinicians can take in the interim.The USPSTF finding of insufficient evidence applies to "Asymptomatic children 5 years or younger whose parents or clinicians do not have specific concerns about their speech, language, hearing, or development." 3 In other words, there is not sufficient evidence to recommend universal screening for all children, particularly those not showing any signs of speech or language delay. However, the USPSTF recommendation does not apply to children whose parents or pediatric primary care clinicians are concerned about a child's speech and language development. For those children whose parents or pediatric primary care clinicians are concerned about speech and/or lan-

show abstract

Parents’ sensemaking processes in the identification of developmental delays and engagement with early intervention services

Cited by 5 publications

References 45 publications

Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis

Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis

Possible unintended consequences of pediatric clinician strategies for communicating about social-emotional and developmental concerns in diverse young children.

Recommendations for Speech and Language Screenings

Contact Info

Product

Resources

About