Supporting Families from a Distance: Implementing Routines-Based Home Visits via Telepractice.

Early intervention is a system of services designed to strengthen child outcomes and build family capacity. One approach of service provision is the Routines-Based Model which implements adult-learning practices wherein service providers and caregivers partner to build family-mediated interventions for children. Owing to COVID-19 and the benefits of telepractice, more and more service providers are likely to incorporate a telepractice modality into service provision. Because the Routines-Based Model uses family consultation, these home-visiting practices translate well to telepractice. In addition to consultation techniques, however, service providers must use technology advantageously to ensure effective communication practices. This article discusses technology uses in telepractice that can be incorporated in the Routines-Based Model, Tele-Routines-Based Home Visits, and examples of Tele-Routines-Based Home Visits.

Serving Individuals With Autism Spectrum Disorder in the Age of COVID-19: Special Considerations for Rural Families.

This position paper explores the needs of rural families of children, adolescents, and adults with autism spectrum disorder (ASD) during the COVID-19 pandemic. Prior to COVID-19, literature portrays elevated stress in families of individuals with ASD and health and socioeconomic disparities for rural and underserved populations. These disparities were exacerbated due to COVID-19 and subsequent lockdowns and economic turmoil. Academic and adaptive skills training were particularly impacted due to school closures, with parents tasked with taking some responsibility for training these skills. Our goals for this article focus on special considerations for rural families regarding (a) neurobiological and developmental impacts of stressful experiences like COVID-19, (b) delineation of the impacts on individuals with ASD and other comorbid and related conditions, and (c) education and intervention needs during these times. Finally, we offer suggestions for future care during pandemic events, including recommendations for improving service delivery under such conditions.

Rural and Racial/Ethnic Differences in Children Receiving Early Intervention Services.

A review of the literature shows that racial and ethnic minority children (eg, African American, Asian, and Hispanic) received diagnoses for developmental concerns later in life compared with their age-matched white counterparts. Research has also documented disparities in access to and receipt of health care services among children with developmental concerns as compared with children with other disabilities. OBJECTIVES: We examined health care providers' (HCPs') responses to parents' developmental concerns about their children. We looked at the association with race, ethnicity, gender, rurality, and time to diagnosis. METHODS: All data were secondary and derived from the Centers for Disease Control and Prevention's Survey of Pathways to Diagnosis and Services. Participants consisted of 1321 parents of children who had received early intervention services as reported by respondents' data collected in 2011. RESULTS: From a nationally representative sample of families receiving early intervention services, 76% were white, 10% were African American, 3% were Asian, 5% were Native American, and 9% were Hispanic. Families who were Hispanic were more likely to have received only a delaying response from HCPs. The average time to a developmental delay diagnosis was 5 months longer for families who received a delaying HCP response. CONCLUSIONS: Families who were Hispanic or who were from rural areas were most likely to receive a delayed HCP response; for parents who received a delayed HCP response, a developmental delay diagnosis took 5 months longer than for families from the other groups listed.

A Parent-Implemented Shared-Reading Intervention to Promote Communication Skills of Preschoolers with Autism Spectrum Disorder.

In the current study, we examined the effect of a parent-implemented early communication intervention during shared book reading. Three mothers of children with autism spectrum disorder were trained and coached to use a set of reading techniques and evidenced-based naturalistic communication teaching strategies (i.e., modeling, mand-model, and time delay). Using a multiple-baseline design across behaviors, the following three components were examined: (a) the mothers' use of reading techniques with fidelity, (b) the mothers' rate and fidelity in using the three naturalistic teaching strategies, and (c) the children's communication outcomes. After training and coaching, the mothers used the reading techniques and naturalistic teaching strategies with high fidelity. The children initiated more communicative acts upon their mothers' use of time delay.