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Early Intervention for Infants and Toddlers with Developmental Delay, Disability,...
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Early Intervention for Infants and Toddlers with Developmental Delay, Disability, and Behavioral Health Considerations

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Community Care".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 7744

Special Issue Editors

Prof. Dr. Toby Long

E-Mail Website
Guest Editor
Department of Pediatrics, Georgetown University, Washington, DC 20057, USA
Interests: service delivery to young children with disabilities; professional development; early childhood development
Dr. Neal Horen

E-Mail Website
Guest Editor
Department of Pediatrics, Georgetown University, Washington, DC 20057, USA
Interests: infant and early childhood mental health

Special Issue Information

Dear Colleagues,

Early intervention for infants and toddlers with disabilities, developmental delay, or with behavioral concerns is critical in shaping the future of these young lives. The significance of identifying and addressing developmental challenges in the earliest stages cannot be overstated. It not only paves the way for better outcomes but also embodies a compassionate and inclusive society.

Early intervention provides infants and toddlers and their families with the services needed to promote development during the early years of life when the brain is at its most malleable. This is an opportune time to stimulate neural pathways and facilitate growth in essential areas such as communication, motor skills, and social interactions. Timely intervention can mitigate developmental delays, providing activities to promote functional and meaningful participation in everyday activities.

Early intervention offers invaluable support to parents, empowering them with the knowledge and skills to advocate for their child's needs and become active participants in their growth and development. In doing so, it fosters stronger bonds within families and promotes a sense of inclusion and acceptance in the broader community.

The field of early intervention has grown exponentially over the last few decades. Research indicates that services that are delivered in partnership with families and other caregivers within activities that children regularly experience is the most effective. Early intervention reduces the long-term societal costs associated with disabilities. By addressing developmental challenges early on, we reduce the need for more intensive and expensive interventions later in life. This not only saves resources but also enhances the quality of life for individuals with disabilities. The aim of this Special Issue is to highlight recent advances in the field of early intervention for young children with disabilities.

This Special Issue of Healthcare is soliciting manuscripts addressing topics related to strategies, initiatives, and interventions designed to promote contemporary early intervention practice. Original articles and reviews on intervention, professional development, and policy, as well as on the evaluation of EI strategies, are invited. Papers that focus on research, leadership, education, and advanced practice are of particular interest. Papers that explore professional development and administrative methods will also be considered. We are particularly interested in papers that explore the intersection of disability and behavioral healthcare and team-based practices. Papers that explore international perspectives, especially those from low- and middle-income countries and areas of conflict, are also of interest.

We look forward to receiving your submissions.

Prof. Dr. Toby Long
Dr. Neal Horen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • early intervention
  • young children
  • disabilities
  • developmental delay
  • behavioral healthcare
  • infant and early childhood mental health consultation

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Published Papers (6 papers)

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24 pages, 4292 KiB  
Article
Examining the Impact of Pyramid Model Implementation to Deepen Social and Emotional Supports for Enrolled Children Within Early Intervention
by Margo Candelaria and Kate Sweeney
Healthcare 2025, 13(5), 515; https://doi.org/10.3390/healthcare13050515 - 27 Feb 2025
Viewed by 652
Abstract
Background/Objectives: Early social and emotional well-being is crucial for child development with life-long outcomes. The Individuals with Disabilities Education Act (IDEA) Part C Early Intervention system, which federally mandates special education services for children ages birth to three, is one place where identifying [...] Read more.
Background/Objectives: Early social and emotional well-being is crucial for child development with life-long outcomes. The Individuals with Disabilities Education Act (IDEA) Part C Early Intervention system, which federally mandates special education services for children ages birth to three, is one place where identifying and addressing early social emotional needs could be strengthened. Focusing on an implementation science approach, the Pyramid Model (PM) is examined to see how the model’s targeted implementation efforts over many years enhance a system’s capacity to identify and address social and emotional well-being in one state over five years. Methods: Implementation science methods were used to evaluate the impact of PM implementation over time in four independently operating sites within one state, emphasizing the use of coaching to support practice change, as well as fidelity tools and examination of system changes over time. Results: All sites increased capacity for PM implementation. Results varied by site but all sites were able to demonstrate improvement and higher fidelity implementation by the last year. Conclusions: The PM is an effective model to use within IDEA Part C programs to enhance capacity to identify and address social and emotional needs of children and families receiving services. Implementation factors are needed for success, including leadership support, organizational dynamics (e.g., creating dedicated time for staff to engage in training, external and internal coaching, and case reviews), committed funding, and dedicated support for implementation and evaluation. Full article
(This article belongs to the Special Issue Early Intervention for Infants and Toddlers with Developmental Delay, Disability, and Behavioral Health Considerations)
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29 pages, 342 KiB  
Article
Fostering Workforce Wellness: Insights from Nurse Managers and Early Childhood Educators
by Dominique Charlot-Swilley, Sabrina Zuskov, Latisha Curtis, Stephanie Mitchell and Elva Anderson
Healthcare 2025, 13(5), 487; https://doi.org/10.3390/healthcare13050487 - 24 Feb 2025
Cited by 1 | Viewed by 1100
Abstract
Background/Objectives: The COVID-19 pandemic has highlighted the challenges faced by essential professionals, such as nurse managers and early childhood educators (ECEs), who grapple with heightened stress, burnout, and compassion fatigue. In response, the Compassion, Practice, Relationships, and Restoration (CPR [...] Read more.
Background/Objectives: The COVID-19 pandemic has highlighted the challenges faced by essential professionals, such as nurse managers and early childhood educators (ECEs), who grapple with heightened stress, burnout, and compassion fatigue. In response, the Compassion, Practice, Relationships, and Restoration (CPR2) program was designed as a virtual, structured wellness intervention to address these pressing concerns among caregiving professionals. Methods: A mixed-methods study was employed to evaluate the feasibility, acceptability, and preliminary outcomes of CPR2, implemented across two cohorts: nurse managers in a pediatric hospital and early childhood educators (ECEs) serving equity-deserving communities. Participants completed electronic surveys at pre- and post-test assessing mindfulness, professional quality of life, healthy lifestyle behaviors, and perceived social cohesion. One month post-program, focus groups were conducted using a facilitation guide to evaluate program elements, including group structure, expectations, discussion themes, and sustainability. Results: Quantitative findings suggest that while nurse managers experienced significant reductions in compassion fatigue, along with improvements in mindfulness and perceived cohesion, ECEs exhibited stable levels of stress and burnout. Both cohorts reported enhanced sleep quality, emphasizing the program’s potential to foster critical aspects of wellbeing. Qualitative participant feedback highlighted the importance of organizational readiness, leadership engagement, and program flexibility for successful implementation. Conclusions: The study highlights the need for tailored, context-sensitive wellness interventions that recognize the unique challenges faced by different caregiving roles. It also emphasizes the potential for sustained impact when wellness initiatives are integrated into the organizational culture, further reinforcing the importance of ongoing commitment to workforce wellbeing in high-stress environments. Full article
(This article belongs to the Special Issue Early Intervention for Infants and Toddlers with Developmental Delay, Disability, and Behavioral Health Considerations)
17 pages, 535 KiB  
Article
Using RE-AIM to Assess Infant Early Childhood Mental Health Practices in Classrooms Serving Children with and Without Disabilities
by Ruby Natale, Tara Kenworthy LaMarca, Tanha Rahman, Elizabeth Howe, Rebecca J. Bulotsky-Shearer, Yaray Agosto and Jason Jent
Healthcare 2024, 12(24), 2501; https://doi.org/10.3390/healthcare12242501 - 11 Dec 2024
Viewed by 750
Abstract
Background/Objectives: High-quality inclusive education is important for promoting the positive development of children with disabilities in early childhood care and education (ECCE) settings. However, ECCE teachers may not have the knowledge and skills to manage challenging behaviors in young children, especially those with [...] Read more.
Background/Objectives: High-quality inclusive education is important for promoting the positive development of children with disabilities in early childhood care and education (ECCE) settings. However, ECCE teachers may not have the knowledge and skills to manage challenging behaviors in young children, especially those with disabilities. Infant and Early childhood mental health consultation (IECMHC) is one mechanism to support the professional development of teachers. This study explored the impact of an evidence-based IECMHC program, Jump Start Plus COVID Support (JS+CS), on outcomes for teachers in classrooms including children with disabilities. Methods: Utilizing a RE-AIM framework, we examined the extent that JS+CS impacted teacher outcomes related to classroom practice and teacher attitudes after the initial intervention period. In addition, we examined the extent that the classroom children with disability ratio moderated the impact of the intervention on teacher outcomes. Using a cluster randomized controlled trial in a sample of 138 racially and ethnically diverse teachers in 31 ECCE centers, we examined the reach, effectiveness, adoption, and implementation of JS+CS. Results: The results indicate that the JS+CS program shows promise as an intervention to support ECCE teachers working in classrooms with children with disabilities, particularly in improving teacher safety practices, behavior management skills, and resiliency coping. In addition, the program was adopted equally in classrooms that served children with and without disabilities. Conclusions: This is a unique contribution to the literature given that no previous IECMHC programs have examined adoption in classrooms serving children with disabilities. Further investigation is needed to determine the specific factors that impact program implementation considering that this study was conducted during various phases of the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Early Intervention for Infants and Toddlers with Developmental Delay, Disability, and Behavioral Health Considerations)
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18 pages, 1198 KiB  
Article
Survive and Thrive: Outcomes of Children Enrolled in a Follow-Up Clinic for Small and Sick Newborns in Rural Rwanda
by Alphonse Nshimyiryo, Dale A. Barnhart, Mathieu Nemerimana, Kathryn Beck, Kim Wilson, Christine Mutaganzwa, Olivier Bigirumwami, Evelyne Shema, Alphonsine Uwamahoro, Cécile Itangishaka, Silas Havugarurema, Felix Sayinzoga, Erick Baganizi, Hema Magge and Catherine M. Kirk
Healthcare 2024, 12(23), 2368; https://doi.org/10.3390/healthcare12232368 - 26 Nov 2024
Viewed by 979
Abstract
Introduction: Children born small or sick are at risk of death and poor development, but many lack access to preventative follow-up services. We assessed the impact of Pediatric Development Clinics (PDC), which provide structured follow-up after discharge from hospital neonatal care units, on [...] Read more.
Introduction: Children born small or sick are at risk of death and poor development, but many lack access to preventative follow-up services. We assessed the impact of Pediatric Development Clinics (PDC), which provide structured follow-up after discharge from hospital neonatal care units, on children’s survival, nutrition and development in rural Rwanda. Methods: This quasi-experimental study compared a historic control group to children receiving PDC in Kayonza and Kirehe districts. Study populations in both districts included children born preterm or with birthweight < 2000 g and discharged alive. Kirehe additionally included children with hypoxic ischemic encephalopathy (HIE). Home-based cross-sectional surveys were conducted in Kayonza among children with expected chronological age 11–36 months in 2014 (controls) and 2018 (PDC group) and in Kirehe among children with expected chronological age 17–39 months in 2018 (controls) and 2019 (PDC group). Outcomes were measured using anthropometrics and the Ages and Stages Questionnaires. We used weighted logistic regression to control for confounding and differential non-participation. Results: PDC children (n = 464/812, 57.1%) were significantly more likely to participate in surveys (83.0% vs. 65.5%), have very low birthweight (27.6% vs. 19.0%), and be younger at the survey (26.2 vs. 31.1 months). 6.9% (n = 56) died before the survey. PDC was associated with reduced odds of death (aOR = 0.49, 95% CI: 0.26–0.92) and reduced odds of developmental delay (aOR = 0.48, 95% CI: 0.30–0.77). In Kayonza, PDC was associated with reduced stunting (aOR = 0.52, 95% CI: 0.28–0.98). PDC was not associated with reduced underweight or wasting. Conclusions: PDC was associated with improved survival and development among children born preterm, with low birthweight, or with HIE. Increased access to PDC, scale-up across Rwanda, and implementation of similar services and early intervention in other low-resource settings could support children born small or sick. Full article
(This article belongs to the Special Issue Early Intervention for Infants and Toddlers with Developmental Delay, Disability, and Behavioral Health Considerations)
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17 pages, 2058 KiB  
Article
Enhancing Parental Understanding of Emotions in Children with Developmental Language Disorder: An Online Parent-Led Intervention Program
by Fatma Canan Durgungoz and Michelle C. St Clair
Healthcare 2024, 12(16), 1571; https://doi.org/10.3390/healthcare12161571 - 8 Aug 2024
Cited by 1 | Viewed by 2176
Abstract
Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents’ perspectives regarding children with DLD emotional understanding through a parent-led [...] Read more.
Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents’ perspectives regarding children with DLD emotional understanding through a parent-led online emotion recognition (ER) intervention. Ten parents of children with DLD aged 6–11 participated in the study. A nonconcurrent multiple baseline design was employed, allowing for a rigorous analysis of changes in parental beliefs over time. Weekly data were collected through the Parents’ Beliefs About Children’s Emotions Questionnaire. Interviews were also conducted to gain deeper insights into parents’ perceptions regarding the ER skills of their children. Results indicated that parents’ beliefs about the need for guiding and supporting their child’s ER skills increased over the intervention. Interviews also supported this, and three main themes were generated. The intervention program increased parents’ awareness of (a) the importance of ER for children with DLD, (b) emotion-focused communication and engagement with their child, and (c) the integration of emotions into daily life. This study is the first known study that explores parents’ beliefs about children with DLD ER skills, highlighting the importance of supporting parents through accessible interventions. Full article
(This article belongs to the Special Issue Early Intervention for Infants and Toddlers with Developmental Delay, Disability, and Behavioral Health Considerations)
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13 pages, 570 KiB  
Perspective
Advancing Mental Health and Equity Through Infant and Early Childhood Mental Health Consultation
by Jennifer Drake-Croft, Amittia Parker, Lauren Rabinovitz, Rachel Brady and Neal Horen
Healthcare 2025, 13(5), 545; https://doi.org/10.3390/healthcare13050545 - 3 Mar 2025
Viewed by 1013
Abstract
Early intervention services are a critical support for young children experiencing developmental delays and disabilities. Due to myriad negative social and economic conditions, some infants and young children, namely Black, Indigenous, and other children of color, as well as those experiencing poverty, are [...] Read more.
Early intervention services are a critical support for young children experiencing developmental delays and disabilities. Due to myriad negative social and economic conditions, some infants and young children, namely Black, Indigenous, and other children of color, as well as those experiencing poverty, are at greater risk of experiencing a developmental delay or disability and experiencing issues of access to needed services and supports within and beyond early intervention programs. Due to these systemic issues, these infants and young children are more likely to have caregivers experiencing mental health concerns and issues of access to services and supports. Early childhood serving programs are faced with meeting the behavioral health needs of families experiencing cumulative vulnerabilities. Some early intervention (EI) programs are partnering with infant and early childhood mental health (IECMH) providers to meet mental health needs. IECMH consultation (IECMHC) is a multi-level support that aims to build the capacity of early childhood programs to meet the needs of young children, families, caregivers, and staff. IECMHC has an intentional focus on promoting and ensuring equity, specifically more equitable systems. It focuses on addressing inequities impacting young children and their caregivers, thus strengthening these essential collaborations. This paper highlights research demonstrating the importance and collective power of IECMHC in early intervention programs to advance behavioral health and equity. Full article
(This article belongs to the Special Issue Early Intervention for Infants and Toddlers with Developmental Delay, Disability, and Behavioral Health Considerations)
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