The Act Early Idaho Project Makes Early Identification a Priority |
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Estimates in the United States indicate that one in six children, ages three to seventeen, have a developmental delay or disability (Zablotsky et al., 2019). Positive developmental outcomes have been strongly associated with early intervention services, indicating a clear priority for identifying children with developmental delays and disabilities early. With high quality intervention in the first three years of life, children’s developmental trajectory can be changed, resulting in improved outcomes across all areas of development (NECTAC, 2011).
In collaboration with the Centers for Disease Control and Prevention (CDC) and the Association for University Centers on Disabilities (AUCD), Act Early Idaho has worked to examine and expand early identification efforts across multiple programs serving families with very young children in Idaho, with specific considerations for impacts of the COVID-19 pandemic. As an initial activity, Act Early Idaho completed a needs assessment to better understand current, emerging, and changing strengths, needs, barriers, and opportunities for early identification in Idaho in the context of COVID-19.
The Act Early Idaho Needs Assessment was conducted through a national survey developed by the CDC and through 21 partner interviews. Findings indicate that engagement in early identification activities is inconsistent and varies greatly across programs serving young children. During the COVID-19 pandemic, early childhood programs have seen further decreases in all early identification activities, including developmental monitoring, developmental screening, referrals to early intervention programs, and receipt of early intervention services. Programs reported hesitancy to refer children and families to early intervention based on uncertainty of service availability and capacity.
Many early childhood programs across a variety of early childhood sectors, including Head Start/Early Head Start, early intervention, and early childhood special education programs utilized technology to continue supporting families with early identification activities when in-person services were not permitted. Disparities in access to technology were noted across Idaho, and especially in rural locations. With increased stressors among families, early identification was reported by one partner “as one more thing for families to worry about,” especially as developmental concerns specific to the social and emotional development of young children notably increased.
In response to information gathered through the needs assessment, Act Early Idaho took initial steps to support the resiliency of Idaho families with young children through the development of a resiliency toolkit. The Act Early Idaho Resiliency Toolkit outlines resources for families as they navigate COVID-19, including information on monitoring children’s development and responding to developmental concerns.
In collaboration with multiple statewide partners, including Idaho WIC, the Idaho Commission for Libraries, Head Start/Early Head Start, IdahoSTARS, the Idaho Chapter of the American Academy of Pediatrics, and Idaho Parents Unlimited (IPUL), and more, Act Early Idaho has provided targeted technical assistance to programs to assist in expanded early identification efforts. Act Early Idaho has also disseminated the CDC’s “Learn the Signs. Act Early” materials across the state, including development milestone checklists, information on the Milestone Tracker App, information on addressing developmental concerns, and children’s books that introduce developmental milestones in engaging ways for children and families.
For more information about the work of Act Early Idaho, including the results of the Act Early Idaho Need Assessment, visit the Act Early Idaho webpage.
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Idaho SESTA is a state-wide training and technical assistance project funded through the Idaho State Department of Education, Special Education. SESTA provides supports to school district personnel across the state.
SESTA training opportunities and resources provide Idaho educators with informational content specific to a variety of evidence-based practices, which can be used to teach and support students in the classroom. Trainings are available in different formats that include asynchronous (e.g., modules, tutorials, and recorded webinars) and/or synchronous (e.g., live meetings and webinars) content. Included in this article are a few of the current training opportunities available. Additional trainings and resources are located on the Idaho SESTA website.
Launching the IEP. Learn how to use what we know about our students to develop and implement high-quality instruction. This training is for special education teachers and provides information on specially designed instruction (SDI) and to strengthen instruction using feedback and engagement strategies. This Hybrid Learning Series includes three (3) online modules, a workbook to accompany the modules, and a follow-up webinar to pull all the information together.
Classroom Management Behavior Series. Relevant information on a variety of topics founded in best practice and science presented in an accessible and digestible manner. Available resources include 1-page topic-based information, infographics, podcasts, self-paced modules, and lots more regarding the crucial keystone of classroom management.
Idaho Tiered Behavior Supports. Positive Behavioral Interventions and Supports (PBIS) is an evidence-based framework developed to assist school teams in providing preventative, positive behavioral support for ALL students. Idaho SESTA aims to support successful and consistent implementation of PBIS in schools across the state. Idaho SESTA PBIS Tiered Support Coordinator will facilitate district-level planning and provide school team training, technical assistance, and ongoing coaching to district PBIS coaches, and schoolwide facilitators to build capacity to implement the PBIS framework.
Low-incidence webinars. Webinar series are provided throughout the year with optional university credit available. Twenty-Five Things to Remember About Social Skills, Facilitating Friendships, and Building Positive Self-Esteem, a three part webinar series, will include the following core components: independence and interdependence and how they are influenced by familial cultural factors, the evolution of social norms over time, the ways in which social relationships change throughout people’s lives, strategies for facilitating and maintaining natural peer relationships, the importance of social skills and other ‘soft skills’ in post-school success, supporting students to have a presence on social media, and the development of communication systems that support making and keeping friends. Maurice Belote, Project Coordinator for California Deafblind Services is the presenter and has been in the field of deaf blindness for 39 years.
Assistive Technology. The Individuals with Disabilities Education Act (IDEA) states that assistive technology (AT) must be considered for every child having an individualized education program (IEP). Under IDEA, AT can be special education (specially designed instruction), a related service, or supplementary aides and services so it can appear in the IEP in a variety of ways. While AT is applicable to persons of all ages and in all environments, in education the key questions to ask are, "What is it that the student needs to do in the educational program that he/she isn't able to do because of the disability?" and secondly, "Are there any AT devices or services that might be enable the child to meet the goal?" The questions are easy. Getting to the answers is more challenging. One of many topics featured on Assistive Technology is Alternative Augmentative Communication (AAC). A 5-part module series titled, Cracking the AAC Code, lays a foundation for understanding AAC including defining terms, identifying types of AAC and who might benefit.
Be sure to check out all of the Idaho SESTA Resources, available free of charge, on the Idaho SESTA website or give them a call at 1-844-437-3782. |
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Naturalistic Observation Diagnostic Assessment |
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Fifteen years ago, the prevalence of children diagnosed with autism spectrum disorder (ASD) was 1 in 160 children. Presently, that number has increased to 1 in 58. This increased prevalence of autism has many families searching for an assessment to diagnose ASD. Service providers around our state are often unable to keep up with the demand for assessments and are subsequently backed up on referrals for six months to a year. The Director of Clinical Services at CDHD, Gwen Mitchell Ph.D. is familiar with this problem. Dr. Mitchell said in regards to assessments “if I didn’t have these three graduate students working here there is no way I could have handled all this on my own. I mean because the referrals are basically nonstop.”
These long wait times for assessments show the need for better access to telehealth medicine. Behavior Imaging, a technology company based in Boise, ID has recognized this issue since 2005 and has worked to create technology that provides telehealth care. Grant funded through the National Institute of Health (NIH), Behavior Imaging’s primary telehealth technology is their Naturalistic Observation Diagnostic Assessment, (NODA). Dr. Mitchell has collaborated with Behavior Imaging on various NODA grants since 2016.
Dr. Mitchell describes this project “using the NODA method, a family is given the right to download an app from Behavior Imaging. Within that app they receive instructions on how to obtain evidence of their child behavior.” Within the NODA method “there are four prescribed videos [to be completed by a family]. The first video is the child playing independently, the second one is playing with a peer or sibling, the third one is mealtime, and the fourth one is parent concern [behavior].” Parents record up to ten-minute videos within each of these categories and can submit multiple videos. NODA has been proven to be valid and reliable for children over one year of age and younger than seven. Once the video is uploaded within the app Dr. Mitchell describes the next step, “we look at the videos and then we tag the videos for characteristics that may or may not be on the spectrum. Using the DSM-5 diagnostic criteria for autism we would tag those behaviors, and we tag associate features. Then we overlay all those criteria that we’ve tagged onto the DSM-5 checklist and see if there is adequate number and severity of symptoms that would constitute a diagnosis.”
Behavior Imaging has received three grants from the NIH to further research surrounding remote diagnosis of autism. The first grant received by Behavior Imaging, contracted through Dr. Mitchell, focused on the validity and reliability of NODA. Dr. Mitchell describes their second grant, Rural NODA, as focused on “investigating the length of time that people were spending after referral from a physician to get their diagnostic assessment done and whether it was faster to get it done using NODA or it was faster to get it done in person.” Dr. Mitchell goes on to describe the results “when a family doesn’t have to travel, they’re going to more likely get their diagnosis sooner.”
The third grant Behavior Imaging received from the NIH is still in the early phases with a start date of May 1st. This grant is in collaboration with CHADIS, a medical health history database, Dr. Mitchell, the University Hospital Los Angeles, and Northwest Autism Center in Phoenix. Clinicians will gather data on the length of time to receive an autism assessment between in person practices that use CHADIS, and remote diagnosis using NODA. Participants will receive a stipend to be contacted at three stages during their assessment process.
If interested in reviewing the published work associated with NODA, articles can be found here:
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Idaho Autism Summit Virtual (Un)conference 2021 |
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This April, CDHD hosted the first virtual (Un)Conference for the 2021 Idaho Autism Summit. In these uncertain times we have all had to adapt our plans. For this reason, we moved our annual Autism Summit to an online format. Each (Un)Conference session featured stories from members of the community. These speakers shared their lived experiences, knowledge, and ideas about creating and promoting acceptance of people with ASD in our communities.
The first session of the Summit took place on April 10. This session featured recorded videos, and live presentations from self-advocates and family members sharing their stories. This session started with a statement from the Autistic Self Advocacy Network on the importance of shifting our language from autism awareness to autism acceptance.
The first presentation featured a video from Katie Hodges, an adult with autism. She spoke about her experience living at the Southwest Idaho Treatment Center (SWITC) and the importance of kindness and friendship. Next, Bailey Butterfield spoke about her brother Brady who has autism. Bailey touched on how influential Brady has been in her life and even influenced her decision to start a career working with people with disabilities. Bailey worked as a trainee at the CDHD during her senior year and now works as a lead behavior intervention specialist at Collaborative Behavior Solutions. The third presentation was from Valerie Illguth, a mother whose child has autism. She discussed how she felt about receiving an autism diagnosis for her child. At first, she felt as if the diagnosis would hinder her child and set them up for a life of hardships. She then goes on to point out that the diagnosis came with positives and provided better services for her child. The fourth presentation was a video provided by DR, an adult with autism. DR spoke about her experience growing up with autism and feeling different from her peers. She goes on to point out the prevalence of mental health disorders that many people with autism deal with. She spoke of the importance of mental health for people on the spectrum; In times in her life where her mental health was struggling, DR felt that people were only focused on her mental health diagnosis, without regard to her autism. Next, Ian Bott (uses pronouns they/them), another self-advocate spoke of the accomplishments they have had. They highlighted the many career fields and successes. Ian believes that people on the spectrum can thrive and lead successful careers. The final presentation was by Ron and Robby Oberleitner. Ron is the CEO and cofounder of Behavior Imaging; Robby, Ron’s son, is an adult with autism. Ron and Robby spoke about Robby’s life and how they as a family navigated Robby’s diagnosis of autism when he was a child. To close the first session, Dr. Abhilash Desai, a board-certified psychiatrist, led three one-minute meditations that focused on autism acceptance.
The second session of the (Un)Conference took place on April 24th. This session focused on educators and professionals providing insights into what they have learned working with the ASD community. This session again started with a statement from the Autistic Self Advocacy Network on the importance of autism acceptance. The first speaker, Adrienne Seamans, is a PhD student at the University of Idaho studying Special Education with an Emphasis in Autism Spectrum Disorder and Related Disabilities. Adrienne is also the mother of three children, two of whom are on the spectrum. In addition, her husband was diagnosed with autism following the diagnosis of their first son. Adrienne spoke about what it is like to be both a parent of children on the spectrum, and as a professional who works in the disability community. She provided advice to other parents, and advice to professionals. The second presentation was given by Janessa Thomas who is a high school special education teacher. She spoke of the importance of secondary transition, and her role in assisting her students to find meaningful employment. Next, Toni DiPietrio a developmental specialist at SWITC, shared a poem about acceptance. She spoke about loneliness, and how we are all searching for our place of acceptance. The last presentation of the day was by Dr. Abhilash Desai. He spoke about the importance of collaborative care and treating individuals from a holistic approach. Dr. Desai emphasized the importance for physicians to look at all aspects of the person they are treating. When physicians are focused on one aspect of care, rather than the whole person, patients can be overmedicated which then leads to further care needs. To conclude the second and final session, Dr. Con Colby, an emeritus professor at Boise State University, led three one-minute meditations that focused on autism acceptance.
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May
25 - CDHD Community Advisory Committee Meeting
31 - CDHD closed in observation of Memorial Day
June
8,9,11,15,16,18 - Strengthening Partnerships Training- Various Locations
July
5 - CDHD closed in observation of Independence Day
August
3-4 - Deaf-Blind Virtual Summer Institute
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