75 Pilot testing of BEAR 4 To date, early intervention studies for autism spectrum disorder (ASD) have been conducted after 6 months of age, either with high risk siblings or with infants showing signs of a neurodevelopmental vulnerability. These very early interventions are often called preemptive intervention, are parent-mediated and derive from evidence-based naturalistic developmental behavioral intervention principles (NDBI’s) (Green & Garg, 2018; Bruinsma et al., 2020). Both previous research and signals from the clinical field show that early detection and access to early intervention for infants and toddlers at elevated likelihood for ASD can be a complex, challenging and lengthy process with barriers related to child, parent, professional and organizational factors (Boshoff et al., 2018; Johnson et al., 2020; Locke et al., 2020; Mandell et al., 2009; Rutherford et al., 2016; Snijder et al., 2021a; Snijder et al., 2021b). In the Netherlands, the SCOPE-project (Social COmmunication Program supported by E-health) was initiated to improve early detection and access to early interventions for infants and toddlers at elevated risk. First, an informative online platform for parents and professionals was set up (www.autismejongekind.nl). This platform offers easy and accessible information about the early indicators of ASD to parents and professionals and at the same time improves awareness about the importance of early detection and intervention. Second, additional training through an e-learning and live-online learning was offered to first line healthcare professionals to improve their knowledge and self-confidence in recognizing possible early behavioral markers of ASD (van ’t Hof et al., 2021). Third, a relatively short and home-based early intervention called BEAR (Blended E-health for children at eArly Risk) was developed (Dietz & Oosterling, 2019). BEAR is a pre-emptive intervention that can be offered to parents of infants and toddlers (aged 12-30 months) with neurodevelopmental vulnerabilities in social-communicative development. There may be ASD related concerns regarding the child’s development, but not a confirmed ASD diagnosis yet. The BEAR intervention is carried out by a first line healthcare professional and is ideally supervised by a specialized mental healthcare professional. The global focus of the intervention is helping parents to understand their child’s behavior, promoting sensitivity in parents to their child’s needs and, through that, to motivate the child to socially engage (i.e. improve joint engagement). Secondary objectives of the intervention are reducing parental stress and decreasing the gap between first concerns and start of adequate intervention. BEAR consists of seven home visits and with five accompanying e-learning modules for parents. The five intervention modules are partially based on the DIR/Floortime model (Greenspan & Wieder, 2007). Modules include (1) improving attention to the (play) environment, (2) becoming interested in social contact, (3) increasing social contact and communication, (4) improving social communication and (5) increasing flexible behavior. The core elements of BEAR are that parents/caregivers follow their child’s interests, match the child’s developmental level and pace, and ensure fun in the interaction as the basis for all further learning.
RkJQdWJsaXNoZXIy MjY0ODMw