94 Chapter 5 Snijder et al., 2021b). First, an informative online platform for parents and professionals was developed (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 spreads awareness about the importance of early detection and intervention. Second, preventive care professionals in the target region are trained in recognizing the early signs of ASD. Previous research shows this as an effective way of improving early detection, if continuously invested in (Bordini et al., 2015; Oosterling, 2010; Pijl et al., 2018). In the Netherlands, preventive care professionals at well-baby clinics are the first healthcare providers to have systematic contact with families, mainly for routine health checks and vaccinations and therefore play a pivotal role in the early detection process of ASD (i.e. signaling, screening and referring). Almost all children aged 0-4 and their parents visit the well-baby clinics (94%; CBS, 2014). Therefore, training in several aspects of early detection of ASD focusses primarily on these preventive care professionals, but also on other important professionals such as general practitioners and pedagogical staff at daycare centers. The third component of SCOPE contains a relatively short and acceptable home-based early intervention (BEAR: Blended E-health for children at eArly Risk) offered to parents with symptomatic high risk infants and toddlers. There might be ASD related concerns regarding the child’s development, but not necessarily a confirmed ASD diagnosis. The BEAR intervention is an pre-emptive intervention offered by a first line healthcare professional, supervised by a specialized mental healthcare professional (and working within a more specialized setting). A recent systematic review by Hampton and Rodriguez (2021) on pre-emptive interventions suggest that parent-mediated interventions are associated with better parental use of strategies and although results do not translate one-on-one into short-term developmental outcomes of the child, there is a proposition that successful parent implementation facilitate later social communication of the child. The global focus of the BEAR 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 (e.g., improving joint engagement, enhancing initiatives in communication). Theoretically BEAR builds on two well-studied principles: 1) high synchrony between parent and child is assumed to be related to decrease in autism symptoms and 2) improved joint attention and joint engagement skills are related to better communicative abilities (Kaale et al., 2012; Kasari et al., 2012; Murza et al., 2016). Like many early interventions (such as Pivotal Response Treatment, Floorplay and JASPER-training) BEAR intervention techniques are based on evidence-based naturalistic developmental behavioral intervention principles (NDBI’s; Bruinsma et al., 2020). BEAR is meant for children for whom referral for a diagnostic trajectory might not be applicable yet (because of unclear indicators or mild signals), or when serious concerns regarding development exist but parents are not yet ready for referral to a more specialized center for infant psychiatry (see Snijder et al., 2021b). The innovative value of BEAR is not so much in the content or
RkJQdWJsaXNoZXIy MjY0ODMw