Consensus Among Early Intervention Autism Experts Regarding Context for Success and Strategies for Suddenly Inclusive Early Education Childcare Settings

Background: A recent national survey of parents of preschool aged children found that 91% of children with ASD were receiving care in community settings (e.g., family-based child care, preschools, child care centers).  Compared to parents of typically developing children (9%) and parents of children with developmental delay (16%), parents of children with ASD (39%) were significantly more likely to report that childcare challenges contributed to employment accommodations (e.g., quit a job, did not take a job, greatly changed their job) at a significantly elevated rate (Montes & Halterman, 2008). Thus, many community early educators in childcare settings may not be prepared to meet the needs of children with ASD. Working towards the development of an intervention that targets strategies early educators can use within the context of a center-based childcare setting could be a partial solution to this problem. Such an intervention should focus on identifying and including active ingredients of early interventions for children with ASD (Kasari, 2002) that can be integrated with best practices for early education.

Objectives: To identify potential active ingredients of early interventions that can be taught to early educators working in childcare settings to support toddlers with ASD.

Methods: Sixteen of 26 early intervention autism experts, identified based on published early intervention autism research articles over the past 20 years, participated in semi-structured interviews regarding early intervention development (e.g., key strategies, training of early educator/child care provider interventionists). Two additional expert interviews will be completed for the final poster presentation. These interviews were one part of a larger project to develop a brief intervention for early educators in child care settings. Interviews were independently transcribed and coded by three people. Ongoing analysis with NVIVO is focused on exploring themes. Thorough systematic coding, categories and themes will be generated and researchers will check for saturation. 

Results: Preliminary analysis highlights the following two themes: 1. creating a context for success (including sub-themes such as child engagement [e.g., toy options, child choice] and awareness of child developmental level [e.g., play above and below child’s developmental level, activities at different levels] and 2. specific strategies critical to the intervention process (including sub-themes such as pausing [e.g., expectant pausing, waiting]  and using routines [e.g., routines to the third power, structure]). Additional sub-themes as well as quotes to substantiate each of these themes will be provided in the final presentation.

Conclusions: A number of early intervention models were represented in the expert interviews (e.g., ESDM, Children’s Toddler School, JASPER, LEAP, Walden School). The level of consensus regarding the context required for a successful intervention is compelling. These themes lend support for common training needs among early educators that could be addressed by an intervention for use in suddenly inclusive early education childcare settings. Additionally, the level of agreement present regarding “the most important intervention strategies” provides researchers with a potential starting point for future studies that should analyze the relative impact of individual intervention strategies and their interaction with one another when used simultaneously.