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Sub-Saharan Africa (SSA) has a scarcity of research on autism spectrum disorder (ASD) and available early interventions, as most of what is known about the disorder is from highincome countries. Early detection and intervention methods were found to have positive effects on developmental delays and to alleviate symptom severity in children with ASD or at risk of it. There is a need for scalable interventions in low-resource settings, which are characterised by a lack of highly-trained specialists, infrastructure and funding. This study explored the barriers and facilitators to implementing and sustaining a caregiver-coaching ASD early intervention, informed by the principles of the Early Start Denver Model (ESDM), adapted for South Africa and for delivery by non-specialists. The study also identified some changes that could be made to improve intervention adoption and sustainability. Nine multilevel stakeholders involved in the implementation of the caregiver-coaching intervention were purposively sampled, individual in-depth interviews were conducted, transcribed verbatim and thematically analysed. Major implementation facilitators included: ECD worker baseline ASD knowledge and experience; skills gained from the training received and coaching; clear in-session caregiver-coaching structure; value of strong team relationships; clear video illustration of intervention concepts; and the mastery and generalisation of skills by the ECD workers, ECD supervisors and caregivers. Implementation barriers included: the complexity of the intervention and coaching concepts; misalignment of ECD teacher training with the caregiver-coaching approach; logistical challenges; and mismatch of the video content with the South African context. Facilitators to sustain the intervention included: child outcomes; caregiver ‘buy-in;’ and competence; and the need for ongoing live supervision. Barriers to sustaining the intervention included: structural issues of poverty, transportation and unemployment. Positive child and caregiver outcomes could be offset by larger contextual and system-level issues such as poverty and the need for ongoing support, supervision and local coaching materials in South African languages. The results will inform tailoring of the intervention training and supervision approach for a larger pilot study.

The aim of this study was to investigate the effectiveness of community playgroups on the playfulness of children ages 15 months to 3 years with special needs. In addition to playfulness of the child, the sensitivity and responsiveness of the caregiver were examined. A quasi-experimental, pretest-and-posttest, repeated measures design was used to follow eight children and their caregivers receiving early intervention services and taking part in a community playgroup. The children and their caregivers were measured during a 4-week standard-of-care baseline, before and after an 8-week intervention period, and 4 week post-intervention. The Test of Playfulness (ToP) was utilized to measure playfulness at baseline, before and after intervention, and at follow-up. Qualitative ratings for caregiver-child interaction based on the National Institute of Child Health and Human Development scales measured the sensitivity and responsiveness of the caregiver. A repeated measures analysis of variance (ANOVA) demonstrated that participation in the 8-week playgroup significantly increased child playfulness ( p < .01). Analysis did not detect a change in caregiver sensitivity and responsiveness as a result of intervention. All caregivers who participated in the playgroup were initially highly sensitive responders to their children. Four weeks post-intervention, a strong, positive linear relationship was found between the sensitivity and responsiveness of the caregiver and the playfulness of the child. The effectiveness of the community playgroup has implications for part of comprehensive occupational therapy practice in early intervention.

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Individuals diagnosed with Autism Spectrum Disorder (ASD) have difficulties in forming functional communication. The purpose of this study was to replicate Ishizuka and Yamamoto (2016) to determine which intervention, contingent vocal imitation or contingent vocal responses, produced the highest level of vocalizations of young children diagnosed with ASD in a play-based setting. For the contingent vocal response treatment phase, the experimenter vocally responded to each child vocalization with a response that was topographically different than the child’s response. For the contingent vocal imitation treatment phase, the experimenter vocally imitated the child’s vocalization with a topographically identical response. Two children diagnosed with ASD, ages 41 and 57 months, participated in this study. An alternating treatment design was used to compare the effects of each treatment on increasing child vocalizations. . Results indicated that contingent vocal imitation resulted in a higher number of child vocal imitations for both children. Results also indicated that contingent vocal responses and contingent vocal imitation produced comparable levels of overall vocalizations, which replicated the findings of Ishizuka and Yamamoto (2016). / Applied Behavioral Analysis

Individuals diagnosed with Autism Spectrum Disorder (ASD) have difficulties in forming functional communication. The purpose of this study was to replicate Ishizuka and Yamamoto (2016) to determine which intervention, contingent vocal imitation or contingent vocal responses, produced the highest level of vocalizations of young children diagnosed with ASD in a play-based setting. For the contingent vocal response treatment phase, the experimenter vocally responded to each child vocalization with a response that was topographically different than the child's response. For the contingent vocal imitation treatment phase, the experimenter vocally imitated the child's vocalization with a topographically identical response. Two children diagnosed with ASD, ages 41 and 57 months, participated in this study. An alternating treatment design was used to compare the effects of each treatment on increasing child vocalizations. . Results indicated that contingent vocal imitation resulted in a higher number of child vocal imitations for both children. Results also indicated that contingent vocal responses and contingent vocal imitation produced comparable levels of overall vocalizations, which replicated the findings of Ishizuka and Yamamoto (2016). / Applied Behavioral Analysis

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Previous research has shown that parent implemented intervention is effective in increasing the speech and language development of children with cleft lip and palate. To further determine the efficacy of this intervention, this study compared the speech and language development of children with CLP, who received parent implemented intervention, with a group of younger, typically developing children, matched for vocabulary size. This study also evaluated the language differences between the mothers of both groups of children. Speech and language assessments were administered to the typically developing children and their mothers at two times to mirror the time of assessment for the children with clefts who received a three-month intervention, in a prior study. The findings revealed that both groups of children demonstrated the same amount of speech and language growth as well as the cleft group exhibiting a decrease in compensatory articulation errors.

This study evaluated the effectiveness of the Systematic and Engaging Early Literacy (SEEL) intervention method to improve consonant-vowel-consonant (CVC) reading in four students receiving Tier 3 services. The SEEL intervention method was also combined with the use of digital books on an iPad to investigate the effects of using technology in reading intervention sessions. Previous research indicates effectiveness for the foundational principles of SEEL, which include instruction in engaging, meaningful contexts that provide frequent and intense opportunities to practice. This research involved 4 kindergarten students who qualified for Tier 3 services based on their performance on an index of difficulty in early literacy skills. The study contrasted trained with untrained literacy targets of comparable difficulty and was conducted as a single-subject multiple-baseline-across-behaviors design. Intervention was delivered three times a week for 15-20 minutes, depending on the engagement of the participants. An analysis of the results showed improvement in three out of four participants in their reading ability of the target CVC words. It gave mixed results as to the effects of using technology in combination with the reading intervention. The analysis also looked at student engagement during both the hands-on manipulation of the materials and the reading and writing tasks performed on the iPad. It found that the engagement between these two parts of each session was similar; if a student had poor engagement for the SEEL intervention, he or she also had poor engagement for the iPad portion, and vice versa. This study provides further insight into the efficacy of SEEL and the use of technology; it also provides suggestions for future research in the area of reading intervention.

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