Mary Beth Bruder

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This meta-analysis examined the post-intervention effects of joint attention interventions on children's joint attention skills and other outcomes for young children with autism spectrum disorder (ASD), as well as identifying characteristics associated with improvements in children's joint attention skills. We searched four databases in February 2025. Randomized controlled trials (RCTs) of joint attention interventions for children with ASD under five years old were included. Risk of bias was assessed using the Risk of Bias 2.0 tool. Effects were synthesized using multivariate random-effects model meta-analysis using robust variance estimation. Eighteen RCTs with 1,165 child participants were included in this meta-analysis. We found improvements in joint attention skills (g = 0.53, 95% CI [0.34, 0.72]) with substantial heterogeneity. Child's chronological age and joint attention types were found statistically moderating the effect on children's joint attention skills. We also found improvements in play (g = 0.33, 95% CI [0.04, 0.63]), and autism symptomatology (g = 0.70, 95% CI [0.13, 1.26]). This meta-analysis of 18 RCTs showed that joint attention interventions effectively improved joint attention skills in young children with ASD. Younger children showed greater improvements than older children. Larger effects on responding to joint attention were observed comparing to other types of joint attention. While positive effects on play skills and autism symptoms were observed, these findings require cautious interpretation due to methodological limitations. Results support joint attention interventions as beneficial for improving developmental outcomes in young children with ASD.

It is estimated that 25% of adults in the US are living with one or more disabilities. Persons with disabilities (PWD) have unmet health care needs, experience health disparities compared to those without disabilities. Barriers to quality health care include structural barriers such as access to transportation, physical access to facilities, and lack of accessible medical equipment. Other barriers include the knowledge, skills, beliefs, and attitudes of health care providers to meet the needs of PWD. To examine the barriers to health care experienced by adults with disabilities in Connecticut, the University of Connecticut Center for Excellence in Developmental Disabilities and Leadership Education in Neurodevelopmental and related Disabilities program (UConn UCEDD; UConn LEND) worked with self-advocates to develop a 25-question online survey in plain language. Data from 78 PWD and/or family members and caregivers of a PWD living in Connecticut were analyzed. Respondents reported experiencing issues scheduling appointments due to lack of availability, challenges with the scheduling system, or transportation difficulties (21%), using devices for telehealth visits (27%), and insurance coverage and cost (17%). More than half of respondents reported needing accessible buildings and exam rooms as well as accessible medical diagnostic equipment (MDE). Finally, 43% of respondents reported problems communicating with health care providers, 39% reported that providers demonstrated negative attitudes towards them during visits, and 61% reported that they did not think their health care providers had enough training about working with PWD. The results of this survey suggest that PWD living in Connecticut experience similar barriers to health care access as PWD across the country. Our findings support the need for federal enforcement of standards for accessible MDE, state-level compliance of the standards, and required training in disability competency for all health care training programs to ensure that providers can meet the needs of PWD.

There are concerns about the quantity and quality of personnel in early childhood intervention (ECI) as the numbers of infants and young children with delays and disabilities grow in number, needs, and diversity. The Early Childhood Personnel Center (ECPC) was funded to provide technical assistance (TA) to state systems of ECI and institutions of higher education (IHE) through the development of comprehensive systems of personnel development (CSPD). A CSPD is comprised of 6 interrelated subcomponents and each provides the infrastructure necessary to meet the current and future needs of a competent workforce. The subcomponents include recruitment and retention, personnel standards, preservice programs, in-service training, leadership and sustainability, and evaluation. TA audiences have included ECI administrators, IHE faculty, doctoral students, professional development providers, and families that jointly develop, implement, and evaluate effective personnel practices, policies, and systems. The purpose of this article is to provide an overview of the TA provided by the ECPC over the past 8 years.

A survey of 955 early childhood practitioners in one Midwestern state was conducted to assess judgments of their desired use versus their current use or implementation of 10 sets of recommended practices from the Division for Early Childhood of the Council of Exceptional Children. Practitioners from early intervention, preschool, preschool special education, Early Head Start, Head Start, and other early childhood programs participated in the study. Results indicated large effect size differences in practitioners’ judgments of their desired versus current use of the practices, differences in terms in which practices were considered most valued and most frequently used by the practitioners, and a continued gap in the use of practices compared with results reported in similar studies conducted 15 and 22 years ago, respectively. The findings are discussed in terms of the need to adopt and use effective professional development practices to ensure practitioner use of valued practices and the need to develop a comprehensive system of personnel development to provide an infrastructure to support practitioners’ knowledge and skills of recommended practices.