The Cost-Effectiveness of Increasing Hours Per Week of Early Intervention Services for Young Children with Disabilities

Although there is a widespread belief that increasing the hours of early intervention services for children with disabilities will result in increased benefits for the participating children and their families, there is little research evidence to support this point of view. In this study, young children with disabilities were randomly assigned to receive either one hour per week of early intervention services, or three hours per week. Measures of child and family outcomes over the subsequent five-year period demonstrated no consistent benefits associated with increasing the hours of intervention. Possible reasons for the lack of benefits are discussed in the context of previous research.     

Early Childhood Intervention in China from the Families’ Perspective

Research highlights the importance of early childhood intervention (ECI) for children with disabilities, and there is an increasing interest in China with respect to research on ECI. However, little research exists exploring the experience of families of young children with disabilities receiving ECI services and supports in China. The purpose of this study was to understand the ECI experiences of families of such children. A qualitative research design was used, and data were collected through interviews with six families in southwest China. This study indicated that, although China has made some progress in ECI for young children with disabilities, progress in this area is still at an early stage of development. Many issues still need to be addressed, including knowledge about typical and atypical development, early identification, professional development, increased government investment, and better implementation of existing laws.     

Defining and Assessing Quality in Early Intervention Programs for Infants and Toddlers with Disabilities and their Families: Challenges and Unresolved Issues

Historically, child care quality research has focused primarily on typically developing children cared for in center-based programs. Findings from this research suggests that variations in quality of care have an effect on children's well-being and developmental outcomes. In this paper, we draw on child care quality research to inform our understanding of quality in early intervention services for infants and toddlers with disabilities and their families. Conceptual issues in defining quality and methodological challenges for assessing quality of early intervention services are presented. In the final sections of this paper, we discuss our efforts to design a measure of quality for early intervention programs and present some of the unresolved issues related to the assessment of quality in early intervention programs.     

Teaching handwriting skills to children with intellectual disabilities using an adapted handwriting programme

Children with intellectual disabilities often struggle with handwriting, but there is very little research to inform intervention approaches. In this study, we developed a teaching manual based on Handwriting Without Tears®, a comprehensive handwriting programme designed for typically developing children. Three children with intellectual disabilities participated in the study and received handwriting instruction based on the manual three times a week over a 32‐week period. Our aims were to explore whether Handwriting Without Tears® can be used as a comprehensive handwriting curriculum for children with intellectual disabilities and to evaluate improvement in handwriting skills. We found that the intervention was successfully incorporated into small group teaching sessions within the child's regular classroom, and that all three children made improvements. Our data show promising results and support the need for larger evaluation studies.     

Examining Services for Young Children with Autism Spectrum Disorder: Parent Satisfaction and Predictors of Service Utilization

Autism spectrum disorder (ASD) is the fastest growing group of neurodevelopmental disorders in childhood. Earlier detection means an increased need for early intervention and other educational services. This study examined what services a sample of young children with ASD received, what variables predicted service utilization, and how satisfied parents were with the services. Sixty children (2–7 years) and their families from the Northwestern United States participated in the study. Results suggest that, on average, children received 13 h of educational and therapeutic services per week, with younger children receiving fewer services than older children. Child age, atypical behavior, and family income predicted number of service hours received. Children’s adaptive behavior and autism symptoms did not predict service hours. Although services received were, by most standards, minimal and far below best practice recommendations, parents reported high satisfaction, especially for their toddlers and preschool-aged children. Implications and future directions are described.     

Effective Social Interaction Strategies for Inclusive Settings

Many strategies and interventions exist in the education of young children with disabilities. One area of intervention is that of social interaction, including social skills instruction, peer interaction strategies, and play skills. Interaction and social skill strategies for use with children with and without disabilities for the purpose of increasing social interactions between children with and without disabilities in educational settings is an area many educators of early childhood special education strive to find in an effective and easy to implement format. Several strategies from research are presented in this article. Only strategies that were demonstrated to be successful through reported research are discussed. Strategies are identified according to their ease of implementation and effectiveness.     

Beyond Part C: Reducing Middle School Special Education for Early Intervention Children with Developmental Delays

This study examined the rates of special education placement during middle school grades (sixth through eighth) among children who participated in the Linda Ray Intervention Program (LRIP) center-based and home-based learning modalities. The study sample included 113 children in Miami Dade County Public Schools who had gestational cocaine exposure and received early intervention services due to developmental delays. This study found that children who participated in the center-based (25 hours per week) learning modality had a significantly lower rate of special education placement (14%) than the students in the home-based (three hours per week) learning modality (30%) in middle school. Also, results indicated that children who were socioeconomically disadvantaged (free/reduced lunch) and in the home-based learning modality were three to four times more likely to be in special education. This study provides evidence for the long-term impact of the LRIP center-based modality on special education outcomes.     

美国个别化家庭服务计划及对我国的启示

个别化家庭服务计划(Individualized Family Service Plan,简称IFSP)是在美国1986年《障碍者教育法修正案》(The Education of the Handicapped Act Amendments of 1986,PL99-457,1986)中提出来的。此计划旨在为0-3岁障碍婴幼儿提供早期干预服务,以促进婴幼儿的发展和成长。本文通过对IFSP的提出、法律规定及内容、实施要求等方面的介绍,为我国制订与实施障碍儿童早期干预服务提供法律制定、政府支持、人员培训、家长参与及转衔等方面的借鉴。     

Does More Intensive Neonatal Intensive Care Unit Follow-Up Service Result in Better Outcomes? A Cost-Effective Analysis

Little is known about the relative cost-effectiveness of the many different types of early intervention services provided to medically fragile infants and their families. This study compared two intensities of services for such infants and their families: (a) a coordinated and comprehensive system of early intervention services initiated prior to discharge from the NICU and designed to transition infants to community-based services were compared with the effects of services (high intensity); and (b) a more traditional hospital follow-up consisting of medical checkups and referrals following discharge (low intensity). High-intensity services resulted in five times more community-based early intervention hours for families and infants when compared with low-intensity services. Annual costs of the high-intensity group were approximately triple the costs of the low-intensity group ($10,814 versus $3,032 per child per year), but there were only a few statistically significant differences on measures of child and family functioning between the groups at 6-, 12-, 18-, and 24months' corrected age. Implications of these findings for research and practice are given.     

Does More Intensive Neonatal Intensive Care Unit Follow-Up Service Result in Better Outcomes? A Cost-Effective Analysis

Little is known about the relative cost-effectiveness of the many different types of early intervention services provided to medically fragile infants and their families. This study compared two intensities of services for such infants and their families: (a) a coordinated and comprehensive system of early intervention services initiated prior to discharge from the NICU and designed to transition infants to community-based services were compared with the effects of services (high intensity); and (b) a more traditional hospital follow-up consisting of medical checkups and referrals following discharge (low intensity). High-intensity services resulted in five times more community-based early intervention hours for families and infants when compared with low-intensity services. Annual costs of the high-intensity group were approximately triple the costs of the low-intensity group ($10,814 versus $3,032 per child per year), but there were only a few statistically significant differences on measures of child and family functioning between the groups at 6-, 12-, 18-, and 24months' corrected age. Implications of these findings for research and practice are given.     

Culturally Relevant Assessment and Support of Grade 1 Students with Mild Disabilities in Tanzania: An Exploratory Study

ABSTRACT

In Tanzania, many people are not aware of the concept of learning disabilities. Parents and teachers often do not realise that children who do poorly in school and do not have visible disabilities, could still have a disability that is causing their poor school performance. This paper presents the results of a research and service project to identify and support students with mild disabilities in an inclusive school in Tanzania during the three-year pilot process. An international NGO implemented a culturally-relevant, curriculum-based assessment for screening grade 1 students with potential delays or disabilities and provided Tier 2 interventions through small group lessons. In this three-year study, 413 students were screened, 108 students received Tier 2 services and six students received Tier 3 services. Students in Tier 2 received small group instruction in mathematics and literacy as a pull-out programme. Students in Tier 3 attended a special school for children with disabilities. Results showed that students who received Tier 2 intervention made statistically significant gains in their assessment scores after six and twelve months of services. This study demonstrated one successful assessment and intervention model in a typical Tanzanian school to support young children with disabilities to improve their academic outcomes.     

Empowering Culturally Diverse Families of Young Children with Disabilities: The Double ABCX Model

Many culturally diverse families and their young children with disabilities or delays are not provided appropriate early intervention/early childhood special education services, especially not in a culturally sensitive and meaningful context. Families with diverse backgrounds often feel helpless and stressful because their values are not respected, concerns are not identified, and therefore their needs are not met due to the lack of support from appropriate resources. The purpose of this article is to provide a positive strategy to empower families of young children with special needs and who are from culturally diverse backgrounds through a family-centered, strength-focused family system model: Double ABCX model. Procedures of implementing the double ABCX model was described and discussed. Supported by previous research and the current case studies, the double ABCX family adaptation model has found to be an effective approach to serving diverse families of children with disabilities.     

Influential Factors in Inclusive Versus Non-Inclusive Placements for Preschool Children with Disabilities

The major purpose of this study was to examine the extent to which preschool inclusion practices were evident in diverse communities, and to identify those child, maternal, and service provider characteristics that significantly related to such practices. Of the 114 children studied, 50 received the majority (> 90%) of their services in public school based classrooms for children with disabilities, and were classified as non-inclusion. Sixty-four children received the majority of their services in community based settings (primarily Head Start) and were classified as inclusion. Major findings included: (a) the likelihood of inclusive placement differed significantly by study community, however, the mere availability and presence of community based inclusive settings did not guarantee their use; (b) no significant associations were evident between child, maternal, and service provider characteristics and type of program placement when the influence of community was controlled for; and (c) children in non-inclusion settings received significantly more hours of service per week than inclusion children (18 versus 11 hours). Data in this study suggest that the paradigm shift away from intensive, segregated educational programs toward fully inclusive, community based programs for preschool children has gained considerable momentum in select communities nationally.     

Before Head Start: Income and Ethnicity, Family Characteristics, Child Care Experiences, and Child Development

The present study describes the early life histories of a large sample of three-year-old children from different ethnic backgrounds living in three levels of family income—poverty, near-poverty, and above-poverty. The study examined the developmental characteristics of children in the three groups and related them to family characteristics and experiences in child care. To no one's surprise, significant differences associated with income were found for most of the family measures. Poverty and near-poverty families were more likely to have mothers with lower education, less sensitivity, more depression, and lower HOME scores. Correlatively, for the child development measures, there was an upward progression associated with income. Poverty children consistently showed the greatest deviation from established norms for cognitive and social behavior. A striking finding, however, was the considerable variability found on all the measures—a pattern not sufficiently stressed in related research. This finding has major implications for curriculum planning in Head Start programs. The analysis also showed that child care experience cannot be disregarded as a significant aspect of the history of a prospective enrollee in Head Start or other intervention programs geared to low-income children. Fewer of these children are likely to have a child care history, as families that used at least 10 hours of child care per week were less likely to be either poor or near-poor and thus eligible for enrollment. While this may reflect selection factors associated with child care usage, it also indicates that availability of child care is essential for borderline families that try to stay out of poverty. Number of hours of care per week and age of enrollment did not predict developmental level when the full income sample was considered. However, when only poor and near-poor children in care for at least 20 hours a week were used in the analysis, higher quality of care was associated with more favorable developmental outcomes in the children.     

Key workers and schools: meeting the needs of children and young people with disabilities

Across the world countries are advocating the education of children and young people with disabilities in mainstream schools. There is also increasing interest in developing effective coordination of the specialist services pupils with disabilities receive from different agencies. This is accompanied by growing recognition that such care coordination can positively influence the experience of inclusion for children and their families. However, while the literature of care coordination generally includes education as a core provider, there is little evidence on involvement of education professionals and the outcomes for children and schools. These issues are addressed by the findings reported here on the role of key workers in care coordination and their relationship with schools. The findings draw on interviews with professionals from seven key worker services across England and Wales, parents and carers who were recipients of these services and teachers in schools serving children supported by key workers. These interviews are part of a wider multi‐method study exploring the effectiveness and costs of different models of key worker services for disabled children. The data reveal the range of education and school issues addressed by key workers and the factors influencing their work with teachers. The benefits for children, families and schools of key worker involvement are identified and the implications for schools explored. Consideration is also given to the advantages and disadvantages of teachers themselves taking on the role of key workers. It is argued that key workers can improve home–school relationships, facilitate the contribution of teachers in inter‐agency working, enable mainstream schools to better meet the individual needs of pupils with disabilities and improve their inclusive practice.     

Before Head Start: Income and Ethnicity,Family Characteristics,Child Care Experiences,and Child Development

The present study describes the early life histories of a large sample of three-year-old children from different ethnic backgrounds living in three levels of family income—poverty, near-poverty, and above-poverty. The study examined the developmental characteristics of children in the three groups and related them to family characteristics and experiences in child care. To no one's surprise, significant differences associated with income were found for most of the family measures. Poverty and near-poverty families were more likely to have mothers with lower education, less sensitivity, more depression, and lower HOME scores. Correlatively, for the child development measures, there was an upward progression associated with income. Poverty children consistently showed the greatest deviation from established norms for cognitive and social behavior. A striking finding, however, was the considerable variability found on all the measures—a pattern not sufficiently stressed in related research. This finding has major implications for curriculum planning in Head Start programs. The analysis also showed that child care experience cannot be disregarded as a significant aspect of the history of a prospective enrollee in Head Start or other intervention programs geared to low-income children. Fewer of these children are likely to have a child care history, as families that used at least 10 hours of child care per week were less likely to be either poor or near-poor and thus eligible for enrollment. While this may reflect selection factors associated with child care usage, it also indicates that availability of child care is essential for borderline families that try to stay out of poverty. Number of hours of care per week and age of enrollment did not predict developmental level when the full income sample was considered. However, when only poor and near-poor children in care for at least 20 hours a week were used in the analysis, higher quality of care was associated with more favorable developmental outcomes in the children.     

The next decade of research on the effectiveness of early intervention.

The effectiveness of early intervention programs for children with developmental disabilities and for children at biologic risk was reviewed and analyzed. A general pattern indicating important effects of early intervention programs was noted, with effect sizes averaging between one-half and three-quarters of a standard deviation. The ability of early intervention programs to minimize declines in development was identified as a significant outcome. The effects of specific program features--age of start and family involvement--were selected for more detailed examination, and the moderating influence of the levels of severity of children's disabilities was also analyzed. Future directions for improving the effectiveness of early intervention include using the emerging knowledge of biobehavioral and child development research, as well as enhancing children's social competence.     

Intellectual Disability and Developmental Risk: Promoting Intervention to Improve Child and Family Well‐Being

Initial intervention processes for children with intellectual disabilities (IDs) largely focused on direct efforts to impact core cognitive and academic deficits associated with the diagnosis. Recent research on risk processes in families of children with ID, however, has influenced new developmental system approaches to early intervention. Recent risk and resilience processes are reviewed that connect stress, family process, and the high rates of behavioral problems in children with ID that have substantial influence on child and family outcomes. These models are linked to emerging evidence‐based intervention processes that focus on strategic parent skill training and mindfulness interventions that reduce parental stress and create indirect benefits for children's behavioral competencies. A family‐focused developmental systems approach (M. J. Guralnick, 2011) is emphasized.     

Involving families in training early childhood educators: Developing a framework for family centeredness

Abstract

More early childhood programs are including young children with disabilities, thereby creating inclusive environments. In order to adequately prepare personnel for working in these inclusive settings and because of the major focus on family involvement, teacher preparation programs have developed competencies related to family centered practices. One of the most valuable methods for assisting students in developing a family‐centered philosophy is to involve families in the training process. Families of children with disabilities already have much experience in dealing with the many diverse services provided to young children such as, medical staff, social service agencies, specialists (i.e., physical therapists, occupational therapists), early interventionists and teachers and therefore, could provide extensive learning opportunities for students especially from a parents’ perspective. While there are many advantages for involving family members in training activities, there are also some challenges. The purpose of this article is to discuss the importance of involving families in early childhood teacher preparation programs, different strategies for including them, and the benefits and challenges of partnering with them. © 2001 Elsevier Science Inc. All rights reserved.