Early Intervention with Medically Fragile Infants: Investigating the Age-at-Start Question

Very few studies have investigated the age at which early intervention should begin. Similarly few studies have examined the effects of early intervention for infants who are medically fragile. The present study responds to these two critical issues by longitudinally comparing groups of infants who are medically fragile. These infants were randomly assigned to receive developmentally appropriate programs beginning at either 3- or 18-months adjusted age. Analysis of measures of child development and family functioning for the first three annual assessments indicated that the two groups were similar on measures of child functioning at the first and second assessment. However, at the third assessment, children who received the intervention at an earlier age scored significantly higher than did children whose intervention began 15 months later. No significant group differences were found on measures of family functioning at any of the assessments. Implications of these results for future research and practice are discussed.     

美国残疾婴儿和学步儿早期干预计划

美国"残疾婴儿和学步儿早期干预计划"旨在为3岁以下残疾婴幼儿提供早期干预服务,以满足3岁以下残疾婴幼儿及其家庭的特殊需要."残疾婴儿和学步儿早期干预计划"的重要特点是免费性、普及性和全纳性.已有研究表明,美国"残疾婴儿和学步儿早期干预计划"的效果是积极的.我国可以借鉴美国的做法,逐步采取残疾婴幼儿早期干预措施,尽可能为残疾婴幼儿的发展提供帮助.     

Measuring the Quality of Early Intervention Services for Infants and Toddlers: Problems and prospects

Comparable scales to measure quality of early intervention services for infants and toddlers as perceived by parents and service providers were developed based on the Recommended Practices in Early Intervention. Each scale consisted of four subscales focusing on: home-based therapies/instruction, centre-based therapies/instruction, medical/ health services, and service coordination. The scales were administered to 209 parents and 177 of their service providers. A sample of 24 parents completed the instrument twice during a two-week interval to assess test-retest reliability of the parent scale. Test-retest reliability for the parent scale was .785. Validity of the scale was assessed by examining the correlation of parent and provider perceptions of quality with family demographic and early intervention service characteristics. Parents' perceptions of quality were related to family centredness of services. Neither parents' nor providers' perceptions of quality were related to family socioeconomic status. Problems and prospects for measuring quality of early intervention services are discussed.     

Prelinguistic Relational Concepts: Investigating Analogical Processing in Infants

This research asks whether analogical processing ability is present in human infants, using the simplest and most basic relation—the same–different relation. Experiment 1 (N = 26) tested whether 7‐ and 9‐month‐olds spontaneously detect and generalize these relations from a single example, as previous research has suggested. The attempted replication failed. Experiment 2 asked whether infants could abstract the relation via analogical processing (Experiment 2, N = 64). Indeed, with four exemplars, 7‐ and 9‐month‐olds could abstract the same–different relation and generalize it to novel pairs. Furthermore, prior experience with the objects disrupted learning. Facilitation from multiple exemplars and disruption by individual object salience are signatures of analogical learning. These results indicate that analogical ability is present by 7 months.     

Mother‐Child Interactions and Early Intervention Programmes for Handicapped Infants and Young Children

Increased emphasis in the provision of early intervention programmes with families of biologically impaired or at‐risk infants, in recent years, has produced a wide variety of such services based upon various conceptual and empirical analyses of early development. The impact of these early interventions has been investigated quite extensively since the mid‐sixties, particularly regarding positive effects upon intellectual development. A synthesis of recent research regarding mother‐child interaction patterns and the influence of these social interactions upon cognitive, linguistic, and social development has resulted in a shifting emphasis in early interventions from the parent‐as‐teacher model to a parent‐infant interaction model. In concert with this shifting emphasis, interactional models of intervention are considered and described which provide the basis for identifying specific intervention strategies related to parent‐child interaction dynamics. These strategies provide the basis for programmes which would be sensitive to the idiosyncracies of individual families. That is, the unique characteristics of each family/infant may be more effectively accommodated through a transactional analysis of individual dyadic interaction patterns, and through the identification of strategies specifically suited to the unique needs of the parent‐child dyad.

     

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.     

A Study of Infant Developmental Outcome with a Sample of Korean Working Mothers of Infants in Poverty: Implications for Early Intervention Program

Using a sample of 42 Korean mothers whose infants are cared for by someone at non-maternal child care facilities, this study first examined both main effects and interaction effects between maternal knowledge of infant development and maternal self-efficacy on parenting behavior. Second, the combined effects of variables of interest in this study including maternal knowledge of infant development, maternal self-efficacy, and parenting behavior on the child developmental outcome were investigated. Significant relationships between maternal knowledge of infant development and parenting behavior and child development outcome were detected. Only main effects of maternal knowledge of infant development were detected. Furthermore, maternal knowledge of infant development was the only significant predictor of infant developmental outcome. Research implications were discussed both on the continuum of findings from previous studies with Western samples and in terms of provision of effective early intervention programs for this targeted population.     

美国残疾婴幼儿早期干预中服务协调的研究综述

文章从早期干预服务协调的概念和特点出发,强调早期干预服务协调是一个持续性的过程,发挥着中介人的作用。并对服务协调员的角色、服务协调的模式以及服务协调的影响因素进行了综述,为我国的早期干预工作的发展提出一些建议。     

Seven-Year Outcome of the Vermont Intervention Program for Low-Birthweight Infants

We compared 24 low-birthweight subjects of an experimental intervention (LBWE), 32 no-treatment controls (LBWC), and 37 normal birthweight (NBW) subjects. The intervention involved 7 hospital sessions and 4 home sessions in which a nurse helped mothers adapt to their LBW babies. At age 7, LBWE scored significantly higher than LBWC on the Kaufman Mental Processing Composite (p less than .001), Sequential (p = .02), and Simultaneous (p = .001) Scales, after statistical adjustments for socioeconomic status. LBWE did not differ from NBW (F less than 1). These results bear out a divergence between the LBWE and LBWC that first became statistically significant at age 3. The findings suggest that the intervention prevented cognitive lags among LBW children, and that long-term follow-ups are needed to evaluate the developmental effects of efforts to overcome major biological and environmental risks.     

Characteristics of the Early Intervention Workforce: An Indiana Perspective

In preparation for implementation of Part H of P.L. 99-457, the Indiana early intervention workforce was surveyed to determine the current status of the workforce and identify implications for policy making. A sample of 837 respondents generated information about the types of personnel providing services, their qualifications, compensation, and longevity in the field. Turnover rates for the personnel categories surveyed were also obtained. Education and licensure for teachers and aides showed considerable variation, with some personnel having training in areas related to early intervention and many with training in unrelated areas. Striking differences were seen in compensation favoring public school personnel over personnel employed in other types of agencies. Personnel turnover rates were high, averaging 30%. The data indicate the need for early intervention training programs and equitable compensation of trained personnel if Indiana, and presumably other states, are to meet the mandate of P.L. 99-457, Part H. The most critical needs are to develop strategies to attract, train, and support specialized early intervention personnel from a wide variety of disciplines.     

Investigating the Validity of the Australian Early Development Index

This article aims to contribute to the ongoing evaluation of the Australian Early Development Index (AEDI) by investigating its construct and concurrent validity with a subsample of 642 children aged 4 to 5 years drawn from the Longitudinal Study of Australian Children (LSAC). Construct validity was examined by considering the theoretical consistency of the network of correlations between the AEDI subconstructs and the independently reported multimethod measures of early learning skills and development collected contemporaneously by the LSAC. Concurrent validity was examined by assessing the extent to which children who were “developmentally vulnerable” on the AEDI domains corresponded with the LSAC outcome indices classification of children as “developmentally at risk.” Moderate to large correlations were observed between each of the AEDI domains and subconstructs when compared to analogous teacher-rated LSAC measures, with lower levels of association observed for parent-rated LSAC measures. Concurrent validity was explored; however, with no criterion measure with which to assess the AEDI, findings are inconclusive prior to predictive validity assessment. Future waves of the LSAC will collect information on the children's abilities at school and developmental outcomes, enabling further interpretation of these concurrent and construct validity findings by triangulation and predictive validity analyses.     

Characteristics of the Early Intervention Workforce: An Indiana Perspective

In preparation for implementation of Part H of P.L. 99–457, the Indiana early intervention workforce was surveyed to determine the current status of the workforce and identify implications for policy making. A sample of 837 respondents generated information about the types of personnel providing services, their qualifications, compensation, and longevity in the field. Turnover rates for the personnel categories surveyed were also obtained. Education and licensure for teachers and aides showed considerable variation, with some personnel having training in areas related to early intervention and many with training in unrelated areas. Striking differences were seen in compensation favoring public school personnel over personnel employed in other types of agencies. Personnel turnover rates were high, averaging 30%. The data indicate the need for early intervention training programs and equitable compensation of trained personnel if Indiana, and presumably other states, are to meet the mandate of P.L. 99–457, Part H. The most critical needs are to develop strategies to attract, train, and support specialized early intervention personnel from a wide variety of disciplines.     

Assessing Early Intervention Outcomes: Beyond Program Variables

THE EARLY INTERVENTION field is witnessing some major shifts in the focus of efficacy research. The traditional preoccupation with the question as to whether early intervention works is giving way to greater concern with understanding how programs make their impact. While this is seen as a progressive shift, much of the focus has so far been placed on how specific dimensions of the intervention process contribute to outcomes. Little attention has been paid to extra‐program variables which impinge upon or interact with the intervention process to shape outcomes. This paper presents the perspective that an intervention program is only one of many factors with potential influence on child and family functioning. Consequently program efficacy must be assessed in relation to both program and extra‐program variables. A framework outlining five classes of “independent” variables and two classes of outcomes to be considered in efficacy research is presented. Regression and path analytic techniques are presented as two potentially useful tools for addressing the different kinds of efficacy questions currently being raised in the literature.     

Early Intervention Programs in Korea for Children with Disabilities

A national survey of 53 early childhood special education teachers in Korea was conducted to investigate their knowledge and perceptions regarding various aspects of kindergarten and preschool programs for children with disabilities. Results from the study indicated that (a) children in the age range of 3 to 7 years were the group most frequently served by early childhood special education in Korea, (b) teachers reported infrequent assessment and scarcity of curriculum resources, (c) most teachers reported using a self- or school-developed curriculum, and (d) confusion exists regarding the concept and use of the Individualised Education Program (IEP). Because of a somewhat lower than expected teacher response rate further study is needed to determine if the results of this study are representative of programs nationally. Also, evaluative steps should be taken to ensure that curricula are appropriate for the various ages and types of learners. Likewise, research is needed to identify those factors that facilitate inclusion of children with disabilities in their schools and communities with peers as early childhood special education programs expand.     

Early Intervention in the South Pacific: Issues in Program Development

Generalizations about the differences between more developed and less developed countries in terms of service provision for people with disabilities sometimes tend to obscure the differences that exist between and within countries. Intervention is a relatively new concern for many countries in the Pacific region but one of the most notable features is the variation in approaches taken to meet the needs of young children with a disability and their families. Diverse cultural patterns and geographical problems of isolated communities require a flexible approach to the delivery of services. Initiatives which arise out of existing frameworks require support with careful consideration being given to extending the services until they reach all sections of the population. Ensuring sustainability is a high priority where resources and Government involvement in service provision are limited.     

The ‘Play’ Focus in Early Intervention: Children with Intellectual Disabilities

This paper examines the characteristics of ‘play’ within the conceptual framework of early education for intellectually disabled children, suggesting that early intervention programs and strategies may have transformed ‘play’ for these children into ‘work’.     

Culturally Responsive Early Intervention Programs: issues in India

The influence of economic factors on socio‐cultural aspects in traditional, industrial, and “transitional” societies is explored through an examination of the socio‐economic structure and organisation in these societies. Transitional societies are defined as those that are moving from a traditional nature to an industrial one. India is used as an example of a transitional society. Links between the socio‐economic contexts of the three societies, their child rearing goals and practices, and features of early intervention programs are established. Key aspects of effective intervention identified in the United States are analysed with respect to their appropriateness for Indian society. It is proposed that the diverse child rearing goals and practices of the Indian culture are not compatible with Western conceptualisations of effective early intervention. In conclusion, issues and questions for research that would lay the foundations for developing culturally responsive early intervention programs in transitional societies are identified.     

Approaches to Early Intervention on the Navajo Reservation

This article describes a research and early intervention project that involves parents and Head Start teachers who live and work in geographically isolated areas of the Navajo Reservation. Social and environmental characteristics of life in remote areas are considered as "risk factors" that impact upon the child's probable success in school. Two promising lines of intervention are reported comprehensive instruction in child development for Head Start teachers and working with parents as children's "first teachers." The teacher education approach involves innovative methods that build upon the Native American oral tradition. The approach to parents as "first teachers" involves Navajo parents in a structured reading approach with culturally relevant materials, where children are encouraged to reconstruct story content in a variety of representational media. Preliminary results include a dramatic rise in the number of CDA credentialed teachers and major improvements in teaching skills and satisfaction with teaching.