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.

     

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.     

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.     

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’.     

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.     

New Orleans Early Intervention Study of Children with Visual Impairments

There is widespread agreement that early intervention for children with visual impairments and their families is important and beneficial. However, few con- trolled prospective studies of the effectiveness of various types of early intervention have been completed with these children. This randomized study evaluated the immediate and long-term effects of a comprehensive, weekly homebased intervention for infants and toddlers with visual impairments, compared with a low-intensity treatment through parent group meetings offered approximately 12 times per year. In annual assessments conducted for t h e years after the intervention was begun, there were negligible statistically significant or practical differences between groups based on a variety of measures of child and family functioning. In light of the cost-effectiveness analyses reported, questions are raised about the type of early intervention that should be provided to children with visual impairments.     

关注特殊需要儿童的早期亲子关系干预

近年来,特殊需要儿童的融合教育在国内外越来越受到社会的关注。笔者认为,建立良好的亲子关系对于特殊需要儿童的发展非常重要,它一方面给特殊儿童提供心理安全环境,另一方面促进特殊儿童的社会性发展。因此,为特殊需要儿童及其家庭提供以构建良好亲子关系为目标的早期干预服务意义重大。亲子关系干预是特殊需要儿童早期干预中的一项重要内容。文章关注于特殊需要儿童的早期亲子关系干预,并提出了干预的原则。     

听觉障碍儿童的家庭应对和以家庭为中心的早期干预

儿童的听觉障碍不仅是儿童的,也是家庭的,它会影响家庭所有的成员和家庭生活的各个方面.本文本着支持儿童必须从支持家庭开始的理念,综述了西方国家近年来有关听觉障碍儿童家庭应对以及以家庭为中心早期干预的研究和研究结果,总结了家庭应对儿童听觉障碍的困难、策略,介绍了以家庭为中心早期干预的主要特点,旨在从理论上和实践上对我国听觉障碍儿童的早期干预和家庭支持提供一些借鉴.     

Early Intervention for Behaviour Problems in Young Children with Developmental Disabilities

This article reviews research on intervention for young children with dual developmental and behavioural problems. It makes a case for intervention to include family variables and to occur in the preschool years. Behaviour problems are common in young children with developmental disabilities. If untreated these problems are likely to persist and become more challenging and severe in adulthood. Behaviour problems interfere with cognitive, social and emotional development, create additional family stress, often lead to exclusion from community services, and result in additional financial costs to the community. Intervention research provides some support for the effectiveness of parent management training and interventions based upon applied behaviour analysis. However, randomised controlled trials with adequate follow-up periods are required, along with the measurement of outcomes for the family as a whole.