Early Intervention Work Research Articles

What We Know and What We Should Find Out About Early Childhood Intervention

We do know something. That is this author's main message. We know that early childhood intervention works. It also has cumulative benefits over time. Children exposed to it build their learning skills. But we have farther to go. The author describes the best empirical methodologies to get there.

Why early intervention works: A reply to Baumeister and Bacharach

In a wide-ranging critique of compensatory education, Baumeister and Bacharach [ Intelligence 23 (1996) 28 (2000)] focus most specifically on the Infant Health and Development Program (IHDP), an intervention program lasting from birth through age 3 for low birth weight (LBW) preterm infants. In response, we identify logical, methodological, and analytical inconsistencies in their critique of early intervention research and offer a balanced assessment of IHDP findings to date. Specifically, we note that Baumeister and Bacharach overinterpret null findings, selectively review the early intervention literature, engage in an inappropriate analytical appeal to variance partitioning, and evidence limited understanding of the ways in which individual differences among program participants and controls may be related to early intervention outcomes. Careful examination of the IHDP study design and database provides a clear indication of what the study accomplished and why. Alternative explanations for the absence of long-term IHDP effects are proposed.

Social work early intervention for young children with developmental disabilities.

Social workers' awareness of and formal involvement in family-centered early intervention for infants and toddlers who are at risk of or who have developmental disabilities has increased considerably during the past 15 years. The functional role that social workers can play on early intervention teams and as coordinators of early intervention services is underscored by the formal recognition of the discipline in the Individuals with Disabilities Education Act. Despite the relevance of social work to early intervention, personnel often enter early intervention practice without the benefit of formal preparation related to very young children with developmental disabilities. This article provides an overview of the definition and identification of developmental disabilities, and discusses the role of and challenges to social work in early intervention.

Early detection of developmental and behavioral problems.

1. Frances Page Glascoe, PhD* 1. 2. *Associate Professor of Pediatrics, Division of Child Development, Vanderbilt University School of Medicine, Nashville, TN. After completing this article, readers should be able to: 1. List the percentage of children who drop out of school and have undetected disabilities or known environmental risk factors. 2. Describe the ways in which early intervention is effective. 3. Delineate methods of detecting disabilities and development delays. 4. Describe the percentage of children in whom assessment tools can detect disabilities correctly. 5. Determine how often children should undergo developmental testing. 6. Describe the role of parents in detecting and addressing developmental and behavioral problems. Approximately 15% to 18% of children in the United States have developmental or behavioral disabilities. An additional 7% to 10% experience substantive school failure and drop out before completing high school. Overall, one in four children has serious psychosocial problems. To ensure that these children are detected early and their difficulties addressed, the American Academy of Pediatrics’ Committee on Children with Disabilities recommends that pediatricians use validated screening tools at each health supervision visit. Many pediatricians find it difficult to comply with this recommendation because of minimal reimbursement, young patients’ limited compliance with requests to stack blocks or answer questions, time constraints, and concerns about the accuracy and length of well-known screening tools. Finally, children who are at environmental risk for developmental delays and subsequent school failure due to poverty, limited parental education, and similar risk factors do not always receive health supervision visits. Accordingly, they are unavailable at times when pediatricians typically are most vigilant in their search for developmental problems. ### UNDERDETECTION Most physicians depend on clinical judgment rather than screening tools. Unfortunately, research shows that clinical judgment detects fewer than 30% of children who have mental retardation, learning disabilities, language impairments, and other developmental disabilities. Clinical judgment also identifies fewer than 50% of children who have serious emotional and behavioral disturbances. Use of improved classification systems, such as the Primary …

Does Early Intervention Work? A Controlled Trial

The study described herein is a controlled trial on the efficacy of a well-structured early intervention program for children with clearly marked biological impairments. Twenty-four children were placed into two matched groups in terms of age, sex, type of disability, functional level, and family socioeconomic status. The treatment group received a weekly educational visit from early intervention advisors for 2 years while the control group received no form of intervention due to lack of provision in the remote provincial towns and islands where the families were living. Four assessments using Griffith's developmental checklists were made in both groups: an initial assessment, a first year assessment, a second year assessment, and 8 months after the end of the program. The results are significantly encouraging. They show remarkable gains for the treatment group both in terms of overall functioning level and in terms of acceleration in different domains of development. The control group remained more or less stable. Gains for the treatment group continued to occur, but at a lesser rate, through the second year. Moreover, gains in development for the treatment group were not lost 8 months after the end of the program. Although the sample is rather small, there are clear indications that early intervention projects that treat children having biologically based disabilities are effective.

Methodological issues and future directions in the evaluation of early intervention programmes.

Early intervention programmes have grown rapidly over the last 30 years. Despite numerous attempts to answer the apparently simple question of whether or not early intervention works, results to date have been equivocal. This paper looks at the reasons why this question has not been answered satisfactorily and suggests that this question may not, in fact, be possible to answer in a global sense. It is suggested that questions must be addressed to the evaluation of specific services rather than to the evaluation of early intervention as a whole.

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 a...

Maternal Directiveness in Interactions with Mentally Handicapped Children: An Analytical Commentary

Maternal directiveness is portrayed as a negative interactional phenomenon in the mental retardation literature. Based on the speculation that a directive interactional style is causally related to poor developmental outcomes, the reduction of maternal directive behaviour is becoming a major thrust in early intervention work. This paper questions the characterization of directiveness as an inherently negative interactional phenomenon and highlights limitations in our current understanding of directiveness. Critical issues requiring attention in future research are identified and early interventionists cautioned that management of maternal directive behaviour must be founded on sound, empirically validated principles.

The use of mother-infant games as therapy with delayed children

The use of mother-infant games as therapy may be useful in early intervention work with delayed children. Within the game context mother first gets the child seated facing the mother (stage-setting), then gets the child's attention (attention-getting). Once this has been achieved, mothers begin playing the particular game, providing the appropriate context (e.g., holding out hands for ball in roll the ball game; leaning forward and vocalizing while hidden in peek-a-boo) to aid infants in the performance of game-relevant behaviors. These strategies, employed in precise patterns in roll the ball game and peek-a-boo with normal infants, can also be applied to work with delayed children. We present a case study of game interactions between a severely delayed two-year-old boy and his mother, employing the techniques of normal infant-mother game interactions to aid development.

Dr. Susan W. Gray

While Susan W. Gray is known primarily for her work with the Early Training Project, a pioneering early intervention program with low-income black children, she has also influenced the development of school psychology and the creation of Early Childhood Education as a discipline. In addition, in her own quiet way, she has supported the career development of a number of professional women who have had impact on child development, early childhood education, and school psychology. Four major themes are used to present Susan Gray's biography: (1) being ahead of her time in terms of thinking which allowed her to take advantage of opportunities; (2) the role of serendipity versus long-range planning of career trajectories; (3) specific influences on her as a woman; and (4) a lifetime of courage and dedication. Examples of work which was in advance of psychology included work in early intervention with low-income children, an emphasis on the use of scientific experimental methodology in field research, an eclectic approach which crossed disciplinary boundaries, a consultative approach to school psychology, and the inclusion of affective and cognitive education in intervention curricula. The influences on her as a woman, including a rural background and attendance at a women's college helped shape her career commitment and ability to play other than the traditional female role, while maintaining her femininity.

Sexual Abuse, Another Hidden Pediatric Problem: The 1977 C. Anderson Aldrich Lecture

Each week we find among our pediatric-adolescent patients, among youngsters at the Kennedy Child Development Center, and among the children seen at our child psychiatric service, increasing numbers of sexually abused children whose presenting chief complaint is nonspecific. The nonspecific symptoms I have described may be the only clues we physicians have that we may be dealing with sexual abuse. One requires sensitive attention to the patient, good listening, taking time, and always going beyond the presenting "chief complaint." The runaway who is simply asked "Why did you run away?" will say, "I had afight with my folks." The next question is "What was your fight about?" The answer, "I was out late." Most professionals stop right there, but that's where we should all start. We simply have to know more. One needs to lead up to the relationships with the child's mother and father, and then one finally has to ask some direct questions, in as kind a way as possible, in order to give the child permission to relate his/her loneliness, shame, and fears. Sexual abuse should always be viewed from a developmental point of view, and it is the point of each child's development which determines the ultimate impact that sexual abuse has. Early and decisive intervention, rescue, and supportive therapy work well, even if the family is not reunited. The child deserves a chance at therapy just as much as if there were any other insult to development. Pediatricians routinely try to find children who have hearing and speech problems. Should we not be equally open and ready, intellectually and emotionally, for the condition of incest, which is the last taboo? Thank you for allowing me to share with you this hour honoring the late Dr. Aldrich. I hope that I have done him honor.