Efficacy Of Early Intervention Research Articles

Physical therapy interventions for patients with movement disorders due to cerebral palsy.

The purpose of this paper is to present evidence of the efficacy of physical therapy interventions for patients with cerebral palsy and identify goals for these patients. Studies suggest that neurodevelopmental treatment and Vojta techniques improve postural control. Little evidence supports the efficacy of early intervention, but researchers have not yet studied effects on the family. Strengthening, electrical stimulation, the use of orthoses, and seating show positive effects in studies of small numbers of subjects. For severely involved children, ease of care and comfort are important goals, as well as prevention of deformity, which is important for all children. To the extent possible, therapy should prepare a child for independent adult life. In early intervention through school age, therapy focuses on promoting communication, self-care, and mobility. Independence is a key issue for adolescents transitioning into adulthood. The rehabilitation and health needs of adults with cerebral palsy need to be addressed. Research needs to determine the effects of physical therapy not only on impairment but also on function and disability.

Vitreous Hemorrhage in Infants

To evaluate the efficacy of early intervention with vitrectomy for dense, nonclearing, infantile vitreous hemorrhage. Case series. Referral practice at a major university hospital eye center. Consecutive, referred sample of six patients (< 1 year old) with dense vitreous hemorrhages. The causes of the vitreous hemorrhages were varied. Follow-up was from 8 months to 15 months, with an average of 10 months. Three-port, pars plana, complete posterior vitrectomies were performed. Improved visual acuity postoperatively and frequency of complications. Complications of the infantile vitreous hemorrhage included traction retinal detachment (two of six), epiretinal membrane formation (one of six), pigmentary retinopathy (four of six), strabismus (two of six), large anisometropic myopia (two of six), and occlusion amblyopia (three of six). These serious complications occurred as early as 5 weeks after the onset of the vitreous hemorrhage. Iatrogenic retinal dialyses, which occurred in two of six patients, were successfully treated. Marked to moderate visual improvement was noted in five of six patients. Vitrectomy is an acceptable early therapy for infantile vitreous hemorrhage, and we recommend that vitrectomy be considered as early as 3 to 4 weeks after the onset of a dense, infantile, vitreous hemorrhage in an attempt to avert serious complications of the hemorrhage.

What is it? How Effective is it?

Summary The findings and methodology of evaluative studies of Clay's Reading Recovery scheme are examined and the extent to which they provide evidence for success is considered. It is argued that the very large claims made by apologists for Reading Recovery receive only limited support and that further carefully designed evaluative studies are required. There follows a comparison of Clay's theoretical stance with that of a modern theorist, Marilyn Adams. It is argued that while Clay claims to adopt a pragmatic and eclectic practical position, her ‘top‐down’ approach has militated against the systematic utilisation of various ‘lower order’ strategies which would appear to enhance the scheme, in particular the inclusion of phonological recoding strategies as advocated by Iversen and Tunmer (1993). Several related matters are then examined: the efficacy of early intervention; the appropriateness of parental involvement to the scheme; the relevance of the integration debate. It is concluded that Reading Reco...

Evaluating the Effects of Early Intervention

As Turnbull1concludes in her elegant and provocative qualitative analysis of early intervention studies for children with or at risk of cerebral palsy, it is quite possible that failure to demonstrate the efficacy of early intervention is due to inadequate methods of assessment. She goes on to suggest that some of the new technological devices that are available now in sophisticated movement analysis laboratories may provide better tools for the assessment of therapy efficacy. As an applied clinical researcher and a self-described techno-peasant, I believe that we have adequate and appropriate tools available to us in our daily treatment settings. From my perspective as a practicing physical therapist, the problem has not been one of inadequate methods of assessment but rather of our failure to provide a match between what we are trying to change in children with cerebral palsy and what strategies we are

Labeling Preschoolers as Learning Disabled: A Cautionary Position

The purpose of this article is to explore the issues concerning the adaptation of school-based service delivery concepts for use in early childhood special education programs. The use of categorical labels for determining eligibility for preschool children is not required by law—and may be detrimental. The following concerns are discussed: (a) definitional issues in learning disabilities versus low achievement, (b) the dangers of labeling and low expectation sets, (c) repeated failure to demonstrate movement through a continuum of services (particularly to least restrictive environments), and (d) the efficacy of early intervention and school-based special services for those with mild or suspected developmental disabilities. Research is reviewed concerning definitional and assessment issues utilizing learning disabilities as a construct. Alternatives for describing the characteristics of young children who are significantly at risk or developmentally delayed are provided.

Infant Health and Development Program for Low Birth Weight, Premature Infants: Program Elements, Family Participation, and Child Intelligence

The Infant Health and Development Program was an eight-site randomized controlled trial testing the efficacy of early intervention to enhance the cognitive, behavioral, and health status of low birth weight, premature infants. The 377 intervention families received for the first 3 years of life: (1) pediatric follow-up, (2) home visits, (3) parent support groups, and (4) a systematic educational program provided in specialized child development centers. The control group (n = 608) received the same pediatric follow-up and referral services only. This paper describes the delivery of the intervention and its outcomes. A Family Participation Index that was the sum of participation frequencies in each of the program modalities unique to the intervention revealed that program implementation was not different across the eight sites. Index scores did not vary systematically with mother's ethnicity, age, or education or with child's birth weight, gender, or neonatal health status; but they were positively related to children's IQ scores at age 3. Only 1.9% of children of families in the highest tercile of participation scored in the mentally retarded range (IQ less than or equal to 70), whereas 3.5% and 13% of children in the middle and lowest participation terciles, respectively, scored in the retarded range. Similar findings were obtained for borderline intellectual functioning. These findings are consistent with previous research linking intensity of intervention services with degree of positive cognitive outcomes for high-risk infants. The determinants of variations in individual family participation remain unknown.

Efficacy of Early Intervention in Pediatric Rehabilitation: A Decade of Evaluation and Review

The initial goals of this article are to define early intervention as it pertains to pediatric rehabilitation and to critically review examples of early intervention studies published during the past decade. A third goal is to summarize other recent review papers on efficacy of early intervention and efficacy of physical and occupational therapy for children with developmental disabilities of a variety of ages. The final goal of this article is to describe future directions for early intervention research in pediatric rehabilitation, including the development of new and more sensitive outcome measures, assessment of the impact of technologic devices on functional independence, and completion of multisite, collaborative studies to evaluate the effects of developmental therapies.

Recent Developments in Early Intervention Efficacy Research

Contemporary developments concerning the effectiveness of family involvement in early intervention programs are described within the framework of P.L. 99-457 and illustrated with recent investigations focusing on children at biological risk, those with cerebral palsy, and children with general developmental delays. Studies emphasizing parental involvement are discussed in the context of the quality of research, the application of contemporary developmental principles, and the specificity of the experimental designs and approaches. The research and public policy implications of efficacy research following the implementation of P.L. 99–457 also are discussed.

Early Intervention Efficacy Research

This article describes a variety of conceptual and methodological limitations of existing research on the efficacy of early intervention programs. Problems related to the specification of both independent and dependent variables are noted, and recent studies using meta-analytic techniques to generate testable hypotheses are reviewed. Recommendations for greater precision in measurement and for improved research design are presented. Finally, some reasons for the persistence of common problems in program evaluation are offered in conjunction with suggestions for future research efforts.

Conducting Longitudinal Research on the Efficacy of Early Intervention with Handicapped Children

An historical analysis of early intervention efficacy research documents the need for rigorously conducted longitudinal studies of early intervention with handicapped children. In this article the issues to be addressed in a series of 16 longitudinal studies recently funded by the U.S. Department of Education are described, the design characteristics of these studies are discussed, and the projected benefits of such research are summarized.

The Effects of Preschool Integration on the Development of Nonhandicapped Children

Nine research studies that reported child change data for nonhandicapped children participating in integrated preschool settings were analyzed in terms of methodology and specific program variables. The findings indicate that the methodological weaknesses in studies of the effectiveness of integration are the same that plague early intervention efficacy studies in general. Analysis of specific program variables indicates that studies of the outcomes of integration have typically viewed integration as a single treatment variable rather than as a process having many possible variations. The implications of the findings are discussed.

Introduction to Special Education Textbooks: What They Say About the Efficacy of Early Intervention

Frequentiy used introductory special education textbooks were analyzed (a) to summarize the information presented and conclusions drawn about the efficacy of early Intervention, (b) to determine the consistency of those conclusions with previously published efficacy reviews and with existing meta-analysis data as summarized by the Early Intervention Research Institute at Utah State University, and (c) to draw conclusions about the implications of the findings for training special and regular educators. Textbooks were consistent in the content covered, and conclusions were generally consistent with major reviews. Chapters concluded with more advocacy-oriented statements than empirically supported ones. In addition, several studies that were cited tended to be from the disadvantaged preschooler literature, with these results used as data for supporting the efficacy of early intervention for handicapped preschoolers. Findings are discussed in relation to the training of special education and regular education teachers.

Early intervention care in the acute stroke patient.

Early intervention care has been identified as an important factor in the functional outcome of patients with completed stroke. Little has been published, however, on the efficacy of early intervention in the acute hospital setting. In a retrospective study of 30 patients in an acute care hospital, there was a statistically significant difference in length of stay and ambulatory status (p less than 0.05) for the group receiving rehabilitation treatment within the first 72 hours after admission. There was no significant difference between the two groups with regard to age, sex, site of lesion, or previous cardiovascular disease. The present study indicates that early intervention shortens hospital stay and improves outcome, considerations especially important with the adoption of Diagnosis-Related Groups (DRGs), as hospitals seek measures of cost-containment in the provision of quality cost-effective health care.

The efficacy of early intervention programs: a meta-analysis.

This article reviews primary research studies investigating the efficacy of early intervention with handicapped preschoolers. Meta-analysis techniques were employed to integrate statistically the findings from 74 studies. Findings indicate that: (a) early intervention with handicapped populations produces a positive sizeable effect size; (b) longer, more intense programs are associated with efficacy; and (c) little support was found for commonly held beliefs about early intervention, such as the importance of age at start and the degree of parental involvement. Implications for future research are discussed.

The importance of structure in early education programs for disadvan‐taged and handicapped children†

An analysis of the amount and type of structure of early intervention programs was conducted as part of a review of literature on the efficacy of early intervention with disadvan‐taged, at‐risk, and handicapped preschoolers. Results indicated that programs with preplanned goals and structured curriculum produced significantly more gains for disadvantaged preschoolers, but the results are less clear cut for handicapped preschoolers. It is not clear just what type of structure for handicapped preschoolers is needed in curriculum and staff model and if this degree in structure is advantageous to children who are not experiencing difficulties. Suggestions for further study of goal setting and evaluation for infants and children and the training and supervison of staff necessary to implement structured programs is given. †The work reported in this article was carried out in part with funds from the U.S. Department of Education (Contract #300‐82‐0367) to the Early Intervention Research Institute at Utah State U...

Efficacy of Early Intervention

Based on an analysis of over 300 previous studies of early intervention efficacy, this article explains how the steps in the scientific method can be used to organize and draw conclusions from existing research. Although it is concluded that early intervention has positive benefits for most children, it is pointed out that there is little, if any, empirical support for the types of intervention that are most effective. Suggestions for future research are given.

Learning From Reviews of Early Intervention

Reviews of the literature are frequently advocated to advance knowledge in the social sciences. Unfortunately, most reviewers do not explicitly consider or attempt to learn from what previous reviewers of the same or closely related topics have done. This omission is inconsistent with good scientific practice and is significantly detrimental to advancing knowledge. Using 52 previous reviews of the early intervention efficacy literature as an example, this article demonstrates the value of systematically considering previous reviews before initiating a new review. The results establish a foundation that should be particularly helpful to future reviewers of the early intervention efficacy literature and demonstrate a process that should be used by reviewers in all areas.

The Efficacy of Early Intervention

Although data concerning the efficacy of early intervention have been available for more than two decades, questions concerning the effectiveness of these programs continue to be raised. This paper examines four basic assumptions of intervention programs that must be clarified before the global question of efficacy can be meaningfully addressed: the implicit theory of human development, the conceptualization of the specific interventions, how developmental change is measured, and the strategies used for selecting program participants. A final discussion highlights the role played by the child's family in effective intervention programs.

Early Intervention

An analysis of the amount and type of training of primary intervention agents in early intervention programs was conducted as part of a review of literature on the efficacy of early intervention with disadvantaged, at-risk, and handicapped preschoolers. Results indicated that intervenors who were certified were significantly more effective than those who were not certified. However, what is meant by "certification" and other critical characteristics of the intervenors is many times unclear in the research literature. Suggestions are offered for the study of characteristics and training of intervenors that produce effective child gains.

Clinician attitudes toward stuttering: A decade of change (1973–1983)

The attitudes of 674 speech-language pathologists toward stuttering, stutterers, stuttering therapy, parents of stutterers, and related issues were studied during the years 1973–1983. During that period, clinician attitudes were found to shift away from support of the John-sonian concepts, which suggest parental causality and dangers in early intervention. In addition, clinicians became less likely to perceive stutterers as possessing psychologic disorders and misperceptions of their problem and of their interpersonal relationships. However, a significant number of clinician's were found to continue to hold unsubstantiated beliefs regarding the personality of stutterers, their parents, and the efficacy of early intervention with very young stutterers. The results of the study were interpreted as suggesting the need to educate fluency specialists.