Family-centered Early Intervention Research Articles

The Brookline Early Education Project: A 25-Year Follow-up Study of a Family-Centered Early Health and Development Intervention

Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn. Outcome studies of BEEP and comparison children during kindergarten and second grade demonstrated the program's effectiveness during the early school years. The goal of this follow-up study was to test the hypotheses that BEEP participants, in comparison with their peers, would have higher levels of educational attainment, higher incomes, and more positive health behaviors, mental health, and health efficacy during the young adult period. Participants were young adults who were enrolled in the BEEP project from 1973 to 1978. Comparison subjects were young adults in Boston and Brookline who did not participate in BEEP but were matched to the BEEP group with respect to age, ethnicity, mother's educational level, and neighborhood (during youth). A total of 169 children were enrolled originally in BEEP and monitored through second grade. The follow-up sample included a total of 120 young adults who had participated in BEEP as children. The sample differed from the original BEEP sample in having a slightly larger proportion of college-educated mothers and a slightly smaller proportion of urban families but otherwise resembled the original BEEP sample. The demographic features of the BEEP and comparison samples were similar. The young adults were asked to complete a survey that focused on the major domains of educational/functional outcomes and health/well-being. The study used a quasi-experimental causal-comparative design involving quantitative analyses of differences between the BEEP program and comparison groups, stratified according to community. Hypotheses were tested with analysis of variance and multivariate analysis of variance techniques. Analyses of the hypotheses included the main effects of group (BEEP versus comparison sample) and community (suburban versus urban location), as well as their interaction. Young adults from the suburban community had higher levels of educational attainment than did those in the urban group, with little difference between the suburban BEEP and comparison groups. In the urban group, participation in the BEEP program was associated with completing >1 additional year of schooling. Fewer BEEP young adults reported having a low income (less than 20000 dollars); the income differences were accounted for largely by the urban participants. The percentage of subjects with private health insurance was significantly lower in the urban group overall, but the BEEP urban group had higher rates of private insurance than did the comparison group. More than 80% of both suburban samples reported being in very good or excellent health; the 2 urban groups had significantly lower ratings, with 64% of the BEEP group and only 41.67% of the comparison group reaching this standard. Overall, suburban participants reported more positive health behaviors, more perceived competence, and less depression. Among the urban samples, however, participation in BEEP was associated with higher levels of health efficacy, more positive health behaviors, and less depression than their peers. No previous study has focused as extensively on health-related outcomes of early education programs. BEEP participants living in urban communities had advantages over their peers in educational attainment, income, health, and well-being. The educational advantages found for BEEP participants in the early years of schooling included executive skills such as planning, organizing, and completing school-related tasks. It is likely that these early advantages in executive function extended beyond education-related tasks to other activities as participants became responsible for their own lives. The long-term benefits revealed in this study are consistent with the findings of previous long-term studies that indicated that participants in high-quality intervention programs are less likely to cost taxpayers money for health, educational, and public assistance services. The BEEP program appears to have somewhat blunted differences between the urban and suburban groups. The results of this study add to the growing body of findings that indicate that long-term benefits occur as the result of well-designed, intensive, comprehensive early education. The health benefits add a unique and important extension to the findings of other studies.

Educational Audiologists Make Changes in the Schools

You have accessThe ASHA LeaderSchool Matters1 Sep 2003Educational Audiologists Make Changes in the Schools Merrill Alterman Merrill Alterman Google Scholar More articles by this author https://doi.org/10.1044/leader.SCM.08162003.24 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Years ago I was introduced to a simple concept that profoundly changed my perspective on working with children who are challenging, with parents who seem to be noncompliant, and with teachers who appear resistant: I needed to stop using negative descriptors and focus on understanding why I wasn’t getting a more positive response. Although we know that most parents do not wish to be unresponsive to their child’s medical or hearing health care, often we label them as “difficult.” As audiologists, we instead need to identify the factors that might be keeping the family from being more responsive. Do the parents fully understand the importance of good hearing? Do the parents have money for bus fare? Will the parent lose wages if he takes time off from work for appointments and meetings? These are issues we face daily in the Baltimore City Public School System, which reflects the city’s problems of poverty, crime, drugs, poor health care, and a dwindling tax base—all of which cause stress for families, children, and schools. Some teachers adamantly refuse to adjust their teaching styles to accommodate a student with a hearing loss, but they do not mean to intentionally obstruct a student’s learning. As audiologists, we need to identify the real issues. Did the teacher have a negative classroom experience previously with a child who had a disability? Is the teacher concerned the student will make their job more difficult? Do they feel that the student should be in a self-contained, special education class? Is the teacher intimidated by the responsibility for an FM system? In the Baltimore City Public School System, nine audiologists (7.5 full-time employees) cover each of the 174 schools, as well as Head Start centers and programs for infants and toddlers. This coverage allows clinicians to be active in the schools by attending IEP team meetings; collaborating with school staff, parents, and caregivers; providing aural habilitation treatment; monitoring or determining the need for individual or group amplification; and advocating for children with hearing loss. By being part of the schools, the principal and staff no longer perceive the audiologists as “outsiders” coming to give teachers more work. As an example, because of an audiologist’s positive presence in the school, a third-grade teacher was looking forward to having a student who uses an FM system in her general education classroom. At the beginning of the year, the audiologist met with the teacher at a time convenient for the teacher and brought a snack to share. During the meeting, the audiologist demonstrated the effects of hearing loss, gave the teacher the opportunity to listen through the FM system, and assured her that she would be there to help. The audiologist responded to any problems that arose and kept the IEP team, administrators, and teachers informed of her activities. As educational audiologists, we can’t solve the societal problems families and teachers face, but we can change our point of view and eliminate the negative language we use to describe children, parents, and teachers who do not meet our expectations. As audiologists become “insiders” in their school, they are seen as a positive presence in the school and a valued part of the educational planning. For audiologists, the “real work” is in the classroom, the teacher’s lunchroom, and the hallway. Resources ASHA Desk Reference. (2002). Guidelines for audiology service provision in and for schools. www.asha.org/members/deskref-journals/deskref/DRVol2.htm Boys Town National Research Hospital. My Baby’s Hearing. http://www.babyhearing.org/ Candidacy and Habilitation of Children With Cochlear Implants. (2003). Two-hour videotape and manual. Earn 0.2 ASHA CEUs through July 2005. Item # 0112454. $125 member; $155 nonmember. Family-Centered Early Intervention for Children Who Are Deaf and Hard-of-Hearing: Strategies and Outcomes. (1999). Two-hour audiotape and manual. Earn 0.2 ASHA CEUs through July 2005. Item #0112256. $74 member; $99 nonmember. Pediatric Audiology: Enhancing Service Delivery to Families. (2002). Reprinted from AJA, JSLHR, and LSHSS. Earn 0.4 ASHA CEUs through January 2005. Item #0112419. $65 member, $80 nonmember. Author Notes Merrill Alterman, is coordinator for related services for the Baltimore City Public School System in Maryland and administers related educational services citywide. She can be reached at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 8Issue 16September 2003 Get Permissions Add to your Mendeley library History Published in print: Sep 1, 2003 Metrics Downloaded 116 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2003 American Speech-Language-Hearing AssociationLoading ...

Early Intervention, Positive Behavior Support, and Transition to School

Problem behaviors are addressed most effectively when children are young, through the avenues of family-centered early intervention services.These types of services have a great potential for reducing children's problem behaviors and increasing families' competencies and abilities to resolve future problems. As children age, however, the transitions from early intervention and family-centered services to school-based interventions are associated with a variety of challenges that can affect the quality and efficacy of behavior support. In this article, we describe positive behavior support as it is applied in the context of early intervention and as children progress through their preschool years into kindergarten and elementary school.Variables that contribute to effective interventions for young children and families are discussed, as are issues that must be considered in order to construct optimally beneficial transitions and subsequent positive school experiences for young children with behavioral challenges.

Predictors of Parenting Stress in Families of Children With Spina Bifida

Examining predictors of stress in a diverse population of caregivers of children with spina bifida, we examined whether any of the same factors characterized caregivers who choose to access available support services. Participants were caretakers of 56 children with spina bifida, ages 1-17 years, who completed paper-and-pencil measures of parenting stress and social support. Multiple regression analyses revealed that maternal age emerged as the sole predictor of parenting stress, with older mothers reporting higher stress. Caregivers with higher stress related to child interaction were less likely to participate in support services. Findings were interpreted to suggest that traditional models of family support and outreach might not be sufficient to reach caregivers who report higher stress. In addition to family-centered early intervention, families might need sustained support throughout their children's school years.

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.

Family-Centered Early Intervention

The term family-centered early intervention refers to both a philosophy of care and a set of practices. Both have been used to guide research, training, and service delivery for well over a decade. Unfortunately, though, the universal adoption of family-centered values and practice in early intervention is problematic for a number of reasons. This article will discuss these reasons in the context of the current state of early intervention and provide recommendations for the new millennium.

Evaluating the Efficacy of Case Method Instruction

Student outcomes were investigated in a preservice training course where the Case Method of Instruction (CMI) was the predominant instructional strategy. Sixty-seven graduate students taking an interdisciplinary families course completed preand post-test measures to evaluate their attitudes about family-centered early intervention and their ability to apply family-centered principles to realistic case situations. Students also completed a final examination composed of knowledge and application questions, and rated the course and instructor. Statistically significant and noteworthy changes in attitudes and application skills occurred. Final examination indicated students not only possessed important knowledge related to working with families, but they also could apply the problem-solving process used in CMI to a novel case. Course and instructor evaluations revealed high levels of satisfaction with the design and delivery of course content. Findings of this study support the premise that CMI is an effective instructional strategy and can be used successfully in early intervention training contexts.

A Demonstration of Behavioral Support for Young Children with Autism

Young children with autism sometimes display severe behavior problems that can cause great disruptions in family life and interfere with attempts to provide needed services. Strategies are needed to resolve these behavior problems in a manner that is effective, durable, and consistent with current approaches to positive, comprehensive, and inclusionary practice in early childhood intervention. This article provides a description of behavioral support as applied in the context of a family-centered early intervention program for young children with autism. Demonstration data are presented to illustrate the effects of the approach in reducing the problem behaviors of six children. The practices and data are discussed in the context of changing perspectives toward early intervention and the prospects of developing effective preventive strategies and functional deterrents to the emergence and occurrence of serious problem behaviors.

Parental Coping Strategies and Strengths in Families of Young Children with Disabilities

Parental Coping Strategies and Strengths in Families of Young Children with Disabilities* Sharon Lesar Judge** This study investigated the relationship between parental perceptions of coping strategies and family strengths in families of young children with disabilities. The 69 participants completed the Ways of Coping Questionnaire and the Family Hardiness Index. Results indicated that the use of social supports was highly associated with family strengths. In contrast, wishful thinking, self-blame, distancing, and self-control were negatively related to family strengths. Implications for practice are discussed Key Words: family strengths, children with disabilities, parental coping, parents of disabled children. Proponents of family-centered services for young children with disabilities have advocated a strength-based approach in promoting positive family functioning (Dunst, Trivette, & Deal, 1988, 1994; Powell, Batsche, Ferro, Fox, & Dunlap, 1997; Weissbourd & Kagan, 1989). This approach assumes that all families have strengths they can build on and that the family's strengths, including the social networks and informal supports already available to and within the family, should be the foundation upon which new supports are designed or provided (Dunst et al., 1994). One goal of family-centered early intervention is to identify existing family strengths and capabilities so that interventions are built on things a particular family already does well. By using family strengths as building blocks and tools, the family becomes even stronger and more capable of supporting the well-being of individual family members and the family unit (Trivette, Dunst, Deal, Hamby, & Sexton, 1994). Since current early intervention practices call for strength-based models of family support, there is a pressing need for empirical evidence about the relationship between parental coping and the family system to guide professionals in their development of programs and provision of services for families. Families use a variety of coping strategies that may influence family functioning. The work of Pearlin and Schooler (1978) and Folkman and Lazarus (Folkman & Lazarus, 1980; Folkman & Lazarus, 1985; Folkman & Lazarus, 1986; Lazarus & Folkman, 1984) indicate that coping is a major factor in the relation between stressful events and adaptational outcomes. This body of research is characterized by an interest in the different coping behaviors people employ in response to different life events. Family coping strategies can potentially strengthen or maintain family resources that serve to protect the family from the demands of stressful encounters (McCubbin et al., 1980). The various types of strengths that families possess reflect the way in which families cope and grow (Dunst et al., 1988). Lazarus and Folkman (1984) have defined coping as constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person (p. 141). According to this definition, coping includes any attempt or effort to manage stress, regardless of how well it works. Coping strategies involve efforts to alter the cause of the stress (problem-focused coping) and efforts to regulate emotional responses to the stressors (emotion-focused coping). For example, problem-focused forms of coping include active problem-solving and seeking social support as well as aggressive interpersonal efforts to alter the situation. In contrast, emotion-focused forms of coping include detaching from the situation, controlling one's feelings, wishing the problem would go away, and blaming oneself for the situation. According to Frey, Greenberg, and Fewell (1989), problem-solving is the preferred style of coping with disability-related problems. Research indicates that emotion-focused coping that involves wishful thinking, denial, or avoidance is positively related to reports of depressed moods (e. …

Family-Centered Early Intervention Services: Factors Contributing to Increased Parent Involvement and Participation

The focus of early intervention and the roles that parents play in planning and implementing services have evolved from an institution/agency approach to a child-centered approach and finally to a family-centered approach. Parents, in their roles as consumers of early intervention services and advocates on behalf of their children, have had a significant impact on the development and implementation of family-centered services. This article provides an overview of two major factors that have influenced the level of parent/family participation in early intervention services. These include (a) an increased focus on families in both state and federal early intervention legislation and (b) the incorporation of social systems frameworks for better understanding child, parent, and family functioning. These conceptual frameworks include family systems theory, ecological theory, the transactional model of development, and social support theory. The article also summarizes the dimensions of family participation in early intervention program practices. Involvement of families in early intervention program services has generally taken two forms, one as teacher/therapist participant in service provision and the other as client or recipient of intervention services. This new client or recipient role for families continues to be the focus of many early intervention programs today.

An Examination of the Effects of Family-Centered Early Intervention on Child and Family Outcomes

This study assesses the impact of family-centered early intervention services on children and their families during a 12-month period. The sample consisted of 47 families who attended 1 of 36 programs. We assessed children's developmental functioning, mothers' styles of interacting with their children, family functioning, and maternal stress both at the beginning and end of this study. At the midpoint of the study, mothers completed the Family-Focused Intervention Scale, which we used to classify the family-centered orientation of their services. Results indicated that during intervention children's developmental gains were equivalent to their rate of development prior to intervention, and there were no significant changes in the family variables assessed. Analyses of outcomes in relationship to two family-centered constructs—“comprehensiveness of family services” and “responsiveness of intervention services to family needs”—produced little evidence that intervention effectiveness was related to these parameters. Reasons for the limited relationships between family-centered services and child and family outcomes are discussed.

Weaving Parents into the Fabric of Early Intervention Interdisciplinary Training

The need to train professionals in the rudiments of interdisciplinary, family-centered care for infants and young children with disabilities and their families has been well documented over the past decade. How best to provide such training has been the focus of the Family-Centered Interdisciplinary Preservice Training Program in Early Intervention at the University of Wisconsin-Madison. This program has a commitment to provide training that fully integrates parent involvement. Student training includes a curricular focus on family-centered early intervention, hands-on activities designed to build interdisciplinary team skills, and an emphasis on providing individualized and diverse opportunities to meet each student's learning objectives. While this training program is multifaceted, this article focuses on one aspect: the utilization of the expertise of parents of young children with special needs as it is woven throughout each training component.

Addressing Parent Priorities through State-Level Policies

In establishing a system of family-centered early intervention services, it is essential to bridge gaps between the needs voiced by families and the policies that drive the delivery of services. This article discusses the findings of a qualitative study involving six states regarding the state-level policy- and organization-centered strategies that are compatible with the needs identified by families of young children with disabilities. Families of Part H-eligible children participated in focus groups and the three priorities they perceived are identified and linked with examples of state-level policies that address the priorities. Challenges states face in meeting parent priorities are discussed, followed by federal recommendations to support family-centered, coordinated service systems.

Seeking a Comfortable Fit Between Family-Centered Philosophy and Infant-Parent Interaction in Early Intervention

This article identifies issues regarding the match between family-centered philosophy and strategies for addressing infant-parent interaction in the early intervention process. A model is proposed for introducing and including infant-parent interaction in family-centered early intervention. This model is based on the family's vision for their child's future and is designed to assist families to be active decision makers. New directions for practice and research are raised based on family, professional team, and methodological concerns.

Parent-Child Interaction—The Foundation for Family-Centered Early Intervention Practice

In their article, Baird and Peterson (this issue) propose that current practice in infant-parent interaction assessment and intervention may conflict with family-centered philosophy. Baird and Peterson suggest that if parents should decide against directly focusing on interactions with their child as a means of attaining desired developmental outcomes, the parents' preferences should be respected. In this article, we have attempted to respond to some of the major assumptions that underlie the early intervention model proposed by Baird and Peterson. We argue that their conceptualizations of both family-centered philosophy and intervention in parent—child interaction are inaccurate. We propose that the central purpose of family-centered philosophy is to support and enhance the effectiveness of parents as caregivers and primary influences on their children's development. Every intervention option, at some level, has the potential to affect parent-child relationships. Given that parents are the primary influences on their children's development, they can never have a real option not to focus on their interactions with their children. We argue that the information derived from the parent-child interaction literature is the foundation for developing intervention procedures that are truly effective at accomplishing the goals of family-centered philosophy.

On becoming a team: a view from the field.

Early intervention services have expanded the concept of team participation for speech-language pathologists. Unlike traditional teams that grew out of the individual, direct service model of treatment, early intervention teams include the child's family along with professionals. Family members are invited to participate in assessing and treating their child, and the child is seen from a slightly different perspective by each team participant. Different viewpoints must be integrated and used to the benefit of the child. In this way, treatment options are expanded. Further, professionals may release their roles to other team members as well as learn new skills from other team members. The process of team development is illustrated through the experiences of one family-centered early intervention team.

Factors Associated With Perceived Control Appraisals in a Family-Centered Early Intervention Program

Findings from 2 studies investigating sources of variations in perceived control appraisals of parents involved in a family-centered early intervention/family support program are described. Results indicated that parent, family, and child characteristics were not related to differences in control appraisals. Practitioner help-giving styles and, to a lesser extent, staff disciplines were the only factors associated with the degree to which participants indicated they had control over needed services, resources, and supports. Implications for improving family-centered practices are described.

Family-centered early intervention with infants and toddlers: Innovative cross-disciplinary approaches, edited by Wesley Brown, S. Kenneth Thurman, and Lynda F. Pearl, Baltimore: Paul H. Brookes Publishing, 1993

Infant Mental Health JournalVolume 17, Issue 2 p. 177-181 Book Review Family-centered early intervention with infants and toddlers: Innovative cross-disciplinary approaches, edited by Wesley Brown, S. Kenneth Thurman, and Lynda F. Pearl, Baltimore: Paul H. Brookes Publishing, 1993 Gilbert M. Foley, Gilbert M. FoleySearch for more papers by this author Gilbert M. Foley, Gilbert M. FoleySearch for more papers by this author First published: Summer 1996 https://doi.org/10.1002/1097-0355(199622)17:2<177::AID-IMHJ2280170205>3.0.CO;2-0AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume17, Issue2Summer 1996Pages 177-181 RelatedInformation

Solution-focused assumptions that support family-centered early intervention

Four solution-focused assumptions used by the authors in providing early intervention services are described and illustrated. These assumptions underlie a treatment approach that emphasizes success and competence In order to promote change. The approach described is particularly well suited to family centered services.

Fathers and family-centered early intervention

Involving fathers in family-centered services presents a number of challenges to early intervention service providers. One is to move beyond practices responsive to the priorities and preferences of only the mother, to providing that intervention in a manner that responds to the priorities and preferences of both mother and father. This article reviews the Influence of the father's positive relationship on his developing child and on his own satisfaction. It also suggests approaches that may facilitate that relationship with his child and with the child's early intervention program.