ERIC ED345425: Early Intervention.

37 Pages·1992·2.6 MB·English

by  ERIC

=METRES=
EC 301 186
ED 345 425
Nathanson, Jeanne H., Bd.
AUTHOR
Early Intervention.
TITLE
Office of Special Education and Rehabilitative
INSTITUTION
Services (ED), Washington, DC.
92
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Agency Cooperation; *Attention Deficit Disorders;
DESCRIPTORS
Compliance (Legal); Deafness; *Disabilities; Drug
Therapy; *Early Intervention; Educational
Legislation; Elementary Secondary Education; Federal
Legislation; Hyperactivity; Interdisciplinary
Approach; Parent Participation; Parent School
Relationship; Program Implementation; Rehabilitation;
Special Education; Substance Abuse; Urban
Education
ABSTRACT
This theme issue focuses on early intervention. The
(1) "Deaf Infants, Hearing
four articles presented on this theme are:
and others),
Mothers: A Research Report" (Kathryn P. Neadow-Orlans,
development;
reporting findings on effects of auditory loss on early
(2) "Naintaining Involvement of Inner City Families in Early
Looking beyond
Intervention Programs through a Program of Incentives:
Brinket, and others)
Family Systems to Societal Systems" (Richard P.
family services; (3)
stressing the need for an integrated approach to
Serving
"Interdisciplinary Interagency Training for Professionals
others),
Chemically Dependent Families" (Vicki Krodenski, and
interdisciplinary and
describing a California program providing
(4) "Policy
interagency training to work with this population;
Implementation of Services for Infants and Toddlers with
others), describing a
Developmental Delays" (James Gallagher, and
Individuals with
project to track implementation of Part H of the
attention deficit
Disabilities Education Act. A special suteection on
of State
disorders include the following articles: "A Clarif!nation
the Needs of
and Local Responsibility under Federal Law To Address
(a Department of Education
Children with Attention Deficit Disorders"
Meeting the Needs of
policy memorandum); "OSEP's Initiatives for
(Ellen Schiller and Jane
Children with Attention Deficit Disorders"
and
Hauser); and "Attention Deficit Disorders: Academic Functioning
(DB)
Stimulant Medication" (Steven R. Forness).
*********ft*************************************************************
te made
Reproductions supplied by EDRS are the best that can
*
from the original document.
***********************************************************************
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Muter 1992
Warne III Number 3
Early Intervention
s. DiftAarlOtlif 011111ICATION
Oft* 42/ Ethashona4 aossovat ono mapromem
EDUCATIONAL RESOURCES INFORMATION
CENTER /MCI
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from the
A Message
Assistant Secretary
Robert R. Davila, Ph.D
governors in 1990: by the year NUL
often fragmented system of services to
Part H of the Individuals with
all children in America will start
infants and
meet the unique needs of
Disabilities Education Act
school ready to learn. In support of
toddlers with disabilities, through an
(IDEA). originally passed in
this national choral have identified
emphasis on interagency cooperation
1986. states that the Congress
the support of early intervention ser-
and ieTVice coordination. At the same
found an urgent and substan-
vim as a key area for USERS during
time. Congress authorized grants for
the next few years. Very simply. this
tial need to:
preschool services for children ages
means that USERS will support activi-
three through five. for the purpose of
enhance the development
(1)
ties that encourage the earliest and
ensuring provision of a free appropri-
of infants and toddlers with
mast effective provision a services
eligible
ate public education to each
disabilities and to minimize
for infants and young children with
child with disabilities.
disabilities to ensure that all children
their potential for developmen-
Since 1975. the nation's special
enter school ready to learn.
education laws have steadily exiyanded
tal delay;
As part of our early intervention
the variety and availability of services
(2) reduce the educational
efforts, we will work with states to
for children and youth with disabilities
including
costs to our society,
in
ensure their continued participation
from birth through age 21. Preschool
schools, by mini-
our Nation's
Part H and preschool programs. Fed-
be
programs are now or soon will
eral funding priorities related to this
mizing the need for special
available for every child with a dis-
initiative will continue to provide
education and related services
ability. Each state is in the process of
technical assistance to early interven-
implementing early intervention ser-
after infants and toddlers with
tion projects. develop creative and
vices for infants and toddlers with dis-
disabilities reach school age:
effective learning plans and curricula
abilities and their families. State and
(3) minimize the likelihood of
for young children, and support early
local school authorities and others
institutionalization of individ-
detection programs. Priorities that
have been extremely responsive and
support training for family members.
uals with disabilities and maxi-
resourceful in working toward ensur-
teachers, and other early childhood
ing the availability of high quality ser-
mize the potential for their
professionals will hell. ensure that
vices for young children with
independent living in society:
infants and toddlers with disabilities
disabilities and their families.
and
will receive services from well-
These programs are fousided on the
(4) enhance the capacity of
trained providers.
principle that every child has poten-
The real benefit of effective educa-
families to meet the special
iial. including children with disabili-
tion and rehabilitation, including
lies. Research has shown that early
needs of their infants and tod-
early intervention programs, is in the
intervention and preschool programs
dlers with disabilities.
opportunity for children and adults
for children
can make a difference
with disabilities to achieve their full
with disabilities by easing the transi-
and Toddlers
n creating the Infants
I
potential. Expectations for outcomes
tion from home to elementary school
Program. the
with
for people with disabilities are higher
and maximizing their opportunities for
Congress provided families with a
than ever before. and I hope they will
interaction with their nondisabled
vision and a promise of a cool dinated
become even higher. I have often
peers. These programs empower par-
the
system of services to help ensure
spoken of OSERS mission of provid-
information
ents. too, by providing the
growth and development of th..ir
ing opportunities for people with dis-
and services they need to attend to
disabilities. This
young children with
abilities to achieve their individual
their child's unique needs.
design
program was special in its
potential and maximum participation
Early intervention programs have
because it focused on the family's role
and pmductivity in society. Early
helping meet the
an important role in
of nurturing young children with dis-
intervention will help make this goal a
first of our nation's education goals.
abilities. The legislation sought to sup-
reality. t
adopted by President Bush and the
together an
port that role by drawing
ti Inter /992
1.
A Message from the Assistant Secretary
Robert R. Davila, Ph.D.
Early Intervendan
4
Deaf Infants. Hearing Mothers: A Research Report
Robert H. Matilark. Ph.D.
Kathryn P. Meadow-Orians. Ph.D.
Volume IV, Number 3
Lynne Sanford Koester. Ph.D.
Wimer 1992
Patricia F.. Spencer, Ph.D.
8
Maintaining Involvement of Inner City Families in Early
.
. .
Intervention Programs Through a Program of Incentives:
Lamar Alexander
Stcreavy
Looking Beyond Family Systems to Societal Systems
United States Department of
Wynetta Frazier. Ph.D.
Richard P. Brinker, Ph.D.
Education
Abigail Baxter Plat
Interdisciplinary-Interagency Training for Professionals
18
Robert R. Davila
.
.
.
Serving Chemically Dependent Families
Assistant Secrriary
Office of Special Education and
Jody Howard, M.D.
Vkkie Kropenske, P.H.N.. M.S.N.
Rehabilitative Savices
Mary Beth Sorensen. M.S.W., LC-S.W.
Edelstein. M.S.W., L.C-S.W.
B.
Susan
Annette Moore. M.A.
Racheliel) ler. M.D.
Jeanne H. Nathansw
Policy Implementation of Services for Infants and
23
Editor
Toddlers with Developmental Delays
Gloria Harbin. Ph.D.
James Gallagher. Ph.D.
Richard Clifford, Ph.D.
Carer art
Jane Eckiand, Ph.D.
Pbuong Tran
Patricia Funny,: Ph.D.
Age 12 Grade 6
OSERS News In Print
is published
AN OSERS NEWS IN PRINT SPECIAL SECTION
quarterly and is available free of
on Attention Deficit Disorders
charge. Contributors of articles for
this issue expressed th.rir own points
of view, which may not necessarily
A Clarification of State and Local Responsibility
reflect the position or policy of the
Under Federal Law to Address the Needs of
U.S. Department of Education. The
27
Children with Attention Deficit Disorders
information in this publication may
be reproduced without further per-
mission: a credit line would be appre-
30
ciated. Please address comments to:
OSEP's Initiatives for Meeting the Needs of Children
.
.
.
OSERS News In Print.
Room
with Attention Deficit Disorders
Editor.
3129. Switzer Building. 330 C Street,
Jane Hauser
Ellen Schilles. Ph.D.
S.W.. Washington, D.C. 20202-2524,
202/732-1723.
32
Attention Deficit Disorders
Academic Functioning and Stimulant Medicine
Steven R. Forness. Ed.D.
li infer 19442
4
3
DEAF INFANTS,
MOTHERS:
HEARING
A Rmarch
Report
Kathryn P. Meadow-Orians,
Ph.D.
a
Robert H. MacTurk,
Ph.D.
PatTicia E. Spencen
1Ph.D.
Lynne Sanford Koester,
Ph.D
Center for Studies in Education
,
and Human Development
Gallaudet Research Institute
Gallaiglet University
Washington. DC 20002
Introduction
Tn the past decade. there has been an
ilenormous expansion in knowledge
,2
about infants development in the first
of life. particularly in relation to
ykntr
their capacities to regulate social and
emotional interaction, to respond to
objects and to their parents, and to
influence their environment by these
responses. Knowledge about the pro-
also has
cess of language acquisition
grown exponentially.
hrter i
4
)
lo
retlillpy
,6
4,0
a
age. The 15-month contact was a
Infant Mastery Motivation. Deaf
Infants who are deaf, however.
and hearing infants did not differ in
home visit during which the mother
have been studied very little. and
their persistence in efforts to master
was interviewed. Other contacts were
available research reports include only
objects. either at nine or at twelve
in a laboratory at one of the five
a few subjects. A major reason tOr this
research sites, tin addition to Gal-
months of age. However. social gaze
gap is a continuing deli.), in the detec-
laudet University. participating
behaviors directed to the examiner m-
tion of congenital deafness. Despite
in the mother at nine months predicted
research groups were based at the Uni-
advances in diagnostic procedures and
mastery motivation (persistencef at
versity of Texas at Dallas: the Univer-
practices, hearing loss is generally not
sity of Pittsburgh: the University of
twelve months for the deaf t hut not the
identified before the age of eighteen
hearing) infants.
Ma.ssachusetts. and Amherst/Boston:
months. As early intervenfion special-
Georgia State University. Atlanta.)
ists address the requirements for pro-
Infant Social Coping Skills. At age
iding serlices to children from birth
nine months, hearing infants were
At the 9-month visit, mothers and
to age three, as mandated in the FAiu-
more likely to elicit responses from
infants were videotaped in a standard
cation For All Handicapped Children
their mothers during the Still-Face sit-
Face-to-Face interaction format, with
Act. P.L. 99457. the absence of devel-
uation. while deaf infants were more
two three-minute intervals of normal
opmental research on infants who are
likely to exhibit self-comforting
interaction separated by a Still-Face
deaf creates serious problems.
behaviors. This was interpreted as
mothers
were
where
episode
reflecting a tendency to internalite
instructed to be non-responsive. Mas-
In response to this situation, the
their discomfort, compared to the
tery Motivation was assessed by the
research summariled here
was
hearing infants' more av've efforts to
presentation of four age-appropriate
designed to investigate the impact of
repair the disrupted interaction.
toys. An interview was conducted and
hearing loss on earl y. mother-infant
questionnaire data on family stress and
interaction. on infants' motivation to
At eighteen months there were no
support were collected.
learn about objects. their social coping
differences in the deaf and hearing
skills. and their early language. These
infants' quality of attachment to their
During the 12-miimrli visit. Mastery
developmental domains were viewed
Motisation was assessed a second
mothers. On the basis of more specific
in the context of the family stress cre-
sub-categories of behavior, infants
time: mothers and children partici-
ated by the diagnosis of deafness and
who were deaf responded to separa-
pated in a fifteen-minute unstructured
the network of social support available
tion by exhibiting greater tivmdawe at
play session, and in the "Strange Situ-
to parents. The purposes of the study
the reunions, compared to the hearing
ation.- a standard laboratory proce-
%ere to provide information to behav-
infants.
dure for assessing infants' attachment
ioral scientists about the influence of
to their mothers through a series of
Infant Communicative Abilities.
loss on earls development.
auditor
brief separations and reunions.
Hearing infants and infants who were
and to pros ide a basis for informed
deaf did not ditTer in their production
At eighteen months. mothers and
intenention to parents and educators.
of prelinguistic visual-gestural com-
children were again engaged in the
munication. in the quantity of socal
Strange Situation and in twenty min-
communication, or i.. frequency of
utes of rice play. Another interview
Stud, Design and Methods:
intentional communication either at
was conducted and additional ques-
en!.
twelve or at eiehteen months. !leafing
normaiiy-developing
tionnaire data collected.
-1-%%
infants with hearing loss were
infants' socal productions were more
sophisticated and their use of formal
recruited from Ilse inetropolitan areas:
language was more athanced. com-
infants with normal hearing were
Findings:
pared to the infants who were deaf.
matched with that group for sex and
On several measures. families with
Howes' cr. there was gr,:.at sariation
mother \ education. Infants' hearing
infants who were deaf or had hearing
losses were diagnosed by the age of
within the two groups. The language
loss reported significantly higher lev-
performance of some individual
se% en months: fifteen had a hearing
els of stress and higher levels of soda!
infants who were deaf exceeded that
1oss in the severe io protOund range.
support. Differences in stress levels
of some Individual hearing infants.
Ilse had a less severe loss. Families
were accounted for primarily by stress
intim. white, middle-
were prtmaril
Mother-Infant
interactions.
related to care of the newborn child:
At
class, and college-educated.
nine, twelve, and eighteen months.
differences in support levels were
mothers with infants who were deaf
Data were collected w hen infants
accounted for by services provided by
exhibited a positive adaptation to
12-. 15-. and 18-months of
were
intervention specialists.
'1":
Ith r
It
5
1 ;
research group. We deduce that fami-
of the variance in imeractions of dyads
infants' auditory deprivation by pm-
lies without the advantages of access
with deaf infants at eighteen months.
iding more s isual cues than did
to appropriate health care are likely to
Of special note is the ,trong positive
mothers with hearing infants. How-
experience even greater delays in
impact of family socia. support on the
with
ever. at nine months. mothers
diagnosis than the advantaged, white,
quality of interactions in mothers and
hearing infants were judged to be
middle class families. Thus, a key tee-
deaf infants.
(in the
more responsive to their babies
mnmendation is that state-wide efforts
Face-to-Face format). and at eighteen
Infants' Language Level.
The sec-
he made to establish at-risk registries
months, mothers with hearing infants
ond outcome measure was an infant
and hearing screening programs.
were judged to be more sensitive to
Language Level Index from the eigh-
their babies tin the free play setting)
Legislation to support this is in place
teen-month communication data. Two
compared to mothers with deaf
tP.L. 99-457), and many states have
predictor variables were identified for
infants. Spoken language of mothers
begun their work in this direction. This
this measure: mother-infant Affective
with hearing infants was more comin-
cannot he done too soon if infants who
Match and mothers' visual-tactile
visual attention at
;ear On infants
benefits
are deaf are to receive the dear
Responsiveness tboth from Face-to-
twelve and eighteen months, com-
that come from an eany diagnosis.
Face data at nine months). These vari-
pared to the spoken language of moth-
ables aecounted for 37 percent of the
ers with infants who were deaf.
for
in language level
variance
the hearing infants. but none of the
Development of Social Interaction
Recommendation 2.
variance in the deaf infants' language
and Language from Nine to Eighteen
Pediatricians and other health
Based on results of
levels.
Months of Age.
professionals should be alert
previous research. we had predicted
that the groups of hearing mothers
for early suggestions of
with deaf and with hearing infants
Recommendations
impaired hearing and should
would display varying patterns of
refer infants for thorough
interaction and mastery motivation at
Recommendation I.
and that
auditory assessments as soon
ages nine and twelve months,
Increased support for early
these patterns would predict differ-
suspected.
as hearing loss is
identification, of and interven-
mother-infant
ences in the quality of
interaction and in infants language
Our findings suggest that early diag-
tion with, deaf infants,
nosis is even more important tor
levels at eighteen months. We also
including the establishment of
infants who are deaf than previous
predicted that these patterns of interac-
statewide Child Find systems
tion and language development would
work had indicated. Health profession-
be specified by family stress and
als likely to have early contact with
early hearing
or registries and
infants and their families must know
social support.
screening programs.
that hearing can he tested reliably dur-
Quality of Mother-Infant Interac-
ing the first weeks of life. Referrals to
The single most important recommen-
tion. Based on qualitative ratings of
early intervention programs immedi-
dation 4C! can make is the broadening
mothers and infants at eighteen
ately' after diagnosis is critical.
of programs for early identifkation
months. a global score was assigned to
and intervention with infants who are
reflect the overall quality of dyadic
deaf. Although the technology exists
interaction. Four predictor variables
for diagnosis even before the age of
Social Sup-
Recommendation 3.
were identified: family
nine months. iwo and one-half years
Mas-
port: infant Social Smile during
Training programs for health
of strenuous effort in five major
infant
tery assessment at nine months:
professionals should expand
metropolitan areas were required to
(ia/e Avert during the Still-Face
recruit the twenty infants who were
their emphasis on skills in
epimide of Face-m-Face interaction at
deaf that were targeted for this project.
nine months: dadic Responsiveness
interacting with and counsel-
Child-Find activities apparently are
during normal Face-to-Face interac-
ing parents of infants with
professionals
not as advanced as most
vari-
tion at nine months). These four
would like to believe. Particularly evi-
ables accounted for slightly less than
disabilities.
dent is the absence of infants from
one-third tif the findings (that is. the
One of the most significant findings
poor. disadvantaged. minority group.
variance) in interactions of dyads with
families in our
from this research is the strong Tell-
or single-parent
hearing infants. hut most (79 percent;
'1
tionship between social support
received by mothers of infants who
are deaf and the quality of their inter-
actions with those infants. The source
of support differentiating mothers with
infants who are deaf from mothers
with hearing infants was that provided
hy professionals. We interpret this set
e,
of results as a clear reflection of the
importance of professionals' support
for families in the early stages of their
adaptation to the diagnosis of deaf-
ness. and as a clear mandate to early
intervention specialists to continue
and to expand their pnwision of emo-
tional support/counseling to families
of Infants who are deaf.
Recommendation 4.
Parents should receive realis-
tic, clear informatioh about
their infant's ability to per-
ceive language in the audito0
cially infants who are deaf
This research was supported by the
mode, and be informed about
Division of Maternal and Child
with parents who are deaf"
implications for choice of
Health. Bureau of Health Care Delis -
and deaf infants from disad-
communication mode.
ery and Assistance IGrant #MC.1-
110563i and hy
the Gallaudet
vantaged families. Research
Our research showed that infants with
Research Institute. Copies of the Final
focused specifically on deaf
scxere to profound hearing losses
Report ("Interaction and Support:
could acquire expressive language at a
infants' processing of visual
Mothers and Deaf infants-) may he
normal rate when they were provided
information and signaling
obtained for a fee from the National
language in a modality they could per-
Technical Information Service. U.S.
strategies during social inter-
ceis e. In order to make informed deci-
Department of Commerce. Spring-
sions about language methods, parents
action is also recommended.
field. VA 22161
need to have: la) information from
intensise auditory assessments, made
This research group has been
on a regular basis and providing mea-
awarded a grant 01023C10077) from
sures of infants' ability to perceive
Conclusion
the Office of Special Education and
sound with and without amplification:
This research provides a rich database
Rehabilitative Services for analysis of
hi Information from assessments of
and intriguing new information ahout
comparable data from deaf and hear-
progress in communication/language
the importance of family stress and
ing ilifants with deaf parents: -Mater-
deselopment on a regular basis: and.
Responsiveness and Child
support for the development of infants
nal
(ci information about language meth-
Competency in Deaf and Hearing
with deafness and their early interac-
ods available to parents.
tions with mothers. Additional
Children.- r,onald F. Moores. Princi-
research is needed, however, to pro-
pal Investigator, Kathryn P. Meadow-
Or fans. Co-Principal Investigator.
vide information enabling infants with
Recommendation 5.
Robert H. Mac Turk, Patricia E.
deafness and their parents to accom-
Additional research is needed
modate successfully to the infants'
Spencer. Lynne Sanford Koester.
with other populations. espe-
auditory hiss. t
Research Scientists.
Winter /992
7
Maintaining
City
Involvement of Inner
Families in Early
Through
Intervention Program
a
Incentives:
Program of
Family
Looking Beyond
Societal
Systems to
Systems
city families with an infant who is dis-
Introduction
abled. The problem that we have faced
partnership
re problem with the
in providing early intervention to
between families and early inter-
infants with disabilities and their fami-
vention programs envisaged in the
lies who live in poverty is that signifi-
Education of the Handicapped Act
Richard P. Brink% PhD.
child's
cant life stresses place the
Amendments of 196 is that it pre-
developmental needs land hence the
beliefs of
sumes some congruence in
Wynetta Frazle4 Ph.D.
need for the early intervention pro-
professionals and parents. Families
gram) at a lower priority than we have
Abigail Baxten Ph.D.
living in poverty in the inner cities of
experienced to be the case when fami-
America may not have many similari-
lies come from middle and higher
ties with professionals and paraprofes-
socioeconomic backgrounds.
sionals employed in early intervention
Institute for the Study of
programs. Hence. the belief that pro-
The purpose of this paper is to
Developmental Disabilities
fessionals wish to work as partners
review efforts to increase the involve-
with a family from the inner city
and College of Education
early
ment of inner city families in
University of Illinois at Maw
whose child is developmentally dis-
intervention through the expansion of
abled may not be held by such fami-
intervention services to include ser-
lies. Neither may the perception of the
vices to families in an effort to reduce
child's disability be shared by early
barriers to their involvement in inter-
intervention professionals and inner
Rimer 1992
8
-§1
ention set-% ices tor their children.
First. we %sill briefly restos the need
to expand the perspective of interven-
tion beyond the developmental needs
t the child ssnh disabilities. Then ue
ill briefly review a protect designed
to provide individualiied incentives to
osercome barriers to participation in
earls inters ention and pre.ent some
prelumnarx data trom this effort.
w ill Inbe the need for a
Finally.
systems perspectise and illustrate this
ith brief tkscriptions of some
neetl
of the tamilies insolsed in the experi-
mental Incentises program.
4gooP"
.Zeitictance to Become
nvoked in Eariv intervention
Me Early Childhood Research and
of the
hitenennon Program
Institute tor Studs ot Deselopmental
t msersity ol Illinois at
(Tneago has been in esisience tor Over
mous years. Although the program is
located in the inner sits. until a tew
ear, auo Most ot the clients were
Middle dass. non-ilifilotIR families
trom the suburbs. It was
lear I rt H11 tin lti% men( skith hospliat
that. although
proerams
f4illow-11p
mans inner sits families were being
eferred to I ..CR IP. not mans were sue-
'4\
essfulls enrolling their inlants with
4
10011,
,lisahrlines nd participating in the
eekl% program. Scseral studies con-
!TRIP confirmed the poth-
lucte,t
lentils me and set-% me infants
lem iii
sith
imin the inner CO.
In a pilot study 01 des Clopmental
screening in IV+ 44 Chli:i1110 Btlard
iii
t)nls 4 percent of the imants identified
Rriimkcr. 1-raner.
agers tor further consideration ot the
Health s.linics.
as suspect or delayed developmemaii
detelopmental status. Sesenty-
\orman. 14044,1m our staff
ancelot.
\sere actually csaluated to confinit
fti cases were referred to case man-
screened 5-0 infants between the atles
disconfirm the problem.
agers tor further study. Of these. tints.
tit lour and 1%% OM -tour months for
eleven families remained in contact
deseloomental delays usine the Infant
The screening ellon illustrates two
with ease managers and agreed to
Monitoring System. a parent-question-
aspects of the mechanism by which
Of
multidisciplinary es aluations.
naire des eloped hy Bricker 11484).
kiss income families become disen-
1(1 percent of the population
tints
the infants screened. 115 (2,0 percent)
franchised from available 'ens ices.
for dc.'laed
identified as suspect agreed to any fur-
were identified as suspect
of the families demon-
. many
Fitst
ther es aluation. Of those int:tots
deselopment. Atter screening. 20 per-
strated that obtaining a full desehip-
whose families agreed to evaluation
he
sem ot the suspect cases could not
mental 71..essment was a loss priority
onh the were actualls esaluated.
located hs the clinics or case man-
friri
1,0Q:
'