Transcript Slide 1

Early Intervention
PSY 417
Dr. Schuetze
Definition
System of coordinated services that
promote child’s growth and development
and supports families during critical early
years
Federally mandated through the Individual
for Disabilities Education Act (IDEA)
History of Early Intervention
What is Early Intervention
Contributions from 4 Fields
Early Childhood Education
– Kindergarten
– Nursery Schools
– Daycare – Lanham Act (1940)
Maternal Child Health Services
– Children’s Bureau (1912)
– Title V (1935)
– Early and Periodic Screening Diagnosis and
Treatment Program (EPSDT)
History of Early Intervention
continued….
Special Education
– Itard – wild boy of Aveyron
– Seguin
– AAMR (1976)
Child Development Research
– Gesell
– Piaget
– Bowlby
Recent Advances in Early
Intervention
1968: Handicapped Children’s Early
Education Assistance Act
1965: Head Start
1975: PL94-142 (Education for all
Handicapped Children Act)
1986: PL 99-457
– Part H
Scientific Basis for
Early Intervention
Research on neuroplasticity (animal models)
Studies of extreme deprivation (orphanages,
maternal deprivation, isolation)
Naturalistic and longitudinal studies
Randomized controlled trials (RCTs) to test
the efficacy of a planned intervention to
alter the life course
Randomized Controlled Trials (RCTs)
to Improve Learning Outcomes
Abecedarian Project
Infant Health and Development Program
Romanian Orphanage Studies
Intensive Pediatric CI Therapy
National Head Start-Public School Transition
Demonstration Study
Pre-K Curriculum Comparison Study
RITE Professional Development Study
The Abecedarian (ABC) Project is a
randomized controlled trial (RCT)
that tests the efficacy of early
childhood education for high-risk
children and their families.
Key Research Question for
Abecedarian (ABC) Project
Can the cumulative developmental toll
experienced by high-risk children
be prevented or reduced significantly
by providing systematic, high-quality,
early childhood education –
from birth through kindergarten entry
and/or
from k through 2nd grade?
Abecedarian Preschool Program
Treatment Group
_ Control Group
_
Adequate nutrition
Adequate nutrition
Supportive social services
Supportive social services
Free primary health care
Low-cost or free primary
Preschool treatment:
health care
Intensive (full day, 5 days/week,
50 weeks/year, 5 years)
“Learningames” Curriculum
Cognitive / Fine Motor
Social / Self
Motor
Campbell & Ramey, 1995
Language
American Educational Research Journal
Individualized pace
Scores for High-Risk Preschool Treatment
and Control Children in the Abecedarian Project
at Nine Preschool Measurement Occasions
Ramey et al, 2000 Applied Developmental Science
Percent of Abecedarian Sample in Normal IQ
Range (>84) by Age (longitudinal analysis)
Martin, Ramey, & Ramey, 1990
American Journal of Public Health
Key Findings from Abecedarian Project
(“Abecedarian” …one who learns
the basics such as the alphabet)
18 Months to 21 Years Old
• Intelligence (IQ)
• Reading and math skills
• Academic locus-of-control
• Social Competence
• Years in school,
including college
• Full-time employment
• Grade Repetition
• Special Education
placement
• Teen Pregnancies
• Smoking and drug
use
Plus benefits to mothers of these children (education, employment)
Ramey et al, 2000
The Infant Health and
Development Program
(IHDP)
Designed to replicate the Abecedarian Project
applied to premature, low birthweight children
gestation and < 2500 gm at birth
Conducted at 8 sites (N=985 children & families)
Intervention modified for biological risk factors
Educational intervention only until 3 yrs old (CA)
Stanford-Binet IQ Scores at 36 Months
Heavier LBW Group (2001-2500gm)
Infant Health and Development, JAMA, 1990
Ramey, AAAS, 1996
Stanford-Binet IQ Scores at 36 Months
Lighter LBW Group (<2000gm)
Infant Health and Development, JAMA, 1990 Ramey, AAAS, 1996
Infant Health and Development Program
Children’s IQ at 36 months:
Maternal Education X Treatment Group
110
105
Control
Intervention
100
95
90
85
80
75
70
Some High
School
High School
Graduate
Some College
College
Graduate
(n=232)(n=162)
(n=166)(n=104)
(n=134)(n=63)
(n=76)(n=48)
Ramey & Ramey (1998),
Preventive Medicine
Outcomes Affected Positively (*p<.01)
by the Infant Health & Development Program
12 Months
24 Months
36 Months
NS
+
+
Adaptive and Prosocial Behavior
-
-
+
Behavior Problems
-
+
+
Vocabulary
-
+
+
Receptive Language
-
+
+
Reasoning
-
-
+
NS
-
+
Maternal Interactive Behavior
-
-
+
Maternal Problem Solving
-
-
+
Cognitive Development
Home Environment
Ramey 1999, adapted from Gross, Spiker, & Haynes, 1997, Helping Low Birth Weight, Premature Babies
Differential response to early
educational intervention
The children who benefited the most had:
 mothers with IQs below 70
 mothers with low levels of education
 poor birth outcome indicators
(PI, Apgar, LBW)
 teen mothers
(Martin, Ramey, and Ramey, American Journal of Public Health, 1990;
Ramey & Ramey, 2000)
Romanian Orphanage Studies
Designed to replicate the ABC Project
when modified to meet the needs of
children who had sustained extreme
learning and social-emotional
deprivation
- conducted for 2 different age groups
- part of a capacity building program in
Romania
Romanian Study
Personal Social (Study 1)
Romanian Study
Language (Study 1)
Denver Developmental Gain Scores (months) by
Treatment Condition (study 2)
Although all children can learn,
when exposed to good teaching,
extremely low levels of academic readiness
among children from low resource families
will not change without vigorous investment
in their early experiences,
their health, and continued support for later
learning and positive lifestyles.
Why Some Well-Intended Preschool Programs
Have Failed to Close the Achievement Gap
Poorly prepared teachers, weak professional
development
Educational programs not intensive enough
Failure to document program quality and impact on
children
Not enough teaching of language and academic skills
Inattention to children’s health and health promotion
Limited or no programs in summer and before and
after school
Benefits of Early Intervention
E.I. services that are delivered within the
context of family can:
– Improve developmental and educational gains
– Reduce future costs of special services
– Reduce family feelings of isolation, stress and
frustration
– Help children with disabilities grow up to be
productive and independent
Early Intervention Steps
Referral (unless parent objects)
– Made when referral source suspects delay or
disability
– Family is informed of benefits
– Child is referred to Early Intervention Officer
(EIO) within 2 days
– EIO assigns Initial Service Coordinator
Initial Service Coordinator
Provides information about Early
Intervention Program (EIP)
Informs family of rights
Reviews list of evaluators
Obtains insurance/Medicaid information
Obtains other relevant information
Evaluation
Determine eligibility
Family assessment
Gather information of IFSP
Summary and report
Individualized Family Service Plan
(IFSP) Meeting
Conducted if child is eligible
Family identifies desired outcomes
EI services specified
Develop written plan
Family and EIO agree to IFSP
IFSP Components
Statement of present level of development
Statement of family resources/ability to meet
developmental needs
Statement of major outcomes expected with
procedures and timelines of follow-ups
Statement of specific EI services including
frequency, intensity and methods
Dates and durations of services
Name of service coordinator
Must be reviewed every 6 months – revised as
needed  dynamic plan
EI Services
Assisting technology devices and services
Audiology
Family training
Medical services – for diagnostic or evaluation purposes only
Nursing services
Nutrition services
Occupational therapy
Physical therapy
Psychological services
Service coordination
Social work services
Special instruction
Speech/language pathology
Vision services
Health services
Transportation/related costs
Transition
Plan for transition included in IFSP
Service Model Options
Home and community-based visits
Facility or center-based visits
Parent-child groups
Family support groups
Group developmental intervention
Eligibility for EI
Under 3 years of age
Disability: child has diagnosed physical
condition that often leads to problems in
development (e.g., Down syndrome,
autism)
Delay: child is behind in at least one area
of development
Areas of Development/Functional
Areas
Cognitive: remembering, reasoning,
understanding and making decisions,
learning, thinking
Physical: vision, hearing, growth, gross
and fine motor abilities
Speech-language
Social/emotional: relating to others
Adaptive development: self-help skills the
child uses for daily living
New York State’s Definition of
Developmental Delay
12 month delay in one functional area
33% delay in one functional area or 25%
delay in each of two areas