Transcript No Slide Title

Research in Early Childhood
Intervention
FuJen Catholic University
Professors Sharon Rosenkoetter & Pauline Su
Fall 2008 – Set #1
This Weekend
• Introductions
• Syllabus
• What is Early Intervention?
• Why intervene early?
• Kinds of risk
• Risk factorsIssues at birth
• Home visiting
• Characteristics of ECI
• Reflections on readings
• Substance exposed children
• Adapted sport
Students Introduce Selves
Here’s Professor Pauline Su
Here’s Dr. Sharon Rosenkoetter
SOP – Standard Operating Procedures
• We will start and stop on time
• Please turn off cell phones
• We will hold classroom comments in
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confidence
We will avoid side conversations
We will try to encourage fearful
colleagues
Food and drink in class are OK
Please voice questions and
comments
Others?
Syllabus
Go over requirements
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Use PEOPLE FIRST language!!!!!
Child with a disability, NOT disabled child
Mother living in poverty, NOT poor mother
Father who is not working, NOT out-of-work
dad
Use the person first, description last
Early Childhood Intervention is…
• entering into typical family &
early childhood activities
• with individualized support
• to help the family
accelerate the child’s
development
Young Children Are at the Center of ECI
BUT families are VERY
important in ECI!
– Families LOVE their child
& are the child’s best
teacher
– Families seek information
& use it to make decisions
– Families guide choice of
program & services
– Families have needs that
ECI can help them meet
Young children may be called…
• typically developing
or
• at-risk
3 Kinds of Risk
1. Biological risk
2. Established risk
3. Environmental risk
Each may exist alone or
with another kind of risk
1. Biological Risk
•
physical possibility of a problem
but it has not yet led to developmental
difficulties
Example: preterm birth, genetic predisposition, weak
immune system)
2. Established Risk
• Child shows a condition or diagnosis that is
known to lead to developmental difficulties
Examples: Down Syndrome,
missing arm or leg,
cystic fibrosis,
Failure to Thrive
3. Environmental Risk
• Issues
– Poverty
– Adolescent parenting
– Parental mental illness or substance abuse
– Maltreatment
– Community or domestic violence
– Unsafe surroundings that may lead to
developmental difficulties
• These may exist alone or with other risks
Programs may be designed
for one kind of risk (e.g., poverty)
but most serve CHILDREN, not RISKS
Every Child Has…
• Risks that endanger the developing child --
may or may not cause actual harm
• Resilience, or protective factors that counter
the effects of risks
Always we want to lower the risks & increase
the resilience
Small Group Activity
• Form into 4 groups
• Two groups list all the risk factors that you
can think of that may lead to bad outcomes
for a child
• Two groups list all the protective factors that
you can think of that may help the child avoid
bad outcomes
• You will report back
REPORT BACK
Prevention
Trying to increase resilience
&
Decrease risk
3 Levels of Prevention – from Public Health
1. Primary prevention – teach all people to use
good health practices to reduce risk
factors & reduce the number
of new
problems (cases)
Example: teach women to avoid alcohol during
pregnancy
3 Levels of Prevention
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2. Secondary prevention – use intervention
to make the condition less serious and
perhaps help it end sooner
Example: Speech therapy to help a child
with Fetal Alcohol Spectrum Disorder talk
better
3 Levels of Prevention
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3. Tertiary prevention – intervention to
reduce related effects of the problem,
direct or indirect
Example: Behavioral planning &
environmental arrangement to help a child
with Fetal Alcohol Spectrum disorder avoid
serious behavior problems
Early Intervention Does All 3 types of
Prevention
#1 – teaches all people so problems don’t
happen
#2 – intervenes to address a problem
#3 – intervenes to prevent secondary problems
that are related to the initial problem
Why is Early Intervention the right
thing to do?
Why is Early Intervention the right
thing to do?
1. Humans can be shaped during the early years
2. The early years set the pattern for later
learning and behavior
3. During the early years, children learn best
4. This is the time to minimize disability &
prevent secondary disabilities
5. The environment & early experience are
significant in determining life outcomes
Why is Early Intervention the right
thing to do?
6. Early Intervention succeeds in improving
outcomes – it works!
7. Families need support to help their children
learn
8. There are economic benefits – Early
Intervention saves money for the society
over the child’s life
9. There are social benefits – it is the right
thing to do to help vulnerable children
Provide examples of these 9 on wall charts
You may write in Chinese!
Then we will go about and read what others
have written
COMMENTS FROM PROFESSOR SU
Reflect & Write – 15 Minutes
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What are the main messages you will take
home?
How you will use this information in your
work or family life?
Continuum for Early Childhood Development –
and Risk
• Prenatal period shapes
“Bottom up” learning
the brain architecture
• Natal events predispose
child to later challenges
• Birth to age 3 – period of
most rapid growth –
foundational for later
development
• Ages 3-5 – development
of complex skills – basic
for a lifetime
In the Beginning…
• A normal pregnancy is
38-42 weeks after
conception
• A birth before 38 weeks
gestation is pre-term
(sometimes called
premature)
• A birth after 42 weeks
gestation is post-term
25-29 weeks gestation
See video: The Miracle of Life
What message do you take from that
video?
In the Beginning…
• Major brain development
happens 25-29 weeks
gestation
• Too early birth means
that development must
happen outside the womb
• Toxic exposure in utero
can harm the brain
forever
• Brains are built over
time
• Interactive influence of
genes & experience
literally shape the
architecture of the
developing brain
• The medium for that is
the turn taking of
relationship with
caregivers
What Can Go Wrong?
• Mortality – death happens
OR
• Morbidity – some part of the body is harmed
Times When the Child Is Most
Vulnerable
Times when biology or environment (or both)
may assault the developing child
• Prenatal – prior to birth
• Perinatal – around the time of birth
• Postnatal – at least 18 hours after
birth
3 Levels of Hospital Nursery in the U.S.
• Level 1 -- typical care center for newborns
• Level 2 -- more intensive care for newborns
• Level 3 -- neonatal intensive
care
– NICU
– only a few in each region
NICU
• Baby lives in a controlled environment -- round
the clock observation
• “Procedures” honor baby’s natural
biological cycles
• Transdisciplinary team serves
baby and family
Video: The Neonatal Experience
Newborn Conditions that May Lead to
Mortality or Morbiditity
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Sepsis -- infection
RLF – vision impairment
RDS – respiratory distress
IVH – brain bleed
PDA – heart defect
NEC – intestinal decay
Video: The Neonatal Experience
For families, the NICU is an unforgettable
experience
What is your reaction to this video?
For families, the NICU is an
unforgettable experience. What
experience have you had with this?
Sometimes infants are “stepped up” or “stepped
down” in nurseries within a hospital or are
transported by helicopter or ambulance to a
facility that provides more or less intensive
care
Early Intervention Begins Early
• Medical and social work in NICU
• Home visits soon after
• Support for family, connection to other
families, help in understanding the condition
• Therapy for baby
• Information!
With a Troubled Pregnancy…
Efforts now to get the mother to the hospital
with a Level 3 nursery (NICU) before the baby
is born
Most important in rural areas
When the Baby Comes Home –
Home-Based Services
• Parents need even more support
• Team of health care professionals, therapists,
teachers
• Use evidence-based approaches & take data on their
effects with this child
• Early Intervention can come into the home
– EI, Early Head Start, Healthy Start, Parents as
Teachers
– Must be frequent enough
– Must focus on child’s needs and the home context
History of Home Visiting
• Began in the 1850s in city slums – visiting nurses
• 1900 – social workers aiding families in poverty
• 1935 – 1st U.S. maternal & child health law with home
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visits
1950s – U.S. home visits for children with
disabilities; expansion of visiting nurses
1970s – growth of War on Poverty home visits
1985 – expansion of Early Intervention (disabilities) &
child abuse prevention home visits; Parents as Teachers
1990s – Early Head Start – most effective when starts
with prenatal
TAIWAN?
Rationale for Home Visiting
Parents are the most important
teachers & home is where they
largely teach; services should
happen there
2. Parents can learn more effective ways to
relate to their children
3. Supporting parents will lead to improved child
outcomes
1.
Possible Emphases for a Home Visit
1. Basic care skills, immunizations OR
2. Reduce parent stress OR
3. Education & development
Issues
1. Should professionals or paraprofessionals
serve?
Which kind(s) of professionals?
2. Does home visiting “work”?
3. Better – under what conditions does it work?
4. Better – who does it work for?
5. What intensity is necessary for home visiting
to have the desired impact?
Video: Home-Based Services
What observations do you have about this?