Transcript Risk Factors and Children not Referred for Special Education Until After Kindergarten Entry –or— The Child Find Study Cynthia Paris and Michael Gamel-McCormick Center for Disabilities.

Risk Factors and Children not
Referred for Special Education
Until After Kindergarten Entry
–or—
The Child Find Study
Cynthia Paris and Michael Gamel-McCormick
Center for Disabilities Studies
University of Delaware
December 7, 2004
Why this study? Why now?
Delaware Department of Education and
Local School Districts reported anecdotal
occurrences of children entering
kindergarten in need of special education
services but not having been identified for
Part B, Section 619 services
Part C personnel were concerned about
children exiting early intervention services
and not being found eligible for preschool
IDEA services
Study Charge
The Delaware Department of Education
charged the Center for Disabilities Studies
with the following:
– Determine who is being referred for special
education services after kindergarten entry
– Determine what developmental and family
characteristics those children had prior to
kindergarten entry
– Determine what opportunities those children
and families had for interacting with possible
referral agents
Oversight and Advisory
An advisory committee was formed of:
– Three Department of Education personnel
(Director of Special Education, Section 619
Coordinator, and a data specialist)
– Two local school district special education
directors
– Department of Services to Children, Youth,
and their Families representative
– A family member
– Three researchers from the University of
Delaware Center for Disabilities Studies
Original Research Questions
Who are the children who were referred for special
education services prior to kindergarten?
Could they have been identified in need of special
education services prior to kindergarten?
Why were these children not identified prior to
kindergarten?
If these children received early intervention services
(Part C services), why were they dismissed from
services and not found eligible for Section 619
services?
Health Care
Community
Family
Child
School
District
Community
Services
Early Care and
Education
Theoretical Framework of Child’s
Experiences
Process
and
Sequence
for
Addressing
Developmental
Concerns
of Young
Children
Opportunities
for Referrals
Concern
Raised
Information Sought
Options Identified
to Assess Concern
Assessment
Conducted
Opportunities
for Responses
Options Identified to
Address Concern
Concern Addressed
with an Intervention
Sample Selection
Records for special education referrals for the
students from 1999-2002 reviewed;
All students found eligible for special education
during those years who were in K, 1st, 2nd, 3rd, or 4th
grade and had never been received special
education services before were included in the
population definition
Students identified as moderate or low income by
food program eligibility
Random sample of students selected from each of
the four grade levels and low or moderate income
levels resulting in 83 students in the sample
Measurements
Family Interview
– Family narrative of
history of child’s
development
– Services child
received
– Concerns expressed
by the family
– Sources of information
about child
development
School Records
Division of Family
Services records
DE Department of
Education Services and
records
State human services data
base review
Department of Public
Health data base review
Review of children’s
medical files
Review of children’s early
care and education
experiences
Students’ Profile (N=67)
Gender
43.3% Female (29)
56.7% Male (38)
Free/Reduced Lunch
64.2% Eligible (43)
35.8% Not eligible (24)
Grade
K: 14.9% (10)
1st: 20.9% (14)
2nd: 20.9% (14)
3rd: 25.4% (17)
4th: 17.9% (12)
Students’ Profile (N=67)
Localities
52.2% New Castle County (35) (primarily suburban)
16.4% Wilmington (11) (primarily urban)
19.4% Kent County (13) (primarily rural)
11.9% Sussex County (8) (a mixture of suburban and
rural)
Student Profile (N=67)
Children’s Ethnicity & Families’ Income when
Children Were Under Five Years of Age
Moderate
Low
Income Not
Ethnicity:
Income
Income
Reported
Total
Caucasian
17
81%
17
45.9%
4
44.4%
38
56.7%
African
American
Latino
0
0.0%
15
40.5%
4
44.4%
19
28.4%
3
14.3
4
10.8%
0
0.0%
7
10.4%
Other
1
4.8%
1
2.7%
1
11.1%
3
4.5%
Total
21
100%
37
100%
9
100%
67
100%
Students’ Profile (N=67)
Special Education Eligibility
N
%
Learning Disability
37
55.2%
Speech
17
25.4%
Physically Impaired
5
7.5%
Sensory Impairment
2
3.0%
Partially Deaf
1
1.5%
Seriously Emotionally Disturbed
2
3.0%
Educable Mentally Handicapped
1
1.5%
Severely Mentally Handicapped
1
1.5%
Partially Sighted
1
1.5%
Family Income
Families’ Report of Income Between
Children’s Births and School Entry
N
%
Moderate Income
Low Income
Not Determinable
Total
21
37
9
67
(31.4%)
(55.2%)
(13.4%)
(100.0%)
FINDINGS
Section I:
Children’s experiences prior to school entry
(N=67)
• Family Context
• Contacts with Professional Community
Family Context
Family Configuration
Potential Sources of Family Stress
Sources of Child Development Information
Family Configurations
Families’ Configuration between Birth
and Kindergarten
Stable*
Transitioning
Total
N
%
34 (50.7%)
33 (49.3%)
67 (100.0%)
*A stable household was one were the adults did not change
during the children’s first five years of life
Even in households that were transitioning, there was at least
one adult who was stable during the child’s first five years of life.
Family Stressors*
Family Events or Stressors by Birth Income
Number of Family Events or
Stressors
Moderate
Income
Low
Income
Income Not
Reported
Total
0
N
%
6
28.5%
1
2.7%
1
11.1%
8
11.9%
1
N
%
5
23.8%
8
21.6%
1
11.1%
14
20.9%
2
N
%
3
14.3%
6
16.2%
0
0.0%
9
13.4%
3
N
%
3
14.3%
6
16.2%
1
11.1%
10
14.9%
4-10
N
%
4
19.0%
16
43.2%
6
66.6%
26
38.8%
Total
N
%
21
100.0%
37
100.0%
9
100.0%
67
100.0%
*Stressors included but were not limited to family violence, divorce, drug
use, custody challenges and child abuse complaints.
Family Context
Sources of Child Development Information
Moderate
Income
Low
Income
Income Not
Reported
Total
Parents and/or in-laws
N
%
18
85.7%
23
63.9%
3
33.3%
44
66.7%
Friends and parents of
young children
N
%
19
90.5%
22
61.1%
2
22.2%
43
65.2%
Doctor
N
%
17
81.0%
19
52.8%
6
66.7%
42
63.6%
Other Relatives
N
%
14
66.7%
19
52.8%
4
44.4%
37
56.1%
Magazines
N
%
14
66.7%
21
58.3%
2
22.2%
37
56.1%
Books
N
%
17
81.0%
13
36.1%
4
44.4%
34
51.5%
Preschool Teacher
N
%
12
57.1%
12
33.3%
0
0%
24
36.4%
Parenting Classes
N
%
5
23.8%
15
41.7%
3
33.3%
23
34.8%
Family Context (continued)
Sources of Child Development Information
Moderate
Low
Not
Reported
Total
Child Care Provider
N
%
7
33.3%
10
27.8%
1
11.1%
18
27.3%
Television
N
%
3
14.2%
10
27.8%
2
22.2%
15
22.4%
Nurse, Parent Educator,
Home Visitor
N
%
4
19.0%
9
25.0%
0
0.0%
13
19.7%
Great Beginnings
N
%
5
23.8%
7
19.4%
0
0.0%
12
18.2%
Internet Resources
N
%
3
14.3%
6
16.7%
1
11.1%
10
15.2%
Parenting Experience
N
%
2
9.5%
6
16.2%
1
11.1%
9
13.4%
Newspapers
N
%
4
19.0%
1
2.8%
2
22.2%
7
10.6%
Contact with Professional
Communities
Health Care Providers
Community Service Providers
Early Care and Education Community
School Districts
Families’ Access to Health Care
Yes
No
Missing
Total
Primary Care Physician
N
66
% 98.5%
1
1.5%
0
0.0%
67
100.0%
Annual Well-Child Visits
N
64
% 95.5%
1
1.5%
2
3.0%
67
100.0%
Health Insurance
Coverage
N
63
% 94.0%
4
6.0%
0
0.0%
67
100.0%
Health or Medical Need
Went Unmet
N
9
% 13.4%
58
86.6%
0
0.0%
67
100.0%
Contact with Professional
Communities
Community Service Providers
The Women Infants and Children Program
Division of Family Services
62% of the families in the
sample were enrolled in WIC
Rating of their Overall Experience
with WIC
N
%
Positive
35
(83.3%)
Negative
2
(4.8%)
Neutral/Unsure
5
(11.9%)
Total
42
(100.0%)
Division of Family Services
Contacts—Age of First Contact
Age:
N*
%
Birth to 12 months
2
14.3%
5
1
3
2
1
14
35.7%
7.1%
21.5%
14.3%
7.1%
100.0%
One Year
Two Years
Three Years
Four Years
Five Years
Total
*14 of the 67 families had contact with the Division of Family Services (21%)
Division of Family Services
Contacts—Days of Service
Cumulative Division of Family Services Days
Number of days in
service
N
%
26 - 35 days
89 – 92 days
164 - 251 days
3
2
3
21.4%
14.2%
21.4%
364 - 597 days
Total
6
14
42.8%
100.0%
*14 of the 67 families had contact with the Division of Family Services (21%)
Early Care and Education
At what age was your child enrolled in an early care and education setting?
Income:
Moderate
(N=21)
Low (N=37)
Not Reported
(N=9)
Total
(N=67)
No Care
N
%
1
4.7%
6
16.2%
4
44.9%
11
16.4%
Infant
N
%
4
19.0%
1
2.7%
0
0.0%
5
7.5%
Toddler
N
%
9
42.9%
8
21.6%
0
0.0%
17
25.4%
Between
age 3 and
school
entrance
N
%
20
95.2%
26
70.3%
5
55.6%
51
76.1%
Age of Care:
Early Care and Education
Types of Early Care and Education Settings
Experienced as 3-5 Year-Olds
Child Care Center and/or
Preschool Program
Family Child Care
Head Start/ECAP Program
Type Not Specified
N
%
43
84.3%
7
9
14
13.7%
17.6%
27.5%
Early Care and Education
Longest Length of Time Spent in One ECE Setting (3 to 5 Years of Age)
Income
Length of Time in 1 Setting:
Moderate
Income
Low
Income
Income Not
Reported
Total
Less than 9 months
N
%
0
0.0%
2
7.7%
0
0.0%
2
3.9%
9 months to 1 year
N
%
6
30.0%
12
46.1%
3
60.0%
21
41.2%
1 year or more
N
%
14
70.0%
10
38.5%
2
40.0%
26
51.0%
Early care and
N
education undefined %
0
0.0%
2
7.7%
0
0.0%
2
3.9%
20
100.0%
26
100.0%
5
100.0%
51
100.0%
Total
N
%
Contact with Professional
Communities
School Districts
School District Evaluation Services
Child Find Screening
School District Evaluation Services
Contact with School District to conduct an
Evaluation
N
%
Did not contact
63
94.0%
Contacted, looking for preschool
1
1.5%
Contacted and evaluation
1
1.5%
suggested
Contact and told to wait
2
3.0%
Total
67 100.0%
Child Find Screening
N
No screening occurred
Screening occurred with
result of no concern
Screening occurred with
result of a concern
Total
%
22
32.8%
37
55.2%
8
11.9%
67
100.0%
Section II:
Children’s and Families’ Experiences
When a Concern is Expressed
(N=23)
Recognition of Concern
Response to Concern
Special Education Categories of
Eligibility (N=23)
Eligibility Categories:
N
Learning Disability
Speech
Physically Impaired
Sensory Impairment
Seriously Emotionally Disturbed
Partially Sighted
11
8
1
1
1
1
%
47.8%
34.8%
4.3%
4.3%
4.3%
4.3%
Recognition of Families’ Concerns
Who First Recognized a Concern?
Relationship to Child
N
Family
Extended Family
Doctor
Early Care and Education
Family and Doctor
Family and Early Care and Education
Total
11
4
1
4
1
2
23
%
47.8%
17.4%
4.3%
17.4%
4.3%
8.7%
100.0%
Examples of Families’ Language
Describing Concern
Special Education Codes:
Inability to sit still
Terrible 2’s started, got worse, never ended
X
X
Sleeping problems, uncontrolled violent rages
X
with no apparent trigger
Chronic ear infections, not hearing
X
Not able to understand him when he talked
compared to other children
Verbal communication limited,
He didn’t talk much
X
XX
Responses to Families’ Concerns
Responses to Concerns Raised Between Children’s Births
and School Entry (N=23)
N
%
17
73.9%
6
26.1%
Family waited
6
2
2
26.1%
8.7%
8.7%
Family did not respond to others’ concern
1
4.3%
Early Care and Education teacher made informal
accommodations
1
4.3%
Family made contact with or received professional
referral
Professional told family child will outgrow the problem,
or too young to tell outcome; concern deferred
Professional performed evaluation
Family tried to solve the problem by themselves
Response to Families Following an
Assessment (N=6)
Response
N
Family told child is not delayed enough/not at
great enough risk, no program availability, or
too young
4
17.4%
2
8.7%
2
8.7%
1
4.3%
Professional performed evaluation, normal
results
Doctor Prescribed medication
Doctor recommended annual follow-up
%
83 children.
67 children
without services.
Experiences
of the 87
children in
the study
Concern
Raised
39 with a concern
raised by their
families.
Information Sought
Options Identified
to Assess Concern
23 children whose
families had a
response to their
concerns.
Assessment
Conducted
6 children who
had an
assessment.
Options Identified to
Address Concern
16 children
receiving services.
Concern Addressed
with an Intervention
Discussion of Findings
Language – Vocabulary of Concerns
Potential Leverage Points (opportunities
for referrals and responses)
– Early Care and Education
– Health Care Providers
– Community Services
Summary
Families and extended family members identify
concerns but more often than not did not have
their concerns responded to or addressed
When an assessment of children’s development
did take place, families were still told to “wait,”
“their development is normal,” or check their
children’s development again in kindergarten
Almost ALL children have at least one primary
extra-familiar contacts that could make referrals
to schools or other programs (e.g., medical,
social service, and early care and education
programs)
Implications
With collaboration between families and
professional communities, children could
be referred earlier and services secured
This calls for a change in the professional
culture regarding children’s development
and linking to services; the protocols
professionals use for referring children and
their families need to be updated
Proposed Professional Protocols
for Referral
Listen to, respond to, and value families’
information about their children’s
development
Making the default action further assessment
and examination rather than waiting
Immediately providing informal intervention
strategies and supports to the family in
response to their stated concerns, while
more formal interventions are secured (if
needed)
Proposed Professional Protocols
for Referral (continued)
Help connect families as early as possible
with informal and formal supports and
services; again, rather than waiting to see
what happens with their children’s
development
Training to begin a cultural shift in our
professional communities to embrace the
role of early identification, provision of
supports, and referral to formal sources for
assessment and intervention