A lot of media attention has occurred this past summer on the many historical and innovative events that transpired 40 years ago during the summer of 1969. Most notably, the first man stepped on the moon, an accomplishment surpassed only by the short time it took to get there. Preceded by President Kennedy's 1960 inaugural promise to have a man on the moon before the decade was out, the actual event demonstrated to the world the capacity of our country to focus on, and achieve, an outcome once only dreamed about.
A number of other accomplishments occurred during the summer of 1969. The Children's Television Workshop and the TV show Sesame Street used technology and media to impact young children's learning. Both the 747 and Concorde were put into service as, respectively, the largest and fastest airplanes. As a result, air travel became the means for many, and the world became smaller. Consumerism became a growing movement, thanks to Ralph Nader, and the first heart implant occurred. And 1969 was also the summer of Woodstock, followed by the World Series win by the Amazing Mets.
Forty years ago also marks a significant event for the field of early childhood intervention. Following on the heels of the 1965 Head Start legislation in 1968, Congress passed Public Law 90-538: The Handicapped Children's Early Education Program (known as HCEEP). This law provided funding to support the development, evaluation, and dissemination of comprehensive and effective early intervention models for infants and young children with disabilities and their families. In 1969, 21 projects for children of differing types of disabilities in 18 states were funded, and thus began the era of early childhood intervention for all children with disabilities. Also known as the “First Chance Network,” these early HCEEP projects formed the foundation of our field today, a foundation built on the individualized and comprehensive needs of children and families, accountability and effectiveness. Forty years later, our field has solidified into a legislatively mandated national network of services available to all eligible infants, young children, and their families. The challenge has evolved from carving out an existence to institutionalizing the value-driven system of services and supports we created 40 years ago. The promise made by the creation of the HCEEP Network in 1969 to provide comprehensive and effective services to children and families as early as possible must continue. In our current era of cost containment and economic struggles, statewide early childhood intervention systems must continue to show the world the capacity of our country to focus on, and achieve, an outcome once only dreamed about. I think you will find articles in this issue do contribute to this promise.
This issue of IYC contains articles representing a range of relevant topics with different methodologies and a subject sample. I am pleased that these articles also address the priorities I stated in my first issue as editor. We have articles from authors from other countries outside of the United States, articles from programs under the Association of University Centers on Disability (AUCD), and articles from early career professionals.
Our first 2 articles address the critical area of family-centered practices. The first is a study examining this area of practice when writing evaluation/assessment reports. For many families, the process to measure a child's developmental strengths and needs is to determine an eligibility for services emotionally laden exercise, and their first of many assessments if, indeed, their child enters early intervention. Dr Farrell utilized a Web-based instrument to investigate the importance of one component of this evaluation process: the effectiveness of using family-centered language in the report that describes child's performance during the assessment. More than 420 practitioners and parents rated sections of an evaluation report and were able to identify passages that reflected more attributes associated with family-centered principles. The most important aspect of the study, however, is the fact that those who read the passages associated with family-centered practices also rated the functional abilities of the child as higher than those who read “standard” report language. This finding has strong implications for the power of words in evaluation reports to ascribe attributes to both families and children. The study adds to the evidence base for family-centered practices and principles.
Our second article by Drs Ylvén and Grunlund focuses on a strength-based approach to addressing family needs in early intervention. Their study was conducted in Sweden and used qualitative methods to document the coping strategies used by 5 families who had young children with disabilities. Through interviews, the families referenced 4 types of coping strategies they used when dealing with situations regarding their child. These coping strategies have been correlated with measures of family strength. The authors suggest ways in which professionals can build family strength as they allow, encourage, and facilitate families to use coping strategies through conversations and planning meetings to problem solve the challenges of everyday life.
Our third article included both families and service providers (therapists) in focus groups to illuminate the challenges inherent with implementing early intervention services within natural environments. It has been well over 20 years since the term and concept of natural environments has appeared in law (Part C), and yet we still are struggling with interpretations of what this construct means to service delivery. An in-depth qualitative study was conducted by Campbell, Sawyer, and Mahlenhaupt in which they implemented 9 focus groups (5 family and 5 early intervention therapists). A number of themes emerged from the groups, and there were some marked differences in how families understood the term of natural environments versus how therapists did. Families, not surprisingly, understood that natural environments described a way of providing services in contexts of their everyday life. Parents saw natural environments as providing learning opportunities for their children to learn and gain acceptance and make friends. On the other hand, therapists seemed to equate natural environments as a location for services. It is no wonder that we are still struggling with this concept, and this article provides recommendations to the field of early intervention on how to operationalize and interpret this important component of early intervention.
Our next 2 articles focus on pre–school-aged children. Jolivette, McCormick, McLaren, and Steed emphasize the importance of interdisciplinary service delivery for young children with and without disabilities. In particular, their article focuses on choice-making opportunities. As choice making allows children to develop contingencies and independent behaviors. The study focused on observed choices provided to young toddler and pre–school-aged children who were attending an inclusive preschool program. The choices were analyzed along a number of variables including choices given by staff from different disciplines. Interestingly, there were no differences between choices offered those of different background disciplines demonstrating that this program had a team that all worked in tandem within the classroom. Implications for classroom structure and management strategies to enhance and increase choice making and subsequent child development are provided by the authors.
Our next preschool article is an international submission from Canada. Frisk, Montgomery, Boychyn, Young, vanRyn, McLachlan, and Neufeld present a study in which they analyzed the ability of 4 language screening instruments to appropriately identify children with language delays. These 4 screening instruments were measured against the Preschool Language Scales and the Bracken Basic Concept Scales. There were challenges found with each of the screening tools in regard to sensitivity and specificity. A number of recommendations are made by these authors including better training for practitioners who utilize screening so that they may better analyze the appropriateness of the instruments they use. One intriguing recommendation from the study is to address the needs of Canadian preschoolers through the establishment of screening norms validated specifically with Canadian children.
We next have 2 articles that focus on the important role of physicians in screening for developmental issues in the pediatric population. With the increase in children identified as having autism spectrum disorders (ASD), there has been an emphasis placed on screening all children early to begin intervention as early as possible. A key component of this process is the medical community as pediatricians and other health care providers see infants and young children regularly as part of well child and immunization visits. In addition, the American Academy of Pediatrics recommends that developmental screening of infants and young children occur at set intervals during well child visits.
The article by Bauer, Smith, Chien, Berry, and Msall provides information about a system that was designed to assist pediatricians gain knowledge and confidence in developmental screening. Pediatric residents were taught screening protocols using guidelines from a formal curriculum to educate them in their role in the medical home. Unfortunately, the study found that this didactic training on developmental screening did not result in any changes in residents' knowledge and confidence in screening and referral. In particular, knowledge of the social emotional developmental domain and risk factors (including ASD) was not impacted by the curriculum. The authors provide a number of recommendations on how to enhance developmental screening opportunities for children, including the placement of a developmental specialist in pediatric audiences to perform the screenings, which go beyond utilizing a pediatrician's time.
The next study by Jennifer Gillis provides some insight as to the actual rates of developmental screening by practicing physicians. Using a sample of 2 states, a survey assessing developmental screening implementation was distributed to primary care providers. While a high percentage of primary care providers indicated they routinely screen for developmental delays, a lower percentage routinely screen for ASD. The survey respondents identified a number of reasons for these findings, and the article provides recommendations to increase the screening practices of physicians.
Our last article provides information for using innovative assistive technology to enhance the delivery of early intervention to families and their children. Videoconferencing has been used across a number of disciplines as a mechanism to provide information and education to audiences who are far from the originating site. This article by Kelso, Fiechtl, Olsen, and Rule provides information about a pilot in which families were provided early intervention via the use of 2-way audio and video. Families reported satisfaction even though they did not have services provided in their home by therapists and teachers who would have done a hands-on model of intervention. This pilot with 4 families provides ample evidence from which to launch a more thorough investigation in which the implementation of early intervention via audio and video can be measured in regard to family and child outcomes as well as satisfaction. This application of technology could prove extremely helpful to assist in those rural and remote areas to which frequent travel to a family's home may be cost prohibitive. This video and audio mechanism would also allow more frequent dialoging and assistance to all families from early interventionists as they help their children learn and develop.
I would like to remind readers that IYC has moved to a journal using open submission. Please review the published guidelines for authors in assessing the appropriateness of any manuscripts for publication in IYC. I invite any and all inquiries as to appropriateness and I would like to encourage author submissions to continue the outstanding reputation IYC has in the field in early childhood intervention.
Mary Beth Bruder, PhD
©2009Lippincott Williams & Wilkins, Inc.