Welcome to 2011! As we enter the 23rd year of publishing Infants and Young Children (IYC), we are making a title change that will affect how we are viewed as a journal and how we represent the work contained within the journal. IYC is described on our Web site as a comprehensive interdisciplinary journal devoted to early intervention for infants and young children (birth to 5 years of age) with, or at risk for, developmental disabilities. To be more descriptive, the children served in early childhood intervention have been identified as having a risk (biological, environmental, established, or a combination) that has resulted in their development being compromised such that there is a delay (or the likelihood of a delay) between expected behaviors for their age, and the behaviors they demonstrate across 1 or more developmental domains (cognition, motor, communication, adaptive, etc.). These children represent a diversity of backgrounds, family structures, and disability types, and this heterogeneity is what provides both the richness and the complexities of our field. Thus the primary title of Infants and Young Children is appropriate to describe our population.
When Jim Blackman founded this journal, he laid out a purpose in his first editorial (July 1988, Vol 1, No. 1) “to provide an interdisciplinary forum for professionals providing services to children who have, or are at risk, of acquiring developmental problems and to their families” (p. v). He further stated:
good intentions (in intervention) are not sufficient and that disciplinary isolation in training and service is not acceptable, ... and in addition to maintaining a high level of expertise in one's own discipline, each professional must become knowledgeable about other fields ... contributors to the journal have been asked to write for professionals outside their own discipline.
This purpose and these beliefs have not been altered over the past 22 years of the journal's history. When Michael Guralnick followed Jim as the editor in 2003, he reinforced the necessity of the interdisciplinary perspective, in particular, how different disciplinary perspectives can be integrated into intervention practice. He further expanded the purpose of IYC to
“effectively link to practice and policy issues the extensive knowledge emerging from the developmental science of normative development, the developmental science of risk and disability and intervention science relevant to the field of early childhood development” (p. 7).
This purpose continues, as has the Journal's association with the International Society on Early Intervention (http://depts.washington.edu/isei/), which is a professional association founded by Mike. Thus, the term interdisciplinary on the second part of the Journal's title is appropriate to describe our audience.
My contribution as the editor of IYC has been to maintain the vision of the 2 editors before me. In addition, I am trying to operationalize this vision by encouraging and publishing peer-reviewed contributions by international colleagues, those from programs represented by the Association of University Centers on Disabilities (a network of interdisciplinary centers advancing policy and practice for and with individuals with developmental and other disabilities, their families, and communities) and novice authors. The diversity, complexity and rigor of the work presented by such authors have illustrated the changes we have seen in our field over the past 22 years.
Indeed, 22 years ago, professional journals, submission requirements, and manuscripts were not housed on electronic platforms utilizing the World Wide Web, nor were any of us utilizing communication strategies such as e-mail, Facebook, skype, or virtual meetings with participants from across the country all sitting at their own computers. Likewise, recent advances in brain-based, genetic, and stem cell research and the subsequent contributions of this to the science of child development were not even conceivable back in 1988. It is no surprise, then, that the theories and practices of early childhood intervention have also changed over these past 2 decades.
In the 1980s, our field was in its infancy. The predominant service delivery model was episodic and discipline-specific, developmental domain referenced interventions in centers or clinics, delivered by individual service providers who may have had little training in family-centered care, team-based service delivery, or using natural learning opportunities as the context for learning. These characteristics have evolved over the years into early childhood service systems that revolve around family needs and partnerships with interdisciplinary teams of early childhood interventionists dedicated to the facilitation of children's development across domains and through everyday learning opportunities as measured through the acquisition of functional outcomes. Families are now recognized as integral to all interventions with their children and, as such, professionals share their expertise in both early developmental processes and effective discipline-specific intervention practices with them (and each other) to design, implement, and measure comprehensive, functional, and effective interventions. Over the 22 years during which IYC has been published, early childhood intervention has moved from a child-centered remediation model to focus on enhancing families' confidence and competence in extending their children's learning into activity settings and places that are unique to each family, whether it be in the home, community, or preschool inclusion classroom.
Simultaneous to this shift in focus in early childhood intervention over the past 2 decades has been an increase in the numbers and needs of children being identified as at risk for, or demonstrating developmental delays and learning challenges. While the rise in children with autism spectrum disorders is an example, we also have many more children living in conditions that present environmental risks that impact development and behavior. This has broadened our need for systems of early childhood supports and services to go beyond the availability of interdisciplinary staff and evidence-based intervention practices for families and professionals. As a broadened field, we are now promoting the creation and maintenance of communities that can accommodate and respond to the changing and challenging needs of all vulnerable children and families.
To accommodate all these complexities, a definition of early childhood intervention has recently been proposed to capture the dynamic interplay of environmental characteristics (including family) and biological traits of a child as we understand them today. This definition states: early childhood intervention is the experiences and opportunities provided to infants and young children by the children's parents and other primary caregivers (including service providers) that are intended to promote the children's acquisition and use of behavioral competencies to shape and influence their prosocial interactions with people and objects (Dunst, 2007). The elements in this definition provide content to Merriam Webster's definition of intervention: (b) to interfere with the outcome or course especially of a condition or process (as to prevent harm or improve functioning). That is what we do as early childhood interventionists: interfere with the outcomes or course of children's development and behavior to improve learning and competence. Thus, we provide intervention.
To accurately present to the public who we are and what we do, I am pleased to present the new secondary title for Infants and Young Children: An Interdisciplinary Journal of Early Childhood Intervention.
True to our new name, I am pleased to present an article by Michael Guralnick as our lead to this issue. He provides us with an expansion of his developmental system approach to early intervention. The systems perspective was designed to provide a common framework in which to integrate the diverse conceptual and practice approaches in the early intervention field. The complexity of both internal and external influences on child development is described, as are child risk and protective factors. These are illustrated within the context of intervention for vulnerable children and families through the operationalization of 3 interrelated mechanisms that promote a child's competence. In particular, these are: the child's developmental resources and organizational processes; the identification of environmental influences as demonstrated by a family's pattern of interactions involving the child; and the identification of those family resources that determine and are available to support optimal family patterns of interaction. This framework allows us to also examine and evaluate the moderating influences that a child's disability may have on overall family functioning and interactions and most importantly provides a platform from which the field of early childhood intervention can continue to evolve.
The next article by Hickman, McCoy, Long, and Rauh provides a thorough analysis of the contributions made by the field of physical therapy in early childhood intervention. The article begins by emphasizing the complexity and evolution of the field by reviewing its historic roots in early childhood special education, pediatric rehabilitation, and cognitive psychology. The article then presents a review of theories, models, and outcomes of early childhood interventions for children with motoric disabilities, and concludes with an integrated model that is based on the science of child development, contemporary systems theory, and family-centered support-based care. The authors present empirical evidence on intervention strategies that are consistent with this model. Recommendations for future research are also provided with a focus on the factors within a child's environment that may contribute to independent mobility and may be amenable to change by early intervention services.
Brown and Woods contribute an article with importance to personnel preparation and the collection of fidelity data on intervention practices. Their single-subject study across participants examined the effectiveness of systematic instruction on communication (SLP) students' implementation of family-centered interview procedures during a practicum experience. A modified AB design with replication across the students' adherence to ethnographic principles demonstrated a functional relationship between the instruction on interviewing and the students' implementation of the interview process. The intervention also included the use of graphic performance feedback and verbatim examples of the behaviors expected of the students. The study was conducted in a clinic, rather than a natural, environment to facilitate adherence to the study protocol within a controlled setting as the students were novice practitioners learning critical professional skills. The skills of family-centered interviewing are seen as an important component of any personnel preparation program in early childhood intervention and, as such, this study has implications for all disciplines that will provide services to children and families.
Comfort, Gordon, and Naples present an article that underscores the importance of parenting behavior to child development. They have been developing a tool to assist early intervention service providers in identifying variables that contribute to parenting quality, which in turn contributes to child learning and development. This article provides information on this tool, the Keys to Interactive Parenting Scale (KIPS), which can be used to enhance the quality and relevance of early intervention. The tool is a structured observational assessment consisting of 12 items, and this study assessed the use of the tool in comparison to other parenting assessments in a population of 397 diverse families who had children younger than 6 years. The families were assessed during 20 minutes of parent-child play to determine the reliability, validity, evaluative value, and clinical relevance of the KIPS. The data collected suggested that the KIPS offers a practical tool to describe variables related to parenting quality. The authors further suggest the use of the tool collaboratively with families to determine interventions, track progress, and document outcomes. The tool is a timely reminder about the interactional nature of early intervention, and the critical role parents play in the facilitation of their child's development.
Hurtubise and Carpenter provide an examination of role negotiation in parent professional partnerships in early intervention through the perspectives of 11 parents of children younger than 3 years. The parents were interviewed to identify their perception of both their role and the roles of professionals in the provision of services to their children. The findings revealed the families' perceptions, their expectations of professionals, and the evolution of these over time. The parents' initial reliance on professionals was documented, as was the change over time of the parents' role into one with greater responsibilities in the early intervention process. This ongoing role negotiation is hypothesized to be integral to the development of effective parent-professional collaboration, and the key to parent satisfaction with early intervention for their children.
Hanson, Miller, Diamond, Odom, Lieber, Butera, Horn, Palmer, and Fleming provide further evidence for Guralnick's developmental systems model. This research team studied an ethnically and geographically diverse sample of 1006 four-year-old children who were considered at risk for poor school performance. They were divided into 3 groups: children living in poverty, children with identified disabilities, and children whose families spoke a primary home language other than English (English language learners/ELL). Similar to most studies, maternal education level predicted child outcomes, but findings also indicated that neighborhood community variables explained differences in child outcomes beyond those contributed by child/family characteristics. The authors conclude that the context in which a child develops (both family characteristics and the neighborhood characteristics) has measurable effects on child development. While the authors caution that more research on neighborhood characteristics is needed, this study provides evidence that early disparities in young children's lives affect later child development. As such, the authors conclude that interventions focused on enhancing a family's ability to provide enriching learning opportunities should be provided to those who may experience risks associated with living in stressful environments.
Johnson, Brown, Chang, Nelson, and Mrazek provide a comprehensive cost analysis on 2260 infants and toddlers participating in the Part C program in Hawaii. This article provides an examination of variables of interest to the nation as most states such as Hawaii are facing budget shortages that affect services under their Part C programs. Of most concern is the number of states that are restricting eligibility for intervention services, thus reducing the numbers of children who may need and benefit from the Part C program. As there have been only a couple of published studies on the cost of the Part C program, this article provides an illumination look at the complexity of the program and the challenges to isolate cost variables in relation to services delivered and outcomes achieved. The variables that were examined included the cost of serving children with various percentages of delay, the cost of providing care-coordination services, and the administrative costs for local- and state-level providers of Part C services, including the cost of transportation. The authors also analyzed the cost of serving 2 special populations of children: (1) children receiving Medicaid compared with children not receiving Medicaid and (2) children with an autism spectrum diagnosis compared with children without an autism spectrum diagnosis. The authors identified many of the concerns that have been acknowledged through the evolution of the Part C program across the country, such as the limited intervention contact time with families, services that may not be sensitive to individual needs of children and families, and a more restricted service population. Most importantly, the authors point out that the growth of early intervention service models within systems restricted by budget shortages may result in eroding the very purpose of the Part C program. These authors remind us that we have yet to address the critical service question raised by Hebbeler, Levin, Perez, Lan, and Chambers (2009), “Who achieves what outcomes as a result of what services provided at what cost?” (p. 85).
As always, I thank the authors who have contributed their work to this issue. I am pleased to acknowledge a number of articles by those in the AUCD network, those who are novice authors and those from outside the United States. In reading the articles, I find ample evidence that our field is increasing its knowledge base. Our next step is to translate this knowledge into early childhood intervention strategies and models that result in positive outcomes for all infants and young children and their families. And, in Jim Blackman's words in the first issue of IYC:
The exploration into how this support (to young children and their families) may best be accomplished—addressing such questions as who, what, where, when, how, and at what cost, must continue and expand.}
And it will, under the new description for Infants and Young Children, An Interdisciplinary Journal in Early Childhood Intervention.
—Mary Beth Bruder, PhD
©2011Lippincott Williams & Wilkins, Inc.