Decisions, decisions! In many respects, a seemingly constant activity for all of us involved in early intervention is to make decisions and to properly utilize information to ensure that those decisions are appropriate and useful. Providers, in particular, faced with children who have complex, ever changing needs develop their own, often idiosyncratic, decision strategies as they work their way through the clinical process. In this issue, IYC provides some guidance to professionals by describing decision processes for children who could benefit from assistive technologies and for those with complex feeding disorders. Models for each of these circumstances provide step-by-step guidance to facilitate thoughtful decision-making.
Other important service issues are also considered in this issue of IYC. Locating a medical home for all children with special health needs is a major focus at national and state levels. As described, despite the name, medical homes represent interdisciplinary collaborations at their most demanding. Equally difficult service issues are those intended to promote the social and communicative development of children with autism spectrum disorders. Professionals and parents are faced with numerous decisions in this instance, given the many approaches to address this problem that are available. IYC brings you a description of one important comprehensive program, well grounded theoretically and empirically. One should not underestimate the value of a coherent, well-organized approach to intervention.
As all good clinicians know, even routine activities can serve many functions. In a discussion of the comprehensive interdisciplinary process, we see how that approach can, if done well, also lead to important, often unintended, benefits for families that include enhancing positive interactions with their child and providing a foundation for future early intervention activities. But, to become a “good” clinician, especially an early interventionist, one must be immersed in the complexities and varying perspectives of all involved. Toward that end, IYC presents a discussion of the case method of instruction, an important technique that promotes growth by encouraging self-reflection and analysis. In that way, decision-processes taking multiple perspectives into account begin to be internalized by the clinician as he or she fully participates in the early intervention service and support system.
Finally, IYC takes a step back and a step forward by providing a fascinating follow-up study of families of children with Down syndrome who participated in early intervention programs a quarter-of-a-century ago. These reports are valuable in their own right, but it is equally important for early intervention professionals to have this longer-term perspective of the challenges faced by graduates of their programs. It is important also for us to consider how contemporary early intervention programs can be adjusted to provide the foundations to meet the needs of children as they grow older.