Synergy had been defined as 1) the increased effectiveness that results when two or more people or entities work together; and, 2) the interaction of elements that when combined, produce a total effect that is greater than the sum of the individual elements.
This concept serves as the foundation of effective and efficient early childhood intervention (ECI).
Synergy begins with the core of ECI: families. A relationship between a family and their child's ECI service providers is created at the beginning of a family's journey in ECI, and continues throughout every phase of service delivery: assessment, design, delivery and evaluation. The relationship should be one of respect and trust, with the result being a partnership between a family and service providers for the child's benefit. If a partnership is not apparent in every interaction a family member has with ECI providers, they will disengage. One result of this being fewer opportunities to focus on facilitating the child's development and behavior in collaboration with service providers. As the family is with their child far more often and across many more activities than a service provider, the overall efficiency and subsequent effectiveness of learning will be diminished for the child.
Likewise, if different service providers representing different professional disciplines in ECI do not understand and/or value a synergistic model of service delivery, the result is an inefficient and ineffective model of service delivery. The individual efforts of one service provider intervening with a child and family in isolation of others has negative repercussions for all involved. The complexities of development and behavior in each child receiving ECI necessitates expertise integrated across developmental areas into one learning plan. As we know, infants and young children do not develop or learn in discipline specific domains of practice.
Lastly, synergy must be demonstrated by agencies and organizations representing different sectors of service delivery; as they each may have different mandates, eligibility requirements, service options and outcomes. If not coordinated, the family must navigate each separate entity to get the services and supports they and their child need. Service integration across all agencies and organizations providing ECI is necessary and integral to the realization of an efficient and effective service systems that will achieve positive outcomes for all.
This need for a synergy across families, practitioners and service delivery agencies is not unique to the United States. As we prepare to come together for the International Society of Early Intervention Conference in Stockholm on June 8-10, it is apparent that ECI has created a synergy across the world. Let us work together to build, refine and adopt synergistic systems of ECI that are efficient and effective and international in scope and impact.
The first article represents the importance of synergy with families when identifying children's developmental needs. Jennifer Marshall, Martha Coulter, Peter Gorski, and Aldenise Ewing conducted a study with 23 parents who had young children with developmental or behavioral concerns. A mixed method design used interviews, focus groups, and questionnaires to assess parental knowledge of child development and children's developmental status. One finding was that the parents' knowledge of child development was low; however, another finding was that the parents' observation skills accurately identified their child's needs across development, temperament, health status, and environment. Recommendations are provided for parent education, and the use of their concerns in the referral process.
Our next two articles represent the importance of synergy across community service providers. Sallie Porter, Rubab Qureshi, Barbara Ann Caldwell, Mercedes Echevarria, William Dubbs, and Margaret Sullivan surveyed 57 pediatric providers in one state on the surveillance and screening practices they used. Most primary care pediatricians reported that they conducted screening on their patients beginning at their first office visit at 3-5 days of age. About half continued to screen and use surveillance at all visits and the other half conducted screening and surveillance at well child visits. Most reported using a screening tool. Disparities in practices were also identified, and recommendations on how to address these are provided.
Angel Fettig, Erin Barton, Alice Carter, and Abbey Eisenhower used electronic coaching to implement intervention on a young child's challenging behavior. The e-coaching used video conferencing to deliver weekly training and support and the early intervention provider. A functional relationship between the e-coaching and the behavior intervention components was demonstrated through a multiple baseline design. Most importantly, the child's challenging behavior decreased. Implications for future practice are discussed.
Our next article provides an example of the importance of synergy across service agencies and organizations to families and the subsequent benefits to their child's development. Marcia Hughes, Allison Joslyn, Morella Wojton, Mairead O'Reilly, and Paul Dworkin contributed a description and evaluation data on the Help Me Grow program. The purpose of this program is to connect vulnerable children to community-based programs and services, and to strengthen parents' perceptions of protective factors that help their family and child grow and develop. A parent survey was used to assess on parents' perceptions of family circumstances and children's development using the Strengthening Families Protective Factors Framework. Case notes by care coordinators were also assessed to examine the families' use of strategies for promoting protective factors. Parents reported a positive change in their family circumstances and a strengthening of protective factors. Future use of this model are discussed.
Lastly, our international article is a contribution from China. Bi Ying Hu, Chih-Ing Lim, and Brian Boyd examined the quality of engagement and interaction of children with disabilities in inclusive kindergartens in China across five types of activities (i.e., group teaching, mealtime, self-care, play, outdoor activities) and subject matter for whole-group lessons (i.e., music, story telling, art, language art, math and science, and general knowledge or life skills). The study included thirteen children with varying disabilities from five inclusive kindergarten programs in Beijing. A total of 127 observation sessions were collected across the five activities and the results indicated there were differences in the level of engagement and interaction for children with disabilities across activities and subject areas. Implications for practice and future research are discussed.
As always, I thank the authors in this issue who chose to submit their work to IYC, and I thank the editorial board members who participated in the editorial process for this issue.
—Mary Beth Bruder, PhD