Relationships are about the way people are connected to one another. Relationships can be close, distant, loving, tolerant, respectful, long-term, short-term, cooperative, collaborative, or any of a number of other qualities. The definition of relationship is connectedness to another person or entity; that is, a relationship can be described as a connection between persons who share a common purpose and outcome. Thus, relationships form the basis of our personal life, our community life, and our work life.
Early Childhood Intervention (ECI) is a field that has been built on relationships: the relationship between a vulnerable child and his or her parent(s); the relationships between a parent, child, and a service provider; the relationships between a service provider and other persons in a child and family's life; and the relationships between and among service providers serving the child and family. I needn't go on as Urie Bronfenbrenner illustrated these relationships quite well in his ecological theory of child development (Bronfenbrenner, 1979). Using his theory, the interrelationships between and among persons, environmental contexts, and experiences contribute to a child's developmental and behavioral competence.
Unfortunately, developing and maintaining relationships can be hard, even in ECI. I am reminded of this every time I learn about a parent who is labeled as noncompliant, or a child who has behavior problems and has been suspended from preschool, or a service provider who doesn't understand how important and motivating he or she is to a child, the child's family, and their learning, or a service provider who doesn't respect or know how to communicate with others on a service delivery team. I wish I could say these are hypothetical examples, but I cannot. In fact, I have witnessed each of these situations in the past week, all within ECI. Situations like these make me wonder if sometimes we forget what ECI is all about: helping a child and family learn and be successful across and within their current and future environments. My conclusion is simple: If we want families and their children to thrive and make progress because of ECI, we need to promote child learning and development through supportive, purposeful, and productive relationships in all that we do and with all whom we interact.
Our first article addresses the state variability in eligibility criteria for services in the Part C of IDEA (Individuals with Disabilities Education Improvement Act) program across the United States. Brian Barger and his colleagues examined eligibility criteria under the category of diagnosed conditions used by state early intervention (EI) programs. Data for eligibility in each state were gathered through websites and state Part C coordinators. More than 629 unique conditions were identified from 49 states, the District of Columbia, and four territories, and there was little uniformity in numbers and types of conditions across states. Furthermore, no single condition was identified by all states that qualified a child for automatic eligibility for their state Part C program. The authors provide recommendations for policy reform to ensure equity of access to EI for children and their families, regardless of the state in which they live.
The next two articles focus on the importance of family support in ECI. Kimberly Cosgrove and colleagues describe a pilot project focused on families with children with disabilities living in a high poverty urban area. Early intervention providers used the FAN (Facilitating Attuned Interactions) approach to building parent–professional relationships by learning to understand parent concerns and their ability to collaborate during EI sessions. During the project, the providers felt more empathic with parents, more collaborative, and more effective and satisfied in their roles. The authors recommend FAN as a tool to strengthen parent–professional relationships during EI.
The next article by Deanna Gibbs, Phillip Harniess, and Siew-Lian Crossley examined the needs of families who had infants who were in a neonatal intensive care unit (NICU) and received EI both in the unit and when transitioned home because of continuing and complex neurodevelopmental needs. Six mothers who had children in this situation were interviewed and their responses were recorded, transcribed, and themed. The qualitative analysis yielded four key themes across the experiences of the families. The themes led to the identification of attributes that facilitated parent–provider relationships for these families, and these included collaborative communication, family support, and clarity about EI services. The authors conclude that EI started in the NICU for families of infants with complex needs provides needed support that can continue after transition to home and the community.
The next two articles provide information for those preparing and supporting service providers from different disciplines to deliver ECI. Beth Elenko describes an occupational therapy (OT) preservice training program that has offered advanced training to students in early childhood intervention for almost 20 years. The training focused on teaching students how to use family-centered best practices in OT service delivery through a family partnership experience that has evolved over time. The experience included assignments that were implemented through visiting a family in the home and community. Both qualitative and quantitative data suggest the success of this experience on the students' knowledge and skills.
Finally, the process used to identify common areas of professional competencies across disciplines in ECI is described. This effort was led by the Early Childhood Personnel Center (ECPC), which is a technical assistance center funded by the Office of Special Education Programs in the U.S. Department of Education. Representatives from seven professional organizations representing different disciplines and stakeholders have been working together with ECPC over the past 5 years. The workgroup reviewed alignments of personnel standards and practices used to guide ECI across the professional disciplines and identified the areas of practice that crossed all disciplines. These are Collaboration and Coordination; Family-Centered Practice; Evidence-Based Practice; and Professionalism. The boards of each of the following organizations approved these four areas of common competencies for ECI service providers: the American Occupational Therapy Association (AOTA); the American Physical Therapy Association (APTA); the American Speech-Language-Hearing Association (ASHA); the Council of Exceptional Children (CEC) and the Division of Early Childhood (DEC); the National Association for the Education of Young Children (NAEYC); and ZERO TO THREE.
I would like to thank the authors for submitting their work to Infants & Young Children and the reviewers who assisted the editorial process through their generosity of time and expertise.
—Mary Beth Bruder, PhD