This summer, in the midst of the coronavirus pandemic and continued racial injustice, John Lewis died. He was a congressional representative and a hero of the civil rights war that is still occurring in the United States. His last act for the country he loved was an editorial he left to be published on the day of his funeral. In it, he called on all Americans to act, stand up, speak up, and speak out when we see an injustice or something that is not right.
Early childhood intervention is a system that is showing strain under the never-ending assault of the coronavirus. Developmental screenings and evaluations of infants and young children have decreased across the country, resulting in a drastic decline in enrollment in early childhood intervention services. Most concerning has been the growing number of families who have eligible infants and young children who are opting out of formal intervention. In addition, there has been a decrease in the amount and intensity of intervention being delivered to preschool-aged children with disabilities because of remote learning and reduced school hours.
While these situations are discouraging, perhaps of most concern is the social inequity that has been exposed by the pandemic. That is, a significant number of families with young children with disabilities are not participating in intervention because of their financial situation. Computers, tablets, Internet access, phones and other tools to access intervention are nonexistent in many low-resource households, especially as the pandemic has cost so many their jobs. This situation is compounded when families also experience racial or language barriers to services.
As we work to address the issues surrounding service delivery, let us remember the last words of John Lewis. All families and their children deserve equitable access to quality services, no matter what their financial situation, their race, or primary language. As a field, we must make this happen and end inequality in service delivery for our most vulnerable children and their families. We must act, stand up, speak up, and speak out.
Our first article, by Carmela DeCandia, Katherine Volk, George Unick, and Laura Rose Donegan, presents information about the development process for a screening tool targeting young children. The tool adopted an ecological framework to measure the development of children from low-resource settings across three domains: child, caregiver, and the environment. After a validation process, the tool was transferred to an online, user-friendly delivery platform and piloted with 60 children aged 3–5. The results suggest the feasibility of using the tool to identify young children at risk for developmental delay who live in low-resource settings.
Our next three articles used single-subject designs to evaluate interventions with preschool-aged children with disabilities. The first, by Jessica Tupou, Hannah Waddington, and Jeff Sigafoos, describes a teacher coaching program for preschoolers who have autism spectrum disorder. The children attended an inclusive preschool, and three general early childhood teachers were coached in the Early Start Denver Model. A multiple-baseline design evaluated the teachers' use of the early intervention techniques and children's levels of participation, imitation, and communication. The teachers improved in their use of intervention techniques, and children demonstrated improved levels of active participation that was maintained at follow-up probes. These results support the use of this coaching program to train teachers on this model.
Aaron Deris, Cynthia DiCarlo, Dana Wagner, and Kellie Krick Oborn integrated literacy interventions into free-choice activities in three inclusive preschool classrooms with nine children. The study used a multiple-baseline design to demonstrate the effectiveness of a teacher-mediated environmental modification on the children's engagement with literacy during a free-choice center time. The children's literacy behaviors all increased from baseline, supporting the effectiveness of the intervention on improving child literacy behavior within classroom activities.
Hunter Gast, Collin Shepley, and Justin D. Lane describe a study that used a multiple-probe design across behaviors to address food selectivity issues with three preschoolers with disabilities. The intervention was implemented during mealtimes in the classroom or lunchroom, with peers and a school-based staff member as the instructor. Although the intervention did not result in increased consumption of nonpreferred foods, exploratory behaviors with food increased for all children. The authors discuss future directions in treating food selectivity using resources available in preschool settings.
Our last two articles addressed the needs of families in early childhood intervention. Juan Bornman, MaryAnn Romski, Marika Rebecca King, Vuledzani Princess Madima, and Rose Ann Sevcik implemented focus groups to evaluate the feasibility of a mobile health application for early intervention in South Africa. Thirteen caregivers and 10 speech–language pathologists participated in focus groups to share their perspectives about the usefulness of the mobile health app. Caregivers focused on the benefits of the app for increased knowledge and skills, empowerment, and reduced cost of services. Speech–language pathologists focused on the ability of the app to enhance and increase service delivery involving caregivers. The authors recommend the perspectives of all stakeholder groups be included when introducing new technology into service delivery.
Our last article, by Phoukim Savanh Bouchard, Marilyn Aita, and Marjolaine Héon, described how the birth and hospitalization of a premature baby may affect siblings. Fourteen articles about siblings' needs, behaviors, and interventions were reviewed and synthesized. The authors discussed how the information provided in this narrative review could help parents and neonatal nurses who may not be aware of the importance of supporting siblings. The authors recommend further studies on interventions to promote sibling adaptation to the birth of a premature baby who spends time in an NICU.
As always, I would like to thank the authors for submitting their work to Infants & Young Children and the reviewers who assisted the editorial process to bring these manuscripts to publication. The articles represent international authors, new authors, and interdisciplinary groups of authors.
—Mary Beth Bruder, PhD