Meeting Early Intervention Challenges: Issues from Birth to Three, 2d ed.

Meeting Early Intervention Challenges: Issues from Birth to Three (Second Edition) L. Johnson, R.J. Gallagher, M.J. LaMontagne, J.B. Jordan, J.J. Gallagher, P.L. Hutinger and M.B. Karnes 1994 Baltimore, MD: Paul H. Brookes Publishing

This text is an expanded sequel to the first text, Early childhood special education.' Birth to three, which was published in 1988 by CEC. The intent of the authors was to produce a forum to discuss current issues in early intervention services and to provide recommendations. "These authors made a commitment to providing readers with practical recommendations that are applicable to the many dimensions of early intervention service delivery and programming." Their aim was to "grapple with reality of these issues and seek some plausible answers given our current knowledge and practice." The second edition stresses the necessity for collaboration among disciplines serving the needs of young children with disabilities and the value of family involvement.

The contributing authors are a sterling lineup of some of the best minds in the nation this topic. Most not only have at least fifteen years experience directing state or federal programs but have also considerable research experience. The text appears to have been written to be used as a college text for special education classes and seems also to be an invaluable resource for persons in leadership positions in agencies serving disabled young children. There is great need for a comprehensive text such as this.

The book is well organized for use as a classroom text or reference. It begins with an overview of the challenges facing early intervention such as, "What does the concept of `family centered' mean to practice? .... How will the various disciplines, each with its own `languages' and traditions, form an effective service team? .... Can public policy empower parents to play a significant role in early intervention?" The overview is followed by twelve chapters, each of which addresses one of the challenges facing early intervention. Each chapter begins with a paragraph or two that states the goals and intent of the chapter.

Chapter one presents the evolution of family-centered services. There is a historical overview with an emphasis on different theories and models of family involvement, followed by a discussion of variables (culture, resources, consensus, expectations) that impact family-centered intervention systems. Chapter two presents model programs for infants and toddlers and their families. Rather than describe specific models, the authors synthesize characteristics of thirty-four projects. Philosophy, assessment procedures, family services, administration, delivery models, staff development, and program evaluation are mentioned. Chapter three focuses on "elements of services for children and reflects some of the changes to expect as we begin to mesh accepted early childhood concepts with intervention practices.." Readers will appreciate the clear description of practical steps for identification, diagnosis, assessment, curriculum, and planning an Individualized Family Service Plan (IFSP).

Chapter 4, "The Transdisciplinary Team", will interest a wide range of readers and should be very useful to providers struggling to improve collaborative efforts and to use resources more efficiently. There is sufficient discussion that any agency wishing to move from multidisciplinary team structure to transdisciplinary team structure could use this chapter as a how to manual. It's also must reading for any graduate student who is preparing to provide direct services to young children since it clearly delineates what to expect when you are a member of different types of team structures. This reviewer has already passed the chapter on to colleagues who supervise such teams. The step-by-step description of arena assessment, in particular, is an invaluable reference for both students and experienced professionals.

Chapter five, "Administrative Challenges in Early Intervention", presents four models of administration. Basic leadership tasks and characteristics of effective teams are highlighted. The chapter is full of practical ideas, including a team effectiveness rating scale, samples for interviewing potential team members, suggestions for planning for planning and scheduling. Even administrators with considerable team building experiencing are likely to find useful, new information.

Chapter six, "Defining the Infancy Specialization in Early Childhood Special Education, is one of the most well-written chapters in the book. It is a succint discussion of the uniqueness of services to infants. This chapter would be valuable as required reading for infant specialists in any discipline. The authors address the nature of the infant as learner, medical issues, the centrality of the attachment relationship, competencies of early intervention specialists, and the infancy specialization in early childhood education.

Chapter seven describes the three phases of program evaluation: input, processes and output. In addition to an overview of the basics of program evaluation are realistic suggestions for practical strategies in evaluation of early intervention programs. Especially helpful are the practical ideas for how to handle the absence of preprogram measures and nontreatment groups.

Chapters eight, nine, ten, and eleven all address policy issues. These chapters may be the most interesting reading for experienced providers working at state and federal levels. It's a very comprehensive and timely discussion of the issues affecting policy. This reviewer found Patricia Place's description of present and future challenges faced by policy makers intriguing, given the national dialogue about family values and the rights of children and families. "Although the definition of parent is included in the federal Part H regulations, these regulations do not define family...Is a partner who lives full time with the child and the child's parent a family member who, by law, must be provided services? .... How does a state determine who is a member of the family?"

The last chapter distinguishes collaboration and cooperation in early intervention practices. The authors provide a solid rationale and several recommendations for fostering collaborative climates without delving into specific strategies. Their suggestions supply food for thought for those training future collaborators.

A strength of the book is the authors' willingness to raise unanswered questions, suggesting future trends and directions for study. Another strength is the timeliness of topics. For example, the impact of HIV/AIDS and technology on issues is addressed in several chapters. The potential impact of health care reform is surprisingly neglected, especially in the chapters dealing with policy. There is some brief mention of funding strategies in chapter nine, but this reviewer was surprised that in all the discussion about transagency collaboration and integrated services there wasn't a more focused discussion about funding strategies, particularly given the national debates about medicaid, medicare and health care reform.

The text does get a bit weighty at times. There is some redundancy in the writing. The same points are made several times, sometimes even within chapters. For example, the issue of misuse of assessment instruments as screening devices is mentioned repeatedly. Also, there are occasions when overexplaining is used when an illustration or example would have been more effective. The university instructor may wish to assign pertinent chapters for reading rather than the whole text due to this weakness, but the repetition is only a minor annoyance.

This text has something for everyone. As a college text it is comprehensive, timely, and well organized. As a reference for direct care providers it is full of practical strategies, "how-to" steps, and references. Researchers and policy makers will find thought provoking questions and suggestions for further study.

Reviewed by Maureen Neihart, Clinical Psychologist, Billings, Montana, and a member of the Editorial Advisory Board of the Roeper Review.