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The many faces of early intervention.

The Many Faces of Early Intervention

In one way or another, early intervention has been around since the turn of the century, when maternal and child care programs were added to public health services. These services have been continued and expanded through the years to include not only health service oriented and related, issues but also experiences that would lead to optimal development for the child. Most recently, services designed to meet the needs of the entire family, including siblings and grandparents, have been added to early intervention services.



For parents looking for services for their baby or young child, early intervention will always seem very new and probably very confusing. It is confusing because early intervention is not one thing, but many different things.

In some programs, medical care is provided for newborns who are born at risk. In others, professionals come into the home to help parents learn to care for the child. Other programs have "classes" where young children come and play together. Still others have "classes" where parents meet to learn and share experiences. In some cases, physical and occupational therapy is delivered.

Some programs serve children with only one type of problem, while others serve children with various problems in the same program. Some children are served in regular day care programs, some in Head Start and some in specially organized schools serving only "special-needs" children. Many times early intervention services are provided by school districts.

Most of the programs, however, are a combination of all these possibilities. Depending on the child's individual needs and age, any combination of the large number of possibilities may be the best.

For new parents, who are just beginning the challenge of helping their special child, early intervention will most likely seem like a maze. The following list can be helpful in understanding the characteristics of services that may be available in your community.



Recipient of Service--Infant or child, parents (usually mother), primary care provider, siblings, grandparents or any combination. Ages Served--Birth to 6 months, birth to 1 year, birth to 2 years, birth to 5 years, 2 years to 5 years, or any combination. Persons Providing the Service--Trained volunteers, trained paraprofessionals, teachers, physical and occupational therapists, speech therapists, psychologists, social workers, nurses, physicians, or any combination. Focus of the Services--Motor Development, Cognitive Development, Social Skills, Self Care Skills, Language Development, or any combination. Location of Services--Hospitals, Public Health Facility, Family Home, Rented Space in Public or Private Building, Head Start Programs, Private Agencies, Regular Day Care, Special Day Care, Schools, or any combination. Length of Service--2 hours a month, 1 hour a week, 1 hour a day, or 3 hours a day. Agencies Responsible--Public Health, Public Education, Specially Created State Agency, Private Corporations, Parent Groups, or any combination. Funding for Services--State Public Health Monies, State Education Monies, Local Health and Education Monies, United Way/other community donation, Tuition, Federal Funds, or any combination of above.


At this time, no one is sure which is the best type of early intervention. When results of the programs that have been in existence for some time are examined, there is very little definitive proof that one type is better than another or that one method is better than another. Although almost all parents and professionals like early intervention and recommend it, there is little clear-cut scientific proof to show that children and/or families function better when early intervention is part of the early years of children who have disabilities or are at risk for disabilities.

The Early Intervention Research Institute at Utah State University has examined the records of projects that have been pioneers in the field and found that some important questions cannot yet be answered. Some of these questions are: 1. Is more parental involvement better? 2. Are results better if a child begins earlier? 3. Is a longer and more intense program better? 4. Is more structure better? 5. What kind of training is best for teachers and others? 6. Is it better if it is coordinated with the public schools? 7. What type of curriculum is best? 8. Is service in the home better than service in a center? 9. Should each child have a specialized program? 10. What is the best child-to-teacher ratio?


It may be many years before we have definitive answers to these questions. The Institute is now implementing longitudinal studies to investigate some of these questions. Each of the studies is designed carefully and will follow the children for a period of years. The costs of each of the programs are assessed. Each study has assigned families randomly to various treatments so comparisons can be made in as unbiased a manner as possible.

Each family participating in these studies fills out a parent consent form that informs the participant of the purpose of the research. The study involves the random assignment of an infant to one of two treatment conditions. The parents are told they have a 50/50 chance of being assigned to the expanded services intervention program. Unfortunately, it is not possible to provide the expanded services to all children.

The potential benefits to an infant from this research are the possibility of improved functioning. In addition, all infants will receive a complete assessment, which would not have been available previously. All records pertaining to the infant are kept confidential; he or she will not be identified by name. Parents can withdraw from the study at any time.

Assessment is made of a child's progress by a trained person who is not associated with the program and has no personal bias about the program. This means that the individual responsible for evaluating the progress of the child will not know in which program the child has been involved, nor will this individual's job security be related to the "success" of a program. Protections of this kind make it possible to describe the results as objective. In addition, descriptions of the families are gathered. Measures will be taken annually to determine not only the immediate impact, but also the long term effectiveness of the programs.

The studies and their focus are explained in following chart. As these brief descriptions show, children in the control group receive a general program of early intervention, while children in the variable group receive a more specific program that varies the amount of time, the people involved and the place where the intervention occurs. By structuring the research in this manner, the programs should provide some answers to the questions aforementioned, by showing that one program is clearly better than another.

Of course, it is exciting to know that all of these research projects are happening, but parents with young children cannot wait for the results, because children are young only once. Today's parents must use their own judgement in deciding how best to provide for the needs of their children.

Brief Descriptions of Ongoing Longitudinal

Studies of Early Intervention STUDY 1 Children: Brain Hemorrhage or Low Birth Weight Age: 3-15 months Comparison: Medical follow-up only VS. Home training to parent by paraprofessional in all areas of development twice monthly plus a medical follow-up STUDY 2 Children: Visually Impaired Age: birth-30 months Comparison: Weekly parent-infant session, parent given information to help child with all areas of development--back up staff and paraprofessional teacher VS. Twice monthly one hour parent meeting and assigned readings. STUDY 3 Children: Hearing Impaired Age: 22-36 months Comparison: Once a week center service; monthly home visit VS. Intense language program; weekly group sessions; one 2 hour individual session plus monthly home visit STUDY 4 Children: Mild to Severe Disability; various disabilities Age: birth-4 years Comparison: Four home visits by paraprofessional teacher who designs individual goals and brings toys VS. Eight visits per month, same program STUDY 5 Children: Severely Disabled; various conditions Age: 4-27 months Comparison: Once a week individual parent/child session in center in all areas of development VS. Three times per week, same program STUDY 6 Children: Brain Injured Children; victims of severe trauma Age: birth-3 years Comparison: Medical follow-up only VS. Medical follow-up and immediate or later in-home assistance with all areas of development STUDY 7 Children: Brain Hemorrhage at Birth (IVH) Age: 3-42 months Comparison: Medical follow-up only VS. Twice a month 1 hour session with licensed physical therapist instructing parent/child in all areas of development and a medical follow-up STUDY 8 Children: Severly Disabled; various disabilities Age: 10-34 months Comparison: Parent group operated day care center based; in-service training for paraprofessional teachers VS. Classroom instruction and in-class feedback for paraprofessional teachers STUDY 9 Children: Moderate to Severe; various disabilities Age: 35-72 months Comparison: Center based program VS. Center based program plus parent training STUDY 10 Children: Mild to Severe; various disabilities Age: 22-50 months Comparison: Center based program VS. Center based program plus parent training STUDY 11 Children: Hearing Impaired Age: 18-60 months Comparison: Oral/aural VS. Total communication STUDY 12 Children: Moderate Speech Disorders Age: 3-4 years Comparison: Home based trained parents VS. Center based trained child STUDY 13 Children: Down syndrome Age: birth-5 years Comparison: Extensive interdisciplinary center based program VS. Above program and individualized parent training and support by licensed psychologist and social worker Current issues are described more thoroughly in Carol Tingey's new book, Implementing Early Intervention, excerpted in this issue's From the Bookshelf.
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Title Annotation:ongoing research
Author:Tingey, Carol
Publication:The Exceptional Parent
Date:Jan 1, 1989
Previous Article:He opened his eyes and smiled; a father's story of early intervention and stimulation.
Next Article:The search process: choosing an early intervention program.

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