Early Intervention 9/25 Flashcards
Broad definition of “early intervention”
Any intervention delivered early (before school age)
Or
Early in progression of illness (e.g. early intervention for schizophrenia)
Narrow Definition of Early intervention
“Part C”
Publicly funded program to provide services, education, and support for children ages 0-3 and their families/caregivers
Serves a population of children who:
Have a DD
Have an “established condition” with a high probability of DD
At risk for developing a delay or special need (in a few states)
What established services for children ages birth through their third birthday?
1986: EHA Revision (Now Part C of Individuals with Disabilities Education Act)
What are the 4 goals of Part C Early Intervention?
- Enhance development of infants and toddlers with disabilities
- Reduce educational costs by minimizing need for subsequent special education as a result of EI
- Minimize likelihood of institutionalization, and maximize independent living
- Enhance the capacity of families to meet their children’s needs
Theoretical Basis of EI
Younger brains more plastic
More neurological difference: Zone of modifiability
Ex. Cochlear implants
Early difficulties create “Development Cascade” of issues.
Early intervention that ______ later problems is less costly (both in monetary and social terms) than providing lifelong services and supports
PREVENTS
Persistent stress/lack of education opportunities can
impact neurological development
lead to significant delays, disabilities, and other poor long-term outcomes for children
Ex: poor children more likely to repeat grades and be high school dropouts
Perry Preschool Project
Successful in the 1960s Michigan with 3-4 year olds
Preschool or no preschool randomized
Adult-child interaction and shared play, high degree of parent involvement, social-emotional AND academic
Less likely to be arrested, more likely to earn 20k+ at 40 and graduate high school
Head Start Impact Study
1998 3-4 year olds (head start or control group other preschool)
Followed through 3rd grade. At the end of program, favorable outcomes, by end of K, small group differences, few sig impacts end 3rd grade
Why was Head start less effective than the model programs studied in RCT’s?
Perry program had parents involved and taught social/emotional skills too.
Essential EI Components
- Family/home nurturing contexts
- Strengthening relationships essential feature of EI/ECSE
3.Children learn through acting on/observing environment - Adults mediate children’s experiences to promote learning
- Participation in more developmentally advanced settings with support is required for later independent participation
- Individually and dynamically goal-oriented
- Transitions enhanced by adult
- Families and programs influenced by broader context
What is a therapeutic model that is “Clinic-based” /private therapy?
Direct Service Provision
What are characteristics of parent TRAINING model?
- Service provider trains parent on specific strategies for promoting development at home
- Structured/formal curriculum focused on specific goals
- Parent is the primary/direct agent of change for the child
Characteristics of Parent COACHING model?
- Parent drives goals and contributes to development of strategies
- Provider supports parent through providing evidence-based strategies, modeling, coaching, and reflective questioning with parent
- Based on a session framework and driven by specific parent-directed goals, but does not use a pre-specified curriculum due to the need to choose strategies based on current needs and goals
Parent Training vs. parent coaching?
Training: provider trains parent on strategies, structured curriculum.
Coaching: Parent drives goals, no pre-specified curriculum.
Early Head Start Partnership (Skip?)
0-3 year old children
Qualify for publically funded child care (at or below poverty line)
Columbus. many with DD.
Barriers:
-recognition of DD/needs
-referral to EI system
-navigating referral and evaluation process
-follow-through with (and effectiveness of) services once child qualifies
Although many specific models have evidence within their fields for efficacy (e.g. speech, PT, OT techniques)? What are the limitations? (Maybe direct service model specific)
Many studies done on non-representative or small samples, particularly when it comes to service barriers
Generalization to “Real-World” settings and long-term outcomes often not robustly assessed
In what sense is part C early intervention “evidence based”?
philosophy, theory, and many of the pieces that are intended to be incorporated into EI programs are based on current knowledge and research on child development.
In what sense is Part C EI NOT evidence based?
research on whether it is effective—as currently delivered in the community—is extremely sparse.
Do children have a legal right to receive EI services (IDEA Part C)?
Yes
Barriers to studying EI effectiveness
Services variable across states, regions, providers, children/families
Children in EI have variety of needs and diagnoses
National EI Longitudinal Study (NEILS)
Department Education, 1996-2006
EI outcomes. 20 states
Who gets services:
1991: ~200,000 children (1.77%)
2020: ~437,234 children (3.70%)
Did NEILS have more or less african american and poor children than are in the general population?
More
What did 14-16% of families say they needed from EI that they didn’t get?
Finding child care, info on rec activities, other agencies and services that might help their child.
