Gap: Early Childhood Intervention and the Development of the Disabled Child
Children with special needs include those who have disabilities, developmental delays, are gifted/talented, and are at risk of future developmental problems. Early intervention consists of the provision of services for such children and their families for the purpose of lessening the effects of their condition. Early intervention may focus on the child alone or on the child and the family together. Early intervention programs may be center-based, home-based, hospital-based, or a combination. Early intervention may begin at any time between birth and school age; however, there are many reasons for it to begin as early as possible. Early Intervention is the key to achieving the most positive outcome in aiding the disabled child to develop as normally as possible.
There are three primary reasons for intervening early with an exceptional child: to enhance the child's development, to provide support and assistance to the family, and to maximize the child's and family's benefit to society. Child development research has established that the rate of human learning and development is most rapid in the preschool years. Timing of intervention becomes particularly important when a child runs the risk of missing an opportunity to learn during a state of maximum readiness. A child may have difficulty learning a particular skill at a later time, if the most teachable moments or stages of greatest readiness are not taken advantage.
Early intervention services have a significant impact on the parents and siblings of an exceptional infant or young child. The family of a young exceptional child often feels disappointment, social isolation, added stress, frustration, and helplessness. The stress of the presence of an exceptional child may affect the family's well-being and interfere with the child's development. Families of handicapped children are found to experience increased instances of divorce and suicide, and the handicapped child is more likely to be abused than is a non-handicapped child.
A third reason for intervening early is that society will reap maximum benefits. The child's increased developmental and educational gains and decreased dependence upon social institutions, the family's increased ability to cope with the presence of an exceptional child, and perhaps the child's increased eligibility for employment, all provide economic as well as social benefits.
The reasons for early intervention are clear. However, many early intervention programs fall short in providing the child a well-rounded development. An effective early Childhood Intervention Program must not only address the academic aspects of the disabled child's development, but must also address the physical, psychological, social, and spiritual development in the contest of family, relationships, and culture of the child as well. This paper will address the current situation and evaluate current programs for their effectiveness in achieving a well-rounded program for pre-school disabled children. It will also examine the elements needed for a program to be successful.
Is Early Intervention Really Effective?
After nearly 50 years of research, there is evidence that early intervention increases the developmental and educational gains for the child, improves the functioning of the family, and reaps long-term benefits for society. Early intervention has been shown to result in the child: needing fewer special education and other habilitative services later in life; being retained in grade less often; and in some cases being indistinguishable from non-handicapped classmates years after intervention.
A top-down perspective on quality takes into account such program and setting characteristics as the ratio of adults to children; the qualifications and stability of the staff; characteristics of adult-child relationships; the quality and quantity of equipment and materials; the quality and quantity of space per child; the number of toilets, fire safety provisions, and so forth; health and hygiene procedures and standards; aspects of working conditions for the staff, etc. There is substantial evidence to suggest that these program and setting characteristics do predict some effects of an early childhood program (Howes, et al., 1992). However, the appropriate physical setting does not always indicate the most effective program.
It is reasonable to assume that the important ultimate effects of a program depend primarily on how it is viewed from another angle. If it is true that the child's experience of a program is the true determinant of the program's effects, assessment of program quality requires answers to the central question: What does it feel like to be a child in this environment?
The older the children served by a program, the longer the time period required for reliable assessment of the quality of daily life as seen from the bottom-up. In other words, a good quality program is one in which, from the child's perspective, experiences are intellectually and socially engaging and satisfying on most days. Such a program is not dependent on holding occasional exciting special events. Isolated events experienced in early childhood programs are unlikely to affect long-term development. However, experiences that may be inconsequential if they are rare, but may be either harmful or beneficial if they are frequent or repeated, must be addressed in assessments of program quality (Katz, 1991).
This approach to the assessment of quality proposed here raises complex issues that suggest that the early childhood profession is obliged to develop a set of standards of professional practice. Each of the perspectives contributes in a different way to an overall assessment of program quality. The early childhood profession must continue to work on developing an accepted set of professional standards of practice to which practitioners can fairly be held accountable. Any approach to the assessment of quality requires not only a set of criteria to apply to each program, but some consensus on the minimum standards for each criterion. A start has been made on the development of consensus about appropriate practices.
In research and evaluation, a sample of subjects typically receives some form of programmatic treatment then outcome scores for these students are compared with outcome scores of a control or comparison group. The traditional control- group, comparison-group design adopts the viewpoint that frequency and nature of observable cognitive activities increase at a steady rate as a result of the growth process. This model assumes that growth among infants is linear and that all infants have the same capacity to learn. These assumptions would result in a uniform program for all, and all would benefit equally from this program.
Another viewpoint is that infants and toddlers are going though a period of rapid, non-linear growth and change along many interwoven lines of development (Horner, 1980). Accordingly, different individuals would present different levels and kinds of cognitive development during different stages of development. Short-term consistency of individual traits would be low, traits measured during infancy would have low correlation with later skills. Broad programmatic treatment effects will be small, and a different research and evaluation model is needed.
We start by examining the short- and long-term consistency of test scores. We then relate this consistency to the literature on the cognitive development of infants and toddlers. We then identify gains associated with some particularly effective programs for infants and toddlers and the statistical implications of those gains. A set of recommendations for the design of research and evaluation studies is the final result.
Test-retest reliability tends to be quite low when scales are administered to infants. As the child gets older, test-retest reliabilities tend to improve. Werner and Bayley (1966) summarized studies examining the test-retest reliability of various infant measures and noted wide variations in scale scores. One study, for example, found 1 day test-retest reliabilities on the Buher Baby tests to range from .40 to .96 depending on the age of the infants. Another study found 2 day test-retest reliabilities on the Linfert-Hierholzer scales for 1-2- and 3-month-olds to be -.24, .44 and .69 respectively. Horner (1980) found 4-10 day test-retest reliabilities on the Bayley for 9-month-old females, 9-month-old males, 15-month-old females and 15-month-old males to be .42, .67, .96, and .76 respectively. Werner and Bayley (1966) found the percentage of agreement across two administrations of the Bayley to 8-month-olds varied from 41% to 95% with a mean of 76%. With 9- and 16-month-olds, Horner (1980) found slightly higher consistencies on the same items, with means of 85% for both age groups.
Thus, test-retest reliability is extremely low for infants and increases moderately for toddlers. The lack of test-retest reliability is consistent with the view of the child going through non-linear growth. It is inconsistent with the notion that the cognitive activity in infants increases at a steady rate as a result of growth.
The classic studies of mental growth in normal infants and toddlers show inconsistent and unpredictable growth rates of these observable skills and traits. Bayley, for example, reported correlations between -.04 and .09 between scores during the first 3 months of life and scores at 18 to 36 months. Looking at race and gender with a sizeable sample, Goffeney, Henderson and Butler (1971) later found virtual no correlation between 8-month and 7-year measures. Escalona and Moriarty (1961) found virtually no correlation between 20-month and 6…