Journal of Early Intervention

This study investigated the economic efficiency of alternative types of intervention with language-impaired preschool children. Forty children were randomly assigned to one of four groups: (a) home-based (parent-delivered) intervention, (b) center-based intervention, (c) both center- and home-based intervention, and (d) no treatment. The home intervention program taught parents to incorporate therapy techniques into ordinary parent-child interactions in the home and to create a language-stimulating home environment. Center-based treatment emphasized language development in individual, small group, and large group settings. The combined intervention group received both the home- and center-based programs. Program effectiveness was measured with two language scales (PLS-R, APPS). Cost analysis encompassed all resources consumed by the program, including the time contributed by parents and students. The results indicated that the home-based program was more efficient. The center-based intervention was more expensive and less effective. Combining the two types of intervention increased costs without significantly increasing effectiveness. Although the study was limited in size and duration, it suggests that future research should investigate the potential of parent-delivered services to be effective, low-cost alternatives to center-based early intervention.

A review of 40 federally funded personnel preparation projects for infant specialists was conducted. The project grants were analyzed along a number of dimensions. Discrepancies were found in the number of training competencies and the lack of rigorous evaluation designs across the programs. Approximately 1000 infant interventionists have received training through the projects funded through this competition.

Prolonged, frequent, or intense crying, particularly when soothing is ineffective, can be detrimental both to the baby and to the persons who provide care. Because handicapped babies may cry more frequently than their nonhandicapped age-peers and in different ways, there is a strong need to develop strategies for dealing with crying in early intervention settings. This paper reviews the literature on the crying of handicapped babies, describes environmental considerations, techniques for providing comfort, and observational and data-collection techniques, and makes suggestions for coping strategies for caregivers.

As programs serving families with at-risk and handicapped children become more family-focused in their approach, they must consider the unique needs of different groups of parents. This paper discusses adolescent parents and the provision of services to families with young parents and children with special needs. Stages of adolescence, parenting behaviors, and issues of support are presented as examples from research and clinical literature that have implication both for family needs and the provision of services to these families. It is emphasized that a family focus for individually determined priorities is an appropriate model and that case management skills are probably needed to serve these families best.

This study was designed to investigate the effects of factile-kinesthetic stimulation on the weight gain, the performance on the Neonatal Behavioral Assessment Scale (NBAS), and the length of hospital stay of preterm infants. Twenty preterm infants in a neonatal intensive care unit were divided equally into treatment and control groups. Tactile-kinesthetic stimulation was provided to the infants in the treatment group for three 15-minute periods per day for 10 days. At the end of the treatment period, the analyses revealed that the weight gains and the performance on the NBAS of the intervention group significantly increased in comparison with the weight gains and NBAS performance of the comparison group. No significant difference was found between the treatment and control groups on length of hospital stay.

"Best practice" guidelines drawn from recent advances within the field of disability are reviewed and synthesized for the purpose of defining exemplary early childhood special education services. With both empirical and ideological support, the paper identifies six major characteristics of exemplary programs. Such programs provide services that are (a) integrated, (b) comprehensive, (c) normalized, (d) adaptable. (e) peer and family-referenced, and (f) outcome-based. Programmatic guidelines are addressed for each characteristic.

Two early childhood teachers of integrated delayed children and two special education early childhood teachers of segregated delayed children were taught to use sample, mand, and delay techniques with five young children with language and cognitive delays. From Baseline to Intervention, the teachers changed significantly the types of initiations they directed to the children: They significantly increased samples, mands, and delays and decreased questions, while they maintained comments. The teachers did not significantly increase the number of initiations they directed to the target children.

From Baseline to Intervention, the children significantly Increased their word rates, utterance rates, number of words per utterance, and percent of responding to the teachers' initiations. The children made nonsignificant gains in rate of initiations and syntax scores. The authors concluded that the sample, mand, and delay techniques were successfully and easily implemented by teachers of young children with language delays and that the implementation of the techniques was followed by increases in the children's language. The data from this study provided support for the use of the techniques by teachers of young children with language and cognitive delays.

Utilizing four pairs of preschoolers with Down's Syndrome, the efficacy of two prompt fading procedures was compared during instruction of two self-help skills. In addition, the efficacy of observational learning was examined. Within a modified multiple baseline and multi-element design, one member of each pair received direct instruction on two skills. One skill was taught using a decreasing assistance prompting procedure, the other using a graduated guidance procedure. The other child was prompted to observe instruction, but not taught directly. Procedure and task were counter-balanced, the reliability of scoring and the social validity of outcomes were estimated, and the integrity of procedural implementation was examined. Results indicate that both procedures were effective in increasing the target behaviors. Surprisingly, children who only observed also acquired both tasks. Results generalized across assessors and were maintained across time. Implications for instructional planning for individuals who are mentally retarded are discussed.

Fourteen studies were reviewed that had employed single-subject methodology to investigate the results of interventions to improve developmental functioning in handicapped preschoolers. Interventions included treatments intended to develop physical responsiveness, as well as treatments to increase feeding behavior and to decrease rumination or compulsive vomiting. Overall, these interventions were highly effective. The most consistent positive results were obtained from interventions on rumination, regardless of whether positive reinforcement or punishment had been employed. As with previous reviews of single-subject literature, generalization and maintenance were insufficiently studied. The conclusions of this investigation are reported within the context of three previous synthesis efforts that taken together constitute all known single-subject research in early intervention with handicapped children.

The purpose of this study was to examine the relationships between individual and overall Estimated Developmental Ages (EDAs) calculated for the Uzgiris and Hunt Scales, as outlined in a clinical manual developed by Dunst, and Bayley mental age scores. Thirty-four infants with handicaps enrolled in early intervention programs served as the subjects. The results indicated that (a) there was a significant difference between overall EDAs and Bayley metal age, with Bayley estimates being on the average some 2.1 months higher; (b) the overall EDA and each of the seven individual EDAs were significantly and positively related to Bayley mental age; (c) when all seven EDAs were used in a multiple regression procedure, schemes for relating to objects (sensorimotor play) emerged as the best single correlate when the effects of the other scales were controlled; and (d) a commonality analysis revealed that schemes for relating to objects also explained the largest percentage of unique variance of Bayley mental scores. Recommendations of a test battery reflecting several approaches to the assessment of infants with handicaps are presented.