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EC 306 991
Evaluation of Early Intervention in Washington State.Literature Summary: Acronyms, Summaries of Selected ResearchStudies, Theoretical Viewpoints, Bibliography.University of South Florida, Tampa. Dept. of Gerontology.1998-00-00117p.; For related document, see EC 306 990.Research and Data Analysis, Department of Social and HealthServices, Olympia, Washington 980504-5204; Report Number7.95b.
Information Analyses (070)MF01/PC05 Plus Postage.*Disabilities; Early Childhood Education; EarlyIntervention; *Educational Strategies; Exceptional ChildResearch; Infants; *Outcomes of Education; *ProgramEffectiveness; Research Projects; *Teaching Methods;ToddlersWashington
This report summarizes research studies on the effectivenessof early intervention for children with disabilities in Washington state. Inchart form, each summary includes information on the study program, studygroup, description of the research, outcome measures, and the results of thestudy. It includes 34 research studies and 20 theoretical research studies.(Contains over 300 references.) (CR)
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rI
Evaluation of Early Interventionin Washington State
Literature Summary
U.S. DEPARTMENT OF EDUCATIONfT0 ice of Educational Research and ImprovementE CATIONAL RESOURCES INFORMATION
CENTER (ERIC)his document has been reproduced as
received from the person or organizationoriginating it.
0 Minor changes have been made toimprove reproduction quality.
Points of view or opinions stated in thisdocument do not necessarily represent
OERLposition_or policy.
1
PERMISSION TO REPRODUCE ANDDISSEMINATE THIS MATER/AL HAS
BEEN GRANTED BY
TiRouJTO THE EDUCATIONAL RESOURCES
INFORMATION CENTER (ERIC)
Washington State Department of Social and Health ServicesResearch and Data Analysis
Infant Toddler Early Intervention Program
ACRONYMS
SUMMARIES OF SELECTED RESEARCH STUDIES
THEORETICAL VIEWPOINTS
BIBLIOGRAPHY
When ordering, please refer toReport Number 7.95b
ACRONYMS
ADD Attention Deficit DisorderAPGAR Scoring system named after. Virginia Apgar used to evaluate condition
of a new infantBDI Battelle Developmental InventoryBPD Bronchopulmonary DysplasiaBW Birth WeightCA Chronological AgeCAMS Curriculum and Monitoring SystemCAPER Early Childhood Continuum of Assessment, Programming Evaluation,
and ResourcesCBCL Child Behavior ChecklistCEEPS Comprehensive Early Evaluation Programming SystemCEFF Comprehensive Evaluation of Family FunctioningCES-D Depression ScaleCIQ Child Improvement QuestionnaireCVS Child Vulnerability ScaleDA Developmental AgeDAS Dyadic Adjustment ScaleDD Developmentally DisabledDQ Developmental Quotient ,
ECRI: SU Early Childhood Research Institute:, Service UtilizationEI Early InterventionEICS Early Intervention Collaborative StudyEMI Early Intervention Research InstituteFACES Family Adaptation and Cohesion Evaluation ScaleFFSS Family Functioning Style ScaleFILE Family Inventory of Life Events and ChangesFRS Family Resource ScaleFSS Family Support ScaleGAS Goal Attainment ScalingHOME Home Observation for Measurement of the Environment InventoryIEI Intervention Efficiency IndexLEP Individualized Education PlanIFSP Individualized Family Service PlanIHDP Infant Health and Development ProgramINFANIB Infant Neurological International BatteryINREAL A language intervention programISCS Inferred Self-Concept ScaleITQ Carey Infant Temperament ScaleIVH Intraventricular Hemorrhage
3
JSI Joseph Preschool and Primary Self-Concept Screening TestLBW Low Birth WeightLICC Local Interagency Coordinating CouncilMA Maturity AgeMCDI Minnesota Child Development InventoryNEILS National Early Intervention Longitudinal StudyNICU Neonatal Intensive Care UnitOSEP Office of Special Education ProgramsPAAT Parent as a Teacher ScalePCI Proportional Change IndexPIE Parent Involvement in EducationPPS Parent Protection ScalePPVT Peabody Picture Vocabulary TestPSAS Parent Self-Awareness ScalePSI Parenting Stress IndexSD Standard DeviationSEM Structural Equation ModelingSES Socioeconomic StatusSIB Scales of Independent BehaviorSICD Sequenced Inventory of Communication DevelopmentSMA Standard Metropolitan AreaSPECS System to Plan Early Childhood ServicesSRI Stanford Research InstituteSRRS Social Readjustment Rating ScaleSSRS Social Skills Rating ScaleWISC III Wechsler Intelligence ScaleWJ-R Woodcock-Johnson Tests of AchievethentCA,CO,CT,FL, California, Colorado, Connecticut, Florida,HA,MI,NJ,NC, Hawaii, Minnesota, New Jersey, North Carolina,PA,UT Pennsylvania, Utah
54
.ST
UD
Y/P
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RE
SUL
TS
And
rew
s, H
., G
oldb
erg,
N=
471,
165
child
ren
born
inSu
rviv
al a
naly
sis
test
ing
cert
ain
Var
iabl
es c
onsi
dere
d as
pos
sibl
e pr
edic
tors
Sign
ific
ant p
redi
ctor
s of
spe
cial
ed
D.,
Wel
len,
N.,
New
Yor
k 19
76 th
roug
h 19
86pa
rent
al, c
hild
-rel
ated
, and
in a
dditi
on to
thos
e m
entio
ned
at r
ight
plac
emen
t wer
e M
edic
aid
paym
ent f
orPi
ttman
, B.,
and
and
enro
lled
in N
YC
pub
licpr
egna
ncy-
rela
ted
fact
ors
for
incl
uded
mot
her's
age
, evi
denc
e of
birt
h (a
pov
erty
indi
cato
r), u
nmar
ried
Stru
enin
g, E
. (19
95).
scho
ols
in 1
992
sign
ific
ant d
iffe
renc
es b
etw
een
the
subs
tanc
e ab
use
by m
othe
r, a
nd p
rese
nce
ofst
atus
of
mot
her,
larg
e fa
mily
siz
e, lo
wPr
edic
tion
of S
peci
al.c
ompa
riso
n po
pula
tions
(sp
ecia
l ed
com
plic
atio
ns o
f pr
egna
ncy.
pare
ntal
ed,
mot
her
born
in th
e U
S, lo
wE
duca
tion
Plac
emen
tvs
. reg
ular
ed)
. In
addi
tion,
mod
eled
leve
l of
pren
atal
car
e, m
ale
gend
er, l
owfr
om B
irth
Cer
tific
ate
Dat
a. A
mer
ican
for
3 di
ffer
ent s
ubgr
oups
: lea
rnin
gdi
sabi
lity,
em
otio
nal d
isor
der,
men
tal
birt
hwei
ght,
and
a lo
w A
pgar
sco
re.,
Jour
nal o
f Pr
even
tive
reta
rdat
ion
.
Med
icin
e, 1
1(3)
, 55-
61.
..
Bai
ley,
E.J
., an
d36
chi
ldre
n 19
81-2
, age
s 6
toO
bjec
tive
was
doc
umen
tatio
n of
chi
ldC
hild
cha
nge:
one
7gro
up p
re-p
ostte
stSu
gges
t a p
ositi
ve im
pact
.B
rick
er, D
. (19
85).
142
wee
ks o
f ag
e, o
f w
hich
chan
ge, a
s w
ell p
opul
atio
nco
mpa
riso
n w
ith a
5-
to 7
-mon
th in
terv
alE
valu
atio
n of
a T
hree
-80
% w
ere
hand
icap
ped
(wid
ech
arac
teri
stic
s, p
aren
t sat
isfa
ctio
n,be
twee
n te
st a
dmin
istr
atio
ns. N
orm
-U
nifo
rmly
pos
itive
CE
EPS
pre
- po
st-t
est
'Yea
r E
arly
Int
erve
ntio
nra
nge
of s
ever
ity).
and
prog
ram
ope
ratio
n co
sts.
refe
renc
ed: G
esel
l Dev
elop
men
tal
com
pari
sons
. Com
pari
sons
usi
ng G
esel
lD
emon
stra
tion
Proj
ect.
Top
ics
in E
arly
46 c
hild
ren
the
follo
win
g ye
ar,
Prog
ram
com
pone
nts:
hom
e ba
sed
upto
15
mon
ths,
cen
ter
base
d 15
to 3
6Sc
hedu
les
(ada
ptiv
e be
havi
or, g
ross
mot
or,
fine
mot
or, l
angu
age,
per
sona
l-so
cial
mat
urity
age
(M
A)
wer
e si
gnif
ican
tlydi
ffer
ent f
or th
e to
tal g
roup
s.C
hild
hood
Spe
cial
ages
9 to
137
wee
ks o
f ag
e, o
fm
onth
s.de
velo
pmen
t). C
rite
rion
-ref
eren
ced:
Com
pari
sons
usi
ng D
Q s
core
s w
ere
gen
Edu
catio
n, 5
(2),
52-
65.
whi
ch 7
4% w
ere
hand
icap
ped.
Com
preh
ensi
ve E
arly
Eva
luat
ion
and
non-
sig
acro
ss a
ll gr
oups
..
Prog
ram
min
g Sy
stem
(C
EE
PS)
(gro
ss-
The
Ear
ly I
nter
vent
ion
mot
or, f
ine-
mot
or, c
omm
unic
atio
n,Su
bgrO
up a
naly
sis
by le
vel o
f di
sabi
lity:
Prog
ram
at t
he U
niv
ofco
gniti
on, s
elf-
help
, soc
ial;
thou
ght t
oC
EE
PS a
nd M
A c
ompa
riso
ns w
ere
OR
, sup
port
ed b
y O
SEP
.m
easu
re s
kills
that
will
lead
to in
crea
sing
.sta
tistic
ally
sig
.exc
ept f
or C
EE
PS f
or th
ean
d R
ehab
ilita
tive
inde
pend
ence
; ass
essm
ent r
esul
ts [
i.e.
at-r
isk
grou
p (Y
ears
2 &
3)
and
MA
for
Serv
ice'
s H
andi
capp
edfa
iled
item
s] d
irec
t int
erve
ntio
n go
als)
.at
-ris
k &
sev
ere
grou
ps, Y
ear
2. G
esel
lC
hild
ren
Ear
lyD
Q s
core
s w
ere
nons
ig, b
ut s
ugge
sts
the
Edu
catio
n Pr
ogra
m.
)D
Q a
lso
used
.m
ajor
ity m
aint
aine
d th
eir
rate
of
deve
lopm
ent.
Pare
nts
wer
e gi
ven
a co
nsum
er s
atis
fact
ion
surv
ey.
87
Miti
t.6W
AN
::1:ii
iiiiii
i:::::
::::::
::::::
::::::
::::::
::0-0
( M
O:::
::::::
:::B
::::%
::i::b
tjf'-'
'....-
''':M
#Agt
ftt:
Bar
nett,
S.W
., an
d39
hal
f-da
y pr
esch
oole
rsC
ompa
red
half
-day
and
ful
l-da
yN
o di
ffer
ence
s in
edu
catio
nal o
utco
mes
No
diff
eren
ces
in e
duca
tiona
l out
com
es;
Pezz
ino,
J. (
1987
).39
ful
l-da
y pr
esch
oole
rspr
esch
ool p
rogr
ams
in c
ost-
mea
sure
d by
sta
ndar
dize
d te
sts
(Min
neso
taha
lf-d
ay p
rogr
ams
appe
ar to
be
mor
e co
st-
Cos
t-ef
fect
iven
ess
Ana
lysi
s fo
r St
ate
and
Chi
ldre
n m
atch
ed w
ithin
prim
irY
han
dica
ppin
g co
nditi
onef
fect
iven
ess
anal
ysis
.C
hild
Dev
elop
men
t Inv
ento
ry (
MC
DI)
,ba
sed
on m
othe
r's o
bser
vatio
ns, a
nd th
eef
fect
ive.
Loc
al D
ecis
ion
Mak
ing:
on: c
hron
olog
ical
age
, mon
ths
Ear
ly C
hild
hood
Con
tinuu
m o
fA
n A
pplic
atio
n to
Hal
f-D
ay a
nd F
ull-
Day
of p
rior
pre
scho
ol p
rogr
amex
peri
ence
, and
dev
elop
men
tal
Ass
essm
ent,
Prog
ram
min
g, E
valu
atio
n,an
d R
esou
rces
(C
APE
R),
cri
teri
on-
Pres
choo
l Spe
cial
leve
l at p
rogr
am e
ntry
. Ave
age
refe
renc
ed m
easu
re o
f ch
ildre
n's
mas
tery
Edu
catio
n Pr
ogra
ms.
48 m
onth
s.of
ski
lls).
Com
bine
d te
st d
omai
ns:
Jour
nal o
f th
e D
ivis
ion
for
Ear
ly C
hild
hood
,co
gniti
ve, l
angu
age,
mot
or, s
ocia
l, an
d se
lf-
help
..
11(2
), 1
71-1
79.
Bel
sky,
J.,R
ovin
e, M
.,an
d T
aylo
r, D
.G.
60 m
othe
r-in
fant
dya
dspa
rtic
ipat
ing
in th
eU
sed
natu
ralis
tic h
ome
obse
rvat
ions
on m
othe
r-in
fant
inte
ract
ion
to a
sses
sM
othe
r-in
fant
inte
ract
ion
obse
rved
at
infa
nt a
ge o
f 1,
3, a
nd 9
mon
ths;
at 1
yr
62%
of
atta
chm
ents
rat
ed a
s se
cure
; 38%
as in
secu
re (
25%
avo
idan
t, 13
%
(198
4). T
hePe
nnsy
lvan
ia I
nfan
t and
Fam
ilyth
e hy
poth
eses
that
infa
nts
clas
sifi
edbr
ough
t to
lab
to a
sses
s qu
ality
of
resi
stan
t).
Penn
sylv
ania
Inf
ant a
ndD
evel
opm
ent P
roje
ct.
as s
ecur
ely
atta
ched
had
exp
erie
nced
atta
chm
ent.
Fam
ily D
evel
opm
ent
the
mos
t sen
sitiv
e ca
re, a
s re
veal
edD
ata
supp
orte
d th
e ge
nera
l con
tent
ion
that
Proj
ect,
III:
The
Ori
gins
of I
ndiv
idua
lD
iffe
renc
es in
Inf
ant-
Prim
arily
mid
dle-
clas
s,by
inte
rmed
iate
leve
ls o
f re
cipr
ocal
inte
ract
ion
and
mat
erna
l stim
ulat
ion,
with
res
ista
nt in
fant
s ex
peri
enci
ng
Beh
avio
r ca
tego
ries
: mat
erna
l voc
aliz
atio
nto
infa
nt, i
nfan
t voc
aliz
atio
n, m
ater
nal
resp
onsi
ve v
ocal
izat
ion
(to
infa
nt
indi
vidu
al d
iffe
renc
es in
atta
chm
ent a
re a
func
tion
of b
oth
mat
erna
l car
e an
dpo
tent
ially
end
urin
g ch
arac
teri
stic
s of
the.
Mot
her
Atta
chm
ent:
Mat
erna
l and
Inf
ant
Con
trib
utio
ns. C
hild
the
leas
t and
avo
idan
t inf
ants
the
mos
t suc
h in
tera
ctiv
e ex
peri
ence
,T
este
d to
det
enni
ne w
heth
er, r
elat
ive
voca
lizat
ion)
, mat
erna
l stim
ulat
ion/
arou
sal,
infa
nt r
espo
nse
to s
timul
atio
n/ar
ousa
l,m
ater
nal p
ositi
ve a
ffec
t, in
fant
look
s at
infa
nt. C
anno
t con
clud
e th
at e
ither
ism
ore
resp
onsi
ble,
but
incl
ined
to b
elie
veth
at c
are
prov
ided
by
the
mot
her
play
s a
Dev
elop
men
t 55,
718
-72
8.
to m
othe
rs o
f se
cure
infa
nts,
mot
hers
of r
esis
tant
infa
nts
wer
e si
gnif
ican
tlym
othe
r, m
ater
nal u
ndiv
ided
atte
ntio
n,th
ree-
step
con
tinge
nt e
xcha
nge,
infa
ntgr
eate
r ro
le.
less
res
pons
ive
to in
fant
dis
tres
s an
dfu
ss/c
ry, m
ater
nal s
ooth
e (p
hysi
cal o
rL
evel
s of
rec
ipro
cal i
nter
actio
n ra
nked
as
nond
istr
ess
voca
lizat
ions
, and
thos
eve
rbal
), m
ater
nal h
old,
and
mat
erna
l fee
dex
pect
ed, a
lthou
gh th
is w
as o
nly
of a
void
ant i
nfan
ts p
rovi
ded
sign
ific
antly
less
phy
sica
l con
tact
.(b
reas
t or
bottl
e).
stat
istic
ally
sig
at 9
mo.
Sam
e fo
r th
em
ater
nal i
nvol
vem
ent c
ompo
nent
of
Als
o te
sted
whe
ther
inse
cure
infa
nts
wou
ld b
e fu
ssie
r th
an s
ecur
ely
Atta
chm
ent m
easu
red
usin
g A
insw
orth
and
Witt
ig (
1969
) st
rang
e si
tuat
ion,
cod
edre
cipr
ocal
inte
ract
ion.
atta
ched
infa
nts.
usin
g A
insw
orth
et a
l.'s
(197
8) P
atte
rns
ofA
ttach
men
t.T
here
is n
o su
ppor
t for
the
pred
ictio
n th
atav
oida
nce
is a
ssoc
iate
d w
ith m
ater
nal
disd
ain
for
phys
ical
con
tact
with
the
infa
nt.
9.
Can
con
clud
e th
at th
e co
vari
atio
n of
fuss
ines
s an
d at
tach
men
t is
dete
rmin
ed, a
tle
ast i
n pa
rt, b
y th
e ef
fect
of
mot
heri
ng o
nin
fant
beh
avio
r.
108
Bra
dley
, R.H
.,Su
bgro
up o
f th
e In
fant
Hea
lthM
ulti-
site
, ran
dom
ized
, clin
ical
tria
lC
ondi
tions
fou
nd to
aff
ord
som
e pr
otec
tion
The
inci
denc
e of
res
ilien
ce ir
i the
Whi
tesi
de, L
.,an
d D
evel
opm
ent P
rogr
am; 4
10co
mpa
red
the
resi
lienc
e of
LB
Wfr
om th
e de
lete
riou
s co
nseq
uenc
es o
f pr
e-in
terv
entio
n gr
oup
was
sig
nifi
cant
ly
Mun
dfro
m, D
.J.,
Cas
ey,
LB
W c
hild
ren
livin
g in
pov
erty
,ch
ildre
n in
two
grou
ps: 1
) st
anda
rdm
atur
ity c
ompo
unde
d by
pov
erty
incl
ude:
grea
ter
(39%
) th
an th
e in
cide
nce
for
the
P.H
., K
elle
her,
K.J
.,an
d Po
pe, S
.K. (
1994
).E
xclu
ded
thos
e w
ith s
erio
usch
roni
c he
alth
pro
blem
s.pe
diat
ric
follo
w u
p fo
r fi
rst 3
yea
rs;
and
2) a
n in
terv
entio
n pr
ogra
m.w
hich
Low
den
sity
in th
e ho
me
A s
afe
area
in w
hich
to p
lay
follo
w-u
p gr
oup
(12%
).
Con
trib
utio
n of
Ear
lyad
ded
fam
ily e
duca
tion
and
supp
ort
Res
pons
ivity
of
the
pare
ntSe
cond
ary
anal
ysis
: In
the
abse
nce
of
Inte
rven
tion
and
Ear
lyse
rvic
es p
rovi
ded
in th
e ho
me,
plu
sA
ccep
tanc
e of
the
child
havi
ng a
t lea
st th
ree
prot
ectiv
e ca
regi
ving
Car
egiv
ing
Exp
erie
nces
an e
duca
tiona
l day
car
e ex
peri
ence
Var
iety
of
expe
rien
ces
for
the
child
expe
rien
ces
at 1
2 m
onth
s, th
e od
ds th
at a
to R
esili
ence
in L
ow-
from
age
1 u
ntil
age
3.T
he a
vaila
bilit
y of
enr
ichi
ng le
arni
ngpr
emat
ure,
LB
W c
hild
livi
ng in
pov
erty
Bir
thw
eigh
t, Pr
emat
ure
mat
eria
lsw
ill s
how
ear
ly s
igns
of
resi
lienc
e ar
e lo
w
Chi
ldre
n L
ivin
g in
Prog
ram
:(<
28%
) de
spite
par
ticip
atin
g in
an
Pove
rty.
Jou
rnal
of
Wee
kly
hom
e vi
sits
thro
ugh
age
Info
rmat
ion
on th
ese
cond
ition
s w
ere
inte
nsiv
e m
ultif
acet
ed in
terv
entio
n su
ch
Clin
ical
Chi
ld1,
biw
eekl
y th
erea
fter
mea
sure
d fr
om th
e H
ome
Obs
erva
tion
for
as I
HD
P. C
onse
quen
ces
wer
e so
mew
hat
Psyc
holo
gy 2
3, 4
25-
From
age
1 to
3, c
hild
Mea
sure
men
t of
the
Env
iron
men
t inv
ento
ryle
ss s
ever
e at
36
mon
ths
(32%
).
434.
deve
lopm
ent c
ente
r at
leas
t 4(H
OM
E; C
aldw
ell &
Bra
dley
, 198
4), t
hehr
s/da
y, 5
day
s/w
k
Hom
e vi
sits
incl
uded
a p
robl
em-
Infa
nt-T
oddl
er a
nd E
arly
Chi
ldho
odve
rsio
ns .
(Lim
itatio
ns to
def
initi
on: c
rite
rion
val
ues
rath
er th
an c
ontin
uum
; bas
ed o
nde
velo
pmen
tal s
core
s at
a s
ingl
e ag
e;.
solv
ing
curr
icul
um, a
nd b
oth
Chi
ld m
easu
res:
'm
easu
re o
f he
alth
sta
tus
wea
k; h
igh
com
pone
nts
used
a c
oord
inat
edSt
anfo
rd-B
inet
Int
ellig
ence
Tes
tnu
mbe
r de
fmed
bas
ed s
olel
y on
IQ
sco
re;
educ
atio
nal c
urri
culu
m o
f le
arni
ngga
mes
and
act
iviti
es.
Chi
ld B
ehav
ior
Che
cklis
tH
ealth
sta
tus
(que
stio
n to
par
ent)
high
num
ber
(70%
) of
Afr
ican
Am
eric
ans)
Gro
wth
sta
tus
Res
ilien
t chi
ldre
n w
ere
iden
tifie
d as
thos
e w
ho w
ere
func
tioni
ng a
t age
3w
ithin
acc
epta
ble
rang
es in
the
area
sof
cog
nitiv
e co
mpe
tenc
e, b
ehav
iora
lco
mpe
tenc
e, h
ealth
sta
tus,
and
gro
wth
stat
us.
1 2
9
Bri
tain
, L.A
., H
olm
es,
698
child
ren
refe
rred
to a
nD
escr
ibed
the
pres
entin
g pr
oble
ms
ofD
evel
opm
enta
l quo
tient
and
com
pari
son
ofR
esul
ts in
clud
ed:
G.E
., an
d H
assa
nein
,ea
rly
inte
rven
tion
prog
ram
ove
ral
l chi
ldre
n by
med
ical
con
ditio
ngr
oup
char
acte
rist
ics
such
as
birt
h w
eigh
t,C
hron
olog
ical
age
ran
ged
from
aR
.S. (
1995
). H
igh-
Ris
k15
yea
rs (
1975
to 1
989)
, 464
of
grou
ps (
25 g
roup
s). C
ompa
red
gest
atio
nal a
ge, a
nd g
ende
r.m
ean
of 6
.6 m
onth
s fo
r th
e 11
4C
hild
ren
Ref
erre
d to
an
Ear
ly I
nter
vent
ion
who
m a
ttend
ed th
e pr
ogra
m f
orat
leas
t 6 m
onth
s.gr
oups
reg
ardi
ng b
irth
wei
ght,
gest
atio
nal a
ge, a
nd g
ende
r. L
ooke
d
child
ren
with
Dow
n sy
ndro
me,
to a
mea
n of
39.
9 m
onth
s in
14
child
ren
Dev
elop
men
t Pro
gram
.at
cha
nges
in g
roup
pro
port
ions
ove
rw
ith s
peec
h ar
ticul
atio
n pr
oble
ms.
.C
linic
al P
edia
tric
s,34
(12)
, 635
-41.
time.
Com
pare
d gr
oup
DQ
cha
nges
duri
ng in
terv
entio
n fo
r th
ose
rem
aini
ng in
the
prog
ram
at l
east
6m
onth
s.
Exc
ept f
or D
own
synd
rom
e ch
ildre
nan
d th
ose
born
of
mot
hers
with
intr
aute
rine
infe
ctio
n, m
ost w
ere
1 yr
or o
lder
, but
less
than
24
mon
ths,
on
adm
issi
on.
Prog
ram
was
bas
ed o
n a
neur
odev
elop
men
tal a
ppro
ach,
with
an e
duca
tiona
l com
pone
nt. I
nitia
las
sess
men
t; re
eval
uatio
ns e
very
12
mon
ths
(eve
ry 6
mon
ths
from
197
5-19
80).
.
Man
y pr
oble
ms
wer
e fa
irly
eve
nly
dist
ribu
ted
betw
een
the
sexe
s.H
owev
er, g
irls
wer
e re
pres
ente
dsi
gnif
ican
tly m
ore
in th
em
oder
ate/
seve
re D
D a
nd m
icro
-ce
phal
y gr
oups
. Boy
s w
ere
stri
king
lyan
d si
gnif
ican
tly m
ore
invo
lved
with
mild
DD
beh
avio
ral p
robl
ems
and
spee
ch a
rtic
ulat
ion
prob
lem
s.M
ost g
roup
s ha
d st
atis
tical
lysi
gnif
ican
t sho
rter
ges
tatio
nal a
ges
than
the
norm
of
40 w
eeks
(exc
eptio
ns w
ere
for
grou
ps w
ithce
ntra
l ner
vous
sys
tem
tum
or,
post
nata
l inf
ectio
n, a
utis
m, m
ostly
spee
ch p
robl
ems,
spe
ech
artic
ulat
ion,
"
intr
aute
rine
infe
ctio
n, s
pina
bif
ida,
met
abol
ic p
robl
ems,
mac
roce
phal
y,an
d po
stna
tal t
raum
a). G
roup
mea
nsra
nged
fro
m 3
6.1
to 3
9.8.
Tes
ts f
or li
near
ity o
f tr
end
inpr
opor
tions
ove
r th
ree
time
peri
ods
show
ed a
dow
nwar
d tr
end
over
tim
ein
adm
issi
on o
f gr
oups
with
mild
DD
, inc
reas
ed m
uscl
e to
ne o
rde
crea
sed
mus
cle
tone
, mos
tly m
otor
prob
lem
s, a
nd h
ydro
ceph
alus
. The
rew
as a
sig
nifi
cant
upw
ard
tren
d fo
rgr
oups
with
sei
zure
his
tory
, mic
rcep
-ha
ly, D
own
synd
rom
e, a
nd a
utis
m.
13In
crea
sed
repr
esen
tatio
n m
ay b
ere
late
d to
ear
lier
diag
nosi
s an
d/or
refe
rral
.
1 4
10
......
....
......
.. ...
:IT
IPO
tti4.
01C
AM
:::::
......
....
......
......
. ..
.
.:8:::
::"o
111%
::::..
....m
::::::
::::::
::::::
::::::
:::::M
OIE
SMIP
TIO
N:::
::::::
::::::
::::::
::::::
::::D
::::::
::::::
::::::
::::::
::::::
:-..1
4.1.
.:::
:M:::
::::::
::::::
::::::
::::::
g::::
::::::
::::::
::::::
::::::
::::::
...M
r. 1
:1:::
::::::
::::::
::::::
::::::
:::::E
::::::
::::::
::;i:i
:
The
2 D
D g
roup
s di
d no
t dif
fer
muc
hei
ther
in m
ean
gest
atio
nal a
ge o
r in
birt
h w
eigh
t. M
oder
ate/
seve
re D
Dch
ildre
n w
ere
mor
e lik
ely
than
thos
ein
the
mild
DD
gro
up to
hav
eab
norm
al m
uscl
e to
ne, m
icro
ceph
aly,
decr
ease
d vi
sion
or
hear
ing,
stra
bism
us, a
nd s
eizu
res.
The
mild
DD
gro
up w
as n
or li
kely
to h
ave
had
mkr
ocep
haly
or
mos
tly s
peec
hpr
oble
ms.
The
re w
as r
elat
ive
stab
ility
in th
em
ean
DQ
fro
m a
dmis
sion
todi
scha
rge.
Exc
eptio
ns: g
roup
s w
ithpo
stna
tal t
raum
a, m
ostly
spe
ech
prob
lem
s, a
nd s
peec
h ar
ticul
atio
npr
oble
ms
show
ed s
ome
over
all
impr
ovem
ent,
and
thos
e w
ith D
own
synd
rom
e an
d in
trau
teri
ne in
fect
ion
,sho
wed
a d
eclin
e ov
er ti
me
(sig
nifi
cant
for
Dow
n gr
oup)
.
Not
e th
at m
aint
enan
ce o
f a
child
's D
Qov
er ti
me
can
be v
iew
ed a
s pr
ogre
ss a
ndiS
a r
ealis
tic g
oal f
or in
terv
entio
npr
ogra
ms
to a
chie
lie.
Car
o, P
., an
dD
erev
ensk
y, J
.L.
(199
1) F
amily
-Foc
used
Inte
rven
tion
Mod
el:
Impl
emen
tatio
n an
dR
esea
rch
Find
ings
,T
opic
s in
Ear
lyC
hild
hood
Spe
cial
Edu
catio
n 11
(3)
66-8
0.,
16 f
amili
es h
avin
g in
fant
s w
ithm
oder
ate
or s
ever
e di
sabi
litie
sfr
om a
ll SE
S le
vels
, with
age
rang
e 2
- 43
mon
ths.
Eva
luat
ed th
e ef
fect
iven
ess
of a
n E
lpr
ogra
m b
ased
on
the
fam
ily-f
ocus
edin
terv
entio
n m
odel
as
conc
eptu
aliz
edby
Bai
ley
et a
l., r
ecog
nizi
ng th
etr
ansa
ctio
nal n
atur
e of
fam
ilies
and
the
use
of v
ario
us c
hild
, sib
ling,
and
pare
nt a
sses
smen
ts to
illu
stra
tein
divi
dual
str
engt
hs &
nee
ds.
Prog
ram
: 2-h
r w
eekl
y ho
me
visi
t ove
r5
mon
th P
erio
d. P
aren
t(s)
& in
fant
spr
esen
t at e
ach
sess
ion,
sib
s at
tend
ing
sess
ions
mon
thly
.Se
t wee
kly
goal
s.
'Chi
ld V
aria
bles
:B
atte
lle D
evel
opm
enta
l Inv
ento
ryM
ovem
ent A
sses
smen
t of
Infa
nts
Pare
nt V
aria
bles
:Fa
mily
Res
ourc
e Sc
ale
Fam
ily S
uppo
rt S
cale
Pare
nt S
atis
fact
ion
Scal
e
Pare
nt-C
hild
Atta
chm
ent a
nd I
nter
actio
n:Pa
rent
Beh
avio
r Pr
ogre
ssio
n (F
orm
s1
& 2
)T
each
ing
Skill
s In
vent
ory
Cri
tical
Eve
nts
Che
cklis
t
Pare
nts
perc
eive
d.si
gnif
ican
t pro
gres
s in
the
abili
ty o
f th
eir
fam
ilies
to m
eet t
hech
alle
nges
of
livin
g w
ith y
oung
chi
ldre
nw
ith d
isab
ilitie
s.
As
a gr
oup,
incr
ease
s in
the
child
ren'
s ag
eeq
uiva
lent
sco
res
on th
e B
DI
wer
e ne
arly
equi
vale
nt to
per
fonn
ance
s ex
pect
ed f
orno
ndis
able
d ch
ildre
n. A
ll ch
ildre
n ha
d a
dim
inis
hed
risk
sco
re a
nd im
prov
emen
t in
the
qual
ity o
f th
eir
mot
or m
ovem
ents
. EI
appe
ared
to r
eirt
forc
e, m
odif
y, o
rsi
gnif
ican
tly e
nhan
ce th
e pe
rcei
ved
qual
ity o
f th
e in
tera
ctio
nal b
ehav
iors
amon
g fa
mily
mem
bers
.
Incr
emen
ts in
the
obse
rved
beh
avio
rsin
dica
ted
the
acqu
isiti
on o
f a
stro
ngpa
rent
-chi
ld b
ond
and
pare
ntal
abi
lity
to
t_15
1116
prom
ote
mat
ure
child
beh
avio
rs in
all
deve
lopm
enta
l dom
ains
. Sig
nifi
cant
incr
ease
s in
par
enta
l tea
chin
g sk
ills.
Incr
ease
d at
tach
men
t and
inte
ract
iona
lbe
havi
ors
in f
amili
es w
ere
obse
rved
; all
fam
ilies
rea
lized
eff
ectiv
e at
tach
men
ts(b
ut a
ll w
ere
volu
ntee
rs &
may
hav
e be
enm
otiv
ated
to r
espo
nd).
.
Cas
to, G
.C.,
and
74 p
rim
ary
rese
arch
stu
dies
Stat
istic
ally
inte
grat
ed f
mdi
ngs
from
IQ, l
angu
age,
mot
or, s
ocia
l-em
otio
nal,
self
-E
arly
inte
rven
tion
prog
ram
s do
res
ult i
nM
astr
opie
ri, M
.A.
with
han
dica
pped
chi
ldre
n74
stu
dies
inve
stig
atin
g th
e ef
fica
cyhe
lp, a
cade
mic
ach
ieve
men
t, pa
rent
mod
erat
ely
larg
e im
med
iate
ben
efits
for
(198
6) T
he E
ffic
acy
ofof
ear
ly in
terv
entio
n w
ithat
titud
e, p
aren
t ski
ll le
vels
, mot
her/
infa
ntha
ndic
appe
d po
pula
tions
.E
arly
Int
erve
ntio
nha
ndic
appe
d pr
esch
oole
rs, c
ondu
cted
eye
cont
act,
wei
ght g
ains
, var
ious
type
s of
Prog
ram
s: A
Met
a-A
naly
sis.
Exe
eptio
nal
Chi
ldre
n, 5
2(5)
, 417
-42
4:
from
193
7 to
198
4 (m
ost s
ince
197
0).
mot
her/
infa
nt in
tera
ctio
nE
vide
nt in
var
iabl
es s
uch
as I
Q, m
otor
,la
ngua
ge, a
cade
mic
ach
ieve
men
t (fe
wre
sults
for
out
com
es s
uch
as s
elf-
conc
ept,
soci
al c
ompe
tenc
y, o
r fa
mily
and
pee
rre
latio
nshi
ps).
(Not
e: th
e ef
fect
siz
es w
hen
only
goo
dqu
ality
stu
dies
are
con
side
red
are
notic
eabl
y lo
wer
)
Dat
a re
late
d to
the
four
var
iabl
es m
ost
cite
d by
pre
viou
s re
view
ers:
1)In
terv
entio
n pr
ogra
ms
whi
ch u
tiliz
epa
rent
invo
lvem
ent a
re n
ot m
ore
effe
ctiv
e th
an th
ose
whi
ch d
o no
t.
2) T
here
are
few
dat
a to
sup
port
the
notio
n. th
at "
earl
ier
is b
ette
r" in
star
ting
inte
rven
tion
prog
ram
s.
)W
ithin
dis
adva
ntag
ed p
opul
atio
ns,
mor
e hi
ghly
str
uctu
red
prog
ram
s ar
eas
soci
ated
with
mor
e ef
fect
ive
outc
omes
. Thi
s is
not
as
wel
lsu
ppor
ted
by th
e da
ta f
rom
the
hand
icap
ped
popu
latio
n.)
With
in d
isad
yant
aged
pop
ulat
ions
,pr
ogra
m in
tens
ity/d
urat
ion
is n
otfo
und
to b
e re
late
d to
inte
rven
tion
effe
ctiv
enes
s. F
or h
andi
capp
edpo
pula
tions
, lon
ger,
mor
e in
tens
epr
ogra
ms
are
asso
ciat
ed w
ithin
terv
entio
n ef
fect
iven
ess.
1 7
121
8
,V1W
W:0
400-
:.
Dih
off,
R.A
., M
c E
wan
,St
udy
1:St
udy
1 re
port
ed e
ffec
tiven
ess
of a
Eva
luat
ion
was
by
deve
lopm
enta
l sta
ndin
g:St
udy
1: S
uppo
rts
the
effe
ctiv
enes
s of
M.,
Farr
elly
, M.,
From
thos
e el
igib
le w
ithin
the
tran
sdis
cipl
inai
y pr
ogra
m f
or c
hild
ren
Phys
ical
and
occ
upat
iona
l the
rapy
earl
y in
terv
entio
n in
gen
eral
, with
mos
tB
rosv
ic, G
.M.,
geog
raph
ic a
rea,
3 g
roup
s w
ere
0-3
duri
ng 1
2 m
onth
s of
par
t- o
r fu
ll-w
ith M
eckl
enbu
rg S
cale
prog
ress
mad
e in
ful
l-tim
e cl
ass.
Car
pent
er, L
.,id
entif
ied
and
subj
ects
in e
ach
time
inte
rven
tion.
Rec
eptiv
e-E
mer
gent
Lan
guag
e Sc
ale
Impr
ovem
ent n
ot ju
st m
atur
atio
n; n
otA
nder
son,
J.,
Kaf
er,
wer
e m
atch
ed o
n ra
ce, s
ex,
Stud
y 2
exam
ined
str
ess
of p
aren
ts,
Lea
rnin
g A
ccom
plis
hmen
t Pro
file
refl
ecte
d in
mat
ched
con
trol
gro
up.
L.B
., R
izzu
to, G
. E.,
and
Blo
szin
shky
, S.
'dis
ease
sta
te, s
ever
ity o
fim
pair
men
t, an
d co
gniti
vean
d ef
fect
s of
a b
imon
thly
par
ent
grou
p(s
ocia
l-ad
aptiv
e sk
ills)
Bay
ley
Scal
es o
f In
fant
Dev
or
Prog
ram
mat
ic d
iffe
renc
es a
lso
refl
ecte
d in
diff
eren
t ass
essm
ents
(pa
rt-t
itne
larg
ely
(199
4). E
ffic
acy
offu
nctio
n.St
andf
ord-
Bin
etR
evis
ed S
cale
gros
s m
otor
act
iviti
es, f
ull-
larg
ely
fine
-Pa
rt-
and
Full-
Tim
ePa
rt-t
ime:
16
boys
, 11
girl
s(c
ogni
tive
func
tioni
ng)
mot
or w
/spe
ech/
lang
uage
inst
ruct
or)
Ear
ly I
nter
vent
ion.
Full-
time:
16
boys
, 21
girl
sPe
rcep
tual
and
Mot
orSt
udy
2:N
o si
g di
ffer
ence
s be
twee
n gr
oups
at
Skill
s, 7
9, 9
07-9
11.
Con
trol
gro
up: 1
4 bo
ys, 9
gir
lsst
art
refe
rred
for
and
qua
lifie
d, b
utPa
rent
ing
Stre
ss I
nven
tory
cho
sen
beca
use.
No
sig
chan
ges
in c
ogni
tive
pare
nts
did
not e
nrol
l. D
id n
otsu
bsca
les
mea
sure
the
reci
proc
al n
atur
e of
func
tioni
ng f
or a
ny o
f th
e gr
oups
part
icip
ate
in p
rogr
amch
ild-t
o-pa
rent
inte
ract
ions
as
wel
l as
Gro
ss m
otor
ski
ll: r
elat
ive
to th
eac
tiviti
es, b
ut w
ere
scre
ened
beha
vior
s re
port
ed to
be
rela
ted
toco
ntro
l chi
ldre
n, b
oth
prog
ram
initi
ally
and
aga
in 6
mon
ths
dysf
unct
ion
with
in th
e ch
ild-p
aren
t sys
tem
.gr
oups
sho
wed
sig
impr
ovem
ents
late
r.C
hild
Cha
ract
eris
tics
Dom
ain
scal
ein
clud
es s
ubsc
ales
mea
suri
ng th
e ch
ild's
oVer
6 m
onth
s (a
dditi
onal
gai
ns f
orpa
rt-t
ime
grou
p ov
er r
d 6
mon
ths)
Stud
y 2:
33 m
othe
rs a
nd 3
fat
hers
of
adap
tabi
lity
and
plas
ticity
, acc
epta
bilit
y to
the
pare
nt, d
eman
ding
ness
, moo
d,di
stra
ctib
ility
and
hyp
erac
tivity
, and
the
Fine
mot
or s
kills
: rel
ativ
e to
the
cont
rol c
hild
ren,
bot
h pr
ogra
mgr
oups
sho
wed
sig
impr
ovem
ents
enro
lled
child
ren
serv
edex
tent
to w
hich
a c
hild
rei
nfor
ces
the
over
6 m
onth
s (a
dditi
onal
gai
ns f
orvo
lunt
arily
as
subj
ects
pare
nt. P
aren
t Cha
ract
eris
tics
Dom
ain
scal
e in
clud
es s
ubsc
ales
mea
suri
ng a
pare
nt's
dep
ress
ion,
unh
appi
ness
, and
guilt
, atta
chm
ent,
rest
rict
ions
impo
sed
byth
e pa
rent
al r
ole,
sen
se o
f co
mpe
tenc
e,so
cial
isol
atio
n, r
elat
ions
hip
with
spo
use,
and
heal
th.
full-
time
grou
p ov
er 2
nd 6
mon
ths)
Lan
guag
e: r
elat
ive
to th
e co
ntro
lch
ildre
n bo
th p
rogr
am g
roup
ssh
owed
sig
impr
ovem
ents
ove
r 12
mon
ths
(sig
gai
ns f
or f
ull-
time
grou
pal
so a
fter
6 m
onth
s)So
cial
ada
ptat
ion
skill
s sh
owed
sig
impr
ovem
ents
fro
m b
asel
ine
for
both
grou
ps a
fter
12
mon
ths
ofin
terv
entio
n
Stud
y 2:
Mut
ual p
redi
ctab
ility
indi
cate
dsi
g re
latio
nshi
ps b
etw
een
stre
ss a
ttrib
uted
to c
hara
cter
istic
s of
the
child
and
the
pare
nt. P
aren
ts a
ttend
ing
the
bim
onth
lypa
rent
s' g
roup
rep
orte
d si
gnif
ican
tde
crea
ses
in s
tres
s at
trib
utab
le to
the
adap
tabi
lity
and
the
dem
andi
ngne
ss o
fth
eir
child
ren.
13
19
20
'O
GR
Am
i....,
,:::::
::::
::::m
voro
wor
s.:::
::::::
::::::
::::::
:::::.
::::::
::::::
::::::
::::::
::::::
::::::
:::r-
-titt
etW
ii::::
::::::
::::::
::::::
::::::
::::::
:i:i::
::::::
::::::
::::::
::::::
::::::
::::''
'''''
'''IO
A0)
)03:
':::
:::::]
::::::
::::::
::::::
::::;:
::::::
::::::
::::::
::::::
::::::
;:::::
::::::
:''''
tifttt
::::::
::::::
::::::
::::::
::::::
::::::
::::::
1::::
::::::
::::0
The
mos
t pre
dict
ive
mea
sure
for
the
Chi
ldC
har.
Dom
ain
was
chi
ldre
n's
adap
tabi
lity
and
flex
ibili
ty. F
or P
aren
t Cha
r:: 1
)pa
rent
s' p
erce
ptio
ns o
f de
pres
sion
,un
happ
ines
s, a
nd g
uilt,
and
2)
sens
e of
com
pete
nce
as a
par
ent.
Edg
ar, E
., H
egge
lund
,M
., an
d Fi
sche
r, M
.(1
988)
A L
ongi
tudi
nal
Stud
y of
Gra
duat
es o
fSp
ecia
l Edu
catio
nPr
esch
ools
: Edu
catio
nal
Plac
emen
t Aft
erPr
esch
ool.
Top
ics
inE
arly
Chi
ldho
odSp
ecia
l Edu
catio
n, 8
(3),
61-7
4.
582
spec
ial e
d pr
esch
ool
grad
uate
s fr
om 1
0 sc
hool
dist
rict
s in
WA
dur
ing
the
1983
-198
6 sc
hool
yea
rs (
3).
.
Add
ress
ed 2
que
stio
ns:
1) W
hat i
s th
e fi
rst e
duca
tiona
lpl
acem
ent f
or s
peci
al e
duca
tion
pres
choo
l gra
duat
es a
fter
age
6?
2) H
ow s
tabl
e ar
e th
ese
plac
emen
tsov
er th
e fi
rst 2
yea
rs o
fel
emen
tary
sch
ool?
Spec
ial e
duca
tion
plac
emen
tIn
itial
pla
cem
ent:
13%
wer
e pl
aced
inre
gula
r ed
ucat
ion
setti
ngs
with
out s
peci
aled
sup
port
(19
% o
f al
l mild
lyha
ndic
appe
d, 1
2% o
f th
e m
ildly
ret
arde
d,an
d 6%
of
the
seve
rely
han
dica
pped
). A
nad
ditio
nal 1
9% w
ere
plac
ed in
reg
ular
ed
with
spe
cial
sup
port
ser
vice
s. 6
4% w
ere
in p
lace
d in
eith
er s
elf-
cont
aine
d or
reso
urce
roo
m s
ettin
gs
Stab
ility
of
plac
emen
t app
eare
d to
be
very
hig
h. O
f th
e 45
chi
ldre
n w
ho m
ade
plac
emen
t cha
nges
, 28
(62%
) m
oved
tole
ss r
estr
ictiv
e se
tting
s.
Inno
cent
i, M
.S. (
1996
).Fi
nal R
epor
t for
Pro
ject
Peri
od O
ctob
er 1
, 199
0-
Dec
embe
r 31
, 199
5 of
the
Lon
gitu
dina
l Stu
dies
of th
e E
ffec
ts o
fA
ltern
ativ
e T
ypes
of
Ear
ly I
nter
vent
ion
for
Chi
ldre
n w
ithD
isab
ilitie
s: F
ollo
w-U
pIn
stitu
te. S
ubm
itted
toth
e U
.S. D
epar
tmen
t of
Edu
catio
n by
the
Ear
lyIn
terv
entio
n R
esea
rch
Inst
itute
,
9 si
tes
(of
16 s
ites
incl
uded
inth
e or
igin
al 5
-yr
stud
y)
Stra
tifie
d, r
ando
m s
ampl
ew
ithin
site
s.
Pare
ntal
con
sent
; ass
esso
rsun
awar
e of
sub
ject
ass
ignm
ents
or s
tudy
hyp
othe
ses.
10-y
r lo
ngitu
dina
l stu
dy c
ontr
acte
d by
the
Dep
t of
Ed
addr
esse
d:T
reat
men
t int
ensi
ty (
com
pare
dex
istin
g hi
gh-q
ualit
y pr
ogra
ms
tom
ore
inte
nsiv
e al
tern
ativ
esde
velo
ped
for
the
stud
y, i.
e.,
1/w
eek
and
3/w
eek)
Mos
t app
ropr
iate
age
for
serv
ices
to b
egin
(co
mpa
red
trea
tmen
t at f
irst
ent
ry o
r at
afu
ture
poi
nt in
tim
esev
erel
ym
edic
ally
fra
gile
chi
ldre
n)Sy
stem
atic
pro
gram
dif
fere
nces
(i.e
., ad
ded
mor
e in
tens
e fa
mily
com
pone
nt to
cla
ssro
om-b
ased
prog
ram
, for
som
e)C
ompa
red
prog
ram
cos
t dat
a fo
rco
st e
ffec
tiven
ess
disc
ussi
ons
Tes
ting
com
mon
ly in
volv
ed o
nepr
etes
t, up
to e
ight
rea
sses
smen
ts
Cog
nitiv
e, m
otor
, lan
guag
e fu
nctio
ning
,m
othe
r an
d ch
ild in
tera
ctio
n, p
aren
tal
attit
udes
tow
ard
thei
r ch
ild w
ith a
disa
bilit
y, c
hild
suc
cess
in s
choo
l as,
indi
cate
d by
spe
cial
edu
catio
n cl
ass
plac
emen
t and
ret
entio
n, a
nd p
erce
ived
stre
ss a
s re
port
ed b
y th
e pa
rent
s. F
or e
ach
case
, the
spe
cifi
c go
als
and
activ
ities
of
the
inte
rven
tion
prog
ram
was
the
prim
ary
cons
ider
atio
n in
sel
ectin
g as
sess
men
tin
stru
men
ts.
,
Ass
essm
ent i
nstr
umen
ts u
sed
for
fmal
asse
ssm
ent b
atte
ry a
t all
site
s (a
ndco
mpl
emen
ted
by s
ite-s
peci
fic
com
plem
enta
ry m
easu
res)
are
:
Chi
ld M
easu
res:
Bat
telle
Dev
elop
men
tal I
nven
tory
(B
DI)
(New
borg
et a
l., 1
984)
;W
oodc
ock-
John
son
Tes
ts o
f A
chie
vem
ent
(WJ-
RX
Woo
dcoc
k &
Joh
nson
, 198
9);
See
indi
vidu
al s
ite s
tudy
des
crip
tions
2114
77:
'stif
fiV
t::::.
:b41
tAtie
iiiii:
ii::::
::::::
::::::
:::::M
OV
VR
e. ''
: '''
:1.::
::::::
::::::
::::::
::::::
:--:
::::::
::::::
::::::
:i:i:i
:1:ii
:::i:i
iiii::
'W
it114
1' .
::::::
::::::
::::::
::::::
::::::
::::::
:..:
::::::
::::::
::::::
::::::
00T
:::*
mm
ots:
i:im
mE
::::::
::i:::
::::m
in:::
::::::
::::::
::::::
:::si
gt*M
mi:i
ii::::
::::::
iiiiii
:iiii:
iiiN
iiiiii
:i:.::
::::::
::::::
:
Mea
sure
d ef
fect
siz
e by
com
pari
ngth
e di
ffer
ence
of
grou
p m
eans
to th
est
anda
rd d
evia
tion
of th
e co
mpa
riso
ngr
oup
scor
es
Scal
es o
f In
depe
nden
t Beh
avio
r (S
IB)
(Bru
inin
ks e
t al,
1985
);So
cial
Ski
lls R
atin
g Sc
ale
(SSR
SXG
resh
am &
Elli
ott,
1990
);Pi
ctor
ial S
cale
of
Perc
eive
d C
ompe
tenc
ean
d A
ccep
tanc
e (H
arte
r &
Pik
es, 1
983)
Fam
ily M
easu
res:
Pare
ntin
g St
ress
Ind
ex (
PSIX
Abi
din,
1983
);Fa
mily
Sup
port
Sca
le (
FSS)
(Dun
st e
t al.,
1984
);Fa
mily
Res
ourc
e Sc
ale
(FR
S)(
Dun
st &
.
Lee
t, 19
85);
Fam
ily I
nven
tory
of
Lif
e E
vent
s an
dC
hang
es (
FIL
E)(
McC
ubbi
n et
al.,
198
3);
Fam
ily A
dapt
atio
n an
d C
ohes
ion
.
Eva
luat
ion
Scal
e -I
II (
FAC
ESX
Ols
on e
tal
., 19
85);
Chi
ld H
ealth
(W
hite
et a
l., 1
987)
;A
dditi
onal
Ser
vice
s (W
hite
et a
l., 1
987)
;Fa
mily
Inf
orm
atio
n Su
rvey
(W
hite
et a
l.,19
87)
Inno
cent
i, M
.S. (
Ear
ly35
chi
ldre
n 0-
30 m
onth
s, w
ithC
ompa
red
wee
kly
indi
vidu
aliz
edM
easu
res.
incl
uded
thos
e us
ed f
or a
llT
here
wer
e no
con
sist
ent d
iffe
renc
esIn
terv
entio
n R
esea
rch
visi
on im
pair
men
t as
maj
orpa
rent
-chi
ld s
essi
ons
with
par
ent
stud
ies
(see
ove
rvie
w),
and
:be
twee
n th
e ch
ildre
n or
thei
r fa
mili
es th
atIn
stitu
te),
199
6di
sabi
lity,
ran
dom
ly a
ssig
ned
togr
oup
mee
tings
app
roxi
mat
ely
12pa
rtic
ipat
ed in
the
wee
kly
pare
nt-c
hild
two
grou
ps.
times
per
yea
rC
hild
Mea
sure
s:se
ssio
ns a
nd th
ose
that
did
not
.L
ongi
tudi
nal S
tudi
es o
fPl
ay A
sses
smen
t Sca
le V
ideo
tape
dth
e E
ffec
ts o
fA
ttriti
on: f
our
subj
ects
The
inte
rven
tion
emph
asiz
edSc
enar
io o
f E
xplo
ratio
n/Pl
ay;
.
Alte
rnat
ive
Typ
es o
fde
velo
pmen
tal t
hera
py d
irec
ted
Ear
ly I
nter
vent
ion
Dev
elop
men
tal P
rofi
le;
Ear
ly I
nter
vent
ion
for
tow
ard
the
child
, rat
her
than
Vin
elan
d A
dapt
ive
Beh
avio
r Sc
ales
;C
hild
ren
with
prov
idin
g pr
imar
y su
ppor
t and
Car
olin
a R
ecor
d of
Ind
ivid
ual B
ehav
ior;
Dis
abili
ties:
Fol
low
-Up
assi
stan
ce to
the
fam
ily.
Boe
hm T
est o
f B
asic
Con
cept
s;In
stitu
teT
est o
f L
angu
age
Dev
elop
men
t, Pr
imar
y,T
d ed
.;N
ew O
rlea
ns V
isua
lM
cCar
thy
Scal
es o
f C
hild
ren'
s A
bilit
ies;
Impa
irm
ent S
tudy
Soci
al S
kill
Rat
ing
Syst
em;
Forc
ed C
hoic
e Pr
efer
entia
l Loo
king
Tec
hniq
ue;
Hill
Per
form
ance
Sca
le;
WIS
C H
I
2315
24
-0.6
16iN
i...
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tillp
iVii:
-: 4
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ils.:]
::::::
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::::::
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010.
0411
:::::
::::::
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:i::::
::::::
:!::3
::!:::
:::::E
::::M
.-V
ta.M
.Rn
iini:i
:i:i:i
::::::
::::i:
::::::
:::...
3itta
; ...
.in
::::::
:::::1
1::::
:::0:
::::::
:: ::
Fam
ily M
easu
res:
Fam
ily A
dapt
atio
n an
d C
ohes
ion
Scal
es;
Vid
eota
ped
Scen
ario
of
Pare
nt/C
hild
Inte
ract
ion;
Hol
mes
-Rah
e Sc
hedu
le o
f R
ecen
t Eve
nts;
Pare
nt S
elf-
Aw
aren
ess
Scal
e;Fa
mily
Fun
ctio
ning
Sty
le S
urve
y
Inno
cent
i, M
.S. (
Ear
lyIn
terv
entio
n R
esea
rch
Inst
itute
), 1
996
Lon
gitu
dina
l Stu
dies
of
the
Eff
ects
of
Alte
rnat
ive
Typ
es o
fE
arly
Int
erve
ntio
n fo
rC
hild
ren
with
Dis
abili
ties:
Fol
low
-Up
Inst
itute
SMA
/Lak
e M
cHen
rySu
mm
ary
Rep
ort
72 c
hild
ren
serv
ed b
y th
ree
diff
eren
t ear
ly in
terv
entio
npr
ogra
ms,
24
mon
ths
of a
ge o
rle
ss a
t ref
erra
l with
a d
iagn
osed
disa
bilit
y or
fun
ctio
ning
at 6
5%or
less
of
wha
t was
exp
ecte
d of
child
ren
thei
r ag
e ba
sed
on th
eW
isco
nsin
Beh
avio
r R
atin
gSc
ale
(ass
esse
s ba
sic
surv
ival
skill
s). S
ubje
cts
ente
red
asth
ey w
ere
iden
tifie
d. G
roup
sw
ere
stra
tifie
d by
deve
lopm
enta
l sta
tus
and
pare
nt's
leve
l of
stre
ss, a
ndw
ere
high
ly c
ompa
rabl
e w
hen
addi
tiona
l dem
ogra
phic
and
cont
extu
al.d
ata
wer
e ex
amin
ed,
Tes
ting:
one
pre
test
, 7 a
nnua
lre
asse
ssm
ents
Attr
ition
: 24
subj
ects
(gr
oups
rem
aine
d co
mpa
rabl
e)
Eac
h si
te, w
hich
ori
gina
lly s
erve
don
ly o
nce
per
wee
k, a
dded
a th
ree-
times
-per
-wee
k co
mpo
nent
to w
hich
subj
ects
at e
ach
site
wer
e ra
ndom
lyas
sign
ed. P
rogr
ams
focu
sed
onim
prov
ing
child
dev
elop
men
t(p
erso
nal/s
ocia
l, ad
aptiv
e, m
otor
,la
ngua
ge, c
ogni
tive)
and
teac
hing
skill
s to
par
ents
that
wou
ld a
llow
them
to a
ssis
t with
thei
r ch
ild's
deve
lopm
enta
l pro
gres
s du
ring
dai
lyliv
ing
activ
ities
. The
pro
gram
sem
phas
ized
the
impo
rtan
ce o
fad
dres
sing
par
ent-
iden
tifie
d ne
eds
asw
ell a
s st
reng
ths
in a
n ef
fort
toem
pow
er p
aren
ts to
bec
ome
capa
ble
of d
ealin
g w
ith th
e de
man
ds o
f ca
ring
for
a ch
ild w
ith s
peci
al n
eeds
.
Mea
sure
s in
clud
ed th
ose
used
for
all
stud
ies
(see
ove
rvie
w),
and
:
Fam
ily M
easu
res:
Pare
nt S
tres
s In
dex
(PSI
)(A
bidi
n, 1
986)
;
No
evid
ence
that
incr
easi
ng th
e am
ount
of
inte
rven
tion
from
one
to th
ree
times
per
wee
k is
cos
t eff
ectiv
e fo
r ch
ildre
n si
mila
rto
thos
e en
rolle
d. T
here
wer
e no
stat
istic
ally
sig
nifi
cant
dif
fere
nces
betw
een
the
grou
ps r
e ch
ild m
easu
res.
Mot
hers
rep
orte
d hi
gher
leve
ls o
f su
ppor
tdu
ring
the
firs
t thr
ee y
ears
, and
less
str
ess
duri
ng Y
ear
4.
.
Inno
cent
i, M
.S. (
Ear
lyIn
terv
entio
n R
esea
rch
Inst
itute
), 1
996
Lon
gitu
dina
l Stu
dies
of
the
Eff
ects
of
Alte
rnat
ive
Typ
es o
fE
arly
Int
erve
ntio
n fo
r,C
hild
ren
with
Dis
abili
ties:
Fol
low
-Up
Inst
itute
78 c
hild
ren
ages
3 to
48
Mon
ths
rece
ivin
g se
rvic
es b
efor
e 86
/87,
or e
nter
ing
serv
ices
fal
l of
87,
at tw
o si
tes.
Gro
ups
wer
est
ratif
ied
by a
ge a
nd le
vel o
fdi
sabi
lity
and
child
ren
Wer
era
ndom
ly a
ssig
ned
to o
ne o
ftw
o tr
eatm
ent g
roup
s.
Attr
ition
: 27
child
ren
Com
pare
d tw
o le
vels
of
inte
nsity
of
hom
e-ba
sed
earl
y in
terv
entio
nse
rvic
es: o
nce
ever
y ot
her
wee
k,in
crea
sed
to o
nce
per
wee
k in
rd
year
of s
tudy
, com
pare
d to
twic
e pe
r w
eek.
Inte
rven
tion
focu
sed
on d
evel
opin
gfu
nctio
nal s
kills
bas
ed o
n ch
ild's
deve
lopm
enta
l lev
el a
nd f
amily
func
tioni
ng a
s re
pres
ente
d in
the
IEP.
Com
pari
son
test
s in
clud
ing
dem
ogra
phic
s su
gges
t a s
light
pre
test
Mea
sure
s in
clud
ed th
ose
used
for
all
stud
ies
(see
ove
rvie
w),
and
:
Chi
ld M
easu
res:
The
Vin
elan
d A
dapt
ive
Beh
avio
r Sc
ales
Surv
ey E
ditio
n (S
parr
ow e
t al.,
198
4);
Sequ
ence
d In
vent
ory
of C
omm
unic
atio
nD
evel
opm
ent (
SIC
DX
Hed
rick
et a
l., 1
984)
;C
hild
Hea
lth (
E.I
.R.I
.);
Infe
rred
Sel
f-C
once
pt S
mile
(IS
CS)
Res
ults
do
not s
uppo
rt th
e hy
poth
esis
that
mor
e in
tens
e fr
eque
ncy
of h
ome
earl
yin
terv
entio
n vi
sits
fro
m tw
ice
per
wee
kco
mpa
red
with
onc
e pe
r w
eek
will
res
ult
in b
ette
r ou
tcom
es f
or p
artic
ipat
ing
child
ren
or f
amili
es. W
hile
ther
e ar
e a
few
sta
tistic
ally
sig
nifi
cant
res
ults
, the
over
all p
atte
rn is
one
of
nO e
ffec
t.
2616
Ark
ansa
s In
tens
itySt
udy
.
.
diff
eren
ce b
etw
een
grou
ps in
fav
or o
fth
e ex
pand
ed in
terv
entio
n go
up.
Ana
lysi
s of
'cov
aria
nce
proc
edur
esw
ere
used
to a
djus
t for
thes
edi
ffer
ence
s.
Dro
pout
pat
tern
s al
so f
avor
ed th
eex
pand
ed in
terv
entio
n gr
oup.
Pret
est a
nd r
eass
essm
ents
at 8
, 18,
30, 4
2, 6
6, 7
8, 9
0, a
nd 1
02 m
onth
s.
Fam
ily M
easu
res:
Pare
nt S
elf-
Aw
aren
ess
Scal
e(P
SASX
Snyd
er e
t al.,
198
5);
Soci
al R
eadj
ustm
ent R
atin
g Sc
ale
(SR
RSX
Hol
mes
& R
ahe,
196
7);
Tea
cher
Rat
ing
of P
aren
t's P
artic
ipat
ion
in E
duca
tion
Prog
ram
(E
.I.R
.I.)
;Pa
rent
ing
Stre
ss I
ndex
(PS
I) S
hort
For
m(A
bidi
n, 1
990)
;
.
.
Inno
cent
i, M
.S. (
Ear
lyIn
terv
entio
n R
esea
rch
Inst
itute
), 1
996
Lon
gitu
dina
l Stu
dies
of
the
Eff
ects
of
Alte
rnat
ive
Typ
es o
fE
arly
Int
erve
ntio
n fo
rC
hild
ren
with
.
Dis
abili
ties:
Fol
low
-Up
Inst
itute
Jord
an I
nten
sity
Stu
dy
53 c
hild
ren
betw
een
36 a
nd 6
2m
onth
s of
age
, mild
tom
oder
atel
y di
sabl
ed w
ith a
wid
e ar
ray
of d
isab
ilitie
s.St
ratif
ied
by s
ever
ity o
fdi
sabi
lity
and
rand
omly
assi
gned
.
Attr
ition
: 1 s
ubje
ct
Com
pare
d tw
o ye
ar-l
ong
pres
choo
lin
terv
entio
n pr
ogra
ms
in f
our
clas
sroo
ms
at tw
o sc
hool
s. S
tand
ard
prog
ram
2 h
rs, 3
day
s pe
r w
eek.
Mor
e in
tens
ive
prog
ram
dev
elop
edfo
r 2
hrs,
5 d
ays
per
wee
k w
ith h
ighe
rst
aff
ratio
s.
Pret
est a
nd 7
ann
ual r
eass
essm
ents
Gro
ups
com
para
ble
over
all,
sign
ific
ant d
iffe
renc
es e
xist
ed, b
utdi
d no
t fav
or a
par
ticul
ar g
roup
.
.
Mea
sure
s in
clud
ed th
ose
used
for
all
stud
ies
(see
ove
rvie
w),
and
:
Chi
ld M
easu
res:
Jose
ph P
resc
hool
and
Pri
mar
y Se
lf-
Con
cept
Scr
eeni
ng T
est (
JSI)
(Jos
eph,
1979
);D
evel
opm
enta
l SPE
CS
(Sys
teth
to P
lan
Ear
ly C
hild
hood
Ser
vice
s) (
Bag
nato
&N
eisw
orth
, 199
0);
Perc
eive
d co
mpe
tenc
e an
d So
cial
Acc
epta
nce
(Har
ter
& P
ikes
, 198
3);
Coo
per
Farr
an B
ehav
iora
l Rat
ing
Scal
es(C
oope
r &
Far
ran,
198
8)
Fam
ily M
easu
res:
Pare
nt S
tres
s In
dex
(PSI
) Sh
ort F
orm
(Abi
din,
198
6);
Com
preh
ensi
ve E
valu
atio
n of
Fam
ilyFu
nctio
ning
(C
EFF
)(M
cLin
den,
198
9);
Pare
nt S
elf-
Aw
aren
ess
Scal
e(P
SAS)
(Sn
yder
et a
l., 1
985)
Mor
e in
tens
ive
inte
rven
tion
had
a m
ildim
med
iate
and
long
itudi
nal i
mpa
ct o
nch
ild d
evel
opm
enta
l out
com
es, m
ost
.cle
arly
on
mea
sure
s of
chi
ld d
evel
opm
ent
and
adap
tive
beha
vior
. Chi
ldre
n w
ithm
ore
seve
re d
isab
ilitie
s be
nefi
ted
mor
efr
om th
e m
ore
inte
nsiv
e in
terv
entio
n th
anch
ildre
n w
ith le
ss s
ever
e di
sabi
litie
s.
Som
e im
med
iate
and
con
flic
ting
find
ings
wer
e fo
und
follo
win
g in
terv
entio
n, b
ut n
otm
aint
aine
d lo
ngitu
dina
lly.
Giv
en th
e po
ssib
ility
of
subs
tant
ial
impa
cts
in la
ter
life
from
incr
ease
s in
adap
tive
beha
vior
fun
ctio
ning
, iss
ues
arou
nd th
e co
st-b
enef
it of
this
inte
rven
tion
are
still
und
er in
vest
igat
ion.
Inno
cent
i, M
.S. (
Ear
lyIn
terv
entio
n R
esea
rch
Inst
itute
), 1
996
Lon
gitu
dina
l Stu
dies
of
the
Eff
ects
of
Alte
rnat
ive
Typ
es o
fE
arly
Int
erve
ntio
n fo
r.
Chi
ldre
n w
ith
60 in
fant
s fr
om e
ither
of
3te
rtia
ry N
eona
tal I
nten
sive
Car
eU
tnts
(N
ICU
S), r
ecru
ited
1985
-19
88, w
ho h
ad e
xper
ienc
edne
onat
al in
trav
entr
icul
arhe
mor
rhag
e (I
VH
). A
ll bu
t 5w
ere
low
bir
thw
eigh
t. Su
bjec
tsw
ere
stra
tifie
d on
sev
erity
of
hem
orrh
age
and
birt
hwei
ght,
and
rand
omly
ass
igne
d.
Com
pare
d 2
grou
ps o
f m
edic
ally
frag
ile c
hild
ren
begi
nnin
gin
terv
entio
n at
dif
fere
nt a
ges
(3m
onth
s co
rrec
ted
age
vs. 1
8 m
onth
s).
Ear
ly in
terv
entio
n in
volv
edse
nsor
imot
or tr
eatm
ent s
essi
ons
once
per
mon
th, f
or o
ne h
our
(mor
ein
tens
ive
prov
ided
whe
n ne
eded
).Pa
rent
s pa
rtic
ipat
ed a
nd w
ere
give
n
Mea
sure
s in
clud
ed th
ose
used
for
all
stud
ies
(see
ove
rvie
w),
and
:
Stan
fOrd
-Bin
et S
cree
ning
Tes
t (T
horn
dike
et a
l., 1
986)
;C
hild
Beh
avio
r C
heck
list
(CB
CL
XA
chen
bach
, 199
1);
Neo
nata
l med
ical
info
rmat
ion
from
hosp
ital d
isch
arge
sum
mar
ies;
hea
lth a
nd
For
thes
e ch
ildre
n an
d at
this
inte
nsity
of
inte
rven
tion,
beg
inni
ng in
terv
entio
n at
3m
onth
s of
age
did
not
nec
essa
rily
res
ult i
nbe
tter
deve
lopm
enta
l out
com
es th
anbe
ginn
ing
inte
rven
tion
at 1
8 m
onth
s.
As
pres
choo
lers
, the
ear
ly in
terv
entio
ngr
oup
scor
ed b
ette
r th
an th
ose
in th
ede
laye
d in
terv
entio
n gr
oup,
but
the
grou
ps
172
8
Inno
cent
i, U
S. (
Ear
ly54
infa
nts
with
med
ical
Com
pare
d tw
o in
tens
ities
of
serv
ice
Mea
sure
s in
clud
ed th
ose
used
for
all
A m
ore
inte
nsiv
e in
terv
entio
n di
d no
t.?
Inte
rven
tion
Res
earc
hco
mpl
icat
ions
, str
atif
ied
byto
med
ical
ly f
ragi
le in
fant
s an
d th
eir
stud
ies
(see
ove
rvie
w),
and
:de
mon
stra
te d
iffe
rent
ial p
ositi
ve e
ffec
tsIn
stitu
te),
199
6pr
imar
y di
agno
sis.
offa
mili
es: r
outin
e m
edic
al s
ervi
ces
for
med
ical
ly f
ragi
le c
hild
ren
but
Bro
ncho
pulm
onar
y D
yspl
asia
prov
ided
aft
er d
isch
arge
by
the
Chi
ld M
easu
res:
som
ewha
t sm
all e
ffec
ts o
n fa
mily
Lon
gitu
dina
l Stu
dies
of
the
Eff
ects
of
(BPD
) or
neu
rolo
gica
l dam
age,
rand
omly
ass
igne
d.ho
spita
l vs.
a c
oord
inat
ed a
ndco
mpr
ehen
sive
sys
tem
of
earl
yB
ayle
y Sc
ales
of
Infa
nt D
evel
opm
ent
(Bay
ley,
196
9);
func
tioni
ng. N
o ev
iden
ce th
at it
was
cos
t-ef
fect
ive.
Alte
rnat
ive
Typ
es o
fin
terv
entio
n se
rvic
es in
itiat
ed b
efor
eV
inel
and
Ada
ptiv
e B
ehav
ior
Scal
esE
arly
Int
erve
ntio
n fo
rN
o si
gnif
ican
t dif
fere
nces
disc
harg
e.(S
parr
ow e
t al.,
198
4);
Chi
ldre
n in
the
low
-int
ensi
ty ig
oup
wer
eC
hild
ren
with
betw
een
grou
ps o
nIn
fant
Neu
rolo
gica
l Int
erna
tiona
l Bat
tery
mor
e lik
ely
to b
e cl
assi
fied
as
diff
icul
tD
isab
ilitie
s: F
ollo
w-U
pde
mog
raph
ic v
aria
bles
Ass
esse
d 2
wks
aft
er d
isch
arge
and
at
(IN
FAN
IB)(
Elli
son
et a
l., 1
985)
;th
an c
hild
ren
in th
e hi
gh-i
nten
sity
gro
up.
Inst
itute
exam
ined
at p
rete
st. S
ome
sig
diff
s du
ring
som
e of
the
late
r6,
12,
18,
24,
36,
48,
60,
and
72
mon
ths
of a
ge.
Car
ey I
nfan
t Tem
pera
men
t Sca
le (
ITQ
)
Col
umbu
s M
edic
ally
asse
ssm
ents
. Cov
aria
nce
Fam
ily M
easu
res:
Frag
ile S
tudy
proc
edur
es u
sed.
Hol
mes
& R
ahe
Maj
or L
ife
Eve
nts
(Hom
es&
Rah
e, 1
967)
;A
ttriti
on: a
ppro
x. 1
4Pa
rent
Pro
tect
ion
Scal
e (P
PS);
Chi
ld V
ulne
rabi
lity
Scal
e (C
VS)
(For
syth
)
Inno
cent
i, M
.S. (
Ear
ly76
chi
ldre
n in
a c
lass
room
-C
ompa
red
EI
serv
ices
with
dif
feri
ngM
easu
res
incl
uded
thos
e us
ed f
or a
llE
vide
nce
for
cost
-eff
ectiv
enes
s of
this
Inte
rven
tion
Res
earc
hba
sed
earl
y in
terv
entio
npa
rent
invo
lvem
ent.
Enh
ance
dst
udie
s (s
ee o
verv
iew
), a
nd:
kind
of
pare
nt c
ompo
nent
is n
ot v
ery
Inst
itute
), 1
996
pres
choo
l pro
gram
(42
grou
ps in
volv
ed p
aren
ts in
pla
nned
com
pelli
ng. T
here
was
a s
mal
l, po
sitiv
ecl
assr
oom
onl
y, 3
4 w
ith a
dded
activ
ities
pri
mar
ily, b
ut n
otC
hild
Mea
sure
s:im
pact
on
child
ren'
s de
velo
pmen
tal
Lon
gitu
dina
l Stu
dies
of
pare
nt in
volv
emen
t), n
otex
clus
ivel
y, f
ocus
ed o
n ch
ild-o
rien
ted
Jose
ph P
resc
hool
and
Pri
mar
y Se
lf-
prog
ress
and
par
enta
l per
cept
ions
of
the
Eff
ects
of
prof
ound
ly d
isab
led,
who
seis
sues
. Par
ent m
eetin
gs o
rgan
ized
Con
cept
Scr
eeni
ng T
est (
JSI)
(Jos
eph,
soci
al s
uppo
rt, b
ut th
ese
wer
e no
tA
ltern
ativ
e T
ypes
of
pare
nts'
sch
edul
es a
llow
edar
ound
the
Pare
nts
Invo
lved
in19
79);
mai
ntai
ned
over
tim
e.E
arly
Int
erve
ntio
n fo
rth
em to
atte
nd th
e pa
rent
Edu
catio
n cu
rric
ula
(chi
ldSt
anfo
rd-B
inet
Int
ellig
ence
Tes
t For
m L
-MC
hild
ren
with
invo
lvem
ent m
eetin
gs. 7
5%de
velo
pmen
t, ob
serv
atio
n an
d(T
erm
an &
Mer
rill,
197
3);
Pare
nts
who
rec
eive
d th
e pa
rent
Dis
abili
ties:
Fol
low
-Up
dem
onst
rate
d de
velo
pmen
tal
reco
rdin
g, ta
rget
ing
inte
rven
tion
Dev
elop
men
tal S
PEC
S (S
yste
m to
Pla
nin
volv
emen
t com
pone
nt w
ere
less
like
lyIn
stitu
tede
lay,
with
dis
abili
ty r
ange
seve
re to
mild
. Str
atif
ied
bybe
havi
ors,
teac
hing
pro
cess
es,
deci
sion
mak
ing,
and
com
mun
icat
ing
Ear
ly C
hild
hood
Ser
vice
s) (
Bag
nato
&N
eisw
orth
, 199
0)th
an o
ther
par
ents
to a
ttrib
ute
thei
r ch
ild's
deve
lopm
enta
l pro
gres
s to
cha
nce.
Mild
Des
Moi
nes
Pare
ntch
rono
logi
cal a
ge b
y te
ache
rw
ith p
rofe
ssio
nals
). P
aren
t sup
port
long
itudi
nal i
mpa
cts
for
enha
nced
gyo
upIn
volv
emen
t Stu
dype
rcep
tion
of p
aren
t mot
ivat
ion,
with
dev
elop
men
tal f
unct
ioni
ngco
mpo
nent
.Fa
mily
Mea
sure
s:,
Pare
ntin
g St
ress
Ind
ex S
hort
For
mw
ere
foun
d on
teac
her
perc
eptio
ns o
fch
ildre
n's
clas
sroo
m b
ehav
iors
.in
form
atio
n.A
ll su
bjec
ts r
ecei
ved
clas
sroo
m-
base
d, h
alf-
day,
5-d
ay-p
er-w
eek
(PSI
)(A
bidi
n, 1
990)
;C
ES-
D D
epre
ssio
n Sc
ale
(Rad
loff
, 197
7);
Attr
ition
: 16
subj
ects
inte
rven
tion
serv
ices
.C
hild
Im
prov
emen
t Que
stio
nnai
re (
CIQ
;D
evel
lis e
t al.,
198
5);
Com
para
bilit
y: s
light
adv
anta
gefo
r en
hanc
ed g
roup
Pret
est,
reas
sess
men
ts a
t end
of
acad
emic
yea
r an
d an
nual
ly th
erea
fter
Pare
nt a
s a
Tea
cher
Sca
le (
PAA
T; S
trom
,19
84);
(8 in
all)
Com
preh
ensi
ve E
valu
atio
n of
Fam
ilyFu
nctio
ning
(C
EFF
)(M
cLin
den,
198
9);
Pare
nt S
elf-
Aw
aren
ess
Scal
e(P
SAS)
(Sny
der
et a
l., 1
985)
;H
olm
es a
nd R
ahe
Maj
or L
ife
Eve
nts
3119
32
.... .
.. ...
... ..
......
.....
......
.....
......
......
. ....
......
.. ...
......
...
......
.....
....
......
.. ...
......
......
......
......
....
(Hol
mes
& R
ahe,
196
7);
Dya
dic
Adj
ustm
ent S
cale
(D
ASX
Span
ier,
1976
);Fa
mily
Fun
ctio
ning
Sty
le S
cale
(FFS
SXD
eal e
t al.,
198
8)In
noce
nti,
MS.
(E
arly
56 p
resc
hool
chi
ldre
n 23
to 6
1E
xplo
red
whe
ther
add
ition
of
pare
nt-
Mea
sure
s in
clud
ed th
ose
used
for
all
A n
umbe
r of
ben
efits
wer
e ga
ined
fro
mIn
terv
entio
n R
esea
rch
mon
ths
of a
ge, w
ith m
oder
ate
toas
-int
erve
ner
focu
s to
cen
ter-
base
dst
udie
s (s
ee o
verv
iew
), a
nd:
this
eas
ily a
dmin
iste
red,
rel
ativ
ely
Inst
itute
), 1
996
seve
re d
isab
ilitie
s, s
trat
ifie
d by
prog
ram
infl
uenc
ed:
inex
pens
ive
prog
ram
of
a sh
ort d
urat
ion.
age,
dev
elop
men
tal l
evel
, and
Chi
ld d
evel
opm
ent
Chi
ld M
easu
res:
Lon
gitu
dina
l Stu
dies
of
thei
r te
ache
r's r
atin
g of
par
ent
Lat
er s
choo
l pla
cem
ent
Dev
elop
men
tal S
PEC
S (S
yste
m to
Pla
n.So
cial
sup
port
and
fam
ily c
ohes
ion
the
Eff
ects
of
mot
ivat
ion,
ran
dom
ly a
ssig
ned
Pare
ntal
inte
ract
ion
beha
vior
sE
arly
Chi
ldho
od S
ervi
ces)
(B
agna
to &
mea
sure
s w
ere
sign
ific
antly
in f
avor
of
Alte
rnat
ive
Typ
es o
fto
2 g
roup
s.w
ith c
hild
Nei
swor
th, 1
990)
;pa
rent
invo
lvem
ent,
but o
nly
duri
ng th
eE
arly
.Int
erve
ntio
n fo
rPa
rent
s' p
erce
ptio
ns o
f so
cial
Min
neso
ta C
hild
Dev
elop
men
t Inv
ento
ryin
volv
emen
t per
iod.
The
invo
lvem
ent
Chi
ldre
n w
ithW
ell-
mat
ched
on
dem
ogra
phic
,su
ppor
t(M
CD
I)(I
reto
n &
Thw
ing,
197
4);
prog
ram
app
ears
to h
ave
had
not e
ffec
t on
Dis
abili
ties:
Fol
low
-Up
child
, and
fam
ily m
easu
res.
Pare
ntin
g st
ress
Chi
ld H
ealth
(E
.I.R
.I.)
pare
nt s
tres
s (w
hich
app
ears
to b
e m
ore
Inst
itute
Gen
eral
fam
ily f
unct
ioni
ngre
late
d to
oth
er c
onte
xtua
l asp
ects
of
the
Attr
ition
: app
rox
3 su
bjec
ts(f
amily
coh
esio
n &
ada
ptab
ility
)Fa
mily
Mea
sure
s:pa
rent
's li
fe).
Par
ents
fro
m th
eU
tah
Pare
ntC
ES-
D D
epre
ssio
n Sc
ale
(Rad
loff
, 197
7);
invo
lvem
ent g
roup
wer
e co
nsis
tent
lyIn
volv
emen
t Stu
dyPr
ogra
m: 3
hr/
day,
5da
ys/w
k at
Chi
ld I
mpr
ovem
ent Q
uest
ionn
aire
cons
ider
ed m
ore
know
ledg
eabl
e an
dce
nter
. Par
ents
fro
m tr
eatm
ent [
coup
Rev
ised
(D
evel
lis e
t al.,
198
5);
mor
e su
ppor
tive
of th
eir
child
ren'
sat
tend
ed 1
5 ni
nety
mM
par
ent
Peab
ody
Pict
ure
Voc
abul
ary
Tes
ted
ucat
ion.
How
ever
, sig
nifi
cant
var
ianc
ein
stru
ctio
n se
ssio
ns o
ver
4 m
onth
s,ba
sed
on th
e Pa
rent
Inv
olve
men
t in
Edu
catio
n (P
IE)
grou
p. P
IE
(PPV
T)(
Dun
n &
Dun
n, 1
981)
;T
est o
f Pa
rent
Kno
wle
dge
(E.I
.R.I
.);
Pare
nt-C
hild
Int
erac
tion
(E.I
.R.I
.);
in te
ache
rs' r
atin
gs o
f pa
rent
s'.
attit
udes
tow
ard,
and
par
ticip
atio
n in
,th
eir
child
's e
duca
tiona
l pro
gram
at
curr
icul
um in
clud
es in
trod
uctio
n an
dPa
rent
Sel
f-A
war
enes
s Sc
ale
(PSA
S);
reas
sess
men
t #4
did
not c
ontin
ue w
ithov
ervi
ew, o
bjec
tive
obse
rvat
ion
ofch
ild b
ehav
ior,
def
inin
g an
dM
ajor
Lif
e E
vent
s Sc
ale
(Hol
mes
& R
ahe,
1967
);la
ter
reas
sess
men
ts. A
mar
ked
incr
ease
inth
e de
velo
pmen
tal s
core
s of
chi
ldre
n in
mea
suri
ng b
ehav
ior,
pri
ncip
les
ofC
ompr
ehen
sive
Eva
luat
ion
of F
amily
the
invo
lvem
ent g
roup
app
ears
to b
e th
ebe
havi
or m
anag
emen
t, an
alyz
ing
Func
tioni
ng (
CE
FFX
McL
inde
n, 1
990)
;re
sult
of th
e in
terv
entio
n (s
tatis
tical
lybe
havi
or c
hain
s, th
eori
es o
f ch
ildFa
mily
APG
AR
(Sm
ilkst
ein,
197
8);
sign
ific
ant d
iffe
renc
e fr
om 2
rld
deve
lopm
ent,
test
ing
and
rete
stin
g,cr
iteri
on-r
efer
ence
d as
sess
men
t,de
velo
ping
lear
ning
obj
ectiv
es, P
.L.
Fam
ily F
unct
ioni
ng S
tyle
Sca
le(F
FSS)
(Dea
l, T
rive
tte, &
Dun
st, 1
988)
;D
yadi
c A
djus
tmen
t Sca
le (
DA
S)(S
pani
er
reas
sess
men
t on)
. Inv
olve
men
t gro
upch
ildre
n sh
owed
few
er p
robl
embe
havi
ors
and
mor
e so
cial
ly a
ppro
pria
te94
-142
and
IE
Ps, i
nter
vent
ion
stra
tegi
es, f
acto
rs r
elat
ed to
teac
hing
succ
ess,
pra
ctic
e te
achi
ng s
essi
ons,
dete
rmin
ing
appr
opri
ate
inte
rven
tions
, com
mun
icat
ing
with
prof
essi
onal
s, s
tres
s m
anag
emen
t,an
d re
view
, com
men
ts, c
once
rns,
and
ques
tions
. lso
ask
ed to
pra
ctic
e
1976
);R
elig
iosi
ty Q
uest
ionn
aire
-
beha
vior
.
Not
e, h
owev
er, t
hat t
wo
repl
icat
ions
of
this
stu
dy r
epor
ted
few
er a
dvan
tage
s.So
me
anal
yses
acr
oss
site
s ha
s be
enun
derw
ay.
3320
34
..1-
..'
trai
ning
act
iviti
es a
t hom
e. N
ote
that
all p
aren
ts w
ere
invo
lved
in I
EP,
teac
her
inte
ract
ion,
occ
asio
nally
pare
nt-h
elpi
ng.
Ass
essm
ents
at s
tart
, aft
er p
aren
tin
stru
ctio
n (7
mo
late
r) a
nd a
nnua
llyth
erea
fter
for
7 y
rs.
.
Mc
Car
ton,
C.M
.,B
rook
s-G
unn,
J.,
Wal
lace
, I.F
., B
auer
,C
.R.,
Ben
nett,
F.C
.,B
ernb
aum
, J.C
.,B
royl
es, R
.S.,
Cas
ey,
P.H
., M
cCor
mic
k,M
.C.,
Scot
t, D
.T.,
Tys
on, J
., T
onas
cia,
J.,
Mei
nert
, C.L
., fo
r th
eIn
fant
Hea
lth a
nd
Dev
elop
men
t Pro
gram
Res
earc
h G
roup
.(1
997)
. Res
ults
at A
ge8
Yea
rs o
f E
arly
Inte
rven
tion
for
Low
-B
irth
-Wei
ght P
rem
atur
eIn
fant
s. J
ourn
al o
f th
eA
mer
ican
Med
ical
Ass
ocia
tion,
277
(2),
126-
132.
874
child
ren
invo
lved
in a
rand
omiz
ed c
linic
al tr
ial o
fsp
ecia
l ser
vice
s fo
r L
BW
prem
atur
e in
fant
s du
ring
the
firs
t 3 y
ears
of
life.
Now
8ye
ars
of a
ge, 3
36 c
hild
ren
wer
eas
sess
ed f
rom
the
inte
rven
tion
grou
p, a
nd 5
38 f
rom
the
follo
w-
up o
nly
grou
p.
Elig
ible
infa
nts.
had
abi
rthw
eigh
t of
2500
g o
r le
ss, a
gest
atio
nal a
ge o
f 37
wee
ks o
rle
ss, r
esid
ed in
the
catc
hmen
tar
ea, a
nd d
id n
ot h
ave
a se
ver
med
ical
illn
ess
or n
euro
logi
cal
impa
irm
ent.
Enr
ollm
ent
occu
rred
10/
84 th
roug
h 8/
85.
Gro
ups
wer
e st
ratif
ied
by 2
birt
hwei
ght g
roup
s (<
200
0 g;
and
from
200
1 to
250
0 g.
)
Infa
nts
wer
e ra
ndom
ly a
ssig
ned
to in
terv
entio
n (n
= 3
77)
and
cont
rol (
n =
608
) gr
oups
.G
roup
s w
ere
bala
nced
for
birt
hwei
ght,
gend
er, m
ater
nal
age,
mat
erna
l edu
catio
n, a
ndm
ater
nal r
ace.
Eig
ht-s
ite, r
ando
miz
ed c
linic
al tr
ial
inve
stig
ated
the
effi
cacy
of
anin
tens
ive,
inte
grat
ed h
ealth
and
educ
atio
n pr
ogra
m f
or lo
wbi
rthw
eigh
t, pr
emat
ure
infa
nts.
The
tria
l inc
lude
d fo
ur m
ain
inte
rven
tion
mod
aliti
es: p
edia
tric
mon
itori
ng a
ndre
ferr
al, w
eekl
y (1
' yea
r) o
r bi
wee
kly
(the
reaf
ter)
hom
e vi
sits
by
a fa
mily
educ
ator
, par
ent s
uppo
rt g
roup
s 4
times
/yr,
and
atte
ndan
ce a
t a f
ull-
day
child
dev
elop
men
t cen
ter
oper
ated
by
earl
y ch
ildho
od e
duca
tors
. The
cont
rol g
roup
rec
eive
d on
ly p
edia
tric
mon
itori
ng a
nd r
efer
ral.
Inte
rven
tion
bega
n im
med
iate
ly a
fter
infa
nt's
disc
harg
e fr
om th
e ho
spita
l and
cont
inue
d un
til a
ge 3
cor
rect
ed f
orpr
e-m
atur
ity.
The
hyp
othe
ses
for
this
stu
dy p
hase
wer
e th
at e
nhan
cem
ents
of
glob
alm
easu
res
of c
ogni
tive
func
tion
that
wer
e fo
und
at 3
yrs
Wou
ld b
e
atte
nuat
ed b
y ag
e 8,
but
that
sign
ific
ant d
iffe
renc
es f
avor
ing
the
inte
rven
tion
grou
p w
ould
be
foun
d in
scho
ol p
erfo
rman
ce m
easu
res
ofre
adin
g an
d m
athe
mat
ics
achi
evem
ent
and
in r
educ
ed r
ates
of
grad
e fa
ilure
.
Cog
nitiv
e fu
nctio
ning
:W
esch
ler
Inte
llige
nce
Scal
e fo
rC
hild
renI
ll;Pe
abod
y Pi
ctur
e V
ocab
ular
y T
est
Rev
ised
;D
evel
opm
enta
l Tes
t of
Vis
ual-
Mot
orIn
tegr
atio
n;R
ey-O
stem
eth
Com
plex
Fig
ure
Mat
rice
s;W
ide-
Ran
ge A
sses
smen
t of
Mem
ory
and
Lea
rnin
g: S
tory
Mem
ory
Aca
dem
ic a
chie
vem
ent
.
odW
ococ
k-Jo
hnso
n T
ests
of
Ach
ieve
men
tRev
ised
;G
rade
ret
entio
n an
d sp
ecia
l edu
catio
n
Beh
avio
r:
Beh
avio
r R
atin
g Pr
ofile
-2;
Psyc
holo
gica
l Exa
min
atio
n B
ehav
ior
Prof
ile;
ld B
hC
hC
hiea
vior
eckl
ist
Hea
lth:
Gro
wth
mea
sure
s;H
ealth
que
stio
nnai
reC
hild
Gen
eral
Hea
lth S
urve
y
At a
ge 3
, chi
ldre
n in
the
inte
rven
tion
grou
p ha
d si
gnif
ican
tly h
ighe
r in
telli
genc
ete
st s
core
s an
d re
cept
ive
voca
bula
ry te
stsc
ores
and
low
er s
core
s on
a p
aren
tal
mea
sure
of
repo
rted
beh
avio
r pr
oble
ms
than
the
child
ren
in th
e fo
llow
-up
grou
p.T
he r
ate
of m
ater
nally
rep
orte
d he
alth
cond
ition
s ov
er th
e fi
rst 3
yea
rs w
as.
grea
ter
for
child
ren
in th
e in
terv
entio
ngr
oup,
alth
ough
they
wer
e no
t hos
pita
lized
to a
gre
ater
ext
ent t
han
thos
e in
the
follo
w-u
p gr
oup.
EI
adva
ntag
es w
ere
mor
e pr
onou
nced
in-t
he h
eavi
er L
BW
stra
tum
than
in th
e lig
hter
str
atum
inte
rms
of I
Q s
core
, rec
eptiv
e vo
cabu
lary
scor
e, a
nd b
ehav
ior
prob
lem
sco
re. R
ate
of m
ater
nally
rep
orte
d he
alth
pro
blem
sw
as g
reat
er in
the
light
er L
BW
EI
grou
pth
an in
the
light
er f
ollo
w-u
p gr
oup;
no
diff
eren
ces
wer
e fo
und
on th
is m
easu
rebe
twee
n gr
oups
in th
e he
avie
r st
ratu
m.
At a
ge 5
, the
re w
ere
no s
igni
fica
nt o
vera
lldi
ffer
ence
s in
IQ
sco
re, r
ecep
tive
voca
bula
ry, r
epor
ted
beha
vior
pro
blem
s,or
hea
lth m
easu
res
betw
een
the
inte
rven
tion
and
follo
w-u
p on
ly c
hild
ren.
How
ever
, with
in th
e he
avie
r L
BW
stra
tum
, the
inte
rven
tion
grou
p ha
d hi
gher
full-
scal
e IQ
sco
res
(4 p
ts)
and
verb
al I
Qsc
ores
(4
pts)
as
wel
l as
high
er r
ecep
tive
voca
bula
ry s
core
s (6
pts
).
3521
36
..
_...
......
. ....
....
....
.
...
.
,
At a
ge 8
:
Cog
nitiv
e:O
vera
ll, th
ere
wer
e no
sta
tistic
aldi
ffer
ence
s be
twee
n th
e in
terv
entio
nan
d fo
llow
up
grou
ps. H
owev
er,
amon
g th
e he
avie
r L
BW
chi
ldre
n, th
ein
terv
entio
n gr
oup
show
edsi
gnif
ican
tly h
ighe
r sc
ores
(no
diff
eren
ce b
etw
een
grou
ps a
mon
glig
hter
LB
W c
hild
ren)
.In
the
entir
e gr
oup,
ther
e w
ere
sign
ific
ant I
Q d
iffe
renc
es b
etw
een
child
ren
as a
fun
ctio
n of
the
mot
her's
leve
l of
educ
atio
n. H
owev
er, t
hedi
ffer
ence
s no
ted
abov
e be
twee
n th
ein
terv
entio
n an
d fo
llow
-up
grou
psw
ere
cons
iste
nt a
cros
s th
e 3
mat
erna
led
ucat
ion
grou
ps.
Scho
ol P
etfo
rman
ce:
The
re w
ere
no o
vera
ll di
ffer
ence
s on
com
posi
te te
sts.
How
ever
, am
ong
the
heav
ier
LB
W c
hild
ren,
the
inte
rven
tion
grou
p ha
d si
gnif
ican
tlyhi
gher
mat
h sc
ores
than
the
follo
w-
up g
roup
. Am
ong
the
light
er L
BW
child
ren,
ther
e w
ere
no d
iffe
renc
es in
read
ing
or m
ath.
Perc
enta
ges
of g
rade
rep
etiti
on a
ndof
chi
ldre
n cl
assi
fied
for
spe
cial
ed
wer
e si
mila
r in
the
over
all
inte
rven
tion
and
follo
w-u
p on
lygr
oups
and
with
in th
e 2
stra
ta.
(Aut
hors
not
e th
at d
iffe
renc
es m
ay b
em
ore
likel
y to
em
erge
)
Beh
avio
r:Sc
ores
wer
e co
mpa
rabl
e be
twee
ngr
oups
and
with
in s
trat
a.
Hea
lth:
'The
gro
ups
had
sim
ilar
ratin
gs o
n
22
38
.
,
serv
ices
, and
will
take
pla
ceup
on e
nrol
lmen
t, an
nual
ly w
hile
still
enr
olle
d, a
t 3, a
nd a
t 5Se
mi-
annu
al r
epor
ts b
y se
rvic
epr
ovid
ers
abou
t ser
vice
sO
ne-t
ime
surv
ey o
f pr
ogra
mdi
rect
ors
abou
t pro
gram
One
-tim
e su
rvey
of
prov
ider
sab
out t
heir
bac
kgro
und,
trai
ning
,an
d w
ays
they
del
iver
ser
vice
sO
ne-t
ime
surv
ey o
f te
ache
rsw
hen
child
ren
are
5, a
bout
the
child
's p
rogr
ess
and
the
serv
ices
bein
g pr
ovid
ed
.
Part
H S
ervi
ceU
tiliz
atio
n R
esea
rch
Inst
itute
(E
CR
LSU
)19
97/ju
st f
inis
hing
Chi
ldre
n w
ith d
isab
ilitie
s an
dth
eir
fam
ilies
, bot
hin
fant
/todd
ler
& p
resc
hool
(no
info
rmat
ion
on s
peci
fics
).
Iden
tify/
com
pare
dif
feri
ng s
ervi
cem
odel
sPe
rcen
t ser
ved,
arr
ay o
f se
rvic
es o
ffer
ed,
degr
ee o
f co
ordi
natio
n an
d na
viga
bilit
y of
the:
syst
em, a
mou
nt o
f se
rvic
es r
ecei
ved,
amou
nt o
f in
divi
dual
izat
ion,
use
of
incl
usiv
e se
tting
s, m
eetin
g se
rvic
e ne
eds
ofch
ildre
n &
fam
ilies
.
The
bes
t out
com
es f
or c
hild
ren
& th
eir
fam
ilies
wer
e fo
und
in th
e m
ost
com
preh
ensi
ve a
nd c
oord
inat
ed s
ervi
cede
liver
y m
odel
for
all
youn
g ch
ildre
n an
dth
eir
fam
ilies
.
Qua
lity
Prac
tices
for
Infa
nts
and
Tod
dler
sw
ith D
isab
ilitie
s an
dth
eir
Fam
ilies
Res
earc
hSt
udy.
Nat
iona
l Cen
ter
for
Ear
ly D
evel
opm
ent
and
Lea
rnin
g, F
rank
Port
er G
raha
m C
hild
Dev
elop
men
t Cen
ter.
Res
earc
h on
the
qual
ity o
f se
rvic
espr
ovid
ed to
infa
nts
& to
ddle
rsw
/dis
abili
ties
and
thei
r fa
mili
es.
Info
rmat
ion
gath
erin
g th
roug
h su
rvey
and
focu
s gr
oups
. Goa
ls in
clud
e:T
o id
entif
y pr
actic
es b
elie
ved
tobe
hig
h qu
ality
Dev
elop
an
inst
rum
ent t
oev
alua
te s
ervi
ce q
ualit
yFi
eld
test
inst
rum
ent
Use
to e
valu
ate
vari
atio
ns in
serv
ice
qual
ityL
ook
at th
e in
flue
nce
ofva
riat
ions
in q
ualit
y on
chi
ld a
ndfa
mily
out
com
es
In p
rogr
ess.
Dev
elop
ing
inst
rum
ent a
ndou
tcom
e m
easu
res.
41
24
42
......
.. ..
......
......
.. .
.....
.....
......
......
......
......
......
......
......
......
......
......
. ....
......
......
......
......
.
Ram
ey, C
.T.,
Bry
ant,
985
LB
W, p
rem
atur
e in
fant
sE
ight
-site
, ran
dom
ized
clin
ical
tria
lC
ogni
tive
deve
lopm
ent (
Stan
ford
-T
he r
esea
rch
prog
ram
was
des
igne
d to
D.M
., W
asik
, B.H
.,an
d th
eir
fam
ilies
fro
min
vest
igat
ed th
e ef
fica
cy o
f an
Bin
et I
ntel
ligen
ce s
cale
, For
m L
-M,
test
the
effi
cacy
of
thre
e co
mbi
ned
Spar
ling,
J.J
., Fe
nclt,
K.H
., an
d L
a V
ange
,.ho
spita
ls in
8 c
ities
.in
tens
ive,
inte
grat
ed h
ealth
and
educ
atio
n pr
ogra
m f
or lo
w
3.1
prog
ram
ele
men
ts in
clud
ing
curr
ently
reco
mm
ende
d pe
diat
ric
prac
tices
, fam
ily
L.M
. (19
92).
Inf
ant
Infa
nts
wer
e ra
ndom
ly a
ssig
ned
prem
atur
e in
fant
s. T
heB
ehav
iora
l coM
pete
nce
(Ach
enba
chsu
ppor
ts, a
nd e
arly
chi
ldho
od e
duca
tion.
Hea
lth a
ndto
inte
rven
tion
(n =
377
) an
d.b
irth
wei
ght,
tria
l inc
lude
d fo
ur m
ain
inte
rven
tion
Chi
ld B
ehav
ior
Che
cklis
t)D
evel
opm
ent P
rogr
am. c
ontr
ol (
n =
608
) gr
oups
.m
odal
ities
: ped
iatr
ic m
onito
ring
and
.C
hild
ren
in th
e in
terv
entio
n gr
oup
for
Low
Bir
th W
eigh
t,G
roup
s w
ere
bala
nced
for
refe
rral
, hom
e vi
sits
by
a fa
mily
Hea
lth s
tatu
s (i
ndex
es s
umm
ariz
ing
dem
onst
rate
d si
gnif
ican
tly h
ighe
r
Prem
atur
e In
fant
s:bi
rthw
eigh
t, ge
nder
, mat
erna
led
ucat
or, p
aren
t sup
port
gro
ups,
and
relio
rted
mor
bidi
ty, t
he F
unct
iona
lSt
anfo
rd-B
inet
IQ
per
form
ance
, and
few
er
Prog
ram
, Ele
men
ts,
age,
mat
erna
l edu
catio
n, a
ndat
tend
ance
at a
ful
l-da
y ch
ildSt
atus
II
( R
) S
cale
, and
Gen
eral
prob
leni
beh
avio
rs, a
nd a
sm
all b
ut
Fam
ily P
artic
ipat
ion,
and
Chi
ld I
ntel
ligen
ce,
Pedi
atri
cs 3
: 454
-465
.
mat
erna
l rac
e.
Stra
tific
atic
in b
y 2
birt
hwei
ght
deve
lopm
ent c
ente
r op
erat
ed b
y ea
rly
child
hood
edu
cato
rs. T
he c
ontr
olgr
oup
rece
ived
onl
y pe
diat
ric
Hea
lth R
atin
gs I
ndex
)
Fam
ily P
artic
ipat
ion
Inde
x =
sign
ific
ant i
ncre
ase
in r
epor
t of
child
's'
mor
bidi
ty (
acut
e no
nser
ious
illn
esse
s fo
rag
es 2
-3).
BW
gro
up <
2001
g a
vera
ged
a
grou
ps w
as in
clud
ed: 2
/3 o
fm
onito
ring
and
ref
erra
l. In
terv
entio
nsu
mm
ativ
e m
easu
re o
f nu
mbe
r of
6.6-
poin
t IQ
adv
anta
ge. B
W g
roup
200
1 -
infa
nts
wei
ghed
< 2
000
g;be
gan
imm
edia
tely
aft
er in
fant
'sho
me
visi
ts, a
ttend
ance
at p
aren
t25
00 g
sco
red
aver
age
of 1
3.2
IQ p
oint
s
rem
aini
ng th
ird
betw
een
2001
disc
harg
e fr
om th
e ho
spita
l and
grou
p m
eetin
gs, a
nd d
ays
atte
nded
at
high
er th
an c
ontr
ols.
The
inte
rven
tion
and
2500
g.
cont
inue
d un
til a
ge 3
cor
rect
ed f
orch
ild d
evel
opm
ent
grou
p pe
rfor
med
sig
nifi
cant
ly b
ette
r th
an
.pr
e-m
atur
ity.
The
des
ign
and
impl
emen
tatio
n of
the
the
cont
rols
and
the
degr
ee o
fpa
rtic
ipat
ion
was
pos
itive
ly r
elat
ed to
cogn
itive
dev
elop
men
t.
IHD
P st
udy
was
gui
ded
by th
e
..
bios
ocia
l sys
tem
s m
odel
for
ear
lyde
velo
pmen
t. A
lthou
gh th
is m
odel
reco
gniz
es m
ultip
le in
flue
nces
fro
mco
ncep
tion
onw
ard,
the
rese
arch
ers
emph
asiz
e th
e ca
regi
ver-
child
inte
ract
ion
as th
e ke
y.
The
stu
dy f
indi
ngs
linke
d in
tens
ity o
fin
terv
entio
n se
rvic
es w
ith d
egre
e of
posi
tive
cogn
itive
out
com
es f
or h
igh
risk
infa
nts.
Res
earc
h In
stitu
te o
nR
easo
ns f
or s
tudy
: 1)
incr
easi
ngT
hey
antic
ipat
e de
velo
ping
a n
atio
nal s
et o
fIn
pro
gres
s; in
ver
y pr
elim
inar
y st
ages
of
Ear
ly C
hild
hood
Gro
wth
dem
ands
for
acc
ount
abili
ty; a
nd 2
) a
deve
lopm
enta
l out
com
es f
or c
hild
ren
atst
udy
deve
lopm
ent.
and
Dev
elop
men
tM
easu
res
(fun
ded
byla
ck o
f co
ncep
tual
link
ages
bet
wee
nea
rly
child
hood
ass
essm
ents
and
late
rag
es 3
, 5, &
8 in
cog
nitiv
e, c
omm
unic
atio
n,so
cial
/em
otio
nal,
adap
tive,
and
mot
or
OSE
P)co
mpe
tenc
ies.
Pur
pose
s/in
tent
:do
mai
ns.
To
iden
tify
and
valid
ate
a se
t of
grow
th/d
evel
opm
ent i
ndic
ator
sto
des
crib
e th
e de
velo
pmen
tal
prog
ress
of
child
ren
with
or
at-
risk
of
disa
bilit
ies,
0-8
, and
thei
rfa
mili
esU
se th
is to
mea
sure
pro
gres
s an
did
entif
y pr
oced
ures
with
pos
itive
impa
cts
4325
44
.....
ox:.,
....
.....
. ....
......
....
.)Se
i:ial
No.
230
Vol
. 57
-qT
.o. 6
1)C
hild
ren
with
sei
zure
diso
rder
s
2)Fa
mili
es r
epor
ting
atyp
ical
ly h
igh
stre
ss
3)M
othe
rs w
ith a
hig
h sc
hool
educ
atio
n or
less
4)Fa
mili
es w
here
mot
hers
had
larg
e ga
ins
inin
tera
ctiv
e sk
ills
Purp
ose:
1) T
o as
sess
the
corr
elat
es o
fad
apta
tion
in y
oung
chi
ldre
nw
ith d
isab
ilitie
s an
d th
eir
fam
ilies
ove
r tim
e
2)T
o in
form
soc
ial p
olic
y by
anal
yzin
g th
e in
flue
nces
of
fam
ily e
colo
gy a
nd f
orm
alse
rvic
es o
n ch
ild a
nd f
amily
outc
omes
) T
o ge
nera
te c
once
ptua
l mod
els
to g
uide
fur
ther
inve
stig
atio
n
Stud
y de
sign
:no
n-ex
peri
men
tal,
pre-
vs. p
ost-
inte
rven
tion
anal
ysis
; pos
t per
iod
was
one
yea
r af
ter
entr
y in
to e
arly
inte
rven
tion
prog
ram
Dat
a co
llect
ion:
Dat
a w
ere
colle
cted
dur
ing
two
hom
evi
sits
(w
ithin
6 w
eeks
of
prog
ram
entr
y an
d 1
year
late
r) a
nd in
clud
edfo
rmal
chi
ld a
sses
smen
ts,
obse
rvat
ions
of
mot
her-
child
Mte
ract
ion,
mat
erna
l int
ervi
ews,
and
ques
tionn
aire
s co
mpl
eted
inde
pend
ently
by
both
par
ents
as
wel
las
mon
thly
ser
vice
dat
a co
llect
edfr
om s
ervi
ce p
rovi
ders
.
Stat
istic
al m
etho
ds:
Em
ploy
ed r
esid
ual c
hang
e sc
ores
(dif
fere
nce
betw
een
post
-tes
t sco
rean
d th
e sc
ore
that
wou
ld b
e pr
edic
ted
by a
reg
ress
ion
line
deri
ved
from
the
pre-
test
sco
re)
in o
rder
to s
ingl
e ou
tth
ose
who
hav
e ch
ange
d m
ore
or le
ssth
an e
xpec
ted,
rat
her
than
abs
olut
ech
ange
(si
nce
thos
e w
ith in
itial
low
scor
es te
nd to
cha
nge
mor
e th
an th
ose
with
hig
h in
itial
sco
res)
.
3)So
cial
sup
port
netw
ork
size
help
fuln
ess
4)Fa
mily
ada
ptat
ion
pare
ntin
g st
ress
effe
cts
on f
amily
Inde
pend
ent v
aria
bles
:
1)ch
ild d
emog
raph
ic a
nd h
ealth
char
acte
rist
ics
(age
, typ
e of
dis
abili
ty,
seve
rity
of
psyc
hom
otor
impa
irm
ent,
gend
er, p
re-m
atur
ity s
tatu
s, p
rese
nce
of c
ardi
ac p
robl
em o
r se
izur
edi
sord
er)
2)fa
mily
dem
ogra
phic
cha
ract
eris
tics
(i.e
. mat
erna
l edu
catio
n, m
arita
lst
atus
, em
ploy
men
t, an
d he
alth
sta
tus)
Med
iatin
g va
riab
les:
child
tem
pera
men
t, fa
mily
eco
logy
, ear
lyin
terv
entio
n se
rvic
es (
staf
fing
str
uctu
re,
serv
ice
inte
nsity
, loc
atio
n, a
nd f
orm
at),
and
othe
r se
rvic
es
Inst
rum
ents
use
d:B
ayle
y Sc
ales
of
Infa
nt D
evel
opm
ent,
EIC
SPl
ay S
cale
, Vin
elan
d A
dapt
ive
Beh
avio
rSc
ales
, Nur
sing
Chi
ld A
sses
smen
tT
each
ing
Scal
e, P
aren
ting
Stre
ss I
ndex
,E
ICS
Pare
nt S
uppo
rt S
cale
, Im
pact
-on-
Fam
ily S
cale
, Hom
e O
bser
vatio
n fo
rM
easu
rem
ent o
f th
e E
nvir
onm
ent
(HO
ME
), F
amily
Ada
ptab
ility
and
Coh
esio
n E
valu
atio
n Sc
ales
(FA
CE
S II
),M
onth
ly S
ervi
ce R
ecor
ds.
Fam
ilies
who
se s
ocia
l sup
port
netw
orks
sho
wed
the
grea
test
incr
ease
in s
ize
and
wer
e pe
rcei
ved
as m
ore
help
ful w
ere
thos
e fa
mili
esw
ith c
hild
ren
who
mad
e le
ssde
velo
pmen
tal p
rogr
ess.
4)Fa
mili
es w
ho r
ecei
ved
mos
t of
thei
rse
rvic
es th
roug
h a
sMgl
e pr
ovid
ersh
owed
sig
nifi
cant
dec
reas
es in
pare
ntin
g st
ress
.
)R
educ
ed p
aren
tirig
str
ess
was
asso
ciat
ed w
ith s
ervi
ces
deliv
ered
prim
arily
thro
ugh
a si
ngle
pro
vide
r.
6)G
reat
er g
ains
in c
hild
ren'
s m
enta
lag
e w
ere
asso
ciat
ed w
ithin
divi
dual
ized
ser
vice
s.
Oth
er f
indi
ngs:
Typ
e of
dis
abili
ty is
not
use
ful i
nex
plai
ning
dif
fere
nces
inde
velo
pmen
tal p
atte
rns
of c
hang
e in
eith
er in
fant
s or
thei
r fa
mili
esA
vera
ge d
evel
opm
enta
l cha
nge
inm
enta
l age
, ada
ptiv
e be
havi
or, a
ndpl
ay w
as p
redi
cted
bes
t by
the
seve
rity
of
the
child
's p
sych
omot
orim
pair
men
t at t
he ti
me
of s
tudy
entr
y, a
nd w
as n
ot c
orre
late
d w
ithfa
mily
cha
ract
eris
tics.
Pare
nts
who
exh
ibite
d hi
gh le
vels
of
pare
ntin
g st
ress
wer
e no
tsi
gnif
ican
tly d
iffe
rent
in te
rms
ofth
eir
dem
ogra
phic
s or
the
deve
lopm
enta
l cha
ract
eris
tics
of th
eir
child
ren
tlian
the
rest
of
the
sam
ple
Ove
rall,
fat
hers
exh
ibite
d gr
eate
rle
vels
of
pare
ntin
g st
ress
than
mot
hers
47ST
CO
PYA
UN
LA
DO
2741
8
......
.
Stat
e St
udy,
Con
nect
icut
:
1)So
cial
Com
pete
nce
Re:
sear
ch P
roje
ct(f
unde
d by
Ear
lyE
duca
tion
Prog
ram
for
Chi
ldre
n w
ithD
isab
ilitie
s br
anch
of th
e U
.S.
Dep
artm
ent o
fE
duca
tion)
2) S
tudy
2 (
fund
ed b
yO
SEP)
Occ
urre
d 19
93-1
996;
exam
ple
incl
uded
inSt
ate
Part
H E
valu
ator
s'C
onso
rtiu
m S
ynth
esis
R e
port
.
.
Stud
y 1:
37
child
ren
rece
ivin
gea
rly
inte
rven
tion
serv
ices
in 2
serv
ice
patte
rns.
No
betw
een
grou
p di
ffer
ence
s in
fam
ily, a
geat
ref
erra
l, pr
imar
yde
velo
pmen
tal n
eed.
Stud
y 2:
68
child
ren
rece
ivin
gse
rvic
es in
incl
usiv
e co
mm
unity
setti
ngs
oper
ated
by
the
Stat
eD
epar
tmen
t of
Men
tal
Ret
arda
tion.
Stud
y 1
exam
ined
the
effe
ct o
f tw
oea
rly
inte
rven
tion
setti
ngs
(int
egra
ted
com
mun
ity p
lace
men
ts v
s. s
egre
gate
dce
nter
-bas
ed p
rogr
ams)
on
soci
albe
havi
or a
nd d
evel
opm
ent o
f en
rolle
dC
hild
ren.
Dat
a w
as c
olle
cted
at 6
-m
onth
inte
rval
s be
ginn
ing
whe
nch
ildre
n en
tere
d th
e st
udy
at 2
4 .
mon
ths
of a
ge u
ntil
exit
at 3
6 m
onth
.42
-mon
th f
ollo
w-u
p.
Stud
y 2
exam
ined
the
diff
eren
tial.
effe
cts
of e
arly
inte
rven
tion
ofch
ildre
n w
ho r
ecei
ve, e
arly
inte
rven
tion
in d
ay c
are
prog
ram
s.T
he s
ampl
e w
as d
emog
raph
ical
lydi
vers
e. C
hild
ren
wer
e.fu
nctio
ning
at
half
thei
r ex
pect
ed d
evel
opm
enta
l age
on a
vera
ge. I
FSPs
incl
uded
an
aver
age
of 4
out
com
es, M
ainl
y ch
ildre
late
d. A
ll ch
ildre
n re
ceiv
edsp
ecia
lized
inst
ruct
ion
in th
ecl
assr
oom
. .,
Out
com
es in
clud
e ch
ild s
tatu
s(d
evel
opm
enta
l and
soc
ial c
ompe
tenc
yin
dice
s), f
amily
sta
tus
(mea
sure
s of
soc
ial
supp
ort,
com
mun
ity r
esou
rces
use
,at
titud
es),
ser
vice
cha
ract
eris
tics
(int
erve
ntio
n se
tting
, sta
ffin
g qu
alif
icat
ions
and
patte
rns,
ser
vice
type
and
inte
nsity
),
Stud
y 1: In in
clus
ive
clas
sroo
ms,
mor
ech
ildre
n w
/dis
abili
ties
wer
e be
ing
serv
ed, m
ore
time/
wk
was
spe
nt b
yth
e ch
ildre
n in
the
clas
sroo
m, a
ndin
stru
ctor
s ha
d hi
gher
leve
ls o
fed
ucat
ion.
No
diff
eren
ce f
ound
innu
mbe
r of
sta
ff in
cla
ssro
oms.
Chi
ldre
n in
seg
rega
ted
setti
ngre
ceiv
ed m
ore
nurs
ing,
spe
ech,
PT
and
OT
, whi
le th
ose
in in
clus
ive
setti
ng r
ecei
ved
high
er in
tens
ity o
fsp
ecia
lized
inst
ruct
ion.
No
diff
eren
ces
wer
e fo
und
on I
FSP
outc
omes
or
focu
s of
out
com
es.
At 3
6 m
onth
s, n
o ev
iden
ce w
as f
ound
for
an e
ffec
t of
setti
ng o
nde
velo
pmen
t.
Stud
y 2:
The
ave
rage
num
ber
of c
hild
ren
per
day
care
cla
ssro
om w
as 9
.13,
with
an
aver
age
of 3
.42
adul
ts. A
vera
gele
ngth
/day
. app
rox
3 hr
s. M
ost
freq
uent
ly o
ccur
ring
act
ivity
was
fre
epl
ay (
43%
of
obse
rvat
ions
).G
reat
er 'd
evel
opm
enta
l del
ay w
asre
late
d to
ear
lier
age
of r
efer
ral a
ndhi
gher
fam
ily in
com
e w
as r
elat
ed to
earl
ier
refe
rral
. Chi
ldre
n w
ithgr
eate
r de
velo
pmen
tal d
elay
and
child
ren
with
a g
reat
er f
amily
inco
me
also
rec
eive
d m
ore
serv
ices
..
Stat
e St
udy,
Mic
higa
n:
Ear
ly O
n E
valu
atio
nPr
ojec
t. Fu
nded
by
lead
agen
cy, e
xam
ple
incl
uded
in S
tate
Par
t HE
valu
ator
s' C
onso
rtiu
mSy
nthe
sis
Rep
ort.
Lar
ge-s
cale
sam
plin
g of
thos
ein
volv
ed in
the
stat
e ea
rly
inte
rven
tion
prog
xam
.
..
Eva
luat
es th
e st
ate
earl
y in
terv
entio
npr
ogra
m u
sing
sta
te tr
acki
ng d
ata,
prog
ram
coo
rdin
ator
sur
veys
, fam
ilysu
rvey
s, in
terv
iew
s an
d su
rvey
s w
ithad
min
istr
ator
s &
ser
vice
coo
rdin
ator
s,si
te s
umm
arie
s, v
igne
ttes
of f
amily
expe
rien
ces. 0
The
loca
l im
plem
enta
tion
surv
ey h
as
Incl
ude: Im
prov
ed a
vaila
bilit
y of
and
acc
ess
tose
rvic
es b
y fa
mili
es a
nd th
eir
serv
ice
coor
dina
tors
Impr
ovem
ents
in th
e se
rvic
e de
liver
ypr
oces
s (s
peci
fica
lly, i
ncre
ases
in th
edi
men
sion
s of
fam
ily c
ente
redn
ess,
fam
ily s
atis
fact
ion,
and
fam
ilype
rcep
tions
of
impa
cts)
Ong
oing
. Now
hav
e 3
year
s of
dat
a.
Dat
a sh
ow c
lear
sig
nifi
cant
rel
atio
nshi
psw
hich
bac
k th
e m
odel
:hi
gh im
plem
enta
tion-
) st
rong
er.
perc
eptio
n th
at s
taff
is f
amily
cen
tere
d-)
stro
nger
fam
ily p
erce
ptio
n of
sup
port
and
empo
wer
men
t-)
perc
eptio
n of
dec
reas
ing
stre
ss-)
incr
ease
d em
pow
erm
ent.
r n u
28
j:,0:
Ott:
Am
,:::::
:::11
:::r7
011.
0.to
ttir
os-
,,::::
::::::
.:::::
::::::
::::::
::::::
::::::
::::::
::::::
:::I
sm*
lc1:
::::::
::::::
::::::
::::::
::::::
::::!
::::::
:i::::
::::::
::::::
::::::
::::::
::::
T:1
IMM
O.-
":::
::::::
::::::
::::::
::::::
::::::
::::::
::::::
::::::
MR
::::::
::::::
:"'
SV.L
':::i:
::iiii
i:::::
::::::
::::::
::::::
::::::
::::::
::::::
:i:::
been
dis
trib
uted
ann
ually
to a
ll lo
cal
Part
H c
oord
inat
ors
and
thei
r ag
ency
coun
terp
arts
.
Fam
ily s
urve
y ha
s be
en a
dmin
iste
red
annu
ally
for
the
past
3 y
ears
to 6
00fa
mili
es. T
his
year
, lon
g or
sho
rtve
rsio
ns w
ill g
o to
all
fam
ilies
in th
est
ate
(app
rox.
350
0).
Incr
ease
s in
the
supp
ort f
amili
esre
ceiv
e fr
om b
oth
form
al a
nd in
form
also
urce
sIn
crea
ses
in a
rea
of f
amily
func
tioni
ng, i
nclu
ding
em
pow
erm
ent
and
copi
ngIn
flue
nce
of f
amily
and
chi
ldch
arac
teri
stic
s up
on th
e ab
ove-
men
tione
dou
tcom
esSt
ate
Stud
y, N
ewJe
rsey
:
New
Jer
sey
Ear
lyIn
terv
entio
n Sy
stem
Stud
y. B
arne
tt, W
.S.,
and
Fred
e,E
.C.,
in,
prog
ress
, exa
mpl
ein
clud
ed in
Sta
te P
art H
Eva
luat
ors'
Con
sort
ium
Synt
hesi
s R
epor
t.
Tw
o sa
mpl
es:
1)O
ne-t
ime,
cro
ss-s
ectio
nal
rand
om s
ampl
e of
220
fam
ilies
str
atif
ied
byco
unty
who
had
rece
ived
serV
ices
for
at l
east
12
mon
ths
2) A
long
itudi
nal r
ando
msa
mpl
e of
350
fam
ilies
stra
tifie
d by
cou
nty
who
had
just
qua
lifie
d fo
rse
rvic
es. B
asel
ine
asse
ssm
ents
, fol
low
-up
inte
rvie
ws
ever
y 6
mo
and
at e
xit a
ge 3
).(
Con
tinui
ng.
Des
igne
d to
obt
ain
and
anal
yze
data
on th
e co
st, q
ualit
y, a
nd o
utco
mes
of
EI
in N
ew J
erse
y.
Maj
or q
uest
ions
incl
uded
:
1) W
hat s
ervi
ces
are
prov
ided
?
2) W
ho is
ser
ved'
?3)
How
muc
h do
ser
vice
s co
st?
4) W
hat i
s th
e qu
ality
of
serv
ices
?5)
How
doe
s qu
ality
rel
ate
to c
ost
and
outc
omes
for
chi
ldre
n an
dfa
mili
es?
.
Sam
ple
#1w
as in
terv
iew
ed a
bout
thei
rco
sts,
the
serv
ices
they
wer
e re
ceiv
ing,
and
perc
eptio
ns o
f pr
ogra
m q
ualit
y an
d ef
fect
sof
ser
vice
s on
thei
r ch
ildre
n an
d fa
mili
es.
Sam
ple
#2In
form
atio
n on
erv
ices
was
prep
ared
fro
m p
aren
ts, p
rogr
am s
taff
,re
cord
s, a
nd in
depe
nden
t obs
erva
tion.
Mea
sure
s on
chi
ld a
nd f
amily
ben
efits
are
obta
ined
fro
m p
aren
t sel
f-re
port
and
stan
dard
ass
essm
ents
, inc
ludi
ng c
hild
deve
lopm
ent a
nd b
ehav
ior,
par
entin
gst
ress
, mot
her-
child
inte
ract
ion,
fam
ilych
arac
teri
stic
s. I
n fu
ture
, hop
e to
hav
e da
taon
pre
scho
ol e
d pl
acem
ents
, eva
luat
ions
for
pres
choo
l spe
cial
ed,
and
oth
er in
fo o
nch
ild o
utco
mes
.
In p
rogr
ess.
Uta
h E
arly
Int
erve
ntio
n(B
irth
to 5
) Pr
ojec
t;E
arly
Int
erve
ntio
nR
esea
rch
Inst
itute
150
Part
H15
5 Pa
rt B
volu
ntee
rs s
elec
ted
from
6re
pres
enta
tive
site
s
Thr
ee y
ear
stud
y. Q
uest
ions
incl
ude:
How
hav
e Pa
rts
H &
B f
orch
ildre
n 0-
5 an
d th
eir
fam
ilies
been
impl
emen
ted
in a
ccor
danc
ew
iili f
eder
al &
sta
te p
olic
ies?
Wha
t are
the
effe
cts
of E
Ise
rvic
es?
Wha
t are
the
over
all c
osts
of
EI?
1996
: One
trea
tmen
t ver
ific
atio
n, 1
pare
nt s
urve
y
1997
: up
to 8
trea
tmen
t ver
ific
atio
ns,
2 pa
rent
sur
veys
.
1998
: lik
e 19
97, p
his
surv
ey o
f
Des
ign
incl
udes
:Pa
rent
inte
rvie
ws
usin
g 2
sepa
rate
tool
s (V
inel
and
Ada
ptiv
e B
ehav
ior
Scal
ecom
mun
icat
ion
skill
s, d
aily
livin
g sk
ills,
mot
or s
kills
, and
soci
aliz
atio
n sk
ills)
(Ped
iatr
icE
valu
atio
n of
Dis
abili
ty In
vent
ory
self
-car
e sk
ills,
mob
ility
ski
lls, a
ndso
cial
fun
ctio
ning
)Pa
rent
/Tea
cher
/Int
erve
ntio
nist
Que
stio
nnai
re(S
ocia
l Ski
lls R
atin
gS
cale
ssoc
ial
skill
s &
sch
ool
.
beha
vior
)(T
reat
men
t Ven
ficat
ion
Form
quan
tity
of s
ervi
ces)
Fam
ily Q
uest
ionn
aire
s (P
aren
ts w
ere
paid
$30
for
com
plet
ed q
uest
ionn
aire
s
In p
rogr
ess.
Som
e pr
elim
inar
y re
sults
from
the
tran
sitio
n st
udy
incl
ude
satis
fact
ion
of p
aren
ts, p
rovi
ders
, lev
el o
fim
port
ance
pla
ced
on p
roce
ss, p
rogr
ams
tran
sitio
ned
into
, site
pla
cem
ent
.
diff
eren
ces
(no
sign
ific
ant d
iffe
renc
e).
5129
52
::::::
::::::
:::::1
::::::
::::E
ND
OM
ME
1:M
USt
atW
tran
sitio
n ou
t of
Part
Hre
turn
rat
e w
as h
igh)
: Par
entin
g
Als
o lo
oked
at p
rogr
amim
plem
enta
tion
issu
es s
uch
as s
ervi
cepr
ovis
ion,
eff
ectiv
enes
s of
LIC
Cs,
Stre
ss I
ndex
pare
ntal
str
ess,
inge
nera
l and
spe
cifi
c to
the
child
;Fa
mily
Sup
port
Sca
lepe
rcei
ved
supp
ort r
ecei
ved
by f
amily
; Fam
ilyA
dapt
abili
ty a
nd C
ohes
ion
.
Eva
luat
ion
Scal
efam
ily's
conn
ecte
dnes
s to
eac
h ot
her
and
the
way
s th
e fa
mily
dea
ls w
ith d
iffe
rent
fam
ily s
ituat
ions
; Ear
ly C
opin
gIn
vent
ory-
-par
ent p
erce
ptio
ns r
e th
ew
ay th
eir
child
rea
cts
to d
iffe
rent
even
ts; L
ife
Eve
nts
Inve
ntor
yin
vent
orie
s lif
e ev
ents
that
may
hav
eoc
curr
ed d
urin
g th
e pa
st y
ear;
Dem
ogra
phic
For
m; C
hild
Hea
lthFo
rm; F
amily
Foc
used
Int
erve
ntio
n.
Scal
eask
s ab
out s
ervi
ces
bein
gre
ceiv
ed f
rom
the
scho
ol d
istr
ict/e
arly
inte
rven
tion
prov
ider
, sat
isfa
ctio
nw
ith th
ese
serv
ices
, and
how
impo
rtan
t the
ser
vice
s ar
e co
nsid
ered
to b
e; A
dditi
onal
Ser
vice
s Fo
rm--
desc
ribe
s se
rvic
es f
amili
es'a
nd0
child
ren
rece
ive
outs
ide
of p
rim
ary
serv
ice
prog
ram
.D
irec
t Chi
ld A
sses
smen
ts (
Bat
elle
Dev
elop
men
tal I
nven
tory
--di
rect
mea
sure
of
cogn
itive
ski
lls)
Reg
iona
l pro
gram
cos
ts d
eter
nnne
d
53
30
54
Bar
nett,
W.S
., an
dD
iscu
sses
con
side
ratio
ns in
taki
ng a
cos
t-be
nefi
t app
roac
h. E
xam
ples
of c
ost-
bene
fit a
naly
ses
pres
ente
d
Esc
obar
, C.M
. (19
90).
incl
ude
the
Perr
y Pr
esch
ool P
roje
ct, t
he a
dditi
on o
f IN
RE
AL
(a
lang
uage
inte
rven
tion
prog
ram
) to
Eco
nom
ic C
osts
and
pres
choo
l and
kin
derg
arte
n pr
ogra
ms,
the
Yal
e Fa
mily
Sup
port
Pro
ject
,an
d po
oled
ana
lyse
s by
the
Ben
efits
of
Ear
lyC
onso
rtiu
m f
or L
ongi
tudi
nal S
tudi
es. O
utco
mes
for
thes
e pr
ojec
tsin
clud
ed m
easu
res
of I
Q, s
choo
l
Inte
rven
tion.
In
S.J.
atte
ndan
ce, g
rade
ret
entio
n, s
peci
al e
duca
tion
plac
emen
t, le
vel o
fedu
catio
n, e
arni
ngs,
red
uced
wel
fare
Mei
sels
and
J.P
.co
sts,
and
cri
me/
delin
quen
cy. S
ome
cost
ben
efits
have
bee
n pr
ojec
ted
over
a li
fetim
e.
Shon
koff
(E
ds.)
,H
andb
ook
of E
arly
Evi
denc
e is
str
ong
that
ear
ly in
terv
entio
n w
ith d
isad
vant
aged
chi
ldre
nin
crea
ses
scho
ol s
ucce
ss, t
here
by
Inte
rven
tion
(pp.
560
-re
duci
ng th
e co
sts
of s
choo
ling.
In
addi
tion,
res
earc
h lin
ks e
duca
tiona
l suc
cess
to k
ey v
aria
bles
for
582)
. New
Yor
k:ec
onom
ic b
enef
its: e
arni
ngs
and
empl
oym
ent,
crim
inal
act
ivity
,ch
ildbe
arin
g, a
nd h
ealth
.
Cam
brid
ge U
nive
rsity
Pres
s.T
he a
utho
r no
tes
that
ther
e is
a s
ubst
antia
l bas
is f
or c
oncl
udin
gth
at E
I ca
n'pr
oduc
e im
med
iate
ben
efits
for
biol
ogic
ally
impa
ired
chi
ldre
n, a
nd th
at th
ese
are
of th
e sa
me
orde
r of
mag
nitu
de a
s in
itial
ben
efits
for
disa
dvan
tage
d ch
ildre
n. T
his
leav
es th
e po
ssib
ility
of
sim
ilar
long
-ter
mbe
nefi
ts f
or b
iolo
gica
lly im
pair
ed
child
ren.
Ben
efits
for
dis
adva
ntag
ed c
hild
ren
and
thei
r pa
rent
s w
ere
foun
d in
the
area
s of
chi
ld c
are,
educ
atio
nal c
osts
, em
ploy
men
t and
ear
ning
s, c
rim
e an
d de
linqu
ency
,an
d w
elfa
re. B
enef
its to
bio
logi
cally
impa
ired
chi
ldre
n an
d th
eir
fam
ilies
see
m p
ossi
ble
in a
ll th
ese
area
s, o
ther
than
cri
me
and
delin
quen
cy, w
hich
the
auth
or a
ssum
es to
be
negl
igib
le f
or p
erso
ns w
ith m
ore
seve
reha
ndic
aps.
Ben
efits
to p
aren
ts w
ould
likel
y di
ffer
. Mod
est d
ecre
ases
in th
e in
tens
ity o
f re
quir
ed s
peci
aled
ucat
ion
mig
ht g
ener
ate
sign
ific
ant c
ost
savi
ngs,
and
incr
ease
s in
cog
nitiv
e an
d so
cial
abi
litie
s, a
nd e
spec
ially
daily
livi
ng s
kills
, mig
ht g
ener
ate
sign
ific
ant b
enef
its to
fam
ilies
of
hand
icap
ped
pers
ons
and
gene
rally
redu
ce c
osts
to s
ocie
ty to
the
exte
nt
that
the
abili
ty f
or in
depe
nden
t liv
ing
is in
crea
sed.
Bla
ir C
. and
Ram
ey C
.T.
The
aut
hors
exa
min
e ra
ndom
ized
con
trol
led
tria
ls o
f ea
rly
inte
rven
tion
for
low
bir
thw
eigh
t inf
ants
(199
7). E
arly
cond
ucte
d si
nce
1986
by
focu
sing
on
seco
nd-g
ener
atio
n re
sear
chis
sues
rel
ated
to g
ener
al p
rogr
am f
acto
rs
Inte
rven
tion
for
Low
-th
at d
eter
min
e ef
fect
iven
ess
of th
e in
terv
entio
n an
d is
sues
rel
ated
toch
ild a
nd f
amily
cha
ract
eris
tics
that
may
Bir
th-W
eigh
t Inf
ants
and
the
Path
to S
econ
d-m
edia
te o
r m
oder
ate
the
earl
y pr
even
tive
inte
rven
tion.
Gen
erat
ion
Res
earc
h..
Und
erly
ing
prog
ram
fac
tors
of
effe
ctiv
e in
terv
entio
n ap
pear
to b
e:in
tens
ity, t
imin
g, d
irec
t ver
sus
In M
.J. G
ural
nick
(E
d.),
inte
rmed
iary
pro
visi
on o
f se
rvic
es, e
nvir
onm
enta
l mai
nten
ance
of
gain
s,co
mpr
ehen
sive
ness
, and
atte
ntio
n
5633
57
58
The
Eff
ectiv
enes
s of
to in
divi
dual
dif
fere
nces
in p
rogr
am d
eliv
ery.
Ear
ly I
nter
vent
ion.
Bal
timor
e: P
aul
Chi
ld f
acto
rs s
uch
as r
espo
nsiti
vity
to e
arly
inte
rven
tion
as a
fun
ctio
n of
the
infa
nt's
bir
thw
eigh
t,H
.Bro
okes
Pub
lishi
ngte
mpe
ram
enta
l, m
otiv
atio
nal a
nd a
ttent
iona
l dif
fere
nces
are
con
side
red
as w
ell a
s fa
mily
cha
ract
eris
tics
such
Co,
pp.
77
- 97
.as
mat
erna
l atti
tude
s, m
ater
nal e
duca
tion
and
soci
al s
uppo
rt.
Sugg
este
d ou
tcom
es n
eedi
ng s
yste
mat
ic a
ttent
ion
incl
ude:
Part
icip
atio
n in
inte
rven
tion
rout
ines
Kno
wle
dge
gain
ed th
roug
h in
terv
entio
nM
ater
nal r
espo
nsiv
enes
sPa
rent
-chi
ld in
tera
ctio
n
In s
umm
ary,
sin
ce 1
986
the
effe
ctiv
enes
s of
ear
ly in
terv
entio
n fo
r lo
w b
irth
wei
ght i
nfan
ts h
as b
een
relia
bly
obse
rved
in a
num
ber
of m
etho
dolo
gica
lly s
ound
stu
dies
. Stu
dy r
esul
ts in
dica
te th
at e
arly
inte
rven
tion
atte
nuat
es th
e de
clin
e in
IQ
that
typi
cally
occ
urs
in lo
w b
irth
wei
ght i
nfan
ts in
con
tras
t to
norm
al b
irth
wei
ght
infa
nts
over
the
firs
t few
yea
rs o
f lif
e. I
nter
vent
ion
grou
p IQ
appe
ars
stab
le o
r de
clin
es s
light
ly o
ver
time.
Con
trol
gro
up in
fant
s sh
ow a
mor
e pr
ecip
itous
dec
line
over
the
firs
t yea
rs o
f lif
e.
Res
earc
h fi
ndin
gs c
once
rnin
g de
term
inan
ts o
f ef
fect
iven
ess
for
low
bir
thw
eigh
t inf
ants
indi
cate
that
com
preh
ensi
ve, i
nten
sive
inte
rven
tions
that
beg
in e
arly
are
mos
t lik
ely
to b
e ef
fect
ive
and
that
mat
erna
led
ucat
ion
leve
l and
bir
thw
eigh
t act
as
mod
erat
ing
infl
uenc
es o
n ef
fect
iven
ess.
Rec
omm
enda
tions
are
mad
e fo
r pa
rent
-foc
used
ser
vice
s (t
o cr
eate
an
envi
ronm
ent i
n w
hich
inte
rven
tion
gain
s ca
n be
mai
ntai
ned)
com
bine
d w
ith a
chi
ld-f
ocus
ed e
duca
tiona
l chi
ld c
are
prog
ram
.
Sugg
este
d in
vest
igat
iona
l are
as in
clud
e: p
aren
t-fo
cuse
d in
terv
entio
ns f
or c
hild
ren
with
bir
thw
eigh
t <1,
500g
and
NIC
U s
timul
atio
n.
Gur
alni
ck, M
..J.
The
re a
ppea
rs to
be
a ge
nera
l con
sens
us th
at th
e br
oad
prin
cipl
es g
uidi
ng s
ucce
ssfu
l ear
ly in
terv
entio
n(1
997)
. Sec
ond-
prog
ram
s in
clud
e pr
ogra
ms
that
cen
ter
on th
e ne
eds
of f
amili
es, a
re b
ased
in lo
cal c
omm
uniti
es, a
re a
ble
toG
ener
atio
n R
esea
rch
thor
ough
ly a
nd e
ffic
ient
ly in
tegr
ate
the
cont
ribu
tions
of
mul
tiple
dis
cipl
ines
, and
hav
e th
e ca
paci
ty to
pla
nin
the
Fiel
d of
Ear
lyan
d co
ordi
nate
sup
port
s an
d se
rvic
es f
rom
num
erou
s ag
enci
es w
ithin
a s
yste
ms
fram
ewor
k.
34
AU
TU
OR
..
fluO
RY
-RE
CO
MM
EN
DA
T1O
NS
,
Inte
rven
tion.
In
M.I
.A
con
cept
ual m
odel
of
deve
lopm
ent i
s pr
esen
ted
that
rep
rese
nts
a lin
kage
bet
wee
n fa
ctor
s in
flue
ncin
g ea
rly
Gur
alni
ck (
Ed.
), T
hech
ildho
od d
evel
opm
ent a
nd th
e co
mpo
nent
s of
ear
ly in
terv
entio
n pr
ogra
ms.
Und
erly
ing
this
link
age
is th
eE
ffec
tiven
ess
of E
arly
conc
eptu
aliz
atio
n of
ris
k an
d di
sabi
lity
stat
us a
s st
ress
ors
capa
ble
of a
dver
sely
aff
ectin
g fa
mily
inte
ract
ion
Inte
rven
tion,
patte
rns
that
gov
ern
the
deve
lopm
enta
l out
com
es o
f ch
ildre
n.B
altim
ore:
Pau
l H.
Bro
okes
Pub
lishi
ngT
he th
ree
prox
imal
fam
ily p
atte
rns
of in
tera
ctio
n th
at h
ave
wel
l-es
tabl
ishe
d as
soci
atio
ns w
ith a
chi
ld's
Co,
pp.
3-
20.
deve
lopm
enta
l out
com
e ar
e:Q
ualit
y of
par
ent-
child
tran
sact
ions
Fam
ily-o
rche
stra
ted
child
exp
erie
nces
Hea
lth a
nd s
afet
y pr
ovid
ed b
y fa
mily
Fam
ily c
hara
cter
istic
s or
con
text
ual f
acto
rs w
hich
aff
ect t
hese
fam
ily p
atte
rns
of in
tera
ctio
n in
clud
e:Pe
rson
al c
hara
cter
istic
s of
par
ents
(e.
g., d
egre
e of
dep
ress
ion,
leve
l of
educ
atio
n, in
terg
ener
atio
nal
pare
ntin
g ex
peri
ence
s in
clud
ing
cultu
ral e
xpec
tatio
ns)
Cha
ract
eris
tics
not r
elat
ed to
chi
ld's
dis
abili
ty o
r bi
olog
ical
ris
k st
atus
(e.
g., s
ocia
l sup
port
, mar
ital
rela
tions
hip,
fin
anci
al r
esou
rces
, chi
ld te
mpe
ram
ent)
In a
dditi
on to
the
pote
ntia
l of
fam
ily c
hara
cter
istic
s ac
ting
as s
tres
sors
to o
ptim
al f
amily
pat
tern
s, th
ere
are
four
cat
egor
ies
of p
oten
tial s
tres
sors
for
fam
ilies
cre
ated
by
child
dis
abili
ty o
r bi
olog
ical
ris
k:In
form
atio
n ne
eds
Inte
rper
sona
l and
fam
ily d
istr
ess
Res
ourc
e ne
eds
Con
fide
nce
thre
ats
Dif
fere
nt a
ppro
ache
s to
ear
ly in
terv
entio
n ar
e ca
lled
for
depe
ndin
g on
the
orig
in a
nd n
atur
e of
str
esso
rs a
ndto
be
effe
ctiv
e, s
ervi
ces
mus
t be
resp
onsi
ve to
fam
ily-i
dent
ifie
d ne
eds.
Com
pone
nts
for
a co
ordi
nate
d ea
rly
inte
rven
tion
prog
ram
whe
re n
eeds
hav
e be
en id
entif
ied
in a
ll fo
ur c
ateg
orie
s of
pot
entia
l str
esso
rs c
reat
ed b
ych
ildre
n w
ith e
stab
lishe
d di
sabi
litie
s or
thos
e at
bio
logi
cal r
isk
incl
ude:
res
ourc
e su
ppor
ts, s
ocia
l sup
port
s,an
d in
form
atio
n an
d se
rvic
es. I
t was
poi
nted
out
that
var
ious
ear
ly in
terv
entio
n pr
ogra
m f
eatu
res
will
be
diff
eren
tially
eff
ectiv
e fo
r ch
ildre
n w
ith d
iffe
rent
type
s of
dis
abili
ties.
6035
61
lail
OR
TH
EO
RY
-RW
OM
ME
ND
AT
ION
SPr
ogra
m c
ompo
nent
s fo
r fa
mili
es a
t hig
h ri
sk m
ay r
equi
re in
tens
ific
atio
n of
the
form
al a
spec
ts o
f ea
rly
inte
rven
tion
prog
ram
s as
soci
ated
with
the
info
rmat
ion
and
serv
ices
com
pone
nt in
clud
ing
exte
nsiv
e ho
me
visi
ts r
egar
ding
chi
ld c
are
to f
acili
tate
the
qual
ity o
f pa
rent
-chi
ld tr
ansa
ctio
ns, e
nrol
lmen
t in
high
-qua
lity,
high
ly in
tens
ive,
inte
rven
tion-
orie
nted
chi
ld c
are
or p
resc
hool
pro
gram
s to
pro
vide
nee
ded
expe
rien
ce n
otfo
und
in th
e ho
me,
and
est
ablis
hmen
t of
clos
e co
nnec
tions
with
loca
l pub
lic h
ealth
cen
ters
to e
nsur
e he
alth
and
safe
ty.
In th
e re
view
of
the
effe
ctiv
enes
s of
ear
ly in
terv
entio
n pr
ogra
ms
for
child
ren
with
dev
elop
men
tal d
isab
ilitie
san
d bi
olog
ical
ris
k, w
hile
ack
now
ledg
ing
met
hodo
logi
cal p
robl
ems
with
fir
st g
ener
atio
n re
sear
ch s
tudi
es,
supp
ort f
or th
e ge
nera
lly h
eld
opin
ion
that
ear
ly in
terv
entio
n pr
ogra
ms
are
effe
ctiv
e w
as n
oted
with
eff
ect
size
s av
erag
ing
betw
een
one-
half
and
thre
e-qu
arte
rs o
f a
stan
dard
dev
iatio
n.
In d
iscu
ssin
g di
rect
ions
for
sec
ond-
gene
ratio
n re
sear
ch, t
he id
entif
icat
ion
of th
ose
spec
ific
pro
gram
fea
ture
sth
at a
re a
ssoc
iate
d w
ith o
ptim
al o
utco
mes
for
chi
ldre
n an
d fa
mili
es w
as n
oted
as
an im
port
ant t
ask.
The
mod
el p
rese
nted
in th
is c
hapt
er li
nkin
g fa
ctor
s th
at a
ffec
t ear
ly c
hild
hood
dev
elop
men
t and
the
com
pone
nts
of e
arly
inte
rven
tion
is s
ugge
sted
as
a fr
amew
ork
for
orga
nizi
ng s
econ
d-ge
nera
tion
rese
arch
que
stio
ns.
Impo
rtan
t fac
tors
to e
xam
ine
in lo
okin
g at
inte
ract
ion
patte
rns
betw
een
prog
ram
fea
ture
s an
d ch
ild a
ndfa
mily
cha
ract
eris
tics
incl
ude
seve
rity
of
the
child
's d
isab
ility
or
risk
sta
tus,
sev
erity
of
fam
ily r
isk,
and
the
type
of
child
-rel
ated
dis
abili
ty o
r ri
sk.
The
exp
ansi
on o
f ou
tcom
e m
easu
res
from
the
prim
ary
dom
ains
of
cogn
itive
, lan
guag
e, a
ffec
tive,
and
mot
orde
velo
pmen
t to
outc
ome
mea
sure
s th
at r
efle
ct a
bro
ader
per
spec
tive
of th
e go
als
of e
arly
inte
rven
tion
such
as th
e in
tegr
ativ
e do
mai
ns o
f ch
ildre
n's
soci
al c
ompe
tenc
e or
impr
ovem
ent o
f ch
ildre
n's
heal
th s
tatu
s is
reco
mm
ende
d.
In s
umm
ary
a m
ultid
imen
sion
al m
odel
is p
rese
nted
not
ing
the
thre
e pr
imar
y el
emen
ts th
at s
houl
d be
cons
ider
ed b
y se
cond
-gen
erat
ion
rese
arch
ers:
the
infl
uenc
e of
pro
gram
fea
ture
s, th
e in
flue
nce
of c
hild
and
fam
ily c
hara
cter
istic
s, a
nd th
e sp
ecif
ic o
utco
mes
or
goal
s of
ear
ly in
terv
entio
n.
62
36
63
AIM
'G
ural
nick
, M.J
. and
In r
elat
ion
to o
utco
me
mea
sure
s, th
e au
thor
s re
com
men
d ex
pans
ion
of m
easu
rem
ent s
yste
ms
beyo
ndB
rick
er, D
. (19
87).
The
prim
arily
cog
nitiv
e m
easu
res
to th
e po
tent
ially
impo
rtan
t fol
low
ing
outc
omes
of
earl
y. in
terv
entio
n:E
ffec
tiven
ess
of E
arly
Soci
al c
ompe
tenc
eIn
terv
entio
n fo
r C
hild
ren
Mot
ivat
ion
with
Cog
nitiv
e an
dFa
mily
fun
ctio
ning
.
Gen
eral
Dev
elop
men
tal
Prob
lem
-sol
ving
ski
llsD
elay
s. I
n M
.J.
Gur
alni
ck a
nd F
.C.
Ben
nett
(Eds
.), T
heE
ffec
tiven
ess
of E
arly
Inte
rven
tion
For
At-
Ris
k.
and
Han
dica
pped
.
Chi
ldre
n. N
ew Y
ork:
Aca
dem
ic P
ress
, pp.
115-
173.
Gur
alni
ck, M
.J. a
ndT
he d
omai
n of
soc
ial c
ompe
tenc
e, a
cen
tral
org
aniz
ing
cons
truc
t in
the
stud
y of
hum
an d
evel
opm
ent,
isN
evill
e, B
. (19
97).
reco
mm
ende
d as
an
impo
rtan
t out
com
e of
ear
ly in
terv
entio
n. S
ocia
l com
pete
nce
is s
een
as a
cen
tral
Des
igni
ng E
arly
mec
hani
sm f
oste
ring
the
goal
of
inde
pend
ence
, whi
ch h
as b
een
a lo
ng e
stab
lishe
d pr
iori
ty.
Inte
rven
tion
Prog
ram
sto
Pro
mot
e C
hild
ren'
sR
esea
rch
in th
e ge
nera
l pop
ulat
ion
has
docu
men
ted
intr
icat
e lin
kage
s th
at e
xist
bet
wee
n fa
mily
and
pee
rSo
cial
Com
pete
nce.
rela
tions
hips
. Fou
r as
pect
s of
fam
ily in
flue
nce
that
app
ear
to h
ave
stro
ng a
ssoc
iatio
ns w
ith c
hild
ren'
s pe
er-
In M
.J. G
ural
nick
rela
ted
soci
al c
ompe
tenc
e in
clud
e:(E
d.),
The
Ear
ly c
areg
iver
-chi
ld r
elat
ions
hips
Eff
ectiv
enes
s of
Ear
lyPa
rent
-chi
ld in
tera
ctio
nsIn
terv
entio
n.C
hild
's p
eer
soci
al n
etw
ork
Bal
timor
e: P
aul H
.Pa
rent
al a
ttitu
des
and
belie
fs r
egar
ding
pee
r re
latio
nshi
ps.
Bro
okes
Pub
lishi
ngC
o, p
p. 5
79 -
610
.So
cial
sup
port
app
ears
to b
e an
impo
rtan
t fac
tor
in f
oste
ring
dev
elop
men
t. T
his
incl
udes
bot
h in
form
also
urce
s of
sup
port
by
fam
ily m
embe
rs a
nd f
rien
ds a
nd f
orm
al s
ourc
es o
f su
ppor
t pro
vide
d by
pro
fess
iona
lsan
d ag
enci
es; e
.g.,
info
rmat
iona
l sup
port
. Soc
ial s
uppo
rt is
rel
ated
to p
eer-
rela
ted
soci
al c
ompe
tenc
e.It
app
ears
to b
e pa
rtic
ular
ly v
alua
ble
in b
uffe
ring
dif
ficu
lt ci
rcum
stan
ces
such
as
thos
e as
soci
ated
with
ach
ild's
cha
ract
eris
tics
(chi
ldre
n w
ith d
iffi
cult
tem
pera
men
ts).
Soc
ial s
uppo
rt h
as b
oth
dire
ct a
nd in
dire
ct
6 4
37
UM
...
__...
::. N
eVir
.
linka
ges
to c
hild
ren'
s pe
er-r
elat
ed s
ocia
l com
pete
nce.
The
nat
ure
of th
is in
flue
nce
is p
resu
med
to o
ccur
prim
arily
thro
ugh
indi
rect
eff
ects
, suc
h as
thro
ugh
faci
litat
ing
secu
re a
ttach
men
ts, h
elpi
ng to
est
ablis
hpo
sitiv
e m
ater
nal p
erce
ptio
ns o
r co
gniti
ons
or r
educ
ing
intr
usiv
e pa
rent
ing
styl
es.
It is
not
ed th
at c
hild
ren
at b
iolo
gica
l ris
k, e
spec
ially
pre
mat
ure,
low
bir
thw
eigh
t chi
ldre
n an
d th
ose
with
esta
blis
hed
disa
bilit
ies
have
unu
sual
dif
ficu
lties
in p
eer-
rela
ted
soci
al c
ompe
tenc
e.
Ris
k fa
ctor
s to
the
deve
lopm
ent o
f a
child
's s
ocia
l com
pete
nce
incl
ude
diff
icul
t chi
ld c
hara
cter
istic
s pa
ired
with
the
abse
nce
of a
dequ
ate
soci
al s
uppo
rts.
Pret
erm
, low
bir
thw
eigh
t inf
ants
with
out i
nter
vent
ion
show
a g
radu
al d
eclin
e ov
er th
e fi
rst t
hree
yea
rs o
flif
e. T
his
can
be a
void
ed w
ith f
amily
7cen
tere
d in
terv
entio
ns, w
hich
res
ult i
n in
crea
sed
cogn
itive
com
pete
nce
and
soci
al c
ompe
tenc
e.
Inte
rven
tion
stra
tegi
es a
re s
ugge
sted
incl
udin
g 10
pri
ncip
les
or p
ract
ices
that
are
rel
ated
to th
e so
cial
com
pete
nce
fram
ewor
k. O
ne o
f th
ese
prin
cipl
es r
ecom
men
ds e
mph
asiz
ing
pare
nt-c
hild
soc
ial a
ndem
otio
nal r
elat
ions
hips
rat
her
than
par
ent-
child
inst
ruct
iona
l or
dida
ctic
type
s of
rel
atio
nshi
ps.
Har
ris,
S. R
. (19
97).
The
exi
stin
g bo
dy o
f re
sear
ch o
ffer
s lit
tle, i
f an
y, s
uppo
rt f
or tr
eatm
ent g
oals
that
are
aim
ed a
tT
he E
ffec
tiven
ess
of"n
orm
aliz
ing"
mus
cle
tone
or
enha
ncin
g th
e "q
ualit
y" o
f m
ovem
ent.
The
cur
rent
tren
d is
to e
xam
ine
Ear
ly I
nter
vent
ion
for
outc
omes
that
are
mor
e fu
nctio
nal i
n na
ture
, aim
ed a
t min
imiz
ing
the
child
's d
isab
ility
, rat
her
than
try
toC
hild
ren
with
chan
ge u
nder
lyin
g im
pair
men
ts. F
unct
iona
l ski
lls:
Cer
ebra
l Pal
sy a
ndA
re im
med
iate
ly u
sefu
lR
elat
ed M
otor
Ena
ble
a ch
ild to
be
mor
e in
depe
nden
tD
isab
ilitie
s. I
n M
.J.
Allo
w a
chi
ld to
lear
n m
ore
com
plex
ski
llsG
ural
nick
(E
d.),
The
.A
llow
a c
hild
to li
ve in
a le
ss r
estr
ictiv
e en
viro
nmen
tE
ffec
tiven
ess
of E
arly
Ena
ble
a ch
ild to
be
care
d fo
r m
ore
easi
ly b
y th
e fa
mily
and
oth
ers.
Inte
rven
tion
(pp.
327
-34
8). B
altim
ore:
Pau
lT
he e
mer
ging
em
phas
is is
on
usin
g ou
tcom
e m
easu
res
that
are
bot
h ev
alua
tive
(use
d to
ass
ess
the
amou
ntH
. Bro
okes
Pub
lishi
ngof
cha
nge
over
tim
e or
as
a di
rect
res
ult o
f in
terv
entio
n) a
nd r
espo
nsiv
e to
cha
nge.
Co.
3867
MY
IBO
R:::
::::::
::::::
::::::
::::::
::::::
:::::
-:.1
:TR
EH
.., -
.....
.: M
IRE
:.:.
..
.,..
...-.
.,::::
::::::
::::::
::::::
::::::
::::::
:::::.
...""
"'":
::::::
:E.
.C
ritic
s ha
ve c
omm
ente
d th
at th
ere
has
been
a m
ism
atch
bet
wee
n th
e go
als
of in
terv
entio
n an
d th
e to
ols
used
to m
easu
re th
e ef
fect
s of
inte
rven
tion.
Stu
dies
hav
e re
lied
on d
iscr
imin
ativ
e te
sts
of m
otor
mile
ston
es o
rsP
ecif
ic m
easu
res
of im
pair
men
t, su
ch a
s ra
nge
of m
otio
n, M
uscl
e st
reng
th, o
r m
uscl
e to
ne. F
utur
e re
sear
chm
ust i
nclu
de o
utco
mes
that
are
fun
ctio
nal,
clin
ical
ly r
elev
ant,
and
resp
onsi
ve to
cha
nge,
and
sho
uld
eval
uate
the
effe
cts
of in
terv
entio
n on
the
child
's c
areg
iver
s. R
esea
rch
shou
ld c
ontin
ue to
exa
min
e th
e re
lativ
eef
fect
s of
dif
fere
nt p
rogr
ams
and
serv
ice
mod
els.
Hau
ser-
Cra
m, P
., an
dSh
onko
ff, J
.P.
(198
8). R
ethi
nkin
gth
e A
sses
smen
t of
Chi
ld-F
ocus
edO
utco
mes
,E
valu
atin
g Fa
mily
Prog
ram
s (p
p. 7
3-94
). N
ew Y
ork:
Ald
ine
de G
ruyt
er.
Des
crib
es c
omm
only
use
d no
rmed
ass
essm
ent s
cale
s/in
stru
men
ts :
Bay
ley
Scal
es o
f In
fant
Dev
elop
men
t are
the
best
sta
ndar
dize
d, m
ost f
requ
ently
use
d. H
owev
er,
cogn
itiV
e as
sess
men
ts a
re s
till h
eavi
ly d
epen
dent
on
mot
or s
kills
..
IQ a
nd a
chie
vem
ent t
ests
are
ref
lect
ive
of p
erso
nalit
y va
riab
les
and
mot
ivat
ion
in a
test
situ
atio
n. T
hey
are
narr
ow in
foc
us, w
hile
pro
gram
s ty
pica
lly a
im to
cha
nge
beha
vior
in m
any
dom
ains
(as
1 o
f se
vera
lou
tcom
e m
easu
tes,
they
can
be
usef
ulas
the
only
mea
sure
of
prog
ram
eff
ectiv
enes
s, th
ey m
ay b
ein
appr
opri
ate
and
mis
lead
ing)
.
Rec
omm
ends
bot
h sh
ort-
and
long
-ter
m o
utco
mes
. Sho
rt: u
sual
ly s
peci
fic
skill
are
as s
uch
as m
otor
ski
lls,
lang
uage
per
form
ance
, cog
nitiv
e ab
ility
. Per
sist
ent l
ong-
term
out
com
es m
ay in
clud
e su
stai
ned
impr
ovem
ent
in s
elf-
este
em a
nd ta
sk m
otiv
atio
n, le
ss s
peci
al e
duca
tion,
bet
ter
high
sch
ool c
ompl
etio
n, a
void
ance
of
delin
quen
cy, s
ucce
ssfu
l em
ploy
men
t in
adul
t lif
e. N
ew d
omai
ns to
con
side
r: S
ocia
l com
pete
nce:
sch
ool-
rela
ted
incl
udes
rat
es o
f ab
sent
eeis
m, c
ompl
etio
n of
hom
ewor
k, te
ache
r &
stu
dent
rat
ings
of
clas
sroo
mbe
havi
or, a
ttitu
des
tow
ard
scho
ol, a
spir
atio
ns f
or th
e fu
ture
; des
crib
es in
stru
men
ts/s
cale
s w
hich
mea
sure
soci
al c
ompe
tenc
e/ p
eer
inte
ract
ions
; Sel
f-re
gula
tory
beh
avio
rs: a
ttent
ion
(mea
sure
d by
Par
ent o
r te
ache
rch
eckl
ists
, dir
ect o
bser
vatio
n m
easu
res,
vig
ilanc
e ta
sksi
nstr
umen
t exa
mpl
es);
mot
ivat
ion
and
curi
osity
.
Hau
ser-
Cra
m, P
enny
.(1
990)
. Des
igni
ngm
eani
ngfu
lev
alua
tions
of
earl
yin
terv
entio
n se
rvic
es,
In S
.J. M
eise
ls a
ndJ.
P. S
honk
off
(Eds
.),
Han
dboo
k of
Ear
lyIn
terv
entio
n (p
p. 5
83-
Prog
ram
:W
hile
ther
e m
ay b
e a
need
for
bro
ad-b
ased
fin
ding
s in
eva
luat
ion,
pro
gram
s m
ay d
iffe
r su
bsta
ntia
llyfr
om o
ne a
noth
er. S
uita
ble
and
effi
cien
t way
s of
doc
umen
ting
such
var
iatio
n ne
ed to
be
foun
d.C
onSi
der
serv
ices
act
ually
impl
eine
nted
. Ser
vice
s pl
anne
d fo
r a
child
and
fam
ily a
re o
ften
qui
te d
iffe
rent
from
thos
e re
ceiv
ed. A
spec
ts o
f im
plem
enta
tion
whi
ch r
equi
re a
ttent
ion
incl
ude:
1) w
heth
er th
ere
has
been
suf
fici
ent q
uant
ity o
f se
rvic
e fo
r an
impa
ct; 2
) ho
w th
e pr
ogra
m p
rodu
ces
its r
esul
ts; a
nd 3
)m
easu
rabl
e sp
ecif
icat
ion
and
iden
tific
atio
n of
ser
vice
s.
?
6839
69
MI
IBE
OR
Y-R
EC
OM
ME
ND
AT
ION
S60
2). N
ew Y
ork:
Succ
ess:
Cam
brid
ge U
nive
rsity
Mos
t eva
luat
ions
hav
e de
fine
d su
cces
s as
chi
ld c
ogni
tive
gain
. Yet
con
vent
iona
l mea
sure
s of
IQ
and
Pres
s.D
Q f
or in
fant
s an
d to
ddle
rs h
ave
poor
pre
dict
ive
valid
ity. C
ritic
ism
of
thes
e m
easu
res
incl
udes
:In
abili
ty to
dis
tingu
ish
betw
een
norm
al a
nd d
isab
led
child
ren
with
in th
e yo
unge
st a
ge g
roup
sSt
eep
grad
ient
of
cert
ain
test
s, s
uch
that
sm
all d
iffe
renc
es y
ield
larg
e sc
ore
chan
ges
Lac
k of
an
appr
opri
ate
(dis
able
d) r
efer
ence
pop
ulat
ion
Hea
vy d
epen
denc
e on
mot
or a
nd p
erce
ptua
l-m
otor
ski
lls, h
ence
mis
lead
ing
resu
lts f
or c
hild
ren
with
mot
or im
pair
men
tsG
loba
l nat
ureo
ften
inse
nsiti
ve to
type
s of
spe
cifi
c ch
ange
s in
dev
elop
men
t (ta
rget
cha
nges
may
be
obsc
ured
by
lack
of
chan
ges
in o
ther
are
as, s
uch
as m
otor
ski
lls)
,
EI
prog
ram
s se
ek to
aff
ect a
bro
ad r
ange
of
deve
lopm
enta
l dom
ains
, suc
h as
fun
ctio
nal s
kills
, soc
ial
com
pete
nce,
sel
f-re
gula
tory
beh
avio
rs, m
otiv
atio
n, a
nd c
urio
sity
. An
arra
y of
chi
ld o
utco
mes
is o
ften
requ
ired
to u
nder
stan
d pr
ogra
m e
ffec
ts. N
ew in
stru
men
ts h
ave
been
rep
orte
d w
hich
are
dir
ecte
d at
dom
ains
for
whi
ch th
ere
are
no s
tand
ardi
zed
mea
sure
s. T
rian
gula
tion
of m
easu
rem
ent c
an d
imin
ish
risk
invo
lved
in u
sing
inst
rum
ents
whi
ch m
ay la
ck s
uffi
cien
t doc
umen
tatio
n of
psy
chom
etri
c pr
oper
ties
and
stan
dard
izat
ion
for
atyp
ical
pop
ulat
ions
.C
onsi
der
both
sho
rt-
and
long
-ter
m e
ffec
ts, s
uch
as la
ter
scho
ol a
djus
tmen
t, pe
er in
tera
ctio
n, a
mou
ntan
d ty
pe o
f ad
ditio
nal s
ervi
ces,
pla
cem
ent i
n an
inte
grat
ed o
r se
greg
ated
set
ting,
par
enta
l adv
ocac
y, a
ndpa
rent
-sch
ool r
elat
ions
hips
.E
I pr
ogra
ms
serv
e a
wid
e ra
nge
of c
hild
ren
and
fam
ilies
. Con
side
r su
bgro
up c
lass
ific
atio
ns. P
ast
eval
uatio
ns h
ave
gene
rally
bee
n ba
sed
on d
iagn
ostic
gro
ups.
Oth
er r
ecom
men
datio
ns h
ave
incl
uded
focu
sing
on
diff
eren
ces
in f
unct
iona
l sta
tus,
and
by
seve
rity
of
disa
bilit
y ra
ther
than
by
type
of
disa
bilit
y.In
mos
t pro
gram
s, p
aren
ts a
re a
lso
part
icip
ants
. Sel
ectio
n of
out
com
e m
easu
res
of f
amily
impa
ct s
houl
dbe
gui
ded
by p
rogr
am m
odel
. Mod
el e
xam
ples
incl
ude
the
pare
nt th
erap
y m
odel
(as
sist
ed th
roug
hco
unse
ling
or s
uppo
rt g
roup
s to
hel
p re
solv
e st
ress
rel
ated
to r
aisi
ng a
chi
ld w
ith d
isab
ilitie
s), t
he p
aren
ttr
aini
ng m
odel
(em
phas
izes
rol
e of
par
ent b
ehav
ior
in te
achi
ng s
kill
to a
chi
ld),
and
the
pare
nt-c
hild
inte
ract
ion
mod
el (
assi
stin
g th
e pa
rent
in le
arni
ng to
rea
d th
e ch
ild's
cue
s an
d in
bei
ng s
ensi
tive
to th
ech
ild's
nee
ds).
The
se m
odel
s re
ly o
n th
eeco
logi
cal v
iew
of
child
and
fam
ily a
nd o
n th
e tr
ansa
ctio
nal
natu
re o
f de
velo
pmen
t.M
ore
prec
ise
and
accu
rate
fin
ding
s ca
n be
gen
erat
ed if
dat
a ar
e an
alyz
ed in
term
s of
sub
grou
ps o
ffa
mili
es. S
trat
egie
s in
clud
e de
mog
raph
ic g
roup
ing
(inc
ome
or e
duca
tiona
l atta
inm
ent)
, gro
upin
g by
diff
eren
ces
alon
g a
dim
ensi
on th
ough
t to
be th
eore
tical
ly im
port
ant (
such
as
exte
nt a
nd s
atis
fact
ion
with
40'7
1
011
a su
ppor
t net
wor
k), a
nd c
lust
eran
alys
is o
n a
num
ber
of th
eore
tical
ly im
port
ant v
aria
bles
. Suc
hdi
ffer
ence
s m
ay h
elp
expl
ain
how
fam
ilies
dif
fer
in th
eir
resp
onse
to E
I.
Res
earc
h D
esig
nA
num
ber
of is
sues
com
plic
ate
atte
mpt
s at
true
exp
erim
enta
l des
ign.
The
aut
hor
disc
usse
s 4
quas
i-ex
peri
men
tal d
esig
ns:
The
unt
reat
ed c
ontr
ol g
roup
des
ign
utili
zes
pre-
and
pos
t-te
st c
ompa
riso
ns (
exam
ple
is f
or a
par
ent
com
pone
nt w
hen
ther
e is
lim
ited
staf
f an
d a
wai
ting
list)
. Thr
eats
tova
lidity
incl
ude
regr
essi
on to
the
mea
n an
d se
lect
ion-
mat
urat
ion.
Coh
ort d
esig
n ga
ther
s da
ta f
rom
one
coh
ort,
adds
a c
ompo
nent
, and
gat
hers
com
pari
son
data
fro
mth
e
next
coh
ort.
His
tory
is a
maj
or th
reat
to v
alid
ity.
A n
oneq
uiva
lent
dep
ende
nt v
aria
bles
des
ign
invo
lves
one
gro
up, w
ith c
ompa
riso
ns o
fcha
nge
ondi
ffer
ent o
utco
me
mea
sure
s. A
dif
ficu
lty in
this
des
ign
is in
the
dete
rmin
atio
n of
one
set
of
outc
omes
assu
med
to b
e af
fect
ed a
nd a
noth
er a
ssum
ed n
ot to
be
affe
cted
by
EI.
Plan
ned
vari
atio
n de
sign
ana
lyze
s gr
oups
that
rec
eive
dif
fere
nt le
vels
of
serv
ice.
Ide
ally
, ass
ignm
ent i
sra
ndom
.E
ach
desi
gn (
incl
udin
g ra
ndom
ized
stu
dy)
has
pote
ntia
l wea
knes
ses.
The
se s
houl
d be
ant
icip
ated
and
evid
ence
col
lect
ed to
cou
nter
alte
rnat
ive
expl
anat
ions
for
fin
ding
s.
Prob
lem
s of
Sta
tistic
al P
ower
are
com
mon
. Sam
ples
of
at le
ast 7
0 su
bjec
ts p
er g
roup
are
nee
ded
to d
etec
tdi
ffer
ence
s on
'/2
stan
dard
dev
iatio
n 90
% o
f th
e tim
e, b
ut f
ew E
I st
udie
s ha
ve s
uch
larg
e sa
mpl
es. T
his
may
requ
ire
sum
mat
ive
eval
uatio
ns a
cros
s pr
ogra
ms.
Mea
suri
ng C
hang
eA
gre
at d
ilem
ma
in E
I ev
alua
tion
is h
ow to
mea
sure
the
effe
cts
of s
ervi
ces
in th
e ab
senc
e of
ran
dom
ized
or
rigo
rous
ly s
elec
ted
cont
rol g
roup
s. A
ppro
ache
seac
h w
ith p
ros
and
cons
have
incl
uded
:N
orm
-ref
eren
ced
mod
els
(see
dis
cuss
ion
abov
e)In
dexe
s of
cha
nge
look
at t
he r
ate
of d
evel
opm
enta
l gai
n ov
er ti
me,
and
may
com
pare
thes
e to
the
rate
of d
evel
opm
ent b
efor
e E
I. H
owev
er, t
hese
are
onl
y us
eful
with
sta
ndar
d m
easu
res
of d
evel
opm
enta
lag
e, a
nd a
re b
ased
on
the
assu
mpt
ion
(with
outs
uppo
rtin
g em
piri
cal e
vide
nce)
that
the
ratio
of
deve
lopm
enta
l age
to c
hron
olog
ical
age
wou
ld b
e st
able
in th
e ab
senc
e of
inte
rven
tion.
7241
73
74
MJT
RO
RT
hEO
RY
-RE
CO
MM
EN
DA
TIO
NS
Dif
fere
nce,
or
gain
, sco
res
are
the
diff
eren
ce b
etw
een
pre-
and
post
-tes
t sco
res.
The
se s
core
s ar
ecr
itici
zed
for
lack
of
relia
bilit
y. C
urre
nt s
tand
ard
appr
oach
has
mov
ed to
the
use
of r
esid
ual c
hang
esc
ores
, in
whi
ch a
reg
ress
ion
equa
tion
is d
evel
oped
that
des
crib
es th
e re
latio
n be
twee
n po
stte
st s
core
san
d pr
etes
t sco
res
for
the
entir
e sa
mpl
e. T
hen
indi
vidu
al s
core
s ar
e ca
lcul
ated
rep
rese
ntin
g th
e di
ffer
ence
("re
sidu
al")
bet
wee
n th
e ac
tual
pos
ttest
sco
re a
nd th
e sc
ore
that
wou
ld b
e pr
edic
ted
by in
sert
ing
pret
est
scor
e in
to th
e re
gres
sion
equ
atio
n. T
he r
elat
ions
hip
betw
een
aspe
cts
of e
arly
inte
rven
tion
and
size
of
resi
dual
s is
ana
lyze
d. S
ome
spec
ific
lim
itatio
ns: 1
) te
lls li
ttle
abou
t how
an
indi
vidu
al a
ctua
lly c
hang
es;
and
2) r
elie
s he
avily
on
grou
p da
ta a
nd la
rge
sam
ples
and
is r
elat
ivel
y in
sens
itive
to th
e in
divi
dual
ized
natu
re o
f se
rvic
es p
rovi
ded
in m
ost E
I pr
ogra
ms.
Goa
l atta
inm
ent s
calin
g (G
AS)
off
ers
a qu
antit
ativ
e m
easu
re o
f pr
ogre
ss to
war
d go
als,
whi
ch c
an b
est
anda
rdiz
ed. S
hort
com
ings
: 1)
the
ques
tion
of th
e va
lidity
of
the
goal
s; a
nd2)
the
mea
ning
of
the
prog
ram
leve
l out
com
e m
easu
re (
mea
n go
al a
ttain
men
t) is
obs
cure
.A
lthou
gh n
ot y
et a
pplie
d to
EI
eval
uatio
ns, g
row
th m
odel
ing
high
light
s di
ffer
ent r
ates
of
grow
th o
fdi
ffer
ent i
ndiv
idua
ls. T
his
allo
ws
exam
inat
ion
of w
heth
er d
iffe
renc
es in
cha
nge
are
a fu
nctio
n of
char
acte
rist
ics
of c
hild
, fam
ily, o
r se
rvic
es. I
t doe
s no
t req
uire
a li
near
mod
el o
f de
velo
pmen
t.St
ruct
ural
equ
atio
n m
odel
ing
(SE
M, s
omet
imes
ref
erre
d to
as
path
ana
lysi
s) in
volv
es th
e de
velo
pmen
t of
a se
ries
of
hier
arch
ical
reg
ress
ion
equa
tions
to te
st p
redi
cted
rel
atio
ns in
a m
odel
of
hypo
thes
ized
rela
tions
hips
. Lim
itatio
ns in
clud
e th
e la
rge
num
ber
of c
ases
req
uire
d (t
he m
ore
vari
able
s sp
ecif
ied,
the
larg
er th
e sa
mpl
e si
ze r
equi
red)
, the
con
tent
ion
that
con
firm
atio
n of
a m
odel
doe
s no
t im
ply
proo
f of
the
mod
el's
val
idity
, and
the
conc
ern
that
SE
M w
ill r
epla
ce th
e th
eore
tical
dev
elop
men
t of
mod
els.
Kra
uss,
M.W
.T
he m
anda
tes
of th
e E
duca
tion
of th
e H
andi
capp
ed A
ct A
men
dmen
ts o
f1986
(PL
99-457)
redi
rect
ed th
e(1997). Two
focu
s of
ser
vice
pla
nnin
g in
ear
ly in
terv
entio
n pr
ogra
ms
from
a c
hild
-ori
ente
d m
odel
to a
fam
ily-o
rien
ted
Gen
erat
ions
of
Fam
ilym
odel
. It i
s no
w a
ssum
ed th
at th
e be
st w
ay to
ens
ure
posi
tive
effe
cts
on f
amili
es is
to h
ave
the
indi
vidu
alR
esea
rch
in E
arly
fam
ilies
dri
ve th
e se
rvic
e sy
stem
acc
ordi
ng to
thei
r un
ique
goa
ls a
nd n
eeds
.In
terv
entio
n. I
n M
.J.
The
re h
as b
een
a co
rres
pond
ing
shif
t in
the
basi
c qu
estio
ns th
at u
nder
lie in
vest
igat
ions
of
the
impa
ct o
f ea
rly
Gur
alni
ck (
Ed.
), T
hein
terV
entio
n pr
ogra
ms
on f
amili
es to
:E
ffec
tiven
ess
of E
arly
The
sup
port
ive
role
of
earl
y in
terv
entio
n pr
ogra
ms
for
fam
ilies
Inte
rven
tion.
The
mec
hani
sms
by w
hich
fam
ily g
oals
and
str
engt
hs a
re a
rtic
ulat
ed f
or p
rogr
am p
lann
ing
purp
oses
Bal
timor
e: P
aul H
.T
he p
rovi
sion
of
cultu
rally
res
pons
ive
serv
ices
to a
n in
crea
sing
ly d
iver
se p
opul
atio
n of
ser
vice
rec
ipie
nts
Bro
okes
Pub
lishi
ngC
o, p
p.611
-624.
42
75
Firs
t gen
erat
ion
rese
arch
on
fam
ily e
ffec
ts w
as f
ocus
ed o
n id
entif
ying
how
fam
ilies
fun
ctio
n, th
e ef
fect
of
earl
y in
terv
entio
n se
rvic
es o
n di
ffer
ent a
spec
ts o
f pa
rent
al o
r fa
mily
fun
ctio
ning
, and
det
erm
inat
ion
of f
acto
rsth
at a
re s
ourc
e§ o
f va
riab
ility
.
In r
elat
ion
to f
utur
e re
sear
ch, o
ne im
port
ant d
irec
tion
note
d is
und
erst
andi
ng th
e co
mpl
ex in
tera
ctio
nsre
gard
ing
fam
ily g
oals
and
out
com
es in
rel
atio
n to
fam
ily (
e.g.
, nee
d fo
r su
ppor
t) a
nd c
hild
(e.
g., s
ever
ity o
fdi
sabi
lity)
cha
ract
eris
tics
and
prog
ram
fea
ture
s.
New
dir
ectio
ns o
f re
sear
ch p
oint
to s
econ
d ge
nera
tion
ques
tions
of
how
and
how
wel
l ear
ly in
terv
entio
npr
ogra
ms
prom
ote
posi
tive
fam
ily f
unct
ioni
ng a
nd e
nhan
ced
child
dev
elop
men
t.
Lee
Sny
der-
McL
ean.
Inst
rum
ents
that
yie
ld I
Q s
core
s ar
e am
ong
the
mos
t wid
ely
used
. Mos
t tes
ts o
f th
is ty
pe r
esul
t in
a(1
987)
. Rep
ortin
gde
velo
pmen
tal a
ge (
DA
) an
d a
deve
lopm
enta
l quo
tient
(D
Q)
for
each
dom
ain
test
ed a
s w
ell a
s fo
r ov
eral
lN
orm
-Ref
eren
ced
perf
orm
ance
. DQ
is th
e ra
tio o
f cu
rren
t DA
to c
urre
nt c
hron
olog
ical
age
(C
A).
Prog
ram
Eva
luat
ion
:D
ata
Som
ePr
etes
t/Pos
ttest
com
pari
son
of D
A d
oes
not f
acto
r ou
t or
cont
rol f
or th
e ef
fect
s of
mat
urat
ion
and
Con
side
ratio
ns.
incr
easi
ng C
A. A
ttem
pts
to a
ddre
ss th
is in
clud
e:
Jour
nal o
f th
eD
Q c
ompa
riso
ns a
ssum
e th
at th
e ch
ild's
pre
inte
rven
tion
rate
of
deve
lopm
ent i
s a
stab
le a
nd c
hara
cter
istic
Div
isio
n fo
r E
arly
lear
ning
rat
e fo
r th
e ch
ild. B
ecau
se D
Q is
cal
cula
ted
on th
e ba
sis
of a
chi
ld's
cur
rent
, cum
ulat
ive
DA
and
Chi
ldho
od, 1
1(3)
,C
A, i
t ten
ds to
min
imiz
e in
terv
entio
n ef
fect
s. T
he o
lder
the
cliil
d pr
ior
to in
terv
entio
n, th
e le
ss s
ensi
tive
DQ
254-
264.
will
be
to r
elat
ive
chan
ges
in th
e de
velo
pmen
tal s
tatu
s. I
t is
not u
ncom
mon
to f
ind
that
sta
tistic
al a
naly
ses
cond
ucte
d on
DQ
cha
nge
scor
es y
ield
non
sign
ific
ant r
esul
ts, e
ven
whe
n th
e ac
tual
gai
ns b
y ch
ildre
n se
emed
ucat
iona
lly s
igni
fica
nt.
Com
pari
sons
of
pred
icte
d ch
ange
to a
ctua
l cha
nge
use
prei
nter
vent
ion
DQ
to p
redi
ct th
e de
velo
pmen
tal
gain
s th
at m
ight
be
expe
cted
with
out i
nter
vent
ion,
The
ass
umpt
ion
that
ent
ry D
Q r
epre
sent
s a
valid
and
stab
le r
ate
of d
evel
opm
ent i
s pr
oble
mat
ic, a
s de
velo
pmen
t pat
tern
s ar
e m
ore
typi
cally
rep
rese
nted
as
a se
ries
of p
eaks
and
pla
teau
s.E
ffic
ienc
y an
d ch
ange
indi
ces:
Eff
icie
ncy
inde
x (E
I) is
cal
cula
ted
by d
ivid
ing
the
child
's a
ctua
l gai
n by
an
"ide
al g
ain"
(1
mon
th p
erch
rono
logi
cal m
onth
), th
en d
ivid
ing
by c
hild
's p
rete
st D
Q, w
hich
in tu
rn h
as b
een
divi
ded
by 1
00. T
his
give
s a
larg
e sc
ore
whi
ch a
llow
s co
mpa
riso
n ac
ross
chi
ldre
n of
dif
fere
nt a
ges
and
deve
lopm
enta
l lev
els.
Prop
ortio
nal c
hang
e in
dex
(PC
I) d
ivid
es d
evel
opm
enta
l gai
n by
tim
e in
inte
rven
tion,
whi
ch is
then
divi
ded
by p
rete
st D
Q (
i.e. D
A/C
A).
Hen
ce, d
iffe
rs f
rom
EI
only
by
deci
mal
poi
nt.
7643
77
78
UM
..
...
.
Inte
rven
tion
effi
cien
cy in
dex
(EI)
is c
alcu
late
d by
div
idin
g de
velo
pmen
tal g
ain
by a
mou
nt o
f tim
ebe
twee
n pr
e- a
nd p
ostte
st. T
his
has
been
cri
ticiz
ed f
or n
ot f
acto
ring
in p
rete
st D
A o
r D
Q.
The
aut
hor
reco
mm
ends
for
con
side
ratio
n th
e co
ncep
t of
"Int
erve
ntio
n D
Q"
(EI
with
a c
lear
er n
ame)
,ca
lcul
ated
by
divi
ding
the
mon
ths
(or
wee
ks)
of m
easu
red
chan
ge in
chi
ld's
DA
bet
wee
n pr
e- a
nd p
ost-
test
ing
by th
e nu
mbe
r of
mon
ths
(or
wee
ks)
that
laps
ed b
etw
een
pre-
and
pos
t-te
st. T
his
refl
ects
the
child
'sra
te o
f de
velo
pmen
t dur
ing
inte
rven
tion,
whi
ch c
an b
e co
mpa
red
to th
e pr
eint
erve
ntio
n D
Q.
Mar
fo, K
., an
dW
eakn
esse
s/re
com
men
datio
ns f
or f
utur
e re
sear
ch in
clud
e:D
iner
o, T
.E. (
1991
).C
lear
er s
peci
fica
tion
of in
terv
entio
n pr
oced
ures
, clie
nt c
hara
cter
istic
sA
sses
sing
Ear
lyA
ddre
ss b
enef
its b
eyon
d ch
ild c
ogni
tive
deve
lopm
enta
l gai
n (i
.e. b
enef
its to
par
ents
& f
amily
; kno
wle
dge
Inte
rven
tion
& s
kills
per
tain
ing
to c
hild
's d
evel
opm
ent.)
Out
com
es: B
eyon
dA
sses
s ou
tcom
es in
rel
atio
n to
spe
cifi
c in
puts
Prog
ram
Var
iabl
es.
Gm
ater
pro
gram
and
pop
ulat
ion
spec
ific
ity in
out
com
e as
sess
men
tIn
tern
atio
nal J
ourn
alof
Dis
abili
ty,
Dev
elop
men
t and
Add
ress
fac
tors
ass
ocia
ted
with
dif
fere
ntia
l int
erve
ntio
n ou
tcom
es
Too
ls to
ass
ess
EI
dete
rmin
ants
with
out t
he n
eed
for
cont
rol g
roup
s:E
duca
tion,
38(
3),
289-
303.
Mul
tiple
reg
ress
ion
to d
isce
rn b
oth
the
mai
n an
d in
tera
ctiv
e ef
fect
s of
dif
fere
nt c
lass
es o
f in
depe
nden
tva
riab
les
on a
giv
en o
utco
me
vari
able
Path
ana
lysi
s us
es r
egre
ssio
n pr
oced
ures
in th
e es
timat
ion
of p
ath
coef
fici
ents
as
a pr
oced
ure
for
stud
ying
a p
atte
rn o
f hy
poth
esiz
ed c
ausa
l rel
atio
nshi
ps w
ithin
a s
et o
f va
riab
les.
Pat
h an
alys
is c
an"d
ecom
pose
" a
rela
tions
hip
betw
een
2 va
riab
les
into
the
dire
ct e
ffec
ts, t
he in
dire
ct e
ffec
ts, s
puri
ous
effe
cts,
any
par
ts u
nana
lyze
d by
the
rese
arch
ers
as a
mat
ter
of c
hoic
e (o
r ne
glec
t) a
nd r
esid
ual e
ffec
ts.
Var
iabl
e cl
asse
s in
a f
ram
ewor
k fo
r as
sess
ing
outc
omes
dep
end
on E
I de
fini
tion
and
unde
rlyi
ng a
ssum
ptio
ns.
Pres
ents
an
exam
ple
for
trad
ition
al E
I co
ncep
tual
izat
ion
in w
hich
inde
pend
ent v
aria
bles
mig
ht in
clud
epr
ogra
m c
hara
cter
istic
s in
tens
ity, d
urat
ion,
par
ent/f
amily
com
mitm
ent,
wor
ker
com
pete
nce,
mat
ch b
etw
een
prog
ram
as
inte
nded
and
as
impl
emen
ted.
..), c
hild
cha
ract
eris
tics
(chr
onol
ogic
al a
ge, d
evel
opm
enta
lco
mpe
tenc
e, n
atur
e &
sev
erity
of
disa
bilit
y...)
, fam
ily d
emog
raph
y (S
ES,
par
ent a
ge a
nd e
d le
vel..
.), f
amily
ecol
ogy
(qua
lity
of h
ome
envi
ronm
ent,
pare
ntal
exp
ecta
tions
, fam
ily r
esou
rces
, qua
lity
of p
aren
t-ch
ildin
tera
ctio
n...)
, and
non
-pro
gram
aux
iliar
y se
rvic
es (
vari
ety,
fre
quen
cy...
). O
utco
me
vari
able
s m
ight
incl
ude
4479
.M
JTU
OR
. .T
EIV
ON
IME
child
out
com
es (
impr
ovem
ent i
n de
velo
pmen
tal c
ompe
tenc
e in
targ
eted
dom
ains
, cha
nges
in in
tera
ctio
nal
skill
s, e
.g.,
incr
ease
d re
spon
sive
ness
, beh
avio
r en
gage
men
t [tim
e in
tera
ctin
g in
dev
elop
men
tally
app
ropr
iate
fash
ion]
...)
and
pare
nt/f
amily
out
com
es (
pare
ntal
sat
isfa
ctio
n w
ith th
e pr
ogra
m, p
aren
tal i
nter
actio
nal s
tyle
,pa
rent
al c
opin
g st
rate
gies
, fam
ily w
ell-
bein
g...)
McL
ean,
L.K
. and
Cri
pe,
Ear
ly in
terv
entio
n fo
r a
broa
d sp
ectr
um o
f co
mm
unic
atio
n di
sord
ers
affe
ctin
g yo
ung
child
ren
can
be v
ery
J.W
. (19
97).
The
effe
ctiv
e in
elim
inat
ing
thos
e di
sord
ers
or a
t lea
st m
itiga
ting
thei
r im
pact
on
a ch
ild's
late
r sp
eech
and
Eff
ectiv
enes
s of
Ear
lyla
ngua
ge d
evel
opm
ent.
Inte
rven
tion
for
Chi
ldre
nw
ith C
omm
unic
atio
nM
easu
res
used
in m
ost o
f th
e st
udie
s re
view
ed w
ere
dire
ct m
easu
res
of th
e ta
rget
com
mun
icat
ion
abili
ty o
rD
isor
ders
. In
M.J
.di
sord
er (
e.g.
, mea
n le
ngth
-of
utte
ranc
e, %
syl
labl
es s
tutte
red.
..). M
any
also
rep
orte
d pr
e- a
nd p
ost-
Gur
alni
ck (
Ed.
), T
hetr
eatm
ent s
core
s on
one
or
mor
e st
anda
rdiz
ed, n
orm
-ref
eren
ced
mea
sure
s of
com
mun
icat
ion
deve
lopm
ent
Eff
ectiv
enes
s of
Ear
ly(s
uch
as S
eque
nced
Inv
ento
ry o
f C
omm
unic
atio
n D
evel
opm
ent (
Hed
rick
et a
l., 1
975)
, Com
mun
icat
ion
and
Inte
rven
tion
(pp.
271
-Sy
mbo
lic B
ehav
ior
Scal
es (
Wet
herb
y &
Pri
zant
, 199
0), a
nd P
eabo
dy P
ictu
re V
ocab
ular
y T
estR
evis
ed30
6). B
altim
ore:
Pau
l H.
(Dun
n &
Dun
n, 1
981)
). S
ome
incl
uded
mea
sure
s of
gen
eral
dev
elop
men
t or
cogn
itive
fun
ctio
ning
(su
ch a
sB
rook
es P
ublis
hing
Co.
Bay
ley
Scal
es o
f In
fant
Dev
elop
men
t (B
ayle
y, 1
993)
, and
Lei
ter
Inte
rnat
iona
l Per
form
ance
Sca
le (
Lei
ter
&A
rthu
r, 1
950)
).
The
aut
hors
enc
oura
ge u
se o
f so
cial
val
idity
mea
sure
s of
com
mun
icat
ion
func
tioni
ng w
ith p
eers
and
fam
ilym
embe
rs, e
vide
nce
for
cost
-eff
ectiv
enes
s in
term
s of
ulti
mat
e im
pact
on
child
's la
ter
scho
ol s
ucce
ss a
ndsu
ppor
t nee
ds, f
urth
er c
ompa
riso
n st
udie
s an
d se
cond
-gen
erat
ion
rese
arch
(cl
eart
hat n
o si
ngle
inte
rven
tion
appr
oach
is m
ost e
ffec
tive
for
all y
oung
chi
ldre
n w
ith c
omm
unic
atio
n di
sord
ers)
, spe
cifi
catio
n of
chi
ld a
ndpr
ogra
m v
aria
bles
ass
ocia
ted
with
dif
fere
ntia
l out
com
es f
ordi
ffer
ent t
reat
men
t app
roac
hes.
Spec
ific
topi
cs f
or f
utur
e re
sear
ch in
clud
e:O
ptim
al ti
min
g fo
r E
IM
axim
um c
ost-
effi
cien
cyL
engt
h &
fre
quen
cy o
f tr
eatm
ent
.
Whe
n is
a c
ycle
s ap
proa
ch m
ore
effi
cien
t tha
n a
trea
tmen
t-to
-cri
teri
on a
ppro
ach
Whe
n is
eff
ectiv
enes
s be
tter
for
grou
p or
1-t
o-1
or h
ome-
base
d m
odel
sIn
tegr
ated
vs.
spe
cial
cla
sses
8045
81
82
UU
OR
YR
EC
OM
ME
ND
AT
iON
SPa
kula
, A.L
. and
Pal
mer
,C
oncl
usiv
e da
ta o
n ef
fect
iven
ess
of e
ither
bro
ad-b
ased
or
focu
sed
inte
rven
tions
for
chi
ldre
n "a
t-ri
sk"
for
F.B
. (19
97).
Ear
lyne
urom
otor
dis
abili
ties
and
crite
ria
for
dete
rmin
ing
whe
ther
a s
peci
fic
serv
ice
mod
el w
ill m
eet t
he in
divi
dual
Inte
rven
tion
for
Chi
ldre
nat
Ris
k fo
r N
euro
mot
orne
eds
of a
spe
cifi
c ch
ild o
r fa
mily
are
not
ava
ilabl
e.
Prob
lem
s. I
n M
.J.
Rec
omm
ends
out
com
es th
at a
re c
linic
ally
and
eco
logi
cally
rel
evan
t, an
d w
hich
mea
sure
cha
nges
that
are
Gur
alni
ck (
Ed.
), T
helik
ely
to b
e si
gnif
ican
t in
the
child
and
fam
ily's
nat
ural
set
ting.
In
addi
tion
to I
Q/D
Q, s
houl
d em
phas
ize
play
Eff
ectiv
enes
s of
Ear
lysk
ills,
par
ent-
infa
nt in
tera
ctio
ns, f
amily
str
ess,
infa
nt a
dapt
ive
skill
s, a
nd th
e fa
mily
's f
unct
iona
l cap
acity
toIn
terv
entio
n (p
p. 2
71-
adap
t to
thei
r ch
ild. O
utco
mes
mus
t be
asse
ssed
in b
oth
the
shor
t- a
nd lo
ng-t
erm
.30
6). B
altim
ore:
Pau
l H.
Bro
okes
Pub
lishi
ng C
o.A
ckno
wle
dges
the
diff
icul
ty o
f co
mpl
ianc
e w
ith tr
eatm
ent o
r di
lutin
g of
con
trol
or
cont
rast
gro
ups,
but
war
ns th
at s
mal
l stu
dies
with
inad
equa
te s
ampl
e si
ze to
det
ect t
he d
esir
ed c
hang
es o
r in
adeq
uate
con
trol
of
conf
ound
ing
vari
able
s ar
e lik
ely
to b
e m
isle
adin
g.
Rob
erts
, R.N
., In
noce
nti,
The
aut
hors
not
e th
at m
ost o
f th
e cu
rren
tly f
unde
d ev
alua
tions
use
a m
ixed
met
hodo
logy
that
incl
ude
M.S
., an
d G
oetz
e,L
.D.
inte
rvie
ws,
que
stio
nnai
res,
and
rec
ord
revi
ews.
Dir
ect a
sses
smen
t tec
hniq
ues
are
mor
e ex
pens
ive.
(199
7)B
y W
hat O
utco
mes
Com
mon
mea
sure
men
t con
cern
s in
clud
e th
e re
liabi
lity
of r
epor
ts f
rom
pro
vide
r an
d pa
rent
, ina
dequ
acy
ofSh
ould
Par
t H b
em
ost s
tate
dat
a ba
ses
for
rese
arch
pur
pose
s, a
nd s
elec
tivity
of
adm
inis
trat
ion
of m
easu
res
whe
n co
ntro
l is
inE
valu
ated
at t
he S
tate
the
hand
s of
the
com
mun
ity (
i.e. s
urve
ys th
ose
who
are
fav
orab
ly p
redi
spos
ed).
Lev
el?
Proc
eedi
ngs
of th
e Pa
rt H
One
que
stio
n of
inte
rest
is w
heth
er e
ligib
ility
req
uire
men
ts a
cros
s ag
enci
es a
ct to
fac
ilita
te o
r lim
it se
rvic
esE
valu
ator
s'fa
mili
es c
an a
cces
s.C
Ons
ortiu
m. E
IRI.
Des
crib
es s
tate
eva
luat
ions
for
: CA
, CO
, CT
, FL
, HA
, MI,
NJ,
NC
, PA
, UT
Dis
cuss
es s
yste
m &
com
mun
ity m
easu
res:
Fam
ily: c
hoic
e, c
ontr
ol (
satis
fact
ion
conc
ern:
res
earc
h sh
ows
fam
ilies
rep
ort h
igh
satis
fact
ion
rega
rdle
ss o
fty
pes
of s
ervi
ces)
, im
prov
ed q
ualit
y of
life
(ch
ild c
are
acce
ss, p
aren
ts a
ble
to r
esum
e w
ork,
abl
e to
part
icip
ate
in c
omm
unity
act
iviti
es, a
ble
to e
ngag
e in
life
act
iviti
es th
at s
uppo
rt b
ette
r m
enta
l hea
lth, c
hild
's.
need
s m
ore
man
agea
ble
for
fam
ily--
- ca
n re
late
to im
prov
ed a
dapt
ive
beha
vior
s, in
crea
ses
in m
edic
alou
tcom
es, i
ncre
ases
in a
ppro
pria
te s
ocia
l beh
avio
rs...
)C
hild
: con
sens
us th
at o
utco
mes
nee
d to
be.
mea
sure
d no
t bro
adly
but
mor
e sp
ecif
ical
ly, i
n ar
eas
whe
re o
ne
4683
'O
n O
RT
HE
OR
Y-R
EC
OM
ME
ND
AT
ION
Sca
n re
ason
ably
exp
ect P
art H
ser
vice
s to
mak
e a
diff
eren
ce. A
dditi
onal
out
com
es: c
hild
eng
agem
ent w
ithth
e en
viro
nmen
t, ch
ild p
ersi
sten
ce, c
hild
tem
pera
men
t, po
sitiv
e ch
ange
s in
par
ent/c
hild
inte
ract
ions
(a
poss
ible
thou
gh p
robl
emat
ic o
utco
me)
, im
prov
ed q
ualit
y of
life
(ri
sk s
tatu
s fo
r ab
use,
mor
e po
sitiv
e ho
me
envi
ronm
ent)
, hea
lth a
nd m
edic
al o
utco
nies
(im
prov
ed h
ealth
, app
ropr
iate
imm
uniz
atio
ns, a
ppro
pria
tem
edic
al c
are
for
disa
bilit
y-sp
ecif
ic c
once
rns,
app
ropr
iate
wel
l chi
ld c
are,
evi
denc
e of
a m
edic
al h
ome)
.
Shon
koff
, J.P
.(1
993)
.D
evel
opm
enta
lV
ulne
rabi
lity:
New
Cha
lleng
es f
orR
esea
rch
and
Serv
ice
Del
iver
y. I
n N
.J.
Ana
stas
iow
& S
.H
arel
, (E
ds.)
, At-
Ris
kIn
fant
s: I
nter
vent
ions
,Fa
mili
es, a
ndR
esea
rch
(pp.
47-
54).
Bal
timor
e: P
aul H
.B
rook
s Pu
blis
hing
Co.
Rec
omm
ends
that
res
earc
h:Se
ek e
mpi
rica
l ver
ific
atio
n of
the
tran
sact
iona
l/eco
logi
cal m
odel
s th
at in
flue
nce
EI
deci
sion
-mak
ing
Add
ress
a b
road
er a
nd r
iche
r ou
tcom
e va
riab
le d
omai
nId
entif
yso
urce
s of
res
ilien
ce a
nd p
rote
ctiv
e fa
ctor
s (r
athe
r th
an ju
st p
redi
ctor
s of
poo
r ou
tcom
es)
Exp
lore
dif
fere
nces
am
ong
subg
roup
sPu
rsue
long
itudi
nal a
sses
smen
ts o
f th
e in
flue
nce
of e
arly
exp
erie
nces
on
the
emer
ging
com
pete
nce
ofyo
ung
child
ren
and
on th
e on
goin
g ad
apta
tion
of th
eir
fam
ilies
Dis
cuss
es th
e E
arly
Int
erve
ntio
n C
olla
bora
tive
Stud
y (d
escr
ibed
els
ewhe
re in
tabl
e) a
nd d
raw
s th
ree
gene
raliz
atio
ns:
1.T
he r
ecei
pt o
f ea
rly
inte
rven
tion
serv
ices
impl
ies
a m
ultid
imen
sion
al e
xper
ienc
e.2.
The
det
erm
inan
ts o
f ch
ange
in c
hild
ren
and
fam
ilies
are
mul
tivar
iate
and
com
plex
.3.
Subg
roup
s of
chi
ldre
n an
d fa
mili
es w
ithin
an
earl
y in
terv
entio
n sy
stem
dem
onst
rate
dif
fere
ntia
lvu
lner
abili
ty a
nd r
esili
ence
.
Shon
koff
, J.P
.,H
ause
r-C
ram
, P.,
Kra
uss,
M.W
., an
dU
pshu
r, C
. (19
88).
Ear
ly I
nter
vent
ion
Eff
icac
y R
esea
rch:
Wha
t Hav
e W
eL
earn
ed a
nd W
here
Do
We
Go
From
Her
e? T
opic
s in
Ear
ly C
hild
hood
Spec
ial E
duca
tthn,
8(1)
, 81-
93.
Shor
tcom
ings
of
man
y pa
st s
tudi
es in
clud
e m
etho
dolo
gica
l fla
ws,
line
ar m
odel
s, r
elia
nce
on c
hild
-rel
ated
cogn
itive
out
com
es o
nly,
inad
equa
te s
peci
fica
tion
of in
depe
nden
t var
iabl
es, l
ack
of b
lind
data
col
lect
ion,
and
failu
re to
min
imiz
e th
reat
s to
val
idity
fro
m s
uch
effe
cts
as h
isto
ry, t
estin
g, a
nd m
atur
atio
n.c
Rec
omm
enda
tions
incl
ude
expl
orin
g in
flue
nces
with
in th
e ec
olog
y of
chi
ld a
nd f
amily
life
, gre
ater
spe
cifi
city
in th
e de
fini
tion
of in
depe
nden
t var
iabl
es, d
elin
eatio
n of
chi
ld a
nd f
amily
cha
ract
eris
tics
(suc
h as
dia
gnos
isdi
ffer
ence
s, s
ever
ity o
f di
sabi
lity,
age
at e
ntry
, hea
lth s
tatu
s, te
mpe
ram
ent,
beha
vior
al c
hara
cter
istic
s,pr
eint
erve
ntio
n di
ffer
ence
s in
soc
iode
mog
raph
ic c
hara
cter
istic
s, p
aren
tal l
ocus
of
cont
rol,
reso
urce
s w
ithin
the.
fam
ilSr,
ext
erna
l soc
ial s
uppo
rts,
and
par
enta
l hea
lth)
whi
ch c
an f
acili
tate
or
inhi
bit p
rogr
am e
ffec
tiven
ess,
defi
ning
ser
vice
var
iabl
es a
nd ty
pes
of s
ervi
ces
(int
ensi
ty, d
urat
ion,
loca
tion,
info
abo
ut p
rovi
ders
).D
eter
min
e fa
mily
eff
ects
by
the
goal
s an
d ob
ject
ives
of
serv
ices
bei
ng e
valu
ated
; var
iabl
es m
ay in
clud
epa
rent
ing
stre
ss, f
amily
rel
atio
nshi
ps, o
ther
soc
ial r
elat
ions
hips
, par
ent-
child
inte
ract
ion,
phy
sica
l and
emot
iona
l hea
lth o
f pa
rent
s an
d si
blin
gs. C
hild
impa
cts
beyo
nd c
ogni
tive
mig
ht in
clud
e ex
plor
ator
y
8447
85
tut
.Is
mbe
havi
or/m
otiv
atio
n, s
ocia
l com
pete
nce,
inte
rper
sona
l rel
atio
nshi
ps w
ith a
dults
, pre
scho
ol a
djus
tmen
t, an
dem
ergi
ng p
eer
inte
ract
ions
.
Supp
orts
dev
elop
ing
new
mea
sure
s an
d ex
peri
men
ting
with
new
ana
lytic
str
ateg
ies.
Pro
mot
es d
eem
phas
ison
sig
nifi
canc
e of
mea
n di
ffer
ence
s be
twee
n gr
oups
and
gre
ater
atte
ntio
n to
sub
grou
p an
alys
es.
Rec
omm
ends
exp
lori
ng lo
ng-t
erm
impa
cts.
Spik
er, D
., an
dH
opm
ann,
M.R
.(1
997)
. The
Eff
ectiv
enes
s of
Ear
lyIn
terv
entio
n fo
rC
hild
ren
with
Dow
nSy
ndro
me.
In
M.J
.G
ural
nick
(E
d.),
The
Eff
ectiv
enes
s of
Ear
lyIn
terv
entio
n (p
p. 2
71-
306)
. Bal
timor
e: P
aul
H. B
rook
es P
ublis
hing
Co.
Rev
iew
s sh
ow s
hort
-ter
m b
enef
its o
n de
velo
pmen
tal r
ates
, esp
ecia
lly f
ine
mot
or a
nd a
dapt
ive
skill
s, a
nd o
nov
eral
l DQ
/IQ
, with
few
er a
nd le
ss c
onsi
sten
t im
prov
emen
ts in
ling
uist
ic, c
ogni
tive,
and
gro
ss m
otor
ski
lls.
No
stro
ng e
vide
nce
to s
uppo
rt lo
ngev
ity o
f ga
ins.
Rec
omm
enda
tions
for
fut
ure
stud
y fo
ci in
clud
e:H
ow p
relin
guis
tic c
omm
unic
atio
n is
bei
ng a
ddre
ssed
in E
I pr
ogra
ms
Dif
fere
ntia
ted
ques
tions
con
side
ring
fam
ily c
hara
cter
istic
s an
d ch
ild f
acto
rs (
e.g.
, hyp
oton
ia, c
ardi
acpr
oble
ms)
, as
wel
l as
prog
ram
inte
nsity
and
par
ent i
nvol
vem
ent
Posi
tive
fam
ily s
uppo
rtC
ompa
riso
ns o
f tr
eatm
ent m
odel
s (a
nd c
onte
xt s
uch
as in
clus
ion,
cur
ricu
la, n
atur
e an
d ex
tent
of
pare
ntin
volv
emen
t, ap
titud
e-tr
eatm
ent i
nter
actio
n ef
fect
s)
The
Acc
redi
tatio
nC
ounc
il on
Ser
vice
sfo
r Pe
ople
with
Dis
abili
ties.
(19
95).
Out
com
e M
easu
res
for
Ear
ly C
hild
hood
Inte
rven
tion
Serv
ices
.T
owso
n, M
D: T
heA
ccre
dita
tion
Cou
ncil.
The
Cou
ncil
defi
nes
qual
ity in
term
s of
fam
ily a
nd c
hild
out
com
es r
athe
r th
an p
roce
dura
l com
plia
nce.
Spec
ifie
s va
lues
in th
e do
mai
ns o
f ch
oice
, goa
ls, r
ight
s, r
espe
ct, h
ealth
and
saf
ety,
rel
atio
nshi
ps, s
ecur
ity,
and
satis
fact
ion.
In
this
con
text
, rec
omm
ends
spe
cifi
c qu
estio
ns f
or f
amily
and
sta
ff, p
rogr
amdo
cum
enta
tion,
and
pro
cess
issu
es r
elat
ed to
the
follo
win
g ou
tcom
es:
Cho
ice
(fam
ilies
are
info
rmed
, fam
ilies
cho
ose
serv
ices
and
sup
port
s)
Goa
ls (
fam
ilies
cho
ose
thei
r go
als,
fam
ilies
cho
ose
child
dev
elop
men
t goa
ls, f
amili
es a
ttain
thei
r go
als,
child
ren
atta
in d
evel
opm
enta
l mile
ston
es)
.
Rig
hts
(fam
ilies
exe
rcis
e th
eir
righ
ts, c
hild
ren
are
free
fro
m a
buse
and
neg
lect
)
8648
87
YR
EC
OM
ME
ND
AflO
NS
Res
pect
(fa
mili
es a
re r
espe
cted
, fam
ilies
dec
ide
whe
n to
sha
re p
erso
nal i
nfor
mat
ion)
Hea
lth a
nd S
afet
y (c
hild
ren
have
the
best
pos
sibl
e he
alth
, chi
ldre
n ar
e sa
fe)
Rel
atio
nshi
ps (
fam
ilies
rem
ain
toge
ther
, chi
ldre
n sp
end
time
in in
clus
ive
envi
ronm
ents
, chi
ldre
n de
velo
pre
latio
nshi
ps, f
amili
es r
emai
n co
nnec
ted
to n
atur
al s
uppo
rts,
fam
ilies
are
a p
art o
f th
eir
com
mun
ities
)
Secu
rity
(fa
mili
es h
ave
econ
omic
res
ourc
es, f
amili
es e
xper
ienc
e co
ntin
uity
and
sec
urity
)
Satis
fact
ion
(fam
ilies
are
sat
isfi
ed w
ith th
eir
serv
ices
, fam
ilies
are
sat
isfi
ed w
ith th
eir
life
situ
atio
ns)
88
49
89
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