Early Intervention

Early intervention refers to a system of services designed to better academic and social outcomes for low-income, academically at-risk preschool-aged children. Additionally, these are services given to children born with disabilities, that impede normal development. Some of the first early intervention programs designed to serve low-income preschool-aged children were the Early Training Project, High/Scope Perry Project, and Project Head Start. Programs were later designed to meet the needs of developmentally delayed children. In many states, the Department of Education oversees the early intervention program for developmentally delayed children and acts as a major service provider.

Early Childhood Education > Early Intervention

Overview

Early intervention is the act of providing services to children of school age or younger that are considered to have—or to be at risk of developing—a condition that impedes their development. Such a condition can stem from a physical, emotional, or psychological impairment or less than adequate conditions at home. These include conditions such as unstable family circumstances or financial hardship that negatively affect a child's self-esteem, cognitive (intellectual) performance, or drive to achieve. Early intervention can be remedial in correcting existing developmental problems or preventive as to deny their occurrence.

Early intervention can involve the child or include the entire family. Services available to at-risk children and their parents begin with identification and screening before proceeding to assessment and diagnosis. These efforts culminate with a referral to services provided by any combination of state education departments, public agencies such as the Departments of Health and Human Services, and private organizations.

History

The roots of early intervention trace back to the Age of Enlightenment in the eighteenth century. European philosophers of the time were the first to believe that childhood was its own separate and unique developmental phase. The "nature vs. nurture" debate also began at this time. Many theorists argued that children enter the world pure and untainted and are molded entirely by their upbringing and environment. Others maintained that children are born with personalities and behaviors already present and that environment does little to change this. Modern theorists and child behavior experts agree that predisposition and environment combine to shape the individual. Though each child is born with certain abilities and personality attributes, they are also susceptible to influence from parenting and the environment. Ultimately, it is the combination of all factors that determines the child’s personality.

As the acknowledgment that children are molded by their environment gained popularity, more attention was given to early childhood development and education. With the Industrial Revolution of the nineteenth century came the possibility for children to develop before assuming adult responsibilities. European child development theory gave way to the first organized early education curriculum as the first kindergarten classes appeared in Germany. Later, America's middle classes enthusiastically adopted the kindergarten model. Eventually, social activists advocated for kindergarten for the poorer urban classes, which had greatly increased in number because of immigration. Activists believed that kindergarten would encourage social assimilation and make up for the lack of childhood experiences enjoyed by children of poor families while providing childcare services for mothers who were forced to work.

By the 2020s, researchers had gained a more critical understanding of the importance of a child’s early years. According to Start Early, a baby will develop one million neural connections every second. This allows the rapid accumulation of information. This phenomenon helps explain why children are more adept at learning things such as a foreign language. Adult learning, on the other hand, is more conducive to tasks they have done multiple times before. Everything that transpires in a child’s environment will have an impact on brain development. A preponderance of evidence now shows the negative effects issues such as poverty will play in early childhood development. Causation is demonstrated in factors such as unstimulating home environments, parents with low education, and mental health challenges experienced by mothers. These impacts on children can be detected at a very early age, beginning from the first year of a child’s life.

Applications

Children from Low-Income Families

This section discusses the first early intervention studies done and their findings. These studies are

• The Early Training Project,
• High/Scope Perry Preschool Project, and
• Head Start.

Soon after kindergartens appeared in urban areas, the "nursery school" became a fixture in London. These began as urban health clinics, growing later into a program focusing on health and education. In America, nursery school became a private institution, available to middle- and upper-class families who could afford it. Except for the 1940s and World War II—when federal funding would make it available to lower-income mothers forced to work while their husbands were away—nursery school remained a luxury for the middle and upper classes.

Circa 1950, the government began greater investment in social programs. Between 1950 and 1979, this spending increased twenty-fold. At the same time, a wealth of research on early childhood development heightened public awareness as to the importance of the early years in a child's development. With the 1960s came three influential early intervention studies.

The Early Training Project

The Early Training Project was a study conducted in Murfreesboro, Tennessee in the early 1960s. It beginnings stemmed from concern over the poor performance of low-income children in school. It sought to improve academic performance by bettering cognition and producing a stronger urge to achieve. Between 1962 and 1965, the project placed 65 African American children from low-income families into intervention programs that met for two or three consecutive summers or, alternatively, into a control group that received no instruction. Those in treatment groups were given weekly home visits during the school year and also took part in a 10-week preschool program that met for partial days during the summer. A significant difference was found in IQs between treatment and control groups in the years immediately following the intervention, with the treated children showing higher intelligence. In 1965, treated children scored higher on Metropolitan Achievement Test. By fourth grade, however, this gap had closed, with the treated children no longer outperforming their control counterparts. In fact, the final tests (conducted in 1975 and 1978) revealed no significant difference between the performances of the two groups on a number of different tests. It was concluded that though intervention did not create lasting differences in the IQs of children, it did reduce the potential for treated children to be placed in special education classes, be held back in a grade, or drop out of high school.

The High/Scope Perry Preschool Project

The High/Scope Perry Preschool Project, conducted in Ypsilanti, Michigan, was one of the longest-running assessments done on the effects of early intervention. As with the Early Training Project, it focused on the underperformance of disadvantaged children. It sought to improve cognitive performance and achievement in these children by enrolling them in either one- or two-year preschool programs. Between 1962 and 1967, 123 Black children and their parents participated in the study and were placed in either treatment or control groups. Between May and October, treatment groups were given daily 2.5-hour classes at an intervention center and weekly 90-minute teacher home visits. These five classes of participants were later assessed at ages 11, 14, 15, 19, and 27. As with the Early Training Project, treated children demonstrated significantly higher IQ scores than control children immediately after the intervention, but this gap disappeared by the time they entered the second grade. Nonetheless, treated children continued to score higher on tests until age 14 and were more likely to graduate from high school. Again, treated children spent less time in special education throughout school than control children. Differences still existed in the final (age 27) assessment. Treated children showed significantly lower utilization of welfare and a lower incidence of criminal activity. Employment rates for intervention participants were also considerably higher.

Project Head Start

Head Start, an immense, federally funded early intervention program that remained functioning into the 2020s, began as Project Head Start. The project originated from a concern by policymakers over the increasing number of American children living in poverty. Launched in 1965, Project Head Start was an eight-week pilot project in 2,500 U.S. communities. Its goal was to improve social outcomes in financially disadvantaged preschool children. The first season involved 500,000 children ages 4 and 5 and their families. Participants were provided social, health, and education services. Parental involvement was a cornerstone of Project Head Start. Results from initial evaluations of Project Head Start in 1965 were favorable and showed improvements in IQ of up to 10 points in the first summer. It was found that after this period, Head Start children were better prepared for school than their control counterparts, although positive effects from the program seemed to fade after only a few months. After three years, President Lyndon Johnson's administration commissioned a national evaluation of the program. The Westinghouse Report, published in 1969, found that first and second-graders who had participated in Head Start performed better on school readiness tests. The report was unable, however, to draw conclusions about third graders because of the small number of children sampled. Further, there were variations in performance that seemed linked to ethnicity and the geographic location of some children assessed. In the end, the study concluded that Head Start was not beneficial, though the validity of these findings has since been debated. Studies done on Head Start since the original 1969 report have produced findings similar to those produced earlier by the Early Training and Perry/High Scope projects. For instance, while participation in Head Start showed immediate cognitive benefits, these faded in time. Still, participants in the program were held back in later grades less frequently and were less apt to need special education.

One thing the earliest Head Start studies revealed was that parental influence and the quality of a child's home life have an overwhelming impact on an intervention program's success. This knowledge helped guide continued study and new intervention models that appeared in the 1970s. Some of these models strove to intervene earlier in a child's development and use the parents—as well as the child—as a focal point. These led to present-day models, which have begun relying on additional criteria to identify academically at-risk children. The trend to catch children at the earliest ages has continued, with some programs beginning at birth. Subsequent evaluations have examined larger experimental and control groups, employed long-term follow-up and reassessment, and looked at a wider range of outcome criteria to determine success.

Developmentally Delayed Children

Definition

This section examines developmentally delayed children, developmental milestones (which help doctors assess a child's development), challenges that exist for the families of developmentally delayed children, and different kinds of intervention systems that exist in different states.

A child is deemed developmentally delayed when he or she continuously fails to reach certain developmental milestones at the expected times. Developmental milestones are a set of functional skills and age-specific tasks—and their expected times of mastery and occurrence—used by pediatricians and other specialists to assess gross motor, fine motor, language, social and cognitive skill development. Each milestone is given an approximate age level when it will occur. Every child is different in terms of when he or she will arrive at a given milestone, but when a child is consistently late in arriving at milestones in a given category, he or she may need to be evaluated by a specialist. Developmental delay can have genetic causes, such as Down syndrome, or be the result of complications during pregnancy or premature birth. Some result from hearing loss or lead poisoning. Others, such as those seen in children with autism spectrum disorders, have unknown causes.

History

Since the 1970s, the field of early intervention for developmentally delayed children has significantly grown. During this time, a number of parent groups and lobbyists successfully applied pressure on the government to enact legislation in favor of early intervention for these children. In October 1986, the Education of the Handicapped Act Amendments were passed, creating a new program for early intervention services for infants and preschool-aged children with disabilities. Interdisciplinary training programs for physicians and other health professionals were developed. Behavioral and neurological studies were conducted, adding to the body of knowledge on how infants and toddlers develop.

Parenting Developmentally Delayed Children

Four significant challenges face the families of children diagnosed as developmentally delayed. First, they must wade through an immense amount of information pertaining to testing and diagnosis, the nature of their child's condition, and which programs are most suitable. Second, assessment and diagnosis of the child create extraordinary stress on families. Additionally, there is the challenge of considering and acting on recommendations. Third, a strain is placed upon family resources. Extra time and money are needed for diagnosis and to provide for the child's special needs. Also, one parent often must commit more time at home—at least in the early stages of diagnosis—which constitutes a loss of income in two-earner families. Fourth, stress can affect the act of child-rearing. The constantly arising, unexpected challenges can shake parents' confidence in their parenting abilities.

The effects of these four challenges can negatively affect the disabled child's relationship with his or her world in three ways. First, interactions between child and parents can suffer. An absence of information regarding the child's condition, for example, can leave parents unable to interpret his or her signals and needs and respond in a nurturing way. Second, the child’s interactions with his or her immediate surroundings and society can suffer. Initially, parents are prone to selecting toys and activities inappropriate for the child's special needs. Some families isolate themselves socially, robbing their child of opportunities to interact with others, which is crucial to any child's development. Third, the parents' ability to provide for their child's nutrition, safety and health can suffer. The drain on financial resources can affect their ability to provide essential food and medicine. In addition, many disabled children have special health problems that require special diets and complex feeding methods, which take time to diagnose, understand, and provide.

The above-mentioned challenges (overwhelming information, stress on family members, drain on resources, impact on child rearing) and their possible effects (interactions between child and parent; interactions between child and immediate surroundings and society; provisions for the child's nutrition, safety, and health) can greatly compromise the well-being and development of the developmentally delayed child. Without early intervention, their effects can cause a downturn in intellectual development between infancy and age five.

Fortunately, early intervention systems have become more responsive to challenges families face in three significant ways. First, most areas of the country offer a wealth of information on intervention services and financial assistance. Second, support groups, counseling services, and community networks that help families have become abundant. Third, most states have established straightforward and easy-to-navigate early intervention systems.

Early intervention has been demonstrated to be key to more favorable, long-term outcomes. This has proven to be more effective the sooner in life it is initiated. Appropriate therapies can be identified and applied, resulting in the developmental path of a child that is influenced in very real ways. The needs of children can be addressed much sooner, and the negative effects on families are better mitigated. .

Agencies That Run Early Intervention Programs

In many states, the Department of Education oversees early intervention programs for developmentally delayed children and acts as a major service provider. In the District of Columbia, Guam, Iowa, Maine, Maryland, Michigan, Minnesota, Missouri, Nebraska, Northern Mariana Islands, Oklahoma, Oregon, South Dakota, Tennessee, and Vermont, the department also handles special education for infants and toddlers. This is as state special education laws also apply to children in this age range. In some states, the education department plays little or no role at all. In Arkansas, Hawaii, Idaho, and Massachusetts, for example, departments of health or human services oversee the program.

Private agencies are often service providers. Some early intervention systems rely on them heavily, while others use almost none. United Cerebral Palsy, the Arc of the United States, and Easter Seals are just a few who participate. In some cases, the department of education or a public agency (e.g., the Department of Health and Human Services) does processing and assessment, and the family is referred to an intervention program offered by a private organization.

Different early intervention systems for developmentally delayed children can vary between different states. For example, in Texas, the Texas Department of Assistive and Rehabilitative Services consists of a number of formerly independent state agencies and oversees the Texas' early intervention system, Early Childhood Intervention (ECI) Services. The council oversees local public and private agencies that administer the system in assigned areas of the state. ECI handles the processing, evaluation, and assessment of individual cases, and provides intervention services in home, school, and community center settings.

North Carolina's early intervention system is overseen by the Division of Mental Health, Developmental Disabilities and Substance Abuse Services(MH/DD/SAS), which is part of the state's Department of Health and Human Services. Other public agencies—such as the North Carolina Division of Public Health—are also involved in case processing, coordinating, and tracking. Entry into North Carolina's early intervention system is done through local branches of the MH/DD/SAS called “local management entities” found in every county across the state.

Much data and anecdotal evidence (accounts of parents and teachers) have been amassed on the effectiveness of early intervention programs since the first intervention projects were launched in the '60s. Despite the unevenness of early assessments done on Early Training, Perry/High Scope, and Head Start and the inconclusiveness of findings, studies since then have added a wealth of information. It is believed that early intervention programs do bring about long-term developmental and academic gains for children. Further, they improve family functioning and interaction and produce lasting benefits for society. It has been proven that children who go through early intervention programs are less apt to need special education services later or be retained in later grades. Some developmentally delayed children become indistinguishable from their regularly functioning classmates years after intervention has ceased.

Terms & Concepts

Cognition: The mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment.

Developmentally Delayed: Continuously failing to reach on time milestones that indicate normal development.

Developmental Milestones: Set of functional skills and age-specific tasks—and their expected times of mastery and occurrence—used to assess gross motor, fine motor, language, social and cognitive skill development in children.

Early Intervention: Providing services to children of school age or younger considered to have—or to be at risk of developing—a condition that interferes with their development.

Early Training Project: A study conducted in the early 1960s that sought to improve academic performance in low-income children by giving them year-round weekly home visits from a teacher and 10-week summer preschool classes.

Perry/High Scope Project: A study in the 1960s that sought to improve academic performance of low-income children by giving them weekly home teacher visits and weekly preschool five months a year.

Project Head Start: A federally funded study similar to the Early Training and Perry/High Scope Projects but using a much larger number of children; gave way to the Head Start, a nationwide, federal early intervention program for low-income children.

Bibliography

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Suggested Reading

Cooper, J. H. (1981). An early childhood special education primer. Chapel Hill, NC: Technical Assistance Development System.

Fordham, L. L., Gibson, F. F., & Bowes, J. J. (2012). Information and professional support: Key factors in the provision of family-centred early childhood intervention services. Child: Care, Health & Development, 38, 647–653. Retrieved December 9, 2013, from EBSCO online database Education Research Complete.

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