Kathleen Hebbeler

Inside the black box of home visiting: a qualitative analysis of why intended outcomes were not achieved

Abstract A longitudinal qualitative investigation of a home visiting program was conducted to explore why the program was not more effective. The sample included 21 case study families and 9 home visitors, plus 60 other mothers who participated in focus groups. Data from interviews with parents and home visitors, videotapes of home visits, and children’s assessments were used to construct and examine a theory of change for the program. The study found that home visits had a consistent structure and that the home visitors emphasized their social support role and placed little emphasis on changing parenting behavior. The discussion suggests that the program’s flawed theory of change that minimally acknowledged parent–child interaction limited the program’s effectiveness. The findings underscore the need to critically examine the theories that underlie home visiting programs and guide the day-to-day interactions of home visitors.

Thirty-six-month outcomes for families of children who have disabilities and participated in early intervention.

Objective. Infants and toddlers with disabilities in the United States and their families are eligible for early intervention services under Part C of the Individuals With Disabilities Education Act. The purpose of this study was to assess family outcomes at the end of early intervention (near the child’s third birthday). Methods. A nationally representative sample of 2586 parents in 20 states completed a 40-minute telephone interview on or near their child’s third birthday. This article summarizes data related to perceived family outcomes at the end of early intervention. Results. At the end of early intervention, most parents felt competent in caring for their children, advocating for services, and gaining access to formal and informal supports. They also were generally optimistic about the future. Most (82%) parents believed that their family was better off as a result of early intervention. Parents were somewhat less positive in their perceived ability to deal with their child’s behavior problems or gain access to community resources, and lower family outcome scores were found for parents of minority children, children with health problems, and children who were living with a single adult. Conclusion. Results suggest that Part C early intervention provides important supports for families of young children with disabilities. The findings reinforce the need for experimental research to identify factors that are most likely to lead to successful outcomes for all families. In the meantime, early identification and expeditious referral are important so that maximum benefit can be realized for children with disabilities and their families.

A National Look at Children and Families Entering Early Intervention

The National Early Intervention Longitudinal Study (NEILS) is the first study of Part C of the Individuals With Disabilities Education Act (IDEA) early intervention system with a nationally representative sample of infants and toddlers with disabilities. This article presents national estimates of characteristics of infants and toddlers and their families at the time they entered the early intervention (EI) system. The variability in children in EI is marked by high proportions of children from low-income families, ethnic minorities, those in foster care, and males. Nearly one third (32%) are low birth weight, four times the rate in the general population. Infants and toddlers in EI are eight times more likely to be rated as having fair or poor general health. Children enter at all ages across the first 3 years of life, but those eligible because of developmental delays enter as toddlers, in comparison with those eligible because of diagnosed conditions or subject to biological or environmental risk factors, who tend to enter in the first year of life. The variability of the infants and toddlers in EI indicates that there is no typical child in EI.

A Framework for Describing Variations in State Early Intervention Systems

As part of the National Early Intervention Longitudinal Study, information about the early intervention service systems in the 20 participating states was gathered. This article organizes this information into dimensions of a framework for describing early intervention systems at the state and local levels. Information collected indicates that considerable variation exists on all dimensions of the framework. Descriptive information is presented about how local jurisdictions are defined, eligibility criteria, what agencies are involved in early intervention, and models of intake and of service coordination, including vignettes for selected states. Research on the significance of this variation for how families experience early intervention is needed if better systems are to be implemented. Frameworks for describing early intervention systems are a necessary first step to this line of research. Future analyses from this study will look at the relationship between early intervention systems, services provided, and outcomes achieved.

Individuals With Disabilities Education Act’s Early Childhood Programs Powerful Vision and Pesky Details

National policy affects local practice in a variety of ways and through a variety of mechanisms. In this article, the authors examine what has been learned from Individuals With Disabilities Education Act’s (IDEA) two early childhood (EC) programs about the power and limitations of policy as a lever to improve the lives of young children. Ecological theory provides a useful framework for understanding how IDEA directly and indirectly influences the provision of services to young children with disabilities and their families. Experience implementing Part C and Part B Preschool for 25 years not only confirms the power of the law’s vision but also reveals some barriers to effective nationwide implementation. Implementation issues in four areas are discussed: access to services, the quality of services, cost and funding, and outcomes. The current move to build coordinated and integrated EC systems in states presents new opportunities and new challenges in these areas for IDEA’s early childhood programs.

Assessment and Accountability for Programs Serving Young Children with Disabilities

States currently are in the process of developing child and family outcome measurement systems for young children with disabilities to meet federal data reporting requirements for the Part C (Infants and Toddlers with Disabilities) and Part B Preschool Grants program supported through the Individuals with Disabilities Education Act. This article reviews issues related to the use of assessments in providing outcome data, discusses challenges raised in conducting valid assessments with young children for accountability purposes, and outlines decisions states must make related to assessment as they design and implement outcome measurement approaches. Considerations related to the standardized or curriculum-based measures are discussed along with other choices related to the use of assessment for accountability.

Federal Early Childhood Special Education Policy: A Model for the Improvement of Services for Children with Disabilities

Services in early childhood special education for children with disabilities, birth through 5 years, and their families have expanded and improved substantially in the past 25 years. The federal government, through legislation, regulation, and a variety of incentives, has played an integral role in this progress. The authors review the evolution of federal education policy in early childhood and the accomplishments achieved, including the development of the Handicapped Childrens Early Education Program, the Early Childhood Research Institutes, and Public Law 99-457, the Handicapped Infant and Toddler Program (Part H). This history can serve as a model for federal involvement in the improvement of services for other groups of individuals with special needs.

The Mismatch between Children's Health Needs and School Resources.

There are increasing numbers of children with special health care needs (CSHCN) who require various levels of care each school day. The purpose of this study was to examine the role of public schools in supporting CSHCN through in-depth key informant interviews. For this qualitative study, the authors interviewed 17 key informants to identify key themes, provide recommendations, and generate hypotheses for further statewide survey of school nurse services. Key informants identified successful strategies and challenges that public schools face in meeting the needs of all CSHCN. Although schools are well intentioned, there is wide variation in the ability of schools to meet the needs of CSHCN. Increased funding, monitoring of school health services, integration of services, and interagency collaboration are strategies that could improve the delivery of health services to CSHCN in schools.

Progress Developing the Kansas Early Childhood Special Education Accountability System Initial Findings Using ECO and COSF

Policy decision makers, early educators, and early interventionists face numerous challenges as they develop and implement statewide accountability systems to evaluate and improve childrens early intervention and early childhood special education outcomes. Kansas was an early adopter of the Child Outcomes Summary Form (COSF) developed by the Early Childhood Outcomes Center as a means of integrating multiple sources of information on childrens performance and to meet policy requirements of the state and the Office of Special Education Programs (OSEP). The purpose of this article is to describe the Kansas experience and to report preliminary findings for entry-level COSF data. Implications are discussed.

Using Survival Analysis to Describe Developmental Achievements of Early Intervention Recipients at Kindergarten.

Survival analysis was used to document the developmental achievements of 2298 kindergarten children who participated in the National Early Intervention Longitudinal Study, a study that followed children from entry to Part C early intervention (EI) through kindergarten. Survival functions were produced depicting the percentage of children at kindergarten who attained age-grouped developmental milestones ranging from 1 to 12 months through over 60 months. Survival functions were compared on the basis of disability characteristics at entry to EI and kindergarten disability and special education status. Larger percentages of former EI recipients receiving special education in kindergarten and those entering EI with a diagnosed condition failed to achieve early milestones. The utility of survival analysis in presenting diverse developmental achievements is discussed.