Mary Beth Bruder

Family-Centered Early Intervention: Clarifying Our Values for the New Millennium

The term family-centered early intervention refers to both a philosophy of care and a set of practices. Both have been used to guide research, training, and service delivery for well over a decade. Unfortunately, though, the universal adoption of family-centered values and practice in early intervention is problematic for a number of reasons. This article will discuss these reasons in the context of the current state of early intervention and provide recommendations for the new millennium.

Everyday Family and Community Life and Children's Naturally Occurring Learning Opportunities

National surveys of nearly 3300 parents (and other caregivers) of infants, toddlers, and preschoolers with or at-risk for developmental delays were conducted to ascertain the sources of naturally occurring learning opportunities afforded young children in the context of family and community life. One group of parents completed a survey about family life as sources of learning opportunities (N = 1723), and another group completed a survey of community life as sources of learning opportunities (N = 1560). Confirmatory factor analysis indicated that both family and community life were each made up of 11 different categories of learning opportunities. Results indicate the 22 categories provide a framework for recognizing and identifying sources of learning opportunities providing children a rich array of experiences constituting natural learning environments.

Characteristics and Consequences of Everyday Natural Learning Opportunities

The relationships between several different person and environment characteristics of everyday natural learning opportunities and changes in both child learning opportunities and child behavior and performance were examined in an intervention study lasting 19 to 26 weeks. Participants were 63 parents or other caregivers and their infants, toddlers, and preschoolers with disabilities or delays. Findings showed that learning opportunities that were interesting, engaging, competence-producing, and mastery-oriented were associated with optimal child behavioral change. Implications for early intervention practices are discussed.

Valued Outcomes of Service Coordination, Early Intervention, and Natural Environments:

A national survey of Part C early intervention program providers (practitioners and program directors) and participants (parents of young children with disabilities) was used to discern the desired outcomes of service coordination, early intervention, and natural environment practices. Survey participants judged from among 69 outcome indicators those that they considered to be the most valued benefits of each IDEA Part C service. Results indicated that certain categories of outcomes were more likely to be judged as the desired benefits of a specific Part C service, and that only two outcome categories (family satisfaction and improved family quality of life) were considered to be valued outcomes for all three services. Implications for practice and research are described.

Recommended Outcomes for Families of Young Children with Disabilities.

The Early Childhood Outcomes (ECO) Center was funded by the Office of Special Education Programs to promote the development and implementation of child and family outcome measures for infants, toddlers, and preschoolers with disabilities. An evidence-based process with extensive stakeholder input led to the identification of five outcomes by which the effectiveness of services for families could be assessed: (a) families understand their childs strengths, abilities, and special needs; (b) families know their rights and advocate effectively for their child; (c) families help their child develop and learn; (d) families have support systems; and (e) families are able to gain access to desired services and activities in their community. These outcomes provide a framework by which states and the federal government could document whether early intervention and preschool programs are providing demonstrable benefits for families, and provide the basis for developing measurement systems to determine the extent to which such benefits have been attained.

Family Supports and Services in Early Intervention: A Bold Vision

This article utilizes four knowledge sources to characterize a current gap in policy and practice related to serving families in early intervention (birth to 5) programs. It argues that the field of early intervention has focused primarily on implementing family-centered practices by focusing on how families and professionals should interact. The field has not sufficiently addressed what supports and services should be offered to families to enhance the likelihood of positive outcomes for families themselves and for their children with disabilities. The paper concludes with recommendations for enhancing policy, research, and professional development related to family services and supports.

Personnel Preparation in Recommended Early Intervention Practices Degree of Emphasis Across Disciplines

University faculty were surveyed to ascertain the degree to which students in early childhood special education, occupational therapy, physical therapy, speech—language pathology, and multidisciplinary personnel preparation programs received training in five early intervention practices (family-centered, individualized family service plans, natural environments, teaming, and service coordination). Findings indicated a primary emphasis on family-centered practices across disciplines, with minimal emphasis on service coordination and teaming practices. Findings also showed that physical therapy faculty provided the least amount of training in the majority of early intervention practices as compared to faculty in other disciplines. Implications for improving student training are described.

Natural Learning Opportunities for Infants, Toddlers, and Preschoolers:

.~ oping child can either t~~M be planned or can haptj~~M pen serendipitously. N~~~ Formally planned learn~~~~~ ing opportunities have BN!!tj been the foundation of early intervention and early childhood special education (e.g., Guralnick, 1997). Recent legislation and research suggest an expanded perspective on natural learning environments that uses everyday family and community life as sources of children’s learn-

Brief report: the medical care of adults with autism spectrum disorders: identifying the needs.

There is a lack of information concerning adults with autism spectrum disorder (ASD), especially with regards to their access to health care. A paper and electronic survey was sent to 1,580 primary care physicians in Connecticut. 346 respondents returned a survey and provided care to adults with an ASD. This physician survey provides data on adults with ASD such as: reasons for physician visits, living arrangements, employment status, and any services they are receiving. Responses revealed inadequate training in the care of adults with an ASD and physicians interest in obtaining additional training. The ability to provide a medical home for adults with autism will need to address effective strategies to train current and future physicians.

YOUNG CHILDREN'S PARTICIPATION IN EVERYDAY FAMILY AND COMMUNITY ACTIVITY

Patterns of participation in everyday family and community activities are described for children from birth to 6 years of age. Parents or other primary caregivers completed a survey of either family life or community life as sources of childrens learning opportunities and experiences. Rates of childrens participation in 50 family activities and 50 community activities at different ages were identified and analyzed in terms of similarities and differences in participation patterns. Findings indicated considerable variability in involvement in 100 family and community activities by young children of different ages. Implications for using everyday family and community activities as sources of enriched learning opportunities that enhance childrens development are discussed.