Rebecca R. Fewell

The Relationship of Parent-Child Interaction to the Effectiveness of Early Intervention Services for at-Risk Children and Children with Disabilities

The results from four early intervention evaluation studies are described in relationship to their impact on parent-child interaction as measured by the Maternal Behavior Rating Scale. Intervention studies included the Infant Health and Development Program, the Longitudinal Studies of the Effects and Costs of Alternative Types of Early Intervention, the Play and Learning Strategies Program, and the Family-Centered Outcome study. Results from these analyses indicated that intervention effects on child development were unlikely to occur unless mothers modified their style of interacting with their children. Although these studies indicated that mothers of children who participated in intervention modified several different parameters of interactional style, only their level of responsiveness was positively associated with their childrens developmental outcomes. These results are discussed in relationship to child-focused and relationship-focused models of early intervention.

The effects of early motor intervention on children with Down syndrome or cerebral palsy: a field-based study.

This study reports the results of a field-based investigation of the effects of two motor intervention approaches-neurodevelopmental treatment and developmental skills-on children with two different diagnoses. The sample included 50 children, of whom 27 were diagnosed as having Down syndrome and 23 as having cerebral palsy. Children had a mean chronological age of 14 months at the beginning of the study. The severity of their motor impairment was assessed with the Gross Motor Function Classification System for Cerebral Palsy. Childrens motor functioning was examined at entry into the study and after they received 1 year of motor intervention services. Dependent measures included childrens general development, rate of motor development, and quality of movement. Pre-post comparisons indicated that children made significant changes in their motor development age and quality of movement over the course of intervention. However, there was no evidence that motor intervention accelerated development or improved quality of movement beyond what could be expected on the basis of maturation. Furthermore, no differential intervention effects were associated either with childrens diagnosis or treatment model. Regression analyses indicated that the rate of motor development children attained after 1 year of intervention was highly related to their rate of development at the onset of intervention and, to a lesser degree, to the number of sessions of intervention children received. These results are discussed in terms of the need for the field of motor intervention to develop new treatment paradigms.

Methods for Assessing Child and Family Outcomes in Early Childhood Special Education Programs Some Views from the Field

Although many concerns have been raised about methods of assessing outcomes in early childhood special education programs, professionals in the field are nevertheless faced with the need to select appropriate instruments for evaluating child and family outcomes as the result of intervention. A conference to address the current assessment needs of professionals was convened. This paper summarizes this conference, in which five prominent individuals in the field of early childhood special education gave specific recommendations for one child and one family outcome measure which would be applicable to a range of handicapped children between birth and age 5 being served in typical early intervention programs.

Stress and Adaptation in Parents of Young Handicapped and Nonhandicapped Children: A Comparative Study.

Three questions were asked in this study; (1) Do parents of handicapped children experience more stress than parents of nonhandicapped children? (2) What are the sources of stress for parents of handicapped children? and (3) is stress in the parents of handicapped children mediated by an external factor of social support? Findings Indicate significantly greater stress in the families with handicapped children, and four factors are identified as significantly related to stress in these families. Perceived family support was significantly greater for families with handicapped children, and although nonsignificant (p < .057), findings suggest that families with handicapped children who have more support have less stress. Results are discussed in rotation to previous findings, particularly with regard to how the age of the child may be a critical factor determining family adjustment.

Play Assessment as a Procedure for Examining Cognitive, Communication, and Social Skills in Multihandicapped Children:

This study explores the use of a play assessment procedure for examining the development of cognition, language, and social behaviors. Subjects were 17 multihandicapped children (median age 4-6). Results from an experimental Play Assessment Scale (PAS) were compared to results from multiple measures of cognition, language, and social behavior. All results were highly significant and are discussed in terms of the construct validity of the PAS and of the possible advantage of using a play format to assess skills in difficult-to-test children.

Grandparents of Children with Special Needs: Insights into Their Experiences and Concerns:

Families with young handicapped children have special needs for instrumental and emotional support. Many of these can be met within the family system. The role of grandparents is often overlooked, yet not only are they affected by a grandchilds handicap, but they often have resources that can strengthen the family. This article reviews findings on grandparents and reports the responses of participants in a grandparent workshop.

Enhancing the Interactions of Teenage Mothers and Their At-Risk Children Effectiveness of a Maternal-Focused Intervention

This study investigated the impact of a short-term interaction-focused parenting curriculum on maternal behaviors and child development outcomes. Participants were 94 teen-mother—child dyads; 48 in the intervention group received a relationship-focused curriculum offered in 24, 1-hour sessions. Maternal behaviors during play were videotaped and coded preintervention and postintervention. Children were assessed using a developmental screening inventory. When the groups were compared at posttest using analyses of variance, mothers in the intervention group were significantly more responsive, less directive, and more facilitative of child language development. Children of mothers in the intervention group had significantly higher developmental quotient scores than children of mothers in the contrast group. Findings corroborate previous research and offer support for interventions focusing on interaction variables to influence child outcomes.

Supporting fathers of handicapped young children: Preliminary findings of program effects*

The rationale for and history of an innovative program designed to meet the special needs of fathers of young handicapped children are described. The Supporting Extended Family Members (SEFAM) Fathers Program provided fathers with both a regular source of information about their child and access to professional and peer support. The program was evaluated by monitoring changes both of fathers who participated in the program and their wives in the following domains: stress, depression, and support systems. Research measures are described which were designed to assess changes in these targeted domains. Preliminary results indicated that parents who participated in the pilot program reported lower levels of stress and depression and higher levels of satisfaction with social support than parents who were newly enrolled in the program. The findings are discussed in light of possible mediating factors for the observed results. Recommendations are made for improving the quality of data on the effects of early interventions on family members.

Siblings of Handicapped Children: A Developmental Perspective on Family Interactions

Research on the impact of the handicapped child on siblings has indicated several sibling characteristics that are associated with increased sibling vulnerability to stress and other problems. The identification of sibling risk factors, in and of itself, however, does not help us understand differences in sibling outcomes. A transactional framework describing family interactions and their effects on the familys development is presented in order to examine ecological variables influencing family adaptation.

Contributions of Receptive Vocabulary and Maternal Style Variables to Later Verbal Ability and Reading in Low-Birthweight Children

The contributions of three variables—childrens receptive vocabulary scores, maternal responsiveness, and maternal directiveness—to the prediction of Verbal IQ and reading over a 5½-year period were investigated. The study sample consisted of 543 low-birthweight children who were participants in the larger Infant Health and Development Program. Three separate multiple regression analyses found that childrens receptive vocabulary scores at 36 months of age accounted for the major portion of the variation in the outcomes. Maternal responsiveness added significantly to the variation in each of the three models. The results suggest that the responsiveness of the mother is an important variable to consider when an intervention target is enhancing the verbal ability of a child.