Research in Early Childhood Intervention

1. Research in Early Childhood Intervention FuJen Catholic University Professors Sharon Rosenkoetter & Pauline Su Fall 2008 – Set #1

2. This Weekend • Introductions • Syllabus • What is Early Intervention? • Why intervene early? • Kinds of risk • Risk factorsIssues at birth • Home visiting • Characteristics of ECI • Reflections on readings • Substance exposed children • Adapted sport

3. Students Introduce Selves

4. Here’s Professor Pauline Su

5. Here’s Dr. Sharon Rosenkoetter

6. SOP – Standard Operating Procedures • We will start and stop on time • Please turn off cell phones • We will hold classroom comments in confidence • We will avoid side conversations • We will try to encourage fearful colleagues • Food and drink in class are OK • Please voice questions and comments • Others?

7. Syllabus Go over requirements * * * Use PEOPLE FIRST language!!!!! Child with a disability, NOT disabled child Mother living in poverty, NOT poor mother Father who is not working, NOT out-of-work dad Use the person first, description last

8. entering into typical family & early childhood activities with individualized support to help the family accelerate the child’s development Early Childhood Intervention is…

9. BUT families are VERY important in ECI! Families LOVE their child & are the child’s best teacher Families seek information & use it to make decisions Families guide choice of program & services Families have needs that ECI can help them meet Young Children Are at the Center of ECI

10. typically developing or at-risk Young children may be called…

11. Biological risk Established risk Environmental risk 3 Kinds of Risk Each may exist alone or with another kind of risk

12. physical possibility of a problem but it has not yet led to developmental difficulties Example: preterm birth, genetic predisposition, weak immune system) 1. Biological Risk

13. Child shows a condition or diagnosis that is known to lead to developmental difficulties 2. Established Risk Examples: Down Syndrome, missing arm or leg, cystic fibrosis, Failure to Thrive

14. Issues Poverty Adolescent parenting Parental mental illness or substance abuse Maltreatment Community or domestic violence Unsafe surroundings that may lead to developmental difficulties These may exist alone or with other risks 3. Environmental Risk

15. Programs may be designed for one kind of risk (e.g., poverty)but most serve CHILDREN, not RISKS

16. Risks that endanger the developing child -- may or may not cause actual harm Resilience, or protective factors that counter the effects of risks Always we want to lower the risks & increase the resilience Every Child Has…

17. Form into 4 groups Two groups list all the risk factors that you can think of that may lead to bad outcomes for a child Two groups list all the protective factors that you can think of that may help the child avoid bad outcomes You will report back REPORT BACK Small Group Activity

18. Trying to increase resilience & Decrease risk Prevention

19. 1. Primary prevention – teach all people to use good health practices to reduce risk factors & reduce the number of new problems (cases) Example: teach women to avoid alcohol during pregnancy 3 Levels of Prevention – from Public Health

20. 2. Secondary prevention – use intervention to make the condition less serious and perhaps help it end sooner Example: Speech therapy to help a child with Fetal Alcohol Spectrum Disorder talk better 3 Levels of Prevention

21. 3. Tertiary prevention – intervention to reduce related effects of the problem, direct or indirect Example: Behavioral planning & environmental arrangement to help a child with Fetal Alcohol Spectrum disorder avoid serious behavior problems 3 Levels of Prevention

22. #1 – teaches all people so problems don’t happen #2 – intervenes to address a problem #3 – intervenes to prevent secondary problems that are related to the initial problem Early Intervention Does All 3 types of Prevention

23. Why is Early Intervention the right thing to do?

24. 1. Humans can be shaped during the early years 2. The early years set the pattern for later learning and behavior 3. During the early years, children learn best 4. This is the time to minimize disability & prevent secondary disabilities 5. The environment & early experience are significant in determining life outcomes Why is Early Intervention the right thing to do?

25. 6. Early Intervention succeeds in improving outcomes – it works! 7. Families need support to help their children learn 8. There are economic benefits – Early Intervention saves money for the society over the child’s life 9. There are social benefits – it is the right thing to do to help vulnerable children Why is Early Intervention the right thing to do?

26. Provide examples of these 9 on wall chartsYou may write in Chinese!Then we will go about and read what others have writtenCOMMENTS FROM PROFESSOR SU

27. What are the main messages you will take home? How you will use this information in your work or family life? Reflect & Write – 15 Minutes

28. Prenatal period shapes the brain architecture Natal events predispose child to later challenges Birth to age 3 – period of most rapid growth – foundational for later development Ages 3-5 – development of complex skills – basic for a lifetime Continuum for Early Childhood Development – and Risk “Bottom up” learning

29. A normal pregnancy is 38-42 weeks after conception A birth before 38 weeks gestation is pre-term (sometimes called premature) A birth after 42 weeks gestation is post-term 25-29 weeks gestation In the Beginning… See video: The Miracle of Life

30. What message do you take from that video?

31. Major brain development happens 25-29 weeks gestation Too early birth means that development must happen outside the womb Toxic exposure in utero can harm the brain forever Brains are built over time Interactive influence of genes & experience literally shape the architecture of the developing brain The medium for that is the turn taking of relationship with caregivers In the Beginning…

32. Mortality – death happens OR Morbidity – some part of the body is harmed What Can Go Wrong?

33. Times when biology or environment (or both) may assault the developing child Prenatal – prior to birth Perinatal – around the time of birth Postnatal – at least 18 hours after birth Times When the Child Is Most Vulnerable

34. Level 1 -- typical care center for newborns Level 2 -- more intensive care for newborns Level 3 -- neonatal intensive care NICU only a few in each region 3 Levels of Hospital Nursery in the U.S.

35. Baby lives in a controlled environment -- round the clock observation “Procedures” honor baby’s natural biological cycles Transdisciplinary team serves baby and family NICU Video: The Neonatal Experience

36. Sepsis -- infection RLF – vision impairment RDS – respiratory distress IVH – brain bleed PDA – heart defect NEC – intestinal decay For families, the NICU is an unforgettable experience Newborn Conditions that May Lead to Mortality or Morbiditity Video: The Neonatal Experience

37. What is your reaction to this video? For families, the NICU is an unforgettable experience. What experience have you had with this?

38. Sometimes infants are “stepped up” or “stepped down” in nurseries within a hospital or are transported by helicopter or ambulance to a facility that provides more or less intensive care

39. Medical and social work in NICU Home visits soon after Support for family, connection to other families, help in understanding the condition Therapy for baby Information! Early Intervention Begins Early

40. Efforts now to get the mother to the hospital with a Level 3 nursery (NICU) before the baby is born Most important in rural areas With a Troubled Pregnancy…

41. Parents need even more support Team of health care professionals, therapists, teachers Use evidence-based approaches & take data on their effects with this child Early Intervention can come into the home EI, Early Head Start, Healthy Start, Parents as Teachers Must be frequent enough Must focus on child’s needs and the home context When the Baby Comes Home – Home-Based Services

42. Began in the 1850s in city slums – visiting nurses 1900 – social workers aiding families in poverty 1935 – 1st U.S. maternal & child health law with home visits 1950s – U.S. home visits for children with disabilities; expansion of visiting nurses 1970s – growth of War on Poverty home visits 1985 – expansion of Early Intervention (disabilities) & child abuse prevention home visits; Parents as Teachers 1990s – Early Head Start – most effective when starts with prenatal TAIWAN? History of Home Visiting

43. Parents are the most important teachers & home is where they largely teach; services should happen there 2. Parents can learn more effective ways to relate to their children 3. Supporting parents will lead to improved child outcomes Rationale for Home Visiting

44. 1. Basic care skills, immunizations OR 2. Reduce parent stress OR 3. Education & development Possible Emphases for a Home Visit

45. 1. Should professionals or paraprofessionals serve? Which kind(s) of professionals? 2. Does home visiting “work”? 3. Better – under what conditions does it work? 4. Better – who does it work for? 5. What intensity is necessary for home visiting to have the desired impact? Issues Video: Home-Based Services

46. What observations do you have about this?