Friday, September 4, 2009

Preschool Services Need Attention

It has become fashionable at early intervention/early childhood special education conferences to decry the supposed sorry state of affairs in Part C. In some places, criticism is warranted; in others, it's not. Many communities--the State of Missouri being one--are making significant strides towards excellent service delivery models.

 

 
Preschool services (Section 619 of Part B of IDE[I]A) have always been in a strange position. On the one hand, they receive much attention; on the other, they receive scant attention. They receive much attention in training in university programs for young children with disabilities, where much of the training is directed at preschool-aged children. In part, this emphasis is because of location: Students can be placed in classrooms for internships and student teaching, whereas placing students in home-based programs is much more problematic. Attention to preschool services is supposedly also revealed in conference presentations, where organizers and attendees alike are concerned about whether enough of the program is devoted to infants and toddlers and their families.
 

 
The scant attention I have noticed is in service delivery models.

 
  • Just how are preschool services organized?
  • What is the rationale?
  • How much are administrators paying to dosage issues?
  • Who are the targets of services?
  • What philosophies underpin services?
  • How much focus is on the influences of children's learning--children's learning opportunities?

 
These questions are related, and I will attempt to answer some of them. Others are for decision makers, practitioners, and families to consider, because my experience is that they often fail to consider them.

First, we can assume that, owing to what we now know about young brains and have long known about successful parenting, young children learn throughout the day better than they do in "lessons." This is related to the power of natural discriminative stimuli and to the difficulty young children, particularly those with developmental delays, have with generalization or "transfer."

Second, we can assume that what they are learning is far more than preschool behaviors (sitting, playing with play dough, negotiating with peers, etc.): They are still learning language, what their growing bodies can and cannot do, and how the world works, which is why learning opportunities exist throughout the day. This concept of alocated learning time is critical for understanding the difference between early childhood education and later education. The older children get, the more their learning can be concentrated into "school" (or Sunday school or piano lesson) time. In the preschool years, caregivers have the opportunity to teach throughout the day. This should make early childhood special educators think about their roles and opportunities.

Third, family systems theory, helpgiving theory, social support theory, and behavioral-ecological theory do not come to a grinding halt when the child turns three years of age. In Part C, there is some understanding that the whole of a child's waking hours is potential intervention time and that the environments in which the child finds him- or herself influence learning. Unfortunately, even though this understanding exist in theory, even in Part C it does not always translate into action. The situation is even worse in preschool, however, where service coordination is no longer a mandated service and where the (special) education mentality is pervasive.
  • If family systems theory were acknowledged, preschool services would be organized to provide emotional, material, and informational support to families, including the systematic assessment of their needs and accountability on the IEP (if that document must continue to be the driving document) for developing family-level goals and providing supports to meet those goals.
  • If helpgiving theory were acknowledged, preschool services would have an expanded view of family-centered practice, so they would attempt to meet families' needs for emotional, material, and informational support, rather than thinking that "parent participation" in school activities was most important.
  • If social support theory were acknowledged, preschool services would see the link between child learning and family well-being and family well-being (quality of life) and their social support, especially informal support. Early childhood special education would therefore spend at least a little time getting to know families' ecologies and helping families preserve and, if they desire, expand their informal-support networks.
  • If behavioral-ecological theory were acknowledged, preschool services would assess children's functioning throughout their typical day, through a family interview, and develop intervention plans that followed our knowledge of how young children learn. These plans would use children's interests and natural learning opportunities to teach them skills so they can participate successfully (i.e., be engaged) in their home, community, and school routines (activities).
Now let's discuss the number of hours that preschool services are provided to a child. If the child can go to school five mornings a week (e.g., 20 hours, allowing for a full 4 hours a morning instead of the measly 2.5 hours some preschool programs offer) or three full days a week (e.g., 15 hours, allowing for a full 8 hours), the school environment becomes a true learning environment. The child spends enough time there for learning opportunities to be distributed across time, and the child's "caregivers" during that time (i.e., teaching staff) spend enough time with the child that they become direct instructional or intervention agents themselves. This can be labeled the classroom model.

If these classrooms are self-contained (i.e., having only children with disabilities), they represent a dated approach that potentially violates moral and legal positions. If they are inclusive (i.e., at least half the children in each classroom have no disabilities), these classrooms are defensible and potentially excellent. This article is not about inclusion; it is about attention to children's learning opportunities and to their families.

Many preschool services are offered on a much leaner schedule, such as one to four 2.5-hour mornings a week, with the number of mornings being related to either the severity of the child's disability or the number of services the child has on the IEP. When a child is "at school" for such a small percentage of his or her waking time, we have to ask what the point of this service time should be. The child is transported in, sometimes by school bus, which is another whole discussion, sometimes by parents. Usually, the child is left "at school" for these short bursts of early childhood special education and related services. Family communication is limited to (a) notebooks, (b) intermittent home visits, or (c) discussions at arrival and departure, sometimes, with those families who do drop off and pick up their children. Often, that communication is about what the school people are working on, what the child did, and what the family can do to support the school's efforts. Sometimes, these short sessions at school are thought of as the times the child comes in for his or her therapies and special ed. Short times at school (i.e., fewer than 15 hours a week) can be thought of as the playgroup/clinic model.

Some preschool services are offered through itinerant services, which have the potential to acknowledge the theoretical bases I earlier described. Itinerant teachers can consult with a child's regular caregivers/teachers in  child care or other classroom-based settings, such as Head Start. If the consultation is done well, using an individualized-within-routines approach and not a pull-out approach, this model of service delivery has the potential to expand intervention throughout the child's classroom day every day. Unfortunately, sometimes itinerant services are restricted to special education, with the therapies still happening in clinical types of settings at a school. If therapists can also travel to children's regular-early-childhood classroom settings and adopt a "consultative approach to direct services" (which is not as contradictory as it sounds), we really have the potential to provide meaningful intervention. There's still the family piece though.... This approach is labeled the itinerant model.

School districts fear that the itinerant model is too expensive, compared to keeping all the personnel in centralized locations and shipping the children in, in groups. For the reasons given above, this solution has to be considered pragmatic but atheoretical, if the playgroup/clinic model is adopted. Beginning steps for preschool administrators can include the following.
  1. Become familiar with the literature on the theory and research related to the concepts described in this article, so decisions are made on intellectually and empirically defensible grounds.
  2. Work towards converting the playgroup/clinic sessions into family support sessions. After all, because they consist of such short bursts, many families are presumably available to transport the children or to care for them when they're not "at school." Do not call this "school" time, because that has the connotation of teachers working directly with children, and these family support sessions will be much more than that.
  3. Take all the FTEs currently devoted to preschool special ed and related services, acknowledging that some therapists might work also with older children, and divide that number into the number of children with IEPs. Consider this then to be potential caseloads, with one professional serving as the primary interventionist with that child and family in whatever location seems appropriate. This is a radical but highly commonsensical approach to resource distribution--and defensible on child-learning and service delivery grounds.
  4. Expand itinerant services, once caseloads are reallocated to a primary service provider. Ensure this is done with both therapies and special education, not just the latter.

11 comments:

甜心 said...

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artichokegrant5 said...

Hi Robin. I was impressed the level of your knowledge in this area and was hoping you could help me with a research question. I am a peds PT and am working on the question of is early intervention for children (especially those with special needs) better provided in home v. in clinic? I am looking for research that would support either side of the argument. Do you by chance know of any studies that compare/contrast the benefits of bringing children to the clinic for treatment as opposed to treating at home in their "natural environment". Thanks! Amanda Edwards, MPT

自己 said...

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cathleen said...

Hello,
i teach in an ECSE preschool class. I understand that the connection between home and school needs to be stronger in order to support the child. I also understand that it is more efficient to bring children with special needs to a classroom(classroom/clinic model) in order to deliver services in a more cost-effective manner.
The idea of pre school for young children is not limited to only those young children with IEP goals, however. Preschool for children who are typically developing is a good thing. I get the feeling that the preschool model for children with special needs is something you find lacking.
My question is:
If high quality part-time pre school has positive benefits for typically developing young children, why is using the same model somehow wrong or less than best practice for young children with special needs?

Sarita said...

Hi,
I also teach in an ECSE preschool class. I know how important it is to have the family involved in every aspect of the childs education and yes, they are learn when there is structure on a daily basis. I use a lot of repetition in my classroom and it works, but I also realize that my school district does not fully support family involvement. I mean I have had parents ask to volunteer in my class and the district says no. I also understand we are trying to get out children to become indepedent and leanr certain life skills without being co-dependent. I guess my question is:
IFSP include family goals, goals that the famikly as a whole can work on with their children. Why do we stop including the family in IEP's? I mean we give the child a goal academic if kinder and others if pre school but initally the family support helps the children to meet their goals.

cathleen said...

Hi Sarita,
I was wondering why we write IEPs with almost no mention of family goals myself. It seems like there is a disconnect between IFSPs and IEPs in terms of what is considered best practice.

Anna Clanin said...

Hello, I am an ECSE teacher in an inclusive preschool classroom and struggle with having a home connection with my special education families. I am able to do home visits but time is limited and not all families are visited as often as they should be. IEP's are so much more academically driven than the IFSP's that I struggle with IEP goals when I know that the child and his family may need more of a family related goal. Instead, the families are encouraged to come to parenting classes, to attend program workshops, or to talk to the school psychologist, etc... I am also Mom to a little girl, with an IEP, who attends a preschool program with other children who have IEP’s. My daughter loves the program and she has learned a lot but it is only twice a week for 90 minutes and there is no parent component. I struggle with trying to keep a relationship with my daughters’ teachers since I work full-time and do not even have the weekly banter between myself and teachers during pick up time. I wonder why at least until through kinder why there can not be a section on the IEP, to better bridge the gap from early intervention to school intervention, to help deal with "family" types of issues and relationships? Early intervention and preschool services have such different focuses for their outcomes and service delivery models - why is there not time for a transition at least until the end of kindergarten? I do believe preschool services need attention as well, especially when families work full-time and are not home during teacher hours and for the parents who do not have transportation and their child goes to school on the bus.

Rosemarie said...

Hello RObin, I liked the way you tackled the classroom model because I work in this ideal kind of classroom setting. My students stay for 5 hours, Monday thru Friday and ours is an inclusion class.
If length of hours and an inclusion program is proven by research based findings as successful, can the State mandate all school districts to adopt this kind of practice in their pre-school programs? In my opinion, this kind of early intervention will be cost effective in the long run as behaviors are already prevented in the foundational years of a child.

M Fusion said...

I noticed the comment about "self contained" classrooms.

I work at an early intervention program in California for infants and toddlers, and every child in the program has a special need of some sort. The range is moderate to severe. The age range is 18 months to 3 years.

I agree that full inclusion is important for children with special needs as they grow older, but I feel that a "self contained" model is still good for children of this younger age group. For one thing, the families bond with each other in a way that I wonder whether or not would carry across to an environment that featured parents of typical children. Also, the wide range of issues among the children cause the dynamic of the group to compliment each other's strengths.

M Fusion said...
This comment has been removed by the author.
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