Wednesday, December 15, 2010

Toddler Groups

I have recently been asked to comment on toddler groups. This was the situation:

I am currently part of a committee that includes staff from our Early Intervention Program and we have been given the charge to explore ways to provide integrated developmental groups for toddlers receiving services. To date this attempt has not proven successful due to a number of factors including low rate of reimbursement, ratios, and trying to come up with incentives for parents to pay to bring their toddlers to such a group.


There’s probably a good reason families have been reluctant to take their toddlers to a group: They don’t see the value, especially when taking the hassle of getting there into consideration. The argument that groups would give families more options would only be valid if it were an option they valued. Most states and local programs have considered them more from a logistical, staff convenience standpoint. A few staff can be at one location, and families can do the traveling, and we can “serve” multiple children at once. In addition to the potential spuriousness of the option argument, the assumption that peer interaction opportunities should be provided by the early intervention program should be questioned. First, toddlers don’t need to interact with peers; as you know, developmentally, the best we can expect in 2-year-olds is parallel play and attentional engagement with peers, with occasional bursts of associative play. Especially when the children might have developmental delays, the argument that it’s good for them to be in groups for a few hours a week is pretty weak.

The amount of time is another issue. We know that experiences in small amounts of time are less valuable for little kids than they are for adults, who can benefit from short (e.g., 1 hour) weekly sessions.

In some states, groups have been discouraged or even disallowed. In other states, people are using them as you describe. Still others have a hybrid, where toddlers get together a number of times a week (e.g., two to four) for short periods (e.g., 2 or 3 hours). Even at 4 days x 3 hours, this is 12 hours. No one knows whether this is long enough to have a meaningful effect, but we do know that it’s an inconvenience or even hardship for families to take their children on this kind of schedule. It makes it very difficult for working families, for example.

Is there a way you could make a group effective? If it were designed primarily for emotional, material, and informational support for families, it has a chance. I have published on taking a support-based approach to home visits with the same three types of support. At the group, families could spend time with each other, which some families really like. They could get information about the four things families typically want information about: child development, resources including services, their child’s disability, and, most important of all, what to do with their child (i.e., interventions). The materials support could come from equipment, toys, diapers, food, clothing, and so on, provided by both the program and some families themselves. If the group of families wanted to meet as a group, they could rotate who plays with the children in an adjacent room, ensuring appropriate ratios, furnishings, toys, and so on. If they wanted to make it more like a gaggle of parents talking while playing with their children, they could do that. As professionals or even other parents make suggestions about how to do something with a child, they can demonstrate with the child, but the hands-on with the child is for the purpose of supporting the family, not with a false premise of actually teaching the child at that time.

Why would families like this option? Perhaps to get out of the house and to meet other parents. They might also want to see how their child acts around other children, but we should be very careful not to insinuate that peer interactions before the age of three are necessary. If we take this preparing-for-the-next-environment to its logical conclusion, before you know it, we’ll be teaching babies to hold crayons, to sit on carpet squares, and to wash their hands, because that’s what they’ll have to do when they reach toddlerhood.

Therefore, you can see that I don’t believe child-directed groups are theoretically sound, effective, or a good use of resources.