TheDevelopmentalSystemsApproachToEarlyInterventionExcerpt.pdf

The Developmental Systems Approach to Early Intervention

The recent history of early intervention services for children who are vulnerable and their families in the United States has certainly been one of progressive expansion and refinement. The model projects operating in select communities or university settings and the beginnings of more widespread programs in the 1960s and 1970s have been transformed into a vibrant and visible national program providing early intervention services and supports to which all eligible young children with established disabilities have access. Preventive intervention programs for children at risk for developmental disabilities have exhibited considerable growth as well, although these programs lack the many legislative mandates and the coherence of programs for children with established disabilities.

Numerous factors working together created the conditions for these transformations as well as for the continuing support for further advances in contemporary systems of early intervention programs. Historical accounts of these factors can be found elsewhere. Taken together, what has emerged from all of these efforts is a strong commitment to make early intervention, in all of its forms, work.

Moreover, as programs in each state and local community have become more visible and prominent, the expectations for early intervention programs have increased considerably. Ensuring the availability of well-coordinated, highly effective early intervention programs in every community is held to be a reasonable goal by policymakers, parents, and professionals. It is further thought that the absence of uniformly high-quality early intervention programs can jeopardize the health and optimal development of our nation’s vulnerable children.

This systems-level thinking was central to the Education of the Handicapped Act Amendments of 1986 and related early intervention legislative changes articulating a national agenda. In particular, focusing on the birth-to-3 age group, the purpose of this legislation was to develop and implement a statewide, comprehensive, coordinated, multidisciplinary, interagency system that provides early intervention services for infants and toddlers with disabilities and their families.

The law identified a number of structural components required for such a statewide system including establishing criteria for eligibility for services, ensuring that timely and appropriate assessments occurred, developing a process so that a family’s needs and priorities were identified systematically, creating a proactive early identification and referral mechanism, establishing a procedure for developing a specific plan for comprehensive intervention, and ensuring that transitions from one program to another were carried out effectively and seamlessly.

Principles of Early Intervention

As suggested, it was reasonable to anticipate not only that some common ground would emerge with respect to the various structural components of an early intervention system but also that a set of common principles and corresponding practices governing systems design and implementation would emerge. Structural components and principles should jointly determine practices of the components and of the system as a whole.

Certain principles were embedded in the legislation itself, which called for the early intervention system to center on families, maximize participation of children and families in natural environments, foster interactions with children without disabilities, and integrate and coordinate activities at all levels of the system. The press for child-find systems as a structural component reflected the principle of the importance of early identification. Moreover, the principle of individualization of intervention was found in many places in the legislation but especially in connection with the design of individualized family service plans (IFSPs) and individualized education programs (IEPs).

Despite an apparent acceptance of these principles at a general level, considerable variability also exists with respect to the implementation of these principles in practice. Differences in interpretations, access to information, and resource availability may account for much of this cross-community variability. Variability is perhaps most apparent for what might best be referred to as core principles (i.e., developmental framework, inclusion, integration, and coordination).

Implementation of Principles

The most fundamental principle is that a developmental orientation should be represented in each structural component and corresponding practice of every early intervention system. The most critical feature of this developmental orientation principle is that interventions center on families. This principle includes concepts related to parent empowerment, the establishment of parent–professional partnerships, and recognition of the significance of family patterns of interaction to children’s development and well-being.

The same can be said for the principle of inclusion, although most subscribe to this principle at a conceptual level. Universal access to inclusive programs is far from a reality, and practices differ radically from community to community.

The extraordinary compatibility of the core principles of inclusion and developmental framework is only now being recognized fully. Evidence also indicates that the core principle of integration and coordination has yet to be effectively applied to many components of the early intervention system. Families frequently identify service coordination as a major concern.

The importance of cross-discipline collaboration poses additional challenges as collaborative consultation models are emerging as best practices in the field. When fully implemented, the collaborative consultation approach is consistent not only with the principle of integration and coordination but also with the other two core principles of developmental framework and inclusion.

The other principles guiding systems of early intervention, however, have not been fully realized in practice. Exemplary models do exist, but they constitute only isolated examples in a context of enormous variability in comprehensiveness and effectiveness. Few communities have comprehensive systems to identify children at risk as early as possible. There are numerous barriers remnant in the design of comprehensive systems, including costs and general problems associated with interagency coordination.