The Developmental Systems Approach To Early Intervention: National and International Perspectives (International Society on Early Intervention) - Hardcover

Robin McWilliam is the originator of the Routines-Based Model, implemented in 10 countries and many states in the U.S. He is a professor of special education at The University of Alabama, where he founded and directs the Evidence-based International Early Intervention Office (EIEIO). He is also the founder and leader of the RAM Group, an international community of practice fostering the Routines-Based Model. He has formerly been a professor of pediatrics at Vanderbilt University Medical Center, a senior scientist at the Frank Porter Graham Child Development Institute, and a professor of education at the University of North Carolina at Chapel Hill. Dr. McWilliam's research centers on infants, toddlers, and preschoolers with and without disabilities, with a specific focus on child engagement, service delivery models, and collaboration with families. He has provided consultation, training, and technical assistance across the United States and in some countries overseas on providing early intervention in natural environments and on the Engagement Classroom Model. His Routines-Based Interview (RBI) is a widely used method of assessing families' needs and developing individualized family service plan (IFSP) outcomes and individualized education program (IEP) goals.

Excerpted from Chapter 1 of The Developmental Systems Approach to Early Intervention, edited by Michael J. Guralnick, Ph.D.

Copyright © 2005 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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 (see Guralnick, 2000a, in press-b). 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, including philosophical shifts, knowledge gained from the developmental science of normative development and the developmental science of risk and disability, the results of intervention science, information derived from clinical practice, increased support for early childhood development programs for all children, and major legislative events can be found elsewhere (Gilliam & Zigler, 2001; Guralnick, 1997b; Meisels & Shonkoff, 2000; National Research Council and Institute of Medicine, 2000; Smith & McKenna, 1994). 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, each representing contemporary principles and practices, is held to be a reasonable goal by policy makers, 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 and pose increasing challenges to the ability of families to function effectively. This systems-level thinking was central to the Education of the Handicapped Act Amendments of 1986 (PL 99-457) and related early intervention legislative changes articulating a national agenda. In particular, focusingon 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" (Individuals with Disabilities Education Act [IDEA] Amendments of 1997, PL 105-17, Section 631). States could also serve children at risk for developmental delays through this mechanism if they elected to do so.

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.

Three- to five-year-old children were served under different provisions of the law. Although differences between the systems serving infants and toddlers and those serving preschool children were often substantial (e.g., less of an emphasis on family involvement for preschoolers), the basic elements remained intact. Accordingly, these requirements were intended to ensure both the existence of a well-coordinated and integrated early intervention system in each state and to ensure the consistency of the systems' structural components across states and communities. Nevertheless, much was left to the discretion of states to interpret and implement the systems they developed. In this manner, states could build on existing relationships and structures, including financing mechanisms, to meet federal requirements.

Yet, despite considerable degrees of discretion accorded each state within the structure put forward, the reasonable expectation was that, over time, states would become more and more similar in their early intervention service and support systems. This would be brought about through national leadership and a common recognition by states and communities of the most effective approaches for each component of the system, gained through formal evaluations of the systems in effect and through informal communication channels. Of course, many differences would remain, but common fundamental components and corresponding practices would eventually come to characterize a national system. After all, the design of structural components of systems, such as those for effective screening and referral mechanisms or for multidisciplinary child assessments that could be conducted to obtain needed information, was based on common sources of knowledge provided by researchers and clinicians in the field.

Similarly, it is reasonable to anticipate that neighboring states would soon see the value of establishing common eligibility criteria. Perhaps more difficult to achieve than the expected convergence with respect to structural components would be convergence with respect to various specific practices and service guidelines and even philosophical perspectives. But even here, it seemed reasonable that considerable agreement would evolve over time as approaches were clarified and evidence accumulated as to what were the most effective and efficient practices in meeting the needs of children who are vulnerable and their families.

Despite these expectations, analyses have revealed surprisingly large variations across states for many components of statewide early intervention systems. More specifically, substantial differences in practice have been found with respect to criteria for eligibility for services, ways in which families gain access to the system (points of access, transitions from program to program), and the comprehensiveness of the available services (Harbin, McWilliam, & Gallagher, 2000; Spiker, Hebbeler, Wagner, Cameto, & McKenna, 2000). Moreover, only limited state-level leadership has been apparent with respect to promoting systems-level issues. As the authors of a comprehensive study of infant and toddler early intervention systems, referred to as the National Early Intervention Longitudinal Study (NEILS), observed, "The early intervention professionals we interviewed in conducting the NEILS enrollment and those around the country with which we have discussed the NEILS have been surprised that there was so much variation in early intervention systems" (Spiker et al., 2000, p. 205). Of importance, considerable variation was found not only across states but also within states.

This general concern about early childhood intervention at the systems level was shared in a comprehensive report from the Committee on Integrating the Science of Early Childhood Development of the National Academy of Sciences. Their analysis indicated that Early...