Archive for January, 2018


    Children who Experience Homelessness: Policy Implications

    Early Childhood Interventions January 31, 2018


    Meeting the Needs of Families with Young Children Experiencing and At Risk of Homelessness provides key guidelines regarding the need for comprehensive cooperation among service providers, educators, and community resources to reduce the vulnerabilities experienced by children growing up in and around homelessness. While the policy statement more broadly targets early childhood and housing providers, the recommendations set forth throughout the document carry paramount implications for childcare and primary school teachers. Some major applications of this policy statement include but are not limited to the identification and contextualization of a child’s disability with regards to his/her particular environment, as well as implementing individualized education strategies both inside and outside of the classroom. The Homes through Community Partnership program indicates that 84% of families experiencing homelessness are female-headed. This is due to a number of factors, including the propensity for family shelters to turn away fathers from entering with their families, both out of precaution and due to histories of domestic violence. In addition, the birth of a new child can greatly affect a parent’s ability to work and provide adequate home care, especially if the child is born to a single low-income mother. The Partnership also indicates that children growing up in poverty without stable housing are at greater risk for experiencing problems related to inadequate prenatal and postnatal care and exposure to dangerous conditions such as inclement weather or violence. In addition, children experiencing or at risk of homelessness are four times more likely to show delayed development, and twice as likely as non-homeless children to have a learning disability.

    Children who are born into poverty or homelessness are often born prematurely. Babies born prematurely are at higher risk for physiological, psychological, or neurodevelopmental disabilities. Babies born at full-term are given the advantage of more mature internal systems, but when infants are born prematurely they are at an increased risk of complications such as atypical muscle tone, delayed motor development, feeding problems due to a weaker suck, and breathing issues related to underdeveloped lungs. These complications can lead to developmental delays and disabilities which last throughout childhood and can impact school performance. Children born prematurely often have decreased attention, poorer visual and motor skills, and delayed language acquisition. Early childhood educational providers and elementary school teachers must be aware of the behaviors and skill sets that are typically found in premature children in an effort to mitigate the negative impacts on the child, and to mediate the academic, social, and emotional difficulties that arise. The development and school performance of children born prematurely should be closely monitored to ensure that early intervention and early intervening services and supports are provided.

    Meeting the Needs of Families with Young Children Experiencing and At Risk of Homelessness, indicates that supporting families who are homeless must be an integrated, comprehensive system as no single system is sufficient to meet all the needs of all family members and children. Every child’s living situation is different in some respect, whether socio-economic, cultural, or generally environmental. As a result, educators should be aware of the complementary programs and resources they may need to consult or work in conjunction with if a child is showing areas in one or more developmental areas and requires further accommodations or assistance. One broad recommendation that is particularly applicable to school and childcare teachers is the importance of “aligning and coordinating the design and delivery of services for the whole family.” This is particularly important for educating children with disabilities, in order to identify the child’s specific developmental strengths and weaknesses and discern what extent external risk factors or stressors are having on the child. Additionally it is critical that classroom teachers and childcare providers maintain an open, respectful and on-going relationship with the family.

    Moreover, the successful integration of child-centered and family-specific needs in children with disabilities or developmental delays rests heavily on the ability of educators and early childcare providers to communicate and cooperate in providing a comprehensive support network. Services such as Continuums of Care (CoCs) are increasingly crucial. These services work to monitor the health of at-risk mothers and newborns during and after pregnancy, educate young mothers about the programs and resources available to families who are in transitional homes or of low SES, and assist families in accessing he services and supports. In conjunction with a non-restrictive learning environment where teachers can individualize the child’s learning objectives and re-define educational success by how fairly and equally he or she benefits from participating in a classroom environment.

    The Policy Statement on Meeting the Needs of Families with Young Children Experiencing and at Risk of Homelessness outlines ways in which various programs, particularly, early childhood providers and CoCs can address a variety of issues. A major issue that families who are homeless confront is the lack of coordinated support systems. In a population with decreased rates of literacy and lower levels of personal advocacy, it is critical that the U.S. puts coordinated systems of care in place. This Policy recommends that early childcare providers conduct more thorough intake procedures, where housing status is taken into account.

    Furthermore, the Departments of Health and Human Services (HHS), Housing and Urban Development (HUD), and Education (DOE) suggest referring and connecting families with different program providers rather than simply giving the family the contact information for the supports. It is suggested that perhaps assigning one single family coordinator or programmer who is in charge of integrating program services and support and insuring that services and support reinforce the goals of all. This family coordinator or programmer could then help to establish academic, social, and developmental supports for each child in the family, along with educational, social, and job assistance supports for each adult in the family. One of the main takeaways from the given Policy Statement is that departments, programs, and coordinators must take a holistic approach when it comes to handling and supporting families with young children who are homeless or at risk of becoming homeless. Because each child and parent has different needs individualizing services and supports to the needs of each family member is critical.

    Young children, particularly infants and children under the age of five, are at the highest risk of experiencing homelessness. Further, nearly 50 percent of children in shelters “in a given year” are under the age of six (p. 3). Because of this, it is imperative that the United States implements programs that both reduce these statistics and increase support for those facing this reality. Early childhood has proven to be the most critical and sensitive period for developing children, thus, a potential recommendation must address the educational and developmental needs of children under the age of five as well as those entering elementary school. Homeless children are at greater risk of falling behind their peers academically; therefore, the U.S. educational system must take care to provide protections and specific educational programs for young homeless children. One possible avenue that the system could take would be to implement after-school academic programs at shelters for young children to attend after their regular school day. Educational personnel, such as teachers and professional academic tutors, would teach these programs which would help to bolster the children’s academic abilities and maintain a continuity between school and home. The policy statement set forth by the U.S. Department of Health and Human Services (HHS), the U.S. Department of Housing and Urban Development (HUD), and the U.S. Department of Education (ED) recommends two-generational programs that target both the child and their parent(s). Therefore, in the possible after-school program discussed above, there could be a separate educational program for the children’s parents in order to help supports their academic needs and to increase their rates of literacy. Furthermore, the recommendations in this Policy underscore the importance of looking after individuals with disabilities. Without a proper and inclusive education, children with disabilities are at risk of becoming more isolated and falling further behind academically and socially. It is imperative that school systems set programs that enhance the learning environments of all children with disabilities who face homelessness, as education creates a platform to break the cycle of poverty and homelessness.

    Alejandra Ruttimann (C’18) Amanda Webb (C’18)

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    Assistive Technology in Early Intervention

    Early Childhood Interventions January 16, 2018

    Sydney is a toddler who lives at home with her parents. She receives daily care from her immediate and extended family members (i.e., grandparents, aunts, and cousins). Sydney has a diagnosis of cerebral palsy and attends her local Early Intervention program. She receives physical and occupational therapy. As she aged, her service providers became concerned with her motor skill development, especially her difficulty in learning to stand and walk. At the age of 18 months, the Individual Family Service Plan (IFSP) team agreed to include assistive technology to promote standing and walking in her home and childcare center. Although Sydney’s family agreed to the use of assistive technology (AT), for some families, AT is a novel concept that takes time to learn, use, and advocate its functional importance across routine based activities.

    Family and caregivers of children with disabilities may see multiple barriers that effect the child’s development, compared to typically developing children. Kang et al (2017) discuss the environmental, social, and attitudinal barriers many families and caregivers of children with disabilities report face compared to families and caregivers of children without disabilities. Families identify lack of resources, equipment, training, and inclusivity that hinder their child’s development compared to children without disabilities. Environmental knowledge (i.e., resources, coaching/training, family support, etc.) can help families of children with disabilities to feel included in their community and promote the overall well-being of their child’s development (Kang et al, 2017). AT devices and strategies are crucial components that help caregivers include children in routine-based activities across a variety of environments. Sydney and her family were more easily included in community based activities by using AT.

    Many young children and their families depend upon AT resources and services to promote function across routine activities and environments. Children with disabilities or delays use AT to access their environment so they can move, play, and communicate safely and effectively. The Individuals with Disabilities Act (IDEA) defines AT “as any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a children with a disability (§602(1), 2004).” IDEA (§602(2), 2004) specifically distinguishes AT services from AT devices and defines AT services as “any service that directly assists a child with a disability in the selection; acquisition, or use of an assistive technology device. This definition highlights that for children and families similar to Sydney’s, AT can be a specific device or a service that is provided to train families to use and maintain the device in order to use it across activities and ensuring that the families have many opportunities to implement learned strategies.

    The IFSP team meets to discuss the need for including AT devices and services in the plan to accomplish family-centered outcomes. The team, which always includes the family, considers the implications for AT use to facilitate effective child involvement in routine-based activities. Sydney’s family and the rest of the IFSP team discuss multiple factors that can affect the success of using the device. Factors such as the persons who Sydney will be interact with, the activities she will be involved in, the environments in which she will use the device, and what types of technology are available all contribute to the decision making process.

    Also, to assist with decision-making there are four questions that the IFSP team should answer: (https://www.teachingei.org/technology/11-consider.php):

    1. Have previous interventions, modifications, and strategies not led to the functional results desired by the team; 2. Has there been a change in environment or circumstance; 3. Has the child’s skills or behavior changed; 4. Is there a change in technology (e.g., compatibility issues)?

    The Student, Environments, Tasks, and Tools (SETT) framework (Zabala, 2010), is used by the IFSP team to consider all aspects of AT decision-making, helping the team make the most efficient, effective and functional recommendations for the device and services ensuring that the child and family will use the device across environments and by many caregivers. This eight-step decision-making process accounts for the interconnections among the: 1) child, 2) environments, 3) tasks, 4) tools, and the need for 5) ongoing evaluation and modification. Dunst, et al (2013) concluded in his meta-analysis that AT devices “promoted child engagement” in routines (e.g., playing with toys, self-feeding, moving around the home) that may otherwise be very difficult or impossible to achieve. AT devices were shown to positively impact the attainment of outcomes regardless of age, disability, or severity of child’s intellectual delay (Dunst, et. al, 2013). AT devices and strategies that are designed in light of family-centered outcomes promote multiple opportunities for the child to achieve success.

    1. Collect Child and Family Information
    2. Examine Natural Environments
    3. Identify Elements of Key Activities
    4. Brainstorm AT Solutions
    5. Create an Implementation Plan
    6. Modifications + Recommendations

    Sydney’s family and service providers collaborate with each other to ensure ease of device use and activity implementation. Unfortunately, studies indicate many families and service providers “abandon” AT devices and strategies after initial implementation.

    Common pitfalls an IFSP team must consider to mitigate abandonment of the device include:

    1. Limited access to Early Intervention specific AT implementation strategies (i.e., routine-based intervention, least intrusive device/strategy across environments, etc.) 2. Lack of evidence-based practices implemented by service providers and family members when using IFSP defined AT devices and/or services; 3. Limited consideration of ongoing AT device maintenance or strategy modification as the child ages or family circumstances change.

    Recent studies have demonstrated the necessary attitudinal shifts of parents and caregivers occur when provided sufficient and effective coaching to implement AT devices and strategies across environments and daily activities. Tamakloe and Agbenyega (2017) concluded that outcomes were achieved when childcare center teachers and staff used AT devices and strategies. Based on a survey that questioned the staff’s interactions with AT, the authors concluded that ‘maintaining positive attitudes’ were paramount for learning, maintaining, and modifying AT device usage of children with disabilities in the classroom. Service providers must provide optimal training and coaching in how to incorporate AT devices in routine based activities. Nelson, et al (2013) reported, based on interviews with teachers about their perceptions of AT use in the classroom, that teachers must know when technology will be beneficial in the classroom, as well as counterproductive to a child’s learning. Both low and high tech devices are appropriate for use by young children in the classroom, home, and community. Children use low-tech device to participate successfully in routine-based activities in the classroom and community.


    Sydney’s family and service providers collaborated, coordinated, and executed an IFSP to include AT device(s) and strategies to address the family-centered outcomes. The family received coaching and training on how best to incorporate these devices in their daily activities to support Sydney’s motor skill development. The family and service providers coached and trained Sydney’s childcare center staff to ensure the AT devices and strategies were frequently and effectively included in the classroom’s daily routine. Providing the equipment, resources, and skills can help resolve environmental, social, and attitudinal barriers that would impede Sydney’s overall development.

    References

    1. Dunst, C.J., Trivette, C.M., Hamby, D.W. (2013). Systematic review of studies promoting the use of assistive technology devices by young children with disabilities. Research Brief Volume 2, Number 1. Tots-n-Tech Research Institute.
    2. Kang, L., Ming-Chieh, H., Liao, H.F., Hwang, A.W. (2017). Environmental Barriers to Participation of Preschool Children with and without Physical Disabilities. International Journal of Environmental Research and Public Health. 14:518. Retrieved from: http://www.mdpi.com/journal.ijerph
    3. Nelson, L.H., Poole, B., Munoz, K. (2013). Preschool Teachers’ Perception and Use of Hearing Assistive Technology in Educational Settings. Language, Speech, and Hearing in Schools. 44. pps. 239-251.
    4. Sawyer, B., Milbourne, S., Dugan, L., Campbell, P. (2005). Report of assistive technology training for providers and families of children in Early Intervention. Research Brief Volume 2, Number 1. Tots-n-Tech Research Institute.
    5. Simpson, L.A., Oh, K. (2013). Using Circle Time Books to Increase Participation in the Morning Circle Routine. Teaching Exceptional Children. 45; 6, pp. 30-36.
    6. Tamakloe, D., Agbenyega, J.S. (2017). Exploring preschool teachers’ and support staff’s use an experiences of assistive technology with children with disabilities. Australasian Journal of Early Childhood. 42:2. Retrieved from: http://dx.doi.org/10.23965/AJEC.42.2.04
    7. Zabala, J. (2010). The SETT Framework: Straight from the Horse’s Mouth. Retrieved on 2 January 2018 at http://www.joyzabala.com/uploads/CA_Kananaskis__SETT_Horses_Mouth.pdf
    8. http://ectacenter.org/~pdfs/decrp/PG_Env_LearningWithinReach_print.pdf
    9. https://www.teachingei.org/technology/01-overview.php
    10. http://www.techfortykes.org/ifsp/decision_tree.htm

    Sharice Lane, SLP, M
    Early Intervention Diversity Fellow, 2017-2018

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