EI Talk: A Blog for Early
Childhood Professionals


Early Childhood Education and Disability Bias

Sharice Lane October 30, 2018

Conscious and Unconscious Biases in Health Care


I took a course in administration and leadership as participant in Georgetown University Certificate in Early Intervention. One of the course’s assignments was to complete an implicit bias quiz. I had taken similar quizzes in previous leadership courses. However, I decided to take the quiz to assess any implicit bias regarding disabilities. Much to my surprise, the results demonstrates a strong association between bias and disability. This information made me consider the thoughts of others who engage with persons with disabilities in both personal and professional spheres.

Being raised by a person with a disability and working with families affected by disabilities for over 10 years can significantly impact one’s view of persons with disabilities. Implicit bias is a relatively new field of study for those who would like to increase inclusion of all types of people and who see multiculturalism positive. The Kirwan Institute of Ohio State University (2015) defines implicit bias as “attitudes or stereotypes that affect our understanding, actions and decisions in an unconscious manner. These biases, which encompass both favorable and unfavorable assessments, are activated involuntarily and without an individual’s awareness or intentional control.”

Implicit bias has been documented in all sectors of society. Unfortunately, implicit bias can negatively affect a person’s access to quality healthcare, employment and social justice. Implicit bias in early childhood education (ECE) has little empirical evidence in peer-reviewed research. Capotosto (2015) discussed the importance of addressing implicit biases in ECE due to the significant growth in development that occurs in the first five years of life. Students with developmental delays and disabilities are at a disproportionate higher risk for instructional and behavior challenges in the education settings. Educators may have negative implicit bias towards those with disabilities, which could affect how they engage such students in the classroom. Implicit bias affects all, including those considered good teachers. According to Capatosto (2015), “good” educators could demonstrate behaviors influenced by such biases, even if they explicitly express a desire to improve social equity. School leadership should develop systematic methods to address implicit bias that may affect access to quality early childhood education.

Training about disability, even when not directed solely on bias, has been shown to positively affect attitudes regarding students with disabilities Ntuli and Traore (2013) assessed the effectiveness of training ECE staff to implement disability-inclusive early childhood education best practices. This training included collaborating with related service providers, utilizing assistive technology and differentiating curriculum for children with development delays and disabilities. The authors noted significant attitudinal shifts for both professional and paraprofessional staff after receiving the trainings. Before training, staff expressed their concern that they did not understand what constituted “inclusion education” and they were inadequately prepared to support the needs for a disability-inclusive classroom for families of children with disabilities. After completing the training, the staff reported an increase in both understanding and interest of supporting young children with developmental delays and disabilities. Early childhood settings provide opportunities for staff to address implicit bias that may influence negatively educational opportunities. Measuring and collecting data about current approaches to disability-inclusive early childhood practices could provide educators a baseline of how to address specific issues. ECE leaders should use data to make decisions regarding training to promote disability-inclusive best practices.

Implicit bias assessments completed by staff would assist in creating data driven trainings, discussions, and other activities and provide opportunities for honest conversations regarding delicate issues that are often avoided. These discussions can serve as qualitative data from which to base ongoing decision-making as well. Future professional development can pair current special educators with general educators of best practices to support disability-inclusive practices in the classroom. Finally, facilitating peer support within heterogeneous small group instruction will provide young children with disabilities support from both teachers and their peers to access their curriculum (Capatosto, 2015). Addressing disability implicit bias in early childhood education is imperative for improving outcomes for young children with developmental delays and disabilities. Increasing awareness amongst educators regarding implicit bias can facilitate necessary instructional and attitudinal shifts in the classroom. As educators shed their biases they will create more welcoming environments for young children with disabilities establishing a foundation for learning, positive self-identity, and self-confidence.

Sharice Lane (Diversity Fellow, 2017-2018)

References

Capatosto, K. (2015). Implicit Bias Strategies. Kirwin Institute, Ohio State University. Available at: http://kirwaninstitute.osu.edu...

Ntuli, E., & Traore, M. (2013). A study of Ghanaian early childhood teachers’ perceptions about inclusive education. The Journal of the International Association of Special Education, 14(1), 50-57.


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Skipping the Straw: The Intersection of Sustainability and Accessibility

Julia Camilli October 30, 2018

The city of Seattle’s July 1st ordinance, closely followed by Starbucks’ July 9th announcement that the company will eliminate their use of plastic straws globally by 2020, have prompted a national discussion around the intersection of sustainability and accessibility. While these recent policy decisions are at the forefront of a necessary environmental push to reduce plastic waste in oceans, plastic straw bans promote sustainability at the cost of accessibility to all, serving as poignant examples of how cities and corporations alike often neglect the needs and voices of people with disabilities.

On July 1st, Seattle became the first major U.S. city to ban the use of plastic straws and utensils, with businesses facing a fine of up to $250 if they are found to be in violation of the ban. Starbucks followed suit a little over a week later, announcing a gradual phasing out of single-use plastic straws through use of a strawless lid or alternative-material straw options available in their stores around the world. This global commitment is projected to eliminate more than one billion plastic straws per year from Starbucks stores. Other businesses and cities are likely to follow suit, with American Airlines, San Francisco, and New York having already vowed or currently considering eliminating the use of straws. Out of all plastic that pollutes the oceans, the question remains: why straws?

Straw bans have quickly gained popularity in recent months because they serve as an easy, low-commitment, initial entry point into the larger issue of plastic pollution. It is simple, effective, and relatively convenient for able-bodied consumers to go without a plastic straw. Buoyed by catchy slogans like “Strawless in Seattle,” “Skip the Straw,” and #stopsucking, straw bans have entered the public’s stream of consciousness with the help of various celebrity campaigns and a disturbing image of a sea turtle with a straw stuck through its nose. The bans help consumers feel that they are doing an environmental good by forgoing the straw while simultaneously raising awareness about the issue of plastic waste in oceans. Yet, bans like Seattle’s ordinance and Starbucks’ recent straw-free announcement exclude the fact that for many people with disabilities, using a plastic straw is a matter of accessibility. Straws are not an amenity or a luxury, but a necessary form of assistive technology that allow consumers with limited mobility to drink. If a business does not include straws when serving beverages, customers with a disability are denied access to a right as basic as something to drink.

Proponents of the straw ban are quick to point out potential accommodations that can be included: there are other materials of straws available, both Seattle and Starbucks’ new policies grant an exception for those with medical or physical needs, and people who truly need straws should bring their own reusable ones. Although all these accommodations exist, they are not friendly to people with disabilities. For consumers who need straws for medical or physical reasons, materials other than plastic do not get the job done. Paper straws dissolve easily and can become a choking hazard, while metal can be too hot or cold, and at times is even painful for those with symptoms like jitters. Plastic straws, although not the most sustainable choice, are currently the best option available due to their low-cost, flexibility for positioning, and ability to safely conduct liquids of different temperatures. Denying people with disabilities access to plastic straws not only restricts what they are able to drink and when they are able to do so, but is fundamentally an issue of accessibility.

Both the city of Seattle and Starbucks included clarifying statements in their respective policies that exceptions would be granted in cases of medical or physical needs. Seattle’s ordinance grants a yearlong exception for those with disabilities through a “waiver for flexible plastic straws, which can be provided to customers who need such a straw due to medical or physical condition” (Archie, Paul 2018). When questioned by the disability community, Starbucks clarified their position in an email, saying “customers are still able to get a straw -- made from alternative materials -- and we will work with the disability community to ensure we continue to meet their needs going forward” (Archie, Paul 2018). Yet, in the case of Seattle, the unfortunate reality is that there does not seem to be widespread awareness of these exemptions. Even if businesses are made aware and have knowledge of an exemption, there is no guarantee that they will automatically comply. This disheartening principle may also play out in Starbucks stores across the country, in addition to the issue that straws made from “alternative materials” are unfriendly for people with disabilities’ use.

Before you ask why can’t people with disabilities merely bring their own reusable straw, take a moment and reflect on why is it that everyone, regardless of ability, doesn’t bring their own straw? Their own reusable mug? Or reusable bag? Simply put, the burden of accessibility should not fall upon people with disabilities. If those who are able-bodied should not be required to carry their own straw around with them, neither should individuals with mobility problems or medical needs. Instead of constantly asking what people with disabilities should be doing to solve the problem, the conversation needs to shift to think of how we can make items accessible to all.

Straw bans are well-intentioned but create a barrier to access for people with disabilities, and the conversation surrounding the bans is representative of a larger issue at hand: why do people with disabilities not have a seat at the decision-making table? By leaving individuals who live the experience of having a disability out of the policy-making conversation, public policy generated by cities and companies alike will continue to exclude those with disabilities. Neither Seattle nor Starbucks appears to have consulted individuals or organizations associated with disability, even when groups such as the Seattle Commission for People with DisAbilities, a volunteer organization whose purpose is to advise the city council or agencies on disabilities issues, are present in the public sphere and more than willing to contribute their thoughts and ideas. By including different voices and perspectives at the decision-making stage of the policy process, sustainability and accessibility can collaborate and complement one another. There is not an absolute choice between one or the other, and with some creative thinking, policies can be designed to be both sustainable and accessible. Inclusivity can ensure environmentally-conscious ideas such as the straw ban do not come at the cost of denying the right to assistive technology.

Julia Camilli (Wellesley '20)

References

1. Anapol, Avery. “Seattle Plastic Straw, Utensil Ban Takes Effect.” TheHill, Capitol Hill Publishing Corp., 2 July 2018, http://thehill.com/policy/energy-environment/395118-seattle-plastic-straw-utensil-ban-takes-effect.

2. Archie, Ayana, and Dalila-Johari Paul. “Why Banning Plastic Straws Upsets People with Disabilities.” CNN, Cable News Network, 12 July 2018, https://www.cnn.com/2018/07/11/health/plastic-straw-bans-disabled-trnd/index.html.

3. Danovich, Tove, and Maria Godoy. “Why People With Disabilities Want Bans On Plastic Straws to Be More Flexible.” NPR, NPR, 11 July 2018, https://www.npr.org/sections/thesalt/2018/07/11/627773979/why-people-with-disabilities-want-bans-on-plastic-straws-to-be-more-flexible.

4. @LCarterLong. “Fabulous. Appreciate you sharing it. Will do the same! RT @JoyceTakako: @JodyJotes @DorfmanDoran @DisVisibility @DREDF @LCarterLong When I don’t have enough spoons to deal with the non disabled I just keep posting this chart. I’m tired.” Twitter, 14 July 2018, 5:59 a.m., https://twitter.com/LCarterLong/status/1018117737405603845.

5. Richardson, Valerie. “Plastic Straw Bans Won’t Save Oceans: ‘We’re Trading a Lot for Nothing’.” The Washington Times, the Washington Times, LLC, 12 July 2018, https://www.washingtontimes.com/news/2018/jul/12/plastic-straw-bans-wont-save-oceans-alarm-disabled/.

6. “Starbucks to Eliminate Plastic Straws Globally by 2020.” Starbucks Newsroom, Starbucks Corporation, 9 July 2018, https://news.starbucks.com/press-releases/starbucks-to-eliminate-plastic-straws-globally-by-2020.

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Inclusion of Children with Disabilities in Early Childhood Programs: US Policy Statements

Kristina Mish & Susu Zhao April 15, 2018

When American society implements policies for inclusion of people with disabilities during early childhood, a tremendous growth will be seen in the social awareness and empathy of the next generation. Teachers and early intervention service providers should be aware of new policy because ultimately it is up to education providers to implement these policies in their classrooms and lay the groundwork for normalizing disability within their students’ everyday life. The Department of Health and Human Services and the Department of Education’s 2015 policy statement on the inclusion of children with disabilities in early childhood programs provides an overview, guidelines, and recommendations for such action.

The underlying reasons for inclusion are backed by scientific studies and legal foundations, as well as economic benefits to society. The Individuals with Disabilities Education Act (IDEA) requires equal opportunities for children with disabilities from birth to age 21. Part B of IDEA mandates special education services and related services for children with disabilities aged three to 21 delivered in the least restrictive environment (LRE). Part C of IDEA provides legal basis for early intervention services for all qualifying infants and toddlers in natural environments, such as the home and the community. The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973 further prohibit discrimination due to disability. The Head Start Act and the Child Care and Development Block Grant Act also support inclusion opportunities for children with disabilities. These laws already dictate the requirements of schools to provide their students with disabilities with equal educational services in the least restrictive environment possible, and the 2015 policy statements reinforces and provides direction for schools to follow through with these services in early childhood programs.

In addition to the scientific and legal foundations for inclusion, the economic benefits to society are significant. Teachers and early intervention service providers also play an integral role in ensuring this aspect of inclusion. Studies conducted on children with disabilities have shown that when children are included from an early stage of development, their social-emotional skills, developmental abilities, and academic prowess are positively impacted. Inclusion of children with disabilities starting from early childhood has been shown to correlate with a greater likelihood of adult employment and higher salaries, a significant return for an early investment in these children. By investing in services and trainings, the government can ensure better outcomes for children with disabilities through inclusion with their peers in educational and community environments. Many lawmakers fear the large up-front costs of programs, but in the long run the government will be saving money in sectors such as unemployment, Medicare, Medicaid, and Social Security. The impact of programs that support children with disabilities will last over time which is what makes them so valuable.


Children without disabilities also benefit from inclusion of children with disabilities through greater empathy and better understanding of diversity and no determent to developmental, academic, social, or behavioral progress. When children with disabilities are segregated into separate environments, disability becomes a foreign concept to their peers. By making inclusion the standard, teachers and providers destigmatize what it means to have an impairment. Implementing the visions of this policy lays the groundwork for creating a new culture that accepts disability and celebrates diversity both in the school system and the broader community.

The policy also outlines clear standards and definitions for the meaning of inclusion of children with disabilities. Teachers and service providers should promote inclusion of children with disabilities with their peers without disabilities. The policy expects providers to encourage participation in all activities, both within the classroom and extracurricular social activities. The use of accommodations, modifications, and scaffolding to address the differing individual needs and abilities is another facet of inclusion. The policy equates inclusion with high-quality childcare and education to emphasize that if a school or care program is not requiring inclusion of children with disabilities, then it cannot be high-quality. The policy also places responsibility upon the states to provide their families comprehensive policies that are sensitive to their cultural needs and streamlines their individualized programs to remove unnecessary burdens that disrupt the child’s progress. Additionally, the policy emphasizes the development of a mixed delivery system for this high quality education through partnerships with private early education program and technical assistance (TA) efforts that reach family child care programs as well as center-based programs to have each early education program equipped to adapt to the specific needs and learning styles of each student.

The process of implementing inclusion, however, comes with its challenges. There seems to be a disconnect between the services provided to the family through early intervention and center-based programs such as preschool special services and child care services as many families struggle to maintaining child care. There is also difficulty in the transition between Part C and Part B, section 619 of IDEA. Although logistics proves a major hurdle for inclusion, one of the prominent obstacles is demonstrated through the resistant attitudes of many providers. Teachers have been inclined to use the special education preschool classroom as a first strategy for children with disability when it should instead be the absolute last resort. Teachers are concerned that the presence of the children in a “typical” or standard classroom setting would disrupt the learning of their peers which has not been supported by research. The bottom line—More needs to be done to equip teachers with the skills they need to be able to teach ALL children, including those with disabilities. Much still needs to be done to be able to achieve the goal of inclusion in every classroom nationwide, but policies such as this one go a long way to making that happen.

Kristina Mish (C’19) and Susu Zhao (C’19)

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ECI in DC: What do we know about Part C Implementation?

Kathleen Ryan March 14, 2018

Early Childhood Intervention (ECI) is provided to infants and toddlers with disabilities or delays by states under Part C of the Individuals with Disabilities Education Act (IDEA). IDEA requires that services be provided in natural settings such as homes, child care centers, or community places, such as grocery stores, playgrounds, and parks, to help the child participate in community activities with other children with or without disabilities or delays.

The Georgetown University Certificate in Early Intervention Program (GUCEI) is a 9-month program that trains ECI professionals to implement evidence-based ECI services as required by the IDEA. GUCEI participants complete a team based capstone project to conclude their studies. The projects evaluate policy and procedures related to ECI programs through Strong Start, the DC Infants and Toddlers with Disabilities Program or other critical aspects of evidence-based intervention.

Ten capstone posters completed between 2014 and 2016 that focused on implementation of Part C in DC were analyzed to identify themes that support evidence-based practices. Three themes emerged: Issues related to Families, the components of the Individualized Family Service Plans (IFSP), and the priorities, concerns, and knowledge of Service Providers.

Families

Home Visiting: What does the MIECHV Program do in DC?

ECI is grounded in what is known as family-centered care. Families play a very important role in ECI since they are the child’s first teachers. IDEA requires that service providers support families, helping them to support their child’s development, understand their specific needs, and ensure that the child is “kindergarten ready.” In addition to Strong Start, the Part C program in DC, the DC Department of Health also supports at-risk families through the Maternal, Infant, Early Childhood Home Visiting (MIECHV) Program. The MIECHV program serves pregnant women and families with children between ages 0 and 5.5 The home visiting programs support women and families to raise a child that is physically, socially, and emotionally healthy. The MIECHV home visits are voluntary. DC has chosen to implement three evidence-based home visiting curriculums:

  • Healthy Families America (HFA) promotes positive parenting to enhance child health and development and prevent child abuse and neglect for socially at-risk families with children from 0 to 5.
  • Parents as Teachers (PAT) provides education and support for parents and families from pregnancy through kindergarten entry.
  • Home Instruction for Parents of Preschool Youngsters (HIPPY) helps parents become their child’s first teacher by providing instructions in the home to prepare their preschool aged (3-5) child for school.10

Home visitors and the MIECHV program collaborate with Strong Start regularly. As part of DC’s Early Success Framework all home visitors receive specific training on referring children to Strong Start if suspected of having a developmental delay or disability. Home visitors are often the first support families receive regarding their children thus they often need to communicate and collaborate with community-based programs to make sure intervention goals, strategies, and messages are consistent among all service providers.10

Home visitors are also trained in a variety of screening tools, like the Ages & Stages Questionnaires (ASQ), which is used to screen infants and young children for developmental delays. Based on the age of the child and the results on the ASQ, home visitors will either refer the family to Strong Start (birth to three) or Early Stages (3 to 5).1 Strong Start or Early Stages will determine if the child is delayed and meets eligibility criteria for services and supports. Once the child is referred, the home visitor needs to follow up with family to support them in creating unique service plan based on the needs of the child. 5

Family Satisfaction with Strong Start Services

Based on the information gathered from GUCEI participants, families are generally happy with the services their child and family received through the Strong Start program. After exiting the program, almost all families who responded to an on-line survey indicated that their child and family benefitted from Strong Start services. Almost all families:

  • received support when their child transitioned out of Strong Start at age 3,
  • were given information about their child’s strengths and needs, and
  • were involved in creating an individualized family service plan (IFSP) for their child.

However, families would like to receive more information on community activities so that the children can be better integrated into the community and socialize with children with and without delays and disabilities.6

The Individualized Family Service Plan

An IFSP is a legal document that describes the resources, priorities, and concerns of the family to identify the family’s desired outcomes, which is then used to guide service delivery. It also outlines the services the team has decided will support the family in reaching the outcomes and provides information to enhance the child’s caregivers’ ability to promote the child’s growth. The IFSP also documents which environments the child will receive services in to meet the individual outcomes. Developing an appropriate strength-based IFSP is critical as the IFSP directs service provision.

GUCEI participants analyzed the quality of IFSPs, assessing the quality of the outcomes written as well as the extent to which requirements of the IFSP were met. Findings indicate that all legal requirements are met, services are provided in the natural environment, and there is an emphasis on the child’s strengths rather than weaknesses. However, IFSPs need to:

  • become more family-centered
  • use less legal and medical terminology
  • prioritize the family’s main concerns
  • reflect the functional skills in the desired outcomes.2

When the outcomes were explored more in depth, the GUCEI participants found that they may be written in a way that it is difficult to interpret them across providers. This miscommunication affects consistency and supports need for clearly established guidelines on writing outcomes.7

Service Providers

Service Provider Perceptions on the Strong Start Process

Service providers play an integral role in coordinating services for children with delays or disabilities. From the first referral to transition into the Strong Start program, over 40 articles of documentation are required from multiple providers at various times. Keeping track of the timeline facilitates the delivery of effective services for children and families while following state and federal regulations. Additionally, tracking progress and effectiveness of interventions will improve efficiency and transparency.3

Strong Start has adopted coaching as an interaction style. Strong Start service providers are required to coach family members, child care workers, teachers, and other caregivers supporting them to help the child meet the IFSP outcomes.4 It is suggested that service providers receive mentoring on how best to integrate services into the classroom and daily routines. This will provide opportunities for service providers to enable the child to participate most fully in activities with other children. It builds upon the caregiver’s existing skills and knowledge to promote the growth and development of children with disabilities.4

GUCEI Graduates Perception on the Training

The GUCEI program has three clear expectations of their graduates. Each graduate is expected to:

  1. Assess infants, toddlers and young children in partnership with their families in the context of their communities
  2. Collaborate to develop a comprehensive Individual Family Service Plan (IFSP)
  3. Use of evidence-based practices to support participation in activities.8

To meet these goals, the participants learn 16 evidence-based practices. Alumni of the program report utilizing certain skills relating to the development of a comprehensive IFSP. For example, 53% of the respondents identified family concerns, priorities, and resources, 59% communicated with families to discuss routines and provide strategies, 59% built relationships with and involved caregivers and team members, and 53% participated in a team to write functional strengths-based outcomes. Alumni also reported on their use of skills relating to evidence-based strategies to promote participation. 53% of the respondents indicated documenting services provided, 42% consulted with caregivers for reflection and joint planning, and 42% monitored and collected information to determine change over time. However, alumni report that they still struggle implementing skills such as supporting families to participate in the decision-making processes and using the coaching approach with caregivers.8

Since the GUCEI program is designed for professionals with early intervention or early childhood service responsibilities, practitioners and policy makers alike, it seeks to empower students to be competent and confident in their knowledge and abilities. Proposed improvement to the program included more face-to-face on-campus interaction and decreased classroom size for the online sessions.8

Conclusion

Based on the information collected for the GUCEI capstone projects, the ECI program by Strong Start in D.C. would benefit from standardizing documentation so that services are consistent, effective, and adhere to the timeline. Using language that is family-centered and reflect family priorities. A special focus on home visiting and coaching are necessary so that caregiver’s and services providers can give children the opportunity to learn in natural environments with other children.

References:

  1. Anderson, J., Daugherty, M., & Hagley, D. (2014). Transitioning from Early Intervention: An On-line Learning Module.
  2. Chimka, J., Curry, C., & Johnson, M. (2014). Quality of Individualized Family Service Plans Created by the District of Columbia, Strong Start Program using the IFSP Rating Scale.
  3. Coates, A. & Agricola, J. (2014). Documentation: Strong Start, Start to Finish.
  4. Cobosco, J. (2016). Collaborative Care: Coaching and Early Intervention in Group Settings.
  5. Davis, E.V. (2016). Ages and Stages: Documented Referrals for DC Maternal, Infant, and Early Childhood Home Visiting Program.
  6. Jackson, J. & Nealy-Shane, D. (2016). DC Strong Start Participant Perceptions of Child & Family Outcomes.
  7. Martinez, E., Rogers, K., & Staton, C. (2015). Reliability of the Goal Functionality Scale III.
  8. Nti-Ampela, A., Brocks, N., & Wise T. (2016). GUCEI Alumni Survey.
  9. Porter, A., Strickland, J., Rogers S., & Behnke, S. (2016). Early Intervention and Center-Based Services Needs.
  10. Young, C. & Hougen, S. (2014). Linking Families to Community Resources: A Home Visitor’s Approach.

Kathleen Ryan (SNHS ’18)

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