EVIDENCEBASED PRACTICES IN EARLY INTERVENTION SERVICE DELIVERY MODELS

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EVIDENCE-BASED PRACTICES IN EARLY INTERVENTION
SERVICE DELIVERY MODELS

• CORINE C. MYERS-JENNINGS
• RUTH H. STONESTREET
• Valdosta State University
• Valdosta, Georgia

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INTRODUCTION

• Speech-language pathologists have been taught in
  pre-service education programs and through
  in-service training to use a treatment model that
  focuses on the remediation of a disorder or
  problem and its consequences. The use of formal
  and informal evaluations, along with

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• informed clinical opinion, was used to highlight
  deficiencies and weaknesses to determine what
  special education services were needed.
  Different types of service delivery models were
  offered pull-out, consultant, collaborative and
  language based.

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• The focus of intervention was on treatment of
  deficient skills. Early intervention services
  have encouraged other models of service
  deliverycoaching, family centered and natural
  environments. In 2000, Dunst described a
  rethinking of service delivery for early
  intervention and compared a traditional

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• paradigm to an evidence-based paradigm. It
  depicts a new set of expected practices that are
  scientifically based and serve as a theoretical
  and conceptual framework for models in early
  intervention. This new paradigm embraces
  practices within capacity building,

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• promotion, strength based, resource based and
  and family centered models (Rush and Shelden,
  2004). In training programs, many delivery models
  are discussed, but few are actually practiced.
  Most of the models focus on remediation of a
  disorder, problem, disease or its consequence.
  The models

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• depend on professional expertise to solve
  problems for people. They focus on correcting a
  persons weaknesses or problems and described
  practices mainly in terms of professional
  services.

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• The models presented in programs are
  professionally centered where professionals are
  viewed as experts who determine the needs of the
  person from their own perspective as opposed to
  the other persons perspective. Conversely,
  family-centered models view

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• professionals as agents of families and
  responsive to family desires and priorities. We,
  as professionals are limited in our view of early
  intervention and early learning if we think of
  childhood services being provided by
  professionals only.

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• Familycentered models embrace the assumptions
  that all families are competent and deserving of
  support. When thinking about service delivery in
  natural environments, professionals must make a
  paradigm shift (Dunst, Hamby, Trivette, Raab and
  Bruder, 2000).

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• As a field, professionals have come from very
  little research in the past to a greater
  understanding of the needs of young children with
  disabilities and their care providers.
• As there is an increase in speech-language
  pathologists working in

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• early intervention settings, it is critically
  important for training programs to provide the
  knowledge, content and skills in evaluation,
  assessment and services to families and their
  infants-toddlers in various environments.

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• Therefore, the question becomes
• Do training programs adequately prepare
  speech-language pathologists for working with
  families and their infants-toddlers in early
  intervention settings?

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METHODS

• A survey of speech-language pathologists working
  with infants-toddlers was conducted to determine
  how university training prepared them for working
  with families in early intervention settings.
  Various service delivery models were used in the
  survey

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• to determine the level of skills and knowledge
  and the use of evidence based practices to
  promote professional growth and collaboration
  among professionals. The survey included
  questions regarding the following

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• Number of years worked
• Number of years worked with infants-toddlers
• Work settings/age groups served
• Course work
• Models of service delivery used

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• Fifty (50) surveys were mailed to SLPs
  throughout the states of Georgia and Florida.
• Twenty-five (25) were returned for a return
  rate of 50.

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RESULTS

• Results indicated that the SLPs surveyed had
  varied numbers of years of experience, ranging
  from 2 ½ years to 33 years. Average years of
  experience for the respondents is shown in Chart
  1.

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Years Worked As SLPN25 Participants
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• Of the 25 participants, the average number of
  years worked with infants/toddlers was 13 years,
  and that was for those who had worked 20 years.
  The least amount was zero (0) for the group that
  worked 0-5 years. See Chart 2.

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Years Worked With Infants/ToddlersN25
Participants
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• Types of work settings for the respondents
  varied from private practice, health departments,
  hospitals, public schools, daycare, Head Start
  and other. The percentage of responses from the
  participants for work setting is seen on Chart 3.
  

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Work SettingsN44 Reponses
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• Populations served indicated that Pre-K and
  Kindergarten were the highest percentage followed
  by elementary, toddlers, middle/high school, and
  adults and infants the lowest percentage.
  Respondents often served more than one
  population. See Chart 4.

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Populations ServedN132 Responses
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• Most respondents reported that they worked in a
  variety of types of service delivery models.
  Pullout/clinical received the highest percentage
  (20), followed by consultative (19),
  collaborative (17), natural environment (15),
  family centered(10) and coaching (5). See Chart
  5.

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Types of Service Delivery ModelsN127 Responses
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• Results of course work taken in the respondents
  training program(s) are as follows
• Overall child development
• Yes 80 No 20
• Birth to three
• Yes 76 No 24

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• Family and/or family life
• Yes 16 No 80 No response 4
• Public Law
• Yes 68 No 32
• Types of services provided for infants and
  toddlers
• Yes 36 No 64

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DISCUSSION

• The majority of the SLP respondents to this
  survey indicated that had strong preparedness in
  overall child development. Secondly, they
  indicated that they had taken courses focusing
  on children birth to three. However, these
  courses were mainly in

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• language development. The need for courses in
  knowledge and skills in evaluation, assessment
  and services to the family and to infant/toddler
  in various environments were needed. The
  majority of the SLPs serving infants/toddlers had
  20 years

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• of experience and had received training from
  continuing education offerings and courses taken
  after graduation.
• This preliminary study indicates that there is a
  need for a change in university training
  programs curricula in order for SLPs to increase

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• their level of knowledge and skills to work with
  families and their infants/toddlers in early
  intervention settings.
• Further studies are planned.

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• References
• Bricker, D. (2000). Inclusion How the scene
  has changed. Topics in Early Childhood Special
  Education, 20(1), 14-19.
• Capers, V. Theilheimer, R. (2000). Hands on,
  hands off, hands out. Zero to Three, June/july
  2000, 5-16.
• Dunst, C. J. (2000). Revisiting rethinking
  early intervention. Topics in Early Childhood
  Special Education, 20, 95-104.

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• Dunst, C.J., Bruder, M.B., Trivette, C.M.,
  Hamby, D. (in press). Young childrens natural
  learning environments Contrasting approaches to
  early childhood intervention result in
  differential learning opportunities.
  Pyschological Reports.
• Dust, C.J. Trivette, C.M., Custspec, P.A. (2002)
  Toward an operational definition of
  evidence-based practices. Centerscope, I(1),
  1-10.

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• Dunst, C.J. Bruder, M.B., Trivette, C.M., Hamby,
  D., Raab, M., McLean, M. (2001).
  Characteristics and consequences of everyday
  natural learning opportunities. Topics in Early
  Childhood Special Education, 21, 68-92.
• Rush, D.D., Shelden, M.L., Hanft, B.E. (2003).
  Coaching families and colleagues A process for
  collaboration in natural setting, Infants and
  Young Children. 16(1) 33-47

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• Rush, D.D Shelden, (2004) Moving to an
  Evidence-Based Practice Model in Early
  Intervention. Georgias BCW Evidence-Based
  Practice Model, 2-13.
• McWilliam, R.A.(Ed.) (1996). Rethinking pull-out
  services in early intervention. Baltimore, MD
  Paul Brookes Publishing.
• McWilliam, R.A.Young, H.J. Harville, K. (1996).
  Therapy services in early intervention Current
  status, barriers, and recommendations. Topics in
  Early Childhood Special Education, 16(3),
  348-374.

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FURTHER INFORMATION

• CONTACT
• Corine C. Myers-Jennings, Ph., CCC-SLP
• cmjennin_at_valdosta.edu
• Ruth H. Stonestreet, Ph.D., CCC-SLP
• rstonest_at_valdosta.edu