ERIC Identifier: ED295399
Publication Date: 1988-03-00
Author: Smith, Barbara J.
Source: ERIC Clearinghouse on
Handicapped and Gifted Children Reston VA.
Does Early Intervention Help? ERIC Digest #455. Revised.
Early intervention applies to children of school age or younger who are
discovered to have or be at risk of developing a handicapping condition or other
special need that may affect their development. Early intervention consists in
the provision of services such children and their families for the purpose of
lessening the effects of the condition. Early intervention can be remedial or
preventive in nature--remediating existing developmental problems or preventing
Early intervention may focus on the child alone or on the child and the
family together. Early intervention programs may be center-based, home-based,
hospital-based, or a combination. Services range from identification--that is,
hospital or school screening and referral services--to diagnostic and direct
intervention programs. Early intervention may begin at any time between birth
and school age; however, there are many reasons for it to begin as early as
WHY INTERVENE EARLY?
There are three primary reasons for intervening early with an exceptional
child: to enhance the child's development, to provide support and assistance to
the family, and to maximize the child's and family's benefit to society.
Child development research has established that the rate of human learning
and development is most rapid in the preschool years. Timing of intervention
becomes particularly important when a child runs the risk of missing an
opportunity to learn during a state of maximum readiness. If the most teachable
moments or stages of greatest readiness are not taken advantage of, a child may
have difficulty learning a particular skill at a later time. Karnes and Lee
(1978) have noted that "only through early identification and appropriate
programming can children develop their potential" (p. 1).
Early intervention services also have a significant impact on the parents and
siblings of an exceptional infant or young child. The family of a young
exceptional child often feels disappointment, social isolation, added stress,
frustration, and helplessness. The compounded stress of the presence of an
exceptional child may affect the family's well-being and interfere with the
child's development. Families of handicapped children are found to experience
increased instances of divorce and suicide, and the handicapped child is more
likely to be abused than is a nonhandicapped child. Early intervention can
result in parents having improved attitudes about themselves and their child,
improved information and skills for teaching their child, and more release time
for leisure and employment. Parents of gifted preschoolers also need early
services so that they may better provide the supportive and nourishing
environment needed by the child.
A third reason for intervening early is that society will reap maximum
benefits. The child's increased developmental and educational gains and
decreased dependence upon social institutions, the family's increased ability to
cope with the presence of an exceptional child, and perhaps the child's
increased eligibility for employment, all provide economic as well as social
IS EARLY INTERVENTION REALLY EFFECTIVE?
After nearly 50 years of research, there is evidence--both quantitative
(data-based) and qualitative (reports of parents and teachers)--that early
intervention increases the developmental/educational gains for the child,
improves the functioning of the family, and reaps long-term benefits for
society. Early intervention has been shown to result in the child: (a) needing
fewer special education and other habilitative services later in life; (b) being
retained in grade less often; and (c) in some cases being indistinguishable from
nonhandicapped classmates years after intervention.
Disadvantaged and gifted preschool-aged children benefit from early
intervention as well. Longitudinal data on disadvantaged children who had
participated in the Ypsilanti Perry Preschool Project showed that they had
maintained significant gains at age 19 (Berrueta-Clement, Schweinhart, Barnett,
Epstein, Weikart, 1984). These children were more committed to schooling and
more of them finished high school and went on to postsecondary programs and
employment than children who did not attend preschool. They scored higher on
reading, arithmetic, and language achievement tests at all grade levels; showed
a 50% reduction in the need for special education services through the end of
high school; and showed fewer anti-social or delinquent behaviors outside of
school. Karnes (1983) asserts that underachievement in the gifted child may be
prevented by early identification and appropriate programming.
IS EARLY INTERVENTION COST EFFECTIVE?
The available data emphasize the long-term cost effectiveness of early
intervention. The highly specialized, comprehensive services necessary to
produce the desired developmental gains are often, on a short-term basis, more
costly than traditional school-aged service delivery models. However, there are
significant examples of long-term cost savings that result from such early
--A longitudinal study of children who had participated in the Perry
Preschool Project (Schweinhart and Weikart, 1980) found that when schools invest
about $3,000 for 1 year of preschool education for a child, they immediately
begin to recover their investment through savings in special education services.
Benenfits included $668 from the mother's released time while the child attended
preschool; $3,353 saved by the public schools because children with preschool
education had fewer years in grades; and $10,798 n projected lifetime earnings
for the child.
--Wood (1981) calculated the total cumulative costs to age 18 of special
education services to child beginning intervention at: (a) birth; (b) age 2; (c)
age 6; and (d) at age 6 with no eventual movement to regular education. She
found that the total costs were actually less if begun at birth! Total cost of
special services begun at birth was $37,273 and total cost if begun at age 6 was
between $46,816 and $53,340. The cost is less when intervention is earlier
because of the remediation and prevention of developmental problems which would
have required special services later in life.
--A 3-year follow-up in Tennessee showed that for every dollar spent on early
treatment, $7.00 in savings were realized within 36 months. This savings
resulted from deferral or special class placement and institutionalization of
severe behavior disordered children (Snider, Sullivan, and Manning, 1974).
--A recent evaluation of Colorado's state-wide early intervention services
reports a cost savings of $4.00 for every dollar spent within a 3-year period
(McNulty, Smith, and Soper, 1983).
ARE THERE CRITICAL FEATURES TO INCLUDE IN EARLY INTERVENTION?
While there have been too few attempts to determine critical features of
effective early intervention programs, there are a few factors which are present
in most studies that report the greatest effectiveness. These program features
include: (a) the age of the child at the time of intervention; (b) parent
involvement; and (c) the intensity and/or the amount of structure of the program
--Many studies and literature reviews report that the earlier the
intervention, the more effective it is. With intervention at birth or soon after
the diagnosis of a disability or high risk factors, the developmental gains are
greater and the likelihood of developing porblems is reduced (Cooper, 1981;
Garland, Stone, Swanson, and Woodruff, 1981; Maisto and German, 1979; Strain,
Young, and Horowitz, 1981).
--The involvement of parents in their child's treatment is also important.
The data show that parents of both handicapped and gifted preschool-aged
children need the support and skills necessary to cope with their child's
special needs. Outcomes of family intervention include: (a) the parent's ability
to implement the child's program at home; and (b) reduced stress that
facilitates the health of the family. Both of these factors appear to play an
important role in the success of the program with the child (Beckman-Bell, 1981;
Cooper, 1981; Garland and others, 1981; Karnes, 1983; Lovaas and Koegel, 1973;
Shonkoff and Hauser-Cram, 1987).
--Certain "structural" features are also related to the effectiveness of
early intervention, regardless of the curriculum model employed. Successful
programs are reported to be more highly structured than less successful ones
(Shonkoff and Hauser-Cram, 1987; Strain and Odom, in press). That is, maximum
benefits are reported in programs that: (a) clearly specify and frequently
monitor child and family behavior objectives; (b) precisely identify teacher
behaviors and activities that are to be used in each lesson; (c) utilize task
analysis procedures; and (d) regularly use child assessment and progress data to
modify instruction. In addition to structure, the intensity of the services,
particularly for severely disordered children, appears to affect outcomes.
Individualizing instruction and services to meet child needs also is reported to
increase effectiveness. This does not necessarily mean one-to-one instruction.
Rather, group activities are structured to reflect the instructional needs of
FOR MORE INFORMATION
Beckman-Bell, P. "Needs of Parents with Developmentally Disabled Children."
In A NATIONAL REVIEW PROJECT OF CHILD DEVELOPMENT SERVICES: A STATE-OF-THE-ART
SERIES, edited by R. Wiegerink and J. M. Bartel. Chapel Hill, NC: University of
North Carolina, Frank Porter Graham Child Development Center, l981.
Berrueta-Clement, J. R., and others. CHANGED LIVES: THE EFFECTS OF THE PERRY
PRESCHOOL PROJECT ON YOUTHS THROUGH AGE 19. Ypsilanti, MI: High/Scope
Educational Research Foundation, 1984.
Cooper, J. H. AN EARLY CHILDHOOD SPECIAL EDUCATION PRIMER. Chapel Hill, NC:
Technical Assistance Development System (TADS), 1981.
Garland, C., N. W. Stone, J. Swanson, and G. Woodruff, eds. EARLY
INTERVENTION FOR CHILDREN WITH SPECIAL NEEDS AND THEIR FAMILIES: FINDINGS AND
RECOMMMENDATIONS. Westar Series Paper No. 11. Seattle, WA: University of
Washington, 1981. ED 207 278.
Karnes, M. B., ed. THE UNDERSERVED: OUR YOUNG GIFTED CHILDREN. Reston, VA:
The Council for Exceptional Children, 1983.
Karnes, M. B., and R. C. Lee. EARLY CHILDHOOD. Reston, VA: The Council for
Lovaas, O. I. and R. L. Koegel "Behavior Modification with Autistic
Children." In M. C. Thoresen ed., BEHAVIOR MODIFICATION IN EDUCATION. Chicago:
University of Chicago Press, 1973.
Maisto, A. A., and M. L. German. "Variables Related to Progress in a
Parent-Infant Training Program for High-Risk Infants." JOURNAL OF PEDIATRIC
PSYCHOLOGY 4 (1979): 409-419.
McNulty, B., D. B. Smith, and E. W. Soper. EFFECTIVENESS OF EARLY SPECIAL
EDUCATION FOR HANDICAPPED CHILDREN. Colorado Department of Education, 1983.
Schweinhart, L. J., and D. P. Weikart. YOUNG CHILDREN GROW UP: THE EFFECTS OF
THE PERRY PRESCHOOL PROGRAM ON YOUTHS THROUGH AGE 19. Ypsilanti, MI: High/Scope
Educational Research Foundation. 1980.
Shonkoff, J. P. and P. Hauser-Cram. "Early Intervention for Disabled Infants
and Their Families: A Quantitative Analysis." PEDIATRICS 80 (1987): 650-658.
Snider, J., W. Sullivan, and D. Manning. "Industrial Engineering
Participation in a Special Education Program." TENNESSEE ENGINEER 1 (1974):
Strain, P. S., and S. Odom. "Innovations in the Education of Preschool
Children with Severe Handicaps." In R. H. Horner, L. M. Voeltz, and H. B.
Fredericks, eds., EDUCATION OF LEARNERS WITH SEVERE HANDICAPS: EXEMPLARY SERVICE
STRATEGIES. (In press).
Strain, P. S., C. C. Young, and J. Horowitz. "Generalized Behavior Change
During Oppositional Child Training: An Examination of Child and Family
Demographic Variables." BEHAVIOR MODIFICATION 1 (1981): 15-26.
Wood, M. E. "Costs of Intervention Programs." In C. Garland and others, eds.,
EARLY INTERVENTION FOR CHILDREN WITH SPECIAL NEEDS AND THEIR FAMILIES: FINDINGS
AND RECOMMENDATIONS. Westar Series Paper No. 11. Seattle, WA: University of
Washington, 1981. ED 207 278.