DOCUMENT RESUME

ED 102 778 EC 071 447

AUTHOR Grim, Janet, Ed.TITLE Training Parents to Teach; Four Models. First Chance

for Children, Vol. 3.INSTITUTION North Carolina Univ., Chapel Hill. Technical

Assistance Development System.SPONS AGENCY Bureau of Education for the Handicapped (DHEW/OE),

Washington, D.C.NOTE 88p.; For related information see ED 067 798, 073

581, 082 422, and 093 116; a few pages may reproducepoorly due to color of original copy

EDRS PRICE MF-$0.76 HC-$4.43 PLUS POSTAGEDESCRIPTORS *Conceptual Schemes; *Delivery Systems; Demonstration

Projects; Exceptional Child Education; *HandicappedChildren; *Individualized Instruction; *Models;*Parent Education; *Parent Role; Preschool Education;Program Descriptions; Training Techniques; Transferof Training

IDENTIFIERS Developmental Disabilities; First Chance Network;TADS; Technical Assistance Delivery System

ABSTRACTDescribed in a monograph published by the Technical

Assistance Delivery System (TADS) are the rationale, intake andscreening procedures, service delivery, liaison and follow through,and evaluation of parent training models from four preschooldemonstration centers for handicapped children. An overview discussesthe purposes and dimensions of parent training (social and emotionalsupport, exchange of informationo opportunities for parentparticipation, and improvement of parent child interactions). Theuniversity-affiliated program at the University of Washington, anexample of a center-based parent training model, offers short-term,individualized parent training emphasizing home carryover of datakeeping and behavior modification programs. Reviewed are threevariations of the home-center parent training model: the carryover byparents of school instruction to the home, the teaching of new skillsin the home, aid the training of parents as volunteers in the center.Examples of parent lessons and child progress are included. Parentparticipation in a home-based program is exemplified in the PortageProject model which uses weekly prescriptions guaranteeing successfor the parent and child. Finally, the parent implemented preschoolmodel as seen in the Regional Intervention Program in Nashville,Tennessee is described in terms of the individual tutoring,generalization, and classroom training modules. An annotatedbibliography of 18 citations is provided- (CL)

co

1:2, TRAINING PARENTS TO TEACH

DEPARTMENTOFALIN,

EDUCATION &WELFARENATIONAL INSTITUTE

OF

EDUCATION

THIS DOCUMENTHAS BEEN REPRO

DUCED EXACTLYAS RECEIVED FROM

THE PERSON OR ORGANIZATIONORIGIN

ATING IT POINTS OF VIEW OR OPINIONS

STATED DO NOT NECESSARILYREPRE

SENT OFFICIALNATIONAL INSTITUTE

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EDUCATIONPOSITION OR POLICY

FOUR MODELSBy

David 1. LillieRice H. Ha.gden

H. D. Bud FredricksVictor L. Baldwin

David GroveMarsha S. Shearer

Ron Wie±gerinkVince P-arrish

,Q)Edited by Janet Grim

first chance forchildtenvolume3

,he

in 1968 the enactment of the HandicappedChildren's Early Education Act authorized theestablishment and operation of model early edu-cation projects. These hundred projects are collectively referred to as the First Chance Network.The responsibility for admin,stering this nElw pro-gram was accepted by the. Bureau of Educationfor the Handicapped, Office of Eckication. Theprojects are designed to develop a:id demonstrateeffective approaches in assisting handicappedchildren during their early years and are struc-tured so that other commu:lities can replicate, oradopt, exemplary components of the projects tomeet their own meds !n similar projects.

The Bureau of Education for the Handicappedhas as its overall goal the equalization of educa-tional opportunity for handicapped children byproviding the leadership and resources neededto help the handicapped achieve their fullestpotential and participate constructively in societyto their maximum abilities. The long-range ob-jective of the Handicapped Children's Early Edu-cation Program is to stimulate services to allestimated 1,000,000 preschool-aged handicappedchildren by 1980.

Technical Assistance Development System(TADS) was established :1 Chapel Hill, N. C. byB.E.H. to provide a wide array of special supportservices for the network of centers. Some of theservices include identifying and providing con-sultants, holding small group workshops, collect.ing and dispensing data about the network, andconferring with individual centers and staffs.Most often, services are offered to First Chanceprojects in the areas of program planning andevaluation, intervention programs, communityprogram development, and media and informa-tion.

First Chance for Children is a series ofmonographs published for the First Chance Net-work. The subject matter is drawn from theknowledge, skills, and techniques of the peoplewho work within the First Chance Network andis collected and published by the TechnicalAssistance Development System.

This monograph is distributed pursuant toa grant from the Office of Education, U.S. Depart-ment of Health, Education, and Welfare. Granteesundertaking such projects under governmentsponsorship are encouraged to express freelytheir judgment in professional and technicalmatters. Points of view or opinions do not, there- Managing Editorfore, necessarily represent official Office of Edu- Designercation position or policy. Typist

616

Rosemary EptingSusan AlmonHelen Knight

CHAPTER 1

CHAPTER 2

CHAPTER 3

CHAPTER 4

CHAPTER 3

CONTENTSDimensions in Parent Programs: An Overview

By David L Lillie

A Center Based Parent Training model 11

By Alice H. Hayden

A Home-Center Based Parent Training Model 27By H. D. Bud Fredricks

Victor L BaldwinDavid Grove

A Home Based Parent Training Model 49By Marsha S. Shearer

A Parent Implemented Preschool Program 65By Ron Wie_gerink

Vince rrish

ANNOTATED BIBLIOGRAPHY 77

WPI

ER

1

Dimensions in Parent Programs:An Overview

There is no doubt in contemporary thoughtabout child development and early educationthat the extent of parent and family involvementis becoming more pervasive. Parents all acrossthe country are finding themselves engaged inactivities ranging from listening to a lecture at aparent meeting to making decisions about thedirection that a child development programshould take. Why this sudden rush to involveparents and families? Is a high level of parentalinvolvement necessary for the success of i childdevelopment program? Are parent-oriented pro-grams to take the place of child-oriented pro-grams? What approaches are most successful?Certainly we don't have the answers to all of thequestions that are being raised. But we do havea substantial base of knowledge to draw on as wediscuss the dimensions of parent and family pro-grams for the development of young children.particularly young children with special problems.

One substantial pool of knowledge of parentprogramming is the First Chance Network. Offici-ally known as the Handicapped Children's EarlyEducation Program, this network represents acomprehensive attempt to demonstrate a numberof educational approaches for young handicapped

I

By David L. Lilliechildren. Al of the demonstration programs (morethan one hundred) in this network have parentprograms. The purpose of this monograph is toprovide information that will assist you in con-ceptualizing, planning, and implementing parentprograms. Represented in this volume are FirstChance projects with exceptionally good parentprograms from across the country.

WHY PARENT AND FAMILY PROGRAMSThere are a number of good reasons why

these and other projects are attPA:ipting to involveparents in their child development efforts. As thenumbers of educational programs for young chil-dren have increased rapidly over the last fewyears, there has been a mounting awareness ofthe need to involve parents in these efforts. Re-search efforts, such as the work of Gray (1970),Karnes, et. al. (1970), and Livenstein (1970) pointout that educational efforts in day care centers,nurseries, Head Start centers, and public schoolsshould be augmented with parent training pro-grams. After an extensive review of the researchliterature on infant-mother interaction, Streiss-guth and B (1972) conclude that the teaching

1

style used by the mother is very important inshaping early motivation and cognitive func-tioning.

Unless we develop effective parent programsas a major element of a child development triadof parents, child, and the program, these effortsare destined to only marginal success. Duringthe early years of life, a large proportion of whatthe young, developing child learns will occur inthe child's home environment. The parent, partic-ularly the child's mother or mother surrogate,will be the primary "teacher." This does notchange even if the child is enrolled in a sub-stitute care situation such as a day care center.

It is interesting to note that Schae:er (1972)concludes his review of research on the effectsof parent training programs by stating that thesetypes of programs do provide an effective supple-ment or even an alternative for pre-school edu-cation. It is logical to assume that unless thereis planned consistency between the center's edu-cational program and the experiences takingplace in the home environment, the experienceprovided in the center program may have littleeffect on the child's development. Communica-tion between parents and program staff is im-portant not only for coordination of trainingbetween home and center, but also to provide thestaff with valuable information about each childand how he is developing in the home. If parentswill relate their observations of the child's be-havior in the home to the center staff, moremeaningful activities can be planned for thechild within the center or school.

It is being more widely acknowledged that theparents of children in child development centersare one of the primary consumers of servicesAs consumers who are paying for a service, if nct

2 10;i

through fees then through public taxes, parentsshould participate in planning activities to assurethat they receive the type of services they want.The gap between parents' expectations and theservices provided by the center or school mustbecome as narrow as possible through coopera-tion and coordination.

It goes without saying that parents and pro-gram personnel contribute uniquely to the prog-ress of the child. Parent and child interactionmust be as productive and adaptive as possible;parents should be encouraged to provide anemotionally warm, secure relationship with theirchild, end to reinforce positive behavior.

Very often when parents recognize the ex-istence of problems, they have a tendency tofocus on those concerns and to ignore the morepositive aspects of we child's functioning. Indoing this, they may overlook normal aspects ofthe child's development. When parents noticethat a child is having difficulty in accepting ap-propriate limits or discipline, they may feel theyoungster is not developing an adequate respectfor authority and may become apprehensiveabout the possibility of serious consequencesduring adolescence and later life. They may notnotice the times when the child's behavior isquite appropriate or they may not respond to thatbehavior. To the contrary, they may be constantlyon guard for misbehavior and may even set upartificial situations in which they attempt to exertauthority.

In most child development programs, thereis a lot of similarity between program and parents'needs. Both are concerned with tne optimal de-velopment of the child in all dimensionsphysi-cal, emotional, intellectual, and interpersonal.Both aim at the child's reaching the highest pos-

sible level of adaptation. The program needs theparents' cooperation and assistance in a varietyof ways; and parents need support, advice, direc-tion, and information from the program personnel.None of this can be accomplished unless there isa close, compatible working relationship betweenthe program staff and the family.

In conclusions there are two general pur-poses for providing viable parent programs inearly childhood education: to improve the center'sability in providing effective services to childrenthrough their parents and to provide a supportivesystem for parents in accepting the role asparent and fulfilling their personal needs asindividuals.

DIMENSIONS OF PARENT PROGRAMSThere are at least four major conceptual

areas in planning parent programs that youshould consider in a precise and systematicmanner: supporting parents emotionally, exchang-ing information with parents, improving parent-child interactions, getting parents to participatein your program. Although the main focus of thedelivery system presented in this monograph ison improving parent-child interactions throughparent training, it is important to place this vitalarea in perspective with some other importantdimensions.

Social and Emotional SupportThe purpose ofactivities in this area is two-fold: to reduce anxie-ties caused by guilt feelings and feelings of in-adequacy in the family, and to provide sociallystimulating activities which increase positivefeelings about the family unit as well as theparents' feelings toward themselves as competentparents.

The birth of a child into a family is by itselfa potential life crisis. In a discussion of the needto attend to emotional and social needs of par-ents, Enzer (1973) stresses the potential for crisisin the family and the crucial role the center staffplay in supporting the parents as an ii.dividual.

As parents strive to fulfill their role success-fully there arise many self doubts, resentment of,and confrontations with the child. It is quite evi-dent that one focus :n parent programs shouldbe on meeting the parent's emotional and socialneeds of this kind.

A few parents, because of prior emotionaldifficulties or lack of emotional support, may beoverwhelmed by their feelings. These parents maynot be relieved by venting their feelings and mayneed additional professional help. However, thesincere teacher or child worker who listens care-fully can give adequate support to most parents.Often the objective in this area is to increase inthe parents a positive attitude toward their roleas an educator of their child and perhaps, moreimportant, to increase their feelings about theirown importance as a worthwhile human being.

There are many ways to meet social andemotional needs of parents once you have identi-fied what those needs are. Often the activitiescenter around a regularly scheduled meeting ofa group of parents. Topics in these meetings mayvary from discussing various types ofcraft activi-ties that parent and child can do together tolistening to book reviews or formal lectures fromprofessionals. For the group meetings to be suc-cessful it is important that the members of thegroup indicate to one another through theiractions as well as their words that these meetingshold value for them.

3

Exchanging informationActivities for parents inthis area should lead to the following goals: (1)providing parents with an understanding of therationale, objectives, and activities of the programin which their child is enrolled; (2) developing anunderstanding of the continuous growth and de-velopment of the child as they apply to the child'sinteractions in the home; and (3) providing theproject personnel with background informationon the child to facilitate the effectiveness of thecenter program. This should include descriptionsof the child's activities in the home.

There are many different kinds of informationthat you can and should be giving parents aboutthe program. Well-thought-out discussions orwritten information indicating what you hope toaccomplish during the year is extremely importantto keep the parents' support and interest. Forexample, the parents should know what kind ofchanges in their child or accomplishments bytheir child they should be able to see. When thesegoals have been articulated well, the parents willthen understand the relationship and purpose ofthe many activities that go on during the year tothe intended goals. Periociically parents shouldbe given a preview of the schedule of activitiesthat lie ahead for their child, and at this timethe importance of the sequence of these eventsand the end results should be presented.

Routine information flowing from your pro-gram to parents is essential. Scheduling, specialevents, parent conference schedules, fee sched-ules (if fees are collected) are examples of routineinformation that may be changing often. Some-times this is accomplished through a newsletter.or a form letter, or by a telephone call.

There is a great deal of information thatshould be received by the center from the parents

414;

about the home and child for the sake of con-sistency between the center's methods and pro-grams and those used in the home. For instance,such information as what the child likes and dis-likes, what kinds of things occupy his time athome, what toys are available in the home, whatthe relationship is between brothers and sistersand the child can be invaluable to the center.Answers to these questions and many others willhelp the center personnel to understand thechild's behavior he is at the center.

Many programs provide information to par-ents on.child-rearing practices and child develop-ment sequences. Often workshops are provided toassist parents in specific areas of child-rearingsuch as "teaching your child to talk," or "disci-plining your child." This kind of information-giving, however, overlaps with what we refer toas parent-child interaction, which we discussnext.Parent ParticipationThe purpose of activities inthis area is to involve parents in the ongoingactivities of the program. The assumption is thatby productively utilizing the parents in activitiessuch as being a teacher's aide, the parents' feel-ings of self-worth will be enhanced. Theirunderstanding of children will increase, and alarger repertoire of experience and activity for theparents to draw upon for interaction with theirown child will be developed. Another importantpurpose for parent participation in the programis to provide needed manpower for the successfulfunctioning of ongoing activities.

Although this area may overlap to some ex-tent with the other areas already discussed, thereare a number of program objectives that you maywant to pursue in this area alone. Parents needto be involved in some of the basic program

I

decision-making, perhaps as member, of an ad-visory group. After all, the parent is one of thetwo primary consumers of your services. Parentsare also involved in financing the programsthrough fees or taxes. It is therefore reasonablethat the program be accountable to parents inprogram decisions.

This is not to say that parents should uni-laterally make program decisions. On the contrary,the program staff are the trained professionalsand should be able to provide viable alternativesfor most aspects of the program. Parents will lookto the staff for leadership in program decisionsand will expect it. In return, the center personnelshould expect from them valuable assistance inprogram decision-making.

For years many programs have found thatparents make excellent volunteer aides. Underthe direction of the teacher or child worker theparent side can be involved in such activities asproviding learning experiences for children,monitoring and assisting in lunch and snacks,assisting in taking off and putting on heavy wraps,constructing learning materials, and providingtransportation.

Usually most groups of parents have somemembers with special skills, such as carpentry,baking, or storytelling. Other parents may havehad interesting jobs or interesting experiences,and they can be utilized as resources for programactivities from time to time.Improving Parent-Child InteractionsThe fourthdimension of parent programs is the primaryfocus of this monographtraining parents to be-come more effective child rearers.

Activities that you plan in this area shouldbe designed to improve the effectiveness o" par-ents as teachers and "rearers" of their child. The

parent, through the years, will be the child'sprimary source of information. Hence, the parentsmust be capable of providing meaningful inter-action with their child to stimulate cognitive,emotional, and social development.

To facilitate parent-child interaction, yourprogram should provide opportunities for parentsto develop skills in (1) general child-rearingpractices, (2) promoting and fostering social andemotional development, (3) utilizing and optimiz-ing everyday experiences, (4) fostering and en-couraging language growth, and (5) utilizingeffectively the community resources available toassist the child in learning activities.

Although perhaps an over-simplification, mostprograms can be identified as following one ofthese three models: a behavioral model, a psy-chological insight model, and an experiencemodel. The behavioral model employs a greatdeal of what we know about learning and de-velopment in a systematic, structured manner.In this approach, the parents are first taught somebasic terminology avid understanding of rein-forcement principles. They are also helped to de-velop their abilities to observe and quantify, orcount, the frequency with which various actionsof the child occur. The next step usually involvesthe parents in observing and counting frequencyof behavior as well as in administering varioustypes of positive reinforcers to the child. After itis apparent that these skills have been developedin the parent, there usually follows a long, formalrelationship between the program personnel andthe parent. Perhaps oncs a week or at anotherset time interval, the parent will review with aprogram specialist the results of his interactionswith the child by presenting and discussing thebehavior frequency charts which he continual,y

sa5

uses. As specific patterns of reinforcement be-come part of the parent's repertoire, often thecharting of behavior is dropped.

A number of behavior modification programsare available today. Parents as Teachers, A ChildManagement Program (1971) is designed to helpparents learn to be more effective teachers oftheir children. Living With Children (1968) isanother often-used book which details the man-ner in which parents actually teach their child.The parent training approaches presented in ther'ext chapters have a strong behavioral founda-tion even though they represent quite differentdelivery approaches.

The psychological insight model deals withdeveloping an understanding in parents aboutwhy children behave the way they do, based onanalysis of interactions between parent and child.This approach has been popularized through theworks of Haim Ginott (Between Parent and Child,1959) during the last few years. This approachemphasizes solving conflict situations throughdeveloping "insight" into the causes of the prob-lem. Many programs use lectures and films enchild development or personality development ofthe child to pursue this model. Thomas Gordon'swork in Parent Effectiveness Training (1970) is anexample of a well-known approach that falls intothis category.

Programs following the experience modelwill concentrate on providing systematic experi-ence for parents to use as a mechanism for inter-acting with their children. These experiences maybe highly focused on an area of developmentsuch as the Teach Your Child 41 Talk program(1969), or on an age of development such asWays to Help Babies Grow and Learn (1970). Eachof these programs offers activities and sugges-

C

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tions for the parents in providing developmentalexperiences for their child.

Another recent development in assieing par-ents in providing positive interactions and ex-periences with and for children is the toy lendinglibrary concept. After a discussion of the de-v"lopmental level and needs of the child, theparent is given an appropriate educational toy totake home for the child to play with. Usuallymini-lesson instructions accompany the toy to thehome to give the parent an understanding of howthe toy can be used for learning. Periodically theparent will bring a toy back to the center andtrade it for another which is geared at a slightlyhigher level of developmental learning.

Parents as Resources, a group of parents inIllinois, have put together a series of suggestedactivities to increase the positive interactions be-tween parent and child in the home. They haveprovided two resource books for parents, Recipesfor Fun and / Saw a Purple Cow (1972). These"recipes" provide many arts and crafts activitiesthat parents and children can do together in thehome, emphasizing the use of articles alreadyavailable in most homes.

DELIVERY SYSTEMSThere are four basic service delivery systems

presented in the following pages of this mono-graph: center based, home-center based, homebased, and parent administrated center based.These approaches represent basic organizationaland management procedure: for the delivery ofthe content of the program.

The term "center" as used in this volume isa generic one. That is, it represents any deliverysystem that brings children and parents into acentral location. This central location could be

a preschool classroom in a public school systemor ia clinical classroom in a university or privatesetting. In a center-based delivery system, theparent and family involvement program is oftenancillary or "in addition to" the actual interven-tion activities with children. In the center-basedapproach, the staff-parent interaction takes placealmost entirely at the center. The desired res.'ltof these interactions, whether they are in thecenter or elsewhere, is a positive change in thechild's or parents' behavior. In Chapter Two, Dr.Alice Hayden discusses the important manage-ment dimensions that you must consider in estab-lishing and operating a center-based program.

Another service delivery system, presented inChapter Three, addresses a combination of twosystemsa home- and center-based project. Thisapproach has elements of both the home- andcenter-based projects. However, the interactionbetween these elements represents a need fordifferent organizational procedures than do thetwo systems when approached separately. In ahome-center approach, parent-staff interactionstake place both in the center and hi the home.These interactions are sequential in nature andcall for careful planning and coordiiation be-tween center and home. Drs. Fredericks, Baldwin,and Grove address these considerations as theydraw upon their experience in operating parentprograms in Oregon.

Home-based programs rely almost exclusivelyon p. wit:ling the eaucational intervention throughthe parents to the child. The parent-child inter-actions in the home environment are the primarytargets for change and much of the staff-parentinteraction takes place in the home as well.Horne -based programs do not provide for group-ing of children outside of the home for instruc-

hon. Instead, it is an alternative to a center- orschool-hased program. As in any specific deliverysystem, there are definite advantages and disad-vantages to home-based programs. In addition,the,e are a number of management dimersionsthat the center staff needs to attend to that witvary from other types of delivery systems. ChapterFour discusses these dimensions in detail as theauthor, Marsha Shearer, shares her experiencesin helping .o develop and operate a home-basedprogram for parents of handicapped children.

in addiCon tc these basic delivery systemsthere have been some recent efforts in turningthe entire remagement and operation of parentprograms over to the parents themselves. Thiscensumereperated delivery system is yet anothermodel and it varies in a number of dimensionsfrom the three approaches mentioned above.Authors Ron Wiegerink and Vince Parrish provideus with some insight into the factors to be con-sidered if this alternative is chosen. The authorshave been with a consumer-operated program inTennessee for several years which is currentlyoperating quite successfully.

Each of these following chapters will addressthe following program components: Rationale.This section discusses the theoretical and philos-ophical bases for the approach. Intake andScreening. The task of finding parents withspecific needs is not an easy one. What criteriashould be used to select parents for the program?How do you develop a cooperative spirit withparents? How do you systematically assess theirneeds? Service Delivery. The methodologies usedto deliver need-related services to parents andfamilies are discussed in detail in each chapter.What resources are needed for a particular de-livery system? What are the constraints? Liaison

157

and Follow-through. Continuing contact is an im-portant dimension of parent programs that isoften overlooked. How do you assure that theintended activities are actually ha ling an impacton child; en and their parents as a result of earlierservices? Evaluation. Each of the approaches pre-sented discuss their evaluation procedures. Whatare the necessary steps that must be taken todetermine the degree of success of the programactivities?

Programs for young children with specialneeds cannot afford to exclude parents from theirprocedures. It is anticipated that this monographwill provide the staff members who are responsi-ble for parent programs with the framework tomake decisions as they plan and operate pro-grams for parents and children.

u 68

David L. Lillie, Ed.D., is the director of TADS(Technical Assistance Development System) atthe University of North Carolina at Chapel Hill.He is the co-author of the Beginning to Learncurriculum packages and numerous journalarticles. He received degrees from Indiana Uni-versity and Western Michigan University.

BIBIJOGRRPHYBecker, W. Parents are teachers; a child manage-

ment program. Champaign, Ill.: ResearchPress, 1971.

Cold, Ann, ed al. Recipes for Fun. Winnetta, III.:Parents as Resources, 1970, 42 pp.

Cole, Ann, Hass, Carolyn, Bushell, Faith, andWeinberger, Betty. I Saw a Purple Cow.Boston, Little, Brown, and Co., 1972.

Enzer, N. The child development triad: an over-view of parent-child and professional inter-action. In D. Lillie (Ed.), Parent programsin child development centers. Chapel Hill,N.C.: Technical Assistance DevelopmentSystem, 1972.

Ginott, H. Between parent and child. New York:Avon, 1969.

Gordon, Thomas, Parent Effectiveness Training:The "No-Lose" Program for Raising Re-sponsible Children, New York: Peter W.Hyden, Inc., 1971, 338 pp.

Gray, S., Klaus, R., Miller, J., and Forrester, B.Before first grade. New York: TeachersCollege Press, 1970.

Karnes, M. Goal: language development. Spring-field, Massachusetts: Milton Bradley, 1972.

Levenstein, P. Cognitive growth in preschoolersthrough verbal interactions with mothers.Am. J. Orthoposychiat., 1970.

Patterson, Gerald R., and Gullion, M. Elizabeth.Living with Children: New Methods for Par-ents and Teachers. Champaign, Illinois:Research Press, 1968.

Pushaw, D., Collins, N., Czuchna, G., Gill, G.,O'Betts, G., and Stahl, M. Teach Your Childto Talk. Cincinnati: CEBCO Standard Pub-lishing Co., 1969.

Schaefer, E. Parents as educators: evidence fromcross-sectional, longitudinal, and interven-tion research. In W. Hartnup (Ed.), Theyoung child. Washington National Associa-tion for the Education of Young Children,1972.

Segner, Leslie, and Patterson, Charlotte: Way toHelp Babies Grow and Learn: Activities forInfant Education. Denver, Colorado: WorldPress, 1970.

9

Center Base

RATIONALEThe degree or extent to which parents and

families are involved in providing special servicesand instruction to young handicapped childrenvaries widely from one program to another de-pending upon some of the following factors: theadministrative organization and purpose(s) of theprogram, school, or agency; the philosophy under-:ying the program; the need for direct parentassistance to the children and to the programs;and the goals and objectives of the program.

What are Multidisciplinary Center-School Pro-gram:IA number of universities having medicalschools and other resources benefiting retardedand handicapped children recognized early theneed to bring many resources together in a Centerin order to permit greater exchange among thedifferent disciplines such as medicine, nursing,L..:r:stry, education, psychology, social work,spewth dathology and audiology. Such exchangewould promote efforts to attack some of the prob-lems of prevention, remediation, and treatmentof handicapping conditions. Professionals andrepresentatives of a number of agencies joinedhands with parents in presenting their problems

nt TrainingAlice R

and plans for such Centers to the President'sCommittee on Mental Retardation. Some of thefirst funding received by such groups was forconstruction only; that is, for building Centerfacilities, The Centers at the University of Wash-ington and at Albert Einstein University in NewYork were the first two such Centers, funded in1964. Perhaps these Centers are now best knownas University-Affiliated Facilities.

The University-Affiliated Program at the Univer-sity ell Washington The Child Development andMental Retardation Center at the University ofWashington has four component units: MedicalResearch, Behavioral Research, Clinical Training(and Diagnosis), and the Experimental EducationUnit, which has three major functionstraining,research, and service to handicapped childrenand their families.

The Experimental Education Unit School pro-vides instructional programs for handicappedchildren from birth to eighteen years of age. Thischapter will focus on the service aspects of theprograms in the Unit's Model Pre-School Centerfor Handicapped Children. (The Model PreschoolCenter for Handicapped Children is funded in

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part by the U.S. Office of Education, Bureau ofEducation for the Handicapped, under P.L. 91-230,Part C.) The school not only provides instructionfor children, but also serves as a demonstration-training facility for university students from manydifferent disciplines, for paraprofessionals in dif-ferent fie1s, and for parents who are trained atschool to work with their own children at home.Each of the five classrooms for preschool agechildren serves two groups of children a day; thechildren Ire grouped into classes according toage and to the severity of their handicaps.

Because the children spend only two or threehours per day at school, it is essential that par-ents learn how to help their children developself-help, motor, communication, cognitive andsocial skills in the home, where the childrenspend so much of their time. The different typesof parent training and involvement depend uponthe particular program the child is in and uponhis and his parents' or family's special needs.The focus is always on the child, and on how thestaff and the parents can best work together tomeet his needs. Those who are working withparents need to recognize that parents' needs areas different and as individual as those of theirchildren.

Parents usually find that, among the manyadvantages of being traired in the Center, ratherthan at home, is the opportunity to talk to andwork with other parents of handicapped children.Those parents who have children with similarhandicapping conditions often develop strorgbonds of friendship and are appreciative of thegains made by all the children.

At the Model Preschool C',nter we do nothave a "parent training package." There areseveral reasons for this. First, our emphasis at

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the Center Is on individualized instruction forevery child, and that emphasis extends to staffand parent training as well. Although there arebasic principles underlying the training giveneveryone at the Center, we believe that individualparents and families, like their children, haveunique needs and problems, and that to be effec-tive in meeting these individual needs, we mustmaintain flexible training. Second, our Center isdifferent from most schools where parents playan active role in that children are referred to usfor relatively short-term interventionmost chil-dren spend from one academic quarter to twoyears at the Model Preschool Center before re-turning to placements in their home communities.Further, the children may arrive at any time dur-ing the school year. So it is not possible for usto plan a single program that begins in Septemberand ends in Junetoo many of our parents wouldbe short-changed by such inflexibility.

The one exception to this general pattern ofshort-term intervention occurs in our Down'sSyndrome Programs. Many of the children whoparticipate in these programs are referred to uswhen they are newborn infants, and they may beentered in the Infant Learning Program as earlyas two weeks of age. Some of the children inthese programs have stayed with us for as longas three years; obviously, their parents have ex-perienced a more typical "parent training pro-gram" than most others in terms of continuityand duration.

INTAKEParents may apply directly to the Child De-

velopment anci Mental Retardation Center forcounselling or service, or they may be referredby clinics, agencies, private physicians, nurses,

psychologists, or school districts. How the parentsget to the Center is not important; what happensafter they arrive there is. If a child needs help,the staff of the Clinical Training Unit at the ChildDevelopment and Mental Retardation Center de-termine which Clinic within the Unit or team ofrepresentatives from different disciplines canbest undertake the information-gathering neces-sary to learn as much about the child's problemsas possible. If a child is not receiving servicesessential to his development or treatment, recom-mendations will be made for placing him in anappropriate program. The first consideration isgiven to the services available in the child's homecommunitywhere would he be best served,given his age and his handicapping conditiontsrIn any case, consultations with personnel fromthe child's home school district are essential in-asmuch as the school district is, or will be, re-sponsible for the child's eventual education in aregular or special education program. An objec-tive of the Experimental Education Unit is toreturn each child to an appropriate placement inhis home community as soon as it appears thathe will be ready to function adequately in aschool district program. The parents must, ofcourse, supply some of the needed informationand must also be involved in any decisions aboutplacement. Parents may be invited to visit variousappropriate programs, to talk with their personnel,and to observe the children enrolled. Practicalconsiderations such as transportation must, ofcourse, be taken into account.

When a child is being considered for place-ment in the Model Preschool Center the Admis-sions Coordinator informs parents of the oppor-tunities for parent involvement and participationin Model Preschool Center programs, and fre-

quently introduces them to another parent whosechild has been enrolled for a while. The parentsare invited to visit the program their child will beplaced in and to meet the staff if they have notalready done so. If the parents are expected toparticipate in one or more class sessions eachweek, they are informed of this before the childis admitted, and a time schedule is worked outwhich will be most convenient for them. Parentsare told about the regular parent-staff meetings,usually held at least once a month and in theevening so that both parents can attend. Thereare also all-school parent-teacher meetings eachquarter. In addition the Admissions Officer ex-plains parent consent forms and clearances,available insurance policies, and services whichmay be provided through the University Hospitalat a very modest fee.

When it appears that a child is a candidatefor placement in one of the Mode! PreschoolPrograms, his needs are discussed at a meetingof the Consultant Advisory Committee. Meetingsof this committee are scheduled once or twice amonth, depending upon the number of childrento be considered for placement. Prior to the meet-ing, the child's records are reviewed to makecertain that all relevant information as well asparenta' consent and clearance forms are in.Program coordinators or head teachers in thedifferent programs discuss how the child's needscan best be met, what support help is needed,and what arrangements have been made to ob-tain it. The latter arrangements are usually madeby the school nurse consultant. The AdmissionsCoordinator may also report on the informationthat has been exchanged with the school districtin which the parents live, arrangements for trans-portii.g the child, and the date when the child

fr

13

will begin his work at the Unit. Every effort ismade to keep the time required for admissionprocedures as short as possible. It it appearsthat 44. I may be a delay in placing the child ina pm n at the Model Preschool because oflack of openings, alternative placements are con-sidered. If a child has to wait until his namecomes up on a "waiting list," services that hebadly needs can be delayed. For this reason, our"waiting list" is short, and we act to place chil-dren in a program as quickly as possible if oneof our programs is considered by the referringagency and the Clinical Training Unit to be themost appropriate or only possible placement fora given child.

Parents have the opportunity to ask any ques-tions they may have. A well-informed parent whois involved in tl'e parent training programs is agood public relations person and can be veryhelpful to other parents of handicapped childrenin the community. By the time a child is admittedto a program in the Model Preschool Center, theparent is usually eager for information and theassistance which can be provided by the staff.The parent may have collected infor:nation aboutthe child's behavior at home which can be veryhelpful to the staff in initiating his program atthe Unit.

For instance, children miy have certain an-noying or puzzling behavior patterns, or problemswhich are of great concern to their parents or thefamily. To give just one example of ways in whichparents and staff work together to remediate suchproblems, parents having children enrolled in anyof the Down's Syndrome Programs are asked tolist home management goals for their children.The staff then helps in the statement of specificobjectives and in determining procedures for the

14 kl*S1

attainment of these goals. The evaluation ofprogress is on-going and integral to this process.Goals for Home Management are indicated on aform such as that shown in Figure 1.

If a child exhibits behaviors that are annoy-ing, the parent may think that the child engagesin these behaviors "all the time." Here at theCenter, the staff members try to get the parent tocollect information on the actual frequency ofthese behaviors and to encourage the parent toreinforce the child for his desirable behaviors orapproximations to desirable behaviors. Helpingthe parent realize that the child does some thingsthat please him is an important function of thedata collection. No child is "bad" all the time or"good" all the time. Staff and parents can worktogether to increase the frequency of desirablebehaviors and to decrease the frequency of theannoying behaviors. Examples of the usefulnessof parent data are included in the section onparent parti,lipation in procedures common toall programs.

DELIVERY OF SERVICESWe start with parent training as soon as pos-

sible after a child's handicapping condition hasbeen identified. Acceptance of tne fact that achild has a handicap is not easy for most parents.While they are going through this period of ad-justment the parents usually discover that thereare mimes of help and that they, the parentsand family, have contributions to make that willhelp the child. In the past, many parents havesaid that the most difficult time they had withtheir nandicapped child was between the timethe pediatrician no longer worked with them ona regular basis and the time the child enteredsome type of school program. During this period

.#

FIGURE 1GOALS FOR HOME MANAGEMENT

Dear Parent:Please indicate one or two objectives in any of the following areas that you would like

your child to attain this quarter. Be specific. After you have identified these objectives, wewill discuss them with you and will help you plan a program or programs to meet them.

(Please state objectives in terms of child behaviors.)

Gross Motor1.

2Fine Motor

1.

2Self-help Skills

1.

2.

Behaviors you would like to increase or decrease1.

2.

Preacademic Skills1.

2.Social Interaction and Language

1.

2.

Please return this form during the first week of school. Thank you.

.

e,

Sincerely yours,Val Dmitriev

4111111111111111111111111111

Coordinator, Down's Syndrome Programs

23 15

the parents did not know what they could "do"for their child; thus, they waited and felt useless.The situation is greatly changed today with themany and increasing numbers of preschool pro-grams now available for infants and young chil-dren. In these, parents can and do play activeroles, thereby decreasing their frustrations.

Support to parents and families while theyare recognizing and accepting the fact that theyhave a child with a handicapping condition mustbe provided so that the parents do not dwell toomuch on being burdened and on the questionsraised in their own minds and by their relativesor neighbors. There are misconceptions aboutmany types of handicapped children; these mis-conceptions may cause parents to be embar-rassed, to have guilt feelings, and to despair.Parents frequently have questions they are afraidto ask or that they do not know how to ask. Thesooner some of their questions are answered ob-jectively and their misconceptions are dispelled,the better it is for all concerned.

Those professionals and paraprofessionalsworking with parents must keep in mind that theneeds of parents and families are as unique anddifferent as those of individual handicappedchildren. It sometimes takes some "extra-sensitive" perception to assess the stated orimplied concerns of the parents and to get theparents to feel free to express these. Some par-ents hesitate to talk about problems related totheir having a handicapped child, such as maritaldifficulties, financial problems, or the well-inten-tioned but not very helpful comments and sug-gestions of relatives and friends. To reiterate,some families need a time for adjustment, a timeto recognize that they need help; and they needencouragement to seek the assistance that isavailable.

16

Perhaps excerpts from two recent publica-tions will express the initial impact on parents ofbeing told at their child's birth that the child ishandicapped. In the first example, a ministershares with his congregation the reaction he andhis wife experienced.

Three of the saddest words in the English languageare 'we had hoped . . ' They capture some of thedeepest pain, loss and disillusionment human beingscan feel..... . . Todd finely arrived at 7:30 p.m., five weeks pre-mature and weighing in at 41/2 pounds.We were very apprehensive about Todd's progressSaturday, since the first 24 hours are a crucial timefor premature infants . .. Then we. learned Saturdaynight that Todd's prematurity was one of our smallerworries. We were told that Todd has Down's syn-drome....We don't see ourselves as unusual or exclusive. Wethink our experience is representative of the processother parents have gone through in this kind ofsituation.Some of you know what it's like to look forward tothe birth of your first child with eagerness and antic-ipation, a child with whom to share your world andyour life, and then be told after the birth that yourhopes and expectations have just been shattered bysome chromosomal accident. It is a grief process be-cause there is real grief over the loss of the childyou expected and grief over the devastation of yourdreams and hopes....There were times when we didn't want to believe thiswas happening to us- -times when, as one of ourprayers of confession put it, we wanted to told outfor better terms.' We could hardly hear, much lessspeak, the words mental retardation. We felt almostoverwhelmed, and the future looked very bleak anduncompromising. (Martz, 1974, pp. 34-35)

Another reaction is expressed by the parentof a child in the Down's Syndrome Program in theMosel Preschool Center for Handicapped Chil-dren. The child was admitted to our programwhen she was five weeks old.

When Angie ... was born 2Y2 years ago, her mother'sreaction was hysteria. Angie was, the doctor said, amongoloid.`I had never even been near a retarded person before,'her mother said. `I thought, `Oh, my God, what did I

do during this pregnancy that caused this?"Angie's parents are long since over their shock.'Pretty soon you just have to get busy,' Angie'smother said ...She often is asked to visit new mothers of Down'schildren in the hospital ...`To be told is devastatilg, and all the books on itpaint such a bleak picture. It's natural to he scared,afraid of pitying the child. We all have a fleeting wishthat the child will die. It's a normal, healthy reaction.It's fear of the unknown.' (Mills, 1974, pp. 8-10)

From these two examples of parents' reac-tions to having a handicapped child, it should beimmediately apparent that professionals who aregoing to work with such parents must start "wherethe parents are" and must not contribute to thefeelings they already have of being overwhelmed.Certainly the professionals will be acutely awareof many things that need to be done for the child.However, the families may be more upset byspecific concerns that seem paramount to themconcern about the child's feeding, the possi-bilities of his having other, associated conditions.and their own perceived inabilty to cope withwhat they consider to be problems in the day-to-day care of the child in the home.

Indeed, there may be many things parentsneed to know, but let's start with what they per-ceive to be their needs and let thf -n discover.other ways we can work together as pLitners.professional team, no matter how expert, canmeet all of the child's or parents' needs at thesame time. We who are concerned with childinstruction often talk about the child's readinessfor certain types of activities. Suppose we also

.

think of "parent readiness" for coping withdifferent problems.

In a multidisciplinary center-school, there areopportunities to work with parents and familiesof handicapped children in a number of differentways. If we are fortunate enough to be able towork with the child and family soon after thehandicapping condition has been identified, wecan relieve many parental anxieties and startfocusing on the child's problem(s) in those early,crucial months and years of the child's life. Earlyidentification and intervention can prevent manyother conditions which compound the child's diffi-culties. It is easier to start applying proceduresthat are effe tive in dealing with certain types ofbehaviors than it is to have to correct ineffectivemethods of coping with problems. Frequently, thefirst step in parent training is to convince theparent of the importance of becoming involved inan early training program. Well-intentioned peoplemay have tried to allay parents' anxieties by sug-gesting that perhaps the child will "grow out ofit." Such suggestions frequently do more harmthan good and in most cases they do not allay theparents' concerns. The parents stiil recognizethat "something is wrong" and that they needhelp in finding out what that something is andwhat they can do about it. Such suggestions oftendelay the parents' search for help.

PROCEDURESSome common procedures are used through-

out the Model Preschool Center for HandicappedChildren and parents learn how to use many ofthem. The procedures derive from the basic prin-ciples of behavior modification: initial assessmentof child needs, on-going assessment and sys-tematic observation, daily measurement of pupil

25 17

progress, modification of individual programswhen data indicate that a child's particular pro-gram is not resulting in the expected progress.Data are kept on at least two behaviors at a timefor each child; in many cases, particularly whereparent or volunteer help is available, data arekept on additional behaviors.

Infant ProgramsIn working with infants frombirth to eighteen months we try to assessthe child's needs and the parents' specific con-cerns. In some cases, we seek assistance fromphysical therapists, nutritionists, social workers,and other representatives of different disciplineswho may be able to provide help and instructionto the individual parent or to groups of parentswho have common needs and problems such asfeeding children or developing their muscle tone.Normally, the parent will bring the child to theModel Preschool Center at least one day a week.Each parent and child pair receives thirty min-utes of individual attention during which theparent is shown how to stimulate the child, tohelp him to attend to sounds or objects, and tomake eye contact with adults. The child's re-sponses are reinforced, as are the parents'. Par-ents frequently stay on after their session towatch our work with other children and theirparents so that they may learn through observa-tion either in the classroom or from an observa-tion booth. We encourage parents to report onthe progress of the child at home and to ask anyquestions they may have. They are invited to callstaff members at the school or at home wheneverthey have questions or special concerns. We wantthe parents to feel that help is as close as theirtelephone.

Professionalism must be coupled with hu-manism in helping parents cope with their needst

18

and the child's needs in these early weeks andmonths when much support is needed. A parenttraining class is not the answer to parents' needsfor assistance at this point. A class could notmove fast enough, and the instructor could notanticipate the needs of a group of parents andplan a program that would accommodate them.

Early Preschool ProgramsChildren from nine-teen months to three years of age participate inearly preschool programs. Such preschool pro-grams may last for two hours or more any may beconducted four or five days a week. The dailyschedule provides a variety of activities designedto develop self-help, motor, communication, socialand cognitive skills. In some programs, the par-ents work with the staff right in the classroom,and each parent has an opportunity to participatein the program at least one day per week. In otherprograms, the parent observes the work beingdone in the classroom and has an opportunity tomeet with a staff member to discuss the child'sprogress and to ask questions about working withthe child in the home. Data are collected onchild progress in every session of every program.Videotapes offer an opportunity to staff and par-ents alike to review the work done and thechildren's responses. Every class. session isfollowed by a staff meeting to which parents areinvited if they have participated in that classsession. Pupil progress is noted and plans aremade for the next day's session.

When children and parents have specialneeds, special classes may be offered. For in-stance, parents of deaf children may attendclasses to learn English sign language and fingerspelling while the children are being taught suchskills in the classroom, so that the parents canmake use of every opportunity which may help

the child acquire language and speech skills.While the emphasis in this chapter is on the

earliest preschool years here at the Center, itshould also be noted that the procedures de-scribed here are used in the Advanced Preschool,Kindergarten, and Pre-Primary classes at theCenter and in all of the Center's field programs.Ours is a demonstration center, offering outreachand technical assistance to a wide variety of fieldprograms; because parent involvement is integralto all programs here at the Center, it is oneprogram component that is heavily emphasizedin field programs. too.

Parent Participation in Procedures Corrwion to AllProgramsIn every program, the staff memberswork with parents in many different ways. Thereare numerous parent conferences, parent groupmeetings, direct parent participation, individualparent instruction, and group parent instruction.Parent groups are instructed in the steps ofnormal child development in the areas of self-help, gross and fine motor, communication, socialand cognitive skills. Emphasis is placed on theparent's understanding of normal developmentbecause one of the goals of the Model Preschoolis to bring each child's development as close tothe norms as possible. However, care is taken topoint out the wide range within normal develop-ment. Parents learn through observing and chart-ing children's progress in these different areasthat children progress at different rates in devel-oping skills. For instance, a child may developnormally in motor and social skills but he mayshow some lag in communication and in cognitivedevelopment. Parents are taught how to apply athome the procedures used in school to help theirchild come closer to the norm, and the parentslearn to keep data on the child's performance at.

home. In this way, the parents of all children aredrawn into a cooperative effort with the schoolstaff to bring each child as close to normal skilldevelopment as possible.

LIAISON AND FOLLOW THROUGHIn addition to showing consideration for the

individual child and his family and individualizingprograms of instruction for both the child and theparents, our staff places emphasis on developingthe competence, confidence and independence ofthe child and his parents. Parents usually feel theneed for much supervision at first --they want tobe certain that they are "doing the right thing."The staff members reinforce the parents whenthey have learned what to do. They also makesure that the parent doesn't feel that the childwill perform a skill for, or respond to the staffmember but not the parent. It is frequently neces-sary to point out"See, he did it for you, too."The staff member asks the parent to report whatthe child does at home. Parents' feelings of in-security and doubt about their abilities to workwith their own children must be dispelled asquickly as possible. Demonstrating that their workis effective is the best way to achieve the goal ofparental security and independence in workingwith their own children.

The following condensed excerpts from ModelPreschool case studies illustrate the importantroles parents can play as data-takers and behaviormodifiers. They also are good examples of waysin which parents and staff work together toremediate a particular problem that the parentor family find worrisome. In both cases, thechildren's names are fictitious.

The first study concerns Randy, a four-year-old boy whose mother was convinced that her son

hot719

was always naughty and getting into mischief, thatno matter what she did he would not change, andfurthermore, that his behavior was worse whenshe was out of the room. Aithoogh his teachersat the Model Preschool agreed that a lot of hisbehavior was inappropriate, they had noticedsome improvement at school. His momer, how-ever, had not noticed any change at home. Thestaff recognized that simply 'elling Randy'smother ,nat he had some appropriate behaviorswould not change her mind; they reasoned that,if she were to collect data herself, she mighthave a different picture of Randy's behavior andwhat could be done to change the inappropriatebehavior. She eagerly agreed to a program inwhich she would collect data over a two-hourperiod each day.

. . . Based on the mother's verbal descriptions ofwhat went on in the home, a data form was drawn up.The left hand side was labeled negative child be-haviors and had four columns in which the parentcould enter 1) each occurrence of an inappropriatebehavior, 2) what she did when it occurred, 3) thetime, and 4) whether or not she was in the same room.The right side of the page was divided into the samefour columns but was labeled positive child behavior.

. She arrived for her next conference armed withseveral days' records and some preliminary conclu-sions that she herself had begun to draw from herdata. Most noteworthy was the indisputable evidencethat Randy was not all bad....Prior to the next conference, the teacher found a wayto code and display the mother's data [to give)almost instant read-out on the dynamics of eachtwo-hour session....There was concrete corroboration that Randy wasn'tall bad; in fact, he was a pretty good boy much ofthe time; that her being out of the room wasn'tnecessarily the SD (discriminative stimulus) for hismisbehaviors [and! that she really was doing a prettygood job of reinforcing Randy's appropriate be-haviors. Further analysis revealed that the bad be-

20 Jt

haviors often occurred in clusters that did not covera long time-span but led the mother to the conclu-sion that Randy was continuously bad; talsol that themother was inconsistent in handling Randy's inap-propriate behaviors: sometimes she scolded, sore-times she spanked, sometimes she ignored, andsometimes she actually rewarded . . . (Allen, 1172,pp. 251-254)

Randy's mother and the staff continued towork together for several weekscollecting andanalyzing data, using these data as a basis forestablishing a program to remediate Randy's be-havior. The changes in Randy's behavior and inhis mother's ability to deal with it were remark-ably good.

The next study concerns four and a half-year-old Leslie, whose problem is dawdlingone thatalmost all parents must cope with at some timeor another.

. . . As most of us who have worked with parentsknow, telling a parent what to do to remediate asituation rarely has durable efficacy. Instead, theteacher asked the mother to describe, that is, pin-point, the times when the child's procrastinatingannoyed or angered her the most. Not getting herselfdressed for school in the morning was a prime an-noyance, for this was the time that the mother wasmost harrassed. The next question asked was whetherLeslie could in fact dress herself. "Of course shecan," answerad the mother with exasperation, "if shewants to. She just never wants to."The teacher asked the mother to jot down the timethat she gave Leslie the first cue to get dressed aswell as each time she checked on her, scolded,helped her, or interacted with her in any way. Thefinal data point was to be the time that the dressingwas finally accomplished by whatever means....The mother had five additional days of data to pre-sent at the next conference. A quick perusal indi-cated three things: 1) most days it was taking Leslie30 to LIS minutes to get dressed, 2) mother wassupplying 6 to 9 prompts and scoldings each day,

and 3) mother usually ended up dressing the childherself. A couple of questions were in order at thispoint. One had to do with finding out what themother considered a reasonable dressing time, andthe second to find out if Leslie preferred coming toschool to staying home. The mother replied she didnot care how long Leslie took to dress as long asshe was ready before the school cab driver came.Mother also reported that Leslie was really upsetwhenever she could not come to school. Armed withthis information, the teacher made the followingsuggestions:1. Continue taking data.2. Tell Leslie that if she did not get herself dressed

in time for her ride, she would have to stay home.3. Reduce to three the number of contacts made

during dressing time. If, when she went into theroom, Leslie was making even an approximationto dressing, the mother could give her a bit ofassistance and much verbal praise for her efforts.If Leslie was doing something other than dressing,the mother was to turn and walk out without say-ing a word.

4. Give Leslie one final warning about 6 or 7 minutesbefore the arrival of the cab.

The next day Leslie and her mother arrived at school15 minutes late. Leslie was teary-eyed, her motherobviously upset. It seemed that Leslie had thrown asuper scene over missing her ride and thereforeschool. She had cried. screamed, pleaded withmother to bring her and mother had finally suc-cumbed. A quick conference with mother followed inwhich she was counseled that if she really did wantto eliminate Leslie's dawdling then she must allowher to experience the negative consequences ofdawdlingnot getting to come to schoolno matterhow difficult it might be for the mother for a fewdays. Within a very few days Leslie was dressing her-self much more quickly and continued to do so withonly an occasional relapse. (Allen, 1972, pp. 248-250)

Professionals interested in parent training willfind an excellent review of procedures such asthose applied in our programs in an article en-titled, "Using Parents Change Agents for Their

Children: A Review." This article by Claudia A.Johnson and Reger C. Katz (1973) provides anextensive review of the literature on "the use ofparents in therapeutic roles (that) has resultedfrom an explicit technology of behavior modifica-ton predicted on the analysis and manipulationof environmental contingencies."

EVALUATIONParents can be and are taught to be reliable

data-takers. However, this takes much time andeffort on the part of both staff and parents. Inour Model Preschool Programs, we spend 500-600hours a quarter with parents in the many differenttypes of parent involvement described earlier.The total time spent with parents over the courseof a full year (four quarters) will range from 2,000to 2,400 hours. It is time and energy well investedfor both staff and parents in terms of pupilprogress. If a child is not making the expectedprogress, we do not ask, "What is wrong with thechild?" or "What is wrong with the parent or thetrainee?" We ask, "What is wrong with the child'sprogram, and how can we modify it to ensure thatthe child's progress can proceed at a reasonablerate appropriate for his age level and handi-capping condition(s)?" Continuous measurmentand analysis of data provide information for im-proving programs. The use of videotapes and thepreparation of case studies also greatly assist inrecording and reviewing training and classroomactivities. These are also excellent disseminationforms useful in our many field programs whereparents play an essential role in replicating ourprocedures and in improving programs for handi-capped children.

2921

What Do Parents Do for Us and for Others Work-ing with Handicapped Children?Certainly thischapter would not be compleie if it did not in-clude some information about the many waysparents have assisted us in our programs and infurthering other programs for handicapped chil-dren and their families. Their contributions takemany forms and it is interesting to note that manyof the things they do are projects they initiated.

First of all, the parents are helpful in work-ing with children .Ind families who are newly en-rolled in our programs. They are enthusiasticabout the gains their own children have madeand are accepting of and reassuring to the newlyenrolled children and their families. They formcar pools if necessary to transport children or tocome to parent meetings. They bring in itemsthey think will be of interest to other parents orto the children.

They also participate in a Parent to ParentProgram, which lets pediatricians know that theyare willing to visit and talk with parents who haverecently been told that they have a handicappedchild. They want other parents to know about theresources that are available to help the child andthe family.

Moreover, it was a parent group that was in-strumental in working with students from theUniversity of Washington Law School in drafting"Education for All' legislation and in getting sup-port for that legislation. These parents are stillinterested in seeing that the law is fully imple-mented and that funds are provided to do anadequate job. They recognize the need for earlychildhood education and are helpful in gettingcommunity support for necessary programs.

Parents working in our classrooms assist inmany ways. They learn to apply our procedures

22

in their homes in order to insure continuity intheir child's program; they learn to take data bothin the school and at home; they encourage otherparents to work effectively with their own chil-dren; they talk with their neighbors and help todispel misconceptions about handicapped chil-dren. In short, they are supporting the staff andextending the efforts to reach and serve familiesof handicapped children.

Additionally, the parents respond to the manyrequests that come to us from other parents, re-porters and site visitors for interviews; they parti-cipate in site visits; they write articles that may behelpful to other parents; and they participate inpanel discussions in university classes and pro-grams, and in workshops. They share our con-cerns about funding and about extending neededservices to greater numbers of handicapped chil-dren. If site visitors from funding agencies wantto talk with parents, we ask for volunteers fromthe parents. At the scheduled timetnat whichis most convenient for the parentswe simplyintroduce the parents to the site visitors and leavethe room, confident that the parents know theprogram's goals as well as we do. Sometimes theparents sense that we have important visitors andthey seek to help even if they have not beenasked to do so.

Parents have also been instrumental inestablishing programs, particularly infant learn-ing programs, 'n communities where none hadpreviously existed. They continue to request as-sistance from our staff when it is needed, and toarrange for some of us to meet with the parentsand other members of the communities in whichthese programs are established. They also workwith school districts in urging them to extendprograms, and are constantly attempting to reach

parents of handicapped children in order to helpthem learn about the resources that are availableto them and their children. They work with estab-lished agencies, organizations, and programs intheir efforts to disseminate information aboutwhat can and should be done in behalf of handi-capped children.

Finally; parents have been active in the move-ment to change legislation so that insurance com-panies include in their coverage provisions forchildren with birth defects. In light of the factthat medical and professional treatment can beextremely expensive, parents should have helpin defraying such costs. Further, publicity givento such efforts to change legislation helps to alertprospective parents of the need to consider"things that could happen in any family" and tolearn more about handicapping conditions thatmay be evident at birth.

Concluding StatementIn their efforts to providetraining and assistance in meeting the needs ofparents and families, professionals can learn agreat deal from the parents and families them-selves. That has certainly been our experiencehere at the Center, where we see our work withhandicapped children as a working partnershipwith the children's parents and families.

As parents and families from the Center moveout into communities and seek to establish newprograms for other handicapped children andtheir familiesprograms that are badly neededbut that are not now provided by any agencieswe applaud their efforts to extend services andfeel a deep commitrnent to heIp them in thiswork. This approach may not be an ideal one

that is, some standards that the parents and wewould like to set for programs cannot possibly bemet initially, and it will take time and a greatdeal of assistance to arrive at "ideal arrange-ments." But these are beginning efforts and theyare extremely important, for without these pro-grams, many children and families needingspecial services would otherwise be denied them.There can hardly be a more appropriate "testi-monial" to the parents' involvement and partner-ship than their determination to extend servicesthat they have benefited from to other families.Their interest and their many forms of supportare richly rewarding to us all.

Alice H. Hayden, Ph.D., is the director of theModel Preschool Center for Handicapped Chil-dren, Experimental Education Unit, Child De-velopment and Mental Retardation Center at theUniversity of Washington.

Her numerous publications include articlesin Teaching Exceptional Children, EducationalHorizons, Education of the Very Young, and Ex-ceptional Children.

23

She has receiveti degrees from Oregon StateUniversity, Purdue University, and Boston Univer-sity, and has te)ne research in the areas ofDowns Syndrome, improvement of instruction foryoung children, systematic observation of youngchildren, and evaluation of programs for youngchildren.

BIBLIOGRAPHYAllen, K. Individualizing instruction for preschool

children through utilization of parent-teacher data. In A. H. Hayden (Ed.),Selected case studies. Model PreschoolCenter for Handicapped Children, Experi-mental Education Unit, Child Developmentand Mental Retardation Center, Universityof Washington, Seattle, Washington, 1972.

Johnson, C., and Katz, R. Using parents as changeagents for their children: A review. Journalof Child Psychology and Psychiatry, 1973,14, 181-200.

Martz, H. We had hoped. United Method'sts To-day, January 1974, 34-37.

Mills, D. Things are looking up for Down's syn-drome children. The Seattle Times Maga-zine, January 6, 1974, 8-10.

24

Home-Center Based Parent Training f modelRD, Bud FteegicksVictor L Boldwin

David GroveRATIONALE

Most parent training models are designed topc wide training to parents whose children arenot enrolled in a program. In fact, many educatorstake the position that if the handicapped child isenrolled in a school-type program there is littleneed for the parents to be trained in the tech-niques of teaching their own child. Two factorsmilitate against this position. First, there is abody of evidence that indicates that if parents ofchildren enrolled in a school or center engagein some teaching of that child, the child's learn-ing will be significantly accelerated. This will bediscussed at length later in the chapter. Second,pressure from the parents who want to participatein the teaching of their child often requires thatthey be taught how to teach their child.

Let us speak to the latter point first. Our ex-perience is that many parents, especially parentsof severely handicapped children, are interestedin doing as much as they can for their child andconsequently are willing to undertake home pro-grams. Moreover, as the child's successes in the

center program increase, parents become moreeager to want b help their child. Frequently,they have been discouraged about their child'scapabilities until the center demonstrates somesuccess with him, at which time the parents' dis-couragement is replaced by optimism and adesire to contribute to their child's new-foundgrowth. Therefore as educators we need to beresponsive to these desires of the parents andinstruct them In teaching their own child.

But even if the parents did not request us toprovide this type of instruction, it is logical thatwe should involve the parents in at least someeducatiwnl activities and training. For instance,it is practically impossible to toilet train a childwith only a school training- program; a- coordi-.nated program between school and home ismandatory if the child is going to be completelytrained before he is a teenager.

Perhaps even more critical than the child'sacquisition of self-help skills is the acquisitionof language skills, which also is accelerated bya home-center ,coordinated program. Language

27

skillsthe acquisition of sounds, blends, words,the chaining of wordscan all be learned throughstructured programs, but it is only with the useof language in the everyday environment of thechild that the handicapped child can use lan-guage fluently. Since the parents usually con-stitute a large portion of the child's environmentand provide him with much of the feedback hereceives each day, it is necessary for the parentsto be actively engaged in the handicapped child'slanguage acquisition to maximize the rate of thatacquisition.

Certainly for the child to progress throughthe entire range of self-help skills, the parentmust become involved in instructing the child.For example, if a teacher is teaching a child totake off his coat, and the child is required to doas much of that behavior as he is able to atschool, it is defeating for the parents to assist thechild in taking off his coat at home to a degreegreater than assistance is given at school. De-velopment of each of the self-help skillsdress-ing, self-feeding, personal hygienebenefits froma very closely coordinated program with theparents.

It is our experience that not only in the areasmentioned above can parents be good teachers,but that they can be effective in any area of in-struction. This effectiveness is demonstrated bythe acceleration in the rate with which childrenlearn and the quality and quantity of what theylearn. In brief, if a parent will conduct for tenminutes to a half hour a day a training programat home in conjunction with the same trainingprogram being conducted at the school, the childwill acquire the taught skill in a significantlyquicker time. In fact the data show that thesystematic program involving the in con-

28

junction with the school program will almostdouble the rate of acquisition of the skill. (For amore complete discussion of this accelerationrate see the evaluation section of this chapter.)

This chapter will describe three variations ofthe Home-Center model which have been usedwith children who have various handicaps, in-cluding deafness and blindness, mental retarda-tion, emotional distrubance and learning disa-bilities. Thus the model has universal applica-bility across all handicapping conditions. Thethree variations of the Home-Center model are:(1) The Lunch Box Data System in which parentsconduct instruction at home similar to that beingconducted at the school; (2) The Modified LunchBox System in which parents conduct instructionat home that is not being taught by the school;and (3) the Volunteer System in which parentsare volunteer wort .,:rs at the school and throughthat experience acquire the instructional capa-bilities to teach their own child.

THE HOME-CENTER MODEL (THE LUNCHBOX DATA SYSTEM)IntakeIn the home-center model the childrenare already students in the center and so weshall not discuss how these children are takeninto the program. We shall, however, focus onhow we take parents into this program.

We think that the parents of every child whois in the program should be given the opportunityto conduct at least one home training program.To start this process a group meeting is heldwith the parents. They an all be brought togetherin a large group, or invited to participate insmaller groups according to their child's class-room, by his age, or by his handicapping condi-tion. The purpose of the meeting is to explain

FIGURE 1TASK ANALYSIS OF THE DRESSING SKILL

OFREMOVING PANTS, UNDERPANTS

Steps1. Child grabs cuffs and removes pants when one leg removed.2. Child grabs cuffs and removes pants when pulled to ankles.3. Child pushes down to ankles, grabs cuffs and removes pants when pulled to knees.4. Child pushes down to ankles, grabs cuffs and removes pants when pulled to thighs.5. Child pushes down to ankles, grabs cuffs and removes pants.

\killr000wsmoowmumissmNmwmmmummihome training programs and "sell" the idea ofparticipating in a program to the parents. Twomajor "selling" points have been found to besuccessful. First, the accelerated rate at whichthe child can acquire skills should be demon-strated to the parents by specific examples.Second, the necessity for the generalization fromcenter to home of the child's learning, especiallyin the areas of self-help skills, toilet training andlanguage acquisition, should be stressed.

After this group meeting, individual confer-ences are scheduled with the parents to deter-mine which program the parent desires toconduct at home. Parents should be encouragedto conduct language acquisition and self-helpskill programs if the child is participating in suchprograms in the center, but they may initiallychoose a motor program or one in a cognitivearea, such as reading or arithmetic. If at all pos-sible the parents' choice should be honoredbecause this choice probably represents theirpriority of what their child should be taught. It

probably also represents skills, which, if the childacquires, will be reinforcing to the parent.

Great care must be exercised in this initialselection of a program. One of the primary con-siderations in this selection is to choose a pro-gram with the parent that is likely to succeedSuch as simple self-help skills like dressing,cognitive skills like rote counting, sound recogni-tion, shape sorting and certain motor tasks. Itshould almost go without saying that we wouldnot pick as an initial skill to be taught onewhich we have been teaching in the center butwith which progress has been slow.

Regardless of which skill we choose, we mustfurther the likelihood of success by breaking thisskill into small parts (task analysis) and showingthe parents how to teach one part at a time.Figure 1 shows the task analysis for the behaviorof removing underpants. If the parents are facedwith having to teach only one small step at atime rather than the entire task, the chances forthe parents to see some progress are greater

Aia

29

and thus the parents will be reinforced for theirefforts. Once the program has been selected, theparent is ready to be trained.

Direct Services DeliveryIt should be pointed outhere that the effectiveness of any parental in-volvement program is largely dependent on howprecise the instructions are that are given to theparents. General instructions will only confuseand frustrate the parents and make them feelguilty when they are not successful. The morespecific the program, the less chance there isfor failure.

After the program has been selected by theparent and the teacher, the teacher models theprogram for the parent. During the course of thismodeling the teacher demonstrates to the parentsall aspects of the teaching paradigm. First, theteacher demonstrates the physical position ofthe child in relationship to the teacher and thepreparation and placement of any cues that maybe necessary or materials that may be needed.For instance, when a teacher is demonstratinghow to teach a deaf and blind child to take offhis socks, the positioning of the teacher and thechild is extremely important. The child shouldbe placed in a position sitting on the floor withthe teacher behind him, with her legs straddlingthe child so that she can reach easily over hisshoulders if necessary and guide his hands tothe socks and through the motions. Likewise, ifthe teacher is teaching a word recognition pro-gram with a child and using picture cards toelicit the words, the placement and the methodof presentation of the cards must be stressedand modeled for the parents.

Once the preparation of cues and the place-ment of the child have been modeled, the teachermust demonstrate precisely the way in which

30

cues are to be given. imagine a child who is on aprogram to increase the number of seconds thechild attends to the teacher's voice. The precise-ness with which the child is told to attend is im-portant. For instance, the cue might be, "Look,Johr,ny," and if the child were deaf a sign mightalso be emited by the teacher. The teacher mayalso desire to touch the child to get his attentioninitially. All of these fine points of the presenta-tion of the cue must be adequately explained andmodeled for the parents by the teacher.

The precision with which cues are given ofcourse is in direct relationship to the severity ofthe handicap of the child. The more severe thehandicap, the more precise must be the cue. Theless severe the handicap, the less precision isrequired in the delivery of the cue although acertain amount of consistency on the part of theparent should be stressed.

The expected behavior that the child is toemit after the delivery of the cue should be ex-plained to the parent. Any shaping proceduresthat are being utilized or the degree of precisionwith which the child must emit should all beincluded in the instruction.

For instance a child is being taught to writethe capital letter A. What degree of precisionmust be expected? Is this correct? :X' Is thiscorrect? 2 or is this correct? ± Hopefullythe teacho.:. has prescribed what degree of ac-ceptability marks success and what is not con-sidered correct. The parent must be willing toaccept the teacher's criteria for success. Thisacceptance will be facilitated by explaining theshaping processhow we first accept a capital Athat looks like this: * . Then we shall demandthat the point of the A start on the line and sowe then shall accept anything resembling an A

as long as the apex is on the line, such as 7g .

Then, we may require the base of the left leg ofthe A to stop on the bottom line, and so on untilwe have step-by-step shaped the child's letter-writing ability.

During the modeling stage the teacher dem-onstrates the way in which to deliver the con-sequences to the child for the behavior emitted.If the behavior is correct, the teacher dem-onstrates the way in which to delivery reinforcers,both social and tangible, paying particular atten-tion to the pairing of tangible and social conse-quences. If signing is required, the delivery ofthe sign, the verbalization and the delivery of thetangible consequence in rapid succession is adifficult thing to coordinate and must be demon-strated precisely in a set order to the parent.

The method of delivering the negative feed-back, or the "No, that is not right, Johnny," whenthe child makes an incorrect response as well ashow to perform a correction procedure, shouldbe demonstrated to the parent. Again, the ac-curacy of this correction procedure and the speedand precision of the delivery of the consequencesare important to the child. The more severelyhandicapped the child is, the greater necessitythere is to deliver reinforcers or negative feed-back promptly. The more severely handicappedthe child, the more precise the correction pro-cedure must be when the child emits an in-correct response. In order to emphasize the in-structions we give to parents of more severelyhandicapped children, we have the parents readselected portions of Isn't It Time He OutgrewThis? by Victor L. Baldwin, H. D. Bud Fredericksand Gerry Brodsky (Charles C. Thomas, 1973).All parents are asked to read the initial chapterson cues, behaviors, consequences and data keep-ing. Additional chapters are read to coordinate

with the behavior being taught. For instance, thechapter on dressing would be read if the parentswere teaching their child to dress or undress. Inaddition, there are chapters discussing self-feeding, toilet training, hygiene habits, languageacquisition, motor skills, and academic learning.

Once the teacher has modeled the entireprocedure a number of times to the parent, theparent is asked to try the procedure with herchild in the presence of the teacher. At this pointin time, if video tape cameras are available, theycan be used to film the parent's attempts andthus facilitate the instructional process. Then, inaddition to the feedback given to the parent bythe teacher as the program is conducted with thechild, the parent can watch a playback of thevideo tape and more vividly understand the cor-rections which the teacher has been giving toher. In correcting the parent during the videotape playback, however, emphasis should beplaced on the positive aspects of the parents'performance. Too frequently we focus only onthe poor aspects.

Once the parent has demonstrated that he orshe can deliver the cues and consequences tothe child correctly and does so three or fourtimes in a row, the parent is then informed ofthe extent of the program and the subsequentsequences of the program. For instance Figure 1shows a sequence for a dressing skill removingunderpants. If the child is on step one, the parentis instructed to work on that step until the childmakes three correct responses in a row. Then theparent is to move automatically to step two. Per-haps a demonstration of the entire sequencemight be necessary at this time.

Since the same program is being conductedin the home as in the center it is important thatthis program be coordinated between the two

31

environments. Therefore, a data system must bedeveloped for passing information about thechild's progress back and forth between theparent and the center on a daily basis. We havedubbed this daily reporting system the Lunch BoxData System. Figure 2 is a data sheet for thedressing program shown in Figure 1 that is passedback and forth between center and home. Theinstructions to the parents before these data weretaken were to move to the next step of the pro-gram if the child was able to do a step threetimes in a row successfully. Figure 2 shows thedata as submitted by the parent after fifteen

minutes of trying the program at home one even-ing. The child obviously was able to do step oneafter a few mistakes and then did step twosuccessfully two times. Therefore, the teacher inthe classroom the next day, on receiving thesedata, will work with the child on step two. Letus suppose for the sake of the example that theteacher achieves success with step two. She thensends home the data sheet to the parent markedas is shown in Figure 3, which indicates to theparent that she is to work with the child on stepthree. This type of daily communication is im-perative if the teacher and the parent are to

FIGURE 2DATA FOR DRESSING PROGRAMBEING COORDINATED AT HOME

32

Child's Name STEPS1. 6.2. 7.3. 8.4. 9.5. 10

Date Reinforcer Used Phase StepTrials

Comments1 2 3 4 5 6 7 8 9 10

z ///7q - .4.-m4.;d IC I X OXOXXX,2/ I/74/ 9"" -. 0 X X

144

39

coordinate their instructional activity with thechild so that there is no lost time in the teachingof this child.

Figures 4 and 5 show two ways in whichteachers in two different types of programs pro-vide information for parents about the programwhich they are conducting. Such directions havebeen found to facilitate the communicationprocess between the center and the home. Al-though the teacher has spent additional timemodeling, demonstrating and explaining the pro-gram to the parents at the center the parentsmay have some questions when they try theprogram at home without assistance. Thesewritten directions help to answer sume of thosequestions. The amount of detail put into thesetypes of communications varies considerablyfrom teacher to teacher and center to center.Figure 4 shows a home program for a child in theMedford pre-school which caters primarily tochildren with learning disabilities and educablementally retarded children, and Figure 5 showsthe program sheet that will be sent home togetherwith a sequence for a child in the TeachingResearch Multiple Handicap Pre-School.

Liaison and Follow ThroughThe parent will con-tinue to run the program and data will continueto circulate back and forth between the schooland the home. Frequently the parent may experi-ence problems. The parent should communicatethese as rapidly as possible to the teacher so thatthe teacher can take remedial action. Often whenthe parent has such problems, the parent shouldbe brought into the school to observe teachersmodeling and to demonstrate how she is con-ducting the program at home in order to isolatethe problem.

Even if the parent is not experiencing prob-lems with the program, periodic conferencesatleast every three to four weeksare recom-mended. During these conferences the parentshould once again demonstrate how she is con-ducting the program at home. All teachers some-times acquire some had habits, and parents arenot exempt from this fault. Thus, this periodicconference serves as a maintenance check on thequality of the home program.

One of the center activities that the parentsseem to enjoy is periodic parent meetings. Duringthe meetings they share the experiences that theyhave been having in teaching children. This typeof conference is especially valuable for thoseparents who may be having some difficulties;after listening to how other parents are solvingproblems, they may be encouraged to try evenharder. For parents that are having success, theopportunity to voice that success publicly can bevery reinforcing and may help to insure theircontinuance in the program.

EVALUATIONEvaluation of this kind of program can be

done on at least two dimensions. The first isprogram-wide. What percentage of the parentsare participating in this type of program? Ourexperience indicates that the average center willhave about fifty percent of their parents activelyrunning home programs. Of this fifty percentabout one-fourth will require rather close moni-toring and frequent liaison on the part of theteacher. The teacher should not become dis-couraged if certain parents refuse to participatein this program or if certain parents who initiallyagree to participate drop out. It would be an ex-traordinary program which had more than sixty

*1; 40 33

FIGURE 3DATA FOR DRESSING PROGRAM

BEING COORDINATED AT HOME AND SCHOOL

Child's Name STEPS1. 6.2. 7.3. 8.4. 9.

5. 10.

Date Reinforcer Used Phase StepTrials

Comments1 2 3 4 5 6 7 8 910

2/1/74 ga.41.t.,-,10e,:di 11 1 X0X0X XX2 /i/P/ 9--, .e 2 0 X X

2./2 /7i )4.4.4.4.- ,opal 2 OX0XXX2/2/74. 3

percent of the parents participating on a con-tinuing basis in this type of home program. Theteacher should strive to prescribe some modelingand instruction to all parents and have the par-ents demonstrate how they would provide theinstruction. Much of this procedure learned bythe parent can be used even though it may notbe on a consistent, daily basis.

Another way to look at program evaluation isthe number of programs which each parent con-ducts. All participating parents should be con-

,

34 41.

ducting at least one program nightly, although itis not unusual to find some parents who willconduct three or four nightly.

A final dimension upon which the value ofthis kind of home-center program can be judgedis the progress of the children. Figures 6 and 7show graphs of childrens' progress in this typeof program. Figure 6 shows a Downs Syndromechild who was first taught to read sight words inthe center only. This method of teaching wasfollowed by a coordinated home and center pro-

FIGURE 4HOME PROGRAM FOR

MEDFORD PRE-SCHOOL

Child 2)ROTE COUNTING

Date Initiated ////3/7' Teacher ?to. C54a-rie6

Goal:

will be able to count by himself to V0 without error four days in a row.

Procedure:

Help your child feel good about himself. Praise him whenever possible. Try to work with yourchild at the same time every day.

1. Count to 10 with 7fleje-/2. Using the cup ar,d beans, have 712-LA-4---/ count each bean as he drops it in a cup.

3. 1714:04--e- counts to /3 by himself.

Each day record the number your child can count to by himself.

Reward:

This should be a realistic and practical choice. --&0 --6 717ac7.,72-42-41-4-Suggested period of time for working with child each day: S.Schedule for evaluation:

IDate to be returned

Yes No

//5-////6

Date to be returned-1

Yes No

/1/47

///i8

It 4?

Date to be returned

Yes No

/1/19

35

FIGURE 5HOME PROGRAM FOR TEACHING RESEARCH

MULTIPLE HANDICAP PRE-SCHOOL

Name: e-; Date started: //4251P/ Date completed:

Task objective: aul-4/ ,-44/.iff,-rn4:42-6-- .2-3- +1 L.44,v-z-el chvar2-0

Materials and Setting: 01-1,-ck a/0"?-1. quo -tide vePrda y s 4'71*

Treatment:

I. Cue or instructions:

,ompeg

B. Non-verbal: Rtede-ntavt-1--

C. Incorrect response: "724) ,4-ee-4-i-e-

A. Verbal:

Criterion level of acceptable behavior:

101.C. 717.4a4G.

co-m44tAz4a-p714w

on

gram. The data demonstrate that after the homeand center program was initiated the child'sprogress accelerated rapidly. Figure 7 shows agraph of a child who is learning to rote countin a learning disability pre-school; the data indi-cate that after the parents became involved inconducting home programs and helping the childto learn to rote count, the .acceleration of his

4336

skills was quite rapid. Although these kinds ofdata have been replicated frequently in this typeof home-center prugram, the evaluation whicheach center must undertake of this type of pro-gram must be on an individual basis, monitoringeach child's progress very carefully. The LunchBox Data System allows that kind of monitoringand evaluating.

MODIFIED LUNCH BOX SYSTEMIn the modified Lunch Box System the home-

center model as previously described is followedexcept that the parent conducts programs withthe child that are not conducted at the school.Another term for this model might be the supple-mentary or modified Lunch Box Model. .

IntakeAgain children are already in the centerreceiving instruction. This model is usuallyinitiated when the parent approaches the teacherand states that she would like to work on a pro-gram at home which is not being conducted inthe center. This request should immediatelycause the center to examine the programs whichthey are conducting with the child, for if theparent is placing such a high priority on this ad-ditional program, perhaps the program should beconducted at the center. However, often this isnot possible; the problem is manifested only athome.

Delivery of Direct ServicesIn the Lunch BoxModel, the collection of baseline data is part ofthe routine data-gathering system within thecenter. However, in the Modified Lunch BoxModel, no baseline data have been gathered inthe center and therefore the first step in thismodified approach must be to gather such data.If the information to be gathered has to do withthe acquisition of a skill, it should be easilycollected at the center. If an inappropriate be-havior is being manifested in the home, baselinedata will have to be gathered there. The parentthen will have to be instructed how to do this.For instance, let us suppose that the child isexhibiting temper tantrums in the home but notin the school. For baseline data the teacher may

request the parent to count the number of tempertantrums and the length of each temper tantrumover a three-day period.

Once the necessary baseline data have beengathered, the procedure for conducting and moni-toring the program is essentially the same as theLunch Box System, except that since the programis not being carried out in the school as well asat home, it is not necessary for the teacher tomonitor the data daily, although the parents mayrequest that the teacher do so. Data submittedevery three to five days by the parent should besufficient for the teacher to modify the programas necessary to insure that the child is makingprogress.

It should be recognized that if this modifiedprogram requires the parent to teach the child askill, the teacher should demonstrate it for theparent and carry out the entire modeling proce-dure described in the Lunch Box Model. Further-more, the teacher's written instructions for theparent should be very specific and precise. Ifthe parent decides to deviate in any way fromthose instructions, the parent should be askedto consult the teacher.

Liaison and Follow ThroughPeriodic liaison ismaintained with the parent on a three-to-five daybasis and the programs are modified based onthe data at that time. Certainly if the parent ishaving difficulty she should feel free to call or tocontact the teacher and arrange for a conferenceso as to make early modification of the program.EvaluationOn a program-wide scale the numberof these types of programs should be tracked andexamined to determine that there are no deficitsin the center programming for the children which

4437

EXPRESSIVE LANGUAGE SKILLS

Imitation of Two, Three and Four Word Chains

Phases: I. Child imitates last word of phrase chain.II. Child imitates last 2 words of phrase chain.III. Child imitates 2 words of phrase chain picture or object presented.IV. Child imitates last 3 words of phrase chain.V. Child imitates 3 words of phrase chain picture or object presented.VI. Child imitates 4 words of phrase chain.VII. Child imitates 4 words of phrase chain picture or object presented.

The following are examples of phrase chains to be used when teaching this skill:

38

Steps: A. Two word chain

1. a boy2. a girl3. a shirt4. the dress5. the milk6. the cake7. a bed8. a chair9. red ball

B. Three word chains

1. is a boy2. is a girl3. is a shirt4. is the dress5. is the milk6. is the cake7. is a bed8. is a chair9. the red ball

10. a car11. the dog12. the cat13. a house14. a boat15. a baby16. the candy17. red wagon

10. is a car11. see the dog12. see the cat13. is a house14. is a boat15. is a baby16. is the candy17. the red wagon

18. a toothbrush19. is eating20. is washing21. is writing22. Is dancing23. is running24. is sleeping25. is ironing

18. have a toothbrush19. man is eating20. woman is washing21. boy is writing22. girl is dancing21 boy is running24. man is sleeping25. woman is ironing

EXPRESSIVE LANGUAGE SKILLSImitation of Two, Three and Four Word Chains (continued)

Examples of phrase chains (continued)

C. Four word chains

1. This is a boy.2. This is a girl.3. This is a shirt.4. This is the dress.5. This is the milk.6. This is the cake.7. This is a bed.8. This is a chair.9. See the red ball.

10. This is a car.11. I see the dog.12. 1 see the cat.13. This is a house.14. Ride in a boat.15. This is a baby.16. This is the candy.17. See the red wagon.

18. I have a toothbrush.19. The man is eating.20. The woman is washing.21. The boy is writing.22. The girl is dancing.23. The boy is running.24. The man is sleeping.25. The woman is ironing.

* Work with a group of 3-5 words at a time, spending a few minutes on each word andgoing over several word chains in each session. Give phrase; Susie must imitate phrase; donot let her give "jargon" before she imitates phrase.

necessitate these additional programs in thehome. On an individual child basis, however, thedata should indicate the progress of the childand how well the program is working.

One case study of a child on a modifiedLunch Box System follows. It illustrates how acenter should keep individualized data. Figure 8shows data for a family whose child is in theTeaching Research Infant and Child Centermultiple handicapped classroom. The parentswere having difficulty with the child's respondingto commands or instructions. In fact, the child'scompliance rate was so low that the parent

deficit. Yet, the center was not experiencing asimilar difficulty. When the child first entered thecenter, the first few days were spent bringingsome inappropriate behaviors under control, butthere was no continual difficulty with compliance.

Consultation was held with the parent aboutthe difficulty she was experiencing at home. Base-line data indicated that the child was complying40% of the time.

A program was initiated in which the parertwas required to exaggerate the consequences forthe child's compliance and for non-compliance.At the time of this writing, the program is con-

suspected that the child might have a hearing tinuing but the compliance rate at home has

4639

reached 82% and the parent is in the process offading the primary reinforcers used in theprogram (see Figure 8).

THE PARENT AS A VOLUNTEERIntakeOftentimes parents are willing to serveas volunteers in the child center. Every oppor-

40

tunity should be made to utilize these parents inthe actual instruction of children because, asthey learn how to instruct children in the center,the parents will then be able to instruct andguide their own child in the home more effec-tively. It is a rare parent who works in an effectivechild center who has not learned to present cues

Figure 5 (Continued)

Child's Name

Criterion: 5 co-rwee..eztwei0-714.44,

1= Correct response0 = Incorrect response

Behavior Date

Phases:Baseline

II //ZS/

/ .28 i .29 V30 .2/31. a boy /2. a girl gig)/3. a shirt Q:Ei)//4. the dress Gi2)5. the milk ci:D'6. the cake / mew7. a bed CED'8. a chair 6309. red ball t*g?)

10. a car / ,c:ii)11. the dog d 000dS012. the cat ci!i)13. a house /14. a boat -E-1)15. a baby_16. the candy /17. red wagon 0 //AweTeaching Time j-- p,u;,r. /5 yyz.,,t, /.5- wi.,;,, As- 7,24-n. ,,t54A 'rt°,414.

47

and consequences properly, who has not learnedto analyze a task, and who has not seen thenecessity for the maintenance of data to insuremore efficient programming of children.

A group meeting of parents might be held toobtain volunteers. The topic of parents' volunteer-ing should be presented and explained. The pres-

entation of video tapes of parents at work in thecenter is particularly effective. Emphasis on thebenefits that will accrue to their own child may"sell" some parents on the idea.Service DeliveryOnce the parents have agreedto volunteer, they must go through a trainingperiod. The limits of this chapter do not allow a

Figure 5 (Continued)

Child's Name

Criterion: 1/4-3 c#1,1-ce-e

077.4411

1= Correct response0 = Incorrect response

Behavior Date

2/3a toothbrush Ow

Gi.,2$

Susie is eating Cam)Susie is washing ic)o.-&i9Susie is writing moiwSusie is dancingSusie is runningSusie is sleepingSusie is ironing

Teaching Time /5-- 7,2442 /5- 7,2-n.

41

FIGURE 6PROGRESS OF A CHILD IN

A HOME-CENTER PROGRAM

SIGHT VOCABULARY

Center Only I Center and Parents

25

20

P

0 15b..

E

10

ChildMongoloidAge: 71/2

8 9 10 11 12 13 14 15 16

Weeks

42C; 49

FIGURE 7PROGRESS OF A CHILD INA HOME-CENTER PROGRAM

Center OnlyROTE COUNTING

Center and Parents

20(17)

ChildEMR (IQ 72)Age: 5 years

10 11 12 13 14 15 16

43

FIGURE 8HOME PROGRAM FOR INAPPROPRIATE BEHAVIOR

TEACHING RESEARCH INFANT AND CHILD CENTER

44

Name . rAwti Date started /01-e-e4911,4, /3) /973Date completed/terminated

Task Objective:

%.17244.taAtt, CO-mereidini eeernra:M4141.. -4) 852 je7.44,ee,n, 900 ea,nd,

condt444,.... dame. ftc at ae....e4e..dies go&yetel.Baseline Data:

/02//1/ 50% /02//6 33% /a2/i8 02.51, X = /D1/a/ 45- 33% /.2//7 SO% AO9 407:Final Data:

If program notcompleted butterminated, statereason:

Treatment:

1.4 .4.4../jord fre- _ea-a cermrsha:pme..e.-

2. 4".4-paioize vii.eprd frt. _tea Co704,11...s.c4.. Re.v.3.4.41

w/1.4.p-pre- 4.e...444d 1;x0 "o-t Acte.4 non- e-427,4a

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complete discussion of the training that shouldbe conducted for a parent volunteer. However, wehave found certain rules for training to be effec-tive guidelines. In short, some of these guidelinesare:

Time must be taken to train volunteers andthe training must be concise and simple.A short lecture describing the center, thethings a volunteer must do, and some prin-ciples of teaching is an excellent way tobegin. This lecture is followed by observa-tion and demonstration, and finally, thevolunteer should be placed in a practicumsituation in which he teaches childrenunder supervision of a teacher or an aide.Volunteers must be given teaching tasks inthe classroom comparable to their level oftraining. It will take time for parents tolearn how to teach all parts of the curic-ulum. Starting them in one areasuchas self-help, motor, development, or arith-meticwill allow them to master that areabefore they are required to teach inanother.A continuous system of feedback as to theadequacy of the volunteers' performancemust exist. To do this the center must havea system of observing volunteers that al-lows center supervisory personnel to moni-tor the quality of the volunteer's teachingand to give feedback to volunteers.A simplified system of communication be-tween the teacher and the volunteer thatdoes not require oral instruction must exist.The teacher should write down specified,detailed directions on how instruction is tobe delivered to children. It further re-quires that the volunteer record the per-formance of the child in some iy41Pmatic

4-

46 53

way, and that the recorded data be exam-ined on a regular basis by the teacher inorder to provide timely updating of chil-dren's programs.A system of flexible scheduling of volun-teers must be maintained. The center mustbe prepared for volunteers to miss days.The scheduling must allow for that pos-sibility. It must also accommodate thetraining level of the volunteer.

For a more complete discussion of the guide-lines, see A Data Based Pre-School for theMultiple Handicapped by H. D. Bud Fredericks,Victor L. Baldwin, David Grove, William Moore,Charles C. Thomas, in press.

Liaison and Follow ThroughIdeally, once theparents have learned these skills of teaching inthe center, it would seem that they should alsobe able to take those skills and utilize them inthe home with their own child. If such a parentis not already conducting home programs, everyeffort should be made to encourage her to do so.She is then ready to move into the Lunch BoxData system.EvaluationEvaluation of parents' participationas volunteers can be done on two dimensions.First, program-wise, a simple count of how manyparents volunteer is useful. Certainly we wouldexpect at least twenty-five percent of the non-working mothers to volunteer at least one day aweek in the center.

The other dimension upon which the effec-tiveness of parents as volunteers can be mea-sured is their success as teachers, which can bemeasured by tabulating their efficiency in dis-pensing cuses and consequences, and the way inwhich they keep data and help manage thechildren.

H. D. "Bud" Fredericks, Ed.D., is AssociateDirector of Teaching Research in Monmouth,Oregon. He is the co-author of Isn't It Time HeOutgrew This?, The Teaching Research MotorDevelopement Scale, and Impact of Title VISeries, State of Oregon.

Dr. Fredericks has received degrees fromHoly Cross, Stanford University, and the Univer-sity of Oregon, and has done research in theareas of the retarded, deaf and blind children,and the emotionally disturbed.

Victor L. Baldwin, Ed.D., is the co-author ofIsn't It Time He Outgrew This? and The TeachingResearch Motor Development Scale, and is pro-fessionally interested in behavior modification,measurement and evaluation, paraprofessionaltraining and classroom management. He is cur-rently the director of the Exceptional Child Re-search Program at Teaching Research in Mon-

Oregon, and holds degrees from KansasState College and the University of Oregon.

David N. Grove, Ph.D., is an Associate Re-search Professor at the University of Oregon. Hehas done research in the areas of physical therapytechniques, parent training and treatment strate-gies for agencies who treat children with behavior

problems. He holds degrees from the Universityof Kansas and the University of Oregon, and hismajor professional interests are in experimentalanalysis of human behavior, parent training, be-havior engineering and children with behaviorproblems.

BIBLIOGRAPHYBaldwin, V. L., Fredericks, H. D., and Brodsky, G.

Isn't it time he outgrew this? or A trainingprogram for parents of retarded children,Charles C. Thorns, Publisher, Springfield,Illinois, 1973.

Fredericks, H. D., Baldwin, V. L., Grove, D., andMoore, W. A data based pre-school for themultiple handicapped, Charles C. Thomas,Publisher, Springfield, Illinois, in press.

47

A Home Based Potent Training ModelBy Marsha S. Shearer

The basic operational premises of thePortage Project, as they relate to parents are:

1) Parents care about their children andwant them to attain their maximumpotential, however gkaat or limited thatpotential may be

2) Parents can, with instruction, modeling,and reinforcement, learn to be moreeffective teachers of their own children

3) The socio-economic and educational orintellectual levels of the parents do notdetermine either their willingness toteach their children or the extent ofgains the children will attain as a resultof parental instruction

4) The precision teaching method is thepreferred learning model since feedbackis provided daily to parents and weeklyto staff, thereby reinforcing both whengoals are met. Moreover, the methodprovides a continual data base for cur-riculum modification thus maximizingthe likelihood of success for parentsand children

OVERVIEW. AND RATIONALE OF THEHOME BASED PRoGRAM

The portage Project'Operates administrativelythrough a regional- educational agency serving.twerity4hree distrietkin toutn-central rural; .

consin. The Project presently serves 140 children;birth to Schee)! .age;:olo have, been. *Miffed 44:being handicapped inpne or more developmental::areas.:Any Preschool child;. with any type' or.severity of handicap residing-,Wfthin, the 3,600.square mite area *led by the agency, quatifieS,for the early intPrm.ent*ProlPct-

In the Portage.Prajtot there is no classroomprogram. Instead of having children come into acenter, we use "home teachers" to visit in everychild's home where they instruct the child'sparents how to teach their own child. So ourmodel is completely home based, rather thancenter based and parents with the help of hometeachers do all the teaching of their own children.

Three practical factors influenced our de-cision to have an exclusively home-based pro-gram. The first was that we were dealing with

49

such a large geographical area that the cost andresponsibility of transporting very young handi-capped children great distances was prohibitive.Second, even when several children were identi-fied within a smaller geographical area, such asone school district, the variance in chronologicalages, functioning levels, and handicapping con-ditions precluded the possibility of establishingclassroom programs. Finally, classroom programswould have severely limited parent involvementbecause of the geographical and psychologicaldistances between home and school. On the basisof these factors we decided that all instructionwould take place in the parent and child's naturalenvironmentthe home.

To implement this program, a home teacheris assigned to each child and family. This educa-tor who may be a trained professional or a trainedparaprofessional, visits each of the assignedfifteen families one day per week for one and a

half hours. Individual curriculum is prescribedweekly based on an assessment of each child'spresent behavior in the areas of language, self-help, cognitive, motor, and social skills. Utilizingthe parents as teachers, the Portage Projectfollows the precision teaching model which iscomprised of these element-:,:

At least three behavioral goals are selectedfor the child to learn each week. The goalsand criteria for accomplishing them arechosen so that the child, and thus theparent, will achieve success within a oneweek period of time.Baseline data is recorded by the hometeacher on each new task prior to instruc-tion to the parent as an additional checkon the reatiness of the child to proceedwith other learning activities.

5750

7 ;:

The parents implement the actual teachingprocess itself, including reinforcement ofdesired behavior and reduction or extinc-tion of behavior that interferes with learn-ing appropriate skills.The home teacher records post-baselinedata one week after the baseline is takento determine if the prescribed skills have,in fact, been learned.

The purpose of the weekly home visit is toinstruct the parents what to teach, how to teach,what to reinforce, and how to observe and recordbehavior. The home teacher instructs the parents(or siblings or parent substitute) during the homevisit. Then, the parents or substitute teach thechild and record his progress daily throughout thefollowing week.

In this model there are certain practical ad-vantagesnot having to transport children or pro-vide a center facilitythat reduce the cost of theprogram by more than half. But even more im-portantly, there are inherent advantages that thePortage Project staff has experienced in thehome-based, precision teaching model. These ad-vantages are based on involving the child's first,and potentially his best teachershis parents.The educational assests that we found are:

The parent teaches the child in theirnatural environment. Therefore, they do nothave the problem of transferring learninginto the home as they would if the childwere in a center-based program.This model is totally dependent on parentinvolvement for success. Since one and ahalf hours one day per week is not a suffi-cient amount of time for a child to learndevelopmental skills from the hometeacher, parents must be taught to teach

their own child between home visits. Thus,training parents is more than an adjunctit is absolutely mandatory.Another major advantage in using thehome-based precision teaching model isthat the home teacher and the parentshave direct access to the child's behavioras it occurs naturally. This situation en-genders realistic curriculum goals that willbe functional for the child within hisunique environment. In fact, the differencesin cultures, life styles, and value systemsof parents are incorporated into curriculumplanning, since the parents determine whatand how their child will be taught.It is more likely that the skills that thechild learns will generalize to other areasand be maintained if the skills have beenlearned in the child's home environmentand taught by the child's natural rein-forcerhis parents.Father, sibling, and extended family in-volvement becomes a realistic and obtain-able goal. When instruction occurs in thehome there is more opportunity for fullfamily participation in the teaching pro-cess.There is access to the full range of thechild's behavior, such as temper tantrumswhich only occur in the home or hearingfrom the parents that their child is crawlinginto bed with them each night. Much ofthis behavior could not be targeted formodification within a classroom.Finally, since the home teacher is workingon a one to one basis with the parents andchild, individualization of instructionalgoals for both is reality rather than anidealized goal.

5b

PARENT PARTICIPATION IN THE INTAKEAND ASSESSMENT PROCESS

After a child has been referred to Fhe Project,(parents can and often do refer their own chil-dren) a home teacher contacts the parents andmakes an appointment to visit the home to ex-plain the project and meet and screen the child.

It is at this time that parents are told thatthey will teach their own child and that they willlearn how to teach him by observing the instruc-tion given by the home teacher. The followingare examples of a few typical reactions of parentsand resultant responses of the home teachers atthis point.

Parent: "Oh, I've tried teaching Mary, likehow to walk, but she can't even crawl yet."Teacher: "Maybe teaching Mary how tocrawl, if she's ready, would be a good placefor us to begin."Parent: "We're not trained teachers; wecan't do anything as important as that."Teacher: "You've been teaching Jim allalong. Just look at all the things he cando. He makes sounds, he's beginning tofeed himself, he matches objects, he pointsto body parts. You've taught him a lot!"Parents: "We've given up trying to accom-plish anything. He just drives us crazy. Youteach him and leave us out of it."Teacher: "I can't. I need you and so doesChris. While I'm here, I'll show you whatto do and how to do it. I'm not going to askyou to try anything without showing youfirst that it's going to work. So let's give ita try together."Parent: "Oh, I don't have time to teachTodd."Teacher: "You do spend some time with, )

51

Todd each day don't you? Okay, all I'masking is that you spend that time workingon these activities, I promise they won'ttake more than half hour a day. And yellany time if you think it's too much,"Parent: "I have no patience. I don't thinkI can do it."Teacher: "Sure you can, I'll give you allthe help you need. Give the program a tryfor a month or so. If you don't think we'regetting anywhere, you're free to withdrawat any time. But give it a try first."Parent: "I work all day, don't get home'till 6:00 and by then I'm exhausted. I fixdinner for Dawn then she goes to bed.There's just no time for me to work withher."Teacher: "I'll be happy to work with Dawn'sbabysitter and I'll call you each week tokeep you posted so you'll know how she'sdoing and what to work on during theweekend."

But the most frequent reaction to our ap-proach to parents is, "We've never gotten anypractical help 'till now. Every time I take her infor an evaluation, we're told nothing. Oh, theytell us Penny will never walk and that she mightbe blind. But no one has ever told us what wecan do to help."

After five years of working with nearly fourhundred parents, we have found that the mostfrequent question asked during the initial visit is,"What can I do with my child; how can I helphim learn?" Parents are accustomed to hearingwhat their child isn't doing, so it isn't surprisingthat they stress the negative too. And this bringsus to the assessment process.

52

The child is screened during this first visit todetermine project eligibility. All screening is donein the home, with parental consent and their helpby contributing their knowledge of the child. Thescreening inst'ument (Alpern and Boll, 1972)which is also used as one of the pre-post meas-ures, is administered as a parental questionnairetogether with direct observation of the child'sbehavior, when possible. In fact, it couldn't beaccomplished without them. We have found thatthe results are likely to be more reliable than iftesting were done without the benefit of parentinvolvement because parents know their childrenbest. Also, since the assessment instruments areadministered on the parent's and child's "homeground", results are likely to be more accuratethan if the assessment were attempted in a

strange environment.The assessment of the child also becomes

the first step in parent training. During this pro-cess questions are asked by the home teacherconcerning the child's present behavior in fivedifferent areas of growth and development. Manyparents voice surprise at how much they knowabout their child in some areas and how littlethey know about their child in others. Parentsmake genera! remarks like: "I must have seenJohnny go up and down steps hundred of times,but I just haven't noticed if he does it with twofeet on the same step or if he walks down likeI do." If the parent is unsure of the answer toany question, the home teacher tests the childdirectly.

Many parents verbalize that they don't knowif their child can cut with a scissors or ride atrike because they haven't given him the oppor-tunity. Often, just asking the parents the ques-tions gives thern the clue to try. One parent called

the office two days after initial assessment toreport that not only could Suzie now cut paperfollowing a straight line she also took advantageof her new-found skill and gave the family doga haircut! (Fortunately, the mother was laughing.)

In addition to the Alpern -Boll, the PortageChecklist is also completed (Shearer, Billingsley,Frohman, et at 1972). A complete description ofthis instrument along with descriptions of otherproject components can be found elsewhere(Shearer and Shearer, 1972; Frohman and Schort-inghuis, in press). This instrument lists a seriesof behavioral sequences from birth to age fiveencompassing self-help, motor, language, sociali-zation and cognitive skills. This checklist aidsthe parent and teacher in breaking developmentaltasks into smaller steps and then assessingwhether the child exhibits the behavior on entryinto the program. What the child can already dodetermines what he's ready to learn next. Theresults of the assessment are discussed with theparents. All of the parents' questions regardingthe assessment are answered honestly and inunderstandable language without psycho-educa-tional jargon. When we discuss the assessmentwith the parent, we emphasize what the child cando. This is because the curriculum the parentwill be asked to carry out will be based on whathe is ready to learn next. The process itselfsometimes makes parents aware of the accom-plishments of their children. One father said,"You know, up to this point, all I've really noticedare all the things Ronnie can't do. Guess he'saccomplished a few things after all."

After the assessment is completed the hometeaching process begins. Based on the informa-tion in the assessment, the home teacher oftenpoints out three or four behavioral goals that are

emerging. The parents are given the choice asto which behavioral goal they would like to targetfirst.

PARENT PARTICIPATION IN THEDELIVERY OF SERVICES --THE HOMEVISIT PROCESS

The home teacher writes up an activity chartincorporating the parents' selection of behavioralgoals (see figures 1 and II). The most importantpoint here is for the home teacher to break tasksdown and prescribe only those which are mostlikely to be achieved within one week and can beachieved with high degree of probability. Whensuccess on these tasks is achieved the parentsare immediately reinforced because what waslearned by the child was a direct result of parentalteaching. The directions are written in simple,clear language so that the parents can refer tothem during the week. The parents are asked tokeep simple records on the activity chart. At firstrecording is uncomplicated and usually involvesfrequency counts.

First the home teacher introduces the activityto the child and records the frequency of correctresponses prior to instruction. This baseline datais recorded on the activity chart. The hometeacher begins the teaching process by followingthe written directions on the activity sheet. Thehome teacher is thus modeling teaching tech-niques for the parentsshowing them what to doand how to do it. After several trials, the parentsmodel for the home teacher. Extra activity sheetsare provided so the parents can practice record-ing the child's behavior as they work with himwhile the home teacher is still there. The hometeacher then is able to offer sugestions and rein-forcement that will maximize the likelihood that

53

FIGURE 1ACTIVITY SHEET

PORTAGE PROJECT

Child's Name 524:41

Home Teacher's Name

Week of /ea.,

BEHAVIOR:

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_44,44cit. y itht. 0.94441).44ti a-.144 u-A4:c4/ -4.21

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ACTIVITY CHART

I a a a a aTWIF35MTDIRECTIONS: DAYS

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3. ic3t4t4Agt, /wt. _eetek ,44.4 ,4,11q4:42-444. 21,4z. a m 0,24a t4.644444 a.~e

5. 4"..t.c.ftd -7744-7714e .t- ?ru,n4,,te,o i444- xylvn4i44-244 ,eadt, ce.y.

54

the parents will work effectively with the childduring the week and then the child will succeedwith the prescribed activity.

Throughout the visit the home teacherstresses the importance of working with the childduring the week. The home teacher leaves his orher home and office phone number with the par-ents and encourages them to call if any questionor problem arises during the week. The hometeacher returns the following week to collect post-baseline data on the previous week's activities.This helps the teacher validate the accuracy ofthe parents' recording and provides the teacherwith feedback concerning the degree of successachieved by the child and his readiness to pro-ceed to the next sequential step. Based on thisdata, the home teacher prepares a new activitysheet. On this new sheet the previous prescrip-tions are altered or new activities are introduced.Baseline data is recorded and so the cycle isrepeated. At the completion of each home visit,the parent writes an evaluation of the week'sprogress, which often serves as an additionalsource of information for curriculum planning andmodification.

Every attempt is made to utilize materialsavailable in the home; however, there are timeswhen materials are brought in and left for theparents to use. This works well because parentstake care of materials. During the past five years,only two percent of these materials have beenlost or broken.

This is the basic sequence of the home visitprocess. However in reality, sometimes modifica-tions of the process are necessary. Parents arenot the same, thus it is as important to indi-vidualize the teaching process for them as it isto do so with their child. The following are ex-amples of how the process has been modified

to accommodate individual differences amongparents.

Parents Who Cannot Read or Write or Who AreThemselves Handicapped.

One family had eight children, seven of whomwere in special education classes, The youngest,a preschooler, was at home and had been re-ferred to the Project by the county nurse. Thefather kept all intruders away from the housewith a shotgun and greeted the home teacher inthis manner; however, both parents listened to anexplanation of the Project. The conversation tookplace on the wooden porch which apparently wasnot able to hold the weight, and it collapsed! Thehome teacher was asked to come back the nextweek anu, possibly because there was no longera front porch, she was invited into the t;ousewhere she met and screened Joey. Based on theassessment it was determined that Joey /vasfunctioning at the "trainable" level. After scmediscussion; the parents agreed to participate inthe Project and work with the child.

There were instances when the home teacherhad to teach the mother the skill before shecould teach it to her son. Sometimes the learningoccurred simultaneously. For example, onemother and son learned to name and discrimi-nate between colors together, and both wereequally proud of their accomplishments.

Because an activity chart would be of no useto this family, the home teacher relied heavilyon demonstrating the teaching process necessaryto implement each prescription, and on parentmodeling. Recording was done on masking tapethat was taped on the kitchen table with onepiece of tape representing each day of the week.Hash marks were drawn on the tape which indi-cated to the mother the number of times the

55

FIGURE 2ACTIVITY SHEET

PORTAGE PROJECT

Child's Name

Home Teacher's Name *e&z./Week of tOSe-e-riilfre /40-4

BEHAVIOR:

oCan.n.it, .44:e

3

.4tcycip-a-rie,n3 .44,-catrui

AIL-rut/41er Acie2,72,c-t-

...4GGandA2-,.

ACTIVITY CHART

56

TFS5MTINTDIRECTIONS: DAYS

1. Aid on J.ogo-o-7,- .44.a` o<07t/n-a/ .Ze.t1sA-Wfrt. L.114,t4,te e 4e.rt.ce,nrt.Ct .41.42-1" ari,rutt afouir. Atemar. Itdcze-4 kt.nd

airurn-dt ,07741- ILe-e, -Asiek2. ayeak Apeet ,hAt -zee de4 4 gay ctia.3

afvuett,o zAt. ia,LA-44t4eti 4,71 e<CA.

3. Count XAG 7:44-rnix44. o ,dge-on.da -442 7na4:91-eiss-n-a is e:Nu-40;n 444/at-0-cd u...4.0-;-ng Ave A'a-neh, ( g 4 4-711 on yow....ha),444dodc.t ,414p

4. irek, k.,t o.5. euuti4t, 5,6-rni.o/da Ac-e-e-ut ,t44.:ah

activity was to be practiced. The mother circleda hash mark for each correct response. Two oldersiblings were interested in the activities so thehome teacher involved them in the teachingprocess too.

After one year in the project, Joey was thefirst child in this family of eight who was able toenter kindergarten. Testing data indicated hewas functioning within the normal range.

Parents Who Do Not Work With Their ChildBetween Home Visits.

Annie, the target child, was especially low inlanguage skills and so the home teacher wantedto acquaint the mother (this is a single parenthome) with the importance of verbalizing to thechild. The first prescription was, "Mom will reada story, five minutes in length, to Annie eachday." The parent could simply record on theactivity chart, "yes" she did read, or "no" shedidn't. When the mother still hadn't accomplishedthe task two weeks later, the home teacher hadto think of a system to motivate the mother toread to the child.

The prescription was modified the followingweek so that the mother would read a short storyto the child daily. The home teacher put eachstory book in an envelope which also containeda small present for the mother, such as a combor a small vial of perfume. She hoped that thepresent would motivate the mother to open theenvelope, although this was no guarantee shewould read to the child.

The home teacher began thinking of anotherkind of reinforcer for the mother. She knew thatthe home was lacking in many modern conveni-ences, like running water. To get water, themother had to walk one mile every week with asled or a wagon, depending on the weather, to a

nearby tavern which was the closest water supply.The real payoff was to come at the next

home visit. The home teacher had told the motherthat if Annie could recall two facts about eachof the stories that had been read to her that she,the home teacher, would get the water for themother that week. The mother worked with thechild that week and Annie could recall the facts.The best thing that happened from our point ofview was that the mother was so reinforced byher child's success that she no longer neededto be coaxed into working with her child. Threeweeks later, the mother sail, "It's akay now. Youdon't have to get my water. I want to work withAnnie."

Parents Who Do Not Record

Although all the parents need to do is recordthe total number of correct responses on theactivity chart, there are so many parents that donot record during the first month that a singleexample would not be instructive. Howevergadgets like clickers, golf counters, and knittingcounters are especially helpful. Even though noneof the parents' data is used to add to or modifyprescriptions, (baseline and post-baseline datacollected by the home teacher determines that)it can serve as a major motivator for the parentsbecause they can see small gains that mightotherwise go unnoticed. Extra praise and atten-tion from the home teacher or staying for anextra cup of coffee have been used as a rewardfor the parent who records. In one case the hometeacher had been trying, unsuccessfully, to getthe parent to record and the parent had beentrying, unsuccessfully, to get the teacher to buypanty hose. They came to a mutual satisfactorytrade offrecording data for panty hose.

57

SOME "HOW TO'S" OF WORKINGWITH PARENTS

The Project has learned several importantlessons, some of them the hard way, as theyrelate to working with parents. A few of thesesuggestions are directly related to working inhomes. However, most would be applicable re-gardless of the instructional setting.

Set Weekly Curriculum GoalsChoosing the goals and writing the prescrip-

tions are the most difficult tasks the teacherfaces, and.probably the most important. In plan-ning individualized goals for a child and theparents, it is important that the chosen goal beone that can be achieved within one week. Theremay be times that this goal will not be met; how-ever, it is extremely important that successesoccur frequently and quickly, especially in thebeginning. When the child succeeds, the parentssucceed since they are the ones who are doingthe teaching.

At this point the teacher knows from theassessment that the child, among other things,is not toilet trained, doesn't feed himself, hastemper tantrums, doesn't imitate sounds, can'tsort primary colors and can't hop. Where to be-gin? Begin where he iswith what he can alreadydo. It really does help to look at the things thechild can do. rather than the things he can't. Hedoes stay dry for one and a half hours; he canhold a spoon, dip it and get it to his mouin withhelp; he does make vowel sounds and some con-sonant sounds spontaneously; he can sort blueplastic cars from blue plastic spoons; and he doesrespond to praise and smiles. Now, what couldbe appropriate beginning objectives that are likelyto be achieved within a week? Here are a fewpossibilities:

58 (66

The family members will take Johnny intothe bathroom with them and they willmodel toileting behaviors.The mother will place Johnny on the toiletevery one and a half hours for no morethan five minutes. If Johnny performs ap-propriately, he will be given praise and ahappy face sticker to put on the bathroomdoor.The mother will put Johnny in trainingpants during the day (not diapers).Johnny will sort blue plastic cars andyellow plastic spoons into two groups.Johnny will dip his spoon into sticky cereal(oatmeal) without help, will hold spoonwithout help, and will guide spoon to mouthwith minimum aid (slight pressure on hiselbow).The mother will count the number of tan-trums Johnny has each day (baseline in-formation).The mother will imitate any sound Johnnymakes and she will count the number oftimes Johnny imitates her.Johnny will stand on one foot without sup-port for five seconds.

The choice of activities would depend totallyon our mythical Johnny. He determines thecurriculum. The choice, in the beginning, shouldbe based as much on the likelihood of successas on the importance of the skill.

Show the Parent What to Do and How to Do ItIn teaching any new skill, it is important to

model the behavior that is expected. For instance,in teaching a child to sort colors, a teacherwouldn't say, "Okay Johnny. sort colors." Theteacher would show him what to do by doing itherself. Adults being taught new skills also learn

better when given concrete examples. For in-stance, a parent is much more likely to deal withtantrums in a certain way if shown how to do itrather than being told how to do it. This meansthat the teacher may have to instigate a tempertantrum and then show the parents how to handleit. The teacher finds out what typically setsJohnny off and then creates the same situation.If the technique suggested by the home teacherdoesn't work, something else is tried until atechnique is found that does work. In this way atechnique that will work is discovered and theparents are not frustrated by trying somethingthat won't work. Teachers need not be afraid oftrying and failing in front of the parents. Theteacher is showing the parents that it is alrightto make mistakes as long as the prescription ismodified to achieve success. The teacher then,is modeling problem-solving behavior for theparents. The moral then is: there is always asolution.

Have the Parents Practice Teaching the SkillThe purpose of the home visit is to instruct

the parents to teach the child, and one conditionnecessary for the parent's learning is the oppor-tunity to practice. After the parents have seenthe teacher work with the child and succeed,they need to experience the same success, sincethere is a major difference in seeing an activitybeing taught and doing it yourself. Parents needto know they can teach effectively too in thepresence of the teacher. Thus, parents will bemore likely to carry out the activity when theteacher is not there. Also this provides an oppor-tunity for the home teacher to spot problemsquickly. For example, the parent might not letthe child know when he is correct, or the parentmight be giving too many cues or not enough.

If these problems can be corrected before theteacher leaves, then the likelihood that the par-ents and child will succeed with the activityduring the week is greatly increased.

Reinforce the ParentsAnother condition necessary to learn new

skills is reinforcement. Just as the child is morelikely to perform actions that are reinforced, soare the parents. Let them know; tell them whenthey're doing it right and be patient. It is notreasonable to expect perfection from parents im-mediately. Sometimes the parent may have tobreak long-established behavior patterns of hisown to be able to apply good techniques in teach-ing his child. For example, the parent may beused to doing things for the child that he cando for himself, ignoring "good" behaviors and at-tending to "bad" ones, or not talking to the childbecause he never responds anyway. It does taketime, practice, and reinforcement to change o;dpatterns, and parents should be praised for smallimprovements. Small improvements lead to bigones!

individualize for ParentsSome parents have experienced so much

failure when trying to work with their child in thepast, that they do not want to try again. To changethis "I give up" attitude to an "I did it!" attitudemay mean that the home teacher must offerparents more tangible encouragements thanpraise. In one home, for example, the teacherand parent drank a beer together and socializedafter the home visit if the child had accomplishedthe skill. (It was the home teacher's last visit ofthe day!)

This rather atypical example serves to showthat in the beginning, praise alone may not beenough to motivate some parents. However, oncetb b

59

parents see that they can succeed and that theirchild can learn as a result of their teaching, youcan substitute praise for more tangible rein-forcers. Success is the greatest reinforcer of all,but in some cases extraordinary measures needto be taken just to get the parents involved sothey can experience success.

Involve the Parents in PlanningAs the parents experience success in teach-

ing their child, the home teacher should reduceher help and involve the parents in planningweekly goals. Thus, the parents do not becomedependent on the teacher but become confidentand self-reliant in planning the curriculum fortheir child as well as teaching it. Some parentswill reach this stage six months after they beginin the program, and some after six years. Theparents should be encouraged to take as muchresponsibility as they can, but the home teachershould always be ready to give support, reinforce-ment, help, and encouragement based on theparent's needs.

EVALUATION OF PARENT PARTICIPATIONThere are several ways to measure the degree

of parent participation. One is to measure theprogress of the children. One of the most tradi-tional ways to do this is to compare I.Q. scores.The average I.Q. of the children in the projectwas seventy-five as determined by standardizedintelligence tests. Therefore, it would be expectedthat on the average, the normal rate of growthwould be seventy-five percent of that of the childwith normal intelligence. One would expect thatthe average gain would be about six months inan eight month period of time. However, theaverage child in the project gained fifteen monthsin an eight month period. Although the home

60

teachers did help the parents plan the curriculum,these gains in I.Q. could only have been attainedthrough parental teaching.

Another way to evaluate the parents' effec-tiveness is to test the child after the summer .

vacation since the program does not operateduring the summer months. Children who aretoo young to go to public school and remain inthe project longer than one year are retested inSeptember, and these test results are comparedto the scores achieved the previous May. In thepast there was no significant difference in thescores although some regression might have beenexpected. This indicates that tha parents con-tinued to work with the child and reinforce himeven though the home teacher was no longermaking visits.

Ninety children were served by the projectlast year and the frequency of parental recordingover the year's period of time was ninety-two per-cent. An average of one hundred and twenty-eightprescriptions were written per child over a year'speriod of time. The children were successful onninety-one percent of the prescriptions written.This indicates that the parents taught the childrenduring the week, and that, based on post-baselinedata taken by the teacher, the children did indeedlearn.

The success of this model also can be meas-ured by the ability of parents to plan curriculumwithout assistance. Approximately sixty percentof the parents have been able to plan curriculumfully and write up activity charts without teacherassistance.

Furthermore, we have found that a significantnumber of parents are using the teaching tech-niques learned from the home teacher to changethe behavior of other family members, in additionto the targeted child's.

The Project has attempted to conduct surveysabout the program after the program year endedto determine if a relationship existed betweenamount of gains made by the children and theparents' attitudes. However, the parent's com-ments were so positive that no relationship couldbe drawn. (Peniston, E., 1972).

We think that one of the most significant in-formal evaluations of our project was the factthat the parents fought so hard to make sure itwas funded. Two years ago (before mandatorylegislation was enacted in Wisconsin) federalfunds were discontinued for the direct servicecomponent of the Project. In order for the pro-gram to continue, financial support from localpublic school districts was necessary. Most schoolboards were eager for program continuation andcontracted with the agency for service. Wherethere were exceptions, parents organized on theirown and went to school board meetings request-ing service. They apparently were quite influentialsince four districts in question did opt to pur-chase the program. (One fatI4P told 5 schoolboard that if the district didn't buy the Project, hewould move his family to a school district thatwould!)

Final Comments Regarding the Portage Home-Based Program

This modal depends upon a structured, con-centrated interaction between the home teacher,the parents, and the child. It is important to betask-oriented during the home visit. There ismuch teaching to do, yet there is usually sometime left for having a cup of coffee and social-izing. During this time a parent may talk aboutmarital, financial and other personal problems,and the home teacher can, and should, refer theparent to agencies or people who are trained to

help. The teacher's expertise is in teachingnotsocial work, counseling, psychology, or psychi-atrybut it is her responsibility to be aware ofcommunity resources that can serve these otherneeds. It then must be the parent's decision tocontact or not to contact the suggested sources.The option and decision must be left with theparents.

Each teacher should set up a scheduled dayand time for the home visit. If there is a change,parents should be informed. Because a familymay have a handicapped child or may be in needof assistance does not mean the family mustforfeit their right to privacy.

The teaching staff members may see homesand family life styles very different from theirown. Thus, it is vital for the teachers to realizeand accept that they are in the homes to aid theparents to learn teaching skills and not to changelife styles or value systems. The teacher shouldremember that he or she is a guest in each homeand can only maintain the child-parent-teacherrelationship with the parent's assent.

Many educators have, for too long, usurpedthe parent's role of responsibility in education.This condition may be magnified as more stateslower the age for mandatory education for handi-capped children by providing early intervention assoon as a problem is identified. Parents of thechildren being served need guidance and sup-port from teachers but it is equally as importantto realize and accept that teachers need parentalsupport and guidance if the children, are toachieve, maintain and increase behavioral com-petence.

The type of program which stimulates directinvolvement of parents in teaching their childrencan provide parents with necessary skills andtechniques to become more effective doing what

61

they already do and being what they already arethe single most important individuals in theirchild's lifehis parents and teachers.

The parent-teacher relationship is one builton mutual respect and need for what each canbring to the child. This relationship with theparents and families may well be one of the mostsatisfying and rewarding that a teacher will everexperience.

Marsha S. Shearer is currently the TrainingCoordinator for the Portage Project, a home-basedproject for preschool handicapped children inPortage, Wisconsin.

Her professional interests include providingtraining and assistance in the areas of parent in-volvement and precision teaching techniques,and she has done research in developing andrefining a curriculum guide for preschool childrenfrom birth to five years of age.

She holds degrees from Butler University andthe University of Wisconsin and has authored anarticle in Exceptional Children about the PortageProject. She also is a co-author of Education andCare of Moderately and Severely Retarded Chil-dren.

Vor

.

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BIBLIOGRAPHYAlpern, G., and Boll, T., Developmental Profile,

Psychological Development Publications,Indianapolis, Indiana (1972).

Frohman, A., and Schortinghuis, N., A comparisonof professional and paraprofessional suc-cess with preschool children. Journal ofLearning Disabilities, in press.

Peniston, E., An evaluation of the Portage Project,Unpublished manuscript, The PortageProject, Cooperative Educational ServiceAgency, #12, Portage, Wisconsin (1972).

Shearer, M., and Shearer, D., The Portage Project:A model for early childhood education, Ex-ceptional Children, 36, 1972, 210-217.

Shearer, D., Billingsley, J., Frohman, S., Hilliard,J., Johnson, F., Shearer, M., Portagechecklist and curriculum guide to earlyeducation, Cooperative Educational ServiceAgency #12, Portage, Wisconsin (1972).

..''

A Parent Implemented Preschool ProgramBy Ron Wiegerink

Vince Fro rrish

RATIONALEThere are several substantial reasons for in-

volving consumers, namely parents, in servicedelivery systems for handicapped children. Toidentify a few: (1) parents know their own childrenbest and this knowledge can be used to good ad-vantage by others working with the children; (2)often parents spend more time with their childrenthan do others and this time can be used to workwith their children in a manner consistent withthe center's goals; (3) parents can be of signifi-cant help to one another in that they share similarproblems and can identify with and support oneanother; (4) parents can provide the project staffwith ongoing evaluative feedback which can as-sist the program in being accountable and inmaking programmatic decisions; (5) parents canprovide child behavioral data that can be usedto monitor intervention effectiveness; (6) parentssupply a source of manpower not readily avail-able from other sources because of the lack offinar s and training.

Each of these points is worth elaboratingupon and most of them have been explored by

other authors (Ora & Reisinger, 1971). Clearly,there are not sufficient preschool services forhandicapped children. Even though serviceshave Increased rapidly since the HandicappedChildren's Early Education Assistance Program(HCEEP) came into being, at the rate services areexpanding it will be decades before all preschoolhandicapped children are provided w;th early as-sistance and education at the rate services arecurrently expanding. There are many reasons furthis state of affairs: two principal reasons arelack of fincncial resources to provide programsfor all handicapped children and a lack of trainedpersonnel. To accelerate the provision of servicesmore rapidly, programs are needed which providequality services for handicapped children at lowcosts and do not rely completely on professionallytrained practitioners for all or even a majority ofthe intervention services. Currently, programsfunded by the HCEEP (Handicapped Children'sEarly Education Program) are averaging over$3,000 per child served and a ratio of fewer thansix children served for the equivalent of eachfull-time, professOlally trained staff member.

65

While these costs in terms of money and man-power are not too great for a society to spend toassist handicapped children, at present oursociety is not willing to make these kinds of re-sources available to serve all handicappedchildren. Therefore, professionally trained per-sons who have the responsibility for providingservices for all handicapped children must de-velop and implement service systems which arelikely to provide quality services with substantiallylower financial and human resources.

Parents are one source of such human re-sources. They are readily available. They arealready engaged in preparing and teaching theirchildren and are eager to learn more effectiveways to rear their children and prepare them tolive in society.

A project that recognized this human resourceearly in its inception is the Regional InterventionProgram of Nashville, Tennessee. This programwas one of the first group of projects funded bythe Bureau of Education for the Handicappedunder the Handicapped Children's Early Educa-tion Program in 1969.

The Regional Intervention Program, or RIP asit is called, was described by its first airector as"a social experiment in which an agency ofpeople, the Tennessee Department of MentalHealth, in cooperation with Peabody College andt:le Nashville Junior League, provides the citizensof the state with a permanent organizationalstructure, with support for that structure, andwith continuity of information within that struc-ture, but the citizens themselves implement theorganization to provide services to their childrento their own satisfaction." (Ora, 1972).

The program se,ves developmentally disabledand behaviorally disordered preschool childrenfrom birth to age five from a twenty-six county

66"19

mental health catchment area. Children and theirfamilies are referred to RIP by mental healthcenters, pediatricians, general practitioners,public health nurses, welfare workers, parentsand other agencies when the family is no longerable to cope with the behavior and learning prob-lems of the child. The time between contact withthe project and the beginning of service to thefamily ranges in most cases from twenty minutesto forty-eight hours. Thus, RIP is a flexible servicesystem always ready to admit additional familieson a no-reject basis. If the family feels it canprofit from the services of the program, it isalways admitted.

The decision to become this flexible hasmeant that RIP had to design a system for de-livering services that is capable of readily pro-viding for new families at any time. Althoughoriginally RIP was designed to provide servicethrough the vehicle of professionals, the utiliza-tion of parents in the service soon became amatter of necessity and desirability. A consumer-implemented service system gradually evolvedwherein consumers provide all direct service andmonitoring of the program, with the support pro-vided by five professionally trained special edu-cators. Designed and implemented as such, it ispossible for the project staff (made up of parentsand professionals) to provide comprehensiveservices for approximately fifty additional familiesduring each year of operation. Comprehensiveservices include transportation, intake, parenttraining, individual tutoring, preschool class-rooms, day care for siblings, medical and be-havioral consultation, home visits, liaison withthe social service agencies, placement and follow-along. Through these services, RIP's one objectiveis to pepare the family and the child for thechild's maintenance and developmental progress

FIGURE 1REGIONAL INTERVENTION PROGRAM

STAFF PATTERN

11

Intake

EVALUATIONCOMMITTEE

RESOURCE PERSONNEL

IndividualTutoring

Intake Language CommunityClassroom Classroom Classroom

GeneralizationTraining Transportation

ANCILLARYSERVICES

Day CareTheory ClassesHome VisitsMedia Productions

outside of institutional care. This goal is realizedif the child continues to make developmentalprogress after being placed in a regular day careprogram or public school classroom.

In order tc meet this objective and deliverservices, RIP is organizationally divided into func-tional modules which achieve management ob-jectives (Figure I). Each module is supervised bya resource person who has had professional train-ing, but all the services are provided by parents

who have been served by RIP. The entire projectis monitored and evaluated by an EvdluationCommittee consisting of three parents and threeconsultants who are selected by the parents

4 through procedures established by the committee.This committee meets regularly and has the re-sponsibility for approving and generating projectpolicies and for evaluating ongoing activities. Allproject personnel meet with the committee atleast monthly to report on module activities and

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individual family progress.The committee in turn transmits a monthly

report, consisting of the minutes of its meetingand its comments on the meeting, to the Coordi-nator, Preschool Programs Branch, Division ofChildren and Youth Services, Department ofMental Health. The Coordinator's office has al-ready perceived that such a system permits ex-tremely close and politically astute monitoringwith minimum administrative overhead.

The second level of the program is the pro-fessional resource staff which provides a middle-management function within the project. Eachstaff member in this level has specified areas ofresponsibility which are outlined by managementobjectives following the format of Reddin's Effec-tive Management by Objectives (1971). For ex-ample, the principal of RIP is responsible for theoverall administrative operations of the program.The professional staff personnel do not provideconventional special education services them-selves. They work individually with parents andchildren only for the purposes of modeling andtraining, but most direct services are providedby trained parents who these resource personnelcontinu.ausly consult with, train, monitor, evaluateand direct. Essentially, the professional staffmembers are consultants to parents responsiblefor the implementation of the program and pro-viding them with expertise and personal supportfor planning and teaching.

The third level of the program is delivery ofservices which is totally parent-Iry rented. Atthis level are parents who have received trainingto work with their own children and have demon-strated particular expertise in at least twodomains: technical and interpersonal compe-tence. Their technical competence is, of course,constantly growing and may be in one or more

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of numerous areas of project services such asintake interviews, child assessment, classroomteaching, individual tutoring, home visits andchild management. In every case, however, theseconsumers have demonstrated that they canoperate within a management-by-objectivesframework and can reliably utilize the data collec-tion procedures of RIP. For at the center of allRIP services is the importance of objectives anddata-based evaluation.

Individual factors such as personality style,interpersonal skills and interests are also con-sidered in determining what responsibilities andfunctions the parent is to have. These decisionsare made by the parents who have provided thenew grant with services along with the resourcepersonnel.

Demands for a variety of regional treatmentservices, constantly shifting referral patterns, andmultiple funding sources over the past five yearshave largely determined the numbers and k;ndsof clients served by the RIP program. The de-scription of the current program in terms of itsclients and referral base which follows will, hope-fully, be a useful referent to those interested inthe evolution of the Regional InterventionProgram.

Between June of 1969 and March 21, 1974,RIP served a total of 254 families. At present, ap-proximately forty families are actively enrolled inthe program with an approximate average rate ofattendance of 65 percent. Thus, about twenty-sixfamilies daily participate in the program. Thesefamilies have an average of 1.6 preschool childrenwho attend RIP, bringing the program's daily at-tendance to approximately twenty-six adults andforty children.

The average RIP child is forty-one months oldupon referral and generally will remain in the

program for 8.1 months.For the past five years, most of the referrals

(76 to 80 percent) were males and approximatelyone-half of RIP's current referrals could be classi-fied as seriously developmentally delayed; that is,significant delay exists in the language, motoricor cognitive areas. The remainder of the childrenare non-developmentally delayed, severely be-haviorally disordered children who typically havebeen referred as "brats," oppositional, or hyper-active children.

Currently, 24 percent of RIP's families areblack, having been typically referred by localWelfare Department social workers, public healthdepartment nurses, child development clinicsand, occasionally, a private pediatrician.

In the first two years of operations RIP reliedvery heavily on local pediatricians from theMetropolitan Nashville area for referrals (in1970-71, 76 percent of all of RIP's referrals origi-nated from pediatricians). However, over the pastthree years, the pediatric referral rate has stabil-ized between 25 percent and 29 percent as moremental health centers, social service organiza-tions and hospital-affiliated diagnostic clinicsbegin to refer to the program. Thus, the programis now fairly representative of the general popu-lation of the middle Tennessee area with 38 per-cent of its families in an income range below$7,000, 51 percent between $7,000 and $13,000,and 11 percent above $13,000 annual income.Further, as awareness of the program has grown,more families from rural middle Tennessee aredaily attending RIP. At present, nearly 25 percentof the program's families travel more than fiftymiles per day (round trip) for services and someof these commute over one hundred miles perday.

INTAKEThe purpose of the Intake Module is to

familiarize new families with the program, to pro-vide them with support and understanding todetermine what are the next steps in providinghelp for the family, and to invite the parents tojoin if they wish. The intake process is designedto be as informal, informative, and supportive aspossible. Because prescriptive diagnosis and as-sessment is seen as an ongoing process and anintegral part of service itself, there is no needto collect involved diagnostic data. Instead, theparent is asked simply to describe what the childdoes or does not do that is excessively disturbing.This information is then used to place the familyin the correct service module and to identifyparents who have had similar problems and canbe of help.

Following the intake interview, the parentsare shown a slide show describing the programservices and are then taken on a tour of theprogram. It is explained that parents are expectedto devote from six to nine hours a week at theprogram working with their children. However,once a prescriptive program has been designedand implemented for them and their child ismaking steady progress, they are expected tocommit themselves to an additional six monthsof volunteer work with the project helping otherslike themselves.

From talking to others who are working, per-spective parents, they discover that most parentsenjoy working after their child's intensive train-ing needs are met because they perform newlyacquired functions that give them a sense ofsatisfaction and accomplishment. To most par-ents, the opportunity to acquire talents andabilities they may not even have known they had

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provides an outlet for self-expression. Also, manyof the parents have realized that the program'sobjectives of helping people to help their childrenand each other reflect their own values and be-liefs. Only after the parents have had a chanceto acquire all the information they need doesthe family make a decision about whether or notto participate in the program. As soon as theyjoin, usually within an hour or so of arriving, caseresponsibility passes from the Intake Module toa Training Module. The coordinator, who directsthe Training Module, immediately assigns otherparents who are successfully dealing with similarproblems to provide support to the new familyuntil they begin to make friends on their own.A training schedule which usually begins thenext day is set up for the child. If the family hasother needs, the Training Module coordinatoralerts support modules. In consultation with theresource personnel the Intake Coordinator canimmediately activate a massive effor from teamsof trained workers as well as educational, medicaland social services. By the end of the morning,the family has a list showing who to call for whatand what to do next. More important, they realizethat they are no longer alone. People like them-selves whom they can trust are using a carefullydesigned system to help them.

DIRECT SERVICESThe family and child are then placed in a

Service Module, either the Individual Tutoring orGeneralization Training Module and a ClassroomModule. The first two modules are designed todevelop individual programs fo; the parent andchild, and the Classroom Modules provide thechild with group learning experiences and hisparents with group teaching experiences.

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A child unable to communicate appropriatelyis assigned first to the Individual Tutoring Module.The Individual Tutoring Module's goals are toproduce functional speech or other adaptive be-havior in the child and to instruct the parentsabout how to develop these skills in their ownchild at home. Training begins at the child'spresent level of development. For instance, itmay start with getting him to look at people, tofollow instructions, to imitate motions, sounds orwords, or to recognize and name things.

In Individual Tutoring rooms the child'smother begins by learning to record which stimuliare presented to the child and how many correctresponses he or she makes. Within a few dailysessions the parent becomes the teacher as weltas the pupil. The parent presents the trainingstimuli to ,the child and reinforces correct re-sponses, teaches the child at home every dayand records the child's responses on a data sheet.All program training is designed solely to teachthe parents what to do at home. The parentcomes in daily to the Individual Tutoring Moduleto demonstrate progress made in the home pro-gram and to confer with the case manager onprocedures as determined by the parent's andthe child's needs. Individual tutoring experiencessuch as imitation and speech training are usedbecause they have been repeatedly found to bean effective method of teaching parents. Onceskilled in these procedures, most parents can,after a little demonstration, not only teach skillslike toileting and dressing, but abide very well bythe program's rule for generalization of learning:"Any desirable behavior that the child learnsanywhere is thereafter required and reinforcedeverywhere."

Some families who enter the program do notgo into the Individual Tutoring Module because

they have other kinds of problems. The Generali-zation Training Module is desigld to take careof these problems. They seek help because theirchild has brought them near collapse with severetantrums, constant crying, whining, and generalunmanageability. The child may have upsetmeals, refused to go to bed, abused himself,his parents, his brothers and sisters, and his pets;destroyed things in the home; or defied all at-tempts by his parents to discipline him.

Assigned to the Generalization TrainingModule, these families soon learn that the prob-lem does not reside solely in the child. Researchhas shown that such behavioral disorders intoddlers are acute and interactive and unless helpis given at an early age, such children are in forserious problems.

In this module, training for parents and childtakes place during a twenty-minute structuredplay session, which is designed to elicit bad be-havior from the child. The parent is instructedto request the child to change toys every twominutes. The parent-child interaction is analyzedby continuous data recording. With the case man-ager, the parent follows a manual of instructionsand videotapes which teach the parents how toassume increasing responsibility for operatingthe module. As in all the training modules, pro-cedures are primarily designed to teach theparents what to do at home.

In most cases the parent's request for thechild to change toys every two minutes resultsin a coIsiderable amount of oppositional behaviorincluding screaming, throwing objects, sulking,and general unmanageability. Parents often re-spond to this behavior with almost constant at-tention as they try to get the child to conform,thus, inadvertently reinforcing the inappropriatebehaviors. After baselines on the parent and child

behavior are established, parents are taught toignore inappropriate behaviors and praise andreinforce appropirate behavior. These proceduresnormally result in significant increase in praisefrom the parent Ftnd sharp decreases in opposi-tional bemvior from the child. Within a three orfour week period most parents are taught newand successful child management skills.

White the family is being served in one ofthese modules they are also assigned to a class-room. Both parent and child begin in the IntakePreschool. In addition, if the family has other pre-school children who do not have day care, theyare included in the classroom programs.

The Intake Preschool does not have responsi-bility for the family; responsibility always restswith only one module at a time. Nonetheless, theIntake Preschool is a major training center forboth parent and child. Again, a standard trainingmanual is used by the mothers. When the parenthas demonstrated that he or she can accuratelyrecord a number of dimensions of teacher andchild s- Troup situations, the parent andchilu advance it .m the Intake Preschool. Contin-uous data recording shows when the child's be-havior is acceptable for one of three otherpreschools. One preschool is for tiny tots andtoddlers who function at the same level. Thecurriculum is built around developing gross andfine motor skills and saying single words. Anotherpreschool is language-oriented and these childrenare usually involved in individual tutoring. How-ever, some brothers and sisters or children fromthe generalization training module are includedas language models. The Language Preschoolworks very closely with the Individual TutoringModule. Unlike any of the other modules relatedto group activities, the Language Preschool some-times assumes responsibility for a family, especi-

71

ally when the primary objective is to provideextensive language stimulation so that the childcan enter a classroom in the community.

The third preschool is a class designed to belike those the children will encounter in the com-munity. Teacher-pupil ratios are lower here thanin other preschools, and social experiences arestressed. As in all the Program's preschools, how-ever, the child is still on an individualized courseof instruction; however, he receives less indi-vidual attention than in the other preschools. Thechild's progress is evaluated on a day-to-day basisby recording behavior and comparing it withinstructional objectives. The resulting informa-tion is monitored by the child's parents, by theteachers and the resource personnei, and by thepersonnel of the Liaison Module who, at thispoint, take over responsibility for the family. Asthe child proves to be ready for return to com-munity schools, the issue of an appropriate matchbetween family and community services arises.The Liaison personnel already have records onthe child from the Program's own community pre-school, and maintain an empirically evaluatedlisting of placements appropriate for variouschildren. They investigate possible placementsand consult with the parents about the most ap-propriate placement. When the child moves on toanother primary educational system, the Liaisonpersonnel (who are a group of parents that helpas they are needed) provide support and consulta-tion to the new teacher. They may actively assista teacher in programming for a child placed inher class.

Also, should the family encounter furtherdifficulties, the Liaison personnel are the link tothe support or intervention systems needed. Allthe famiiles going back to community servicesknow they can obtain help from the program if

72

they have problems. Conversely, the program doesnot hesitate to call on its ever-growing network ofparents throughout the region for temporaryassistance.

PARENT TRAININGIn RIP, parent training and project services

are the same; the entire project is designed tohelp parents help themselves and other parents.Parents are first taught to collect data systemati-cally, using baseline and multiple baseline record-ing procedures. .lata for the purposes of titoringtheir child ar"1 01 evaluating child progress in thepreschool classrooms is collected by them. Next,parents are taught the essential skills of behaviormodification, reinforcement, timing, shaping, fad-ing, stimulus selection, and programming. As theydemonstrate their behavior competencies theybegin to receive instruction in the generaltheories of behaviorism as presented by Skinner(1953) and Bijou & Baer (1961). They then learnmore about child development primarily focusingon la iguage development, but also social andmotor development.

Once their child is making steady progressand parents have demonstrated competency insome of the basic skills, they begin to offer volun-teer services which can be the beginning of anew career for some. If the parents have demon-strated mastery in individual tutoring or generali-zation training, they can begin as assistants inthese modules. If they showed interest in oneof the preschool classrooms, they could begin anassistantship there. In some cases, the parentsteach others to collect basic behavioral data, butif they show programming and decision-makingcompetencies they can take on more and moreresponsibilities in one of the service modules.

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In most cases parents finish their six monthsof volunteer service e-4nd leave the service-givingaspects of the program but some stay on with theprogram. In some cases they serve as volunteerassistants but in cases where particular skillsand interests are shown, they may become paidemployees responsible for a service module suchas the Intake Preschool. In some few cases,having demonstrated a good understanding of allfunctions of RIP, they would take on more re-sponsibilities such as directing the Intake orLiaison Modules or being responsible for parentcoordination and assignment. Some of theseparents may become members of the EvaluationCommittee, or may, with the additional profes-sional training, become full-time resource per-sonnel. Within the program all parents learnimportant and valuable competencies which theyhave an opportunity to use continuously in posi-tions of their own choice.

EVALUATIONThere are three types of evaluation per-

formed by the RIP staff: individual child progressevaluation, group or module evaluation, andproject evaluation. Data are the basis for alldecision-making in the program. The success ofprogrammatic intervention is dependent uponvalid and reliable data. Therefore, RIP placessubstantial emphasis on training staff andparents in data-collection procedures that havebeen designed to measure relevant behavior withreliability.

Individual data are collected in individualtutoring, generalization training, the classrooms,and by the Liaison Module. Using baseline andmultiple baseline procedures the staff observesspecific behavior in various response classes such

as imitations, verbal behavior, motor behavior,cooperativeness, and attending. The data areused to determine the functional effects of theintervention being employed.

Group data are collected primarily by theclassroom module. In the Intake Classroom dataare collected to determine both individual andgroup performance on the on-task/off-task dimen-sion. The goal for each child is to be on task 85percent of the time or more for three consecutivedays. During specified times children and tasksare observed by two independent observers.These observers scan the room at specified timeintervals and independently record who is on taskor off task as well as teacher attention. Percent-ages of on- and off-task behavior are developedafter twenty minutes of classroom observation.These data are used to determine individual childprogress as well as group performance as ameasure of program effectiveness.

Similar data procedures are used to measureverbal behavior to determine the amount of socialplay and interaction in the language classroomwhere the goals are to increase overall expressivebehavior and in the community classroom. Here,the objective is for each child to engage in co-operative play behavior at least 40 percent of thetime during a free play period. The LiaisonModule uses similar procedures to follow-up onchildren as they are placed in other settings andalso to describe and evaluate other preschoolprograms for the purpose of cataloging potentialplacement settings for RIP children.

RIP is also constantly in the process ofutilizing data to determine overall program effec-tiveness. The Evaluation Committee regularlyevaluates module performance and program effec-tiveness. In addition, RIP has been the subjectof two major evaluations. One was conducted by

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the research cooperative and funded by theBureau of Education for the Handicapped. Theresult of this study was the designation of theRegional Intervention Program as one of twelveexemplary programs for children with behavioralproblems in the nation (General Learning Corpo-ration, 1972).

Another study was conducted at the requestof RIP staff and on a subcontract basis. The goatof the study was to determine RIP's cost effec-tiveness as a service program. The results of thisdetailed cost analysis study are published by theGeneral Learning Corporation (Final Report, 1972).

These figures, however, do not reflect someof the program's non-monetary benefits:

1. probable prevention of behavior problemsin children born to mothers subsequent tothe mothers' training at RIP,

2. development of trained volunteers whocould prove useful to other communityaction programs,

3. improved manageability of children inpublic schools,

4. provision of a laboratory for testing novelapproaches to keeping family life intacL,

5. possible reduction in juvenile delinquencyfor children treated in RIP,

6. training in marketable skills for parents,and

7. porlible additional tax revenues resultingfrom gainful employment of parents whomay have been unable to work without RIPinvolvement.

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In summary, the Regional Intervention Pro-gram is a service delivery system carefullydesigned to provide for, and implemented by,parents of developmentally disabled and be-haviorally disordered children. It is a systemwhich is managed by stated objectives and evalu-ated by data to serve the best interest of thechildren and parents. It is a service through whichparents learn to help themselves and others likethem at costs which are lower than custodialand institutional care.

Ronald Wiegerink, Ph.D., is the director ofDevelopmental Disabilities/Technical AssistanceSystem (DD/TAS) at the University of NorthCarolina at Chapel Hilt and is the author or co-author of articles published in Journal of SpecialEducation and Child Development. He has doneresearch in the fields of early language develop-ment, social development and the effectivenessof special education.

Vince Parrish is the principal of the RegionalIntervention Program in Nashville, Tennessee andhis professional interests include consumer im-plementation and evaluation of human serviceprograms and parent training.

BIBLIOGRAPHYBijou, S. W. and Baer, D. M. Child development

Vol. 1: A systematic and empirical theory,New York: Appleton-Century-Crafts, 1961.

Final report. General Learning Corporation, BEH,1972. Grant No. 0EG-0-8-743242-5656.

Ora, J. P. and Reisinger, J. "Preschool Interven-tion: Behavioral Ser-ice Delivery System:American Psychological Association, Wash-ington, D.C., September, 1971.

Ora, J. P. "The Involvement and Training of Parentand Citizen-Workers in Early Education forthe Handicapped and Their Implication: Aworking paper for the Council on Excep-tional Children, Invisible College on EarlyChildhood," San Antonio, Texas, January20-21, 1972.

Ora, J. P. "Final Report for the Regional Inter-vention Project for Preschoolers andParents," December 31, 1972. Grant No.OEG-0-9-520320-4535 (618).

Reddin, W. J. Effective management by objectives.McGraw Hill, New York, 1971.

Regional Intervention Program Slide Show. Com-posed, edited and reviewed by the RegionalIntervention Staff from 1970-1974.

Skinner, B. F. Science and human behavior, NewYork: MacMillan, 1953.

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ANNOTATED BIBLIOGRAPHYBaldwin, A. L., and Baldwin, C. P. The study of mother-child interaction. American Scienist, November/December, 1973, 61: 6, 714-721.

The authors state the case for research based on naturalistic observations and report on their studiesof a large sample of mother-child pairs interacting in a "free play" setting. Their "most striking"finding is that, among the "normal" pairs that have been studied, ". . . free-play interaction showsmany similarities across families. There are ethric, social-class, and age differences, but they arerelatively small variations on a very consistent theme...."

These findings do not hold, however, in their preliminary data analysis of mother-child pairs in whichthere is "real [psychological] disturbance."

The authors provide a valuable discussion of some of the methodological and ethical barriers tosmooth sailing in this kind of research, matters of obvious concern to professionals who work withyoung children and their families.

Baldwin, V., Fredericks, H. D., and Brodsky, G. Isn't it time he outgrew this? or A training program forparents of retarded children. Springfield, Illinois: Charles C. Thomas, Publisher, 1973.

This manual contains specific programs by which parents can develop the types of desired behaviorsthey wish to see in their retarded child. The parent, without prior training or consultation from pro-fessionals, should be able to implement his own specific programs and measure the progress of hischild by utilizing the behavior modification techniques and basic learning principles described inthis book.

In non-technical language the book presents detailed explanations of learning principles involved inself-help skills, language development, motor development;' academic skills, and behavior problems.

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Included is just enough theory to justify the time invested by the parents who will implement thesestrategies and programs.

The manual is useful primarily to parents, whether in a group or as individuals; however, the bookaddresses itself also to the professional involved in parent training. The goal is to involve the parentsas the principle teacher of their retarded child.

The Exceptional Parent. Boston, Massachusetts: Psy-Ed Corporation.

This periodical offers practical information for parents of children with all kinds of handicaps. Day-to-day care and long range planning are issues covered by professionals.

A few of the topics covered are professional information, without professional jargon, on key issuessuch as psychological testing, visits to the dentist, "fun stuff" to make for parents and kids, generaldiscussions of disabilities, and a parent forum with questions and answers from parents.

This magazine is a forum for the mutual sharing of information by parents and professionals con-cerned with handicapped children.

Jelinek, J. A., and Kasper, A. G. The University of Wyoming communicative disorders and parent train-ing program: Program procedures and activities handbook. Grant Project No. 0EG-0-70-4696 (616), Officeof Education, U.S. Department of Health, Education, and Welfare.

The Parent Training chapter of this volume is a clear and comprehensive statement of parent trainingobjectives for the program, and includes many of the materials used for training parents.

Johnson, C. A., and Katz, R. C. Using parents as change agents for their children: A review. Journal ofChild Psychology and Psychiatry, 1973, 14, 181-200.

A comprehensive review of studies in which parents were used as agents for changing their children'sbehavior, the paper covers not only the varieties of behavior to be changed, but the various methodsused for training parents to effect change. For instance, the authors criticaly review instructions toparents for their clarity or vagueness; one contribution that will be appreciated by professionals inthe field is an estimate of therapist's time invested in all the studies reviewed. As the authors note,"some critical methodological issuesdata collection, reliability of measurement, demonstrations ofbehavioral control, follow-up, and cost-effectiveness factors ... require routine and more careful con-sideration before the efficacy of parent therapists can be adequately assessed."

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LaCrosse, E. L. Planning for the needs of multihandicapped children and their families. Regional Con-ference for Parents of Deaf-Blind Children, 1973.

While this paper will be of interest to all who are concerned with handicapped children, the first halfof the paper should be required reading for any professional who works with the children's parentsand famines. LaCrosse offers a telling critique of the attitudes of professionals who work with parents,and of the research that has been done on parental attitudes. From there on, he presents a cogentand comprehensive plan for meeting the needs of handicapped children and their families that startswith birth and follows the children into adulthood. For instance: "Along with all of this is a built-incounseling service that is always there to assist the parents in the decisions that have to he madeas the youngster growsnot the decisions, but the assistance with the making of decisions, someoneto whom you can go and think out loud and receive guidance as to what is available, what is goingon, and what it all means."

Marshall-Poweshiek joint County Department of Special Education. Home stimulation of handicappedchildren. Marshalltown, Iowa.

This is a very complete guide for parents to use at home with their children. It is a "how-to" manualthat contains many excellent concrete suggestions for ways to stimulate a preschool child at home.

Many areas are covered including: behavior modification, how parents can enhance creativity, dis-cipline, toys vs. learning tools. Each chapter has a learning episode evaluation for parents to complete.

It is written in such a way that it can be utilized by all types of parents either in groups or individually.There is an accompanying guide for use by professionals as they work with parents in groups. Itshouldn't be limited to parents of handicapped children.

Marx, 0. H. Physical activities for handicapped children in the home. Iowa City: The University ofIowa, 1972.

This manual was developed for use by parents of physically handicapped children attending theChildren's Rehabilitation Section at the University Hospital School, The University of Iowa. Activitydescriptions and construction information on equipment may be utilized by other personnel such asphysical education teachers or special education teachers. Guidelines are given for planning thehome program in addition to a major section on suggestions for teaching physical skills: Part I dis-cusses basic developmental activities which progress from head lift to walking skills. Part II describeselementary skills such as catching and self testing, equipment, starting position, and skill analyses.In the subsequent section on braces, information is given on application, removal, and maintenance

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of braces. Photographic illustrations of orthopedic apparatus and physical education equipment isshown in addition to line drawings for the construction of homemade apparatus. A glossary of termsis include:I.

A mediated training program for parents of preschool mentally retarded children. Instructional Tech-nology Project, Logan, Utah: Utah State University Special Education.

This mediated training package is designed to equip parents of preschool mentally retarded childrenwith the techniques necessary to train their children in self-help skills.

The package contains four units; each unit has a participant's workbook and slide tape program. Theunits are: behavior (analysis of complex behaviors and the synthesis of simple behaviors into aninstructional sequence), cues, reinforcement, programming and record keeping. A monitor's manualand script book are also included.

This package could be very useful in teaching parents how to teach their children. It would requirea skilled monitor and dedicated parents.

Ora, J. P. "Parents and Citizen Workers," Invisible College Conference on Early Childhood Educationand the Exceptional Child. Reston, Va.: Council for Exceptional Children.

This 20 minute tape discusses citizen workers as early educators of the handicapped.

Ora discusses citizen involvement in terms of: examples of programs utilizing parents; why parentimplemented systems are important; citii ^n workers as a solution to the manpower crisis; and, therole of the professional as developers of automated instructional systems.

This tape presents provocative ideas to stimulate thinking about citizen involvement. The conceptsand language are sophisticated but the ideas are excellent and worth listening to.

$75.00 for complete set of five sixty-minute cassette tapes, made by 13 professionals.

Stedman, D. J., Anastasiow, N. J., Dokecki, P. R., Gordon, I. J., and Parker, R. K. How can effectiveearly intervention programs be delivered to potentially retarded children? A condensation of a Reportfor the Office of the Secretary of the Department of Health, Education, and Welfare. (Contract HEW-0S-72.2W Washington, D.C., DHEW, December, 1972.

In their summary of this project review, the authors state that "In general, intervention researchappears to be a fruitful encseavor but in need of considerable refinement prior to massive dissemi-

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nation of children's services." The critical words are considerable refinement, suggestions for whichpack this condensed report. Of particular interest is a theme that recurs throughout the report: therole of the parents and families of target children. "Early family involvement ... [has] a significantimpact on a child's development before he reaches his second birthday . . ." is a major finding ofintervention research, say the authors. Yet in programs reviewed, "the factor of varying parental sup-port has been largely ignored." A panel of early childhood experts consu..ed by the authors cites thevaried roles parents play in their children's programs, and they recognize parent involvement as amajor criterion for program success. Yet they, too, mention, among other criticisms, the failure ofprograms to research thoroughly the relationship between parent and child behavior and to developmaterials for parents to use in their homes.

Perske, R. New directions for parents of persons who are retarded. Nashville, Tennessee: AbingdonPress, 1973.

[Annotation by PCMR Message, January, 1974] Written especially for parents who elect to keep theretarded family member in their own home or a nearby residential facility. Four sections focus on"yourself, your child, the family, and society." Delightfully illustrated by Martha Perske.

Partners in language - -A guide for parents; Companeros en el itliomagura pars los padres. Washing-ton, D.C.: American Speech and Hearing Association, 1973.

This book is concerned mainly with the normal language development of the young child, from birthto approximately three and one-half years of age. It was developed to increase parents' understandingand knowledge of early childhood language acquisition; and to provide useful suggestions to parentsfor developing communicative competence in young children by utilizing normal, daily activities aslanguage learning experiences. Through the booklet, parents are encouraged to remember that everychild is a unique individual whose rate of development in all areas is also unique.

Simplified developmental charts are included so that parents will be aware of some broad expectationsin children's development.

This booklet has beautiful illustrations that reflect different ethnic groups. All materials is written inboth Spanish and English in isy to read format.

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Preschool learning activities for the visually Impaired child: A guide for parents. Springfield, Illinois:Instructional Materials Center.

This manual is for parents of blind children to suggest activities and games that will help developtheir child's skills and abilities at home. It also gives parents concrete suggestions for daily inter-action with their child such as, "always place the child's tablewear in the same position."

Games and activities are listed according to the types of skills they develop and include: what do Itouch, what do I hear, I use my body, the child looks at himself.

Each section is divided into activities for three-, four-, and five-year olds that have normal deve:.opmentwith the exception of visual impairment. At the end of each section is a list of suggested materialsand where they ::.an be obtained. Most of the items listed are expensive, but moderately pricedsubstitutions could be easily made. Directions and words for songs and games are also included.

This manual has excellent pictures, and the format is easy to follow. It would be a very valuableresource to both parents and teachers.

The Portage guide to early education. Portage, Wisconsin: Cooperative Educational Service, 1973.

The Portage Guide to Early Education is a developmentally formulated curriculum to be used withchildren, either handicapped or normal, between the mental ages of birth to five years. These mater:alscan be used regardless of the specific handicapping condition(s), of the instructional delivery system(home, classroom, institution), of the teacher/child ratio, or of the professional status of the instructor.

The Guide comes in two parts: a Checklist of Behaviors and a Card File containing curriculum ideas.These materials were developed and utilized by the Portage Project staff over a period of four years.Professional educators, paraprofessionals and parents have used these materials as a major source ofbehavioral evaluation and assessment and as'a curriculum guide.

The Checklist and Card File are color coded and divided into five developmental areas: cognitive, self-help, motor, language, and socialization.

Pushaw, D., Collins, N., Czuchna, G., Gill, G., O'Betts, G., and Stahl, M. Teach your child to talk.Cincinnati: CEBCO Standard Publishing Co., 1969.

This training package is designed to provide parents of preschool children with a better understandingof how they can help children learn to talk.

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The complete workshop kit contains:

(1) Workshop manual(152 pages) complete lesson plans for 3 workshops(2) 200 35 mm color slidesaugment the workshops(3) 19 minute cassette tape recordingexamples of child's speech(4) 16 mm color moviesummarizes the major points made in the workshop(5) parent handbookgives normal speech guidelines at appropriate age levels. Also included are

suggested activities that parents can share with children and a suggested book list.(6) "Teach Me to Talk" bookletcartoon booklet designed for parents of newborn chlidren.

These materials would be useful with any group of parents that are interested in language develop-ment. The workshop is designed in suci; a way that it could be presented by most persons. TheParent Handbook is a useful resource and could be used separately.

Report of First National Home Start Confers 'Ice, St. Louis, Missouri, April 3-7, 1972. Washington, D.C.:Home Start.

This report describes the Home Start conferences in narrative form. The focus of the Home Start effortis home-based programs for preschool children; this report contains excerpts from speeches givenat the conferences, listings of films used, and descriptions of home-based programs that were pre-sented. It is an excellent resource for information about home-based programs since most of the majorhome-based programs are represented in this booklet.

Williams, D. and Jaffa, E. Ice cream, poker chips, and very goods: A behavior modification manual forparents. College Park Maryland: The Maryland Book Exchange, 1971.

The purpose of this manual is to teach parents the basic concepts and language of behavior modifi-cation; to train parents in the practical application of these techniques with their own children; and toincrease the frequency of the parents' use of these techniques within the home.

The basic content of the manual is directly derived from the research literature related to the func-tional analysis of behavior. It covers reinforcers, changing behavior, and maintaining changes.

It is organized a great deal like a textbook; therefore, it would not be appropriate for all levels ofparents. However, it is useful with more sophisticated parents and could be used in groups orindividually.

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