Risk Factors and Children not Referred for Special Education Until After Kindergarten Entry

–or—The Child Find Study

Cynthia Paris and Michael Gamel-McCormickCenter for Disabilities StudiesUniversity of DelawareDecember 7, 2004

Why this study? Why now?Why this study? Why now?

Delaware Department of Education and Delaware Department of Education and Local School Districts reported anecdotal Local School Districts reported anecdotal occurrences of children entering occurrences of children entering kindergarten in need of special education kindergarten in need of special education services but not having been identified for services but not having been identified for Part B, Section 619 servicesPart B, Section 619 servicesPart C personnel were concerned about Part C personnel were concerned about children exiting early intervention services children exiting early intervention services and not being found eligible for preschool and not being found eligible for preschool IDEA servicesIDEA services

Study ChargeStudy ChargeThe Delaware Department of Education The Delaware Department of Education charged the Center for Disabilities Studies charged the Center for Disabilities Studies with the following:with the following:– Determine who is being referred for special Determine who is being referred for special

education services after kindergarten entryeducation services after kindergarten entry– Determine what developmental and family Determine what developmental and family

characteristics those children had prior to characteristics those children had prior to kindergarten entrykindergarten entry

– Determine what opportunities those children Determine what opportunities those children and families had for interacting with possible and families had for interacting with possible referral agentsreferral agents

Oversight and AdvisoryOversight and Advisory

An advisory committee was formed of:An advisory committee was formed of:– Three Department of Education personnel Three Department of Education personnel

(Director of Special Education, Section 619 (Director of Special Education, Section 619 Coordinator, and a data specialist)Coordinator, and a data specialist)

– Two local school district special education Two local school district special education directorsdirectors

– Department of Services to Children, Youth, Department of Services to Children, Youth, and their Families representativeand their Families representative

– A family memberA family member– Three researchers from the University of Three researchers from the University of

Delaware Center for Disabilities Studies Delaware Center for Disabilities Studies

Original Research Questions

Who are the children who were referred for special Who are the children who were referred for special education services prior to kindergarten?education services prior to kindergarten?Could they have been identified in need of special Could they have been identified in need of special education services prior to kindergarten?education services prior to kindergarten?Why were these children not identified prior to Why were these children not identified prior to kindergarten?kindergarten?If these children received early intervention services If these children received early intervention services (Part C services), why were they dismissed from (Part C services), why were they dismissed from services and not found eligible for Section 619 services and not found eligible for Section 619 services?services?

Theoretical Framework of Child’s Theoretical Framework of Child’s ExperiencesExperiences

Family

Child

Ear

ly C

are

and

Edu

catio

n

Health CareCommunity

Com

munity

Services

School District

AssessmentConducted

Concern Addressed with an Intervention

Concern Raised

Options Identified to Address Concern

Information SoughtOptions Identified to Assess Concern

Process and

Sequence for

Addressing Develop-mental

Concerns of Young Children

Opportunities for Referrals

Opportunities for Responses

Sample SelectionSample Selection

Records for special education referrals for the Records for special education referrals for the students from 1999-2002 reviewed;students from 1999-2002 reviewed;All students found eligible for special education All students found eligible for special education during those years who were in K, 1during those years who were in K, 1stst, 2, 2ndnd, 3, 3rd, rd, or 4or 4thth grade and had never been received special grade and had never been received special education services before were included in the education services before were included in the population definitionpopulation definitionStudents identified as moderate or low income by Students identified as moderate or low income by food program eligibilityfood program eligibilityRandom sample of students selected from each of Random sample of students selected from each of the four grade levels and low or moderate income the four grade levels and low or moderate income levels resulting in 83 students in the samplelevels resulting in 83 students in the sample

MeasurementsMeasurementsFamily InterviewFamily Interview– Family narrative of Family narrative of

history of child’s history of child’s developmentdevelopment

– Services child receivedServices child received– Concerns expressed Concerns expressed

by the familyby the family– Sources of information Sources of information

about child about child developmentdevelopment

School RecordsSchool RecordsDivision of Family Division of Family Services recordsServices records

DE Department of DE Department of Education Services and Education Services and recordsrecords

State human services data State human services data base reviewbase review

Department of Public Department of Public Health data base reviewHealth data base review

Review of children’s Review of children’s medical filesmedical files

Review of children’s early Review of children’s early care and education care and education experiencesexperiences

Students’ Profile (N=67)Students’ Profile (N=67)

Free/Reduced LunchFree/Reduced Lunch

64.2% Eligible (43)64.2% Eligible (43)

35.8% Not eligible 35.8% Not eligible (24)(24)

GenderGender

43.3% Female (29)43.3% Female (29)

56.7% Male (38)56.7% Male (38)

GradeGrade

K: 14.9% K: 14.9% (10)(10)

11stst: 20.9% (14): 20.9% (14)

22ndnd: 20.9% : 20.9% (14)(14)

33rdrd: 25.4% : 25.4% (17)(17)

44thth: 17.9% (12) : 17.9% (12)

Students’ Profile (N=67)Students’ Profile (N=67)

LocalitiesLocalities

52.2% New Castle County (35) (primarily 52.2% New Castle County (35) (primarily suburban)suburban)

16.4% Wilmington (11) (primarily urban)16.4% Wilmington (11) (primarily urban)

19.4% Kent County (13) (primarily rural)19.4% Kent County (13) (primarily rural)

11.9% Sussex County (8) (a mixture of 11.9% Sussex County (8) (a mixture of suburban and rural)suburban and rural)

Student Profile (N=67)Student Profile (N=67)Children’s Ethnicity & Families’ Income when Children’s Ethnicity & Families’ Income when

Children Were Under Five Years of AgeChildren Were Under Five Years of Age

Ethnicity:Ethnicity: ModerateModerate

IncomeIncome

LowLow

IncomeIncome

Income NotIncome Not

ReportedReported TotalTotal

CaucasianCaucasian 1717

81%81%

1717

45.9%45.9%

44

44.4%44.4%

3838

56.7%56.7%

African African AmericanAmerican

00

0.0%0.0%

1515

40.5%40.5%

44

44.4%44.4%

1919

28.4%28.4%

LatinoLatino 33

14.314.3

44

10.8%10.8%

00

0.0%0.0%

77

10.4%10.4%

OtherOther 11

4.8%4.8%

11

2.7%2.7%

11

11.1%11.1%

33

4.5%4.5%

TotalTotal 2121

100%100%

3737

100%100%

99

100%100%

6767

100%100%

Students’ Profile (N=67)Students’ Profile (N=67)

Special Education Eligibility N %

Learning Disability 37 55.2%

Speech 17 25.4%

Physically Impaired 5 7.5%

Sensory Impairment 2 3.0%

Partially Deaf 1 1.5%

Seriously Emotionally Disturbed 2 3.0%

Educable Mentally Handicapped 1 1.5%

Severely Mentally Handicapped 1 1.5%

Partially Sighted 1 1.5%

Family IncomeFamily Income

Families’ Report of Income Between Children’s Births and School Entry

N %

Moderate Income 21 (31.4%)

Low Income 37 (55.2%)

Not Determinable 9 (13.4%)

Total 67 (100.0%)

FINDINGSFINDINGS

Section I:Section I:

Children’s experiences prior to school entry Children’s experiences prior to school entry (N=67)(N=67)

• Family ContextFamily Context

• Contacts with Professional CommunityContacts with Professional Community

Family ContextFamily Context

Family ConfigurationFamily Configuration

Potential Sources of Family StressPotential Sources of Family Stress

Sources of Child Development InformationSources of Child Development Information

Family Family ConfigurationsConfigurations

Families’ Configuration between Birth and Kindergarten

N %

Stable* 34 (50.7%)

Transitioning 33 (49.3%)

Total 67 (100.0%)

*A stable household was one were the adults did not change during the children’s first five years of lifeEven in households that were transitioning, there was at least one adult who was stable during the child’s first five years of life.

Family Events or Stressors by Birth Income

Number of Family Events or Stressors

ModerateIncome

LowIncome

Income Not Reported Total

0N%

628.5%

12.7%

111.1%

811.9%

1N%

523.8%

821.6%

111.1%

1420.9%

2N%

314.3%

616.2%

00.0%

913.4%

3N%

314.3%

616.2%

111.1%

1014.9%

4-10N%

419.0%

1643.2%

666.6%

2638.8%

TotalN%

21100.0%

37100.0%

9100.0%

67100.0%

Family Stressors*

*Stressors included but were not limited to family violence, divorce, drug use, custody challenges and child abuse complaints.

Family ContextFamily ContextSources of Child Development Information

Moderate Income

Low Income

Income Not Reported

Total

Parents and/or in-lawsN%

1885.7%

2363.9%

333.3%

4466.7%

Friends and parents of young children

N%

1990.5%

2261.1%

222.2%

4365.2%

DoctorN%

1781.0%

1952.8%

666.7%

4263.6%

Other RelativesN%

1466.7%

1952.8%

444.4%

3756.1%

MagazinesN%

1466.7%

2158.3%

222.2%

3756.1%

BooksN%

1781.0%

1336.1%

444.4%

3451.5%

Preschool TeacherN%

1257.1%

1233.3%

00%

2436.4%

Parenting ClassesN%

523.8%

1541.7%

333.3%

2334.8%

Family Context (continued)Family Context (continued)Sources of Child Development Information

Moderate LowNot

ReportedTotal

Child Care ProviderN%

733.3%

1027.8%

111.1%

1827.3%

TelevisionN%

314.2%

1027.8%

222.2%

1522.4%

Nurse, Parent Educator,Home Visitor

N%

419.0%

925.0%

00.0%

1319.7%

Great BeginningsN%

523.8%

719.4%

00.0%

1218.2%

Internet ResourcesN%

314.3%

616.7%

111.1%

1015.2%

Parenting ExperienceN%

29.5%

616.2%

111.1%

913.4%

NewspapersN%

419.0%

12.8%

222.2%

710.6%

Contact with Professional Communities

Health Care Providers

Community Service Providers

Early Care and Education Community

School Districts

Families’ Access to Health Care

Yes No Missing Total

Primary Care PhysicianN%

6698.5%

11.5%

00.0%

67100.0%

Annual Well-Child VisitsN%

6495.5%

11.5%

23.0%

67100.0%

Health Insurance Coverage

N%

6394.0%

46.0%

00.0%

67100.0%

Health or Medical Need Went Unmet

N%

913.4%

5886.6%

00.0%

67100.0%

Contact with Professional Contact with Professional CommunitiesCommunities

Community Service ProvidersCommunity Service ProvidersThe Women Infants and Children ProgramThe Women Infants and Children Program

Division of Family ServicesDivision of Family Services

62% of the families in the 62% of the families in the sample were enrolled in sample were enrolled in WICWIC

Rating of their Overall Experience with WIC

N %

Positive 35 (83.3%)

Negative 2 (4.8%)

Neutral/Unsure 5 (11.9%)

Total 42 (100.0%)

Division of Family Services Division of Family Services Contacts—Age of First Contacts—Age of First ContactContact

Age: N* %

Birth to 12 months 2 14.3%One Year 5 35.7%Two Years 1 7.1%Three Years 3 21.5%Four Years 2 14.3%Five Years 1 7.1%Total 14 100.0%

*14 of the 67 families had contact with the Division of Family Services (21%)

Cumulative Division of Family Services Days

Number of days in service N %

26 - 35 days 3 21.4%

89 – 92 days 2 14.2%

164 - 251 days 3 21.4%

364 - 597 days 6 42.8%

Total 14 100.0%

Division of Family Services Division of Family Services Contacts—Days of ServiceContacts—Days of Service

*14 of the 67 families had contact with the Division of Family Services (21%)

Early Care and EducationEarly Care and Education

At what age was your child enrolled in an early care and education setting?

Income:

Age of Care:

Moderate (N=21)

Low (N=37)Not Reported

(N=9)Total

(N=67)

No CareN%

14.7%

616.2%

444.9%

1116.4%

InfantN%

419.0%

12.7%

00.0%

57.5%

ToddlerN%

942.9%

821.6%

00.0%

1725.4%

Betweenage 3 and

school entrance

N%

2095.2%

2670.3%

555.6%

5176.1%

Types of Early Care and Education Settings Experienced as 3-5 Year-Olds

N %

Child Care Center and/or Preschool Program

43 84.3%

Family Child Care 7 13.7%

Head Start/ECAP Program 9 17.6%

Type Not Specified 14 27.5%

Early Care and EducationEarly Care and Education

Longest Length of Time Spent in One ECE Setting (3 to 5 Years of Age)Income

Length of Time in 1 Setting:ModerateIncome

Low Income

Income Not Reported

Total

Less than 9 monthsN%

00.0%

27.7%

00.0%

23.9%

9 months to 1 yearN%

630.0%

1246.1%

360.0%

2141.2%

1 year or moreN%

1470.0%

1038.5%

240.0%

2651.0%

Early care and education undefined

N%

00.0%

27.7%

00.0%

23.9%

TotalN%

20100.0%

26100.0%

5100.0%

51100.0%

Early Care and EducationEarly Care and Education

School DistrictsSchool Districts School District Evaluation ServicesSchool District Evaluation Services

Child Find ScreeningChild Find Screening

Contact with Professional Contact with Professional CommunitiesCommunities

School District Evaluation ServicesSchool District Evaluation Services

Contact with School District to conduct an Evaluation

N %

Did not contact 63 94.0%

Contacted, looking for preschool 1 1.5%

Contacted and evaluation suggested

1 1.5%

Contact and told to wait 2 3.0%

Total 67 100.0%

Child Find ScreeningChild Find Screening

N %

No screening occurred 22 32.8%

Screening occurred with result of no concern

37 55.2%

Screening occurred with result of a concern

8 11.9%

Total 67 100.0%

Section II:

Children’s and Families’ Experiences When a Concern is Expressed (N=23)

Recognition of ConcernRecognition of Concern

Response to ConcernResponse to Concern

Special Education Categories of Special Education Categories of Eligibility Eligibility (N=23)(N=23)

Eligibility Categories: N %

Learning Disability 11 47.8%

Speech 8 34.8%

Physically Impaired 1 4.3%

Sensory Impairment 1 4.3%

Seriously Emotionally Disturbed 1 4.3%

Partially Sighted 1 4.3%

Who First Recognized a Concern?Relationship to Child N %

Family 11 47.8%

Extended Family 4 17.4%

Doctor 1 4.3%

Early Care and Education 4 17.4%

Family and Doctor 1 4.3%

Family and Early Care and Education 2 8.7%

Total 23 100.0%

Recognition of Families’ ConcernsRecognition of Families’ Concerns

Examples of Families’ Language Examples of Families’ Language Describing ConcernDescribing Concern

Special Education Codes:Special Education Codes:

Inability to sit stillInability to sit still XX

Terrible 2’s started, got worse, never endedTerrible 2’s started, got worse, never ended XX

Sleeping problems, uncontrolled violent rages Sleeping problems, uncontrolled violent rages with no apparent triggerwith no apparent trigger XX

Chronic ear infections, not hearingChronic ear infections, not hearing XX

Not able to understand him when he talked Not able to understand him when he talked compared to other childrencompared to other children XX

Verbal communication limited,Verbal communication limited,He didn’t talk muchHe didn’t talk much XX XX

LD

LD

Sp

eec

Sp

eec

hh PI

PI

ED

ED

Responses to Families’ ConcernsResponses to Families’ ConcernsResponses to Concerns Raised Between Children’s Births Responses to Concerns Raised Between Children’s Births and School Entry (N=23)and School Entry (N=23)

N %

Family made contact with or received professional referral

17 73.9%

Professional told family child will outgrow the problem, or too young to tell outcome; concern deferred

6 26.1%

Professional performed evaluation 6 26.1%

Family tried to solve the problem by themselves 2 8.7%

Family waited 2 8.7%

Family did not respond to others’ concern 1 4.3%

Early Care and Education teacher made informal accommodations

1 4.3%

Response to Families Following an Assessment (N=6)

Response N %

Family told child is not delayed enough/not at great enough risk, no program availability, or too young

4 17.4%

Professional performed evaluation, normal results

2 8.7%

Doctor Prescribed medication 2 8.7%

Doctor recommended annual follow-up 1 4.3%

AssessmentConducted

Concern Addressed with an Intervention

Concern Raised

Options Identified to Address Concern

Information SoughtOptions Identified to Assess Concern

Experiences of the 87

children in the study

83 children.

67 children without

services.

39 with a concern raised

by their families.

23 children whose families had a response

to their concerns.

6 children who had an

assessment.

16 children receiving services.

Discussion of FindingsDiscussion of Findings

Language – Vocabulary of ConcernsLanguage – Vocabulary of Concerns

Potential Leverage Points (opportunities Potential Leverage Points (opportunities for referrals and responses)for referrals and responses)– Early Care and EducationEarly Care and Education– Health Care ProvidersHealth Care Providers– Community ServicesCommunity Services

SummarySummary

Families and extended family members identify Families and extended family members identify concerns but more often than not did not have concerns but more often than not did not have their concerns responded to or addressedtheir concerns responded to or addressedWhen an assessment of children’s development When an assessment of children’s development did take place, families were still told to “wait,” did take place, families were still told to “wait,” “their development is normal,” or check their “their development is normal,” or check their children’s development again in kindergartenchildren’s development again in kindergartenAlmost ALL children have at least one primary Almost ALL children have at least one primary extra-familiar contacts that could make referrals extra-familiar contacts that could make referrals to schools or other programs (e.g., medical, to schools or other programs (e.g., medical, social service, and early care and education social service, and early care and education programs)programs)

ImplicationsImplications

With collaboration between families and With collaboration between families and professional communities, children could professional communities, children could be referred earlier and services securedbe referred earlier and services secured

This calls for a change in the professional This calls for a change in the professional culture regarding children’s development culture regarding children’s development and linking to services; the protocols and linking to services; the protocols professionals use for referring children and professionals use for referring children and their families need to be updatedtheir families need to be updated

Proposed Professional Protocols Proposed Professional Protocols for Referralfor Referral

Listen to, respond to, and value families’ Listen to, respond to, and value families’ information about their children’s information about their children’s developmentdevelopmentMaking the default action further assessment Making the default action further assessment and examination rather than waitingand examination rather than waitingImmediately providing informal intervention Immediately providing informal intervention strategies and supports to the family in strategies and supports to the family in response to their stated concerns, while response to their stated concerns, while more formal interventions are secured (if more formal interventions are secured (if needed)needed)

Proposed Professional Protocols Proposed Professional Protocols for Referral (continued)for Referral (continued)

Help connect families as early as possible Help connect families as early as possible with informal and formal supports and with informal and formal supports and services; again, rather than waiting to see services; again, rather than waiting to see what happens with their children’s what happens with their children’s developmentdevelopmentTraining to begin a cultural shift in our Training to begin a cultural shift in our professional communities to embrace the professional communities to embrace the role of early identification, provision of role of early identification, provision of supports, and referral to formal sources for supports, and referral to formal sources for assessment and interventionassessment and intervention