Intellectual and developmental disabilities research centers: Fifty years of scientific accomplishments.

Progress in addressing the origins of intellectual and developmental disabilities accelerated with the establishment 50 years ago of the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health and associated Intellectual and Developmental Disabilities Research Centers. Investigators at these Centers have made seminal contributions to understanding human brain and behavioral development and defining mechanisms and treatments of disorders of the developing brain. ANN NEUROL 2019;86:332-343.

Early Intervention for Children with Intellectual Disabilities: An Update.

This article provides an update on advances in both developmental and intervention science that have occurred in the field of early intervention for children with developmental delays in the past decade. From the perspective of developmental science, findings related to multiple and reciprocal pathways of influence on the development of children with delays that can inform early intervention practice are discussed. This is followed by a review of two prominent lines of early intervention research: promoting children's developm-ent by enhancing parent-sensitive responsiveness and improving children's cognitive and social outcomes in inclusive preschool settings. Merging policy initiati-ves with our knowledge of developmental processes is discussed as the key to accelerating progress in the development of comprehensive early intervention systems.

The Peer Social Networks of Young Children with Down Syndrome in Classroom Programmes.

BACKGROUND: The nature and characteristics of the peer social networks of young children with Down syndrome in classroom settings were examined within a developmental framework. METHOD: Comparisons were made with younger typically developing children matched on mental age and typically developing children matched on chronological age. RESULTS: Similar patterns were found for all three groups for most peer social network measures. However, group differences were obtained for measures of teacher assistance and peer interactions in unstructured situations. CONCLUSIONS: Positive patterns appeared to be related to the social orientation of children with Down syndrome and the special efforts of teachers to support children's peer social networks. Findings also suggested that fundamental peer competence problems for children with Down syndrome remain and may best be addressed within the framework of contemporary models of peer-related social competence.

Applying the Developmental Systems Approach to Inclusive Community-Based Early Intervention Programs: Process and Practice.

A developmentally oriented framework is presented designed to establish or enhance the quality of inclusive community-based early intervention systems. This conceptually and empirically integrated developmental approach supports a comprehensive family-centered model. Outlined is a process that coordinates children's goals with family priorities, identifies developmental pathways most likely to influence those goals, guides the selection of objectives and intervention activities, and provides an approach for evaluation and problem solving. Principles of relationships, comprehensiveness, and continuity are central to this framework and address the general problem of "what to implement" in inclusive community-based early childhood programs.

Mothers' social communicative adjustments to young children with mild developmental delays.

The social communication and compliance patterns of 63 mothers interacting with their young children who had mild developmental delays in social play and instructional tasks were examined in a longitudinal study. Results were consistent with the hypothesis that mothers appropriately adjust their social communications in accordance with children's developmental characteristics and task demands. The extent of scaffolding specificity that mothers used in the instructional task also indicated a high level of sensitivity to children's developmental characteristics. Analyses conducted over a 2-year period revealed that adjustments were commensurate with children's emerging social communication abilities, suggesting that mothers of children with developmental delays continue to display social communication patterns that are supportive of their child's development.

Developmentally delayed children's influence attempts with mothers predict interactions with peers over time.

We examined whether influence attempts of 4-6 year-old children with mild developmental delays occurring when interacting with their mothers predicted children's interactions with peers two years later. Hierarchical regressions controlling for relevant child characteristics and a measure of direct parental actions to influence their children's peer interactions revealed a consistent association between influence attempts with mothers and four important aspects of children's peer relationships: successful social bids to peers, initiations to peers, extent of involvement with peers, and overall level of peer interactions. Results were consistent with social communicative processes likely to emerge during children's influence attempts with mothers, which are relevant to peer relationships. The fact that influence attempts with mothers were associated with peer interactions over a time period when peers occupy a more dominant role in children's social relationships supports the role of indirect family influences as a potential intervention strategy to further the peer competence of children with delays.

Continuity and Change From Full-Inclusion Early Childhood Programs Through the Early Elementary Period.

A large and well-characterized group of children with mild developmental delays initially enrolled in full-inclusion preschool or kindergarten programs was followed for 3 years. Changes in the type of inclusive placements as children transitioned to first and second grades were monitored, and associations between placement type and child and family characteristics were examined. Results revealed a high level of continuity in that most children remained in partial or full inclusion settings over time. However, a substantial reduction in full-inclusion placements occurred between the 2nd and 3rd year when children were completing the transition to first and second grades. Placements in less inclusive settings were associated with children's levels of cognitive and language development but not their adaptive, social, or behavioral characteristics. A hypothesis was put forward that placement in full-inclusion programs during the early childhood years creates a momentum to continue maximum participation in inclusive settings over time.

Parent Support of Preschool Peer Relationships in Younger Siblings of Children with Autism Spectrum Disorder.

Preschool-aged siblings of children with ASD are at high-risk (HR) for ASD and related challenges, but little is known about their emerging peer competence and friendships. Parents are the main providers of peer-relationship opportunities during preschool. Understanding parental challenges supporting early peer relationships is needed for optimal peer competence and friendships in children with ASD. We describe differences in peer relationships among three groups of preschool-aged children (15 HR-ASD, 53 HR-NonASD, 40 low-risk, LR), and examine parent support activities at home and arranging community-based peer activities. Children with ASD demonstrated precursors to poor peer competence and friendship outcomes. Parents in the HR group showed resilience in many areas, but providing peer opportunities for preschool-age children with ASD demanded significant adaptations.

The Friendships of Young Children with Developmental Delays: A Longitudinal Analysis.

This longitudinal study examined the social interactions of children with mild developmental (cognitive) delays with friends across the early childhood and early elementary years. Results revealed increases in many forms of social exchange with effect sizes in the moderate range, but no changes in sustained interactive play. Social interaction patterns, difficulties in identifying friends to participate in the study, and concerns evident in children's peer and friendship networks suggest the general absence of reciprocal friendships. These findings are consistent with the hypothesis that children's limited peer-related social competence constrains all aspects of their development of friendships. Despite these problems, the potential benefits of interventions designed to support relationships at this stage of friendship development for children with delays were noted.

Promoting the peer-related social development of young children with mild developmental delays: effectiveness of a comprehensive intervention.

To address the unusual peer-related social competence difficulties characteristic of young children with mild developmental delays, we conducted a randomized clinical trial to evaluate the effectiveness of a comprehensive, developmentally oriented, highly individualized intervention extending over a 2-year period. Outcome measures emphasized generalization of peer interactions in unfamiliar playgroups. Results revealed modest effects of the intervention, with children who had lower cognitive levels benefiting most. Intervention effects were best conceptualized as preventative, minimizing the negative features and atypical patterns of children's social play with peers. Our discussion of future work was focused on alternative implementation models to enhance intervention intensity, inclusion of specific subgroups of children, and direct measurement of children engaging in social tasks.

Merging Policy Initiatives and Developmental Perspectives in Early Intervention.

The provision of early intervention services for vulnerable children and their families is now both accepted and expected by the international community. This article considers the importance of a developmental perspective as an essential guide to early intervention service systems. Emphasized in this framework are three critical features: relationship formation, the continuity of interventions, and the comprehensiveness of interventions. Guidance to early intervention systems design with respect to structural and values principles is also discussed. Future advances in early intervention may well depend upon the merging of these perspectives to create policy initiatives to enhance early intervention systems.

Family factors associated with the peer social competence of young children with mild delays.

A model addressing family influences on the peer-related social competence of young children with mild developmental (cognitive) delays was developed and tested. Constructs representing child peer competence, types of parent action (arranging play for their child and socialization strategies varying in degree of control or power), parent attitudes (beliefs as to the degree their child's peer interactions could be influenced by external actions), parent stress, social support, and child risk were examined. Path analytic techniques were used to evaluate the model. Results supported the importance of family influences on the peer-related social competence of young children with mild developmental delays. With the exception of parent attitude, all theoretical constructs were retained in the analysis and significant paths followed predicted relationships.

Subtypes of nonsocial play: comparisons between young children with and without developmental delays.

Subtypes of nonsocial play were examined for matched groups of young typically developing children and children with mild developmental (cognitive) delays. Based on intercorrelation patterns, interindividual stability, and associations with peer interaction measures, findings indicated that the nonsocial play of children with delays can be characterized as multidimensional in a manner similar to that of typically developing children. However, analyses suggest different interpretations of the psychological meaning of nonsocial play subtypes for both groups of children than indicated by previous work. Context factors did not influence nonsocial play subtypes. Evidence was found indicating considerable heterogeneity within subtypes, suggesting the need for longitudinal studies focusing on children's peer-related social competence, which may reveal subgroups within subtypes that both refine the constructs and provide direction for clinical interventions.

Developmental Science and Preventive Interventions for Children at Environmental Risk.

The current status of preventive intervention programs for young children at environmental risk designed to reduce the school readiness gap is examined in the context of developmental science. A review of program effectiveness suggests that future progress may depend upon committing to a specific developmental approach consistent with the knowledge base of developmental science and establishing a generally agreed upon and unambiguous framework, set of goals, and associated mechanisms. The Developmental Systems Approach is suggested as one model that is consistent with developmental and existing intervention science, supporting an emphasis on program continuity, relationships, and comprehensiveness. A long-term plan for community-based systems development is presented.

Preventive interventions for preterm children: effectiveness and developmental mechanisms.

This article provides an integrative review of the effectiveness of and possible developmental mechanisms associated with preventive interventions for preterm children. An analysis of randomized clinical trials carried out within the last 15 years was framed within a contemporary developmental model emphasizing the role of parental adjustments to preterm children's characteristics. Evidence suggested positive outcomes could be understood in terms of improvements in developmental pathways associated with parental sensitive-responsiveness and child participation in intensive intervention-oriented child care. Implications for the critical role of the Medical Home model for preventive interventions for preterm children were discussed.

International Human Rights to Early Intervention for Infants and Young Children with Disabilities: Tools for Global Advocacy.

With almost universal ratification of the Convention on the Rights of the Child and the growing number of States Parties that have signed or ratified the Convention on the Rights of Persons with Disabilities, the majority of countries in the world have now committed to implementing the human rights articulated in these treaties. In this article we first provide an overview of both Conventions, highlight the articles in the treaties that are relevant to early intervention for infants and young children with disabilities, and describe the specific duties required of States Parties to ensure compliance including international cooperation. Second, a series of early intervention action principles are put forward that can help States Parties translate the underlying values of the Conventions into practice.

Why Early Intervention Works: A Systems Perspective.

A systems perspective is put forward designed to place the many diverse conceptual and practice approaches and accomplishments in the early intervention field within a common framework. Complex reciprocal patterns of influence are described emphasizing risk and protective factors operating at 3 levels: child social and cognitive competence, family patterns of interaction, and family resources. It is argued that this framework can provide an understanding with respect to why early intervention works when it does as well as establish a new assessment and intervention approach firmly grounded in developmental science.

Peer-related social competence of young children with Down syndrome.

The peer-related social competence of children with Down syndrome was examined in an observational study. Dyadic interactions with peers of children with Down syndrome were compared with the dyadic interactions of matched groups of typically developing children and with playmates differing in both familiarity and social skills. Results suggested that both risk and protective factors influenced the peer interactions of children with Down syndrome. Recommendations are made for applying contemporary models of peer-related social competence to etiologic subgroups to better understand the mechanisms involved and to provide direction for the design of intervention programs.

Early Intervention Approaches to Enhance the Peer-Related Social Competence of Young Children With Developmental Delays: A Historical Perspective.

This article presents a framework for future research and program development designed to support children's peer-related social competence. Intervention research is examined within a historical perspective culminating with a discussion of contemporary translational approaches capable of integrating models of normative development, developmental models of risk and disability, and intervention science.