Health and educational outcomes of children who experienced severe neonatal medical complications.

To determine the long-term developmental and educational outcomes of a sample of low birthweight infants with intraventricular hemorrhage (IVH), the authors conducted developmental assessments and interviews 8 years after the initiation of an early intervention project. At the time of the follow-up, 62% of the children were experiencing some developmental or behavior problems, with visual impairments, cerebral palsy, and attention deficits occurring most frequently. Grade of IVH and the number of days spent in the neonatal intensive care unit were the best predictors of later developmental delays. The sample also scored below average on school achievement; approximately 30% of those in school were eligible for special education services. These findings corroborate results from investigations with similar populations whose birth characteristics put them at risk for subsequent developmental delay.

Predictors of developmental outcomes for medically fragile early intervention participants.

Little is documented about the determinants of developmental outcomes for medically fragile infants who receive early intervention. In this controlled longitudinal study 65 premature infants with intraventricular hemorrhage (IVH) were randomly assigned to intervention groups beginning at 3 months adjusted age (Early) or 12 months adjusted age (Delayed). The sample was 65% African American and 35% Caucasian, and over half the youngsters were being raised by single mothers. Although cost analyses revealed that it was almost twice as expensive to begin sensorimotor intervention at the earlier age, annual comprehensive assessments revealed no significant differences in developmental outcomes based on age at start. Stepwise multiple regression analyses revealed that Maternal Education and Neonatal Medical Problems were significant predictors of outcomes at years 1, 3, 5, and 7 regardless of age at start. Related findings from other studies are discussed along with implications for policy and future research.

Family support in the home. Programs, policy, and social change.

The need for a coordinated national policy on family support in the home is discussed. First, the history of home visiting programs is reviewed. Then, recommendations for practice, training, and research in family support programs are presented. A discussion of the impact of new federal initiatives on family support programs and research demonstration efforts follows.

Ameliorating the impact of teen-age pregnancy on parent and child.

The increase in teen-age pregnancy creates a growing population of young mothers unable to care adequately for themselves or their children. Responding to budget cuts in Utah, the authors report on a program that combines the resources of an agency and a university program to teach mothers child care and self-sufficiency, promotes the healthy development of their children, and gives field training to social work students.

PIP: This article reports on a program that combines the resources of an agency and a university program to teach mothers child care and self sufficiency, promotes the healthy development of their children, and gives field training to social work students. The program was a response to budget cuts in Utah and awareness that the increase in teengage pregnancy creates a growing population of young mothers unable to care adequately for themselves or their children. The increase is attributed to a drop in the age of menarche and a steady increase in the number of sexually active young people. In Utah, where conservative mores concerning sexuality predominate, teenage unmarried mothers frequently perceive themselves as alienated from the mainstream of society and human service agencies have been unable to deal adequately with the increased demands for service. The Single Parent Project combines the resources of the Children's Aid Society and the Early Childhood Research Program at Utah State University to help pregnant adolescents and their at risk preschool children. In 1980-81, a core group of 15 mothers and 29 children were serviced. Mothers had to meet 4 criteria from a list that included health problems, economic privation, substance abuse, age factors, deficient parenting, negative or no support network and previous victim of abuse. Children had to meet two or more criteria including birth problems, nutrition, developmental and behavioral problems or reported victim of abuse or neglect. The program included weekly group sessions with mothers, and home intervention using individualized plans for each child. Activities and resources used are described. Success is measured in a comparison with non program users. A significantly higher percentage of program graduates found employment, went on to college, had less dependence on welfare and fewer referrals for child abuse. The programs next phase calls for an experimental design to test the program's effectiveness.

"What's wrong with my baby?".

The birth of a child with any developmental disability is an occasion of marked trauma to parents. Early, honest and frank counseling is imperative, and the family physician can play a unique role in this counseling process. When the physician is not knowledgeable in a paretcular case, he or she should seek expert help and fully utilize available community services.

Relative efficacy of two token economy procedures for decreasing the disruptive classroom behavior of retarded children.

Numerous studies have demonstrated that disruptive classroom behavior can be decreased by delivering tokens contingent upon periods of time during which children do not engage in it or by removing tokens contingent upon its occurrence. To date, the best controlled of these studies have consistently reported the two procedures to be qually effective. However, in these studies, token the two procedures to be equally effective. However, in these studies, token contingencies have been combined with instructions regarding the contigencies. The present study compared these two procedures when no instructions were given regarding the token contingencies. Token delivery was not effective in decreasing disruptive behavior in any of the children, while a combination of token delivery and removal was effective for three of four children. The results token delivery and removal was effective for three of four children. The results suggest that the combined procedure may be effective with certain populations that are not readily controlled by instructions.