DOCUMENT RESUME ED 369 240 AUTHOR Doan-Sampon, Mary … · intervention with a family. 4. How to...

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DOCUMENT RESUME ED 369 240 EC 302 971 AUTHOR Doan-Sampon, Mary Anne; And Others TITLE Growing: Birth to Three. Piecing It All Together. INSTITUTION Cooperative Educational Service Agency #5, Portage, WI. SPONS AGENCY Department of Education, Washington, DC. PUB DATE 93 CONTRACT H024000031 NOTE 29p.; For the final report, see ED 364 032. PUB TYPE Information Analyses (070) Reports Descriptive (141) EDRS PRICE MFOI/PCO2 Plus Postage. DESCRIPTORS Child Rearing; *Disabilities; *Early Intervention; *Ecological Factors; Environmental Influences; *Family Involvement; Family Life; Family Programs; Infants; *Parent Child Relationship; Preschool Education; Toddlers ABSTRACT This guide is one part of a set of materials designed to support an ecological intervention system for families and their special needs children between birth and three. The system is constructed on four premises: (1) intervention is guided by the family; (2) parent-child interactions are the heart of early intervention; (3) family ritual, daily routines, and play reflect the patterns of family life and are the medium into which intervention is embedded; and (4) recorded ongoing observations and conversations between parents and interventionists are the basis for intervention decisions. The materials respond to the importance of multiple environmental influences on child and family life, the power and influence of interactions between parent and child, and the rights of families to fully guide the course and shape the content of the intervenLion program. The system is appropriate for early intervention, Head Start programs, day care centers, migrant programs, family resource centers, hospital personnel working with infants and premature babies, and others. The guide describes the research and literature foundation relating to each of the four premises and introduces the parts of the "Growing: Birth to Three" system. (Contains 60 references.) (JDD) *********************************************************************** Reproductions supplied by EDRS are the best that can be made * from the original document. * **********************************************************************

Transcript of DOCUMENT RESUME ED 369 240 AUTHOR Doan-Sampon, Mary … · intervention with a family. 4. How to...

Page 1: DOCUMENT RESUME ED 369 240 AUTHOR Doan-Sampon, Mary … · intervention with a family. 4. How to conduct and document observations and informal interviews with families. 5. How to

DOCUMENT RESUME

ED 369 240 EC 302 971

AUTHOR Doan-Sampon, Mary Anne; And OthersTITLE Growing: Birth to Three. Piecing It All Together.INSTITUTION Cooperative Educational Service Agency #5, Portage,

WI.

SPONS AGENCY Department of Education, Washington, DC.PUB DATE 93

CONTRACT H024000031NOTE 29p.; For the final report, see ED 364 032.PUB TYPE Information Analyses (070) Reports Descriptive

(141)

EDRS PRICE MFOI/PCO2 Plus Postage.DESCRIPTORS Child Rearing; *Disabilities; *Early Intervention;

*Ecological Factors; Environmental Influences;*Family Involvement; Family Life; Family Programs;Infants; *Parent Child Relationship; PreschoolEducation; Toddlers

ABSTRACTThis guide is one part of a set of materials designed

to support an ecological intervention system for families and theirspecial needs children between birth and three. The system isconstructed on four premises: (1) intervention is guided by thefamily; (2) parent-child interactions are the heart of earlyintervention; (3) family ritual, daily routines, and play reflectthe patterns of family life and are the medium into whichintervention is embedded; and (4) recorded ongoing observations andconversations between parents and interventionists are the basis forintervention decisions. The materials respond to the importance ofmultiple environmental influences on child and family life, the powerand influence of interactions between parent and child, and therights of families to fully guide the course and shape the content ofthe intervenLion program. The system is appropriate for earlyintervention, Head Start programs, day care centers, migrantprograms, family resource centers, hospital personnel working withinfants and premature babies, and others. The guide describes theresearch and literature foundation relating to each of the fourpremises and introduces the parts of the "Growing: Birth to Three"system. (Contains 60 references.) (JDD)

***********************************************************************

Reproductions supplied by EDRS are the best that can be made* from the original document. *

**********************************************************************

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Growing: Birth to Three

Developed by:Mary Anne Doan-SamponKaren WollenburgAnn Campbelland the Portage Project Staff

© 1993 Cooperative Educational Service Agency 5, Portage Project

All rights reserved including translation. No part of this book may bereproduced in any form of printing or by any other means, electronic ormechanical, including, but not limited to, photocopying, audiovisual recordingand transmission, and portrayal or duplication in any information storage andretrieval system, without permission from the authors.

These materials were developed by the Portage Project, CooperativeEducational Service Agency 5; Portage, Wisconsin with partial support from theU.S. Department of Education, grant # H 024000031. The suggested practicesand procedures described herein are not necessarily endorsed by theDepartment of Education.

Printed in the United States of America

First printing, 1993

Portage ProjectJulia Herwig, Director626 E. Slifer StreetPortage, Wisconsin 53901Telephone: (608) 742-8811

Growing: Birth to Three is published as a rescurce to those providing servicesto families with young children between birth and three years of age. Thesematerials are neither exclusive nor all inclusive and are not intended to limitproviders to the suggestions, procedures, and practices contained herein.

This package of materials may be used by anyone desiring to do so, and everyeffort has been made to assure the accuracy and reliability of the informationcontained herein. However, the authors and CESA 5 make no representation,warranty, or guarantee in connection with the publication of Growing: Birth toThree, and hereby, expressly disclaim any liability or responsibility for injuryresulting from its use.

Throughout these materials specific gender terms are used when referring toparents, children, and interventionists. This style is chosen for ease ofreadability only and is not intended to imply limitation or exclusion of eithergender related to the specific example.

4

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ACKNOWLEDGEMENTS

The development and completion of these materials would not have been possible without thetireless commitment and encouragement of the entire Portage Project staff. A special thanksand recognition to Julia Herwig for committing the necessary resources and personnel for thedevelopment of Growing: Birth to Three. Her unflagging optimism and faith in us are greatlyappreciated. A special acknowledgement is also given to Patti Herman, who was not only anexceptional editor, but also provided guidance and leadership in our efforts to meet timelines,drafts, and integrate the ideas and styles of multiple persons into a cohesive product. We areespecially grateful to Gail Saviano, who with unfailing good humor and persistence decipheredhandwritten text and patiently fashioned rough scribbles on second and third drafts into afinished manuscript. Fernando Hernandez deserves a standing ovation, not only for his artisticand technical talents in designing, creating artwork, and laying out these materials, but alsofor his ability to listen carefully to the ideas of different people and translate those ideas intovisual images. We also wish to thank Margaret Stine for her impeccable and thorough editingefforts.

To all who contributed activity ideas from their many personal and professional experienceswith the routines and interactions of caregivers o.nd children, we offer our gratitude andappreciation. We recognize that your contribution was, in most cases, done above and beyondthe demands of an already busy workscope. To the Birth to Three staff in particular we expressour appreciation for your critical and thoughtful ongoing use of these materials and forproviding practical feedback. You continue to be an inspiration through your commitment toyour profession and to the families you serve.

We would like to acknowledge the support of Barbra Lancelot, who assisted in the writingof Piecing It All Together and encouraged us to view the developing product as a truecontribution to the field of early intervention. Her professional knowledge helped us tocorrelateour practical, clinical experiences in the field with a comprehensive, relevant, and currentresearch base. We also acknowledge the guidance of Michael Trout, who encouraged us toquestion the purpose of each act of intervention and both sharpened and broadened our focuson family systems. He challenged us to recognize the importance of developing an "informedand principled" intervention relationship with families and children.

We would like to offer our gratitude to all of the families and young children who havegraciously allowed us into their homes and lives throughout the years. It is they who havetaught us the meaning and purpose of our intervention relationships.

Lastly, we extend a special thanks to Don Stevens, CESA 5 Agency Administrator, and theCESA 5 Board of Control for their support in the development of Growing: Birth to Three .

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Activity Writers

Elma Wilson

Pat GauthierCarolyn Milam

Barbara JurgensonMichelle Davies

Beth Hecht

Vonda Hainstock

Carol Irwin

Mary Ellen Rattunde

Tricia Naparalla

Consultants

Barbra LancelotMichael Trout

George Jesien

Cecilia McCormick

Molly Murphy

Artwork, Layout, Design

Fernando Hernandez

Word Proces'sing

Gail Saviano

Editing

Patti HermanMargaret Stine

Julia Herwig

CONTRIBUTORS

Thanks to the following programs and individualswho provided feedback on a first draft of some of thematerials:

Connections, Madison, WI

Headwaters Birth to Three,Rhinelander, WI

St. Francis Children's Center,Milwaukee, WI

Marquette Electronics Day CareCenter, Milwaukee, WI

Parent and Child Program,Eau Claire, WI

Ripon Memorial Hospital,Ripon, WI

Ann Decker, Oshkosh, WI

Sheboygan Early InterventionProgram, Sheboygan, WI

Ann Haines, Milwaukee, WI

Native American Portage ProjectReplication, Albuquerque, NM

Office for Children Parent-Child Center,Fairfax, VA

Allen County ARC, Fort Wayne, IN

Kathy Colton, Cedar Rapids, IA

To any that we have inadvertently omitted fromthis list, we extend our sincere thanks.

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Purpose

GROWING: BIRTH TO THREE FACT SHEET

These materials are designed tosupport an ecological interventionsystem for families and their childrenbetween birth and three. Fourpremises guided the development ofthese materials:

Suggested Order For Review

PIECING IT `._L TOGETHER

describes the research andliterature foundation for Growing:Birth to Three

introduces the pails of Growing:Birth to Three

ECOLOGICAL PLANNERdirections for use of Growing:Birth to Three

Part I Conversation, Observation,Planning Forms

Part ll Developmental ObservationGuide

QUICK REFERENCE

If You Need This Information

1. Intervention is guided by the family

2. Parent-child interactions are theheart of early intervention

3. Family rituals, daily routines, andplay reflect the patterns of familylife and are the medium into whichIntervention is embedded

4. Recorded ongoing observationsand conversations between parentsand interventionists are the basisfor intervention decisions

MASTER FORMSreproducible forms to assist ingathering important family informa-tion and documenting child/familychange

includes forms for recordingInformation gathered duringconversations.and observations,developing a family generatedservice plan, and developingintervention suggestions responsiveto each family

INTERACTIVE GROW PACKsuggestions for facilitating mutuallysatisfying interactions betweenparents/caregivers and children

strategies for interactive communi-cation with cargivers

36 Daily Routine Situation Ex-amples illustrate use of interactivecommunication strategies inintervention

INTERACTIONS AND DAILYROUTINES BOOKS

four books correlated with thesections of the DevelopmentalObservation Guide

suggestions for interactive anddaily routine activities to helpsupport child/family goals

activities are individualized for eachfamily.through use of activityplanning sheets

NURTURING JOURNALStwo Journals for use by parents orprimary caregivers

open-ended questions and state-ments help parens reflect on theprocess of parenting

includes information on childnutrition and immunizations

See These Items If You Need This Information See These Items

1. An understanding of the Piecing It All Togetherresearch base and rationalefor these materials

2. A quick overview of theintervention planningprocess using thesematerials

3. What to do when beginningintervention with a family

4. How to conduct anddocument observationsand informal interviewswith families

5. How to respond to thefamlly's concerns about thedevelopment and matura-tion of their child

Review the Flow Chart atthe beginning of every book

Ecological PlannerInteractive Grow Pack

Ecological PlannerInteractive Grow Pack

Ecological Planner

7

6. How to explain wilycertain skills and behav-iors are important

7. How to observe andrespond to the interactivebehaviors of the child andfamily

8. How to develop theindividual family serviceplan

9. How to develop dailyroutine and interactiveactivities with families

10.How to help parentsreilect on and record theirthoughts about parenting

Interactions and DailyRoutines Books

Interactive Grow PackEcological Planner

Ecological PlannerNurturing JournalsInteractive Grow Pack

Interactions and DailyRoutines Books

Ecological Planner

Nurturing Journals

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PIECING IT ALL TOGETHER

INTRODUCTION

growing: Birth to Three is asystem of materials designed tosupport family guided interventionand may be best understood throughcomparison with a quilt. The multiplefabrics, designs, and textures of a quiltare analogous to the many pieces ofinformation, the conversations, and theobservations that occur between a fam-ily and an interventionist during theintervention process. Growing: Birth toThree offers formats and strategies toincorporate the multifaceted perspectiveof families into an intervention processwhich is ecological, interactive, andfamily guided. Piecing It All Togetherdescribes the research and literaturefoundation for Growing: Birth to Three.This foundation is described through adiscussion of the basic premises thathelped guide the development of Grow-ing: Birth to Three and a description ofthe materials.

A number of unique features charac-terize Growing: Birth to Three. Thematerials provide a prototype for anintervention process which begins withthe parent rather than the child, andwhich focuses on parent-child interac-tions occurring within the family as

well as the larger community.The suggested process is

sensitive to family uniqueness,accepting each family's individual

plan for childrearing and facilitatingthe development of their child. Theextensive use of observation and conver-sations with the family helps assurethat the intervention is guided by thefamily and incorporated into theirindividual lifestyle. The Growing: Birthto Three materials can help acknowl-edge and respond to the importance ofmultiple environmental influences onchild and family life, the power andinfluence of interactions between parentand child, and the rights of families tofully guide the course and shape thecontent of the intervention program(Turnbull and Turnbull, 1985, 1990).

Who Is It For!

The design of Growing: Birth to Threemakes it appropriate for a wide varietyof programs serving children from birthto three and involving families as anintegral part of the intervention pro-cess. This includes, but is not limitedto, early interventionists working with

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children with disabilities and theirfamilies, therapists working with chil-dren and their families, Head StartParent Child Centers and migrantprograms, day care centers, family daycare providers, family resource centers,social workers, and hospital personnelworking with infants and prematurebabies. The materials are also useful asa training tool in university personnelpreparation programs for early inter-vention, social work, nursing, and otherrelated disciplines. As with any materi-als and intervention process, trainingand supervision are essential to insureefficacy and quality of interventionactivities.

How Will It Impact the Field ofEarly Intervention?

Growing: Birth to Three has wide-reaching potential for interventionists,families, and children.

For interventionists, Growing: Birth toThree:

provides a set of materials whichsupports family guided serviceshelps organize the complexity ofinterventionprovides a way to support positiveparent-child interactionsoffers a structure and framework forecological interventionsuggests strategies to enhance par-ent-interventionist interacE, ns andcommunicationencourages a cultural match be-tween each family and the interven-tion approaches

For families, Growing: Birth to Three:

ingziures that what is important to thefamily becomes the intervention plangives credit to the family and theirenvironment as the optimal settingfor infant growth and developmentbuilds on each family's routines andrituals as defined by their familialcultural code (Sameroff and Fiese,1990)helps the family better understandhow to observe their child so theycan better anticipate and supportthe next steps in developmentmakes life easier for caregivers asthey address their child's develop-mental needs within their dailyroutines and ritualsassists caregivers in supporting thechild's development within everydayactivitiesrespects and builds on existingparent-child interactionsprc-rides a journal for the family touse to reflect upon their relationshipwith their child

For children, Growing: Birth to Three:

recognizes children as active partici-pants in their own developmentrecognizes the influence of the fam-ily, other caregivers, maturationalfactors, environments, and the inter-ventionist on the development ofchildrenoffers opportunities for developmentwithin the context of play, dailyroutines, and family ritualskeeps children within the familysystem, rather than isolating themfor developmental activities

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recognizes that development isunique to each child, and develop-mental competence is defined byeach child's familial and culturalexperience (Sameroff and Fiese,1990)

The development of Growing: Birthto Three can be compared to the processof creating a handcrafted quilt. Typi-cally, quilters refer to patterns anddesigns which have been developed byother experts and use their own creativ-ity and experience in selecting specificfabrics and color combinations to createa unique piece of work that representsthe style and skills of the quilt maker.Likewise, thie developers of Growing:Birth to Three referred to current re-search and literature on child develop-ment and intervention to create thefoundation for these materials. Inaddition, more than thirty years of s

combined experience in providing fam-ily centered intervention guided thedevelopment of this product, resultingin a unique system of materials sensi-tive to the complexity of both familiesand the intervention process. Thisresearch and experiential foundationhas resulted in four basic premisesupon which Growing: Birth to Three isbased.

1. Intervention is guided by the family.

2. Parent-child interactions are theheart of early intervention.

3. Family rituals, daily routines, andplay reflect the patterns of familylife and are the medium into whichintervention is embedded.

4. Recorded ongoing observations and

conversations between parents andintArventionists are the basis forintervention decisions.

Each of these premises is discussedhere.

BASIC PREMISE NUMBER ONE:Intervention is guided by the family

Families today differ widely in composi-tion, values, resources, and needs. Eachfamily is unique in their culture, theirconcerns and needs relative to interven-tion, and how they wish intervention tobe carried out within their family. Therecognition of the influence of ethnicand cultural diversity on our under-standing of development has led to theeffort to avoid imposing one culturaldevelopmental agenda on all families infavor of accepting the family's own planfor childrearing and facilitating devel-opment (Turnbull and Turnbull, 1986).Family guided intervention follows thefamily's lead in order to respect not onlythe child's development and matura-tion, but also the family's definition ofwhat developmental issues are impor-tant for them.

Research on intervention effects inprograms for infants reveals more posi-tive results, as measured by child devel-opmental change, in those programswhich focused on child and family. Thelevel of active engagement of families inthe intervention process is linked to theimpact of intervention (Meisels, 1992).Intrafamilial and informal supportaccounted for a significant number ofoutcome variables related to child,

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parent, and family functioning, whereastraditional early intervention whichfocused only on the child accounted foronly one of ten outcome variables.Dunst suggests that these researchresults, as well as other studies, "pro-vide support for the broad-based socialsystem definition of intervention"(Dunst, Trivette, and Deal, 1988).

Growing: Birth to Three is not de-signed to give simple intervention solu-tions to complex situations. The materi-als are designed to encourage the inter-ventionist to join with the family, tolisten and observe, to ask the rightquestions, and to learn from the family'shistory, perceptions, dreams, fears, andexpectations. The intervention processsuggested by these materials fosters athree-pronged approach that recognizesand builds on existing strengths in thefamily, assists the family in identifyingand meeting their goals, and supportsthe child's development and parent-child interactions. Through this pro-cess, the parents and interventionisttogether determine how the programcan best provide what the family wants(Dunst, Trivette,and Deal, 1988; Bailey,1987; Salisbury, Vincent, Gorrafa, 1987;Strain, 1987). As Sameroff and Fiese(1990) state:

It is beyond the scope of even themost ambitious intervention programto manipulate all the parametersthat influence child development.The alternative is to understanddeterminants of development insufficient degree to choose a level ofcomplexity appropriate to the prob-lem to be solved, the developmental

stages of the child and family, andavailable supports.

Research into developmental out-comes for young children with neuro-logical damage (Parmelee and Sigman,1984), mental health disorders (Rutter,1979), and a combination of biologicaland family risk factors (Sameroff,Seifer, Barocas, Zax, and Greenspan,1987) has demonstrated conclusivelythat it is the effect of multiple riskfactors, rather than the existence of asingle biological, psychological, or envi-ronmental factor, which results inadverse developmental outcome(Sameroff and Chandler, 1975;Sameroff, Seifer, Barocas, Zax, andGreenspan, 1987; Siders, Riall,Campbell, and Crow, 1987; Vincent,Salisbury, Strain, McCormick, andTessier, 1990). The elimination ofaccumulating risks.to optimal develop-mental outcome therefore becomes thegoal of intervention, rather than theteaching of developmental skills andmilestones (Parmelee and Haber, 1973;Rutter, 1979; Greenspan, 1981). Recog-nizing the complexity of intervention,Growing: Birth to Three takes a trans-actional and ecological approach tofamily guided intervention.

The transactional model (Sameroffand Fiese, 1990) supports a comprehen-sive and ecological approach to earlyintervention. The focus of early inter-vention has shifted from a child-ori-ented perspective to one which reflectsan emphasis on the ecology of the fam-ily and community, as described byBroffenbrenner (Broffenbrenner, 1979;

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Sameroff and Fiese, 1990). This ap-proach, supported both in human ecol-ogy theory and family systems theory(Carter and McGoldrick, 1980), exam-ines multiple systems, including thefamily, its culture, and roles of mem-bers.; the neighborhood and community;and the larger society in which we alllive. These systems all interact andinfluence each other and cannot betreated in isolation. The ecologicalapproach is reflected in recent legisla-tion, Public Law 99-457 and subsequentreauthorizations. Sections of this lawspecifically relating to programs forchildren with disabilities between theages of birth and three mandate thatservices be family centered and thatintervention address the broader con-text of family and community. AnIndividual Family Service Plan (IFSP)identifying family resources, priorities,and concerns guides the interventionprocess described through this legisla-tion.

Growing: Birth to Three offers apractical application of the transac-tional model of intervention (Sameroffand Chandler, 1975) as applied to theinteractive patterns of family life withinfants by Sameroff and Fiese (1990).The transactional model proposes thatparents and infants influence eachother reciprocally and continuously overtime. This process of influence is car-ried out within an environmental con-text which is also reciprocally influenc-ing and influenced.

The transactional model describessignificant, ongoing exchanges betweenparents and their children, lasting from

moment to moment and extending to alifetime. As Sameroff and Fiese defineit, "Whenever parents change their wayof thinking about or behaving towardthe child as a result of something thechild does, a transaction has occurred"(Sameroff and Fiese, 1990). A transac-tion also occurs when a child changes asa result of interacting with the parentsand others in the environment. The twoimportant characteristics of transac-tions are that they are changes in be-havior or attitude contingent on theactions of the others in the environ-ment, and that transactions occuracross time, from one event or mutualexperience to the next, so that the influ-ence is continuing. This process ofinfluence occurs within an environmentwhich is influenced by the child andfamily and which influences the par-ents' attitudes toward the child's devel-opment and the child's opportunities toexperience the world. Not only is thechild's developmental status continuallychanging, but the cultural and environ-mental influences are determining andchanging the experiences of the familyin a dynamic interplay of environmentand culture, parent-child interaction,and individual parent and child learn-ing and development.

Growing: Birth to Three supportssensitivity to each family's uniquenessby providing a format that insures thatthe family guides the intervention.Emphasis is placed on conversing withfamilies through open-ended formats togather information which directs theintervention process. The materialsalso offer means for parents to reflect on

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family and child issues which they maywish to discuss with the interventionist.The process recognizes the importanceof the many environments which influ-ence the family and supports interven-tion across these environments.

BASIC PREMISE NUMBER TWO:Parent-child interactions are theheart of early intervention

Growing: Birth to Three places thefamily and the nurturing of parent-child interactions at the heart of theintervention process. It considers howthe parents understand and empathizewith their child's capacity to develop,and what personal strengths, knowl-edge, and resources the parents haveavailable to help them facilitate thechild's developmental agenda(Greenspan, 1990; Norris, 1991; Dunst,1988). The Growing: Birth to Threematerials support taking an in-depthview of parent-child interactions, recog-nizing that the daily interactions thatoccur between a caregiver and child area primary influence on the developmen-tal outcomes of that child (Beckwith,1976; Barnard, Booth, Mitchell,Telzrow, 1988). This emphasis is consis-tent with research in the field of earlyintervention. Interpreting Vygotsky,Kaye suggests that parents createpersons by responding as if the infant'sexpressions are more meaningful thanthey are (Kaye, 1982). Trevarthen(1988) asserts that even newborns are"primed" for "good mothering", as evi-denced by "excessive sleep, inertia, andsilence when affectionate human care is

withheld." Early attachment relation-ships critically influence personalitydevelopment (Bowlby, 1969) and inter-actions with sensitive, predictable, andresponsive adults allows infants todevelop an idea of their own competence(Watson, 1972; Watson and Ramey,1972). The parents' environmentalaccommodations in response to theinfant's communications promote theunderstanding of social contingenciesand effect behaviors such as smiling,holding, talking, and looking (Emde,1980). Mothers who respond promptlyto their infant's cries have children whocry less and communicate more (Bell,Ainsworth, 1972; Crockenberg andMcCluskey, 1986). Children who formstrong attachments to primary caregiv-ers show less distress and positivedifferences in task persistence, qualityof play, and problem solving (Sroufeand Fleeson, 1986).

Parents and children may experi-ence difficulty relating due to a varietyof possible risk factors, biological oremotional vulnerability, or the mis-match of temperament and style. Thechallenge in such a circumstance is tofind and nurture the interactive pat-terns that are adequate and satisfyingand then attempt to facilitate an in-crease in their occurrence so that theycompete with and replace less satisfyingtransactions.

The techniques put forth in Grow-ing: Birth to Three are designed toassist interventionists in meeting thischallenge. The intervention process isnot intended to intrude upon or judgethe family's patterns of interaction. The

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role of the interventionist is to join withthe family in finding interactivestrengths, provide requested or func-tional information, and support thefamily's efforts to optimize their child'sdevelopmental outcomes and theirindividual competence in theirparenting role. The interventionistworks in partnership with parents toprovide a bridge or scaffold (Kaye, 1982;Vygotsky, 1967, 1978) when needed toassist them as they support the nextsteps in their child's development orstrive to attain other family goals.

Growing: Birth to Three supportsand encourages naturalistic parent-child interactions by embedding activi-ties into the family's natural environ-ment and interaction style. The work ofMahoney supports the importance ofparents as interactive partners. Aseries of research studies used a mea-sure of parent directiveness developedby Kaye and Charney (1980, 1981) toidentify aspects of parent-child interac-tions which are most predictive of com-petence in early childhood (Mahoney,Robinson, and Powell, 1992). The stud-ies were based on the observation thatparents of young children with develop-mental delays and disabilities oftenadopt a highly directive and perfor-mance-focused style of interaction,which has been shown to produce lessoptimal developmental outcomes innormally developing young children.Results indicate that children withdisabilities achieve optimal rates ofdevelopment when adults are respon-sive, child-oriented, non-directive, andnot instructionally oriented, perhaps

because the parents' style of interactioninfluences children's intrinsic or devel-opmental motivation. These findingsreplicate reports from investigations ofparents' interactions with normallydeveloping children (Bell andAinsworth, 1972; Yarrow, Rubenstein,and Pederson, 1975).

BASIC PREMISE NUMBER THREE:Family rituals, daily routines, andplay reflect the patterns of familylife and are the medium into whichintervention is embedded

One of the ideas which guided develop-ment of Growing: Birth to Three wasthat family culture and environmentinfluence the selection of interventiongoals and the means for reaching thegoals (Hanson and Lynch, 1992). Cul-tural codes organize and regulate asociety's childrearing system. Thesecultural codes operate within eachfamily to help the family organize andrelate to the society as a whole. Thefamily codes are demonstrated throughfamily rituals, stories, beliefs, andmyths about the family (Sameroff andFiese, 1990). The family guided inter-vention process blends into these exist-ing cultural and family codes, ratherthan creating disruptions and intrusionwithin the family.

Growing: Birth to Three suggeststhat the interventionist listen, watch,and then respond with interventionideas which are organized around typi-cal daily routines. These activities canbe adapted to fit each individualfamily's specific routines so that theyaren't a burden on the family. Daily

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routines and rituals provide opportuni-ties to explore and practice new behav-iors in a wide variety of situations,giving the child a chance to generalizeand maintain behaviors that will sup-port functional competence throughoutlife.

Play activities within the familyoffer additional opportunities for sup-porting intervention goals. Growing:Birth to Three emphasizes the impor-tance of play in the family, encouragingparents and family members to observeand join the child's play in ways thatare interactive and reflective of thechild's motivation and interests, as wellas the child's developmental capabilities(Norris, 1991). Through play, the childdevelops cognitive, social, emotional,motor, and language competence(Westby, 1991; Fenson, 1986; Slade,1987; Vygotsky, 1978). It offers theyoung child important opportunities todevelop a sense of personal control; topractice and integrate behaviors, skills,and goal-directed activities; and toassimilate and experiment with rules,constraints, and strategies (Bruner,1973; Vygotsky, 1967). Play is motivat-ing and can be used as a means ofencouraging cooperation, has potentialfor carryover with readily available toysand/or interactions with family mem-bers, and facilitates integration of sen-sory information (Rast, 1984; Manolson,1984; Musselwhite, 1986).

Growing: Birth to Three takes anecological approach through interven-tion activity suggestions that are em-bedded within daily routines and ritu-als of family life. Interactive strategies

are provided that can heip the familysupport the child's engagement withobjects and people in the environment.The interactive communication strate-gies in the Interactive Grow Pack assistthe interventionist to support and influ-ence mutually positive play and interac-tive experiences between caregivers andchildren.

BASIC PREMISE NUMBER FOUR:Recorded ongoing observations andconversations between parents andinterventionist are the basis forintervention decisions

Record keeping is a necessary part ofplanning and service provision. How-ever, the interactions between familiesand professionals prior to, and during,goal planning and program implemen-tation are of critical importance. Estab-lishing a positive, trusting, and collabo-rative relationship with families isnecessary to assure beneficial outcomesfor the family (Bailey, Winton, Rouse,Turnbull, 1990). If this mutual trustand interaction does not occur, informa-tion gathering and intervention ingeneral are likely to have little meaningand less than optimal success.

Recognition of the complex system ofvariables that are influenced by inter-vention challenges the field of earlyintervention to devise appropriatesystems to document change (Baird,Hass, McCormick, Corrith, and Turner,1992). Variables present in the familysystem are not easy to control andmethods for their measurement are notwidely available.

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Traditional clinical treatment pro-grams can be readily measured; whenthe child makes measurable develop-mental progress the professional feelsrewarded. Conventional tools used inearly intervention are based on profes-sional definitions of appropriatechildrearing environments and childdevelopment skills. Parents often havelittle opportunity to state their ownopinion of appropriate environments,routines, and rituals that may fosteroptimal development within their fam-ily. In addition, interventionists mustrealize that their own personal experi-ence base and value system will impactthe accuracy of the data tollected. Theobservations made and data collectedmay be influenced by interpretive andcultural bias (Baird, Hass, McCormick,Corrith, and Turner, 1992).

Growing: Birth to Three attempts toaddress the challenge of appropriatedata collection in a number of ways.Rather than look only at developmental

DESCRIPTION OFGROWING: BIRTH TO THREE

Growing: Birth to Three consists of anumber of distinct pieces which supporta continuous, individualized curriculumplanning and intervention process.This five-step process will focus onfamily-generated goals and the selection

milestones for the child, Growing: Birthto Three provides a format for informa-tion collection relative to environments,including formal and informal familysupport systems; interactions; develop-ment of the child; and parent satisfac-tion. Forms are provided to help theinterventionist work with the family togather information over time about thechild, the interactions within the fam-ily, and the environment. This informa-tion guides the interventionist to askthe appropriate questions and to gain adeeper understanding of the family.Ongoing communication with the familyinsures the flexibility and fluidity ofintervention as new information isincorporated into the family serviceplan according to the changing priori-ties and perceptions of the family mem-bers. Progress toward the achievementof family generated goals is documentedand monitored through this familyservice plan.

of interventions which reflect thefamily's perspective, history, wishes,and resources. The following flow chartidentifies the specific Growing: Birth toThree materials to be used in each stepof the process.

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A system of materials developed to support theprocess of ecological i tervention.

Step 5DETERMININGNEW GOALS

Ecological PlannerInteractiveGrow PackNurturing Journals

Step 4DOCUMENTING& MONITORINGPROGRESS

Ecological PlannerIntervention PlanningForms

The Growing: Birth toThree materials will bedescribed briefly in this section.A more detailed description of their usecan be found in the Ecological Planner.

,

rJiriiirth to Three

\Step 3

FAMILY GUIDEDINTERVENTION

Interactions & DailyRoutines BooksInteractive Grow PackNurturing JournalsIntervention PlanningForms

Ecological PlannerPart I of the Ecological Planner

suggests guidelines for observation andcommunication, provides a way to docu-ment transactions across time, andoffers a selection of formats for indi-vidualized intervention planning. Thiscollection of materials is designed tohelp gather an:.: acknowledge the impor-tant information shared by the family,and to reflect the goals and activitiesthe family wants to address throughintervention. The forms and sugges-

Step 1GATHERING ANDRECORDINGINFORMATION

Ecological PlannerNurturing JournalsInteractive Grow Pack

Step 2DETERMININGFUNCTIONAL GOALSAND OBJECTIVESWITH FAMILY

Ecological PlannerNurturing JournalsInteractive Grow Pack

tions provided in Part I can helporganize the information relativeto:

environmental supports and re-sources available to the family;caregiver-child interaction patterns;the child's current developmentalprofile;caregiver perceptions of strengthsand needs of the family;caregiver goals, expectations, andwishes.

Part II of the Ecologicai Planner iscalled the Developmental ObservationGuide. This Guide provides an in-depth, developmentally sequencedseries of behaviors that children fre-

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quently display from birth throughthirty-six months. It is designed toassist caregivers to predict and antici-pate the next steps in development sothey can prepare to best support theirchild's progress through daily routines,rituals, and play interactions. TheGuide is not intended to be used as achecklist, nor is it to be completed in itsentirety for each child. Parental priori-ties and previous medical/educationalrecommendations, along with interven-tionist observations and the informationgathered during visits with the family,help to identify the sections of theGuide to be completed at a given time.These sections contain the developmen-tal information related to the expressedconcerns and interests of the family.The developmental information identi-fied in a selected section will contributeto that part of the individualized cur-riculum plan designed to facilitate thechild's success in daily family and com-munity activities. It should be notedthat the developmental information isonly a small part of what the familymay determine as important goals fortheir intervention plan. This familyguided process helps insure that theservices provided match what the fam-ily has said they want from interven-tion.

The Developmental ObservationGuide is organized into eleven sections,each of which is briefly described here.

A. I've Arrived! Are You Ready?(Premature Infants andNewborns) This section providessupport for parent observations andinformation to help parents redog-

nize the sometimes subtle and am-biguous cues that premature infantsand newborns offer (Bromwich,1981). It is designed to help parentsrespond to all the things the baby isbeginning todo, and draws parents'attention to the infant's capacity forsensory and motor communication.

B. I'm Hungry (Oral Motor Develop-ment) This section addresses thedevelopment of feeding patterns,which can influence mutually satis-fying parent-child interactions andfuture language skills. As Barnard,Hammond, Booth, and colleagues(1989) state: "Interactions involvedin normal feeding propel an infantfrom a state of isolation and self-absorption to an active engagementwith other people and the world.High quality feeding interactionsduring the first years of life tend tobe positively linked to the child'ssubsequent cognitive and linguisticcompetence and to more secure at-tachments to major caregivers."

C. Using My Senses (Organization ofSensory Information) The sensorysystem's crucial contribution to laterdevelopment is highlighted in thissection. The behaviors included herepoint out the amazing variety oforganized responses an infant pos-sesses or learns in order to controlboth self and the outside world(Greenspan, 1990).

D. I'm Catching On (Object Perma-nence/Individuation/Self-Esteem)This section focuses on the childlearning to form expectations about

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the continuing existence of peopleand objects and to distinguish be-tween self and others (Piaget, 1952).These awarenesses build the child'sconfidence and self-esteem.

E. Understanding My World (Recep-tive LanguagelAttentionlCogni-tion) This section highlights theimportance of developing sharedmeaning between child and family.As the caregiver attributes meaningto the child's actions and vocaliza-tions and responds contingently, thechild learns ways to think about,explore, and communicate about theworld.

F. Finding My Voice (Communica-tion [gesture, vocallICognition)Realizing that it is impossible toseparate social, cognitive, and com-municative development, the impor-tance of interactive fit between thechild and the caregiving environ-ment is considered in this section.Developing relatedness, contingentresponsiveness, turntaking, two-waycommunication, establishing sharedmeaning, and communicative intentand motivation are the focus ofobservations relative to this section(Norris, 1991; Mahoney and Powell,1986).

G. Who's In Charge? (Cause andEffectlGaining Control) Thissection begins with self-protectiveacts like turning away and crying,and then moves to the essential non-verbal signals which establish theground rules between infants andparents. Greenspan (1990) has

demonstrated that young childrenlearn to adjust their behavior to theparents' non-verbal gestures andfacial expressions before their firstbirthday. This self-awareness israpidly transformed into the delight-ful understanding that the child canmake things happen, as the infantbegins to understand how actions onobjects or people can produce inter-esting and complex results (Piaget,1952).

H. I'm Getting Organized (Function!TimelClassification) Babies usetheir developing skills in perception,discrimination, and exploration toorganize what they know about theirworld. Even newborns have someability to recognize that objectsbelong to different categories, atleast that some are similar and somedissimilar (Mandler, 1983). Thisgives babies a "road map" or founda-tion for understanding and catego-rizing objects and people in theenvironment, anticipating changesin schedule or daily routines and,later, pairing language symbols withthe classifications made regardingobjects, their function, uniqueproperties,and similarities.

I. I'd Rather Do It Myself (FedinglDressinglDeveloping Indepen-dence) This section includes theactions and activities usually foundunder the heading of "Self-help" andincludes the child's motivation forindependence and mastery (Yarrow,1981).

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J. On The Move (Large Muscle De-velopment) Behaviors in this sec-tion focus on early motor progres-sions as prerequisites for more com-plex motor skills. Weight shifting,balance, coordination, and bodypositioning are emphasized, as wellas the sequencing of movements toaccomplish a goal, such as ball playor jumping.

K Using My Hands (Small MuscleDevelopment) The child's ability tocoordinate small muscle movementsfor critical exploration and masteryof the environment is addressedhere.

The two-part Ecological Plannersupports the family guided process. TheDevelopmental Observation Guide is tobe used over time to help parents betterunderstand and predict their child'snext steps in development and respondin ways that facilitate growth. Thesegoals, along with other family-identifiedgoals, may gain or lose a priority posi-tion due to continuously changing cir-cumstance in the family's life. In thisprocess the family, in collaboration withthe interventionist, determines when agoal is accomplished and when newthings need to happen. The forms andsuggestions included in Part I of theEcological Planner can be used tofacilitate this process.

Developmental Observation GuideA I VE ARRIVED.

Lk ARE YOU READY?

I'VE ARRIVED! ARE YOU READY?Premature Infants & Newborns (over 32 weeks gestation)

DavolopmantalRang As your child grows hersh will . Thongs to consodr

49 1 0ommnt

I'm Awake 1. Maintain body in flexed posi-tion, legs and arms bent.

2. Wake up slowly.

3. Have limited energy; weaksucking strength.

4. Usually have fisted hands.

5. Startle to sudden sound,touch.

6. Have arrhythmic (burst,pause) breathing patterns,especially when feeding orexcited.

7. Avoid bright lights.

8. Arch, sneeze, yawn, look awayto *void stimulation.

9. Cover eyes, face. spread fin-gers. or frown to show discom-fort.

In the wornb, baby was curled up. His bodyshe hires thos posrbon.

When piddng baby up. 11:11Ch him Ana ebovethe kneecaps. would the thigh or tummy tohelp lin prepare tor movement.

PrOillki "-dents hoe yen/ quickly. Use apuma., neppre on S. bort* and allow forlrequent but short awake periods.

Slip your Moir in the Nee Wawa child to !cidstile leedirp. or way nerssage born °anewpan wt.

Protect intent horn sudden sounds it posut4e.but you can abisper and sing to hirn.

Chld organlzing breathing lath otterPile may take several weeks of

mortis deposing upon the thild's rreturity.

tiaturai lot provides good background for asoft vac* and gent. touch.

These may Indicate %avow agnallon.Reduce sensory**my (loud% sounds vssomnximmnn.

That' ate 'overload' signals Pedro* scene ofthe sensory actrnty

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Nurturing JournalsThe Nurturing Journals are de-

signed for use by parents or primarycaregivers. Each book contains open-ended questions or statements to helpparents reflect on the process ofparenting. The parents choose whetherto use the Journals and whether toshare this information with the inter-ventionist. If the parents choose todiscuss the items in the Journals, theinterventionist may gain insight andincreased understanding of the morecomplex issues important to the family.

Interactive Grow PackThe Interactive Grow Pack repre-

sents the heart of interactive interven-tion. It offers strategies for interactivecommunication with parents, as well asways to enhance and encourage mutu-ally satisfying interactionsbetween caregiver and child.These materials help theinterventionist: attend to andnurture the emerging capa-bilities of child and parents;announce and applaud suc-cesses; assist in problemsolving relative to interac-tions; encourage family inde-pendence and autonomy; andrecognize the unique agendaof each child and family.

Nurturing Journal

Things to Consow

PAyee. Ivahear, enureamid Noe lo

_La!'

I I know I must take care of myeelf in order to have thehealth and energy to care for my baby. At leant once a dayI will take a 10mmute cat nap, walk. read good book, ordo sornethusg I enjoy.

I like to

2. I watch nd Itsten to my baby

Things I like to do oath my baby:

r.ROWING Nununno Journal

Interactive Grow Pack

PLAYTIME: BIRTH TO Ii MONTHS

Looking ct Listening:

Situation: While watching Mother and Anna play together younotice that whenever Anna shows interest in a toy. Mom pute adifferent toy in front of her and takes the other toy away. Annasoon lose. interest in play altogether and crawls off to the otherside of the room. "I Just can't seem to keep her ttention: she won'tplay with these educational toys that cost lot of money.- Momsays.

Existing Strengths: Mom gets down to eye level when she playswith Anna: child coos and looks at Mom otten.

Possible Interpretations:Mom mar be thmkuneeelIng

can never do enough to keep Anna happy She's just like her sister.and now rtly husband is upset hereon° I spent all this money on toss

or

I want to boo good mom, I hos the nght toys, and I want Ann in hesmart I wish she'd spend more ume with the toys i pick for her

nr

Why does Anna like the interventionist better than me'? She Iwavsplays longer with her

Helpful Ideas:

Giving Information. 'You've done great job of providing lots of interestingthings for Anna to play with. She wems to like to make her own choice aste which one rho wants This is very natural and shows that she hasopinions and ideas that an. uniquely hers.

&framing Naturally you are eager for Anna to play with educational toysthat you have picked, but she can learn from all aorta of things she choosesas welt When she chooses something on her own, thin motivates her towant to play and learn for longer penod of time We could work togetherto find ways to encourage her development with the toy. she chottant

Commenting Anna certainly seemed interested in the pop.up toy Sheplayed with it for quite a while.

ORC/WeK1 INTERACTIVE 011CAV PACK

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Interactions and Daily RoutinesBooks

The Interactions and Daily RoutinesBooks offer activity suggestions for eachskill or behavior listed in the Develop-mental Observation Guide. Activitysuggestions are embedded into dailyroutines, rituals, play, and interactions.Information is provided to explain whythe behavior is important, and a child'sperspective is given as to how to bestsupport the development of the behav-ior. Individual activities can be devel-oped for use with individual familiesusing the activity planning sheets foundin the Master Forms Packet.

Developmental ObservationGuide

t %O.( %Pi arsh t itI went, tour to lion, six Months

HERIAVIOR eAS: Step Up And Donn Height, such As Mow Step. WithoutPolling

AREA: Csing My Senses

This alerts the caregiver to the child's perception of height and how shemaneuvers her body in space

Commentary:

No sooner did Ikora ro walk than I began noticing a most fascinating partof our house, the grain As I tackle these to reach new heights of physicalagility, your lob gets more complicated Good luck in keeping me in oneplace now'

Interactive Aativities:

Adjusting Rhythm Rectum my legs are not es long as your. and I am rungetting used to the idea of using my feet to go up or down. please don't pullme up or down the stairs too fast! Slow your pace to match mine nd aft Itake each step. pause moment to let me catch my balance before we go onto the next one.

Daily Routine Activities:

Going Planrs Moat tnps to the hbrary. church. or the doctor may involvefew stairs. If I really balk when I see those step. coming. be patient withme: I may nnt yet know how far to gault my alana frorn one atm, toanother You can help by holding my hand. giving cues like big step nnwand rxaegerating your own step as you show sue how to step up

Bedtime The washing up nd brushing teeth routine before bed MaV nowInvolve small stool to help me reach the sink Help me to step up anddown seversi wiles before you let me do it for myself

nathtime Even though I may have been using the bathtub for some timenow. I may still need help climbing over and stepping out Help me figureout rust how far it la to the ground by holding my hand and telling me whento step down.

Partime A small slide or step.up box during outside or indoor playactivities would be a great way to help me practice stepping up and down.You may need to hold iny hand and help me with my foot placement until Iget the hang of it.

Organizationof Senory

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Master Forms PacketThis packet of reproducible forms

assists the interventionist in carryingout intervention which is family guided.Forms included are designed to docu-ment communications and observations,develop a family generatedservice plan, and developintervention suggestionsresponsive to each indi-vidual family being served.

Master Forms

GROWING Non Ne hops

INTERACTIVE AC

CNN t Nemo

GoaliStrategies.

Why is thts important'

Activity suggestions

GROWING INn to Now Pc..DAILY ROUTIN

Goan Nome

GoabStrateme.

Why is this important?

Actardy suggestIons:

,

GROWING: Ont to Now. Pales* rm.. Clans

OBSERVING INTERACTIONS Casan we owner a For& onl rAnne env arnownonwoom Form 1

Look For. Listen To. and Encourage:

reepouding quickly to child. communication cues

malcing cooing or soothing bounds to child

mutual smiling and leaking

understanding and acting on child's signals to'toper Mart activity

watching and listening to baby

holding child close to own body

pausto4 or waiting for child responee

gaung at child

adjusting activity level to child'n actenty level

telling child what is going to happen beforeIt happens

asking simple questions

getting down to child, eye level when talkingor playing

doing things at the cluld's pace

Ullungormaglovothild

touching, rocking, holding

pausing to pre child a turn

imitating child's actions or play sound.

Aims chasm

encouraging arploration

wailing for child to toU something completely

playing 'nth child

encouraging and pruning child*, uidependence

creating calm, relaxed atmosphere

having simple rules and routines

Others You Observe

GROWING. MASTER RAMS

Changes noted

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GRONVO MASTER rORNs

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INTERACTIVE V"STRATEGIES "drq

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paolootry ertlaWN downbing ctobts paypool. NMI Epnywoon orlon,* rowllyWm., Old* load admen myevo Ieednp chiefs OMR

GROWNG WRIER MOMS

Intervention is a complex process andno set of materials can be expected tostand alone in meeting the diverseneeds of families. Therefore, it is rec-ommended that the ideas in Growing:Birth to Three be implemented in col-

laboration with community referralresources and intervention servicesystems, and that these materials besupplemented with the rich resourcesoutlined in the bibliography includedwith Growing: Birth to Three.

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BIBLIOGRAPHY

Ainsworth, M.D.S. (1979). Attachment as related to mother-infant interaction. In J.S.Rosenblatt, R.A. Hinde, C. Beer, and M.C. Busnel (Eds.), Advances in the Study ofBehavior, Vol. 9. NY: Academic Press.

Bailey, D.B. (1987). Differences in values and priorities for services. Topics in EarlyChildhood Special Education, 7, pp 59-71.

Bailey, D., Winton, P., Rouse, L., Tumbull, A. (1990). Family pals in infant intervention:analysis and issues. Journal of Early Intervention, Vol. 14, No. 1, pp 15-26.

Baird, S., Haas, L., McCormick, K., Corrith, C., Turner, K. (1992). Approaching anobjective system for observation and measurement: Infant -parent social interaction code.Topics In Early Childhood Special Education. 12(4), pp 544-571.

Barnard, K.E.; Booth, C.L., Mitchell, S.K., & Telzrow, R. (1988). Newborn nursing models:A test of early intervention to high risk infants and families. In E. Hibbs (Ed.), Childrenand Families: Studies In Prevention and Intervention, pp 63-81. Madison, CT:International Universities Press.

Barnard, K., Hammond, M.A., Booth, C.L., et. al. (1989). Measurement and meaning ofparent-child interaction. In F. Morrison, C. Lord, & D. Keting, (Eds.), AppliedDevelopmental Psychology, Vol. 3. New York: Academic Press.

Beckwith, L. (1976). Caregiver-infant interaction and the development of the high riskinfant. In T.D. Tjossem (Ed.), Intervention Strategies for High Risk Infants and YoungChildren, pp 119-140. Baltimore: University Park Press.

Bell, S.M., & Ainsworth, M.D.S. (1972). Infant crying and maternal responsiveness. ChildDevelopment, 43, pp 1171-1190.

Bowlby, J. ((1969). Attachment and Loss, Vol. 1 - Attachment. New York: Basic Books.

Broffenbrenner, U. (1979). The Ecology of Human Development: Experiments by Nature andDesign. Cambridge: Harvard Press.

Bromwich, R. (1981). Working with Parents and Infants: An Interactional Approach.Baltimore, MD: University Park Press.

Bruner, J. (1973). Organization of early skilled action. Child Development, 44, pp 1-11.

Carter, E., & McGoldrick, M. (1980). The Family Life Cycle: A Framework for FamilyTheory. New York: Gardner Press.

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