DOCUMENT RESUME

ED 243 258 EC 162 162

AUTHOR Zabel, Mary KayTITLE Identification and Programming for Behaviorally

Impaired Preschoo] Children: Current Procedures andPrograms.

INSTITUTION Nebraska Univ., Lincoln. Dept. of SpecialEducation.

SPONS AGENCY Nebraska State Dept. of Education, Lincoln. SpecialEducation Section.

PUB .-\TE May 82NOTE 27p.; In: Peterson, R., Ed. and Rosell, J., Ed.

Current Topics in the Education of BehaviorallyImpaired Children. Lincoln, NE, Barkley MemorialCenter, University of Nebraska-Lincoln, 1982. Chapter5. For related documents, see EC 162 159-168.

AVAILABLE r,ZOM Support System Project for Behaviorally Impaired,Barkley Memorial Center, University ofNebraska-Lincoln, NE 68583 ($2.25, quantity discountsavailable).

PUB TYPE Information Analyses (070)

EDRS PRICEDESCRIPTORS

MF01/PCO2 Plus Postage.*Behavior Disorders; Evaluation Methods; *HandicapIdentification; Infants; *Intervention; PreschoolEducation; Program Descriptions; Student Evaluation;Young Children

ABSTRACTThis document reviews problems in the identification

and assessment of behavioral impairment in young students. Severalmodels of emotional disturbance are reviewed and characteristics ofbehavior problems are outlined. Assessment methods discussed includeobservation of student behavior patterns and more formal instruments(such as the "Neonatal Behavioral Assessment Scale," the "Mother's'Assessment of the Behavior of Her Infant," "Parent BehaviorProgression" and the "Preschool Behavior Questionnaire").Intervention issues are addressed in terms of prevention as well ashome and center-based approaches including developmental therapy andthe Portage Project Model. Reactions to the paper by teachers,administrators, and faculty members conclude the monograph. (CL)

**************************************A********************************Reproductions supplied by EDRS are the best that can be made

from the original document.***********************************************************************

OZ)

tre(NiCr\4" 11111r

CNJ1=1LLJ L toIPPLY.1% or! tot ,Setikei

U.S. DEPARTMENT OF EDUCATIONNATIONAL INSTITUTE OF EDUCATION

EDUCATIONAL RESOURCES INFORMATIONCENTER 1ERICS

This ti.r, brrn trprOdlArrd as,,r1 r nn tru. :wry. Sir org.initation

A.Itrlor LILI ..... r71,1dIr lalprovert.irrodLAt

ROadi. in )his dorumer. do not Itprt.S.11 official NIEPOSOion or policy

Identification and Programming for

Behaviorally Impaired Preschool Children:

Current Procedures and Programs

"PERMISSION TO REP' s UCE THIS

MATERIAL HAS BEEN GRANTED BY

Department of Special Education, IlarTO THE EDUCATIONAL RESOURCESINFORMATION CENTER (ERIC)."

Lincoln, NE 68583

2s.

From: R. Peterson and J. Rosell (Eds.) Current Topics in the

Education of Behaviorally impaired, Lincoln, Nebraska

Barkley Memorial Center, University of Nebraska-Lincoln, 1982.

Identification and Programming for

Behaviorally Impaired Preschool Children:

Current Procedures and Programs

Mary Kay Zabel, Ph.D.

Kansas State University

A publication of the Support System Project for Behaviorally Impaired

Barkley Memorial Center, University of Nebraska-Lincoln,

Lincoln, Nebraska 68583

Partial Pub

Copies of the items listed below may be I from: The Support

System Project for Behaviorally Impaired, of Special Education,Barkley Memorial Center, University of Nebla HLincoln, Lincoln,

Nebraska 68583-0775, (402) 472-3955.

Single complimentary copies of each item al' available in limitedsupply. Thereafter copies will he availah for cost of reproduction

and handling (inquire about current costs', 1 10% discount is

available on multiple copies in excess of , shipped to the same

address. Write for a complete listing of publications and audiovisualmaterials.

Peterson, R. L. and Rosell, J. (Eds.) Current Topics in the Education

of Behaviorallylmpaired Children. Lincoln, Nebraska: BarkleyMemorial Center, University of Nebraska-Lincoln, 1982. This bookis also available by individual chapters as follows:

Peterson, R. L. Identification of Behaviorally ImpairedStudents. Chapter 1, 1982.

Smith, C. R., and McGinnis, E. Professional and EthicalIssues Related to Teaching Behaviorally ImpairedStudents. Chapter 2, 1982.

Rc'hertshaw, C. S. The Legal Considerations Concerning theAssaultive Behavior of Behaviorally impaired Students.Chapter 3, 1982.

Wood. F. Developing Guidelines for the Use of Non-traditional Educational Interventions. Chapter 4, 1982.

Zabel, M. K., Identification & Programming for BehaviorallyImpaired Preschool Children: Current Procedures & Proarams.Chapter 5, 1982.

Vasa, S. Resource Consultant Model for Delivery of Service toBehaviorally Impaired Students in Rural Areas. Chapter6, 1982.

Zabel, R. H., and Peterson, R. L., Providing Education forPehaviorally Impaired Student's in Rural Areas.Cnapter 7, 1952.

Rosell, J. Residential Treatment of Behavior Disordered ChildrenChapter 8, 1982.

E3Alow, B., Raison, S., Ralson, J., Policy Options for ServingAutistic-like Children. Chapter 9, 1982.

R. H., Etiology, Characteristics, and Interventionswith Autistic Children: Implications for Delivery of

Services. Chapter 10, 1982.

Writing of this material wassupported by project #81-203-02 ofthe Special Education Branch ofthe Nebraska Department of Edu-cation. Views expressed hereinare views of individual con-tlibutors end do not necessarilyrepresent the position or policyof the Nebraska Department ofEducation.

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

May, 1982Lincoln, Nebraska*****************

Copies may be ordered from theSupport System Project for Be-haviorally Impaired, Departmentof Special Education, BarkleyMemorial Center, University ofNebraska-Lincoln, Lincoln, NE68583-0775. Phone: (402)472-3955. Single complimentarycopies are available in limitedsupply. Thereafter copies avail-able at $2.25 each postpaid; 10%discount on multiple copies inexcess of five shipped to the sameaddress.

Table of Contents

Identification and Programming for Behaviorally ImpairedPreschool Children: Current Procedures and Programs

Mary Kay Zabel, Ph.D.

Assessment 3

Interventions 7

Conclusions 10

References 10

A Series of Reactions:

Marge Beatty, Director of Special Education,ESU #16, Ogallala, Nebraska 12

Phyllis Burger, Special Education Director,ESU #8, Neligh, Nebraska 13

Mary Dickerson, Supervisor of Special Education,Millard Public Schools, Omaha, Nebraska 13

Dr. Linda Douglas, Preschool Program Coordinator,Lincoln Public Schools, Lincoln, Nebraska

Jane Drew, Assistant Director,Educational Therapy Department, Richard YoungMemorial Hospital, Omaha, Nebraska 16

Patricia Gass, Preschool Coordinator,ESU #16, Ogallala, Nebraska 18

tinny Locke, Preschool Coordinator,ESU #9, Hastings, Nebraska 18

Dr. Stephen Pew, Director of the Community Officeof Mental Health, Omaha, Nebraska 19

Barbara and Iry Ross, Program Managers,ESU #9, Hastings, Nebraska 20

Marcia Wythers, Instructor in Speech Pathology and Audioloay,University of Nebraska-Lincoln, Lincoln, Nebraska 20

6

I 7.ntification x Programming for Behaviorally Impaired Preschool Children:Current Procedures & Programs

Mary K. Zabel

Behaviorally impaired (emo-tionally disturbed) childrenrepresent one of the mostunderserved categories of excep-tionality. The National NeedsAnalysis Project (Grosenick,1980) reported 6,736 preschoolemotionally disturbed children(ages 3-5) currently beingserved; 4,300 'underserved' and6,200 'unserved.' There are, ofcourse, many children who do noteven make it into the count of'unserved.' Wood, et al (1981)have estimated that between13,000 and 78,000 children inthis category are not receivingservices.

While general special edu-cation services for preschoolhandicapped children have notkept pace with services forschool age children, the recordis somewhat better in the areasof mental retardation, physicaland sensory handicaps. The lackof services for behaviorallyimpaired children may be due tomany factors, with the difficultyin identification being a primaryone. Defining and identifyingbehavioral impairment is dif-ficult at any age, as tne defi-nitions utilized by the clinicianhave much to do with the out-come. The way an individualdefines disturbance will cer-tainly affect the way he per-ceives it - and definition leadsdirectly to different types ofintervention. Rhodes and Tracy(1972) have distilled the manyviews of emotional disturbanceinto several models, each with

its own emphasis. These modelsinclude:

Biophysical Emotional dis-turbance is seen as an inborndefect, one which may be organ-ically caused. Interaction withthe environment is acknowledged,but primarily emphasis is givento the biological causation.

Behavioral Disorderedbehavior is believed to have beenlearned as most behavior islearned. The individual, due tofaulty socialization, inappro-priate reinforcement or incon-sistent control, has learned tobehave in a deviant way.

Psychoanalytic - Follows theFreudian tradition. Deviantbehavior may be due to the stressof normal development. Theindividual may have fixated at aparticular stage or regressed toa previous one. E7ikson'sadditions to and modifications ofFreud's theories are ofparticular importance to thosedealing with young children.

Sociological Deviance isviewed as a group phenomenon.Theorists investigate the role ofdeviance or disordered behaviorin society.

Ecological Disorderedbehavior is seen as a product ofinteraction. It is not simply anindividual flaw, but the resultof a certain interaction betweenthe individual and hisenvironment.

Each of these models hasrelevance in attempting to define

emotio,hal disturbance and each

has something specific to say to

those working with disturbed

young children. The biophysical

model has helped identify

children whose disturbed behavior

may be the result of a physical

cause, such as ingesting lead (a

arobable cause of hyperactive

behavior) and certain nutritionaldeficiencies (with symptoms of

diaorientation and halluci-

aation). The behavioral model

hsc provided the intervention

bas ia for numerous programs thatuse a behavior modification

approach. Erik Erikson's

theories have been most helpful

in defining disturbance in young

children through the psycho-

analytic model. His deliniation

of the psychosocial stages of

development, and the important

issues being addressed in each of

them, has given teachers of young

disturbed children both insight

:300 ideas for intervention. The

sociological and ecological

models have supported the field

of family therapy, where the

family interactions are viewed as

the problem. This view has

allowed therapy for very young

children who might not have

received help n'herwise.While each of the models of

emotional disturbance has con-

tributed to a greater under-

standing of this disorder, there

is that includes all of them, and

this lack of a single definition

has slowed down the development

of programs in the area.Another factor for the delay

in establishing programs for

behavior disordered young chil-

dren may be tne unwillingness of

professionals to label children

M. K. Zabel

in this age group. Parents of

handicapped children in several

categories are often told to

"wait and see - he may outgrow

it." While this is merely wish-ful thinking or avoidance in many

cases, when dealing with the

social behavior of young chil-

dren, it may in fact be true.

Social development does not

follow a strict timetable, and

most professionals are justi-

fiably cautious in labeling

children as "behavior problems"

or "emotionally disturbed" unless

the behavior is quite extreme.

Social development is greatly

infle_nced by many factors,

including the child's culture,

his environment, intelligence andphysical state. All of these

aspects of personality must be

considered when identifying a

child as behaviorally impaired.Lack of good assessment in-

struments is also a factor in thepaucity of services for this pop-

ulation. While physical and sen-

sory impairments may be tested

somewhat objectively, and cog-

nitive delay may be assessed in a

variety of ways; assessment of

behavioral impairment is

limited. When dealing with the

very young, observation and

parent report are about the onlymethods available. This has led

many programs to devise their own

instruments, which, while useful

for their purposes, may not

generalize well to other programs.A final factor involved in

the lack of services to the pre-school emotionally disturbed

child may be the difficulty in

referral. Preschool education

is, of course, not mandatory as

is school age education. Con-

ZabT'1

,equhntly, referrals of disturbedchildren must come, in the

mrity of cases, from theprivate sector. Staff in privatepreschool programs, alert

physicians and parents are the

primary sources for identifying

disturbed preschool children,

while for children in elementaryschool, teachers are the primaryreferring source. Consequently,

there may be a large number ofd iHren in need of service butwho have no access to an agency

it individual who is aware of

that need.

AssessmentA major problem for pro-

fessionals working with emo-

tionally disturbed children of

all ages is assessment. We haveno good paper and pencil tests,no physiological exam, nodevelopmental checklist that willgive us an absolute yes or no

answer on a child's behavioral

diagnosis. Therefore, assessing

emotionally disturbed youngchildren calls for a good deal ofknowledge and creativity on the

part of the diagnostician.There are many types of

assessment, of course, but they

may be grouped into the

categories of 'informal' and

'formal.' Informal assessment

must be based on sound knowledgeof normal social development.

Tho person most likely to

correctly assess abnormal or

deviant functioning is the

individual with a broad knowledgeof normal behavior at the age

level in question. To suc-

cessfully identify deviant

behavior in a 3-year old, one

must have a basic knowledge of

I

the range of behavior commonly

seen in normally well-adjusted3-year olds. Only then will theobserver be able to determine

whether the "severe aggressive

acting- -out" is in fact a symptomof underlying disturbance or

simply evidence of a highly

active, slightly immature child.The Rutland Center DevelopmentalTherapy Project (Wood, 1972) hasprepared the following list of 10behaviors to be used by teachersof young children to identifythose who may have emotional pro-blems. The teacher is asked:

Have you noticed a child whoseems to have a harder time in

school than others? Have you

noticed children who seem to needsomething special to help them

along? Is a child's behaviormaking things so hard for thechild and others that he/she isnot progressing? Sometimes achild's problem may be one youcan see easily. But for other

children a problem may behidden. If a child in your classhas any one of these character-istics listed below, you may needto provide "something special."

SHORT ATTENTION SPAN; UNABLETO CONCENTRATE:

- not able to pay attentionlong enough to finish an activity.

RESTLESS OR HYPERACTIVE:moves around constantly,

fidgets; does not seem to movewith a purpose in mind; picks onother children.

DOES NOT COMPLETE TASKS;

ELE":,S, UNORGANIZED APPROACH TO

ACTIvIIIES:does not finish what is

,,tarted; does not seem to know

Pow to plan to get wcrk done.

LISTENING DIFFICULTIES: DOES

NCT SEEM TO UNDERSTAND:has trouble following

directions; turns away whileothers are talking; does not seem`n be interested.

AVOIDS PARTICIPATION WITHnHFR CHILDREN OR ONLY KNOWS HOWTi PLAY BY HURTING OTHERS:

stays away from otherchildren; always plays alone;leaves a group of children whenan activity is going on; bites,hits, or bullies.

AVOIDS ADULTS:stays away from adults;

Lines not like to come to adultsfor attention.

REPETITIVE BEHAVIOR:does some unusual movement

or repeats words over and over;cannot stop activity himself.

RITUALISTIC OR UNUSUALBEHAVIOR:

- has a fixed way of doingcertain activities in ways notusually seen in other children.

RESISTANT TO DISCIPLINE ORDIRECTION (Impertinent, defiant,

resentful, destructive, ornegative): - does not acceptdirections or training;disagreeable; hard tomanage; destroys materials ortoys deliberately; tempertantrums.

H. K.

UNUSUAL LANGUAGE CONTENT(bizarre, strange, fearful,jargon, fantasy):

very odd or different talkwith others or in stories.

SPEECH PROBLEMS:- rate (speech that is

unusually fast or slow)articulation (difficulty making

clear speech sounds) - stuttering(difficulty with flow of speech;repeating sounds, words, orphrases; blocking words or sounds)- voice (unusually loud, soft,high, or low; scratchy) - nospeech (chooses not to talk ordoes not know how to talk so thatothers can understand).

PHYSICAL COMPLAINTS:talks of being sick or

hurt; seems tired or withoutenergy.

ECHOES OTHERS SPEECH:- repeats another person's

words without intending for thewords to mean anything.

LACK OF SELF-HELP SKILLS:unable to feed self; unable

to dress self; unable to conducttoilet activities unaided or tocarry out health practices suchas washing hands, brushing teeth,etc.

SELF-AGGRESSIVE ORSELF-DEROGATORY:

- does things to hurt self;says negative things about self.

TEMPERMENTAL, OVERLYSENSITIVE, SAD, IRRITABLE:

moody, easily depressed,unhappy, shows extreme emotions

infh,rmH1 observation of

hildrh. coupled with guidelines1.:ch as these and a sound

'rnowledge of normal developmentalrange becomes a most effective

Leo]. in identifying children in

Heed of service.Formal assessment instruments

are also helpful in attempting toliagnose disturbance in young

tlildren. Of course, no pro-

fessional would attempt to diag-nose or label a child on the

basis of formal assessment

alone. But used carefully, theseinstruments can provide infor-

mation which will add to know-

ledge about a particular child.

Some of the instruments discussedhere are in the formative stagesof development and are included

because of their great rele-

vance. Information on sta-

tistical design, reliability,

validity and standardization

procedures may be obtained from

the individual authors.T. Berry Brazelton has

observed that the infant's

behavior when combined withmaternal expectation can be usedto predict the outcome of theirearly interaction (Brazelton,1973) and to assist in this task,he has developed the Neonatal

Behavioral Assessment Scale

(NBAS). It is a psychologicalscale for the newborn infant andprovides some very early

information on the infant's

developing social responses. Itis designed for assessing normalinfants and begins with four

habituation items which measurerate of decline in responding topresentations of a light, bell,

rattle, and pin prick. The rate

of shut down in respondingreflects the efficiency of infor-mation processing and the organ-ization of protective mechanismsthat the infant may use. The

Scale also includes assessment ofneonatal reflexes, motor tone

evaluation, observation of

response to uncovering, un-

dressing, and responses to aver-sive stimuli (Doyle, 1979). The

NBAS has been used to identify

neurological abnormalities but

the information it provides on

the newborn's social interactionpatterns is equally important.

Disturbance in the very young

infant is really disturbance in

the interaction that infant lels

with his caregivers. The extremeimportance of a positive attach-ment and the devastating con-sequences of non-attachment havebeen well documented (Bowiby,

1969; 1973), and professionalsare beginning to acknowledge thatthis area is too important to beleft to chance, particularly inhigh risk cases. The NBAS pro-vides information on the infant's

reaction patterns that can becommunicated to the caregivers sothat their expectations can be

more realistically aligned with

the infant's actual behavior.The Mother's Assessment of

the Behavior of her Infant (MABI)is an adaptation of the NBAS

(Doyle, 1979). It emphasizes

interactive rather than reflex

items and may be given by the

mother to her own infant. Withthe information provided by theNBAS and the MABI, parents can

learn the most effective ways tointeract with their child.

The Infant Temperament

Questionnaire is useful for the

niid a,-_;ec 14 Ito 8 months (Carey &i)evitt, 1977). The aiestion-

naire is a multiple-choice ver-,;ion of the procedure employed inrho Thomas, Chess and Birch(1.68) longitudinal study. It

includes 70 items and requires

about 28 minutes to administerJF,d 10 minutes to score. Items

concerning sleeping, feeding,soiling and wetting, diaperingend dressing, bathing, visits to

the doctor, responses to illness:ino people, reactions to new

places and situations and play

cehaviors are included. The

terns can then be grouped into

rsoegories such as activitylevel, rhythmicity, adaptabilityco change, approach, threshold ofstimulation, intensity and per-

sistence (Doyle, 1979). Although

the questionnaire was designedfor four to eight year olds,

:71antations are available up toone year of age.

Formal assessment instrumentsrnich focus on the parent half oftne parent-infant dyad includethe Parent Behavior Progression(POP) (Bromwich,et al, 1978) andthe Home Observation for Measure-msnt of the Environment (HOME)

(Caldwell, 1978). The PBP con-sists of levels made up of statements describing behaviors whichreflect attitudes and feelings ofparents, as well as patterns ofparenting. It is designed to beused as a part of an ongoing

parentis,taff relationship rather

than an initial diagnostic tool.The HOME was designed to assemblea set of items to assess thosequalities of person-person and

person-ohject interactions which

comprlse the infant's learningenvironment. It samples certain

Y. K. Zabel

aspects of the quantity andquality of social, emotional, andcognitive support available to ayoung child (birth to six years)within his home. the assessmentis conducted by a person who ob-serves the child in his home, andinformation is gained both fromthe observation and from inter-

view data. (For an overview ofother types of observationaltechniques for mother-infantinteraction, see Ramey, 1979.)

There have been many assess-ment instruments and checklistsdeveloped by individual programsand these usually attempt tosample a wide range of behavior,including cognitive, motor,self-help, language and socialdevelopment. The social beha.viorsection of many of these instru-ments may be helpful to the pro-fessional looking for a develop-mental sequence of social be-haviors. Two of the most widelyused are the check list devisedby the Portage Project (Bluma, etal, 1976) and the DTORF (Develop-mental Therapy Objectives RatingForm, Wood, 1979). The DTORF wasdesigned for use with severelyemotionally disturbed childrenand provides sequentially orderedsteps in development.

Another formal instrument forassess!.ng young emotionally dis-turbed children is the PreschoolBehavior Questionnaire (PBO).The PBO is a 32 item question-naire listing behaviors. Therater checks one of threechoices, "does not apply",

"sometimes applies", or "fre-quently applies" for each be-havior listed. The items canthen he grouped into threefactors: hostile-aggressive,

hype

a formal observ-

remains one of theto assess chil-

nehaviar disorders.u,--il,,.ation can provide

datd on toe child's per-in a uarticular setting

partLular time. By con-formal dbservations OverJf time, a useful sample

tr4: child's behavior may he

ined that can be used in the.,Lot educational pro-

monitorind changesiw nf the W.-J.St

are dowood,

which iecarus bothaac negative behavior of

tive nature; and the

E;- x00'001 Observation Form-;75) which compares Ine

the target child 7fl:'zIrltly selected peer.only by utilizing the

r:.:ms DV assessment and

no available that know-

-cisions can be made

the most appropriate

ntograms for young

.:isturbed children.

1cipation of assessment andurec, opsErvation is pro-

tuFhance Lme:. be pre-

H:omotino and pro-

motL :;font bondin the attachment

De fle roe molt.

7

at this early stage. There areseveral ways professionals canassist in the development of thisinteraction which will be of

lifelong importance to the .ndi-viduals involved. First, hos-

pitals can begin assistingmothers of premature and high

risk infants (groups which maynave difficulty in the bonding

process) by their procedures inthe newborn nursery. Most hos-pitals now encourage parents of

premature and high risk infants

to he as actively involved as

possible in their children'scare. Parents whose infants areconfind to an incubator areallowed and encouraged to visit,to touch, to feed (if possible),

and denerally to be as involvedwith their infants as is medic-

ally possible. Parents whose

infants have been labeled "high

risk" due to illness or handicap,or who have had a previous nega-tive experience with a child areinstructed in the special needs

of their infants, emotional as

well as physical. They are, in

many areas, alerted to the dif-ferent sorts of behavior they

might expect from their childrenin an attempt to better match

expectations and reality.

Secondly,necially pediatroiaos can beaware of this vital process andcan observe parent/infant inter-action as the child is brought infor checkups in the early

months. They may cultivate heattitude of one pediatrican whosaid he liked mothers who "get in

the way" - who are so cmcernedwith attending to their child'sneeds that they do so even duringa 3m. I- "7 W":7

sits silently by, looking bored

and uninterested, is the one forwhom the physician should be con-cerned.

A third "prevention inter-

vention" can be instituted by a

variety of professional child

care workers psychologists,

social workers, medical per-

sonnel, special educators. This

procedure involves acquainting

parents of infants, (and those

about to become parents) with thecurrent knowledge concerning com-petence in newborns. Many people

still view the newborn infant asa mass of protoplasm, unable to

.e, hear, selectively respond or

initiate. If parents are aware

the many interactive "skills"the newborn infant, and of the

tremendous importance of the

interactive bond, they may be

more willing and able to

participate in such social

development. Brazelton (1980)

reports a study in which a groupof high ris: mothers (under 18,

many under 16; low socioeconomic

status; single parents) were

given such information. The

young mothers were divided intothree groups after the birth oftheir children; group one

received the typical pediatric

interview "Do you have any

questions"? (most did not); grouptwo heard a pediatrician discussthe competence of newborn in-

fants; and group three had a

oediatrician demonstrate, with

their own infants, the reflexes

and responses assessed by the

NE3AS, The next day nursing staff

(who were unaware of the group

assignments) rated the mothers in

group three as more actively

il-;volvec, more caring and "better

M. K. Zabel

mothers." Follow-up over the

child's first year indicatedfewer health problems, more wellbaby check ups and more positivestatements about the child for

mothers in group three. This

intervention took approximately

15 minutes, yet had effects

lasting at the very least, a full

year.Young children. Once the

child completes infancy, programsare likely to become more formal,and in most instances, center orschool-based. Programs for emo-tionally disturbed young childrenmay follow any of the theoretical

models previously discussed, or

be a combination of several. Forexample, the preschool program atthe Menninger Clinic, Topeka,

Karsas is based on the psycho -

an model, while the Chil-

dren's Center, Salt Lake City,

Utah is based on an eclectic

approach, combining Redl's Life

Space Interview with Bandura's

social learning theory and

Erikson's developmental approach

(Plenk, 1978). Two programs thatexemplify many current practicesin the field are the Rutland Cen-ter Developmental Therapy and thePortage Project.

Developmental Therapy is a

therapeutic curriculum for socialand emotional growth. It is apsychoeducational approach to thetreatment of severely emotionallydisturbed children from birth to15 years of age, and is used in aclassroom setting with five to

eight individuals in a class.

This intervention process is

based on the assumption that

young disturbed children go

through the same stages of

development that normal young-

M. K. Zabel

,ters do but at a different

pace. The program reflects a

blend of psychoanalytic and be-havioral theories and guidestreatment and measures progress

by focusing on the normal

developmental milestones whichall children must master.

Developmental Therapy utilizes agrowth model rather than a defi-cit model. The Center is one ofa group of 24 in the state ofGeorgia, designed as alternativesto residential placement. The

approach involves intensive, sti-mulating, pleasurable group ex-perience using all sensory chan-nels to communicate that the

world can be a pleasure and thatadults help bring pleasure andsuccess. The curriculum is basedon five developmental stages infour curriculum areas: behavior,communication, socialization andacademic skills with teaching

objectives specified for eachdevelopmental stage in each cur-riculum area. This curriculum isfully detailed in DevelopmentalTherapy (Wood, 1975).

The Portage Project was ori-ginally funded in 1969 and oper-ates administratively through a

regional educational agency

serving twenty-three schooldistricts in south central ruralWisconsin. It serves childrenbetween the ages of birth and sixyears in a home based model. Anypreschool child, with any type ofdegree of handicapping conditionresiding within the 3,600 squaremile area served by the agency,qualifies for the project. Thehome based model involves theparents of the handicapped

children as teachers of theirchildren. Project teachers

visit the home each week toassess progress on previousgoals, introduce new behaviorsand demonstrate theirinstruction, and observe theparent teaching the new behavior(Shearer & Shearer, 1972). Theproject's materials addressseveral areas, including infant

stimulation, motor, self-help,cognitive, language, and social-ization. The home based modelhas the benefits of instructingthe parents along with the child,allowing parents to intervenewhenever the behavior occurs (notjust in the two or three hours acenter based program lasts), andteaching new forms of inter-action. The materials can, how-ever, be adapted to a classroomsetting, and their format (a

sequential series of cards withspecific goals, activities forreaching the goal, and criteriafor evaluating progress) makesthem a useful addition to anypreschool program (for furtherinformation, contact the PortageProject, Box 564, Portage,

Wisconsin, 53901).Another curriculum guide

which may be particularly usefulin a center based program foryoung emotionally disturbed chil-dren is that created by the Cir-cle Preschool, Piedmont, Cali-fornia (Myers, 1976). This pro-gram, also for children with alltypes of handicapping conditions,includes the areas of art mate-rials, self image, language arts,dramatic arts, music, movement,mathematics, science and cook-ing. Projects or lessons in eachof these areas are geared toseveral developmental levels andcomplete planning and evaluation

10

instructions are given.There are also several

commercially available materialsthat are useful for behaviorallyimpaired preschool children, suchas the Peabody Early ExperiencesKit (Dunn et al, 1976) which in-cludes pictures, songs, puppets,

sensory awareness activities andcognitive activities; and My

Friends And Me (Davis, 1977)which also includes puppets, mu-sic. discussion activities and

stories to help young childrenheqin to understand and deal withtheir feelings.

ConclusionsPrograms for emotionally dis-

turbed young children are still

not available in many areas dueto problems with identification,assessment and referral. How-

ever, assessment instruments arebeing developed and by combiningthose with the developmental

checklists and structured obser-vation forms currently available,valuable diagnostic data may beobtained. Programming for chil-dren in this category takes placeon many levels. Infant progamsmay deal with the parent/infant

interaction, or be home based

instructional models. For youngchildren, center based classes

are founded on a variety of

models and theories and utilize avariety of approaches. Suchprograms are neither numerous norwidespread, however, it is to behoped that the mounting evidenceconcerning children with social-ization delay or serious distur-bance will foster the growth ofprograms, just as the evidence onearly intervention in cognitivedelay led to programs for young

M. K. Zabel

mentally retarded children. Thesocial interaction patterns of achild emerge early, and if theseare negative patterns, the childmust be helped without delay torestructure them into usefulskills that will enable him tofully participate in theexperiences that await him.

References

Behar, L. & Stringfield, S. Abehavior rating scale for thepreschool child.Developmental Psychology,1974, 10, 601-610.

Bluma, S., Shearer, M., Frohman,A., & Hilliard, J. Portageguide to early educationchecklist. Portage Project,CESA 12, Box 564, Portage,Wisconsin 53901.

Bowlby, J. Attachment and Loss,Volume I: Attachment. 1969,New York; Basic Books.

Bowlby, J. Attachment and Loss,Volume II: Separation. 1973,New York; Basic Books.

Brazelton, T. NeonatalBehavioral Assessment Scale.1973, Philadelphia; Lippincott.

Brazelton, T. unpublishedpresentation, Conference onInfant Psychiatry, MenningerClinic, Topeka, Kansas;October, 1980.

16

M. K. Zabel 11

Bromwich, R. M., Khokha, E.,Fust, L. S., Baxter, E., &Burge, D. Manual for theparent behavior progression.Unpublished manuscript, 1976,(revised 1978). Availablefrom Rose Bromwich, CaliforniaState University, 18111Nordhoff St., Northridge, CA91330.

Caldwell, B. M. Instructionmanual inventory for infants(Home observation formeasurement of theenvironment. Unpublishedmanuscript, 1978. Available

from Betty Caldwell,University of Arkansas, LittleRock, AR.

Carey, W. 8. & McDevitt, S C.Infant temperamentquestionnaire. Unpublishedmanuscript, 1977. Availablefrom W. B. Carey, 319 WestFront Street, Media, PA 19063.

Davis, D. E. My friends and me.Circle Pines, MN: AmericanGuidance Service, 1977.

Doyle, P. Social development andassessment, in Darby, B. L. &May, M. J. (Eds.), InfantAssessment: issues andapplications. 1979, WesternStates Technical AssistanceResource.

Dunn, L. M., Chun, L. T.,Crowell, D. C., Halevi, L. G.,& Yackel, E. R. Peabody EarlyExperiences Kit. CirclePines, MN: American GuidanceService, 1976.

Grosenick, J. Report on theNational Needs AnalysisProject. Paper presented atthe CEC Topical Conference onthe Seriously EmotionallyDisturbed, Minneapolis, MN,August, 1980.

Myers, C. (Ed.) The live oakcurriculum, 1976. Availablefrom Circle Preschool, 9 LakeAvenue, Piedmont, CA 94611.

Plenk, A. M. Activity grouptherapy for emotionallydisturbed preschool children.Behavior Disorders, 3, May,1978, 210-2'8.

Ramey, . T. Methods ofassessing mother- infantinteractions. In Darby,B. L. & May, M. J. (Eds.),Infant assessment: Issues andapplications. 1979, WesternStates Technical AssistanceResource.

Rhodes, W. C. & Tracy, M. L. Astudy of child variance,Volume I: Conceptual Models.1974, Ann Arbor; University ofMichigan Press.

Shearer, M. S. & Shearer, D. E.The Portage Project: A modelfor early childhood educationExceptional Children,November, 1972.

Thomas, A., Chess, S., & Birch,H. G. Temperament and behaviordisorders in children. NewYork; New York UniversityPress, 1968.

17

12 M. K. Zabel

Walker, H. Observing andrecording child behavior inthe classroom; skills forprofessionals. IowaDepartment of PublicInstruction: IowaPerspective, October, 1978.

Wood, F. Pupil observationschedule, Unpublishedmanuscript, University ofMinnesota, 1973.

Wood, M. M. (Ed.) The RutlandCenter model for treatingemotionally disturbedchildren. Athens: TechnicalAssistance Office to theGeorgia PsychoeducationalCenter Network, 1972.

Wood, M. M. (Ed.). Developmental

Therapy. Baltimore:University Park Press, 1975.

Wood, M. M. (Ed.). The

Developmental TherapyObjectives: A self-instructional workbook (3rd

edition). Baltimore:University Park Press, 1979.

Wood, M. M., Dodge, G. R.,Pendleton, V. M., Perras, D.F., Stone, N. W. & Swap, S.Preschool children with severeemotional or behavioral dis-orders: Program directionsand unmet needs. In F. Wood(Ed.) Perspectives for a New

Decade: Educationresponsibility for seriouslydisturbed and behaviorallydisordered children and youth.Reston, VA: Council forExceptional Children, 1981.

A Series of Reactions:

A Reaction by:

Beatty, MargeDirector of Special EducationESU 16Ogallala, Nebraska

The paper accurately highlightssome of the difficulties in thereferral, assessment, identi-

fication, and services offered

for behaviorally impaired chil-

dren between the ages of birthand five. The National Needs

Analysis Project information

pointed to the necessity for

further investigation of this

topic.I found the paper most en-

lightening in the area of assess-ment. Currently our service areais not using a standardized

assessment form for preschool

behaviorally impaired children.

The information on the Mother'sAssessment of the Behavior of HerInfant, The Infant Temperament

Questionnaire, and the PreschoolBehavior Questionnaire was a stepin the right direction foraccurately assessing and identi-fying behavioral needs.Some of the therapy materials

outlined including the Portage,the Peabody Early Experience Kit,and My Friends and Me are

currently being used within ourservice area. Nebraska has

addressed the issue of

programming for preschoolhandicapped children in Rule 54.

M. K. Zabel 13

Provision is made within thisRule for assessment identi-fication and services for pre-school behaviorally impairedchildren. Nebraska faces pro-blems similar to the ones out-lined in this paper. Nebraskahas additional problems in thefact that much of its territoryis rural, the problem arises inthe incidence rate and thelogistics of the state.

A Reaction by:

Burger, PhyllisDirector of Special EducationESU #8Neligh, Nebraska

This paper was well organizedand easy to follow. It flowed inprofessional yet understand-able, realistic, tangible terms.I especially appreciated thelisting, description and summaryof instruments available foridentifying behaviorally im-paired preschool children. I wasalso pleased with the time givento definition of behaviorallyimpaired and reasons for non-

referrals. The information re-garding intervention is veryvaluable.

I see and experience many ofthe non-referral cases, pro-fessionals not wanting to "label"behaviorally impaired children ata young preschool age, but at theschool age, junior high level aswell. I feel there is a real

need to work with the

medical profession, All toooften parents take their child toan M.D. only to get the responseof "wait and see" or he's/she'shyperactive, prescribing medi-cation and instructing the edu-cational profession "to take careof it." There needs to be morecommunication and acceptance be-tween both professions; medicaland educational.

The education of parents inpre-natal and post-natal care ofinfants is lacking in Nebraska.Parents need to know what to beaware of in the developmentalgrowth of their child and how,where, or when to refer to agen-cies for information.

19

A Reaction by:

Dickerson, MarySupervisor, Special EducationMillard Public SchoolsOmaha, Nebraska

My general reactions to thepaper are very positive. Thepaper is complete, readable andpractical. It provides a conciseoverview of the subject and makesfew assumptions - it is under-standable by someone not gener-ally knowledgeable about thetopic.

The issues addressed are impor-tant and timely. In order forearly intervention to be fullyeffective we must become able toidentify young children who areemotionally disturbed or at riskfor emotional disturbance,

14 M. K. Zabel

just n5 we now do for those

children physically, sen-

sorially or cognitively impaired.Being new to Nebraska myself, I

do not know how the topic is

being dealt with here, but I canassure you that the problems arenot unique to Nebraska. My con-

cern is that as funds are de-,

creased we will become even lessable to explore and develop ser-vices for the emotionally dis-

turbed population at the pre-

school level and will be forcedto focus more and more upon themost severely handicapped chil-

dren, who unfortunatley often arethe least remediable.

The major uniqueness toNebraska's problems in this area,

as usual, are our ruralness andlow incidence ratios. The paperdefinitely contains useful infor-mation for preschool handicappedprograms in Millard Public

Schools and I appreciate the op-portunity to read and share it.

A Reaction by:

Douglas, LindaPreschool Program CoordinatorLincoln Public SchoolsLincoln, Nebraska

My general reactions to the

paper are mixed - for various

reasons. I was disappointedafter reading the title that sofew answers were given regardingthe actual identification and

programming for behaviorally im-paired preschool children.

realize that research is indeed

quite limited pertaining to thistopic. However, some suggestionsby the author, integrated with

the research, would have been

helpful.On the other hand, my reactions

were positive from the standpointof organization of the paper. Iappreciated the background infor-mation as well as an overview ofinstruments which may be used asa part of identification. The

checklist could be very helpfulto teachers/parents if theyunderstand that all children mayexhibit one or more of these be-haviors at times. The brief re-view of models of emotional dis-turbance was helpful, but could

have been expanded to be more

specific.The section relating to inter-

vention was very well prepared asit related to prevention of be-havioral impairments by mothers,pediatricians, and child care

workers. However, the section

relating to young children shouldhave contained descriptions ofmore than 2 programs as examplesof programs for behaviorally im-paired. The author's statement

that preschool education is not

mandatory should be modifiedsince it is mandatory for handi-capped children in Nebraska.The paper is helpful as a re-

view of the state of the art inidentification and programmingfor behavioral impairments. Icertainly agree with the aul.-)or's

rationale statements regarding

the delay in establishing pro-grams for behavior disorderedyoung children. We have found

that these four delays are pre-valent in our program: diffi-

M. K. Zabel 15

culty in identification; unwill-ingness of professionals to labelyoung children; lack of goodassessment instruments; and dif-ficulty in referral.The checklist for informal

assessment is helpful from thestandpoint that teachers/parentsmay focus on specific behaviors.The emphasis toward both formaland informal assessment is impor-tant for assessors.

A more in depth discussion ofthe models of behavioral impair-ments would have been helpful.Descriptions were limited to thepoint that I felt that they wereof minimal value. The review offormal assessment instrumentsshould be helpful to psycholo-gists who are "new" to a pre-school program for handicappedchildren. The bibliography isalso helpful for a more in depthreview of any aspects of thepaper.

In my opinion, the issues whichthis paper addresses are of ut-most importance, as we provideprograms/services for preschoolhandicapped children. We mustcontinue to strive to improveidentification procedures forbehaviorally impaired children.Tnerefore, it is important toreview methods for identification- both formal and informal.

Intervention techniques both

for infants and young childrenare important. These techniquesare important for teachertraining institutions to consideras they prepare teachers forpreschool handicapped programs.Inservice must be provided forveteran teachers as they workwith behaviorally impaired

children.

LB888 mandates that all schoolsystems provide services for pre-school children who are moder-ately to severely handicapped inany educational manner. There-fore, children who are behavior-ally impaired may qualify forservices. Many of the instru-ments mentioned in this paper areutilized in the identificationprocess. Informal observationsand checklists are also utilizedby the school psychologist.The problems which we encounter

in the identification process aresimilar to those discussed inthis paper. However, we use bothinformal and formal assessmentmethods in the identification ofbehaviorally impaired children.Since we serve children from ages0 - 5 years of age, we attempt toidentify BI children as early aspossible. Our interventionmethods depend upon specificneeds of the child.

There are several ideas dis-cussed in this paper which willbe useful to us in our program.The checklist from the RutlandCenter Development Therapy Pro-ject could be used by our psy-chologist as well as shared withpreschool staff members as theyrefer children for evaluation.The models described in thispaper are interesting to reviewwith staff members as they con-sider etiologies of behavioralimpairments. Consideration ofthe models may also be useful inidentification of BI children asstaff members investigate back-ground/experiences of children.The bibliography is also usefulto share with staff members asthey review specific topics in anin depth manner. I especially

16

appreciated the section of the

paper which describes the conceptof prevention during infancy andthe roles of mother, pedia-

trician, and child care worker inthis process.

A Reaction by:

Drew, Jane, M.S.Assistant DirectorRichard Young HospitalOmaha, Nebraska

The findings of the paper,

"Identification and Programmingfor Behaviorally Impaired Pre-

school Children" were quite pre-dictable to the extent that mostprofessionals in the field of

behavior disorders are aware thatthere are many behaviorally im-

paired children who remain un-

diagnosed. However, the paper

successfully demonstrates that

the problem is far greater thanmost had previously been aware.

The report stating that nation-ally there continues to he 4,300"underserved" and 6,200 "un-

served" emotionally disturbed

children between the ages of 3

and 5 is astounding. That fact

alone reiterates the importance

of educating adolescents andadults to the basic knowledge ofchild development. Only when

people are aware of normaldevelopment can they be aware ofdevelopment which is atypical andthus identify a child with

special needs.Perhaps in the past people have

M. K. Zabel

been too casual about observing alag in the development of a

child. It may have been due tothe denial of the parents, the

unwillingness of a physician to

label a child behaviorally im-

paired, or simply a lack of

awareness. In any case, it seemsextremely important that parents,educators, and physicians becomeinformed about basic childdevelopment and at least examinethe child in question, using med-ical tests and some of the

assessment instruments available,in order to rule out a behaviorimpairment or an emotional pro-blem. In all fairness to thechild and his family, it is im-portant that a problem be diag-nosed at a young age so that pro-per treatment can begin.

Preschool teachers would un-

doubtedly find the list of be-haviors prepared by the RutlandCenter Developmental TherapyProject most helpful. It appears

to be easy to use and would makeone more aware of the types ofbehaviors one should be lookingfor in identifying behaviorallyimpaired children. Many pre-school teachers have received notraining in special education.

Too often a student eventually

diagnosed hyperactive has beenreprimanded and has endured dam-age to his self-concept by

parents and other unknowing

adults before he was evaluatedand placed on medication to helphim control his behavior. Had hebeen diagnosed earlier, many ofhis behavioral problems could

have been alleviated and he wouldhave experienced more success inearly childhood.

Most teachers do not realize

.22

H. K. Zabel

how powerful their observationsof students are with the physi-cian. It is a great respons-ibility for a teacher to observea child objectively with a per-ception or a basic knowledge ofwell adjusted behavior. Thephysician often depends upon thisinformation, as well as theparents' information to help himmake his diagnosis and prescribethe treatment plan.

It seems imperative that moreorganized training be given toteach parenting skills. Thestudy done by Brazelton provesthe significance of educatingparents about infant develop-ment. In that study, the pedia-trician worked with the youngmothers for only 15 minutes andthe effects lasted for more thana year. It seems to have beentime very well spent. Perhapsthere should also be a supportsystem available for all parentsin which they can find answ-rs toquestions they have regardingtheir child's progress and be-havior. If such a service wasavailable, the parents would morelikely be aware of a possibleproblem manifesting itself intheir child, and seek profes-sional help.The information on the Portage

Project in Wisconsin was mostexciting. It appears to be anideal solution to working with avery young behaviorally impairedchild. By including the parentsas an important integral part ofthe team working with the child,it allows much more consistentinstruction and behavior modi-fication to take place. However,one must be aware of the realitythat some parents would be unable

17

to follow through with such aninvolved and time consumingtask. In those cases, an alter-native solution must be con-sidered. Perhaps, as with olderbehaviorally impaired children, aLevel 3 Agency should be con-sidered for certain severe be-haviorally impaired preschoolchildren. In such an environ-ment, trained professionals andphysicians would be constantlyavailable to work with the childand develop an individualizedprogram to suit his social, emo-tional and physical needs.Due to the vastness and sparse

population in many parts ofNebraska, it is very difficultfor some parents to readily at-tain professional help. However,the importance of early identi-fication of behaviorally impairedchildren is most helpful intreating and improving the dis-order. It is much more difficultto rebuild a low self-conceptthan to nurture a healthy one.All Nebraskans must supportlegislation and facilities todeal with all special needs chil-dren. The resulting productwould be children with bettermental health and more appro-priate socialization skills, liv-ing with happier families andattending schools where theycould function more successfully.

Hopefully, as people becomemore aware of the importance ofsound mental health, they willmore readily support ideas andfacilities to attain it. Societyis very much aware of :he mal-adjusted or mentally ill adult.His problem often manifests it-self in a manner which we cannotignore. Why then, can't we see

23

1A

the importance of identifyingmaladjusted behavior patterns in

children? The child who is con-stantly acting out, seeking nega-tive attention, or isolating him-self frequently becomes the adultwho painfully repays society forignoring his cry for help. Per-haps if suitable treatment had

been administered at a young age,the adult could better cope withhis problem. At least he wouldbe aware of his problem and wouldseek professional help in time ofneed.

A Reaction by:

Cass, PatriciaPreschool CoordinatorESU 16Ogallala, Nebraska

This paper deals with a subjectabout which little has been writ-ten. The issues of identifi-

cation, assessment, referral and

rrneFamming for emotionally dis-turbed young children are impor-tant to Nebraska educators.N.D.E. Rule 54 makes school

districts responsible for

identifying these children.

identification of preschool chil-dren is a challenge and behavior-ally impaired preschool childrenare even more challenging to

identify.Nebraska programs face program-

ming problems similar to thosecited in the article. In addi-tion, there is a problem findingpersonnel with knowledge, back-

M. K. Zabel

ground and experience to imple-

ment programming. This is not

necessarily a problem unique toNebraska. Of specific value andinterest were the ten behaviors

from the Center DevelopmentTherapy Project (Wood, 1972), aswell as information about cur-

rently used and recently deve-

i:ped assessment and interventiontechniques.

A Reaction by:

Locke, GinnyPreschool CoordinatorESU 9Hastings, Nebraska

The section on definition wasaccurate and the problems were

discussed adequately. The sec-

tion on labeling and assessmentwas quite brief and should be

more thorough.The Rutland list of behaviors

would identify a child who neededservice, but a BI child would notparticularly be identified. Thedescriptions of many of the testswere not complete enough to beuseful to the reader.

The paper offered good, work-

able suggestions for inter-

vention. This information shouldbe shared with pediatricians.

I am very familiar with the

Portage Project and feel it is

misrepresented as a BI program.It is one of hundreds of programsthrough HCEEP demonstrationgrants and is geared to teachhandicapped preschoolers, but not

M. K. Zabel

behaviorally impaired pre-

schoolers. The social stages arenot in any way diagnostic or evenwell enough sequenced to be of

help in determining or reme-

diating BI children.This paper mirrors the state of

the art. Like the field of BI,the paper is incomplete and in-conclusive. The writer has drawnexamples out of the field seem-ingly at random. Some fit for

use in diagnosing and treating BIand some clearly do not. If onewere looking for direction, it

could not be found in this paper.One extremely important pro-

cess, in my opinion, for diag-

nosing and labeling any child BI,preschool or school age, that isignored in this presentation, is

the team process.In addition, whereas the writer

accurately outlines the problemsin the field, the reader is ledto believe that there are solu-tions developed for inter-

vention. In my opinion, there

are no valid solutions to inter-vention and many programs are

"flying by the seat of their

pants" waiting for solutions.

The writer does not accurately

portray the confusion and con-

tradictions in the current pro-

gram.

reaction by:

Pew, Steve, Ph.D.Director, Office ofMental HealthEastern Nebraska HumanServices AgencyOmaha, Nebraska

19

The paper is very useful

because it gives explicit refer-ences for assessment techniquesas well as good excerpts in theappendices. The issues addressed.ire extremely important, parti-cularly in Nebraska since LB 889makes mandatory the education ofall handicapped children from theday of identification, including

birth, if children are diagnosedat birth as having a handicap.There are a wide variety of pro-fessionals and educators in thisstate who would find the articlevery useful. I think a copy ofthis should be sent to every pre-school, day care center, and

public school (since they are

legally responsible for assess-ment of handicapped children), aswell as relevant medical facil-

ities that routinely have the

potential of diagnosing handicapsin preschool children, i.e.,

schools of medicine, nursing

schools, etc..I did notice in the paper that

Dr. Zabel did not make referenceto the Brigance, which is an

excellent diagnostic and inter-

vention source for developmentalas well as emotional delays.

Another resource to tie intowould be the Coordinated EarlyEducational Program (CEEP), whichthe Eastern Nebraska Community

Office on Retardation operated,

funded by a grant from the

federal government in the early70's. This program developed anumber of intervention techniquesfor mentally retarded childrenwho in many cases had significantemotional disturbance and mentalillness. Since that project wasNebraska based, and one of the

few national demonstration pro-

25

H7.t(i, it may have diagnosticmaterials or intervention tech-

niques to offer. Ms. PhyllisChandler, Coordinator of the Cen-ter for Children, at 66th and

Dodge Streets in Omaha, was thepast coordinator of that projectand may be able to direct you toany diagnostic materials devel-oped on that grant.

It has been a pleasure review-ing this article and with your

and Dr. Zabel's permission, Iwould like to copy and distributethis article first to our Dir-ector of Partial Care, who servesemotionally disturbed pre-schoulLrs in her program as wellas other interested professionalsin the Omaha area. Before dis-seminating this paper, I will

await the proper authorizationfrom ycu and/or Dr. 7abel.

If I can he of any assistanceto you in the future, please feelfree to contact me. It has beena pleasure working with you.

4 Reaction by:

Ross, Barb & TryProgram ManagersESU 9Hings, Nebraska

nis paper provided good in-formation as a primer overview,

especially in areas of toolsavailable for pediatric inter-

vention. The article reflectscurrent problems in identi-fication of BI that are also pre-sent in dealing with school age

M. K. Zabel

population, i.e., we must rely onbehavioral observations, docu-mentation of behavioral patternsand limited assessment tools.

The point was made that identi-fication of BI as a primary hand-icap is very difficult at thepreschool level, partly becausetools available are so limitedand those observing must have astrong foundation in normaldevelopment. Many times the be-havioral deviation may be asso-ciated with another primaryhandicap, usually organic in na-ture. The section on studyingearly socialization patterns hadvery interesting implications fordiagnosis and treatment. Whilethe definition for BI is animportant issue, especially atthe preschool level, this issue

may not be easily resolved. Inthe meantime, diagnosis mustdepend on good behavioral ob-servation data, and interventionsmust be tried and documented.

A Reaction by:

Wythers, MarciaInstructorUniversity of Nebraska-LincolnLincoln, Nebraska

My first general reaction isthat the beginning needs to bere-worked. This paper doesn't"grab" the reader in a way thathe or she would want to continueto read. This is too bad,because if you make yourself goon, you find that this is a very

._ally i-critter

page : is helpful.expellent...olnpmert

his is essentialpaPPI. of this type there

"jumping off" place,1-iprully, it comes from nor-

-!pielopment principles:normal development; then,lations.

though the definitions may-ring, they are necessary to

- total understanding of ther. The differentiation of

five models is good. Point-the lack of good assess-

tuhis for assessino emo-dp.,/elopmeht is good.

orcblems convincing my

nP students that good ob-inn procedures are still

hest tool in our setting,

are l know this point needsreiterated to the classroom

7_eacher. including_ PH.land Pro-, indicators was extremely

rui, even though it may be

titive to some. We tend to

.u-L;et that wHit we take for

::-ant oh, is not that obvious torhers in the field.

issue of the behaviorally

ITaireo preschool child is of:pat importance any there isortainly a need for more infor--,tino and better dissemination

' I:ration. At the practicaltois

issue is finally be-w:th. However, in my

is due to 7-4 -142 and

L_58b9, which are finallyattention to handicapped pre-schoolers. A. handicapping con-ditions are recognized and talkedabout, the problem of the he-haviorally impaired child isbrought to our attention. Inscrutinizing handicapped childrenand in mainstreaming them with"normal" children, it becomesevident that emotional develop-ment has been overlooked. Itshould not continue to be over-looked. I cannot say thatNebraska's situation is unique inthis area; my perception is thatall programs in special educationneed more people trained in nor-mal development, and that pro-grams need to give more attentionto emotional and social develop-ment and self concept, rather

than only to cognitive develop-ment and/or physical-motordevelopment.

The discussion of variousassessment techniques containsinformation that will be veryuseful to me for use with my stu-dents; but I feel that thisarticle has its greatest use andpotential impact for teachersworking with young children incenters throughout the state.This article contains excellentinformation in a fairly readable,understandable style and deserveswider circulation. I hope it canbe circulated in a way it will beread--not in an "unused profes-sional jou7al."