Early Childhood Inclusion - Association of University …€¦ · · 2017-03-30Early Childhood...
Transcript of Early Childhood Inclusion - Association of University …€¦ · · 2017-03-30Early Childhood...
Early Childhood Inclusion: Peer Competence as a Core Element
Michael J. Guralnick, Ph.D.Director, Center on Human Development
and DisabilityProfessor of Psychology and Pediatrics
University of Washington Seattle, Washington USA
Access – universal access to inclusive programs
Accommodations – adjustments that maintain integrity of program model
Developmental Progress – at minimum, equivalent social and cognitive competencies in inclusive settings compared to specialized settings
Social Integration – meaningful social participation between children with and without disabilities; sense of belonging
Goals for Preschool Inclusion
(Guralnick, 2001; Guralnick & Bruder, 2016)
Inclusive Goals Tied to Peer Competence
Social Competence
Peer-Related Social Competence
Peer Relationships and Friendships
Developmental Progress and Social Integration
Peer Relationships and Friendships
Features• Characterized by more balanced exchanges• Relationships with peers are often
unpredictable and unforgiving• Peer system easily perturbed by
environmental or biological factors
Building relationships is core component of child development—including relationships with peers
Peer-Related Social Competence
Fundamental Issue in Our Field
Functions of Peer Relationships• Carry implications for cognitive, communicative,
emotion-regulation, and prosocial domains of development (developmental progress)
• Essential element in social integrationat all levels
• Key to independence and self-determination
• Inclusion must be a core component of all early intervention programs
• Enhancing peer competence must be a goal and high priority in the context of early intervention programs
• Critical to consider the broad developmental influences on peer competence, including family patterns of interaction
Three Key Points
Definition: Use of appropriate and effective social strategies in carrying out one’s interpersonal goals in the peer context
Peer-Related Social Competence
Peer-Related Social Competence
Social Strategies Within Social Tasks
• Peer group entry• Conflict resolution• Maintaining play
Building Peer Relationships
Peer Context: Goals as Social Tasks
Research Program
• Peer system of 3 to 6 year old children with mild (cognitive) delays
• Begin to see emergence of various complex forms of peer interactions
• Evidence of problems and their nature becomes most apparent during this developmental period
Study Population
Sources of Information
Findings- Consistent patterns suggesting existence of
major and pervasive peer-competence difficulties for young children with mild intellectual delays
- Significant implications for the inclusion goals of developmental progress and social integration
• Observational measures• Parent reports• Teacher reports• Children’s reports
Dimensions of quality and quantity of social interactions with peers to index peer competence
• Free-play settings: window to interpersonal expression- Group (sustained interactive play)- Positive / negative exchanges- Communication: compromise/negotiate
Observational Measures of Peer Social Competence: Profile
• Transition• Conversation• Rough & Tumble• Exploratory• Adult Involved
Social Participation Scale• Solitary• Parallel• Group• Unoccupied• Onlooker• Reading
Cognitive Play• Functional• Constructive• Dramatic• Games
• Attention *• Resource *• Lead - Positive *• Lead - Negative *• Follow Activity• Imitate • Affection• Hostility
Individual Social Behavior Scale
* Successful or unsuccessful
• Compete - Adult *
• Compete - Equipment *
• Pride Product
• Follow Lead
• Refuse/Ignore
• Modeling
• Structural- MLU- no. complex utterances
• Functional- behavior requests- information statements- information requests
• Discourse and Speech Style- attentionals- exemplification & demonstration- mitigated directives- permission requests- agreement/disagreement
Communicative Measures
Conditions• Cross-sectional• Moderate-mild delay• Community preschool (specialized)
Concerns
(Developmental Psychology, 1984)
10
25
5
15
30-41 42-53Chronological Age Range (months)
20End of Year
54-65 66-77
Beginning of Year
Tota
l Soc
ially
D
irect
ed B
ehav
ior
Findings• Absence of change over time (30-77 months)• Dominance of two-unit exchanges• Fragility after summer hiatus—lower level at beginning of each year• Small percentage dominated group play
Conditions• Longitudinal (2 year period): mild delay• Quartets with typically developing children
Problems Persist Over Time
(Child Development, 2006)
10
40
Chronological Age (mean months)
20
High initial levels
61 84
Low initial levels
Peer
Inte
ract
ion
Com
posi
te
30
Findings• No gains for high interactors• Low levels of group play overall
(8% at 84 months)• Negative and positive behaviors
highly correlated—conflicts• Minimal gain for low interactors
70
TypicallyDeveloping4-year-olds
TypicallyDeveloping3-year-olds
MildlyDelayed
4-year-olds
Soci
al P
lay
Com
posi
te 60
50
40
30
20
10
0
Peer Competence Comparisons
250
TypicallyDeveloping4-year-olds
TypicallyDeveloping3-year-olds
MildlyDelayed
4-year-olds
Tota
l Pos
itive
Inte
ract
ions
200
150
100
50
0
Directiveness
18
TypicallyDeveloping4-year-olds
TypicallyDeveloping3-year-olds
MildlyDelayed
4-year-olds
Perc
ent G
roup
Pla
y
16
14
12
10
0
8
6
4
2
Dyadic Interactions
(Journal of Speech and Hearing Research,1989)
Prop
ortio
n of
Com
mun
icat
ions
In
volv
ing
a D
isag
reem
ent
.30
.20
.10
0
–Less mitigation of imperatives–More insist negatives as a strategy–High use of non-adaptive strategies
TypicallyDeveloping4-year-olds
TypicallyDeveloping3-year-olds
DevelopmentallyDelayed
4-year-olds
Conflicts
Unfamiliar Typically
Developing Peers
Peer
Inte
ract
ion
Com
posi
te 30
25
20
15
10
5
0
Constraints Imposed by Peer Competence
Friends: Primarily Typically
Developing
Correlations Between Settings
r = .60 compositer = .55 group play
(Journal of Applied Developmental Psychology, 2007)
Perc
ent Y
es
50
40
20
0
Peer Social Networks in the Community
Typically Developing4-6-year-olds
Developmentally Delayed4-6-year-olds
3
5
2
1
0
Rat
ing
Typically Developing4-6-year-olds
Developmentally Delayed4-6-year-olds
Frequency of Play with Peers in Community
1 = less than one/month5 = 4 or more times/week
30
10
4
Met in preschool / daycare
In same preschool / daycare
Linkage
(American Journal on Mental Deficiency,1997)
• Problems of peer competence extend beyond those expected based on developmental level
• Low levels of productive, especially group play• Lack of directiveness (organization)• Social goals (tasks) not well established• Conflicts are common; high correlation between positive
and negative interactions• Modest changes over time; fragile set of social skills
Peer-Related Social Competence: Summary
1970s Emerging recognition of problem
• Peers as agents of change (reinforcement and modeling)
• Application of reinforcement strategies and environmental manipulations for individual children
1980s
1990s
2000-present
Behavioral Interventions• Translation of contemporary
models to intervention programs
• Understanding of social competence and family-peer linkages: Emergence of models
• Recognition of magnitude and pervasiveness of problem
• Inclusion as intervention
(Guralnick, 2010)
Family Patterns of Interaction
Child Social and Cognitive Competence
(Guralnick, 2011)
Discourse frameworkInstructional partnershipSocioemotionalconnectedness
Parent’s social networkPeer networkStimulating environmentChild care (Inclusive)Community activitiesPreschool program (Inclusive)Focus on special interests and needs
Protection from violencePreventative healthEnvironmental hazards
Health and Safety Provided by Family
Parent-Child Transactions
Family Orchestrated Child Experiences
Family Resources
Mental and physical healthIntellectual abilityAttitudes and cognitive readiness
Coping stylePerceived confidence and competence
Financial resourcesSocial support
Material ResourcesPersonal Characteristics of Parents
Organizational ProcessesDevelopmental Resources
CognitionLanguageMotorSocial-emotionalSensory-perceptual
Executive functionMetacognitionSocial cognitionMotivation Emotion regulation
Peer Competence
Family-Peer Linkages
Developmental Systems
Approach
Family Patterns of Interaction
Child Social and Cognitive Competence
(Guralnick, 2011)
Discourse frameworkInstructional partnershipSocioemotionalconnectedness
Parent’s social networkPeer networkStimulating environmentChild care (Inclusive)Community activitiesPreschool program (Inclusive)Focus on special interests and needs
Protection from violencePreventative healthEnvironmental hazards
Health and Safety Provided by Family
Parent-Child Transactions
Family Orchestrated Child Experiences
Family Resources
Mental and physical healthIntellectual abilityAttitudes and cognitive readiness
Coping stylePerceived confidence and competence
Financial resourcesSocial support
Material ResourcesPersonal Characteristics of Parents
Organizational ProcessesDevelopmental Resources
CognitionLanguageMotorSocial-emotionalSensory-perceptual
Executive functionMetacognitionSocial cognitionMotivation Emotion regulation
Peer Competence
Family-Peer Linkages
Developmental Systems
Approach
Family Patterns of Interaction
Child Social and Cognitive Competence
(Guralnick, 2005, 2012, 2013, 2016)
Discourse frameworkInstructional partnershipSocioemotionalconnectedness
Parent’s social networkPeer networkStimulating environmentChild care (Inclusive)Community activitiesPreschool program (Inclusive)Focus on special interests and needs
Protection from violencePreventative healthEnvironmental hazards
Health and Safety Provided by Family
Parent-Child Transactions
Family Orchestrated Child Experiences
Family Resources
Mental and physical healthIntellectual abilityAttitudes and cognitive readiness
Coping stylePerceived confidence and competence
Financial resourcesSocial support
Material ResourcesPersonal Characteristics of Parents
Organizational ProcessesDevelopmental Resources
CognitionLanguageMotorSocial-emotionalSensory-perceptual
Executive functionMetacognitionSocial cognitionMotivation Emotion regulation
Peer Competence
DevelopmentalMechanisms
Family-Peer Linkages
What Can the Early Intervention Team and Families Do to Promote Peer Competence?
Evidence for:• Finding and supporting an inclusive preschool• Arranging, monitoring, and facilitating peer
play at home (peer networks)• Strengthening “horizontal” parent-child
interaction patterns (parent-child transactions)
Developmental Systems Framework
Inclusive Preschool: Promoting peer social networks and peer competence at school
Promoting peer networks: arranging, monitoring, and facilitating peer play at home and community
Family-Peer Linkages
Peer Competence
Social Strategies
Family Factors
Promoting parent-child transactions
Peer-Competence Mechanisms
Outcomes
Motivation● ● ●
Emotionregulation● ● ●
Social cognition● ● ●
Executive function
Language● ● ●
Cognition
Inclusive Preschool: Promoting peer social networks and peer competence at school
Family-Peer Linkages
Motivation● ● ●
Emotionregulation● ● ●
Social cognition● ● ●
Executive function
Peer Competence
Social Strategies
Family Factors Peer-Competence Mechanisms
Outcomes
Promoting peer networks: arranging, monitoring, and facilitating peer play at home and community
Promoting parent-child transactions
Language● ● ●
Cognition
Conditions• Majority of children were TD and similar CAs• Within subject design (matched on other programmatic factors such as teacher-child ratio and
number of children)
Effects of Inclusion
60
Inclusive Specialized
Tota
l Pos
itive
Inte
ract
ions
D
D C
hild
ren 50
30
20
0
40
Findings• Inclusion had major impact on overall positive interactions with peers• Suggest value of majority of TD peers and potential influences related to modeling and demand
characteristics
Minimal Influence on Social Strategies or Mechanisms
Inclusive Preschool: Promoting peer social networks and peer competence at school
Promoting peer networks: arranging, monitoring, and facilitating peer play at home and community
Family-Peer Linkages
Motivation● ● ●
Emotionregulation● ● ●
Social cognition● ● ●
Executive function
Peer Competence
Social Strategies
Family Factors Peer-Competence Mechanisms
Outcomes
Promoting parent-child transactions
Language● ● ●
Cognition
• Arranging playdates• Potential for promoting peer competence
High
Low
Medium
1 2
Extent of Maternal Arranging (rate per week)
Children with developmental delays
4 5
Children with Down syndrome
Invo
lvem
ent w
ith P
eers
(num
ber a
nd fr
eque
ncy
of p
laym
ates
)
Family Influences on Peer Interactions
3
(r=.50)
(r=.43)
(Journal of Intellectual Disability Research, 2002)
Inclusive Preschool: Promoting peer social networks and peer competence at school
Promoting peer networks: arranging, monitoring, and facilitating peer play at home and community
Family-Peer Linkages
Motivation● ● ●
Emotionregulation● ● ●
Social cognition● ● ●
Executive function
Peer Competence
Social Strategies
Family Factors
Promoting parent-child transactions
Peer-Competence Mechanisms
Outcomes
Language● ● ●
Cognition
Family Influences on Peer CompetencePe
er C
ompe
tenc
e(c
ompo
site
)
• Mother-child play interaction• Importance of horizontal (mutual) vs vertical exchanges
Children’s Influence Attempts with Mothers During Play (Frequency) (Requests, Directives, and Mother Compliance)
• Controlling for child characteristics and mother arranging
• Predicts peer competence two years later• Suggests a new intervention approach
(Child Development,2007;Journal of Applied Developmental Psychology, 2007)
Features of the First Comprehensive, Randomized, Prospective, Controlled Design
• Developmental systems approach framework to guide early intervention
• Longer-term intervention (2 years)
• Children in inclusive settings
• Highly individualized (Assessment of Peer Relations; Family Assessment)
• Comprehensive – consultant model involving teachers and mothers (partnerships)
Contemporary Models
Assessment of Peer RelationsSocial Strategies
A. Peer Group EntryStrategies• initial attempt• second efforts
B. Conflict ResolutionStrategies• conciliatory/agreeable• negative/disconnected
C. Maintaining PlayStrategies• role and activity structure• management
Social ProcessesA. Shared UnderstandingB. Emotion RegulationC. Social-CognitiveD. Higher-Order
Clinical Tools
Intervention Framework• Promote effective and appropriate use of social
strategies within social tasks
• For mothers: address playdates, monitoring and facilitating dyadic play, improve social support, control issues, and promote horizontal interactions
• Frequent use of role playing relying on scripts, both mothers and teachers
• Guidance in script development based on mechanisms identified on APR: A social task context
• Assume structure within each social task• Remembering and acting upon event sequences• Critical events have nodes (variations around nodes)• Teach scripts for the three social tasks; repetition and variation are keys• Content of scripts:
- goal of social task- a cue to evoke the goal- strategies toward goal - successful resolution of task
• Attempt addresses issue of generalization: teach scripts in context of play
Scripts
NodesMaintaining Play Script Icons
Goal: Stay Together
4
1
65
2 3
Engaged Disengagement Strategy
Stay TogetherSecond effortFailure
Building the Script• Follow nodal structure• Practice at school and home • Always worry about Social Task Recognition
(higher - order); Executive function–emphasize cues that one is involved in a social task –emphasize goal (join, happy, stay together)
Mechanisms to be addressed incorporate fictional characters
Mechanisms to be addressed incorporate fictional characters
Mechanisms: Organizational Processes
Executive Function
SocialCognition
EmotionRegulation
Motivation
• Not just teach strategy • Not teach mechanisms independent of social task
(e.g., strengthen emotion regulation)• Address process as part of fictional characters representing mechanisms of
interest in context of a social task• Examples:
1. child fails to persist (executive function / motivation) – choose character who tries again and again
2. child easily upset (emotion regulation) – choose character who exhibits even or consistent mood
3. child fails to encode cues accurately (social-cognitive) – choose character who is attentive to cues
Use of Fictional Characters:Mechanisms
75M
ean
Scor
e
70
65
60
55
45
ControlCA (months) 64.17InterventionCA (months) 63.57
Full Scale IQ (WPPSI-R)
VABS Adaptive Behavior Composite
CBCL Total Behavior Problems
Family SES
50
N=90Pre-test
• Focus on generalization• Three typically developing children (slightly familiar
with one another) – entry task• Same CA and gender as target child• Quartets played for three consecutive days (1 hr/day)
Evaluation Setting
Prop
ortio
n C
hang
ePr
e-Te
st to
Pos
t-Tes
t.6
.4
.2
0
-.2
-.4
-.6
ControlIntervention
Non-Responsive to Peer Positive
Responsive to Peer Positive -
Proportion
Total Negative Behavior
Panel A (IQ < 70) Panel B
Parallel-DramaticPlay
(American Journal on Mental Retardation, 2006)
• Major improvement in peer competence not found• Encouraging—bar set high for generalization
(unfamiliar peers in unfamiliar settings)• Preventing peer interaction problems
Summary of Research Findings
• Peer competence is critical to goals of inclusive practice• Relevant to developmental progress and social integration• Inclusion is a critical component of early intervention
programs needed to support children’s peer competence• Promoting peer competence requires an understanding of
family-peer linkages within a developmental framework• Peer competence is strongly associated with long-term
independence and quality of life• Future research and practice must take a systems-level
approach and directly target peer competence
Conclusions