The interaction approach to early intervention

A brief summary of research, supportive of the idea that quality of parent-infant interaction has a powerful effect on infant development, introduces an early intervention model based on that proposition. Also, central to the interaction model is the knowledge that (1) parent and infant both contribute to what happens between them and that (2) a multitude of factors, environmental and internal to parent and infant, affect the parent, the infant, and their interaction. Ten sets of principles and strategies that convey the essence of the interaction model constitute the core of this article. The principles and strategies address the importance of identifying sources of support and stress in the family, of developing relationships with both parents, and of supporting positive interactions between parents and the infant's siblings. The limitations of this model are also addressed, especially in cases where the parent is the primary risk factor. The infant's exposure to nurturing adults in quality day care programs and a more clinical approach with the parent and infant, such as Selma Fraiberg's model, may be more effective with such families.     

Internal control beliefs and reference frame concurrently impact early performance monitoring ERPs

This study investigated the impact of criterion-based vs. social reference frames on behavioural and neural correlates of performance monitoring while taking individual differences in control beliefs into account. We conducted two experiments administering a time estimation task in which feedback was either delivered pertaining to participants’ own performance (nonsocial/criterion-based reference) or to the performance of a reference group of previous participants (social reference). In Experiment 1, 34 male volunteers participated. To test generalizability of the observed results to both sexes/genders, we recruited 36 female volunteers for Experiment 2. P2 and P300 amplitudes were generally larger in social than in nonsocial reference trials in the male participants of Experiment 1. ΔFRN amplitudes were larger for social compared to non-social reference trials in Experiment 1. No effects of reference frame were found in the female sample of Experiment 2. Rather, P2 and ΔFRN effects showed opposing patterns for nonsocial versus social reference frames. However, stronger internal control beliefs were accompanied by larger FRN amplitudes of negative social reference trials in both samples, suggesting generalizable effects independent of sex/gender. Enhanced P2 and ΔFRN amplitudes for social versus nonsocial reference trials suggest enhanced attentional capture and higher saliency of socially framed feedback in male participants only. In both sexes/genders, however, the social reference frame possibly challenges internal control beliefs and by this enhances performance monitoring. Our results demonstrate the complex interplay of trait variables and reference frames during performance monitoring influencing our daily lives-reference frames are omnipresent in education and one’s working environment.     

Working with high-risk youth in prevention and early intervention programs: toward a comprehensive wellness model

Societal problems resulting from school dropouts, teenage pregnancy, drug abuse, suicide and other health-damaging behavior are increasing, along with the financial costs. This paper presents a theory of youth development and learning, and an integrated, interactive and reciprocal model for the prevention of health-damaging behavior.     

Stress intervention programs for reducing medical costs and accident claims in a hospital

Job stress is an important area for study among Industrial/ Organizational Psychologists. Previous studies have noted the relationship of stress to psychological, physiological and behavioral functions among employees. Little research has been done to intervene and reduce the effects of stress on workers, and to document the impact of reduced stress on corporate level outcomes. The present case evaluates a comprehensive hospital stress intervention program designed to reduce losses that have been associated with stress, such as accidents and associated medical costs. An organizational stress survey, theHuman Factors Inventory (HFI), was administered and the results compiled, followed by the implementation of organization-wide stress intervention programs. The purpose here is to assess changes from pre-intervention to post-intervention in insurance losses due to accidents.     

Tier 1 and Tier 2 early intervention for handwriting and composing

Three studies evaluated Tier 1 early intervention for handwriting at a critical period for literacy development in first grade and one study evaluated Tier 2 early intervention in the critical period between third and fourth grades for composing on high stakes tests. The results contribute to knowledge of research-supported handwriting and composing instruction that informs practice as school psychologists are empowered to embrace the role of intervention specialist. The first study found that neurodevelopmental training (orthographic-free motor activities and motor-free orthographic activities) led to improved accuracy and legibility of letter formation, but that direct handwriting instruction with visual cues and verbal mediation led to improved automatic handwriting (rate of writing legible letters) and transfer to improved word reading. The second study found that neither motor training nor orthographic training alone added value to direct instruction in automatic letter writing and composing practice in developing handwriting skills, which transferred to improved word reading; but the added motor training did improve performance on a grapho-motor planning task for sequential finger movements that is relevant to composing. A related analysis showed that direct instruction with visual cues and memory delays may reduce reversals. A third study found that adding handwriting to reading instruction improved handwriting but did not add value to reading outcomes for at risk readers; reading instruction alone was beneficial for word reading, decoding, and comprehension. The fourth study showed that comprehensive, explicit instruction in the processes of composition led to more significant improvement, based on group and individual data, than did the regular fourth grade program, on high stakes writing assessment.     

Targeting adolescent mothers with depressive symptoms for early intervention

Infants of mothers with depressive symptoms show developmental delays if symptoms persist over the first 6 months of the infant's life, thus highlighting the importance of identifying those mothers for early intervention. In Study 1, mothers with depressive symptoms (n = 160) and mothers without depressive symptoms (n = 100) and their infants were monitored to identify variables from the first 3 months that predict which mothers would still be symptomatic at 6 months. A "dysregulation" profile was noted for the infants of depressed mothers, including lower Brazelton scores, more indeterminate sleep, and elevated norepinephrine, epinephrine, and dopamine levels at the neonatal period, and greater right frontal EEG activation, lower vagal tone, and negative interactions at the 3- and 6-month periods. A group of maternal variables from the neonatal and 3-month assessments accounted for 51% of the variance in the mothers' continuing depressive symptoms. These variables included greater right frontal EEG activation, lower vagal tone, and less positive interactions at 3 months, and elevated norepinephrine, serotonin, and cortisol levels at the neonatal stage. In Study 2, a similar sample of mothers with depressive symptoms (n = 160) and without depressive symptoms (n = 100) was recruited and followed to 3 months. Those symptomatic mothers who had values above (or below) the median (depending on the negative direction) on the predictor variables identified in Study 1 (taken from the first 3 months) were then randomly assigned to an intervention or a control group at 3 months. These groups were then compared with each other, as well as with the group without depressive symptoms, at 6 and 12 months. The intervention, conducted from 3 to 6 months, consisted of free day care for the infants and a rehab program (social, educational, and vocational) plus several mood induction interventions for the mothers, including relaxation therapy, music mood induction, massage therapy, and mother-infant interaction coaching. Although the mothers who received the intervention continued to have more depressive symptoms than did the nondepressed mothers, their interactions significantly improved and their biochemical values and vagal tone normalized. Their infants also showed more positive interations, better growth, fewer pediatric complications, and normalized biochemical values, and by 12 months their mental and motor scores were better than those of the infants in the control group.     

Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology

A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.     

Home-based early intervention: Emerging purposes,intervention approaches,and evaluation strategies

Infant and toddler home visiting programs constitute an important subgroup within the rapidly growing field of early intervention. Scores of such programs have been implemented by health, educational, and mental health agencies during the past decade. Recent reviews have reported on home-based early intervention for specific populations, such as biologically impaired infants or infants from economically disadvantaged families. Other reviews have focused on the effects of home-based early intervention in particular outcome domains, such as I.Q., or infant health. In this review the author draws together the information emerging from partial reviews and specific program reports in order to describe the full range of purposes and strategies encompassed by home-based early intervention and to draw inferences about its potential to enhance infant health and development and broader family functioning.     

Using heteromodal communication to optimize knowledge and awareness

Accurate, error-free communication is essential for success in many areas, such as eyewitness testimony, human factors design, business, education, and personal relationships. Traditional communication uses similar modalities: Participants communicate by talking or by writing, but not both at the same time with the same addressees. New communicative technologies have broadened this vista. For example, one communicator can speak and the other can type. We tested communicative effectiveness using accuracy and error detection in a trivia recall test, evaluating the roles of presentation and retrieval modalities on reporting facts stored in long-term memory. Heteromodal communication (hearing and writing or reading and saying) was more effective than homomodal communication (hearing and saying or reading and writing), with the most correct responses and the most errors caught. This has direct connections to communicative success and applied tests of skill.     

Formulating policies concerning effective early childhood education and development programs

School psychologists should play a critical role in determining the policy implications of effective early childhood education and development programs. The tools they use are: (1) knowledge about human growth and development, learning, and program impact; (2) knowledge about differential effects of programs on children; and (3) knowledge about the process of program implementation at the local level. The essential findings from research are provided to clarify and support these tools. Using these tools, school psychologist are able to establish a set of procedures for determining what current policies are, what the policy implications of the new program are, and what policy changes need to be made to assure successful adaptation of the new program.     

The relationship between cognitive performance and electrophysiological indices of performance monitoring

Studies of electrophysiological indices of performance monitoring, such as the error-related negativity (ERN), posterror positivity (Pe), and N2 components of the event-related potential (ERP), suggest that increased ERN and Pe amplitudes and decreased N2 amplitudes are associated with better cognitive flexibility and cognitive control abilities; however, few studies have directly examined the relationship between cognitive performance and ERP indices of performance monitoring. We examined the neuropsychological profile of 89 healthy individuals who performed a modified flanker task. The neuropsychological domains tested included memory, verbal fluency, and attention/executive functioning. Pearson’s correlations and multiple regression analyses showed a significant relationship between measures of attention/executive functioning and ERN amplitude, even when negative affect, reaction time interference, and posterror slowing were controlled. N2 amplitude related only to posterror slowing. The amplitude of the Pe was not significantly related to any cognitive domains. These findings are consistent with recent work indicating that performance monitoring requires attention skills and cognitive flexibility. Implications for the conflict-monitoring and reinforcement-learning theories are discussed.     

Rationale and principles for early intervention with young children at risk for anxiety disorders

Anxiety disorders are one of the most prevalent categories of disorder among adults and children. Children of parents with anxiety disorders are known to be at higher risk for anxiety disorders themselves, with manifestations of this risk often appearing in toddlerhood or early childhood. Yet because affected parents are often unskilled in anxiety management, they often have difficulty in helping their young children learn to manage anxiety. Literature on the course of anxiety disorders through childhood and on effective cognitive-behavioral interventions suggests that preventive interventions even with very young children could potentially be of benefit in mitigating the course of these often debilitating disorders. This paper outlines the rationale for offering early or preventive interventions to preschool-age children at risk and their parents and discusses means of identifying children to target for intervention and the importance of parental involvement. Drawing upon the literature on parental factors in childhood anxiety disorders as well as on effective intervention strategies with preschool-age children, it delineates principles for intervention with parents and effective components of intervention with youngsters in this age range.     

Effectiveness of school-based prevention and intervention programs for children and adolescents with emotional disturbance: A meta-analysis

The present study evaluated the effectiveness of school-based prevention and intervention programs for children and adolescents at-risk for and with emotional disturbance. Published outcome studies (k = 29) from December, 1988, to March, 2006, including 1405 children and adolescents were reviewed. Each investigation was coded on several variables describing the child, parent, and teacher samples, as well as reported outcome results. The overall mean weighted effect size was 1.00 at post-test and 1.35 at follow-up. Mean weighted ESs were 0.42 for between-subjects design studies, 0.87 for within-subjects design studies, and 1.87 for single-subject design studies. Prevention programs yielded a mean weighted ES of 0.54 and intervention programs produced a mean weighted ES of 1.35. Findings for specific outcome foci are presented and implications are discussed.     

Symbolic play performance and early language development

The object-substitution symbolic play abilities of young children at three early language levels (i.e., MLU Stage Pre I, Early Stage I, and Late Stage I) were compared. In addition, the relationship between early language performance and object-substitution symbolic play was investigated. Results support the view that symbolic play performance is related to early language development, and in particular to the beginnings of combinational language (i.e., early syntax). Children at the combinatorial level of language development demonstrated significantly more representational ability than children at the single-word level.     

Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for autism

Intensive behavioral intervention for very young children with autism has received increased attention in recent years. Researchers have documented unprecedented success in educating some young children with autism, although not every child makes dramatic developmental gains. It might be useful to identify early in treatment those children who will benefit most from the current methodology and who might require slight variations in instructional format or curricular focus. The present study suggests that initial learning rates are moderately correlated with treatment outcomes after two years. Among 20 children receiving early, intensive behavioral intervention, initial acquisition of skills was correlated with later learning rates, severity of autism symptomatology and adaptive behavior profiles two years into treatment. Implications are discussed, especially in light of the universal need for intensive intervention in this population. Copyright © 1999 John Wiley & Sons, Ltd.