PEER INTERVENTION EFFECTS ON COMMUNICATIVE INTERACTION AMONG HANDICAPPED AND NONHANDICAPPED PRESCHOOLERS

A peer-mediated intervention designed to promote communicative interaction on the part of three language-delayed children was evaluated. Two nonhandicapped preschoolers were taught strategies thought to facilitate interaction and were prompted to use these strategies during free play with three handicapped classmates. The intervention resulted in higher rates of interaction for each of the handicapped children that persisted above baseline levels after teacher prompting was withdrawn.     

A university-based incentive program to increase safety belt use: Toward cost-effective institutionalization

A cost-effective incentive program to increase safety belt use was implemented by the campus police of a large university. For each of the 3-week intervention periods during three consecutive academic quarters, the 22 campus police officers recorded the license plate numbers of vehicles with drivers wearing a shoulder belt. From these numbers, 10 raffle winners were drawn who received gift certificates donated by community merchants. Faculty and staff increased their belt usage markedly as a result of the "Seatbelt Sweepstakes," whereas students increased their belt use only slightly. A cost-effectiveness analysis indicated that the sweepstakes cost an average of $0.98 per each newly buckled driver. During each sweepstakes intervention, officers' belt usage increased significantly, but diminished to initial baseline levels after the final withdrawal of the program. Surveys of officers' opinions indicated that the police would accept the program demands as a regular task requirement. This result and the fact that program promotion and coordination were eventually taken over by two student organizations suggest that institutionalization of the "Seatbelt Sweepstakes" is feasible.     

Evaluation of an islandwide screening,assessment and treatment program

This article reports on the effectiveness of the Islandwide Screening, Assessment, and Treatment Program of the Child Development Project in Bermuda. From 1982 to 1984, approximately 1100 families with 2-year-old children were screened for children's cognitive and language delay, for behaviour management problems and for other home characteristics that put children at risk for later school failure. Children who failed the screening and subsequent assessment procedures (of whom random samples received treatment) and samples of others who passed screening and assessment were evaluated from 1984 to 1986 at 4 years of age. This article focuses on the results of the cognitive and language programs; the more problematic behaviour management analyses were reported elsewhere (Miller and Scarr, 1988). The screening procedures and assessment measures developed for this project were themselves evaluated and adjusted to maximize efficiency and costeffectiveness. The screening and assessment procedures proved effective in bringing to the attention of the Child Development Project those families and children who need developmental services, and in not overidentifying normal children as potentially delayed in development. Two kinds of treatment services were compared: The Mother-Child Home Program (MCHP), administered by paraprofessional toy demonstrators, and other interventions tailored by professionals to the language and cognitive problems of the child (called ‘tailored programs’). Children who were not extremely delayed or disturbed were randomly assigned either to the MCHP or to a tailored program. Neither intervention program was preferable to the other. Even though improved, the 4-year-olds identified as developmentally delayed at 24 months still lagged behind children who passed all parts of screening and those who failed screening but passed assessment 2 years earlier. The screening and assessment procedures were very effective in the early identification of children with developmental problems, but the treatment programs failed to bring most children to normal levels of cognitive and language functioning.     

Psychological impact of breast cancer on the patient and the family: A clinical perspective

Breast cancer is the most frequently occurring cancer in women, with 182,000 new cases diagnosed in 1993. Breast cancer will strike a sizable percentage of women during the child-rearing years impacting, therefore, not only on the woman, but on the significant others in her life. This article explores the impact of breast cancer for the patient's life partner, parents, and children. A model intervention program for cancer patients with young children, piloted at the Derner Institute and developed in conjunction with the American Cancer Society, is also discussed.     

Educational Success in High-Risk Settings: Contributions of the Chicago Longitudinal Study

I provide an overview of the Chicago Longitudinal Study. This prospective study traces the educational and social success of a large sample of low-income children (over 90% of whom are African American) from high-poverty neighborhoods in the Chicago Public Schools. In 1985–1986, the sample participated in the Child–Parent Centers and other early childhood programs. The four studies reported in this special issue highlight the contributions of school mobility, parent involvement, educational expectations, and other family and school experiences in preventing learning problems and promoting educational success.     

Triple P-Positive Parenting Program: Towards an Empirically Validated Multilevel Parenting and Family Support Strategy for the Prevention of Behavior and Emotional Problems in Children

This paper outlines the theoretical and empirical foundations of a unique multilevel parenting and family support strategy designed to reduce the prevalence of behavioral and emotional problems in preadolescent children. The program known as Triple P-Positive Parenting Program is a multilevel system of family intervention, which provides five levels of intervention of increasing strength. These interventions include a universal population-level media information campaign targeting all parents, two levels of brief primary care consultations targeting mild behavior problems, and two more intensive parent training and family intervention programs for children at risk for more severe behavioral problems. The program aims to determine the minimally sufficient intervention a parent requires in order to deflect a child away from a trajectory towards more serious problems. The self-regulation of parental skill is a central construct in the program. The program uses flexible delivery modalities (including individual face-to-face, group, telephone assisted, and self-directed programs) to tailor the strength of the intervention to the requirements of individual families. Its multidisciplinary, preventive and community-wide focus gives the program wide reach, permitting the targeting of destigmatized access points through primary care services for families who are reluctant to participate in parenting skills programs. The available empirical evidence supporting the efficacy of the program is discussed and its implications for research on dissemination are discussed.     

Mood Management Mail Intervention Increases Abstinence Rates for Spanish-Speaking Latino Smokers

A self-administered mood management intervention program for smoking cessation provided through the mail to Spanish-speaking Latinos resulted in a 23% abstinence rate at 3 months compared to an 11% abstinence rate for a smoking cessation guide alone. Participants (N = 136) were randomly assigned to receive either the cessation guide (the Guía), or the Guía plus a mood management intervention (Tomando Control de su Vida) presented in writing and in audiotape format. At 3 months after random assignment, 16 out of 71 of those assigned to the Guía-plus-mood management condition reported being abstinent (not smoking for at least 7 days) compared to 7 out of 65 in the Guía-only condition (z = 1.8; p = .04, one-tailed). Moreover, those with a history of major depressive episodes, but not currently depressed, reported an even higher abstinence rate in the Guía-plus-mood management condition, compared to the Guía-only condition (31 vs. 11%, z = 1.8, p = .04, one-tailed). We conclude that the mood management mail intervention substantially increases abstinence rates, especially for those with a history of major depressive episodes.     

Empowering Parents: The Use of the Parent as Researcher Paradigm in Early Intervention

Whilst family-focussed models of service delivery are proving more effective in early intervention, it is the parents who ultimately carry the burden of responsibility. They often evolve their own strategies for coping with difficulties and solving problems within a family context. Through case study analysis, I report on some of the key outcomes of early intervention for families of very young children with disabilities. The analysis challenges traditional definitions of the family and suggests a recontextualisation of this concept. Similarly parental perceptions of the style of early intervention services are contrasted with those models reported to be effective by professionals. In striving for optimal effectiveness in early intervention, the unique knowledge and understanding of parents is pivotal, and ways are suggested of objectively collecting and collating that knowledge to inform practice and identify important research questions. This case study analysis has led to the evolution of the parent as researcher paradigm, and the implications for the practical implementation of this model will be considered.