CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
ASSESSING PARENT AND INFANT DEVELOPMENT
\l
IN A PROGRAM FOR HANDICAPPED INFANTS:
AN ANALYSIS OF ISSUES AND INSTRUMENTS
A thesis submitted in partial satisfaction of the
requirements for the degree of Master of Arts in
Education
Educational Psychology, Early Childhood
by
Susan L. Recchia
June, 1979
"
The Thesis of Susan L. Recchia is approved:
Rose M. Bromwich, Chairperson
California State University, Northridge
ii
'
To my godson, Anthony Frank Maul,
A most delightful infant
iii
ACKNOWLEDGEMENTS
First and foremost, I would like to thank Dr. Rose
Bromwich for her time, her help, and her inspiration in
seeing this project through.
Betsy Ringsmuth, from the on-
set of my graduate career, has been a constant source of
support.
I thank her most of all for her good humor and
encouragement.
Dr. Margaret Thompson has shared with me
her ability to bring statistical analysis to life.
Her
skill and knowledge are greatly appreciated.
The people of the Infant Special Education Project,
Judy Lewis, Trudy Latzko, and Nancy Sweet, deserve special
recognition for the long and dedicated hours that they invested in making their program a success.
I thank them for
taking the time to discuss the project with me and for
allowing me to use their data.
My parents, Frank and Mary Recchia, have provided continuous support and encouragement.
I thank them sincerely
for their respect and their faith in me.
Many thanks are
also extended to my sisters; Marilyn Recchia Maul for her
long distance ego-boosting, and Peah Recchia, for contributing her excellent typing skills.
Special thanks go to my dear friend Wendy Holloway for
listening, caring, and understanding.
And most of all, I
want to thank my husband, Bernard Feigenbaum, for sharing
in all the trials and triumphs, and encouraging me at every
step along the way.
iv
TABLE OF CONTENTS
Page
DEDICATION . . . .
iii
ACKNOWLEDGEMENTS .
iv
LIST OF TABLES . .
vi
vii
ABSTRACT
CHAPTER
1
INTRODUCTION AND STATEMENT OF
PROBLEM
. . .
. .
.
..
.......
1
...
7
Purpose of Study
Research Question
Hypotheses
2
. ..
REVIEW OF THE LlTERATURE
Parent-Infant Interaction
Intervention Programs
Analysis of Parent and Infant Measures
Su~ary of the Review of the Literature
3
METHODOLOGY . . . . . . .
........
39
Program Description
Characteristics of the Sample Population
Instrumentation
Procedure
Methodological Assumptions
Limitations in Methodology
4
50
FINDINGS
Outcomes of Present Study
Discussion
5
SUMMARY, CONCLUSIONS, AND
RECOMMENDATIONS
. . . . . .
74
REFERENCE NOTES
82
REFERENCES . . . .
84
v
LIST OF TABLES
Page
TABLE
A
MEAN AND RANGE SCORES FOR NUMERICAL
DEMOGRAPHIC DATA OF INFANTS AND PARENTS
42
B
MEAN AND STANDARD DEVIATION SCORES FOR
PBP, HOME, AND BAYLEY
51
c
RELATIONSHIP BETWEEN PBP AND BAYLEY
SCORES AT INTAKE
54
D
RELATIONSHIP BETWEEN PBP AND BAYLEY
REASSESSMENT SCORES
55
E
RELATIONSHIP BETWEEN CHANGE SCORES
FOR PBP AND BAYLEY
56
F
RELATIONSHIP BETWEEN HOME AND BAYLEY
SCORES AT INTAKE
58
G
RELATIONSHIP BETWEEN HOME AND BAYLEY
REASSESSMENT SCORES
60
H
RELATIONSHIP BETWEEN CHANGE SCORES
FOR HOME AND BAYLEY
61
I
RELATIONSHIP BETWEEN PBP AND HOME
SCORES AT INTAKE
63
RELATIONSHIP BETWEEN PBP AND HOME
REASSESSMENT SCORES
64
RELATIONSHIP BETWEEN PBP AND HOME
CHANGE SCORES
65
J
K
vi
ABSTRACT
ASSESSING PARENT AND INFANT DEVELOPMENT
IN A PROGRAM FOR HANDICAPPED INFANTS:
AN ANALYSIS OF ISSUES AND INSTRUMENTS
by
Susan L. Recchia
Master of Arts in Educational Psychology,
Early Childhood Education
This study attempted to show the relationship between
two types of parent measures representative of those used
throughout intervention programs, as well as the relationship between each of these measures and a widely used infant development inventory.
Thirteen parent-infant dyads
participating in a Home Teaching Program were assessed
with the use of the Caldwell HOME Inventory (HOME), the
Bromwich Parent Behavior Progression (PBP), and the Bayley
Scales of Infant Development at intake and after six months
of intervention.
The sample was multi-ethnic and repre-
vii
sented children with a variety of handicaps.
Individual
subscale scores, as well as total scores on the measures at
intake, at reassessment, and for change over time were intercorrelated.
Few significant relationships were found
between the parent and infant measures.
A positive rela-
tionship, significant beyond the 0.05 level, was found between the two parent measures, both at intake and at reassessment.
Several significant positive relationships
were also found between various subscales on each of the
measures.
It was tentatively concluded that the Bromwich
PBP and the Caldwell HOME Inventory are positively related.
Findings from this study supported other research which
has shown that parent involvement promotes later growth in
the child's intellectual development.
viii
CHAPTER 1
INTRODUCTION AND STATEMENT OF PROBLEM
The idea of involving parents in early intervention
programs is both relatively new and for the most part,
open to a variety of conceptual interpretations.
Until
recently, intervention dealt largely in working with
young children independent of their families, using professionals as teachers in the preschool years.
Much of
the literature focuses on programs for the disadvantaged,
such as Head Start, aimed at stimulating the child's
potential for future school success.
Later evaluation of
these programs has pointed out two variables that have
been crucial in determining a move toward a whole new
area of concentration, namely the importance of reaching
children in the very early years prior to age J, and the
importance of involving the family unit if we are to expect any continuing changes in the overall development of
the child (Bronfenbrenner 1974).
This information, paired
with recent research on the effect of parent-infant interaction on infant development (Clarke-Stewart 1973,
Goldberg 1977) has resulted in the evolution of a variety
of educational programs for very young children in which
the parent is an important component.
The concept of educational planning for handicapped
infants has developed much along these same lines.
1
2
Getting an early start and involving the parent might be
seen as even more important in the case of a child with a
mentally and/or physically handicapping condition because
of the parent's confusion in forming expectations and
understanding and coping with developmental problems
(Burge et al. Note 1) .
The. need for support and encourage-
ment in enhancing the developmental potential of these infants can be overwhelming.
Having the parent take an
active role in developing an educational plan for her child
may serve to direct some of the feelings of inadequacy
into a productive channel, while at the same time laying
the framework for the development of a positive and
nurturing relationship between parent and infant.
Historically, approaches toward working with handicapped children have developed from two sometimes opposing
schools of thought.
From the clinical perspective, these
children are often evaluated in terms of how they deviate
from the norm.
This viewpoint lends itself to dealing
with specific areas of developmental delay and the concept
of parent involvement here is often manifested in programs
designed to teach parents "how to teach" their children,
aiming at the growth of individualized measurable areas
of development.
From a child development perspective
however, the tendency is more to look at the whole child
and to focus more on what may be a normal sequence of
development for an individual infant within the structure
3
of his environment.
Here, the approach is more often to
increase the parent's awareness of her integral part in
this process.
The importance of designing tools to assess the
development of both parent and child in educational intervention programs for the handicapped is evident.
In order
to be able to establish some criterion of success we must
define and look at those variables which appear to facilitate optimal growth.
Because of the diversity in ap-
proaches to programs of this nature, however, it has been
difficult to find much consistency in either the goals
stated or the measuring devices used to evaluate whether
or not they have been met throughout documented program
reports.
Frequently, the objectives stated as those to be
achieved through participation in a particular program are
not those that are actually measured by the instruments
used.
The reason for this seems to be twofold:
there
are no standardized tools for assessing parent development,
and those for assessing infant development deal largely
with mental ability only.
Because of the convenience of
using already standardized measures, and because of the
facility they seem to lend to comparability among programs,
they are often relied on even when they do not necessarily
tie in with specific program objectives (Lewis and McGurk
1972).
Many programs have attempted to develop their own
affective measures, but these are often looking at differ-
4
ent things throughout different programs (Gordon et al.
Note 2).
Consequently, we are left with a barrage of
relatively subjective observations with no apparent way
of pulling together an acceptable scientific analysis of
program effectiveness.
Purpose of Study
For the purpose of this study, I would like to do a
closer investigation of individual intervention program
philosophies and program measures in an attempt to reveal
some recurring ideas about what seems to be most important
in promoting optimal infant development.
Despite their
sometimes major differences in presentation and approach,
one should be able to assemble some variables from different programs that could be agreed upon as educational
goals.
I want to explore whether or not some of the inde-
pendently developed "affective" or "environmental" measures
are assessing some of the same things.
Beyond that, I will
try to examine whether these variables are indeed related
to the attributes of optimal infant behavior which are
expressed in the items contained on an infant development
inventory.
My analysis will be based upon an assemblance of raw
data from an early intervention program for handicapped
infants which used both parent and infant measures.
In
this program, parents were assessed with the use of the
Bromwich Parent Behavior Progression (PBP), an individu-
5
alized parent development assessment, and the Caldwell Home
Observation for Measurement of the Environment (HOME) Inventory, an inventory of home stimulation; the infants were
given the Bayley Scales of Infant Development (Bayley) at
intake and approximately every 6 months thereafter, for the
duration of their time in the program.
Research Question
I will try to determine whether there is a significant
relationship between (A) parent measures and infant measures of development and (B) two separate parent measures
of involvement used within the same program.
The null
hypothesis will be used to examine this in a number of
ways.
Hypotheses
1.
There will be no significant relationship between
the measure of parent development as assessed by
the Bromwich PBP and the measure of infant development as assessed by the Bayley Scale.
2.
There will be no significant relationship between
the measure of home stimulation as assessed by the
Caldwell H01ill Inventory and the measure of infant
development as assessed by the Bayley Scale.
J.
There will be no significant relationship between
the measure of parent development as assessed by
the Bromwich PBP and the measure of home stimulation as assessed by the Caldwell HOME Inventory.
6
In addition to this investigation, I will examine
more closely the nature of the similarities and differences
between the measures by making an in-depth analysis of the
six different subscales on each of the two parent measures
being used.
I will also examine some of the specific de-
velopmental areas on the Bayley Scale as to whether they
appear to follow as logical outcomes of enhanced parent
involvement as assessed by the parent measures in question.
Gordon et al. (Note 2) have strongly stated the need for
more consistency in measurement across programs, in order
to evaluate effectiveness of intervention.
I hope to
contribute to this search for more effective evaluation by
examining the relationship among three evaluative measures
in the context of an intervention program.
CHAPTER 2
REVIEW OF THE LITERATURE
My literature search focuses on three major content
areas.
They are the fundamentals of parent-infant inter-
action, the nature of intervention programs and their
i~~erent
problems, and some of the parent and infant mea-
sures of development used within intervention programs.
Though the specific population used for my own investigation was comprised of infants who had a variety of diagnosed mental and/or physical handicapps, I have chosen to
review several studies which concentrated on normal or
disadvantaged children partly because these are more widely
discussed throughout the literature, and because of the
generalizability of parent-infant interaction to all parent
infant dyads.
Affective and environmental correlates play
a part in the growth of all infants, regardless of their
mental or physical developmental potential.
Throughout,
the parent will be referred to as "she", and the infant
as "he" for the sake of convenience.
Parent-Infant Interaction
The Development of Competence in Infancy
In a rather extensive report from the Harvard Preschool Project, White et al. (1976) focus on the development of competence in early childhood and the ways in which
it is affected by environmental
7
experi~nce.
They see the
8
role of the family during a child's first J years of life
as that of providing a source of language development,
curiosity, social development and the foundations of cognitive intelligence.
The family, he says, is the first
educational delivery system.
He talks about the obstacles
to parenting of young children emphasizing ignorance,
stress and lack of assistance as the most outstanding.
For the most part, White et al. (1976) see no measureable differences of competence in children until their
second year of life.
tial.
By age J, the difference is substan-
They state:
The more we have ... worked with children less
than one year of age, the more convinced we have
become that the key period when the great majority
of American children first undergo unusually supportive or non-supportive experience begins at
6-8 months of age, and by 24 months of age the
effects (good or poor) have become solidly established. ( p. 5)
They surmise that it is around the age of 6-8 months that
the infant becomes "more difficult to care for."
He is
more active and needs more restrictions placed on him for
his own safety.
Parents deal with these demands in highly
varied ways.
The authors have produced a quantitative instrument
to characterize the subsequent varying experiences of young
children, which will be discussed in the section on analysis of measuring devices.
Through the use of this mea-
sure, they have gathered and
following recommendations.
analy~ed
data which merit the
For optimal development of
9
competence, the prescription for the infant is a good deal
of social experience, encouragement to seek attention and
assistance if he can't do something on his own, a lot of
language in his environment (he should be talked to) and
minimal restriction of his space.
The three functions of
an effective child-rearer as seen by White, et al. are:
(1)
designing the child's world, which includes "child-
proofing" the living setting and maximizing access to it,
(2)
consulting for the child, which implies responsiveness
and didactic child-adult experiences, comfort conversation
and instruction, and (3)
disciplining or controlling the
child, which should be done in such a way as.to show firmness and consistency, but at the same time, love andrespect for the child's interest.
Appleton, et al., (1975) in an extensive review of the
abilities of infants at different ages, point out behaviors
which show direction, selectivity, and persistence that
seem independent of physiological drives.
They also define
the general principles involved in facilitating competence
in infants as related primarily to the environment and the
primary caretaker, emphasizing variety, freedom of exploration, an interested and responsive caretaker, childinitiated activities, and contingent stimulation as most
conducive to the development of competence.
Parent Behaviors and Attitudes
One description of those parenting behaviors which
10
contribute optimally to infant growth has been outlined by
Drezek (Note
J).
She emphasizes the importance of the
parent's involvement with the infant, describing her role
as an engager in reciprocal interaction with the baby, a
sensitive communicator who interprets the infant's full
range of communication and responds to it meaningfully, a
designer of the environment, and a play facilitator and
elaborator.
Clarke-Stewart (1973) made an extensive review of
those behaviors on the part of mothers which promote an
expected response from their infants, as verified in the
literature.
included:
Among those interactions, the following are
(1)
overt demonstration of affection is re-
lated to enhanced infant development, involvement with
mother, social and play initiative, and ability to cope'
with stress; (2)
distinctive and frequent verbal stimu-
lation by mother is related to more frequent vocalization
and greater language ability;
(J)
high amount of eye
contact between mother and infant has been observed to
lead to immediate cessation of crying and stronger tie with
mother; (4)
combined verbal and visual stimulation appears
to accelerate development and benefit adjustment generally,
and even more effectively if it occurs during play rather
than caretaking;
(5)
mother serves as both direct source
of stimulation from the environment and mediation of materials by mother is more closely related to the infant's
11
skill with objects than is mere exposure to a stimulating
environment;
(6)
deliberate and playful maternal stimu-
lation appears to have a strong influence on infant development;
(?)
mother's immediate response to infant's be-
havior has a significant effect on later occurence of the
behavior;
(8)
mother's prompt, contingent and consistent
response to infant may help the infant learn that his
behavior does have consequences and that he has some control over his environment, thus promoting motivation necessary for further learning;
(9)
infant can have an ef-
fect on the quality of parental behaviors.
Clarke-Stewart identifies a factor called "optimal
maternal care" in the following way:
Not only warm,. loving and nonrejecting [maternal
care] but ... [also] stimulating and enriching-visually, verbally, and with appropriate materials-and which, as well, was immediately and contingently
responsive both to the child's signs of distress
and to his social behaviors •.. The existence of this
factor of general maternal competence clearly
demonstrates that maternal behaviors which stimulate child development are interrelated (p.48)
According to Clarke-Stewart, the "optimal mother" 's behavior is adapted as the infant grows, appropriately becoming more responsive to social demands, more playful and
more socially stimulating over time.
The Infant's Effect on his Environment
Yarrow (1972) did a series of home observations on 5
month old infants looking at both the human and the inanimate environment.
He examined the differential effects
12
of early stimulation on infant development, commenting on
the role of the infant's personality in effecting his environment.
He states:
There is a reciprocal interaction between infant
characteristics and environmental events. It is
likely that an active and responsive infant elicits
more social response from others as well as greater
inanimate stimulation than a lethargic, withdrawn
infant (p.216).
Goldberg (1977) addresses the capacity of the infant
to support his own optimal development through those interactions with his caregiver which promote mutual feelings
of competence.
She argues that
the normally competent infant is capable of providing contingency experiences which give rise
to feelings of effectiveness on the part of parents (p.167)
She goes on to illustrate how healthy infant behaviors can
be naturally responsive and encouraging to adults and serve
as reinforcement for and motivation of adult responses.
Parent's feelings of
parental evaluations
parent perception of
behavior is probably
of interactions than
infant (p.171).
efficacy are derived from
of interactions. Hence,
infant characteristics and
a more powerful determinant
any other assessment of the
Further on, the author points out how a non-responsive or a
low-competent infant can affect the interaction:
It is important to note· that the predictable,
readable responsive infant has the potential for
"capturing" the initially unresponsive parent
into cycles of effective interactions by generating parental feelings of efficacy. Similarly,
the unpredictable, unreadable, unresponsive infant has the potential for "trapping" an initially
responsive parent in cycles of ineffective interaction by generating parental feelings of failure
1~
_,
and helplessness.
(p.1?4)
Goldberg suggests that intervention to enhance the
baby's cue giving ability and responsiveness and/or to
enhance the parents ability to read cues more effectively
might begin the cycle again, getting a more positive interaction under way.
Summary
In this section, the development of competence in infancy was discussed in terms of the interactive behaviors
of parents and their infants.
Those parental behaviors
which consistently appear throughout the literature as most
important in promoting optimal infant development were
defined.
In addition, the role of the infant in effecting
his own environment was emphasized, with some commentary on·
those behavioral attributes which may pose problems in the
normal cycle of interactive growth over time.
Following is a description of some intervention programs which take their leads from this philosophical framework.
Discussion will include the goals and gains of
individual programs, as well as some of their inherent
problems.
Intervention Programs
Program Descriptions
The Houston Program (Leler Note 4), both bilingual and
bicultural, was designed to meet the needs of the families
within the community it served--largely poor, but intact,
14
Mexican-Americans living in Texas.
Families were involved
with the center when their children were 12-36 months old.
The first year consisted of 31 home visits which lasted for
90 minutes each, language classes for interested mothers,
and family workshop sessions.
The second year, mothers
and their children were involved in a center-based program,
where the mothers took home-management and child development classes and interacted some of the time with their
children, and the fathers were involved in an evening discussion group.
The focus in family sessions was on the
real interests and needs of the community.
(Mothers
learned to drive, families joined food coops, fathers
pooled their resources, etc.)
A control group received the
community services, but no educational program.
Problems in finding good early predictors of success
for infants, as well as measures for parental behavior were
expressed by the authors.
Nonetheless, several evaluation
measures were employed, among them the Maternal Interaction
Structured Situation (MISS), a tool developed by the program staff.
In addition, the Caldwell HOME Inventory and
several language measures were used with parents, and the
Bayley Scales, Stanford-Binet, and Concept Familiarity
Index were used with the children.
Though at the time of this report the evaluation results were only in preliminary stages of sophistication,
Leler, et al. did see positive change over time.
The MISS
15
showed behavioral evidence of
(1)
more warm and affec-
tionate behavior on part of mothers,
and more praise and
verbalization.
(3)
(2)
less criticism
greater encouragement of child
Results for the HOME Inventory were sketchy
but some change was clear on
(1)
organization of physical
and temporal environment and
(2)
provision of appropriate
play materials.
The Bayley test showed no change in pro-
gram infants, but a decline among control scores.
The authors state what they feel to be some important
features of the effect of the parent-child relationship on
child competence:
parental warmth,
authorit~tive
but non-
restrictive control techniques, achievement standard setting, verbal encouragement, and intellectual stimulation.
The focus of The Birmingham Model (Lasater Note 5)
was largely on increasing later school performance through
greater cognitive, social-emotional, and physical-motor
development between 3 1/2 and 36 months of age.
The pro-
gram was center-based, for infants and mothers together,
with mothers serving first as "student teachers" and later
as "supervising teachers" as they progressed through the
program.
For the first 9 months, mothers and infants at-
tended the program half day, three days a week.
participation was 5 days per week.
Later,
Mothers were paid a
small allowance for each session they attended.
Their
function while at the center was largely working with their
own child.
16
Goals for the mothers were again in tune with community needs.
This group consisted of largely very poor,
black single mothers in Alabama.
The aim was to increase
their coping ability, as both facilitator of their children's development and as a "functional adult" in a stressful environment.
Measures of the children's development throughout the
program show more excitement, more vocalization, and more
exploration in the experimental group at 11 1/2 months.
Also shown are increasing gains in IQ scores over a four
year span, with the 4th year follow up at a 14 point difference between experimental and control groups.
Emotion-
ally, children were seen as having stronger attachments,
more exploratory behavior, and as being more friendly
toward new people.
Though all of the planned evaluation
and interpretation of results had not been completed at
this writing, Lasater predicts significantly better school
performance for the experimental group.
The New Orleans Model (Andrews Note 6) focused once
again on mothers, with the intention of increasing their
knowledge and understanding of child development and changing their behavior in the direction of the development of
competenc_e in their children.
It provided two separate
models in intervention--one center-based and the other
home-based.
The children were between 2 and 36 months old,
and all families were low-income, inner-city blacks in
17
Louisiana.
Paraprofessional educators were used in both
groups.
A mother-child interaction scale was used to evaluate
this program.
Mothers were observed with their infants
every six months, and rated on these eight behavioral dimensions:
.
positive maternal techniques, negative maternal
techniques, initiator of activities, amount of child's
language, positive uses of mother's language, negative
uses of mother's language, amount of mother's language, and
maternal encouragement/discouragement of child's activity.
Findings showed no evidence of change over time with the
home-based model.
The center-based model, however, showed
a definite effect on both mothers and children.
At 12
months, the differences were not significant, but by 22
months, and even more so by 36 months, center mothers were
found to be more sensitive, accepting, cooperative and
responsive.
They used richer and more elaborated language
with their children, and talked to them more.
They were
more encouraging in child-initiated activities and used
more positive techniques in interaction, including active
participation, general conversation, information giving,
labelling, facilitating child's activity, positive control,
affection, and praise.
One interesting finding emphasized in this study was
that change in the mothers was found to precede change in
the children.
It was only after the mothers became more
18
involved with and sensitive to them that we saw a significant change in the children's development.
The large dif-
ference found between the center-based and home-based
models was speculatively attributed to the power of the
center's group dynamics.
Here mothers had the support and
friendship of other women like themselves, going through
similar problems.
Merle Karnes (1970) directed a program over a 15 month
period in which mothers of disadvantaged infants received
home intervention.
Infants were between 12 and 24 months
old at the time of intervention, and mothers were paid to
attend special meetings where transportation was provided
and toys were donated to their babies.
The emphasis of the
mother's discussion groups was on working with the mothers
to develop
children,
(1)
(2)
a good working relationship with their
a positive approach,
(3)
the ability to
break tasks into steps for their children, and
(4)
the
ability to refrain from scolding, e.g. if a child is not
ready to do a task, simply try later.
It was felt that
reaching the mothers was of utmost importance in changing
their influence over their children.
The author states:
Programs which train the mother to serve as the
agent for intervention hold potential for developing her self-help capabilities and sense of
personal worth, pivotal factors in effecting
broader changes within the disadvantaged family
(p.934).
After 15 months, the experimental subjects scored significantly superior to two different control groups--one a
19
matched sample from the community with no intervention, the
other, sibling scores before the intervention took place.
The Ypsilante Carnegie Infant Education Project
(Weikart 1974) was based on two major assumptions:
(1)
Preventative programming must start earlier than current
preschool efforts since the essential framework for intellectual growth is completed by age three and
(2)
Preven-
tative intervention has unusual potential for success when
provided as a home teaching program for both the mother and
her infant.
This program used school teachers as their
visitors, who spent 1 hour per week in the home.
were organized around five points:
(1)
programming for each mother-child dyad,
of the mother's teaching style,
mother's language style,
control techniques and
(4)
(5)
(3)
Visits
individualized
(2)
development
development of the
development of the mother's
direct tutoring of the child.
The key element of concern here was that the mother
stimulate and support her infant's growth, and this end was
always kept in mind.
Teachers were seen as facilitators of
·the responsive relationship between mother and infant, supporting the vital interest a mother has in her child by
helping her to achieve success in some activity with the
baby.
Data collected was both qualitative and quantitative
in nature, including observation of and program plans for
individual mother-infant dyads, as well as Bayley scores
for the infants.
A change over time was seen in the latter
20
scores.
Weikart points out a very important aspect of planning for intervention programs that is not often seen-that of observing the mother-infant interaction before
planning the program.
to look at:
Those items they deem most important
mother's attitude toward child's intellectual
development, her understanding of the growth process, the
way she reacts to his experimentation, alternatives known
and used by her in language training, amount of infant stimulation, behavior controls, and expectation for performance.
An instrument was developed specifically for use
in this program, to facilitate and systematize the process
of understanding these mother-child factors.
It will be
discussed further in the section on analysis of measurements.
Problems in Intervention
Bronfenbrenner (1974) takes a rather extensive look at
the status of existing intervention programs, attempting to
answer the question of whether early intervention really
can have enduring effects.
He talks about the limitations
of available data, regretting that the only comparable measures are IQ scores.
He also looks at the families of the
"disadvantaged", those most often served by such programs,
and points out the importance of providing more than just
an educational program for their children if we are to expect any continuing changes in the effects of deprivation.
21
The intervention programs that held the greatest gains for
children over time were those that started in the first two
years of life and directly involved the parents in the
teaching process.
Speaking on one such program,
Bronfenbrenner states:
... reciprocal interaction between mother and child
involves both cognitive and emotional components
that reinforce each other. When this reciprocal
interaction takes place in an interpersonal relationship that endures over time (as occurs between mother and child), it leads to the development of a strong emotional attachment that, in
turn, increases the motivation of the young child
to attend to and learn from the mother. It is
important ..• that this process be reinforced when
the child's dependency on the mother is greatest-that is, in the second year of life (p.460).
Ira Gordon et al. (Note 2) have also investigated
several early intervention programs, describing them in
terms of their approach, delivery, goals and objectives,
target populations, and evaluation procedures.
In their
overview, the authors point out three very important variables that they feel contribute to the sucess of intervention.
They are
early years,
(3)
(2)
(1)
approaching children in the very
focusing on the home environment, and
involving parents as teachers of their children.
overall objectives seen for parents were (1)
skills in teaching the child, (2)
The
improving
improving responsiveness
and sensitivity to the child and (3)
improving the home
setting, particularly in relation to nutritional and health
arrangements for the child.
Objectives for children gen-
erally covered cognitive, psycho-motor (for 0-3 years) and
22
social-personal gains, in that order.
Again, the lack of
good measurement devices was emphasized, particularly in
the affective domain.
The need for parent measures was
also strongly stressed.
Gordon et al. note the lack of
commonality ih measures being used among individual programs, and the problem this presents for any effective comparison of programs.
At the same time, however, they warn
against the dangers of overriding local considerations with
standardized measures.
They state:
Informal evaluation sometimes yields more useful
data than some of the quantitative measures which
are required by funding agencies (p.II-9).
While the authors seem to feel that as yet the majority of
programs are not measuring what they set up as objectives,
they are hopeful that they are on the right track.
They
conclude:
In spite of the gaps between objectives and measurement and the lack of elegant research design,
the general thrust of these programs suggests that
they are bringing about useful changes for parents
and children (p.II-8).
Karnes and Teska (1975) reviewed a variety of early
intervention programs, pointing up some of their inherent
problems and suggesting further areas for investigation.
One of their biggest criticisms of programs is their emphasis on looking at immediate outcomes only.
They state
a real lack of any good longitudinal data, attributing this
at least partly to funding patterns, which distinguish between infant (O-J) and preschool (J-5) research.
They also
23
state a lack of hard data on what actually transpires in
the classroom on a day-to-day basis--the process.
They
state:
While program developers had interests in
areas beyond cognitive-language development and
academic-readiness achievement, they tended to
focus their measurement efforts in these restricted
areas (p.202).
After reviewing several programs, the authors conclude:
We maintain our belief that the period of infancy, when development is occurring at its highest
rate, is the crucial time for the initiation of
intervention. Data to support such a belief have
not been generated, especially because of the dearth
of longitudinal data concerning sustained intervention at different age levels (p.209).
The areas that the authors emphasize as needing further investigation are partially listed as follows:
need
to look at actual events which occur in the classroom, actual behavior of the children, what events may produce
cognitive gains; must look more at intermediate and longterm effects of programs; need to look further into the
variety of delivery systems and begin to evaluate them;
transactional observation is needed in teacher-child and
parent-child interaction; and the program antecedents must
be evaluated more closely--if there are differences among
families at the entry level, we must expect to see different levels in the effectiveness of the programs.
A more current body of knowledge regarding some longterm findings from early intervention programs has been
compiled by Brown (1978).
Ninety-six major studies are
24
represented as reporting positive impacts from intervention
programs.
Brown cites the existence of a "sleeper effect"
in describing how children who had gone through programs
such as Head Start in the preschool years showed a drop in
their early gains in IQ scores once they reached the first
grade.
Further study has shown however that by the 4th
grade, the IQ scores for these children are significantly
superior to those of matched controls who received no
intervention.
Nonetheless, these children still test below
the normal population in their age group.
The contributors to Brown's book address themselves to
some of the continuing· problems in organizing and evaluating programs for early intervention.
Because most pro-
grams have primarily a service function, i.e. to foster
child development, evaluation is usually given second priority.
Field conditions are not set up for "research"
specifically and evaluation designs are often less than
ideal.
It may well be that the rigors of science can at
times work against the overall benefit of a program for its
families.
It is sometimes difficult to find an acceptable
balance between fostering interactive human growth and
pursuing rigorous scientific analysis.
Brown also comments on the problem of continual use of
achievement and IQ scores as measures of success, despite
their suspect validity in representing a child's basic
level of competence.
Though it is be.lieved that parent
25
involvement plays a large part in affecting the course of
a child's development, this remains difficult to document
impressively with "hard" data.
It is concluded however
that:
The evidence to date indicates that knowledgeable
and skillful parenting is the most effective and
economical means for fostering the optimum development of the child. Active participation by
family members is· critical to the long-term success
of any intervention program (p.5).
The development of more sensitive measures of change
in parents and children is sorely needed, as well as more
follow-up and more long-term studies if we are to discover
whether programs can create a relatively permanent change
in the environment of the home, thus offering a continuing
impact on children and their siblings.
Summary
A variety of intervention program formats was presented in this section, discussing their goals and their
reported gains over time.
An array of problems involved in
designing and carrying out such programs was addressed,
with a particular emphasis on the area of measurement.
As stated in the literature, the trend in intervention
is definitely toward working with younger children and
within the family unit.
uation is evident:
The problem this poses for eval-
We need new and more sensitive measures
for parents and for very young children which can tap those
same areas of developmental change that are seen as most
important in promoting optimal growth.
26
What follows is a presentation of some of the measures
that have been developed within individual intervention
programs with the hope of coming closer to a realization of
this goal.
Additionally, the nature of infant testing will
be discussed.
Analysis of Parent and Infant Measures
Parent Measures
The Ypsilante Carnegie Picture Sorting Inventory
(YPSI) was put together by Weikart, Bond and Lambie (1974)
for use in their early intervention program (described
above).
It consists of 122 drawings of infants engaged in
a wide variety of motor, cognitive and verbal activities.
Each picture is presented to the mother and she is asked
to describe the activity, to say whether she thinks her own
child has ever done it, and if she thinks he will do it in
four months.
The advantages that the authors saw in this
measure were its immediate diagnostic provision of information, and the possibility it provides to directly measure
the accuracy of the mother's observations and to see how
realistic her expectations are.
Results are compared with
actual Bayley performance of the child at immediate time of
YPSI, and again four months later.
The Maternal Interaction Structured Situation (MISS)
was developed by Leler et al. (Note 4) specifically for the
Houston Parent Child Development Center.
Mother and child
are videotaped in a structured interaction situation.
27
Their behavior is scaled and analyzed from the recording.
Variables looked at include the mother's affect, control,
and use of praise, and the child's interest and involvement
in the situation.
Videotaped samples are obtained prior to exposure to
the In-Home Curriculum, providing a baseline measurement;
again at age two, prior to the In-Center Program; at age
three, upon completion of the two year program; and at age
four, as a follow-up procedure.
Behaviors of interest in
the child are competence-seeking behavior and patterns of
cooperation.
The MISS procedure consists of:
(1)
book task--
mother is instructed to help her child learn from the book
(all age levels)
(2)
semi-structured teaching task--
mother is not given a specific goal, but merely instructed
to help her child learn from the toys involved (all age
levels)
(J)
structured teaching tasks--sorting and block
design tasks (ages 2, J, and 4)
(4)
free play situation
(all age levels).
Measurement consists of a set of rating scales.
The
rater views the tapes for a one-minute period, then rates
the interactions for all scales across a coding sheet.
Seven scales are used for evaluation:
Mother's Affection-
ateness, Use of Praise, Use of Criticism, Control of Child
Behavior, Use of Reasoning with Child, Encouragement of
Child's Verbalization, and Child's Verbal Communication.
28
Seven more scales are used to describe aspects of the
interaction which provide a context for interpretation of
scales one through seven above:
Mother's Interest in
Situation, Child's Interest in Situation, Mother-Child Interaction, Child's Enjoyment of the Situation- Typica,
Child's Enjoyment of Situation- Low Point, Child's Enjoyment of Situation- High Point, and Child's Engagement in
Activity.
The Caldwell (Note ?) Home Observation for Measurement
of the Environment (HOME) Inventory samples aspects of
quantity and quality of social, emotional, and cognitive
support available to a young child within his home.
It
claims to provide a more accurate assessment of the learning environment than the more widely used SES, and to help
to pinpoint areas in which intervention is needed.
One-
third of the items are based on interview, the other twothirds are observed.
Scoring is of a binary mode
(either/or).
Inventory items are divided into the following six
categories:
1.
2.
J,
4.
5,
6.
Emotional and Verbal Responsivity of Mother
Avoidance of Restriction and Punishment
Organization of the Physical and Temporal
Environment
Provision of Appropriate Play Materials
Maternal Involvement with Child
Opportunities for Variety in Daily Stimulation
The assessment is made in the home, when the child is
awake, and normally takes about one hour.
The author
,,
29
recommends that the interviewers be "good"--objective and
accepting, non-threatening, and reassuring.
done during the
inte~riew
All scoring is
and before leaving the premises.
The author reassures us that this tool is not so much
appraising the caregiving abilities of the mother as assessing the home environment from the child's perspective.
The score consists of the total number of "yes" items
out of a possible 45.
The Bromwich (Note 8) Parent Behavior Progression
(PBP) assesses parental behavior in parent-infant interaction that enhances cognitive and affective development of
the infant.
Variables of parental behavior deemed favor-
able to infant development are organized into a sequence of
six levels which can later be used as a guideline in formulating short term goals for changes in parental attitudes
and behaviors.
This assessment is based on three under-
lying assumptions:
(1)
Infant-parent interaction is a truly reciprocal
process, the behaviors of each affecting the
other's responses.
(2)
The prime requisite for the infant's optimum development is a mutually satisfying relationship
between parent and infant.
(3)
The parent gains competence as she enjoys her
baby's increasing responsiveness to her successful efforts in motivating the infant's growth-
JO
promoting activities.
The six levels of the PBP are as follows:
1.
2.
J.
4.
5.
6.
Parent enjoys being with her infant.
Parent is a sensitive observer of infant, reads
behavioral cues accurately, and is responsive to
them.
Parent engages in a quality and quantity of interaction with infant that is mutually satisfying and
provides opportunity for development of attachment
and the beginning of a system of communication.
Parent demonstrates an awareness of materials, activities, and experiences suitable for infants
current stage of development.
Parent initiates new play activities and experiences suggested to or modeled for her.
Parent independently generates wide range of developmentally appropriate activities and experiences, interesting to infant, in familiar and new
situations and at new levels of infant's development.
For each level there are several criterion behaviors •. The
number of these behaviors shown or reported by the parent
.
determines how she is rated on each of the levels on the
Progression.
Levels 1-4 of the PBP can be used to assess parentinfant interaction in any family.
Levels 5 and 6 however,
are designated for use in intervention programs.
The goal
is to help the mother (or primary caregiver) to become independent in her ability to act as an effective change
agent in her infant's developmental progress.
The advantages in using the PBP as stated by the
authors include the following:
it is flexible in its scor-
ing, so that different parental behaviors reflecting the
same objective can earn the same score; it acts as a goalsetting device in intervention, adaptable to individual
J1
parent-infant dyads; and it focuses on providing a base for
ongoing quality in the parent-child relationship.
Infant Measures
Two measures which have been developed and used by
White et al. (1976) to look at parent-child interaction are
the Manual for Adult Assessment Scales and the Human Interaction Scale (by Jean Carew Watts).
The former is designed
to measure competence in children, based on the behavior of
their caregivers.
Child-adult interactions are observed
and recorded as either adult-initiated or child-initiated.
Environmental effect on the child and adult encouragement
of competence are evaluated in accordance with a separate
scale.
The Human Interaction Scale is a continuous, detailed
observational record.
The observer follows the child with
a tape recorder and a stop-watch, timing and recording behavior and surrounding events much like "a commentator who
reports a.ball game."
The measure is designed to assess a
child's quantity and quality of interaction with people in
his environment.
Five dimensions comprise the scale:
quality ·of interaction, initiation, encouragement, technique of interaction, and compliance.
Raw data are col-
lected by recording interactional units of time for each
10-minute protocol.
Major dimensions of the scale differ-
entiate between children who are developing above average
versus those developing below average by age
J.
J2
The Bayley Scales of Infant Development is the most
widely used infant measure throughout intervention programs.
There are two separate rating scales, the Mental
Scale and the Motor Scale (though many programs now use
only the Mental Scale).
The Mental Scale consists of 16J items which measure
responses to visual and auditory stimuli, manipulation,
play with objects, responses involving social interaction,
discrimination of shapes, memory or object constancy,
simple problem solving, naming objects, understanding
prepositions, and the concept of the number one.
The Motor Scale consists of 81 items looking at:
gross-motor abilities--sitting, standing, walking, stair
climbing; and fine-motor
abilities-~grasping
objects of
various sizes.
Social behavior relating to activity level, responses
to objects, sensory areas of interest, attention span,
persistence, and endurance can be observed and rated by
the tester.
The test is designed to be given to infants between
the ages of 2-JO months.
Scoring consists of a Mental
Measure, a Motor Measure, and behavior ratings.
Thus far,
there is no data to show the validity of the Motor Scale or
the predictive validity of the Mental Scale, but the Bayley
has been appraised as being able to establish the current
developmental status of an infant in relation to others
JJ
his age (Collard 1975).
The Nature of Infant Tests
McCall (1973) reports an inquiry into the stability
and proper interpretation of mental assessment in the early
years.
One area which he strongly emphasized was that of
the parental behavior correlates of IQ change in children.
He picks out several variables in the home environment
which he feels must be taken into consideration when looking at IQ scores over time.
He sums up this idea in the
following words:
Children who evidenced predominantly decling
IQ patterns in the preschool years tended to come
from homes which did not make an attempt to accelerate or stimulate them and which had either very
severe or very mild punishment regimes. In contrast, children showing increases in IQ until
approximately age 8 came from homes which emphasized
the acceleration of their child in an encouraging
and clear manner, but with structure and enforcement (p.56).
Reviewing how and why infant tests are being used,
Ames (1967) points out the importance of looking at what
most so-called infant intelligence tests are really measuring.
Because these tests focus on developmental be-
havior, she maintains they should be correlated not to
later tests of intelligence, but to later tests of behavior.
She also brings to light the problems involved in using a
flat Developmental Quotient (DQ) score as a meaningful
standard figure to check statistically the relation of
early behavior to later behavior.
A random DQ of 100 can
be attained in different ways by different test subjects.
34
In addition, Ames reminds us that there are many aspects of
an infant's behavior which are not at the present time
tapped by specific test items.
Kamii and Elliott (1973) talk about the various problems within the state of the art of evaluation
They mention three
uation as follows:
prere~uisites
(1)
techni~ues.
for good summative eval-
a match between program objectives
and the content of instruction,
(2)
a match between the
content of instruction and evaluation instruments used, and
(3)
a match between the program objectives and the evalu-
ation instruments.
Unfortunately, many programs are lack-
ing in one or more of these matches.
Comparative evaluations pose even more problems, among
them:
(1)
data bearing the same name are not necessarily
comparable between programs,
(2)
there appear to be sev-
eral assumptions regarding what constitutes appropriate
evidence of learning and development, and
(3)
some di-
mensions of development are not included in the list of
objectives in all programs being compared.
Two major areas in which the authors recommend further research before summative and comparative evaluations
can be made
ade~uately
in early childhood programs are in
the conceptualization and evaluation of program objectives,
and the development of better measurement
techni~ues
to
determine what various programs have accomplished in relation to their objectives.
f·
'
__ _
,
35
Lewis and McGurk (1972) address the issue of the lack
of predictive validity in measures of infant intelligence.
Despite the established evidence of this deficit, such
tests are still widely used in clinical settings, assuming
that they are valuable in assessing the overall health and
developmental status of babies at the time of testing,
relative to other same age babies.
The authors feel this
is justified if the scores are regarded as measures of
present performance only, and not as indices of future potential.
They argue very strongly, however, against the
use of such scores as criteria in evaluating the efficiency
of infant intervention programs.
In support of this
argu~
ment, they have launched a research project comparing the
scores of 20 infants on the Bayley scales to scores on the
Escalona and Corman object permanence scale.
The authors
conclude:
Our data ... cast doubt on the notion that
scores on infant intelligence scales can be generalized beyond the particular set of abilities
or factors sampled by the items administered at
the time of testing (p.1176).
They also claim that infant intelligence scales are thus
unsuitable instruments for assessing the effects of specific intervention procedures.
Stott and Ball (1965) did an extensive review of
existing early intelligence tests.
Of all the infant tests
studied, they found the Bayley to be "the most adequate
mental testing program at the infant level yet to appear"
36
(p.?J).
One general comment they had regarding infant
testing was that to have any merit, prediction "must be
based on more knowledge about the individual than most mental tests now available can give" (p.77).
One very im-
portant closing comment:
Perhaps one of the reasons for the lack of
"predictive validity" of infant tests is that
babies, as a result of wide variations in environmental stimulation, acquire varying degrees
of ability within the limits of their developed
capacity; tests measure the acquisition of the
abilities rather than the capacity (p.1J8).
Summary
This section described several parent measures that
have been developed for use in intervention programs, along
with the most widely used measure for infant development
across programs, the Bayley Scale.
Further discussion
focused on the nature of infant testing, including the
problem of establishing predictive validity for tests at
so early a stage in development, as well as the question of
whether infant intelligence measures really tell us enough
about overall development to be considered truly valuable
in evaluating even short-term growth in some areas.
Summary of the Review of the Literature
The literature reviewed here serves to clarify, support and validate the ideas expressed in Chapter 1, which
form the foundation for the investigation described in the
following sections of this report.
Discussion centered
around the three main topic areas of (1)
parent-infant
37
interaction,
(2)
intervention, and
the development of programs for early
(J)
an analysis of some of the measures
used within such programs.
The idea of beginning the intervention process early
for children at risk for developmental delay, and of involving the parent in that process, has been repeatedly
emphasized as crucial in promoting optimal development.
Several programs which have evolved over the past decade
based on this philosophy have shown positive outc·omes in a
variety of ways.
Until now, however, comparability among
these programs has been difficult to establish due to their
differences in goals and objectives stated, as well as the
variability among measures used to show effectiveness,
particularly in the area of parent growth.
Though infant development has been measured more consistently throughout programs, particularly through the use
of the Bayley Scales, some question remains as to whether
this tool is a sensitive enough indicator of change in all
areas of infant development.
Further, the Bayley Scale has
shown no predictive validity, and though it does seem to
indicate deviations from normal development for same age
infants, it was designed as an index for use with normally
developing infants rather than specifically for use with
the developmentally delayed population so often found in
intervention programs.
As it appears to be the best mea-
sure available, however, it continues to be used.
J8
Despite the myriad of problems yet to be resolved in
the planning, execution, and evaluation of infant intervention programs, the majority of authors cited seem to
hold some very fundamental beliefs in common.
Among them
is the idea that the interaction of the home environment,
the parent's involvement with her child, and the infant's
response to both of these promotes positive growth and
change over time.
CHAPTER 3
METHODOLOGY
The analysis presented here is based on data obtained
from an ongoing program (see below).
The population sample
will be described, with particular attention paid to demographic variables.
The use of the evaluative measures
focused upon in this study was an integral part of the program's plan and the data from these measures were obtained
by the program staff.
Some analyses were performed on the
data by the program's own external evaluator.
The research
problem presented in this report bears a relationship to
this previous work.
Program Description
The Infant Special Education Project (ISEP) was a
program of the Family Development Center of the Family
Service Agency of San Francisco, California (Lewis, et al.
Note 9).
It began in 1975 and continued through June,
1978, and was funded by a three year demonstration grant
from the Bureau of Education for tne Handicapped, U.S.
Office of Education.
Assistance was provided for parents
and their infants with handicaps or developmental difficulties for whom early education might mean a reduction or
prevention of learning problems.
gram before 18 months of age.
Infants entered the pro-
Parents were given a choice
of a weekly home teaching and therapy program or a main-
39
40
streamed daycare program five days a week.
There were no
age or educational prerequisites for parents.
Though the
program gave priority to low-income families, it was open
to those who qualified at higher SES levels.
Data analysis for this report was limited to the homebased program only.
The ISEP coordinator visited families
in the Home Teaching Program on a weekly basis or as needed
and spent one to one and one half hours working with the
parent and child together.
When appropriate, the coordin-
ator was accompanied by the social worker or one of various
therapists.
Teaching suggestions were left with the par-
ents to be worked on with their child during the week.
Ongoing consultation was provided by physical, occupational and speech therapists and by a child development
specialist, pediatrician and child psychiatrist as appropriate to individual needs of families.
Characteristics of the Sample Population
Data is based on scores for 13 infants, 5 female and
8 male, and their families served by the Home Teaching Program.
Though the sample is small, there is variety repre-
sented in its ethnicity, primary language used in the home,
employment status of the parents, and handicapping conditions of the infants.
In the child population, 4 were Caucasian, 2 Black,
1 Spanish, 1 Philipino, 1 Greek, 1 Arabic, and 3 were of
ethnically mixed backgrounds.
The primary language used
41
in the home was English for 9 of the 13 families, with the
remaining having Spanish, Philipino, Greek and Arabic
spoken.
Most were nuclear families, with the exception of
one extended family, and one single mother.
Only the sin-
gle mother was employed, with the other 12 mothers in the
home on a full-time basis.
Half (6) of the fathers were
employed, half (6) unemployed at intake.
Handicapping conditions for children were 3 at risk
for developmental delay, 2 Down's Syndrome, 2 hydrocephalic
and crippled, 1 failure-to-thrive, 1 speech impaired, 1
blind, 1 neurologically damaged, 1 Cri du Chat, and 1 undiagnosed developmental delay.
Demographic data concerning child and parent age at
entry, parental education, and number of siblings is presented in Table A below.
Instrumentation
Program parents were assessed by the Caldwell Home
Observation for Measurement of the Environment (HOME) Inventory as a measure of stimulation in the home and the
Bromwich Parent Behavior Progression (PBP) as an index of
parent development, at intake, and at approximately 6-month
intervals thereafter.
Only parents who received both tests
at least once were included in the sample. *
* Only
Infants were
mothers were assessed with the parent measures as
they were the primary caregivers for all program infants.
42
TABLE A
MEAN AND RANGE SCORES FOR NUMERICAL
DEMOGRAPHIC DATA OF INFANTS AND PARENTS
Demographic
Variable
Mean
Child's Age
at Intake
in Months
Range
Number
Sampled
1/2-18
13
Mother's Age
at Entry
in Years
27.85
18-43
13
Mother's
Education Level*
at Entry
1.85
1-4
13
26-52
12
Father's Age
at Entry
in Years
Father's
Education Level*
at Entry
1.67
1-3
12
Number of
Siblings**
1.31
0-3
13
*
Educational level was rated on a four point scale as
follows:
1= Some high school, 2= High school graduate,
3= Some college, and 4= College graduate.
** Infants #9 and #10 were siblings, and infants #13 and
#14 were each one of twins.
43
assessed by the Bayley Scale at these same intervals.
All
instruments were given in the home by the Special Education
Coordinator.
The Caldwell HOME Inventory (described in Chapter 2),
is based on both interview and observation.
It requires
no previous knowledge or observation of the parent-infant
relationship.
The entire inventory can be carried out and
scored within one home visit.
It is recommended, however, that the PBP not be used
until the home visitor has had the opportunity to get a
good sense of the parent's feelings toward her child and
has observed her interactions with him across situations.
Accordingly, the initial PBP assessment is generally not
complete until after the third home visit (Bromwich Note 8).
The PBP scores referred to as
~intake~
scores here will be
those of the first assessment.
The Caldwell HOME Inventory
This measure consists of 45 yes/no items which are
divided into six subscales.
Total scores as well as in-
dividual subscale scores were recorded for all 13 families
at intake, and for 8 families as a second assessment approximately 6 months later.
The number of items contained
in each SMbscale varies, with the total possible scores as
follows:
Subscale I-- 11 points, Subscale II-- 8 points,
Subscale III-- 6 points, Subscale::::r:v---- 9 points, Subscale
V-- 6 points, and Subscale VI-- 5 points.
The total number
44
of points possible is 45.
The Bromwich PBP
Though this measure is also divided into six subscales
the scoring procedure for the PBP is not of a binary mode.
The six different scoring areas are seen as levels in a
parental development sequence.
Each level merits a score
of 0, 1, 2, or 3, depending on the number of behaviors exhibited by the parent regarding that stage in the developmental progression.
Observation and report by parent in
the context of discussion are used in scoring, but only a
portion of the criterion behaviors referenced for each
level need to be achieved to obtain even the highest score
(3) on any subscale.
Each subscale score and the total
point score was recorded, the highest possible score being
18.
All 13 families received an intake score, and though
12 families were assessed with the PBP at least twice, only
scores for those 8 parents who were assessed with both measures at 6-month intervals will be included in the analysis
of change.
The Bayley Scale
The full Bayley test, both the Mental Scale and the
Motor Scale, was administered to all sample infants at the
same testing intervals used for the parent measures.
Scoring on this measure consists of the total number of
passed items as a raw score for each scale, which is later
converted to a Mental (MDI) or Psychomotor (PDI) Devel-
opment Index as a function of the child's age.
It is
recommended that in the case of exceptional children, an
age equivalent score be used rather than the MDI or PDI,
as it is a more direct estimate of effective level of
functioning (Bayley 1969).
The ISEP intervention staff computed MDI and PDI
scoring on the Bayley scale for those children for whom it
was appropriate (scores greater than 50).
Age equivalents
were also indicated for all infant's scores.
The Bayley scale has been broken down into nine separate subscales in determining a developmental profile.
Developmental profiles were prepared for all program infants using mean developmental age equivalents for each
area tested.
The nine areas indexed are:
Sensory, Gross-
Motor, Fine-Motor, Exploration, Competence, Social-Relatedness, Imitation, Perceptuo-Cognitive, and Language development.
Procedure
The relationship between the HOME Inventory and the
PBP was examined by comparing
each of the two measures,
(1)
(2)
of ongoing intervention, and
the intake scores on
the scores after 6 months
(3)
over the 6-month time interval.
the change in scores
An analysis was done for
total scores and for individual subscale scores, comparing
each of the six subscales on one measure with each of the
six subscales on the other.
46
Additionally, scores on five of the nine subscales
from the Bayley Developmental Profile were examined in
relation to the subscales on the parent measures at intake,
and 6 months later.
The change in Bayley Developmental
Profile mean age equivalents between intake and the first
interval in intervention was also compared to the change in
subscale scores over time for the two parent measures.
Mean and standard deviation scores are shown for all measures.
The Bayley subscales analyzed include:
Explo-
ration, Competence, Social-Relatedness, Perceptuo-Cognitive, and Language.
These five were chosen over the others
as they appeared to be most related to parent involvement
as shown in the literature.
Statistical Analysis .
An intercorrelation matrix was done for each of the
three sets of data;
scores, and
(3)
(1)
intake scores,
(2)
reassessment
change scores, using the Pearson corre-
lation computer procedure of the Statistical Analysis
System (SAS) (Barret al. 1976).
This procedure computes
a correlation coefficient for each possible pair of scores.
Where there is missing data on either of the two values
being computed, as was the case with some Bayley scores,
that individual score relationship is omitted from the
computation.
The correlation coefficients indicate the degree of
the relationship between two scores.
The direction of the
relationship, positive or negative, is indicated by the
sign of the coefficient.
In order to provide a comparable score on the Bayley
Developmental Profile, the mean age equivalent score was
divided by the chronological age of the child at the time
of testing, before the computations were performed.
Level of Significance
The level of significance used for the study was 0.05.
Probability values of 0.05 or less will be accepted as
significant.
Methodological Assumptions
The following assumptions are made in accepting the
instrumentation and data analysis described above as the
basic working mechanisms for this study:
(1)
It is assumed that the scales used are valid,
i.e. that they measure what they intend to measure, namely that the HOME scale measures stimulation in the home environment, that the PBP
measures the growth of parent behavior, and that
the five Bayley Developmental Profile subscales
measure those areas of infant development for the
population in question.
(2)
It is assumed that these measures are comparable
despite the differences in the scoring procedures
used on the various tools in question.
48
Limitations in Methodology
The ISEP was primarily a demonstration project and a
service oriented program, not a research study.
As in all
BEH funded projects, evaluation of program effectiveness
was built in.
Some of the limitations of this analysis
using the data from a demonstration project rather than a
research study are described below.
Sample Size and Variety Within the Sample
One cannot claim that a small sample, such as the one
used for this study, is truly representative of handicapped
infants and their parents.
Attrition rates and follow-
through problems reduce the sample size further,
leavi~g
us
in this case with only 8 subject's scores for the analysis
of change over time.
The great variety in the infant's
handicaps makes it difficult to compare scores on infant
and parent measures even within the sample studied.
This
further complicates generalizing results to a larger population.
Control Group
The absence of a matched control group receiving no
intervention weakens the impact of results of change over
time, no matter how impressive the data may be, as one has
nothing to compare them to.
The use of control groups in
programs of this nature is difficult, however, because of
ethical considerations.
One cannot easily justify denying
a selected group of parents and infants a potentially bene-
49
ficial service.
Objectivity in Scoring
Using the program coordinator to do both the intervention and the testing with families casts doubt on the
objectivity of testing and the reliability of test scores.
Age Consistency for Infants
In order to serve as wide a population as possible,
the only age stipulation for infants entering the ISEP was
that they be under 18 months old.
Consequently, there is
no age consistency for infants in evaluating the effects of
parent-infant relationships with the parent measures used.
Further, no adjustments are made on the parent measures for
the item content, the assessment procedure, or the scoring
system when assessing parents of different aged infants.
This leaves some question as to the internal validity in
comparing the scores these measures produced.
CHAPTER 4
FINDINGS
Results of the correlational computations performed on
the data will be presented here, with an indication of
which correlation coefficients were found to be significant at or beyond the 0.05 level.
Findings will be dis-
cussed in terms of each of the three null hypotheses previously stated, and these hypotheses will be accepte,d or
rejected based on relevant data.
Previous findings rele-
vant to this study will be presented to facilitate the
interpretation of these results.
Outcomes of Present Study
Mean and standard deviation scores were recorded at
intake, at the first 6-month reassessment, and for change
over time on all measures.
These computations are shown
in Table B.
The most dramatic changes shown were those on PBP
Level 4-- "Parent demonstrates an awareness of materials,
activities, and experiences suitable for infnat's current
stage of development;" on HOME Subscale IV-- Provision of
Appropriate Play Materials; and on the Bayley area of
Language Development.
Hypothesis 1
There will be no significant relationship between the
measure of parent development as assessed by the
50
I'
TABLE B
MEAN AND STANDARD DEVIATION SCORES
FOR PBP, HOME, AND BAYLEY
INTAKE ( n=TJT~~-
REASS-ESSMENT (n=B}- CHANGE (n=8J**
Mean
S.D.
Mean
S.D.
Mean
S.D.
Level 1
1.54
0.78
2.63
0.74
0.88
0.99
Level 2
1.46
1. 20
2.25
1.16
0.75
0.89
Level 3
1.08
0.64
2.00
1.20
0.88
0.83
Level 4
0.46
0.52
1.88
1. 25
1.38
0.74
Level 5
o.oo
o.oo
0.75
1.16
0.75
1.16
Level 6
o.oo
o.oo
0.13
0.35
0.13
0.35
Total
4.54
2.60
9.63
5.04
4.75
3.33
PBP
*Not all infants were scorable at intake on all Bayley subscales. The sample
number for Exploration and ]i>ierceptuo-Cognitive was 12. The sample number for
C:ompetence was 8.
**Only 5 change scores were shown on Competence, as 3 of the 8 reassessed had
no intake scores.
V\
~
1_
TABLE B (continued)
INTAKE (n=13)*
REASSESSMENT (n=8)
CHANGE (n=8)**
BAYLEY
Mean
S.D.
Mean
S.D.
Mean
S.D.
Exploration
0.72
0.26
0.79
0.18
0.07
0.18
Competence
0.65
0.27
0.79
0.18
0.05
0.12
Social-R'elatedness
0.61
0.34
0.75
0.18
0.08
0.28
Perceptuo-Cognitive
0. 72
0.28
0.81
0.24
0.06
0.16
Language
0.63
0.27
0.85
0.19
0.16
0.18
Subscale I
7.46
2.96
8.75
2.38
1.00
1. 31
Subscale II
3.77
2.62
4.50
2.56
0.25
2.60
Subscale III
3.23
1.54
4.00
2.00
0.88
0.99
Subscale IV
2. 92
3. 25
6.75
3.06
4.25
2.49
Subscale V
2.31
2.14
4.63
1.85
2.25
1.83
Subscale VI
1.62
1.50
1.75
0.71
o.oo
1.20
21.31
10.25
30.38
10.10
8.63
3.93
HOME
Total
V\
{\)
53
Bromwich PBP and the measure of infant development as
assessed by the Bayley Scale.
The intercorrelational relationship between the six
levels and the total score on the PBP and the five areas of
development on the Bayley are shown in Tables C, D, and E.
Table C shows the relationship between the PBP and
Bayley scores at intake.
in
Exploration~~
The Bayley area of development
showed a significant negative correlation
to the PBP Level 2-- "Parent is a sensitive observer of her
infant, reads behavioral cues accurately, and is responsive
to them."
All other relationships were non-significant at
intake.
Table D shows the relationship between scores on the
PBP and Bayley measures at reassessment.
No significance
was shown in any of the intercorrelati-ons.
Table E shows the relationship between the change
scores on the PBP and Bayley measures.
One significant
negative correlation was found between the Bayley area of
Language development and the PBP Level 2, again.
Results from Tables C, D, and E above, taken as a
whole, show few significant correlations.
The two mean-
ingful negative relationships, found between PBP Level 2
and Bayley Exploration (Table C), and between PBP Level 2
and Bayley Language (Table E), are unusually high in re*Exploration includes both visual and physical reaching,
touching, and searching behaviors.
TABLE C
RELATIONSHIP BETWEEN
PBP AND BAYLEY SCORES AT INTAKE
BAYLEY
( n=12)
EXPLORATION
(n=8)
COMPETENCE
(n=13)
SOCIAL-RELATEDNESS
( n=12)
PERCEPTUO-COGNITIVE
(n=13)
LANGUAGE
Level 1
o.oo
0.03
0.23
0.15
0.13
Level 2
-0.62*
-0.56
-0.10
-O.J6
-0.22
Level J
-0.28
-0.25
0.20
-0.08
O.OJ
Level 4
-0.45
""-0.55
0.1J
-0.12
-0.01
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
0.00
o.oo
-0.45
-0.44
0.10
-0.16
-0.06
PBP
Level 5**
Level
Total
6-l~*
*P
~
*"'~PBP
0. 05
Levels 5 and 6 showed no scores at Intake.
\..)\
-{:::"'
TABLE D
RELATIONSHIP BETWEEN
PBP AND BAYLEY REASSESSMENT SCORES
BAYLEY
I
( n=8)
EXPLORATION
COIVIPETENCE
SOCIAL-RELATEDNESS
PERCEPTUO-COGNITIVE
LANGUAGE
Level 1
0.42
0.24
0.27
0.16
0.38
Level 2
0.4.5
· 0.34
0.40
0,26
0.60
Level 3
0.28
0.17
0.23
0.10
0 . .57
Level 4
0.18
0.03
0.07
-0.0.5
0.42
Level .5
-0.12
-0.11
0,10
-0.16
0 . .51
Level 6
-0.03
0.09
0.14
0,22
0.19
0.2.5
0.14
0.24
0.07
0 . .56
PBP
Total
\..r1.
\..r1.
?
TABLE E
RELATIONSHIP BETWEEN CHANGE SCORES
FOR PBP AND BAYLEY
BAYLEY
PBP
(n=8)
EXPLORATION
(n=5)
COMPETENCE
(n=8)
SOCIAL-RELATEDNESS
(n=8)
PERCEPTUO-COGNITIVE
(n=8)
LANGUAGE
Level 1
-0.02
0.20
-0.02
0.31
-0.65
Level 2
-0.45
-0.54
-0.31
-0.12
-0.71*
Level 3
-0.04
0.36
-0.65
-0.39
-0.47
Level 4
0.48
0.39
-0.38
-0.32
-0.07
Level 5
0.30
0.65
-0.03
0.14
0.17
Level 6
0.01
o.63
-0.11
0.26
-0.34
Total
0.08
0.38
-0.36
-0.03
-0.49
i}p
:$
0. 05
'-"
0'\
57
lation to most of the other scores in their categories,"
which show only a moderate trend in the same direction.
Total PBP scores show a relatively weak relationship to
most areas on the Bayley Scale.
Null Hypothesis 1 is partially supported by the data
analysis presented above.
Though no significant relation-
ships were shown between 5 of the 6 PBP Levels and any of
the Bayley areas of development, PBP Level 2 showed a significant correlation with Bayley Exploration and Language.
Hypothesis 2
There will be no significant relationship between the
measure of home stimulation as assessed by the
Caldwell HOME Inventory and the measure of infant
development as assessed by the Bayley Scale.
The intercorrelational relationship between the six
subscales and the total score on the HOME Inventory and the
five areas of development on the Bayley is shown in Tables
F, G, and H.
Table F shows the relationship between the HOME and
Bayley scores at intake.
A significant negative correla-
tion was found between the Bayley area of
developme~t
in
Exploration and the HOME Subscale IV-- Provision of
Appropriate Play Materials.
A significant positive corre-
lation was found between the Bayley area of development in
Social-Relatedness and the HOME Subscale II-- Avoidance of
Restriction and Punishment.
TABLE F
RELATIONSHIP BETWEEN HOME AND BAYLEY
SCORES AT INTAKE
BAYLEY
HOME
(n=12)
EXPLORATION
( n=8)
COMPETENCE
(n=13)
SOCIAL-RELATEDNESS
-0.10
( n=12)
PERCEPTUO-COGNITIVE
(n=13)
LANGUAGE
-0.16
-0.10
0.64*
0.51
0.41
-0.09
0.41
0.04
0.32
-0.61*
-0.62
-0.25
-0.55
-0.29
Subscale V
-0.40
-0.40
-0.09
-0.28
-0.07
Subscale VI
-0.05
0.03
0.12
0.12
0.04
Total
-0.35
-0.29
0.12
-0.14
0.02
Subscale I
-0.40
-0.19
Subscale II
0.25
0.33
Subscale III
0.03
Subscale IV
*P~0.05
V\
CD
59
Table G shows the relationship between the
Bayley scores at reassessment.
HO~lli
and
A significant positive re-
lationship was found between the Bayley area of SocialRelatedness and the HOME Subscale I-- Emotional and Verbal
Responsivity of Mother.
A significant positive relation-
ship was also found between the Bayley area of Language development and the HOME Subscale I.
The latter correlation
was significant beyond the 0.01 level.
Table H shows the relationship between the change
scores on the HOME and Bayley measures.
A significant
negative relationship was found between the Bayley area of
development in Competence and the HOME Subscale V-- Maternal
Involvement with Child.
Results from Tables F, G, and H, taken as a whole,
show few significant correlations.
Two meaningful negative
relationships were significant at the 0.05 level:
between
HOME Subscale IV and Bayley Exploration (Table F), and
between HOME Subscale V and Bayley Competence (Table H).
Three meaningful positive relationships were found, between
HOME Subscale II and Bayley Social-Relatedness (Table F),
and between HOME Subscale I and both Bayley Social-Relatedness and Bayley Language (Table G).
These associations are
unusually high in relation to the other socres in their
categories, which generally show only a low to moderate
trend in the same direction.
correlations is limited.
Overall, the strength of the
1
TABLE G
RELATIONSHIP BETWEEN HOME AND BAYLEY
REASSESSMENT SCORES
BAYLEY
(n=8)
EXPLORATION
COMPETENCE
0.61
o.63
Subscale II
-0.28
-0.53
-0.52
-0,60
-0.16
Subscale III
0,11
0.08
0.19
0.05
0.44
Subscale IV
0.35
0.17
0.23
0.07
0.43
Subscale V
0.19
0.11
0.23
0,08
0.56
Subscale VI
-0.19
-0.02
0.12
0.07
0.35
0.22
0.10
0.20
0.03
0.51
HOME
Subscale I
Total
SOCIAL-RELATEDNESS
0.74*
PERCEPTUO-COGNITIVE
0.57
LANGUAGE
0.89**
-~:-p:so.o5
**P:S0,01
()'.
0
?
TABLE H
RELATIONSHIP BETWEEN CHANGE SCORES
FOR HOME AND BAYLEY
BAYLEY
(n=5)
COMPETENCE
(n=8)
SOCIAL-RELATEDNESS
(n=8)
PERCEPTUO-COGNITIVE
(n=8)
LANGUAGE
-0.07
O.J1
0.50
0.57
0.17
Subscale II
0. 69
o.6J
O.J4
O.J5
0.40
Subscale III
-0.17
-O.JJ
-0.11
O.OJ
-O.J9
Subscale IV
0.07
-0.77
. -0 .1J
-0.46
o.os
Subscale V
-0.21
-0.92*
-0.22
-0.59
0. 27
Subscale VI
-0.40
-0.76
-0.06
-0.21
-0.12
0.21
-0.61
0.16
-0.20
O.J6
HOME
Subscale I
Total
(n=8)
EXPLORATION
*P:::; 0. 05
0'\
~
62
The analysis of the data partially supports Null
Hypothesis 2.
Total scores on the HOME Inventory show no
significant relationship to scores on any of the Bayley
developmental areas.
However, several of the HOME Sub-
scales correlate significantly with individual Bayley areas
of development.
Hypothesis 3
There will be no significant relationship between the
measure of parent development as assessed by the
Bromwich PBP and the measure of home stimulation as
assessed by the Caldwell
HOr~
Inventory.
The intercorrelational relationship between the six
levels and the total score on the PBP and the six subscales
and the total score on the HOME Inventory is shown in
Tables I, J, and K.
Table I shows the relationship between the Bromwich
PBP and the Caldwell HOME scores at intake.
Significant
positive correlations were found between total scores on
the two measures, between total PBP scores and HOME Subscales I, III, IV, and V, between total HOME scores and
PBP Levels 2, J, and 4, between PBP Levels 2, J, and 4 and
HOME Subscales I, III, and IV, and between PBP Levels 2 and
4 and HOME Subscales V and VI.
Table J shows the relationship between the HOME and
PBP scores at reassessment.
Significant positive correla-
tions were found between total scores on the two measures,
TABLE I
RELATIONSHIP BETWEEN PBP AND HOME
SCORES AT INTAKE
HOME
PBP
Sub scale
I
Sub scale
II
Sub scale
III
( n=1J)
Sub scale
IV
Sub scale
Sub scale
VI
-0.08
-0.16
-0.09
v
Total
Level 1
0.10
0.19
0.10
Level 2
0.80***
0.04
0.62**
0.82***
0.72**
0.57*
0.83***
Level 3
0.55*
O.J1
0.74 7~*
o. 56 ~
0.5J
0.47
0.71**
Level 4
0. 77*-l~
0.08
0. 59-l~
0. 76 7~*
0.84***
0.67**
0.85***
·Level 5****
Level 6****
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
o.oo
Total
0.69**
0.17
0.61*
0.65*
0.58*
0.48
0.7J**
7
0.02
*P :$0.05
**P :$0.01
***P s; 0, 001
****No scores were shown at intake for PBP Levels 5 and 6.
0'\
\.0
'
j.
I
TABLE J
RELATIONSHIP BETWEEN PBP AND HOME
REASSESSMENT SCORES
HOME
PBP
Sub scale
I
Sub scale
II
Sub scale
III
(n=8)
Sub scale
IV
Subscale
v
Sub scale
VI
Total
Level 1
0. 67
0.49
0.86**
0.96***
0. 82~~*
0.34
0.92***
Level 2
0.80*
0.48
0.86**
0.94***
0.91**
0.43
0.96***
Level 3
0.75*
0.65
o. 72*
0.82**
0.91**
0.34
0.92***
Level 4
0.66
0.74*
0.57
0.70*
0.78*
0.12
0.82**
Level 5
0.65
0.38
0.43
0.38
0.55
0.09
0.56
Level 6
0.38
0.08
0.20
o.o3
0.30
0.14
0.23
Total
0.80*
0.61
0.75*
0.82**
0.89**
0.29
0.92***
*P :50.05
**P$0,01
-~~**P::;
0 001
I
0'\
-{:::"
TABLE K
RELATIONSHIP BETWEEN PBP AND HOME
CHANGE SCORES
HOME
PBP
Subscale
I
Sub scale
II
Sub scale
III
( n=8)
--
Sub scale
IV
Sub scale
Subscale
VI
Total
v
Level 1
0,22
-0.21
0.27
0.13
-0.53
-0.36
-0.27
Level 2
o.oo
-0.59
0.45
0.48
-0.04
o.oo
0.01
Level 3
-0.13
-0.12
0.32
0.29
-0.07
-0.57
-0.06
Level 4
-0.44
0.39
0.46
0.40
0,03
-0.48
0.35
Level 5
-0.09
0.68
0.34
-0.17
-0.10
-0.51
0.20
Level 6
0.31
-0.04
0.05
-0.20
-0.28
-0.68
-0.37
-0.07
0.07
0.51
0.25
-0.25
-0.61
0.01
Total
0'\
Vl.
66
between total PBP scores and HOME Subscales I, III,
rv; and
V, between total HOME scores and PBP Levels 1, 2, 3, and 4,
between PBP Levels 1, 2, and 3 and HOME Subscales III, IV,
and V, between PBP Levels 2 and 3 and HOME Subscale I, and
between PBP Level 4 and HOME Subscales II, IV, and V.
Table K shows the relationship between the change
scores on the PBP and HOME measures.
No significant re-
lationship was found for any of the variables.
Results from Tables I and J show a highly significant
positive relationship between total scores on the Bromw.ich
PBP and the Caldwell HOME Inventory, at intake and at the
first reassessment, respectively.
PBP Level 1-- "Parent
enjoys being with her infant"-- showed no significant relationship to any other variables at intake, but at the
first reassessment it ralated positively to all HOME Subscales, showing significance at Subscale III-- Organization
of the Physical and Temporal Environment, Subscale TV-Provision of Appropriate Play Materials, and Subscale V-Maternal Involvement with Child.
PBP Level 2-- "Parent is
a sensitive observer of infant, reads behavioral cues
accurately, and is responsive to them"-- showed a significantly positive relationship to all HOME Subscale scores
with the exception of Subscale II-- Avoidance of Restriction and Punishment.
This relationship was maintained at
reassessment for all but Subscale VI-- Opportunities for
Variety in Daily Stimulation.
PBP Level 3-- "Parent en-
67
gages in a quality and quantity of interaction with infant
that is mutually satisfying and provides opportunity for
development of attachment and the beginning of a system of
communication"-- showed a significantly positive relationship to HOME Subscale I-- Emotional and Verbal Responsivity
of Mother, Subscale III-- Organization of the Physical and
Temporal Environment, and Subscale IV-- Provision of Appropriate Play Materials at intake, which was maintained, with
the addition of Subscale V-- Maternal Involvement with
Child at reassessment.
PBP Level 4-- "Parent demonstrates
an awareness of materials, activities, and experiences
suitable for infant's current stage of development"-showed a significantly positive relationship to all HOME
Subscales at intake, with the exception of Subscale IT-Avoidance of Restriction and Punishment.
The relationship
was maintained at reasses.sment for Subscales II, IV, and V.
PBP Levels
5 and 6 showed no scores at intake, and
consequently had no relationship with any of the HOME Subscales.
At the first reassessment, PBP Level
5 and 6
scores were minimal and correlations with the HOME Subscales remained weak.
Data on Table K shows no significant relationship between the change in PBP scores and the change in HOME
scores.
Though the measures appear to be highly interre-
lated, the rate at which changes are assessed by them may
vary.
68
Null Hypothesis 3 is rejected on the basis of the data
presented above.
A highly significant positive relation-
ship has been shown between the two parent measures.
Discussion
Previous Findings Relevant to Study
ISEP Program Evaluation.
The ISEP data were analyzed
by an external evaluator upon termination of the three year
program.
examined.
Total scores on each of the three measures were
Results showed an indication of positive change
for both parents and infants in the home program sample.
A
high positive correlation was found between the PBP and
HOME scores at intake.
In the analysis of gain scores, a
significantly positive correlation was also found between
the Bromwich PBP and the Bayley MDI (Mental Development
Index) age equivalent scores, based on data from all 12
families who were reassessed on both measures at least
once.
This result covered gains across two six-month re-
assessment intervals for 6 of the families in question
(Lewis et al. Note 10).
Previous Caldwell Studies.
Bradley and Caldwell (1977)
have attempted to measure the screening efficiency of the
Caldwell HOME Inventory.
Findings indicate that this mea-
sure, used to assess the level of home stimulation when the
child is 6 months old, can reasonably predict (71% accuracy)
which children will score below 70 on a 36-month IQ test.
Low scores on the following subscales were found to be most
closely associated with low IQ:
Subscale III-- Organiza-
tion of the Physical and Temporal Environment, Subscale IVProvision of Appropriate Play Materials, and Subscale V-Maternal Involvement with Child.
Additional work has shown a relationship between HOME
Inventory subscale scores and mental test performance in
young children (Bradley and Caldwell 1976, Elardo et al.
1975).
Though only a weak association was found between
HOME scores and Bayley MDI scores, a significantly positive
relationship was found between HOME scores and later
Stanford Binet IQ scores at 36 months and again at 54
months.
The HOME subscales found to be most closely re-
lated to increases in IQ were:
Subscale I-- Emotional and
Verbal Responsivity of Mother, Subscale IV-- Provision of
Appropriate Play Materials, and Subscale V-- Maternal Involvement with Child.
Comments on Findings from this Study
Though only seven out of a total possible 210 correlations between scores on the parent measures and scores
on the Bayley showed significance at or beyond the 0.05
level, a closer examination of Tables C through H shows
several notable relationships.
The Bayley developmental
areas of Exploration and Competence show consistently high
negative correlations at intake (Table C) with PBP levels
2 and 4.
These same Bayley areas also show negative re-
lationships to HOME Subscale IV (Table F).
These results
70
imply that parents whose infants explored their environment
less and were less competent showed greater sensitivity to
their cues (PBP Level 2), were more aware of materials,
activities, and experiences suitable for their infant's
stage of development (PBP Level 4) and provided more appropriate play materials for them (HOME Subscale IV).
A
negative direction is also shown for scores between HOME
Subscale V (Maternal Involvement with Child) and both Exploration and Competence.
These findings may indicate that
parents within this population were generally more involved
with their "less able" infants before intervention.
A
lower level of functioning (a lower score on the Bayley) at
an early age may have produced a higher level of concern
for the infant on the part of the parent.
The parent's
greater concern might have caused her to be more sensitive
and responsive to signs of distress in her infant.
The
same concern might have caused the parent to limit her
child's exploration of his environment.
It is interesting
to note the original negative relationship between the
areas of the parent and infant measures mentioned above
changed to a positive relationship after 6 months of intervention.
A trend appears toward a positive relationship between
the Bayley area of Language development and PBP Levels 2,
3, 4, and 5 and HOME Subscales I, III, IV, and V.
Total
scores on both parent measures also show a positive rela-
71
tionship to Language development.
These results imply that
parents who were more sensitive to their infant's cues
(PBP Level 2) , more verbally and emotionally responsive to
their infant (HOME Subscale I), interacted with them more
(PBP L:evel J, HOME Sub scale V) , and provided them with more
materials and richer experiences (HOME Subscale IV, PBP
Level 4) had babies who were more advanced in their language development after a period of intervention.
Consid-
ering the importance of language development in the overall development of the infant (see Chapter 2), this finding
is impressive.
Tables I, J, and K also reveal some interesting information upon closer examination.
Intake scores (Table I)
show a consistently positive relationship between PBP
Levels 2, J, and 4 and Harm Subscales I, III, IV, V, and
VI.
PBP Level 1, however, shows a weak relationship to
all HOME Subscales and to total HOME scores.
This result
implies that before intervention, a parent's enjoyment of
her infant was independent of the amount of stimulation
she provided within his enivronment.
At reassessment
(Table J) this relationship takes a much more positive direction, with scores showing significance beyond the 0.01
level between PBP Level 1 and three of the six HOME Subscales, as well as with total HOME scores.
The remaining
three HOME Subscales also show positive correlations (although below the 0.05 level of significance) with PBP
72
Level 1.
These findings may indicate that as parents began
to provide more stimulating experiences for their infants,
they were able to enjoy them to a greater extent, which, in
turn, may have motivated the parents to provide their infants with even more appropriate experiences.
This result
lends support to Goldberg's (1977) theory of the development of cyclical interaction patterns between parents and
infants (see Chapter 2).
She maintain that as infants be-
come more responsive to their parents, they bring about
more responsiveness from their parents, thus promoting more
effective parent-infant interaction.
Another interesting area for discussion is the lack of
a relationship between HOME Subscale II and all of the PBP
Levels as well as the total PBP scores at intake (Table I).
HOME Subscale II-- Avoidance of Restriction and Punishment,
deals specifically with negative parent behaviors.
Parents
who score high on this subscale must neither report nor
demonstrate any verbal or physical restraint or punishment
of their infants.
At reassessment (Table J), a more pos-
itive relationship was shown between Subscale II and all
PBP Levels, with PBP Level 4 showing significance beyond
the 0.05 level.
This finding is in accordance with White's
(1976) contention that parenting becomes more difficult as
infants become more active (6-8 months for healthy infants).
Results from this study indicate that though parental restriction and punishment may not have been an issue in
73
parent development at intake, as the infants approached a
more challenging stage of development, parent's enjoyment
of their infants, sensitivity and responsiveness to them,
interaction with them, and awareness of appropriate play
materials and experiences for them (PBP Levels 1-4) were
more highly related to a lack of restrictiveness on their
part.
The description of the "optimal mother" presented by
Clarke-Stewart (1973) and supported by others throughout
the literature (see Chapter 2) is reflected in this finding.
CHAPTER 5
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
This chapter presents a summary of the major findings
of the study, some conclusions drawn from their discovery
and several recommendations for further investigation of
the topic area.
Summary
This study attempted to show the relationship between
two types of parent measures representative of those used
throughout a variety of programs.
One assessed the home
environment; the other assessed parent development.
Fur-
ther, the relationship between each of these parent measures and a widely used assessment of infant development
was examined.
This analysis was to be a first step toward
understanding how these three variables interact in promoting optimal parent and infant growth through early intervention.
Thirteen parent-infant dyads participating in a Home
Teaching Program were assessed with the use of the Caldwell
HOME Inventory, the Bromwich Parent Behavior Progression
and the Bayley Scales of Infant Development at intake and
after six months of program participation.
mult~ethnicand
The sample was
represented children with a variety of
handicapping conditions.
Parents ranged in age from 18 to
52 years, infants from 2 weeks to 18 months, at intake.
74
75
The Pearson correlation computer procedure of the
Statistical Analysis System (SAS) was used to compute a
series of intercorrelation matrices on scores from the
three program measures.
were:
(J)
(1)
The three sets of data analyzed
intake scores,
change scores.
(2)
reassessment scores and
Five areas of development as assessed
by the Bayley Developmental Profile were used in the
analysis:
Exploration, Competence, Social-Relatedness,
Perceptuo-Cognitive, and Language.
cance was set at 0.05.
The level of signifi-
Relationships found to be signifi-
cant at the 0.05 level, the 0.01 level, and the 0.001 level
were indicated.
Few significant relationships were found between the
measure of parent development as assessed by the Bromwich
PBP and the measure of infant development as assessed by
the Bayley Scale.
This outcome partially supported Null
Hypothesis 1.
Few significant relationships were found between the
measure of home stimulation as assessed by the Caldwell
HOME Inventory and the measure of infant development as
assessed by the Bayley Scale.
partially supported.
Null Hypothesis 2 was also
Those relationships which were found
are described in Chapter 4.
A positive relationship, significant beyond the 0.05
level, was found between the measure of parent development
as assessed by the Bromwich PBP and the measure of home
76
stimulation as assessed by the Caldwell HOME Inventory.
At
intake, total scores for the measures showed a correlation
of r=. 7 3 ( P
$
0. 01) , with several of the individual PBP
Levels and HOME Subscales also indicating high positive
correlations.
At reassessment, total scores showed a
correlation of r=. 92 (P
$
0. 001) , and Level and Sub scale
relationships remained high.
Though change scores were
not significant, it appears that the two measures may be
closely related in their ability to assess aspects of
parental involvement which are believed to promote optimal
infant development.
Conclusions
Measuring the effectiveness of parent-infant intervention programs is a difficult task.
Program designs stem
from a variety of philosophical frameworks, and evaluative
measures run the gamut from "clipboard and stopwatch" techniques to highly subjective interpersonal assessments.
Consistency in measurement across programs, particularly
in the area of parent growth, is sorely needed if we are to
be able to draw any conclusions regarding success in intervention.
Assessing infant development through the use of standar~ized
measures has also been proven difficult through-
out intervention programs.
In the case of handicapped in-
fants this problem is heightened, for many of the behaviors
assessed by a scale such as the Bayley are not appropriate
77
for the population.
This tool was designed to be used with
normally developing infants.
Until more sensitive tools
for accurately assessing behavioral change in handicapped
infants are developed, programs will continue to rely on
measures like the Bayley simply because they are available.
Results from the use of such measures, however, are not as
valid as one would like them to be.
Though the interven-
tion staff of the ISEP believed that changes in both home
stimulation and parent development did contribute to infant
growth, this belief was not supported by the program's test
data.
This may be due to the inadequacy of the Bayley
Scale in documenting in sufficient detail all areas of development, particularly for handicapped infants.
It may
also reflect a common finding in intervention studies, that
changes in parents must precede changes in their infants.
The most impressive results found between parent and
infant measures involved HOME Subscale I-- Emotional and
Verbal Responsivity of Mother.
Reassessment data showed a
positive relationship between this area of home stimulation
and all areas on the Bayley Developmental Profile.
Sig-
nificant correlations of r=. 74 (P S 0. 05 and r=. 89 (P S 0. 01)
were found for Social-Relatedness and Language, respectively.
These results may indicate that a highly responsive
parent can influence the development of her infant.
In
light of the intake relationship shown for this same area,
however, one is more likely to conclude that the high cor-
78
relation is a result of the small reassessment sample, or
the age change in the infants.
Assessing growth in parents of infants is always confounded by the speed with which developmental changes take
place in the first three years of life.
Parent-infant in-
teraction is a result of the responses of both members of
the dyad.
Because not all parents are equally effective in
dealing with their infants at all stages of development, we
cannot expect to see a steadily rising score over time when
using parent measures.
Furthermore, most measures do not
allow for adjustments in assessment for parents of different aged infants.
These factors add to the complexity in
accurately interpreting parent assessment scores.
The Bromwich PBP lends itself to changes in scoring
over time as a function of the intervention process.
The
first four levels of the Progression can be used to assess
parent development in any family.
Levels 5 and 6, however,
measure changes expected to result specifically from intervention.
This is reflected in the scores for the sample
studied.
At intake, none of the parents received scores on
Levels 5 or 6.
After 6 months of intervention, four par-
ents showed behaviors at Level 5, and one parent at Level 6.
The entire Caldwell HOME Inventory is designed to assess the home environment of any infant.
Though weighted
differently in their scoring, each Subscale is an integral
part of the total assessment at each testing.
Change
in
79
the level of home stimulation brought about through the
intervention process was reflected in increases in scores
on all HOME Subscales.
The relationship between home stimulation and parent
development shown in this study, despite the differences in
the measures, is impressive.
Therefore, it can be tenta-
tively concluded that there is a positive relationship between the HOME Inventory and the PBP.
Findings from previous studies using the Caldwell HOME
Inventory lend support to the results of this investigation.
(See Chapter 4).
Those HOME Subscales which have been
shown to relate most directly to later IQ scores in young
children were also found to relate most directly to PBP
scores in the present study.
These findings support con-
current validity for the Bromwich PBP.
These findings also
imply that the Bromwich PBP, as well as the Caldwell HOME
Inventory, may be useful in assessing the strengths and
weaknesses in the parent's involvement, and they confirm
other research (see Chapter 2) which shows that such parent
involvement promotes later growth in the child's intellectual development.
Recommendations
The following recommendations for further study are
suggested by this small sample investigation:
1.
More and better tools for assessing infant be-
havior, particularly for use with handicapped infants, are
80
desperately needed before we can rely on the use of such
measures to show the effectiveness of infant intervention
programs.
2.
Further examinations of parent measures must be
begun in an attempt to show their validity and reliability
over time.
J.
Replications of this study should include several
programs operating on the same principles and with the same
underlying philosophy.
Results from a study combining
samples from a number of programs could more easily be generalized to a larger population.
4.
There is a need for more longitudinal studies
focusing on the effects of intervention over several years.
A serious limitation in this research was the short participation span of many of the sample subjects.
If we are
to be able to show that early intervention can have a lasting effect on program participants, we must continue to
measure their development over time.
5.
Further analyses of the relationships between
individual areas of infant development and individual areas
of parental growth are recommended.
These analyses could
further examine the relationships between the subscale
areas which were found to exist in this study.
6.
This study sheds some light on the relationship
between program measures.
It is hoped that further in-
vestigations will be conducted attempting to explore re-
81
lationships between measures of parent involvement, both
quantitatively and qualitatively.
Such studies can test
the concurrent validity of various measures.
It is important that parents continue to be involved
in infant intervention programs.
I hope that this study,
in its own small way, will further support that involvement.
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