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Coping in Young Children

Coping in Young Children

Early Intervention Practices to Enhance Adaptive Behavior and Resilience
Authors: Shirley Zeitlin, G. Gordon Williamson Ph.D., OTR

ISBN: 978-1-55766-127-2
Pages: 336
Copyright: 1994
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Early intervention professionals will turn to this informative book for a deeper understanding of how young children cope or adjust to the stresses of daily living. Based on the premise that effective coping facilitates effective learning, this essential guide explains how to integrate a child's developmental skills with daily functional living.

Step by step, this comprehensive guide shows how to assess coping behaviors, develop coping-oriented IFSPs through collaborative decision making implement individualized intervention strategies, and support parent-selected activities that enhance coping abilities. Also included are detailed case examples, sample forms, and well-organized charts—all designed to help support the efforts of those serving young children.

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"A validated frame of reference for planning and implementing early intervention services."
About the Authors
  1. Introduction
  2. The Coping Process
  3. Adaptive Functioning in Young Children
  4. The Family System
  5. Planning Coping-Related Services
  6. Assessment from a Coping Perspective
  7. Intervention Planning
  8. Intervention Strategies and Activities
  9. Enhancing the Coping Resources of Families
  10. Developing an IFSP with a Coping Perspective: First Steps
  11. Completing the IFSP: Developing the 6-Month Implementation Plan
  12. The COPING Project: Our Learning Experience
  13. Experiences of Four Families
  14. Staff Coping: Demands and Resources
Appendix A: Case Report of a Parent Support Group
Appendix B: Early Intervention and Development and Coping with Transition Workshops
Appendix C: Reflections of the Johnson Family


Excerpted from Chapter 1 of Coping in Young Children
By Shirley Zeitlin, Ed.D., and G. Gordon Williamson, Ph.D., O.T.R.
©1994. Brookes Publishing. All Rights Reserved.

A major task during childhood is transforming early adaptive behaviors into a mature coping style (Lipsitt, 1983). A child must acquire developmental skills and learn to apply them functionally to manage daily activities. A child's early experiences of interacting with the environment are essential for the emergence of an effective coping style and a positive sense of self. A developmental delay, disability, or at-risk condition may impede this transactional process. Therefore, from the perspective of this book, the goals of early intervention are:

  • To enhance the life outcomes of young children with special needs by increasing their developmental and coping capability
  • To enhance the coping resources of families of children with special needs
Goals serve as the foundation for planning and evaluating services. The goals above emphasize functional outcomes and are based on the following research-supported assumptions:
  • The more effectively a child copes, the more effectively a child learns (Bricker & Cripe, 1992; Greenspan, 1992; Werner & Smith, 1991; Williamson, Szczepanski, & Zeiltin, 1993). For the child, developmental skills are the building blocks for growth. Coping is the integration and application of these skills to functional living and mastery of new learning.
  • The more effectively families are able to cope with the demands of daily living, the more able they are able to provide support and nurturance and to achieve a sense of well-being (Beckwith, 1990; Dunst, Trivette, & Deal, 1988; Gallagher, 1990; Holahan & Moos, 1990; Lipsky, 1985).
The Frame of Reference

This book presents a validated frame of reference for planning and implementing early intervention services. It has three unique components: 1) a theoretical model based on the transactional coping process, 2) a decision-making model for personalized planning, and 3) intervention options that expand coping resources and support effective transactions in daily living. These components are interwoven into an intervention approach that is flexible and practical. It can be tailored to meet the needs of children with a range of special needs and families of diverse socioeconomic and cultural backgrounds. The components are adaptable to programs with differing philosophies, resources, and curricula. The decision-making process is used by parents and staff to develop and implement service plans for the child and family. Likewise, this framework facilitates team building and fosters parent-professional collaboration.

The Theoretical Model

There is growing recognition of the importance of having a theoretical rationale for early intervention, especially one that incorporates an ecologically based systems approach (Fenichel & Eggbeer, 1990; Sameroff & Fiese, 1990). This orientation, which views the person interacting with the environment, considers the transactions within the family as well as those of the family within the community. As frame of reference for intervention, the model of the coping process provides a relevant theoretical foundation for linking child, family, and environmental interactions. The model emphasizes the enhancement of coping resources that enable the child and family to manage current and future challenges and opportunities. This approach has a positive theme, focusing on adaptation and growth rather than pathology.

The Decision-Making Model

Perhaps the most dramatic change in the field of early intervention is the trend toward collaboration between parents and service providers. Currently, parents and professionals are moving away from the role of the professional who directs and controls events toward the achievement of true partnerships. For this approach to be most effective, new skills are required of all participants. The decision-making model described in Chapter 5 uses a sequence of facilitative questions as a structure to foster communication and mutual problem solving. The model can be applied in many ways, ranging from program planning to supporting informal exchanges. It is particularly helpful in the development of individualized family service plans (IFSPs), which were mandated in Public Law 99-457, the Education of the Handicapped Act Amendments of 1986, and its subsequent reauthorization, Public Law 102-119, the Individuals with Disabilities Education Act Amendments of 1991. These plans designate the goals and outcomes that are desired, the services the child and family are to receive, and the activities used to achieve them.

Intervention Options

The field of early intervention is shifting from a primary focus on the remediation of isolated deficits to an emphasis on the integrated, functional application of skills in daily living. This practical orientation is based on the importance of effective transactions to support coping and learning. Therefore, intervention within this context addresses the concrete realities of everyday experiences and involves the following options to enhance expanding coping resources, and providing contingent feedback. Developmental skills—a critical coping resource—are taught in ways that foster adaptation (e.g., assisting the child to manage new or difficult situations). There is concern about the fit between the individual's resources and environmental demands and expectations. Intervention services draw from a whole range of methods and activities to achieve an optimal fit.

Historical Trends

To appreciate how this frame of reference for planning and implementing early intervention services evolved, it is helpful to review certain historical trends that have influenced its development—changing views of infancy, the shift to family-centered intervention, and the role of government in early intervention.

Changing Perceptions of Infancy as Related to Professional Practice

Modes of intervention reflect the ways young children are perceived by adults. Around the turn of the century, infants were viewed as virtually helpless and incompetent. Their needs were considered primarily biological and medical. The main focus, therefore, was on the delivery of health care. For example, the specialty of pediatric medicine emerged during this time and hospitals created nurseries in which to isolate newborns, minimizing their risk of infection.

Over the years this concern became more targeted to the needs of premature newborns. These infants first received care in a station at the Sarah Morris Hospital in Chicago in 1922. The unit was provided with specially trained nurses as well as incubators to regulate the body temperature of the infants. The first city-wide program for preterm infants was developed in Chicago in 1934. By 1970, intensive care units for infants biologically at risk were established throughout the United States (Zeitlin, 1984).

Concurrent with this movement, theorists in child development, such as Gesell (1940) and Piaget (1952), began to pay increased attention to the period of infancy and demonstrated that the greatest growth in physical, cognitive, affective, and linguistic skills occur during the first 5 or 6 years of life. This insight lent support to the need for intervention as early as possible. Behaviorists, such as Skinner (1953), provided a technology for arranging child's environment to increase and enhance development. Sameroff and Chandler (1975) recognized the importance of the transactional effects familial, social and environmental factors on the child's development.

The relevance of these findings to early intervention lay in the growing awareness of the interplay of external and internal factors. It was recognized that some developmental delays can be traced back to environmental causes, and that the severity of physical damage can be ameliorated by modifying the environment. With this expanding appreciation of development, there was increased recognition of the range of children and families who can benefit from early intervention. This population can now be described in three categories.

  1. Children with established risk are those with developmental disabilities, such as cerebral palsy, Down syndrome, or spina bifida, or those with functional delays in specific areas of development.
  2. Children who are biologically at risk are those who have early health factors that are known to be a potential threat to their developmental outcome. Common risk factors include small-for gestational age, neonatal seizures, symptomatic drug withdrawal, and perinatal asphyxia.
  3. Children who are environmentally at risk are those for whom the postnatal physical or social environments are a vulnerability. Examples are infants who are abused or neglected, whose parents have a mental illness, or who are living in conditions of extreme poverty.
These categories are not mutually exclusive. For example, children with physical disabilities also may be environmentally at risk if their parents are teenagers and unable to understand or manage their medical condition. Infants with low birth weight may at some point be diagnosed as having a disability if developmental delays persist. In this book, the term children with special needs is used to refer to children in all three categories. The coping-related approach is equally appropriate to each of these groups of children and their families.

Shift to Family-Centered Intervention

Intervention programs have shifted from an earlier focus on the child to a more family-centered perspective. The child-centered programs of former years emphasized primarily the achievement of developmental skills. In some programs, the staff provided all of the services and the involvement of parents was limited to such activities as transporting the child, providing information regarding the child's history and receiving professional reports pertaining to the child's status and progress. In other programs, the opposite was the case—parents were expected to assume the major responsibility for intervention activities. The parent became the child's teacher and therapist with guidance of professionals.

During this period, parents also played a very important role in advocating for services at the local and national levels. They were catalysts for the development of such organizations as United Cerebral Palsy and The Arc. Individually and through these organizations, parents were active in generating public awareness, raising funds, and lobbying for legislation.

Over time, programs started to provide other family-oriented services, such as parent support groups, educational workshops, and specialized activities for siblings. Although these services were regarded as worthwhile, they were viewed as supplementary in nature and separate from the child's program. Families were frequently treated as a homogeneous group with similar resources and needs. Consequently, whereas intervention strategies with the children were numerous, only common program-wide goals were developed for family involvement. Predetermined activities were conducted in which all families were usually expected to participate, with the assumption that each would benefit equally. This approach often left both the family and the staff frustrated.

With experience and changing legislation, a more diverse family-centered approach has evolved. The child is now viewed within the context of the family unit (Dunst, Johansson, Trivette, & Hanby, 1991). Thus, in the development of the family service plan, the concerns and priorities of all family members are considered. Activities are directed toward functional outcomes for the child and family. In addition, parents are collaborators in the planning and implementation of services as well as recipients of these services. Furthermore, activities are increasingly in naturalistic environments in which the community works together with the family.

Role of Government in Early Intervention

The thrust for change often requires legal mandates with accompanying financial support. During this century, a series of federal initiatives contributed to the establishment of a diverse service delivery system for young children and their families. The legislation reflects over time an increasingly family-centered approach. In the area of maternal and child health services, three legislative actions are of particular relevance. In 1912, the Children's Bureau was established by Congress to address concerns related to child welfare, such as physical health, infant mortality, and factors associated with disabling conditions. Next came passage of the Social Security Act in 1935 (Title V), which authorized the funding of three programs still active today—the Maternal and Child Health Services, Services for Crippled Children (now known as Children with Special Health Care Needs), and Child Welfare Services. In 1965, the Medicaid provisions of the Social Security Act implemented the Early and Periodic Screening Diagnosis and Treatment (EPSDT) Program to provide accessible medical and developmental services for children living in poverty. The emphasis was on prevention and early identification.

The first educationally oriented federal program for preschool children came in 1965 with the establishment of the Head Start program for children from economically disadvantaged circumstances. (In 1972, Head Start's services were extended by a congressional mandate to ensure that 10% of the program's enrollment would be available to children with disabling conditions.) In 1968, with the passage of Public Law 90-538 (the Handicapped Children's Early Education Assistance Act), the government authorized funds to create model demonstration projects to serve exceptional children under 5 years of age and their families. The Handicapped Children's Early Education Program (now renamed Early Education Program for Children with Disabilities) has played a seminal role in the development and dissemination of innovative practices.

The passage of Public Law 94-142 (the Education for All Handicapped Children Act) in 1975 was legislative landmark. It ensured a free and appropriate public education and related services for all children of school age with disabilities. Although the law did not require children under 6 years of age to be served, financial assistance was provided to states to encourage the established of preschool programs.

In 1986, Public Law 99-457 amended Public Law 94-142 to include two main provisions. Section 619 of the law required states to provide the services mandated by Public Law 940142 to eligible children from the age of 3 so they may qualify for any federal preschool funds. Part H established a discretionary program for states for states to develop a comprehensive, coordinated, multidisciplinary, interagency service delivery system for infants with developmental disabilities or delays and their families. States were then allowed to choose whether children who were biologically or environmentally at risk were eligible for services. A lead agency and interagency coordinating council were major vehicles for implementing this system. Families were recognized as recipients of services, with the individualized family service plan (IFSP) replacing the traditional individualized education program (IEP). Case management (i.e., service coordination) and procedural safeguards were also required. This law was updated in 1990 with passage of the Individuals with Disabilities Education Act (IDEA), Public Law 101-476. The new law extended the benefits of the earlier legislation. Changes in wording and expansion of some services reflected the importance of the family and the provision of services in natural environments in which people without disabilities participate. An important coping-related change in wording is the replacement of the term self-help skills as an area of concern with the term adaptive development.

This brief historical overview highlighted evolving trends in early intervention focusing on children, families, and the role of government. Table 1.1 provides a summary of the changes that have occurred—and are still occurring—in the field of early intervention. It is generally believed that these changes represent a movement toward recommended practice; however, there is diversity among states and programs in their interpretation and implementation.

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