U.S. Department of Education
Office of Special Education Programs
The University of Toledo
These materials made possible by grant # H325N110014 which is funded by the U.S. Department of Education, Office of Special Education
Programs. The contents are solely the responsibility of the authors and do not represent the official views or policies of the funding
agency, nor does publication in any way constitute an endorsement by the funding agency.
Addressing Inclusion Content and Practices
in “Intro to ECE” Course in ECE Curriculum
Webinar 5 - June 5, 2013
Guide: Bill McInerney, Ph.D.
Co-Director - The Partner Project
Selected content for slides to accompany this
webinar have been secured and edited from
open source sites accessible via the www
Including Content Related to Inclusion in ECE
in an “Introduction to ECE” Course
Sample Course Description:
“Introduction to ECE”
“This comprehensive survey course of ECE
identifies the core knowledge and competencies
necessary for individuals working with all
young children. This course is designed to…….
• Introduce students to the field of ECE
• Provide students an understanding of
the complexity of the field and the issues
around it
• Develop an awareness of the diversity
of the field
• Understand the diversity of the
children and populations with whom
early childhood professionals work
• Provide the opportunity to apply that
knowledge with young children and
their families within a variety of early
childhood settings
Another Sample Course Description:
“Introduction to ECE”
“Introduction to child development and philosophy of early
childhood education, including developmentally appropriate
practices in a variety of child care settings. Identification of
effective multicultural and inclusive early childhood learning
environments. Recognition of the importance of integrated
curriculum as teaching strategy for young children.
Introduction to role of the early childhood teacher as facilitator,
and the development of effective family/center relationships.
Observations in early childhood education settings.
Course descriptions suggest that basic
information relating to inclusion should be
addressed:
• Legal mandates for early
intervention and early education
• Background information describing public
agencies charged with identifying and
serving young children with special needs
Course descriptions suggests that this
basic information relating to inclusion
should be addressed:
• Awareness of the scope of early
intervention and early childhood
special education service delivery
options
Course descriptions suggest that basic
information relating to inclusion,
should be addressed:
• Range of ability and disability
conditions of children who are eligible
for enrollment in early education
programs
• Implications for professional
practices
Course description suggests that this
basic information relating to inclusion,
should be addressed:
• Range of programs in which young
children with disabilities may be
expected to be enrolled, including child
care, public and private preschools,
before and after school care programs,
and Head Start
2010 NAEYC Standards Relevant to
“Introduction to ECE Course”
NAEYC Standards for Initial & Advanced
Early Childhood Professional
Preparation Programs
WHAT IS DIFFERENT IN THE 2010
NAEYC INITIAL AND ADVANCED
STANDARDS ?
Revisions to NAEYC’s Initial Standards (2001),
Advanced Standards (2002) and Associate
Standards (2003) included a strengthened
emphasis on academic content, diversity,
inclusion, technology and early childhood focus
Standard 1 b
Knowing and understanding the multiple
influences on early development and
learning
Standard 1 c
Using developmental knowledge to
create healthy, respectful, supportive,
and challenging learning environments
for young children
Standard 6 d
Integrating knowledgeable, reflective,
and critical perspectives on early
education based upon mastery of
relevant theory and research
Standard 6 e
Engaging in informed advocacy for
children and the profession,
skillfully articulating and advocating
for sound professional practices and
public policies
The challenge to ECE faculty in
expanding and enhancing the ECE
teacher education curriculum is to:
• Recognize and accept the changing
landscape of ECE, and to……..
• Organize key curriculum components
(i.e. courses, course-related field
requirements, and practica) to
systematically and developmentally
address information, skills, attitudes
and values related to inclusion in ECE
There are several critical aspects to this
task that involve collaborating with other
ECE faculty in the ECE teacher education
program in order to determine the scope
and sequence of information and skills
related to inclusion that will be
introduced in the ECE curriculum
Before addressing the task of curriculum
enhancement, it is important to consider
a number of relevant facts. These
realities must be recognized and
respected in any redesign or
enhancement of the ECE teacher
education curriculum………..
ECE Student Perceptions of
Content Related to Inclusion in
ECE Teacher Education Programs
• Most ECE students have had limited
experience with young children with
special needs
• ECE students who have relevant
experiences (in child care, preschool
programs, Head Start, etc.) probably
had “unguided” experiences that did
not include meaningful
communication with early
intervention/early childhood special
education professionals or related
services professionals (i.e. occupational
therapists, physical therapists, speech
and language pathologists, etc.)
• Some ECE students do not have a keen
interest in working with young children with
special needs. They are seeking to enter the
profession to work with young children who
are typically developing. Some of these
students may be resistant, at least initially, to
exposure to information and skills related to
inclusion. They also may not welcome
additional elements in course and field
assignments that require students to address
the characteristics, competencies and needs of
young children with special needs
• The focus of the ECE teacher education
curriculum is effective and supportive
interaction and engagement with young
children who are typically developing
however….. this is not at the exclusion
of balanced content in the ECE
curriculum
Approximately 10-20% of young children
may be expected to be eligible for early
intervention or preschool special
education services. Encountering
children with special needs in child care
and early childhood education settings is
likely and ECE program graduates
should become awareness of this via
focused experiences within the ECE
curriculum
• Despite the possibilities of ECE
students’ lack of interest in inclusion,
their intent to work only with young
children who are developing typically,
and/or their emerging or firm belief that
inclusion “doesn’t work for all children”,
it is incumbent upon ECE faculty and
program administrators to address the
issue of curriculum enhancement…….
ECE faculty involved in the enhancement
process must understand that the expectations
for content and skill acquisition in CC programs
are tempered by an understanding that content
and skills to be addressed are entry level.
Outcome expectations are not the same as
those for a student completing a 4 year
program resulting in licensure by the Ohio
Dept. of Education.
ECE Program Faculty Perceptions
of Content Related to Inclusion in
ECE Teacher Education Programs
• ECE faculty may evidence a range of
comfort/discomfort in being asked to
include information and content related
to young children with special needs
within course content, course
assignments and field assignments. This
may be related to lack of academic
preparation or professional experiences
relating to young children with special
needs.
• Some ECE faculty may be uncomfortable
with the task of enhancing the ECE
curriculum re: inclusion as a result of their
perception or experiences with inclusion of
young children with special needs in child
care, preschool, Head Start or related
programs. In other words, some ECE faculty
may have a belief system that does not
support inclusion in ECE as a positive
development
Position Statement Related to Addressing
Inclusion Content and Practices in the ECE
Teacher Education Curriculum
As the models and mandates for early
education, child care, and early intervention
change as the result of contemporary political,
social and legal forces, public entities charged
with preparation of professionals (i.e.
community colleges and 4 year universities)
must ensure that future graduates are
prepared to meet the needs of all children,
including children with special needs, children
living in poverty, children whose primary
language is not English, and children from a
wide spectrum of family-living models…….
As members of the ECE profession, we
have no choice but to inform ECE
teachers of the future that awaits them,
even if we cannot fully understand that
future or are uncomfortable with
emerging and projected paradigms of
early care and education. This is the
challenge that must be met in the process
of curriculum enhancement in ECE
teacher education
Curriculum Enhancement in ECE
While the process is comprehensive, it is not
complex....... ECE faculty need to decide:
• Scope of content and skills related to
inclusion. These decisions are driven by
NAEYC and CEC-DEC guidelines for
program standards in ECE teacher
education
The Process of Curriculum Enhancement in ECE
• Appropriate sequence for introduction and
refinement of content and skills within the ECE
program course and field experience sequence.
In other words, where, when and how will:
• Basic content and skills be introduced?
• Advanced content and skills be refined and
practiced?
The Process of Curriculum Enhancement in ECE
These guiding questions will shape decisions
about which courses will include relevant
content related to inclusion, including
relevant instructional resources and
assignments, as well as opportunities for skill
practice in field and practicum placements.
The Process of Curriculum Enhancement in ECE
ECE faculty will need to decide……
• Which courses in ECE program sequence (e.g.
1000 level vs. 2000 level) will focus on basic
information/content and…. which course will
focus on acquisition of skills and practice ?
• Should inclusion content be included in courses
outside the control of ECE faculty (e.g. courses
managed by other depts. such as PSY, etc.)?
The Process of Curriculum Enhancement in ECE
ECE faculty will need to decide:
• Which courses will require complementary or
separate instructional resources (i.e. articles,
text, www links, etc.) that address content and
skills related to successful inclusion in ECE
settings
• Which courses will include introductory OR
advanced assignments that address the needs of
young children with developmental differences
The Process of Curriculum Enhancement in ECE
ECE faculty will need to decide:
• Which course-related field hour experiences
will address content and skills related to
successful inclusion in ECE settings
• Which practicum or student teaching
experience (s) will address advanced skills
related to successful inclusion in ECE settings
The Process of Curriculum Enhancement in ECE
ECE faculty will need to decide:
• What information or skills need repeated
exposure and refinement and….. which do not
• Whether certain information or skills needs
to be addressed in a developmental sequence
that reflects the academic and professional
maturation of ECE students (in 1000 level or
2000 level course and/or the student teaching
experience)
Examples of Inclusion Content that can be
be Appropriately Embedded in the “Intro
to ECE” Course in the ECE Curriculum
• LEGAL MANDATES FOR EARLY
INTERVENTION AND EARLY EDUCATION
• BACKGROUND INFORMATION DESCRIBING
PUBLIC AGENCIES CHARGED WITH
IDENTIFYING AND SERVING YOUNG CHILDREN
WITH SPECIAL NEEDS
Content Related to Policies and
Program Options in Early Childhood
Special Education
FEDERAL MANDATES AND
STATE OF OHIO COMPLIANCE:
EARLY INTERVENTION (PART
C) AND PRESCHOOL SPECIAL
EDUCATION SERVICES (PART
B 619)
The Promise of IDEA (2004)
 All children with disabilities are entitled to:

A “Free, Appropriate, Public Education”(FAPE)

In the “Least Restrictive Environment”(LRE)
 Pursuant
to Individualized Education Plan (IEP) or
Individualized Family Service Plan (IFSP)
Part C of IDEA
 Infants and Toddlers with Disabilities
 For children under the age of 3, with some
exceptions, …
 “urgent and substantial need … to
recognize the significant brain
development that occurs during a child’s
first 3 years of life …”
 “urgent and substantial need to
maximize the potential for individuals
with disabilities to live independently in
society …”
Early Intervention
 Developmental services are:
 Provided
under public supervision;
 Provided at no cost, except where Federal
or State law provides for a system of
payments by families, including a schedule
of sliding fees;
 Designed to meet the developmental
needs of an infant or toddler (ages birth to
3 years) with a disability, as identified by
the individualized family service plan
(IFSP) team in 1 or more developmental
domains
Requirements for States Under Early
Intervention Program (Part C IDEA, 2004)
 Early intervention services based on scientific






research
Timely, comprehensive, multidisciplinary
evaluation of child and family
Individualized Family Service Plan (IFSP)
Comprehensive Child Find system
Public awareness program focusing on early
identification
Central directory that includes information on
early intervention services, resources, and experts
Comprehensive system of personnel development
More requirements …
 An EI lead agency in each state
 A policy re: contracting with service providers
 A procedure for securing timely reimbursements
 A system for compiling data on program
outcomes
 A state Interagency Coordinating Council (ICC)
 Policies and procedures to ensure that:
 To the maximum extent possible, services are
provided in natural environments or most
appropriate setting, as determined by the parents
and IFSP team
Child Find
 Child Find requires school districts to identify,
locate, and evaluate ALL children with disabilities,
including children who are homeless, home
schooled, wards of the state, and children who attend
private schools.
 If the child has a disability and is eligible for special
education services, the school does not have to give
the child a “label” before providing services.
Infant or Toddler with a
Disability
 Any child under 3 years of age who needs early
intervention services because the individual is
experiencing developmental delays or has a
diagnosed physical or mental condition that has a
high probability of resulting in developmental delay.
Developmental Delay
 Extent of delay defined by each state however,
generally, a delay in 1 or more of these
areas/domains of development:
Cognitive development
Physical development
Communication development
Social/Emotional development
Adaptive development, or……
A diagnosed mental or physical condition that
has a high probability of resulting in
developmental delay (“risk factor”).
“At Risk” Infant or Toddler
 Any child under 3 years of age who would be at risk
of experiencing a substantial developmental delay if
early intervention services were not provided
Indicators of Risk and Qualification for EI Services
 Generally accepted definitions of “Risk” status
 Birth
weight under 1,500 grams (3.3 lbs)
 Neonatal intensive care unit treatment
 Born to chemically dependent mother
And referred by doctor and parent
 Seriously abused and/or neglected
As substantiated and referred by Children &
Youth protection agency
Individualized Family Service Plan
(IFSP)
 Legal requirements similar to IEPs (ages 3-22), but
including a “family-directed assessment” of the
family’s resources, priorities, and concerns.
 New requirement that the IFSP must include
“measurable results or outcomes expected to be
achieved … including pre-literacy and language
skills”
 Usually used for infants and
toddlers, but may be used w
preschoolers/older children
The IFSP
 IFSP: Individualized Family Service Plan
 Services
must be free of cost and be based on
evaluation and assessment data/reports
 Created by a team of individuals:
Parent of infant/toddler
A Service Coordinator
A Person directly involved in the evaluation
Persons who will provide EI services to
infant/toddler
The IFSP (cont.)
 What is included in the IFSP?
Current
levels in the 5
developmental areas (& results of
family assessment, if consented to)
List of Major outcomes child should
achieve & how to measure child’s
progress
Name of service coordinator
The IFSP (cont.)
 IFSP: Individualized Family Service Plan
 Services
child/family will receive
How often
Where: In“natural environment” (including
home, community settings); if not…. IFSP must
explain why not in natural setting
Whether service is directly provided to the
child or will be provided via consultation with
another adult who will work with the child
Early Intervention
• Requires that intervention agencies use “proven
methods of teaching and learning” based on
“replicable research.”
 Provided in “natural environments, including the
home, and community settings” to the maximum
extent possible.
Part C Services in Ohio:
“Help Me Grow” Agencies
http://www.ohiohelpmegrow.or/
Who Refers Children to EI/ECSE Programs?
The greatest number of referrals are from:
• Parents
• Child care provider recommendations
(via parents)
• Preschool teachers (via parents)
• Physicians
• Head Start/EHS (via parents)
• Child Advocacy agencies
EI/ECSE Programs
How are children served?
Specialized preschools
Inclusive preschools
Home visits
Parent training
Parent-Toddler classes
Consultation
Community preschools
Service Coordination
Related Services
Early Intervention Services
 Family training and
counseling
 Home visits
 Special instruction
 Speech-language
pathology and
audiology services,
occupational therapy,
physical therapy,
psychological, etc.
Early Intervention Services
 Service
coordination
services
 Medical services
only for
diagnostic or
evaluation
purposes
Early Intervention Services
 Early identification,
screening, and
assessment services
 Health services
necessary to enable
the infant or toddler
to benefit from the
other early
intervention services
Early Intervention Services
 Social work services
 Vision services
Early Intervention Services
 Assistive technology
 Transportation and
devices and
assistive technology
services
related costs that
are necessary to
enable an infant or
toddler and their
family to receive
another service.
Early Intervention Services
 Types of services (to child/family) also include:
 Service
Coordination
 Facilitate assessments, development and
review of IFSPs, and transition to pre-school
services
Coordinate/monitor delivery of EI services &
more (even if services are not the
responsibility of EI).
Early Interventionists and Related
Services Professionals
 Special educators
 Speech/language








pathologists
Audiologists
Occupational
therapists
Physical therapists
Psychologists
Social workers
Nurses
Registered dieticians
Family therapists
 Vision specialists,
including optometrists
and ophthalmologists
 Orientation and
mobility specialists
 Pediatricians and
other physicians
Is EI Effective?
 EI improves developmental and educational gains
for the child
 EI improves the functioning of the family
 Children in EI need fewer special education services
later, and level of services (and costs…) may be
reduced
 Following EI, children
are retained in early grades
less often
Part B Section 619 of IDEA
 Part B Section 619 governs special education and
related services for children with disabilities between
the ages of 3 and 5 (preschool special education)
The Special Education Process
 Child must be “referred” to be
evaluated for possible special
education services
 Initial evaluation is usually
conducted by a school psychologist
 Parent may wish to submit
information from treating physician
to supplement evaluation
 “IEP Team” -- parent & relevant
school personnel – make decisions
about eligibility and child’s
individualized education program
What is an Individual Education Plan (IEP)?
 IEP (like an IFSP) is a guide for a child’s
special education
 Includes annual goals
 Specifies what kind of special
education the student will receive and
the frequency/intensity of services
 Specifies the setting in which the
services will be delivered
 Specifies accommodations child will
need to participate in LRE
Who is Responsible for Providing Special
Education Services to 3-5 Year Olds in Ohio?
• The local school district in which the child lives is
responsible for the screening, assessment and
identification of preschool ages children (3-5) who
have special needs. There are approximately 614 local
school districts in the 88 counties in Ohio
• Some school districts choose to contract for
preschool special education services with regional
Education Service Centers (ESCs) or County Boards of
Developmental Disability versus providing the service
through the local school district
What Special Education Services are LEAs
Responsible for Providing 3-5 Year Olds in Ohio?
• The local school districts are responsible for providing
educational, developmental and related services to a 3-5
year old child with special needs as stipulated in the child’s
IEP. The IEP specifies the nature and intensity of
specialized services to be provided. The IEP team
determines the content of the IEP.
• Representatives of school districts or LEAs who provide
special education services must be licensed or validated by
the Ohio Department of Education. Preschool special
education teachers usually hold the Early Childhood
Interventions Specialist (ECIS) license or the Preschool
Special Needs validation
How are Special Education Services
Provided for 3-5 Year Olds in Ohio?
• Children with IEPs are served via 3 primary service delivery options:
• Preschool classroom under the direction of a licensed/validated
preschool special needs teacher employed by the LEA. Related services
also may be provided if included in the IEP.
• Preschool classrooms in Head Start, private for profit (i.e.
Montessori) or not-for-profit preschool programs. Services are
provided by an “Itinerant” teacher who visits children with IEPs in
these programs and provides services to the child as well as
consultation services to the lead teacher and other adults in the
classroom. The Itinerant teacher is required to hold an appropriate
license or validation. Related services also may be provided if included
in the IEP. Itinerant services are specified in the IEP.
• Visits to the child in his home by an Itinerant teacher and/or
related services professional (e.g. speech pathologist, occupational
therapist, physical therapist, etc.) as specified in the IEP.
EARLY CHILDHOOD SETTINGS
IN WHICH INCLUSION IS
SUPPORTED
What is the “Least Restrictive Environment”
or LRE ?
 The LRE is the setting in which children with
disabilities can be educated with typical children to
the maximum extent possible. LRE options in
preschool services might include local preschool
centers, inclusive preK classrooms operated by local
school districts, County Bd of DD preK classrooms,
Head Start, and other options
Head Start
Open door policy – ALL children who met the
economic requirement, regardless of
developmental status, were included in Head
Start.
Head Start
 1972 – 10% of enrollment reserved for
children with developmental disabilities,
even children with “severely handicapped
children.”
 Since Head Start began in 1965, more than
23 million children have attended.
 Today, more than 12.5% of children who
attend have an identified disability.
Head Start Act Requires…
 ...no less than 10 % of the total number of
enrollment opportunities in Head Start
programs in each state shall be available for
children with disabilities and that services
shall be provided to meet their special needs.
 Such policies and procedures shall require
Head Start agencies to coordinate
programmatic efforts with efforts to
implement Part C and Section 619 of the
Individuals with Disabilities Education Act
Head Start Disability Resources
Head Start Center for Inclusion University of Washington
depts.washington.edu/hscenter/
Children with Disabilities in Early
Head Start: Research to Practice ...
www.acf.hhs.gov › Office of Planning,
Research & Evaluation
Technical Assistance Contacts
 National Early Childhood  Regional Resource Centers
Technical Assistance
Center (NECTAC)
www.nectac.org
 National Child Care
Information Center
(NCCIC)
http://nccic.org/itcc
for Special Education
http://www.dssc.org/frc/rrfc.h
tm
 National Head Start Training
and Technical Assistance
Resource Center
www.hsnrc.org
 Head Start Regional
Disabilities Services TA
Providers
Integrated Activities and
Instruction in Inclusive Settings
Definition of Inclusive Environments
Early childhood inclusion embodies the
values, policies, and practices that support
the right of every infant and young child,
and his or her family, regardless of ability, to
participate in a broad range of activities and
contexts as full members of families,
communities, and society.
Curriculum Content is:
EMBEDDED INTERVENTION
Weaving Teaching
and Intervention into
Routine Activities
Embedded Interventions
Embedded Interventions
are specially designed practices that are used to
promote children’s engagement, learning, and
independence in everyday activities, routines, and
transitions in the classroom, home, and
community.
Source: CONNECT Module 1: Embedded Interventions
A “Routines-Based” or “Activity-Based”
Model for Intervention: Embedded Instruction
- Focuses on a child’s daily routines or activities like
snack, playtime, circle time, dramatic play as a
context for learning and OPPORTUNITY for
EMBEDDING
- Teachers give children opportunities to practice
targeted IEP or IFSP goals or activities during these
daily routines or activities instead of creating
special instructional time.
Environmental Modifications
Adaptations Help All Children
 Adaptations allow teachers to do the same
things that they would do with all children—
facilitate their participation in activities and
routines. Adaptations can be used to:
 Make situations better
for a particular child.
 Improve situations for
the entire group.
Peer Supports
DIVERSITY OF YOUNG
CHILDREN:
DEVELOPMENTAL DISABILITIES
IN EARLY CHILDHOOD
Incidence of Developmental Disability in Childhood
 An estimated 12-16% of children have a developmental and/or
behavior disorder
 Approximately 30% are identified before school entrance
 Those detected after school entrance have missed out on early
intervention services proven to have long term benefits
 Pediatricians, child care providers and preschool teachers are the
primary professionals with whom families have contact during a
child’s first five years of life
 Early identification by primary care providers of developmental
delays leads to early referral for evaluation and treatment
Exceptional Children
Under IDEA, can public schools choose not to
provide education for some students with
disabilities ?
Federal legislation specifies that to receive
federal funds, every school system must
provide a free, appropriate education for
every student regardless of any disabling
condition or the extent/degree of
impairment
Exceptional Children
Under IDEA, the student with a disability must be
placed in the least restrictive environment (LRE).
Is the LRE always the regular or general education
classroom?
The law does require the student with a
disability to be placed in the LRE however,
the LRE is not always the regular
classroom. What the LRE does mean is that
the student shall be separated as little as
possible from home, family, community,
and the regular class setting while
appropriate education is provided. In
many, but not all instances, this will mean
placement in the regular classroom.
Multicultural & Bilingual Aspects
Is Disproportionate Representation of ethnic
minorities in special education still a problem under
IDEA (2004) ?
Some ethnic minorities are still
underrepresented or overrepresented in
certain special education categories. For
example, African American students,
especially males, are overrepresented in
programs for students with emotional or
behavioral disorders and underrepresented in
programs for gifted and talented students.
Is disability ever related to ethnicity?
Some disabilities are genetically linked and
therefore more prevalent in some ethnic
groups. For example, sickle cell disease (a
severe, chronic, hereditary blood disease)
occurs disproportionately in children with
ancestry from Africa, Mediterranean and
Caribbean regions, Saudi Arabia, and India.
Special Education Eligibility Categories
 Speech/Language/Co




mmunication
Impairment
Autism Spectrum
Disorder (ASD)
Emotionally Impaired
Cognitive Impairment
Developmentally
Delayed (preK use)
 Physically Impaired
 Other Health Impaired
(includes ADHD)
 Hearing impaired
 Multi-handicapped
 Visually Impaired
** Learning Disability is a
school-age category (ages
6-22)
Communication Disorders
Communications Disorders
Do children with language disorders always
have speech difficulties as well?
It is possible for a child to have good
quality speech; however, most children
with language disorders have speech
disorders, as well.
Communications Disorders
Do individuals with communication
disorders always have emotional or
behavioral disorders or mental
retardation?
Some children with communication
disorders experience typical cognitive,
social, and emotional development.
Communications Disorders
Are disorders of phonology (or articulation)
ever very serious, or are these problems
always easy to correct?
Disorders of phonology can make
speech unintelligible; it is sometimes
very difficult to correct phonological or
articulation problems, especially if the
individual has cerebral palsy, mental
retardation, or emotional or behavioral
disorders.
Communications Disorders
Is there much overlap between language
disorders and learning disabilities?
Problems with verbal skills-- listening,
reading, writing, speaking-- are often
central features of learning disabilities.
The definitions of language disorders and
several other disabilities overlap.
Communications Disorders
Can children who learn few language
skills before entering kindergarten easily
pick up all the skills they need, if they
have good peer models in typical
classrooms?
Early language learning is critical for
later language development; a child
whose language is delayed in
kindergarten is unlikely to learn to use
language effectively solely by
observing peer models. More explicit
intervention is typically required.
Autism Spectrum Disorder
(ASD)
Autism Spectrum Disorders
 Autism Spectrum
Disorders (ASD)
 Neurodevelopmental
disorders
characterized by
impairments in three
domains:
•
•
•
Socialization
Communication
Behavior
Includes:
 Autistic disorder
 Asperger disorder
 Rhett’s disorder
 Childhood
Disintegrating
disorder
 Pervasive
developmental
disorder, not
otherwise specified
(PDD-NOS)
ASD
 Autism Spectrum Disorders
 Occurs
in ~1 in 80 to 1 in 150 children
 Increasing incidence since 1970s—due to
increased awareness/changes in definition
 CD/MR /seizures commonly associated w ASD
 Causes not completely understood
 Overwhelming evidence does not support
association of ASD with childhood
immunizations
Autism Spectrum Disorder (ASD)
 For the preschool child, “Autism” signifies a
developmental disability affecting the processing,
integrating, and organizing of information that
significantly impacts communication, social
interaction, and developmental progress.
 “Autism is a spectrum disorder. The symptoms and
characteristics of autism present themselves in a
wide variety of combinations, from mild to severe.
Diagnosis of ASD

Delays or abnormal functioning in at least
one of the following areas, with onset before
3 years old: (1) social interaction, (2)
language as used in social communication, or
(3) symbolic or imaginative play.

The disturbance is not better accounted for
by Rett's Disorder or childhood disintegrative
disorder.
Characteristics of Children with ASD
Qualitative impairments in communication as manifested by at
least one of the following:

Delay in, or total lack of, the development of spoken
language (not accompanied by an attempt to
compensate through alternative modes of
communication such as gesture or mime)

In individuals with adequate speech, marked
impairment in the ability to initiate or sustain a
conversation with others
Characteristics of Children with ASD (cont.)
Qualitative impairments in communication as manifested
by at least one of the following:

Stereotyped and repetitive use of language or
idiosyncratic language

Lack of varied, spontaneous make-believe play
or social imitative play appropriate to
developmental level
Characteristics of Children with ASD (cont.)
Restricted repetitive and stereotyped patterns of
behavior, interests, and activities, as manifested by at
least one of the following:

Encompassing preoccupation with one or more
stereotyped and restricted patterns of interest
that is abnormal either in intensity or focus

Apparently inflexible adherence to specific,
nonfunctional routines or rituals
Characteristics of Children with ASD (cont.)
Restricted repetitive and stereotyped patterns of
behavior, interests, and activities, as manifested by at
least one of the following:


Stereotyped and repetitive motor mannerisms
(eg, hand or finger flapping or twisting, or
complex whole-body movements)

Persistent preoccupation with parts of objects
ASD
Early Indicators of ASD and/or Communication
and Interaction Disorders
• Often suspect the child may be deaf. Doesn’t have typical
•
•
•
•
startle response. Doesn’t turn when you come into the room.
Seems unaware of sounds in the room, etc.
Extremely “good” babies – seldom cry, are not demanding,
seem very content to be alone or very fussy, colicky babies-cry a
lot, sleep problems, not easily comforted.
Engage in an excessive amount of rocking
May “hand gaze”, look at lights through fingers or have other
self-stimulatory behavior.
Often very fussy eaters. Become upset with the change from
pureed baby foods to junior baby foods. Prefer only salty foods
or only sweet foods, etc.
ASD
 Lack of molding – the baby “just doesn’t feel right” when you





pick him up. Often feels stiff, arches his back, etc.
Does not have anticipatory response. Doesn’t put up his arms
to be picked up. Doesn’t seem to want to be held.
Seems to actively avoid looking at people. Lack of eye contact.
Seems to “tune out” a lot. Isn’t aware of what is happening
around him
Prolonged tantrums –up to two hours in duration or more.
Often it is difficult to figure out what set the child off.
Wants things to “stay the same”. May have difficulty adapting
to winter coat or boots. Wants to wear the same clothes.
Doesn’t want furniture or toys to be “out of place”.
ASD
 Doesn’t play typically with toys is more likely to spin wheels
on truck rather than move truck across the floor. Will line
things up rather than play.
 Does not begin to talk or use words in a communicative way at
the appropriate age. Fails to develop language or uses
echolalic speech (echoing) without really understanding the
meaning of the words.
 Often seems to be a perfectionistic. Wants everything to be
“just right”. If he tries to make something work and it doesn’t,
he gets upset and will quit or get angry and won’t try the
activity again.
ASD
• Often has “splinter skill” in areas like music or can do puzzles
•
•
•
•
•
extremely well or has excellent gross motor skills or is very
interested in numbers and letters.
Seems to have an excellent memory. Knows exactly where
cookie jar is in a home he hasn’t visited for several months,
etc.
Likes to watch things go around such as record players, tops,
etc.
May bang his head or engage in other self-injurious behaviors
May have very high tolerance for pain. He may get hurt but
not come to an adult for comfort.
Changes in routine are very upsetting.
ASD
 Does not spontaneously imitate the play of other children.
 May have difficulty generalizing information from one setting to
another
 May not experience separation anxiety at the typical age of 8 –
12 months.
 May experience extreme auditory sensitivity.
 May use an adult’s hand like a tool for accomplishing a task.
Attention DeficitHyperactivity Disorder
(ADHD)
ADHD/ADD
Early Indicators:
The following list should serve as a guideline to determine if
further medical examination is warranted. Not all children with ADD
will exhibit these behaviors and not all children with these behaviors
will have ADD/ADHD. A good developmental screening is important
when considering any further evaluation.
If a child has had inconsistency in parenting, has experienced
traumatic events, or has delays in language development they may
exhibit many of the symptoms listed in the following slides.
ADHD/ADD
Infancy/Late Infancy
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
Problems sleeping through the night
Short, sporadic naps during the day
Excessive crying/colic
Ear infections/allergies/asthma
Not interested in being held
Content when put down
Difficulty bonding
Cries when held
Rapid or delayed milestones
Irritable in high stimulus settings
Irritable when routines change
ADHD/ADD
Toddler
–
–
–
–
–
–
–
–
–
–
Does not respond to normal behavioral controls
Difficulty in sharing/taking turns
Inability to sit still or sustain attention
High incident of falling or accidents
Clumsiness
Can be destructive with toys
Trouble with playing with other children, higher incident of biting,
kicking, or pushing playmates
Does not like to be read to
Fidgets when restrained or help for more than a few minutes
Can act as if driven by a motor
ADHD/ADD
Preschool
–
–
–
–
–
–
–
–
–
–
Always in motion
Inability to sit sill or sustain
Clumsiness
Coordination problems or delays
Difficulty following directions
Seem as if they are not paying attention
Impulsive: grabs toys, acts before thinking
Difficulty sharing and taking turns
Trouble waiting turn or standing in line
Inappropriate touching, poking of other children or intruding on
other’s personal space
ADHD/ADD
Preschool



Interrupts often
Can be aggressive: hitting, kicking or biting playmates
Forgetful
http://add.about.com/cs/adhdinpreschool/a/earlyindicators.htm
Summary ADHD/ADD
 ADD/ADHD is a medical diagnosis, not an
education diagnosis (similar to ASD as a medical
diagnosis)
 Many children with ADD/ADHD do not require
special education and may not meet
requirements for eligibility for special education
services
Cognitive Impairment/
Developmental Delay
Developmental Disability/Delay (DD)
 Developmental Disability/Delay (DD) is present when
functional aspects of a child’s development in one or
more domains (gross/fine motor, speech/language,
cognition, social/personal, and activities of daily living) are
significantly delayed compared to the expected level for
age (≥25% from the expected rate or a discrepancy of 1.5 to
2 standard deviations from the norm)
Global or General Developmental Delay (GDD)
 Global or General Developmental Delay (GDD)
is a subset of DD defined as significant delay in 2
or more developmental domains (reserved for
children less than 5 years old)
Cognitive Delay or Intellectual Impairment
 Mental Retardation (MR)-a state of functioning beginning in childhood
characterized by limitations in intelligence and adaptive skills.
Prevalence of CD/MR in general population is 1-3%
 DSM-IV Criteria for MR (current DSM V just released….2013):



Significant sub-average intellectual functioning
Adaptive functioning deficit or impairment
Onset before 18 years of age
 Cognitive impairment requires IQ testing (accurate ages ≥5 yrs.)




Mild—50 to 70 IQ ( 70 is 2 SD from normal—100)
Moderate—40 to 50
Severe—20 to 40
Profound—<20
Other Elements of Cognitive Delay
 Impairment in adaptive skills- skills of daily living
needed to live, work, and play in the community
 Communication, social skills, self-care, home living,
reading, writing, mathematics, work, leisure, health
and safety
 Considered impaired when there is a deficit in two or
more areas
 American Association on Mental Retardation (AAMR)
also has similar definitions of MR, but also describes
supports needed (intermittent, limited, extensive, or
pervasive)
Physical and Other Health
Impairments
Physical Disabilities
Examples of Physical Disabilities
and Health Impairing Conditions
• Cerebral Palsy
• Neural Tube Defects (Spina Bifida)
• Epilepsy
• Asthma
• Cystic Fibrosis
• Diabetes
• Sickle-cell anemia
• Muscular Dystrophy
Is cerebral palsy a disease ?
Cerebral palsy is not a disease. It is a nonprogressive neurological injury (damage to
brain). It is a disorder of muscle control and
coordination caused by injury to the brain
during pregnancy, during birth, or in early
childhood.
Physical Disabilities
Is it true that physical disabilities of all
kinds are decreasing because of medical
advances?
As a result of advances in medical
technology, a number of children with
severe disabilities are surviving. The
number of survivors of serious medical
conditions (i.e. very low and low birth
weights) who develop normally or have
mild impairments, such as hyperactivity
and learning disabilities, also is
increasing.
Is it true that the more severe a child’s physical
disability, the lower their intelligence?
Not necessarily. A person may be severely
physically disabled by a condition such as
cerebral palsy but have a at least normal
intelligence.
Hearing Impairment
Hearing Impairmen
Is it true that deafness is not as severe a
disability as blindness?
Although it is impossible to predict the
specific implications of a disability on a
child’s functioning, deafness may
contribute to greater difficulties in
adjustment than blindness. This may be
due to the effects hearing loss can have
on the ability to understand and use oral
language (speech).
Hearing Impairmen
Is speech reading or lip reading relatively
easy to learn and used by most people with
hearing impairment?
Speech reading is extremely difficult to
learn, and very few people who are
hearing impaired actually become
proficient speech readers.
Hearing Impairmen
Is American Sign Language (ASL) really a
loosely structured group of hand gestures
that is easy to learn and use?
ASL is a true language with its a set of
grammatical rules. Some children with
perceptual, motor and/or significant
cognitive impairment may not become
effective users of ASL, or may use a
modified or adapted version of ASL with
limited signs
Visual Impairment
Prevalence of Vision Impairment
Blindness is primarily an adult disability.
Most estimates indicate that blindness is
approximately 1/10th as prevalent in schoolage children as in adults. Only about 1/200
children are classified as “visually
impaired.” This makes visual impairment
one of the least prevalent disabilities in
children.
Visual Impairment
Do children who are legally blind have any
sight?
Only a small percentage of children
who are legally blind have absolutely
no vision. Many have some degree of
functional vision.
Visual Impairment
Do people who are blind automatically
develop better acuity in their other senses?
Through concentration and attention,
individuals who are blind can learn to
make very fine discriminations in the
sensations they obtain. This is not
automatic but rather represents a
better use of received sensations.
Is Braille useful for most people who
are blind?
Very few people who are blind have
learned Braille, primarily due to fear that
using it is a sign of failure and historical
professional bias against use of Braille.
Authorities in vision impairment
acknowledge the utility of Braille for
people who are blind. Braille decoding
requires good cognitive skills.
Visual Impairment
Should mobility instruction of young children
with vision impairments be delayed until
elementary school or secondary school?
Many authorities now recognize that even
preschoolers can take advantage of mobility
instruction, including the use of a cane.
Giftedness
Giftedness
Definition of Giftedness
Federal Legislation encourages states to develop
programs for gifted students and support research
in this area. Gifted and talented students are
defined in federal law as children and youths who
(1) give evidence of high performance capability in
such areas as intellectual, creative, artistic, or
leadership capacity or in specific academic fields
and (2) require services or activities not ordinarily
provided by the school in order to develop such
capabilities fully.
What percent of of the population is gifted?
The percentage of the population that is
gifted depends on the definition of
giftedness used. Some definitions include
only 1 or 2 % of the population; others, over
20 %.
Giftedness
Is it true that children who are gifted are
physically weak, socially inept, narrow in
interests, and prone to emotional instability?
There are wide individual variations,
and most gifted individuals are healthy,
well adjusted socially attractive, and
morally responsible persons.
Giftedness
Is it true that gifted children are usually
bored with school and antagonistic toward
those who are responsible for their
education?
Most gifted children like school and
adjust well to their peers and teachers,
although some do not like school and
have social or emotional problems.
Gifted
Do children who are gifted do everything well?
Some people characterized as gifted have
superior abilities of many kinds; others
have clearly superior talents in only one
area.
Gifted
Is a child gifted if they score above a
certain level on intelligence tests?
IQ is only one indication of one kind of
giftedness. Creativity and high
motivation are as important indications
as general intelligence. Gifts or talents
in some areas, such as the visual and
performing arts, are not assessed by IQ
tests.
Gifted
Won’t children who are gifted excel without special
attention? Won’t they excel if provided with the same
incentives and instruction that are appropriate for all
children?
Some gifted children will perform at a
remarkably high level without special
opportunities of any kind. Some will make
outstanding contributions even in the face of
great obstacles to their achievement. But most
will not achieve at a level commensurate with
their potential unless their talents are
deliberately fostered by interactions that support
their advanced abilities.
Modification of Course/Field
Assignments to Address Content
Related to Inclusion in ECE
EXAMPLES OF MODIFICATION OF
ASSIGNMENTS……
Suggestion…….
• ADD a component related to children with
disabilities and/or their families to selected
assignments/projects across courses/practica
experiences in “Intro to ECE” course. This can result
in creating a different or additional assignment
or….adding a component in which students must
present evidence of their knowledge of the
implications of disability on child development,
interaction with peers or engagement in the typical
preschool curriculum, or awareness of the range of
services available to young children with special needs
Suggestion (cont.)
Example 1: An element could be added to an assignment in
“Intro to ECE” that requires a student to:
• Locate a www site that provides information on eligibility
requirements for preschool special education services (ages 3-5),
and to then describe the basic requirements for eligibility
• Locate a www site that describes the Part B 619 services
provided for young children with special needs (ages 3-5) in
Ohio. This information could include which agencies provide
this service, the basic requirements of the IEP, and the role of
the ECE teacher or childcare provider in providing services as a
member of the IEP team.
• This assignment also could include an option for students to
examine the requirements, etc. for Part C (birth to age 3)
services in Ohio
Suggestion (cont.)
Example 2: An element in “Intro to ECE” that requires a
student to:
• Locate a www site that provides information on
developmental characteristics of young children with a high
incidence disability condition (i.e. Autism, Communication
Disorder, Cognitive Impairment, ADHD, etc.)
• Describe how 3 of these expected characteristics might have
an impact on the child’s participation in the classroom
• Describe which community agencies might be involved with
this child and what resources/ consultative services might be
expected to be provided to the child’s preschool teacher (e.g.
occupational therapy, speech services, Head Start Disability
Coordinator, etc.)
Resources for ECE Students
EARLY INDICATORS OF POTENTIAL FOR
DEVELOPMENTAL DELAY AND
RATIONALE FOR REFERRAL FOR
DETERMINATION OF ELIGIBILITY FOR
EARLY INTERVENTION OR EARLY
CHILDHOOD SPECIAL EDUCATION
Developmental Red Flags
1 to 3 months
 Doesn’t seem to respond to loud noises
 Doesn’t follow moving objects with eyes by 2 to 3 months
 Doesn’t smile at the sound of your voice by 2 months
 Doesn’t grasp and hold objects by 3 months
 Doesn’t smile at people by 3 months
 Cannot support head well at 3 months
 Doesn’t reach for and grasp toys by 3 to 4 months
 Doesn’t bring objects to mouth by 4 months
 Doesn’t push down with legs when feet are placed on a firm surface by 4
months
 Has trouble moving one or both eyes in all directions
 Crosses eyes most of the time (occasional crossing of the eyes is normal in
these first months)
Developmental Red Flags
4 to 7 months
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
–
Seems very stiff, tight muscles
Seems very floppy, like a rag doll
Head still flops back when body is pulled to sitting position (by 5months
still exhibits head lag)
Shows no affection for the person who cares for them
Doesn’t seem to enjoy being around people
One or both eyes consistently turn in or out
Persistent tearing, eye drainage, or sensitivity to light
Does not respond to sounds around them
Has difficulty getting objects to mouth
Does not turn head to locate sounds by 4 months
Doesn’t roll over (stomach to back) by 6 months
Cannot sit with help by 6 months (not by themselves)
Does not laugh or make squealing sounds by 5 months
Does not actively reach for objects by 6 months
Does not follow objects with both eyes
Does not bear some weight on legs by 5 months
Developmental Red Flags
8 to 12 months
 Does not crawl
 Drags one side of body while crawling (for over one month)
 Cannot stand when supported
 Does not search for objects that are hidden (10-12 mos.)
 Says no single words (“mama” or “dada”)
 Does not learn to use gestures such as waving or shaking head
 Does not sit steadily by 10 months
 Does not show interest in “peek-a-boo" or "patty cake” by 8 mos.
 Does not babble by 8 mos. (“dada,” “baba,” “mama”)
Developmental Red Flags
12 to 24 months
 Cannot walk by 18 months
 Fails to develop a mature heel-toe walking pattern after several months of





walking, or walks exclusively on toes
Does not speak at least 15 words by 18 months
Does not use two-word sentences by age 2
By 15 months does not seem to know the function of common household
objects (brush, telephone, bell, fork, spoon)
Does not imitate actions or words by 24 mos.
Does not follow simple one-step instructions by 24 mos.
Developmental Red Flags
24 to 36 months
 Frequent falling and difficulty with stairs
 Persistent drooling or very unclear speech
 Inability to build a tower of more than 4 blocks
 Difficulty manipulating small objects
 Inability to copy a circle by 3 years old
 Inability to communicate in short phrases
 No involvement in pretend play
 Failure to understand simple instructions
 Little interest in other children
 Extreme difficulty separating from primary caregiver
Developmental Red Flags
3 to 4 years















Cannot jump in place
Cannot ride a trike
Cannot grasp a crayon between thumb and fingers
Has difficulty scribbling
Cannot copy a circle
Cannot stack 4 blocks
Still clings or cries when parents leave him
Shows no interest in interactive games
Ignores other children
Doesn't respond to people outside the family
Doesn't engage in fantasy play
Resists dressing, sleeping, using the toilet
Lashes out without any self-control when angry or upset
Doesn't use sentences of more than three words
Doesn't use "me" or "you" appropriately
Developmental Red Flags
4 to 5 years
 Exhibits extremely aggressive, fearful or timid behavior
 Is unable to separate from parents
 Is easily distracted and unable to concentrate on any single activity for










more than 5 minutes
Shows little interest in playing with other children
Refuses to respond to people in general
Rarely uses fantasy or imitation in play
Seems unhappy or sad much of the time
Avoids or seems aloof with other children and adults
Doesn't express a wide range of emotions
Has trouble eating, sleeping or using the toilet
Can't differentiate between fantasy and reality
Seems unusually passive
Can't understand two-part commands and prepositions ("put the cup on
the table"; "get the ball under the couch")
Developmental Red Flags
4 to 5 years continues
 Can't give his first and last name
 Doesn't use plurals or past tense
 Cannot build a tower of 6 to 8 blocks
 Seems uncomfortable holding a crayon
 Has trouble taking off clothing
 Can't brush teeth or wash and dry hands
Developmental Red Flags conclusion
Communication Disorder
 For a phonological or articulation disorder:


The student’s phonology or articulation is rated significantly discrepant
as measured by a standardized test; and
The disorder is substantiated by a language sample or other
evaluation(s).
 For a syntax, morphology, pragmatic, or semantic disorder:



The student’s language in the area of syntax, morphology, pragmatics,
or semantics is significantly discrepant as measured by standardized
test(s); and
The disorder is substantiated by a language sample or other
evaluation(s); and
The disorder is not the result of another disability.
Resources to Support Content
Related to Inclusion in
ECE Courses/Practica
NICHCY
nichcy.org/
NICHCY (National Information Center for
Handicapped Children and Youth) is a national
information center that provides information on
disabilities and disability related issues, focusing
on children and youth, birth to age 22. There are
links to images, files and media that describe, in
some detail, the entire spectrum of disability
conditions
Early Childhood Learning and Knowledge Center
National Center on Quality
Teaching and Learning
Fred Rogers Center Early Learning Environment
Curriculum Toolkit
Crosswalks http://fpg.unc.edu/~crosswalks
See For Yourself
Find It Online
National Center to
Improve Practice Early
Childhood Guided Tour
Read About It
See For Yourself
From
CONNECT
Module 5
Find It Online
Tots-n-Tech Research Institute