1

King

Research Project: Key Assessment

Emma King

Early Childhood Development Program

EDUC 315: Observation, Assessment, and Intervention

September 27, 2020

2
King
Research Project: Key Assessment

Family Centered Early Supports and Services

Program Y is an agency that is local to Region M. This agency provides children’s and

adult services to people with developmental disabilities or acquired brain injuries and their

families. Program Y offers children’s services to people ages birth through 21 years of age,

however, this section will primarily focus on the Family Centered Early Supports and Services

(FCESS) birth to three program within agency. Program Y serves 34 towns within Region M and

employs about 11 professionals within the children’s services program. The entire organization

serves about 600 families within Region M (Program Y 2, 2020). Region M is a rural region that

houses approximately 76,500 people (NHES, 2018).

Description of the Program

Program Y’s mission is “to work toward inclusion, participation, and mutual

relationships for all people who are at risk for isolation from the community” (Program Y 2,

2020). This FCESS program within the organization works with infants and toddlers with

disabilities and their families. Program Y provides services to families that involve early

intervention. Early intervention is a system of services for children ages birth to three with

developmental delays or disabilities and their families (Brilliante, 2017). Early intervention is a

process that will lead young children and their families to developing an Individualized Family

Service Plan (IFSP).

Program Y offers many different services for families based on their individual needs

(See Appendix A). The services that Program Y offers are as follows: developmental evaluations,

guidance on how to incorporate therapeutic activities in to the family’s routines, special

3
King
instruction, speech pathology, occupational therapy, physical therapy, and service coordination

that helps to link families with information about community resources, assistance with

transitioning from early intervention, advocacy groups, feeding and nutrition programs, special

medical services, child development clinics, Multi-sensory intervention through consultation

and education (MICE), and neuromotor clinic (Program Y 1, 2020).

Community, Population, and Services

Region M is a rural area that has a population of approximately 76,100 people. This

Region has a 10.2% poverty rate, with about 40,000 of the region’s people being employed

(DATAUSA, 2017). This region has a median property value of $188,700 (DATAUSA, 2017). The

state that houses the region had 476 drug related deaths in 2017, and in 2014, the percentage

of people needing addiction treatment but not receiving it was at 88% (Opioid & Health

Indicators Database, n.d.).

Program Y serves a population of 600 families within the entire organization. The main

focus of the FCESS program within Program Y is families with children ages birth to three who

have or might be at risk for developmental delays or disabilities. This also includes children who

may have been born with an exposure to opioids or alcohol. The state that houses Region M

had a 3.9 percent of newborn infants in 2019 who were being monitored for opioid or alcohol

exposure (Albertson-Grove, 2020). The program also serves children who have a developmental

delay of at least 33% or have an established condition. The program may serve children and

families who do not have the resources for private help, as Program Y is funded by family’s

private insurance, Medicaid and State and Federal programs so that families do not need to pay

out of pocket (Program Y 1, 2020).

4
King
Program Y meets the needs of the community by offering a multitude of services for

each family based on their need. Program Y is an organization that wishes to work toward

inclusion and participation for all the people who are at risk of isolation from the community

(Program Y 2, 2020). This connects to Bronfenbrenner’s Bioecological Model. The Bioecological

Model explains that the world of the child consists of five systems of interaction: (1)

Microsystem, (2) Mesosystem, (3) Exosystem, (4) Macrosystem, and (5) Chronosystem (Swick &

Williams, 2006). Each of the bioecological systems depend on the child or individuals’ life and it

grows and changes through every system as the person grows (Swick & William, 2006).

Program Y helps to build up children and adults with disabilities entire systems by helping them

gain more opportunities in their communities, schools, churches, which help to compose their

microsystem. The children and adults with disabilities will also become a part of their

exosystem and macrosystem. The exosystem is the relationship that an individual has with the

parts of the community that involve the neighborhood that the child lives in, local politics, and

media. The program also helps to put a new lens on the macrosystem that an individual is a

part of (Exploring Your Mind, 2020). This is the culture and its attitudes. This gives the culture of

the community a new ideology about people with disabilities.

IDEA and Family Centered Early Supports and Services

Description of IDEA Law

The Individuals with Disabilities Education Act (IDEA) is a law that has four connected

parts, Part A, Part B, Part C, and Part D. Part A of the IDEA law sets the foundation for the entire

law by outlining the general provisions of the law which includes the purpose of the law, the

effective date of each amendment and the definitions of terminology that is used throughout
5
King
the law. Part A also outlines details such as the employment of individuals with disabilities, and

how each individual state can administer the IDEA law (Individuals with Disabilities Education

Act [IDEA], 2004) (See Appendix B).

Part B of IDEA includes the provision that explains the use of grants that assist states to

provide special education for children ages 3 to 21 with disabilities (IDEA, 2004). Part B states

that a free and appropriate public education is available for all children with disabilities (IDEA,

2004). This part of the law states that each U.S. state administers its own program for children

with disabilities, and the regulations outline each of the eligibility requirements and the

procedure for the referral process as well as the Individualized Education Program (IEP) process

(Brilliante, 2017). Part B of IDEA provides procedural safeguards which allow the child and their

family the safeguard of being guaranteed a free public education (IDEA, 2004). Lastly, Part B

offers the provision of monitoring, technical assistance, and enforcement of the law (IDEA,

2004).

Part C of IDEA includes the provisions that explain the use of grants that assist states to

provide early intervention services to children ages birth to two years of age and their families

(IDEA, 2004). This section includes the reasonings for including early intervention for infants

and toddlers as well as definitions on the terminology used throughout the law. Part C covers

who is eligible for early intervention services, how grants work and the state’s requirements for

the system (IDEA, 2004). Part C of IDEA covers the Individualized Family Service Plan (IFSP), the

referral process, assessing the infant or toddler, periodic reviews and the content of the IFSP

(IDEA, 2004). Like Part B, Part C also explains the uses of funds and procedural safeguards.

Lastly, Part D of IDEA covers national activities to improve education of children with
6
King
disabilities. This part of the law explains the federal government’s obligation to support

activities that contribute to a positive education for children with disabilities (IDEA, 2004).

Program Y uses Part C of IDEA for their FCESS program when determining eligibility. Part

C of IDEA and Program Y both state that in order for a child to be eligible, they must be under

three years of age and have a developmental delay or be at risk for a developmental delay in

one or more of the areas that they support which are physical, cognitive, social-emotional, and

adaptive development (Program Y 1, 2020). Program Y follows Part C of IDEA when connecting

families with the referral process. The program states that parents, caregivers and members of

the medical community can make a referral to Program Y for FCESS and the team will them

start the eligibility process (Program Y 1, 2020).

Special Education Process

One of the main pieces from Part C of IDEA is the developing of the IFSP. Every state has

a referral process that connects with Part C of IDEA; however, some states the Department of

Education coordinates the FCESS and in others, the Department of Health and Human Services

coordinates the FCESS. There are six steps to the IFSP process which include the referral, the

interdisciplinary evaluation, the development and implementation of the IFSP, 6-month

reviews, and the transition to public school for children turning three (Brilliante, 2017).

The referral can be made by parents, caregivers, or medical professionals and this will

begin the eligibility process. During the process of determining eligibility, there will be a

multidisciplinary assessment that takes place in a child’s natural environment to determine

their eligibility and what services they will have (IDEA, 2004). The state will also provide the
7
King
family with their rights in an easy to understand format in their home language (Brilliante,

2017).

The writing and implementation of the IFSP is a process that involves the family, and

each member of the IFSP team. The IFSP will identify the services that the family is receiving,

and the services will begin within 30 calendar days after the family consents to implement the

IFSP (Brilliante, 2017). Once the IFSP is implemented, there will be 6-month and annual reviews

to see that the child is making progress with their services (Brilliante, 2017). Finally, children will

transition to special education at age three and the family and the interdisciplinary team will

develop an Individualized Education Program (IEP) which is covered under Part B of IDEA

(Brilliante, 2017).

(Dis)ability, Assessment, & Intervention

Cerebral Palsy

Cerebral Palsy (CP) is a group of disorders that affect a person’s ability to maintain

posture, balance and mobility and is caused by abnormal brain development or damage to the

developing brain. CP is the most common motor disability in children (Hadders-Algra, 2014).

The symptoms of CP vary greatly from person to person, as there are four main types of CP

(Centers for Disease Control and Prevention (CDC), 2020). The four main types of CP are spastic

cerebral palsy, dyskinetic cerebral palsy, ataxic cerebral palsy, and mixed cerebral palsy (CDC,

2020).

Spastic CP is the most common type of CP and involves increased muscle tone, which

results in still muscles. People who have spastic CP can have one of the three types of spastic CP

which are described by the part of the body that is affected by it. Spastic diplegia is when there
8
King
is stiffness in the legs when the arms are less affected by stiffness or not affected at all. Spastic

hemiplegia is when the stiffness is only present on one side of the body. Spastic quadriplegia is

the most severe form of spastic CP and it affects all limbs, the torso and sometimes the face

(CDC, 2020).

Dyskinetic CP affects the movement of the hands, arms, feet and legs, which can make it

hard for people with dyskinetic CP to sit and walk. The movement of the hands, feet and legs

can be fast, or slow and it varies between each person’s individual muscle tone (CDC, 2020).

Ataxic CP affects balance and coordination. It may be harder for someone with this form of CP

to write, reach or control their steady movements (CDC, 2020). Lastly, mixed CP happens when

someone has more than one type of CP (CDC, 2020).

Assessment: Identification and Eligibility

Cerebral palsy in the past has been typically diagnosed around 12 to 24 months of age in

children, but early diagnosis at 12 weeks of age is possible for a percentage of the population.

CP can be diagnosed in children with a combination of best practice techniques such as learning

the risk factor history, providing a neurological examination, a standardized motor assessment

to learn the quality of the child’s movement, neuroimaging, and ruling out other diagnoses

(Novak, 2014). Children with CP will most likely be automatically eligible for early intervention

services, however, a child will still go through an interdisciplinary evaluation to determine what

specific services the child will be eligible for (Stern, 2020). Children with CP often receive the

greatest number of individual services and intervention compared to other children who

receive early intervention services (Chiarello et al., 2012).

Assessment Process
9
King
Children with CP can be diagnosed anywhere from an early diagnosis age of 12 weeks,

to a later diagnosis of 24 months. It is best for a child to be diagnosed as early as possible so

that the child can go through the assessment process as early as possible and find the

diagnosis-specific intervention that is best for them (Novak, 2014). During the assessment

process for infants and young children with CP, the child’s neurologist will most likely diagnose

the child with CP, then refer the family to an early intervention agency where they will begin

the interdisciplinary evaluation to determine the specific child’s need for services. If a

neurologist is unsure of the child’s diagnosis, they will recommend that the family seek an early

intervention agency that will accept family referrals, and then the interdisciplinary evaluation

will begin (Novak, 2014) for the Individualized Family Service Plan (IFSP).

The assessment process is used to determine the child’s present level of performance

(Conaster, James & Ledingham, 2013), and they are performed in the child’s natural

environment. Assessments for young children with CP should be used as a screening tool for

identifying the infant or toddler’s strengths and weaknesses rather than giving them a

numerical score (Conaster et al., 2013). A team of professionals who specialize in infants and

toddlers and the five areas of development will come together and assess the child’s

functioning in each of the five domains of development which are physical, cognitive,

communication, social and emotional, and adaptive development (Brilliante, 2017). Each child

with CP and their symptoms vary greatly, so conducting interdisciplinary assessments is an

important part of the early intervention process. For example, one child with severe spastic

quadriplegic CP may have mastered social, emotional and communication development, but

need to continue working on physical development (Conaster et al., 2013), while another child
10
King
with the same diagnosis may need to continue working on cognitive development, but reached

a goal with physical development (Brilliante, 2017). There are many different assessment

strategies that are used from birth to age three to determine diagnosis and early intervention

eligibility in children with CP.

Developmental Assessment of Young Children: Second Edition

The Developmental Assessment of Young Children: Second Edition (DAYC-2) is an

assessment tool that is used to evaluate the five developmental domains with infants and

young children as old as five years 11 months (Voress & Maddox, 2012). The assessment was

normed on a national sample of 1,832 children (Pearson Assessments, 2020). The format of the

DAYC-2 assessment allows multiple ways for the administrator of the text to obtain the

information for each of the five tests (See Appendix C). The assessment administrator can use

direct assessment, which would be asking the child a question, observation of the child in their

natural environment, or an interview of the parents, caregivers and teachers of the child (Ford,

2015). Each domain can be assessed individually, however it is best practice that all five

domains are assessed (Ford, 2015), because this will help to create a whole picture of the child.

The chronological age of the child should be determined prior to administering the test in order

to obtain accurate results (Ford, 2015). Each domain observation or interview takes anywhere

from 10 to 20 minutes to complete (Pearson Assessments, 2020), and the assessment is meant

to be administered by a professional, but the family may join in the assessment and present the

materials for the child to show their skills (Ford, 2015). Once the assessments have been

administered, they will be scored and interpreted by providing standard scores, percentile

ranks and age equivalents for the child in their areas and domains (Pearson Assessments,
11
King
2020). Age equivalents are the least reliable scores, and standard scores are the most reliable

scores when making decisions for the family’s IFSP.

Goals/Purpose of DAYC-2. The goals and purpose of this assessment is to determine the

child’s present level of skills in each of the domains which are adaptive behavior, cognitive,

communication, physical, and social-emotional development (Pearson Assessments, 2020). The

DAYC-2 assessment allows for a multitude of benefits. The assessment helps to obtain

information about a child’s abilities through observing their skills, interviewing the primary

caregivers of the child and by assessing the child directly. The assessment also allows for a child

to be assessed on only the domain that is needed or all five domains if needed (Pearson

Assessments, 2020).

Cons of DAYC-2. The assessment does come with a small number of disadvantages. The

administrator of the assessment is required to have a Level B qualification in order to

administer the test. Someone with a qualification Level B has a master’s degree in psychology,

education, speech-language pathology, occupational therapy, social work, counseling, or a field

that is closely related to the field in which the assessment is intended for. The alternatives to

having a master’s degree for Level B is having a degree to practice medicine or having a

certification from a professional organization to administer the test such as National

Association for the Education of Young Children (NAEYC) (Pearson Assessments, 2020). Another

disadvantage to this assessment is that there is no materials kit available to order from the

complete DAYC-2 kit, so any toys, games or materials beside the test themselves must be

collected by the examiner themselves (Ford, 2015).

Kids Assisting Hands Assessment

12
King
The Kids Assisting Hands Assessment (Kids AHA) is an assessment strategy that

measures how well children with hemiplegic cerebral palsy use their most affected hand when

using both hands together during play. The Kids AHA offers three different versions of the test

depending on the child’s age. The different assessments are the Mini AHA which is for infants

ages eight to 18 months, the Small-Kids AHA which is for children ages 18 months to five years,

and the School-Kids AHA which is for children ages six years to 12 years (Cerebral Palsy Alliance

(CPA), 2018). This part of the research paper will cover the Mini-AHA and the Small-Kids AHA.

The assessment is administered by a qualified therapist and is observation and play based. The

assessment bases the child’s performance on 20 items which are later scored on an electronic

spreadsheet which calculates the raw score (CPA, 2018). The Kids-AHA assessment has good

evidence for construct validity, which is whether the test measures the characteristics that it is

supposed to measure, and has an excellent inter-rater, intra-rater and test-retest reliability

which is the tests ability to measure the child’s characteristics accurately under different

conditions (CPA, 2018; Wortham & Hardin, 2016).

Goals/Purpose of Kids Assisting Hands Assessment. The main purpose for

interventionists to use Kids- AHA is to describe how a child with hemiplegic CP uses their

affected hand, it allows for the interventionist and IFSP team to plan intervention around the

child’s level of ability, and the measure whether the intervention has been effective (CPA,

2018). The Kids- AHA has many benefits. For infants, the assessment occurs during an enjoyable

play session between the interventionist and the child, so the child is having fun, playing with

toys and also being assessed. The session is recorded so the interventionist can be present with

the child and re watch the video later to score the interaction. For young children, the child is
13
King
presented with a series of toys in a play session, and the toys are carefully selected to provoke

the child to use both hands together while playing in order to get an accurate reading of their

abilities. Like the infant session, this one is also recorded so the interventionist can be present

with the child during the session and record it at a later time (CPA, 2018).

Cons of Kids Assisting Hands Assessment. The Kids-AHA does have a few cons. One of

the disadvantages to this assessment is that there is training needed for a health professional to

earn a certificate in order to administer, score and interpret any of the versions of the Kids-

AHA. In order for a professional to become qualified, they may take a training and receive the

certification, however, it does cost money (CPA, 2018).

Ethical Considerations of Assessment

Special educators and interventionists have many ethical responsibilities and

considerations that they must follow surrounding assessment strategies in Family Centered

Early Supports and Services. The main ethics that are followed in early childhood and in special

education connect with recognizing the individual values, culture and belief that families and

their children have, recognizing diversity, and understanding that people achieve their full

potential in life when they are met with a trusting and respectful relationship, as well as

respecting the family’s autonomy when it comes to making decisions about their own children

(NAEYC, 2011; DEC, 2009). The two assessment strategies above consider two different types of

growth and development. The DAYC-2 can be used with any child to determine their

development in each of the five domains, however, the Kids-AHA will most likely only be used

for children with CP or a similar disability. Practitioners in early childhood and special education
14
King
need to understand that families can make their own decisions on their own child, even if it

may not be in the child’s best interest (DEC, 2009).

The Division of Exceptional Children’s Code of Conduct (2009) explains that practitioners

must rely upon evidence-based research and interventions to inform the practice with children

and families, while also using every resource to assure high quality services are available to

families. Many of the DEC and NAEYC ideals and principles connect with the Family Educational

Rights and Privacy Act (FERPA) as well as the Health Insurance Portability and Accountability Act

(HIPAA). Both FERPA and HIPAA protect the privacy of students and patients under the law. DEC

and NAYEC connect in the NAEYC Code of Ethical Conduct (2011) under section 1 Ideal I-1.9

which states “to advocate for and ensure that all children, including those with special needs,

have access to the support services needed to be successful”, and DEC Code of Conduct (2009)

under Enhancement of Children’s and Families’ Quality of Lives number 4 “we shall advocate

for equal access to high quality services and supports for all children and families to enhance

their quality of lives”. This is an important connection to make because both organizations want

what is best for children. What is best for children, is for their families to be a part of the

assessment process, to make that connection with their FCESS and IFSP team (CPA, 2018).

Evidence-Based Interventions

Early intervention services are supports that are given to children with disabilities or

developmental delays that are ages birth to three and their families. Early intervention services

support the growth and development of children by finding the evidence-based interventions

that will work best for their development. Evidence-based interventions are a practice, strategy

or curriculum that is implemented in a home, classroom or caregiving setting that is created for
15
King
an individual child or group of children to target a specific need (PRIME, 2020). This section of

research will cover evidence-based interventions for improving hand function in children with

CP, social skills training for young children, and the Lovaas Model of Applied Behavior Analysis

(WWC, 2010; WWC, 2013; Basu et al., 2014). Region M mainly focuses on the family coaching

model for early intervention, but some children with CP may need more intensive intervention

when it comes to hand function improvement and behavior strategies (Program Y 1, 2020, Basu

et al., 2014)

Hand Function Improvement Intervention Strategy

Children with hemiplegic cerebral palsy often have difficulty with hand involvement and

limited wrist extension from the time of infancy, but early intervention can help to break the

cycle of soft tissue and bone changes in early childhood that lead to contractures in later life

(Basu et al., 2014). The nature of the intervention must be carefully considered when deciding

how to continue with the therapy. The Kids-AHA is a great place to start when determining the

intervention needed for children with hemiplegic CP (CPA, 2018). Evidence-based approaches

to intervention for hemiplegic CP allow the child to be an active participant when participating

in play-based intervention which allow the child to have fun while participating in the

intervention (Basu et al., 2014; Brilliante, 2017). Some of the interventions that take place are

video game playing or virtual reality games for children who are older. This therapy allows a

child to use the controller to deliver upper limb therapy in a fun and engaging way (Basu, 2014).

Other play-based interventions for hemiplegic CP include playing with toys that involve problem

solving, and goal centered games that can also involve daily activities for very young children.
16
King
Families and interventionists can work together with very young children to hold a spoon and

feed themselves using their affected hand (Basu, 2014).

There are some challenges that come with early intervention therapy for infants, as it is

harder to keep their attention, and they have little understanding that they are receiving

therapy and why. Additionally, there is only one validated assessment for upper limb function

in infants which is the Mini-AHA, and this covers the youngest age of infants that can be

assessed properly for assisted hand therapy needs (Basu et al., 2014; CPA, 2018). In conclusion,

early intervention can be challenging for the upper limb in hemiplegic CP, but validated

assessments for young children and infants are available, and they offer important information

about what interventions the child will need to be successful later in life (CPA, 2018, Basu et al.,

2014).

Social Skills Training Intervention

Social skills training is not one specific curriculum, instead, it is a collection of practices

that use a behavioral approach to teaching young children social skills (WWC, 2013). After the

DAYC-2 assessment is scored, it may be identified that a child with CP will receive supports for

social intervention. Often times, children who have CP will have behavior problems (CDC, 2020).

This is when the social skills training will come in. This form of intervention targets the idea that

children who often act in a way that is looked at as misbehaving need to learn the proper skills

to react in a different way than they usually do. The social skills training intervention shows

caregivers a new way to look at behavior. This intervention gives four different reasons for why

children with disabilities may be misbehaving. (1) they don’t know another way to act other

than their present pattern of behavior, (2) they know cognitively other ways to behave but have
17
King
not yet had enough practice to display them properly, (3) they tried another way, but it did not

work the first time, so they assumed it didn’t work, and (4) tension and anxiety interfere with

the ability to perform practiced behavior well in real life (WWC, 2013).

Often times, children with CP will act out because of their tension and anxiety in their

household (Schulze, 2020). With the social skills intervention, the children will learn about

positive interaction with others, appropriate classroom behavior, better ways to handle

frustration and anger, and acceptable ways to resolve conflicts with others (WWC, 2013).

Teachers can use targeted instruction with 3-5 children in small groups and teach them about

these acceptable practices while allowing them to practice and watch other children at the

same time (WWC, 2013). This strategy works not only with young children, but also older

children as well. One way that family coaching could be used with this type of model is by the

interventionist showing family members of a child way to speak to a child so that they learn

about feelings and correct ways to react throughout the day, and not only when a child is

exhibiting strong emotions (Rush & Shelton, 2005).

Lovaas Model of Applied Behavior Analysis

The Lovaas Model of Applied Behavior Analysis (Lovaas Model) is a type of behavior

intervention that is used as brief one-on-one instruction in the home, in an inclusion classroom

and natural environment of the child. During this intervention strategy, there are periods of

one-on-one instruction where the teacher cues a behavior, prompts the appropriate response,

and provides reinforcement to the child (WWC, 2010). This program consists of about 35 to 40

hours of intervention per week and typically lasts about three years (WWC, 2010). The studies

done on this intervention strategy considers the evidence to have an impact on the cognitive
18
King
development, communication and language development, and social-emotional development

(WWC, 2010). This intervention strategy may be helpful for children with CP, as it targets three

domains of development and could be helpful for a child who needs support in any of those

three domains. This can be used with infants and toddlers in a natural way. Interventionists can

modify it in a way that it is less intensive and more play-based while showing the family

appropriate ways to cue a respond to the behaviors when using a coaching model (Rush &

Shelton, 2008).

Progress Monitoring

Progress monitoring is the monitoring of the child’s development to see that they are

showing movement toward their goals in their IFSP (Brilliante, 2017). Progress monitoring can

happen in different ways. Every IFSP has a six-month review where the team will determine if

the child is getting the services that they need, and whether they should make new goals.

States are required under IDEA Part C to re-evaluate the IFSP once a year and review the

document even 6 months (Brilliante, 2017; IDEA, 2004). During this time, the child may be

assessed using the same assessments that were used when the child was being evaluated for

services. The DAYC-2 assessments can be used to re-assess the child and see if they need more,

less, or different services (Pearson Assessments, 2020). The Kids-AHA assessment can be used

to monitor the use of the affected hand every six months during an IFSP review by reassessing

the child. The rating scale of the Kids-AHA is on a scale of 1 point which means that the child

has not used their affected hand at all, to 4 points which means that they used their hand

effectively throughout (CPA, 2018). By completing the assessment over again, the IFSP team can
19
King
determine if the child has made progress with their affected hand or if they should continue

interventions (CPA, 2018).

Primary Grades Public School

School S is a local public school that is located in City K. School S teaches about 290

children and families from Kindergarten to Fifth grade. There are three sections of

Kindergarten, 2nd Grade, 3r Grade, 4th Grade, and 5th Grade, and two sections of 1st Grade

(School S, 2020). The public-school employs about 51 teachers and faculty members (School S,

2019). City K is city that houses four public elementary schools, one public middle school, one

public high school and a public vocational school as well as one public preschool (K School

District, 2016).

Description of the School

School S is a public school that is one of the for elementary schools located in City K.

School S’s mission (School S, 2020) is to provide a positive, caring and academic climate for

children where every individual child is given the opportunity to realize their potential (See

Appendix D) (School S, 2019). The mission statement further explains that the school works

with students, parent and staff to create a sense of community throughout the school while

also recognizing the cultural diversity, uniqueness and creativity that each child has to ensure

that each student in their own way can build the confidence to meet the challenges of being a

lifelong learner (School S, 2019). School S also holds a schoolwide philosophy that intends to

provide educational opportunities where students can create a positive self-image, and respect

for others to ensure that each child becomes a contributing member of our local and global

society (School S, 2020).

20
King
In grades K through three at School S, each level of learning follows a focus of their own.

The kindergarten classrooms follow a play based; theme integrated curriculum for each area of

the curriculum such as science, social studies, mathematics, and social and emotional learning

(School S 1, 2020). The first-grade classrooms follow a curriculum that assists children in how to

build independent work habits for language arts, mathematics, science, and social studies

(School S 2, 2020). The second-grade classrooms follow a curriculum that incorporates the

Responsive Classroom approach where the curriculum blends social and academic curricula

throughout the day such as language arts, math, science and social studies (School S 3, 2020).

The third-grade classrooms start to shift to an academic curriculum with reading to learn,

spelling in cursive, multiplication, division, and learning about global cultures. In the third-grade

year, student start to use Next Generation Science Standards (School S 4, 2020).

Children and families at School S are provided with a large scope of resources ranging

from free or reduced lunch, specials that include physical education, art and music (School S,

2019). The school also offers special education services that include speech therapy, physical

therapy, occupational therapy and psychological services. The school provides a reading

specialist, intervention services, a learning center or resource room and the Attachment,

Regulation and Competency (ARC) program that provides services to students whose emotional

conditions may interfere with their ability to thrive academically and socially (School S, 2019).

The School S handbook (2019) offers families and children the resources that they need to get

started with special education services for their children and what steps they should take when

wanting an evaluation.

Community, Population, and Services.

21
King
City K is small city within a rural county in New England with a population of about

23,000 people (NHES, 2018). City K offers four public elementary schools, one public preschool,

one public middle school and one public high school. The median family income in City K is

$78,298, and a poverty rate of 14.7% (NHES, 2018). This city has a median property value of

$187,900 (DATAUSA, 2017). The city’s poverty rate is slightly higher than that of Region M’s

which is 10.2%, and the median property value is slightly lower than that Region M which is

$188,700 (DATAUSA, 2017). Within City K, 33.1% of students use the free or reduced lunch

program (Department of Education, 2010).

School S serves a population of approximately 290 children and families. Based on the

demographic information of the city that School S is located in, the students may have potential

financial needs based on the 14.7% poverty rate and the school districts 33.1% free or reduced

lunch rate.

School S meets the needs of the community by offering a multitude of services for each

child and family based on their individual support need. School S is a public school that

emphasizes Part B of IDEA in their parent and family handbook (School S, 2019). School S (2019)

states that children with disabilities should be educated in their least restrictive environment,

and not discriminated based on their disability, race or culture. This school offers many services

for students with disabilities including speech therapy, physical therapy, occupational therapy,

psychological services, a reading specialist, intervention services for students who are not

eligible for special education, a learning center or resource room, and the ARC program for

students with trauma who need extra social and emotional supports in order to succeed

academically (School S, 2019).

22
King
School S’s special education programs connect to Abraham Maslow’s Hierarchy of

Needs (McLeod, 2018). The hierarchy of needs is a psychological model that shows the five tiers

of human needs. From the bottom of the hierarchy to the top, the needs are physiological

needs, safety needs, belongingness and love needs, esteem needs, and self-actualization

(McLeod, 2018). Physiological needs consist of food, water, warmth rest. Physiological needs

along with safety needs are the basic needs in human life. Belongingness and love needs consist

of intimate relationships and friends. Along with esteem needs which are the feeling of

accomplishment and prestige, these two tiers are the psychological needs. Lastly, self-

actualization is the top piece of the pyramid. This tier is when one achieves their full potential,

and builds their own creative needs, which connects with self-fulfillment needs. Together, these

five tiers make up the hierarchy of needs (McLeod, 2018). School S’s special education

programs connect to this hierarchy because they offer so many services to help children to feel

secure, build upon their social and emotional needs in order to create intimate relationships,

and achieve their full potential in life by having each of these services available to them (school

S, 2019).

IDEA and Special Education Process in Primary Grade

Description of Part B in IDEA Law

IDEA (2004) is a law that has four connected parts: Part A, Part B, Part C, and Part D. Part

A sets the foundation for the entirety of the law by outlining provisions for Parts B through D.

Part B states that children with disabilities from the ages of 3 to 21 are entitled to a free and

appropriate public education, and the safeguards that are guaranteed to families in IDEA Part B.

Part C states that children ages birth to three with disabilities are entitled to early intervention
23
King
services. Lastly, Part D covers the national activities that are meant to improve education for

children with disabilities and states the federal government’s obligation to support those

activities financially (IDEA, 2004). Part B of IDEA connects to School S with their explanation in

the parent and family handbook about the IDEA laws, how to be eligible and the ways in which

a student and family can begin the evaluation process (See Appendix E) (School S, 2019). Part B

of the IDEA law states that children with disabilities are entitled to receive special education if

they are between the ages of three and 21 (IDEA, 2004). The special education team, the child,

their family and other members of the team will get together to determine if the child needs to

be evaluated for special education, and what testing will be needed for the evaluation process

(Parent Information Center on Special Education, 2017). School S outlines in their handbook

(2019) the disabilities that are represented in the IDEA law which are developmental delay,

visual disability, hearing disability, speech and language impairment, emotional disturbances,

physical disabilities, learning disabilities, and other health disabilities (IDEA, 2004; School S,

2019).

Special Education Process

The special education process in Part B is a series of steps that is called the

Individualized Education Program (IEP) process. This process is a series of six steps that include

(1) the referral, (2) the interdisciplinary evaluation in all areas of the suspected disability, (3)

eligibility determination, (4) the development and implementation of the IEP, (5) annual

reviews, (6) transition planning for postsecondary school (Brilliante, 2017; Parent Information

Center on Special Education, 2017). Children who are involved in Part C early intervention

services will often transition into Part B services by going through this process with the local
24
King
public school and possibly some professionals from the IFSP team. Children ages three to 21

who have never received any IDEA services before may be referred by a family member to the

local public school or by a teacher (School S, 2019; Brilliante, 2017). School districts are

required to identify, locate and evaluate all children who have suspected disabilities to ensure

that all children with disabilities are referred and provided with special education services if

they are eligible. This process is called Child Find and it is outlined under IDEA Part B (IDEA,

2004; Brilliante, 2017, Parent Information Center on Special Education, 2017).

The referral process begins with a family member or professional who suspects that a

child may have a disability. This person will write a referral, preferably with the date, child’s

name, and why they suspect the child may be eligible for services under IDEA (Parent

Information Center on Special Education, 2017). This letter will be sent to the superintendent,

the special education director, the school principal, and the classroom teacher as well as

anyone else who should know about the referral. The next step is the evaluation process.

During this step, the IEP team will come together to review the child’s educational history and

decide which interdisciplinary team of experts will evaluate the child (Brilliante, 2017). These

evaluations must be done in the child’s native language (Parent Information Center on Special

Education, 2017). Once the child is determined eligible, the IEP development step will begin.

The IEP meeting must happen within 30 days of the determination of eligibility (Brilliante,2017).

The IEP will specify the child’s Present Level of Academic Achievement and Functional

Performance (PLAAFP), the goals that will be addressed in the annual review, and the supports

and services that will be needed for the child to make progress toward their goals (Brilliante,

2017).
25
King
Lastly, the IEP team meets once a year to review the IEP and determine if progress has

been made toward the child’s goals and develop new goals for the following year (Brilliante,

2017). When the child is 16 years old, the transition planning for postsecondary school will

begin. During this time, the student and family will develop goals that will help prepare the

student for adult life outside of Part B services. This planning includes preparing for skills

needed for a job, living independently, and being a productive and contributing member of

society (Brilliante, 2017).

(Dis)ability, Assessment, and Intervention in Public School

Childhood Apraxia of Speech

Speech and language impairments are communication disabilities that can range from

spoken language (speech) and comprehending words which can either be written, spoken or

expressed (language) (Kolso, 2020; NIDCD, 2017). Childhood Apraxia of Speech (CAS) is a speech

and sound impairment that affects a child’s ability to say what they want correctly (NIDCD,

2017). CAS is present from birth and is different from a language delay. Some symptoms of the

impairment are difficulty pronouncing words correctly, possibly because of incorrect tongue

placement when speaking, difficulty finding the correct sound when trying to speak, and/or

making errors in the tone, stress or rhythm of the voice (NIDCD, 2017). CAS has a difficult

definition, as CAS has no diagnostic differentiation from other speech impairments, however,

professionals who have researched and studied CAS have expressed that children with CAS

have typical characteristics such as inconsistent phonemic errors, difficulties sequencing speech

movements and increasing errors in speech when words becomes longer or more complex
26
King
(Martikainen & Korpilahti, 2011). Children who have CAS may experience difficulty with oral

motor skills and physical coordination, cognitive functions, or reading, writing and spelling

(Nijland et al., 2015).

Assessment: Identification and Eligibility

CAS has a controversial definition because there is no diagnostic differentiation between

CAS and other speech impairments. However, the CAS technical report from the American

Speech-Language-Hearing Association (ASHA, 2007) proposed that there are three

characteristics that are consistent with an impairment in speech motor planning and

programming that are specific to CAS. The three characteristics are (1) inconsistent errors on

consonants and vowels in repeated productions of syllables or words, (2) lengthened and

disrupted coarticulatory transitions between sounds and syllables, and (3) inappropriate

prosody, especially in the areas of word and phrase stress (ASHA, 2007; Terband et al., 2019).

Furthermore, a speech-language pathologist (SLP) or the child’s primary care doctor would

make the diagnosis of CAS, which would then allow a child to be referred for special education

services under Part B of IDEA to begin the evaluation process to determine if the child is eligible

for services other than speech-language therapy (Brilliante, 2017; Nijland et al., 2015).

Assessment Process

Children with CAS may show signs as early as 18 months old, as this is when children

begin to speak. CAS may be suspected as early as 18 months, but most children begin to

produce more speech between the ages of two to four. This is when a child may be clinically

diagnosed with CAS by a doctor or an SLP (Mayo Clinic, 2020). Once a child with diagnosed CAS

turns three, they will transition to Part B services under IDEA, or may begin the evaluation
27
King
process if they had not previously received services under Part C (IDEA, 2004). Once the

transition or referral happens, the team working with the child will begin the evaluation process

and develop an IEP for the child with CAS (Brilliante, 2017).

During primary school and Part B services under IDEA (2004), typically family members

will refer the child for services, but with CAS, children will most likely already be eligible for Part

B services and may possibly be eligible for services other than speech and language therapy.

When determining if the child is eligible for other services, the IEP team will conduct an

interdisciplinary evaluation in all areas that the child could be eligible for services in (Brilliante,

2017). Once the assessment in each interdisciplinary subject have been conducted, the child

will begin services that may be unique compared to other children who are receiving Part B

services (Hammer, 2009). SLPs play a huge role in working with children with CAS. The SPLs in

the school systems who work with children with CAS face a unique job. These professionals will

complete assessments with the child and keep the family up to date for each change in the

work that is being done with the child with CAS so that the family can continue the work at

home, as the work done at home with the family will make a larger impact on the child’s

development than the hour spent with an SLP (Hammer, 2009).

The Dynamic Evaluation of Motor Speech Skill

The Dynamic Evaluation of Motor Speech Skill (DEMSS) is an assessment that was

developed to help diagnose children with speech motor planning difficulties, such as CAS.

DEMSS was created for children who have a severe speech impairment, as articulation nor

phonology assessments have the ability to differentially diagnose CAS from any other speech

impairment (Strand et al., 2012). The DEMSS assessment includes nine subtests and 66
28
King
utterances that the child will be asked to imitate while the clinician directs eye contact with the

child. The assessment offers results in 171 judgements that are related to the overall

articulatory accuracy, vowel accuracy, prosodic accuracy and consistency (Strand et al., 2012).

The child is asked to imitate the clinicians’ utterances using different levels of cues that can be

visual or tactile. The assessment may be scored on site during the administration of the

assessment, or afterward if recorded by video. The DEMSS is scored by four sub scores that sum

together as the DEMSS score (Strand et al., 2012).

The DEMSS assessment has an 89 percent test-retest reliability, and a 90 percent

validity based on the probability of correct classification based on the ability to discriminate

children with or without CAS (Strand et al., 2012). The DEMSS must be administered by a

clinician, preferably an SLP with experience and training in DEMSS administration (Strand et al.,

2012).

Goal/Purpose of The Dynamic Evaluation of Motor Speech Skill. The goals and purpose

of this assessment is to determine the child’s diagnosis of CAS (Strand et al., 2012). The

assessment is criterion referenced which means that the assessment is measured based on a

fixed set of predetermined criteria (Wortham & Hardin, 2016). The administration time is

estimated to be seven to twenty-five minutes based on the child and how many levels will be

performed and observed (Strand et al., 2012).

Con of The Dynamic Evaluation of Motor Speech Skill. The DEMSS assessment does

come with a small number of disadvantages. The assessment has an 89 percent test-retest

reliability, which means that there is an 11 percent chance that the child may be retested and
29
King
receive different results. This can also connect to the disadvantage that some children who

have more mild symptoms of CAS may be missed by DEMSS (Strand et al., 2012).

Differential Ability Scales-II

The Differential Ability Scales-II (DAS-II) is an assessment tool that gives insight into how

a child cognitively processes information in the classroom so that a child’s IEP team can

determine what interventions would be best for the child in the classroom and at home (Elliot,

2020). This assessment can be used for children with CAS as they may exhibit delays or

impairments that are related to cognitive abilities (Gildersleeve-Neumann, 2007). The DAS-II

includes 20 cognitive subtests that are organized into early childhood and school aged children

based on the age and grade of the child taking the test (Elliot, 2020). The assessment

administrator required a Level C qualification which means that the administrator must hold a

doctorate degree in psychology (PhD), education (EdD) or a related field (Pearson Assessments,

2020).

Goals/Purpose of Differential Ability Scales-II. The DAS-II is used to identify a child’s

strengths and weaknesses in their learning and cognitive abilities in order for the IEP team to

create appropriate IEP interventions, goals and progress monitoring for the child (Elliot, 2020).

The assessment is created in multiple languages and can predict achievement on the basis of

different cultures and background of children (Elliot, 2020). Clinical studies have been done

with this assessment to determine appropriate interventions for developmental risk,

intellectual disabilities, learning disorders in reading, writing, math, expressive language

disorders such as CAS, ADHD, limited English proficiency and children who are deaf and hard of

hearing (Elliot, 2020).

30
King
Con of Differential Ability Scales-II. The DAS-II comes with small disadvantages. One

disadvantage that is connected to the assessment is the qualification level needed for the

administrator. The qualification level for this particular assessment is Level C (Elliot, 2020). This

means that unless an administrator has a PhD, EdD, or a state licensure or certification to

administer this assessment, it may not be bought or administered (Pearson Assessments, 2020).

Another disadvantage to this assessment is that it is scored from the administrator’s computer

that uses software that is not compatible with Mac OS computers (Elliot, 2020).

Ethical Considerations of Assessment

Special educators and interventionists hold many ethical responsibilities and

considerations when it comes to special education and assessment strategies that are used with

children who follow an IEP. Ethical philosophy is a large part of early childhood and special

education (NAEYC, 2011; DEC, 2009). Children who have been diagnosed with a disability by

their doctor such as CAS or even CP will have confidential information that should be shared on

a need-to-know basis, and their records are held confidentially using HIPAA (HIPAA, 1996).

Children who are students at public schools will have their right to privacy under FERPA (FERPA,

1974). General and special educators have the ethical responsibility to hold themselves

accountable when it comes to keeping children and family educational and medical information

private (FERPA, 1974; HIPAA, 1996). Each of the assessments that are mentioned above should

be done lawfully and appropriately with the child’s family knowingly consenting to the

assessment and IEP evaluation. Although some educators may believe that they know what is

best for a child who has a disability, it is still the family’s decision on if they would like the child

to receive services and intervention (DEC, 2009). The DEC and NAEYC code of conduct help
31
King
early childhood teachers, general and special educators to have something to fall back on if

they need help understanding an ethical consideration.

Evidence-Based Interventions

Special education supports and services for children in the primary grades facilitates

growth and development for children with (dis)abilities. Special education services are supports

that are given to children with disabilities who are the ages three to twenty-one under Part B of

IDEA (2004) law. School S (2020) that has been written about above works with children who

have disabilities within their learning center and the classrooms as they believe that learning is

social. This section will cover evidence-based interventions to help children reach their IEP goals

in speech, literacy and cognition by using integral stimulation, early intervention in reading, and

self-regulated strategy development for cognitive awareness (Strand, 2005; WWC, 2008; WWC,

2017).

Integral Stimulation (Dynamic Temporal and Tactile Cueing)

Children with CAS require intervention most of the time, and although SLPs are the

professionals who decide which evidence-based intervention is the best for the child, the family

of the child plays an even more important role in the development of speech for the child with

CAS because they spend the most time with them (Hammer, 2009). Integral stimulation is an

intervention that uses a bottom-up approach, which means that is starts with short, phonetic

utterances and graduates to longer more phonetically difficult stimuli (Strand, 2005). Integral

stimulation involves cueing and an SLP or family member asking the child to listen, watch and

do what they do when speaking utterances.

32
King
Dynamic Temporal and Tactile Cueing (DTTC) is an approach that is used with integral

stimulation and is adapted from intervention for adults with apraxia to children with apraxia.

The child approach has the SLP speak an utterance and the child will try to imitate the

utterance. If they are unsuccessful, then they will simultaneously say the utterance together

slowly while the SLP makes sure that the child’ lip and jaw position are correct (Strand, 2005).

This intervention strategy would be done in a separate room than the general education

classroom and it would be direct one on one work with an SLP and a family member can

continue the work at home with the child (Strand, 2005).

Early Intervention in Reading

Early intervention in reading is a program that is used for children who may be at risk for

difficulties in reading (WWC, 2008). Some children with CAS may be at risk for reading

difficulties, and others may be on track for reading for their grade level. Assessments like DAS-II

can help to determine if a child with CAS needs intervention in reading. This intervention is

used in the primary kindergarten through fourth grade classes. In grades K-2, the program is

used during whole-class instruction with picture books to stress phonemic awareness, phonics,

contextual analysis and repeated reading and writing. Within these grades, struggling readers

can have additional small group instruction for 20 minutes, four days a week (See Appendix F)

(WWC, 2008).

Within the kindergarten setting, the early intervention in reading program focuses on

the children listening to stories, and learning about print, rhyme, and phonemic awareness,

letter and sound recognition (WWC, 2008). In the first and second grade classrooms, the

program focuses on repeated readings of stories, coached reading with stories that the children
33
King
have not read before, and phonemic awareness with phonics instruction (WWC, 2008). This

program can be used by a teacher, a reading specialist, or a paraprofessional.

Self-Regulated Strategy Development

Self-regulated strategy development (SRSD) is an intervention that is used for children

who have a specific disability like CAS who need extra help with their cognitive surroundings

and completing tasks. Some children with CAS may need extra help with completing tasks,

while others may be on tract cognitively. Assessment tools like the DAS-II may help the IEP

team determine if the child needs an intervention for cognitive awareness. SRSD is similar to

integral stimulation (Strand, 2005) in that it is a bottom-up strategy where special educator or

general educator will work one on one with a child to discuss the strategy, model the strategy,

help the child memorize the strategy, support the strategy and then watch the child complete

the task (WWC, 2017). In the realm of early childhood, this intervention tool can be used with

children who are in second and third grade who are learning about self-regulation strategies for

getting their work done (WWC, 2017).

Progress Monitoring

Progress monitoring is something that is done throughout a child’s IEP and can be done

in different ways. Specifically, with integral stimulation, the progress is constantly being

monitored, because of the nature of the intervention strategy. The child must have completed

simple utterances, the child will move onto more difficult stimuli within the program (Strand,

2005). Within intervention in reading, because it can be done as a whole class or in smaller

groups, the child(ren) may be monitored by taking data throughout each season (fall, spring) to

determine if they have improved (WWC, 2008). Similarly, the child’s IEP team will hold a review
34
King
one a year or more if needed to determine if the child has improved in each of the subjects that

are being worked on (Brilliante, 2017). Lastly, with SRSD, the child’s progress will be monitored

throughout the development of each task that they are working on. The IEP team will work

together closely throughout the time that the child is using interventions, and assessments that

monitor developmental progress can be used with children throughout their schooling.

Educators and SLPs can use assessment strategies that can be used to monitor a child’s

progress and score them throughout the year to determine if the child is making progress in

their development (Hammer, 2009).

Reflection on Learning

Overview

Early childhood is a time where a lot of development happens, and children with

(dis)abilities can make a lot of progress when they have a team of professionals working

together on their IFSP or IEP to help them gain lifelong skills (Brilliante, 2017). Early childhood

ranges from birth to about eight years of age and a lot of development happens through those

years. Children who have (dis)abilities can take advantage of early supports and services and

special education in order to learn from professionals who use assessments and evidence-

based interventions.

Ideas and Practices that Resonated

Throughout this semester and writing this research, I have a newfound love for special

educators and the work that they do. While doing research, I learned all about speech-language

pathologists and the important work that they do to help children learn about speech and

language. One piece of this research that was meaningful and important to me was the idea
35
King
that speech and language are similar, yet different. Although I had a small understanding, once

learning about the difference, it became clear to me that I want to learn even more about the

work that SLPs do in their work.

New Understandings and Remaining Questions

This research has given me a lot of new understandings. I learned about how hard work

IEP and IFSP processes can become, yet how important assessments are for determining the

child’s development. One that especially connected with me was the DAYC-2 assessment

(Pearson Assessments, 2020). This assessment measures so much about a child and can tell a

practitioner a lot just by watching a child play and interviewing their caregivers. I also think that

this research has given me a different perspective on children with (dis)abilities. Having never

quite worked with children with (dis)abilities, I think I can have a deeper understanding of the

IEP and IFSP process and if I am a part of a team one day I can look back on my knowledge from

this class and this research and reflect. Although I do not have any remaining questions from

this research, I do think that although I never was able observe in the field, my research from

this paper has given me a deep understanding of the two disabilities of cerebral palsy and

childhood apraxia of speech.

Research Process

Researching, writing and collecting artifacts helped me to understand the law in a

different way from how I had learned it in past coursework. Learning about it in this way has

shaped my understanding to know that the IDEA law is there to help families get the

information and support that they need when their child us in school and early supports. It

helped me to understand the IFSP and IEP process by writing each step and reflecting on how
36
King
the steps are used in processes for children with (dis)abilities. When engaging in this work, I

was mostly challenged by finding reputable sources to fall back on. However, once I found the

resources that are true and accurate based on the peer edited work, I felt great knowing that

what I am learning about is shaping my knowledge of early childhood and special education for

my career. The research connections helped me to understand the different between

references that are reputable versus those that are not. Through the semester I used time

management skills so as to not become overwhelmed with the amount of work that I had set

up for me.

Advocacy

In my opinion, advocacy is one of the most important pieces of early childhood. Children

are some of the most vulnerable people, and when they have a (dis)ability, professionals who

understand the ins and outs of special education and early supports and services are there to

advocate for that child and their family. The DEC code of Ethics and the NAEYC Code of Ethical

Conduct (NAEYC, 2011; DEC, 2009) are two important documents that give professionals a leg

to fall back onto if there is ever a question of advocacy. In the future, I hope to enter the special

education field and become an advocate for children and families. I can become an advocate

for them by becoming as educated as I can and understanding the laws so that families can feel

comfortable asking me any question and I can help them reach the goals that they need for

their child to success.

Growth as a Professional and Educator

This semester has been unique for every student everywhere, and I think as a person

and a professional, I have grown. I have gained new skills of how to manage my time under
37
King
difficult circumstances, and specifically working diligently to achieve success (Keene State

College Education Department, 2007). The work overall from this course has helped me grow as

a writer. I have reflected on the legal and ethical obligations of not only early childhood, but

also special education and the laws that back up the profession. Lastly, I have become

committed to professional growth and development with the finding and completing of

modules to better my knowledge of the field that I am working in.

Conclusion

In conclusion, this semester has shaped me to become a better person, professional,

and student. As I continue my work in education, I will have a better sense of special education

and early childhood alike. My newfound knowledge of special education has helped shape me

as a professional and a teacher.

38
King
References

Albertson-Grove, J. (2020, February 16). Report: 3.5% of NH babies monitored for opioid or

alcohol exposure. Union Leader. https://www.unionleader.com/news/health/report-3-

5-of-nh-babies-monitored-for-opioid-or-alcohol-exposure/article_dcc5c159-719b-5bd7-

8cfc-66ff1106d39b.html

American Speech-Language-Hearing Association [ASHA] (2007). Childhood apraxia of

speech: Technical report. https://www.asha.org/policy/tr2007-00278/

Basu, A. P., Pearse, J., Kelly, S., Wisher, V., Kisler, J. (2014). Early intervention to improve hand

function in hemiplegic cerebral palsy. Frontiers in Neurology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285072/

Brillante, P. (2017). The essentials: Supporting young children with disabilities in the classroom.

Washington, DC: NAEYC Books.

Cerebral Palsy Alliance. (2018). Kids Assisting Hands Assessment.

https://cerebralpalsy.org.au/our-research/about-cerebral-palsy/assessments-and-

outcome-measures/assisting-hand-assessment-kids-aha-kids/#1463365033138-

a7373587-b171

Conaster, P., James, E., Ledingham, C. (2014). Early intervention: Developmental screening

assessment. Palaestra, 27(3), 37-41.

Chiarello, L. A., Palisano, R. J., Orlin, M. N., Chang, H., Begnoche, D., An. M. (2012).

Understanding participation of preschool-age children with cerebral palsy. Journal of

Early Intervention, 34. (1), 3-19. Retrieved October 13, 2020 from
39
King
http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=5&sid=16fc6a3d-cada-

4543-ae40-ec0e28e9191c%40sessionmgr4006

Department of Education. (2010). NH school and district profiles: Keene, NH.

https://my.doe.nh.gov/profiles/profile.aspx?d=279&year=2017&tab=student

Data USA. (2017). DATAUSA: Cheshire county, NH.

https://datausa.io/profile/geo/cheshire-county-nh

Division for Early Childhood (DEC). (2009). Code of ethics.

https://www.decdocs.org/member-code-of-ethics

Elliot, C. D. (2020). Differential Ability Scales-II. Pearson Assessments.

https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-

Assessments/Cognition-%26-Neuro/Comprehensive-Ability/Differential-Ability-Scales-

II/p/100000468.html?tab=product-details

Exploring Your Mind. (2020). Bronfenbrenner’s Ecological Systems Theory.

https://exploringyourmind.com/bronfenbrenners-ecological-systems-theory/

Family Educational Rights and Privacy Act [FERPA]. 20 U.S.C. §1232g (1974).

https://www.govinfo.gov/app/details/USCODE-2011-title20/USCODE-2011-title20-

chap31-subchapIII-part4-sec1232g

Ford, H. (2015). DAYC-2. [PowerPoint Presentation]. United Cerebral Palsy of Alabama.

http://ucpalabama.org/wp-content/uploads/2015/05/dayc-2.pdf

Gildersleeve-Neumann, C. (2007). Treatment of childhood apraxia of speech. The ASHA Leader,

12(15), 10-30. DOI: 10.1044/leader.FTR3.12152007.10

Hadders-Algra, M. (2014). Early diagnosis and early intervention in cerebral palsy. National
40
King
Center for Biotechnology Information.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173665/

Hammer, D. W. (2009). Apraxia services in the schools. The ASHA Leader, 14(12), 24-34.

DOI: 10.1044/leader.FMP.14122009.24

The Health Insurance Portability and Accountability Act of 1996 [HIPAA], 5 U.S.C. §552a (1996).

https://www.hhs.gov/foia/privacy/index.html

Individuals with Disabilities Education Act [IDEA], 20 U.S.C §1400-1482 (2004).

https://uscode.house.gov/view.xhtml?

path=/prelim@title20/chapter33/subchapter1&edition=prelim

Koslo, E. (2020). What’s the difference between a speech impairment and a language disorder?

Understood. https://www.understood.org/en/learning-thinking-differences/child-

learning-disabilities/communication-disorders/difference-between-speech-impairment-

and-language-disorder

Keene State College Education Department (2007). Keene State College teacher candidate

dispositions assessment. KSC Education Department.

K School District. (2016). Keene School District.

https://www.keeneschoolsnh.org/apps/pages/index.jsp?

uREC_ID=1220701&type=d&pREC_ID=1455665

Mayo Foundation for Medical Education and Research (MFMER). (2020). Cerebral palsy.

https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/diagnosis-

treatment/drc-20354005

Martikainen, A. & Korpilahti, P. (2011). Intervention for childhood apraxia of speech: A single
41
King
case study. Child Language Teaching and Therapy, 27(1), 9-20. DOI:

10.1177/0265659010369985

Mayo Clinic. (2020). Childhood apraxia of speech. https://www.mayoclinic.org/diseases-

conditions/childhood-apraxia-of-speech/diagnosis-treatment/drc-20352051

McLeod, S. S. (2018). Maslow’s hierarchy of needs. Simply Psychology.

https://canadacollege.edu/dreamers/docs/Maslows-Hierarchy-of-Needs.pdf

National Association for the Education of Young Children (NAEYC). (2011). Code of ethical

conduct and statement of commitment.

https://www.naeyc.org/sites/default/files/globally-

shared/downloads/PDFs/resources/position-statements/Ethics%20Position

%20Statement2011_09202013update.pdf

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control

and Prevention (CDC). (2020, September 11). What is cerebral palsy.

https://www.cdc.gov/ncbddd/cp/facts.html

NHES. (2018). Community profiles: Keene, NH.

https://www.nhes.nh.gov/elmi/products/cp/profiles-htm/keene.htm

National Institute on Deafness and Other Communication Disorders [NIDCD] (2017). Childhood

apraxia of speech. U.S. Department of Health and Human Services.

https://www.nidcd.nih.gov/health/apraxia-speech

Nijland, L., Terband, H., & Maassen, B. (2015). Cognitive functions in childhood apraxia of

speech. Journal of Speech, Language, and Hearing Research, (58), 550-565. DOI:

10.1044/2015_JSLHR-S-14-0084
42
King
Novak, I. (2014, June 22). Evidence based diagnosis, health care, and rehabilitation for children

with cerebral palsy. Journal of Child Neurology, 29. (8), 1141-1156. DOI:

10.1177/0883073814535503

Opioid & Health Indicators Database (n.d.). New Hampshire Opioid Epidemic.

https://opioid.amfar.org/NH

Parent Information Center on Special Education (2017). Steps in the NH special education

process. http://nhfv.org/wp-content/uploads/2017/04/Steps-in-NH-Special-Education-

2017VA.pdf

Pearson Assessments. (2020). Developmental assessment of young children: Second edition.

https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-

Assessments/Developmental-Early-Childhood/Developmental-Assessment-of-Young-

Children-%7C-Second-Edition/p/100000730.html?tab=product-details

PRIME. (2020). How to select an evidence-based intervention: A guide. Retrieved from

https://implementationscience.uconn.edu/wp-

content/uploads/sites/1115/2014/12/PRIME_quickguide_edvidence-

based_intervention.pdf

Program Y. (2020). Birth to three: Partnering with families. MDS.

https://www.mdsnh.org/index.php/services/children/71--sp-742/577-mds-birth-to-

three

Program Y. (2020). Children’s services. MDS. http://www.mds-nh.org/

Rush, D. D. & Shelton, M. L. (2008). Common misperceptions about coaching in Early

intervention. CASEinPoint, 4(1), 1-4.

43
King
Rush, D. D., & Sheldon, M. L. (2005). Evidence-based definition of coaching

practices. CASEinPoint, 1(6), 1-6. 

School S 1. (2020). Kindergarten. School Administrative Unit 29.

https://sym.keeneschoolsnh.org/apps/pages/index.jsp?

uREC_ID=1379175&type=d&pREC_ID=1458928

School S 2. (2020). Grade 1. School Administrative Unit 29.

https://sym.keeneschoolsnh.org/apps/pages/index.jsp?

uREC_ID=1379175&type=d&pREC_ID=1458929

School S 3. (2020). Grade 2. School Administrative Unit 29.

https://sym.keeneschoolsnh.org/apps/pages/index.jsp?

uREC_ID=1379175&type=d&pREC_ID=1458930

School S 4. (2020). Grade 3. School Administrative Unit 29.

https://sym.keeneschoolsnh.org/apps/pages/index.jsp?

uREC_ID=1379175&type=d&pREC_ID=1458931

School S. (2019). Handbook. School Administrative Unit 29.

https://drive.google.com/file/d/1Jzic29dnzLgbyQcKGTebR9v4yfCm7xEX/view

School S. (2020). About [School S]. School Administrative Unit 29.

https://sym.keeneschoolsnh.org/apps/pages/index.jsp?

uREC_ID=1223991&type=d&pREC_ID=1458886

Schulze, S. (2020). Cerebral palsy and behavioral disorders. Cerebral Palsy Guidance.

https://www.cerebralpalsyguidance.com/cerebral-palsy/associated-

disorders/behavioral/

Stern, K. A. (2020). Therapy. Cerebral Palsy Foundation.

44
King
https://www.cerebralpalsy.org/about-cerebral-palsy/treatment/therapy

Strand, E. A. (2005). Integral stimulation method (Adapted for children as DTTC).

https://www.apraxia-kids.org/apraxia_kids_library/integral-stimulation-method-

adapted-for-children-as-dttc/

Strand, E. A., McCauley, R. J., Weigand, S. D., Stoeckel, R. E., Baas, B. S. (2012). A motor speech

assessment for children with severe speech disorders: Reliability and validity evidence.

https://www.apraxia-kids.org/apraxia_kids_library/a-motor-speech-assessment-for-

children-with-severe-speech-disorders-reliability-and-validity-evidence/

Swick, K. J., & Williams, R. D. (2006). An analysis of Bronfenbrenner’s bio-ecological perspective

for early childhood educators: Implications for working with families experiencing stress.

Early Childhood Education Journal, 33(5). DOI: 10.1007/s10643-006-0078-y

Terband, H., Namasivayam, A., Maas, E., Van Brenk, F., Mailend, M., Diepeveen, S., Van

Lieshout, P., Maassen, B. (2019). Assessment of childhood apraxia of speech: A

review/tutorial of objective measurement techniques. Journal of Speech, Language, and

Hearing Research, (62), 2999-3032.

Voress, K., & Maddox, T. (2012). Developmental assessment of young children: Second edition.

WWC. (2008). Early intervention in reading. U.S. Department of Education, Institute

of Education Sciences, Beginning Reading, What Works Clearinghouse.

WWC. (2010). Lovaas model of applied behavior analysis: Intervention report. U.S. Department

of Education, Institute of Education Sciences, National Center for Education

Evaluation and Regional Assistance, What Works Clearinghouse.

WWC. (2017). Self-regulation strategy development. U.S. Department of Education, Institute

45
King
of Education Sciences, Students with a Specific Learning Disability, What Works

Clearinghouse.

WWC. (2013). Social skills training: Intervention report. U.S. Department of Education, Institute

of Education Sciences, National Center for Education Evaluation and Regional

Assistance, What Works Clearinghouse.

Wortham, S.C. & Hardin, B. J. (2016). Assessment in early childhood education (7th edition).

Pearson Education, Inc.

46
King
Appendix A

Description of Program Y’s Children’s Services

This artifact is a detailed description of the children’s services that Program Y offers. This

artifact explains the programs evaluation process and the services that are available to children

and their families.

(Program Y, 2020)
47
King
Appendix B

List of Subchapter I General Provisions

This artifact is a screenshot of the main points of Subchapter I, also known as Part A of

IDEA (2004). This elaborates on the different topics covered in Part A of the IDEA Law. The first

subchapter has many points and there are too many to fit in the Description of IDEA Law in this

paper.

(IDEA, 2004).
48
King
Appendix C

Format of DAYC-2 Assessment

This artifact is a photo of one of the Developmental Assessment of Young Children

scoring sheets. It shows what type of questions are asked for this assessment and how it is

scored. It is scored by putting a 1 next to an action that has happened and putting a 0 or blank

next to an action that has not happened.

49
King

(Ford, 2015).

Appendix D

School S Mission Statement

This artifact is the mission statement from School S (2020) that explains deeper what

the mission statement of the school is and each of the skills that the school is working toward

each of the children learning so they can become contributing members of the community.
50
King

(School S, 2020)

Appendix E

School S Special Education Statement

This artifact is the special education statement from School S (2019) that explains the

IDEA law and how the school works with the law, how a child is referred, evaluated, and how

the family is involved within the IEP process. This artifact explains the learning centers and how
51
King
they are used at School S, as well as documents that are available to families to understand the

process and their legal rights that are written in the document.

(School S, 2019)
52
King
Appendix F

Early Intervention in Reading Description

This artifact is a deeper description of the Early Intervention in Reading program. This

program is a simple intervention that requires teacher training that had many more parts to it

than was explained in the research above.

(WWC, 2008).
53
King
Appendix G

Dispositions Assessment

This artifact is the dispositions given by the Keene State College Education Department

that is written briefly about under growth as a professional and educator. The explanation is

brief, so the artifact is included to give the reader an understanding of what the dispositions

are.
54
King

(Keene State College Education Department, 2007).