Integrated Classroom Services

• Professionals visiting classrooms to provide services to young children with disabilities do so by consulting with the teaching staff, rather than taking the child out of the classroom or working with the child in the classroom but isolated from the ongoing activity.
• The rationale is that very young children are highly unlikely to learn skills through short periodic (e.g., weekly) sessions but that they can learn from ongoing intervention from their teachers—and, of course, parents.
• An approach called “individualized within routines” is the most promising, followed by “group activities.”
• The professionals who have been studied are occupational therapists, physical therapists, early childhood special educators (or special-instruction teachers), and speech-language pathologists.
• This area of research has also highlighted practices that have become popular despite dodgy theory and a poor empirical base. It is one reason to be cautious about the fashionable confusion of “wisdom,” personal experience, and values with an evidence base.
  
  

Research

• U.S. Department of Education, Office of Special Education and Rehabilitative Services. Field-Initiated Research Project. “Integrated versus isolated services in early intervention.” (PIs: Donald B. Bailey, Jr., then R. A. McWilliam) (5 years).
• U.S. Department of Education, Office of Special Education and Rehabilitative Services, Early Education Program for Children with Disabilities, Outreach Grants. “Project INTEGRATE: Integrated Therapy and Education Garnered from Research And Treatment Experiences.” (3 years).
• McWilliam, R. A. (1993). Patterns of therapy and instruction in early intervention: What predicts pull-out services? Developmental Medicine and Child Neurology (Supplement No. 69), 35, 14.
• McWilliam, R. A., & Bailey, D. B. (1994). Predictors of service delivery models in center-based early intervention. Exceptional Children, 61, 56-71.
• McWilliam, R. A. (1995). Integration of therapy and consultative special education: A continuum in early intervention. Infants and Young Children 7(4), 29-38.
• McWilliam, R. A., & Sekerak, D. (1995). Integrated practices in center-based early intervention: Perceptions of physical therapists. Pediatric Physical Therapy, 7, 51-58.
• Roberts, J. E., Prizant, B., & McWilliam, R. A. (1995). Out-of-class vs. in-class service delivery in language intervention: Effects on communicative interactions with young children. American Journal of Speech-Language Pathology, 4(2), 87-93.
• McWilliam, R. A., Young, H. J., & Harville, K. (1996). Therapy services in early intervention: Current status, barriers, and recommendations. Topics in Early Childhood Special Education, 16, 348-374.
• Scott, S. M., McWilliam, R. A., & Mayhew, L. (1999). Integrating therapies into the classroom. Young Exceptional Children, 2(3), 15-24.
• McWilliam, R. A. (1999). Controversial practices: The need for a reacculturation of early intervention fields. Topics in Early Childhood Special Education, 19, 189-193.
• Rapport, M. J., McWilliam, R. A., & Smith, B. J. (2004). Practices across disciplines in early intervention: The research base. Infants and Young Children, 17, 32-44.
• McWilliam, R. A., & Strain, P. S. (1993).  Service delivery models.  In Task Force on Recommended Practices, Division for Early Childhood, Council for Exceptional Children, DEC recommended practices: Indicators of quality in programs for infants and young children with special needs and their families (pp. 40-49).  Reston, VA: Council for Exceptional Children.
• Strain, P. S., Smith, B. J., & McWilliam, R. A. (1996). The widespread adoption of service delivery recommendations: A systems change perspective. In S. L. Odom & M. E. McLean (Eds.), Early intervention for infants and young children with disabilities and their families: Recommended practices (pp. 101-124). Austin, TX: Pro-Ed.
• McWilliam, R. A. (Ed.) (1996). Rethinking pull-out services in early intervention: A professional resource. Baltimore, MD: Paul H. Brookes.
• McWilliam, R. A. (2005). DEC recommended practices: Interdisciplinary models (Introduction). In S. Sandall, M. L. Hemmeter, B. J. Smith, & M. E. McLean (Eds.), DEC recommended practices: A comprehensive guide for practical application in early intervention/early childhood special education. Longmont, CO: Sopris West and Missoula, MT: DEC.
  

Consultation, Training, and Technical Assistance Opportunities

CTTO on integrating services in classroom programs is available.

Future Directions

Assumptions about the dosage of intervention that results in functional change in children need to be examined.