DOCUMENT RESUME
ED 367 115
EC 302 824
TITLE
The Status or Handicapped Children in Head Start
Programs. Sixteenth Annual Report of the U.S.
Department of Health and Human Services to
the
Congress of the United States on Services Provided to
Children with Disabilities in the
Head Start
Program.
INSTITUTION
Administration for Children, Youth, and Families
(DHHS), Washington, DC. Head Start Bureau.
REPORT NO
DHHS-ACF-91-31130
PUB DATE
91
NOTE
43p.; For the Fifteenth Annual Report, see ED 328
027; for the Seventeenth Annual Report, see EC 302
825.
PUB TYPE
Reports
Descriptive (141)
EDRS PRICE
MF01/PCO2 Plus Postage.
DESCRIPTORS
*Disabilities; Disability Identification;
Early
Intervention; *Economically Disadvantaged;
*Enrollment Rate; Enrollment Trends; Federal
Programs; *Incidence; Low Income Groups;
Mainstreaming; *Preschool Education; *Special
Education
IDENTIFIERS
*Project Head Start
ABSTRACT
This report, covering the
program year 1987-1988, is
designed to inform the Congress of the status of children with
disabilities in Head Start programs. The report state.; that the
program's mandate of having 10 percent or more of thr, total number of
enrollment opportunities in Head Start programs available for
handicapped children was met in each
state or jurisdiction except
Alaska, the Virgin Islands, and the Pacific
Territories. Head Start
nationally achieved a 13.3 percent level
of enrollment of children
with professionally diagnosed disabilities. Head Start is the largest
program that integrates preschool children with disabilities
in group
experiences with nondisabled children on a systematic basis. The
number of children with disabilities served by Head Start programs
increased from 65,276 in 1987 to 65,740 in 1988.
Head Start programs
were unable to enroll 4,096 potencially eligible children with
disabilities because of age requirements
or lack of vacancies.
Special education or related services provided by Head Start staff
include individualized teaching, speech therapy and language
stimulation, and transportation. Special services provided by other
agencies include medical and psychological diagnosis, evaluation or
testing, special therapy and language stimulation,
and medical
treatment. Appendixes contain guidelines on diagnw.tic criteria, a
list of participants in the Resource Access Project Network, and
tables showing numbers of children with disabilities
in Head Start by
state. (JDD)
***********************************************************************
*
Reproductions supplied by EDRS are the best that can be made
from the original document.
***********************************************************************
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Administration for Children, Youth and Families
Head Start Bureau
The Status of Handicapped Children
in Head Start Programs
Sixteenth Annual Report of the
U.S. Department of Health and Human Services
to the Congress of the United States on
Services Provided to Children with Disabilities
in the Head Start Program
1991
..41111--_
U.S. DEPARTMENT OF EDUCATION
Orfice or Educationat Research and improvement
EDUCATIONAL RESOURCES INFORMATION
CENTER (ERIC)
t<rus document has been reproduced as
recerved I rorn the person or organezabon
orrgenabng ct
o Menor changes have been made to .mprove
reproducbon ouanty
Pornts 01 view Or op.mons stated en thIS cOCu .
ment do not necessarily represent ofIrc.aI
OERI pos.bon or pobcy
2
DESIL
,n14.UE
1
TABLE OF CONTENTS
FOREWORD
SUMMARY
Chapter 1.
Children With Disabilities in Head Start
1
Page
ii
A.
Purpose of This Report
1
B.
Background Information
1
C.
Overview of Head Start Policies on Services
to Children With Disabilities
4
Chapter 2.
Status of Children With Disabilities in
Head Start, 1987-1988 Program Year
11
A.
Number of Children With Disabilities Enrolled
12
B.
Types of Disabilities
14
C.
Severity of Disabilities
16
Chapter 3.
Services to Children With Disabilitius
18
1987-1988 Program Year
A.
Outreach and Recruitment
18
B.
Diagnosis and Assessment of Children With
Disabilities
19
C.
Mainstreaming and Special Services
21
D.
Coordination With Other Agencies
27
APPENDIX A
Diagnostic Criteria for Reporting
Children With Disabilities in Head Start
29
APPENDIX B
1987-1988 Resource Access Project Network
32
APPENDIX C
Survey Results of Children With Disabilities
in Head Start by State (or Geographical
Entity)
DHHS Publication No. (ACF) 91-31130
3
34
THE SECRETARY OF HEALTH AND HUMAN SERVICES
WASHINGTON. D.C. 20201
AUG 2 2 1991
FOREWORD
Head Start provides.educational, medical, nutritional, dental
and mental health services for children from low-income
families, along with parent involvement and social services for
their parents.
In the 1987-1988 program year, comprehensive
developmental services were provided to 515,931 children.
Of
these, the number of children with disabilities served was
65,740, or 13.3 percent of the total enrollment.
As they have
each year since 1972, Head Start programs worked hard tO
identify and serve children with disabilities during their
important preschool years.
This Administration is committed to maintaining and expanding
its support to Head Start, believing that it gives children from
low-income families a better start in life.
For children with
disabilities, opportunities to learn, to play and to interact
with children without disabilities and to be part of a
comprehensive program such as Head Start are especially
important.
For the past 25 years, Head Start has been available
and accessible to many of these children.
Community-based services and the working relationships which
Head Start has developed with other agencies and organizations,
such as local public schools and health providers, are critical
to Head Start's success.
These relationships have augmented the
special services for children with disabilities which Head Start
provides directly.
They have also played an important part in
enabling Head Start to increase the number of children with
disabilities served from 22,807 in 1972 to 65,740 in 1988.
In
addition, 49 interagency agreements with State Education
Agencies were in effect in 1988, indicating the acceptance of
Head Start as a full partner in providing preschool services for
children with disabilities.
I commend the Head Start program
for its special achievements in serving the interests of
economically disadvantaged families and the special needs of
children with disabilities.
Cdri4441:*41464:(45.
Louis W. Sullivan, M.D.
SUMMARY
Section 640(d) of the Head Start Act,
as amended (42 U.S.C.
9835(d)], requires "that for fiscal year 1982 and thereafter no
less than 10 percent of the total number of enrollment
opportunities in Head Start programs in each State shall be
available for handicapped children, and that services shall be
provided to meet their special needs."
The Head Start Program
met this mandate for the 1987-1988 program year in each of the
States except Alaska.
Puerto Rico, the District of Columbia,
the American Indian programs, and the Migrant programs all also
met the goal.
Only the Virgin Islands and the Pacific
Territories fell short of the 10 percent mandate.
All grantees completed the Program Information Report (PIR),
which provides information about children with disabilities,
for
the 1987-1988 program year.
Analyses of the PIR data show that
Head Start nationally achieved a 13.3 percent level of
enrollment of children with professionally diagnosed
disabilities.
The enrollment and,mainstreaming of children with disabilities
has become a characteristic feature of local Head Start
programs.
In 1988, all Head Start programs reported serving at
least one child with disabilities.
Head Start continues to be
the largest program that integrates preschool children with
disabilities in group experiences with non-disabled children on
a systematic basis, i.e., that mainstreams preschool children
with disabilities.
Preschool programs that integrate children with disabilities
give disabled children a chance to learn and play with children
who will someday be their co-workers, friends, and neighbors.
Both groups benefit most from being together on a regular basis
during the years when their attitudes and perceptions of
themselves and others are most pliable.
In addition, the child
with disabilities begins to develop a sense of control
over his
or her own life and a capacity to function among other people in
spite of a disability.
This report is based on data from the PIR which was completed by
Head Start programs in June 1988.
Therefore, the data used in
this report are frequently cited as 1988 data, although the
report covers program year 1987-1988.
Highlights are:
The number of children with disabilities served by
Head Start programs increased from 65,276 in 1987 to
65,740 in 1988 -- an increase of 467.
o
Children professionally diagnosed as disabled
increased to 13.3 percent of the total enrollment in
full year programs in 1988.
By comparison, in 1987,
children professionally diagnosed as disabled
accounted for 12.7 percent of total enrollment.
In 1988, all Head Start programs had enrolled at
least one disabled child.
o
In 1988, Head Start programs reported that they were
unable to enroll 4,096 potentially eligible children
with disabilities located by them or referred to
them.
The reasons most frequently reported were that
the children did not fit the age requirements or that
there were no vacancies.
In 1987, programs reported
that they were unable to enroll 3,355 children with
disabilities.
o
The distribution of children with disabilities in
Head Start, categorized by primary disabling
condition, is:
66 percent speech impaired, 10.6
percent health impaired, 5.7 percent specific
learning disability, 4.7 percent physically disabled,
4.5 percent seriously emotionally disturbed, 4.2
percent mentally retarded, 2.1 percent hearing
impaired, 1.9 percent visually impaired, 0.2 perrent
deaf, and 0.2 percent blind.
o
In 1988, 16.5 percent of the children with
disabilities enrolled in Head Start programs had
multiple disabling conditions.
This reflected a
slight decrease from 17.1 percent in 1987.
Head Start programs reported that special education or related
services are provided to children with disabilities by Head
Start staff.
These include individualized teaching, speech
therapy and language stimulation, and transportation.
Special
services were also provided to Head Start children by other
agencies.
Examples include medical and psychological
diagnosis, evaluation or testing, special therapy and language
stimulation, and medical treatment.
Head Start programs also reported that the following special
services were provided to parents of children with
disabilities: counseling, referrals to other agencies, visits
to homes or hospitals, parent conferences with technical staff
and other parent meetings, transportation, literature and
special teaching equipment, workshops, medical assistance, and
special classes.
Head Start programs reported working with other agencies in
several ways:
o
Thirty-one percent of the children with disabilities,
or 20,565 children, were professionally diagnosed
prior to the beginning of the program year.
Some of
these children were referred from other agencies and
some had received services in Head Start the previous
year.
o
Fifty-nine percent of the children received special
education or related services from other agencies.
Of these children, the overwhelming majority
(92
percent) received special education and related
services from a combination of Head Start and other
agencies.
o
There were 49 agreements with State Education
Agencies or those in the Territories, 1,555 written
or informal agreements with local education agencies,
and 1,539 written or informal agreements with other
agencies regarding services for children with
disabilities.
In 1988, Head Start continued its strong emphasis
on meeting
the needs of children with disabilities.
Local programs
continued to cooperate with other agencies to make maximum use
of limited resources and to provide the appropriate special
services which have become hallmarks of Head Start.
CHAPTER 1
Children With Disabilities in Head Start
A.
Purpose of This Report
This is the Sixteenth Annual Report to the Congress on "The
Status of Handicapped Children in Head Start Programs."
Pursuant to Section 640(d) of the Head Start Act, as amended
[42 U.S.C. 9835(d)], the purpose of this report is to inform
the Congress of the status of children with disabilities in
Head Start programs, including the number of children being
served, their disabling conditions and the services being
provided to them.
This report discusses the status of children with disabilities
in full year Head Start programs in 1987-1988.
It is based on
the Program Information Report (PIR) survey for that year, a
survey to which all programs responded.
In 1988, Head Start
programs were funded to serve 452,389 children.
However, the
total number of children who were served during the year was
515,931.
This total enrollment figure includes children who
were enrolled for less than a full year but received some
services.
Almost all Head Start programs are full year programs that
operate eight to twelve months of the year.
Thirty-six Parent
and Child Centers (designed to serve children from birth to
three years of age and their families) were included in the
1987-1988 PIR survey for the third time.
B.
Background Information
The following information on the Head Start program describes
the context in which special services are provided.
In 1988,
Head Start served 38 percent of all eligible children for one
year before they entered school.
A full range of ethnic groups
was represented, with 4 percent of the children being American
Indian, 22 percent Hispanic, 38 percent Black, 33 percent white
and 3 percent Asian.
The diversity of Head Start children is also shown by the array
of their dominant languages.
Programs reported that, in the
1987-1988 program year, English was not the dominant language
for 102,875 children (20 percent of those enrolled).
Among
these children, Spanish was the most frequently used language
(81,541), followed in descending order by Vietnamese
(2,319),
1
Chinese (1,682), Hmong (1,576), Haitian
(1,542) ,Cambodian
(1,275), French (326), Korean (315) and Japanese (33).
Particularly noteworthy is the fact that, for 12,266 additional
children, other (unspecified) languages were dominant.
The
diversity of dominant languages makes more difficult the
challenge of screening, assessing and providing appropriate
services to children with disabilities.
Each Head Start program carries out a community needs
assessment and is encouraged to use non-Head Start resources in
the community, saving scarce resources for services not
available elsewhere.
Head Start agencies are requfred to
establish procedures to obtain payment for services provided to
children from other agencies which are responsible for those
services as stated in Section 642(b) (4)
of the Head Start Act,
[42 U.S.C. 9837(b) (4)].
With respect to medical or dental
services, payments may not be made with Head Start funds if
funding is available from non-Head Start sources [45 C.F.R.
1304.3-4(a)(1)].
Fifty-two percent of the Head Start children
are enrolled in the Medicaid/Early Periodic Screening
Diagnostic and Treatment (EPSDT)
program, which pays for
medical and dental services.
Ninety-four percent of the Head
Start families received social services
from Head Start and/or
through referrals to other agencies.
For every five children enrolled, at least four Head Start
parents are providing a volunteer service.
Slightly more than
34 percent of the staff are parents of current or former Head
Start children, and many parents have built upon their
experiences in Head Start to enter other
career fields.
It has been estimated that there are 241,000 Head
Start
eligible three to five-year-old children with disabilities in
the United States.
Although there are various programs
available to assist children with disabilities, Head Start
makes a notable contribution, particularly for those children
with disabilities who can benefit from a comprehensive
developmental experience in a mainstream setting, one that
integrates disabled and non-disabled children.
The number of
children with disabilities enrolled in Head Start has risen
since 1973 (when the data from the PIR were first reported)
from 22,807 to 65,740 children in the 1988 program year.
Children with disabilities enrolled in Head Start programs
received the full range of child development
services required
for all children by the Head Start Program Performance
Standards [45 CFR 1304].
These include education, parent
involvement, social services, and nutrition and health services
(medical, dental, and mental health).
In addition, they
2
received the special education and related services required by
the Head Start legislation.
The Head Start programs reported
special efforts to enroll and serve more severely disabled"
children.
Programs provided assessment and diagnosis by
professionals to evaluate accurately the nature and severity of
each child's disability in order to serve the child most
effectively.
Head Start programs are also involved in several national
efforts to serve children with disabilities.
Under the
Education for All Handicapped Children Act of 1975 (P.L.
94-142), each State's maximum allocation is based on the number
of children with disabilities, three through 21 years of age,
currently being served [20 U.S.C. 1431(a)(1)(A)].
As a major
provider of services to preschool children with disabilities,
Head Start program personnel work with local education agencies
to ensure that children who have been professionally diagnosed
as disabled and who are receiving Head Start services .=.re
included in the State "Child Count" [34 C.F.R. 300.750].
In
addition, Head Start programs coordinate their searches for
unserved children with disabilities with the Statewide "Child
Find" efforts required under P.L. 94-142 [34 C.F.R. 300.220].
Head Start personnel also utilize other resources such as the
Crippled Children Program, Title V of the Social Security Act.
The 'Administration for Children, Youth and Families (ACYF) has
funded a network of projects called Resource Access Projects
(RAPs) to provide training and technical assistance to Head
Start grantees to enable them to serve children with
disabilities and their families.
In 1977, an interagency
agreement between ACYF and the Office of Special Education
Programs in the Department of Education designated the RAPs as
liaisons between Head Start and the State Education Agencies
(SEAs).
The RAPs have been facilitating the participation of
Head Start grantees in the development of State plans for
preschool children with disabilities as supported under P.L.
94-142 and the 1986 Amendments, P.L. 99-457.
Formal collaborative agreements describing how Head Start and
SEAs will coordinate services to preschool
children with
disabilities are now in effect in 49 States and Territories.
The RAP training is based on an annual needs assessment.
The
training includes the use of eight program manuals designed to
assist teachers, parents, and others (such as diagnosticians
and therapists) in mainstreaming children with disabilities.
The manuals were developed in collaboration with teams of
national experts and Head Start teachers under the direction of
the Head Start Bureau.
3
Parent involvement is a keystone of the Head Start program.
Parents have opportunities to participate actively on Policy
Councils, to volunteer in the program, and to learn about child
development and disabling conditions.
To ensure appropriate special services and the optimal
transition by disabled Head Start children into public school,
Head Start personnel help parents participate in developing an
Individual Education Program (IEP) for each child with
disabilities.
The Administration for Children,
Youth, and
Families (ACYF) has applied its experience with the transition
process for children with disabilities to the needs of all
children as they leave Head Start for other programs.
During
the 1987-1988 program year, materials on effective transition
strategies were widely disseminated within Head Start and made
available to public schools and
other agencies.
The RAPs have developed complementary materials to assist in
the smooth transition of children with disabilities.
C.
Overview of Head Start Policies
on Services to Children
With Disabilities
Section 640(d) of the Head Start Act [42 U.S.C. 9835(d)]
requires "that for fiscal year 1982 and thereafter no less than
10 percent of the total number of enrollment opportunities in
Head Start programs in each State shall be available for
handicapped children and that services
shall be provided to
meet their special needs."
The data presented here reflect
Head Start efforts to respond to this legislative mandate.
In addition, the Head Start Act specifies the definition of
children with disabilities provided in paragraph (1) of Section
602 of P.L. 91-230, the Education of the Handicapped Act, as
amended [20 U.S.C. 1401(a)(1)].
That Act defines the term
handicapped children as "mentally retarded, hard of hearing,
deaf, speech or language impaired, visually handicapped,
seriously emotionally disturbed, orthopedically
impaired, or
other health impaired children,
or children with specific
learning disabilities, who by reason thereof require special
education and related services."
Children with disabilities
must meet the eligibility requirements for Head Start programs.
Eligibility refers to the ages of the participating children
(between three years and the age of compulsory school
attendance) and family income (at least 90 percent of the
children must be from low-income families, including families
receiving public assistance).
All Head Start programs must meet the requirements of the
Program Performance Standards as specified in the regulations
4
[45 CFR 1304].
While these regulations clearly define the
services to be provided to non-disabled children, they state
that programs must be individualized to meet each child's
needs.
However, no standards have ever been set forth in
regulations for services for children with disabilities and
their families in Head Start.
Based on the definition of
children with disabilities, guidance for services to children
with disabilities and services to meet the special needs of
their parents was distributed to grantees between 1973 and
1980.
This was accomplished through various transmittal
memoranda and other ACYF policy issuances on such topics as
diagnostic criteria.
During the 1984-1986 program years, grantees requested that
ACYF consolidate and complete performance standards for
services for children with disabilities to complement the
general Program Performance Standards.
Extensive consultation
was held with the field concerning the adequacy and usefulness
of the current diagnostic criteria and the comprehensiveness of
the current guidance on services to children with disabilities.
Head Start directors, coordinators, professional organizations,
and technical assistance providers of Head Start services for
children with disabilities provided suggestions, comments and
recommendations.
The comments indicated that regulations
should be developed.
The development of draft standards was
undertaken in 1986-1987.
Draft standards were published in the
Federal Register for comment in October 1988.
Five hundred
comment letters were received, and more than 2,000 individual
comments were entered into a database for analysis.
Final
regulations will be published in 1991.
Another major development which affects Head Start services for
children with disabilities was the passage of P.L. 99-457, the
Education of the Handicapped Amendments of 1986.
This landmark
legislation mandates State Education Agencies to serve all
three-, four and five-year-old children with disabilities by
the 1990-1991 school year.
The right to a free, appropriate
education is extended to these children.
Children may be
served directly or through contracts.
States also were offered
funds to plan for services beginning at birth by 1990-1991.
At-risk children from birth to age three can be served at
State
discretion.
The Head Start Bureau and RAPs disseminated
information to all programs concerning this legislation and
its
family-centered approach.
The legislation is noteworthy
because of its emphasis on interagency coordination.
In
response to this legislation, which requires that existing
services continue to be provided by all agencies serving young
children with disabilities and their families, a Federal
Interagency Coordinating Council was established.
Head Start
serves as an active partner on ttis Council.
During the
1987-1988 program year the Federal Interagency Coordinating
Council sponsored a conference on the implementation of P.L.
99-457.
The conference was planhed by representatives of Head
Start, as well as the Administration on Developmental
Disabilities, the Office of Special Education and
Rehabilitative Services, the Bureau of Maternal and Child
Health, and the National Institute of Mental Health.
The Head Start Bureau has consistently given priority to
assisting local Head Start programs to identify, recruit, and
serve children with disabilities.
These efforts are consistent
with Head Start's philosophy of responding to the unique needs
and potential of each child and his or her family.
Head Start
policies that relate to children with disabilities are:
1.
Outreach and Recruitment - head Start programs are
required to develop and implement outreach and
recruitment activities, in cooperation with other
community groups and agencies serving children with
disabilities, in order to identify and enroll
children with disabilities who meet eligibility
requirements and whose parents desire the child's
participation.
No child may be denied admission to
Head Start solely on the basis of the nature or
extent of a disabling condition.
However, there are
instances where it is determined that such a program
experience would not benefit the child.
2.
reeds Assessment. Screening and Diagnosis - Needs
assessment, screening and diagnostic procedures
utilized by Head Start programs address all
disabilities specified in the legislation in order to
provide an adequate basis for special education,
treatment and related services.
Head Start programs
must ensure that the initial identification
of a
child as disabled is confirmed by professionals
trained and qualified to assess disabling conditions.
Assessment must be carried out as an ongoing process
that takes into account the child's continuing growth
and developmentS.
Careful procedures are required,
including confidentiality of program records, to
ensure that no child or family is mislabeled or
stigmatized with reference to a disabling condition.
Emphasis is placed on ensuring that the needs of all
eligible children with disabilities are accurately
assessed in order to form a sound basis for meeting
those needs.
6
13
3.
Diagnostic Criteria and Reloortinq - In 1975, Head
Start, the Office of Special Education Programs
(formerly the Bureau of Education for the
Handicapped) in the Department of Education, and
other agencies that serve children with disabilities
reviewed the criteria then being used by Head Start
for reporting purposes.
Based on that review, an
expanded set of criteria was developed which includes
the addition of a "learning disabilities" category in
order to be consistent with P.L. 94-142, the
Education for All Handicapped Children Act of 1975,
as amended [20 U.S.C. 1401(a)(1),(15)].
The revised
criteria also clarified the reporting of "multiple
handicaps."
Furthermore, the criteria were
specifically tailored to the developmental levels of
the preschool population, aged three to five.
In 1978, malnutrition was deleted from the
"health
impairment" category.
A careful review of this
category indicated that the inclusion of severe
malnutrition was inconsistent with other conditions
included under "health impairment." Since then,
malnutrition has been dealt with as part of the
overall health services reporting and evaluation.
Since program year 1981-1982, the reference to
II autistic" children has been deleted from the
category "serious emotional disturbance" and added to
the category "health impairment" for the subsequent
reporting of children with disabilities in Head
Start.
This was done in accordance with the
regulation issued in January 1981 by the Secretary of
the Department of Education that made changes in the
definition of "handicapped children" under Part B of
the Education of the Handicapped Act.
Appendix A presents the diagnostic criteria used in
reporting disabling conditions of the children in
1987-1988 Head Start programs.
Head Start policy distinguishes between two groups of
children: (1) those children who are disabled as
defined in the legislation and who, by reason of
their disability, require special education and
related services (see Appendix A), and (2)
those
children who have correctable conditions (e.g.,
children whose vision with eyeglasses
is normal or
nearly so) and who do not require special education
services.
The purpose of making this distinction
is
so that only children who require additional
education or support services will receive special
services to help overcome the effects of the
disability.
Only these children can be counted for
the purpose of the 10 percent enrollment
opportunities requirement.
Head Start considers as
disabled only the children who need special services,
namely those whose disability cannot be corrected or
ameliorated without special education or related
services.
Children with minimal or other problems,
such as a delay caused by lack of experiences which
can be overcome by regular Head Start programming,
but who do not require special education
services,
will continue to receive appropriate Head Start
services but are not considered as part of the
Congressionally mandated enrollment target.
For
example, the category "speech impairment" states that
"conditions of a transitional nature consequent to
the early developmental processes of the child" are
not to be considered as a disability.
4.
Severely Disabled Children - Severely disabled
children are enrolled in Head Start when the
professional diagnostic resource recommends that the
placement would be appropriate for the child.
Some of the children with severe disabilities have
been referred from other agencies to Head Start so
that they can participate in a mainstream
developmental environment.
This opportunity for
severely disabled children to learn and play with
non-disabled children is vital to their optimal
development.
Placement is made on the basis of the child's
Individualized Education Program (IEP).
Certain
severely disabled children (e.g., the profoundly
retarded) require intensive special services on a
one-to-one basis which often cannot be provided
in a
mainstream setting with non-disabled children.
Many
severely disabled children have been successfully
integrated, some on a part-time basis or by dual
enrollment with other organizations.
5.
Services for the Disabled Child - Head Start grantees
and delegate agencies must ensure that all children
with disabilities enrolled in the program receive the
full range of comprehensive services available to
non-disabled Head Start children, including provision
8
for participation in regular classroom activities.
These services--education, social services, parent
involvement, and health services (including medical,
dental, mental health and nutrition) --should consider
the child's needs, his or her developmental level,
and family circumstances.
In addition, special
education services and support services are provided
to meet the unique needs of the individual disabled
child.
6.
Mainstreaming - Since its beginning in 1965, Head
Start has maintained a policy of open enrollment for
all eligible children, including children with
disabilities.
As was noted in the Head Start Manual
of September 1967, "Head Start encourages the
inclusion of mentally or physically handicapped
preschool children in an integrated setting with
other Head Start children."
The legislative
requirement that a specific portion of the enrollment
opportunities be available to children with
disabilities is consistent with Head Start's approach
to serving children with disabilities in a
mainstreamed setting.
This mainstream experience of
learning and playing with non-disabled children helps
foster a positive self-image and assists the child
with disabilities in realizing his or her potential.
7.
Program Options - Head Start programs are encouraged
to consider several program options and to select the
one best suited to meeting the individual needs cf
children.
These program options, which include the
standard five day center-based option, home-based
services (with a weekly visit and a monthly group
activity for parents and children), and variation in
center attendance, allow the flexibility necessary to
individualize services to children with disabilities
and their families.
Within each option, Head Start
programs are encouraged to develop an IEP based on a
professional's diagnosis and, with input from parents
and the teacher, to respond to the child's unique
needs and capabilities.
The needs of the individual child are taken into
account when services are planned at the IEP meeting.
Some fragile children with disabilities are most
appropriately served in a combination of home and
center placements, for example, while some children
receive the most appropriate services through dual
placement in Head Start and a specialized agency
9
program, such as United Cerebral Palsy or Easter Seal
Societies.
The great majority of Head Start children
with disabilities are served in regular center-based
programs on a full- or part-time basis where they
receive the important benefits of contact with other
children.
8.
Collaboration With Other Agencies - As part of the
effort to strengthen and expand services to children
with disabilities, Head Start programs are required
to make every effort to work with other programs and
agencies serving children with disabilities in order
to mobilize and maximize the available resources and
services.
Interagency collaborative efforts have
been undertaken in the areas of:
o
outreach, recruitment, identification and
referral assistance;
o
screening, assessment and diagnosis;
o
provision of treatment and support services; and
o
training and technical assistance.
Local Head Start programs are encouraged to
participate in the implementation of P.L. 99-457, the
1986 Amendments to P.L. 94-142, the Education for All
Handicapped Children Act.
Head Start personnel have
been working with local education agencies to
ensure
that the count of children who have been
professionally diagnosed as disabled and who are
receiving Head Start services is included in the
State "Child Count" on which the allocation of
Federal education for disability funds is based.
A
number of Head Start and RAP staff members serve
on
State Interagency Coordinating Couriils, which plan
standards and procedures under P.L. 99-457.
Head
Start programs are also working with Statewide "Child
Find" efforts in the search for unserved children
with disabilities.
Some Head Start programs are
reimbursed by local school systems for providing
services to preschool children with disabilities
under the Education for All Handicapped Children Act
and by other State and local funding auspices.
Head
Start actively pursues such arrangements.
The Administration for Children, Youth and Families
encourages the development and implementation of
7
10
interagency agreements between Head Start at the
national and local levels and other Federal,
Regional, State, local, and professional agencies and
organizations concerned with the education of young
children with disabilities and their families.
There
were 49 agreements in effect between State Education
Agencies and Head Start during the 1987-1988 program
year, for example.
They addressed such matters of
mutual interest as screening, training, and the
provision of transportation services.
9.
Ten Percent Disabled Enrollment by State - Head
Start's objective is to achieve at least a 10 percent
level of enrollment of children with disabilities in
each State and to provide the special education and
related services necessary to meet the children's
needs.
The Human Development Services (HDS) Regional
Offices work with individual Head Start grantees to
determine enrollment targets, to strengthen
recruitment strategies, to develop plans for
providing services, and to conduct liaison activities
with other community resources.
CHAPTER 2
Status of Children With Disabilities in Head Start
Section 640(d) of the Head Start Act requires that "the
Secretary shall report to the Congress at least annually on the
status of handicapped children in Head Start programs,
including the number of children being served, their
handicapping conditions, and the services being provided such
children."
The data contained in this report were obtained through the
Handicapped Services section of the Project Head Start
1987-1988 Annual Program Information Report
(PIR).
The PIR
data were collected by the HDS Regional Offices.
The Program
Information Report was mailed to all Head Start grantees and
delegate agencies in May 1988.
Head Start programs reported on
the status of children with disabilities as of June 30, 1988,
or the end of their program year.
The data in this report are based on responses from 1,287 Head
Start full year programs.
Almost all Head Start programs are
full year programs that operate eight to 12 months of the year.
Thirty-six Parent and Child Centers (designed to serve children
from birth to three years of age and their families) were
included in the 1987-1988 PIR survey.
The questionnaire gathered data in the following categories:
1.
General - Number of both disabled and non-disabled
children actually enrolled.
2.
Staff - Number of programs with full or part-time
coordinators of services for children with
disabilities.
Type of degrees or licenses held.
3.
Enrollment of Children with Disabilities - Number of
children with disabilities enrolled who were
professionally diagnosed (reported by disabling
conditions, multiple disabilities and age).
Number of children with disabilities who were located
by and referred to Head Start programs that were not
able to be enrolled.
Number of children professionally diagnosed who
dropped out.
12
1 9
Number who underwent diagnosis and were found not to
be disabled.
4.
Services - Number of children with disabilities, by
disabling condition, receiving service.; from Head
Start and from other agencies.
Agreements with other agencies to provide needed
services to children with disabilities.
A.
Number of Children with Disabilities Enrolled
It has been estimated that there are 241,000 Head Start
eligible three- to-five-year-old children with disabilities in
the United States.*
Although Head Start cannot meet the needs
of all of these children with disabilities, it
is making a
notable contribution.
A Head Start experience is particularly
valuable for those children with disabilities who need a
comprehensive developmental experience in a mainstream setting
that integrates disabled and non-disabled children.
The number
of children with disabilities enrolled in Head
Start has
increased since the data were first reported in 1973.
In
November-December 1973, Head Start programs were serving 22,807
children with disabilities or 10.1 percent of their
enrollment.
As of June 1988, Head Start programs reported that they had
served 65,740 children with disabilities, or 13.3 percent of
their enrollment during the 1987-1988 program year.
All but a
small fraction of these children were fully
integrated into
regular Head Start programs.
Integrated programs provide peer
models and higher levels of cognitive, language, and social
stimulation than can be offered by programs serving only the
disabled.
Highlights:
o
There were 65,740 children with disabilities served
in Head Start programs in 1988.
This represents an
increase of 467 children over the 65,276 children
with disabilities served in 1987.
Children
professionally diagnosed as disabled accounted for
*
The March 1987 Current Population survey conducted by the
Bureau of Census reported that the number of children in
poverty in the age group three to five is 2,441,000.
Based on the estimated prevalence of children with
disabilities used by the Office of Special Education
Programs, U.S. Department of Education,
it is estimated
that 10 percent, or 241,000, of these children are
disabled.
13 20
i
13.3 percent of children professionally diagnosed as
disabled accounted for 13.3 percent of total actual
enrollment in Head Start programs, a slight increase from
the 12.7 percent in 1987.
o
Children professionally diagnosed as disabled
accounted for at least 10 percent of all Head Start
enrollment in each of the 50 States.
o
American Indian programs, the Migrant programs and
Puerto Rico met the goal in
1988.
o
The District of Columbia also exceeded the 10 percent
enrollment requirement, with 11.5 percent.
Only the
Virgin Islands and the Pacific Territories were below
the 10 percent level.
During 1986-1987 a number of Pacific Territories elected to
become independent of the United States.
As a result, funding
for the Head Start programs on Yap, Truk, Palau, Ponape and the
Commonwealth of the Mariana Islands was reduced in accordance
with a phase-out plan.
Technical assistance was also removed.
As a result of this change, the number of children with
disabilities enrolled and served decreased to 5.2 percent.
(Appendix C provides disabilities enrollment data for each
State and Territory, as well as for the Indian and Migrant
programs.)
The ACF Regional Offices are working with Head Start programs
in these areas to identify the reasons for the level of
enrollment of children with disabilities and to devise specific
strategies, such as increasing coordination of resources, for
expanding enrollment of children with disabilities.
Each full year Head Start program served at least one child
with disabilities.
Table 1 indicates that services are
provided for infants and toddlers as well as preschoolers.
It
reflects recognition of the importance of providing special
assistance as early as possible.
Of the 65,740 children with
disabilities served by Head Start programs, 1.5 percent were
less than three years of age, 22.3 percent were three years
old, 66.1 percent were four years old, 9.1 percent were five
years old, and about 0.3 percent were six years or older.
(Head Start children six years of age or older are in
communities where there are few programs that provide
appropriate services.
The number of six year olds, 168,
declined from 234 in the previous program year as more outside
placements became available.)
14
TABLE 1
Ages of Children Professionally Diagnosed as Disabled
Ages
Numbers
Under 1 Year
1 Year Old
2 Years Old
3 Years Old
4 Years Old
5 Years Old
6 Years and Older
116
251
586
14,661
43,429
6,529
168
Data were collected on the dropout rate
or children with
disabilities for the fifth time in the 1987-1988 PIR.
Of the
total number of children with disabilities served in Head Start
during the 1987-1988 operating year, 5,770 or 8.8 percent
dropped out during the operating period.
This is a
substantially lower proportion than reflected for all children
enrolled in Head Start in 1987-1988, when 14.8 percent of the
total actual enrollment dropped out during the operating
period.
Further, of the total number of children who dropped
out, 7.5 percent were children with disabilities.
This is also
substantially lower than the proportion of children with
disabilities to the total actual enrollment (13.3 percent).
In each of the five years during which these data have been
collected, the percentage of children with disabilities
dropping out has been less than the percentage of dropouts for
the total enrollment.
This may indicate that the parents of
the children with disabilities realize the importance of early
services for their children and may be making a greater effort
not to move the children during the program year.
They may
also consider the services beneficial to their children to a
higher degree than do the parents of the non-disabled children.
An absence of other service options may also be a large factor.
B. Types of Disabilities
Head Start is mandated to serve children with a broad range of
disabilities such as those who are mentally retarded, hard of
hearing, deaf, speech impaired, visually disabled,
seriously
emotionally disturbed, orthopedically impaired, or other health
impaired children, or children with specific learning
disabilities who by reason thereof require special education
and related services.
15
et 0
L.,
The types of disabling conditions of those children
professionally diagnosed as disabled are presented in Table 2
as a proportion of the total population of children with
disabilities in Head Start programs in 1988.
Of the children
with disabilities enrolled in Head Start, 66 percent have been
diagnosed as speech impaired.
This is by far the largest
category of children with disabilities
served in Head Start
programs.
However, Head Start requires that all children be
professionally diagnosed.
A previously completed study on the
speech impaired children determined that most of the children
categorized as speech impaired in Head Start had been
appropriately diagnosed.
In their reports to the Office of Special Education over the
last decade, State Education Agencies have reported an even
higher proportion of preschool age, speech impaired children
being served under P.L. 94-142.
Thus, the proportion of speech
impaired children served by Head Start is consistent with the
proportion of preschool children in the larger population
served under P.L. 94-142 by public schools, as well as with
reports from other preschool programs.
The ACYF maintained a
focus on working with speech and language impaired children and
also stressed the prevention of such impairment in the training
and materials provided for Head Start programs in 1987-1988.
The RAPs provided training sessions on language development,
speech skills, and otitis media (middle ear infection, which is
very prevalent among preschoolers and can adversely affect
speech and language development).
Additionally, a RAP Task
Force continued to study ways to
access related services,
particularly speech and language therapy.
TABLE 2
Types of Disabling Conditions of Children
Professionally Diagnosed as Disabled
Total Number and Percent
of Children Professionally Diagnosed
Disabling Condition
Number of
Disabled
Percent
Diagnosed as
Disabled
Speech Impairment
Health Impairment
Specific Learning Disability
Physical Disability
43,364
6,971
3,776
66.0
10.6
5.7
(Orthopedic)
3,089
4.7
Serious Emotional Disturbance
2,927
4.5
Mental Retardation
2,750
4.2
Hearing Impairment
1,355
2.1
Visual Impairment
1,274
1.9
Blindness
122
0.2
Deafness
112
0.2
Total
65,740
100.0
The distribution in the 1987-1988 program year was very
similar
to that reported in the previous year.
C. Seve'rity of Disabilities
Head Start serves a significant proportion of children with
severe or multiple disabilities.
Such children present
additional challengns to Head Start staff in the planning and
provision of individualized services.
Head Start policy
requires that the individual plan of action for special
education, treatment, and related services be based on the
child's specific disabling condition(s) and the unique needs
arising from those conditions.
A child with multiple
disabilities is likely to need a variety of treatments and
services.
A deaf-blind child, for example, might need mobility
skills training, auditory training for use of slight residual
hearing, occupational therapy to develop small motor skills,
and pre-Braille training.
Head Start staff, in conjunction
with other professionals and the child's family, have to
set
priorities and objectives, and have to tailor services for that
child in order to provide a focused, systematic plan of action.
17
r1 A
In 1988, 10,847 (16.5 percent) of the children with
disabilities enrolled in Head Start programs had multiple
disabling cànditions.
This is a slight decrease from the
number and percent of children with multiple disabilities
reported last year, i.e., 11,184 or 17.1 percent.
The highest incidence of multiple disabling conditions occur
among children whose primary disability is deafness (52.7
percent) and children whose primary disabling condition is
mental retardation (58.4 percent).
Speech impaired children
show the lowest incidence of multiple disabilities (8.9
percent).
Table 3 provides specific data by primary disabling
condition on the number of children who have multiple disabling
conditions.
TABLE 3
Distribution of Children Who Have One or More Disabling
Conditions by Primary or Most Disabling Condition
Total Number
Children With
Other Disabling
Percent With
Multiple
Disabling
Primary Condition
of Children
Conditions
Conditions
Blindness
122
43
35.24
Visual Impairment
1,274
241
19.00
Deafness
112
59
52.70
Hearing Impairment
1,355
548
40.44
Physical Disability
3,089
1,010
32.70
Speech Impairment
43,364
3,743
8.60
Health Impairment
6,971
1,409
20.20
Mental Retardation
2,750
1,605
58.36
Emotional
Disturbance
2,927
748
25.60
Learning
Disability
3,776
1,441
38.16
Total
65,740
10,847
16.50
The Administration for Children, Youth and Families continues to
pursue an active outreach and recruitment effort for enrolling
and serving severely disabled children.
The agency encourages
sharing resources and joint enrollment with other programs and
agreements between Head Start programs and local education
agencies.
Additional materials have been developed for use by
the Resource Access Projects in training programs to work with
severely disabled children.
18
CHAPTER 3
Services to Children With Disabilities
In program year 1987-1988, local Head Start programs developed
and carried out activities and services of direct and immediate
benefit to children with disabilities.
These activities and
services started with the active recruitment of children with
disabilities, particularly more severely disabled children, who
might benefit from Head Start.
Programs provided assessments
and diagnoses to evaluate accurately the nature and severity of
each child's disability in order to serve the child most
effectively.
Head Start programs continue to increase their own
resources and other capabilities to meet the needs of the
children with disabilities enrolled.
In addition, the programs
use other agencies as sources of special services.
This chapter
reports on the degree to which these activities and services are
being performed and reports on the utilization of staff,
facilities, and materials.
A. Outreach and Recruitment of Severely Disabled Children
Head Start programs reported these steps taken to enroll and
serve more severely disabled children:
coordination with other
agencies serving severely disabled children, sharing services
with other agencies serving severely disabled children, and
specific outreach and recruitment procedures aimed at recruiting
severely disabled children.
Programs reported that they held
orientation sessions for local diagnosticians and provided them
with special materials.
Programs also reported making changes
in recruitment and enrollment criteria.
Head Start programs and other agencies serving severely disabled
children have come to recognize the roles of each in providing
services.
Generally, the Head Start program serves as the
primary provider of mainstreamed learning experiences, while the
other agencies provide some or all of the needed special
services.
Reasons For Not Enrolling Some Children With Disabilities
Head Start programs reported that they were not able to enroll
4,096 children with disabilities located by or referred to them.
In 1987, programs reported that they were not able to enroll
3,355 children with disabilities.
As in previous years, the
most common reasons given were: the children did not fit the age
requirements, other agencies serve these children, and there
19
were no available openings.
The nature of the Head Start
mandate is not to serve every child with disabilities who might
apply but to ensure that at least 10 percent of the enrollment
opportunities are made available to such children.
The majority
of children enrolled in Head Start programs do not have
disabilities.
This circumstance makes it possible to maintain a
typical setting into which children with disabilities can be
mainstreamed.
Children who cannot be served in Head Start are
referred to other programs.
ACYF is participating with other
members of the Federal Interagency Coordinating Council in the
development of an interagency agreement to improve the
coordination of early identification,
referral and service
provision for young children with disabilities.
B. Diagnosis and Assessment of Children With Disabilities
The Head Start statutory definition of children with
disabilities excludes from reporting as disabled those children
with correctable conditions who do not need special services,
or
children who will not require services additional to those which
Head Start programs regularly provide.
In order to meet the legislated requirement for reporting, to
identify the needed special education and related services,
and,
more importantly, to ensure that children who are considered
disabled are not mislabeled or misdiagnosed, Head Start requires
that each child reported as disabled be diagnosed by appropriate
professionals.
At the time of data collection,
all of the
65,740 children reported as disabled had been diagnosed by
qualified professionals.
This includes children referred to
Head Start by other agencies or individuals and diagnosed prior
to Head Start enrollment.
In the 1987-1988 program year, 31
percent had either been diagnosed and referred to Head Start by
other agencies or individuals outside Head Start or diagnosed by
Head Start prior to the start of program services in the fall.
Enrolling children who have already been diagnosed by other
agencies is a cost-saving procedure which encourages prompt
provision of services.
Head Start encourages timely screening and assessment of all
children entering the program.
Of the children who were not
referred with a diagnosis but were diagnosed through Head Start
efforts, more than half (51 percent)
were diagnosed between the
time of enrollment in Head Start and January 31, 1988.
In
addition to the 65,740 children diagnosed as disabled, Head
Start provided assessments for another 21,436 children who had
failed screening or been referred,
but were found to be not
disabled.
20
Head Start programs are encouraged to work with other agencies
and private diagnostic providers and to use the following
strategy for each child suspected of being disabled:
Step 1:
An interdisciplinary diagnostic team (or an appropriate
professional qualified to diagnose the specific disability)
makes both a categorical diagnosis and a functional assessment.
Head Start diagnostic criteria (see Appendix A) are used to make
a categorical diagnosis.
The categorical diagnosis is used
primarily for reporting purposes and for overall program
planning.
The categorical diagnosis is consistent with
procedures Head Start programs must follow to ensure
confidentiality and to guard against mislabeling.
No individual
child is identified publicly as "disabled." Only the aggregated
numbers of children with specific disabling conditions are
reported by local Head Start programs to ACYF.
Step 2:
The diagnostic team also develops a functional
assessment of the child.
The functional assessment is a
developmental profile that describes what the child can and
cannot do and identifies areas that require special education
and related services.
The primary purpose of diagnosis is the
functional assessment.
The parents and child's teacher should
be active participants in the functional assessment and
contributors to the diagnostic file.
Step 3:
An Individualized Education Program (IEP) is developed
based on the functional assessment and becomes part of the
diagnostic file.
The plan reflects the child's participation in
the full range of Head Start comprehensive services and also
describes the special education and related services needed to
respond to the child's disability.
The plan spells out
classroom activities, involvement of parents, and special
services provided by Head Start or other agencies.
The plan is
developed in concert with the diagnostic team, the parents,
and
the child's teacher.
Step 4:
Ongoing Assessment of the child's program is made by
the Head Start teacher, the parents, and, as needed, by the
diagnostic team.
The IEP and the delivery of services are
modified, if needed, based on this periodic evaluation.
Step 5:
The Head Start program makes appropriate arrangements
for continuity of services when the child leaves the program.
This may include (1) updating the assessment information with
the development of recommendations for future treatment; (2)
conducting an exit interview with parents, schools, and other
agencies describing the services rendered to and needed by the
21
child; and (3) transferring of files, with parental consent.
The public school is the _primary agency responsible for
following up to ensure continuity of services
after the child
leaves the Head Start program.
Staff interchange between Head Start programs and outside
diagnostic providers to form a combined diagnostic team, with
close and continuing involvement of the parents, appears to be
the best way to ensure that the above strategy of diagnosis and
assessment is implemented.
Because many Head Start programs do
not have all of the necessary staff expertise in this area, a
working relationship with various other diagnostic providers in
the community facilitates a comprehensive approach to
assessment.
C. Mainstreaming and Special Services
In mainstreaming children with disabilities befw:e the age of
five, Head Start has built on accepted principles of the
importance of the early.years in all aspects of a child's
development.
All children share the same basic needs for love,
acceptance, praise, and a feeling of self-worth.
All
developmental early childhood programs address themselves to the
child's individual strengths, weaknesses, mode of learning, and
special problems.
Head Start attempts to meet these needs
through a carefully sequenced educational component and a
network of supporting services--medical, dental, nutritional,
mental health, social services, and parent participation
tailored to the specific capabilities of each child.
In
addition, children with disabilities are to receive special
education, therapy, or other services, either within the Head
Start program or as provided by other agencies.
Parents of
these children with disabilities also receive training,
counseling, and support services.
Mainstreaming - By functioning in an integrated group during the
early years, the child with disabilities can learn the ways of
the world and some of the problems to be faced.
Being with
non-disabled children at an early age fosters social
interaction
and motivates children with disabilities to participate more
actively with others.
As a result of these experiences, the
child will begin to develop a sense of control
over his or her
own life and an ability to function among other people in spite
of the disability.
Preschool programs which integrate children with disabilities
give them a chance to play and learn with children who will some
day be their co-workers, friends, and neighbors.
Both groups
22
29
benefit most from being together on a regular basis during the
years when their attitudes and perceptions of themselves and
others are most pliable.
The non-disabled child will gain a
greater understanding of the range of human differences and will
learn to enjoy being with other children who manifest different
characteristics and capabilities.
Experience in Head Start since 1972 has corroborated the
positive effects of mainstreaming on developmental gains and
social interaction and the lack of negative effects which are
reported in the literature for the early childhood special
education field as a whole.
Mainstreaming is in the best
interests of most children with disabilities.
The IEP is the
determining factor.
There are a few children who, at least
initially, may do better in a home-based or in a part-time
program.
A home-based option can provide the necessary bridge
between the family and the non-disabled peer group.
Others
benefit from a flexible approach and may spend part of the week
in a special program and part in a mainstream program.
Children
with disabilities are not over-represented in home-based
programs, as Head Start policy requires that the child with
disabilities be placed in an integrated classroom setting as
soon as appropriate.
Head Start continues to be the largest program that includes
preschool children with disabilities in group experiences with
non-disabled children on a systematic basis.
In 1988, all Head
Start programs had mainstreamed at least one child with
disabilities.
Special Services - Children with disabilities have special needs
which require special services.
They may also require special
equipment, materials, or modification of existing facilities.
The special services required may be provided through Head
Start, through outside agencies, or through a combination of
both.
Table 4 reports comparative levels for special services
provided to children with disabilities and their parents in
1986, 1987 and 1988 by reporting Head Start programs.
23
:3 0
TABLE 4
Three Year Comparison of Special Services
Provided to Children With Disabilities Enrolled in
Full Year Reporting Head Start Programs
Services Provided
1986
1987
1988
Total number of children who
received special education
or related services from Head
Start staff
62,255
65,276
65,740
Total number of children who
received special services
from other agencies
38,312
39,623
38,968
Total number of parents
who received special services
from Head Start related to their
child's disability
36,965
36,861
36,368
Special Services Provided by Head Start and Other Agencies
Head Start programs provide many special education and related
services to children with disabilities.
Head Start also
provides services for children with disabilities in their
programs through other agencies.
These services include
individualized instruction; psychological and physical therapy;
medical or psychological diagnosis;
evaluation or testing;
individualized teaching techniques; speech therapy and language
stimulation; transportation; education in diet, food, health and
nutrition; assistance in obtaining special services included in
the IEP; special teaching equipment; psychotherapy, counseling
and behavioral management; medical treatment; special equipment
for children; physiotherapy; and occupational therapy.
24
TABLE 5
Children Receiving Special Education or Related Services
From Head Start Only.
Other Agencies Only or Both
Both Head
Start and
Primary Disabling
Head Start
Other Agencies
Other
Condition
Only
Only
Agencies
Blindness
13
4
100
Visual Impairment
355
84
760
Deafness
10
5
96
Hearing Impairment
351
47
930
Physical Disability
608
188
2,228
Speech Impairment
19,131
1,498
22,066
Health Impairment
1,557
499
4,401
Mental Retardation
879
95
1,755
Emotional Disturbance
1,054
134
1,683
Learning Disability
1,263
188
2,207
Total
25,221
2,742
36,226
(39.3%)
(4.3%)
(56.4%)
As indicated in Table 5, 39.3 percent of the children with
disabilities served received special education or related
services from Head Start only; 4.3 percent received such services
from another agency only; and 56.4 percent received special
services to help overcome the disability from both Head Start and
another agency.
In the previous program year, 1986-1987, 54.7
percent of the children received special education or related
services from both Head Start and other agencies.
While the
percent of children receiving services from other agencies
declined very slightly, it is significant that more than half of
the children with disabilities enrolled were receiving services
from other agencies as well as from the Head Start programs which
enrolled them.
This level of coordination represents
considerable attention devoted to arranging for cooperative
efforts.
25
Special Services Provided by Head Start to Parents
Whose Disabled Children Participate
in Head Start
Head Start programs offer special services to all parents of
children with disabilities in addition to the services offered
all parents, such as the opportunity to observe and participate
in the program and the opportunity to serve on the Policy
Council.
Each year, most of the parents of children with
disabilities have accepted and used special services designed to
help them understand their children's special problems and the
effects of the disability on development and learning.
These
services include: referrals to other agencies, counseling,
conferences with technical staff and other meetings, literature
or special teaching equipment, visits to homes and hospitals,
transportation, parent meetings,
assistance in securing medical
services, workshops on school services, special classes,
and
other services.
Coordination of Special Services - High quality services for
children with disabilities require the cooperation of staff in
each of the Head Start program components--education, health,
social services, and parent
involvement.
In order to assure
coordination, Head Start has recommended that a coordinator of
services for children with disabilities be designated on a full-
time or part-time basis.
In 1988, 97 percent of the Head Start
programs had a coordinator of services for children with
disabilities.
Over a third (36.7 percent) of these programs
reported a full-time coordinator.
About half (47.6 percent)
reported a part-time coordinator,
and 12.9 percent indicated that
as a delegate agency they were served by a disabilities
coordinator at the grantee level.
Of the 1,287 programs
reporting in 1988, 85.6 percent had a coordinator with a degree
or license:
16 percent in early childhood/special education; 12
percent in special education; 8.1 percent in psychology; 5.8
percent in speech pathology/audiology;
and 44 percent in some
other area, including nursing,
psychology and social work.
A
number had degrees in more than one specialty area.
Resource Access Proiects (RAPs)
- Head Start's commitment to
individualization for all children,
including those with
disabilities, has provided the basis
for integrating children
with disabilities in a setting with non-disabled youngsters.
Head Start's effort to serve children with disabilities,
including those with severe disabilities, has placed an increased
responsibility on grantees to locate and provide specialized
services and staff training.
In support of the Head Start
mainstreaming movement, the Head Start Bureau has established a
network of 10 Resource Access Projects
(RAPs) to serve Head Start
program- in each Region throughout the nation.
2 6
In 1986, the 10 RAPs began providing services to Migrant
grantees.
Since 1986, Indian programs in five western States
have received technical assistance and training from the American
Indian Programs Branch Resource Center, which also provides
assistance in serving non-disabled children.
During the 1987-1988 program year, the RAPs emphasized
establishing working relationships with many kinds of State,
local and Regional organizations and agencies, and the fostering
of jointly planned training conferences.
It is the
responsibility of each RAP to assist Head Start in working with
children with disabilities.
Activities performed by each RAP are
based on annual assessments of grantee needs and include the
following:
identifying local, Regional and national resources;
o
determining local Head Start needs and matching these
needs with available resources;
o
coordinating the delivery of services to Head Start
programs;
o
providing training and technical assistance;
o
promoting and facilitating collaborative efforts and
interagency agreements between Head Start and other
agencies; and
o
providing resource materials to Head Start grantees.
Additionally, the RAPs have responsibility for providing
training, including the use of the eight resource manuals in the
series, Mainstreaming Preschoolers.
The manuals focus on
mainstreaming in Head Start and spell out techniques that can be
used by teachers and parents in working with children with
-disabilities.
The RAPs are responsible for conducting a minimum
of one workshop per State each year and have been designated as
the primary mechanism for dissemination of the Mainstreaming
Preschoolers series.
Progress reports show that the RAPs offer training annually and
disseminate information at least monthly to all programs.
Consistently high numbers of teachers and others trained,
information requests filled and interactions carried out with
personnel of other key agencies, especially State Education
Agencies, have been reported.
Analysis of the progress reports
for the 1987-1988 program year corroborates the extensive
specific information on the impact of the RAPs that was gathered
and validated by site visits during the years 1973-1985 by a
third party contractor.
27
4
The RAP training and the Mainstreaming Preschoolers manuals not
only have been widely acclaimed throughout the Head Start
community, but have also achieved recognition far beyond the Head
Start programs for which they were primarily intended.
The
manuals have been sent to other Federal agencies, national
professional associations, volunteer organizations that provide
services to children with disabilities, and State Education
Agencies.
They are also being used in public schools, day care
programs, universities and other organizations.
The series has
been shared with foreign governments as well.
A list of the 10 RAPs and the American Indian Programs Branch
Resource Center is provided in Appendix B.
D.
Coordination With Other Agencies
Other major foci of the RAPs include promoting collaboration
between Head Start and other programs and agencies serving
children with disabilities and facilitating the inclusion of Head
Start in State plans for serving children with disabilities as
supported under P.L. 99-457.
In 1974, an interagency agreement
between ACYF and the Office of
Special Education Programs in the
Department of Education designated the RAPs as liaison between
Head Start and the State Education Agencies (SEAs).
The RAPs
have been facilitating the participation of Head Start grantees
in the development or updating of the State plans for preschool
children with disabilities which are supported under P.L. 94-142.
Formal collaborative agreements describing how Head Start and
SEAs will coordinate services to preschool children with
disabilities are now in place in 49 States or Territories.
Four
new or updated written agreements were signed during the
1986-1987 program year between Head Start and the State Education
Agencies in Nebraska, Massachusetts, Missouri and the Virgin
Islands.
During the 1987-1988 program year, new or substantially
revised agreements were concluded with State Education Agencies
in Texas, Alabama, and Maryland.
Many agreements call for an
annual update of action plans.
In a number of States, the action
plans were updated.
However, agreements became obsolete in some
States because of staff turnover,
policy and legislative changes
and other changed circumstances.
New agreements are being
pursued in these instances.
Agreements with some of the former
Pacific Territories that have declared independence have been
terminated.
Local level agreements are also important to enabling Head Start
to serve children with disabilities.
About 97 percent of the
programs reported having written or informal agreements with
local education agencies (LEAs)
or other agencies regarding
services for children with disabilities.
A total of 1,555 Head
Start programs (82.6 percent) had written or informal agreements
28
with LEAs regarding services to be provided to children with
disabilities in Head Start.
A total of 1,539 (81.8 percent) of
the Head Start programs had such written or informal agreements
with agencies other than LEAs.
Head Start uses cooperative
arrangements widely at the local level, often receiving valuable
assistance such as resource teachers, related services, and
training.
Agreements with local education agencies can play an important
role in facilitating the transition of Head Start children into
the public schools.
The agreements cover areas of mutual
interest and concern including Child Find, screening, training,
transportation, participation in IEP preparation, and sharing of
specialists.
The results of Head Start's work with children with disabilities
and their families show sustained commitment to providing
appropriate services to meet the dual needs caused by economic
disadvantage and disabling conditions.
During the 1987-1988
program year, the Head Start program continued to be a model
for
the nation in integrating disabled and non-disabled children in a
developmental program with education, health (medical, dental,
nutrition, and mental health), social services, and active parent
participation.
In addition, the Head Start program demonstrated
community involvement on a broad scale by working closely with
public schools and other agencies with common concerns for
children and families with special needs.
29
APPENDIX A
Diagnostic Criteria for Reporting
Children With Disabilities in Head Start
All children reported in the following categories* must have been
diagnosed by the appropriate professionals who work with children
with these conditions and have certification and/or licensure to
make these diagnoses.
These professionals must take into
consideration the cultural and/or ethnic characteristics of the
Head Start children.
To be counted as disabled in Head Start,
children must meet two
criteria.
They must have one of the following disabling
conditions (by professional diagnosis)
and, by reason thereof,
require special eCucation and related services:
Blindness - A child shall be reported as blind when any of the
following exists:
(a) the child is sightless or has such limited
vision that he/she must rely on hearing and touch as his/her
chief means of learning; (b)
a determination of legal blindness
in the State of residence has been made; (c) central acuity does
not exceed 20/200 in the better eye, with correcting lenses, or
whose visual acuity is greater than 20/200, but is accompanied by
a limitation in the field of vision such that the widest diameter
of the visual field subtends an angle of no greater than 20
degrees.
Visual Impairment (Dis=bility)
- A child who is not blind shall
be reported as visually impaired if:
(a) central acuity, with
corrective lenses, does not exceed 20/70 in either eye; (b)
visual acuity is greater than 20/70,
but is accompanied by a
limitation in the field of vision such that the widest diameter
of visual field subtends an angle of no greater than 140 degrees
or Ae/she suffers any other loss of visual function that will
restrict learning processes,
e.g., faulty muscular action.
Not
to be included in this category are persons whose vision with
eyeglasses is normal or nearly so.
Deafness
A child shall be reported as deaf when any ore of the
following exists:
(a) his/her hearing is.extremely defective so
as to be essentially non-functional for the ordinary purposes of
life;
(b) hearing loss is greater than 92 decibels
(ANSI 1969) in
the better ear; (c) legal determination of deafness has been made
in the State of residence.
*
Multiple Disabilities:
Children will be reported as having
multiple disabilities when, in addition to their primary or
most disabling disabilities, one or more other disabling
conditions are present.
30
37
Hearing Impairment (Disability) - A child shall be reported as
hearing impaired when any one of the following exists:
(a) the
child has slightly to severely defective hearing, as determined
by his/her ability to use residual hearing in daily life,
sometimes with the use of a hearing aid;
(b) the child has
hearing loss from 26-92 decibels (ANSI 1969) in the better ear.
Physical Disability (Orthopedic Disability) - A child shall be
reported as crippled or with an orthopedic disability who has a
condition which prohibits or impedes normal development of gross
or fine motor abilities.
Such functioning is impaired as a
result of conditions associated with congenital anomalies,
accidents, or diseases.
These conditions include, for example,
spina bifida, lost or deformed limbs, burns which cause
contractures, and cerebral palsy.
Speech Impairment (Communication Disorder) - A child shall be
reported as speech impaired with such identifiable disorders as
receptive and/or expressive language impairment, stuttering,
chronic voice disorders, and serious articulation problems
affecting social, emotional and/or educational achievements; or
speech and language disorders accompanying conditions of hearing
loss, cleft palate, cerebral palsy, mental retardation, emotional
disturbance, multiple disabling conditions, and other sensory and
health impairments.
This category excludes conditions of a
transitional nature consequent to the early developmental
processes of the child.
Health Impairment
The impairments refer to illness of a chronic
nature or with prolonged convalescence including, but not limited
to, epilepsy, severe asthma, severe cardiac conditions, severe
allergies, blood disorders (e.g., sickle cell disease,
hemophilia, leukemia), diabetes, neurological disorders, or
autism.
Mental Retardation - A child shall be considered mentally
retarded who, during the early developmental period, exhibits
significant sub-average intellectual functioning accompanied by
impairment in adaptive behavior.
In any determination of
intellectual functioning using standardized tests that lack
adequate norms for all racial/ethnic groups at the preschool age,
adequate consideration should be given to cultural influences as
well as age and developmental level (i.e., finding of a low I.Q.
is never by itself sufficient to make the diagnosis of mental
retardation).
Serious Emotional Disturbance - A child shall be considered
seriously emotionally disturbed who is identified by
professionally qualified personnel (psychologist or psychiatrist)
as requiring special services.
This definition would include,
31
but not be limited to, conditions that indicate the child is:
dangerously aggressive towards others,
self-destructive, severely
withdrawn and non-communicative, hyperactive to the extent that
it affects adaptive behavior, severely anxious, depressed or
phobic, or psychotic.
Special Learning Disabilities - These disabilities refer to a
disorder in one or more of the basic psychological processes
involved in understanding or in using language, spoken or
written, which may manifest itself in
imperfect ability to
listen, think, speak, read, write,
spell or do mathematical
calculations.
Such disorders include such conditions as
perceptual disabilities, brain injury, minimal brain dysfunction,
dyslexia, and developmental aphasia.
Not included are learning
problems which are primarily the result of visual, hearing, or
motor disabilities, of mental retardation,
of emotional
disturbance, or of environmental disadvantage.
For preschool
children, precursor functions to understanding and using
language, spoken or written, and computational
or reasoning
abilities are included.
(Professionals considered qualified to
make this diagnosis are physicians and psychologists with
evidence of special training in the diagnosis of learning
disabilities and special educators with at least Master's degrees
and evidence of special training in the diagnosis of learning
disabilities.)
II
III
IV
APPENDIX B
Resource Access Project Network
States Served
Connecticut
Maine
Massachusetts
New Hampshire
Rhode Island
Vermont
New Jersey
New York
Puerto Rico
Virgin Islands
Delaware
District
of Columbia
Maryland
Pennsylvania
Virginia
West Virginia
Florida
Georgia
North Carolina
South Carolina
Alabama
Kentucky
Tennessee
Mississippi
V
Illinois
Indiana
Ohio
Michigan
Minnesota
Wisconsin
Resource Access Project (RAP)
Education Development Center, Inc.
55 Chapel Street
Newton, Massachusetts 02160
New York University
School of Continuing Education
48 Cooper Square, Room 103
New York, New York 10012
University of Maryland
University College
University Boulevard at Adelphi Rd
Hyattsville, Maryland
20742
Chapel Hill Training-Outreach
Suite 105
800 Eastowne Drive
Chapel Hill, North Carolina
27514
(subcontract)
Friends of Children Head Start
119 Mayes Street
Jackson, Mississippi 39213
University of Illinois
Colonel Wolfe School
403 East Healey
Champagne, Illinois 61820
(subcontract)
Pottage Project
626 East Slifer Street
Portage, Wisconsin 53901
33
4
HHS
Region
States Served
VI
VII
VIII
IX
Arkansas
Louisiana
New Mexico
Oklahoma
Texas
Iowa
Kansas
Missouri
Nebraska
Colorado
Montana
North Dakota
South Dakota
Utah
Wyoming
Arizona
California
Hawaii
Pacific Terri-
tories
Idaho
Oregon
Washington
Alaska
Resource Access Project (RAP)
Texas Tech University
Special Project Division
P.O. Box 4170
Lubbock, Texas 79409
University of Kansas
Medical Center
Children's Rehabilitation Unit
26
Kansas City, Kansas
66103
University of Colorado at Denver
Campus Box 193
P.O. Box 173364
Denver, Colorado
80217-3364
Southwest Human Development
1366 East Thomas Road
Phoenix, Arizona
85014
Portland State University
Division of Continuing Education
P.O. Box 1491
Portland, Oregon 97207
American Indian Programs: Resource Center
Arizona
Colorado
Montana
Nevada
New Mexico
North Dakota
Oklahoma
South Dakota
Utah
Wyoming
Three Feathers Associates
P.O. Box 5508
Norman, Oklahoma
73070
34
4
APPENDIX C
Children With Disabilities
in Head Start by State*
(or Geographical Entity)
Full Year 1987-1988
State (or
Number of
Number of
Percent of
Geographical
Grantees
Children
Enrollment
Entity)
and
Professionally
Profess-
Delegate
Diagnosed as
sionally
Agencies
Disabled
Diagnosed as
Reporting
Through End
Disabled
of Operating
Through End
Year
of Operating
Year
Alabama
37
1,279
11.31
Alaska
5
114
10.98
Arizona
20
455
11.56
Arkansas
4
943
13.89
California
140
4,791
11.54
Colorado
2
653
12.51
Connecticut
29
550
11.68
Delaware
5
114
10.36
District of
Columbia
9
211
11.46
Florida
39
1,888
13.46
Georgia
42
1,357
11.09
Hawaii
5
247
15.46
Idaho
8
300
22.08
llinois
81
2,957
11.86
Indiana
40
1,318
17.58
Iowa
21
695
16.51
Kansas
22
632
17.64
Kentucky
48
1,667
14.63
Louisiana
44
1,491
13.71
Maine
13
566
20.78
Maryland
30
940
15.52
Massachusetts
35
1,336
15.02
Michigan
87
2,589
11.68
Minnesota
27
832
13.57
Mississippi
22
2,646
11.60
Missouri
23
1,509
15.80
Montana
9
181
13.51
Nebraska
16
370
16.48
Nevada
4
75
10.77
New Hampshire
6
122
14.54
New Jersey
30
1,268
12.66
New Mexico
23
540
13.64
35
42
APPENDIX C (Continuedy
Children With Disabilities
in Head Start by State*
(or Geographical Entity)
Full Year 1987-1988
State (or
Number of
Number of
Percent of
Geographical
Grantees
Children
Enrollment
Entity)
and
Professionally
Profess-
Delegate
Diagnosed as
sionally
Agencies
Disabled
Diagnosed
Reporting
Through End
as Disabled
of Operating
Through End
Year
of Operating
Year
New York
151
3,935
14.55
North Carolina
43
1,733
14.80
North Dakota
8
102
13.71
Ohio
79
3,703
15.23
Oklahoma
24
1,201
15.22
Oregon
21
588
18.15
Pennsylvania
67
3,056
16.69
Rhode Island
8
219
14.78
South Carolina
16
837
12.24
South Dakota
7
165
13.28
Tennessee
29
1,446
15.34
Texas
84
3,012
12.43
Utah
12
307
13.79
Vermont
7
155
15.04
Virginia
40
986
14.38
Washington
31
698
13.78
West Virginia
29
831
18.65
Wisconsin
36
960
11.97
Wyoming
5
120
15.95
Puerto Rico
35
2,434
11.54
Virgin Islands
1
109
9.64
Pacific
Territories **
9
264
5.05
Indian Programs
108
2,057
13.15
Migrant Programs
66
2,186
10.02
TOTAL
1,842
65,740
13.30
* *
State data exclude Migrant and Indian Programs
Includes Head Start programs in the Commonwealth of Northern
Mariana Islands, Palau, Ponape, Truk, Guam, American Samoa,
and Yap
its.GOVERJMENT PP1N11NG OFFKX 1601-628447/40886
36
4 3