DOCUMENT RESUME
ED 297 559
EC 211 294
TITLE
The Status of Handicapped Children in Head Start
Programs: Fourteenth Annual Report of the U.S.
Department of Health and Human Services to the
Congress of the United States on Services Provided to
Handicapped Children in Project Head Start.
INSTITUTION
Administration for Children, Youth, and Families
(DHHS), Washington, DC. Head Start Bureau.
PUB DATE
87
NOTE
50p.
PUB TYPE
Reports - Descriptive (141)
Legal /Legislative /Regulatory Materials (090)
EDRS PRICE
MF01/PCO2 Plus Postage.
DESCRIPTORS
*Compliance (Legal); Definitions; *Disabilities;
*Eligibility; *Enrollment Trends; Handicap
Identification; *Incidence; *Mainstreaming; Preschool
Education; Trend Analysis
IDENTIFIERS
*Project Head Start
ABSTRACT
The annual report on the status of handicapped
children in Head Start programs during 1985-86 provides background
information, statistical data, and analysis. The mandate that 10% of
enrollment be available for handicapped children was met by all
states except Alaska and the District of Columbia, the Virgin
Islands, American Samoa, and the Migrant programs. Overall, 12.5% (a
slight increase) of enrollment was of children with professionally
diagnosed handicaps. Only 15 of 1,881 Head Start programs reported
serving no handicapped children. Other highlights of the report
include: number of handicapped children served increased to 64,994;
S9.2% of all Head Start programs had enrolled at least one
handicapped child; about 50% of the programs reported being unable to
enroll 4,022 handicapped children usually due to lack of vacancies or
not meeting the age requirements; that 18.5% of the handicapped
children enrolled had multiple handicapping conditions; and that
categorization by primary handicapping condition showed 62.9% speech
impaired, 11.3% health impaired, 5.5% specific learning disabled,
5.1% physically handicapped, 5.1% mentally retarded, 4.7% seriously
emotionally disturbed, 2.8% hearing impaired, and 2.1% visually
impaired. Appendixes provide (1) the ±lagnostic criteria for
reporting handicapped children; (2) Resource Access Project Network
addresses; and (3) survey results by state or geographic entity.
(DB)
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Reproductions supplied by EDRS are the best that can be made
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from the original document.
*
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U.S DEPARTMENT OF EDUCATION
Office of Educational Research and Improvement
EDUCATIONAL RESOURCES INFORMATION
CENTER (ERIC)
1-""fris document has been reproduced as
received I rpm the person or organization
originating it
r Minor changes have been made to improve
reproduction duality
Points of voew or opinions stated in thiSdocu
ment do not necessarily represent &kat
OFRI ,00s.,00,,, 0, 0C, cy
THE STATUS OF HANDICAPPED CHILDREN IN HEAD START PROGRAMS
FOURTEENTH ANNUAL REPORT OF THE
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
TO THE CONGRESS OF THE UNITED STATES ON
SERVICES PROVIDED TO HANDICAPPED CHILDREN
IN PROJECT HEAD START
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of Human Development Services
Administration for Children, Youth and Families
Head Start Bureau
Washington, D.C.
1987
2
BEST COPY AVAILABLE
TABLE OF CONTENTS
Page
FOREWORD
SUMMARY
i
Chapter 1.
Handicapped Children in Head Start
1
A.
Purpose of This Report
1
B.
Background Information
1
C.
Overview of Head Start Policies on
Services to Handicapped Children
5
Chapter 2.
Status of Handicapped Children in
Head Start, 1985-86 Program Year
11
A.
Number of Handicapped Children
Enrolled
12
B.
Types of Handicaps
14
C.
Severity of Handicaps
18
Chapter 3.
Services to Handicapped Children
20
1985-8E Program Year
A.
Outreach and Recruitment
20
B.
Diagnosis and Assessment of
Handicapped Children
21
C.
Mainstreaming and Special Services
23
D.
Coordination With Other Agencies
29
APPENDIX A
APPENDIX B
APPENDIX C
Diagnostic Criteria for Reporting
Handicapped Children in Head Start
1985-1986 Resource Access Project Network
Survey Results of Handicapped Children
in Head Start by State (or Geographic
Entity)
3
34
37
39
THE SECRETARY OF HEALTH AND HUMAN SEP vCES
wasNoToN o C
:0201
FOREWORD
In the 1985-1986 program year, Head Start provided
comprehensive
developmental services to 517,799 low income preschool children
and their families.
As it has since 1965, the program seeks
to
foster the development of children and enable them to deal more
effectively with both their present environment and later
responsibilities in school and communities.
Head Start programs
emphasize education; social services;
medical, dental, nutrition
and mental health services; and parent involvement to enable each
child to develop to his or her highest potential.
One facet of the Head Start program merits a special salute: its
services to handicapped children.
In 1972 Head Start mounted a
major effort to serve handicapped children.
The number of
handicapped children enrolled in Head Start has risen steadily
since the data were first reported from 22,807 in 1973 to 64,994
handicapped children in 1986.
Head Start is in the forefront of the provision of services to
the preschool handicapped child as the largest mainstream
placement program in the nation.
Mainstreaming provides
handicapped children with active, day-to-day group experiences
with non-handicapped children.
Giving handicapped children an
opportunity to learn, to play,
to live with non-handicapped
children takes them a giant step in the direction of
participating in the general society as responsible adults in
their later years.
During the early, crucial years of growth, it
is important for children to develop healthy attitudes and
perceptions about each other
as well as themselves.
Mainstreaming helps children reach that goal.
In 1986, 99.2 percent of all Head Start programs had enrolled at
least one handicapped child.
These children received a full
range of child development services in addition to special
education or related services in accordance with their special
needs.
These special services were provided
through the Head
Start program, through outside agencies or, for the children,
through a combination of both.
During 1986, 46 State agreements
and 3.120 local level agreements between Head Start and other
agencies were in effect.
This Administration believes in Head Start.
We will continue to
support comprehensive services which improve the quality of
family life.
It is through an alliance -- a working partnership
-- between the Head Start program, community resources and State
and local government agencies
that we can best make an important
contribution to the lives of preschool children and their
families.
Otis R. Bowen, M.D.
Secretary
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 1985-1986 program year in each of 49
of the 50 States and in Guam,
Puerto Rico, the American Indian
Programs and the Trust Territories of the Pacific Islands.
Alaska with 9.7 percent,
was the only State not meeting the
mandate.
The District of Columbia, the Virgin Islands,
American Samoa and the Migrant programs fell short of the 10
percent goal.
Every grantee completed the
Program Information Report (PIR)
for the 1985-1986 program year.
Analysis of the data shows
that Head Start nationally achieved a 12.5 percent level of
enrollment of children with professionally diagnosed handicaps.
The enrollment and mainstreaming of handicapped children has
become a charactcristic feature of
local Head Start programs.
In 1986, only 15 of 1,881 Head Start programs reported serving
no handicapped children.
Head Start continues to be the
largest program that includes preschool handicapped children in
group experiences with non-handicapped children on a systematic
basis, i.e., that mainstreams preschool handicapped children.
Preschool programs that mainstream handicapped children give
disabled children a chance to learn and play with children who
will someday be their co-workers,
friends, and neighbors.
Both
roups benefit most from being together on a regular basis
uring the years when their attitudes and perceptions of
hemselves and others are most pliable.
In addition, the
ndicapped child begins to develop a sense of control over his
her own life and an ability to function among other people
spite of a disability.
g
d
t
ha
or
in
Thi
by
in t
repo
s report is based on data from the PIR which was completed
Head Start programs in June 1986.
Therefore, the data used
his report are frequently cited as 1986 data, although the
rt covers program year 1985-1986.
Highlights are:
The number of handicapped children served by Head
Start programs increased from 61,898 in the previous
year to 64,994 in 1986 (an increase of 3,096).
ii
4
o
Children professionally diagnosed as handicapped
increased to 12.5 percent of the total enrollment in
1986.
By comparison, in 1985, children
professionally diagnosed as handicapped. accounted for
12.2 percent of the total enrollment in full year
programs.
o
In 1986, 99.2 percent of
all Head Start programs had
enrolled at least one handicapped child reflecting an
increase over 98.3 percent in 1985.
o
In 1986, about 50 percent of
the programs reported
that they were unable to enroll 4,022 handicapped
children located by 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 1985, about 50 percent of the programs
reported that they were unable to enroll 5,971
handicapped children.
o
The distribution of handicapped children in Head
Start, categorized by primary handicapping condition,
is:
62.9 percent speech impaired,
11.3 percent
health impaired, 5.5 percent specific learning
disabled, 5.1 percent physically handicapped, 5.1
percent mentally retarded, 4.7 percent seriously
emotionally disturbed, 2.8 percent hearing impaired,
2,1 percent visually impaired, 0.2 percent deaf, and
0.2 percent blind.
o
In 1986, 18.5 percent of the handicapped children
enrolled in the reporting Head Start programs had
multiple handicapping conditions.
This reflected a
slight increase from 18.1 percent in 1985.
Head St,,,rt programs reported that special education or related
services are provided to handicapped children by Head Start
staff.
These include individualized teaching techniques,
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 the following special
services provided to parents of
handicapped children: 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.
iii
6
Head Start and other agencies and organizations concerned with
handi'lapped children coordinate efforts in order to make
max'
m use of their limited resources.
Head Start programs
rep,,Lted working with other agencies. in several ways:
o
32 percent of the handicapped children were referred
from other agencies and were professionally diagnosed
prior to entry into Head Start.
o
58 percent of the children received special education
or related services from other agencies.
o
The program had 46 agreements with State Education
Agencies, 1,557 written or informal agreements with
local education agencies and 1,563 written or
informal agreements with other agencies regarding
services fo: handicapped children.
Only 69 programs
reported no agreements.
In 1986 Head Start continued the emphasis on serving children
with handicaps and cooperating with other agencies to provide
appropriate special services which have become hallmarks of
this program.
J':
7
iv
CHAPTER 1
Handicapped Children in Head Start
A.
Purpose of this Report
This is the Fourteenth Annual Report to the Congress on Head Start
Services to Handicapped Children.
Pursuant to Section 640(d) of
the Head Start Act, as amended [42 U.S.C. 9835(d)], this report is
to inform the Congress of the status of handicapped children in
Head Start programs, including the number
of children being
served, their handicapping conditions and the services being
provided to them.
This report discusses the status of handicapped children in those
full year Head Start programs in 1985-1986 that responded to the
Program Information Report (PIR) survey (all programs responded).
In 1986 Head Start programs were funded to
serve 451,732
children.
However, the total number of children who were served
during the year was 517,799.
This total enrollment figure
includes children who were enrolled for
less than a full year but
received some services, and is the base figure used to calculate
the percentage of handicapped children served.
Almost all Head Start programs are full year programs that
operate
eight to twelve months of the
year.
Thirty-five Parent and Child
Centers (designed to serve children 0 to three years of age and
their families) were included in the 1985-1986 PIR for the first
time.
B.
Background Information
The following information on the Head Start program describes the
context in which special services are provided.
In 1986 Head
Start enrolled one out of six of the income-eligible
preschool
children.
A full range of ethnic groups was represented, with 4
percent of the children being American Indian,
21 percent
Hispanic, 40 percent black, 32 percent white
and 3 percent Asian.
Each Head Start program carries out
a community needs assessment
and is encouraged to use non::ead Start resources in the
community, saving scarce resources for services not available
elsewhere.
Head Start agencies are required to establish
procedures to obtain payment for services provided to children
from other agencies which are responsible for
those services.
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 percent of Head
Start children are enrolled in the Medicaid/Early Periodic
Screening Diagnostic and Treatment (EPSDT) program which pays for
medical and dental services, for example.
Ninety-three percent of
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.
Thirty-one 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 othei career fields.
It has been estimated that there are 250,000 Head Start eligible
handicapped children of preschool
age, three to five, in the
United States.
Although there are various programs available
to
assist handicapped children, Head Start makes a notable
contribution, particularly for those handicapped children who can
benefit from a comprehensive developmental experience in a
mainstream setting, one that integrates
handicapped and
non-handicapped children.
The number of handicapped children
enrolled in Head Start has risen since 1973 (when the d to from
the PIR were first reported) from 22,807 to 64,994 handicapped
children in the 1986 program
year.
The growth is indicated by
Figure 1.
75 000
70 000
65 000
60 000
S5 000
50.000
65.000
40.000
35.000
30.000
25.0e0
20.000
15.00
10.000
5.000
Figure
1
1
''/A/
/4
I
0
/
:972
.373 :r4
_376
:376
:.377
.371
:3'1
.350
.,1:
.132
.::33
334
O.,:
.373
.4'4 :371
:)"5
:)77
..)73
.97)
1990
:31:
Liii:
.)33
..E4
.i3;
0.;-;
t4uninof 01 Mndlesoped ChIldnpn Sorved
In FulIonter lonalronis
-2.-
Handicapped children enrolled in Head Start programs received
the full range of child development services required for all
children in the Head Start Program' Performance Standards as
published in 45 CFR Part
1304.
These include education,
parent
involvement, social services, nutrition and health services
(medical, dental and mental health).
In addition, they
received the special education and related services required
by
the Head Start legislation.
Some 96.1 percent of the Head
Start programs reported special efforts to enroll and
serve
more severely handicapped children.
Programs provided
assessment and diagnosis by professionals to evaluate
accurately the nature and severity of each child's handicap in
order to serve the child most effectively.
Head Start programs are also involved in several national
efforts to serve handicapped children.
Under the Education for
All Handicapped Children Act of 1975 (P.L. 94-142), each
State's allocation figures are based on the number of
handicapped children, 3
through 21 years of age, currently
being served (20 U.S.C.
§1411(a)(1)(A)).
As a major provider
of services to preschool handicapped children, Head Start
program personnel work with local education agencies to ensure
that children who have been professionally diagnosed as
handicapped and who are receiving Head Start services
are
included in the State "Child
Count" (34 C.F.R. §300.750).
In
addition, Head Start programs coordinate their searches for
unserved handicapped children with the Statewide "Child Find"
efforts required under
P.L. 94-142 (34C.F.R. §300.220).
Head
Start personnel also utilize other resources such as the
Crippled Children Program,
Title V.
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 handicapped children and
their families.
In 1977, an interagency anreement 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 handicapped children
as supported under P.L. 94-142.
Formal collaborative
agreements describing how Head Start and SEAs will coordinate
services to preschool handicapped children are now in place in
46 States and territories.
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 handicapped children.
The series
was developed in collaboration with teams of national experts
and Head Start teachers,
under the direction of the Head Start
Bureau.
1
Parent involvement is a keystone of the Head Start program.
Parents have opportunities to participate actively on policy
councils, volunteer in the program, for the children and
learn
about child development and handicapping conditions.
To ensure appropriate special services and optimal transition
by handicapped Head Start children into public school, Head
Start personnel help parents participate
in developing an
Individualized Education Program (IEP)
for each handicapped
child.
Beginning with the 1985-1986 program year, ACYF has
placed added emphasis
on the successful transition of all
children from Head Start into public
school or other
placement.
ACYF established a National
Interagency Steering
Committee on Transition of Preschoolers Into Public School.
The Committee developed materials
to help staff and parents
during a time of change,
which is often stressful.
The RAPs
developed complementary materials to assist in the smooth
transition of children with handicaps.
C.
Overview of Head Start Policies
on Services to Handicapped
Children
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
handicapped children 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(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."
Handicapped children 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
'he
children must be from low income
families, incluling families
receiving public assistance).
In response to the Congressional mandate to strengthen
Head
Start efforts on behalf of handicapped children, the Head Start
Bureau, located in the Administration for Children,
Youth and
Families (ACYF) in the Department's Office of Human Development
Services, has given priority to assisting local Head Start
programs to identify, recruit, and serve handicapped children.
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
handicapped children 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 handicapped
children, in order to identify and enroll handicapped
children 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 handicapping
condition unless there is a clear indication that
such a program experience would be inappropriate for
the child.
-5-
12
2.
Needs Assessment, Screening and Diagnosis - Needs
assessment, screening and diagnostic procedures
utilized by Head Start programs address all handicaps
specified in the legislation in order .4,:c provide an
adequate basis for special education, treatment and
-related services.
Head Start programs must ensure
that the initial identification of a child as
aandicapped is confirmed by professionals trained and
qualified to assess handicapping condition,:,.
Assessment must be carried out as an ongoing process
that takes into account the child's continuing growth
and development.
Car3ful procedures are required,
including confidentiality of program records, to
ensure that no child or family is mi-labeled or
stigmatized with reference to a handicapping
condition.
Emphasis is placed on ensuring that the
needs of all eligible handicapped children are
accurately assessed in order to form a sound basis
for meeting those needs.
3.
Diagnostic Criteria and Reporting - In 1975, Head
Start, the Office of Special Education Programs
(foryierly the Bureau of Education for the
Handicapped) in the Department of Education, and
other agencies that serve handicapped children
reviewed the criteria then being used by Head Start
for reporting purposes.
Based on that review, an
expanded set of criteria were developed which
includes the addition of a "learning disabilities"
category in order to be consistent with P.L. 94-142,
them Education for All Handicapped Children Act of
1975, as amended, [20 U.S.C. §1401(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 cond: ,)ons
included under "health impairment."
Since then,
malnutrition has been dealt with as part of the
overall health services reporting and evaluation.
Since program year 1981-82, the reference to
"autistic" children has been deleted from the
category "serious emotional disturbance" and added to
the category "health impairment" for the subsequent
reporting of handicapped children in Head Start.
This was done in accordance with
regulation
-6-
13
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 handicapping conditions of the children in
1985-1986 Head Start programs.
4.
Severely and Substantially Handicapped Children
-
Head Start policy distinguishes between two groups of
children:
children who have minimal handicapping
conditions and do not require special services (e.g.
children whose vision with eyeglasses is normal or
nearly so); and those children who are handicapped,
as defined in the legislation and who, by reason of
their handicap, require special education and related
services (see Appendix A).
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
handicap.
Only such children can be counted for the
purpose of the 10 percent enrollment opportunities
requirement.
Head Start considers as handicapped
only the children who need special
services, namely
those whose handicap 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 handicap.
Some of the children with severe handicaps have been
referred from other agencies to Head Start so that
they can participate in a mainstream developmental
environment.
This opportunity for severely and
substantially handicapped children to learn and play
with non-handicapped children is vital to their
optimal development.
Severely handicapped children are enrolled in Head
Start except when the professional diagnostic
resource recommends that the placement would
be
inappropriate for the child.
-7-
ii.
14
Placement is made on the basis of the child's
Individual Education Program.
Certain severely
handicapped 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-handicapped children.
While not all
handicapped children are best served in Head Start
programs, many severely handicapped children can be
served, some on a part-time basis
or by dual
enrollment with other organizations.
5.
Services for the Handicapped Child - Head Start
grantees and delegate agencies must ensure that all
handicapped children enrolled in the program receive
the full range of comprehensive services available
to
non-handicapped Head Start children, including
provision 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 handicapped child.
6.
Mainstreaming
- Since its beginning in 1965, Head
Start has maintained a policy of open enrollment for
all eligible children, including handicapped
children.
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 handicapped children is consistent with
Head Start's approach of serving handicapped children
in a mainstreamed setting.
This mainstream
experience of learning and playing with
non-handicapped children helps foster a positive
self-image and assists the handicapped child
in
enhancing his or her potential.
7.
Program Options - Head Start programs are encouraged
to consider several program options and to select the
one best suited for meeting the individual needs of
children.
These program options, which include the
standard five day center-based options, 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 handicapped children and
-8-
15
:heir families.
Within each option, Head Start
programs are encouraged to develop an IEP based on a
professional's diagnosisana, 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 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
program, such as United Cerebral Palsey or Easter
Seal.
The great majority of Head Start's children
with handicaps
are served in regular center-based
programs on a full or part-time basis where they
receive the benefits of contact with other children.
8.
Collaboration with Other Agencies
- As part of the
effort to strengthen and expand services
to
handicapped children, Head Start programs are
required to make every effort
to work with other
programs and agencies serving handicapped children in
order to mobilize and maximize the available
resources and services.
Interagency collaborative
efforts have been undertaken in
the areas of
outreach, recruitment, identification and referral
assistance; screening, assessment and diagnosis;
provision of treatment and support services; and
training and technical assistance.
Local Head Start
programs are required to take affirmative action to
seek the support and involvement of other agencies on
behalf of handicapped children.
Local Head Start programs are encouraged to
participate in the implementation of P.L. 94-142, the
Education for All Handicapped Children Act of 1975.
Head Start personnel have been working with local
education agencies to ensure that the number of
children who have been professionally diagnosed as
handicapped and who are receiving Head Start services
are included in the State "Child Count" on which
allocation of Federal education for handicapped funds
is based.
Head Start programs are also working with
Statewide "Child Find" efforts in the
search for
unserved handicapped children.
Some Head Start
programs are reimbursed by local school systems for
providing services to preschool handicapped children
under the Education for All Handicapped Children Act
of 1975 and by other State and
local funding
auspices.
Head Start actively pursues such
arrangements.
ACYF encourages the development and implementation of
interagency agreements between Head Start, at the
r.ational and local levels, and
other Federal,
regional, State, local and professional
agencies and
organizations concerned with young children with
handicaps and their families.
There were 46
agreements in effect between State Education Agencies
and Head Start during the 1985-86 program year, for
example.
They addressed such matters of mutual
interest as screening, training and the provision of
transportation services.
9.
Ten Percent Handicapped Enrollment by State - Head
Start's objective is to achieve at least a 10 percent
level of enrollment of handicapped
children in each
State and to provide the special education and
related services necessary to meet the children's
needs.
ACYF 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 Handicapped Children 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
1985-1986 Annual Program Information Report (PIR).
The PIR
data were collected by the regional offices of ACYF.
The
Program Information Report was mailed to all Head Start
grantees and delegate agencies in May 1986.
Head Start
programs reported on the status of handicapped children as of
June 30, 1986 or the end of their program year.
The data in this report are based on responses from 1,881 Head
Start full year programs.
All questionnaires mailed to Head
Start programs were completed and returned, so a response rate
of 100 percent was achieved.
Almost all Head Start programs
are full year programs that operate eight to twelve months of
the year.
Thirty-five Parent and Child Centers (designed to
serve children from birth to three years of age and their
families) were included in the 1985-1986 PIR.
The questionnaire gathered data in the following categories:
1.
General - Number of both handicapped and
non-handicapped childrer actually enrolled.
2.
Staff - Number of programs with full or part-time
coordinators of services for handicapped children and
type of degrees or licenses held.
3.
Enrollment of Handicapped Children - Data on number of
handicapped children enrolled who were professionally
diagnosed (reported by handicapping conditions),
multiple handicaps and age.
Also reported were the
number of handicapped children who were located by and
referred to Head Start programs that were not able to
be enrolled, the number of children professionally
diagnosed who dropped out, and the number who underwent
diagnosis and were found not to be handicapped.
4.
Services - Data on number of handicapped children,
by
handicapping condition, receiving services from Head
Start and other agencies and agreements with other
agencies to provide needed services to handicapped
children.
A.
Number of Handicapped Children Enrolled
It has been estimated that there are 250,000 Head Start
eligible handicapped children of preschool age three to five in
the United States.*
Although Head Start cannot meet the needs
of all these handicapped children,
it is making a notable
contribution.
A Head Start experience is particularly valuable
for those handicapped children who can benefit from a
comprehensive developmental
experience in a mainstream setting,
one that integrates handicapped and non-handicapped children.
The number of handicapped children 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
handicapped children or 10.1 percent of their enrollment.
As
of June 1986, Head Start programs reported that they had served
64,994 handicapped children,
or 12.5 percent of their
enrollment during the 1985-1986 program year.
All but a small
fraction of these children are being mainstreamed.
This
provides peer models and higher levels of cognitive, language
and social stimulation than self-contained programs offer.
Highlights:
o
There were 64,994 handicapped children served in Head Start
programs in 1986.
This represents an increase of
3,096
children over the 61,898 handicapped children served in
1985.
Children professionally diagnosed as handicapped
accounted for 12.5 percent of total actual enrollment in
Head Start programs,
a slight increase from the 12.2
percent in 1985.
*
The March 1986 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 2,500,000.
Based
on the estimated prevalence of handicapped children used by
the office
of Special Education Programs, U.S. Department
of Education, it is estimated that 10 percent, or 250,000,
of these children are handicapped.
-12-
19
o
Children professionally diagnosed as handicapped accounted
for at least 10 percent of all
Head Start enrollment in
each of 49 of the 50 States, Puerto Rico, Guam and the
Trust Territories of the Pacific
Islands in 1986.
o
American Indian Programs also surpassed the 10 percent
enrollment target.
Head Start has exceeded the
10 percent enrollment level
nationally with a 12.5 percent enrollment of handicapped
children in program year 1985-86.
Alaska, with a 9.7 percent
enrollment of handicapped children,
was the only State which
fell short of the 10 percent enrollment target.
The District of Columbia also did
:Lot meet an enrollment level
of 10 percent, with 9.1 percent.
The Migrant Programs served
9.7 percent children with handicaps.
In addition, the
following territories were below the 10 percent enrollment
level: Virgin Islands, with 7.3 percent, and American Samoa,
with .56 percent.
Both these areas made gains over the 1985
figures, however.
(Appendix C provides enrollment data for
each State and territory, and
Indian and Migrant programs).
Both Guam and the Trust Territories of the Pacific Islands
showed strong increases over the 1985 figures.
In 1985 Guam
reported 9.9 percent, raised
to 11.2 percent in 1986; and the
Trust Territories reported an increase from 6.3 percent in 1985
to 13.8 percent in 1986.
In the case of the one State and the territories that have less
than 10 percent handicapped enrollment, efforts continue to
increase the enrollment of handicapped children.
The ACYF
regional offices are working with
the Head Start programs in
tnese areas to identify the reasons for the level of enrollment
of handicapped children and to devise specific strategies, such
as increasing coordination of
resources, for expanding
enrollment of handicapped children.
Progress toward increasing
enrollment in these areas will be reported in next year's
Annual Report.
Approximately 99.2 percent of the full year Head Start programs
served at least one handicapped child.
Of the 64,994
handicapped children served by Head Start programs, 26.1
percent were three years of age or under, 60.1 percent were
four years old, 13.3 percent were five years old, and about 0.5
percent were six years or older.
(Head Start children six
years of age or older are in
com 'iunities where the children go
directly from Head Start into first grade, predominantly in
southeaccern States.)
Data were collected on the dropout rate for handicapped
children for the third time on the 1985-1986 PIR.
Of the total
number of handicapped children served in Head Start during the
1985-1986 operating year, 5,812 or 8.9 percent dropped out
during the operating period.
Thisis a substantially lower
proportion than reflected for all children enrolled in Head
Start in 1985-86 where 14.9 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 handicapped children; this is also substantially lower
than the proportion of handicapped children to the total actual
enrollment (12.1; percent).
In each of the three years during which this data have been
collected, the percentage of handicapped children dropping out
has been less than the percentage of dropouts
for the total
enrollment.
This may indicate that the parents of the children
with handicaps realize the importance of early services for
their children and may be making a greater effort not to move
the children during Cle program year.
They may also consider
the services beneficial to their children to a higher degree
than the parents of the non-handicapped children.
B.
Types of Handicaps
Head Start is mandated to serve children with a broad range of
handicaps such as those who are mentally retarded, hard of
hearing, deaf, speech 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.
The types of handicapping conditions of those children
professionally diagnosed as handicapped are presented in Table
1 on page 15 and Figure 2 on page 16 as a proportion of the
total population of handicapped children in Head Start programs
in 1986.
Of the handicapped children enrolled in Head Start,
62.9 percent have been diagnosed as speech impaired.
This is
by far the largest category of handicapped children served in
Head Start programs.
The size of this category has been of
concern.
However, Head Start requires that all children be
professionally diagnosed and a previously completed study on
the speech impaired has determined that most of the children
categorized as speech impaired in Head
Start had been
appropriately diagnosed.
The State Education Agencies report
an even higher proportion of speech impaired children in the
preschool age range which they are serving under P.L. 94-142
(see Figure 3 on page 17).
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 the public school, as well as with
-14-
21
reports from other preschool programs.
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 19'85-86.
A
special issue of the Head Start Bulletin addressed the ways
staff, parents, volunteers and all those in contact with Head
Start children could foster communication skills and language
development.
Resource Access Projects (RAPs) provided training
sessions on otitis media, middle ear infection, whch is very
prevalent among preschoolers and can adversely affect speech
and language development.
TABLE 1
Types of Handicapping Conditions of Children
Professionally Diagnosed as Handicapped
Professionally
Number
Percent of Total Number
of Children
Diagnosed as Handicapped
Handicapping Condition
Speech Impairment
40,866
62.9
Health Impairment
7,333
11.3
Specific Learning
Disability
3,663
5.6
Physical Handicap
(Orthopedic)
3,31q
5.1
Mental Retardation
3,286
5.1
Serious Emotional
Disturbance
3,041
4.7
Hearing Impairment
1,801
2.8
Visual Impairment
1,373
2.1
Deafness
167
0.2
Blindness
145
0.2
Total
64,994
100.0
The distribution in the 1985-1986 program year was very similar
to that reported in the previous year.
Figure 2
Primary or Most Disabling Handicapping Condition
of Handicapped Children Enrolled in Full Year Head Start
June 1985
Deafness
Visual impalement
n = 167 2% n= 1,373 2.1%
Blindness
n = 145 .2%
(Total NurnI-Er 64,994)
e 3
Diagnostic Category cf Handicapped Chidieen
Ages 3-5 Served Under P.L. 94.142 as Reported by
State Education Agencies
December 1985
Other Health Impaired
n = 4,506 1.7%
Visually Handicapped
1 = 1,935 .7%
Deafblind and Other
n = 144 .1%
Hearing Impaired
n = 5,400 2.1%
lonalty Disturbed
n = 6,274 2.4%
(Total Nutter 260,313)
Source: Data from the Office of Special Education, U.S. Department of Education. The data
were reported by State Education Agencies as Child Count figures for 3-5 oid children served.
Note: The Visually Handicapped category 'acludes blind children. Hearing Impaired inclurias
deaf chicilren.
C. Severity of Handicaps
Head Start serves a significant proportion of children with
severe or multiple handicaps.
Such children present additional
challenges to Head Start
staff in the planning and provision of
individualized plans.
Head Start policy requires that the
individual plan of action for special education, treatment,
and
related services be based on the child's specific handicapping
condition(s) and the unique needs arising from those conditions.
A child with multiple handicaps
is likely to need a variety of
treatments and services.
Head Start staff, in conjunction with
other professionals and the child's
family, have to set
priorities and objectives,
and tailor services for that child
in
order to provide a focused, systematic plan of action.
In 1986, 12,050 (18.5 percent) of the handicapped children
enrolled in Head Start programs had multiple handicapping
conditions.
This is a slight increase over the number and
percent of multiple handicapped children reported last year
(11,203 or 18.1 percent).
Compared to other handicapping conditions, mentally retarded
children (57.9 percent) and deaf
children (50.9 percent) show the
highest incidence zif multiple'handicap,
and speech impaired
children the lowest (1G.3 percent).
Table 2 provides specific
data by primary handicapping condition on the number of children
who have multiple handicapping conditions.
TABLE 2
Distribution of Children by Primary or Most Disabling Handicap
Who Have One or More Other Handicapping Conditions
Percent with
Total Number
Children with
Multiple
of Children
other Handicap-
Handicapping
ping Conditions
Conditions
Primary Condition
Blindness
145
38
26.21 %
Visual Impairment
1,373
303
22.07 %
Deafness
167
85
50.90 %
Hearing Impairment
1,801
666
36.94 %
Physical Handicap
3,319
1,110
33.42 %
Speech Impairment
40,866
4,214
10.31 %
Health Impairment
7,333
1,533
20.91 %
Mental Retardation
3,286
1,901
57.85 %
Emotional
Disturbance
3,041
754
24.79 %
Learning
Disability
3,663
1,446
39.48 %
Total
64,994
12,050
18.54 %
ACYF continues to pursue an active outreach and recruitment
effort for enrolling and serving severely handicapped
children.
ACYF 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 more severely
handicapped children.
-19-
26
CHAPTER 3
Services to Handicapped Children
In program year 1985-1986, local Head Start programs developed
and carried out activities and services
of direct and immediate
benefit to handicapped children.
These activities and services
started with active recruitment of handicapped children who
might benefit from Head Start, particularly more severely
handicapped children.
Programs provided assessment and
diagnosis to evaluate accurately the
nature and severity of
each child's handicap 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
handicapped children 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 utilization of staff, facilities, and
materials.
A.
Outreach and Recruitment
Severely Handicapped Children
The data regarding outreach and recruitment were collected
specifically on efforts to enroll and serve more severely
handicapped children.
In previous years, programs reported on
special efforts and outreach and
recruitment activities
utilized to recruit handicapped children in general.
Of the
Head Start programs, 96.1 percent
reported steps take,
to
enroll and serve more severely handicapped children.
The most
frequent steps taken by programs reporting these data were:
coordination with other agencies
serving severely handicapped
children (89.9 percent), sharing services with other agencies
serving severely handicapped children (63 percent) and specific
outreach and recruitment procedures aimed at severely
handicapped children (62.3 percent).
Programs also reported
that they held orientation sessions for local diagnosticians
and provided them with special materials, etc. (38.1 percent),
made change(s) in recruitment and enrollment criteria (23.2
percent), and took other steps (10.3 percent).
Head Start programs and other agencies serving handicapped
children have come tc recognize the roles of each in providing
services.
Generally, the Head Start program
serves as the
primary provider of a mainstreamed learning exper
nice, while
other agencies provided some or all of the needed special
services.
Reasons for Not Enrollin
Some Handica
d Children
About one-half of all Head Start programs reported that they
were not able to enroll 4,022 handicapped children located by
or referred to them.
In 1985, 50 percent of the programs
reported that they were not able to enroll 5,971 handicapped
children.
As in previous years, the most common reason:: given
were:
the children did not fit the age requirements, other
agencies serve these children and there were ri:d available
openings.
B.
Diagnosis and Assessment of Handicapped Children
The Head Start statutory definition of handicapped children as
interpreted excludes from reporting as handicapped 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 requested special education and related services,
and, more importantly, to ensure that children who are
considered handicapped are not mislabeled or misdiagnosed,
Head Start requires that each child reported as handicapped be
diagnosed by appropriate professionals.
At the time of data
collection, all of the 64,994 children reported as handicapped
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.
For
the last several years more than 44 percent had been referred
to Head Start by other agencies or individuals outside Head
Start.
Almost half (49 percent) of the total handicapped children were
diagnosed between the time of enrollment in Head Start and
January 31, 1986.
Close to one-third (32 percent) were
diagnosed prior to enrollment in Head Start, and 19 percent
between February 1, 1986 and the end of the operating period
for the programs.
In addition to the 64,994 children diagnosed
as handicapped, Head Start provided assessment for another
22,975 children who had failed screening or been referred but
were found to be not handicapped.
In some communities, the Head Start program was the only
channel of diagnosis for preschool handicapped children; in
others, the Head Start program supplemented existing diagnostic
services.
In some situations, Head Start purchased needed
services from private or public sources.
-21-
28
Head Start programs
are encouraged tc, work with other agencies
and private diagnostic providers and to use the following
strategy for each child suspected of being handicapped:
Step 1:
An interdisciplinary diagnostic
team (or an
appropriate professional qualified to diagnose the specific
handicap) 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
"handicapped."
Only the aggregated numbers of children
with specific handicapping conditions are reported by local
Head Start programs to the 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 anr4 identifies areas that require
special
education ang 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 Individual 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
handicap.
The plan spells out activities that take place
in the classroom, 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 Individual Education Program and
the delivery of services
are modified based on this
periodic evaluation.
-22-
29
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
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
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 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 handicapped children before 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, handicapped children
are to receive special education, therapy,
or other services,
either within the Head Start program or as provided by other
agencies.
Parents of these handicapped children
also receive
training, counseling, and support services.
Mainstreaming - By functioning in an integrated group during
the early years, the handicapped child can learn the ways of
the world and some of the problems
to be faced.
Being with
non-handicapped children at an early age can make the
inevitable adjustments of the handicapped
child easier.
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 where handicapped children
are mainstreamed
give disabled children a chance to play and learn 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.
The non-handicapped
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.
A two year evaluation of mainstreaming in Head Start, conducted
for ACYF,* indicated that mainstreaming 'n Head Start has been
generally successful and has included nearly all handicapped
children in Head Start.
The study established that high levels
of time spent in a mainstreaming situation were positively
related to developmental gains and increased positive social
interaction by Head start handicapped children.
Mainstreaming is in the best interests of a large proportion of
handicapped children.
There are, of course, some children who,
at least initially, may do better in a home-based program.
For
example, some children may have initial difficulty in adjusting
to a center-based Head Start experience.
A home-based option
can provide the necessary bridge between the family and the
non-handicapped 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.
Head Start policy requires
that the handicapped child be placed in a mainstream classroom
setting as soon as appropriate.
Head Start continues to be the largest program that includes
preschool handicapped children in group experiences with
non-handicapped children on a systematic basis.
In 1986, 99.2
percent of the Head Start programs mainstreamed at least one
handicapped child.
Applied Management Sciences (AMS), an independent research
firm, completed their evaluation of mainstreaming in Head
Start in February 1919.
The AMS evaluation reports are
available through the Educational Resources Information
Center (ERIC) system.
These reports are available for
purchase from Computer Microfilm International Corp., ERIC
Document Reproduction Service, P.O. Box 190, Arlington,
Virginia 22210 (Telephone: 703-841-1212).
The order
numbers are ED 168-236 through 240, ED 168-291, ED 176-433,
and ED 177-803.
-24-
31
Special Services - Handicapped children 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 3 reports comparative levels
for special services
provided to handicapped children and their parents in 1984,
1985 and 1986, by reporting Head Start programs.
TABLE 3
Three Year Comparison of Special
Services
Provided to Handicapped Children
Enrolled in
Full Year Reporting Head Start Programs
Services Provided
1984
1985
1986
Total number of children who are
receiving special education
or
related services from Head
Start staff
55,416
58,250
62,255
Total number of children who
are
receiving special services from
other agencies
38,380
42,016
38,312
Total number of parents receiving
special services from Head Start
related to their child's
handicap
43,756
43,583
36,965
Special Services Provided by Head Start and Other Agencies
Head Start programs provide many special education and related
services to handicapped children.
Head Start also receives
services for handicapped children
in their programs from 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/IPP; special teaching equipment; psychotherapy, counseling
and behavioral management; medical
treatment; special equipment
for children; physiotherapy;
and occupational therapy.
-25-
32
TABLE 4
Children Receiving Special Education or Related Services
from Head Start only, Other Agency Only, or Both
Primary Handicapping
Condition
Head Start
Other Agency
Both Head
Only
Only
Start and
Other Agency
Blindness
15
8
122
Visual Impairment
481
89
803
Deafness
18
6
143
Hearing Impairment
501
73
1,227
Physical Handicap
761
184
2,374
Speech Impairment
19,014
1,473
20,379
Health Impairment
2,227
530
4,576
Mental Retardation
1,060
80
2,146
Emotional Disturbance
1,041
144
1,856
Learning Disability
1,564
152
1,947
Total
26,682
2,739
35,573
As indicated in Table 4, 41 percent of the handicapped children
served received special education or related services from Head
Start only; 4.2 percent received such services from another
agency only; and 54.7 percent received special services to help
overcome the handicap from both Head Start and another agency.
In the 1984-85 program year, 67.9 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
somewhat, it is
still significant that more than half of the handicapped children
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.
Special Services Provided
to Parents of Handicapped Children
by Head Start
Head Start programs offer special services
to all parents of
handicapped children, 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 handicapped children have accepted
and used special
services designed to help them understand
their children's
special problems and the effects of
the
handicap on development and learning.
The services are:
referrals to other
agencies; counse'ing; conferences with
technical staff and other meetings; literature
or special
teaching equipment; visits to homes hospitals,
etc.;
transportation; parent meetings; assistance in securing medical
services; workshops on school services; special classes _Ind
other services.
Coordination of Special Services - High quality services for
children with handicaps 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 handicaps be designated on a full
or
part-time basis.
In 1986, 97 percent of
the Head Start
programs had a coordinator of services for handicapped
children.
Over a third (37 percent) of these programs reported
a full-time coordinator.
About half (48 percent) reported
a
part-time coordinator
and 15 percent indicated that as a
delegate agency they were served by a handicapped coordinator
at the grantee level.
Of the 1,881 programs in 1986, 84.5
percent had a coordinator with a degree or license:
22.9
percent in early childhood/special
education; 21.7 percent in
special education; 10.4 percent in psychology; 9.4 percent in
speech pathology/audiology;
and 51.9 percent in some other
area, including nursing and social
work.
A number had degrees
in more than one specialty area.
Resource Access Projects (RAPs)
Head Start's commitment to
individualization for all children,
including those with
handicaps, has provided the basis for mainstreaming handicapped
children in a setting with
non-handicapped youngsters.
Head Start's effort to serve handicapped children, including
the severely handicapped,
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 of ACYF
established a network of 12 Resource Access Projects (RAPs)
to
serve Head Start programs in each ACYF region throughout the
nation.
In 1986, the 12 RAPs began providing services to
Migrant grantees.
During 1986 Indian programs in five western
States received technical
assistance and training from
the
American Indian Program
Branch Resource Center, which provides
assistance in serving non-handicapped children.
-27-
34
It .is the responsibility of each RAP to assist Head Start in
working with handicapped children.
Activities performed by
each RAP include the following:
o
Identify local, regional and national resources;
o
Determine local Head Start needs and match these needs
with available resources;
o
Coordinate the delivery of services to Head Start
programs;
o
Provide train
and technical assistance;
o
Promote and facilitate collaborative efforts between
Head Start and other agencies; and
o
Provide resource materials to Head Start grantees.
Additionally, the RAPs have responsibility for providing
training, including use of the eight resource manuals in the
series Mainstreaming Preschoolers which focus on mainstreaming
in Head Start and spell out techniques that can be used by
teachers and parents in working with handicapped children.
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.
In 1985-86, the RAPs conducted 525 training events for 29,232
persons including teachers, teacher aides, and other
personnel.
Approximately 84 percent of those attending the
training events were Head Start teaching staff.
A separate
contract was awarded to assess the performance of the RAPs.
Evaluations by participants have shown that these conferences
were very successful.
Teachers and other Head Start staff
members, including aides, directors, component coordinators,
parents, and support staff, have indicated that they have
benefited greatly from the training.
Ninety-six percent of the
trainees who completed evaluation forms gave the RAPs the top
two ra,ings on the scale used to evaluate training.
Participants indicated they learned new skills for working with
handicapped children and learned to work more comfortably with
handicapped children.
They anticipated that they would do
specific things differently as a result of training (e.g.,
closer observation of handicapped children, use of new
materials and resources to work with handicapped children in
the classroom, etc.).
Further, from the telephone survey
sample of programs, Head Start programs indicated that training
was the most valuable service provided by RAPs.
-28-
35
The RAP training and the Mainstreamin
Preschoolers manuals
haVe been widely acclaimed not on y t roug out t e 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 handicapped children, 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.
The list of twelve RAPs and the supplement to 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 otLer programs and agencies serving
handicapped children and facilitating
the inclusion of Head
Start in the State plans for serving handicapped children as
supported under P.L. 94-142.
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 handicapped children which are supported under P.L.
94-142.
Formal collaborative agreements describing how Head
Start and SEAs will coordinate services to preschool
handicapped children are
now in place in 46 States or
territories.
Four new written agreements
were signed during
the 1985-86 program year, between
Head Start and the State
Education Agencies in Alabama,
Iowa, American Samoa and the
Commonwealth of the Northern Mariana Islands.
The Tables on pages 30 and 31 from the Impact Evaluation of the
Resource Access Projects, 1985-1986,
developed by Roy
Littlejohn Associates under a management support contract, show
the major features of the agreements and their scope.
-29-
36
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Abbreviated Contents of SEA/Head Start Collaborative Agreements
STARS
At
Nt A I N I
C O Q Or OC
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16 ContrvctorANP SID. 1/1A provider, state hardtop advocate. eft.; Irmot a /awl sired agreement. e.g.. 16 included in a woo. State tartan or legIsIssIon;
t.
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4.
Ointnts of agreements rot available.
38
31--
BESI COPY
AV A11_ABa
39
Local level agreements are also important to enabling Head
Start to serve children with handicaps.
About 97 percent of
the programs reported having written or informal agreements
with local education agencies (LEAs) or other agencies
regarding services for handicapped children.
A total of 1,557
Head Start-programs (82.7 percent) had a written or informal
agreement with LEAs regarding services to be provided to
handicapped children in Head Start.
A total of 1,563 (83
percent) of the Head Start programs had written or informal
agreements with agencies other than LEAs regarding services to
be provided to handicapped children in Head Start.
The following table shows the importance of both local
education agencies and other types of agencies in coordinating
with Head Start programs for service delivery and training.
It
also indicates how widely Head Start uses cooperative
arrangements at the local level.
Table 6
Distribution of Programs According to Type of Agreement
with Agencies for Services to Handicapped Children
Written or informal agreement with local
education agency
1,557
Written or informal agreement with other agency
1,563
None of the above
69
Agreements with local education agencies can play an important
role in facilitating the transition of Head Start children into
the public schools.
During the 1985-1986 program year, ACYF
placed added emphasis on the successful transition of all
children from Head Start into public school or other placement
by establishing a National Interagency Steering Committee on
Transition of Preschoolers into Public School.
The Committee
developed material to help staff and parents during a time of
change which can be very stressful.
The RAPs developed
additional materials to assist in the smooth transition of
children with handicaps.
-32-
40
The results of Head Start programs' work with children with
handicaps and their families show sustained commitment to
providing appropriate services to meet
the dual needs caused by
disadvantage and handicapping conditions.
During the 1985-86
program year the Head Start program continued
to be a model for
the nation integrating handicapped and non-handicapped children
in a developmental program with education,
health (medical,
dental, nutrition, and mental health), social services and
parent involvement.
In addition, the Head Start program
demonstrated community involvement or a broad scale by working
closely with public schools and other agencies with
common
concerns for children and families with special needs.
-33-
41
APPENDIX A
Diagnostic Criteria for Reporting
Handicapped Children 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/ethnic characteristics of
the Head Start children.
To be counted as handicapped, children must meet two criteria.
They must have one of the following handicapping
conditions (by
professional diagnosis) and, by reason thereof, require special
education 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 (Handicap)
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 he/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 one of
the following exists:
(a) his/her hearing is extremely
defective so as to be essentially nonfunctional 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 Handicaps:
Children will be reported as having
multiple handicaps when, in addition
to their primary or
most disabling handicap,
one or more other handicapping
conditions are present.
-34-
42
Hearing Impairment (Handicap)
- 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 Handicap (Orthopedic Handicap) - A child shall be
reported as crippled or with an orthopedic handicap 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, loss of 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 .isorders, 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 handicapping 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 tc 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
-35-
43
Serious Emotional Disturbance
- A child shall be considered
seriously emotions
y disturbed who is identified by
prcfessionally qualified personnel' (psychologist or
psychiatrist) as requiring special services.
This definition
would include, but not be limited to, conditions that indicate
the child is: dangerously aggressive towards others,
self-destructive, severely withdrawn and noncommunicative,
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 handicaps, brain injury,
minimal brain dysfunction,
dylexia, and developmental aphasia.
Not included are learning
problems which are primarily the
result of visual, hearing,
or
motor handicaps, 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 physi.::ians 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 diagno
s
of
learning disabilities.)
44
-36-
VI&
APPENDIX B
1985-1986 Resource Access
Project Network
DHHS
Region
States Served
I
II
III
IV
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 (PAP)
Education Development Center,
Inc.
55 Chapel Street
Newton, Massachusetts 02160
New York University
School of Continuing Education
3 Washington Square Village
Suite IM
New York, New York 10012
University of Maryland
University Center
6525 Bellcrest Rd
Hyattsville, Maryland
20782
Chapel Hill Training-Outreach
Project
Lincoln Center
Merritt Mill Road
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
Champaign, Illinois 61820
(subcontract)
Portage Project
626 East Slifer Street
Portage, Wisconsin 53901
4 531
DHHS
Region
VI
VII
VIII
IX
States Served
Arkansas
Louisiana
New Mexir_o
Oklahoma
Texas
Iowa
Kansas
Missouri
Nebraska
Colorado
Montana
North Dakota
South Dakota
Utah
Wyoming
Arizona
California
Hawaii
Trust
Territories of
the Pacific
Idaho
Oregon
Washington
Alaska
American Indian Programs in
:
Arizona
Colorado
Montana
Nevada
New Mexico
North Dakota
Oklahoma
South Dakota
Utah
Wyoming
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
Greenlee Metro Llb School
Metropolitan State College
1150 Lipan Street, Room 105
Denver, Colorado
80204
Southwest Human Development
3008 N. Third Street
Phoenix, Arizona
85012
Portland State University
Division of Continuing Education
P.O. Box 1491
Portland, Oregon 97207
Three Feathers Associates
P.O. Box 5508
Norman, Oklahoma
73070
-38--
46
APPENDIX C
Survey Results of Handicapped Children in Head Start by State *
(or Geographidal Entity)
Full Year 1985-1986
State (or
Number of
Geographical
Grantees
Entity)
and
Delegate
Agencies
Responding
Total Number
Number of
of Children
Children
Enrolled **
Professionally
Diagnosed as
Handicapped
Through End of
Operating
Year ***
Percent of
Enrollment
Profes-
sionally
Diagnosed
as Handi-
capped
Through End
of
Operating
Year
Alabama
36
10,708
1,233
11.51
Alaska
4
1,030
100
9.71
Arizona
20
4,138
426
10.29
Arkansas
21
6,864
880
12.82
California
141
43,547
4,712
10.82
Colorado
25
5,583
635
11.37
Connecticut
30
5,151
665
12.91
Delaware
5
993
176
17.72
District of
Columbia
7
2,266
207
9.14
Florida
39
13,672
1,665
12.18
Georgia
42
11,886
1,430
12.03
Hawaii
4
1,612
216
13.40
Idaho
8
1,433
279
19.47
Illinois
86
26,041
2,740
10.52
Indiana
39
7,805
1,263
16.18
State data exclude Migrant and Indian Programs.
Thes? enrollment data reflect total actual enrollment as
obtained from item 9a.8 of the Project Head Start 1985-86
Annual Program Information Report (PIR).
***
The data on the Head Start Handicapped Efforts were obtained
as part of the PIR and were collected as of June 30, 1986 or
the end of the operating year.
-39-
4'7
APPENDIX C (Continued)
Survey Results of Handicapped Children
in Head Start by State *
(or Geographical Entity)
Full Year 1985-1986
State (or
Number of
Total Number
Number of
Geographical
Grantees
of Children
Children
Entity)
and
Enrolled **
Professionally
Delegate
Diagnosed as
Agencies
Handicapped
Respoi.ding
Through End of
Operating
Year ***
Percent of
Enrollment
Profes-
sionally
Diagnosed
as Handi-
capped
Through End
of
Operating
Year
Iowa
22
4,184
681
16.28
Kansas
22
3,954
620
15.68
Kentucky
48
11,772
1,385
11.77
Louisiana
43
11,635
1,377
11.83
Maine
13
2,069
442
21.36
Maryland
28
6,403
863
13.48
Massachusetts
35
8,917
1,500
16.82
Michigan
86
22,811
2,530
11.09
Minnesota
27
5,493
713
12.98
Mississippi
22
30,271
3,044
10.06
Missouri
23
10,332
1,447
14.01
Montana
9
1,358
165
12.15
Nebraska
15
2,467
402
16.30
Nevada
4
675
176
26.07
New Hampshire
6
881
138
15.66
New Jersey
36
10,671
1,390
13.03
***
State data exclude Migrant and Indian Programs.
These enrollment data reflect total actual enrollment as
obtained from item 9a.8 of
the Project Head Start 1985-86
Annual Program Information Report (PIR).
The data on the Head Start
Handicapped Efforts were obtained
as part of the PIR and were collected as of June 30, 1986 or
the end of the operating year.
-40-
48
APPENDIX C (Continued)
Survey Results of Handicapped Children in Heat-Start by State *
(or Geographical Entity)
Full Year 1985-1986
State (or
Number of
Geographical
Grantees
Entity)
and
Delegate
Agencies
Responding
Total Number
Number of
of Children
Children
Enrolled **
Professionally
Diagnosed as
Handicapped
Through End of
Operating
Year ***
Percent of
Enrollment
Profes-
sioally
Diagnosed
as Handi-
capped
Through End
of
Operating
Year
New Mexico
24
4,362
598
13.71
New York
154
30,092
3,926
13.05
North Carolina
45
11,930
1,613
13.52
North Dakota
8
828
96
11.59
Ohio
81
24,920
3,769
15.12
Oklahoma
25
8,683
1,324
15.25
Oregon
21
3,401
560
16.47
Pennsylvania
64
18,708
3,145
16.81
Rhode Island.
8
1,585
190
11.99
South Carolina
16
7,155
814
11.38
South Dakota
7
1,190
215
18.07
Tennessee
29
10,028
1,432
14.28
Texas
88
26,097
2,978
11.44
Utah
11
2,386
302
12.66
Vermont
7
1,160
150
12.93
State data exclude Migrant and Indian Programs.
These enrollment data reflect total actual
enrollment as
obtained from item 9a.8 of the Project Head Start 1985-86
Annual Program Information Report (PIR).
***
The data on the Head Start Handicapped
Efforts were obtained
as part of the PIR and were collected
as of June 30, 1986 or
the end of the operating
year.
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APPENDIX C (Continued)
Survey Results of Handicapped Children in Heat Start
by State *
(or Geographical Entity)
Full Year 1985-1986
State (or
N' mbar of
Geographical
Grantees
Entity)
and
Delegate
Agencies
Responding
Total Number
Number of
of Children
Children
Enrolled **
Professionally
Diagnosed as
Handicapped
Through End of
Operating
Year ***
Percent of
Enrollment
Profes-
sionally
Diagnosed
as Handi-
capped
Through End
of
Operating
Year
Virginia
7
6,442
957
14.86
Washington
28
4,971
633
12.73
West Virginia
28
4,587
750
16.35
Wisconsin
36
7,910
928
11.73
Wyoming
5
901
111
12.32
American Samoa
1
1,800
10
.56
Guam
1
410
46
11.22
Puerto Rico
34
19,936
2,316
11.62
Trust Territories
of the Pacific
Islands****
6
2,745
378
13.77
Virgin Islands
1
1,233
90
7.30
State Subtotal
480,082
60,831
12.71
Indian Programs
107
16,331
2,079
12.73
Migrant Programs
67
21,386
12,084
9.74
TOTAL
1,881
517,799
64,994
12.55
State data exclude Migrant and Indian
Programs.
These enrollment data
reflect total actual enrollment
as
obtained from items 9a.8 of the Project Head Start 1985-86
Annual Program Information Report (PIR).
The data on the Head Start Handicapped Efforts were
obtained as part of the PIR and were collected as of June
30, 1986 or the end of
the operating year.
Include Head Start Programs in the Commonwealth of Northern
Koxiana Islands, Palau, Ponape,
Truk, and Yap.
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