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CHAPTER 4 - IMPLEMENTATION
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In this chapter:
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The implementation of the Transition Demonstration Program in each local
site was a complex endeavor involving the simultaneous implementation of
four major components: supportive social services, family involvement, health
and nutrition, and educational enhancements. This chapter builds upon previous
discussions of implementation (see Head Start Children’s Entry into
Public School: Interim Report on the National Head Start/Public School Early
Childhood Transition Demonstration Study). The underlying philosophical
bases for the local implementations are addressed first, followed by a discussion
of the vital role played by family service workers in the implementation
of the Transition Demonstration Program.
The chapter describes implementation of the four components -- family involvement,
education, supportive social services, and health and nutrition. Each discussion
begins with a brief review of the philosophical and pragmatic aspects of
service delivery in the component, such as the expansion of definitions
and roles, predominant service delivery models, and staffing patterns used
to address the implementation. In addition, the following specific topics
are addressed for each component:
- Family Involvement – parent resource rooms; parent participation in planning; educational involvement in the home; parent participation in classrooms; and barrier reduction.
- Education – transition meetings; Individualized Transition Plans; transfer of written records; and developmentally appropriate curriculum and teaching practices.
- Supportive Social Services – types of services provided for children and families; utilization of home visits; and barrier reduction.
- Health & Nutrition – screening programs; health services; and health information and education.
Finally, the extent to which Transition-like supports were offered in comparison schools is discussed.
PHILOSOPHY
The Transition Demonstration Programs endorsed a philosophy that builds on the existing strengths in families, children, schools, teachers, and communities and then sought to provide supports in areas of identified needs. Various approaches have affirmed this strengths-based orientation. The “family services team” in several sites, for example, used a family assessment tool that identifies areas of strength in family functioning, rather than relying on a more traditional needs assessment that focuses on problems only. Other sites used an approach known as “family resource mapping” to highlight family strengths and identify areas where additional resources might be needed. The use of a strengths model, rather than a deficit model which has dominated much of the intervention with poverty families, was widely evident. In the efforts to strengthen the use of developmentally appropriate educational practices in classrooms, sites encouraged teachers to identify and build on the strengths of each child in the classroom, as well as to develop and expand their own repertoire of teaching skills. In the area of parent and family involvement, Transition Program staff worked with school personnel to identify and nurture the talents of parents as primary teachers for their children, as caregivers, as learning assistants for others (children and adults), and as decision makers. In the health component, there was a strong emphasis on wellness, nutrition, and preventing illness and injury. Programs assisted families in establishing a source for primary health care, learning more about how to prevent problems, and becoming more proactive in their family’s health and health care management.Sites also strongly endorsed an individualized approach to working with families, children, and teachers. The supportive social services for families were based on individual family service plans and often were implemented through personalized contacts and home visits. The same was true of the health and nutrition component, which was tied to supportive social services. In the area of parent and family involvement, many of the successes reported related to individualized efforts to remove barriers and facilitate program participation. In working with teachers to implement the education component, many sites began with a general, large group approach to training and consultation. By the end of the five years of implementation, however, the majority of sites adopted a more individualized approach, offering teachers a variety of choices for further professional development, based on their interests or most pressing needs. In the site located in Arkansas, for example, the program worked with teachers to complete self-assessments of their skills and then encouraged them to develop professional growth goals. A number of sites provided personalized assistance to teachers in the form of educational consultants or mentors, who then worked individually with teachers. Thus, the philosophical hallmarks of the Transition Demonstration Project incorporated those of good teaching itself, namely, building on strengths and individualizing instruction and supports.
ROLE OF FAMILY SERVICE WORKERS
A unique aspect of the Transition Demonstration was the assignment of family service workers to schools. At most sites, the family service workers were pivotal to the implementation of the program, particularly the social services component. Family service workers were central to efforts to help families access existing public and private community services, and to promote the well being of individual family members (adults and children) as well as the family as a unit. They also actively sought to strengthen communication between families and schools, help parents learn more about child development and how to support their children’s learning, help school personnel become more aware of family issues and the demands placed on children by their environments and cultures, and recruit and encourage parents to participate in school and the Transition Program. Even though many sites hired additional staff to address specific health needs of families or to coordinate family involvement activities, the family service workers participated substantially in these efforts as well. Much of this involvement was founded in the strong caring, trusting, and personal relationships developed between the family service workers and the families they served.Over the five years of implementation, family service workers became increasingly integrated into the schools. Since family service workers were primarily housed in the school buildings, their proximity to school personnel facilitated the development of collaborative relationships and frequent communication between school and project personnel. Family service workers gained the respect of teachers, principals, and other school personnel. They served as a resource for individual school staff members and participated regularly on student assistance teams, multidisciplinary team meetings, and other school-based support meetings. In addition to collaborating with counselors, nurses, behavior specialists, and school social workers, they developed strong working relationships with a range of community service providers, and frequently served on community-based committees charged with identifying needs and gaps in service delivery, developing cooperative programs, and removing barriers to access for consumers. At the heart of their efforts, however, were the personal contacts between the family service worker and the family and child. These personalized interactions were consistently reported during site visits by parents, teachers, principals, and project directors to have been the key element in the success of the Transition Demonstration Programs in delivering high quality, individualized supports to families and children and in engaging families in home-school partnerships.
FAMILY INVOLVEMENT
Increasing parental involvement in their children’s education was a focus for each of the 31 local Transition Demonstration Programs. This component served as the primary focal point for several local implementations and held a key position in the implementation of all other sites. Family service workers were instrumental in providing linkages between families and schools and encouraging family participation in program activities.
Approaches
The traditional definition of parent involvement in schools often emphasized
participation in school-based activities, such as attending parent-teacher
conferences, attending PTA or PTO meetings and other school events, helping
to raise money for school improvement projects, assisting with field trips,
and volunteering at the school. Increasingly, however, schools and families
are shifting this definition of parent involvement to include a broader
range of activities (Epstein, 1995). The broader definition of parent involvement
in education endorsed by most of the 31 Transition Demonstration Programs
included an expanded role for parent volunteers within schools, involving
them in more direct student assistance and organization of the overall volunteer
effort in the school. In addition, parent involvement also endorsed home-based
activities that support children’s learning and positive school
adjustment.
| Expanded role for parents:
In the school:
Home-based activities:
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Further, sites endorsed a philosophy of family involvement that included parents, grandparents, siblings, and other caregivers and significant adults in school involvement and home- based learning activities. Some sites initiated programs targeted at specific caregivers, (for example, fathers or grandparents), while other sites focused on bringing extended family members into the school and into active participation.
SERVICE DELIVERY
Staffing. The staffing related to the family involvement component varied across sites. Nearly three fourths of the sites relied on the family service workers to implement the family involvement component. Some sites, however, had a designated Parent Involvement Coordinator as part of the Transition Demonstration Program staff, and a few sites hired Parent Assistants to support the family service workers and/or the activities within the parent resource rooms.Following the Head Start model of supporting family growth and employment, over half of the sites chose to support parents or family members, at least occasionally, as paid employees of the school or the Transition Demonstration Program. Site visit interviews indicated that some parents were paid (either hourly or on salary) to provide assistance to teachers in classrooms, to assist family service workers in parent resource rooms, or to help school staff in developing family involvement activities.
| Parent Resource Rooms
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| Alternative Approaches to Parent Resource Rooms:
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Parent resource rooms. During the
1995-96 site visits, over one-third of the sites were noted to sponsor parent
resource rooms within schools. On the Program Implementation Profile,
completed in the winter of 1997, 83 percent of sites indicated that a parent/family
area was available in most or all of the schools, and 96 percent indicated
that such space was available for parents in at least some of the schools.
Even though space is a premium commodity in many school buildings, sites
were able to secure classroom space (often in the last year of implementation)
to develop parent resource rooms.
Parent resource rooms were the location of a variety of parent-focused materials and activities, including:
- informational brochures and pamphlets
- application forms for community agencies, social services, and supportive programs
- multicultural materials for families
- lending libraries for families (developmentally appropriate educational materials (games, books, supplies, and activities)
- audiovisual materials for both adults and children
- ESL, adult basic education, and GED materials for adults
A few sites placed computers in the resource rooms for use by parents and children, and several had audiovisual equipment (such as videocassette players and tape recorders) available for on-site use or for check-out. Parents were encouraged to use the computers to assist children with homework, develop personal computer skills, and complete job applications. In a number of sites, the parent resource rooms were the sites of parent education workshops, ESL classes, and GED preparation classes supported by the Transition Demonstration Program. In a few sites, the parent resource rooms also served as the offices for the family service workers.
Parent participation in planning. Efforts to involve parents in decision-making within the schools gained strength over the years of the implementation. Over 90 percent of sites planned and presented parent education and family-school activities based on surveys of parents that identified their interests and needs. Approximately half of the sites indicated by their responses on the Program Implementation Profile that family involvement activities were regularly planned and implemented by the families themselves. In a number of sites, parents also participated on school improvement teams, and it was noted by project directors and principals that these teams had grown in substance and importance within the schools over the past five years. Over half of the site visit reports in the final year indicated that Transition parents were highly involved in the parent-teacher organizations within their schools, often holding leadership positions.
Educational involvement in the home. Transition Demonstration Programs assisted parents in identifying home-based activities to support classroom instruction and each provided families with ideas, materials, and/or tools to complete home-based instructional activities. Many sites distributed newsletters that included ideas for home-based learning activities, and family service workers universally supported parent efforts during home visits and other contacts. Project staff shared information about child development and school readiness, ideas for home-based activities, instructions for the completion of activities, and basic materials (crayons, paper, glue, etc.). They also focused on helping parents communicate more effectively with teachers about educational goals and activities.
Parents in classrooms. Families were brought into the schools in supporting roles (traditionally spoken of as “volunteers”) in increasing numbers, within individual sites and throughout the Transition Demonstration Project. Approximately 95 percent of the sites indicated via the Program Implementation Profile that family members participated in the classroom as observers or volunteers at least occasionally, and over 50 percent indicated that families were in the classrooms on a regular basis. Parents recruited and coordinated parent volunteers for the school, assisted teachers by completing clerical duties, assisted children by giving them one-to-one attention and assistance in the classroom, and completed other tasks such as organizing and offering story hours and reading clubs for students, making arrangements for field trips (in addition to serving as chaperones), and assisting in the office and cafeteria.
Barrier reduction. Sites made substantial efforts to reduce barriers to family involvement.
Strategies used to remove language and logistic barriers included:
- Provision of translation services
- Changing school policies to open school buildings for meetings and events in the evenings and on weekends
- Creating telephone trees manned by parents to ensure awareness of and encourage participation in events
- Providing transportation using Head Start vans, school buses, vouchers for public transportation
- Establishing carpools for parents
- Providing child care during meetings and school events
EDUCATION
As a component of the Transition Demonstration Project effort, the education component proved for many sites to be one of the most challenging to implement. Grantees were required to address four educational areas: (1) transition meetings to include the sending and receiving teachers and the parents; (2) individualized Transition Plans for each child; (3) some transfer of written information (records) about the child; and (4) the implementation of developmentally appropriate curricula and teaching practices within the classrooms. Sites were very creative in devising strategies to meet these requirements.
Transition Meetings. A clear goal of the education component was to have sending and receiving teachers meet with the child’s parents to plan the child’s transition from one grade to the next. Several barriers were encountered. First, class assignments were often not made by principals until just before, or even just after, the opening of school in the fall. Thus, it was not possible to know who the receiving teacher was so that a meeting about a specific child could occur. Second, Head Start children entering public school for the first time often did not actually enroll in the anticipated kindergarten because of a change in family residence during the summer or for other reasons. Third, conflicting schedules or limited teacher availability often made it difficult for all three parties to meet together.
Almost all sites were able to schedule meetings between the parent and either the sending or receiving teacher. Even when no formal teacher-to-teacher meetings were scheduled, teachers reported that there were informal contacts between sending and receiving teachers that facilitated the transition from grade to grade.
| Alternative Strategies for Transition Planning:
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Individualized Transition Plans. Three-fourths of the sites indicated that they were able to develop individualized transition plans for each child, addressing the transition between Head Start and kindergarten. Sites tended to view the plans as working documents that set goals and identified strategies and responsibilities. Only half of the sites, however, completed similar plans to transition children from grade to grade within the elementary school. Teachers in many sites reported during site visits that informal communications between teachers, the cumulative records and work portfolios, and teacher-parent conferences held each spring and/or fall served together to create a more informal planning process without the attendant paperwork of a formal transition planning document.
Transfer of Written Records. The large majority of sites were able to put into place procedures for the transfer of records from Head Start to public schools and from grade to grade within the public schools. In most sites, the transfer was accomplished with parental permission, which was obtained routinely as part of the Head Start exit conference or the kindergarten registration process. Nearly half of the sites reported that transferred records were specifically sought and used by school personnel to plan classes, curriculum, and instruction.
Developmentally Appropriate Teaching Practices. One of the key program elements specified by ACYF in the Request for Proposals (1991) was “a developmentally appropriate curriculum” (p. 31822) defined as:
“a curriculum that is appropriate for the child’s age and all areas of the individual child’s development, including educational, physical, emotional, social, cognitive, and communication.” (p. 31819)
The concept of developmental appropriateness of classroom practices and curriculum is a relatively new educational approach, endorsed by the National Association for the Education of Young Children (NAEYC) and many leading early childhood educators. Generally, developmentally appropriate practices (Bredekamp, 1986; Howes & Olenick, 1986; McCartney, 1984) are seen as including:
- An integrated curriculum that provides for social and emotional as well as physical and cognitive development
- Promotion of learning through free play and interaction
- Provision of opportunities for children to choose from a variety of learning materials and activities
- Organization of classroom environments and schedules in a child-focused manner
- Individualization of instruction to match the developmental level of the child
- Guidance of children’s learning by teachers, rather than didactic instruction
Integral to the concept of developmentally appropriate practices is the issue of continuity — of learning environment, curriculum, teaching approaches and practices, and learning experiences (Barbour & Seefeldt, 1993). The continuous nature of children’s growth and development, from preschool through the elementary and secondary years, requires educational experiences that are also continuous, coordinated, and that build one upon another (Barbour & Seefeldt, 1993). The National Transition Demonstration Programs, in bringing together Head Start and elementary school programs, sought to bring about the developmental continuity of curriculum, learning environment, and teaching practices that would enhance the learning of children.
The implementation of developmentally appropriate practices was a particularly challenging aspect of the Transition Demonstration Program’s effort for many sites. Most sites included experienced teachers, some of whom viewed developmentally appropriate practices (DAP) as one of the “teaching fads” that affect educational systems over time. Other teachers, both novice and experienced, embraced the opportunity to expand their repertoire of teaching practices and incorporate different strategies into their classrooms. Nearly all sites faced the challenge of meeting the diverse needs of teachers who are distributed along a continuum of acceptance and implementation of DAP.
| Supports for Teachers
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Staffing. Approximately 65 percent of the Transition Demonstration Programs provided on-site, technical assistance for elementary teachers in the form of a peer coach, mentor, or education coordinator. These persons were available on a regular and frequent basis to provide specific and direct assistance to teachers and principals in the form of materials, guidance, teaching demonstrations, support and encouragement, problem-solving and strategy building, and mentoring. Teachers reported that the availability of an education coordinator or mentor to provide one-on-one assistance and feedback was highly valued and promoted their implementation of developmentally appropriate educational practices. A few sites provided teaching assistants for demonstration classrooms, in an effort to reduce child-to-adult ratios in classrooms and provide additional support for teachers.
Professional development. Virtually every site supported teachers in their efforts to develop a greater understanding of the theory and practice of developmentally appropriate practices. This support was provided in a variety of ways, including:
- professional articles, books, and other resources
- training provided directly by project personnel
- professional development workshops or conferences sponsored locally
- joint training for Head Start and elementary school teachers
- opportunities to attend state, regional, or national workshops or conferences
- funds for substitute teachers when training occurred and/or registration fees
All sites worked with local school districts and school administrators to identify potentially helpful professional development opportunities, encourage teachers and principals to take advantage of these opportunities, and facilitate teacher attendance by providing release time. In a number of sites, teachers chose from an array of professional development activities, creating an individual plan (formal or informal) to meet their own unique needs. As diversity among teachers increased, the smorgasbord strategy served to increase participation by and satisfaction among teachers.
Classroom materials. All of the sites provided at least some additional classroom materials and supplies to classrooms participating in the Transition Demonstration Program, although the specific method and extent of assistance varied by site. Some sites provided funds to the demonstration schools to be used at the principals’ discretion and with some guidance from the project. Other sites provided funds to each classroom and teacher, and teachers made purchasing requests to the project. Still other Transition Programs chose and purchased materials for distribution to the demonstration classrooms. Developmentally appropriate, anti-bias, and multicultural materials were included in the purchases. Further, over 60 percent of the Transition Demonstration Programs also purchased equipment and non-consumables, such as computers and classroom furniture, for use in the elementary demonstration classrooms.
Collaboration among teachers. Sites provided many opportunities for teachers to collaborate with one another. Collaboration opportunities, provided by more than 80 percent of sites, included classroom observations, joint planning, curriculum development, and sharing of information, strategies, and materials. Like the training opportunities, many of these were made possible by the Transition Demonstration Programs, which provided substitutes or other staff to create release time.
Child assessment practices. School districts in many sites continued to use traditional report cards as indicators of achievement and student progress, although some schools at almost every site have investigated the utility and practicality of alternative assessment methods. Local Transition Demonstration Programs (92%) provided training, technical support, and materials in the area of developmentally appropriate child assessment. Over 80 percent of the sites reported that authentic assessment procedures (e.g., use of portfolios of children’s products, narrative reports) were implemented in the primary grades to at least some degree, and 54 percent indicated that those procedures were used regularly in the schools in their Transition Demonstration Programs.
SUPPORTIVE SOCIAL SERVICES
In most sites, the provision of supportive social services for families was another highly valued cornerstone of the program. Especially in an educational environment where the provision of social services was not traditionally part of the school’s mission, the advent of the Transition Demonstration Project with its social services component and family service workers was a unique experience for many participating schools. At the end of the fifth year of implementation, many principals and superintendents participating in the local Transition Demonstration Programs were aggressively seeking local, state, federal, and nonprofit foundation funding to maintain these social services within the schools.
| Alternative Approach: Although most sites provided on-site services, at least five sites located their family service staff in places other than school buildings. Four of those sites were Head Start grantees that had transition Demonstration Program family service staff work in the Head Start offices; the other family-based program was a statewide project. |
Approaches to Service Delivery. The majority of sites endorsed a two-generational approach to service delivery, addressing the needs of both children and families. In most sites, the service delivery systems were school-based — that is, family service workers, parent involvement specialists, and health coordinators were located at the schools, reaching out to families and drawing them into the school buildings. This model follows on the school-linked services models that have seen increasing popularity in recent years (e.g., Larson, Gornby, Shiono, Lewit, & Behrman, 1992). School-based services are considered practical because: (1) school is where children already go; (2) frequent contacts between school personnel and families can facilitate the identification of and response to needs; and (3) school buildings tend to be accessible within neighborhoods and can serve as positive community centers (Levy & Shepardson, 1992).
A case management model was the primary approach to meeting the social service and health needs of children and families in the large majority of sites. Whenever possible, Transition Demonstration Programs tended to utilize existing services in the school or community rather than provide the services (counseling, child care, etc.) directly. The extent to which this occurred reflected: (1) the availability of service providers within the community able to meet the needs of families; (2) the emphasis on helping families develop the ability to access services independently; (3) the emphasis on building capacity (within families, within communities) that would continue when funding for the Transition Demonstration Program ended; and (4) a specific decision to use case management to extend the capacity of family service staff to meet the needs of greater numbers of families.
Service Delivery. The Transition Demonstration Programs offered a wide range of comprehensive services to help families develop skills that could prevent difficulties and enhance development as well as help families meet immediate, more basic needs. In areas related to education, literacy, and employment, sites reported that they regularly met needs in a broad array of areas. Family service workers operated tutoring programs for children, provided basic counseling for families, led parenting education and family development workshops, shared health promotion and nutrition information, and worked with family members to develop interviewing and job skills. They helped family members locate, enroll in, and complete GED, vocational, English as Second Language (ESL), Adult Basic Education (ABE), and community college or university courses.| Service Delivery Areas
|
All sites offered at least some education or employment support services to families and all sites offered services through all of the service delivery options (direct, referral, partnerships). As in the basic needs areas, education and employment supports typically involved referrals to existing community programs. Services most frequently provided directly by the Transition Demonstration Programs included daily living skills, life skills, and parenting skills. Anecdotal information obtained during site visits indicated that these topics frequently arose during home visits and were addressed by family service workers in that forum. Assistance with increasing parenting skills was frequently delivered through partnership agreements. Family service workers helped families obtain safe and affordable housing, clothing and food, financial assistance, and legal assistance. There was, however, some substantial variation in the types of services provided. As noted above, basic needs of families were most often met using referrals to community providers, although transportation and translation services tended to be provided more directly by sites. Some sites, however, frequently and consistently met the basic needs of families by a combination of direct services and referrals.
| Service Delivery Methods
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| Service Delivery What:
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| Frequency of Home Visits Influenced by:
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Barriers to access:
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Home Visits. Home visits have long been a central feature of Head Start programs, enabling program staff to reach and involve families who might otherwise have not participated. Following on this successful tradition, home visits were required to be a part of the service delivery and outreach program for each Transition Demonstration Program (ACYF, 1991). From the mandate, home visiting evolved into a highly valued and productive activity in the work of the family service workers, serving to help personalize the contacts and bridge the gap between families and the school. Other contacts with families — such as school visits and conferences, school-sponsored or program-sponsored events, and telephone contacts — increased in frequency and utility over time, as family independence grew and as family service workers were drawn into school- and community-based planning and coordination activities.
The frequency of home visits appeared to be impacted by the diversity of activities in which family service workers engaged. As the five-year implementation progressed, family service workers were more frequently asked to serve on school-wide committees, to serve as members of student intervention teams, to serve on service planning and integration committees within the community, and to provide training for other agencies or providers seeking to adopt some portion of the family service model implemented by the Transition Demonstration Program. These activities were perceived as essential to the effort to extend, coordinate, and institutionalize family support services, but they reduced the amount of time available for direct contact with families. Eighty percent of the sites indicated that school personnel — teachers, principals, nurses, counselors, and school social workers accompanied family service workers on home visits at least occasionally. . Over 30 percent of the sites indicated that these joint home visits were frequent occurrences. In 60 percent of the sites, family service workers made at least 2 home visits per year to each participating family. Nearly 20 percent of the sites, however, indicated that they were not able to make 2 visits per family per year.
Overcoming barriers to accessing services. Overcoming barriers to access was a significant focus for the majority of sites. Transportation and language barriers were key areas of concern for Transition Demonstration Program staff helping families access community services, although the exact nature of the barrier varied with site locale. In most cases, family service teams developed strategies that helped to overcome barriers for many families. These strategies included:
- direct intervention of project staff — such as staff providing transportation for appointments, accompanying families as translators, or providing child care during appointments with doctors or community agencies
- utilization of project resources — such as projects providing taxi vouchers for families or emergency funds to pay for dental or medical follow-up when other funds were not available
- coordination and collaboration of project staff with community agencies — such as creating on-site screening clinics, developing satellite clinics or offices in schools or other neighborhood locations, providing translation services within community agencies or by the school district, and utilizing Head Start vans or buses to provide transportation for families
The choice of strategies for reducing or eliminating barriers depended on family resources, community resources, and the philosophy and resources of the local project. Those sites with a strong emphasis on family empowerment and independence and on capacity building within schools, communities, and families tended to rely less on direct intervention or project resources and more on coordination and collaboration with community services and supports.
HEALTH/NUTRITION
Support models for nursing services:
|
Approaches. The health and nutrition component in most sites was tied to family support services, and in some sites was indistinguishable from those efforts. All sites offered supports to families as they sought medical and dental care, encouraged families to seek needed mental health care and provided information and services related to nutrition. In addition, most sites placed some emphasis on preventive care. In fact, in seven sites (nearly a quarter of the total number), the emphasis on wellness and prevention of disease and injury was noted in site visit reports as a particular feature of the site’s health component implementation.
Staffing. Staffing patterns utilized to address the implementation of the health component varied across the 31 sites. Only a few sites chose to follow the Head Start model and designate within the project staff a health coordinator to develop and coordinate activities. In the large majority of sites (over 75%), the component was implemented by nurses, a more traditional approach within schools. In a few sites, health assistants were available in demonstration schools, and in at least four sites a mental health or behavioral specialist was supported by the Transition Demonstration Program. In virtually every site, the family service workers were pivotal to the provision of health services.
| Health Services
|
Service Delivery
Screening programs. Screening clinics were among the most
common and most popular health services supported by the Transition Demonstration
Programs. Each of the 31 sites offered vision, hearing, and mental health
screening of some type for children. All but one of the sites offered nutrition
screening, and all but one offered physical health screening as well. Over
two-thirds of the sites offered lead screening to children under the auspices
of the Transition Demonstration Program. In many cases these screening activities
were completed in cooperation with local health departments, school district
personnel, medical and nursing schools, and other community agencies and service
providers.
Relatively fewer sites offered screening to adult family members. Less than half of the sites indicated that they provided screening for adults for vision or hearing problems, nutrition or physical health, or for tuberculosis or lead exposure. When these services were offered, they were typically offered by referral or, less frequently, by partnership agreement. There was, however, a great deal of variability in the frequency of offerings reported across all service delivery options.
Health services. Sites reported that they regularly provided services to meet health needs of children and adults in each of 13 areas (see Table 7). The most frequently addressed needs for children included injury or illness, dental care, behavioral or emotional problems, and medical follow-up. The most frequently addressed health needs among adult family members were nutrition and weight loss, dental care, and mental health services. Services for both children and adults were most often provided via referrals to community providers. Over half the sites indicated that they provided immunization follow-up and/or administration, transportation, dental treatment, and mental health follow-up and treatment services using partnership agreements with community providers.
| Health Services for
Children |
Health Services for
Adults |
|||||
|---|---|---|---|---|---|---|
| Services Provided Directly |
Service Provided by Referral |
Services Provided by Partnership |
Services Provided Directly |
Services Provided by Referral |
Services Provided by Partnership |
|
| Area of Need | ||||||
| Immunization follow-up
|
75% |
86% |
70% |
20% |
48% |
36% |
| Immunization administration |
12% |
82% |
65% |
0% |
45% |
39% |
| Height/Weight charts
|
48% |
65% |
52% |
23% |
44% |
20% |
| Nutrition counseling
|
66% |
84% |
34% |
53% |
82% |
56% |
| Medication administration |
37% |
50% |
40% |
0% |
34% |
6% |
| Injury/illness treatment
|
52% |
91% |
49% |
22% |
62% |
36% |
| Transportation |
86% |
85% |
61% |
79% |
79% |
47% |
| Dental treatment |
31% |
95% |
61% |
22% |
87% |
48% |
| Mental health follow-up |
67% |
87% |
58% |
50% |
86% |
52% |
| Counseling/behavior
mod. |
77% |
100% |
76% |
64% |
95% |
55% |
| Medical health follow-up
|
55% |
91% |
47% |
20% |
70% |
31% |
| Tuberculosis testing |
12% |
50% |
50% |
10% |
63% |
24% |
| Hematocrit |
11% |
70% |
53% |
6% |
62% |
31% |
Health information and education services. In the majority of sites, efforts were made to provide health-related information to children, parents, school personnel, and others. Methods used to deliver information included:
- a regular project newsletter
- personal contacts (home visits, telephone contacts)
- brochures and pamphlets in parent resource centers
- health fairs
- workshops for families and school personnel
Site responses on the Program Implementation Profile indicated that
information and education on health and safety, as well as nutrition, mental
health and, substance abuse were provided to children, families, and Transition
staff on a regular basis by 50 percent or more of the sites (see Table 8).
Sites were less likely to provide similar information on a regular basis
to Head Start staff or school personnel (about a third of the sites). Ten
sites (about a third) indicated that they rarely, if ever, provided health
information or education for Head Start staff and eight sites (about a fourth)
rarely, if ever, provided such information for school personnel.
| Children | Head Start Families | Transition staff | School staff | Personnel | |
|---|---|---|---|---|---|
| Health information |
75% | 83% | 58% | 83% | 65% |
| Health education |
54% | 54% | 50% | 67% | 42% |
| Nutrition information |
67% | 75% | 54% | 71% | 46% |
| Nutrition education |
50% | 54% | 37% | 58% | 29% |
| Mental health information |
70% | 75% | 46% | 75% | 42% |
| CPR, First Aid |
21% | 33% | 33% | 50% | 21% |
| Substance abuse prevention |
70% | 65% | 35% | 61% | 43% |
| Safety information |
68% | 73% | 45% | 71% | 55% |
| Safety education |
57% | 50% | 43% | 52% | 39% |
TRANSITION-LIKE ACTIVITIES AND SUPPORTS IN COMPARISON SCHOOLS
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The implementation of the 31 Transition Demonstration Programs occurred in environments that are dynamic and subject to secular trends. Even though the schools participating in the Transition Demonstration Programs were randomized either to receive the demonstration services or to participate as comparison schools, there was early and ongoing evidence that comparison schools often incorporated programs, activities, staffing patterns, teaching practices, and other features consistent with those found in demonstration schools and actively promoted by the Transition Demonstration Program. In some cases, comparison schools were the recipients of professional development opportunities and Transition-like supports because of school district policies that required equal access to opportunities by all schools. In other cases, the schools that were randomly selected to be comparison schools had already begun to incorporate Transition-like activities and simply continued on their charted course without additional encouragement or assistance from the Transition Demonstration Program. In a few cases, the leadership and staff of comparison schools were disappointed that they were not selected to receive demonstration services, perceiving the significant needs of their families and children, and so made a strong commitment to secure such services independent of the program. Finally, and to an increasing degree as the implementation progressed, networks of principals (including those from both demonstration and comparison schools) began to share their positive experiences with the program and the successes achieved for children and families, and the programming ideas and strategies promulgated by the Transition Demonstration Program were informally shared across schools.
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The extent to which comparison schools incorporated features and services that were essentially the same as those in the demonstration schools is important to the understanding and interpretation of outcomes for children and families. To that end, information was gathered from principals in both demonstration and comparison schools about services available for parents and children. Questionnaires at the end of the project period also gathered data from principals about changes in their schools over the previous 5 years. In fact demonstration and comparison principals reported strikingly similar services. Regarding staff available to address the health and other basic needs of children, principals in both the demonstration and comparison schools reported that they had nurses, paraprofessionals, and/or parent volunteers to assist in meeting children’s health and screening needs in the school (see Table 9). There was a trend toward having health-related personnel of all types (professional, paraprofessional, and parent volunteers) in the demonstration schools for 4 or more days per week. These included additional staff members hired by the local Transition Demonstration Program.
The types of services provided by these health related staff generally did not differ significantly between the demonstration and comparison schools (see Table 10). The single exception was that health education for parents was provided in significantly more demonstration schools (71%) than comparison schools (56%).
Findings about the availability of staff (counselors, behavioral specialists, and social workers) to address the social, emotional, and mental health needs of students and to promote family involvement (see Table 11) indicate that in all professional categories, more demonstration than comparison schools had additional support staff. The largest differences were the availability of In the area of family involvement, there was a greater tendency for demonstration schools to have professional and paraprofessional staff to address family involvement and to have these persons in the school for more time during the week.
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Approximately equal numbers of principals in both groups indicated that
they had parent resource rooms in the school, formal and informal links
with community resources, partnerships with businesses, Head Start and other
preschool programs integrated into the school, before- and after-school
programs for children, and tutoring and recreational programs during the
summer months (see Table 12). It was noted that somewhat fewer comparison
schools offered tutoring programs during the school year, but more comparison
than demonstration schools offered tutoring for students in the summer.
An interesting difference in school programming was noted in the area of
language programs offered for children and families (see Figure 4.1). Demonstration
and comparison principals reported relatively equal percentages of schools
offering bilingual education and ESL classes for children, but more demonstration
schools reported providing ESL classes for families (45% versus 35%).
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[D] |
SUMMARY FINDINGS
Overall, it is noted that the 31 sites did, indeed, implement the Transition Demonstration Program in accordance with the mandates and guidelines included in the original Request for Proposal. Each site addressed the four major components and provided an array of comprehensive services designed to meet the social, health, and educational needs of children and families and to stimulate family involvement in all aspects of the educational processes of children. The specific strategies and activities employed to address the implementation varied substantially across sites. While there were many implementation features shared by sites, the actual program implementation within each of the 31 sites was a unique configuration of activities and personnel devised specifically to take advantage of the strengths and address the needs of the children, families, schools, and community agencies participating in a given Transition Demonstration Program. In many sites, transition-like services were also offered in comparison schools, sometimes with very similar quality and intensity.As might be expected, individual sites varied in the extent to which they achieved implementation of each of the four components and overall. The nature and degree of this variation in extent of implementation is described in Chapter 5. Possible reasons for variation in program design and extent of implementation are addressed in Chapter 7.
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