The article reviews studies showing that speech and language intervention during the period of cannulation can benefit tracheostomized and ventilator-dependent children by improving their communicative functioning while decreasing their frustration with the tracheostomy placement. Therapeutic interventions with feeding skills are also recommended.…

Discussion of medical homes for children with special health care needs suggests such homes can provide quality health care services to children in partnership with families and community professionals. Early intervention and early childhood special education providers are encouraged to collaborate with primary health care professionals, thereby…

Provides a case analysis of a child with a medically complex profile in which early-intervention staff and special-education staff worked to determine family priorities and utilized the local hospice agency to devise creative programming that meets the needs of the family and child. (Author/CR)

Addresses responding to a child with special health care needs with a life-threatening medical emergency, including an equipment malfunction, when it occurs in community settings. Collaborative development of portable individualized emergency response plans is discussed, and illustrative care scenarios, a sample plan, and policy recommendations…

This article describes medical problems that occur more frequently in young children with Down syndrome. These include common cardiac, hearing, and vision problems and less common thyroid and celiac diseases. Guidelines for preventing dental and obesity problems are followed by suggestions to early interventionists for watching for leukemia, neck…

This article outlines historical, socio-cultural, and research information that attests to the fundamental relationship between touch and child development. It describes applications including touch therapies with very low-birthweight infants, with fragile premature infants, and with infants of depressed mothers. (Contains extensive references.)…

Directors of 86 day care centers were surveyed to determine factors affecting the availability of day care services for preschool children with special health care needs. Barriers to admission included restrictive admittance requirements, lack of staff, fear of not meeting a child's needs, and lack of trained personnel. (Author/CR)

Analysis of 51 studies of developmental effects of prenatal exposure to alcohol in children from birth to 72 months found that, although adverse outcomes were found within each domain, age grouping, and exposure category, they comprised fewer than 50% of all outcomes measured. Most adverse outcomes were found in the neurobehavioral domain with…

This article highlights the complexity of and critical need for service coordination for medically fragile infants and their families through an in-depth case study of a child and his family who "slipped through the cracks" of the system. The retrospective analysis describes problems and suggests alternative strategies for more effective…

A naturalistic inquiry involving early childhood special education teachers' perceptions of integrating children with complex health care needs into the classroom found that teachers' initial reactions were fear and apprehension, but teachers later had positive feelings and adjusted to dealing with life-threatening situations and communicable…

An overview of community planning for response to and recovery from natural disasters is provided, with applications for young children who are medically fragile. Key concerns for technology-dependent children are outlined, and guidelines for preparing and managing staff teams are provided. Suggestions for helping children and staff overcome…

The Specialized Health Needs Interagency Collaboration is a statewide technical assistance project to assist school and related-services personnel in Maryland to manage the specialized health needs of students with developmental disabilities and handicapping conditions within the educational setting. The project's purpose, scope, staffing,…

The Chronically Ill Infant Intervention Project at Georgetown University (Washington, D.C.) initiates treatment in the special care nursery for chronically ill infants and infants with multiple health problems. The project's interdisciplinary team provides developmental evaluations, direct intervention in the hospital and in the home, and parent…

This article reviews the legal issues raised when parents request that early intervention professionals implement Do Not Resuscitate orders for their young children with special health care needs. The article explores divergent viewpoints, recommends administrative procedures, and calls for open discussion of the issues and development of clear…

The Prescribed Pediatric Center (Toledo, Ohio) is a community-based, multidisciplinary program for infants and children with chronic, complex medical conditions. This article describes program beginnings; the planning process; and the program's growth, development, and components. Initial program evaluation indicates positive effects on some…