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Parents’ beliefs, attitudes, and values and their relationship to the home environments provided for… Tolleson, Barbara Lynn Martin 1978

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PARENTS' BELIEFS, ATTITUDES, AND VALUES AND THEIR RELATIONSHIP TO THE HOME ENVIRONMENTS PROVIDED FOR DEVELOPMENTALLY DELAYED INFANTS INVOLVED IN A HOME-BASED INTERVENTION PROGRAM by BARBARA LYNN MARTIN TOLLESON B.A., Univ e r s i t y of B r i t i s h Columbia, 1971 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n THE FACULTY OF GRADUATE STUDIES Department of Psychology, Clinical/Community Program We accept t h i s thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA A p r i l , 1978 0 Barbara Lynn Martin Tolleson, 1978 In presenting th i s thesis in pa r t i a l fu l f i lment of the requirements for an advanced degree at the Un ivers i ty of B r i t i s h Columbia, I agree that the L ibrary sha l l make it f ree ly ava i l ab le for reference and study. I fur ther agree that permission for extensive copying of th is thes is for scho la r l y purposes may be granted by the Head of my Department or by his representat ives . It is understood that copying or pub l i ca t ion of th is thes is fo r f inanc ia l gain sha l l not be allowed without my wri t ten permiss ion. Department of (P^rJL?jsj,j Cfau^aA j C&f7i*n*<*u£j a^t^cJ The Univers i ty of B r i t i s h Columbia 2075 Wesbrook Place Vancouver, Canada V6T 1W5 Date Jtd 19 7? i . ABSTRACT The home environment has been shown to be of c r i t i c a l importance for optimal c h i l d development, p a r t i c u l a r l y for infants demonstrating develop-mental delays with or without organic cause. Successful intervention pro-grams f or these c h i l d r e n have been linked to parent involvement and to concomitant changes i n the home environment. L i t t l e research, however, has concerned i t s e l f with parental b e l i e f s , a t t i t u d e s and values which may be r e f l e c t e d i n the kinds of home environments provided for these delayed c h i l d r e n . The present study, therefore, provides an i n i t i a l i n v e s t i g a t i o n into several of these parental factors as they r e l a t e to the c h i l d ' s early environment. F i f t y - n i n e f a m i l i e s involved i n a home-based intervention program for developmentally delayed infants were v i s i t e d . Home environments were assessed by means of the.HOME, a s t a t i s t i c a l l y r e l i a b l e scale developed by Bettye Caldwell (1972) to measure important aspects of the quantity and qua l i t y of s o c i a l , emotional, and cognitive support a v a i l a b l e to the young c h i l d within the home. Parents of these f a m i l i e s were asked to complete a questionnaire containing various b e l i e f , a t t i t u d e , and value scales. Parental b e l i e f s , attitudes and values were found to s i g n i f i c a n t l y r e l a t e to the kinds of home environments experienced by the developmentally delayed infants i n the Program sample. In general, parents providing the most optimal home environments were those who believed i n t h e i r a b i l i t y to influence t h e i r children's development, f e l t a personal sense of responsi-b i l i t y towards that development, accepted t h e i r c h i l d r e n f or who they were and f e l t warmly towards them, and who endorsed such r e l a t i o n a l values as i i . family security and loving. Results were more striking for mothers than for fathers, perhaps due in part to their greater involvement with Program staff and a c t i v i t i e s . Further research i s needed in order to c l a r i f y the complex relationship observed between Program impact and these various parental beliefs, attitudes, and values. TABLE OF CONTENTS Abstract Introduction and L i t e r a t u r e Review Introductory Overview Early Environments and t h e i r Impact on Ch i l d Development Early Home Environments Parental Attitudes C h i l d C h a r a c t e r i s t i c s Parental Responses to a Developmentally Delayed Infant Early Intervention Programs B r i t i s h Columbia Infant Development Program Method and Materials Results Discussion and Conclusions References Appendix X V . LIST OF TABLES Page TABLE I The HOME Inventory 12 TABLE II Diagnostic Breakdown of B r i t i s h Columbia Infant Development Program Children - September, 1977 64 TABLE I I I Sample Family and Program C h a r a c t e r i s t i c s 67 TABLE IV Demographic C h a r a c t e r i s t i c s of Sample Families 68 TABLE V Diagnoses of Children i n Sample 70 TABLE VI Sample and Comparison Groups' Mean HOME Scores 80 TABLE VII Relationship Between Maternal Dependent Variables and Sample Demographic Variables 84 TABLE VIII Relationship Between Paternal Dependent Variables and Sample Demographic Variables 85 TABLE IX Tot a l Sample Mean and Modal Terminal Value Rankings 88-89 TABLE X Total Sample Mean and Modal Instrumental Value Rankings 90 TABLE XI Mothers' and Fathers' C h i l d Value Rankings 92-93 TABLE XII Length of Time i n Program and Maternal Dependent Variables 95 TABLE XIII Pearson Correlating Between Maternal Dependent Variable and HOME Score 96 TABLE XIV Spearman Rank Order Correlations Between Maternal Value Rankings and Home Environment"Scores 100 TABLE XV Spearman Rank Order Correlations Between Paternal Value Rankings and Home Environment Scores 101 TABLE XVI Differences i n Maternal Dependent Variables f o r Optimal Versus Poor Homes 103 TABLE XVII Mean Terminal Value Rankings f o r Mothers 106 TABLE XVIII Mean Instrumental Value Rankings for Mothers 107 TABLE XIX Mothers' and Fathers' Regression Analyses on Tota l HOME Scores 109 LIST OF TABLES (continued) TABLE XX Mothers' Regression Analyses on HOME Subscale Scores (n=56) TABLE XXI Fathers' Regression Analyses on HOME Subscale Scores LIST OF FIGURES Page FIGURE I Sample Distribution of Home Scores 79 ACKNOWLEDGEMENTS I would l i k e to express sincere gratitude to my advisor, Dr. Park Davidson, and to my committee members, Drs. Tannis Williams and Jerry W i l l i s , for t h e i r continued guidance and help. I would l i k e to expend both personal appreciation, and praise to the s t a f f of the B r i t i s h Columbia Infant Development Program for t h e i r caring and committed s e r v i c e . To t h e i r Program Director Ms. Dana Brynelson, and to the f a m i l i e s whose homes I v i s i t e d , I owe a s p e c i a l thank you. To my husband and family, whose f a i t h and encouragement sustained me, I owe the completion of t h i s work. 1. INTRODUCTION AND LITERATURE REVIEW OVERVIEW In 1972, a task group of f i v e professionals i n the c h i l d development and mental retardation research f i e l d s presented a summary report of a de-t a i l e d study of intervention programs for ch i l d r e n at r i s k of mental r e t a r d -a t i o n (Stedman, Anastasiov, Dokecki, Gordon, and Parker, 1972). The major findings of t h e i r extensive reviews, interviews and evaluations stressed the need for working as early as possible with young a t - r i s k or handicapped child r e n , and for including parents i n a l l phases of intervention strategy and implementation. Their conclusions have been outlined by Stedman (1977) i n t h i r t e e n major points; h i g h l i g h t s of which are presented below. "1. I t has been demonstrated without much doubt that how a c h i l d i s rai s e d and the environment into which he i s born have a major impact on what he w i l l become. 2. The family's methods of est a b l i s h i n g s o c i a l rules leave l i t t l e doubt that e a r l y family environment (parental language s t y l e s , a t t i t u d e s toward achievement, parental involvement and concern for the child) have a s i g n i f i c a n t impact on the c h i l d ' s development before he reaches h i s second birthday. 5. The e f f e c t s of a stimulating or depriving environment appear to be most powerful i n the early years of c h i l d -hood, when the most rapid growth and development take place. The primary focus of the c h i l d during these early years i s the home. Therefore, home-based i n t e r -vention programs or one-to-one teacher-child r a t i o stimulation a c t i v i t i e s appear to be the most appropriate and e f f e c t i v e during t h i s period. 6. There i s evidence that the e f f e c t s of early intervention programs f o r ch i l d r e n are strengthened by the involve-ment of the c h i l d ' s parents." (p. 99-100) These conclusions regarding the c r i t i c a l importance of the c h i l d ' s early environment, the need for intervention as early as possible for c h i l d r e n a t - r i s k of developmental delay, and the need f o r intervention incorporating 2. an emphasis on parental involvement, have been r e i t e r a t e d strongly through-out the research and c l i n i c a l l i t e r a t u r e (Bronfenbrenner, 1974; Dokecki & Kra f t , 1977; L e v i t t & Cohen, 1977; Schaefer, 1972; Tjossem, 1976; Walters, 1976). Recognition of the importance of early stimulation f or normal i n t e l -l e c t u a l growth, and the e f f e c t of i t s lack on subsequent learning and school achievement d i f f i c u l t i e s , were key factors i n the inception and blossoming of intervention programs during the l a s t decade. These programs, led by the massive Head Start Programs i n the United States (begun i n February, 1965), were aimed at a l l e v i a t i n g the cumulative d e f i c i t s f e l t to be charac-t e r i s t i c of disadvantaged c h i l d r e n - those chil d r e n , t y p i c a l l y from poorer socio-economic groups, who demonstrate a progressive decline i n i n t e l l e c -t u a l functioning, poor school achievement, and a greater chance of pre-mature school termination. ( M i l l e r , 1970). Results of many of these Head Start Programs were disappointing. Intervention gains i n cognitive and i n t e l l e c t u a l a b i l i t i e s were often temporary, and l o s t during the following year of school. Disappointment, however, led to a search f o r a l t e r n a t i v e s t r a t e g i e s ; one being the p r o l i f e r a t i o n of home-based programs incorporat-ing the family or mother i n i t s intervention approach, another being a decrease i n the age of the c h i l d at time of contact ( L e v i t t & Cohen, 1977). Both of these st r a t e g i e s have proved encouraging. Although research r e s u l t s are complex, and t h e i r i n t e r p r e t a t i o n often hampered by lack of informa-ti o n , l i m i t e d assessment procedures, small samples, and incomplete knowledge of optimal c h i l d development and environmental i n t e r a c t i o n ; intervention at an early age has been successful i n preventing the c h a r a c t e r i s t i c drop i n measured IQ t y p i c a l l y witnessed i n young disadvantaged c h i l d r e n (e.g. 3. Caldwell & Smith, 1970; Hamilton, 1972; Karnes & Teska, 1975, Levenstein, 1973; Ramey & Campbell, 1977). Intervention programs have mainly served two groups of ch i l d r e n : those at r i s k due to environmental disadvantage, and those at r i s k due to b i o l o g i c a l , genetic, and medical damage or suspected d i f f i c u l t y . Results for the former group have generally been p o s i t i v e , producing mean IQ gains of from 4 to 20 points. As i n the early Head Start Programs, however, these gains are sometimes l o s t or diminished once intervention has been terminated (Horowitz & Paden, 1973). Results f o r the l a t t e r group have also been p o s i t i v e , though more d i f f i c u l t to assess i n terms of mean changes, as each c h i l d e x hibits a unique blend of organic and unknown complicating f a c t o r s . In addition, fewer programs serving t h i s second group of ch i l d r e n have been evaluated and reported i n the research l i t e r a t u r e . Successful intervention, p a r t i c u l a r l y i n terms of longterm s t a b i l i t y of Program r e s u l t s , has been linked to parents; p a r t i c i p a t i o n , to concomi-tant changes i n the stimulus p o t e n t i a l of homes, and to changes i n parental st y l e s of c h i l d - i n t e r a c t i o n (Bronfenbrenner, 1974; Dokecki & K r a f t , 1977; Hamilton, 1972; L a l l y & Honig, 1975; RAlin, 1972; Willerman, 1969). For handicapped c h i l d r e n , i n p a r t i c u l a r , the need for parents to supply more than the average stimulation and caretaker a c t i v i t y has been stressed ( L e v i t t & Cohen, 1977; Moss & Mayer, 1975; Tjossem, 1976). Few researchers, however, have d i r e c t l y assessed parental factors which might bear on t h e i r l i k e l i h o o d to cooperate with an intervention program, nor on those which might characterize parents providing r i c h or poorly stimulating environ-ments f o r t h e i r c h i l d r e n . As an i n i t i a l , i n v e s t i g a t i v e study, therefore, t h i s author assessed various b e l i e f s , a t t i t u d e s , and values of parents involved i n a home-based intervention program for developmentally delayed infants and r e l a t e d these factors to the kinds of home environments these parents were providing for t h e i r c h i l d r e n . Parental factors were chosen which would t h e o r e t i c a l l y contribute to parents:' willingness to incorporate suggestions made by Program workers and thus to t h e i r p r o v i s i o n of an optimal home environment for t h e i r developmentally delayed c h i l d . To pro-vide a background for t h i s study, the research l i t e r a t u r e on the importance and e f f e c t s of early home environments w i l l be discussed. This w i l l be followed by a review of early intervention programs, p a r t i c u l a r l y those home-based programs serving a population of developmentally delayed infants and concluded by a b r i e f d e s c r i p t i o n of the goals and practices of the p a r t i c u l a r program under consideration. EARLY ENVIRONMENT AND ITS IMPACT ON CHILD DEVELOPMENT Theoretical opinion concerning the r e l a t i v e impact of environment, predetermined developmental sequences, and in h e r i t e d c h a r a c t e r i s t i c s has played a large part i n the kinds of research and educational programs undertaken during the past few decades. The mid-1930's saw a vigorous debate between th e o r i s t s favouring a s t r i c t l y i n h e r i t e d , predetermined maturational sequence for an i n d i v i d u a l ' s development, and those defending a p o s i t i o n s t r e s s i n g the almost l i m i t l e s s influence of early experience and environment. Although t h i s "nature-nurture" question, as i t came to be c a l l e d , has not been "answered"; most workers i n the f i e l d have resolved that the question i s i n i t s e l f misleading, and incapable of r e c e i v i n g a polarized ye 5. or no resolution (Horowitz & Paden, 1973). Instead, a rapprochement has been achieved. Both environment and heredity, as well as common species— determined developmental sequences, influence a person's development (Miller, 1970; Uzgiris, 1970). This "interactionist" view has led to a more open and f r u i t f u l quest for empirical data concerning the nature and course of early infant and child development, recognizing the complex and intertwining effects of a number of influencing factors. Theorists, of course, differ as to the weight they assign to these various factors, but the basic belief in an interactionist philosophy has encouraged an increase of both basic and applied research into the areas of infant development and early inter-vention. One of the f i r s t , and most compelling studies to provoke sc i e n t i f i c respect and further study into the impact of environment on child develop-ment was that reported by Skeels and Dye in 1939. After an inadvertant discovery that two infants transferred from an overcrowded orphanage to an institution for mentally retarded adolescent g i r l s showed a subsequent spurt in development, Skeels and Dye (1939) arranged for an experimental group of 13 babies f a i l i n g to thrive in the orphanage to be transferred to a state institution for the mentally retarded. There, in contrast to the orphanage setting, these infants with an average age of 19 months at time of transfer and a mean IQ of 64 experienced a one-to-one relationship with an adult who provided a generous amount of love and affection, as well as an environment much richer in stimulation from a variety of sources. Tested again after a 19 month interval, these infants showed an average IQ gain of 28.5 points. A contrast group of 12 children who remained in the orphanage and who had an i n i t i a l l y higher IQ average of 86.7, at a mean age of 16.6 6. months, showed an average loss of 26.2 IQ points. These r e s u l t s were made even more dramatic and persuasive at follow-up 21 years l a t e r . Reported by Skeels i n 1966: "The two groups had maintained t h e i r divergent patterns of competency into adulthood. A l l t h i r t e e n c h i l d r e n i n the experimental group were self-supporting, and none was a ward of any i n s t i t u t i o n , public or p r i v a t e " (p. 54). These c h i l d r e n had completed an average of the twelfth grade, eleven were married having c h i l d r e n whose IQ's ranged from 85 to 125, and i n no cases was there any " i n d i c a t i o n of mental retardation or demonstra-ble abnormality" (p. 55). The c h i l d r e n i n the contrast group, however, remained as wards of state i n s t i t u t i o n s , completed a median of l e s s than t h i r d grade, and only one of the twelve attained an occupational l e v e l above that of u n s k i l l e d labour. This study perhaps r a i s e s more questions as to the nature and means of environmental influence than i t can hope to provide answers f o r . At a time when b e l i e f i n the fixed nature of i n t e l l i g e n c e was strong, however, i t s r e s u l t s were d i f f i c u l t to ignore, or to explain away within the t h e o r e t i c a l confines of predetermined i n t e l l i g e n c e . Following t h i s early work of Skeels and Dye, other researchers began to investigate the developmental patterns of c h i l d r e n who were i n s t i t u t i o n a l i z e d , separated from human contact, or h o s p i t a l i z e d for prolonged periods of time. Dennis and Najarian (1957), for instance, compared the developmental rates of infants reared i n a foundling home i n Beirut, Lebanon with a contrast group of home-reared infants brought to a nearby Well-Baby C l i n i c for check-ups. I n s t i t u t i o n a l i z e d infants were kept i n i n d i v i d u a l i z e d c r i b s with white coverings blocking the view on a l l sides, u n t i l such time as they could p u l l themselves up to a standing p o s i t i o n . They were then placed i n a small playpen with several other 7. children. At two months, the Cattell DQ was comparable for the two groups. Differences were visible at three months, however, and by eight months there was no overlap in scores. Infants from the foundling home had a mean DQ of 63, home-reared infants of the same age had a mean DQ of 101. Dennis (1960) in a subsequent study of infants in three institutions in Tehran, Iran, found that infants from two of these institutions -described as overcrowded, understaffed, and providing l i t t l e stimulation to the infants were well below norms in their motor development. Infants from the third institution, however, which had a low ratio of children to attendants, and which placed a value on toys and stimulating experiences, had infants who were only slightly below norms in motor development. Provence and Lipton (1962), studied 75 infants reared in an i n s t i t u -tion having good physical and adequate sensory stimulation, though no interaction with a consistent mother-figure. Infants obtained a mean Gesell DQ of 101 between 14 and 26 weeks of age. This score, however, declined to an average of 85 for the rest of the f i r s t year. A comparison group of 75 infants raised in foster homes from the time of birth remained stable at a mean DQ of 111. Results from these early studies led to some preliminary conclusions that institutionalism per se, and lack of a consistent mother figure, were always detrimental to a child's early and subsequent development. Research-ers have found, however, that institutionalized children can show normal or accelerated development - when the institution provides a more stim-ulating environment than that from which the infant is taken, or would otherwise have been subjected to (e.g. Gaurin & Sacks, 1963; Tizard & Rees, 8. 1974). For example, infants taken from homes in which they are neglected or unwanted (Gaurin & Sacks, 1963) or transferred from environments of social deprivation (Clarke & Clarke, 1976) have shown significant increases in IQ. In general, however, studies on children receiving an institutional upbringing in infancy report outcomes of reduction in vocalizations, mild retardation of sensorimotor development, passive attitudes, and poor achievement motivation. (Collard, 1971; Uzgiris, 1970). Therefore, although i t would be unjust to label institutionalization per se as bad for a devel-oping child, the pattern nevertheless does suggest that most institutions cannot offer the same degree of individualized care and attention which most parents or foster parents can and do provide for their children. Studies such as the ones cited above, which demonstrate the harmful effects of a nonstimulating institutional upbringing in early infancy, as well as the potential for change which can be effected by changes in that environment, provide only one of several sources of evidence for the importance of early environment and experiences. Evidence i s drawn from animal studies of deprivation and environmental manipulations, from new empirical knowledge of the sensory and learning capabilities of the young infant, and from developmental studies of children reared i n differing, noninstitutional environments (e.g. Beckwith, 1976; Bower, 1974; Caldwell, 1970; Tjossem, 1976). The debilitating effects which can occur in an institutional environment are similarly evident in the below average intellectual functioning, poor school achievement, and inadequate l i f e adjustments often witnessed in poorer socioeconomic groups (Miller, 1970). Variously labelled as culturally-disadvantaged, culturally deprived, or psycho-socially deprived; children from these environments 9. show a c h a r a c t e r i s t i c drop i n measured IQ during t h e i r preschool years (Bloom, et a l , 1965; Caldwell, 1970; U z g i r i s , 1970). This stratum of the general population has an unequally high percentage of those i n d i v i d u a l s c l a s s i f i e d as mentally retarded without recognizable organic impairment (Heber & Garber, 1975). Thus, i t i s to t h i s group of c h i l d r e n at r i s k of developmental delay that most preschool intervention programs have been addressed. The success of these programs provides yet another source of evidence for the importance of early environment f o r the o v e r a l l devel-opment of the c h i l d . What are the q u a l i t i e s needed i n an environment to insure not only adequate, but optimal, early experiences f o r the developing child? To date, an exhaustive and d e f i n i t i v e answer cannot be given. There i s , however, general agreement concerning the need for adequate and appropriate sensory stimulation, and for a supportive and s e n s i t i v e human environment. The complexity and enormity of the issues involved require a much greater body of empirical data than i s now a v a i l a b l e , as well as being a topic too extensive to discuss f u l l y here. Because parents play such a c r u c i a l and p i v o t a l r o l e i n the pr o v i s i o n of the kinds of environments t h e i r c h i l d r e n w i l l experience, (and because of the focused concerns of the present study) the following discussion w i l l l i m i t i t s e l f to studies of early home envir-onments, and to various aspects of parenting and infant-caretaker i n t e r -actions which have been t i e d to the c h i l d ' s developmental progress. EARLY HOME ENVIRONMENTS The v a r i a b l e which has most often been used as an ind i c a t o r of devel-10. opmental status i s that of the c h i l d ' s c o g n i t i v e - i n t e l l e c t u a l growth, as measured by standardized 10 and achievement t e s t s . Fraught with d i f f i c u l t -ies of c u l t u r a l bias, test motivation, and verbal weighting as these tests are, they nevertheless provide a measure of a c h i l d ' s standing i n r e l a t i o n to the p r e v a i l i n g I n t e l l e c t u a l and academic achievement norms of the present society. For young infan t s , tests such as the Gesell or C a t t e l l Infant Development Scales have been used. These scales, although accurate at the time of assessment and more unive r s a l and c u l t u r e - f r e e than those used with older chi l d r e n , have been found to be of l i t t l e p r e d i c t i v e u t i l i t y (Beckwith, 1971; McCall, Appelbaum & Hogarty, 1973; U z g i r i s , 1970). Environmental factors measured during infancy have proved to be better predictors of the c h i l d ' s l a t e r IQ and i n t e l l e c t u a l competence (Honzig, 1967; McCall, et. al, 1973; Willerman & Broman, 1970). During the preschool years, as early as the f i r s t year i n some cases (Wachs, U z g i r i s & Hunt, 1972), c h a r a c t e r i s t i c differences i n c h i l d r e n from lower socio-economic groups begin to appear. Socio-economic status, however, as i t i s generally defined by means of parental occupation, income, education, or area of residence (Caldwell, 1970), i s not a unitary, explanatory variable.(Beckwith, 1976; Seltzer, 1973). Rather, there are many differences i n the kinds of environments provided by members of various s o c i a l groups, and i t i s these differences which are most highly r e l a t e d to a c h i l d ' s developmental progress (Beckwith, 1971; Elardo, Bradley & Caldwell, 1975; Gordon, 1976; Moore, 1968; VanDoorninck, __t a l , 1975; Walberg & Marjoribanks, 1973). As one means of measuring the environmental factors t h e o r e t i c a l l y presumed to have d i f f e r e n t i a l e f f e c t s on the c h i l d ' s i n t e l l e c t u a l - c o g n i t i v e growth, Bettye Caldwell and her associates at Syracuse Un i v e r s i t y developed 11. a home assessment procedure called the Inventory of Home Stimulation (STLM) (Caldwell, 1967). Now in i t s fourth revision, and renamed the HOME (Home Observation for Measurement of the Environment), the test is based on a series of observations and interview data obtained from an approximate hour-long v i s i t with a mother and her child. The test yields a total score, plus scores on each of six factored categories of stimulation available to the infant in the home: emotional and verbal responsivity of the mother, avoidance of restriction and punishment, organization of the physical and temporal environment, provision of appropriate play materials, maternal involvement with the child, and opportunities for variety in daily a c t i v i t i e s . (See Table I for the kinds of experiences listed under each category). The HOME has been used in a number of studies by Caldwell and others, and proved successful in demonstrating significant relation-ships between the home environment and the child's developmental progress (e.g. Arlett, 1977; Bradley & Caldwell, 1976-1977; Hamilton, 1972; Wachs, __t a l , 1972). In order to assess differences in home stimulation associated with children at-risk of developmental delay, Ramey and Campbell (1975) studied 60 mother and infant dyads. Thirty were taken from an intervention program aimed at preventing the development of socio-culturally determined retardation, and thirty were drawn from a st r a t i f i e d random sample of the general population. The former was divided into two matched groups: a high-risk experimental group receiving full-time daycare, and a high-risk control group receiving no systematic intervention. By means of a multivariate analysis of variance, groups were found to differ significantly on a l l of the sub-scales of the HOME. The general population group showed significantly 12. TABLE I S u b s c a l e I : E x a m p l e : S u b s c a l e I I : Example : S u b s c a l e I I I : Example : S u b s c a l e I V . Example : S u b s c a l e V . Example S u b s c a l e V I : Example : The HOME I n v e n t o r y E m o t i o n a l and V e r b a l R e s p o n s i v i t y o f M o t h e r M o t h e r s p o n t a n e o u s l y v o c a l i z e s to c h i l d a t l e a s t t w i c e d u r i n g v i s i t , ( e x c l u d e s c o l d i n g ) M o t h e r c a r e s s e s o r k i s s e s c h i l d a t l e a s t once d u r i n g v i s i t . A v o i d a n c e o f R e s t r i c t i o n and Puni shment M o t h e r n e i t h e r s l a p s n o r spanks c h i l d d u r i n g v i s i t . M o t h e r does n o t i n t e r f e r e w i t h c h i l d ' s a c t i o n s o r r e s t r i c t c h i l d ' s movements more t h a n t h r e e t i m e s d u r i n g v i s i t . O r g a n i z a t i o n o f P h y s i c a l and T e m p o r a l E n v i r o n m e n t s Someone t a k e s c h i l d i n t o g r o c e r y s t o r e a t l e a s t once a week. C h i l d ' s p l a y e n v i r o n m e n t a p p e a r s s a f e and f r e e o f h a z a r d s , P r o v i s i o n o f A p p r o p r i a t e P l a y M a t e r i a l s C h i l d has one o r more m u s c l e a c t i v i t y t o y s o r p i e c e s o f e q u i p m e n t . P r o v i d e s t o y s f o r l i t e r a t u r e and m u s i c ( b o o k s , r e c o r d s , t o y m u s i c a l i n s t r u m e n t s ) M a t e r n a l I n v o l v e m e n t w i t h C h i l d : M o t h e r i n v e s t s " m a t u r i n g " t o y s w i t h v a l u e v i a h e r a t t e n t i o n . M o t h e r s t r u c t u r e s c h i l d ' s p l a y p e r i o d s . O p p o r t u n i t i e s f o r V a r i e t y i n D a i l y S t i m u l a t i o n F a t h e r p r o v i d e s some c a r e g i v i n g e v e r y d a y . C h i l d e a t s a t l e a s t one m e a l p e r day w i t h mother and f a t h e r . 13. higher scores on a l l s i x subscales. The h i g h - r i s k experimental group d i f f e r e d s i g n i f i c a n t l y from the h i g h - r i s k controls only i n terms of greater maternal involvement. Age of the c h i l d at time of assessment ranged from 3.5 to 9.5 months, with a mean of 6.8 months. Developmental status of the c h i l d r e n was not included i n the report. An e a r l i e r study by Wachs, U z g i r i s , and Hunt (1972) employing the STIM, also found s u b s t a n t i a l differences i n the kinds of homes experienced by two groups of infants of d i f f e r i n g socio-economic status. The f i r s t group of 51 i n f a n t s , tested at 7, 11, 15, 18, and 22 months of age, was from a slum area of Champaign-Urbana, I l l i n o i s . The second group was a matched sample of infants from middle-class f a m i l i e s i n the nonslum areas of Champaign-Urbana. Infant development was assessed on four scales of the Infant Psychological Development Scale (IPDS), a scale constructed on the basis of Piaget's model of i n t e l l e c t u a l development. These authors reported developmental differences s i g n i f i c a n t l y correlated to d i f f e r e n t home environment variables at a l l age l e v e l s of t e s t i n g , with lower-class infants c o n s i s t e n t l y behind t h e i r middle-class contemporaries. From t h e i r r e s u l t s , Wachs ^ t al_ concluded that two kinds of home circumstances re l a t e d most consi s t e n t l y to the infant's development. One was the i n t e n s i t y and v a r i -ety of stimulation, the second was the opportunity to hear vocal signs for s p e c i f i c objects, actions, and r e l a t i o n s h i p s . High i n t e n s i t y stimulation from which the infant was unable to escape was negatively r e l a t e d to various aspects of development, and was evident at 7 months and c o n s i s t e n t l y there-a f t e r . Variety and opportunity to explore, however, was p o s i t i v e l y related to development. The d i f f e r e n t i a t i n g f a c t o r , therefore, appeared to be the involuntary exposure to a d i f f u s e , loud, and r e l a t i v e l y unstructured 14. environment. For example, two of the scales, which correlated negatively with infant development measures were: T e l e v i s i o n on most of the time when observer there; C h i l d cannot escape noises i n home. Beginning at 15 months, parent's encouragement of verbal i n t e r a c t i o n and use of verbal i n s t r u c t i o n correlated s i g n i f i c a n t l y with the c h i l d ' s development progress. The d i s c r i m i n a t i v e power of the HOME has been investigated more r e -cently by Bradley and Caldwell (1976, 1977). Subjects i n these studies were 77 normal infants taken from a longitud-i n a l intervention study designed to reveal the e f f e c t s of d i f f e r e n t types of environments on infant development. At 6 months of age a HOME assessment was made. These scores were subsequently r e l a t e d to the c h i l d ' s Stanford Binet (S-B) 10 at age 3. The mean vectors of HOME subscale scores were able to s i g n i f i c a n t l y p r e d i ct whether a c h i l d would be low IQ (below 70), low average IQ (70-89), or average to superior IQ (90 or above). The HOME was p a r t i c u l a r l y e f f e c t i v e i n p r e d i c t i n g low IQ (accuracy rate of 71%); les s so f o r the average to superior group (accuracy rate of 62%). Three of the subscales were found to s i g n i f i c a n t l y d i f f e r e n t i a t e among groups: organiza-t i o n of the phys i c a l and temporal environment, p r o v i s i o n of appropriate play materials, and maternal involvement with c h i l d (Bradley & Caldwell, 1977). In a separate analysis (Bradley & Caldwell, 1976), the c h i l d r e n were divided into three groups on the basis of t h e i r mental test patterns between the ages of 6 months and 3 years. Children whose 3-year S-B IQ scores were at l e a s t 21 points higher than t h e i r 6-month Bayley Mental Development Index Score were c l a s s i f i e d as increasers (_,=10); those whose scores were at l e a s t 21 points lower were c a l l e d decreasers (n_=17); and the remaining 50 ch i l d r e n were c l a s s i f i e d as nonchangers. A multiple 15. discriminant analysis revealed that the HOME at 6 months was able to signif-icantly differentiate among these three groups. (A second analysis performed with extreme cases excluded showed an even stronger relation between early home environment scores and changes in mental test performance). Subsequent univariate analyses revealed that increases in test performance were significantly related to the two subscales of maternal involvement with child and provision of appropriate play materials. Decreases in test performance were significantly related to inadequate organization of the physical and temporal environments. Their results, though provocative, cannot be analyzed in terms of a causal relationship; nor can i t be known at what exact point in time the effects of the environment were most operative. Did the home environments of these children remain essentially the same over the 2% year period between testing, and thus perhaps have their major impact at the time of second IQ testing? Or did the early home environments provide a basis for the child which was effective 2% years later, regardless of the environments experienced during that 2^ year interval? The former would seem more likel y , as environmental changes engineered by intervention strategies have successfully changed mental test performances at this early age. If this is true, then children who show large changes in their mental test perform-ance are most lik e l y reflecting not only individual differences, but also the effects of homes either rich or poor in the kinds of early experiences related to optimal child development. It is less l i k e l y that the effects of a good home environment at 6 months would be able to over-ride a poor one during the next lh years. The ab i l i t y of the HOME to better predict poor IQ attainments, also suggests a minimum level of home stimulation 16. below which poor c h i l d development i s almost sure to occur. (Such a f i n d -ing would p a r a l l e l r e s u l t s for i n s t i t u t i o n a l i z e d infants discussed previously.) Wulbert, I n g l i s , Kriegsman & M i l l s (1975) assessed the home environ-ments of three groups of chil d r e n ranging i n age from 2.83 to 5.66 years. The f i r s t was a group of 20 non-organic language delayed c h i l d r e n whose L e i t e r IQ's (a non-verbal test of i n t e l l e c t u a l functioning) were at l e a s t 15 points higher than t h e i r S-B IQ's. The second was a group of matched normal controls, the t h i r d a contrast group of 20 c h i l d r e n with Down's Syndrome. Analyses of variance revealed s i g n i f i c a n t differences between the language-delayed group and the l a t t e r two groups on t o t a l Home scores, and on a l l subscale scores except organization of the physi c a l and temporal environment. The greatest discrepancies occurred on the three subscales which bear d i r e c t l y on mother-child i n t e r a c t i o n : emotional and verbal responsivity of mother, avoidance of punishment, and maternal involvement with c h i l d . The Down's Syndrome group did not d i f f e r s i g n i f i c a n t l y from the normals. The authors found that home environment was p o s i t i v e l y related to the S-B IQ of the c h i l d (r=.76), negatively r e l a t e d to the degree of discrepancy between the L e i t e r IQ and the S-B IQ (r=r51), and not rel a t e d s i g n i f i c a n t l y either to the L e i t e r IQ i t s e l f (r=.13) . In t h e i r discussion, the authors note that the mothers of the language delayed ch i l d r e n had for some time viewed these c h i l d r e n as " d i f f e r e n t " or " d i f f i -c u l t " , though none had previously defined the c h i l d as abnormal. At the time of assessment, therefore, the poor and mutually unpleasurable i n t e r -actions between these mothers and th e i r c h i l d r e n were d e f i n i t e l y r e c i p r o c a l . 17. Results of t h i s study give strong support f o r the importance of the early home environment for a c h i l d showing a developmental delay with no apparent organic base. Home environment,however, l i k e socio-economic status, i s too broad and comprehensive a v a r i a b l e . Here, i t i s the s i g n i f i -cantly infrequent in t e r a c t i o n s p r i m a r i l y of a negative and r e s t r i c t i v e q u a l i t y between mother and c h i l d which bear most strongly on the c h i l d ' s language delay. That a mother's in t e r a c t i o n s with her developmentally delayed c h i l d need not d i f f e r from those of a mother with her normal c h i l d was demonstrated by the p o s i t i v e HOME assessments f o r mothers' Down's Syn-drome ch i l d r e n . The l a t t e r children, however, were both recognizably handicapped and involved i n the Univ e r s i t y of Washington's program at the Chi l d Development and Retardation Centre (extent and nature of t h i s involvement not given). The q u a l i t y of mother-child i n t e r a c t i o n f o r t h i s l a t t e r group, therefore, cannot be generalized to those r e c e i v i n g no intervention or support. Again, the r e s u l t s of Wulbert'et_'al demonstrate the u t i l i t y of the HOME scale and i t s consistent and s i g n i f i c a n t r e l a t i o n s h i p to a c h i l d ' s developmental status; but r a i s e questions as to the time and process of environmental influence. Some l i g h t on th i s issue i s given by a study of the language development of 74 normal chi l d r e n recently reported by Elardo, Bradley & Caldwell (1977). Homes of these c h i l d r e n were assessed at 6 and 24 months of age, and correlated with t h e i r scores on the I l l i n o i s Test of Psy c h o l i n g u i s t i c A b i l i t i e s (ITPA) at 3 years of age. A l l s i x dimensions of the HOME were rel a t e d s i g n i f i c a n t l y to language development at both 6 and 24 months (except for avoidance of r e s t r i c t i o n and punishment, which did not achieve s i g n i f i c a n c e u n t i l 24 months). 18. Relationships were strongest at 24 months; p a r t i c u l a r l y f o r the subscales involving maternal involvement (r=.52 for subscale 1, r=.51 for subscale 4), opportunities f or v a r i e t y (r=.61), and for pr o v i s i o n of appropriate play materials (r=.55). Some i n t e r e s t i n g differences were observed when the data was analyzed separately f or g i r l s and boys. For g i r l s at s i x months, maternal involvement and play materials were s i g n i f i c a n t l y r e l a t e d to 3-year language performance. At 24 months, these two scales were again p o s i t i v e l y correlated with advanced language development, but a l l other scales were s i g n i f i c a n t as w e l l . For boys at s i x months, pr o v i s i o n of appropriate toys, v a r i e t y of d a i l y stimulation, and organization of the physic a l and temporal environments were a l l s i g n i f i c a n t l y r e l a t e d to language development. At 24 months, emotional and verbal r e s p o n s i v i t y of the mother was the factor most strongly t i e d to language performance, though play materials, maternal involvement, and v a r i e t y of d a i l y stimu-l a t i o n were s i g n i f i c a n t as w e l l . These studies i n which the home environment of the young c h i l d from b i r t h to 3 years i s d i r e c t l y assessed and related to the c h i l d " s cognitive development a l l demonstrate a clear pattern of influence. In some instances, t h i s pattern becomes more obvious as the c h i l d grows older. Moore (1968), for example, using a structured home interview format, found that the s i g n i f i c a n t r e l a t i o n s h i p s between the c h i l d ' s early home environment and hi s or her i n t e l l e c t u a l competencies grew stronger as the c h i l d matured. For a sample of 76 London ch i l d r e n , the q u a l i t y of the home environments assessed when the c h i l d was 30 months of age was a better predictor of the c h i l d ' s IQ and verbal competency at 8 years than at 3 years. Honzig (1967), reporting on a group of 124 ch i l d r e n followed i n the Guidance 19. Study at the I n s t i t u t e of Human Development i n Berkely, C a l i f o r n i a , also found that home environment factors measured at 21 months increased i n th e i r p o s i t i v e r e l a t i o n s h i p to the c h i l d ' s IQ as the c h i l d grew older. The pattern of influence demonstrated by these studies reveals at lea s t two important kinds of environmental input: the r e l a t i o n s h i p between the infant and his family, i n a l l of i t s various aspects; and the inanimate environment, as i t i s provided for and organized for the young c h i l d . For c h i l d r e n over three years of age, numerous studies have shown strong and consistent r e l a t i o n s h i p s between the former environmental variables ( i e . various parental factors) and the c h i l d ' s cognitive development (e.g. B i l l e r , 1974; Freeberg & Payne, 1967; McCall, 1973; Walberg & Marjoribanks, 1973). Hess (1969), i n an extensive review of the l i t e r a t u r e , summarized those parental factors which have been found to most consistent-l y r e l a t e to the older c h i l d ' s i n t e l l e c t u a l development and academic achievement. He i s o l a t e d three classes of r e l a t i o n s h i p s found i n the research l i t e r a t u r e : 1) i n t e l l e c t u a l , 2) a f f e c t i v e , and 3) i n t e r a c t i o n patterns. I n t e l l e c t u a l r e l a t i o n s h i p s which were found to r e l a t e to a ch i l d ' s performance were: 1. a demand for high achievement; the parent's tendency to value i n t e l l e c t u a l achievement i n t h e i r children, and to set high standards for them. 2. maximization of verbal i n t e r a c t i o n ; providing opportunities f o r conversation enlarging the c h i l d ' s vocabulary and verbal acuity. 3. engagement with and attentiveness to the c h i l d ; awareness and in t e r e s t i n the c h i l d ' s a c t i v i t i e s . 4. parental teaching behaviour; giving s p e c i f i c d i r e c t i o n s and feed-back, use of language. 5. general i n t e l l e c t u a l stimulation i n the home; arousing c u r i o s i t y , creating learning s i t u a t i o n s i n the home, and providing books and i n t e l l e c t u a l l y stimulating materials. A f f e c t i v e r e l a t i o n s h i p s i n terms of parental warmth, emotional support, 20. acceptance, and high regard for the c h i l d and f o r s e l f were found to be p o s i t i v e l y r e l a t e d to the c h i l d ' s performance. Pressure for independence, and the use of c l e a r , consistent, and r a t i o n a l d i s c i p l i n a r y rules were found to be p o s i t i v e l y s i g n i f i c a n t i n the realm of i n t e r a c t i o n patterns. Although the v a r i a b l e s summarized by Hess (1969) were taken from research which deals p r i m a r i l y with older, school-age c h i l d r e n , they c l e a r l y p a r a l l e l the r e s u l t s found i n the homes of i n f a n t s . There again, v e r b a l l y fluent parents who i n t e r a c t p o s i t i v e l y and frequently with t h e i r young infant s , who provide them with developmentally appropriate toys, and who v e r b a l l y and p h y s i c a l l y provide a s e n s i t i v e and meaningful environmental structure f o r them, have chi l d r e n who w i l l tend to show average or above-average i n t e l l e c t u a l progress. Zigler(1970) and others (e.g. Chilman, 1973; LallyS. Honig, 1975; Yarrow, K l e i n , Lomanaco & Morgan, 1975; Yarrow, 1963), however, o f f e r a needed word of caution and perspective. "We can c e r t a i n l y a l l agree that experience i n t e r a c t s with the c h i l d ' s genetic endowment i n the production of i n t e l l i g e n c e . " ( Z i g l e r , 1970, p. 406) ... however, the ... "notion that we w i l l produce a homogeneous race of geniuses through the program-ming of experiences i s a daydream... The very nature of the gene pool of our population w i l l always guarantee v a r i a b i l i t y i n cognitive development." And further: "We must be just as concerned with the development of p o s i t i v e attitudes and motives as with the development of the i n t e l l e c t . F a i l u r e to appreciate how much a c h i l d ' s values, motives, and general psychological o r i e n t a t i o n determine h i s s o c i a l competence as an adult has led to misunder-standing of what optimal c h i l d development i s a l l about and to i n t e r a c t i n g with the c h i l d i n an erroneous fashion." ( Z i g l e r , 1970,p. 408). Indeed, some have suggested that the 21. p o s i t i v e r e s u l t s of many early intervention programs stem more from these l a t t e r f a c t ors than from a program's more d i r e c t l y targeted i n t e l l e c t u a l and cognitive achievements (Williams, 1977) . These l a t t e r aspects of the c h i l d ' s developmental progress are also the ones perhaps most strongly t i e d to the human environment to which the infant and young c h i l d i s exposed. (Stayton, Hogan & Ainsworth, 1971; Yarrow & Goodwin, 1965; Z i g l e r , 1970). Although l e s s easy to define and measure than cognitive achievements on standardized t e s t s , some attempts have been made to assess and r e l a t e the infant and young c h i l d ' s emotional, s o c i a l , and motivational development to his. or her early home environment. Ainsworth and her colleagues have investigated the attachment devel-oped between a mother and her in f a n t , and r e l a t e d t h i s f a c t o r to the c h i l d ' s o v e r a l l development. Yarrow and h i s co-workers have looked at various environmental factors and linked these to the c h i l d ' s developmental pro-gress. Others, such as White and Watts (1973) and Clarke-Stewart (1973), have focused on competency behaviours i n the infant and young c h i l d , and then looked to t h e i r home environments i n hopes of f i n d i n g a pattern to d i s t i n g u i s h between homes producing competent and incompetent c h i l d r e n . Their r e s u l t s , converging from these various research perspectives, sub-s t a n t i a t e the pervasive e f f e c t s of early environmental experiences on the c h i l d ' s development i n a l l of i t s various modalities. However, as Clarke-Stewart (1973) has pointed out, not a l l measures of the environment are s i g n i f i c a n t l y related to the c h i l d ' s development, nor do a l l have l a s t i n g i nfluence. Such s u p e r f i c i a l caretaking practices as v a r i a t i o n s i n feeding procedures, (without concomitant measures of the s i g n i f i c a n t confounding c h a r a c t e r i s t i c s of the mother-child r e l a t i o n s h i p ) , have not demonstrated 22. consistent or long-term r e l a t i o n s h i p s to infant development.(Clarke-Stewart, 1973). There i s a r i s k , therefore, of missing some important environmental influences which are perhaps l e s s obvious and observable i n nature, while overestimating the importance of some more d i r e c t l y observable environmental patterns. B e l l and Ainsworth (1972), for example, i n a comprehensive and en-li g h t e n i n g study, chose to measure infant crying and maternal responsive-ness for 26 white middle-class, infant-mother p a i r s . During the f i r s t year of the c h i l d ' s l i f e , n a t u r a l i s t i c observations were made i n the c h i l d ' s home for approximately 4 hours, t y p i c a l l y at 3-week i n t e r v a l s . I n i t i a l i n d i v i d u a l differences i n i n f a n t s ' crying did not p e r s i s t beyond the f i r s t 6 months. Instead, i n d i v i d u a l differences s t a b i l i z e d during the 7 to 12-month period, i n s i g n i f i c a n t r e l a t i o n s h i p to maternal responsiveness during the previous 6 months. In other words, mothers who did not respond quickly to t h e i r infant's crying during the f i r s t 6 months had infants who c r i e d more often during the next 6 months. Contrary to what might have been expected from a s t r i c t reinforcement-theory framework, swift and continuous response to the baby's crying during i t s f i r s t months did not lead to increased crying, but to i t s decrease. In t h e i r discussion, B e l l and Ainsworth describe the differences i n mother-child in t e r a c t i o n s and t h e i r e f f e c t s which they observed i n t h i s , and previous studies: "...our analysis of mother-infant i n t e r a c t i o n i n the f i r s t year confirm the conclusion that maternal responsiveness promotes desireable behaviour rather than " s p o i l i n g " a c h i l d . Infants whose mothers have given them r e l a t i v e l y much tender and a f f e c t i o n -ate holding i n the e a r l i e s t months of l i f e are content with sur-p r i s i n g l y l i t t l e p h y s i c a l contact by the end of the f i r s t year; although they enjoy being held, when put down they are happy to move o f f into i n d i v i d u a l exploratory play. In contrast, those held for r e l a t i v e l y b r i e f periods during the early months tend to be 23. ambivalent about contact by the end of the f i r s t year; they did not respond p o s i t i v e l y when held, but yet protest when put down and do not turn r e a d i l y to independent a c t i v i t y . . . . those infants i n our sample who are fussy, demanding, and d i f f i c u l t to control are those whose mothers have been unresponsive to signals and generally i n s e n s i t i v e or i n t e r f e r i n g i n t h e i r e f f o r t s to mold th e i r babies to the i r routines, wishes, and expectations." (p. 1187) B e l l and Ainsworth found that mothers were r e l a t i v e l y consistent i n t h e i r responsiveness to the i n f a n t s ' crying u n t i l the l a t t e r months of the c h i l d ' s f i r s t year, when those mothers with babies who c r i e d a great deal tended to delay even more i n responding to the infant's cry. Why did some mothers delay i n responding to th e i r infant? In some cases, mothers were " d e l i b e r a t e l y unresponsive", following a b e l i e f that to respond to the baby's crying would make him "demanding, dependent, and s p o i l e d " . Unfortu-nately, t h i s aspect of the mother's b e l i e f s and values was not i n v e s t i -gated further. Results indicate, however, that the major r e s p o n s i b i l i t y f o r the infant's pattern of crying, and i t s influence on the beginnings of the c h i l d ' s communication system and sense of environmental mastery, lay mainly with the mother and her pattern of response. Yarrow and h i s colleagues have looked at mother-child i n t e r a c t i o n patterns including both the animate and inanimate aspects of the infant's environment. The inanimate environment, measured i n terms of v a r i e t y , responsiveness, and complexity, r e l a t e s s i g n i f i c a n t l y to various aspects of the infant's cognitive-motivational development at 6 months, but seems l a r g e l y independent of measures of the s o c i a l environment, . The animate or s o c i a l environment, measured i n terms of l e v e l , v a r i e t y , p o s i t i v e affect,, and contingent maternal responses to v o c a l i z a t i o n and d i s t r e s s , i s also found to r e l a t e to various cognitive-motivational f a c t o r s . These factors include the infant's goal-directed a c t i v i t i e s and manipulation of 24. novel objects, as well as the infant's s o c i a l responsiveness and use of language. (Yarrow, 1963; Yarrow, et a l , 1972; 1975). Yarrow and Goodwin (1965) report that, i n terms of maternal care v a r i a b l e s , the infant's developmental progress as i t r e l a t e s to IQ at 6 months i s most highly correlated with the mother's stimulation of the c h i l d outside of the c h i l d ' s routine care. Mother's f e e l i n g s and a t t i t u d e s are highly r e l a t e d to other character-i s t i c s of the i n f a n t , such as h i s or her a b i l i t y to cope with s t r e s s . Stern & Caldwell (1969) factor analyzed t h e i r ratings of mother's p e r s o n a l i -ty, mother's behaviour, c h i l d ' s personality, c h i l d ' s behaviour, and c h i l d ' s mental, and motor development f o r a sample of 30 mother-infant p a i r s . They found nine factors which they believed were suggestive of a c h i l d - t o -mother-centred maternal functioning continuum which rel a t e d s i g n i f i c a n t l y to the infant's development and personality s t y l e . S i m i l a r l y , Clarke-Stewart (1973) found one complex factor which subsumed a l l measures of "optimal" maternal care: expression of a f f e c t i o n , s o c i a l stimulation, con-tingent responsiveness, acceptance of the c h i l d ' s behaviour, stimulation and effectiveness with materials, and appropriateness of maternal behaviour for the c h i l d ' s age and a b i l i t y . In her sample of 36 mothers and t h e i r f i r s t - b o r n c h i l d r e n followed over a 9-month period from 9 to 18 months, highly s i g n i f i c a n t l i n e a r r e l a t i o n s h i p s were found between measures of the c h i l d ' s competence and the j u s t mentioned aspects of maternal care. S p e c i f i c r e l a t i o n s were found between the infant's language development and the mother's .verbal stimulation, between the c h i l d ' s s k i l l with objects and the mother's presentation of play materials, and between mother and c h i l d ' s p o s i t i v e s o c i a l behaviour towards each other. 25. White and Watts (1973) began i n 1970 to investigate those environmen-t a l experiences which would best prepare a young c h i l d f o r formal education at age s i x . Not t i e d to cognitive development ex c l u s i v e l y , however, these authors developed l i s t s of tasks and behaviours which would characterize a competent c h i l d at various ages. Then, based on the competency ratings of an older s i b l i n g , 31 c h i l d r e n and parent dyads were observed i n t h e i r homes during the c h i l d ' s 12th to 15th months, or 24th to 27th months. Children, whose older s i b l i n g s scored high on the competency scales and who were as a r e s u l t expected to come from optimal home environments, did i n f a c t receive more attention from t h e i r mothers than did chi l d r e n , whose older s i b l i n g s scored low on the competency scales. Mothers of the former chil d r e n , (designated "A"), engaged t h e i r infants s i g n i f i c a n t l y more often i n i n t e l l e c t u a l a c t i v i t i e s , taught, encouraged, and i n i t i a t e d a c t i v i t i e s f o r them more often, played with them more often i n a s o c i a l context, and d i f f e r e d i n t h e i r s t y l e s of c o n t r o l l i n g t h e i r c h i l d ' s behaviour s i g n i f i -cantly at the 24 to 27 month l e v e l . When the c h i l d reached 2 years of age, these mothers encouraged over three times as many a c t i v i t i e s as they d i s -couraged. Mothers of the l a t t e r c h i l d r e n , designated "C", now discouraged twice as many a c t i v i t i e s as they had previously. White and Watts, on the basis of t h e i r r e s u l t s , stress the c r i t i c a l importance of the 10 to 18 month age range for the development of the c h i l d ' s general competence. Two very s i g n i f i c a n t developments occur at t h i s time. F i r s t , the c h i l d becomes mo t o r i c a l l y independent. Secondly, he or she has a growing sense of s e l f and the use of language. Parents, there-fore, must make at l e a s t three major sets of choices i n regard to c h i l d -rearing practices during t h i s period. One i s how to deal with the c h i l d ' s 26. locomobility and i t s resulting problems of self-injury, destructiveness, intrusion and clutter; another is to either pattern or ignore the child's acquisition and use of language; and third, how to deal with the two-year-old's characteristic negativism and stubbornness. As these responsibili-ties usually rest with the mother in our society, White and Watts discuss some of the factors which they believe have a major influence on her child-rearing practices and decisions. The f i r s t concerns her attitudes and values as they relate to l i f e in general, young children, beliefs concern-ing the formative role of the one to three year age range, possessions, housekeeping and safety.. The second relates to her resources, both mate-r i a l and psychological. Measurement of these factors, however, was not attempted. Although their sample size was small, and analyses for the children incomplete, White and Watts did observe differences in behavioural style and developmental progress between A' and "Yjv children. 'A' children were clear-ly ahead of their 'cl counterparts in general intellectual and language development; and showed a consistent, though less significant, trend to increased social mastery and desire to imitate adult role models. There seems l i t t l e doubt that the mother, in her usual role as de-signer and organizer of the child's daily environment, and embodied in herself as a person in her interaction with the child, has a profound effect on her child's developmental progress. A mother who is sensitive to her child's needs, who responds quickly and graciously to them, who supplies the child with appropriate toys and opportunities to learn, and who provides the child with a warm and accepting human relationships 27. comes close to achieving an optimal home environment insofar as research and c l i n i c a l experience shows to date. A poor environment, on the other hand, i s one i n which the infant's needs are met r e l a t i v e l y infrequently and i n c o n s i s t e n t l y , where the physical environment i s ei t h e r grossly de-f i c i e n t i n sensory stimulation or excessive i n an undi f f e r e n t i a t e d and inescapable manner, and one i n which i n t e r a c t i o n s with parents or care-givers are pr i m a r i l y negative or passively neutral i n the development of a unique and dependable r e l a t i o n s h i p . Bronfenbrenner argues that one of the c l e a r e s t and strongest findings i n developmental psychology i s that "...a warm, predictable r e l a t i o n s h i p (between caregiver and c h i l d ) within which there i s an increasingly complex seri e s of r e c i p r o c a l and contingent i n t e r a c t i o n s i s associated with excellence of childhood development." (cited, i n Dokecki, p. 69). As i t i s the mother i n our society who t y p i c a l -l y c a r r i e s the greater r e s p o n s i b i l i t y for caring for the young c h i l d each day, paternal factors have les s often been assessed and t i e d to early devel-opmental progress. Father-oriented research reviewed by B i l l e r (1974), however, demonstrates that fathers also have a potent e f f e c t on the devel-opment of t h e i r c h i l d . Longitudinal studies by such workers as Block (1971) suggest that father's p e r s o n a l i t i e s , t h e i r sense of personal r e s p o n s i b i l i t y for t h e i r c h i l d r e n , and t h e i r r e l a t i o n s h i p s with t h e i r wives are i n general at l e a s t equally as important as that of the corresponding q u a l i t i e s i n mothers. Research i n t o the impact of various paternal factors i s an area of much needed i n v e s t i g a t i o n . There i s also a lack of research i n v e s t i g a t i n g parental factors which d i r e c t l y bear on the pro v i s i o n of an optimal home environment f o r a c h i l d . Parental b e l i e f s , a t t i t u d e s , and values are frequently mentioned as impor-28. tant f a c t o r s , but r a r e l y assessed (e.g. Sears, Maccoby & Levin, 1957; Smart & Smart, 1973; White & Watts, 1973). Tulkin and Kagan (1972), f o r instance, i n a study of mother-child i n t e r a c t i o n patterns of middle and working-class mothers and t h e i r 10-month old daughters, found that the major differences i n maternal stimulation of cognitive development were linked to differences i n mothers' b e l i e f s . Working-class mothers often f e l t that i t was " s i l l y " to i n t e r a c t with t h e i r young infan t s , e s p e c i a l l y when they were unable to t a l k . Many also f e l t that they had l i t t l e or no impact on the c h i l d ' s development i n any case. Tulkin and Kagan con-cluded that.one of the goals of an early intervention program should be to help the parents r e a l i z e the influence they do have on t h e i r c h i l d ' s devel-opment, and to understand the consequences to the c h i l d of various types of environmental experiences. DeLissovoy (1973), i n studying a group of adolescent parents, found that these parents had an extremely poor knowledge base of the normal sequences of c h i l d development -a factor which would d i r e c t l y bear on a parent's a b i l i t y to be s e n s i t i v e to a c h i l d ' s needs or to provide appropriate toys and learning opportunities f o r them. Emmerich (1969).studied components of parents' values, at t i t u d e s and b e l i e f s con-cerning the behaviours they wished to see i n t h e i r c h i l d r e n , how they believed these could.best be molded, and the extent to which they believed t h e i r c h i l d had achieved these behaviours. He found that parents, admit-tedly from a well-educated population, were i n d i v i d u a l l y consistent i n t h e i r a t t i t u d e s and values, and as a group showed some general trends towards the kinds of behaviours and c h i l d - r e a r i n g techniques they believed were most e f f e c t i v e . Though Emmerich demonstrated the existence of a cognitive mediational and fu n c t i o n a l framework f or t h i s group of parents, no behav-29. i o u r a l c o rrelates of the home environments were obtained. That parents' unstated values can and do have a s i g n i f i c a n t e f f e c t on t h e i r c h i l d ' s be-haviour has been demonstrated by such researchers as Olejnik and McKinney (1973) and Jessor and Jessor (1974). In the former study, 78 four-year-olds were given the opportunity to anonymously donate some of t h e i r candy to poor c h i l d r e n . The giving behaviour of these c h i l d r e n was s i g n i f i c a n t l y r e l a t e d to t h e i r parents' value orie n t a t i o n s , and not to any s p e c i f i c means of d i s c i p l i n e or reward/punishment practices used. In the l a t t e r study, Jessor and Jessor found that adolescent g i r l s ' problem behaviours were s i g n i f i c a n t l y related to t h e i r mother's i d e o l o g i c a l b e l i e f s . Siegelman, Block, Block, & Lippe (197.0) i n t h e i r l o n g i t u d i n a l study of 171 adults followed from early childhood, found that greater psychological adjustment i n t h e i r subjects was related to having parents whose value o r i e n t a t i o n s were towards personal r e s p o n s i b i l i t y , moral i d e a l s , and "the higher c u l t u r a l values", (p. 287) PARENTAL ATTITUDES Parents' a t t i t u d e s towards p a r t i c u l a r c h i l d - r e a r i n g p ractices have, unlike t h e i r b e l i e f s and values, generated a s u b s t a n t i a l amount of research i n t e r e s t , much of which has been inconclusive or contradictory. Becker and Krug (1965), i n t h e i r review of studies using the Parental Research Instrument (the PARI, developed by Schaefer (Schaefer & B e l l , 1958) and one of the scales used most frequently i n research involving parents' attitudes) concluded that the r e s u l t s are f o r the most part ambiguous, and infrequently t i e d to s p e c i f i c behavioural c o r r e l a t e s . Parental attitudes 30. have generally been measured along two dimensions, that of the s t y l e of d i s c i p l i n e generally accepted, and that of parental warmth or r e j e c t i o n . Variously referred to as autonomy/control or a u t h o r i t a r i a n c o n t r o l , and as h o s t i l i t y / l o v e or acceptance/rejection (Cook, 1963); these two orthogonal f a c t o r s , often displayed i n a four-quadrant plane, have been con s i s t e n t l y i d e n t i f i e d by the paper and p e n c i l measures used to measure parents' a t t i t u d e s . ( R i e c i , .1970; Schaefer, 1975). High scores on the a u t h o r i t a r i a n control factor represent a parental o r i e n t a t i o n towards strong obedience and conformity expected by the parent on the part of the c h i l d . Strong at t i t u d e s along t h i s dimension have been found to have various negative e f f e c t s on the c h i l d ' s developing i n t e r -a ction patterns with peers, and on those with people i n authority (Becker, 1964; Baumrind, 1970; Johnson & Medinnus, 1965). High parental r e j e c t i o n scores have been found to c o r r e l a t e with children's lower i n t e l l e c t u a l achievements (Bromwich, 1970; Hurley, 1965), and with disturbed s o c i a l -motivational development . ( Z i g l e r , 1970). Z i g l e r and Brodey (1969) found that poor task o r i e n t a t i o n and i n e f f i c i e n t attention-seeking behaviours often occurred i n c h i l d r e n receiving l i t t l e warmth and p o s i t i v e support from t h e i r mothers. The r e l a t i o n s h i p between r e j e c t i n g parental attitudes and resultant adolescent aggression and delinquency has been well documented. (Baumrind, 1970; Johnson & Medinnus, 1965; Schaefer, 1972^1975;). Schaefer argues that f or mothers i n p a r t i c u l a r , parental warmth and acceptance have the most stable, consistent, and pervasive e f f e c t s on the long-term develop-ment of children's behaviours. (Schaefer, 1975; p. 146). In an e f f o r t to t i e parental at t i t u d e s more c l o s e l y to the develop-31. mental sequences and tasks required of the parent during the c h i l d ' s early years, and i n order to assess more than the two factors discussed above, Cohler and h i s colleagues (1970) developed the Maternal A t t i t u d e Scale. The attitudes measured by t h i s scale r e f l e c t f i v e c h i l d - r e a r i n g issues which must be negotiated between mother and c h i l d during the c h i l d ' s f i r s t f i v e years of l i f e . In a study of 30 middle-class and 26 working-class mothers and t h e i r 10-month old daughters, Tulkin and Cohler (1971) found several s i g n i f i c a n t - r e l a t i o n s h i p s between mothers' stated a t t i t u d e s and t h e i r observed behaviours at home with t h e i r i n f a n t s . Differences i n attitudes between middle and working-class mothers were also observed. Attitudes r e f l e c t i n g encouragement of r e c i p r o c i t y yielded the most s i g n i f i -cant and consistent r e l a t i o n s h i p s with maternal behaviour, and were held more frequently by middle-class mothers than by working-class mothers. Mothers scoring high on t h i s scale spent more time i n verbal and nonverbal i n t e r a c t i o n with t h e i r i n f a n t s , kept them les s often i n playpens, held and gave them objects more often, and tended to remain i n closer proximity to them. Attitudes toward appropriate c o n t r o l were r e l a t e d to the number of p r o h i b i t i o n s used, both verbal and p h y s i c a l . A sense of being able to understand and meet the i n f a n t s ' needs was linked to a f f e c t i o n a t e p h y s i c a l contact, play and p r o v i s i o n of toys, and was negatively r e l a t e d to the number of p r o h i b i t i o n s used and the time an infant spent i n her playpen. Tu l k i n and Cohler a t t r i b u t e the strength of the r e l a t i o n s h i p s they obtained to the appropriateness of the scale attitudes towards the issues mothers were currently facing. The subscale providing the most s i g n i f i -cant c o r r e l a t i o n s , encouragement of r e c i p r o c i t y , i s one t y p i c a l l y not assessed by most a t t i t u d e measures. Their r e s u l t s demonstrate that mothers 32. who are s e n s i t i v e and responsive to children's needs and behaviours, and who provide them with opportunities to learn and develop, are those who believe i n the c h i l d ' s a b i l i t y and need to communicate with and i n t e r a c t with the environment. These mothers are also ones who are confident i n t h e i r own a b i l i t y to understand and meet t h e i r infant's needs. Attitudes towards c h i l d - r e a r i n g i n the case of a developmentally delayed c h i l d have r a r e l y been investigated using scales other than those r e f l e c t i n g the t r a d i t i o n a l d i s c i p l i n a r y and acceptance/rejection o r i e n -tations; nor have they been investigated during the time of early infancy. R i c c i (1970) i n a study using the PARI with 60 mothers of retarded, emo-t i o n a l l y disturbed, and normal c h i l d r e n between the ages of 4 and 10, found several s i g n i f i c a n t differences between these three groups. Mothers of normal c h i l d r e n scored s i g n i f i c a n t l y higher than the other mothers on the dimension of a u t h o r i t a r i a n c o n t r o l , with the mothers of emotionally disturbed c h i l d r e n scoring the lowest. On the acceptance/rejection dimen-sion, mothers of retarded c h i l d r e n showed the most r e j e c t i n g a t t i t u d e s when instructed to think of t h e i r retarded c h i l d . Mothers of normal c h i l d r e n showed the l e a s t r e j e c t i n g a t t i t u d e s . No differences were obtained along t h i s dimension when mothers were requested to think of a l l t h e i r c h i l d r e n . An e a r l i e r study by Cook (1963) using the PARI with 178 mothers of b l i n d , deaf, mongoloid (Down's Syndrome), cerebral p a l s i e d , and o r g a n i c a l l y impaired c h i l d r e n (ages of 4 to 10), found no s i g n i f i c a n t differences among the groups along the warmth/hostility dimension, but several d i f f e r -ences for autonomy/control. Mothers of b l i n d c h i l d r e n tended to be over-protective; mothers of deaf and o r g a n i c a l l y impaired ch i l d r e n overindulgent{ and mothers of cerebral palsied and mongoloid c h i l d r e n tended to be 33. punitive i n t h e i r d i s c i p l i n a r y a t t i t u d e s . No contrast group of mothers of normal children.was included i n t h i s study, but the author found an i n t e r -esting across-group v a r i a t i o n . Children who were rated "mild" by the a t -tending physician had mothers whose attitudes tended to be r e j e c t i n g ; c h i l d r e n rated "severe" had mothers who tended to score high on overprotec-t i o n . Cummings, Bayley & Rie (1966) i n a study whose main objective was to assess the e f f e c t s of a d e f i c i e n t c h i l d on the mother( nevertheless^included three child-care a t t i t u d e scales measuring dimensions of possessiveness, dominating, and ignoring. No s i g n i f i c a n t differences among the 240 mothers of mentally retarded, c h r o n i c a l l y p h y s i c a l l y i l l , neurotic, and healthy c h i l d r e n (aged 4 to 13) were found. Mothers of retarded c h i l d r e n showed a s l i g h t tendency towards greater possessiveness and r e j e c t i o n on these scales. I t has been suggested that the general public's a t t i t u d e s towards de-f i c i e n c y has an e f f e c t on parents' perception and attitudes towards t h e i r d e f i c i e n t c h i l d . Nonspecific a t t i t u d e surveys toward handicapped c h i l d r e n have, however, produced inconsistent r e s u l t s of l i t t l e p r a c t i c a l u t i l i t y (Love, 1970). Often, surveys have been administered to college students or those, working i n a re l a t e d c l i n i c a l f i e l d , with the general f i n d i n g that these groups prefer working with normal or superior c h i l d r e n (Love, 1970). Surveys of the general population reveal a lack of knowledge and misunder-standing of most handicapping conditions, though t h i s lack i s evident among parents of exceptional c h i l d r e n as w e l l . In a group of.75 undergraduate education majors and i n a random sample of 430 adults i n the greater Boston area, g o t t l i e b and h i s colleagues 34. found s i g n i f i c a n t differences i n attitudes depending on the severity of the handicap (Gottlieb & Sipperstein, 1976); and on the age, education, sex, and contact with a retarded person experienced by the attitudee (Gottlieb & Corman, 1975),. Factor analysis of the attitudes expressed by the com-munity revealed four s i g n i f i c a n t f a c t o r s ; one, a p o s i t i v e stereotype r e -f l e c t i n g a general acceptance of the mentally retarded c h i l d i n the com-munity., two, segregation i n the' community; three, segregation i n the c l a s s -room; and four, perceived ph y s i c a l and i n t e l l e c t u a l handicap, r e f l e c t i n g a ttitudes that mentally retarded ch i l d r e n always look d i f f e r e n t and are i n f e r i o r to other c h i l d r e n . I t seems l o g i c a l to expect at l e a s t a mini-mal r e l a t i o n s h i p between parents' at t i t u d e s towards t h e i r d e f i c i e n t c h i l d and that of the p r e v a i l i n g c u l t u r a l framework; however, t h i s r e l a t i o n s h i p has yet to be demonstrated. CHILD CHARACTERISTICS Major emphasis i n the present review has u n t i l t h i s point been given to parents and the r o l e they play i n providing environmental experiences f o r t h e i r c h i l d . Before looking at the remaining research as i t r e l a t e s to parents of developmentally delayed c h i l d r e n i n p a r t i c u l a r , therefore, c h a r a c t e r i s t i c s of the c h i l d r e n themselves require consideration. Children are major contributors to t h e i r own early experiences, as i n i t i a t o r s and as reactors to early environmental stimulation (Beckwith, 1976; Bromwich, 1977; Westman, 1973). Moss and Robson (1968), for instance, have observed that 1-month-old infants i n i t i a t e d approximately four out of f i v e i n t e r a c t i o n s with t h e i r mothers. B e l l (1974) argues that i t i s the 35. infant, through h i s di s c r i m i n a t i v e crying, looking, and smiling who f a c i l i -tates and maintains, i n t e r a c t i o n s . Or, as Rheingold (1969) has stated, the baby more powerfully s o c i a l i z e s the adult into parenthood than the parent s o c i a l i z e s the i n f a n t . Recent studies with neonates and very young infants have revealed s i g n i f i c a n t i n d i v i d u a l differences which are evident from the f i r s t weeks of l i f e . Infants d i f f e r i n frequency and length of spontaneous crying (Korner, 1973;. B e l l & Ainsworth, 1972), i n s o o t h a b i l i t y , i n duration of wakefulness and sleep, i n sensory response thresholds (Korner, 1973), and i n t h e i r desire for and response to cuddling. (Schaefer & Emerson, 1964; Korner, 1973). These differences would c l e a r l y a f f e c t the frequency and kinds of stimulation and i n t e r a c t i o n s experienced by these i n f a n t s . They would also influence parents' f e e l i n g s of competency, oneness, and enjoy-ment of t h e i r young c h i l d . Another major dimension of i n d i v i d u a l d i f f e r -ences stems from the l o n g i t u d i n a l studies of Thomas, Chess and Birch (1963). Based on home observations, parent interviews, and standard test-play sessions these authors i d e n t i f i e d nine categories of behavioural functioning which, r e l a t e d to the i n d i v i d u a l temperament s t y l e s of the 136 c h i l d r e n i n -cluded i n t h e i r sample population. During the f i r s t two years of l i f e , c h i ldren remained r e l a t i v e l y consistent i n t h e i r c h a r a c t e r i s t i c tempera-mental s t y l e s of response (Chess & Thomas, 1973). In succeeding years, however, temperament scores became i n c r e a s i n g l y modified by environment i n t e r a c t i o n s . Clusters of temperamental a t t r i b u t e s tended to occur f r e -quently i n c e r t a i n combinations, p a r t i c u l a r l y three: the "easy c h i l d " , the " d i f f i c u l t c h i l d " , and the "slow-to-warm-up c h i l d " . The easy c h i l d was one characterized by r e g u l a r i t y of b i o l o g i c a l functions, p o s i t i v e approach 36. responses to new s t i m u l i , easy a d a p t a b i l i t y to change, preponderance of po s i t i v e mood, and reactions of mild to moderate i n t e n s i t y . In contrast, the d i f f i c u l t c h i l d showed i r r e g u l a r i t y i n b i o l o g i c a l functions, predomin-at e l y negative, withdrawal responses to new s t i m u l i , slow a d a p t a b i l i t y to change, frequent negative mood, and responses of high i n t e n s i t y . In the infant years, i t i s obviously the d i f f i c u l t c h i l d who has the most poten-t i a l for less than optimal environmental experience, and as emphasized by Chess and Thomas: "...the environmental handling i s . c r u c i a l i n determining whether they ( d i f f i c u l t children) are enabled to move, episode by episode, toward adaptive as opposed to maladaptive i n t e r a c t i o n s " (p. 88), Tempera-ment s t y l e , parental functioning, and/or other environmental influences alone,could not predict the future adjustments and behaviour of these c h i l d r e n . Rather, i t was the nature of the temperament-environment-i n t e r a c t i o n a l process which was necessary f o r successful p r e d i c t i o n . Escalona and Heider (1959) report s i m i l a r findings i n t h e i r studies of infants and f a m i l i e s . Although predictions of i n d i v i d u a l behaviour c h a r a c t e r i s t i c s made from infancy to the l a t e preschool years were for most c h i l d r e n unsuccessful; a minority of ch i l d r e n were found to be s e l f -consistent. These c h i l d r e n a l l shared a common fac t o r of developmental de-: v i a t i o n or outright maladjustment. Escalona (1973) suggests that many i n -fant c h a r a c t e r i s t i c s of mobili t y , expressive behaviour, response to sensory s t i m u l i , and the l i k e , d i s s o l v e during the course of normal development, as early schemas and adaptive patterns break up to permit new behaviour i n t e -grations. When development and adaptation proceed s t r e s s f u l l y and not en-t i r e l y s u c c e s s f u l l y , however, c e r t a i n early patterns are more l i k e l y to remain i n t a c t and to be present unaltered at l a t e r ages. Predictions made for i n d i v i d u a l infants with respect to early t h e o r e t i c a l l y predisposing factors were more successful. An i n f a n t , f o r instance, who demonstrated a high a c t i v i t y l e v e l was predicted to show a superior l e v e l of gross motor coordination to that of h i s f i n e motor coordination. 86% of these predictions were borne out by the data, none showed the opposite trend. A high score on gross motor coordination, however, did not indicate a poor score on f i n e motor coordination. Predictions were l i m i t e d to the r e l a t i v e strengths of c e r t a i n a b i l i t i e s i n a c h i l d without reference to his or her peers. Results reported by Chess and Thomas and Escalona are supported by those of Graham, Rotter and George (1973) and.by.those of B e l l and Ains-worth (1972) discussed e a r l i e r . In the l a t t e r study, infant crying beha-viour was i n d i v i d u a l l y unique and r e l a t i v e l y consistent over the f i r s t s i x months of l i f e . During the next s i x months, however, these i n d i v i d u a l patterns changed according to the maternal responses these infants had experienced during t h e i r f i r s t s i x months, as well as i n r e l a t i o n to the ongoing influence of t h e i r mother's in t e r a c t i o n s with them. Ind i v i d u a l differences i n infancy, therefore, seem to provide developmental p o t e n t i a l s which then i n t e r a c t with the human and p h y s i c a l environments. I f those environments and the experiences flowing from them are negative and i n -s e n s i t i v e to the i n d i v i d u a l q u a l i t i e s , needs, and response patterns of a p a r t i c u l a r c h i l d , then the c h i l d i s at r i s k to show c h a r a c t e r i s t i c s of developmental delay or maladjustment, and be more "predictable" from h i s early i n f a n t i l e c h a r a c t e r i s t i c s . I f the i n d i v i d u a l c h a r a c t e r i s t i c s of the i n f a n t s are themselves apt to pose d i f f i c u l t i e s and produce negative reactions i n t h e i r parents, then the c h i l d i s at greater than average r i s k 38. to have a c o n f l i c t i n g and d e b i l i t a t i n g early l i f e experience. The developmentally delayed infant, f or whatever cause, f a l l s unfor-tunately within that category of a t - r i s k i n f a n t s . These infants are often c h a r a c t e r i s t i c a l l y " d i f f i c u l t " . (Bromwich, 1977; Thomas, Chess, & Birch, 1963). B l i n d , deaf, a u t i s t i c , or o r g a n i c a l l y impaired c h i l d r e n a l l tend to e x h i b it temperamental c h a r a c t e r i s t i c s which can lead to unsatisfactory and adverse r e l a t i o n s h i p s with the p h y s i c a l and s o c i a l environments. ( L e v i t t & Cohen, 1977). Down^s Syndrome ch i l d r e n are t y p i c a l l y very hypotonic and floppy, so that the baby " f e e l s wrong" and i s d i f f i c u l t to handle and support (Hughes, 1971; Brenylsson, 1977). Seriously impaired infants tend to place fewer s o c i a l l y i n t e r a c t i v e demands on t h e i r parents, and at the same time provide parents with very l i t t l e p o s i t i v e feedback ( B r a s s e l l , 1977). Delay i n the development of such important milestones as smiling (Schmitt & Erickson, 1973; Bromwich, 1976) can have a retarding e f f e c t on the par-ents' f e e l i n g s of a f f e c t i o n and ownership. Research by Robson and Moss (1970) has shown, for instance, that mothers tend to follow a common pat-tern of attachment towards t h e i r i n f a n t s . Mothers report that t h e i r r e a l f e e l i n g s of love and attachment come with t h e i r c h i l d ' s smiling, eye gazing, and other s o c i a l l y i d e n t i f i a b l e behaviours. Not only are these developmentally delayed c h i l d r e n at r i s k due to the foregoing f a c t o r s , but to t h e i r inherent need for more s p e c i f i c and often intensive kinds of environmental stimulation as w e l l . (Hughes, 1971; Moss & Mayer, 1975).. As.their development i s subject to the same general developmental p r i n c i p l e s which apply to normal c h i l d r e n , lack of appropri-ate early stimulation can lead to problems of cumulative i n t e l l e c t u a l d e f i -c i t s ( L e v i t t & Cohen, 1977) . These c h i l d r e n are le s s l i k e l y , without 39. intervention, to receive sufficient and meaningful environmental interaction in order to lay important baseline sensori-motor and cognitive-conceptual frameworks (Willerman & Broman, 1970). Without these primary functionings, later developmental s k i l l s may be impaired or missed altogether. A lack of satisfying, environmental mastery kinds of experiences, hampered and accentuated by an observed tendency towards a low level of int r i n s i c moti-vation (Levitt & Cohen, 1977), adds to an already large risk for decreased competency in these developmentally delayed infants. PARENTAL RESPONSES TO DEVELOPMENTALLY DELAYED INFANTS In addition to the potentially debilitating factors which stem from the infant's actual characteristics and behaviours, are those which arise from the parent's own responses to having created a handicapped or "abnor-mal" child. As much as any child, developmentally delayed infants need affection, acceptance and dependable care; care which they are sometimes less l i k e l y to receive. Greenberg (1971), for instance, observed mothers of atypical infants as alternating between extremes of apathy and vigorous activity, having inconsistent, poorly organized play; having stereotyped or fixed expressions, restrained gross body movements, l i t t l e animated be-haviour, and as engaging in frequent physical overstimulation. As the physical appearances of these infants are often indicative of their delayed status, parents are required to adjust not only to their own feelings of possible repulsion, but also to those obviously or inadvertantly expressed by relatives, friends, and others. Various individuals involved c l i n i c a l l y with families of atypical i n -40. fants have recorded t h e i r observations of parents' adjustments to t h e i r c h i l d . Most frequently c i t e d are cases involving the b i r t h of a retarded or obviously handicapped c h i l d . As no parent hopes or plans f o r the b i r t h of an exceptional c h i l d , the i n i t i a l r e a c t i o n to such an occurrence i s often analagous to that of mourning. The a n t i c i p a t i o n s which these parents bring to the task of c h i l d rearing are l a r g e l y based on the image of the normal c h i l d ; and although no c h i l d i s perhaps ever the i d e a l h i s or her parents may have envisioned, an a t y p i c a l infant brings immediate and pain-f u l emotional and psychosocial confrontations. Parents must face such dilemmas as t h e i r own personal investment i n that c h i l d , t h e i r fears f o r the c h i l d ' s future, t h e i r anxieties concerning t h e i r own and. others' reactions to the c h i l d , and to t h e i r fears concern-ing the e f f e c t s the c h i l d w i l l have on t h e i r l i f e s t y l e now and i n the future. Parents' reactions have been traced through the general pattern of g r i e f : from den i a l of abnormality, to h o s t i l i t y ; through f e e l i n g s of g u i l t and shame, bitterness and fear; to appeals for help, withdrawal; and f i n a l l y to an acceptance of the s i t u a t i o n and an adjustment to the needs and f a c t s of r e a l i t y (Baum, 1962; Hunter, Schucman & Friedlander, 1972; Kirk, Karnes & Kirk, 1955; Love, 1970). Fathers more often than mothers are observed to hold themselves aloof and removed from the intense emo-t i o n a l demands of the c h i l d and a l l he represents (Baum, 1962; Love, 1970). Fathers, therefore, often remain for longer periods of time i n the primary stages of d e n i a l , thereby placing an even greater emotional and p r a c t i c a l burden, on the mother. In such a s i t u a t i o n , the mother becomes responsible f o r the t o t a l care of the c h i l d , and alone must face the discouragements, 41. resentments, despair, and peculiar loneliness experienced by parents of these exceptional c h i l d r e n . Not every parent, of course, experiences a l l the aforementioned emotions, nor a l l to the same degree. For some, adjustment comes r e l a t i v e l y e a s i l y . For others, a true adjustment to the r e a l i t y of t h e i r c h i l d ' s condition i s never reached. Jordan (1962), i n an early review of studies on the e f f e c t s of a handicapped c h i l d on the family, reported that the presence of such a c h i l d i n the family led to increased m a r i t a l d i f f i c u l t i e s , damaged l i v e s , an arr e s t of normal family growth, and to harm to the other c h i l d r e n i n the family (p. 243). Fowle (1969) and Shelton (1972), however, i n l a t e r studies of f a m i l i e s who had either h o s p i t a l i z e d or kept t h e i r mentally retarded c h i l d at home, reported no s i g n i f i c a n t differences i n m a r i t a l i n t e g r a t i o n or parental concerns for t h e i r c h i l d . Caldwell and Guze (1960) obtained s i m i l a r r e s u l t s i n t h e i r study of 32 mothers whose retarded c h i l d had e i t h e r been i n s t i t u t i o n a l i z e d or kept at home. Caldwell and Guze stated that both groups of mothers appeared to be adjusting well to the s i t u a t i o n , were ac-cepting the retardation and coping with i t as e f f e c t i v e l y as could be ex-pected, had r e l a t i v e l y l i t t l e g u i l t , expressed strong love for the c h i l d r e n , had l i t t l e r e j e c t i o n of the c h i l d , had p o s i t i v e attitudes towards t h e i r husbands, and that family morale was high (p. 850). In addition, these authors noted that mothers had become more s e n s i t i v e and sympathetic to people with a l l kinds of problems and handicaps; and were e s p e c i a l l y impressed by the "nearly universal courage, strength, and a d a p t a b i l i t y of these mothers", (p. 851). Both Fowle and Caldwell and Guze found a tendency for increased s i b l i n g r o l e tension for the older daughters i n f a m i l i e s whose retarded member was kept at home. Of a l l the c h i l d r e n i n the family, care for the 4 2 . retarded s i b l i n g most often was assigned to her. Cleveland and M i l l e r (1977) i n a study of 90 adult s i b l i n g s of mentally retarded persons, however, found that t h i s greater contact often had a p o s i t i v e rather than a negative e f f e c t . Elder daughters more often chose "helping" careers as a r e s u l t of t h e i r early r e s p o n s i b i l i t y f o r t h e i r retarded s i b l i n g . S i b l i n g s who were the only "normal" ch i l d r e n i n a family were l i k e l y to be the most educationally achieve-ment oriented s i b l i n g s i n the study. In general, s i b l i n g s reported a p o s i t i v e home experience, with good parent and s i b l i n g r e l a t i o n s h i p s , and normal s o c i a l a c t i v i t i e s and experiences. Although the foregoing studies are based on non-observational measures, often retrospective i n nature, and the l a t t e r dealing e x c l u s i v e l y with fam-i l i e s of mentally retarded c h i l d r e n , there i s an.evident inconsistency to th e i r r e s u l t s . Perhaps some of the differences may be a t t r i b u t e d to varying times of assessment, to prepotent c h a r a c t e r i s t i c s of f a m i l i e s , to the diag-nosis and seve r i t y of the c h i l d ' s handicap, and to the kinds of parents and s i b l i n g s w i l l i n g to p a r t i c i p a t e i n the studies. Most l i k e l y , the f a c t of an a t y p i c a l c h i l d produces a greater r i s k f or m a r i t a l stress and poor home environments; a r i s k , however, which need not ma t e r i a l i z e and which may i n fa c t lead to greater s e n s i t i v i t y and care among a l l family members. Kramm (1963), f o r instance, i n her family interview study of 50 f a m i l i e s with Down's Syndrome c h i l d r e n l i v i n g i n the home, found that many of these fami-l i e s f e l t they had benefited from having a retarded c h i l d . Although many had experienced increased m a r i t a l and personal stress at the time of b i r t h , many f e l t that over time they had grown closer together, and had learned such q u a l i t i e s as patience, sympathy, and tolerance. Similar findings are reported by English (1977) f o r fa m i l i e s with c h i l d r e n evidencing a v a r i e t y 43. of impairments. Research by Holroyd and McArthur (1976) concerning the amount and kind of stress experienced by mothers of Down's Syndrome, a u t i s t i c , and outpatient p s y c h i a t r i c c l i n i c c h i l d r e n (ages 3 to 12) revealed several s i g -n i f i c a n t d i f f e r e n c e s . By means of a questionaire developed by the f i r s t author, parents were asked to answer 285 t r u e - f a l s e questions on scales pertaining to parent problems, problems i n family functioning, and problems they saw i n and for the c h i l d . Mothers of a u t i s t i c c h i l d r e n reported the most d i f f i c u l t i e s i n every area. Mothers of Down's Syndrome c h i l d r e n scored higher than c l i n i c mothers on scales r e f l e c t i n g the c h i l d ' s developmental d i s a b i l i t y , negative or p e s s i m i s t i c a t t i t u d e s towards the c h i l d , and the f e e l i n g that most of the c h i l d ' s care problems f e l l on t h e i r shoulders. Down's Syndrome mothers, however, did not d i f f e r s i g n i f i c a n t l y from the c l i n i c mothers i n the amount of o v e r a l l stress reported. Unfortunately, the nature of the questionnaire i i t s e l f precluded the i n c l u s i o n of a comparison group of normal c h i l d r e n i n the study. (Father's questionnaires were not included i n the report, as too few of the fathers completed and returned the forms.) Cummings, Bayley, and Rie (1966) compared.the e f f e c t s of d i f f e r i n g groups of d e f i c i e n t c h i l d r e n on t h e i r mother's p e r s o n a l i t i e s , and found that mothers d i f f e r e d s i g n i f i c a n t l y i n several ways from each other and from a group of healthy controls. Mothers of retarded c h i l d r e n (n=60 f o r each group, c h i l d r e n aged 4 to 13) demonstrated s i g n i f i c a n t l y more dysphoric a f f e c t , . ( a s defined by depressive f e e l i n g s , preoccupation with t h e i r c h i l d , and d i f f i c u l t y i n handling anger towards the c h i l d ) than did mothers i n the other groups. Mothers of c h r o n i c a l l y i l l or neurotic chi l d r e n , along with 44. mothers of Down's Syndrome ch i l d r e n , expressed s i g n i f i c a n t l y fewer f e e l i n g s of maternal competency than did mothers of healthy ch i l d r e n . They also expressed s i g n i f i c a n t lack of enjoyment of the c h i l d . Only mothers of neurotic c h i l d r e n showed negative evaluations of t h e i r r e l a t i o n s h i p s with t h e i r husbands and neighbours. Age of the c h i l d did not contribute s i g -n i f i c a n t l y to any of the r e l a t i o n s h i p s found i n t h i s study. Worchel and Worchel (1960) found i n an early study of 39 parents of retarded c h i l d r e n that these parents rated t h e i r a t y p i c a l c h i l d s i g n i f i c a n t l y l e s s favour-ably than the "normal" or " i d e a l " c h i l d . Peck and Stephans (1960) also found l e s s favourable at t i t u d e s expressed towards a mentally retarded c h i l d i n the family. Their parents tended to overly c r i t i c i z e and evaluate the retarded c h i l d ' s behaviour, and to respond to him or her with more "emotion" than " i n t e l l e c t " , (p. 842). I n t e r e s t i n g l y , father's acceptance or r e j e c -t i o n of the c h i l d correlated .83 with the amount of acceptance or r e j e c t i o n a c t u a l l y observed i n the home, but mother's ratings correlated e s s e n t i a l l y zero (_r=.09) . D i r e c t observational studies of young d e f i c i e n t c h i l d r e n and t h e i r parents are r a r e . Kogan, Wimberger & Bobbitt (1969) observed a small sample of 6 retarded c h i l d r e n aged 3 to 7, and compared c h a r a c t e r i s t i c s of t h e i r verbal and.nonverbal i n t e r a c t i o n patterns with those of 10 non-retarded 4 to 5 year-olds and t h e i r mothers. Mothers of retarded c h i l d r e n assumed low status i n t h e i r r e l a t i o n s to t h e i r c h i l d r e n , thereby allowing them to assert c o n t r o l , s i g n i f i c a n t l y l e s s often than did mothers of normal ch i l d r e n . These mothers also displayed greater extremes of warmth or h o s t i l i t y , when such behaviours were exhibited. In general, however, they tended to be more neutral, stereotyped, and lacking i n i n d i v i d u a l i t y dur-45. ing the majority of t h e i r observed i n t e r a c t i o n s . S e r a f i c a and C i c c h e t t i (1976). observed 18 Down's Syndrome and. 12 normal chil d r e n , aged 33.5 and 32.8 months re s p e c t i v e l y , i n a standard laboratory s i t u a t i o n designed to measure early attachment behaviours between mother and c h i l d . They r e -ported that Down's Syndrome c h i l d r e n used verbal s i g n a l l i n g behaviours les s often than t h e i r normal peers, and evoked fewer attachment behaviours during t h e i r mother's absence. The authors suggested that Down's Syndrome and normal c h i l d r e n attach d i f f e r e n t meanings to being alone i n a new environment, and that therefore these differences should not be equated with delays i n s o c i a l development. Unfortunately, no maternal data were reported i n . t h i s study. Conclusions which may be drawn from the studies j u s t c i t e d seem few. The amount of stress experienced by parents of an a t y p i c a l c h i l d i s l i k e l y to be greater than that experienced by parents of normal c h i l d r e n . The amount, q u a l i t y , and possible adversive e f f e c t s of that s t r e s s , however, vary according to the kind of deficiency the c h i l d has, and perhaps most importantly, according to c h a r a c t e r i s t i c s embedded i n the i n d i v i d u a l parents and ch i l d r e n themselves. Inconsistencies i n r e s u l t s , plus a lack of d i r e c t observational studies, p a r t i c u l a r l y with young in f a n t s , make i t d i f f i c u l t to maintain that a l l f a m i l i e s are adversely affected by a handi-capped c h i l d . That there i s a trend towards negative at t i t u d e s towards the c h i l d , with concomitant maternal f e e l i n g s of incompetence and depression seem c l e a r ; but the conclusion that such a pattern i s i n e v i t a b l e does not seem warranted. Differences i n parental response have been linked to the degree to which the parents adhere to the prevalent success-oriented values of our 46. culture (Cummlngs,'eti'al, 1966; Ross, 1964). Parents who place a high value on i n t e l l e c t u a l prowess and academic excellence may f i n d i t more d i f f i c u l t to accept retardation and l i m i t e d p o t e n t i a l i n t h e i r c h i l d (Love, 1970, Ross, 1964). I t seems l i k e l y that a parent who values family and r e l a t i o n -ships to others over personal achievement and s o c i a l recognition would more e a s i l y accept and spend the needed time with a delayed c h i l d . No researchers have as yet investigated these r e l a t i o n s h i p s ; nor have any looked,at parents' concomitant b e l i e f s i n t h e i r own importance to the over-a l l development of t h e i r c h i l d . EARLY INTERVENTION PROGRAMS Tjossem (1976) has i d e n t i f i e d three major groups of infants who have been targeted f o r int e r v e n t i o n programs: 1) those at environmental r i s k , due to depriving l i f e experiences, 2) those at b i o l o g i c a l r i s k , having an increased p r o b a b i l i t y for delayed or aberrant development consequent to b i o l o g i c a l i n s u l t s , and 3) those of established r i s k , evidencing early aberrant development rel a t e d to diagnosed medical disorders. Most r e -search, as well as most programs, has been concerned with the f i r s t group of i n f a n t s . The l a t t e r two groups have t y p i c a l l y been purposely excluded from programs i n an e f f o r t to achieve desired experimental and s t a t i s t i c a l c o n t r o l . The early Head Start programs i n the United States o f f e r r e d a r e l a t i v e l y short period of preshcool experience f o r young c h i l d r e n p r i o r to t h e i r f i r s t year of formal schooling. Disappointing r e s u l t s of these programs 47. ( C i r i c e l l i , Evans &S c h i l l e r , 1970; Sontag, S e l l o &Hiorndike, 1969), as stated e a r l i e r , led to a search for a l t e r n a t i v e strategies which would produce greater long-term benefits f o r these c h i l d r e n . Home-based programs and intervention at an e a r l i e r age were two of the major approaches t r i e d . Home-based programs were structured along a p h i l o s o p h i c a l - t h e o r e t i c a l -b e l i e f continuum according to whether the p r i n c i p l e focus was on the parent, or on the c h i l d . Programs such as those developed by Gray and Klaus (1970) and Levenstein (1970) had home v i s i t o r s who worked d i r e c t l y with the moth-ers; while those by Schaefer and Aaronson (1972) and K i r k (1969) used tutors who worked d i r e c t l y with the c h i l d r e n i n the home. Programs developed by such workers as Ryan (1976) and Gordon (1973) incorporated both parental involvement and d i r e c t infant stimulation. Intervention during infancy was t r i e d both i n daycare and i n the home. Daycare for the very young infant t y p i c a l l y involved a substitute caregiver who remained with the infant on a one-to-one basis u n t i l such time as i t was f e l t t h e o r e t i c a l l y sound to move the infants into small groups. An early study by Caldwell, Wright, Honnig, & Tannenbaum,(1970), was designed to investigate any i l l - e f f e c t s which might follow as a r e s u l t of removing a c h i l d from h i s or her primary attachment fi g u r e into a daycare f a c i l i t y . E s s e n t i a l l y negative r e s u l t s were reported. No differences were found i n the r e l a t i o n s h i p s between infants and mothers of the daycare and a contrast home group. There was a tendency, however, for mothers of the daycare group to express a more p o s i t i v e r e l a t i o n s h i p to t h e i r infant than did mothers who were r a i s i n g t h e i r infants more exc l u s i v e l y st home. Ramey, M i l l s , Campbell and O'Brien (1975) also found that t h e i r h i g h - r i s k experi-mental mothers scored higher on the HOME maternal involvement subscale than 48. did t h e i r h i g h - r i s k control mothers whose c h i l d r e n were not attending the daycare. Various authors over the past few years have reviewed the r e s u l t s of the d i f f e r e n t programs implemented for c h i l d r e n at environmental r i s k (e.g. Bronfenbrenner, 1974; Horowitz & Paden, 1973; Karnes & Teska, 1975; M i l l e r , 1970; Ryan, 1972; Stedman, 1977; Tjossem, 1976). Bronfenbrenner's analysis, perhaps c i t e d most often i n the research l i t e r a t u r e , reviewed home-based and centre-based programs which reported follow-up r e s u l t s f or at l e a s t two years a f t e r intervention, incorporated a contrast or c o n t r o l group i n i t s design, and provided data which was comparable to r e s u l t s obtained i n other studies. His f i r s t and major conclusion was as follows: "...the family seems to be the most e f f e c t i v e and economical system for f o s t e r i n g and sustaining the c h i l d ' s development. Without family involve-ment, intervention i s l i k e l y to be unsuccessful, and what few e f f e c t s are achieved are l i k e l y to disappear once the intervention i s discontinued", (p. 126). Bronfenbrenner's further conclusions c a l l f o r a comprehensive, e c o l o g i c a l approach to the needs of the disadvantaged -adequate health care, housing, employment and opportunity, parent t r a i n i n g , and home v i s i t a t i o n programs during the f i r s t three years of l i f e , with the purpose of encour-aging parent-child i n t e r a c t i o n centreing around developmental stimulation and challenging a c t i v i t i e s . Similar conclusions have been drawn from the research r e s u l t s as i n -terpreted by other i n v e s t i g a t o r s . Daycare or centre-based programs for young infan t s , such as those developed by Caldwell and her associates at the Syracuse U n i v e r s i t y Children's Centre i n the l a t e 1960's (Caldwell & Smith, 1970)(and continued by L a l l y ; L a l l y & Honig, 1975), have i n general 49. been successful i n preventing the abrupt decline i n development t y p i c a l l y witnessed i n disadvantaged groups. Infants enter the Syracuse program at various ages; but according to r e s u l t s reported by Caldwell (1968) and more recently by L a l l y (1973), those c h i l d r e n who entered the program between 6 months and 3 years, and who remained i n the program for at l e a s t 6 months, increased an average of 5.6 to 14 IQ points from the time of entry to the time of leaving. L a l l y (1973),.however, reported an i n i t i a l entry plateau between the 6 and 12-month testin g s . In addition, c h i l d r e n who came from homes scoring high on the STIM (Caldwell's early version, of the HOME Inventory) showed s i g n i f i c a n t l y larger gains during the daycare experience than did c h i l d r e n coming from homes with a low STIM score. (VanDoorninck, 1977) Fowler (1972), i n a Toronto-based program for infants ranging i n age from 3 to 30 months, also found s i g n i f i c a n t differences i n the gains of infants who attended the daycare. Infants from middle-class f a m i l i e s d i f f e r i n the amounts &'quality of stimulation a v a i l a b l e i n the home; e.g. Ramey, jejr a_l, 1975; Tulkin & Kagan, 1972), made s i g n i f i c a n t l y greater gains than ' did infants from lower-class f a m i l i e s . Other centre-based programs f o r infants have been reported by Hamil-ton (1972), Ramey and Campbell (1977), and Heber and Garber (1975). Hamilton, i n r e s u l t s which are i n some ways analagous to those of Caldwell and Fowler, found that infants enrolled i n t h e i r program increased s i g n i f i -cantly i n the number of developmental tasks they achieved i n comparison to a contrast group, but also that these gains e s s e n t i a l l y p a r a l l e l e d measured changes i n the infant's home environments. Scores on Caldwell's STIM increased s i g n i f i c a n t l y during the i f r s t three months, as did the 50. i n f a n t s ' development scores. Both scores then continued to r i s e during the next three months, but not s i g n i f i c a n t l y beyond those obtained at the 3-month l e v e l . Changes i n home environments were not re l a t e d to the length of time mothers p a r t i c i -pated as paid teacher's aides i n the program. As a possible explanation for t h i s somewhat s u r p r i s i n g lack of r e l a t i o n s h i p , Hamilton suggested a main e f f e c t on mothers which occurred during the f i r s t few weeks of con-tact. Ramey and Campbell (1977) provide some i n i t i a l r e s u l t s f o r t h e i r experimental h i g h - r i s k infants attending daycare at the Carolina Abecedar-ian Project. Compared to a group of h i g h - r i s k home-reared controls, who drop an average of 16 IQ points between 12 and 18 months of age, and who continue to lose over the next 12 months, infants attending the centre remained r e l a t i v e l y stable over time. These infants l o s t an average of 5.6 IQ points from the 6 to 36 month te s t i n g s . Both experimental and con-t r o l f a m i l i e s could receive s o c i a l work services on request, but no i n f o r -mation concerning t h e i r use was included i n the report. Heber and Garber (1975) took 3-month-old infants from an experimental group of mothers whose IQ's f e l l below 70, and placed them i n an intensive daycare program during most of t h e i r waking hours. The program incorporated high l e v e l s of sensory, language, and developmental stimulation of a l l kinds thought p o t e n t i a l l y h e l p f u l . At 42 months, daycare c h i l d r e n had a mean S-B IQ of over 125, a 33 point d i f f e r e n c e over an untreated co n t r o l group. Although mothers i n the experimental group received homemaking and child-care t r a i n i n g , as well as occupational t r a i n i n g and work opportunities, the authors reported disappointing responses to t h i s aspect of the program. Results for these centre-based programs for young infants generally 51. r e i n f o r c e the need for parent and home support which emerged from e a r l i e r research e f f o r t s with pre-schoolers. (Bronfenbrenner, 1974; Dokecki & Kraft , 1977). Willerman (1969), for example, found that the 531 c h i l d r e n enrolled i n the Head Start Programs i n Tallahassee, F l o r i d a during the summer of 1966, scored d i f f e r e n t l y on the Metropolitan Reading Readiness test given at the end of the program i n r e l a t i o n s h i p to the amount of involvement t h e i r parents had shown i n the program. Children whose parents were a c t i v e l y involved i n the program (n=97) scored s i g n i f i c a n t l y higher than those whose parents were either not involved at a l l (n=187), or i n -volved to a f a i r l y l i m i t e d degree (n=354). Children from the l a t t e r group also scored s i g n i f i c a n t l y higher than the middle group on the reading readiness t e s t . Radin (1972) found that parent involvement i n a compensa-tory preschool program for 71 four-year-olds was the most c r i t i c a l f a c t o r i n the c h i l d ' s developmental gains, although t h i s r e l a t i o n s h i p was not evident u n t i l a year follow-up. During the program year, mothers of a group of 21 c h i l d r e n were involved i n biweekly home t u t o r i a l sessions i n which they were encouraged to p a r t i c i p a t e , and to continue throughout the week. A second group of mothers attended weekly small group meetings l e d by a s o c i a l worker, who focussed discussions on c h i l d r e a r i n g p ractices conducive to optimal c h i l d development. This second group also received biweekly t u t o r i a l sessions. A t h i r d group of mothers received no i n t e r -vention. Home sessions were continued, but not i n the presence of the mothers. At the end of the program, a l l group c h i l d r e n showed s i g n i f i c a n t gains on the Binet and Peabody Picture Vocabulary Tests (PPVT), and on several scales of the P u p i l Behaviour Inventory. Mothers of the f i r s t two groups changed s i g n i f i c a n t l y on several factors of the Cognitive Home Environment Scale, and on several c h i l d - r e a r i n g a t t i t u d e measures. At a year follow-up, c h i l d r e n from these groups did not d i f f e r from each other, but d i f f e r e d s i g n i f i c a n t l y from the t h i r d group whose mothers had received no d i r e c t intervention. Children from t h i s l a t t e r group showed a mean drop of 1 PPVT point to an average of 95.3; c h i l d r e n from the other two groups showed gains of 14.0 and 9.7 points to l e v e l s of 105.3 and 105.2 respective-l y . No s i g n i f i c a n t differences were found among the groups on the Weschler I n t e l l i g e n c e Scale f or Children (WISC) however. Karnes & Teska (1975), encouraged by t h e i r highly s i g n i f i c a n t r e s u l t s with a. program of home-visiting and weekly mothers' group meetings (Karnes, Teska, Hodgins & Badger, 1970), designed a subsequent program for 4-year-olds incorporating both preschool f o r the c h i l d and home v i s i t s to the mother. No s i g n i f i c a n t differences were found i n IQ scores between the experimental and control groups a f t e r two years, with the controls a c t u a l l y scoring r e l i a b l y higher i n tests of language development. The authors concluded that t h e i r second program's added preschool experience, i n i t s suggestion to the.mother that her r o l e was no longer the most important one i n deter-mining her c h i l d ' s developmental progress, was the factor responsible for t h i s program's negative r e s u l t s . HOME-BASED PROGRAMS Home-based programs which have focused e x c l u s i v e l y on the c h i l d have been found to produce mainly temporary gains (Gordon, 1971; Schaefer & Aar-onson, 1972; Tjossem, 1976) . Children i n the home t u t o r i a l programs offered by K i r k (1969), and by Schaefer and Aaronson (1972) did make s i g n i f i c a n t 53. gains over t h e i r c o n t r o l groups at f i r s t post-test sessions, but these gains were not maintained once intervention was terminated. Ryan (1974), i n a home t u t o r i a l program offered through the Carleton University C h i l d Devel-opment Project, was unable to show any gains for h i s experimental group of 1 to 24-month-old i n f a n t s . Authors of these studies c i t e lack of parental involvement and no change i n the basic home si t u a t i o n s as key factors i n the f a i l u r e of t h e i r programs to incur l a s t i n g , or even temporary e f f e c t s . Programs which have centred on the r e l a t i o n s h i p between mother and c h i l d , and focused t h e i r intervention on the mother and home s i t u a t i o n , have generally shown the most long-term e f f e c t s , though t h e i r i n i t i a l r e -su l t s may not be so s t r i k i n g . (Bronfenbrenner, 1974; Gordon, 1976). An early such program begun as a p i l o t project i n 1965 i n New York by Leven-stein,.has shown cons i s t e n t l y p o s i t i v e and s i g n i f i c a n t gains f o r her experimental c h i l d r e n . (Levenstein, 1970; 1971;1974). Experimental f a m i l i e s of c h i l d r e n ages 20.to 43 months are v i s i t e d twice weekly by "toy demonstra-tors" . She, over a 7-month period, provides the target c h i l d with a toy chest, and a t o t a l of 28 toys and books to be used as a means of stimu-l a t i n g developmentally oriented play. Mothers are treated as colleagues, drawn into the play, and encouraged to model the v e r b a l l y oriented kinds of inte r a c t i o n s enjoyed by the demonstrator. Control subjects are also v i s -i t e d , brought g i f t s not included i n those given to the experimental child r e n , and mothers are encouraged not to be present. Results f o r the younger ch i l d r e n are e s p e c i a l l y encouraging, showing mean gains of 16 to 18 IQ points sustained at the grade one l e v e l . Experimental c h i l d r e n also achieved superior ratings on scales of task o r i e n t a t i o n and social-emotion-al competencies (Levenstein, 1970-1974) . 54. Control c h i l d r e n decreased i n measured IQ, following the pattern gen-e r a l l y evidenced among disadvantaged groups. Parents, when interviewed at the end of the 1971-72 program year, stated an almost unanimous sense of family r e s p o n s i b i l i t y f o r preparing the young c h i l d for school. Only one parent mentioned Toy Demonstrators as the main persons responsible f o r a c h i l d ' s readiness. (Levenstein, 1971). Number of home v i s i t s , sex, or age of the c h i l d , however, were not found to s i g n i f i c a n t l y r e l a t e to the gains these c h i l d r e n made i n the program. Other early programs which centred on the mother's i n t e r a c t i o n s and teaching, s t y l e s were i n i t i a t e d by Weikart and Lambie (1968) at the Y p s i -lanti-Carnegie Infant Education Project, by Gray,and Klaus (1970) at the Early Training Project i n Tennessee, and by Gordon (1969) i n F l o r i d a . As with other kinds of intervention programs, r e s u l t s were not always consis-tent. However, these programs convinced many of the greater p o t e n t i a l and t h e o r e t i c a l a d v i s a b i l i t y of home-based programs centred on the parent-child r e l a t i o n s h i p . Programs which have followed, therefore, have tended to incorporate at l e a s t some aspects of parental involvement as key (e.g. Karnes & Teska, 1975; Schaefer, 1972; Tjossem, 1976; M i t t l e r , 1977). Gray (1977) and her colleagues now operate a program c a l l e d the Family-Oriented Home V i s i t i n g Program out of Na s h v i l l e , Tennessee. This program o f f e r s weekly home v i s i t s to f a m i l i e s with two or three c h i l d r e n under f i v e years of age, with a toddler between 16 and 24 months at pretest. Each v i s i t i s designed to meet the unique needs of a p a r t i c u l a r family, within the s p e c i f i c program objectives of working pr i m a r i l y with the mother to improve her teaching s t y l e , to help her with behaviour management, to en-courage more r e c i p r o c a l language i n t e r a c t i o n between her and her c h i l d , and 55. to help her organize her day and home s i t u a t i o n i n order to provide more educational opportunities f o r her ch i l d r e n . Early r e s u l t s are p o s i t i v e . Home environments as measured by the HOME have improved; experimental mothers' teaching s t y l e s have improved; and experimental c h i l d r e n show s i g n i f i c a n t improvement i n language. Johnson (1975) reports i n i t i a l success f o r a parent-centred program at the Houston Parent C h i l d Development Centre. There, working i n the homes of Mexican-Americans from b i r t h to two years, mean s i g n i f i c a n t gains of 10 IQ points have been demonstrated. L a l l y and Honig (1975), who incorpor-ated a weekly: home v i s i t a t i o n program by paraprofessional c h i l d develop-ment tr a i n e r s i n t h e i r Syracuse program, state t h e i r p o s i t i o n as follows: "Our the s i s , then,.is to move away from l i m i t e d tests of intervention procedures. I t i s i r r e l e v a n t , f o r example, i f a home-visit program i s more or less e f f e c t i v e than a centre-based program as judged by immediate evaluation, i f i n fac t the ch i l d r e n from both programs regress i n development scores back down to the l e v e l of t h e i r control groups a few years a f t e r intervention ceases.... This i s why i t i s e s s e n t i a l to make, changes i n his (the ch i l d ' s ) permanent environ-ment, h i s home, and to help h i s parents deal with changes i n the ch i l d . t h a t l i f e at an enrichment centre brings about." (p. 290) Scheinfeld and h i s colleagues i n Chicago (1970) demonstrated a model family oriented program with a small group of nursery-school c h i l d r e n assigned to the lowest of three competency groupings. The goals of the intervention strategy were to a l t e r the nature of the parent-child r e l a t i o n -ship per se, and to help create a family environment i n which children's competence development became a part of everyday l i f e , and valued as an end i n i t s e l f . To achieve these ends, workers v i s i t e d the homes and s e l e c t i v e l y a s s i s t e d i n planning and modelling a c t i v i t i e s designed to r e f l e c t the .values and b e l i e f s offered by parents as t h e i r goals and aims for t h e i r p a r t i c u l a r c h i l d . Results were assessed by means of post-test 56. interviews, and workers' reports. In general, experimental mothers had gained a concept of themselves as c h i l d developers and showed s i g n i f i c a n t increases i n t h e i r reported concerns for competency-promoting child-care a c t i v i t i e s . Heinicke (1976) reports on a family-oriented program f o r low-income fa m i l i e s i n the Los Angeles area. Mothers of 65 c h i l d r e n attending a preschool centre were offered s o c i a l work services involving home v i s i t s using one of four approaches: open-ended i n t e r p r e t i v e , open-ended suppor-t i v e , problem-oriented, or cons u l t a t i v e . On the basis of worker assess-ments done a f t e r each v i s i t , and at s p e c i f i c i n t e r v a l s , mothers experi-encing the open-ended approaches encouraging free discussion of a l l problems showed.the greatest improvement i n personal as well as parent-child func-t i o n i n g . Children of these mothers showed s i g n i f i c a n t l y greater IQ gains than a contrast group from another preschool, and from those of ch i l d r e n whose mothers did not take advantage of the s o c i a l work services o f f e r e d . Follow-up i n kindergarten showed improvement for the former c h i l d r e n , with a unanimous group decline for the contrast c h i l d r e n . INTERVENTION PROGRAMS FOR ATYPICAL INFANTS Intervention for c h i l d r e n with i d e n t i f i e d handicaps or developmental delays has u n t i l r e c ently involved mainly r e s i d e n t i a l or centre-based t r e a t -ment. Deaf, b l i n d , or severely retarded c h i l d r e n have been i n s t i t u t i o n -a l i z e d , or brought to a daycare centre for s p e c i a l i z e d care. L e v i t t and Cohen (1977) i n t h e i r search for home-based programs for handicapped or developmentally delayed infants found very few such programs reported i n 57. the research l i t e r a t u r e . Early intervention programs f o r these i n f a n t s , however, are now beginning to p r o l i f e r a t e , and most are adopting a r a t i o n -ale of heavy parent involvement and r e s p o n s i b i l i t y . In an early project designed to determine the e f f e c t s of preschool education on the s o c i a l and mental development of young educable mentally handicapped chil d r e n , K i r k (1958), showed that early home environments as well as preschool experiences can s i g n i f i c a n t l y e f f e c t the rate of growth and development l e v e l s attained by these c h i l d r e n . More recent programs developed f o r retarded c h i l d r e n have also evidenced s i g n i f i c a n t benefits f o r these c h i l d r e n . Hayden and Haring (1977) at the Model Preschool Centre f o r home-reared Down's Syndrome c h i l d r e n have been able to increase the developmental attainments of these c h i l d r e n to 95% of those attained by t h e i r normal peers. In contrast, a group of c h i l d r e n not attending the preschool achieved only 61% of these behaviours. Mothers of ch i l d r e n aged 5 weeks to 18 months meet once a week for 30 minutes of i n d i v i d u a l i z e d t r a i n i n g i n e arly sensory-motor development. Mothers of ch i l d r e n aged 18 months to 3 years attend t h e i r c h i l d ' s preschool f o r at l e a s t one of the four, weekly 2-hour sessions (Hayden & Dmitriev, 1975). Hunter, Schuman and Friedlander (1972) report on a home and centre-based program for mentally retarded infants i n New York. They report gains i n infant s e l f - c a r e a b i l i t i e s , motor s k i l l s , and o v e r a l l language develop-ment; as well as p o s i t i v e changes i n parents' a t t i t u d e s , a b i l i t i e s to handle stress and plans f o r the future, and i n t h e i r d i s c i p l i n a r y actions towards the c h i l d . Connolly and Russ e l l (1976) describe t h e i r program for Down's Syndrome infants at the Chi l d Development Centre of the Univ e r s i t y of 58. Tennessee. For 10-week sessions i n the spring and f a l l of each year, mothers of Down's Syndrome ch i l d r e n ages b i r t h to three years bring t h e i r c h i l d r e n to the centre f o r a half-day each week. In group settings, c h i l d development information and development exercises are demonstrated and provided, and .parents are encouraged to express and share t h e i r problems and concerns. Children i n the program reach development milestones s i g -n i f i c a n t l y ahead of an e a r l i e r contrast group of Down's Syndrome c h i l d r e n r e c e i v i n g no treatment, and reach these milestones not f a r behind that of th e i r normal peers. Children who begin the program before 6 months of age also develop s i g n i f i c a n t l y ahead of those beginning the program a f t e r 6 months of age. The authors report that the fa m i l i e s show evidence of im-proved i n t r a f a m i l y r e l a t i o n s h i p s and improved adaptation to the handi-capped c h i l d , though no objective assessment of t h i s change i s made. Bidder, Bryant, and Gray (1975) worked s p e c i f i c a l l y with the mothers of eight Down's Syndrome.children aged 12 to 33 months. Mothers attended 12 1% hour sessions over a 7-month period. The f i r s t portion of each session was devoted to teaching behaviour modification techniques found to be ben-e f i c i a l i n t r a i n i n g mentally retarded c h i l d r e n . The second part involved a general discussion of family and personal problems stemming from the b i r t h and care of a Down's Syndrome c h i l d . On the G r i f f i t h s Scale of Infant Development, experimental infants showed s i g n i f i c a n t gains i n language and performance over a control group of eight matched Down Syn-drome Children. Programs developed by Hughes (1971), by Rynders and Hor-robin ,(1975) at the University of Minnesota, and by Zadig and Crocker (1975) i n Boston also report success i n t h e i r work with Down's Syndrome infants and t h e i r parents. No parent or c h i l d data, however, are yet offered by 59. these programs. Fewer studies have been reported for programs serving a t y p i c a l infants as a whole. One such program i s that developed by Nielson and his c o l -leagues (1975) i n Maine County, C a l i f o r n i a . The program includes both weekly home v i s i t s . a n d weekly c l i n i c sessions. The l a t t e r involves i n d i -v i d u a l i z e d parent-infant supervision and t r a i n i n g , and small group d i s -cussions. Infants i n the program have shown s i g n i f i c a n t i n d i v i d u a l devel-opmental gains during t h e i r time i n the program. Although parents are considered to be the primary programmers of t h e i r infant's environments, and as such the c e n t r a l focus of the program, unfortunately no parent data are reported. Another program for a t y p i c a l infants i s that described by B r a s s e l l (1977) at Western Carolina's Infant Program. Families are v i s i t e d on a weekly basis, and expected to carry out the demonstrated development procedures on a d a i l y b a s i s . Changes i n rates of mental and motor development f o r 73 infants exposed to the program fo r an average of 10 months, (with a mean entry age of 20.8 months) were calculated and analyzed according to several organismic and psychosocial f a c t o r s . Females gained s i g n i f i c a n t l y more than males , during the home intervention period, as did infants with a le s s e r degree of motor or mental defect. Paternal age, b i r t h order, paternal education, and family status ( i e . whether the c h i l d was l i v i n g i n an i n t a c t family, with a s i n g l e parent, or i n a fos t e r home) were also s i g n i f i c a n t l y related to the devel-opmental gains of these c h i l d r e n . In an e a r l i e r study, not reported, B r a s s e l l found that parental responsiveness as measured by a modified form of the HOME .was highly s i g n i f i c a n t i n p r e d i c t i n g infants who made substan-t i a l increases i n developmental r a t e . 60. Shearer and Shearer (1976) report success f o r t h e i r home v i s i t a t i o n program f o r developmentally delayed c h i l d r e n from b i r t h to s i x . Program c h i l d r e n demonstrate s i g n i f i c a n t l y larger IQ, cognitive, and s o c i a l gains than those evidenced by a matched group of c h i l d r e n attending a nearby centre f o r the c u l t u r a l l y and economically depressed. Parents i n the pro-gram are t h e i r c h i l d ' s teachers, and expected to teach and record at le a s t three targeted behaviours each week. The Infant Studies Project at the Un i v e r s i t y of C a l i f o r n i a i n Los Angeles i s another program which intervenes d i r e c t l y with f a m i l i e s of developmentally delayed i n f a n t s . (Kass, Sigman, Bromwich & Parmalee, 1976). At f i r s t designed p r i m a r i l y for premature a t - r i s k i n f a n t s , fewer than h a l f of the 27 delayed infants followed to date were a c t u a l l y born premature. Program goals are to increase a mother's s e n s i t i v i t y to her c h i l d , increase the infant's s k i l l s , and to improve the o v e r a l l status of the home environ-ment. Home v i s i t s focus on improving mother-infant i n t e r a c t i o n by t r a i n i n g mothers to respond to the s p e c i f i c cognitive and developmental strengths and weaknesses of th e i r i n f a n t s . Bromwich (1976) describes i n d e t a i l the program's six-stage l e v e l of maternal intervention, which moves from a p o s i t i v e a f f e c t i v e base f o r mutually enjoyable and s a t i s f y i n g mother-infant interactions,, to a maternally independent l e v e l of providing a wide range of developmentally appropriate a c t i v i t i e s and experiences f o r the i n f a n t . Unfortunately, no objective parent or c h i l d data are yet a v a i l a b l e . The pattern which emerges from the r e s u l t s of the early i n t e r v e n t i o n programs reviewed here substantiate the conclusions drawn by Bronfenbrenner (1974), and by the 1972 task force headed by Stedman. (Stedman, et_ a l , ; 1972). Parents and the t o t a l home environment, are of c r i t i c a l importance 61. to the c h i l d ' s development. In the words of Lambie, Bond and Weikart: "...the most s a l i e n t component of an infant's environment—both as a d i r e c t source of stimulation and reinforcement and as a manipulator of environ-mental a c c e s s — i s the infant's family, and i n p a r t i c u l a r h i s mother" (Lambie et a l , , 1975, p. 281). Intervention programs which promote p o s i t i v e and s e n s i t i v e i n t e r a c t i o n between parent and infant, and which do not upset a sense of d i r e c t parental r e s p o n s i b i l i t y for the c h i l d ' s develop-ment, are those which appear to produce the most stable and long-term r e s u l t s . Intervention gains i n the c h i l d ' s development are found to par-a l l e l changes i n the i n f a n t s ' home environments, whenever measures of the homes are included i n the research evaluation. Children who gain most from an intervention program are usually those whose parents are most i n -volved, again, whenever parental involvement i s included as a research parameter. For very young infan t s , parent-centred programs, as contrasted to child-centred ones, appear to have at l e a s t equal immediate e f f e c t i v e -ness, as w e l l as several p r a c t i c a l advantages. Their r e s u l t s show greater long-term effectiveness; they are le s s expensive to operate, and there i s evidence that t h e i r benefits are extended to other s i b l i n g s and members of the surrounding neighbourhood and community (Gordon, 1976; Schaefer, 1972; Tjossem, 1976). 62. BRITISH COLUMBIA INFANT DEVELOPMENT PROGRAM The B r i t i s h Columbia Infant Development Program i s a home-based i n t e r -vention . program serving f a m i l i e s of developmentally delayed c h i l d r e n from b i r t h to three years. Begun i n 1972 with a program i n the Vancouver-Rich-mond area, ther are now eleven i n d i v i d u a l programs throughout the province. Under the auspices of the M i n i s t r y of Human Resources, and coordinated by an appointed P r o v i n c i a l Steering Committee, programs are implemented i n communities which independently recognize t h e i r need and p e t i t i o n for ser-v i c e . Local Committees, necessarily including parents of young develop-mentally delayed c h i l d r e n , administer the program for t h e i r p a r t i c u l a r area. The number of s t a f f serving a community depends on the s i z e and need of that area. At the present time, there are sixteen infant workers employed by the eleven programs. Infant workers a l l have professional t r a i n i n g i n a f i e l d or f i e l d s r e l a t i n g to early childhood development. Once employed, workers receive monthly i n s e r v i c e t r a i n i n g , p a r t i c i p a t e i n a u n i v e r s i t y -sponsored correspondence course on infancy and early intervention, and are encouraged to attend conferences and workshops pertaining to the needs of the i r Program c h i l d r e n . The B.C. Program has an open r e f e r r a l system. Any c h i l d from b i r t h to three years, who demonstrates a developmental delay i n one or more major s k i l l areas, i s e l i g i b l e f o r s e r v i c e . S t a t i s t i c s gathered through the summer of 1977 reveal that the main current sources of r e f e r r a l are p u b l i c health nurses (43%), doctors and p a e d i a t r i c i a n s (15%), parents (9%), and s o c i a l workers (8%).. Of the 800 c h i l d r e n reached to date, approximately h a l f have been recognizably handicapped—with diagnoses of Down's Syndrome, 63. cerebral palsy, brain damage, or other medical or genetic abnormalities. The other 50% of chi l d r e n evidence developmental delays with no recogniz-able organic cause. Table II gives a breakdown of these diagnostic categories, as well as the number and percentage of c h i l d r e n included i n each group. Services provided to the family follow a s p e c i f i e d general o u t l i n e , but within that framework seek to serve a family's unique i n d i v i d u a l needs. When a c h i l d i s referred to the Program, a s t a f f member makes an i n i t i a l contact v i s i t , u s ually i n the home. In the case of a Down's Syndrome baby, however, who can be diagnosed at b i r t h , contact i s begun as early as possible i n the h o s p i t a l . T y p i c a l l y , during the course of the f i r s t and second v i s i t s , the c h i l d i s assessed, and the parents are informed of the services provided by the Program. The r a t i o n a l e and need for such a pro-gram are explained, and a regular s e r i e s of home v i s i t s i s i n i t i a t e d . Except i n smaller communities where geographic distance can be a problem, most f a m i l i e s are v i s i t e d on a weekly or biweekly basis during the f i r s t year. Later, home v i s i t s are usually reduced to one every three to four weeks, and eventually discontinued when the c h i l d begins preschool, or when both worker and family f e e l the v i s i t s are no longer necessary or p r a c t i c a l . Home v i s i t s involve d i r e c t developmentally-oriented stimulation of the c h i l d , with the mother encouraged to p a r t i c i p a t e and model these a c t i v i t i e s . Current developmental needs of the c h i l d are discussed and relat e d to p r a c t i c a l d a i l y exercises and a c t i v i t i e s which the parents are asked to incorporate during the following weeks. Toys are brought to the home each week, and frequently l e f t f o r the c h i l d to master. Parents are given books and reference materials on c h i l d development, and encouraged 64. TABLE II Diagnostic Breakdown of B r i t i s h Columbia Infant Development Program Children - September 1977 Handicapped Number % Down's Syndrome 136 19% Cerebral Palsy 56 8% Seizures 58 8% Mul t i p l e Handicaps 45 6% Single Sensory Impairments 29 4% Chromosome Abnormalities 28 4% Congenital Abnormalities 20 3% Mental Retardation 13 2% Brain Damage 11 2% Hyperkinesis 3 .4% Autism 2 .3% Other 20 3% Non-Handicapped Number % Delayed Development 181 26% Environmental 53 8% At-Risk 50 7% to take advantage of opportunities to meet other parents, to attend r e l e -vant workshops and group meetings, and to make use of other a v a i l a b l e community resources. Mothers p a r t i c u l a r l y are given a great deal of person-a l support and encouragement. Workers seek to b u i l d a r e l a t i o n s h i p of trust and rapport i n which the parent f e e l s free to discuss any problems or f e e l i n g s she may have with regard to hers e l f or her c h i l d . The stated goal of the B.C. Program i s to provide services f o r devel-opmentally delayed infants i n order to optimize t h e i r development and con-tinuing p a r t i c i p a t i o n i n a f u l l range of community a c t i v i t i e s . Within that goal are two s p e c i f i c objectives: 1) to encourage the o v e r a l l development of the c h i l d , with emphasis on i n d i v i d u a l requirements, by a s s i s t i n g f a m i l i e s to provide appropriate a c t i v i t i e s and experiences; and 2) to a s s i s t fami-l i e s to accept and to respond to t h e i r infant i n a p o s i t i v e way (Brynelson Steering Committee, 1977). Success of the Program, i n terms of the a c c e l -erated development of 14 Down's Syndrome child r e n , has been demonstrated i n a p i l o t project by Mannis and Sykanda (1977). Parent a f f i r m a t i o n and expression of support and commendation i s high, r e f l e c t e d i n the increasing numbers of c h i l d r e n referred by parents themselves, and i n the steady growth and expansion of the Program throughout the province. Recently, the Pro-gram has hired a part-time psychologist to help i n designing a standardized infant assessment procedure. She has also been asked to prepare a Program evaluation component to be used i n the ongoing operation of the Program. METHOD AND MATERIALS Subjects Subjects f o r t h i s study were drawn from four Infant Development Programs 66. i n B r i t i s h Columbia. These Programs varied i n number of s t a f f , and i n the kinds of communities they served. As many f a m i l i e s as possible were v i s i -ted from each area. In order to p a r t i a l l y c o n t r o l f o r d i f f e r e n t i a l t r e a t -ment e f f e c t s , only f a m i l i e s r e ceiving weekly or biweekly v i s i t s during t h e i r f i r s t program year were included. A t o t a l of f i f t y - n i n e f a m i l i e s were v i s i t e d during October and November of 1977. Three f a m i l i e s could unfortunately not be included i n the a n a l y s i s ; one due to language d i f f i -c u l t i e s , and two because they did not meet the above c r i t e r i a . No family refused to be v i s i t e d when contacted. Table III presents the number of f a m i l i e s v i s i t e d per program, and the general c h a r a c t e r i s t i c s of the com-munities served. Demographic information was c o l l e c t e d for a l l f a m i l i e s , but i s not complete f o r those subjects who d i d not return the questionnaires given to them. In a l l , s i x mothers and eight fathers did not return the forms. Fathers, however,, were l e s s conscientious than mothers i n following d i r e c -tions c o r r e c t l y and comprehensively. S t a t i s t i c a l analyses, therefore, have been adjusted for varying n.'s when necessary. Families i n t h i s sample ranged i n s i z e from two to nine, with the average family having a mother, father, and two c h i l d r e n . Three c h i l d r e n were with foster-parents; two were with si n g l e foster mothers. A l l f o s t e r c h i l d r e n had been taken within three months of b i r t h . Three mothers were separated from t h e i r husbands with custody of the c h i l d r e n , and one mother was s i n g l e and l i v e d alone with her developmentally delayed c h i l d . A t o t a l of s i x c h i l d r e n came from one-parent homes. Table IV gives a d e t a i l e d d e s c r i p t i o n of the demographic information for the mothers and fathers 67. TABLE I I I Sample Family and Program C h a r a c t e r i s t i c s Kamloops Surrey-Cloverdale- Vancouver-Langley-White Rock Richmond Type of urban centre small towns + Community + large r u r a l semi-rural areas farming areas large urban centre + suburbs V i c t o r i a -Sydney urban centre + semi-rural farming areas Number of Staff Number of Families V i s i t e d 19 10 20 10 Number Inculded i n Basic Sample 17 10 19 10 Mothers Not Returning Forms Fathers Not Returning Forms 68. TABLE IV Demographic Characteristics of Sample Families Mothers Fathers Number % Number % Age: 15-20 1 2% - -21-30 28 56% 18 37.5% 31-40 19 38% 24 50.0% 41-50 4 4% 4 8.3% A 50+ - - 2 4.2% Education: grade school 4 8% 6 12.6% high school 20 40% 19 39.6% trade school 11 22% 12 25.0% university 15 30% 11 22.9% Occupation: homemaker 43 84.3% part-time c l e r i c a l 4 7.8% professional 1 2.0% professional 1 2.0% unemployed 2 4.8% unskilled labour 11 22.4% skilled labour 8 16.3% skilled tradesmen 8 16.3% office worker 3 6.1% management 11 22.4% professional 6 12.2% Religious Protestant 26 50% 11 29% A f f i l i a t i o n : None 11 21% 14 36% Catholic 10 19% 8 21% Christian 2 4% 2 5% Anglican 1 2% 1 3% Eckankar 1 2% Greek Orthodox 1 3% Muslim 1 2% 1 3% Family Size: Family Income: Number % Number % 2 3 5.4% less than 5,000 3 6% 3 15 26.8% 5,000 - 10,000 2 4% 4 24 42.9% 10,000 - 15,000 12 24% 5 6 10.7% 15,000 - 20,000 14 28% 6 4 7.1% 20,000 - 30,000 14 28% 7 2 3.6% 30,000 or more 5 10% 8 1 1.8% 9 1 1.8% *Subjects are assigned at the point of greatest educational attainment. 69. involved i n t h i s study. Children i n the study ranged i n age from 2% weeks to 94 months, with a mean age of 103.39 weeks. Length of time i n the Program ranged from an i n i t i a l v i s i t to 118 weeks. Mean length of time i n the Program was 35.75 weeks. Mean age before r e f e r r a l was 66.95 weeks, ranging from a low of 1 week.to a high of 46 months. An equal number of boys and g i r l s was included i n the sample, and t h e i r respective diagnoses are presented i n Table V. PROCEDURE Once p a r t i c i p a t i o n i n the study was s o l i c i t e d and obtained by Program s t a f f , f a m i l i e s were v i s i t e d i n t h e i r homes when the Program c h i l d and at leas t the mother were present. During the v i s i t , which las t e d from 45 to 90 minutes, Caldwell's HOME ..was administered. At the conclusion of the v i s i t , parents were given an eleven-page questionnaire and asked to independently complete the forms for t h e i r infant worker at her next v i s i t . Fathers and mothers completed i d e n t i c a l forms. Approximately ha l f of the v i s i t s were done i n conjunction with the regular home v i s i t scheduled by the infant worker. I n i t i a l l y , and at random i n t e r v a l s , r e l i a b i l i t y checks were made on the HOME assessment pro-cedure. Ratings made by the author and the respective infant worker ranged from 92 to 100% agreement. Parents who did not return t h e i r forms immedi-ately, were contacted by phone, reminded several times by s t a f f workers, and on occasion, given a new form to complete. 70. TABLE V Diagnoses of Children i n Sample* Male Female To t a l Mild Moderate Severe Mild Moderate Severe % Down's Syn-drome 2 2 2 6 1 13 23.2% Developmental 4 4 1 4 13 23.2% Delay Chromosome 3 1 1 5 8.9% Abnormalities Congenital 1 1 2 4 7.1% Abnormalities Suspected 1 2 1 4 7.1% Brain Damage Cerebral Palsy 1 1 1 3 5.4% Seizures 2 2 3.6% Microcephalic 1 1 2 3.6% Hydrocephalic 1 1 1 . 7 % Single Sensory 1 1 1.7% Impairment Hyperkinesis 1 1 1.7% Other Medical 1 2 1 1 5 8.9% Disorders A u t i s t i c 1 1 1.7% Tendencies A t - r i s k Pre- 1 1 1.7% mature *Many of these c h i l d r e n had unconfirmed diagnoses, or demonstrated multiple symptomatology. In the l a t t e r case, the most severe or s p e c i f i c diagnosis was used for i d e n t i f i c a t i o n purposes. Severity was rated by s t a f f on basis of c h i l d ' s present function and predicted future competency. 71. MATERIALS HOME: Home environments were assessed by means of the HOME. Designed to sample c e r t a i n aspects of the quantity and qu a l i t y of s o c i a l , emotional, and cognitive support a v a i l a b l e to the young c h i l d ( b i r t h to three years) within the home, the HOME requires a yes or no response to 45 items f a c -t o r i a l l y grouped under s i x major headings. (See Table I, page 12, for a l i s t of these headings, and for examples of the kinds of items included under each heading.) Scores for each category, as well as a t o t a l HOME score, are obtained by adding the number of p o s i t i v e responses. Approxi-mately two-thirds of the items are based on observational data; the remain-der are assessed by verbal interview. Reported i n t e r - r a t e r r e l i a b i l i t i e s for the HOME average about .90 (Elardo, et^ al_, 1976)- a r a t i n g which com-pares favourably with the 92 to 100% r e l i a b i l i t y found i n the present study. VanDoorninck (1977) and Ramey et a l (1975) argue that a t o t a l HOME score of 30 or less i s i n d i c a t i v e of environmental " a t - r i s k " status for the young c h i l d . During the home v i s i t , a Maternal Warmth score was also obtained. Based on a ra t i n g scale developed by Clarke-Stewart (1973) for her research concerning i n t e r a c t i o n s between mother-infant p a i r s , mothers were given a t o t a l Warmth score ranging from 0 to 11. This score was obtained by adding three i n d i v i d u a l scores: a r a t i n g of -2 to +3 for tone of voice, a rat i n g of 0 to 4 for amount of expressed p o s i t i v e emotion, and a f i n a l r a t i n g of 0 to 4 f o r the mother's accepting or unaccepting a t t i t u d e t o -wards her c h i l d ' s behaviour. Maternal Warmth scores were taken as a secondary, supportive measure of the mother's emotional involvement with 72. her c h i l d ; and, as such, were based on the author's observations only. PARENTAL DEPENDENT VARIABLES: The eleven-page questionnaire which a l l parents were asked to com-plete contained scales f or the various dependent variables assessed i n t h i s s tudy. BELIEFS. Following a page of requested demographic information, parents were asked to respond to 31 items designed to measure t h e i r b e l i e f s con-cerning both the causal influence parents have on t h e i r c h i l d ' s develop-ment and behaviour, and the importance and q u a l i t y of early r e c i p r o c a l i n t e r a c t i o n s . Items for t h i s B e l i e f Scale were mainly drawn from the Reciprocity Subscale of Cohler's Maternal A t t i t u d e Scale discussed e a r l i e r , and from the Causality Subscale of Hereford's Parent-Attitude Survey (Here-ford, 1963). The l a t t e r scale was used s u c c e s s f u l l y by Hereford to measure and assess changes i n the attitudes of parents involved i n a study concerning the effectiveness of several experimental parent education programs i n Austin, Texas. A small number of items composed by the author were also included i n the B e l i e f Scale. Subjects were asked to rate t h e i r agreement or disagreement with a p a r t i c u l a r item on a 5-point scale from strongly agree to strongly disagree. The mean score from infant workers completing t h i s scale was 31.69 (n=13), with a range of 22 to 44. PARENT VALUES. The B e l i e f Scale was followed by an assessment of the subjects" personal values. The Value Survey, developed by Rokeach (1973) and administered i n the form used by MacDonald (1973), was the measuring device used. The Value Survey provides a separate ranked score for each 73. of 18 terminal values and 18 instrumental values. Values, as defined by Rokeach, are enduring beliefs that specific modes of conduct or end-states of existence are personally or socially preferable to an opposite or con-verse mode of conduct or end-state of existence (Rokeach, 1973, p.5). Terminal values refer to preferred end-states of existence; instrumental values refer to preferred modes of conduct. Although Rokeach has theoretic-all y divided terminal values into two groups reflecting either a personal or a social orientation and likewise divided instrumental values into moral as opposed to personal competency values no research has as yet demonstrated the practical u t i l i t y of these dimensions. Factor analyses by Rokeach (1973)., MacDonald (1973), and Mahoney and Katz (1976) have sug-gested the operation of some common within-group value orientations. Dif-ferences in their results, however, argue against the across-group st a b i l i t y of particular value clusters. Since i t s development, the Value Survey has become the major instrument of value assessment, and proved i t s e l f a useful and s t a t i s t i c a l l y reliable tool. Differences in value rankings have been found to differentiate among groups defined by various philosophical and p o l i t i c a l ideologies (e.g. Rokeach, 1973; Mahoney, 1975; MacDonald, 1973), by religious and vocational orientations (e.g. Miller, 1976; Rokeach, 1969; Silverman-, Bishop & Jaffe, 1976; Tate & Miller, 1971), and by various personality and behavioural characteristics (e.g. Merritt, 1977; Rokeach, 1973). Research has also shown a significant relationship between certain value orderings and such diverse behaviours as good student teaching (Greenstein, 1976), and returning borrowed pencils (Shotland & Berger, 1970). 74. GENERAL RESPONSIBILITY. Parents were next asked to complete the Responsi-b i l i t y Denial Scale developed by Schwartz (1968). This instrument i s a 28-item scale designed to measure an i n d i v i d u a l ' s general set towards accep-ting or denying personal r e s p o n s i b i l i t y f o r the consequences of h i s or her actions. On a 4-point scale ranging from strongly agree to strongly d i s -agree, subjects are asked to respond to statements concerning various e t h i -c a l and p r a c t i c a l s i t u a t i o n s . A high score Indicates a strong tendency to accept personal r e s p o n s i b i l i t y , as well as a tendency to judge actions according to a set of standardized p r i n c i p l e s . A lower score indicates a tendency to accept personal r e s p o n s i b i l i t y , as well as a tendency to judge actions according to a set of standardized p r i n c i p l e s . A lower score indicates a tendency to accrue le s s s e l f - r e s p o n s i b i l i t y . Such a score s i g n i f i e s a person's willingness to accept the e x p l i c i t or i m p l i c i t r a t i o n -ale for a s c r i b i n g r e s p o n s i b i l i t y away from the actor contained i n each of the 28 items. For instance, agreeing strongly with: " F a i l i n g to return the money when you are given too much change i s the same as s t e a l i n g from a store", i s given a score of 4. Agreeing strongly with: "When a man i s completely involved i n valuable work, you can't blame him i f he i s i n -se n s i t i v e to those around him" i s , on the other hand, given a score of 1. Schwartz and h i s colleagues have used the R e s p o n s i b i l i t y Denial Scale i n conjunction with measures of personal norms to suc c e s s f u l l y predict subjects' behaviours i n various s i t u a t i o n s . Subjects who score high on the scale are more predictable than those scoring low on the scale. When high scores are coupled with strong personal norms, there, i s a s i g n i f i c a n t l y p o s i t i v e r e l a t i o n s h i p between the former two va r i a b l e s and the subject's behavioural response (Schwartz, 1970, 1973; Schwartz & Tessler, 1972; 75. Schwartz & Fleishman, 1977). The R e s p o n s i b i l i t y Denial Scale was used i n the present study .to measure a parent's general tendency towards accepting personal r e s p o n s i b i l i t y , and as a safeguard against parents who might ex-press a strong b e l i e f i n t h e i r own importance for the development of t h e i r c h i l d , and yet f a i l to express t h i s b e l i e f i n any observable fashion. PARENT-CHILD SCALES. Parents next completed a series of questions which were used as a basis for a Child A f f e c t score, a Personal R e s p o n s i b i l i t y score, and a Chi l d Value score. The C h i l d A f f e c t Scale was designed to measure the parent's current f e e l i n g s towards the c h i l d . An example of one of the scale items follows: "Although your f e e l i n g s have probably changed from day to day over the past month or so, how close would you say you f e e l to your c h i l d r i g h t now?" very close 1 2 3 4 5 seems l i k e a stranger to me A high score of a possible 25 maximum, indicated a subjective f e e l i n g of closeness towards the c h i l d , as w e l l as a subjective f e e l i n g of e a s i l y expressed warmth and love. Although parental f e e l i n g s of warmth might not n e c e s s a r i l y be expressed i n action, and though t h e i r measure might be clouded by a tendency towards parental defensiveness, i t was nevertheless considered an important aspect of the parent's personal r e l a t i o n s h i p with the c h i l d and therefore worthy of atten t i o n . The Personal R e s p o n s i b i l i t y Scale was designed to assess a parent's sense of d i r e c t r e s p o n s i b i l i t y towards the c h i l d ' s development, h i s or her sense of personal potency i n that development, and his or her set towards following the in s t r u c t i o n s provided by the infant worker. A maximum score 76. of 25 was again p o s s i b l e . Higher scores ind i c a t e a strong sense of d i r e c t r e s p o n s i b i l i t y , power, and comrriitment. An example of one of the items used i n . t h i s scale follows: "How much of an e f f e c t do you believe you can have on your c h i l d ' s development?" very l i t t l e a very great i n r e a l i t y 1 2 3 4 5 deal This scale was modelled a f t e r the personal norm scales used by Schwartz and h i s colleagues, and was designed to tap differences i n home environments which might prove to depend on the personal norm dimensions measured by t h i s s c ale. Subjects were next asked to rank order eight values which they con-sidered to be most important to them i n making decisions concerning t h e i r developmentally delayed c h i l d . Inclusion of t h i s scale was based on the t h e o r e t i c a l p o s s i b i l i t y that parents might d i f f e r i n the values they con-sidered of primary importance for t h e i r developmentally delayed c h i l d , and that these differences might be r e f l e c t e d i n the kinds of homes they pro-vided for them. F i n a l l y , parents were asked to rate t h e i r c h i l d on a ser i e s of 25 b i -polar adjectives. Parents were instructed to place a check mark i n one of a ser i e s of seven parantheses which best described how they saw t h e i r c h i l d at the moment.. An X was to be placed i n the parenthesis defining how they wished t h e i r c h i l d to be. Derived from a procedure s u c c e s s f u l l y used by Worchel and.Worchel (1960) with a group of parents of mentally retarded c h i l d r e n , t h i s scale provides a cumulative measure of the distance between how the parent perceives the c h i l d i s now, and how the parent would wish him or her to be. A very high score on t h i s scale indicates d i f f i c u l t y i n 77. accepting the c h i l d for who he or she i s ; a lower score indicates a greater adjustment to, and acceptance of, the personal q u a l i t i e s and behaviour evidenced by the c h i l d i n h i s or her present r e a l i t y . This method of assessment was chosen over a comparison of the developmentally delayed c h i l d with an ' i d e a l ' or a 'normal' c h i l d used i n previously discussed studies (Peck & Stephens, 1960; Worchel & Worchel, 1960) f o r several rea-sons. F i r s t , the r e a l i t y i s that the c h i l d i s i n fa c t d i f f e r e n t from the 'normal' or ' i d e a l ' . Second, s e n s i t i v i t y to the f e e l i n g s and needs of t h i s group of parents precluded asking them to assess t h e i r c h i l d against some external norm. Third, and i n a p o s i t i v e vein, acceptance of the c h i l d i n h i s present r e a l i t y i s a t h e o r e t i c a l l y important facet of the infant-caregiver r e l a t i o n s h i p . (Yarrow & Goodwin, 1965, for example, describe maternal acceptance as a major factor i n the communication of basic f e e l i n g s and a t t i t u d e s between mother and infant.) Conceptually d i s t i n c t from a subjective f e e l i n g of warmth, although contained under the general r u b r i c of love and a f f e c t i o n , p o s i t i v e parental acceptance provides both a means and an expression of a favourable parent-infant r e l a t i o n s h i p . Conversely, parental expression of a favourable parent-infant r e l a t i o n s h i p . Conversely, parental expression of a great deal of d i s s a t i s f a c t i o n with who the c h i l d i s now indicates disharmony i n the parent-child r e l a t i o n s h i p . I t would also represent a parental factor of d i f f i c u l t y i n providing the c h i l d with optimal personal and interpersonal experiences The instruments used i n t h i s study are shown i n Appendix I. 78. RESULTS HOME HOME scores f o r the 56 fa m i l i e s included i n the basic study sample ranged from 21 to 45, with a mean of 35.88 and a standard deviation of 5.92. Figure I provides a graphic representation of the spread of t o t a l HOME scores obtained. Table VI gives a breakdown of mean subscale scores and the i r respective standard deviations. Eleven f a m i l i e s , or 19.6% of the sample, had t o t a l scores of 30 or le s s . Children from.these fa m i l i e s therefore f e l l i n the category of environmental a t - r i s k status suggested e a r l i e r by VanDoorninck (1977) and Ramey et a l (1975). Low-scoring f a m i l i e s , however, were more than balanced by the 18 fa m i l i e s (31%) scoring 40 or above. The majority of fa m i l i e s clustered i n the 34 to 42 score range. Comparison t o t a l HOME scores are a v a i l a b l e only from A r l e t t (1977) f o r her sample of 48 fa m i l i e s from the Richmond, B r i t i s h Columbia area. Her fam i l i e s were chosen on the basis of low family income and low maternal education. Before an 8-week intervention program, these f a m i l i e s had a mean score of 34.88 (SD=4.42). Mean scores at post-assessment f o r the three groups r e c e i v i n g intervention were 37.55 f or a home v i s i t s only program, 33.11 for a group meetings only program, and 38,33 f or a home v i s i t s , plus group meetings program. A group of w a i t i n g - l i s t controls had a mean HOME score of 34.55. Ramey et a l (1975) report mean subscale scores for t h e i r North Carolina sample of hig h - r i s k experimental and control groups, and f o r a matched random sample of the general population (__'s=15, 15, and 30). Adding the mean subscale scores to give an approximate t o t a l 79. FIGURE I Sample Distribution of HOME Scores Numbir of families T ? + * r 2 2. TABLE VI Sample and Comparison Groups' Mean HOME Scores B r i t i s h Columbia Infant Program Mean SD Subscale I: Emotional 9.23 Responsivity of Mother Subscale I I : Avoidance of Punishment Subscale V: Maternal Involvement Subscale VI: Opportunities 2.79 for Stimulation Total= 1.82 6.32 1.45 Subscale I I I : Organization 5.18 0.96 of Physical Environments Subscale IV: Provision of 7.75 1.52 Play Materials 4.73 1.46 1.38 35.88 5.92 North Carolina 1975 Sample High Risk Exp. Mean High Risk General Controls Population SD Mean SD Mean SD 6.67 1.80 6.93 2.02 8.70 0.95 5.80 0.86 5.53 1.41 6.70 0.70 4.47 1.19 4.40 0.99 5.63 0.56 4.53 1.69 3.80 1.94 7.60 1.55 3.67 1.40 2.73 1.71 5.67 0.99 2.00 1.20 2.13 0.92 3.47 1.14 27.14** 26.52** 37.17** *Ramey, M i l l s , Campbell, & O'Brien, 1975, p. 41 ** estimated means mean HOME score f o r t h e i r three groups gives means of 27.14, 25.52, and 37.77 re s p e c t i v e l y . (Results of Ramey et a l are included i n Table VI.) The mean t o t a l HOME score of 35.88 obtained f o r the present sample compares favourably with the mean scores of fa m i l i e s receiving intervention from at l e a s t two other programs. In the case of Ramey et a l , homes assessed from the B.C.Program are more s i m i l a r to those found i n the general population than to those found i n a hig h - r i s k population group. The present study subjects' mean HOME score, were most s i m i l a r to the v i s i t s only intervention group from A r l e t t ' s study; i e . the group r e c e i v i n g b a s i c a l l y the same kind of intervention approach. Comparisons must be made with caution, however, as the groups d i f f e r i n a number of f a c t o r s . Families from the present study, f o r example, vary as to the amount of time i n treatment, the age of c h i l d at r e f e r r a l , and include c h i l d r e n with established handicaps as well as those considered to be at environmental r i s k . Families in.the A r l e t t study shared a common low-income/low-maternal education status, had ch i l d r e n varying i n age from two months to three years, and a l l p a r t i c i p a t e d i n a set 8-week intervention program. Although high-r i s k f a m i l i e s i n the Ramey et_'al study also shared a common low-income/ low-maternal-education status, t h e i r c h i l d r e n were an average age of 6.5 months, and fa m i l i e s varied as to length of time i n treatment. Children i n the l a t t e r studies did not, by design, include andy demonstrably im-paired c h i l d r e n . In order to look more c l o s e l y at the r e l a t i o n s h i p between length of time i n the Program and home environment scores, a large c o r r e l a t i o n matrix was generated including these and other demographic v a r i a b l e s . No s i g n i f i c a n t c o r r e l a t i o n s were obtained between length of time i n the 82. Program and HOME scores. When fami l i e s were divided into blocks represent-ing four d i f f e r e n t ranges of treatment time, again, no s i g n i f i c a n t d i f -ferences were found. Demographic v a r i a b l e s which did tend to corr e l a t e p o s i t i v e l y with some HOME scale scores were mother's education (r=.30) and family income (r=.36). Paternal age and severity of the c h i l d ' s condition, tended to cor r e l a t e negatively with various HOME scale scores (__=-.28 and -.27 r e s p e c t i v e l y ) . Maternal age, paternal education, family s i z e , and sex of c h i l d did not re l a t e to the HOME scale scores i n any systematic fashion. I t i s i n t e r -esting to note that the two var i a b l e s which correlated p o s i t i v e l y with the HOME were those which were used by A r l e t t to i d e n t i f y her high-ri s k f a m i l i e s . Correlations between observed Maternal Warmth and HOME scores ranged from a high of r=.71 with subscale I, (emotional and verbal responsivity of mother) to a low of .12 with subscale I I I (organization of the phys i c a l and temporal environments). The t o t a l HOME score correlated r=.62 with observed Maternal Warmth, and a l l remaining subscale c o r r e l a t i o n s were s i g -n i f i c a n t as w e l l . As confidence i n the HOME was confirmed by the pattern and strength of these c o r r e l a t i o n s , only HOME scores were used i n the study's major analyses. PARENTAL BELIEFS Scores f o r mothers on the B e l i e f Scale ranged from 0 to 45, with a mean of 25.26 and a standard deviation of 9.94. Fathers' scores ranged from 0 to 35,.with a mean of 17.86 and a standard deviation of 7.52. As stated e a r l i e r , comparison s t a f f scores ranged from 22 to 44, with a mean 83. of 31.69. A c o r r e l a t i o n matrix was generated r e l a t i n g parents' b e l i e f s (as well as the remaining parental dependent variables) to the demographic c h a r a c t e r i s t i c s measured. Table VII gives the resultant s i g n i f i c a n t r e l a t i o n s h i p s f or mothers; Table VIII gives these data for fathers. As the number of c o r r e l a t i o n s was large, and therefore the l i k e l i h o o d of achieving a s i g n i f i c a n t r e l a t i o n s h i p by chance alone increased, only those r e l a t i o n s h i p s . s i g n i f i c a n t at the 0.01 l e v e l of p r o b a b i l i t y were considered r e l i a b l e . Mothers' b e l i e f s were p o s i t i v e l y r e l a t e d to t h e i r own educational standing, but even more strongly t i e d to fathers' educational and occu-pational status. Fathers' b e l i e f s r e l a t e d s i g n i f i c a n t l y only to mothers' education, although they also tended to r e l a t e to maternal age, paternal education and occupation, and to family income. GENERAL RESPONSIBILITY Mothers achieved a mean score of 80.10 on Schwartz's R e s p o n s i b i l i t y Denial Scale, with a standard deviation of 7.70. Fathers obtained a mean score of 76.68, with a standard deviation of 4.48. Mothers' general sense of r e s p o n s i b i l i t y was not r e l a t e d systemat-i c a l l y to any of the demographic variables measured. Fathers' scores, however, rel a t e d s i g n i f i c a n t l y to maternal age, and tended to r e l a t e to the c h i l d ' s age and to the c h i l d ' s age at r e f e r r a l (See Table V H I ) . 84'. TABLE VII Relationships Between Maternal Dependent Variables and Sample Demographic Variables B e l i e f s General C h i l d C h i l d Personal R e s p o n s i b i l i t y A f f e c t Acceptance R e s p o n s i b i l i t y Child's Age Age at Re f e r r a l Child's Sex Chi l d Severity Maternal Age .24 Maternal .37* Education Paternal .47 Education Maternal Occupation Paternal .43 Occupation Family Income .27 Family Size -.29 -.28 .26 .35* .30 -.45 .26 .34* *p<0.01 85.' TABLE VIII Relationships Between Paternal Dependent Variables and Sample Demographic Variables B e l i e f s General C h i l d C h i l d Personal R e s p o n s i b i l i t y A f f e c t Acceptance R e s p o n s i b i l i t y Child's Age Age of R e f e r r a l Maternal Age .30 Maternal .34* Education Paternal .27 Education Paternal .32 Occupation ,28 ,29 ,46* -.32 -.35* -.44* -.43* .33 .32 .37* Family Income .26 ,43* *p<0.01 86. CHILD AFFECT The mean score f o r mothers on the Chi l d A f f e c t Scale was 21.73, with a standard deviation of 2.77. For fathers, the mean score was 21.00, with a standard deviation of 2.86. Both fathers' and mothers' a f f e c t scores tended to r e l a t e negatively to the c h i l d ' s age and to h i s or her age at r e f e r r a l . For fathers i n p a r t i c u l a r , the older the c h i l d , the les s often paternal f e e l i n g s of closeness and warmth were expressed. Mothers showed a tendency to f e e l closer to daughters than to sons. C h i l d A f f e c t scores were not systematically t i e d to any maternal or paternal demographic va r i a b l e s . CHILD ACCEPTANCE The mean maternal C h i l d Acceptance score was 32.06, with a standard deviation of 19.04. Paternal mean Chi l d Acceptance score was 30.94, with a standard deviation of 19.18. Maternal Acceptance scores were negatively rel a t e d both to the sev e r i t y of the c h i l d ' s assessed condition and to family s i z e . In other words, mothers who had more than one c h i l d i n the home, or who had more severely handicapped c h i l d r e n , tended to be les s accepting of t h e i r Program c h i l d . Fathers' acceptance scores, on the other hand, were quite strongly associated with the c h i l d ' s present age and age at time of r e f e r r a l . Older c h i l d r e n were generally le s s w ell accepted by t h e i r fathers. Fathers with more accepting attitudes tended to have more responsible kinds of jobs, and to earn larger s a l a r i e s . There was also a tendency f o r better educated parents to be more accepting of t h e i r c h i l d . 87. Unlike the r e s u l t s reported e a r l i e r by Cook (1963), mothers of c h i l d r e n . rated 'mild' tended to be the l e a s t r e j e c t i n g of th e i r c h i l d r e n . PERSONAL RESPONSIBILITY Mothers' scores on the Personal R e s p o n s i b i l i t y Scale had a mean of . 19.88 and a standard deviation of 2.36. Fathers obtained a mean of 18.88, with a standard deviation of 3.03. Only severity of the c h i l d ' s condition re l a t e d systematically to parental sense of r e s p o n s i b i l i t y , and that only for mothers. Children who were rated as most severe tended to have mothers who f e l t the greatest sense of personal r e s p o n s i b i l i t y f or them. VALUES Tables IX and X give the means for mothers' and fathers' terminal and instrumental values as determined by Rokeach's Value Survey. The ranking most often given each value i s also included i n the tables. Com-pared to the rankings reported by Rokeach for a national sample of Ameri-can men and women (Rokeach, 1976, pp. 57,58), mothers i n t h i s sample tended to place a greater value on the terminal values of an ex c i t i n g l i f e , inner harmony, and mature love. They placed l e s s p r i o r i t y on a world at peace, nation a l s e c u r i t y , and sa l v a t i o n . Fathers placed a greater value on inner harmony, mature love, and se l f - r e s p e c t ; and again placed l e s s p r i o r i t y to being l o g i c a l and loving, and less on being clean. Compared to each other, mothers' and fathers' terminal values were b a s i c a l l y very much the same. Both tended to place greatest value on family s e c u r i t y , TABLE IX Total Sample Mean and Modal Terminal Value Rankings Mothers Fathers Mean SD_ Mode Mean SD_ Mode A Comfortable L i f e 12.4 4.1 14 11.1 4.9 8 (a prosperous l i f e ) An E x c i t i n g L i f e 12.8 3.3 13 10.9 4.0 15 (a stimulating, a c t i v e l i f e ) A Sense of Accomplishment 9.0 4.1 10 7.9 4.4 4 ( l a s t i n g contribution) A World at Peace 10.6 4.8 14 10.1 4.7 10 (free of war and c o n f l i c t ) A World of Beauty 12.6 5.6 10 11.8 3.3 14 (beauty of nature and the arts) Equality 10.0 11.9 5 10.0 4.4 7 (brotherhood, equal opportunity for a l l ) Family Security 4.5 10.7 1 3.9 3.5 2 (taking care of loved ones) Freedom 7.5 4.0 8 7.1 3.9 8 (independence, free choice) Happiness 5.4 5.0 3 5.3 3.8 1 (contentedness) Inner Harmony 7.1 4.9 2 8.1 4.7 3 (freedom from inner c o n f l i c t ) Mature Love 8.3 5.6 5 8.9 5.1 9 (sexual and s p i r i t u a l intimacy) National Security 16.1 9.1 17 13.6 4.1 17 (protection from attack) Pleasure 14.5 8.3 15 12.1 5.4 14 (an enjoyable, l e i s u r e l y l i f e ) Salvation 15.8 11.4 18 14.4 5.4 18 (saved, eternal l i f e ) 89. TABLE IX (cont'd) Self-Respect (self-esteem) Social Recognition (respect, admiration) True Friendship (close companionship) Wisdom Mothers Mean SD Mode 5.2 4.0 1 14.5 6.5 15 8.0 8.9 10.2 13.5 Fathers Mean SD Mode 5.6 3.4 2 14.2 3.3 7.5 4.3 8.0 5.2 13 (a mature understanding of l i f e ) TABLE X Tota l Sample Mean and Modal Instrumental Value Rankings Mothers Fathers Mean SD Mode Mean SJJ Mode Ambitious 10.9 5.2 15 7.4 5.0 1 (hard-working, aspiring) Broadminded 8.6 6.8 6 9.7 5.0 3 (open-minded) Capable 11.8 7.5 8 7.8 4.6 8 (competent, e f f e c t i v e ) Cheerful 10.3 12.1 5 10.4 4.6 15 (lighthearted, j o y f u l ) Clean 14.4 10.5 17 12.7 4.3 14 (neat, tidy) Courageous 10.7 12.7 3 9.4 4.9 16 (standing up for your b e l i e f s ) Forgiving 8.6 10.8 7 9.4 5.9 2 ( w i l l i n g to pardon others) H e l p f u l 9.4 5.5 10 10.5 4.7 8 (working f o r the welfare of others) Honest 4.8 5.8 1 4.4 2.8 1 (sincere, t r u t h f u l ) Imaginative 15.9 7.1 18 13.2 5.4 18 (daring, creative) Independent 11.9 16.8 2 9.5 5.4 6 ( s e l f - r e l i a n t , s e l f - s u f f i c i e n t ) I n t e l l e c t u a l 15.3 9.0 17 11.8 5.1 9 ( i n t e l l i g n e t , r e f l e c t i v e ) L o g i c a l 12.1 5.9 11 9.9 3.8 11 (consistent, r a t i o n a l ) Loving 6.5 12.5 1 6.4 4.9 2 (affectionate, tender) Obedient 14.1 5.4 18 12.0 4.5 13 ( d u t i f u l , respectful) P o l i t e 11.5 10.6 5 11.3 4.4 6 (courteous, well-mannered) Responsible 9.3 18.1 2 5.5 3.7 2 (dependable, r e l i a b l e ) S e l f - C o n t r o l l e d 11.4 6.4 9 9.8 4.8 10 (restrained, s e l f - d i s c i p l i n e d ) 91. happiness, and s e l f - r e s p e c t . Greater parental differences were observed i n rankings of instrumental values. Here, fathers tended to place greater importance on being ambitious, capable, clean, imaginative, i n t e l l e c t u a l , and responsible. Parents shared, however, honesty and loving as generally t h e i r most important instrumental values. Looking at the degree of v a r i a t i o n on many i n d i v i d u a l value rankings necessitates care i n drawing any conclusions from these r e s u l t s f o r the sample as a whole. Because parents i n the study come from such diverse backgrounds and l i v i n g s i t u a t i o n s , v a r i a t i o n i n t h e i r i n d i v i d u a l value rankings i s perhaps to be expected. Ranking consistencies when they appear, therefore, would be i n d i c a t i v e of some common influences. Table XI prov/ides a d e t a i l e d breakdown of the r e l a t i v e importance parents placed on various c h i l d - r e l a t e d values. When asked which value would be of greatest help to them.in making decisions concerning t h e i r c h i l d , mothers generally chose the c h i l d ' s present happiness, the c h i l d ' s over-a l l development, or h i s or her a b i l i t y to form loving r e l a t i o n s h i p s . Fath-ers chose the c h i l d ' s o v e r a l l development, h i s or her f i n d i n g a meaning and purpose for l i f e , and the needs of a l l family members. Neither parent gave p r i o r i t y to community acceptance and p a r t i c i p a t i o n or to personal needs and ambitions. Fathers tended to be somewhat more concerned about the future s e c u r i t y of t h e i r c h i l d , though t h i s concern was not a domin-ating one for the average parent of either sex. Values chosen as most important for the c h i l d , or for the parents' own personal l i f e - g o a l s and instrumental values, were not found to r e l a t e systematically to any of the c h i l d or demographic va r i a b l e s measured. None of the parental dependent variables correlated s i g n i f i c a n t l y 92. TABLE XI Mothers ' and Fathers' Child Value Rankings Mothers Fathers Rank Number % Number % Concern for the 1 2 4% 5 14% c h i l d 1 s Future 2 6 13% 6 17% Security 3 3 6% 3 8% 4 8 18% 8 23% 5 7 15% 2 5% 6 13 28% 4 11% 7 5 10% 6 17% 8 3 6% 2 5% Child's Happiness and .1 16 33% 4 11% Enjoyment Now 2 3 6% 7 18% 3 9 19% 10 26% 4 4 8% 4 11% 5 7 15% 3 8% 6 5 10% 5 13% 7 3 6% 3 8% 8 1 3% 1 5% Needs of a l l Family 1 10 23% 7 19% Members for Love 2 10 23% 7 19% and Attention, and 3 6 14% 4 12% Opportunities to 4 9 20% 10 28% Grow 5 3 6% 4 12% 6 5 10% 2 5% 7 1 4% 2 5% Child's Finding a 1 3 6% 4 11% Meaning and Purpose 2 4 8% 8 22% for His/Her L i f e 3 5 12% 3 8% 4 5 12% 4 11% 5 11 26% . 7 21% 6 5 12% 5 14% 7 8 20% 4 11% 8 2 6% 1 2% Child's Development 1 11 24% 15 41% of His/Her Potentials 2 13 29% 6 18% i n as many Ways as 3 10 22% 8 23% Possible 4 6 14% 4 11% 5 3 7% 1 2 5% 6 1 2% 1 2% 7 1 2% - -93. TABLE XI (cont'd) Mothers Fathers Rank Number % Number % Child's A b i l i t y to 1 10 22% 6 18% Form Loving Relation-- 2 10 22% 1 2% ships with Others, 3 8 18% 6 18% such as Family and 4 8 18% 4 12% Friends 5. 5 10% 10 29% 6 5 10% 3 8% 7 - - 2 5% 8 - - 3 8% Personal Needs for using 1 1 2% 1 3% Talents and 2 2 5% 1 3% Accomplishing Goals 3 2 5% - -4 1 2% 3 8% 5 5 11% 3 8% 6 4 9% 6 18% 7 11 25% 6 18% 8 18 41% 14 42% Child's Acceptance 1 1 2% 1 3% and Enjoyment of 2 - - 1 3% the Community At 3 2 4% 1 3% Large 4 5 10% 3 9% 5 5 10% 4 12% 6 6 13% 6 17% 7 15 33% 10 28% 8 13 28% 9 25% 94. with the length of time families had been in the Program. When families were divided into the four representative blocks of intervention time used earlier to assess HOME score changes, and tested by means of a multi-variate analysis of variance, there were again no differences which reached s t a t i s t i c a l significance. Similar to the former results, however, there were some noticeable trends in the data. (As before, large within-group variation, and relatively small _n's probably helped to prevent mean d i f -ferences from reaching significance.) (See Table XII). Except for maternal belief scores, the trends in the data parallel those observed earlier for the HOME scores. There is a tendency for an i n i t i a l decrease in personal responsibility and child-oriented scores at the three-to-six month period, which then increases to more favourable levels at the eight-to-twelve month period. Maternal belief scores, on the other hand, steadily rise during the f i r s t year. As before, however, these results need to be confirmed by following individual families throughout their time in the Program. RELATIONSHIPS BETWEEN THE HOME ENVIRONMENT AND PARENTAL DEPENDENT VARIABLES Two large correlation matrices were generated relating scores on the HOME to scores on the parental dependent variables measured. Table XIII gives the significant relationships found for mothers between their scores on the HOME and their scores on the various questionnaire scales. It can readily be seen that there are many significant relationships obtained. The mothers' beliefs, her sense of personal responsibility, her primary instrumental value, and her expressed acceptance of her child are strongly related to the total HOME score and to most of the subscale scores as well. 95. TABLE XII Length, of Time i n Program and Maternal Dependent Variables B e l i e f s C h i l d C h i l d Personal A f f e c t Acceptance R e s p o n s i b i l i t y Mean SD Mean SD Mean SD Mean SD Time i n Program — 0-4 weeks (n=5) 24.2 6.2 22.6 2.5 23.0 12.9 20.8 2.2 12-24 weeks 26.0 7.9 21.1 2.6 35.2 16.3 18.7 2.4 (n=ll) 32-52 weeks 28.3 10.0 22.0 2.6 25.5 18.8 20.5 1.9 (n=8) 18 months-2 years , 25.7 8.8 22.1 2.0 34.9 17.7 19.4 3.2 (n=7) TABLE XIII Pearson Correlating Between Maternal Dependent Variable and HOME Score Subscale I: Emotional Responsivity of Mother Subscale I I : Avoidance of Punishment A .26 B C .28 D E .38* .27 H ,50**.27 49** .37* .26- .35* Subscale I I I : Organization of Physical .27 Environment Subscale IV: Provision of Play Materials Subscale V: Maternal Involvement 38* .36* ,33* .39* ,57**.37* 33* ,34* .49* ,36* A=Beliefs B= General Responsi-b i l i t y C=Child A f f e c t D=Child Acceptance E=Personal R e s p o n s i b i l i t y F=Primary Terminal Value G=Primary Instru-mental Value H=Primary C h i l d Value Subscale V i Opportunities for Stimulation: ,22 .27 .49** .40* Tota-l-V ,51** .27 .33* .54** .47** . 43** *p 0.01 97. High scores on the Ch i l d A f f e c t Scale were associated mainly with subscale I I , r e f l e c t i n g a r e l a t i o n s h i p between frequent use of negative d i s c i p l i n a r y p ractices and reduced f e e l i n g s of c h i l d a f f e c t i o n . Mothers' most important terminal values re l a t e d s i g n i f i c a n t l y to her score on subscale II as w e l l . No systematic r e l a t i o n s h i p was obtained between her primary c h i l d value and scores obtained on the HOME. Fathers' c o r r e l a t i o n s , present a f a r d i f f e r e n t p i c t u r e . Few c o r r e l a -tions were s i g n i f i c a n t . Only the father's acceptance of the c h i l d (r=.31) and h i s primary value for the c h i l d (r=.32) attained s i g n i f i c a n c e . Subscal VI, which d i r e c t l y measures fathers' i n t e r a c t i o n s with t h e i r c h i l d , does not reach r e l i a b l e s i g n i f i c a n c e f or any of the dependent va r i a b l e s assessed There i s an i n d i c a t i o n , however, that the father's general sense of respons b i l i t y and his primary personal l i f e value do r e l a t e to the amount of time he spends with h i s c h i l d . Unlike r e s u l t s reported e a r l i e r by Peck and Stephens (1960), fathers' acceptance of the c h i l d was not more strongly t i e d to home environment measures than were mothers' expressed f e e l i n g s of acceptance. Several factors may bear on the d i f f e r e n t r e l a t i o n s h i p s obtained f o r mothers and fathers. F i r s t , the HOME procedure i s done with the mother s p e c i f i c a l l y , and r e l a t i v e l y few items d i r e c t l y assess paternal involvement Second, fathers are r a r e l y at home during the workers' v i s i t s , and are usually l e s s involved i n the Program's workshop and parent group meetings. Third, the c u l t u r a l . m i l i e u i s such that most parents f e e l the mother should assume the greater r e s p o n s i b i l i t y f o r the d a i l y care of the c h i l d . And fourth, there i s a tendency reported e a r l i e r i n the l i t e r a t u r e , and sub-j e c t i v e l y confirmed i n the present sample of parents, that fathers often 98. f i n d i t more d i f f i c u l t to accept the delayed status of t h e i r c h i l d . Some fathers remain aloof and withdrawn; others deny that any abnormality e x i s t s . One sample father, f o r example, who held a prestigious professional job, refrained from any child-caregiver a c t i v i t i e s whatsoever. Another, who had one of the most obviously handicapped ch i l d r e n i n the study, refused for almost three years to acknowledge any abnormality i n his c h i l d . This father accepted the c h i l d ' s handicap only a f t e r seeing other impaired youngsters at a group session. The r e l a t i o n s h i p between parents' i n d i v i d u a l values and the kinds of home environments they provided f o r the i r developmentally delayed c h i l d was ascertained by means of a non-paramentric s t a t i s t i c a l procedure (Spearman rank order c o r r e l a t i o n s ) . This procedure was used i n order to adjust for the ranked nature of the value data. Again, only those comparisons reach-ing a s i g n i f i c a n c e of 0 . 0 1 were considered r e l i a b l e . For mother, only the terminal values of mature love and true f r i e n d -ship reached the set s t a t i s t i c a l r e l i a b i l i t y . Mothers who ranked mature love or true friendship as very important tended to score higher on HOME subscales II and VI re s p e c t i v e l y . Trends i n the data i n d i c a t e , however, that mothers who value a world of beauty, family security, mature love, s e l f - r e s p e c t , true friendship, and wisdom over such values as s o c i a l recognition, s a l v a t i o n , and pleasure tend to score higher on the HOME. For instrumental values, high rankings for cl e a n l i n e s s strongly r e l a t e to lower scores on the HOME. High rankings for independence and loving were associated with higher scores on the HOME. Trends for these values i n d i -cate p r i o r i t y given to such values as ambitious, broadminded, l o g i c a l , i n -dependent, lovin g , and obedient over such values as cleanliness and po-99-. l i t e n e s s r e l a t e s to the pro v i s i o n of better home environments. O v e r a l l , homes i n which mothers express a greater commitment to i n t r i n s i c and r e l a -t i o n a l - o r i e n t e d values (e.g. mature love, true friendship, loving) as op-posed to more e x t r i n s i c and s e l f - g r a t i f y i n g values (e.g. s o c i a l recogni-t i o n , pleasure, c l e a n l i n e s s , and politeness) are homes i n which the c h i l d i s more l i k e l y to receive a p o s i t i v e home experience. (See Table XIV). Results f o r fathers' value preferences are given i n Table XV. For terminal values, a world of beauty, happiness, and sa l v a t i o n reach the set s t a t i s t i c a l s i g n i f i c a n c e . High rankings of a sense of accomplishment, a world of beauty, family sec u r i t y , freedom, and happiness i n d i c a t e higher scores on the HOME. High rankings of pleasure, s a l v a t i o n , and s o c i a l r e c-ognition r e l a t e to lower scores on the HOME. Fathers' instrumental values show the most s t a t i s t i c a l l y r e l i a b l e r e l a t i o n s h i p s to the HOME. Here, high rankings for ambitious, clean, courageous, independent, and responsible r e l a t e to higher HOME scores. High rankings for f o r g i v i n g , i n t e l l e c t u a l , loving, and s e l f - c o n t r o l l e d r e l a t e to lower scores on the HOME. Like mothers, fathers' l i f e goals having i n t r i n s i c and other-centred q u a l i t i e s correspond to the pro v i s i o n of a more p o s i t i v e home environment for the c h i l d . Unlike mothers, fathers who value i n t e l l e c t u a l competence and s e l f - c o n t r o l score s i g n i f i c a n t l y lower on HOME subscales r e f l e c t i n g the amount of time they spend with t h e i r c h i l d , and the amount of developmental stimulation they provide for t h e i r c h i l d . Somewhat s u r p r i s i n g l y , fathers' high rankings of f o r g i v i n g and loving tended to r e l a t e to lower scores on HOME scales r e f l e c t i n g mothers' emotional and d i s c i p l i n a r y r e l a t i o n s h i p s with the c h i l d . Parents from higher scoring homes both tend to value i n -dependence and ambition; but the negative r e l a t i o n s h i p between poor scores 100. TABLE XIV Spearman Rank Order Correlations Between Maternal Value Rankings and Home Environment Scores HOME Scores Terminal Values World of Beauty Family Security Mature Love Pleasure Salvation Self-Respect S o c i a l Recognition True Friendship Wisdom II -.33 -.38* -.28 -.27 III IV V -.32 -.31 -.33 .26 .29 -.29 .25 VI -.30 -.32 -.26 -.37* T o t a l -.30 -.25 .31 -.25 Instrumental Values Ambitious -.29 Broadminded -.28 Clean .35* .37* .32 .26 .47* Independent -.42* -.30 Lo g i c a l -.27 -.31 Loving -.27 -.44 -.31 Obedient -.27 P o l i t e .33 *p<0.01 101. TABLE XV Spearman Rank Order Correlations Between Paternal Value Rankings and Home Environment Scores HOME Scores II Terminal Values Sense of Accomp-lishment World of Beauty -.34 Family Security -.32 Freedom Happiness National .39* Security Pleasure -.30 Salvation S o c i a l Recog-n i t i o n Instrumental Values Ambitious Capable Clean Courageous -.45* Forgiving .41* Honest Independent I n t e l l e c t u a l Loving Responsible Self- C o n t r o l l e d -.35 -.60' .52* -.48* III -.35 IV VI Tot a l -.35 .32 -.33 -.34 -.32 .42* -.39* -.31 .44* .31 -.43* -.33 -.36 .50* .42* -.39 -.42* .39 -.33 .44* .32 -.55 -.34 ,35 -.46* -.38 .38 *p<0.01 102. and high values f o r cl e a n l i n e s s and politeness obtained for mothers i s not evidenced for fathers. POOR VS. OPTIMAL HOMES Parents scoring high and low on the HOME were compared i n order to look more c l o s e l y at c h a r a c t e r i s t i c s which might s i g n i f i c a n t l y d i f f e r e n t i -ate between them. Those receiving HOME scores of 41 or above (n=ll) were c l a s s i f i e d as "optimal" parents, and compared with those receiving scores of 31 or below (n=12), who were c a l l e d "poor" parents. Using a m u l t i v a r i -2 ate H o t e l l i n g s T_ procedure, the two groups of mothers were found to d i f f e r s i g n i f i c a n t l y o v e r a l l on t h e i r b e l i e f s , c h i l d a f f e c t , c h i l d acceptance, and personal and general r e s p o n s i b i l i t y scores (F=5.52; df=5.15; p_ 0.005). However, no i n d i v i d u a l scale differences were s t a t i s t i c a l l y s i g n i f i c a n t . Looking at Table XVI, which l i s t s the means and standard deviations for each group, i t can be seen that the mean scores of "optimal" mothers are consis t e n t l y higher than are those for "poor" mothers—with the exception of the c h i l d acceptance score. A lower c h i l d acceptance score, however, a c t u a l l y indicates a greater sense of acceptance of the c h i l d f o r who he or she i s now. Cl e a r l y , most mothers from optimal homes have stronger be-l i e f s concerning t h e i r own r o l e i n t h e i r c h i l d ' s development, f e e l more warmly and accepting towards t h e i r c h i l d , accept a greater personal respon-s i b i l i t y f o r h i s or her development, and i n general are more w i l l i n g to take r e s p o n s i b i l i t y f or the consequences of t h e i r actions than are "poor" mothers. For fathers, only two of the "poor" fathers f u l l y completed and 103. Poor Mothers (n=12) TABLE XVI Differences i n Maternal Dependent Variables for Optimal Versus Poor Homes B e l i e f s Child C h i l d Personal General A f f e c t Acceptance R e s p o n s i b i l i t y R e s p o n s i b i l i t y Mean SD Mean SD Mean SD Mean SD Mean SD 18.7 10.0 20.2 2.7 48.0 23.5 17.8 2.1 76.8 6.1 Optimal 30.4 8.2 21.9 2.1 24.6 13.1 21.1 2.3 80.7 7.1 Mothers (n=ll) Note: A lower c h i l d acceptance score r e f l e c t s greater acceptance of the ch i l d ' s current status. 104. returned the forms. One copied h i s wife's; another refused before a c t u a l l y seeing the form. Thus, although a l l the "optimal" fathers cooperated, these groups could not be compared s t a t i s t i c a l l y . Of the eleven mothers included i n the "optimal" group, seven (or 63.6%) chose family s e c u r i t y as t h e i r most important l i f e - v a l u e , three (27.3%) chose s e l f - r e s p e c t , and one chose freedom. In contrast, only three "poor" mothers (27.3%) chose family security as t h e i r most important l i f e - v a l u e , and none chose s e l f - r e s p e c t or freedom. The remainder i n d i v i d u a l l y chose a comfortable l i f e , a sense of accomplishment, a world at peace, equality, happiness, inner harmony, true friendship, or wisdom. Of the ten fathers included i n the "optimal" parent group (one home was that of a sing l e mother), f i v e (or 50%) chose family security as t h e i r most important l i f e -value. Others chose a sense of accomplishment, a world at peace, freedom, or happiness. For t h e i r most important instrumental value, 72.7% (n=8) of the "optimal" mothers chose l o v i n g . Two chose honesty, and one chose respon-s i b l e . Of the ten "poor" mothers, three chose loving, three chose honesty, and four chose ambitious, broadminded, clean, or independent. Several MANOVA's were performed to s t a t i s t i c a l l y assess the value differences among various groups of parents. When mothers were divided into three groups: an optimal group (HOME scores of 41 to 45), a middle group (HOME scores of 35 to 40), and a low group (HOME scores of 21 to 34); no s i g n i f i c a n t differences were obtained. When mothers were divided by means of a median s p l i t on t o t a l HOME scores, however, t h e i r rankings of terminal values from inner harmony to wisdom d i f f e r e d s i g n i f i c a n t l y at the _p<0.05 l e v e l (F=2.35; df=9/32; £<o.o4). No i n d i v i d u a l value differences T O 5. achieved s i g n i f i c a n c e . In a l l these comparisons, however, the v a r i a b i l i t y i n rankings of the non-optimal mothers p a r t i c u l a r l y either achieved or ap-proached s t a t i s t i c a l s i g n i f i c a n c e . This large v a r i a b i l i t y precluded many of the observed differences i n means from reaching s i g n i f i c a n c e . Tables XVII and XVIII give the mean value rankings f o r "optimal" and "poor" mothers, and f o r the two groups obtained by the median s p l i t as w e l l . Trends i n the data e s s e n t i a l l y p a r a l l e l those demonstrated by the c o r r e l a t i o n a l r e l a t i o n -ships discussed e a r l i e r . Terminal values generally ranked s u b s t a n t i a l l y more important by higher HOME-scoring mothers are equality, family sec u r i t y , mature love, true f r i e n d s h i p , and wisdom. Although the mean ranking of pleasure i s lower for "optimal" mothers than for "poor" mothers, the large v a r i a b i l i t y i n t h i s ranking for "poor" mothers only, suggests that as a group, "optimal"' mothers r a r e l y value pleasure very highly, but poorer mothers often do1. "Poor" mothers, for instance, most often give pleasure a ranking of 8, whereas higher scoring mothers most often give i t a ranking of 13. The e a r l i e r r e l a t i o n s h i p observed between higher HOME scores and less importance placed on s o c i a l recognition, however, was not borne out by the data here. Modal values were e s s e n t i a l l y the same for t h i s value across groups, at a ranking of 8, even though poorer mothers again showed a much greater v a r i a b i l i t y i n scores. Instrumental values generally ranked sub-s t a n t i a l l y more important by higher HOME-scoring mothers were brodminded, capable, cheerful, courageous, independent, lovi n g , and responsible. Less su b s t a n t i a l differences are noted f o r the mean rankings of cleanliness and politeness obtained e a r l i e r . 106. TABLE XVII Mean Terminal Value Rankings for Mothers Optimal Mothers (n=ll) High Median Low Median S p l i t Mothers S p l i t Mothers (n=24) (n=18) Poor Mothers (n=12) Mean SD Mean SD Mean SD Mean SD A Comfortable L i f e 13.5 2.3 12.4 3.0 12.3 5.4 11.3 6.0 An E x c i t i n g L i f e 11.9 2.7 13.1 3.0 12.4 3.8 11.9 4.0 A Sense of Accomp-lishment 9.9 3.8 9.3 3.4 8.5 4.4 9.0 3.5 A World at Peace 13.5 4.4 10.6 4.8 10.6 5.0 10.2 5.6 A World of Beauty 11.4 2.4 11.4 3.1 14.3 7.6 15.1 8.2 Equality 8.9 2.7 8.1 3.6 12.6 17.6 13.8 20.7 Family Security 2.3 2.2 2.4 2.8 7.4 15.8 7.9 18.7 Freedom 7.0 4.2 7.8 5.0 7.2 2.0 8.2 3.0 Happiness 4.8 3.1 4.5 3.1 6.6 6.7 7.2 7.6 Inner Harmony 6.7 4.5 6.6 3.8 7.8 6.1 7.1 5.7 Mature Love 6.1 3.6 7.5 4.1 9.4 7.1 10.0 7.8 National Security 15.5 2.5 14.6 3.3 18.1 13.3 18.0 15.8 Pleasure 13.5 4.0 12.7 4.7 16.8 11.2 17.2 13.2 Salvation 16.4 3.3 15.9 3.8 15.7 17.1 17.2 20.1 Self-Respect 3.9 2.9 5.3 3.6 5.2 4.4 6.1 4.8 So c i a l Recognition 12.6 3.9 14.1 3.2 15.2 9.4 16.3 10.6 True Friendship 5.5 . 2.5 6.8 3.5 9.7 13.1 11.8 15.1 Wisdom 7.6 3.8 7.8 .3.6 13.4 20.0 16.2 23.2 I 107. TABLE XVIII Mean Instrumental Value Rankings Optimal High Median Mothers S p l i t Mothers (E= =11) (£= =24) Mean SD Mean SD Ambitious 11.0 4.8 10.6 5.3 Broadminded 6.9 2.5 7.2 3.7 Capable 10.4 3.3 11.2 3.8 Cheerful 8.5 2.9 8.7 3.3 Clean 16.2 2.9 14.5 4.0 Courageous 6.9 3.6 8.0 4.6 Forgiving 7.9 4.0 7.3 3.7 H e l p f u l 8.6 3.9 8.5 3.9 Honest 2.7 1.5 3.8 3.3 Imaginative 14.8 4.4 15.1 3.8 Independent 6.5 3.8 7.9 4.9 I n t e l l e c t u a l 15.4 2.3 14.4 3.6 L o g i c a l 10.5 3.3 11.2 3.5 Loving 3.3 5.1 3.4 4.1 Obedient 12.8 5.3 12.0 5.5 P o l i t e 10.0 4.9 10.0 4.6 Responsible 6.0 3.5 5.7 3.3 Self-Controlled' 10.5 4.8 10.5 4.4 for Mothers Low Median Poor S p l i t Mothers Mothers (h_= •18) (Br =12) Mean SD Mean SD 11.2 5.3 10.5 5.8 10.4 9.3 11.1 10.9 12.6 10.7 14.3 11.9 12.4 18.0 14.0 21.1 14.4 15.6 15.1 18.4 14.1 18.3 12.1 16.1 10.3 15.9 11.7 18.7 10.4 7.0 10.8 7.5 6.2 7.9 5.7 8.3 16.9 10.0 18.7 10.8 17.2 24.2 15.0 20.8 16.4 13.1 17.8 14.1 13.2 8.1 11.8 4.2 10.6 17.8 7.3 10.8 16.7 4.0 15.5 2.3 13.5 15.1 9.3 4.6 14.1 26.8 12.3 24.6 12.5 8.2 10.6 4.7 I 108. RELATIVE IMPORTANCE OF PARENTAL DEPENDENT VARIABLES The r e l a t i v e importance of the various dependent v a r i a b l e s measured was ascertained by multiple step-wise regression analyses on the t o t a l HOME and subscale scores. Results for these analyses are given i n Tables XIX, XX, and XXI. 2 R values, which represent the proportion of variance accounted f o r . by the best regression equation generated (Cooley & Lohnes, 1971; Tatsuoka, 1971), were a l l s i g n i f i c a n t at the p_<0.01 l e v e l of p r o b a b i l i t y for mothers' t o t a l and subscale HOME scores. A l l but subscales I, I I I , and V were highly s i g n i f i c a n t , achieving p r o b a b i l i t y values lower than 0.0001. For 2 fathers, subscales IV, V, and VI had R values s i g n i f i c a n t at the p_<0.01 . 2 l e v e l ; subscale I and the t o t a l HOME score had R values s i g n i f i c a n t at the p_<TJ.05 l e v e l . Looking at the dependent variables used i n the various regression equations generated, as well as at th e i r respective normalized regression c o e f f i c i e n t s -these c o e f f i c i e n t s s i g n i f y the amount each v a r i a b l e c o n t r i b -utes to the regression equation -one can determine which v a r i a b l e s carry the most weight i n p r e d i c t i n g favourable home environment scores. Be-ginning with mothers, i t can be seen from Table XIX that mothers' b e l i e f s and acceptance of the c h i l d are the v a r i a b l e s most strongly associated with 2 high t o t a l HOME scores. The R value of 0.51 indicates that these v a r i a -bles account for a large proportion of the variance between the actual HOME scores obtained and those predicted by the best regression equations generated. For subscale I, mother's emotional and verbal responsivity, i t i s the 109. TABLE XIX Mothers' and Fathers' Regression Analyses on Total HOME Scores Mothers (n=56) Variables Entered R Values p Values Fathers (n=49) B e l i e f s 12.43 Chil d Acceptance 9.06 Personal 8.26 Res p o n s i b i l i t y R 2 =0.51 p_ 0.001 Terminal Value 4.38 0.0001 0.005 0.05 Normalized Regression C o e f f i c i e n t s 0.39 -0.36 0.25 0.05 -0.34 R =0.12 p<0.05 I I 110. I TABLE XX Mothers' Regression Analyses on HOME Subscale Scores (n=56) F Values p_ Values Variables Entered Normalized Regression C o e f f i c i e n t s Subscale I : Emotional Responsivity C h i l d 7.61 of Mother Acceptance R =0.14 p 0.01 0.01 -0.38 Subscale I I : Avoidance of Punishment B e l i e f C h i l d A f f e c t R =0.39 p 0.001 10.63 9.45 0.005 0.005 0.40 0.38 Subscale I I I : Organization of Phy s i c a l Environment Personal 6.60 Res p o n s i b i l i t y Instrumental 4.56 Value 0.05 0.05 0.34 0.29 Subscale IV: Provision of Play Materials C h i l d 21.84 Acceptance Instrumental 14.48 Value R2=0.49 p 0.001 0.001 0.001 -0.51 0.41 Subscale V: Maternal Involve-ment B e l i e f s 6.87 R =0.13 p 0.01 0.01 0.36 Subscale VI: Opportunities f o r Stimulation Personal 12.42 Res p o n s i b i l i t y Instrumental 7.09 R2=0.35 p<0.001 0.001 0.01 0.44 0.33 i i i . TABLE XXI Fathers' Regression Analyses on HOME Subscale Scores (n=50) Variables F_ ]3 Normalized Entered Values Values Regression C o e f f i c i e n t s Subscale 1 Chi l d Value 4.43 0.05 0.34 R2=0.12 p<0.05 Subscale IV Chi l d Accep- 11.97 0.005 -0.53 tance Terminal Value 7.98 0.01 -0.44 R2=0.31 p<0.005 Subscale V Chi l d Value 11.81 0.005 0.51 R2=0.26 p<0.005 Subscale VI Personal 10.39 0.005 0.46 Re s p o n s i b i l i t y General 6.31 0.05 0.33 Res p o n s i b i l i t y C h i l d Accep- 4.22 0.05 -0.29 tance Terminal Value 17.72 0.001 -0.64 R2=0.47 p_< 0.001 112. mother's acceptance of the c h i l d which bears most strongly on the observed q u a l i t y of her in t e r a c t i o n s with her c h i l d . For subscale I I , measuring the mother's s t y l e and use of d i s c i p l i n e , i t i s her b e l i e f s and sense of warmth and closeness towards her c h i l d which i s most important. For subscale I I I , organization of the physi c a l and temporal environment, the mother's sense of personal r e s p o n s i b i l i t y and her most important instrumental value are the v a r i a b l e s carrying the most weight. Subscale IV, pro v i s i o n of approp-r i a t e toys, r e l a t e s most strongly to the mother's acceptance of her c h i l d and again to her prime instrumental value choice. For subscale V, the degree to which,the mother i s a c t i v e l y engaged i n encouraging the develop-ment of her c h i l d , both mother's b e l i e f s and sense of c h i l d acceptance are important. For subscale VI, v a r i e t y i n d a i l y stimulation, mothers' sense of personal r e s p o n s i b i l i t y and t h e i r most important instrumental v a l -i ues are of greatest s i g n i f i c a n c e . Results f o r fathers portray a d i f f e r e n t pattern of weighted r e l a t i o n -ships. Only the father's choice of h i s most important terminal value r e l a t e s to the t o t a l HOME score, and that i s s i g n i f i c a n t only when an ex-treme case i s excluded from the an a l y s i s . Subscale I achieves an equally 2 low R value of 0.12, and i s rela t e d to the father's c h i l d value choice. Subscale IV, provision of appropriate toys, r e l a t e s most strongly i n fathers to t h e i r sense of c h i l d acceptance and to t h e i r terminal value choice. Subscale V, which l i k e subscale I b a s i c a l l y measures only d i r e c t maternal involvement with the c h i l d , weights most highly on the father's c h i l d value 2 choice. This r e l a t i o n s h i p , with an R value of 0.26, i s even stronger than that observed for mothers when no extreme cases are removed from the moth-i ers' f i r s t regression equation. Subscale VI, opportunities for v a r i e t y i n {1*3. d a i l y stimulation, and the only scale which d i r e c t l y assesses father 2 involvement, l o g i c a l l y achieves a higher R for fathers than for mothers. Here, fathers' highest ranking terminal values and t h e i r sense of personal r e s p o n s i b i l i t y are key f a c t o r s . Their general sense of r e s p o n s i b i l i t y as wel l as t h e i r acceptance of the c h i l d are also important v a r i a b l e s r e l a t e d to the amount of time they spend with t h e i r c h i l d . Results from the various regression equations generated ind i c a t e that parents' behaviours i n the home are d i f f e r e n t i a l l y r e l a t e d to various aspects of t h e i r b e l i e f s , a t t i t u d e s , and values. For mothers i n p a r t i c u l a r , a c t i v i t i e s r e q u i r i n g d i r e c t parent-child i n t e r a c t i o n r e l a t e s more on her b e l i e f s and f e e l i n g s of acceptance and a f f e c t i o n f o r the c h i l d than on her more personally-oriented concerns. Maternal e f f o r t s at organizing the ch i l d ' s inanimate environment, however, are more c l o s e l y t i e d to her person-a l values and sense of r e s p o n s i b i l i t y . The two factors which stand out i n the o v e r a l l HOME analysis for mothers are the importance of her b e l i e f s and the importance of her acceptance of the c h i l d f o r who he or she i s now. Father involvement i n the home environment, as measured i n t h i s study, both d i r e c t l y with the c h i l d and i n d i r e c t l y through the mother and through pr o v i s i o n of toys and other a c t i v i t i e s , r e l a t e s more on the father's values and sense of r e s p o n s i b i l i t y than on hi s c h i l d - r e l a t e d b e l i e f s or f e e l i n g s . Father's acceptance of the c h i l d , however, does r e l a t e s i g n i f i c a n t l y to hi s contribution towards the home environment f o r h i s developmentally de-layed c h i l d . DISCUSSION AND CONCLUSIONS The homes i n t h i s study, as representatives of a cross-section of f a m i l i e s involved i n a home intervention program for developmentally delayed infan t s , demonstrate some strong r e l a t i o n s h i p s between home environment q u a l i t i e s and various parental b e l i e f s , a t t i t u d e s , and values. Homes which provide the most optimal c h a r a c t e r i s t i c s f o r infant development are generally those i n which parents believe they can have a profound i n f l u -ence on t h e i r c h i l d ' s development, f e e l a personal sense of r e s p o n s i b i l i t y towards that development, accept th e i r c h i l d r e n f or who they are and f e e l warmly towards them, and who endorse such r e l a t i o n a l values as family s e c u r i t y and l o v i n g . The home environments and parental b e l i e f s , a t t i t u d e s , or values, were not found to r e l a t e i n a simple l i n e a r fashion either to each other or to the length of time parents had been involved i n the pro-gram. Instead, a complex r e l a t i o n s h i p among these various inf l u e n c i n g factors was indicated. The average home i n the Program sample was providing adequate to more-than-adequate stimulation for i t s developmentally delayed c h i l d . Maternal i n t e r a c t i o n with the c h i l d was generally p o s i t i v e ; and i n p a r t i c u l a r , parents through the influences of the Program were providing t h e i r c h i l d r e n with numerous and appropriate play and learning materials. Most mothers did not seem to evidence the tendency towards c h i l d r e j e c t i o n reported by some e a r l i e r studies (e.g. Cummings, et a l , 1966; Holroyd & McArthur, 1976)-Although no comparative scores for normal c h i l d r e n were included i n the study. P o s i t i v e c h i l d acceptance was, however, s i g n i f i c a n t l y r e l a t e d to the q u a l i t y of homes these mothers did provide for t h e i r c h i l d r e n . Fathers, 115. on the other hand, were often below average i n the amount of involvement and time they spent with t h e i r developmentally delayed c h i l d . Their f e e l -ings of acceptance toward the c h i l d were rel a t e d to the kinds of toys and opportunities they provided for them, and i n d i r e c t l y to the mothers' s t y l e s of interactions, with the c h i l d . Both parents showed a tendency to f i n d i t more d i f f i c u l t to accept an older c h i l d . As a l l infants are r e l a t i v e l y helpless and dependent during t h e i r f i r s t year, the behaviour problems of these a t y p i c a l c h i l d r e n are often more obvious and demanding only as the c h i l d grows older. As a r e s u l t , parents may f i n d i t more d i f f i c u l t to accept the c h i l d when he/she becomes older. To date, however, Program fami l i e s appear,to have suc c e s s f u l l y kept t h i s p o t e n t i a l problem of a nega-t i v e r e l a t i o n s h i p between increasing c h i l d age and parental acceptance to a minimum. Mothers from the better-ranked homes i n the study were p a r t i c u l a r l y consistent and cohesive as a group. These mothers received the most favourable scores on a l l parent scales; and, s i m i l a r to the value r e l a t i o n -ships observed by Siegelman >et a l (1970), showed the greatest commitment to other or self-transcendent values concerning such moral ideals as loving, responsible, family s e c u r i t y , true fr i e n d s h i p , and wisdom. Mothers from lower-ranking homes showed the greatest v a r i a b i l i t y i n t h e i r commitment to i n d i v i d u a l values, but i n general placed le s s importance on the r e l a t i o n a l , moral, and self-competency values endorsed by higher-scoring parents. Many mothers (68%) and fathers (48%) f e l t that t h e i r r e l a t i o n s h i p with the c h i l d was the major factor i n that c h i l d ' s development. More fathers (39.5%) than mothers (27%), however, considered the c h i l d ' s handicap to be more important than t h i s r e l a t i o n s h i p or than the kinds of home experiences 116. they were able to provide for them. Most fathers accepted a large degree of r e s p o n s i b i l i t y f or t h e i r c h i l d ' s development; mothers more frequently expressed a lower sense of personal r e s p o n s i b i l i t y . For mothers more than fathers, however, a strong sense of personal r e s p o n s i b i l i t y was r e l a t e d to higher home environment scores. I t i s possible that fathers construed t h e i r r e s p o n s i b i l i t y f or the c h i l d i n a le s s d i r e c t and personal manner. I t i s also.possible that fathers were more defensive concerning t h i s one c h i l d , and therefore found i t more d i f f i c u l t to be honest i n t h e i r answers. Their personal sense of r e s p o n s i b i l i t y , however, was found to be a s i g n i f i -cant contributor to the p r e d i c t i v e r e l a t i o n s h i p generated f o r one subscale of the HOME -that scale which most d i r e c t l y assessed father's involvement with the c h i l d . Less s t r i k i n g than the r e s u l t s reported by Ramey et a l (1975) and Wachs ^ t a l (1972) was the tendency for "middle-class" parents (defined by income, education, and paternal occupation) to provide better homes for t h e i r c h i l d r e n . This tendency reached s t a t i s t i c a l s i g n i f i c a n c e only for family income. Parents' b e l i e f s and a t t i t u d e s , however, were more strong-l y t i e d to the factors of parental education, occupation, and income. "Middle-class" parents, as i n the Tulkin and Cohler (1972) study, were m o r e l i k e l y to hold strong b e l i e f s concerning parents' r e c i p r o c a l and causal influences on t h e i r c h i l d ' s development. In addition, "middle-class" fathers i n p a r t i c u l a r were more l i k e l y than "working-class" fathers to have p o s i t i v e acceptance a t t i t u d e s towards t h e i r c h i l d . As i n the A r l e t t (1977) study, and i n the r e s u l t s reported by VanDoorninck (1975) and B r a s s e l l (1977), perhaps "middle-class" f a m i l i e s are better able to p r o f i t from an i n t e r -vention program,-thus changing the stimulus p o t e n t i a l of t h e i r homes to a 117. more noticeable degree. The fact that changes i n HOME and maternal v a r i a b l e scores followed some common trends throughout the f i r s t year, however, sug-gests that a l l f a m i l i e s were b e n e f i t t i n g to some extent from t h e i r involve-ment i n the Program. Also, c o r r e l a t i o n s between HOME scores and maternal dependent v a r i a b l e scores were much greater than those achieved for e i t h e r of the former dimensions with the demographic variables measured. From the design of the present study, i t i s not possible to unravel the d i r e c -t i o n a l complexities of these i n t e r l o c k i n g r e l a t i o n s h i p s . I t i s good to remember, however, that regardless of educational status or income l e v e l , parents' b e l i e f s , a t t i t u d e s , and values were the more important parameters r e l a t i n g to the q u a l i t y of homes provided for these developmentally de-layed c h i l d r e n . The demonstrated importance of these parental c h a r a c t e r i s t i c s provides support for the Program's strategy of working with the parents i n order to provide an optimal environment for the c h i l d . In addition, the r e l a t i v e importance of the various parental b e l i e f s , a t t i t u d e s , and values measured suggests some avenues of Program d i r e c t i o n and emphasis. F i r s t , parents need to be informed and confirmed i n t h e i r understand-ing of t h e i r own c r i t i c a l r o l e i n t h e i r c h i l d ' s development. They need to know not only the normal course of c h i l d development, but also the s p e c i f -i c s concerning the c h a r a c t e r i s t i c s .of t h e i r own c h i l d ' s responses and c a p a b i l i t i e s . Fathers, i n p a r t i c u l a r , need to be more cognizant of th e i r influence and p o t e n t i a l i n helping t h e i r c h i l d develop. In giving knowledge and encouragement, workers must at the same time try not to disrupt the parents' sense of primary ownership, competency, and r e s p o n s i b i l i t y . Second, parents need to come to a r e a l i s t i c acceptance of who t h e i r 118, c h i l d i s now, and a l l that he or she might represent to them. Parents are often informed of t h e i r c h i l d ' s delay i n a r e l a t i v e l y heartless and abrupt manner; or, conversely, t o l d that there i s "nothing wrong" with the c h i l d and that they are simply "over-anxious". Others have decided prenatally not to keep a mentally retarded or handicapped c h i l d , only to f i n d out 'too l a t e ' a f t e r b i r t h that t h e i r c h i l d i s , i n f a c t , delayed. To promote a r e a l i s t i c parent adjustment to t h e i r a t y p i c a l c h i l d , therefore, parents need to be able to express t h e i r f e e l i n g s and problems i n a free and sup-portive r e l a t i o n s h i p . Heinicke (1976) has demonstrated the b e n e f i c i a l e f f e c t s of a staff-to-parent r e l a t i o n s h i p allowing a free communication of a l l parental fee l i n g s and concerns. Fathers e s p e c i a l l y may need to meet with other parents and c h i l d r e n experiencing the same kinds of emotional s t r a i n s and d i f f i c u l t i e s . Although p o s i t i v e f e e l i n g s of parental warmth and closeness were not as strongly re l a t e d to home environment scores as was c h i l d acceptance, they are nevertheless s i g n i f i c a n t aspects of the c h i l d ' s early environment. P o s i t i v e and mutually enjoyable i n t e r a c t i o n s i between parent and c h i l d , therefore, as described by Bromwich (1976) for t h e i r C a l i f o r n i a program f o r a t y p i c a l i n f a n t s , would be a p r a c t i c a l and important component of Program strategy. Third, parental values, although important, are l e s s e t h i c a l l y a v a i l a -ble to Program intervention. Parents' values for t h e i r c h i l d r e n , however, (as u t i l i z e d by workers such as Scheinfeld, et a l , 1970), can be used as a basis for i n d i v i d u a l i z e d family approaches. Allowing parents a greater share i n determining the scope and d i r e c t i o n of t h e i r c h i l d ' s a c t i v i t i e s would hopefully r e i n f o r c e not only t h e i r f e e l i n g s of potency and personal r e s p o n s i b i l i t y , but also help to strengthen and encourage a greater degree 119. of parental involvement and commitment to the Program. In conclusion, parents' b e l i e f s , a t t i t u d e s , and values are important concerns i n the kinds of home environments provided f o r a developmentally delayed c h i l d . • P o s i t i v e and r e a l i s t i c acceptance of the c h i l d , a sense of personal r e s p o n s i b i l i t y and b e l i e f i n a parent's i n f l u e n t i a l r o l e i n c h i l d ' s development, and values f o r family and loving r e l a t i o n s h i p s , argue w e l l f o r that parent's commitment to an optimal home environment f o r t h e i r c h i l d . Further research i s needed to assess the d i r e c t i o n a l influence of these r e l a t i o n s h i p s , as w e l l as to confirm or q u a l i f y the suggestions made for various aspects of t h i s study's r e s u l t s . i 120. REFERENCES Ainsworth, M.D.S. The development of infant-mother attachment. In B.M. Caldwell & H.N. R i c c u i t t i (Eds.), Review of C h i l d Development Research, V o l . I I I . 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Haywood, Ed., S o c i a l - C u l t u r a l Aspects of Mental Retardation., Appleton-Century-Crofts, New York, 1970, (p. 7-58) 132. U z g i r i s , I.C. Patterns of cognitive development i n infancy, M e r r i l l - Palmer Quarterly., 1973, 19, 180-204. VanDoorninck, W.J. Families with c h i l d r e n at r i s k f or school problems, i n MJ. Kraj i c e k & A. I. Tearney, Eds., Detection of Developmental  Problems i n Children., Univ. Park Press, 1977. (p. 151-159). VanDoorninck, W.J.; Caldwell, B.M.; Wright, C. & Frankenburg, W.K. The re l a t i o n s h i p between the 12-month Inventory of Home Stimulation and school competence, Paper presented at the meeting of the Society for Research i n Chi l d Development, Denver, Colorado, A p r i l , 1975. Wachs, T.D.; U z g i r i s , I.C. & Hunt, J . McV. 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Dimensions of early stimulation and t h e i r d i f f e r e n t i a l e f f e c t s on infant development, Merrill-Palmer Quarterly., 1972, 19, 205-218. Zadig, J.M. & Crocker, A.C. A centre for study of the young c h i l d with developmental delay, i n B.Z. Friedlander: G.M. S t e r r i t t & G.E. Ki r k , Eds., The Exceptional Infant., V ol. I l l , Assessment and Intervention, Brunner/Mazel, New York, 1975. (p. 5-39). Z i g l e r , E. The environmental mystique, Childhood.Educ., 1970, 46, 402-412. Z i g l e r , E. The nature-nurture issue reconsidered, i n H.C. Haywood, Ed., S o c i a l - C u l t u r a l Aspects of Mental Retardation., Appleton-Century-Crofts, New York, 1970. (p. 81-106). Zuk, G.H.; M i l l e r , R.L.; Bartram, J.B. & K l i n g , F. Maternal acceptance of retarded c h i l d r e n : a questionnaire study of attitudes and r e l i g i o u s background, Ch i l d Dev., 1961, 32, 525-540. 134. APPENDIX I QUESTIONNAIRES USED IN STUDY Dear Parent, Firs t I would like to thank you very much for giving us your time and assistance in helping us with the present study. I hope you w i l l find some of the following scales enjoyable and interesting to f i l l out; they should take approximately 20 to 30 minutes to complete. The information you give w i l l be of great help to the Infant Program in i t s planning and service to you, and to others having similar concerns and experiences. Your answers are completely confidential. No one w i l l ever be iden-t i f i e d by name, nor w i l l anyone in the Program have access to an individual parent's stated opinion or feelings. Again, we very much appreciate your time and honesty in completing these forms. Thank you. Please check the appropriate spaces for the following: , , & a o . Family in the Mother's Age: T a t h e r S A g e ' home at the pres-ent time: Grandparents 15-20 oil™ ~~~~~ Father _ 2 1 - 3 0 _ _ _ _ it I" Mother_ _ 31-40_ Il 50 ' Children _ 4 1 - 5 0 _ _ _ Other 51+ 135. Mother's Education: Father's Education: grade school high school u n i v e r s i t y trade or technical school Mother's Present Occupation: Father's Present Occupation^ grade school ''' high school u n i v e r s i t y ' trade or technical school Family Income at the Present: les s than $5,000 ______ $5,000-10,000 $10,000-$15,000 $15,000-$20,000 $20,000-$30,000 . more than $30,000 If you adhere to a p a r t i c u l a r r e l i g i o u s f a i t h or o r i e n t a t i o n which i s not l i s t e d here, please f e e l free to state i t on the blank l i n e provided. Catholicism Judaism Protestantism No Religious Commitment ' Other Please continue to the next page. Thank you. 136. On the following pages are a number of statements concerning parents and ch i l d r e n . Please i n d i c a t e the extent to which you believe the statement to be true by c i r c l i n g the appropriate number. There are no r i g h t or wrong responses to these statements; t h i s survey i s concerned only with the a t -titudes and opinions parents may have. Strongly Agree Undecided : Disagree Strongly Agree Disagree 1. Parents should help . 1 2 3 4 5 chi l d r e n f e e l they belong and are needed. 2. A neat, well-ordered 1 2 3 4 5 home i s one of the most im- . portant things a parent can provide a c h i l d i n growing up 3. When you come r i g h t down to i t , a c h i l d i s either good or bad and there's not much you can do about i t . 4. With a l l a c h i l d hears at school and from f r i e n d s , there's l i t t l e a parent can do to influence him. 5. I t i s important to t a l k with a young c h i l d , even though he may not under-stand what i s being said 6. Psychologists now know that what a c h i l d i s born with determines the kind of person he becomes. 7. I f parents play very much 1 2 3 4 with t h e i r seven-month-old baby, he w i l l want them to be around a l l the time 1 2 3 1 2 3 1 2 3 1 2 3 8. A c h i l d may le a r n to be a j u v e n i l e delinquent from playing games l i k e cops and robber and war too much. 9. A c h i l d i s only as curious about the world as h i s parents encourage him to be. 10. Most a l l c h i l d r e n are j u s t the same at b i r t h ; i t ' s what happens to them afterwards that i s important. 11. Most ten-month-old babies are too young to enjoy being with other babies of the same age. 12. There are many things that influence a young ch i l d . t h a t parents don't understand and can't do anything about. 13. Many times parents are punished for t h e i r own sins through the bad behaviour of t h e i r c h i l -dren. 14. Holding and cares-sing a baby when he c r i e s i s good f o r him. 15. Most of the bad t r a i t s c h i l d r e n have ( l i k e nervousness or bad temper) are i n h e r i t e d 16. A one-year-old c h i l d enjoys playing games with h i s parents but cannot be expected to begin them himself. 138. 17. Some c h i l d r e n are so na t u r a l l y headstrong that a parent can't r e a l l y do much about them. 18. Parents often over-estimate the importance of encouraging children's c u r i o s i t y about the world around them. 1 2 3 1 2 3 1 2 3 1 2 3 19. Not even psychologists understand exactly why chi l d r e n act the way they do 20. Newborn babies are f r a g i l e and d e l i c a t e and must be handled extremely c a r e f u l l y 21. When three-year-olds want 1 to.help you with what you're doing, you should encourage them because that's how they learn. 22. I f a c h i l d i s born bad 1 there's not much you can do about i t . 23. Even though a seven-month- 1 old baby can do some things for himself, i t i s better f o r the parent to do them u n t i l they are sure. 24. A c h i l d i s destined to be 1 a c e r t a i n kind of person no matter what the parents do. 25. Some c h i l d r e n are j u s t 1 na t u r a l l y bad. 26. I t i s important that c h i l - 1 dren spend a l o t of time learning to play alone. 27. A c h i l d that comes from 1 bad stock doesn't have much chance of amounting to anything. 2 3 4 5 2 3 4 5 2 3 4 5 2 3 4 5 2 3 4 . 5 2 3 4 5 2 3 4 5 28. Why c h i l d r e n behave the way they do i s too much for anyone to fi g u r e out. 29. I t i s better to wait u n t i l the c h i l d s t a r t s school before t r y i n g to teach him things. 30. Parents should ignore t h e i r c h i l d ' s crying when i t i s j u s t f o r atten t i o n . 31. Infants under f i v e months of age are not well able to occupy themselves and they l i k e frequent adult a t t e n t i o n . 140. Below, and s i m i l a r l y on the next page, i s a l i s t of 18 values arranged i n alphabetical order. Please mark the ones l i s t e d below i n order of t h e i r importance to you, as guiding p r i n c i p l e s i n your l i f e . F i r s t , study the whole l i s t c a r e f u l l y . Then, rate how i portant each value i s by placing an X i n the appropriate column. Please do not leave any blanks. Extremely Important A COMFORTABLE LIFE (a prosperous l i f e ) Very Important Somewhat I Important Mildly to not Very Important AN EXCITING LIFE (a stimulating and acti v e l i f e ) A SENSE OF ACCOMPLISHMENT ( l a s t i n g c o n t r i -1-m t" •? nn") A WORLD AT PEACE (free of war and r.nnf 1 n ct) A WORLD OF BEAUTY (beauty of nature and EQUALITY (brotherhood, equal opportuni tv^ FAMILY SECURITY (taking care of loved ones) FREEDOM (independence, free choice) HAPPINESS (contentedness). INNER HARMONY (freedom from inner c o n f l i c t ) MATURE LOVE (sexual and s p i r i t u a l intimacv) NATIONAL SECURITY (protection from attack) PLEASURE (an enjoyable, l e i s u r e l v l i f e ) k— 141. SALVATION (saved, eternal l i f e ) SELF-RESPECT (self-esteem). SOCIAL.RECOGNITION (respect, admiration)^ TRUE FRIENDSHIP (close companionship) WISDOM (a mature understanding .of l i f e ) Now,.in each column i n which more than one X appears, please rank the X"s i n order of importance. For example, i f you have 3 X"s i n the "Somewhat important" column, you should read a l l 3 values and place a 1 next to the '.' X for the value you consider most important of the 3; a 2 next to the next most important, and a 3 next.to the l e a s t important within that column. In the same way, rank the X's i n a l l columns that contain more than one X. Remember to give a rank of 1 to the most important value i n each column. 142. Below, i s a l i s t of 18 values arranged i n alpha b e t i c a l order. Please mark, them i n order of t h e i r importance to you, as guiding p r i n c i p l e s i n your l i f e . F i r s t , study the whole l i s t c a r e f u l l y . Then, rate how important each value i s by placing an X i n the appropriate column. Please do not leave any blanks. Extremely Important AMBITIOUS (hard-working, aspiring) Very Important Somewhat Important M i l d l y to not very Important BROADMINDED (open-minded) CAPABLE (competent, e f f e c t i v e ) CHEERFUL (lighthearted. i o v f u l ) CLEAN (neat, tidv) COURAGEOUS (standing up for your b e l i e f s ) FORGIVING ( w i l l i n g to pardon ' others) HELPFUL (working for the welfare of others) HONEST (sincere, t r u t h f u l ) IMAGINATIVE (daring, creative) INDEPENDENT ( s e l f - r e l i a n t , s e l f - . -s u f f i c i e n t ) INTELLECTUAL ( i n t e l l i g e n t , r e f l e c t i v e ) LOGICAL (consistent, r a t i o n a l ) LOVING (affe c t i o n a t e , tender) OBEDIENT ( d u t i f u l , respectful), POLITE . (rnnrf p o n s , w e l l mannered -) RESPONSIBLE ( r l p p e m r l a b l p 3 r e l i a b l e " ) SELF-CONTROLLED ( - t -ps trained , s e l f - d i s c i p l i n e d ) 143. Now i n each column i n which more than one X appears, please rank the X's i n order of importance. For example, i f you have 3 X's i n the "Extremely Important" column, you should read a l l 3 values and place a 1 next to the X for the value you consider most important of the 3; a 2 next to the next most important, and a 3 next to the l e a s t important within that column. Then go on to the next column and so on u n t i l you have ranked the X's i n a l l columns that contain more than one X. Remember to give a rank of _1 to the most important value i n each column. 144. Each of the items below i s a statement of an a t t i t u d e or opinion some people have. There are no righ t or wrong responses to these statements. For each item, please c i r c l e the number which best in d i c a t e s the extent to which you agree or disagree with i t . I f you are not c e r t a i n , answer agree or disagree according to which comes closer to your opinion. Strongly Agree Disagree Strongly Agree ' Disagree 1. If a good f r i e n d of mine wanted to in j u r e an enemy of h i s , i t would be my"duty to .try to "stop him. 2. F a i l i n g to return the money when you are given too much change i s the same as s t e a l i n g from a store. 3. I wouldn't f e e l that I had to do my part i n a group project i f everyone else was lazy. 4. If I hurt someone uni n t e n t i o n a l l y , I would f e e l almost as g u i l t y as I would f e e l i f I had done the same thing i n t e n t i o n a l l y . 5. Gossiping i s so common i n our society that a person who gossips once i n a while can't r e a l l y be blamed so much. 6. When a person i s nasty to me, I f e e l very l i t t l e r e s p o n s i b i l i t y to treat him w e l l . 7. I would f e e l l e s s bothered about leaving l i t t e r i n a d i r t y park than i n a clean one. 8. No matter what a person has done to us, there i s no excuse f o r taking advantage of him. 9. When a man i s completely involved i n valuable work, you can't blame him i f he i s i n s e n s i t i v e to those around him. 145. Strongly Agree Disagree Strongly 10. I f I damaged someone's car i n an accident that was l e g a l l y h i s f a u l t , I would s t i l l f e e l some-what g u i l t y . 11. When you consider how hard i t i s for an honest businesssman to get ahead, i t i s easier to forgive shrewdness i n business. 12. When a person i s pushed hard enough, there comes a point beyond which anything he does i s j u s t i f i a b l e . 13. Even i f something you borrow i s defective, you should s t i l l r e-place i t i f i t gets broken.: 14. You can't blame b a s i c a l l y good people who are forced by t h e i r environment to be inconsiderate of others. 15. No matter how much a person i s provoked, he i s always responsible for whatever he does. 16. Being upset or preoccupied does not excuse a person for doing anything he would o r d i n a r i l y avoid. 17. As long as a businessman doesn't break laws, he should f e e l free to do h i s business as he sees f i t . 18. Occasionally i n l i f e a person finds himself i n a s i t u a t i o n i n which he has absolutely no control over what he does to others. 19. I would f e e l obligated to do a favour f or a person who needed i t , even though he had not shown gratitude f o r past favours. 20. With the pressure f or grades and the widespread cheating i n school nowadays, the i n d i v i d u a l who cheats occasionally i s not r e a l l y as much at f a u l t . Agree 1 Disagree 4 146. Strongly Agree Disagree Strongly „„..,.,, , Agree Disagree 21. I wouldn t f e e l badly about ^ 2 3 4 giving offense to someone i f my intentions had been good. 22. Extenuating circumstances never 1 2 3 4 completely remove a person's r e s p o n s i b i l i t y f or h i s actions. 23. You can't expect a person to act 1 2 3 4 much d i f f e r e n t l y from everyone else. 24. I t doesn't make much sense to be 1 2 3 4 very concerned about how we act when we are s i c k and f e e l i n g miserable. 25. You j u s t can't hold a store c l e r k 1 2 3 4 responsible for being rude and impolite at the end of a long work day. 26. Professional obligations can 1 2 3 4 never j u s t i f y neglecting the welfare of others. 27. If I broke a machine through 1 2 3 4 mishandling, I would f e e l l e s s g u i l t y i f i t was already damaged before I used i t . 28. When you have a job to do, i t i s 1 2 3 4 impossible to look out for every-..'-' ". :"• v: body's best i n t e r e s t s . 147. The following questions are concerned s p e c i f i c a l l y with your c h i l d who i s , or has been, involved with the B r i t i s h Columbia Infant Program. In order that our r e s u l t s may be t r u l y representative, we would r e a l l y appreciate your e f f o r t s to answer these questions as honestly and accurately as you can. Your answers are number coded, so that you and your c h i l d w i l l remain anonymous. Again, thank you very much for your time and cooperation. Although your feel i n g s have probably changed from day to day over the past month or so, how close would you say you f e e l to your c h i l d r i g h t now? v f - r v 1 2 3 4 5 seems l i k e a close stranger to me Do you f i n d your baby responds to your care and attention as much as you would l i k e him/her to? never seldom sometimes usually always_ Is i t r e l a t i v e l y easy for you to express your love towards your ch i l d ? never seldom sometimes usually always Can you show your anger towards him/her? never seldom sometimes usually_ always 5. For the most part, do you enjoy the routine care of your child? (for example, feeding, diapering, etc.) neve r s e ldom s ome t ime s us ua 1 l y always Do you ever f i n d yourself resenting the amount of time your c h i l d ' s care requires? never seldom sometimes usually always Do you sometimes f i n d i t d i f f i c u l t to f e e l warmly towards your baby? neve r s eld om s ome t ime s us ua 1 l y always i When did you f e e l you could accept your c h i l d ' s need of help? r i 8 h t 1 2 3 4 5 s t i l l am not sure a w a y he/she r e a l l y does 148. 9. Do you f i n d the suggestions made to you by the infant worker who comes to your home h e l p f u l and encouraging? never. seldom sometimes usually alway s 10. Do you f e e l the suggestions the worker makes are sometimes unnecessary or impractical? never seldom sometimes usually always 11. Do you f e e l obligated to follow the suggestions made to you by the infant worker? never seldom sometimes usually always ' 12. Do you f e e l that the major f a c t o r i n your c h i l d ' s development i s : his?her handicap or problem the help he/she receives from doctors and other trained people the r e l a t i o n s h i p you, as a parent, have with your c h i l d the kind of home l i f e you are able to provide for him/her Please number these.in the order you f e e l have the most influence. (If you think two are of equal importance, then give them the same number). 13. Even i f people don't seem to be looking at your baby, do you f i n d ij.rc yourself wondering what they might be thinking? never seldom some t ime s usually alway s 14. How much of an e f f e c t do you believe you can have on your c h i l d ' s development? very l i t t l e .. „ „ , c J . . 1 2 3 4 5 a very great i n r e a l x t y d e k l 15. I f you had to judge the degree of r e s p o n s i b i l i t y you f e e l towards your c h i l d ' s development, as i t belongs to you as a parent, would i t be c l o s e s t to: 0% 100% 16. As parents, you have many other r e s p o n s i b i l i t i e s besides the care of one c h i l d . To what extent can you make his/her development a p r i o r i t y i n your d a i l y a c t i v i t i e s ? never seldom sometimes usually . always 17. Parents are often c a l l e d upon to make d i f f i c u l t and important decisions fo r themselves and t h e i r c h i l d r e n , often costing time, money, and . s a c r i f i c e . Which of the following would be of greatest value to you i n helping you to make decisions concerning your ch i l d ? 149. concern for his/her future security his/her happiness and enjoyment now the needs of a l l family members for love and attention, and opportunities to grow his/her f i n d i n g a meaning and purpose for his/her l i f e development of his/her p o t e n t i a l s i n as many ways as possible his/her a b i l i t y to form strong and loving r e l a t i o n s h i p s with others, such as family and friends personal needs,for using your own t a l e n t s , and accomplishing your own goals his/her acceptance and enjoyment of the community at large Please rank these i n the order i n which you would use them as guidelines for making your decisions. (l=the most important, and so on). If there are others which are of greater importance to you, please f e e l free to l i s t them here. 18 What do you f e e l , as a parent, i s the best thing you can do for your child? No c h i l d i s ever exactly how we would wish him to be. For the following l i s t of adjectives, place a check mark within the set of parentheses at the point on each scale which you f e e l most accurately describes the way your c h i l d i s now. Then, place an X i n the parentheses at the point which best describes where you would wish your c h i l d to be. In other words, i f you could change your c h i l d i n some way, i n d i c a t e by an X the degree of the given c h a r a c t e r i s t i c you would l i k e to see i n your c h i l d . Some adjectives you may not think are very d e s c r i p t i v e of your c h i l d , or you might f i n d that your c h i l d has the desired amount of a given q u a l i t y ( i n which case, you would put a check and an X i n the same parentheses): however, please mark each scale. 150. ( ): how I see my child now (X): how I would like my child to be Adventurous Cooperative , Demanding Easily Disciplined Excitable Fearful Fluctuating Happy Independent Ineffective Interesting Irritable Loving Meaningless Nervous Noisy Obedient Prone to Anger Prone to Tantrums Responsive Slow Strong Willed Subject to Distrac Trusting Warm ion (, )Timid ( ^Obstructive ( )Not demanding ( ^Difficult to Discipline ( )Calm ( )Not Fearful ( )Stable ( )Depressed ( )Dependent ( )Effective ( )Boring ( )Easygoing ( )Not Loving ( )Meaningful ( )Placid ( )Quiet ( )Disobedient ( )Not Prone to Anger ( )Not Prone to Tantrums ( )Aloof ( )Quick ( )Weak Willed ( ) Able to Concentrate ( )Distrusting ( )Cold Thank you 

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