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DOCUMENT RESUME ED 318 183 EC 230 588 AUTHOR Garber, Howard L. TITLE The Milwaukee Project: Preventing Mental Retardation in Children At Risk. SPONS AGENCY National Inst. of Handicapped Research (ED), Washington, DC. REPORT NO ISBN-0-940898-16-0 PUB DATE 88 GRANT G008300148 NOTE 451p. AVAILABLE FROM American Association on Mental Retardation, 1719 Kalorama Rd., N.W., Washington, DC 20009 ($40.00). PUB TYPE Books (010) -- Reports - Research/Technical (143) EDRS PRICE MFO1 Plus Postage. PC Not Available from EDRS. DESCRIPTORS *At Risk Persons; *Cognitive Development; Disadvantaged; Disadvantaged Environment; *Early Intervention; Elementary Secondary Education; *Family Influence; Followup Studies; Intervention; Language Acquisition; *Mental Retardation; Mothers; Parent Child Relationship; Parent Role; Preschool Education; *Prevention ABSTRACT This study examines effectiveness of preschool and family intervention in prevention of cultural-familial retardation. It attempts to resolve part of the complex of influences on early intellectual development in those born into seriously disadvantaged environments that could account for the increased risk for certain children to be identified as mentally retarded. Development of 17 subjects from infancy through age 15 is charted in terms of intellectual and related measurements, alongside 18 controls. Chapters include "Introduction to the Problem"; "The Course of Early Intellectual Development"; "Design and. Method"; "Assessment of Intellectual Development"; "Learning and Performance"; "Assessment of Language Development"; "Mother-Child Interaction"; "Follow-up Assessment of Development"; "Analysis of the Children's Performance in School"; "Family Risk and Child's Intellectual Development"; "The Chilaren and Their Families"; and an epilogue discussing the role of maternal mediation and methodological factors.(PB) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** U.S. DEPANTMENN OF EDUCATION Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) /Thisdocurnont has been reproduced as received from the person or organization originating it f ' Minor changes have been made to improve reproduction quality Points of view or opinions staled in this docu ment do not necessarily represent official OERI position or policy 00 The Milwaukee Project PREVENTING MENTAL RETARDATION IN CHILDREN AT RISK BY HOWARD L. GARBER University of WisconsinMadison MICHAEL J. BEGAB Editor, AAMR Special Publications AMERICAN ASSOCIATION ON MENTAL RETARDATION "PERMISSION TO REPRODUCE THIS MATERIAL INMICROFICHE ONLY HAS BEEN GRANTED BY BEST COPYAVAILABLE (i.,,Vt-oe_ ti TO THE EDUCATIONAL RESOURCES INFORIIATION CENTER (ERIC)." Research supported in part by funds from the National Institute of Handi- capped Research Grant No. G008300148, U.S. Department of Education, Washington, D.C. 20202. Copyright ©1988 by the American Association on Mental Retardation All rights reserved Published by American Association on Mental Retardation 1719 Kalorama Road, NW Washington, D.C. 20009 Library of Congress Cataloging-in-Publication Data Garber, Howard L. The Milwaukee project. Bibliography: p. 1. Mental retardation - prevention. 2. Socially handicapped children - Mental health. 3. Socially handicapped children-Testing. 4. Mothers- Mental health. I. Begab, Michael J.II. American Association on Mental Retardation. III. Title. IV. Title: Preventing mental retardation in children at risk. [DNLM: 1. Child Development Disorders-prevention & control. 2. Mental Retardation-prevention & control. 3. Probability. WS 107 G213m] RC570. G37 1987 618.92'8588 87-26970 ISBN 0-940898-16-0 First printing March 1988 Second printing June 1989 Printed in the United States of America This report is dedicated to those children whose needs might deprive them of opportunity to make their contribution to society. We hope this report helps in understanding how each to the best of his or her ability can have that opportunity to accomplish. Contents List of Figures xiii List of Tables xvii Foreword xxiii Preface xxvii Acknowledgments xxix 1 Introduction to the Problem 1 Intellectual Development and Retardation 6 Definition in Mental Retardation 7 Prevalence of Cultural-Familial Mental Retardation 9 2 The Course of Early Intellectual Development 13 Studying Intellectual Growth 13 Attempts to Understand Lowered Intellectual Performance 15 Attempts to Manipulate the Environment 16 Maternal Influences on Development 19 The High Risk Population Laboratory 21 3Design and Method 29 Design Considerations 30 Subject Selection 30 Subject Assignment 31 Attrition 32 Comparability of Groups 32 Screening and Assignment Criteria 33 Family Characteristics 33 Infant Characteristics 34 vii viii Contents Experimental Intervention 36 Family/Maternal Rehabilitation 37 Infant/Early Childhood Stimulation Program 41 Medical/Health Concerns 48 Stimulation-Education Program Overview 49 Early Infancy Program 50 Toddler Phase 52 Early Childhood Phase 58 School Readiness Component 67 4Assessment of Intellectual Development 75 Assessment 75 Assessment During Intervention 76 Follow-up Period 76 Analysis Procedures 77 Gesell Developmental Schedules 79 Gesell Developmental Quotient 79 Gesell Motor Schedule 83 Gesell Adaptive Schedule 84 Ges01 Language Schedule 84 Gesell Social Schech!le 84 Low Risk Contrast Group Gesell Comparisons 86 Intellectual Development (24 to 72 months) 88 Measured Intelligence to 72 Months 89 Test of Examiner Bias 91 Low Risk Contrast Group Measured Intelligence to 72 Months. 91 Within Differences Among Groups 93 Mental Age Growth 93 General IQ 94 5Learning and Performance 97 Developing Discriminate Attention to Stimuli Cues 99 Response Strategies for Problem Solving Tasks 105 The Role of Perceptual Recogr ition in Identity Difference Problems 112 Conclusion 120 6Assessment of Language Development 125 Free Speech Analysis: Gross Feature Tabulation 126 The Grammatical Comprehension Test 136 Analysis of Results 137 Acquisition Patterns 139 Comparison with Other Groups 143 Contents ix Sentence Repetition Test I 144 Types of Response 147 Analysis of Imperfect Repetitions 151 Comparison of Morphemes Repeated, Structure Preserving Responses, and Exact Repetitions 152 Analysis of Omissions 153 Sentence Repetition Test II 157 Scoring 159 Exact Repetition: Type 3 Responses 159 Inexact Repetition: Type 1 Responses 162 Inexact Repetition: Type 2 Responses 162 Comparisons Within Groups: Sentence Complexity and Sentence Length 163 Comparison with Other Children 165 Tests of Morphology: The Picture Morphology Test and the Berko Test of Morphology 167 Picture Morphology Test 169 Berko Test of Morphology 171 The Illinois Test of Psycho linguistic Abilities 175 Overview 183 7Mother-Child Interaction 189 Study I 195 Task 1: Storytelling 196 Task 2: Block Sort and Etch-a-Sketch 197 Study II 202 Procedures 203 Rating Procedure and Analysis 204 Report and Interpretation of Results 206 Behavior Rating Analysis 206 Information Theory Analysis 208 Cognitive Style: Correlate Tasks 213 Child Measures 213 Perception of Self 217 Maternal Attitude 218 ,mmary 223 8Follow-up Assessment of Development 225 Follow-up Stability of Measured Intelligence 226 The "Artificial" Influence of Intervention 235 Verbal IQ and Performance IQ 236 General IQ (GIQ) 240 Control Children and the Preschool Experience 247 Inter- and Intraindividual IQ Performance Variation 247 x Contents Relationship of Experimental and Control Children and Maternal IQ 249 Discussion 253 9Analysis of the Children's Performance in School 255 School Placements 256 Summer School Tutorial Program 258 Assessment of School Performance 259 School Deadlines 260 Metropolitan Achievement Assessment Procedure 261 Comparison of Low Risk Children's Performance in School 268 Special Education Services 270 Report Cards and Teacher Rated Reading Levels 274 Comparison of School Achievement and Wechsler IQ. 276 Summary 280 10Family Risk and Child's Intellectual Deyelopimiit 281 Family Risk and the Fallacy of Population Base Rates. 282 Comparisons of Development for Sibling and Contrast Samples 290 Intellectual Development of Treated Experimental Siblings 291 Combined Experimental Siblings 296 Nontarget Siblings of Both the Experimental and Control Target Children 297 Low Risk Contrast Siblings 301 Comparison of Target Children by Ordinal Pusi"on . 301 Experimental and Control Group Performance Beyond 120 Months 305 Comparisons of Intellectual Development 307 Summary 310 11The Children and Their Families 311 Experimental Group Children 313 Control Group Children 357 Low Risk Contrast Children 391 IQ 399 School Achievement (MAT) 399 School Adjustment 400 xi 12Epilogue: Commentary 403 Dei:neating the Role of Maternal Mediation 405 Individual Performance and Population Base Rates 406 Subject Selection and Treatment Effects 408 Commentary 411 References 417 Figures 2-1Mean IQs of 586 Children of 88 Mothersas a Function of Age of Children 23 2-2Relation of Father and Mother PQ Levels 24 3-1Decoding Skills Required in the Process of Word Recognition 69 3-2Overview of Preschool Math Program 72 4-1Comparison of Low Risk Contrast, Experimental, and Control Groups' Performance Mean Deviation from Norm Scores on the Gesell Developmental Schedules 81 4-2Mean Gesell DQ and Stanford-Binet IQ Scores for Low Risk, Experimental, and Control Groups for
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